Wikiversity enwikiversity https://en.wikiversity.org/wiki/Wikiversity:Main_Page MediaWiki 1.39.0-wmf.26 first-letter Media Special Talk User User talk Wikiversity Wikiversity talk File File talk MediaWiki MediaWiki talk Template Template talk Help Help talk Category Category talk School School talk Portal Portal talk Topic Topic talk Collection Collection talk Draft Draft talk TimedText TimedText talk Module Module talk Gadget Gadget talk Gadget definition Gadget definition talk 102 1870 2419411 2138245 2022-08-26T08:46:08Z 2600:8801:F000:9300:D692:4932:6D18:68DC /* Logos */ wikitext text/x-wiki {{RightTOC}} {{center top}}'''Welcome to the Marketing Department of the [[School:Business|School of Business]]'''{{center bottom}} In popular usage, "marketing" is the promotion of products, especially advertising and branding. However, in professional usage the term has a wider meaning which recognizes that marketing is customer centered. Products are often developed to meet the desires of groups of customers or even, in some cases, for specific customers. This department, if you desire, will attempt to facilitate your learning about marketing. ==Learning projects== {{Courses}} {{Col list|3| * [[Meaning of Market]] * [['No Money' Marketing for Start-Ups and Growing Businesses]] * [[Principles of Marketing]] * [[Customer Satisfaction]] * [[Consumer Behavior]] * [[International Marketing]] * [[Introductory Marketing Research]] * [[Advanced Marketing Research]] * [[Applications of Market Research]] * [[Advertising and Promotions Management]] * [[Marketing Planning and Strategy]] * [[Quantitative Marketing Analysis]] * [[Decision Models In Marketing]] * [[Marketing Communications]] * [[Branding]] * [[Marketing Strategy for Electronic Business]] * [[Marketing Information System]] * [[Marketing Execution]] * [[Retail Marketing Execution]] * [[Marketing Execution Communications]] * [[Marketing Strategies]] * [[Marketing Implementation]] * [[Introduction to Advertising]] * [[Service Marketing]] * [[Principles of Marketing]] * [[Digital Marketing]] }} {{Col}} ==Resources== * [[w:Marketing|Marketing]] * [[w:Marketing ethics|Marketing ethics]] * [[Self serve advertising]] * [http://en.wikiversity.org/w/index.php?title=Special%3ASearch&ns0=1&ns4=1&ns100=1&ns102=1&ns104=1&search=Marketing&fulltext=Advanced+search Search for Marketing at Wikiversity] {{Break}} == Interested participants == * [[User:Toyota8489|Toyota8489]] * [[User:Amscco|Amscco]] * [[User:Jitesh|Jitesh]] * [[User:Msdaehn|Puck185]] * [[naveedtaji]] * [[User:Bema_Self|Bema]] {{Col/end}} {{Col}} ==See also== * [[Topic:Advertising]] * [[Topic:Marketing Ph.D]] * [[School:Entrepreneurship]] {{Break}} == External links == * May 2008 ''[http://www.eurekalert.org/pub_releases/2008-05/uom-ndo051508.php New driver of brand extension success found by University of Minnesota professor]'' * March 2008 ''[http://physorg.com/news125073871.html Logo Can Make You 'Think Different']'' * March 2007 ''[http://www.nanotech-now.com/news.cgi?story_id=21195 Company rebrands its proprietary desalination nanotechnology.]'' {{Col/end}} ==Logos== Learn by seeing. {{Col list|4| [[Image:GTK.png|50px|center]] [[Image:Perennial symbol.svg|50px|center]] [[Image:Cc-GPL.png|50px|center]] [[Image:Definition of Free Cultural Works logo notext.svg|50px|center]] [[Image:Dcpp logo.jpg|50px|center]] [[Image:Archer.jpg|50px|center]] [[Image:AgBASE Logo.JPG|50px|center]] [[Image:Dodge Red Pentastar.jpg|50px|center]] [[Image:Explicit Architecture Logo.jpg|50px|center]] }} [[Category:Marketing| ]] [[Category:Business|*]] r73qvblrut1chuben575d913785ij63 0 2962 2419194 2411272 2022-08-26T02:34:35Z 139.130.234.26 More advanced changes wikitext text/x-wiki [[File:Router on a stick concept.png|thumb|right|Network components]] [[File:Server-multiple.svg|thumb|right|120px|Servers]] [[File:Gnome-fs-client.svg|thumb|right|120px|Client]] [[File:Cisco CCENT Router Switch 4 PCs.png|thumb|right|120px|Router, switch, and PCs]] [[File:EthernetCableBlue2.jpg|thumb|right|120px|Ethernet cable]] Computer networks share common devices, functions, and features including servers, clients, transmission media, shared data, shared printers and other hardware etwork components. Switch is like a Hub but built in with advanced features. It uses physical device addresses in each incoming messages so that it can deliver the message to the right destination or port. Unlike a hub, switch doesn't broadcast the received message to entire network, rather before sending it checks to which system or port should the message be sent. In other words, switch connects the source and destination directly which increases the speed of the network. Both switch and hub have common features: Multiple RJ-45 ports, power supply and connection lights. '''Router''' - When we talk about computer network components, the other device that used to connect a LAN with an internet connection is called Router. When you have two distinct networks (LANs) or want to share a single internet connection to multiple computers, we use a Router. In most cases, recent rout '''LAN Cable''' A local area Network cable is also known as data cable or Ethernet cable which is a wired cable used to connect a device to the internet or to other devices like computer, printers, etc. == See Also == * [[Network Fundamentals]] * [[Computer Networks]] [[Category: Computer Networks]] 83yaeep070wtlwt00h6yk2mzgw51vp5 0 34381 2419177 2416885 2022-08-26T01:57:47Z 45.248.45.99 wikitext text/x-wiki {| class="wikitable" ! [[Introduction_to_Computers/What_is_a_computer|'''>> Start - What_is_a_computer''']] |} {{RoundBoxTop|theme=16}} powered by android == Prerequisites == Prerequisites are courses it is suggested you understand before you attempt this course. If you're having a hard time understanding the material in this course, make sure you understand these prerequisites first. * There are no prerequisites! (You should be able to follow along no matter how little experience you have in this subject.) {{RoundBoxBottom|theme=16}} {{RoundBoxTop|theme=16}} == Lessons == # {{100Percent}} Introduction #* {{100Percent}} [[Introduction_to_Computers/What is a computer|What is a computer?]] #* {{100Percent}} [[Introduction_to_Computers/History|History of computers]] #* {{100Percent}} [[Introduction_to_Computers/Computer types|Computer types]] #* {{100Percent}} [[Introduction_to_Computers/Hardware and software|Hardware and software]] #* {{100Percent}} [[Introduction_to_Computers/Basic operations|Basic operations]] #* {{100Percent}} [[Introduction_to_Computers/Data sizes and speeds|Data sizes and speeds]] # {{100Percent}} Inside a computer case #* {{100Percent}} [[Introduction_to_Computers/Motherboard|Motherboard]] #* {{100Percent}} [[Introduction_to_Computers/Processor|Processor]] #* {{100Percent}} [[Introduction_to_Computers/Memory|Memory]] #* {{100Percent}} [[Introduction_to_Computers/Disks|Disks]] # {{50Percent}} Peripherals #* {{75Percent}} [[Introduction_to_Computers/Input Devices|Input Devices]] #* {{75Percent}} [[Introduction_to_Computers/Output Devices|Output Devices]] #* {{25Percent}} [[Introduction_to_Computers/Future Peripherals|Future Peripherals]] # {{100Percent}} [[Introduction_to_Computers/System software|System software]] # {{100Percent}} [[Introduction_to_Computers/Application software|Application software]] # {{100Percent}} [[Introduction_to_Computers/Personal|Personal]] # {{100Percent}} [[Introduction_to_Computers/Networks|Networks]] # {{100Percent}} [[Introduction_to_Computers/Security|Security]] # {{100Percent}} [[Introduction_to_Computers/Internet|Internet]] # {{100Percent}} [[Introduction_to_Computers/Development|Development]] # {{100Percent}} [[Introduction_to_Computers/Databases|Databases]] # {{100Percent}} [[Introduction_to_Computers/AI|Artificial intelligence]] {{RoundBoxBottom|theme=16}} {{RoundBoxTop|theme=16}} == What Next? == Once you have completed this course, you have learned enough to take these courses: * [[Computer Skills]] * [[IC3 | Internet and Computing Core Certification (IC³)]] * [[IT Fundamentals]] * [[Introduction to Computer Science]] {{RoundBoxBottom|theme=16}} __NOTOC__ [[Category:Computing]] ===Course Navigation=== {| class="wikitable" ! [[Introduction_to_Computers/What_is_a_computer|'''>> Start - What_is_a_computer''']] |} t3ayspxcbao9wsjafxcs9sancwakv33 0 47245 2419259 2190989 2022-08-26T04:27:58Z 79.178.23.170 /* Online resources */ wikitext text/x-wiki {|style="width:100%;margin-top:+.7em;background-color:#fcfcfc;border:1px solid #ccc" |style="width:50%;color:#000"| {|style="width:280px;border:solid 0px;background:none" |- |style="width:280px;text-align:center;white-space:nowrap;color:#000" | <div style="font-size:133%;border:none;margin: 0;padding:.1em;color:#000">It is a course of [[Topic:Electronic engineering|Electronic engineering]]</div> <div style="top:+0.2em;font-size: 95%"></div> <div style="width:100%;text-align:center;font-size:80%;"></div> |} |style="width:18%;font-size:95%;color:#000"| * Level 1 |style="width:22%;font-size:95%";color:#000"| * Term 1 |style="width:10%;font-size:95%";color:#000"| [[Image:Nuvola apps bookcase.svg|center|50px|Electronic engineering]] |} ==Syllabus== {{info|Unless otherwise noted, all courses in this curriculum are Wikibooks modules, not wikiversity course modules.}} EE 215 ==Lecture plan== *[[b:Digital Circuits|Digital Circuits]] *[[b:Programmable Logic|Programmable Logic]] ==Lab Materials== *[[b:VHDL for FPGA Design - Principles and Practices|VHDL for FPGA Design - Principles and Practices]] ==Reference books== ==Online resources== * [https://www.fpgatutorial.com/vhdl/ VHDL Tutorials for beginners] * [https://fpgaer.tech VHDL projects on FPGA] ==Learning projects== ==Research projects== ==News== ==Wikiversity activities== ===Active participants=== ===To do=== ==See also== [[Category:Electronic engineering]] kmgefuptvto9ra63qi1u0xkj3ddx1w5 2419272 2419259 2022-08-26T04:46:17Z 79.178.23.170 /* Online resources */ wikitext text/x-wiki {|style="width:100%;margin-top:+.7em;background-color:#fcfcfc;border:1px solid #ccc" |style="width:50%;color:#000"| {|style="width:280px;border:solid 0px;background:none" |- |style="width:280px;text-align:center;white-space:nowrap;color:#000" | <div style="font-size:133%;border:none;margin: 0;padding:.1em;color:#000">It is a course of [[Topic:Electronic engineering|Electronic engineering]]</div> <div style="top:+0.2em;font-size: 95%"></div> <div style="width:100%;text-align:center;font-size:80%;"></div> |} |style="width:18%;font-size:95%;color:#000"| * Level 1 |style="width:22%;font-size:95%";color:#000"| * Term 1 |style="width:10%;font-size:95%";color:#000"| [[Image:Nuvola apps bookcase.svg|center|50px|Electronic engineering]] |} ==Syllabus== {{info|Unless otherwise noted, all courses in this curriculum are Wikibooks modules, not wikiversity course modules.}} EE 215 ==Lecture plan== *[[b:Digital Circuits|Digital Circuits]] *[[b:Programmable Logic|Programmable Logic]] ==Lab Materials== *[[b:VHDL for FPGA Design - Principles and Practices|VHDL for FPGA Design - Principles and Practices]] ==Reference books== ==Online resources== * [https://www.fpgatutorial.com/vhdl/ VHDL Tutorials for beginners] * [https://fpgaer.tech FPGA projects in VHDL] ==Learning projects== ==Research projects== ==News== ==Wikiversity activities== ===Active participants=== ===To do=== ==See also== [[Category:Electronic engineering]] fxwyh2g9gty9h18stsnnv9wgfomv8yu 2 56061 2419338 2391495 2022-08-26T06:58:28Z Jtneill 10242 + Map wikitext text/x-wiki {{TOCright}} ''A loose, personal (i.e., somewhat idiosynchratic) organisation of Wikiversity-related how-tos and links.'' ==To sort== {|style="background:transparent;" |valign=top| * [http://tools.wikimedia.de/~magnus/commonshelper.php commonshelper] * [[User:Jtneill/Wikification|Wikification]] * [[w:Help:Interwiki_linking#Project_titles_and_shortcuts|Interwiki linking]] * [[Wikiversity:Activity bars]] * [[Wikiversity:Percent complete]] |valign=top| * [[Wikiversity:Import|import]] * [[Wikiversity:Interactive whiteboard]] * [[Wikiversity:Maintenance]] * [[Wikiversity:Namespaces]] * [[Wikiversity:Naming conventions]] |valign=top| * [[Wikiversity:Participants]] * [[Wikiversity:Peer review]] * [[Wikiversity:Review board]] * [[Wikiversity:Searching]] * [[How to be a Wikimedia sysop]] |} ==Anchor== * [[Template:Anchor]], e.g., [[#test]] will go to <code><nowiki>{{anchor|test}}</nowiki></code> or <code><nowiki>{{anchor|anchor=test}}</nowiki></code> (should go to end of page) ==Archiving== * Example of autoarchiving: [[User talk:Terra]] ==Blogging== * [[Wikiversity Blog howto]] ==Categorisation== Using titleparts <nowiki>[[Category:{{#titleparts:{{PAGENAME}}|1}}]]</nowiki> ==[[/Centering/]]== {{User:Jtneill/Wikiversity/Centering}} ==Chat== * [[irc:wikiversity-en|#wikiversity-en]] ==Collapse boxes== {{collapse top|Mary had a little lamb}} Mary had a little lamb, Little lamb, little lamb, Mary had a little lamb, Its fleece was white as snow And everywhere that Mary went, Mary went, Mary went, Everywhere that Mary went The lamb was sure to go It followed her to school one day School one day, school one day It followed her to school one day Which was against the rules. It made the children laugh and play, Laugh and play, laugh and play, It made the children laugh and play To see a lamb at school And so the teacher turned it out, Turned it out, turned it out, And so the teacher turned it out, But still it lingered near And waited patiently about, Patiently about, patiently about, And waited patiently about Till Mary did appear "Why does the lamb love Mary so?" Love Mary so? Love Mary so? "Why does the lamb love Mary so?" The eager children cry "Why, Mary loves the lamb, you know." Loves the lamb, you know, loves the lamb, you know "Why, Mary loves the lamb, you know." The teacher did reply {{collapse bottom}} ==Colour== * [[Wikiversity web page colors|Color tables]] | [[Wikiversity:Color names|Color names]] * e.g., Font: {{font|color=green|Green}}, Background: <span style="background:hotpink; color:white;">Pink</span> ==Columns== ===Column breaks=== {| |- | Works on all browsers (col-begin/break/end): {{col-begin}} {{col-break}} * Col1 {{col-break}} * Col2 {{col-break}} * Col3 {{col-end}} Works on all browsers (col/break/colend): {{col}} {{break}} * Col1 {{break}} * Col2 {{break}} * Col3 {{col/end}} |} ===Moz-column=== Easier to use, but doesn't work on all browsers: <div style="column-count:3;-moz-column-count:3;-webkit-column-count:3"> * Ant * Bee * Buzzard * Cat * Dog * Egret * Elephant * Tiger * Whale * Worm </div> ==Conversions== ===HTML=== * [[w:Wikipedia:Tools/Editing_tools#From_HTML]] * [http://www.ebruni.it/en/software/os/i_love_wiki/index.mpl i love wiki] * {{tick}} [http://diberri.dyndns.org/wikipedia/html2wiki/index.html HTML::WikiConverter] * {{tick}} [http://openfacts2.berlios.de/html2wiki/index.php HTML::WikiConverter]] Add URL ==CSS== * [[MediaWiki:Common.css]] ==Custodianship== * [[Wikiversity:Custodianship]] ** [[Wikiversity:Candidates for Custodianship]] ** [[Wikiversity:Notices for custodians]] ** [[Wikiversity:Request custodian action]] ** [[:Category:Wikiversity custodians]] ==Edit page== <nowiki> {{edit page}} </nowiki> gives: {{edit page}} <nowiki> {{edit page box}} </nowiki> gives: {{edit page box}} ==Extensions== * [[Special:Version#Extensions]] * [[/CategoryTree|CategoryTree]] * [http://www.sandboxserver.org/wiki/index.php?title=Testing_Mediawiki_extensions Sandbox server - testing extensions] * [[User:Jtneill/WYSIWIG|WYSIWIG]] ==Font== <p>{{font|face="courier"|size=medium|courier size 3}}</p> <p>{{font|face="verdana"|size=large|verdana size 4}}</p> <p>{{font|face="arial"|size=x-large|arial size 5}}</p> <p>{{font|face="times new roman"|size=xx-large|times new roman size 6}}</p> <p><b>{{font|face="verdana"|size=xx-large|verdana bold size 6}}</b></p> <p>{{font|face="lucida calligraphy"|size=xx-large|lucida calligraphy size 7}}</p> ==Formatting== ===Justification=== <div style="text-align: justify"> This text is right justified (but it doesn't look like unless the paragraph is long enough to go over one line on the page, so this is intentionally a particularly and unnecessarily long sentence in order to demonstrate right justification using <nowiki><div style="text-align: justify">...</div></nowiki>).</div> ==Line height== {{center top}}<p style="line-height: 36px;"> <big><big><big><big>This uses a<br>line height of 36px</big></big></big></big></p> <pre><p style="line-height: 36px;">...</p></pre> {{center bottom}} ===Mouse-over=== * [[Help:Mouse-over]] * [[Template:H:title]] ==Getting started== * [[Wikiversity:Guided tour|Guided tour]] * [[Wikiversity:Introduction|Introduction]] (Wikiversity) * [[/Introduction|Introduction]] (Jtneill) * [[/Welcome|Welcome]] (Jtneill) * [[Introduction to Wiki]] - [[Wiki 101]] * [[How to use wiki technology as a free learner]] * [[:Image:Short.ogg|Wikiversity - short intro]] (10 sec. video) * [[:Image:Editing_tutorial-large.ogg|Wikiversity editing tutorial]] (2 min video) * [[Wikiversity:Community Portal]] * [[Wikiversity:Content development]] * [[Help:Edit summary]] * [[Making links]] ==Good design== * [[User:Jtneill/Good design]] ==Icons== * [[Help:Icons]] * [[User:McCormack/icons]] ==Images== ===[[Template:Gallery|Gallery]]=== {{Gallery |title=Gallery of images |footer=Uses this [[Template:Gallery|template]] |width=150 |lines=2 ||Comment |File:Wikiversity-logo-Snorky.svg|[[Help:Contents/Links|Links]] can be put in captions. |File:Wikiversity-logo-Snorky.svg|Full [[MediaWiki]]<br />[[syntax]] may be used… |File:Wikiversity-logo-Snorky.svg| }} <!-- Fixed image in bottom right which is linked --> <div id="template-navbar" style="position: fixed; left:1; right:0; bottom:0; padding:0; font-size:122%;">[[Image:Happy.png|right|50px|link=en:Happiness|Happiness]]</div> ===ImageMap=== * [[mw:Extension:ImageMap|Extension ImageMap]] e.g., {{center top}} <imagemap>File:Treasurchest.svg|center|80px default [[Special:Random/|Random Wikiversity mainspace page]] desc none</imagemap>Click the treasure box to go to a random [[Wikiversity]] page{{center bottom}} ;Explanation The ImageMap extension allows, among other things, an image to link directly to a page e.g., as an internal link: <imagemap> File:Treasurchest.svg|center|150px|alt=Alt text default [[Motivation and emotion/Book/2015|Motivation and emotion Book - 2015]] </imagemap> The syntax is: <pre style="overflow:auto"> <imagemap> File:Treasurchest.svg|center|150px|alt=Alt text default [[Motivation and emotion/Book/2015|Motivation and emotion Book - 2015]] </imagemap> </pre> or as an external link: <imagemap> File:Treasurchest.svg|center|150px|alt=Alt text default [https://www.psychologytoday.com/basics/motivation Motivation (Psychology Today)] </imagemap> The syntax is: <pre style="overflow:auto"> <imagemap> File:Treasurchest.svg|center|150px|alt=Alt text default [https://www.psychologytoday.com/basics/motivation Motivation (Psychology Today)] </imagemap> </pre> ==Integrations== I'm interested to explore possible connections between WV and: * [http://archive.org Archive.org] * [[w:Citizendium|Citizendium]] * [[w:Google Groups]] * [[Moodle]] * [[Open University]] * [http://openlearn.open.ac.uk/course/view.php?name=Cohere Cohere] * [[WikiMedia Sister Projects]], particularly: ** [[Wikibooks]] ** [[Wikipedia]] ** [[Simple Wikipedia]] ==Licensing== * My teaching materials are licensed under [[Wikiversity:License tags#Free licenses|creative commons attribution 2.5]] and hosted either on http://wilderdom.com or http://ucspace.canberra.edu.au. I am thinking I should be dual licensing, but am still coming to grips with trying to understand the licensing similarities, differences, and issues. * I plan to gradually transfer most of my teaching materials to the various [[w:WikiMedia Foundation|WikiMedia Foundation]] wiki projects, particularly wikiversity. [[m:Polls|Let's just hope Jimbo doesn't put adds on these sites]], otherwise I will be transferring the materials somewhere else (again). * [http://beta.wikiversity.org/wiki/Wikiversity:IRC_meeting:New_licence_for_Wikiversity_Beta New_licence_for_Wikiversity_Beta] * {{tl|db-copyvio}} * {{tl|hangon}} * [[:Category:Astronomy Images]] ==Links== * Plain links: e.g., <span class="plainlinks">[http://archive.org http://archive.org]</span>: <br><nowiki><span class="plainlinks"> ... </span></nowiki> * [[mw:Manual:Opening external links in a new window]] ==Long page warning== * [[MediaWiki:Longpagewarning]] ==[[Main page]]== * [[:Category:Main page templates]] * [[Main Page/Layout 0.5]] * <span class="plainlinks">[http://en.wikiversity.org/w/index.php?title=Wikiversity:Main_Page&oldid=209253 Main page]</span> (old) ==Map== <mapframe latitude="-28.420391" longitude="136.757813" zoom="2" width="200" height="109" align="right">{ "type": "FeatureCollection", "features": [ { "type": "Feature", "properties": {}, "geometry": { "type": "Point", "coordinates": [ 149.12419, -35.308275 ] } } ] }</mapframe> ==Navigation== {{nav|User:Jtneill}} * [[Template:nav]] ==Notes== e.g., {{attention}} <small>For calendar due dates, see unit outline.</small> ==Notifications== * [[Help:Notifications]] ==[[Project:Participants|Participants]]== ===Custodians=== {{user|Adambro}}<br> {{user|CQ}}<br> {{user|Cormaggio}}<br> {{user|Draicone}}<br> {{user|Erkan Yilmaz}}<br> {{user|Gbaor}}<br> {{user|Leighblackall}}<br> {{user|McCormack}}<br> {{user|Mike.lifeguard}}<br> {{user|Mu301}}<br> {{user|SB_Johnny}} ===Users=== *{{Participant|Donek}} *{{Participant|CQ}} - see Person of the Hour script ==Pedagogy== * [[Learning by doing]] * [[Wikiversity:Project incubator]] ==Policy== * [[w:Wikipedia:Contributing_FAQ#Is_there_a_minimum_age_requirement_to_contribute_or_register.3F|Is there a minimum age requirement?]] {{Official policies}} {{Proposed policies}} ==Project boxes== * [[Help:Resource attribution]] ==Purge== ?action=purge [[mw:Manual:Purge]] ==Quotes== * [[Template:Quote]] * ==[[Quizzes]]== * [[Help:Quiz-Simple]] * [http://www.qedoc.org/en/index.php?title=User:Jtneill My Qedoc user page] ** [http://eduforge.org/forum/forum.php?forum_id=1138 Qedoc now exports quizzes to Wikiversity] ==Referencing== * [[WV:REF]] * [[Template:Citation]] * [[:Category:Citation templates]] * Example: Outward Bound Process Model<ref>Walsh, V., & Golins, G. L. (1976). ''[http://wilderdom.com/theory/OutwardBoundProcessModel.html The exploration of the Outward Bound process]''. Denver, CO: Colorado Outward Bound School.</ref> ===References=== {{reflist|1}} ==Sandbox== * http://www.sandboxserver.org/ * [[Wikiversity:Sandbox Server]] * [[Topic:Sandbox Server 0.5]] * [http://scratchpad.wikia.com/wiki/Scratchpad_Wiki_Labs Scratchpad] * [[../Sandbox]] ==Searching== * [[Help:Google]] * [[Wikiversity:Colloquium/archives/April 2008#Google search|Google search]] - <nowiki>[[google:wikiversity]]</nowiki> [[google:wikiversity]] * Use a + instead of a space ==Search multiple categories== ;Dual category search including one category with subcategories Search for chapters which [[Template:Clarification templates|need clarification]]: <inputbox> type=search width=33 default=incategory:"Resources needing clarification" namespaces=Main** prefix=Motivation and emotion/Book searchbuttonlabel=Search book chapters bgcolor=transparent break=no </inputbox> ==Sitenotice== * [[MediaWiki:Sitenotice]] * [[MediaWiki:Sitenotice id]] ==Size== ===Big/small=== * Use <code><nowiki><big>...</big> - could be also <big><big>...</big></big> etc. and also <small>...</small></nowiki></code> ===CSS=== <div style="font-size: 200%">200% text</div><code><nowiki><div style="font-size: 200%">200% text</div></nowiki></code> <div style="font-size: 150%">150% text</div><code><nowiki><div style="font-size: 150%">150% text</div></nowiki></code> ==Special== * [[Special:SpecialPages]] * [[Special:Allpages]] * [[Special:ListGroupRights]] * [[Random]] - [[Special:Random]] - [[Wikiversity:Random]] * [[Special:Version#Installed extensions]] ==Strategy== * [[Wikiversity:Publicity]] * [[Wikiversity:Vision]] * [[Wikiversity:Vision 2009]] ==Statistics== * [[Wikiversity:Statistics]] * [[Google Search and Wikiversity]] * [http://wikistics.falsikon.de/latest/wikiversity/en/ Monthly page hits for wikiversity.en] * [http://gtools.org/tool/wikipedia-edit-counter/?str=jtneill&project=en.wikiversity Jtneill edit count] ==Sub-pages== * [[Special:Prefixindex/User:Jtneill]] * Transclude: ** <code><nowiki>{{Special:Prefixindex/User:Jtneill}}</nowiki></code> ** <code><nowiki>{{Special:Prefixindex/{{NAMESPACE}}:{{PAGENAME}}}}</nowiki></code> ==Stubs== * [[:Category:Stub templates]] ==Structure== * [[Wikiversity:Browse/Concept]] ==System messages== * [[Special:AllMessages]] * [[#Site notice|Site notice]] ==Style== * [[MoS]] * [[MediaWiki:Common.css]] ==Tables== * [[Help:Table]] * [[User:Jtneill/Sandbox/Tables and boxes]] ==Templates== ===Page development=== * {{tl|welcome and expand}} - {{tl|we}} * {{tl|main welcome}} * {{tl|search}} * {{tl|draft}} * {{tl|underconstruction}} * {{tl|Learning project boilerplate}} * {{tl|info}} * {{tl|note}} * {{tl|notice}} * <nowiki>{{notice|{{findsources}}}}</nowiki> ===Page navigation=== * [[Template:EasyNavBar]] * [[Template:Recovery psychology]] (example) * [[Workshop for Australian education policy]] (example) ===Sister projects=== * [[Template:Sisterprojectsearch]] * [[Template:Wikibooks]] * [[Template:Wikipedia]] * [[Template:Wikiversity]] ===User talk=== * {{tl|Welcomeip}} ===Administrative=== * [[Template:Category redirect]] * [[Template:Warning]] ==Theory== * [[Learning by engagement]] * [[User:JWSchmidt/Wiki Scholar]] ==Thoughts== * [[Red link]]s are doorways to the infinite library ==User== * [[w:Special:GlobalRenameRequest]] ==Usability== * [[Wikiversity:Usability]] * http://usability.wikimedia.org - [http://usability.wikimedia.org/wiki/User:Jtneill Jtneill] ==Video== * .ogg files can be uploaded and embedded * See [[/Video]] for examples ==x Test anchor== <!-- Test anchor - don't delete! --> {{anchor|test}} ==See also== * [[User:Jade Knight/Tools]] rkb0foobgt9d9kjzq8ahmc0hxa61o1v 0 63298 2419072 2259837 2022-08-25T15:41:31Z 2409:4072:6D06:8705:34EB:23BD:45E4:9CC4 wikitext text/x-wiki A '''RLC circuit''' (also known as a [[w:Resonant|resonant]] circuit, [[w:Tuner|tuned]] circuit, or LCR circuit) is an [[w:Electrical_circuit|electrical circuit]] consisting of a [[w:Resistor|resistor]] (R), an [[w:Inductor|inductor]] (L), and a [[w:Capacitor|capacitor]] (C), connected in series or in parallel. This configuration forms a [[w:Harmonic_oscillator|harmonic oscillator]]. Tuned circuits have many applications particularly for oscillating circuits and in radio and communication engineering. They can be used to select a certain narrow range of frequencies from the total [[w:Spectrum|spectrum]] of ambient radio waves. For example, AM/FM radios with analog tuners typically use an RLC circuit to tune a radio frequency. Most commonly a variable capacitor is attached to the tuning knob, which allows you to change the value of C in the circuit and tune to stations on different frequencies. An RLC circuit is called a ''second-order'' circuit as any voltage or current in the circuit can be described by a second-order [[w:Differential_equation|differential equation]] for circuit analysis ==Configurations== Every RLC circuit consists of two components: a ''power source'' and ''resonator''. There are two types of power sources &ndash; [[w:Thévenin_equivalent|Thévenin ]] and [[w:Norton_equivalent|Norton]]. Likewise, there are two types of resonators &ndash; series [[LC circuit|LC]] and parallel LC. As a result, there are four configurations of RLC circuits: *Series LC with Thévenin power source *Series LC with Norton power source *Parallel LC with Thévenin power source *Parallel LC with Norton power source. ==Similarities and differences between series and parallel circuits== The expressions for the bandwidth in the series and parallel configuration are inverses of each other. This is particularly useful for determining whether a series or parallel configuration is to be used for a particular circuit design. However, in circuit analysis, usually the reciprocal of the latter two variables is used to characterize the system instead. They are known as the [[w:Resonance|resonant frequency]] and the [[w:Q_factor|Q factor]] respectively. == Fundamental parameters == There are two fundamental [[w:Parameter#Engineering|parameters]] that describe the behavior of ''RLC circuits'': the resonant frequency and the damping factor. In addition, other parameters derived from these first two are discussed below. ===Resonant frequency === The [[w:Damping|undamped]] [[w:Resonance|resonance or natural frequency]] of an ''RLC circuit'' (in [[w:Radian|radian]]s per second) is given by ::<math>\omega_0 = {1 \over \sqrt{L C}}</math> In the more familiar unit [[w:Hertz|hertz]] (or cycles per second), the natural frequency becomes ::<math>f_0 = {\omega_0 \over 2 \pi} = {1 \over 2 \pi \sqrt{L C}}</math> Resonance occurs when the [[w:Electrical_impedance|complex impedance]] ''Z_LC'' of the LC resonator becomes zero: ::<math>Z_{LC} = Z_L + Z_C = 0\quad</math> Both of these impedances are functions of [[w:Angular_frequency|angular frequency]] <math>\omega</math>: ::<math>Z_C = {1 \over {j \omega C}}</math> ::<math>Z_L = jL\omega \quad</math> Setting the magnitude of the impedance to be zero at <math>\omega=\omega_0</math> and using <math>j^2=-1</math>: ::<math>|Z_{LC}|=L\omega_0-{1\over {\omega_0 C}}=0</math> ::<math>\omega_0^2={1\over{LC}}\Rightarrow\omega_0={1\over\sqrt{LC}}</math> === Damping factor === The normalized damping factor of the circuit is: ::<math>\zeta_N = {\zeta\over\omega_0} = {R \over 2} \sqrt{C\over L}</math> for a series RLC circuit, and: ::<math>\zeta_N = {\zeta\over\omega_0} = {1 \over 2R}\sqrt{L\over C}</math> for a parallel RLC circuit. It's desirable to use the normalized forced damping factor (non-dimensional) instead of the regular one (in [[w:Radian|radian]]s per second) to analyze the properties of the resonant circuit For applications in oscillator circuits, it is generally desirable to make the damping factor as small as possible, or equivalently, to increase the quality factor (Q) as much as possible. In practice, this requires decreasing the resistance ''R'' in the circuit to as small as physically possible for a series circuit, and increasing ''R'' to as large a value as possible for a parallel circuit. In this case, the ''RLC circuit'' becomes a good approximation to an ideal [[LC circuit]]. Alternatively, for applications in bandpass filters, the value of the damping factor is chosen based on the desired bandwidth of the filter. For a wider bandwidth, a larger value of the damping factor is required (and vice versa). In practice, this requires adjusting the relative values of the resistor ''R'' and the inductor ''L'' in the circuit. == Derived parameters == The derived parameters include '''Bandwidth''', '''Q factor''', and '''damped resonance frequency'''. === Bandwidth === The ''RLC circuit'' may be used as a [[w:Bandpass|bandpass]] or [[w:Band-stop|band-stop]] filter by replacing R with a receiving device with the same input resistance. In the Series case the [[w:Bandwidth_(signal_processing)|bandwidth]] (in radians per second) is ::<math> \Delta \omega = 2 \zeta = { R \over L}</math> Alternatively, the bandwidth in hertz is ::<math> \Delta f = { \Delta \omega \over 2 \pi } = { \zeta \over \pi } = { R \over 2 \pi L }</math> The bandwidth is a measure of the width of the frequency response at the two ''half-power'' frequencies. As a result, this measure of bandwidth is sometimes called the '''full-width at half-power'''. Since electrical [[w:Power_(physics)|power]] is proportional to the square of the circuit voltage (or current), the frequency response will drop to <math> { 1 \over \sqrt{2} } </math> at the half-power frequencies. === Resonance damping === The [[w:Damping|damped]] resonance frequency derives from the natural frequency and the damping factor. If the circuit is ''underdamped'', meaning :<math> \displaystyle \zeta < \omega_0 </math> then we can define the damped resonance as :<math> \omega_d = \sqrt{ \omega_0^2 - \zeta^2 } </math> In an oscillator circuit :<math> \zeta \ll \omega_0 </math>. As a result :<math> \omega_d \approx \omega_0 </math>. See discussion of underdamping, overdamping, and critical damping, below. ==Circuit analysis== ===Series RLC with Thévenin power source=== In this circuit, the three components are all in series with the [[w:Voltage_source|voltage source]]. {| class="toccolours" align="center" style="float:center; margin: 1em 1em 0 0; width:75%; text-align:left;" | [[Image:RLC series circuit v1.svg|center|RLC series circuit]] | Series RLC Circuit notations: : '''V''' - the voltage of the power source (measured in [[w:Volt|volt]]s V) : '''I''' - the current in the circuit (measured in [[w:Ampere|ampere]]s A) : '''R''' - the [[w:Electrical_resistance|resistance]] of the resistor (measured in [[w:Ohm_(unit)|ohm]]s = V/A); : '''L''' - the [[inductance]] of the inductor (measured in [[w:Henry_(unit)|henrys]] = H = V·[[w:Second|s]]/A) : '''C''' - the [[capacitance]] of the capacitor (measured in [[w:Farad|farad]]s = F = [[w:Coulomb|C]]/V = A·s/V) : '''q''' - the charge across the capacitor (measured in [[w:Coulomb|coulomb]]s C) |- |} Given the parameters v, R, L, and C, the solution for the charge, q, can be found using [[w:Kirchhoff's circuit laws|Kirchhoff's voltage law]]. (KVL) gives ::<math> {v_R+v_L+v_C=v} \, </math> For a time-changing voltage ''v(t)'', this becomes ::<math> Ri(t) + L { {di} \over {dt}} + {1 \over C} \int_{-\infty}^{t} i(\tau)\, d\tau = v(t) </math> Using the relationship between charge and current: ::<math> i(t) = {{dq} \over {dt}} </math> The above expression can be expressed in terms of charge across the capacitor: ::<math> L {{d^2 q} \over {dt^2}} +{R} {{dq} \over {dt}} + {1 \over {C}} q(t) = v(t) </math> Dividing by L gives the following second order differential equation: ::<math> {{d^2 q} \over {dt^2}} +{R \over L} {{dq} \over {dt}} + {1 \over {LC}} q(t) = {1 \over L} v(t) </math> We now define two key parameters: ::<math>\zeta_N = {R \over 2} \sqrt{C \over L}</math> and <math> \omega_0 = { 1 \over \sqrt{LC}} </math> Substituting these parameters into the differential equation, we obtain: ::<math> {{d^2 q} \over {dt^2}} + 2 \zeta_N . \omega_0{{dq} \over {dt}} + \omega_0^2 q(t) = {1 \over L} v(t) </math> or ::<math> q''+2\zeta_N . \omega_0 q' + \omega_0^2 q = {1 \over L} v(t) </math> ==== Frequency domain ==== The series RLC can be analyzed in the [[w:Frequency_domain|frequency domain]] using [[w:Complex_number|complex]] [[Electrical impedance|impedance]] relations. If the voltage source above produces a complex exponential wave form with amplitude v(s) and [[w:Angular_frequency|angular frequency ]] <math> s = \sigma + i \omega</math> , [[w:KVL|KVL]] can be applied: ::<math>v(s) = i(s) \left ( R + Ls + \frac{1}{Cs} \right ) </math> where i(s) is the complex current through all components. Solving for i: ::<math>i(s) = \frac{1}{ R + Ls + \frac{1}{Cs} } v(s) </math> And rearranging, we have at ::<math>i(s) = \frac{s}{ L \left ( s^2 + {R \over L}s + \frac{1}{LC} \right ) } v(s)</math> ===== Complex admittance ===== Next, we solve for the complex [[admittance]] Y(s): ::<math> Y(s) = { i(s) \over v(s) } = \frac{s}{ L \left ( s^2 + {R \over L}s + \frac{1}{LC} \right ) } </math> Finally, we simplify using parameters ζ and ω_o ::<math> Y(s) = { i(s) \over v(s) } = \frac{s}{ L \left ( s^2 + 2 \zeta \omega_0 s + \omega_0^2 \right ) } </math> Notice that this expression for ''Y(s)'' is the same as the one we found for the Zero State Response. ===== Poles and zeros ===== The [[w:Zero_(complex_analysis)|zeros]] of ''Y(s)'' are those values of ''s'' such that <math>Y(s) = 0</math>: ::<math> s = 0 </math> and <math> s = \infty </math> The [[w:Pole_(complex_analysis)|poles]] of ''Y(s)'' are those values of ''s'' such that <math> Y(s) = \infty</math>. By the [[w:Quadratic_equation|quadratic formula]], we find :: <math> s = - \zeta \pm \sqrt{\zeta^2 - \omega_0^2} </math> Notice that the poles of ''Y(s)'' are identical to the roots <math>\lambda_1</math> and <math>\lambda_2</math> of the characteristic polynomial. ===== Sinusoidal steady state ===== Now let <math> s = i \omega </math>.... Taking the magnitude of the above equation: ::<math> | Y(s=i \omega) | = \frac{1}{\sqrt{ R^2 + \left ( \omega L - \frac{1}{\omega C} \right )^2 }}. </math> Next, we find the magnitude of current as a function of ω ::<math> | I( i \omega ) | = | Y(i \omega) | | V(i \omega) |.\,</math> If we choose values where ''R'' = 1 ohm, ''C'' = 1 farad, ''L'' = 1 henry, and ''V'' = 1.0 volt, then the graph of magnitude of the current ''i'' (in amperes) as a function of ω (in radians per second) is: <div style="float: center; text-align: center; margin: 1em 1em 1em 1em;">[[Image:RLC series imag.png]]<br>''Sinusoidal steady-state analysis''</div> Note that there is a peak at <math>i_{mag}(\omega) = 1</math>. This is known as the [[w:Resonant_frequency|resonant frequency]]. Solving for this value, we find: ::<math>\omega_0 = \frac{1}{\sqrt{L C}}. </math> ==Parallel RLC circuit== {| class="toccolours" align="center" style="float:center; margin: 1em 1em 0 0; width:95%; text-align:left;" | [[Image:RLC parallel circuit v1.svg|Left|RLC Parallel circuit]] | | | Parallel RLC Circuit notations: : '''V''' - the voltage of the power source (measured in [[w:Volt|volt]]s V) : '''I''' - the current in the circuit (measured in [[w:Ampere|ampere]]s A) : '''R''' - the [[w:Electrical_resistance|resistance]] of the resistor (measured in [[w:Ohm_(unit)|ohm]]s = V/A); : '''L''' - the [[inductance]] of the inductor (measured in [[w:Henry_(unit)|henrys]] = H = V·[[w:Second|s]]/A) : '''C''' - the [[capacitance]] of the capacitor (measured in [[w:Farad|farad]]s = F = [[w:Coulomb|C]]/V = A·s/V) |- |} The complex impedance of this circuit is given by adding up the impedances in parallel: ::<math>{1\over Z}={1\over Z_L}+{1\over Z_C}+{1\over Z_R}={1\over{j\omega L}}+{j\omega C}+{1\over R}</math> The change from a series arrangement to a parallel arrangement has some very real consequences for the behaviour. This can be seen by plotting the magnitude of the current <math>I={V\over Z}</math>. For comparison with the earlier graph we choose values where R = 1 ohm, C = 1 farad, L = 1 henry, and V = 1.0 volt and ω in radians per second: <div style="float: center; text-align: center; margin: 1em 1em 1em 1em;"><br>''Sinusoidal steady-state analysis''</div> There is a minimum in the frequency response at the resonant frequency <math>\omega_0={1\over\sqrt{LC}}</math>. A parallel RLC circuit is a example of a [[w:Band-stop|band-stop]] circuit response that can be used as a filter to block frequencies at the resonance frequency but allow others to pass. {{cleanup-remainder|date=August 2006}} A much more elegant way of recovering the circuit properties of an RLC circuit is through the use of [[w:Nondimensionalization|nondimensionalization]]. For a parallel configuration of the same components, where Φ is the magnetic flux in the system {{center top}} <math> C \frac{d^2 \Phi}{dt^2} + \frac{1}{R} \frac{d \Phi}{dt} + \frac{1}{L} \Phi = i_0 \cos(\omega t) \Rightarrow \frac{d^2 \chi}{d \tau^2} + 2 \zeta_N \frac{d \chi}{d\tau} + \chi = \cos(\Omega \tau) </math>{{center bottom}} with substitutions {{center top}} <math>\Phi = \chi x_c, \ t = \tau t_c, \ x_c = L i_0, \ t_c = \sqrt{LC}, \ 2 \zeta_N = \frac{1}{R} \sqrt{\frac{L}{C}}, \ \Omega = \omega t_c . </math>{{center bottom}} The first variable corresponds to the maximum magnetic flux stored in the circuit. The second corresponds to the period of resonant oscillations in the circuit. ==See also== *[[w:Resonant_frequency|Resonant frequency]] *[[w:Electronic_oscillator|Electronic oscillator]] *[[w:Bandwidth_%28signal_processing%29|Bandwidth (signal processing)]] *[[w:Bandpass_filter|Bandpass filter]] *[[w:Q_factor|Q factor]] *[[w:Oliver_Heaviside|Oliver Heaviside]] *[[w:RC_circuit|RC circuit]] ==External links== * [[Wikipedia:Category:Analog circuits]] * [http://www.lightandmatter.com/html_books/0sn/ch10/ch10.html a treatment that starts with the mechanical analogy] * [http://www.phy.hk/wiki/englishhtm/RLC.htm An interactive simulation on series RCL circuit] * [http://resonanceswavesandfields.blogspot.com/2007_06_01_archive.html Interactive Visual Representation of the LRC Circuit] * [http://automeasure.com/pulse.htm Pulse Response Examiner freeware (Windows)] * [https://allaboutcircuits.com All About Circuits] * [https://eepower.com EE Power] * [https://maker.pro Maker Pro] * [https://www.electronicspoint.com/ Electronics Point] [[Category:Electronics]] [[Category:Engineering]] [[Category:Physics]] [[Category:Wikipedia copies]] iz140qb67x1vqnrajfhchl3sl9b4gbc 2419079 2419072 2022-08-25T17:57:00Z Dave Braunschweig 426084 Reverted edits by [[Special:Contributions/2409:4072:6D06:8705:34EB:23BD:45E4:9CC4|2409:4072:6D06:8705:34EB:23BD:45E4:9CC4]] ([[User_talk:2409:4072:6D06:8705:34EB:23BD:45E4:9CC4|talk]]) to last version by [[User:Chongkian|Chongkian]] using [[Wikiversity:Rollback|rollback]] wikitext text/x-wiki A '''RLC circuit''' (also known as a [[w:Resonant|resonant]] circuit, [[w:Tuner|tuned]] circuit, or LCR circuit) is an [[w:Electrical_circuit|electrical circuit]] consisting of a [[w:Resistor|resistor]] (R), an [[w:Inductor|inductor]] (L), and a [[w:Capacitor|capacitor]] (C), connected in series or in parallel. This configuration forms a [[w:Harmonic_oscillator|harmonic oscillator]]. Tuned circuits have many applications particularly for oscillating circuits and in radio and communication engineering. They can be used to select a certain narrow range of frequencies from the total [[w:Spectrum|spectrum]] of ambient radio waves. For example, AM/FM radios with analog tuners typically use an RLC circuit to tune a radio frequency. Most commonly a variable capacitor is attached to the tuning knob, which allows you to change the value of C in the circuit and tune to stations on different frequencies. An RLC circuit is called a ''second-order'' circuit as any voltage or current in the circuit can be described by a second-order [[w:Differential_equation|differential equation]] for circuit analysis. ==Configurations== Every RLC circuit consists of two components: a ''power source'' and ''resonator''. There are two types of power sources &ndash; [[w:Thévenin_equivalent|Thévenin ]] and [[w:Norton_equivalent|Norton]]. Likewise, there are two types of resonators &ndash; series [[LC circuit|LC]] and parallel LC. As a result, there are four configurations of RLC circuits: *Series LC with Thévenin power source *Series LC with Norton power source *Parallel LC with Thévenin power source *Parallel LC with Norton power source. ==Similarities and differences between series and parallel circuits== The expressions for the bandwidth in the series and parallel configuration are inverses of each other. This is particularly useful for determining whether a series or parallel configuration is to be used for a particular circuit design. However, in circuit analysis, usually the reciprocal of the latter two variables is used to characterize the system instead. They are known as the [[w:Resonance|resonant frequency]] and the [[w:Q_factor|Q factor]] respectively. == Fundamental parameters == There are two fundamental [[w:Parameter#Engineering|parameters]] that describe the behavior of ''RLC circuits'': the resonant frequency and the damping factor. In addition, other parameters derived from these first two are discussed below. ===Resonant frequency === The [[w:Damping|undamped]] [[w:Resonance|resonance or natural frequency]] of an ''RLC circuit'' (in [[w:Radian|radian]]s per second) is given by ::<math>\omega_0 = {1 \over \sqrt{L C}}</math> In the more familiar unit [[w:Hertz|hertz]] (or cycles per second), the natural frequency becomes ::<math>f_0 = {\omega_0 \over 2 \pi} = {1 \over 2 \pi \sqrt{L C}}</math> Resonance occurs when the [[w:Electrical_impedance|complex impedance]] ''Z_LC'' of the LC resonator becomes zero: ::<math>Z_{LC} = Z_L + Z_C = 0\quad</math> Both of these impedances are functions of [[w:Angular_frequency|angular frequency]] <math>\omega</math>: ::<math>Z_C = {1 \over {j \omega C}}</math> ::<math>Z_L = jL\omega \quad</math> Setting the magnitude of the impedance to be zero at <math>\omega=\omega_0</math> and using <math>j^2=-1</math>: ::<math>|Z_{LC}|=L\omega_0-{1\over {\omega_0 C}}=0</math> ::<math>\omega_0^2={1\over{LC}}\Rightarrow\omega_0={1\over\sqrt{LC}}</math> === Damping factor === The normalized damping factor of the circuit is: ::<math>\zeta_N = {\zeta\over\omega_0} = {R \over 2} \sqrt{C\over L}</math> for a series RLC circuit, and: ::<math>\zeta_N = {\zeta\over\omega_0} = {1 \over 2R}\sqrt{L\over C}</math> for a parallel RLC circuit. It's desirable to use the normalized forced damping factor (non-dimensional) instead of the regular one (in [[w:Radian|radian]]s per second) to analyze the properties of the resonant circuit For applications in oscillator circuits, it is generally desirable to make the damping factor as small as possible, or equivalently, to increase the quality factor (Q) as much as possible. In practice, this requires decreasing the resistance ''R'' in the circuit to as small as physically possible for a series circuit, and increasing ''R'' to as large a value as possible for a parallel circuit. In this case, the ''RLC circuit'' becomes a good approximation to an ideal [[LC circuit]]. Alternatively, for applications in bandpass filters, the value of the damping factor is chosen based on the desired bandwidth of the filter. For a wider bandwidth, a larger value of the damping factor is required (and vice versa). In practice, this requires adjusting the relative values of the resistor ''R'' and the inductor ''L'' in the circuit. == Derived parameters == The derived parameters include '''Bandwidth''', '''Q factor''', and '''damped resonance frequency'''. === Bandwidth === The ''RLC circuit'' may be used as a [[w:Bandpass|bandpass]] or [[w:Band-stop|band-stop]] filter by replacing R with a receiving device with the same input resistance. In the Series case the [[w:Bandwidth_(signal_processing)|bandwidth]] (in radians per second) is ::<math> \Delta \omega = 2 \zeta = { R \over L}</math> Alternatively, the bandwidth in hertz is ::<math> \Delta f = { \Delta \omega \over 2 \pi } = { \zeta \over \pi } = { R \over 2 \pi L }</math> The bandwidth is a measure of the width of the frequency response at the two ''half-power'' frequencies. As a result, this measure of bandwidth is sometimes called the '''full-width at half-power'''. Since electrical [[w:Power_(physics)|power]] is proportional to the square of the circuit voltage (or current), the frequency response will drop to <math> { 1 \over \sqrt{2} } </math> at the half-power frequencies. === Resonance damping === The [[w:Damping|damped]] resonance frequency derives from the natural frequency and the damping factor. If the circuit is ''underdamped'', meaning :<math> \displaystyle \zeta < \omega_0 </math> then we can define the damped resonance as :<math> \omega_d = \sqrt{ \omega_0^2 - \zeta^2 } </math> In an oscillator circuit :<math> \zeta \ll \omega_0 </math>. As a result :<math> \omega_d \approx \omega_0 </math>. See discussion of underdamping, overdamping, and critical damping, below. ==Circuit analysis== ===Series RLC with Thévenin power source=== In this circuit, the three components are all in series with the [[w:Voltage_source|voltage source]]. {| class="toccolours" align="center" style="float:center; margin: 1em 1em 0 0; width:75%; text-align:left;" | [[Image:RLC series circuit v1.svg|center|RLC series circuit]] | Series RLC Circuit notations: : '''V''' - the voltage of the power source (measured in [[w:Volt|volt]]s V) : '''I''' - the current in the circuit (measured in [[w:Ampere|ampere]]s A) : '''R''' - the [[w:Electrical_resistance|resistance]] of the resistor (measured in [[w:Ohm_(unit)|ohm]]s = V/A); : '''L''' - the [[inductance]] of the inductor (measured in [[w:Henry_(unit)|henrys]] = H = V·[[w:Second|s]]/A) : '''C''' - the [[capacitance]] of the capacitor (measured in [[w:Farad|farad]]s = F = [[w:Coulomb|C]]/V = A·s/V) : '''q''' - the charge across the capacitor (measured in [[w:Coulomb|coulomb]]s C) |- |} Given the parameters v, R, L, and C, the solution for the charge, q, can be found using [[w:Kirchhoff's circuit laws|Kirchhoff's voltage law]]. (KVL) gives ::<math> {v_R+v_L+v_C=v} \, </math> For a time-changing voltage ''v(t)'', this becomes ::<math> Ri(t) + L { {di} \over {dt}} + {1 \over C} \int_{-\infty}^{t} i(\tau)\, d\tau = v(t) </math> Using the relationship between charge and current: ::<math> i(t) = {{dq} \over {dt}} </math> The above expression can be expressed in terms of charge across the capacitor: ::<math> L {{d^2 q} \over {dt^2}} +{R} {{dq} \over {dt}} + {1 \over {C}} q(t) = v(t) </math> Dividing by L gives the following second order differential equation: ::<math> {{d^2 q} \over {dt^2}} +{R \over L} {{dq} \over {dt}} + {1 \over {LC}} q(t) = {1 \over L} v(t) </math> We now define two key parameters: ::<math>\zeta_N = {R \over 2} \sqrt{C \over L}</math> and <math> \omega_0 = { 1 \over \sqrt{LC}} </math> Substituting these parameters into the differential equation, we obtain: ::<math> {{d^2 q} \over {dt^2}} + 2 \zeta_N . \omega_0{{dq} \over {dt}} + \omega_0^2 q(t) = {1 \over L} v(t) </math> or ::<math> q''+2\zeta_N . \omega_0 q' + \omega_0^2 q = {1 \over L} v(t) </math> ==== Frequency domain ==== The series RLC can be analyzed in the [[w:Frequency_domain|frequency domain]] using [[w:Complex_number|complex]] [[Electrical impedance|impedance]] relations. If the voltage source above produces a complex exponential wave form with amplitude v(s) and [[w:Angular_frequency|angular frequency ]] <math> s = \sigma + i \omega</math> , [[w:KVL|KVL]] can be applied: ::<math>v(s) = i(s) \left ( R + Ls + \frac{1}{Cs} \right ) </math> where i(s) is the complex current through all components. Solving for i: ::<math>i(s) = \frac{1}{ R + Ls + \frac{1}{Cs} } v(s) </math> And rearranging, we have at ::<math>i(s) = \frac{s}{ L \left ( s^2 + {R \over L}s + \frac{1}{LC} \right ) } v(s)</math> ===== Complex admittance ===== Next, we solve for the complex [[admittance]] Y(s): ::<math> Y(s) = { i(s) \over v(s) } = \frac{s}{ L \left ( s^2 + {R \over L}s + \frac{1}{LC} \right ) } </math> Finally, we simplify using parameters ζ and ω_o ::<math> Y(s) = { i(s) \over v(s) } = \frac{s}{ L \left ( s^2 + 2 \zeta \omega_0 s + \omega_0^2 \right ) } </math> Notice that this expression for ''Y(s)'' is the same as the one we found for the Zero State Response. ===== Poles and zeros ===== The [[w:Zero_(complex_analysis)|zeros]] of ''Y(s)'' are those values of ''s'' such that <math>Y(s) = 0</math>: ::<math> s = 0 </math> and <math> s = \infty </math> The [[w:Pole_(complex_analysis)|poles]] of ''Y(s)'' are those values of ''s'' such that <math> Y(s) = \infty</math>. By the [[w:Quadratic_equation|quadratic formula]], we find :: <math> s = - \zeta \pm \sqrt{\zeta^2 - \omega_0^2} </math> Notice that the poles of ''Y(s)'' are identical to the roots <math>\lambda_1</math> and <math>\lambda_2</math> of the characteristic polynomial. ===== Sinusoidal steady state ===== Now let <math> s = i \omega </math>.... Taking the magnitude of the above equation: ::<math> | Y(s=i \omega) | = \frac{1}{\sqrt{ R^2 + \left ( \omega L - \frac{1}{\omega C} \right )^2 }}. </math> Next, we find the magnitude of current as a function of ω ::<math> | I( i \omega ) | = | Y(i \omega) | | V(i \omega) |.\,</math> If we choose values where ''R'' = 1 ohm, ''C'' = 1 farad, ''L'' = 1 henry, and ''V'' = 1.0 volt, then the graph of magnitude of the current ''i'' (in amperes) as a function of ω (in radians per second) is: <div style="float: center; text-align: center; margin: 1em 1em 1em 1em;">[[Image:RLC series imag.png]]<br>''Sinusoidal steady-state analysis''</div> Note that there is a peak at <math>i_{mag}(\omega) = 1</math>. This is known as the [[w:Resonant_frequency|resonant frequency]]. Solving for this value, we find: ::<math>\omega_0 = \frac{1}{\sqrt{L C}}. </math> ==Parallel RLC circuit== {| class="toccolours" align="center" style="float:center; margin: 1em 1em 0 0; width:95%; text-align:left;" | [[Image:RLC parallel circuit v1.svg|Left|RLC Parallel circuit]] | | | Parallel RLC Circuit notations: : '''V''' - the voltage of the power source (measured in [[w:Volt|volt]]s V) : '''I''' - the current in the circuit (measured in [[w:Ampere|ampere]]s A) : '''R''' - the [[w:Electrical_resistance|resistance]] of the resistor (measured in [[w:Ohm_(unit)|ohm]]s = V/A); : '''L''' - the [[inductance]] of the inductor (measured in [[w:Henry_(unit)|henrys]] = H = V·[[w:Second|s]]/A) : '''C''' - the [[capacitance]] of the capacitor (measured in [[w:Farad|farad]]s = F = [[w:Coulomb|C]]/V = A·s/V) |- |} The complex impedance of this circuit is given by adding up the impedances in parallel: ::<math>{1\over Z}={1\over Z_L}+{1\over Z_C}+{1\over Z_R}={1\over{j\omega L}}+{j\omega C}+{1\over R}</math> The change from a series arrangement to a parallel arrangement has some very real consequences for the behaviour. This can be seen by plotting the magnitude of the current <math>I={V\over Z}</math>. For comparison with the earlier graph we choose values where R = 1 ohm, C = 1 farad, L = 1 henry, and V = 1.0 volt and ω in radians per second: <div style="float: center; text-align: center; margin: 1em 1em 1em 1em;"><br>''Sinusoidal steady-state analysis''</div> There is a minimum in the frequency response at the resonant frequency <math>\omega_0={1\over\sqrt{LC}}</math>. A parallel RLC circuit is a example of a [[w:Band-stop|band-stop]] circuit response that can be used as a filter to block frequencies at the resonance frequency but allow others to pass. {{cleanup-remainder|date=August 2006}} A much more elegant way of recovering the circuit properties of an RLC circuit is through the use of [[w:Nondimensionalization|nondimensionalization]]. For a parallel configuration of the same components, where Φ is the magnetic flux in the system {{center top}} <math> C \frac{d^2 \Phi}{dt^2} + \frac{1}{R} \frac{d \Phi}{dt} + \frac{1}{L} \Phi = i_0 \cos(\omega t) \Rightarrow \frac{d^2 \chi}{d \tau^2} + 2 \zeta_N \frac{d \chi}{d\tau} + \chi = \cos(\Omega \tau) </math>{{center bottom}} with substitutions {{center top}} <math>\Phi = \chi x_c, \ t = \tau t_c, \ x_c = L i_0, \ t_c = \sqrt{LC}, \ 2 \zeta_N = \frac{1}{R} \sqrt{\frac{L}{C}}, \ \Omega = \omega t_c . </math>{{center bottom}} The first variable corresponds to the maximum magnetic flux stored in the circuit. The second corresponds to the period of resonant oscillations in the circuit. ==See also== *[[w:Resonant_frequency|Resonant frequency]] *[[w:Electronic_oscillator|Electronic oscillator]] *[[w:Bandwidth_%28signal_processing%29|Bandwidth (signal processing)]] *[[w:Bandpass_filter|Bandpass filter]] *[[w:Q_factor|Q factor]] *[[w:Oliver_Heaviside|Oliver Heaviside]] *[[w:RC_circuit|RC circuit]] ==External links== * [[Wikipedia:Category:Analog circuits]] * [http://www.lightandmatter.com/html_books/0sn/ch10/ch10.html a treatment that starts with the mechanical analogy] * [http://www.phy.hk/wiki/englishhtm/RLC.htm An interactive simulation on series RCL circuit] * [http://resonanceswavesandfields.blogspot.com/2007_06_01_archive.html Interactive Visual Representation of the LRC Circuit] * [http://automeasure.com/pulse.htm Pulse Response Examiner freeware (Windows)] * [https://allaboutcircuits.com All About Circuits] * [https://eepower.com EE Power] * [https://maker.pro Maker Pro] * [https://www.electronicspoint.com/ Electronics Point] [[Category:Electronics]] [[Category:Engineering]] [[Category:Physics]] [[Category:Wikipedia copies]] dh0u6klrcg1fpq4fegjpbihu8s8xoob 0 91892 2419080 2418908 2022-08-25T17:58:51Z Dave Braunschweig 426084 Reverted edits by [[Special:Contributions/102.149.28.61|102.149.28.61]] ([[User_talk:102.149.28.61|talk]]) to last version by [[User:Dave Braunschweig|Dave Braunschweig]] using [[Wikiversity:Rollback|rollback]] wikitext text/x-wiki ---- <big>'''NEW TESTAMENT'''</big> <big>'''Lesson 7'''</big> ---- ---- <p style="text-align:center;"><big>'''ACTS'''</big></p> <p style="text-align:center;"><big>'''II. The Ministry of Paul'''</big></p> ---- ---- [[File:Roman Empire in 54 AD.png|thumb|350px|The Roman Empire in the middle of the first century AD, during the time of Paul's missionary travels.]] ===='''''<big>Saul (Paul) Persecutes the Church</big>'''''==== In Chapter 9 of Acts, we come into close contact with Saul, later known as Paul, for the first time. Paul has already been briefly mentioned in Acts in Chapters 7 and 8, in connection with the stoning of Stephen. Luke writes: :They cast [Stephen] out of the city and stoned him. And the witnesses laid down their clothes at the feet of a young man whose name was Saul. And Saul was consenting to his death. And devout men carried Stephen to his burial and made great lamentation over him. As for Saul, he made havoc of the church, entering every house, and dragging off men and women, committing them to prison. (Acts 7:58, 8:1-3) Such was the unpromising introduction to Paul. No one could have foreseen that this man who was so bent on eradicating Christianity was to become one of the greatest leaders in church history. ===='''''<big>Paul’s Background</big>'''''==== Apart from Paul’s natural characteristics, there were several things in his background that contributed to his effectiveness as a missionary, evangelist and church leader. Firstly, he was born near the beginning of the first century in the city of [[w:Tarsus (city)|Tarsus]] in the province of Cilicia, which is now a part of Turkey. Tarsus was a busy Greco-Roman city at the northeast corner of the Mediterranean which was noted as a trading center and for its university. This environment provided Paul with his knowledge of the Greek language, philosophy and culture. Secondly, he was born a Roman citizen. This citizenship was to prove invaluable to him when his rights were in danger of being denied, and it probably saved his life on more than one occasion. Thirdly, having been born into a devout Jewish family, he was educated in the traditions and scriptures of Judaism. At the appropriate age, probably thirteen, he was sent to Jerusalem to study under the famous teacher Gamaliel, where he proved himself to be a superior and zealous student. ===='''''<big>Paul’s Conversion</big>'''''==== When Paul first appeared in Acts at the stoning of Stephen, he was probably about thirty years old and had already become an acknowledged leader in Judaism. Paul clearly saw Christianity as a heresy and a major threat to Judaism, and he made it his business to persecute the church wherever he found it, even in other cities. It was one such mission that led him to set out for Damascus in Syria in about 37 A.D. Luke writes, “Saul, still breathing threats and murder against the disciples of the Lord, went to the high priest and asked letters from him to the synagogues of Damascus, so that if he found any who were of the Way, whether men or women, he might bring them bound to Jerusalem” (9:1-2). Paul was completely unprepared for what was to happen to him on that journey. As he approached Damascus, a brilliant light shone around him. He then heard a voice which spoke to him the now famous words, “Saul, Saul, why are you persecuting me?” (9:4). The speaker identified himself as Jesus. Paul asked, “Lord, what do you want me to do?” (9:6), to which Jesus replied, “Arise and go into the city, and you will be told what you must do” (9:6). After this experience, he was blind for three days, and during this time he fasted. After the three days, a disciple named Ananias came and laid hands on him, and Paul received his sight and was baptized. Following his conversion, Paul immediately began to preach that Jesus was the Messiah in the synagogues in Damascus. He then went into the Arabian desert. It is not known exactly how long he was there, but it is believed that this was a time of retreat, rather than an evangelistic journey. When he returned to Damascus, the Jews, no doubt feeling betrayed, plotted to kill him, but hearing of their plot, he escaped by being let down at night from the city wall in a large basket. Paul returned to Jerusalem in about 40 A.D., but was unable to stay because of further threats to his life. He then returned to his home town of Tarsus for several years, but we do not have any definite information concerning this period. ===='''''<big>Paul Goes to Antioch</big>'''''==== Following the acceptance of non-Jews into the church after 41 A.D., Antioch in Syria began to emerge as a leading center of Christianity. Barnabas, the overseer of the church there, needed help and called on Paul to come from Tarsus to assist him. Although we know nothing of Paul’s ministry in Tarsus, it seems likely that he had already established himself as a mature Christian leader for Barnabas to request him to come to Antioch and help with the church there. Luke writes, “For a whole year they assembled with the church and taught many people. And the disciples were first called Christians in Antioch” (11:26). When the time had come for Paul to begin his missionary travels, the Holy Spirit spoke through certain “prophets and teachers” who were at Antioch, saying, “Separate to me Barnabas and Saul for the work to which I have called them” (13:2). After fasting and laying hands on the two, the disciples sent them on their way. [[w:Antioch|Antioch]] in Syria (not to be confused with [[w:Antioch, Pisidia|Antioch in Pisidia]]) was about three hundred miles north of Jerusalem, not far from the Mediterranean coast. Having a population of half a million, it was the third largest city in the Roman Empire, surpassed only by Rome and Alexandria. The city was a center for the cult of Ashtoreth, the goddess of fertility, which was noted for sexual indulgence. Nevertheless, the people accepted Christ in large numbers and Antioch also became a major center of Christianity in the middle of the first century. The word Christian was first used there, and it was the starting point of Paul’s famous missionary journeys. ===='''''<big>Paul’s First Missionary Journey</big>'''''==== The first missionary journey began in about 45 A.D. From Antioch, Barnabas and Saul traveled about sixteen miles to the coast, to the port at [[w:Seleucia Pieria|Seleucia Pieria]]. From there, they boarded a ship bound for Cyprus, which is the third largest island in the Mediterranean, being about a hundred and fifty miles long and averaging about twenty miles across. The island lay about a hundred miles southwest of Seleucia and was important for copper mines and timber. While in Paphos, the island’s capital city, Paul cursed the sorcerer Elymas with temporary blindness for obstructing the work of the Lord. This miracle caused Sergius Paulus, who as the Roman proconsul was ruler of the island, to become a believer. Up until this time, Paul is referred to as Saul, the Hebrew version of his name, but from this time forward, he is always called by the Greek version: Paul. When his work in Cyprus was completed, Paul set sail for [[w:Perga|Perga]] in Pamphylia, about a hundred and fifty miles to the northwest. The region of Pamphylia was located on the Mediterranean coast in what is today southwestern Turkey. At this point, Mark, who had accompanied Paul and Barnabas, left them and returned to Jerusalem. They then went north to another city named Antioch, in the province of Pisidia (often referred to as “Pisidian Antioch” to distinguish it from “Syrian Antioch”). The message was so well-received at Antioch that the Jewish leaders became jealous and began to obstruct them, causing them to turn from the Jews and preach to the non-Jewish population. The Jewish leaders then stirred up the leaders of the city and had Paul and Barnabas expelled from the region. Despite this opposition, Luke writes, “The word of the Lord was being spread throughout all the region” (13:49). After being expelled from this region, they continued north into [[w:Galatia|Galatia]], a Roman province in what is central Turkey today, where they preached in the cities of Iconium, Lystra and Derbe. It is probable that Paul’s letter to the Galatians was intended for the Christians in these towns. In Iconium, “the multitude of the city was divided: part sided with the Jews and part with the apostles” (14:4). After an attempt was made to stone them, they moved on to Lystra where, after Paul healed a man who had been crippled from birth, the population tried to worship them as gods. Then some of the Jews from Antioch and Iconium came and stirred up a crowd who stoned Paul and left him for dead, but he recovered and continued to Derbe. After making many disciples at Derbe, they returned to Lystra, Iconium and Antioch, encouraging the churches they had started and appointing elders over them. Then they returned to Syria, arriving back in Antioch after a journey lasting about two years. They gave account of all their experiences, causing great joy among the disciples there. ===='''''<big>Rejected by His Own People</big>'''''==== Jesus said, “A prophet is not without honor, except in his own country and in his own house" (Mt 13:57). This was certainly true in Paul’s case. In the course of his evangelistic travels, he was constantly making enemies of the Jewish communities in the cities where he preached. For various reasons, it was his policy when entering a city for the first time to go and preach the Gospel in the synagogue first. Often, his initial reception would be warm. But he was invariably rejected when envious synagogue leaders saw that his powerful and convincing teaching was resulting in many converts. Undoubtedly, one reason for Paul’s lack of popularity with the Jewish leaders was his teaching that in Jesus all could find salvation, regardless of ethnicity. Salvation, for Paul, was no longer the exclusive privilege of the Jewish nation, as it had been for so long. It now included all who were willing to come to God through faith in Christ. The coming of Jesus had marked the beginning of a new age in “salvation history.” This teaching must have seemed, to the synagogue leaders, to undermine the importance of their role as spiritual leaders, as well as the role of the Jewish nation as a whole as God’s chosen people on the Earth. ===='''''<big>The Jerusalem Council</big>'''''==== In about 50 A.D., a conflict arose when certain Jewish believers came to Antioch from Judea saying that the new non-Jewish believers must be circumcised and keep the law of Moses. This was in sharp contrast to Paul’s doctrine which stated that salvation comes only by the grace of God through faith in Christ, and that the religious observances given by Moses were no longer necessary to salvation. The age of law had been replaced by the age of grace. As a result, Paul, Barnabas, and “certain others” went to Jerusalem to resolve the matter in what has come to be known as the Jerusalem Council. At this meeting, Peter stood up and said of the non-Jewish converts, “God, who knows the heart, acknowledged them, giving them the Holy Spirit just as he did to us, and made no distinction between us and them, purifying their hearts by faith. Now, therefore, why do you test God by putting a yoke on the neck of the disciples which neither our fathers nor we were able to bear?” (15:8-10). As a result of the arguments of Peter, Paul, Barnabas, and James, it was resolved that the non-Jewish believers should be required only to “abstain from things polluted by idols, from sexual immorality, from things strangled, and from blood” (15:20) – things which were associated with the idolatrous practices of the time. ===='''''<big>Paul’s Second Missionary Journey</big>'''''==== Soon after the Jerusalem Council, Paul embarked on his second missionary journey. Luke writes, “After some days, Paul said to Barnabas, ‘Let us go back and visit our brethren in every city where we have preached the word of the Lord, and see how they are doing’” (15:36). However, there was a disagreement between the two when Barnabas decided he wanted to take Mark, because Mark had returned home before completing the first journey. As a result, Barnabas and Mark (who were cousins) traveled together, while Paul teamed up with Silas (also known by his Latin name, Sylvanus) instead. On this occasion, Paul chose to take the overland route, going north from Syrian Antioch about a hundred miles, then west into Asia Minor. Luke writes, “He went through Syria and Cilicia, strengthening the churches” (15:41). Paul’s home town of Tarsus was in Cilicia, and no doubt he stopped there on his way. Continuing west, Paul came into Galatia, where he revisited the churches at Derbe, Lystra and Iconium. At Lystra, the group was joined by Timothy. After visiting the towns of Galatia, they arrived at the coastal city of Troas on the Aegean Sea. Luke writes, “A vision appeared to Paul in the night. A man of Macedonia stood and pleaded with him, saying, ‘Come over to Macedonia and help us’” (16:9). This led him to cross the Aegean to the region of Macedonia, now in northern Greece. After a voyage of about a hundred and twenty miles, Paul and his party arrived at Neapolis ([[w:Kavala|Kavala]]) on the coast, and from there journeyed a few miles inland to [[w:Philippi|Philippi]], where the first known Christian convert was made in Europe: “Lydia, a seller of purple from the city of Thyatira” (16:14). Paul and Silas were whipped and imprisoned at Philippi after Paul cast a fortune-telling demon out of a slave girl, who, as already noted, had made much money for her master. However, Acts tells us that the Holy Spirit miraculously opened the doors of the prison in the night, and as a result, the jailer and his family were converted. After his release, Paul traveled westward to [[w:Thessalonica|Thessalonica]] where he made many converts, both Jewish and non-Jewish. Encountering opposition from the Jewish leaders, Paul continued west to [[w:Berea (Bible)|Berea]], where he ministered for a time before traveling south to Athens, which was then in the province of Achaia. Paul did not have great success in Athens, although “some men joined him and believed” (17:34). The Westminster Historical Atlas to the Bible (Westminster, 1956) says: ::In its golden age, Athens had been the center of the classical culture of ancient times. On its Acropolis stood famous masterpieces of art and architecture. In Paul’s day, Athens was less brilliant, but it was still a city to thrill any lover of culture. Objects of art abounded; interest in poetry, mythology, and philosophy continued; tradition was rich. While in Achaia, Paul also spent time at [[w:Corinth|Corinth]], fifty miles west of Athens. Corinth was the political and commercial center of Achaia. It was also famous for a huge temple dedicated to the goddess of love which was situated on the Acrocorinth, a nearby mountain. Paul met with great success there, even being able to convert Crispus, a leader in the Jewish community, together with his household. Luke writes, “He continued there a year and six months, teaching the word of God among them” (18:11). After Corinth, Paul set his sights toward home. Wishing to attend the coming festival in Jerusalem, he boarded a ship and sailed to Caesarea on the Mediterranean coast of Palestine, then continued overland to Jerusalem. After the festival, he returned to Syrian Antioch, arriving in about 52 A.D. He had traveled over three thousand miles, an incredibly large distance in those days. ===='''''<big>Paul’s Third Missionary Journey</big>'''''==== After only a short stay in Antioch, Paul departed on his third missionary journey, which began in about 53 A.D. Luke writes, “He departed and went over all the region of Galatia and [[w:Phrygia|Phrygia]] in order, strengthening all the disciples” (18:23). After revisiting the churches that he had founded on his previous journeys, Paul continued on to [[w:Ephesus|Ephesus]], where he remained for nearly three years. The time he spent there was the high point of the third missionary journey. He taught extensively in and around Ephesus and his ministry was accompanied by extraordinary miracles. Unfortunately, a silversmith named Demetrius who had a business making idols saw a serious threat in Paul, who was turning people away from idol worship in large numbers. He stirred up others of his trade and together they incited the people to riot. Although the riot ended without any harm to Paul or the other disciples, it became necessary for Paul to leave Ephesus. Nevertheless, the work there had been extremely successful. Acts tells us that during this period, “All who dwelt in [the province of] Asia heard the word of the Lord Jesus, both Jews and Greeks” (19:10). After Ephesus, Paul continued westward into Macedonia and Achaia (now in Greece), where he revisited the cities where he had ministered on his second journey. He met with sufficient success to warrant spending three months there, most of it probably in Corinth. While there, he made plans for his final visit to Jerusalem. Paul finally left Greece after discovering a plot by the Jewish leaders to kill him. After he left Greece, Paul returned to the province of Asia, where he sojourned in the city of [[w:Alexandria Troas|Troas]] on the Aegean coast. He stunned everybody there when he miraculously raised a young man named Eutychus back to life. Eutychus had fallen from a third storey window while listening to Paul preach. From Troas, he traveled overland to nearby [[w:Assos|Assos]], where he boarded a ship bound for Jerusalem. The ship made several stops and among them was [[w:Miletus|Miletus]], which was near enough to Ephesus for Paul to make contact with the elders of that church, who he exhorted to continue steadfastly in the work which he had started. Luke writes, “They all wept greatly, and fell on Paul’s neck and kissed him, sorrowing most of all for the words which he spoke, that they would see his face no more” (20:37 38). Paul knew that he would be arrested in Jerusalem, for he had told them, “I go bound in the Spirit to Jerusalem, not knowing the things that will happen to me there, except that the Holy Spirit testifies in every city, saying that chains and tribulations await me” (20:23). ===='''''<big>Paul is Arrested</big>'''''==== In about 58 AD, at the end of his third missionary journey, Paul arrived in Jerusalem for the purpose of observing the Feast of Pentecost. He had not been there many days when some of the people who had come from the province of Asia for the festival stirred up the crowd against him and he was arrested in the temple grounds. He was accused of turning people against Judaism and of defiling the temple by bringing a person into it who was not Jewish, a charge for which there was apparently no basis. As a result, an unruly crowd tried to kill Paul, but he was rescued by Roman soldiers and taken into custody. The next day he was brought before the Sanhedrin (the ruling body of the Jewish people in Palestine). However, they could not agree among themselves concerning the charges, so the commander took Paul back to the barracks. The following night, Paul had a vision of Jesus standing by him and saying, “Be cheerful, Paul, for as you have testified for me in Jerusalem, so you must bear witness also at Rome” (23:11). Hearing of a plot to kill Paul, the military commander sent him away with a heavy escort to Felix, the Roman governor, who lived in Caesarea on the coast. When Ananias, the high priest, came down from Jerusalem with the elders, Paul defended himself eloquently before both them and Felix. Finding nothing substantial in the charges against him, Felix refused to condemn Paul to death, but not wanting to antagonize the Jewish leadership, he kept him in custody. Paul was to remain imprisoned in Caesarea for two years. Nevertheless, Acts tells us that Felix “commanded a centurion to keep Paul and to let him have liberty, and told him not to forbid any of his friends to provide for or visit him” (24:23). ===='''''<big>Caesarea</big>'''''==== Caesarea was a cosmopolitan city whose prevailing culture was Greco-Roman, rather than Jewish. It was the Roman administrative capital of Palestine and, as already mentioned, had the distinction of being the first place where non-Jewish converts were accepted into the church. It was developed by King Herod the Great to honor the Roman emperor Caesar Augustus, and inaugurated in 10 B.C. It was the site of Palestine’s most important seaport, and ships from there made connections with all parts of the empire. Among the many fine buildings were the governor’s palace and an amphitheater which was larger than the Colosseum in Rome, and in which gladiators spilled their blood in exciting tournaments for the entertainment of the people. ===='''''<big>Paul Appeals to Caesar</big>'''''==== After two years, a new governor, Festus, replaced Felix. Wanting to please the Jewish leadership, Festus was ready to send Paul back to Jerusalem, but knowing that this would mean certain death, Paul availed himself of his right as a Roman citizen and “appealed to Caesar.” By law, this required that Festus send him for trial in Rome. Several days later, King Herod Agrippa II, great-grandson of Herod the Great, was in Caesarea with his sister Bernice, so Festus invited them to come and hear Paul speak. Paul gave an account of his life as a Pharisee and his conversion and subsequent efforts to spread the Gospel. Agrippa was so impressed that he told Paul, “You almost persuade me to become a Christian” (26:28). Then, speaking aside to Bernice and Festus, Agrippa said, “This man might have been set free if he had not appealed to Caesar” (26:32). This was now the second occasion when Paul’s Roman citizenship had come to his aid. The first was when he was arrested in Jerusalem. The Roman commander had ordered that Paul be “examined under scourging”, i.e. that he be questioned with a few lashes of a whip to help him talk. As he was being bound, Paul asked, “Is it lawful for you to scourge a man who is a Roman, and uncondemned?” (22:25). When the commander found out that Paul was a Roman, he was afraid of the potential consequences of what he had done and immediately ordered that Paul be unbound. This is the same commander who, hearing of a plot to kill Paul, sent him under protection of a heavy guard to the governor at Caesarea, where his enemies would not be able to harm him. Clearly, there was one law for citizens and another for non-citizens. It is unlikely that Paul would have been given continued protection if he had not been a Roman citizen. ===='''''<big>Paul Goes to Rome</big>'''''==== Probably in 60 A.D., Paul began his voyage to Rome. On the way, the ship ran into a storm and was shipwrecked on the island of Malta, which lies in the Mediterranean about sixty miles south of Sicily. They decided to stay there for the winter, and while there, Paul healed many sick and disabled people. After three months, they continued in another ship to [[w:Puteoli|Puteoli]], on the west coast of Italy, completing the journey to Rome overland. In Rome, Paul seems to have had a relatively comfortable existence for one who was a prisoner, being allowed to live in his own rented house (with a soldier guarding him), and being able to receive visitors freely. It was during this time that he wrote the “Prison Epistles”: Colossians, Philemon, Ephesians, and Philippians. While the next few years are somewhat vague, it is generally believed that Paul was released from custody after two years, because Acts ends by saying, “Paul dwelt two years in his own rented house” (28:30). After this time, it is likely that he revisited the churches in Greece and Asia Minor. He may also have gone to Spain, as he had previously indicated a desire to do so. Several years later, Paul fell victim to a great persecution of Christians which arose in 64 A.D. after much of Rome burned in a devastating fire. The Christian community, which was thought by many to be an unusual and somewhat strange sect, was a convenient scapegoat. Christians were ostracized, tortured, and murdered in barbaric ways. During this time of persecution, Paul was imprisoned in Rome and finally beheaded in about 66 A.D. His last remaining words were written from his prison cell and are preserved in his second epistle to Timothy. In it, there are surprisingly no words of condemnation for the emperor or for the Roman political system by which he was imprisoned and soon to be executed. He merely writes: “Do not be ashamed of the testimony of our Lord, nor of me his prisoner, but share with me in the sufferings for the Gospel according to the power of God” (2 Tim 1:8). ===='''''<big>The Roman Empire and Church Growth</big>'''''==== Notwithstanding the persecution mentioned above, Rome had a great deal to do with the establishment of the early churches. Roman forces had united all of the lands surrounding the Mediterranean under one government. Travel, communication, and trade flourished between these numerous provinces. Overland travel was made possible by the vast network of quality roads that the Romans built, and the empire was made safe by the Roman military forces, which for the most part ensured that law and order prevailed everywhere. The sea-routes were safe also, for the entire Mediterranean coast was ruled by Rome and there were no enemy ships to worry about. This provided an ideal setting for the spread of the Gospel. Paul and the other apostles were able to travel freely, establishing churches throughout Palestine, Syria, Asia Minor, Greece and even in Rome itself. Another by-product of the unity of the empire was that the Jews had been able to establish synagogues in most major cities, and Paul generally preached in the synagogue on arrival in a town where the Gospel had not been previously taught. As a well-educated Pharisee with an expert knowledge of the scriptures, he was always welcome to speak, though he was usually rejected by the synagogues once he began to make converts. Nevertheless, the overall political environment created by the empire, itself a pagan institution, created an ideal field for evangelization. ===='''''<big>An "Unexcelled Missionary Statesman"</big>'''''==== Paul’s life has been an inspiration to people for two thousand years. According to the ''Zondervan Pictorial Bible Dictionary'' (Zondervan, 1967): “Paul’s achievements proclaim him as an unexcelled missionary statesman. His epistolary writings, formulating, interpreting, and applying the essence of Christianity, are vital to Christian theology and practice. He grasped truth at its full value and logically worked out its implications. Having understood his duty, he followed it unflinchingly, undeterred by possible consequences to himself.” ---- ===='''''<big>Test Your Knowledge</big>'''''==== ---- <quiz display=simple> { What form did Paul’s first contact with Christianity take? |type="()"} -He advocated the cause of Christians among the Jewish leadership -He helped find sources of funding for the Christians +He persecuted and imprisoned Christians -a and b { Which of the following are true of Paul? |type="()"} -He was born in the city of Tarsus, in the region of Cilicia (in Turkey today). -He was a devout Jew and a Roman citizen. -At the age of 13, Paul was sent to study in Jerusalem with the great Jewish scholar, Gamaliel. +All of the above. { What eventually caused Paul to change his mind about Christianity? |type="()"} -He had a meeting with Peter in Jerusalem and was impressed with his message. +On the road to Damascus, he had a vision of Jesus. -He felt betrayed by his Jewish friends. -He felt ready for a new direction in his life. { Which city was the starting point for Paul’s missionary journeys? |type="()"} +Antioch (in Syria) -Antioch (in Pisidia) -Jerusalem -Caesarea { On Paul’s first missionary journey, from whom did he experience the greatest opposition? |type="()"} +The Jews -The Romans -The Greeks -All of the above { What was the central issue of the Jerusalem Council in about 50 AD? |type="()"} -Malicious gossip among church members. -Widows and orphans were being neglected in the charitable work of the church. +Whether non-Jewish converts should be required to observe the laws of Moses, especially circumcision. -Whether church leaders should be permitted to marry. { On Paul’s second missionary journey, what led him to cross unexpectedly from Asia Minor over to Greece? |type="()"} -He decided he would like to see Athens -He was being pursued by the police -He was offered a large sum of money if he would go to Greece +He had a vision at Troas, in Asia Minor { Which of the following happened on Paul’s third missionary journey? |type="()"} -The idol makers at Ephesus had Paul expelled from the city because they were losing business as a result of his teachings. -He revisited the communities of his first two journeys for the purpose of strengthening the disciples and continuing the momentum which had been established. -He miraculously raised a man to life who had been killed by falling from a third storey window. +All of the above. { After Paul’s arrest in Jerusalem, the Roman governor, Felix, decided there was no basis for the charges against him. Why, then, did he not set him free? |type="()"} -He personally disliked Paul. +He did not want to antagonize the Jewish leadership. -He was motivated by anti-semitism. -All of the above. { After his arrest in Jerusalem, Paul remained imprisoned, though with considerable liberty, in Caesarea for two years. Which of the following is true of Caesarea? |type="()"} -It was the Roman administrative capital of Palestine. -The prevailing culture was Greco-Roman. -It was the site of many impressive buildings and an important seaport. +All of the above. { Why did Paul leave Caesarea and go to Rome? |type="()"} -Festus, the new governor, wanted to get him out of his way. -Paul had escaped from prison and needed to get as far away as possible. +Paul appealed to Caesar, which under Roman law meant that he must be tried in Rome. -None of the above. { Paul was executed during a persecution of Christians by Emperor Nero after the Great Fire of Rome. In approximately which year was he executed? |type="()"} -29 AD -50 AD +66 AD -95 AD { Apart from the occasional persecutions, why did the Roman Empire provide an ideal setting for the growth of Christianity? |type="()"} -It had a good infrastructure (roads, shipping, etc) -It was generally tolerant with regard to various religious practices -Law and order were strictly enforced throughout the empire by the Roman army. +All of the above { In addition to his inestimable contribution to the spread of Christianity, what influential legacy did Paul leave to the world? |type="()"} +A collection of brilliant theological writings -A book of church by-laws -A book of prayer -An award-winning novel </quiz> {| class="messagebox" id="practicum" align="center" style="text-align:center;background-color: CornSilk;" |- |Read the following passages in Acts: Chapter 19 21:15 to 23:10 25:1-12 28:16-30 |} Next lesson: [http://en.wikiversity.org/wiki/Biblical_Studies_(NT)/The_Epistles_of_Paul:_Saved_by_Grace] Home Page:[http://en.wikiversity.org/wiki/Biblical_Studies_(NT)] {{subpage navbar}} [[Category:Biblical studies]] 3d6k3mr8i9igf37pbi60mwswkybyr8f 0 126925 2419438 2399200 2022-08-26T09:23:38Z Marshallsumter 311529 wikitext text/x-wiki [[Image:Aurore australe - Aurora australis.jpg|thumb|right|300px|Auroras are mostly caused by energetic electrons precipitating into the atmosphere.<ref name=Wolpert>{{ cite web | author = S. Wolpert | date = July 24, 2008 | title = Scientists solve 30-year-old aurora borealis mystery | url = http://www.universityofcalifornia.edu/news/article/18277 | publisher = University of California | accessdate = 2008-10-11 }}</ref> Credit: [[c:User:Ehquionest|Samuel Blanc]][http://www.sblanc.com/].{{tlx|free media}}]] Although '''electron astronomy''' is usually not recognized as a formal branch of astronomy, the measurement of electron fluxes helps to understand a variety of natural phenomena. ""[E]lectron astronomy" has an interesting future".<ref name=Hudson/> {{clear}} ==Astronomy== {{main|Radiation astronomy/Astronomy}} [[Image:Upperatmoslight1.jpg|thumb|right|250px|The composite shows upper atmospheric lightning and electrical discharge phenomena. Credit: [[c:User:Abestrobi|Abestrobi]].{{tlx|free media}}]] With respect to the rocky-object Earth, between the surface and various altitudes there is an electric field induced by the ionosphere. It changes with altitude from about 150 [[w:volt|volt]]s per [[w:meter|meter]] at the suface to lower values at higher altitude. In fair weather, it is relatively constant, in turbulent weather it is accompanied by [[w:Ion|ion]]s. At greater altitude these chemical species continue to increase in [[w:concentration|concentration]]. To dissipate the accumulation of greater charge differential between the surface and the ionosphere, the gases between suffer breakdown (ionization) that permits [[lightning]] to be either a draw of negative charge, usually electrons, upward from the surface or a transfer of positive charge to the ground. {{clear}} ==Radiation== {{main|Radiation}} [[Image:PIA22566-VoyagerProgram&Heliosphere-Chart-20181003.jpg|thumb|left|250px|This graphic shows the position of the Voyager 1 and Voyager 2 probes, relative to the heliosphere. Credit: NASA/JPL-Caltech.{{tlx|free media}}]] [[Image:Voyager1-rate-of-paticles.jpg|thumb|right|250px|Chronology, from July to October 2012, of the rate of particles with energy greater than 0.5 MeV received by the Voyager 1 probe, marks its exit from the heliosphere. Credit: NASA.{{tlx|free media}}]] '''Def.''' "the non-linear scattering of radiation off electrons" is called '''induced Compton scattering'''.<ref name=Wilson>{{ cite journal |author=D. B. Wilson |author2=M. J. Rees |title=Induced Compton scattering in pulsar winds |journal=Monthly Notices of the Royal Astronomical Society |month=October |year=1978 |volume=185 |issue=10 |pages=297-304 |url= |arxiv= |bibcode=1978MNRAS.185..297W |doi= |pmid= |accessdate=2012-03-08 }}</ref> "The effect of scattering is to move photons to lower frequencies."<ref name=Wilson/> "[T]he fact that the radio pulses [from a pulsar] are not suppressed by induced scattering suggests that the wind's Lorentz factor exceeds ~10⁴.<ref name=Wilson/> The Lorentz factor is defined as:<ref name=Forshaw>Dynamics and Relativity, J.R. Forshaw, A.G. Smith, Wiley, 2009, {{ISBN|978 0 470 01460 8}}</ref> :<math>\gamma = \frac{1}{\sqrt{1 - v^2/c^2}} = \frac{1}{\sqrt{1 - \beta^2}} = \frac{\mathrm{d}t}{\mathrm{d}\tau} </math> where: * ''v'' is the relative velocity between inertial reference frames, * &beta; is the ratio of ''v'' to the speed of light ''c''. * ''&tau;'' is the proper time for an observer (measuring time intervals in the observer's own frame), * ''c'' is the ''speed of light''. As an example, "[t]he power into the Crab Nebula is apparently supplied by an outflow [wind] of ~10³⁸ erg/s from the pulsar"<ref name=Wilson/> where there are "electrons (and positrons) in such a wind"<ref name=Wilson/>. These beta particles coming out of the pulsar are moving very close to light speed. {{clear}} ==Electrons== {{main|Charges/Interactions}} [[Image:Nuclear particle in a diffusion cloud chamber.png|thumb|right|250px|This rare picture show the 4 type of charged particles that we can detect in a cloud chamber : alpha, proton, electron and muons (probably). Credit: [[c:User:Mauswiesel|Cloudylabs]].{{tlx|free media}}]] The electron is a subatomic particle with a negative charge, equal to -1.60217646x10^-19 [[w:coulomb|''C'']]. Current, or the rate of flow of charge, is defined such that one coulomb, so 1/-1.60217646x10^-19, or 6.24150974x10¹⁸ electrons flowing past a point per second give a current of one [[w:ampere|ampere]]. The charge on an electron is often given as ''-e''. Note that charge is always considered positive, so the charge of an electron is always negative. The electron has a mass of 9.10938188x10^-31 ''kg'', or about 1/1840 that of a proton. The mass of an electron is often written as ''m_e''. When working, these values can usually be safely approximated to: ::''-e'' = -1.60x10^-19 ''C'' ::''m_e'' = 9.11x10^-31''kg'' It has no known components or substructure; in other words, it is generally thought to be an [[w:elementary particle|elementary particle]].<ref name=Eichten>{{ cite journal | author = E.J. Eichten |author2=M.E. Peskin |author3=M. Peskin | year = 1983 | title = New Tests for Quark and Lepton Substructure | journal = Physical Review Letters | volume = 50 | pages = 811–814 | issue = 11 | doi = 10.1103/PhysRevLett.50.811 | bibcode=1983PhRvL..50..811E }}</ref><ref name=Gabrielse>{{ cite journal | author = G. Gabrielse ''et al.'' | year = 2006 | title = New Determination of the Fine Structure Constant from the Electron ''g'' Value and QED | journal = Physical Review Letters | volume = 97 | pages = 030802(1–4) | doi = 10.1103/PhysRevLett.97.030802 | bibcode=2006PhRvL..97c0802G | issue = 3 }}</ref> The intrinsic [[w:angular momentum|angular momentum]] ([[w:spin (physics)|spin]]) of the electron is a half-integer value in units of [[w:reduced Planck constant|''ħ'']], which means that it is a [[w:fermion|fermion]]. As of December 5, 2011, "Voyager 1 is about ... 18 billion kilometers ... from the [S]un [but] the direction of the magnetic field lines has not changed, indicating Voyager is still within the heliosphere ... the outward speed of the solar wind had diminished to zero in April 2010 ... inward pressure from interstellar space is compacting [the magnetic field] ... Voyager has detected a 100-fold increase in the intensity of high-energy electrons from elsewhere in the galaxy diffusing into our solar system from outside ... [while] the [solar] wind even blows back at us."<ref name=Cole>{{ cite book |author=Steve Cole |author2=Jia-Rui C. Cook |author3=Alan Buis |title=NASA's Voyager Hits New Region at Solar System Edge |publisher=NASA |location=Washington, DC |date=December 2011 |url=http://www.nasa.gov/home/hqnews/2011/dec/HQ_11-402_AGU_Voyager.html |accessdate=2012-02-09 }}</ref> {{clear}} ==Delta rays== [[Image:Delta electron.png|thumb|right|250px|Delta electron is knocked out by a 180 GeV muon at the SPS at CERN. Credit: [[c:user:Wilcokoppert|Wilcokoppert]].{{tlx|free media}}]] A '''delta ray''' is characterized by very fast [[w:electron|electron]]s produced in quantity by [[w:alpha particles|alpha particles]] or other fast energetic charged particles knocking orbiting electrons out of [[w:atoms|atoms]]. Collectively, these electrons are defined as delta radiation when they have sufficient energy to ionize further atoms through subsequent interactions on their own. "The conventional procedure of delta-ray counting to measure charge (Powell, Fowler, and Perkins 1959), which was limited to resolution sigma_z = 1-2 because of uncertainties of the criterion of delta-ray ranges, has been significantly improved by the application of delta-ray range distribution measurements for ¹⁶O and ³²S data of 200 GeV per nucleon (Takahashi 1988; Parnell ''et al.'' 1989)."<ref name=Burnett>{{ cite journal |author=T. H. Burnett ''et al.'' |author2=The JACEE Collaboration |title=Energy spectra of cosmic rays above 1 TeV per nucleon |journal=The Astrophysical Journal |month=January |year=1990 |volume=349 |issue=1 |pages=L25-8 |url=http://adsabs.harvard.edu/cgi-bin/nph-data_query?bibcode=1990ApJ...349L..25B&link_type=GIF&db_key=AST |arxiv= |bibcode=1990ApJ...349L..25B |doi=10.1086/185642 |pmid= |pdf=http://adsabs.harvard.edu/cgi-bin/nph-data_query?bibcode=1990ApJ...349L..25B&link_type=ARTICLE&db_key=AST&high= |accessdate=2011-11-25 }}</ref> Here, the delta-ray tracks in emulsion chambers have been used for "[d]irect measurements of cosmic-ray nuclei above 1 TeV/nucleon ... in a series of balloon-borne experiments".<ref name=Burnett/> {{clear}} ==Epsilon rays== '''Epsilon radiation''' is [[w:Tertiary Radiation|tertiary radiation]] caused by [[w:secondary radiation|secondary radiation]] (''e.g.'', delta radiation). Epsilon rays are a form of [[w:particle radiation|particle radiation]] and are composed of electrons. The term is very rarely used today. ==Antimatter== '''Def.''' an elementary subatomic particle which forms matter is called a '''quark'''. '''Note:''' quarks are never found alone in nature. '''Def.''' the smallest possible, and therefore indivisible, unit of a given quantity or quantifiable phenomenon is called the '''quantum'''. '''Def.''' one of certain integers or half-integers that specify the state of a quantum mechanical system is called a '''quantum number'''. '''Def.''' a quantum number that depends upon the relative number of strange quarks and anti-strange quarks is called '''strangeness'''. '''Def.''' symmetry of interactions under spatial inversion is called '''parity'''. '''Def.''' "the quantity of [unbalanced]<ref name=ElectricChargeWikt1/> positive or negative ions in or on an object;<ref name=ElectricChargeWikt>{{ cite web |author=[[wikt:User:Cem BSEE|Cem BSEE]] |title=electric charge |publisher=Wikimedia Foundation, Inc |location=San Francisco, California |date=19 December 2006 |url=https://en.wiktionary.org/wiki/electric_charge |accessdate=2015-08-08 }}</ref> measured in coulombs"<ref name=ElectricChargeWikt1>{{ cite web |author=[[wikt:User:SemperBlotto|SemperBlotto]] |title=electric charge |publisher=Wikimedia Foundation, Inc |location=San Francisco, California |date=21 January 2007 |url=https://en.wiktionary.org/wiki/electric_charge |accessdate=2015-08-08 }}</ref> or "a quantum number of some subatomic particles which determines their electromagnetic interactions"<ref name=ElectricChargeWikt2>{{ cite web |author=[[wikt:User:SemperBlotto|SemperBlotto]] |title=electric charge |publisher=Wikimedia Foundation, Inc |location=San Francisco, California |date=13 August 2005 |url=https://en.wiktionary.org/wiki/electric_charge |accessdate=2015-08-08 }}</ref> is called an '''electric charge'''. '''Def.''' the mean duration of the life of someone or something is called the '''mean lifetime'''. '''Def.''' a quantum angular momentum associated with subatomic particles, which also creates a magnetic moment is called a '''spin'''. '''Def.''' the "quantity of matter which a body contains, irrespective of its bulk or volume"<ref name=MassWikt>{{ cite web |author=[[wikt:User:Eclecticology|Eclecticology]] |title=mass |publisher=Wikimedia Foundation, Inc |location=San Francisco, California |date=12 September 2003 |url=http://en.wiktionary.org/wiki/mass |accessdate=2013-08-12 }}</ref> or a "quantity of matter cohering together so as to make one body, or an aggregation of particles or things which collectively make one body or quantity"<ref name=MassWikt1>{{ cite web |author=[[wikt:User:Emperorbma|Emperorbma]] |title=mass |publisher=Wikimedia Foundation, Inc |location=San Francisco, California |date=14 November 2003 |url=https://en.wiktionary.org/wiki/mass |accessdate=2014-02-28 }}</ref> is called '''mass''', or a '''mass'''. '''Def.''' a subatomic particle corresponding to another particle with the same mass, spin and mean lifetime but with charge, parity, strangeness and other quantum numbers flipped in sign is called an '''antiparticle'''. '''Def.''' matter that is composed of antiparticles of those that constitute normal matter is called '''antimatter'''. A positron differs from a quark by its lack of [[strong interaction]]. '''Def.''' "[t]he antimatter equivalent of an electron,<ref name=PositronWikt>{{ cite web |author=[[wikt:User:Fonzy~enwiktionary|Fonzy~enwiktionary]] |title=positron |publisher=Wikimedia Foundation, Inc |location=San Francisco, California |date=17 May 2003 |url=http://en.wiktionary.org/wiki/positron |accessdate=2012-07-12 }}</ref> having the same mass but a positive charge"<ref name=PositronWikt1>{{ cite web |author=[[wikt:User:SemperBlotto|SemperBlotto]] |title=positron |publisher=Wikimedia Foundation, Inc |location=San Francisco, California |date=14 June 2005 |url=http://en.wiktionary.org/wiki/positron |accessdate=2012-07-12 }}</ref> is called a '''positron'''. ==Nuclear transmutations== {{main|Radiation astronomy/Transmutations}} [[Image:Table isotopes en.svg|thumb|right|250px|This graph shows positron emissions, among others, from nuclear transmutation. Credit: [[c:user:Napy1kenobi|Napy1kenobi]].]] If the proton and neutron are part of an [[w:atomic nucleus|atomic nucleus]], these decay processes [[w:Nuclear transmutation|transmute]] one chemical element into another. For example: :<math> ^A_ZN \rightarrow ~ ^{~~~A}_{Z-1}N' + e^+ + \nu_e, </math> where A = 22, Z = 11, ''N'' = Na, ''Z''-1 = 10, and ''N''' = Ne. Beta decay does not change the number of [[w:nucleon|nucleon]]s, ''A'', in the nucleus but changes only its [[w:electric charge|charge]], ''Z''. Thus the set of all [[w:nuclide|nuclide]]s with the same ''A'' can be introduced; these [[w:isobar (nuclide)|''isobaric'' nuclides]] may turn into each other via beta decay. Among them, several nuclides (at least one) are beta stable, because they present local minima of the [[w:mass excess|mass excess]]: if such a nucleus has (''A'', ''Z'') numbers, the neighbour nuclei (''A'', ''Z''&minus;1) and (''A'', ''Z''+1) have higher mass excess and can beta decay into (''A'', ''Z''), but not vice versa. For all odd mass numbers ''A'' the global minimum is also the unique local minimum. For even ''A'', there are up to three different beta-stable isobars experimentally known. There are about 355 known [[w:beta-decay stable isobars|beta-decay stable nuclides]] total. {{clear}} ==Radioactivity== {{main|Radioactivity}} [[Image:Radioactivity of a Thorite mineral seen in a cloud chamber.jpg|thumb|right|250px|Radioactivity of a Thorite mineral is seen in a cloud chamber Credit: [[c:User:Mauswiesel|Cloudylabs]].{{tlx|free media}}]] In {{SubatomicParticle|Beta+}} decay, or "positron emission", the weak interaction converts a nucleus into its next-lower neighbor on the periodic table while emitting an positron ({{SubatomicParticle|Positron}}) and an electron neutrino ({{SubatomicParticle|Electron neutrino}}): :<math> ^A_ZN \rightarrow ~ ^{~~~A}_{Z-1}N' + e^+ + \nu_e. </math> {{SubatomicParticle|Beta+}} decay cannot occur in an isolated proton because it requires energy due to the [[mass]] of the neutron being greater than the mass of the proton. {{SubatomicParticle|Beta+}} decay can only happen inside nuclei when the value of the [[w:binding energy|binding energy]] of the mother nucleus is less than that of the daughter nucleus. The difference between these energies goes into the reaction of converting a proton into a neutron, a positron and a neutrino and into the kinetic energy of these particles. ''Positron emission''' or '''beta plus decay''' ([[w:Beta particle|β⁺]] decay) is a type of [[beta decay]] in which a [[w:proton|proton]] is converted, via the [[w:weak force|weak force]], to a [[w:neutron|neutron]], releasing a positron and a [[w:neutrino|neutrino]]. [[w:Isotope|Isotope]]s which undergo this decay and thereby emit positrons include [[w:carbon-11|carbon-11]], [[w:Isotopes of potassium|potassium-40]], [[w:nitrogen-13|nitrogen-13]], [[w:Isotopes of oxygen|oxygen-15]], [[w:fluorine-18|fluorine-18]], and [[w:Isotopes of iodine|iodine-121]]. As an example, the following equation describes the beta plus decay of carbon-11 to [[w:boron|boron]]-11, emitting a positron and a neutrino: :<math> ^{11}_{6}C \rightarrow ~ ^{11}_{5}B + e^+ + \nu_e + \gamma {(0.96 MeV)}. </math> {{clear}} ==Annihilations== [[Image:Annihilation.png|thumb|right|250px|Naturally occurring electron-positron annihilation is a result of beta plus decay. Credit: Jens Maus.{{tlx|free media}}]] [[Image:Annihilation Radiation.JPG|thumb|right|250px|A Germanium detector spectrum shows the annihilation radiation peak (under the arrow). Note the width of the peak compared to the other gamma rays visible in the spectrum. Credit: [[w:user:Hidesert|Hidesert]].{{tlx|free media}}]] The '''positron''' or '''antielectron''' is the [[w:antiparticle|antiparticle]] or the antimatter counterpart of the electron. The positron has an [[w:electric charge|electric charge]] of +1e, a [[w:spin (physics)|spin]] of ½, and has the same mass as an electron. When a low-energy positron collides with a low-energy electron, [[w:annihilation|annihilation]] occurs, resulting in the production of two or more [[w:gamma ray|gamma ray]] [[w:photon|photon]]s. '''Def.''' the process of a [[wikt:particle|particle]] and its corresponding [[wikt:antiparticle|antiparticle]] combining to produce energy is called '''annihilation'''. The figure at right shows a positron (e⁺) emitted from an atomic nucleus together with a [[wikt:neutrino|neutrino]] (v). Subsequently, the positron moves randomly through the surrounding matter where it hits several different electrons (e^-) until it finally loses enough energy that it interacts with a single electron. This process is called an "annihilation" and results in two diametrically emitted photons with a typical energy of 511 keV each. Under normal circumstances the photons are not emitted exactly diametrically (180 degrees). This is due to the remaining energy of the positron having conservation of momentum. '''Electron–positron annihilation''' occurs when an [[electron]] ({{SubatomicParticle|Electron}}) and a [[w:positron|positron]] ({{SubatomicParticle|Positron}}, the electron's [[w:antiparticle|antiparticle]]) collide. The result of the collision is the [[w:annihilation|annihilation]] of the electron and positron, and the creation of [[w:gamma ray|gamma ray]] [[w:photon|photon]]s or, at higher energies, other particles: :{{SubatomicParticle|Electron}}&nbsp;+&nbsp;{{SubatomicParticle|Positron}}&nbsp;&rarr;&nbsp;{{SubatomicParticle|Photon}}&nbsp;+&nbsp;{{SubatomicParticle|Photon}} The process [does] satisfy a number of [[w:conservation law|conservation law]]s, including: * Conservation of electric charge. The net [[w:electric charge|charge]] before and after is zero. * Conservation of [[w:momentum|linear momentum]] and total [[w:energy|energy]]. This forbids the creation of a single gamma ray. However, in [[w:quantum field theory|quantum field theory]] this process is [described]; see [[w:Annihilation#Examples of annihilation|examples of annihilation]]. * Conservation of [[w:angular momentum|angular momentum]]. As with any two charged objects, electrons and positrons may also interact with each other without annihilating, in general by [[w:elastic scattering|elastic scattering]]. The creation of only one photon can occur for tightly bound atomic electrons.<ref name=Sodickson>{{ cite journal |author=L. Sodickson |author2=W. Bowman |author3=J. Stephenson |author4=R. Weinstein |year=1960 |title=Single-Quantum Annihilation of Positrons |journal=Physical Review |volume=124 |pages=1851 |doi=10.1103/PhysRev.124.1851 |bibcode = 1961PhRv..124.1851S }}</ref> In the most common case, two photons are created, each with energy equal to the rest energy of the electron or positron (511 keV).<ref name=Atwood>{{cite journal |author=W.B. Atwood |author2=P.F. Michelson |author3=S.Ritz |year=2008 |title=Una Ventana Abierta a los Confines del Universo |journal=Investigación y Ciencia |volume=377 |pages=24–31 |doi= }}</ref> It is also common for three to be created, since in some angular momentum states, this is necessary to conserve C parity.<ref name=Griffiths>{{cite book |author=D.J. Griffiths |date=1987 |title=Introduction to Elementary Particles |publisher=John Wiley & Sons |isbn=0-471-60386-4 }}</ref> Any larger number of photons [can be created], but the probability becomes lower with each additional photon. When either the electron or positron, or both, have appreciable [[w:kinetic energy|kinetic energies]], other heavier particles can also be produced (such as [[w:D meson|D meson]]s), since there is enough kinetic energy in the relative velocities to provide the [[w:rest energy|rest energies]] of those particles. Photons and other light particles may be produced, but they will emerge with higher energies. At energies near and beyond the mass of the carriers of the [[w:weak interaction|weak force]], the [[w:W and Z bosons|W and Z bosons]], the strength of the weak force becomes comparable with [[w:electromagnetism|electromagnetism]].<ref name=Griffiths/> It becomes much easier to produce particles such as neutrinos that interact only weakly. The heaviest particle pairs yet produced by electron–positron annihilation are [[w:W boson|{{SubatomicParticle|W boson+}}–{{SubatomicParticle|W boson-}}]] pairs. The heaviest single particle is the [[w:Z boson|Z boson]]. Annihilation radiation is not monoenergetic, unlike gamma rays produced by [[w:radioactive decay|radioactive decay]]. The production mechanism of annihilation radiation introduces [[w:Doppler broadening|Doppler broadening]].<ref name=Gilmore>Gilmore, G., and Hemmingway, J.: "Practical Gamma Ray Spectrometry", page 13. John Wiley & Sons Ltd., 1995</ref> The annihilation peak produced in a gamma spectrum by annihilation radiation therefore has a higher [[w:full width at half maximum|full width at half maximum]] (FWHM) than other gamma rays in [the] spectrum. The difference is more apparent with high resolution detectors, such as [[w:Germanium|Germanium]] detectors, than with low resolution detectors such as [[w:Sodium iodide|Sodium iodide]]. Because of their well-defined energy (511 keV) and characteristic, Doppler-broadened shape, annihilation radiation can often be useful in defining the energy calibration of a gamma ray spectrum. ==Pair production== The reverse reaction, electron–positron creation, is a form of [[w:pair production|pair production]] governed by [[w:Two-photon physics|two-photon physics]]. '''Two-photon physics''', also called '''gamma-gamma physics''', [studies] the interactions between two photons. If the energy in the center of mass system of the two photons is large enough, matter can be created.<ref name=Moffat>{{ cite journal |author=Moffat JW |title=Superluminary Universe: A Possible Solution to the Initial Value Problem in Cosmology |journal=Intl J Mod Phys D |month= |year=1993 |volume=2 |issue=3 |pages=351–65 |arxiv=gr-qc/9211020 |doi=10.1142/S0218271893000246 |bibcode = 1993IJMPD...2..351M }}</ref> :{{SubatomicParticle|Photon}}&nbsp;&rarr;&nbsp;{{SubatomicParticle|Electron}}&nbsp;+&nbsp;{{SubatomicParticle|Positron}} In [[Charges/Nuclear physics|nuclear physics]], [the above reaction] occurs when a high-energy [[w:photon|photon]] interacts with a [[w:atomic nucleus|nucleus]]. The photon must have enough energy [> 2*511 keV, or 1.022 MeV] to create an electron plus a positron. Without a nucleus to absorb momentum, a photon decaying into electron-positron pair (or other pairs for that matter such as a muon and anti-muon or a tau and anti-tau can never conserve energy and momentum simultaneously.<ref name=Hubbell>{{ cite journal | last=Hubbell | first=J. H. | title=Electron positron pair production by photons: A historical overview | journal=Radiation Physics and Chemistry | year=2006 | month=June | volume=75 | issue=6 | pages=614–623 | doi=10.1016/j.radphyschem.2005.10.008 | bibcode=2006RaPC...75..614H }}</ref> These interactions were first observed in [[w:Patrick Maynard Stuart Blackett|Patrick Blackett]]'s counter-controlled [[w:cloud chamber|cloud chamber]]. In 2008 the [[w:Titan laser|Titan laser]] aimed at a 1-millimeter-thick gold target was used to generate positron–electron pairs in large numbers.<ref name=Bevy>{{ cite book |author= |title=Laser technique produces bevy of antimatter |url=http://www.msnbc.msn.com/id/27998860/ |date=2008 |accessdate=2008-12-04 }}</ref> "The LLNL scientists created the positrons by shooting the lab's high-powered Titan laser onto a one-millimeter-thick piece of gold."<ref name=Bevy/> ==Planetary sciences== {{main|Planetary sciences}} [[Image:Jupiter magnetosphere schematic.jpg|thumb|right|250px|This is a schematic of Jupiter's magnetosphere and the components influenced by Io (near the center of the image). Credit: John Spencer.]] The image at right represents "[t]he Jovian magnetosphere [magnetic field lines in blue], including the Io flux tube [in green], Jovian aurorae, the sodium cloud [in yellow], and sulfur torus [in red]."<ref name=Spencer>{{ cite book |author=John Spencer |title=John Spencer's Astronomical Visualizations |publisher=University of Colorado |location=Boulder, Colorado USA |date=November 2000 |url=http://www.boulder.swri.edu/~spencer/digipics.html |accessdate=2013-04-05 }}</ref> "Io may be considered to be a unipolar generator which develops an emf [electromotive force] of 7 x 10⁵ volts across its radial diameter (as seen from a coordinate frame fixed to Jupiter)."<ref name=Goldreich>{{ cite journal |author=Peter Goldreich |author2=Donald Lynden-Bell |title=Io, a jovian unipolar inductor |journal=The Astrophysical Journal |month=April |year=1969 |volume=156 |issue=04 |pages=59-78 |url= |arxiv= |bibcode=1969ApJ...156...59G |doi=10.1086/149947 |pmid= |accessdate=2013-04-05 }}</ref> "This voltage difference is transmitted along the magnetic flux tube which passes through Io. ... The current [in the flux tube] must be carried by keV electrons which are electrostatically accelerated at Io and at the top of Jupiter's ionosphere."<ref name=Goldreich/> "Io's high density (4.1 g cm^-3) suggests a silicate composition. A reasonable guess for its electrical conductivity might be the conductivity of the Earth's upper mantle, 5 x 10^-5 ohm^-1 cm^-1 (Bullard 1967)."<ref name=Goldreich/> As "a conducting body [transverses] a magnetic field [it] produces an induced electric field. ... The Jupiter-Io system ... operates as a unipolar inductor" ... Such unipolar inductors may be driven by electrical power, develop hotspots, and the "source of heating [may be] sufficient to account for the observed X-ray luminosity".<ref name=Wu>{{ cite journal |author=Kinwah Wu |author2=Mark Cropper |author3=Gavin Ramsay |author4=Kazuhiro Sekiguchi |title=An electrically powered binary star? |journal=Monthly Notices of the Royal Astronomical Society |month=March |year=2002 |volume=321 |issue=1 |pages=221-7 |url= |arxiv=astro-ph/0111358 |bibcode=2002MNRAS.331..221W |doi=10.1046/j.1365-8711.2002.05190.x |pmid= |accessdate=2013-04-05 }}</ref> "The electrical surroundings of Io provide another energy source which has been estimated to be comparable with that of the [gravitational] tides (7). A current of 5 x 10⁶ A is ... shunted across flux tubes of the Jovian field by the presence of Io (7-9)."<ref name=Gold>{{ cite journal |author=Thomas Gold |title=Electrical Origin of the Outbursts on Io |journal=Science |month=November |year=1979 |volume=206 |issue=4422 |pages=1071-3 |url= |arxiv= |bibcode=1979Sci...206.1071G |doi=10.1126/science.206.4422.1071 |pmid= |accessdate=2013-04-05 }}</ref> "[W]hen the currents [through Io] are large enough to cause ohmic heating ... currents ... contract down to narrow paths which can be kept hot, and along which the conductivity is high. Tidal heating [ensures] that the interior of Io has a very low eletrical resistance, causing a negligible extra amount of heat to be deposited by this current. ... [T]he outermost layers, kept cool by radiation into space [present] a large resistance and [result in] a concentration of the current into hotspots ... rock resistivity [and] contact resistance ... contribute to generate high temperatures on the surface. [These are the] conditions of electric arcs [that can produce] temperatures up to ionization levels ... several thousand kelvins".<ref name=Gold/> "[T]he outbursts ... seen [on the surface may also be] the result of the large current ... flowing in and out of the domain of Io ... Most current spots are likely to be volcanic calderas, either provided by tectonic events within Io or generated by the current heating itself. ... [A]s in any electric arc, very high temperatures are generated, and the locally evaporated materials ... are ... turned into gas hot enough to expand at a speed of 1 km/s."<ref name=Gold/> {{clear}} ==Colors== {{main|Radiation astronomy/Colors}} '''Notation:''' '''WN5''' is a component of V444 Cygni, with its Wolf-Rayet (W) spectrum dominated by Nitrogen_III-V and Helium_I-II lines and WN2 to WN5 considered hotter or "early". "The color temperature of the central part of the WN5 disk for λ < 7512 Å, where the main source of opacity is electron scattering, is ''T''_c = 80,000-100,000 K. This high temperature represents the electron temperature slightly below the surface of the WN5 core--the level at which the star becomes optically thick in electron scattering."<ref name=Cherepashchuk>{{ cite journal |author=A. M. Cherepashchuk |author2=K. F. Khaliullin |author3=J. A. Eaton |title=Ultraviolet photometry from the Orbiting Astronomical Observatory. XXXIX - The structure of the eclipsing Wolf-Rayet binary V444 Cygni as derived from light curves between 2460 A and 3. 5 microns |journal=The Astrophysical Journal |month=June 15, |year=1984 |volume=281 |issue=06 |pages=774-88 |url=http://adsabs.harvard.edu/full/1984ApJ...281..774C |arxiv= |bibcode=1984ApJ...281..774C |doi=10.1086/162156 |pmid= |accessdate=2014-01-23 }}</ref> ==Minerals== {{main|Radiation astronomy/Minerals}} [[Image:FluoriteUV.jpg|thumb|250px|left|Fluorescing fluorite is from Boltsburn Mine [[w:Weardale|Weardale]], [[w:North Pennines|North Pennines]], [[w:County Durham|County Durham]], England, UK. Credit: .]] "Many samples of fluorite exhibit [[w:fluorescence|fluorescence]] under ultraviolet light, a property that takes its name from fluorite.<ref name=Stokes>{{ cite journal |title=On the Change of Refrangibility of Light |author=Stokes, G. G. |year=1852 |journal=Philosophical Transactions of the Royal Society of London |volume=142 |pages=463–562 |doi=10.1098/rstl.1852.0022 }}</ref> Many minerals, as well as other substances, fluoresce. Fluorescence involves the elevation of electron energy levels by quanta of ultraviolet light, followed by the progressive falling back of the electrons into their previous energy state, releasing quanta of visible light in the process. In fluorite, the visible light emitted is most commonly blue, but red, purple, yellow, green and white also occur. The fluorescence of fluorite may be due to mineral impurities such as [[w:yttrium|yttrium]], [[w:ytterbium|ytterbium]], or organic matter in the crystal lattice. In particular, the blue fluorescence seen in fluorites from certain parts of Great Britain responsible for the naming of the phenomenon of fluorescence itself, has been attributed to the presence of inclusions of divalent [[w:europium|europium]] in the crystal.<ref name=Przibram>{{ cite journal |author=K. Przibram |title=Fluorescence of Fluorite and the Bivalent Europium Ion |journal=Nature |volume=135 |pages=100 |year=1935 |doi=10.1038/135100a0 |issue=3403 |bibcode=1935Natur.135..100P }}</ref> {{clear}} ==Theoretical electron astronomy== "We now assume that the γ-rays are produced [from 3C 279] by relativistic electrons via Compton scattering of synchrotron photons (SSC). In any such model, the fact that the γ-ray luminosity, produced via Compton scattering, is higher than that emitted at lower frequencies (10¹⁴ - 10¹⁶ Hz), supposedly via the synchrotron process, implies a radiation energy density, ''U''_r, higher than the magnetic energy density, ''U''_B. From the observed power ratio we derive that ''U''_r must be one order of magnitude greater than ''U''_B, which may be a lower limit if Klein-Nishina effects reduce the efficiency of the self-Compton emission. This result is independent of the degree of beaming, which, for a homogeneous source, affects both the synchrotron and the self-Compton fluxes in the same way. This source is therefore the first observed case of the result of a ''Compton catastrophe'' (Hoyle, Burbidge, & Sargent 1966)."<ref name=Maraschi>{{ cite journal |author=L. Maraschi |author2=G. Ghisellini |author3=A. Celotti |title=A jet model for the gamma-ray emitting blazar 3C 279 |journal=The Astrophysical Journal |month=September |year=1992 |volume=397 |issue=1 |pages=L5-9 |url=http://adsabs.harvard.edu/abs/1992ApJ...397L...5M |arxiv= |bibcode=1992ApJ...397L...5M |doi=10.1086/186531 |pmid= |accessdate=2014-01-10 }}</ref> Here's a [[Definitions/Theory#Theoretical definition|theoretical definition]]: '''Def.''' an observational astronomy that primarily detects electron fluxes to study their production and sources is called an '''electron astronomy'''. ==Sources== {{main|Radiation astronomy/Sources}} [[Image:Moodswingerscale.svg|thumb|right|250px|In this diagram, the higher harmonics of the first frequency at the top are shown. Credit: Y Landman, derivative work by [[commons:User:W axell|W axell]].]] The process of [[w:Ionization|ionization]] removes one or more electrons from a neutral atom to yield a variety of ions depending on the chemical element species and incidence of sufficient energy to remove the electrons. The preflare solar material is observed "to be an elevated cloud of prominence-like material which is suddenly lit up by the onslaught of hard electrons accelerated in the flare; the acceleration may be inside or outside the cloud, and brightening is seen in other areas of the solar surface on the same magnetic field lines."<ref name=Zirin78>{{ cite journal |author=Harold Zirin |title=The L-alpha/H-alpha ratio in solar flares, quasars, and the chromosphere |journal=Astrophysical Journal |month=June |year=1978 |volume=222 |issue=6 |pages=L105-7 |url= |bibcode=1978ApJ...222L.105Z |doi= 10.1086/182702 |pmid= |accessdate=2011-08-01 }}</ref> A coronal mass ejection (CME) is an ejected plasma consisting primarily of electrons and protons. "The suprathermal electrons in the solar wind and in solar particle events have excellent properties for this application: they move rapidly, they remain tightly bound to their field lines, and they may arrive "scatter-free" even at low energies, and from deep in the solar atmosphere (Lin 1985)."<ref name=Hudson>{{ cite journal |author=H. S. Hudson |author2=A. B. Galvin |title=Correlated Studies at Activity Maximum: the Sun and the Solar Wind, In: ''Correlated Phenomena at the Sun, in the Heliosphere and in Geospace'' |publisher=European Space Agency |location=Noordwijk, The Netherlands |month=September |year=1997 |editor=A. Wilson |pages=275-82 |url= |bibcode=1997ESASP.415..275H |doi= |pmid= |isbn=92-9092-660-0 |accessdate=2011-11-25 }}</ref> As of December 5, 2011, "Voyager 1 is about ... 18 billion kilometers ... from the [S]un [but] the direction of the magnetic field lines has not changed, indicating Voyager is still within the heliosphere ... the outward speed of the solar wind had diminished to zero in April 2010 ... inward pressure from interstellar space is compacting [the magnetic field] ... Voyager has detected a 100-fold increase in the intensity of high-energy electrons from elsewhere in the galaxy diffusing into our solar system from outside ... [while] the [solar] wind even blows back at us."<ref name=Cole>{{ cite book |author=Steve Cole |author2=Jia-Rui C. Cook |author3=Alan Buis |title=NASA's Voyager Hits New Region at Solar System Edge |publisher=NASA |location=Washington, DC |date=December 2011 |url=http://www.nasa.gov/home/hqnews/2011/dec/HQ_11-402_AGU_Voyager.html |accessdate=2012-02-09 }}</ref> "[W]hen the medium [behaves] like an amplifier to the incident radiation" it is "possible for negative absorption to arise at radio wavelengths".<ref name=Twiss>{{ cite journal |author=R. Q. Twiss |title=Radiation Transfer and the Possibility of Negative Absorption in Radio Astronomy |journal=Australian Journal of Physics |month=December |year=1958 |volume=11 |issue=12 |pages=564 |url= |arxiv= |bibcode=1958AuJPh..11..564T |doi= |pmid= |accessdate=2012-02-03 }}</ref> The necessary and sufficient conditions for negative absorption to occur at radio wavelengths are # "the kinetic energy distribution ''F''(η) of the radiating electrons [is] markedly non-thermal with an appreciable excess of high energy electrons such that ∂''F''/∂η is positive over a finite range of the kinetic energy η" and # "the stimulated transition probability [has] a maximum at some finite value of the kinetic energy, the most favorable case occurring when this maximum is a sharp one at the value of η at which ∂''F''/∂η has a positive maximum."<ref name=Twiss/> "These conditions can both be met in principle for the cases in which the dominant radiation process is due [to] # [the] Cerenkov effect, # gyro radiation by non-relativistic electrons, [and] # synchrotron-type radiation by highly relativistic electrons".<ref name=Twiss/> '''Def.''' "radiation at the fundamental or at the first few harmonics of the gyro frequency by weakly relativistic electrons rotating in a magnetic field" is called '''gyro radiation'''.<ref name=Twiss/> '''Def.''' "radiation by strongly relativistic electrons at high harmonics of the gyro frequency" is called '''synchrotron radiation'''.<ref name=Twiss/> {{clear}} ==Strong forces== {{main|Charges/Interactions/Strong}} "The idea behind baryon matter is that a macroscopic state may exist in which a smaller effective baryon mass inside some region makes the state energetically favored over free particles. [...] This state will appear in the limit of large baryon number as an electrically neutral coherent bound state of neutrons, protons, and electrons in ''β''-decay equilibrium."<ref name=Bahcall>{{ cite journal |author=Safi Bahcall |author2=Bryan W. Lynn |author3=Stephen B. Selipsky |title=New Models for Neutron Stars |journal=The Astrophysical Journal |month=October 10, |year=1990 |volume=362 |issue=10 |pages=251-5 |url=http://adsabs.harvard.edu/abs/1990ApJ...362..251B |arxiv= |bibcode=1990ApJ...362..251B |doi=10.1086/169261 |pmid= |accessdate=2014-01-11 }}</ref> ==Continua== {{main|Radiation astronomy/Continua}} The X-ray continuum can arise from [[w:bremsstrahlung|bremsstrahlung]], [[w:Thermal radiation|black-body radiation]], [[w:synchrotron radiation|synchrotron radiation]], or what is called [[w:Compton scattering#Inverse Compton scattering|inverse Compton scattering]] of lower-energy photons by relativistic electrons, knock-on collisions of fast protons with atomic electrons, and atomic recombination, with or without additional electron transitions.<ref name=Morrison>{{ cite journal |author=P Morrison |title=Extrasolar X-ray Sources |journal=Annual Review of Astronomy and Astrophysics |year=1967 |volume=5 |issue=1 |pages=325–50 |doi=10.1146/annurev.aa.05.090167.001545 |bibcode=1967ARA&A...5..325M }}</ref> ==Cosmic rays== {{main|Radiation/Cosmic rays}} '''Aluminium-26''', ²⁶Al, is a radioactive [[w:isotope|isotope]] of the chemical element aluminium, decaying by either of the [[w:Radioactive decay#Modes of decay|modes]] [[w:Positron emission|beta-plus]] or [[w:electron capture|electron capture]], both resulting in the stable [[w:nuclide|nuclide]] magnesium-26. The [[w:half-life|half-life]] of ²⁶Al is 7.17{{e|5}} years. This is far too short for the isotope to survive to the present, but a small amount of the nuclide is produced by collisions of argon atoms with cosmic ray protons. ==Beta particles== {{main|Radiation astronomy/Beta particles}} [[Image:NuclideMap C-F.png|thumb|right|250px|This graph is a [[w:Chart of nuclides|chart of the nuclides]] for [[w:carbon|carbon]] to [[w:fluorine|fluorine]]. [[w:Decay mode|Decay mode]]s: <br><br> {{legend|#ff9472|[[w:proton emission|proton emission]]}} {{legend|#e78cc7|[[w:positron emission|positron emission]] or [[w:electron capture|electron capture]]}} {{legend|#000000|[[w:stable isotope|stable isotope]]}} {{legend|#63c5de|[[w:beta decay|beta decay]]}} {{legend|#9b7bbc|[[w:neutron emission|neutron emission]]}} Credit: original: National Nuclear Data Center, stitched: [[commons:User:Neokortex|Neokortex]], cropped: [[commons:User:Limulus|Limulus]].]] '''Beta particles''' are high-energy, high-speed [[electron]]s or [[w:positron|positron]]s emitted by certain types of [[w:radioactive|radioactive]] [[w:Atomic nucleus|nuclei]] such as [[w:potassium-40|potassium-40]]. The beta particles emitted are a form of [[w:ionizing radiation|ionizing radiation]] also known as beta rays. The production of beta particles is termed [[w:beta decay|beta decay]]. They are designated by the [[Greek alphabet|Greek letter]] beta (β). At right is a graph or block diagram that shows the boundaries for nuclear particle stability. The boundaries are conceptualized as '''drip lines'''. The nuclear landscape is understood by plotting boxes, each of which represents a unique nuclear species, on a graph with the number of neutrons increasing on the [[w:abscissa|abscissa]] and number of protons increasing along the [[w:ordinate|ordinate]], which is commonly referred to as the [[w:Chart of nuclides|table of nuclides]], being to [[w:nuclear physics|nuclear physics]] what the more commonly known [[w:periodic table of the elements|periodic table of the elements]] is to [[chemistry]]. However, an arbitrary combination of [[w:protons|protons]] and [[w:neutrons|neutrons]] does not necessarily yield a stable [[w:atomic nucleus|nucleus]], and ultimately when continuing to add more of the same type of [[w:nucleon|nucleon]]s to a given nucleus, the newly formed nucleus will essentially undergo immediate decay where a nucleon of the same [[w:isospin|isospin quantum number]] (proton or neutron) is emitted; colloquially the nucleon has 'leaked' or 'dripped' out of the target nucleus, hence giving rise to the term "drip line". The nucleons drip out of such unstable nuclei for the same reason that water drips from a leaking faucet: the droplet, or nucleon in this case, sees a lower potential which is great enough to overcome surface tension in the case of water droplets, and the [[w:strong nuclear force|strong nuclear force]] in the case of [[w:proton emission|proton emission]] or [[w:alpha decay|alpha decay]]. As nucleons are [[w:Quantization (physics)|quantized]], then only [[w:Integer|integer values]] are plotted on the table of isotopes, indicating that the drip line is not [[w:linear|linear]] but instead looks like a [[w:step function|step function]] up close. Beta particles (electrons) are more penetrating [than alpha particles], but still can be absorbed by a few millimeters of aluminum. However, in cases where high energy beta particles are emitted shielding must be accomplished with low density materials, ''e.g.'' plastic, wood, water or acrylic glass (Plexiglas, Lucite). This is to reduce generation of Bremsstrahlung X-rays. In the case of beta⁺ radiation (positrons), the gamma radiation from the electron-positron annihilation reaction poses additional concern. {{clear}} ==Muons== {{main|Radiation astronomy/Muons|Muon astronomy}} "TeV muons from γ ray primaries ... are rare because they are only produced by higher energy γ rays whose flux is suppressed by the decreasing flux at the source and by absorption on interstellar light."<ref name=Halzen>{{ cite journal |author=Francis Halzen |author2=Todor Stanev |author3=Gaurang B. Yodh |title=γ ray astronomy with muons |journal=Physical Review D Particles, Fields, Gravitation, and Cosmology |month=April 1, |year=1997 |volume=55 |issue=7 |pages=4475-9 |url=http://prd.aps.org/abstract/PRD/v55/i7/p4475_1 |arxiv=astro-ph/9608201 |bibcode=1997PhRvD..55.4475H |doi=10.1103/PhysRevD.55.4475 |pmid= |accessdate=2013-01-18 }}</ref> Muon decay produces three particles, an [[electron]] plus two neutrinos of different types. ==Gamma rays== {{main|Radiation astronomy/Gamma rays|Gamma-ray astronomy}} Most astronomical gamma-rays may be produced from the same type of accelerations of electrons, and electron-photon interactions, that produce X-rays in astronomy (but occurring at a higher energy in the production of gamma-rays). A number of different processes occurring in the universe may result in gamma-ray emission. These processes include the interactions of energetic [[electron]]s with [[w:magnetic field|magnetic field]]s. The correlations of the high energy electrons energized during a solar flare and the gamma rays produced are mostly caused by nuclear combinations of high energy protons and other heavier ions. ==X-rays== {{main|Radiation astronomy/X-rays|X-ray astronomy}} X-rays remove electrons from atoms and ions, and those photoelectrons can provoke secondary ionizations. As the intensity is often low, this X-ray heating is only efficient in warm, less dense atomic medium (as the column density is small). For example in molecular clouds only hard x-rays can penetrate and x-ray heating can be ignored. This is assuming the region is not near an x-ray source such as a supernova remnant. In an X-ray tube, electrons are accelerated in a vacuum by an electric field and shot into a piece of metal called the "target". X-rays are emitted as the electrons slow down (decelerate) in the metal. The output spectrum consists of a continuous spectrum of X-rays, with additional sharp peaks at certain energies characteristic of the elements of the target. ==Ultraviolets== {{main|Radiation astronomy/Ultraviolets|Ultraviolet astronomy}} Carbon has several emission lines that occur in an electron cyclotron resonance (ECR) heated plasmas: 229.687 nm from C III, 227.089, 227.727, and 227.792 nm from C V, 207.025, 208.216, 313.864, and 343.366 nm from C VI.<ref name=McCarthy/> Argon has several emission lines that occur in an electron cyclotron resonance (ECR) heated plasmas: 333.613, 334.472, 335.211, 335.849, and 336.128 nm from Ar III.<ref name=McCarthy/> ==Visuals== {{main|Radiation astronomy/Visuals|Visual astronomy}} '''Fluorescence''' is the emission of light by a substance that has absorbed light or other electromagnetic radiation. It is a form of [[w:luminescence|luminescence]]. In most cases, the emitted light has a longer wavelength, and therefore lower energy, than the absorbed radiation. However, when the absorbed electromagnetic radiation is intense, it is possible for one electron to absorb two photons; this two-photon absorption can lead to emission of radiation having a shorter wavelength than the absorbed radiation. The emitted radiation may also be of the same wavelength as the absorbed radiation, termed "resonance fluorescence".<ref name=Holler>''Principles Of Instrumental Analysis'' F.James Holler, Douglas A. Skoog & Stanley R. Crouch 2006</ref> ==Violets== {{main|Radiation astronomy/Violets|Violet astronomy}} [[Image:Hydrogen Spectra.jpg|thumb|center|500px|The spectrum shows the lines in the visible due to emission from elemental hydrogen. Credit:[[w:User:Teravolt|Teravolt]].]] [[Image:Oxygen spectre.jpg|thumb|center|500px|The spectrum shows the lines in the visible due to emission from elemental oxygen. Credit:[[w:User:Teravolt|Teravolt]].]] Hydrogen has two emission lines that occur in an electron cyclotron resonance (ECR) heated plasmas at 397.007 nm of the Balmer series (H_ε) and 434.05 nm H_γ.<ref name=McCarthy>{{ cite book |author=K. J. McCarthy |author2=A. Baciero |author3=B. Zurro |author4=TJ-II Team |title=Impurity Behaviour Studies in the TJ-II Stellarator, In: ''27th EPS Conference on Contr. Fusion and Plasma Phys.'' |publisher=ECA |location=Budapest |date=June 12, 2000 |volume=24B |editor= |pages=1244-7 |url=http://crpppc42.epfl.ch/Buda/pdf/p3_116.pdf |arxiv= |bibcode= |doi= |pmid= |isbn= |accessdate=2013-01-20 }}</ref> Oxygen has several emission lines that occur in an electron cyclotron resonance (ECR) heated plasmas: 406.963, 406.99, 407.22, 407.59, 407.89, 408.51, 435.12, 441.489, and 441.697 nm from O II, and 434.045 nm from O VIII.<ref name=McCarthy/> "Electron temperatures are generally derived from the ratio of auroral to nebular lines in [O III] or [N II]."<ref name=Hawley>{{ cite journal |author=S. A. Hawley |title=The chemical composition of galactic and extragalactic H II regions |journal=The Astrophysical Journal |month=September 1, |year=1978 |volume=224 |issue=9 |pages=417-36 |url= |arxiv= |bibcode=1978ApJ...224..417H |doi=10.1086/156389 |pmid= |accessdate=2012-03-19 }}</ref> "[B]ecause of the proximity of strong night-sky lines at λ4358 and λλ5770, 5791, the auroral lines of [O III] λ4363 and [N II] λ5755 are often contaminated."<ref name=Hawley/> Argon has several emission lines that occur in an electron cyclotron resonance (ECR) heated plasmas: 426.653, 428.29, 433.12, 434.8064, 437.075, 437.967, 442.60, and 443.019 nm from Ar II.<ref name=McCarthy/> {{clear}} ==Yellows== {{main|Radiation astronomy/Yellows|Yellow astronomy}} "The temperature of yellow coronal regions is ... about 2.5 [x] 10⁶ [K]. ... although some ions Ca XV will exist at lower, as well as higher temperatures."<ref name=Kleczek/> "The AS prominences [AS in Menzel-Evans' classification [4];] move with velocities exceeding by far the velocities of other types of prominences [7], [8]. As short-living phenomena, they are condensed quickly and the temperature of the coronal gases should rise in the early stages of their condensation. Indeed, the AS prominences use to be allied with yellow line emission (λ 5694)."<ref name=Kleczek/> "The yellow line is namely due to the ion Ca XV, according to Edlen's and Waldmeier's identification. ... the line λ 5694 is emitted by ³''P''₁ - ³''P''₀ transition of Ca XV."<ref name=Kleczek/> "The solar corona is not in thermodynamical equilibrium. In particular, the photo-recombination is compensated with electron impact ionization, while the reverse processes viz. the photoionization and recombination by impact with two electrons are there negligible."<ref name=Kleczek>{{ cite journal |author=J. Kleczek |title=Temperature of Yellow Coronal Regions |journal=Bulletin of the Astronomical Institutes of Czechoslovakia |month= |year=1957 |volume=8 |issue= |pages=68-70 |url=http://adsabs.harvard.edu/full/1957BAICz...8...68K |arxiv= |bibcode=1957BAICz...8...68K |doi= |pmid= |accessdate=2013-09-26 }}</ref> ==Infrareds== {{main|Radiation astronomy/Infrareds|Infrared astronomy}} In [[infrared astronomy]], the cosmic infrared background (CIB) causes a significant attenuation for very high energy electrons through inverse [[w:Compton scattering|Compton scattering]], photopion and electron-positron pair production. ==Submillimeters== {{main|Radiation astronomy/Submillimeters|Submillimeter astronomy}} Radio observations at 210 GHz taken by the Bernese Multibeam Radiometer for KOSMA (BEMRAK) of high-energy particle acceleration during the energetic solar flare of 2003 October 28 at submillimeter wavelengths reveal a gradual, long-lasting (>30 minutes) component with large apparent source sizes (~60"). Its spectrum below ~200 GHz is consistent with synchrotron emission from flare-accelerated electrons producing hard X-ray and γ-ray bremsstrahlung assuming a magnetic field strength of ≥200 G in the radio source and a confinement time of the radio-emitting electrons in the source of less than 30 s. There is a close correlation in time and space of radio emission with the production of pions".<ref name=Trottet>{{ cite journal |author=G. Trottet |author2=Säm Krucker |author3=T. Lüthi |author4=A. Magun |title=Radio Submillimeter and γ-Ray Observations of the 2003 October 28 Solar Flare |journal=The Astrophysical Journal |month=May 1 |year=2008 |volume=678 |issue=1 |pages=509 |url=http://iopscience.iop.org/0004-637X/678/1/509 |arxiv= |bibcode= |doi=10.1086/528787 |pmid= |accessdate=2013-10-22 }}</ref> ==Superluminals== {{main|Radiation astronomy/Superluminals|Superluminal astronomy}} There is a cut-off frequency above which the equation <math>\cos\theta=1/(n\beta)</math> cannot be satisfied. Since the [[w:refractive index|refractive index]] is a function of frequency (and hence wavelength), the intensity does not continue increasing at ever shorter wavelengths even for ultra-relativistic particles (where v/[[w:speed of light|c]] approaches 1). At X-ray frequencies, the refractive index becomes less than unity (note that in media the phase velocity may exceed ''c'' without violating relativity) and hence no X-ray emission (or shorter wavelength emissions such as gamma rays) would be observed. However, X-rays can be generated at special frequencies just below those corresponding to core electronic transitions in a material, as the index of refraction is often greater than 1 just below a resonance frequency (see [[w:Kramers-Kronig relation|Kramers-Kronig relation]] and [[w:anomalous dispersion|anomalous dispersion]]). "Throughout the shower development, the electrons and positrons which travel faster than the speed of light in the air emit Cherenkov radiation."<ref name=Moralejo>{{ cite journal |author=A. Moralejo for the MAGIC collaboration |title=The MAGIC telescope for gamma-ray astronomy above 30 GeV |journal=Memorie della Societa Astronomica Italiana |month= |year=2004 |volume=75 |issue= |pages=232-9 |url=http://adsabs.harvard.edu/abs/2004MmSAI..75..232M |arxiv= |bibcode=2004MmSAI..75..232M |doi= |pmid= |accessdate=2012-07-28 }}</ref> "High energy processes such as [[w:Compton scattering|Compton]], [[w:Bhabha scattering|Bhabha]], and [[w:Møller scattering|Moller scattering]], along with [[w:Positron annihilation|positron annihilation]] rapidly lead to a ~20% negative charge asymmetry in the electron-photon part of a cascade ... initiated by a ... 100 PeV neutrino"<ref name=Gorham>{{ cite journal |author= P. W. Gorham |author2=S. W. Barwick |author3=J. J. Beatty |author4=D. Z.Besson |author5=W. R. Binns |author6=C. Chen |author7=P. Chen |author8=J. M. Clem |author9=A. Connolly |author10=P. F. Dowkontt |author11=M. A. DuVernois |author12=R. C. Field |author13=D. Goldstein |author14=A. Goodhue |author15=C. Hast |author16=C. L. Hebert |author17=S. Hoover |author18=M. H. Israel |author19=J. Kowalski |author20=J. G. Learned |author21=K. M. Liewer |author22=J. T. Link |author23=E. Lusczek |author24=S. Matsuno |author25=B. Mercurio |author26=C. Miki |author27=P. Miocinovic |author28=J. Nam |author29=C. J. Naudet |author30=J. Ng |author31=R. Nichol |author32=K. Palladino |author33=K. Reil |author34=A. Romero-Wolf |author35=M. Rosen |author36=L. Ruckman |author37=D. Saltzberg |author38=D. Seckel |author39=G. S. Varner |author40=D. Walz |author41=F. Wu |title=Observations of the Askaryan Effect in Ice |journal=Physical Review Letters |month=October 25, |year=2007 |volume=99 |issue=17 |pages=5 |url=http://arxiv.org/pdf/hep-ex/0611008.pdf |arxiv= |bibcode= |doi=10.1103/PhysRevLett.99.171101 |pmid= |accessdate=2012-07-28 }}</ref>. "The tachyonic spectral densities generated by ultra-relativistic electrons in uniform motion are fitted to the high-energy spectra of Galactic supernova remnants, such as RX J0852.0−4622 and the pulsar wind nebulae in G0.9+0.1 and MSH 15-52. ... Tachyonic cascade spectra are quite capable of generating the spectral curvature seen ... Estimates on the electron/proton populations generating the tachyon flux are obtained from the spectral fits"<ref name=Tomaschitz>{{ cite journal |author=Roman Tomaschitz |title=Superluminal cascade spectra of TeV [gamma]-ray sources |journal=Annals of Physics |month=March |year=2007 |volume=322 |issue=3 |pages=677-700 |url=http://wallpaintings.at/geminga/superluminal_cascade_spectra_TeV_gamma-ray_sources.pdf |arxiv= |bibcode= |doi=10.1016/j.aop.2006.11.005 |pmid= |accessdate=2011-11-24 }}</ref> ==Plasma objects== {{main|Plasmas/Plasma objects|Plasma objects}} "Plasma is the fourth state of matter, consisting of electrons, ions and neutral atoms, usually at temperatures above 10⁴ degrees Kelvin."<ref name=Birdsall>{{ cite book |author=CK Birdsall, A. Bruce Langdon |title=Plasma Physics via Computer Simulation |publisher=CRC Press |location=New York |date=October 1, 2004 |editor= |pages=479 |url=http://books.google.com/books?hl=en&lr=&id=S2lqgDTm6a4C&oi=fnd&pg=PR13&dq=stars+%22plasma+physics%22&ots=nOPXyqtDo8&sig=-kA8YfaX6nlfFnaW3CYkATh-QPg |arxiv= |bibcode= |doi= |pmid= |isbn=9780750310253 |accessdate=2011-12-17 }}</ref> '''Plasma''' is a [[w:state of matter|state of matter]] similar to gas in which a certain portion of the particles are [[w:ion|ion]]ized. Heating a gas may [[w:ionization|ionize]] its molecules or atoms (reduce or increase the number of [[w:electrons|electrons]] in them), thus turning it into a plasma, which contains [[w:charge (physics)|charge]]d particles: positive [[w:ions|ions]] and negative electrons or ions.<ref name=Luo>{{ cite journal |last1=Luo |first1=Q-Z|last2=D'Angelo|first2=N|last3=Merlino|first3=R. L. | year=1998 |title=Shock formation in a negative ion plasma |journal= |volume=5 |issue=8 |publisher=Department of Physics and Astronomy |url=http://www.physics.uiowa.edu/~rmerlino/nishocks.pdf |accessdate=2011-11-20}}</ref> For plasma to exist, [[w:ionization|ionization]] is necessary. The term "plasma density" by itself usually refers to the "electron density", that is, the number of free electrons per unit volume. The [[w:degree of ionization|degree of ionization]] of a plasma is the proportion of atoms that have lost or gained electrons, and is controlled mostly by the temperature. Even a partially ionized gas in which as little as 1% of the particles are ionized can have the characteristics of a plasma (i.e., response to magnetic fields and high [[w:electrical conductivity|electrical conductivity]]). The degree of ionization, ''α'' is defined as ''α'' = ''n''_i/(''n''_i + ''n''_a) where ''n''_i is the number density of ions and ''n''_a is the number density of neutral atoms. The ''electron density'' is related to this by the average charge state <Z> of the ions through ''n''_e = <Z> ''n''_i where ''n''_e is the number density of electrons. ==Gaseous objects== {{main|Gases/Gaseous objects}} Above the photosphere visible sunlight is free to propagate into space, and its energy escapes the Sun entirely. The change in opacity is due to the decreasing amount of H⁻ ions, which absorb visible light easily.<ref name=Abhyankar1977>{{ cite journal |author=K.D. Abhyankar |title=A Survey of the Solar Atmospheric Models |year=1977 |journal=Bull. Astr. Soc. India |volume=5 |bibcode=1977BASI....5...40A |pages=40–44 |url=http://prints.iiap.res.in/handle/2248/510 }}</ref> Conversely, the visible light we see is produced as electrons react with hydrogen atoms to produce H⁻ ions.<ref name="Gibson">{{ cite book |author=E.G. Gibson |title=The Quiet Sun |publisher=NASA |date=1973 |isbn= |asin=B0006C7RS0 }}</ref><ref name="Shu">{{ cite book |last=Shu |first=F.H. |title=The Physics of Astrophysics |publisher=University Science Books |volume=1 |date=1991 |isbn=0-935702-64-4 }}</ref> The photosphere has a particle density of ~10²³&nbsp;m⁻³ (this is about 0.37% of the particle number per volume of Earth's atmosphere at sea level; however, photosphere particles are electrons and protons, so the average particle in air is 58 times as heavy). ==Materials== {{main|Chemicals/Materials}} '''Def.''' an object, usually made of glass, that focuses or defocuses the light or an electron beam that passes through it is called a '''lens'''. ==Coronal clouds== {{main|Plasmas/Plasma objects/Coronal clouds}} [[Image:Helmet streamers at max.gif|thumb|right|250px|An abundance of helmet streamers is shown at solar maximum. Credit: NASA.]] [[Image:Helmet streamers at min.jpg|thumb|left|250px|Helmet streamers are shown at solar minimum restricted to mid latitudes. Credit: NASA.]] '''Helmet streamers''' are bright loop-like structures which develop over active regions on the [[Stars/Sun|sun]]. They are closed magnetic loops which connect regions of opposite magnetic polarity. Electrons are captured in these loops, and cause them to glow very brightly. The solar wind elongates these loops to pointy tips. They far extend above most prominences into the [[Coronal cloud|corona]], and can be readily observed during a solar eclipse. Helmet streamers are usually confined to the "streamer belt" in the mid latitudes, and their distribution follows the movement of active regions during the [[w:solar cycle|solar cycle]]. Small blobs of plasma, or "plasmoids" are sometimes released from the tips of helmet streamers, and this is one source of the slow component of the [[w:solar wind|solar wind]]. In contrast, formations with open magnetic field lines are called [[w:coronal holes|coronal holes]], and these are darker and are a source of the fast solar wind. Helmet streamers can also create coronal mass ejections if a large volume of plasma becomes disconnected near the tip of the streamer. In the corona [[w:thermal conduction|thermal conduction]] occurs from the external hotter atmosphere towards the inner cooler layers. Responsible for the diffusion process of the heat are the electrons, which are much lighter than ions and move faster. {{clear}} ==Solar winds== Particles such as electrons are used as tracers of cosmic magnetic fields.<ref name=Hudson>{{ cite journal |author=H. S. Hudson |author2=A. B. Galvin |title=Correlated Studies at Activity Maximum: the Sun and the Solar Wind, In: ''Correlated Phenomena at the Sun, in the Heliosphere and in Geospace'' |publisher=European Space Agency |location=Noordwijk, The Netherlands |month=September |year=1997 |editor=A. Wilson |pages=275-82 |url= |bibcode=1997ESASP.415..275H |doi= |pmid= |isbn=92-9092-660-0 |accessdate=2011-11-25 }}</ref> "From a plasma-physics point of view, the particles represent the correct way to identify magnetic field lines."<ref name=Hudson/> "The suprathermal electrons in the solar wind and in solar particle events have excellent properties for this application: they move rapidly, they remain tightly bound to their field lines, and they may arrive "scatter-free" even at low energies, and from deep in the solar atmosphere (Lin 1985)."<ref name=Hudson/> "Energetic photons, ions and electrons from the solar wind, together with galactic and extragalactic cosmic rays, constantly bombard surfaces of planets, planetary satellites, dust particles, comets and asteroids."<ref name=Madey>{{ cite journal |author=Theodore E. Madey |author2=Robert E. Johnson |author3=Thom M. Orlando |title=Far-out surface science: radiation-induced surface processes in the solar system |journal=Surface Science |month=March |year=2002 |volume=500 |issue=1-3 |pages=838-58 |url=http://www.physics.rutgers.edu/~madey/Publications/Full_Publications/PDF/madey_SS_2002.pdf |arxiv= |bibcode= |doi=10.1016/S0039-6028(01)01556-4 |pmid= |accessdate=2012-02-09 }}</ref> ==Mercury== {{main|Liquids/Liquid objects/Mercury}} Mariner 10 has aboard "one backward facing electron spectrometer (BESA). ... An electron spectrum [is] obtained every 6 s, ... within the energy range 13.4-690 eV. ... [B]y taking into account [the angular] distortion [caused by the solar wind passing the spacecraft] and the spacecraft sheath characteristics ... some of the solar wind plasma parameters such as ion bulk speed, electron temperature, and electron density [are derived]."<ref name=Williams>{{ cite book |author=David R. Williams |title=Scanning Electrostatic Analyzer and Electron Spectrometer |publisher=NASA Goddard Space Flight Center |location=Greenbelt, Maryland |date=May 14, 2012 |url=http://nssdc.gsfc.nasa.gov/nmc/experimentDisplay.do?id=1973-085A-03 |accessdate=2012-08-23 }}</ref> Mariner 10 had three encounters with Mercury on March 29, 1974, September 21, 1974, and on March 16, 1975.<ref name=Williams2>{{ cite book |author=David R. Williams |title=Mariner 10 |publisher=NASA Goddard Space Flight Center |location=Greenbelt, Maryland |date=May 14, 2012 |url=http://nssdc.gsfc.nasa.gov/nmc/spacecraftDisplay.do?id=1973-085A |accessdate=2012-08-23 }}</ref> The BESA measurements "show that the planet interacts with the solar wind to form a bow shock and a permanent magnetosphere. ... The magnetosphere of Mercury appears to be similar in shape to that of the earth but much smaller in relation to the size of the planet. The average distance from the center of Mercury to the subsolar point of the magnetopause is ∼ 1.4 planetary radii. Electron populations similar to those found in the earth’s magnetotail, within the plasma sheet and adjacent regions, were observed at Mercury; both their spatial location and the electron energy spectra within them bear qualitative and quantitative resemblance to corresponding observations at the earth."<ref name=Ogilvie>{{ cite journal |author=K. W. Ogilvie |author2=J. D. Scudder |author3=V. M. Vasyliunas |title=Observations at the Planet Mercury by the Plasma Electron Experiment: Mariner 10 |journal=Journal of Geophysical Research |month= |year=1977 |volume=82 |issue=13 |pages=1807-24 |url=http://www.agu.org/pubs/crossref/1977/JA082i013p01807.shtml |arxiv= |bibcode= |doi=10.1029/JA082i013p01807 |pmid= |accessdate=2012-08-23 }}</ref> "[T]he Mercury encounter (M I) by Mariner 10 on 29 March 1974 occurred during the height of a Jovian electron increase in the interplanetary medium."<ref name=Russell/> ==Venus== {{main|Gases/Gaseous objects/Venus}} [[Image:Venus xray 420.jpg|thumb|right|250px|This Chandra X-ray Observatory image is the first X-ray image ever made of Venus. Credit: NASA/MPE/K.Dennerl et al.]] The first ever X-ray image of Venus is shown at right. The "half crescent is due to the relative orientation of the Sun, Earth and Venus. The X-rays from Venus are produced by fluorescent radiation from oxygen and other atoms in the atmosphere between 120 and 140 kilometers above the surface of the planet. In contrast, the optical light from Venus is caused by the reflection from clouds 50 to 70 kilometers above the surface. Solar X-rays bombard the atmosphere of Venus, knock electrons out of the inner parts of atoms, and excite the atoms to a higher energy level. The atoms almost immediately return to their lower energy state with the emission of a fluorescent X-ray. A similar process involving ultraviolet light produces the visible light from fluorescent lamps."<ref name=Dennerl >{{ cite book |author=K. Dennerl |title=Venus: Venus in a New Light |publisher=Harvard University, NASA |location=Boston, Massachusetts, USA |date=November 29, 2001 |url=http://chandra.harvard.edu/photo/2001/venus/ |accessdate=2012-11-26 }}</ref> {{clear}} ==Earth== {{main|Gases/Gaseous objects/Earth}} [[Image:Atmosphere with Ionosphere.svg|thumb|right|250px|This graph shows the relationship of the atmosphere and ionosphere to electron density. Credit: .]] [[Image:Earth's_x-ray_aurora_borealis_2004_composite.jpg|thumb|250px|right|Bright X-ray arcs of low energy (0.1 - 10 keV) are generated during auroral activity. Observation dates: 10 pointings between December 16, 2003 and April 13, 2004. Instrument: HRC. Credit: NASA/MSFC/CXC/A.Bhardwaj & R.Elsner, et al.; Earth model: NASA/GSFC/L.Perkins & G.Shirah.]] [[Image:Earthxray polar.jpg|thumb|right|250px|This image is a composite of the first picture of the Earth in X-rays over a diagram of the Earth below. Credit: NASA, Ruth Netting.]] "[L]ow-altitude regions of downward electric current on auroral magnetic field lines are sites of dramatic upward magnetic field-aligned electron acceleration that generates intense magnetic field-aligned electron beams within Earth’s equatorial middle magnetosphere."<ref name=Mauk>{{ cite journal |author=Barry H. Mauk |author2=Joachim Saur |title=Equatorial electron beams and auroral structuring at Jupiter |journal=Journal of Geophysical Research |month=October 26, |year=2007 |volume=112 |issue=A10221 |pages=20 |url=http://www.igpp.ucla.edu/public/mkivelso/refs/PUBLICATIONS/Mauk2007JA012370.pdf |arxiv= |bibcode= |doi=10.1029/2007JA012370 |pmid= |accessdate=2012-06-02 }}</ref> The ionosphere is a shell of electrons and electrically charged [[w:atom|atom]]s and [[w:molecule|molecule]]s that surrounds the Earth, stretching from a height of about 50&nbsp;km to more than 1000&nbsp;km. It owes its existence primarily to [[w:ultraviolet|ultraviolet]] radiation from the Sun. The images [lower right] are superimposed on a simulated image of the Earth. The color code represents brightness, maximum in red. Distance from the North pole to the black circle is {{convert|3,340|km|mi|abbr=on}}. "Auroras are produced by solar storms that eject clouds of energetic charged particles. These particles are deflected when they encounter the Earth’s magnetic field, but in the process large electric voltages are created. Electrons trapped in the Earth’s magnetic field are accelerated by these voltages and spiral along the magnetic field into the polar regions. There they collide with atoms high in the atmosphere and emit X-rays".<ref name=Bhardwaj>{{ cite book |author=A. Bhardwaj |author2=R. Elsner |title=Earth Aurora: Chandra Looks Back At Earth |publisher=Harvard-Smithsonian Center for Astrophysics |location=Cambridge, Massachusetts, USA |date=February 20, 2009 |url=http://chandra.harvard.edu/photo/2005/earth/ |accessdate=2013-05-10 }}</ref> At right is a composite image which contains the first picture of the Earth in X-rays, taken in March, 1996, with the orbiting [[w:Polar (satellite)|Polar]] satellite. The area of brightest X-ray emission is red. Energetic charged particles from the Sun energize electrons in the Earth's magnetosphere. These electrons move along the Earth's magnetic field and eventually strike the ionosphere, causing the X-ray emission. Lightning strikes or bolts across the sky also emit X-rays.<ref name=Newitz>Newitz, A. (2007) ''Educated Destruction 101''. Popular Science magazine, September. pg. 61.</ref> {{clear}} ==Van Allen radiation belts== The '''Van Allen radiation belt''' is split into two distinct belts, with energetic electrons forming the outer belt and a combination of protons and electrons forming the inner belts. In addition, the radiation belts contain lesser amounts of other nuclei, such as [[w:alpha particle|alpha particle]]s. "The large outer radiation belt extends from an altitude of about three to ten Earth radii (''R_E'') or 13,000 to 60,000 kilometres above the Earth's surface. Its greatest intensity is usually around 4–5 ''R_E''. The outer electron radiation belt is mostly produced by the inward radial diffusion<ref name=Elkington>{{ cite book | author=Elkington, S. R. |author2=Hudson, M. K. |author3=Chan, A. A. | title=Enhanced Radial Diffusion of Outer Zone Electrons in an Asymmetric Geomagnetic Field, In: ''Spring Meeting 2001'' | publisher=American Geophysical Union | date=May 2001 | bibcode=2001AGUSM..SM32C04E }}</ref><ref name=Shprits>{{ cite journal | author=Shprits, Y. Y. |author2=Thorne, R. M. | title=Time dependent radial diffusion modeling of relativistic electrons with realistic loss rates | journal=Geophysical Research Letters | volume=31 | issue=8 | doi=10.1029/2004GL019591 | year=2004 | pages=L08805 | bibcode=2004GeoRL..3108805S }}</ref> and local acceleration<ref name=Horne>{{ cite journal | author=Horne, Richard B. |author2=Thorne, Richard M. ''et al'' | title=Wave acceleration of electrons in the Van Allen radiation belts | journal=Nature | volume=437 | issue=7056 | pages=227&ndash;230 | year=2005 | doi=10.1038/nature03939 | pmid=16148927 |bibcode = 2005Natur.437..227H }}</ref> due to transfer of energy from whistler mode [[w:plasma waves|plasma waves]] to radiation belt electrons. Radiation belt electrons are also constantly removed by collisions with atmospheric neutrals,<ref name=Horne/> losses to [[w:magnetopause|magnetopause]], and the outward radial diffusion. The outer belt consists mainly of high energy (0.1–10 MeV) electrons trapped by the Earth's [[w:magnetosphere|magnetosphere]]. The [[w:gyroradius|gyroradii]] for energetic protons would be large enough to bring them into contact with the Earth's atmosphere. The electrons here have a high [[w:flux|flux]] and at the outer edge (close to the magnetopause), where [[w:geomagnetic field|geomagnetic field]] lines open into the geomagnetic "tail", fluxes of energetic electrons can drop to the low interplanetary levels within about 100&nbsp;km (a decrease by a factor of 1,000). ==Moon== {{main|Liquids/Liquid objects/Moon}} [[Image:Moon ER magnetic field.jpg|thumb|right|250px|These two hemispheric Lambert azimuthal equal area projections show the total magnetic field strength at the surface of the Moon, derived from the Lunar Prospector electron reflectometer (ER) experiment. Credit: Mark A. Wieczorek.]] [[Image:Moon-Mdf-2005.jpg|thumb|left|250px|In the shadows, the Moon charges negatively in the interplanetary medium. Credit: [[w:User:Mdf|Mdf]].{{tlx|free media}}]] The Moon where a prediction of a lunar double layer<ref>Borisov, N.; Mall, U. "[http://adsabs.harvard.edu/cgi-bin/nph-bib_query?bibcode=2002JPlPh..67..277B&db_key=PHY&data_type=HTML&format=&high=42ca922c9c05280 The structure of the double layer behind the Moon]" (2002) ''Journal of Plasma Physics'', vol. 67, Issue 04, pp. 277&ndash;299</ref> was confirmed in 2003.<ref>Halekas, J. S.; Lin, R. P.; Mitchell, D. L. "[http://adsabs.harvard.edu/cgi-bin/nph-bib_query?bibcode=2003GeoRL..30uPLA1H&db_key=AST&data_type=HTML&format=&high=42ca922c9c27734 Inferring the scale height of the lunar nightside double layer]" (2003) ''Geophysical Research Letters'', Volume 30, Issue 21, pp. PLA 1-1. ([http://sprg.ssl.berkeley.edu/adminstuff/webpubs/2003_grl_2117.pdf PDF])</ref> In the shadows, the Moon charges negatively in the interplanetary medium.<ref>Halekas, J. S ''et al.'' "[http://adsabs.harvard.edu/cgi-bin/nph-bib_query?bibcode=2002GeoRL..29j..77H&amp;db_key=AST&amp;data_type=HTML&amp;format=&amp;high=42ca922c9c05119 Evidence for negative charging of the lunar surface in shadow]" (2002) ''Geophysical Research Letters'', Volume 29, Issue 10, pp. 77&ndash;81</ref> The electron reflectometer (ER) [aboard the Lunar Prospector determines] the location and strength of magnetic fields from the [[w:energy spectrum|energy spectrum]] and direction of [[w:electron|electron]]s. The instrument [measures] the pitch [[w:angle|angle]]s of [[w:solar wind|solar wind]] electrons reflected from the Moon by lunar magnetic fields. Stronger local magnetic fields can reflect electrons with larger pitch angles. [[w:Field strength|Field strength]]s as small as 0.01 [nanotesla] [[w:nanotesla|nT]] could be measured with a spatial accuracy of about 3 km (1.9 mi) at the lunar surface. "[T]he shadowed lunar surface charges negative."<ref name=Halekas>{{ cite journal |author=J. S. Halekas |author2=R. P. Lin |author3=D. L. Mitchell |title=Inferring the scale height of the lunar nightside double layer |journal=Geophysical Research Letters |month=November |year=2003 |volume=30 |issue=21 |pages=4 |url= |arxiv= |bibcode=2003GeoRL..30uPLA1H |doi=10.1029/2003GL018421 |pmid= |accessdate=2012-11-16 }}</ref> {{clear}} ==Jupiter== {{main|Jupiter}} "Field-aligned equatorial electron beams [have been] observed within Jupiter’s middle magnetosphere. ... the Jupiter equatorial electron beams are spatially and/or temporally structured (down to <20 km at auroral altitudes, or less than several minutes), with regions of intense beams intermixed with regions absent of such beams."<ref name=Mauk/> "Jovian electrons, both at Jupiter and in the interplanetary medium near Earth, have a very hard spectrum that varies as a power law with energy (see, e.g., Mewaldt et al. 1976). This spectral character is sufficiently distinct from the much softer solar and magnetospheric electron spectra that it has been used as a spectral filter to separate Jovian electrons from other sources ... A second Jovian electron characteristic is that such electrons in the interplanetary medium tend to consist of flux increases of several days duration which recur with 27 day periodicities ... A third feature of Jovian electrons at 1 AU is that the flux increases exhibit a long-term modulation of 13 months which is the synodic period of Jupiter as viewed from Earth".<ref name=Russell>{{ cite book |author=C. T. Russell |author2=D. N. Baker |author3=J. A. Slavin |title=The Magnetosphere of Mercury, In: ''Mercury'' |publisher=University of Arizona Press |location=Tucson, Arizona, United States of America |date=January 1, 1988 |editor=Faith Vilas |editor2=Clark R. Chapman |editor3=Mildred Shapley Matthews |pages=514-61 |url=http://www-ssc.igpp.ucla.edu/personnel/russell/papers/magMercury.pdf |arxiv= |bibcode=1988merc.book..514R |doi= |isbn=0816510857 |pmid= |accessdate=2012-08-23 }}</ref> Jovian electrons propagate "along the spiral magnetic field of the interplanetary medium [from Jupiter and its magnetosphere to the Sun]".<ref name=Russell/> ==Callisto== {{main|Rocks/Rocky objects/Callisto}} [[Image:Callisto.jpg|thumb|right|250px|This image of Callisto from NASA's Galileo spacecraft, taken in May 2001, is the only complete global color image of Callisto obtained by Galileo. Credit: NASA/JPL/DLR(German Aerospace Center).]] At right is a complete global color image of Callisto. Bright scars on a darker surface testify to a long history of impacts on Jupiter's moon Callisto. The picture, taken in May 2001, is the only complete global color image of Callisto obtained by Galileo, which has been orbiting Jupiter since December 1995. Of Jupiter's four largest moons, Callisto orbits farthest from the giant planet. Callisto's surface is uniformly cratered but is not uniform in color or brightness. Scientists believe the brighter areas are mainly ice and the darker areas are highly eroded, ice-poor material. Callisto's ionosphere was first detected during ''Galileo'' flybys;<ref name="Kliore 2002">{{ cite journal |author=A. J. Kliore |author2=A. Anabtawi |author3=R. G. Herrera |author4=et al. |title=Ionosphere of Callisto from Galileo radio occultation observations |journal=Journal of Geophysics Research |year=2002 |volume=107 |issue=A11 |page=1407 |doi=10.1029/2002JA009365 | bibcode=2002JGRA.107kSIA19K }}</ref> its high electron density of 7&ndash;17 x 10⁴&nbsp;cm^&minus;3 cannot be explained by the photoionization of the atmospheric [[w:carbon dioxide|carbon dioxide]] alone. {{clear}} ==Saturn== {{main|Gases/Gaseous objects/Saturn}} "[M]agnetospheric electron (bi-directional) beams connect to the expected locations of Saturn’s aurora".<ref name=Saur>{{ cite journal |author=J. Saur |author2=B.H. Mauk |author3=D.G. Mitchell |author4=N. Krupp |author5=K.K. Khurana |author6=S. Livi |author7=S.M. Krimigis |author8=P.T. Newell |author9=D.J. Williams |author10=P.C. Brandt |author11=A. Lagg |author12=E. Roussos |author13=M.K. Dougherty |title=Anti-planetward auroral electron beams at Saturn |journal=Nature |month=February |year=2006 |volume=439 |issue=7077 |pages=699-702 |url= |arxiv= |bibcode=2006Natur.439..699S |doi=10.1038/nature04401 |pmid= |accessdate=2012-06-02 }}</ref> Powered by the Saturnian equivalent of (filamentary) Birkeland currents, streams of charged particles from the interplanetary medium interact with the planet's magnetic field and funnel down to the poles.<ref name=Isbell>Isbell, J.; Dessler, A. J.; Waite, J. H. "[http://adsabs.harvard.edu/cgi-bin/nph-bib_query?bibcode=1984JGR....8910715I&amp;db_key=PHY&amp;data_type=HTML&amp;format=&amp;high=42ca922c9c16745 Magnetospheric energization by interaction between planetary spin and the solar wind]" (1984) ''Journal of Geophysical Research'', Volume 89, Issue A12, pp. 10715&ndash;10722</ref> Double layers are associated with (filamentary) currents,<ref name=Theisen>Theisen, William L. "[http://adsabs.harvard.edu/cgi-bin/nph-bib_query?bibcode=1994PhDT........19T&amp;db_key=AST&amp;data_type=HTML&amp;format=&amp;high=42ca922c9c05019 Langmuir Bursts and Filamentary Double Layers in Plasmas.]" (1994) Ph.D Thesis U. of Iowa, 1994</ref><ref name=Deverapalli>Deverapalli, C. M.; Singh, N.; Khazanov, I. "[http://adsabs.harvard.edu/cgi-bin/nph-bib_query?bibcode=2005AGUFMSM41C1202D&amp;db_key=AST&amp;data_type=HTML&amp;format=&amp;high=42ca922c9c05019 Filamentary Structures in U-Shaped Double Layers]" (2005) American Geophysical Union, Fall Meeting 2005, abstract #SM41C-1202</ref> and their electric fields accelerate ions and [[electron]]s.<ref name=Borovsky>Borovsky, Joseph E. "[http://adsabs.harvard.edu/cgi-bin/nph-bib_query?bibcode=1992PhRvL..69.1054B&amp;db_key=PHY&amp;data_type=HTML&amp;format=&amp;high=42ca922c9c27309 Double layers do accelerate particles in the auroral zone]" (1992) ''Physical Review Letters'' (ISSN 0031-9007), vol. 69, no. 7, Aug. 17, 1992, pp. 1054&ndash;1056</ref> ==Heliospheres== {{main|Stars/Sun/Heliospheres}} These electrons "provide remote-sensing observations of distant targets in the heliosphere - the Sun, the Moon, Jupiter, and various heliospheric structures."<ref name=Hudson/> ==Electron winds== "The power into the [[w:Crab Nebula|Crab Nebula]] is apparently supplied by an outflow [wind] of ~10³⁸ erg/s from the pulsar"<ref name=Wilson>{{ cite journal |author=D. B. Wilson |author2=M. J. Rees |title=Induced Compton scattering in pulsar winds |journal=Monthly Notices of the Royal Astronomical Society |month=October |year=1978 |volume=185 |issue=10 |pages=297-304 |url= |arxiv= |bibcode=1978MNRAS.185..297W |doi= |pmid= |accessdate=2012-03-08 }}</ref> where there are "electrons (and positrons) in such a wind"<ref name=Wilson/>. These beta particles coming out of the pulsar are moving very close to light speed. "An '''electron beam furnace''' ('''EB furnace''') is a type of [[w:vacuum furnace|vacuum furnace]] employing a high-energy [[w:electron beam|electron beam]] in vacuum as the mean for delivery of [[w:heat|heat]] to the material being melted. The source of heat that brings the coronal cloud near the Sun hot enough to emit X-rays may be an electron beam heating effect due to "high-energy electrons from elsewhere in the galaxy diffusing into our solar system from outside"<ref name=Cole/>. ==Interstellar medium== {{main|Interstellar medium}} The "many other types of radio sources in our galaxy [...] include so-called radio stars, emission nebula, flare stars and pulsars. [...] Pulsars were first discovered in 1967 by Cambridge post-graduate student Jocelyn Bell as she processed charts associated with an unrelated project to study twinkling radio sources. She noticed recurrent signals when the antenna was pointed in a certain direction. Further study revealed a precise timing interval of about 1 second. It also was found that the pulses were dispersed such that the lower frequencies arrived later than the higher frequencies. This dispersion could be attributed to scattering of the radiation by interstellar electrons and, if so, could provide an indication of the pulsar distance."<ref name=Reeve>{{ cite book |author=Whitham D. Reeve |title=Book Review |publisher=Whitham D. Reeve |location=Anchorage, Alaska USA |date=1973 |url=http://www.reeve.com/Documents/Book%20Reviews/Reeve_Book%20Review-Evolution%20of%20Radio%20Astronomy.pdf |accessdate=2014-01-11 }}</ref> "A particular subject of interest is the cluster ion series (NH₃)_nNH₄⁺, since it is the dominant group of ions over the whole investigated temperature range."<ref name=Martinez>{{ cite journal |author=R. Martinez |author2=L. S. Farenzena |author3=P. Iza |author4=C. R. Ponciano |author5=M. G. P. Homem |author6=A. Naves de Brito |author7=K. Wien |author8=E. F. da Silveira |title=Secondary ion emission induced by fission fragment impact in CO--NH₃ and CO--NH₃--H₂O ices: modification in the CO--NH₃ ice structure |journal=Journal of Mass Spectrometry |month=October |year=2007 |volume=42 |issue=10 |pages=1333-41 |url=http://onlinelibrary.wiley.com/doi/10.1002/jms.1241/full |arxiv= |bibcode= |doi=10.1002/jms.1241 |pmid= |accessdate=2011-12-12 }}</ref> For astrochemisty, "[t]hese studies are expected to throw light on the sputtering from planetary and interstellar ices and the possible formation of new organic molecules in CO--NH₃–H₂O ice by megaelectronvolt ion bombardment."<ref name=Martinez/> "lnterstellar scintillation (ISS), fluctuations in the amplitude and phase of radio waves caused by scattering in the [[interstellar medium]], is important as a diagnostic of interstellar plasma turbulence. ISS is also of interest because it is noise for other radio astronomical observations. [As a remote, sensing tool, ISS is used to diagnose the plasma turbulence in the interstellar medium (lSM). However, where ISS acts as a noise source in other observations, the plasma physics of the medium is only of secondary interest.] The unifying concern is the power spectrum of the interstellar electron density."<ref name=Armstrong>{{ cite journal |author=J. W. Armstrong |author2=B. J. Rickett |author3=S. R. Spangler |title=Electron density power spectrum in the local interstellar medium |journal=The Astrophysical Journal |month=April |year=1995 |volume=443 |issue=1 |pages=209-21 |url=http://adsabs.harvard.edu/abs/1995ApJ...443..209A |arxiv= |bibcode=1995ApJ...443..209A |doi=10.1086/175515 |pmid= |accessdate=2014-01-29 }}</ref> "From measurements of angular broadening of pulsars and extragalactic sources, decorrelation bandwidth of pulsars, refractive steering of features in pulsar dynamic spectra, dispersion measure fluctuations of pulsars, and refractive scintillation index measurements, [...] a composite structure function that is approximately power law over 2 x 10⁶ m < scale < 10¹³ m [is constructed]. The data are consistent with the structure function having a logarithmic slope versus baseline Iess than 2; thus there is a meaningful connection between scales in the radiowave fluctuation field and the scales in the electron density field causing the scattering."<ref name=Armstrong/> A "composite electron density spectrum [is] approximately power law over at least the ≈ 5 decade wavenumber range 10^-13 m^-1 < wavenumber < 10^-8 m^-1 and that may extend to higher wavenumbers."<ref name=Armstrong/> ==Physics== '''Def.''' a quasiparticle produced as a result of electron spin-charge separation is called a '''chargon''', or '''holon'''. '''Def.''' a quasiparticle that electrons in solids are able to split into during the process of spin-charge separation, when extremely tightly confined at temperatures close to absolute zero is called a '''spinon'''. ==Electron volts== [[Image:Colors in eV.svg|thumb|upright=2|center|400px|Energy of photons is shown in the visible spectrum. Credit: [[:meta:user:egg|Vojtěch Hála]] and [[c:User:Gringer|Gringer]].]] [[Image:EV to nm vis.png|thumb|right|250px|This is a graph of eV versus nm. Credit: [[commons:User:Mrdupont|User:Mrdupont]].]] '''Def.''' a unit for measuring the energy of subatomic particles; the energy equal to that attained by an electron moving through a potential of one volt is called an '''electron volt'''. The electron volt (eV) is the energy gained (or lost) by an electron in passing through a potential difference of one volt. Since the charge on an electron is 1.60218 x 10^-19 Coulombs, an eV is 1.60218 x 10^-19 J. A keV is 1000 eV and a MeV is 1000 keV. A photon with an energy of 1 eV has a frequency of 1 eV/h = 2.41799 x 10¹⁴ Hz or about 242 THz and a wavelength of c*h/1 eV = 1.23984 x 10^-6 m or about 1,240 nm or 12,400 Å. That would put the photon in the infrared range. In practice, photon energies are seldom stated for such long wavelengths. Generally, the energy ''E'', frequency ''ν'', and wavelength λ of a photon are related by :<math>E=h\nu=\frac{hc}{\lambda}=\frac{(4.135 667 33\times 10^{-15}\,\mbox{eV}\,\mbox{s})(299\,792\,458\,\mbox{m/s})}{\lambda},</math> where ''h'' is the [[w:Planck constant|Planck constant]], ''c'' is the [[w:speed of light|speed of light]]. This reduces to :<math>E\mbox{(eV)}=\frac{1239.84187\,\mbox{eV}\,\mbox{nm}}{\lambda\ \mbox{(nm)}}.</math> ==Electron density== [[Image:ElectronDensityAniline.PNG|250px|thumb|right|Electron density calculated for aniline, high density values indicate atom positions, intermediate density values emphasize bonding, low values provide information on a molecule's shape and size. Credit: [[c:User:Williamseanohlinger|Sean Ohlinger]].]] '''Def.''' a measure of the number of electrons per unit volume of space is called an '''electron density'''. Electron density is the measure of the probability of an electron being present at a specific location. In molecules, regions of electron density are usually found around the atom, and its bonds. In quantum chemical calculations, the electron density, ρ('''r'''), is a function of the coordinates '''r''', defined so ρ('''r''')d'''r''' is the number of electrons in a small volume d'''r'''. For closed-shell molecules, <math> \rho(\mathbf{r}) </math> can be written in terms of a sum of products of basis functions, φ: :<math> \rho(\mathbf{r}) = \sum_\mu \sum_\nu P_{\mu \nu} \phi_\mu(\mathbf{r}) \phi_\nu(\mathbf{r}) </math> where P is the density matrix. Electron densities are often rendered in terms of an isosurface (an isodensity surface) with the size and shape of the surface determined by the value of the density chosen, or in terms of a percentage of total electrons enclosed. {{clear}} ==Spin density== '''Spin density''' is electron density applied to free radicals. It is defined as the total electron density of electrons of one spin minus the total electron density of the electrons of the other spin. One of the ways to measure it experimentally is by electron spin resonance,<ref>IUPAC Gold Book[http://www.iupac.org/goldbook/S05864.pdf Link]</ref> neutron diffraction allows direct mapping of the spin density in 3D-space. ==Electron temperatures== If the [[w:velocity|velocities]] of a group of [[electron]]s, e.g., in a [[w:plasma (physics)|plasma]], follow a [[w:Maxwell-Boltzmann distribution#Distribution of the velocity vector|Maxwell-Boltzmann distribution]], then the '''electron temperature''' is well-defined as the [[w:temperature|temperature]] of that distribution. For other distributions, two-thirds of the average energy is often referred to as the temperature, since for a Maxwell-Boltzmann distribution with three [[w:Degrees of freedom (physics and chemistry)|degrees of freedom]], <math>\langle E \rangle = (3/2) \langle k_BT \rangle</math>. The [[w:International System of Units|SI]] unit of temperature is the [[w:kelvin|kelvin]] (K), but using the above relation the electron temperature is often expressed in terms of the energy unit [[w:electronvolt|electronvolt]] (eV). Each kelvin (1&nbsp;K) corresponds to 8.617343(15) x 10^-5&nbsp;eV; this factor is the ratio of the [[w:Boltzmann constant|Boltzmann constant]] to the [[w:elementary charge|elementary charge]]. The electron temperature of a plasma can be several orders of magnitude higher than the temperature of the neutral species or of the [[w:ion|ion]]s. This is a result of two facts. Firstly, many [[w:plasma source|plasma source]]s heat the electrons more strongly than the ions. Secondly, atoms and ions are much heavier than electrons, and energy transfer in a two-body [[w:collision|collision]] is much more efficient if the masses are similar. ==Technology== {{main|Technology}} [[Image:Cyclotron motion.jpg|thumb|right|250px|Beam of electrons are moving in a circle in a magnetic field (cyclotron motion). Lighting is caused by excitation of atoms of gas in a bulb. Credit: [[commons:User:Sfu|Marcin Białek]].]] A '''cyclotron''' is a compact type of particle accelerator in which charged particles in a static magnetic field are travelling outwards from the center along a spiral path and get accelerated by radio frequency electromagnetic fields. Cyclotrons accelerate charged particle beams using a high frequency alternating voltage which is applied between two "D"-shaped electrodes (also called "dees"). An additional static magnetic field <math>B</math> is applied in perpendicular direction to the electrode plane, enabling particles to re-encounter the accelerating voltage many times at the same phase. To achieve this, the voltage frequency must match the particle's cyclotron resonance frequency :<math>f = \frac{q B}{2\pi m}</math>, with the relativistic mass ''m'' and its charge ''q''. This frequency is given by equality of centripetal force and magnetic Lorentz force. The particles, injected near the center of the magnetic field, increase their kinetic energy only when recirculating through the gap between the electrodes; thus they travel outwards along a spiral path. '''Cyclotron radiation''' is [[electromagnetic radiation]] emitted by moving charged particles deflected by a magnetic field. The Lorentz force on the particles acts perpendicular to both the magnetic field lines and the particles' motion through them, creating an acceleration of charged particles that causes them to emit radiation (and to spiral around the magnetic field lines). ... Cyclotron radiation is emitted by all charged particles travelling through magnetic fields, however, not just those in cyclotrons. Cyclotron radiation from plasma in the [[interstellar medium]] or around black holes and other astronomical phenomena is an important source of information about distant magnetic fields. The power (energy per unit time) of the emission of each electron can be calculated using: <math>{-dE \over dt}={\sigma_t B^2 V^2 \over c \mu_o} </math> where ''E'' is energy, ''t'' is time, <math> \sigma_t </math> is the Thomson cross section (total, not differential), ''B'' is the magnetic field strength, ''V'' is the velocity perpendicular to the magnetic field, ''c'' is the speed of light and <math> \mu_o </math> is the permeability of free space. "Electron beams can be generated by thermionic emission, field emission or the anodic arc method. The generated electron beam is accelerated to a high kinetic energy and focused towards the [target]. When the accelerating voltage is between 20 kV – 25 kV and the beam current is a few amperes, 85% of the kinetic energy of the electrons is converted into thermal energy as the beam bombards the surface of the [target]. The surface temperature of the [target] increases resulting in the formation of a liquid melt. Although some of incident electron energy is lost in the excitation of X-rays and secondary emission, the [target] material evaporates under vacuum."<ref name=Gray>{{ cite web |author=[[User:Dgray|Dgray]] |title=Materials Science and Engineering/Doctoral review questions/Daily Discussion Topics/01162008 |date=January 17, 2008 |url=http://en.wikiversity.org/wiki/Materials_Science_and_Engineering/Doctoral_review_questions/Daily_Discussion_Topics/01162008#E-Beam_Source |accessdate=2013-07-21 }}</ref> {{clear}} ==Scintillation detectors== {{main|Radiation astronomy/Detectors}} A '''scintillator''' is a material, which exhibits [[w:scintillation (physics)|scintillation]]—the property of [[w:luminescence|luminescence]]<ref name=Leo>Leo, W. R. (1994). [http://books.google.com/books?id=8VufE4SD-AkC&printsec=frontcover “Techniques for Nuclear and particle Physics Experiments”], 2nd edition, Springer, {{ISBN|978-3540572800}}</ref> when excited by [[w:ionizing radiation|ionizing radiation]]. Luminescent materials, when struck by an incoming particle, absorb its energy and scintillate, i.e., reemit the absorbed energy in the form of light. Here, "particle" refers to "ionizing radiation" and can refer either to charged [[w:Particle radiation|particulate radiation]], such as [[w:electrons|electrons]] and heavy charged particles, or to uncharged radiation, such as [[w:photons|photons]] and [[w:neutrons|neutrons]], provided that they have enough energy to induce ionization. A scintillation detector or [[w:scintillation counter|scintillation counter]] is obtained when a scintillator is coupled to an electronic light sensor such as a [[w:photomultiplier|photomultiplier tube]] (PMT) or a [[w:photodiode|photodiode]]. PMTs absorb the light emitted by the scintillator and reemit it in the form of electrons via the [[w:photoelectric effect|photoelectric effect]]. The subsequent multiplication of those electrons (sometimes called photo-electrons) results in an electrical pulse which can then be analyzed and yield meaningful information about the particle that originally struck the scintillator. ==Galileo Orbiter== [[Image:Galileo Energetic Particles Detector.jpg|thumb|right|250px|This is an image of the Energetic Particles Detector (EPD) aboard the Galileo Orbiter. Credit: NASA.]] The Energetic Particles Detector (EPD) aboard the [[w:Galileo (spacecraft)|Galileo Orbiter]] is designed to measure the numbers and energies of electrons whose energies exceed about 20 [[w:keV|keV]]. The EPD can also measure the direction of travel of electrons. The EPD uses silicon solid state detectors and a [[w:time-of-flight|time-of-flight]] detector system to measure changes in the energetic electron population at Jupiter as a function of position and time. "[The] two bi-directional, solid-state detector telescopes [are] mounted on a platform which [is] rotated by a stepper motor into one of eight positions. This rotation of the platform, combined with the spinning of the orbiter in a plane perpendicular to the platform rotation, [permits] a 4-pi [or 4π] steradian coverage of incoming [electrons]. The forward (0 degree) ends of the two telescopes [have] an unobstructed view over the [4π] sphere or [can] be positioned behind a shield which not only [prevents] the entrance of incoming radiation, but [contains] a source, thus allowing background corrections and in-flight calibrations to be made. ... The 0 degree end of the [Low-Energy Magnetospheric Measurements System] LEMMS [uses] magnetic deflection to separate incoming electrons and ions. The 180 degree end [uses] absorbers in combination with the detectors to provide measurements of higher-energy electrons ... The LEMMS [provides] measurements of electrons from 15 keV to greater than 11 MeV ... in 32 rate channels."<ref name=DJWilliams>{{ cite book |author=Donald J. Williams |title=Energetic Particles Detector (EPD) |publisher=NASA Goddard Space Flight Center |location=Greenbelt, Maryland USA |date=May 14, 2012 |url=http://nssdc.gsfc.nasa.gov/nmc/experimentDisplay.do?id=1989-084B-06 |accessdate=2012-08-11 }}</ref> {{clear}} ==Lunar Prospector== The electron reflectometer (ER) [aboard the Lunar Prospector determines] the location and strength of magnetic fields from the [[w:energy spectrum|energy spectrum]] and direction of [[w:electron|electron]]s. The instrument measures the pitch [[w:angle|angle]]s of [[w:solar wind|solar wind]] electrons reflected from the Moon by lunar magnetic fields. Stronger local magnetic fields can reflect electrons with larger pitch angles. [[w:Field strength|Field strength]]s as small as 0.01 nanotesla [[w:nanotesla|nT]] could be measured with a spatial accuracy of about {3 km (1.9 mi) at the lunar surface. The ER is located at the end of one of the three radial science booms on the Lunar Prospector. ==Imaging Compton Telescope== [[Image:Compton - Diagrama esquematico.png|thumb|right|200px|This is a schematic of the various experiments aboard the Gamma-ray Observatory. Credit: NASA/JPL.]] [[Image:Comptel.png|thumb|left|200px|The Imaging Compton Telescope (COMPTEL) utilizes the Compton Effect and two layers of gamma-ray detectors. Credit: NASA.]] For cosmic gamma-ray events, the experiment required two nearly simultaneous interactions, in a set of front and rear scintillators. Gamma rays would [[w:Compton scattering|Compton scatter]] in a forward detector module, where the interaction energy ''E₁'', given to the recoil electron was measured, while the Compton scattered photon would then be caught in one of a second layer of scintillators to the rear, where its total energy, ''E₂'', would be measured. From these two energies, ''E₁'' and ''E₂'', the Compton scattering angle, angle θ, can be determined, along with the total energy, ''E₁ + E₂'', of the incident photon. The positions of the interactions, in both the front and rear scintillators, was also measured. The [[w:Euclidean vector|vector]], '''V''', connecting the two interaction points determined a direction to the sky, and the angle θ about this direction, defined a cone about '''V''' on which the source of the photon must lie, and a corresponding "event circle" on the sky. "COMPTEL's upper layer of detectors are filled with a liquid scintillator which scatters an incoming gamma-ray photon according to the Compton Effect. This photon is then absorbed by NaI crystals in the lower detectors. The instrument records the time, location, and energy of the events in each layer of detectors which makes it possible to determine the direction and energy of the original gamma-ray photon and reconstruct an image and energy spectrum of the source."<ref name=Gehrels>{{ cite book |author=Neil Gehrels |title=The Imaging Compton Telescope (COMPTEL) |publisher=NASA Goddard Space Flight Center |location=Greenbelt, Maryland USA |date=August 1, 2005 |url=http://heasarc.gsfc.nasa.gov/docs/cgro/cgro/comptel.html |accessdate=2013-04-05 }}</ref> {{clear}} ==Hypotheses== {{main|Hypotheses}} # Superluminal electrons exist. ==See also== {{div col|colwidth=20em}} * [[Radiation/Cosmic rays|Cosmic-ray astronomy]] * [[Neutrino astronomy]] * [[Radiation/Neutrons|Neutron astronomy]] * [[Positron astronomy]] * [[Proton astronomy]] {{Div col end}} ==References== {{reflist|2}} ==Further reading== * {{ cite journal |author=H. S. Hudson |author2=A. B. Galvin |title=Correlated Studies at Activity Maximum: the Sun and the Solar Wind, In: ''Correlated Phenomena at the Sun, in the Heliosphere and in Geospace'' |publisher=European Space Agency |location=Noordwijk, The Netherlands |month=September |year=1997 |editor=A. Wilson |pages=275-82 |url= |bibcode=1997ESASP.415..275H |doi= |pmid= |isbn=92-9092-660-0 |accessdate=2011-11-25 }} ==External links== * [http://www.iau.org/ International Astronomical Union] * [http://nedwww.ipac.caltech.edu/ NASA/IPAC Extragalactic Database - NED] * [http://nssdc.gsfc.nasa.gov/ NASA's National Space Science Data Center] * [http://www.osti.gov/ Office of Scientific & Technical Information] * [http://www.adsabs.harvard.edu/ The SAO/NASA Astrophysics Data System] * [http://www.scirus.com/srsapp/advanced/index.jsp?q1= Scirus for scientific information only advanced search] * [http://cas.sdss.org/astrodr6/en/tools/quicklook/quickobj.asp SDSS Quick Look tool: SkyServer] * [http://simbad.u-strasbg.fr/simbad/ SIMBAD Astronomical Database] * [http://nssdc.gsfc.nasa.gov/nmc/SpacecraftQuery.jsp Spacecraft Query at NASA] * [http://heasarc.gsfc.nasa.gov/cgi-bin/Tools/convcoord/convcoord.pl Universal coordinate converter] <!-- footer templates --> {{Principles of radiation astronomy}}{{tlx|Radiation astronomy resources}}{{Sisterlinks|Electron}}{{Sisterlinks|Electron astronomy}} <!-- categories --> [[Category:Astrophysics/Lectures]] [[Category:Radiation astronomy/Lectures]] [[Category:Radiation/Lectures]] n2rl86lgq5pevxzboajyvjqhqy8oyau 0 127989 2419074 2418959 2022-08-25T16:40:38Z Marshallsumter 311529 wikitext text/x-wiki [[Image:Sudbury neutrino observatory.png|thumb|right|250px|The Sudbury Neutrino Observatory is a 12-meter sphere filled with heavy water surrounded by light detectors located 2000 meters below the ground in Sudbury, Ontario, Canada. Credit: A. B. McDonald (Queen's University) ''et al''., The Sudbury Neutrino Observatory Institute.{{tlx|fairuse}}]] The field of '''neutrino astronomy''' is still very much in its infancy &ndash; the only confirmed extraterrestrial sources so far are the [[Stars/Sun|Sun]] and [[w:SN1987A|supernova SN1987A]]. Neutrino astronomy observes astronomical objects with neutrino detectors in special observatories. {{clear}} ==Universals== The "neutrino fluxes [may be] predicted by such scenarios [as the standard model or grand unification] if consistency with the observed cosmic ray flux and the universal γ-ray background at 1 − 10 GeV is required. Flux levels detectable by proposed km³ scale neutrino observatories are allowed by these constraints. Bounds on or detection of a neutrino flux above ~ 1 EeV would allow neutrino astronomy to probe grand unification scale physics."<ref name="Sigl">{{cite journal |author=Günter Sigl, Sangjin Lee, and David N. Schramm |title=Cosmological Neutrino Signatures for Grand Unification Scale Physics |journal=Physics Letters B |month=January |year=1997 |volume=392 |issue=1-2 |pages=129-34 |url=http://www.sciencedirect.com/science/article/pii/S0370269396015341 |arxiv= |bibcode= |doi= |pmid= |accessdate=2014-02-07 }}</ref> "The shapes of the [ultra-high energy] UHE nucleon and γ-ray spectra predicted within ["top-down"] TD models are “universal” in the sense that they depend only on the physics of [a supermassive elementary "X" particle associated with some grand unified theory (GUT)] X particle decay."<ref name="Sigl"/> "In contrast to the universality of UHE spectral shapes, the predicted γ-ray flux below ∼ 10¹⁴ eV (the threshold for pair production of photons on the [cosmic microwave background] CMB) and the predicted neutrino flux depend on the total energy release integrated over redshift and thus on the specific TD model."<ref name="Sigl"/> "Observational data on the universal γ-ray background in the 1 − 10 GeV region [27], to which the generic cascade spectrum would contribute directly, turn out to provide an important constraint. Since the UHE γ-ray flux is especially sensitive to certain astrophysical parameters such as the extragalactic magnetic field (EGMF), a reliable calculation of the predicted spectral shapes requires numerical methods."<ref name="Sigl"/> "The calculations take into account all the relevant interactions with the (redshift dependent) universal low energy photon background in the radio, microwave and optical/infrared regime."<ref name="Sigl"/> "Above ≃ 100 EeV the corresponding fluxes would dominate all present model predictions for AGN neutrino fluxes [14] as well as the flux of “cosmogenic” neutrinos produced by interactions of UHE [cosmic rays] CRs with the universal photon background [37,38,31]."<ref name="Sigl"/> The "constraint imposed by requiring that TD scenarios do not overproduce the measured universal γ-ray background at 1 − 10 GeV implies an upper limit on these neutrino fluxes which only depends on the ratio r of energy injected into the neutrino versus [electromagnetic] EM channel, and not on any specific TD scenario or even a possible connection to UHE CRs."<ref name="Sigl"/> ==Astronomy== {{main|Radiation astronomy/Astronomy}} [[Image:Balloons on Ice Launch - 2 takes flight in Antarctica (30561119904).jpg|thumb|right|250px|The second of three missions as part of NASA’s Antarctica Long Duration Balloon Flight Campaign was successfully launched at 8:10 a.m. EDT, Dec. 2, 2016. Credit: NASA Goddard Space Flight Center from Greenbelt, MD, USA.{{tlx|free media}}]] The Antarctic Impulsive Transient Antenna (ANITA) from the University of Hawaii at Manoa was launched from Antarctica’s Ross Ice Shelf near McMurdo Station. ANITA’s instruments were used to study the reactions in the core of stars and as they explode via the release of neutrinos that travel to Earth and interact with the Antarctica ice. "[O]ccultation by our planet's core-mantle structure can help constrain the locations of extragalactic neutrino sources."<ref name="Kuo"/> {{clear}} ==Radiation== {{main|Radiation}} Instead of emitting positrons and neutrinos, some proton-rich nuclides were found to capture their own atomic electrons ([[w:electron capture|electron capture]]), and emit only a neutrino (and usually also a gamma ray). Each of these types of decay involves the capture or emission of nuclear electrons or positrons, and acts to move a nucleus toward the ratio of neutrons to protons that has the least energy for a given total number of [[w:nucleon|nucleon]]s (neutrons plus protons). ==Leptogenesis== [[Image:Higgs boson mass peak in four-lepton final state (ATLAS).pdf|thumb|right|250px|The observed (data points) and expected (colored bands) four-lepton invariant mass distributions for the Higgs boson candidates in ATLAS detector at the LHC (CERN). Credit: CERN for the benefit of the ATLAS collaboration.{{tlx|free media}}]] The observed (data points) and expected (colored bands) four-lepton invariant mass distributions for the Higgs boson candidates in ATLAS detector at the LHC (CERN). A prominent blue peak is due to Higgs boson decays, while the other colors depict various Standard Model backgrounds. "In realistic unified models involving so-called SO(10)-inspired patterns of Dirac and heavy right-handed (RH) neutrino masses, the lightest right-handed neutrino N₁ is too light to yield successful thermal leptogenesis, barring highly fine tuned solutions, while the second heaviest right-handed neutrino N₂ is typically in the correct mass range."<ref name=Bari>{{ cite journal |author=Pasquale Di Bari and Stephen F. King |title=Successful N₂ leptogenesis with flavour coupling effects in realistic unified models |journal=Journal of Cosmology and Astroparticle Physics |date=2 October 2015 |volume=10 |issue= |pages=008 |url=https://iopscience.iop.org/article/10.1088/1475-7516/2015/10/008/pdf |arxiv= |bibcode= |doi=10.1088/1475-7516/2015/10/008 |pmid= |accessdate=16 July 2019 }}</ref> Flavour "coupling effects in the Boltzmann equations may be crucial to the success of such N₂ dominated leptogenesis, by helping to ensure that the flavour asymmetries produced at the N₂ scale survive N₁ washout."<ref name=Bari/> The "only relevant asymmetry is that one produced at the N₂ scale in the tauon flavour".<ref name=Bari/> "This implies that, at least at lower order, the observed asymmetry can only be produced in the tauon flavour".<ref name=Bari/> The "asymmetry is mainly produced by the next-to-lightest RH neutrinos in the tauon flavour but this asymmetry is fully washed-out by the lightest RH neutrinos since the condition K_1τ ≲􏰗 1 is not compatible with the measured values of the mixing parameters."<ref name=Bari/> One "has also to consider that part of the asymmetry in the tauon flavour is transferred to the electron and muon flavours by flavour coupling effects due primarily to the fact that N₂-decays produce in addition to an asymmetry in the tauon lepton doublets also an (hyper charge) asymmetry in the Higgs bosons. This Higgs asymmetry unavoidably induces, through the inverse decays, also an asymmetry in the lepton doublets that at the production are a coherent admixture of electron and muon components. Therefore, in this case, inverse decays actually produce an asymmetry instead of wash it out as in a traditional picture."<ref name=Bari/> "It should be noticed how the source of the electron and muon asymmetries is in any case the tauon asymmetry, but part of this induces a muon and an electron asymmetry thanks to flavour coupling."<ref name=Bari/> "The A to Z model can not only provide a satisfactory fit to all parameters in the leptonic mixing matrix but can also reproduce the correct value of the matter-antimatter asymmetry with N₂-dominated leptogenesis. In this respect it is crucial to account for flavour coupling effects due to the redistribution of the asymmetry in particles that do not participate directly to the generation of the asymmetry, in primis the Higgs asymmetry. In particular a “flavour swap” scenario is realised whereby the asymmetry generated in the tauon flavour emerges as a surviving asymmetry dominantly in the muon flavour. The solution works even in the simplest case where the neutrino Dirac mass matrix is equal to the up quark mass matrix."<ref name=Bari/> "The muon and the tauon are unstable and after a while they decay into electrons."<ref name=Barrett>{{ cite book |author=Ross Barrett, Pier Paolo Delsanto and Angelo Tartaglia |title=Fields and Particles, In: ''Physics: The Ultimate Adventure'' |publisher=Springer |location=Cham |date=8 May 2016 |editor= |pages=137-151 |url=https://link.springer.com/chapter/10.1007/978-3-319-31691-8_10 |arxiv= |bibcode= |doi=10.1007/978-3-319-31691-8_10 |pmid= |isbn=978-3-319-31690-1 |accessdate=17 July 2019 }}</ref> {{clear}} ==Neutrinos== [[Image:FirstNeutrinoEventAnnotated.jpg|thumb|right|250px|In this photograph is recorded the first use of a hydrogen bubble chamber to detect neutrinos, on November 13, 1970. A neutrino hit a proton in a hydrogen atom. The collision occurred at the point where three tracks emanate on the right of the photograph. Credit: Argonne National Laboratory.{{tlx|free media}}]] A '''neutrino''' is an electrically neutral, weakly interacting [[w:elementary particle|elementary subatomic particle]]<ref name="Max">{{cite book |title=Neutrino, In: ''Glossary for the Research Perspectives of the Max Planck Society'' |url=http://www.mpg.de/12928/Glossary |publisher=Max Planck Gesellschaft |accessdate=2012-03-27 }}</ref> with [[w:spin-1/2|half-integer spin]]. ... Neutrinos do not carry [[w:electric charge|electric charge]], which means that they are not affected by the [[w:electromagnetic force|electromagnetic force]]s that act on charged particles such as electrons and protons. Neutrinos are affected only by the [[w:weak interaction|weak sub-atomic force]], of much shorter range than electromagnetism, and [[w:gravity|gravity]], which is relatively weak on the subatomic scale. They are therefore able to travel great distances through matter without being affected by it. "If neutrinos have negligible rest mass, the present density expected for relic neutrinos from the big bang is ''n''_ν = 110 (''T''_γ/2.7 K)³ cm^–3 for each two-component species. This is of order the photon density ''n''_γ, differing just by a factor 3/11 (i.e. a factor 3/4 because neutrinos are fermions rather than bosons, multiplied by 4/11, the factor by which the neutrinos are diluted when e⁺–e^– annihilation boosts the photon density). This conclusion holds for non-zero masses, provided that m_vc² is far below the thermal energy (~ 5 MeV) at which neutrinos decoupled from other species and that the neutrinos are stable for the Hubble time. Comparison with the baryon density, related to Ω via ''n''_b = 1.5 x 10^–5 Ω_b ''h''² cm^–3, shows that neutrinos outnumber baryons by such a big factor that they can be dynamically dominant over baryons even if their masses are only a few electron volts. In fact, a single species of neutrino would yield a contribution to Ω of Ω_v = 0.01 ''h''^–2 (m_v)_eV, so if ''h'' = 0.5, only 25 eV is sufficient to provide the critical density."<ref name="Rees"/> "Neutrinos of nonzero mass would be dynamically important not only for the expanding universe as a whole but also for large bound systems such as clusters of galaxies. This is because they would now be moving slowly: if the universe had cooled homogeneously, primordial neutrinos would now be moving at around 200 (m_v)^-1_eV km s^–1. They would be influenced even by the weak (~ 10^–5 c²) gravitational potential fluctuations of galaxies and clusters. If the three (or more) types of neutrinos have different masses, then the heaviest will obviously be gravitationally dominant, since the numbers of each species should be the same."<ref name="Rees"/> The "lightest of the three neutrinos has a mass of at most 0.086 electronvolts, meaning it is at least 6 million times lighter than an electron."<ref name=Loureiro>{{ cite book |author=Arthur Loureiro |title=Lightest neutrino is at least 6 million times lighter than an electron |publisher=Nature |location= |date=22 August 2019 |url=https://www.nature.com/articles/d41586-019-02538-z?utm_source=Nature+Briefing&utm_campaign=967f4cba00-briefing-dy-20190823&utm_medium=email&utm_term=0_c9dfd39373-967f4cba00-43855389 |accessdate=24 August 2019 }}</ref> {{clear}} ==Neutrino astrophysics== [[Image:41467 2015 Article BFncomms7935 Fig1 HTML.webp|thumb|right|250px|Illustration shows neutrino oscillations. Credit: P. Vogel, L.J. Wen & C. Zhang.{{tlx|free media}}]] The expected flavour composition of the reactor neutrino flux, for neutrinos of 4 MeV energy used as an example, is plotted as a function of distance to the reactor cores. The fraction of neutrino flavours is calculated on the basis of the neutrino oscillation theory introduced in Box 1. Reactor neutrino oscillation experiments are placed at different baselines to measure the oscillation features driven by different mechanisms. The experiments are usually categorized as follows: very short-baseline (L∼10 m); short-baseline (L∼100 m); kilometre-baseline (L∼1 km); medium-baseline (L∼50 km); and long-baseline (L>100 km) experiments. "The observations of solar and supernova neutrinos open up a new area of science: neutrino astrophysics. [...] solar neutrinos provide a beam of elementary particles that can be used to investigate fundamental physics, in particular to study intrinsic neutrino properties."<ref name="Bahcall"/> "Neutrino astrophysics offers new perspectives on the Universe investigation: high energy neutrinos, produced by the most energetic phenomena in our Galaxy and in the Universe, carry complementary (if not exclusive) information about the cosmos with respect to photons. While the small interaction cross section of neutrinos allows them to come from the core of astrophysical objects, it is also a drawback, as their detection requires a large target mass. This is why it is convenient put huge cosmic neutrino detectors in natural locations, like deep underwater or under-ice sites."<ref name="Chiarusi">{{cite journal |author=T. Chiarusi and M. Spurio |title=High-Energy Astrophysics with Neutrino Telescopes |journal=The European Physical Journal C |month=February |year=2010 |volume=65 |issue=3-4 |pages=649-701 |url=http://arxiv.org/pdf/0906.2634.pdf |arxiv= |bibcode= |doi=10.1140/epjc/s10052-009-1230-9 |pmid= |accessdate=2013-07-04 }}</ref> {{clear}} ==Planetary sciences== {{main|Planetary sciences}} "Astrophysical sources of very high energy neutrinos may offer a novel means of imaging the Earth's internal structure."<ref name="Kuo">{{cite journal |author=Chaincy Kuo, H. J. Crawford, Raymond Jeanloz, Barbara Romanowicz, Gilbert Shapiro, M. Lynn Stevenson |title=Extraterrestrial neutrinos and Earth structure |journal=Earth and Planetary Science |month=June |year=1995 |volume=133 |issue=1-2 |pages=95-103 |url=http://www.sciencedirect.com/science/article/pii/0012821X9500050M |arxiv= |bibcode=1995E&PSL.133...95K |doi=10.1016/0012-821X(95)00050-M |pmid= |accessdate=2013-11-06 }}</ref> "The Kamioka liquid scintillator anti-neutrino detector (KamLAND) is a low-energy and low-background neutrino detector which could be a useful probe for determining the U and Th abundances of the Earth."<ref name="Enomoto">{{cite journal |author=S. Enomoto, E. Ohtani, K. Inoue, A. Suzuki |title=Neutrino geophysics with KamLAND and future prospects |journal=Earth and Planetary Science Letters |month=June |year=2007 |volume=258 |issue=1-2 |pages=147-59 |url=http://www.sciencedirect.com/science/article/pii/S0012821X07001872 |arxiv= |bibcode=2007E&PSL.258..147E |doi=10.1016/j.epsl.2007.03.038 |pmid= |accessdate=2013-11-06 }}</ref> ==Colors== {{main|Radiation astronomy/Colors}} [[Image:Atmosheric neutrino numu to nue oscillation probability for NH.png|thumb|right|250px|Atmospheric neutrino oscillation probabilities as a function of energy and cosine of the neutrino zenith angle (−1 corresponds to upward-going). The plot shows the νμ → νe probability in case of the normal mass hierarchy or ν̄μ → ν̄e in case of the inverted mass hierarchy. Credit: Hyper-Kamiokande Collaboration (K. Abe ''et al''.).{{tlx|free media}}]] '''Neutrino oscillation''' is a [[w:quantum mechanics|quantum mechanical]] phenomenon predicted by [[w:Bruno Pontecorvo|Bruno Pontecorvo]]<ref name="Pontecorvo1957">{{cite journal |author=B. Pontecorvo |title=Mesonium and anti-mesonium |journal=Zh. Eksp. Teor. Fiz. |volume=33 |pages=549–551 |year=1957 |doi= }} reproduced and translated in {{cite journal |journal=Sov. Phys. JETP |volume=6 |pages=429 |year=1957 |doi= }} and {{cite journal |author=B. Pontecorvo |title=Neutrino Experiments and the Problem of Conservation of Leptonic Charge |journal=Zh. Eksp. Teor. Fiz. |volume=53 |pages=1717 |year=1967 |doi= }} reproduced and translated in {{cite journal |journal=Sov. Phys. JETP |volume=26 |pages=984 |year=1968 |doi= |bibcode = 1968JETP...26..984P }}</ref> whereby a neutrino created with a specific lepton flavor (electron, muon or |tau) can later be measured to have a different flavor. The probability of measuring a particular flavor for a neutrino varies periodically as it propagates. Neutrino oscillation is of theoretical and experimental interest since observation of the phenomenon implies that the neutrino has a non-zero mass. A great deal of evidence for neutrino oscillation has been collected from many sources, over a wide range of neutrino energies and with many different detector technologies.<ref name="Garcia">{{cite journal | author=M. C. Gonzalez-Garcia and Michele Maltoni | year=2008 | journal=Physics Reports | volume=460 | pages=1-129 | arxiv=0704.1800 | title=Phenomenology with Massive Neutrinos | doi=10.1016/j.physrep.2007.12.004 |bibcode = 2008PhR...460....1G }}</ref> {{clear}} ==Minerals== {{main|Radiation astronomy/Minerals}} [[Image:Lorandite-Orpiment-sea81b.jpg|thumb|right|250px|Sharp, very rare lorandite crystals to 3 mm on matrix, is a rare thallium-containing species. Credit: [[c:user:Robert M. Lavinsky|Robert M. Lavinsky]].{{tlx|free media}}]] "LOREX, the acronym of LORandite EXperiment, is the only long-time solar neutrino experiment still actively pursued. It addresses the long-time detection of the solar neutrino flux with the thallium-bearing mineral lorandite, TlAsS₂ at the mine of Allchar"<ref name="Pavicevic">{{cite journal |author=Pavićević, M. K.; Bosch, F.; Amthauer, G.; Aničin, I.; Boev, B.; Brüchle, W.; Djurcic, Z.; Faestermann, T.; Henning, W. F.; Jelenković, R.; Pejović, V. |title=New data for the geochemical determination of the solar pp-neutrino flux by means of lorandite mineral |journal=Nuclear Instruments and Methods in Physics Research Section A |month=September |year=2010 |volume=621 |issue=1-3 |pages=278-85 |url=http://adsabs.harvard.edu/cgi-bin/nph-basic_connect |arxiv= |bibcode=2010NIMPA.621..278P |doi=10.1016/j.nima.2010.06.090 |pmid= |accessdate=2013-11-06 }}</ref> {{clear}} ==Theoretical neutrino astronomy== [[Image:Bahcall-Serenelli 2005.jpg|thumb|right|250px|This diagram contains the neutrino flux predictions for the 2005 Bahcall and Serenelli Standard Solar Model. Credit: John N. Bahcall, Aldo M. Serenelli, and Sarbani Basu.{{tlx|fairuse}}]] '''Def.''' an "elementary particle that is classified as a lepton, and has an extremely small but nonzero mass and no electric charge"<ref name=NeutrinoWikt>{{ cite book |author=[[wikt:User:Tohru|Tohru]] |title=neutrino |publisher=Wikimedia Foundation, Inc |location=San Francisco, California |date=19 December 2005 |url=https://en.wiktionary.org/wiki/neutrino |accessdate=17 July 2019 }}</ref> is called a '''neutrino'''. '''Def.''' the "detection and study of neutrinos, in order to investigate astronomical objects and the universe"<ref name=NeutrinoAstronomyWikt>{{ cite book |author=[[wikt:User:SemperBlotto|SemperBlotto]] |title=neutrino astronomy |publisher=Wikimedia Foundation, Inc |location=San Francisco, California |date=3 May 2006 |url=https://en.wiktionary.org/wiki/neutrino_astronomy |accessdate=17 July 2019 }}</ref> is called '''neutrino astronomy'''. At right is the predicted solar neutrino spectrum. "The [neutrino] line fluxes (pep and ⁷Be) are given in number per cm² per second. The spectra from the pp chain are drawn with solid lines; the CNO spectra are drawn with dotted lines."<ref name="Bahcall"/> The lower "energy thresholds for the ongoing neutrino experiments" are about 0.2 MeV for Gallium, ~0.82 MeV for Cl, and ~7.5 MeV for Kamiokande.<ref name="Bahcall"/> The huge number of neutrinos [a neutron star] emits carries away so much energy that the temperature falls within a few years [after formation] to around 10⁶ kelvin.<ref name="Miller">{{cite book | url=http://www.astro.umd.edu/~miller/nstar.html | title=Introduction to neutron stars | accessdate=2007-11-11 }}</ref> Even at 1 million kelvin, most of the light generated by a neutron star is in X-rays. In visible light, neutron stars probably radiate approximately the same energy in all parts of visible spectrum, and therefore appear white. {{clear}} ==Entities== {{main|Radiation astronomy/Entities}} [[Image:IsolatedNeutronStar.jpg|thumb|right|250px|This image is the first direct observation of a neutron star in visible light. The neutron star is [[w:RX J185635-3754|RX J185635-3754]]. Credit: Fred Walter (State University of New York at Stony Brook) and NASA.{{tlx|free media}}]] "[T]he huge number of neutrinos [a neutron star] emits carries away so much energy that the temperature falls within a few years [after formation] to around 10⁶ kelvin.<ref name=Miller/> Even at 1 million kelvin, most of the light generated by a neutron star is in X-rays. In visible light, neutron stars probably radiate approximately the same energy in all parts of visible spectrum, and therefore appear white. "For three quarters of a century, neutrinos have proven the most ghostly of all the quantum entities that make up the universe."<ref name="Boyle">{{cite journal |author=Alison Boyle and Ken Grimes |title=Ghostbusting the universe |journal=Astronomy |month=December 1, |year=2003 |volume=31 |issue=12 |pages=44 |url=http://cds.cern.ch/record/718186 |arxiv= |bibcode= |doi= |pmid= |accessdate=2013-11-07 }}</ref> {{clear}} ==Sources== {{main|Radiation astronomy/Sources}} [[Image:NASA X-ray Telescopes Find Black Hole May Be a Neutrino Factory (19057084225).jpg|thumb|right|250px|The supermassive black hole at the center of the Milky Way may be producing tiny particles, called neutrinos, that have virtually no mass and carry no electric charge. Credit: Smithsonian Institution from United States.{{tlx|free media}}]] This Chandra image shows the region around the black hole, known as Sagittarius A*, in low, medium, and high-energy X-rays (red, green, and blue respectively.) Scientists have found a connection to outbursts generated by the black hole and seen by Chandra and other X-ray telescopes with the detection of high-energy neutrinos in an observatory under the South Pole. Neutrinos are created as a result of certain types of radioactive decay, or nuclear reactions, or when cosmic rays hit atoms. {{clear}} ==Objects== {{main|Radiation astronomy/Objects|Object astronomy}} [[Image:NASA-PerseusGalaxyCluster-ChandraXRayObservatory-20140624.jpg|thumb|right|250px|A new study of the central region of the Perseus galaxy cluster, shown in this image, using NASA's Chandra X-ray Observatory and 73 other clusters with ESA's XMM-Newton has revealed a mysterious X-ray signal in the data. Credit: NASA/CXC/SAO/E. Bulbul, ''et al''.{{tlx|free media}}]] This signal is represented in the circled data points in the inset, which is a plot of X-ray intensity as a function of X-ray energy. The signal is also seen in over 70 other galaxy clusters using XMM-Newton. This unidentified X-ray emission line - that is, a spike of intensity at a very specific energy, in this case centered on about 3.56 kiloelectron volts (keV) - requires further investigation to confirm both the signal's existence and nature as described in the latest Chandra press release. One intriguing possible explanation of this X-ray emission line is that it is produced by the decay of sterile neutrinos, a type of particle that has been proposed as a candidate for dark matter. While holding exciting potential, these results must be confirmed with additional data to rule out other explanations and determine whether it is plausible that dark matter has been observed. There is uncertainty in these results, in part, because the detection of this emission line is pushing the capabilities of both Chandra and XMM-Newton in terms of sensitivity. Also, there may be explanations other than sterile neutrinos if this X-ray emission line is deemed to be real. For example, there are ways that normal matter in the cluster could have produced the line, although the team's analysis suggested that all of these would involve unlikely changes to our understanding of physical conditions in the galaxy cluster or the details of the atomic physics of extremely hot gases. This image is Chandra's latest view of hot gas in the central region of the Perseus Cluster, where red, green, and blue show low, medium, and high-energy X-rays respectively. It combines data equivalent to more than 17 days worth of observing time taken over a decade with Chandra. The Perseus Cluster is one of the most massive objects in the Universe, and contains thousands of galaxies immersed in an enormous cloud of superheated gas. In Chandra's X-ray image, enormous bright loops, ripples, and jet-like streaks throughout the cluster can be seen. The dark blue filaments in the center are likely due to a galaxy that has been torn apart and is falling into NGC 1275 (a.k.a. Perseus A), the giant galaxy that lies at the center of the cluster. Since many neutrinos [are assumed to] come from stellar cores and supernovae, they are released at great temperature/energy. As neutrinos do not interact with matter electromagnetically, they are by definition [[w:dark matter|dark matter]]. "Other possible ‘escape clauses’ [to Ω_b''h''²) ≲ 0.1 but not with Ω_b''h''² = 1 (for ≥ 3 species of neutrinos)] can be invoked—for instance, there might be large-amplitude inhomogeneities in the initial baryon distribution, such that all the baryonic material we can now sample comes from underdense regions, the overdense regions having turned into dark population III objects (Rees 1983)."<ref name="Rees"/> {{clear}} ==Strong forces== {{main|Charges/Interactions/Strong}} [[Image:NASA’s Hubble Finds Universe Is Expanding Faster Than Expected (27415340994).jpg|thumb|right|250px|Astronomers using NASA’s Hubble Space Telescope have discovered that the universe is expanding 5 percent to 9 percent faster than expected. Credit: NASA Hubble Space Telescope.{{tlx|free media}}]] “This surprising finding may be an important clue to understanding those mysterious parts of the universe that make up 95 percent of everything and don’t emit light, such as dark energy, dark matter and dark radiation.”<ref name=Riess>{{ cite book |author=Adam Riess |title=NASA's Hubble finds universe is expanding faster than expected |publisher=NASA |location=Washington, DC USA |date=2016 |url=https://www.nasa.gov/feature/goddard/2016/nasa-s-hubble-finds-universe-is-expanding-faster-than-expected |accessdate=24 August 2022 }}</ref> The universe is expanding 5 percent to 9 percent faster than expected to an accuracy of 2.4 percent, which was achieved by measuring about 2,400 Cepheid stars in 19 galaxies and comparing the observed brightness of both types of stars, to their true brightness and calculating distances to roughly 300 Type Ia supernovae in far-flung galaxies. Compared to distances with the expansion of space as measured by the stretching of light from receding galaxies to calculate how fast the universe expands with time, or the Hubble constant. The improved Hubble constant value 45.5 miles per second per megaparsec. (A megaparsec equals 3.26 million light-years.) The new value means the distance between cosmic objects will double in another 9.8 billion years. This refined calibration does not quite match the expansion rate predicted for the universe from its trajectory seen shortly after the Big Bang. Measurements of the afterglow from the Big Bang by NASA’s Wilkinson Microwave Anisotropy Probe (WMAP) and the European Space Agency’s Planck satellite mission< yield predictions that are 5 percent and 9 percent smaller for the Hubble constant, respectively. “If we know the initial amounts of stuff in the universe, such as dark energy and dark matter, and we have the physics correct, then you can go from a measurement at the time shortly after the Big Bang and use that understanding to predict how fast the universe should be expanding today. However, if this discrepancy holds up, it appears we may not have the right understanding, and it changes how big the Hubble constant should be today.”<ref name=Riess/> “But now the ends are not quite meeting in the middle and we want to know why.”<ref name=Riess/> “We know so little about the dark parts of the universe, it’s important to measure how they push and pull on space over cosmic history.”<ref name= Macri >{{ cite book |author=Lucas Macri |title=NASA's Hubble finds universe is expanding faster than expected |publisher=NASA |location=Washington, DC USA |date=2016 |url=https://www.nasa.gov/feature/goddard/2016/nasa-s-hubble-finds-universe-is-expanding-faster-than-expected |accessdate=24 August 2022 }}</ref> "When two particles are very close, the mutual screening [gives] rise to a short-range strong force which is of the right strength to hold protons and neutrons within the atomic nuclei. [...] The same process originates also a short-range "weak" force on the electron [of the simple deuterium nucleus] closely orbiting a proton, giving rise to the neutron structure which undergoes β^- decay."<ref name="Michelini">{{cite journal |author=Maurizio Michelini |title=The Common Physical Origin of the Gravitational, Strong and Weak Forces |journal=Apeiron |month=October |year=2008 |volume=15 |issue=4 |pages=440-64 |url=http://www.rxiv.org/pdf/0810.0003v1.pdf |arxiv= |bibcode= |doi= |pmid= |accessdate=2013-11-07 }}</ref> {{clear}} ==Electromagnetics== {{main|Charges/Interactions/Electromagnetics}} "Charged-current charged pion production (CC þ) is a process in which a neutrino interacts with an atomic nucleus and produces a muon, a charged pion, and recoiling nuclear fragments."<ref name="Arevalo">{{cite journal |author=A. A. Aguilar-Arevalo, C. E. Anderson, A. O. Bazarko, ''et al.'' |title=Measurement of neutrino-induced charged-current charged pion production cross sections on mineral oil at E_v ~ 1 GeV |journal=Physical Review D |month=March |year=2011 |volume=83 |issue=5 |pages=052007 |url=http://adsabs.harvard.edu/abs/2011PhRvD..83e2007A |arxiv=1011.3572 |bibcode=2011PhRvD..83e2007A |doi=10.1103/PhysRevD.83.052007 |pmid= |accessdate=2013-11-06 }}</ref> ==Weak forces== {{main|Charges/Interactions/Weak}} [[Image:T2k flux run1to7 nd5 anumode.png|thumb|right|250px|The predicted flux is a function of energy at the ND280 detector for the antineutrino beam. Credit: T2K Collaboration.{{tlx|free media}}]] In each case, the muon neutrino, muon antineutrino, electron neutrino and electron antineutrino components of the beam are shown. As part of the Mikheyev–Smirnov–Wolfenstein effect, The presence of electrons in matter affects neutrino propagation due to charged current coherent forward scattering of the electron neutrinos (i.e., [[Weak interaction|weak interaction]]). The coherent forward scattering is analogous to the electromagnetic process leading to the refractive index of light in a medium. With antineutrinos, the effective charge that the weak interaction couples to (called ''weak isospin'') has an opposite sign. "The observation of a neutrino burst within 3 h of the associated optical burst from supernova 1987A in the Large Magellanic Cloud provides a new test of the weak equivalence principle, by demonstrating that neutrinos and photons follow the same trajectories in the gravitational field of the galaxy."<ref name="Krauss">{{cite journal |author=Lawrence M. Krauss, Scott Tremaine |title=Test of the Weak Equivalence Principle for Neutrinos and Photons |journal=Physical Review Letters |month=January |year=1988 |volume=60 |issue=3 |pages=176–7 |url=http://link.aps.org/doi/10.1103/PhysRevLett.60.176 |doi=10.1103/PhysRevLett.60.176 |bibcode=1988PhRvL..60..176K }}</ref> {{clear}} ==Continua== {{main|Radiation astronomy/Continua}} In the solar neutrino spectrum predicted by the [[standard solar model]], "The neutrino fluxes from the continuum sources (like pp and ⁸Be) are given in the units of number per cm² per second per MeV at one astronomical unit."<ref name="Bahcall"/> ==Emissions== {{main|Radiation astronomy/Emissions}} [[Image:J-PARC neutrino beam Japan to Korea.png|thumb|right|250px|Map shows the baseline and off-axis angle of the J-PARC beam in Japan and Korea. Credit: Hyper-Kamiokande Collaboration (K. Abe ''et al''.).{{tlx|free media}}]] The off-axis angle of the neutrino beam from J-PARC is on sea level. The baseline lengths (distance travelled by neutrinos from the source) are shown by vertical red contours, and the off-axis angles at the sea level are shown by the black elliptic contours between 0.5° and 3.0°. The SK (which is at 2.5° off the beam centre) is slightly off the corresponding contour because it is about 320 m above sea level. There is a "tight overlapping of the MeV photon flow [prompt MeV γ-ray emission] with the shocked regions [containing GeV photons produced in the shocks] [from supernovae ...] These high energy photons are absorbed by the MeV photon flow and generate relativistic e^± pairs. [...] Overlapping also influence neutrino emission. Besides the [3 x] 10¹⁵ ~ [3 x] 10¹⁷ eV neutrino emission [from photomeson interaction] powered by the interaction of the shock accelerated protons with the synchrotron photons [...] there comes another 10¹⁴ neutrino emission component powered by protons interacting with the MeV photon flow."<ref name="Fan">{{cite journal |author=Y. Z. Fan, Bing Zhang, and D. M. Wei |title=Early photon-shock interaction in a stellar wind: A sub-GeV photon flash and high-energy neutrino emission from long gamma-ray bursts |journal=The Astrophysical Journal |month=August 10, |year=2005 |volume=629 |issue=1 |pages=334-40 |url=http://iopscience.iop.org/0004-637X/629/1/334 |arxiv= |bibcode= |doi=10.1086/431473 |pmid= |accessdate=2013-11-07 }}</ref> ==Absorptions== {{main|Radiation astronomy/Absorptions|Absorption astronomy}} The "[[intergalactic medium]] (IGM) may be ionized by photons emitted from a cosmological distribution of massive neutrinos."<ref name="Sciama"/> "The absence of absorption troughs in quasar spectra due to atomic hydrogen and helium, and the possible presence of a trough due to singly ionized helium, would then imply that the neutrino mass lies between 50 and 110 eV."<ref name="Sciama">{{cite journal |author=D. W. Sciama |title=Massive neutrino decay and the photoionization of the intergalactic medium |journal=Monthly Notices of the Royal Astronomical Society |month=February |year=1982 |volume=198 |issue=02 |pages=1P-5P |url=http://adsabs.harvard.edu/full/1982MNRAS.198P...1S |arxiv= |bibcode=1982MNRAS.198P...1S |doi= |pmid= |accessdate=2014-02-07 }}</ref> A "calculated lifetime depends critically on whether a mechanism called GIM suppression is operating (de Rujula & Glashow 1980). [...] However, if GIM suppression does not operate (e.g. if there are four neutrino flavours) [... and] the C^IV observed by ''IUE'' high up in our galactic halo owes its ionization to photons from decaying neutrinos which dominant the halo [...] 96 eV ≤ ''m''_ν ≤ 110 eV τ ~ 10²⁷ s. These latter ideas might be tested by searching above the atmosphere for a faint narrow emission line (Δλ ~ 10^-3λ) at high galactic latitudes with a photon energy lying between 47.9 and ~ 55 eV."<ref name="Sciama"/> ==Bands== {{main|Radiation astronomy/Bands}} [[Image:Neutrino flavor flux.jpg|thumb|right|250px|Flux (Φ) of ⁸B solar neutrinos which are ''μ'' or ''τ'' flavor vs the flux of electron neutrinos (Φ_e) deduced from the three neutrino reactions in the Sudbury Neutrino Observatory (SNO). Credit: Ahmad ''et al.''{{tlx|fairuse}}]] "Using the neutral current [NC], elastic scattering [ES], and charged current [CC] reactions and assuming the standard ⁸B shape, the ''ν''_e component of the ⁸B solar flux is ''Φ''_e = 1.76±0.05 ([statistical uncertainty] stat.)±0.09 ([systematic uncertainty]syst.) x 10⁶ cm^-2s^-1 for a kinetic threshold of 5 MeV. The non-''ν''_e component is ''Φ''_µτ = 3.41±0.45 (stat.) +0.48 or -0.45 (syst.) x 10⁶ cm^-2s^-1, 5.3σ greater than zero, providing strong evidence for solar ''ν''_e flavor transformation."<ref name="Ahmad"/> "The Sudbury Neutrino Observatory (SNO) detects ⁸B solar neutrinos through the reactions:"<ref name="Ahmad"/> :<math>\nu_e + d \rightarrow p^+ + p^+ + e^- (CC),</math> :<math>\nu_x + d \rightarrow p^+ + n^0 + \nu_x (NC),</math> :<math>\nu_x + e^- \rightarrow \nu_x + e^- (ES).</math> "The charged current reaction (CC) is sensitive exclusively to electron-type neutrinos, while the neutral current reaction (NC) is equally sensitive to all active neutrino flavors (x = e, μ, τ). The elastic scattering reaction (ES) is sensitive to all flavors as well, but with reduced sensitivity to ''ν''_μ and ''ν''_τ."<ref name="Ahmad"/> "The bands intersect [in the figure at right] at the fit values for ''Φ''_e and ''Φ''_µτ, indicating that the combined flux results are consistent with neutrino flavor transformation assuming no distortion in the ⁸B neutrino energy spectrum."<ref name="Ahmad">{{cite journal |author=Q.R. Ahmad, R.C. Allen, T.C. Andersen, J.D. Anglin, J.C. Barton, E.W. Beier, M. Bercovitch, J. Bigu, S.D. Biller, R.A. Black, I. Blevis, R.J. Boardman, J. Boger, E. Bonvin, M.G. Boulay, M.G. Bowler, T.J. Bowles, S.J. Brice, M.C. Browne, T.V. Bullard, G. Bühler, J. Cameron, Y.D. Chan, H.H. Chen, M. Chen, X. Chen, B.T. Cleveland, E.T.H. Clifford, J.H.M. Cowan, D.F. Cowen, G.A. Cox, X. Dai, F. Dalnoki-Veress, W.F. Davidson, P.J. Doe, G. Doucas, M.R. Dragowsky, C.A. Duba, F.A. Duncan, M. Dunford, J.A. Dunmore, E.D. Earle, S.R. Elliott, H.C. Evans, G.T. Ewan, J. Farine, H. Fergani, A.P. Ferraris, R.J. Ford, J.A. Formaggio, M.M. Fowler, K. Frame, E.D. Frank, W. Frati, N. Gagnon, J.V. Germani, S. Gil, K. Graham, D.R. Grant, R.L. Hahn, A.L. Hallin, E.D. Hallman, A.S. Hamer, A.A. Hamian, W.B. Handler, R.U. Haq, C.K. Hargrove, P.J. Harvey, R. Hazama, K.M. Heeger, W.J. Heintzelman, J. Heise, R.L. Helmer, J.D. Hepburn, H. Heron, J. Hewett, A. Hime, M. Howe, J.G. Hykawy, M.C.P. Isaac, P. Jagam, N.A. Jelley, C. Jillings, G. Jonkmans, K. Kazkaz, P.T. Keener, J.R. Klein, A.B. Knox, R.J. Komar, R. Kouzes, T. Kutter, C.C.M. Kyba, J. Law, I.T. Lawson, M. Lay, H.W. Lee, K.T. Lesko, J.R. Leslie, I. Levine, W. Locke, S. Luoma, J. Lyon, S. Majerus, H.B. Mak, J. Maneira, J. Manor, A.D. Marino, N. McCauley, A.B. McDonald, D.S. McDonald, K. McFarlane, G. McGregor, R. Meijer Drees, C. Mifflin, G.G. Miller, G. Milton, B.A. Moffat, M. Moorhead, C.W. Nally, M.S. Neubauer, F.M. Newcomer, H.S. Ng, A.J. Noble, E.B. Norman, V.M. Novikov, M. O’Neill, C.E. Okada, R.W. Ollerhead, M. Omori, J.L. Orrell, S.M. Oser, A.W.P. Poon, T.J. Radcliffe, A. Roberge, B.C. Robertson, R.G.H. Robertson, S.S.E. Rosendahl, J.K. Rowley, V.L. Rusu,12 E. Saettler, K.K. Schaffer, M.H. Schwendener, A. Schülke, H. Seifert, M. Shatkay, J.J. Simpson, C.J. Sims, D. Sinclair, P. Skensved, A.R. Smith, M.W.E. Smith, T. Spreitzer, N. Starinsky, T.D. Steiger, R.G. Stokstad, L.C. Stonehill, R.S. Storey, B. Sur, R. Tafirout, N. Tagg, N.W. Tanner, R.K. Taplin, M. Thorman, P.M. Thornewell, P.T. Trent, Y.I. Tserkovnyak, R. Van Berg, R.G. Van de Water, C.J. Virtue, C.E. Waltham, J.-X. Wang, D.L. Wark, N. West, J.B. Wilhelmy, J.F. Wilkerson, J.R. Wilson, P. Wittich, J.M. Wouters, and M. Yeh |title=Direct evidence for neutrino flavor transformation from neutral-current interactions in the Sudbury Neutrino Observatory |journal=Physical Review Letters |year=2002 |volume=89 |issue=1 |pages=e011301 |url=http://prl.aps.org/abstract/PRL/v89/i1/e011301 |arxiv=nucl-ex/0204008 |bibcode= |doi= |pmid= |accessdate=2014-02-07 }}</ref> {{clear}} ==Backgrounds== {{main|Radiation astronomy/Backgrounds}} [[Image:Spectrum2017.png|thumb|right|250px|Spectrum of the Borexino data used for the simultaneous determination of the pp, pep and 7Be solar neutrino fluxes, as well as the best available limit on CNO neutrino flux with weak constraints. Credit: [[c:user:Eeergo|Eeergo]].{{tlx|free media}}]] Shown in red are the solar neutrino components, while background components are shown in other colors. Lower plot shows the difference between the datapoints' shape and the expected shape when adding together the expected fitting functions yielded by each species. The cosmic neutrino background (CNB) is the background particle radiation composed of neutrinos as a relic of the big bang which decoupled from matter when the universe was 2 seconds old. {{clear}} ==Meteors== {{main|Radiation/Meteors}} "The isotope ⁹²Nb decays to ⁹²Zr with a half-life of 3.47 × 10⁷ yr. Although this isotope does not exist in the current solar system, initial abundance ratios for ⁹²Nb/⁹³Nb at the time of solar system formation have been measured in primitive meteorites."<ref name="Hayakawa">{{cite journal |author=T. Hayakawa, K. Nakamura, T. Kajino, S. Chiba1,5, N. Iwamoto1, M. K. Cheoun6, and G. J. Mathews |title=Supernova Neutrino Nucleosynthesis of the Radioactive ⁹²Nb Observed in Primitive Meteorites |journal=The Astrophysical Journal Letters |month=December 10, |year=2013 |volume=779 |issue=1 |pages=L9 |url=http://iopscience.iop.org/2041-8205/779/1/L9 |arxiv= |bibcode= |doi=10.1088/2041-8205/779/1/L9 |pmid= |accessdate=2014-02-07 }}</ref> A "novel origin for ⁹²Nb may be via neutrino-induced reactions in core-collapse supernovae (ν-process)."<ref name="Hayakawa"/> The "observed ratio of ⁹²Nb/⁹³Nb ~ 10^-5 can be explained by the ν-process.<ref name="Hayakawa"/> ==Subatomics== {{main|Radiation astronomy/Subatomics|Subatomic astronomy}} Based on interactions between cosmic rays and the photons of the [[w:Cosmic microwave background radiation|cosmic microwave background radiation]] (CMB), cosmic rays with energies over the threshold energy of some 5 x 10¹⁹ [[w:electron-volt|eV]], a theoretical upper limit: the [[w:Greisen–Zatsepin–Kuzmin limit|Greisen–Zatsepin–Kuzmin limit]] (GZK limit), interact with cosmic microwave background photons <math>\gamma_{\rm CMB}</math> to produce [[w:pion|pion]]s via the <math>\Delta</math> resonance, :<math>\gamma_{\rm CMB}+p\rightarrow\Delta^+\rightarrow p + \pi^0,</math> or :<math>\gamma_{\rm CMB}+p\rightarrow\Delta^+\rightarrow n + \pi^+.</math> Pions produced in this manner proceed to decay in the standard pion channels—ultimately to photons for neutral pions, and photons, positrons, and various neutrinos for positive pions. Neutrons decay also to similar products, so that ultimately the energy of any cosmic ray proton is drained off by production of high energy photons plus (in some cases) high energy electron/positron pairs and neutrino pairs. ==Cosmic rays== {{main|Radiation/Cosmic rays}} [[Image:IceCube dataset1548 MuonEff.png|thumb|right|250px|This is the pass rate of the 2008 muon file for IceCube neutrino dataset 1548. Credit: [[c:user:ChenxuUDelPhysics|ChenxuUDelPhysics]].{{tlx|free media}}]] Neutrinos are created as a result of certain types of [[w:radioactive decay|radioactive decay]], or [[w:nuclear reaction|nuclear reaction]]s, or when [[w:cosmic ray|cosmic ray]]s hit atoms. Cosmic "ray neutrinos of local origin are also the background for neutrino astronomy."<ref name="Gaisser">{{cite book |author=Thomas K. Gaisser |title=Cosmic Rays and Particle Physics |publisher=Cambridge University Press |location= |year=1990 |editor= |pages=279 |url=http://books.google.com/books?hl=en&lr=&id=qJ7Z6oIMqeUC&oi=fnd&pg=PR15&ots=IxjwLxBwXu&sig=voHKIYstBlBYla4jcbur_b-Zwxs |arxiv= |bibcode= |doi= |pmid= |isbn=0521339316 |accessdate=2014-01-11 }}</ref> {{clear}} ==Neutrals== {{main|Radiation astronomy/Neutrals|Neutrals astronomy}} [[Image:Leptonic event in Gargamelle bubble chamber.jpg|thumb|right|250px|This event shows the real tracks produced in the Gargamelle bubble chamber that provided the first confirmation of a neutral current interaction. Credit: CERN.{{tlx|free media}}]] A neutrino interacts with an electron, the track of which is seen horizontally, and emerges as a neutrino without producing a muon. The discovery of the neutral current was announced in the CERN main auditorium in July 1973. "Neutral current single π⁰ production induced by neutrinos with a mean energy of 1.3GeV is measured at a 1000 ton water Cherenkov detector as a near detector of the K2K long baseline neutrino experiment."<ref name="Nakayama">{{cite journal |author=S. Nakayama, C. Mauger, M.H. Ahn, S. Aoki, Y. Ashie, H. Bhang, S. Boyd, D. Casper, J.H. Choi, S. Fukuda, Y. Fukuda, R. Gran, T. Hara, M. Hasegawa, T.Hasegawa, K. Hayashi, Y. Hayato, J. Hill, A.K. Ichikawa, A. Ikeda, T. Inagaki, T. Ishida, T. Ishii, M. Ishitsuka, Y. Itow, T. Iwashita, H.I. Jang, J.S. Jang, E.J. Jeon, K.K. Joo, C.K. Jung, T. Kajita, J. Kameda, K. Kaneyuki, I. Kato, E. Kearns, A. Kibayashi, D. Kielczewska, B.J. Kim, C.O. Kim, J.Y. Kim, S.B. Kim, K. Kobayashi, T. Kobayashi, Y. Koshio, W.R. Kropp, J.G. Learned, S.H. Lim, I.T. Lim, H. Maesaka, T. Maruyama, S. Matsuno, C. Mcgrew, A. Minamino, S. Mine, M. Miura, K. Miyano, T. Morita, S. Moriyama, M. Nakahata, K. Nakamura, I. Nakano, F. Nakata, T. Nakaya, T. Namba, R. Nambu, K. Nishikawa, S. Nishiyama, K. Nitta, S. Noda, Y. Obayashi, A. Okada, Y. Oyama, M.Y. Pac, H. Park, C. Saji, M. Sakuda, A. Sarrat, T. Sasaki, N. Sasao, K. Scholberg, M. Sekiguchi, E. Sharkey, M. Shiozawa, K.K. Shiraishi, M. Smy, H.W. Sobel, J.L. Stone, Y. Suga, L.R. Sulak, A. Suzuki, Y. Suzuki, Y. Takeuchi, N. Tamura, M. Tanaka, Y. Totsuka, S. Ueda, M.R. Vagins, C.W. Walter, W. Wang, R.J. Wilkes, S. Yamada, S. Yamamoto, C. Yanagisawa, H. Yokoyama, J. Yoo, M. Yoshida, and J. Zalipska |title=Measurement of single π⁰ production in neutral current neutrino interactions with water by a 1.3 GeV wide band muon neutrino beam |journal=Physics Letters B |month=July |year=2005 |volume=619 |issue=3-4 |pages=255-62 |url=http://www.sciencedirect.com/science/article/pii/S0370269305007161 |arxiv= |bibcode= |doi= |pmid= |accessdate=2014-02-07 }}</ref> "The single π⁰ production rate by atmospheric neutrinos could be usable to distinguish between the ν_µ ↔ ν_τ and ν_µ ↔ ν_s oscillation hypotheses. The NC rate is attenuated in the case of transitions of ν_µ’s into sterile neutrinos, while it does not change in the ν_µ ↔ ν_τ scenario."<ref name="Nakayama"/> {{clear}} ==Hadrons== {{main|Radiation astronomy/Hadrons}} [[Image:Technical sketch of the upgraded CDHS detector.png|thumb|right|250px|The image shows a technical sketch of the upgraded CDHS detector at CERN, which was operational until 1984. Credit: P. Berge ''et al''.{{tlx|free media}}]] The neutrino beam enters the detector from the left side, where it hits the Anti counter. The core of the detector consisted of 20 (19 before the upgrade) magnetized iron modules. In the spacings between these, drift chambers for track reconstruction were installed. Additionally, plastic scintillators were inserted into the iron. Each iron module served successively as an interaction target, where the neutrinos hit and produced hadron showers, a calorimeter that measured those hadrons' energy and a spectrometer, determining the momenta of produced muons via magnetic deflection. "Atmospheric neutrinos can interact with the detector producing also hadrons. The most probable of these reactions is the single pion production [20][21]:"<ref name=Undagoitia>{{ cite journal |author=T. Marrodán Undagoitia, F. von Feilitzsch, M. Göger-Neff, C. Grieb, K. A. Hochmuth, L. Oberauer, W. Potzel, and M. Wurm |title=Search for the proton decay p→ K+ ν in the large liquid scintillator low energy neutrino astronomy detector LENA |journal=Physical Review D |month=1 October |year=2005 |volume=72 |issue=7 |pages=075014 |url=http://arxiv.org/pdf/hep-ph/0511230.pdf |arxiv= |bibcode= |doi=10.1103/PhysRevD.72.075014 |pmid= |accessdate=2015-06-21 }}</ref> :<math>\nu_{\mu} + p \rightarrow \mu^- + \pi^+ + p^'.</math> "There is also a small loss due to inelastic hadronic interactions of the decay particles before they are stopped."<ref name=Undagoitia/> The "optical properties of mixtures of PXE [phenyl-o-xylylethane] and derivatives of mineral oils are under investigation [3]."<ref name=Undagoitia/> "Neutrino detection includes four remarkable reactions:"<ref name=Berezinsky>{{ cite journal |author=V. Berezinsky |title=Ultra High Energy Neutrino Astronomy |journal=Nuclear Physics. B, Proceedings Supplements |date=January 2006 |volume=151 |issue=1 |pages=260-9 |url=https://arxiv.org/pdf/astro-ph/0505220.pdf |arxiv= |bibcode=2006NuPhS.151..260B |doi=10.1016/j.nuclphysbps.2005.07.062 |pmid= |accessdate=10 July 2019 }}</ref> # Muon production ν_μ + N → μ + all gives an excellent tool to search for the discrete sources, since directions of UHE muon and neutrino coincide. # Resonant production of W-boson, {{SubatomicParticle|Antineutrino}}_e + e → W⁻ → hadrons results in production of monoenergetic showers with energy ''E''₀ = <math>m^2_W</math>/2m_e = 6.3 × 10⁶ GeV. This reaction has a large cross-section. # Tau production in a detector, ν_τ + N → τ + hadrons, is characterised by time sequence of three signals: a shower from prompt hadrons, the Cherenkov light from τ and hadron shower from τ-decay. SuperGZK ν_τ are absorbed less in the Earth due to regeneration: absorbed ν_τ is converted into τ, which decays producing ν_τ again. # Z-bursts provide a signal from the space, caused by the resonant Z⁰ production on DM neutrinos, ν + {{SubatomicParticle|Antineutrino}}_DM → Z⁰ → hadrons. The energy of the detected neutrino must be tremendous: E⁰ = <math> \frac{m^2_Z}{2m_{\nu}} = 1.7 \times 10^{13} \frac{0.23 eV}{m_{\nu}} GeV.</math> Non-accelerator neutrino sources "include objects with annihilation of DM (the Sun, Earth, cores of the galaxies), objects with the decays of superheavy DM particles (galactic halos) and topological defects. In the last two cases neutrinos are produced in the decays of superheavy particles with the masses up to M_GUT ∼ 10¹⁶ GeV. A particle decays to virtual particles, partons, which are cascading due to QCD interaction, and at the confinement radius cascade partons are converted to hadrons, most of which are pions. Neutrinos are produced in pion decays with spectrum which can be approximately described at highest energies as dE/E².<ref name=Berezinsky/> {{clear}} ==Neutrons== {{main|Radiation/Neutrons}} [[Image:1Superfluid in nuetro star.jpg|thumb|right|250px|This composite image shows a beautiful X-ray and optical view of Cassiopeia A (Cas A), a supernova remnant located in our Galaxy about 11,000 light years away. Credit: NASA.{{tlx|free media}}]] These are the remains of a massive star that exploded about 330 years ago, as measured in Earth's time frame. X-rays from Chandra are shown in red, green and blue along with optical data from Hubble in gold. At the center of the image is a neutron star, an ultra-dense star created by the supernova. Ten years of observations with Chandra have revealed a 4% decline in the temperature of this neutron star, an unexpectedly rapid cooling. This cooling is likely caused by a neutron superfluid forming in its central regions, the first direct evidence for this bizarre state of matter in the core of a neutron star. The inset shows an artist's impression of the neutron star at the center of Cas A. The different colored layers in the cutout region show the crust (orange), the core (red), where densities are much higher, and the part of the core where the neutrons are thought to be in a superfluid state (inner red ball). The blue rays emanating from the center of the star represent the copious numbers of neutrinos -- nearly massless, weakly interacting particles -- that are created as the core temperature falls below a critical level and a neutron superfluid is formed, a process that began about 100 years ago as observed from Earth. These neutrinos escape from the star, taking energy with them and causing the star to cool much more rapidly. This new research has placed the first observational constraints on a range of properties of superfluid material in neutron stars. The critical temperature was constrained to between one half a billion to just under a billion degrees Celsius. A wide region of the neutron star is expected to be forming a neutron superfluid as observed now, and to fully explain the rapid cooling, the protons in the neutron star must have formed a superfluid even earlier after the explosion. Because they are charged particles, the protons also form a superconductor. Using a model that has been constrained by the Chandra observations, the future behavior of the neutron star has been predicted. The rapid cooling is expected to continue for a few decades and then it should slow down. Around EeV (10¹⁸ eV) energies of ultra high energy neutron astronomy there may be associated ultra high energy neutrons “observed in anisotropic clustering ... because of the relativistic neutrons boosted lifetime.”<ref name="Fargion">{{cite journal |author=Fargion D, Khlopov M, Konoplich R, De Sanctis Lucentini PG, De Santis M, Mele B |title=Ultra High Energy Particle Astronomy, Neutrino Masses and Tau Airshowers |journal=Recent Res Dev Astrophys |month=March |year=2003 |volume=1 |issue=3 |pages=395-454 |url=http://arxiv.org/pdf/astro-ph/0303233 |doi= }}</ref> “[A]t ''E''_n = 10²⁰ eV, [these neutrons] are flying a Mpc, with their directional arrival (or late decayed proton arrival) ... more on-line toward the source.”<ref name="Fargion"/> Although “neutron (and anti-neutron) life-lengths (while being marginal or meaningless at tens of Mpcs, the growth of their half-lives with energy may naturally explain an associated, showering neutrino halo.”<ref name="Fargion"/> {{clear}} ==Protons== {{main|Radiation astronomy/Protons|Proton astronomy}} [[Image:Proton proton cycle.svg|250px|thumb|left|Solar neutrinos are shown for the proton-proton chain in the Standard Solar Model. Credit: [[:hu:User:SzDóri|Dorottya Szam]].{{tlx|free media}}]] [[Image:Conus crosssections.png|thumb|right|250px|Interaction crosssections are for different neutrino interaction channels at MeV energies. Credit: [[c:user:0nuBB|0nuBB]].{{tlx|free media}}]] On the right, one can see clearly that the coherent scattering due to the number of neutrons (N), N² enhancement, is by far the strongest interaction. IBD = Inverse Beta Decay. The following fusion reaction produces neutrinos and accompanying gamma-rays of the energy indicated: ::<math>\mathrm{_1^1H} + \mathrm{_1^1H} \rightarrow \mathrm{_{1}^{2}D} + e^+ + \nu_e + \gamma (0.42 MeV). </math> Observation of gamma rays of this energy likely indicate this reaction is occurring nearby. In the Cowan–Reines neutrino experiment, antineutrinos created in a nuclear reactor by beta decay reacted with protons producing neutrons and positrons: :{{SubatomicParticle|Electron antineutrino}} + {{SubatomicParticle|Proton+}} → {{SubatomicParticle|Neutron0}} + {{SubatomicParticle|Electron+}} The positron quickly finds an electron, and they [[w:Annihilation|annihilate]] each other. The two resulting gamma rays (γ) [511 keV each] are detectable. The neutron can be detected by its capture on an appropriate nucleus, releasing a gamma ray. The coincidence of both events – positron annihilation and neutron capture – gives a unique signature of an antineutrino interaction. "It is fair to note, however, that almost all theories which invoke non-baryonic matter require some level of coincidence in order that the luminous and unseen mass contribute comparable densities (to within one or two powers often). For instance, in a neutrino-dominated universe, (m_v/m_proton) must be within a factor ~ 10 of ''n''_b/''n''_γ. The only model that seems to evade this requirement is Witten’s (1984) idea that the quark-hadron phase transition may leave comparable amounts of material in ‘ordinary’ baryons and in ‘nuggets’ of exotic matter."<ref name="Rees"/> {{clear}} ==Electrons== {{main|Radiation astronomy/Electrons|Electron astronomy}} [[Image:HD.6D.639 (11999959835).jpg|thumb|right|250px|Photograph shows a neutrino collision in the Columbia University 10-ton aluminum spark chamber installed at the 33-billion-electron-volt Alternating Gradient Synchrotron at Brookhaven National Laboratory. Credit: [https://www.flickr.com/people/37916456@N02 ENERGY.GOV].{{tlx|free media}}]] The long straight spark track is that of a mu-meson created by an incident neutrino. A "PeV energy photon cannot deliver information from a source at the edge of our own galaxy because it will annihilate into an electron [positron] pair in an encounter with a 2.7 Kelvin microwave photon before reaching our telescope."<ref name="Halzen2002">{{cite journal |author=Francis Halzen and Dan Hooper |title=High-energy neutrino astronomy: the cosmic ray connection |journal=Reports on Progress in Physics |month=June 12, |year=2002 |volume=65 |issue=7 |pages=1025-107 |url=http://iopscience.iop.org/0034-4885/65/7/201 |arxiv=astro-ph/0204527 |bibcode= |doi=10.1088/0034-4885/65/7/201 |pmid= |accessdate=2014-02-08 }}</ref> "In general, energetic photons above a threshold ''E'' given by :<math>4E\epsilon \sim (2m_e)^2,</math> where ''E'' and ε are the energy of the high-energy and background photon, respectively. [This] implies that TeV-photons are absorbed on infrared light, PeV photons on the cosmic microwave background and EeV photons on radio-waves".<ref name="Halzen2002"/> "Each [optical module] OM contains a 10 inch [photo-multiplier tube] PMT that detects individual photons of Cerenkov light generated in the optically clear ice by muons and electrons moving with velocities near the speed of light."<ref name="Halzen2002"/> "Radio Cerenkov experiments detect the Giga-Hertz pulse radiated by shower electrons produced in the interaction of neutrinos in ice."<ref name="Halzen2002"/> "Above a threshold of ≃ 1PeV, the large number of low energy(≃ MeV ) photons in a shower will produce an excess of electrons over positrons by removing electrons from atoms by Compton scattering. These are the sources of coherent radiation at radio frequencies, i.e. above ∼ 100MHz."<ref name="Halzen2002"/> {{clear}} ==Positrons== {{main|Radiation astronomy/Positrons|Positron astronomy}} [[Image:Table isotopes en.svg|thumb|right|200px|This graph shows positron emissions, among others, from nuclear transmutation. Credit: [[c:user:Napy1kenobi|Napy1kenobi]] and [[c:user:Sjlegg|Sjlegg]].{{tlx|free media}}]] [[Image:Annihilation.png|thumb|right|200px|Naturally occurring electron-positron annihilation is a result of beta plus decay. Credit: Jens Maus.{{tlx|free media}}]] "If the proton and neutron are part of an [[w:atomic nucleus|atomic nucleus]], these decay processes [[w:Nuclear transmutation|transmute]] one chemical element into another. For example: :<math> A_ZN \rightarrow ~ ^{~~~A}_{Z-1}N' + e^+ + \nu_e, </math> where A = 22, Z = 11, ''N'' = Na, ''Z''-1 = 10, and ''N''' = Ne. Beta decay does not change the number of [[w:nucleon|nucleon]]s, ''A'', in the nucleus but changes only its [[w:electric charge|charge]], ''Z''. Thus the set of all [[w:nuclide|nuclide]]s with the same ''A'' can be introduced; these [[w:isobar (nuclide)|''isobaric'' nuclides]] may turn into each other via beta decay. Among them, several nuclides (at least one) are beta stable, because they present local minima of the [[w:mass excess|mass excess]]: if such a nucleus has (''A'', ''Z'') numbers, the neighbour nuclei (''A'', ''Z''&minus;1) and (''A'', ''Z''+1) have higher mass excess and can beta decay into (''A'', ''Z''), but not vice versa. For all odd mass numbers ''A'' the global minimum is also the unique local minimum. For even ''A'', there are up to three different beta-stable isobars experimentally known. There are about 355 known [[w:beta-decay stable isobars|beta-decay stable nuclides]] total. In {{SubatomicParticle|Beta+}} decay, or "positron emission", the weak interaction converts a nucleus into its next-lower neighbor on the periodic table while emitting an positron ({{SubatomicParticle|Positron}}) and an electron neutrino ({{SubatomicParticle|Electron neutrino}}): :<math> ^A_ZN \rightarrow ~ ^{~~~A}_{Z-1}N' + e^+ + \nu_e. </math> {{SubatomicParticle|Beta+}} decay cannot occur in an isolated proton because it requires energy due to the mass of the neutron being greater than the mass of the proton. {{SubatomicParticle|Beta+}} decay can only happen inside nuclei when the value of the [[w:binding energy|binding energy]] of the mother nucleus is less than that of the daughter nucleus. The difference between these energies goes into the reaction of converting a proton into a neutron, a positron and a neutrino and into the kinetic energy of these particles. ''Positron emission''' or '''beta plus decay''' (β⁺ decay) is a type of [[beta decay]] in which a proton is converted, via the weak force, to a neutron, releasing a positron and a neutrino. Isotopes which undergo this decay and thereby emit positrons include [[w:carbon-11|carbon-11]], [[w:Isotopes of potassium|potassium-40]], [[w:nitrogen-13|nitrogen-13]], [[w:Isotopes of oxygen|oxygen-15]], [[w:fluorine-18|fluorine-18]], and [[w:Isotopes of iodine|iodine-121]]. As an example, the following equation describes the beta plus decay of carbon-11 to [[w:boron|boron]]-11, emitting a positron and a neutrino: :<math> ^{11}_{6}C \rightarrow ~ ^{11}_{5}B + e^+ + \nu_e + \gamma {(0.96 MeV)}. </math> The figure at right shows a positron (e⁺) emitted from an atomic nucleus together with a [[wikt:neutrino|neutrino]] (v). Subsequently, the positron moves randomly through the surrounding matter where it hits several different electrons (e^-) until it finally loses enough energy that it interacts with a single electron. This process is called an "annihilation" and results in two diametrically emitted photons with a typical energy of 511 keV each. Under normal circumstances the photons are not emitted exactly diametrically (180 degrees). This is due to the remaining energy of the positron having conservation of momentum. At energies near and beyond the mass of the carriers of the [[w:weak interaction|weak force]], the [[w:W and Z bosons|W and Z bosons]], the strength of the weak force becomes comparable with [[w:electromagnetism|electromagnetism]].<ref name="Griffiths">{{cite book |author=D.J. Griffiths |year=1987 |title=Introduction to Elementary Particles |publisher=John Wiley & Sons |isbn=0-471-60386-4 }}</ref> It becomes much easier to produce particles such as neutrinos that interact only weakly. {{clear}} ==Muons== {{main|Radiation astronomy/Muons|Muon astronomy}} "TeV muons from γ ray primaries ... are rare because they are only produced by higher energy γ rays whose flux is suppressed by the decreasing flux at the source and by absorption on interstellar light."<ref name=Halzen1997>{{ cite journal |author=Francis Halzen, Todor Stanev, Gaurang B. Yodh |title=γ ray astronomy with muons |journal=Physical Review D Particles, Fields, Gravitation, and Cosmology |month=April 1, |year=1997 |volume=55 |issue=7 |pages=4475-9 |url=http://prd.aps.org/abstract/PRD/v55/i7/p4475_1 |arxiv=astro-ph/9608201 |bibcode=1997PhRvD..55.4475H |doi=10.1103/PhysRevD.55.4475 |pmid= |accessdate=2013-01-18 }}</ref> Muon decay produces three particles, an electron plus two neutrinos of different types. "The muons created through decays of secondary pions and kaons are fully polarized, which results in electron/positron decay asymmetry, which in turn causes a difference in their production spectra."<ref name=Moskalenko>{{ cite journal |author=I. V. Moskalenko and A. W. Strong |title=Production and propagation of cosmic-ray positrons and electrons |journal=The Astrophysical Journal |month=February 1, |year=1998 |volume=493 |issue=2 |pages=694-707 |url=http://iopscience.iop.org/0004-637X/493/2/694 |arxiv=astro-ph/9710124 |bibcode=1998ApJ...493..694M |doi=10.1086/305152 |pmid= |accessdate=2014-02-01 }}</ref> ==Gamma rays== {{main|Radiation astronomy/Gamma rays|Gamma-ray astronomy}} "The important conclusion is that, independently of the specific blueprint of the source, it takes a kilometer-scale neutrino observatory to detect the neutrino beam associated with the highest energy cosmic rays and gamma rays."<ref name="Halzen2002"/> "As with supernovae, [gamma-ray burst] GRB are expected to radiate the vast majority of their initial energy as thermal [MeV] neutrinos."<ref name="Halzen2002"/> "Protons [shocked protons: TeV - EeV neutrinos] accelerated in GRB can interact with fireball gamma rays and produce pions that decay into neutrinos."<ref name="Halzen2002"/> "In a GRB fireball, neutrons can decouple from protons in the expanding fireball. If their relative velocity is sufficiently high, their interactions will be the source of pions and, therefore, neutrinos [GeV]. Typical energies of the neutrinos produced are much lower than those resulting from interactions with gamma rays."<ref name="Halzen2002"/> ==X-rays== {{main|Radiation astronomy/X-rays|X-ray astronomy}} Some "of the possible sources of the ultra-high energy cosmic rays, such as very young supernova remnants and X-ray binaries, are associated with relatively dense concentrations of matter and would therefore be likely point sources of secondary photons and neutrinos."<ref name="Gaisser"/> ==Ultraviolets== {{main|Radiation astronomy/Ultraviolets|Ultraviolet astronomy}} "Massive neutrinos are expected to decay into lighter neutrinos and uv photons, with lifetimes long on the Hubble scale."<ref name="Rujula">{{cite journal |author=A De Rujula, SL Glashow |title=Galactic neutrinos and UV astronomy |journal=Physical Review Letters |month=September 15, |year=1980 |volume=45 |issue=09 |pages=942-4 |url=http://www.osti.gov/energycitations/product.biblio.jsp?osti_id=5001920 |arxiv= |bibcode=1980PhRvL..45..942D |doi=10.1103/PhysRevLett.45.942 |pmid= |accessdate=2014-02-08 }}</ref> ==Opticals== {{main|Radiation astronomy/Opticals|Optical astronomy}} "The arrival times of the Cerenkov photons in 6 optical sensors determine the direction of the muon track."<ref name="Halzen2002"/> "The optical requirements on the detector medium are severe. A large absorption length is needed because it determines the required spacing of the optical sensors and, to a significant extent, the cost of the detector. A long scattering length is needed to preserve the geometry of the Cerenkov pattern. Nature has been kind and offered ice and water as natural Cerenkov media. Their optical properties are, in fact, complementary. Water and ice have similar attenuation length, with the roles of scattering and absorption reversed. Optics seems, at present, to drive the evolution of ice and water detectors in predictable directions: towards very large telescope area in ice exploiting the long absorption length, and towards lower threshold and good muon track reconstruction in water exploiting the long scattering length."<ref name="Halzen2002"/> "The Baikal experiment represents a proof of concept for future deep ocean projects that have the advantage of larger depth and optically superior water."<ref name="Halzen2002"/> "With the attenuation length peaking at 55m near 470 nm, the site is optically similar to that of the best deep water sites investigated for neutrino astronomy."<ref name="Halzen2002"/> "Astronomy, whether in the optical or in any other wave-band, thrives on a diversity of complementary instruments, not on “a single best instrument”."<ref name="Halzen2002"/> ==Visuals== {{main|Radiation astronomy/Visuals|Visual astronomy}} "With an optical depth of order ∼ 10¹⁵, photons are trapped in the fireball. This results in the highly relativistic expansion of the fireball powered by radiation pressure [168, 177]. The fireball will expand with increasing velocity until it becomes transparent and the radiation is released. This results in the visual display of the GRB."<ref name="Halzen2002"/> ==Violets== {{main|Radiation astronomy/Violets|Violet astronomy}} "At present all the LEDs used [in the ANTARES neutrino telescope] emit light in the blue at 470nm with a FWHM of 15nm, however, the design is flexible enough to use violet or near-ultraviolet LEDs if there is sufficient interest in water transmission monitoring at these wavelengths and if the individual LED prices permit."<ref name="McMillan">{{cite journal |author=JE McMillan, A Collaboration |title=Calibration systems for the ANTARES neutrino telescope |journal=International Cosmic Ray |year=2001 |volume= |issue= |pages= |url=http://hepwww.shef.ac.uk/reports/0201.pdf |arxiv= |bibcode= |doi= |pmid= |accessdate=2014-02-08 }}</ref> ==Blues== {{main|Radiation astronomy/Blues|Blue astronomy}} [[Image:SN 1987A HST.jpg|thumb|right|250px|Supernova SN 1987A is one of the brightest stellar explosions since the invention of the telescope more than {{nowrap|400 years}} ago.<ref name="PictureoftheWeek">{{cite book |title=Hubble Revisits an Old Friend, In: ''Picture of the Week'' |url=http://www.spacetelescope.org/images/potw1142a/ |publisher=ESA/Hubble |accessdate=17 October 2011 }}</ref> Credit: ESA/Hubble & NASA.{{tlx|free media}}]] "On February 23.316 UT, 1987, [blue] light and neutrinos from the brightest supernova in 383 years arrived at Earth ... it has been observed ... at all wavelengths from radio through gamma rays, SN 1987A is the only object besides the Sun to have been detected in neutrinos."<ref name="Arnett">{{cite journal |author=W. David Arnett, John N. Bahcall, Robert P. Kirshner, and Stanford E. Woosley |title=Supernova 1987A |journal=Annual Review of Astronomy and Astrophysics |year=1989 |volume=27 |issue= |pages=629-700 |url=http://articles.adsabs.harvard.edu/full/1989ARA%26A..27..629A |arxiv= |bibcode=1989ARA&A..27..629A |doi=10.1146/annurev.aa.27.090189.003213 |pmid= |accessdate=2013-05-31 }}</ref> At right is an image of supernova SN 1987A, one of the brightest stellar explosions since the invention of the telescope more than {{nowrap|400 years}} ago.<ref name="PictureoftheWeek"/> Four days after the event was recorded, the progenitor star was tentatively identified as Sanduleak -69° 202, a [[w:blue supergiant|blue supergiant]].<ref name="Sonneborn">{{cite book | author=G. Sonneborn | title=The Progenitor of SN1987A, In: ''Supernova 1987a in the Large Magellanic Cloud'' | editor=Minas Kafatos, Andreas Gerasimos Michalitsianos | publisher=Cambridge University Press | year=1987 | isbn=0-521-35575-3 }}</ref> This was an unexpected identification, because at the time a blue supergiant was not considered a possibility for a supernova event in existing models of [[w:Stellar_evolution#Massive_stars|high mass stellar evolution]]. Many models of the progenitor have attributed the color to its chemical composition, particularly the low levels of heavy elements, among other factors.<ref name="Arnett"/> {{clear}} ==Reds== {{main|Radiation astronomy/Reds|Red astronomy}} "[N]on-standard neutrino losses [may have an] impact on the red giant branch (RGB)".<ref name="Raffelt">{{cite journal |author=Georg Raffelt and Achim Weiss |title=Non-standard neutrino interactions and the evolution of red giants |journal=Astronomy and Astrophysics |month=October |year=1992 |volume=264 |issue=2 |pages=536-46 |url=http://adsabs.harvard.edu/abs/1992A&A...264..536R |arxiv= |bibcode=1992A&A...264..536R |doi= |pmid= |accessdate=2013-08-02 }}</ref> ==Infrareds== {{main|Radiation astronomy/Infrareds|Infrared astronomy}} "For neutrino masses in the eV regime, such a radiative decay process would contribute to the infrared background."<ref name="Biller">{{cite journal |author=SD Biller, J Buckley, A Burdett, JB Gordo |title=New Limits to the Infrared Background: Bounds on Radiative Neutrino Decay and on Contributions of Very Massive Objects to the Dark Matter Problem |journal=Physical Review Letters |year=1998 |volume=80 |issue=14 |pages=2992 |url=http://prl.aps.org/abstract/PRL/v80/i14/p2992_1 |arxiv= |bibcode= |doi= |pmid= |accessdate=2014-02-08 }}</ref> ==Radars== {{main|Radiation astronomy/Radars|Radar astronomy}} The "Shapiro geodesic time delay is identical, to this accuracy, for different elementary particles, independent of spin and internal quantum numbers."<ref name="Krauss"/> "To test the [weak equivalence principle] WEP, however, the issue is not the value of γ but whether it is the same for all species of particles, that is, whether, for example, the same time delay would be measured if neutrino radar rather than photon radar were used."<ref name="Krauss"/> ==Radios== {{main|Radiation astronomy/Radios|Radio astronomy|Radio astronomy}} "The neutrino energy is, however, above the threshold for EeV telescopes using acoustic, radio or horizontal air shower detection techniques. This mechanism may represent an opportunity for detectors with very high threshold, but also large effective area to do GRB physics."<ref name="Halzen2002"/> ==Superluminals== {{main|Radiation astronomy/Superluminals|Superluminal astronomy}} "Because neutrinos are electrically neutral, conventional Cherenkov radiation of superluminal neutrinos does not arise or is otherwise weakened. However neutrinos do carry electroweak charge and ... may emit Cherenkov-like radiation via weak interactions when traveling at superluminal speeds."<ref name="Antonello">{{cite journal |author=M. Antonello, P. Aprili, B. Baibussinov, M. Baldo Ceolin, P. Benetti, E. Calligarich, N. Canci, F. Carbonara, S. Centro, A. Cesana, K. Cieslik, D. B. Cline, A. G. Cocco, A. Dabrowska, D. Dequal, A. Dermenev, R. Dolfini, C. Farnese, A. Fava, A. Ferrari, G. Fiorillo, D. Gibin, A. Gigli Berzolari, S. Gninenko, A. Guglielmi, M. Haranczyk, J. Holeczek, A. Ivashkin, J. Kisiel, I. Kochanek, J. Lagoda, S. Mania, G. Mannocchi, A. Menegolli, G. Meng, C. Montanari, S. Otwinowski, L. Periale, A. Piazzoli, P. Picchi, F. Pietropaolo, P. Plonski, A. Rappoldi, G. L. Raselli, M. Rossella, C. Rubbia, P. Sala, E. Scantamburlo, A. Scaramelli, E. Segreto, F. Sergiampietri, D. Stefan, J. Stepaniak, R. Sulej, M. Szarska, M. Terrani, F. Varanini, S. Ventura, C. Vignoli, H. Wang, X. Yang, A. Zalewska, K. Zaremba, A. Cohen |title=A search for the analogue to Cherenkov radiation by high energy neutrinos at superluminal speeds in ICARUS |journal=Physics Letters B |month=May 15, |year=2012 |volume=711 |issue=3-4 |pages=270-5 |url=http://inspirehep.net/record/940150/files/arXiv:1110.3763.pdf |arxiv= |bibcode= |doi= |pmid= |accessdate=2012-07-28 }}</ref> "[S]uperluminal neutrinos may lose energy rapidly via the bremsstrahlung [Cherenkov radiation] of electron-positron pairs <math>(\nu \rightarrow \nu + e^- + e^+).</math>"<ref name="Cohen">{{cite journal |author=Andrew G. and Sheldon L. Glashow |title=Pair Creation Constrains Superluminal Neutrino Propagation |journal=Physical Review Letters |month=October |year=2011 |volume=107 |issue=18 |pages=181803 |url=http://adsabs.harvard.edu/abs/2011PhRvL.107r1803C |arxiv=1109.6562 |bibcode=2011PhRvL.107r1803C |doi=10.1103/PhysRevLett.107.181803 |pmid= |accessdate=2013-08-16 }}</ref> Assumption: "muon neutrinos with energies of order tens of GeV travel at superluminal velocity."<ref name="Cohen"/> For "all cases of superluminal propagation, certain otherwise forbidden processes are kinematically permitted, even in vacuum."<ref name="Cohen"/> Consider : <math> \nu_{\mu} \rightarrow \begin{bmatrix} {\nu_{\mu} + \gamma} & (a) \\ {\nu_{\mu} + \nu_e + \overline\nu_e } & (b) \\ {\nu_{\mu} + e^+ + e^-} & (c) \end{bmatrix} </math><ref name="Cohen"/> "These processes cause superluminal neutrinos to lose energy as they propagate and ... process (c) places a severe constraint upon potentially superluminal neutrino velocities. ... Process (c), pair bremsstrahlung, proceeds through the neutral current weak interaction."<ref name="Cohen"/> "Throughout the shower development, the electrons and positrons which travel faster than the speed of light in the air emit Cherenkov radiation."<ref name="Moralejo">{{cite journal |author=A. Moralejo for the MAGIC collaboration |title=The MAGIC telescope for gamma-ray astronomy above 30 GeV |journal=Memorie della Societa Astronomica Italiana |year=2004 |volume=75 |issue= |pages=232-9 |url=http://adsabs.harvard.edu/abs/2004MmSAI..75..232M |arxiv= |bibcode=2004MmSAI..75..232M |doi= |pmid= |accessdate=2012-07-28 }}</ref> "High energy processes such as [[w:Compton scattering|Compton]], [[w:Bhabha scattering|Bhabha]], and [[w:Møller scattering|Moller scattering]], along with [[w:Positron annihilation|positron annihilation]] rapidly lead to a ~20% negative charge asymmetry in the electron-photon part of a cascade ... initiated by a ... 100 PeV neutrino"<ref name="Gorham">{{cite journal |author= P. W. Gorham, S. W. Barwick, J. J. Beatty, D. Z.Besson, W. R. Binns, C. Chen, P. Chen, J. M. Clem, A. Connolly, P. F. Dowkontt, M. A. DuVernois, R. C. Field, D. Goldstein, A. Goodhue, C. Hast, C. L. Hebert, S. Hoover, M. H. Israel, J. Kowalski, J. G. Learned, K. M. Liewer, J. T. Link, E. Lusczek, S. Matsuno, B. Mercurio, C. Miki, P. Miocinovic, J. Nam, C. J. Naudet, J. Ng, R. Nichol, K. Palladino, K. Reil, A. Romero-Wolf, M. Rosen, L. Ruckman, D. Saltzberg, D. Seckel, G. S. Varner, D. Walz, F. Wu |title=Observations of the Askaryan Effect in Ice |journal=Physical Review Letters |month=October 25, |year=2007 |volume=99 |issue=17 |pages=5 |url=http://arxiv.org/pdf/hep-ex/0611008.pdf |arxiv= |bibcode= |doi=10.1103/PhysRevLett.99.171101 |pmid= |accessdate=2012-07-28 }}</ref>. ==Plasma objects== {{main|Plasmas/Plasma objects|Plasma objects}} "The exploding [GRB] fireballs original size, R₀, is that of the compact progenitor, for instance the black hole created by the collapse of a massive star. As the fireball expands the flow is shocked in ways familiar from the emission of jets by the black holes at the centers of active galaxies or mini-quasars. (A way to visualize the formation of shocks is to imagine that infalling material accumulates and chokes the black hole. At this point a blob of plasma is ejected. Between these ejections the emission is reduced.) The net result is that the expanding fireball is made up of multiple shocks. These are the sites of the acceleration of particles to high-energy and the seeds for the complex millisecond structures observed in individual bursts"<ref name="Halzen2002"/> ==Gaseous objects== {{main|Gases/Gaseous objects}} All "these signals are electromagnetic waves and, as such, interact rather strongly with matter. This means that only the information on the thin surface of stellar objects and/or on diffuse gaseous objects can be conveyed by these signals."<ref name="Koshiba">{{cite book |author=M Koshiba |title=Neutrino Astrophysics: Its Birth and Future, In: ''Astronomy, Cosmology and Fundamental Physics'' |publisher=Springer |location=New york |year=1989 |editor= |pages= |url=http://link.springer.com/content/pdf/10.1007/978-94-009-0965-6_24.pdf |arxiv= |bibcode= |doi=10.1007/978-94-009-0965-6_24 |pmid= |isbn= |accessdate=2014-02-08 }}</ref> ==Hydrogens== {{main|Chemicals/Hydrogens}} Cosmic "rays interact with the Earth’s atmosphere [109, 110] and with the hydrogen concentrated in the galactic plane [46, 47, 111, 112, 113] producing high-energy neutrinos."<ref name="Halzen2002"/> ==Heliums== {{main|Chemicals/Heliums}} "The cosmic helium abundance can however be measured with sufficient precision to suggest that the primordial ⁴He is less than 26 per cent at the 3 σ level (Pagel 1982). This is compatible with Ω_b''h''²) ≲ 0.1 but not with Ω_b''h''² = 1 (for ≥ 3 species of neutrinos)."<ref name="Rees"/> ==Lithiums== {{main|Chemicals/Lithiums}} There is a practical "possibility for utilizing lithium as a solar-neutrino detector".<ref name="Veretenkin">{{cite journal |author=E. P. Veretenkin, V. N. Gavrin, E. A. Yanovich |title=Use of metallic lithium for detecting solar neutrinos |journal=Soviet Atomic Energy |month=January 1, |year=1985 |volume=58 |issue=1 |pages=82-3 |url=http://link.springer.com/article/10.1007%2FBF01123252?LI=true |arxiv= |bibcode= |doi=10.1007/BF01123252 |pmid= |accessdate=2014-02-08 }}</ref> ==Berylliums== {{main|Chemicals/Berylliums}} The isotopes ⁷Be, with a half-life of 53 days, and ¹⁰Be are both [[w:cosmogenic nuclides|cosmogenic nuclides]] because they are made on a recent timescale in the solar system by spallation, like ¹⁴C. These two radioisotopes of beryllium in the atmosphere track the sun spot cycle and solar activity, since this affects the magnetic field that shields the Earth from cosmic rays. The rate at which the short-lived ⁷Be is transferred from the air to the ground is controlled in part by the weather. ⁷Be decay in the sun is one of the sources of [[w:solar neutrino|solar neutrino]]s, and the first type ever detected using the [[w:Homestake experiment|Homestake experiment]]. ==Borons== "Also of importance in this emerging field [of observational neutrino astrophysics] are the observation of solar boron-8 neutrinos and the detection of high-energy point sources."<ref name="Koshiba1987">{{cite journal |author=Masa-Toshi Koshiba |title=Observational neutrino astrophysics |journal=Physics Today |month=December |year=1987 |volume=40 |issue= |pages=38-42 |url=http://adsabs.harvard.edu/abs/1987PhT....40l..38K |arxiv= |bibcode=1987PhT....40l..38K |doi=10.1063/1.881092 |pmid= |accessdate=2014-02-08 }}</ref> ==Carbons== "In any case a star with a mass equal to or smaller than 7 M_⊙ cannot have a nonviolent carbon burning phase if the neutrino emission due to “universal Fermi interaction” exists."<ref name="Paczynski">{{cite journal |author=B Paczynski |title=Evolution of Single Stars. I. Stellar Evolution from Main Sequence to White Dwarf or Carbon Ignition |journal=Acta Astronomica |year=1970 |volume=20 |issue=2 |pages=47-58 |url=http://adsabs.harvard.edu/full/1970AcA....20...47P |arxiv= |bibcode=1970AcA....20...47P |doi= |pmid= |accessdate=2014-02-08 }}</ref> ==Nitrogens== {{main|Chemicals/Nitrogens}} "The [cosmic-ray] shower can be observed by: i) sampling the electromagnetic and hadronic components when they reach the ground with an array of particle detectors such as scintillators, ii) detecting the fluorescent light emitted by atmospheric nitrogen excited by the passage of the shower particles, iii) detecting the Cerenkov light emitted by the large number of particles at shower maximum, and iv) detecting muons and neutrinos underground."<ref name="Halzen2002"/> ==Oxygens== "These “atmospheric neutrinos” come from the decay of pions and kaons produced by the collisions of cosmic-ray particles with nitrogen and oxygen in the atmosphere."<ref name="Halzen2010">{{cite journal |author=Francis Halzen and Spencer R. Klein |title=IceCube: An instrument for neutrino astronomy |journal=Review of Scientific Instruments |month=August |year=2010 |volume=81 |issue=8 |pages=081101 - 081101-24 |url=http://ieeexplore.ieee.org/xpls/abs_all.jsp?arnumber=5574379 |arxiv= |bibcode= |doi=10.1063/1.3480478 |pmid= |accessdate=2014-02-08 }}</ref> ==Fluorines== "Measurements of fluorine in the interstellar medium (Federman et al. 2005) show no evidence of F overabundances due to the neutrino process in Type II supernova."<ref name="Lucatello">{{cite journal |author=Sara Lucatello, Thomas Masseron, Jennifer A. Johnson, Marco Pignatari, and Falk Herwig |title=Fluorine and Sodium in C-rich Low-metallicity Stars |journal=The Astrophysical Journal |month=March 1, |year=2011 |volume=729 |issue=1 |pages=40 |url=http://iopscience.iop.org/0004-637X/729/1/40 |arxiv= |bibcode= |doi=10.1088/0004-637X/729/1/40 |pmid= |accessdate=2014-02-08 }}</ref> ==Neons== The neutrino oscillation signatures are discussed regarding "flavor conversion of neutrinos from core-collapse supernovae that have oxygen-neon-magnesium (ONeMg) cores."<ref name="Lunardini">{{cite journal |author=C Lunardini, B Müller, HT Janka |title=Neutrino oscillation signatures of oxygen-neon-magnesium supernovae |journal=Physical Review D |year=2008 |volume=78 |issue=2 |pages=e023016 |url=http://prd.aps.org/abstract/PRD/v78/i2/e023016 |arxiv= |bibcode= |doi= |pmid= |accessdate=2014-02-08 }}</ref> ==Galliums== "[R]adiochemical experiments using gallium (the GALLEX experiment^6,7 in Italy and the SAGE experiment^8,9 in Russia) have detected the copious low energy (below 400 keV) neutrinos that are the primary component of the solar neutrino flux."<ref name="Bahcall"/> ==Compounds== {{main|Radiation astronomy/Compounds}} The first detection of "solar neutrinos [used] radiochemical techniques and a cleaning fluid (perchloroethylene [C₂Cl₄]) as a target. [...] After about two months [...] the standard solar model^22-24 predicts that only about 54 ³⁷Ar atoms are present in the 615 tons of C₂Cl₄ [...] at extraction [the number observed is] only 17, corresponding to a solar neutrino induced production rate of 0.5 atoms per day, far fewer than the 1.5 atoms per day expected on the basis of the standard model. In terms of the solar neutrino unit, SNU [...] 1 SNU = 10^-36 interactions per target atom per second), the observations yield 2.55 ± 0.25 SNU, about one third of the prediction of the standard model."<ref name="Bahcall">{{cite journal |author=John N. Bahcall, K. Lande, R. E. Lanou Jr, J. G. Learned, R. G. H. Robertson, L. Wolfenstein |title=Progress and prospects in neutrino astrophysics |journal=Nature |month=May |year=1995 |volume=375 |issue=6526 |pages=29-34 |url=http://adsabs.harvard.edu/abs/1995Natur.375...29B |arxiv= |bibcode=1995Natur.375...29B |doi= |pmid= |accessdate=2013-11-07 }}</ref> ==Atmospheres== {{main|Radiation astronomy/Atmospheres|Atmospheric astronomy}} Atmospheric neutrinos result from the interaction of cosmic rays with atomic nuclei in the [[w:Earth's atmosphere|Earth's atmosphere]], creating showers of particles, many of which are unstable and produce neutrinos when they decay. A collaboration of particle physicists from the [[w:Tata Institute of Fundamental Research|Tata Institute of Fundamental Research]] (India), [[w:Osaka City University|Osaka City University]] (Japan) and [[w:Durham University|Durham University]] (UK) recorded the first cosmic ray neutrino interaction in an underground laboratory in [[w:Kolar Gold Fields|Kolar Gold Fields]] in India in 1965. ==Sun== {{main|Stars/Sun|Sun (star)}} [[Image:Neusun1 superk1.jpg|thumb|right|200px|This "neutrino image" of the Sun is produced by using the Super-Kamiokande to detect the neutrinos from nuclear fusion coming from the Sun. Credit: R. Svoboda and K. Gordan (LSU).{{tlx|fairuse}}]] Neutrinos are hard to detect. The Super-Kamiokande, or "Super-K" is a large-scale experiment constructed in an unused mine in Japan to detect and study neutrinos. The image at right required 500 days worth of data to produce the "neutrino image" of the Sun. The image is centered on the Sun's position. It covers a 90° x 90° octant of the sky (in right ascension and declination). The higher the brightness of the color, the larger is the neutrino flux. "The detection of solar neutrinos demonstrates that fusion energy is the basic source of energy received from the sun."<ref name="Bahcall"/> In detecting solar neutrinos, it became clear that the number detected was half or a third than that predicted by models of the solar interior. The problem was solved by revising the properties of neutrinos and understanding the limits of the detection mechanisms - only one third of the forms of neutrinos coming in was being detected and all neutrinos oscillate between the three forms. The first experiment to detect the effects of neutrino oscillation was Ray Davis's Homestake Experiment in the late 1960s, in which he observed a deficit in the flux of [[Sun (star)|solar]] neutrinos with respect to the prediction of the Standard Solar Model, using a chlorine-based detector. This gave rise to the Solar neutrino problem. Many subsequent radiochemical and water Cherenkov detectors confirmed the deficit, but neutrino oscillation was not conclusively identified as the source of the deficit until the Sudbury Neutrino Observatory provided clear evidence of neutrino flavor change in 2001. Solar neutrinos have energies below 20&nbsp;MeV and travel an astronomical unit between the source in the Sun and detector on the Earth. At energies above 5&nbsp;MeV, solar neutrino oscillation actually takes place in the Sun through a resonance known as the Mikheyev–Smirnov–Wolfenstein effect (MSW) effect, a different process from the vacuum oscillation. Most neutrinos passing through the Earth emanate from the Sun. About 65&nbsp;billion (6.5 x 10¹⁰) solar neutrinos per second pass through every square centimeter perpendicular to the direction of the Sun in the region of the Earth.<ref name="Bahcall2005">{{cite journal |author=J. Bahcall ''et al.'' |year=2005 |title=New solar opacities, abundances, helioseismology, and neutrino fluxes |journal=The Astrophysical Journal |volume=621 |issue= |pages=L85–L88 |arxiv=astro-ph/0412440 |bibcode=2005ApJ...621L..85B |doi=10.1086/428929 }}</ref> The Mikheyev Smirnov Wolfenstein (MSW) effect is important at the very large electron densities of the [[Stars/Sun|Sun]] where electron neutrinos are produced. The high-energy neutrinos seen, for example, in the Sudbury Neutrino Observatory (SNO) and in Super-Kamiokande, are produced mainly as the higher mass eigenstate in matter ν_2m, and remain as such as the density of solar material changes. (When neutrinos go through the ''MSW resonance'' the neutrinos have the maximal probability to change their nature, but it happens that this probability is negligibly small—this is sometimes called propagation in the adiabatic regime). Thus, the neutrinos of high energy leaving the sun are in a vacuum propagation eigenstate, ν₂, that has a reduced overlap with the electron neutrino ν_e = ν₁ cosθ + ν₂ sinθ seen by charged current reactions in the detectors. For high-energy solar neutrinos the MSW effect is important, and leads to the expectation that ''P''_ee&nbsp;=&nbsp;sin²''θ'', where θ&nbsp;=&nbsp;34° is the solar mixing angle. This was dramatically confirmed in the Sudbury Neutrino Observatory (SNO), which has resolved the solar neutrino problem. SNO measured the flux of Solar electron neutrinos to be ~34% of the total neutrino flux (the electron neutrino flux measured via the charged current reaction, and the total flux via the neutral current reaction). The SNO results agree well with the expectations. For the low-energy solar neutrinos, on the other hand, the matter effect is negligible, and the formalism of oscillations in vacuum is valid. The size of the source (i.e. the Solar core) is significantly larger than the oscillation length, therefore, averaging over the oscillation factor, one obtains ''P''_ee&nbsp;=&nbsp;1&nbsp;−&nbsp;sin²2''θ''&nbsp;/&nbsp;2. For the same value of the solar mixing angle (θ&nbsp;=&nbsp;34°) this corresponds to a survival probability of P_ee&nbsp;≈&nbsp;60%. This is consistent with the experimental observations of low energy Solar neutrinos by the [[w:Homestake experiment|Homestake experiment]] (the first experiment to reveal the solar neutrino problem), followed by GALLEX, the Gallium Neutrino Observatory (GNO), and Soviet–American Gallium Experiment (SAGE) (collectively, gallium radiochemical experiments), and, more recently, the Borexino experiment. These experiments provided further evidence of the MSW effect. The transition between the low energy regime (the MSW effect is negligible) and the high energy regime (the oscillation probability is determind by matter effects) lies in the region of about 2 MeV for the Solar neutrinos. {{clear}} ==Chromospheres== "[N]eutrino flux increases noted in Homestake results [coincide] with major solar flares [14]."<ref name="Dubin">{{cite journal |author=Maurice Dubin and Robert K. Soberman |title=Resolution of the Solar Neutrino Anomaly |journal=arXiv |month=April |year=1996 |volume= |issue= |pages=1-8 |url=http://arxiv.org/pdf/astro-ph/9604074.pdf |arxiv=astro-ph/9604074 |bibcode=1996astro.ph..4074D |doi= |pmid= |accessdate=2012-11-11 }}</ref> "The correlation between a great solar flare and Homestake neutrino enhancement was tested in 1991. Six major flares occurred from May 25 to June 15 including the great June 4 flare associated with a coronal mass ejection and production of the strongest interplanetary shock wave ever recorded (later detected from spacecraft at 34, 35, 48, and 53 AU) [15]. It also caused the largest and most persistent (several months) signal ever detected by terrestrial cosmic ray neutron monitors in 30 years of operation [16]. The Homestake exposure (June 1–7) measured a mean ³⁷Ar production rate of 3.2 ± 1.5 atoms/day (≈19 ³⁷Ar atoms produced in 6 days) [13]; about 5 times the rate of ≈ 0.65 day ⁻¹ for the preceding and following runs, > 6 times the long term mean of ≈ 0.5 day⁻¹ and > 2 1/2 times the highest rates recorded in ∼ 25 operating years."<ref name="Dubin"/> ==Coronal clouds== {{main|Plasmas/Plasma objects/Coronal clouds}} The highest flux of solar neutrinos come directly from the proton-proton interaction, and have a low energy, up to 400 keV. There are also several other significant production mechanisms, with energies up to 18 MeV.<ref name="Bellerive">A. Bellerive, [http://arxiv.org/abs/hep-ex/0312045 Review of solar neutrino experiments]. Int.J.Mod.Phys. A19 (2004) 1167-1179</ref> The parts of the Sun above the photosphere are referred to collectively as the ''solar atmosphere''.<ref name="Abhyankar1977">{{cite journal |author=K.D. Abhyankar |title=A Survey of the Solar Atmospheric Models |year=1977 |journal=Bull. Astr. Soc. India |volume=5 |bibcode=1977BASI....5...40A|pages=40–44 |url=http://prints.iiap.res.in/handle/2248/510 }}</ref> "Neutrinos can be produced by energetic protons accelerated in solar magnetic fields. Such protons produce pions, and therefore muons, hence also neutrinos as a decay product, in the solar atmosphere."<ref name="Bahcall1987">{{cite journal |author=J. N. Bahcall and G. B. Field and W. H. Press |title=Is solar neutrino capture rate correlated with sunspot number? |journal=The Astrophysical Journal |month=September 1, |year=1987 |volume=320 |issue=9 |pages=L69-73 |url=http://articles.adsabs.harvard.edu//full/1987ApJ...320L..69B/L000069.000.html |arxiv= |bibcode=1987ApJ...320L..69B |doi=10.1086/184978 |pmid= |accessdate=2013-07-07 }}</ref> "Energetic protons in the solar corona could explain Figure 2 only if (1) they tap a substantial fraction of the entire energy generated in the corona, (2) the energy generated in the corona is at least 3 times what has been deduced from the observations, (3) the vast majority of energetic protons do not escape the Sun, (4) the proton energy spectrum is unusually hard (''p''₀ = 300 MeV c^-1, and (5) the sign of the variation is opposite to what one would predict. As the likelihood of all of these conditions being fulfilled seems extremely small, we do not believe that neutrinos produced by energetic protons in the solar atmosphere contribute significantly to the neutrino capture in the ³⁷Cl experiment."<ref name="Bahcall1987"/> {{clear}} ==Earth== {{main|Gases/Gaseous objects/Earth}} Neutrinos are part of the natural [[w:background radiation|background radiation]]. In particular, the decay chains of ²³⁸[[w:uranium|U]] and ²³²[[w:Thorium|Th]] isotopes, as well as ⁴⁰[[w:Potassium|K]], include [[w:beta decay|beta decay]]s which emit antineutrinos. These so-called geoneutrinos can provide valuable information on the Earth's interior. A first indication for geoneutrinos was found by the [[w:KamLAND|KamLAND]] experiment in 2005. KamLAND's main background in the geoneutrino measurement are the antineutrinos coming from [[w:Nuclear reactor|reactor]]s. Atmospheric neutrinos result from the interaction of [[w:cosmic ray|cosmic ray]]s with atomic nuclei in the [[w:Earth's atmosphere|Earth's atmosphere]], creating showers of particles, many of which are unstable and produce neutrinos when they decay. A collaboration of particle physicists from the [[w:Tata Institute of Fundamental Research|Tata Institute of Fundamental Research]] (India), [[w:Osaka City University|Osaka City University]] (Japan) and [[w:Durham University|Durham University]] (UK) recorded the first cosmic ray neutrino interaction in an underground laboratory in [[w:Kolar Gold Fields|Kolar Gold Fields]] in India in 1965. ==Moon== The "moon, viewed by ground-based radio telescopes, has been used as a target [87]."<ref name="Halzen2002"/> ==Supernovas== {{main|Stars/Supernovas}} [[Image:Supernova-1987a.jpg|thumb|right|200px|The 1987A supernova remnant is near the center of this image. Credit: First image: Dr. Christopher Burrows, ESA/STScI and NASA; Second image: Hubble Heritage team.{{tlx|free media}}]] "In the 1980s two early water-Cherenkov experiments were built. The Irvine-Michigan-Brookhaven detector in an Ohio salt mine and the Kamiokande detector in a Japanese zinc mine were tanks containing thousands of tons of purified water, monitored with phototubes. The two detectors launched the field of neutrino astronomy by detecting some 20 low-energy (about 10 MeV) neutrinos from Supernova 1987A—the first supernova since the 17th century that was visible to the naked eye."<ref name="Halzen2008">{{cite journal |author=Francis Halzen and Spencer R. Klein |title=Astronomy and astrophysics with neutrinos |journal=Physics Today |month=May |year=2008 |volume= |issue= |pages=29-35 |url=http://www.lbl.gov/today/2008/Jun/06-Fri/PTNuAstronomy.pdf |arxiv= |bibcode= |doi= |pmid= |accessdate=2012-07-28 }}</ref> The water-based detectors [[w:Kamiokande II|Kamiokande II]] and [[w:Irvine-Michigan-Brookhaven (detector)|IMB]] detected 11 and 8 antineutrinos of thermal origin,<ref name="Mannbook">{{cite book |author=A.K. Mann |year=1997 |title=Shadow of a star: The neutrino story of Supernova 1987A |url=http://www.whfreeman.com/GeneralReaders/book.asp?disc=TRAD&id_product=1058001008&@id_course=1058000240 |page=122 |publisher=W. H. Freeman |isbn=0-7167-3097-9 }}</ref> respectively, while the scintillator-based [[w:Baksan Neutrino Observatory|Baksan]] detector found 5 neutrinos ([[w:lepton number|lepton number]] = 1) of either thermal or electron-capture origin, in a burst lasting less than 13 seconds. {{clear}} ==Large Magellanic Cloud== "In 1987, astronomers counted 19 neutrinos from an explosion of a star in the nearby Large Magellanic Cloud, 19 out of the billion trillion trillion trillion trillion neutrinos that flew from the supernova."<ref name="Chang">{{cite book |author= KENNETH CHANG |title= Tiny, Plentiful and Really Hard to Catch, In: ''The New York Times'' |date= April 26, 2005 |url= http://www.nytimes.com/2005/04/26/science/26neut.html?pagewanted=print&position= |accessdate= 2011-06-16 }}</ref> Because neutrinos are only [[Weak interaction|weakly interacting]] with other particles of matter, neutrino detectors must be very large in order to detect a significant number of neutrinos. Neutrino detectors are often built underground to isolate the detector from cosmic rays and other background radiation.<ref name="Chang"/> ==Active galactic nuclei== {{main|Radiation astronomy/Active galactic nuclei}} The neutrino experiments that are sensitive to active galactic nuclei neutrinos are # Astronomy with a Neutrino Telescope and Abyss Environmental RESearch (ANTARES), # Antarctic Ross Ice-Shelf ANtenna Neutrino Array (ARIANNA), # Baikal Deep Underwater Neutrino Telescope / Gigaton Volume Detector (BDUNT (NT-200+) Baikal-GVD), # Giant Radio Array for Neutrino Detection (GRAND), # IceCube Neutrino Detector (IceCube), and # KM3 Neutrino Telescope (KM3NeT). ==Astrography== [[Image:Fermilab.jpg|thumb|right|200px|The photograph is of the [[w:Fermi National Accelerator Laboratory|Fermi National Accelerator Laboratory]], Main Ring and Main Injector as seen from the air. Credit: Fermilab, Reidar Hahn.{{tlx|free media}}]] '''Fermi National Accelerator Laboratory''' ('''Fermilab'''), located just outside [[w:Batavia, Illinois|Batavia]], [[w:Illinois|Illinois]], near [[w:Chicago|Chicago]], is a [[w:United States Department of Energy|US Department of Energy]] [[w:United States Department of Energy National Labs|national laboratory]] specializing in high-energy [[w:particle physics|particle physics]]. In addition to high energy collider physics, Fermilab is also host to a number of smaller [[w:fixed-target experiment|fixed-target]] and [[w:neutrino|neutrino]] experiments, such as [[w:MiniBooNE|MiniBooNE]] (Mini Booster Neutrino Experiment), [[w:Sciboone|SciBooNE]] (SciBar Booster Neutrino Experiment) and [[w:MINOS|MINOS]] (Main Injector Neutrino Oscillation Search). The MiniBooNE detector is a 40-foot (12 m) diameter sphere which contains 800 tons of mineral oil lined with 1520 individual [[w:photomultiplier|phototube detectors]]. An estimated 1 million neutrino events are recorded each year. SciBooNE is the newest neutrino experiment at Fermilab; it sits in the same neutrino beam as MiniBooNE but has fine-grained tracking capabilities. The MINOS experiment uses Fermilab's [[w:NuMI|NuMI]] (Neutrinos at the Main Injector) beam, which is an intense beam of neutrinos that travels 455 miles (732 km) through the Earth to the [[w:Soudan Mine|Soudan Mine]] in [[w:Minnesota|Minnesota]]. {{clear}} ==Cosmogony== {{main|Cosmogony}} Consider a universe "dominated by neutrinos and 'cold dark matter'".<ref name="Rees"/> "The evidence for unseen mass [...] suggests that the cosmological density parameter Ω is at least 0.1-0.2 [rather than for an] Einstein-de-Sitter 'flat' universe with Ω = 1 [... This] can only be reconciled with the data if the galaxies are more 'clumped' than the overall mass distribution, and are poor tracers of the unseen mass even on scales of several Mpc."<ref name="Rees"/> "Particle physicists have other particles ‘in reserve’ which could make a substantial (non-baryonic) contribution to Ω, but which differ from neutrinos in that their freestreaming velocity is negligible, so that small-scale adiabatic perturbations are not phase-mixed away. Such particles can be described as ‘cold dark matter’, in contrast to neutrinos whose free streaming velocity renders them ‘hot’."<ref name="Rees"/> "There is no shortage of ‘cold dark matter’ candidate particles—although each of them is highly speculative, to say the least. The motivation for nonetheless considering the hypothesis that the universe is dominated by cold dark matter is that it leads to a cosmogonic scheme that avoids the difficulties of the neutrino-dominated scheme and correctly predicts many of the observed properties of galaxies, including their range of masses, irrespective of the identity of the cold particle (Peebles 1984; Blumenthal et al. 1984)."<ref name="Rees">{{cite journal |author=Martin J. Rees |title=Is the Universe flat? |journal=Journal of Astrophysics and Astronomy |month=December |year=1984 |volume=5 |issue=4 |pages=331-48 |url=http://link.springer.com/article/10.1007/BF02714464 |arxiv= |bibcode= |doi= |pmid= |accessdate=2013-12-18 }}</ref> ==Astromathematics== {{main|Mathematics/Astronomy|Mathematical astronomy}} Free neutrons decay by emission of an electron and an electron antineutrino to become a proton, a process known as [[w:beta decay|beta decay]]:<ref name="lbl">[http://pdg.lbl.gov/2007/tables/bxxx.pdf Particle Data Group Summary Data Table on Baryons]</ref> :{{SubatomicParticle|Neutron0}} => {{SubatomicParticle|Proton+}} + {{SubatomicParticle|Electron}} + {{SubatomicParticle|Electron antineutrino}} For the above relation :{| border="1" cellpadding="5" cellspacing="0" align="none" |- ! colspan="3" |'''Notational locations''' |- |'''Weight''' |'''Oversymbol''' |'''Exponent''' |- |'''Coefficient''' |'''Variable''' |'''Operation''' |- |'''Number''' |'''Range''' |'''Index''' |- |} Starting with the left symbol, '''Weight''' is 1 (not mentioned), '''Oversymbol''' is not used, '''Exponent''' is replaced by '''Charge''', the '''Coefficient''' is 1 (not mentioned), the '''Variable''' is a letter designation for the subatomic particle of interest (n for neutron), the '''Operation''' is actually a relation '''decays to''' (=>), '''Number''' is the atomic number Z = 0 for a neutron (not mentioned), the '''Range''' is not applicable, and no '''Index''' is being used. The neutron's decay products are a proton (p), electron (e), and a neutrino (ν), where '''Index''' is used to indicate that the neutrino is an electron neutrino and '''Oversymbol''' indicates it is actually an antineutrino. The '''Operation''' (+) is not mathematical addition, but indicates another decay product. ==Detectors== {{main|Radiation astronomy/Detectors}} Because neutrinos are only [[w:Weak interaction|weakly interacting]] with other particles of matter, neutrino detectors must be very large in order to detect a significant number of neutrinos. Neutrino detectors are often built underground to isolate the detector from [[w:cosmic ray|cosmic ray]]s and other background radiation.<ref name="twsP16">{{cite book |author= KENNETH CHANG |title= Tiny, Plentiful and Really Hard to Catch, In: ''The New York Times'' |quote= In 1987, astronomers counted 19 neutrinos from an explosion of a star in the nearby Large Magellanic Cloud, 19 out of the billion trillion trillion trillion trillion neutrinos that flew from the supernova. |date= April 26, 2005 |url= http://www.nytimes.com/2005/04/26/science/26neut.html?pagewanted=print&position= |accessdate= 2011-06-16 }}</ref> ==Antarctic Impulse Transient Antenna== The Antarctic Impulsive Transient Antenna (ANITA) experiment has been designed to study ultra-high-energy (UHE) cosmic neutrinos by detecting the radio pulses emitted by their interacting with the [[w:Antarctic|Antarctic]] ice sheet. This is to be accomplished using an array of 32 radio antennas (cylindrically arranged with an approximate radius of 3m and a height of 5m) suspended from a [[w:high altitude balloon|helium balloon]] flying at a height of about 35,000 meters.<ref>{{cite book |title=ANITA: Antarctic Impulsive Transient Antenna |url=http://www.ps.uci.edu/~anita/ }}</ref> The neutrinos, with energies on the order of 10¹⁸&nbsp;eV, produce radio pulses in the ice because of the [[w:Askaryan effect|Askaryan effect]]. ==ANTARES== [[Image:Antares Neutrinoteleskop.jpg|thumb|right|250px|An artist illustration of the Antares neutrino detector and the [[w:Nautile|Nautile]]. Credit: François Montanet.{{tlx|free media}}]] '''ANTARES''' is the name of a neutrino detector residing 2.5&nbsp;km under the Mediterranean Sea off the coast of Toulon, France. It is designed to be used as a directional ''Neutrino Telescope'' to locate and observe neutrino flux from cosmic origins in the direction of the Southern Hemisphere of the Earth, a complement to the southern hemisphere neutrino detector IceCube that detects neutrinos from the North. {{clear}} ==Baikal Neutrino Telescope== [[Image:Baikal array.gif|thumb|right|200px|This diagram shows the arrangement of modules for the Baikal Neutrino Detector in Lake Baikal, Russia. Credit: DESY Zeuthen.{{tlx|fairuse}}]] "The underwater neutrino telescope NT200 is located in the Siberian lake Baikal at a depth of approximately 1 km. Deployment and maintenance of the Baikal detector is carried out during the winter months, when the lake is covered with a thick ice sheet. From the ice surface, the optical sensors can easily be lowered into the water underneath. Once deployed, the optical sensors take data over the whole year and the data taken are permanently transmitted to the shore over electrical cables."<ref name="Zeuthen">{{cite book |author=DESY Zeuthen |title=The BAIKAL Neutrino Telescope |publisher=Deutsches Elektronen-Synchrotron A Research Centre of the Helmholtz Association |location=Deutschland |date= 2010 |url=http://astro.desy.de/neutrino_astronomy/previous_projects/baikal/index_eng.html |accessdate=2014-02-07 }}</ref> "During spring 1993, scientists from Russian institutes and from DESY were the first to install an underwater telescope which took data not only for some hours, but for a whole year. At that time, the detector comprised only three strings carrying 36 optical sensors in total. Since 1998 the Baikal collaboration takes data with the NT200 telescope which consists of 192 optical sensors deployed on eight strings."<ref name="Zeuthen"/> {{clear}} ==Baksan Neutrino Observatory== [[Image:Gallium–Germanium Neutrino Telescope main room - 2010-07-19 - DSC 0764.jpg|thumb|right|250px|Main hall of Gallium–Germanium Neutrino Telescope (GGNT) is at the Baksan Neutrino Observatory (BNO). Credit: Konstantin Malanchev.{{tlx|free media}}]] The '''Baksan Neutrino Observatory''' ('''BNO''') consists of the Baksan Underground Scintillation Telescope, located 300m below the surface,<ref name="bno">{{cite book | title = Baksan Neutrino Observatory | url = http://www.inr.troitsk.ru/eng/ebno.html | publisher=Institute for Nuclear Research | accessdate = 2006-07-25 }}</ref> a [[w:gallium|gallium]]–[[w:germanium|germanium]] neutrino telescope (the [[w:SAGE (Soviet–American Gallium Experiment)|SAGE]] experiment) located 3,500m deep,<ref name="bno" /> as well as a number of ground facilities. {{clear}} ==Brookhaven solar neutrino detector== [[Image:Atomic Energy Commission's Brookhaven National Laboratory solar neutrino detector. c. 1972 (diagram).jpg|thumb|right|250px|The first chemical detection of neutrinos produced by the sun have been recorded at the Atomic Energy Commission's Brookhaven National Laboratory solar neutrino detector. Credit: [https://www.flickr.com/people/37916456@N02 ENERGY.GOV].{{tlx|free media}}]] The first chemical detection of neutrinos produced by the Sun were recorded at the Brookhaven solar neutrino detector. {{clear}} ==Extreme Universe Space Observatory== [[Image:Nasasupports.jpg|thumb|right|200px|This is a computer-generated image of the Extreme Universe Space Observatory (EUSO) as part of the Japanese Experiment Module (JEM) on the International Space Station (ISS). Credit: JEM-EUSO, Angela Olinto.{{tlx|fairuse}}]] The '''Extreme Universe Space Observatory''' ('''EUSO''') is the first Space mission concept devoted to the investigation of cosmic rays and neutrinos of [[w:Ultra-high-energy cosmic ray|extreme energy]] ({{nowrap|E > {{val|5|e=19|u=eV}}}}). Using the Earth's atmosphere as a giant detector, the detection is performed by looking at the streak of [[w:fluorescence|fluorescence]] produced when such a particle interacts with the Earth's atmosphere. {{clear}} ==IceCube Neutrino Observatory== [[Image:Icecube-architecture-diagram2009.PNG|thumb|left|200px|This is an architecture diagram of IceCube. Credit: [[w:User:Nasa-verve|Nasa-verve]].{{tlx|free media}}]] The '''IceCube Neutrino Observatory''' (or simply '''IceCube''') is a [[w:neutrino telescope|neutrino telescope]] constructed at the [[w:Amundsen-Scott South Pole Station|Amundsen-Scott South Pole Station]] in [[w:Antarctica|Antarctica]].[1] Similar to its predecessor, the Antarctic Muon And Neutrino Detector Array (AMANDA)<!-- which relied on analog data transmission except for one digital development string -->, IceCube contains thousands of spherical optical sensors called Digital Optical Modules (DOMs), each with a [[w:photomultiplier tube|photomultiplier tube]] (PMT)<ref name="Abbasi">{{cite journal |author=R. Abbasi ''et al.'' (IceCube Collaboration) |year=2010 |title=Calibration and Characterization of the IceCube Photomultiplier Tube |journal = Nuclear Instruments and Methods A | volume = 618| pages= 139–152 | doi = 10.1016/j.nima.2010.03.102 |arxiv=1002.2442 |bibcode=2010NIMPA.618..139A }}</ref> and a single board data acquisition computer which sends digital data to the counting house on the surface above the array.<ref name="Abbasi09">{{cite journal |author=R. Abbasi ''et al.'' (IceCube Collaboration) |year=2009 |title=The IceCube Data Acquisition System: Signal Capture, Digitization, and Timestamping |journal=Nuclear Instruments and Methods A |volume=601 |pages=294–316 |doi=10.1016/j.nima.2009.01.001 |bibcode = 2009NIMPA.601..294T |arxiv=0810.4930 }}</ref> IceCube was completed on 18 December, 2010, New Zealand time.<ref>[http://icecube.wisc.edu/ IceCube Neutrino Observatory<!-- Bot generated title -->]</ref> {{clear}} ==Sudbury Neutrino Observatory== The Sudbury Neutrino Observatory detector was designed to detect [[w:Solar neutrino|solar neutrino]]s through their interactions with a large tank of [[w:Heavy water|heavy water]]. The detector turned on in May 1999, and was turned off on 28 November 2006. The experiment observed the light produced by [[w:special relativity|relativistic]] electrons in the water created by neutrino interactions. As relativistic electrons travel through a medium, they lose energy producing a cone of blue light through the [[w:Cerenkov effect|Cerenkov effect]], and it is this light that is directly detected. ==Super-Kamiokande== [[Image:Super Kamiokande, 1 to 135th.jpg|thumb|right|250px|Super-Kamioka Neutrino Detection Experiment, also abbreviated to Super-K or SK, is a neutrino observatory located under Mount Ikeno near the city of Hida, Gifu Prefecture, Japan. Credit: [[c:user:Motokoka|Motokoka]].{{tlx|free media}}]] The ability of the Kamiokande experiment to observe the direction of electrons produced in solar neutrino interactions allowed experimenters to directly demonstrate for the first time that the sun was a source of neutrinos. {{clear}} ==Hypotheses== {{main|Hypotheses}} # Most or all the neutrinos coming from the octant of the Sun originate from above the photosphere. ==See also== {{div col|colwidth=20em}} * [[Radiation astronomy/Atomics|Atomic astronomy]] * [[Radiation astronomy/Baryons|Baryon astronomy]] * [[Radiation astronomy/Hadrons|Hadron astronomy]] * [[Radiation astronomy/Mesons|Meson astronomy]] * [[Radiation astronomy/Minerals|Mineral astronomy]] * [[Radiation astronomy/Muons|Muon astronomy]] * [[Radiation astronomy/Neutrals|Neutrals astronomy]] * [[Neutrino astronomy/Quiz]] * [[Radiation/Neutrons|Neutron astronomy]] * [[Radiation astronomy/Rocks|Rock astronomy]] * [[Radiation astronomy/Subatomics|Subatomics astronomy]] * [[Radiation astronomy/Tauons|Tauon astronomy]] {{Div col end}} ==References== {{reflist|2}} ==External links== * [http://www.iau.org/ International Astronomical Union] * [http://nedwww.ipac.caltech.edu/ NASA/IPAC Extragalactic Database - NED] * [http://nssdc.gsfc.nasa.gov/ NASA's National Space Science Data Center] * [http://www.ncbi.nlm.nih.gov/sites/gquery NCBI All Databases Search] * [http://www.ncbi.nlm.nih.gov/ncbisearch/ NCBI Site Search] * [http://www.osti.gov/ Office of Scientific & Technical Information] * [http://www.ncbi.nlm.nih.gov/pccompound PubChem Public Chemical Database] * [http://www.adsabs.harvard.edu/ The SAO/NASA Astrophysics Data System] * [http://www.scirus.com/srsapp/advanced/index.jsp?q1= Scirus for scientific information only advanced search] * [http://cas.sdss.org/astrodr6/en/tools/quicklook/quickobj.asp SDSS Quick Look tool: SkyServer] * [http://simbad.u-strasbg.fr/simbad/ SIMBAD Astronomical Database] * [http://nssdc.gsfc.nasa.gov/nmc/SpacecraftQuery.jsp Spacecraft Query at NASA] * [http://heasarc.gsfc.nasa.gov/cgi-bin/Tools/convcoord/convcoord.pl Universal coordinate converter] <!-- footer templates --> {{tlx|Charge ontology}}{{tlx|Geology resources}}{{Principles of radiation astronomy}}{{tlx|Radiation astronomy resources}}{{Sisterlinks|Neutrino astronomy}} <!-- categories --> [[Category:Astrophysics/Lectures]] [[Category:Radiation astronomy/Lectures]] [[Category:Radiation/Lectures]] e0mukvovowjqa14c5itxt7jcowazoq0 0 139384 2419063 2418475 2022-08-25T14:13:03Z Young1lim 21186 /* Adder */ wikitext text/x-wiki {{nocat}} == Adder == * Binary Adder Architecture Exploration ( [[Media:adder.20131113.pdf |pdf]] ) {| class="wikitable" |- ! Adder type !! Overview !! Analysis !! VHDL Level Design !! CMOS Level Design |- | '''1. Ripple Carry Adder''' || [[Media:VLSI.Arith.1A.RCA.20211108.pdf |pdf]] || || [[Media:adder.rca.20140313.pdf |pdf]] || [[Media:VLSI.Arith.1D.RCA.CMOS.20211108.pdf |pdf]] |- | '''2. Carry Lookahead Adder''' || [[Media:VLSI.Arith.1.A.CLA.20211106.pdf |pdf]] || || [[Media:adder.cla.20140313.pdf |pdf]] || |- | '''3. Carry Save Adder''' || [[Media:VLSI.Arith.1.A.CSave.20151209.pdf |pdf]] || || || |- || '''4. Carry Select Adder''' || [[Media:VLSI.Arith.1.A.CSelA.20191002.pdf |pdf]] || || || |- || '''5. Carry Skip Adder''' || [[Media:VLSI.Arith.5A.CSkip.20211111.pdf |pdf]] || || || [[Media:VLSI.Arith.5D.CSkip.CMOS.20211108.pdf |pdf]] |- || '''6. Carry Chain Adder''' || [[Media:VLSI.Arith.6A.CCA.20211109.pdf |pdf]] || || [[Media:VLSI.Arith.6C.CCA.VHDL.20211109.pdf |pdf]], [[Media:adder.cca.20140313.pdf |pdf]] || [[Media:VLSI.Arith.6D.CCA.CMOS.20211109.pdf |pdf]] |- || '''7. Kogge-Stone Adder''' || [[Media:VLSI.Arith.1.A.KSA.20140315.pdf |pdf]] || || [[Media:adder.ksa.20140409.pdf |pdf]] || |- || '''8. Prefix Adder''' || [[Media:VLSI.Arith.1.A.PFA.20140314.pdf |pdf]] || || || |- || '''9. Variable Block Adder''' || [[Media:VLSI.Arith.1.A.VBA.20220825.pdf |pdf]] || || || |} </br> === Adder Architectures Suitable for FPGA === * FPGA Carry-Chain Adder ([[Media:VLSI.Arith.1.A.FPGA-CCA.20210421.pdf |pdf]]) * FPGA Carry Select Adder ([[Media:VLSI.Arith.1.B.FPGA-CarrySelect.20210522.pdf |pdf]]) * FPGA Variable Block Adder ([[Media:VLSI.Arith.1.C.FPGA-VariableBlock.20220125.pdf |pdf]]) * FPGA Carry Lookahead Adder ([[Media:VLSI.Arith.1.D.FPGA-CLookahead.20210304.pdf |pdf]]) * Carry-Skip Adder </br> == Barrel Shifter == * Barrel Shifter Architecture Exploration ([[Media:bshift.20131105.pdf |bshfit.vhdl]], [[Media:bshift.makefile.20131109.pdf |bshfit.makefile]]) </br> '''Mux Based Barrel Shifter''' * Analysis ([[Media:Arith.BShfiter.20151207.pdf |pdf]]) * Implementation </br> == Multiplier == === Array Multipliers === * Analysis ([[Media:VLSI.Arith.1.A.Mult.20151209.pdf |pdf]]) </br> === Tree Mulltipliers === * Lattice Multiplication ([[Media:VLSI.Arith.LatticeMult.20170204.pdf |pdf]]) * Wallace Tree ([[Media:VLSI.Arith.WallaceTree.20170204.pdf |pdf]]) * Dadda Tree ([[Media:VLSI.Arith.DaddaTree.20170701.pdf |pdf]]) </br> === Booth Multipliers === * [[Media:RNS4.BoothEncode.20161005.pdf |Booth Encoding Note]] * Booth Multiplier Note ([[Media:BoothMult.20160929.pdf |H1.pdf]]) </br> == Divider == * Binary Divider ([[Media:VLSI.Arith.1.A.Divider.20131217.pdf |pdf]])</br> </br> </br> go to [ [[Electrical_%26_Computer_Engineering_Studies]] ] [[Category:Computer architecture]] r3ubs210tnw0zt8rm2upsmw97r8io37 10 148360 2419463 2418768 2022-08-26T09:58:29Z Jtneill 10242 /* References */ wikitext text/x-wiki <noinclude> {{title|Chapter title:<br>Subtitle?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== You are underway {{smile}}! This template provides tips for [[Motivation and emotion/Assessment/Topic|topic development]]. Gradually remove these suggestions as you develop the chapter. Also consult the [[Motivation and emotion/Assessment/Chapter|author guidelines]]. At the top of the chapter, the title and sub-title should match the ''exact'' wording and casing as shown in the {{Motivation and emotion/Book}}. The sub-titles all end with a question mark. This Overview section should be concise but consist of several paragraphs which engage the reader, illustrate the problem, and outline how psychological science can help. {{RoundBoxTop|theme=3}} '''Focus questions:''' * What is the first focus question? * What is the second focus question? * What is the third focus question? {{RoundBoxBottom}} {{tip| Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Provide an example or case study. * Conclude with Focus questions to guide the chapter. }} ==Main headings== How you are going to structure the chapter? Aim for three to six main headings between the [[#Overview|Overview]] and [[#Conclusion|Conclusion]]. {{tip|Suggestions for this section: * For the [[Motivation and emotion/Assessment/Topic|topic development]], provide at least 3 bullet-points about key content per section. Include key citations. * For the [[Motivation and emotion/Assessment/Chapter|book chapter]], expand the bullet points into paragraphs. * If a section has a lot of content, arrange it into two to five sub-headings such as in the [[#Interactive learning features|interactive learning features section]]. Avoid having sections with only one sub-heading. }} ==Learning features== What brings an online book chapter to life are its interactive learning features. Case studies, feature boxes, figures, links, tables, and quiz questions can be used throughout the chapter. ===Case studies=== Case studies describe real-world examples of concepts in action. Case studies can be real or fictional. A case could be used multiple times during a chapter to illustrate different theories or stages. It is often helpful to present case studies using [[#Feature boxes|feature boxes]]. ===Boxes=== Boxes can be used to highlight content, but don't overuse them. There are many different ways of creating boxes (e.g., see [[Help:Pretty boxes|Pretty boxes]]). Possible uses include: * Focus questions * Case studies or examples * Quiz questions * Take-home messages {{RoundBoxTop|theme=3}} ;Feature box example * Shaded background * Coloured border {{RoundBoxBottom}} ===Figures=== [[File:Monkey-typing.jpg|right|205px|thumb|''Figure 1''. Example image with descriptive caption.]] Use figures to illustrate concepts, add interest, and provide examples. Figures can be used to show photographs, drawings, diagrams, graphs, etcetera. Figures can be embedded throughout the chapter, starting with the Overview section. Figures should be captioned (using a number and a description) in order to explain their relevance to the text. Possible images can be found at [[commons:|Wikimedia Commons]]. Images can also be uploaded if they are licensed for re-use or if you created the image. Each figure should be referred to at least once in the main text (e.g., see Figure 1). ===Links=== Where key words are first used, make them into [[Help:Links|interwiki links]] such as Wikipedia links to articles about famous people (e.g., [[w:Sigmund Freud|Sigmund Freud]] and key concepts (e.g., [[w:Dreams|dreams]]) and links to book chapters about related topics (e.g., would you like to learn about how to overcome [[Motivation and emotion/Book/2020/Writer's block|writer's block]]?). ===Tables=== Tables can be an effective way to organise and summarise information. Tables should be captioned (using APA style) to explain their relevance to the text. Plus each table should be referred to at least once in the main text (e.g., see Table 1 and Table 2). Here are some [[Motivation and emotion/Wikiversity/Tables|example 3 x 3 tables]] which could be adapted. ===Quizzes=== Quizzes are a direct way to engage readers. But don't make quizzes too hard or long. It is better to have one or two review questions per major section than a long quiz at the end. Try to quiz conceptual understanding, rather than trivia. Here are some simple quiz questions which could be adapted. Choose the correct answers and click "Submit": <quiz display=simple> {Quizzes are an interactive learning feature: |type="()"} + True - False {Long quizzes are a good idea: |type="()"} - True + False </quiz> To learn about different types of quiz questions, see [[Help:Quiz|Quiz]]. ==Conclusion== The Conclusion is arguably the most important section. It should be possible for someone to read the [[#Overview|Overview]] and the Conclusion and still get a good idea of the topic. {{tip|Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? }} ==See also== Provide up to half-a-dozen [[Help:Contents/Links#Interwiki_links|internal (wiki) links]] to relevant Wikiversity pages (esp. related [[Motivation and emotion/Book|motivation and emotion book chapters]]) and [[w:|Wikipedia articles]]. For example: * [[Motivation and emotion/Book/2016/Anorexia nervosa and extrinsic motivation|Anorexia nervosa and extrinsic motivation]] (Book chapter, 2016) * [[w:David McClelland|David McClelland]] (Wikipedia) * [[Motivation and emotion/Book/2018/Loss aversion|Loss aversion]] (Book chapter, 2018) * [[w:Maslow's hierarchy of needs|Maslow's hierarchy of needs]] (Wikipedia) {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== List the cited references in [[w:APA style|APA style]] (7th ed.) or [[w:Wikipedia:Citing sources|wiki style]]. APA style example: {{Hanging indent|1= Blair, R. J. R. (2004). The roles of orbital frontal cortex in the modulation of antisocial behavior. ''Brain and Cognition'', ''55''(1), 198–208. https://doi.org/10.1016/S0278-2626(03)00276-8 Buckholtz, J. W., & Meyer-Lindenberg, A. (2008). MAOA and the neurogenetic architecture of human aggression. ''Trends in Neurosciences'', ''31''(3), 120–129. https://doi.org/10.1016/j.tins.2007.12.006 Eckardt, M., File, S., Gessa, G., Grant, K., Guerri, C., Hoffman, P., & Tabakoff, B. (1998). Effects of moderate alcohol consumption on the central nervous system. ''Alcoholism, Clinical and Experimental Research'', ''22''(5), 998–1040. https://doi.org/10.1111/j.1530-0277.1998.tb03695.x }} {{tip|Suggestions for this section: * Important aspects for APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except first letter and proper names, ending in a full-stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full-stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't actually read or consulted }} ==External links== Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * [https://students.unimelb.edu.au/academic-skills/explore-our-resources/essay-writing/six-top-tips-for-writing-a-great-essay Six top tips for writing a great essay] (University of Melbourne) * [http://www.skillsyouneed.com/write/structure.html The importance of structure] (skillsyouneed.com) {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] {{:Motivation and emotion/Assessment/Topic/Quickstarttip}} <hr> </noinclude>{{title|Chapter title:<br>Subtitle?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== You are underway {{smile}}! This template provides tips for [[Motivation and emotion/Assessment/Topic|topic development]]. Gradually remove these suggestions as you develop the chapter. Also consult the [[Motivation and emotion/Assessment/Chapter|author guidelines]]. At the top of the chapter, the title and sub-title should match the ''exact'' wording and casing as shown in the {{Motivation and emotion/Book}}. The sub-titles all end with a question mark. This Overview section should be concise but consist of several paragraphs which engage the reader, illustrate the problem, and outline how psychological science can help. {{RoundBoxTop|theme=3}} '''Focus questions:''' * What is the first focus question? * What is the second focus question? * What is the third focus question? {{RoundBoxBottom}} {{tip| Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Provide an example or case study. * Conclude with Focus questions to guide the chapter. }} ==Main headings== How you are going to structure the chapter? Aim for three to six main headings between the [[#Overview|Overview]] and [[#Conclusion|Conclusion]]. {{tip|Suggestions for this section: * For the [[Motivation and emotion/Assessment/Topic|topic development]], provide at least 3 bullet-points about key content per section. Include key citations. * For the [[Motivation and emotion/Assessment/Chapter|book chapter]], expand the bullet points into paragraphs. * If a section has a lot of content, arrange it into two to five sub-headings such as in the [[#Interactive learning features|interactive learning features section]]. Avoid having sections with only one sub-heading. }} ==Learning features== What brings an online book chapter to life are its interactive learning features. Case studies, feature boxes, figures, links, tables, and quiz questions can be used throughout the chapter. ===Case studies=== Case studies describe real-world examples of concepts in action. Case studies can be real or fictional. A case could be used multiple times during a chapter to illustrate different theories or stages. It is often helpful to present case studies using [[#Feature boxes|feature boxes]]. ===Boxes=== Boxes can be used to highlight content, but don't overuse them. There are many different ways of creating boxes (e.g., see [[Help:Pretty boxes|Pretty boxes]]). Possible uses include: * Focus questions * Case studies or examples * Quiz questions * Take-home messages {{RoundBoxTop|theme=3}} ;Feature box example * Shaded background * Coloured border {{RoundBoxBottom}} ===Figures=== [[File:Monkey-typing.jpg|right|205px|thumb|''Figure 1''. Example image with descriptive caption.]] Use figures to illustrate concepts, add interest, and provide examples. Figures can be used to show photographs, drawings, diagrams, graphs, etcetera. Figures can be embedded throughout the chapter, starting with the Overview section. Figures should be captioned (using a number and a description) in order to explain their relevance to the text. Possible images can be found at [[commons:|Wikimedia Commons]]. Images can also be uploaded if they are licensed for re-use or if you created the image. Each figure should be referred to at least once in the main text (e.g., see Figure 1). ===Links=== Where key words are first used, make them into [[Help:Links|interwiki links]] such as Wikipedia links to articles about famous people (e.g., [[w:Sigmund Freud|Sigmund Freud]] and key concepts (e.g., [[w:Dreams|dreams]]) and links to book chapters about related topics (e.g., would you like to learn about how to overcome [[Motivation and emotion/Book/2020/Writer's block|writer's block]]?). ===Tables=== Tables can be an effective way to organise and summarise information. Tables should be captioned (using APA style) to explain their relevance to the text. Plus each table should be referred to at least once in the main text (e.g., see Table 1 and Table 2). Here are some [[Motivation and emotion/Wikiversity/Tables|example 3 x 3 tables]] which could be adapted. ===Quizzes=== Quizzes are a direct way to engage readers. But don't make quizzes too hard or long. It is better to have one or two review questions per major section than a long quiz at the end. Try to quiz conceptual understanding, rather than trivia. Here are some simple quiz questions which could be adapted. Choose the correct answers and click "Submit": <quiz display=simple> {Quizzes are an interactive learning feature: |type="()"} + True - False {Long quizzes are a good idea: |type="()"} - True + False </quiz> To learn about different types of quiz questions, see [[Help:Quiz|Quiz]]. ==Conclusion== The Conclusion is arguably the most important section. It should be possible for someone to read the [[#Overview|Overview]] and the Conclusion and still get a good idea of the topic. {{tip|Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? }} ==See also== Provide up to half-a-dozen [[Help:Contents/Links#Interwiki_links|internal (wiki) links]] to relevant Wikiversity pages (esp. related [[Motivation and emotion/Book|motivation and emotion book chapters]]) and [[w:|Wikipedia articles]]. For example: * [[Motivation and emotion/Book/2016/Anorexia nervosa and extrinsic motivation|Anorexia nervosa and extrinsic motivation]] (Book chapter, 2016) * [[w:David McClelland|David McClelland]] (Wikipedia) * [[Motivation and emotion/Book/2018/Loss aversion|Loss aversion]] (Book chapter, 2018) * [[w:Maslow's hierarchy of needs|Maslow's hierarchy of needs]] (Wikipedia) {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== List the cited references in [[w:APA style|APA style]] (7th ed.) or [[w:Wikipedia:Citing sources|wiki style]]. APA style example: {{Hanging indent|1= Blair, R. J. R. (2004). The roles of orbital frontal cortex in the modulation of antisocial behavior. ''Brain and Cognition'', ''55''(1), 198–208. https://doi.org/10.1016/S0278-2626(03)00276-8 Buckholtz, J. W., & Meyer-Lindenberg, A. (2008). MAOA and the neurogenetic architecture of human aggression. ''Trends in Neurosciences'', ''31''(3), 120–129. https://doi.org/10.1016/j.tins.2007.12.006 Eckardt, M., File, S., Gessa, G., Grant, K., Guerri, C., Hoffman, P., & Tabakoff, B. (1998). Effects of moderate alcohol consumption on the central nervous system. ''Alcoholism, Clinical and Experimental Research'', ''22''(5), 998–1040. https://doi.org/10.1111/j.1530-0277.1998.tb03695.x }} {{tip|Suggestions for this section: * Important aspects for APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except first letter and proper names, ending in a full-stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full-stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** citing sources that weren't actually read or consulted }} ==External links== Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * [https://students.unimelb.edu.au/academic-skills/explore-our-resources/essay-writing/six-top-tips-for-writing-a-great-essay Six top tips for writing a great essay] (University of Melbourne) * [http://www.skillsyouneed.com/write/structure.html The importance of structure] (skillsyouneed.com) {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }}<includeonly> [[Category:{{#titleparts:{{PAGENAME}}|3}}]]</includeonly><noinclude> [[Category:Motivation and emotion/Book]]</noinclude> 2nzp76mjq1355tmcyjk5hymgaqwroio 2419464 2419463 2022-08-26T09:59:11Z Jtneill 10242 wikitext text/x-wiki <noinclude> {{title|Chapter title:<br>Subtitle?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== You are underway {{smile}}! This template provides tips for [[Motivation and emotion/Assessment/Topic|topic development]]. Gradually remove these suggestions as you develop the chapter. Also consult the [[Motivation and emotion/Assessment/Chapter|author guidelines]]. At the top of the chapter, the title and sub-title should match the ''exact'' wording and casing as shown in the {{Motivation and emotion/Book}}. The sub-titles all end with a question mark. This Overview section should be concise but consist of several paragraphs which engage the reader, illustrate the problem, and outline how psychological science can help. {{RoundBoxTop|theme=3}} '''Focus questions:''' * What is the first focus question? * What is the second focus question? * What is the third focus question? {{RoundBoxBottom}} {{tip| Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Provide an example or case study. * Conclude with Focus questions to guide the chapter. }} ==Main headings== How you are going to structure the chapter? Aim for three to six main headings between the [[#Overview|Overview]] and [[#Conclusion|Conclusion]]. {{tip|Suggestions for this section: * For the [[Motivation and emotion/Assessment/Topic|topic development]], provide at least 3 bullet-points about key content per section. Include key citations. * For the [[Motivation and emotion/Assessment/Chapter|book chapter]], expand the bullet points into paragraphs. * If a section has a lot of content, arrange it into two to five sub-headings such as in the [[#Interactive learning features|interactive learning features section]]. Avoid having sections with only one sub-heading. }} ==Learning features== What brings an online book chapter to life are its interactive learning features. Case studies, feature boxes, figures, links, tables, and quiz questions can be used throughout the chapter. ===Case studies=== Case studies describe real-world examples of concepts in action. Case studies can be real or fictional. A case could be used multiple times during a chapter to illustrate different theories or stages. It is often helpful to present case studies using [[#Feature boxes|feature boxes]]. ===Boxes=== Boxes can be used to highlight content, but don't overuse them. There are many different ways of creating boxes (e.g., see [[Help:Pretty boxes|Pretty boxes]]). Possible uses include: * Focus questions * Case studies or examples * Quiz questions * Take-home messages {{RoundBoxTop|theme=3}} ;Feature box example * Shaded background * Coloured border {{RoundBoxBottom}} ===Figures=== [[File:Monkey-typing.jpg|right|205px|thumb|''Figure 1''. Example image with descriptive caption.]] Use figures to illustrate concepts, add interest, and provide examples. Figures can be used to show photographs, drawings, diagrams, graphs, etcetera. Figures can be embedded throughout the chapter, starting with the Overview section. Figures should be captioned (using a number and a description) in order to explain their relevance to the text. Possible images can be found at [[commons:|Wikimedia Commons]]. Images can also be uploaded if they are licensed for re-use or if you created the image. Each figure should be referred to at least once in the main text (e.g., see Figure 1). ===Links=== Where key words are first used, make them into [[Help:Links|interwiki links]] such as Wikipedia links to articles about famous people (e.g., [[w:Sigmund Freud|Sigmund Freud]] and key concepts (e.g., [[w:Dreams|dreams]]) and links to book chapters about related topics (e.g., would you like to learn about how to overcome [[Motivation and emotion/Book/2020/Writer's block|writer's block]]?). ===Tables=== Tables can be an effective way to organise and summarise information. Tables should be captioned (using APA style) to explain their relevance to the text. Plus each table should be referred to at least once in the main text (e.g., see Table 1 and Table 2). Here are some [[Motivation and emotion/Wikiversity/Tables|example 3 x 3 tables]] which could be adapted. ===Quizzes=== Quizzes are a direct way to engage readers. But don't make quizzes too hard or long. It is better to have one or two review questions per major section than a long quiz at the end. Try to quiz conceptual understanding, rather than trivia. Here are some simple quiz questions which could be adapted. Choose the correct answers and click "Submit": <quiz display=simple> {Quizzes are an interactive learning feature: |type="()"} + True - False {Long quizzes are a good idea: |type="()"} - True + False </quiz> To learn about different types of quiz questions, see [[Help:Quiz|Quiz]]. ==Conclusion== The Conclusion is arguably the most important section. It should be possible for someone to read the [[#Overview|Overview]] and the Conclusion and still get a good idea of the topic. {{tip|Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? }} ==See also== Provide up to half-a-dozen [[Help:Contents/Links#Interwiki_links|internal (wiki) links]] to relevant Wikiversity pages (esp. related [[Motivation and emotion/Book|motivation and emotion book chapters]]) and [[w:|Wikipedia articles]]. For example: * [[Motivation and emotion/Book/2016/Anorexia nervosa and extrinsic motivation|Anorexia nervosa and extrinsic motivation]] (Book chapter, 2016) * [[w:David McClelland|David McClelland]] (Wikipedia) * [[Motivation and emotion/Book/2018/Loss aversion|Loss aversion]] (Book chapter, 2018) * [[w:Maslow's hierarchy of needs|Maslow's hierarchy of needs]] (Wikipedia) {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== List the cited references in [[w:APA style|APA style]] (7th ed.) or [[w:Wikipedia:Citing sources|wiki style]]. APA style example: {{Hanging indent|1= Blair, R. J. R. (2004). The roles of orbital frontal cortex in the modulation of antisocial behavior. ''Brain and Cognition'', ''55''(1), 198–208. https://doi.org/10.1016/S0278-2626(03)00276-8 Buckholtz, J. W., & Meyer-Lindenberg, A. (2008). MAOA and the neurogenetic architecture of human aggression. ''Trends in Neurosciences'', ''31''(3), 120–129. https://doi.org/10.1016/j.tins.2007.12.006 Eckardt, M., File, S., Gessa, G., Grant, K., Guerri, C., Hoffman, P., & Tabakoff, B. (1998). Effects of moderate alcohol consumption on the central nervous system. ''Alcoholism, Clinical and Experimental Research'', ''22''(5), 998–1040. https://doi.org/10.1111/j.1530-0277.1998.tb03695.x }} {{tip|Suggestions for this section: * Important aspects for APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except first letter and proper names, ending in a full-stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full-stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** citing sources that weren't actually read or consulted }} ==External links== Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * [https://students.unimelb.edu.au/academic-skills/explore-our-resources/essay-writing/six-top-tips-for-writing-a-great-essay Six top tips for writing a great essay] (University of Melbourne) * [http://www.skillsyouneed.com/write/structure.html The importance of structure] (skillsyouneed.com) {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] {{:Motivation and emotion/Assessment/Topic/Quickstarttip}} <hr> </noinclude>{{title|Chapter title:<br>Subtitle?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== You are underway {{smile}}! This template provides tips for [[Motivation and emotion/Assessment/Topic|topic development]]. Gradually remove these suggestions as you develop the chapter. Also consult the [[Motivation and emotion/Assessment/Chapter|author guidelines]]. At the top of the chapter, the title and sub-title should match the ''exact'' wording and casing as shown in the {{Motivation and emotion/Book}}. The sub-titles all end with a question mark. This Overview section should be concise but consist of several paragraphs which engage the reader, illustrate the problem, and outline how psychological science can help. {{RoundBoxTop|theme=3}} '''Focus questions:''' * What is the first focus question? * What is the second focus question? * What is the third focus question? {{RoundBoxBottom}} {{tip| Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Provide an example or case study. * Conclude with Focus questions to guide the chapter. }} ==Main headings== How you are going to structure the chapter? Aim for three to six main headings between the [[#Overview|Overview]] and [[#Conclusion|Conclusion]]. {{tip|Suggestions for this section: * For the [[Motivation and emotion/Assessment/Topic|topic development]], provide at least 3 bullet-points about key content per section. Include key citations. * For the [[Motivation and emotion/Assessment/Chapter|book chapter]], expand the bullet points into paragraphs. * If a section has a lot of content, arrange it into two to five sub-headings such as in the [[#Interactive learning features|interactive learning features section]]. Avoid having sections with only one sub-heading. }} ==Learning features== What brings an online book chapter to life are its interactive learning features. Case studies, feature boxes, figures, links, tables, and quiz questions can be used throughout the chapter. ===Case studies=== Case studies describe real-world examples of concepts in action. Case studies can be real or fictional. A case could be used multiple times during a chapter to illustrate different theories or stages. It is often helpful to present case studies using [[#Feature boxes|feature boxes]]. ===Boxes=== Boxes can be used to highlight content, but don't overuse them. There are many different ways of creating boxes (e.g., see [[Help:Pretty boxes|Pretty boxes]]). Possible uses include: * Focus questions * Case studies or examples * Quiz questions * Take-home messages {{RoundBoxTop|theme=3}} ;Feature box example * Shaded background * Coloured border {{RoundBoxBottom}} ===Figures=== [[File:Monkey-typing.jpg|right|205px|thumb|''Figure 1''. Example image with descriptive caption.]] Use figures to illustrate concepts, add interest, and provide examples. Figures can be used to show photographs, drawings, diagrams, graphs, etcetera. Figures can be embedded throughout the chapter, starting with the Overview section. Figures should be captioned (using a number and a description) in order to explain their relevance to the text. Possible images can be found at [[commons:|Wikimedia Commons]]. Images can also be uploaded if they are licensed for re-use or if you created the image. Each figure should be referred to at least once in the main text (e.g., see Figure 1). ===Links=== Where key words are first used, make them into [[Help:Links|interwiki links]] such as Wikipedia links to articles about famous people (e.g., [[w:Sigmund Freud|Sigmund Freud]] and key concepts (e.g., [[w:Dreams|dreams]]) and links to book chapters about related topics (e.g., would you like to learn about how to overcome [[Motivation and emotion/Book/2020/Writer's block|writer's block]]?). ===Tables=== Tables can be an effective way to organise and summarise information. Tables should be captioned (using APA style) to explain their relevance to the text. Plus each table should be referred to at least once in the main text (e.g., see Table 1 and Table 2). Here are some [[Motivation and emotion/Wikiversity/Tables|example 3 x 3 tables]] which could be adapted. ===Quizzes=== Quizzes are a direct way to engage readers. But don't make quizzes too hard or long. It is better to have one or two review questions per major section than a long quiz at the end. Try to quiz conceptual understanding, rather than trivia. Here are some simple quiz questions which could be adapted. Choose the correct answers and click "Submit": <quiz display=simple> {Quizzes are an interactive learning feature: |type="()"} + True - False {Long quizzes are a good idea: |type="()"} - True + False </quiz> To learn about different types of quiz questions, see [[Help:Quiz|Quiz]]. ==Conclusion== The Conclusion is arguably the most important section. It should be possible for someone to read the [[#Overview|Overview]] and the Conclusion and still get a good idea of the topic. {{tip|Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? }} ==See also== Provide up to half-a-dozen [[Help:Contents/Links#Interwiki_links|internal (wiki) links]] to relevant Wikiversity pages (esp. related [[Motivation and emotion/Book|motivation and emotion book chapters]]) and [[w:|Wikipedia articles]]. For example: * [[Motivation and emotion/Book/2016/Anorexia nervosa and extrinsic motivation|Anorexia nervosa and extrinsic motivation]] (Book chapter, 2016) * [[w:David McClelland|David McClelland]] (Wikipedia) * [[Motivation and emotion/Book/2018/Loss aversion|Loss aversion]] (Book chapter, 2018) * [[w:Maslow's hierarchy of needs|Maslow's hierarchy of needs]] (Wikipedia) {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== List the cited references in [[w:APA style|APA style]] (7th ed.) or [[w:Wikipedia:Citing sources|wiki style]]. APA style example: {{Hanging indent|1= Blair, R. J. R. (2004). The roles of orbital frontal cortex in the modulation of antisocial behavior. ''Brain and Cognition'', ''55''(1), 198–208. https://doi.org/10.1016/S0278-2626(03)00276-8 Buckholtz, J. W., & Meyer-Lindenberg, A. (2008). MAOA and the neurogenetic architecture of human aggression. ''Trends in Neurosciences'', ''31''(3), 120–129. https://doi.org/10.1016/j.tins.2007.12.006 Eckardt, M., File, S., Gessa, G., Grant, K., Guerri, C., Hoffman, P., & Tabakoff, B. (1998). Effects of moderate alcohol consumption on the central nervous system. ''Alcoholism, Clinical and Experimental Research'', ''22''(5), 998–1040. https://doi.org/10.1111/j.1530-0277.1998.tb03695.x }} {{tip|Suggestions for this section: * Important aspects for APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except first letter and proper names, ending in a full-stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full-stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** citing sources that weren't actually read or consulted }} ==External links== Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * [https://students.unimelb.edu.au/academic-skills/explore-our-resources/essay-writing/six-top-tips-for-writing-a-great-essay Six top tips for writing a great essay] (University of Melbourne) * [http://www.skillsyouneed.com/write/structure.html The importance of structure] (skillsyouneed.com) {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }}<includeonly> [[Category:{{#titleparts:{{PAGENAME}}|3}}]]</includeonly><noinclude> [[Category:Motivation and emotion/Book]]</noinclude> nvksg5erhing98sejdxv1wanekd1dk7 0 149311 2419357 2146725 2022-08-26T07:23:14Z Marshallsumter 311529 wikitext text/x-wiki [[Image:Neusun1 superk1.jpg|thumb|right|250px|This "neutrino image" of the Sun is produced by using the Super-Kamiokande to detect the neutrinos from nuclear fusion coming from the Sun. Credit: R. Svoboda and K. Gordan (LSU).{{tlx|fairuse}}]] '''[[Neutrino astronomy]]''' is a lecture as part of the radiation astronomy course on the [[principles of radiation astronomy]]. You are free to take this quiz based on [[neutrino astronomy]] at any time. To improve your score, read and study the lecture, the links contained within, listed under [[Radiation astronomy/Neutrinos/Quiz#See also|'''See also''']], [[Radiation astronomy/Neutrinos/Quiz#External links|'''External links''']], and in the {{tlx|principles of radiation astronomy}} template. This should give you adequate background to get 100 %. As a "learning by doing" resource, this quiz helps you to assess your knowledge and understanding of the information, and it is a quiz you may take over and over as a learning resource to improve your knowledge, understanding, test-taking skills, and your score. '''Suggestion:''' Have the lecture available in a separate window. To master the information and use only your memory while taking the quiz, try rewriting the information from more familiar points of view, or be creative with association. Enjoy learning by doing! {{clear}} ==Quiz== <quiz> {True or False, A dominant group associated with neutrino astronomy differs from a control group in that it rules the treatment of the control group. |type="()"} + TRUE - FALSE {Which of the following is not characteristic of a neutrino? |type="()"} - neutrinos are affected by the weak nuclear force + produced by a positron annihilating an electron - a decay product of a neutron - produced by the near surface fusion on the [[Sun (star)|Sun]] - may have a mass - comes in mutable varieties {Yes or No, A control group may be used in neutrino astronomy to demonstrate no effect or a standard effect versus a novel effort applied to a treatment group. |type="()"} + Yes - No {Evidence that demonstrates that a model or idea in neutrino astronomy versus a control group is feasible is called a |type="{}"} { proof of concept (i) }. {True or False, The disparity between the atomic number of an atom and its atomic mass is explained by the existence of the neutrino. |type="()"} - TRUE + FALSE {Complete the text: |type="{}"} A short or { incomplete (i) } realization of a certain { method (i) } or idea to { demonstrate (i) } a treament's feasibility in neutrino astronomy is called a proof of { concept (i) }. {True or False, Pure neutrino astronomy involves no doing apart from itself. |type="()"} + TRUE - FALSE {Complete the text: |type="{}"} A proof-of-concept structure, including a control group, consists of { background (i) }, procedures, findings, and { interpretation (i) }. {True or False, The purpose of a treatment group in neutrino astronomy is to describe natural processes or phenomena for the first time relative to a control group. |type="()"} + TRUE - FALSE {Which of the following are theoretical radiation astronomy phenomena associated with the Sun? |type="[]"} + a core which emits neutrinos - a solar wind which emanates out the polar coronal holes + gravity + the barycenter for the solar system - polar coronal holes - coronal clouds + its position {True or False, Neutrinos emanate from a neutron star because an atomic nucleus the size hypothesized for a neutron star is unstable and the neutrons decompose giving off neutrinos. |type="()"} - TRUE + FALSE {Which of the following is not in the history of neutrino astronomy? |type="()"} - Enrico Fermi coined the term "neutrino" + Wolfgang Pauli postulated the [[w:Lepton|muon neutrino]] - in the Cowan–Reines neutrino experiment, antineutrinos are created - a hydrogen bubble chamber was used to detect neutrinos - Niels Bohr was opposed to the neutrino interpretation of beta decay - a neutrino hitting a proton is detectable {True or False, Terrestrial gamma-ray flashes pose a challenge to current theories of lightning, especially with the discovery of the clear signatures of neutrinos produced in lightning. |type="()"} - TRUE + FALSE {Sputnik I was involved in which of the following astronomies? |type="()"} - red astronomy - stellar astronomy - neutrino astronomy + radio astronomy - neutron astronomy - X-ray astronomy {True or False, The Sudbury Neutrino Observatory is a 12-meter sphere filled with heavy water surrounded by light detectors located 2 km above the ground in Sudbury, Ontario, Canada. |type="()"} - TRUE + FALSE {Cheomseongdae was involved in which of the following astronomies? |type="()"} - cosmic-ray astronomy - infrared astronomy - neutrino astronomy + visual astronomy - ultraviolet astronomy - radio astronomy {True or False, The ANITA experiment is designed to study ultra-high-energy cosmic neutrinos using the Greenland ice sheet. |type="()"} - TRUE + FALSE {Which of the following are the differences between a star and an astronomical yellow source? |type="[]"} + a star may emit predominantly green rays - an astronomical yellow source is spherical - a yellow star is an astronomical yellow source + a star with nuclear fusion in its chromosphere emits neutrinos, but a yellow source with no nuclear fusion ongoing does not + a yellow source may be cloud like + an astronomical yellow source my be a rocky object {Which of the following are theoretical radiation astronomy phenomena associated with the Earth? |type="[]"} - a core which emits neutrinos - a charged particle wind which emanates out the polar ionosphere holes + gravity + near the barycenter for the Earth-Moon system + the swirls of tan, green, blue, and white are most likely sediment in the water - coronal clouds + chlorophyll-containing phytoplankton aloft in the upper atmosphere {Which of the following are theoretical radiation astronomy phenomena associated with a laboratory on Earth? |type="[]"} + a core which emits neutrinos + a charged particle wind which emanates out of a beam line + gravity + near the barycenter for the Earth-Moon system + swirls of tan, green, blue, and white in the water + electric arcs - chlorophyll-containing phytoplankton aloft in the upper atmosphere {Complete the text: |type="{}"} Some neutrinos originating from the Sun may be produced by the { particle accelerator-type (i) } reactions occurring in and above the { chromosphere (i) }. Differentiating these coronal cloud-induced neutrinos from the neutrino background and those theorized to be produced within the { core (i) } of the Sun may someday be possible with neutrino astronomy. {The MINOS experiment uses Fermilab's NuMI beam, which is an intense beam of neutrinos, that travels 455 miles (732 km) through the Earth to the? |type="{}"} { Soudan Mine|Soudan mine (i) } {Which of the following are associated with the IceCube Neutrino Observatory? |type="[]"} + under ice + the Amundsen-Scott South Pole Station + Digital Optical Modules + the counting house is on the surface above the array - the baryon neutrino + the electron neutrino {ANTARES is the name of a neutrino detector designed to be used as a directional Neutrino Telescope residing under the |type="{}"} { Mediterranean Sea|Mediterranean (i) } {Complete the text: |type="{}"} Match up the radiation letter with each of the detector possibilities below: Meteors - A Cosmic rays - B Neutrons - C Protons - D Electrons - E Positrons - F Neutrinos - G Muons - H Gamma rays - I X-rays - J Ultraviolet rays - K Optical rays - L Visual rays - M Violet rays - N Blue rays - O Cyan rays - P Green rays - Q Yellow rays - R Orange rays - S Red rays - T Infrared rays - U Submillimeter rays - V Radio rays - W Superluminal rays - X multialkali (Na-K-Sb-Cs) photocathode materials { L (i) }. F547M { Q (i) }. 511 keV gamma-ray peak { F (i) }. F675W { T (i) }. broad-band filter centered at 404 nm { N (i) }. a cloud chamber { B (i) }. ring-imaging Cherenkov { X (i) }. coherers { W (i) }. effective area is larger by 10⁴ { H (i) }. F588N { R (i) }. pyroelectrics { U (i) }. a blemish about 8,000 km long { A (i) }. a metal-mesh achromatic half-wave plate { V (i) }. coated with lithium fluoride over aluminum { K (i) }. thallium bromide (TlBr) crystals { O (i) }. F606W { S (i) }. aluminum nitride { J (i) }. heavy water { G (i) }. 18 micrometers FWHM at 490 nm { P (i) }. wide-gap II-VI semiconductor ZnO doped with Co²⁺ (Zn_1-xCo_xO) { M (i) }. a recoiling nucleus { C (i) } high-purity germanium { I (i) }. magnetic deflection to separate out incoming ions { E (i) }. 2.2-kilogauss magnet used to sweep out electrons { D (i) }. {The name of a neutrino detector residing 2.5 km under the Mediterranean Sea off the coast of Toulon, France, is? |type="{}"} { ANTARES|Antares (i) } {The name of a neutrino detector under the ice at the Amundsen-Scott South Pole Station in Antarctica is? |type="{}"} { IceCube (i) } {An argon-37 atom is converted by a neutrino by the charged current interaction from what atom? |type="{}"} { chlorine-37|³⁷Cl (i) } {A gallium detector design converts incoming neutrinos to what element? |type="{}"} { germanium (i) } {Which of the following are characteristic of solar proton astronomy? |type="[]"} + the solar wind + polar coronal holes + protons originating from the photosphere - the electron neutrino + GOES 11 - neutrons {Neutrinos detected from the solar octant may be from nucleosynthesis within the coronal cloud in the near vicinity of the Sun or perhaps from nucleosynthesis occurring within what theoretical interior structure of the Sun? |type="{}"} { the core|core (i) } {Which of the following phenomena are associated with the core of the Sun? |type="[]"} - origin of the magnetic field - the convection zone - the tachocline + Solar neutrinos - radiative zone + gamma-rays {Which types of radiation astronomy directly observe the rocky-object surface of Venus? |type="[]"} - meteor astronomy - cosmic-ray astronomy - neutron astronomy - proton astronomy - beta-ray astronomy - neutrino astronomy - gamma-ray astronomy - X-ray astronomy - ultraviolet astronomy - visual astronomy - infrared astronomy - submillimeter astronomy + radio astronomy + radar astronomy + microwave astronomy - superluminal astronomy {Which of the following are X-radiation astronomy phenomena associated with the Sun? |type="[]"} - a core which emits neutrinos - a solar wind which emanates out the polar coronal holes - gravity - the barycenter for the solar system - polar coronal holes + coronal clouds - its position + temperatures at or above 1 MK {Which of the following are X-radiation astronomy phenomena associated with the Sun? |type="[]"} - a chromosphere which emits neutrinos + coronal loops that are particle accelerator-like + synchrotron radiation - a photosphere - a polar diameter that exceeds ever so slightly the equatorial diameter at solar cycle minimum + a polar temperature inside two radii of 1 MK + hot active regions with temperatures hot enough to fuse hydrogen - sunspots at the feet of coronal loops {Which of the following are X-radiation astronomy phenomena associated with the Crab Nebula? |type="[]"} - a core which emits neutrinos + low-energy X-rays detected by the Chandra X-ray Observatory - ²⁶Al - undetectable with balloon-borne detectors + hard X-rays + steady enough emission to be used as a standard for X-ray emission - observed with X-rays in 1731 + Taurus X-1 {Complete the text: |type="{}"} Match up the item letter with each of the possibilities below: Hydrogen - H, or D Helium - He Lithium - Li Beryllium - Be Boron - B Carbon - C Nitrogen - N Oxygen - O Fluorine - F Neon - Ne consumed in chromosphere fusion to produce lithium and neutrinos { Be (i) }. isotope fusion in the chromosphere producing neutrinos { He (i) } fusion in the chromosphere producing the most neutrinos { H|D (i) }. a factor of ~200 below meteorite abundance in the Sun's photosphere { Li (i) }. detected with X-rays on the Moon { O (i) }. an organic form detected in Allan Hills 84001 probably from Mars { C (i) }. detected marginally on Venus with Chandra { N (i) }. found in the X-ray spectra of comets { Ne (i) }. consumed to produce beryllium and neutrinos { B (i) }. a surface impurity on meteorites { F (i) }. {Which of the following are characteristic of the first true astrophysical gamma-ray source? |type="[]"} + a strong 2.223 MeV emission line + a solar flare + the formation of deuterium - the electron neutrino + OSO-3 + neutrons {Which of the following are characteristic of solar green astronomy? |type="[]"} + limb faculae + polar coronal holes + black body temperature of the photosphere - the electron neutrino + iron (Fe XIV) green line - neutrons </quiz> ==Hypotheses== {{main|Hypotheses}} # Even with the limited directionality of the neutrino data, it should be possible to decide between the solar core and the solar corona as the most likely source of neutrinos from the solar octant. ==See also== {{div col|colwidth=20em}} * [[Radiation astronomy/Alpha particles/Quiz|Alpha-particle astronomy quiz]] * [[Radiation astronomy/Atomics/Quiz|Atomic astronomy quiz]] * [[Radiation astronomy/Baryons/Quiz|Baryon astronomy quiz]] * [[Radiation astronomy/Beta particles/Quiz|Beta-particles astronomy/Quiz]] * [[Cosmic-ray astronomy/Quiz]] * [[Electron astronomy/Quiz]] * [[Radiation astronomy/Hadrons/Quiz|Hadron astronomy quiz]] * [[Radiation astronomy/Mesons/Quiz|Meson astronomy quiz]] * [[Muon astronomy/Quiz]] * [[Radiation astronomy/Nebulas/Quiz|Nebula quiz]] * [[Radiation astronomy/Neutrals/Quiz|Neutrals astronomy quiz]] * [[Neutrino astronomy/Quiz]] * [[Neutron astronomy/Quiz]] * [[Positron astronomy/Quiz]] * [[Proton astronomy/Quiz]] * [[Radiation astronomy/Subatomics/Quiz|Subatomic astronomy quiz]] * [[Radiation astronomy/Synchrotrons/Quiz|Synchrotron astronomy quiz]] * [[Radiation astronomy/Tauons/Quiz|Tauon astronomy quiz]] {{Div col end}} ==External links== * [http://www.iau.org/ International Astronomical Union] * [http://nedwww.ipac.caltech.edu/ NASA/IPAC Extragalactic Database - NED] * [http://nssdc.gsfc.nasa.gov/ NASA's National Space Science Data Center] * [http://www.adsabs.harvard.edu/ The SAO/NASA Astrophysics Data System] * [http://cas.sdss.org/astrodr6/en/tools/quicklook/quickobj.asp SDSS Quick Look tool: SkyServer] * [http://simbad.u-strasbg.fr/simbad/ SIMBAD Astronomical Database] * [http://simbad.harvard.edu/simbad/ SIMBAD Web interface, Harvard alternate] * [http://nssdc.gsfc.nasa.gov/nmc/SpacecraftQuery.jsp Spacecraft Query at NASA] * [http://heasarc.gsfc.nasa.gov/cgi-bin/Tools/convcoord/convcoord.pl Universal coordinate converter] <!-- footer templates --> {{tlx|Radiation astronomy resources}}{{Principles of radiation astronomy}}{{Sisterlinks|Neutrino astronomy}} <!-- categories --> [[Category:Astrophysics quizzes]] [[Category:Radiation astronomy quizzes]] [[Category:Radiation quizzes]] jkrj3uoz3nuc5t2b46w8smndsz5o7d1 0 149823 2419346 2121136 2022-08-26T07:10:43Z Marshallsumter 311529 wikitext text/x-wiki [[Image:Hubble views new supernova in Messier 82.jpg|thumb|right|200px|Spiral galaxy Messier 82 has long been known for its remarkable starburst activity. Credit: NASA, ESA, A. Goobar (Stockholm University), and Hubble Heritage.{{tlx|free media}}]] A large number of '''standard candles''' have been used over the recent history of stellar and galactic studies to estimate distances for sources well beyond those calculated from visual trigonometric parallax. This laboratory is an activity for you to evaluate a standard candle of your choosing. While it is part of the astronomy course [[Radiation astronomy/Courses/Principles|principles of radiation astronomy]], it is also independent. Some suggested entities to consider are brightness, diameter, tilt, emission lines, absorption lines, periodic variability, mass, time, Euclidean space, Non-Euclidean space, or spacetime. More importantly, there are '''your''' entities. You may choose to define your entities or use those already defined. Usually, searching follows someone else's ideas of how to do something. But, in this laboratory you can create these too. Okay, this is an [[astronomy]] standard candles [[laboratory]], but you may create what a '''standard candle''' is. Yes, this laboratory is structured. I will provide one example of standard candles or their use. The rest is up to you. Questions, if any, are best placed on the discussion page. {{clear}} ==Notations== You are free to create your own notation or use that already provided. ==Control groups== For creating a standard candle, what would make an acceptable control group? Think about a control group to compare your standard candle or your process of creating a standard candle to. ==Experimentation== The star Betelgeuse may still be too far away for visual trigonometric parallax. Standard candles have probably been used to estimate its distance from the Sun. Estimates from visual trigonometric parallax may be available to evaluate the historical accuracy of standard stellar candles. In 1977 the first direct angular-diameter observations of 119 Tauri were made.<ref name=White>{{ cite journal |author=Nathaniel M. White |title=The Occultation of 119 Tauri and the Effective Temperatures of Three M Supergiants |journal=The Astrophysical Journal |month=December 1, |year=1980 |volume=242 |issue=12 |pages=646-56 |url=http://articles.adsabs.harvard.edu/full/1980ApJ...242..646W |arxiv= |bibcode=1980ApJ...242..646W |doi=10.1086/158501 |pmid= |accessdate=2014-03-26 }}</ref> As a spectral type M2.2 Iab information is inferred about Betelgeuse (a type M2.2 Iab) from the occultation measurements of 119 Tauri.<ref name=White/> The occultations were on January 31, and April 23, 1977. The spectral type of 119 Tau has been constant since 1940.<ref name=White/> In 1977, 119 Tauri (CE Tau) was a spectral type M2.2 Iab, with a spectral range of M2.0-M2.4 Iab-Ib.<ref name=White/> In 1977, Betelgeuse was a spectral type M2.0 Iab^-, with a range of M1.3-M2.8 Iab-Ib.<ref name=White/> For α Sco in 1980 it was M1.1 Iab with a range of M0.7-M1.5 Iab-Ib As of 2014, 119 Tauri is an M2Iab according to SIMBAD. As of 2014, Betelgeuse (alf Ori) is an M2Iab according to SIMBAD. "The spectral type of α Ori varies roughly with the 5.8 yr period and epoch [...] for brightness, radial velocity, and possible angular-diameter variations. Recently, α Ori has shown the latest spectral type between 1973 and 1975 and again in 1980 January-February with a spectral type of M2.8 Iab^-. Its spectral type was about M1.5 around 1969-1971 and again around 1977-1978. By 1982 or 1983, α Ori should again have a spectral type of about M1.5."<ref name=White/> In 1977, apparently α Scorpii (Antares) was an M2.2 Iab, but in 2014 it is an M1.5Iab-b. The standard candle being used in 1977 for spectral region K5-M4 is the CN (cyanide) index from the CN absorption in selected bands.<ref name=White/> The apparent magnitude needed for calculating an object's distance in pc is obtained using a photospheric magnitude received for the 1.04 µm flux peak, ''I''(104) in early-M stars.<ref name=White/> Near-infrared "photometry on the narrow-band eight-color system [...] has been obtained for these stars. The mean [CN] indices and spectral types derived from photometry of the three supergiants are"<ref name=White/> # 119 Tau, CN index = 18 ± 2, ''I''(104) mag = +0.84 ± 0.03, ''M''_V = -5.2 (-4.8 to -5.6), distance = 417 pc, # α Ori, CN index = 18 ± 3, ''I''(104) mag = -2.68 ± 0.03, ''M''_V = -5.2, (-4.5 to -5.8), distance = 96 pc, and # α Sco, CN index = 19 ± 3, ''I''(104) mag = -2.28 ± 0.02, ''M''_V = -5.5, (-4.5 to -5.9), distance = 107 pc. "The distance to α Ori is about half the value, 200 pc, that is almost universally used in the literature."<ref name=White/> "The direct evidence for a distance of 200 pc [to Betelgeuse] is a trigonometric parallax of 0.005, which is 10 times smaller than the expected error of measurement [0.005 ± 0.05 mas]."<ref name=White/> ==Results== In 1977 using the absorption spectrum of cyanide believed to be applicable for the spectral region K5-M4 to produce a CN index and the relationship between apparent magnitude and absolute magnitude, a distance of 96 pc was estimated for Betelgeuse. Parallax measurements at that time estimated a distance of 200 pc, but the error was 10 times greater than the value derived.<ref name=White/> A parallax measurement by the satellite ''Hipparcos'' indicated a distance of 197 ± 45 pc published in 2008. While post 1980 adjustments were made to increase the estimated distance of Betelgeuse, the initial discrepancy is quite large, at least a factor of 2 using a standard candle. ==Discussion== Estimates made using standard candles rather than some type of direct measurement are expected to be inaccurate. In 1977, the distance to Betelgeuse estimated by various standard candles suggested 200 pc, "almost universally used in the literature."<ref name=White/> Adjustments after 1980 to the standard candle used to estimate the absolute magnitude of Betelgeuse and the 96 pc distance tended toward the universally accepted value. The ESA's Gaia spacecraft is expected to start collecting data in May 2014 on approximately 10⁹ Milky Way objects. This data will be used to determine their parallax and relative motions. Betelgeuse is a likely target. Standard candles are hoped to achieve distances within an order of magnitude of reality. It may take another 50 years to produce a device beyond the technology of Gaia to determine distances directly to galaxies beyond the Milky Way. ==Conclusion== The analysis of an attempt at a more precise distance to Betelgeuse which in 1977 was beyond direct measurement by trigonometric parallax demonstrates both the strengths and weaknesses of indirect measurements or estimates. Astronomical objects may be sufficiently novel, one to another, to make standard candles at best only good to an order of magnitude. ==Report== '''Title:''' A standard candle distance to Betelgeuse by [[User:Marshallsumter|Marshallsumter]] ([[User talk:Marshallsumter|discuss]] • [[Special:Contributions/Marshallsumter|contribs]]) 19:57, 27 March 2014 (UTC) '''Abstract''' The standard candle of the absorption by cyanide (CN) to produce a CN index applicable to the spectral region K5-M4 was analyzed for the star Betelgeuse. The underestimate of the distance to Betelgeuse demonstrates both the value and limitations of standard candles. '''Introduction''' In 1977 the direct measurement of the distance to Betelgeuse was lacking. To fill this gap, an accepted standard candle was used to estimate the absolute magnitude of Betelgeuse. Once estimated, an apparent magnitude obtained in the infrared provided an estimate of the distance. '''Experiment''' The experimental effort was to locate and analyze the test of a standard candle for the distance to Betelgeuse. In 1977 using the absorption spectrum of cyanide believed to be applicable for the spectral region K5-M4 to produce a CN index and the relationship between apparent magnitude and absolute magnitude, a distance of 96 pc was estimated for Betelgeuse. '''Results''' The estimate did not conform to a universally accepted distance to Betelgeuse. The standard candle with some adjustments seems to be well founded in a qualitative approach to distance estimates currently beyond direct measurement. '''Discussion''' Any effort to make a standard candle more accurate than an order of magnitude as a replacement for direct measurement is likely to be inaccurate. '''Conclusion''' Standard candles fill in a necessary gap between techniques of direct distance measurement and back of the envelope guesses. ==Evaluation== To assess your standard candle, including your justification, analysis and discussion, I will provide such an assessment of my example for comparison. '''Evaluation''' Using only one standard candle is anecdotal. At least five separate standard candles, especially four others that were much closer to the universally accepted distance for Betelgeuse should have been included. This would have presented a more statistically sound treatment of standard candles. ==Hypotheses== {{main|Hypotheses}} # There is a minimum diameter to a blue star that yields a minimum distance for nearby galaxies. ==See also== {{div col|colwidth=20em}} * [[Radiation/Analysis/Laboratory|Analytical astronomy]] * [[Cosmogony laboratory|Cosmogony]] * [[Cratering laboratory|Cratering]] * [[Electric orbits]] * [[Electron beam heating/Laboratory|Electron beam heating]] * [[Galaxies/Laboratory|Galaxies]] * [[Intergalactic medium/Laboratory|Intergalactic medium]] * [[Locating the Sun]] * [[Magnetic field reversals/Laboratory|Magnetic field reversal]] * [[Meteorites/Laboratory|Meteorites]] * [[Neutrinos from the Sun]] * [[Spectrum of Vega]] * [[Vertical precession]] * [[X-ray classification of a star]] * [[X-ray trigonometric parallax/Laboratory|X-ray trigonometric parallax]] {{Div col end}} ==References== {{reflist|2}} ==External links== * [http://www.iau.org/ International Astronomical Union] * [http://nedwww.ipac.caltech.edu/ NASA/IPAC Extragalactic Database - NED] * [http://nssdc.gsfc.nasa.gov/ NASA's National Space Science Data Center] * [http://www.osti.gov/ Office of Scientific & Technical Information] * [http://www.ncbi.nlm.nih.gov/pccompound PubChem Public Chemical Database] * [http://www.adsabs.harvard.edu/ The SAO/NASA Astrophysics Data System] * [http://www.scirus.com/srsapp/advanced/index.jsp?q1= Scirus for scientific information only advanced search] * [http://cas.sdss.org/astrodr6/en/tools/quicklook/quickobj.asp SDSS Quick Look tool: SkyServer] * [http://simbad.u-strasbg.fr/simbad/ SIMBAD Astronomical Database] * [http://simbad.harvard.edu/simbad/ SIMBAD Web interface, Harvard alternate] * [http://nssdc.gsfc.nasa.gov/nmc/SpacecraftQuery.jsp Spacecraft Query at NASA] * [http://heasarc.gsfc.nasa.gov/cgi-bin/Tools/convcoord/convcoord.pl Universal coordinate converter] <!-- footer templates --> {{tlx|Chemistry resources}}{{tlx|Charge ontology}}{{tlx|History of science resources}}{{Principles of radiation astronomy}}{{tlx|Radiation astronomy resources}}{{tlx|Reasoning resources}}{{tlx|Terminology resources}}{{Sisterlinks|Standard candles}}{{Sisterlinks|Laboratory}} <!-- categories --> [[Category:Astrophysics/Laboratories]] [[Category:History of Science/Laboratories]] [[Category:Radiation astronomy/Laboratories]] [[Category:Radiation/Laboratories]] 5l5tf6k1pd1k6ti4h2ojn5qx6k9iqzw 0 164547 2419094 1919499 2022-08-25T22:33:37Z Jtneill 10242 + categories wikitext text/x-wiki {{title|Hedonic treadmill and emotion:<br>What is the hedonic treadmill and how does it influence our emotional lives?}} {{MECR|http://screencast.com/t/l0rVKIc0Hi}} __TOC__ ==Overview== {{RoundBoxTop|theme=6}} '''Emotion:''' A “particular state of an organism facing well defined conditions (a so-called emotional situation) which is coupled with a subjective experience and with somatic and visceral manifestations" (Doron & Parot,19911). Emotion involves a short term reaction to a specific event. {{RoundBoxBottom}} As a child can you remember ever getting so excited for [[w:Christmas|Christmas]] day and not being able to wait to open all your presents? Can you remember opening them and feeling overjoyed with excitement because of your brand new toy? Can you remember getting to the end of the day and feeling that the brand new toy was no longer exciting to play with? When you do finally open all your presents you do not feel as happy as you thought you would. You no longer have that intense feeling of excitement. Have you ever had a really bad day that made you just want to cry? Can you remember expecting things to only get worse? Can you remember waking up the next day and feeling better? Although you had a bad day and expected things to get worse this feeling was only temporary. After a day or so you are back to normal and feeling fine, forgetting all about it. It is our [[w:hedonic treadmill|hedonic treadmill]] or set point of [[Motivation and emotion/Book/2011/Happiness|happiness]] that allows us to experience both good and bad feelings only to return to our normal state of happiness or hedonic neutrality. This chapter aims to explain the hedonic treadmill and how it influences our emotional lives. This chapter will outline both the hedonic treadmill and what is meant by emotional lives. This chapter will examine theoretical approaches to happiness in relation to the hedonic treadmill. Lastly this chapter will review evidence about how the hedonic treadmill motivates our emotional lives, how it relates to [[Motivation and emotion/Textbook/Motivation/Depression|depression]] and examine critical views against the hedonic treadmill. After reading this chapter you should be able to understand the hedonic treadmill, our emtional {{spelling}} lives and the role that the hedonic treamill plays in our emotional lives. You should also be able to understand how the hedonic treadmill relates to resilience and why it is we are able to 'bounce back' from negative events in our life. == Introduction == =====What is the Hedonic treadmill?===== [[File:Balinese Money.jpg|thumb|300px|right| Figure 2: Money does not buy happiness{{fact}}]] The idea that a persons {{grammar}} happiness or [[w:well-being|well-being]] is relative to ones {{grammar}} circumstances has been around for centuries. The hedonic treadmill was constructed by Brickman and Campbell in 1971 (Brickman et al, 1978) and is also known as the set-point theory. According to the hedonic treadmill model people temporarily experience both good and bad events that affect their happiness but quickly adapt back to equilibrium or hedonic neutrality (Diener, Lucas & Scollon, 2006). Although our lives are constantly changing, our happiness is at a relatively constant state or has what is known as its set-point (Brickman et al, 1978). Similar to a treadmill, we are constantly striving for more, only to then return to our original position on the treadmill, also known as our set point of happiness or hedonic neutrality. For example, the hedonic treadmill suggests that just because a person is wealthy does not mean that they are happier than someone who is poor. This is seen in Brickman et al's (1978) study which found that major lottery winners are not significantly happier than the control subjects. Major lottery winners also derive significantly less satisfaction from ordinary daily life activities (Brickman et al, 1978). The hedonic treadmill or set point theory is an important tool for explaining resilience. Resilience involves an interaction between both risk and protective processes that act to modify the effects of an adverse life event (Garmezy, (1985). Therefore it is a persons ability to recover from negative events (Garmezy, 1991). Resilience and the hedonic treadmill or a persons set point are correlated. The hedonism theory suggests that there are two forms of happiness, including: Hedonia and eudaimonia (Waterman, 2007). Firstly, hedonia is the affective component of happiness. It consists of conscious feelings of pleasure and well-being (Waterman, 2007). Whereas,{{grammar}} eudaimonia emerged from Aristotelian philosophy (Kristjansson, 2010). Aristotle defined happiness as being centred around what it means to live a good life (Ryan, Huta & Deci, 2006). Therefore, eudaimonia is a persons sense of life satisfaction regarding their life meaning (Waterman, 2007). Seligman & Royzman (2003) agree that happiness is labelled by a subjective feeling, but stated that in order to be a happy person one must maximise pleasurable feelings and minimise negative. Studies suggest that eudaimonic happiness has a strong correlation with relatedness and a personal concern for others (Haybron, 2000). However, the hedonic treadmill only functions {{missing}} one level of happiness being hedonia (Waterman, 2007). [[File:Learned optimism 3.jpg|thumbnail|300px|left|Figure 3: Negative events never last]] =====What is our emotional life?===== As humans we all experience a range of different emotions across certain periods of time. Firstly it is important to understand emotion. Emotion a complex idea with no universal agreed definition. A general definition of emotion identifies it as a short lived phenomena that helps us to adapt to life events (Ekman, 1992). Life is full of a number of stresses, challenges and problems. Emotions arise as a solution to these stresses, challenges and problems (Ekman, 1992). Our emotional life involves the complex range of emotions we feel throughout the entirety of our lives. Our emotions change rapidly and a number of times in one day, therefore constantly changing throughout our lifetime. For example James may feel angry and frustrated one morning because his car will not start. However at lunchtime James feels joy because as he is marking students work a number of them are of high standard. Over a period of approximately 4 hours James' emotions have changed from one side of the spectrum to the other. The emotional life is this roller-coaster of changing emotions over a persons lifetime. The emotional life is a domain that requires a unique set of competencies (Goleman & Sutherland, 1996) and those who do not have some control over their emotional life fight inner battles which effect their ability to focus (Goleman & Sutherland, 1996). This is seen in children who suffer particularly from Attention Deficit Hyperactivity Disorder (Peris, 2003). Our emotional lives are similar to a roller coaster as we all experience a number of highs, lows and varying in between stages. == Theoretical approaches == =====Behavioural===== As Brickman et. al. (1978) suggested, a person who is rich is not necessarily happier than those who are not rich. The behavioural approach to the hedonic treadmill poses that once we experience a positive event, this experience only temporary. According to Frederick and Lowenstein (1999) the behavioural approach to the hedonic treadmill includes three types of processes. These processes include: shifting adaption levels, desensitisation and sensitisation. When there is a shift in what a person perceives as a 'neutral stimulus' but they are still sensitive to stimulus differences, shifting adaption levels occur (Frederick & Lowenstein, 1999). An example of this is when someone believes a new job will significantly improve their life. When they obtain the wanted job they are initially happier about getting the job. They then become accustomed to the new job and return to feeling dull at work. They have returned to their hedonic neutrality or set happiness. However, when the employee receives a change in areas for their new job they are still pleased. The shifting adaption levels mean that a persons happiness is temporarily increased by a particular event. After time this event no longer has the same effect and a persons happiness returns to normal. Desensitisation decreases sensitivity in general causing a person to be less sensitive to change (Frederick & Lowenstein, 1999). For example, someone who has lived in an outback rural area may become desensitised to the death of animals as this is a regular occurrence on large farms. Later in life when needing to put down a pet they will find this less emotionally upsetting than others due to their desensitisation. Desensitisation is one example to why people who have lived in war torn areas tend to find the loss of close ones less impacting because they have become desensitised to devastation and loss. For example, someone who was a child in Germany during World War II will not tend be as effected by the loss of a family member than people who did not grow up in a war torn area. Thirdly, continuous exposure to a stimulus may increase hedonic response, resulting in sensitisation (Frederick & Lowenstein, 1999). For example increased pleasure of chocolate makes a person want to go back for more. These three processes play a key role in the behavioural approach to the hedonic treadmill. [[File:LyubomirskyHappiness.jpg|thumb|400px|left|Figure 4: Biologically determined happiness{{explain}}]] =====Biological===== According to the biological approach to happiness, an individuals happiness is genetically influenced. Studies have found a correlation between a persons happiness and their levels of dopamine and serotonin (Ebstein et al, 1996). This suggests that an individuals happiness is inherited through their genes as studies have found that genes play a major role in regulating levels of dopamine and serotonin (Ebstein et al, 1996).Studies of over 3,000 identical and fraternal twins revealed that genetically identical twins showed similar levels of happiness, even when raised apart from each other (Lykken & Tellegen, 1996). The reported well-being of someone's identical twin has been found to be a better predictor of someone's happiness than income, educational achievement or social status (Lykken & Tellegen, 1996). These studies of twins suggest that a persons happiness is inherited in their genes. Genes play a important role in understanding an individual. Similarly{{grammar}} to the hedonic treadmill people also have a biologically determined weight. This set-point theory argues that an individuals biologically determined weight is set by genetics at birth or shortly after (Powley & Keesey, 1970). The biological approach to happiness is the most significant approach to the hedonic treadmill as it suggests that a persons baseline level is biologically determined (Brickman et al, 1978). == How does the hedonic treadmill influence our emotional lives? == [[File:Depression-loss of loved one.jpg|300px|thumbnail|right|''Figure 5''. The hedonic treadmill model is useful in returning people to their set happiness after depressive episodes]] The hedonic treadmill plays an important role in our emotional lives. As we strive to increase our happiness, after positive events occur, a persons happiness will return to their personal set point of happiness (Brickman et al, 1978) . Alternatively we also experience negative events in our lives which makes a persons happiness level decrease. The hedonic treadmill also works as a form of resilience returning a persons happiness to their set point of happiness (Masten, 2009). This is important because, without resilience or this return to our set point of a happiness, several negative life events may cause a person to feel extremely dull and depressed all the time (Masten, 2009). Imagine the embarrassment you feel when you fall over in front of your friends, this feeling of embarrassment decreases a persons level of happiness. Imagine the next day you go to work feeling dull, only to be fired. This in turn also drops a persons level of happiness. Now imagine that your happiness level were not to increase until a positive event occurred. This 'bouncing back' from negative events that have decreased happiness is important for a persons well-being. =====Moods and emotions===== Both moods and emotions play a role in how we feel. Our emotions are short lived responses to a specific significant event in our lives (Ekman, 1992). Whereas {{grammar}} moods arise from ill-defined sources that are often unknown and are long lived (Goldsmith, 1994). Davidson (1994) found that our emotions influence our behaviours whereas our moods influence our cognition's {{grammar}}. Our emotions change more rapidly than moods as our events change (Ekman, 1992). It is these positive or negative events which change our emotions. As a result, our happiness levels alter with our emotions. This is where the hedonic treadmill comes in. =====How the hedonic treadmill influences our emotional lives===== The hedonic treadmill influences ou,r emotional lives by controlling our baseline happiness and despite life events we always return to this baseline. The most famous study involving the hedonic treadmill is Brickmans (1978) study. Brickman interviewed both lottery winners and paraplegics. This study found that {{missing}} years after winning the lottery people were no happier than they were before winning the lottery. The large gain of money from the lottery winners had no effect on peoples baseline or set happiness. These results were also found for paraplegics. {{Missing}} years after the accident paraplegics reported similar levels of happiness to before the accident. Paraplegics did experience a significant decline in happiness as a result of the accident. They then returned to their baseline happiness {{missing}} years after the accident. Similarly, Silver's (1982) study of the effects of a traumatic accident causing spinal injury on a persons baseline level of happiness{{grammar}}. Silver followed participants over 8 weeks. After the first week participants showed greater levels of negative emotions than positive. In the eighth week after their accident participants showed greater levels of positive emotions than negative. These studies reveal that despite the persons situation being positive or negative, and the direction of emotions being either positive or negative, our happiness or emotions always return to the baseline. Therefore the hedonic treadmill influences our emotional lives by allowing our emotions to be temporary to our situation. Headly and Wearing (1989) ran a longitudinal study where participants were followed over a period of 8 years. They made a number of variations to the hedonic treadmill theory. Headly and Wearing (1989) proposed that similar to the hedonic treadmill a persons baseline happiness is within the positive range and also that people return to differing baselines depending on their personalities. This study found that happy people were more likely than unhappy people to to {{grammar}} experience good events and therefore argued that a persons baseline is due to an individuals likelihood to experience certain affect-inducing events (Headly & Wearing, 1989). This modification of the hedonic treadmill is important as it states that peoples baseline happiness varies depending on the persons personality. Some researchers suggest that trying to be happier is a pointless battle, similar to trying to be taller (Lykken & Tellegen, 1996). This is because the hedonic treadmill continues to draw us back to our set point of happiness. =====Hedonic treadmill and depression===== In modern society depression has become a large psychological issue. Depression is one of the most impacting mood disorders. Depression is a state of low mood that affects a persons behaviour, thoughts, feelings and sense of well-being (Salmans & Sandra, 1997). The hedonic treadmill is a useful tool in clinical psychology to help patients return to their hedonic set point when negative events happen. This is important for patients with depression and post traumatic stress disorder who struggle to return to their hedonic set point. Determining when someone is mentally distant from their personal set point and what causes these changes are helpful in treating a number of conditions, specifically depression (Sheldon, Lyubomirsky & Sonja, 2006). Clinical psychologists work with patients to recover from a depressive episode and return to their hedonic set point more quickly (Sheldon, Lyubomirsky & Sonja, 2006).One treatment provides patients with different altruristic activities, as acts of kindness to promote a persons long-term well-being. On top of this it is important that patients understand the hedonic treadmill and that long-term happiness is relatively stable. This helps to ease anxiety over strong impacting events (Sheldon, Lyubomirsky & Sonja, 2006). This treatment uses a persons hedonic treadmill to restore them to their set point of happiness. Hedonic adaptation also applies to resilience research. Resilience is a class of phenomena characterised by patterns of good outcomes in the context of serious risk or threat (Masten, 2001). Therefore resilience is a persons ability to remain at their hedonic set point while experiencing negative events. A number of factors that contribute towards a person being resilient includ: positive attachment relationships, positive self perceptions, self-regulatory skills and a positive outlook on life (Masten, 2009). Resilience or a persons ability to 'bounce back' from negative events is also important for patients with depression. Patients with depression tend to struggle with resilience to negative events, therefore the use of the hedonic treadmill on resilience studies is important. == Critical views == There is significant evidence to support the idea of the hedonic treadmill or a persons biological set happiness{{fact}}. Like all theories the hedonic treadmill also has it downfalls. The biggest limitation of the hedonic treadmill is that it does not allow for a persons overall happiness to increase despite individual and societal efforts. There is an increasing amount of evidence that with the use of appropriate measures and specific interventions aimed at fostering strengths and virtues that happiness can be increased (Narrish & Vella-Brodrick, 2008). Diener, Lucas & Scollon (2006) found that different types of well-being change at different rates. Evidence also suggests that individuals adaption rates vary and although adaption may proceed slowly over time, in some cases the process in never complete (Diener, Lucas, & Scollon, 2006). Headly and Wearings's (1989) study could not explain if people always return to the same baseline or if new ones are created. Alternative views to the hedonic treadmill include desire theory, objective list theory and authentic happiness theory. Desire theory suggests that people experience a sense of happiness as a result of obtaining what they want or desire (Seligman & Royzman, 2003). These wants and desires are subjective. For example an individual is happier after receiving a book they have wanted. According to this theory if a person is able to fulfil their desires they may experience a negative affect, but still be considered happy. Objective theory proposes that happiness results from large achievements such as lifetime goals (Seligman & Royzman, 2003). These lifetime goals could include events such as obtaining a doctorate degree. Finally, the authentic happiness theory suggests that three types of happiness which incorporate hedonism, desire and objective list theories (Seligman & Royzman, 2003). This includes pleasant life, good life and meaningful life (Seligman & Royzman, 2003). Authentic happiness results in satisfying a persons entire life by satisfying all areas of happiness. Another alternative view to the hedonic treadmill accepts that a persons happiness is stable and heritable, it is not genetically predetermined and can be altered by ones behaviour (Byrnes & Strohminger, 2005). Various controllable life factors have been shown to predict high happiness (Byrnes & Strohminger, 2005). Placebo studies have shown that antidepressant medications are effective in treating depression and psychotherapy such as cognitive therapy teach a person to control negative thoughts (Byrnes & Strohminger, 2005). Despite the use of antidepressants by those who do not suffer from depression not being advisable it is suggested that people with average happiness could increase their overall life happiness by using cognitive therapy to control negative thoughts (Byrnes & Strohminger, 2005). People dismiss the hedonic treadmill for a number of reasons. The biggest critic of the hedonic treadmill is due to the fact it does not allow people to increase their happiness despite their efforts. ==Conclusion== The hedonic treadmill suggests that each individual has a biologically determined set happiness that is stable over their lifetime. Studies of lottery winners and paraplegics reveal that despite a person experiencing significant positive or negative life events, over time they return to their set happiness. This influences an individuals emotional life because it allows them to experience both positive and negative events. The hedonic treadmill allows individuals to experience positive experiences such as pay rises, engagements, marriage, births and so on {{missing}}. On the other hand it also allow people to experience negative events such as loss of a job, accidents, death of family or close ones and more {{explain}}. After both positive and negative events we return to our baseline happiness allowing us to continue to experience positive and negative events, in our emotional lives. The hedonic treadmill poses as a tool to help those who suffer from depression to return to their set happiness as fast as possible. The downside of the hedonic treadmill is that no matter how hard an individual or society tries to increase their happiness, the hedonic treadmill suggests that a persons biological set happiness does not vary significantly over ones lifetime. Similar to a roller-coaster, our emotional lives are constantly moving and changing, similar to the hedonic treadmill we continue to strive for more and once there we return to our original position. ; Take home message Our emotional lives constantly change, {{grammar}} this is because the hedonic treadmill allows a person to experience positive and negative events, only to return to their biologically set happiness. Despite our negative life events the hedonic treadmill allows a person to be resilient and bounce back to their set happiness. Therefore there are two important message to take away from this book chapter: # receiving gifts and achieving small goals can make one immediately happy but it does not always bring long-term happiness, and # remember that a bad day will always get better no matter how much you think it won't. ==See also== * [[Motivation and emotion/Book/2011/Change and happiness|Change and happiness]] (Book chapter, 2011) * [[Motivation and emotion/Textbook/Motivation/Depression|Depression]] (Book chapter, 2010) * [[Motivation and emotion/Book/2011/Happiness|Happiness]] (Book chapter, 2011) * [[Motivation and emotion/Book/2014/Chocolate and mood|Chocolate and mood]] (Book chapter, 2014) ==References== {{Hanging indent|1= Brickman, P., Coates, D., & Janoff-Bulman, R. (1978). Lottery winners and accident victims: is happiness relative? ''Journal of Personality and Social Psychology, 36''(8), pp917-927 Byrnes, S., & Strohminger, N. (2005). The Hedonic Treadmill. ''Science B62'', University of. Davidson, K. J. (1994). Un emotion, mood, and related affective constructs. In P. Ekman & R. N. Davidson (Eds) The nature of emotion: Fundamental questions. (pp.51-55). New York: Oxford University Press. Diener, E., Lucas, R. E., & Scollon, C. (2006). Beyond the hedonic treadmill: Revising the adaption theory of well-being. ''American Psychologist, 61''(4), 305-314. doi:10.1037/0003-066X.61.4.305 Doron, R., Parot, F. (1991). Dictionnaire de psychologie. Paris: Presses Universitaires de France Ebstein, R. P., et al. (1996). Dopamine D4 receptor (D4DR) exon III polymorphism associated with the human personality trait of Novelty Seeking. ''Nature Genetics'', 12, 78-80 Ekman, P. (1992). An argument for basic emotions. ''Cognitive and Emotion'', 6, 169-200 Frederick., & Lowenstein.(1999) Hedonic Adaptation. ''Well-being: The foundations of hedonic psychology'', 302-329 Garmezy, N. (1991). Resilience in children's adaptation to negative life events and stressed environments. ''Pediatric Annals'', 20, pp. 459–466 Gilbert, D. T., Pinel, E. C., Wilson, T. D., Blumberg, S. J., & Wheatley, T. P. (1998). Immune neglect: A source of durability bias in affective forecasting. ''Journal of Personality and Social Psychology, 75''(3), 617–638. Goleman, D., & Sutherland, S. (1996). Emotional intelligence: Why it can matter more than IQ. London: Bloomsbury. Goldsmith, H. H. (1994). Parsing the emotional domain from a developmental perspective. In P. Ekman & R. J. Davidson (Eds) The nature of emotion: Fundamental questions. (pp.68-73). New York: Oxford University Press. Haybron, D.M. (2000). Two philosophical problems in the study of happiness. ''The Journal of Happiness Studies, 1''(2), 207-225. Headly, B., & Wearing, A. (1989). Personality, life events, and subjective well-being: Toward a dynamic equilibrium model. ''Journal of Personality and Social Psychology, 57,'' 731-739 Krisjansson, K. (2010). Positive psychology, happiness and virtue: The troublesome conceptual issues. ''Review of General Psychology, 14''(4), 296-310. Lykken, D., & Tellegen, A. (1996) Happiness is a stochastic phenomenon. ''Psychological Science, 7'', 186-189 Masten, A. S., Cutuli, J. J., Herbers, J. E., & Reed, M.-G. J. (2009). Resilience in development. In C. R. Snyder & S. J. Lopez (Eds.), Oxford Handbook of Positive Psychology, 2nd ed. (pp. 117 - 131). New York: Oxford University Press. Masten, A. S. (2001). Ordinary magic: Resilience processes in development. ''American Psychologist, 56''(3), 227-238. doi:10.1037/0003-066X.56.3.227 Norrish, J., & Vella-Brodrick, D. (2008). Is the Study of Happiness a Worthy Scientific Pursuit?. ''Social Indicators Research, 87''(3), 393-407. Peris, T. P. (2003). Family dynamics and preadolescent girls with ADHD: the relationship between expressed emotion, ADHD symptomatology, and comorbid disruptive behavior. ''Journal Of Child Psychology & Psychiatry & Allied Disciplines, 44''(8), 1177-1190. Powley, T. L, & Keesey, R. E. (197). Relationship of body weight to the lateral hypothalamus feeding syndrome. ''Journal of Comparative and Clinical Psychology, 70,'' 25-36 Ryan, R.M., Huta, V., & Deci, E.L. (2006). Living well: A self-determination theory perspective on eudaimonia. ''Journal of Happiness Studies, 9''(1), 139-170. Salmans, Sandra (1997). Depression: Questions You Have – Answers You Need. ''People's Medical Society''. {{ISBN|978-1-882606-14-6}}. Seligman, M. & Royzman, E. (2003). Happiness: the three traditional theories. Retrieved from http://pq.2004.tripod.com/happiness_three_traditional_theories.pdf Sheldon, K. M.; Lyubomirsky, & Sonja (2006). "Achieving Sustainable Gains in Happiness: Change Your Actions Not Your Circumstances". ''Journal of Happiness Studies,'' 7, 55–86. doi:10.1007/s10902-005-0868-8. Silver (1982). Coping with an undesirable life event: A study of early reactions to physical disability. Northwestern University Waterman, A. (2007). “On the Importance of Distinguishing Hedonia and Eudaimonia When Contemplating the Hedonic Treadmill.” ''American Psychologist'', September 2007, Vol. 62, No. 6, 612-613. }} ==External links:== * [[http://mysuperchargedlife.com/blog/the-science-of-happiness-your-happiness-set-point/|The Science of Happiness]] * [[http://www.youtube.com/watch?v=DIJeX965zv4| The hedonic treamill explained - video]] * [[http://www.huffingtonpost.com/gaiam-tv/happiness-tips_b_2521500.html| Deepak Chopra suggestion on changing your set point happiness]] * [[http://www.livetocoach.com/index.php/2010/09/| Hedonia and eudaimonia]] [[Category:{{#titleparts:{{PAGENAME}}|3}}]] [[Category:Motivation and emotion/Book/Pleasure]] 7rjxdrrq79dz179agt5qj667p5d7pkc 0 167267 2419355 1856300 2022-08-26T07:21:45Z Jtneill 10242 + categories wikitext text/x-wiki {{title|Amygdala and emotion:<br>What role does the amygdala play in emotion?}} {{MECR|https://www.screenr.com/vkDN}} __TOC__ == Overview == What is the amygdala? What does the amygdala do? How is the amgydala related to emotion? This book chapter is aimed at using research knowledge and emotion theory to answer these questions which in turn will assist the community to understand and improve their lives. To understand how the amygdala relates to emotion it is first important to have an understanding of what the amygdala is, where it is located, and what the roles of the amygdala are. Not only is it important to understand what the amygdala is but it is also important to know what an emotion is. The following paragraphs will explain both before delving into the more specific roles the amygdala plays within emotion and how they interact with each other using psychological and biomedical research. == What is the amygdala? == [[File:Amygdala small.gif|thumb|250px|left| ''Figure 1.'' The Amygdala is shown in red]] Amydale is the Greek word for almond, and eidos is the Greek word for like; therefore the translation would be 'like an almond' (Healthline, 2014). The amygdaloid body (amygdala) is a small almond shaped structure made up of nuclei which is apart of the limbic system (Bailey, 2014). The amygaloid body was named as such because of its almond shape (Healthline, 2014). The amygdaloid body is also known as the amygdale, nucleus amygdalae, porpus amygdalolieum, amygdaloid complex, and amygdaloid nucleus (Healthline, 2014). The most common name is the amygdala. The amygdala can be located deep within the temporal lobe of the brain (Bailey, 2014). Specifically it is associated with the hypothalamus, cingulated gyrus, and hippocampus (Healthline, 2014). A concrete definition of the roles of the amygdala has not yet been established, nor has exact functions been allocated to each of its subgroups (Holt, 2008). There has been much debate on how many subgroups there are within the amygdala resulting in categories between 5 and 22 (Holt, 2008). On the other hand there are four main groups that have been universally agreed upon which are the Basolateral, Lateral, Central and Basomedial Nuclei (Holt, 2008). Smelling, motivation, and emotional responses are made by the olfactory system and the limbic system and are partly made by the amygdaloid body (Healthline, 2014). The amygdala is central to our emotions and motivations, especially emotions related to survival (Bailey, 2014). The amygdala's function is to process emotions such as fear, anger and anxiety (Bailey, 2014). The amygdala is also essential for determining what memories are stored and where memories are stored within the brain (Bailey, 2014). It has been suggested that the decision as to where the memory is stored is based on how huge an emotional response a particular event invokes (Bailey, 2014). == What is an emotion? == [[File:Emotions3.jpg|thumb|300px|right| ''Figure 2.'' Emotion Mosaic]] Emotions tend to occur as reactions to important life events (Reeve, 2009). Emotions consist of four main elements- feeling, arousal, purpose and expression (Reeve, 2009). Feelings give emotions subjective personal meaning (Reeve, 2009). Arousal is the biological activity that prepares the body for adaptive coping behaviour (Reeve, 2009). Purpose gives an emotion goal-direction and motivation to take a certain course of action (Reeve, 2009). Expression gives emotion a social aspect which is important for communication with others (Reeve, 2009). Emotion is therefore defined as a psychological construct which unifies and coordinates these four elements of experience to create an orchestrated and adaptive pattern (Reeve, 2009). == Fear and the amygdala == The pathways which allow us to both consciously and subconsciously interpret fear is still not understood by neuroscientists (Bergland, 2013). However the amygdala has been proven to be involved in various aspects of fear processing (Feinstein, Adolphs, Dasmasio & Tranel, 2011). This includes fear conditioning, modulation of attention and memory for fear-related stimuli, fear recognition, and the induction of fear-related behaviours (Feinstein et al., 2011). These are all subconscious aspects of fear. Not alot is known about the amygdala's role in conscious experiences of fear due to the fact that nonhuman animals with lesions lack the ability to verbally report on their internal subjective experience (Feinstein et al., 2011). The second reason is that humans with focal bilateral amygdala damage are extremely difficult to find (Feinstein et al., 2011). === The amygdala's role in fear conditioning === [[File:Ivan Pavlov NLM3.jpg|thumb|200px|right| ''Figure 3.'' Pavlov famous for Classical Conditioning]] Fears can be either innate or learned. Innate fears are defined as any fear that has been encoded within our genes. Learned fears are acquired through painful or traumatic life experiences. A majority of what is known about learned fear is from Pavlovian fear conditioning (Erlich, 2006). Fear conditioning is a form of classical conditioning where both humans and animals learn to fear specific objects or situations (Layton, 2014). The amygdala is an essential component in the neural circuit underlying fear conditioning (Erlich, 2006). For example the four main nuclei which are important for auditory fear conditioning are the lateral, central, basal, and intercalated nuclei (Elrich 2006). Each of these nuclei play a specific part in fear conditioning (Elrich, 2006). The lateral nucleus is the accepted area of learning where the CS and the US input form together to create the CS-US association (Elrich, 2006). The central nucleus is important for automatic reactions to fear such as freezing (Elrich, 2006). The intercalated area is suggested to be a gateway between the lateral nuclei and the central and has been proposed to be the component responsible for the regulation of fear (Elrich, 2006). Lastly, the basal nucleus is said to be necessary for the active responses to the CS such as the act of escaping a certain situation (Elrich, 2006). === The fight or flight response === The fight or flight response is the body’s reaction to acute stress which prepares the body to either flee or fight a threat (Cherry, 2014). This threat can be either real or imaginary (Cherry, 2014). When an animal experiences a stressful event the amygdala is the area of the brain responsible for sending a distress signal through to the hypothalamus (Harvard University, 2014). The hypothalamus then activates the sympathetic nervous system by sending messages through the autonomic nerves to the adrenal glands (Harvard University, 2014). The adrenal glands respond by pumping the hormone epinephrine (commonly known as adrenaline) into the bloodstream (Harvard University, 2014). The adrenaline causes all kinds of physiological responses to occur which happen so rapidly that people aren't aware of them (Harvard University, 2014). The wiring is so efficient that the amygdala and hypothalamus start this train of events even before the brain's visual centres have had a chance to fully process what is happening (Harvard University, 2014). The amygdala is the brain's radar for threat (Goleman, 2011). If it detects a threat the amygdala has the ability to take control of the entirety of the brain (Goleman, 2011). This occurrence is more commonly known as an amygdala hijack (Goleman, 2011). To put it simply when this happens the person is no longer able to concentrate on anything else other than the perceived threat (Goleman, 2011). The person then relies on habitual behaviour and is no longer able to learn, innovate or be flexible (Goleman, 2011). This phenomena is referred to as the fight-flight-freeze response (Goleman, 2011). The main problem with this is that the amygdala can often make mistakes (Goleman, 2011). For example the amygdala will only retrieve some of the data in which the senses have picked up rather than accepting the entire picture of what is happening (Goleman, 2011). Because of this non complete picture the amygdala can often act instantly causing the person to overreact toward the situation (Goleman, 2011). == The amygdala's role in anxiety disorders == === Post-traumatic stress disorder (PTSD) === '''What is post-traumatic stress disorder (PTSD)?''' PTSD is an anxiety disorder which develops after an individual has lived through a traumatic event. This traumatic event would have caused that person to feel as if their life or their love ones lives were in danger. Individuals with PTSD frequently display significant distress that they would have felt during the traumatic event (BeyondBlue, 2014). '''The amygdala's role in PTSD:''' Research has shown that there is a connection between the amygdala and Post Traumatic Stress Disorder (PTSD) (Smith, Abou-Khalil, & Zald, 2008; Ruden, 2010; Dębiec, 2011). For example Smith, Abou-Khalil, & Zald (2008) conducted research on the link between the amygdala and the development of PTSD. They conducted a case study using a patient with PTSD who had their left amygdala removed after a car accident (Smith et al., 2008). They found that the right amygdala was responsible for some of the processes that assist the body in the expression of PTSD (Smith et al., 2008). They concluded that a person is still capable of presenting with PTSD even within the absence of the left amygdala (Smtih et al., 2008). These findings are supported by Dębiec (2011) who used stimulation of the amygdala of PTSD patients to find out whether the stimulation would increase the likelihood of reconsolidation of fear memories. Dębiec (2011) suggested that reconsolidation may be useful in understanding PTSD and by extension increase understanding of how to treat PTSD. === Antisocial personality disorder === '''What is antisocial personality disorder?''' Anti-social personality disorder (Diagnostic and Statistical Manual Fifth Edition; DSM V) is characterized by an individual displaying consistent disregard for other individual's rights and often violating these rights (PsychCentral, 2014). Antisocial Personality Disorder is also referred to as psychopathy and sociopathy, however these terms are not used for professional diagnosis nor are they mentioned within the DSM V (PsychCentral, 2014). People with anti-social personality disorder often lack empathy and tend to be cold and cynical (PsychCentral, 2014). They also disregard the feelings, rights, and sufferings of others as well as being excessively opinionated, self-assured and demonstrates arrogant self-appraisal (PsychCentral, 2014). A personality disorder is a consistent, long lasting pattern of inner experience and behaviour that deviates from the norm of the individual’s culture (PsychCentral, 2014). '''The amygdala's role in antisocial personality disorder:''' Research has demonstrated that there is a connection between the amygdala and Anti-social Personality Disorder (Gao, 2009; Marsh, 2013). Goa (2009) found that defects within the amygdala-hippocampal complex have been associated with emotional defects such as shallowness, lack of remorse, pathological lying and superficial charm that are present within people with anti-social Personality Disorder. These findings were later supported by Marsh (2013) who examined youthful individuals with psychopathic traits. Marsh (2013) demonstrated that those with psychopathic traits had low activity within the amygdala which in turn is associated with empathic pain as the displayed pain increased. This reduction within the amygdala was at its lowest when the injury was happening to someone else (Marsh, 2013). === Phobias === '''What is a phobia?''' According to the American Psychiatric Association a phobia is defined as an anxiety disorder which causes the person to have irrational and excessive fear of a certain situation or object (Cherry, 2014). This fear is so extreme that the individual with go to great lengths to avoid what is causing them to feel the fear, often disrupting day-to-day life (Medical News Today, 2014). If confronted with the certain situation or object it will cause the individual significant distress, so much so that it interferes with their normal functioning (Medical News Today, 2014). The two main categories of phobias are as follows: # Specific phobias (also known as Simple Phobias) that involve a disproportionate fear about specific situations, living creatures, places, activities, or things (Medical News Today, 2014). Some examples of specific phobias are as follows: :* Dentists (dentophobia) :* Snakes (opidiophobia) :* Birds (ornithophobia) # Complex phobias which are linked to a deep-rooted fear or anxiety about certain situations, incidents or circumstances (Medical News Today, 2014). These complex phobias are called as such due to these phobias being a great deal more disabling than the simple phobias (Medical News Today, 2014). The two main categories of complex phobias are as follows: :* Social anxiety disorder: finding social situations extremely uncomfortable and possibly even unbearable e.g. party or wedding (Medical News Today, 2014). :* Agoraphobia: fear of finding ones self in a situation where one cannot escape e.g. lifts or small rooms (Medical News Today, 2014). '''The amygdala's role in phobias''' Research has found that the amygdala plays a role in phobias by examining abnormalities in the volume, shape and activation of the amygdala (Lipka, Miltner, & Straube 2011; Fisler, Federspiel, Horn, Dierks, Schmitt, Wiest, De Quervain, & Soravia, 2014; Burklund, Craske, Taylor, & Lieberman, 2014). Lipka et al. (2011) examined the activation of the amygdala in those who had a specific phobia (spiders), finding that the patients showed stronger responses of both amygdalae to consciously perceived spiders. Whereas during unconscious stimulus processing, enhanced activation was present only within the right amygdala (Lipka et al., 2011). These findings were later supported by Fisler et al.{{grammar}} (2014) finding that a spider phobia might be characterized by a deregulation in both an initial amplified fear response during exposure to spiders as well as a subsequent impaired down-regulation of the elicited fear response. The amygdala (among other parts of the brain) has been found to be responsible for the storage and retrieval of dangerous or potentially dangerous memories of situations and events (Medical News Today, 2014). Should an individual be in the same or similar situation they were in before, the amygdala retrieves that same memory resulting in the rest of the body reacting in much the same way as it had the last time this occurred (Medical News Today, 2014). Depending on the individual it may feel as if the person is going through the event several times rather than just once (Medical News Today, 2014). == The recognition and regulation of emotions == === Emotion recognition === One of the first social skills humans learn as infants is the ability to recognize emotions. The expressions of others can assist us to recognize the emotions and even the intentions of others (Cristinzio, Sander, & Vuilleumier, 2007). Having difficulty recognizing emotional expressions can occur after neurological diseases, which indicates that the human brain has inbuilt circuits for discriminating facial expressions (Cristinzio et al., 2007). In particular, the amygdala has been demonstrated as being a key aspect in emotional face processing (Pessoa, & Adolphs, 2010; Hooker, Bruce, Fisher, Verosky, Miyakawa, D’Esposito, & Vinogradov, 2013). Pessoa & Adolphs (2010) evaluated the significance of the amygdala in processing emotional visual stimuli and how emotional visual stimuli is processed throughout the brain. They proposed that the amygdala's role within the processing of emotional stimuli is to coordinate the function of cortical networks (Pessoa & Adolphs, 2010). Hooker et al. (2013) supported these findings showing that the amygdala is more activated during facial recognition than face identity or other face judgments. They also demonstrated that those with schizophrenia tend to have low activation within the amygdala during emotion recognition (Hooker et al., 2013). They did occasionally find individuals with schizophrenia showing high rates of activation during emotion recognition (Hooker et al., 2013). However, they suggested that this was simply due to misinterpretation of emotional stimuli rather than accurate emotion recognition (Hooker et al., 2013). ==== Universal facial expressions of emotion ==== The first person to suggest that facial expressions of emotion was universal was Charles Darwin (Matsumoto & Hwang, 2011). Charles Darwin proposed that facial expressions of emotion were biologically innate and evolutionarily adaptive (Matsumoto & Hwang, 2011). Tomkins later added to this suggesting that emotion was the basis of human motivation and found evidence that facial expressions were associated with certain emotional states (Matsumoto & Hwang, 2011). Additionally Tomkins, Ekman and Izard later conducted what is commonly known as 'the universal studies' proving that emotional facial expressions were the same in both literate and preliterate cultures (Matsumoto & Hwang, 2011). They also found that people across cultures were in high agreement in judgments of emotions in faces from both literate and preliterate cultures (Matsumoto & Hwang, 2011). Many researchers have since replicated these studies and found overwhelming evidence in support for the universal facial expression of seven emotions - anger, contempt, disgust, fear, joy, sadness, and surprise (Matsumoto & Hwang, 2011). ==== Microexpressions ==== Microexpressions are likely signs of concealed emotions (Matsumoto & Hwang, 2011). Microexpressions are expressions that happen so fast that people are often unaware that they even occurred at all (Matsumoto & Hwang, 2011). Darwin (1872) suggested that facial actions that cannot be controlled voluntarily may be produced involuntarily even if the individual is trying to control his or her expressions (Matsumoto & Hwang, 2011). The existence of microexpressions was confirmed by Haggard & Issac (1966) while they were scanning films in slow motion (Matsumoto & Hwang, 2011). This was later supported by Ekman and Friesen (1974) and most recently by Porter and Brinke (2008) who demonstrated that microexpressions occurred when individuals were attempting to be deceitful about their emotional expressions (Matsumoto & Hwang, 2011). === Emotion regulation === Emotion regulation is an individual's ability to understand and accept his or her emotional experience, to actively participate in healthy strategies to manage uncomfortable emotional experiences, and to display appropriate behaviour when distressed (Salters-Pedneault, 2014). Research has shown that the amygdala plays a role in emotion regulation (Banks, Eddy, Angstadt, Nathan, & Phan, 2007; Gross, 2011; Lee, Heller, Reekum, Nelson, & Davidson, 2012). Lee et al. (2012) demonstrated that the greater the coordination between the amygdala and the prefrontal cortex the better the individual was able to down-regulate negative emotion. Down-regulation is the process of decreasing a number of receptors for a chemical on cell surfaces in a certain area, usually due to long-term exposure to the agent (Farlex, 2014). Therefore the amygdala plays an important role in emotion regulation by playing a part in an individual's ability to down-regulate negative emotion. ==== Ways to improve your emotion regulation ==== [[File:So happy smiling cat.jpg|thumb|150px|left| ''Figure 4.'' Cat expressing joy]] # '''Identify and label specific emotions that you are feeling''' - What prompted the emotion? What is happening in your body? How did you feel about the event? What behaviour(s) you were expressing? # '''Be proactive and seek balance''' - balance healthy eating, sleep, exercise, staying away from mood altering drugs etc. # '''Increase positive experiences''' - do things that you enjoy doing # '''Change your behaviour''' - for example when you are angry do not yell stay quiet and walk away from the situation that is causing the anger # '''Stay mindful''' - be aware that experiencing emotions is a part of normal human life == Aggression and the amygdala == Aggression within society has become an increasingly important area of study within the psychological and biomedical communities. Aggression within the psychological community can be defined as any behaviour that results in the physical or psychological harm to oneself, another or objects within the environment (Cherry, 2014). The expression of aggression can form in a variety of ways such as verbally, mentally and physically (Cherry, 2014). There are two main forms of aggression and they are premeditated aggression and impulsive aggression (Damasio, 2007). Premeditated aggression is when a person plans to be aggressive before the situation takes place hence the name 'premeditated' aggression (Damasio, 2007). Impulsive aggression is mostly unplanned and spontaneous acts of aggressive behaviour (Damasio, 2007). Research has demonstrated that the amygdala plays a role in aggression. Matthies, Rusch, Weber, Lieb, Philipsen,Tuecher, Ebert, Hennig, and Van Elst (2012) showed by using morphometric brain imaging and amygdala measurements that the amygdala's volume was connected to how much aggression any given individual would display. They found that individuals with higher aggression scores showed roughly a 16-18% reduction of amygdala volumes (Matthies et al., 2012). They suggested that amygdala volumes may be an important marker for indicating aggressiveness within mentally healthy human beings (Matthies et al., 2012). Passamonti, Crockett, Apergis-Schoute, Clark, Rowe, Calder, and Robbins (2012) supported these findings that the amygdala is responsible for emotions such as aggression when they conducted research using serotonin. Passamonti et al. (2012) conducted research on whether ATD would affect functional connectivity in neural networks involved in processing social signals of aggression (e.g., angry faces). Passamonti et al. (2012) showed that ATD significantly modulated the connectivity between the amygdala and two PFC regions (ventral anterior, cingulate cortex, and ventrolateral PFC) when processing angry vs. neutral and angry vs. sad but not sad vs. neutral faces. They also showed that serotonin depletion reduced the influence of processing angry vs. neutral faces on circuits within PFC and on PFC–amygdala pathways (Passamonti et al., 2012). They concluded that serotonin significantly influences PFC–amygdala circuits implicated in aggression and other affective behaviors (Passamonti et al., 2012). == Emotional memories == [[File:Hippocampus small.gif|thumb|right| ''Figure 5.'' The Hippocampus is shown in red]] Emotionally arousing and stressful experiences are retained within memory and it has been long known that the amygdala plays a substantial role in this process (Hermans, Battaglia, Atsak, de Voogd, Fernandez, & Roozendaal, 2014). This notion dates back to the report by Kluver and Bucy (1937) who demonstrated the effects of temporal lobectomy in rhesus monkeys (Hermans et al., 2014). Bilateral lesions of this area where demonstrated to result in striking behavioural changes such as alterations in affective behaviours, including loss of fear (Hermans et al., 2014). However, beneficial effects of emotional arousal extended beyond fear learning (Hermans et al., 2014). During an emotionally arousing period, stress hormones (epinephrine and glucocorticoids) are released from the adrenal glands and numerious neurotransmitters and neuropeptides are released in the brain (Hermans et al, 2014). The amygdala plays an essential role in combining together these various influences on memory (Hermans et al, 2014). The modulation hypothesis suggested that during and shortly after an emotionally arousing experience, the amygdala uses stress-related hormones and neurotransmitters to enhance the consolidation and storage of memory within other areas of the brain (Hermans et al., 2014). The amygdala and the hippocampus are both major structures within the temporal lobe that are linked to two independent memory systems (Phelps, 2004). However when people are in emotional situations these two separate systems interact (Phelps, 2004).The amygdala both encodes and stores the hippocampal-dependent memories (Phelps, 2004). The hippocampus can influence the amygdala's response when emotional stimuli is presented (Phelps, 2004). These findings have been supported by Paz & Pare (2013) stating that in emotionally arousing situations, whether they are positive and negative, the amygdala allows incoming information to be processed more efficiently in distributed cerebral networks. Hermans et al. (2014) further supported these findings stating that the amygdala activation enhances memory consolidation by facilitating neural plasticity and information storage processes in its target regions. == Conclusion == The amygdala is an almond shaped structure located in the limbic system within the brain. The amygdala plays a number of roles within emotion such as processing emotions such as aggression, anxiety and fear. The amygdala also plays an important role in the storage and retrieval of emotional memories. The amygdala is responsible for processing fear which includes includes the modulation of attention and memory for fear-related stimuli, fear recognition, the induction of fear-related behaviours, and fear conditioning. The amygdala also plays an important role within the fight or flight response. Research has proven the association between abnormalities in the amygdala and the presence of anxiety disorders which include PTSD, antisocial personality disorder and phobias. Research has also proven an association between activation within the amygdala and emotional facial recognition as well as emotional regulation. On top of that research has proven an association between the amygdala and aggression through the examination of serotonin levels and amygdala volume. Lastly, the amygdala encodes, stores and retrieves emotional memories. == See also == *[[Motivation_and_emotion/Book/2013/Aggression|Aggression]] *[[Motivation_and_emotion/Book/2013/Emotion and memory|Emotion and Memory]] *[[Motivation_and_emotion/Book/2013/Memory and emotion|Memory and Emotion]] *[[Motivation_and_emotion/Book/2013/Facial expressions and the emotions of others|Facial Expressions and the Emotions of Others]] *[[Motivation_and_emotion/Book/2013/Fear|Fear]] *[[Motivation_and_emotion/Book/2013/Joy|Joy]] == Test your memory == <quiz> {What are the four main subgroups of the amygdala? |type="()"} - Lateral, Prefrontal, Basomedial, and Central + Basolateral, Lateral, Central and Basomedial nuclei - Amygdaloid Body, Lateral, Central and Prefrontal - Basomedial, Lateral, Central, and Prefrontal { What is an innate fear? |type="()"} - Overt fears that cannot be observed - Fears that are learnt through experience - Fears that are observable + Any fear that has been encoded within our genes { Who was the first to suggest that emotions were universal? |type="()"} + Darwin - Ekman - Tomkins - Izard { What is the amygdala's roles in emotional regulation? |type="()"} + to down-regulate negative emotion - to over-regulate positive emotion - to over-regulate negative emotion - to down-regulate positive emotion </quiz> == References == {{Hanging indent|1= Bailey, R. (2014). ''Amygdala''. Retrieved from the about education website: http://biology.about.com/od/anatomy/p/Amygdala.htm Banks, S. J., Eddy, K. T., Angstadt, M., Nathan, P. J., & Phan, K. L. (2007). Amygdala-frontal connectivity during emotion regulation. ''Social Cognitive and Affective Neuroscience'', ''2'' (4): 303-312. Bergland, C. (2013). ''Decoding the Neuroscience of Fear and Fearlessness.'' Retrieved from the Psychology Today website: http://www.psychologytoday.com/blog/the-athletes-way/201302/decoding-the-neuroscience-fear-and-fearlessness BeyondBlue. (2014). ''Post-Traumatic Stress Disorder.'' Retrieved from the BeyondBlue website: http://www.beyondblue.org.au/the-facts/anxiety/types-of-anxiety/ptsd Burklund, L. J., Craske, M. G., Taylor, S. E, & Lierberman, M. D. (2014). Altered emotion regulation capacity in social phobia as a function of cormorbidity. Social Cognitive and Affective Neuroscience. ''Oxford University Press''. Retrieved from: http://scan.oxfordjournals.org.ezproxy.canberra.edu.au/content/early/2014/06/19/scan.nsu058 Cherry, K. (2014). ''What is Aggression?''. Retrieved from the about education website: http://psychology.about.com/od/aindex/g/aggression.htm Cherry, K. (2014). ''What is the Fight or Flight Response?''. Retrieved from the about education website: http://psychology.about.com/od/findex/g/fight-or-flight-response.htm Cherry, K. (2014). ''What is a Phobia?''. Retrieved form the about education website: http://psychology.about.com/od/phobias/f/dis_phobiadef.htm Cristinzio, C., Sander, D., & Vuilleumier, P. (2007). Recognition of Emotional Face Expressions and Amygdala Pathology. Retrieved from: http://cms.unige.ch/fapse/EmotionLab/pdf/CristinzioSanderVuilleumier_2007_epileptologie.pdf Damasio, A. (2007). ''Violence and Aggression- The Dana Guide.'' Retrieved from The Dana Foundation website: http://www.dana.org/Publications/GuideDetails.aspx?id=50057 Dębiec, J. E. (2011). Noradrenergic enhancement of reconsolidation in the amygdala impairs extinction of conditioned fear in rats-a possible mechanism for the persistence of traumatic memories in PTSD. ''Depression & Anxiety'' (1091-4269), ''28''(3), 186-193. Erlich, J. (2006). To Fear or Not to Fear: The role of the amygdala & prefrontal cortex in the regulation of fear. ''New York University''. Retrieved from: http://www.cns.nyu.edu/~jerlich/pub/JCE_thesis.pdf Farlex. (2014). Down-regulation. Retrieved from the free dictionary website: http://medical-dictionary.thefreedictionary.com/down-regulation Feinstein, J., Adolphs, R., Damasio, A., & Tranel, D. (2011). The Human Amygdala and the Induction and Experience of Fear. ''Current Biology''. Vol 21 Iss: 1 pp, 34-28. Fisler, M. S., Federspiel, A., Horn, H., Dierks, T., Schmitt, W., Wiest, R., De Quervain, D .J-F., & Soravia, L. M. (2014). Pinpointing regional surface distortions of the amygdala in patients with spider phobia. ''Journal of Psychiatry and Brain Functions'', Vol: 1. Gao, G. Y. (2009). The Neurobiology of Psychopathy: A Neurodevelopmental Perspective. ''Canadian Journal Of Psychiatry'', ''54''(12), 813-823. Goleman, D. (2011). Emotional Mastery. ''Leadership Excellence'', 2''8''(6), 12-13. Gross, J. J. (2011). Handbook of Emotion Regulation (First Edition). Guilford Press. Harvard University. (2014). ''Understanding the stress response''. Retrieved from the Harvard Health Publications (Harvard Medical School) website: http://www.health.harvard.edu/newsletters/Harvard_Mental_Health_Letter/2011/March/understanding-the-stress-response Healthline. (2014). ''Body Maps: Amygdala Body''. Retrieved from the Healthline website: http://www.healthline.com/human-body-maps/amygdala Hermans, E. J., Battaglia, F. P., Atsak, P., de Voogd, L. D., Fernandez, G., & Roozendaal, B. (2014). How the amygdala affects emotional memory by altering brain network properties. ''Neurobiology of Learning and Memory'', Vol: 112, pp2-16. Holt, D. (2008). ''The Role of the Amygdala in Fear and Panic''. Retrieved from the Serendip Studio website: http://serendip.brynmawr.edu/exchange/node/1749 Hooker, C., Bruce, L., Fisher, M., Verosky, S. C., Miyakawa, A., D’Esposito, M., & Vinogradov, S. (2013). The influence of combined cognitive plus social-cognitive training on amygdala response during face emotion recognition in schizophrenia. ''Psychiatry Research: Neuroimaging'', ''213'',2, 99-107. Layton, J. (2014). ''How fear works''. Retrieved from the how stuff works website: http://science.howstuffworks.com/life/inside-the-mind/emotions/fear4.htm Lee, H., Heller, A. S., Reekum, C. M. V., Nelson, B., & Davidson, R. J. (2012). Amygdala-prefrontal coupling underlies individual differences in emotion regulation. ''NeuroImage'', ''62'',3,1575-1581. Lipka, J., Miltner, W. H. R, & Straube. (2011). Vigilance for Threat interacts with Amygdala Responses to Subliminal Threat Cues in Specific Phobia. ''Biological Psychiatry'', ''1'',5, 472-478. Marsh, A. R. (2013). Empathic responsiveness in amygdala and anterior cingulate cortex in youths with psychopathic traits. ''Journal Of Child Psychology & Psychiatry'', ''54'',8, 900-910. Matsumoto, D., & Hwang, H. S. (2011). ''Reading facial expressions of emotion.'' Retrieved from the American Psychological Association website: http://www.apa.org/science/about/psa/2011/05/facial-expressions.aspx Matthies, S., Rusch, N., Weber, M., Lieb, K., Philipsen, A., Tuecher, O., Ebert, D., Hennig, J., & Van Elst, L. T. (2012). Small amygdala- high aggression? The role amygdala in modulating aggression in healthy subjects. ''World Journal Of Biological Psychiatry'',''13'',1, 75-81. Medical News Today. (2014). ''What is a Phobia? What causes Phobia?''. Retrieved from the Medical News Today website: http://www.medicalnewstoday.com/articles/249347.php Pessoa, L. & Adolphs, R. (2010). Emotion processing and the amygdala: from a 'low road' to 'many roads' of evaluating biological significance. ''Nature Reviews Neuroscience'', 11''11'', 773-783. Passamonti, L., Crockett, M. J., Apergis-Schoute, A. M., Clark, L. Rowe, J. B., Calder, A. J., & Robbins, T. W. (2012). Effects of Acute Tryptophan Depletion on Prefrontal-Amygdala Connectivity While Viewing Facial Signals of Aggression. ''Biological Psychiatry'',71, ''1'', 36-43. Paz, R., & Pare, D. (2013). Physiological basis for emotional modulation of memory circuits by the amygdala. ''Current Opinion in Neurobiology'', ''23'',3, 381-386. Phelps, E. A. (2004). Human emotion and memory: interaction of the amygdala and hippocampal complex. ''Current Opinion in Neurobiology'',14,198-202. PsychCentral. (2014). Antisocial Personality Disorder Symptoms. Retrieved from the PsychCentral website: http://psychcentral.com/disorders/antisocial-personality-disorder-symptoms/ Reeve, J. (2009). ''Understanding Motivation and Emotion'' (5th Edition). John Wiley & Sons Inc. pp298-305. Ruden, R. A. (2010). Review of 'Post-traumatic stress disorder: Basic science and clinical practice'. ''Traumatology'', 16(2), 55. Salters-Pedneault, K. (2014). Emotion Regulation. Retrieved from the about health website: http://bpd.about.com/od/glossary/g/emotreg.htm Smith, S. D., Abou-Khalil, B., & Zald, D. H. (2008). Posttraumatic stress disorder in a patient with no left amygdala. ''Journal Of Abnormal Psychology'', ''117'',2, 479-484. Wilner, J. (2011). How to Regulate Emotions and Feel Better. Retrieved from the PsychCentral website: http://blogs.psychcentral.com/positive-psychology/2011/01/how-to-regulate-emotions-and-feel-better/}} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] [[Category:Motivation and emotion/Book/Amygdala]] a7il5t44iijunuywe4mkoicekm3p1wf 0 170452 2419083 2399196 2022-08-25T19:44:58Z Marshallsumter 311529 wikitext text/x-wiki [[Image:How thunderstorms launch particle beams into space 300dpi.jpg|thumb|right|300px|The simulation attempts to answer how thunderstorms launch particle beams into space. Credit: NASA/Goddard Space Flight Center.{{tlx|free media}}]] A number of subatomic reactions can be detected in astronomy that yield beta particles. The detection of beta particles or the reactions that include them in an astronomical situation is '''beta-particles astronomy'''. '''Notation:''' let '''TGF''' stand for a '''Terrestrial Gamma-ray Flash'''. {{clear}} ==Universals== A "clumpiness in the [galactic] halo [is] through a spatially continuous elevation in the density of dark matter, rather than the more realistic ''discrete'' distribution of clumps. [...] the former approach reproduces the ''average'' results obtained when considering the essentially infinite set of possible configurations of discrete clumps within the halo. This was demonstrated in the work by Lavalle et al. (2006), who deduced that the associated relative variance in the observed positron flux, as a result of the different clump configurations, is proportional to <math>M_c^{1/2}</math>, where <math>M_c</math> is the typical clump mass, and diverges as ''E''_e⁺ → m_χ . It is found that for <math>M_c = 10^6 M_{\odot}</math> and a universal clump boost factor, ''B''_c ∼ 100, this relative variance is less than 5 per cent for ''E''_e⁺ ≤ 20 GeV, which is where the positron excess observed by the [''High-Energy Antimatter Telescope''] ''HEAT'' is located. Since the clump mass distribution deduced by Diemand et al. indicates that ''M''_c ∼ 10⁻⁶M_⊙, it seems very unlikely that such a variance will significantly affect our conclusions, and we use this to strengthen our use of a spatially continuous elevation in dark matter density as a way of acknowledging clumpiness in the galactic halo.<ref name=Cumberbatch>{{ cite journal |author=Daniel Cumberbatch |author2=Joseph Silk |title=Local dark matter clumps and the positron excess |journal=Monthly Notices of the Royal Astronomical Society |month=January |year=2007 |volume=374 |issue=2 |pages=455-65 |url=http://mnras.oxfordjournals.org/content/374/2/455.full.pdf+html |arxiv= |bibcode= |doi=10.1111/j.1365-2966.2006.11123.x |pmid= |accessdate=2014-01-31 }}</ref> ==Astronomy== {{main|Radiation/Astronomy}} [[Image:Aurore australe - Aurora australis.jpg|thumb|right|250px|Auroras are mostly caused by energetic electrons precipitating into the [[w:atmosphere|atmosphere]].<ref name=Wolpert>{{ cite book | author = S. Wolpert | date = July 24, 2008 | title = Scientists solve 30-year-old aurora borealis mystery | url = http://www.universityofcalifornia.edu/news/article/18277 | publisher = University of California | accessdate = 2008-10-11 }}</ref> Credit: [[c:User:Ehquionest|Samuel Blanc]].{{tlx|free media}}]] [[Image:509305main GBM positron event 300dpi.jpg|thumb|right|250px|Observation of positrons from a terrestrial gamma ray flash is performed by the Fermi gamma ray telescope. Credit: NASA Goddard Space Flight Center.{{tlx|free media}}]] Although '''electron astronomy''' is usually not recognized as a formal branch of astronomy, the measurement of electron fluxes helps to understand a variety of natural phenomena. ""[E]lectron astronomy" has an interesting future".<ref name=Hudson/> "'''Positron astronomy''' is 30 years old but remains in its infancy."<ref name=Milne>{{ cite journal |author=P.A.Milne |author2=J.D.Kurfess |author3=R.L.Kinzer |author4=M.D.Leising |author5=D.D.Dixon |title=Investigations of positron annihilation radiation, In: ''Proceedings of the 5th COMPTON Symposium'' |publisher=American Institute of Physics |location=Washington, DC |month=April |year=2000 |volume=510 |issue=4 |pages=21-30 |url=http://arxiv.org/pdf/astro-ph/9911184 |arxiv=astro-ph/9911184v1 |bibcode=2000AIPC..510...21M |doi=10.1063/1.1303167 |pmid= |accessdate=2011-11-25 }}</ref> A High-Energy Antimatter Telescope (HEAT) has been developed and tested in the mid 1990s to measure the positron fraction in cosmic rays.<ref name=Barwick/> {{clear}} ==Radiation== {{main|Radiation}} [[Image:NuclideMap C-F.png|thumb|right|250px|This graph is a chart of the nuclides for carbon to fluorine. Decay modes: <br><br> {{legend|#ff9472|proton emission}} {{legend|#e78cc7|positron emission or electron capture}} {{legend|#000000|stable isotope}} {{legend|#63c5de|beta decay}} {{legend|#9b7bbc|neutron emission}} Credit: original: National Nuclear Data Center, stitched: [[c:User:Neokortex|Neokortex]], cropped: [[c:User:Limulus|Limulus]].{{tlx|free media}}]] '''Beta particles''' are high-energy, high-speed electrons or positrons emitted by certain types of radioactive nuclei such as potassium-40. The beta particles emitted are a form of ionizing radiation also known as beta rays. The production of beta particles is termed beta decay. They are designated by the Greek letter beta (β). At right is a graph or block diagram that shows the boundaries for nuclear particle stability. The boundaries are conceptualized as '''drip lines'''. The nuclear landscape is understood by plotting boxes, each of which represents a unique nuclear species, on a graph with the number of neutrons increasing on the abscissa and number of protons increasing along the ordinate, which is commonly referred to as the table of nuclides, being to nuclear physics what the more commonly known periodic table of the elements is to [[chemistry]]. However, an arbitrary combination of protons and neutrons does not necessarily yield a stable nucleus, and ultimately when continuing to add more of the same type of nucleons to a given nucleus, the newly formed nucleus will essentially undergo immediate decay where a nucleon of the same isospin quantum number (proton or neutron) is emitted; colloquially the nucleon has 'leaked' or 'dripped' out of the target nucleus, hence giving rise to the term "drip line". The nucleons drip out of such unstable nuclei for the same reason that water drips from a leaking faucet: the droplet, or nucleon in this case, sees a lower potential which is great enough to overcome surface tension in the case of water droplets, and the strong nuclear force in the case of proton emission or alpha decay. As nucleons are quantized, then only integer values are plotted on the table of isotopes, indicating that the drip line is not linear but instead looks like a step function up close. Beta particles (electrons) are more penetrating [than alpha particles], but still can be absorbed by a few millimeters of aluminum. However, in cases where high energy beta particles are emitted shielding must be accomplished with low density materials, ''e.g.'' plastic, wood, water or acrylic glass (Plexiglas, Lucite). This is to reduce generation of Bremsstrahlung X-rays. In the case of beta⁺ radiation (positrons), the gamma radiation from the electron-positron annihilation reaction poses additional concern. As an example, "[t]he power into the Crab Nebula is apparently supplied by an outflow [wind] of ~10³⁸ erg/s from the pulsar"<ref name=Wilson/> where there are "electrons (and positrons) in such a wind"<ref name=Wilson>{{ cite journal |author=D. B. Wilson |author2=M. J. Rees |title=Induced Compton scattering in pulsar winds |journal=Monthly Notices of the Royal Astronomical Society |month=October |year=1978 |volume=185 |issue=10 |pages=297-304 |url= |arxiv= |bibcode=1978MNRAS.185..297W |doi= |pmid= |accessdate=2012-03-08 }}</ref>. These beta particles coming out of the pulsar are moving very close to light speed. "The two conversions of protons into neutrons are assumed to take place inside the nucleus, and the extra positive charge is emitted as a positron."<ref name=Shaviv>{{ cite book |author=Giora Shaviv |title=Towards the Bottom of the Nuclear Binding Energy, In: ''The Synthesis of the Elements'' |publisher=Springer-Verlag |location=Berlin |date=2013 |editor=Giora Shaviv |pages=169-94 |url=http://link.springer.com/chapter/10.1007/978-3-642-28385-7_5#page-1 |arxiv= |bibcode= |doi=10.1007/978-3-642-28385-7_5 |pmid= |isbn=978-3-642-28384-0 |accessdate=2013-12-19 }}</ref> '''Def.''' "the non-linear scattering of radiation off electrons" is called '''induced Compton scattering'''.<ref name=Wilson>{{ cite journal |author=D. B. Wilson |author2=M. J. Rees |title=Induced Compton scattering in pulsar winds |journal=Monthly Notices of the Royal Astronomical Society |month=October |year=1978 |volume=185 |issue=10 |pages=297-304 |url= |arxiv= |bibcode=1978MNRAS.185..297W |doi= |pmid= |accessdate=2012-03-08 }}</ref> "The effect of scattering is to move photons to lower frequencies."<ref name=Wilson/> "[T]he fact that the radio pulses [from a pulsar] are not suppressed by induced scattering suggests that the wind's Lorentz factor exceeds ~10⁴.<ref name=Wilson/> ==Electrons== {{main|Radiation astronomy/Electrons}} [[Image:Nuclear particle in a diffusion cloud chamber.png|thumb|right|250px|This rare picture show the 4 type of charged particles that we can detect in a cloud chamber : alpha, proton, electron and muons (probably). Credit: [[c:User:Mauswiesel|Cloudylabs]].{{tlx|free media}}]] The electron is a subatomic particle with a negative charge, equal to -1.60217646x10^-19 coulomb (''C''). Current, or the rate of flow of charge, is defined such that one coulomb, so 1/-1.60217646x10^-19, or 6.24150974x10¹⁸ electrons flowing past a point per second give a current of one [[w:ampere|ampere]]. The charge on an electron is often given as ''-e''. note that charge is always considered positive, so the charge of an electron is always negative. The electron has a mass of 9.10938188x10^-31 ''kg'', or about 1/1840 that of a proton. The mass of an electron is often written as ''m_e''. When working, these values can usually be safely approximated to: ::''-e'' = -1.60x10^-19 ''C'' ::''m_e'' = 9.11x10^-31''kg'' It has no known components or substructure; in other words, it is generally thought to be an [[w:elementary particle|elementary particle]].<ref name=Eichten>{{ cite journal | author = E.J. Eichten |author2=M.E. Peskin |author3=M. Peskin | year = 1983 | title = New Tests for Quark and Lepton Substructure | journal = Physical Review Letters | volume = 50 | pages = 811–814 | issue = 11 | doi = 10.1103/PhysRevLett.50.811 | bibcode=1983PhRvL..50..811E }}</ref><ref name=Gabrielse>{{ cite journal | author = G. Gabrielse ''et al.'' | year = 2006 | title = New Determination of the Fine Structure Constant from the Electron ''g'' Value and QED | journal = Physical Review Letters | volume = 97 | pages = 030802(1–4) | doi = 10.1103/PhysRevLett.97.030802 | bibcode=2006PhRvL..97c0802G | issue = 3 }}</ref> The intrinsic [[w:angular momentum|angular momentum]] (spin) of the electron is a half-integer value in units of ''ħ'', which means that it is a fermion. {{clear}} ==Delta rays== [[Image:Delta electron.png|thumb|right|250px|Delta electron is knocked out by a 180 GeV muon at the SPS at CERN. Credit: [[c:user:Wilcokoppert|Wilcokoppert]].]] A '''delta ray''' is characterized by very fast electrons produced in quantity by alpha particles or other fast energetic charged particles knocking orbiting electrons out of atoms. Collectively, these electrons are defined as delta radiation when they have sufficient energy to ionize further atoms through subsequent interactions on their own. "The conventional procedure of delta-ray counting to measure charge (Powell, Fowler, and Perkins 1959), which was limited to resolution sigma_z = 1-2 because of uncertainties of the criterion of delta-ray ranges, has been significantly improved by the application of delta-ray range distribution measurements for ¹⁶O and ³²S data of 200 GeV per nucleon (Takahashi 1988; Parnell ''et al.'' 1989)."<ref name=Burnett>{{ cite journal |author=T. H. Burnett ''et al.'' |author2=The JACEE Collaboration |title=Energy spectra of cosmic rays above 1 TeV per nucleon |journal=The Astrophysical Journal |month=January |year=1990 |volume=349 |issue=1 |pages=L25-8 |url=http://adsabs.harvard.edu/cgi-bin/nph-data_query?bibcode=1990ApJ...349L..25B&link_type=GIF&db_key=AST |arxiv= |bibcode=1990ApJ...349L..25B |doi=10.1086/185642 |pmid= |pdf=http://adsabs.harvard.edu/cgi-bin/nph-data_query?bibcode=1990ApJ...349L..25B&link_type=ARTICLE&db_key=AST&high= |accessdate=2011-11-25 }}</ref> Here, the delta-ray tracks in emulsion chambers have been used for "[d]irect measurements of cosmic-ray nuclei above 1 TeV/nucleon ... in a series of balloon-borne experiments".<ref name=Burnett/> {{clear}} ==Epsilon rays== '''Epsilon radiation''' is tertiary radiation caused by secondary radiation (''e.g.'', delta radiation). Epsilon rays are a form of particle radiation and are composed of electrons. The term is very rarely used today. ==Antimatter== '''Def.''' an elementary subatomic particle which forms matter is called a '''quark'''. '''Note:''' quarks are never found alone in nature. '''Def.''' the smallest possible, and therefore indivisible, unit of a given quantity or quantifiable phenomenon is called the '''quantum'''. '''Def.''' one of certain integers or half-integers that specify the state of a quantum mechanical system is called a '''quantum number'''. '''Def.''' a quantum number that depends upon the relative number of strange quarks and anti-strange quarks is called '''strangeness'''. '''Def.''' symmetry of interactions under spatial inversion is called '''parity'''. '''Def.''' "the quantity of [unbalanced]<ref name=ElectricChargeWikt1/> positive or negative ions in or on an object;<ref name=ElectricChargeWikt>{{ cite book |author=[[wikt:User:Cem BSEE|Cem BSEE]] |title=electric charge |publisher=Wikimedia Foundation, Inc |location=San Francisco, California |date=19 December 2006 |url=https://en.wiktionary.org/wiki/electric_charge |accessdate=2015-08-08 }}</ref> measured in coulombs"<ref name=ElectricChargeWikt1>{{ cite book |author=[[wikt:User:SemperBlotto|SemperBlotto]] |title=electric charge |publisher=Wikimedia Foundation, Inc |location=San Francisco, California |date=21 January 2007 |url=https://en.wiktionary.org/wiki/electric_charge |accessdate=2015-08-08 }}</ref> or "a quantum number of some subatomic particles which determines their electromagnetic interactions"<ref name=ElectricChargeWikt2>{{ cite book |author=[[wikt:User:SemperBlotto|SemperBlotto]] |title=electric charge |publisher=Wikimedia Foundation, Inc |location=San Francisco, California |date=13 August 2005 |url=https://en.wiktionary.org/wiki/electric_charge |accessdate=2015-08-08 }}</ref> is called an '''electric charge'''. '''Def.''' the mean duration of the life of someone or something is called the '''mean lifetime'''. '''Def.''' a quantum angular momentum associated with subatomic particles, which also creates a magnetic moment is called a '''spin'''. '''Def.''' the "quantity of matter which a body contains, irrespective of its bulk or volume"<ref name=MassWikt>{{ cite book |author=[[wikt:User:Eclecticology|Eclecticology]] |title=mass |publisher=Wikimedia Foundation, Inc |location=San Francisco, California |date=12 September 2003 |url=http://en.wiktionary.org/wiki/mass |accessdate=2013-08-12 }}</ref> or a "quantity of matter cohering together so as to make one body, or an aggregation of particles or things which collectively make one body or quantity"<ref name=MassWikt1>{{ cite book |author=[[wikt:User:Emperorbma|Emperorbma]] |title=mass |publisher=Wikimedia Foundation, Inc |location=San Francisco, California |date=14 November 2003 |url=https://en.wiktionary.org/wiki/mass |accessdate=2014-02-28 }}</ref> is called '''mass''', or a '''mass'''. '''Def.''' a subatomic particle corresponding to another particle with the same mass, spin and mean lifetime but with charge, parity, strangeness and other quantum numbers flipped in sign is called an '''antiparticle'''. '''Def.''' matter that is composed of antiparticles of those that constitute normal matter is called '''antimatter'''. A positron differs from a quark by its lack of [[strong interaction]]. '''Def.''' "[t]he antimatter equivalent of an electron,<ref name=PositronWikt>{{ cite book |author=[[wikt:User:Fonzy~enwiktionary|Fonzy~enwiktionary]] |title=positron |publisher=Wikimedia Foundation, Inc |location=San Francisco, California |date=17 May 2003 |url=http://en.wiktionary.org/wiki/positron |accessdate=2012-07-12 }}</ref> having the same mass but a positive charge"<ref name=PositronWikt1>{{ cite book |author=[[wikt:User:SemperBlotto|SemperBlotto]] |title=positron |publisher=Wikimedia Foundation, Inc |location=San Francisco, California |date=14 June 2005 |url=http://en.wiktionary.org/wiki/positron |accessdate=2012-07-12 }}</ref> is called a '''positron'''. ==Nuclear transmutations== {{main|Radiation astronomy/Transmutations}} [[Image:Table isotopes en.svg|thumb|right|250px|This graph shows positron emissions, among others, from nuclear transmutation. Credit: [[c:user:Napy1kenobi|Napy1kenobi]] and [[c:user:Sjlegg|Sjlegg]].{{tlx|free media}}]] If the proton and neutron are part of an [[w:atomic nucleus|atomic nucleus]], these decay processes [[w:Nuclear transmutation|transmute]] one chemical element into another. For example: :<math> ^A_ZN \rightarrow ~ ^{~~~A}_{Z-1}N' + e^+ + \nu_e, </math> where A = 22, Z = 11, ''N'' = Na, ''Z''-1 = 10, and ''N''' = Ne. Beta decay does not change the number of [[w:nucleon|nucleon]]s, ''A'', in the nucleus but changes only its [[w:electric charge|charge]], ''Z''. Thus the set of all [[w:nuclide|nuclide]]s with the same ''A'' can be introduced; these [[w:isobar (nuclide)|''isobaric'' nuclides]] may turn into each other via beta decay. Among them, several nuclides (at least one) are beta stable, because they present local minima of the [[w:mass excess|mass excess]]: if such a nucleus has (''A'', ''Z'') numbers, the neighbour nuclei (''A'', ''Z''&minus;1) and (''A'', ''Z''+1) have higher mass excess and can beta decay into (''A'', ''Z''), but not vice versa. For all odd mass numbers ''A'' the global minimum is also the unique local minimum. For even ''A'', there are up to three different beta-stable isobars experimentally known. There are about 355 known [[w:beta-decay stable isobars|beta-decay stable nuclides]] total. {{clear}} ==Radioactivity== {{main|Radioactivity}} In {{SubatomicParticle|Beta+}} decay, or "positron emission", the weak interaction converts a nucleus into its next-lower neighbor on the periodic table while emitting an positron ({{SubatomicParticle|Positron}}) and an electron neutrino ({{SubatomicParticle|Electron neutrino}}): :<math> ^A_ZN \rightarrow ~ ^{~~~A}_{Z-1}N' + e^+ + \nu_e. </math> {{SubatomicParticle|Beta+}} decay cannot occur in an isolated proton because it requires energy due to the mass of the neutron being greater than the mass of the proton. {{SubatomicParticle|Beta+}} decay can only happen inside nuclei when the value of the [[w:binding energy|binding energy]] of the mother nucleus is less than that of the daughter nucleus. The difference between these energies goes into the reaction of converting a proton into a neutron, a positron and a neutrino and into the kinetic energy of these particles. ''Positron emission''' or '''beta plus decay''' ([[w:Beta particle|β⁺]] decay) is a type of [[beta decay]] in which a [[w:proton|proton]] is converted, via the [[w:weak force|weak force]], to a [[w:neutron|neutron]], releasing a positron and a [[w:neutrino|neutrino]]. [[w:Isotope|Isotope]]s which undergo this decay and thereby emit positrons include [[w:carbon-11|carbon-11]], [[w:Isotopes of potassium|potassium-40]], [[w:nitrogen-13|nitrogen-13]], [[w:Isotopes of oxygen|oxygen-15]], [[w:fluorine-18|fluorine-18]], and [[w:Isotopes of iodine|iodine-121]]. As an example, the following equation describes the beta plus decay of carbon-11 to [[w:boron|boron]]-11, emitting a positron and a neutrino: :<math> ^{11}_{6}C \rightarrow ~ ^{11}_{5}B + e^+ + \nu_e + \gamma {(0.96 MeV)}. </math> ==Positroniums== [[Image:Positronium.svg|thumb|right|200px|An electron and positron orbit around their common centre of mass. This is a bound quantum state known as positronium. Credit: [[c:User:Manticorp|Manticorp]].{{tlx|free media}}]] '''Def.''' an exotic atom consisting of a positron and an electron, but having no nucleus or an onium consisting of a positron (anti-electron) and an electron, as a particle&ndash;anti-particle bound pair is called '''positronium'''. Being unstable, the two particles annihilate each other to produce two gamma ray photons after an average lifetime of 125 ps or three gamma ray photons after 142 ns in vacuum, depending on the relative spin states of the positron and electron. The ''singlet'' state with antiparallel spins ([spin quantum number] ''S'' = 0, ''M_s'' = 0) is known as '''para-positronium''' (''p''-Ps) and denoted {{SubatomicParticle|para-positronium}}. It has a mean lifetime of 125 picoseconds and decays preferentially into two gamma quanta with energy of 511 keV each (in the center of mass frame). Detection of these photons allows for the reconstruction of the vertex of the decay. Para-positronium can decay into any even number of photons (2, 4, 6, ...), but the probability quickly decreases as the number increases: the branching ratio for decay into 4 photons is {{val|1.439|(2)|e=-6}}.<ref name=Karshenboim>{{cite journal |author=Savely G. Karshenboim |year=2003 |title=Precision Study of Positronium: Testing Bound State QED Theory |doi=10.1142/S0217751X04020142 |journal=International Journal of Modern Physics A [Particles and Fields; Gravitation; Cosmology; Nuclear Physics] |volume=19 |issue=23 |pages=3879–96 |arxiv=hep-ph/0310099 |bibcode = 2004IJMPA..19.3879K }}</ref> para-positronium lifetime (S = 0):<ref name=Karshenboim/> :<math>t_{0} = \frac{2 \hbar}{m_e c^2 \alpha^5} = 1.244 \times 10^{-10} \; \text{s}</math> The ''triplet'' state with parallel spins (''S'' = 1, ''M_s'' = −1, 0, 1) is known as '''ortho-positronium''' (''o''-Ps) and denoted ³S₁. The triplet state in vacuum has a mean lifetime of {{val|142.05|0.02|u=ns}}<ref name=Badertscher>{{cite journal |author=A. Badertscher ''et al.'' |year=2007 |title=An Improved Limit on Invisible Decays of Positronium |journal=Physical Review D |volume=75 |pages=032004 |doi=10.1103/PhysRevD.75.032004 |arxiv=hep-ex/0609059 |bibcode = 2007PhRvD..75c2004B |issue=3 }}</ref> and the leading mode of decay is three gamma quanta. Other modes of decay are negligible; for instance, the five photons mode has branching ratio of ~{{val|1.0|e=-6}}.<ref name=Czarnecki> {{cite journal |author=Andrzej Czarnecki, Savely G. Karshenboim |year=1999 |title=Decays of Positronium |volume=14 |issue=99 |journal=B.B. Levchenko and V.I. Savrin (eds.), Proc. of the the International Workshop on High Energy Physics and Quantum Field Theory (QFTHEP, Moscow , MSU-Press 2000, pp. 538 - 44. |arxiv=hep-ph/9911410 |bibcode = 1999hep.ph...11410C }}</ref> ortho-positronium lifetime (S = 1):<ref name=Karshenboim/> :<math>t_{1} = \frac{\frac{1}{2} 9 h}{2 m_e c^2 \alpha^6 (\pi^2 - 9)} = 1.386 \times 10^{-7} \; \text{s}</math> {{clear}} ==Annihilations== [[Image:Annihilation.png|thumb|right|250px|Naturally occurring electron-positron annihilation is a result of beta plus decay. Credit: Jens Maus.{{tlx|free media}}]] [[Image:Annihilation Radiation.JPG|thumb|right|250px|A Germanium detector spectrum shows the annihilation radiation peak (under the arrow). Note the width of the peak compared to the other gamma rays visible in the spectrum. Credit: Hidesert.{{tlx|free media}}]] The '''positron''' or '''antielectron''' is the [[w:antiparticle|antiparticle]] or the [[w:antimatter|antimatter]] counterpart of the electron. The positron has an [[w:electric charge|electric charge]] of +1e, a [[w:spin (physics)|spin]] of ½, and has the same mass as an electron. When a low-energy positron collides with a low-energy electron, [[w:annihilation|annihilation]] occurs, resulting in the production of two or more [[w:gamma ray|gamma ray]] [[w:photon|photon]]s. '''Def.''' the process of a [[wikt:particle|particle]] and its corresponding [[wikt:antiparticle|antiparticle]] combining to produce energy is called '''annihilation'''. The figure at right shows a positron (e⁺) emitted from an atomic nucleus together with a [[wikt:neutrino|neutrino]] (v). Subsequently, the positron moves randomly through the surrounding matter where it hits several different electrons (e^-) until it finally loses enough energy that it interacts with a single electron. This process is called an "annihilation" and results in two diametrically emitted photons with a typical energy of 511 keV each. Under normal circumstances the photons are not emitted exactly diametrically (180 degrees). This is due to the remaining energy of the positron having conservation of momentum. '''Electron–positron annihilation''' occurs when an electron ({{SubatomicParticle|Electron}}) and a [[w:positron|positron]] ({{SubatomicParticle|Positron}}, the electron's [[w:antiparticle|antiparticle]]) collide. The result of the collision is the [[w:annihilation|annihilation]] of the electron and positron, and the creation of [[w:gamma ray|gamma ray]] [[w:photon|photon]]s or, at higher energies, other particles: :{{SubatomicParticle|Electron}}&nbsp;+&nbsp;{{SubatomicParticle|Positron}}&nbsp;&rarr;&nbsp;{{SubatomicParticle|Photon}}&nbsp;+&nbsp;{{SubatomicParticle|Photon}} The process [does] satisfy a number of [[w:conservation law|conservation law]]s, including: * [[w:Charge conservation|Conservation of electric charge]]. The net [[w:electric charge|charge]] before and after is zero. * Conservation of [[w:momentum|linear momentum]] and total [[w:energy|energy]]. This forbids the creation of a single gamma ray. However, in [[w:quantum field theory|quantum field theory]] this process is [described]; see [[w:Annihilation#Examples of annihilation|examples of annihilation]]. * Conservation of [[w:angular momentum|angular momentum]]. As with any two charged objects, electrons and positrons may also interact with each other without annihilating, in general by [[w:elastic scattering|elastic scattering]]. The creation of only one photon can occur for tightly bound atomic electrons.<ref name=Sodickson>{{ cite journal |author=L. Sodickson |author2=W. Bowman |author3=J. Stephenson |author4=R. Weinstein |year=1960 |title=Single-Quantum Annihilation of Positrons |journal=Physical Review |volume=124 |pages=1851 |doi=10.1103/PhysRev.124.1851 |bibcode = 1961PhRv..124.1851S }}</ref> In the most common case, two photons are created, each with energy equal to the [[w:rest energy|rest energy]] of the electron or positron (511 keV).<ref name=Atwood>{{cite journal |author=W.B. Atwood |author2=P.F. Michelson |author3=S.Ritz |year=2008 |title=Una Ventana Abierta a los Confines del Universo |journal=Investigación y Ciencia |volume=377 |pages=24–31 |doi= }}</ref> It is also common for three to be created, since in some angular momentum states, this is necessary to conserve [[w:C parity|C parity]].<ref name=Griffiths>{{cite book |author=D.J. Griffiths |date=1987 |title=Introduction to Elementary Particles |publisher=John Wiley & Sons |isbn=0-471-60386-4 }}</ref> Any larger number of photons [can be created], but the probability becomes lower with each additional photon. When either the electron or positron, or both, have appreciable [[w:kinetic energy|kinetic energies]], other heavier particles can also be produced (such as [[w:D meson|D meson]]s), since there is enough kinetic energy in the relative velocities to provide the [[w:rest energy|rest energies]] of those particles. Photons and other light particles may be produced, but they will emerge with higher energies. At energies near and beyond the mass of the carriers of the [[w:weak interaction|weak force]], the [[w:W and Z bosons|W and Z bosons]], the strength of the weak force becomes comparable with [[w:electromagnetism|electromagnetism]].<ref name=Griffiths/> It becomes much easier to produce particles such as neutrinos that interact only weakly. The heaviest particle pairs yet produced by electron–positron annihilation are [[w:W boson|{{SubatomicParticle|W boson+}}–{{SubatomicParticle|W boson-}}]] pairs. The heaviest single particle is the [[w:Z boson|Z boson]]. Annihilation radiation is not monoenergetic, unlike gamma rays produced by [[w:radioactive decay|radioactive decay]]. The production mechanism of annihilation radiation introduces [[w:Doppler broadening|Doppler broadening]].<ref name=Gilmore>Gilmore, G., and Hemmingway, J.: "Practical Gamma Ray Spectrometry", page 13. John Wiley & Sons Ltd., 1995</ref> The annihilation peak produced in a gamma spectrum by annihilation radiation therefore has a higher [[w:full width at half maximum|full width at half maximum]] (FWHM) than other gamma rays in [the] spectrum. The difference is more apparent with high resolution detectors, such as [[w:Germanium|Germanium]] detectors, than with low resolution detectors such as [[w:Sodium iodide|Sodium iodide]]. Because of their well-defined energy (511 keV) and characteristic, Doppler-broadened shape, annihilation radiation can often be useful in defining the energy calibration of a gamma ray spectrum. ==Pair production== The reverse reaction, electron–positron creation, is a form of [[w:pair production|pair production]] governed by [[w:Two-photon physics|two-photon physics]]. '''Two-photon physics''', also called '''gamma-gamma physics''', [studies] the [[w:interaction|interaction]]s between two [[w:photons|photons]]. If the [[w:energy|energy]] in the [[w:center of mass|center of mass]] system of the two photons is large enough, [[w:matter|matter]] can be created.<ref name=Moffat>{{ cite journal |author=Moffat JW |title=Superluminary Universe: A Possible Solution to the Initial Value Problem in Cosmology |journal=Intl J Mod Phys D |month= |year=1993 |volume=2 |issue=3 |pages=351–65 |arxiv=gr-qc/9211020 |doi=10.1142/S0218271893000246 |bibcode = 1993IJMPD...2..351M }}</ref> :{{SubatomicParticle|Photon}}&nbsp;&rarr;&nbsp;{{SubatomicParticle|Electron}}&nbsp;+&nbsp;{{SubatomicParticle|Positron}} In [[w:nuclear physics|nuclear physics]], [the above reaction] occurs when a high-energy [[w:photon|photon]] interacts with a [[w:atomic nucleus|nucleus]]. The photon must have enough energy [> 2*511 keV, or 1.022 MeV] to create an electron plus a positron. Without a nucleus to absorb momentum, a photon decaying into electron-positron pair (or other pairs for that matter such as a muon and anti-muon or a tau and anti-tau can never conserve energy and momentum simultaneously.<ref name=Hubbell>{{ cite journal | last=Hubbell | first=J. H. | title=Electron positron pair production by photons: A historical overview | journal=Radiation Physics and Chemistry | year=2006 | month=June | volume=75 | issue=6 | pages=614–623 | doi=10.1016/j.radphyschem.2005.10.008 | bibcode=2006RaPC...75..614H }}</ref> These interactions were first observed in [[w:Patrick Maynard Stuart Blackett|Patrick Blackett]]'s counter-controlled [[w:cloud chamber|cloud chamber]]. In 2008 the [[w:Titan laser|Titan laser]] aimed at a 1-millimeter-thick gold target was used to generate positron–electron pairs in large numbers.<ref name=Bevy>{{ cite book |author= |title=Laser technique produces bevy of antimatter |url=http://www.msnbc.msn.com/id/27998860/ |date=2008 |accessdate=2008-12-04 }}</ref> "The LLNL scientists created the positrons by shooting the lab's high-powered Titan laser onto a one-millimeter-thick piece of gold."<ref name=Bevy/> ==Colors== {{main|Radiation astronomy/Colors}} '''Notation:''' '''WN5''' is a component of V444 Cygni, with its Wolf-Rayet (W) spectrum dominated by Nitrogen_III-V and Helium_I-II lines and WN2 to WN5 considered hotter or "early". "The color temperature of the central part of the WN5 disk for λ < 7512 Å, where the main source of opacity is electron scattering, is ''T''_c = 80,000-100,000 K. This high temperature represents the electron temperature slightly below the surface of the WN5 core--the level at which the star becomes optically thick in electron scattering."<ref name=Cherepashchuk>{{ cite journal |author=A. M. Cherepashchuk, K. F. Khaliullin, & J. A. Eaton |title=Ultraviolet photometry from the Orbiting Astronomical Observatory. XXXIX - The structure of the eclipsing Wolf-Rayet binary V444 Cygni as derived from light curves between 2460 A and 3. 5 microns |journal=The Astrophysical Journal |month=June 15, |year=1984 |volume=281 |issue=06 |pages=774-88 |url=http://adsabs.harvard.edu/full/1984ApJ...281..774C |arxiv= |bibcode=1984ApJ...281..774C |doi=10.1086/162156 |pmid= |accessdate=2014-01-23 }}</ref> ==Minerals== {{main|Radiation astronomy/Minerals}} [[Image:FluoriteUV.jpg|thumb|250px|left|Fluorescing fluorite is from Boltsburn Mine Weardale, North Pennines, County Durham, England, UK. Credit: [[c:user:Archaeodontosaurus|Didier Descouens]].{{tlx|free media}}]] Many samples of fluorite exhibit [[w:fluorescence|fluorescence]] under ultraviolet light, a property that takes its name from fluorite.<ref name=Stokes>{{ cite journal |title=On the Change of Refrangibility of Light |author=Stokes, G. G. |year=1852 |journal=Philosophical Transactions of the Royal Society of London |volume=142 |pages=463–562 |doi=10.1098/rstl.1852.0022 }}</ref> Many minerals, as well as other substances, fluoresce. Fluorescence involves the elevation of electron energy levels by quanta of ultraviolet light, followed by the progressive falling back of the electrons into their previous energy state, releasing quanta of visible light in the process. In fluorite, the visible light emitted is most commonly blue, but red, purple, yellow, green and white also occur. The fluorescence of fluorite may be due to mineral impurities such as [[w:yttrium|yttrium]], [[w:ytterbium|ytterbium]], or organic matter in the crystal lattice. In particular, the blue fluorescence seen in fluorites from certain parts of Great Britain responsible for the naming of the phenomenon of fluorescence itself, has been attributed to the presence of inclusions of divalent [[w:europium|europium]] in the crystal.<ref name=Przibram>{{ cite journal |author=K. Przibram |title=Fluorescence of Fluorite and the Bivalent Europium Ion |journal=Nature |volume=135 |pages=100 |year=1935 |doi=10.1038/135100a0 |issue=3403 |bibcode=1935Natur.135..100P }}</ref> Excessive "²⁶Mg [has] been reported in meteoritic carbonaceous chondrites [...] which demonstrate an excess of ²⁶Mg of up to 40% combined with essentially solar concentrations of ²⁴Mg and ²⁵Mg. Many of the data are well correlated with the ²⁷Al content of the samples, and this is interpreted as evidence that the excess ²⁶Mg has arisen from the ''in situ'' decay (via positron emission and electron capture) of the ground state of ²⁶Al in these minerals."<ref name=Champagne>{{ cite journal |author=A. E. Champagne |author2=A. J. Howard |author3=P. D. Parker |title=Nucleosynthesis of ²⁶Al at low stellar temperatures |journal=The Astrophysical Journal |month=June 15, |year=1983 |volume=269 |issue=06 |pages=686-9 |url=http://adsabs.harvard.edu/full/1983ApJ...269..686C |arxiv= |bibcode=1983ApJ...269..686C |doi=10.1086/161077 |pmid= |accessdate=2014-02-01 }}</ref> {{clear}} ==Theoretical beta-particle astronomy== "We now assume that the γ-rays are produced [from 3C 279] by relativistic electrons via Compton scattering of synchrotron photons (SSC). In any such model, the fact that the γ-rays luminosity, produced via Compton scattering, is higher than that emitted at lower frequencies (10¹⁴ - 10¹⁶ Hz), supposedly via the synchrotron process, implies a radiation energy density, ''U''_r, higher than the magnetic energy density, ''U''_B. From the observed power ratio we derive that ''U''_r must be one order of magnitude greater than ''U''_B, which may be a lower limit if Klein-Nishina effects reduce the efficiency of the self-Compton emission. This result is independent of the degree of beaming, which, for a homogeneous source, affects both the synchrotron and the self-Compton fluxes in the same way. This source is therefore the first observed case of the result of a ''Compton catastrophe'' (Hoyle, Burbidge, & Sargent 1966)."<ref name=Maraschi>{{ cite journal |author=L. Maraschi |author2=G. Ghisellini |author3=A. Celotti |title=A jet model for the gamma-ray emitting blazar 3C 279 |journal=The Astrophysical Journal |month=September |year=1992 |volume=397 |issue=1 |pages=L5-9 |url=http://adsabs.harvard.edu/abs/1992ApJ...397L...5M |arxiv= |bibcode=1992ApJ...397L...5M |doi=10.1086/186531 |pmid= |accessdate=2014-01-10 }}</ref> '''Notation:''' let the symbol '''Ps''' stand for '''positronium'''. "Comparison between direct annihilation and radiative capture to positronium [in thermal plasmas] shows that the two rates are equal at ''T'' = 6.8 x 10⁵ K with the former (latter) dominating at the higher (lower) temperatures."<ref name=Gould>{{ cite journal |author=Robert J. Gould |title=Direct positron annihilation and positronium formation in thermal plasmas |journal=The Astrophysical Journal |month=September 1, |year=1989 |volume=344 |issue=09 |pages=232-8 |url=http://articles.adsabs.harvard.edu/full/1989ApJ...344..232G |arxiv= |bibcode=1989ApJ...344..232G |doi= |pmid= |accessdate=2013-08-12 }}</ref> The process : <math> \mathrm{e^+ + e^- \rightarrow Ps + \gamma},</math> has a related mechanism in atomic hydrogen:<ref name=Gould/> : <math> \mathrm{p^+ + e^- \rightarrow H + \gamma}.</math> ==Entities== {{main|Radiation astronomy/Entities}} There may be a "connection ... between the magnetic field strengths inside an electron, in newly-born pulsars, and the sun. ... the upper limit to the strength of magnetic field ... is that which would permit emission of a photon at the non-relativistic electron gyrofrequency, with the energy of the order of the electron rest mass."<ref name=Cole/> A "basic process in the formation of pulsar magnetic fields [may be] a variant of electron-positron spin-zero annihilation, as follows : <math> e^-\uparrow + e^+\uparrow \, \rightarrow \, \uparrow \cup \uparrow + \gamma + \gamma,</math> where the [up] arrow represents the magnetic moment of an electron.<ref name=Cole>{{ cite journal |author=K. D. Cole |title=The Magnetic Fields of Pulsars, Electrons and the Sun |journal=Proceedings of the Astronomical Society of Australia |month= |year=1992 |volume=10 |issue=2 |pages=110-2 |url=http://adsabs.harvard.edu/full/1992PASAu..10..110C |arxiv= |bibcode=1992PASAu..10..110C |doi= |pmid= |accessdate=2013-08-13 }}</ref> This relation "symbolises the formation of a magnetic entity, <math>\uparrow \cup \uparrow</math>, here called an M-particle, with twice the magnetic moment of an electron or a positron, and [γ] represents a photon."<ref name=Cole/> ==Sources== {{main|Radiation astronomy/Sources}} Low-mass X-ray binaries (LMXBs) "have long been suggested as positron sources on theoretical grounds and because their distribution peaks in the bulge region (eg Prantzos, 2004); however, it is only those LMXBs detected at hard X-ray energies that in addition exhibit an imbalance in their disk distribution."<ref name=Weidenspointner>{{ cite journal |author=G. Weidenspointner |author2=G.K. Skinner |author3=P. Jean |author4=J. Knödlseder |author5=P. von Ballmoos |author6=R. Diehl |author7=A. Strong |author8=B. Cordier |author9=S. Schanne |author10=C. Winkler |title=Positron astronomy with SPI/INTEGRAL |journal=New Astronomy Reviews |month=October |year=2008 |volume=52 |issue=7-10 |pages=454-6 |url=http://www.sciencedirect.com/science/article/pii/S1387647308001164 |arxiv= |bibcode=2008NewAR..52..454W |doi=10.1016/j.newar.2008.06.019 |pmid= |accessdate=2013-08-13 }}</ref> ==Objects== {{main|Radiation astronomy/Objects|Object astronomy}} "It is possible that the X-ray continuum is primary while the radio and optical emission are secondary for all BL Lac objects when the effect of relativistic beaming is considered. Pair production is a possible mechanism for producing X-ray emissions, while the optical and radio emission would be a consequence of this model (Zdziarski & Lightman 1985; Svensson 1986; Fabian et al. 1986). Barr & Mushotzky (1986) showed a significant correlation between the X-ray luminosity and timescale of X-ray variability for Seyfert galaxies and quasars and interpreted this as evidence that the emitting plasma is near the limit of being dominated by electron-positron pairs."<ref name=Xie>{{ cite journal |author=G. Z. Xie |author2=B. F. Liu |author3=J. C. Wang |title=A Signature of Relativistic Electron-Positron Beams in BL Lacertae Objects |journal=The Astrophysical Journal |month=November 20, |year=1995 |volume=454 |issue=11 |pages=50-4 |url=http://adsabs.harvard.edu/full/1995ApJ...454...50X |arxiv= |bibcode=1995ApJ...454...50X |doi=10.1086/176463 |pmid= |accessdate=2013-08-13 }}</ref> ==Strong forces== {{main|Charges/Interactions/Strong}} "The idea behind baryon matter is that a macroscopic state may exist in which a smaller effective baryon mass inside some region makes the state energetically favored over free particles. [...] This state will appear in the limit of large baryon number as an electrically neutral coherent bound state of neutrons, protons, and electrons in ''β''-decay equilibrium."<ref name=Bahcall>{{ cite journal |author=Safi Bahcall |author2=Bryan W. Lynn |author3=Stephen B. Selipsky |title=New Models for Neutron Stars |journal=The Astrophysical Journal |month=October 10, |year=1990 |volume=362 |issue=10 |pages=251-5 |url=http://adsabs.harvard.edu/abs/1990ApJ...362..251B |arxiv= |bibcode=1990ApJ...362..251B |doi=10.1086/169261 |pmid= |accessdate=2014-01-11 }}</ref> ==Weak forces== {{main|Charges/Interactions/Weak}} "Energy deposit or escape is a major issue in expanding envelopes of stellar explosions, supernovae (positrons from ⁵⁶Co and ⁴⁴Ti) and novae (many ''β''⁺ decays such as ¹³N)".<ref name=Diehl>{{ cite book |author=Roland Diehl |title=Introduction to Astronomy with Radioactivity, In: ''Astronomy with Radioactivities'' |publisher=Springer |location= |date=2011 |editor= |pages= |url=http://link.springer.com/chapter/10.1007/978-3-642-12698-7_1 |arxiv=1007.2206 |bibcode= |doi= |pmid= |isbn= |accessdate=1 February 2014 }}</ref> ==Continua== {{main|Radiation astronomy/Continua}} The X-ray continuum can arise from [[w:bremsstrahlung|bremsstrahlung]], [[w:Thermal radiation|black-body radiation]], [[w:synchrotron radiation|synchrotron radiation]], or what is called [[w:Compton scattering#Inverse Compton scattering|inverse Compton scattering]] of lower-energy photons by relativistic electrons, knock-on collisions of fast protons with atomic electrons, and atomic recombination, with or without additional electron transitions.<ref name=Morrison>{{ cite journal |author=P Morrison |title=Extrasolar X-ray Sources |journal=Annual Review of Astronomy and Astrophysics |year=1967 |volume=5 |issue=1 |pages=325–50 |doi=10.1146/annurev.aa.05.090167.001545 |bibcode=1967ARA&A...5..325M }}</ref> "The annihilation of positrons with electrons gives rise to two spectral features, a line emission at 511 keV and a positronium continuum emission (which increases in intensity with energy roughly as a power law up to 511 keV and falls abruptly to zero above 511 keV)[4]."<ref name=Milne2002>{{ cite journal |author=P.A. Milne |author2=J.D. Kurfess |author3=R.L. Kinzer |author4=M.D. Leising |title=Supernovae and Positron Annihilation Radiation |journal=New Astronomy Reviews |month=July |year=2002 |volume=46 |issue=8-10 |pages=553-8 |url=http://www.sciencedirect.com/science/article/pii/S1387647302002002 |arxiv=astro-ph/0110442 |bibcode= |doi= |pmid= |accessdate=2013-08-13 }}</ref> ==Emissions== {{main|Radiation astronomy/Emissions}} '''Notation:''' let the symbol '''LAT''' represent '''Large Area Telescope'''. '''Notation:''' let the symbol '''GBM''' represent '''Gamma-ray Burst Monitor'''. "The observed correlated variability of the GBM and LAT emissions indicates that photons formed co-spatially, with the lower-energy (GBM) photons providing target photons that can interact with higher energy γ rays to produce electron-positron pairs."<ref name=Abdo>{{ cite journal |author=AA Abdo |author2=M Ackermann |author3=M Arimoto |author4=K Asano |author5=The Fermi LAT |author6=Fermi GBM Collaborations |title=Fermi observations of high-energy gamma-ray emission from GRB 080916C |journal=Science |month=March 27, |year=2009 |volume=323 |issue=5922 |pages=1688-93 |url=http://www.sciencemag.org/content/323/5922/1688.short |arxiv= |bibcode= |doi=10.1126/science.1169101 |pmid= |accessdate=2013-08-13 }}</ref> ==Absorptions== {{main|Radiation astronomy/Absorptions|Absorption astronomy}} "[M]odels in which γ-rays are absorbed in collisions with X-rays producing nonthermal electron-positron pairs, which in turn radiate further X-rays [have been developed]."<ref name=Zdziarski>{{ cite journal |author=Andrzej A. Zdziarski |author2=Gabriele Ghisellini |author3=Ian M. George |author4=R. Svensson |author5=A. C. Fabian |author6=Chris Done |title=Electron-positron pairs, Compton reflection, and the X-ray spectra of active galactic nuclei |journal=The Astrophysical Journal |month=November 1, |year=1990 |volume=363 |issue=11 |pages=L1-4 |url=http://adsabs.harvard.edu/full/1990ApJ...363L...1Z |arxiv= |bibcode=1990ApJ...363L...1Z |doi=10.1086/185851 |pmid= |accessdate=2013-08-15 }}</ref> "[T]he reprocessing of radiation by ''e''⁺ ''e''^- pairs could be a sufficiently robust mechanism to yield the canonical spectrum, independent of the details of the particle acceleration mechanism and the parameters of the source, such as the X- and γ-ray luminosity, ''L'', and the size, R."<ref name=Zdziarski/> "[T]he hard X-ray spectrum of a growing number of [active galactic nuclei] AGN [in] the 1-30 keV X-ray emission has four distinct components":<ref name=Zdziarski/> # "an incident power law spectrum with a spectral index αⁱ_x ≃ 0.9,"<ref name=Zdziarski/> # "an emission line at the energy ~6.4 keV (interpreted as a fluorescent iron K-line),"<ref name=Zdziarski/> # "an absorption edge at 7-8 keV (interpreted as an iron K-edge), and"<ref name=Zdziarski/> # "a broad excess of emission with respect to the underlying power law at energies ≳ 10 keV (interpreted as Compton reflection from cold [T < 10⁶ K, optically thick] material)." <ref name=Zdziarski/> ==Bands== {{main|Radiation astronomy/Bands}} "For <math>N_s</math> sources located in the field of view, the data <math>D_p</math> obtained during an exposure (pointing) p, for a given energy band, can be expressed by the relation:" : <math> D_p = \sum^{N_p}_{j=1}R_{p,j}S_{p,j} + B_p</math> "where <math>R_{p,j}</math> is the response of the instrument for the source j, <math>S_{p,j}</math> is the flux of the source j, and <math>B_p</math> is the background recorded during the pointing p. <math>D_p, R_{p,j}</math>, and <math>B_p</math> are vectors of 19 elements."<ref name=Bouchet/> "[I]n the 508.25-513.75 keV band ... a 5.5 keV wide band centered at 511 keV takes into account the Germanium energy resolution (FWHM 2.05 keV) including its degradation between two consecutive annealings (5%). At this energy, the gain calibration (performed orbit-wise) accuracy is better than ±0.01 keV."<ref name=Bouchet>{{ cite journal |author=On the morphology of the electron-positron annihilation emission as seen by SPI/INTEGRAL |title=L. Bouchet, J. P. Roques, and E. Jourdain |journal=The Astrophysical Journal |month=September 10, |year=2010 |volume=720 |issue=2 |pages=1772-80 |url=http://iopscience.iop.org/0004-637X/720/2/1772 |arxiv=1007.4753 |bibcode=2010ApJ...720.1772B |doi=10.1088/0004-637X/720/2/1772 |pmid= |accessdate=2013-08-16 }}</ref> ==Backgrounds== {{main|Radiation astronomy/Backgrounds}} "[Taking] advantage of the relative stability of the background pattern to rewrite the background term as:" : <math>B_p = A_p \cdot U \cdot t_p</math> "where <math>A_P</math> is a normalization coefficient per pointing, <math>U</math> is the "uniformity map" or background count rate pattern on the SPI camera [of the [[w:INTEGTAL|INTEGRAL]] satellite] and <math>t_p</math> the effective observation time for pointing p. <math>U</math> and <math>t</math> are vectors of 19 elements (one per detector)."<ref name=Bouchet/> ==Meteors== {{main|Radiation/Meteors}} "The main physical processes at play are the emission of γ-rays and positrons from radioactive decays in the ⁵⁶Ni → ⁵⁶Co → ⁵⁶Fe chain [...], their interaction with the ejecta, and the spectrum of the radiation produced by the thermalization processes and the radiative transfer in the expanding ejecta. [...] Positron interaction with the ejecta [from the Type Ic SN 1994I] strongly depends on the presence, and geometry, of magnetic fields (Ruiz-Lapuente & Spruit 1998)."<ref name=Clocchiatti>{{ cite journal |author=Alejandro Clocchiatti |author2=J. Craig Wheeler |author3=Robert P. Kirshner |author4=David Branch |author5=Peter Challis |author6=Roger A. Chevalier |author7=Alexei V. Filippenko |author8=Claes Fransson |author9=Peter Garnavich |author10=Bruno Leibundgut |author11=Nino Panagia |author12=Mark M. Phillips |author13=Nicholas B. Suntzeff |author14=Peter A. Höflich |author15=José Gallardo |title=Late-Time HST Photometry of SN 1994I: Hints of Positron Annihilation Energy Deposition |journal=Publications of the Astronomical Society of the Pacific |month=March |year=2008 |volume=120 |issue=865 |pages=290-300 |url=http://www.jstor.org/stable/10.1086/533458 |arxiv= |bibcode= |doi=10.1086/533458 |pmid= |accessdate=2014-01-31 }}</ref> ==Cosmic rays== {{main|Radiation/Cosmic rays}} '''Aluminium-26''', ²⁶Al, is a radioactive [[w:isotope|isotope]] of the chemical element aluminium, decaying by either of the [[w:Radioactive decay#Modes of decay|modes]] [[w:Positron emission|beta-plus]] or [[w:electron capture|electron capture]], both resulting in the stable [[w:nuclide|nuclide]] magnesium-26. The [[w:half-life|half-life]] of ²⁶Al is 7.17{{e|5}} years. This is far too short for the isotope to survive to the present, but a small amount of the nuclide is produced by collisions of argon atoms with cosmic ray protons. There is an "unexpected rise of the positron fraction, observed by HEAT and PAMELA experiments, for energies larger than a few GeVs."<ref name=Rodriguez>{{ cite journal |author=Roberto Alfredo Lineros Rodriguez |title=Positrons from cosmic rays interactions and dark matter annihilations |journal=Rivista Del Nuovo Cimento |month= |year=2010 |volume=125B |issue= |pages=1053-70 |url=http://adsabs.harvard.edu/abs/2010arXiv1002.0671A |arxiv=1002.0671 |bibcode=2010arXiv1002.0671A |doi=10.1393/ncb/i2010-10910-7 |pmid= |accessdate=2013-08-17 }}</ref> "[T]he HEAT balloon experiment [30] ... has mildly indicated a possible positron excess at energies larger than 10 GeV ... In October 2008, the latest results of PAMELA experiment [36] have confirmed and extended this feature [37]."<ref name=Rodriguez/> Earlier measurements indicate that "the positron fraction, [f = ] e⁺/(e^- + e⁺), increases with energy at energies above 10 GeV. Such an increase would require either the appearance of a new source of positrons or a depletion of primary electrons."<ref name=Barwick>{{ cite journal |author=S. W. Barwick |author2=J. J. Beatty |author3=A. Bhattacharyya |author4=C. R. Bower |author5=C. J. Chaput |author6=S. Coutu |author7=G. A. de Nolfo |author8=J. Knapp |author9=D. M. Lowder |author10=S. McKee |author11=D. Müller |author12=J. A. Musser |author13=S. L. Nutter |author14=E. Schneider |author15=S. P. Swordy |author16=G. Tarlé |author17=A. D. Tomasch |author18=E. Torbet |title=Measurements of the Cosmic-Ray Positron Fraction from 1 to 50 GeV |journal=The Astrophysical Journal Letters |month=June 20, |year=1997 |volume=482 |issue=2 |pages=L191-4 |url=http://iopscience.iop.org/1538-4357/482/2/L191/pdf/1538-4357_482_2_L191.pdf |arxiv= |bibcode=1997ApJ...482L.191B |doi=10.1086/310706 |pmid= |accessdate=2012-07-13 }}</ref> All results taken together suggest a slight decrease with increasing energy from about 1 GeV to 10 GeV, but overall the fraction may be constant, per Figure 2.<ref name=Barwick/> ==Neutrals== {{main|Radiation astronomy/Neutrals|Neutrals astronomy}} "The positrons can annihilate in flight before being slowed to thermal energies, annihilate directly with electrons when both are at thermal energies, or form positronium at thermal energies (or at greater than thermal energies if positronium formation occurs via charge exchange with neutrals)."<ref name=Leising/> ==Subatomics== {{main|Radiation astronomy/Subatomics|Subatomic astronomy}} "Few exceptional lines arise at high energy from annihilations of positrons and pions."<ref name=Diehl/> ==Neutrons== {{main|Radiation/Neutrons}} "''Reuven Ramaty High Energy Solar Spectroscopic Imager'' (RHESSI) hard X-ray (HXR) and γ-ray imaging and spectroscopy observations [were made] of the intense (X4.8) γ-ray line flare of 2002 July 23."<ref name=Lin/> "For the first time, the positron annihilation line is resolved, and the detailed high-resolution measurements are obtained for the neutron-capture line. The first ever solar γ-ray line and continuum imaging shows that the source locations for the relativistic electron bremsstrahlung overlap the 50-100 keV HXR sources, implying that electrons of all energies are accelerated in the same region. The centroid of the ion-produced 2.223 MeV neutron-capture line emission, however, is located ~20'' ± 6'' away, implying that the acceleration and/or propagation of the ions must differ from that of the electrons. Assuming that Coulomb collisions dominate the energetic electron and ion energy losses (thick target), we estimate that a minimum of ~2 × 10³¹ ergs is released in accelerated >~20 keV electrons during the rise phase, with ~10³¹ ergs in ions above 2.5 MeV nucleon^-1 and about the same in electrons above 30 keV released in the impulsive phase."<ref name=Lin/> "The collisions also produce neutrons, positrons, and pions. Neutron capture on hydrogen and positron annihilation yield narrow lines at 2.223 and 0.511 MeV, respectively, both of which are delayed."<ref name=Lin>{{ cite journal |author=R. P. Lin |author2=S. Krucker |author3=G. J. Hurford |author4=D. M. Smith |author5=H. S. Hudson |author6=G. D. Holman |author7=R. A. Schwartz |author8=B. R. Dennis |author9=G. H. Share |author10=R. J. Murphy |author11=A. G. Emslie |author12=C. Johns-Krull |author13=N. Vilmer |title=''RHESSI'' Observations of Particle Acceleration and Energy Release in an Intense Solar Gamma-Ray Line Flare |journal=The Astrophysical Journal Letters |month= |year=2003 |volume=595 |issue=2 |pages=L69- |url=http://iopscience.iop.org/1538-4357/595/2/L69 |arxiv= |bibcode= |doi=10.1086/378932 |pmid= |accessdate=2014-02-01 }}</ref> ==Protons== {{main|Radiation astronomy/Protons|Proton astronomy}} Based on interactions between cosmic rays and the photons of the [[w:Cosmic microwave background radiation|cosmic microwave background radiation]] (CMB), cosmic rays with energies over the threshold energy of 5x10¹⁹ [[w:electron-volt|eV]] interact with cosmic microwave background photons <math>\gamma_{\rm CMB}</math> to produce [[w:pion|pion]]s via the <math>\Delta</math> resonance, :<math>\gamma_{\rm CMB}+p\rightarrow\Delta^+\rightarrow p + \pi^0,</math> or :<math>\gamma_{\rm CMB}+p\rightarrow\Delta^+\rightarrow n + \pi^+.</math> Pions produced in this manner proceed to decay in the standard pion channels—ultimately to photons for neutral pions, and photons, positrons, and various neutrinos for positive pions. Neutrons decay also to similar products, so that ultimately the energy of any cosmic ray proton is drained off by production of high energy photons plus (in some cases) high energy electron/positron pairs and neutrino pairs. The pion production process begins at a higher energy than ordinary electron-positron pair production (lepton production) from protons impacting the CMB, which starts at cosmic ray proton energies of only about 10¹⁷[[w:electron-volt|eV]]. However, pion production events drain 20% of the energy of a cosmic ray proton as compared with only 0.1% of its energy for electron positron pair production. This factor of 200 is from two sources: the pion has only about ~130 times the mass of the leptons, but the extra energy appears as different kinetic energies of the pion or leptons, and results in relatively more kinetic energy transferred to a heavier product pion, in order to conserve momentum. The much larger total energy losses from pion production result in the pion production process becoming the limiting one to high energy cosmic ray travel, rather than the lower-energy light-lepton production process. ==Muons== {{main|Radiation astronomy/Muons|Muon astronomy}} "TeV muons from γ ray primaries ... are rare because they are only produced by higher energy γ rays whose flux is suppressed by the decreasing flux at the source and by absorption on interstellar light."<ref name=Halzen>{{ cite journal |author=Francis Halzen |author2=Todor Stanev |author3=Gaurang B. Yodh |title=γ ray astronomy with muons |journal=Physical Review D Particles, Fields, Gravitation, and Cosmology |month=April 1, |year=1997 |volume=55 |issue=7 |pages=4475-9 |url=http://prd.aps.org/abstract/PRD/v55/i7/p4475_1 |arxiv=astro-ph/9608201 |bibcode=1997PhRvD..55.4475H |doi=10.1103/PhysRevD.55.4475 |pmid= |accessdate=2013-01-18 }}</ref> Muon decay produces three particles, an electron plus two neutrinos of different types. "The muons created through decays of secondary pions and kaons are fully polarized, which results in electron/positron decay asymmetry, which in turn causes a difference in their production spectra."<ref name=Moskalenko>{{ cite journal |author=I. V. Moskalenko |author2=A. W. Strong |title=Production and propagation of cosmic-ray positrons and electrons |journal=The Astrophysical Journal |month=February 1, |year=1998 |volume=493 |issue=2 |pages=694-707 |url=http://iopscience.iop.org/0004-637X/493/2/694 |arxiv=astro-ph/9710124 |bibcode=1998ApJ...493..694M |doi=10.1086/305152 |pmid= |accessdate=2014-02-01 }}</ref> ==Neutrinos== {{main|Radiation astronomy/Neutrinos|Neutrino astronomy}} [[Image:Proton proton cycle.svg|250px|thumb|center|Solar neutrinos are shown for the [[w:Proton-proton chain reaction|proton-proton chain]] in the Standard Solar Model. Credit: [[:hu:User:SzDóri|Dorottya Szam]].{{tlx|free media}}]] The following fusion reaction produces neutrinos and accompanying gamma-rays of the energy indicated: ::<math>\mathrm{_1^1H} + \mathrm{_1^1H} \rightarrow \mathrm{_{1}^{2}D} + e^+ + \nu_e + \gamma (0.42 MeV). </math> Observation of gamma rays of this energy likely indicate this reaction is occurring nearby. In the [[w:Cowan–Reines neutrino experiment|Cowan–Reines neutrino experiment]], antineutrinos created in a nuclear reactor by beta decay reacted with protons producing [[w:neutron|neutron]]s and [[w:positron|positron]]s: :{{SubatomicParticle|Electron antineutrino}} + {{SubatomicParticle|Proton+}} → {{SubatomicParticle|Neutron0}} + {{SubatomicParticle|Electron+}} The positron quickly finds an electron, and they [[w:Annihilation|annihilate]] each other. The two resulting gamma rays (γ) 511 keV each are detectable. The neutron can be detected by its capture on an appropriate nucleus, releasing a gamma ray. The coincidence of both events – positron annihilation and neutron capture – gives a unique signature of an antineutrino interaction. {{clear}} ==Gamma rays== {{main|Radiation astronomy/Gamma rays|Gamma-ray astronomy}} [[Image:Glast allsky1-a.png|thumb|right|250px|This is a high-energy gamma radiation allsky image about the Earth, taken from [[w:Energetic Gamma Ray Experiment Telescope|Energetic Gamma Ray Experiment Telescope]] on the NASA’s [[w:Compton Gamma Ray Observatory|Compton Gamma Ray Observatory]] satellite. Credit: United States Department of Energy.{{tlx|free media}}]] Most astronomical gamma-rays may be produced from the same type of accelerations of electrons, and electron-photon interactions, that produce X-rays in astronomy (but occurring at a higher energy in the production of gamma-rays). A number of different processes occurring in the universe may result in gamma-ray emission. These processes include the interactions of energetic electrons with [[w:magnetic field|magnetic field]]s. The correlations of the high energy electrons energized during a solar flare and the gamma rays [produced] are mostly caused by nuclear combinations of high energy protons and other heavier ions. "The '''Energetic Gamma Ray Experiment Telescope''', ('''EGRET''') measured high energy (20 MeV to 30 GeV) gamma ray source positions to a fraction of a degree and photon energy to within 15 percent. EGRET was developed by NASA [[w:Goddard Space Flight Center|Goddard Space Flight Center]], the [[w:Max Planck Institute for Extraterrestrial Physics|Max Planck Institute for Extraterrestrial Physics]], and [[w:Stanford University|Stanford University]]. Its detector operated on the principle of electron-[[w:positron|positron]] [[w:pair production|pair production]] from high energy photons interacting in the detector. The tracks of the high-energy electron and positron created were measured within the detector volume,and the axis of the ''V'' of the two emerging particles projected to the sky. Finally, their total energy was measured in a large [[w:calorimeter (particle physics)|calorimeter]] [[w:scintillation detector|scintillation detector]] at the rear of the instrument. {{clear}} ==X-rays== {{main|Radiation astronomy/X-rays|X-ray astronomy}} X-rays remove electrons from atoms and ions, and those photoelectrons can provoke secondary ionizations. As the intensity is often low, this [X-ray] heating is only efficient in warm, less dense atomic medium (as the column density is small). For example in molecular clouds only hard x-rays can penetrate and x-ray heating can be ignored. This is assuming the region is not near an x-ray source such as a supernova remnant. In an X-ray tube, electrons are accelerated in a vacuum by an electric field and shot into a piece of metal called the "target". X-rays are emitted as the electrons slow down (decelerate) in the metal. The output spectrum consists of a continuous spectrum of X-rays, with additional sharp peaks at certain energies characteristic of the elements of the target. The '''Energetic Gamma Ray Experiment Telescope''', ('''EGRET''') measured high energy (20 MeV to 30 GeV) gamma ray source positions to a fraction of a degree and photon energy to within 15 percent. EGRET was developed by NASA [[w:Goddard Space Flight Center|Goddard Space Flight Center]], the [[w:Max Planck Institute for Extraterrestrial Physics|Max Planck Institute for Extraterrestrial Physics]], and [[w:Stanford University|Stanford University]]. Its detector operated on the principle of electron-[[w:positron|positron]] [[w:pair production|pair production]] from high energy photons interacting in the detector. The tracks of the high-energy electron and positron created were measured within the detector volume,and the axis of the ''V'' of the two emerging particles projected to the sky. Finally, their total energy was measured in a large [[w:calorimeter (particle physics)|calorimeter]] [[w:scintillation detector|scintillation detector]] at the rear of the instrument. ==Blues== {{main|Radiation astronomy/Blues|Blue astronomy}} In "the spectrum of a middle-aged [pulsar] PSR B0656+14 [may be] two wide, red and blue, flux depressions whose frequency ratio is about 2 and which could be the 1st and 2nd harmonics of electron/positron cyclotron absorption formed at magnetic fields [of] ~10⁸ G in [the] upper magnetosphere of the pulsar."<ref name=Zharikov>{{ cite journal |author=S. Zharikov |author2=R. E. Mennickent |author3=Yu. Shibanov |author4=V. Komarova |title=Optical spectroscopy of the radio pulsar PSR B0656+14 |journal=Astrophysics and Space Science |month=April |year=2007 |volume=308 |issue=1-4 |pages=545-9 |url=http://adsabs.harvard.edu/abs/2007Ap%26SS.308..545Z |arxiv=astro-ph/0608527 |bibcode=2007Ap&SS.308..545Z |doi=10.1007/s10509-007-9308-z |pmid= |accessdate=2013-05-31 }}</ref> ==Yellows== {{main|Radiation astronomy/Yellows|Yellow astronomy}} "The temperature of yellow coronal regions is ... about 2.5 [x] 10⁶ [K]. ... although some ions Ca XV will exist at lower, as well as higher temperatures."<ref name=Kleczek/> "The AS prominences [AS in Menzel-Evans' classification [4];] move with velocities exceeding by far the velocities of other types of prominences [7], [8]. As short-living phenomena, they are condensed quickly and the temperature of the coronal gases should rise in the early stages of their condensation. Indeed, the AS prominences use to be allied with yellow line emission (λ 5694)."<ref name=Kleczek/> "The yellow line is namely due to the ion Ca XV, according to Edlen's and Waldmeier's identification. ... the line λ 5694 is emitted by ³''P''₁ - ³''P''₀ transition of Ca XV."<ref name=Kleczek/> "The solar corona is not in thermodynamical equilibrium. In particular, the photo-recombination is compensated with electron impact ionization, while the reverse processes viz. the photoionization and recombination by impact with two electrons are there negligible."<ref name=Kleczek>{{ cite journal |author=J. Kleczek |title=Temperature of Yellow Coronal Regions |journal=Bulletin of the Astronomical Institutes of Czechoslovakia |month= |year=1957 |volume=8 |issue= |pages=68-70 |url=http://adsabs.harvard.edu/full/1957BAICz...8...68K |arxiv= |bibcode=1957BAICz...8...68K |doi= |pmid= |accessdate=2013-09-26 }}</ref> ==Infrareds== {{main|Radiation astronomy/Infrareds|Infrared astronomy}} In [[infrared astronomy]], the cosmic infrared background (CIB) causes a significant attenuation for very high energy electrons through inverse [[w:Compton scattering|Compton scattering]], photopion and electron-positron pair production. ==Submillimeters== {{main|Radiation astronomy/Submillimeters|Submillimeter astronomy}} "Radio observations at 210 GHz taken by the Bernese Multibeam Radiometer for KOSMA (BEMRAK) [of] high-energy particle acceleration during the energetic solar flare of 2003 October 28 [...] at submillimeter wavelengths [reveal] a gradual, long-lasting (>30 minutes) component with large apparent source sizes (~60"). Its spectrum below ~200 GHz is consistent with synchrotron emission from flare-accelerated electrons producing hard X-ray and γ-ray bremsstrahlung assuming a magnetic field strength of ≥200 G in the radio source and a confinement time of the radio-emitting electrons in the source of less than 30 s. [... There is a] close correlation in time and space of radio emission with the production of pions".<ref name=Trottet>{{ cite journal |author=G. Trottet |author2=Säm Krucker |author3=T. Lüthi |author4=A. Magun |title=Radio Submillimeter and γ-Ray Observations of the 2003 October 28 Solar Flare |journal=The Astrophysical Journal |month=May 1 |year=2008 |volume=678 |issue=1 |pages=509 |url=http://iopscience.iop.org/0004-637X/678/1/509 |arxiv= |bibcode= |doi=10.1086/528787 |pmid= |accessdate=2013-10-22 }}</ref> ==Superluminals== {{main|Radiation astronomy/Superluminals|Superluminal astronomy}} There is a cut-off frequency above which the equation <math>\cos\theta=1/(n\beta)</math> cannot be satisfied. Since the [[w:refractive index|refractive index]] is a function of frequency (and hence wavelength), the intensity does not continue increasing at ever shorter wavelengths even for ultra-relativistic particles (where v/[[w:speed of light|c]] approaches 1). At X-ray frequencies, the refractive index becomes less than unity (note that in media the phase velocity may exceed ''c'' without violating relativity) and hence no X-ray emission (or shorter wavelength emissions such as gamma rays) would be observed. However, X-rays can be generated at special frequencies just below those corresponding to core electronic transitions in a material, as the index of refraction is often greater than 1 just below a resonance frequency (see [[w:Kramers-Kronig relation|Kramers-Kronig relation]] and [[w:anomalous dispersion|anomalous dispersion]]). "Throughout the shower development, the electrons and positrons which travel faster than the speed of light in the air emit Cherenkov radiation."<ref name=Moralejo>{{ cite journal |author=A. Moralejo for the MAGIC collaboration |title=The MAGIC telescope for gamma-ray astronomy above 30 GeV |journal=Memorie della Societa Astronomica Italiana |month= |year=2004 |volume=75 |issue= |pages=232-9 |url=http://adsabs.harvard.edu/abs/2004MmSAI..75..232M |arxiv= |bibcode=2004MmSAI..75..232M |doi= |pmid= |accessdate=2012-07-28 }}</ref> "High energy processes such as [[w:Compton scattering|Compton]], [[w:Bhabha scattering|Bhabha]], and [[w:Møller scattering|Moller scattering]], along with [[w:Positron annihilation|positron annihilation]] rapidly lead to a ~20% negative charge asymmetry in the electron-photon part of a cascade ... initiated by a ... 100 PeV neutrino"<ref name=Gorham>{{ cite journal |author= P. W. Gorham |author2=S. W. Barwick |author3=J. J. Beatty |author4=D. Z.Besson |author5=W. R. Binns |author6=C. Chen |author7=P. Chen |author8=J. M. Clem |author9=A. Connolly |author10=P. F. Dowkontt |author11=M. A. DuVernois |author12=R. C. Field |author13=D. Goldstein |author14=A. Goodhue |author15=C. Hast |author16=C. L. Hebert |author17=S. Hoover |author18=M. H. Israel |author19=J. Kowalski |author20=J. G. Learned |author21=K. M. Liewer |author22=J. T. Link |author23=E. Lusczek |author24=S. Matsuno |author25=B. Mercurio |author26=C. Miki |author27=P. Miocinovic |author28=J. Nam |author29=C. J. Naudet |author30=J. Ng |author31=R. Nichol |author32=K. Palladino |author33=K. Reil |author34=A. Romero-Wolf |author35=M. Rosen |author36=L. Ruckman |author37=D. Saltzberg |author38=D. Seckel |author39=G. S. Varner |author40=D. Walz |author41=F. Wu |title=Observations of the Askaryan Effect in Ice |journal=Physical Review Letters |month=October 25, |year=2007 |volume=99 |issue=17 |pages=5 |url=http://arxiv.org/pdf/hep-ex/0611008.pdf |arxiv= |bibcode= |doi=10.1103/PhysRevLett.99.171101 |pmid= |accessdate=2012-07-28 }}</ref>. "The tachyonic spectral densities generated by ultra-relativistic electrons in uniform motion are fitted to the high-energy spectra of Galactic supernova remnants, such as RX J0852.0−4622 and the pulsar wind nebulae in G0.9+0.1 and MSH 15-52. ... Tachyonic cascade spectra are quite capable of generating the spectral curvature seen ... Estimates on the electron/proton populations generating the tachyon flux are obtained from the spectral fits"<ref name=Tomaschitz>{{ cite journal |author=Roman Tomaschitz |title=Superluminal cascade spectra of TeV [gamma]-ray sources |journal=Annals of Physics |month=March |year=2007 |volume=322 |issue=3 |pages=677-700 |url=http://wallpaintings.at/geminga/superluminal_cascade_spectra_TeV_gamma-ray_sources.pdf |arxiv= |bibcode= |doi=10.1016/j.aop.2006.11.005 |pmid= |accessdate=2011-11-24 }}</ref> "[S]uperluminal neutrinos may lose energy rapidly via the bremsstrahlung [Cherenkov radiation] of electron-positron pairs <math>(\nu \rightarrow \nu + e^- + e^+).</math>"<ref name=Cohen>{{ cite journal |author=Andrew G. Glashow |author2=Sheldon L. Glashow |title=Pair Creation Constrains Superluminal Neutrino Propagation |journal=Physical Review Letters |month=October |year=2011 |volume=107 |issue=18 |pages=181803 |url=http://adsabs.harvard.edu/abs/2011PhRvL.107r1803C |arxiv=1109.6562 |bibcode=2011PhRvL.107r1803C |doi=10.1103/PhysRevLett.107.181803 |pmid= |accessdate=2013-08-16 }}</ref> Assumption: "muon neutrinos with energies of order tens of GeV travel at superluminal velocity."<ref name=Cohen/> For "all cases of superluminal propagation, certain otherwise forbidden processes are kinematically permitted, even in vacuum."<ref name=Cohen/> Consider : <math> \nu_{\mu} \rightarrow \begin{bmatrix} {\nu_{\mu} + \gamma} & (a) \\ {\nu_{\mu} + \nu_e + \overline\nu_e } & (b) \\ {\nu_{\mu} + e^+ + e^-} & (c) \end{bmatrix} </math><ref name=Cohen/> "These processes cause superluminal neutrinos to lose energy as they propagate and ... process (c) places a severe constraint upon potentially superluminal neutrino velocities. ... Process (c), pair bremsstrahlung, proceeds through the neutral current weak interaction."<ref name=Cohen/> "Throughout the shower development, the electrons and positrons which travel faster than the speed of light in the air emit Cherenkov radiation."<ref name=Moralejo>{{ cite journal |author=A. Moralejo for the MAGIC collaboration |title=The MAGIC telescope for gamma-ray astronomy above 30 GeV |journal=Memorie della Societa Astronomica Italiana |month= |year=2004 |volume=75 |issue= |pages=232-9 |url=http://adsabs.harvard.edu/abs/2004MmSAI..75..232M |arxiv= |bibcode=2004MmSAI..75..232M |doi= |pmid= |accessdate=2012-07-28 }}</ref> ==Plasma objects== {{main|Plasmas/Plasma objects|Plasma objects}} "Plasma is the fourth state of matter, consisting of electrons, ions and neutral atoms, usually at temperatures above 10⁴ degrees Kelvin."<ref name=Birdsall>{{ cite book |author=CK Birdsall, A. Bruce Langdon |title=Plasma Physics via Computer Simulation |publisher=CRC Press |location=New York |date=1 October 2004 |editor= |pages=479 |url=http://books.google.com/books?hl=en&lr=&id=S2lqgDTm6a4C&oi=fnd&pg=PR13&dq=stars+%22plasma+physics%22&ots=nOPXyqtDo8&sig=-kA8YfaX6nlfFnaW3CYkATh-QPg |arxiv= |bibcode= |doi= |pmid= |isbn=9780750310253 |accessdate=17 December 2011 }}</ref> '''[P]lasma''' is a [[w:state of matter|state of matter]] similar to gas in which a certain portion of the particles are [[w:ion|ion]]ized. Heating a gas may [[w:ionization|ionize]] its molecules or atoms (reduce or increase the number of [[w:electrons|electrons]] in them), thus turning it into a plasma, which contains [[w:charge (physics)|charge]]d particles: positive [[w:ions|ions]] and negative electrons or ions.<ref name=Luo>{{ cite journal |last1=Luo |first1=Q-Z|last2=D'Angelo|first2=N|last3=Merlino|first3=R. L. | year=1998 |title=Shock formation in a negative ion plasma |journal= |volume=5 |issue=8 |publisher=Department of Physics and Astronomy |url=http://www.physics.uiowa.edu/~rmerlino/nishocks.pdf |accessdate=2011-11-20}}</ref> For plasma to exist, [[w:ionization|ionization]] is necessary. The term "plasma density" by itself usually refers to the "electron density", that is, the number of free electrons per unit volume. The [[w:degree of ionization|degree of ionization]] of a plasma is the proportion of atoms that have lost or gained electrons, and is controlled mostly by the temperature. Even a partially ionized gas in which as little as 1% of the particles are ionized can have the characteristics of a plasma (i.e., response to magnetic fields and high [[w:electrical conductivity|electrical conductivity]]). The degree of ionization, ''α'' is defined as ''α'' = ''n''_i/(''n''_i + ''n''_a) where ''n''_i is the number density of ions and ''n''_a is the number density of neutral atoms. The ''electron density'' is related to this by the average charge state <Z> of the ions through ''n''_e = <Z> ''n''_i where ''n''_e is the number density of electrons. ==Gaseous objects== {{main|Gases/Gaseous objects}} Above the photosphere visible sunlight is free to propagate into space, and its energy escapes the Sun entirely. The change in opacity is due to the decreasing amount of H⁻ ions, which absorb visible light easily.<ref name=Abhyankar1977>{{ cite journal |author=K.D. Abhyankar |title=A Survey of the Solar Atmospheric Models |year=1977 |journal=Bull. Astr. Soc. India |volume=5 |bibcode=1977BASI....5...40A |pages=40–44 |url=http://prints.iiap.res.in/handle/2248/510 }}</ref> Conversely, the visible light we see is produced as electrons react with hydrogen atoms to produce H⁻ ions.<ref name="Gibson">{{ cite book |author=E.G. Gibson |title=The Quiet Sun |publisher=NASA |date=1973 |isbn= |asin=B0006C7RS0 }}</ref><ref name="Shu">{{ cite book |last=Shu |first=F.H. |title=The Physics of Astrophysics |publisher=University Science Books |volume=1 |date=1991 |isbn=0-935702-64-4 }}</ref> The photosphere has a particle density of ~10²³&nbsp;m⁻³ (this is about 0.37% of the particle number per volume of Earth's atmosphere at sea level; however, photosphere particles are electrons and protons, so the average particle in air is 58 times as heavy). "Positrons entering a gaseous medium at [0.6 to 4.5 MeV] are quickly slowed by ionizing collisions with neutral atoms and by long-range Coulomb interactions with any ionized component."<ref name=Leising>{{ cite journal |author=M. D. Leising |author2=D. D. Clayton |title=Positron annihilation gamma rays from novae |journal=The Astrophysical Journal |month=December 1, |year=1987 |volume=323 |issue=1 |pages=159-69 |url=http://adsabs.harvard.edu/full/1987ApJ...323..159L |arxiv= |bibcode=1987ApJ...323..159L |doi=10.1086/165816 |pmid= |accessdate=2014-02-01 }}</ref> ==Rocky objects== {{main|Rocks/Rocky objects}} "Even in small solids and dust grains, energy deposition from ²⁶Al ''β''-decay, for example, injects 0.355 W kg^-1 of heat. This is sufficient to result in melting signatures, which have been used to study condensation sequences of solids in the early solar system".<ref name=Diehl/> ==Atmospheres== {{main|Radiation astronomy/Atmospheres|Atmospheric astronomy}} "The major problems associated with the balloon borne positron measurements are (i) the unique identification against a vast background of protons, and (ii) corrections for the positrons produced in the residual atmosphere."<ref name=Barbiellini>{{ cite journal |author=G. Barbiellini |author2=G. Basini |author3=R. Bellotti |author4=M. Bpcciolini |author5=M. Boezio |author6=F. Massimo Brancaccio |author7=U. Bravar |author8=F. Cafagna |author9=M. Candusso |author10=P. Carlson |author11=M. Casolino |author12=M. Castellano |author13=M. Circella |author14=A. Codino |author15=G. De Cataldo |author16=C. De Marzo |author17=M.P. De Pascale |author18=N. Finetti |author19=T. Francke |author20=N. Giglietto |author21=R.L. Golden |author22=C. Grimani |author23=M. Hof |author24=B. Marangelli |author25=W. Menn |author26=J.W. Mitchell |author27=A. Morselli |author28=J.F. Ormes |author29=P. Papini |author30=a. Perego |author31=S. Piccardi |author32=P. Picozza |author33=M. Ricci |author34=P. Schiavon |author35=M. Simon |author36=R. Sparvoli |author37=P. Spillatini |author38=P. Spinelli |author39=S.A. Stephens |author40=S.J. Stochaj |author41=R.E. Streitmatter |author42=M. Suffert |author43=A. Vacchi |author44=N. Weber |author45=N. Zampa |title=The cosmic-ray positron-to-electron ratio in the energy range 0.85 to 14 GeV |journal=Astronomy and Astrophysics |month=May |year=1996 |volume=309 |issue=05 |pages=L15-8 |url=http://adsabs.harvard.edu/abs/1996A&A...309L..15B |arxiv= |bibcode=1996A&A...309L..15B |doi= |pmid= |accessdate=2013-08-11 }}</ref> "[T]o account for the atmospheric corrections ... first [use] the instrument to determine the negative muon spectrum at float altitude. ... [Use this] spectrum ... to normalize the analytically determined atmospheric electron-positron spectra. ... most of the atmospheric electrons and positrons at small atmospheric depths are produced from muon decay at [the energies from 0.85 to 14 GeV]."<ref name=Barbiellini/> ==Meteorites== {{main|Rocks/Meteorites|Meteorites}} ²⁶Al "decays into excited ²⁶Mg by either positron decay or electron capture. In both cases, the excited magnesium isotope de-excites radatively, releasing a photon of energy 1.809 MeV."<ref name=Markwick>{{ cite journal |author=A. J. Markwick |author2=M. Ilgner |author3=T. J. Millar |author4=Th. Henning |title=Molecular distributions in the inner regions of protostellar disks |journal=Astronomy & Astrophysics |month=April |year=2002 |volume=385 |issue=04 |pages=632-46 |url=http://www.gps.caltech.edu/~gab/ge128/lectures/henning_disk.pdf |arxiv= |bibcode=2002A&A...385..632M |doi=10.1051/0004-6361:20020050 |pmid= |accessdate=2013-08-17 }}</ref> "The ²⁶Al concentration in a meteorite depends upon different [parameters] like the exposure age, the shielding conditions of the analyzed sample and the terrestrial age of the meteorite."<ref name=Altmaier/> "As ²⁶Al is a positron emitting isotope, it is possible to measure ²⁶Al in meteorites by gamma-coincidence low level counting techniques [1]. Positron annihilation radiation (due to the destructive recombination of a positron and an electron) is emitted as two simultaneous 511 keV gamma rays with 180° angle correlation. By focusing exclusively on the coincident 511 keV events, a drastic reduction of the detected radiation background is achieved, and the non-destructive determination of ²⁶Al in bulk samples of 5-50 g becomes possible."<ref name=Altmaier>{{ cite journal |author=M. Altmaier |author2=U. Herpers |title=Al-26 in 34 Stony Meteorites Measured via Gamma-gamma Coincidence Counting |journal=Meteoritics & Planetary Science Supplement |month=September |year=2001 |volume=36 |issue=09 |pages=A10 |url=http://adsabs.harvard.edu/full/2001M%26PSA..36R..10A |arxiv= |bibcode=2001M&PSA..36R..10A |doi= |pmid= |accessdate=2013-08-11 }}</ref> ==Sun== {{main|Stars/Sun|Sun (star)}} The preflare solar material is observed "to be an elevated cloud of prominence-like material which is suddenly lit up by the onslaught of hard electrons accelerated in the flare; the acceleration may be inside or outside the cloud, and brightening is seen in other areas of the solar surface on the same magnetic field lines."<ref name=Zirin78>{{ cite journal |author=Harold Zirin |title=The L-alpha/H-alpha ratio in solar flares, quasars, and the chromosphere |journal=Astrophysical Journal |month=June |year=1978 |volume=222 |issue=6 |pages=L105-7 |url= |bibcode=1978ApJ...222L.105Z |doi= 10.1086/182702 |pmid= |accessdate=2011-08-01 }}</ref> A [[w:coronal mass ejection|coronal mass ejection]] (CME) is an ejected plasma consisting primarily of electrons and [[w:proton|proton]]s. "The suprathermal electrons in the solar wind and in solar particle events have excellent properties for this application: they move rapidly, they remain tightly bound to their field lines, and they may arrive "scatter-free" even at low energies, and from deep in the solar atmosphere (Lin 1985)."<ref name=Hudson>{{ cite journal |author=H. S. Hudson |author2=A. B. Galvin |title=Correlated Studies at Activity Maximum: the Sun and the Solar Wind, In: ''Correlated Phenomena at the Sun, in the Heliosphere and in Geospace'' |publisher=European Space Agency |location=Noordwijk, The Netherlands |month=September |year=1997 |editor=A. Wilson |pages=275-82 |url= |bibcode=1997ESASP.415..275H |doi= |pmid= |isbn=92-9092-660-0 |accessdate=2011-11-25 }}</ref> ==Coronal clouds== {{main|Plasmas/Plasma objects/Coronal clouds}} [[Image:Helmet streamers at max.gif|thumb|right|250px|An abundance of helmet streamers is shown at solar maximum. Credit: NASA.{{tlx|free media}}]] [[Image:Helmet streamers at min.jpg|thumb|left|250px|Helmet streamers are shown at solar minimum restricted to mid latitudes. Credit: NASA.{{tlx|free media}}]] [[Image:Rhessi0269 web.jpg|thumb|right|250px|RHESSI observes high-energy phenomena from a solar flare. Credit: NASA/Goddard Space Flight Center Scientific Visualization Studio.{{tlx|free media}}]] '''Helmet streamers''' are bright loop-like structures which develop over active regions on the sun. They are closed magnetic loops which connect regions of opposite magnetic polarity. Electrons are captured in these loops, and cause them to glow very brightly. The solar wind elongates these loops to pointy tips. They far extend above most prominences into the [[Coronal cloud|corona]], and can be readily observed during a solar eclipse. Helmet streamers are usually confined to the "streamer belt" in the mid latitudes, and their distribution follows the movement of active regions during the [[w:solar cycle|solar cycle]]. Small blobs of plasma, or "plasmoids" are sometimes released from the tips of helmet streamers, and this is one source of the slow component of the [[w:solar wind|solar wind]]. In contrast, formations with open magnetic field lines are called [[w:coronal holes|coronal holes]], and these are darker and are a source of the fast solar wind. Helmet streamers can also create coronal mass ejections if a large volume of plasma becomes disconnected near the tip of the streamer. In the corona [[w:thermal conduction|thermal conduction]] occurs from the external hotter atmosphere towards the inner cooler layers. Responsible for the diffusion process of the heat are the electrons, which are much lighter than ions and move faster. The solar flare at Active Region 10039 on July 23, 2002, exhibits many exceptional high-energy phenomena including the 2.223 MeV neutron capture line and the 511 keV electron-positron (antimatter) annihilation line. In the image at right, the RHESSI low-energy channels (12-25 keV) are represented in red and appear predominantly in coronal loops. The high-energy flux appears as blue at the footpoints of the coronal loops. Violet is used to indicate the location and relative intensity of the 2.2 MeV emission. During solar flares “[s]everal radioactive nuclei that emit positrons are also produced; [which] slow down and annihilate in flight with the emission of two 511 keV photons or form positronium with the emission of either a three gamma continuum (each photon < 511 keV) or two 511 keV photons."<ref name=Share>{{ cite book |author=Gerald H. Share |author2=Ronald J. Murphy |title=Solar Gamma-Ray Line Spectroscopy – Physics of a Flaring Star, In: ''Stars as Suns: Activity, Evolution and Planets'' |publisher=Astronomical Society of the Pacific |location=San Francisco, CA |date=January 2004 |editor=Andrea K. Dupree |editor2=A. O. Benz |pages=133-44 |url=http://heseweb.nrl.navy.mil/gamma/solar/papers/share_iau_04.pdf |arxiv= |bibcode=2004IAUS..219..133S |doi= |pmid= |isbn=158381163X |accessdate=2012-03-15 }}</ref> The [[w:Reuven Ramaty High Energy Solar Spectroscopic Imager|Reuven Ramaty High Energy Solar Spectroscopic Imager]] (RHESSI) made the first high-resolution observation of the solar positron-electron annihilation line during the July 23, 2003 solar flare.<ref name=Share/> The observations are somewhat consistent with electron-positron annihilation in a quiet solar atmosphere via positronium as well as during flares.<ref name=Share/> Line-broadening is due to "the velocity of the positronium."<ref name=Share/> "The width of the annihilation line is also consistent ... with thermal broadening (Gaussian width of 8.1 ± 1.1 keV) in a plasma at 4-7 x 10⁵ K. ... The ''RHESSI'' and all but two of the ''SMM'' measurements are consistent with densities ≤ 10¹² H cm^-3 [but] <10% of the p and α interactions producing positrons occur at these low densities. ... positrons produced by ³He interactions form higher in the solar atmosphere ... all observations are consistent with densities > 10¹² H cm^-3. But such densities require formation of a substantial mass of atmosphere at transition region temperatures."<ref name=Share/> {{clear}} ==Solar winds== Particles such as electrons are used as tracers of cosmic magnetic fields.<ref name=Hudson>{{ cite journal |author=H. S. Hudson |author2=A. B. Galvin |title=Correlated Studies at Activity Maximum: the Sun and the Solar Wind, In: ''Correlated Phenomena at the Sun, in the Heliosphere and in Geospace'' |publisher=European Space Agency |location=Noordwijk, The Netherlands |month=September |year=1997 |editor=A. Wilson |pages=275-82 |url= |bibcode=1997ESASP.415..275H |doi= |pmid= |isbn=92-9092-660-0 |accessdate=2011-11-25 }}</ref> "From a plasma-physics point of view, the particles represent the correct way to identify magnetic field lines."<ref name=Hudson/> "The suprathermal electrons in the solar wind and in solar particle events have excellent properties for this application: they move rapidly, they remain tightly bound to their field lines, and they may arrive "scatter-free" even at low energies, and from deep in the solar atmosphere (Lin 1985)."<ref name=Hudson/> "Energetic photons, ions and electrons from the solar wind, together with galactic and extragalactic cosmic rays, constantly bombard surfaces of planets, planetary satellites, dust particles, comets and asteroids."<ref name=Madey>{{ cite journal |author=Theodore E. Madey |author2=Robert E. Johnson |author3=Thom M. Orlando |title=Far-out surface science: radiation-induced surface processes in the solar system |journal=Surface Science |month=March |year=2002 |volume=500 |issue=1-3 |pages=838-58 |url=http://www.physics.rutgers.edu/~madey/Publications/Full_Publications/PDF/madey_SS_2002.pdf |arxiv= |bibcode= |doi=10.1016/S0039-6028(01)01556-4 |pmid= |accessdate=2012-02-09 }}</ref> ==Mercury== {{main|Liquids/Liquid objects/Mercury}} Mariner 10 has aboard "one backward facing electron spectrometer (BESA). ... An electron spectrum [is] obtained every 6 s, ... within the energy range 13.4-690 eV. ... [B]y taking into account [the angular] distortion [caused by the solar wind passing the spacecraft] and the spacecraft sheath characteristics ... some of the solar wind plasma parameters such as ion bulk speed, electron temperature, and electron density [are derived]."<ref name=Williams>{{ cite book |author=David R. Williams |title=Scanning Electrostatic Analyzer and Electron Spectrometer |publisher=NASA Goddard Space Flight Center |location=Greenbelt, Maryland |date=May 14, 2012 |url=http://nssdc.gsfc.nasa.gov/nmc/experimentDisplay.do?id=1973-085A-03 |accessdate=2012-08-23 }}</ref> Mariner 10 had three encounters with Mercury on March 29, 1974, September 21, 1974, and on March 16, 1975.<ref name=Williams2>{{ cite book |author=David R. Williams |title=Mariner 10 |publisher=NASA Goddard Space Flight Center |location=Greenbelt, Maryland |date=May 14, 2012 |url=http://nssdc.gsfc.nasa.gov/nmc/spacecraftDisplay.do?id=1973-085A |accessdate=2012-08-23 }}</ref> The BESA measurements "show that the planet interacts with the solar wind to form a bow shock and a permanent magnetosphere. ... The magnetosphere of Mercury appears to be similar in shape to that of the earth but much smaller in relation to the size of the planet. The average distance from the center of Mercury to the subsolar point of the magnetopause is ∼ 1.4 planetary radii. Electron populations similar to those found in the earth’s magnetotail, within the plasma sheet and adjacent regions, were observed at Mercury; both their spatial location and the electron energy spectra within them bear qualitative and quantitative resemblance to corresponding observations at the earth."<ref name=Ogilvie>{{ cite journal |author=K. W. Ogilvie |author2=J. D. Scudder |author3=V. M. Vasyliunas |title=Observations at the Planet Mercury by the Plasma Electron Experiment: Mariner 10 |journal=Journal of Geophysical Research |month= |year=1977 |volume=82 |issue=13 |pages=1807-24 |url=http://www.agu.org/pubs/crossref/1977/JA082i013p01807.shtml |arxiv= |bibcode= |doi=10.1029/JA082i013p01807 |pmid= |accessdate=2012-08-23 }}</ref> "[T]he Mercury encounter (M I) by Mariner 10 on 29 March 1974 occurred during the height of a Jovian electron increase in the interplanetary medium."<ref name=Russell/> ==Venus== {{main|Gases/Gaseous objects/Venus}} [[Image:Venus xray 420.jpg|thumb|right|250px|This Chandra X-ray Observatory image is the first X-ray image ever made of Venus. Credit: NASA/MPE/K.Dennerl ''et al''.{{tlx|free media}}]] The first ever X-ray image of Venus is shown at right. The "half crescent is due to the relative orientation of the Sun, Earth and Venus. The X-rays from Venus are produced by fluorescent radiation from oxygen and other atoms in the atmosphere between 120 and 140 kilometers above the surface of the planet. In contrast, the optical light from Venus is caused by the reflection from clouds 50 to 70 kilometers above the surface. Solar X-rays bombard the atmosphere of Venus, knock electrons out of the inner parts of atoms, and excite the atoms to a higher energy level. The atoms almost immediately return to their lower energy state with the emission of a fluorescent X-ray. A similar process involving ultraviolet light produces the visible light from fluorescent lamps."<ref name=Dennerl >{{ cite book |author=K. Dennerl |title=Venus: Venus in a New Light |publisher=Harvard University, NASA |location=Boston, Massachusetts, USA |date=November 29, 2001 |url=http://chandra.harvard.edu/photo/2001/venus/ |accessdate=2012-11-26 }}</ref> {{clear}} ==Earth== {{main|Gases/Gaseous objects/Earth}} [[Image:Upperatmoslight1.jpg|thumb|right|250px|The composite shows upper atmospheric lightning and electrical discharge phenomena. Credit: [[c:User:Abestrobi|Abestrobi]].{{tlx|free media}}]] [[Image:Atmosphere with Ionosphere.svg|thumb|right|250px|This graph shows the relationship of the atmosphere and ionosphere to electron density. Credit: Bhamer.{{tlx|free media}}]] [[Image:Earth's_x-ray_aurora_borealis_2004_composite.jpg|thumb|250px|right|Bright X-ray arcs of low energy (0.1 - 10 keV) are generated during auroral activity. Observation dates: 10 pointings between December 16, 2003 and April 13, 2004. Instrument: HRC. Credit: NASA/MSFC/CXC/A.Bhardwaj & R.Elsner, et al.; Earth model: NASA/GSFC/L.Perkins & G.Shirah.{{tlx|free media}}]] [[Image:Earthxray polar.jpg|thumb|right|250px|This image is a composite of the first picture of the Earth in X-rays over a diagram of the Earth below. Credit: NASA, Ruth Netting.{{tlx|free media}}]] With respect to the rocky-object Earth, between the surface and various altitudes there is an [[w:electric field|electric field]] induced by the ionosphere. It changes with altitude from about 150 [[w:volt|volt]]s per [[w:meter|meter]] at the suface to lower values at higher altitude. In fair weather, it is relatively constant, in turbulent weather it is accompanied by [[w:Ion|ion]]s. At greater altitude these chemical species continue to increase in [[w:concentration|concentration]]. To dissipate the accumulation of greater charge differential between the surface and the ionosphere, the gases between suffer breakdown (ionization) that permits [[lightning]] to be either a draw of negative charge, usually electrons, upward from the surface or a transfer of positive charge to the ground. "[L]ow-altitude regions of downward electric current on auroral magnetic field lines are sites of dramatic upward magnetic field-aligned electron acceleration that generates intense magnetic field-aligned electron beams within Earth’s equatorial middle magnetosphere."<ref name=Mauk>{{ cite journal |author=Barry H. Mauk |author2=Joachim Saur |title=Equatorial electron beams and auroral structuring at Jupiter |journal=Journal of Geophysical Research |month=October 26, |year=2007 |volume=112 |issue=A10221 |pages=20 |url=http://www.igpp.ucla.edu/public/mkivelso/refs/PUBLICATIONS/Mauk2007JA012370.pdf |arxiv= |bibcode= |doi=10.1029/2007JA012370 |pmid= |accessdate=2012-06-02 }}</ref> The ionosphere is a shell of electrons and electrically charged [[w:atom|atom]]s and [[w:molecule|molecule]]s that surrounds the Earth, stretching from a height of about 50&nbsp;km to more than 1000&nbsp;km. It owes its existence primarily to [[w:ultraviolet|ultraviolet]] radiation from the [[Sun (star)|Sun]]. The images [lower right] are superimposed on a simulated image of the Earth. The color code represents brightness, maximum in red. Distance from the North pole to the black circle is {{convert|3,340|km|mi|abbr=on}}. "Auroras are produced by solar storms that eject clouds of energetic charged particles. These particles are deflected when they encounter the Earth’s magnetic field, but in the process large electric voltages are created. Electrons trapped in the Earth’s magnetic field are accelerated by these voltages and spiral along the magnetic field into the polar regions. There they collide with atoms high in the atmosphere and emit X-rays".<ref name=Bhardwaj>{{ cite book |author=A. Bhardwaj |author2=R. Elsner |title=Earth Aurora: Chandra Looks Back At Earth |publisher=Harvard-Smithsonian Center for Astrophysics |location=Cambridge, Massachusetts, USA |date=February 20, 2009 |url=http://chandra.harvard.edu/photo/2005/earth/ |accessdate=2013-05-10 }}</ref> At right is a composite image which contains the first picture of the Earth in X-rays, taken in March, 1996, with the orbiting [[w:Polar (satellite)|Polar]] satellite. The area of brightest X-ray emission is red. Energetic charged particles from the Sun energize electrons in the Earth's magnetosphere. These electrons move along the Earth's magnetic field and eventually strike the ionosphere, causing the X-ray emission. Lightning strikes or bolts across the sky also emit X-rays.<ref name=Newitz>Newitz, A. (2007) ''Educated Destruction 101''. Popular Science magazine, September. pg. 61.</ref> “One approach for characterizing the sky distribution of positron annihilation radiation is to fit to the data parameterized (and idealized) model distributions, representing the Galactic bulge, halo, and disk.”<ref name=Weidenspointner/> “Two scenarios for the Galactic dsitribution of 511 keV line emission that remain viable after more than 4 years of observations with SPI [are] # bulge + thick disk (BD) and # halo + thin disk (HD).”<ref name=Weidenspointner/> In 2009, the Fermi Gamma Ray Telescope in Earth orbit observed [an] intense burst of gamma rays corresponding to positron annihilations coming out of a storm formation. Scientists wouldn't have been surprised to see a few positrons accompanying any intense gamma ray burst, but the lightning flash detected by Fermi appeared to have produced about 100 trillion positrons. This has been reported by media in January 2011, it is an effect, never considered to happen before.<ref>http://news.nationalgeographic.com/news/2011/01/110111-thunderstorms-antimatter-beams-fermi-radiation-science-space/</ref> "The Gamma-ray Burst Monitor (GBM) detects sudden flares of gamma-rays produced by gamma ray bursts and solar flares. Its scintillators are on the sides of the spacecraft to view all of the sky which is not blocked by the earth. The design is optimized for good resolution in time and photon energy. The Gamma-ray Burst Monitor has detected gamma rays from positrons generated in powerful thunderstorms.<ref name=Glast>http://www.nasa.gov/mission_pages/GLAST/news/fermi-thunderstorms.html</ref> {{clear}} ==Van Allen radiation belts== The '''Van Allen radiation belt''' is split into two distinct belts, with energetic electrons forming the outer belt and a combination of protons and electrons forming the inner belts. In addition, the radiation belts contain lesser amounts of other nuclei, such as [[w:alpha particle|alpha particle]]s. The large outer radiation belt extends from an altitude of about three to ten Earth radii (''R_E'') or 13,000 to 60,000 kilometres above the Earth's surface. Its greatest intensity is usually around 4–5 ''R_E''. The outer electron radiation belt is mostly produced by the inward radial diffusion<ref name=Elkington>{{ cite book | author=Elkington, S. R. |author2=Hudson, M. K. |author3=Chan, A. A. | title=Enhanced Radial Diffusion of Outer Zone Electrons in an Asymmetric Geomagnetic Field | publisher=American Geophysical Union | date=May 2001 | bibcode=2001AGUSM..SM32C04E }}</ref><ref name=Shprits>{{ cite journal | author=Shprits, Y. Y. |author2=Thorne, R. M. | title=Time dependent radial diffusion modeling of relativistic electrons with realistic loss rates | journal=Geophysical Research Letters | volume=31 | issue=8 | doi=10.1029/2004GL019591 | year=2004 | pages=L08805 | bibcode=2004GeoRL..3108805S }}</ref> and local acceleration<ref name=Horne>{{ cite journal | author=Horne, Richard B. |author2=Thorne, Richard M. ''et al'' | title=Wave acceleration of electrons in the Van Allen radiation belts | journal=Nature | volume=437 | issue=7056 | pages=227&ndash;230 | year=2005 | doi=10.1038/nature03939 | pmid=16148927 |bibcode = 2005Natur.437..227H }}</ref> due to transfer of energy from whistler mode [[w:plasma waves|plasma waves]] to radiation belt electrons. Radiation belt electrons are also constantly removed by collisions with atmospheric neutrals,<ref name=Horne/> losses to [[w:magnetopause|magnetopause]], and the outward radial diffusion. The outer belt consists mainly of high energy (0.1–10 MeV) electrons trapped by the Earth's [[w:magnetosphere|magnetosphere]]. The [[w:gyroradius|gyroradii]] for energetic protons would be large enough to bring them into contact with the Earth's atmosphere. The electrons here have a high [[w:flux|flux]] and at the outer edge (close to the magnetopause), where [[w:geomagnetic field|geomagnetic field]] lines open into the geomagnetic "tail", fluxes of energetic electrons can drop to the low interplanetary levels within about 100&nbsp;km (a decrease by a factor of 1,000). ==Moon== {{main|Liquids/Liquid objects/Moon}} [[Image:Moon ER magnetic field.jpg|thumb|right|250px|These two hemispheric Lambert azimuthal equal area projections show the total magnetic field strength at the surface of the Moon, derived from the Lunar Prospector electron reflectometer (ER) experiment. Credit: Mark A. Wieczorek.{{tlx|free media}}]] [[Image:Moon-Mdf-2005.jpg|thumb|left|250px|The '''Moon''' where a prediction of a lunar double layer<ref>Borisov, N.; Mall, U. "[http://adsabs.harvard.edu/cgi-bin/nph-bib_query?bibcode=2002JPlPh..67..277B&db_key=PHY&data_type=HTML&format=&high=42ca922c9c05280 The structure of the double layer behind the Moon]" (2002) ''Journal of Plasma Physics'', vol. 67, Issue 04, pp. 277&ndash;299</ref> was confirmed in 2003.<ref>Halekas, J. S.; Lin, R. P.; Mitchell, D. L. "[http://adsabs.harvard.edu/cgi-bin/nph-bib_query?bibcode=2003GeoRL..30uPLA1H&db_key=AST&data_type=HTML&format=&high=42ca922c9c27734 Inferring the scale height of the lunar nightside double layer]" (2003) ''Geophysical Research Letters'', Volume 30, Issue 21, pp. PLA 1-1. ([http://sprg.ssl.berkeley.edu/adminstuff/webpubs/2003_grl_2117.pdf PDF])</ref> In the shadows, the Moon charges negatively in the interplanetary medium.<ref>Halekas, J. S ''et al.'' "[http://adsabs.harvard.edu/cgi-bin/nph-bib_query?bibcode=2002GeoRL..29j..77H&amp;db_key=AST&amp;data_type=HTML&amp;format=&amp;high=42ca922c9c05119 Evidence for negative charging of the lunar surface in shadow]" (2002) ''Geophysical Research Letters'', Volume 29, Issue 10, pp. 77&ndash;81</ref> Credit: [[w:User:Mdf|Mdf]].{{tlx|free media}}]] The electron reflectometer (ER) aboard the Lunar Prospector determines the location and strength of magnetic fields from the [[w:energy spectrum|energy spectrum]] and direction of [[w:electron|electron]]s. The instrument measures the pitch [[w:angle|angle]]s of [[w:solar wind|solar wind]] electrons reflected from the Moon by lunar magnetic fields. Stronger local magnetic fields can reflect electrons with larger pitch angles. [[w:Field strength|Field strength]]s as small as 0.01 [nanotesla] [[w:nanotesla|nT]] could be measured with a spatial accuracy of about 3 km (1.9 mi) at the lunar surface. "[T]he shadowed lunar surface charges negative."<ref name=Halekas>{{ cite journal |author=J. S. Halekas |author2=R. P. Lin |author3=D. L. Mitchell |title=Inferring the scale height of the lunar nightside double layer |journal=Geophysical Research Letters |month=November |year=2003 |volume=30 |issue=21 |pages=4 |url= |arxiv= |bibcode=2003GeoRL..30uPLA1H |doi=10.1029/2003GL018421 |pmid= |accessdate=2012-11-16 }}</ref> {{clear}} ==Mars== {{main|Liquids/Liquid objects/Mars}} "[L]uminescence dating techniques [may] provide absolute age determinations of eolian sediments on the surface of Mars, including those incorporated in the martian polar ice caps. Fundamental thermally and optically stimulated luminescence properties of bulk samples of JSC Mars-1 soil simulant [have been studied]. The radiation-induced luminescence signals (both thermoluminescence, TL, and optically stimulated luminescence, OSL) from JSC Mars-1 are found to have a wide dynamic dose–response range, with the luminescence increasing linearly to the highest doses used (936 Gy), following irradiation with ⁹⁰Sr/⁹⁰Y beta particles."<ref name=Lepper>{{ cite journal |author=Kenneth Lepper |author2=Stephen W.S. McKeever |title=Characterization of Fundamental Luminescence Properties of the Mars Soil Simulant JSC Mars-1 and Their Relevance to Absolute Dating of Martian Eolian Sediments |journal=Icarus |month=April |year=2000 |volume=144 |issue=2 |pages=295–301 |url=http://www.sciencedirect.com/science/article/pii/S0019103599962954 |arxiv= |bibcode= |doi=10.1006/icar.1999.6295 |pmid= |accessdate=2014-09-21 }}</ref> ==Jupiter== {{main|Jupiter}} [[Image:Jupiter magnetosphere schematic.jpg|thumb|right|250px|This is a schematic of Jupiter's magnetosphere and the components influenced by Io (near the center of the image). Credit: John Spencer.{{tlx|free media}}]] The image at right represents "[t]he Jovian magnetosphere [magnetic field lines in blue], including the Io flux tube [in green], Jovian aurorae, the sodium cloud [in yellow], and sulfur torus [in red]."<ref name=Spencer>{{ cite book |author=John Spencer |title=John Spencer's Astronomical Visualizations |publisher=University of Colorado |location=Boulder, Colorado USA |date=November 2000 |url=http://www.boulder.swri.edu/~spencer/digipics.html |accessdate=2013-04-05 }}</ref> "Io may be considered to be a unipolar generator which develops an emf [electromotive force] of 7 x 10⁵ volts across its radial diameter (as seen from a coordinate frame fixed to Jupiter)."<ref name=Goldreich>{{ cite journal |author=Peter Goldreich |author2=Donald Lynden-Bell |title=Io, a jovian unipolar inductor |journal=The Astrophysical Journal |month=April |year=1969 |volume=156 |issue=04 |pages=59-78 |url= |arxiv= |bibcode=1969ApJ...156...59G |doi=10.1086/149947 |pmid= |accessdate=2013-04-05 }}</ref> "This voltage difference is transmitted along the magnetic flux tube which passes through Io. ... The current [in the flux tube] must be carried by keV electrons which are electrostatically accelerated at Io and at the top of Jupiter's ionosphere."<ref name=Goldreich/> "Io's high density (4.1 g cm^-3) suggests a silicate composition. A reasonable guess for its electrical conductivity might be the conductivity of the Earth's upper mantle, 5 x 10^-5 ohm^-1 cm^-1 (Bullard 1967)."<ref name=Goldreich/> As "a conducting body [transverses] a magnetic field [it] produces an induced electric field. ... The Jupiter-Io system ... operates as a unipolar inductor" ... Such unipolar inductors may be driven by electrical power, develop hotspots, and the "source of heating [may be] sufficient to account for the observed X-ray luminosity".<ref name=Wu>{{ cite journal |author=Kinwah Wu |author2=Mark Cropper |author3=Gavin Ramsay |author4=Kazuhiro Sekiguchi |title=An electrically powered binary star? |journal=Monthly Notices of the Royal Astronomical Society |month=March |year=2002 |volume=321 |issue=1 |pages=221-7 |url= |arxiv=astro-ph/0111358 |bibcode=2002MNRAS.331..221W |doi=10.1046/j.1365-8711.2002.05190.x |pmid= |accessdate=2013-04-05 }}</ref> "The electrical surroundings of Io provide another energy source which has been estimated to be comparable with that of the [gravitational] tides (7). A current of 5 x 10⁶ A is ... shunted across flux tubes of the Jovian field by the presence of Io (7-9)."<ref name=Gold>{{ cite journal |author=Thomas Gold |title=Electrical Origin of the Outbursts on Io |journal=Science |month=November |year=1979 |volume=206 |issue=4422 |pages=1071-3 |url= |arxiv= |bibcode=1979Sci...206.1071G |doi=10.1126/science.206.4422.1071 |pmid= |accessdate=2013-04-05 }}</ref> "[W]hen the currents [through Io] are large enough to cause ohmic heating ... currents ... contract down to narrow paths which can be kept hot, and along which the conductivity is high. Tidal heating [ensures] that the interior of Io has a very low eletrical resistance, causing a negligible extra amount of heat to be deposited by this current. ... [T]he outermost layers, kept cool by radiation into space [present] a large resistance and [result in] a concentration of the current into hotspots ... rock resistivity [and] contact resistance ... contribute to generate high temperatures on the surface. [These are the] conditions of electric arcs [that can produce] temperatures up to ionization levels ... several thousand kelvins".<ref name=Gold/> "[T]he outbursts ... seen [on the surface may also be] the result of the large current ... flowing in and out of the domain of Io ... Most current spots are likely to be volcanic calderas, either provided by tectonic events within Io or generated by the current heating itself. ... [A]s in any electric arc, very high temperatures are generated, and the locally evaporated materials ... are ... turned into gas hot enough to expand at a speed of 1 km/s."<ref name=Gold/> "Field-aligned equatorial electron beams [have been] observed within Jupiter’s middle magnetosphere. ... the Jupiter equatorial electron beams are spatially and/or temporally structured (down to <20 km at auroral altitudes, or less than several minutes), with regions of intense beams intermixed with regions absent of such beams."<ref name=Mauk/> "Jovian electrons, both at Jupiter and in the interplanetary medium near Earth, have a very hard spectrum that varies as a power law with energy (see, e.g., Mewaldt et al. 1976). This spectral character is sufficiently distinct from the much softer solar and magnetospheric electron spectra that it has been used as a spectral filter to separate Jovian electrons from other sources ... A second Jovian electron characteristic is that such electrons in the interplanetary medium tend to consist of flux increases of several days duration which recur with 27 day periodicities ... A third feature of Jovian electrons at 1 AU is that the flux increases exhibit a long-term modulation of 13 months which is the synodic period of Jupiter as viewed from Earth".<ref name=Russell>{{ cite book |author=C. T. Russell |author2=D. N. Baker |author3=J. A. Slavin |title=The Magnetosphere of Mercury, In: ''Mercury'' |publisher=University of Arizona Press |location=Tucson, Arizona, United States of America |date=January 1, 1988 |editor=Faith Vilas |editor2=Clark R. Chapman |editor3=Mildred Shapley Matthews |pages=514-61 |url=http://www-ssc.igpp.ucla.edu/personnel/russell/papers/magMercury.pdf |arxiv= |bibcode=1988merc.book..514R |doi= |isbn=0816510857 |pmid= |accessdate=2012-08-23 }}</ref> Jovian electrons propagate "along the spiral magnetic field of the interplanetary medium [from Jupiter and its magnetosphere to the Sun]".<ref name=Russell/> {{clear}} ==Callisto== {{main|Rocks/Rocky objects/Callisto}} [[Image:Callisto.jpg|thumb|right|250px|This image of Callisto from NASA's Galileo spacecraft, taken in May 2001, is the only complete global color image of Callisto obtained by Galileo. Credit: NASA/JPL/DLR(German Aerospace Center).{{tlx|free media}}]] At right is a complete global color image of Callisto. Bright scars on a darker surface testify to a long history of impacts on Jupiter's moon Callisto. The picture, taken in May 2001, is the only complete global color image of Callisto obtained by Galileo, which has been orbiting Jupiter since December 1995. Of Jupiter's four largest moons, Callisto orbits farthest from the giant planet. Callisto's surface is uniformly cratered but is not uniform in color or brightness. Scientists believe the brighter areas are mainly ice and the darker areas are highly eroded, ice-poor material. Callisto's ionosphere was first detected during ''Galileo'' flybys;<ref name="Kliore 2002">{{ cite journal |author=A. J. Kliore |author2=A. Anabtawi |author3=R. G. Herrera |author4=''et al.'' |title=Ionosphere of Callisto from Galileo radio occultation observations |journal=Journal of Geophysics Research |year=2002 |volume=107 |issue=A11 |page=1407 |doi=10.1029/2002JA009365 | bibcode=2002JGRA.107kSIA19K }}</ref> its high electron density of 7&ndash;17 x 10⁴&nbsp;cm^&minus;3 cannot be explained by the photoionization of the atmospheric [[w:carbon dioxide|carbon dioxide]] alone. {{clear}} ==Saturn== {{main|Gases/Gaseous objects/Saturn}} "[M]agnetospheric electron (bi-directional) beams connect to the expected locations of Saturn’s aurora".<ref name=Saur>{{ cite journal |author=J. Saur |author2=B.H. Mauk |author3=D.G. Mitchell |author4=N. Krupp |author5=K.K. Khurana |author6=S. Livi |author7=S.M. Krimigis |author8=P.T. Newell |author9=D.J. Williams |author10=P.C. Brandt |author11=A. Lagg |author12=E. Roussos |author13=M.K. Dougherty |title=Anti-planetward auroral electron beams at Saturn |journal=Nature |month=February |year=2006 |volume=439 |issue=7077 |pages=699-702 |url= |arxiv= |bibcode=2006Natur.439..699S |doi=10.1038/nature04401 |pmid= |accessdate=2012-06-02 }}</ref> Powered by the Saturnian equivalent of (filamentary) Birkeland currents, streams of charged particles from the interplanetary medium interact with the planet's magnetic field and funnel down to the poles.<ref name=Isbell>Isbell, J.; Dessler, A. J.; Waite, J. H. "[http://adsabs.harvard.edu/cgi-bin/nph-bib_query?bibcode=1984JGR....8910715I&amp;db_key=PHY&amp;data_type=HTML&amp;format=&amp;high=42ca922c9c16745 Magnetospheric energization by interaction between planetary spin and the solar wind]" (1984) ''Journal of Geophysical Research'', Volume 89, Issue A12, pp. 10715&ndash;10722</ref> Double layers are associated with (filamentary) currents,<ref name=Theisen>Theisen, William L. "[http://adsabs.harvard.edu/cgi-bin/nph-bib_query?bibcode=1994PhDT........19T&amp;db_key=AST&amp;data_type=HTML&amp;format=&amp;high=42ca922c9c05019 Langmuir Bursts and Filamentary Double Layers in Plasmas.]" (1994) Ph.D Thesis U. of Iowa, 1994</ref><ref name=Deverapalli>Deverapalli, C. M.; Singh, N.; Khazanov, I. "[http://adsabs.harvard.edu/cgi-bin/nph-bib_query?bibcode=2005AGUFMSM41C1202D&amp;db_key=AST&amp;data_type=HTML&amp;format=&amp;high=42ca922c9c05019 Filamentary Structures in U-Shaped Double Layers]" (2005) American Geophysical Union, Fall Meeting 2005, abstract #SM41C-1202</ref> and their electric fields accelerate ions and electrons.<ref name=Borovsky>Borovsky, Joseph E. "[http://adsabs.harvard.edu/cgi-bin/nph-bib_query?bibcode=1992PhRvL..69.1054B&amp;db_key=PHY&amp;data_type=HTML&amp;format=&amp;high=42ca922c9c27309 Double layers do accelerate particles in the auroral zone]" (1992) ''Physical Review Letters'' (ISSN 0031-9007), vol. 69, no. 7, Aug. 17, 1992, pp. 1054&ndash;1056</ref> ==Heliospheres== {{main|Stars/Sun/Heliospheres}} These electrons "provide remote-sensing observations of distant targets in the heliosphere - the Sun, the Moon, Jupiter, and various heliospheric structures."<ref name=Hudson/> ==Interstellars== {{main|Interstellar medium}} As of December 5, 2011, "Voyager 1 is about ... 18 billion kilometers ... from the [S]un [but] the direction of the magnetic field lines has not changed, indicating Voyager is still within the heliosphere ... the outward speed of the solar wind had diminished to zero in April 2010 ... inward pressure from interstellar space is compacting [the magnetic field] ... Voyager has detected a 100-fold increase in the intensity of high-energy electrons from elsewhere in the galaxy diffusing into our solar system from outside ... [while] the [solar] wind even blows back at us."<ref name=SteveCole>{{ cite book |author=Steve Cole |author2=Jia-Rui C. Cook |author3=Alan Buis |title=NASA's Voyager Hits New Region at Solar System Edge |publisher=NASA |location=Washington, DC |date=December 2011 |url=http://www.nasa.gov/home/hqnews/2011/dec/HQ_11-402_AGU_Voyager.html |accessdate=2012-02-09 }}</ref> "In the first 18 months of operations, AMS-02 [image under Cherenkov detectors] recorded 6.8 million positron (an antimatter particle with the mass of an electron but a positive charge) and electron events produced from cosmic ray collisions with the interstellar medium in the energy range between 0.5 giga-electron volt (GeV) and 350 GeV. These events were used to determine the positron fraction, the ratio of positrons to the total number of electrons and positrons. Below 10 GeV, the positron fraction decreased with increasing energy, as expected. However, the positron fraction increased steadily from 10 GeV to 250 GeV. This increase, seen previously though less precisely by instruments such as the Payload for Matter/antimatter Exploration and Light-nuclei Astrophysics (PAMELA) and the Fermi Gamma-ray Space Telescope, conflicts with the predicted decrease of the positron fraction and indicates the existence of a currently unidentified source of positrons, such as pulsars or the annihilation of dark matter particles. Furthermore, researchers observed an unexpected decrease in slope from 20 GeV to 250 GeV. The measured positron to electron ratio is isotropic, the same in all directions."<ref name=Ting>{{ cite book |author=Samuel Ting |author2=Manuel Aguilar-Benitez |author3=Silvie Rosier |author4=Roberto Battiston |author5=Shih-Chang Lee |author6=Stefan Schael |author7=Martin Pohl |title=Alpha Magnetic Spectrometer - 02 (AMS-02) |publisher=NASA |location=Washington, DC USA |date=April 13, 2013 |url=http://www.nasa.gov/mission_pages/station/research/experiments/742.html |accessdate=2013-05-17 }}</ref> ==X-ray novas== "The day after its discovery by the Watch instrument, the X-ray nova GRS 1124-684 in Musca was detected by the soft γ-ray telescope SIGMA at the limit of its field of view. [...] an emission feature around 500 keV in the source spectrum during one postflare observation [...] is [the] first clear evidence of γ-ray line emission from soft X-ray transients, and, [is] interpreted as a positron annihilation line".<ref name=Goldwurm>{{ cite journal |author=A. Goldwurm |author2=J. Ballet |author3=B. Cordier |author4=J. Paul |author5=L. Bouchet |author6=J. P. Roques |author7=D. Barret |author8=P. Mandrou |author9=R. Sunyaev |author10=E. Churazov |author11=M. Gilfanov |author12=A. Dyachkov |author13=N. Khavenson |author14=V. Kotunenko |author15=R. Kremnev |author16=K. Sukhanov |title=Sigma/GRANAT soft gamma-ray observations of the X-ray nova in Musca - Discovery of positron annihilation emission line |journal=The Astrophysical Journal |month=April 20, |year=1992 |volume=389 |issue=04 |pages=L79-82 |url=http://adsabs.harvard.edu/full/1992ApJ...389L..79G |arxiv= |bibcode=1992ApJ...389L..79G |doi=10.1086/186353 |pmid= |accessdate=2014-01-30 }}</ref> ==Cygnus X-1== In "a 10 keV to 1 MeV X-ray spectrum of Cyg X-1 in its low state, accumulated over ≡3 months in 1977 and 1978. The spectrum is smooth up to 300 keV. The excess at higher energy may be interpreted as a broad 511 keV emission line from the annihilation of positrons."<ref name=Nolan>{{ cite journal |author=P. L. Nolan |author2=J. L. Matteson |title=A feature in the X-ray spectrum of Cygnus X-1 - A possible positron annihilation line |journal=The Astrophysical Journal |month=February 1, |year=1983 |volume=265 |issue=02 |pages=389-92 |url=http://adsabs.harvard.edu/abs/1983ApJ...265..389N |arxiv= |bibcode=1983ApJ...265..389N |doi=10.1086/160683 |pmid= |accessdate=2014-01-30 }}</ref> ==Galactic center== On November 25, 1970, from Paraná, Argentina, latitude 32° S, "[a] balloon-altitude observation was conducted ... of the galactic-center region, at energies between 23 and 930 keV. ... evidence for a spectral feature at 0.5 MeV is [detected]."<ref name=Johnson>{{ cite journal |author=W. N. Johnson III |author2=F. R. Harnden Jr. |author3=R. C. Haymes |title=The Spectrum of Low-Energy Gamma Radiation from the Galactic-Center Region |journal=The Astrophysical Journal |month=February 15, |year=1972 |volume=172 |issue=2 |pages=L1-7 |url= |arxiv= |bibcode=1972ApJ...172L...1J |doi=10.1086/180878 |pmid= |accessdate=2012-03-15 }}</ref> The radiation detected over about 300 to 10³ keV fit a power law of : ''N''(''E'') = (10.5 ± 2.2) ''E''^{-(2.37±0.05)} photons cm^-2 s^-1 keV^-1.<ref name=Johnson/> The 0.5 MeV peak is broad at 473 ± 30 keV and "is consistent with a single γ-ray spectral line [of flux] (1.8 ± 0.5) x 10^-3 photons cm^-2 s^-1 keV^-1 at the top of the [[w:Earth's atmosphere|Earth's atmosphere]] ... Gamma-ray lines in the 0.5-MeV energy region may arise from either the annihilation of positrons or from the de-excitation of nuclei. However, it seems likely, on the basis of evidence presented herein, that the energy of the peak is not at 0.511 MeV (unless the radiation is redshifted by ~0.07 in energy)."<ref name=Johnson/>. More recent measurements from 1979 through 2003 with germanium detectors observed the peak at 511 keV.<ref name=Jean>{{ cite journal |author=P. Jean |author2=J. Knödlseder |author3=V. Lonjou |author4=M. Allain |author5=J.-P. Roques |author6=G.K. Skinner |author7=B.J. Teegarden |author8=G. Vedrenne |author9=P. von Ballmoos |author10=B. Cordier |author11=R. Diehl |author12=Ph. Durouchoux |author13=P. Mandrou |author14=J. Matteson |author15=N. Gehrels |author16=V. Schönfelder |author17=A.W. Strong |author18=P. Ubertini |author19=G. Weidenspointner |author20=C. Winkler |title=Early SPI/INTEGRAL measurements of 511 keV line emission from the 4th quadrant of the Galaxy |journal=Astronomy & Astrophysics |month=August |year=2003 |volume=407 |issue=8 |pages=L55-8 |url=http://arxiv.org/pdf/astro-ph/0309484 |arxiv= |bibcode=2003A&A...407L..55J |doi=10.1051/0004-6361:20031056 |pmid= |accessdate=2012-03-15 }}</ref> "[A] single point source is inconsistent with the data. Formally, we cannot exclude the possibility that the emission originates in at least 2 point sources."<ref name=Jean/> ==Seyfert 1 coronas== "On the basis of spectroscopic observations, the leading models of the X-ray continuum production are based on a hot, Comptonizing electron or electron-positron pair corona close to the black hole."<ref name=Markowitz>{{ cite journal |author=A. Markowitz |author2=R. Edelson |title=An expanded Rossi X-ray timing explorer survey of X-ray variability in Seyfert 1 galaxies |journal=The Astrophysical Journal |month=December 20, |year=2004 |volume=617 |issue=2 |pages=939-65 |url=http://iopscience.iop.org/0004-637X/617/2/939 |arxiv=astro-ph/0409045 |bibcode=2004ApJ...617..939M |doi=10.1086/425559 |pmid= |accessdate=2013-07-07 }}</ref> ==Geography== "The Earth’s magnetic field significantly affects the CR distribution in near-Earth space. At energies below 10 GeV, a significant fraction of the incoming particles are deflected back to interplanetary space by the magnetic field (“geomagnetic cutoff”). The exact value of the geomagnetic cutoff rigidity depends on the detector position and viewing angle. In addition to the geomagnetic cutoff effect, the Earth blocks trajectories for particles of certain rigidities and directions while allowing other trajectories. This results in a different rate of CRs from the east than the west (the “east-west effect”) [24–26]."<ref name=Ackermann/> "Positive charges propagating toward the east are curved outward, while negative charges are curved inward toward the Earth [...] This results in a region of particle directions from which positrons can arrive, while electrons are blocked by the Earth. At each particle rigidity there is a region to the west from which positrons are allowed and electrons are forbidden. There is a corresponding region to the east from which electrons are allowed and positrons are forbidden. The precise size and shape of these regions depend on the particle rigidity and instrument location."<ref name=Ackermann/> ==Technology== {{main|Technology}} "The GAMMA-400 space observatory will provide precise measurements of gamma rays, electrons, and positrons in the energy range 0.1–3000 GeV."<ref name=Galper>{{ cite journal |author=A. M. Galper |author2=R. L. Aptekar |author3=I. V. Arkhangelskaya |author4=M. Boezio |author5=V. Bonvicini |author6=B. A. Dolgoshein |author7=M. O. Farber |author8=M. I. Fradkin |author9=V. Ya. Gecha |author10=V. A. Kachanov |author11=V. A. Kaplin |author12=E. P. Mazets |author13=A. L. Menshenin |author14=P. Picozza |author15=O. F. Prilutskii |author16=V. G. Rodin |author17=M. F. Runtso |author18=P. Spillantini |author19=S. I. Suchkov |author20=N. P. Topchiev |author21=A. Vacchi |author22=Yu. T. Yurkin |author23=N. Zampa |author24=V. G. Zverev |title=The possibilities of simultaneous detection of gamma rays, cosmic-ray electrons and positrons on the GAMMA-400 space observatory |journal=Astrophysics and Space Sciences Transactions |month= |year=2011 |volume=7 |issue= |pages=75-8 |url=http://www.astrophys-space-sci-trans.net/7/75/2011/astra-7-75-2011.html |arxiv= |bibcode= |doi=10.5194/astra-7-75-2011 |pmid= |accessdate=2013-12-10 }}</ref> ==Balloons== {{main|Radiation astronomy/Balloons}} Measurements "of the cosmic-ray positron fraction as a function of energy have been made using the High-Energy Antimatter Telescope (HEAT) balloon-borne instrument."<ref name=Barwick/> "The first flight took place from Fort Sumner, New Mexico, [on May 3, 1994, with a total time at float altitude of 29.5 hr and a mean atmospheric overburden of 5.7 g cm^-2] ... The second flight [is] from Lynn Lake, Manitoba, [on August 23, 1995, with a total time at float altitude of 26 hr, and a mean atmospheric overburden of 4.8 g cm^-2]"<ref name=Barwick/>. ==Fermi Gamma-ray Space Telescope== [[Image:GLAST on the payload attach fitting.jpg|thumb|right|250px|The Fermi Gamma-ray Space Telescope sits on its payload attachment fitting. Credit: NASA/Kim Shiflett.{{tlx|free media}}]] "The Large Area Telescope (LAT) is a pair-conversion gamma-ray telescope onboard the Fermi Gamma-ray Space Telescope satellite. It has been used to measure the combined [cosmic-ray] CR electron and positron spectrum from 7 GeV to 1 TeV [20, 21]. The LAT does not have a magnet for charge separation. However, as pioneered by [22] and [23], the geomagnetic field can also be used to separate the two species without an onboard magnet. Müller and Tang [23] used the difference in geomagnetic cutoff for positrons and electrons from the east and west to determine the positron fraction between 10 GeV and 20 GeV. As reported below, we used the shadow imposed by the Earth and its offset direction for electrons and positrons due to the geomagnetic field, to separately measure the spectra of CR electrons and positrons from 20 GeV to 200 GeV. In this energy range, the 68% containment radius of the LAT point-spread function is 0.1° or better and the energy resolution is 8% or better."<ref name=Ackermann>{{ cite journal |author=M. Ackermann |author2=M. Ajello |author3=A. Allafort |author4=W. B. Atwood |author5=L. Baldini |author6=G. Barbiellini |author7=D. Bastieri |author8=K. Bechtol |author9=R. Bellazzini |author10=B. Berenji |author11=R. D. Blandford |author12=E. D. Bloom |author13=E. Bonamente |author14=A. W. Borgland |author15=A. Bouvier |author16=J. Bregeon |author17=M. Brigida |author18=P. Bruel |author19=R. Buehler |author20=S. Buson |author21=G. A. Caliandro |author22=R. A. Cameron |author23=P. A. Caraveo |author24=J. M. Casandjian |author25=C. Cecchi |author26=E. Charles |author27=A. Chekhtman |author28=C. C. Cheung |author29=J. Chiang |author30=S. Ciprini |author31=R. Claus |author32=J. Cohen-Tanugi |author33=J. Conrad |author34=S. Cutini |author35=A. de Angelis |author36=F. de Palma |author37=C. D. Dermer |author38=S. W. Digel |author39=E. do Couto e Silva |author40=P. S. Drell |author41=A. Drlica-Wagner |author42=C. Favuzzi |author43=S. J. Fegan |author44=E. C. Ferrara |author45=W. B. Focke |author46=P. Fortin |author47=Y. Fukazawa |author48=S. Funk |author49=P. Fusco |author50=F. Gargano |author51=D. Gasparrini |author52=S. Germani |author53=N. Giglietto |author54=P. Giommi |author55=F. Giordano |author56=M. Giroletti |author57=T. Glanzman |author58=G. Godfrey |author59=I. A. Grenier |author60=J. E. Grove |author61=S. Guiriec |author62=M. Gustafsson |author63=D. Hadasch |author64=A. K. Harding |author65=M. Hayashida |author66=R. E. Hughes |author67=G. Jóhannesson |author68=A. S. Johnson |author69=T. Kamae |author70=H. Katagiri |author71=J. Kataoka |author72=J. Knǒdlseder |author73=M. Kuss |author74=J. Lande |author75=L. Latronico |author76=M. Lemoine-Goumard |author77=M. Llena Garde |author78=F. Longo |author79=F. Loparco |author80=M. N. Lovellette |author81=P. Lubrano |author82=G. M. Madejski |author83=M. N. Mazziotta |author84=J. E. McEnery |author85=P. F. Michelson |author86=W. Mitthumsiri |author87=T. Mizuno |author88=A. A. Moiseev |author89=C. Monte |author90=M. E. Monzani |author91=A. Morselli |author92=I. V. Moskalenko |author93=S. Murgia |author94=T. Nakamori |author95=P. L. Nolan |author96=J. P. Norris |author97=E. Nuss |author98=M. Ohno |author99=T. Ohsugi |author100=A. Okumura |author101=N. Omodei |author102=E. Orlando |author103=J. F. Ormes |author104=M. Ozaki |author105=D. Paneque |author106=D. Parent |author107=M. Pesce-Rollins |author108=M. Pierbattista |author109=F. Piron |author110=G. Pivato |author111=T. A. Porter |author112=S. Rainò |author113=R. Rando |author114=M. Razzano |author115=S. Razzaque |author116=A. Reimer |author117=O. Reimer |author118=T. Reposeur |author119=S. Ritz |author120=R. W. Romani |author121=M. Roth |author122=H. F.-W. Sadrozinski |author123=C. Sbarra |author124=T. L. Schalk |author125=C. Sgrò |author126=E. J. Siskind |author127=G. Spandre |author128=P. Spinelli |author129=A. W. Strong |author130=H. Takahashi |author131=T. Takahashi |author132=T. Tanaka |author133=J. G. Thayer |author134=J. B. Thayer |author135=L. Tibaldo |author136=M. Tinivella |author137=D. F. Torres |author138=G. Tosti |author139=E. Troja |author140=Y. Uchiyama |author141=T. L. Usher |author142=J. Vandenbroucke |author143=V. Vasileiou |author144=G. Vianello |author145=V. Vitale |author146=A. P. Waite |author147=B. L. Winer |author148=K. S. Wood |author149=M. Wood |author150=Z. Yang |author151=S. Zimmer |title=Measurement of separate cosmic-ray electron and positron spectra with the Fermi Large Area Telescope |journal=Physical Review Letters |month= |year=2012 |volume=108 |issue=1 |pages=e011103 |url=http://prl.aps.org/abstract/PRL/v108/i1/e011103 |arxiv= |bibcode= |doi= |pmid= |accessdate=2014-01-31 }}</ref> "The Large Area Telescope (LAT) detects individual gamma rays using technology similar to that used in terrestrial [[w:particle accelerator|particle accelerator]]s. [[w:Photons|Photons]] hit thin metal sheets, converting to electron-positron pairs, via a process known as [[w:pair production|pair production]]. These charged particles pass through interleaved layers of silicon [[w:microstrip detector|microstrip detector]]s, causing [[w:ionization|ionization]] which produce detectable tiny pulses of electric charge. Researchers can combine information from several layers of this tracker to determine the path of the particles. After passing through the tracker, the particles enter the [[w:calorimeter|calorimeter]], which consists of a stack of [[w:caesium iodide|caesium iodide]] [[w:scintillator|scintillator]] crystals to measure the total energy of the particles. The LAT's field of view is large, about 20% of the sky. The resolution of its images is modest by astronomical standards, a few arc minutes for the highest-energy photons and about 3 degrees at 100 MeV. The LAT is a bigger and better successor to the [[w:EGRET (telescope)|EGRET]] instrument on NASA's [[w:Compton Gamma Ray Observatory|Compton Gamma Ray Observatory]] satellite in the 1990s. {{clear}} ==GRANAT== [[Image:Granat.gif|thumb|right|250px|Granat observe the universe at energies ranging from X-rays to gamma rays. Credit: NASA.{{tlx|free media}}]] The ''GRANAT'' satellite has aboard the [French coded aperture] γ-ray telescope SIGMA which on "January 9 [1991] detected Nova Muscae at the very edge of its field of view (FOV)."<ref name=Goldwurm/> "SIGMA provides high-resolution (≈ 15') images of the sky in the 35-1300 keV band (see Paul et al. 1991)."<ref name=Goldwurm/> Granat discovered the electron/positron annihilation line (511 keV) from the galactic microquasar 1E1740-294 and the GRS 1124-683 (X-ray Nova Muscae).<ref name="NASA2">{{ cite book |url=http://imagine.gsfc.nasa.gov/docs/sats_n_data/missions/granat.html |title=The Granat Satellite |publisher=NASA HEASARC Imagine the Universe! |accessdate=2007-12-05}}</ref> {{clear}} ==INTEGRAL== [[Image:INTEGRAL-spacecraft410.jpg|thumb|right|250px|Positron astronomy results have been obtained using the INTEGRAL spectrometer SPI shown. Credit: Medialab, ESA.{{tlx|fairuse}}]] "[P]ositron astronomy results ... have been obtained using the INTEGRAL spectrometer SPI".<ref name=Weidenspointner/> The positrons are not directly observed by the INTEGRAL space telescope, but "the 511 keV positron annihilation emission is".<ref name=Weidenspointner/> {{clear}} ==Hypotheses== {{main|Hypotheses}} # Beta-particles astronomy may provide more information than just [[electron astronomy]] or [[positron astronomy]] alone. ==See also== {{div col|colwidth=20em}} * [[Radiation astronomy/Alpha particles|Alpha particle radiation astronomy]] * [[Radiation astronomy/Atomics|Atomic radiation astronomy]] * [[Radiation astronomy/Hadrons|Hadron radiation astronomy]] * [[Radiation astronomy/Mesons|Meson astronomy]] * [[Radiation astronomy/Muons|Muon astronomy]] * [[Radiation/Neutrons|Neutron radiation astronomy]] * [[Radiation astronomy/Protons|Proton radiation astronomy]] * [[Subatomic astronomy]] {{Div col end}} ==References== {{reflist|2}} ==External links== * [http://www.adsabs.harvard.edu/ The SAO/NASA Astrophysics Data System] <!-- footer templates --> {{Principles of radiation astronomy}}{{Sisterlinks|Beta-particles astronomy}} <!-- categories --> [[Category:Astrophysics/Lectures]] [[Category:Radiation astronomy/Lectures]] [[Category:Radiation/Lectures]] 5ce4h25ofqgvyo7swwqfy767fq5t1xx 2419084 2419083 2022-08-25T20:06:20Z Marshallsumter 311529 /* Delta rays */ wikitext text/x-wiki [[Image:How thunderstorms launch particle beams into space 300dpi.jpg|thumb|right|300px|The simulation attempts to answer how thunderstorms launch particle beams into space. Credit: NASA/Goddard Space Flight Center.{{tlx|free media}}]] A number of subatomic reactions can be detected in astronomy that yield beta particles. The detection of beta particles or the reactions that include them in an astronomical situation is '''beta-particles astronomy'''. '''Notation:''' let '''TGF''' stand for a '''Terrestrial Gamma-ray Flash'''. {{clear}} ==Universals== A "clumpiness in the [galactic] halo [is] through a spatially continuous elevation in the density of dark matter, rather than the more realistic ''discrete'' distribution of clumps. [...] the former approach reproduces the ''average'' results obtained when considering the essentially infinite set of possible configurations of discrete clumps within the halo. This was demonstrated in the work by Lavalle et al. (2006), who deduced that the associated relative variance in the observed positron flux, as a result of the different clump configurations, is proportional to <math>M_c^{1/2}</math>, where <math>M_c</math> is the typical clump mass, and diverges as ''E''_e⁺ → m_χ . It is found that for <math>M_c = 10^6 M_{\odot}</math> and a universal clump boost factor, ''B''_c ∼ 100, this relative variance is less than 5 per cent for ''E''_e⁺ ≤ 20 GeV, which is where the positron excess observed by the [''High-Energy Antimatter Telescope''] ''HEAT'' is located. Since the clump mass distribution deduced by Diemand et al. indicates that ''M''_c ∼ 10⁻⁶M_⊙, it seems very unlikely that such a variance will significantly affect our conclusions, and we use this to strengthen our use of a spatially continuous elevation in dark matter density as a way of acknowledging clumpiness in the galactic halo.<ref name=Cumberbatch>{{ cite journal |author=Daniel Cumberbatch |author2=Joseph Silk |title=Local dark matter clumps and the positron excess |journal=Monthly Notices of the Royal Astronomical Society |month=January |year=2007 |volume=374 |issue=2 |pages=455-65 |url=http://mnras.oxfordjournals.org/content/374/2/455.full.pdf+html |arxiv= |bibcode= |doi=10.1111/j.1365-2966.2006.11123.x |pmid= |accessdate=2014-01-31 }}</ref> ==Astronomy== {{main|Radiation/Astronomy}} [[Image:Aurore australe - Aurora australis.jpg|thumb|right|250px|Auroras are mostly caused by energetic electrons precipitating into the [[w:atmosphere|atmosphere]].<ref name=Wolpert>{{ cite book | author = S. Wolpert | date = July 24, 2008 | title = Scientists solve 30-year-old aurora borealis mystery | url = http://www.universityofcalifornia.edu/news/article/18277 | publisher = University of California | accessdate = 2008-10-11 }}</ref> Credit: [[c:User:Ehquionest|Samuel Blanc]].{{tlx|free media}}]] [[Image:509305main GBM positron event 300dpi.jpg|thumb|right|250px|Observation of positrons from a terrestrial gamma ray flash is performed by the Fermi gamma ray telescope. Credit: NASA Goddard Space Flight Center.{{tlx|free media}}]] Although '''electron astronomy''' is usually not recognized as a formal branch of astronomy, the measurement of electron fluxes helps to understand a variety of natural phenomena. ""[E]lectron astronomy" has an interesting future".<ref name=Hudson/> "'''Positron astronomy''' is 30 years old but remains in its infancy."<ref name=Milne>{{ cite journal |author=P.A.Milne |author2=J.D.Kurfess |author3=R.L.Kinzer |author4=M.D.Leising |author5=D.D.Dixon |title=Investigations of positron annihilation radiation, In: ''Proceedings of the 5th COMPTON Symposium'' |publisher=American Institute of Physics |location=Washington, DC |month=April |year=2000 |volume=510 |issue=4 |pages=21-30 |url=http://arxiv.org/pdf/astro-ph/9911184 |arxiv=astro-ph/9911184v1 |bibcode=2000AIPC..510...21M |doi=10.1063/1.1303167 |pmid= |accessdate=2011-11-25 }}</ref> A High-Energy Antimatter Telescope (HEAT) has been developed and tested in the mid 1990s to measure the positron fraction in cosmic rays.<ref name=Barwick/> {{clear}} ==Radiation== {{main|Radiation}} [[Image:NuclideMap C-F.png|thumb|right|250px|This graph is a chart of the nuclides for carbon to fluorine. Decay modes: <br><br> {{legend|#ff9472|proton emission}} {{legend|#e78cc7|positron emission or electron capture}} {{legend|#000000|stable isotope}} {{legend|#63c5de|beta decay}} {{legend|#9b7bbc|neutron emission}} Credit: original: National Nuclear Data Center, stitched: [[c:User:Neokortex|Neokortex]], cropped: [[c:User:Limulus|Limulus]].{{tlx|free media}}]] '''Beta particles''' are high-energy, high-speed electrons or positrons emitted by certain types of radioactive nuclei such as potassium-40. The beta particles emitted are a form of ionizing radiation also known as beta rays. The production of beta particles is termed beta decay. They are designated by the Greek letter beta (β). At right is a graph or block diagram that shows the boundaries for nuclear particle stability. The boundaries are conceptualized as '''drip lines'''. The nuclear landscape is understood by plotting boxes, each of which represents a unique nuclear species, on a graph with the number of neutrons increasing on the abscissa and number of protons increasing along the ordinate, which is commonly referred to as the table of nuclides, being to nuclear physics what the more commonly known periodic table of the elements is to [[chemistry]]. However, an arbitrary combination of protons and neutrons does not necessarily yield a stable nucleus, and ultimately when continuing to add more of the same type of nucleons to a given nucleus, the newly formed nucleus will essentially undergo immediate decay where a nucleon of the same isospin quantum number (proton or neutron) is emitted; colloquially the nucleon has 'leaked' or 'dripped' out of the target nucleus, hence giving rise to the term "drip line". The nucleons drip out of such unstable nuclei for the same reason that water drips from a leaking faucet: the droplet, or nucleon in this case, sees a lower potential which is great enough to overcome surface tension in the case of water droplets, and the strong nuclear force in the case of proton emission or alpha decay. As nucleons are quantized, then only integer values are plotted on the table of isotopes, indicating that the drip line is not linear but instead looks like a step function up close. Beta particles (electrons) are more penetrating [than alpha particles], but still can be absorbed by a few millimeters of aluminum. However, in cases where high energy beta particles are emitted shielding must be accomplished with low density materials, ''e.g.'' plastic, wood, water or acrylic glass (Plexiglas, Lucite). This is to reduce generation of Bremsstrahlung X-rays. In the case of beta⁺ radiation (positrons), the gamma radiation from the electron-positron annihilation reaction poses additional concern. As an example, "[t]he power into the Crab Nebula is apparently supplied by an outflow [wind] of ~10³⁸ erg/s from the pulsar"<ref name=Wilson/> where there are "electrons (and positrons) in such a wind"<ref name=Wilson>{{ cite journal |author=D. B. Wilson |author2=M. J. Rees |title=Induced Compton scattering in pulsar winds |journal=Monthly Notices of the Royal Astronomical Society |month=October |year=1978 |volume=185 |issue=10 |pages=297-304 |url= |arxiv= |bibcode=1978MNRAS.185..297W |doi= |pmid= |accessdate=2012-03-08 }}</ref>. These beta particles coming out of the pulsar are moving very close to light speed. "The two conversions of protons into neutrons are assumed to take place inside the nucleus, and the extra positive charge is emitted as a positron."<ref name=Shaviv>{{ cite book |author=Giora Shaviv |title=Towards the Bottom of the Nuclear Binding Energy, In: ''The Synthesis of the Elements'' |publisher=Springer-Verlag |location=Berlin |date=2013 |editor=Giora Shaviv |pages=169-94 |url=http://link.springer.com/chapter/10.1007/978-3-642-28385-7_5#page-1 |arxiv= |bibcode= |doi=10.1007/978-3-642-28385-7_5 |pmid= |isbn=978-3-642-28384-0 |accessdate=2013-12-19 }}</ref> '''Def.''' "the non-linear scattering of radiation off electrons" is called '''induced Compton scattering'''.<ref name=Wilson>{{ cite journal |author=D. B. Wilson |author2=M. J. Rees |title=Induced Compton scattering in pulsar winds |journal=Monthly Notices of the Royal Astronomical Society |month=October |year=1978 |volume=185 |issue=10 |pages=297-304 |url= |arxiv= |bibcode=1978MNRAS.185..297W |doi= |pmid= |accessdate=2012-03-08 }}</ref> "The effect of scattering is to move photons to lower frequencies."<ref name=Wilson/> "[T]he fact that the radio pulses [from a pulsar] are not suppressed by induced scattering suggests that the wind's Lorentz factor exceeds ~10⁴.<ref name=Wilson/> ==Electrons== {{main|Radiation astronomy/Electrons}} [[Image:Nuclear particle in a diffusion cloud chamber.png|thumb|right|250px|This rare picture show the 4 type of charged particles that we can detect in a cloud chamber : alpha, proton, electron and muons (probably). Credit: [[c:User:Mauswiesel|Cloudylabs]].{{tlx|free media}}]] The electron is a subatomic particle with a negative charge, equal to -1.60217646x10^-19 coulomb (''C''). Current, or the rate of flow of charge, is defined such that one coulomb, so 1/-1.60217646x10^-19, or 6.24150974x10¹⁸ electrons flowing past a point per second give a current of one [[w:ampere|ampere]]. The charge on an electron is often given as ''-e''. note that charge is always considered positive, so the charge of an electron is always negative. The electron has a mass of 9.10938188x10^-31 ''kg'', or about 1/1840 that of a proton. The mass of an electron is often written as ''m_e''. When working, these values can usually be safely approximated to: ::''-e'' = -1.60x10^-19 ''C'' ::''m_e'' = 9.11x10^-31''kg'' It has no known components or substructure; in other words, it is generally thought to be an [[w:elementary particle|elementary particle]].<ref name=Eichten>{{ cite journal | author = E.J. Eichten |author2=M.E. Peskin |author3=M. Peskin | year = 1983 | title = New Tests for Quark and Lepton Substructure | journal = Physical Review Letters | volume = 50 | pages = 811–814 | issue = 11 | doi = 10.1103/PhysRevLett.50.811 | bibcode=1983PhRvL..50..811E }}</ref><ref name=Gabrielse>{{ cite journal | author = G. Gabrielse ''et al.'' | year = 2006 | title = New Determination of the Fine Structure Constant from the Electron ''g'' Value and QED | journal = Physical Review Letters | volume = 97 | pages = 030802(1–4) | doi = 10.1103/PhysRevLett.97.030802 | bibcode=2006PhRvL..97c0802G | issue = 3 }}</ref> The intrinsic [[w:angular momentum|angular momentum]] (spin) of the electron is a half-integer value in units of ''ħ'', which means that it is a fermion. {{clear}} ==Delta rays== [[Image:Delta electron.png|thumb|right|250px|Delta electron is knocked out by a 180 GeV muon at the SPS at CERN. Credit: [[c:user:Wilcokoppert|Wilcokoppert]].{{tlx|free media}}]] A '''delta ray''' is characterized by very fast electrons produced in quantity by alpha particles or other fast energetic charged particles knocking orbiting electrons out of atoms. Collectively, these electrons are defined as delta radiation when they have sufficient energy to ionize further atoms through subsequent interactions on their own. "The conventional procedure of delta-ray counting to measure charge (Powell, Fowler, and Perkins 1959), which was limited to resolution sigma_z = 1-2 because of uncertainties of the criterion of delta-ray ranges, has been significantly improved by the application of delta-ray range distribution measurements for ¹⁶O and ³²S data of 200 GeV per nucleon (Takahashi 1988; Parnell ''et al.'' 1989)."<ref name=Burnett>{{ cite journal |author=T. H. Burnett ''et al.'' |author2=The JACEE Collaboration |title=Energy spectra of cosmic rays above 1 TeV per nucleon |journal=The Astrophysical Journal |month=January |year=1990 |volume=349 |issue=1 |pages=L25-8 |url=http://adsabs.harvard.edu/cgi-bin/nph-data_query?bibcode=1990ApJ...349L..25B&link_type=GIF&db_key=AST |arxiv= |bibcode=1990ApJ...349L..25B |doi=10.1086/185642 |pmid= |pdf=http://adsabs.harvard.edu/cgi-bin/nph-data_query?bibcode=1990ApJ...349L..25B&link_type=ARTICLE&db_key=AST&high= |accessdate=2011-11-25 }}</ref> Here, the delta-ray tracks in emulsion chambers have been used for "[d]irect measurements of cosmic-ray nuclei above 1 TeV/nucleon ... in a series of balloon-borne experiments".<ref name=Burnett/> {{clear}} ==Epsilon rays== '''Epsilon radiation''' is tertiary radiation caused by secondary radiation (''e.g.'', delta radiation). Epsilon rays are a form of particle radiation and are composed of electrons. The term is very rarely used today. ==Antimatter== '''Def.''' an elementary subatomic particle which forms matter is called a '''quark'''. '''Note:''' quarks are never found alone in nature. '''Def.''' the smallest possible, and therefore indivisible, unit of a given quantity or quantifiable phenomenon is called the '''quantum'''. '''Def.''' one of certain integers or half-integers that specify the state of a quantum mechanical system is called a '''quantum number'''. '''Def.''' a quantum number that depends upon the relative number of strange quarks and anti-strange quarks is called '''strangeness'''. '''Def.''' symmetry of interactions under spatial inversion is called '''parity'''. '''Def.''' "the quantity of [unbalanced]<ref name=ElectricChargeWikt1/> positive or negative ions in or on an object;<ref name=ElectricChargeWikt>{{ cite book |author=[[wikt:User:Cem BSEE|Cem BSEE]] |title=electric charge |publisher=Wikimedia Foundation, Inc |location=San Francisco, California |date=19 December 2006 |url=https://en.wiktionary.org/wiki/electric_charge |accessdate=2015-08-08 }}</ref> measured in coulombs"<ref name=ElectricChargeWikt1>{{ cite book |author=[[wikt:User:SemperBlotto|SemperBlotto]] |title=electric charge |publisher=Wikimedia Foundation, Inc |location=San Francisco, California |date=21 January 2007 |url=https://en.wiktionary.org/wiki/electric_charge |accessdate=2015-08-08 }}</ref> or "a quantum number of some subatomic particles which determines their electromagnetic interactions"<ref name=ElectricChargeWikt2>{{ cite book |author=[[wikt:User:SemperBlotto|SemperBlotto]] |title=electric charge |publisher=Wikimedia Foundation, Inc |location=San Francisco, California |date=13 August 2005 |url=https://en.wiktionary.org/wiki/electric_charge |accessdate=2015-08-08 }}</ref> is called an '''electric charge'''. '''Def.''' the mean duration of the life of someone or something is called the '''mean lifetime'''. '''Def.''' a quantum angular momentum associated with subatomic particles, which also creates a magnetic moment is called a '''spin'''. '''Def.''' the "quantity of matter which a body contains, irrespective of its bulk or volume"<ref name=MassWikt>{{ cite book |author=[[wikt:User:Eclecticology|Eclecticology]] |title=mass |publisher=Wikimedia Foundation, Inc |location=San Francisco, California |date=12 September 2003 |url=http://en.wiktionary.org/wiki/mass |accessdate=2013-08-12 }}</ref> or a "quantity of matter cohering together so as to make one body, or an aggregation of particles or things which collectively make one body or quantity"<ref name=MassWikt1>{{ cite book |author=[[wikt:User:Emperorbma|Emperorbma]] |title=mass |publisher=Wikimedia Foundation, Inc |location=San Francisco, California |date=14 November 2003 |url=https://en.wiktionary.org/wiki/mass |accessdate=2014-02-28 }}</ref> is called '''mass''', or a '''mass'''. '''Def.''' a subatomic particle corresponding to another particle with the same mass, spin and mean lifetime but with charge, parity, strangeness and other quantum numbers flipped in sign is called an '''antiparticle'''. '''Def.''' matter that is composed of antiparticles of those that constitute normal matter is called '''antimatter'''. A positron differs from a quark by its lack of [[strong interaction]]. '''Def.''' "[t]he antimatter equivalent of an electron,<ref name=PositronWikt>{{ cite book |author=[[wikt:User:Fonzy~enwiktionary|Fonzy~enwiktionary]] |title=positron |publisher=Wikimedia Foundation, Inc |location=San Francisco, California |date=17 May 2003 |url=http://en.wiktionary.org/wiki/positron |accessdate=2012-07-12 }}</ref> having the same mass but a positive charge"<ref name=PositronWikt1>{{ cite book |author=[[wikt:User:SemperBlotto|SemperBlotto]] |title=positron |publisher=Wikimedia Foundation, Inc |location=San Francisco, California |date=14 June 2005 |url=http://en.wiktionary.org/wiki/positron |accessdate=2012-07-12 }}</ref> is called a '''positron'''. ==Nuclear transmutations== {{main|Radiation astronomy/Transmutations}} [[Image:Table isotopes en.svg|thumb|right|250px|This graph shows positron emissions, among others, from nuclear transmutation. Credit: [[c:user:Napy1kenobi|Napy1kenobi]] and [[c:user:Sjlegg|Sjlegg]].{{tlx|free media}}]] If the proton and neutron are part of an [[w:atomic nucleus|atomic nucleus]], these decay processes [[w:Nuclear transmutation|transmute]] one chemical element into another. For example: :<math> ^A_ZN \rightarrow ~ ^{~~~A}_{Z-1}N' + e^+ + \nu_e, </math> where A = 22, Z = 11, ''N'' = Na, ''Z''-1 = 10, and ''N''' = Ne. Beta decay does not change the number of [[w:nucleon|nucleon]]s, ''A'', in the nucleus but changes only its [[w:electric charge|charge]], ''Z''. Thus the set of all [[w:nuclide|nuclide]]s with the same ''A'' can be introduced; these [[w:isobar (nuclide)|''isobaric'' nuclides]] may turn into each other via beta decay. Among them, several nuclides (at least one) are beta stable, because they present local minima of the [[w:mass excess|mass excess]]: if such a nucleus has (''A'', ''Z'') numbers, the neighbour nuclei (''A'', ''Z''&minus;1) and (''A'', ''Z''+1) have higher mass excess and can beta decay into (''A'', ''Z''), but not vice versa. For all odd mass numbers ''A'' the global minimum is also the unique local minimum. For even ''A'', there are up to three different beta-stable isobars experimentally known. There are about 355 known [[w:beta-decay stable isobars|beta-decay stable nuclides]] total. {{clear}} ==Radioactivity== {{main|Radioactivity}} In {{SubatomicParticle|Beta+}} decay, or "positron emission", the weak interaction converts a nucleus into its next-lower neighbor on the periodic table while emitting an positron ({{SubatomicParticle|Positron}}) and an electron neutrino ({{SubatomicParticle|Electron neutrino}}): :<math> ^A_ZN \rightarrow ~ ^{~~~A}_{Z-1}N' + e^+ + \nu_e. </math> {{SubatomicParticle|Beta+}} decay cannot occur in an isolated proton because it requires energy due to the mass of the neutron being greater than the mass of the proton. {{SubatomicParticle|Beta+}} decay can only happen inside nuclei when the value of the [[w:binding energy|binding energy]] of the mother nucleus is less than that of the daughter nucleus. The difference between these energies goes into the reaction of converting a proton into a neutron, a positron and a neutrino and into the kinetic energy of these particles. ''Positron emission''' or '''beta plus decay''' ([[w:Beta particle|β⁺]] decay) is a type of [[beta decay]] in which a [[w:proton|proton]] is converted, via the [[w:weak force|weak force]], to a [[w:neutron|neutron]], releasing a positron and a [[w:neutrino|neutrino]]. [[w:Isotope|Isotope]]s which undergo this decay and thereby emit positrons include [[w:carbon-11|carbon-11]], [[w:Isotopes of potassium|potassium-40]], [[w:nitrogen-13|nitrogen-13]], [[w:Isotopes of oxygen|oxygen-15]], [[w:fluorine-18|fluorine-18]], and [[w:Isotopes of iodine|iodine-121]]. As an example, the following equation describes the beta plus decay of carbon-11 to [[w:boron|boron]]-11, emitting a positron and a neutrino: :<math> ^{11}_{6}C \rightarrow ~ ^{11}_{5}B + e^+ + \nu_e + \gamma {(0.96 MeV)}. </math> ==Positroniums== [[Image:Positronium.svg|thumb|right|200px|An electron and positron orbit around their common centre of mass. This is a bound quantum state known as positronium. Credit: [[c:User:Manticorp|Manticorp]].{{tlx|free media}}]] '''Def.''' an exotic atom consisting of a positron and an electron, but having no nucleus or an onium consisting of a positron (anti-electron) and an electron, as a particle&ndash;anti-particle bound pair is called '''positronium'''. Being unstable, the two particles annihilate each other to produce two gamma ray photons after an average lifetime of 125 ps or three gamma ray photons after 142 ns in vacuum, depending on the relative spin states of the positron and electron. The ''singlet'' state with antiparallel spins ([spin quantum number] ''S'' = 0, ''M_s'' = 0) is known as '''para-positronium''' (''p''-Ps) and denoted {{SubatomicParticle|para-positronium}}. It has a mean lifetime of 125 picoseconds and decays preferentially into two gamma quanta with energy of 511 keV each (in the center of mass frame). Detection of these photons allows for the reconstruction of the vertex of the decay. Para-positronium can decay into any even number of photons (2, 4, 6, ...), but the probability quickly decreases as the number increases: the branching ratio for decay into 4 photons is {{val|1.439|(2)|e=-6}}.<ref name=Karshenboim>{{cite journal |author=Savely G. Karshenboim |year=2003 |title=Precision Study of Positronium: Testing Bound State QED Theory |doi=10.1142/S0217751X04020142 |journal=International Journal of Modern Physics A [Particles and Fields; Gravitation; Cosmology; Nuclear Physics] |volume=19 |issue=23 |pages=3879–96 |arxiv=hep-ph/0310099 |bibcode = 2004IJMPA..19.3879K }}</ref> para-positronium lifetime (S = 0):<ref name=Karshenboim/> :<math>t_{0} = \frac{2 \hbar}{m_e c^2 \alpha^5} = 1.244 \times 10^{-10} \; \text{s}</math> The ''triplet'' state with parallel spins (''S'' = 1, ''M_s'' = −1, 0, 1) is known as '''ortho-positronium''' (''o''-Ps) and denoted ³S₁. The triplet state in vacuum has a mean lifetime of {{val|142.05|0.02|u=ns}}<ref name=Badertscher>{{cite journal |author=A. Badertscher ''et al.'' |year=2007 |title=An Improved Limit on Invisible Decays of Positronium |journal=Physical Review D |volume=75 |pages=032004 |doi=10.1103/PhysRevD.75.032004 |arxiv=hep-ex/0609059 |bibcode = 2007PhRvD..75c2004B |issue=3 }}</ref> and the leading mode of decay is three gamma quanta. Other modes of decay are negligible; for instance, the five photons mode has branching ratio of ~{{val|1.0|e=-6}}.<ref name=Czarnecki> {{cite journal |author=Andrzej Czarnecki, Savely G. Karshenboim |year=1999 |title=Decays of Positronium |volume=14 |issue=99 |journal=B.B. Levchenko and V.I. Savrin (eds.), Proc. of the the International Workshop on High Energy Physics and Quantum Field Theory (QFTHEP, Moscow , MSU-Press 2000, pp. 538 - 44. |arxiv=hep-ph/9911410 |bibcode = 1999hep.ph...11410C }}</ref> ortho-positronium lifetime (S = 1):<ref name=Karshenboim/> :<math>t_{1} = \frac{\frac{1}{2} 9 h}{2 m_e c^2 \alpha^6 (\pi^2 - 9)} = 1.386 \times 10^{-7} \; \text{s}</math> {{clear}} ==Annihilations== [[Image:Annihilation.png|thumb|right|250px|Naturally occurring electron-positron annihilation is a result of beta plus decay. Credit: Jens Maus.{{tlx|free media}}]] [[Image:Annihilation Radiation.JPG|thumb|right|250px|A Germanium detector spectrum shows the annihilation radiation peak (under the arrow). Note the width of the peak compared to the other gamma rays visible in the spectrum. Credit: Hidesert.{{tlx|free media}}]] The '''positron''' or '''antielectron''' is the [[w:antiparticle|antiparticle]] or the [[w:antimatter|antimatter]] counterpart of the electron. The positron has an [[w:electric charge|electric charge]] of +1e, a [[w:spin (physics)|spin]] of ½, and has the same mass as an electron. When a low-energy positron collides with a low-energy electron, [[w:annihilation|annihilation]] occurs, resulting in the production of two or more [[w:gamma ray|gamma ray]] [[w:photon|photon]]s. '''Def.''' the process of a [[wikt:particle|particle]] and its corresponding [[wikt:antiparticle|antiparticle]] combining to produce energy is called '''annihilation'''. The figure at right shows a positron (e⁺) emitted from an atomic nucleus together with a [[wikt:neutrino|neutrino]] (v). Subsequently, the positron moves randomly through the surrounding matter where it hits several different electrons (e^-) until it finally loses enough energy that it interacts with a single electron. This process is called an "annihilation" and results in two diametrically emitted photons with a typical energy of 511 keV each. Under normal circumstances the photons are not emitted exactly diametrically (180 degrees). This is due to the remaining energy of the positron having conservation of momentum. '''Electron–positron annihilation''' occurs when an electron ({{SubatomicParticle|Electron}}) and a [[w:positron|positron]] ({{SubatomicParticle|Positron}}, the electron's [[w:antiparticle|antiparticle]]) collide. The result of the collision is the [[w:annihilation|annihilation]] of the electron and positron, and the creation of [[w:gamma ray|gamma ray]] [[w:photon|photon]]s or, at higher energies, other particles: :{{SubatomicParticle|Electron}}&nbsp;+&nbsp;{{SubatomicParticle|Positron}}&nbsp;&rarr;&nbsp;{{SubatomicParticle|Photon}}&nbsp;+&nbsp;{{SubatomicParticle|Photon}} The process [does] satisfy a number of [[w:conservation law|conservation law]]s, including: * [[w:Charge conservation|Conservation of electric charge]]. The net [[w:electric charge|charge]] before and after is zero. * Conservation of [[w:momentum|linear momentum]] and total [[w:energy|energy]]. This forbids the creation of a single gamma ray. However, in [[w:quantum field theory|quantum field theory]] this process is [described]; see [[w:Annihilation#Examples of annihilation|examples of annihilation]]. * Conservation of [[w:angular momentum|angular momentum]]. As with any two charged objects, electrons and positrons may also interact with each other without annihilating, in general by [[w:elastic scattering|elastic scattering]]. The creation of only one photon can occur for tightly bound atomic electrons.<ref name=Sodickson>{{ cite journal |author=L. Sodickson |author2=W. Bowman |author3=J. Stephenson |author4=R. Weinstein |year=1960 |title=Single-Quantum Annihilation of Positrons |journal=Physical Review |volume=124 |pages=1851 |doi=10.1103/PhysRev.124.1851 |bibcode = 1961PhRv..124.1851S }}</ref> In the most common case, two photons are created, each with energy equal to the [[w:rest energy|rest energy]] of the electron or positron (511 keV).<ref name=Atwood>{{cite journal |author=W.B. Atwood |author2=P.F. Michelson |author3=S.Ritz |year=2008 |title=Una Ventana Abierta a los Confines del Universo |journal=Investigación y Ciencia |volume=377 |pages=24–31 |doi= }}</ref> It is also common for three to be created, since in some angular momentum states, this is necessary to conserve [[w:C parity|C parity]].<ref name=Griffiths>{{cite book |author=D.J. Griffiths |date=1987 |title=Introduction to Elementary Particles |publisher=John Wiley & Sons |isbn=0-471-60386-4 }}</ref> Any larger number of photons [can be created], but the probability becomes lower with each additional photon. When either the electron or positron, or both, have appreciable [[w:kinetic energy|kinetic energies]], other heavier particles can also be produced (such as [[w:D meson|D meson]]s), since there is enough kinetic energy in the relative velocities to provide the [[w:rest energy|rest energies]] of those particles. Photons and other light particles may be produced, but they will emerge with higher energies. At energies near and beyond the mass of the carriers of the [[w:weak interaction|weak force]], the [[w:W and Z bosons|W and Z bosons]], the strength of the weak force becomes comparable with [[w:electromagnetism|electromagnetism]].<ref name=Griffiths/> It becomes much easier to produce particles such as neutrinos that interact only weakly. The heaviest particle pairs yet produced by electron–positron annihilation are [[w:W boson|{{SubatomicParticle|W boson+}}–{{SubatomicParticle|W boson-}}]] pairs. The heaviest single particle is the [[w:Z boson|Z boson]]. Annihilation radiation is not monoenergetic, unlike gamma rays produced by [[w:radioactive decay|radioactive decay]]. The production mechanism of annihilation radiation introduces [[w:Doppler broadening|Doppler broadening]].<ref name=Gilmore>Gilmore, G., and Hemmingway, J.: "Practical Gamma Ray Spectrometry", page 13. John Wiley & Sons Ltd., 1995</ref> The annihilation peak produced in a gamma spectrum by annihilation radiation therefore has a higher [[w:full width at half maximum|full width at half maximum]] (FWHM) than other gamma rays in [the] spectrum. The difference is more apparent with high resolution detectors, such as [[w:Germanium|Germanium]] detectors, than with low resolution detectors such as [[w:Sodium iodide|Sodium iodide]]. Because of their well-defined energy (511 keV) and characteristic, Doppler-broadened shape, annihilation radiation can often be useful in defining the energy calibration of a gamma ray spectrum. ==Pair production== The reverse reaction, electron–positron creation, is a form of [[w:pair production|pair production]] governed by [[w:Two-photon physics|two-photon physics]]. '''Two-photon physics''', also called '''gamma-gamma physics''', [studies] the [[w:interaction|interaction]]s between two [[w:photons|photons]]. If the [[w:energy|energy]] in the [[w:center of mass|center of mass]] system of the two photons is large enough, [[w:matter|matter]] can be created.<ref name=Moffat>{{ cite journal |author=Moffat JW |title=Superluminary Universe: A Possible Solution to the Initial Value Problem in Cosmology |journal=Intl J Mod Phys D |month= |year=1993 |volume=2 |issue=3 |pages=351–65 |arxiv=gr-qc/9211020 |doi=10.1142/S0218271893000246 |bibcode = 1993IJMPD...2..351M }}</ref> :{{SubatomicParticle|Photon}}&nbsp;&rarr;&nbsp;{{SubatomicParticle|Electron}}&nbsp;+&nbsp;{{SubatomicParticle|Positron}} In [[w:nuclear physics|nuclear physics]], [the above reaction] occurs when a high-energy [[w:photon|photon]] interacts with a [[w:atomic nucleus|nucleus]]. The photon must have enough energy [> 2*511 keV, or 1.022 MeV] to create an electron plus a positron. Without a nucleus to absorb momentum, a photon decaying into electron-positron pair (or other pairs for that matter such as a muon and anti-muon or a tau and anti-tau can never conserve energy and momentum simultaneously.<ref name=Hubbell>{{ cite journal | last=Hubbell | first=J. H. | title=Electron positron pair production by photons: A historical overview | journal=Radiation Physics and Chemistry | year=2006 | month=June | volume=75 | issue=6 | pages=614–623 | doi=10.1016/j.radphyschem.2005.10.008 | bibcode=2006RaPC...75..614H }}</ref> These interactions were first observed in [[w:Patrick Maynard Stuart Blackett|Patrick Blackett]]'s counter-controlled [[w:cloud chamber|cloud chamber]]. In 2008 the [[w:Titan laser|Titan laser]] aimed at a 1-millimeter-thick gold target was used to generate positron–electron pairs in large numbers.<ref name=Bevy>{{ cite book |author= |title=Laser technique produces bevy of antimatter |url=http://www.msnbc.msn.com/id/27998860/ |date=2008 |accessdate=2008-12-04 }}</ref> "The LLNL scientists created the positrons by shooting the lab's high-powered Titan laser onto a one-millimeter-thick piece of gold."<ref name=Bevy/> ==Colors== {{main|Radiation astronomy/Colors}} '''Notation:''' '''WN5''' is a component of V444 Cygni, with its Wolf-Rayet (W) spectrum dominated by Nitrogen_III-V and Helium_I-II lines and WN2 to WN5 considered hotter or "early". "The color temperature of the central part of the WN5 disk for λ < 7512 Å, where the main source of opacity is electron scattering, is ''T''_c = 80,000-100,000 K. This high temperature represents the electron temperature slightly below the surface of the WN5 core--the level at which the star becomes optically thick in electron scattering."<ref name=Cherepashchuk>{{ cite journal |author=A. M. Cherepashchuk, K. F. Khaliullin, & J. A. Eaton |title=Ultraviolet photometry from the Orbiting Astronomical Observatory. XXXIX - The structure of the eclipsing Wolf-Rayet binary V444 Cygni as derived from light curves between 2460 A and 3. 5 microns |journal=The Astrophysical Journal |month=June 15, |year=1984 |volume=281 |issue=06 |pages=774-88 |url=http://adsabs.harvard.edu/full/1984ApJ...281..774C |arxiv= |bibcode=1984ApJ...281..774C |doi=10.1086/162156 |pmid= |accessdate=2014-01-23 }}</ref> ==Minerals== {{main|Radiation astronomy/Minerals}} [[Image:FluoriteUV.jpg|thumb|250px|left|Fluorescing fluorite is from Boltsburn Mine Weardale, North Pennines, County Durham, England, UK. Credit: [[c:user:Archaeodontosaurus|Didier Descouens]].{{tlx|free media}}]] Many samples of fluorite exhibit [[w:fluorescence|fluorescence]] under ultraviolet light, a property that takes its name from fluorite.<ref name=Stokes>{{ cite journal |title=On the Change of Refrangibility of Light |author=Stokes, G. G. |year=1852 |journal=Philosophical Transactions of the Royal Society of London |volume=142 |pages=463–562 |doi=10.1098/rstl.1852.0022 }}</ref> Many minerals, as well as other substances, fluoresce. Fluorescence involves the elevation of electron energy levels by quanta of ultraviolet light, followed by the progressive falling back of the electrons into their previous energy state, releasing quanta of visible light in the process. In fluorite, the visible light emitted is most commonly blue, but red, purple, yellow, green and white also occur. The fluorescence of fluorite may be due to mineral impurities such as [[w:yttrium|yttrium]], [[w:ytterbium|ytterbium]], or organic matter in the crystal lattice. In particular, the blue fluorescence seen in fluorites from certain parts of Great Britain responsible for the naming of the phenomenon of fluorescence itself, has been attributed to the presence of inclusions of divalent [[w:europium|europium]] in the crystal.<ref name=Przibram>{{ cite journal |author=K. Przibram |title=Fluorescence of Fluorite and the Bivalent Europium Ion |journal=Nature |volume=135 |pages=100 |year=1935 |doi=10.1038/135100a0 |issue=3403 |bibcode=1935Natur.135..100P }}</ref> Excessive "²⁶Mg [has] been reported in meteoritic carbonaceous chondrites [...] which demonstrate an excess of ²⁶Mg of up to 40% combined with essentially solar concentrations of ²⁴Mg and ²⁵Mg. Many of the data are well correlated with the ²⁷Al content of the samples, and this is interpreted as evidence that the excess ²⁶Mg has arisen from the ''in situ'' decay (via positron emission and electron capture) of the ground state of ²⁶Al in these minerals."<ref name=Champagne>{{ cite journal |author=A. E. Champagne |author2=A. J. Howard |author3=P. D. Parker |title=Nucleosynthesis of ²⁶Al at low stellar temperatures |journal=The Astrophysical Journal |month=June 15, |year=1983 |volume=269 |issue=06 |pages=686-9 |url=http://adsabs.harvard.edu/full/1983ApJ...269..686C |arxiv= |bibcode=1983ApJ...269..686C |doi=10.1086/161077 |pmid= |accessdate=2014-02-01 }}</ref> {{clear}} ==Theoretical beta-particle astronomy== "We now assume that the γ-rays are produced [from 3C 279] by relativistic electrons via Compton scattering of synchrotron photons (SSC). In any such model, the fact that the γ-rays luminosity, produced via Compton scattering, is higher than that emitted at lower frequencies (10¹⁴ - 10¹⁶ Hz), supposedly via the synchrotron process, implies a radiation energy density, ''U''_r, higher than the magnetic energy density, ''U''_B. From the observed power ratio we derive that ''U''_r must be one order of magnitude greater than ''U''_B, which may be a lower limit if Klein-Nishina effects reduce the efficiency of the self-Compton emission. This result is independent of the degree of beaming, which, for a homogeneous source, affects both the synchrotron and the self-Compton fluxes in the same way. This source is therefore the first observed case of the result of a ''Compton catastrophe'' (Hoyle, Burbidge, & Sargent 1966)."<ref name=Maraschi>{{ cite journal |author=L. Maraschi |author2=G. Ghisellini |author3=A. Celotti |title=A jet model for the gamma-ray emitting blazar 3C 279 |journal=The Astrophysical Journal |month=September |year=1992 |volume=397 |issue=1 |pages=L5-9 |url=http://adsabs.harvard.edu/abs/1992ApJ...397L...5M |arxiv= |bibcode=1992ApJ...397L...5M |doi=10.1086/186531 |pmid= |accessdate=2014-01-10 }}</ref> '''Notation:''' let the symbol '''Ps''' stand for '''positronium'''. "Comparison between direct annihilation and radiative capture to positronium [in thermal plasmas] shows that the two rates are equal at ''T'' = 6.8 x 10⁵ K with the former (latter) dominating at the higher (lower) temperatures."<ref name=Gould>{{ cite journal |author=Robert J. Gould |title=Direct positron annihilation and positronium formation in thermal plasmas |journal=The Astrophysical Journal |month=September 1, |year=1989 |volume=344 |issue=09 |pages=232-8 |url=http://articles.adsabs.harvard.edu/full/1989ApJ...344..232G |arxiv= |bibcode=1989ApJ...344..232G |doi= |pmid= |accessdate=2013-08-12 }}</ref> The process : <math> \mathrm{e^+ + e^- \rightarrow Ps + \gamma},</math> has a related mechanism in atomic hydrogen:<ref name=Gould/> : <math> \mathrm{p^+ + e^- \rightarrow H + \gamma}.</math> ==Entities== {{main|Radiation astronomy/Entities}} There may be a "connection ... between the magnetic field strengths inside an electron, in newly-born pulsars, and the sun. ... the upper limit to the strength of magnetic field ... is that which would permit emission of a photon at the non-relativistic electron gyrofrequency, with the energy of the order of the electron rest mass."<ref name=Cole/> A "basic process in the formation of pulsar magnetic fields [may be] a variant of electron-positron spin-zero annihilation, as follows : <math> e^-\uparrow + e^+\uparrow \, \rightarrow \, \uparrow \cup \uparrow + \gamma + \gamma,</math> where the [up] arrow represents the magnetic moment of an electron.<ref name=Cole>{{ cite journal |author=K. D. Cole |title=The Magnetic Fields of Pulsars, Electrons and the Sun |journal=Proceedings of the Astronomical Society of Australia |month= |year=1992 |volume=10 |issue=2 |pages=110-2 |url=http://adsabs.harvard.edu/full/1992PASAu..10..110C |arxiv= |bibcode=1992PASAu..10..110C |doi= |pmid= |accessdate=2013-08-13 }}</ref> This relation "symbolises the formation of a magnetic entity, <math>\uparrow \cup \uparrow</math>, here called an M-particle, with twice the magnetic moment of an electron or a positron, and [γ] represents a photon."<ref name=Cole/> ==Sources== {{main|Radiation astronomy/Sources}} Low-mass X-ray binaries (LMXBs) "have long been suggested as positron sources on theoretical grounds and because their distribution peaks in the bulge region (eg Prantzos, 2004); however, it is only those LMXBs detected at hard X-ray energies that in addition exhibit an imbalance in their disk distribution."<ref name=Weidenspointner>{{ cite journal |author=G. Weidenspointner |author2=G.K. Skinner |author3=P. Jean |author4=J. Knödlseder |author5=P. von Ballmoos |author6=R. Diehl |author7=A. Strong |author8=B. Cordier |author9=S. Schanne |author10=C. Winkler |title=Positron astronomy with SPI/INTEGRAL |journal=New Astronomy Reviews |month=October |year=2008 |volume=52 |issue=7-10 |pages=454-6 |url=http://www.sciencedirect.com/science/article/pii/S1387647308001164 |arxiv= |bibcode=2008NewAR..52..454W |doi=10.1016/j.newar.2008.06.019 |pmid= |accessdate=2013-08-13 }}</ref> ==Objects== {{main|Radiation astronomy/Objects|Object astronomy}} "It is possible that the X-ray continuum is primary while the radio and optical emission are secondary for all BL Lac objects when the effect of relativistic beaming is considered. Pair production is a possible mechanism for producing X-ray emissions, while the optical and radio emission would be a consequence of this model (Zdziarski & Lightman 1985; Svensson 1986; Fabian et al. 1986). Barr & Mushotzky (1986) showed a significant correlation between the X-ray luminosity and timescale of X-ray variability for Seyfert galaxies and quasars and interpreted this as evidence that the emitting plasma is near the limit of being dominated by electron-positron pairs."<ref name=Xie>{{ cite journal |author=G. Z. Xie |author2=B. F. Liu |author3=J. C. Wang |title=A Signature of Relativistic Electron-Positron Beams in BL Lacertae Objects |journal=The Astrophysical Journal |month=November 20, |year=1995 |volume=454 |issue=11 |pages=50-4 |url=http://adsabs.harvard.edu/full/1995ApJ...454...50X |arxiv= |bibcode=1995ApJ...454...50X |doi=10.1086/176463 |pmid= |accessdate=2013-08-13 }}</ref> ==Strong forces== {{main|Charges/Interactions/Strong}} "The idea behind baryon matter is that a macroscopic state may exist in which a smaller effective baryon mass inside some region makes the state energetically favored over free particles. [...] This state will appear in the limit of large baryon number as an electrically neutral coherent bound state of neutrons, protons, and electrons in ''β''-decay equilibrium."<ref name=Bahcall>{{ cite journal |author=Safi Bahcall |author2=Bryan W. Lynn |author3=Stephen B. Selipsky |title=New Models for Neutron Stars |journal=The Astrophysical Journal |month=October 10, |year=1990 |volume=362 |issue=10 |pages=251-5 |url=http://adsabs.harvard.edu/abs/1990ApJ...362..251B |arxiv= |bibcode=1990ApJ...362..251B |doi=10.1086/169261 |pmid= |accessdate=2014-01-11 }}</ref> ==Weak forces== {{main|Charges/Interactions/Weak}} "Energy deposit or escape is a major issue in expanding envelopes of stellar explosions, supernovae (positrons from ⁵⁶Co and ⁴⁴Ti) and novae (many ''β''⁺ decays such as ¹³N)".<ref name=Diehl>{{ cite book |author=Roland Diehl |title=Introduction to Astronomy with Radioactivity, In: ''Astronomy with Radioactivities'' |publisher=Springer |location= |date=2011 |editor= |pages= |url=http://link.springer.com/chapter/10.1007/978-3-642-12698-7_1 |arxiv=1007.2206 |bibcode= |doi= |pmid= |isbn= |accessdate=1 February 2014 }}</ref> ==Continua== {{main|Radiation astronomy/Continua}} The X-ray continuum can arise from [[w:bremsstrahlung|bremsstrahlung]], [[w:Thermal radiation|black-body radiation]], [[w:synchrotron radiation|synchrotron radiation]], or what is called [[w:Compton scattering#Inverse Compton scattering|inverse Compton scattering]] of lower-energy photons by relativistic electrons, knock-on collisions of fast protons with atomic electrons, and atomic recombination, with or without additional electron transitions.<ref name=Morrison>{{ cite journal |author=P Morrison |title=Extrasolar X-ray Sources |journal=Annual Review of Astronomy and Astrophysics |year=1967 |volume=5 |issue=1 |pages=325–50 |doi=10.1146/annurev.aa.05.090167.001545 |bibcode=1967ARA&A...5..325M }}</ref> "The annihilation of positrons with electrons gives rise to two spectral features, a line emission at 511 keV and a positronium continuum emission (which increases in intensity with energy roughly as a power law up to 511 keV and falls abruptly to zero above 511 keV)[4]."<ref name=Milne2002>{{ cite journal |author=P.A. Milne |author2=J.D. Kurfess |author3=R.L. Kinzer |author4=M.D. Leising |title=Supernovae and Positron Annihilation Radiation |journal=New Astronomy Reviews |month=July |year=2002 |volume=46 |issue=8-10 |pages=553-8 |url=http://www.sciencedirect.com/science/article/pii/S1387647302002002 |arxiv=astro-ph/0110442 |bibcode= |doi= |pmid= |accessdate=2013-08-13 }}</ref> ==Emissions== {{main|Radiation astronomy/Emissions}} '''Notation:''' let the symbol '''LAT''' represent '''Large Area Telescope'''. '''Notation:''' let the symbol '''GBM''' represent '''Gamma-ray Burst Monitor'''. "The observed correlated variability of the GBM and LAT emissions indicates that photons formed co-spatially, with the lower-energy (GBM) photons providing target photons that can interact with higher energy γ rays to produce electron-positron pairs."<ref name=Abdo>{{ cite journal |author=AA Abdo |author2=M Ackermann |author3=M Arimoto |author4=K Asano |author5=The Fermi LAT |author6=Fermi GBM Collaborations |title=Fermi observations of high-energy gamma-ray emission from GRB 080916C |journal=Science |month=March 27, |year=2009 |volume=323 |issue=5922 |pages=1688-93 |url=http://www.sciencemag.org/content/323/5922/1688.short |arxiv= |bibcode= |doi=10.1126/science.1169101 |pmid= |accessdate=2013-08-13 }}</ref> ==Absorptions== {{main|Radiation astronomy/Absorptions|Absorption astronomy}} "[M]odels in which γ-rays are absorbed in collisions with X-rays producing nonthermal electron-positron pairs, which in turn radiate further X-rays [have been developed]."<ref name=Zdziarski>{{ cite journal |author=Andrzej A. Zdziarski |author2=Gabriele Ghisellini |author3=Ian M. George |author4=R. Svensson |author5=A. C. Fabian |author6=Chris Done |title=Electron-positron pairs, Compton reflection, and the X-ray spectra of active galactic nuclei |journal=The Astrophysical Journal |month=November 1, |year=1990 |volume=363 |issue=11 |pages=L1-4 |url=http://adsabs.harvard.edu/full/1990ApJ...363L...1Z |arxiv= |bibcode=1990ApJ...363L...1Z |doi=10.1086/185851 |pmid= |accessdate=2013-08-15 }}</ref> "[T]he reprocessing of radiation by ''e''⁺ ''e''^- pairs could be a sufficiently robust mechanism to yield the canonical spectrum, independent of the details of the particle acceleration mechanism and the parameters of the source, such as the X- and γ-ray luminosity, ''L'', and the size, R."<ref name=Zdziarski/> "[T]he hard X-ray spectrum of a growing number of [active galactic nuclei] AGN [in] the 1-30 keV X-ray emission has four distinct components":<ref name=Zdziarski/> # "an incident power law spectrum with a spectral index αⁱ_x ≃ 0.9,"<ref name=Zdziarski/> # "an emission line at the energy ~6.4 keV (interpreted as a fluorescent iron K-line),"<ref name=Zdziarski/> # "an absorption edge at 7-8 keV (interpreted as an iron K-edge), and"<ref name=Zdziarski/> # "a broad excess of emission with respect to the underlying power law at energies ≳ 10 keV (interpreted as Compton reflection from cold [T < 10⁶ K, optically thick] material)." <ref name=Zdziarski/> ==Bands== {{main|Radiation astronomy/Bands}} "For <math>N_s</math> sources located in the field of view, the data <math>D_p</math> obtained during an exposure (pointing) p, for a given energy band, can be expressed by the relation:" : <math> D_p = \sum^{N_p}_{j=1}R_{p,j}S_{p,j} + B_p</math> "where <math>R_{p,j}</math> is the response of the instrument for the source j, <math>S_{p,j}</math> is the flux of the source j, and <math>B_p</math> is the background recorded during the pointing p. <math>D_p, R_{p,j}</math>, and <math>B_p</math> are vectors of 19 elements."<ref name=Bouchet/> "[I]n the 508.25-513.75 keV band ... a 5.5 keV wide band centered at 511 keV takes into account the Germanium energy resolution (FWHM 2.05 keV) including its degradation between two consecutive annealings (5%). At this energy, the gain calibration (performed orbit-wise) accuracy is better than ±0.01 keV."<ref name=Bouchet>{{ cite journal |author=On the morphology of the electron-positron annihilation emission as seen by SPI/INTEGRAL |title=L. Bouchet, J. P. Roques, and E. Jourdain |journal=The Astrophysical Journal |month=September 10, |year=2010 |volume=720 |issue=2 |pages=1772-80 |url=http://iopscience.iop.org/0004-637X/720/2/1772 |arxiv=1007.4753 |bibcode=2010ApJ...720.1772B |doi=10.1088/0004-637X/720/2/1772 |pmid= |accessdate=2013-08-16 }}</ref> ==Backgrounds== {{main|Radiation astronomy/Backgrounds}} "[Taking] advantage of the relative stability of the background pattern to rewrite the background term as:" : <math>B_p = A_p \cdot U \cdot t_p</math> "where <math>A_P</math> is a normalization coefficient per pointing, <math>U</math> is the "uniformity map" or background count rate pattern on the SPI camera [of the [[w:INTEGTAL|INTEGRAL]] satellite] and <math>t_p</math> the effective observation time for pointing p. <math>U</math> and <math>t</math> are vectors of 19 elements (one per detector)."<ref name=Bouchet/> ==Meteors== {{main|Radiation/Meteors}} "The main physical processes at play are the emission of γ-rays and positrons from radioactive decays in the ⁵⁶Ni → ⁵⁶Co → ⁵⁶Fe chain [...], their interaction with the ejecta, and the spectrum of the radiation produced by the thermalization processes and the radiative transfer in the expanding ejecta. [...] Positron interaction with the ejecta [from the Type Ic SN 1994I] strongly depends on the presence, and geometry, of magnetic fields (Ruiz-Lapuente & Spruit 1998)."<ref name=Clocchiatti>{{ cite journal |author=Alejandro Clocchiatti |author2=J. Craig Wheeler |author3=Robert P. Kirshner |author4=David Branch |author5=Peter Challis |author6=Roger A. Chevalier |author7=Alexei V. Filippenko |author8=Claes Fransson |author9=Peter Garnavich |author10=Bruno Leibundgut |author11=Nino Panagia |author12=Mark M. Phillips |author13=Nicholas B. Suntzeff |author14=Peter A. Höflich |author15=José Gallardo |title=Late-Time HST Photometry of SN 1994I: Hints of Positron Annihilation Energy Deposition |journal=Publications of the Astronomical Society of the Pacific |month=March |year=2008 |volume=120 |issue=865 |pages=290-300 |url=http://www.jstor.org/stable/10.1086/533458 |arxiv= |bibcode= |doi=10.1086/533458 |pmid= |accessdate=2014-01-31 }}</ref> ==Cosmic rays== {{main|Radiation/Cosmic rays}} '''Aluminium-26''', ²⁶Al, is a radioactive [[w:isotope|isotope]] of the chemical element aluminium, decaying by either of the [[w:Radioactive decay#Modes of decay|modes]] [[w:Positron emission|beta-plus]] or [[w:electron capture|electron capture]], both resulting in the stable [[w:nuclide|nuclide]] magnesium-26. The [[w:half-life|half-life]] of ²⁶Al is 7.17{{e|5}} years. This is far too short for the isotope to survive to the present, but a small amount of the nuclide is produced by collisions of argon atoms with cosmic ray protons. There is an "unexpected rise of the positron fraction, observed by HEAT and PAMELA experiments, for energies larger than a few GeVs."<ref name=Rodriguez>{{ cite journal |author=Roberto Alfredo Lineros Rodriguez |title=Positrons from cosmic rays interactions and dark matter annihilations |journal=Rivista Del Nuovo Cimento |month= |year=2010 |volume=125B |issue= |pages=1053-70 |url=http://adsabs.harvard.edu/abs/2010arXiv1002.0671A |arxiv=1002.0671 |bibcode=2010arXiv1002.0671A |doi=10.1393/ncb/i2010-10910-7 |pmid= |accessdate=2013-08-17 }}</ref> "[T]he HEAT balloon experiment [30] ... has mildly indicated a possible positron excess at energies larger than 10 GeV ... In October 2008, the latest results of PAMELA experiment [36] have confirmed and extended this feature [37]."<ref name=Rodriguez/> Earlier measurements indicate that "the positron fraction, [f = ] e⁺/(e^- + e⁺), increases with energy at energies above 10 GeV. Such an increase would require either the appearance of a new source of positrons or a depletion of primary electrons."<ref name=Barwick>{{ cite journal |author=S. W. Barwick |author2=J. J. Beatty |author3=A. Bhattacharyya |author4=C. R. Bower |author5=C. J. Chaput |author6=S. Coutu |author7=G. A. de Nolfo |author8=J. Knapp |author9=D. M. Lowder |author10=S. McKee |author11=D. Müller |author12=J. A. Musser |author13=S. L. Nutter |author14=E. Schneider |author15=S. P. Swordy |author16=G. Tarlé |author17=A. D. Tomasch |author18=E. Torbet |title=Measurements of the Cosmic-Ray Positron Fraction from 1 to 50 GeV |journal=The Astrophysical Journal Letters |month=June 20, |year=1997 |volume=482 |issue=2 |pages=L191-4 |url=http://iopscience.iop.org/1538-4357/482/2/L191/pdf/1538-4357_482_2_L191.pdf |arxiv= |bibcode=1997ApJ...482L.191B |doi=10.1086/310706 |pmid= |accessdate=2012-07-13 }}</ref> All results taken together suggest a slight decrease with increasing energy from about 1 GeV to 10 GeV, but overall the fraction may be constant, per Figure 2.<ref name=Barwick/> ==Neutrals== {{main|Radiation astronomy/Neutrals|Neutrals astronomy}} "The positrons can annihilate in flight before being slowed to thermal energies, annihilate directly with electrons when both are at thermal energies, or form positronium at thermal energies (or at greater than thermal energies if positronium formation occurs via charge exchange with neutrals)."<ref name=Leising/> ==Subatomics== {{main|Radiation astronomy/Subatomics|Subatomic astronomy}} "Few exceptional lines arise at high energy from annihilations of positrons and pions."<ref name=Diehl/> ==Neutrons== {{main|Radiation/Neutrons}} "''Reuven Ramaty High Energy Solar Spectroscopic Imager'' (RHESSI) hard X-ray (HXR) and γ-ray imaging and spectroscopy observations [were made] of the intense (X4.8) γ-ray line flare of 2002 July 23."<ref name=Lin/> "For the first time, the positron annihilation line is resolved, and the detailed high-resolution measurements are obtained for the neutron-capture line. The first ever solar γ-ray line and continuum imaging shows that the source locations for the relativistic electron bremsstrahlung overlap the 50-100 keV HXR sources, implying that electrons of all energies are accelerated in the same region. The centroid of the ion-produced 2.223 MeV neutron-capture line emission, however, is located ~20'' ± 6'' away, implying that the acceleration and/or propagation of the ions must differ from that of the electrons. Assuming that Coulomb collisions dominate the energetic electron and ion energy losses (thick target), we estimate that a minimum of ~2 × 10³¹ ergs is released in accelerated >~20 keV electrons during the rise phase, with ~10³¹ ergs in ions above 2.5 MeV nucleon^-1 and about the same in electrons above 30 keV released in the impulsive phase."<ref name=Lin/> "The collisions also produce neutrons, positrons, and pions. Neutron capture on hydrogen and positron annihilation yield narrow lines at 2.223 and 0.511 MeV, respectively, both of which are delayed."<ref name=Lin>{{ cite journal |author=R. P. Lin |author2=S. Krucker |author3=G. J. Hurford |author4=D. M. Smith |author5=H. S. Hudson |author6=G. D. Holman |author7=R. A. Schwartz |author8=B. R. Dennis |author9=G. H. Share |author10=R. J. Murphy |author11=A. G. Emslie |author12=C. Johns-Krull |author13=N. Vilmer |title=''RHESSI'' Observations of Particle Acceleration and Energy Release in an Intense Solar Gamma-Ray Line Flare |journal=The Astrophysical Journal Letters |month= |year=2003 |volume=595 |issue=2 |pages=L69- |url=http://iopscience.iop.org/1538-4357/595/2/L69 |arxiv= |bibcode= |doi=10.1086/378932 |pmid= |accessdate=2014-02-01 }}</ref> ==Protons== {{main|Radiation astronomy/Protons|Proton astronomy}} Based on interactions between cosmic rays and the photons of the [[w:Cosmic microwave background radiation|cosmic microwave background radiation]] (CMB), cosmic rays with energies over the threshold energy of 5x10¹⁹ [[w:electron-volt|eV]] interact with cosmic microwave background photons <math>\gamma_{\rm CMB}</math> to produce [[w:pion|pion]]s via the <math>\Delta</math> resonance, :<math>\gamma_{\rm CMB}+p\rightarrow\Delta^+\rightarrow p + \pi^0,</math> or :<math>\gamma_{\rm CMB}+p\rightarrow\Delta^+\rightarrow n + \pi^+.</math> Pions produced in this manner proceed to decay in the standard pion channels—ultimately to photons for neutral pions, and photons, positrons, and various neutrinos for positive pions. Neutrons decay also to similar products, so that ultimately the energy of any cosmic ray proton is drained off by production of high energy photons plus (in some cases) high energy electron/positron pairs and neutrino pairs. The pion production process begins at a higher energy than ordinary electron-positron pair production (lepton production) from protons impacting the CMB, which starts at cosmic ray proton energies of only about 10¹⁷[[w:electron-volt|eV]]. However, pion production events drain 20% of the energy of a cosmic ray proton as compared with only 0.1% of its energy for electron positron pair production. This factor of 200 is from two sources: the pion has only about ~130 times the mass of the leptons, but the extra energy appears as different kinetic energies of the pion or leptons, and results in relatively more kinetic energy transferred to a heavier product pion, in order to conserve momentum. The much larger total energy losses from pion production result in the pion production process becoming the limiting one to high energy cosmic ray travel, rather than the lower-energy light-lepton production process. ==Muons== {{main|Radiation astronomy/Muons|Muon astronomy}} "TeV muons from γ ray primaries ... are rare because they are only produced by higher energy γ rays whose flux is suppressed by the decreasing flux at the source and by absorption on interstellar light."<ref name=Halzen>{{ cite journal |author=Francis Halzen |author2=Todor Stanev |author3=Gaurang B. Yodh |title=γ ray astronomy with muons |journal=Physical Review D Particles, Fields, Gravitation, and Cosmology |month=April 1, |year=1997 |volume=55 |issue=7 |pages=4475-9 |url=http://prd.aps.org/abstract/PRD/v55/i7/p4475_1 |arxiv=astro-ph/9608201 |bibcode=1997PhRvD..55.4475H |doi=10.1103/PhysRevD.55.4475 |pmid= |accessdate=2013-01-18 }}</ref> Muon decay produces three particles, an electron plus two neutrinos of different types. "The muons created through decays of secondary pions and kaons are fully polarized, which results in electron/positron decay asymmetry, which in turn causes a difference in their production spectra."<ref name=Moskalenko>{{ cite journal |author=I. V. Moskalenko |author2=A. W. Strong |title=Production and propagation of cosmic-ray positrons and electrons |journal=The Astrophysical Journal |month=February 1, |year=1998 |volume=493 |issue=2 |pages=694-707 |url=http://iopscience.iop.org/0004-637X/493/2/694 |arxiv=astro-ph/9710124 |bibcode=1998ApJ...493..694M |doi=10.1086/305152 |pmid= |accessdate=2014-02-01 }}</ref> ==Neutrinos== {{main|Radiation astronomy/Neutrinos|Neutrino astronomy}} [[Image:Proton proton cycle.svg|250px|thumb|center|Solar neutrinos are shown for the [[w:Proton-proton chain reaction|proton-proton chain]] in the Standard Solar Model. Credit: [[:hu:User:SzDóri|Dorottya Szam]].{{tlx|free media}}]] The following fusion reaction produces neutrinos and accompanying gamma-rays of the energy indicated: ::<math>\mathrm{_1^1H} + \mathrm{_1^1H} \rightarrow \mathrm{_{1}^{2}D} + e^+ + \nu_e + \gamma (0.42 MeV). </math> Observation of gamma rays of this energy likely indicate this reaction is occurring nearby. In the [[w:Cowan–Reines neutrino experiment|Cowan–Reines neutrino experiment]], antineutrinos created in a nuclear reactor by beta decay reacted with protons producing [[w:neutron|neutron]]s and [[w:positron|positron]]s: :{{SubatomicParticle|Electron antineutrino}} + {{SubatomicParticle|Proton+}} → {{SubatomicParticle|Neutron0}} + {{SubatomicParticle|Electron+}} The positron quickly finds an electron, and they [[w:Annihilation|annihilate]] each other. The two resulting gamma rays (γ) 511 keV each are detectable. The neutron can be detected by its capture on an appropriate nucleus, releasing a gamma ray. The coincidence of both events – positron annihilation and neutron capture – gives a unique signature of an antineutrino interaction. {{clear}} ==Gamma rays== {{main|Radiation astronomy/Gamma rays|Gamma-ray astronomy}} [[Image:Glast allsky1-a.png|thumb|right|250px|This is a high-energy gamma radiation allsky image about the Earth, taken from [[w:Energetic Gamma Ray Experiment Telescope|Energetic Gamma Ray Experiment Telescope]] on the NASA’s [[w:Compton Gamma Ray Observatory|Compton Gamma Ray Observatory]] satellite. Credit: United States Department of Energy.{{tlx|free media}}]] Most astronomical gamma-rays may be produced from the same type of accelerations of electrons, and electron-photon interactions, that produce X-rays in astronomy (but occurring at a higher energy in the production of gamma-rays). A number of different processes occurring in the universe may result in gamma-ray emission. These processes include the interactions of energetic electrons with [[w:magnetic field|magnetic field]]s. The correlations of the high energy electrons energized during a solar flare and the gamma rays [produced] are mostly caused by nuclear combinations of high energy protons and other heavier ions. "The '''Energetic Gamma Ray Experiment Telescope''', ('''EGRET''') measured high energy (20 MeV to 30 GeV) gamma ray source positions to a fraction of a degree and photon energy to within 15 percent. EGRET was developed by NASA [[w:Goddard Space Flight Center|Goddard Space Flight Center]], the [[w:Max Planck Institute for Extraterrestrial Physics|Max Planck Institute for Extraterrestrial Physics]], and [[w:Stanford University|Stanford University]]. Its detector operated on the principle of electron-[[w:positron|positron]] [[w:pair production|pair production]] from high energy photons interacting in the detector. The tracks of the high-energy electron and positron created were measured within the detector volume,and the axis of the ''V'' of the two emerging particles projected to the sky. Finally, their total energy was measured in a large [[w:calorimeter (particle physics)|calorimeter]] [[w:scintillation detector|scintillation detector]] at the rear of the instrument. {{clear}} ==X-rays== {{main|Radiation astronomy/X-rays|X-ray astronomy}} X-rays remove electrons from atoms and ions, and those photoelectrons can provoke secondary ionizations. As the intensity is often low, this [X-ray] heating is only efficient in warm, less dense atomic medium (as the column density is small). For example in molecular clouds only hard x-rays can penetrate and x-ray heating can be ignored. This is assuming the region is not near an x-ray source such as a supernova remnant. In an X-ray tube, electrons are accelerated in a vacuum by an electric field and shot into a piece of metal called the "target". X-rays are emitted as the electrons slow down (decelerate) in the metal. The output spectrum consists of a continuous spectrum of X-rays, with additional sharp peaks at certain energies characteristic of the elements of the target. The '''Energetic Gamma Ray Experiment Telescope''', ('''EGRET''') measured high energy (20 MeV to 30 GeV) gamma ray source positions to a fraction of a degree and photon energy to within 15 percent. EGRET was developed by NASA [[w:Goddard Space Flight Center|Goddard Space Flight Center]], the [[w:Max Planck Institute for Extraterrestrial Physics|Max Planck Institute for Extraterrestrial Physics]], and [[w:Stanford University|Stanford University]]. Its detector operated on the principle of electron-[[w:positron|positron]] [[w:pair production|pair production]] from high energy photons interacting in the detector. The tracks of the high-energy electron and positron created were measured within the detector volume,and the axis of the ''V'' of the two emerging particles projected to the sky. Finally, their total energy was measured in a large [[w:calorimeter (particle physics)|calorimeter]] [[w:scintillation detector|scintillation detector]] at the rear of the instrument. ==Blues== {{main|Radiation astronomy/Blues|Blue astronomy}} In "the spectrum of a middle-aged [pulsar] PSR B0656+14 [may be] two wide, red and blue, flux depressions whose frequency ratio is about 2 and which could be the 1st and 2nd harmonics of electron/positron cyclotron absorption formed at magnetic fields [of] ~10⁸ G in [the] upper magnetosphere of the pulsar."<ref name=Zharikov>{{ cite journal |author=S. Zharikov |author2=R. E. Mennickent |author3=Yu. Shibanov |author4=V. Komarova |title=Optical spectroscopy of the radio pulsar PSR B0656+14 |journal=Astrophysics and Space Science |month=April |year=2007 |volume=308 |issue=1-4 |pages=545-9 |url=http://adsabs.harvard.edu/abs/2007Ap%26SS.308..545Z |arxiv=astro-ph/0608527 |bibcode=2007Ap&SS.308..545Z |doi=10.1007/s10509-007-9308-z |pmid= |accessdate=2013-05-31 }}</ref> ==Yellows== {{main|Radiation astronomy/Yellows|Yellow astronomy}} "The temperature of yellow coronal regions is ... about 2.5 [x] 10⁶ [K]. ... although some ions Ca XV will exist at lower, as well as higher temperatures."<ref name=Kleczek/> "The AS prominences [AS in Menzel-Evans' classification [4];] move with velocities exceeding by far the velocities of other types of prominences [7], [8]. As short-living phenomena, they are condensed quickly and the temperature of the coronal gases should rise in the early stages of their condensation. Indeed, the AS prominences use to be allied with yellow line emission (λ 5694)."<ref name=Kleczek/> "The yellow line is namely due to the ion Ca XV, according to Edlen's and Waldmeier's identification. ... the line λ 5694 is emitted by ³''P''₁ - ³''P''₀ transition of Ca XV."<ref name=Kleczek/> "The solar corona is not in thermodynamical equilibrium. In particular, the photo-recombination is compensated with electron impact ionization, while the reverse processes viz. the photoionization and recombination by impact with two electrons are there negligible."<ref name=Kleczek>{{ cite journal |author=J. Kleczek |title=Temperature of Yellow Coronal Regions |journal=Bulletin of the Astronomical Institutes of Czechoslovakia |month= |year=1957 |volume=8 |issue= |pages=68-70 |url=http://adsabs.harvard.edu/full/1957BAICz...8...68K |arxiv= |bibcode=1957BAICz...8...68K |doi= |pmid= |accessdate=2013-09-26 }}</ref> ==Infrareds== {{main|Radiation astronomy/Infrareds|Infrared astronomy}} In [[infrared astronomy]], the cosmic infrared background (CIB) causes a significant attenuation for very high energy electrons through inverse [[w:Compton scattering|Compton scattering]], photopion and electron-positron pair production. ==Submillimeters== {{main|Radiation astronomy/Submillimeters|Submillimeter astronomy}} "Radio observations at 210 GHz taken by the Bernese Multibeam Radiometer for KOSMA (BEMRAK) [of] high-energy particle acceleration during the energetic solar flare of 2003 October 28 [...] at submillimeter wavelengths [reveal] a gradual, long-lasting (>30 minutes) component with large apparent source sizes (~60"). Its spectrum below ~200 GHz is consistent with synchrotron emission from flare-accelerated electrons producing hard X-ray and γ-ray bremsstrahlung assuming a magnetic field strength of ≥200 G in the radio source and a confinement time of the radio-emitting electrons in the source of less than 30 s. [... There is a] close correlation in time and space of radio emission with the production of pions".<ref name=Trottet>{{ cite journal |author=G. Trottet |author2=Säm Krucker |author3=T. Lüthi |author4=A. Magun |title=Radio Submillimeter and γ-Ray Observations of the 2003 October 28 Solar Flare |journal=The Astrophysical Journal |month=May 1 |year=2008 |volume=678 |issue=1 |pages=509 |url=http://iopscience.iop.org/0004-637X/678/1/509 |arxiv= |bibcode= |doi=10.1086/528787 |pmid= |accessdate=2013-10-22 }}</ref> ==Superluminals== {{main|Radiation astronomy/Superluminals|Superluminal astronomy}} There is a cut-off frequency above which the equation <math>\cos\theta=1/(n\beta)</math> cannot be satisfied. Since the [[w:refractive index|refractive index]] is a function of frequency (and hence wavelength), the intensity does not continue increasing at ever shorter wavelengths even for ultra-relativistic particles (where v/[[w:speed of light|c]] approaches 1). At X-ray frequencies, the refractive index becomes less than unity (note that in media the phase velocity may exceed ''c'' without violating relativity) and hence no X-ray emission (or shorter wavelength emissions such as gamma rays) would be observed. However, X-rays can be generated at special frequencies just below those corresponding to core electronic transitions in a material, as the index of refraction is often greater than 1 just below a resonance frequency (see [[w:Kramers-Kronig relation|Kramers-Kronig relation]] and [[w:anomalous dispersion|anomalous dispersion]]). "Throughout the shower development, the electrons and positrons which travel faster than the speed of light in the air emit Cherenkov radiation."<ref name=Moralejo>{{ cite journal |author=A. Moralejo for the MAGIC collaboration |title=The MAGIC telescope for gamma-ray astronomy above 30 GeV |journal=Memorie della Societa Astronomica Italiana |month= |year=2004 |volume=75 |issue= |pages=232-9 |url=http://adsabs.harvard.edu/abs/2004MmSAI..75..232M |arxiv= |bibcode=2004MmSAI..75..232M |doi= |pmid= |accessdate=2012-07-28 }}</ref> "High energy processes such as [[w:Compton scattering|Compton]], [[w:Bhabha scattering|Bhabha]], and [[w:Møller scattering|Moller scattering]], along with [[w:Positron annihilation|positron annihilation]] rapidly lead to a ~20% negative charge asymmetry in the electron-photon part of a cascade ... initiated by a ... 100 PeV neutrino"<ref name=Gorham>{{ cite journal |author= P. W. Gorham |author2=S. W. Barwick |author3=J. J. Beatty |author4=D. Z.Besson |author5=W. R. Binns |author6=C. Chen |author7=P. Chen |author8=J. M. Clem |author9=A. Connolly |author10=P. F. Dowkontt |author11=M. A. DuVernois |author12=R. C. Field |author13=D. Goldstein |author14=A. Goodhue |author15=C. Hast |author16=C. L. Hebert |author17=S. Hoover |author18=M. H. Israel |author19=J. Kowalski |author20=J. G. Learned |author21=K. M. Liewer |author22=J. T. Link |author23=E. Lusczek |author24=S. Matsuno |author25=B. Mercurio |author26=C. Miki |author27=P. Miocinovic |author28=J. Nam |author29=C. J. Naudet |author30=J. Ng |author31=R. Nichol |author32=K. Palladino |author33=K. Reil |author34=A. Romero-Wolf |author35=M. Rosen |author36=L. Ruckman |author37=D. Saltzberg |author38=D. Seckel |author39=G. S. Varner |author40=D. Walz |author41=F. Wu |title=Observations of the Askaryan Effect in Ice |journal=Physical Review Letters |month=October 25, |year=2007 |volume=99 |issue=17 |pages=5 |url=http://arxiv.org/pdf/hep-ex/0611008.pdf |arxiv= |bibcode= |doi=10.1103/PhysRevLett.99.171101 |pmid= |accessdate=2012-07-28 }}</ref>. "The tachyonic spectral densities generated by ultra-relativistic electrons in uniform motion are fitted to the high-energy spectra of Galactic supernova remnants, such as RX J0852.0−4622 and the pulsar wind nebulae in G0.9+0.1 and MSH 15-52. ... Tachyonic cascade spectra are quite capable of generating the spectral curvature seen ... Estimates on the electron/proton populations generating the tachyon flux are obtained from the spectral fits"<ref name=Tomaschitz>{{ cite journal |author=Roman Tomaschitz |title=Superluminal cascade spectra of TeV [gamma]-ray sources |journal=Annals of Physics |month=March |year=2007 |volume=322 |issue=3 |pages=677-700 |url=http://wallpaintings.at/geminga/superluminal_cascade_spectra_TeV_gamma-ray_sources.pdf |arxiv= |bibcode= |doi=10.1016/j.aop.2006.11.005 |pmid= |accessdate=2011-11-24 }}</ref> "[S]uperluminal neutrinos may lose energy rapidly via the bremsstrahlung [Cherenkov radiation] of electron-positron pairs <math>(\nu \rightarrow \nu + e^- + e^+).</math>"<ref name=Cohen>{{ cite journal |author=Andrew G. Glashow |author2=Sheldon L. Glashow |title=Pair Creation Constrains Superluminal Neutrino Propagation |journal=Physical Review Letters |month=October |year=2011 |volume=107 |issue=18 |pages=181803 |url=http://adsabs.harvard.edu/abs/2011PhRvL.107r1803C |arxiv=1109.6562 |bibcode=2011PhRvL.107r1803C |doi=10.1103/PhysRevLett.107.181803 |pmid= |accessdate=2013-08-16 }}</ref> Assumption: "muon neutrinos with energies of order tens of GeV travel at superluminal velocity."<ref name=Cohen/> For "all cases of superluminal propagation, certain otherwise forbidden processes are kinematically permitted, even in vacuum."<ref name=Cohen/> Consider : <math> \nu_{\mu} \rightarrow \begin{bmatrix} {\nu_{\mu} + \gamma} & (a) \\ {\nu_{\mu} + \nu_e + \overline\nu_e } & (b) \\ {\nu_{\mu} + e^+ + e^-} & (c) \end{bmatrix} </math><ref name=Cohen/> "These processes cause superluminal neutrinos to lose energy as they propagate and ... process (c) places a severe constraint upon potentially superluminal neutrino velocities. ... Process (c), pair bremsstrahlung, proceeds through the neutral current weak interaction."<ref name=Cohen/> "Throughout the shower development, the electrons and positrons which travel faster than the speed of light in the air emit Cherenkov radiation."<ref name=Moralejo>{{ cite journal |author=A. Moralejo for the MAGIC collaboration |title=The MAGIC telescope for gamma-ray astronomy above 30 GeV |journal=Memorie della Societa Astronomica Italiana |month= |year=2004 |volume=75 |issue= |pages=232-9 |url=http://adsabs.harvard.edu/abs/2004MmSAI..75..232M |arxiv= |bibcode=2004MmSAI..75..232M |doi= |pmid= |accessdate=2012-07-28 }}</ref> ==Plasma objects== {{main|Plasmas/Plasma objects|Plasma objects}} "Plasma is the fourth state of matter, consisting of electrons, ions and neutral atoms, usually at temperatures above 10⁴ degrees Kelvin."<ref name=Birdsall>{{ cite book |author=CK Birdsall, A. Bruce Langdon |title=Plasma Physics via Computer Simulation |publisher=CRC Press |location=New York |date=1 October 2004 |editor= |pages=479 |url=http://books.google.com/books?hl=en&lr=&id=S2lqgDTm6a4C&oi=fnd&pg=PR13&dq=stars+%22plasma+physics%22&ots=nOPXyqtDo8&sig=-kA8YfaX6nlfFnaW3CYkATh-QPg |arxiv= |bibcode= |doi= |pmid= |isbn=9780750310253 |accessdate=17 December 2011 }}</ref> '''[P]lasma''' is a [[w:state of matter|state of matter]] similar to gas in which a certain portion of the particles are [[w:ion|ion]]ized. Heating a gas may [[w:ionization|ionize]] its molecules or atoms (reduce or increase the number of [[w:electrons|electrons]] in them), thus turning it into a plasma, which contains [[w:charge (physics)|charge]]d particles: positive [[w:ions|ions]] and negative electrons or ions.<ref name=Luo>{{ cite journal |last1=Luo |first1=Q-Z|last2=D'Angelo|first2=N|last3=Merlino|first3=R. L. | year=1998 |title=Shock formation in a negative ion plasma |journal= |volume=5 |issue=8 |publisher=Department of Physics and Astronomy |url=http://www.physics.uiowa.edu/~rmerlino/nishocks.pdf |accessdate=2011-11-20}}</ref> For plasma to exist, [[w:ionization|ionization]] is necessary. The term "plasma density" by itself usually refers to the "electron density", that is, the number of free electrons per unit volume. The [[w:degree of ionization|degree of ionization]] of a plasma is the proportion of atoms that have lost or gained electrons, and is controlled mostly by the temperature. Even a partially ionized gas in which as little as 1% of the particles are ionized can have the characteristics of a plasma (i.e., response to magnetic fields and high [[w:electrical conductivity|electrical conductivity]]). The degree of ionization, ''α'' is defined as ''α'' = ''n''_i/(''n''_i + ''n''_a) where ''n''_i is the number density of ions and ''n''_a is the number density of neutral atoms. The ''electron density'' is related to this by the average charge state <Z> of the ions through ''n''_e = <Z> ''n''_i where ''n''_e is the number density of electrons. ==Gaseous objects== {{main|Gases/Gaseous objects}} Above the photosphere visible sunlight is free to propagate into space, and its energy escapes the Sun entirely. The change in opacity is due to the decreasing amount of H⁻ ions, which absorb visible light easily.<ref name=Abhyankar1977>{{ cite journal |author=K.D. Abhyankar |title=A Survey of the Solar Atmospheric Models |year=1977 |journal=Bull. Astr. Soc. India |volume=5 |bibcode=1977BASI....5...40A |pages=40–44 |url=http://prints.iiap.res.in/handle/2248/510 }}</ref> Conversely, the visible light we see is produced as electrons react with hydrogen atoms to produce H⁻ ions.<ref name="Gibson">{{ cite book |author=E.G. Gibson |title=The Quiet Sun |publisher=NASA |date=1973 |isbn= |asin=B0006C7RS0 }}</ref><ref name="Shu">{{ cite book |last=Shu |first=F.H. |title=The Physics of Astrophysics |publisher=University Science Books |volume=1 |date=1991 |isbn=0-935702-64-4 }}</ref> The photosphere has a particle density of ~10²³&nbsp;m⁻³ (this is about 0.37% of the particle number per volume of Earth's atmosphere at sea level; however, photosphere particles are electrons and protons, so the average particle in air is 58 times as heavy). "Positrons entering a gaseous medium at [0.6 to 4.5 MeV] are quickly slowed by ionizing collisions with neutral atoms and by long-range Coulomb interactions with any ionized component."<ref name=Leising>{{ cite journal |author=M. D. Leising |author2=D. D. Clayton |title=Positron annihilation gamma rays from novae |journal=The Astrophysical Journal |month=December 1, |year=1987 |volume=323 |issue=1 |pages=159-69 |url=http://adsabs.harvard.edu/full/1987ApJ...323..159L |arxiv= |bibcode=1987ApJ...323..159L |doi=10.1086/165816 |pmid= |accessdate=2014-02-01 }}</ref> ==Rocky objects== {{main|Rocks/Rocky objects}} "Even in small solids and dust grains, energy deposition from ²⁶Al ''β''-decay, for example, injects 0.355 W kg^-1 of heat. This is sufficient to result in melting signatures, which have been used to study condensation sequences of solids in the early solar system".<ref name=Diehl/> ==Atmospheres== {{main|Radiation astronomy/Atmospheres|Atmospheric astronomy}} "The major problems associated with the balloon borne positron measurements are (i) the unique identification against a vast background of protons, and (ii) corrections for the positrons produced in the residual atmosphere."<ref name=Barbiellini>{{ cite journal |author=G. Barbiellini |author2=G. Basini |author3=R. Bellotti |author4=M. Bpcciolini |author5=M. Boezio |author6=F. Massimo Brancaccio |author7=U. Bravar |author8=F. Cafagna |author9=M. Candusso |author10=P. Carlson |author11=M. Casolino |author12=M. Castellano |author13=M. Circella |author14=A. Codino |author15=G. De Cataldo |author16=C. De Marzo |author17=M.P. De Pascale |author18=N. Finetti |author19=T. Francke |author20=N. Giglietto |author21=R.L. Golden |author22=C. Grimani |author23=M. Hof |author24=B. Marangelli |author25=W. Menn |author26=J.W. Mitchell |author27=A. Morselli |author28=J.F. Ormes |author29=P. Papini |author30=a. Perego |author31=S. Piccardi |author32=P. Picozza |author33=M. Ricci |author34=P. Schiavon |author35=M. Simon |author36=R. Sparvoli |author37=P. Spillatini |author38=P. Spinelli |author39=S.A. Stephens |author40=S.J. Stochaj |author41=R.E. Streitmatter |author42=M. Suffert |author43=A. Vacchi |author44=N. Weber |author45=N. Zampa |title=The cosmic-ray positron-to-electron ratio in the energy range 0.85 to 14 GeV |journal=Astronomy and Astrophysics |month=May |year=1996 |volume=309 |issue=05 |pages=L15-8 |url=http://adsabs.harvard.edu/abs/1996A&A...309L..15B |arxiv= |bibcode=1996A&A...309L..15B |doi= |pmid= |accessdate=2013-08-11 }}</ref> "[T]o account for the atmospheric corrections ... first [use] the instrument to determine the negative muon spectrum at float altitude. ... [Use this] spectrum ... to normalize the analytically determined atmospheric electron-positron spectra. ... most of the atmospheric electrons and positrons at small atmospheric depths are produced from muon decay at [the energies from 0.85 to 14 GeV]."<ref name=Barbiellini/> ==Meteorites== {{main|Rocks/Meteorites|Meteorites}} ²⁶Al "decays into excited ²⁶Mg by either positron decay or electron capture. In both cases, the excited magnesium isotope de-excites radatively, releasing a photon of energy 1.809 MeV."<ref name=Markwick>{{ cite journal |author=A. J. Markwick |author2=M. Ilgner |author3=T. J. Millar |author4=Th. Henning |title=Molecular distributions in the inner regions of protostellar disks |journal=Astronomy & Astrophysics |month=April |year=2002 |volume=385 |issue=04 |pages=632-46 |url=http://www.gps.caltech.edu/~gab/ge128/lectures/henning_disk.pdf |arxiv= |bibcode=2002A&A...385..632M |doi=10.1051/0004-6361:20020050 |pmid= |accessdate=2013-08-17 }}</ref> "The ²⁶Al concentration in a meteorite depends upon different [parameters] like the exposure age, the shielding conditions of the analyzed sample and the terrestrial age of the meteorite."<ref name=Altmaier/> "As ²⁶Al is a positron emitting isotope, it is possible to measure ²⁶Al in meteorites by gamma-coincidence low level counting techniques [1]. Positron annihilation radiation (due to the destructive recombination of a positron and an electron) is emitted as two simultaneous 511 keV gamma rays with 180° angle correlation. By focusing exclusively on the coincident 511 keV events, a drastic reduction of the detected radiation background is achieved, and the non-destructive determination of ²⁶Al in bulk samples of 5-50 g becomes possible."<ref name=Altmaier>{{ cite journal |author=M. Altmaier |author2=U. Herpers |title=Al-26 in 34 Stony Meteorites Measured via Gamma-gamma Coincidence Counting |journal=Meteoritics & Planetary Science Supplement |month=September |year=2001 |volume=36 |issue=09 |pages=A10 |url=http://adsabs.harvard.edu/full/2001M%26PSA..36R..10A |arxiv= |bibcode=2001M&PSA..36R..10A |doi= |pmid= |accessdate=2013-08-11 }}</ref> ==Sun== {{main|Stars/Sun|Sun (star)}} The preflare solar material is observed "to be an elevated cloud of prominence-like material which is suddenly lit up by the onslaught of hard electrons accelerated in the flare; the acceleration may be inside or outside the cloud, and brightening is seen in other areas of the solar surface on the same magnetic field lines."<ref name=Zirin78>{{ cite journal |author=Harold Zirin |title=The L-alpha/H-alpha ratio in solar flares, quasars, and the chromosphere |journal=Astrophysical Journal |month=June |year=1978 |volume=222 |issue=6 |pages=L105-7 |url= |bibcode=1978ApJ...222L.105Z |doi= 10.1086/182702 |pmid= |accessdate=2011-08-01 }}</ref> A [[w:coronal mass ejection|coronal mass ejection]] (CME) is an ejected plasma consisting primarily of electrons and [[w:proton|proton]]s. "The suprathermal electrons in the solar wind and in solar particle events have excellent properties for this application: they move rapidly, they remain tightly bound to their field lines, and they may arrive "scatter-free" even at low energies, and from deep in the solar atmosphere (Lin 1985)."<ref name=Hudson>{{ cite journal |author=H. S. Hudson |author2=A. B. Galvin |title=Correlated Studies at Activity Maximum: the Sun and the Solar Wind, In: ''Correlated Phenomena at the Sun, in the Heliosphere and in Geospace'' |publisher=European Space Agency |location=Noordwijk, The Netherlands |month=September |year=1997 |editor=A. Wilson |pages=275-82 |url= |bibcode=1997ESASP.415..275H |doi= |pmid= |isbn=92-9092-660-0 |accessdate=2011-11-25 }}</ref> ==Coronal clouds== {{main|Plasmas/Plasma objects/Coronal clouds}} [[Image:Helmet streamers at max.gif|thumb|right|250px|An abundance of helmet streamers is shown at solar maximum. Credit: NASA.{{tlx|free media}}]] [[Image:Helmet streamers at min.jpg|thumb|left|250px|Helmet streamers are shown at solar minimum restricted to mid latitudes. Credit: NASA.{{tlx|free media}}]] [[Image:Rhessi0269 web.jpg|thumb|right|250px|RHESSI observes high-energy phenomena from a solar flare. Credit: NASA/Goddard Space Flight Center Scientific Visualization Studio.{{tlx|free media}}]] '''Helmet streamers''' are bright loop-like structures which develop over active regions on the sun. They are closed magnetic loops which connect regions of opposite magnetic polarity. Electrons are captured in these loops, and cause them to glow very brightly. The solar wind elongates these loops to pointy tips. They far extend above most prominences into the [[Coronal cloud|corona]], and can be readily observed during a solar eclipse. Helmet streamers are usually confined to the "streamer belt" in the mid latitudes, and their distribution follows the movement of active regions during the [[w:solar cycle|solar cycle]]. Small blobs of plasma, or "plasmoids" are sometimes released from the tips of helmet streamers, and this is one source of the slow component of the [[w:solar wind|solar wind]]. In contrast, formations with open magnetic field lines are called [[w:coronal holes|coronal holes]], and these are darker and are a source of the fast solar wind. Helmet streamers can also create coronal mass ejections if a large volume of plasma becomes disconnected near the tip of the streamer. In the corona [[w:thermal conduction|thermal conduction]] occurs from the external hotter atmosphere towards the inner cooler layers. Responsible for the diffusion process of the heat are the electrons, which are much lighter than ions and move faster. The solar flare at Active Region 10039 on July 23, 2002, exhibits many exceptional high-energy phenomena including the 2.223 MeV neutron capture line and the 511 keV electron-positron (antimatter) annihilation line. In the image at right, the RHESSI low-energy channels (12-25 keV) are represented in red and appear predominantly in coronal loops. The high-energy flux appears as blue at the footpoints of the coronal loops. Violet is used to indicate the location and relative intensity of the 2.2 MeV emission. During solar flares “[s]everal radioactive nuclei that emit positrons are also produced; [which] slow down and annihilate in flight with the emission of two 511 keV photons or form positronium with the emission of either a three gamma continuum (each photon < 511 keV) or two 511 keV photons."<ref name=Share>{{ cite book |author=Gerald H. Share |author2=Ronald J. Murphy |title=Solar Gamma-Ray Line Spectroscopy – Physics of a Flaring Star, In: ''Stars as Suns: Activity, Evolution and Planets'' |publisher=Astronomical Society of the Pacific |location=San Francisco, CA |date=January 2004 |editor=Andrea K. Dupree |editor2=A. O. Benz |pages=133-44 |url=http://heseweb.nrl.navy.mil/gamma/solar/papers/share_iau_04.pdf |arxiv= |bibcode=2004IAUS..219..133S |doi= |pmid= |isbn=158381163X |accessdate=2012-03-15 }}</ref> The [[w:Reuven Ramaty High Energy Solar Spectroscopic Imager|Reuven Ramaty High Energy Solar Spectroscopic Imager]] (RHESSI) made the first high-resolution observation of the solar positron-electron annihilation line during the July 23, 2003 solar flare.<ref name=Share/> The observations are somewhat consistent with electron-positron annihilation in a quiet solar atmosphere via positronium as well as during flares.<ref name=Share/> Line-broadening is due to "the velocity of the positronium."<ref name=Share/> "The width of the annihilation line is also consistent ... with thermal broadening (Gaussian width of 8.1 ± 1.1 keV) in a plasma at 4-7 x 10⁵ K. ... The ''RHESSI'' and all but two of the ''SMM'' measurements are consistent with densities ≤ 10¹² H cm^-3 [but] <10% of the p and α interactions producing positrons occur at these low densities. ... positrons produced by ³He interactions form higher in the solar atmosphere ... all observations are consistent with densities > 10¹² H cm^-3. But such densities require formation of a substantial mass of atmosphere at transition region temperatures."<ref name=Share/> {{clear}} ==Solar winds== Particles such as electrons are used as tracers of cosmic magnetic fields.<ref name=Hudson>{{ cite journal |author=H. S. Hudson |author2=A. B. Galvin |title=Correlated Studies at Activity Maximum: the Sun and the Solar Wind, In: ''Correlated Phenomena at the Sun, in the Heliosphere and in Geospace'' |publisher=European Space Agency |location=Noordwijk, The Netherlands |month=September |year=1997 |editor=A. Wilson |pages=275-82 |url= |bibcode=1997ESASP.415..275H |doi= |pmid= |isbn=92-9092-660-0 |accessdate=2011-11-25 }}</ref> "From a plasma-physics point of view, the particles represent the correct way to identify magnetic field lines."<ref name=Hudson/> "The suprathermal electrons in the solar wind and in solar particle events have excellent properties for this application: they move rapidly, they remain tightly bound to their field lines, and they may arrive "scatter-free" even at low energies, and from deep in the solar atmosphere (Lin 1985)."<ref name=Hudson/> "Energetic photons, ions and electrons from the solar wind, together with galactic and extragalactic cosmic rays, constantly bombard surfaces of planets, planetary satellites, dust particles, comets and asteroids."<ref name=Madey>{{ cite journal |author=Theodore E. Madey |author2=Robert E. Johnson |author3=Thom M. Orlando |title=Far-out surface science: radiation-induced surface processes in the solar system |journal=Surface Science |month=March |year=2002 |volume=500 |issue=1-3 |pages=838-58 |url=http://www.physics.rutgers.edu/~madey/Publications/Full_Publications/PDF/madey_SS_2002.pdf |arxiv= |bibcode= |doi=10.1016/S0039-6028(01)01556-4 |pmid= |accessdate=2012-02-09 }}</ref> ==Mercury== {{main|Liquids/Liquid objects/Mercury}} Mariner 10 has aboard "one backward facing electron spectrometer (BESA). ... An electron spectrum [is] obtained every 6 s, ... within the energy range 13.4-690 eV. ... [B]y taking into account [the angular] distortion [caused by the solar wind passing the spacecraft] and the spacecraft sheath characteristics ... some of the solar wind plasma parameters such as ion bulk speed, electron temperature, and electron density [are derived]."<ref name=Williams>{{ cite book |author=David R. Williams |title=Scanning Electrostatic Analyzer and Electron Spectrometer |publisher=NASA Goddard Space Flight Center |location=Greenbelt, Maryland |date=May 14, 2012 |url=http://nssdc.gsfc.nasa.gov/nmc/experimentDisplay.do?id=1973-085A-03 |accessdate=2012-08-23 }}</ref> Mariner 10 had three encounters with Mercury on March 29, 1974, September 21, 1974, and on March 16, 1975.<ref name=Williams2>{{ cite book |author=David R. Williams |title=Mariner 10 |publisher=NASA Goddard Space Flight Center |location=Greenbelt, Maryland |date=May 14, 2012 |url=http://nssdc.gsfc.nasa.gov/nmc/spacecraftDisplay.do?id=1973-085A |accessdate=2012-08-23 }}</ref> The BESA measurements "show that the planet interacts with the solar wind to form a bow shock and a permanent magnetosphere. ... The magnetosphere of Mercury appears to be similar in shape to that of the earth but much smaller in relation to the size of the planet. The average distance from the center of Mercury to the subsolar point of the magnetopause is ∼ 1.4 planetary radii. Electron populations similar to those found in the earth’s magnetotail, within the plasma sheet and adjacent regions, were observed at Mercury; both their spatial location and the electron energy spectra within them bear qualitative and quantitative resemblance to corresponding observations at the earth."<ref name=Ogilvie>{{ cite journal |author=K. W. Ogilvie |author2=J. D. Scudder |author3=V. M. Vasyliunas |title=Observations at the Planet Mercury by the Plasma Electron Experiment: Mariner 10 |journal=Journal of Geophysical Research |month= |year=1977 |volume=82 |issue=13 |pages=1807-24 |url=http://www.agu.org/pubs/crossref/1977/JA082i013p01807.shtml |arxiv= |bibcode= |doi=10.1029/JA082i013p01807 |pmid= |accessdate=2012-08-23 }}</ref> "[T]he Mercury encounter (M I) by Mariner 10 on 29 March 1974 occurred during the height of a Jovian electron increase in the interplanetary medium."<ref name=Russell/> ==Venus== {{main|Gases/Gaseous objects/Venus}} [[Image:Venus xray 420.jpg|thumb|right|250px|This Chandra X-ray Observatory image is the first X-ray image ever made of Venus. Credit: NASA/MPE/K.Dennerl ''et al''.{{tlx|free media}}]] The first ever X-ray image of Venus is shown at right. The "half crescent is due to the relative orientation of the Sun, Earth and Venus. The X-rays from Venus are produced by fluorescent radiation from oxygen and other atoms in the atmosphere between 120 and 140 kilometers above the surface of the planet. In contrast, the optical light from Venus is caused by the reflection from clouds 50 to 70 kilometers above the surface. Solar X-rays bombard the atmosphere of Venus, knock electrons out of the inner parts of atoms, and excite the atoms to a higher energy level. The atoms almost immediately return to their lower energy state with the emission of a fluorescent X-ray. A similar process involving ultraviolet light produces the visible light from fluorescent lamps."<ref name=Dennerl >{{ cite book |author=K. Dennerl |title=Venus: Venus in a New Light |publisher=Harvard University, NASA |location=Boston, Massachusetts, USA |date=November 29, 2001 |url=http://chandra.harvard.edu/photo/2001/venus/ |accessdate=2012-11-26 }}</ref> {{clear}} ==Earth== {{main|Gases/Gaseous objects/Earth}} [[Image:Upperatmoslight1.jpg|thumb|right|250px|The composite shows upper atmospheric lightning and electrical discharge phenomena. Credit: [[c:User:Abestrobi|Abestrobi]].{{tlx|free media}}]] [[Image:Atmosphere with Ionosphere.svg|thumb|right|250px|This graph shows the relationship of the atmosphere and ionosphere to electron density. Credit: Bhamer.{{tlx|free media}}]] [[Image:Earth's_x-ray_aurora_borealis_2004_composite.jpg|thumb|250px|right|Bright X-ray arcs of low energy (0.1 - 10 keV) are generated during auroral activity. Observation dates: 10 pointings between December 16, 2003 and April 13, 2004. Instrument: HRC. Credit: NASA/MSFC/CXC/A.Bhardwaj & R.Elsner, et al.; Earth model: NASA/GSFC/L.Perkins & G.Shirah.{{tlx|free media}}]] [[Image:Earthxray polar.jpg|thumb|right|250px|This image is a composite of the first picture of the Earth in X-rays over a diagram of the Earth below. Credit: NASA, Ruth Netting.{{tlx|free media}}]] With respect to the rocky-object Earth, between the surface and various altitudes there is an [[w:electric field|electric field]] induced by the ionosphere. It changes with altitude from about 150 [[w:volt|volt]]s per [[w:meter|meter]] at the suface to lower values at higher altitude. In fair weather, it is relatively constant, in turbulent weather it is accompanied by [[w:Ion|ion]]s. At greater altitude these chemical species continue to increase in [[w:concentration|concentration]]. To dissipate the accumulation of greater charge differential between the surface and the ionosphere, the gases between suffer breakdown (ionization) that permits [[lightning]] to be either a draw of negative charge, usually electrons, upward from the surface or a transfer of positive charge to the ground. "[L]ow-altitude regions of downward electric current on auroral magnetic field lines are sites of dramatic upward magnetic field-aligned electron acceleration that generates intense magnetic field-aligned electron beams within Earth’s equatorial middle magnetosphere."<ref name=Mauk>{{ cite journal |author=Barry H. Mauk |author2=Joachim Saur |title=Equatorial electron beams and auroral structuring at Jupiter |journal=Journal of Geophysical Research |month=October 26, |year=2007 |volume=112 |issue=A10221 |pages=20 |url=http://www.igpp.ucla.edu/public/mkivelso/refs/PUBLICATIONS/Mauk2007JA012370.pdf |arxiv= |bibcode= |doi=10.1029/2007JA012370 |pmid= |accessdate=2012-06-02 }}</ref> The ionosphere is a shell of electrons and electrically charged [[w:atom|atom]]s and [[w:molecule|molecule]]s that surrounds the Earth, stretching from a height of about 50&nbsp;km to more than 1000&nbsp;km. It owes its existence primarily to [[w:ultraviolet|ultraviolet]] radiation from the [[Sun (star)|Sun]]. The images [lower right] are superimposed on a simulated image of the Earth. The color code represents brightness, maximum in red. Distance from the North pole to the black circle is {{convert|3,340|km|mi|abbr=on}}. "Auroras are produced by solar storms that eject clouds of energetic charged particles. These particles are deflected when they encounter the Earth’s magnetic field, but in the process large electric voltages are created. Electrons trapped in the Earth’s magnetic field are accelerated by these voltages and spiral along the magnetic field into the polar regions. There they collide with atoms high in the atmosphere and emit X-rays".<ref name=Bhardwaj>{{ cite book |author=A. Bhardwaj |author2=R. Elsner |title=Earth Aurora: Chandra Looks Back At Earth |publisher=Harvard-Smithsonian Center for Astrophysics |location=Cambridge, Massachusetts, USA |date=February 20, 2009 |url=http://chandra.harvard.edu/photo/2005/earth/ |accessdate=2013-05-10 }}</ref> At right is a composite image which contains the first picture of the Earth in X-rays, taken in March, 1996, with the orbiting [[w:Polar (satellite)|Polar]] satellite. The area of brightest X-ray emission is red. Energetic charged particles from the Sun energize electrons in the Earth's magnetosphere. These electrons move along the Earth's magnetic field and eventually strike the ionosphere, causing the X-ray emission. Lightning strikes or bolts across the sky also emit X-rays.<ref name=Newitz>Newitz, A. (2007) ''Educated Destruction 101''. Popular Science magazine, September. pg. 61.</ref> “One approach for characterizing the sky distribution of positron annihilation radiation is to fit to the data parameterized (and idealized) model distributions, representing the Galactic bulge, halo, and disk.”<ref name=Weidenspointner/> “Two scenarios for the Galactic dsitribution of 511 keV line emission that remain viable after more than 4 years of observations with SPI [are] # bulge + thick disk (BD) and # halo + thin disk (HD).”<ref name=Weidenspointner/> In 2009, the Fermi Gamma Ray Telescope in Earth orbit observed [an] intense burst of gamma rays corresponding to positron annihilations coming out of a storm formation. Scientists wouldn't have been surprised to see a few positrons accompanying any intense gamma ray burst, but the lightning flash detected by Fermi appeared to have produced about 100 trillion positrons. This has been reported by media in January 2011, it is an effect, never considered to happen before.<ref>http://news.nationalgeographic.com/news/2011/01/110111-thunderstorms-antimatter-beams-fermi-radiation-science-space/</ref> "The Gamma-ray Burst Monitor (GBM) detects sudden flares of gamma-rays produced by gamma ray bursts and solar flares. Its scintillators are on the sides of the spacecraft to view all of the sky which is not blocked by the earth. The design is optimized for good resolution in time and photon energy. The Gamma-ray Burst Monitor has detected gamma rays from positrons generated in powerful thunderstorms.<ref name=Glast>http://www.nasa.gov/mission_pages/GLAST/news/fermi-thunderstorms.html</ref> {{clear}} ==Van Allen radiation belts== The '''Van Allen radiation belt''' is split into two distinct belts, with energetic electrons forming the outer belt and a combination of protons and electrons forming the inner belts. In addition, the radiation belts contain lesser amounts of other nuclei, such as [[w:alpha particle|alpha particle]]s. The large outer radiation belt extends from an altitude of about three to ten Earth radii (''R_E'') or 13,000 to 60,000 kilometres above the Earth's surface. Its greatest intensity is usually around 4–5 ''R_E''. The outer electron radiation belt is mostly produced by the inward radial diffusion<ref name=Elkington>{{ cite book | author=Elkington, S. R. |author2=Hudson, M. K. |author3=Chan, A. A. | title=Enhanced Radial Diffusion of Outer Zone Electrons in an Asymmetric Geomagnetic Field | publisher=American Geophysical Union | date=May 2001 | bibcode=2001AGUSM..SM32C04E }}</ref><ref name=Shprits>{{ cite journal | author=Shprits, Y. Y. |author2=Thorne, R. M. | title=Time dependent radial diffusion modeling of relativistic electrons with realistic loss rates | journal=Geophysical Research Letters | volume=31 | issue=8 | doi=10.1029/2004GL019591 | year=2004 | pages=L08805 | bibcode=2004GeoRL..3108805S }}</ref> and local acceleration<ref name=Horne>{{ cite journal | author=Horne, Richard B. |author2=Thorne, Richard M. ''et al'' | title=Wave acceleration of electrons in the Van Allen radiation belts | journal=Nature | volume=437 | issue=7056 | pages=227&ndash;230 | year=2005 | doi=10.1038/nature03939 | pmid=16148927 |bibcode = 2005Natur.437..227H }}</ref> due to transfer of energy from whistler mode [[w:plasma waves|plasma waves]] to radiation belt electrons. Radiation belt electrons are also constantly removed by collisions with atmospheric neutrals,<ref name=Horne/> losses to [[w:magnetopause|magnetopause]], and the outward radial diffusion. The outer belt consists mainly of high energy (0.1–10 MeV) electrons trapped by the Earth's [[w:magnetosphere|magnetosphere]]. The [[w:gyroradius|gyroradii]] for energetic protons would be large enough to bring them into contact with the Earth's atmosphere. The electrons here have a high [[w:flux|flux]] and at the outer edge (close to the magnetopause), where [[w:geomagnetic field|geomagnetic field]] lines open into the geomagnetic "tail", fluxes of energetic electrons can drop to the low interplanetary levels within about 100&nbsp;km (a decrease by a factor of 1,000). ==Moon== {{main|Liquids/Liquid objects/Moon}} [[Image:Moon ER magnetic field.jpg|thumb|right|250px|These two hemispheric Lambert azimuthal equal area projections show the total magnetic field strength at the surface of the Moon, derived from the Lunar Prospector electron reflectometer (ER) experiment. Credit: Mark A. Wieczorek.{{tlx|free media}}]] [[Image:Moon-Mdf-2005.jpg|thumb|left|250px|The '''Moon''' where a prediction of a lunar double layer<ref>Borisov, N.; Mall, U. "[http://adsabs.harvard.edu/cgi-bin/nph-bib_query?bibcode=2002JPlPh..67..277B&db_key=PHY&data_type=HTML&format=&high=42ca922c9c05280 The structure of the double layer behind the Moon]" (2002) ''Journal of Plasma Physics'', vol. 67, Issue 04, pp. 277&ndash;299</ref> was confirmed in 2003.<ref>Halekas, J. S.; Lin, R. P.; Mitchell, D. L. "[http://adsabs.harvard.edu/cgi-bin/nph-bib_query?bibcode=2003GeoRL..30uPLA1H&db_key=AST&data_type=HTML&format=&high=42ca922c9c27734 Inferring the scale height of the lunar nightside double layer]" (2003) ''Geophysical Research Letters'', Volume 30, Issue 21, pp. PLA 1-1. ([http://sprg.ssl.berkeley.edu/adminstuff/webpubs/2003_grl_2117.pdf PDF])</ref> In the shadows, the Moon charges negatively in the interplanetary medium.<ref>Halekas, J. S ''et al.'' "[http://adsabs.harvard.edu/cgi-bin/nph-bib_query?bibcode=2002GeoRL..29j..77H&amp;db_key=AST&amp;data_type=HTML&amp;format=&amp;high=42ca922c9c05119 Evidence for negative charging of the lunar surface in shadow]" (2002) ''Geophysical Research Letters'', Volume 29, Issue 10, pp. 77&ndash;81</ref> Credit: [[w:User:Mdf|Mdf]].{{tlx|free media}}]] The electron reflectometer (ER) aboard the Lunar Prospector determines the location and strength of magnetic fields from the [[w:energy spectrum|energy spectrum]] and direction of [[w:electron|electron]]s. The instrument measures the pitch [[w:angle|angle]]s of [[w:solar wind|solar wind]] electrons reflected from the Moon by lunar magnetic fields. Stronger local magnetic fields can reflect electrons with larger pitch angles. [[w:Field strength|Field strength]]s as small as 0.01 [nanotesla] [[w:nanotesla|nT]] could be measured with a spatial accuracy of about 3 km (1.9 mi) at the lunar surface. "[T]he shadowed lunar surface charges negative."<ref name=Halekas>{{ cite journal |author=J. S. Halekas |author2=R. P. Lin |author3=D. L. Mitchell |title=Inferring the scale height of the lunar nightside double layer |journal=Geophysical Research Letters |month=November |year=2003 |volume=30 |issue=21 |pages=4 |url= |arxiv= |bibcode=2003GeoRL..30uPLA1H |doi=10.1029/2003GL018421 |pmid= |accessdate=2012-11-16 }}</ref> {{clear}} ==Mars== {{main|Liquids/Liquid objects/Mars}} "[L]uminescence dating techniques [may] provide absolute age determinations of eolian sediments on the surface of Mars, including those incorporated in the martian polar ice caps. Fundamental thermally and optically stimulated luminescence properties of bulk samples of JSC Mars-1 soil simulant [have been studied]. The radiation-induced luminescence signals (both thermoluminescence, TL, and optically stimulated luminescence, OSL) from JSC Mars-1 are found to have a wide dynamic dose–response range, with the luminescence increasing linearly to the highest doses used (936 Gy), following irradiation with ⁹⁰Sr/⁹⁰Y beta particles."<ref name=Lepper>{{ cite journal |author=Kenneth Lepper |author2=Stephen W.S. McKeever |title=Characterization of Fundamental Luminescence Properties of the Mars Soil Simulant JSC Mars-1 and Their Relevance to Absolute Dating of Martian Eolian Sediments |journal=Icarus |month=April |year=2000 |volume=144 |issue=2 |pages=295–301 |url=http://www.sciencedirect.com/science/article/pii/S0019103599962954 |arxiv= |bibcode= |doi=10.1006/icar.1999.6295 |pmid= |accessdate=2014-09-21 }}</ref> ==Jupiter== {{main|Jupiter}} [[Image:Jupiter magnetosphere schematic.jpg|thumb|right|250px|This is a schematic of Jupiter's magnetosphere and the components influenced by Io (near the center of the image). Credit: John Spencer.{{tlx|free media}}]] The image at right represents "[t]he Jovian magnetosphere [magnetic field lines in blue], including the Io flux tube [in green], Jovian aurorae, the sodium cloud [in yellow], and sulfur torus [in red]."<ref name=Spencer>{{ cite book |author=John Spencer |title=John Spencer's Astronomical Visualizations |publisher=University of Colorado |location=Boulder, Colorado USA |date=November 2000 |url=http://www.boulder.swri.edu/~spencer/digipics.html |accessdate=2013-04-05 }}</ref> "Io may be considered to be a unipolar generator which develops an emf [electromotive force] of 7 x 10⁵ volts across its radial diameter (as seen from a coordinate frame fixed to Jupiter)."<ref name=Goldreich>{{ cite journal |author=Peter Goldreich |author2=Donald Lynden-Bell |title=Io, a jovian unipolar inductor |journal=The Astrophysical Journal |month=April |year=1969 |volume=156 |issue=04 |pages=59-78 |url= |arxiv= |bibcode=1969ApJ...156...59G |doi=10.1086/149947 |pmid= |accessdate=2013-04-05 }}</ref> "This voltage difference is transmitted along the magnetic flux tube which passes through Io. ... The current [in the flux tube] must be carried by keV electrons which are electrostatically accelerated at Io and at the top of Jupiter's ionosphere."<ref name=Goldreich/> "Io's high density (4.1 g cm^-3) suggests a silicate composition. A reasonable guess for its electrical conductivity might be the conductivity of the Earth's upper mantle, 5 x 10^-5 ohm^-1 cm^-1 (Bullard 1967)."<ref name=Goldreich/> As "a conducting body [transverses] a magnetic field [it] produces an induced electric field. ... The Jupiter-Io system ... operates as a unipolar inductor" ... Such unipolar inductors may be driven by electrical power, develop hotspots, and the "source of heating [may be] sufficient to account for the observed X-ray luminosity".<ref name=Wu>{{ cite journal |author=Kinwah Wu |author2=Mark Cropper |author3=Gavin Ramsay |author4=Kazuhiro Sekiguchi |title=An electrically powered binary star? |journal=Monthly Notices of the Royal Astronomical Society |month=March |year=2002 |volume=321 |issue=1 |pages=221-7 |url= |arxiv=astro-ph/0111358 |bibcode=2002MNRAS.331..221W |doi=10.1046/j.1365-8711.2002.05190.x |pmid= |accessdate=2013-04-05 }}</ref> "The electrical surroundings of Io provide another energy source which has been estimated to be comparable with that of the [gravitational] tides (7). A current of 5 x 10⁶ A is ... shunted across flux tubes of the Jovian field by the presence of Io (7-9)."<ref name=Gold>{{ cite journal |author=Thomas Gold |title=Electrical Origin of the Outbursts on Io |journal=Science |month=November |year=1979 |volume=206 |issue=4422 |pages=1071-3 |url= |arxiv= |bibcode=1979Sci...206.1071G |doi=10.1126/science.206.4422.1071 |pmid= |accessdate=2013-04-05 }}</ref> "[W]hen the currents [through Io] are large enough to cause ohmic heating ... currents ... contract down to narrow paths which can be kept hot, and along which the conductivity is high. Tidal heating [ensures] that the interior of Io has a very low eletrical resistance, causing a negligible extra amount of heat to be deposited by this current. ... [T]he outermost layers, kept cool by radiation into space [present] a large resistance and [result in] a concentration of the current into hotspots ... rock resistivity [and] contact resistance ... contribute to generate high temperatures on the surface. [These are the] conditions of electric arcs [that can produce] temperatures up to ionization levels ... several thousand kelvins".<ref name=Gold/> "[T]he outbursts ... seen [on the surface may also be] the result of the large current ... flowing in and out of the domain of Io ... Most current spots are likely to be volcanic calderas, either provided by tectonic events within Io or generated by the current heating itself. ... [A]s in any electric arc, very high temperatures are generated, and the locally evaporated materials ... are ... turned into gas hot enough to expand at a speed of 1 km/s."<ref name=Gold/> "Field-aligned equatorial electron beams [have been] observed within Jupiter’s middle magnetosphere. ... the Jupiter equatorial electron beams are spatially and/or temporally structured (down to <20 km at auroral altitudes, or less than several minutes), with regions of intense beams intermixed with regions absent of such beams."<ref name=Mauk/> "Jovian electrons, both at Jupiter and in the interplanetary medium near Earth, have a very hard spectrum that varies as a power law with energy (see, e.g., Mewaldt et al. 1976). This spectral character is sufficiently distinct from the much softer solar and magnetospheric electron spectra that it has been used as a spectral filter to separate Jovian electrons from other sources ... A second Jovian electron characteristic is that such electrons in the interplanetary medium tend to consist of flux increases of several days duration which recur with 27 day periodicities ... A third feature of Jovian electrons at 1 AU is that the flux increases exhibit a long-term modulation of 13 months which is the synodic period of Jupiter as viewed from Earth".<ref name=Russell>{{ cite book |author=C. T. Russell |author2=D. N. Baker |author3=J. A. Slavin |title=The Magnetosphere of Mercury, In: ''Mercury'' |publisher=University of Arizona Press |location=Tucson, Arizona, United States of America |date=January 1, 1988 |editor=Faith Vilas |editor2=Clark R. Chapman |editor3=Mildred Shapley Matthews |pages=514-61 |url=http://www-ssc.igpp.ucla.edu/personnel/russell/papers/magMercury.pdf |arxiv= |bibcode=1988merc.book..514R |doi= |isbn=0816510857 |pmid= |accessdate=2012-08-23 }}</ref> Jovian electrons propagate "along the spiral magnetic field of the interplanetary medium [from Jupiter and its magnetosphere to the Sun]".<ref name=Russell/> {{clear}} ==Callisto== {{main|Rocks/Rocky objects/Callisto}} [[Image:Callisto.jpg|thumb|right|250px|This image of Callisto from NASA's Galileo spacecraft, taken in May 2001, is the only complete global color image of Callisto obtained by Galileo. Credit: NASA/JPL/DLR(German Aerospace Center).{{tlx|free media}}]] At right is a complete global color image of Callisto. Bright scars on a darker surface testify to a long history of impacts on Jupiter's moon Callisto. The picture, taken in May 2001, is the only complete global color image of Callisto obtained by Galileo, which has been orbiting Jupiter since December 1995. Of Jupiter's four largest moons, Callisto orbits farthest from the giant planet. Callisto's surface is uniformly cratered but is not uniform in color or brightness. Scientists believe the brighter areas are mainly ice and the darker areas are highly eroded, ice-poor material. Callisto's ionosphere was first detected during ''Galileo'' flybys;<ref name="Kliore 2002">{{ cite journal |author=A. J. Kliore |author2=A. Anabtawi |author3=R. G. Herrera |author4=''et al.'' |title=Ionosphere of Callisto from Galileo radio occultation observations |journal=Journal of Geophysics Research |year=2002 |volume=107 |issue=A11 |page=1407 |doi=10.1029/2002JA009365 | bibcode=2002JGRA.107kSIA19K }}</ref> its high electron density of 7&ndash;17 x 10⁴&nbsp;cm^&minus;3 cannot be explained by the photoionization of the atmospheric [[w:carbon dioxide|carbon dioxide]] alone. {{clear}} ==Saturn== {{main|Gases/Gaseous objects/Saturn}} "[M]agnetospheric electron (bi-directional) beams connect to the expected locations of Saturn’s aurora".<ref name=Saur>{{ cite journal |author=J. Saur |author2=B.H. Mauk |author3=D.G. Mitchell |author4=N. Krupp |author5=K.K. Khurana |author6=S. Livi |author7=S.M. Krimigis |author8=P.T. Newell |author9=D.J. Williams |author10=P.C. Brandt |author11=A. Lagg |author12=E. Roussos |author13=M.K. Dougherty |title=Anti-planetward auroral electron beams at Saturn |journal=Nature |month=February |year=2006 |volume=439 |issue=7077 |pages=699-702 |url= |arxiv= |bibcode=2006Natur.439..699S |doi=10.1038/nature04401 |pmid= |accessdate=2012-06-02 }}</ref> Powered by the Saturnian equivalent of (filamentary) Birkeland currents, streams of charged particles from the interplanetary medium interact with the planet's magnetic field and funnel down to the poles.<ref name=Isbell>Isbell, J.; Dessler, A. J.; Waite, J. H. "[http://adsabs.harvard.edu/cgi-bin/nph-bib_query?bibcode=1984JGR....8910715I&amp;db_key=PHY&amp;data_type=HTML&amp;format=&amp;high=42ca922c9c16745 Magnetospheric energization by interaction between planetary spin and the solar wind]" (1984) ''Journal of Geophysical Research'', Volume 89, Issue A12, pp. 10715&ndash;10722</ref> Double layers are associated with (filamentary) currents,<ref name=Theisen>Theisen, William L. "[http://adsabs.harvard.edu/cgi-bin/nph-bib_query?bibcode=1994PhDT........19T&amp;db_key=AST&amp;data_type=HTML&amp;format=&amp;high=42ca922c9c05019 Langmuir Bursts and Filamentary Double Layers in Plasmas.]" (1994) Ph.D Thesis U. of Iowa, 1994</ref><ref name=Deverapalli>Deverapalli, C. M.; Singh, N.; Khazanov, I. "[http://adsabs.harvard.edu/cgi-bin/nph-bib_query?bibcode=2005AGUFMSM41C1202D&amp;db_key=AST&amp;data_type=HTML&amp;format=&amp;high=42ca922c9c05019 Filamentary Structures in U-Shaped Double Layers]" (2005) American Geophysical Union, Fall Meeting 2005, abstract #SM41C-1202</ref> and their electric fields accelerate ions and electrons.<ref name=Borovsky>Borovsky, Joseph E. "[http://adsabs.harvard.edu/cgi-bin/nph-bib_query?bibcode=1992PhRvL..69.1054B&amp;db_key=PHY&amp;data_type=HTML&amp;format=&amp;high=42ca922c9c27309 Double layers do accelerate particles in the auroral zone]" (1992) ''Physical Review Letters'' (ISSN 0031-9007), vol. 69, no. 7, Aug. 17, 1992, pp. 1054&ndash;1056</ref> ==Heliospheres== {{main|Stars/Sun/Heliospheres}} These electrons "provide remote-sensing observations of distant targets in the heliosphere - the Sun, the Moon, Jupiter, and various heliospheric structures."<ref name=Hudson/> ==Interstellars== {{main|Interstellar medium}} As of December 5, 2011, "Voyager 1 is about ... 18 billion kilometers ... from the [S]un [but] the direction of the magnetic field lines has not changed, indicating Voyager is still within the heliosphere ... the outward speed of the solar wind had diminished to zero in April 2010 ... inward pressure from interstellar space is compacting [the magnetic field] ... Voyager has detected a 100-fold increase in the intensity of high-energy electrons from elsewhere in the galaxy diffusing into our solar system from outside ... [while] the [solar] wind even blows back at us."<ref name=SteveCole>{{ cite book |author=Steve Cole |author2=Jia-Rui C. Cook |author3=Alan Buis |title=NASA's Voyager Hits New Region at Solar System Edge |publisher=NASA |location=Washington, DC |date=December 2011 |url=http://www.nasa.gov/home/hqnews/2011/dec/HQ_11-402_AGU_Voyager.html |accessdate=2012-02-09 }}</ref> "In the first 18 months of operations, AMS-02 [image under Cherenkov detectors] recorded 6.8 million positron (an antimatter particle with the mass of an electron but a positive charge) and electron events produced from cosmic ray collisions with the interstellar medium in the energy range between 0.5 giga-electron volt (GeV) and 350 GeV. These events were used to determine the positron fraction, the ratio of positrons to the total number of electrons and positrons. Below 10 GeV, the positron fraction decreased with increasing energy, as expected. However, the positron fraction increased steadily from 10 GeV to 250 GeV. This increase, seen previously though less precisely by instruments such as the Payload for Matter/antimatter Exploration and Light-nuclei Astrophysics (PAMELA) and the Fermi Gamma-ray Space Telescope, conflicts with the predicted decrease of the positron fraction and indicates the existence of a currently unidentified source of positrons, such as pulsars or the annihilation of dark matter particles. Furthermore, researchers observed an unexpected decrease in slope from 20 GeV to 250 GeV. The measured positron to electron ratio is isotropic, the same in all directions."<ref name=Ting>{{ cite book |author=Samuel Ting |author2=Manuel Aguilar-Benitez |author3=Silvie Rosier |author4=Roberto Battiston |author5=Shih-Chang Lee |author6=Stefan Schael |author7=Martin Pohl |title=Alpha Magnetic Spectrometer - 02 (AMS-02) |publisher=NASA |location=Washington, DC USA |date=April 13, 2013 |url=http://www.nasa.gov/mission_pages/station/research/experiments/742.html |accessdate=2013-05-17 }}</ref> ==X-ray novas== "The day after its discovery by the Watch instrument, the X-ray nova GRS 1124-684 in Musca was detected by the soft γ-ray telescope SIGMA at the limit of its field of view. [...] an emission feature around 500 keV in the source spectrum during one postflare observation [...] is [the] first clear evidence of γ-ray line emission from soft X-ray transients, and, [is] interpreted as a positron annihilation line".<ref name=Goldwurm>{{ cite journal |author=A. Goldwurm |author2=J. Ballet |author3=B. Cordier |author4=J. Paul |author5=L. Bouchet |author6=J. P. Roques |author7=D. Barret |author8=P. Mandrou |author9=R. Sunyaev |author10=E. Churazov |author11=M. Gilfanov |author12=A. Dyachkov |author13=N. Khavenson |author14=V. Kotunenko |author15=R. Kremnev |author16=K. Sukhanov |title=Sigma/GRANAT soft gamma-ray observations of the X-ray nova in Musca - Discovery of positron annihilation emission line |journal=The Astrophysical Journal |month=April 20, |year=1992 |volume=389 |issue=04 |pages=L79-82 |url=http://adsabs.harvard.edu/full/1992ApJ...389L..79G |arxiv= |bibcode=1992ApJ...389L..79G |doi=10.1086/186353 |pmid= |accessdate=2014-01-30 }}</ref> ==Cygnus X-1== In "a 10 keV to 1 MeV X-ray spectrum of Cyg X-1 in its low state, accumulated over ≡3 months in 1977 and 1978. The spectrum is smooth up to 300 keV. The excess at higher energy may be interpreted as a broad 511 keV emission line from the annihilation of positrons."<ref name=Nolan>{{ cite journal |author=P. L. Nolan |author2=J. L. Matteson |title=A feature in the X-ray spectrum of Cygnus X-1 - A possible positron annihilation line |journal=The Astrophysical Journal |month=February 1, |year=1983 |volume=265 |issue=02 |pages=389-92 |url=http://adsabs.harvard.edu/abs/1983ApJ...265..389N |arxiv= |bibcode=1983ApJ...265..389N |doi=10.1086/160683 |pmid= |accessdate=2014-01-30 }}</ref> ==Galactic center== On November 25, 1970, from Paraná, Argentina, latitude 32° S, "[a] balloon-altitude observation was conducted ... of the galactic-center region, at energies between 23 and 930 keV. ... evidence for a spectral feature at 0.5 MeV is [detected]."<ref name=Johnson>{{ cite journal |author=W. N. Johnson III |author2=F. R. Harnden Jr. |author3=R. C. Haymes |title=The Spectrum of Low-Energy Gamma Radiation from the Galactic-Center Region |journal=The Astrophysical Journal |month=February 15, |year=1972 |volume=172 |issue=2 |pages=L1-7 |url= |arxiv= |bibcode=1972ApJ...172L...1J |doi=10.1086/180878 |pmid= |accessdate=2012-03-15 }}</ref> The radiation detected over about 300 to 10³ keV fit a power law of : ''N''(''E'') = (10.5 ± 2.2) ''E''^{-(2.37±0.05)} photons cm^-2 s^-1 keV^-1.<ref name=Johnson/> The 0.5 MeV peak is broad at 473 ± 30 keV and "is consistent with a single γ-ray spectral line [of flux] (1.8 ± 0.5) x 10^-3 photons cm^-2 s^-1 keV^-1 at the top of the [[w:Earth's atmosphere|Earth's atmosphere]] ... Gamma-ray lines in the 0.5-MeV energy region may arise from either the annihilation of positrons or from the de-excitation of nuclei. However, it seems likely, on the basis of evidence presented herein, that the energy of the peak is not at 0.511 MeV (unless the radiation is redshifted by ~0.07 in energy)."<ref name=Johnson/>. More recent measurements from 1979 through 2003 with germanium detectors observed the peak at 511 keV.<ref name=Jean>{{ cite journal |author=P. Jean |author2=J. Knödlseder |author3=V. Lonjou |author4=M. Allain |author5=J.-P. Roques |author6=G.K. Skinner |author7=B.J. Teegarden |author8=G. Vedrenne |author9=P. von Ballmoos |author10=B. Cordier |author11=R. Diehl |author12=Ph. Durouchoux |author13=P. Mandrou |author14=J. Matteson |author15=N. Gehrels |author16=V. Schönfelder |author17=A.W. Strong |author18=P. Ubertini |author19=G. Weidenspointner |author20=C. Winkler |title=Early SPI/INTEGRAL measurements of 511 keV line emission from the 4th quadrant of the Galaxy |journal=Astronomy & Astrophysics |month=August |year=2003 |volume=407 |issue=8 |pages=L55-8 |url=http://arxiv.org/pdf/astro-ph/0309484 |arxiv= |bibcode=2003A&A...407L..55J |doi=10.1051/0004-6361:20031056 |pmid= |accessdate=2012-03-15 }}</ref> "[A] single point source is inconsistent with the data. Formally, we cannot exclude the possibility that the emission originates in at least 2 point sources."<ref name=Jean/> ==Seyfert 1 coronas== "On the basis of spectroscopic observations, the leading models of the X-ray continuum production are based on a hot, Comptonizing electron or electron-positron pair corona close to the black hole."<ref name=Markowitz>{{ cite journal |author=A. Markowitz |author2=R. Edelson |title=An expanded Rossi X-ray timing explorer survey of X-ray variability in Seyfert 1 galaxies |journal=The Astrophysical Journal |month=December 20, |year=2004 |volume=617 |issue=2 |pages=939-65 |url=http://iopscience.iop.org/0004-637X/617/2/939 |arxiv=astro-ph/0409045 |bibcode=2004ApJ...617..939M |doi=10.1086/425559 |pmid= |accessdate=2013-07-07 }}</ref> ==Geography== "The Earth’s magnetic field significantly affects the CR distribution in near-Earth space. At energies below 10 GeV, a significant fraction of the incoming particles are deflected back to interplanetary space by the magnetic field (“geomagnetic cutoff”). The exact value of the geomagnetic cutoff rigidity depends on the detector position and viewing angle. In addition to the geomagnetic cutoff effect, the Earth blocks trajectories for particles of certain rigidities and directions while allowing other trajectories. This results in a different rate of CRs from the east than the west (the “east-west effect”) [24–26]."<ref name=Ackermann/> "Positive charges propagating toward the east are curved outward, while negative charges are curved inward toward the Earth [...] This results in a region of particle directions from which positrons can arrive, while electrons are blocked by the Earth. At each particle rigidity there is a region to the west from which positrons are allowed and electrons are forbidden. There is a corresponding region to the east from which electrons are allowed and positrons are forbidden. The precise size and shape of these regions depend on the particle rigidity and instrument location."<ref name=Ackermann/> ==Technology== {{main|Technology}} "The GAMMA-400 space observatory will provide precise measurements of gamma rays, electrons, and positrons in the energy range 0.1–3000 GeV."<ref name=Galper>{{ cite journal |author=A. M. Galper |author2=R. L. Aptekar |author3=I. V. Arkhangelskaya |author4=M. Boezio |author5=V. Bonvicini |author6=B. A. Dolgoshein |author7=M. O. Farber |author8=M. I. Fradkin |author9=V. Ya. Gecha |author10=V. A. Kachanov |author11=V. A. Kaplin |author12=E. P. Mazets |author13=A. L. Menshenin |author14=P. Picozza |author15=O. F. Prilutskii |author16=V. G. Rodin |author17=M. F. Runtso |author18=P. Spillantini |author19=S. I. Suchkov |author20=N. P. Topchiev |author21=A. Vacchi |author22=Yu. T. Yurkin |author23=N. Zampa |author24=V. G. Zverev |title=The possibilities of simultaneous detection of gamma rays, cosmic-ray electrons and positrons on the GAMMA-400 space observatory |journal=Astrophysics and Space Sciences Transactions |month= |year=2011 |volume=7 |issue= |pages=75-8 |url=http://www.astrophys-space-sci-trans.net/7/75/2011/astra-7-75-2011.html |arxiv= |bibcode= |doi=10.5194/astra-7-75-2011 |pmid= |accessdate=2013-12-10 }}</ref> ==Balloons== {{main|Radiation astronomy/Balloons}} Measurements "of the cosmic-ray positron fraction as a function of energy have been made using the High-Energy Antimatter Telescope (HEAT) balloon-borne instrument."<ref name=Barwick/> "The first flight took place from Fort Sumner, New Mexico, [on May 3, 1994, with a total time at float altitude of 29.5 hr and a mean atmospheric overburden of 5.7 g cm^-2] ... The second flight [is] from Lynn Lake, Manitoba, [on August 23, 1995, with a total time at float altitude of 26 hr, and a mean atmospheric overburden of 4.8 g cm^-2]"<ref name=Barwick/>. ==Fermi Gamma-ray Space Telescope== [[Image:GLAST on the payload attach fitting.jpg|thumb|right|250px|The Fermi Gamma-ray Space Telescope sits on its payload attachment fitting. Credit: NASA/Kim Shiflett.{{tlx|free media}}]] "The Large Area Telescope (LAT) is a pair-conversion gamma-ray telescope onboard the Fermi Gamma-ray Space Telescope satellite. It has been used to measure the combined [cosmic-ray] CR electron and positron spectrum from 7 GeV to 1 TeV [20, 21]. The LAT does not have a magnet for charge separation. However, as pioneered by [22] and [23], the geomagnetic field can also be used to separate the two species without an onboard magnet. Müller and Tang [23] used the difference in geomagnetic cutoff for positrons and electrons from the east and west to determine the positron fraction between 10 GeV and 20 GeV. As reported below, we used the shadow imposed by the Earth and its offset direction for electrons and positrons due to the geomagnetic field, to separately measure the spectra of CR electrons and positrons from 20 GeV to 200 GeV. In this energy range, the 68% containment radius of the LAT point-spread function is 0.1° or better and the energy resolution is 8% or better."<ref name=Ackermann>{{ cite journal |author=M. Ackermann |author2=M. Ajello |author3=A. Allafort |author4=W. B. Atwood |author5=L. Baldini |author6=G. Barbiellini |author7=D. Bastieri |author8=K. Bechtol |author9=R. Bellazzini |author10=B. Berenji |author11=R. D. Blandford |author12=E. D. Bloom |author13=E. Bonamente |author14=A. W. Borgland |author15=A. Bouvier |author16=J. Bregeon |author17=M. Brigida |author18=P. Bruel |author19=R. Buehler |author20=S. Buson |author21=G. A. Caliandro |author22=R. A. Cameron |author23=P. A. Caraveo |author24=J. M. Casandjian |author25=C. Cecchi |author26=E. Charles |author27=A. Chekhtman |author28=C. C. Cheung |author29=J. Chiang |author30=S. Ciprini |author31=R. Claus |author32=J. Cohen-Tanugi |author33=J. Conrad |author34=S. Cutini |author35=A. de Angelis |author36=F. de Palma |author37=C. D. Dermer |author38=S. W. Digel |author39=E. do Couto e Silva |author40=P. S. Drell |author41=A. Drlica-Wagner |author42=C. Favuzzi |author43=S. J. Fegan |author44=E. C. Ferrara |author45=W. B. Focke |author46=P. Fortin |author47=Y. Fukazawa |author48=S. Funk |author49=P. Fusco |author50=F. Gargano |author51=D. Gasparrini |author52=S. Germani |author53=N. Giglietto |author54=P. Giommi |author55=F. Giordano |author56=M. Giroletti |author57=T. Glanzman |author58=G. Godfrey |author59=I. A. Grenier |author60=J. E. Grove |author61=S. Guiriec |author62=M. Gustafsson |author63=D. Hadasch |author64=A. K. Harding |author65=M. Hayashida |author66=R. E. Hughes |author67=G. Jóhannesson |author68=A. S. Johnson |author69=T. Kamae |author70=H. Katagiri |author71=J. Kataoka |author72=J. Knǒdlseder |author73=M. Kuss |author74=J. Lande |author75=L. Latronico |author76=M. Lemoine-Goumard |author77=M. Llena Garde |author78=F. Longo |author79=F. Loparco |author80=M. N. Lovellette |author81=P. Lubrano |author82=G. M. Madejski |author83=M. N. Mazziotta |author84=J. E. McEnery |author85=P. F. Michelson |author86=W. Mitthumsiri |author87=T. Mizuno |author88=A. A. Moiseev |author89=C. Monte |author90=M. E. Monzani |author91=A. Morselli |author92=I. V. Moskalenko |author93=S. Murgia |author94=T. Nakamori |author95=P. L. Nolan |author96=J. P. Norris |author97=E. Nuss |author98=M. Ohno |author99=T. Ohsugi |author100=A. Okumura |author101=N. Omodei |author102=E. Orlando |author103=J. F. Ormes |author104=M. Ozaki |author105=D. Paneque |author106=D. Parent |author107=M. Pesce-Rollins |author108=M. Pierbattista |author109=F. Piron |author110=G. Pivato |author111=T. A. Porter |author112=S. Rainò |author113=R. Rando |author114=M. Razzano |author115=S. Razzaque |author116=A. Reimer |author117=O. Reimer |author118=T. Reposeur |author119=S. Ritz |author120=R. W. Romani |author121=M. Roth |author122=H. F.-W. Sadrozinski |author123=C. Sbarra |author124=T. L. Schalk |author125=C. Sgrò |author126=E. J. Siskind |author127=G. Spandre |author128=P. Spinelli |author129=A. W. Strong |author130=H. Takahashi |author131=T. Takahashi |author132=T. Tanaka |author133=J. G. Thayer |author134=J. B. Thayer |author135=L. Tibaldo |author136=M. Tinivella |author137=D. F. Torres |author138=G. Tosti |author139=E. Troja |author140=Y. Uchiyama |author141=T. L. Usher |author142=J. Vandenbroucke |author143=V. Vasileiou |author144=G. Vianello |author145=V. Vitale |author146=A. P. Waite |author147=B. L. Winer |author148=K. S. Wood |author149=M. Wood |author150=Z. Yang |author151=S. Zimmer |title=Measurement of separate cosmic-ray electron and positron spectra with the Fermi Large Area Telescope |journal=Physical Review Letters |month= |year=2012 |volume=108 |issue=1 |pages=e011103 |url=http://prl.aps.org/abstract/PRL/v108/i1/e011103 |arxiv= |bibcode= |doi= |pmid= |accessdate=2014-01-31 }}</ref> "The Large Area Telescope (LAT) detects individual gamma rays using technology similar to that used in terrestrial [[w:particle accelerator|particle accelerator]]s. [[w:Photons|Photons]] hit thin metal sheets, converting to electron-positron pairs, via a process known as [[w:pair production|pair production]]. These charged particles pass through interleaved layers of silicon [[w:microstrip detector|microstrip detector]]s, causing [[w:ionization|ionization]] which produce detectable tiny pulses of electric charge. Researchers can combine information from several layers of this tracker to determine the path of the particles. After passing through the tracker, the particles enter the [[w:calorimeter|calorimeter]], which consists of a stack of [[w:caesium iodide|caesium iodide]] [[w:scintillator|scintillator]] crystals to measure the total energy of the particles. The LAT's field of view is large, about 20% of the sky. The resolution of its images is modest by astronomical standards, a few arc minutes for the highest-energy photons and about 3 degrees at 100 MeV. The LAT is a bigger and better successor to the [[w:EGRET (telescope)|EGRET]] instrument on NASA's [[w:Compton Gamma Ray Observatory|Compton Gamma Ray Observatory]] satellite in the 1990s. {{clear}} ==GRANAT== [[Image:Granat.gif|thumb|right|250px|Granat observe the universe at energies ranging from X-rays to gamma rays. Credit: NASA.{{tlx|free media}}]] The ''GRANAT'' satellite has aboard the [French coded aperture] γ-ray telescope SIGMA which on "January 9 [1991] detected Nova Muscae at the very edge of its field of view (FOV)."<ref name=Goldwurm/> "SIGMA provides high-resolution (≈ 15') images of the sky in the 35-1300 keV band (see Paul et al. 1991)."<ref name=Goldwurm/> Granat discovered the electron/positron annihilation line (511 keV) from the galactic microquasar 1E1740-294 and the GRS 1124-683 (X-ray Nova Muscae).<ref name="NASA2">{{ cite book |url=http://imagine.gsfc.nasa.gov/docs/sats_n_data/missions/granat.html |title=The Granat Satellite |publisher=NASA HEASARC Imagine the Universe! |accessdate=2007-12-05}}</ref> {{clear}} ==INTEGRAL== [[Image:INTEGRAL-spacecraft410.jpg|thumb|right|250px|Positron astronomy results have been obtained using the INTEGRAL spectrometer SPI shown. Credit: Medialab, ESA.{{tlx|fairuse}}]] "[P]ositron astronomy results ... have been obtained using the INTEGRAL spectrometer SPI".<ref name=Weidenspointner/> The positrons are not directly observed by the INTEGRAL space telescope, but "the 511 keV positron annihilation emission is".<ref name=Weidenspointner/> {{clear}} ==Hypotheses== {{main|Hypotheses}} # Beta-particles astronomy may provide more information than just [[electron astronomy]] or [[positron astronomy]] alone. ==See also== {{div col|colwidth=20em}} * [[Radiation astronomy/Alpha particles|Alpha particle radiation astronomy]] * [[Radiation astronomy/Atomics|Atomic radiation astronomy]] * [[Radiation astronomy/Hadrons|Hadron radiation astronomy]] * [[Radiation astronomy/Mesons|Meson astronomy]] * [[Radiation astronomy/Muons|Muon astronomy]] * [[Radiation/Neutrons|Neutron radiation astronomy]] * [[Radiation astronomy/Protons|Proton radiation astronomy]] * [[Subatomic astronomy]] {{Div col end}} ==References== {{reflist|2}} ==External links== * [http://www.adsabs.harvard.edu/ The SAO/NASA Astrophysics Data System] <!-- footer templates --> {{Principles of radiation astronomy}}{{Sisterlinks|Beta-particles astronomy}} <!-- categories --> [[Category:Astrophysics/Lectures]] [[Category:Radiation astronomy/Lectures]] [[Category:Radiation/Lectures]] fptxju126kzkjb66lv72e8od02eh3gb 0 171005 2419061 2418473 2022-08-25T14:12:36Z Young1lim 21186 /* Geometric Series Examples */ wikitext text/x-wiki Many of the functions that arise naturally in mathematics and real world applications can be extended to and regarded as complex functions, meaning the input, as well as the output, can be complex numbers <math>x+iy</math>, where <math>i=\sqrt{-1}</math>, in such a way that it is a more natural object to study. '''Complex analysis''', which used to be known as '''function theory''' or '''theory of functions of a single complex variable''', is a sub-field of analysis that studies such functions (more specifically, '''holomorphic''' functions) on the complex plane, or part (domain) or extension (Riemann surface) thereof. It notably has great importance in number theory, e.g. the [[Riemann zeta function]] (for the distribution of primes) and other <math>L</math>-functions, modular forms, elliptic functions, etc. <blockquote>The shortest path between two truths in the real domain passes through the complex domain. — [[wikipedia:Jacques_Hadamard|Jacques Hadamard]]</blockquote>In a certain sense, the essence of complex functions is captured by the principle of [[analytic continuation]].{{mathematics}} ==''' Complex Functions '''== * Complex Functions ([[Media:CAnal.1.A.CFunction.20140222.Basic.pdf|1.A.pdf]], [[Media:CAnal.1.B.CFunction.20140111.Octave.pdf|1.B.pdf]], [[Media:CAnal.1.C.CFunction.20140111.Extend.pdf|1.C.pdf]]) * Complex Exponential and Logarithm ([[Media:CAnal.5.A.CLog.20131017.pdf|5.A.pdf]], [[Media:CAnal.5.A.Octave.pdf|5.B.pdf]]) * Complex Trigonometric and Hyperbolic ([[Media:CAnal.7.A.CTrigHyper..pdf|7.A.pdf]], [[Media:CAnal.7.A.Octave..pdf|7.B.pdf]]) '''Complex Function Note''' : 1. Exp and Log Function Note ([[Media:ComplexExp.29160721.pdf|H1.pdf]]) : 2. Trig and TrigH Function Note ([[Media:CAnal.Trig-H.29160901.pdf|H1.pdf]]) : 3. Inverse Trig and TrigH Functions Note ([[Media:CAnal.Hyper.29160829.pdf|H1.pdf]]) ==''' Complex Integrals '''== * Complex Integrals ([[Media:CAnal.2.A.CIntegral.20140224.Basic.pdf|2.A.pdf]], [[Media:CAnal.2.B.CIntegral.20140117.Octave.pdf|2.B.pdf]], [[Media:CAnal.2.C.CIntegral.20140117.Extend.pdf|2.C.pdf]]) ==''' Complex Series '''== * Complex Series ([[Media:CPX.Series.20150226.2.Basic.pdf|3.A.pdf]], [[Media:CAnal.3.B.CSeries.20140121.Octave.pdf|3.B.pdf]], [[Media:CAnal.3.C.CSeries.20140303.Extend.pdf|3.C.pdf]]) ==''' Residue Integrals '''== * Residue Integrals ([[Media:CAnal.4.A.Residue.20140227.Basic.pdf|4.A.pdf]], [[Media:CAnal.4.B.pdf|4.B.pdf]], [[Media:CAnal.4.C.Residue.20140423.Extend.pdf|4.C.pdf]]) ==='''Residue Integrals Note'''=== * Laurent Series with the Residue Theorem Note ([[Media:Laurent.1.Residue.20170713.pdf|H1.pdf]]) * Laurent Series with Applications Note ([[Media:Laurent.2.Applications.20170327.pdf|H1.pdf]]) * Laurent Series and the z-Transform Note ([[Media:Laurent.3.z-Trans.20170831.pdf|H1.pdf]]) * Laurent Series as a Geometric Series Note ([[Media:Laurent.4.GSeries.20170802.pdf|H1.pdf]]) === Laurent Series and the z-Transform Example Note === * Overview ([[Media:Laurent.4.z-Example.20170926.pdf|H1.pdf]]) ====Geometric Series Examples==== * Causality ([[Media:Laurent.5.Causality.1.A.20191026n.pdf|A.pdf]], [[Media:Laurent.5.Causality.1.B.20191026.pdf|B.pdf]]) * Time Shift ([[Media:Laurent.5.TimeShift.2.A.20191028.pdf|A.pdf]], [[Media:Laurent.5.TimeShift.2.B.20191029.pdf|B.pdf]]) * Reciprocity ([[Media:Laurent.5.Reciprocity.3A.20191030.pdf|A.pdf]], [[Media:Laurent.5.Reciprocity.3B.20191031.pdf|B.pdf]]) * Combinations ([[Media:Laurent.5.Combination.4A.20200702.pdf|A.pdf]], [[Media:Laurent.5.Combination.4B.20201002.pdf|B.pdf]]) * Properties ([[Media:Laurent.5.Property.5A.20220105.pdf|A.pdf]], [[Media:Laurent.5.Property.5B.20220126.pdf|B.pdf]]) * Applications ([[Media:Laurent.6.Application.6A.20220825.pdf|A.pdf]], [[Media:Laurent.5.Application.6B.20220723.pdf|B.pdf]]) * Double Pole Case :- Examples ([[Media:Laurent.5.DPoleEx.7A.20220722.pdf|A.pdf]], [[Media:Laurent.5.DPoleEx.7B.20220720.pdf|B.pdf]]) :- Properties ([[Media:Laurent.5.DPoleProp.5A.20190226.pdf|A.pdf]], [[Media:Laurent.5.DPoleProp.5B.20190228.pdf|B.pdf]]) ====The Case Examples==== * Example Overview : ([[Media:Laurent.4.Example.0.A.20171208.pdf|0A.pdf]], [[Media:Laurent.6.CaseExample.0.B.20180205.pdf|0B.pdf]]) * Example Case 1 : ([[Media:Laurent.4.Example.1.A.20171107.pdf|1A.pdf]], [[Media:Laurent.4.Example.1.B.20171227.pdf|1B.pdf]]) * Example Case 2 : ([[Media:Laurent.4.Example.2.A.20171107.pdf|2A.pdf]], [[Media:Laurent.4.Example.2.B.20171227.pdf|2B.pdf]]) * Example Case 3 : ([[Media:Laurent.4.Example.3.A.20171017.pdf|3A.pdf]], [[Media:Laurent.4.Example.3.B.20171226.pdf|3B.pdf]]) * Example Case 4 : ([[Media:Laurent.4.Example.4.A.20171017.pdf|4A.pdf]], [[Media:Laurent.4.Example.4.B.20171228.pdf|4B.pdf]]) * Example Summary : ([[Media:Laurent.4.Example.5.A.20171212.pdf|5A.pdf]], [[Media:Laurent.4.Example.5.B.20171230.pdf|5B.pdf]]) ==''' Conformal Mapping '''== * Conformal Mapping ([[Media:CAnal.6.A.Conformal.20131224.pdf|6.A.pdf]], [[Media:CAnal.6.A.Octave..pdf|6.B.pdf]]) go to [ [[Electrical_%26_Computer_Engineering_Studies]] ] [[Category:Complex analysis]] m3a6md5m94cmz9lp013m81zvepk1svv 0 171008 2419081 2418597 2022-08-25T19:42:19Z Young1lim 21186 /* The Temporal Characteristics of Random Processes */ wikitext text/x-wiki ==''' Random Variables '''== === Single Random Variables === * Random Variables ([[Media:RV1.RVariable.1.A.20200427.pdf |A.pdf]]) * Distribution Function ([[Media:RV1.Distribution.2.A.201200428.pdf |A.pdf]]) * Density Function ([[Media:RV1.Density.3.A.20200429.pdf |A.pdf]]) * Functions of Random Variables ([[Media:RV1.RVFunction.4.A.20220317.pdf |A.pdf]]) * Gaussian Random Variables ([[Media:RV1.4.Gaussian.20200430.pdf |A.pdf]], [[Media:RV1.4B.Gaussian.20180314.pdf |B.pdf]]) * Other Distribution and Density Functions ([[Media:RV1.5.Other.20200501.pdf |A.pdf]]) * Conditional Distribution and Density Functions ([[Media:RV1.6.Conditional.20200506.pdf |A.pdf]]) </br> === The Characteristics of a Single Random Variable === * Expected Value ([[Media:RV2.Expectation.1.A.20200506.pdf |A.pdf]]) * Moments ([[Media:RV2.Moment.2.B.20200507.pdf |A.pdf]], [[Media:RV2.Moment.2.B.20180320.pdf |B.pdf]]) * Moment Generating Functions ([[Media:RV2.MFunctions.3.A.20200508.pdf |A.pdf]]) * Transformations of Random Variables ([[Media:RV2.Transform.4.A.20200514.pdf |A.pdf]]) </br> === Multiple Random Variables === * Vector Random Variables ([[Media:3MRV.1A.VectorRV.20200515.pdf |A.pdf]]) * Joint Distribution ([[Media:3MRV.2A.JointDist.20200518.pdf |A.pdf]]) * Joint Density ([[Media:3MRV.3A.JointDensity.20200521.pdf |A.pdf]]) * Conditional Joint Distribution and Density ([[Media:3MRV.4A.CondDistrib.20200527.pdf |A.pdf]]) * Statistical Independence ([[Media:3MRV.5A.StatIndep.20200423.pdf |A.pdf]]) * Sums of Random Variables ([[Media:3MRV.6A.RVSum.20200528.pdf |A.pdf]]) * Central Limit Theorem ([[Media:3MRV.7A.CLimit.20200612.pdf |A.pdf]]) </br> === The Characteristics of Multiple Random Variables === * Expected Values ([[Media:4MRV.1A.Expect.20200617.pdf |A.pdf]]) * Joint Characteristic Functions ([[Media:4MRV.2A.JChar.20200618.pdf |A.pdf]]) * Jointly Gaussian Random Variables ([[Media:4MRV.3A.JGauss.20200619.pdf |A.pdf]]) * Transformations of Multiple Random Variables ([[Media:4MRV.4A.Transform.20200620.pdf |A.pdf]]) * Linear Transformation of Gaussian Random Variables ([[Media:4MRV.5A.LinearTrans.20200623.pdf |A.pdf]]) * Simulating Multiple Random Variables ([[Media:4MRV.6A.Simulation.20200624.pdf |A.pdf]]) * Sampling and Some Limit Theorem ([[Media:4MRV.7A.LimitTheorem.20200625.pdf |A.pdf]]) * Complex Random Variables ([[Media:4MRV.8A.ComplexRV.20200626.pdf |A.pdf]]) </br> ==''' Random Processes '''== === The Temporal Characteristics of Random Processes === * Random Processes ([[Media:5MRV.1A.RandomProcess.20210216.pdf |A.pdf]]) * Joint Distribution, Independence, Processes ([[Media:5MRV.2A.JointDistribution.20210220.pdf |A.pdf]]) * Stationary Random Processes ([[Media:5MRV.3A.Stationary.20220402.pdf |A.pdf]], [[Media:5MRV.3B.Stationary.20220825.pdf |B.pdf]]) * Covariance & Correlation of Random Variables ([[Media:5MRV.4A.CovCorrRV.20210910.pdf |A.pdf]]) * Covariance & Correlation of Random Processses ([[Media:5MRV.5A.CovCorrRP.20210911.pdf |A.pdf]]) * Example Random Processes ([[Media:5MRV.4A.Example.20210227.pdf |A.pdf]]) * Ergodic Random Processes ([[Media:5MRV.5A.Ergodicity.20211022.pdf |A.pdf]], [[Media:5MRV.7B.Ergodicity.20211215.pdf |B.pdf]]) * Measurement of Correlation Functions ([[Media:5MRV.6A.Measure.20201013.pdf |A.pdf]]) * Complex Random Processes ([[Media:5MRV.7A.Complex.20201022.pdf |A.pdf]]) </br> === The Spectral Characteristics of Random Processes === * Power Density Spectrum - Continuous Time ([[Media:6MRV.1A.PSpecCT.20210204.pdf |A.pdf]]) * Auto Correlation Function ([[Media:6MRV.2A.AutoCor.20201218.pdf |A.pdf]]) * Power Density Spectrum - Discrete Time ([[Media:6MRV.3A.PSpecDT.20201203.pdf |A.pdf]]) * Cross Power Density Spectrum ([[Media:6MRV.4A.CPSpec.20191108.pdf |A.pdf]]) * Cross Correlation Function ([[Media:6MRV.5A.CCorrel.20191114.pdf |A.pdf]]) * Noise Definitions ([[Media:6MRV.6A.Noise.20191121.pdf |A.pdf]]) * Power Spectrum of Complex Random Processes ([[Media:6MRV.7A.ComplexProc.20191125.pdf |A.pdf]]) </br> === Linear System with Random Inputs === * Continuous Time LTI System ([[Media:7LTI.1A.CTime.20191203.pdf |A.pdf]]) * Discrete Time LTI System ([[Media:7LTI.2A.DTime.20191211.pdf |A.pdf]]) * System Response ([[Media:7LTI.3A.Response.20191224.pdf |A.pdf]]) * Spectral Characteristics ([[Media:7LTI.4A.Spectral.20200104.pdf |A.pdf]]) * Noise Modeling ([[Media:7LTI.5A.Noise.20200122.pdf |A.pdf]]) <br> === Optimum Linear System === * Maximum SNR ([[Media:8OPT.1A.MaxSNR.20200128.pdf |A.pdf]]) * Minimum Squared Error ([[Media:8OPT.2A.MinSE.20200207.pdf |A.pdf]]) <br> === Noise in Some Application Systems === * AM Communication Systems ([[Media:9APP.1A.AM.20200212.pdf |A.pdf]]) * FM Communication Systems ([[Media:9APP.2A.FM.20200221.pdf |A.pdf]]) * Control Systems ([[Media:9APP.3A.Control.20200225.pdf |A.pdf]]) * PLL Systems ([[Media:9APP.4A.PLL.20200305.pdf |A.pdf]]) * Random Waveforms ([[Media:9APP.5A.RandWave.20200311.pdf |A.pdf]]) * Radar Systems ([[Media:9APP.6A.Radar.20200313.pdf |A.pdf]]) <br> ==''' Correlation and Power Spectra '''== # Correlation Functions of Random Signals ([[Media:RAND.1.A.Correlation.20121106.pdf |pdf]]) # Spectra of Random Signals ([[Media:RAND.2.A.Spectra.20121108.pdf |pdf]]) </br> ==''' Ergodicity, Statistics, Estimation '''== </br> ==''' Random Processes and Linear Systems '''== </br> # Time Domain Techniques for Noisy Signals ([[Media:RAND.3.A.Time.20130205.pdf |A.pdf]], [[Media:Dirichlet.pdf |B.pdf]]) # Frequency Domain Techniques for Noisy Signals # Correlation v.s. Convolution for Noisy Signals </br> # System Identification ([[Media:RP.SysId.1.A.pdf |pdf]]) # Matched Filter <ref>[[Understanding Digital Communications]], See Baseband Mod/Demod Section</ref> </br> </br> go to [ [[Electrical_%26_Computer_Engineering_Studies]] ] lzkt1wugadgk6u18bpy1q7c5g508nob 0 171605 2419377 1969485 2022-08-26T07:43:08Z Marshallsumter 311529 wikitext text/x-wiki [[Image:PSM V87 D127 Beta particles produced by x rays passing through air.png|thumb|right|250px|Beta particles are produced by X-rays passing through air. Credit: Unknown.{{tlx|free media}}]] '''[[Beta-particles astronomy]]''' is a lecture from the [[Portal:Radiation astronomy|radiation astronomy department]] that is under development for possible inclusion in the course on the [[principles of radiation astronomy]]. You are free to take this quiz based on [[beta-particles astronomy]] at any time. To improve your score, read and study the lecture, the links contained within, listed under [[Radiation astronomy/Beta particles/Quiz#See also|'''See also''']], [[Radiation astronomy/Beta particles/Quiz#External links|'''External links''']], and in the {{tlx|radiation astronomy resources}} and {{tlx|principles of radiation astronomy}} templates. This should give you adequate background to get 100 %. As a "learning by doing" resource, this quiz helps you to assess your knowledge and understanding of the information, and it is a quiz you may take over and over as a learning resource to improve your knowledge, understanding, test-taking skills, and your score. '''Suggestion:''' Have the lecture available in a separate window. To master the information and use only your memory while taking the quiz, try rewriting the information from more familiar points of view, or be creative with association. Enjoy learning by doing! {{clear}} ==Quiz== <quiz> {Yes or No, Van Allen radiation belt electrons are constantly removed by collisions with atmospheric neutrals, losses to the magnetopause, and outward radial diffusion. |type="()"} + Yes - No {Yes or No, Beta particles (electrons) are more penetrating than alpha particles, but still can be absorbed by a few millimeters of aluminum. |type="()"} + Yes - No {Which types of radiation astronomy directly observe the rocky-object surface of Venus? |type="[]"} - meteor astronomy - cosmic-ray astronomy - neutron astronomy - proton astronomy - beta-ray astronomy - neutrino astronomy - gamma-ray astronomy - X-ray astronomy - ultraviolet astronomy - visual astronomy - infrared astronomy - submillimeter astronomy + radio astronomy + radar astronomy + microwave astronomy - superluminal astronomy {Yes or No, Beta particles are high-energy, high-speed electrons or positrons emitted by certain types of radioactive nuclei. |type="()"} + Yes - No {When the Earth is viewed from space using X-ray astronomy what characteristic is readily observed? |type="()"} - the magnetic north pole - the Hudson Bay meteorite crater - the South Atlantic Anomaly - the Bermuda Triangle - solar positron events + electrons striking the ionosphere {True or False, Electrons in the Earth's magnetosphere are energized by neutral particles from the Sun. |type="()"} - TRUE + FALSE {Complete the text: |type="{}"} Match up the item letter with each of the possibilities below: Meteors - A Cosmic rays - B Neutrons - C Protons - D Electrons - E Positrons - F Gamma rays - G Superluminals - H X-ray jets { C (i) } the index of refraction is often greater than 1 just below a resonance frequency { H (i) }. iron, nickel, cobalt, and traces of iridium { A (i) }. Sagittarius X-1 { G (i) }. escape from a typical hard low-mass X-ray binary { F (i) }. collisions with argon atoms { B (i) }. X-rays are emitted as they slow down { E (i) }. Henry Moseley using X-ray spectra { D (i) }. {Yes or No, Positron astronomy is 30 years old but remains in its infancy. |type="()"} + Yes - No {What are some of the characteristics of Jovian electrons? |type="[]"} + hard spectrum + Jovian electrons near Earth are on their way to the Sun + an energy power law + flux increases with 27 day periodicities - at 1 AU, flux decreases exhibit a short-term modulation of 13 minutes - come in mutable varieties {Yes or No, A clumpiness in the galactic halo is through a spatially continuous elevation in the density of dark matter, rather than the more realistic discrete distribution of clumps. |type="()"} + Yes - No </quiz> ==Hypotheses== {{main|Hypotheses}} # The radiation astronomy of beta particles (electrons and positrons as a group) may provide insight into fusion reactions above the Sun's photosphere. ==See also== {{div col|colwidth=20em}} * [[Radiation astronomy/Alpha particles/Quiz|Alpha-particle astronomy quiz]] * [[Radiation astronomy/Atomics/Quiz|Atomic astronomy quiz]] * [[Radiation astronomy/Baryons/Quiz|Baryon astronomy quiz]] * [[Cosmic-ray astronomy/Quiz]] * [[Electron astronomy/Quiz]] * [[Radiation astronomy/Hadrons/Quiz|Hadron astronomy quiz]] * [[Radiation astronomy/Mesons/Quiz|Meson astronomy quiz]] * [[Muon astronomy/Quiz]] * [[Radiation astronomy/Nebulas/Quiz|Nebula quiz]] * [[Radiation astronomy/Neutrals/Quiz|Neutrals astronomy quiz]] * [[Neutrino astronomy/Quiz]] * [[Neutron astronomy/Quiz]] * [[Positron astronomy/Quiz]] * [[Proton astronomy/Quiz]] * [[Radiation astronomy/Subatomics/Quiz|Subatomic astronomy quiz]] * [[Radiation astronomy/Synchrotrons/Quiz|Synchrotron astronomy quiz]] * [[Radiation astronomy/Tauons/Quiz|Tauon astronomy quiz]] {{Div col end}} ==External links== * [http://www.adsabs.harvard.edu/ The SAO/NASA Astrophysics Data System] <!-- footer templates --> {{Principles of radiation astronomy}}{{tlx|Radiation astronomy resources}}{{Sisterlinks|Beta-particles astronomy}} <!-- categories --> [[Category:Astrophysics quizzes]] [[Category:Radiation astronomy quizzes]] [[Category:Radiation quizzes]] o1qrett5ghye1pq9tu0avs76v8l36hc 14 200224 2419458 1417320 2022-08-26T09:50:27Z Jtneill 10242 wikitext text/x-wiki [[Category:Motivation and emotion/Book/Motivation]] sgbrtgady469t2sbp0nspse0dmk6mj6 0 200399 2419358 2363605 2022-08-26T07:23:29Z Jtneill 10242 + category wikitext text/x-wiki {{title|Prefrontal cortex and emotion:<br>What role does the prefrontal cortex play in emotion?}} {{MECR3|1=https://prezi.com/xbaoob-nthet/what-role-does-the-prefrontal-cortex-play-in-emotion/}} __TOC__ ==Overview== Emotions are important aspects of everyday life as we feel a variety of different ones across the span of just one day. But many people do not know why or how we experience emotions. Why are some people always happy no matter the situation? Why do I have to experience sadness and fear? Why are teenagers so moody? Why do people’s emotions change after accidents? These questions are all related to the functioning of the prefrontal cortex. The prefrontal cortex is one of the main areas of the brain responsible for the processing and regulation of emotions. This chapter will focus on the core question of what role does the prefrontal cortex play in emotion? Which in turn will look at the introductory concepts of emotions and the prefrontal cortex, theoretical explanations explaining the individual differences between emotions, the changes of emotions throughout development, and the emotional limitations due to injuries of the prefrontal cortex{{grammar}}. All {{missing}} which place an emphasis on the fact that everyone experiences situations differently. Some cope well when others do not. But all emotional experiences are not meant to be embarrassing or shameful, they are just a form of the body’s natural reaction. ==Introductory concepts== {{expand}} ===Prefrontal Cortex=== [[File:Prefrontal cortex (left) - lateral view.png|thumb|''Figure 1''. Location of the Prefrontal Cortex.]] The [[w:prefrontal cortex|prefrontal cortex]] is the area of the brain responsible for higher cognitive and executive functioning such as [[w:perception|perception]], planning ahead, emotional regulation and [[w:top-down|top-down]] processing (Miller & Cohen, 2001). It is the part of the brain that stores our thoughts, goals and memories across the left and right prefrontal cortex (Gianotti et al., 2009). The left prefrontal cortex often produces positive emotions and the “go” approach [[w:motivation|motivation]], while the right prefrontal cortex produces negative emotions and the “no-go” avoidance motivation (Miller & Cohen, 2001). These differences can indicate which side of the cortex will be displaying more activity depending on the situation someone is in. If someone sees a friend they have not seen in awhile, they are likely to feel happy and go and speak to them. This means their left cortex will be more activated because they are feeling happy which is a positive emotion. However, each individual may be more inclined to have one side of the cortex more sensitive than the other (Gianotti et al., 2009). The prefrontal cortex is also further differentiated into four main parts with different functions. The [[w:orbitofrontal cortex|orbitofrontal cortex]] and the [[w:ventromedial prefrontal cortex|ventromedial prefrontal cortex]] are highly recognised as important regions of the prefrontal cortex in terms of explaining its significance towards emotion (Bechara, Damasio & Damasio, 2000). These are displayed in Table 1. Table 1. ''The functions of the prefrontal cortex.'' {| class="wikitable" |- ! Region !! Function !! |- | Orbitofrontal Cortex || Decision-Making, Reward/Punishment Expectation, Emotional Processing |- | Dorsolateral Cortex || Working Memory, Inhibit Selfish Urges, Socioemotional Competence |- | Anterior Cingulate Cortex|| Monitors Conflict, Predicts Outcomes, Prioritises Attention |- |Ventromedial Cortex|| Social/Moral Judgment, Emotional Regulation |} ===Emotion=== [[File:Emotions - 3.png|thumb|''Figure 2.'' Examples of different emotions.]] [[w:Emotions|Emotions]] are short-lived but very complex conscious mental states or reactions to external life situations (Reeve, 2015). Life events trigger neural activity that produces emotional reactions (Reeve, 2015). When receiving a good grade many people will express the emotion of happiness and joy, while being fired from your job may lead to anger or disappointment. Emotions are often the result of a direct and specific event (Klimes-Dougan et al., 2014). They help express the body’s reaction to stimuli and can result in [[w:physiological|physiological]] and [[w:behavioural|behavioural]] changes (Vandenberghe & Silvestre, 2014). For example if you feel excited, physiologically your heart may start to race, and behaviourally, you may begin to smile and jump up and down. When you are sad, physiologically you can feel fatigued, and behaviourally you may cry and isolate yourself. [[w:Cognition|Cognition]] also plays an important role in understanding emotion. For example, a racing heart rate is a physiological response for excitement and anger. Therefore, cognition allows individuals to differentiate and identify the emotions they are experiencing (Vandenberghe & Silvestre, 2014). Emotions are also often displayed through facial expressions that allow others to interpret what you are feeling. Paul Ekman identified six primary emotions that are universally communicated across many different cultures. The six emotions include anger, happiness, disgust, surprise, sadness and fear (Sabini & Silver, 2005). More recently, contempt was added to make seven primary emotions that can occur instantly and involuntarily (Reeve, 2015). Ekman is one of the more famous theories of emotion but other theorists have suggested different numbers, such as five or even eight cross-cultural emotions (Reeve, 2015). Emotions can often be described as positive, such as interest and enthusiasm, or negative, such as hatred and regret. While they are known as positive and negative emotions, they are not necessarily good or bad (Klimes-Dougan et al., 2014). Research has shown the importance of experiencing both kinds of emotions, as you cannot go through life feeling only one type of emotion and not the other (Vandenberghe & Silvestre, 2014). Table 2 provides examples of why both positive and negative emotions are fundamental to coping with life experiences. Table 2. ''Fundamental View of Emotional Behaviour (Reeve, 2015).'' {| class="wikitable" |- ! Fundamental Life Task !! Emotion !! Purpose of the Emotion |- | Threat or Danger Present || Fear || Protect, Avoid |- | Achievement || Pride || Acquire skills, Persist |- | Behaving inadequately || Guilt || Reconsider and change that behaviour |} <quiz display=simple> {The left prefrontal cortex produces negative emotions and the "no-go" avoidance motivation. |type="()"} -True +False {Emotions are often the result of a direct event. |type="()"} +True -False </quiz> ==Theoretical explanations== {{expand}} ===Gray's Biopsychological Theory of Personality=== [[Motivation and emotion/Book/2014/Biopsychological theory of personality and motivation|Gray proposed a theory made up of two systems that help continue the discussion of the differences between the left and right prefrontal cortex]]. He developed this theory to explain concepts such as personality traits in a more physiological way (Gable, Reis & Elliot, 2000). The behavioural inhibition system (BIS) and the behavioural activation system (BAS), contribute to empirical research findings that state each individual can be more sensitive on one side of their prefrontal cortex, which in turn relates to their emotional experiences. ====Behavioural Inhibition System (BIS)==== The behavioural inhibition system is evident when someone has a more active or sensitive right prefrontal cortex, with susceptibility to negative cues (DeYoung, 2010). These people are likely to experience more negative emotions, display avoidant behaviour, are more attuned to punishment and may experience [[w:anxiety|anxiety]] (Carver & White, 1994). The BIS provides the capacity to become aware of potential negative consequences which then motivates the withdrawal, avoidance and caution by provoking negative emotionality (DeYoung, 2010). ====Behavioural Activation System (BAS)==== The behavioural activation system is clear when there is more activation in the left prefrontal cortex, showing a susceptibility to positive cues (DeYoung, 2010). This system is connected with positive emotions, goal-orientated behaviours, rewards and a likelihood of [[w:impulsivity|impulsivity]] (Carver & White, 1994). The BAS provides the capacity to approach behaviours that are centered around goals due to positive emotionality (DeYoung, 2010). ===James-Lange Theory=== [[File:James-Lange Theory of Emotions.jpg|thumb|320x320px|''Figure 3.'' Example of James-Lange Theory of Emotion.]] The [[w:James-Lange theory|James-Lange theory]] is that we feel physiological arousal and responses before we experience emotion (Moors, 2009). They{{who}} theorised that emotions are felt based on the intensity of the physiological experience, and that each emotion has its own response pattern that occurs due to a stimulus (Moors, 2009). This theory has been criticised, however, for being unable to explain where these physiological responses are first elicited. Other researchers have stated that there needs to be some form of processing between the physiological response and the subsequent emotion (Moors, 2009). For example, an individual would need to draw on previous experience, environmental cues and have an understanding of the context before knowing which emotion to react with (Moors, 2009). All of this requires the prefrontal cortex’s abilities such as social judgment, decision-making and working memory. These criticisms help highlight the need of a functioning prefrontal cortex in order to process emotions. ===Dynamic Filtering Theory=== Shimamura (2000) developed the dynamic filtering theory in order to determine what type of role the prefrontal cortex, and more specifically the [[w:dorsolateral prefrontal cortex|dorsolateral prefrontal cortex]], played in memory and cognitive concepts. It was discussed that selecting, maintaining, updating and rerouting were four aspects responsible for executive control (Shimamura, 2000). These findings led to the belief that the prefrontal cortex uses selective filtering or gating in an attempt to control information processing (Shimamura, 2000). It was also found that this theory could be useful in explaining the prefrontal cortex's role in emotional regulation. Broadening his theory to include emotion was influenced by the events that happened to [[w:Phineas Gage|Phineas Gage]]. Gage's damage to the orbitofrontal cortex was strongly correlated with his ability to control and regulate their emotions (Shimamura, 2000). For example, this theory would explain that emotional outbursts are due to the inability to filter or gate incoming information. Therefore, something is happening to prevent regulation in areas of the brain such as the orbitofrontal cortex that are responsible for emotional expressions (Shimamura, 2000). Research studies have indicated that this could be occurring due to damage or perhaps even the underdevelopment of the prefrontal cortex. <quiz display=simple> {The BIS is associated with the display of avoidance behaviours. |type="()"} +True -False {According to Shimamura's (2000) theory, emotional regulation occurs through the prefrontal cortex's ability to filter and gate incoming information. |type="()"} +True -False </quiz> ==Development of the prefrontal cortex== Research has consistently stated that the brain is not fully developed until around the age of 25 (Yifang, Hongyun, & Yanjie, 2014). This means that as people grow older their prefrontal cortex is slowly developing and so is their emotional maturity. Emotional maturity is often measured by someone’s ability to regulate his or her emotions through their understanding of them. While emotional regulation involves being able to identify or change emotions based on duration and intensity, and to have the ability to recover from them (Zimmermann & Iwanski, 2014). Key distinctions can be made in terms of emotional development at certain milestones throughout life. ===Childhood=== In one study it was found that children had developed an understanding of basic emotions, similar to those of Paul Ekman’s seven primary emotions{{fact}}. The study found that children who were of preschool age were significantly better at identifying positive emotions such as happiness, rather than negative emotions such as anger (Yifang et al., 2014). Although, when identifying feelings out of two negative emotions, the study found that the children would understand anger before they understood fear (Yifang et al., 2014). The emotions that children were able to identify and comprehend were always the simplest out of the two options. They indicated that at this age there was a strong development in emotional maturity for two years, and then the participants began to steady their emotional development (Yifang et al., 2014). These findings indicate that a beneficial research study could be conducted on the prefrontal cortex to see if the left side develops quicker than the right, or conclude that these findings may be reduced to just this study. Either way, studies have shown that during childhood, children are able to grasp a wider variety of basic emotions compared to infancy. ===Adolescence=== [[File:Amygdala small.gif|left|thumb|''Figure 4.'' Location of the amygdala.]] During adolescence there can be an increase in both avoidant and impulsive behaviour (Zimmermann & Iwanski, 2014). During this time [[w:emotional regulation|emotional regulation]] is not as effective, likely due to the prefrontal cortex still developing. This period in the lifespan displays the most instability emotion-wise{{fact}}. As teenagers start to develop, they experience an influx of negative emotions due to changes in relationships with peers and parents (Zimmerman & Iwanski, 2014). This can be a difficult time due to the fact that throughout childhood they would have been feeling predominately positive emotions and only basic negative emotions (Yifang et al., 2014). Now emotions will start to become more complex. They also have not necessarily developed efficient emotion regulation strategies, for these emotions that they have not experienced as often such as regret (Zimmermann & Iwanski, 2014). One very informative point that emphasises the importance of the prefrontal cortex in emotion is that other areas of the brain such as the [[w:amygdala|amygdala]] develop before the prefrontal cortex (Sieb, 2013). The amygdala is another part of the brain that is substantially involved with emotions, but does not contribute to the regulation and control of emotions as much as the prefrontal cortex does (Sieb, 2013). Its role is associated with emotions that are more intense such as fear and aggression, and they are triggered quite quickly (Sieb, 2013). Adolescents are often linked to impulsive and risky behaviour, and as stated before they have difficulties regulating their emotions. Based on research, teenagers are behaving this way because they have the capacity to feel these emotions, but they do not have the ability to regulate them yet (Sieb, 2013). When people reach adulthood it is more likely that their emotions will start to settle and become more manageable. ===Adulthood=== During most of the adult era the brain is completely developed and functioning properly, which means that emotional maturity and regulation, is at the highest level. Research has shown that life experiences allow people to develop strategies to help regulate their emotions (Zimmermann & Iwanski, 2014). Put more simply, people learn how to cope with the negatives and enhance the positives. By the time people reach adulthood they would have experienced a variety of events eliciting a wide variation of emotions. This means in conjunction with the prefrontal cortex’s cognitive abilities, people develop empathy and they have an understanding of their own emotional triggers (Zimmermann & Iwanski, 2014). At this stage in life, people have likely developed a tendency to lean towards either the BIS or BAS, which they may or may not be aware of (Zimmermann & Iwanski, 2014). It has however been mentioned that differentiating between adolescent and adult emotional maturity can be difficult due to personal differences. [[w:Personality|Personality]], in terms of openness, conscientiousness, extraversion, agreeableness and neuroticism can sometimes affect an individual’s ability to regulate their emotions even in adulthood (Zimmermann & Iwanski, 2014). Which means that not all adults have necessarily developed effective regulation strategies, which indicates the dynamic filtering model's validity in these cases. This proves that while adulthood results in a fully function cortex, it may function differently between person to person. ===Later Life=== Older age is the stage when emotions are at their most stable and regular state. Middle to late life is when people can display an increase of self-control and high conscientiousness in terms of their emotional regulation and maturity (Zimmermann & Iwanski, 2014). However, there can be a decline due to illnesses that occur in old age, such as [[w:dementia|dementia]]. When the prefrontal cortex is no longer functioning properly due to illness, someone’s emotional maturity can revert back to earlier stages involving a common presence of negative emotions, or new emotional issues may arise (Zimmermann & Iwanski, 2014). These effects that are attributed to illness are similar to those of damaged prefrontal cortices which will be discussed further. <quiz display=simple> {Adolescents only feel basic emotions such as happiness and sadness rather than complex ones. |type="()"} -True +False {The more you age the more capable you are at developing strategies to regulate your emotions. |type="()"} +True -False </quiz> ==Damage to the prefrontal cortex== <div style="background-color: #FDD5B1; border: 1px solid #000; margin: 5px; padding: 1em;">In 1848 a man named Phineas Gage experienced one of the most famous and bewildering neurological injuries of all time. He was blasting holes into rocks to make way for a new railway when the accident occurred. One of the blasts went off unplanned and the iron rod he was using went through the left side of his face, up past his left eye and protruded through the top of his head. The reason this case is so famous and puzzling is that not only did Gage not die, shortly after he was able to sit up and speak to the doctor when he arrived. Research has shown that the iron rod went up through the prefrontal cortex and more specifically the orbitofrontal region. After the accident, the damage to his brain proved to have drastic effects on him both psychologically and behaviourally. He was described as impatient and rude, he used profanities, was unable to finish tasks and his mind was unbalanced. These characteristics were not present before the accident. Due to the prefrontal cortex playing such an important role in emotion, it was likely Gage’s emotions were also going to be effected. It has been reported that he had difficulty processing emotions and he lost his emotional inhibition, meaning he was likely to behave inappropriately at emotionally sensitive times. He also had difficulties with his [[w:emotional intelligence|emotional intelligence]], which meant he struggled to recognise emotions and manage them. This evidence ties in with the left prefrontal cortex’s ability to control positive emotions as Gage was expressing negative emotions when most people would experience positive ones, and the BAS being goal-orientated as his had difficulties completing tasks. - Ratiu, Talos, Haker, Lieberman & Everett, 2004; Sigglekow, 2007. </div> [[File:Phineas Gage injury - animation (frontal lobe).gif|thumb|''Figure 5''. Reconstruction of damage to Gage's frontal lobe.]] ===Empirical Research=== When trying to understand how a certain brain structure functions or what aspects of daily life it is responsible for, it is common for research to be conducted when that structure is no longer there or when it is not functioning adequately. Research has consistently shown that damage to the prefrontal cortex can result in a lack of emotional awareness, regulation and processing. Sanchez-Navarro and colleagues (2014) found that it was harder to process emotions when damage had occurred to the cortex. Their study consisted of participants being shown pictures of emotionally evoking stimuli, and it was discovered that those with damage to the prefrontal cortex had trouble maintaining their attention towards the emotional material (Sanchez-Navarro et al., 2014). Understanding and feeling emotions is normally seen as an automatic process, however some participants struggled to do this. Upon investigating their participants{{grammar}} profiles, it was also found that in this particular study participants who had experienced damage to their cortex during childhood, found it to be substantially debilitating in comparison to the other participants who faced their damage in adulthood (Sanchez-Navarro et al., 2014). Further research has been conducted involving the use of specific emotions. [[w:Empathy|Empathy]] is the ability to recognise and share emotions, and it is an important aspect involved with interpreting emotions. Vandekerckhove et al (2014) found that impairments to the ventromedial prefrontal cortex meant there was a greater likelihood that the participant would have difficulties interpreting emotions through facial recognition. This was especially evident when the participants were asked to identify fear, disgust and surprise (Vandekerckhove et al., 2014). Other studies looking at facial recognition reported that damage to the orbitofrontal cortex also resulted in difficulties in distinguishing between different emotions (Willis, Palermo, McGrillen, Miller, 2014). Again, the emotions that were the most problematic were negative emotions, similar to Vandekerckhove’s et al (2014) study. However, they proved to be the most difficult when displayed for a short amount of time, and the results improved when the participants were given more opportunity to identify them (Willis et al., 2014). These studies provide an interesting comparison to Phineas Gage’s emotional limitations, where only the left side of the prefrontal cortex was severely damaged. These studies, among many others continue to show how important the prefrontal cortex is in terms of understanding and interpreting emotions. They demonstrate that the cortex plays a significant role in the way emotions function. Without the cortex operating efficiently people are likely to experience differences in their emotional abilities. ===Lobotomy=== [[w:Lobotomies|Lobotomies]] are a type of [[w:psychosurgery|psychosurgery]] that were performed in order to help cure mental disorders by reducing their symptoms. The procedure was carried out by using a leucotome that was placed either through a hole that had been drilled into the skull or placed under the eyelid, which would then sever the fibres connected to the cortex (Older, 1974). Lobotomies were used for many disorders like anxiety which can involve a heighten sense of emotion, but once the procedure was conducted patients were left with little complexity and intensity of emotional responses (Freeman, Watts, & Hunt, 1942). Lobotomies can be interpreted as damage to the prefrontal cortex even though they were deliberately performed. This outdated method indicates again that the prefrontal cortex plays a substantial role in what we feel everyday. <quiz display=simple> {Despite his accident, Phineas Gage's emotional intelligence was still intact. |type="()"} -True +False {Lobotomies were performed to reduce the symptoms of mental disorders. |type="()"} +True -False </quiz> ==Conclusion== Emotions are a significant part of everyone’s lives. Many people probably cannot imagine a life without happiness. It is important to remember that we feel emotions for a reason, whether it is sadness or joy. They are simply a natural reaction to life events that everyone should embrace. The prefrontal cortex’s development and limitations show that emotions are often out of our control. With theoretical explanations proving that everyone is different in terms of their emotional experiences{{grammar}}. If you struggle with your emotions take a look at some self-help tips for personal growth and improvement. Do the things you enjoy and accept the feelings that are not always pleasant, as they will pass. ==See also== [[w:Prefrontal Cortex|Prefrontal Cortex]] [[w:Emotion|Emotion]] [[w:Gray's biopsychological theory of personality|Gray's biopsychological theory of personality]] [[w:James-Lange theory|James-Lange theory]] [[w:Phineas Gage|Phineas Gage]] [[w:Emotional dysregulation|Emotional dysregulation]] ==References== {{Hanging indent|1= Bechara, A., Damasio, H., & Damasio, A. (2000). Emotion, decision-making and the orbitofrontal cortex. ''Cerebral Cortex, 10,'' 295-307. doi: 10.1093/cercor/10.3.295 Carver, C. S., & White, T. L. (1994). Behavioural inhibition, behavioural activation, and affective responses to impending reward and punishment: The BIS/BAS scales. ''Journal of Personality and Social Psychology, 67'', 319-333. doi: 10.1037/0022-3514.67.2.319 DeYoung, C. (2010). Mapping personality traits onto brain systems: BIS, BAS, FFFS and beyond. ''European Journal of Personality, 24,'' 404-422. doi: 10.2010/1769-0003 Freeman, W., Watts, J., & Hunt, T. (1942). ''Psychosurgery: Intelligence, emotion, and social behaviour following prefrontal lobotomy for mental disorders.'' London, England: Bailliere, Tindall & Cox. Gable, S., Reis, H., & Elliot, A. (2000). Behavioural activation and inhibition in everyday life. ''Journal of Personality and Social Psychology, 78,'' 1135-1149. Gianotti, L., Knoch, D., Faber, P., Lehmann, D., Pascual-Marqui, R., Diezi, C., Schoch, C., Eisenegger, C., & Fehr, E. (2009). Tonic activity level in the right prefrontal cortex predicts individuals’ risk taking. ''Psychological Science, 20'', 33-38. doi: 10.1111/j.1467-9280.2008.02260.x Klimes-Dougan, B., Pearson, T., Jappe, L., Mathieson, L., Simard, M., Hastings, P., & Zahn-Waxler, C. (2014). Adolescent emotion socialization: A longitudinal study of friends’ responses to negative emotions. ''Social Development, 23,'' 395-412. doi: 10.1111/sode.12045 Miller, E., & Cohen, J. (2001). An integrative theory of prefrontal cortex function. ''Annual Review of Neuroscience, 24,'' 163-202. doi: 10.0147/006x-5367.057 Older, J. (1974). Psychosurgery: Ethical issues and a proposal for control. ''American Journal of Orthopsychiatry, 44'', 661-674. doi: 10.1111/j.1939-0025.1974.tb01145.x Ratiu, P., Talos, I., Haker, S., Lieberman, D., & Everett, P. (2004). The tale of Phineas Gage, digitally remastered. ''Journal of Neurotrauma, 21,'' 637-643. Reeve, J. (2015). Understanding motivation and emotion (6th ed.). Hoboken, NJ: Wiley. Sabini, J., & Silver, M. (2005). Ekman’s basic emotions: Why not love and jealousy? ''Cognition and Emotion, 19'', 693-712. doi: 10.1080/02699930441000481 Sanchez-Navarro, J., Driscoll, D., Anderson, S., Tranel, D., Bechara, A., & Buchanan, T. (2014). Alterations of attention and emotional processing following childhood-onset damage to the prefrontal cortex. ''Behavioural Neuroscience, 128'', 1-11. doi: 10.1037/a0035415 Shimamura, A. (2000). The role of the prefrontal cortex in dynamic filtering. ''Psychobiology, 28'', 207-218. Sieb, R. (2013). The emergence of emotions. ''Activitas Nervosa Superior, 55'', 115-145. doi: 10.1080/2014-07703-001 Sigglekow, N. (2007). Persuasion with case studies. ''Academy of Management Journal, 50,'' 20-24. Vandekerckhove, M., Plessers, M., Van Mieghem, A., Beeckmans, K., Van Acker, F., Maex, R., Markowitsch, H., Marien, P., & Van Overwalle, F. (2014). Impaired facial emotion recognition in patients with ventromedial prefrontal hypo-perfusion. ''Neuropsychology, 28'', 605-612. doi: 10.1037/neu0000057 Vandenberghe, L., & Silvestre, R. (2014). Therapists’ positive emotions in-session: Why they happen and what they are good for. ''Counselling & Psychotherapy Research, 14'', 119-127. doi: 10.1080/14733145.2013.7904455 Willis, M., Palermo, R., McGrillen, K., & Miller, L. (2014). The nature of facial expression recognition deficits following orbitofrontal cortex damage. ''Neuropsychology, 28,'' 613-623. doi: 10.1037/neu0000059 Yifang, W., Hongyun, L., & Yanjie, S. (2014). Development of preschoolers’ emotion and false belief understanding: A longitudinal study. ''Social Behaviour and Personality, 42'', 645-654. doi: 10.2224/sbp.2014.42.4.645 Zimmermann, P., & Iwanski, A. (2014). Emotion regulation from early adolescence to emerging adulthood and middle adulthood: Age differences, gender differences, and emotion-specific developmental variations. ''International Journal of Behavioural Development, 38'', 182-194. doi: 10.1177/0165025413515405 }} ==External links== [http://www.psy.miami.edu/faculty/ccarver/sclBISBAS.html Test Yourself Using the BIS/BAS Scale] [http://www.erosresearch.org/index.php/emotion_regulation/an%20easy%20guide/ Learn how to regulate your emotions] [[Category:{{#titleparts:{{PAGENAME}}|3}}]] [[Category:Motivation and emotion/Book/Cortex]] s8n1gm5fojmm2siwrrjcugujp87u2au 0 201360 2419448 2223665 2022-08-26T09:37:44Z Jtneill 10242 + category wikitext text/x-wiki {{title|Travel motivation:<br>What motivates people to seek out travel experiences?}} {{MECR3|1=https://www.youtube.com/watch?v=fibrEPwPCmQ}} == Overview == {{RoundBoxTop|theme=2}}[[File:Airplane silhouette.svg|frameless|right|55px]]Jenny runs a large company with many employees; this year more employees have applied for [[w:Leave of absence|leave]] than ever before. Assuming all of her employees are going on leave to [[w:Travel|travel]], Jenny wants to know more about why they go and if she can do anything to influence this behaviour. {{RoundBoxBottom}} [[File:Travel motive.jpg|thumbnail|[https://www.qzzr.com/quiz/ad0f4764-a8c8-4ae5-9754-71742d1e092b/fi9xdWl6emVzLzEwNjQ2OA Fig 1. Click here to take the quiz!] Adapted from Figler, Weinstein, Sollers & Devan, 1992|314x314px]] Crompton (1979) notes it is possible to describe the who, when, where, and how of travel motivation, but there is no answer to the question ‘why’, the most interesting question about travel behaviour. Travel [[motivation]] relates to why people travel (Woodside & Martin, 2007). If we can explain what an individual gets out of travel experiences then we can explain the motivation behind them seeking it out. Motivation is crucial in explaining travel behaviour as it constitutes the driving force behind all actions. Motivation sets the stage for individual goal formation, reflected in both travel choice and behaviour while further influencing expectations and experience perception. Motivation is therefore a factor in satisfaction formation (Reissmann, n.d). Basic motivation theory suggests a dynamic process of internal psychological factors (needs, wants and goals), causing an uncomfortable level of tension within individuals’ minds and bodies, resulting in actions aimed at releasing that tension and satisfying these needs (Fodness, 1994), moving people to do. This chapter delves into the reasons behind pursuing travel experiences through reviewing psychological literature. Most travel motivation literature is based on application of theories from mainstream psychology. This chapter highlights [[Wikipedia:Maslow%27s hierarchy of needs|Maslow’s (1943) hierarchy of needs]] and its application to travel motivation, stemming from here a less well known of Maslow’s theories is the aesthetic need and the need to know and understand. Examination of the Travel Career Ladder (TCL) and Travel Career Pattern (TCP) will also help explain the motives behind seeking travel experiences. [[Wikipedia:Murray%27s system of needs|Murray’s (1938) classification of human needs]], Crompton’s (1979) push/pull theory and Plog's (2001) allocentrism/psychocentrism concept will further contribute to describing the relationship between travel and motivation. &nbsp;&nbsp;&nbsp; The aim of this chapter is to use psychological theories to uncover the motivation behind travel. It is hoped that this investigation will aid readers in understanding their employees, consumers, families, friends or own travel motives better. <p align="center">''"I travel not to go anywhere, but to go. I travel for travel’s'' ''sake. The great affair is to move.” – [[Wikipedia:Robert Louis Stevenson|Robert Louis Stevenson]] &nbsp;''</p> <p align="center">''“We travel for fulfilment.”''–&nbsp;[[Wikipedia:Hilaire Belloc|Hilaire Belloc]]</p> <p align="center">''“I travel because half the fun is the aesthetic of lostness.”'' – [[Wikipedia:Ray Bradbury&nbsp;Ray|Bradbury]]</p> == Maslow's hierarchy of needs: Application to travel motivation == [[File:Maslow's hierarchy of needs.svg|left|thumb|440x440px|Fig 2. Maslow's hierarchy of needs, also known as Maslow's pyramid.]] An influential psychological theory and one that many travel motivation researchers base their theoretical analysis around is Maslow's hierarchy of needs (1954) (Jang & Cai, 2002), also known as Maslow's pyramid. According to Maslow (1970), human needs can be arranged in a hierarchy of five categories (see Figure 2). The most basic needs are physiological, such as hunger, thirst, and sex (Huang & Hsu, 2009). Climbing the pyramid, Maslow’s other needs include safety, belongingness and love, esteem, and self-actualisation. Typically, people fulfill their needs starting from the lower segments of the pyramid, upwards, as each level of need is satisfied. Human needs usually follow this hierarchical order; however, circumstances exist when higher level needs outweigh lower level needs even though they have not been met (Maslow, 1970). This can be the case when it comes to travel motivation. Maslow’s hierarchy theory helps us to understand the different needs that motivate travellers while also providing knowledge about what kinds of experiences travellers seek, especially for certain groups of people. Nationality and age play a role in the motivation to travel, however gender has no effect when predicting motivation to travel (Jönsson & Devonish, 2008). Many researchers have used motivational theory to try to interpret the motivations of tourists. On the idea that motivations derive from a real or perceived need, it is justifiable to analyse individuals' travel experience seeking choices as a consequence of need deficiency (Brown, 2005). Maslow’s hierarchy of needs forms the basis for further development and applications to understand travel behaviour (Maslow, 1970).This hierarchy can be related to the travel industry in the sense that unless individuals have their physiological and safety needs met, they are less likely to be interested in travelling the world. Self-actualisation can, in fact, be considered the end or goal of leisure (Brown, 2005), with travel experiences offering the opportunity to re-evaluate and discover more about the self, to act out one’s self-image as a way of modifying or correcting it. Maslow discusses two other sets of important human needs: the aesthetic need and the need to know and understand, {{grammar}} they are less known because they were not included in the hierarchy model (Huang & Hsu, 2009). If placed in the pyramid these two needs would come between self-actualisation and esteem (see Table 1). '''The aesthetic need & the need to know and understand''' {{RoundBoxTop|theme=4}} ''It has been suggested that this section is more important in travel motivation than Maslow's Hierarchy of needs{{fact}}. [https://en.wikiversity.org/wiki/Talk:Motivation_and_emotion/Book/2015/Travel_motivation Discuss]''{{RoundBoxBottom}} Referring to Figure 2 and Table 1 the first four needs, Maslow identified as deficit needs{{grammar}}: &nbsp;if the needs are not met, they make us uncomfortable and we are motivated or driven by these needs until we are able to sufficiently fulfill these needs (Gautam, 2007). However the last three needs, particularly the aesthetic need and the need to know and understand, he{{who}} identifies as growth needs: we never get enough of these. We are constantly motivated by these needs as they affect our growth and development (Gautam, 2007). It is obvious how important these needs are when explaining travel motivation and the experience seeking behaviour behind it. # '''The need to know and understand''': at the fifth level of Maslow’s pyramid humans have the need to increase their intelligence and thereby chase knowledge. This need is the expression of the natural human need to learn, explore, discover and create to get a better understanding of the world around them (Martin & Loomis, 2007). # '''The aesthetic need''': at the sixth level based on Maslow’s beliefs, it is stated in the hierarchy that humans need beautiful imagery or something new and aesthetically pleasing to continue up towards self-actualisation (the seventh and last level). Humans need to refresh themselves in the presence and beauty of nature while carefully absorbing and observing their surroundings to extract the beauty that the world has to offer (Martin & Loomis, 2007).&nbsp; {| class="wikitable" |+Table 1 - Needs and motives ! rowspan="5" |Deficiency needs !Need !Motive ! colspan="2" |Travel Literature |- |Physiological |Relaxation |Escape, relaxation, relief of tension, sunlust, physical and mental relaxation |Maslow, 1943 Gary, 1970 McIntosh, 1977 Pearce, 1988 Figler et al, 1992 |- |Safety |Security |Health, recreation, keep one's self active and healthy |Maslow, 1943 McIntosh, 1977 Pearce, 1988 |- |Belonging |Love |Family togetherness, enhancement of kinship relationships, companionship, facilitation of social interaction, maintenance of personal ties, interpersonal relations, roots, ethnic, show one's affection for family members, maintain social contacts |Maslow, 1943 McIntosh, 1977 Pearce, 1988 |- |Esteem |Achievement, status |Convince oneself of one's achievements, show one's importance to others, prestige, social recognition, ego-enhancement, professional business, personal development, status |Maslow, 1943 McIntosh, 1977 Pearce, 1988 Figler et al, 1992 |- ! rowspan="3" |'''Growth needs''' |To know and understand |Knowledge |Cultural, education, wanderlust, interest in foreign areas |Maslow, 1943 Gary, 1970 Figler et al, 1992 |- |Aesthetics |Appreciation of beauty |Environmental, scenery |Maslow, 1943 |- |Self-actualisation |Be true to one's own nature |Exploration and evaluation of self, self discovery, satisfaction of inner desires |Maslow, 1943 Pearce, 1988 |} Maslow’s hierarchy of needs is a key theory in travel motivation research. Two conceptual frameworks in understanding travel motivation – the travel career ladder (TCL) and travel career patterns (TCP) – emerged from his work and apply to this field (Huang & Hsu, 2009). === Travel Career Ladder (TCL) === The core idea underlying this conceptual framework is that an individual’s travel motivation changes with his/her travel experience. The Travel Career Ladder (TLC) suggests that peoples’ travel needs change over their life span and with accumulated travel experience. As tourists become more experienced, they increasingly seek satisfaction of higher level needs.[[File:Travel Career Ladder.png|thumb|390x390px|Fig 3. Travel Career Ladder (Ryan, 1998)|left]] Many people move systematically through a series of stages, or have predictable travel motivational patterns (Huang & Hsu, 2009). Some travellers ascend the hierarchy, while others remain at a particular level. Pearce, (1988) suggests that the TCL proposes that people progress upward through motivation levels with accumulated travel experience and these travel experiences enable people to psychologically mature. Based on Maslow’s hierarchy, Pearce’s 1988 model specified that there are five different steps affecting tourist behaviour (see Figure 3) which may be used to explain the TCL concept.&nbsp;Pearce (1996) describes his theory as distinguishing between intrinsic and extrinsic motivation at the four lower levels of the system. The travel career ladder emphasises all the tourists’ patterns or motives, rather than a single motive for traveling. Pearce (1996), observes that the direction of the change within the TCL is variable; some individuals may ascend the ladder predominantly on the left hand side of the system, while others may go through all the steps on both the left and right hand side of the model. This shows that travel motivation is developmental and dynamic, as people acquire touristic experiences (a career), their motivations change (Ryan, 1998). Those going abroad for the first time may prefer the security of a group tour, but in time may opt for independent ones as they become more experienced. Pearce explicitly recognised that tourists’ travel motivation can be self-directed or other-directed (see Figure 3); individuals do not always seek the same type of fulfillment from travel, and people can descend as well as ascend on the ladder. To what extent tourists do so from one trip to the next, or whether this only occurs over longer time periods, is not quite as clear (Brown, 2005). ===Travel Career Patterns (TCP) === Another theoretical outline based on Maslow’s hierarchy of needs is the Travel Career Patterns (TCP) framework, presented by Pearce and Lee (2002). The TCP is essentially a modified version of the TCL. The TCL theory proposed that travellers progress up the ladder of travel motives as their travel experience increases, which created some questions of validity of the theory{{why}} (Ryan 1998; Pearce and Lee 2005), and led to development of Travel Career Pattern (TCP) theory (Paris & Teye, 2010). The TCP reduced the hierarchical focus of the TCL and recognised that travel motivation is dynamic and multi-leveled (Paris & Teye, 2010). The concept of travel career is still central to the TCP, as is the idea that travellers will have changing motivational patterns during those travel careers (Pearce and Lee 2005). The TCP is centred on 14 motivational factors: # Self-actualisation – ''internal'' # Self-enhancement – ''internal'' # Romance – ''internal'' # Belonging – ''internal'' # Autonomy – ''internal'' # Self-development (host site involvement) – ''external'' # Nature – ''external'' # Escape/relax – ''most important'' # Novelty – ''most important'' # Kinship – ''most important'' # Nostalgia – ''less important'' # Stimulation – ''less important'' # Isolation – ''less important'' # Recognition/social status – ''less important'' The ''most important'' and core concepts (see figure 4) of the Travel Career Pathway are the most common motives among travellers (Lee, 2004). The next layer or middle layer is moderately important and is where traveller’s motives change from inner to externally orientated. Individuals at a higher travel career level were more ''externally'' orientated and motivated to travel, while people with lower travel career levels were more ''internally'' motivated to travel. The final and outer layer consists of common, stable and ''less important'' travel motives (Huang & Hsu, 2009). == Murray's classification of human needs: Application to travel motivation == Another motivation theory from mainstream psychology which may offer an explanation behind travel motives and behaviour is Murray’s classification of human needs. [[Wikipedia:Henry Murray|Henry Murray’s]] 1938 needs classification theory provides a comprehensive list of human needs that could influence travel behaviour (Pizam & Mansfeld, 1999). Murray listed 14 physiological and 30 psychological needs from which it is possible to identify factors that could act as travel motives (Pizam & Mansfeld, 1999), offering considerable scope for the exploration of needs and travel destination decisions (Ross, 1998). For example, Table 2 provides a selection of Murray’s needs that may be applicable to travel motivation. {| class="wikitable" |+Table 2: A selection of Murry's needs applicable to travel motivation (more at: [[w:Murray's_system_of_needs|https://en.wikipedia.org/wiki/Murray%27s_system_of_needs]]) !Need !Behaviour |- |Achievement |To accomplish difficult tasks, overcoming obstacles and becoming expert |- |Acquisition |Obtaining things |- |Autonomy |To break free from constraints. To be irresponsible and independent |- |Cognisance |Understanding; to be curious, ask questions and find answers |- |Play |To have fun, laugh, relax and enjoy oneself |- |Recognition |Describing accomplishments |- |Sentience |To seek out and enjoy sensual experiences |- |Succorance |To have one's needs satisfied by someone or something |} However this theory suggests that needs will change independently, so knowing the strength of one need will not necessarily explain the strength of others (Ross, 1998), due to its complexity Murray’s work is not as easy to apply as Maslow’s hierarchy and has not been adopted by travel researchers and is also therefore not as well known (Pizam & Mansfeld, 1999). == Push/pull theory == {| cellpadding="10" cellspacing="5" style="float: right; width: 30%; background-color: Inherent; margin-left: auto; margin-right: auto" | style="width: 40%; background-color: Lightyellow; border: 1px solid Yellow; vertical-align: top; -moz-border-radius-topleft: 8px; -moz-border-radius-bottomleft: 8px; -moz-border-radius-topright: 8px; -moz-border-radius-bottomright: 8px; height: 10px;" | <div style="text-align:center;">'''Quick quasi-psychological theory''' : ''Wanderlust'' - the desire to exchange the known for the unknown, to leave things familiar and to go and see different places, people, and cultures or relics of the past in places famous for their historical monuments and associations of for their current fashions and contributions to society. ''Sunlust'' - a type of travel which depends on the existence else where of better amenities for a specific purpose than are available in the domicile; it is prominent with particular activities such as sports and literally the search for the sun. Gary (1970)</div> |} One of the best known theories of travel motives, after Maslow’s, was proposed originally by Dan (1977) who suggested a two-tiered scheme of motivational factors: the ‘push’ and the ‘pull’ (Brown, 2005). The push factors social-psychological motives that drive the desire to travel{{rewrite}}. The pull factors are external factors that affect where a person travels to fulfil the identified needs or desires. Dann suggested that anomie and ego-enhancement were the basic underlining reasons for travel (Brown, 2005). John Crompton (1979) agreed with Dann’s basic idea of push and pull motives but went further to classify these motives as those that push people to travel and motives that pull people towards a travel experience as well as identifying nine motives for travel. They were: * The escape from a perceived mundane environment * Exploration and evaluation of self * Relaxation * Prestige * Regression * Enhancement of kinship relationships * Facilitation of social interaction * Novelty * Education He classified the first seven motives as push factors, and the last two as pull factors (Brown, 2005). According to Crompton (1979) people travel because they are pushed by their inner motives and/or because they are pulled by the external factors of an experience. It is considered that most motives that push people originate from non-materialistic inner desires to escape, experience adventure, fulfill dreams, develop relationships, rest and relax, improve health and recreate or from a desire for prestige and socialisation (Huang & Hsu, 2009). On the other hand, the motives that pull are based on the attractive factors of the destination and expectations like a search for novelty and education (Vukic, Kuzmanovic, & Kostic Stankovic, 2014). Some researchers only accept push factors as motivation (Woodside & Martin, 2007), while they are considered important in initiating travel desire to satisfy or reduce the need, travellers are also pulled by destination attractions and attributes{{grammar}}. == Plog's allocentrism/psychocentrism model == Stanley Plog (1974; 1987) developed the influential allocentrism/psychocentrism model, the earliest model that forms the basis of tourism typology theory. Individuals either fall into the allocentrism or psychocentrism category in relation to travel seeking behaviour. Psychocentrics are defined as people who experience territorial boundaries: a tendency to have travelled less throughout one’s lifetime, generalised anxieties: a strong feeling of insecurity in daily life and a sense of powerlessness: inability to control fortunes and misfortunes throughout their lifetime (Plog, 1974). Psychocentrics dislike destinations that offer unfamiliarity or insecurity. It is suggested that the psychocentric is dominated by safety needs (Brown, 2005). Allocentrism however exists on the opposite side of psychocentrism; allocentric people are venturesome and self-assured (Huang & Hsu, 2009) who tend to choose remote, untouched destinations (Brown, 2005), and unstructured holidays with more involvement in local culture (Pizam & Mansfeld, 1999). Between the psychocentric and allocentric groups are clusters of near-psychocentric, near-allocentric and mid-centric individuals (see Figure 5), the latter group displaying characteristics of an adventurer, but they want home comforts. It is this group that represents the mass travel seeking crowd (Brown, 2005). Recently, Plog (2001) updated his model and re-labelled the term psychocentrics with dependables, and allocentrics with venturers. The remainder falls in between: near-dependables, near-venturers, and centrics (the largest group). Based on the model, Plog (2001) argues that most destinations follow a predictable but uncontrolled developmental pattern from birth to maturity, old age, and declination (Huang & Hsu, 2009). At each stage, a destination appeals to a different psychographic group of travellers based on the destination’s character and success. In the early stage, mass tourists do not arrive; only a few venturers visit. When the venturers return home, they talk with friends and relatives about what they have discovered. Some friends and relatives, the near-venturers, visit the intriguing place they had just heard about. When the near-venturers return home satisfied, they pass the message to their mid-centric friends. The destination gradually takes on a more touristy look, which is more appealing to dependables but unattractive to venturers. Some researchers criticise Plog’s model because tourists travel with different motivations on different occasions (Huang & Hsu, 2009). However, compared to other tourist typology forms, Plog’s model seems to provide better tourist motivation explanations (Huang & Hsu, 2009). == Conclusion == Ultimately travel motivation is a multidimensional concept that has been proposed by many researchers. Tourist motivation studies need to be carried out on a regular basis as people’s motivations change over time, with accumulated travel experience and with the social and cultural evolution of travel. Travel motivation is an important topic for researchers to understand and develop individuals' travel ideas and behaviour, with hopes of predicting the who, what, where, when and why of travel seeking experiences with ease. Future study areas include the reasons for people not wanting to travel or the differences in motivation between ages, life stages, income status, cultural backgrounds or occupation types. This chapter has examined the psychological domain of motivation and its application to reasons for people seeking out travel experiences. It was aimed at improving the readers' understanding of their own travel motives as well as their employees, consumers, family or friends. &nbsp;{{RoundBoxTop|theme=2}} It is clear that knowledge of people's travel motivations plays a critical role in predicting future travel patterns, to find out specifically why her employees travel Jenny may want to send out a survey or questionnaire. However, unfortunately for Jenny most people are [[Wikipedia:Motivation#Intrinsic motivation||intrinsically]] motivated or pushed to travel so even if she does know why her employees seek travel experiences she most likely will not be able to influence them into changing their travel plans and staying at work.{{RoundBoxBottom}} == See also == *[[Wikipedia:Motivation|Motivation]] *[[Wikipedia:Travel|Travel]] == References == {{Hanging indent|1= Brown, S. (2005). Travelling with a Purpose: Understanding the Motives and Benefits of Volunteer Vacationers. Current Issues In Tourism, 8(6), 479-496. http://dx.doi.org/10.1080/13683500508668232 Dann, G. (1977). Anomie, ego-enhancement and tourism. Annals Of Tourism Research, 4(4), 184-194. http://dx.doi.org/10.1016/0160-7383(77)90037-8 Figler, M., Weinstein, A., Sollers, J., & Devan, B. (1992). Pleasure Travel (tourist) Motivation: A Factor Analytic Approach. Bulletin Of The Psychonomic Society, 30(2), 113-116. Retrieved from http://download.springer.com/static/pdf/649/art%253A10.3758%252FBF03330412.pdf?originUrl=http%3A%2F%2Flink.springer.com%2Farticle%2F10.3758%2FBF03330412&token2=exp=1442557615~acl=%2Fstatic%2Fpdf%2F649%2Fart%25253A10.3758%25252FBF03330412.pdf%3ForiginUrl%3Dhttp%253A%252F%252Flink.springer.com%252Farticle%252F10.3758%252FBF03330412*~hmac=1cc8cdcbe38f87ed76946ca0977e211336d026322734289e5adab4d8f4ace108 Fodness, D. (1994). Measuring tourist motivation. Annals Of Tourism Research, 21(3), 555-581. http://dx.doi.org/10.1016/0160-7383(94)90120-1 Gautam, S. (2007). Maslow’s eight basic needs and the eight stage developmental model. The Mouse Trap. Retrieved from http://the-mouse-trap.com/2007/12/14/maslows-eight-basic-needs-and-the-eight-stage-devlopmental-model/ Huang, S., & Hsu, C. (2009). Travel motivation: linking theory to practice. International Journal Of Culture, Tourism And Hospitality Research, 3(4), 287-295. Jönsson, C., & Devonish, D. (2008). Does Nationality, Gender, and Age Affect Travel Motivation? A Case of Visitors to The Caribbean Island of Barbados. Journal Of Travel & Tourism Marketing, 25(3-4), 398-408. http://dx.doi.org/10.1080/10548400802508499 Lee, U. (2004). Travel Motivation and Travel Career Pattern - A Study on Australians. Journal Of Tourism And Leisure Research, 16(4), 163-184. Lee, U., & Pearce, P. (2002). Travel motivation and travel career patterns. Proceedings Of First Asia Pacific Forum For Graduate Students Research In Tourism, 17-35. Martin, D., & Loomis, K. (2007). Building teachers: A Constructivist Approach to Introducing Education, (pp. 72-75). Belmont, CA: Wadsworth Cengage Learning. Paris, C., & Teye, V. (2010). Backpacker Motivations: A Travel Career Approach. Journal Of Hospitality Marketing & Management, 19(3), 244-259. http://dx.doi.org/10.1080/19368621003591350 Pearce, P. (1988). The Ulysses Factor. New York, NY: Springer New York. Pearce, P. (1993). Fundamentals of Tourist Motivation. In Tourism research: Critiques and Challenges. London: Routledge. Pearce, P., & Lee, U. (2005). Developing the Travel Career Approach to Tourist Motivation. Journal Of Travel Research, 43(3), 226-237. http://dx.doi.org/10.1177/0047287504272020 Pizam, A., & Mansfeld, Y. (1999). Consumer behavior in travel and tourism. New York: Haworth Hospitality Press. Plog, S. (1974). Why Destination Areas Rise and Fall in Popularity. Cornell Hotel And Restaurant Administration Quarterly, 14(4), 55-58. http://dx.doi.org/10.1177/001088047401400409 Plog, S. (1987). Travel, Tourism and Hospitality Research. A Handbook for Managers and Researchers. (pp. 203-213). New York: John Wiley & Sons. Plog, S. (2001). Why Destination Areas Rise and Fall in Popularity: An Update of a Cornell Quarterly Classic. The Cornell Hotel And Restaurant Administration Quarterly, 42(3), 13-24. http://dx.doi.org/10.1177/0010880401423001 Reissmann, T. Motivation Theory. Bringing Holidays to life. Retrieved from: http://www.authenticholidayfilms.com/tourist_motivation_35.html Ross, G. (1998). The psychology of tourism. Melbourne: Hospitality Press. Ryan, C. (1998). The travel career ladder An Appraisal. Annals Of Tourism Research, 25(4), 936-957. http://dx.doi.org/10.1016/s0160-7383(98)00044-9 Vukic, M., Kuzmanovic, M., & Kostic Stankovic, M. (2014). Understanding the Heterogeneity of Generation Y's Preferences for Travelling: a Conjoint Analysis Approach. International Journal Of Tourism Research, 17(5), 482-491. http://dx.doi.org/10.1002/jtr.2015 Woodside, A., & Martin, D. (2007). ''Tourism management''. Wallingford, Oxfordshire: CABI Pub. }} == External links == * '''Intriguing blog piece to read''', Reissmann thinks outside the box http://www.authenticholidayfilms.com/tourist_motivation_35.html * '''Social contributions''': [[Talk:Motivation and emotion/Book/2015/Travel motivation]] * '''Quiz''': What travel motive best describes you? https://www.qzzr.com/quiz/ad0f4764-a8c8-4ae5-9754-71742d1e092b/fi9xdWl6emVzLzEwNjQ2OA<nowiki/>- Made with Qzzr.com - Further information available from this article: http://download.springer.com/static/pdf/649/art%253A10.3758%252FBF03330412.pdf?originUrl=http%3A%2F%2Flink.springer.com%2Farticle%2F10.3758%2FBF03330412&token2=exp=1442557615~acl=%2Fstatic%2Fpdf%2F649%2Fart%25253A10.3758%25252FBF03330412.pdf%3ForiginUrl%3Dhttp%253A%252F%252Flink.springer.com%252Farticle%252F10.3758%252FBF03330412*~hmac=1cc8cdcbe38f87ed76946ca0977e211336d026322734289e5adab4d8f4ace108 This quiz is based on the Travel Motivation Survey (TMS) from the above article, results support past and present papers in travel research. There are 5 possible categories that a participant could be placed in: '''Anomie/authenticity seeking''' Specifically this category validates Dann's (1977) position that people travel in search of something better or more comfortable for themselves, Pearce (1983) also suggested that positive travel experiences reflect fulfillment of self-actualisation, and needs for love and belonging. It further maintains Cohen's (1979) description of diversity, experimental and existential travel modes. McCannell's (1976) thesis is also all about people seeking a more authentic travel existence. '''Culture/education seeking''' Present data reinforces that travel can be for cultural enhancement and educational pursuits (Crompton, 1979, Dann, 1977), meaning that individuals are 'pulled' toward the attributes of the destination rather then social-psychological factors that motivate one to travel. '''Escape/regression seeking''' Many researchers are supported in this category (Crompton. 1979, Cohen, 1979, Farber 1954) with suggestions that travel is to escape from pressure, dissatisfaction and routine at home. Trying to shed responsibility and relax. '''Wanderlust/exploring seeking''' Relating to the desire to roam and explore Gary, 1970, Cohen, 1979 & Vogt, 1976 all acknowledge this motive. '''Jetsetting/prestige seeking''' Finally this motive implies a desire for personal recognition, status and higher living, Lett (1983), Dann (1977) and Crompton (1979) support this social prestige seeking travel motive. [[Category:{{#titleparts:{{PAGENAME}}|3}}]] [[Category:Motivation and emotion/Book/Travel]] [[Category:Motivation and emotion/Book/Tourism]] 4nuzj3s93oss1c1of8lmyb6c6wr4dcp 0 203163 2419073 2418665 2022-08-25T16:17:57Z Platos Cave (physics) 2562653 wikitext text/x-wiki '''Is God a Programmer; a deep-universe simulation hypothesis at the Planck scale''' The [[w:simulation hypothesis |simulation hypothesis]] or simulation theory is the proposal that all of reality, including the Earth and the rest of the universe, could in fact be an artificial simulation, such as a computer simulation. [[w:Neil_deGrasse_Tyson |Neil deGrasse Tyson]] put the odds at 50-50 that our entire existence is a program on someone else’s hard drive <ref>Are We Living in a Computer Simulation? https://www.scientificamerican.com/article/are-we-living-in-a-computer-simulation/</ref>. [[w:David_Chalmers |David Chalmers]] noted “We in this universe can create simulated worlds and there’s nothing remotely spooky about that. Our creator isn’t especially spooky, it’s just some teenage hacker in the next universe up. Turn the tables, and we are essentially gods over our own computer creations <ref>https://www.youtube.com/watch?v=yqbS5qJU8PA, David Chalmers, Serious Science</ref> <ref>The Matrix as Metaphysics, David Chalmers http://consc.net/papers/matrix.pdf</ref> <ref>Are We Living in a Computer Simulation?https://www.scientificamerican.com/article/are-we-living-in-a-computer-simulation/</ref>. The commonly postulated [[w:Ancestor_simulation |ancestor simulation]] approach, which [[w:Nick Bostrom |Nick Bostrom]] called "the simulation argument", argues for "high-fidelity" simulations of ancestral life that would be indistinguishable from reality to the simulated ancestor. However this simulation variant can be traced back to an 'organic base reality' (the original programmer ancestors and their physical planet). The [[v:God_(programmer) |Programmer God]] hypothesis<ref>[https://theprogrammergod.com/ The Programmer God, Are We in a Computer Simulation (Malcolm Macleod, 2003-2022)]</ref> conversely states that the simulation began with the big bang (the deep universe simulation) and was programmed by an external intelligence (external to the physical universe), the Programmer by definition a God in the creator of the universe context. Our universe in its entirety, down to the smallest detail, is within the simulation <ref>[https://codingthecosmos.com/planck-scale.html Programming a deep-universe simulation hypothesis at the Planck scale using geometrical objects (the mathematical electron model)]</ref>. == Philosophy == === Discussion === [[w:Philosophy of mathematics |Philosophy of mathematics]] is that branch of philosophy which attempts to answer questions such as: ‘why is mathematics useful in describing nature?’, ‘in which sense, if any, do mathematical entities such as numbers exist?’ and ‘why and how are mathematical statements true?’ This reasoning comes about when we realize (through thought and experimentation) how the behavior of Nature follows mathematics to an extremely high degree of accuracy. The deeper we probe the laws of Nature, the more the physical world disappears and becomes a world of pure math. Mathematical realism holds that mathematical entities exist independently of the human mind. We do not invent mathematics, but rather discover it. Triangles, for example, are real entities that have an existence <ref>- http://plato.stanford.edu/entries/platonism-mathematics/</ref>. The [[w:Mathematical universe hypothesis |Mathematical universe hypothesis]] states that ''Our external physical reality is a mathematical structure''.<ref>{{cite journal|last=Tegmark |first=Max |date=February 2008 |title=The Mathematical Universe |journal=Foundations of Physics |volume=38 |issue=2 |pages=101–150 |doi=10.1007/s10701-007-9186-9 |arxiv=0704.0646|bibcode = 2008FoPh...38..101T |s2cid=9890455 }}</ref> That is, the physical universe is not merely ''described by'' mathematics, but ''is'' mathematics (specifically, a [[w:mathematical structure |mathematical structure]]). The principle constraints to any mathematical universe simulation hypothesis are; 1. the computational resources required. The ancestor simulation can resolve this by adapting from the [[w:virtual rality |virtual reality]] approach where only the observable region is simulated and only to the degree required, and 2. that any 'self-aware structures' (humans for example) within the simulation must "subjectively perceive themselves as existing in a physically 'real' world".<ref>Tegmark (1998), p. 1.</ref>. Succinctly, our computer games may be able to simulate our physical world, but they are still only simulations of a physical reality (regardless of how realistic they may seem) ... we are not yet able to program the physical dimensions of mass, space and time from mathematical structures. === Deep-universe simulation === As a deep-universe simulation is programmed by an external (external to the universe) intelligence (the Programmer God hypothesis), we cannot presume a priori knowledge regarding the simulation source code other than from this code the laws of physics could emerge, and so any deep-universe simulation model we emulate must be universal, i.e.: independent of any system of units, of the dimensioned physical constants (G, c, h, e .. ) and of any numbering systems. Furthermore, although a deep-universe simulation source code may use mathematical forms we are familiar with, it will have been developed by a non-human intelligence and so we may have to develop new mathematical tools to decipher the underlying logic. By implication therefore, any theoretical basis for a source code that fits the above criteria (that uses techniques that we are not cognizance of) could be construed as our first tangible evidence of a non-human intelligence. === Planck scale === The [[w:Planck scale |Planck scale]] refers to the magnitudes of space, time, energy and other units, below which (or beyond which) the predictions of the [[w:Standard Model |Standard Model]], [[w:quantum field theory |quantum field theory]] and [[w:general relativity |general relativity]] are no longer reconcilable, and [[w:Quantum Gravity |quantum effects of gravity]] are expected to dominate (quantum gravitational effects only appear at length scales near the Planck scale). Although particles may not be cognizance of our 'laws of physics', they do know the 'laws of nature'. These laws of nature, in a simulation model, would describe the universe OS (operating system), and so below this OS, 'physics' as we know it must necessarily break down. At present the Planck scale is the lowest known level, consequently any attempt to detect evidence of an underlying simulation coding must consider (if not actually begin at) this, the Planck scale<ref>Planck scale, Brian Greene; "[https://youtu.be/jaIAmpdaLvQ]"</ref>. {{see|Planck units (geometrical)}} === Dimensioned quantities === A [[w:physical constant |physical constant]] is a [[w:physical quantity |physical quantity]] that is generally believed to be both universal in nature and have a constant value in time. These can be divided into 1) dimension-ed (measured using physical units kg, m, s, A ...) such as the [[w:speed of light |speed of light]] ''c'', [[w:gravitational constant |gravitational constant]] ''G'', [[w:Planck constant |Planck constant]] ''h'' ... and 2) dimension-less (units = 1), such as the [[w:Fine-structure_constant |fine structure constant]] ''α''. There are also dimension-less [[w:mathematical constant |mathematical constants]] such as [[w:pi |pi]]. The mathematical constant is a number that can occur within the simulation, pi for example can emerge from the rotation of an object. The fundamental physical constant conversely is a parameter specifically chosen by the programmer and encoded into the simulation code directly and so whilst it may be inferable, it is not derived from mathematical constants ([[w:Fine-structure_constant#Numerological_explanations_and_multiverse_theory |Richard Feynman on the fine structure constant]]). It should also be dimension-less otherwise the simulation itself becomes dimensioned, and so the dimensioned constants themselves must be derivable (from within the simulation). Physicist [[w: |Lev Okun]] noted "Theoretical equations describing the physical world deal with dimensionless quantities and their solutions depend on dimensionless fundamental parameters. But experiments, from which these theories are extracted and by which they could be tested, involve measurements, i.e. comparisons with standard dimension-ful scales. Without standard dimension-ful units and hence without certain conventions physics is unthinkable <ref>Michael J. Duff et al, Journal of High Energy Physics, Volume 2002, JHEP03(2002)</ref>. The [[w:International_System_of_Units |SI units]] for the dimension-ful mksa units are; meter (length), kilogram (mass), second (time), ampere (electric current). As physics is dependent on dimension-ful units, physics as a science is the observation of underlying patterns generated (from within the simulation) by the OS (laws of nature), and as physics can experimentally measure down to the quantum level, the universe OS must operate at a much lower level (just as our computer programs run at a higher level to the OS). The best candidate at present for this level (the level at which the mathematical laws of nature operate), is the Planck level, the corresponding Planck units are [[w:Planck length |Planck length]], [[w:Planck mass |Planck mass]], [[w:Planck time |Planck time]], [[w:Planck charge |Planck charge]]. === Avatars === Video games project our 3-D space onto a 2-D screen with the users manipulating the game as external observers. The VR helmet is an attempt to place the user within the simulation (within a 3-D space) but it is still a projection onto a 2-D screen and so is limited by the mobility of the operator (via a [[w:haptic suit |haptic suit]]) and thus not suitable for interactive games if the terrain of the game is limited by the terrain of the operator. An avatar could be placed within a 3-D simulation, however the problem of haptic suit mobility remains. However, if the avatar is programmed to closely resemble the operator, then the avatar may autonomously represent the operator from within the game. For example, avatars could be programmed to play tennis with the skill level of their operators, realistic virtual tournaments can then be arranged within a 3-D simulation between operators via avatars. In a Game of Life scenario, the avatars could be programmed to achieve certain goals ('Purpose') via experience and learning. === Purpose === Any simulated universe, whether a simple computer game or NASA program, may presume a 'Purpose', that the simulation, being the result of an 'intelligent design', is intended for an 'intelligent reason' (intent). If ours is a simulated universe then we cannot judge the motives of the Programmer God, however in theological texts we do find a common thread and that is the battle between [[w:good and evil |Good and Evil]] and so this may be taken as an example 'Purpose'. [[w:Zoroastrianism |Zoroastrianism]] is one of the world's oldest continuously practiced [[w:religion |religion]]s. It is a multi-faceted faith centered on a [[w:dualistic cosmology |dualistic cosmology]] of [[w:good and evil |good and evil]] and an [[w:eschatology |eschatology]] predicting the ultimate conquest of evil. The [[w:Genesis creation narrative|opening chapters of the Book of Genesis]] provide a [[w:myth |mythic]] history of the infiltration of evil into the world. God places the first man and woman (Adam and Eve) in his [[w:Garden of Eden |Garden of Eden]], from whence they are expelled. In the context of the above, this becomes a multi-layered Game in which Evil is given dominion over the physical 3-D world and Good dominion over the spiritual realm <ref>New Testament Matthew 4:8-9</ref>, the battle between these worlds played out within mankind as both an internal and external struggle <ref>[https://codingthecosmos.com/good-and-evil-the-programmer-god.html The Great Game]</ref>. To account for suffering and misery as an integral construct to the Game, we could consider the earth as analogous to a meta-verse prison. For example, an avatar could be tasked (unknowingly) with self-rehabilitation on earth as the means to complete a prison sentence, upon which their 'real' self is then set free in the 'real' world <ref>https://www.wga.org/ Life Sentence, WGA #2126049</ref>. === Evidence of a simulation === “Science presumes the fundamental physical constants (''G'', ''h'', ''c'', ''e'', ''m''_e, ''k''_B, ...) are fundamental, but this requires the dimensioned units (''kg'', ''m'', ''s'', ''A'' ... ) to be independent of each other, the simulation hypothesis however requires that these units can overlap and cancel, for the universe itself does not exist outside of the 'Computer'. Evidence of a relationship between these units could therefore be construed as evidence of a simulation.” <ref>[https://theprogrammergod.com/programmer-god-evidence-simulation-universe.html Is this anomaly in the fundamental physical constants proof we are in a simulation?]</ref> At our level, and at the quantum level, the dimensions of mass, length (distance), time and charge (amperes), represented by such units as ''kilograms'', ''pounds'', ''meters'', ''miles'', ''seconds'' … etc. are independent of each other (we cannot measure the distance from Tokyo to London using pounds or kilograms or amperes). The units appear to be distinct (mass cannot be confused with length or time), the independence of these units then becoming an inviolable rule, as every high school science student can attest (the units must always add up!). Indeed, what characterizes a physical universe as opposed to a simulated universe is the notion that there is a fundamental structure underneath, that in some sense mass is, time is and space is … thus we cannot write ''kg'' or ''s'' in terms of ''m''. To do so would totally render our concepts of a physical mass, space and time meaningless. A simulation universe however is required to be (in sum total) unit-less (units = 1), for the simulated universe does not 'exist' in any physical sense outside of the 'Computer'. Evidence therefore that the units do overlap and in certain combinations cancel, rendering our sum universe unit-less, could therefore be construed as evidence that we are in a deep-universe (Programmer God) simulation. An anomaly that appears to link the fundamental physical constants (''G'', ''h'', ''c'', ''e'', ''m''_e, ''k''_B) via a mathematical relationship between the units (''kg'' = 15, ''m'' = -13, ''s'' = -30, ''A'' = 3) has been offered as evidence that we are in a simulation <ref>Macleod, Malcolm J. {{Cite journal |title= Do the physical constants (''G'', ''h'', ''c'', ''e'', ''m''_e, ''k''_B) embed evidence of a simulation universe at the Planck scale? |journal=RG | doi=10.13140/RG.2.2.15874.15041/2 }}</ref>. == Programming == “God vs. science debates tend to be restricted to the premise that a God does not rely on science and that science does not need a God. As science and God are thus seen as mutually exclusive there are few, if any, serious attempts to construct mathematical models of a universe whose principle axiom does require a God. However, if there is an Intelligence responsible for the 14 billion year old universe of modern physics, being the universe of Einstein and Dirac, and beginning with the big bang as the act of 'creation', then we must ask how it might be done? What construction technique could have been used to set the laws of physics in motion?” <ref>[https://theprogrammergod.com/ The Programmer God, Are We in a Computer Simulation (Malcolm Macleod, 2003-2022)]</ref> === Numbering systems === As well as our decimal system, computers apply binary and hexadecimal numbering systems. In particular the decimal and hexadecimal are of terrestrial origin and may not be considered 'universal'. Furthermore numbering systems measure only the frequency of an event and contain no information as to the event itself. The number 299 792 458 could refer to the speed of light (299 792 458 m/s) or could equally be referring to the number of apples in a container (299 792 458 apples). As such, numbers require a 'descriptive', whether m/s or apples. Numbers also do not include their history, is 299 792 458 for example a derivation of other base numbers? Present universe simulations use the laws of physics and the physical constants are built in, however both these laws and the physical constants are known only to a limited precision, and so a simulation with 10⁶² iterations (the present age of the universe in units of Planck time) will accumulate errors. Number based computing may be sufficient for ancestor-simulation models where only the observed region needs to be calculated, but has inherent limitations for deep universe simulations where the entire universe is continuously updated. The actual computational requirements for a Planck scale universe simulation based on a numbering system with the laws of physics embedded would be an unknown and consequently lead to an 'non-testable' hypothesis. This is a commonly applied reasoning for rejecting the deep universe simulation. === Geometrical objects === A number such as [[w: |pi]] refers to a geometrical construct (the ratio of circle circumference to circle radius) and so is not constrained by any particular numbering system (in the decimal system π = 3.14159...), and so may be considered both universal and eternal. Likewise, by assigning geometrical objects instead of numbers to the Planck units, the problems with a numbering system can be resolved. These objects would however have to fulfill the following conditions, for example the object for length must; 1. embed the function of ''length'' such that a descriptive (km, mile ... ) is not required. Electron wavelength would then be measurable in terms of the length object, as such the length object must be embedded within the electron (the electron object). Although the mass object would incorporate the function ''mass'', the time object the function ''time'' ..., it is not necessary that there be an individual physical mass or physical length or physical time ..., but only that in relation to the other units, the object must express that function (i.e.: the mass object has the function of mass when in the presence of the objects for space and time). The electron would then be a complex event (complex geometrical object) constructed by combining the objects for mass, length, time and charge into 1 event, and thus electron charge, wavelength, frequency and mass would be different aspects of that 1 geometry (the electron event) and not independent parameters (independent of each other). The objects for mass, length, time and charge must therefore 2. be able to combine with other objects (for mass, time, charge ...) to form more complex objects (events) such as electrons and apples whilst still retaining the underlying information (the individual objects that combined to form that event). 3. combine in such a ratio that they cancel whereby the sum universe, the simulation itself, being a mathematical universe, is unit-less. While internally the universe has measurable units, externally (seen from outside the simulation) the universe has no physical structure. Not only must these objects be able to form complex events such as particles, but these events themselves are geometrical objects and so must likewise function according to their geometries. Electrons would orbit protons according to their respective electron and proton geometries, these orbits the result of geometrical imperatives and not due to any built-in laws of physics (the electron does not need to know physics, the orbital path is a consequence of all the underlying geometries). However, as orbits follow regular and repeating patterns, they can be described (by us) using mathematical formulas. As the events grow in complexity (from atoms to molecules to planets), so too will the patterns (and the formulas we use to describe them). Consequently the ''laws of physics'' would then become our mathematical descriptions of the underlying geometrically imposed patterns. The computational problem could thus be alleviated by instituting a geometrically autonomous universe. Furthermore, as the sum universe is unit-less, there is no limit to the number of (mass, time, length ...) objects (aka the information content of the universe), other than the capacity of the celestial hard disk upon which the simulation resides. If the 'Programmer' can determine appropriate geometrical objects that satisfy the above and also include a mechanism for the addition of further objects, then a universe could 'grow' accordingly. There is a caveat; self aware structures within the simulation will perceive a physical mass, space and time as forming their physical reality, in our universe therefore, these mathematical objects must be indistinguishable from our observed physical reality. === Simulation Time === The (dimensionless) simulation clock-rate would be defined as the minimum 'time variable' ('''age''') increment to the simulation. It may be that Gods use analog computers, but as an example; 'begin simulation FOR age = 1 TO the_end 'big bang = 1 conduct certain processes ........ NEXT age 'end simulation [[w:Quantum spacetime |Quantum spacetime]] and [[w:Quantum gravity |Quantum gravity]] models refer to [[w:Planck time | Planck time]] as the smallest discrete unit of time and so the incrementing variable '''age''' could be used to generate units of Planck time (and other Planck units, the physical scaffolding of the universe), for example; Initialize_physical_constants; FOR age = 1 TO the_end 'age is a dimensionless variable generate 1 unit of Planck time; '1 time object generate 1 unit of Planck mass; '1 mass object generate 1 unit of Planck length; '1 length object ........ NEXT age The variable ''age'' is the simulation clock-rate (the universe age). If ''age'' is the origin of Planck time then ''age'' = 10⁶², the present age of the universe measured in units of Planck time. For each ''age'', certain operations are performed, only after they are finished does ''age'' increment (there is no 'time' interval between increments). As ''age'' is dimensionless, it is not the same as dimensioned Planck time (which is a geometrical object). Although operations (between increments) may be extensive, self-aware structures from within the simulation would have no means to determine this, they could only perceive themselves as being in a real-time. Their dimension of time would be a measure of relative motion (a change of state) and so although ultimately deriving from the variable ''age'', their time would not be the same as ''age''. If there were no motion, if all particles and photons were still (no change of state), then their time dimension could not update, ''age'' however would continue to increment. The analogy being pressing the pause button on a movie, this would not affect the computer clock-rate itself. Thus we have 3 time structures; the dimension-less simulation clock-rate variable ''age'', the physical time unit (Planck time object), and time as change of state (the observers time dimension). ==== Expanding universe ==== By thus adding units of mass, space and time with each increment to the simulation ''age'', the universe would grow in size and mass accordingly. As the universe expands in size per increment to ''age'', this expansion could also be used to 'pull' particles with it thus introducing momentum (particle motion). The expansion of the observable universe would not be the same as this expansion, although it would be driven by this expansion. The velocity of expansion would be the maximum attainable velocity and so the origin of the speed of light ''c'' (to go faster than this velocity would mean leaving the simulation itself), thus both the velocity of expansion (and so ''c'') and the incrementing variable ''age'' (and so Planck time) are constants. The forward increment to ''age'' would constitute the [[w:arrow of time |arrow of time]]. Reversing this would reverse the arrow of time, the universe would likewise shrink in size and mass accordingly (a [[w:white hole |white hole]] is the (time) reversal of a [[w:black hole |black hole]]). FOR age = the_end TO 1 STEP -1 delete 1 unit of Planck time; delete 1 unit of Planck mass; delete 1 unit of Planck length; ........ NEXT age ====Universe time-line==== As the universe expands and if the data storage capacity expands proportionately, then the 'past' could be retained. FOR age = 1 TO the_end ........ FOR n = 1 TO total_number_of_particles ......... SAVE particle_details{age, particle(n)} NEXT n NEXT age Because particles are pulled along by this expansion, which has the effect of increasing simulation data storage capacity accordingly, previous information will not be over-written by new information. The analogy would be the storing of every [[w:Keystroke_logging |keystroke]]. This also forms a universe '''time-line''' against which previous information can be compared with new information (a 'memory' of events). ====Time travel==== If the simulation data is stored in entirety (a Planck scale version of the [[w:Akashic records |Akashic records]]), the simulation can be replayed. We could even speculate that if mankind made a bad 'move', such as initiating a nuclear war, it may be possible to rewind the simulation clock back to a period prior to that move and continue from there (as we can do when playing chess against a computer). All future events from that point in time would then be over-written. Time-travel (travelling backwards in time) for an individual may not be possible but for the entire universe it is simply time reversal. === Singularity === In a simulation, the data (software) requires a storage device that is ultimately hardware (RAM, HD ...). In a data world of 1's and 0's such as a computer game, characters within that game may analyze other parts of their 1's and 0's game, but they have no means to analyze the hard disk upon which they (and their game) are stored, for the hard disk is an electro-mechanical device, is not part of their 1's and 0's world, it is a part of the 'real world', the world of the Programmer. Furthermore the rules programmed into their game would constitute for them the laws of physics (the laws by which their game operates), but these may or may not resemble the laws that operate in the 'real world'. Thus any region where the laws of physics (the laws of the game world) break down would be significant. A [[w:singularity |singularity]] inside a black hole is such a region. For the black-hole electron, the mass point-state would then be analogous to a storage address on a hard disk, the interface between the simulation world and the real world, a massive black-hole as a data sector. The surface of the black-hole would then be of the simulation world, the size of the black hole surface reflecting the stored information, the interior of the black-hole however would be the interface between the data world and the 'hard disk' of the real world, and so would not exist in any 'physical' terms. It is external to the simulation. As analogy, we may discuss the 3-D surface area of a black-hole but not its volume (interior). === Laws of Physics === The scientific method is built upon testable hypothesis and reproducible results. Water always boils (in defined conditions), at 100°C. In a geometrical universe particles behave according to geometrical imperatives, the geometry of the electron and proton ensuring that electrons will orbit nuclei in repeating and predictable patterns. The laws of physics would then be a set of mathematical formulas that describe these patterns, the more complex the orbits, the more complex the formulas required to describe them and so forth. However if there is a source code from which these geometrical conditions were programmed, then there may also be non-repeating events, back-doors built into the code (a common practice by terrestrial programmers), these by definition would lie outside the laws of physics and so be labelled as miracles, yet they would be no less valid. === Determinism === [[File:Three body problem figure-8 orbit animation.gif|400px|thumb|An animation of the figure-8 solution to the three-body problem over a single period T ≃ 6.3259.<ref>Here the gravitational constant ''G'' has been set to 1, and the initial conditions are '''r'''₁(0) = −'''r'''₃(0) = (−0.97000436, 0.24308753); '''r'''₂(0) = (0,0); '''v'''₁(0) = '''v'''₃(0) = (0.4662036850, 0.4323657300); '''v'''₂(0) = (−0.93240737, −0.86473146). The values are obtained from Chenciner & Montgomery (2000).</ref>]] Particles form more complex structures such as atoms and molecules via a system of orbitals; nuclear, atomic and gravitational. The [[w:Three-body_problem |3-body problem]] is the problem of taking the initial positions and velocities (or [[w:momentum|momenta |momentum|momenta]]) of three or more point masses and solving for their subsequent motion according to [[w:Newton's laws of motion |Newton's laws of motion]] and [[w:Newton's law of universal gravitation |Newton's law of universal gravitation]].<ref name="PrincetonCompanion">{{Citation | last = Barrow-Green | first = June | year = 2008 | title = The Three-Body Problem | editor-last1 = Gowers | editor-first1 = Timothy | editor-last2 = Barrow-Green | editor-first2 = June | editor-last3 = Leader | editor-first3 = Imre | encyclopedia = The Princeton Companion to Mathematics | pages = 726–728 | publisher = Princeton University Press }}</ref>. Simply put, this means that although a simulation using gravitational orbitals of similar mass may have a pre-determined outcome, it seems that for gods and men alike the only way to know what that outcome will be is to run the simulation itself. === Mathematical Universe === The mathematical universe refers to universe models whose underlying premise is that the physical universe has a mathematical origin, the physical (particle) universe is a construct of the mathematical universe, and as such physical reality is a perceived reality. It can be considered a form of [[w:Pythagoreanism | Pythagoreanism]] or [[w:Platonism | Platonism]] in that it proposes the existence of ''mathematical objects''; and a form of [[w:philosophy of mathematics | mathematical monism]] in that it denies that anything exists except these ''mathematical objects''. Physicist [[w:Max Tegmark | Max Tegmark]] in his book "Our Mathematical Universe: My Quest for the Ultimate Nature of Reality"<ref name="Tegmark1998">{{cite journal|last=Tegmark |first=Max |date=November 1998 |title=Is "the Theory of Everything" Merely the Ultimate Ensemble Theory? |journal=Annals of Physics |volume=270 |issue=1 |pages=1–51 |doi=10.1006/aphy.1998.5855 |arxiv = gr-qc/9704009 |bibcode = 1998AnPhy.270....1T }}</ref><ref>M. Tegmark 2014, "[http://mathematicaluniverse.org Our Mathematical Universe]", Knopf</ref> proposed that ''Our external physical reality is a mathematical structure''.<ref name="Tegmark2008">{{cite journal|last=Tegmark |first=Max |date=February 2008 |title=The Mathematical Universe |journal=Foundations of Physics |volume=38 |issue=2 |pages=101–150 |doi=10.1007/s10701-007-9186-9 |arxiv=0704.0646|bibcode = 2008FoPh...38..101T }}</ref> That is, the physical universe is not merely ''described by'' mathematics, but ''is'' mathematics (specifically, a [[w:mathematical structure | mathematical structure]]). Mathematical existence equals physical existence, and all structures that exist mathematically exist physically as well. Any "self-aware substructures will subjectively perceive themselves as existing in a physically 'real' world".<ref>Tegmark (1998), p. 1.</ref> == Physics == Physicist [[w:Eugene Wigner |Eugene Wigner]] ([[w:The_Unreasonable_Effectiveness_of_Mathematics_in_the_Natural_Sciences |The Unreasonable Effectiveness of Mathematics in the Natural Sciences]]) <ref>{{Cite journal | last1 = Wigner | first1 = E. P. | authorlink = Eugene Wigner| doi = 10.1002/cpa.3160130102 | title = The unreasonable effectiveness of mathematics in the natural sciences. Richard Courant lecture in mathematical sciences delivered at New York University, May 11, 1959 | journal = Communications on Pure and Applied Mathematics | volume = 13 | pages = 1–14 | year = 1960 | pmid = | pmc = |bibcode = 1960CPAM...13....1W }}</ref> <blockquote>The miracle of the appropriateness of the language of mathematics for the formulation of the laws of physics is a wonderful gift which we neither understand nor deserve. </blockquote> The following is taken from the mathematical electron model <ref>[https://codingthecosmos.com/planck-scale.html Programming a deep-universe simulation hypothesis at the Planck scale using geometrical objects (the mathematical electron model)]</ref> and illustrates how a geometrical approach to a Planck scale deep universe simulation could be implemented. === Mass, length, time, charge === {{main|Planck units (geometrical)}} ''The biggest problem with any mathematical universe approach is constructing a physical reality (the physical dimensions of mass, space and time) from mathematical structures. Our computer games may be able to simulate our physical world, but they are still simulations of a physical reality. The 1999 film The Matrix and the ancestor simulation both still begin with a physical level (a base reality), the planet earth. Here we look at the theory behind constructing physical units from mathematical structures''. We can assign geometrical objects to the primary units mass '''M''', length '''L''', time '''T''', ampere '''A'''. However for a simulated universe to be unit-less, the units must be able to cancel within a certain ratio such that in sum total there is no physical universe (when seen from outside the simulation, the universe is merely a data set on a celestial hard-drive). In the following table are illustrated objects '''MTLA''' in terms of 2 dimensionless physical constants; the [[w:fine-structure constant | fine structure constant '''α''']] and [[v:Electron_(mathematical)#Omega | Omega '''Ω''']], and to fulfill the above condition, a unit number is assigned to each geometry whereby a relationship between them may be established <ref>{{Cite journal | last1 = Macleod | first1 = Malcolm J. |title= Programming Planck units from a mathematical electron; a Simulation Hypothesis |journal=Eur. Phys. J. Plus |volume=113 |pages=278 |date=22 March 2018 | doi=10.1140/epjp/i2018-12094-x }}</ref>. These objects correspond to the Planck units, and so by equating the unit number '''u''' with its SI equivalent (i.e.: ''u'' = 15 == ''kg''), these geometrical mass, length, time and charge objects can be interchangeable with (and will be indistinguishable from) the 'physical' Planck mass, length, time and charge units. As these are geometrical objects, we can also use them to build more complex objects. The energy object for example is M*L²/T². The electron object is shown below. {| class="wikitable" |+Geometrical units ! Attribute ! Geometrical object ! Unit number ''n'' |- | mass | <math>M = 1</math> | <math>15</math> |- | time | <math>T = 2\pi</math> | <math>-30</math> |- | length | <math>L = 2\pi^2\Omega^2</math> | <math>-13</math> |- | velocity | <math>V = 2\pi\Omega^2</math> | <math>17</math> |- | ampere | <math>A = \frac{2^6 \pi^3 \Omega^3}{\alpha}</math> | <math>3</math> |} The unit relationships show how these units interrelate to each other. In a particular ratio they will overlap and cancel, for example, here (amperes, length, time) and (mass, length and time) ratios cancel (''n'' = 3*3 -13*3 +30 = 0, ''n'' = -13*15 -15*9 +30*11 = 0). As these units in a physical universe are independent, for a physical universe requires that somehow mass is, space is, time is ... evidence of these ratio can be used as evidence that we are in a simulation <ref>[https://theprogrammergod.com/programmer-god-evidence-simulation-universe.html Is this anomaly in the fundamental physical constants proof we are in a simulation?]</ref>. Thus we may have dimensioned units from within (from inside) the simulation, yet still maintain a dimensionless universe externally. :<math>\frac{({u^3})^3{(u^{-13}})^3}{(u^{-30})}\;(\frac{ampere^3 \;length^3}{time}) = \frac{{(u^{-13})}^{15}} {{(u^{15})}^{9}{(u^{-30})}^{11}} (\frac{length^{15}}{mass^9 \;time^{11}}) = 1</math> === Mathematical electron === {{main|Electron (mathematical)}} ''If the electron is a mathematical particle, and the universe is constructed from electrons, then the universe is a mathematical universe'' We can use the above ratio to construct our '[[v:Electron_(mathematical) |mathematical electron]]' formula; '''f_e''' (AL as an ampere-meter are the units for a [[w:magnetic monopole | magnetic monopole]]). :<math>T = (\pi),\; u^{-30}</math> :<math>\sigma_{e} = \frac{3 \alpha^2 A L}{2\pi^2} = ({2^7 3 \pi^3 \alpha \Omega^5}),\; u^{-10}</math> :<math>f_e = \frac{ \sigma_{e}^3}{2T} = \frac{(2^7 3 \pi^3 \alpha \Omega^5)^3}{2\pi},\; units = \frac{(u^3)^3 (u^{-13})^3}{u^{-30}} = 1</math> In order that the electron may have dimensioned (measurable) parameters; electron mass, wavelength, frequency, charge ... the geometry of the mathematical electron (the electron 'event' <math>f_e</math>) includes the MLTA (mass, length, time, charge) objects, this electron 'event' dictating how these objects are arranged into those dimensioned electron parameters. The electron itself is then equivalent to a programming sub-routine, <math>f_e</math> does not have dimension units of its own (there is no physical electron), it is a geometrical formula that encodes the MLTA information required to implement those electron parameters. :<math>f_e = 4\pi^2(2^6 3 \pi^2 \alpha \Omega^5)^3 = .23895453...x10^{23}</math>, units = 1 [[w:electron mass | electron mass]] <math>m_e = \frac{M}{f_e}</math> (M = [[w:Planck mass | Planck mass]]) [[w:Compton wavelength | electron wavelength]] <math>\lambda_e = 2\pi L f_e</math> (L = [[w:Planck length | Planck length]]) [[w:elementary charge | elementary charge]] <math>e = A.T</math> Embedded within the function ''f_e'' are the objects ''ALT''. The ''AL'' magnetic monopoles confer the electric properties of the electron and also determine the duration of the electron frequency (0.2389 x 10²³ units of the simulation clock-rate variable ''age'' corresponding to 0.2389 x 10²³ units of Planck time). At the conclusion of this electric state duration (0.2389 x 10²³ units of ''age''), the ''AL'' units intersect with time ''T'', the units then collapse (units ''(A*L)³/T'' = 1), exposing a unit of ''M'' (Planck mass) for 1 unit of ''age'', which we could define as the '''mass point-state'''. This would be the electron center. This mass state, as a single 'point', can have assigned co-ordinates within the universe super-structure. [[w:Wave-particle duality |Wave-particle duality]] at the Planck level can then be simulated as an oscillation between an electric (magnetic monopole) '''wave-state''' (the duration dictated by the particle formula, for the electron = 0.2389 x 10²³ units of Planck time) to this unitary mass '''point-state'''. In the formula ''E = hv'', ''h'' ([[w:Planck constant |Planck's constant]]) refers to the wave-state, with the ''v'' term referring to the frequency of occurrence of ''h'' (per second). Conversely ''E = mc2'' refers to the point-state, and as there is 1 wave-state per 1 point-state, ''hv = mc2''. The ''m'' of physics however refers to mass as a constant property of the particle whereas here particle mass has a frequency component (it is a measure of the frequency of occurrence of the mass point-state over time) and so particle mass becomes average particle mass (average occurrence of the point mass per second). By this artifice, although the 'physical' mass, space, time universe is constructed from particles, particles themselves are not physical, they are mathematical, and when summed, the mass, length, time, charge units cancel. Thus we may construct a physical universe from within a mathematical framework <ref> [https://codingthecosmos.com/ Programming at the Planck scale using geometrical objects]</ref>. === Null universe === {{main|Black-hole (Planck)}} ''We next need to construct a scaffolding for our particles'' If the universe expands per increment of '''age''' by adding units of mass, length, time and charge, and if these units overlap and cancel, then the sum universe is unit-less. This also means that to make the object time '''T''', we must also make an equivalent of '''MLA''' to balance this ratio (so that the sum universe is always dimensionless), and so to create time T, the time required to read this sentence for example, the universe has to grow larger (add space L³) and more massive (add mass M). Likewise, if time went backward the universe would have to shrink in size and mass. But regardless of the age of the universe, if we combine all the mass, space and time within, the universe would disappear (units = 1). Seen from the outside, there is no universe. This also means that if we know the age of the universe (number of units of T), then we know its mass (number of units of M) and size (number of units of L). === Relativistic universe === {{main|Relativity (Planck)}} ''The simulation clock can give us the expansion of the universe in size and mass via these Planck objects. A 14 billion year old universe would put ''age'' = 10⁶². This expansion can also be used to introduce motion (particle momentum) by pulling particles with it, the problem however is that this expansion occurs at the speed of light (''c'' = 1 unit of Planck length per 1 unit of Planck time), and so we need to provide a reference for our surroundings (if everything is moving away from us at the speed of light). One solution is for an expanding 4-axis hyper-sphere universe to project onto a fixed 3-D (Newtonian) background using the mathematics of perspective. If we can perceive only this 3-D background, then we will perceive the motion of all objects as relative to our motion. The expansion of the universe at the speed of light will be 'invisible' to us. This can be achieved using the electromagnetic spectrum''. The [[w:Perspective_(graphical) |mathematics of perspective]] is a technique used to project a 3-D image onto a 2-D screen (i.e.: a photograph or a landscape painting), using the same approach here would implement a 4-axis expanding hypersphere super-structure in which 3-D space is the projection <ref>{{Cite journal | last1 = Macleod | first1 = Malcolm J. |title= 4. Programming cosmic microwave background for Planck unit Simulation Hypothesis modeling |journal=RG |date=March 2020 | doi=10.13140/RG.2.2.31308.16004/7 }}</ref>. The expanding hyper-sphere can be used to replace independent particle motion (momentum) with motion as a function of the expansion itself, as the universe expands, it pulls all particles along with it. In the mass point-state, the particle can be assigned defined co-ordinates in the hyper-sphere and so all particles simultaneously in the point-state per unit of '''age''' may then be measured relative to each other. As photons (the electromagnetic spectrum) have no mass state, they cannot be pulled along by the universe expansion (consequently they are date stamped, as it takes 8 minutes for a photon to travel from the sun, that photon is 8 minutes old when it reaches us), and so photons would be restricted to a lateral motion within the hyper-sphere. As the electromagnetic spectrum is the principal source of information regarding the environment, a 3-D relative space would be observed (as a projected image from within the 4-axis hyper-sphere), the [[w:Lorentz_transformation |relativity formulas]] can then be used to translate between the [[v:Relativity_(Planck) |hyper-sphere co-ordinates]] and 3-D space co-ordinates <ref>{{Cite journal | last1 = Macleod | first1 = Malcolm J. |title= 1. Programming relativity for Planck unit Simulation Hypothesis modeling |journal=RG |date=March 2020 | doi=10.13140/RG.2.2.18574.00326/3 }}</ref>. In hyper-sphere co-ordinate terms; '''age''' (the simulation clock-rate), and velocity (the velocity of expansion as the origin of '''c''') would be constants and thus all particles and objects would travel at, and only at, the speed of light, ''V = c'', however in 3-D space co-ordinate terms, time and motion would be relative to the observer. The [[w:Dimension#Time |time dimension]] of the observer measures the change in state = change of information = change in relative position of particles in respect to each other and thus derives from, but is not the same as, the expansion clock-rate '''age''' or object time '''T''', for in the absence of motion there is no means for the observer to measure either, the dimensionless '''age''' variable however would continue to increment (the universe hyper-sphere would continue to expand at the speed of light). [[File:8body-27orbital-gravitational-orbit.gif|thumb|right|640px|8-body (8 mass points, 28 point-point orbitals) orbit]] === Gravitational orbitals === {{main|Quantum gravity (Planck)}} ''Although we can accurately predict the motion of planetary bodies in space using our gravity models, these are not suitable when we have to include the influence of grains of sand blowing in the wind or waves crashing onto a rocky beach as a deep simulation must do in real time. A solution is to form individual (dimensionless) rotating particle to particle orbital pairs at the Planck scale, each rotating according to the orbital radius, the planetary orbits emerging naturally as the averaging over time of these underlying rotating orbitals. For example, using this approach, it would not be necessary to have any information regarding the earth and the moon, their relative masses, their (constantly changing) [[w:barycenter |barycenter]], or any dimensioned constants, for the orbit to be plotted in real (universe) time down to the particle level.'' All particles simultaneously in the point-state at any unit of '''age''' form gravitational orbital pairs with each other <ref>{{Cite journal | last1 = Macleod | first1 = Malcolm J. |title=2. Quantum gravity n-body orbitals for Planck scale simulation hypothesis |journal=RG |date=Feb 2011 | doi=10.13140/RG.2.2.11496.93445/12}}</ref>. For each increment to ''age'', these orbital pairs then rotate by a specific angle depending on the radius of the orbital to travel 1 unit of Planck length. The results are then summed and averaged and so the entire universe can be updated in real time (before the next increment to ''age''). The observed [[w:orbits |gravitational orbits]] of planets are the sum of these ([[w:n-body |n-body]]) orbital pairs averaged over time. Thus it is in principle not necessary to have direct information regarding the orbiting objects in order to derive their respective orbits. FOR age = 1 TO the_end 'gravitational orbits via orbitals FOR n = 1 TO total_number_of_particles IF particle{n}_is_in_the_point_state form_an_orbital_with_all_other_point_state_particles rotate_orbital_1_Planck_length END IF sum_and_average_all_coordinates NEXT n NEXT age Orbits, being also driven by the universe expansion, occur at the speed of light, however if the orbit along the expansion time-line is not noted by the observer, who instead relies on the electromagnetic spectrum, then the orbital period will be measured in terms of 3D space co-ordinates. === Atomic orbitals === As atomic orbitals also involve 2 particles rotating, they can be treated as modified gravitational orbitals. If the orbital itself is a 'physical' unit of momentum, akin to a photon, albeit of inverse phase, then when the photon strikes the atom, it will impact the orbital, not the particle, resulting in a lengthening or shortening of the orbital radius in the process. Electron transition between orbitals can then be mapped as a modification of the orbital (change in orbital radius) in discrete steps according to the wavelength of the incoming photon (which is absorbed or ejected by the orbital), the electron itself is not directly involved <ref>{{Cite journal | last1 = Macleod | first1 = Malcolm J. |title=4. Atomic orbitals in Planck scale simulation hypothesis |journal=RG |date=Feb 2011 | doi=10.13140/RG.2.2.23106.71367/2}}</ref>. == External links == * [[v:Planck_units_(geometrical) | Programming Planck units as geometrical objects]] * [[v:electron_(mathematical) | The mathematical electron]] * [[v:Relativity_(Planck) | Programming relativity at the Planck scale]] * [[v:Quantum_gravity_(Planck) | Programming gravity at the Planck level]] * [[v:Black-hole_(Planck) | Programming the cosmic microwave background at the Planck level]] * [[v:Sqrt_Planck_momentum | The sqrt of Planck momentum]] * [https://theprogrammergod.com/ The Programmer God, Are We in a Computer Simulation] (eBook) * [https://codingthecosmos.com/ Programming at the Planck scale using geometrical objects] -Malcolm Macleod's website * [http://www.simulation-argument.com/ Simulation Argument] -Nick Bostrom's website * [https://www.amazon.com/Our-Mathematical-Universe-Ultimate-Reality/dp/0307599809 Our Mathematical Universe: My Quest for the Ultimate Nature of Reality] -Max Tegmark (Book) * [https://link.springer.com/article/10.1134/S0202289308020011/ Dirac-Kerr-Newman black-hole electron] -Alexander Burinskii (article) * [https://www.imdb.com/title/tt0133093/ The Matrix, (1999)] * [https://plato.stanford.edu/entries/pythagoras/ Pythagoras "all is number"] - Stanford University * [[w:Simulation Hypothesis | Simulation Hypothesis]] * [[w:Mathematical universe hypothesis | Mathematical universe hypothesis]] * [[w:Philosophy of mathematics | Philosophy of mathematics]] * [[w:Philosophy of physics | Philosophy of physics]] * [[w:Platonism | Platonism]] * [https://philpapers.org/rec/GRUTIA-2 Simulation theory as evidence for God] (academic peer-reviewed article) ==References== {{Reflist}} [[Category:Philosophy| ]] [[Category:Philosophy of science| ]] 2gzyqxrosi8dpnevxtt44u0b2fc5y4x 0 207094 2419174 2413987 2022-08-26T01:56:00Z Ardenguo 2944162 /* Treatment */ made the collapsible box expanded by default wikitext text/x-wiki <noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{medical disclaimer}} {{:{{BASEPAGENAME}}/Sidebar}} ==[[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio"?''']]== For background information on what assessment portfolios are, click the link in the heading above. Want even 'more' information about this topic? There's an extended version of this page [[Evidence-based assessment/Anorexia nervosa (assessment portfolio)/extended version|here]]. == [[Evidence based assessment/Preparation phase|'''Preparation phase''']] == === Diagnostic criteria for anorexia nervosa === {{blockquotetop}} '''ICD-11 Criteria''' Anorexia Nervosa is characterized by significantly low body weight, which is less than minimal normal/expected weight for the individual’s height, sex, age and developmental stage (body mass index (BMI) less than 18.5 kg/m2 in adults and BMI-for-age under fifth percentile in children and adolescents) that is not due to another health condition or to the unavailability of food. Low body weight is accompanied by a persistent pattern of behaviors to prevent restoration of normal weight, which may include behaviors aimed at reducing energy intake (restricted eating), purging behaviors (e.g., self-induced vomiting, misuse of laxatives), and behaviors aimed at increasing energy expenditure (e.g., excessive exercise), typically associated with a fear of weight gain. Low body weight or shape is central to the person's self-evaluation or is inaccurately perceived to be normal or even excessive. '''Changes in DSM-5''' * The diagnostic criteria for anorexia nervosa changed slightly from [[DSM-IV]] to [[w:Diagnostic_and_Statistical_Manual_of_Mental_Disorders#DSM-IV-TR_.282000.29|DSM-5]]. Summaries are available [http://www.dsm5.org/Documents/changes%20from%20dsm-iv-tr%20to%20dsm-5.pdf here] and [[w:DSM-5|here]]. {{blockquotebottom}} === Base rates of anorexia nervosa in different populations and clinical settings === This section describes the demographic setting of the population(s) sampled, base rates of diagnosis such as prevalence rates, country/region sampled, and the diagnostic method that was used. Using this information, clinicians will be able to anchor the rate of adolescent depression that they are likely to see in their clinical practice. * '''''To see prevalence rates across multiple disorders,''''' [[Evidence based assessment/Preparation phase#Base rates for transdiagnostic comparison|'''''click here.''''']] {| class="wikitable sortable" |- ! Demography ! Setting (Reference) ! Base Rate ! Diagnostic Method |- |Nationally representative US sample of adults |Non-clinical: Population-based (NCS-R)<ref>Hudson, James I.; Hiripi, Eva; Pope, Harrison G.; Kessler, Ronald C. (2007-02-01). "The prevalence and correlates of eating disorders in the National Comorbidity Survey Replication".''Biological Psychiatry'' '''61''' (3): 348–358. doi:10.1016/j.biopsych.2006.03.040. ISSN 0006-3223. PMC 1892232. <nowiki>PMID 16815322</nowiki></ref> |.9% Female, .3% Male |World Health Organization-Clinical International Diagnostic Interview (WHO-CIDI) |- |Nationally representative US sample of adolescents |Non-clinical: Population-based (NCS-A)<ref>Swanson, Sonja A.; Crow, Scott J.; Le Grange, Daniel; Swendsen, Joel; Merikangas, Kathleen R. (2011-07-01). "Prevalence and correlates of eating disorders in adolescents. Results from the national comorbidity survey replication adolescent supplement". ''Archives of General Psychiatry'' '''68''' (7): 714–723. doi:10.1001/archgenpsychiatry.2011.22. ISSN 1538-3636.<nowiki>PMID 21383252</nowiki></ref> |.3% Female, .3% Male |WHO-CIDI |- |Nationally representative US sample of 9- and 10-year old children |Non-clinical: US Population-based prevalence (Adolescent Brain Cognitive Development (ABCD) study<ref>{{Cite journal|last=Rozzell|first=Kaitlin|last2=Moon|first2=Da Yeoun|last3=Klimek|first3=Patrycja|last4=Brown|first4=Tiffany|last5=Blashill|first5=Aaron J.|date=2019-01-01|title=Prevalence of Eating Disorders Among US Children Aged 9 to 10 Years: Data From the Adolescent Brain Cognitive Development (ABCD) Study|url=http://archpedi.jamanetwork.com/article.aspx?doi=10.1001/jamapediatrics.2018.3678|journal=JAMA Pediatrics|language=en|volume=173|issue=1|pages=100|doi=10.1001/jamapediatrics.2018.3678|issn=2168-6203|pmc=PMC6583451|pmid=30476983}}</ref> |0.1%, no gender differences |DSM-5 using Kiddie Schedule for Affective Disorders and Schizophrenia (KSADS) |- |Latino Households in the US |Non-clinical: Latinos in US<ref>Alegria, Margarita; Woo, Meghan; Cao, Zhun; Torres, Maria; Meng, Xiao-li; Striegel-Moore, Ruth (2007-11-01). "Prevalence and correlates of eating disorders in Latinos in the United States".''The International Journal of Eating Disorders''. 40 Suppl: S15–21. doi:10.1002/eat.20406. ISSN 0276-3478. PMC 2680162. <nowiki>PMID 17584870</nowiki></ref> |.12% Female, .03% Male |WHO-CIDI |- |National probability sample of adult and adolescent African Americans and Caribbean Black people |Non-clinical: African Americans and Caribbean Black people in the US (NSAL)<ref>Taylor, Jacquelyn Y.; Caldwell, Cleopatra Howard; Baser, Raymond E.; Faison, Nakesha; Jackson, James S. (2007-11-01). "Prevalence of eating disorders among Blacks in the National Survey of American Life". ''The International Journal of Eating Disorders''. 40 Suppl: S10–14. doi:10.1002/eat.20451. ISSN 0276-3478. PMC 2882704. <nowiki>PMID 17879287</nowiki></ref> |.14% Female, .2% Male |WHO-CIDI |- |Asian American adults in US households |Non-clinical: National Latino and Asian American Study (NLAAS) |.12% Female, .05% Male |WHO-CIDI |- | US African American college females | Non-clinical; college students<ref>Tyler ID. A true picture of eating disorders among African American women: a review of literature. ABNF J. 2003;14(3):73-4.</ref> || .0% || Eating Disorder Diagnostic Questionnaire (EDD-Q) |- | US Female Adolescents | Non-clinical; Adolescents<ref>Stice, E., Becker, C. B., & Yokum, S. (2013). Eating disorder prevention: Current evidence-base and future directions. ''Int. J. Eat. Disord. International Journal of Eating Disorders,'' ''46''(5), 478-485.</ref> || .8% || Eating Disorder Diagnosis Interview (EDDI) |- | US Division-I Varsity Student Athletes | Non-clinical; student-athletes<ref>Johnson C, Powers PS, Dick R. Athletes and eating disorders: the national collegiate athletic association study. Int J Eat Disord 1999;26:179e88.</ref> || .0% || Eating Disorder Inventory-2 (EDI-2) |- | Active duty females in US Army, Navy, Airforce, and Marines | Non-clinical; Military<ref>McNulty, PAF. (2001). Prevalence and contributing factors of eating disorder behaviors in active duty service women in the Army, Navy, Air Force and Marines. Military Medicine, 166(1), 53-58. </ref> || 1.1% || EDI-2 |- |US Caucasian female same-sex twins |Non-clinical; Commonwealth of Virginia Mid-Atlantic Twin Registry (MATR)<ref>Kendler KS, Walters EE, Neale MC, Kessler R, Heath A, Eaves L. The structure of genetic and environmental risk factors for six major psychiatric disorders in women. Archives of general psychiatry. 1995;52:374–383.</ref> |1.62% (narrow), 3.70% (broad) |Structured Clinical Interview for DSM Disorders (SCID) |- |South Australian older adolescents and adults |Non-clinical; Health Omnibus Survey (HOS) |.46% (3 months; combined) |Eating Disorder Examination (EDE) |- |US Military |Military<ref>{{Cite journal|title=Diagnosed eating disorders in the U.S. Military: a nine year review|url=http://www.ncbi.nlm.nih.gov/pubmed/18821361|journal=Eating Disorders|date=2008-12-01|issn=1532-530X|pmid=18821361|pages=363–377|volume=16|issue=5|doi=10.1080/10640260802370523|first=Amanda J.|last=Antczak|first2=Teresa L.|last2=Brininger}}</ref> |.04% (combined) |ICD codes from electronic records |- |US Military Academy cadets |Non-clinical; Military |.02% (7 years) Female, 0.0% (7 years) Males |[https://www.eat-26.com/ Eating Attitudes Test- 26 items] (EAT-26)<ref>{{Cite web|url=https://www.eat-26.com/|title=EAT-26: Eating Attitudes Test & Eating Disorder Testing – Use the EAT-26 to help you determine if you need to speak to a mental health professional to get help for an eating disorder.|last=admin|language=en|access-date=2022-05-30}}</ref> |- |US Navy female nurses |Non-clinical; Military |1.1% (current & past) Female |DSM-III |- |US veterans |Non-clinical; Military |.04% Female, .005% Males |ICD-9-CM |- |Active duty males in US Navy |Non-clinical; Military |2.5% Males |N/A |- |US alcohol-dependent adults from San Diego, St. Lois, Iowa City, Farmington, New York, & Indianapolis |Clinical; Collaborative Study on the Genetics of Alcoholism (COGA)<ref>{{Cite journal|title=Anorexia nervosa and bulimia nervosa in alcohol-dependent men and women and their relatives|url=http://www.ncbi.nlm.nih.gov/pubmed/8540597|journal=The American Journal of Psychiatry|date=1996-01-01|issn=0002-953X|pmid=8540597|pages=74–82|volume=153|issue=1|doi=10.1176/ajp.153.1.74|first=M. A.|last=Schuckit|first2=J. E.|last2=Tipp|first3=R. M.|last3=Anthenelli|first4=K. K.|last4=Bucholz|first5=V. M.|last5=Hesselbrock|first6=J. I.|last6=Nurnberger}}</ref> |1.41% (lifetime) Female, .00% (lifetime) Male |SSAGA |- |Healthcare provider records |Non-clinical; healthcare members |.0269% (current) | |- |US high school students in west central Oregon |Non-clinical; high school students |. 00% (point), .45% (lifetime) Female .00% (point), .00% (lifetime) Males |DSM-III-R₄ |- |Canadian treatment-seeking substance users |Clinical; substance users |.4% (lifetime), .3% (current) Female .4% (lifetime), .3% (current) Males |DIS₉ |- | | colspan="3" style="font-size:110%; text-align:center;" |'''Europe''' |- |Adolescent females residing in Navarra, Spain |Non-clinical; adolescents |.3% Female |EAT-40₃ |- |Adolescents in secondary schools in Sør-Trøndelag, County in Norway |Non-clinical; adolescents |.7% (lifetime) Female, .2% Male |SEDs₁₀ |- |Adolescents in a comprehensive school in Ostrobothnia district in Finland |Non-clinical; adolescents |.7% (point; age 15), 1.8% (lifetime, age 15), .00% (point, age 18), 2.6% (lifetime, age 18), .9% (3 years) Female .00% (point & lifetime) Males |RAB-T₁₁&nbsp;& RAB-R₁₂ |- | | colspan="3" style="font-size:110%; text-align:center;" |'''Australia''' |- |Adolescent females residing in Victoria, Australia |Non-clinical; adolescents |.00% (full), 1.8% (partial) Female |BET₁₃ |- | | colspan="3" style="font-size:110%; text-align:center;" |'''Central & South America''' |- |Mexican first & second year college females |Non-clinical; college students |.00% Female |EAT-40₃ |- | | colspan="3" style="font-size:110%; text-align:center;" |'''East Asia''' |- |Adolescent and adult Japanese patients at a university hospital |Clinical; eating disorder patients |.53% Female |DSM-III-R₄ |- |Korean adults |Non-clinical; Korean Epidemiologic Catchment Area (KECA) Study |.1% (lifetime), .1% (12 months) Female .2% (lifetime), .00% (12 months) Males |K-CIDI₁₅&nbsp;2.1 |- |Alcohol-dependent adults |Centers participating in the Collaborative Study on the Genetics of Alcoholism in San Diego; St. Louis; Iowa City; Farmington, CN; New York; & Indianapolis |1.41% Females |Semi-Structured Assessment for the Genetics of Alcoholism; criteria based on DSM-III-R |} ==[[Evidence based assessment/Prediction phase|'''Prediction phase''']]== === Psychometric properties of screening instruments for anorexia nervosa === The following section contains a list of screening and diagnostic instruments for anorexia nervosa. The section includes administration information, psychometric data, and PDFs or links to the screenings. * Screenings are used as part of the [[Evidence based assessment/Prediction phase|prediction phase]] of assessment; for more information on interpretation of this data, or how screenings fit in to the assessment process, click [[Evidence based assessment/Prediction phase|here.]] * ''For a list of more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Psychometric_properties_of_common_screening_instruments '''click here.''']'' {| class="wikitable" |- ! Measure !Format (Reporter) !Age Range !Administration/ Completion Time !Where to Access |- |[[wikipedia:Eating_Disorder_Examination_Interview|Eating Disorder Examination Questionnaire (EDE-Q)]]<ref>{{Cite journal|last=Cooper|first=Zafra|last2=Fairburn|first2=Christopher|date=1987-01|title=The eating disorder examination: A semi-structured interview for the assessment of the specific psychopathology of eating disorders|url=http://dx.doi.org/10.1002/1098-108x(198701)6:1<1::aid-eat2260060102>3.0.co;2-9|journal=International Journal of Eating Disorders|volume=6|issue=1|pages=1–8|doi=10.1002/1098-108x(198701)6:1<1::aid-eat2260060102>3.0.co;2-9|issn=0276-3478}}</ref> |Questionnaire (Patient) |14+ |15-20 min | [http://www.corc.uk.net/media/1273/ede-q_quesionnaire.pdf PDF] |- |[[wikipedia:Eating_Disorder_Diagnostic_Scale|EDDS (Eating Disorder Diagnosis Scale)]]<ref>{{Cite journal|last=Stice|first=Eric|last2=Telch|first2=Christy F.|last3=Rizvi|first3=Shireen L.|date=2000|title=Development and validation of the Eating Disorder Diagnostic Scale: A brief self-report measure of anorexia, bulimia, and binge-eating disorder.|url=http://doi.apa.org/getdoi.cfm?doi=10.1037/1040-3590.12.2.123|journal=Psychological Assessment|language=en|volume=12|issue=2|pages=123–131|doi=10.1037/1040-3590.12.2.123|issn=1939-134X}}</ref> |Questionnaire (Patient) |13 - 65 |10-15 min | [http://www.ori.org/files/Static%20Page%20Files/EDDSDSM-5_10_14.pdf PDF] |- |Eating Attitudes Test- 26(EAT-26; Adult version)<ref>{{Cite journal|last=Garner|first=David M.|last2=Garfinkel|first2=Paul E.|date=1979-05|title=The Eating Attitudes Test: an index of the symptoms of anorexia nervosa|url=http://dx.doi.org/10.1017/s0033291700030762|journal=Psychological Medicine|volume=9|issue=2|pages=273–279|doi=10.1017/s0033291700030762|issn=0033-2917}}</ref> Child Eating Attitudes Test - 26 (ChEAT-26; child version)<ref>{{Cite journal|last=Almeida|first=M.C.|last2=Carvalho|first2=D.L.D.B.|last3=Rigolino|first3=R.|date=2012-07|title=Reliability of a Brazilian version of children's eating attitude test|url=http://dx.doi.org/10.1016/j.neurenf.2012.04.196|journal=Neuropsychiatrie de l'Enfance et de l'Adolescence|volume=60|issue=5|pages=S158|doi=10.1016/j.neurenf.2012.04.196|issn=0222-9617}}</ref> |Questionnaire (Patient) |13+ (adult version) 8 -13 (child version) |5-10 min |PDFs * [https://www.eat-26.com/eat-26/ Adult Version PDF] * [http://www.1000livesplus.wales.nhs.uk/sitesplus/documents/1011/ChEAT.pdf Child Version PDF] |} <ref>Hunsley, J., & Mash, E. J. (2008). Guide to Assessments that Work. Cary, NC, USA: Oxford University Press, USA. Retrieved from <nowiki>http://www.ebrary.com</nowiki></ref>'''Note:''' '''L''' = Less than adequate; '''A''' = Adequate; '''G''' = Good; '''E''' = Excellent; '''U''' = Unavailable; '''NA''' = Not applicable ===Likelihood ratios and AUCs of screening instruments for anorexia nervosa=== * ''For a list of the likelihood ratios for more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Likelihood_ratios_and_AUCs_of_common_screening_instruments '''click here.''']'' {| class="wikitable sortable" border="1" |- ! <ref name=":4">{{Cite journal|last=Mintz|first=L. B.|last2=O'Halloran|first2=M. S.|date=June 2000|title=The Eating Attitudes Test: validation with DSM-IV eating disorder criteria|url=https://www.ncbi.nlm.nih.gov/pubmed/10900574|journal=Journal of Personality Assessment|volume=74|issue=3|pages=489–503|doi=10.1207/S15327752JPA7403_11|issn=0022-3891|pmid=10900574}}</ref>Screening Measure (Primary Reference) ! AUC ! DiLR+ (Score) ! DiLR- (Score) !Clinical Generalizability !Where to access |- |Serum leptin level<ref name=":7">{{Cite journal|last=Föcker|first=M.|last2=Timmesfeld|first2=N.|last3=Scherag|first3=S.|last4=Bühren|first4=K.|last5=Langkamp|first5=M.|last6=Dempfle|first6=A.|last7=Sheridan|first7=E. M.|last8=Zwaan|first8=M. de|last9=Fleischhaker|first9=C.|date=2011-04-01|title=Screening for anorexia nervosa via measurement of serum leptin levels|url=https://link.springer.com/article/10.1007/s00702-010-0551-z|journal=Journal of Neural Transmission|language=en|volume=118|issue=4|pages=571–578|doi=10.1007/s00702-010-0551-z|issn=0300-9564}}</ref> |0.984 (N=139) |14.72 (<2.31) |0.10 (2.31+) |Adolescent and adult patients in the acute phase of AN according to the DSM-IV and no AN pretreatment versus healthy lean female volunteer university students. |None |- |Body Mass Index (BMI)<ref name=":7" /> |0.936 (N=139) |5.89 (<17.10) |0.11 (17.10+) |Adolescent and adult patients in the acute phase of AN according to the DSM-IV and no AN pretreatment versus healthy lean female volunteer university students. |None |- |EAT-26&nbsp;<ref name=":4" /><ref>{{Cite journal|title = The eating attitudes test: psychometric features and clinical correlates|url = http://www.ncbi.nlm.nih.gov/pubmed/6961471|journal = Psychological Medicine|date = 1982-11-01|issn = 0033-2917|pmid = 6961471|pages = 871–878|volume = 12|issue = 4|first = D. M.|last = Garner|first2 = M. P.|last2 = Olmsted|first3 = Y.|last3 = Bohr|first4 = P. E.|last4 = Garfinkel}}</ref> |.90 (N=129) |12.83 (20+) |.24 (<20) |Low-moderate: College women with no eating disorder versus college women with a DSM-IV eating disorder. Eating disorders were not separated. |PDFs * [https://www.eat-26.com/eat-26/ Adult Version PDF] * [http://www.1000livesplus.wales.nhs.uk/sitesplus/documents/1011/ChEAT.pdf Child Version PDF] |- |EDE-Q&nbsp;<ref name=":1">{{Cite journal|title = Assessment of eating disorders: interview or self-report questionnaire?|url = http://www.ncbi.nlm.nih.gov/pubmed/7866415|journal = The International Journal of Eating Disorders|date = 1994-12-01|issn = 0276-3478|pmid = 7866415|pages = 363–370|volume = 16|issue = 4|first = C. G.|last = Fairburn|first2 = S. J.|last2 = Beglin}}</ref> |.96 &nbsp;<ref name=":1" />(N=1170) | 6.57 (2.3+)<ref name=":5">{{Cite journal|last=Fairburn|first=C. G.|last2=Beglin|first2=S. J.|date=December 1994|title=Assessment of eating disorders: interview or self-report questionnaire?|url=https://www.ncbi.nlm.nih.gov/pubmed/7866415|journal=The International Journal of Eating Disorders|volume=16|issue=4|pages=363–370|issn=0276-3478|pmid=7866415}}</ref> | 0.09 (<2.3)<ref name=":5" /> |Moderate: Dutch treatment-seeking females meeting DSM-IV criteria for an eating disorder versus female adult general population sample recruited through advertisements and personal contacts. Eating disorders were not separated.&nbsp;<ref name=":1" /> Moderate: “Clinically significant eating disorder” from a community sample versus female adults individuals without “clinically significant eating disorder” from same sample. Eating disorders were not separated.<ref name=":5" /> |[http://www.corc.uk.net/media/1273/ede-q_quesionnaire.pdf PDF] |} === Interpreting anorexia nervosa screening measure scores === * For information on interpreting screening measure scores, click [[Evidence based assessment/Prediction phase#Interpreting screening measure scores|here.]] * Also see the page on [https://en.wikipedia.org/wiki/Likelihood_ratios_in_diagnostic_testing likelihood ratios in diagnostic testing] for more information. ==[[Evidence based assessment/Prescription phase|'''Prescription phase''']]== ===Gold standard diagnostic interviews=== * For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews click here.] ===Recommended diagnostic interviews for anorexia nervosa=== {| class="wikitable sortable" border="1" ! colspan="5" |Diagnostic instruments for anorexia nervosa |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time !Where to access |- |[https://www.credo-oxford.com/7.2.html Eating Disorder Examination (EDE)] <ref>{{Cite book|url=https://www.worldcat.org/oclc/1160972551|title=Assessment of disorders in childhood and adolescence|date=2020|others=Eric Arden Youngstrom, Mitchell J. Prinstein, Eric J. Mash, Russell A. Barkley|isbn=978-1-4625-4365-6|edition=Fifth edition|location=New York|oclc=1160972551}}</ref> <ref>{{Cite book|url=https://www.worldcat.org/oclc/314222270|title=A guide to assessments that work|date=2008|publisher=Oxford University Press|others=John Hunsley, Eric J. Mash|isbn=0-19-804245-0|location=New York|oclc=314222270}}</ref> |Semistructured (child and adult) |8-16 (child version) 16+ (adult version) |45-75 minutes |PDFs * [https://www.phenxtoolkit.org/protocols/view/230101 Child version PDF] * [https://www.credo-oxford.com/7.2.html Adult version PDF] |- |Structured Clinical Interview for DSM-5-Clinician Version (SCID-5-CV)<ref>{{Cite journal|last=Shabani|first=Amir|last2=Masoumian|first2=Samira|last3=Zamirinejad|first3=Somayeh|last4=Hejri|first4=Maryam|last5=Pirmorad|first5=Tahereh|last6=Yaghmaeezadeh|first6=Hooman|date=2021-05|title=Psychometric properties of Structured Clinical Interview for DSM‐5 Disorders‐Clinician Version (SCID‐5‐CV)|url=https://onlinelibrary.wiley.com/doi/10.1002/brb3.1894|journal=Brain and Behavior|language=en|volume=11|issue=5|doi=10.1002/brb3.1894|issn=2162-3279|pmc=PMC8119811|pmid=33729681}}</ref> |Structured Interview (Adult ) |16+ |Varies |[https://www.columbiapsychiatry.org/research/research-labs/diagnostic-and-assessment-lab/structured-clinical-interview-dsm-disorders-11 Website to purchase] |- | [https://dawba.info/a0.html Development and Well-Being Assessment (DAWBA)] <ref>{{Cite book|url=https://www.worldcat.org/oclc/1160972551|title=Assessment of disorders in childhood and adolescence|date=2020|others=Eric Arden Youngstrom, Mitchell J. Prinstein, Eric J. Mash, Russell A. Barkley|isbn=978-1-4625-4365-6|edition=Fifth edition|location=New York|oclc=1160972551}}</ref> | Structured (child/adolescent and parent) | 11-18 |10-20 minutes for the eating disorder module |[https://osf.io/zpbna/?view_only=245bef061d284c17ab9dedad5a59e1b8 English PDF] [https://dawba.info/py/dawbainfo/b1.py Additional languages] |} '''Note:''' '''L''' = Less than adequate; '''A''' = Adequate; '''G''' = Good; '''E''' = Excellent; '''U''' = Unavailable; '''NA''' = Not applicable ==[[Evidence based assessment/Process phase|'''Process phase''']]== The following section contains a brief overview of treatment options for anorexia nervosa and a list of process and outcome measures for anorexia nervosa. The section includes benchmarks based on published norms for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the [[Evidence based assessment/Process phase|process phase]] of assessment. For more information on the differences between process and outcome measures, see the page on the [[Evidence based assessment/Process phase|process phase of assessment]]. ===Process measures=== Body weight is commonly monitored by clinicians throughout the AN treatment process as helping individuals regain and maintain a healthy weight is a primary treatment goal for AN. Many treatment centers have policies prohibiting patients from seeing their weight. Motivational Stages of Change may be used to monitor individuals’ readiness to take action against eating disorder behaviors. It has demonstrated predictive validity in a sample of female adolescents attending eating disorder treatment groups.<ref>{{Cite journal|last=Gusella|first=Joanne|last2=Butler|first2=Gordon|last3=Nichols|first3=Laura|last4=Bird|first4=Debbie|date=2003-01-01|title=A brief questionnaire to assess readiness to change in adolescents with eating disorders: its applications to group therapy|url=http://onlinelibrary.wiley.com/doi/10.1002/erv.481/abstract|journal=European Eating Disorders Review|language=en|volume=11|issue=1|pages=58–71|doi=10.1002/erv.481|issn=1099-0968}}</ref> See Appendix E. === Outcome and severity measures === This table includes clinically significant benchmarks for anorexia nervosa specific outcome measures * Information on how to interpret this table can be [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase found here]. * Additionally, these [[Evidence based assessment/Vignettes|vignettes]] might be helpful resources for understanding appropriate adaptation of outcome measures in practice. *''<u>For clinically significant change benchmarks for the CBCL, YSR, and TRF total, externalizing, internalizing, and attention benchmarks,</u>'' [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase&wteswitched=1#Clinically_significant_change_benchmarks_for_widely-used_outcome_measures see here.] {| class="wikitable sortable" border="1" | colspan="8" |'''Clinically significant change benchmarks with common instruments for anorexia nervosa''' |- | colspan="8" span style="font-size:110%; text-align:center;" | <b> Benchmarks Based on Published Norms</b> |- | rowspan="2" style="text-align:center;font-size:130%;" |<b> Measure</b> | rowspan="2" style="text-align:center;font-size:130%;" | <b> Subscale</b> | colspan="3" style="text-align:center;font-size:130%" width="300" | <b> Cut-off scores</b> | colspan="3" style="text-align:center;font-size:120%" | <b> Critical Change <br> (unstandardized scores)</b> |- | style="text-align:center;font-size:110%" |<b> A</b> | style="text-align:center;font-size:110%" |<b> B</b> | style="text-align:center;font-size:110%" |<b> C</b> | style="text-align:center;font-size:110%" |<b> 95%</b> | style="text-align:center;font-size:110%" |<b> 90%</b> | style="text-align:center;font-size:110%" |<b> SE_difference</b> |- | rowspan="5" style="text-align:center;" |'''EDE-Q <ref name=":2">{{Cite journal|last=Mond|first=J. M.|last2=Hay|first2=P. J.|last3=Rodgers|first3=B.|last4=Owen|first4=C.|last5=Beumont|first5=P. J. V.|date=May 2004|title=Validity of the Eating Disorder Examination Questionnaire (EDE-Q) in screening for eating disorders in community samples|url=https://www.ncbi.nlm.nih.gov/pubmed/15033501|journal=Behaviour Research and Therapy|volume=42|issue=5|pages=551–567|doi=10.1016/S0005-7967(03)00161-X|issn=0005-7967|pmid=15033501}}</ref>''' | style="text-align:right;" |''Global'' |1.4 |3.2 |2.3 |.7 |.6 |.3 |- | style="text-align:right;" |''Restraint'' |(-.3) |3.6 |1.8 |1.5 |1.2 |.8 |- | style="text-align:right;" |''Eating Concern'' |.1 |2.0 |1.2 |1.1 |.9 |.6 |- | style="text-align:right;" |''Weight Concern'' |1.5 |3.9 |2.6 |1.0 |.9 |.5 |- | style="text-align:right;" |''Shape Concern'' |2.1 |4.8 |3.2 |.9 |.7 |.4 |- | rowspan="5" style="text-align:center;" |'''EDE <ref name=":2" />''' | style="text-align:right;" |''Global'' |1.7 |2.3 |1.9 |1.9 |1.6 |1.0 |- | style="text-align:right;" |''Restraint'' |.3 |3.3 |1.9 |1.8 |1.5 |.9 |- | style="text-align:right;" |''Eating Concern'' |(-.5) |.9 |.5 |.8 |.7 |.4 |- | style="text-align:right;" |''Weight Concern'' |2.0 |2.8 |2.4 |1.3 |1.1 |.7 |- | style="text-align:right;" |''Shape Concern'' |2.0 |3.2 |2.6 |1.2 |1.0 |.6 |- | rowspan="1" style="text-align:center;" |'''EAT-26 <ref name=":0">{{Cite journal|last=Mintz|first=L. B.|last2=O'Halloran|first2=M. S.|date=2000-06-01|title=The Eating Attitudes Test: validation with DSM-IV eating disorder criteria|url=http://www.ncbi.nlm.nih.gov/pubmed/10900574|journal=Journal of Personality Assessment|volume=74|issue=3|pages=489–503|doi=10.1207/S15327752JPA7403_11|issn=0022-3891|pmid=10900574}}</ref>''' | style="text-align:right;" |''Total'' |6.5 |19.6 |15.0 |7.9 |6.7 |4.0 |} '''Note:''' “A” = Away from the clinical range, “B” = Back into the nonclinical range, “C” = Closer to the nonclinical than clinical mean. '''Search terms:''' [Anorexia Nervosa OR eating disorder] AND [validity OR clinical significance] in Google Scholar === Treatment === {{collapse top| More information on treatment for AN|expand=yes}} * Treatment of AN typically consists of restoring the individual to a healthy weight and addressing thoughts and behaviors which are related to the eating disorder. It may involve re-nutrition, psychotherapy, nutritional counseling, and medication. * Literature reviews of existing research indicate that evidence supporting AN treatment is lacking. A systematic review of AN treatment efficacy studies by Bulik<ref>{{Cite journal|title = Anorexia nervosa treatment: a systematic review of randomized controlled trials|url = http://www.ncbi.nlm.nih.gov/pubmed/17370290|journal = The International Journal of Eating Disorders|date = 2007-05-01|issn = 0276-3478|pmid = 17370290|pages = 310–320|volume = 40|issue = 4|doi = 10.1002/eat.20367|first = Cynthia M.|last = Bulik|first2 = Nancy D.|last2 = Berkman|first3 = Kimberly A.|last3 = Brownley|first4 = Jan A.|last4 = Sedway|first5 = Kathleen N.|last5 = Lohr}}</ref> found that evidence supporting medications, medications and behavioral interventions, and behavioral interventions alone in adults is weak. * There is moderately strong evidence suggesting that behavioral interventions may be helpful for adolescents. In particular, adolescents may benefit from family therapy. * Clinical trials investigating AN treatment suffer from high rates of attrition, as key features of AN (e.g., denial, fear of weight gain) may contribute to low motivation for remaining in treatment. * More severe cases of AN may be treated in inpatient settings, which are equipped to manage the re-nutrition process and provide medical monitoring. * Partial hospitalization and intensive outpatient programs may provide intermediate levels of treatment intensity to assist individuals in the transition from intensive care to outpatient care after weight restoration. {{collapse bottom}} * Please refer to the page on [https://en.wikipedia.org/wiki/Anorexia_nervosa anorexia nervosa] for more information on available treatment or go to [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/eating-body-image-problems/ the Effective Child Therapy page for Eating & Body Image Problems] for a curated resource on effective treatments for anorexia nervosa. == '''External resources''' == # [http://apps.who.int/classifications/icd10/browse/2010/en#/F50.0 ICD-10 diagnostic criteria] # [https://en.wikiversity.org/w/index.php?title=Helping_Give_Away_Psychological_Science/Resources/Annotated_List_of_Where_and_How_to_Find_a_Therapist&wteswitched=1#Other_low-cost_options Find-a-Therapist] ##This is a curated list of find-a-therapist websites where you can find a provider # NIMH: [https://www.nimh.nih.gov/health/publications/eating-disorders/index.shtml ''Eating Disorders--About More Than Food''] and [https://www.nimh.nih.gov/health/topics/eating-disorders/index.shtml ''Eating Disorders''] ##These NIMH website posts provide more information on anorexia nervosa #[https://www.hopkinsmedicine.org/psychiatry/specialty_areas/eating_disorders/ John's Hopkins Resource] (guide about anorexia nervosa, treatment, and more) # OMIM (Online Mendelian Inheritance in Man) ##[https://www.omim.org/entry/606788?search=anorexia%20nervosa&highlight=nervosa%20anorexia Anorexia nervosa] #[http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/eating-body-image-problems/ Effective Child Therapy page for anorexia nervosa] ##Effective Child Therapy is website sponsored by Division 53 of the American Psychological Association (APA), or The [https://sccap53.org Society of Clinical Child and Adolescent Psychology] (SCCAP), in collaboration with the Association for Behavioral and Cognitive Therapies (ABCT). Use for information on symptoms and available treatments. == '''References''' == {{collapse top|Click here for references}} {{Reflist|30em}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] {{collapse bottom}} 8c47eoiests35fw7dvky5k0ax7rsqde 2419176 2419174 2022-08-26T01:56:46Z Ardenguo 2944162 /* Treatment */ wikitext text/x-wiki <noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{medical disclaimer}} {{:{{BASEPAGENAME}}/Sidebar}} ==[[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio"?''']]== For background information on what assessment portfolios are, click the link in the heading above. Want even 'more' information about this topic? There's an extended version of this page [[Evidence-based assessment/Anorexia nervosa (assessment portfolio)/extended version|here]]. == [[Evidence based assessment/Preparation phase|'''Preparation phase''']] == === Diagnostic criteria for anorexia nervosa === {{blockquotetop}} '''ICD-11 Criteria''' Anorexia Nervosa is characterized by significantly low body weight, which is less than minimal normal/expected weight for the individual’s height, sex, age and developmental stage (body mass index (BMI) less than 18.5 kg/m2 in adults and BMI-for-age under fifth percentile in children and adolescents) that is not due to another health condition or to the unavailability of food. Low body weight is accompanied by a persistent pattern of behaviors to prevent restoration of normal weight, which may include behaviors aimed at reducing energy intake (restricted eating), purging behaviors (e.g., self-induced vomiting, misuse of laxatives), and behaviors aimed at increasing energy expenditure (e.g., excessive exercise), typically associated with a fear of weight gain. Low body weight or shape is central to the person's self-evaluation or is inaccurately perceived to be normal or even excessive. '''Changes in DSM-5''' * The diagnostic criteria for anorexia nervosa changed slightly from [[DSM-IV]] to [[w:Diagnostic_and_Statistical_Manual_of_Mental_Disorders#DSM-IV-TR_.282000.29|DSM-5]]. Summaries are available [http://www.dsm5.org/Documents/changes%20from%20dsm-iv-tr%20to%20dsm-5.pdf here] and [[w:DSM-5|here]]. {{blockquotebottom}} === Base rates of anorexia nervosa in different populations and clinical settings === This section describes the demographic setting of the population(s) sampled, base rates of diagnosis such as prevalence rates, country/region sampled, and the diagnostic method that was used. Using this information, clinicians will be able to anchor the rate of adolescent depression that they are likely to see in their clinical practice. * '''''To see prevalence rates across multiple disorders,''''' [[Evidence based assessment/Preparation phase#Base rates for transdiagnostic comparison|'''''click here.''''']] {| class="wikitable sortable" |- ! Demography ! Setting (Reference) ! Base Rate ! Diagnostic Method |- |Nationally representative US sample of adults |Non-clinical: Population-based (NCS-R)<ref>Hudson, James I.; Hiripi, Eva; Pope, Harrison G.; Kessler, Ronald C. (2007-02-01). "The prevalence and correlates of eating disorders in the National Comorbidity Survey Replication".''Biological Psychiatry'' '''61''' (3): 348–358. doi:10.1016/j.biopsych.2006.03.040. ISSN 0006-3223. PMC 1892232. <nowiki>PMID 16815322</nowiki></ref> |.9% Female, .3% Male |World Health Organization-Clinical International Diagnostic Interview (WHO-CIDI) |- |Nationally representative US sample of adolescents |Non-clinical: Population-based (NCS-A)<ref>Swanson, Sonja A.; Crow, Scott J.; Le Grange, Daniel; Swendsen, Joel; Merikangas, Kathleen R. (2011-07-01). "Prevalence and correlates of eating disorders in adolescents. Results from the national comorbidity survey replication adolescent supplement". ''Archives of General Psychiatry'' '''68''' (7): 714–723. doi:10.1001/archgenpsychiatry.2011.22. ISSN 1538-3636.<nowiki>PMID 21383252</nowiki></ref> |.3% Female, .3% Male |WHO-CIDI |- |Nationally representative US sample of 9- and 10-year old children |Non-clinical: US Population-based prevalence (Adolescent Brain Cognitive Development (ABCD) study<ref>{{Cite journal|last=Rozzell|first=Kaitlin|last2=Moon|first2=Da Yeoun|last3=Klimek|first3=Patrycja|last4=Brown|first4=Tiffany|last5=Blashill|first5=Aaron J.|date=2019-01-01|title=Prevalence of Eating Disorders Among US Children Aged 9 to 10 Years: Data From the Adolescent Brain Cognitive Development (ABCD) Study|url=http://archpedi.jamanetwork.com/article.aspx?doi=10.1001/jamapediatrics.2018.3678|journal=JAMA Pediatrics|language=en|volume=173|issue=1|pages=100|doi=10.1001/jamapediatrics.2018.3678|issn=2168-6203|pmc=PMC6583451|pmid=30476983}}</ref> |0.1%, no gender differences |DSM-5 using Kiddie Schedule for Affective Disorders and Schizophrenia (KSADS) |- |Latino Households in the US |Non-clinical: Latinos in US<ref>Alegria, Margarita; Woo, Meghan; Cao, Zhun; Torres, Maria; Meng, Xiao-li; Striegel-Moore, Ruth (2007-11-01). "Prevalence and correlates of eating disorders in Latinos in the United States".''The International Journal of Eating Disorders''. 40 Suppl: S15–21. doi:10.1002/eat.20406. ISSN 0276-3478. PMC 2680162. <nowiki>PMID 17584870</nowiki></ref> |.12% Female, .03% Male |WHO-CIDI |- |National probability sample of adult and adolescent African Americans and Caribbean Black people |Non-clinical: African Americans and Caribbean Black people in the US (NSAL)<ref>Taylor, Jacquelyn Y.; Caldwell, Cleopatra Howard; Baser, Raymond E.; Faison, Nakesha; Jackson, James S. (2007-11-01). "Prevalence of eating disorders among Blacks in the National Survey of American Life". ''The International Journal of Eating Disorders''. 40 Suppl: S10–14. doi:10.1002/eat.20451. ISSN 0276-3478. PMC 2882704. <nowiki>PMID 17879287</nowiki></ref> |.14% Female, .2% Male |WHO-CIDI |- |Asian American adults in US households |Non-clinical: National Latino and Asian American Study (NLAAS) |.12% Female, .05% Male |WHO-CIDI |- | US African American college females | Non-clinical; college students<ref>Tyler ID. A true picture of eating disorders among African American women: a review of literature. ABNF J. 2003;14(3):73-4.</ref> || .0% || Eating Disorder Diagnostic Questionnaire (EDD-Q) |- | US Female Adolescents | Non-clinical; Adolescents<ref>Stice, E., Becker, C. B., & Yokum, S. (2013). Eating disorder prevention: Current evidence-base and future directions. ''Int. J. Eat. Disord. International Journal of Eating Disorders,'' ''46''(5), 478-485.</ref> || .8% || Eating Disorder Diagnosis Interview (EDDI) |- | US Division-I Varsity Student Athletes | Non-clinical; student-athletes<ref>Johnson C, Powers PS, Dick R. Athletes and eating disorders: the national collegiate athletic association study. Int J Eat Disord 1999;26:179e88.</ref> || .0% || Eating Disorder Inventory-2 (EDI-2) |- | Active duty females in US Army, Navy, Airforce, and Marines | Non-clinical; Military<ref>McNulty, PAF. (2001). Prevalence and contributing factors of eating disorder behaviors in active duty service women in the Army, Navy, Air Force and Marines. Military Medicine, 166(1), 53-58. </ref> || 1.1% || EDI-2 |- |US Caucasian female same-sex twins |Non-clinical; Commonwealth of Virginia Mid-Atlantic Twin Registry (MATR)<ref>Kendler KS, Walters EE, Neale MC, Kessler R, Heath A, Eaves L. The structure of genetic and environmental risk factors for six major psychiatric disorders in women. Archives of general psychiatry. 1995;52:374–383.</ref> |1.62% (narrow), 3.70% (broad) |Structured Clinical Interview for DSM Disorders (SCID) |- |South Australian older adolescents and adults |Non-clinical; Health Omnibus Survey (HOS) |.46% (3 months; combined) |Eating Disorder Examination (EDE) |- |US Military |Military<ref>{{Cite journal|title=Diagnosed eating disorders in the U.S. Military: a nine year review|url=http://www.ncbi.nlm.nih.gov/pubmed/18821361|journal=Eating Disorders|date=2008-12-01|issn=1532-530X|pmid=18821361|pages=363–377|volume=16|issue=5|doi=10.1080/10640260802370523|first=Amanda J.|last=Antczak|first2=Teresa L.|last2=Brininger}}</ref> |.04% (combined) |ICD codes from electronic records |- |US Military Academy cadets |Non-clinical; Military |.02% (7 years) Female, 0.0% (7 years) Males |[https://www.eat-26.com/ Eating Attitudes Test- 26 items] (EAT-26)<ref>{{Cite web|url=https://www.eat-26.com/|title=EAT-26: Eating Attitudes Test & Eating Disorder Testing – Use the EAT-26 to help you determine if you need to speak to a mental health professional to get help for an eating disorder.|last=admin|language=en|access-date=2022-05-30}}</ref> |- |US Navy female nurses |Non-clinical; Military |1.1% (current & past) Female |DSM-III |- |US veterans |Non-clinical; Military |.04% Female, .005% Males |ICD-9-CM |- |Active duty males in US Navy |Non-clinical; Military |2.5% Males |N/A |- |US alcohol-dependent adults from San Diego, St. Lois, Iowa City, Farmington, New York, & Indianapolis |Clinical; Collaborative Study on the Genetics of Alcoholism (COGA)<ref>{{Cite journal|title=Anorexia nervosa and bulimia nervosa in alcohol-dependent men and women and their relatives|url=http://www.ncbi.nlm.nih.gov/pubmed/8540597|journal=The American Journal of Psychiatry|date=1996-01-01|issn=0002-953X|pmid=8540597|pages=74–82|volume=153|issue=1|doi=10.1176/ajp.153.1.74|first=M. A.|last=Schuckit|first2=J. E.|last2=Tipp|first3=R. M.|last3=Anthenelli|first4=K. K.|last4=Bucholz|first5=V. M.|last5=Hesselbrock|first6=J. I.|last6=Nurnberger}}</ref> |1.41% (lifetime) Female, .00% (lifetime) Male |SSAGA |- |Healthcare provider records |Non-clinical; healthcare members |.0269% (current) | |- |US high school students in west central Oregon |Non-clinical; high school students |. 00% (point), .45% (lifetime) Female .00% (point), .00% (lifetime) Males |DSM-III-R₄ |- |Canadian treatment-seeking substance users |Clinical; substance users |.4% (lifetime), .3% (current) Female .4% (lifetime), .3% (current) Males |DIS₉ |- | | colspan="3" style="font-size:110%; text-align:center;" |'''Europe''' |- |Adolescent females residing in Navarra, Spain |Non-clinical; adolescents |.3% Female |EAT-40₃ |- |Adolescents in secondary schools in Sør-Trøndelag, County in Norway |Non-clinical; adolescents |.7% (lifetime) Female, .2% Male |SEDs₁₀ |- |Adolescents in a comprehensive school in Ostrobothnia district in Finland |Non-clinical; adolescents |.7% (point; age 15), 1.8% (lifetime, age 15), .00% (point, age 18), 2.6% (lifetime, age 18), .9% (3 years) Female .00% (point & lifetime) Males |RAB-T₁₁&nbsp;& RAB-R₁₂ |- | | colspan="3" style="font-size:110%; text-align:center;" |'''Australia''' |- |Adolescent females residing in Victoria, Australia |Non-clinical; adolescents |.00% (full), 1.8% (partial) Female |BET₁₃ |- | | colspan="3" style="font-size:110%; text-align:center;" |'''Central & South America''' |- |Mexican first & second year college females |Non-clinical; college students |.00% Female |EAT-40₃ |- | | colspan="3" style="font-size:110%; text-align:center;" |'''East Asia''' |- |Adolescent and adult Japanese patients at a university hospital |Clinical; eating disorder patients |.53% Female |DSM-III-R₄ |- |Korean adults |Non-clinical; Korean Epidemiologic Catchment Area (KECA) Study |.1% (lifetime), .1% (12 months) Female .2% (lifetime), .00% (12 months) Males |K-CIDI₁₅&nbsp;2.1 |- |Alcohol-dependent adults |Centers participating in the Collaborative Study on the Genetics of Alcoholism in San Diego; St. Louis; Iowa City; Farmington, CN; New York; & Indianapolis |1.41% Females |Semi-Structured Assessment for the Genetics of Alcoholism; criteria based on DSM-III-R |} ==[[Evidence based assessment/Prediction phase|'''Prediction phase''']]== === Psychometric properties of screening instruments for anorexia nervosa === The following section contains a list of screening and diagnostic instruments for anorexia nervosa. The section includes administration information, psychometric data, and PDFs or links to the screenings. * Screenings are used as part of the [[Evidence based assessment/Prediction phase|prediction phase]] of assessment; for more information on interpretation of this data, or how screenings fit in to the assessment process, click [[Evidence based assessment/Prediction phase|here.]] * ''For a list of more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Psychometric_properties_of_common_screening_instruments '''click here.''']'' {| class="wikitable" |- ! Measure !Format (Reporter) !Age Range !Administration/ Completion Time !Where to Access |- |[[wikipedia:Eating_Disorder_Examination_Interview|Eating Disorder Examination Questionnaire (EDE-Q)]]<ref>{{Cite journal|last=Cooper|first=Zafra|last2=Fairburn|first2=Christopher|date=1987-01|title=The eating disorder examination: A semi-structured interview for the assessment of the specific psychopathology of eating disorders|url=http://dx.doi.org/10.1002/1098-108x(198701)6:1<1::aid-eat2260060102>3.0.co;2-9|journal=International Journal of Eating Disorders|volume=6|issue=1|pages=1–8|doi=10.1002/1098-108x(198701)6:1<1::aid-eat2260060102>3.0.co;2-9|issn=0276-3478}}</ref> |Questionnaire (Patient) |14+ |15-20 min | [http://www.corc.uk.net/media/1273/ede-q_quesionnaire.pdf PDF] |- |[[wikipedia:Eating_Disorder_Diagnostic_Scale|EDDS (Eating Disorder Diagnosis Scale)]]<ref>{{Cite journal|last=Stice|first=Eric|last2=Telch|first2=Christy F.|last3=Rizvi|first3=Shireen L.|date=2000|title=Development and validation of the Eating Disorder Diagnostic Scale: A brief self-report measure of anorexia, bulimia, and binge-eating disorder.|url=http://doi.apa.org/getdoi.cfm?doi=10.1037/1040-3590.12.2.123|journal=Psychological Assessment|language=en|volume=12|issue=2|pages=123–131|doi=10.1037/1040-3590.12.2.123|issn=1939-134X}}</ref> |Questionnaire (Patient) |13 - 65 |10-15 min | [http://www.ori.org/files/Static%20Page%20Files/EDDSDSM-5_10_14.pdf PDF] |- |Eating Attitudes Test- 26(EAT-26; Adult version)<ref>{{Cite journal|last=Garner|first=David M.|last2=Garfinkel|first2=Paul E.|date=1979-05|title=The Eating Attitudes Test: an index of the symptoms of anorexia nervosa|url=http://dx.doi.org/10.1017/s0033291700030762|journal=Psychological Medicine|volume=9|issue=2|pages=273–279|doi=10.1017/s0033291700030762|issn=0033-2917}}</ref> Child Eating Attitudes Test - 26 (ChEAT-26; child version)<ref>{{Cite journal|last=Almeida|first=M.C.|last2=Carvalho|first2=D.L.D.B.|last3=Rigolino|first3=R.|date=2012-07|title=Reliability of a Brazilian version of children's eating attitude test|url=http://dx.doi.org/10.1016/j.neurenf.2012.04.196|journal=Neuropsychiatrie de l'Enfance et de l'Adolescence|volume=60|issue=5|pages=S158|doi=10.1016/j.neurenf.2012.04.196|issn=0222-9617}}</ref> |Questionnaire (Patient) |13+ (adult version) 8 -13 (child version) |5-10 min |PDFs * [https://www.eat-26.com/eat-26/ Adult Version PDF] * [http://www.1000livesplus.wales.nhs.uk/sitesplus/documents/1011/ChEAT.pdf Child Version PDF] |} <ref>Hunsley, J., & Mash, E. J. (2008). Guide to Assessments that Work. Cary, NC, USA: Oxford University Press, USA. Retrieved from <nowiki>http://www.ebrary.com</nowiki></ref>'''Note:''' '''L''' = Less than adequate; '''A''' = Adequate; '''G''' = Good; '''E''' = Excellent; '''U''' = Unavailable; '''NA''' = Not applicable ===Likelihood ratios and AUCs of screening instruments for anorexia nervosa=== * ''For a list of the likelihood ratios for more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Likelihood_ratios_and_AUCs_of_common_screening_instruments '''click here.''']'' {| class="wikitable sortable" border="1" |- ! <ref name=":4">{{Cite journal|last=Mintz|first=L. B.|last2=O'Halloran|first2=M. S.|date=June 2000|title=The Eating Attitudes Test: validation with DSM-IV eating disorder criteria|url=https://www.ncbi.nlm.nih.gov/pubmed/10900574|journal=Journal of Personality Assessment|volume=74|issue=3|pages=489–503|doi=10.1207/S15327752JPA7403_11|issn=0022-3891|pmid=10900574}}</ref>Screening Measure (Primary Reference) ! AUC ! DiLR+ (Score) ! DiLR- (Score) !Clinical Generalizability !Where to access |- |Serum leptin level<ref name=":7">{{Cite journal|last=Föcker|first=M.|last2=Timmesfeld|first2=N.|last3=Scherag|first3=S.|last4=Bühren|first4=K.|last5=Langkamp|first5=M.|last6=Dempfle|first6=A.|last7=Sheridan|first7=E. M.|last8=Zwaan|first8=M. de|last9=Fleischhaker|first9=C.|date=2011-04-01|title=Screening for anorexia nervosa via measurement of serum leptin levels|url=https://link.springer.com/article/10.1007/s00702-010-0551-z|journal=Journal of Neural Transmission|language=en|volume=118|issue=4|pages=571–578|doi=10.1007/s00702-010-0551-z|issn=0300-9564}}</ref> |0.984 (N=139) |14.72 (<2.31) |0.10 (2.31+) |Adolescent and adult patients in the acute phase of AN according to the DSM-IV and no AN pretreatment versus healthy lean female volunteer university students. |None |- |Body Mass Index (BMI)<ref name=":7" /> |0.936 (N=139) |5.89 (<17.10) |0.11 (17.10+) |Adolescent and adult patients in the acute phase of AN according to the DSM-IV and no AN pretreatment versus healthy lean female volunteer university students. |None |- |EAT-26&nbsp;<ref name=":4" /><ref>{{Cite journal|title = The eating attitudes test: psychometric features and clinical correlates|url = http://www.ncbi.nlm.nih.gov/pubmed/6961471|journal = Psychological Medicine|date = 1982-11-01|issn = 0033-2917|pmid = 6961471|pages = 871–878|volume = 12|issue = 4|first = D. M.|last = Garner|first2 = M. P.|last2 = Olmsted|first3 = Y.|last3 = Bohr|first4 = P. E.|last4 = Garfinkel}}</ref> |.90 (N=129) |12.83 (20+) |.24 (<20) |Low-moderate: College women with no eating disorder versus college women with a DSM-IV eating disorder. Eating disorders were not separated. |PDFs * [https://www.eat-26.com/eat-26/ Adult Version PDF] * [http://www.1000livesplus.wales.nhs.uk/sitesplus/documents/1011/ChEAT.pdf Child Version PDF] |- |EDE-Q&nbsp;<ref name=":1">{{Cite journal|title = Assessment of eating disorders: interview or self-report questionnaire?|url = http://www.ncbi.nlm.nih.gov/pubmed/7866415|journal = The International Journal of Eating Disorders|date = 1994-12-01|issn = 0276-3478|pmid = 7866415|pages = 363–370|volume = 16|issue = 4|first = C. G.|last = Fairburn|first2 = S. J.|last2 = Beglin}}</ref> |.96 &nbsp;<ref name=":1" />(N=1170) | 6.57 (2.3+)<ref name=":5">{{Cite journal|last=Fairburn|first=C. G.|last2=Beglin|first2=S. J.|date=December 1994|title=Assessment of eating disorders: interview or self-report questionnaire?|url=https://www.ncbi.nlm.nih.gov/pubmed/7866415|journal=The International Journal of Eating Disorders|volume=16|issue=4|pages=363–370|issn=0276-3478|pmid=7866415}}</ref> | 0.09 (<2.3)<ref name=":5" /> |Moderate: Dutch treatment-seeking females meeting DSM-IV criteria for an eating disorder versus female adult general population sample recruited through advertisements and personal contacts. Eating disorders were not separated.&nbsp;<ref name=":1" /> Moderate: “Clinically significant eating disorder” from a community sample versus female adults individuals without “clinically significant eating disorder” from same sample. Eating disorders were not separated.<ref name=":5" /> |[http://www.corc.uk.net/media/1273/ede-q_quesionnaire.pdf PDF] |} === Interpreting anorexia nervosa screening measure scores === * For information on interpreting screening measure scores, click [[Evidence based assessment/Prediction phase#Interpreting screening measure scores|here.]] * Also see the page on [https://en.wikipedia.org/wiki/Likelihood_ratios_in_diagnostic_testing likelihood ratios in diagnostic testing] for more information. ==[[Evidence based assessment/Prescription phase|'''Prescription phase''']]== ===Gold standard diagnostic interviews=== * For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews click here.] ===Recommended diagnostic interviews for anorexia nervosa=== {| class="wikitable sortable" border="1" ! colspan="5" |Diagnostic instruments for anorexia nervosa |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time !Where to access |- |[https://www.credo-oxford.com/7.2.html Eating Disorder Examination (EDE)] <ref>{{Cite book|url=https://www.worldcat.org/oclc/1160972551|title=Assessment of disorders in childhood and adolescence|date=2020|others=Eric Arden Youngstrom, Mitchell J. Prinstein, Eric J. Mash, Russell A. Barkley|isbn=978-1-4625-4365-6|edition=Fifth edition|location=New York|oclc=1160972551}}</ref> <ref>{{Cite book|url=https://www.worldcat.org/oclc/314222270|title=A guide to assessments that work|date=2008|publisher=Oxford University Press|others=John Hunsley, Eric J. Mash|isbn=0-19-804245-0|location=New York|oclc=314222270}}</ref> |Semistructured (child and adult) |8-16 (child version) 16+ (adult version) |45-75 minutes |PDFs * [https://www.phenxtoolkit.org/protocols/view/230101 Child version PDF] * [https://www.credo-oxford.com/7.2.html Adult version PDF] |- |Structured Clinical Interview for DSM-5-Clinician Version (SCID-5-CV)<ref>{{Cite journal|last=Shabani|first=Amir|last2=Masoumian|first2=Samira|last3=Zamirinejad|first3=Somayeh|last4=Hejri|first4=Maryam|last5=Pirmorad|first5=Tahereh|last6=Yaghmaeezadeh|first6=Hooman|date=2021-05|title=Psychometric properties of Structured Clinical Interview for DSM‐5 Disorders‐Clinician Version (SCID‐5‐CV)|url=https://onlinelibrary.wiley.com/doi/10.1002/brb3.1894|journal=Brain and Behavior|language=en|volume=11|issue=5|doi=10.1002/brb3.1894|issn=2162-3279|pmc=PMC8119811|pmid=33729681}}</ref> |Structured Interview (Adult ) |16+ |Varies |[https://www.columbiapsychiatry.org/research/research-labs/diagnostic-and-assessment-lab/structured-clinical-interview-dsm-disorders-11 Website to purchase] |- | [https://dawba.info/a0.html Development and Well-Being Assessment (DAWBA)] <ref>{{Cite book|url=https://www.worldcat.org/oclc/1160972551|title=Assessment of disorders in childhood and adolescence|date=2020|others=Eric Arden Youngstrom, Mitchell J. Prinstein, Eric J. Mash, Russell A. Barkley|isbn=978-1-4625-4365-6|edition=Fifth edition|location=New York|oclc=1160972551}}</ref> | Structured (child/adolescent and parent) | 11-18 |10-20 minutes for the eating disorder module |[https://osf.io/zpbna/?view_only=245bef061d284c17ab9dedad5a59e1b8 English PDF] [https://dawba.info/py/dawbainfo/b1.py Additional languages] |} '''Note:''' '''L''' = Less than adequate; '''A''' = Adequate; '''G''' = Good; '''E''' = Excellent; '''U''' = Unavailable; '''NA''' = Not applicable ==[[Evidence based assessment/Process phase|'''Process phase''']]== The following section contains a brief overview of treatment options for anorexia nervosa and a list of process and outcome measures for anorexia nervosa. The section includes benchmarks based on published norms for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the [[Evidence based assessment/Process phase|process phase]] of assessment. For more information on the differences between process and outcome measures, see the page on the [[Evidence based assessment/Process phase|process phase of assessment]]. ===Process measures=== Body weight is commonly monitored by clinicians throughout the AN treatment process as helping individuals regain and maintain a healthy weight is a primary treatment goal for AN. Many treatment centers have policies prohibiting patients from seeing their weight. Motivational Stages of Change may be used to monitor individuals’ readiness to take action against eating disorder behaviors. It has demonstrated predictive validity in a sample of female adolescents attending eating disorder treatment groups.<ref>{{Cite journal|last=Gusella|first=Joanne|last2=Butler|first2=Gordon|last3=Nichols|first3=Laura|last4=Bird|first4=Debbie|date=2003-01-01|title=A brief questionnaire to assess readiness to change in adolescents with eating disorders: its applications to group therapy|url=http://onlinelibrary.wiley.com/doi/10.1002/erv.481/abstract|journal=European Eating Disorders Review|language=en|volume=11|issue=1|pages=58–71|doi=10.1002/erv.481|issn=1099-0968}}</ref> See Appendix E. === Outcome and severity measures === This table includes clinically significant benchmarks for anorexia nervosa specific outcome measures * Information on how to interpret this table can be [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase found here]. * Additionally, these [[Evidence based assessment/Vignettes|vignettes]] might be helpful resources for understanding appropriate adaptation of outcome measures in practice. *''<u>For clinically significant change benchmarks for the CBCL, YSR, and TRF total, externalizing, internalizing, and attention benchmarks,</u>'' [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase&wteswitched=1#Clinically_significant_change_benchmarks_for_widely-used_outcome_measures see here.] {| class="wikitable sortable" border="1" | colspan="8" |'''Clinically significant change benchmarks with common instruments for anorexia nervosa''' |- | colspan="8" span style="font-size:110%; text-align:center;" | <b> Benchmarks Based on Published Norms</b> |- | rowspan="2" style="text-align:center;font-size:130%;" |<b> Measure</b> | rowspan="2" style="text-align:center;font-size:130%;" | <b> Subscale</b> | colspan="3" style="text-align:center;font-size:130%" width="300" | <b> Cut-off scores</b> | colspan="3" style="text-align:center;font-size:120%" | <b> Critical Change <br> (unstandardized scores)</b> |- | style="text-align:center;font-size:110%" |<b> A</b> | style="text-align:center;font-size:110%" |<b> B</b> | style="text-align:center;font-size:110%" |<b> C</b> | style="text-align:center;font-size:110%" |<b> 95%</b> | style="text-align:center;font-size:110%" |<b> 90%</b> | style="text-align:center;font-size:110%" |<b> SE_difference</b> |- | rowspan="5" style="text-align:center;" |'''EDE-Q <ref name=":2">{{Cite journal|last=Mond|first=J. M.|last2=Hay|first2=P. J.|last3=Rodgers|first3=B.|last4=Owen|first4=C.|last5=Beumont|first5=P. J. V.|date=May 2004|title=Validity of the Eating Disorder Examination Questionnaire (EDE-Q) in screening for eating disorders in community samples|url=https://www.ncbi.nlm.nih.gov/pubmed/15033501|journal=Behaviour Research and Therapy|volume=42|issue=5|pages=551–567|doi=10.1016/S0005-7967(03)00161-X|issn=0005-7967|pmid=15033501}}</ref>''' | style="text-align:right;" |''Global'' |1.4 |3.2 |2.3 |.7 |.6 |.3 |- | style="text-align:right;" |''Restraint'' |(-.3) |3.6 |1.8 |1.5 |1.2 |.8 |- | style="text-align:right;" |''Eating Concern'' |.1 |2.0 |1.2 |1.1 |.9 |.6 |- | style="text-align:right;" |''Weight Concern'' |1.5 |3.9 |2.6 |1.0 |.9 |.5 |- | style="text-align:right;" |''Shape Concern'' |2.1 |4.8 |3.2 |.9 |.7 |.4 |- | rowspan="5" style="text-align:center;" |'''EDE <ref name=":2" />''' | style="text-align:right;" |''Global'' |1.7 |2.3 |1.9 |1.9 |1.6 |1.0 |- | style="text-align:right;" |''Restraint'' |.3 |3.3 |1.9 |1.8 |1.5 |.9 |- | style="text-align:right;" |''Eating Concern'' |(-.5) |.9 |.5 |.8 |.7 |.4 |- | style="text-align:right;" |''Weight Concern'' |2.0 |2.8 |2.4 |1.3 |1.1 |.7 |- | style="text-align:right;" |''Shape Concern'' |2.0 |3.2 |2.6 |1.2 |1.0 |.6 |- | rowspan="1" style="text-align:center;" |'''EAT-26 <ref name=":0">{{Cite journal|last=Mintz|first=L. B.|last2=O'Halloran|first2=M. S.|date=2000-06-01|title=The Eating Attitudes Test: validation with DSM-IV eating disorder criteria|url=http://www.ncbi.nlm.nih.gov/pubmed/10900574|journal=Journal of Personality Assessment|volume=74|issue=3|pages=489–503|doi=10.1207/S15327752JPA7403_11|issn=0022-3891|pmid=10900574}}</ref>''' | style="text-align:right;" |''Total'' |6.5 |19.6 |15.0 |7.9 |6.7 |4.0 |} '''Note:''' “A” = Away from the clinical range, “B” = Back into the nonclinical range, “C” = Closer to the nonclinical than clinical mean. '''Search terms:''' [Anorexia Nervosa OR eating disorder] AND [validity OR clinical significance] in Google Scholar === Treatment === {{collapse top| More information on treatment for AN|expand=yes}} * Treatment of AN typically consists of restoring the individual to a healthy weight and addressing thoughts and behaviors which are related to the eating disorder. It may involve re-nutrition, psychotherapy, nutritional counseling, and medication. * Literature reviews of existing research indicate that evidence supporting AN treatment is lacking. A systematic review of AN treatment efficacy studies by Bulik<ref>{{Cite journal|title = Anorexia nervosa treatment: a systematic review of randomized controlled trials|url = http://www.ncbi.nlm.nih.gov/pubmed/17370290|journal = The International Journal of Eating Disorders|date = 2007-05-01|issn = 0276-3478|pmid = 17370290|pages = 310–320|volume = 40|issue = 4|doi = 10.1002/eat.20367|first = Cynthia M.|last = Bulik|first2 = Nancy D.|last2 = Berkman|first3 = Kimberly A.|last3 = Brownley|first4 = Jan A.|last4 = Sedway|first5 = Kathleen N.|last5 = Lohr}}</ref> found that evidence supporting medications, medications and behavioral interventions, and behavioral interventions alone in adults is weak. * There is moderately strong evidence suggesting that behavioral interventions may be helpful for adolescents. In particular, adolescents may benefit from family therapy. * Clinical trials investigating AN treatment suffer from high rates of attrition, as key features of AN (e.g., denial, fear of weight gain) may contribute to low motivation for remaining in treatment. * More severe cases of AN may be treated in inpatient settings, which are equipped to manage the re-nutrition process and provide medical monitoring. * Partial hospitalization and intensive outpatient programs may provide intermediate levels of treatment intensity to assist individuals in the transition from intensive care to outpatient care after weight restoration. {{collapse bottom}} * Please refer to the page on [https://en.wikipedia.org/wiki/Anorexia_nervosa anorexia nervosa] for more information on available treatment or go to [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/eating-body-image-problems/ the Effective Child Therapy page for Eating & Body Image Problems] for a curated resource on effective treatments for anorexia nervosa. == '''External resources''' == # [http://apps.who.int/classifications/icd10/browse/2010/en#/F50.0 ICD-10 diagnostic criteria] # [https://en.wikiversity.org/w/index.php?title=Helping_Give_Away_Psychological_Science/Resources/Annotated_List_of_Where_and_How_to_Find_a_Therapist&wteswitched=1#Other_low-cost_options Find-a-Therapist] ##This is a curated list of find-a-therapist websites where you can find a provider # NIMH: [https://www.nimh.nih.gov/health/publications/eating-disorders/index.shtml ''Eating Disorders--About More Than Food''] and [https://www.nimh.nih.gov/health/topics/eating-disorders/index.shtml ''Eating Disorders''] ##These NIMH website posts provide more information on anorexia nervosa #[https://www.hopkinsmedicine.org/psychiatry/specialty_areas/eating_disorders/ John's Hopkins Resource] (guide about anorexia nervosa, treatment, and more) # OMIM (Online Mendelian Inheritance in Man) ##[https://www.omim.org/entry/606788?search=anorexia%20nervosa&highlight=nervosa%20anorexia Anorexia nervosa] #[http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/eating-body-image-problems/ Effective Child Therapy page for anorexia nervosa] ##Effective Child Therapy is website sponsored by Division 53 of the American Psychological Association (APA), or The [https://sccap53.org Society of Clinical Child and Adolescent Psychology] (SCCAP), in collaboration with the Association for Behavioral and Cognitive Therapies (ABCT). Use for information on symptoms and available treatments. == '''References''' == {{collapse top|Click here for references}} {{Reflist|30em}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] {{collapse bottom}} h2fbecyjdzhq13lhu46eabsbns03v02 2419178 2419176 2022-08-26T01:57:51Z Ardenguo 2944162 /* References */ Made references box expanded by default wikitext text/x-wiki <noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{medical disclaimer}} {{:{{BASEPAGENAME}}/Sidebar}} ==[[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio"?''']]== For background information on what assessment portfolios are, click the link in the heading above. Want even 'more' information about this topic? There's an extended version of this page [[Evidence-based assessment/Anorexia nervosa (assessment portfolio)/extended version|here]]. == [[Evidence based assessment/Preparation phase|'''Preparation phase''']] == === Diagnostic criteria for anorexia nervosa === {{blockquotetop}} '''ICD-11 Criteria''' Anorexia Nervosa is characterized by significantly low body weight, which is less than minimal normal/expected weight for the individual’s height, sex, age and developmental stage (body mass index (BMI) less than 18.5 kg/m2 in adults and BMI-for-age under fifth percentile in children and adolescents) that is not due to another health condition or to the unavailability of food. Low body weight is accompanied by a persistent pattern of behaviors to prevent restoration of normal weight, which may include behaviors aimed at reducing energy intake (restricted eating), purging behaviors (e.g., self-induced vomiting, misuse of laxatives), and behaviors aimed at increasing energy expenditure (e.g., excessive exercise), typically associated with a fear of weight gain. Low body weight or shape is central to the person's self-evaluation or is inaccurately perceived to be normal or even excessive. '''Changes in DSM-5''' * The diagnostic criteria for anorexia nervosa changed slightly from [[DSM-IV]] to [[w:Diagnostic_and_Statistical_Manual_of_Mental_Disorders#DSM-IV-TR_.282000.29|DSM-5]]. Summaries are available [http://www.dsm5.org/Documents/changes%20from%20dsm-iv-tr%20to%20dsm-5.pdf here] and [[w:DSM-5|here]]. {{blockquotebottom}} === Base rates of anorexia nervosa in different populations and clinical settings === This section describes the demographic setting of the population(s) sampled, base rates of diagnosis such as prevalence rates, country/region sampled, and the diagnostic method that was used. Using this information, clinicians will be able to anchor the rate of adolescent depression that they are likely to see in their clinical practice. * '''''To see prevalence rates across multiple disorders,''''' [[Evidence based assessment/Preparation phase#Base rates for transdiagnostic comparison|'''''click here.''''']] {| class="wikitable sortable" |- ! Demography ! Setting (Reference) ! Base Rate ! Diagnostic Method |- |Nationally representative US sample of adults |Non-clinical: Population-based (NCS-R)<ref>Hudson, James I.; Hiripi, Eva; Pope, Harrison G.; Kessler, Ronald C. (2007-02-01). "The prevalence and correlates of eating disorders in the National Comorbidity Survey Replication".''Biological Psychiatry'' '''61''' (3): 348–358. doi:10.1016/j.biopsych.2006.03.040. ISSN 0006-3223. PMC 1892232. <nowiki>PMID 16815322</nowiki></ref> |.9% Female, .3% Male |World Health Organization-Clinical International Diagnostic Interview (WHO-CIDI) |- |Nationally representative US sample of adolescents |Non-clinical: Population-based (NCS-A)<ref>Swanson, Sonja A.; Crow, Scott J.; Le Grange, Daniel; Swendsen, Joel; Merikangas, Kathleen R. (2011-07-01). "Prevalence and correlates of eating disorders in adolescents. Results from the national comorbidity survey replication adolescent supplement". ''Archives of General Psychiatry'' '''68''' (7): 714–723. doi:10.1001/archgenpsychiatry.2011.22. ISSN 1538-3636.<nowiki>PMID 21383252</nowiki></ref> |.3% Female, .3% Male |WHO-CIDI |- |Nationally representative US sample of 9- and 10-year old children |Non-clinical: US Population-based prevalence (Adolescent Brain Cognitive Development (ABCD) study<ref>{{Cite journal|last=Rozzell|first=Kaitlin|last2=Moon|first2=Da Yeoun|last3=Klimek|first3=Patrycja|last4=Brown|first4=Tiffany|last5=Blashill|first5=Aaron J.|date=2019-01-01|title=Prevalence of Eating Disorders Among US Children Aged 9 to 10 Years: Data From the Adolescent Brain Cognitive Development (ABCD) Study|url=http://archpedi.jamanetwork.com/article.aspx?doi=10.1001/jamapediatrics.2018.3678|journal=JAMA Pediatrics|language=en|volume=173|issue=1|pages=100|doi=10.1001/jamapediatrics.2018.3678|issn=2168-6203|pmc=PMC6583451|pmid=30476983}}</ref> |0.1%, no gender differences |DSM-5 using Kiddie Schedule for Affective Disorders and Schizophrenia (KSADS) |- |Latino Households in the US |Non-clinical: Latinos in US<ref>Alegria, Margarita; Woo, Meghan; Cao, Zhun; Torres, Maria; Meng, Xiao-li; Striegel-Moore, Ruth (2007-11-01). "Prevalence and correlates of eating disorders in Latinos in the United States".''The International Journal of Eating Disorders''. 40 Suppl: S15–21. doi:10.1002/eat.20406. ISSN 0276-3478. PMC 2680162. <nowiki>PMID 17584870</nowiki></ref> |.12% Female, .03% Male |WHO-CIDI |- |National probability sample of adult and adolescent African Americans and Caribbean Black people |Non-clinical: African Americans and Caribbean Black people in the US (NSAL)<ref>Taylor, Jacquelyn Y.; Caldwell, Cleopatra Howard; Baser, Raymond E.; Faison, Nakesha; Jackson, James S. (2007-11-01). "Prevalence of eating disorders among Blacks in the National Survey of American Life". ''The International Journal of Eating Disorders''. 40 Suppl: S10–14. doi:10.1002/eat.20451. ISSN 0276-3478. PMC 2882704. <nowiki>PMID 17879287</nowiki></ref> |.14% Female, .2% Male |WHO-CIDI |- |Asian American adults in US households |Non-clinical: National Latino and Asian American Study (NLAAS) |.12% Female, .05% Male |WHO-CIDI |- | US African American college females | Non-clinical; college students<ref>Tyler ID. A true picture of eating disorders among African American women: a review of literature. ABNF J. 2003;14(3):73-4.</ref> || .0% || Eating Disorder Diagnostic Questionnaire (EDD-Q) |- | US Female Adolescents | Non-clinical; Adolescents<ref>Stice, E., Becker, C. B., & Yokum, S. (2013). Eating disorder prevention: Current evidence-base and future directions. ''Int. J. Eat. Disord. International Journal of Eating Disorders,'' ''46''(5), 478-485.</ref> || .8% || Eating Disorder Diagnosis Interview (EDDI) |- | US Division-I Varsity Student Athletes | Non-clinical; student-athletes<ref>Johnson C, Powers PS, Dick R. Athletes and eating disorders: the national collegiate athletic association study. Int J Eat Disord 1999;26:179e88.</ref> || .0% || Eating Disorder Inventory-2 (EDI-2) |- | Active duty females in US Army, Navy, Airforce, and Marines | Non-clinical; Military<ref>McNulty, PAF. (2001). Prevalence and contributing factors of eating disorder behaviors in active duty service women in the Army, Navy, Air Force and Marines. Military Medicine, 166(1), 53-58. </ref> || 1.1% || EDI-2 |- |US Caucasian female same-sex twins |Non-clinical; Commonwealth of Virginia Mid-Atlantic Twin Registry (MATR)<ref>Kendler KS, Walters EE, Neale MC, Kessler R, Heath A, Eaves L. The structure of genetic and environmental risk factors for six major psychiatric disorders in women. Archives of general psychiatry. 1995;52:374–383.</ref> |1.62% (narrow), 3.70% (broad) |Structured Clinical Interview for DSM Disorders (SCID) |- |South Australian older adolescents and adults |Non-clinical; Health Omnibus Survey (HOS) |.46% (3 months; combined) |Eating Disorder Examination (EDE) |- |US Military |Military<ref>{{Cite journal|title=Diagnosed eating disorders in the U.S. Military: a nine year review|url=http://www.ncbi.nlm.nih.gov/pubmed/18821361|journal=Eating Disorders|date=2008-12-01|issn=1532-530X|pmid=18821361|pages=363–377|volume=16|issue=5|doi=10.1080/10640260802370523|first=Amanda J.|last=Antczak|first2=Teresa L.|last2=Brininger}}</ref> |.04% (combined) |ICD codes from electronic records |- |US Military Academy cadets |Non-clinical; Military |.02% (7 years) Female, 0.0% (7 years) Males |[https://www.eat-26.com/ Eating Attitudes Test- 26 items] (EAT-26)<ref>{{Cite web|url=https://www.eat-26.com/|title=EAT-26: Eating Attitudes Test & Eating Disorder Testing – Use the EAT-26 to help you determine if you need to speak to a mental health professional to get help for an eating disorder.|last=admin|language=en|access-date=2022-05-30}}</ref> |- |US Navy female nurses |Non-clinical; Military |1.1% (current & past) Female |DSM-III |- |US veterans |Non-clinical; Military |.04% Female, .005% Males |ICD-9-CM |- |Active duty males in US Navy |Non-clinical; Military |2.5% Males |N/A |- |US alcohol-dependent adults from San Diego, St. Lois, Iowa City, Farmington, New York, & Indianapolis |Clinical; Collaborative Study on the Genetics of Alcoholism (COGA)<ref>{{Cite journal|title=Anorexia nervosa and bulimia nervosa in alcohol-dependent men and women and their relatives|url=http://www.ncbi.nlm.nih.gov/pubmed/8540597|journal=The American Journal of Psychiatry|date=1996-01-01|issn=0002-953X|pmid=8540597|pages=74–82|volume=153|issue=1|doi=10.1176/ajp.153.1.74|first=M. A.|last=Schuckit|first2=J. E.|last2=Tipp|first3=R. M.|last3=Anthenelli|first4=K. K.|last4=Bucholz|first5=V. M.|last5=Hesselbrock|first6=J. I.|last6=Nurnberger}}</ref> |1.41% (lifetime) Female, .00% (lifetime) Male |SSAGA |- |Healthcare provider records |Non-clinical; healthcare members |.0269% (current) | |- |US high school students in west central Oregon |Non-clinical; high school students |. 00% (point), .45% (lifetime) Female .00% (point), .00% (lifetime) Males |DSM-III-R₄ |- |Canadian treatment-seeking substance users |Clinical; substance users |.4% (lifetime), .3% (current) Female .4% (lifetime), .3% (current) Males |DIS₉ |- | | colspan="3" style="font-size:110%; text-align:center;" |'''Europe''' |- |Adolescent females residing in Navarra, Spain |Non-clinical; adolescents |.3% Female |EAT-40₃ |- |Adolescents in secondary schools in Sør-Trøndelag, County in Norway |Non-clinical; adolescents |.7% (lifetime) Female, .2% Male |SEDs₁₀ |- |Adolescents in a comprehensive school in Ostrobothnia district in Finland |Non-clinical; adolescents |.7% (point; age 15), 1.8% (lifetime, age 15), .00% (point, age 18), 2.6% (lifetime, age 18), .9% (3 years) Female .00% (point & lifetime) Males |RAB-T₁₁&nbsp;& RAB-R₁₂ |- | | colspan="3" style="font-size:110%; text-align:center;" |'''Australia''' |- |Adolescent females residing in Victoria, Australia |Non-clinical; adolescents |.00% (full), 1.8% (partial) Female |BET₁₃ |- | | colspan="3" style="font-size:110%; text-align:center;" |'''Central & South America''' |- |Mexican first & second year college females |Non-clinical; college students |.00% Female |EAT-40₃ |- | | colspan="3" style="font-size:110%; text-align:center;" |'''East Asia''' |- |Adolescent and adult Japanese patients at a university hospital |Clinical; eating disorder patients |.53% Female |DSM-III-R₄ |- |Korean adults |Non-clinical; Korean Epidemiologic Catchment Area (KECA) Study |.1% (lifetime), .1% (12 months) Female .2% (lifetime), .00% (12 months) Males |K-CIDI₁₅&nbsp;2.1 |- |Alcohol-dependent adults |Centers participating in the Collaborative Study on the Genetics of Alcoholism in San Diego; St. Louis; Iowa City; Farmington, CN; New York; & Indianapolis |1.41% Females |Semi-Structured Assessment for the Genetics of Alcoholism; criteria based on DSM-III-R |} ==[[Evidence based assessment/Prediction phase|'''Prediction phase''']]== === Psychometric properties of screening instruments for anorexia nervosa === The following section contains a list of screening and diagnostic instruments for anorexia nervosa. The section includes administration information, psychometric data, and PDFs or links to the screenings. * Screenings are used as part of the [[Evidence based assessment/Prediction phase|prediction phase]] of assessment; for more information on interpretation of this data, or how screenings fit in to the assessment process, click [[Evidence based assessment/Prediction phase|here.]] * ''For a list of more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Psychometric_properties_of_common_screening_instruments '''click here.''']'' {| class="wikitable" |- ! Measure !Format (Reporter) !Age Range !Administration/ Completion Time !Where to Access |- |[[wikipedia:Eating_Disorder_Examination_Interview|Eating Disorder Examination Questionnaire (EDE-Q)]]<ref>{{Cite journal|last=Cooper|first=Zafra|last2=Fairburn|first2=Christopher|date=1987-01|title=The eating disorder examination: A semi-structured interview for the assessment of the specific psychopathology of eating disorders|url=http://dx.doi.org/10.1002/1098-108x(198701)6:1<1::aid-eat2260060102>3.0.co;2-9|journal=International Journal of Eating Disorders|volume=6|issue=1|pages=1–8|doi=10.1002/1098-108x(198701)6:1<1::aid-eat2260060102>3.0.co;2-9|issn=0276-3478}}</ref> |Questionnaire (Patient) |14+ |15-20 min | [http://www.corc.uk.net/media/1273/ede-q_quesionnaire.pdf PDF] |- |[[wikipedia:Eating_Disorder_Diagnostic_Scale|EDDS (Eating Disorder Diagnosis Scale)]]<ref>{{Cite journal|last=Stice|first=Eric|last2=Telch|first2=Christy F.|last3=Rizvi|first3=Shireen L.|date=2000|title=Development and validation of the Eating Disorder Diagnostic Scale: A brief self-report measure of anorexia, bulimia, and binge-eating disorder.|url=http://doi.apa.org/getdoi.cfm?doi=10.1037/1040-3590.12.2.123|journal=Psychological Assessment|language=en|volume=12|issue=2|pages=123–131|doi=10.1037/1040-3590.12.2.123|issn=1939-134X}}</ref> |Questionnaire (Patient) |13 - 65 |10-15 min | [http://www.ori.org/files/Static%20Page%20Files/EDDSDSM-5_10_14.pdf PDF] |- |Eating Attitudes Test- 26(EAT-26; Adult version)<ref>{{Cite journal|last=Garner|first=David M.|last2=Garfinkel|first2=Paul E.|date=1979-05|title=The Eating Attitudes Test: an index of the symptoms of anorexia nervosa|url=http://dx.doi.org/10.1017/s0033291700030762|journal=Psychological Medicine|volume=9|issue=2|pages=273–279|doi=10.1017/s0033291700030762|issn=0033-2917}}</ref> Child Eating Attitudes Test - 26 (ChEAT-26; child version)<ref>{{Cite journal|last=Almeida|first=M.C.|last2=Carvalho|first2=D.L.D.B.|last3=Rigolino|first3=R.|date=2012-07|title=Reliability of a Brazilian version of children's eating attitude test|url=http://dx.doi.org/10.1016/j.neurenf.2012.04.196|journal=Neuropsychiatrie de l'Enfance et de l'Adolescence|volume=60|issue=5|pages=S158|doi=10.1016/j.neurenf.2012.04.196|issn=0222-9617}}</ref> |Questionnaire (Patient) |13+ (adult version) 8 -13 (child version) |5-10 min |PDFs * [https://www.eat-26.com/eat-26/ Adult Version PDF] * [http://www.1000livesplus.wales.nhs.uk/sitesplus/documents/1011/ChEAT.pdf Child Version PDF] |} <ref>Hunsley, J., & Mash, E. J. (2008). Guide to Assessments that Work. Cary, NC, USA: Oxford University Press, USA. Retrieved from <nowiki>http://www.ebrary.com</nowiki></ref>'''Note:''' '''L''' = Less than adequate; '''A''' = Adequate; '''G''' = Good; '''E''' = Excellent; '''U''' = Unavailable; '''NA''' = Not applicable ===Likelihood ratios and AUCs of screening instruments for anorexia nervosa=== * ''For a list of the likelihood ratios for more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Likelihood_ratios_and_AUCs_of_common_screening_instruments '''click here.''']'' {| class="wikitable sortable" border="1" |- ! <ref name=":4">{{Cite journal|last=Mintz|first=L. B.|last2=O'Halloran|first2=M. S.|date=June 2000|title=The Eating Attitudes Test: validation with DSM-IV eating disorder criteria|url=https://www.ncbi.nlm.nih.gov/pubmed/10900574|journal=Journal of Personality Assessment|volume=74|issue=3|pages=489–503|doi=10.1207/S15327752JPA7403_11|issn=0022-3891|pmid=10900574}}</ref>Screening Measure (Primary Reference) ! AUC ! DiLR+ (Score) ! DiLR- (Score) !Clinical Generalizability !Where to access |- |Serum leptin level<ref name=":7">{{Cite journal|last=Föcker|first=M.|last2=Timmesfeld|first2=N.|last3=Scherag|first3=S.|last4=Bühren|first4=K.|last5=Langkamp|first5=M.|last6=Dempfle|first6=A.|last7=Sheridan|first7=E. M.|last8=Zwaan|first8=M. de|last9=Fleischhaker|first9=C.|date=2011-04-01|title=Screening for anorexia nervosa via measurement of serum leptin levels|url=https://link.springer.com/article/10.1007/s00702-010-0551-z|journal=Journal of Neural Transmission|language=en|volume=118|issue=4|pages=571–578|doi=10.1007/s00702-010-0551-z|issn=0300-9564}}</ref> |0.984 (N=139) |14.72 (<2.31) |0.10 (2.31+) |Adolescent and adult patients in the acute phase of AN according to the DSM-IV and no AN pretreatment versus healthy lean female volunteer university students. |None |- |Body Mass Index (BMI)<ref name=":7" /> |0.936 (N=139) |5.89 (<17.10) |0.11 (17.10+) |Adolescent and adult patients in the acute phase of AN according to the DSM-IV and no AN pretreatment versus healthy lean female volunteer university students. |None |- |EAT-26&nbsp;<ref name=":4" /><ref>{{Cite journal|title = The eating attitudes test: psychometric features and clinical correlates|url = http://www.ncbi.nlm.nih.gov/pubmed/6961471|journal = Psychological Medicine|date = 1982-11-01|issn = 0033-2917|pmid = 6961471|pages = 871–878|volume = 12|issue = 4|first = D. M.|last = Garner|first2 = M. P.|last2 = Olmsted|first3 = Y.|last3 = Bohr|first4 = P. E.|last4 = Garfinkel}}</ref> |.90 (N=129) |12.83 (20+) |.24 (<20) |Low-moderate: College women with no eating disorder versus college women with a DSM-IV eating disorder. Eating disorders were not separated. |PDFs * [https://www.eat-26.com/eat-26/ Adult Version PDF] * [http://www.1000livesplus.wales.nhs.uk/sitesplus/documents/1011/ChEAT.pdf Child Version PDF] |- |EDE-Q&nbsp;<ref name=":1">{{Cite journal|title = Assessment of eating disorders: interview or self-report questionnaire?|url = http://www.ncbi.nlm.nih.gov/pubmed/7866415|journal = The International Journal of Eating Disorders|date = 1994-12-01|issn = 0276-3478|pmid = 7866415|pages = 363–370|volume = 16|issue = 4|first = C. G.|last = Fairburn|first2 = S. J.|last2 = Beglin}}</ref> |.96 &nbsp;<ref name=":1" />(N=1170) | 6.57 (2.3+)<ref name=":5">{{Cite journal|last=Fairburn|first=C. G.|last2=Beglin|first2=S. J.|date=December 1994|title=Assessment of eating disorders: interview or self-report questionnaire?|url=https://www.ncbi.nlm.nih.gov/pubmed/7866415|journal=The International Journal of Eating Disorders|volume=16|issue=4|pages=363–370|issn=0276-3478|pmid=7866415}}</ref> | 0.09 (<2.3)<ref name=":5" /> |Moderate: Dutch treatment-seeking females meeting DSM-IV criteria for an eating disorder versus female adult general population sample recruited through advertisements and personal contacts. Eating disorders were not separated.&nbsp;<ref name=":1" /> Moderate: “Clinically significant eating disorder” from a community sample versus female adults individuals without “clinically significant eating disorder” from same sample. Eating disorders were not separated.<ref name=":5" /> |[http://www.corc.uk.net/media/1273/ede-q_quesionnaire.pdf PDF] |} === Interpreting anorexia nervosa screening measure scores === * For information on interpreting screening measure scores, click [[Evidence based assessment/Prediction phase#Interpreting screening measure scores|here.]] * Also see the page on [https://en.wikipedia.org/wiki/Likelihood_ratios_in_diagnostic_testing likelihood ratios in diagnostic testing] for more information. ==[[Evidence based assessment/Prescription phase|'''Prescription phase''']]== ===Gold standard diagnostic interviews=== * For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews click here.] ===Recommended diagnostic interviews for anorexia nervosa=== {| class="wikitable sortable" border="1" ! colspan="5" |Diagnostic instruments for anorexia nervosa |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time !Where to access |- |[https://www.credo-oxford.com/7.2.html Eating Disorder Examination (EDE)] <ref>{{Cite book|url=https://www.worldcat.org/oclc/1160972551|title=Assessment of disorders in childhood and adolescence|date=2020|others=Eric Arden Youngstrom, Mitchell J. Prinstein, Eric J. Mash, Russell A. Barkley|isbn=978-1-4625-4365-6|edition=Fifth edition|location=New York|oclc=1160972551}}</ref> <ref>{{Cite book|url=https://www.worldcat.org/oclc/314222270|title=A guide to assessments that work|date=2008|publisher=Oxford University Press|others=John Hunsley, Eric J. Mash|isbn=0-19-804245-0|location=New York|oclc=314222270}}</ref> |Semistructured (child and adult) |8-16 (child version) 16+ (adult version) |45-75 minutes |PDFs * [https://www.phenxtoolkit.org/protocols/view/230101 Child version PDF] * [https://www.credo-oxford.com/7.2.html Adult version PDF] |- |Structured Clinical Interview for DSM-5-Clinician Version (SCID-5-CV)<ref>{{Cite journal|last=Shabani|first=Amir|last2=Masoumian|first2=Samira|last3=Zamirinejad|first3=Somayeh|last4=Hejri|first4=Maryam|last5=Pirmorad|first5=Tahereh|last6=Yaghmaeezadeh|first6=Hooman|date=2021-05|title=Psychometric properties of Structured Clinical Interview for DSM‐5 Disorders‐Clinician Version (SCID‐5‐CV)|url=https://onlinelibrary.wiley.com/doi/10.1002/brb3.1894|journal=Brain and Behavior|language=en|volume=11|issue=5|doi=10.1002/brb3.1894|issn=2162-3279|pmc=PMC8119811|pmid=33729681}}</ref> |Structured Interview (Adult ) |16+ |Varies |[https://www.columbiapsychiatry.org/research/research-labs/diagnostic-and-assessment-lab/structured-clinical-interview-dsm-disorders-11 Website to purchase] |- | [https://dawba.info/a0.html Development and Well-Being Assessment (DAWBA)] <ref>{{Cite book|url=https://www.worldcat.org/oclc/1160972551|title=Assessment of disorders in childhood and adolescence|date=2020|others=Eric Arden Youngstrom, Mitchell J. Prinstein, Eric J. Mash, Russell A. Barkley|isbn=978-1-4625-4365-6|edition=Fifth edition|location=New York|oclc=1160972551}}</ref> | Structured (child/adolescent and parent) | 11-18 |10-20 minutes for the eating disorder module |[https://osf.io/zpbna/?view_only=245bef061d284c17ab9dedad5a59e1b8 English PDF] [https://dawba.info/py/dawbainfo/b1.py Additional languages] |} '''Note:''' '''L''' = Less than adequate; '''A''' = Adequate; '''G''' = Good; '''E''' = Excellent; '''U''' = Unavailable; '''NA''' = Not applicable ==[[Evidence based assessment/Process phase|'''Process phase''']]== The following section contains a brief overview of treatment options for anorexia nervosa and a list of process and outcome measures for anorexia nervosa. The section includes benchmarks based on published norms for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the [[Evidence based assessment/Process phase|process phase]] of assessment. For more information on the differences between process and outcome measures, see the page on the [[Evidence based assessment/Process phase|process phase of assessment]]. ===Process measures=== Body weight is commonly monitored by clinicians throughout the AN treatment process as helping individuals regain and maintain a healthy weight is a primary treatment goal for AN. Many treatment centers have policies prohibiting patients from seeing their weight. Motivational Stages of Change may be used to monitor individuals’ readiness to take action against eating disorder behaviors. It has demonstrated predictive validity in a sample of female adolescents attending eating disorder treatment groups.<ref>{{Cite journal|last=Gusella|first=Joanne|last2=Butler|first2=Gordon|last3=Nichols|first3=Laura|last4=Bird|first4=Debbie|date=2003-01-01|title=A brief questionnaire to assess readiness to change in adolescents with eating disorders: its applications to group therapy|url=http://onlinelibrary.wiley.com/doi/10.1002/erv.481/abstract|journal=European Eating Disorders Review|language=en|volume=11|issue=1|pages=58–71|doi=10.1002/erv.481|issn=1099-0968}}</ref> See Appendix E. === Outcome and severity measures === This table includes clinically significant benchmarks for anorexia nervosa specific outcome measures * Information on how to interpret this table can be [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase found here]. * Additionally, these [[Evidence based assessment/Vignettes|vignettes]] might be helpful resources for understanding appropriate adaptation of outcome measures in practice. *''<u>For clinically significant change benchmarks for the CBCL, YSR, and TRF total, externalizing, internalizing, and attention benchmarks,</u>'' [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase&wteswitched=1#Clinically_significant_change_benchmarks_for_widely-used_outcome_measures see here.] {| class="wikitable sortable" border="1" | colspan="8" |'''Clinically significant change benchmarks with common instruments for anorexia nervosa''' |- | colspan="8" span style="font-size:110%; text-align:center;" | <b> Benchmarks Based on Published Norms</b> |- | rowspan="2" style="text-align:center;font-size:130%;" |<b> Measure</b> | rowspan="2" style="text-align:center;font-size:130%;" | <b> Subscale</b> | colspan="3" style="text-align:center;font-size:130%" width="300" | <b> Cut-off scores</b> | colspan="3" style="text-align:center;font-size:120%" | <b> Critical Change <br> (unstandardized scores)</b> |- | style="text-align:center;font-size:110%" |<b> A</b> | style="text-align:center;font-size:110%" |<b> B</b> | style="text-align:center;font-size:110%" |<b> C</b> | style="text-align:center;font-size:110%" |<b> 95%</b> | style="text-align:center;font-size:110%" |<b> 90%</b> | style="text-align:center;font-size:110%" |<b> SE_difference</b> |- | rowspan="5" style="text-align:center;" |'''EDE-Q <ref name=":2">{{Cite journal|last=Mond|first=J. M.|last2=Hay|first2=P. J.|last3=Rodgers|first3=B.|last4=Owen|first4=C.|last5=Beumont|first5=P. J. V.|date=May 2004|title=Validity of the Eating Disorder Examination Questionnaire (EDE-Q) in screening for eating disorders in community samples|url=https://www.ncbi.nlm.nih.gov/pubmed/15033501|journal=Behaviour Research and Therapy|volume=42|issue=5|pages=551–567|doi=10.1016/S0005-7967(03)00161-X|issn=0005-7967|pmid=15033501}}</ref>''' | style="text-align:right;" |''Global'' |1.4 |3.2 |2.3 |.7 |.6 |.3 |- | style="text-align:right;" |''Restraint'' |(-.3) |3.6 |1.8 |1.5 |1.2 |.8 |- | style="text-align:right;" |''Eating Concern'' |.1 |2.0 |1.2 |1.1 |.9 |.6 |- | style="text-align:right;" |''Weight Concern'' |1.5 |3.9 |2.6 |1.0 |.9 |.5 |- | style="text-align:right;" |''Shape Concern'' |2.1 |4.8 |3.2 |.9 |.7 |.4 |- | rowspan="5" style="text-align:center;" |'''EDE <ref name=":2" />''' | style="text-align:right;" |''Global'' |1.7 |2.3 |1.9 |1.9 |1.6 |1.0 |- | style="text-align:right;" |''Restraint'' |.3 |3.3 |1.9 |1.8 |1.5 |.9 |- | style="text-align:right;" |''Eating Concern'' |(-.5) |.9 |.5 |.8 |.7 |.4 |- | style="text-align:right;" |''Weight Concern'' |2.0 |2.8 |2.4 |1.3 |1.1 |.7 |- | style="text-align:right;" |''Shape Concern'' |2.0 |3.2 |2.6 |1.2 |1.0 |.6 |- | rowspan="1" style="text-align:center;" |'''EAT-26 <ref name=":0">{{Cite journal|last=Mintz|first=L. B.|last2=O'Halloran|first2=M. S.|date=2000-06-01|title=The Eating Attitudes Test: validation with DSM-IV eating disorder criteria|url=http://www.ncbi.nlm.nih.gov/pubmed/10900574|journal=Journal of Personality Assessment|volume=74|issue=3|pages=489–503|doi=10.1207/S15327752JPA7403_11|issn=0022-3891|pmid=10900574}}</ref>''' | style="text-align:right;" |''Total'' |6.5 |19.6 |15.0 |7.9 |6.7 |4.0 |} '''Note:''' “A” = Away from the clinical range, “B” = Back into the nonclinical range, “C” = Closer to the nonclinical than clinical mean. '''Search terms:''' [Anorexia Nervosa OR eating disorder] AND [validity OR clinical significance] in Google Scholar === Treatment === {{collapse top| More information on treatment for AN|expand=yes}} * Treatment of AN typically consists of restoring the individual to a healthy weight and addressing thoughts and behaviors which are related to the eating disorder. It may involve re-nutrition, psychotherapy, nutritional counseling, and medication. * Literature reviews of existing research indicate that evidence supporting AN treatment is lacking. A systematic review of AN treatment efficacy studies by Bulik<ref>{{Cite journal|title = Anorexia nervosa treatment: a systematic review of randomized controlled trials|url = http://www.ncbi.nlm.nih.gov/pubmed/17370290|journal = The International Journal of Eating Disorders|date = 2007-05-01|issn = 0276-3478|pmid = 17370290|pages = 310–320|volume = 40|issue = 4|doi = 10.1002/eat.20367|first = Cynthia M.|last = Bulik|first2 = Nancy D.|last2 = Berkman|first3 = Kimberly A.|last3 = Brownley|first4 = Jan A.|last4 = Sedway|first5 = Kathleen N.|last5 = Lohr}}</ref> found that evidence supporting medications, medications and behavioral interventions, and behavioral interventions alone in adults is weak. * There is moderately strong evidence suggesting that behavioral interventions may be helpful for adolescents. In particular, adolescents may benefit from family therapy. * Clinical trials investigating AN treatment suffer from high rates of attrition, as key features of AN (e.g., denial, fear of weight gain) may contribute to low motivation for remaining in treatment. * More severe cases of AN may be treated in inpatient settings, which are equipped to manage the re-nutrition process and provide medical monitoring. * Partial hospitalization and intensive outpatient programs may provide intermediate levels of treatment intensity to assist individuals in the transition from intensive care to outpatient care after weight restoration. {{collapse bottom}} * Please refer to the page on [https://en.wikipedia.org/wiki/Anorexia_nervosa anorexia nervosa] for more information on available treatment or go to [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/eating-body-image-problems/ the Effective Child Therapy page for Eating & Body Image Problems] for a curated resource on effective treatments for anorexia nervosa. == '''External resources''' == # [http://apps.who.int/classifications/icd10/browse/2010/en#/F50.0 ICD-10 diagnostic criteria] # [https://en.wikiversity.org/w/index.php?title=Helping_Give_Away_Psychological_Science/Resources/Annotated_List_of_Where_and_How_to_Find_a_Therapist&wteswitched=1#Other_low-cost_options Find-a-Therapist] ##This is a curated list of find-a-therapist websites where you can find a provider # NIMH: [https://www.nimh.nih.gov/health/publications/eating-disorders/index.shtml ''Eating Disorders--About More Than Food''] and [https://www.nimh.nih.gov/health/topics/eating-disorders/index.shtml ''Eating Disorders''] ##These NIMH website posts provide more information on anorexia nervosa #[https://www.hopkinsmedicine.org/psychiatry/specialty_areas/eating_disorders/ John's Hopkins Resource] (guide about anorexia nervosa, treatment, and more) # OMIM (Online Mendelian Inheritance in Man) ##[https://www.omim.org/entry/606788?search=anorexia%20nervosa&highlight=nervosa%20anorexia Anorexia nervosa] #[http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/eating-body-image-problems/ Effective Child Therapy page for anorexia nervosa] ##Effective Child Therapy is website sponsored by Division 53 of the American Psychological Association (APA), or The [https://sccap53.org Society of Clinical Child and Adolescent Psychology] (SCCAP), in collaboration with the Association for Behavioral and Cognitive Therapies (ABCT). Use for information on symptoms and available treatments. == '''References''' == {{collapse top|References|expand=yes}} {{Reflist|30em}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] {{collapse bottom}} r0igjlh72eapqvz7m5c5crpdcw2sjor 2419243 2419178 2022-08-26T03:42:39Z Ardenguo 2944162 /* Prediction phase */ Removed all "Note: L = Less than adequate; A = Adequate; G = Good; E = Excellent; U = Unavailable; NA = Not applicable" because the condensed-version portfolios don't include reliability/validity. wikitext text/x-wiki <noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{medical disclaimer}} {{:{{BASEPAGENAME}}/Sidebar}} ==[[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio"?''']]== For background information on what assessment portfolios are, click the link in the heading above. Want even 'more' information about this topic? There's an extended version of this page [[Evidence-based assessment/Anorexia nervosa (assessment portfolio)/extended version|here]]. == [[Evidence based assessment/Preparation phase|'''Preparation phase''']] == === Diagnostic criteria for anorexia nervosa === {{blockquotetop}} '''ICD-11 Criteria''' Anorexia Nervosa is characterized by significantly low body weight, which is less than minimal normal/expected weight for the individual’s height, sex, age and developmental stage (body mass index (BMI) less than 18.5 kg/m2 in adults and BMI-for-age under fifth percentile in children and adolescents) that is not due to another health condition or to the unavailability of food. Low body weight is accompanied by a persistent pattern of behaviors to prevent restoration of normal weight, which may include behaviors aimed at reducing energy intake (restricted eating), purging behaviors (e.g., self-induced vomiting, misuse of laxatives), and behaviors aimed at increasing energy expenditure (e.g., excessive exercise), typically associated with a fear of weight gain. Low body weight or shape is central to the person's self-evaluation or is inaccurately perceived to be normal or even excessive. '''Changes in DSM-5''' * The diagnostic criteria for anorexia nervosa changed slightly from [[DSM-IV]] to [[w:Diagnostic_and_Statistical_Manual_of_Mental_Disorders#DSM-IV-TR_.282000.29|DSM-5]]. Summaries are available [http://www.dsm5.org/Documents/changes%20from%20dsm-iv-tr%20to%20dsm-5.pdf here] and [[w:DSM-5|here]]. {{blockquotebottom}} === Base rates of anorexia nervosa in different populations and clinical settings === This section describes the demographic setting of the population(s) sampled, base rates of diagnosis such as prevalence rates, country/region sampled, and the diagnostic method that was used. Using this information, clinicians will be able to anchor the rate of adolescent depression that they are likely to see in their clinical practice. * '''''To see prevalence rates across multiple disorders,''''' [[Evidence based assessment/Preparation phase#Base rates for transdiagnostic comparison|'''''click here.''''']] {| class="wikitable sortable" |- ! Demography ! Setting (Reference) ! Base Rate ! Diagnostic Method |- |Nationally representative US sample of adults |Non-clinical: Population-based (NCS-R)<ref>Hudson, James I.; Hiripi, Eva; Pope, Harrison G.; Kessler, Ronald C. (2007-02-01). "The prevalence and correlates of eating disorders in the National Comorbidity Survey Replication".''Biological Psychiatry'' '''61''' (3): 348–358. doi:10.1016/j.biopsych.2006.03.040. ISSN 0006-3223. PMC 1892232. <nowiki>PMID 16815322</nowiki></ref> |.9% Female, .3% Male |World Health Organization-Clinical International Diagnostic Interview (WHO-CIDI) |- |Nationally representative US sample of adolescents |Non-clinical: Population-based (NCS-A)<ref>Swanson, Sonja A.; Crow, Scott J.; Le Grange, Daniel; Swendsen, Joel; Merikangas, Kathleen R. (2011-07-01). "Prevalence and correlates of eating disorders in adolescents. Results from the national comorbidity survey replication adolescent supplement". ''Archives of General Psychiatry'' '''68''' (7): 714–723. doi:10.1001/archgenpsychiatry.2011.22. ISSN 1538-3636.<nowiki>PMID 21383252</nowiki></ref> |.3% Female, .3% Male |WHO-CIDI |- |Nationally representative US sample of 9- and 10-year old children |Non-clinical: US Population-based prevalence (Adolescent Brain Cognitive Development (ABCD) study<ref>{{Cite journal|last=Rozzell|first=Kaitlin|last2=Moon|first2=Da Yeoun|last3=Klimek|first3=Patrycja|last4=Brown|first4=Tiffany|last5=Blashill|first5=Aaron J.|date=2019-01-01|title=Prevalence of Eating Disorders Among US Children Aged 9 to 10 Years: Data From the Adolescent Brain Cognitive Development (ABCD) Study|url=http://archpedi.jamanetwork.com/article.aspx?doi=10.1001/jamapediatrics.2018.3678|journal=JAMA Pediatrics|language=en|volume=173|issue=1|pages=100|doi=10.1001/jamapediatrics.2018.3678|issn=2168-6203|pmc=PMC6583451|pmid=30476983}}</ref> |0.1%, no gender differences |DSM-5 using Kiddie Schedule for Affective Disorders and Schizophrenia (KSADS) |- |Latino Households in the US |Non-clinical: Latinos in US<ref>Alegria, Margarita; Woo, Meghan; Cao, Zhun; Torres, Maria; Meng, Xiao-li; Striegel-Moore, Ruth (2007-11-01). "Prevalence and correlates of eating disorders in Latinos in the United States".''The International Journal of Eating Disorders''. 40 Suppl: S15–21. doi:10.1002/eat.20406. ISSN 0276-3478. PMC 2680162. <nowiki>PMID 17584870</nowiki></ref> |.12% Female, .03% Male |WHO-CIDI |- |National probability sample of adult and adolescent African Americans and Caribbean Black people |Non-clinical: African Americans and Caribbean Black people in the US (NSAL)<ref>Taylor, Jacquelyn Y.; Caldwell, Cleopatra Howard; Baser, Raymond E.; Faison, Nakesha; Jackson, James S. (2007-11-01). "Prevalence of eating disorders among Blacks in the National Survey of American Life". ''The International Journal of Eating Disorders''. 40 Suppl: S10–14. doi:10.1002/eat.20451. ISSN 0276-3478. PMC 2882704. <nowiki>PMID 17879287</nowiki></ref> |.14% Female, .2% Male |WHO-CIDI |- |Asian American adults in US households |Non-clinical: National Latino and Asian American Study (NLAAS) |.12% Female, .05% Male |WHO-CIDI |- | US African American college females | Non-clinical; college students<ref>Tyler ID. A true picture of eating disorders among African American women: a review of literature. ABNF J. 2003;14(3):73-4.</ref> || .0% || Eating Disorder Diagnostic Questionnaire (EDD-Q) |- | US Female Adolescents | Non-clinical; Adolescents<ref>Stice, E., Becker, C. B., & Yokum, S. (2013). Eating disorder prevention: Current evidence-base and future directions. ''Int. J. Eat. Disord. International Journal of Eating Disorders,'' ''46''(5), 478-485.</ref> || .8% || Eating Disorder Diagnosis Interview (EDDI) |- | US Division-I Varsity Student Athletes | Non-clinical; student-athletes<ref>Johnson C, Powers PS, Dick R. Athletes and eating disorders: the national collegiate athletic association study. Int J Eat Disord 1999;26:179e88.</ref> || .0% || Eating Disorder Inventory-2 (EDI-2) |- | Active duty females in US Army, Navy, Airforce, and Marines | Non-clinical; Military<ref>McNulty, PAF. (2001). Prevalence and contributing factors of eating disorder behaviors in active duty service women in the Army, Navy, Air Force and Marines. Military Medicine, 166(1), 53-58. </ref> || 1.1% || EDI-2 |- |US Caucasian female same-sex twins |Non-clinical; Commonwealth of Virginia Mid-Atlantic Twin Registry (MATR)<ref>Kendler KS, Walters EE, Neale MC, Kessler R, Heath A, Eaves L. The structure of genetic and environmental risk factors for six major psychiatric disorders in women. Archives of general psychiatry. 1995;52:374–383.</ref> |1.62% (narrow), 3.70% (broad) |Structured Clinical Interview for DSM Disorders (SCID) |- |South Australian older adolescents and adults |Non-clinical; Health Omnibus Survey (HOS) |.46% (3 months; combined) |Eating Disorder Examination (EDE) |- |US Military |Military<ref>{{Cite journal|title=Diagnosed eating disorders in the U.S. Military: a nine year review|url=http://www.ncbi.nlm.nih.gov/pubmed/18821361|journal=Eating Disorders|date=2008-12-01|issn=1532-530X|pmid=18821361|pages=363–377|volume=16|issue=5|doi=10.1080/10640260802370523|first=Amanda J.|last=Antczak|first2=Teresa L.|last2=Brininger}}</ref> |.04% (combined) |ICD codes from electronic records |- |US Military Academy cadets |Non-clinical; Military |.02% (7 years) Female, 0.0% (7 years) Males |[https://www.eat-26.com/ Eating Attitudes Test- 26 items] (EAT-26)<ref>{{Cite web|url=https://www.eat-26.com/|title=EAT-26: Eating Attitudes Test & Eating Disorder Testing – Use the EAT-26 to help you determine if you need to speak to a mental health professional to get help for an eating disorder.|last=admin|language=en|access-date=2022-05-30}}</ref> |- |US Navy female nurses |Non-clinical; Military |1.1% (current & past) Female |DSM-III |- |US veterans |Non-clinical; Military |.04% Female, .005% Males |ICD-9-CM |- |Active duty males in US Navy |Non-clinical; Military |2.5% Males |N/A |- |US alcohol-dependent adults from San Diego, St. Lois, Iowa City, Farmington, New York, & Indianapolis |Clinical; Collaborative Study on the Genetics of Alcoholism (COGA)<ref>{{Cite journal|title=Anorexia nervosa and bulimia nervosa in alcohol-dependent men and women and their relatives|url=http://www.ncbi.nlm.nih.gov/pubmed/8540597|journal=The American Journal of Psychiatry|date=1996-01-01|issn=0002-953X|pmid=8540597|pages=74–82|volume=153|issue=1|doi=10.1176/ajp.153.1.74|first=M. A.|last=Schuckit|first2=J. E.|last2=Tipp|first3=R. M.|last3=Anthenelli|first4=K. K.|last4=Bucholz|first5=V. M.|last5=Hesselbrock|first6=J. I.|last6=Nurnberger}}</ref> |1.41% (lifetime) Female, .00% (lifetime) Male |SSAGA |- |Healthcare provider records |Non-clinical; healthcare members |.0269% (current) | |- |US high school students in west central Oregon |Non-clinical; high school students |. 00% (point), .45% (lifetime) Female .00% (point), .00% (lifetime) Males |DSM-III-R₄ |- |Canadian treatment-seeking substance users |Clinical; substance users |.4% (lifetime), .3% (current) Female .4% (lifetime), .3% (current) Males |DIS₉ |- | | colspan="3" style="font-size:110%; text-align:center;" |'''Europe''' |- |Adolescent females residing in Navarra, Spain |Non-clinical; adolescents |.3% Female |EAT-40₃ |- |Adolescents in secondary schools in Sør-Trøndelag, County in Norway |Non-clinical; adolescents |.7% (lifetime) Female, .2% Male |SEDs₁₀ |- |Adolescents in a comprehensive school in Ostrobothnia district in Finland |Non-clinical; adolescents |.7% (point; age 15), 1.8% (lifetime, age 15), .00% (point, age 18), 2.6% (lifetime, age 18), .9% (3 years) Female .00% (point & lifetime) Males |RAB-T₁₁&nbsp;& RAB-R₁₂ |- | | colspan="3" style="font-size:110%; text-align:center;" |'''Australia''' |- |Adolescent females residing in Victoria, Australia |Non-clinical; adolescents |.00% (full), 1.8% (partial) Female |BET₁₃ |- | | colspan="3" style="font-size:110%; text-align:center;" |'''Central & South America''' |- |Mexican first & second year college females |Non-clinical; college students |.00% Female |EAT-40₃ |- | | colspan="3" style="font-size:110%; text-align:center;" |'''East Asia''' |- |Adolescent and adult Japanese patients at a university hospital |Clinical; eating disorder patients |.53% Female |DSM-III-R₄ |- |Korean adults |Non-clinical; Korean Epidemiologic Catchment Area (KECA) Study |.1% (lifetime), .1% (12 months) Female .2% (lifetime), .00% (12 months) Males |K-CIDI₁₅&nbsp;2.1 |- |Alcohol-dependent adults |Centers participating in the Collaborative Study on the Genetics of Alcoholism in San Diego; St. Louis; Iowa City; Farmington, CN; New York; & Indianapolis |1.41% Females |Semi-Structured Assessment for the Genetics of Alcoholism; criteria based on DSM-III-R |} ==[[Evidence based assessment/Prediction phase|'''Prediction phase''']]== === Psychometric properties of screening instruments for anorexia nervosa === The following section contains a list of screening and diagnostic instruments for anorexia nervosa. The section includes administration information, psychometric data, and PDFs or links to the screenings. * Screenings are used as part of the [[Evidence based assessment/Prediction phase|prediction phase]] of assessment; for more information on interpretation of this data, or how screenings fit in to the assessment process, click [[Evidence based assessment/Prediction phase|here.]] * ''For a list of more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Psychometric_properties_of_common_screening_instruments '''click here.''']'' {| class="wikitable" |- ! Measure !Format (Reporter) !Age Range !Administration/ Completion Time !Where to Access |- |[[wikipedia:Eating_Disorder_Examination_Interview|Eating Disorder Examination Questionnaire (EDE-Q)]]<ref>{{Cite journal|last=Cooper|first=Zafra|last2=Fairburn|first2=Christopher|date=1987-01|title=The eating disorder examination: A semi-structured interview for the assessment of the specific psychopathology of eating disorders|url=http://dx.doi.org/10.1002/1098-108x(198701)6:1<1::aid-eat2260060102>3.0.co;2-9|journal=International Journal of Eating Disorders|volume=6|issue=1|pages=1–8|doi=10.1002/1098-108x(198701)6:1<1::aid-eat2260060102>3.0.co;2-9|issn=0276-3478}}</ref> |Questionnaire (Patient) |14+ |15-20 min | [http://www.corc.uk.net/media/1273/ede-q_quesionnaire.pdf PDF] |- |[[wikipedia:Eating_Disorder_Diagnostic_Scale|EDDS (Eating Disorder Diagnosis Scale)]]<ref>{{Cite journal|last=Stice|first=Eric|last2=Telch|first2=Christy F.|last3=Rizvi|first3=Shireen L.|date=2000|title=Development and validation of the Eating Disorder Diagnostic Scale: A brief self-report measure of anorexia, bulimia, and binge-eating disorder.|url=http://doi.apa.org/getdoi.cfm?doi=10.1037/1040-3590.12.2.123|journal=Psychological Assessment|language=en|volume=12|issue=2|pages=123–131|doi=10.1037/1040-3590.12.2.123|issn=1939-134X}}</ref> |Questionnaire (Patient) |13 - 65 |10-15 min | [http://www.ori.org/files/Static%20Page%20Files/EDDSDSM-5_10_14.pdf PDF] |- |Eating Attitudes Test- 26(EAT-26; Adult version)<ref>{{Cite journal|last=Garner|first=David M.|last2=Garfinkel|first2=Paul E.|date=1979-05|title=The Eating Attitudes Test: an index of the symptoms of anorexia nervosa|url=http://dx.doi.org/10.1017/s0033291700030762|journal=Psychological Medicine|volume=9|issue=2|pages=273–279|doi=10.1017/s0033291700030762|issn=0033-2917}}</ref> Child Eating Attitudes Test - 26 (ChEAT-26; child version)<ref>{{Cite journal|last=Almeida|first=M.C.|last2=Carvalho|first2=D.L.D.B.|last3=Rigolino|first3=R.|date=2012-07|title=Reliability of a Brazilian version of children's eating attitude test|url=http://dx.doi.org/10.1016/j.neurenf.2012.04.196|journal=Neuropsychiatrie de l'Enfance et de l'Adolescence|volume=60|issue=5|pages=S158|doi=10.1016/j.neurenf.2012.04.196|issn=0222-9617}}</ref> |Questionnaire (Patient) |13+ (adult version) 8 -13 (child version) |5-10 min |PDFs * [https://www.eat-26.com/eat-26/ Adult Version PDF] * [http://www.1000livesplus.wales.nhs.uk/sitesplus/documents/1011/ChEAT.pdf Child Version PDF] |} ===Likelihood ratios and AUCs of screening instruments for anorexia nervosa=== * ''For a list of the likelihood ratios for more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Likelihood_ratios_and_AUCs_of_common_screening_instruments '''click here.''']'' {| class="wikitable sortable" border="1" |- ! <ref name=":4">{{Cite journal|last=Mintz|first=L. B.|last2=O'Halloran|first2=M. S.|date=June 2000|title=The Eating Attitudes Test: validation with DSM-IV eating disorder criteria|url=https://www.ncbi.nlm.nih.gov/pubmed/10900574|journal=Journal of Personality Assessment|volume=74|issue=3|pages=489–503|doi=10.1207/S15327752JPA7403_11|issn=0022-3891|pmid=10900574}}</ref>Screening Measure (Primary Reference) ! AUC ! DiLR+ (Score) ! DiLR- (Score) !Clinical Generalizability !Where to access |- |Serum leptin level<ref name=":7">{{Cite journal|last=Föcker|first=M.|last2=Timmesfeld|first2=N.|last3=Scherag|first3=S.|last4=Bühren|first4=K.|last5=Langkamp|first5=M.|last6=Dempfle|first6=A.|last7=Sheridan|first7=E. M.|last8=Zwaan|first8=M. de|last9=Fleischhaker|first9=C.|date=2011-04-01|title=Screening for anorexia nervosa via measurement of serum leptin levels|url=https://link.springer.com/article/10.1007/s00702-010-0551-z|journal=Journal of Neural Transmission|language=en|volume=118|issue=4|pages=571–578|doi=10.1007/s00702-010-0551-z|issn=0300-9564}}</ref> |0.984 (N=139) |14.72 (<2.31) |0.10 (2.31+) |Adolescent and adult patients in the acute phase of AN according to the DSM-IV and no AN pretreatment versus healthy lean female volunteer university students. |None |- |Body Mass Index (BMI)<ref name=":7" /> |0.936 (N=139) |5.89 (<17.10) |0.11 (17.10+) |Adolescent and adult patients in the acute phase of AN according to the DSM-IV and no AN pretreatment versus healthy lean female volunteer university students. |None |- |EAT-26&nbsp;<ref name=":4" /><ref>{{Cite journal|title = The eating attitudes test: psychometric features and clinical correlates|url = http://www.ncbi.nlm.nih.gov/pubmed/6961471|journal = Psychological Medicine|date = 1982-11-01|issn = 0033-2917|pmid = 6961471|pages = 871–878|volume = 12|issue = 4|first = D. M.|last = Garner|first2 = M. P.|last2 = Olmsted|first3 = Y.|last3 = Bohr|first4 = P. E.|last4 = Garfinkel}}</ref> |.90 (N=129) |12.83 (20+) |.24 (<20) |Low-moderate: College women with no eating disorder versus college women with a DSM-IV eating disorder. Eating disorders were not separated. |PDFs * [https://www.eat-26.com/eat-26/ Adult Version PDF] * [http://www.1000livesplus.wales.nhs.uk/sitesplus/documents/1011/ChEAT.pdf Child Version PDF] |- |EDE-Q&nbsp;<ref name=":1">{{Cite journal|title = Assessment of eating disorders: interview or self-report questionnaire?|url = http://www.ncbi.nlm.nih.gov/pubmed/7866415|journal = The International Journal of Eating Disorders|date = 1994-12-01|issn = 0276-3478|pmid = 7866415|pages = 363–370|volume = 16|issue = 4|first = C. G.|last = Fairburn|first2 = S. J.|last2 = Beglin}}</ref> |.96 &nbsp;<ref name=":1" />(N=1170) | 6.57 (2.3+)<ref name=":5">{{Cite journal|last=Fairburn|first=C. G.|last2=Beglin|first2=S. J.|date=December 1994|title=Assessment of eating disorders: interview or self-report questionnaire?|url=https://www.ncbi.nlm.nih.gov/pubmed/7866415|journal=The International Journal of Eating Disorders|volume=16|issue=4|pages=363–370|issn=0276-3478|pmid=7866415}}</ref> | 0.09 (<2.3)<ref name=":5" /> |Moderate: Dutch treatment-seeking females meeting DSM-IV criteria for an eating disorder versus female adult general population sample recruited through advertisements and personal contacts. Eating disorders were not separated.&nbsp;<ref name=":1" /> Moderate: “Clinically significant eating disorder” from a community sample versus female adults individuals without “clinically significant eating disorder” from same sample. Eating disorders were not separated.<ref name=":5" /> |[http://www.corc.uk.net/media/1273/ede-q_quesionnaire.pdf PDF] |} === Interpreting anorexia nervosa screening measure scores === * For information on interpreting screening measure scores, click [[Evidence based assessment/Prediction phase#Interpreting screening measure scores|here.]] * Also see the page on [https://en.wikipedia.org/wiki/Likelihood_ratios_in_diagnostic_testing likelihood ratios in diagnostic testing] for more information. ==[[Evidence based assessment/Prescription phase|'''Prescription phase''']]== ===Gold standard diagnostic interviews=== * For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews click here.] ===Recommended diagnostic interviews for anorexia nervosa=== {| class="wikitable sortable" border="1" ! colspan="5" |Diagnostic instruments for anorexia nervosa |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time !Where to access |- |[https://www.credo-oxford.com/7.2.html Eating Disorder Examination (EDE)] <ref>{{Cite book|url=https://www.worldcat.org/oclc/1160972551|title=Assessment of disorders in childhood and adolescence|date=2020|others=Eric Arden Youngstrom, Mitchell J. Prinstein, Eric J. Mash, Russell A. Barkley|isbn=978-1-4625-4365-6|edition=Fifth edition|location=New York|oclc=1160972551}}</ref> <ref>{{Cite book|url=https://www.worldcat.org/oclc/314222270|title=A guide to assessments that work|date=2008|publisher=Oxford University Press|others=John Hunsley, Eric J. Mash|isbn=0-19-804245-0|location=New York|oclc=314222270}}</ref> |Semistructured (child and adult) |8-16 (child version) 16+ (adult version) |45-75 minutes |PDFs * [https://www.phenxtoolkit.org/protocols/view/230101 Child version PDF] * [https://www.credo-oxford.com/7.2.html Adult version PDF] |- |Structured Clinical Interview for DSM-5-Clinician Version (SCID-5-CV)<ref>{{Cite journal|last=Shabani|first=Amir|last2=Masoumian|first2=Samira|last3=Zamirinejad|first3=Somayeh|last4=Hejri|first4=Maryam|last5=Pirmorad|first5=Tahereh|last6=Yaghmaeezadeh|first6=Hooman|date=2021-05|title=Psychometric properties of Structured Clinical Interview for DSM‐5 Disorders‐Clinician Version (SCID‐5‐CV)|url=https://onlinelibrary.wiley.com/doi/10.1002/brb3.1894|journal=Brain and Behavior|language=en|volume=11|issue=5|doi=10.1002/brb3.1894|issn=2162-3279|pmc=PMC8119811|pmid=33729681}}</ref> |Structured Interview (Adult ) |16+ |Varies |[https://www.columbiapsychiatry.org/research/research-labs/diagnostic-and-assessment-lab/structured-clinical-interview-dsm-disorders-11 Website to purchase] |- | [https://dawba.info/a0.html Development and Well-Being Assessment (DAWBA)] <ref>{{Cite book|url=https://www.worldcat.org/oclc/1160972551|title=Assessment of disorders in childhood and adolescence|date=2020|others=Eric Arden Youngstrom, Mitchell J. Prinstein, Eric J. Mash, Russell A. Barkley|isbn=978-1-4625-4365-6|edition=Fifth edition|location=New York|oclc=1160972551}}</ref> | Structured (child/adolescent and parent) | 11-18 |10-20 minutes for the eating disorder module |[https://osf.io/zpbna/?view_only=245bef061d284c17ab9dedad5a59e1b8 English PDF] [https://dawba.info/py/dawbainfo/b1.py Additional languages] |} ==[[Evidence based assessment/Process phase|'''Process phase''']]== The following section contains a brief overview of treatment options for anorexia nervosa and a list of process and outcome measures for anorexia nervosa. The section includes benchmarks based on published norms for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the [[Evidence based assessment/Process phase|process phase]] of assessment. For more information on the differences between process and outcome measures, see the page on the [[Evidence based assessment/Process phase|process phase of assessment]]. ===Process measures=== Body weight is commonly monitored by clinicians throughout the AN treatment process as helping individuals regain and maintain a healthy weight is a primary treatment goal for AN. Many treatment centers have policies prohibiting patients from seeing their weight. Motivational Stages of Change may be used to monitor individuals’ readiness to take action against eating disorder behaviors. It has demonstrated predictive validity in a sample of female adolescents attending eating disorder treatment groups.<ref>{{Cite journal|last=Gusella|first=Joanne|last2=Butler|first2=Gordon|last3=Nichols|first3=Laura|last4=Bird|first4=Debbie|date=2003-01-01|title=A brief questionnaire to assess readiness to change in adolescents with eating disorders: its applications to group therapy|url=http://onlinelibrary.wiley.com/doi/10.1002/erv.481/abstract|journal=European Eating Disorders Review|language=en|volume=11|issue=1|pages=58–71|doi=10.1002/erv.481|issn=1099-0968}}</ref> See Appendix E. === Outcome and severity measures === This table includes clinically significant benchmarks for anorexia nervosa specific outcome measures * Information on how to interpret this table can be [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase found here]. * Additionally, these [[Evidence based assessment/Vignettes|vignettes]] might be helpful resources for understanding appropriate adaptation of outcome measures in practice. *''<u>For clinically significant change benchmarks for the CBCL, YSR, and TRF total, externalizing, internalizing, and attention benchmarks,</u>'' [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase&wteswitched=1#Clinically_significant_change_benchmarks_for_widely-used_outcome_measures see here.] {| class="wikitable sortable" border="1" | colspan="8" |'''Clinically significant change benchmarks with common instruments for anorexia nervosa''' |- | colspan="8" span style="font-size:110%; text-align:center;" | <b> Benchmarks Based on Published Norms</b> |- | rowspan="2" style="text-align:center;font-size:130%;" |<b> Measure</b> | rowspan="2" style="text-align:center;font-size:130%;" | <b> Subscale</b> | colspan="3" style="text-align:center;font-size:130%" width="300" | <b> Cut-off scores</b> | colspan="3" style="text-align:center;font-size:120%" | <b> Critical Change <br> (unstandardized scores)</b> |- | style="text-align:center;font-size:110%" |<b> A</b> | style="text-align:center;font-size:110%" |<b> B</b> | style="text-align:center;font-size:110%" |<b> C</b> | style="text-align:center;font-size:110%" |<b> 95%</b> | style="text-align:center;font-size:110%" |<b> 90%</b> | style="text-align:center;font-size:110%" |<b> SE_difference</b> |- | rowspan="5" style="text-align:center;" |'''EDE-Q <ref name=":2">{{Cite journal|last=Mond|first=J. M.|last2=Hay|first2=P. J.|last3=Rodgers|first3=B.|last4=Owen|first4=C.|last5=Beumont|first5=P. J. V.|date=May 2004|title=Validity of the Eating Disorder Examination Questionnaire (EDE-Q) in screening for eating disorders in community samples|url=https://www.ncbi.nlm.nih.gov/pubmed/15033501|journal=Behaviour Research and Therapy|volume=42|issue=5|pages=551–567|doi=10.1016/S0005-7967(03)00161-X|issn=0005-7967|pmid=15033501}}</ref>''' | style="text-align:right;" |''Global'' |1.4 |3.2 |2.3 |.7 |.6 |.3 |- | style="text-align:right;" |''Restraint'' |(-.3) |3.6 |1.8 |1.5 |1.2 |.8 |- | style="text-align:right;" |''Eating Concern'' |.1 |2.0 |1.2 |1.1 |.9 |.6 |- | style="text-align:right;" |''Weight Concern'' |1.5 |3.9 |2.6 |1.0 |.9 |.5 |- | style="text-align:right;" |''Shape Concern'' |2.1 |4.8 |3.2 |.9 |.7 |.4 |- | rowspan="5" style="text-align:center;" |'''EDE <ref name=":2" />''' | style="text-align:right;" |''Global'' |1.7 |2.3 |1.9 |1.9 |1.6 |1.0 |- | style="text-align:right;" |''Restraint'' |.3 |3.3 |1.9 |1.8 |1.5 |.9 |- | style="text-align:right;" |''Eating Concern'' |(-.5) |.9 |.5 |.8 |.7 |.4 |- | style="text-align:right;" |''Weight Concern'' |2.0 |2.8 |2.4 |1.3 |1.1 |.7 |- | style="text-align:right;" |''Shape Concern'' |2.0 |3.2 |2.6 |1.2 |1.0 |.6 |- | rowspan="1" style="text-align:center;" |'''EAT-26 <ref name=":0">{{Cite journal|last=Mintz|first=L. B.|last2=O'Halloran|first2=M. S.|date=2000-06-01|title=The Eating Attitudes Test: validation with DSM-IV eating disorder criteria|url=http://www.ncbi.nlm.nih.gov/pubmed/10900574|journal=Journal of Personality Assessment|volume=74|issue=3|pages=489–503|doi=10.1207/S15327752JPA7403_11|issn=0022-3891|pmid=10900574}}</ref>''' | style="text-align:right;" |''Total'' |6.5 |19.6 |15.0 |7.9 |6.7 |4.0 |} '''Note:''' “A” = Away from the clinical range, “B” = Back into the nonclinical range, “C” = Closer to the nonclinical than clinical mean. '''Search terms:''' [Anorexia Nervosa OR eating disorder] AND [validity OR clinical significance] in Google Scholar === Treatment === {{collapse top| More information on treatment for AN|expand=yes}} * Treatment of AN typically consists of restoring the individual to a healthy weight and addressing thoughts and behaviors which are related to the eating disorder. It may involve re-nutrition, psychotherapy, nutritional counseling, and medication. * Literature reviews of existing research indicate that evidence supporting AN treatment is lacking. A systematic review of AN treatment efficacy studies by Bulik<ref>{{Cite journal|title = Anorexia nervosa treatment: a systematic review of randomized controlled trials|url = http://www.ncbi.nlm.nih.gov/pubmed/17370290|journal = The International Journal of Eating Disorders|date = 2007-05-01|issn = 0276-3478|pmid = 17370290|pages = 310–320|volume = 40|issue = 4|doi = 10.1002/eat.20367|first = Cynthia M.|last = Bulik|first2 = Nancy D.|last2 = Berkman|first3 = Kimberly A.|last3 = Brownley|first4 = Jan A.|last4 = Sedway|first5 = Kathleen N.|last5 = Lohr}}</ref> found that evidence supporting medications, medications and behavioral interventions, and behavioral interventions alone in adults is weak. * There is moderately strong evidence suggesting that behavioral interventions may be helpful for adolescents. In particular, adolescents may benefit from family therapy. * Clinical trials investigating AN treatment suffer from high rates of attrition, as key features of AN (e.g., denial, fear of weight gain) may contribute to low motivation for remaining in treatment. * More severe cases of AN may be treated in inpatient settings, which are equipped to manage the re-nutrition process and provide medical monitoring. * Partial hospitalization and intensive outpatient programs may provide intermediate levels of treatment intensity to assist individuals in the transition from intensive care to outpatient care after weight restoration. {{collapse bottom}} * Please refer to the page on [https://en.wikipedia.org/wiki/Anorexia_nervosa anorexia nervosa] for more information on available treatment or go to [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/eating-body-image-problems/ the Effective Child Therapy page for Eating & Body Image Problems] for a curated resource on effective treatments for anorexia nervosa. == '''External resources''' == # [http://apps.who.int/classifications/icd10/browse/2010/en#/F50.0 ICD-10 diagnostic criteria] # [https://en.wikiversity.org/w/index.php?title=Helping_Give_Away_Psychological_Science/Resources/Annotated_List_of_Where_and_How_to_Find_a_Therapist&wteswitched=1#Other_low-cost_options Find-a-Therapist] ##This is a curated list of find-a-therapist websites where you can find a provider # NIMH: [https://www.nimh.nih.gov/health/publications/eating-disorders/index.shtml ''Eating Disorders--About More Than Food''] and [https://www.nimh.nih.gov/health/topics/eating-disorders/index.shtml ''Eating Disorders''] ##These NIMH website posts provide more information on anorexia nervosa #[https://www.hopkinsmedicine.org/psychiatry/specialty_areas/eating_disorders/ John's Hopkins Resource] (guide about anorexia nervosa, treatment, and more) # OMIM (Online Mendelian Inheritance in Man) ##[https://www.omim.org/entry/606788?search=anorexia%20nervosa&highlight=nervosa%20anorexia Anorexia nervosa] #[http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/eating-body-image-problems/ Effective Child Therapy page for anorexia nervosa] ##Effective Child Therapy is website sponsored by Division 53 of the American Psychological Association (APA), or The [https://sccap53.org Society of Clinical Child and Adolescent Psychology] (SCCAP), in collaboration with the Association for Behavioral and Cognitive Therapies (ABCT). Use for information on symptoms and available treatments. == '''References''' == {{collapse top|References|expand=yes}} {{Reflist|30em}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] {{collapse bottom}} 8mvnezw5ojv51xc0bkgez3fvdxuproj 2419294 2419243 2022-08-26T05:19:12Z Ardenguo 2944162 /* Psychometric properties of screening instruments for anorexia nervosa */ Added "Note: Reliability and validity are included in the extended version. This table includes measures with Good or Excellent ratings." wikitext text/x-wiki <noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{medical disclaimer}} {{:{{BASEPAGENAME}}/Sidebar}} ==[[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio"?''']]== For background information on what assessment portfolios are, click the link in the heading above. Want even 'more' information about this topic? There's an extended version of this page [[Evidence-based assessment/Anorexia nervosa (assessment portfolio)/extended version|here]]. == [[Evidence based assessment/Preparation phase|'''Preparation phase''']] == === Diagnostic criteria for anorexia nervosa === {{blockquotetop}} '''ICD-11 Criteria''' Anorexia Nervosa is characterized by significantly low body weight, which is less than minimal normal/expected weight for the individual’s height, sex, age and developmental stage (body mass index (BMI) less than 18.5 kg/m2 in adults and BMI-for-age under fifth percentile in children and adolescents) that is not due to another health condition or to the unavailability of food. Low body weight is accompanied by a persistent pattern of behaviors to prevent restoration of normal weight, which may include behaviors aimed at reducing energy intake (restricted eating), purging behaviors (e.g., self-induced vomiting, misuse of laxatives), and behaviors aimed at increasing energy expenditure (e.g., excessive exercise), typically associated with a fear of weight gain. Low body weight or shape is central to the person's self-evaluation or is inaccurately perceived to be normal or even excessive. '''Changes in DSM-5''' * The diagnostic criteria for anorexia nervosa changed slightly from [[DSM-IV]] to [[w:Diagnostic_and_Statistical_Manual_of_Mental_Disorders#DSM-IV-TR_.282000.29|DSM-5]]. Summaries are available [http://www.dsm5.org/Documents/changes%20from%20dsm-iv-tr%20to%20dsm-5.pdf here] and [[w:DSM-5|here]]. {{blockquotebottom}} === Base rates of anorexia nervosa in different populations and clinical settings === This section describes the demographic setting of the population(s) sampled, base rates of diagnosis such as prevalence rates, country/region sampled, and the diagnostic method that was used. Using this information, clinicians will be able to anchor the rate of adolescent depression that they are likely to see in their clinical practice. * '''''To see prevalence rates across multiple disorders,''''' [[Evidence based assessment/Preparation phase#Base rates for transdiagnostic comparison|'''''click here.''''']] {| class="wikitable sortable" |- ! Demography ! Setting (Reference) ! Base Rate ! Diagnostic Method |- |Nationally representative US sample of adults |Non-clinical: Population-based (NCS-R)<ref>Hudson, James I.; Hiripi, Eva; Pope, Harrison G.; Kessler, Ronald C. (2007-02-01). "The prevalence and correlates of eating disorders in the National Comorbidity Survey Replication".''Biological Psychiatry'' '''61''' (3): 348–358. doi:10.1016/j.biopsych.2006.03.040. ISSN 0006-3223. PMC 1892232. <nowiki>PMID 16815322</nowiki></ref> |.9% Female, .3% Male |World Health Organization-Clinical International Diagnostic Interview (WHO-CIDI) |- |Nationally representative US sample of adolescents |Non-clinical: Population-based (NCS-A)<ref>Swanson, Sonja A.; Crow, Scott J.; Le Grange, Daniel; Swendsen, Joel; Merikangas, Kathleen R. (2011-07-01). "Prevalence and correlates of eating disorders in adolescents. Results from the national comorbidity survey replication adolescent supplement". ''Archives of General Psychiatry'' '''68''' (7): 714–723. doi:10.1001/archgenpsychiatry.2011.22. ISSN 1538-3636.<nowiki>PMID 21383252</nowiki></ref> |.3% Female, .3% Male |WHO-CIDI |- |Nationally representative US sample of 9- and 10-year old children |Non-clinical: US Population-based prevalence (Adolescent Brain Cognitive Development (ABCD) study<ref>{{Cite journal|last=Rozzell|first=Kaitlin|last2=Moon|first2=Da Yeoun|last3=Klimek|first3=Patrycja|last4=Brown|first4=Tiffany|last5=Blashill|first5=Aaron J.|date=2019-01-01|title=Prevalence of Eating Disorders Among US Children Aged 9 to 10 Years: Data From the Adolescent Brain Cognitive Development (ABCD) Study|url=http://archpedi.jamanetwork.com/article.aspx?doi=10.1001/jamapediatrics.2018.3678|journal=JAMA Pediatrics|language=en|volume=173|issue=1|pages=100|doi=10.1001/jamapediatrics.2018.3678|issn=2168-6203|pmc=PMC6583451|pmid=30476983}}</ref> |0.1%, no gender differences |DSM-5 using Kiddie Schedule for Affective Disorders and Schizophrenia (KSADS) |- |Latino Households in the US |Non-clinical: Latinos in US<ref>Alegria, Margarita; Woo, Meghan; Cao, Zhun; Torres, Maria; Meng, Xiao-li; Striegel-Moore, Ruth (2007-11-01). "Prevalence and correlates of eating disorders in Latinos in the United States".''The International Journal of Eating Disorders''. 40 Suppl: S15–21. doi:10.1002/eat.20406. ISSN 0276-3478. PMC 2680162. <nowiki>PMID 17584870</nowiki></ref> |.12% Female, .03% Male |WHO-CIDI |- |National probability sample of adult and adolescent African Americans and Caribbean Black people |Non-clinical: African Americans and Caribbean Black people in the US (NSAL)<ref>Taylor, Jacquelyn Y.; Caldwell, Cleopatra Howard; Baser, Raymond E.; Faison, Nakesha; Jackson, James S. (2007-11-01). "Prevalence of eating disorders among Blacks in the National Survey of American Life". ''The International Journal of Eating Disorders''. 40 Suppl: S10–14. doi:10.1002/eat.20451. ISSN 0276-3478. PMC 2882704. <nowiki>PMID 17879287</nowiki></ref> |.14% Female, .2% Male |WHO-CIDI |- |Asian American adults in US households |Non-clinical: National Latino and Asian American Study (NLAAS) |.12% Female, .05% Male |WHO-CIDI |- | US African American college females | Non-clinical; college students<ref>Tyler ID. A true picture of eating disorders among African American women: a review of literature. ABNF J. 2003;14(3):73-4.</ref> || .0% || Eating Disorder Diagnostic Questionnaire (EDD-Q) |- | US Female Adolescents | Non-clinical; Adolescents<ref>Stice, E., Becker, C. B., & Yokum, S. (2013). Eating disorder prevention: Current evidence-base and future directions. ''Int. J. Eat. Disord. International Journal of Eating Disorders,'' ''46''(5), 478-485.</ref> || .8% || Eating Disorder Diagnosis Interview (EDDI) |- | US Division-I Varsity Student Athletes | Non-clinical; student-athletes<ref>Johnson C, Powers PS, Dick R. Athletes and eating disorders: the national collegiate athletic association study. Int J Eat Disord 1999;26:179e88.</ref> || .0% || Eating Disorder Inventory-2 (EDI-2) |- | Active duty females in US Army, Navy, Airforce, and Marines | Non-clinical; Military<ref>McNulty, PAF. (2001). Prevalence and contributing factors of eating disorder behaviors in active duty service women in the Army, Navy, Air Force and Marines. Military Medicine, 166(1), 53-58. </ref> || 1.1% || EDI-2 |- |US Caucasian female same-sex twins |Non-clinical; Commonwealth of Virginia Mid-Atlantic Twin Registry (MATR)<ref>Kendler KS, Walters EE, Neale MC, Kessler R, Heath A, Eaves L. The structure of genetic and environmental risk factors for six major psychiatric disorders in women. Archives of general psychiatry. 1995;52:374–383.</ref> |1.62% (narrow), 3.70% (broad) |Structured Clinical Interview for DSM Disorders (SCID) |- |South Australian older adolescents and adults |Non-clinical; Health Omnibus Survey (HOS) |.46% (3 months; combined) |Eating Disorder Examination (EDE) |- |US Military |Military<ref>{{Cite journal|title=Diagnosed eating disorders in the U.S. Military: a nine year review|url=http://www.ncbi.nlm.nih.gov/pubmed/18821361|journal=Eating Disorders|date=2008-12-01|issn=1532-530X|pmid=18821361|pages=363–377|volume=16|issue=5|doi=10.1080/10640260802370523|first=Amanda J.|last=Antczak|first2=Teresa L.|last2=Brininger}}</ref> |.04% (combined) |ICD codes from electronic records |- |US Military Academy cadets |Non-clinical; Military |.02% (7 years) Female, 0.0% (7 years) Males |[https://www.eat-26.com/ Eating Attitudes Test- 26 items] (EAT-26)<ref>{{Cite web|url=https://www.eat-26.com/|title=EAT-26: Eating Attitudes Test & Eating Disorder Testing – Use the EAT-26 to help you determine if you need to speak to a mental health professional to get help for an eating disorder.|last=admin|language=en|access-date=2022-05-30}}</ref> |- |US Navy female nurses |Non-clinical; Military |1.1% (current & past) Female |DSM-III |- |US veterans |Non-clinical; Military |.04% Female, .005% Males |ICD-9-CM |- |Active duty males in US Navy |Non-clinical; Military |2.5% Males |N/A |- |US alcohol-dependent adults from San Diego, St. Lois, Iowa City, Farmington, New York, & Indianapolis |Clinical; Collaborative Study on the Genetics of Alcoholism (COGA)<ref>{{Cite journal|title=Anorexia nervosa and bulimia nervosa in alcohol-dependent men and women and their relatives|url=http://www.ncbi.nlm.nih.gov/pubmed/8540597|journal=The American Journal of Psychiatry|date=1996-01-01|issn=0002-953X|pmid=8540597|pages=74–82|volume=153|issue=1|doi=10.1176/ajp.153.1.74|first=M. A.|last=Schuckit|first2=J. E.|last2=Tipp|first3=R. M.|last3=Anthenelli|first4=K. K.|last4=Bucholz|first5=V. M.|last5=Hesselbrock|first6=J. I.|last6=Nurnberger}}</ref> |1.41% (lifetime) Female, .00% (lifetime) Male |SSAGA |- |Healthcare provider records |Non-clinical; healthcare members |.0269% (current) | |- |US high school students in west central Oregon |Non-clinical; high school students |. 00% (point), .45% (lifetime) Female .00% (point), .00% (lifetime) Males |DSM-III-R₄ |- |Canadian treatment-seeking substance users |Clinical; substance users |.4% (lifetime), .3% (current) Female .4% (lifetime), .3% (current) Males |DIS₉ |- | | colspan="3" style="font-size:110%; text-align:center;" |'''Europe''' |- |Adolescent females residing in Navarra, Spain |Non-clinical; adolescents |.3% Female |EAT-40₃ |- |Adolescents in secondary schools in Sør-Trøndelag, County in Norway |Non-clinical; adolescents |.7% (lifetime) Female, .2% Male |SEDs₁₀ |- |Adolescents in a comprehensive school in Ostrobothnia district in Finland |Non-clinical; adolescents |.7% (point; age 15), 1.8% (lifetime, age 15), .00% (point, age 18), 2.6% (lifetime, age 18), .9% (3 years) Female .00% (point & lifetime) Males |RAB-T₁₁&nbsp;& RAB-R₁₂ |- | | colspan="3" style="font-size:110%; text-align:center;" |'''Australia''' |- |Adolescent females residing in Victoria, Australia |Non-clinical; adolescents |.00% (full), 1.8% (partial) Female |BET₁₃ |- | | colspan="3" style="font-size:110%; text-align:center;" |'''Central & South America''' |- |Mexican first & second year college females |Non-clinical; college students |.00% Female |EAT-40₃ |- | | colspan="3" style="font-size:110%; text-align:center;" |'''East Asia''' |- |Adolescent and adult Japanese patients at a university hospital |Clinical; eating disorder patients |.53% Female |DSM-III-R₄ |- |Korean adults |Non-clinical; Korean Epidemiologic Catchment Area (KECA) Study |.1% (lifetime), .1% (12 months) Female .2% (lifetime), .00% (12 months) Males |K-CIDI₁₅&nbsp;2.1 |- |Alcohol-dependent adults |Centers participating in the Collaborative Study on the Genetics of Alcoholism in San Diego; St. Louis; Iowa City; Farmington, CN; New York; & Indianapolis |1.41% Females |Semi-Structured Assessment for the Genetics of Alcoholism; criteria based on DSM-III-R |} ==[[Evidence based assessment/Prediction phase|'''Prediction phase''']]== === Psychometric properties of screening instruments for anorexia nervosa === The following section contains a list of screening and diagnostic instruments for anorexia nervosa. The section includes administration information, psychometric data, and PDFs or links to the screenings. * Screenings are used as part of the [[Evidence based assessment/Prediction phase|prediction phase]] of assessment; for more information on interpretation of this data, or how screenings fit in to the assessment process, click [[Evidence based assessment/Prediction phase|here.]] * ''For a list of more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Psychometric_properties_of_common_screening_instruments '''click here.''']'' {| class="wikitable" |- ! Measure !Format (Reporter) !Age Range !Administration/ Completion Time !Where to Access |- |[[wikipedia:Eating_Disorder_Examination_Interview|Eating Disorder Examination Questionnaire (EDE-Q)]]<ref>{{Cite journal|last=Cooper|first=Zafra|last2=Fairburn|first2=Christopher|date=1987-01|title=The eating disorder examination: A semi-structured interview for the assessment of the specific psychopathology of eating disorders|url=http://dx.doi.org/10.1002/1098-108x(198701)6:1<1::aid-eat2260060102>3.0.co;2-9|journal=International Journal of Eating Disorders|volume=6|issue=1|pages=1–8|doi=10.1002/1098-108x(198701)6:1<1::aid-eat2260060102>3.0.co;2-9|issn=0276-3478}}</ref> |Questionnaire (Patient) |14+ |15-20 min | [http://www.corc.uk.net/media/1273/ede-q_quesionnaire.pdf PDF] |- |[[wikipedia:Eating_Disorder_Diagnostic_Scale|EDDS (Eating Disorder Diagnosis Scale)]]<ref>{{Cite journal|last=Stice|first=Eric|last2=Telch|first2=Christy F.|last3=Rizvi|first3=Shireen L.|date=2000|title=Development and validation of the Eating Disorder Diagnostic Scale: A brief self-report measure of anorexia, bulimia, and binge-eating disorder.|url=http://doi.apa.org/getdoi.cfm?doi=10.1037/1040-3590.12.2.123|journal=Psychological Assessment|language=en|volume=12|issue=2|pages=123–131|doi=10.1037/1040-3590.12.2.123|issn=1939-134X}}</ref> |Questionnaire (Patient) |13 - 65 |10-15 min | [http://www.ori.org/files/Static%20Page%20Files/EDDSDSM-5_10_14.pdf PDF] |- |Eating Attitudes Test- 26(EAT-26; Adult version)<ref>{{Cite journal|last=Garner|first=David M.|last2=Garfinkel|first2=Paul E.|date=1979-05|title=The Eating Attitudes Test: an index of the symptoms of anorexia nervosa|url=http://dx.doi.org/10.1017/s0033291700030762|journal=Psychological Medicine|volume=9|issue=2|pages=273–279|doi=10.1017/s0033291700030762|issn=0033-2917}}</ref> Child Eating Attitudes Test - 26 (ChEAT-26; child version)<ref>{{Cite journal|last=Almeida|first=M.C.|last2=Carvalho|first2=D.L.D.B.|last3=Rigolino|first3=R.|date=2012-07|title=Reliability of a Brazilian version of children's eating attitude test|url=http://dx.doi.org/10.1016/j.neurenf.2012.04.196|journal=Neuropsychiatrie de l'Enfance et de l'Adolescence|volume=60|issue=5|pages=S158|doi=10.1016/j.neurenf.2012.04.196|issn=0222-9617}}</ref> |Questionnaire (Patient) |13+ (adult version) 8 -13 (child version) |5-10 min |PDFs * [https://www.eat-26.com/eat-26/ Adult Version PDF] * [http://www.1000livesplus.wales.nhs.uk/sitesplus/documents/1011/ChEAT.pdf Child Version PDF] |} '''Note:''' Reliability and validity are included in the extended version. This table includes measures with Good or Excellent ratings. ===Likelihood ratios and AUCs of screening instruments for anorexia nervosa=== * ''For a list of the likelihood ratios for more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Likelihood_ratios_and_AUCs_of_common_screening_instruments '''click here.''']'' {| class="wikitable sortable" border="1" |- ! <ref name=":4">{{Cite journal|last=Mintz|first=L. B.|last2=O'Halloran|first2=M. S.|date=June 2000|title=The Eating Attitudes Test: validation with DSM-IV eating disorder criteria|url=https://www.ncbi.nlm.nih.gov/pubmed/10900574|journal=Journal of Personality Assessment|volume=74|issue=3|pages=489–503|doi=10.1207/S15327752JPA7403_11|issn=0022-3891|pmid=10900574}}</ref>Screening Measure (Primary Reference) ! AUC ! DiLR+ (Score) ! DiLR- (Score) !Clinical Generalizability !Where to access |- |Serum leptin level<ref name=":7">{{Cite journal|last=Föcker|first=M.|last2=Timmesfeld|first2=N.|last3=Scherag|first3=S.|last4=Bühren|first4=K.|last5=Langkamp|first5=M.|last6=Dempfle|first6=A.|last7=Sheridan|first7=E. M.|last8=Zwaan|first8=M. de|last9=Fleischhaker|first9=C.|date=2011-04-01|title=Screening for anorexia nervosa via measurement of serum leptin levels|url=https://link.springer.com/article/10.1007/s00702-010-0551-z|journal=Journal of Neural Transmission|language=en|volume=118|issue=4|pages=571–578|doi=10.1007/s00702-010-0551-z|issn=0300-9564}}</ref> |0.984 (N=139) |14.72 (<2.31) |0.10 (2.31+) |Adolescent and adult patients in the acute phase of AN according to the DSM-IV and no AN pretreatment versus healthy lean female volunteer university students. |None |- |Body Mass Index (BMI)<ref name=":7" /> |0.936 (N=139) |5.89 (<17.10) |0.11 (17.10+) |Adolescent and adult patients in the acute phase of AN according to the DSM-IV and no AN pretreatment versus healthy lean female volunteer university students. |None |- |EAT-26&nbsp;<ref name=":4" /><ref>{{Cite journal|title = The eating attitudes test: psychometric features and clinical correlates|url = http://www.ncbi.nlm.nih.gov/pubmed/6961471|journal = Psychological Medicine|date = 1982-11-01|issn = 0033-2917|pmid = 6961471|pages = 871–878|volume = 12|issue = 4|first = D. M.|last = Garner|first2 = M. P.|last2 = Olmsted|first3 = Y.|last3 = Bohr|first4 = P. E.|last4 = Garfinkel}}</ref> |.90 (N=129) |12.83 (20+) |.24 (<20) |Low-moderate: College women with no eating disorder versus college women with a DSM-IV eating disorder. Eating disorders were not separated. |PDFs * [https://www.eat-26.com/eat-26/ Adult Version PDF] * [http://www.1000livesplus.wales.nhs.uk/sitesplus/documents/1011/ChEAT.pdf Child Version PDF] |- |EDE-Q&nbsp;<ref name=":1">{{Cite journal|title = Assessment of eating disorders: interview or self-report questionnaire?|url = http://www.ncbi.nlm.nih.gov/pubmed/7866415|journal = The International Journal of Eating Disorders|date = 1994-12-01|issn = 0276-3478|pmid = 7866415|pages = 363–370|volume = 16|issue = 4|first = C. G.|last = Fairburn|first2 = S. J.|last2 = Beglin}}</ref> |.96 &nbsp;<ref name=":1" />(N=1170) | 6.57 (2.3+)<ref name=":5">{{Cite journal|last=Fairburn|first=C. G.|last2=Beglin|first2=S. J.|date=December 1994|title=Assessment of eating disorders: interview or self-report questionnaire?|url=https://www.ncbi.nlm.nih.gov/pubmed/7866415|journal=The International Journal of Eating Disorders|volume=16|issue=4|pages=363–370|issn=0276-3478|pmid=7866415}}</ref> | 0.09 (<2.3)<ref name=":5" /> |Moderate: Dutch treatment-seeking females meeting DSM-IV criteria for an eating disorder versus female adult general population sample recruited through advertisements and personal contacts. Eating disorders were not separated.&nbsp;<ref name=":1" /> Moderate: “Clinically significant eating disorder” from a community sample versus female adults individuals without “clinically significant eating disorder” from same sample. Eating disorders were not separated.<ref name=":5" /> |[http://www.corc.uk.net/media/1273/ede-q_quesionnaire.pdf PDF] |} === Interpreting anorexia nervosa screening measure scores === * For information on interpreting screening measure scores, click [[Evidence based assessment/Prediction phase#Interpreting screening measure scores|here.]] * Also see the page on [https://en.wikipedia.org/wiki/Likelihood_ratios_in_diagnostic_testing likelihood ratios in diagnostic testing] for more information. ==[[Evidence based assessment/Prescription phase|'''Prescription phase''']]== ===Gold standard diagnostic interviews=== * For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews click here.] ===Recommended diagnostic interviews for anorexia nervosa=== {| class="wikitable sortable" border="1" ! colspan="5" |Diagnostic instruments for anorexia nervosa |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time !Where to access |- |[https://www.credo-oxford.com/7.2.html Eating Disorder Examination (EDE)] <ref>{{Cite book|url=https://www.worldcat.org/oclc/1160972551|title=Assessment of disorders in childhood and adolescence|date=2020|others=Eric Arden Youngstrom, Mitchell J. Prinstein, Eric J. Mash, Russell A. Barkley|isbn=978-1-4625-4365-6|edition=Fifth edition|location=New York|oclc=1160972551}}</ref> <ref>{{Cite book|url=https://www.worldcat.org/oclc/314222270|title=A guide to assessments that work|date=2008|publisher=Oxford University Press|others=John Hunsley, Eric J. Mash|isbn=0-19-804245-0|location=New York|oclc=314222270}}</ref> |Semistructured (child and adult) |8-16 (child version) 16+ (adult version) |45-75 minutes |PDFs * [https://www.phenxtoolkit.org/protocols/view/230101 Child version PDF] * [https://www.credo-oxford.com/7.2.html Adult version PDF] |- |Structured Clinical Interview for DSM-5-Clinician Version (SCID-5-CV)<ref>{{Cite journal|last=Shabani|first=Amir|last2=Masoumian|first2=Samira|last3=Zamirinejad|first3=Somayeh|last4=Hejri|first4=Maryam|last5=Pirmorad|first5=Tahereh|last6=Yaghmaeezadeh|first6=Hooman|date=2021-05|title=Psychometric properties of Structured Clinical Interview for DSM‐5 Disorders‐Clinician Version (SCID‐5‐CV)|url=https://onlinelibrary.wiley.com/doi/10.1002/brb3.1894|journal=Brain and Behavior|language=en|volume=11|issue=5|doi=10.1002/brb3.1894|issn=2162-3279|pmc=PMC8119811|pmid=33729681}}</ref> |Structured Interview (Adult ) |16+ |Varies |[https://www.columbiapsychiatry.org/research/research-labs/diagnostic-and-assessment-lab/structured-clinical-interview-dsm-disorders-11 Website to purchase] |- | [https://dawba.info/a0.html Development and Well-Being Assessment (DAWBA)] <ref>{{Cite book|url=https://www.worldcat.org/oclc/1160972551|title=Assessment of disorders in childhood and adolescence|date=2020|others=Eric Arden Youngstrom, Mitchell J. Prinstein, Eric J. Mash, Russell A. Barkley|isbn=978-1-4625-4365-6|edition=Fifth edition|location=New York|oclc=1160972551}}</ref> | Structured (child/adolescent and parent) | 11-18 |10-20 minutes for the eating disorder module |[https://osf.io/zpbna/?view_only=245bef061d284c17ab9dedad5a59e1b8 English PDF] [https://dawba.info/py/dawbainfo/b1.py Additional languages] |} '''Note:''' Reliability and validity are included in the extended version. This table includes measures with Good or Excellent ratings. ==[[Evidence based assessment/Process phase|'''Process phase''']]== The following section contains a brief overview of treatment options for anorexia nervosa and a list of process and outcome measures for anorexia nervosa. The section includes benchmarks based on published norms for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the [[Evidence based assessment/Process phase|process phase]] of assessment. For more information on the differences between process and outcome measures, see the page on the [[Evidence based assessment/Process phase|process phase of assessment]]. ===Process measures=== Body weight is commonly monitored by clinicians throughout the AN treatment process as helping individuals regain and maintain a healthy weight is a primary treatment goal for AN. Many treatment centers have policies prohibiting patients from seeing their weight. Motivational Stages of Change may be used to monitor individuals’ readiness to take action against eating disorder behaviors. It has demonstrated predictive validity in a sample of female adolescents attending eating disorder treatment groups.<ref>{{Cite journal|last=Gusella|first=Joanne|last2=Butler|first2=Gordon|last3=Nichols|first3=Laura|last4=Bird|first4=Debbie|date=2003-01-01|title=A brief questionnaire to assess readiness to change in adolescents with eating disorders: its applications to group therapy|url=http://onlinelibrary.wiley.com/doi/10.1002/erv.481/abstract|journal=European Eating Disorders Review|language=en|volume=11|issue=1|pages=58–71|doi=10.1002/erv.481|issn=1099-0968}}</ref> See Appendix E. === Outcome and severity measures === This table includes clinically significant benchmarks for anorexia nervosa specific outcome measures * Information on how to interpret this table can be [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase found here]. * Additionally, these [[Evidence based assessment/Vignettes|vignettes]] might be helpful resources for understanding appropriate adaptation of outcome measures in practice. *''<u>For clinically significant change benchmarks for the CBCL, YSR, and TRF total, externalizing, internalizing, and attention benchmarks,</u>'' [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase&wteswitched=1#Clinically_significant_change_benchmarks_for_widely-used_outcome_measures see here.] {| class="wikitable sortable" border="1" | colspan="8" |'''Clinically significant change benchmarks with common instruments for anorexia nervosa''' |- | colspan="8" span style="font-size:110%; text-align:center;" | <b> Benchmarks Based on Published Norms</b> |- | rowspan="2" style="text-align:center;font-size:130%;" |<b> Measure</b> | rowspan="2" style="text-align:center;font-size:130%;" | <b> Subscale</b> | colspan="3" style="text-align:center;font-size:130%" width="300" | <b> Cut-off scores</b> | colspan="3" style="text-align:center;font-size:120%" | <b> Critical Change <br> (unstandardized scores)</b> |- | style="text-align:center;font-size:110%" |<b> A</b> | style="text-align:center;font-size:110%" |<b> B</b> | style="text-align:center;font-size:110%" |<b> C</b> | style="text-align:center;font-size:110%" |<b> 95%</b> | style="text-align:center;font-size:110%" |<b> 90%</b> | style="text-align:center;font-size:110%" |<b> SE_difference</b> |- | rowspan="5" style="text-align:center;" |'''EDE-Q <ref name=":2">{{Cite journal|last=Mond|first=J. M.|last2=Hay|first2=P. J.|last3=Rodgers|first3=B.|last4=Owen|first4=C.|last5=Beumont|first5=P. J. V.|date=May 2004|title=Validity of the Eating Disorder Examination Questionnaire (EDE-Q) in screening for eating disorders in community samples|url=https://www.ncbi.nlm.nih.gov/pubmed/15033501|journal=Behaviour Research and Therapy|volume=42|issue=5|pages=551–567|doi=10.1016/S0005-7967(03)00161-X|issn=0005-7967|pmid=15033501}}</ref>''' | style="text-align:right;" |''Global'' |1.4 |3.2 |2.3 |.7 |.6 |.3 |- | style="text-align:right;" |''Restraint'' |(-.3) |3.6 |1.8 |1.5 |1.2 |.8 |- | style="text-align:right;" |''Eating Concern'' |.1 |2.0 |1.2 |1.1 |.9 |.6 |- | style="text-align:right;" |''Weight Concern'' |1.5 |3.9 |2.6 |1.0 |.9 |.5 |- | style="text-align:right;" |''Shape Concern'' |2.1 |4.8 |3.2 |.9 |.7 |.4 |- | rowspan="5" style="text-align:center;" |'''EDE <ref name=":2" />''' | style="text-align:right;" |''Global'' |1.7 |2.3 |1.9 |1.9 |1.6 |1.0 |- | style="text-align:right;" |''Restraint'' |.3 |3.3 |1.9 |1.8 |1.5 |.9 |- | style="text-align:right;" |''Eating Concern'' |(-.5) |.9 |.5 |.8 |.7 |.4 |- | style="text-align:right;" |''Weight Concern'' |2.0 |2.8 |2.4 |1.3 |1.1 |.7 |- | style="text-align:right;" |''Shape Concern'' |2.0 |3.2 |2.6 |1.2 |1.0 |.6 |- | rowspan="1" style="text-align:center;" |'''EAT-26 <ref name=":0">{{Cite journal|last=Mintz|first=L. B.|last2=O'Halloran|first2=M. S.|date=2000-06-01|title=The Eating Attitudes Test: validation with DSM-IV eating disorder criteria|url=http://www.ncbi.nlm.nih.gov/pubmed/10900574|journal=Journal of Personality Assessment|volume=74|issue=3|pages=489–503|doi=10.1207/S15327752JPA7403_11|issn=0022-3891|pmid=10900574}}</ref>''' | style="text-align:right;" |''Total'' |6.5 |19.6 |15.0 |7.9 |6.7 |4.0 |} '''Note:''' “A” = Away from the clinical range, “B” = Back into the nonclinical range, “C” = Closer to the nonclinical than clinical mean. '''Search terms:''' [Anorexia Nervosa OR eating disorder] AND [validity OR clinical significance] in Google Scholar === Treatment === {{collapse top| More information on treatment for AN|expand=yes}} * Treatment of AN typically consists of restoring the individual to a healthy weight and addressing thoughts and behaviors which are related to the eating disorder. It may involve re-nutrition, psychotherapy, nutritional counseling, and medication. * Literature reviews of existing research indicate that evidence supporting AN treatment is lacking. A systematic review of AN treatment efficacy studies by Bulik<ref>{{Cite journal|title = Anorexia nervosa treatment: a systematic review of randomized controlled trials|url = http://www.ncbi.nlm.nih.gov/pubmed/17370290|journal = The International Journal of Eating Disorders|date = 2007-05-01|issn = 0276-3478|pmid = 17370290|pages = 310–320|volume = 40|issue = 4|doi = 10.1002/eat.20367|first = Cynthia M.|last = Bulik|first2 = Nancy D.|last2 = Berkman|first3 = Kimberly A.|last3 = Brownley|first4 = Jan A.|last4 = Sedway|first5 = Kathleen N.|last5 = Lohr}}</ref> found that evidence supporting medications, medications and behavioral interventions, and behavioral interventions alone in adults is weak. * There is moderately strong evidence suggesting that behavioral interventions may be helpful for adolescents. In particular, adolescents may benefit from family therapy. * Clinical trials investigating AN treatment suffer from high rates of attrition, as key features of AN (e.g., denial, fear of weight gain) may contribute to low motivation for remaining in treatment. * More severe cases of AN may be treated in inpatient settings, which are equipped to manage the re-nutrition process and provide medical monitoring. * Partial hospitalization and intensive outpatient programs may provide intermediate levels of treatment intensity to assist individuals in the transition from intensive care to outpatient care after weight restoration. {{collapse bottom}} * Please refer to the page on [https://en.wikipedia.org/wiki/Anorexia_nervosa anorexia nervosa] for more information on available treatment or go to [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/eating-body-image-problems/ the Effective Child Therapy page for Eating & Body Image Problems] for a curated resource on effective treatments for anorexia nervosa. == '''External resources''' == # [http://apps.who.int/classifications/icd10/browse/2010/en#/F50.0 ICD-10 diagnostic criteria] # [https://en.wikiversity.org/w/index.php?title=Helping_Give_Away_Psychological_Science/Resources/Annotated_List_of_Where_and_How_to_Find_a_Therapist&wteswitched=1#Other_low-cost_options Find-a-Therapist] ##This is a curated list of find-a-therapist websites where you can find a provider # NIMH: [https://www.nimh.nih.gov/health/publications/eating-disorders/index.shtml ''Eating Disorders--About More Than Food''] and [https://www.nimh.nih.gov/health/topics/eating-disorders/index.shtml ''Eating Disorders''] ##These NIMH website posts provide more information on anorexia nervosa #[https://www.hopkinsmedicine.org/psychiatry/specialty_areas/eating_disorders/ John's Hopkins Resource] (guide about anorexia nervosa, treatment, and more) # OMIM (Online Mendelian Inheritance in Man) ##[https://www.omim.org/entry/606788?search=anorexia%20nervosa&highlight=nervosa%20anorexia Anorexia nervosa] #[http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/eating-body-image-problems/ Effective Child Therapy page for anorexia nervosa] ##Effective Child Therapy is website sponsored by Division 53 of the American Psychological Association (APA), or The [https://sccap53.org Society of Clinical Child and Adolescent Psychology] (SCCAP), in collaboration with the Association for Behavioral and Cognitive Therapies (ABCT). Use for information on symptoms and available treatments. == '''References''' == {{collapse top|References|expand=yes}} {{Reflist|30em}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] {{collapse bottom}} gfnw7q0cgw8oklgrtucc81drh8h6g4u 2419295 2419294 2022-08-26T05:20:48Z Ardenguo 2944162 /* Prediction phase */ linked extended page to "Note: Reliability and validity are included in the extended version. This table includes measures with Good or Excellent ratings." wikitext text/x-wiki <noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{medical disclaimer}} {{:{{BASEPAGENAME}}/Sidebar}} ==[[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio"?''']]== For background information on what assessment portfolios are, click the link in the heading above. Want even 'more' information about this topic? There's an extended version of this page [[Evidence-based assessment/Anorexia nervosa (assessment portfolio)/extended version|here]]. == [[Evidence based assessment/Preparation phase|'''Preparation phase''']] == === Diagnostic criteria for anorexia nervosa === {{blockquotetop}} '''ICD-11 Criteria''' Anorexia Nervosa is characterized by significantly low body weight, which is less than minimal normal/expected weight for the individual’s height, sex, age and developmental stage (body mass index (BMI) less than 18.5 kg/m2 in adults and BMI-for-age under fifth percentile in children and adolescents) that is not due to another health condition or to the unavailability of food. Low body weight is accompanied by a persistent pattern of behaviors to prevent restoration of normal weight, which may include behaviors aimed at reducing energy intake (restricted eating), purging behaviors (e.g., self-induced vomiting, misuse of laxatives), and behaviors aimed at increasing energy expenditure (e.g., excessive exercise), typically associated with a fear of weight gain. Low body weight or shape is central to the person's self-evaluation or is inaccurately perceived to be normal or even excessive. '''Changes in DSM-5''' * The diagnostic criteria for anorexia nervosa changed slightly from [[DSM-IV]] to [[w:Diagnostic_and_Statistical_Manual_of_Mental_Disorders#DSM-IV-TR_.282000.29|DSM-5]]. Summaries are available [http://www.dsm5.org/Documents/changes%20from%20dsm-iv-tr%20to%20dsm-5.pdf here] and [[w:DSM-5|here]]. {{blockquotebottom}} === Base rates of anorexia nervosa in different populations and clinical settings === This section describes the demographic setting of the population(s) sampled, base rates of diagnosis such as prevalence rates, country/region sampled, and the diagnostic method that was used. Using this information, clinicians will be able to anchor the rate of adolescent depression that they are likely to see in their clinical practice. * '''''To see prevalence rates across multiple disorders,''''' [[Evidence based assessment/Preparation phase#Base rates for transdiagnostic comparison|'''''click here.''''']] {| class="wikitable sortable" |- ! Demography ! Setting (Reference) ! Base Rate ! Diagnostic Method |- |Nationally representative US sample of adults |Non-clinical: Population-based (NCS-R)<ref>Hudson, James I.; Hiripi, Eva; Pope, Harrison G.; Kessler, Ronald C. (2007-02-01). "The prevalence and correlates of eating disorders in the National Comorbidity Survey Replication".''Biological Psychiatry'' '''61''' (3): 348–358. doi:10.1016/j.biopsych.2006.03.040. ISSN 0006-3223. PMC 1892232. <nowiki>PMID 16815322</nowiki></ref> |.9% Female, .3% Male |World Health Organization-Clinical International Diagnostic Interview (WHO-CIDI) |- |Nationally representative US sample of adolescents |Non-clinical: Population-based (NCS-A)<ref>Swanson, Sonja A.; Crow, Scott J.; Le Grange, Daniel; Swendsen, Joel; Merikangas, Kathleen R. (2011-07-01). "Prevalence and correlates of eating disorders in adolescents. Results from the national comorbidity survey replication adolescent supplement". ''Archives of General Psychiatry'' '''68''' (7): 714–723. doi:10.1001/archgenpsychiatry.2011.22. ISSN 1538-3636.<nowiki>PMID 21383252</nowiki></ref> |.3% Female, .3% Male |WHO-CIDI |- |Nationally representative US sample of 9- and 10-year old children |Non-clinical: US Population-based prevalence (Adolescent Brain Cognitive Development (ABCD) study<ref>{{Cite journal|last=Rozzell|first=Kaitlin|last2=Moon|first2=Da Yeoun|last3=Klimek|first3=Patrycja|last4=Brown|first4=Tiffany|last5=Blashill|first5=Aaron J.|date=2019-01-01|title=Prevalence of Eating Disorders Among US Children Aged 9 to 10 Years: Data From the Adolescent Brain Cognitive Development (ABCD) Study|url=http://archpedi.jamanetwork.com/article.aspx?doi=10.1001/jamapediatrics.2018.3678|journal=JAMA Pediatrics|language=en|volume=173|issue=1|pages=100|doi=10.1001/jamapediatrics.2018.3678|issn=2168-6203|pmc=PMC6583451|pmid=30476983}}</ref> |0.1%, no gender differences |DSM-5 using Kiddie Schedule for Affective Disorders and Schizophrenia (KSADS) |- |Latino Households in the US |Non-clinical: Latinos in US<ref>Alegria, Margarita; Woo, Meghan; Cao, Zhun; Torres, Maria; Meng, Xiao-li; Striegel-Moore, Ruth (2007-11-01). "Prevalence and correlates of eating disorders in Latinos in the United States".''The International Journal of Eating Disorders''. 40 Suppl: S15–21. doi:10.1002/eat.20406. ISSN 0276-3478. PMC 2680162. <nowiki>PMID 17584870</nowiki></ref> |.12% Female, .03% Male |WHO-CIDI |- |National probability sample of adult and adolescent African Americans and Caribbean Black people |Non-clinical: African Americans and Caribbean Black people in the US (NSAL)<ref>Taylor, Jacquelyn Y.; Caldwell, Cleopatra Howard; Baser, Raymond E.; Faison, Nakesha; Jackson, James S. (2007-11-01). "Prevalence of eating disorders among Blacks in the National Survey of American Life". ''The International Journal of Eating Disorders''. 40 Suppl: S10–14. doi:10.1002/eat.20451. ISSN 0276-3478. PMC 2882704. <nowiki>PMID 17879287</nowiki></ref> |.14% Female, .2% Male |WHO-CIDI |- |Asian American adults in US households |Non-clinical: National Latino and Asian American Study (NLAAS) |.12% Female, .05% Male |WHO-CIDI |- | US African American college females | Non-clinical; college students<ref>Tyler ID. A true picture of eating disorders among African American women: a review of literature. ABNF J. 2003;14(3):73-4.</ref> || .0% || Eating Disorder Diagnostic Questionnaire (EDD-Q) |- | US Female Adolescents | Non-clinical; Adolescents<ref>Stice, E., Becker, C. B., & Yokum, S. (2013). Eating disorder prevention: Current evidence-base and future directions. ''Int. J. Eat. Disord. International Journal of Eating Disorders,'' ''46''(5), 478-485.</ref> || .8% || Eating Disorder Diagnosis Interview (EDDI) |- | US Division-I Varsity Student Athletes | Non-clinical; student-athletes<ref>Johnson C, Powers PS, Dick R. Athletes and eating disorders: the national collegiate athletic association study. Int J Eat Disord 1999;26:179e88.</ref> || .0% || Eating Disorder Inventory-2 (EDI-2) |- | Active duty females in US Army, Navy, Airforce, and Marines | Non-clinical; Military<ref>McNulty, PAF. (2001). Prevalence and contributing factors of eating disorder behaviors in active duty service women in the Army, Navy, Air Force and Marines. Military Medicine, 166(1), 53-58. </ref> || 1.1% || EDI-2 |- |US Caucasian female same-sex twins |Non-clinical; Commonwealth of Virginia Mid-Atlantic Twin Registry (MATR)<ref>Kendler KS, Walters EE, Neale MC, Kessler R, Heath A, Eaves L. The structure of genetic and environmental risk factors for six major psychiatric disorders in women. Archives of general psychiatry. 1995;52:374–383.</ref> |1.62% (narrow), 3.70% (broad) |Structured Clinical Interview for DSM Disorders (SCID) |- |South Australian older adolescents and adults |Non-clinical; Health Omnibus Survey (HOS) |.46% (3 months; combined) |Eating Disorder Examination (EDE) |- |US Military |Military<ref>{{Cite journal|title=Diagnosed eating disorders in the U.S. Military: a nine year review|url=http://www.ncbi.nlm.nih.gov/pubmed/18821361|journal=Eating Disorders|date=2008-12-01|issn=1532-530X|pmid=18821361|pages=363–377|volume=16|issue=5|doi=10.1080/10640260802370523|first=Amanda J.|last=Antczak|first2=Teresa L.|last2=Brininger}}</ref> |.04% (combined) |ICD codes from electronic records |- |US Military Academy cadets |Non-clinical; Military |.02% (7 years) Female, 0.0% (7 years) Males |[https://www.eat-26.com/ Eating Attitudes Test- 26 items] (EAT-26)<ref>{{Cite web|url=https://www.eat-26.com/|title=EAT-26: Eating Attitudes Test & Eating Disorder Testing – Use the EAT-26 to help you determine if you need to speak to a mental health professional to get help for an eating disorder.|last=admin|language=en|access-date=2022-05-30}}</ref> |- |US Navy female nurses |Non-clinical; Military |1.1% (current & past) Female |DSM-III |- |US veterans |Non-clinical; Military |.04% Female, .005% Males |ICD-9-CM |- |Active duty males in US Navy |Non-clinical; Military |2.5% Males |N/A |- |US alcohol-dependent adults from San Diego, St. Lois, Iowa City, Farmington, New York, & Indianapolis |Clinical; Collaborative Study on the Genetics of Alcoholism (COGA)<ref>{{Cite journal|title=Anorexia nervosa and bulimia nervosa in alcohol-dependent men and women and their relatives|url=http://www.ncbi.nlm.nih.gov/pubmed/8540597|journal=The American Journal of Psychiatry|date=1996-01-01|issn=0002-953X|pmid=8540597|pages=74–82|volume=153|issue=1|doi=10.1176/ajp.153.1.74|first=M. A.|last=Schuckit|first2=J. E.|last2=Tipp|first3=R. M.|last3=Anthenelli|first4=K. K.|last4=Bucholz|first5=V. M.|last5=Hesselbrock|first6=J. I.|last6=Nurnberger}}</ref> |1.41% (lifetime) Female, .00% (lifetime) Male |SSAGA |- |Healthcare provider records |Non-clinical; healthcare members |.0269% (current) | |- |US high school students in west central Oregon |Non-clinical; high school students |. 00% (point), .45% (lifetime) Female .00% (point), .00% (lifetime) Males |DSM-III-R₄ |- |Canadian treatment-seeking substance users |Clinical; substance users |.4% (lifetime), .3% (current) Female .4% (lifetime), .3% (current) Males |DIS₉ |- | | colspan="3" style="font-size:110%; text-align:center;" |'''Europe''' |- |Adolescent females residing in Navarra, Spain |Non-clinical; adolescents |.3% Female |EAT-40₃ |- |Adolescents in secondary schools in Sør-Trøndelag, County in Norway |Non-clinical; adolescents |.7% (lifetime) Female, .2% Male |SEDs₁₀ |- |Adolescents in a comprehensive school in Ostrobothnia district in Finland |Non-clinical; adolescents |.7% (point; age 15), 1.8% (lifetime, age 15), .00% (point, age 18), 2.6% (lifetime, age 18), .9% (3 years) Female .00% (point & lifetime) Males |RAB-T₁₁&nbsp;& RAB-R₁₂ |- | | colspan="3" style="font-size:110%; text-align:center;" |'''Australia''' |- |Adolescent females residing in Victoria, Australia |Non-clinical; adolescents |.00% (full), 1.8% (partial) Female |BET₁₃ |- | | colspan="3" style="font-size:110%; text-align:center;" |'''Central & South America''' |- |Mexican first & second year college females |Non-clinical; college students |.00% Female |EAT-40₃ |- | | colspan="3" style="font-size:110%; text-align:center;" |'''East Asia''' |- |Adolescent and adult Japanese patients at a university hospital |Clinical; eating disorder patients |.53% Female |DSM-III-R₄ |- |Korean adults |Non-clinical; Korean Epidemiologic Catchment Area (KECA) Study |.1% (lifetime), .1% (12 months) Female .2% (lifetime), .00% (12 months) Males |K-CIDI₁₅&nbsp;2.1 |- |Alcohol-dependent adults |Centers participating in the Collaborative Study on the Genetics of Alcoholism in San Diego; St. Louis; Iowa City; Farmington, CN; New York; & Indianapolis |1.41% Females |Semi-Structured Assessment for the Genetics of Alcoholism; criteria based on DSM-III-R |} ==[[Evidence based assessment/Prediction phase|'''Prediction phase''']]== === Psychometric properties of screening instruments for anorexia nervosa === The following section contains a list of screening and diagnostic instruments for anorexia nervosa. The section includes administration information, psychometric data, and PDFs or links to the screenings. * Screenings are used as part of the [[Evidence based assessment/Prediction phase|prediction phase]] of assessment; for more information on interpretation of this data, or how screenings fit in to the assessment process, click [[Evidence based assessment/Prediction phase|here.]] * ''For a list of more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Psychometric_properties_of_common_screening_instruments '''click here.''']'' {| class="wikitable" |- ! Measure !Format (Reporter) !Age Range !Administration/ Completion Time !Where to Access |- |[[wikipedia:Eating_Disorder_Examination_Interview|Eating Disorder Examination Questionnaire (EDE-Q)]]<ref>{{Cite journal|last=Cooper|first=Zafra|last2=Fairburn|first2=Christopher|date=1987-01|title=The eating disorder examination: A semi-structured interview for the assessment of the specific psychopathology of eating disorders|url=http://dx.doi.org/10.1002/1098-108x(198701)6:1<1::aid-eat2260060102>3.0.co;2-9|journal=International Journal of Eating Disorders|volume=6|issue=1|pages=1–8|doi=10.1002/1098-108x(198701)6:1<1::aid-eat2260060102>3.0.co;2-9|issn=0276-3478}}</ref> |Questionnaire (Patient) |14+ |15-20 min | [http://www.corc.uk.net/media/1273/ede-q_quesionnaire.pdf PDF] |- |[[wikipedia:Eating_Disorder_Diagnostic_Scale|EDDS (Eating Disorder Diagnosis Scale)]]<ref>{{Cite journal|last=Stice|first=Eric|last2=Telch|first2=Christy F.|last3=Rizvi|first3=Shireen L.|date=2000|title=Development and validation of the Eating Disorder Diagnostic Scale: A brief self-report measure of anorexia, bulimia, and binge-eating disorder.|url=http://doi.apa.org/getdoi.cfm?doi=10.1037/1040-3590.12.2.123|journal=Psychological Assessment|language=en|volume=12|issue=2|pages=123–131|doi=10.1037/1040-3590.12.2.123|issn=1939-134X}}</ref> |Questionnaire (Patient) |13 - 65 |10-15 min | [http://www.ori.org/files/Static%20Page%20Files/EDDSDSM-5_10_14.pdf PDF] |- |Eating Attitudes Test- 26(EAT-26; Adult version)<ref>{{Cite journal|last=Garner|first=David M.|last2=Garfinkel|first2=Paul E.|date=1979-05|title=The Eating Attitudes Test: an index of the symptoms of anorexia nervosa|url=http://dx.doi.org/10.1017/s0033291700030762|journal=Psychological Medicine|volume=9|issue=2|pages=273–279|doi=10.1017/s0033291700030762|issn=0033-2917}}</ref> Child Eating Attitudes Test - 26 (ChEAT-26; child version)<ref>{{Cite journal|last=Almeida|first=M.C.|last2=Carvalho|first2=D.L.D.B.|last3=Rigolino|first3=R.|date=2012-07|title=Reliability of a Brazilian version of children's eating attitude test|url=http://dx.doi.org/10.1016/j.neurenf.2012.04.196|journal=Neuropsychiatrie de l'Enfance et de l'Adolescence|volume=60|issue=5|pages=S158|doi=10.1016/j.neurenf.2012.04.196|issn=0222-9617}}</ref> |Questionnaire (Patient) |13+ (adult version) 8 -13 (child version) |5-10 min |PDFs * [https://www.eat-26.com/eat-26/ Adult Version PDF] * [http://www.1000livesplus.wales.nhs.uk/sitesplus/documents/1011/ChEAT.pdf Child Version PDF] |} '''Note:''' Reliability and validity are included in the [[Evidence-based assessment/Anorexia nervosa (assessment portfolio)/extended version|extended version]]. This table includes measures with Good or Excellent ratings. ===Likelihood ratios and AUCs of screening instruments for anorexia nervosa=== * ''For a list of the likelihood ratios for more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Likelihood_ratios_and_AUCs_of_common_screening_instruments '''click here.''']'' {| class="wikitable sortable" border="1" |- ! <ref name=":4">{{Cite journal|last=Mintz|first=L. B.|last2=O'Halloran|first2=M. S.|date=June 2000|title=The Eating Attitudes Test: validation with DSM-IV eating disorder criteria|url=https://www.ncbi.nlm.nih.gov/pubmed/10900574|journal=Journal of Personality Assessment|volume=74|issue=3|pages=489–503|doi=10.1207/S15327752JPA7403_11|issn=0022-3891|pmid=10900574}}</ref>Screening Measure (Primary Reference) ! AUC ! DiLR+ (Score) ! DiLR- (Score) !Clinical Generalizability !Where to access |- |Serum leptin level<ref name=":7">{{Cite journal|last=Föcker|first=M.|last2=Timmesfeld|first2=N.|last3=Scherag|first3=S.|last4=Bühren|first4=K.|last5=Langkamp|first5=M.|last6=Dempfle|first6=A.|last7=Sheridan|first7=E. M.|last8=Zwaan|first8=M. de|last9=Fleischhaker|first9=C.|date=2011-04-01|title=Screening for anorexia nervosa via measurement of serum leptin levels|url=https://link.springer.com/article/10.1007/s00702-010-0551-z|journal=Journal of Neural Transmission|language=en|volume=118|issue=4|pages=571–578|doi=10.1007/s00702-010-0551-z|issn=0300-9564}}</ref> |0.984 (N=139) |14.72 (<2.31) |0.10 (2.31+) |Adolescent and adult patients in the acute phase of AN according to the DSM-IV and no AN pretreatment versus healthy lean female volunteer university students. |None |- |Body Mass Index (BMI)<ref name=":7" /> |0.936 (N=139) |5.89 (<17.10) |0.11 (17.10+) |Adolescent and adult patients in the acute phase of AN according to the DSM-IV and no AN pretreatment versus healthy lean female volunteer university students. |None |- |EAT-26&nbsp;<ref name=":4" /><ref>{{Cite journal|title = The eating attitudes test: psychometric features and clinical correlates|url = http://www.ncbi.nlm.nih.gov/pubmed/6961471|journal = Psychological Medicine|date = 1982-11-01|issn = 0033-2917|pmid = 6961471|pages = 871–878|volume = 12|issue = 4|first = D. M.|last = Garner|first2 = M. P.|last2 = Olmsted|first3 = Y.|last3 = Bohr|first4 = P. E.|last4 = Garfinkel}}</ref> |.90 (N=129) |12.83 (20+) |.24 (<20) |Low-moderate: College women with no eating disorder versus college women with a DSM-IV eating disorder. Eating disorders were not separated. |PDFs * [https://www.eat-26.com/eat-26/ Adult Version PDF] * [http://www.1000livesplus.wales.nhs.uk/sitesplus/documents/1011/ChEAT.pdf Child Version PDF] |- |EDE-Q&nbsp;<ref name=":1">{{Cite journal|title = Assessment of eating disorders: interview or self-report questionnaire?|url = http://www.ncbi.nlm.nih.gov/pubmed/7866415|journal = The International Journal of Eating Disorders|date = 1994-12-01|issn = 0276-3478|pmid = 7866415|pages = 363–370|volume = 16|issue = 4|first = C. G.|last = Fairburn|first2 = S. J.|last2 = Beglin}}</ref> |.96 &nbsp;<ref name=":1" />(N=1170) | 6.57 (2.3+)<ref name=":5">{{Cite journal|last=Fairburn|first=C. G.|last2=Beglin|first2=S. J.|date=December 1994|title=Assessment of eating disorders: interview or self-report questionnaire?|url=https://www.ncbi.nlm.nih.gov/pubmed/7866415|journal=The International Journal of Eating Disorders|volume=16|issue=4|pages=363–370|issn=0276-3478|pmid=7866415}}</ref> | 0.09 (<2.3)<ref name=":5" /> |Moderate: Dutch treatment-seeking females meeting DSM-IV criteria for an eating disorder versus female adult general population sample recruited through advertisements and personal contacts. Eating disorders were not separated.&nbsp;<ref name=":1" /> Moderate: “Clinically significant eating disorder” from a community sample versus female adults individuals without “clinically significant eating disorder” from same sample. Eating disorders were not separated.<ref name=":5" /> |[http://www.corc.uk.net/media/1273/ede-q_quesionnaire.pdf PDF] |} === Interpreting anorexia nervosa screening measure scores === * For information on interpreting screening measure scores, click [[Evidence based assessment/Prediction phase#Interpreting screening measure scores|here.]] * Also see the page on [https://en.wikipedia.org/wiki/Likelihood_ratios_in_diagnostic_testing likelihood ratios in diagnostic testing] for more information. ==[[Evidence based assessment/Prescription phase|'''Prescription phase''']]== ===Gold standard diagnostic interviews=== * For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews click here.] ===Recommended diagnostic interviews for anorexia nervosa=== {| class="wikitable sortable" border="1" ! colspan="5" |Diagnostic instruments for anorexia nervosa |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time !Where to access |- |[https://www.credo-oxford.com/7.2.html Eating Disorder Examination (EDE)] <ref>{{Cite book|url=https://www.worldcat.org/oclc/1160972551|title=Assessment of disorders in childhood and adolescence|date=2020|others=Eric Arden Youngstrom, Mitchell J. Prinstein, Eric J. Mash, Russell A. Barkley|isbn=978-1-4625-4365-6|edition=Fifth edition|location=New York|oclc=1160972551}}</ref> <ref>{{Cite book|url=https://www.worldcat.org/oclc/314222270|title=A guide to assessments that work|date=2008|publisher=Oxford University Press|others=John Hunsley, Eric J. Mash|isbn=0-19-804245-0|location=New York|oclc=314222270}}</ref> |Semistructured (child and adult) |8-16 (child version) 16+ (adult version) |45-75 minutes |PDFs * [https://www.phenxtoolkit.org/protocols/view/230101 Child version PDF] * [https://www.credo-oxford.com/7.2.html Adult version PDF] |- |Structured Clinical Interview for DSM-5-Clinician Version (SCID-5-CV)<ref>{{Cite journal|last=Shabani|first=Amir|last2=Masoumian|first2=Samira|last3=Zamirinejad|first3=Somayeh|last4=Hejri|first4=Maryam|last5=Pirmorad|first5=Tahereh|last6=Yaghmaeezadeh|first6=Hooman|date=2021-05|title=Psychometric properties of Structured Clinical Interview for DSM‐5 Disorders‐Clinician Version (SCID‐5‐CV)|url=https://onlinelibrary.wiley.com/doi/10.1002/brb3.1894|journal=Brain and Behavior|language=en|volume=11|issue=5|doi=10.1002/brb3.1894|issn=2162-3279|pmc=PMC8119811|pmid=33729681}}</ref> |Structured Interview (Adult ) |16+ |Varies |[https://www.columbiapsychiatry.org/research/research-labs/diagnostic-and-assessment-lab/structured-clinical-interview-dsm-disorders-11 Website to purchase] |- | [https://dawba.info/a0.html Development and Well-Being Assessment (DAWBA)] <ref>{{Cite book|url=https://www.worldcat.org/oclc/1160972551|title=Assessment of disorders in childhood and adolescence|date=2020|others=Eric Arden Youngstrom, Mitchell J. Prinstein, Eric J. Mash, Russell A. Barkley|isbn=978-1-4625-4365-6|edition=Fifth edition|location=New York|oclc=1160972551}}</ref> | Structured (child/adolescent and parent) | 11-18 |10-20 minutes for the eating disorder module |[https://osf.io/zpbna/?view_only=245bef061d284c17ab9dedad5a59e1b8 English PDF] [https://dawba.info/py/dawbainfo/b1.py Additional languages] |} '''Note:''' Reliability and validity are included in the [[Evidence-based assessment/Anorexia nervosa (assessment portfolio)/extended version|extended version]]. This table includes measures with Good or Excellent ratings. ==[[Evidence based assessment/Process phase|'''Process phase''']]== The following section contains a brief overview of treatment options for anorexia nervosa and a list of process and outcome measures for anorexia nervosa. The section includes benchmarks based on published norms for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the [[Evidence based assessment/Process phase|process phase]] of assessment. For more information on the differences between process and outcome measures, see the page on the [[Evidence based assessment/Process phase|process phase of assessment]]. ===Process measures=== Body weight is commonly monitored by clinicians throughout the AN treatment process as helping individuals regain and maintain a healthy weight is a primary treatment goal for AN. Many treatment centers have policies prohibiting patients from seeing their weight. Motivational Stages of Change may be used to monitor individuals’ readiness to take action against eating disorder behaviors. It has demonstrated predictive validity in a sample of female adolescents attending eating disorder treatment groups.<ref>{{Cite journal|last=Gusella|first=Joanne|last2=Butler|first2=Gordon|last3=Nichols|first3=Laura|last4=Bird|first4=Debbie|date=2003-01-01|title=A brief questionnaire to assess readiness to change in adolescents with eating disorders: its applications to group therapy|url=http://onlinelibrary.wiley.com/doi/10.1002/erv.481/abstract|journal=European Eating Disorders Review|language=en|volume=11|issue=1|pages=58–71|doi=10.1002/erv.481|issn=1099-0968}}</ref> See Appendix E. === Outcome and severity measures === This table includes clinically significant benchmarks for anorexia nervosa specific outcome measures * Information on how to interpret this table can be [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase found here]. * Additionally, these [[Evidence based assessment/Vignettes|vignettes]] might be helpful resources for understanding appropriate adaptation of outcome measures in practice. *''<u>For clinically significant change benchmarks for the CBCL, YSR, and TRF total, externalizing, internalizing, and attention benchmarks,</u>'' [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase&wteswitched=1#Clinically_significant_change_benchmarks_for_widely-used_outcome_measures see here.] {| class="wikitable sortable" border="1" | colspan="8" |'''Clinically significant change benchmarks with common instruments for anorexia nervosa''' |- | colspan="8" span style="font-size:110%; text-align:center;" | <b> Benchmarks Based on Published Norms</b> |- | rowspan="2" style="text-align:center;font-size:130%;" |<b> Measure</b> | rowspan="2" style="text-align:center;font-size:130%;" | <b> Subscale</b> | colspan="3" style="text-align:center;font-size:130%" width="300" | <b> Cut-off scores</b> | colspan="3" style="text-align:center;font-size:120%" | <b> Critical Change <br> (unstandardized scores)</b> |- | style="text-align:center;font-size:110%" |<b> A</b> | style="text-align:center;font-size:110%" |<b> B</b> | style="text-align:center;font-size:110%" |<b> C</b> | style="text-align:center;font-size:110%" |<b> 95%</b> | style="text-align:center;font-size:110%" |<b> 90%</b> | style="text-align:center;font-size:110%" |<b> SE_difference</b> |- | rowspan="5" style="text-align:center;" |'''EDE-Q <ref name=":2">{{Cite journal|last=Mond|first=J. M.|last2=Hay|first2=P. J.|last3=Rodgers|first3=B.|last4=Owen|first4=C.|last5=Beumont|first5=P. J. V.|date=May 2004|title=Validity of the Eating Disorder Examination Questionnaire (EDE-Q) in screening for eating disorders in community samples|url=https://www.ncbi.nlm.nih.gov/pubmed/15033501|journal=Behaviour Research and Therapy|volume=42|issue=5|pages=551–567|doi=10.1016/S0005-7967(03)00161-X|issn=0005-7967|pmid=15033501}}</ref>''' | style="text-align:right;" |''Global'' |1.4 |3.2 |2.3 |.7 |.6 |.3 |- | style="text-align:right;" |''Restraint'' |(-.3) |3.6 |1.8 |1.5 |1.2 |.8 |- | style="text-align:right;" |''Eating Concern'' |.1 |2.0 |1.2 |1.1 |.9 |.6 |- | style="text-align:right;" |''Weight Concern'' |1.5 |3.9 |2.6 |1.0 |.9 |.5 |- | style="text-align:right;" |''Shape Concern'' |2.1 |4.8 |3.2 |.9 |.7 |.4 |- | rowspan="5" style="text-align:center;" |'''EDE <ref name=":2" />''' | style="text-align:right;" |''Global'' |1.7 |2.3 |1.9 |1.9 |1.6 |1.0 |- | style="text-align:right;" |''Restraint'' |.3 |3.3 |1.9 |1.8 |1.5 |.9 |- | style="text-align:right;" |''Eating Concern'' |(-.5) |.9 |.5 |.8 |.7 |.4 |- | style="text-align:right;" |''Weight Concern'' |2.0 |2.8 |2.4 |1.3 |1.1 |.7 |- | style="text-align:right;" |''Shape Concern'' |2.0 |3.2 |2.6 |1.2 |1.0 |.6 |- | rowspan="1" style="text-align:center;" |'''EAT-26 <ref name=":0">{{Cite journal|last=Mintz|first=L. B.|last2=O'Halloran|first2=M. S.|date=2000-06-01|title=The Eating Attitudes Test: validation with DSM-IV eating disorder criteria|url=http://www.ncbi.nlm.nih.gov/pubmed/10900574|journal=Journal of Personality Assessment|volume=74|issue=3|pages=489–503|doi=10.1207/S15327752JPA7403_11|issn=0022-3891|pmid=10900574}}</ref>''' | style="text-align:right;" |''Total'' |6.5 |19.6 |15.0 |7.9 |6.7 |4.0 |} '''Note:''' “A” = Away from the clinical range, “B” = Back into the nonclinical range, “C” = Closer to the nonclinical than clinical mean. '''Search terms:''' [Anorexia Nervosa OR eating disorder] AND [validity OR clinical significance] in Google Scholar === Treatment === {{collapse top| More information on treatment for AN|expand=yes}} * Treatment of AN typically consists of restoring the individual to a healthy weight and addressing thoughts and behaviors which are related to the eating disorder. It may involve re-nutrition, psychotherapy, nutritional counseling, and medication. * Literature reviews of existing research indicate that evidence supporting AN treatment is lacking. A systematic review of AN treatment efficacy studies by Bulik<ref>{{Cite journal|title = Anorexia nervosa treatment: a systematic review of randomized controlled trials|url = http://www.ncbi.nlm.nih.gov/pubmed/17370290|journal = The International Journal of Eating Disorders|date = 2007-05-01|issn = 0276-3478|pmid = 17370290|pages = 310–320|volume = 40|issue = 4|doi = 10.1002/eat.20367|first = Cynthia M.|last = Bulik|first2 = Nancy D.|last2 = Berkman|first3 = Kimberly A.|last3 = Brownley|first4 = Jan A.|last4 = Sedway|first5 = Kathleen N.|last5 = Lohr}}</ref> found that evidence supporting medications, medications and behavioral interventions, and behavioral interventions alone in adults is weak. * There is moderately strong evidence suggesting that behavioral interventions may be helpful for adolescents. In particular, adolescents may benefit from family therapy. * Clinical trials investigating AN treatment suffer from high rates of attrition, as key features of AN (e.g., denial, fear of weight gain) may contribute to low motivation for remaining in treatment. * More severe cases of AN may be treated in inpatient settings, which are equipped to manage the re-nutrition process and provide medical monitoring. * Partial hospitalization and intensive outpatient programs may provide intermediate levels of treatment intensity to assist individuals in the transition from intensive care to outpatient care after weight restoration. {{collapse bottom}} * Please refer to the page on [https://en.wikipedia.org/wiki/Anorexia_nervosa anorexia nervosa] for more information on available treatment or go to [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/eating-body-image-problems/ the Effective Child Therapy page for Eating & Body Image Problems] for a curated resource on effective treatments for anorexia nervosa. == '''External resources''' == # [http://apps.who.int/classifications/icd10/browse/2010/en#/F50.0 ICD-10 diagnostic criteria] # [https://en.wikiversity.org/w/index.php?title=Helping_Give_Away_Psychological_Science/Resources/Annotated_List_of_Where_and_How_to_Find_a_Therapist&wteswitched=1#Other_low-cost_options Find-a-Therapist] ##This is a curated list of find-a-therapist websites where you can find a provider # NIMH: [https://www.nimh.nih.gov/health/publications/eating-disorders/index.shtml ''Eating Disorders--About More Than Food''] and [https://www.nimh.nih.gov/health/topics/eating-disorders/index.shtml ''Eating Disorders''] ##These NIMH website posts provide more information on anorexia nervosa #[https://www.hopkinsmedicine.org/psychiatry/specialty_areas/eating_disorders/ John's Hopkins Resource] (guide about anorexia nervosa, treatment, and more) # OMIM (Online Mendelian Inheritance in Man) ##[https://www.omim.org/entry/606788?search=anorexia%20nervosa&highlight=nervosa%20anorexia Anorexia nervosa] #[http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/eating-body-image-problems/ Effective Child Therapy page for anorexia nervosa] ##Effective Child Therapy is website sponsored by Division 53 of the American Psychological Association (APA), or The [https://sccap53.org Society of Clinical Child and Adolescent Psychology] (SCCAP), in collaboration with the Association for Behavioral and Cognitive Therapies (ABCT). Use for information on symptoms and available treatments. == '''References''' == {{collapse top|References|expand=yes}} {{Reflist|30em}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] {{collapse bottom}} gdkbb5b249c0i48t9kynnm20iny66cb 0 207099 2419102 2404436 2022-08-25T22:50:12Z Eyoungstrom 1933979 /* Severity interviews for ADHD */ deleted stub table (and pasted on Discuss page) wikitext text/x-wiki 3<noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{medical disclaimer}} {{:{{BASEPAGENAME}}/Sidebar}} ==[[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio"?''']]== For background information on what assessment portfolios are, click the link in the heading above. Want even 'more' information about this topic? There's an extended version of this page [[Evidence-based assessment/Attention deficit hyperactivity disorder (assessment portfolio)/extended version|here]]. ==[[Evidence based assessment/Preparation phase|'''Preparation phase''']]== === Diagnostic Criteria of ADHD in youth === {{blockquotetop}} <big>ICD-11 Diagnostic Criteria </big><br> <br> '''General Description:''' Attention deficit hyperactivity disorder is characterised by a persistent pattern (at least 6 months) of inattention and/or hyperactivity-impulsivity that has a direct negative impact on academic, occupational, or social functioning. There is evidence of significant inattention and/or hyperactivity-impulsivity symptoms prior to age 12, typically by early to mid-childhood, though some individuals may first come to clinical attention later. The degree of inattention and hyperactivity-impulsivity is outside the limits of normal variation expected for age and level of intellectual functioning. Inattention refers to significant difficulty in sustaining attention to tasks that do not provide a high level of stimulation or frequent rewards, distractibility and problems with organisation. Hyperactivity refers to excessive motor activity and difficulties with remaining still, most evident in structured situations that require behavioural self-control. Impulsivity is a tendency to act in response to immediate stimuli, without deliberation or consideration of the risks and consequences. The relative balance and the specific manifestations of inattentive and hyperactive-impulsive characteristics varies across individuals and may change over the course of development. In order for a diagnosis to be made, manifestations of inattention and/or hyperactivity-impulsivity must be evident across multiple situations or settings (e.g., home, school, work, with friends or relatives), but are likely to vary according to the structure and demands of the setting. <br> <br> '''Predominantly Inattentive Presentation:''' All definitional requirements for attention deficit hyperactivity disorder are met and inattentive symptoms are predominant in the clinical presentation. Inattention refers to significant difficulty in sustaining attention to tasks that do not provide a high level of stimulation or frequent rewards, distractibility and problems with organization. Some hyperactive-impulsive symptoms may also be present, but these are not clinically significant in relation to the inattentive symptoms. <br> <br> '''Predominantly Hyperactive-Impulsive:''' All definitional requirements for attention deficit hyperactivity disorder are met and hyperactive-impulsive symptoms are predominant in the clinical presentation. Hyperactivity refers to excessive motor activity and difficulties with remaining still, most evident in structured situations that require behavioural self-control. Impulsivity is a tendency to act in response to immediate stimuli, without deliberation or consideration of the risks and consequences. Some inattentive symptoms may also be present, but these are not clinically significant in relation to the hyperactive-impulsive symptoms. <br> <br> <big>Changes in DSM-5</big> <br> The diagnostic criteria for ADHD changed slightly from DSM-IV to DSM-5. See the changes [https://www.ncbi.nlm.nih.gov/books/NBK519712/table/ch3.t3/ here]. {{blockquotebottom}}<ref>{{Cite web|url=https://icd.who.int/browse11/l-m/en#/http://id.who.int/icd/entity/821852937|title=ICD-11 for Mortality and Morbidity Statistics|website=icd.who.int|access-date=2022-06-21}}</ref> ===Base rates of youth ADHD in different populations and clinical settings=== This section describes the demographic setting of the population(s) sampled, base rates of diagnosis, country/region sampled, and the diagnostic method that was used. Using this information, clinicians will be able to anchor the rates of adolescent depression that they are likely to see in their clinical practices. * '''''To find prevalence rates across multiple disorders,''''' [[Evidence based assessment/Preparation phase#Base rates for transdiagnostic comparison|click here.]] {| class="wikitable sortable" |- ! Demography ! Setting ! Base Rate(s) ! Diagnostic Method |- |Worldwide, Ages 3-18 |Meta-Analysis of worldwide prevalence of Child/Adolescent ADHD<ref>{{cite journal |last=Willcutt |first=Erik G. |date=July 2012 |title=The Prevalence of DSM-IV Attention-Deficit/Hyperactivity Disorder: A Meta-Analytic Review |journal=Neurotherapeutics |volume=9 |issue=3 |pages=490-99 |pmid=22976615 |pmc=3441936 |doi=10.1007/s13311-012-0135-8 }}</ref> |6.1% (parent rating)<br>7.1% (teacher rating)<br>10.5% (ages 3-5)<br>11.4% (ages 6-12)<br>8.0% (ages 13-18) |Multiple, but each focused on DSM-IV criteria |- |USA Nationally Representative, Ages 3-17 |Epidemiological [[w:National Health Interview Survey|NHIS]] (US CDC, 2011) |8.4% (Overall)<br>12.0% (Male)<br>4.7% (Female)<br>2.1% (ages 3-5)<br>8.4% (ages 6-11)<br>11.9% (ages 12-17)<br>10.3% (southern region of US) |Parent-report of whether child had ever been diagnosed |- |USA Nationally Representative, Ages 4-17 |Child and Adolescent Epidemiological National Survey of Children's Health (US CDC, 2007) |9.5% (overall)<br>12.3% (male)<br>5.3% (female)<br>1.5% (ages 3-5)<br>9.1% (ages 6-11)<br>12.4% (ages 12-17)<br>15.6% (North Carolina) |Parent-report of whether child had ever been diagnosed |- |USA Nationally Representative, Ages 5-14 |Teacher-Reported Prevalence of ADHD<ref>{{cite journal |last1=Fabiano |first1=Gregory A. |last2=Pelham |first2=William E., Jr. |last3=Majumdar |first3=Antara |last4=Evans |first4=Steven W. |last5=Manos |first5=Michael J. |last6=Caserta |first6=Donald |last7=Girio-Herrera |first7=Erin L. |last8=Pisecco |first8=Stewart |last9=Hannah |first9=Jane N. |last10=Carter |first10=Randy L. |date=April 2013 |title=Elementary and Middle School Teacher Perceptions of Attention-Deficit/Hyperactivity Disorder Prevalence |journal=Child & Youth Care Forum |volume=42 |issue=2 |pages=87-99 |doi=10.1007/s10566-013-9194-1 }}</ref> |5.25% (overall)<br>5.58% (elementary schoolers)<br>3.53% (middle schoolers)<br>7.1% (one county in rural NC) |Teacher report of number of children who have been identified with ADHD in their class |- |USA Nationally Representative, Ages 13-18 |Adolescent Epidemiological [[w:National Comorbidity Survey|National Comorbidity Survey-Adolescent Supplement]]<ref>{{cite journal |last1=Merikangas |first1=Kathleen Ries |last2=He |first2=Jian-Ping |last3=Burstein |first3=Marcy |last4=Swanson |first4=Sonja A. |last5=Avenevoli |first5=Shelli |last6=Cui |first6=Lihong |last7=Benjet |first7=Corina |last8=Georgiades |first8=Katholiki |last9=Swendsen |first9=Joel |date=October 2010 |title=Lifetime prevalence of mental disorders in U.S. adolescents: results from the National Comorbidity Survey Replication—Adolescent Supplement (NCS-A) |journal=Journal of the American Academy of Child and Adolescent Psychiatry |volume=49 |issue=10 |pages=980-9 |pmid=20855043 |pmc=2946114 |doi=10.1016/j.jaac.2010.05.017 }}</ref> |8.7% |CIDI 3.0 structured diagnostic interview |- |Ages 6-90 |Meta-Analysis of Clinical Samples<ref name="Rettew_et_al-2009">{{cite journal |last1=Rettew |first1=David C. |last2=Lynch |first2=Alicia Doyle |last3=Achenbach |first3=Thomas M. |last4=Dumenci |first4=Levent |last5=Ivanova |first5=Masha Y. |date=September 2009 |title=Meta-analyses of agreement between diagnoses made from clinical evaluations and standardized diagnostic interviews |journal=International Journal of Methods in Psychiatric Research |volume=18 |issue=3 |pages=169-84 |pmid=19701924 |doi=10.1002/mpr.289 }}</ref> |38% |Structured Diagnostic Interviews |- |Ages 6-90 |Meta-Analysis of Clinical Samples<ref name="Rettew_et_al-2009" /> |23% |Clinical Evaluations |- |Representative Sample of Johnston County School Children, North Carolina, Ages 6-12 |Johnston County, North Carolina Sample<ref>{{cite journal |last1=Rowland |first1=Andrew S. |last2=Skipper |first2=Betty J. |last3=Umbach |first3=David M. |last4=Rabiner |first4=David L. |last5=Campbell |first5=Richard A. |last6=Naftel |first6=Albert J. |last7=Sandler |first7=Dale P. |date=11 December 2013 |title=The Prevalence of ADHD in a Population-Based Sample |journal=Journal of Attention Disorders |volume=19 |issue=9 |pages=741-54 |pmid=24336124 |pmc=4058092 |doi=10.1177/1087054713513799 }}</ref> |15.5% |Combined parent and teacher report (NTRS and DISC) with DSM-IV criteria |- |Sample drawn from 11 counties in Western NC, Ages 9-16 |North Carolina Community Sample<ref>{{cite journal |last1=Costello |first1=E. Jane |last2=Mustillo |first2=Sarah |last3=Erkanli |first3=Alaattin |last4=Keeler |first4=Gordon |last5=Angold |first5=Adrian |date=August 2003 |title=Prevalence and development of psychiatric disorders in childhood and adolescence |journal=Archives of General Psychiatry |volume=60 |issue=8 |pages=837-44 |pmid=12912767 |doi=10.1001/archpsyc.60.8.837 |doi-access=free |url=http://jamanetwork.com/journals/jamapsychiatry/fullarticle/207725 }}</ref> |0.9% (3-month prevalence)<br>4.1% (estimated by age 16) |CAPA structured diagnostic interview |- |Sample recruited at Durham, NC, Seattle, Nashville, and Central Pennsylvania sites. Sample was followed longitudinally and identified as at high risk for externalizing disorders in kindergarten. 50% African American, Ages 12-15 |High-Risk Community Sample<ref>{{cite journal |last1=Jones |first1=Damon E. |last2=Foster |first2=E. Michael |date=October 2009 |title=Service Use Patterns for Adolescents with ADHD and Comorbid Conduct Disorder |journal=Journal of Behavioral Health Services & Research |volume=36 |issue=4 |pages=436-49 |pmid=18618263 |pmc=3534729 |doi=10.1007/s11414-008-9133-3 }}</ref> |14.3% |Diagnostic Interview Schedule for Children (DISC) |} ==[[Evidence based assessment/Prediction phase|'''Prediction phase''']]== === Psychometric properties of screening instruments for youth ADHD === The following section contains a list of screening and diagnostic instruments for ADHD. The section includes administration information, psychometric data, and PDFs or links to the screenings. * Screenings are used as part of the [[Evidence based assessment/Prediction phase|prediction phase]] of assessment; for more information on interpretation of this data, or how screenings fit in to the assessment process, [[Evidence based assessment/Prediction phase|'''click here''']]. * '''''For a list of more broadly-reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Common_screening_instruments click here.]''''' === Screening and diagnostic instruments for attention deficit hyperactivity disorder=== {| class="wikitable sortable" border="1" |- ! Measure ! Format (Reporter) ! Age Range ! Administration/<br>Completion Time !Where to Access |- | colspan="5" style="font-size:110%; text-align:center;" span |'''Youth''' |- |ADHD Rating Scale (ADHD-RS-V)<ref>DuPaul, G. J., Power, T. J., Anastopoulos, A. D., & Reid, R. (1998). ADHD Rating Scale–IV: Checklists, norms, and clinical interpretation. New York: Guilford Press</ref> |Teacher, Parent |5-10 y/o: Child Version 11-17 y/o: Adolescent Version |5 minutes for each scale | |- |Conners 3rd Edition<ref>{{Cite web|url=https://www.pearsonassessments.com/store/usassessments/en/Store/Professional-Assessments/Behavior/Comprehensive/Conners-3rd-Edition/p/100000523.html|title=Conners 3rd Edition|website=www.pearsonassessments.com|language=en|access-date=2022-06-30}}</ref> |Teacher, Parent |6-18 y/o: Administered to parents and teachers of children and adolescents age 8-18 y/o: Self-report |20 minutes: Long Version 10 minutes: Short Version <5 Minutes: Conners 3AI and Conners 3GI |[https://www.pearsonassessments.com/store/usassessments/en/Store/Professional-Assessments/Behavior/Comprehensive/Conners-3rd-Edition/p/100000523.html Not Free] |- |Vanderbilt ADHD Parent Rating Scale (VADPRS) |Teacher, Parent |6-12 y/o | |Free |- |Child Behavior Checklist (CBCL/6-18) |Parent |6-18 y/o |15-20 minutes |Free |- |Behavior Assessment Scale for Children (BASC-3) | | |10-20 minutes: (TRS and PRS) 30 minutes: (SRP) |Not Free |- | colspan="5" style="font-size:110%; text-align:center;" span |'''Adults''' |- |} '''Note:''' L = Less than adequate; A = Adequate; G = Good; E = Excellent <ref>{{Cite web|url=https://en.wikiversity.org/wiki/Evidence-based_assessment/Reliability#Evaluating_norms_and_reliability|title=Evidence-based assessment/Reliability - Wikiversity|website=en.wikiversity.org|access-date=2020-11-13}}</ref> === Likelihood ratios and AUCs of screening measures for '''ADHD''' === * '''''For a list of the likelihood ratios for more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Likelihood_ratios_and_AUCs_of_common_screening_instruments click here.]''''' {| class="wikitable sortable mw-collapsible" border="1" |- ! Screening Measure (Primary Reference) !data-sort-type="number"| {{abbr|AUC (sample size)|Area under curve}} !data-sort-type="number"| {{abbr|DiLR+ (score)|Positive likelihood ratio}} Score !data-sort-type="number"| {{abbr|DiLR- (score)|Negative likelihood ratio}} Score ! Clinical Generalizeability and Study Description ! class="unsortable"| Study description !Where to Access |- |- | colspan="7" style="font-size:110%; text-align:center;" span |'''Youth''' |- |rowspan="4"| [[w:Child Behavior Checklist|Child Behavior Checklist]] (CBCL) - Attention Problems {{var|T}}-Score<ref name=Achenbach-1991>{{cite book |last1=Achenbach |first1=Thomas M. |author1-link=w:Thomas M. Achenbach |title=Child behavior checklist for ages 4-18 |date=1991 |publisher=Department of Psychiatry, University of Vermont |location=Burlington, VT |isbn=978-0-938565-08-6 }}</ref> |rowspan="4"| .84 ({{var|N}}=187) | 6.92 (>55) | 0.19 (<55) |rowspan="4"| Somewhat High Utilized sample ages 6-18 recruited from local pediatricians, psychiatrists, and community advertisements. Included 95 children who met criteria for ADHD. 70 of these children also met criteria for ODD/CD.<ref name="Hudziak_et_al-2004" /> |rowspan="4"| Utilized sample ages 6-18 recruited from local pediatricians, psychiatrists, and community advertisements. Included 95 children who met criteria for ADHD. 70 of these children also met criteria for ODD/CD.<ref name=Hudziak_et_al-2004>{{cite journal |last1=Hudziak |first1=James J. |last2=Copeland |first2=William |last3=Stanger |first3=Catherine |last4=Wadsworth |first4=Martha |title=Screening for DSM-IV externalizing disorders with the Child Behavior Checklist: A receiver-operating characteristic analysis |journal=Journal of Child Psycholology and Psychiatry |date=October 2004 |volume=45 |issue=7 |pages=1299-307 |pmid=15335349 |doi=10.1111/j.1469-7610.2004.00314.x }}</ref> | rowspan="4" | |- | 12.2 (>60) | 0.41 (<60) |- | 47 (>65) | 0.53 (<65) |- | 34 (>70) | 0.66 (<70) |- |rowspan="2"| Child Behavior Checklist (CBCL) - Attention and Aggression Problems {{var|T}}-Score<ref name=Achenbach-1991/> |data-sort-value="0.86"| Boys: .86 ({{var|N}}=111) | {{nowrap|10.2 (>55)}} | {{nowrap|0.41 (<55)}} |rowspan="2"| Somewhat High Utilized sample ages 6-18 which consisted of 219 brothers and sisters of children who were referred to a hospital pediatric unit for ADHD or other symptoms. Half of these siblings had brothers and sisters who had ADHD, half did not.<ref name="Chen_et_al-1994" /> |rowspan="2"| Utilized sample ages 6-18 which consisted of 219 brothers and sisters of children who were referred to a hospital pediatric unit for ADHD or other symptoms. Half of these siblings had brothers and sisters who had ADHD, half did not.<ref name=Chen_et_al-1994>{{cite journal |last1=Chen |first1= Wei J. |last2=Faraone |first2=Stephen V. |author2-link=w:Stephen Faraone |last3=Biederman |first3=Joseph |author3-link=w:Joseph Biederman |last4=Tsuang |first4=Ming T. |title=Diagnostic accuracy of the Child Behavior Checklist scales for attention-deficit hyperactivity disorder: A receiver-operating characteristic analysis |journal=Journal of Consulting and Clinical Psychology |date=October 1994 |volume=62 |issue=5 |pages=1017-25 |pmid=7806710 |doi=10.1037/0022-006X.62.5.1017 }}</ref> | rowspan="2" | |- |data-sort-value="0.90"| Girls: 0.90 ({{var|N}}=108) |{{nowrap|11.2 (>55)}} |{{nowrap|0.35 (<55)}} |- | [[w:Achenbach System of Empirically Based Assessment|Teacher Response Form]] (TRF) - Attention Problems {{var|T}}-Score<ref name=Achenbach-1991/> | Not reported ({{var|N}}=184) | 3.66 (>70) | 0.73 (<70) | Somewhat High Utilized sample ages 5-12 years referred to a research clinic for assessment of ADHD. 108 children were ultimately diagnosed with ADHD, while 76 were not. LR's are calculated for discriminating between those two groups.<ref name="Tripp_et_al-2006" /> |rowspan="2"| Utilized sample ages 5-12 years referred to a research clinic for assessment of ADHD. 108 children were ultimately diagnosed with ADHD, while 76 were not. LR's are calculated for discriminating between those two groups.<ref name=Tripp_et_al-2006>{{cite journal |last1=Tripp |first1=Gail |last2=Schaughency |first2=Elizabeth A. |last3=Clarke |first3=Bronwyn |title=Parent and teacher rating scales in the evaluation of attention-deficit hyperactivity disorder: Contribution to diagnosis and differential diagnosis in clinically referred children |journal=Journal of Developmental and Behavioral Pediatrics |date=2006 |volume=27 |issue=3 |pages=209-18 |pmid=16775518 }}</ref> | |- | Teacher Response Form (TRF) - Attention and Aggression Problems {{var|T}}-Score<ref name=Achenbach-1991/> | Not reported ({{var|N}}=184) | 4.33 (>70) | 0.89 (<70) | Somewhat High Utilized sample ages 5-12 years referred to a research clinic for assessment of ADHD. 108 children were ultimately diagnosed with ADHD, while 76 were not. LR's are calculated for discriminating between those two groups.<ref name="Tripp_et_al-2006" /> | |- | [[w:Disruptive Behavior Disorders Rating Scale|Disruptive Behavior Disorder Rating Scale]] (DBDRS) - Parent Report (Pelham et. al, 1992) | 0.78 ({{var|N}}=232) | 5.06 (Endorsed ≥ 6 symptoms of inattention or hyperactivity) | 0.20 (<9) (Endorsed < 6 symptoms of inattention or hyperactivity) | Somewhat High Sample consisted of 232 ethnically diverse children ages 5-10 with (n = 121) and without (n=111) ADHD recruited through advertisements at school and through self-help groups.<ref name="Shemmassian_Lee-2012" /><ref name="Shemmassian_Lee-2016" /> |rowspan="2"| Sample consisted of 232 ethnically diverse children ages 5-10 with (n = 121) and without (n=111) ADHD recruited through advertisements at school and through self-help groups.<ref name="Shemmassian_Lee-2012">{{cite journal |last1=Shemmassian |first1=Shirag K. |last2=Lee |first2=Steve S. |date=March 2012 |title=Comparing Four Methods of Integrating Parent and Teacher Symptom Ratings of Attention-deficit/hyperactivity Disorder (ADHD) |journal=Journal of Psychopathology and Behavioral Assessment |volume=34 |issue=1 |pages=1-10 |doi=10.1007/s10862-011-9262-5 |url=https://www.researchgate.net/profile/Steve_Lee11/publication/230888173_Comparing_Four_Methods_of_Integrating_Parent_and_Teacher_Symptom_Ratings_of_Attention-deficithyperactivity_Disorder_ADHD/links/09e41505caa13a5913000000.pdf |format=PDF }}</ref><ref name="Shemmassian_Lee-2016">{{cite journal |last1=Shemmassian |first1=Shirag K. |last2=Lee |first2=Steve S. |title=Predictive Utility of Four Methods of Incorporating Parent and Teacher Symptom Ratings of ADHD for Longitudinal Outcomes |journal=Journal of Clinical Child and Adolescent Psychology |date=2016 |volume=45 |issue=2 |pages=176-87 |pmid=25643854 |doi=10.1080/15374416.2014.971457 }}</ref> | |- | Disruptive Behavior Disorder Rating Scale (DBDRS) - Teacher Report (Pelham et. al, 1992) | 0.63 ({{var|N}}=232) | 1.97 (Endorsed ≥ 6 symptoms of inattention or hyperactivity) | 0.24 (Endorsed < 6 symptoms of inattention or hyperactivity) | Somewhat High Sample consisted of 232 ethnically diverse children ages 5-10 with (n = 121) and without (n=111) ADHD recruited through advertisements at school and through self-help groups.<ref name="Shemmassian_Lee-2012" /><ref name="Shemmassian_Lee-2016" /> | |- | [[w:Vanderbilt ADHD diagnostic rating scale#Parent version|Vanderbilt ADHD Diagnostic Parent Rating Scale]] (VADPRS)<ref>{{cite journal |last1=Wolraich |first1=Mark L. |last2=Lambert |first2=Warren |last3=Doffing |first3=Melissa A. |last4=Bickman |first4=Leonard |last5=Simmons |first5=Tonya |last6=Worley |first6=Kim |date=December 2003 |title=Psychometric Properties of the Vanderbilt ADHD Diagnostic Parent Rating Scale in a Referred Population |journal=Journal of Pediatric Psychology |volume=28 |issue=8 |pages=559-68 |pmid=14602846 |doi=10.1093/jpepsy/jsg046 |url=https://academic.oup.com/jpepsy/article/28/8/559/1020465/Psychometric-Properties-of-the-Vanderbilt-ADHD }}</ref> | Not reported | 4.79 (Endorsed ≥ 6 symptoms of inattention or hyperactivity) | 0.38 (Endorsed < 6 symptoms of inattention or hyperactivity) | Moderate Sample consists of 582 children ages 5-15 recruited through schools in Oklahoma. Sample includes children screened as "high risk" for ADHD and "low risk" for ADHD.<ref name=":0" /> | Sample consists of 582 children ages 5-15 recruited through schools in Oklahoma. Sample includes children screened as "high risk" for ADHD and "low risk" for ADHD.<ref name=":0">{{cite journal |last1=Bard |first1=David E. |last2=Wolraich |first2=Mark L. |last3=Neas |first3=Barbara |last4=Doffing |first4=Melissa |last5=Beck |first5=Laoma |date=February 2013 |title=The psychometric properties of the Vanderbilt attention-deficit hyperactivity disorder diagnostic parent rating scale in a community population |journal=Journal of Developmental and Behavioral Pediatrics |volume=34 |issue=2 |pages=72-82 |pmid=23363972 |doi=10.1097/DBP.0b013e31827a3a22 }}</ref> | |- | [[w:Vanderbilt ADHD diagnostic rating scale#Teacher version|Vanderbilt ADHD Diagnostic Teacher Rating Scale]] (VADTRS)<ref>{{cite journal |last1=Wolraich |first1=ML |last2=Feurer |first2=ID |last3=Hannah |first3=JN |last4=Baumgaertel |first4=A |last5=Pinnock |first5=TY |date=April 1998 |title=Obtaining systematic teacher reports of disruptive behavior disorders utilizing DSM-IV |journal=Journal of Abnormal Child Psychology |volume=26 |issue=2 |pages=141-52 |pmid=9634136 }}</ref> | Not reported | 2.91 (Positive risk score) | 0.657 (Negative risk score) | Moderate | Sample consisted of 370 children ages 5-15 recruited though schools in Oklahoma. Sample was representative community sample.<ref>{{cite journal |last1=Wolraich |first1=Mark L. |last2=Bard |first2=David E. |last3=Neas |first3=Barbara |last4=Doffing |first4=Melissa |last5=Beck |first5=Laoma |title=The psychometric properties of the Vanderbilt attention-deficit hyperactivity disorder diagnostic teacher rating scale in a community population |journal=Journal of Developmental and Behavioral Pediatrics |date=February 2013 |volume=34 |issue=2 |pages=83-93 |pmid=23363973 |doi=10.1097/DBP.0b013e31827d55c3 }}</ref> | |- | Conners Rating Scale (Revised) - Long Form Parent Report (Conners, 1997) | Not reported | 15.33 (>93rd percentile) | 0.09 (<93rd percentile) | Moderate | Data come from normative sample of 2482 children ages 3 to 17 across the United States and Canada. Diagnostic likelihood ratios here discriminate ADHD from Non-Clinical.<ref name=Collett_et_al-2003>{{cite journal |last1=Collett |first1=Brent R. |last2=Ohan |first2=Jeneva L. |last3=Myers |first3=Kathleen M. |title=Ten-year review of rating scales. V: Scales assessing attention-deficit/hyperactivity disorder |journal=Journal of the American Academy of Child and Adolescent Psychiatry |date=September 2003 |volume=42 |issue=9 |pages=1015-37 |pmid=12960702 |doi=10.1097/01.CHI.0000070245.24125.B6 }}</ref> | |- | Conners Parent Rating Scale-48 (CPRS-48) Impulsive-Hyperactive Subscale {{var|T}}-Score (Conners, 1990) | Not reported | 1.26 (>70) | 0.79 (>70) | Somewhat High | rowspan="2"| Utilized sample ages 5-12 years referred to a research clinic for assessment of ADHD. 108 children were ultimately diagnosed with ADHD, while 76 were not. LR's are calculated for discriminating between those two groups.<ref name=Tripp_et_al-2006 /> | |- | Conners Teacher Rating Scale-39 Hyperactivity Subscale {{var|T}}-Score (Conners, 1990) | Not reported | 5.2 (>70) | 0.53 (<70) | Somewhat High | |- | Conners Teacher Rating Scale (Revised) - Long Form (Conners, 1997) | Not reported | 8.66 (>93rd percentile) | 0.24 (<93rd percentile) | Moderate | Data come from normative sample of 1973 children ages 5 to 17 across the United States and Canada. Likelihood ratios discriminate ADHD from non-clinical.<ref name=Collett_et_al-2003 /> | |- | ADHD Symptom Checklist-4 (ADHD-SC4) - Parent Report<ref name=Gadow_Sprafkin-1997>{{cite book |last1=Gadow |first1=Kenneth D. |last2=Sprafkin |first2=Joyce N. |date=1997 |title=ADHD Symptom Checklist-4 |publisher=Checkmate Plus |location=Stony Brook, NY |oclc=49637921 }}</ref> | Not reported | 1.45 (Endorsed ≥ 6 symptoms of inattention or hyperactivity) | 0.70 (Endorsed < 6 symptoms of inattention or hyperactivity) | Somewhat High | rowspan="2"| Data come from sample of 207 children ages 5-17 years old who were referred to psychiatric outpatient service with variety of emotional and behavioral disorders.<ref name=Sprafkin_Gadow-2007>{{cite journal |last1=Sprafkin |first1=Joyce |last2=Gadow |first2=Kenneth D. |title=Choosing an attention-deficit/hyperactivity disorder rating scale: is item randomization necessary? |journal=Journal of Child and Adolescent Psychopharmacology |date=February 2007 |volume=17 |issue=1 |pages=75-84 |pmid=17343555 |doi=10.1089/cap.2006.0035 }}</ref> | |- | ADHD Symptom Checklist-4 (ADHD-SC4) - Teacher Report<ref name=Gadow_Sprafkin-1997/> | Not reported | 1.53 (Endorsed ≥ 6 symptoms of inattention or hyperactivity) | 0.60 (Endorsed < 6 symptoms of inattention or hyperactivity) | Somewhat High | |- | [[w:ADHD rating scale|ADHD RS-IV]] - Home (DuPaul et. al, 1998b) | Not reported | 1.63 (>80th percentile) | 0.35 (<80th percentile) | Moderate | rowspan="2"| Sample of 2000 children ages 5 to 18 years old from geographically representative normative base.<ref name=Collett_et_al-2003 /> | |- | ADHD RS-IV - School (DuPaul et. al, 1998b) | Not reported | 4.5 (>80th percentile) | 0.42 (<80th percentile) | Moderate | |- | colspan="7" style="font-size:110%; text-align:center;" span |'''Adults''' |- |} '''Note:''' All studies with one exception used structured or semi-structured clinical interviews to establish diagnosis of ADHD. The exception, the Sprafkin & Gadow study (2007), used a combination of CBCL rating scales, clinician review, and clinician consensus to confirm ADHD diagnosis.<ref name=Sprafkin_Gadow-2007 /> “LR+” refers to the change in likelihood ratio associated with a positive test score, and “LR-” is the likelihood ratio for a low score. Likelihood ratios of 1 indicate that the test result did not change impressions at all. LRs larger than 10 or smaller than .10 are frequently clinically decisive; 5 or .20 are helpful, and between 2.0 and .5 are small enough that they rarely result in clinically meaningful changes of formulation (Sackett et al., 2000). === Interpreting ADHD screening measure scores === * For information on interpreting screening measure scores, click [[Evidence based assessment/Prediction phase#Interpreting screening measure scores|here.]] * Also see the page on [https://en.wikipedia.org/wiki/Likelihood_ratios_in_diagnostic_testing likelihood ratios in diagnostic testing] for more information ==[[Evidence based assessment/Prescription phase|'''Prescription phase''']]== ===Gold standard diagnostic interviews=== * For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews click here.] ===Recommended diagnostic interviews for ADHD=== ''****Depression instruments are placeholders'' {| class="wikitable sortable" border="1" ! colspan="5" |Diagnostic instruments for '''ADHD''' |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time !Where to Access |- |- | colspan="5" style="font-size:110%; text-align:center;" span |'''Youth''' |- | Barkley Functional Impairment Scale—Children and Adolescents (BFIS-CA) | Parent Report | 6-17 | 5-7 minutes |Link to [https://www.guilford.com/books/Barkley-Functional-Impairment-Scale-Children-Adolescents-BFIS-CA/Russell-Barkley/9781462503957 purchase] |- | Weiss Functional Impairment Rating Scale<ref>{{Cite journal|last=Thompson|first=Trevor|last2=Lloyd|first2=Andrew|last3=Joseph|first3=Alain|last4=Weiss|first4=Margaret|date=2017|title=The Weiss Functional Impairment Rating Scale-Parent Form for assessing ADHD: evaluating diagnostic accuracy and determining optimal thresholds using ROC analysis|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5486894/|journal=Quality of Life Research|volume=26|issue=7|pages=1879–1885|doi=10.1007/s11136-017-1514-8|issn=0962-9343|pmc=5486894|pmid=28220338}}</ref> | Parent/Caregiver Report | 5-19 | |[http://www.shared-care.ca/files/WFIRS-Parent_with_Instructions_May_2012.pdf PDF] |- |- | colspan="5" style="font-size:110%; text-align:center;" span |'''Adults''' |- |} '''Note:''' '''L''' = Less than adequate; '''A''' = Adequate; '''G''' = Good; '''E''' = Excellent; '''U''' = Unavailable; '''NA''' = Not applicable<ref>{{Cite web|url=https://en.wikiversity.org/wiki/Evidence-based_assessment/Reliability#Evaluating_norms_and_reliability|title=Evidence-based assessment/Reliability - Wikiversity|website=en.wikiversity.org|access-date=2020-11-13}}</ref> ==[[Evidence based assessment/Process phase|'''Process phase''']]== The following section contains a brief overview of treatment options for ADHD and list of process and outcome measures for ADHD. The section includes benchmarks based on published norms for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the [[Evidence based assessment/Process phase|process phase]] of assessment. For more information of differences between process and outcome measures, see the page on the [[Evidence based assessment/Process phase|process phase of assessment]]. === Process measures === {{blockquotetop}} ; CBCL Attention Problems Subscale : Could be used on a weekly basis to track changes in ADHD symptomotology. T-scores from this measure could also be recorded on a weekly basis to determine if reliable and clinically significant changes in ADHD symptoms are occuring. The CBCL Attention Problems Subscale has repeatedly demonstrated good-to-excellent convergence with diagnostic interviews for diagnosing ADHD.<ref name=Pelham_et_al-2005>{{cite journal |last1=Pelham |first1=William E., Jr. |last2=Fabiano |first2=Gregory A. |last3=Massetti |first3=Greta M. |date=September 2005 |title=Evidence-based assessment of attention deficit hyperactivity disorder in children and adolescents |journal=Journal of Clinical Child and Adolescent Psychology |volume=34 |issue=3 |pages=449-76 |pmid=16026214 |doi=10.1207/s15374424jccp3403_5 |url=https://www.researchgate.net/profile/Greta_Massetti/publication/7719090_Evidence-Based_Assessment_of_Attention_Deficit_Hyperactivity_Disorder_in_Children_and_Adolescents/links/09e415107e6e01c28e000000.pdf |format=PDF }}</ref><ref>{{cite journal |last1=Lampert |first1=TL |last2=Polanczyk |first2=G |last3=Tramontina |first3=S |last4=Mardini |first4=V |last5=Rohde |first5=LA |date=October 2004 |title=Diagnostic performance of the CBCL-Attention Problem Scale as a screening measure in a sample of Brazilian children with ADHD |journal=Journal of Attention Disorders |volume=8 |issue=2 |pages=63-71 |pmid=15801336 }}</ref><ref name=Hudziak_et_al-2004/><ref name=Chen_et_al-1994/> '''The CBCL Attention Problems Subscale is a scale on the CBCL, which is readily available at the Finley Clinic.''' ; Daily Report Card : Several scholars have pointed out that it is equally important to track changes in the functional behaviors that a child with ADHD engages in, in addition to their ADHD symptoms, to capture the full range of adaptive changes that are made by children with ADHD throughout the course of treatment.<ref name=Pelham_et_al-2005/><ref>{{cite book |last1=Sowerby |first1=Paula |last2=Tripp |first2=Gail |date=2009 |chapter=Evidence-Based Assessment of Attention-Deficit/Hyperactivity Disorder (ADHD) |editor1-last=Matson |editor1-first=Johnny L. |editor2-last=Andrasik |editor2-first=Frank |editor3-last=Matson |editor3-first=Michael L. |title=Assessing Childhood Psychopathology and Developmental Disabilities |pages=209-239 |publisher=Springer Science & Business Media |location=New York |oclc=314175875 |doi=10.1007/978-0-387-09528-8 |isbn=978-0-387-09528-8 |chapter-url=https://books.google.com/books?id=TyJClvRUgY4C&pg=PA209 }}</ref> The daily report card is a mechanism by which such adaptive behavioral changes can be tracked. When implementing the daily report card, problematic child behaviors at home and at school are targeted for change. Rewards are offered to the child for reaching daily and weekly goals for reducing maladaptive behaviors and increasing adaptive behaviors. Parents and Teachers track child behaviors on a daily basis and provide feedback to one another and the child with behavior frequency counts and/or daily "grades" on how well the child behaved. Daily report cards are a mainstay of cognitive-behavioral and behavioral modification evidence-based intervention strategies for ADHD,<ref name=DuPaul_et_al-2012/><ref>{{cite journal |last1=Eiraldi |first1=Ricardo B. |last2=Mautone |first2=Jennifer A. |last3=Power |first3=Thomas J. |date=January 2012 |title=Strategies for implementing evidence-based psychosocial interventions for children with attention-deficit/hyperactivity disorder |journal=Child and Adolescent Psychiatric Clinics of North America |volume=21 |issue=1 |pages=145-59 |pmid=22137818 |pmc=3233687 |doi=10.1016/j.chc.2011.08.012 }}</ref> and they are highly recommended for tracking child treatment outcomes. '''Instructions for creating a daily report card are attached in Appendix 1.''' {{blockquotebottom}} === Outcome and severity measures === This table includes clinically significant benchmarks for ADHD specific outcome measures * Information on how to interpret this table can be [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase found here]. * Additionally, these [[Evidence based assessment/Vignettes|vignettes]] might be helpful resources for understanding appropriate adaptation of outcome measures in practice. * ''<u>For clinically significant change benchmarks for the CBCL, YSR, and TRF total, externalizing, internalizing, and attention benchmarks,</u>'' [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase&wteswitched=1#Clinically_significant_change_benchmarks_for_widely-used_outcome_measures see here.] {| class="wikitable" border="1" |+Clinically significant change benchmarks with common instruments and ADHD rating scales |- ! rowspan="2" scope="col" | Measure ! rowspan="2" scope="col" | Diagnostic category ! colspan="3" scope="colgroup" width="300" | Cut Scores* ! colspan="3" scope="colgroup" | Critical Change<br>(Unstandardized Scores) |- ! scope="col" | A ! scope="col" | B ! scope="col" | C ! scope="col" | 95% ! scope="col" | 90% ! scope="col" | SE_difference |- | colspan="8" style="text-align:center" |'''Benchmarks Based on Published Norms''' |- | rowspan="4" style="text-align:center;" |''{{abbr|CBCL|Child Behavior Checklist}} {{var|T}}-scores<br>(2001 Norms)'' | style="text-align:right" | Total | style="text-align:center;" | 49 | style="text-align:center;" | 70 | style="text-align:center;" | 58 | style="text-align:center;" | 5 | style="text-align:center;" | 4 | style="text-align:center;" | 2.4 |- | style="text-align:right" | Externalizing | style="text-align:center;" | 49 | style="text-align:center;" | 70 | style="text-align:center;" | 58 | style="text-align:center;" | 7 | style="text-align:center;" | 6 | style="text-align:center;" | 3.4 |- | style="text-align:right" | Internalizing | {{n/a}} | style="text-align:center;" | 70 | style="text-align:center;" | 56 | style="text-align:center;" | 9 | style="text-align:center;" | 7 | style="text-align:center;" | 4.5 |- | style="text-align:right" | Attention Problems | {{n/a}} | style="text-align:center;" | 66 | style="text-align:center;" | 58 | style="text-align:center;" | 8 | style="text-align:center;" | 7 | style="text-align:center;" | 4.2 |- | rowspan="4" style="text-align:center;" |''{{abbr|TRF|Teacher Response Form}} {{var|T}}-Scores<br>(2001 Norms)'' | style="text-align:right" | Total | {{n/a}} | style="text-align:center;" | 70 | style="text-align:center;" | 57 | style="text-align:center;" | 5 | style="text-align:center;" | 4 | style="text-align:center;" | 2.3 |- | style="text-align:right" | Externalizing | {{n/a}} | style="text-align:center;" | 70 | style="text-align:center;" | 56 | style="text-align:center;" | 6 | style="text-align:center;" | 5 | style="text-align:center;" | 3.0 |- | style="text-align:right" | Internalizing | {{n/a}} | style="text-align:center;" | 70 | style="text-align:center;" | 55 | style="text-align:center;" | 9 | style="text-align:center;" | 7 | style="text-align:center;" | 4.4 |- | style="text-align:right" | Attention Problems | {{n/a}} | style="text-align:center;" | 66 | style="text-align:center;" | 57 | style="text-align:center;" | 5 | style="text-align:center;" | 4 | style="text-align:center;" | 2.3 |- | rowspan="2" style="text-align:center" |''Conners 3-Teacher Rating Scale {{var|T}}-Scores'' | style="text-align:right" | ADHD Inattentive | style="text-align:center;" | 36 | style="text-align:center;" | 74 | style="text-align:center;" | 57 | style="text-align:center;" | 11 | style="text-align:center;" | 10 | style="text-align:center;" | 5.6 |- | style="text-align:right" | ADHD Hyperactive-Impulsive | style="text-align:center;" | 36 | style="text-align:center;" | 74 | style="text-align:center;" | 57 | style="text-align:center;" | 11 | style="text-align:center;" | 9 | style="text-align:center;" | 5.5 |- | rowspan="2" style="text-align:center" |''Conners 3-Parent Rating Scale {{var|T}}-Scores'' | style="text-align:right" | ADHD Inattentive | style="text-align:center;" | 37 | style="text-align:center;" | 72 | style="text-align:center;" | 58 | style="text-align:center;" | 10 | style="text-align:center;" | 10 | style="text-align:center;" | 5.6 |- | style="text-align:right" | ADHD Hyperactive-Impulsive | style="text-align:center;" | 37 | style="text-align:center;" | 72 | style="text-align:center;" | 58 | style="text-align:center;" | 10 | style="text-align:center;" | 8 | style="text-align:center;" | 4.7 |- | colspan="8" style="text-align:center" |'''Benchmarks Based on ADHD Samples'''<ref name="Shemmassian_Lee-2012" /> |- | colspan="2" |''Disruptive Behavior Disorders Rating Scale'' | style="text-align:center;" | 1.4 | style="text-align:center;" | 8.6 | style="text-align:center;" | 5.7 | style="text-align:center;" | 12 | style="text-align:center;" | 10 | style="text-align:center;" | 0.9 |} '''Note:''' “A” = Away from the clinical range, “B” = Back into the nonclinical range, “C” = Closer to the nonclinical than clinical mean. <ref>{{Cite web|url=https://en.wikiversity.org/wiki/Evidence-based_assessment/Reliability#Evaluating_norms_and_reliability|title=Evidence-based assessment/Reliability - Wikiversity|website=en.wikiversity.org|access-date=2020-11-13}}</ref> '''Search terms:''' [ADHD or CONNERS or DBD] AND [clinical significance OR group means] in PsycINFO === Treatment === * Please refer to the Wikipedia page on [[wikipedia:Attention_deficit_hyperactivity_disorder|Attention Deficit Hyperactivity Disorder]] for more information on available treatment for ADHD or go to [https://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/inattention-and-hyperactivity-adhd/ Effective Child Therapy] for a curated resource on effective treatments for ADHD. {{collapse top| Click here for ADHD Treatment Information}} === Executive summary === 1. If intervening with children ages 4-5, behavior therapy should be the first line of treatment. 2. If intervening with children ages 6-11, behavior therapy should be the first line of treatment, in conjunction with medication. 3. If intervening with children ages 12-18, medication should probably be the first line of treatment, though behavior therapy could be used in combination. 4. Three types of therapeutic interventions have well established evidence-bases: :a. Behavioral Parent Training Interventions :b. Behavioral Classroom Management Interventions :c. Behavioral Peer interventions involving recreational peer groups (e.g. summer camps) 5. If considering a classroom management intervention: :a. Academic and Cognitive-Behavioral Interventions are most effective in changing academic outcomes :b. Cognitive Behavioral and Contingency Management Interventions are most effective in changing behavioral outcomes === Clinical practice guidelines === Published by the American Academy of Pediatrics in 2011.<ref name="AAP_Guideline-2011">{{cite journal |author1=Subcommittee on Attention-Deficit/Hyperactivity Disorder |author2=Steering Committee on Quality Improvement and Management |last3=Wolraich |first3=Mark |last4=Brown |first4=Lawrence |last5=Brown |first5=Ronald T. |last6=DuPaul |first6=George |last7=Earls |first7=Marian |last8=Feldman |first8=Heidi M. |last9=Ganiats |first9=Theodore G. |last10=Kaplanek |first10=Beth |last11=Meyer |first11=Bruce |last12=Perrin |first12=James |last13=Pierce |first13=Karen |last14=Reiff |first14=Michael |last15=Stein |first15=Martin T. |last16=Visser |first16=Susanna |date=November 2011 |title=ADHD: Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents |journal=Pediatrics |volume=128 |issue=5 |pages=1007-22 |pmid=22003063 |pmc=4500647 |doi=10.1542/peds.2011-2654 }}</ref> ; Preschool-aged children (ages 4–5) : Primary care clinicians should prescribe evidence-based parent and/or teacher-administered behavior therapy as the first line of treatment, and may prescribe methylphenidate if behavioral interventions are not effective. ; Elementary-aged children (ages 6–11) : Primary care clinicians should prescribe FDA-approved medications for ADHD and/or evidence based parent and teacher administered behavior therapy. Preferably, both medication and behavior therapy will be prescribed. ; Adolescents (ages 12–18) : Primary care clinicians should prescribe FDA approved medications for ADHD with the assent of the adolescent and may prescribe behavior therapy as a treatment for ADHD, preferably both. === Behavioral therapies === These meet the American Academy of Pediatrics and American Psychological Association Task Force criteria for well-established evidence-based treatments. Descriptions and effect sizes are taken from the American Academy of Pediatrics' guidelines<ref name="AAP_Guideline-2011" /> and Pelham & Fabiano's review article.<ref>{{cite journal |last1=Pelham |first1=William E., Jr. |last2=Fabiano |first2=Gregory A. |date=January 2008 |title=Evidence-based psychosocial treatments for attention-deficit/hyperactivity disorder |journal=Journal of Clinical Child and Adolescent Psychology |volume=37 |issue=1 |pages=184-214 |doi=10.1080/15374410701818681 |pmid=18444058 |lay-url=https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0026847/ |lay-source=Database of Abstracts of Reviews of Effects: Quality-assessed Reviews |lay-date=12 February 2009 }}</ref> ; Behavioral Parent Training : Behavior modification principles provided to parents for implementation in home settings. Typical outcomes include improved compliance with parental commands, improved parental understanding of behavioral principles, high levels of parental satisfaction with treatment. :'''Median effect size:''' 0.55 ; Behavioral Classroom Management : Behavior-modification principles provided to teachers for implementation in classroom settings. Typical outcomes include improved attention to instruction, improved compliance with classroom rules, decreased disruptive behavior, improved work productivity, and improved academic achievement. :'''Median effect size:''' 0.61 ; Behavioral Peer Interventions : Interventions focused on peer interactions/relationships. These could include group-based interventions provided weekly and include clinic-based social skills training used either alone or concurrently with behavioral parent training and/or medication. Typical outcomes are more mixed with these interventions. Some clinical-office based interventions have produced minimal effects, while some studies of behavioral peer intervention coupled with behavioral parent training found positive effects on parental ratings of ADHD symptoms. No studies of this type of intervention reveal differences on social functioning or parental ratings of social behavior. Behavioral Peer Interventions implemented in peer group/recreational settings (e.g. summer camps) have the most evidence of being effective. :'''Median effect size:''' None reported, effect sizes found are considered moderate. === School based interventions === {| class="wikitable" align="right" |+Single Subject Design Effect Sizes |- ! rowspan="2" scope="col" | Intervention type ! colspan="2" scope="colgroup" | Effect size |- ! scope="col" | Academic<br>outcomes ! scope="col" | Behavioral<br>outcomes |- | {{rh}} class="table-rh" |Academic | style="text-align:right" | 4.73 | style="text-align:right" | 1.53 |- | {{rh}} class="table-rh" |Cognitive behavioral | style="text-align:right" | 3.77 | style="text-align:right" | 3.31 |- | {{rh}} class="table-rh" |Contingency management | style="text-align:right" | 2.29 | style="text-align:right" | 2.40 |- | {{rh}} class="table-rh" |Combined | style="text-align:right" | 2.29 | style="text-align:right" | 1.31 |} Findings from a review by DuPaul and colleagues.<ref name="DuPaul_et_al-2012">{{cite journal |last1=DuPaul |first1=George J. |last2=Eckert |first2=Tanya L. |last3=Vilardo |first3=Brigid |date=December 2012 |title=The effects of school-based interventions for attention deficit hyperactivity disorder: A meta-analysis 1996-2010 |journal=School Psychology Review |volume=41 |issue=4 |pages=387-412 |issn=0279-6015 |id=ERIC [https://eric.ed.gov/?id=EJ1001907 EJ1001907] }}</ref> ; Associated with greater effects on academic outcomes :''Academic'' — interventions focus primarily on manipulating antecedent conditions via things like peer tutoring, computer-aided instruction, and organizational skills. :''Combined'' academic and contingency management interventions. ; Associated with greater effects for behavior outcomes :''Contingency management'' — interventions use reinforcement and punishment. :''Cognitive behavioral'' — interventions focus on development of self-control skills and reflective problem-solving strategies. {{clear}} {{collapse bottom}} == '''External Links''' == *[https://sccap53.org Society of Clinical Child and Adolescent Psychology] *[http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/inattention-and-hyperactivity-adhd/ EffectiveChildTherapy.Org information on ADHD] *[https://ccf.fiu.edu/_assets/pdfs/how_to_establish_a_school_drc.pdf Establishing a School-Home Daily Report Card] *[https://ccf.fiu.edu/_assets/pdfs/what-parents-and-teachers-should-know-about-adhd-updated-1214.pdf What Parents and Teachers Should Know About ADHD (Fact Sheet)] *[https://ccf.fiu.edu/_assets/pdfs/psychosocial_fact_sheet-updated-1214.pdf Psychosocial Interventions for ADHD] *[https://ccf.fiu.edu/_assets/pdfs/adhd-medication-information-sheet-for-parents-and-teachers1.pdf ADHD Medication Information Sheet for Parents and Teachers] =='''References'''== {{collapse top|Click here for references}} {{Reflist|30em}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] {{collapse bottom}} {{subpage navbar}} dx79slwxtrrfjwtosa3gt58elgmffc3 2419179 2419102 2022-08-26T01:58:57Z Ardenguo 2944162 /* Treatment */ Made the collapsible box expanded by default wikitext text/x-wiki 3<noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{medical disclaimer}} {{:{{BASEPAGENAME}}/Sidebar}} ==[[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio"?''']]== For background information on what assessment portfolios are, click the link in the heading above. Want even 'more' information about this topic? There's an extended version of this page [[Evidence-based assessment/Attention deficit hyperactivity disorder (assessment portfolio)/extended version|here]]. ==[[Evidence based assessment/Preparation phase|'''Preparation phase''']]== === Diagnostic Criteria of ADHD in youth === {{blockquotetop}} <big>ICD-11 Diagnostic Criteria </big><br> <br> '''General Description:''' Attention deficit hyperactivity disorder is characterised by a persistent pattern (at least 6 months) of inattention and/or hyperactivity-impulsivity that has a direct negative impact on academic, occupational, or social functioning. There is evidence of significant inattention and/or hyperactivity-impulsivity symptoms prior to age 12, typically by early to mid-childhood, though some individuals may first come to clinical attention later. The degree of inattention and hyperactivity-impulsivity is outside the limits of normal variation expected for age and level of intellectual functioning. Inattention refers to significant difficulty in sustaining attention to tasks that do not provide a high level of stimulation or frequent rewards, distractibility and problems with organisation. Hyperactivity refers to excessive motor activity and difficulties with remaining still, most evident in structured situations that require behavioural self-control. Impulsivity is a tendency to act in response to immediate stimuli, without deliberation or consideration of the risks and consequences. The relative balance and the specific manifestations of inattentive and hyperactive-impulsive characteristics varies across individuals and may change over the course of development. In order for a diagnosis to be made, manifestations of inattention and/or hyperactivity-impulsivity must be evident across multiple situations or settings (e.g., home, school, work, with friends or relatives), but are likely to vary according to the structure and demands of the setting. <br> <br> '''Predominantly Inattentive Presentation:''' All definitional requirements for attention deficit hyperactivity disorder are met and inattentive symptoms are predominant in the clinical presentation. Inattention refers to significant difficulty in sustaining attention to tasks that do not provide a high level of stimulation or frequent rewards, distractibility and problems with organization. Some hyperactive-impulsive symptoms may also be present, but these are not clinically significant in relation to the inattentive symptoms. <br> <br> '''Predominantly Hyperactive-Impulsive:''' All definitional requirements for attention deficit hyperactivity disorder are met and hyperactive-impulsive symptoms are predominant in the clinical presentation. Hyperactivity refers to excessive motor activity and difficulties with remaining still, most evident in structured situations that require behavioural self-control. Impulsivity is a tendency to act in response to immediate stimuli, without deliberation or consideration of the risks and consequences. Some inattentive symptoms may also be present, but these are not clinically significant in relation to the hyperactive-impulsive symptoms. <br> <br> <big>Changes in DSM-5</big> <br> The diagnostic criteria for ADHD changed slightly from DSM-IV to DSM-5. See the changes [https://www.ncbi.nlm.nih.gov/books/NBK519712/table/ch3.t3/ here]. {{blockquotebottom}}<ref>{{Cite web|url=https://icd.who.int/browse11/l-m/en#/http://id.who.int/icd/entity/821852937|title=ICD-11 for Mortality and Morbidity Statistics|website=icd.who.int|access-date=2022-06-21}}</ref> ===Base rates of youth ADHD in different populations and clinical settings=== This section describes the demographic setting of the population(s) sampled, base rates of diagnosis, country/region sampled, and the diagnostic method that was used. Using this information, clinicians will be able to anchor the rates of adolescent depression that they are likely to see in their clinical practices. * '''''To find prevalence rates across multiple disorders,''''' [[Evidence based assessment/Preparation phase#Base rates for transdiagnostic comparison|click here.]] {| class="wikitable sortable" |- ! Demography ! Setting ! Base Rate(s) ! Diagnostic Method |- |Worldwide, Ages 3-18 |Meta-Analysis of worldwide prevalence of Child/Adolescent ADHD<ref>{{cite journal |last=Willcutt |first=Erik G. |date=July 2012 |title=The Prevalence of DSM-IV Attention-Deficit/Hyperactivity Disorder: A Meta-Analytic Review |journal=Neurotherapeutics |volume=9 |issue=3 |pages=490-99 |pmid=22976615 |pmc=3441936 |doi=10.1007/s13311-012-0135-8 }}</ref> |6.1% (parent rating)<br>7.1% (teacher rating)<br>10.5% (ages 3-5)<br>11.4% (ages 6-12)<br>8.0% (ages 13-18) |Multiple, but each focused on DSM-IV criteria |- |USA Nationally Representative, Ages 3-17 |Epidemiological [[w:National Health Interview Survey|NHIS]] (US CDC, 2011) |8.4% (Overall)<br>12.0% (Male)<br>4.7% (Female)<br>2.1% (ages 3-5)<br>8.4% (ages 6-11)<br>11.9% (ages 12-17)<br>10.3% (southern region of US) |Parent-report of whether child had ever been diagnosed |- |USA Nationally Representative, Ages 4-17 |Child and Adolescent Epidemiological National Survey of Children's Health (US CDC, 2007) |9.5% (overall)<br>12.3% (male)<br>5.3% (female)<br>1.5% (ages 3-5)<br>9.1% (ages 6-11)<br>12.4% (ages 12-17)<br>15.6% (North Carolina) |Parent-report of whether child had ever been diagnosed |- |USA Nationally Representative, Ages 5-14 |Teacher-Reported Prevalence of ADHD<ref>{{cite journal |last1=Fabiano |first1=Gregory A. |last2=Pelham |first2=William E., Jr. |last3=Majumdar |first3=Antara |last4=Evans |first4=Steven W. |last5=Manos |first5=Michael J. |last6=Caserta |first6=Donald |last7=Girio-Herrera |first7=Erin L. |last8=Pisecco |first8=Stewart |last9=Hannah |first9=Jane N. |last10=Carter |first10=Randy L. |date=April 2013 |title=Elementary and Middle School Teacher Perceptions of Attention-Deficit/Hyperactivity Disorder Prevalence |journal=Child & Youth Care Forum |volume=42 |issue=2 |pages=87-99 |doi=10.1007/s10566-013-9194-1 }}</ref> |5.25% (overall)<br>5.58% (elementary schoolers)<br>3.53% (middle schoolers)<br>7.1% (one county in rural NC) |Teacher report of number of children who have been identified with ADHD in their class |- |USA Nationally Representative, Ages 13-18 |Adolescent Epidemiological [[w:National Comorbidity Survey|National Comorbidity Survey-Adolescent Supplement]]<ref>{{cite journal |last1=Merikangas |first1=Kathleen Ries |last2=He |first2=Jian-Ping |last3=Burstein |first3=Marcy |last4=Swanson |first4=Sonja A. |last5=Avenevoli |first5=Shelli |last6=Cui |first6=Lihong |last7=Benjet |first7=Corina |last8=Georgiades |first8=Katholiki |last9=Swendsen |first9=Joel |date=October 2010 |title=Lifetime prevalence of mental disorders in U.S. adolescents: results from the National Comorbidity Survey Replication—Adolescent Supplement (NCS-A) |journal=Journal of the American Academy of Child and Adolescent Psychiatry |volume=49 |issue=10 |pages=980-9 |pmid=20855043 |pmc=2946114 |doi=10.1016/j.jaac.2010.05.017 }}</ref> |8.7% |CIDI 3.0 structured diagnostic interview |- |Ages 6-90 |Meta-Analysis of Clinical Samples<ref name="Rettew_et_al-2009">{{cite journal |last1=Rettew |first1=David C. |last2=Lynch |first2=Alicia Doyle |last3=Achenbach |first3=Thomas M. |last4=Dumenci |first4=Levent |last5=Ivanova |first5=Masha Y. |date=September 2009 |title=Meta-analyses of agreement between diagnoses made from clinical evaluations and standardized diagnostic interviews |journal=International Journal of Methods in Psychiatric Research |volume=18 |issue=3 |pages=169-84 |pmid=19701924 |doi=10.1002/mpr.289 }}</ref> |38% |Structured Diagnostic Interviews |- |Ages 6-90 |Meta-Analysis of Clinical Samples<ref name="Rettew_et_al-2009" /> |23% |Clinical Evaluations |- |Representative Sample of Johnston County School Children, North Carolina, Ages 6-12 |Johnston County, North Carolina Sample<ref>{{cite journal |last1=Rowland |first1=Andrew S. |last2=Skipper |first2=Betty J. |last3=Umbach |first3=David M. |last4=Rabiner |first4=David L. |last5=Campbell |first5=Richard A. |last6=Naftel |first6=Albert J. |last7=Sandler |first7=Dale P. |date=11 December 2013 |title=The Prevalence of ADHD in a Population-Based Sample |journal=Journal of Attention Disorders |volume=19 |issue=9 |pages=741-54 |pmid=24336124 |pmc=4058092 |doi=10.1177/1087054713513799 }}</ref> |15.5% |Combined parent and teacher report (NTRS and DISC) with DSM-IV criteria |- |Sample drawn from 11 counties in Western NC, Ages 9-16 |North Carolina Community Sample<ref>{{cite journal |last1=Costello |first1=E. Jane |last2=Mustillo |first2=Sarah |last3=Erkanli |first3=Alaattin |last4=Keeler |first4=Gordon |last5=Angold |first5=Adrian |date=August 2003 |title=Prevalence and development of psychiatric disorders in childhood and adolescence |journal=Archives of General Psychiatry |volume=60 |issue=8 |pages=837-44 |pmid=12912767 |doi=10.1001/archpsyc.60.8.837 |doi-access=free |url=http://jamanetwork.com/journals/jamapsychiatry/fullarticle/207725 }}</ref> |0.9% (3-month prevalence)<br>4.1% (estimated by age 16) |CAPA structured diagnostic interview |- |Sample recruited at Durham, NC, Seattle, Nashville, and Central Pennsylvania sites. Sample was followed longitudinally and identified as at high risk for externalizing disorders in kindergarten. 50% African American, Ages 12-15 |High-Risk Community Sample<ref>{{cite journal |last1=Jones |first1=Damon E. |last2=Foster |first2=E. Michael |date=October 2009 |title=Service Use Patterns for Adolescents with ADHD and Comorbid Conduct Disorder |journal=Journal of Behavioral Health Services & Research |volume=36 |issue=4 |pages=436-49 |pmid=18618263 |pmc=3534729 |doi=10.1007/s11414-008-9133-3 }}</ref> |14.3% |Diagnostic Interview Schedule for Children (DISC) |} ==[[Evidence based assessment/Prediction phase|'''Prediction phase''']]== === Psychometric properties of screening instruments for youth ADHD === The following section contains a list of screening and diagnostic instruments for ADHD. The section includes administration information, psychometric data, and PDFs or links to the screenings. * Screenings are used as part of the [[Evidence based assessment/Prediction phase|prediction phase]] of assessment; for more information on interpretation of this data, or how screenings fit in to the assessment process, [[Evidence based assessment/Prediction phase|'''click here''']]. * '''''For a list of more broadly-reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Common_screening_instruments click here.]''''' === Screening and diagnostic instruments for attention deficit hyperactivity disorder=== {| class="wikitable sortable" border="1" |- ! Measure ! Format (Reporter) ! Age Range ! Administration/<br>Completion Time !Where to Access |- | colspan="5" style="font-size:110%; text-align:center;" span |'''Youth''' |- |ADHD Rating Scale (ADHD-RS-V)<ref>DuPaul, G. J., Power, T. J., Anastopoulos, A. D., & Reid, R. (1998). ADHD Rating Scale–IV: Checklists, norms, and clinical interpretation. New York: Guilford Press</ref> |Teacher, Parent |5-10 y/o: Child Version 11-17 y/o: Adolescent Version |5 minutes for each scale | |- |Conners 3rd Edition<ref>{{Cite web|url=https://www.pearsonassessments.com/store/usassessments/en/Store/Professional-Assessments/Behavior/Comprehensive/Conners-3rd-Edition/p/100000523.html|title=Conners 3rd Edition|website=www.pearsonassessments.com|language=en|access-date=2022-06-30}}</ref> |Teacher, Parent |6-18 y/o: Administered to parents and teachers of children and adolescents age 8-18 y/o: Self-report |20 minutes: Long Version 10 minutes: Short Version <5 Minutes: Conners 3AI and Conners 3GI |[https://www.pearsonassessments.com/store/usassessments/en/Store/Professional-Assessments/Behavior/Comprehensive/Conners-3rd-Edition/p/100000523.html Not Free] |- |Vanderbilt ADHD Parent Rating Scale (VADPRS) |Teacher, Parent |6-12 y/o | |Free |- |Child Behavior Checklist (CBCL/6-18) |Parent |6-18 y/o |15-20 minutes |Free |- |Behavior Assessment Scale for Children (BASC-3) | | |10-20 minutes: (TRS and PRS) 30 minutes: (SRP) |Not Free |- | colspan="5" style="font-size:110%; text-align:center;" span |'''Adults''' |- |} '''Note:''' L = Less than adequate; A = Adequate; G = Good; E = Excellent <ref>{{Cite web|url=https://en.wikiversity.org/wiki/Evidence-based_assessment/Reliability#Evaluating_norms_and_reliability|title=Evidence-based assessment/Reliability - Wikiversity|website=en.wikiversity.org|access-date=2020-11-13}}</ref> === Likelihood ratios and AUCs of screening measures for '''ADHD''' === * '''''For a list of the likelihood ratios for more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Likelihood_ratios_and_AUCs_of_common_screening_instruments click here.]''''' {| class="wikitable sortable mw-collapsible" border="1" |- ! Screening Measure (Primary Reference) !data-sort-type="number"| {{abbr|AUC (sample size)|Area under curve}} !data-sort-type="number"| {{abbr|DiLR+ (score)|Positive likelihood ratio}} Score !data-sort-type="number"| {{abbr|DiLR- (score)|Negative likelihood ratio}} Score ! Clinical Generalizeability and Study Description ! class="unsortable"| Study description !Where to Access |- |- | colspan="7" style="font-size:110%; text-align:center;" span |'''Youth''' |- |rowspan="4"| [[w:Child Behavior Checklist|Child Behavior Checklist]] (CBCL) - Attention Problems {{var|T}}-Score<ref name=Achenbach-1991>{{cite book |last1=Achenbach |first1=Thomas M. |author1-link=w:Thomas M. Achenbach |title=Child behavior checklist for ages 4-18 |date=1991 |publisher=Department of Psychiatry, University of Vermont |location=Burlington, VT |isbn=978-0-938565-08-6 }}</ref> |rowspan="4"| .84 ({{var|N}}=187) | 6.92 (>55) | 0.19 (<55) |rowspan="4"| Somewhat High Utilized sample ages 6-18 recruited from local pediatricians, psychiatrists, and community advertisements. Included 95 children who met criteria for ADHD. 70 of these children also met criteria for ODD/CD.<ref name="Hudziak_et_al-2004" /> |rowspan="4"| Utilized sample ages 6-18 recruited from local pediatricians, psychiatrists, and community advertisements. Included 95 children who met criteria for ADHD. 70 of these children also met criteria for ODD/CD.<ref name=Hudziak_et_al-2004>{{cite journal |last1=Hudziak |first1=James J. |last2=Copeland |first2=William |last3=Stanger |first3=Catherine |last4=Wadsworth |first4=Martha |title=Screening for DSM-IV externalizing disorders with the Child Behavior Checklist: A receiver-operating characteristic analysis |journal=Journal of Child Psycholology and Psychiatry |date=October 2004 |volume=45 |issue=7 |pages=1299-307 |pmid=15335349 |doi=10.1111/j.1469-7610.2004.00314.x }}</ref> | rowspan="4" | |- | 12.2 (>60) | 0.41 (<60) |- | 47 (>65) | 0.53 (<65) |- | 34 (>70) | 0.66 (<70) |- |rowspan="2"| Child Behavior Checklist (CBCL) - Attention and Aggression Problems {{var|T}}-Score<ref name=Achenbach-1991/> |data-sort-value="0.86"| Boys: .86 ({{var|N}}=111) | {{nowrap|10.2 (>55)}} | {{nowrap|0.41 (<55)}} |rowspan="2"| Somewhat High Utilized sample ages 6-18 which consisted of 219 brothers and sisters of children who were referred to a hospital pediatric unit for ADHD or other symptoms. Half of these siblings had brothers and sisters who had ADHD, half did not.<ref name="Chen_et_al-1994" /> |rowspan="2"| Utilized sample ages 6-18 which consisted of 219 brothers and sisters of children who were referred to a hospital pediatric unit for ADHD or other symptoms. Half of these siblings had brothers and sisters who had ADHD, half did not.<ref name=Chen_et_al-1994>{{cite journal |last1=Chen |first1= Wei J. |last2=Faraone |first2=Stephen V. |author2-link=w:Stephen Faraone |last3=Biederman |first3=Joseph |author3-link=w:Joseph Biederman |last4=Tsuang |first4=Ming T. |title=Diagnostic accuracy of the Child Behavior Checklist scales for attention-deficit hyperactivity disorder: A receiver-operating characteristic analysis |journal=Journal of Consulting and Clinical Psychology |date=October 1994 |volume=62 |issue=5 |pages=1017-25 |pmid=7806710 |doi=10.1037/0022-006X.62.5.1017 }}</ref> | rowspan="2" | |- |data-sort-value="0.90"| Girls: 0.90 ({{var|N}}=108) |{{nowrap|11.2 (>55)}} |{{nowrap|0.35 (<55)}} |- | [[w:Achenbach System of Empirically Based Assessment|Teacher Response Form]] (TRF) - Attention Problems {{var|T}}-Score<ref name=Achenbach-1991/> | Not reported ({{var|N}}=184) | 3.66 (>70) | 0.73 (<70) | Somewhat High Utilized sample ages 5-12 years referred to a research clinic for assessment of ADHD. 108 children were ultimately diagnosed with ADHD, while 76 were not. LR's are calculated for discriminating between those two groups.<ref name="Tripp_et_al-2006" /> |rowspan="2"| Utilized sample ages 5-12 years referred to a research clinic for assessment of ADHD. 108 children were ultimately diagnosed with ADHD, while 76 were not. LR's are calculated for discriminating between those two groups.<ref name=Tripp_et_al-2006>{{cite journal |last1=Tripp |first1=Gail |last2=Schaughency |first2=Elizabeth A. |last3=Clarke |first3=Bronwyn |title=Parent and teacher rating scales in the evaluation of attention-deficit hyperactivity disorder: Contribution to diagnosis and differential diagnosis in clinically referred children |journal=Journal of Developmental and Behavioral Pediatrics |date=2006 |volume=27 |issue=3 |pages=209-18 |pmid=16775518 }}</ref> | |- | Teacher Response Form (TRF) - Attention and Aggression Problems {{var|T}}-Score<ref name=Achenbach-1991/> | Not reported ({{var|N}}=184) | 4.33 (>70) | 0.89 (<70) | Somewhat High Utilized sample ages 5-12 years referred to a research clinic for assessment of ADHD. 108 children were ultimately diagnosed with ADHD, while 76 were not. LR's are calculated for discriminating between those two groups.<ref name="Tripp_et_al-2006" /> | |- | [[w:Disruptive Behavior Disorders Rating Scale|Disruptive Behavior Disorder Rating Scale]] (DBDRS) - Parent Report (Pelham et. al, 1992) | 0.78 ({{var|N}}=232) | 5.06 (Endorsed ≥ 6 symptoms of inattention or hyperactivity) | 0.20 (<9) (Endorsed < 6 symptoms of inattention or hyperactivity) | Somewhat High Sample consisted of 232 ethnically diverse children ages 5-10 with (n = 121) and without (n=111) ADHD recruited through advertisements at school and through self-help groups.<ref name="Shemmassian_Lee-2012" /><ref name="Shemmassian_Lee-2016" /> |rowspan="2"| Sample consisted of 232 ethnically diverse children ages 5-10 with (n = 121) and without (n=111) ADHD recruited through advertisements at school and through self-help groups.<ref name="Shemmassian_Lee-2012">{{cite journal |last1=Shemmassian |first1=Shirag K. |last2=Lee |first2=Steve S. |date=March 2012 |title=Comparing Four Methods of Integrating Parent and Teacher Symptom Ratings of Attention-deficit/hyperactivity Disorder (ADHD) |journal=Journal of Psychopathology and Behavioral Assessment |volume=34 |issue=1 |pages=1-10 |doi=10.1007/s10862-011-9262-5 |url=https://www.researchgate.net/profile/Steve_Lee11/publication/230888173_Comparing_Four_Methods_of_Integrating_Parent_and_Teacher_Symptom_Ratings_of_Attention-deficithyperactivity_Disorder_ADHD/links/09e41505caa13a5913000000.pdf |format=PDF }}</ref><ref name="Shemmassian_Lee-2016">{{cite journal |last1=Shemmassian |first1=Shirag K. |last2=Lee |first2=Steve S. |title=Predictive Utility of Four Methods of Incorporating Parent and Teacher Symptom Ratings of ADHD for Longitudinal Outcomes |journal=Journal of Clinical Child and Adolescent Psychology |date=2016 |volume=45 |issue=2 |pages=176-87 |pmid=25643854 |doi=10.1080/15374416.2014.971457 }}</ref> | |- | Disruptive Behavior Disorder Rating Scale (DBDRS) - Teacher Report (Pelham et. al, 1992) | 0.63 ({{var|N}}=232) | 1.97 (Endorsed ≥ 6 symptoms of inattention or hyperactivity) | 0.24 (Endorsed < 6 symptoms of inattention or hyperactivity) | Somewhat High Sample consisted of 232 ethnically diverse children ages 5-10 with (n = 121) and without (n=111) ADHD recruited through advertisements at school and through self-help groups.<ref name="Shemmassian_Lee-2012" /><ref name="Shemmassian_Lee-2016" /> | |- | [[w:Vanderbilt ADHD diagnostic rating scale#Parent version|Vanderbilt ADHD Diagnostic Parent Rating Scale]] (VADPRS)<ref>{{cite journal |last1=Wolraich |first1=Mark L. |last2=Lambert |first2=Warren |last3=Doffing |first3=Melissa A. |last4=Bickman |first4=Leonard |last5=Simmons |first5=Tonya |last6=Worley |first6=Kim |date=December 2003 |title=Psychometric Properties of the Vanderbilt ADHD Diagnostic Parent Rating Scale in a Referred Population |journal=Journal of Pediatric Psychology |volume=28 |issue=8 |pages=559-68 |pmid=14602846 |doi=10.1093/jpepsy/jsg046 |url=https://academic.oup.com/jpepsy/article/28/8/559/1020465/Psychometric-Properties-of-the-Vanderbilt-ADHD }}</ref> | Not reported | 4.79 (Endorsed ≥ 6 symptoms of inattention or hyperactivity) | 0.38 (Endorsed < 6 symptoms of inattention or hyperactivity) | Moderate Sample consists of 582 children ages 5-15 recruited through schools in Oklahoma. Sample includes children screened as "high risk" for ADHD and "low risk" for ADHD.<ref name=":0" /> | Sample consists of 582 children ages 5-15 recruited through schools in Oklahoma. Sample includes children screened as "high risk" for ADHD and "low risk" for ADHD.<ref name=":0">{{cite journal |last1=Bard |first1=David E. |last2=Wolraich |first2=Mark L. |last3=Neas |first3=Barbara |last4=Doffing |first4=Melissa |last5=Beck |first5=Laoma |date=February 2013 |title=The psychometric properties of the Vanderbilt attention-deficit hyperactivity disorder diagnostic parent rating scale in a community population |journal=Journal of Developmental and Behavioral Pediatrics |volume=34 |issue=2 |pages=72-82 |pmid=23363972 |doi=10.1097/DBP.0b013e31827a3a22 }}</ref> | |- | [[w:Vanderbilt ADHD diagnostic rating scale#Teacher version|Vanderbilt ADHD Diagnostic Teacher Rating Scale]] (VADTRS)<ref>{{cite journal |last1=Wolraich |first1=ML |last2=Feurer |first2=ID |last3=Hannah |first3=JN |last4=Baumgaertel |first4=A |last5=Pinnock |first5=TY |date=April 1998 |title=Obtaining systematic teacher reports of disruptive behavior disorders utilizing DSM-IV |journal=Journal of Abnormal Child Psychology |volume=26 |issue=2 |pages=141-52 |pmid=9634136 }}</ref> | Not reported | 2.91 (Positive risk score) | 0.657 (Negative risk score) | Moderate | Sample consisted of 370 children ages 5-15 recruited though schools in Oklahoma. Sample was representative community sample.<ref>{{cite journal |last1=Wolraich |first1=Mark L. |last2=Bard |first2=David E. |last3=Neas |first3=Barbara |last4=Doffing |first4=Melissa |last5=Beck |first5=Laoma |title=The psychometric properties of the Vanderbilt attention-deficit hyperactivity disorder diagnostic teacher rating scale in a community population |journal=Journal of Developmental and Behavioral Pediatrics |date=February 2013 |volume=34 |issue=2 |pages=83-93 |pmid=23363973 |doi=10.1097/DBP.0b013e31827d55c3 }}</ref> | |- | Conners Rating Scale (Revised) - Long Form Parent Report (Conners, 1997) | Not reported | 15.33 (>93rd percentile) | 0.09 (<93rd percentile) | Moderate | Data come from normative sample of 2482 children ages 3 to 17 across the United States and Canada. Diagnostic likelihood ratios here discriminate ADHD from Non-Clinical.<ref name=Collett_et_al-2003>{{cite journal |last1=Collett |first1=Brent R. |last2=Ohan |first2=Jeneva L. |last3=Myers |first3=Kathleen M. |title=Ten-year review of rating scales. V: Scales assessing attention-deficit/hyperactivity disorder |journal=Journal of the American Academy of Child and Adolescent Psychiatry |date=September 2003 |volume=42 |issue=9 |pages=1015-37 |pmid=12960702 |doi=10.1097/01.CHI.0000070245.24125.B6 }}</ref> | |- | Conners Parent Rating Scale-48 (CPRS-48) Impulsive-Hyperactive Subscale {{var|T}}-Score (Conners, 1990) | Not reported | 1.26 (>70) | 0.79 (>70) | Somewhat High | rowspan="2"| Utilized sample ages 5-12 years referred to a research clinic for assessment of ADHD. 108 children were ultimately diagnosed with ADHD, while 76 were not. LR's are calculated for discriminating between those two groups.<ref name=Tripp_et_al-2006 /> | |- | Conners Teacher Rating Scale-39 Hyperactivity Subscale {{var|T}}-Score (Conners, 1990) | Not reported | 5.2 (>70) | 0.53 (<70) | Somewhat High | |- | Conners Teacher Rating Scale (Revised) - Long Form (Conners, 1997) | Not reported | 8.66 (>93rd percentile) | 0.24 (<93rd percentile) | Moderate | Data come from normative sample of 1973 children ages 5 to 17 across the United States and Canada. Likelihood ratios discriminate ADHD from non-clinical.<ref name=Collett_et_al-2003 /> | |- | ADHD Symptom Checklist-4 (ADHD-SC4) - Parent Report<ref name=Gadow_Sprafkin-1997>{{cite book |last1=Gadow |first1=Kenneth D. |last2=Sprafkin |first2=Joyce N. |date=1997 |title=ADHD Symptom Checklist-4 |publisher=Checkmate Plus |location=Stony Brook, NY |oclc=49637921 }}</ref> | Not reported | 1.45 (Endorsed ≥ 6 symptoms of inattention or hyperactivity) | 0.70 (Endorsed < 6 symptoms of inattention or hyperactivity) | Somewhat High | rowspan="2"| Data come from sample of 207 children ages 5-17 years old who were referred to psychiatric outpatient service with variety of emotional and behavioral disorders.<ref name=Sprafkin_Gadow-2007>{{cite journal |last1=Sprafkin |first1=Joyce |last2=Gadow |first2=Kenneth D. |title=Choosing an attention-deficit/hyperactivity disorder rating scale: is item randomization necessary? |journal=Journal of Child and Adolescent Psychopharmacology |date=February 2007 |volume=17 |issue=1 |pages=75-84 |pmid=17343555 |doi=10.1089/cap.2006.0035 }}</ref> | |- | ADHD Symptom Checklist-4 (ADHD-SC4) - Teacher Report<ref name=Gadow_Sprafkin-1997/> | Not reported | 1.53 (Endorsed ≥ 6 symptoms of inattention or hyperactivity) | 0.60 (Endorsed < 6 symptoms of inattention or hyperactivity) | Somewhat High | |- | [[w:ADHD rating scale|ADHD RS-IV]] - Home (DuPaul et. al, 1998b) | Not reported | 1.63 (>80th percentile) | 0.35 (<80th percentile) | Moderate | rowspan="2"| Sample of 2000 children ages 5 to 18 years old from geographically representative normative base.<ref name=Collett_et_al-2003 /> | |- | ADHD RS-IV - School (DuPaul et. al, 1998b) | Not reported | 4.5 (>80th percentile) | 0.42 (<80th percentile) | Moderate | |- | colspan="7" style="font-size:110%; text-align:center;" span |'''Adults''' |- |} '''Note:''' All studies with one exception used structured or semi-structured clinical interviews to establish diagnosis of ADHD. The exception, the Sprafkin & Gadow study (2007), used a combination of CBCL rating scales, clinician review, and clinician consensus to confirm ADHD diagnosis.<ref name=Sprafkin_Gadow-2007 /> “LR+” refers to the change in likelihood ratio associated with a positive test score, and “LR-” is the likelihood ratio for a low score. Likelihood ratios of 1 indicate that the test result did not change impressions at all. LRs larger than 10 or smaller than .10 are frequently clinically decisive; 5 or .20 are helpful, and between 2.0 and .5 are small enough that they rarely result in clinically meaningful changes of formulation (Sackett et al., 2000). === Interpreting ADHD screening measure scores === * For information on interpreting screening measure scores, click [[Evidence based assessment/Prediction phase#Interpreting screening measure scores|here.]] * Also see the page on [https://en.wikipedia.org/wiki/Likelihood_ratios_in_diagnostic_testing likelihood ratios in diagnostic testing] for more information ==[[Evidence based assessment/Prescription phase|'''Prescription phase''']]== ===Gold standard diagnostic interviews=== * For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews click here.] ===Recommended diagnostic interviews for ADHD=== ''****Depression instruments are placeholders'' {| class="wikitable sortable" border="1" ! colspan="5" |Diagnostic instruments for '''ADHD''' |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time !Where to Access |- |- | colspan="5" style="font-size:110%; text-align:center;" span |'''Youth''' |- | Barkley Functional Impairment Scale—Children and Adolescents (BFIS-CA) | Parent Report | 6-17 | 5-7 minutes |Link to [https://www.guilford.com/books/Barkley-Functional-Impairment-Scale-Children-Adolescents-BFIS-CA/Russell-Barkley/9781462503957 purchase] |- | Weiss Functional Impairment Rating Scale<ref>{{Cite journal|last=Thompson|first=Trevor|last2=Lloyd|first2=Andrew|last3=Joseph|first3=Alain|last4=Weiss|first4=Margaret|date=2017|title=The Weiss Functional Impairment Rating Scale-Parent Form for assessing ADHD: evaluating diagnostic accuracy and determining optimal thresholds using ROC analysis|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5486894/|journal=Quality of Life Research|volume=26|issue=7|pages=1879–1885|doi=10.1007/s11136-017-1514-8|issn=0962-9343|pmc=5486894|pmid=28220338}}</ref> | Parent/Caregiver Report | 5-19 | |[http://www.shared-care.ca/files/WFIRS-Parent_with_Instructions_May_2012.pdf PDF] |- |- | colspan="5" style="font-size:110%; text-align:center;" span |'''Adults''' |- |} '''Note:''' '''L''' = Less than adequate; '''A''' = Adequate; '''G''' = Good; '''E''' = Excellent; '''U''' = Unavailable; '''NA''' = Not applicable<ref>{{Cite web|url=https://en.wikiversity.org/wiki/Evidence-based_assessment/Reliability#Evaluating_norms_and_reliability|title=Evidence-based assessment/Reliability - Wikiversity|website=en.wikiversity.org|access-date=2020-11-13}}</ref> ==[[Evidence based assessment/Process phase|'''Process phase''']]== The following section contains a brief overview of treatment options for ADHD and list of process and outcome measures for ADHD. The section includes benchmarks based on published norms for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the [[Evidence based assessment/Process phase|process phase]] of assessment. For more information of differences between process and outcome measures, see the page on the [[Evidence based assessment/Process phase|process phase of assessment]]. === Process measures === {{blockquotetop}} ; CBCL Attention Problems Subscale : Could be used on a weekly basis to track changes in ADHD symptomotology. T-scores from this measure could also be recorded on a weekly basis to determine if reliable and clinically significant changes in ADHD symptoms are occuring. The CBCL Attention Problems Subscale has repeatedly demonstrated good-to-excellent convergence with diagnostic interviews for diagnosing ADHD.<ref name=Pelham_et_al-2005>{{cite journal |last1=Pelham |first1=William E., Jr. |last2=Fabiano |first2=Gregory A. |last3=Massetti |first3=Greta M. |date=September 2005 |title=Evidence-based assessment of attention deficit hyperactivity disorder in children and adolescents |journal=Journal of Clinical Child and Adolescent Psychology |volume=34 |issue=3 |pages=449-76 |pmid=16026214 |doi=10.1207/s15374424jccp3403_5 |url=https://www.researchgate.net/profile/Greta_Massetti/publication/7719090_Evidence-Based_Assessment_of_Attention_Deficit_Hyperactivity_Disorder_in_Children_and_Adolescents/links/09e415107e6e01c28e000000.pdf |format=PDF }}</ref><ref>{{cite journal |last1=Lampert |first1=TL |last2=Polanczyk |first2=G |last3=Tramontina |first3=S |last4=Mardini |first4=V |last5=Rohde |first5=LA |date=October 2004 |title=Diagnostic performance of the CBCL-Attention Problem Scale as a screening measure in a sample of Brazilian children with ADHD |journal=Journal of Attention Disorders |volume=8 |issue=2 |pages=63-71 |pmid=15801336 }}</ref><ref name=Hudziak_et_al-2004/><ref name=Chen_et_al-1994/> '''The CBCL Attention Problems Subscale is a scale on the CBCL, which is readily available at the Finley Clinic.''' ; Daily Report Card : Several scholars have pointed out that it is equally important to track changes in the functional behaviors that a child with ADHD engages in, in addition to their ADHD symptoms, to capture the full range of adaptive changes that are made by children with ADHD throughout the course of treatment.<ref name=Pelham_et_al-2005/><ref>{{cite book |last1=Sowerby |first1=Paula |last2=Tripp |first2=Gail |date=2009 |chapter=Evidence-Based Assessment of Attention-Deficit/Hyperactivity Disorder (ADHD) |editor1-last=Matson |editor1-first=Johnny L. |editor2-last=Andrasik |editor2-first=Frank |editor3-last=Matson |editor3-first=Michael L. |title=Assessing Childhood Psychopathology and Developmental Disabilities |pages=209-239 |publisher=Springer Science & Business Media |location=New York |oclc=314175875 |doi=10.1007/978-0-387-09528-8 |isbn=978-0-387-09528-8 |chapter-url=https://books.google.com/books?id=TyJClvRUgY4C&pg=PA209 }}</ref> The daily report card is a mechanism by which such adaptive behavioral changes can be tracked. When implementing the daily report card, problematic child behaviors at home and at school are targeted for change. Rewards are offered to the child for reaching daily and weekly goals for reducing maladaptive behaviors and increasing adaptive behaviors. Parents and Teachers track child behaviors on a daily basis and provide feedback to one another and the child with behavior frequency counts and/or daily "grades" on how well the child behaved. Daily report cards are a mainstay of cognitive-behavioral and behavioral modification evidence-based intervention strategies for ADHD,<ref name=DuPaul_et_al-2012/><ref>{{cite journal |last1=Eiraldi |first1=Ricardo B. |last2=Mautone |first2=Jennifer A. |last3=Power |first3=Thomas J. |date=January 2012 |title=Strategies for implementing evidence-based psychosocial interventions for children with attention-deficit/hyperactivity disorder |journal=Child and Adolescent Psychiatric Clinics of North America |volume=21 |issue=1 |pages=145-59 |pmid=22137818 |pmc=3233687 |doi=10.1016/j.chc.2011.08.012 }}</ref> and they are highly recommended for tracking child treatment outcomes. '''Instructions for creating a daily report card are attached in Appendix 1.''' {{blockquotebottom}} === Outcome and severity measures === This table includes clinically significant benchmarks for ADHD specific outcome measures * Information on how to interpret this table can be [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase found here]. * Additionally, these [[Evidence based assessment/Vignettes|vignettes]] might be helpful resources for understanding appropriate adaptation of outcome measures in practice. * ''<u>For clinically significant change benchmarks for the CBCL, YSR, and TRF total, externalizing, internalizing, and attention benchmarks,</u>'' [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase&wteswitched=1#Clinically_significant_change_benchmarks_for_widely-used_outcome_measures see here.] {| class="wikitable" border="1" |+Clinically significant change benchmarks with common instruments and ADHD rating scales |- ! rowspan="2" scope="col" | Measure ! rowspan="2" scope="col" | Diagnostic category ! colspan="3" scope="colgroup" width="300" | Cut Scores* ! colspan="3" scope="colgroup" | Critical Change<br>(Unstandardized Scores) |- ! scope="col" | A ! scope="col" | B ! scope="col" | C ! scope="col" | 95% ! scope="col" | 90% ! scope="col" | SE_difference |- | colspan="8" style="text-align:center" |'''Benchmarks Based on Published Norms''' |- | rowspan="4" style="text-align:center;" |''{{abbr|CBCL|Child Behavior Checklist}} {{var|T}}-scores<br>(2001 Norms)'' | style="text-align:right" | Total | style="text-align:center;" | 49 | style="text-align:center;" | 70 | style="text-align:center;" | 58 | style="text-align:center;" | 5 | style="text-align:center;" | 4 | style="text-align:center;" | 2.4 |- | style="text-align:right" | Externalizing | style="text-align:center;" | 49 | style="text-align:center;" | 70 | style="text-align:center;" | 58 | style="text-align:center;" | 7 | style="text-align:center;" | 6 | style="text-align:center;" | 3.4 |- | style="text-align:right" | Internalizing | {{n/a}} | style="text-align:center;" | 70 | style="text-align:center;" | 56 | style="text-align:center;" | 9 | style="text-align:center;" | 7 | style="text-align:center;" | 4.5 |- | style="text-align:right" | Attention Problems | {{n/a}} | style="text-align:center;" | 66 | style="text-align:center;" | 58 | style="text-align:center;" | 8 | style="text-align:center;" | 7 | style="text-align:center;" | 4.2 |- | rowspan="4" style="text-align:center;" |''{{abbr|TRF|Teacher Response Form}} {{var|T}}-Scores<br>(2001 Norms)'' | style="text-align:right" | Total | {{n/a}} | style="text-align:center;" | 70 | style="text-align:center;" | 57 | style="text-align:center;" | 5 | style="text-align:center;" | 4 | style="text-align:center;" | 2.3 |- | style="text-align:right" | Externalizing | {{n/a}} | style="text-align:center;" | 70 | style="text-align:center;" | 56 | style="text-align:center;" | 6 | style="text-align:center;" | 5 | style="text-align:center;" | 3.0 |- | style="text-align:right" | Internalizing | {{n/a}} | style="text-align:center;" | 70 | style="text-align:center;" | 55 | style="text-align:center;" | 9 | style="text-align:center;" | 7 | style="text-align:center;" | 4.4 |- | style="text-align:right" | Attention Problems | {{n/a}} | style="text-align:center;" | 66 | style="text-align:center;" | 57 | style="text-align:center;" | 5 | style="text-align:center;" | 4 | style="text-align:center;" | 2.3 |- | rowspan="2" style="text-align:center" |''Conners 3-Teacher Rating Scale {{var|T}}-Scores'' | style="text-align:right" | ADHD Inattentive | style="text-align:center;" | 36 | style="text-align:center;" | 74 | style="text-align:center;" | 57 | style="text-align:center;" | 11 | style="text-align:center;" | 10 | style="text-align:center;" | 5.6 |- | style="text-align:right" | ADHD Hyperactive-Impulsive | style="text-align:center;" | 36 | style="text-align:center;" | 74 | style="text-align:center;" | 57 | style="text-align:center;" | 11 | style="text-align:center;" | 9 | style="text-align:center;" | 5.5 |- | rowspan="2" style="text-align:center" |''Conners 3-Parent Rating Scale {{var|T}}-Scores'' | style="text-align:right" | ADHD Inattentive | style="text-align:center;" | 37 | style="text-align:center;" | 72 | style="text-align:center;" | 58 | style="text-align:center;" | 10 | style="text-align:center;" | 10 | style="text-align:center;" | 5.6 |- | style="text-align:right" | ADHD Hyperactive-Impulsive | style="text-align:center;" | 37 | style="text-align:center;" | 72 | style="text-align:center;" | 58 | style="text-align:center;" | 10 | style="text-align:center;" | 8 | style="text-align:center;" | 4.7 |- | colspan="8" style="text-align:center" |'''Benchmarks Based on ADHD Samples'''<ref name="Shemmassian_Lee-2012" /> |- | colspan="2" |''Disruptive Behavior Disorders Rating Scale'' | style="text-align:center;" | 1.4 | style="text-align:center;" | 8.6 | style="text-align:center;" | 5.7 | style="text-align:center;" | 12 | style="text-align:center;" | 10 | style="text-align:center;" | 0.9 |} '''Note:''' “A” = Away from the clinical range, “B” = Back into the nonclinical range, “C” = Closer to the nonclinical than clinical mean. <ref>{{Cite web|url=https://en.wikiversity.org/wiki/Evidence-based_assessment/Reliability#Evaluating_norms_and_reliability|title=Evidence-based assessment/Reliability - Wikiversity|website=en.wikiversity.org|access-date=2020-11-13}}</ref> '''Search terms:''' [ADHD or CONNERS or DBD] AND [clinical significance OR group means] in PsycINFO === Treatment === * Please refer to the Wikipedia page on [[wikipedia:Attention_deficit_hyperactivity_disorder|Attention Deficit Hyperactivity Disorder]] for more information on available treatment for ADHD or go to [https://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/inattention-and-hyperactivity-adhd/ Effective Child Therapy] for a curated resource on effective treatments for ADHD. {{collapse top| Click here for ADHD Treatment Information|expand=yes}} === Executive summary === 1. If intervening with children ages 4-5, behavior therapy should be the first line of treatment. 2. If intervening with children ages 6-11, behavior therapy should be the first line of treatment, in conjunction with medication. 3. If intervening with children ages 12-18, medication should probably be the first line of treatment, though behavior therapy could be used in combination. 4. Three types of therapeutic interventions have well established evidence-bases: :a. Behavioral Parent Training Interventions :b. Behavioral Classroom Management Interventions :c. Behavioral Peer interventions involving recreational peer groups (e.g. summer camps) 5. If considering a classroom management intervention: :a. Academic and Cognitive-Behavioral Interventions are most effective in changing academic outcomes :b. Cognitive Behavioral and Contingency Management Interventions are most effective in changing behavioral outcomes === Clinical practice guidelines === Published by the American Academy of Pediatrics in 2011.<ref name="AAP_Guideline-2011">{{cite journal |author1=Subcommittee on Attention-Deficit/Hyperactivity Disorder |author2=Steering Committee on Quality Improvement and Management |last3=Wolraich |first3=Mark |last4=Brown |first4=Lawrence |last5=Brown |first5=Ronald T. |last6=DuPaul |first6=George |last7=Earls |first7=Marian |last8=Feldman |first8=Heidi M. |last9=Ganiats |first9=Theodore G. |last10=Kaplanek |first10=Beth |last11=Meyer |first11=Bruce |last12=Perrin |first12=James |last13=Pierce |first13=Karen |last14=Reiff |first14=Michael |last15=Stein |first15=Martin T. |last16=Visser |first16=Susanna |date=November 2011 |title=ADHD: Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents |journal=Pediatrics |volume=128 |issue=5 |pages=1007-22 |pmid=22003063 |pmc=4500647 |doi=10.1542/peds.2011-2654 }}</ref> ; Preschool-aged children (ages 4–5) : Primary care clinicians should prescribe evidence-based parent and/or teacher-administered behavior therapy as the first line of treatment, and may prescribe methylphenidate if behavioral interventions are not effective. ; Elementary-aged children (ages 6–11) : Primary care clinicians should prescribe FDA-approved medications for ADHD and/or evidence based parent and teacher administered behavior therapy. Preferably, both medication and behavior therapy will be prescribed. ; Adolescents (ages 12–18) : Primary care clinicians should prescribe FDA approved medications for ADHD with the assent of the adolescent and may prescribe behavior therapy as a treatment for ADHD, preferably both. === Behavioral therapies === These meet the American Academy of Pediatrics and American Psychological Association Task Force criteria for well-established evidence-based treatments. Descriptions and effect sizes are taken from the American Academy of Pediatrics' guidelines<ref name="AAP_Guideline-2011" /> and Pelham & Fabiano's review article.<ref>{{cite journal |last1=Pelham |first1=William E., Jr. |last2=Fabiano |first2=Gregory A. |date=January 2008 |title=Evidence-based psychosocial treatments for attention-deficit/hyperactivity disorder |journal=Journal of Clinical Child and Adolescent Psychology |volume=37 |issue=1 |pages=184-214 |doi=10.1080/15374410701818681 |pmid=18444058 |lay-url=https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0026847/ |lay-source=Database of Abstracts of Reviews of Effects: Quality-assessed Reviews |lay-date=12 February 2009 }}</ref> ; Behavioral Parent Training : Behavior modification principles provided to parents for implementation in home settings. Typical outcomes include improved compliance with parental commands, improved parental understanding of behavioral principles, high levels of parental satisfaction with treatment. :'''Median effect size:''' 0.55 ; Behavioral Classroom Management : Behavior-modification principles provided to teachers for implementation in classroom settings. Typical outcomes include improved attention to instruction, improved compliance with classroom rules, decreased disruptive behavior, improved work productivity, and improved academic achievement. :'''Median effect size:''' 0.61 ; Behavioral Peer Interventions : Interventions focused on peer interactions/relationships. These could include group-based interventions provided weekly and include clinic-based social skills training used either alone or concurrently with behavioral parent training and/or medication. Typical outcomes are more mixed with these interventions. Some clinical-office based interventions have produced minimal effects, while some studies of behavioral peer intervention coupled with behavioral parent training found positive effects on parental ratings of ADHD symptoms. No studies of this type of intervention reveal differences on social functioning or parental ratings of social behavior. Behavioral Peer Interventions implemented in peer group/recreational settings (e.g. summer camps) have the most evidence of being effective. :'''Median effect size:''' None reported, effect sizes found are considered moderate. === School based interventions === {| class="wikitable" align="right" |+Single Subject Design Effect Sizes |- ! rowspan="2" scope="col" | Intervention type ! colspan="2" scope="colgroup" | Effect size |- ! scope="col" | Academic<br>outcomes ! scope="col" | Behavioral<br>outcomes |- | {{rh}} class="table-rh" |Academic | style="text-align:right" | 4.73 | style="text-align:right" | 1.53 |- | {{rh}} class="table-rh" |Cognitive behavioral | style="text-align:right" | 3.77 | style="text-align:right" | 3.31 |- | {{rh}} class="table-rh" |Contingency management | style="text-align:right" | 2.29 | style="text-align:right" | 2.40 |- | {{rh}} class="table-rh" |Combined | style="text-align:right" | 2.29 | style="text-align:right" | 1.31 |} Findings from a review by DuPaul and colleagues.<ref name="DuPaul_et_al-2012">{{cite journal |last1=DuPaul |first1=George J. |last2=Eckert |first2=Tanya L. |last3=Vilardo |first3=Brigid |date=December 2012 |title=The effects of school-based interventions for attention deficit hyperactivity disorder: A meta-analysis 1996-2010 |journal=School Psychology Review |volume=41 |issue=4 |pages=387-412 |issn=0279-6015 |id=ERIC [https://eric.ed.gov/?id=EJ1001907 EJ1001907] }}</ref> ; Associated with greater effects on academic outcomes :''Academic'' — interventions focus primarily on manipulating antecedent conditions via things like peer tutoring, computer-aided instruction, and organizational skills. :''Combined'' academic and contingency management interventions. ; Associated with greater effects for behavior outcomes :''Contingency management'' — interventions use reinforcement and punishment. :''Cognitive behavioral'' — interventions focus on development of self-control skills and reflective problem-solving strategies. {{clear}} {{collapse bottom}} == '''External Links''' == *[https://sccap53.org Society of Clinical Child and Adolescent Psychology] *[http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/inattention-and-hyperactivity-adhd/ EffectiveChildTherapy.Org information on ADHD] *[https://ccf.fiu.edu/_assets/pdfs/how_to_establish_a_school_drc.pdf Establishing a School-Home Daily Report Card] *[https://ccf.fiu.edu/_assets/pdfs/what-parents-and-teachers-should-know-about-adhd-updated-1214.pdf What Parents and Teachers Should Know About ADHD (Fact Sheet)] *[https://ccf.fiu.edu/_assets/pdfs/psychosocial_fact_sheet-updated-1214.pdf Psychosocial Interventions for ADHD] *[https://ccf.fiu.edu/_assets/pdfs/adhd-medication-information-sheet-for-parents-and-teachers1.pdf ADHD Medication Information Sheet for Parents and Teachers] =='''References'''== {{collapse top|Click here for references}} {{Reflist|30em}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] {{collapse bottom}} {{subpage navbar}} 6tpmqige1jxzh0o2w6jxycspx6p8gx0 2419181 2419179 2022-08-26T01:59:31Z Ardenguo 2944162 /* References */ Made the references box expanded by default wikitext text/x-wiki 3<noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{medical disclaimer}} {{:{{BASEPAGENAME}}/Sidebar}} ==[[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio"?''']]== For background information on what assessment portfolios are, click the link in the heading above. Want even 'more' information about this topic? There's an extended version of this page [[Evidence-based assessment/Attention deficit hyperactivity disorder (assessment portfolio)/extended version|here]]. ==[[Evidence based assessment/Preparation phase|'''Preparation phase''']]== === Diagnostic Criteria of ADHD in youth === {{blockquotetop}} <big>ICD-11 Diagnostic Criteria </big><br> <br> '''General Description:''' Attention deficit hyperactivity disorder is characterised by a persistent pattern (at least 6 months) of inattention and/or hyperactivity-impulsivity that has a direct negative impact on academic, occupational, or social functioning. There is evidence of significant inattention and/or hyperactivity-impulsivity symptoms prior to age 12, typically by early to mid-childhood, though some individuals may first come to clinical attention later. The degree of inattention and hyperactivity-impulsivity is outside the limits of normal variation expected for age and level of intellectual functioning. Inattention refers to significant difficulty in sustaining attention to tasks that do not provide a high level of stimulation or frequent rewards, distractibility and problems with organisation. Hyperactivity refers to excessive motor activity and difficulties with remaining still, most evident in structured situations that require behavioural self-control. Impulsivity is a tendency to act in response to immediate stimuli, without deliberation or consideration of the risks and consequences. The relative balance and the specific manifestations of inattentive and hyperactive-impulsive characteristics varies across individuals and may change over the course of development. In order for a diagnosis to be made, manifestations of inattention and/or hyperactivity-impulsivity must be evident across multiple situations or settings (e.g., home, school, work, with friends or relatives), but are likely to vary according to the structure and demands of the setting. <br> <br> '''Predominantly Inattentive Presentation:''' All definitional requirements for attention deficit hyperactivity disorder are met and inattentive symptoms are predominant in the clinical presentation. Inattention refers to significant difficulty in sustaining attention to tasks that do not provide a high level of stimulation or frequent rewards, distractibility and problems with organization. Some hyperactive-impulsive symptoms may also be present, but these are not clinically significant in relation to the inattentive symptoms. <br> <br> '''Predominantly Hyperactive-Impulsive:''' All definitional requirements for attention deficit hyperactivity disorder are met and hyperactive-impulsive symptoms are predominant in the clinical presentation. Hyperactivity refers to excessive motor activity and difficulties with remaining still, most evident in structured situations that require behavioural self-control. Impulsivity is a tendency to act in response to immediate stimuli, without deliberation or consideration of the risks and consequences. Some inattentive symptoms may also be present, but these are not clinically significant in relation to the hyperactive-impulsive symptoms. <br> <br> <big>Changes in DSM-5</big> <br> The diagnostic criteria for ADHD changed slightly from DSM-IV to DSM-5. See the changes [https://www.ncbi.nlm.nih.gov/books/NBK519712/table/ch3.t3/ here]. {{blockquotebottom}}<ref>{{Cite web|url=https://icd.who.int/browse11/l-m/en#/http://id.who.int/icd/entity/821852937|title=ICD-11 for Mortality and Morbidity Statistics|website=icd.who.int|access-date=2022-06-21}}</ref> ===Base rates of youth ADHD in different populations and clinical settings=== This section describes the demographic setting of the population(s) sampled, base rates of diagnosis, country/region sampled, and the diagnostic method that was used. Using this information, clinicians will be able to anchor the rates of adolescent depression that they are likely to see in their clinical practices. * '''''To find prevalence rates across multiple disorders,''''' [[Evidence based assessment/Preparation phase#Base rates for transdiagnostic comparison|click here.]] {| class="wikitable sortable" |- ! Demography ! Setting ! Base Rate(s) ! Diagnostic Method |- |Worldwide, Ages 3-18 |Meta-Analysis of worldwide prevalence of Child/Adolescent ADHD<ref>{{cite journal |last=Willcutt |first=Erik G. |date=July 2012 |title=The Prevalence of DSM-IV Attention-Deficit/Hyperactivity Disorder: A Meta-Analytic Review |journal=Neurotherapeutics |volume=9 |issue=3 |pages=490-99 |pmid=22976615 |pmc=3441936 |doi=10.1007/s13311-012-0135-8 }}</ref> |6.1% (parent rating)<br>7.1% (teacher rating)<br>10.5% (ages 3-5)<br>11.4% (ages 6-12)<br>8.0% (ages 13-18) |Multiple, but each focused on DSM-IV criteria |- |USA Nationally Representative, Ages 3-17 |Epidemiological [[w:National Health Interview Survey|NHIS]] (US CDC, 2011) |8.4% (Overall)<br>12.0% (Male)<br>4.7% (Female)<br>2.1% (ages 3-5)<br>8.4% (ages 6-11)<br>11.9% (ages 12-17)<br>10.3% (southern region of US) |Parent-report of whether child had ever been diagnosed |- |USA Nationally Representative, Ages 4-17 |Child and Adolescent Epidemiological National Survey of Children's Health (US CDC, 2007) |9.5% (overall)<br>12.3% (male)<br>5.3% (female)<br>1.5% (ages 3-5)<br>9.1% (ages 6-11)<br>12.4% (ages 12-17)<br>15.6% (North Carolina) |Parent-report of whether child had ever been diagnosed |- |USA Nationally Representative, Ages 5-14 |Teacher-Reported Prevalence of ADHD<ref>{{cite journal |last1=Fabiano |first1=Gregory A. |last2=Pelham |first2=William E., Jr. |last3=Majumdar |first3=Antara |last4=Evans |first4=Steven W. |last5=Manos |first5=Michael J. |last6=Caserta |first6=Donald |last7=Girio-Herrera |first7=Erin L. |last8=Pisecco |first8=Stewart |last9=Hannah |first9=Jane N. |last10=Carter |first10=Randy L. |date=April 2013 |title=Elementary and Middle School Teacher Perceptions of Attention-Deficit/Hyperactivity Disorder Prevalence |journal=Child & Youth Care Forum |volume=42 |issue=2 |pages=87-99 |doi=10.1007/s10566-013-9194-1 }}</ref> |5.25% (overall)<br>5.58% (elementary schoolers)<br>3.53% (middle schoolers)<br>7.1% (one county in rural NC) |Teacher report of number of children who have been identified with ADHD in their class |- |USA Nationally Representative, Ages 13-18 |Adolescent Epidemiological [[w:National Comorbidity Survey|National Comorbidity Survey-Adolescent Supplement]]<ref>{{cite journal |last1=Merikangas |first1=Kathleen Ries |last2=He |first2=Jian-Ping |last3=Burstein |first3=Marcy |last4=Swanson |first4=Sonja A. |last5=Avenevoli |first5=Shelli |last6=Cui |first6=Lihong |last7=Benjet |first7=Corina |last8=Georgiades |first8=Katholiki |last9=Swendsen |first9=Joel |date=October 2010 |title=Lifetime prevalence of mental disorders in U.S. adolescents: results from the National Comorbidity Survey Replication—Adolescent Supplement (NCS-A) |journal=Journal of the American Academy of Child and Adolescent Psychiatry |volume=49 |issue=10 |pages=980-9 |pmid=20855043 |pmc=2946114 |doi=10.1016/j.jaac.2010.05.017 }}</ref> |8.7% |CIDI 3.0 structured diagnostic interview |- |Ages 6-90 |Meta-Analysis of Clinical Samples<ref name="Rettew_et_al-2009">{{cite journal |last1=Rettew |first1=David C. |last2=Lynch |first2=Alicia Doyle |last3=Achenbach |first3=Thomas M. |last4=Dumenci |first4=Levent |last5=Ivanova |first5=Masha Y. |date=September 2009 |title=Meta-analyses of agreement between diagnoses made from clinical evaluations and standardized diagnostic interviews |journal=International Journal of Methods in Psychiatric Research |volume=18 |issue=3 |pages=169-84 |pmid=19701924 |doi=10.1002/mpr.289 }}</ref> |38% |Structured Diagnostic Interviews |- |Ages 6-90 |Meta-Analysis of Clinical Samples<ref name="Rettew_et_al-2009" /> |23% |Clinical Evaluations |- |Representative Sample of Johnston County School Children, North Carolina, Ages 6-12 |Johnston County, North Carolina Sample<ref>{{cite journal |last1=Rowland |first1=Andrew S. |last2=Skipper |first2=Betty J. |last3=Umbach |first3=David M. |last4=Rabiner |first4=David L. |last5=Campbell |first5=Richard A. |last6=Naftel |first6=Albert J. |last7=Sandler |first7=Dale P. |date=11 December 2013 |title=The Prevalence of ADHD in a Population-Based Sample |journal=Journal of Attention Disorders |volume=19 |issue=9 |pages=741-54 |pmid=24336124 |pmc=4058092 |doi=10.1177/1087054713513799 }}</ref> |15.5% |Combined parent and teacher report (NTRS and DISC) with DSM-IV criteria |- |Sample drawn from 11 counties in Western NC, Ages 9-16 |North Carolina Community Sample<ref>{{cite journal |last1=Costello |first1=E. Jane |last2=Mustillo |first2=Sarah |last3=Erkanli |first3=Alaattin |last4=Keeler |first4=Gordon |last5=Angold |first5=Adrian |date=August 2003 |title=Prevalence and development of psychiatric disorders in childhood and adolescence |journal=Archives of General Psychiatry |volume=60 |issue=8 |pages=837-44 |pmid=12912767 |doi=10.1001/archpsyc.60.8.837 |doi-access=free |url=http://jamanetwork.com/journals/jamapsychiatry/fullarticle/207725 }}</ref> |0.9% (3-month prevalence)<br>4.1% (estimated by age 16) |CAPA structured diagnostic interview |- |Sample recruited at Durham, NC, Seattle, Nashville, and Central Pennsylvania sites. Sample was followed longitudinally and identified as at high risk for externalizing disorders in kindergarten. 50% African American, Ages 12-15 |High-Risk Community Sample<ref>{{cite journal |last1=Jones |first1=Damon E. |last2=Foster |first2=E. Michael |date=October 2009 |title=Service Use Patterns for Adolescents with ADHD and Comorbid Conduct Disorder |journal=Journal of Behavioral Health Services & Research |volume=36 |issue=4 |pages=436-49 |pmid=18618263 |pmc=3534729 |doi=10.1007/s11414-008-9133-3 }}</ref> |14.3% |Diagnostic Interview Schedule for Children (DISC) |} ==[[Evidence based assessment/Prediction phase|'''Prediction phase''']]== === Psychometric properties of screening instruments for youth ADHD === The following section contains a list of screening and diagnostic instruments for ADHD. The section includes administration information, psychometric data, and PDFs or links to the screenings. * Screenings are used as part of the [[Evidence based assessment/Prediction phase|prediction phase]] of assessment; for more information on interpretation of this data, or how screenings fit in to the assessment process, [[Evidence based assessment/Prediction phase|'''click here''']]. * '''''For a list of more broadly-reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Common_screening_instruments click here.]''''' === Screening and diagnostic instruments for attention deficit hyperactivity disorder=== {| class="wikitable sortable" border="1" |- ! Measure ! Format (Reporter) ! Age Range ! Administration/<br>Completion Time !Where to Access |- | colspan="5" style="font-size:110%; text-align:center;" span |'''Youth''' |- |ADHD Rating Scale (ADHD-RS-V)<ref>DuPaul, G. J., Power, T. J., Anastopoulos, A. D., & Reid, R. (1998). ADHD Rating Scale–IV: Checklists, norms, and clinical interpretation. New York: Guilford Press</ref> |Teacher, Parent |5-10 y/o: Child Version 11-17 y/o: Adolescent Version |5 minutes for each scale | |- |Conners 3rd Edition<ref>{{Cite web|url=https://www.pearsonassessments.com/store/usassessments/en/Store/Professional-Assessments/Behavior/Comprehensive/Conners-3rd-Edition/p/100000523.html|title=Conners 3rd Edition|website=www.pearsonassessments.com|language=en|access-date=2022-06-30}}</ref> |Teacher, Parent |6-18 y/o: Administered to parents and teachers of children and adolescents age 8-18 y/o: Self-report |20 minutes: Long Version 10 minutes: Short Version <5 Minutes: Conners 3AI and Conners 3GI |[https://www.pearsonassessments.com/store/usassessments/en/Store/Professional-Assessments/Behavior/Comprehensive/Conners-3rd-Edition/p/100000523.html Not Free] |- |Vanderbilt ADHD Parent Rating Scale (VADPRS) |Teacher, Parent |6-12 y/o | |Free |- |Child Behavior Checklist (CBCL/6-18) |Parent |6-18 y/o |15-20 minutes |Free |- |Behavior Assessment Scale for Children (BASC-3) | | |10-20 minutes: (TRS and PRS) 30 minutes: (SRP) |Not Free |- | colspan="5" style="font-size:110%; text-align:center;" span |'''Adults''' |- |} '''Note:''' L = Less than adequate; A = Adequate; G = Good; E = Excellent <ref>{{Cite web|url=https://en.wikiversity.org/wiki/Evidence-based_assessment/Reliability#Evaluating_norms_and_reliability|title=Evidence-based assessment/Reliability - Wikiversity|website=en.wikiversity.org|access-date=2020-11-13}}</ref> === Likelihood ratios and AUCs of screening measures for '''ADHD''' === * '''''For a list of the likelihood ratios for more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Likelihood_ratios_and_AUCs_of_common_screening_instruments click here.]''''' {| class="wikitable sortable mw-collapsible" border="1" |- ! Screening Measure (Primary Reference) !data-sort-type="number"| {{abbr|AUC (sample size)|Area under curve}} !data-sort-type="number"| {{abbr|DiLR+ (score)|Positive likelihood ratio}} Score !data-sort-type="number"| {{abbr|DiLR- (score)|Negative likelihood ratio}} Score ! Clinical Generalizeability and Study Description ! class="unsortable"| Study description !Where to Access |- |- | colspan="7" style="font-size:110%; text-align:center;" span |'''Youth''' |- |rowspan="4"| [[w:Child Behavior Checklist|Child Behavior Checklist]] (CBCL) - Attention Problems {{var|T}}-Score<ref name=Achenbach-1991>{{cite book |last1=Achenbach |first1=Thomas M. |author1-link=w:Thomas M. Achenbach |title=Child behavior checklist for ages 4-18 |date=1991 |publisher=Department of Psychiatry, University of Vermont |location=Burlington, VT |isbn=978-0-938565-08-6 }}</ref> |rowspan="4"| .84 ({{var|N}}=187) | 6.92 (>55) | 0.19 (<55) |rowspan="4"| Somewhat High Utilized sample ages 6-18 recruited from local pediatricians, psychiatrists, and community advertisements. Included 95 children who met criteria for ADHD. 70 of these children also met criteria for ODD/CD.<ref name="Hudziak_et_al-2004" /> |rowspan="4"| Utilized sample ages 6-18 recruited from local pediatricians, psychiatrists, and community advertisements. Included 95 children who met criteria for ADHD. 70 of these children also met criteria for ODD/CD.<ref name=Hudziak_et_al-2004>{{cite journal |last1=Hudziak |first1=James J. |last2=Copeland |first2=William |last3=Stanger |first3=Catherine |last4=Wadsworth |first4=Martha |title=Screening for DSM-IV externalizing disorders with the Child Behavior Checklist: A receiver-operating characteristic analysis |journal=Journal of Child Psycholology and Psychiatry |date=October 2004 |volume=45 |issue=7 |pages=1299-307 |pmid=15335349 |doi=10.1111/j.1469-7610.2004.00314.x }}</ref> | rowspan="4" | |- | 12.2 (>60) | 0.41 (<60) |- | 47 (>65) | 0.53 (<65) |- | 34 (>70) | 0.66 (<70) |- |rowspan="2"| Child Behavior Checklist (CBCL) - Attention and Aggression Problems {{var|T}}-Score<ref name=Achenbach-1991/> |data-sort-value="0.86"| Boys: .86 ({{var|N}}=111) | {{nowrap|10.2 (>55)}} | {{nowrap|0.41 (<55)}} |rowspan="2"| Somewhat High Utilized sample ages 6-18 which consisted of 219 brothers and sisters of children who were referred to a hospital pediatric unit for ADHD or other symptoms. Half of these siblings had brothers and sisters who had ADHD, half did not.<ref name="Chen_et_al-1994" /> |rowspan="2"| Utilized sample ages 6-18 which consisted of 219 brothers and sisters of children who were referred to a hospital pediatric unit for ADHD or other symptoms. Half of these siblings had brothers and sisters who had ADHD, half did not.<ref name=Chen_et_al-1994>{{cite journal |last1=Chen |first1= Wei J. |last2=Faraone |first2=Stephen V. |author2-link=w:Stephen Faraone |last3=Biederman |first3=Joseph |author3-link=w:Joseph Biederman |last4=Tsuang |first4=Ming T. |title=Diagnostic accuracy of the Child Behavior Checklist scales for attention-deficit hyperactivity disorder: A receiver-operating characteristic analysis |journal=Journal of Consulting and Clinical Psychology |date=October 1994 |volume=62 |issue=5 |pages=1017-25 |pmid=7806710 |doi=10.1037/0022-006X.62.5.1017 }}</ref> | rowspan="2" | |- |data-sort-value="0.90"| Girls: 0.90 ({{var|N}}=108) |{{nowrap|11.2 (>55)}} |{{nowrap|0.35 (<55)}} |- | [[w:Achenbach System of Empirically Based Assessment|Teacher Response Form]] (TRF) - Attention Problems {{var|T}}-Score<ref name=Achenbach-1991/> | Not reported ({{var|N}}=184) | 3.66 (>70) | 0.73 (<70) | Somewhat High Utilized sample ages 5-12 years referred to a research clinic for assessment of ADHD. 108 children were ultimately diagnosed with ADHD, while 76 were not. LR's are calculated for discriminating between those two groups.<ref name="Tripp_et_al-2006" /> |rowspan="2"| Utilized sample ages 5-12 years referred to a research clinic for assessment of ADHD. 108 children were ultimately diagnosed with ADHD, while 76 were not. LR's are calculated for discriminating between those two groups.<ref name=Tripp_et_al-2006>{{cite journal |last1=Tripp |first1=Gail |last2=Schaughency |first2=Elizabeth A. |last3=Clarke |first3=Bronwyn |title=Parent and teacher rating scales in the evaluation of attention-deficit hyperactivity disorder: Contribution to diagnosis and differential diagnosis in clinically referred children |journal=Journal of Developmental and Behavioral Pediatrics |date=2006 |volume=27 |issue=3 |pages=209-18 |pmid=16775518 }}</ref> | |- | Teacher Response Form (TRF) - Attention and Aggression Problems {{var|T}}-Score<ref name=Achenbach-1991/> | Not reported ({{var|N}}=184) | 4.33 (>70) | 0.89 (<70) | Somewhat High Utilized sample ages 5-12 years referred to a research clinic for assessment of ADHD. 108 children were ultimately diagnosed with ADHD, while 76 were not. LR's are calculated for discriminating between those two groups.<ref name="Tripp_et_al-2006" /> | |- | [[w:Disruptive Behavior Disorders Rating Scale|Disruptive Behavior Disorder Rating Scale]] (DBDRS) - Parent Report (Pelham et. al, 1992) | 0.78 ({{var|N}}=232) | 5.06 (Endorsed ≥ 6 symptoms of inattention or hyperactivity) | 0.20 (<9) (Endorsed < 6 symptoms of inattention or hyperactivity) | Somewhat High Sample consisted of 232 ethnically diverse children ages 5-10 with (n = 121) and without (n=111) ADHD recruited through advertisements at school and through self-help groups.<ref name="Shemmassian_Lee-2012" /><ref name="Shemmassian_Lee-2016" /> |rowspan="2"| Sample consisted of 232 ethnically diverse children ages 5-10 with (n = 121) and without (n=111) ADHD recruited through advertisements at school and through self-help groups.<ref name="Shemmassian_Lee-2012">{{cite journal |last1=Shemmassian |first1=Shirag K. |last2=Lee |first2=Steve S. |date=March 2012 |title=Comparing Four Methods of Integrating Parent and Teacher Symptom Ratings of Attention-deficit/hyperactivity Disorder (ADHD) |journal=Journal of Psychopathology and Behavioral Assessment |volume=34 |issue=1 |pages=1-10 |doi=10.1007/s10862-011-9262-5 |url=https://www.researchgate.net/profile/Steve_Lee11/publication/230888173_Comparing_Four_Methods_of_Integrating_Parent_and_Teacher_Symptom_Ratings_of_Attention-deficithyperactivity_Disorder_ADHD/links/09e41505caa13a5913000000.pdf |format=PDF }}</ref><ref name="Shemmassian_Lee-2016">{{cite journal |last1=Shemmassian |first1=Shirag K. |last2=Lee |first2=Steve S. |title=Predictive Utility of Four Methods of Incorporating Parent and Teacher Symptom Ratings of ADHD for Longitudinal Outcomes |journal=Journal of Clinical Child and Adolescent Psychology |date=2016 |volume=45 |issue=2 |pages=176-87 |pmid=25643854 |doi=10.1080/15374416.2014.971457 }}</ref> | |- | Disruptive Behavior Disorder Rating Scale (DBDRS) - Teacher Report (Pelham et. al, 1992) | 0.63 ({{var|N}}=232) | 1.97 (Endorsed ≥ 6 symptoms of inattention or hyperactivity) | 0.24 (Endorsed < 6 symptoms of inattention or hyperactivity) | Somewhat High Sample consisted of 232 ethnically diverse children ages 5-10 with (n = 121) and without (n=111) ADHD recruited through advertisements at school and through self-help groups.<ref name="Shemmassian_Lee-2012" /><ref name="Shemmassian_Lee-2016" /> | |- | [[w:Vanderbilt ADHD diagnostic rating scale#Parent version|Vanderbilt ADHD Diagnostic Parent Rating Scale]] (VADPRS)<ref>{{cite journal |last1=Wolraich |first1=Mark L. |last2=Lambert |first2=Warren |last3=Doffing |first3=Melissa A. |last4=Bickman |first4=Leonard |last5=Simmons |first5=Tonya |last6=Worley |first6=Kim |date=December 2003 |title=Psychometric Properties of the Vanderbilt ADHD Diagnostic Parent Rating Scale in a Referred Population |journal=Journal of Pediatric Psychology |volume=28 |issue=8 |pages=559-68 |pmid=14602846 |doi=10.1093/jpepsy/jsg046 |url=https://academic.oup.com/jpepsy/article/28/8/559/1020465/Psychometric-Properties-of-the-Vanderbilt-ADHD }}</ref> | Not reported | 4.79 (Endorsed ≥ 6 symptoms of inattention or hyperactivity) | 0.38 (Endorsed < 6 symptoms of inattention or hyperactivity) | Moderate Sample consists of 582 children ages 5-15 recruited through schools in Oklahoma. Sample includes children screened as "high risk" for ADHD and "low risk" for ADHD.<ref name=":0" /> | Sample consists of 582 children ages 5-15 recruited through schools in Oklahoma. Sample includes children screened as "high risk" for ADHD and "low risk" for ADHD.<ref name=":0">{{cite journal |last1=Bard |first1=David E. |last2=Wolraich |first2=Mark L. |last3=Neas |first3=Barbara |last4=Doffing |first4=Melissa |last5=Beck |first5=Laoma |date=February 2013 |title=The psychometric properties of the Vanderbilt attention-deficit hyperactivity disorder diagnostic parent rating scale in a community population |journal=Journal of Developmental and Behavioral Pediatrics |volume=34 |issue=2 |pages=72-82 |pmid=23363972 |doi=10.1097/DBP.0b013e31827a3a22 }}</ref> | |- | [[w:Vanderbilt ADHD diagnostic rating scale#Teacher version|Vanderbilt ADHD Diagnostic Teacher Rating Scale]] (VADTRS)<ref>{{cite journal |last1=Wolraich |first1=ML |last2=Feurer |first2=ID |last3=Hannah |first3=JN |last4=Baumgaertel |first4=A |last5=Pinnock |first5=TY |date=April 1998 |title=Obtaining systematic teacher reports of disruptive behavior disorders utilizing DSM-IV |journal=Journal of Abnormal Child Psychology |volume=26 |issue=2 |pages=141-52 |pmid=9634136 }}</ref> | Not reported | 2.91 (Positive risk score) | 0.657 (Negative risk score) | Moderate | Sample consisted of 370 children ages 5-15 recruited though schools in Oklahoma. Sample was representative community sample.<ref>{{cite journal |last1=Wolraich |first1=Mark L. |last2=Bard |first2=David E. |last3=Neas |first3=Barbara |last4=Doffing |first4=Melissa |last5=Beck |first5=Laoma |title=The psychometric properties of the Vanderbilt attention-deficit hyperactivity disorder diagnostic teacher rating scale in a community population |journal=Journal of Developmental and Behavioral Pediatrics |date=February 2013 |volume=34 |issue=2 |pages=83-93 |pmid=23363973 |doi=10.1097/DBP.0b013e31827d55c3 }}</ref> | |- | Conners Rating Scale (Revised) - Long Form Parent Report (Conners, 1997) | Not reported | 15.33 (>93rd percentile) | 0.09 (<93rd percentile) | Moderate | Data come from normative sample of 2482 children ages 3 to 17 across the United States and Canada. Diagnostic likelihood ratios here discriminate ADHD from Non-Clinical.<ref name=Collett_et_al-2003>{{cite journal |last1=Collett |first1=Brent R. |last2=Ohan |first2=Jeneva L. |last3=Myers |first3=Kathleen M. |title=Ten-year review of rating scales. V: Scales assessing attention-deficit/hyperactivity disorder |journal=Journal of the American Academy of Child and Adolescent Psychiatry |date=September 2003 |volume=42 |issue=9 |pages=1015-37 |pmid=12960702 |doi=10.1097/01.CHI.0000070245.24125.B6 }}</ref> | |- | Conners Parent Rating Scale-48 (CPRS-48) Impulsive-Hyperactive Subscale {{var|T}}-Score (Conners, 1990) | Not reported | 1.26 (>70) | 0.79 (>70) | Somewhat High | rowspan="2"| Utilized sample ages 5-12 years referred to a research clinic for assessment of ADHD. 108 children were ultimately diagnosed with ADHD, while 76 were not. LR's are calculated for discriminating between those two groups.<ref name=Tripp_et_al-2006 /> | |- | Conners Teacher Rating Scale-39 Hyperactivity Subscale {{var|T}}-Score (Conners, 1990) | Not reported | 5.2 (>70) | 0.53 (<70) | Somewhat High | |- | Conners Teacher Rating Scale (Revised) - Long Form (Conners, 1997) | Not reported | 8.66 (>93rd percentile) | 0.24 (<93rd percentile) | Moderate | Data come from normative sample of 1973 children ages 5 to 17 across the United States and Canada. Likelihood ratios discriminate ADHD from non-clinical.<ref name=Collett_et_al-2003 /> | |- | ADHD Symptom Checklist-4 (ADHD-SC4) - Parent Report<ref name=Gadow_Sprafkin-1997>{{cite book |last1=Gadow |first1=Kenneth D. |last2=Sprafkin |first2=Joyce N. |date=1997 |title=ADHD Symptom Checklist-4 |publisher=Checkmate Plus |location=Stony Brook, NY |oclc=49637921 }}</ref> | Not reported | 1.45 (Endorsed ≥ 6 symptoms of inattention or hyperactivity) | 0.70 (Endorsed < 6 symptoms of inattention or hyperactivity) | Somewhat High | rowspan="2"| Data come from sample of 207 children ages 5-17 years old who were referred to psychiatric outpatient service with variety of emotional and behavioral disorders.<ref name=Sprafkin_Gadow-2007>{{cite journal |last1=Sprafkin |first1=Joyce |last2=Gadow |first2=Kenneth D. |title=Choosing an attention-deficit/hyperactivity disorder rating scale: is item randomization necessary? |journal=Journal of Child and Adolescent Psychopharmacology |date=February 2007 |volume=17 |issue=1 |pages=75-84 |pmid=17343555 |doi=10.1089/cap.2006.0035 }}</ref> | |- | ADHD Symptom Checklist-4 (ADHD-SC4) - Teacher Report<ref name=Gadow_Sprafkin-1997/> | Not reported | 1.53 (Endorsed ≥ 6 symptoms of inattention or hyperactivity) | 0.60 (Endorsed < 6 symptoms of inattention or hyperactivity) | Somewhat High | |- | [[w:ADHD rating scale|ADHD RS-IV]] - Home (DuPaul et. al, 1998b) | Not reported | 1.63 (>80th percentile) | 0.35 (<80th percentile) | Moderate | rowspan="2"| Sample of 2000 children ages 5 to 18 years old from geographically representative normative base.<ref name=Collett_et_al-2003 /> | |- | ADHD RS-IV - School (DuPaul et. al, 1998b) | Not reported | 4.5 (>80th percentile) | 0.42 (<80th percentile) | Moderate | |- | colspan="7" style="font-size:110%; text-align:center;" span |'''Adults''' |- |} '''Note:''' All studies with one exception used structured or semi-structured clinical interviews to establish diagnosis of ADHD. The exception, the Sprafkin & Gadow study (2007), used a combination of CBCL rating scales, clinician review, and clinician consensus to confirm ADHD diagnosis.<ref name=Sprafkin_Gadow-2007 /> “LR+” refers to the change in likelihood ratio associated with a positive test score, and “LR-” is the likelihood ratio for a low score. Likelihood ratios of 1 indicate that the test result did not change impressions at all. LRs larger than 10 or smaller than .10 are frequently clinically decisive; 5 or .20 are helpful, and between 2.0 and .5 are small enough that they rarely result in clinically meaningful changes of formulation (Sackett et al., 2000). === Interpreting ADHD screening measure scores === * For information on interpreting screening measure scores, click [[Evidence based assessment/Prediction phase#Interpreting screening measure scores|here.]] * Also see the page on [https://en.wikipedia.org/wiki/Likelihood_ratios_in_diagnostic_testing likelihood ratios in diagnostic testing] for more information ==[[Evidence based assessment/Prescription phase|'''Prescription phase''']]== ===Gold standard diagnostic interviews=== * For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews click here.] ===Recommended diagnostic interviews for ADHD=== ''****Depression instruments are placeholders'' {| class="wikitable sortable" border="1" ! colspan="5" |Diagnostic instruments for '''ADHD''' |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time !Where to Access |- |- | colspan="5" style="font-size:110%; text-align:center;" span |'''Youth''' |- | Barkley Functional Impairment Scale—Children and Adolescents (BFIS-CA) | Parent Report | 6-17 | 5-7 minutes |Link to [https://www.guilford.com/books/Barkley-Functional-Impairment-Scale-Children-Adolescents-BFIS-CA/Russell-Barkley/9781462503957 purchase] |- | Weiss Functional Impairment Rating Scale<ref>{{Cite journal|last=Thompson|first=Trevor|last2=Lloyd|first2=Andrew|last3=Joseph|first3=Alain|last4=Weiss|first4=Margaret|date=2017|title=The Weiss Functional Impairment Rating Scale-Parent Form for assessing ADHD: evaluating diagnostic accuracy and determining optimal thresholds using ROC analysis|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5486894/|journal=Quality of Life Research|volume=26|issue=7|pages=1879–1885|doi=10.1007/s11136-017-1514-8|issn=0962-9343|pmc=5486894|pmid=28220338}}</ref> | Parent/Caregiver Report | 5-19 | |[http://www.shared-care.ca/files/WFIRS-Parent_with_Instructions_May_2012.pdf PDF] |- |- | colspan="5" style="font-size:110%; text-align:center;" span |'''Adults''' |- |} '''Note:''' '''L''' = Less than adequate; '''A''' = Adequate; '''G''' = Good; '''E''' = Excellent; '''U''' = Unavailable; '''NA''' = Not applicable<ref>{{Cite web|url=https://en.wikiversity.org/wiki/Evidence-based_assessment/Reliability#Evaluating_norms_and_reliability|title=Evidence-based assessment/Reliability - Wikiversity|website=en.wikiversity.org|access-date=2020-11-13}}</ref> ==[[Evidence based assessment/Process phase|'''Process phase''']]== The following section contains a brief overview of treatment options for ADHD and list of process and outcome measures for ADHD. The section includes benchmarks based on published norms for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the [[Evidence based assessment/Process phase|process phase]] of assessment. For more information of differences between process and outcome measures, see the page on the [[Evidence based assessment/Process phase|process phase of assessment]]. === Process measures === {{blockquotetop}} ; CBCL Attention Problems Subscale : Could be used on a weekly basis to track changes in ADHD symptomotology. T-scores from this measure could also be recorded on a weekly basis to determine if reliable and clinically significant changes in ADHD symptoms are occuring. The CBCL Attention Problems Subscale has repeatedly demonstrated good-to-excellent convergence with diagnostic interviews for diagnosing ADHD.<ref name=Pelham_et_al-2005>{{cite journal |last1=Pelham |first1=William E., Jr. |last2=Fabiano |first2=Gregory A. |last3=Massetti |first3=Greta M. |date=September 2005 |title=Evidence-based assessment of attention deficit hyperactivity disorder in children and adolescents |journal=Journal of Clinical Child and Adolescent Psychology |volume=34 |issue=3 |pages=449-76 |pmid=16026214 |doi=10.1207/s15374424jccp3403_5 |url=https://www.researchgate.net/profile/Greta_Massetti/publication/7719090_Evidence-Based_Assessment_of_Attention_Deficit_Hyperactivity_Disorder_in_Children_and_Adolescents/links/09e415107e6e01c28e000000.pdf |format=PDF }}</ref><ref>{{cite journal |last1=Lampert |first1=TL |last2=Polanczyk |first2=G |last3=Tramontina |first3=S |last4=Mardini |first4=V |last5=Rohde |first5=LA |date=October 2004 |title=Diagnostic performance of the CBCL-Attention Problem Scale as a screening measure in a sample of Brazilian children with ADHD |journal=Journal of Attention Disorders |volume=8 |issue=2 |pages=63-71 |pmid=15801336 }}</ref><ref name=Hudziak_et_al-2004/><ref name=Chen_et_al-1994/> '''The CBCL Attention Problems Subscale is a scale on the CBCL, which is readily available at the Finley Clinic.''' ; Daily Report Card : Several scholars have pointed out that it is equally important to track changes in the functional behaviors that a child with ADHD engages in, in addition to their ADHD symptoms, to capture the full range of adaptive changes that are made by children with ADHD throughout the course of treatment.<ref name=Pelham_et_al-2005/><ref>{{cite book |last1=Sowerby |first1=Paula |last2=Tripp |first2=Gail |date=2009 |chapter=Evidence-Based Assessment of Attention-Deficit/Hyperactivity Disorder (ADHD) |editor1-last=Matson |editor1-first=Johnny L. |editor2-last=Andrasik |editor2-first=Frank |editor3-last=Matson |editor3-first=Michael L. |title=Assessing Childhood Psychopathology and Developmental Disabilities |pages=209-239 |publisher=Springer Science & Business Media |location=New York |oclc=314175875 |doi=10.1007/978-0-387-09528-8 |isbn=978-0-387-09528-8 |chapter-url=https://books.google.com/books?id=TyJClvRUgY4C&pg=PA209 }}</ref> The daily report card is a mechanism by which such adaptive behavioral changes can be tracked. When implementing the daily report card, problematic child behaviors at home and at school are targeted for change. Rewards are offered to the child for reaching daily and weekly goals for reducing maladaptive behaviors and increasing adaptive behaviors. Parents and Teachers track child behaviors on a daily basis and provide feedback to one another and the child with behavior frequency counts and/or daily "grades" on how well the child behaved. Daily report cards are a mainstay of cognitive-behavioral and behavioral modification evidence-based intervention strategies for ADHD,<ref name=DuPaul_et_al-2012/><ref>{{cite journal |last1=Eiraldi |first1=Ricardo B. |last2=Mautone |first2=Jennifer A. |last3=Power |first3=Thomas J. |date=January 2012 |title=Strategies for implementing evidence-based psychosocial interventions for children with attention-deficit/hyperactivity disorder |journal=Child and Adolescent Psychiatric Clinics of North America |volume=21 |issue=1 |pages=145-59 |pmid=22137818 |pmc=3233687 |doi=10.1016/j.chc.2011.08.012 }}</ref> and they are highly recommended for tracking child treatment outcomes. '''Instructions for creating a daily report card are attached in Appendix 1.''' {{blockquotebottom}} === Outcome and severity measures === This table includes clinically significant benchmarks for ADHD specific outcome measures * Information on how to interpret this table can be [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase found here]. * Additionally, these [[Evidence based assessment/Vignettes|vignettes]] might be helpful resources for understanding appropriate adaptation of outcome measures in practice. * ''<u>For clinically significant change benchmarks for the CBCL, YSR, and TRF total, externalizing, internalizing, and attention benchmarks,</u>'' [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase&wteswitched=1#Clinically_significant_change_benchmarks_for_widely-used_outcome_measures see here.] {| class="wikitable" border="1" |+Clinically significant change benchmarks with common instruments and ADHD rating scales |- ! rowspan="2" scope="col" | Measure ! rowspan="2" scope="col" | Diagnostic category ! colspan="3" scope="colgroup" width="300" | Cut Scores* ! colspan="3" scope="colgroup" | Critical Change<br>(Unstandardized Scores) |- ! scope="col" | A ! scope="col" | B ! scope="col" | C ! scope="col" | 95% ! scope="col" | 90% ! scope="col" | SE_difference |- | colspan="8" style="text-align:center" |'''Benchmarks Based on Published Norms''' |- | rowspan="4" style="text-align:center;" |''{{abbr|CBCL|Child Behavior Checklist}} {{var|T}}-scores<br>(2001 Norms)'' | style="text-align:right" | Total | style="text-align:center;" | 49 | style="text-align:center;" | 70 | style="text-align:center;" | 58 | style="text-align:center;" | 5 | style="text-align:center;" | 4 | style="text-align:center;" | 2.4 |- | style="text-align:right" | Externalizing | style="text-align:center;" | 49 | style="text-align:center;" | 70 | style="text-align:center;" | 58 | style="text-align:center;" | 7 | style="text-align:center;" | 6 | style="text-align:center;" | 3.4 |- | style="text-align:right" | Internalizing | {{n/a}} | style="text-align:center;" | 70 | style="text-align:center;" | 56 | style="text-align:center;" | 9 | style="text-align:center;" | 7 | style="text-align:center;" | 4.5 |- | style="text-align:right" | Attention Problems | {{n/a}} | style="text-align:center;" | 66 | style="text-align:center;" | 58 | style="text-align:center;" | 8 | style="text-align:center;" | 7 | style="text-align:center;" | 4.2 |- | rowspan="4" style="text-align:center;" |''{{abbr|TRF|Teacher Response Form}} {{var|T}}-Scores<br>(2001 Norms)'' | style="text-align:right" | Total | {{n/a}} | style="text-align:center;" | 70 | style="text-align:center;" | 57 | style="text-align:center;" | 5 | style="text-align:center;" | 4 | style="text-align:center;" | 2.3 |- | style="text-align:right" | Externalizing | {{n/a}} | style="text-align:center;" | 70 | style="text-align:center;" | 56 | style="text-align:center;" | 6 | style="text-align:center;" | 5 | style="text-align:center;" | 3.0 |- | style="text-align:right" | Internalizing | {{n/a}} | style="text-align:center;" | 70 | style="text-align:center;" | 55 | style="text-align:center;" | 9 | style="text-align:center;" | 7 | style="text-align:center;" | 4.4 |- | style="text-align:right" | Attention Problems | {{n/a}} | style="text-align:center;" | 66 | style="text-align:center;" | 57 | style="text-align:center;" | 5 | style="text-align:center;" | 4 | style="text-align:center;" | 2.3 |- | rowspan="2" style="text-align:center" |''Conners 3-Teacher Rating Scale {{var|T}}-Scores'' | style="text-align:right" | ADHD Inattentive | style="text-align:center;" | 36 | style="text-align:center;" | 74 | style="text-align:center;" | 57 | style="text-align:center;" | 11 | style="text-align:center;" | 10 | style="text-align:center;" | 5.6 |- | style="text-align:right" | ADHD Hyperactive-Impulsive | style="text-align:center;" | 36 | style="text-align:center;" | 74 | style="text-align:center;" | 57 | style="text-align:center;" | 11 | style="text-align:center;" | 9 | style="text-align:center;" | 5.5 |- | rowspan="2" style="text-align:center" |''Conners 3-Parent Rating Scale {{var|T}}-Scores'' | style="text-align:right" | ADHD Inattentive | style="text-align:center;" | 37 | style="text-align:center;" | 72 | style="text-align:center;" | 58 | style="text-align:center;" | 10 | style="text-align:center;" | 10 | style="text-align:center;" | 5.6 |- | style="text-align:right" | ADHD Hyperactive-Impulsive | style="text-align:center;" | 37 | style="text-align:center;" | 72 | style="text-align:center;" | 58 | style="text-align:center;" | 10 | style="text-align:center;" | 8 | style="text-align:center;" | 4.7 |- | colspan="8" style="text-align:center" |'''Benchmarks Based on ADHD Samples'''<ref name="Shemmassian_Lee-2012" /> |- | colspan="2" |''Disruptive Behavior Disorders Rating Scale'' | style="text-align:center;" | 1.4 | style="text-align:center;" | 8.6 | style="text-align:center;" | 5.7 | style="text-align:center;" | 12 | style="text-align:center;" | 10 | style="text-align:center;" | 0.9 |} '''Note:''' “A” = Away from the clinical range, “B” = Back into the nonclinical range, “C” = Closer to the nonclinical than clinical mean. <ref>{{Cite web|url=https://en.wikiversity.org/wiki/Evidence-based_assessment/Reliability#Evaluating_norms_and_reliability|title=Evidence-based assessment/Reliability - Wikiversity|website=en.wikiversity.org|access-date=2020-11-13}}</ref> '''Search terms:''' [ADHD or CONNERS or DBD] AND [clinical significance OR group means] in PsycINFO === Treatment === * Please refer to the Wikipedia page on [[wikipedia:Attention_deficit_hyperactivity_disorder|Attention Deficit Hyperactivity Disorder]] for more information on available treatment for ADHD or go to [https://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/inattention-and-hyperactivity-adhd/ Effective Child Therapy] for a curated resource on effective treatments for ADHD. {{collapse top| Click here for ADHD Treatment Information|expand=yes}} === Executive summary === 1. If intervening with children ages 4-5, behavior therapy should be the first line of treatment. 2. If intervening with children ages 6-11, behavior therapy should be the first line of treatment, in conjunction with medication. 3. If intervening with children ages 12-18, medication should probably be the first line of treatment, though behavior therapy could be used in combination. 4. Three types of therapeutic interventions have well established evidence-bases: :a. Behavioral Parent Training Interventions :b. Behavioral Classroom Management Interventions :c. Behavioral Peer interventions involving recreational peer groups (e.g. summer camps) 5. If considering a classroom management intervention: :a. Academic and Cognitive-Behavioral Interventions are most effective in changing academic outcomes :b. Cognitive Behavioral and Contingency Management Interventions are most effective in changing behavioral outcomes === Clinical practice guidelines === Published by the American Academy of Pediatrics in 2011.<ref name="AAP_Guideline-2011">{{cite journal |author1=Subcommittee on Attention-Deficit/Hyperactivity Disorder |author2=Steering Committee on Quality Improvement and Management |last3=Wolraich |first3=Mark |last4=Brown |first4=Lawrence |last5=Brown |first5=Ronald T. |last6=DuPaul |first6=George |last7=Earls |first7=Marian |last8=Feldman |first8=Heidi M. |last9=Ganiats |first9=Theodore G. |last10=Kaplanek |first10=Beth |last11=Meyer |first11=Bruce |last12=Perrin |first12=James |last13=Pierce |first13=Karen |last14=Reiff |first14=Michael |last15=Stein |first15=Martin T. |last16=Visser |first16=Susanna |date=November 2011 |title=ADHD: Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents |journal=Pediatrics |volume=128 |issue=5 |pages=1007-22 |pmid=22003063 |pmc=4500647 |doi=10.1542/peds.2011-2654 }}</ref> ; Preschool-aged children (ages 4–5) : Primary care clinicians should prescribe evidence-based parent and/or teacher-administered behavior therapy as the first line of treatment, and may prescribe methylphenidate if behavioral interventions are not effective. ; Elementary-aged children (ages 6–11) : Primary care clinicians should prescribe FDA-approved medications for ADHD and/or evidence based parent and teacher administered behavior therapy. Preferably, both medication and behavior therapy will be prescribed. ; Adolescents (ages 12–18) : Primary care clinicians should prescribe FDA approved medications for ADHD with the assent of the adolescent and may prescribe behavior therapy as a treatment for ADHD, preferably both. === Behavioral therapies === These meet the American Academy of Pediatrics and American Psychological Association Task Force criteria for well-established evidence-based treatments. Descriptions and effect sizes are taken from the American Academy of Pediatrics' guidelines<ref name="AAP_Guideline-2011" /> and Pelham & Fabiano's review article.<ref>{{cite journal |last1=Pelham |first1=William E., Jr. |last2=Fabiano |first2=Gregory A. |date=January 2008 |title=Evidence-based psychosocial treatments for attention-deficit/hyperactivity disorder |journal=Journal of Clinical Child and Adolescent Psychology |volume=37 |issue=1 |pages=184-214 |doi=10.1080/15374410701818681 |pmid=18444058 |lay-url=https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0026847/ |lay-source=Database of Abstracts of Reviews of Effects: Quality-assessed Reviews |lay-date=12 February 2009 }}</ref> ; Behavioral Parent Training : Behavior modification principles provided to parents for implementation in home settings. Typical outcomes include improved compliance with parental commands, improved parental understanding of behavioral principles, high levels of parental satisfaction with treatment. :'''Median effect size:''' 0.55 ; Behavioral Classroom Management : Behavior-modification principles provided to teachers for implementation in classroom settings. Typical outcomes include improved attention to instruction, improved compliance with classroom rules, decreased disruptive behavior, improved work productivity, and improved academic achievement. :'''Median effect size:''' 0.61 ; Behavioral Peer Interventions : Interventions focused on peer interactions/relationships. These could include group-based interventions provided weekly and include clinic-based social skills training used either alone or concurrently with behavioral parent training and/or medication. Typical outcomes are more mixed with these interventions. Some clinical-office based interventions have produced minimal effects, while some studies of behavioral peer intervention coupled with behavioral parent training found positive effects on parental ratings of ADHD symptoms. No studies of this type of intervention reveal differences on social functioning or parental ratings of social behavior. Behavioral Peer Interventions implemented in peer group/recreational settings (e.g. summer camps) have the most evidence of being effective. :'''Median effect size:''' None reported, effect sizes found are considered moderate. === School based interventions === {| class="wikitable" align="right" |+Single Subject Design Effect Sizes |- ! rowspan="2" scope="col" | Intervention type ! colspan="2" scope="colgroup" | Effect size |- ! scope="col" | Academic<br>outcomes ! scope="col" | Behavioral<br>outcomes |- | {{rh}} class="table-rh" |Academic | style="text-align:right" | 4.73 | style="text-align:right" | 1.53 |- | {{rh}} class="table-rh" |Cognitive behavioral | style="text-align:right" | 3.77 | style="text-align:right" | 3.31 |- | {{rh}} class="table-rh" |Contingency management | style="text-align:right" | 2.29 | style="text-align:right" | 2.40 |- | {{rh}} class="table-rh" |Combined | style="text-align:right" | 2.29 | style="text-align:right" | 1.31 |} Findings from a review by DuPaul and colleagues.<ref name="DuPaul_et_al-2012">{{cite journal |last1=DuPaul |first1=George J. |last2=Eckert |first2=Tanya L. |last3=Vilardo |first3=Brigid |date=December 2012 |title=The effects of school-based interventions for attention deficit hyperactivity disorder: A meta-analysis 1996-2010 |journal=School Psychology Review |volume=41 |issue=4 |pages=387-412 |issn=0279-6015 |id=ERIC [https://eric.ed.gov/?id=EJ1001907 EJ1001907] }}</ref> ; Associated with greater effects on academic outcomes :''Academic'' — interventions focus primarily on manipulating antecedent conditions via things like peer tutoring, computer-aided instruction, and organizational skills. :''Combined'' academic and contingency management interventions. ; Associated with greater effects for behavior outcomes :''Contingency management'' — interventions use reinforcement and punishment. :''Cognitive behavioral'' — interventions focus on development of self-control skills and reflective problem-solving strategies. {{clear}} {{collapse bottom}} == '''External Links''' == *[https://sccap53.org Society of Clinical Child and Adolescent Psychology] *[http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/inattention-and-hyperactivity-adhd/ EffectiveChildTherapy.Org information on ADHD] *[https://ccf.fiu.edu/_assets/pdfs/how_to_establish_a_school_drc.pdf Establishing a School-Home Daily Report Card] *[https://ccf.fiu.edu/_assets/pdfs/what-parents-and-teachers-should-know-about-adhd-updated-1214.pdf What Parents and Teachers Should Know About ADHD (Fact Sheet)] *[https://ccf.fiu.edu/_assets/pdfs/psychosocial_fact_sheet-updated-1214.pdf Psychosocial Interventions for ADHD] *[https://ccf.fiu.edu/_assets/pdfs/adhd-medication-information-sheet-for-parents-and-teachers1.pdf ADHD Medication Information Sheet for Parents and Teachers] =='''References'''== {{collapse top|Click here for references|expand=yes}} {{Reflist|30em}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] {{collapse bottom}} {{subpage navbar}} 1n51gvracedr4u2mhp3enqpawc0mbz3 2419206 2419181 2022-08-26T02:41:15Z Ardenguo 2944162 /* Treatment */ changed box title wikitext text/x-wiki 3<noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{medical disclaimer}} {{:{{BASEPAGENAME}}/Sidebar}} ==[[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio"?''']]== For background information on what assessment portfolios are, click the link in the heading above. Want even 'more' information about this topic? There's an extended version of this page [[Evidence-based assessment/Attention deficit hyperactivity disorder (assessment portfolio)/extended version|here]]. ==[[Evidence based assessment/Preparation phase|'''Preparation phase''']]== === Diagnostic Criteria of ADHD in youth === {{blockquotetop}} <big>ICD-11 Diagnostic Criteria </big><br> <br> '''General Description:''' Attention deficit hyperactivity disorder is characterised by a persistent pattern (at least 6 months) of inattention and/or hyperactivity-impulsivity that has a direct negative impact on academic, occupational, or social functioning. There is evidence of significant inattention and/or hyperactivity-impulsivity symptoms prior to age 12, typically by early to mid-childhood, though some individuals may first come to clinical attention later. The degree of inattention and hyperactivity-impulsivity is outside the limits of normal variation expected for age and level of intellectual functioning. Inattention refers to significant difficulty in sustaining attention to tasks that do not provide a high level of stimulation or frequent rewards, distractibility and problems with organisation. Hyperactivity refers to excessive motor activity and difficulties with remaining still, most evident in structured situations that require behavioural self-control. Impulsivity is a tendency to act in response to immediate stimuli, without deliberation or consideration of the risks and consequences. The relative balance and the specific manifestations of inattentive and hyperactive-impulsive characteristics varies across individuals and may change over the course of development. In order for a diagnosis to be made, manifestations of inattention and/or hyperactivity-impulsivity must be evident across multiple situations or settings (e.g., home, school, work, with friends or relatives), but are likely to vary according to the structure and demands of the setting. <br> <br> '''Predominantly Inattentive Presentation:''' All definitional requirements for attention deficit hyperactivity disorder are met and inattentive symptoms are predominant in the clinical presentation. Inattention refers to significant difficulty in sustaining attention to tasks that do not provide a high level of stimulation or frequent rewards, distractibility and problems with organization. Some hyperactive-impulsive symptoms may also be present, but these are not clinically significant in relation to the inattentive symptoms. <br> <br> '''Predominantly Hyperactive-Impulsive:''' All definitional requirements for attention deficit hyperactivity disorder are met and hyperactive-impulsive symptoms are predominant in the clinical presentation. Hyperactivity refers to excessive motor activity and difficulties with remaining still, most evident in structured situations that require behavioural self-control. Impulsivity is a tendency to act in response to immediate stimuli, without deliberation or consideration of the risks and consequences. Some inattentive symptoms may also be present, but these are not clinically significant in relation to the hyperactive-impulsive symptoms. <br> <br> <big>Changes in DSM-5</big> <br> The diagnostic criteria for ADHD changed slightly from DSM-IV to DSM-5. See the changes [https://www.ncbi.nlm.nih.gov/books/NBK519712/table/ch3.t3/ here]. {{blockquotebottom}}<ref>{{Cite web|url=https://icd.who.int/browse11/l-m/en#/http://id.who.int/icd/entity/821852937|title=ICD-11 for Mortality and Morbidity Statistics|website=icd.who.int|access-date=2022-06-21}}</ref> ===Base rates of youth ADHD in different populations and clinical settings=== This section describes the demographic setting of the population(s) sampled, base rates of diagnosis, country/region sampled, and the diagnostic method that was used. Using this information, clinicians will be able to anchor the rates of adolescent depression that they are likely to see in their clinical practices. * '''''To find prevalence rates across multiple disorders,''''' [[Evidence based assessment/Preparation phase#Base rates for transdiagnostic comparison|click here.]] {| class="wikitable sortable" |- ! Demography ! Setting ! Base Rate(s) ! Diagnostic Method |- |Worldwide, Ages 3-18 |Meta-Analysis of worldwide prevalence of Child/Adolescent ADHD<ref>{{cite journal |last=Willcutt |first=Erik G. |date=July 2012 |title=The Prevalence of DSM-IV Attention-Deficit/Hyperactivity Disorder: A Meta-Analytic Review |journal=Neurotherapeutics |volume=9 |issue=3 |pages=490-99 |pmid=22976615 |pmc=3441936 |doi=10.1007/s13311-012-0135-8 }}</ref> |6.1% (parent rating)<br>7.1% (teacher rating)<br>10.5% (ages 3-5)<br>11.4% (ages 6-12)<br>8.0% (ages 13-18) |Multiple, but each focused on DSM-IV criteria |- |USA Nationally Representative, Ages 3-17 |Epidemiological [[w:National Health Interview Survey|NHIS]] (US CDC, 2011) |8.4% (Overall)<br>12.0% (Male)<br>4.7% (Female)<br>2.1% (ages 3-5)<br>8.4% (ages 6-11)<br>11.9% (ages 12-17)<br>10.3% (southern region of US) |Parent-report of whether child had ever been diagnosed |- |USA Nationally Representative, Ages 4-17 |Child and Adolescent Epidemiological National Survey of Children's Health (US CDC, 2007) |9.5% (overall)<br>12.3% (male)<br>5.3% (female)<br>1.5% (ages 3-5)<br>9.1% (ages 6-11)<br>12.4% (ages 12-17)<br>15.6% (North Carolina) |Parent-report of whether child had ever been diagnosed |- |USA Nationally Representative, Ages 5-14 |Teacher-Reported Prevalence of ADHD<ref>{{cite journal |last1=Fabiano |first1=Gregory A. |last2=Pelham |first2=William E., Jr. |last3=Majumdar |first3=Antara |last4=Evans |first4=Steven W. |last5=Manos |first5=Michael J. |last6=Caserta |first6=Donald |last7=Girio-Herrera |first7=Erin L. |last8=Pisecco |first8=Stewart |last9=Hannah |first9=Jane N. |last10=Carter |first10=Randy L. |date=April 2013 |title=Elementary and Middle School Teacher Perceptions of Attention-Deficit/Hyperactivity Disorder Prevalence |journal=Child & Youth Care Forum |volume=42 |issue=2 |pages=87-99 |doi=10.1007/s10566-013-9194-1 }}</ref> |5.25% (overall)<br>5.58% (elementary schoolers)<br>3.53% (middle schoolers)<br>7.1% (one county in rural NC) |Teacher report of number of children who have been identified with ADHD in their class |- |USA Nationally Representative, Ages 13-18 |Adolescent Epidemiological [[w:National Comorbidity Survey|National Comorbidity Survey-Adolescent Supplement]]<ref>{{cite journal |last1=Merikangas |first1=Kathleen Ries |last2=He |first2=Jian-Ping |last3=Burstein |first3=Marcy |last4=Swanson |first4=Sonja A. |last5=Avenevoli |first5=Shelli |last6=Cui |first6=Lihong |last7=Benjet |first7=Corina |last8=Georgiades |first8=Katholiki |last9=Swendsen |first9=Joel |date=October 2010 |title=Lifetime prevalence of mental disorders in U.S. adolescents: results from the National Comorbidity Survey Replication—Adolescent Supplement (NCS-A) |journal=Journal of the American Academy of Child and Adolescent Psychiatry |volume=49 |issue=10 |pages=980-9 |pmid=20855043 |pmc=2946114 |doi=10.1016/j.jaac.2010.05.017 }}</ref> |8.7% |CIDI 3.0 structured diagnostic interview |- |Ages 6-90 |Meta-Analysis of Clinical Samples<ref name="Rettew_et_al-2009">{{cite journal |last1=Rettew |first1=David C. |last2=Lynch |first2=Alicia Doyle |last3=Achenbach |first3=Thomas M. |last4=Dumenci |first4=Levent |last5=Ivanova |first5=Masha Y. |date=September 2009 |title=Meta-analyses of agreement between diagnoses made from clinical evaluations and standardized diagnostic interviews |journal=International Journal of Methods in Psychiatric Research |volume=18 |issue=3 |pages=169-84 |pmid=19701924 |doi=10.1002/mpr.289 }}</ref> |38% |Structured Diagnostic Interviews |- |Ages 6-90 |Meta-Analysis of Clinical Samples<ref name="Rettew_et_al-2009" /> |23% |Clinical Evaluations |- |Representative Sample of Johnston County School Children, North Carolina, Ages 6-12 |Johnston County, North Carolina Sample<ref>{{cite journal |last1=Rowland |first1=Andrew S. |last2=Skipper |first2=Betty J. |last3=Umbach |first3=David M. |last4=Rabiner |first4=David L. |last5=Campbell |first5=Richard A. |last6=Naftel |first6=Albert J. |last7=Sandler |first7=Dale P. |date=11 December 2013 |title=The Prevalence of ADHD in a Population-Based Sample |journal=Journal of Attention Disorders |volume=19 |issue=9 |pages=741-54 |pmid=24336124 |pmc=4058092 |doi=10.1177/1087054713513799 }}</ref> |15.5% |Combined parent and teacher report (NTRS and DISC) with DSM-IV criteria |- |Sample drawn from 11 counties in Western NC, Ages 9-16 |North Carolina Community Sample<ref>{{cite journal |last1=Costello |first1=E. Jane |last2=Mustillo |first2=Sarah |last3=Erkanli |first3=Alaattin |last4=Keeler |first4=Gordon |last5=Angold |first5=Adrian |date=August 2003 |title=Prevalence and development of psychiatric disorders in childhood and adolescence |journal=Archives of General Psychiatry |volume=60 |issue=8 |pages=837-44 |pmid=12912767 |doi=10.1001/archpsyc.60.8.837 |doi-access=free |url=http://jamanetwork.com/journals/jamapsychiatry/fullarticle/207725 }}</ref> |0.9% (3-month prevalence)<br>4.1% (estimated by age 16) |CAPA structured diagnostic interview |- |Sample recruited at Durham, NC, Seattle, Nashville, and Central Pennsylvania sites. Sample was followed longitudinally and identified as at high risk for externalizing disorders in kindergarten. 50% African American, Ages 12-15 |High-Risk Community Sample<ref>{{cite journal |last1=Jones |first1=Damon E. |last2=Foster |first2=E. Michael |date=October 2009 |title=Service Use Patterns for Adolescents with ADHD and Comorbid Conduct Disorder |journal=Journal of Behavioral Health Services & Research |volume=36 |issue=4 |pages=436-49 |pmid=18618263 |pmc=3534729 |doi=10.1007/s11414-008-9133-3 }}</ref> |14.3% |Diagnostic Interview Schedule for Children (DISC) |} ==[[Evidence based assessment/Prediction phase|'''Prediction phase''']]== === Psychometric properties of screening instruments for youth ADHD === The following section contains a list of screening and diagnostic instruments for ADHD. The section includes administration information, psychometric data, and PDFs or links to the screenings. * Screenings are used as part of the [[Evidence based assessment/Prediction phase|prediction phase]] of assessment; for more information on interpretation of this data, or how screenings fit in to the assessment process, [[Evidence based assessment/Prediction phase|'''click here''']]. * '''''For a list of more broadly-reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Common_screening_instruments click here.]''''' === Screening and diagnostic instruments for attention deficit hyperactivity disorder=== {| class="wikitable sortable" border="1" |- ! Measure ! Format (Reporter) ! Age Range ! Administration/<br>Completion Time !Where to Access |- | colspan="5" style="font-size:110%; text-align:center;" span |'''Youth''' |- |ADHD Rating Scale (ADHD-RS-V)<ref>DuPaul, G. J., Power, T. J., Anastopoulos, A. D., & Reid, R. (1998). ADHD Rating Scale–IV: Checklists, norms, and clinical interpretation. New York: Guilford Press</ref> |Teacher, Parent |5-10 y/o: Child Version 11-17 y/o: Adolescent Version |5 minutes for each scale | |- |Conners 3rd Edition<ref>{{Cite web|url=https://www.pearsonassessments.com/store/usassessments/en/Store/Professional-Assessments/Behavior/Comprehensive/Conners-3rd-Edition/p/100000523.html|title=Conners 3rd Edition|website=www.pearsonassessments.com|language=en|access-date=2022-06-30}}</ref> |Teacher, Parent |6-18 y/o: Administered to parents and teachers of children and adolescents age 8-18 y/o: Self-report |20 minutes: Long Version 10 minutes: Short Version <5 Minutes: Conners 3AI and Conners 3GI |[https://www.pearsonassessments.com/store/usassessments/en/Store/Professional-Assessments/Behavior/Comprehensive/Conners-3rd-Edition/p/100000523.html Not Free] |- |Vanderbilt ADHD Parent Rating Scale (VADPRS) |Teacher, Parent |6-12 y/o | |Free |- |Child Behavior Checklist (CBCL/6-18) |Parent |6-18 y/o |15-20 minutes |Free |- |Behavior Assessment Scale for Children (BASC-3) | | |10-20 minutes: (TRS and PRS) 30 minutes: (SRP) |Not Free |- | colspan="5" style="font-size:110%; text-align:center;" span |'''Adults''' |- |} '''Note:''' L = Less than adequate; A = Adequate; G = Good; E = Excellent <ref>{{Cite web|url=https://en.wikiversity.org/wiki/Evidence-based_assessment/Reliability#Evaluating_norms_and_reliability|title=Evidence-based assessment/Reliability - Wikiversity|website=en.wikiversity.org|access-date=2020-11-13}}</ref> === Likelihood ratios and AUCs of screening measures for '''ADHD''' === * '''''For a list of the likelihood ratios for more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Likelihood_ratios_and_AUCs_of_common_screening_instruments click here.]''''' {| class="wikitable sortable mw-collapsible" border="1" |- ! Screening Measure (Primary Reference) !data-sort-type="number"| {{abbr|AUC (sample size)|Area under curve}} !data-sort-type="number"| {{abbr|DiLR+ (score)|Positive likelihood ratio}} Score !data-sort-type="number"| {{abbr|DiLR- (score)|Negative likelihood ratio}} Score ! Clinical Generalizeability and Study Description ! class="unsortable"| Study description !Where to Access |- |- | colspan="7" style="font-size:110%; text-align:center;" span |'''Youth''' |- |rowspan="4"| [[w:Child Behavior Checklist|Child Behavior Checklist]] (CBCL) - Attention Problems {{var|T}}-Score<ref name=Achenbach-1991>{{cite book |last1=Achenbach |first1=Thomas M. |author1-link=w:Thomas M. Achenbach |title=Child behavior checklist for ages 4-18 |date=1991 |publisher=Department of Psychiatry, University of Vermont |location=Burlington, VT |isbn=978-0-938565-08-6 }}</ref> |rowspan="4"| .84 ({{var|N}}=187) | 6.92 (>55) | 0.19 (<55) |rowspan="4"| Somewhat High Utilized sample ages 6-18 recruited from local pediatricians, psychiatrists, and community advertisements. Included 95 children who met criteria for ADHD. 70 of these children also met criteria for ODD/CD.<ref name="Hudziak_et_al-2004" /> |rowspan="4"| Utilized sample ages 6-18 recruited from local pediatricians, psychiatrists, and community advertisements. Included 95 children who met criteria for ADHD. 70 of these children also met criteria for ODD/CD.<ref name=Hudziak_et_al-2004>{{cite journal |last1=Hudziak |first1=James J. |last2=Copeland |first2=William |last3=Stanger |first3=Catherine |last4=Wadsworth |first4=Martha |title=Screening for DSM-IV externalizing disorders with the Child Behavior Checklist: A receiver-operating characteristic analysis |journal=Journal of Child Psycholology and Psychiatry |date=October 2004 |volume=45 |issue=7 |pages=1299-307 |pmid=15335349 |doi=10.1111/j.1469-7610.2004.00314.x }}</ref> | rowspan="4" | |- | 12.2 (>60) | 0.41 (<60) |- | 47 (>65) | 0.53 (<65) |- | 34 (>70) | 0.66 (<70) |- |rowspan="2"| Child Behavior Checklist (CBCL) - Attention and Aggression Problems {{var|T}}-Score<ref name=Achenbach-1991/> |data-sort-value="0.86"| Boys: .86 ({{var|N}}=111) | {{nowrap|10.2 (>55)}} | {{nowrap|0.41 (<55)}} |rowspan="2"| Somewhat High Utilized sample ages 6-18 which consisted of 219 brothers and sisters of children who were referred to a hospital pediatric unit for ADHD or other symptoms. Half of these siblings had brothers and sisters who had ADHD, half did not.<ref name="Chen_et_al-1994" /> |rowspan="2"| Utilized sample ages 6-18 which consisted of 219 brothers and sisters of children who were referred to a hospital pediatric unit for ADHD or other symptoms. Half of these siblings had brothers and sisters who had ADHD, half did not.<ref name=Chen_et_al-1994>{{cite journal |last1=Chen |first1= Wei J. |last2=Faraone |first2=Stephen V. |author2-link=w:Stephen Faraone |last3=Biederman |first3=Joseph |author3-link=w:Joseph Biederman |last4=Tsuang |first4=Ming T. |title=Diagnostic accuracy of the Child Behavior Checklist scales for attention-deficit hyperactivity disorder: A receiver-operating characteristic analysis |journal=Journal of Consulting and Clinical Psychology |date=October 1994 |volume=62 |issue=5 |pages=1017-25 |pmid=7806710 |doi=10.1037/0022-006X.62.5.1017 }}</ref> | rowspan="2" | |- |data-sort-value="0.90"| Girls: 0.90 ({{var|N}}=108) |{{nowrap|11.2 (>55)}} |{{nowrap|0.35 (<55)}} |- | [[w:Achenbach System of Empirically Based Assessment|Teacher Response Form]] (TRF) - Attention Problems {{var|T}}-Score<ref name=Achenbach-1991/> | Not reported ({{var|N}}=184) | 3.66 (>70) | 0.73 (<70) | Somewhat High Utilized sample ages 5-12 years referred to a research clinic for assessment of ADHD. 108 children were ultimately diagnosed with ADHD, while 76 were not. LR's are calculated for discriminating between those two groups.<ref name="Tripp_et_al-2006" /> |rowspan="2"| Utilized sample ages 5-12 years referred to a research clinic for assessment of ADHD. 108 children were ultimately diagnosed with ADHD, while 76 were not. LR's are calculated for discriminating between those two groups.<ref name=Tripp_et_al-2006>{{cite journal |last1=Tripp |first1=Gail |last2=Schaughency |first2=Elizabeth A. |last3=Clarke |first3=Bronwyn |title=Parent and teacher rating scales in the evaluation of attention-deficit hyperactivity disorder: Contribution to diagnosis and differential diagnosis in clinically referred children |journal=Journal of Developmental and Behavioral Pediatrics |date=2006 |volume=27 |issue=3 |pages=209-18 |pmid=16775518 }}</ref> | |- | Teacher Response Form (TRF) - Attention and Aggression Problems {{var|T}}-Score<ref name=Achenbach-1991/> | Not reported ({{var|N}}=184) | 4.33 (>70) | 0.89 (<70) | Somewhat High Utilized sample ages 5-12 years referred to a research clinic for assessment of ADHD. 108 children were ultimately diagnosed with ADHD, while 76 were not. LR's are calculated for discriminating between those two groups.<ref name="Tripp_et_al-2006" /> | |- | [[w:Disruptive Behavior Disorders Rating Scale|Disruptive Behavior Disorder Rating Scale]] (DBDRS) - Parent Report (Pelham et. al, 1992) | 0.78 ({{var|N}}=232) | 5.06 (Endorsed ≥ 6 symptoms of inattention or hyperactivity) | 0.20 (<9) (Endorsed < 6 symptoms of inattention or hyperactivity) | Somewhat High Sample consisted of 232 ethnically diverse children ages 5-10 with (n = 121) and without (n=111) ADHD recruited through advertisements at school and through self-help groups.<ref name="Shemmassian_Lee-2012" /><ref name="Shemmassian_Lee-2016" /> |rowspan="2"| Sample consisted of 232 ethnically diverse children ages 5-10 with (n = 121) and without (n=111) ADHD recruited through advertisements at school and through self-help groups.<ref name="Shemmassian_Lee-2012">{{cite journal |last1=Shemmassian |first1=Shirag K. |last2=Lee |first2=Steve S. |date=March 2012 |title=Comparing Four Methods of Integrating Parent and Teacher Symptom Ratings of Attention-deficit/hyperactivity Disorder (ADHD) |journal=Journal of Psychopathology and Behavioral Assessment |volume=34 |issue=1 |pages=1-10 |doi=10.1007/s10862-011-9262-5 |url=https://www.researchgate.net/profile/Steve_Lee11/publication/230888173_Comparing_Four_Methods_of_Integrating_Parent_and_Teacher_Symptom_Ratings_of_Attention-deficithyperactivity_Disorder_ADHD/links/09e41505caa13a5913000000.pdf |format=PDF }}</ref><ref name="Shemmassian_Lee-2016">{{cite journal |last1=Shemmassian |first1=Shirag K. |last2=Lee |first2=Steve S. |title=Predictive Utility of Four Methods of Incorporating Parent and Teacher Symptom Ratings of ADHD for Longitudinal Outcomes |journal=Journal of Clinical Child and Adolescent Psychology |date=2016 |volume=45 |issue=2 |pages=176-87 |pmid=25643854 |doi=10.1080/15374416.2014.971457 }}</ref> | |- | Disruptive Behavior Disorder Rating Scale (DBDRS) - Teacher Report (Pelham et. al, 1992) | 0.63 ({{var|N}}=232) | 1.97 (Endorsed ≥ 6 symptoms of inattention or hyperactivity) | 0.24 (Endorsed < 6 symptoms of inattention or hyperactivity) | Somewhat High Sample consisted of 232 ethnically diverse children ages 5-10 with (n = 121) and without (n=111) ADHD recruited through advertisements at school and through self-help groups.<ref name="Shemmassian_Lee-2012" /><ref name="Shemmassian_Lee-2016" /> | |- | [[w:Vanderbilt ADHD diagnostic rating scale#Parent version|Vanderbilt ADHD Diagnostic Parent Rating Scale]] (VADPRS)<ref>{{cite journal |last1=Wolraich |first1=Mark L. |last2=Lambert |first2=Warren |last3=Doffing |first3=Melissa A. |last4=Bickman |first4=Leonard |last5=Simmons |first5=Tonya |last6=Worley |first6=Kim |date=December 2003 |title=Psychometric Properties of the Vanderbilt ADHD Diagnostic Parent Rating Scale in a Referred Population |journal=Journal of Pediatric Psychology |volume=28 |issue=8 |pages=559-68 |pmid=14602846 |doi=10.1093/jpepsy/jsg046 |url=https://academic.oup.com/jpepsy/article/28/8/559/1020465/Psychometric-Properties-of-the-Vanderbilt-ADHD }}</ref> | Not reported | 4.79 (Endorsed ≥ 6 symptoms of inattention or hyperactivity) | 0.38 (Endorsed < 6 symptoms of inattention or hyperactivity) | Moderate Sample consists of 582 children ages 5-15 recruited through schools in Oklahoma. Sample includes children screened as "high risk" for ADHD and "low risk" for ADHD.<ref name=":0" /> | Sample consists of 582 children ages 5-15 recruited through schools in Oklahoma. Sample includes children screened as "high risk" for ADHD and "low risk" for ADHD.<ref name=":0">{{cite journal |last1=Bard |first1=David E. |last2=Wolraich |first2=Mark L. |last3=Neas |first3=Barbara |last4=Doffing |first4=Melissa |last5=Beck |first5=Laoma |date=February 2013 |title=The psychometric properties of the Vanderbilt attention-deficit hyperactivity disorder diagnostic parent rating scale in a community population |journal=Journal of Developmental and Behavioral Pediatrics |volume=34 |issue=2 |pages=72-82 |pmid=23363972 |doi=10.1097/DBP.0b013e31827a3a22 }}</ref> | |- | [[w:Vanderbilt ADHD diagnostic rating scale#Teacher version|Vanderbilt ADHD Diagnostic Teacher Rating Scale]] (VADTRS)<ref>{{cite journal |last1=Wolraich |first1=ML |last2=Feurer |first2=ID |last3=Hannah |first3=JN |last4=Baumgaertel |first4=A |last5=Pinnock |first5=TY |date=April 1998 |title=Obtaining systematic teacher reports of disruptive behavior disorders utilizing DSM-IV |journal=Journal of Abnormal Child Psychology |volume=26 |issue=2 |pages=141-52 |pmid=9634136 }}</ref> | Not reported | 2.91 (Positive risk score) | 0.657 (Negative risk score) | Moderate | Sample consisted of 370 children ages 5-15 recruited though schools in Oklahoma. Sample was representative community sample.<ref>{{cite journal |last1=Wolraich |first1=Mark L. |last2=Bard |first2=David E. |last3=Neas |first3=Barbara |last4=Doffing |first4=Melissa |last5=Beck |first5=Laoma |title=The psychometric properties of the Vanderbilt attention-deficit hyperactivity disorder diagnostic teacher rating scale in a community population |journal=Journal of Developmental and Behavioral Pediatrics |date=February 2013 |volume=34 |issue=2 |pages=83-93 |pmid=23363973 |doi=10.1097/DBP.0b013e31827d55c3 }}</ref> | |- | Conners Rating Scale (Revised) - Long Form Parent Report (Conners, 1997) | Not reported | 15.33 (>93rd percentile) | 0.09 (<93rd percentile) | Moderate | Data come from normative sample of 2482 children ages 3 to 17 across the United States and Canada. Diagnostic likelihood ratios here discriminate ADHD from Non-Clinical.<ref name=Collett_et_al-2003>{{cite journal |last1=Collett |first1=Brent R. |last2=Ohan |first2=Jeneva L. |last3=Myers |first3=Kathleen M. |title=Ten-year review of rating scales. V: Scales assessing attention-deficit/hyperactivity disorder |journal=Journal of the American Academy of Child and Adolescent Psychiatry |date=September 2003 |volume=42 |issue=9 |pages=1015-37 |pmid=12960702 |doi=10.1097/01.CHI.0000070245.24125.B6 }}</ref> | |- | Conners Parent Rating Scale-48 (CPRS-48) Impulsive-Hyperactive Subscale {{var|T}}-Score (Conners, 1990) | Not reported | 1.26 (>70) | 0.79 (>70) | Somewhat High | rowspan="2"| Utilized sample ages 5-12 years referred to a research clinic for assessment of ADHD. 108 children were ultimately diagnosed with ADHD, while 76 were not. LR's are calculated for discriminating between those two groups.<ref name=Tripp_et_al-2006 /> | |- | Conners Teacher Rating Scale-39 Hyperactivity Subscale {{var|T}}-Score (Conners, 1990) | Not reported | 5.2 (>70) | 0.53 (<70) | Somewhat High | |- | Conners Teacher Rating Scale (Revised) - Long Form (Conners, 1997) | Not reported | 8.66 (>93rd percentile) | 0.24 (<93rd percentile) | Moderate | Data come from normative sample of 1973 children ages 5 to 17 across the United States and Canada. Likelihood ratios discriminate ADHD from non-clinical.<ref name=Collett_et_al-2003 /> | |- | ADHD Symptom Checklist-4 (ADHD-SC4) - Parent Report<ref name=Gadow_Sprafkin-1997>{{cite book |last1=Gadow |first1=Kenneth D. |last2=Sprafkin |first2=Joyce N. |date=1997 |title=ADHD Symptom Checklist-4 |publisher=Checkmate Plus |location=Stony Brook, NY |oclc=49637921 }}</ref> | Not reported | 1.45 (Endorsed ≥ 6 symptoms of inattention or hyperactivity) | 0.70 (Endorsed < 6 symptoms of inattention or hyperactivity) | Somewhat High | rowspan="2"| Data come from sample of 207 children ages 5-17 years old who were referred to psychiatric outpatient service with variety of emotional and behavioral disorders.<ref name=Sprafkin_Gadow-2007>{{cite journal |last1=Sprafkin |first1=Joyce |last2=Gadow |first2=Kenneth D. |title=Choosing an attention-deficit/hyperactivity disorder rating scale: is item randomization necessary? |journal=Journal of Child and Adolescent Psychopharmacology |date=February 2007 |volume=17 |issue=1 |pages=75-84 |pmid=17343555 |doi=10.1089/cap.2006.0035 }}</ref> | |- | ADHD Symptom Checklist-4 (ADHD-SC4) - Teacher Report<ref name=Gadow_Sprafkin-1997/> | Not reported | 1.53 (Endorsed ≥ 6 symptoms of inattention or hyperactivity) | 0.60 (Endorsed < 6 symptoms of inattention or hyperactivity) | Somewhat High | |- | [[w:ADHD rating scale|ADHD RS-IV]] - Home (DuPaul et. al, 1998b) | Not reported | 1.63 (>80th percentile) | 0.35 (<80th percentile) | Moderate | rowspan="2"| Sample of 2000 children ages 5 to 18 years old from geographically representative normative base.<ref name=Collett_et_al-2003 /> | |- | ADHD RS-IV - School (DuPaul et. al, 1998b) | Not reported | 4.5 (>80th percentile) | 0.42 (<80th percentile) | Moderate | |- | colspan="7" style="font-size:110%; text-align:center;" span |'''Adults''' |- |} '''Note:''' All studies with one exception used structured or semi-structured clinical interviews to establish diagnosis of ADHD. The exception, the Sprafkin & Gadow study (2007), used a combination of CBCL rating scales, clinician review, and clinician consensus to confirm ADHD diagnosis.<ref name=Sprafkin_Gadow-2007 /> “LR+” refers to the change in likelihood ratio associated with a positive test score, and “LR-” is the likelihood ratio for a low score. Likelihood ratios of 1 indicate that the test result did not change impressions at all. LRs larger than 10 or smaller than .10 are frequently clinically decisive; 5 or .20 are helpful, and between 2.0 and .5 are small enough that they rarely result in clinically meaningful changes of formulation (Sackett et al., 2000). === Interpreting ADHD screening measure scores === * For information on interpreting screening measure scores, click [[Evidence based assessment/Prediction phase#Interpreting screening measure scores|here.]] * Also see the page on [https://en.wikipedia.org/wiki/Likelihood_ratios_in_diagnostic_testing likelihood ratios in diagnostic testing] for more information ==[[Evidence based assessment/Prescription phase|'''Prescription phase''']]== ===Gold standard diagnostic interviews=== * For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews click here.] ===Recommended diagnostic interviews for ADHD=== ''****Depression instruments are placeholders'' {| class="wikitable sortable" border="1" ! colspan="5" |Diagnostic instruments for '''ADHD''' |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time !Where to Access |- |- | colspan="5" style="font-size:110%; text-align:center;" span |'''Youth''' |- | Barkley Functional Impairment Scale—Children and Adolescents (BFIS-CA) | Parent Report | 6-17 | 5-7 minutes |Link to [https://www.guilford.com/books/Barkley-Functional-Impairment-Scale-Children-Adolescents-BFIS-CA/Russell-Barkley/9781462503957 purchase] |- | Weiss Functional Impairment Rating Scale<ref>{{Cite journal|last=Thompson|first=Trevor|last2=Lloyd|first2=Andrew|last3=Joseph|first3=Alain|last4=Weiss|first4=Margaret|date=2017|title=The Weiss Functional Impairment Rating Scale-Parent Form for assessing ADHD: evaluating diagnostic accuracy and determining optimal thresholds using ROC analysis|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5486894/|journal=Quality of Life Research|volume=26|issue=7|pages=1879–1885|doi=10.1007/s11136-017-1514-8|issn=0962-9343|pmc=5486894|pmid=28220338}}</ref> | Parent/Caregiver Report | 5-19 | |[http://www.shared-care.ca/files/WFIRS-Parent_with_Instructions_May_2012.pdf PDF] |- |- | colspan="5" style="font-size:110%; text-align:center;" span |'''Adults''' |- |} '''Note:''' '''L''' = Less than adequate; '''A''' = Adequate; '''G''' = Good; '''E''' = Excellent; '''U''' = Unavailable; '''NA''' = Not applicable<ref>{{Cite web|url=https://en.wikiversity.org/wiki/Evidence-based_assessment/Reliability#Evaluating_norms_and_reliability|title=Evidence-based assessment/Reliability - Wikiversity|website=en.wikiversity.org|access-date=2020-11-13}}</ref> ==[[Evidence based assessment/Process phase|'''Process phase''']]== The following section contains a brief overview of treatment options for ADHD and list of process and outcome measures for ADHD. The section includes benchmarks based on published norms for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the [[Evidence based assessment/Process phase|process phase]] of assessment. For more information of differences between process and outcome measures, see the page on the [[Evidence based assessment/Process phase|process phase of assessment]]. === Process measures === {{blockquotetop}} ; CBCL Attention Problems Subscale : Could be used on a weekly basis to track changes in ADHD symptomotology. T-scores from this measure could also be recorded on a weekly basis to determine if reliable and clinically significant changes in ADHD symptoms are occuring. The CBCL Attention Problems Subscale has repeatedly demonstrated good-to-excellent convergence with diagnostic interviews for diagnosing ADHD.<ref name=Pelham_et_al-2005>{{cite journal |last1=Pelham |first1=William E., Jr. |last2=Fabiano |first2=Gregory A. |last3=Massetti |first3=Greta M. |date=September 2005 |title=Evidence-based assessment of attention deficit hyperactivity disorder in children and adolescents |journal=Journal of Clinical Child and Adolescent Psychology |volume=34 |issue=3 |pages=449-76 |pmid=16026214 |doi=10.1207/s15374424jccp3403_5 |url=https://www.researchgate.net/profile/Greta_Massetti/publication/7719090_Evidence-Based_Assessment_of_Attention_Deficit_Hyperactivity_Disorder_in_Children_and_Adolescents/links/09e415107e6e01c28e000000.pdf |format=PDF }}</ref><ref>{{cite journal |last1=Lampert |first1=TL |last2=Polanczyk |first2=G |last3=Tramontina |first3=S |last4=Mardini |first4=V |last5=Rohde |first5=LA |date=October 2004 |title=Diagnostic performance of the CBCL-Attention Problem Scale as a screening measure in a sample of Brazilian children with ADHD |journal=Journal of Attention Disorders |volume=8 |issue=2 |pages=63-71 |pmid=15801336 }}</ref><ref name=Hudziak_et_al-2004/><ref name=Chen_et_al-1994/> '''The CBCL Attention Problems Subscale is a scale on the CBCL, which is readily available at the Finley Clinic.''' ; Daily Report Card : Several scholars have pointed out that it is equally important to track changes in the functional behaviors that a child with ADHD engages in, in addition to their ADHD symptoms, to capture the full range of adaptive changes that are made by children with ADHD throughout the course of treatment.<ref name=Pelham_et_al-2005/><ref>{{cite book |last1=Sowerby |first1=Paula |last2=Tripp |first2=Gail |date=2009 |chapter=Evidence-Based Assessment of Attention-Deficit/Hyperactivity Disorder (ADHD) |editor1-last=Matson |editor1-first=Johnny L. |editor2-last=Andrasik |editor2-first=Frank |editor3-last=Matson |editor3-first=Michael L. |title=Assessing Childhood Psychopathology and Developmental Disabilities |pages=209-239 |publisher=Springer Science & Business Media |location=New York |oclc=314175875 |doi=10.1007/978-0-387-09528-8 |isbn=978-0-387-09528-8 |chapter-url=https://books.google.com/books?id=TyJClvRUgY4C&pg=PA209 }}</ref> The daily report card is a mechanism by which such adaptive behavioral changes can be tracked. When implementing the daily report card, problematic child behaviors at home and at school are targeted for change. Rewards are offered to the child for reaching daily and weekly goals for reducing maladaptive behaviors and increasing adaptive behaviors. Parents and Teachers track child behaviors on a daily basis and provide feedback to one another and the child with behavior frequency counts and/or daily "grades" on how well the child behaved. Daily report cards are a mainstay of cognitive-behavioral and behavioral modification evidence-based intervention strategies for ADHD,<ref name=DuPaul_et_al-2012/><ref>{{cite journal |last1=Eiraldi |first1=Ricardo B. |last2=Mautone |first2=Jennifer A. |last3=Power |first3=Thomas J. |date=January 2012 |title=Strategies for implementing evidence-based psychosocial interventions for children with attention-deficit/hyperactivity disorder |journal=Child and Adolescent Psychiatric Clinics of North America |volume=21 |issue=1 |pages=145-59 |pmid=22137818 |pmc=3233687 |doi=10.1016/j.chc.2011.08.012 }}</ref> and they are highly recommended for tracking child treatment outcomes. '''Instructions for creating a daily report card are attached in Appendix 1.''' {{blockquotebottom}} === Outcome and severity measures === This table includes clinically significant benchmarks for ADHD specific outcome measures * Information on how to interpret this table can be [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase found here]. * Additionally, these [[Evidence based assessment/Vignettes|vignettes]] might be helpful resources for understanding appropriate adaptation of outcome measures in practice. * ''<u>For clinically significant change benchmarks for the CBCL, YSR, and TRF total, externalizing, internalizing, and attention benchmarks,</u>'' [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase&wteswitched=1#Clinically_significant_change_benchmarks_for_widely-used_outcome_measures see here.] {| class="wikitable" border="1" |+Clinically significant change benchmarks with common instruments and ADHD rating scales |- ! rowspan="2" scope="col" | Measure ! rowspan="2" scope="col" | Diagnostic category ! colspan="3" scope="colgroup" width="300" | Cut Scores* ! colspan="3" scope="colgroup" | Critical Change<br>(Unstandardized Scores) |- ! scope="col" | A ! scope="col" | B ! scope="col" | C ! scope="col" | 95% ! scope="col" | 90% ! scope="col" | SE_difference |- | colspan="8" style="text-align:center" |'''Benchmarks Based on Published Norms''' |- | rowspan="4" style="text-align:center;" |''{{abbr|CBCL|Child Behavior Checklist}} {{var|T}}-scores<br>(2001 Norms)'' | style="text-align:right" | Total | style="text-align:center;" | 49 | style="text-align:center;" | 70 | style="text-align:center;" | 58 | style="text-align:center;" | 5 | style="text-align:center;" | 4 | style="text-align:center;" | 2.4 |- | style="text-align:right" | Externalizing | style="text-align:center;" | 49 | style="text-align:center;" | 70 | style="text-align:center;" | 58 | style="text-align:center;" | 7 | style="text-align:center;" | 6 | style="text-align:center;" | 3.4 |- | style="text-align:right" | Internalizing | {{n/a}} | style="text-align:center;" | 70 | style="text-align:center;" | 56 | style="text-align:center;" | 9 | style="text-align:center;" | 7 | style="text-align:center;" | 4.5 |- | style="text-align:right" | Attention Problems | {{n/a}} | style="text-align:center;" | 66 | style="text-align:center;" | 58 | style="text-align:center;" | 8 | style="text-align:center;" | 7 | style="text-align:center;" | 4.2 |- | rowspan="4" style="text-align:center;" |''{{abbr|TRF|Teacher Response Form}} {{var|T}}-Scores<br>(2001 Norms)'' | style="text-align:right" | Total | {{n/a}} | style="text-align:center;" | 70 | style="text-align:center;" | 57 | style="text-align:center;" | 5 | style="text-align:center;" | 4 | style="text-align:center;" | 2.3 |- | style="text-align:right" | Externalizing | {{n/a}} | style="text-align:center;" | 70 | style="text-align:center;" | 56 | style="text-align:center;" | 6 | style="text-align:center;" | 5 | style="text-align:center;" | 3.0 |- | style="text-align:right" | Internalizing | {{n/a}} | style="text-align:center;" | 70 | style="text-align:center;" | 55 | style="text-align:center;" | 9 | style="text-align:center;" | 7 | style="text-align:center;" | 4.4 |- | style="text-align:right" | Attention Problems | {{n/a}} | style="text-align:center;" | 66 | style="text-align:center;" | 57 | style="text-align:center;" | 5 | style="text-align:center;" | 4 | style="text-align:center;" | 2.3 |- | rowspan="2" style="text-align:center" |''Conners 3-Teacher Rating Scale {{var|T}}-Scores'' | style="text-align:right" | ADHD Inattentive | style="text-align:center;" | 36 | style="text-align:center;" | 74 | style="text-align:center;" | 57 | style="text-align:center;" | 11 | style="text-align:center;" | 10 | style="text-align:center;" | 5.6 |- | style="text-align:right" | ADHD Hyperactive-Impulsive | style="text-align:center;" | 36 | style="text-align:center;" | 74 | style="text-align:center;" | 57 | style="text-align:center;" | 11 | style="text-align:center;" | 9 | style="text-align:center;" | 5.5 |- | rowspan="2" style="text-align:center" |''Conners 3-Parent Rating Scale {{var|T}}-Scores'' | style="text-align:right" | ADHD Inattentive | style="text-align:center;" | 37 | style="text-align:center;" | 72 | style="text-align:center;" | 58 | style="text-align:center;" | 10 | style="text-align:center;" | 10 | style="text-align:center;" | 5.6 |- | style="text-align:right" | ADHD Hyperactive-Impulsive | style="text-align:center;" | 37 | style="text-align:center;" | 72 | style="text-align:center;" | 58 | style="text-align:center;" | 10 | style="text-align:center;" | 8 | style="text-align:center;" | 4.7 |- | colspan="8" style="text-align:center" |'''Benchmarks Based on ADHD Samples'''<ref name="Shemmassian_Lee-2012" /> |- | colspan="2" |''Disruptive Behavior Disorders Rating Scale'' | style="text-align:center;" | 1.4 | style="text-align:center;" | 8.6 | style="text-align:center;" | 5.7 | style="text-align:center;" | 12 | style="text-align:center;" | 10 | style="text-align:center;" | 0.9 |} '''Note:''' “A” = Away from the clinical range, “B” = Back into the nonclinical range, “C” = Closer to the nonclinical than clinical mean. <ref>{{Cite web|url=https://en.wikiversity.org/wiki/Evidence-based_assessment/Reliability#Evaluating_norms_and_reliability|title=Evidence-based assessment/Reliability - Wikiversity|website=en.wikiversity.org|access-date=2020-11-13}}</ref> '''Search terms:''' [ADHD or CONNERS or DBD] AND [clinical significance OR group means] in PsycINFO === Treatment === * Please refer to the Wikipedia page on [[wikipedia:Attention_deficit_hyperactivity_disorder|Attention Deficit Hyperactivity Disorder]] for more information on available treatment for ADHD or go to [https://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/inattention-and-hyperactivity-adhd/ Effective Child Therapy] for a curated resource on effective treatments for ADHD. {{collapse top| ADHD Treatment Information|expand=yes}} === Executive summary === 1. If intervening with children ages 4-5, behavior therapy should be the first line of treatment. 2. If intervening with children ages 6-11, behavior therapy should be the first line of treatment, in conjunction with medication. 3. If intervening with children ages 12-18, medication should probably be the first line of treatment, though behavior therapy could be used in combination. 4. Three types of therapeutic interventions have well established evidence-bases: :a. Behavioral Parent Training Interventions :b. Behavioral Classroom Management Interventions :c. Behavioral Peer interventions involving recreational peer groups (e.g. summer camps) 5. If considering a classroom management intervention: :a. Academic and Cognitive-Behavioral Interventions are most effective in changing academic outcomes :b. Cognitive Behavioral and Contingency Management Interventions are most effective in changing behavioral outcomes === Clinical practice guidelines === Published by the American Academy of Pediatrics in 2011.<ref name="AAP_Guideline-2011">{{cite journal |author1=Subcommittee on Attention-Deficit/Hyperactivity Disorder |author2=Steering Committee on Quality Improvement and Management |last3=Wolraich |first3=Mark |last4=Brown |first4=Lawrence |last5=Brown |first5=Ronald T. |last6=DuPaul |first6=George |last7=Earls |first7=Marian |last8=Feldman |first8=Heidi M. |last9=Ganiats |first9=Theodore G. |last10=Kaplanek |first10=Beth |last11=Meyer |first11=Bruce |last12=Perrin |first12=James |last13=Pierce |first13=Karen |last14=Reiff |first14=Michael |last15=Stein |first15=Martin T. |last16=Visser |first16=Susanna |date=November 2011 |title=ADHD: Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents |journal=Pediatrics |volume=128 |issue=5 |pages=1007-22 |pmid=22003063 |pmc=4500647 |doi=10.1542/peds.2011-2654 }}</ref> ; Preschool-aged children (ages 4–5) : Primary care clinicians should prescribe evidence-based parent and/or teacher-administered behavior therapy as the first line of treatment, and may prescribe methylphenidate if behavioral interventions are not effective. ; Elementary-aged children (ages 6–11) : Primary care clinicians should prescribe FDA-approved medications for ADHD and/or evidence based parent and teacher administered behavior therapy. Preferably, both medication and behavior therapy will be prescribed. ; Adolescents (ages 12–18) : Primary care clinicians should prescribe FDA approved medications for ADHD with the assent of the adolescent and may prescribe behavior therapy as a treatment for ADHD, preferably both. === Behavioral therapies === These meet the American Academy of Pediatrics and American Psychological Association Task Force criteria for well-established evidence-based treatments. Descriptions and effect sizes are taken from the American Academy of Pediatrics' guidelines<ref name="AAP_Guideline-2011" /> and Pelham & Fabiano's review article.<ref>{{cite journal |last1=Pelham |first1=William E., Jr. |last2=Fabiano |first2=Gregory A. |date=January 2008 |title=Evidence-based psychosocial treatments for attention-deficit/hyperactivity disorder |journal=Journal of Clinical Child and Adolescent Psychology |volume=37 |issue=1 |pages=184-214 |doi=10.1080/15374410701818681 |pmid=18444058 |lay-url=https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0026847/ |lay-source=Database of Abstracts of Reviews of Effects: Quality-assessed Reviews |lay-date=12 February 2009 }}</ref> ; Behavioral Parent Training : Behavior modification principles provided to parents for implementation in home settings. Typical outcomes include improved compliance with parental commands, improved parental understanding of behavioral principles, high levels of parental satisfaction with treatment. :'''Median effect size:''' 0.55 ; Behavioral Classroom Management : Behavior-modification principles provided to teachers for implementation in classroom settings. Typical outcomes include improved attention to instruction, improved compliance with classroom rules, decreased disruptive behavior, improved work productivity, and improved academic achievement. :'''Median effect size:''' 0.61 ; Behavioral Peer Interventions : Interventions focused on peer interactions/relationships. These could include group-based interventions provided weekly and include clinic-based social skills training used either alone or concurrently with behavioral parent training and/or medication. Typical outcomes are more mixed with these interventions. Some clinical-office based interventions have produced minimal effects, while some studies of behavioral peer intervention coupled with behavioral parent training found positive effects on parental ratings of ADHD symptoms. No studies of this type of intervention reveal differences on social functioning or parental ratings of social behavior. Behavioral Peer Interventions implemented in peer group/recreational settings (e.g. summer camps) have the most evidence of being effective. :'''Median effect size:''' None reported, effect sizes found are considered moderate. === School based interventions === {| class="wikitable" align="right" |+Single Subject Design Effect Sizes |- ! rowspan="2" scope="col" | Intervention type ! colspan="2" scope="colgroup" | Effect size |- ! scope="col" | Academic<br>outcomes ! scope="col" | Behavioral<br>outcomes |- | {{rh}} class="table-rh" |Academic | style="text-align:right" | 4.73 | style="text-align:right" | 1.53 |- | {{rh}} class="table-rh" |Cognitive behavioral | style="text-align:right" | 3.77 | style="text-align:right" | 3.31 |- | {{rh}} class="table-rh" |Contingency management | style="text-align:right" | 2.29 | style="text-align:right" | 2.40 |- | {{rh}} class="table-rh" |Combined | style="text-align:right" | 2.29 | style="text-align:right" | 1.31 |} Findings from a review by DuPaul and colleagues.<ref name="DuPaul_et_al-2012">{{cite journal |last1=DuPaul |first1=George J. |last2=Eckert |first2=Tanya L. |last3=Vilardo |first3=Brigid |date=December 2012 |title=The effects of school-based interventions for attention deficit hyperactivity disorder: A meta-analysis 1996-2010 |journal=School Psychology Review |volume=41 |issue=4 |pages=387-412 |issn=0279-6015 |id=ERIC [https://eric.ed.gov/?id=EJ1001907 EJ1001907] }}</ref> ; Associated with greater effects on academic outcomes :''Academic'' — interventions focus primarily on manipulating antecedent conditions via things like peer tutoring, computer-aided instruction, and organizational skills. :''Combined'' academic and contingency management interventions. ; Associated with greater effects for behavior outcomes :''Contingency management'' — interventions use reinforcement and punishment. :''Cognitive behavioral'' — interventions focus on development of self-control skills and reflective problem-solving strategies. {{clear}} {{collapse bottom}} == '''External Links''' == *[https://sccap53.org Society of Clinical Child and Adolescent Psychology] *[http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/inattention-and-hyperactivity-adhd/ EffectiveChildTherapy.Org information on ADHD] *[https://ccf.fiu.edu/_assets/pdfs/how_to_establish_a_school_drc.pdf Establishing a School-Home Daily Report Card] *[https://ccf.fiu.edu/_assets/pdfs/what-parents-and-teachers-should-know-about-adhd-updated-1214.pdf What Parents and Teachers Should Know About ADHD (Fact Sheet)] *[https://ccf.fiu.edu/_assets/pdfs/psychosocial_fact_sheet-updated-1214.pdf Psychosocial Interventions for ADHD] *[https://ccf.fiu.edu/_assets/pdfs/adhd-medication-information-sheet-for-parents-and-teachers1.pdf ADHD Medication Information Sheet for Parents and Teachers] =='''References'''== {{collapse top|Click here for references|expand=yes}} {{Reflist|30em}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] {{collapse bottom}} {{subpage navbar}} k8vvp0w1did1wp6u3y9o05n0cr8i2sr 2419207 2419206 2022-08-26T02:41:44Z Ardenguo 2944162 /* References */ changed box title wikitext text/x-wiki 3<noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{medical disclaimer}} {{:{{BASEPAGENAME}}/Sidebar}} ==[[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio"?''']]== For background information on what assessment portfolios are, click the link in the heading above. Want even 'more' information about this topic? There's an extended version of this page [[Evidence-based assessment/Attention deficit hyperactivity disorder (assessment portfolio)/extended version|here]]. ==[[Evidence based assessment/Preparation phase|'''Preparation phase''']]== === Diagnostic Criteria of ADHD in youth === {{blockquotetop}} <big>ICD-11 Diagnostic Criteria </big><br> <br> '''General Description:''' Attention deficit hyperactivity disorder is characterised by a persistent pattern (at least 6 months) of inattention and/or hyperactivity-impulsivity that has a direct negative impact on academic, occupational, or social functioning. There is evidence of significant inattention and/or hyperactivity-impulsivity symptoms prior to age 12, typically by early to mid-childhood, though some individuals may first come to clinical attention later. The degree of inattention and hyperactivity-impulsivity is outside the limits of normal variation expected for age and level of intellectual functioning. Inattention refers to significant difficulty in sustaining attention to tasks that do not provide a high level of stimulation or frequent rewards, distractibility and problems with organisation. Hyperactivity refers to excessive motor activity and difficulties with remaining still, most evident in structured situations that require behavioural self-control. Impulsivity is a tendency to act in response to immediate stimuli, without deliberation or consideration of the risks and consequences. The relative balance and the specific manifestations of inattentive and hyperactive-impulsive characteristics varies across individuals and may change over the course of development. In order for a diagnosis to be made, manifestations of inattention and/or hyperactivity-impulsivity must be evident across multiple situations or settings (e.g., home, school, work, with friends or relatives), but are likely to vary according to the structure and demands of the setting. <br> <br> '''Predominantly Inattentive Presentation:''' All definitional requirements for attention deficit hyperactivity disorder are met and inattentive symptoms are predominant in the clinical presentation. Inattention refers to significant difficulty in sustaining attention to tasks that do not provide a high level of stimulation or frequent rewards, distractibility and problems with organization. Some hyperactive-impulsive symptoms may also be present, but these are not clinically significant in relation to the inattentive symptoms. <br> <br> '''Predominantly Hyperactive-Impulsive:''' All definitional requirements for attention deficit hyperactivity disorder are met and hyperactive-impulsive symptoms are predominant in the clinical presentation. Hyperactivity refers to excessive motor activity and difficulties with remaining still, most evident in structured situations that require behavioural self-control. Impulsivity is a tendency to act in response to immediate stimuli, without deliberation or consideration of the risks and consequences. Some inattentive symptoms may also be present, but these are not clinically significant in relation to the hyperactive-impulsive symptoms. <br> <br> <big>Changes in DSM-5</big> <br> The diagnostic criteria for ADHD changed slightly from DSM-IV to DSM-5. See the changes [https://www.ncbi.nlm.nih.gov/books/NBK519712/table/ch3.t3/ here]. {{blockquotebottom}}<ref>{{Cite web|url=https://icd.who.int/browse11/l-m/en#/http://id.who.int/icd/entity/821852937|title=ICD-11 for Mortality and Morbidity Statistics|website=icd.who.int|access-date=2022-06-21}}</ref> ===Base rates of youth ADHD in different populations and clinical settings=== This section describes the demographic setting of the population(s) sampled, base rates of diagnosis, country/region sampled, and the diagnostic method that was used. Using this information, clinicians will be able to anchor the rates of adolescent depression that they are likely to see in their clinical practices. * '''''To find prevalence rates across multiple disorders,''''' [[Evidence based assessment/Preparation phase#Base rates for transdiagnostic comparison|click here.]] {| class="wikitable sortable" |- ! Demography ! Setting ! Base Rate(s) ! Diagnostic Method |- |Worldwide, Ages 3-18 |Meta-Analysis of worldwide prevalence of Child/Adolescent ADHD<ref>{{cite journal |last=Willcutt |first=Erik G. |date=July 2012 |title=The Prevalence of DSM-IV Attention-Deficit/Hyperactivity Disorder: A Meta-Analytic Review |journal=Neurotherapeutics |volume=9 |issue=3 |pages=490-99 |pmid=22976615 |pmc=3441936 |doi=10.1007/s13311-012-0135-8 }}</ref> |6.1% (parent rating)<br>7.1% (teacher rating)<br>10.5% (ages 3-5)<br>11.4% (ages 6-12)<br>8.0% (ages 13-18) |Multiple, but each focused on DSM-IV criteria |- |USA Nationally Representative, Ages 3-17 |Epidemiological [[w:National Health Interview Survey|NHIS]] (US CDC, 2011) |8.4% (Overall)<br>12.0% (Male)<br>4.7% (Female)<br>2.1% (ages 3-5)<br>8.4% (ages 6-11)<br>11.9% (ages 12-17)<br>10.3% (southern region of US) |Parent-report of whether child had ever been diagnosed |- |USA Nationally Representative, Ages 4-17 |Child and Adolescent Epidemiological National Survey of Children's Health (US CDC, 2007) |9.5% (overall)<br>12.3% (male)<br>5.3% (female)<br>1.5% (ages 3-5)<br>9.1% (ages 6-11)<br>12.4% (ages 12-17)<br>15.6% (North Carolina) |Parent-report of whether child had ever been diagnosed |- |USA Nationally Representative, Ages 5-14 |Teacher-Reported Prevalence of ADHD<ref>{{cite journal |last1=Fabiano |first1=Gregory A. |last2=Pelham |first2=William E., Jr. |last3=Majumdar |first3=Antara |last4=Evans |first4=Steven W. |last5=Manos |first5=Michael J. |last6=Caserta |first6=Donald |last7=Girio-Herrera |first7=Erin L. |last8=Pisecco |first8=Stewart |last9=Hannah |first9=Jane N. |last10=Carter |first10=Randy L. |date=April 2013 |title=Elementary and Middle School Teacher Perceptions of Attention-Deficit/Hyperactivity Disorder Prevalence |journal=Child & Youth Care Forum |volume=42 |issue=2 |pages=87-99 |doi=10.1007/s10566-013-9194-1 }}</ref> |5.25% (overall)<br>5.58% (elementary schoolers)<br>3.53% (middle schoolers)<br>7.1% (one county in rural NC) |Teacher report of number of children who have been identified with ADHD in their class |- |USA Nationally Representative, Ages 13-18 |Adolescent Epidemiological [[w:National Comorbidity Survey|National Comorbidity Survey-Adolescent Supplement]]<ref>{{cite journal |last1=Merikangas |first1=Kathleen Ries |last2=He |first2=Jian-Ping |last3=Burstein |first3=Marcy |last4=Swanson |first4=Sonja A. |last5=Avenevoli |first5=Shelli |last6=Cui |first6=Lihong |last7=Benjet |first7=Corina |last8=Georgiades |first8=Katholiki |last9=Swendsen |first9=Joel |date=October 2010 |title=Lifetime prevalence of mental disorders in U.S. adolescents: results from the National Comorbidity Survey Replication—Adolescent Supplement (NCS-A) |journal=Journal of the American Academy of Child and Adolescent Psychiatry |volume=49 |issue=10 |pages=980-9 |pmid=20855043 |pmc=2946114 |doi=10.1016/j.jaac.2010.05.017 }}</ref> |8.7% |CIDI 3.0 structured diagnostic interview |- |Ages 6-90 |Meta-Analysis of Clinical Samples<ref name="Rettew_et_al-2009">{{cite journal |last1=Rettew |first1=David C. |last2=Lynch |first2=Alicia Doyle |last3=Achenbach |first3=Thomas M. |last4=Dumenci |first4=Levent |last5=Ivanova |first5=Masha Y. |date=September 2009 |title=Meta-analyses of agreement between diagnoses made from clinical evaluations and standardized diagnostic interviews |journal=International Journal of Methods in Psychiatric Research |volume=18 |issue=3 |pages=169-84 |pmid=19701924 |doi=10.1002/mpr.289 }}</ref> |38% |Structured Diagnostic Interviews |- |Ages 6-90 |Meta-Analysis of Clinical Samples<ref name="Rettew_et_al-2009" /> |23% |Clinical Evaluations |- |Representative Sample of Johnston County School Children, North Carolina, Ages 6-12 |Johnston County, North Carolina Sample<ref>{{cite journal |last1=Rowland |first1=Andrew S. |last2=Skipper |first2=Betty J. |last3=Umbach |first3=David M. |last4=Rabiner |first4=David L. |last5=Campbell |first5=Richard A. |last6=Naftel |first6=Albert J. |last7=Sandler |first7=Dale P. |date=11 December 2013 |title=The Prevalence of ADHD in a Population-Based Sample |journal=Journal of Attention Disorders |volume=19 |issue=9 |pages=741-54 |pmid=24336124 |pmc=4058092 |doi=10.1177/1087054713513799 }}</ref> |15.5% |Combined parent and teacher report (NTRS and DISC) with DSM-IV criteria |- |Sample drawn from 11 counties in Western NC, Ages 9-16 |North Carolina Community Sample<ref>{{cite journal |last1=Costello |first1=E. Jane |last2=Mustillo |first2=Sarah |last3=Erkanli |first3=Alaattin |last4=Keeler |first4=Gordon |last5=Angold |first5=Adrian |date=August 2003 |title=Prevalence and development of psychiatric disorders in childhood and adolescence |journal=Archives of General Psychiatry |volume=60 |issue=8 |pages=837-44 |pmid=12912767 |doi=10.1001/archpsyc.60.8.837 |doi-access=free |url=http://jamanetwork.com/journals/jamapsychiatry/fullarticle/207725 }}</ref> |0.9% (3-month prevalence)<br>4.1% (estimated by age 16) |CAPA structured diagnostic interview |- |Sample recruited at Durham, NC, Seattle, Nashville, and Central Pennsylvania sites. Sample was followed longitudinally and identified as at high risk for externalizing disorders in kindergarten. 50% African American, Ages 12-15 |High-Risk Community Sample<ref>{{cite journal |last1=Jones |first1=Damon E. |last2=Foster |first2=E. Michael |date=October 2009 |title=Service Use Patterns for Adolescents with ADHD and Comorbid Conduct Disorder |journal=Journal of Behavioral Health Services & Research |volume=36 |issue=4 |pages=436-49 |pmid=18618263 |pmc=3534729 |doi=10.1007/s11414-008-9133-3 }}</ref> |14.3% |Diagnostic Interview Schedule for Children (DISC) |} ==[[Evidence based assessment/Prediction phase|'''Prediction phase''']]== === Psychometric properties of screening instruments for youth ADHD === The following section contains a list of screening and diagnostic instruments for ADHD. The section includes administration information, psychometric data, and PDFs or links to the screenings. * Screenings are used as part of the [[Evidence based assessment/Prediction phase|prediction phase]] of assessment; for more information on interpretation of this data, or how screenings fit in to the assessment process, [[Evidence based assessment/Prediction phase|'''click here''']]. * '''''For a list of more broadly-reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Common_screening_instruments click here.]''''' === Screening and diagnostic instruments for attention deficit hyperactivity disorder=== {| class="wikitable sortable" border="1" |- ! Measure ! Format (Reporter) ! Age Range ! Administration/<br>Completion Time !Where to Access |- | colspan="5" style="font-size:110%; text-align:center;" span |'''Youth''' |- |ADHD Rating Scale (ADHD-RS-V)<ref>DuPaul, G. J., Power, T. J., Anastopoulos, A. D., & Reid, R. (1998). ADHD Rating Scale–IV: Checklists, norms, and clinical interpretation. New York: Guilford Press</ref> |Teacher, Parent |5-10 y/o: Child Version 11-17 y/o: Adolescent Version |5 minutes for each scale | |- |Conners 3rd Edition<ref>{{Cite web|url=https://www.pearsonassessments.com/store/usassessments/en/Store/Professional-Assessments/Behavior/Comprehensive/Conners-3rd-Edition/p/100000523.html|title=Conners 3rd Edition|website=www.pearsonassessments.com|language=en|access-date=2022-06-30}}</ref> |Teacher, Parent |6-18 y/o: Administered to parents and teachers of children and adolescents age 8-18 y/o: Self-report |20 minutes: Long Version 10 minutes: Short Version <5 Minutes: Conners 3AI and Conners 3GI |[https://www.pearsonassessments.com/store/usassessments/en/Store/Professional-Assessments/Behavior/Comprehensive/Conners-3rd-Edition/p/100000523.html Not Free] |- |Vanderbilt ADHD Parent Rating Scale (VADPRS) |Teacher, Parent |6-12 y/o | |Free |- |Child Behavior Checklist (CBCL/6-18) |Parent |6-18 y/o |15-20 minutes |Free |- |Behavior Assessment Scale for Children (BASC-3) | | |10-20 minutes: (TRS and PRS) 30 minutes: (SRP) |Not Free |- | colspan="5" style="font-size:110%; text-align:center;" span |'''Adults''' |- |} '''Note:''' L = Less than adequate; A = Adequate; G = Good; E = Excellent <ref>{{Cite web|url=https://en.wikiversity.org/wiki/Evidence-based_assessment/Reliability#Evaluating_norms_and_reliability|title=Evidence-based assessment/Reliability - Wikiversity|website=en.wikiversity.org|access-date=2020-11-13}}</ref> === Likelihood ratios and AUCs of screening measures for '''ADHD''' === * '''''For a list of the likelihood ratios for more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Likelihood_ratios_and_AUCs_of_common_screening_instruments click here.]''''' {| class="wikitable sortable mw-collapsible" border="1" |- ! Screening Measure (Primary Reference) !data-sort-type="number"| {{abbr|AUC (sample size)|Area under curve}} !data-sort-type="number"| {{abbr|DiLR+ (score)|Positive likelihood ratio}} Score !data-sort-type="number"| {{abbr|DiLR- (score)|Negative likelihood ratio}} Score ! Clinical Generalizeability and Study Description ! class="unsortable"| Study description !Where to Access |- |- | colspan="7" style="font-size:110%; text-align:center;" span |'''Youth''' |- |rowspan="4"| [[w:Child Behavior Checklist|Child Behavior Checklist]] (CBCL) - Attention Problems {{var|T}}-Score<ref name=Achenbach-1991>{{cite book |last1=Achenbach |first1=Thomas M. |author1-link=w:Thomas M. Achenbach |title=Child behavior checklist for ages 4-18 |date=1991 |publisher=Department of Psychiatry, University of Vermont |location=Burlington, VT |isbn=978-0-938565-08-6 }}</ref> |rowspan="4"| .84 ({{var|N}}=187) | 6.92 (>55) | 0.19 (<55) |rowspan="4"| Somewhat High Utilized sample ages 6-18 recruited from local pediatricians, psychiatrists, and community advertisements. Included 95 children who met criteria for ADHD. 70 of these children also met criteria for ODD/CD.<ref name="Hudziak_et_al-2004" /> |rowspan="4"| Utilized sample ages 6-18 recruited from local pediatricians, psychiatrists, and community advertisements. Included 95 children who met criteria for ADHD. 70 of these children also met criteria for ODD/CD.<ref name=Hudziak_et_al-2004>{{cite journal |last1=Hudziak |first1=James J. |last2=Copeland |first2=William |last3=Stanger |first3=Catherine |last4=Wadsworth |first4=Martha |title=Screening for DSM-IV externalizing disorders with the Child Behavior Checklist: A receiver-operating characteristic analysis |journal=Journal of Child Psycholology and Psychiatry |date=October 2004 |volume=45 |issue=7 |pages=1299-307 |pmid=15335349 |doi=10.1111/j.1469-7610.2004.00314.x }}</ref> | rowspan="4" | |- | 12.2 (>60) | 0.41 (<60) |- | 47 (>65) | 0.53 (<65) |- | 34 (>70) | 0.66 (<70) |- |rowspan="2"| Child Behavior Checklist (CBCL) - Attention and Aggression Problems {{var|T}}-Score<ref name=Achenbach-1991/> |data-sort-value="0.86"| Boys: .86 ({{var|N}}=111) | {{nowrap|10.2 (>55)}} | {{nowrap|0.41 (<55)}} |rowspan="2"| Somewhat High Utilized sample ages 6-18 which consisted of 219 brothers and sisters of children who were referred to a hospital pediatric unit for ADHD or other symptoms. Half of these siblings had brothers and sisters who had ADHD, half did not.<ref name="Chen_et_al-1994" /> |rowspan="2"| Utilized sample ages 6-18 which consisted of 219 brothers and sisters of children who were referred to a hospital pediatric unit for ADHD or other symptoms. Half of these siblings had brothers and sisters who had ADHD, half did not.<ref name=Chen_et_al-1994>{{cite journal |last1=Chen |first1= Wei J. |last2=Faraone |first2=Stephen V. |author2-link=w:Stephen Faraone |last3=Biederman |first3=Joseph |author3-link=w:Joseph Biederman |last4=Tsuang |first4=Ming T. |title=Diagnostic accuracy of the Child Behavior Checklist scales for attention-deficit hyperactivity disorder: A receiver-operating characteristic analysis |journal=Journal of Consulting and Clinical Psychology |date=October 1994 |volume=62 |issue=5 |pages=1017-25 |pmid=7806710 |doi=10.1037/0022-006X.62.5.1017 }}</ref> | rowspan="2" | |- |data-sort-value="0.90"| Girls: 0.90 ({{var|N}}=108) |{{nowrap|11.2 (>55)}} |{{nowrap|0.35 (<55)}} |- | [[w:Achenbach System of Empirically Based Assessment|Teacher Response Form]] (TRF) - Attention Problems {{var|T}}-Score<ref name=Achenbach-1991/> | Not reported ({{var|N}}=184) | 3.66 (>70) | 0.73 (<70) | Somewhat High Utilized sample ages 5-12 years referred to a research clinic for assessment of ADHD. 108 children were ultimately diagnosed with ADHD, while 76 were not. LR's are calculated for discriminating between those two groups.<ref name="Tripp_et_al-2006" /> |rowspan="2"| Utilized sample ages 5-12 years referred to a research clinic for assessment of ADHD. 108 children were ultimately diagnosed with ADHD, while 76 were not. LR's are calculated for discriminating between those two groups.<ref name=Tripp_et_al-2006>{{cite journal |last1=Tripp |first1=Gail |last2=Schaughency |first2=Elizabeth A. |last3=Clarke |first3=Bronwyn |title=Parent and teacher rating scales in the evaluation of attention-deficit hyperactivity disorder: Contribution to diagnosis and differential diagnosis in clinically referred children |journal=Journal of Developmental and Behavioral Pediatrics |date=2006 |volume=27 |issue=3 |pages=209-18 |pmid=16775518 }}</ref> | |- | Teacher Response Form (TRF) - Attention and Aggression Problems {{var|T}}-Score<ref name=Achenbach-1991/> | Not reported ({{var|N}}=184) | 4.33 (>70) | 0.89 (<70) | Somewhat High Utilized sample ages 5-12 years referred to a research clinic for assessment of ADHD. 108 children were ultimately diagnosed with ADHD, while 76 were not. LR's are calculated for discriminating between those two groups.<ref name="Tripp_et_al-2006" /> | |- | [[w:Disruptive Behavior Disorders Rating Scale|Disruptive Behavior Disorder Rating Scale]] (DBDRS) - Parent Report (Pelham et. al, 1992) | 0.78 ({{var|N}}=232) | 5.06 (Endorsed ≥ 6 symptoms of inattention or hyperactivity) | 0.20 (<9) (Endorsed < 6 symptoms of inattention or hyperactivity) | Somewhat High Sample consisted of 232 ethnically diverse children ages 5-10 with (n = 121) and without (n=111) ADHD recruited through advertisements at school and through self-help groups.<ref name="Shemmassian_Lee-2012" /><ref name="Shemmassian_Lee-2016" /> |rowspan="2"| Sample consisted of 232 ethnically diverse children ages 5-10 with (n = 121) and without (n=111) ADHD recruited through advertisements at school and through self-help groups.<ref name="Shemmassian_Lee-2012">{{cite journal |last1=Shemmassian |first1=Shirag K. |last2=Lee |first2=Steve S. |date=March 2012 |title=Comparing Four Methods of Integrating Parent and Teacher Symptom Ratings of Attention-deficit/hyperactivity Disorder (ADHD) |journal=Journal of Psychopathology and Behavioral Assessment |volume=34 |issue=1 |pages=1-10 |doi=10.1007/s10862-011-9262-5 |url=https://www.researchgate.net/profile/Steve_Lee11/publication/230888173_Comparing_Four_Methods_of_Integrating_Parent_and_Teacher_Symptom_Ratings_of_Attention-deficithyperactivity_Disorder_ADHD/links/09e41505caa13a5913000000.pdf |format=PDF }}</ref><ref name="Shemmassian_Lee-2016">{{cite journal |last1=Shemmassian |first1=Shirag K. |last2=Lee |first2=Steve S. |title=Predictive Utility of Four Methods of Incorporating Parent and Teacher Symptom Ratings of ADHD for Longitudinal Outcomes |journal=Journal of Clinical Child and Adolescent Psychology |date=2016 |volume=45 |issue=2 |pages=176-87 |pmid=25643854 |doi=10.1080/15374416.2014.971457 }}</ref> | |- | Disruptive Behavior Disorder Rating Scale (DBDRS) - Teacher Report (Pelham et. al, 1992) | 0.63 ({{var|N}}=232) | 1.97 (Endorsed ≥ 6 symptoms of inattention or hyperactivity) | 0.24 (Endorsed < 6 symptoms of inattention or hyperactivity) | Somewhat High Sample consisted of 232 ethnically diverse children ages 5-10 with (n = 121) and without (n=111) ADHD recruited through advertisements at school and through self-help groups.<ref name="Shemmassian_Lee-2012" /><ref name="Shemmassian_Lee-2016" /> | |- | [[w:Vanderbilt ADHD diagnostic rating scale#Parent version|Vanderbilt ADHD Diagnostic Parent Rating Scale]] (VADPRS)<ref>{{cite journal |last1=Wolraich |first1=Mark L. |last2=Lambert |first2=Warren |last3=Doffing |first3=Melissa A. |last4=Bickman |first4=Leonard |last5=Simmons |first5=Tonya |last6=Worley |first6=Kim |date=December 2003 |title=Psychometric Properties of the Vanderbilt ADHD Diagnostic Parent Rating Scale in a Referred Population |journal=Journal of Pediatric Psychology |volume=28 |issue=8 |pages=559-68 |pmid=14602846 |doi=10.1093/jpepsy/jsg046 |url=https://academic.oup.com/jpepsy/article/28/8/559/1020465/Psychometric-Properties-of-the-Vanderbilt-ADHD }}</ref> | Not reported | 4.79 (Endorsed ≥ 6 symptoms of inattention or hyperactivity) | 0.38 (Endorsed < 6 symptoms of inattention or hyperactivity) | Moderate Sample consists of 582 children ages 5-15 recruited through schools in Oklahoma. Sample includes children screened as "high risk" for ADHD and "low risk" for ADHD.<ref name=":0" /> | Sample consists of 582 children ages 5-15 recruited through schools in Oklahoma. Sample includes children screened as "high risk" for ADHD and "low risk" for ADHD.<ref name=":0">{{cite journal |last1=Bard |first1=David E. |last2=Wolraich |first2=Mark L. |last3=Neas |first3=Barbara |last4=Doffing |first4=Melissa |last5=Beck |first5=Laoma |date=February 2013 |title=The psychometric properties of the Vanderbilt attention-deficit hyperactivity disorder diagnostic parent rating scale in a community population |journal=Journal of Developmental and Behavioral Pediatrics |volume=34 |issue=2 |pages=72-82 |pmid=23363972 |doi=10.1097/DBP.0b013e31827a3a22 }}</ref> | |- | [[w:Vanderbilt ADHD diagnostic rating scale#Teacher version|Vanderbilt ADHD Diagnostic Teacher Rating Scale]] (VADTRS)<ref>{{cite journal |last1=Wolraich |first1=ML |last2=Feurer |first2=ID |last3=Hannah |first3=JN |last4=Baumgaertel |first4=A |last5=Pinnock |first5=TY |date=April 1998 |title=Obtaining systematic teacher reports of disruptive behavior disorders utilizing DSM-IV |journal=Journal of Abnormal Child Psychology |volume=26 |issue=2 |pages=141-52 |pmid=9634136 }}</ref> | Not reported | 2.91 (Positive risk score) | 0.657 (Negative risk score) | Moderate | Sample consisted of 370 children ages 5-15 recruited though schools in Oklahoma. Sample was representative community sample.<ref>{{cite journal |last1=Wolraich |first1=Mark L. |last2=Bard |first2=David E. |last3=Neas |first3=Barbara |last4=Doffing |first4=Melissa |last5=Beck |first5=Laoma |title=The psychometric properties of the Vanderbilt attention-deficit hyperactivity disorder diagnostic teacher rating scale in a community population |journal=Journal of Developmental and Behavioral Pediatrics |date=February 2013 |volume=34 |issue=2 |pages=83-93 |pmid=23363973 |doi=10.1097/DBP.0b013e31827d55c3 }}</ref> | |- | Conners Rating Scale (Revised) - Long Form Parent Report (Conners, 1997) | Not reported | 15.33 (>93rd percentile) | 0.09 (<93rd percentile) | Moderate | Data come from normative sample of 2482 children ages 3 to 17 across the United States and Canada. Diagnostic likelihood ratios here discriminate ADHD from Non-Clinical.<ref name=Collett_et_al-2003>{{cite journal |last1=Collett |first1=Brent R. |last2=Ohan |first2=Jeneva L. |last3=Myers |first3=Kathleen M. |title=Ten-year review of rating scales. V: Scales assessing attention-deficit/hyperactivity disorder |journal=Journal of the American Academy of Child and Adolescent Psychiatry |date=September 2003 |volume=42 |issue=9 |pages=1015-37 |pmid=12960702 |doi=10.1097/01.CHI.0000070245.24125.B6 }}</ref> | |- | Conners Parent Rating Scale-48 (CPRS-48) Impulsive-Hyperactive Subscale {{var|T}}-Score (Conners, 1990) | Not reported | 1.26 (>70) | 0.79 (>70) | Somewhat High | rowspan="2"| Utilized sample ages 5-12 years referred to a research clinic for assessment of ADHD. 108 children were ultimately diagnosed with ADHD, while 76 were not. LR's are calculated for discriminating between those two groups.<ref name=Tripp_et_al-2006 /> | |- | Conners Teacher Rating Scale-39 Hyperactivity Subscale {{var|T}}-Score (Conners, 1990) | Not reported | 5.2 (>70) | 0.53 (<70) | Somewhat High | |- | Conners Teacher Rating Scale (Revised) - Long Form (Conners, 1997) | Not reported | 8.66 (>93rd percentile) | 0.24 (<93rd percentile) | Moderate | Data come from normative sample of 1973 children ages 5 to 17 across the United States and Canada. Likelihood ratios discriminate ADHD from non-clinical.<ref name=Collett_et_al-2003 /> | |- | ADHD Symptom Checklist-4 (ADHD-SC4) - Parent Report<ref name=Gadow_Sprafkin-1997>{{cite book |last1=Gadow |first1=Kenneth D. |last2=Sprafkin |first2=Joyce N. |date=1997 |title=ADHD Symptom Checklist-4 |publisher=Checkmate Plus |location=Stony Brook, NY |oclc=49637921 }}</ref> | Not reported | 1.45 (Endorsed ≥ 6 symptoms of inattention or hyperactivity) | 0.70 (Endorsed < 6 symptoms of inattention or hyperactivity) | Somewhat High | rowspan="2"| Data come from sample of 207 children ages 5-17 years old who were referred to psychiatric outpatient service with variety of emotional and behavioral disorders.<ref name=Sprafkin_Gadow-2007>{{cite journal |last1=Sprafkin |first1=Joyce |last2=Gadow |first2=Kenneth D. |title=Choosing an attention-deficit/hyperactivity disorder rating scale: is item randomization necessary? |journal=Journal of Child and Adolescent Psychopharmacology |date=February 2007 |volume=17 |issue=1 |pages=75-84 |pmid=17343555 |doi=10.1089/cap.2006.0035 }}</ref> | |- | ADHD Symptom Checklist-4 (ADHD-SC4) - Teacher Report<ref name=Gadow_Sprafkin-1997/> | Not reported | 1.53 (Endorsed ≥ 6 symptoms of inattention or hyperactivity) | 0.60 (Endorsed < 6 symptoms of inattention or hyperactivity) | Somewhat High | |- | [[w:ADHD rating scale|ADHD RS-IV]] - Home (DuPaul et. al, 1998b) | Not reported | 1.63 (>80th percentile) | 0.35 (<80th percentile) | Moderate | rowspan="2"| Sample of 2000 children ages 5 to 18 years old from geographically representative normative base.<ref name=Collett_et_al-2003 /> | |- | ADHD RS-IV - School (DuPaul et. al, 1998b) | Not reported | 4.5 (>80th percentile) | 0.42 (<80th percentile) | Moderate | |- | colspan="7" style="font-size:110%; text-align:center;" span |'''Adults''' |- |} '''Note:''' All studies with one exception used structured or semi-structured clinical interviews to establish diagnosis of ADHD. The exception, the Sprafkin & Gadow study (2007), used a combination of CBCL rating scales, clinician review, and clinician consensus to confirm ADHD diagnosis.<ref name=Sprafkin_Gadow-2007 /> “LR+” refers to the change in likelihood ratio associated with a positive test score, and “LR-” is the likelihood ratio for a low score. Likelihood ratios of 1 indicate that the test result did not change impressions at all. LRs larger than 10 or smaller than .10 are frequently clinically decisive; 5 or .20 are helpful, and between 2.0 and .5 are small enough that they rarely result in clinically meaningful changes of formulation (Sackett et al., 2000). === Interpreting ADHD screening measure scores === * For information on interpreting screening measure scores, click [[Evidence based assessment/Prediction phase#Interpreting screening measure scores|here.]] * Also see the page on [https://en.wikipedia.org/wiki/Likelihood_ratios_in_diagnostic_testing likelihood ratios in diagnostic testing] for more information ==[[Evidence based assessment/Prescription phase|'''Prescription phase''']]== ===Gold standard diagnostic interviews=== * For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews click here.] ===Recommended diagnostic interviews for ADHD=== ''****Depression instruments are placeholders'' {| class="wikitable sortable" border="1" ! colspan="5" |Diagnostic instruments for '''ADHD''' |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time !Where to Access |- |- | colspan="5" style="font-size:110%; text-align:center;" span |'''Youth''' |- | Barkley Functional Impairment Scale—Children and Adolescents (BFIS-CA) | Parent Report | 6-17 | 5-7 minutes |Link to [https://www.guilford.com/books/Barkley-Functional-Impairment-Scale-Children-Adolescents-BFIS-CA/Russell-Barkley/9781462503957 purchase] |- | Weiss Functional Impairment Rating Scale<ref>{{Cite journal|last=Thompson|first=Trevor|last2=Lloyd|first2=Andrew|last3=Joseph|first3=Alain|last4=Weiss|first4=Margaret|date=2017|title=The Weiss Functional Impairment Rating Scale-Parent Form for assessing ADHD: evaluating diagnostic accuracy and determining optimal thresholds using ROC analysis|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5486894/|journal=Quality of Life Research|volume=26|issue=7|pages=1879–1885|doi=10.1007/s11136-017-1514-8|issn=0962-9343|pmc=5486894|pmid=28220338}}</ref> | Parent/Caregiver Report | 5-19 | |[http://www.shared-care.ca/files/WFIRS-Parent_with_Instructions_May_2012.pdf PDF] |- |- | colspan="5" style="font-size:110%; text-align:center;" span |'''Adults''' |- |} '''Note:''' '''L''' = Less than adequate; '''A''' = Adequate; '''G''' = Good; '''E''' = Excellent; '''U''' = Unavailable; '''NA''' = Not applicable<ref>{{Cite web|url=https://en.wikiversity.org/wiki/Evidence-based_assessment/Reliability#Evaluating_norms_and_reliability|title=Evidence-based assessment/Reliability - Wikiversity|website=en.wikiversity.org|access-date=2020-11-13}}</ref> ==[[Evidence based assessment/Process phase|'''Process phase''']]== The following section contains a brief overview of treatment options for ADHD and list of process and outcome measures for ADHD. The section includes benchmarks based on published norms for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the [[Evidence based assessment/Process phase|process phase]] of assessment. For more information of differences between process and outcome measures, see the page on the [[Evidence based assessment/Process phase|process phase of assessment]]. === Process measures === {{blockquotetop}} ; CBCL Attention Problems Subscale : Could be used on a weekly basis to track changes in ADHD symptomotology. T-scores from this measure could also be recorded on a weekly basis to determine if reliable and clinically significant changes in ADHD symptoms are occuring. The CBCL Attention Problems Subscale has repeatedly demonstrated good-to-excellent convergence with diagnostic interviews for diagnosing ADHD.<ref name=Pelham_et_al-2005>{{cite journal |last1=Pelham |first1=William E., Jr. |last2=Fabiano |first2=Gregory A. |last3=Massetti |first3=Greta M. |date=September 2005 |title=Evidence-based assessment of attention deficit hyperactivity disorder in children and adolescents |journal=Journal of Clinical Child and Adolescent Psychology |volume=34 |issue=3 |pages=449-76 |pmid=16026214 |doi=10.1207/s15374424jccp3403_5 |url=https://www.researchgate.net/profile/Greta_Massetti/publication/7719090_Evidence-Based_Assessment_of_Attention_Deficit_Hyperactivity_Disorder_in_Children_and_Adolescents/links/09e415107e6e01c28e000000.pdf |format=PDF }}</ref><ref>{{cite journal |last1=Lampert |first1=TL |last2=Polanczyk |first2=G |last3=Tramontina |first3=S |last4=Mardini |first4=V |last5=Rohde |first5=LA |date=October 2004 |title=Diagnostic performance of the CBCL-Attention Problem Scale as a screening measure in a sample of Brazilian children with ADHD |journal=Journal of Attention Disorders |volume=8 |issue=2 |pages=63-71 |pmid=15801336 }}</ref><ref name=Hudziak_et_al-2004/><ref name=Chen_et_al-1994/> '''The CBCL Attention Problems Subscale is a scale on the CBCL, which is readily available at the Finley Clinic.''' ; Daily Report Card : Several scholars have pointed out that it is equally important to track changes in the functional behaviors that a child with ADHD engages in, in addition to their ADHD symptoms, to capture the full range of adaptive changes that are made by children with ADHD throughout the course of treatment.<ref name=Pelham_et_al-2005/><ref>{{cite book |last1=Sowerby |first1=Paula |last2=Tripp |first2=Gail |date=2009 |chapter=Evidence-Based Assessment of Attention-Deficit/Hyperactivity Disorder (ADHD) |editor1-last=Matson |editor1-first=Johnny L. |editor2-last=Andrasik |editor2-first=Frank |editor3-last=Matson |editor3-first=Michael L. |title=Assessing Childhood Psychopathology and Developmental Disabilities |pages=209-239 |publisher=Springer Science & Business Media |location=New York |oclc=314175875 |doi=10.1007/978-0-387-09528-8 |isbn=978-0-387-09528-8 |chapter-url=https://books.google.com/books?id=TyJClvRUgY4C&pg=PA209 }}</ref> The daily report card is a mechanism by which such adaptive behavioral changes can be tracked. When implementing the daily report card, problematic child behaviors at home and at school are targeted for change. Rewards are offered to the child for reaching daily and weekly goals for reducing maladaptive behaviors and increasing adaptive behaviors. Parents and Teachers track child behaviors on a daily basis and provide feedback to one another and the child with behavior frequency counts and/or daily "grades" on how well the child behaved. Daily report cards are a mainstay of cognitive-behavioral and behavioral modification evidence-based intervention strategies for ADHD,<ref name=DuPaul_et_al-2012/><ref>{{cite journal |last1=Eiraldi |first1=Ricardo B. |last2=Mautone |first2=Jennifer A. |last3=Power |first3=Thomas J. |date=January 2012 |title=Strategies for implementing evidence-based psychosocial interventions for children with attention-deficit/hyperactivity disorder |journal=Child and Adolescent Psychiatric Clinics of North America |volume=21 |issue=1 |pages=145-59 |pmid=22137818 |pmc=3233687 |doi=10.1016/j.chc.2011.08.012 }}</ref> and they are highly recommended for tracking child treatment outcomes. '''Instructions for creating a daily report card are attached in Appendix 1.''' {{blockquotebottom}} === Outcome and severity measures === This table includes clinically significant benchmarks for ADHD specific outcome measures * Information on how to interpret this table can be [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase found here]. * Additionally, these [[Evidence based assessment/Vignettes|vignettes]] might be helpful resources for understanding appropriate adaptation of outcome measures in practice. * ''<u>For clinically significant change benchmarks for the CBCL, YSR, and TRF total, externalizing, internalizing, and attention benchmarks,</u>'' [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase&wteswitched=1#Clinically_significant_change_benchmarks_for_widely-used_outcome_measures see here.] {| class="wikitable" border="1" |+Clinically significant change benchmarks with common instruments and ADHD rating scales |- ! rowspan="2" scope="col" | Measure ! rowspan="2" scope="col" | Diagnostic category ! colspan="3" scope="colgroup" width="300" | Cut Scores* ! colspan="3" scope="colgroup" | Critical Change<br>(Unstandardized Scores) |- ! scope="col" | A ! scope="col" | B ! scope="col" | C ! scope="col" | 95% ! scope="col" | 90% ! scope="col" | SE_difference |- | colspan="8" style="text-align:center" |'''Benchmarks Based on Published Norms''' |- | rowspan="4" style="text-align:center;" |''{{abbr|CBCL|Child Behavior Checklist}} {{var|T}}-scores<br>(2001 Norms)'' | style="text-align:right" | Total | style="text-align:center;" | 49 | style="text-align:center;" | 70 | style="text-align:center;" | 58 | style="text-align:center;" | 5 | style="text-align:center;" | 4 | style="text-align:center;" | 2.4 |- | style="text-align:right" | Externalizing | style="text-align:center;" | 49 | style="text-align:center;" | 70 | style="text-align:center;" | 58 | style="text-align:center;" | 7 | style="text-align:center;" | 6 | style="text-align:center;" | 3.4 |- | style="text-align:right" | Internalizing | {{n/a}} | style="text-align:center;" | 70 | style="text-align:center;" | 56 | style="text-align:center;" | 9 | style="text-align:center;" | 7 | style="text-align:center;" | 4.5 |- | style="text-align:right" | Attention Problems | {{n/a}} | style="text-align:center;" | 66 | style="text-align:center;" | 58 | style="text-align:center;" | 8 | style="text-align:center;" | 7 | style="text-align:center;" | 4.2 |- | rowspan="4" style="text-align:center;" |''{{abbr|TRF|Teacher Response Form}} {{var|T}}-Scores<br>(2001 Norms)'' | style="text-align:right" | Total | {{n/a}} | style="text-align:center;" | 70 | style="text-align:center;" | 57 | style="text-align:center;" | 5 | style="text-align:center;" | 4 | style="text-align:center;" | 2.3 |- | style="text-align:right" | Externalizing | {{n/a}} | style="text-align:center;" | 70 | style="text-align:center;" | 56 | style="text-align:center;" | 6 | style="text-align:center;" | 5 | style="text-align:center;" | 3.0 |- | style="text-align:right" | Internalizing | {{n/a}} | style="text-align:center;" | 70 | style="text-align:center;" | 55 | style="text-align:center;" | 9 | style="text-align:center;" | 7 | style="text-align:center;" | 4.4 |- | style="text-align:right" | Attention Problems | {{n/a}} | style="text-align:center;" | 66 | style="text-align:center;" | 57 | style="text-align:center;" | 5 | style="text-align:center;" | 4 | style="text-align:center;" | 2.3 |- | rowspan="2" style="text-align:center" |''Conners 3-Teacher Rating Scale {{var|T}}-Scores'' | style="text-align:right" | ADHD Inattentive | style="text-align:center;" | 36 | style="text-align:center;" | 74 | style="text-align:center;" | 57 | style="text-align:center;" | 11 | style="text-align:center;" | 10 | style="text-align:center;" | 5.6 |- | style="text-align:right" | ADHD Hyperactive-Impulsive | style="text-align:center;" | 36 | style="text-align:center;" | 74 | style="text-align:center;" | 57 | style="text-align:center;" | 11 | style="text-align:center;" | 9 | style="text-align:center;" | 5.5 |- | rowspan="2" style="text-align:center" |''Conners 3-Parent Rating Scale {{var|T}}-Scores'' | style="text-align:right" | ADHD Inattentive | style="text-align:center;" | 37 | style="text-align:center;" | 72 | style="text-align:center;" | 58 | style="text-align:center;" | 10 | style="text-align:center;" | 10 | style="text-align:center;" | 5.6 |- | style="text-align:right" | ADHD Hyperactive-Impulsive | style="text-align:center;" | 37 | style="text-align:center;" | 72 | style="text-align:center;" | 58 | style="text-align:center;" | 10 | style="text-align:center;" | 8 | style="text-align:center;" | 4.7 |- | colspan="8" style="text-align:center" |'''Benchmarks Based on ADHD Samples'''<ref name="Shemmassian_Lee-2012" /> |- | colspan="2" |''Disruptive Behavior Disorders Rating Scale'' | style="text-align:center;" | 1.4 | style="text-align:center;" | 8.6 | style="text-align:center;" | 5.7 | style="text-align:center;" | 12 | style="text-align:center;" | 10 | style="text-align:center;" | 0.9 |} '''Note:''' “A” = Away from the clinical range, “B” = Back into the nonclinical range, “C” = Closer to the nonclinical than clinical mean. <ref>{{Cite web|url=https://en.wikiversity.org/wiki/Evidence-based_assessment/Reliability#Evaluating_norms_and_reliability|title=Evidence-based assessment/Reliability - Wikiversity|website=en.wikiversity.org|access-date=2020-11-13}}</ref> '''Search terms:''' [ADHD or CONNERS or DBD] AND [clinical significance OR group means] in PsycINFO === Treatment === * Please refer to the Wikipedia page on [[wikipedia:Attention_deficit_hyperactivity_disorder|Attention Deficit Hyperactivity Disorder]] for more information on available treatment for ADHD or go to [https://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/inattention-and-hyperactivity-adhd/ Effective Child Therapy] for a curated resource on effective treatments for ADHD. {{collapse top| ADHD Treatment Information|expand=yes}} === Executive summary === 1. If intervening with children ages 4-5, behavior therapy should be the first line of treatment. 2. If intervening with children ages 6-11, behavior therapy should be the first line of treatment, in conjunction with medication. 3. If intervening with children ages 12-18, medication should probably be the first line of treatment, though behavior therapy could be used in combination. 4. Three types of therapeutic interventions have well established evidence-bases: :a. Behavioral Parent Training Interventions :b. Behavioral Classroom Management Interventions :c. Behavioral Peer interventions involving recreational peer groups (e.g. summer camps) 5. If considering a classroom management intervention: :a. Academic and Cognitive-Behavioral Interventions are most effective in changing academic outcomes :b. Cognitive Behavioral and Contingency Management Interventions are most effective in changing behavioral outcomes === Clinical practice guidelines === Published by the American Academy of Pediatrics in 2011.<ref name="AAP_Guideline-2011">{{cite journal |author1=Subcommittee on Attention-Deficit/Hyperactivity Disorder |author2=Steering Committee on Quality Improvement and Management |last3=Wolraich |first3=Mark |last4=Brown |first4=Lawrence |last5=Brown |first5=Ronald T. |last6=DuPaul |first6=George |last7=Earls |first7=Marian |last8=Feldman |first8=Heidi M. |last9=Ganiats |first9=Theodore G. |last10=Kaplanek |first10=Beth |last11=Meyer |first11=Bruce |last12=Perrin |first12=James |last13=Pierce |first13=Karen |last14=Reiff |first14=Michael |last15=Stein |first15=Martin T. |last16=Visser |first16=Susanna |date=November 2011 |title=ADHD: Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents |journal=Pediatrics |volume=128 |issue=5 |pages=1007-22 |pmid=22003063 |pmc=4500647 |doi=10.1542/peds.2011-2654 }}</ref> ; Preschool-aged children (ages 4–5) : Primary care clinicians should prescribe evidence-based parent and/or teacher-administered behavior therapy as the first line of treatment, and may prescribe methylphenidate if behavioral interventions are not effective. ; Elementary-aged children (ages 6–11) : Primary care clinicians should prescribe FDA-approved medications for ADHD and/or evidence based parent and teacher administered behavior therapy. Preferably, both medication and behavior therapy will be prescribed. ; Adolescents (ages 12–18) : Primary care clinicians should prescribe FDA approved medications for ADHD with the assent of the adolescent and may prescribe behavior therapy as a treatment for ADHD, preferably both. === Behavioral therapies === These meet the American Academy of Pediatrics and American Psychological Association Task Force criteria for well-established evidence-based treatments. Descriptions and effect sizes are taken from the American Academy of Pediatrics' guidelines<ref name="AAP_Guideline-2011" /> and Pelham & Fabiano's review article.<ref>{{cite journal |last1=Pelham |first1=William E., Jr. |last2=Fabiano |first2=Gregory A. |date=January 2008 |title=Evidence-based psychosocial treatments for attention-deficit/hyperactivity disorder |journal=Journal of Clinical Child and Adolescent Psychology |volume=37 |issue=1 |pages=184-214 |doi=10.1080/15374410701818681 |pmid=18444058 |lay-url=https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0026847/ |lay-source=Database of Abstracts of Reviews of Effects: Quality-assessed Reviews |lay-date=12 February 2009 }}</ref> ; Behavioral Parent Training : Behavior modification principles provided to parents for implementation in home settings. Typical outcomes include improved compliance with parental commands, improved parental understanding of behavioral principles, high levels of parental satisfaction with treatment. :'''Median effect size:''' 0.55 ; Behavioral Classroom Management : Behavior-modification principles provided to teachers for implementation in classroom settings. Typical outcomes include improved attention to instruction, improved compliance with classroom rules, decreased disruptive behavior, improved work productivity, and improved academic achievement. :'''Median effect size:''' 0.61 ; Behavioral Peer Interventions : Interventions focused on peer interactions/relationships. These could include group-based interventions provided weekly and include clinic-based social skills training used either alone or concurrently with behavioral parent training and/or medication. Typical outcomes are more mixed with these interventions. Some clinical-office based interventions have produced minimal effects, while some studies of behavioral peer intervention coupled with behavioral parent training found positive effects on parental ratings of ADHD symptoms. No studies of this type of intervention reveal differences on social functioning or parental ratings of social behavior. Behavioral Peer Interventions implemented in peer group/recreational settings (e.g. summer camps) have the most evidence of being effective. :'''Median effect size:''' None reported, effect sizes found are considered moderate. === School based interventions === {| class="wikitable" align="right" |+Single Subject Design Effect Sizes |- ! rowspan="2" scope="col" | Intervention type ! colspan="2" scope="colgroup" | Effect size |- ! scope="col" | Academic<br>outcomes ! scope="col" | Behavioral<br>outcomes |- | {{rh}} class="table-rh" |Academic | style="text-align:right" | 4.73 | style="text-align:right" | 1.53 |- | {{rh}} class="table-rh" |Cognitive behavioral | style="text-align:right" | 3.77 | style="text-align:right" | 3.31 |- | {{rh}} class="table-rh" |Contingency management | style="text-align:right" | 2.29 | style="text-align:right" | 2.40 |- | {{rh}} class="table-rh" |Combined | style="text-align:right" | 2.29 | style="text-align:right" | 1.31 |} Findings from a review by DuPaul and colleagues.<ref name="DuPaul_et_al-2012">{{cite journal |last1=DuPaul |first1=George J. |last2=Eckert |first2=Tanya L. |last3=Vilardo |first3=Brigid |date=December 2012 |title=The effects of school-based interventions for attention deficit hyperactivity disorder: A meta-analysis 1996-2010 |journal=School Psychology Review |volume=41 |issue=4 |pages=387-412 |issn=0279-6015 |id=ERIC [https://eric.ed.gov/?id=EJ1001907 EJ1001907] }}</ref> ; Associated with greater effects on academic outcomes :''Academic'' — interventions focus primarily on manipulating antecedent conditions via things like peer tutoring, computer-aided instruction, and organizational skills. :''Combined'' academic and contingency management interventions. ; Associated with greater effects for behavior outcomes :''Contingency management'' — interventions use reinforcement and punishment. :''Cognitive behavioral'' — interventions focus on development of self-control skills and reflective problem-solving strategies. {{clear}} {{collapse bottom}} == '''External Links''' == *[https://sccap53.org Society of Clinical Child and Adolescent Psychology] *[http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/inattention-and-hyperactivity-adhd/ EffectiveChildTherapy.Org information on ADHD] *[https://ccf.fiu.edu/_assets/pdfs/how_to_establish_a_school_drc.pdf Establishing a School-Home Daily Report Card] *[https://ccf.fiu.edu/_assets/pdfs/what-parents-and-teachers-should-know-about-adhd-updated-1214.pdf What Parents and Teachers Should Know About ADHD (Fact Sheet)] *[https://ccf.fiu.edu/_assets/pdfs/psychosocial_fact_sheet-updated-1214.pdf Psychosocial Interventions for ADHD] *[https://ccf.fiu.edu/_assets/pdfs/adhd-medication-information-sheet-for-parents-and-teachers1.pdf ADHD Medication Information Sheet for Parents and Teachers] =='''References'''== {{collapse top|References|expand=yes}} {{Reflist|30em}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] {{collapse bottom}} {{subpage navbar}} 4oixsn96xhdsqdvsvwxtdfnonzdpfq1 2419244 2419207 2022-08-26T03:46:34Z Ardenguo 2944162 /* Screening and diagnostic instruments for attention deficit hyperactivity disorder */ Removed all "Note: L = Less than adequate; A = Adequate; G = Good; E = Excellent; U = Unavailable; NA = Not applicable" because the condensed-version portfolios don't include reliability/validity. // removed empty "adults" row wikitext text/x-wiki 3<noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{medical disclaimer}} {{:{{BASEPAGENAME}}/Sidebar}} ==[[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio"?''']]== For background information on what assessment portfolios are, click the link in the heading above. Want even 'more' information about this topic? There's an extended version of this page [[Evidence-based assessment/Attention deficit hyperactivity disorder (assessment portfolio)/extended version|here]]. ==[[Evidence based assessment/Preparation phase|'''Preparation phase''']]== === Diagnostic Criteria of ADHD in youth === {{blockquotetop}} <big>ICD-11 Diagnostic Criteria </big><br> <br> '''General Description:''' Attention deficit hyperactivity disorder is characterised by a persistent pattern (at least 6 months) of inattention and/or hyperactivity-impulsivity that has a direct negative impact on academic, occupational, or social functioning. There is evidence of significant inattention and/or hyperactivity-impulsivity symptoms prior to age 12, typically by early to mid-childhood, though some individuals may first come to clinical attention later. The degree of inattention and hyperactivity-impulsivity is outside the limits of normal variation expected for age and level of intellectual functioning. Inattention refers to significant difficulty in sustaining attention to tasks that do not provide a high level of stimulation or frequent rewards, distractibility and problems with organisation. Hyperactivity refers to excessive motor activity and difficulties with remaining still, most evident in structured situations that require behavioural self-control. Impulsivity is a tendency to act in response to immediate stimuli, without deliberation or consideration of the risks and consequences. The relative balance and the specific manifestations of inattentive and hyperactive-impulsive characteristics varies across individuals and may change over the course of development. In order for a diagnosis to be made, manifestations of inattention and/or hyperactivity-impulsivity must be evident across multiple situations or settings (e.g., home, school, work, with friends or relatives), but are likely to vary according to the structure and demands of the setting. <br> <br> '''Predominantly Inattentive Presentation:''' All definitional requirements for attention deficit hyperactivity disorder are met and inattentive symptoms are predominant in the clinical presentation. Inattention refers to significant difficulty in sustaining attention to tasks that do not provide a high level of stimulation or frequent rewards, distractibility and problems with organization. Some hyperactive-impulsive symptoms may also be present, but these are not clinically significant in relation to the inattentive symptoms. <br> <br> '''Predominantly Hyperactive-Impulsive:''' All definitional requirements for attention deficit hyperactivity disorder are met and hyperactive-impulsive symptoms are predominant in the clinical presentation. Hyperactivity refers to excessive motor activity and difficulties with remaining still, most evident in structured situations that require behavioural self-control. Impulsivity is a tendency to act in response to immediate stimuli, without deliberation or consideration of the risks and consequences. Some inattentive symptoms may also be present, but these are not clinically significant in relation to the hyperactive-impulsive symptoms. <br> <br> <big>Changes in DSM-5</big> <br> The diagnostic criteria for ADHD changed slightly from DSM-IV to DSM-5. See the changes [https://www.ncbi.nlm.nih.gov/books/NBK519712/table/ch3.t3/ here]. {{blockquotebottom}}<ref>{{Cite web|url=https://icd.who.int/browse11/l-m/en#/http://id.who.int/icd/entity/821852937|title=ICD-11 for Mortality and Morbidity Statistics|website=icd.who.int|access-date=2022-06-21}}</ref> ===Base rates of youth ADHD in different populations and clinical settings=== This section describes the demographic setting of the population(s) sampled, base rates of diagnosis, country/region sampled, and the diagnostic method that was used. Using this information, clinicians will be able to anchor the rates of adolescent depression that they are likely to see in their clinical practices. * '''''To find prevalence rates across multiple disorders,''''' [[Evidence based assessment/Preparation phase#Base rates for transdiagnostic comparison|click here.]] {| class="wikitable sortable" |- ! Demography ! Setting ! Base Rate(s) ! Diagnostic Method |- |Worldwide, Ages 3-18 |Meta-Analysis of worldwide prevalence of Child/Adolescent ADHD<ref>{{cite journal |last=Willcutt |first=Erik G. |date=July 2012 |title=The Prevalence of DSM-IV Attention-Deficit/Hyperactivity Disorder: A Meta-Analytic Review |journal=Neurotherapeutics |volume=9 |issue=3 |pages=490-99 |pmid=22976615 |pmc=3441936 |doi=10.1007/s13311-012-0135-8 }}</ref> |6.1% (parent rating)<br>7.1% (teacher rating)<br>10.5% (ages 3-5)<br>11.4% (ages 6-12)<br>8.0% (ages 13-18) |Multiple, but each focused on DSM-IV criteria |- |USA Nationally Representative, Ages 3-17 |Epidemiological [[w:National Health Interview Survey|NHIS]] (US CDC, 2011) |8.4% (Overall)<br>12.0% (Male)<br>4.7% (Female)<br>2.1% (ages 3-5)<br>8.4% (ages 6-11)<br>11.9% (ages 12-17)<br>10.3% (southern region of US) |Parent-report of whether child had ever been diagnosed |- |USA Nationally Representative, Ages 4-17 |Child and Adolescent Epidemiological National Survey of Children's Health (US CDC, 2007) |9.5% (overall)<br>12.3% (male)<br>5.3% (female)<br>1.5% (ages 3-5)<br>9.1% (ages 6-11)<br>12.4% (ages 12-17)<br>15.6% (North Carolina) |Parent-report of whether child had ever been diagnosed |- |USA Nationally Representative, Ages 5-14 |Teacher-Reported Prevalence of ADHD<ref>{{cite journal |last1=Fabiano |first1=Gregory A. |last2=Pelham |first2=William E., Jr. |last3=Majumdar |first3=Antara |last4=Evans |first4=Steven W. |last5=Manos |first5=Michael J. |last6=Caserta |first6=Donald |last7=Girio-Herrera |first7=Erin L. |last8=Pisecco |first8=Stewart |last9=Hannah |first9=Jane N. |last10=Carter |first10=Randy L. |date=April 2013 |title=Elementary and Middle School Teacher Perceptions of Attention-Deficit/Hyperactivity Disorder Prevalence |journal=Child & Youth Care Forum |volume=42 |issue=2 |pages=87-99 |doi=10.1007/s10566-013-9194-1 }}</ref> |5.25% (overall)<br>5.58% (elementary schoolers)<br>3.53% (middle schoolers)<br>7.1% (one county in rural NC) |Teacher report of number of children who have been identified with ADHD in their class |- |USA Nationally Representative, Ages 13-18 |Adolescent Epidemiological [[w:National Comorbidity Survey|National Comorbidity Survey-Adolescent Supplement]]<ref>{{cite journal |last1=Merikangas |first1=Kathleen Ries |last2=He |first2=Jian-Ping |last3=Burstein |first3=Marcy |last4=Swanson |first4=Sonja A. |last5=Avenevoli |first5=Shelli |last6=Cui |first6=Lihong |last7=Benjet |first7=Corina |last8=Georgiades |first8=Katholiki |last9=Swendsen |first9=Joel |date=October 2010 |title=Lifetime prevalence of mental disorders in U.S. adolescents: results from the National Comorbidity Survey Replication—Adolescent Supplement (NCS-A) |journal=Journal of the American Academy of Child and Adolescent Psychiatry |volume=49 |issue=10 |pages=980-9 |pmid=20855043 |pmc=2946114 |doi=10.1016/j.jaac.2010.05.017 }}</ref> |8.7% |CIDI 3.0 structured diagnostic interview |- |Ages 6-90 |Meta-Analysis of Clinical Samples<ref name="Rettew_et_al-2009">{{cite journal |last1=Rettew |first1=David C. |last2=Lynch |first2=Alicia Doyle |last3=Achenbach |first3=Thomas M. |last4=Dumenci |first4=Levent |last5=Ivanova |first5=Masha Y. |date=September 2009 |title=Meta-analyses of agreement between diagnoses made from clinical evaluations and standardized diagnostic interviews |journal=International Journal of Methods in Psychiatric Research |volume=18 |issue=3 |pages=169-84 |pmid=19701924 |doi=10.1002/mpr.289 }}</ref> |38% |Structured Diagnostic Interviews |- |Ages 6-90 |Meta-Analysis of Clinical Samples<ref name="Rettew_et_al-2009" /> |23% |Clinical Evaluations |- |Representative Sample of Johnston County School Children, North Carolina, Ages 6-12 |Johnston County, North Carolina Sample<ref>{{cite journal |last1=Rowland |first1=Andrew S. |last2=Skipper |first2=Betty J. |last3=Umbach |first3=David M. |last4=Rabiner |first4=David L. |last5=Campbell |first5=Richard A. |last6=Naftel |first6=Albert J. |last7=Sandler |first7=Dale P. |date=11 December 2013 |title=The Prevalence of ADHD in a Population-Based Sample |journal=Journal of Attention Disorders |volume=19 |issue=9 |pages=741-54 |pmid=24336124 |pmc=4058092 |doi=10.1177/1087054713513799 }}</ref> |15.5% |Combined parent and teacher report (NTRS and DISC) with DSM-IV criteria |- |Sample drawn from 11 counties in Western NC, Ages 9-16 |North Carolina Community Sample<ref>{{cite journal |last1=Costello |first1=E. Jane |last2=Mustillo |first2=Sarah |last3=Erkanli |first3=Alaattin |last4=Keeler |first4=Gordon |last5=Angold |first5=Adrian |date=August 2003 |title=Prevalence and development of psychiatric disorders in childhood and adolescence |journal=Archives of General Psychiatry |volume=60 |issue=8 |pages=837-44 |pmid=12912767 |doi=10.1001/archpsyc.60.8.837 |doi-access=free |url=http://jamanetwork.com/journals/jamapsychiatry/fullarticle/207725 }}</ref> |0.9% (3-month prevalence)<br>4.1% (estimated by age 16) |CAPA structured diagnostic interview |- |Sample recruited at Durham, NC, Seattle, Nashville, and Central Pennsylvania sites. Sample was followed longitudinally and identified as at high risk for externalizing disorders in kindergarten. 50% African American, Ages 12-15 |High-Risk Community Sample<ref>{{cite journal |last1=Jones |first1=Damon E. |last2=Foster |first2=E. Michael |date=October 2009 |title=Service Use Patterns for Adolescents with ADHD and Comorbid Conduct Disorder |journal=Journal of Behavioral Health Services & Research |volume=36 |issue=4 |pages=436-49 |pmid=18618263 |pmc=3534729 |doi=10.1007/s11414-008-9133-3 }}</ref> |14.3% |Diagnostic Interview Schedule for Children (DISC) |} ==[[Evidence based assessment/Prediction phase|'''Prediction phase''']]== === Psychometric properties of screening instruments for youth ADHD === The following section contains a list of screening and diagnostic instruments for ADHD. The section includes administration information, psychometric data, and PDFs or links to the screenings. * Screenings are used as part of the [[Evidence based assessment/Prediction phase|prediction phase]] of assessment; for more information on interpretation of this data, or how screenings fit in to the assessment process, [[Evidence based assessment/Prediction phase|'''click here''']]. * '''''For a list of more broadly-reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Common_screening_instruments click here.]''''' === Screening and diagnostic instruments for attention deficit hyperactivity disorder=== {| class="wikitable sortable" border="1" |- ! Measure ! Format (Reporter) ! Age Range ! Administration/<br>Completion Time !Where to Access |- | colspan="5" style="font-size:110%; text-align:center;" span |'''Youth''' |- |ADHD Rating Scale (ADHD-RS-V)<ref>DuPaul, G. J., Power, T. J., Anastopoulos, A. D., & Reid, R. (1998). ADHD Rating Scale–IV: Checklists, norms, and clinical interpretation. New York: Guilford Press</ref> |Teacher, Parent |5-10 y/o: Child Version 11-17 y/o: Adolescent Version |5 minutes for each scale | |- |Conners 3rd Edition<ref>{{Cite web|url=https://www.pearsonassessments.com/store/usassessments/en/Store/Professional-Assessments/Behavior/Comprehensive/Conners-3rd-Edition/p/100000523.html|title=Conners 3rd Edition|website=www.pearsonassessments.com|language=en|access-date=2022-06-30}}</ref> |Teacher, Parent |6-18 y/o: Administered to parents and teachers of children and adolescents age 8-18 y/o: Self-report |20 minutes: Long Version 10 minutes: Short Version <5 Minutes: Conners 3AI and Conners 3GI |[https://www.pearsonassessments.com/store/usassessments/en/Store/Professional-Assessments/Behavior/Comprehensive/Conners-3rd-Edition/p/100000523.html Not Free] |- |Vanderbilt ADHD Parent Rating Scale (VADPRS) |Teacher, Parent |6-12 y/o | |Free |- |Child Behavior Checklist (CBCL/6-18) |Parent |6-18 y/o |15-20 minutes |Free |- |Behavior Assessment Scale for Children (BASC-3) | | |10-20 minutes: (TRS and PRS) 30 minutes: (SRP) |Not Free |} === Likelihood ratios and AUCs of screening measures for '''ADHD''' === * '''''For a list of the likelihood ratios for more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Likelihood_ratios_and_AUCs_of_common_screening_instruments click here.]''''' {| class="wikitable sortable mw-collapsible" border="1" |- ! Screening Measure (Primary Reference) !data-sort-type="number"| {{abbr|AUC (sample size)|Area under curve}} !data-sort-type="number"| {{abbr|DiLR+ (score)|Positive likelihood ratio}} Score !data-sort-type="number"| {{abbr|DiLR- (score)|Negative likelihood ratio}} Score ! Clinical Generalizeability and Study Description ! class="unsortable"| Study description !Where to Access |- |- | colspan="7" style="font-size:110%; text-align:center;" span |'''Youth''' |- |rowspan="4"| [[w:Child Behavior Checklist|Child Behavior Checklist]] (CBCL) - Attention Problems {{var|T}}-Score<ref name=Achenbach-1991>{{cite book |last1=Achenbach |first1=Thomas M. |author1-link=w:Thomas M. Achenbach |title=Child behavior checklist for ages 4-18 |date=1991 |publisher=Department of Psychiatry, University of Vermont |location=Burlington, VT |isbn=978-0-938565-08-6 }}</ref> |rowspan="4"| .84 ({{var|N}}=187) | 6.92 (>55) | 0.19 (<55) |rowspan="4"| Somewhat High Utilized sample ages 6-18 recruited from local pediatricians, psychiatrists, and community advertisements. Included 95 children who met criteria for ADHD. 70 of these children also met criteria for ODD/CD.<ref name="Hudziak_et_al-2004" /> |rowspan="4"| Utilized sample ages 6-18 recruited from local pediatricians, psychiatrists, and community advertisements. Included 95 children who met criteria for ADHD. 70 of these children also met criteria for ODD/CD.<ref name=Hudziak_et_al-2004>{{cite journal |last1=Hudziak |first1=James J. |last2=Copeland |first2=William |last3=Stanger |first3=Catherine |last4=Wadsworth |first4=Martha |title=Screening for DSM-IV externalizing disorders with the Child Behavior Checklist: A receiver-operating characteristic analysis |journal=Journal of Child Psycholology and Psychiatry |date=October 2004 |volume=45 |issue=7 |pages=1299-307 |pmid=15335349 |doi=10.1111/j.1469-7610.2004.00314.x }}</ref> | rowspan="4" | |- | 12.2 (>60) | 0.41 (<60) |- | 47 (>65) | 0.53 (<65) |- | 34 (>70) | 0.66 (<70) |- |rowspan="2"| Child Behavior Checklist (CBCL) - Attention and Aggression Problems {{var|T}}-Score<ref name=Achenbach-1991/> |data-sort-value="0.86"| Boys: .86 ({{var|N}}=111) | {{nowrap|10.2 (>55)}} | {{nowrap|0.41 (<55)}} |rowspan="2"| Somewhat High Utilized sample ages 6-18 which consisted of 219 brothers and sisters of children who were referred to a hospital pediatric unit for ADHD or other symptoms. Half of these siblings had brothers and sisters who had ADHD, half did not.<ref name="Chen_et_al-1994" /> |rowspan="2"| Utilized sample ages 6-18 which consisted of 219 brothers and sisters of children who were referred to a hospital pediatric unit for ADHD or other symptoms. Half of these siblings had brothers and sisters who had ADHD, half did not.<ref name=Chen_et_al-1994>{{cite journal |last1=Chen |first1= Wei J. |last2=Faraone |first2=Stephen V. |author2-link=w:Stephen Faraone |last3=Biederman |first3=Joseph |author3-link=w:Joseph Biederman |last4=Tsuang |first4=Ming T. |title=Diagnostic accuracy of the Child Behavior Checklist scales for attention-deficit hyperactivity disorder: A receiver-operating characteristic analysis |journal=Journal of Consulting and Clinical Psychology |date=October 1994 |volume=62 |issue=5 |pages=1017-25 |pmid=7806710 |doi=10.1037/0022-006X.62.5.1017 }}</ref> | rowspan="2" | |- |data-sort-value="0.90"| Girls: 0.90 ({{var|N}}=108) |{{nowrap|11.2 (>55)}} |{{nowrap|0.35 (<55)}} |- | [[w:Achenbach System of Empirically Based Assessment|Teacher Response Form]] (TRF) - Attention Problems {{var|T}}-Score<ref name=Achenbach-1991/> | Not reported ({{var|N}}=184) | 3.66 (>70) | 0.73 (<70) | Somewhat High Utilized sample ages 5-12 years referred to a research clinic for assessment of ADHD. 108 children were ultimately diagnosed with ADHD, while 76 were not. LR's are calculated for discriminating between those two groups.<ref name="Tripp_et_al-2006" /> |rowspan="2"| Utilized sample ages 5-12 years referred to a research clinic for assessment of ADHD. 108 children were ultimately diagnosed with ADHD, while 76 were not. LR's are calculated for discriminating between those two groups.<ref name=Tripp_et_al-2006>{{cite journal |last1=Tripp |first1=Gail |last2=Schaughency |first2=Elizabeth A. |last3=Clarke |first3=Bronwyn |title=Parent and teacher rating scales in the evaluation of attention-deficit hyperactivity disorder: Contribution to diagnosis and differential diagnosis in clinically referred children |journal=Journal of Developmental and Behavioral Pediatrics |date=2006 |volume=27 |issue=3 |pages=209-18 |pmid=16775518 }}</ref> | |- | Teacher Response Form (TRF) - Attention and Aggression Problems {{var|T}}-Score<ref name=Achenbach-1991/> | Not reported ({{var|N}}=184) | 4.33 (>70) | 0.89 (<70) | Somewhat High Utilized sample ages 5-12 years referred to a research clinic for assessment of ADHD. 108 children were ultimately diagnosed with ADHD, while 76 were not. LR's are calculated for discriminating between those two groups.<ref name="Tripp_et_al-2006" /> | |- | [[w:Disruptive Behavior Disorders Rating Scale|Disruptive Behavior Disorder Rating Scale]] (DBDRS) - Parent Report (Pelham et. al, 1992) | 0.78 ({{var|N}}=232) | 5.06 (Endorsed ≥ 6 symptoms of inattention or hyperactivity) | 0.20 (<9) (Endorsed < 6 symptoms of inattention or hyperactivity) | Somewhat High Sample consisted of 232 ethnically diverse children ages 5-10 with (n = 121) and without (n=111) ADHD recruited through advertisements at school and through self-help groups.<ref name="Shemmassian_Lee-2012" /><ref name="Shemmassian_Lee-2016" /> |rowspan="2"| Sample consisted of 232 ethnically diverse children ages 5-10 with (n = 121) and without (n=111) ADHD recruited through advertisements at school and through self-help groups.<ref name="Shemmassian_Lee-2012">{{cite journal |last1=Shemmassian |first1=Shirag K. |last2=Lee |first2=Steve S. |date=March 2012 |title=Comparing Four Methods of Integrating Parent and Teacher Symptom Ratings of Attention-deficit/hyperactivity Disorder (ADHD) |journal=Journal of Psychopathology and Behavioral Assessment |volume=34 |issue=1 |pages=1-10 |doi=10.1007/s10862-011-9262-5 |url=https://www.researchgate.net/profile/Steve_Lee11/publication/230888173_Comparing_Four_Methods_of_Integrating_Parent_and_Teacher_Symptom_Ratings_of_Attention-deficithyperactivity_Disorder_ADHD/links/09e41505caa13a5913000000.pdf |format=PDF }}</ref><ref name="Shemmassian_Lee-2016">{{cite journal |last1=Shemmassian |first1=Shirag K. |last2=Lee |first2=Steve S. |title=Predictive Utility of Four Methods of Incorporating Parent and Teacher Symptom Ratings of ADHD for Longitudinal Outcomes |journal=Journal of Clinical Child and Adolescent Psychology |date=2016 |volume=45 |issue=2 |pages=176-87 |pmid=25643854 |doi=10.1080/15374416.2014.971457 }}</ref> | |- | Disruptive Behavior Disorder Rating Scale (DBDRS) - Teacher Report (Pelham et. al, 1992) | 0.63 ({{var|N}}=232) | 1.97 (Endorsed ≥ 6 symptoms of inattention or hyperactivity) | 0.24 (Endorsed < 6 symptoms of inattention or hyperactivity) | Somewhat High Sample consisted of 232 ethnically diverse children ages 5-10 with (n = 121) and without (n=111) ADHD recruited through advertisements at school and through self-help groups.<ref name="Shemmassian_Lee-2012" /><ref name="Shemmassian_Lee-2016" /> | |- | [[w:Vanderbilt ADHD diagnostic rating scale#Parent version|Vanderbilt ADHD Diagnostic Parent Rating Scale]] (VADPRS)<ref>{{cite journal |last1=Wolraich |first1=Mark L. |last2=Lambert |first2=Warren |last3=Doffing |first3=Melissa A. |last4=Bickman |first4=Leonard |last5=Simmons |first5=Tonya |last6=Worley |first6=Kim |date=December 2003 |title=Psychometric Properties of the Vanderbilt ADHD Diagnostic Parent Rating Scale in a Referred Population |journal=Journal of Pediatric Psychology |volume=28 |issue=8 |pages=559-68 |pmid=14602846 |doi=10.1093/jpepsy/jsg046 |url=https://academic.oup.com/jpepsy/article/28/8/559/1020465/Psychometric-Properties-of-the-Vanderbilt-ADHD }}</ref> | Not reported | 4.79 (Endorsed ≥ 6 symptoms of inattention or hyperactivity) | 0.38 (Endorsed < 6 symptoms of inattention or hyperactivity) | Moderate Sample consists of 582 children ages 5-15 recruited through schools in Oklahoma. Sample includes children screened as "high risk" for ADHD and "low risk" for ADHD.<ref name=":0" /> | Sample consists of 582 children ages 5-15 recruited through schools in Oklahoma. Sample includes children screened as "high risk" for ADHD and "low risk" for ADHD.<ref name=":0">{{cite journal |last1=Bard |first1=David E. |last2=Wolraich |first2=Mark L. |last3=Neas |first3=Barbara |last4=Doffing |first4=Melissa |last5=Beck |first5=Laoma |date=February 2013 |title=The psychometric properties of the Vanderbilt attention-deficit hyperactivity disorder diagnostic parent rating scale in a community population |journal=Journal of Developmental and Behavioral Pediatrics |volume=34 |issue=2 |pages=72-82 |pmid=23363972 |doi=10.1097/DBP.0b013e31827a3a22 }}</ref> | |- | [[w:Vanderbilt ADHD diagnostic rating scale#Teacher version|Vanderbilt ADHD Diagnostic Teacher Rating Scale]] (VADTRS)<ref>{{cite journal |last1=Wolraich |first1=ML |last2=Feurer |first2=ID |last3=Hannah |first3=JN |last4=Baumgaertel |first4=A |last5=Pinnock |first5=TY |date=April 1998 |title=Obtaining systematic teacher reports of disruptive behavior disorders utilizing DSM-IV |journal=Journal of Abnormal Child Psychology |volume=26 |issue=2 |pages=141-52 |pmid=9634136 }}</ref> | Not reported | 2.91 (Positive risk score) | 0.657 (Negative risk score) | Moderate | Sample consisted of 370 children ages 5-15 recruited though schools in Oklahoma. Sample was representative community sample.<ref>{{cite journal |last1=Wolraich |first1=Mark L. |last2=Bard |first2=David E. |last3=Neas |first3=Barbara |last4=Doffing |first4=Melissa |last5=Beck |first5=Laoma |title=The psychometric properties of the Vanderbilt attention-deficit hyperactivity disorder diagnostic teacher rating scale in a community population |journal=Journal of Developmental and Behavioral Pediatrics |date=February 2013 |volume=34 |issue=2 |pages=83-93 |pmid=23363973 |doi=10.1097/DBP.0b013e31827d55c3 }}</ref> | |- | Conners Rating Scale (Revised) - Long Form Parent Report (Conners, 1997) | Not reported | 15.33 (>93rd percentile) | 0.09 (<93rd percentile) | Moderate | Data come from normative sample of 2482 children ages 3 to 17 across the United States and Canada. Diagnostic likelihood ratios here discriminate ADHD from Non-Clinical.<ref name=Collett_et_al-2003>{{cite journal |last1=Collett |first1=Brent R. |last2=Ohan |first2=Jeneva L. |last3=Myers |first3=Kathleen M. |title=Ten-year review of rating scales. V: Scales assessing attention-deficit/hyperactivity disorder |journal=Journal of the American Academy of Child and Adolescent Psychiatry |date=September 2003 |volume=42 |issue=9 |pages=1015-37 |pmid=12960702 |doi=10.1097/01.CHI.0000070245.24125.B6 }}</ref> | |- | Conners Parent Rating Scale-48 (CPRS-48) Impulsive-Hyperactive Subscale {{var|T}}-Score (Conners, 1990) | Not reported | 1.26 (>70) | 0.79 (>70) | Somewhat High | rowspan="2"| Utilized sample ages 5-12 years referred to a research clinic for assessment of ADHD. 108 children were ultimately diagnosed with ADHD, while 76 were not. LR's are calculated for discriminating between those two groups.<ref name=Tripp_et_al-2006 /> | |- | Conners Teacher Rating Scale-39 Hyperactivity Subscale {{var|T}}-Score (Conners, 1990) | Not reported | 5.2 (>70) | 0.53 (<70) | Somewhat High | |- | Conners Teacher Rating Scale (Revised) - Long Form (Conners, 1997) | Not reported | 8.66 (>93rd percentile) | 0.24 (<93rd percentile) | Moderate | Data come from normative sample of 1973 children ages 5 to 17 across the United States and Canada. Likelihood ratios discriminate ADHD from non-clinical.<ref name=Collett_et_al-2003 /> | |- | ADHD Symptom Checklist-4 (ADHD-SC4) - Parent Report<ref name=Gadow_Sprafkin-1997>{{cite book |last1=Gadow |first1=Kenneth D. |last2=Sprafkin |first2=Joyce N. |date=1997 |title=ADHD Symptom Checklist-4 |publisher=Checkmate Plus |location=Stony Brook, NY |oclc=49637921 }}</ref> | Not reported | 1.45 (Endorsed ≥ 6 symptoms of inattention or hyperactivity) | 0.70 (Endorsed < 6 symptoms of inattention or hyperactivity) | Somewhat High | rowspan="2"| Data come from sample of 207 children ages 5-17 years old who were referred to psychiatric outpatient service with variety of emotional and behavioral disorders.<ref name=Sprafkin_Gadow-2007>{{cite journal |last1=Sprafkin |first1=Joyce |last2=Gadow |first2=Kenneth D. |title=Choosing an attention-deficit/hyperactivity disorder rating scale: is item randomization necessary? |journal=Journal of Child and Adolescent Psychopharmacology |date=February 2007 |volume=17 |issue=1 |pages=75-84 |pmid=17343555 |doi=10.1089/cap.2006.0035 }}</ref> | |- | ADHD Symptom Checklist-4 (ADHD-SC4) - Teacher Report<ref name=Gadow_Sprafkin-1997/> | Not reported | 1.53 (Endorsed ≥ 6 symptoms of inattention or hyperactivity) | 0.60 (Endorsed < 6 symptoms of inattention or hyperactivity) | Somewhat High | |- | [[w:ADHD rating scale|ADHD RS-IV]] - Home (DuPaul et. al, 1998b) | Not reported | 1.63 (>80th percentile) | 0.35 (<80th percentile) | Moderate | rowspan="2"| Sample of 2000 children ages 5 to 18 years old from geographically representative normative base.<ref name=Collett_et_al-2003 /> | |- | ADHD RS-IV - School (DuPaul et. al, 1998b) | Not reported | 4.5 (>80th percentile) | 0.42 (<80th percentile) | Moderate | |- | colspan="7" style="font-size:110%; text-align:center;" span |'''Adults''' |- |} '''Note:''' All studies with one exception used structured or semi-structured clinical interviews to establish diagnosis of ADHD. The exception, the Sprafkin & Gadow study (2007), used a combination of CBCL rating scales, clinician review, and clinician consensus to confirm ADHD diagnosis.<ref name=Sprafkin_Gadow-2007 /> “LR+” refers to the change in likelihood ratio associated with a positive test score, and “LR-” is the likelihood ratio for a low score. Likelihood ratios of 1 indicate that the test result did not change impressions at all. LRs larger than 10 or smaller than .10 are frequently clinically decisive; 5 or .20 are helpful, and between 2.0 and .5 are small enough that they rarely result in clinically meaningful changes of formulation (Sackett et al., 2000). === Interpreting ADHD screening measure scores === * For information on interpreting screening measure scores, click [[Evidence based assessment/Prediction phase#Interpreting screening measure scores|here.]] * Also see the page on [https://en.wikipedia.org/wiki/Likelihood_ratios_in_diagnostic_testing likelihood ratios in diagnostic testing] for more information ==[[Evidence based assessment/Prescription phase|'''Prescription phase''']]== ===Gold standard diagnostic interviews=== * For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews click here.] ===Recommended diagnostic interviews for ADHD=== ''****Depression instruments are placeholders'' {| class="wikitable sortable" border="1" ! colspan="5" |Diagnostic instruments for '''ADHD''' |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time !Where to Access |- | colspan="5" style="font-size:110%; text-align:center;" span |'''Youth''' |- | Barkley Functional Impairment Scale—Children and Adolescents (BFIS-CA) | Parent Report | 6-17 | 5-7 minutes |Link to [https://www.guilford.com/books/Barkley-Functional-Impairment-Scale-Children-Adolescents-BFIS-CA/Russell-Barkley/9781462503957 purchase] |- | Weiss Functional Impairment Rating Scale<ref>{{Cite journal|last=Thompson|first=Trevor|last2=Lloyd|first2=Andrew|last3=Joseph|first3=Alain|last4=Weiss|first4=Margaret|date=2017|title=The Weiss Functional Impairment Rating Scale-Parent Form for assessing ADHD: evaluating diagnostic accuracy and determining optimal thresholds using ROC analysis|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5486894/|journal=Quality of Life Research|volume=26|issue=7|pages=1879–1885|doi=10.1007/s11136-017-1514-8|issn=0962-9343|pmc=5486894|pmid=28220338}}</ref> | Parent/Caregiver Report | 5-19 | |[http://www.shared-care.ca/files/WFIRS-Parent_with_Instructions_May_2012.pdf PDF] |} ==[[Evidence based assessment/Process phase|'''Process phase''']]== The following section contains a brief overview of treatment options for ADHD and list of process and outcome measures for ADHD. The section includes benchmarks based on published norms for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the [[Evidence based assessment/Process phase|process phase]] of assessment. For more information of differences between process and outcome measures, see the page on the [[Evidence based assessment/Process phase|process phase of assessment]]. === Process measures === {{blockquotetop}} ; CBCL Attention Problems Subscale : Could be used on a weekly basis to track changes in ADHD symptomotology. T-scores from this measure could also be recorded on a weekly basis to determine if reliable and clinically significant changes in ADHD symptoms are occuring. The CBCL Attention Problems Subscale has repeatedly demonstrated good-to-excellent convergence with diagnostic interviews for diagnosing ADHD.<ref name=Pelham_et_al-2005>{{cite journal |last1=Pelham |first1=William E., Jr. |last2=Fabiano |first2=Gregory A. |last3=Massetti |first3=Greta M. |date=September 2005 |title=Evidence-based assessment of attention deficit hyperactivity disorder in children and adolescents |journal=Journal of Clinical Child and Adolescent Psychology |volume=34 |issue=3 |pages=449-76 |pmid=16026214 |doi=10.1207/s15374424jccp3403_5 |url=https://www.researchgate.net/profile/Greta_Massetti/publication/7719090_Evidence-Based_Assessment_of_Attention_Deficit_Hyperactivity_Disorder_in_Children_and_Adolescents/links/09e415107e6e01c28e000000.pdf |format=PDF }}</ref><ref>{{cite journal |last1=Lampert |first1=TL |last2=Polanczyk |first2=G |last3=Tramontina |first3=S |last4=Mardini |first4=V |last5=Rohde |first5=LA |date=October 2004 |title=Diagnostic performance of the CBCL-Attention Problem Scale as a screening measure in a sample of Brazilian children with ADHD |journal=Journal of Attention Disorders |volume=8 |issue=2 |pages=63-71 |pmid=15801336 }}</ref><ref name=Hudziak_et_al-2004/><ref name=Chen_et_al-1994/> '''The CBCL Attention Problems Subscale is a scale on the CBCL, which is readily available at the Finley Clinic.''' ; Daily Report Card : Several scholars have pointed out that it is equally important to track changes in the functional behaviors that a child with ADHD engages in, in addition to their ADHD symptoms, to capture the full range of adaptive changes that are made by children with ADHD throughout the course of treatment.<ref name=Pelham_et_al-2005/><ref>{{cite book |last1=Sowerby |first1=Paula |last2=Tripp |first2=Gail |date=2009 |chapter=Evidence-Based Assessment of Attention-Deficit/Hyperactivity Disorder (ADHD) |editor1-last=Matson |editor1-first=Johnny L. |editor2-last=Andrasik |editor2-first=Frank |editor3-last=Matson |editor3-first=Michael L. |title=Assessing Childhood Psychopathology and Developmental Disabilities |pages=209-239 |publisher=Springer Science & Business Media |location=New York |oclc=314175875 |doi=10.1007/978-0-387-09528-8 |isbn=978-0-387-09528-8 |chapter-url=https://books.google.com/books?id=TyJClvRUgY4C&pg=PA209 }}</ref> The daily report card is a mechanism by which such adaptive behavioral changes can be tracked. When implementing the daily report card, problematic child behaviors at home and at school are targeted for change. Rewards are offered to the child for reaching daily and weekly goals for reducing maladaptive behaviors and increasing adaptive behaviors. Parents and Teachers track child behaviors on a daily basis and provide feedback to one another and the child with behavior frequency counts and/or daily "grades" on how well the child behaved. Daily report cards are a mainstay of cognitive-behavioral and behavioral modification evidence-based intervention strategies for ADHD,<ref name=DuPaul_et_al-2012/><ref>{{cite journal |last1=Eiraldi |first1=Ricardo B. |last2=Mautone |first2=Jennifer A. |last3=Power |first3=Thomas J. |date=January 2012 |title=Strategies for implementing evidence-based psychosocial interventions for children with attention-deficit/hyperactivity disorder |journal=Child and Adolescent Psychiatric Clinics of North America |volume=21 |issue=1 |pages=145-59 |pmid=22137818 |pmc=3233687 |doi=10.1016/j.chc.2011.08.012 }}</ref> and they are highly recommended for tracking child treatment outcomes. '''Instructions for creating a daily report card are attached in Appendix 1.''' {{blockquotebottom}} === Outcome and severity measures === This table includes clinically significant benchmarks for ADHD specific outcome measures * Information on how to interpret this table can be [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase found here]. * Additionally, these [[Evidence based assessment/Vignettes|vignettes]] might be helpful resources for understanding appropriate adaptation of outcome measures in practice. * ''<u>For clinically significant change benchmarks for the CBCL, YSR, and TRF total, externalizing, internalizing, and attention benchmarks,</u>'' [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase&wteswitched=1#Clinically_significant_change_benchmarks_for_widely-used_outcome_measures see here.] {| class="wikitable" border="1" |+Clinically significant change benchmarks with common instruments and ADHD rating scales |- ! rowspan="2" scope="col" | Measure ! rowspan="2" scope="col" | Diagnostic category ! colspan="3" scope="colgroup" width="300" | Cut Scores* ! colspan="3" scope="colgroup" | Critical Change<br>(Unstandardized Scores) |- ! scope="col" | A ! scope="col" | B ! scope="col" | C ! scope="col" | 95% ! scope="col" | 90% ! scope="col" | SE_difference |- | colspan="8" style="text-align:center" |'''Benchmarks Based on Published Norms''' |- | rowspan="4" style="text-align:center;" |''{{abbr|CBCL|Child Behavior Checklist}} {{var|T}}-scores<br>(2001 Norms)'' | style="text-align:right" | Total | style="text-align:center;" | 49 | style="text-align:center;" | 70 | style="text-align:center;" | 58 | style="text-align:center;" | 5 | style="text-align:center;" | 4 | style="text-align:center;" | 2.4 |- | style="text-align:right" | Externalizing | style="text-align:center;" | 49 | style="text-align:center;" | 70 | style="text-align:center;" | 58 | style="text-align:center;" | 7 | style="text-align:center;" | 6 | style="text-align:center;" | 3.4 |- | style="text-align:right" | Internalizing | {{n/a}} | style="text-align:center;" | 70 | style="text-align:center;" | 56 | style="text-align:center;" | 9 | style="text-align:center;" | 7 | style="text-align:center;" | 4.5 |- | style="text-align:right" | Attention Problems | {{n/a}} | style="text-align:center;" | 66 | style="text-align:center;" | 58 | style="text-align:center;" | 8 | style="text-align:center;" | 7 | style="text-align:center;" | 4.2 |- | rowspan="4" style="text-align:center;" |''{{abbr|TRF|Teacher Response Form}} {{var|T}}-Scores<br>(2001 Norms)'' | style="text-align:right" | Total | {{n/a}} | style="text-align:center;" | 70 | style="text-align:center;" | 57 | style="text-align:center;" | 5 | style="text-align:center;" | 4 | style="text-align:center;" | 2.3 |- | style="text-align:right" | Externalizing | {{n/a}} | style="text-align:center;" | 70 | style="text-align:center;" | 56 | style="text-align:center;" | 6 | style="text-align:center;" | 5 | style="text-align:center;" | 3.0 |- | style="text-align:right" | Internalizing | {{n/a}} | style="text-align:center;" | 70 | style="text-align:center;" | 55 | style="text-align:center;" | 9 | style="text-align:center;" | 7 | style="text-align:center;" | 4.4 |- | style="text-align:right" | Attention Problems | {{n/a}} | style="text-align:center;" | 66 | style="text-align:center;" | 57 | style="text-align:center;" | 5 | style="text-align:center;" | 4 | style="text-align:center;" | 2.3 |- | rowspan="2" style="text-align:center" |''Conners 3-Teacher Rating Scale {{var|T}}-Scores'' | style="text-align:right" | ADHD Inattentive | style="text-align:center;" | 36 | style="text-align:center;" | 74 | style="text-align:center;" | 57 | style="text-align:center;" | 11 | style="text-align:center;" | 10 | style="text-align:center;" | 5.6 |- | style="text-align:right" | ADHD Hyperactive-Impulsive | style="text-align:center;" | 36 | style="text-align:center;" | 74 | style="text-align:center;" | 57 | style="text-align:center;" | 11 | style="text-align:center;" | 9 | style="text-align:center;" | 5.5 |- | rowspan="2" style="text-align:center" |''Conners 3-Parent Rating Scale {{var|T}}-Scores'' | style="text-align:right" | ADHD Inattentive | style="text-align:center;" | 37 | style="text-align:center;" | 72 | style="text-align:center;" | 58 | style="text-align:center;" | 10 | style="text-align:center;" | 10 | style="text-align:center;" | 5.6 |- | style="text-align:right" | ADHD Hyperactive-Impulsive | style="text-align:center;" | 37 | style="text-align:center;" | 72 | style="text-align:center;" | 58 | style="text-align:center;" | 10 | style="text-align:center;" | 8 | style="text-align:center;" | 4.7 |- | colspan="8" style="text-align:center" |'''Benchmarks Based on ADHD Samples'''<ref name="Shemmassian_Lee-2012" /> |- | colspan="2" |''Disruptive Behavior Disorders Rating Scale'' | style="text-align:center;" | 1.4 | style="text-align:center;" | 8.6 | style="text-align:center;" | 5.7 | style="text-align:center;" | 12 | style="text-align:center;" | 10 | style="text-align:center;" | 0.9 |} '''Note:''' “A” = Away from the clinical range, “B” = Back into the nonclinical range, “C” = Closer to the nonclinical than clinical mean. <ref>{{Cite web|url=https://en.wikiversity.org/wiki/Evidence-based_assessment/Reliability#Evaluating_norms_and_reliability|title=Evidence-based assessment/Reliability - Wikiversity|website=en.wikiversity.org|access-date=2020-11-13}}</ref> '''Search terms:''' [ADHD or CONNERS or DBD] AND [clinical significance OR group means] in PsycINFO === Treatment === * Please refer to the Wikipedia page on [[wikipedia:Attention_deficit_hyperactivity_disorder|Attention Deficit Hyperactivity Disorder]] for more information on available treatment for ADHD or go to [https://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/inattention-and-hyperactivity-adhd/ Effective Child Therapy] for a curated resource on effective treatments for ADHD. {{collapse top| ADHD Treatment Information|expand=yes}} === Executive summary === 1. If intervening with children ages 4-5, behavior therapy should be the first line of treatment. 2. If intervening with children ages 6-11, behavior therapy should be the first line of treatment, in conjunction with medication. 3. If intervening with children ages 12-18, medication should probably be the first line of treatment, though behavior therapy could be used in combination. 4. Three types of therapeutic interventions have well established evidence-bases: :a. Behavioral Parent Training Interventions :b. Behavioral Classroom Management Interventions :c. Behavioral Peer interventions involving recreational peer groups (e.g. summer camps) 5. If considering a classroom management intervention: :a. Academic and Cognitive-Behavioral Interventions are most effective in changing academic outcomes :b. Cognitive Behavioral and Contingency Management Interventions are most effective in changing behavioral outcomes === Clinical practice guidelines === Published by the American Academy of Pediatrics in 2011.<ref name="AAP_Guideline-2011">{{cite journal |author1=Subcommittee on Attention-Deficit/Hyperactivity Disorder |author2=Steering Committee on Quality Improvement and Management |last3=Wolraich |first3=Mark |last4=Brown |first4=Lawrence |last5=Brown |first5=Ronald T. |last6=DuPaul |first6=George |last7=Earls |first7=Marian |last8=Feldman |first8=Heidi M. |last9=Ganiats |first9=Theodore G. |last10=Kaplanek |first10=Beth |last11=Meyer |first11=Bruce |last12=Perrin |first12=James |last13=Pierce |first13=Karen |last14=Reiff |first14=Michael |last15=Stein |first15=Martin T. |last16=Visser |first16=Susanna |date=November 2011 |title=ADHD: Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents |journal=Pediatrics |volume=128 |issue=5 |pages=1007-22 |pmid=22003063 |pmc=4500647 |doi=10.1542/peds.2011-2654 }}</ref> ; Preschool-aged children (ages 4–5) : Primary care clinicians should prescribe evidence-based parent and/or teacher-administered behavior therapy as the first line of treatment, and may prescribe methylphenidate if behavioral interventions are not effective. ; Elementary-aged children (ages 6–11) : Primary care clinicians should prescribe FDA-approved medications for ADHD and/or evidence based parent and teacher administered behavior therapy. Preferably, both medication and behavior therapy will be prescribed. ; Adolescents (ages 12–18) : Primary care clinicians should prescribe FDA approved medications for ADHD with the assent of the adolescent and may prescribe behavior therapy as a treatment for ADHD, preferably both. === Behavioral therapies === These meet the American Academy of Pediatrics and American Psychological Association Task Force criteria for well-established evidence-based treatments. Descriptions and effect sizes are taken from the American Academy of Pediatrics' guidelines<ref name="AAP_Guideline-2011" /> and Pelham & Fabiano's review article.<ref>{{cite journal |last1=Pelham |first1=William E., Jr. |last2=Fabiano |first2=Gregory A. |date=January 2008 |title=Evidence-based psychosocial treatments for attention-deficit/hyperactivity disorder |journal=Journal of Clinical Child and Adolescent Psychology |volume=37 |issue=1 |pages=184-214 |doi=10.1080/15374410701818681 |pmid=18444058 |lay-url=https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0026847/ |lay-source=Database of Abstracts of Reviews of Effects: Quality-assessed Reviews |lay-date=12 February 2009 }}</ref> ; Behavioral Parent Training : Behavior modification principles provided to parents for implementation in home settings. Typical outcomes include improved compliance with parental commands, improved parental understanding of behavioral principles, high levels of parental satisfaction with treatment. :'''Median effect size:''' 0.55 ; Behavioral Classroom Management : Behavior-modification principles provided to teachers for implementation in classroom settings. Typical outcomes include improved attention to instruction, improved compliance with classroom rules, decreased disruptive behavior, improved work productivity, and improved academic achievement. :'''Median effect size:''' 0.61 ; Behavioral Peer Interventions : Interventions focused on peer interactions/relationships. These could include group-based interventions provided weekly and include clinic-based social skills training used either alone or concurrently with behavioral parent training and/or medication. Typical outcomes are more mixed with these interventions. Some clinical-office based interventions have produced minimal effects, while some studies of behavioral peer intervention coupled with behavioral parent training found positive effects on parental ratings of ADHD symptoms. No studies of this type of intervention reveal differences on social functioning or parental ratings of social behavior. Behavioral Peer Interventions implemented in peer group/recreational settings (e.g. summer camps) have the most evidence of being effective. :'''Median effect size:''' None reported, effect sizes found are considered moderate. === School based interventions === {| class="wikitable" align="right" |+Single Subject Design Effect Sizes |- ! rowspan="2" scope="col" | Intervention type ! colspan="2" scope="colgroup" | Effect size |- ! scope="col" | Academic<br>outcomes ! scope="col" | Behavioral<br>outcomes |- | {{rh}} class="table-rh" |Academic | style="text-align:right" | 4.73 | style="text-align:right" | 1.53 |- | {{rh}} class="table-rh" |Cognitive behavioral | style="text-align:right" | 3.77 | style="text-align:right" | 3.31 |- | {{rh}} class="table-rh" |Contingency management | style="text-align:right" | 2.29 | style="text-align:right" | 2.40 |- | {{rh}} class="table-rh" |Combined | style="text-align:right" | 2.29 | style="text-align:right" | 1.31 |} Findings from a review by DuPaul and colleagues.<ref name="DuPaul_et_al-2012">{{cite journal |last1=DuPaul |first1=George J. |last2=Eckert |first2=Tanya L. |last3=Vilardo |first3=Brigid |date=December 2012 |title=The effects of school-based interventions for attention deficit hyperactivity disorder: A meta-analysis 1996-2010 |journal=School Psychology Review |volume=41 |issue=4 |pages=387-412 |issn=0279-6015 |id=ERIC [https://eric.ed.gov/?id=EJ1001907 EJ1001907] }}</ref> ; Associated with greater effects on academic outcomes :''Academic'' — interventions focus primarily on manipulating antecedent conditions via things like peer tutoring, computer-aided instruction, and organizational skills. :''Combined'' academic and contingency management interventions. ; Associated with greater effects for behavior outcomes :''Contingency management'' — interventions use reinforcement and punishment. :''Cognitive behavioral'' — interventions focus on development of self-control skills and reflective problem-solving strategies. {{clear}} {{collapse bottom}} == '''External Links''' == *[https://sccap53.org Society of Clinical Child and Adolescent Psychology] *[http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/inattention-and-hyperactivity-adhd/ EffectiveChildTherapy.Org information on ADHD] *[https://ccf.fiu.edu/_assets/pdfs/how_to_establish_a_school_drc.pdf Establishing a School-Home Daily Report Card] *[https://ccf.fiu.edu/_assets/pdfs/what-parents-and-teachers-should-know-about-adhd-updated-1214.pdf What Parents and Teachers Should Know About ADHD (Fact Sheet)] *[https://ccf.fiu.edu/_assets/pdfs/psychosocial_fact_sheet-updated-1214.pdf Psychosocial Interventions for ADHD] *[https://ccf.fiu.edu/_assets/pdfs/adhd-medication-information-sheet-for-parents-and-teachers1.pdf ADHD Medication Information Sheet for Parents and Teachers] =='''References'''== {{collapse top|References|expand=yes}} {{Reflist|30em}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] {{collapse bottom}} {{subpage navbar}} gbhdvxzy20b8yc5snlp3mdcvncz8sro 2419296 2419244 2022-08-26T05:22:05Z Ardenguo 2944162 /* Screening and diagnostic instruments for attention deficit hyperactivity disorder */ added Note: Reliability and validity are included in the extended version. This table includes measures with Good or Excellent ratings. wikitext text/x-wiki 3<noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{medical disclaimer}} {{:{{BASEPAGENAME}}/Sidebar}} ==[[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio"?''']]== For background information on what assessment portfolios are, click the link in the heading above. Want even 'more' information about this topic? There's an extended version of this page [[Evidence-based assessment/Attention deficit hyperactivity disorder (assessment portfolio)/extended version|here]]. ==[[Evidence based assessment/Preparation phase|'''Preparation phase''']]== === Diagnostic Criteria of ADHD in youth === {{blockquotetop}} <big>ICD-11 Diagnostic Criteria </big><br> <br> '''General Description:''' Attention deficit hyperactivity disorder is characterised by a persistent pattern (at least 6 months) of inattention and/or hyperactivity-impulsivity that has a direct negative impact on academic, occupational, or social functioning. There is evidence of significant inattention and/or hyperactivity-impulsivity symptoms prior to age 12, typically by early to mid-childhood, though some individuals may first come to clinical attention later. The degree of inattention and hyperactivity-impulsivity is outside the limits of normal variation expected for age and level of intellectual functioning. Inattention refers to significant difficulty in sustaining attention to tasks that do not provide a high level of stimulation or frequent rewards, distractibility and problems with organisation. Hyperactivity refers to excessive motor activity and difficulties with remaining still, most evident in structured situations that require behavioural self-control. Impulsivity is a tendency to act in response to immediate stimuli, without deliberation or consideration of the risks and consequences. The relative balance and the specific manifestations of inattentive and hyperactive-impulsive characteristics varies across individuals and may change over the course of development. In order for a diagnosis to be made, manifestations of inattention and/or hyperactivity-impulsivity must be evident across multiple situations or settings (e.g., home, school, work, with friends or relatives), but are likely to vary according to the structure and demands of the setting. <br> <br> '''Predominantly Inattentive Presentation:''' All definitional requirements for attention deficit hyperactivity disorder are met and inattentive symptoms are predominant in the clinical presentation. Inattention refers to significant difficulty in sustaining attention to tasks that do not provide a high level of stimulation or frequent rewards, distractibility and problems with organization. Some hyperactive-impulsive symptoms may also be present, but these are not clinically significant in relation to the inattentive symptoms. <br> <br> '''Predominantly Hyperactive-Impulsive:''' All definitional requirements for attention deficit hyperactivity disorder are met and hyperactive-impulsive symptoms are predominant in the clinical presentation. Hyperactivity refers to excessive motor activity and difficulties with remaining still, most evident in structured situations that require behavioural self-control. Impulsivity is a tendency to act in response to immediate stimuli, without deliberation or consideration of the risks and consequences. Some inattentive symptoms may also be present, but these are not clinically significant in relation to the hyperactive-impulsive symptoms. <br> <br> <big>Changes in DSM-5</big> <br> The diagnostic criteria for ADHD changed slightly from DSM-IV to DSM-5. See the changes [https://www.ncbi.nlm.nih.gov/books/NBK519712/table/ch3.t3/ here]. {{blockquotebottom}}<ref>{{Cite web|url=https://icd.who.int/browse11/l-m/en#/http://id.who.int/icd/entity/821852937|title=ICD-11 for Mortality and Morbidity Statistics|website=icd.who.int|access-date=2022-06-21}}</ref> ===Base rates of youth ADHD in different populations and clinical settings=== This section describes the demographic setting of the population(s) sampled, base rates of diagnosis, country/region sampled, and the diagnostic method that was used. Using this information, clinicians will be able to anchor the rates of adolescent depression that they are likely to see in their clinical practices. * '''''To find prevalence rates across multiple disorders,''''' [[Evidence based assessment/Preparation phase#Base rates for transdiagnostic comparison|click here.]] {| class="wikitable sortable" |- ! Demography ! Setting ! Base Rate(s) ! Diagnostic Method |- |Worldwide, Ages 3-18 |Meta-Analysis of worldwide prevalence of Child/Adolescent ADHD<ref>{{cite journal |last=Willcutt |first=Erik G. |date=July 2012 |title=The Prevalence of DSM-IV Attention-Deficit/Hyperactivity Disorder: A Meta-Analytic Review |journal=Neurotherapeutics |volume=9 |issue=3 |pages=490-99 |pmid=22976615 |pmc=3441936 |doi=10.1007/s13311-012-0135-8 }}</ref> |6.1% (parent rating)<br>7.1% (teacher rating)<br>10.5% (ages 3-5)<br>11.4% (ages 6-12)<br>8.0% (ages 13-18) |Multiple, but each focused on DSM-IV criteria |- |USA Nationally Representative, Ages 3-17 |Epidemiological [[w:National Health Interview Survey|NHIS]] (US CDC, 2011) |8.4% (Overall)<br>12.0% (Male)<br>4.7% (Female)<br>2.1% (ages 3-5)<br>8.4% (ages 6-11)<br>11.9% (ages 12-17)<br>10.3% (southern region of US) |Parent-report of whether child had ever been diagnosed |- |USA Nationally Representative, Ages 4-17 |Child and Adolescent Epidemiological National Survey of Children's Health (US CDC, 2007) |9.5% (overall)<br>12.3% (male)<br>5.3% (female)<br>1.5% (ages 3-5)<br>9.1% (ages 6-11)<br>12.4% (ages 12-17)<br>15.6% (North Carolina) |Parent-report of whether child had ever been diagnosed |- |USA Nationally Representative, Ages 5-14 |Teacher-Reported Prevalence of ADHD<ref>{{cite journal |last1=Fabiano |first1=Gregory A. |last2=Pelham |first2=William E., Jr. |last3=Majumdar |first3=Antara |last4=Evans |first4=Steven W. |last5=Manos |first5=Michael J. |last6=Caserta |first6=Donald |last7=Girio-Herrera |first7=Erin L. |last8=Pisecco |first8=Stewart |last9=Hannah |first9=Jane N. |last10=Carter |first10=Randy L. |date=April 2013 |title=Elementary and Middle School Teacher Perceptions of Attention-Deficit/Hyperactivity Disorder Prevalence |journal=Child & Youth Care Forum |volume=42 |issue=2 |pages=87-99 |doi=10.1007/s10566-013-9194-1 }}</ref> |5.25% (overall)<br>5.58% (elementary schoolers)<br>3.53% (middle schoolers)<br>7.1% (one county in rural NC) |Teacher report of number of children who have been identified with ADHD in their class |- |USA Nationally Representative, Ages 13-18 |Adolescent Epidemiological [[w:National Comorbidity Survey|National Comorbidity Survey-Adolescent Supplement]]<ref>{{cite journal |last1=Merikangas |first1=Kathleen Ries |last2=He |first2=Jian-Ping |last3=Burstein |first3=Marcy |last4=Swanson |first4=Sonja A. |last5=Avenevoli |first5=Shelli |last6=Cui |first6=Lihong |last7=Benjet |first7=Corina |last8=Georgiades |first8=Katholiki |last9=Swendsen |first9=Joel |date=October 2010 |title=Lifetime prevalence of mental disorders in U.S. adolescents: results from the National Comorbidity Survey Replication—Adolescent Supplement (NCS-A) |journal=Journal of the American Academy of Child and Adolescent Psychiatry |volume=49 |issue=10 |pages=980-9 |pmid=20855043 |pmc=2946114 |doi=10.1016/j.jaac.2010.05.017 }}</ref> |8.7% |CIDI 3.0 structured diagnostic interview |- |Ages 6-90 |Meta-Analysis of Clinical Samples<ref name="Rettew_et_al-2009">{{cite journal |last1=Rettew |first1=David C. |last2=Lynch |first2=Alicia Doyle |last3=Achenbach |first3=Thomas M. |last4=Dumenci |first4=Levent |last5=Ivanova |first5=Masha Y. |date=September 2009 |title=Meta-analyses of agreement between diagnoses made from clinical evaluations and standardized diagnostic interviews |journal=International Journal of Methods in Psychiatric Research |volume=18 |issue=3 |pages=169-84 |pmid=19701924 |doi=10.1002/mpr.289 }}</ref> |38% |Structured Diagnostic Interviews |- |Ages 6-90 |Meta-Analysis of Clinical Samples<ref name="Rettew_et_al-2009" /> |23% |Clinical Evaluations |- |Representative Sample of Johnston County School Children, North Carolina, Ages 6-12 |Johnston County, North Carolina Sample<ref>{{cite journal |last1=Rowland |first1=Andrew S. |last2=Skipper |first2=Betty J. |last3=Umbach |first3=David M. |last4=Rabiner |first4=David L. |last5=Campbell |first5=Richard A. |last6=Naftel |first6=Albert J. |last7=Sandler |first7=Dale P. |date=11 December 2013 |title=The Prevalence of ADHD in a Population-Based Sample |journal=Journal of Attention Disorders |volume=19 |issue=9 |pages=741-54 |pmid=24336124 |pmc=4058092 |doi=10.1177/1087054713513799 }}</ref> |15.5% |Combined parent and teacher report (NTRS and DISC) with DSM-IV criteria |- |Sample drawn from 11 counties in Western NC, Ages 9-16 |North Carolina Community Sample<ref>{{cite journal |last1=Costello |first1=E. Jane |last2=Mustillo |first2=Sarah |last3=Erkanli |first3=Alaattin |last4=Keeler |first4=Gordon |last5=Angold |first5=Adrian |date=August 2003 |title=Prevalence and development of psychiatric disorders in childhood and adolescence |journal=Archives of General Psychiatry |volume=60 |issue=8 |pages=837-44 |pmid=12912767 |doi=10.1001/archpsyc.60.8.837 |doi-access=free |url=http://jamanetwork.com/journals/jamapsychiatry/fullarticle/207725 }}</ref> |0.9% (3-month prevalence)<br>4.1% (estimated by age 16) |CAPA structured diagnostic interview |- |Sample recruited at Durham, NC, Seattle, Nashville, and Central Pennsylvania sites. Sample was followed longitudinally and identified as at high risk for externalizing disorders in kindergarten. 50% African American, Ages 12-15 |High-Risk Community Sample<ref>{{cite journal |last1=Jones |first1=Damon E. |last2=Foster |first2=E. Michael |date=October 2009 |title=Service Use Patterns for Adolescents with ADHD and Comorbid Conduct Disorder |journal=Journal of Behavioral Health Services & Research |volume=36 |issue=4 |pages=436-49 |pmid=18618263 |pmc=3534729 |doi=10.1007/s11414-008-9133-3 }}</ref> |14.3% |Diagnostic Interview Schedule for Children (DISC) |} ==[[Evidence based assessment/Prediction phase|'''Prediction phase''']]== === Psychometric properties of screening instruments for youth ADHD === The following section contains a list of screening and diagnostic instruments for ADHD. The section includes administration information, psychometric data, and PDFs or links to the screenings. * Screenings are used as part of the [[Evidence based assessment/Prediction phase|prediction phase]] of assessment; for more information on interpretation of this data, or how screenings fit in to the assessment process, [[Evidence based assessment/Prediction phase|'''click here''']]. * '''''For a list of more broadly-reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Common_screening_instruments click here.]''''' === Screening and diagnostic instruments for attention deficit hyperactivity disorder=== {| class="wikitable sortable" border="1" |- ! Measure ! Format (Reporter) ! Age Range ! Administration/<br>Completion Time !Where to Access |- | colspan="5" style="font-size:110%; text-align:center;" span |'''Youth''' |- |ADHD Rating Scale (ADHD-RS-V)<ref>DuPaul, G. J., Power, T. J., Anastopoulos, A. D., & Reid, R. (1998). ADHD Rating Scale–IV: Checklists, norms, and clinical interpretation. New York: Guilford Press</ref> |Teacher, Parent |5-10 y/o: Child Version 11-17 y/o: Adolescent Version |5 minutes for each scale | |- |Conners 3rd Edition<ref>{{Cite web|url=https://www.pearsonassessments.com/store/usassessments/en/Store/Professional-Assessments/Behavior/Comprehensive/Conners-3rd-Edition/p/100000523.html|title=Conners 3rd Edition|website=www.pearsonassessments.com|language=en|access-date=2022-06-30}}</ref> |Teacher, Parent |6-18 y/o: Administered to parents and teachers of children and adolescents age 8-18 y/o: Self-report |20 minutes: Long Version 10 minutes: Short Version <5 Minutes: Conners 3AI and Conners 3GI |[https://www.pearsonassessments.com/store/usassessments/en/Store/Professional-Assessments/Behavior/Comprehensive/Conners-3rd-Edition/p/100000523.html Not Free] |- |Vanderbilt ADHD Parent Rating Scale (VADPRS) |Teacher, Parent |6-12 y/o | |Free |- |Child Behavior Checklist (CBCL/6-18) |Parent |6-18 y/o |15-20 minutes |Free |- |Behavior Assessment Scale for Children (BASC-3) | | |10-20 minutes: (TRS and PRS) 30 minutes: (SRP) |Not Free |} '''Note:''' Reliability and validity are included in the extended version. This table includes measures with Good or Excellent ratings. === Likelihood ratios and AUCs of screening measures for '''ADHD''' === * '''''For a list of the likelihood ratios for more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Likelihood_ratios_and_AUCs_of_common_screening_instruments click here.]''''' {| class="wikitable sortable mw-collapsible" border="1" |- ! Screening Measure (Primary Reference) !data-sort-type="number"| {{abbr|AUC (sample size)|Area under curve}} !data-sort-type="number"| {{abbr|DiLR+ (score)|Positive likelihood ratio}} Score !data-sort-type="number"| {{abbr|DiLR- (score)|Negative likelihood ratio}} Score ! Clinical Generalizeability and Study Description ! class="unsortable"| Study description !Where to Access |- |- | colspan="7" style="font-size:110%; text-align:center;" span |'''Youth''' |- |rowspan="4"| [[w:Child Behavior Checklist|Child Behavior Checklist]] (CBCL) - Attention Problems {{var|T}}-Score<ref name=Achenbach-1991>{{cite book |last1=Achenbach |first1=Thomas M. |author1-link=w:Thomas M. Achenbach |title=Child behavior checklist for ages 4-18 |date=1991 |publisher=Department of Psychiatry, University of Vermont |location=Burlington, VT |isbn=978-0-938565-08-6 }}</ref> |rowspan="4"| .84 ({{var|N}}=187) | 6.92 (>55) | 0.19 (<55) |rowspan="4"| Somewhat High Utilized sample ages 6-18 recruited from local pediatricians, psychiatrists, and community advertisements. Included 95 children who met criteria for ADHD. 70 of these children also met criteria for ODD/CD.<ref name="Hudziak_et_al-2004" /> |rowspan="4"| Utilized sample ages 6-18 recruited from local pediatricians, psychiatrists, and community advertisements. Included 95 children who met criteria for ADHD. 70 of these children also met criteria for ODD/CD.<ref name=Hudziak_et_al-2004>{{cite journal |last1=Hudziak |first1=James J. |last2=Copeland |first2=William |last3=Stanger |first3=Catherine |last4=Wadsworth |first4=Martha |title=Screening for DSM-IV externalizing disorders with the Child Behavior Checklist: A receiver-operating characteristic analysis |journal=Journal of Child Psycholology and Psychiatry |date=October 2004 |volume=45 |issue=7 |pages=1299-307 |pmid=15335349 |doi=10.1111/j.1469-7610.2004.00314.x }}</ref> | rowspan="4" | |- | 12.2 (>60) | 0.41 (<60) |- | 47 (>65) | 0.53 (<65) |- | 34 (>70) | 0.66 (<70) |- |rowspan="2"| Child Behavior Checklist (CBCL) - Attention and Aggression Problems {{var|T}}-Score<ref name=Achenbach-1991/> |data-sort-value="0.86"| Boys: .86 ({{var|N}}=111) | {{nowrap|10.2 (>55)}} | {{nowrap|0.41 (<55)}} |rowspan="2"| Somewhat High Utilized sample ages 6-18 which consisted of 219 brothers and sisters of children who were referred to a hospital pediatric unit for ADHD or other symptoms. Half of these siblings had brothers and sisters who had ADHD, half did not.<ref name="Chen_et_al-1994" /> |rowspan="2"| Utilized sample ages 6-18 which consisted of 219 brothers and sisters of children who were referred to a hospital pediatric unit for ADHD or other symptoms. Half of these siblings had brothers and sisters who had ADHD, half did not.<ref name=Chen_et_al-1994>{{cite journal |last1=Chen |first1= Wei J. |last2=Faraone |first2=Stephen V. |author2-link=w:Stephen Faraone |last3=Biederman |first3=Joseph |author3-link=w:Joseph Biederman |last4=Tsuang |first4=Ming T. |title=Diagnostic accuracy of the Child Behavior Checklist scales for attention-deficit hyperactivity disorder: A receiver-operating characteristic analysis |journal=Journal of Consulting and Clinical Psychology |date=October 1994 |volume=62 |issue=5 |pages=1017-25 |pmid=7806710 |doi=10.1037/0022-006X.62.5.1017 }}</ref> | rowspan="2" | |- |data-sort-value="0.90"| Girls: 0.90 ({{var|N}}=108) |{{nowrap|11.2 (>55)}} |{{nowrap|0.35 (<55)}} |- | [[w:Achenbach System of Empirically Based Assessment|Teacher Response Form]] (TRF) - Attention Problems {{var|T}}-Score<ref name=Achenbach-1991/> | Not reported ({{var|N}}=184) | 3.66 (>70) | 0.73 (<70) | Somewhat High Utilized sample ages 5-12 years referred to a research clinic for assessment of ADHD. 108 children were ultimately diagnosed with ADHD, while 76 were not. LR's are calculated for discriminating between those two groups.<ref name="Tripp_et_al-2006" /> |rowspan="2"| Utilized sample ages 5-12 years referred to a research clinic for assessment of ADHD. 108 children were ultimately diagnosed with ADHD, while 76 were not. LR's are calculated for discriminating between those two groups.<ref name=Tripp_et_al-2006>{{cite journal |last1=Tripp |first1=Gail |last2=Schaughency |first2=Elizabeth A. |last3=Clarke |first3=Bronwyn |title=Parent and teacher rating scales in the evaluation of attention-deficit hyperactivity disorder: Contribution to diagnosis and differential diagnosis in clinically referred children |journal=Journal of Developmental and Behavioral Pediatrics |date=2006 |volume=27 |issue=3 |pages=209-18 |pmid=16775518 }}</ref> | |- | Teacher Response Form (TRF) - Attention and Aggression Problems {{var|T}}-Score<ref name=Achenbach-1991/> | Not reported ({{var|N}}=184) | 4.33 (>70) | 0.89 (<70) | Somewhat High Utilized sample ages 5-12 years referred to a research clinic for assessment of ADHD. 108 children were ultimately diagnosed with ADHD, while 76 were not. LR's are calculated for discriminating between those two groups.<ref name="Tripp_et_al-2006" /> | |- | [[w:Disruptive Behavior Disorders Rating Scale|Disruptive Behavior Disorder Rating Scale]] (DBDRS) - Parent Report (Pelham et. al, 1992) | 0.78 ({{var|N}}=232) | 5.06 (Endorsed ≥ 6 symptoms of inattention or hyperactivity) | 0.20 (<9) (Endorsed < 6 symptoms of inattention or hyperactivity) | Somewhat High Sample consisted of 232 ethnically diverse children ages 5-10 with (n = 121) and without (n=111) ADHD recruited through advertisements at school and through self-help groups.<ref name="Shemmassian_Lee-2012" /><ref name="Shemmassian_Lee-2016" /> |rowspan="2"| Sample consisted of 232 ethnically diverse children ages 5-10 with (n = 121) and without (n=111) ADHD recruited through advertisements at school and through self-help groups.<ref name="Shemmassian_Lee-2012">{{cite journal |last1=Shemmassian |first1=Shirag K. |last2=Lee |first2=Steve S. |date=March 2012 |title=Comparing Four Methods of Integrating Parent and Teacher Symptom Ratings of Attention-deficit/hyperactivity Disorder (ADHD) |journal=Journal of Psychopathology and Behavioral Assessment |volume=34 |issue=1 |pages=1-10 |doi=10.1007/s10862-011-9262-5 |url=https://www.researchgate.net/profile/Steve_Lee11/publication/230888173_Comparing_Four_Methods_of_Integrating_Parent_and_Teacher_Symptom_Ratings_of_Attention-deficithyperactivity_Disorder_ADHD/links/09e41505caa13a5913000000.pdf |format=PDF }}</ref><ref name="Shemmassian_Lee-2016">{{cite journal |last1=Shemmassian |first1=Shirag K. |last2=Lee |first2=Steve S. |title=Predictive Utility of Four Methods of Incorporating Parent and Teacher Symptom Ratings of ADHD for Longitudinal Outcomes |journal=Journal of Clinical Child and Adolescent Psychology |date=2016 |volume=45 |issue=2 |pages=176-87 |pmid=25643854 |doi=10.1080/15374416.2014.971457 }}</ref> | |- | Disruptive Behavior Disorder Rating Scale (DBDRS) - Teacher Report (Pelham et. al, 1992) | 0.63 ({{var|N}}=232) | 1.97 (Endorsed ≥ 6 symptoms of inattention or hyperactivity) | 0.24 (Endorsed < 6 symptoms of inattention or hyperactivity) | Somewhat High Sample consisted of 232 ethnically diverse children ages 5-10 with (n = 121) and without (n=111) ADHD recruited through advertisements at school and through self-help groups.<ref name="Shemmassian_Lee-2012" /><ref name="Shemmassian_Lee-2016" /> | |- | [[w:Vanderbilt ADHD diagnostic rating scale#Parent version|Vanderbilt ADHD Diagnostic Parent Rating Scale]] (VADPRS)<ref>{{cite journal |last1=Wolraich |first1=Mark L. |last2=Lambert |first2=Warren |last3=Doffing |first3=Melissa A. |last4=Bickman |first4=Leonard |last5=Simmons |first5=Tonya |last6=Worley |first6=Kim |date=December 2003 |title=Psychometric Properties of the Vanderbilt ADHD Diagnostic Parent Rating Scale in a Referred Population |journal=Journal of Pediatric Psychology |volume=28 |issue=8 |pages=559-68 |pmid=14602846 |doi=10.1093/jpepsy/jsg046 |url=https://academic.oup.com/jpepsy/article/28/8/559/1020465/Psychometric-Properties-of-the-Vanderbilt-ADHD }}</ref> | Not reported | 4.79 (Endorsed ≥ 6 symptoms of inattention or hyperactivity) | 0.38 (Endorsed < 6 symptoms of inattention or hyperactivity) | Moderate Sample consists of 582 children ages 5-15 recruited through schools in Oklahoma. Sample includes children screened as "high risk" for ADHD and "low risk" for ADHD.<ref name=":0" /> | Sample consists of 582 children ages 5-15 recruited through schools in Oklahoma. Sample includes children screened as "high risk" for ADHD and "low risk" for ADHD.<ref name=":0">{{cite journal |last1=Bard |first1=David E. |last2=Wolraich |first2=Mark L. |last3=Neas |first3=Barbara |last4=Doffing |first4=Melissa |last5=Beck |first5=Laoma |date=February 2013 |title=The psychometric properties of the Vanderbilt attention-deficit hyperactivity disorder diagnostic parent rating scale in a community population |journal=Journal of Developmental and Behavioral Pediatrics |volume=34 |issue=2 |pages=72-82 |pmid=23363972 |doi=10.1097/DBP.0b013e31827a3a22 }}</ref> | |- | [[w:Vanderbilt ADHD diagnostic rating scale#Teacher version|Vanderbilt ADHD Diagnostic Teacher Rating Scale]] (VADTRS)<ref>{{cite journal |last1=Wolraich |first1=ML |last2=Feurer |first2=ID |last3=Hannah |first3=JN |last4=Baumgaertel |first4=A |last5=Pinnock |first5=TY |date=April 1998 |title=Obtaining systematic teacher reports of disruptive behavior disorders utilizing DSM-IV |journal=Journal of Abnormal Child Psychology |volume=26 |issue=2 |pages=141-52 |pmid=9634136 }}</ref> | Not reported | 2.91 (Positive risk score) | 0.657 (Negative risk score) | Moderate | Sample consisted of 370 children ages 5-15 recruited though schools in Oklahoma. Sample was representative community sample.<ref>{{cite journal |last1=Wolraich |first1=Mark L. |last2=Bard |first2=David E. |last3=Neas |first3=Barbara |last4=Doffing |first4=Melissa |last5=Beck |first5=Laoma |title=The psychometric properties of the Vanderbilt attention-deficit hyperactivity disorder diagnostic teacher rating scale in a community population |journal=Journal of Developmental and Behavioral Pediatrics |date=February 2013 |volume=34 |issue=2 |pages=83-93 |pmid=23363973 |doi=10.1097/DBP.0b013e31827d55c3 }}</ref> | |- | Conners Rating Scale (Revised) - Long Form Parent Report (Conners, 1997) | Not reported | 15.33 (>93rd percentile) | 0.09 (<93rd percentile) | Moderate | Data come from normative sample of 2482 children ages 3 to 17 across the United States and Canada. Diagnostic likelihood ratios here discriminate ADHD from Non-Clinical.<ref name=Collett_et_al-2003>{{cite journal |last1=Collett |first1=Brent R. |last2=Ohan |first2=Jeneva L. |last3=Myers |first3=Kathleen M. |title=Ten-year review of rating scales. V: Scales assessing attention-deficit/hyperactivity disorder |journal=Journal of the American Academy of Child and Adolescent Psychiatry |date=September 2003 |volume=42 |issue=9 |pages=1015-37 |pmid=12960702 |doi=10.1097/01.CHI.0000070245.24125.B6 }}</ref> | |- | Conners Parent Rating Scale-48 (CPRS-48) Impulsive-Hyperactive Subscale {{var|T}}-Score (Conners, 1990) | Not reported | 1.26 (>70) | 0.79 (>70) | Somewhat High | rowspan="2"| Utilized sample ages 5-12 years referred to a research clinic for assessment of ADHD. 108 children were ultimately diagnosed with ADHD, while 76 were not. LR's are calculated for discriminating between those two groups.<ref name=Tripp_et_al-2006 /> | |- | Conners Teacher Rating Scale-39 Hyperactivity Subscale {{var|T}}-Score (Conners, 1990) | Not reported | 5.2 (>70) | 0.53 (<70) | Somewhat High | |- | Conners Teacher Rating Scale (Revised) - Long Form (Conners, 1997) | Not reported | 8.66 (>93rd percentile) | 0.24 (<93rd percentile) | Moderate | Data come from normative sample of 1973 children ages 5 to 17 across the United States and Canada. Likelihood ratios discriminate ADHD from non-clinical.<ref name=Collett_et_al-2003 /> | |- | ADHD Symptom Checklist-4 (ADHD-SC4) - Parent Report<ref name=Gadow_Sprafkin-1997>{{cite book |last1=Gadow |first1=Kenneth D. |last2=Sprafkin |first2=Joyce N. |date=1997 |title=ADHD Symptom Checklist-4 |publisher=Checkmate Plus |location=Stony Brook, NY |oclc=49637921 }}</ref> | Not reported | 1.45 (Endorsed ≥ 6 symptoms of inattention or hyperactivity) | 0.70 (Endorsed < 6 symptoms of inattention or hyperactivity) | Somewhat High | rowspan="2"| Data come from sample of 207 children ages 5-17 years old who were referred to psychiatric outpatient service with variety of emotional and behavioral disorders.<ref name=Sprafkin_Gadow-2007>{{cite journal |last1=Sprafkin |first1=Joyce |last2=Gadow |first2=Kenneth D. |title=Choosing an attention-deficit/hyperactivity disorder rating scale: is item randomization necessary? |journal=Journal of Child and Adolescent Psychopharmacology |date=February 2007 |volume=17 |issue=1 |pages=75-84 |pmid=17343555 |doi=10.1089/cap.2006.0035 }}</ref> | |- | ADHD Symptom Checklist-4 (ADHD-SC4) - Teacher Report<ref name=Gadow_Sprafkin-1997/> | Not reported | 1.53 (Endorsed ≥ 6 symptoms of inattention or hyperactivity) | 0.60 (Endorsed < 6 symptoms of inattention or hyperactivity) | Somewhat High | |- | [[w:ADHD rating scale|ADHD RS-IV]] - Home (DuPaul et. al, 1998b) | Not reported | 1.63 (>80th percentile) | 0.35 (<80th percentile) | Moderate | rowspan="2"| Sample of 2000 children ages 5 to 18 years old from geographically representative normative base.<ref name=Collett_et_al-2003 /> | |- | ADHD RS-IV - School (DuPaul et. al, 1998b) | Not reported | 4.5 (>80th percentile) | 0.42 (<80th percentile) | Moderate | |- | colspan="7" style="font-size:110%; text-align:center;" span |'''Adults''' |- |} '''Note:''' All studies with one exception used structured or semi-structured clinical interviews to establish diagnosis of ADHD. The exception, the Sprafkin & Gadow study (2007), used a combination of CBCL rating scales, clinician review, and clinician consensus to confirm ADHD diagnosis.<ref name=Sprafkin_Gadow-2007 /> “LR+” refers to the change in likelihood ratio associated with a positive test score, and “LR-” is the likelihood ratio for a low score. Likelihood ratios of 1 indicate that the test result did not change impressions at all. LRs larger than 10 or smaller than .10 are frequently clinically decisive; 5 or .20 are helpful, and between 2.0 and .5 are small enough that they rarely result in clinically meaningful changes of formulation (Sackett et al., 2000). === Interpreting ADHD screening measure scores === * For information on interpreting screening measure scores, click [[Evidence based assessment/Prediction phase#Interpreting screening measure scores|here.]] * Also see the page on [https://en.wikipedia.org/wiki/Likelihood_ratios_in_diagnostic_testing likelihood ratios in diagnostic testing] for more information ==[[Evidence based assessment/Prescription phase|'''Prescription phase''']]== ===Gold standard diagnostic interviews=== * For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews click here.] ===Recommended diagnostic interviews for ADHD=== ''****Depression instruments are placeholders'' {| class="wikitable sortable" border="1" ! colspan="5" |Diagnostic instruments for '''ADHD''' |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time !Where to Access |- | colspan="5" style="font-size:110%; text-align:center;" span |'''Youth''' |- | Barkley Functional Impairment Scale—Children and Adolescents (BFIS-CA) | Parent Report | 6-17 | 5-7 minutes |Link to [https://www.guilford.com/books/Barkley-Functional-Impairment-Scale-Children-Adolescents-BFIS-CA/Russell-Barkley/9781462503957 purchase] |- | Weiss Functional Impairment Rating Scale<ref>{{Cite journal|last=Thompson|first=Trevor|last2=Lloyd|first2=Andrew|last3=Joseph|first3=Alain|last4=Weiss|first4=Margaret|date=2017|title=The Weiss Functional Impairment Rating Scale-Parent Form for assessing ADHD: evaluating diagnostic accuracy and determining optimal thresholds using ROC analysis|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5486894/|journal=Quality of Life Research|volume=26|issue=7|pages=1879–1885|doi=10.1007/s11136-017-1514-8|issn=0962-9343|pmc=5486894|pmid=28220338}}</ref> | Parent/Caregiver Report | 5-19 | |[http://www.shared-care.ca/files/WFIRS-Parent_with_Instructions_May_2012.pdf PDF] |} '''Note:''' Reliability and validity are included in the extended version. This table includes measures with Good or Excellent ratings. ==[[Evidence based assessment/Process phase|'''Process phase''']]== The following section contains a brief overview of treatment options for ADHD and list of process and outcome measures for ADHD. The section includes benchmarks based on published norms for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the [[Evidence based assessment/Process phase|process phase]] of assessment. For more information of differences between process and outcome measures, see the page on the [[Evidence based assessment/Process phase|process phase of assessment]]. === Process measures === {{blockquotetop}} ; CBCL Attention Problems Subscale : Could be used on a weekly basis to track changes in ADHD symptomotology. T-scores from this measure could also be recorded on a weekly basis to determine if reliable and clinically significant changes in ADHD symptoms are occuring. The CBCL Attention Problems Subscale has repeatedly demonstrated good-to-excellent convergence with diagnostic interviews for diagnosing ADHD.<ref name=Pelham_et_al-2005>{{cite journal |last1=Pelham |first1=William E., Jr. |last2=Fabiano |first2=Gregory A. |last3=Massetti |first3=Greta M. |date=September 2005 |title=Evidence-based assessment of attention deficit hyperactivity disorder in children and adolescents |journal=Journal of Clinical Child and Adolescent Psychology |volume=34 |issue=3 |pages=449-76 |pmid=16026214 |doi=10.1207/s15374424jccp3403_5 |url=https://www.researchgate.net/profile/Greta_Massetti/publication/7719090_Evidence-Based_Assessment_of_Attention_Deficit_Hyperactivity_Disorder_in_Children_and_Adolescents/links/09e415107e6e01c28e000000.pdf |format=PDF }}</ref><ref>{{cite journal |last1=Lampert |first1=TL |last2=Polanczyk |first2=G |last3=Tramontina |first3=S |last4=Mardini |first4=V |last5=Rohde |first5=LA |date=October 2004 |title=Diagnostic performance of the CBCL-Attention Problem Scale as a screening measure in a sample of Brazilian children with ADHD |journal=Journal of Attention Disorders |volume=8 |issue=2 |pages=63-71 |pmid=15801336 }}</ref><ref name=Hudziak_et_al-2004/><ref name=Chen_et_al-1994/> '''The CBCL Attention Problems Subscale is a scale on the CBCL, which is readily available at the Finley Clinic.''' ; Daily Report Card : Several scholars have pointed out that it is equally important to track changes in the functional behaviors that a child with ADHD engages in, in addition to their ADHD symptoms, to capture the full range of adaptive changes that are made by children with ADHD throughout the course of treatment.<ref name=Pelham_et_al-2005/><ref>{{cite book |last1=Sowerby |first1=Paula |last2=Tripp |first2=Gail |date=2009 |chapter=Evidence-Based Assessment of Attention-Deficit/Hyperactivity Disorder (ADHD) |editor1-last=Matson |editor1-first=Johnny L. |editor2-last=Andrasik |editor2-first=Frank |editor3-last=Matson |editor3-first=Michael L. |title=Assessing Childhood Psychopathology and Developmental Disabilities |pages=209-239 |publisher=Springer Science & Business Media |location=New York |oclc=314175875 |doi=10.1007/978-0-387-09528-8 |isbn=978-0-387-09528-8 |chapter-url=https://books.google.com/books?id=TyJClvRUgY4C&pg=PA209 }}</ref> The daily report card is a mechanism by which such adaptive behavioral changes can be tracked. When implementing the daily report card, problematic child behaviors at home and at school are targeted for change. Rewards are offered to the child for reaching daily and weekly goals for reducing maladaptive behaviors and increasing adaptive behaviors. Parents and Teachers track child behaviors on a daily basis and provide feedback to one another and the child with behavior frequency counts and/or daily "grades" on how well the child behaved. Daily report cards are a mainstay of cognitive-behavioral and behavioral modification evidence-based intervention strategies for ADHD,<ref name=DuPaul_et_al-2012/><ref>{{cite journal |last1=Eiraldi |first1=Ricardo B. |last2=Mautone |first2=Jennifer A. |last3=Power |first3=Thomas J. |date=January 2012 |title=Strategies for implementing evidence-based psychosocial interventions for children with attention-deficit/hyperactivity disorder |journal=Child and Adolescent Psychiatric Clinics of North America |volume=21 |issue=1 |pages=145-59 |pmid=22137818 |pmc=3233687 |doi=10.1016/j.chc.2011.08.012 }}</ref> and they are highly recommended for tracking child treatment outcomes. '''Instructions for creating a daily report card are attached in Appendix 1.''' {{blockquotebottom}} === Outcome and severity measures === This table includes clinically significant benchmarks for ADHD specific outcome measures * Information on how to interpret this table can be [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase found here]. * Additionally, these [[Evidence based assessment/Vignettes|vignettes]] might be helpful resources for understanding appropriate adaptation of outcome measures in practice. * ''<u>For clinically significant change benchmarks for the CBCL, YSR, and TRF total, externalizing, internalizing, and attention benchmarks,</u>'' [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase&wteswitched=1#Clinically_significant_change_benchmarks_for_widely-used_outcome_measures see here.] {| class="wikitable" border="1" |+Clinically significant change benchmarks with common instruments and ADHD rating scales |- ! rowspan="2" scope="col" | Measure ! rowspan="2" scope="col" | Diagnostic category ! colspan="3" scope="colgroup" width="300" | Cut Scores* ! colspan="3" scope="colgroup" | Critical Change<br>(Unstandardized Scores) |- ! scope="col" | A ! scope="col" | B ! scope="col" | C ! scope="col" | 95% ! scope="col" | 90% ! scope="col" | SE_difference |- | colspan="8" style="text-align:center" |'''Benchmarks Based on Published Norms''' |- | rowspan="4" style="text-align:center;" |''{{abbr|CBCL|Child Behavior Checklist}} {{var|T}}-scores<br>(2001 Norms)'' | style="text-align:right" | Total | style="text-align:center;" | 49 | style="text-align:center;" | 70 | style="text-align:center;" | 58 | style="text-align:center;" | 5 | style="text-align:center;" | 4 | style="text-align:center;" | 2.4 |- | style="text-align:right" | Externalizing | style="text-align:center;" | 49 | style="text-align:center;" | 70 | style="text-align:center;" | 58 | style="text-align:center;" | 7 | style="text-align:center;" | 6 | style="text-align:center;" | 3.4 |- | style="text-align:right" | Internalizing | {{n/a}} | style="text-align:center;" | 70 | style="text-align:center;" | 56 | style="text-align:center;" | 9 | style="text-align:center;" | 7 | style="text-align:center;" | 4.5 |- | style="text-align:right" | Attention Problems | {{n/a}} | style="text-align:center;" | 66 | style="text-align:center;" | 58 | style="text-align:center;" | 8 | style="text-align:center;" | 7 | style="text-align:center;" | 4.2 |- | rowspan="4" style="text-align:center;" |''{{abbr|TRF|Teacher Response Form}} {{var|T}}-Scores<br>(2001 Norms)'' | style="text-align:right" | Total | {{n/a}} | style="text-align:center;" | 70 | style="text-align:center;" | 57 | style="text-align:center;" | 5 | style="text-align:center;" | 4 | style="text-align:center;" | 2.3 |- | style="text-align:right" | Externalizing | {{n/a}} | style="text-align:center;" | 70 | style="text-align:center;" | 56 | style="text-align:center;" | 6 | style="text-align:center;" | 5 | style="text-align:center;" | 3.0 |- | style="text-align:right" | Internalizing | {{n/a}} | style="text-align:center;" | 70 | style="text-align:center;" | 55 | style="text-align:center;" | 9 | style="text-align:center;" | 7 | style="text-align:center;" | 4.4 |- | style="text-align:right" | Attention Problems | {{n/a}} | style="text-align:center;" | 66 | style="text-align:center;" | 57 | style="text-align:center;" | 5 | style="text-align:center;" | 4 | style="text-align:center;" | 2.3 |- | rowspan="2" style="text-align:center" |''Conners 3-Teacher Rating Scale {{var|T}}-Scores'' | style="text-align:right" | ADHD Inattentive | style="text-align:center;" | 36 | style="text-align:center;" | 74 | style="text-align:center;" | 57 | style="text-align:center;" | 11 | style="text-align:center;" | 10 | style="text-align:center;" | 5.6 |- | style="text-align:right" | ADHD Hyperactive-Impulsive | style="text-align:center;" | 36 | style="text-align:center;" | 74 | style="text-align:center;" | 57 | style="text-align:center;" | 11 | style="text-align:center;" | 9 | style="text-align:center;" | 5.5 |- | rowspan="2" style="text-align:center" |''Conners 3-Parent Rating Scale {{var|T}}-Scores'' | style="text-align:right" | ADHD Inattentive | style="text-align:center;" | 37 | style="text-align:center;" | 72 | style="text-align:center;" | 58 | style="text-align:center;" | 10 | style="text-align:center;" | 10 | style="text-align:center;" | 5.6 |- | style="text-align:right" | ADHD Hyperactive-Impulsive | style="text-align:center;" | 37 | style="text-align:center;" | 72 | style="text-align:center;" | 58 | style="text-align:center;" | 10 | style="text-align:center;" | 8 | style="text-align:center;" | 4.7 |- | colspan="8" style="text-align:center" |'''Benchmarks Based on ADHD Samples'''<ref name="Shemmassian_Lee-2012" /> |- | colspan="2" |''Disruptive Behavior Disorders Rating Scale'' | style="text-align:center;" | 1.4 | style="text-align:center;" | 8.6 | style="text-align:center;" | 5.7 | style="text-align:center;" | 12 | style="text-align:center;" | 10 | style="text-align:center;" | 0.9 |} '''Note:''' “A” = Away from the clinical range, “B” = Back into the nonclinical range, “C” = Closer to the nonclinical than clinical mean. <ref>{{Cite web|url=https://en.wikiversity.org/wiki/Evidence-based_assessment/Reliability#Evaluating_norms_and_reliability|title=Evidence-based assessment/Reliability - Wikiversity|website=en.wikiversity.org|access-date=2020-11-13}}</ref> '''Search terms:''' [ADHD or CONNERS or DBD] AND [clinical significance OR group means] in PsycINFO === Treatment === * Please refer to the Wikipedia page on [[wikipedia:Attention_deficit_hyperactivity_disorder|Attention Deficit Hyperactivity Disorder]] for more information on available treatment for ADHD or go to [https://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/inattention-and-hyperactivity-adhd/ Effective Child Therapy] for a curated resource on effective treatments for ADHD. {{collapse top| ADHD Treatment Information|expand=yes}} === Executive summary === 1. If intervening with children ages 4-5, behavior therapy should be the first line of treatment. 2. If intervening with children ages 6-11, behavior therapy should be the first line of treatment, in conjunction with medication. 3. If intervening with children ages 12-18, medication should probably be the first line of treatment, though behavior therapy could be used in combination. 4. Three types of therapeutic interventions have well established evidence-bases: :a. Behavioral Parent Training Interventions :b. Behavioral Classroom Management Interventions :c. Behavioral Peer interventions involving recreational peer groups (e.g. summer camps) 5. If considering a classroom management intervention: :a. Academic and Cognitive-Behavioral Interventions are most effective in changing academic outcomes :b. Cognitive Behavioral and Contingency Management Interventions are most effective in changing behavioral outcomes === Clinical practice guidelines === Published by the American Academy of Pediatrics in 2011.<ref name="AAP_Guideline-2011">{{cite journal |author1=Subcommittee on Attention-Deficit/Hyperactivity Disorder |author2=Steering Committee on Quality Improvement and Management |last3=Wolraich |first3=Mark |last4=Brown |first4=Lawrence |last5=Brown |first5=Ronald T. |last6=DuPaul |first6=George |last7=Earls |first7=Marian |last8=Feldman |first8=Heidi M. |last9=Ganiats |first9=Theodore G. |last10=Kaplanek |first10=Beth |last11=Meyer |first11=Bruce |last12=Perrin |first12=James |last13=Pierce |first13=Karen |last14=Reiff |first14=Michael |last15=Stein |first15=Martin T. |last16=Visser |first16=Susanna |date=November 2011 |title=ADHD: Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents |journal=Pediatrics |volume=128 |issue=5 |pages=1007-22 |pmid=22003063 |pmc=4500647 |doi=10.1542/peds.2011-2654 }}</ref> ; Preschool-aged children (ages 4–5) : Primary care clinicians should prescribe evidence-based parent and/or teacher-administered behavior therapy as the first line of treatment, and may prescribe methylphenidate if behavioral interventions are not effective. ; Elementary-aged children (ages 6–11) : Primary care clinicians should prescribe FDA-approved medications for ADHD and/or evidence based parent and teacher administered behavior therapy. Preferably, both medication and behavior therapy will be prescribed. ; Adolescents (ages 12–18) : Primary care clinicians should prescribe FDA approved medications for ADHD with the assent of the adolescent and may prescribe behavior therapy as a treatment for ADHD, preferably both. === Behavioral therapies === These meet the American Academy of Pediatrics and American Psychological Association Task Force criteria for well-established evidence-based treatments. Descriptions and effect sizes are taken from the American Academy of Pediatrics' guidelines<ref name="AAP_Guideline-2011" /> and Pelham & Fabiano's review article.<ref>{{cite journal |last1=Pelham |first1=William E., Jr. |last2=Fabiano |first2=Gregory A. |date=January 2008 |title=Evidence-based psychosocial treatments for attention-deficit/hyperactivity disorder |journal=Journal of Clinical Child and Adolescent Psychology |volume=37 |issue=1 |pages=184-214 |doi=10.1080/15374410701818681 |pmid=18444058 |lay-url=https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0026847/ |lay-source=Database of Abstracts of Reviews of Effects: Quality-assessed Reviews |lay-date=12 February 2009 }}</ref> ; Behavioral Parent Training : Behavior modification principles provided to parents for implementation in home settings. Typical outcomes include improved compliance with parental commands, improved parental understanding of behavioral principles, high levels of parental satisfaction with treatment. :'''Median effect size:''' 0.55 ; Behavioral Classroom Management : Behavior-modification principles provided to teachers for implementation in classroom settings. Typical outcomes include improved attention to instruction, improved compliance with classroom rules, decreased disruptive behavior, improved work productivity, and improved academic achievement. :'''Median effect size:''' 0.61 ; Behavioral Peer Interventions : Interventions focused on peer interactions/relationships. These could include group-based interventions provided weekly and include clinic-based social skills training used either alone or concurrently with behavioral parent training and/or medication. Typical outcomes are more mixed with these interventions. Some clinical-office based interventions have produced minimal effects, while some studies of behavioral peer intervention coupled with behavioral parent training found positive effects on parental ratings of ADHD symptoms. No studies of this type of intervention reveal differences on social functioning or parental ratings of social behavior. Behavioral Peer Interventions implemented in peer group/recreational settings (e.g. summer camps) have the most evidence of being effective. :'''Median effect size:''' None reported, effect sizes found are considered moderate. === School based interventions === {| class="wikitable" align="right" |+Single Subject Design Effect Sizes |- ! rowspan="2" scope="col" | Intervention type ! colspan="2" scope="colgroup" | Effect size |- ! scope="col" | Academic<br>outcomes ! scope="col" | Behavioral<br>outcomes |- | {{rh}} class="table-rh" |Academic | style="text-align:right" | 4.73 | style="text-align:right" | 1.53 |- | {{rh}} class="table-rh" |Cognitive behavioral | style="text-align:right" | 3.77 | style="text-align:right" | 3.31 |- | {{rh}} class="table-rh" |Contingency management | style="text-align:right" | 2.29 | style="text-align:right" | 2.40 |- | {{rh}} class="table-rh" |Combined | style="text-align:right" | 2.29 | style="text-align:right" | 1.31 |} Findings from a review by DuPaul and colleagues.<ref name="DuPaul_et_al-2012">{{cite journal |last1=DuPaul |first1=George J. |last2=Eckert |first2=Tanya L. |last3=Vilardo |first3=Brigid |date=December 2012 |title=The effects of school-based interventions for attention deficit hyperactivity disorder: A meta-analysis 1996-2010 |journal=School Psychology Review |volume=41 |issue=4 |pages=387-412 |issn=0279-6015 |id=ERIC [https://eric.ed.gov/?id=EJ1001907 EJ1001907] }}</ref> ; Associated with greater effects on academic outcomes :''Academic'' — interventions focus primarily on manipulating antecedent conditions via things like peer tutoring, computer-aided instruction, and organizational skills. :''Combined'' academic and contingency management interventions. ; Associated with greater effects for behavior outcomes :''Contingency management'' — interventions use reinforcement and punishment. :''Cognitive behavioral'' — interventions focus on development of self-control skills and reflective problem-solving strategies. {{clear}} {{collapse bottom}} == '''External Links''' == *[https://sccap53.org Society of Clinical Child and Adolescent Psychology] *[http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/inattention-and-hyperactivity-adhd/ EffectiveChildTherapy.Org information on ADHD] *[https://ccf.fiu.edu/_assets/pdfs/how_to_establish_a_school_drc.pdf Establishing a School-Home Daily Report Card] *[https://ccf.fiu.edu/_assets/pdfs/what-parents-and-teachers-should-know-about-adhd-updated-1214.pdf What Parents and Teachers Should Know About ADHD (Fact Sheet)] *[https://ccf.fiu.edu/_assets/pdfs/psychosocial_fact_sheet-updated-1214.pdf Psychosocial Interventions for ADHD] *[https://ccf.fiu.edu/_assets/pdfs/adhd-medication-information-sheet-for-parents-and-teachers1.pdf ADHD Medication Information Sheet for Parents and Teachers] =='''References'''== {{collapse top|References|expand=yes}} {{Reflist|30em}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] {{collapse bottom}} {{subpage navbar}} ce83jhvrwkniok5d72hsmru4e5du9tp 2419311 2419296 2022-08-26T05:34:13Z Ardenguo 2944162 /* Screening and diagnostic instruments for attention deficit hyperactivity disorder */ linked extended version to "Note: Reliability and validity are included in the extended version. This table includes measures with Good or Excellent ratings." wikitext text/x-wiki 3<noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{medical disclaimer}} {{:{{BASEPAGENAME}}/Sidebar}} ==[[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio"?''']]== For background information on what assessment portfolios are, click the link in the heading above. Want even 'more' information about this topic? There's an extended version of this page [[Evidence-based assessment/Attention deficit hyperactivity disorder (assessment portfolio)/extended version|here]]. ==[[Evidence based assessment/Preparation phase|'''Preparation phase''']]== === Diagnostic Criteria of ADHD in youth === {{blockquotetop}} <big>ICD-11 Diagnostic Criteria </big><br> <br> '''General Description:''' Attention deficit hyperactivity disorder is characterised by a persistent pattern (at least 6 months) of inattention and/or hyperactivity-impulsivity that has a direct negative impact on academic, occupational, or social functioning. There is evidence of significant inattention and/or hyperactivity-impulsivity symptoms prior to age 12, typically by early to mid-childhood, though some individuals may first come to clinical attention later. The degree of inattention and hyperactivity-impulsivity is outside the limits of normal variation expected for age and level of intellectual functioning. Inattention refers to significant difficulty in sustaining attention to tasks that do not provide a high level of stimulation or frequent rewards, distractibility and problems with organisation. Hyperactivity refers to excessive motor activity and difficulties with remaining still, most evident in structured situations that require behavioural self-control. Impulsivity is a tendency to act in response to immediate stimuli, without deliberation or consideration of the risks and consequences. The relative balance and the specific manifestations of inattentive and hyperactive-impulsive characteristics varies across individuals and may change over the course of development. In order for a diagnosis to be made, manifestations of inattention and/or hyperactivity-impulsivity must be evident across multiple situations or settings (e.g., home, school, work, with friends or relatives), but are likely to vary according to the structure and demands of the setting. <br> <br> '''Predominantly Inattentive Presentation:''' All definitional requirements for attention deficit hyperactivity disorder are met and inattentive symptoms are predominant in the clinical presentation. Inattention refers to significant difficulty in sustaining attention to tasks that do not provide a high level of stimulation or frequent rewards, distractibility and problems with organization. Some hyperactive-impulsive symptoms may also be present, but these are not clinically significant in relation to the inattentive symptoms. <br> <br> '''Predominantly Hyperactive-Impulsive:''' All definitional requirements for attention deficit hyperactivity disorder are met and hyperactive-impulsive symptoms are predominant in the clinical presentation. Hyperactivity refers to excessive motor activity and difficulties with remaining still, most evident in structured situations that require behavioural self-control. Impulsivity is a tendency to act in response to immediate stimuli, without deliberation or consideration of the risks and consequences. Some inattentive symptoms may also be present, but these are not clinically significant in relation to the hyperactive-impulsive symptoms. <br> <br> <big>Changes in DSM-5</big> <br> The diagnostic criteria for ADHD changed slightly from DSM-IV to DSM-5. See the changes [https://www.ncbi.nlm.nih.gov/books/NBK519712/table/ch3.t3/ here]. {{blockquotebottom}}<ref>{{Cite web|url=https://icd.who.int/browse11/l-m/en#/http://id.who.int/icd/entity/821852937|title=ICD-11 for Mortality and Morbidity Statistics|website=icd.who.int|access-date=2022-06-21}}</ref> ===Base rates of youth ADHD in different populations and clinical settings=== This section describes the demographic setting of the population(s) sampled, base rates of diagnosis, country/region sampled, and the diagnostic method that was used. Using this information, clinicians will be able to anchor the rates of adolescent depression that they are likely to see in their clinical practices. * '''''To find prevalence rates across multiple disorders,''''' [[Evidence based assessment/Preparation phase#Base rates for transdiagnostic comparison|click here.]] {| class="wikitable sortable" |- ! Demography ! Setting ! Base Rate(s) ! Diagnostic Method |- |Worldwide, Ages 3-18 |Meta-Analysis of worldwide prevalence of Child/Adolescent ADHD<ref>{{cite journal |last=Willcutt |first=Erik G. |date=July 2012 |title=The Prevalence of DSM-IV Attention-Deficit/Hyperactivity Disorder: A Meta-Analytic Review |journal=Neurotherapeutics |volume=9 |issue=3 |pages=490-99 |pmid=22976615 |pmc=3441936 |doi=10.1007/s13311-012-0135-8 }}</ref> |6.1% (parent rating)<br>7.1% (teacher rating)<br>10.5% (ages 3-5)<br>11.4% (ages 6-12)<br>8.0% (ages 13-18) |Multiple, but each focused on DSM-IV criteria |- |USA Nationally Representative, Ages 3-17 |Epidemiological [[w:National Health Interview Survey|NHIS]] (US CDC, 2011) |8.4% (Overall)<br>12.0% (Male)<br>4.7% (Female)<br>2.1% (ages 3-5)<br>8.4% (ages 6-11)<br>11.9% (ages 12-17)<br>10.3% (southern region of US) |Parent-report of whether child had ever been diagnosed |- |USA Nationally Representative, Ages 4-17 |Child and Adolescent Epidemiological National Survey of Children's Health (US CDC, 2007) |9.5% (overall)<br>12.3% (male)<br>5.3% (female)<br>1.5% (ages 3-5)<br>9.1% (ages 6-11)<br>12.4% (ages 12-17)<br>15.6% (North Carolina) |Parent-report of whether child had ever been diagnosed |- |USA Nationally Representative, Ages 5-14 |Teacher-Reported Prevalence of ADHD<ref>{{cite journal |last1=Fabiano |first1=Gregory A. |last2=Pelham |first2=William E., Jr. |last3=Majumdar |first3=Antara |last4=Evans |first4=Steven W. |last5=Manos |first5=Michael J. |last6=Caserta |first6=Donald |last7=Girio-Herrera |first7=Erin L. |last8=Pisecco |first8=Stewart |last9=Hannah |first9=Jane N. |last10=Carter |first10=Randy L. |date=April 2013 |title=Elementary and Middle School Teacher Perceptions of Attention-Deficit/Hyperactivity Disorder Prevalence |journal=Child & Youth Care Forum |volume=42 |issue=2 |pages=87-99 |doi=10.1007/s10566-013-9194-1 }}</ref> |5.25% (overall)<br>5.58% (elementary schoolers)<br>3.53% (middle schoolers)<br>7.1% (one county in rural NC) |Teacher report of number of children who have been identified with ADHD in their class |- |USA Nationally Representative, Ages 13-18 |Adolescent Epidemiological [[w:National Comorbidity Survey|National Comorbidity Survey-Adolescent Supplement]]<ref>{{cite journal |last1=Merikangas |first1=Kathleen Ries |last2=He |first2=Jian-Ping |last3=Burstein |first3=Marcy |last4=Swanson |first4=Sonja A. |last5=Avenevoli |first5=Shelli |last6=Cui |first6=Lihong |last7=Benjet |first7=Corina |last8=Georgiades |first8=Katholiki |last9=Swendsen |first9=Joel |date=October 2010 |title=Lifetime prevalence of mental disorders in U.S. adolescents: results from the National Comorbidity Survey Replication—Adolescent Supplement (NCS-A) |journal=Journal of the American Academy of Child and Adolescent Psychiatry |volume=49 |issue=10 |pages=980-9 |pmid=20855043 |pmc=2946114 |doi=10.1016/j.jaac.2010.05.017 }}</ref> |8.7% |CIDI 3.0 structured diagnostic interview |- |Ages 6-90 |Meta-Analysis of Clinical Samples<ref name="Rettew_et_al-2009">{{cite journal |last1=Rettew |first1=David C. |last2=Lynch |first2=Alicia Doyle |last3=Achenbach |first3=Thomas M. |last4=Dumenci |first4=Levent |last5=Ivanova |first5=Masha Y. |date=September 2009 |title=Meta-analyses of agreement between diagnoses made from clinical evaluations and standardized diagnostic interviews |journal=International Journal of Methods in Psychiatric Research |volume=18 |issue=3 |pages=169-84 |pmid=19701924 |doi=10.1002/mpr.289 }}</ref> |38% |Structured Diagnostic Interviews |- |Ages 6-90 |Meta-Analysis of Clinical Samples<ref name="Rettew_et_al-2009" /> |23% |Clinical Evaluations |- |Representative Sample of Johnston County School Children, North Carolina, Ages 6-12 |Johnston County, North Carolina Sample<ref>{{cite journal |last1=Rowland |first1=Andrew S. |last2=Skipper |first2=Betty J. |last3=Umbach |first3=David M. |last4=Rabiner |first4=David L. |last5=Campbell |first5=Richard A. |last6=Naftel |first6=Albert J. |last7=Sandler |first7=Dale P. |date=11 December 2013 |title=The Prevalence of ADHD in a Population-Based Sample |journal=Journal of Attention Disorders |volume=19 |issue=9 |pages=741-54 |pmid=24336124 |pmc=4058092 |doi=10.1177/1087054713513799 }}</ref> |15.5% |Combined parent and teacher report (NTRS and DISC) with DSM-IV criteria |- |Sample drawn from 11 counties in Western NC, Ages 9-16 |North Carolina Community Sample<ref>{{cite journal |last1=Costello |first1=E. Jane |last2=Mustillo |first2=Sarah |last3=Erkanli |first3=Alaattin |last4=Keeler |first4=Gordon |last5=Angold |first5=Adrian |date=August 2003 |title=Prevalence and development of psychiatric disorders in childhood and adolescence |journal=Archives of General Psychiatry |volume=60 |issue=8 |pages=837-44 |pmid=12912767 |doi=10.1001/archpsyc.60.8.837 |doi-access=free |url=http://jamanetwork.com/journals/jamapsychiatry/fullarticle/207725 }}</ref> |0.9% (3-month prevalence)<br>4.1% (estimated by age 16) |CAPA structured diagnostic interview |- |Sample recruited at Durham, NC, Seattle, Nashville, and Central Pennsylvania sites. Sample was followed longitudinally and identified as at high risk for externalizing disorders in kindergarten. 50% African American, Ages 12-15 |High-Risk Community Sample<ref>{{cite journal |last1=Jones |first1=Damon E. |last2=Foster |first2=E. Michael |date=October 2009 |title=Service Use Patterns for Adolescents with ADHD and Comorbid Conduct Disorder |journal=Journal of Behavioral Health Services & Research |volume=36 |issue=4 |pages=436-49 |pmid=18618263 |pmc=3534729 |doi=10.1007/s11414-008-9133-3 }}</ref> |14.3% |Diagnostic Interview Schedule for Children (DISC) |} ==[[Evidence based assessment/Prediction phase|'''Prediction phase''']]== === Psychometric properties of screening instruments for youth ADHD === The following section contains a list of screening and diagnostic instruments for ADHD. The section includes administration information, psychometric data, and PDFs or links to the screenings. * Screenings are used as part of the [[Evidence based assessment/Prediction phase|prediction phase]] of assessment; for more information on interpretation of this data, or how screenings fit in to the assessment process, [[Evidence based assessment/Prediction phase|'''click here''']]. * '''''For a list of more broadly-reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Common_screening_instruments click here.]''''' === Screening and diagnostic instruments for attention deficit hyperactivity disorder=== {| class="wikitable sortable" border="1" |- ! Measure ! Format (Reporter) ! Age Range ! Administration/<br>Completion Time !Where to Access |- | colspan="5" style="font-size:110%; text-align:center;" span |'''Youth''' |- |ADHD Rating Scale (ADHD-RS-V)<ref>DuPaul, G. J., Power, T. J., Anastopoulos, A. D., & Reid, R. (1998). ADHD Rating Scale–IV: Checklists, norms, and clinical interpretation. New York: Guilford Press</ref> |Teacher, Parent |5-10 y/o: Child Version 11-17 y/o: Adolescent Version |5 minutes for each scale | |- |Conners 3rd Edition<ref>{{Cite web|url=https://www.pearsonassessments.com/store/usassessments/en/Store/Professional-Assessments/Behavior/Comprehensive/Conners-3rd-Edition/p/100000523.html|title=Conners 3rd Edition|website=www.pearsonassessments.com|language=en|access-date=2022-06-30}}</ref> |Teacher, Parent |6-18 y/o: Administered to parents and teachers of children and adolescents age 8-18 y/o: Self-report |20 minutes: Long Version 10 minutes: Short Version <5 Minutes: Conners 3AI and Conners 3GI |[https://www.pearsonassessments.com/store/usassessments/en/Store/Professional-Assessments/Behavior/Comprehensive/Conners-3rd-Edition/p/100000523.html Not Free] |- |Vanderbilt ADHD Parent Rating Scale (VADPRS) |Teacher, Parent |6-12 y/o | |Free |- |Child Behavior Checklist (CBCL/6-18) |Parent |6-18 y/o |15-20 minutes |Free |- |Behavior Assessment Scale for Children (BASC-3) | | |10-20 minutes: (TRS and PRS) 30 minutes: (SRP) |Not Free |} '''Note:''' Reliability and validity are included in the [[Evidence-based assessment/Attention deficit hyperactivity disorder (assessment portfolio)/extended version|extended version]]. This table includes measures with Good or Excellent ratings. === Likelihood ratios and AUCs of screening measures for '''ADHD''' === * '''''For a list of the likelihood ratios for more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Likelihood_ratios_and_AUCs_of_common_screening_instruments click here.]''''' {| class="wikitable sortable mw-collapsible" border="1" |- ! Screening Measure (Primary Reference) !data-sort-type="number"| {{abbr|AUC (sample size)|Area under curve}} !data-sort-type="number"| {{abbr|DiLR+ (score)|Positive likelihood ratio}} Score !data-sort-type="number"| {{abbr|DiLR- (score)|Negative likelihood ratio}} Score ! Clinical Generalizeability and Study Description ! class="unsortable"| Study description !Where to Access |- |- | colspan="7" style="font-size:110%; text-align:center;" span |'''Youth''' |- |rowspan="4"| [[w:Child Behavior Checklist|Child Behavior Checklist]] (CBCL) - Attention Problems {{var|T}}-Score<ref name=Achenbach-1991>{{cite book |last1=Achenbach |first1=Thomas M. |author1-link=w:Thomas M. Achenbach |title=Child behavior checklist for ages 4-18 |date=1991 |publisher=Department of Psychiatry, University of Vermont |location=Burlington, VT |isbn=978-0-938565-08-6 }}</ref> |rowspan="4"| .84 ({{var|N}}=187) | 6.92 (>55) | 0.19 (<55) |rowspan="4"| Somewhat High Utilized sample ages 6-18 recruited from local pediatricians, psychiatrists, and community advertisements. Included 95 children who met criteria for ADHD. 70 of these children also met criteria for ODD/CD.<ref name="Hudziak_et_al-2004" /> |rowspan="4"| Utilized sample ages 6-18 recruited from local pediatricians, psychiatrists, and community advertisements. Included 95 children who met criteria for ADHD. 70 of these children also met criteria for ODD/CD.<ref name=Hudziak_et_al-2004>{{cite journal |last1=Hudziak |first1=James J. |last2=Copeland |first2=William |last3=Stanger |first3=Catherine |last4=Wadsworth |first4=Martha |title=Screening for DSM-IV externalizing disorders with the Child Behavior Checklist: A receiver-operating characteristic analysis |journal=Journal of Child Psycholology and Psychiatry |date=October 2004 |volume=45 |issue=7 |pages=1299-307 |pmid=15335349 |doi=10.1111/j.1469-7610.2004.00314.x }}</ref> | rowspan="4" | |- | 12.2 (>60) | 0.41 (<60) |- | 47 (>65) | 0.53 (<65) |- | 34 (>70) | 0.66 (<70) |- |rowspan="2"| Child Behavior Checklist (CBCL) - Attention and Aggression Problems {{var|T}}-Score<ref name=Achenbach-1991/> |data-sort-value="0.86"| Boys: .86 ({{var|N}}=111) | {{nowrap|10.2 (>55)}} | {{nowrap|0.41 (<55)}} |rowspan="2"| Somewhat High Utilized sample ages 6-18 which consisted of 219 brothers and sisters of children who were referred to a hospital pediatric unit for ADHD or other symptoms. Half of these siblings had brothers and sisters who had ADHD, half did not.<ref name="Chen_et_al-1994" /> |rowspan="2"| Utilized sample ages 6-18 which consisted of 219 brothers and sisters of children who were referred to a hospital pediatric unit for ADHD or other symptoms. Half of these siblings had brothers and sisters who had ADHD, half did not.<ref name=Chen_et_al-1994>{{cite journal |last1=Chen |first1= Wei J. |last2=Faraone |first2=Stephen V. |author2-link=w:Stephen Faraone |last3=Biederman |first3=Joseph |author3-link=w:Joseph Biederman |last4=Tsuang |first4=Ming T. |title=Diagnostic accuracy of the Child Behavior Checklist scales for attention-deficit hyperactivity disorder: A receiver-operating characteristic analysis |journal=Journal of Consulting and Clinical Psychology |date=October 1994 |volume=62 |issue=5 |pages=1017-25 |pmid=7806710 |doi=10.1037/0022-006X.62.5.1017 }}</ref> | rowspan="2" | |- |data-sort-value="0.90"| Girls: 0.90 ({{var|N}}=108) |{{nowrap|11.2 (>55)}} |{{nowrap|0.35 (<55)}} |- | [[w:Achenbach System of Empirically Based Assessment|Teacher Response Form]] (TRF) - Attention Problems {{var|T}}-Score<ref name=Achenbach-1991/> | Not reported ({{var|N}}=184) | 3.66 (>70) | 0.73 (<70) | Somewhat High Utilized sample ages 5-12 years referred to a research clinic for assessment of ADHD. 108 children were ultimately diagnosed with ADHD, while 76 were not. LR's are calculated for discriminating between those two groups.<ref name="Tripp_et_al-2006" /> |rowspan="2"| Utilized sample ages 5-12 years referred to a research clinic for assessment of ADHD. 108 children were ultimately diagnosed with ADHD, while 76 were not. LR's are calculated for discriminating between those two groups.<ref name=Tripp_et_al-2006>{{cite journal |last1=Tripp |first1=Gail |last2=Schaughency |first2=Elizabeth A. |last3=Clarke |first3=Bronwyn |title=Parent and teacher rating scales in the evaluation of attention-deficit hyperactivity disorder: Contribution to diagnosis and differential diagnosis in clinically referred children |journal=Journal of Developmental and Behavioral Pediatrics |date=2006 |volume=27 |issue=3 |pages=209-18 |pmid=16775518 }}</ref> | |- | Teacher Response Form (TRF) - Attention and Aggression Problems {{var|T}}-Score<ref name=Achenbach-1991/> | Not reported ({{var|N}}=184) | 4.33 (>70) | 0.89 (<70) | Somewhat High Utilized sample ages 5-12 years referred to a research clinic for assessment of ADHD. 108 children were ultimately diagnosed with ADHD, while 76 were not. LR's are calculated for discriminating between those two groups.<ref name="Tripp_et_al-2006" /> | |- | [[w:Disruptive Behavior Disorders Rating Scale|Disruptive Behavior Disorder Rating Scale]] (DBDRS) - Parent Report (Pelham et. al, 1992) | 0.78 ({{var|N}}=232) | 5.06 (Endorsed ≥ 6 symptoms of inattention or hyperactivity) | 0.20 (<9) (Endorsed < 6 symptoms of inattention or hyperactivity) | Somewhat High Sample consisted of 232 ethnically diverse children ages 5-10 with (n = 121) and without (n=111) ADHD recruited through advertisements at school and through self-help groups.<ref name="Shemmassian_Lee-2012" /><ref name="Shemmassian_Lee-2016" /> |rowspan="2"| Sample consisted of 232 ethnically diverse children ages 5-10 with (n = 121) and without (n=111) ADHD recruited through advertisements at school and through self-help groups.<ref name="Shemmassian_Lee-2012">{{cite journal |last1=Shemmassian |first1=Shirag K. |last2=Lee |first2=Steve S. |date=March 2012 |title=Comparing Four Methods of Integrating Parent and Teacher Symptom Ratings of Attention-deficit/hyperactivity Disorder (ADHD) |journal=Journal of Psychopathology and Behavioral Assessment |volume=34 |issue=1 |pages=1-10 |doi=10.1007/s10862-011-9262-5 |url=https://www.researchgate.net/profile/Steve_Lee11/publication/230888173_Comparing_Four_Methods_of_Integrating_Parent_and_Teacher_Symptom_Ratings_of_Attention-deficithyperactivity_Disorder_ADHD/links/09e41505caa13a5913000000.pdf |format=PDF }}</ref><ref name="Shemmassian_Lee-2016">{{cite journal |last1=Shemmassian |first1=Shirag K. |last2=Lee |first2=Steve S. |title=Predictive Utility of Four Methods of Incorporating Parent and Teacher Symptom Ratings of ADHD for Longitudinal Outcomes |journal=Journal of Clinical Child and Adolescent Psychology |date=2016 |volume=45 |issue=2 |pages=176-87 |pmid=25643854 |doi=10.1080/15374416.2014.971457 }}</ref> | |- | Disruptive Behavior Disorder Rating Scale (DBDRS) - Teacher Report (Pelham et. al, 1992) | 0.63 ({{var|N}}=232) | 1.97 (Endorsed ≥ 6 symptoms of inattention or hyperactivity) | 0.24 (Endorsed < 6 symptoms of inattention or hyperactivity) | Somewhat High Sample consisted of 232 ethnically diverse children ages 5-10 with (n = 121) and without (n=111) ADHD recruited through advertisements at school and through self-help groups.<ref name="Shemmassian_Lee-2012" /><ref name="Shemmassian_Lee-2016" /> | |- | [[w:Vanderbilt ADHD diagnostic rating scale#Parent version|Vanderbilt ADHD Diagnostic Parent Rating Scale]] (VADPRS)<ref>{{cite journal |last1=Wolraich |first1=Mark L. |last2=Lambert |first2=Warren |last3=Doffing |first3=Melissa A. |last4=Bickman |first4=Leonard |last5=Simmons |first5=Tonya |last6=Worley |first6=Kim |date=December 2003 |title=Psychometric Properties of the Vanderbilt ADHD Diagnostic Parent Rating Scale in a Referred Population |journal=Journal of Pediatric Psychology |volume=28 |issue=8 |pages=559-68 |pmid=14602846 |doi=10.1093/jpepsy/jsg046 |url=https://academic.oup.com/jpepsy/article/28/8/559/1020465/Psychometric-Properties-of-the-Vanderbilt-ADHD }}</ref> | Not reported | 4.79 (Endorsed ≥ 6 symptoms of inattention or hyperactivity) | 0.38 (Endorsed < 6 symptoms of inattention or hyperactivity) | Moderate Sample consists of 582 children ages 5-15 recruited through schools in Oklahoma. Sample includes children screened as "high risk" for ADHD and "low risk" for ADHD.<ref name=":0" /> | Sample consists of 582 children ages 5-15 recruited through schools in Oklahoma. Sample includes children screened as "high risk" for ADHD and "low risk" for ADHD.<ref name=":0">{{cite journal |last1=Bard |first1=David E. |last2=Wolraich |first2=Mark L. |last3=Neas |first3=Barbara |last4=Doffing |first4=Melissa |last5=Beck |first5=Laoma |date=February 2013 |title=The psychometric properties of the Vanderbilt attention-deficit hyperactivity disorder diagnostic parent rating scale in a community population |journal=Journal of Developmental and Behavioral Pediatrics |volume=34 |issue=2 |pages=72-82 |pmid=23363972 |doi=10.1097/DBP.0b013e31827a3a22 }}</ref> | |- | [[w:Vanderbilt ADHD diagnostic rating scale#Teacher version|Vanderbilt ADHD Diagnostic Teacher Rating Scale]] (VADTRS)<ref>{{cite journal |last1=Wolraich |first1=ML |last2=Feurer |first2=ID |last3=Hannah |first3=JN |last4=Baumgaertel |first4=A |last5=Pinnock |first5=TY |date=April 1998 |title=Obtaining systematic teacher reports of disruptive behavior disorders utilizing DSM-IV |journal=Journal of Abnormal Child Psychology |volume=26 |issue=2 |pages=141-52 |pmid=9634136 }}</ref> | Not reported | 2.91 (Positive risk score) | 0.657 (Negative risk score) | Moderate | Sample consisted of 370 children ages 5-15 recruited though schools in Oklahoma. Sample was representative community sample.<ref>{{cite journal |last1=Wolraich |first1=Mark L. |last2=Bard |first2=David E. |last3=Neas |first3=Barbara |last4=Doffing |first4=Melissa |last5=Beck |first5=Laoma |title=The psychometric properties of the Vanderbilt attention-deficit hyperactivity disorder diagnostic teacher rating scale in a community population |journal=Journal of Developmental and Behavioral Pediatrics |date=February 2013 |volume=34 |issue=2 |pages=83-93 |pmid=23363973 |doi=10.1097/DBP.0b013e31827d55c3 }}</ref> | |- | Conners Rating Scale (Revised) - Long Form Parent Report (Conners, 1997) | Not reported | 15.33 (>93rd percentile) | 0.09 (<93rd percentile) | Moderate | Data come from normative sample of 2482 children ages 3 to 17 across the United States and Canada. Diagnostic likelihood ratios here discriminate ADHD from Non-Clinical.<ref name=Collett_et_al-2003>{{cite journal |last1=Collett |first1=Brent R. |last2=Ohan |first2=Jeneva L. |last3=Myers |first3=Kathleen M. |title=Ten-year review of rating scales. V: Scales assessing attention-deficit/hyperactivity disorder |journal=Journal of the American Academy of Child and Adolescent Psychiatry |date=September 2003 |volume=42 |issue=9 |pages=1015-37 |pmid=12960702 |doi=10.1097/01.CHI.0000070245.24125.B6 }}</ref> | |- | Conners Parent Rating Scale-48 (CPRS-48) Impulsive-Hyperactive Subscale {{var|T}}-Score (Conners, 1990) | Not reported | 1.26 (>70) | 0.79 (>70) | Somewhat High | rowspan="2"| Utilized sample ages 5-12 years referred to a research clinic for assessment of ADHD. 108 children were ultimately diagnosed with ADHD, while 76 were not. LR's are calculated for discriminating between those two groups.<ref name=Tripp_et_al-2006 /> | |- | Conners Teacher Rating Scale-39 Hyperactivity Subscale {{var|T}}-Score (Conners, 1990) | Not reported | 5.2 (>70) | 0.53 (<70) | Somewhat High | |- | Conners Teacher Rating Scale (Revised) - Long Form (Conners, 1997) | Not reported | 8.66 (>93rd percentile) | 0.24 (<93rd percentile) | Moderate | Data come from normative sample of 1973 children ages 5 to 17 across the United States and Canada. Likelihood ratios discriminate ADHD from non-clinical.<ref name=Collett_et_al-2003 /> | |- | ADHD Symptom Checklist-4 (ADHD-SC4) - Parent Report<ref name=Gadow_Sprafkin-1997>{{cite book |last1=Gadow |first1=Kenneth D. |last2=Sprafkin |first2=Joyce N. |date=1997 |title=ADHD Symptom Checklist-4 |publisher=Checkmate Plus |location=Stony Brook, NY |oclc=49637921 }}</ref> | Not reported | 1.45 (Endorsed ≥ 6 symptoms of inattention or hyperactivity) | 0.70 (Endorsed < 6 symptoms of inattention or hyperactivity) | Somewhat High | rowspan="2"| Data come from sample of 207 children ages 5-17 years old who were referred to psychiatric outpatient service with variety of emotional and behavioral disorders.<ref name=Sprafkin_Gadow-2007>{{cite journal |last1=Sprafkin |first1=Joyce |last2=Gadow |first2=Kenneth D. |title=Choosing an attention-deficit/hyperactivity disorder rating scale: is item randomization necessary? |journal=Journal of Child and Adolescent Psychopharmacology |date=February 2007 |volume=17 |issue=1 |pages=75-84 |pmid=17343555 |doi=10.1089/cap.2006.0035 }}</ref> | |- | ADHD Symptom Checklist-4 (ADHD-SC4) - Teacher Report<ref name=Gadow_Sprafkin-1997/> | Not reported | 1.53 (Endorsed ≥ 6 symptoms of inattention or hyperactivity) | 0.60 (Endorsed < 6 symptoms of inattention or hyperactivity) | Somewhat High | |- | [[w:ADHD rating scale|ADHD RS-IV]] - Home (DuPaul et. al, 1998b) | Not reported | 1.63 (>80th percentile) | 0.35 (<80th percentile) | Moderate | rowspan="2"| Sample of 2000 children ages 5 to 18 years old from geographically representative normative base.<ref name=Collett_et_al-2003 /> | |- | ADHD RS-IV - School (DuPaul et. al, 1998b) | Not reported | 4.5 (>80th percentile) | 0.42 (<80th percentile) | Moderate | |- | colspan="7" style="font-size:110%; text-align:center;" span |'''Adults''' |- |} '''Note:''' All studies with one exception used structured or semi-structured clinical interviews to establish diagnosis of ADHD. The exception, the Sprafkin & Gadow study (2007), used a combination of CBCL rating scales, clinician review, and clinician consensus to confirm ADHD diagnosis.<ref name=Sprafkin_Gadow-2007 /> “LR+” refers to the change in likelihood ratio associated with a positive test score, and “LR-” is the likelihood ratio for a low score. Likelihood ratios of 1 indicate that the test result did not change impressions at all. LRs larger than 10 or smaller than .10 are frequently clinically decisive; 5 or .20 are helpful, and between 2.0 and .5 are small enough that they rarely result in clinically meaningful changes of formulation (Sackett et al., 2000). === Interpreting ADHD screening measure scores === * For information on interpreting screening measure scores, click [[Evidence based assessment/Prediction phase#Interpreting screening measure scores|here.]] * Also see the page on [https://en.wikipedia.org/wiki/Likelihood_ratios_in_diagnostic_testing likelihood ratios in diagnostic testing] for more information ==[[Evidence based assessment/Prescription phase|'''Prescription phase''']]== ===Gold standard diagnostic interviews=== * For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews click here.] ===Recommended diagnostic interviews for ADHD=== ''****Depression instruments are placeholders'' {| class="wikitable sortable" border="1" ! colspan="5" |Diagnostic instruments for '''ADHD''' |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time !Where to Access |- | colspan="5" style="font-size:110%; text-align:center;" span |'''Youth''' |- | Barkley Functional Impairment Scale—Children and Adolescents (BFIS-CA) | Parent Report | 6-17 | 5-7 minutes |Link to [https://www.guilford.com/books/Barkley-Functional-Impairment-Scale-Children-Adolescents-BFIS-CA/Russell-Barkley/9781462503957 purchase] |- | Weiss Functional Impairment Rating Scale<ref>{{Cite journal|last=Thompson|first=Trevor|last2=Lloyd|first2=Andrew|last3=Joseph|first3=Alain|last4=Weiss|first4=Margaret|date=2017|title=The Weiss Functional Impairment Rating Scale-Parent Form for assessing ADHD: evaluating diagnostic accuracy and determining optimal thresholds using ROC analysis|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5486894/|journal=Quality of Life Research|volume=26|issue=7|pages=1879–1885|doi=10.1007/s11136-017-1514-8|issn=0962-9343|pmc=5486894|pmid=28220338}}</ref> | Parent/Caregiver Report | 5-19 | |[http://www.shared-care.ca/files/WFIRS-Parent_with_Instructions_May_2012.pdf PDF] |} '''Note:''' Reliability and validity are included in the [[Evidence-based assessment/Attention deficit hyperactivity disorder (assessment portfolio)/extended version|extended version]]. This table includes measures with Good or Excellent ratings. ==[[Evidence based assessment/Process phase|'''Process phase''']]== The following section contains a brief overview of treatment options for ADHD and list of process and outcome measures for ADHD. The section includes benchmarks based on published norms for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the [[Evidence based assessment/Process phase|process phase]] of assessment. For more information of differences between process and outcome measures, see the page on the [[Evidence based assessment/Process phase|process phase of assessment]]. === Process measures === {{blockquotetop}} ; CBCL Attention Problems Subscale : Could be used on a weekly basis to track changes in ADHD symptomotology. T-scores from this measure could also be recorded on a weekly basis to determine if reliable and clinically significant changes in ADHD symptoms are occuring. The CBCL Attention Problems Subscale has repeatedly demonstrated good-to-excellent convergence with diagnostic interviews for diagnosing ADHD.<ref name=Pelham_et_al-2005>{{cite journal |last1=Pelham |first1=William E., Jr. |last2=Fabiano |first2=Gregory A. |last3=Massetti |first3=Greta M. |date=September 2005 |title=Evidence-based assessment of attention deficit hyperactivity disorder in children and adolescents |journal=Journal of Clinical Child and Adolescent Psychology |volume=34 |issue=3 |pages=449-76 |pmid=16026214 |doi=10.1207/s15374424jccp3403_5 |url=https://www.researchgate.net/profile/Greta_Massetti/publication/7719090_Evidence-Based_Assessment_of_Attention_Deficit_Hyperactivity_Disorder_in_Children_and_Adolescents/links/09e415107e6e01c28e000000.pdf |format=PDF }}</ref><ref>{{cite journal |last1=Lampert |first1=TL |last2=Polanczyk |first2=G |last3=Tramontina |first3=S |last4=Mardini |first4=V |last5=Rohde |first5=LA |date=October 2004 |title=Diagnostic performance of the CBCL-Attention Problem Scale as a screening measure in a sample of Brazilian children with ADHD |journal=Journal of Attention Disorders |volume=8 |issue=2 |pages=63-71 |pmid=15801336 }}</ref><ref name=Hudziak_et_al-2004/><ref name=Chen_et_al-1994/> '''The CBCL Attention Problems Subscale is a scale on the CBCL, which is readily available at the Finley Clinic.''' ; Daily Report Card : Several scholars have pointed out that it is equally important to track changes in the functional behaviors that a child with ADHD engages in, in addition to their ADHD symptoms, to capture the full range of adaptive changes that are made by children with ADHD throughout the course of treatment.<ref name=Pelham_et_al-2005/><ref>{{cite book |last1=Sowerby |first1=Paula |last2=Tripp |first2=Gail |date=2009 |chapter=Evidence-Based Assessment of Attention-Deficit/Hyperactivity Disorder (ADHD) |editor1-last=Matson |editor1-first=Johnny L. |editor2-last=Andrasik |editor2-first=Frank |editor3-last=Matson |editor3-first=Michael L. |title=Assessing Childhood Psychopathology and Developmental Disabilities |pages=209-239 |publisher=Springer Science & Business Media |location=New York |oclc=314175875 |doi=10.1007/978-0-387-09528-8 |isbn=978-0-387-09528-8 |chapter-url=https://books.google.com/books?id=TyJClvRUgY4C&pg=PA209 }}</ref> The daily report card is a mechanism by which such adaptive behavioral changes can be tracked. When implementing the daily report card, problematic child behaviors at home and at school are targeted for change. Rewards are offered to the child for reaching daily and weekly goals for reducing maladaptive behaviors and increasing adaptive behaviors. Parents and Teachers track child behaviors on a daily basis and provide feedback to one another and the child with behavior frequency counts and/or daily "grades" on how well the child behaved. Daily report cards are a mainstay of cognitive-behavioral and behavioral modification evidence-based intervention strategies for ADHD,<ref name=DuPaul_et_al-2012/><ref>{{cite journal |last1=Eiraldi |first1=Ricardo B. |last2=Mautone |first2=Jennifer A. |last3=Power |first3=Thomas J. |date=January 2012 |title=Strategies for implementing evidence-based psychosocial interventions for children with attention-deficit/hyperactivity disorder |journal=Child and Adolescent Psychiatric Clinics of North America |volume=21 |issue=1 |pages=145-59 |pmid=22137818 |pmc=3233687 |doi=10.1016/j.chc.2011.08.012 }}</ref> and they are highly recommended for tracking child treatment outcomes. '''Instructions for creating a daily report card are attached in Appendix 1.''' {{blockquotebottom}} === Outcome and severity measures === This table includes clinically significant benchmarks for ADHD specific outcome measures * Information on how to interpret this table can be [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase found here]. * Additionally, these [[Evidence based assessment/Vignettes|vignettes]] might be helpful resources for understanding appropriate adaptation of outcome measures in practice. * ''<u>For clinically significant change benchmarks for the CBCL, YSR, and TRF total, externalizing, internalizing, and attention benchmarks,</u>'' [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase&wteswitched=1#Clinically_significant_change_benchmarks_for_widely-used_outcome_measures see here.] {| class="wikitable" border="1" |+Clinically significant change benchmarks with common instruments and ADHD rating scales |- ! rowspan="2" scope="col" | Measure ! rowspan="2" scope="col" | Diagnostic category ! colspan="3" scope="colgroup" width="300" | Cut Scores* ! colspan="3" scope="colgroup" | Critical Change<br>(Unstandardized Scores) |- ! scope="col" | A ! scope="col" | B ! scope="col" | C ! scope="col" | 95% ! scope="col" | 90% ! scope="col" | SE_difference |- | colspan="8" style="text-align:center" |'''Benchmarks Based on Published Norms''' |- | rowspan="4" style="text-align:center;" |''{{abbr|CBCL|Child Behavior Checklist}} {{var|T}}-scores<br>(2001 Norms)'' | style="text-align:right" | Total | style="text-align:center;" | 49 | style="text-align:center;" | 70 | style="text-align:center;" | 58 | style="text-align:center;" | 5 | style="text-align:center;" | 4 | style="text-align:center;" | 2.4 |- | style="text-align:right" | Externalizing | style="text-align:center;" | 49 | style="text-align:center;" | 70 | style="text-align:center;" | 58 | style="text-align:center;" | 7 | style="text-align:center;" | 6 | style="text-align:center;" | 3.4 |- | style="text-align:right" | Internalizing | {{n/a}} | style="text-align:center;" | 70 | style="text-align:center;" | 56 | style="text-align:center;" | 9 | style="text-align:center;" | 7 | style="text-align:center;" | 4.5 |- | style="text-align:right" | Attention Problems | {{n/a}} | style="text-align:center;" | 66 | style="text-align:center;" | 58 | style="text-align:center;" | 8 | style="text-align:center;" | 7 | style="text-align:center;" | 4.2 |- | rowspan="4" style="text-align:center;" |''{{abbr|TRF|Teacher Response Form}} {{var|T}}-Scores<br>(2001 Norms)'' | style="text-align:right" | Total | {{n/a}} | style="text-align:center;" | 70 | style="text-align:center;" | 57 | style="text-align:center;" | 5 | style="text-align:center;" | 4 | style="text-align:center;" | 2.3 |- | style="text-align:right" | Externalizing | {{n/a}} | style="text-align:center;" | 70 | style="text-align:center;" | 56 | style="text-align:center;" | 6 | style="text-align:center;" | 5 | style="text-align:center;" | 3.0 |- | style="text-align:right" | Internalizing | {{n/a}} | style="text-align:center;" | 70 | style="text-align:center;" | 55 | style="text-align:center;" | 9 | style="text-align:center;" | 7 | style="text-align:center;" | 4.4 |- | style="text-align:right" | Attention Problems | {{n/a}} | style="text-align:center;" | 66 | style="text-align:center;" | 57 | style="text-align:center;" | 5 | style="text-align:center;" | 4 | style="text-align:center;" | 2.3 |- | rowspan="2" style="text-align:center" |''Conners 3-Teacher Rating Scale {{var|T}}-Scores'' | style="text-align:right" | ADHD Inattentive | style="text-align:center;" | 36 | style="text-align:center;" | 74 | style="text-align:center;" | 57 | style="text-align:center;" | 11 | style="text-align:center;" | 10 | style="text-align:center;" | 5.6 |- | style="text-align:right" | ADHD Hyperactive-Impulsive | style="text-align:center;" | 36 | style="text-align:center;" | 74 | style="text-align:center;" | 57 | style="text-align:center;" | 11 | style="text-align:center;" | 9 | style="text-align:center;" | 5.5 |- | rowspan="2" style="text-align:center" |''Conners 3-Parent Rating Scale {{var|T}}-Scores'' | style="text-align:right" | ADHD Inattentive | style="text-align:center;" | 37 | style="text-align:center;" | 72 | style="text-align:center;" | 58 | style="text-align:center;" | 10 | style="text-align:center;" | 10 | style="text-align:center;" | 5.6 |- | style="text-align:right" | ADHD Hyperactive-Impulsive | style="text-align:center;" | 37 | style="text-align:center;" | 72 | style="text-align:center;" | 58 | style="text-align:center;" | 10 | style="text-align:center;" | 8 | style="text-align:center;" | 4.7 |- | colspan="8" style="text-align:center" |'''Benchmarks Based on ADHD Samples'''<ref name="Shemmassian_Lee-2012" /> |- | colspan="2" |''Disruptive Behavior Disorders Rating Scale'' | style="text-align:center;" | 1.4 | style="text-align:center;" | 8.6 | style="text-align:center;" | 5.7 | style="text-align:center;" | 12 | style="text-align:center;" | 10 | style="text-align:center;" | 0.9 |} '''Note:''' “A” = Away from the clinical range, “B” = Back into the nonclinical range, “C” = Closer to the nonclinical than clinical mean. <ref>{{Cite web|url=https://en.wikiversity.org/wiki/Evidence-based_assessment/Reliability#Evaluating_norms_and_reliability|title=Evidence-based assessment/Reliability - Wikiversity|website=en.wikiversity.org|access-date=2020-11-13}}</ref> '''Search terms:''' [ADHD or CONNERS or DBD] AND [clinical significance OR group means] in PsycINFO === Treatment === * Please refer to the Wikipedia page on [[wikipedia:Attention_deficit_hyperactivity_disorder|Attention Deficit Hyperactivity Disorder]] for more information on available treatment for ADHD or go to [https://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/inattention-and-hyperactivity-adhd/ Effective Child Therapy] for a curated resource on effective treatments for ADHD. {{collapse top| ADHD Treatment Information|expand=yes}} === Executive summary === 1. If intervening with children ages 4-5, behavior therapy should be the first line of treatment. 2. If intervening with children ages 6-11, behavior therapy should be the first line of treatment, in conjunction with medication. 3. If intervening with children ages 12-18, medication should probably be the first line of treatment, though behavior therapy could be used in combination. 4. Three types of therapeutic interventions have well established evidence-bases: :a. Behavioral Parent Training Interventions :b. Behavioral Classroom Management Interventions :c. Behavioral Peer interventions involving recreational peer groups (e.g. summer camps) 5. If considering a classroom management intervention: :a. Academic and Cognitive-Behavioral Interventions are most effective in changing academic outcomes :b. Cognitive Behavioral and Contingency Management Interventions are most effective in changing behavioral outcomes === Clinical practice guidelines === Published by the American Academy of Pediatrics in 2011.<ref name="AAP_Guideline-2011">{{cite journal |author1=Subcommittee on Attention-Deficit/Hyperactivity Disorder |author2=Steering Committee on Quality Improvement and Management |last3=Wolraich |first3=Mark |last4=Brown |first4=Lawrence |last5=Brown |first5=Ronald T. |last6=DuPaul |first6=George |last7=Earls |first7=Marian |last8=Feldman |first8=Heidi M. |last9=Ganiats |first9=Theodore G. |last10=Kaplanek |first10=Beth |last11=Meyer |first11=Bruce |last12=Perrin |first12=James |last13=Pierce |first13=Karen |last14=Reiff |first14=Michael |last15=Stein |first15=Martin T. |last16=Visser |first16=Susanna |date=November 2011 |title=ADHD: Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents |journal=Pediatrics |volume=128 |issue=5 |pages=1007-22 |pmid=22003063 |pmc=4500647 |doi=10.1542/peds.2011-2654 }}</ref> ; Preschool-aged children (ages 4–5) : Primary care clinicians should prescribe evidence-based parent and/or teacher-administered behavior therapy as the first line of treatment, and may prescribe methylphenidate if behavioral interventions are not effective. ; Elementary-aged children (ages 6–11) : Primary care clinicians should prescribe FDA-approved medications for ADHD and/or evidence based parent and teacher administered behavior therapy. Preferably, both medication and behavior therapy will be prescribed. ; Adolescents (ages 12–18) : Primary care clinicians should prescribe FDA approved medications for ADHD with the assent of the adolescent and may prescribe behavior therapy as a treatment for ADHD, preferably both. === Behavioral therapies === These meet the American Academy of Pediatrics and American Psychological Association Task Force criteria for well-established evidence-based treatments. Descriptions and effect sizes are taken from the American Academy of Pediatrics' guidelines<ref name="AAP_Guideline-2011" /> and Pelham & Fabiano's review article.<ref>{{cite journal |last1=Pelham |first1=William E., Jr. |last2=Fabiano |first2=Gregory A. |date=January 2008 |title=Evidence-based psychosocial treatments for attention-deficit/hyperactivity disorder |journal=Journal of Clinical Child and Adolescent Psychology |volume=37 |issue=1 |pages=184-214 |doi=10.1080/15374410701818681 |pmid=18444058 |lay-url=https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0026847/ |lay-source=Database of Abstracts of Reviews of Effects: Quality-assessed Reviews |lay-date=12 February 2009 }}</ref> ; Behavioral Parent Training : Behavior modification principles provided to parents for implementation in home settings. Typical outcomes include improved compliance with parental commands, improved parental understanding of behavioral principles, high levels of parental satisfaction with treatment. :'''Median effect size:''' 0.55 ; Behavioral Classroom Management : Behavior-modification principles provided to teachers for implementation in classroom settings. Typical outcomes include improved attention to instruction, improved compliance with classroom rules, decreased disruptive behavior, improved work productivity, and improved academic achievement. :'''Median effect size:''' 0.61 ; Behavioral Peer Interventions : Interventions focused on peer interactions/relationships. These could include group-based interventions provided weekly and include clinic-based social skills training used either alone or concurrently with behavioral parent training and/or medication. Typical outcomes are more mixed with these interventions. Some clinical-office based interventions have produced minimal effects, while some studies of behavioral peer intervention coupled with behavioral parent training found positive effects on parental ratings of ADHD symptoms. No studies of this type of intervention reveal differences on social functioning or parental ratings of social behavior. Behavioral Peer Interventions implemented in peer group/recreational settings (e.g. summer camps) have the most evidence of being effective. :'''Median effect size:''' None reported, effect sizes found are considered moderate. === School based interventions === {| class="wikitable" align="right" |+Single Subject Design Effect Sizes |- ! rowspan="2" scope="col" | Intervention type ! colspan="2" scope="colgroup" | Effect size |- ! scope="col" | Academic<br>outcomes ! scope="col" | Behavioral<br>outcomes |- | {{rh}} class="table-rh" |Academic | style="text-align:right" | 4.73 | style="text-align:right" | 1.53 |- | {{rh}} class="table-rh" |Cognitive behavioral | style="text-align:right" | 3.77 | style="text-align:right" | 3.31 |- | {{rh}} class="table-rh" |Contingency management | style="text-align:right" | 2.29 | style="text-align:right" | 2.40 |- | {{rh}} class="table-rh" |Combined | style="text-align:right" | 2.29 | style="text-align:right" | 1.31 |} Findings from a review by DuPaul and colleagues.<ref name="DuPaul_et_al-2012">{{cite journal |last1=DuPaul |first1=George J. |last2=Eckert |first2=Tanya L. |last3=Vilardo |first3=Brigid |date=December 2012 |title=The effects of school-based interventions for attention deficit hyperactivity disorder: A meta-analysis 1996-2010 |journal=School Psychology Review |volume=41 |issue=4 |pages=387-412 |issn=0279-6015 |id=ERIC [https://eric.ed.gov/?id=EJ1001907 EJ1001907] }}</ref> ; Associated with greater effects on academic outcomes :''Academic'' — interventions focus primarily on manipulating antecedent conditions via things like peer tutoring, computer-aided instruction, and organizational skills. :''Combined'' academic and contingency management interventions. ; Associated with greater effects for behavior outcomes :''Contingency management'' — interventions use reinforcement and punishment. :''Cognitive behavioral'' — interventions focus on development of self-control skills and reflective problem-solving strategies. {{clear}} {{collapse bottom}} == '''External Links''' == *[https://sccap53.org Society of Clinical Child and Adolescent Psychology] *[http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/inattention-and-hyperactivity-adhd/ EffectiveChildTherapy.Org information on ADHD] *[https://ccf.fiu.edu/_assets/pdfs/how_to_establish_a_school_drc.pdf Establishing a School-Home Daily Report Card] *[https://ccf.fiu.edu/_assets/pdfs/what-parents-and-teachers-should-know-about-adhd-updated-1214.pdf What Parents and Teachers Should Know About ADHD (Fact Sheet)] *[https://ccf.fiu.edu/_assets/pdfs/psychosocial_fact_sheet-updated-1214.pdf Psychosocial Interventions for ADHD] *[https://ccf.fiu.edu/_assets/pdfs/adhd-medication-information-sheet-for-parents-and-teachers1.pdf ADHD Medication Information Sheet for Parents and Teachers] =='''References'''== {{collapse top|References|expand=yes}} {{Reflist|30em}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] {{collapse bottom}} {{subpage navbar}} 6p9sw5i4xg767ow8ppzsjyr4s29tcyc 0 207100 2419197 2413868 2022-08-26T02:36:29Z Ardenguo 2944162 /* References */ wikitext text/x-wiki <noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{medical disclaimer}} {{:{{BASEPAGENAME}}/Sidebar}} ==[[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio"?''']]== For background information on what assessment portfolios are, click the link in the heading above. Want even '''more''' information about this topic? There's an extended version of this page [[Evidence-based assessment/Depression in youth (assessment portfolio)/extended version|here]]. ==[[Evidence based assessment/Preparation phase|'''Preparation phase''']]== ===Diagnostic criteria for depression in youth === {{blockquotetop}}'''ICD-11 Diagnostic Criteria''' *Depressive Disorders **Depressive disorders are characterized by depressive mood (e.g., sad, irritable, empty) or loss of pleasure accompanied by other cognitive, behavioural, or neurovegetative symptoms that significantly affect the individual’s ability to function. A depressive disorder should not be diagnosed in individuals who have ever experienced a manic, mixed or hypomanic episode, which would indicate the presence of a bipolar disorder. *Single Episode Depressive Disorder **Single episode depressive disorder is characterized by the presence or history of one depressive episode when there is no history of prior depressive episodes. A depressive episode is characterized by a period of almost daily depressed mood or diminished interest in activities lasting at least two weeks accompanied by other symptoms such as difficulty concentrating, feelings of worthlessness or excessive or inappropriate guilt, hopelessness, recurrent thoughts of death or suicide, changes in appetite or sleep, psychomotor agitation or retardation, and reduced energy or fatigue. There have never been any prior manic, hypomanic, or mixed episodes, which would indicate the presence of a bipolar disorder. ***Note: The ICD-11 lists 10 additional subcategories of single episode depressive disorder. They can be found [https://icd.who.int/browse11/l-m/en#/http%3a%2f%2fid.who.int%2ficd%2fentity%2f578635574 here]. *Recurrent Depressive Disorder **Recurrent depressive disorder is characterized by a history or at least two depressive episodes separated by at least several months without significant mood disturbance. A depressive episode is characterized by a period of almost daily depressed mood or diminished interest in activities lasting at least two weeks accompanied by other symptoms such as difficulty concentrating, feelings of worthlessness or excessive or inappropriate guilt, hopelessness, recurrent thoughts of death or suicide, changes in appetite or sleep, psychomotor agitation or retardation, and reduced energy or fatigue. There have never been any prior manic, hypomanic, or mixed episodes, which would indicate the presence of a Bipolar disorder. ***Note: The ICD-11 lists 10 additional subcategories of recurrent depressive disorder. They can be found [https://icd.who.int/browse11/l-m/en#/http%3a%2f%2fid.who.int%2ficd%2fentity%2f1194756772 here]. *Dysthymic Disorder **Dysthymic disorder is characterized by a persistent depressive mood (i.e., lasting 2 years or more), for most of the day, for more days than not. In children and adolescents depressed mood can manifest as pervasive irritability.The depressed mood is accompanied by additional symptoms such as markedly diminished interest or pleasure in activities, reduced concentration and attention or indecisiveness, low self-worth or excessive or inappropriate guilt, hopelessness about the future, disturbed sleep or increased sleep, diminished or increased appetite, or low energy or fatigue. During the first 2 years of the disorder, there has never been a 2-week period during which the number and duration of symptoms were sufficient to meet the diagnostic requirements for a Depressive Episode. There is no history of Manic, Mixed, or Hypomanic Episodes. *Mixed Depressive and Anxiety Disorder **Mixed depressive and anxiety disorder is characterized by symptoms of both anxiety and depression more days than not for a period of two weeks or more. Neither set of symptoms, considered separately, is sufficiently severe, numerous, or persistent to justify a diagnosis of a depressive episode, dysthymia or an anxiety and fear-related disorder. Depressed mood or diminished interest in activities must be present accompanied by additional depressive symptoms as well as multiple symptoms of anxiety. The symptoms result in significant distress or significant impairment in personal, family, social, educational, occupational or other important areas of functioning. There have never been any prior manic, hypomanic, or mixed episodes, which would indicate the presence of a bipolar disorder. # ==== Changes in DSM-5 ==== * The diagnostic criteria for depressive disorders changed slightly from [[DSM-IV]] to [[w:Diagnostic_and_Statistical_Manual_of_Mental_Disorders#DSM-IV-TR_.282000.29|DSM-5-TR]]. Summaries are available [https://psychiatry.org/psychiatrists/practice/dsm/updates-to-dsm/updates-to-dsm-5-tr-criteria-text here] and [[w:DSM-5|here]]. {{blockquotebottom}} ===Base rates of adolescent depression in different clinical settings=== This section describes the demographic setting of the population(s) sampled, base rates of diagnosis, country/region sampled, and the diagnostic method that was used. Using this information, clinicians will be able to anchor the rates of adolescent depression that they are likely to see in their clinical practices. * '''''To find prevalence rates across multiple disorders,''''' [[Evidence based assessment/Preparation phase#Base rates for transdiagnostic comparison|click here.]] {| class="wikitable" |- ! Demography ! Setting !! Base Rate !! Diagnostic Method |- | French general practitioner network<ref>{{Cite journal|last=Mathet|first=F.|last2=Martin-Guehl|first2=C.|last3=Maurice-Tison|first3=S.|last4=Bouvard|first4=M.-P.|date=2003-09|title=[Prevalence of depressive disorders in children and adolescents attending primary care. A survey with the Aquitaine Sentinelle Network]|url=https://pubmed.ncbi.nlm.nih.gov/14615688|journal=L'Encephale|volume=29|issue=5|pages=391–400|issn=0013-7006|pmid=14615688}}</ref> | Children and adolescents attending primary care (2002) || 5.0% || CES-D, CBCL, Kiddie Schedule for Affective Disorders and Schizophrenia - Present and Lifetime Version (KSADS-PL) ^y |- | All of U.S.A.<ref name=":0">{{Cite journal|last=Merikangas|first=Kathleen Ries|last2=He|first2=Jian-Ping|last3=Burstein|first3=Marcy|last4=Swanson|first4=Sonja A.|last5=Avenevoli|first5=Shelli|last6=Cui|first6=Lihong|last7=Benjet|first7=Corina|last8=Georgiades|first8=Katholiki|last9=Swendsen|first9=Joel|date=2010-10|title=Lifetime prevalence of mental disorders in U.S. adolescents: results from the National Comorbidity Survey Replication--Adolescent Supplement (NCS-A)|url=https://pubmed.ncbi.nlm.nih.gov/20855043|journal=Journal of the American Academy of Child and Adolescent Psychiatry|volume=49|issue=10|pages=980–989|doi=10.1016/j.jaac.2010.05.017|issn=1527-5418|pmc=2946114|pmid=20855043}}</ref> | National Comorbidity Survey-Adolescent (ages 13-18) (2010) || 6.9%-15.4% || National Comorbidity Survey-Adolescent (NCS-A) Interview Schedule ^{p, y} |- | North Carolina<ref>{{Cite journal|last=Costello|first=E. J.|last2=Farmer|first2=E. M.|last3=Angold|first3=A.|last4=Burns|first4=B. J.|last5=Erkanli|first5=A.|date=1997-05|title=Psychiatric disorders among American Indian and white youth in Appalachia: the Great Smoky Mountains Study|url=https://pubmed.ncbi.nlm.nih.gov/9184514|journal=American Journal of Public Health|volume=87|issue=5|pages=827–832|doi=10.2105/ajph.87.5.827|issn=0090-0036|pmc=1381058|pmid=9184514}}</ref><ref>{{Cite journal|last=Angold|first=A.|last2=Costello|first2=E. J.|date=2000-01|title=The Child and Adolescent Psychiatric Assessment (CAPA)|url=https://pubmed.ncbi.nlm.nih.gov/10638066|journal=Journal of the American Academy of Child and Adolescent Psychiatry|volume=39|issue=1|pages=39–48|doi=10.1097/00004583-200001000-00015|issn=0890-8567|pmid=10638066}}</ref> | Great Smoky Mountains Study: Community Sample (ages 9-13) (1997)|| .03-1.45% || CAPA = Child and Adolescent Psychiatric Assessment |- | All of U.S.A. | Acute psychiatric hospitalizations in 2009-2010 children (under the age of 15) (Blader & Carlson, 2010) || 13% || Centers for Disease Control survey of discharge diagnoses |- | Northwestern U.S.A. high school<ref name="LewinsohnEtAl1993">{{cite journal|last1=Lewinsohn|first1=PM|last2=Hops|first2=H|last3=Roberts|first3=RE|last4=Seeley|first4=JR|last5=Andrews|first5=JA|date=February 1993|title=Adolescent psychopathology: I. Prevalence and incidence of depression and other DSM-III-R disorders in high school students.|journal=Journal of abnormal psychology|volume=102|issue=1|pages=133-44|pmid=8436689}}</ref> | High school students (1993)|| 9.6% || KSADS |- | All of U.S.A.<ref name=":0" /> | Gender differences, males and females, respectively (2010)|| 7.5%-15% || NCS-A Interview Schedule ^{p, y} |- | Varied<ref name="CostelloEtAl2006">{{cite journal|last1=Costello|first1=EJ|last2=Erkanli|first2=A|last3=Angold|first3=A|date=December 2006|title=Is there an epidemic of child or adolescent depression?|journal=Journal of child psychology and psychiatry, and allied disciplines|volume=47|issue=12|pages=1263-71|pmid=17176381}}</ref> | Meta-analysis, adolescents 13 to 18 years (2006)|| 5.7% || DISC, CIDI, SDI, K-SADS, CAS, CAPA, IOW, DAWBA |- | All of U.S.A.<ref name="AvenevoliEtAl2015">{{cite journal|last1=Avenevoli|first1=S|last2=Swendsen|first2=J|last3=He|first3=JP|last4=Burstein|first4=M|last5=Merikangas|first5=KR|date=January 2015|title=Major depression in the national comorbidity survey-adolescent supplement: prevalence, correlates, and treatment.|journal=Journal of the American Academy of Child and Adolescent Psychiatry|volume=54|issue=1|pages=37-44.e2|pmid=25524788}}</ref> | National Comorbidity Survey-Adolescent Supplement (NCS-A) (2015)|| 11.0% || CIDI |- | American middle school<ref name="RobertsEtAl1997">{{cite journal|last1=Roberts|first1=RE|last2=Roberts|first2=CR|last3=Chen|first3=YR|date=February 1997|title=Ethnocultural differences in prevalence of adolescent depression.|journal=American journal of community psychology|volume=25|issue=1|pages=95-110|pmid=9231998}}</ref> | Ethnically diverse sample of middle school (Grades 6-8) students (1997)|| 1.9% (Chinese descent) to 6.6% (Mexican descent) || DISC |- |American public school<ref>{{Cite journal|last=Goyal|first=Sunil|last2=Srivastava|first2=Kalpana|last3=Bansal|first3=Vivek|date=2009-01-01|title=Study of prevalence of depression in adolescent students of a public school|url=http://www.industrialpsychiatry.org/text.asp?2009/18/1/43/57859|journal=Industrial Psychiatry Journal|language=en|volume=18|issue=1|doi=10.4103/0972-6748.57859}}</ref> |High school freshman in public school (2009) |18.4% |GHQ-12 and BDI |- |Cross-sectional sample of socioeconomic groups<ref>{{Cite journal|last=Mojtabai|first=Ramin|last2=Olfson|first2=Mark|last3=Han|first3=Beth|date=2016-12-01|title=National Trends in the Prevalence and Treatment of Depression in Adolescents and Young Adults|url=http://pediatrics.aappublications.org/content/138/6/e20161878|journal=Pediatrics|language=en|volume=138|issue=6|pages=e20161878|doi=10.1542/peds.2016-1878|issn=0031-4005|pmid=27940701}}</ref> |Adolescents 12-17 (2016) |increased from 8.7% in 2005 to 11.3% in 2014 |NCS-Replication |- |Epidemiological (CDC)<ref name=":02">{{Cite journal|last=Perou|first=Ruth|last2=Bitsko|first2=Rebecca H.|last3=Blumberg|first3=Stephen J.|last4=Pastor|first4=Patricia|last5=Ghandour|first5=Reem M.|last6=Gfroerer|first6=Joseph C.|last7=Hedden|first7=Sarra L.|last8=Crosby|first8=Alex E.|last9=Visser|first9=Susanna N.|date=2013-05-17|title=Mental health surveillance among children--United States, 2005-2011|url=https://www.ncbi.nlm.nih.gov/pubmed/23677130|journal=MMWR supplements|volume=62|issue=2|pages=1–35|issn=2380-8942|pmid=23677130}}</ref> | |2.1% | |} ^p:Parent interviewed as component of diagnostic assessment; ^y:youth interviewed as part of diagnostic assessment. ==[[Evidence based assessment/Prediction phase|'''Prediction phase''']]== === Psychometric properties of screening instruments for adolescent depression === The following section contains a list of screening and diagnostic instruments for adolescent depression. The section includes administration information, psychometric data, and PDFs or links to the screenings. * Screenings are used as part of the [[Evidence based assessment/Prediction phase|prediction phase]] of assessment; for more information on interpretation of this data, or how screenings fit in to the assessment process, [[Evidence based assessment/Prediction phase|'''click here''']]. * '''''For a list of more broadly-reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Common_screening_instruments click here.]''''' {| class="wikitable sortable" border="1" ! colspan="5" |Screening instruments for adolescent depression |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time !Where to Access |- |[[wikipedia:The_Mood_and_Feelings_Questionnaire|Mood and Feelings Questionnaire]] (MFQ)<ref>{{Cite web|url=http://www.cebc4cw.org/assessment-tool/mood-and-feelings-questionnaire-mfq/|title=CEBC » Assessment Tool › Mood And Feelings Questionnaire Mfq|website=www.cebc4cw.org|language=en|accessdate=2018-03-01}}</ref> | Self-report | 6-17 | 5-10 minutes | * [https://mfr.osf.io/render?url=https://osf.io/enx4b/?action=download%26mode=render Child Self Report - long version] * [https://mfr.osf.io/render?url=https://osf.io/mcg5w/?action=download%26mode=render Child Self Report - short version] * [https://mfr.osf.io/render?url=https://osf.io/cw27p/?action=download%26mode=render Parent Report on Child - long version] * [https://mfr.osf.io/render?url=https://osf.io/kybr4/?action=download%26mode=render Parent Report on Child - short version] * [https://mfr.osf.io/render?url=https://osf.io/sb5xw/?action=download%26mode=render Adult Self-Report - long version] * [https://mfr.osf.io/render?url=https://osf.io/xa7v6/?action=download%26mode=render Adult Self-Report - short version] |- |Revised Children’s Anxiety and Depression Scale (RCADS) <ref>{{Cite journal|last=Ebesutani|first=Chad|last2=Reise|first2=Steven P.|last3=Chorpita|first3=Bruce F.|last4=Ale|first4=Chelsea|last5=Regan|first5=Jennifer|last6=Young|first6=John|last7=Higa-McMillan|first7=Charmaine|last8=Weisz|first8=John R.|date=2012|title=The Revised Child Anxiety and Depression Scale-Short Version: Scale reduction via exploratory bifactor modeling of the broad anxiety factor.|url=http://doi.apa.org/getdoi.cfm?doi=10.1037/a0027283|journal=Psychological Assessment|language=en|volume=24|issue=4|pages=833–845|doi=10.1037/a0027283|issn=1939-134X}}</ref> |Questionnaire (Child) |6-18 |12 minutes | *[https://www.corc.uk.net/outcome-experience-measures/revised-childrens-anxiety-and-depression-scale-rcads/ RCADS homepage] '''PDFs for RCADS''' *[https://mfr.osf.io/render?url=https://osf.io/s3fu2/?action=download%26mode=render RCADS Child Self-reported (8-18 years)] *[https://mfr.osf.io/render?url=https://osf.io/fp9mk/?action=download%26mode=render RCADS Parent-reported] *[https://mfr.osf.io/render?url=https://osf.io/vy7ta/?action=download%26mode=render Child Scoring Aid] *[https://mfr.osf.io/render?url=https://osf.io/t4bz6/?action=download%26mode=render Parent Scoring Aid] '''Subscales''' *[https://mfr.osf.io/render?url=https://osf.io/za8we/?action=download%26mode=render Depression Self-reported] *[https://mfr.osf.io/render?url=https://osf.io/nezbk/?action=download%26mode=render Depression Parent-reported] '''Translations''' '''[https://mfr.osf.io/render?url=https://osf.io/qsjh9/?action=download%26mode=render User Guide]''' |} '''Note:''' Reliability and validity are included in the [[Evidence-based assessment/Depression in youth (assessment portfolio)/extended version|extended version]]. This table includes measures with Good or Excellent ratings. === Likelihood ratios and AUCs of screening measures for adolescent depression === {| class="wikitable sortable" |- ! Screening Measure (Primary Reference) !! AUC !! LR+ (score) !! LR- (score) !! Clinical Generalizability !Download |- |WHO-5 Well-being Index (WHO-5) [http://www.ncbi.nlm.nih.gov/pubmed/12830302 3]<ref name="BechEtAl2003">{{cite journal|last1=Bech|first1=P|last2=Olsen|first2=LR|last3=Kjoller|first3=M|last4=Rasmussen|first4=NK|title=Measuring well-being rather than the absence of distress symptoms: a comparison of the SF-36 Mental Health subscale and the WHO-Five Well-Being Scale.|journal=International journal of methods in psychiatric research|date=2003|volume=12|issue=2|pages=85-91|pmid=12830302}}</ref><ref name="ChristensenEtAl2015">{{cite journal|last1=Christensen|first1=KS|last2=Haugen|first2=W|last3=Sirpal|first3=MK|last4=Haavet|first4=OR|date=June 2015|title=Diagnosis of depressed young people--criterion validity of WHO-5 and HSCL-6 in Denmark and Norway.|journal=Family practice|volume=32|issue=3|pages=359-63|pmid=25800246}}</ref>|| .885 (N=294) || 4.40 (raw score 11+) || .15 (raw score ≤) || General sample of adolescents from Norway and Denmark |Link to free download: [https://osf.io/5wdrx/?view_only=8cbe7a43150d45dab590717e1e0313fb WHO-5] |- |Hopkins Symptom Checklist-10 (HSCL-10) (short version of SCL-90)<ref name="HaavetEtAl2007">{{cite journal|last1=Haavet|first1=OR|last2=Christensen|first2=KS|last3=Sirpal|first3=MK|last4=Haugen|first4=W|title=Diagnosis of depression among adolescents--a clinical validation study of key questions and questionnaire.|journal=BMC family practice|date=13 July 2007|volume=8|pages=41|pmid=17626643}}</ref> <ref name="HaavetEtAl2011">{{cite journal|last1=Haavet|first1=OR|last2=Sirpal|first2=MK|last3=Haugen|first3=W|last4=Christensen|first4=KS|date=April 2011|title=Diagnosis of depressed young people in primary health care--a validation of HSCL-10.|journal=Family practice|volume=28|issue=2|pages=233-7|pmid=20937663}}</ref>|| .8862 (N=294) || Boys: 7.2, Girls:3.2 (raw score 16/10) || Boys:.14, Girls:.17 (raw score ≤) || General sample of adolescents from Norway and Denmark |Link to site to contact: [https://hprt-cambridge.org/screening/hopkins-symptom-checklist/ HSCL-10] |- |6-item Kutcher Adolescent Depression Scale (KADS)<ref name="LeBlancEtAl2002">{{cite journal|last1=LeBlanc|first1=JC|last2=Almudevar|first2=A|last3=Brooks|first3=SJ|last4=Kutcher|first4=S|title=Screening for adolescent depression: comparison of the Kutcher Adolescent Depression Scale with the Beck depression inventory.|journal=Journal of child and adolescent psychopharmacology|date=2002|volume=12|issue=2|pages=113-26|pmid=12188980}}</ref> || .89 (N=309) || 3.17 (raw score 6) || .11 (raw score ≤) || |Link to free download: [https://osf.io/872ky/?view_only=90c7b0a0dabd4a75b8ac4e88a240d4c8 KADS] |- |} === Interpreting depression screening measure scores === For information on interpreting screening measure scores, click [[Evidence based assessment/Prediction phase#Interpreting screening measure scores|here.]] ==[[Evidence based assessment/Prescription phase|'''Prescription phase''']]== ===Gold standard diagnostic interviews=== * For a list of broad-reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews click here.] ===Diagnostic instruments specific for adolescent depression === {| class="wikitable" ! colspan="5" |Diagnostic instruments for adolescent depression |- !Measure !Format (Reporter) !Age Range !Administration Time !Where to Access |- |Child and Adolescent Psychiatric Assessment (CAPA)<ref>{{Cite journal|last=Angold|first=Adrian|last2=Costello|first2=E. Jane|date=2000-1|title=The Child and Adolescent Psychiatric Assessment (CAPA)|url=https://linkinghub.elsevier.com/retrieve/pii/S0890856709660998|journal=Journal of the American Academy of Child & Adolescent Psychiatry|language=en|volume=39|issue=1|pages=39–48|doi=10.1097/00004583-200001000-00015}}</ref> |Structured with the option for additional semi-structured inquires |9-18 |1 to 2 hours |Information available through the Developmental Epidemiology Center at Duke University [https://devepi.duhs.duke.edu/measures/the-child-and-adolescent-psychiatric-assessment-capa/ here] |- |Children’s Interview for Psychiatric Syndromes (ChIPS)<ref>{{Cite journal|last=Weller|first=Elizabeth B.|last2=Weller|first2=Ronald A.|last3=Fristad|first3=Mary A.|last4=Rooney|first4=Marijo Teare|last5=Schecter|first5=Jennifer|date=2000-1|title=Children's Interview for Psychiatric Syndromes (ChIPS)|url=https://linkinghub.elsevier.com/retrieve/pii/S0890856709661037|journal=Journal of the American Academy of Child & Adolescent Psychiatry|language=en|volume=39|issue=1|pages=76–84|doi=10.1097/00004583-200001000-00019}}</ref> |Structured with the option for additional semi-structured inquires |6-18 |20-50 minutes |Approximately $90; Available through various retailers such as APA [https://www.appi.org/Products/Interviewing/ChIPS-Childrens-Interview-for-Psychiatric-Syndrome here] |- |Diagnostic Individual Schedule for Children IV (DISC-IV)<ref>{{Cite journal|last=Shaffer|first=David|last2=Fisher|first2=Prudence|last3=Lucas|first3=Christopher P.|last4=Dulcan|first4=Mina K.|last5=Schwab-Stone|first5=Mary E.|date=2000-1|title=NIMH Diagnostic Interview Schedule for Children Version IV (NIMH DISC-IV): Description, Differences From Previous Versions, and Reliability of Some Common Diagnoses|url=https://linkinghub.elsevier.com/retrieve/pii/S0890856709660986|journal=Journal of the American Academy of Child & Adolescent Psychiatry|language=en|volume=39|issue=1|pages=28–38|doi=10.1097/00004583-200001000-00014}}</ref> |Structured |Parent Age: 6-17 Youth Age: 9-17 |1.5 to 2 hours |Interviewer manual download found [https://osf.io/3qmzw/?view_only=4958fe554c5a4baf83f1d7dc65cd3b25 here] |- |Mini-International Neuropsychiatric Interview for Children and Adolescents (MINI-KIDS) |Structured |Parent Age: 6-17 Youth Age: 13-17 |15-50 minutes |Free for download and use if specific criteria met. Can be downloaded [https://osf.io/3x8ew/?view_only=d7ac65e1ee0548cd88f6d3e612df240d here] |- |[[wikipedia:Patient_Health_Questionnaire|Patient Health Questionnaire 9 (PHQ-9)]] |Self Report |18+ |3-5 minutes |Free for download and use if specific criteria met. Can be downloaded [https://osf.io/ztdr8/?view_only=9f0a8a39b776442694209f31e065364e here] |} ===Severity scales for adolescent depression=== {| class="wikitable sortable" border="1" ! colspan="6" |Diagnostic instruments for adolescent d'''epression''' |- ! Measure !Informant ! Format (Reporter) ! Age Range ! Administration/ Completion Time !Free and Accessible Measures |- | Children's Depression Rating Scale - Revised (CDRS-R)<ref name=":4">{{Cite journal|last=Mayes|first=Taryn L.|last2=Bernstein|first2=Ira H.|last3=Haley|first3=Charlotte L.|last4=Kennard|first4=Betsy D.|last5=Emslie|first5=Graham J.|date=2010-12|title=Psychometric Properties of the Children's Depression Rating Scale–Revised in Adolescents|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3003451/|journal=Journal of Child and Adolescent Psychopharmacology|volume=20|issue=6|pages=513–516|doi=10.1089/cap.2010.0063|issn=1044-5463|pmc=PMC3003451|pmid=21186970}}</ref> |Parent | Structured Interview | 6-12 | 15-20 minutes | * Link to purchase [https://www.wpspublish.com/cdrs-r-childrens-depression-rating-scale-revised CDRS-R] |- |Reynolds Adolescent Depression Scale 2 (RADS-2) |Youth |Questionnaire |13-17 |5-10 minutes | * Link to purchase [https://www.parinc.com/products/pkey/348 RADS-2] |- |Revised Children's Anxiety and Depression Scale (RCADS) |Youth |Questionnaire |6-18 |12 minutes | * Link to download [https://osf.io/dkz6x/ RCADS] |} '''Note:''' Reliability and validity are included in the [[Evidence-based assessment/Depression in youth (assessment portfolio)/extended version|extended version]]. This table includes measures with Good or Excellent ratings. ==[[Evidence based assessment/Process phase|'''Process phase''']]== The following section contains a brief overview of treatment options for depression and a list of process and outcome measures for adolescent depression. The section includes benchmarks based on published norms and on mood samples for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the [[Evidence based assessment/Process phase|process phase]] of assessment. For more information on differences between process and outcome measures, see the page on the [[Evidence based assessment/Process phase|process phase of assessment]]. === Process measures === {{blockquotetop}} '''A. Mood and Energy Thermometer''' &nbsp;This is an improved and practical way of monitoring complex mood cycles and daily schedules. Given that some clinicians and patients may get confused about different 1 to 10 scales (e.g., a 10 could mean extreme depression or extreme mania or no depression), the Mood & Energy Thermometer improves the language in communicating (and monitoring) mood. Moreover, many children report their energy levels more accurately than their moods and therefore, energy levels are incorporated into the mood rating. The Mood & Energy Thermometer that was developed at Western Psychiatric Institute and Clinic (WPIC; and used in about 400 kids) rates mania and increased energy on a 1 to 10 scale, rates depression and tiredness on a -1 to -10 scale, and attempts to form a common language between patients, families, and clinicians. This scale also takes into account the amount of time spent depressed or manic; for example, -4 would mean “mild depression” and “mild tiredness” present ≥50% of the time, and -3 would mean “mild depression” and “mild tiredness” present < 50% of the time. The inclusion of measuring energy levels is consistent with the DSM-5, as energy level is now included in the DSM-5 as a main mood symptom criterion. Bipolar track patients (whether they experienced mania, depression, or mixed features) rated their (Q: is the parent rating his/her own moods/energy, or his/her child's?) mood and energy levels every day on this scale, and a master’s-level clinician met with them on a daily basis to help them better identify and record their mood symptoms, which has significant clinical value not only for treatment but also to prevent future episodes.<ref name=":3">{{Cite web|url=http://pediatricbipolar.pitt.edu/resources/instruments|title=Instruments {{!}} CABS {{!}} University of Pittsburgh|website=pediatricbipolar.pitt.edu|language=en|access-date=2018-05-31}}</ref> *[https://mfr.osf.io/render?url=https://osf.io/p4a8s/?action=download%26mode=render Mood and Energy Thermometer]<ref name=":3" /> *[https://mfr.osf.io/render?url=https://osf.io/upe2a/?action=download%26mode=render Mood and Energy Thermometer with Anger and Anxiety (with recording/monitoring card)]<ref name=":3" /> *[https://mfr.osf.io/render?url=https://osf.io/d2fge/?action=download%26mode=render Mood and Energy Thermometer with Anger and Anxiety - Simplified Version]<ref name=":3" /> '''B. Life Charts''' * To learn more about how life charts can be used with adolescent depression, [http://www.bipolarnews.org/Life%20Charting%20Description.htm see here] * [https://mfr.osf.io/render?url=https://osf.io/amq6k/?action=download%26mode=render Life Charts for Depression and Bipolar] {{blockquotebottom}} === Outcome and severity measures === * This table includes clinically significant benchmarks for '''Depression in Youth''' specific outcome measures * Information on how to interpret this table can be [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase found here]. * Additionally, these [[Evidence based assessment/Vignettes|vignettes]] might be helpful resources for understanding appropriate adaptations of outcome measures in practice. *''<u>For clinically significant change benchmarks for the CBCL, YSR, and TRF total, externalizing, internalizing, and attention benchmarks,</u>'' [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase&wteswitched=1#Clinically_significant_change_benchmarks_for_widely-used_outcome_measures see here.] {| class="wikitable sortable" border="1" | colspan="8" |'''Clinically significant change benchmarks with common instruments for adolescent depression''' |- | rowspan="1&quot;" style="text-align:center;font-size:130%;" | <b> Measure</b> | style="text-align:center;font-size:130%;" | <b>Subscale</b> | colspan="3" style="text-align:center;font-size:130%" width="300" | <b> Cut-off scores</b> | colspan="3" style="text-align:center;font-size:120%" | <b> Critical Change <br> (unstandardized scores)</b> |- | colspan="8" span style="font-size:110%; text-align:center;" | <b> Benchmarks Based on Published Norms </b> |- | colspan="2" | | style="text-align:center;font-size:110%" | <b> A</b> | style="text-align:center;font-size:110%" | <b> B</b> | style="text-align:center;font-size:110%" | <b> C</b> | style="text-align:center;font-size:110%" | <b> 95%</b> | style="text-align:center;font-size:110%" | <b> 90%</b> | style="text-align:center;font-size:110%" | <b> SE_difference</b> |- | rowspan="1" style="text-align:center;" | <b>Beck Depression Inventory-II</b> | style="text-align:center;"| | style="text-align:center;"| 4 | style="text-align:center;"| 22 | style="text-align:center;"| 15 | style="text-align:center;"| 9 | style="text-align:center;"| 8 | style="text-align:center;"| 4.8 |- | rowspan="1" style="text-align:center;" | <b> CBCL T-scores <br> (2001 Norms)</b> | style="text-align:right;" | <i> Total</i> | style="text-align:center;"| 49 | style="text-align:center;"| 70 | style="text-align:center;"| 58 | style="text-align:center;"| 5 | style="text-align:center;"| 4 | style="text-align:center;"| 2.4 |- | colspan="8" span style="font-size:110%; text-align:center;" | <b> Benchmarks Based on Mood Samples </b> |- | colspan="8" span style="font-size:100%; text-align:center;" | <b>[http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.198.9176&rep=rep1&type=pdf Gracious et al., 2002]<ref>{{cite journal|last1=Gracious|first1=BL|last2=Youngstrom|first2=EA|last3=Findling|first3=RL|last4=Calabrese|first4=JR.|title=Discriminative validity of a parent version of the Young Mania Rating Scale.|journal=Journal of American Academy of Child and Adolescent Psychiatry|date=November 2002|volume=41|issue=11|url=http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.198.9176&rep=rep1&type=pdf|accessdate=10 February 2014}}</ref></b> |- | rowspan="1" style="text-align:center;" | <b> Young Mania Rating Scale - Parent <br> (Full)</b> | style="text-align:center;"| n/a | style="text-align:center;"| 5.2 | style="text-align:center;"| 22.1 | style="text-align:center;"| 14.4 | style="text-align:center;"| 4.3 | style="text-align:center;"| 3.6 | style="text-align:center;"| 2 |- | rowspan="1" style="text-align:center;" | <b> Young Mania Rating Scale - Parent <br> (Brief)</b> | style="text-align:center;"| n/a | style="text-align:center;"| 6.8 | style="text-align:center;"| 27.4 | style="text-align:center;"| 17.5 | style="text-align:center;"| 5 | style="text-align:center;"| 4.2 | style="text-align:center;"| 2.5 |} '''4.1.b – Beck Depression Inventory- II, ages 13 and up'''<ref>'''Beck AT''', '''Steer RA''', '''Brown G'''. '''1996'''. ''Beck Depression Inventory''. San Antonio, TX: Harcourt Brace Educ. Meas. 2nd ed.</ref> '''4.1.c – KSADS Depression Rating Scale (Axelson, 2006)''' '''4.1.d – Children’s Depression Rating Scale-Revised (CDRS-R; Elva et al., 1996)''' '''4.1.e – Children’s Depression Inventory, ages 7-17 (CDI; Kovacs, 1992)''' === Treatment === For treatment of depression in youth, there are two main types of treatment: psychosocial interventions and medication. There has been significant controversy over the use of psychotropic medications with children and many studies have looked at the efficacy of medication, psychosocial interventions, or a combination of both. One of the most effective treatments for depression in youth is psychosocial interventions, which has been shown to lead to substantial reduction in symptoms for children and adolescents. A recent meta-analysis found that psychosocial interventions had an effect size of 1.14 and the reduction in depressive symptoms was maintained over time. On the other hand, the meta-analysis reported that pharmacological treatments did not lead to significant symptom reduction and had an effect size of 0.19.<ref>{{Cite journal|last=Michael|first=Kurt D|last2=Crowley|first2=Susan L|title=How effective are treatments for child and adolescent depression?|url=https://doi.org/10.1016/S0272-7358(01)00089-7|journal=Clinical Psychology Review|volume=22|issue=2|pages=247–269|doi=10.1016/s0272-7358(01)00089-7}}</ref> Additionally, medications such as Selective Serotonin Reuptake Inhibitors (SSRIs) have presented concerns about increasing suicidality and harmful behavior.<ref>{{Cite journal|last=Jane Garland|first=E.|last2=Kutcher|first2=Stan|last3=Virani|first3=Adil|last4=Elbe|first4=Dean|date=2016|title=Update on the Use of SSRIs and SNRIs with Children and Adolescents in Clinical Practice|url=https://www.ncbi.nlm.nih.gov/pubmed/27047551|journal=Journal of the Canadian Academy of Child and Adolescent Psychiatry = Journal De l'Academie Canadienne De Psychiatrie De L'enfant Et De L'adolescent|volume=25|issue=1|pages=4–10|issn=1719-8429|pmc=PMC4791100|pmid=27047551}}</ref> One of the most commonly used psychosocial interventions is cognitive behavioral therapy, which consists of individual or group sessions in which the provider helps the client address cognitive distortions and maladaptive thinking patterns that contribute to the maintenance of depressive thoughts.<ref>{{Cite journal|last=Driessen|first=Ellen|last2=Hollon|first2=Steven D.|title=Cognitive Behavioral Therapy for Mood Disorders: Efficacy, Moderators and Mediators|url=http://linkinghub.elsevier.com/retrieve/pii/S0193953X1000047X|journal=Psychiatric Clinics of North America|volume=33|issue=3|pages=537–555|doi=10.1016/j.psc.2010.04.005}}</ref> * Please refer to the page on adolescent [https://www.aacap.org/AACAP/Families_Youth/Resource_Centers/AACAP/Families_and_Youth/Resource_Centers/Depression_Resource_Center/Depression_Resource_Center.aspx depression] for more information on available treatment for adolescent depression or go to [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/sadness-hopelessness-and-depression/ Effective Child Therapy] for a curated resource on effective treatments for adolescent depression. =='''External Resources'''== # [http://apps.who.int/classifications/icd10/browse/2010/en#/F33 ICD-10 diagnostic criteria] # [https://en.wikiversity.org/w/index.php?title=Helping_Give_Away_Psychological_Science/Resources/Annotated_List_of_Where_and_How_to_Find_a_Therapist&wteswitched=1#Other_low-cost_options Find-a-Therapist] (a curated list of find-a-therapist websites where you can find a provider) # [https://www.nimh.nih.gov/health/publications/teen-depression/index.shtml NIMH] (information about adolescent depression) # [https://www.hopkinsmedicine.org/psychiatry/specialty_areas/moods/ADAP/docs/ADAP-Booklet_FINAL.pdf John's Hopkins Resource Guide] (a guide about adolescent depression, treatment, and more) # OMIM (Online Mendelian Inheritance in Man) ## [https://www.omim.org/entry/608516 608516] ## [https://www.omim.org/entry/608520 608520] ## [https://www.omim.org/entry/608691 608691] # [https://emedicine.medscape.com/article/286759-overview eMedicine entry for adult depression] #[http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/sadness-hopelessness-and-depression/ Effective Child Therapy] ##Effective Child Therapy is a website sponsored by Division 53 of the American Psychological Association (APA), or The [https://sccap53.org Society of Clinical Child and Adolescent Psychology] (SCCAP), in collaboration with the Association for Behavioral and Cognitive Therapies (ABCT). Use for information on symptoms and available treatments. == '''References''' == {{collapse top|References|expand=yes}} {{Reflist|30em}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] {{collapse bottom}} t6y9kapmcwae5zk0gbfxv9pa3t0pppt 2419300 2419197 2022-08-26T05:26:02Z Ardenguo 2944162 /* Diagnostic instruments specific for adolescent depression */ added a "Note: Reliability and validity are included in the extended version. This table includes measures with Good or Excellent ratings." wikitext text/x-wiki <noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{medical disclaimer}} {{:{{BASEPAGENAME}}/Sidebar}} ==[[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio"?''']]== For background information on what assessment portfolios are, click the link in the heading above. Want even '''more''' information about this topic? There's an extended version of this page [[Evidence-based assessment/Depression in youth (assessment portfolio)/extended version|here]]. ==[[Evidence based assessment/Preparation phase|'''Preparation phase''']]== ===Diagnostic criteria for depression in youth === {{blockquotetop}}'''ICD-11 Diagnostic Criteria''' *Depressive Disorders **Depressive disorders are characterized by depressive mood (e.g., sad, irritable, empty) or loss of pleasure accompanied by other cognitive, behavioural, or neurovegetative symptoms that significantly affect the individual’s ability to function. A depressive disorder should not be diagnosed in individuals who have ever experienced a manic, mixed or hypomanic episode, which would indicate the presence of a bipolar disorder. *Single Episode Depressive Disorder **Single episode depressive disorder is characterized by the presence or history of one depressive episode when there is no history of prior depressive episodes. A depressive episode is characterized by a period of almost daily depressed mood or diminished interest in activities lasting at least two weeks accompanied by other symptoms such as difficulty concentrating, feelings of worthlessness or excessive or inappropriate guilt, hopelessness, recurrent thoughts of death or suicide, changes in appetite or sleep, psychomotor agitation or retardation, and reduced energy or fatigue. There have never been any prior manic, hypomanic, or mixed episodes, which would indicate the presence of a bipolar disorder. ***Note: The ICD-11 lists 10 additional subcategories of single episode depressive disorder. They can be found [https://icd.who.int/browse11/l-m/en#/http%3a%2f%2fid.who.int%2ficd%2fentity%2f578635574 here]. *Recurrent Depressive Disorder **Recurrent depressive disorder is characterized by a history or at least two depressive episodes separated by at least several months without significant mood disturbance. A depressive episode is characterized by a period of almost daily depressed mood or diminished interest in activities lasting at least two weeks accompanied by other symptoms such as difficulty concentrating, feelings of worthlessness or excessive or inappropriate guilt, hopelessness, recurrent thoughts of death or suicide, changes in appetite or sleep, psychomotor agitation or retardation, and reduced energy or fatigue. There have never been any prior manic, hypomanic, or mixed episodes, which would indicate the presence of a Bipolar disorder. ***Note: The ICD-11 lists 10 additional subcategories of recurrent depressive disorder. They can be found [https://icd.who.int/browse11/l-m/en#/http%3a%2f%2fid.who.int%2ficd%2fentity%2f1194756772 here]. *Dysthymic Disorder **Dysthymic disorder is characterized by a persistent depressive mood (i.e., lasting 2 years or more), for most of the day, for more days than not. In children and adolescents depressed mood can manifest as pervasive irritability.The depressed mood is accompanied by additional symptoms such as markedly diminished interest or pleasure in activities, reduced concentration and attention or indecisiveness, low self-worth or excessive or inappropriate guilt, hopelessness about the future, disturbed sleep or increased sleep, diminished or increased appetite, or low energy or fatigue. During the first 2 years of the disorder, there has never been a 2-week period during which the number and duration of symptoms were sufficient to meet the diagnostic requirements for a Depressive Episode. There is no history of Manic, Mixed, or Hypomanic Episodes. *Mixed Depressive and Anxiety Disorder **Mixed depressive and anxiety disorder is characterized by symptoms of both anxiety and depression more days than not for a period of two weeks or more. Neither set of symptoms, considered separately, is sufficiently severe, numerous, or persistent to justify a diagnosis of a depressive episode, dysthymia or an anxiety and fear-related disorder. Depressed mood or diminished interest in activities must be present accompanied by additional depressive symptoms as well as multiple symptoms of anxiety. The symptoms result in significant distress or significant impairment in personal, family, social, educational, occupational or other important areas of functioning. There have never been any prior manic, hypomanic, or mixed episodes, which would indicate the presence of a bipolar disorder. # ==== Changes in DSM-5 ==== * The diagnostic criteria for depressive disorders changed slightly from [[DSM-IV]] to [[w:Diagnostic_and_Statistical_Manual_of_Mental_Disorders#DSM-IV-TR_.282000.29|DSM-5-TR]]. Summaries are available [https://psychiatry.org/psychiatrists/practice/dsm/updates-to-dsm/updates-to-dsm-5-tr-criteria-text here] and [[w:DSM-5|here]]. {{blockquotebottom}} ===Base rates of adolescent depression in different clinical settings=== This section describes the demographic setting of the population(s) sampled, base rates of diagnosis, country/region sampled, and the diagnostic method that was used. Using this information, clinicians will be able to anchor the rates of adolescent depression that they are likely to see in their clinical practices. * '''''To find prevalence rates across multiple disorders,''''' [[Evidence based assessment/Preparation phase#Base rates for transdiagnostic comparison|click here.]] {| class="wikitable" |- ! Demography ! Setting !! Base Rate !! Diagnostic Method |- | French general practitioner network<ref>{{Cite journal|last=Mathet|first=F.|last2=Martin-Guehl|first2=C.|last3=Maurice-Tison|first3=S.|last4=Bouvard|first4=M.-P.|date=2003-09|title=[Prevalence of depressive disorders in children and adolescents attending primary care. A survey with the Aquitaine Sentinelle Network]|url=https://pubmed.ncbi.nlm.nih.gov/14615688|journal=L'Encephale|volume=29|issue=5|pages=391–400|issn=0013-7006|pmid=14615688}}</ref> | Children and adolescents attending primary care (2002) || 5.0% || CES-D, CBCL, Kiddie Schedule for Affective Disorders and Schizophrenia - Present and Lifetime Version (KSADS-PL) ^y |- | All of U.S.A.<ref name=":0">{{Cite journal|last=Merikangas|first=Kathleen Ries|last2=He|first2=Jian-Ping|last3=Burstein|first3=Marcy|last4=Swanson|first4=Sonja A.|last5=Avenevoli|first5=Shelli|last6=Cui|first6=Lihong|last7=Benjet|first7=Corina|last8=Georgiades|first8=Katholiki|last9=Swendsen|first9=Joel|date=2010-10|title=Lifetime prevalence of mental disorders in U.S. adolescents: results from the National Comorbidity Survey Replication--Adolescent Supplement (NCS-A)|url=https://pubmed.ncbi.nlm.nih.gov/20855043|journal=Journal of the American Academy of Child and Adolescent Psychiatry|volume=49|issue=10|pages=980–989|doi=10.1016/j.jaac.2010.05.017|issn=1527-5418|pmc=2946114|pmid=20855043}}</ref> | National Comorbidity Survey-Adolescent (ages 13-18) (2010) || 6.9%-15.4% || National Comorbidity Survey-Adolescent (NCS-A) Interview Schedule ^{p, y} |- | North Carolina<ref>{{Cite journal|last=Costello|first=E. J.|last2=Farmer|first2=E. M.|last3=Angold|first3=A.|last4=Burns|first4=B. J.|last5=Erkanli|first5=A.|date=1997-05|title=Psychiatric disorders among American Indian and white youth in Appalachia: the Great Smoky Mountains Study|url=https://pubmed.ncbi.nlm.nih.gov/9184514|journal=American Journal of Public Health|volume=87|issue=5|pages=827–832|doi=10.2105/ajph.87.5.827|issn=0090-0036|pmc=1381058|pmid=9184514}}</ref><ref>{{Cite journal|last=Angold|first=A.|last2=Costello|first2=E. J.|date=2000-01|title=The Child and Adolescent Psychiatric Assessment (CAPA)|url=https://pubmed.ncbi.nlm.nih.gov/10638066|journal=Journal of the American Academy of Child and Adolescent Psychiatry|volume=39|issue=1|pages=39–48|doi=10.1097/00004583-200001000-00015|issn=0890-8567|pmid=10638066}}</ref> | Great Smoky Mountains Study: Community Sample (ages 9-13) (1997)|| .03-1.45% || CAPA = Child and Adolescent Psychiatric Assessment |- | All of U.S.A. | Acute psychiatric hospitalizations in 2009-2010 children (under the age of 15) (Blader & Carlson, 2010) || 13% || Centers for Disease Control survey of discharge diagnoses |- | Northwestern U.S.A. high school<ref name="LewinsohnEtAl1993">{{cite journal|last1=Lewinsohn|first1=PM|last2=Hops|first2=H|last3=Roberts|first3=RE|last4=Seeley|first4=JR|last5=Andrews|first5=JA|date=February 1993|title=Adolescent psychopathology: I. Prevalence and incidence of depression and other DSM-III-R disorders in high school students.|journal=Journal of abnormal psychology|volume=102|issue=1|pages=133-44|pmid=8436689}}</ref> | High school students (1993)|| 9.6% || KSADS |- | All of U.S.A.<ref name=":0" /> | Gender differences, males and females, respectively (2010)|| 7.5%-15% || NCS-A Interview Schedule ^{p, y} |- | Varied<ref name="CostelloEtAl2006">{{cite journal|last1=Costello|first1=EJ|last2=Erkanli|first2=A|last3=Angold|first3=A|date=December 2006|title=Is there an epidemic of child or adolescent depression?|journal=Journal of child psychology and psychiatry, and allied disciplines|volume=47|issue=12|pages=1263-71|pmid=17176381}}</ref> | Meta-analysis, adolescents 13 to 18 years (2006)|| 5.7% || DISC, CIDI, SDI, K-SADS, CAS, CAPA, IOW, DAWBA |- | All of U.S.A.<ref name="AvenevoliEtAl2015">{{cite journal|last1=Avenevoli|first1=S|last2=Swendsen|first2=J|last3=He|first3=JP|last4=Burstein|first4=M|last5=Merikangas|first5=KR|date=January 2015|title=Major depression in the national comorbidity survey-adolescent supplement: prevalence, correlates, and treatment.|journal=Journal of the American Academy of Child and Adolescent Psychiatry|volume=54|issue=1|pages=37-44.e2|pmid=25524788}}</ref> | National Comorbidity Survey-Adolescent Supplement (NCS-A) (2015)|| 11.0% || CIDI |- | American middle school<ref name="RobertsEtAl1997">{{cite journal|last1=Roberts|first1=RE|last2=Roberts|first2=CR|last3=Chen|first3=YR|date=February 1997|title=Ethnocultural differences in prevalence of adolescent depression.|journal=American journal of community psychology|volume=25|issue=1|pages=95-110|pmid=9231998}}</ref> | Ethnically diverse sample of middle school (Grades 6-8) students (1997)|| 1.9% (Chinese descent) to 6.6% (Mexican descent) || DISC |- |American public school<ref>{{Cite journal|last=Goyal|first=Sunil|last2=Srivastava|first2=Kalpana|last3=Bansal|first3=Vivek|date=2009-01-01|title=Study of prevalence of depression in adolescent students of a public school|url=http://www.industrialpsychiatry.org/text.asp?2009/18/1/43/57859|journal=Industrial Psychiatry Journal|language=en|volume=18|issue=1|doi=10.4103/0972-6748.57859}}</ref> |High school freshman in public school (2009) |18.4% |GHQ-12 and BDI |- |Cross-sectional sample of socioeconomic groups<ref>{{Cite journal|last=Mojtabai|first=Ramin|last2=Olfson|first2=Mark|last3=Han|first3=Beth|date=2016-12-01|title=National Trends in the Prevalence and Treatment of Depression in Adolescents and Young Adults|url=http://pediatrics.aappublications.org/content/138/6/e20161878|journal=Pediatrics|language=en|volume=138|issue=6|pages=e20161878|doi=10.1542/peds.2016-1878|issn=0031-4005|pmid=27940701}}</ref> |Adolescents 12-17 (2016) |increased from 8.7% in 2005 to 11.3% in 2014 |NCS-Replication |- |Epidemiological (CDC)<ref name=":02">{{Cite journal|last=Perou|first=Ruth|last2=Bitsko|first2=Rebecca H.|last3=Blumberg|first3=Stephen J.|last4=Pastor|first4=Patricia|last5=Ghandour|first5=Reem M.|last6=Gfroerer|first6=Joseph C.|last7=Hedden|first7=Sarra L.|last8=Crosby|first8=Alex E.|last9=Visser|first9=Susanna N.|date=2013-05-17|title=Mental health surveillance among children--United States, 2005-2011|url=https://www.ncbi.nlm.nih.gov/pubmed/23677130|journal=MMWR supplements|volume=62|issue=2|pages=1–35|issn=2380-8942|pmid=23677130}}</ref> | |2.1% | |} ^p:Parent interviewed as component of diagnostic assessment; ^y:youth interviewed as part of diagnostic assessment. ==[[Evidence based assessment/Prediction phase|'''Prediction phase''']]== === Psychometric properties of screening instruments for adolescent depression === The following section contains a list of screening and diagnostic instruments for adolescent depression. The section includes administration information, psychometric data, and PDFs or links to the screenings. * Screenings are used as part of the [[Evidence based assessment/Prediction phase|prediction phase]] of assessment; for more information on interpretation of this data, or how screenings fit in to the assessment process, [[Evidence based assessment/Prediction phase|'''click here''']]. * '''''For a list of more broadly-reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Common_screening_instruments click here.]''''' {| class="wikitable sortable" border="1" ! colspan="5" |Screening instruments for adolescent depression |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time !Where to Access |- |[[wikipedia:The_Mood_and_Feelings_Questionnaire|Mood and Feelings Questionnaire]] (MFQ)<ref>{{Cite web|url=http://www.cebc4cw.org/assessment-tool/mood-and-feelings-questionnaire-mfq/|title=CEBC » Assessment Tool › Mood And Feelings Questionnaire Mfq|website=www.cebc4cw.org|language=en|accessdate=2018-03-01}}</ref> | Self-report | 6-17 | 5-10 minutes | * [https://mfr.osf.io/render?url=https://osf.io/enx4b/?action=download%26mode=render Child Self Report - long version] * [https://mfr.osf.io/render?url=https://osf.io/mcg5w/?action=download%26mode=render Child Self Report - short version] * [https://mfr.osf.io/render?url=https://osf.io/cw27p/?action=download%26mode=render Parent Report on Child - long version] * [https://mfr.osf.io/render?url=https://osf.io/kybr4/?action=download%26mode=render Parent Report on Child - short version] * [https://mfr.osf.io/render?url=https://osf.io/sb5xw/?action=download%26mode=render Adult Self-Report - long version] * [https://mfr.osf.io/render?url=https://osf.io/xa7v6/?action=download%26mode=render Adult Self-Report - short version] |- |Revised Children’s Anxiety and Depression Scale (RCADS) <ref>{{Cite journal|last=Ebesutani|first=Chad|last2=Reise|first2=Steven P.|last3=Chorpita|first3=Bruce F.|last4=Ale|first4=Chelsea|last5=Regan|first5=Jennifer|last6=Young|first6=John|last7=Higa-McMillan|first7=Charmaine|last8=Weisz|first8=John R.|date=2012|title=The Revised Child Anxiety and Depression Scale-Short Version: Scale reduction via exploratory bifactor modeling of the broad anxiety factor.|url=http://doi.apa.org/getdoi.cfm?doi=10.1037/a0027283|journal=Psychological Assessment|language=en|volume=24|issue=4|pages=833–845|doi=10.1037/a0027283|issn=1939-134X}}</ref> |Questionnaire (Child) |6-18 |12 minutes | *[https://www.corc.uk.net/outcome-experience-measures/revised-childrens-anxiety-and-depression-scale-rcads/ RCADS homepage] '''PDFs for RCADS''' *[https://mfr.osf.io/render?url=https://osf.io/s3fu2/?action=download%26mode=render RCADS Child Self-reported (8-18 years)] *[https://mfr.osf.io/render?url=https://osf.io/fp9mk/?action=download%26mode=render RCADS Parent-reported] *[https://mfr.osf.io/render?url=https://osf.io/vy7ta/?action=download%26mode=render Child Scoring Aid] *[https://mfr.osf.io/render?url=https://osf.io/t4bz6/?action=download%26mode=render Parent Scoring Aid] '''Subscales''' *[https://mfr.osf.io/render?url=https://osf.io/za8we/?action=download%26mode=render Depression Self-reported] *[https://mfr.osf.io/render?url=https://osf.io/nezbk/?action=download%26mode=render Depression Parent-reported] '''Translations''' '''[https://mfr.osf.io/render?url=https://osf.io/qsjh9/?action=download%26mode=render User Guide]''' |} '''Note:''' Reliability and validity are included in the [[Evidence-based assessment/Depression in youth (assessment portfolio)/extended version|extended version]]. This table includes measures with Good or Excellent ratings. === Likelihood ratios and AUCs of screening measures for adolescent depression === {| class="wikitable sortable" |- ! Screening Measure (Primary Reference) !! AUC !! LR+ (score) !! LR- (score) !! Clinical Generalizability !Download |- |WHO-5 Well-being Index (WHO-5) [http://www.ncbi.nlm.nih.gov/pubmed/12830302 3]<ref name="BechEtAl2003">{{cite journal|last1=Bech|first1=P|last2=Olsen|first2=LR|last3=Kjoller|first3=M|last4=Rasmussen|first4=NK|title=Measuring well-being rather than the absence of distress symptoms: a comparison of the SF-36 Mental Health subscale and the WHO-Five Well-Being Scale.|journal=International journal of methods in psychiatric research|date=2003|volume=12|issue=2|pages=85-91|pmid=12830302}}</ref><ref name="ChristensenEtAl2015">{{cite journal|last1=Christensen|first1=KS|last2=Haugen|first2=W|last3=Sirpal|first3=MK|last4=Haavet|first4=OR|date=June 2015|title=Diagnosis of depressed young people--criterion validity of WHO-5 and HSCL-6 in Denmark and Norway.|journal=Family practice|volume=32|issue=3|pages=359-63|pmid=25800246}}</ref>|| .885 (N=294) || 4.40 (raw score 11+) || .15 (raw score ≤) || General sample of adolescents from Norway and Denmark |Link to free download: [https://osf.io/5wdrx/?view_only=8cbe7a43150d45dab590717e1e0313fb WHO-5] |- |Hopkins Symptom Checklist-10 (HSCL-10) (short version of SCL-90)<ref name="HaavetEtAl2007">{{cite journal|last1=Haavet|first1=OR|last2=Christensen|first2=KS|last3=Sirpal|first3=MK|last4=Haugen|first4=W|title=Diagnosis of depression among adolescents--a clinical validation study of key questions and questionnaire.|journal=BMC family practice|date=13 July 2007|volume=8|pages=41|pmid=17626643}}</ref> <ref name="HaavetEtAl2011">{{cite journal|last1=Haavet|first1=OR|last2=Sirpal|first2=MK|last3=Haugen|first3=W|last4=Christensen|first4=KS|date=April 2011|title=Diagnosis of depressed young people in primary health care--a validation of HSCL-10.|journal=Family practice|volume=28|issue=2|pages=233-7|pmid=20937663}}</ref>|| .8862 (N=294) || Boys: 7.2, Girls:3.2 (raw score 16/10) || Boys:.14, Girls:.17 (raw score ≤) || General sample of adolescents from Norway and Denmark |Link to site to contact: [https://hprt-cambridge.org/screening/hopkins-symptom-checklist/ HSCL-10] |- |6-item Kutcher Adolescent Depression Scale (KADS)<ref name="LeBlancEtAl2002">{{cite journal|last1=LeBlanc|first1=JC|last2=Almudevar|first2=A|last3=Brooks|first3=SJ|last4=Kutcher|first4=S|title=Screening for adolescent depression: comparison of the Kutcher Adolescent Depression Scale with the Beck depression inventory.|journal=Journal of child and adolescent psychopharmacology|date=2002|volume=12|issue=2|pages=113-26|pmid=12188980}}</ref> || .89 (N=309) || 3.17 (raw score 6) || .11 (raw score ≤) || |Link to free download: [https://osf.io/872ky/?view_only=90c7b0a0dabd4a75b8ac4e88a240d4c8 KADS] |- |} === Interpreting depression screening measure scores === For information on interpreting screening measure scores, click [[Evidence based assessment/Prediction phase#Interpreting screening measure scores|here.]] ==[[Evidence based assessment/Prescription phase|'''Prescription phase''']]== ===Gold standard diagnostic interviews=== * For a list of broad-reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews click here.] ===Diagnostic instruments specific for adolescent depression === {| class="wikitable" ! colspan="5" |Diagnostic instruments for adolescent depression |- !Measure !Format (Reporter) !Age Range !Administration Time !Where to Access |- |Child and Adolescent Psychiatric Assessment (CAPA)<ref>{{Cite journal|last=Angold|first=Adrian|last2=Costello|first2=E. Jane|date=2000-1|title=The Child and Adolescent Psychiatric Assessment (CAPA)|url=https://linkinghub.elsevier.com/retrieve/pii/S0890856709660998|journal=Journal of the American Academy of Child & Adolescent Psychiatry|language=en|volume=39|issue=1|pages=39–48|doi=10.1097/00004583-200001000-00015}}</ref> |Structured with the option for additional semi-structured inquires |9-18 |1 to 2 hours |Information available through the Developmental Epidemiology Center at Duke University [https://devepi.duhs.duke.edu/measures/the-child-and-adolescent-psychiatric-assessment-capa/ here] |- |Children’s Interview for Psychiatric Syndromes (ChIPS)<ref>{{Cite journal|last=Weller|first=Elizabeth B.|last2=Weller|first2=Ronald A.|last3=Fristad|first3=Mary A.|last4=Rooney|first4=Marijo Teare|last5=Schecter|first5=Jennifer|date=2000-1|title=Children's Interview for Psychiatric Syndromes (ChIPS)|url=https://linkinghub.elsevier.com/retrieve/pii/S0890856709661037|journal=Journal of the American Academy of Child & Adolescent Psychiatry|language=en|volume=39|issue=1|pages=76–84|doi=10.1097/00004583-200001000-00019}}</ref> |Structured with the option for additional semi-structured inquires |6-18 |20-50 minutes |Approximately $90; Available through various retailers such as APA [https://www.appi.org/Products/Interviewing/ChIPS-Childrens-Interview-for-Psychiatric-Syndrome here] |- |Diagnostic Individual Schedule for Children IV (DISC-IV)<ref>{{Cite journal|last=Shaffer|first=David|last2=Fisher|first2=Prudence|last3=Lucas|first3=Christopher P.|last4=Dulcan|first4=Mina K.|last5=Schwab-Stone|first5=Mary E.|date=2000-1|title=NIMH Diagnostic Interview Schedule for Children Version IV (NIMH DISC-IV): Description, Differences From Previous Versions, and Reliability of Some Common Diagnoses|url=https://linkinghub.elsevier.com/retrieve/pii/S0890856709660986|journal=Journal of the American Academy of Child & Adolescent Psychiatry|language=en|volume=39|issue=1|pages=28–38|doi=10.1097/00004583-200001000-00014}}</ref> |Structured |Parent Age: 6-17 Youth Age: 9-17 |1.5 to 2 hours |Interviewer manual download found [https://osf.io/3qmzw/?view_only=4958fe554c5a4baf83f1d7dc65cd3b25 here] |- |Mini-International Neuropsychiatric Interview for Children and Adolescents (MINI-KIDS) |Structured |Parent Age: 6-17 Youth Age: 13-17 |15-50 minutes |Free for download and use if specific criteria met. Can be downloaded [https://osf.io/3x8ew/?view_only=d7ac65e1ee0548cd88f6d3e612df240d here] |- |[[wikipedia:Patient_Health_Questionnaire|Patient Health Questionnaire 9 (PHQ-9)]] |Self Report |18+ |3-5 minutes |Free for download and use if specific criteria met. Can be downloaded [https://osf.io/ztdr8/?view_only=9f0a8a39b776442694209f31e065364e here] |} '''Note:''' Reliability and validity are included in the [[Evidence-based assessment/Depression in youth (assessment portfolio)/extended version|extended version]]. This table includes measures with Good or Excellent ratings. ===Severity scales for adolescent depression=== {| class="wikitable sortable" border="1" ! colspan="6" |Diagnostic instruments for adolescent d'''epression''' |- ! Measure !Informant ! Format (Reporter) ! Age Range ! Administration/ Completion Time !Free and Accessible Measures |- | Children's Depression Rating Scale - Revised (CDRS-R)<ref name=":4">{{Cite journal|last=Mayes|first=Taryn L.|last2=Bernstein|first2=Ira H.|last3=Haley|first3=Charlotte L.|last4=Kennard|first4=Betsy D.|last5=Emslie|first5=Graham J.|date=2010-12|title=Psychometric Properties of the Children's Depression Rating Scale–Revised in Adolescents|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3003451/|journal=Journal of Child and Adolescent Psychopharmacology|volume=20|issue=6|pages=513–516|doi=10.1089/cap.2010.0063|issn=1044-5463|pmc=PMC3003451|pmid=21186970}}</ref> |Parent | Structured Interview | 6-12 | 15-20 minutes | * Link to purchase [https://www.wpspublish.com/cdrs-r-childrens-depression-rating-scale-revised CDRS-R] |- |Reynolds Adolescent Depression Scale 2 (RADS-2) |Youth |Questionnaire |13-17 |5-10 minutes | * Link to purchase [https://www.parinc.com/products/pkey/348 RADS-2] |- |Revised Children's Anxiety and Depression Scale (RCADS) |Youth |Questionnaire |6-18 |12 minutes | * Link to download [https://osf.io/dkz6x/ RCADS] |} '''Note:''' Reliability and validity are included in the [[Evidence-based assessment/Depression in youth (assessment portfolio)/extended version|extended version]]. This table includes measures with Good or Excellent ratings. ==[[Evidence based assessment/Process phase|'''Process phase''']]== The following section contains a brief overview of treatment options for depression and a list of process and outcome measures for adolescent depression. The section includes benchmarks based on published norms and on mood samples for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the [[Evidence based assessment/Process phase|process phase]] of assessment. For more information on differences between process and outcome measures, see the page on the [[Evidence based assessment/Process phase|process phase of assessment]]. === Process measures === {{blockquotetop}} '''A. Mood and Energy Thermometer''' &nbsp;This is an improved and practical way of monitoring complex mood cycles and daily schedules. Given that some clinicians and patients may get confused about different 1 to 10 scales (e.g., a 10 could mean extreme depression or extreme mania or no depression), the Mood & Energy Thermometer improves the language in communicating (and monitoring) mood. Moreover, many children report their energy levels more accurately than their moods and therefore, energy levels are incorporated into the mood rating. The Mood & Energy Thermometer that was developed at Western Psychiatric Institute and Clinic (WPIC; and used in about 400 kids) rates mania and increased energy on a 1 to 10 scale, rates depression and tiredness on a -1 to -10 scale, and attempts to form a common language between patients, families, and clinicians. This scale also takes into account the amount of time spent depressed or manic; for example, -4 would mean “mild depression” and “mild tiredness” present ≥50% of the time, and -3 would mean “mild depression” and “mild tiredness” present < 50% of the time. The inclusion of measuring energy levels is consistent with the DSM-5, as energy level is now included in the DSM-5 as a main mood symptom criterion. Bipolar track patients (whether they experienced mania, depression, or mixed features) rated their (Q: is the parent rating his/her own moods/energy, or his/her child's?) mood and energy levels every day on this scale, and a master’s-level clinician met with them on a daily basis to help them better identify and record their mood symptoms, which has significant clinical value not only for treatment but also to prevent future episodes.<ref name=":3">{{Cite web|url=http://pediatricbipolar.pitt.edu/resources/instruments|title=Instruments {{!}} CABS {{!}} University of Pittsburgh|website=pediatricbipolar.pitt.edu|language=en|access-date=2018-05-31}}</ref> *[https://mfr.osf.io/render?url=https://osf.io/p4a8s/?action=download%26mode=render Mood and Energy Thermometer]<ref name=":3" /> *[https://mfr.osf.io/render?url=https://osf.io/upe2a/?action=download%26mode=render Mood and Energy Thermometer with Anger and Anxiety (with recording/monitoring card)]<ref name=":3" /> *[https://mfr.osf.io/render?url=https://osf.io/d2fge/?action=download%26mode=render Mood and Energy Thermometer with Anger and Anxiety - Simplified Version]<ref name=":3" /> '''B. Life Charts''' * To learn more about how life charts can be used with adolescent depression, [http://www.bipolarnews.org/Life%20Charting%20Description.htm see here] * [https://mfr.osf.io/render?url=https://osf.io/amq6k/?action=download%26mode=render Life Charts for Depression and Bipolar] {{blockquotebottom}} === Outcome and severity measures === * This table includes clinically significant benchmarks for '''Depression in Youth''' specific outcome measures * Information on how to interpret this table can be [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase found here]. * Additionally, these [[Evidence based assessment/Vignettes|vignettes]] might be helpful resources for understanding appropriate adaptations of outcome measures in practice. *''<u>For clinically significant change benchmarks for the CBCL, YSR, and TRF total, externalizing, internalizing, and attention benchmarks,</u>'' [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase&wteswitched=1#Clinically_significant_change_benchmarks_for_widely-used_outcome_measures see here.] {| class="wikitable sortable" border="1" | colspan="8" |'''Clinically significant change benchmarks with common instruments for adolescent depression''' |- | rowspan="1&quot;" style="text-align:center;font-size:130%;" | <b> Measure</b> | style="text-align:center;font-size:130%;" | <b>Subscale</b> | colspan="3" style="text-align:center;font-size:130%" width="300" | <b> Cut-off scores</b> | colspan="3" style="text-align:center;font-size:120%" | <b> Critical Change <br> (unstandardized scores)</b> |- | colspan="8" span style="font-size:110%; text-align:center;" | <b> Benchmarks Based on Published Norms </b> |- | colspan="2" | | style="text-align:center;font-size:110%" | <b> A</b> | style="text-align:center;font-size:110%" | <b> B</b> | style="text-align:center;font-size:110%" | <b> C</b> | style="text-align:center;font-size:110%" | <b> 95%</b> | style="text-align:center;font-size:110%" | <b> 90%</b> | style="text-align:center;font-size:110%" | <b> SE_difference</b> |- | rowspan="1" style="text-align:center;" | <b>Beck Depression Inventory-II</b> | style="text-align:center;"| | style="text-align:center;"| 4 | style="text-align:center;"| 22 | style="text-align:center;"| 15 | style="text-align:center;"| 9 | style="text-align:center;"| 8 | style="text-align:center;"| 4.8 |- | rowspan="1" style="text-align:center;" | <b> CBCL T-scores <br> (2001 Norms)</b> | style="text-align:right;" | <i> Total</i> | style="text-align:center;"| 49 | style="text-align:center;"| 70 | style="text-align:center;"| 58 | style="text-align:center;"| 5 | style="text-align:center;"| 4 | style="text-align:center;"| 2.4 |- | colspan="8" span style="font-size:110%; text-align:center;" | <b> Benchmarks Based on Mood Samples </b> |- | colspan="8" span style="font-size:100%; text-align:center;" | <b>[http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.198.9176&rep=rep1&type=pdf Gracious et al., 2002]<ref>{{cite journal|last1=Gracious|first1=BL|last2=Youngstrom|first2=EA|last3=Findling|first3=RL|last4=Calabrese|first4=JR.|title=Discriminative validity of a parent version of the Young Mania Rating Scale.|journal=Journal of American Academy of Child and Adolescent Psychiatry|date=November 2002|volume=41|issue=11|url=http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.198.9176&rep=rep1&type=pdf|accessdate=10 February 2014}}</ref></b> |- | rowspan="1" style="text-align:center;" | <b> Young Mania Rating Scale - Parent <br> (Full)</b> | style="text-align:center;"| n/a | style="text-align:center;"| 5.2 | style="text-align:center;"| 22.1 | style="text-align:center;"| 14.4 | style="text-align:center;"| 4.3 | style="text-align:center;"| 3.6 | style="text-align:center;"| 2 |- | rowspan="1" style="text-align:center;" | <b> Young Mania Rating Scale - Parent <br> (Brief)</b> | style="text-align:center;"| n/a | style="text-align:center;"| 6.8 | style="text-align:center;"| 27.4 | style="text-align:center;"| 17.5 | style="text-align:center;"| 5 | style="text-align:center;"| 4.2 | style="text-align:center;"| 2.5 |} '''4.1.b – Beck Depression Inventory- II, ages 13 and up'''<ref>'''Beck AT''', '''Steer RA''', '''Brown G'''. '''1996'''. ''Beck Depression Inventory''. San Antonio, TX: Harcourt Brace Educ. Meas. 2nd ed.</ref> '''4.1.c – KSADS Depression Rating Scale (Axelson, 2006)''' '''4.1.d – Children’s Depression Rating Scale-Revised (CDRS-R; Elva et al., 1996)''' '''4.1.e – Children’s Depression Inventory, ages 7-17 (CDI; Kovacs, 1992)''' === Treatment === For treatment of depression in youth, there are two main types of treatment: psychosocial interventions and medication. There has been significant controversy over the use of psychotropic medications with children and many studies have looked at the efficacy of medication, psychosocial interventions, or a combination of both. One of the most effective treatments for depression in youth is psychosocial interventions, which has been shown to lead to substantial reduction in symptoms for children and adolescents. A recent meta-analysis found that psychosocial interventions had an effect size of 1.14 and the reduction in depressive symptoms was maintained over time. On the other hand, the meta-analysis reported that pharmacological treatments did not lead to significant symptom reduction and had an effect size of 0.19.<ref>{{Cite journal|last=Michael|first=Kurt D|last2=Crowley|first2=Susan L|title=How effective are treatments for child and adolescent depression?|url=https://doi.org/10.1016/S0272-7358(01)00089-7|journal=Clinical Psychology Review|volume=22|issue=2|pages=247–269|doi=10.1016/s0272-7358(01)00089-7}}</ref> Additionally, medications such as Selective Serotonin Reuptake Inhibitors (SSRIs) have presented concerns about increasing suicidality and harmful behavior.<ref>{{Cite journal|last=Jane Garland|first=E.|last2=Kutcher|first2=Stan|last3=Virani|first3=Adil|last4=Elbe|first4=Dean|date=2016|title=Update on the Use of SSRIs and SNRIs with Children and Adolescents in Clinical Practice|url=https://www.ncbi.nlm.nih.gov/pubmed/27047551|journal=Journal of the Canadian Academy of Child and Adolescent Psychiatry = Journal De l'Academie Canadienne De Psychiatrie De L'enfant Et De L'adolescent|volume=25|issue=1|pages=4–10|issn=1719-8429|pmc=PMC4791100|pmid=27047551}}</ref> One of the most commonly used psychosocial interventions is cognitive behavioral therapy, which consists of individual or group sessions in which the provider helps the client address cognitive distortions and maladaptive thinking patterns that contribute to the maintenance of depressive thoughts.<ref>{{Cite journal|last=Driessen|first=Ellen|last2=Hollon|first2=Steven D.|title=Cognitive Behavioral Therapy for Mood Disorders: Efficacy, Moderators and Mediators|url=http://linkinghub.elsevier.com/retrieve/pii/S0193953X1000047X|journal=Psychiatric Clinics of North America|volume=33|issue=3|pages=537–555|doi=10.1016/j.psc.2010.04.005}}</ref> * Please refer to the page on adolescent [https://www.aacap.org/AACAP/Families_Youth/Resource_Centers/AACAP/Families_and_Youth/Resource_Centers/Depression_Resource_Center/Depression_Resource_Center.aspx depression] for more information on available treatment for adolescent depression or go to [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/sadness-hopelessness-and-depression/ Effective Child Therapy] for a curated resource on effective treatments for adolescent depression. =='''External Resources'''== # [http://apps.who.int/classifications/icd10/browse/2010/en#/F33 ICD-10 diagnostic criteria] # [https://en.wikiversity.org/w/index.php?title=Helping_Give_Away_Psychological_Science/Resources/Annotated_List_of_Where_and_How_to_Find_a_Therapist&wteswitched=1#Other_low-cost_options Find-a-Therapist] (a curated list of find-a-therapist websites where you can find a provider) # [https://www.nimh.nih.gov/health/publications/teen-depression/index.shtml NIMH] (information about adolescent depression) # [https://www.hopkinsmedicine.org/psychiatry/specialty_areas/moods/ADAP/docs/ADAP-Booklet_FINAL.pdf John's Hopkins Resource Guide] (a guide about adolescent depression, treatment, and more) # OMIM (Online Mendelian Inheritance in Man) ## [https://www.omim.org/entry/608516 608516] ## [https://www.omim.org/entry/608520 608520] ## [https://www.omim.org/entry/608691 608691] # [https://emedicine.medscape.com/article/286759-overview eMedicine entry for adult depression] #[http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/sadness-hopelessness-and-depression/ Effective Child Therapy] ##Effective Child Therapy is a website sponsored by Division 53 of the American Psychological Association (APA), or The [https://sccap53.org Society of Clinical Child and Adolescent Psychology] (SCCAP), in collaboration with the Association for Behavioral and Cognitive Therapies (ABCT). Use for information on symptoms and available treatments. == '''References''' == {{collapse top|References|expand=yes}} {{Reflist|30em}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] {{collapse bottom}} d23vn797wzc9ouxpv3605jh2qqulzm8 0 207101 2419105 2413863 2022-08-25T22:53:01Z Ardenguo 2944162 /* Recommended diagnostic interviews for autism spectrum disorder */ filled in some cells for administration time and age wikitext text/x-wiki <noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{medical disclaimer}} {{:{{BASEPAGENAME}}/Sidebar}} ==[[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio"?''']]== For background information on what assessment portfolios are, click the link in the heading above. Want even 'more' information about this topic? There's an extended version of this page [[Evidence-based assessment/Autism spectrum disorder (assessment portfolio)/extended version|here]]. == [[Evidence based assessment/Preparation phase|'''Preparation phase''']] == === Diagnostic criteria for autism spectrum disorder=== {{blockquotetop}} <big>'''ICD-11 Diagnostic Criteria''':</big> Autism spectrum disorder is characterized by persistent deficits in the ability to initiate and to sustain reciprocal social interaction and social communication, and by a range of restricted, repetitive, and inflexible patterns of behaviour and interests. The onset of the disorder occurs during the developmental period, typically in early childhood, but symptoms may not become fully manifest until later, when social demands exceed limited capacities. Deficits are sufficiently severe to cause impairment in personal, family, social, educational, occupational or other important areas of functioning and are usually a pervasive feature of the individual’s functioning observable in all settings, although they may vary according to social, educational, or other context. Individuals along the spectrum exhibit a full range of intellectual functioning and language abilities. Note: The ICD-11 contains seven subcategories of ASD that can be found in the ICD-11, [https://icd.who.int/browse11/l-m/en#/http%3a%2f%2fid.who.int%2ficd%2fentity%2f120443468 here]. <big>'''ASD encompasses these previous DSM-IV diagnoses''':</big> *Autistic disorder (autism) *Asperger’s disorder *Childhood disintegrative disorder *Pervasive developmental disorder not otherwise specified '''<big>ASD is characterized by:</big>''' # deficits in social communication and social interaction and # restricted repetitive behaviors, interests, and activities (RRBs). Because both components are required for diagnosis of ASD, social communication disorder is diagnosed if no RRBs are present. '''<big>Changes in DSM-5 Criteria</big>''' * The diagnostic criteria for ASD changed from [[DSM-IV]] to [[wikipedia:Diagnostic_and_Statistical_Manual_of_Mental_Disorders#DSM-IV-TR_.282000.29|DSM-5]]. Summaries are available [http://www.dsm5.org/Documents/changes%20from%20dsm-iv-tr%20to%20dsm-5.pdf here] and [[wikipedia:DSM-5|here]]. {{blockquotebottom}} ===Base rates of ASD in children and adolescents in different populations and clinical settings=== {| class="wikitable sortable" border="1" |- ! Demography ! Setting (Reference) ! Base Rate ! Diagnostic Method |- | 11 ADDM sites | Autism and Developmental Disabilities Monitoring (ADDM) Network (2014) - 8 year olds *** | 1.5% (1 per 68) | Diagnosis by doctor based on DSM-IV-TR criteria |- | Epidemiological: 43,283 household surveys | National Health Statistics Report (NHIS; 2014), 3-17 year olds<ref>{{cite journal|last1=Zablotsky|first1=B|last2=Black|first2=LI|last3=Maenner|first3=MJ|last4=Schieve|first4=LA|last5=Blumberg|first5=SJ|title=Estimated Prevalence of Autism and Other Developmental Disabilities Following Questionnaire Changes in the 2014 National Health Interview Survey.|journal=National health statistics reports|date=13 November 2015|issue=87|pages=1-20|pmid=26632847}}</ref> | 2.2% (1 per 45) | DSM-IV-TR |- | 11 ADDM sites: Male/Female Ratio | The Autism and Developmental Disabilities Monitoring (ADDM) Network (2014) – 8 year olds | 1 in 42 boys (2.4%), 1 in 189 girls (.05%) | DSM-IV-TR |- | Came from family registry for those who had children under 18 years old in United States | Interactive Autism Network (IAN): Individual Sibling Recurrence<ref>{{cite journal|last1=Constantino|first1=JN|last2=Zhang|first2=Y|last3=Frazier|first3=T|last4=Abbacchi|first4=AM|last5=Law|first5=P|title=Sibling recurrence and the genetic epidemiology of autism.|journal=The American journal of psychiatry|date=November 2010|volume=167|issue=11|pages=1349-56|pmid=20889652}}</ref> | ASD status occurred in an additional child in 10.9% of families | DSM-IV-TR |- | 11 ADDM sites (Race/ethnicity study) | The Autism and Developmental Disabilities Monitoring (ADDM) Network (2014) – 8 year olds Race/Ethnicity: * Non-Hispanic White * Non-Hispanic Black * Hispanic * Asian | * '''Non-Hispanic White:''' 1 in 63 (1.6%) * '''Non-Hispanic Black:''' 1 in 81 (1.2%) * '''Hispanic:''' 1 in 91 (1.1%) * '''Asian:''' 1 in 81 (1.2%) | DSM-IV-TR |- | | style="text-align:left" | The Autism and Developmental Disabilities Monitoring (ADDM) Network (2010) – 8 year olds <br> :Race/Ethnicity<br> ::- Non-Hispanic White<br> - Non-Hispanic Black<br> - Hispanic<br> - Asian<br> - Other | style="text-align:left" | <br><br> <br>60.3%<br>15.7%<br>17.2%<br>3.3%<br>3.5% | DSM-IV-TR |- | Male/Female Ratio | Epidemiological study: Review of 43 studies<ref>{{Cite journal|last=Kogan|first=M. D.|last2=Blumberg|first2=S. J.|last3=Schieve|first3=L. A.|last4=Boyle|first4=C. A.|last5=Perrin|first5=J. M.|last6=Ghandour|first6=R. M.|last7=Singh|first7=G. K.|last8=Strickland|first8=B. B.|last9=Trevathan|first9=E.|date=2009-11-01|title=Prevalence of Parent-Reported Diagnosis of Autism Spectrum Disorder Among Children in the US, 2007|url=http://pediatrics.aappublications.org/cgi/doi/10.1542/peds.2009-1522|journal=PEDIATRICS|language=en|volume=124|issue=5|pages=1395–1403|doi=10.1542/peds.2009-1522|issn=0031-4005}}</ref> | 4.2% (4.2 male:1 female) | DSM-IV/Rating Scales/Clinical |} ==[[Evidence based assessment/Prediction phase|'''Prediction phase''']]== === Psychometric properties of screening instruments for autism spectrum disorder === The following section contains a list of screening and diagnostic instruments for autism. The section includes administration information, psychometric data, and PDFs or links to the screenings. * Screenings are used as part of the [[Evidence based assessment/Prediction phase|prediction phase]] of assessment; for more information on interpretation of this data, or how screenings fit in to the assessment process, click [[Evidence based assessment/Prediction phase|here.]] * '''''For a list of more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Common_screening_instruments click here.]''''' {| class="wikitable sortable" |- ! Measure (Wikipedia Link) !Format (Reporter) !Age Range !Administration/ Completion Time !Where to Access |- |[[Evidence based assessment/Instruments/Modified checklist for autism in toddlers|Modified Checklist for Autism in Toddlers (M-CHAT)]] |Questionnaire (Parent report) |18-30 months |5-10 minutes | * [https://mfr.osf.io/render?url=https://osf.io/utmxg/?action=download%26mode=render Free printable PDF MCHAT] *[https://www.autismspeaks.org/screen-your-child Free Online MCHAT] |- |[[wikipedia:Autism-spectrum_quotient|Autism Spectrum Quotient (AQ)]] |Questionnaire |16 years and up |10-15 minutes | * [https://psychology-tools.com/autism-spectrum-quotient/ Online version with scoring] * [https://mfr.osf.io/render?url=https://osf.io/4xu3y/?action=download%26mode=render AQ free printable PDF] * [https://mfr.osf.io/render?url=https://osf.io/fqsxm/?action=download%26mode=render Printable scoring guide] |- |[[wikipedia:Childhood_Autism_Rating_Scale|Childhood Autism Rating Scale (CARS)]] |Observation |2 years-adult |5-10 minutes |Not free |- |} === Interpreting autism screening measure scores === * For information on interpreting screening measure scores, [[Evidence based assessment/Prediction phase#Interpreting screening measure scores|'''click here.''']] ==[[Evidence based assessment/Prescription phase|'''Prescription phase''']]== ===Gold standard diagnostic interviews=== * For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews '''click here.'''] ===Recommended diagnostic interviews for autism spectrum disorder=== {| class="wikitable sortable" border="1" ! colspan="3" |Diagnostic instruments for ASD |- Format (Reporter) !Measure !Age Range !Administration/ Completion Time |- |Autism Diagnostic Observation Schedule, Second Edition (ADOS-2) |12 months- 30 months |40-60 minutes |- |Autism Diagnostic Interview, Revised (ADI-R) |18 months- adult | 90-150 minutes |- |Vineland Adaptive Behavior Scales-Second edition (VABS-II) |Birth- 18 years |20-60 minutes |- |Adaptive Behavior Assessment System, Second Edition (ABAS-II) |Birth- 89 years |20-30 minutes |}'''Note:''' '''L''' = Less than adequate; '''A''' = Adequate; <b>G</b> = Good; '''E''' = Excellent; '''U''' = Unavailable; '''NA''' = Not applicable {{collapse top|Click here for more information on the above interviews}} '''A. Autism Diagnostic Observation Schedule, Second Edition (ADOS-2)''' -- &nbsp;The ADOS-2 is a semi-structured, play-based assessment of social and communicative behaviors indicative of autism. There are several different modules that can be used based off of the individual’s speech/communication level. Training is necessary to conduct the ADOS-2. '''B. Autism Diagnostic Interview, Revised (ADI-R) --'''&nbsp;The ADI-R is a caregiver interview that helps to provide a developmental history (ages 4-5) and current functioning level of restricted and repetitive behaviors and social impairment. Training is necessary to conduct the ADI-R. Due to the homogeneity of the population, there are many other process measures that can be used in autism assessments. Clinical judgment is recommended when deciding what additional measures should be included (e.g. executive functioning, sensory processing, cognitive flexibility, motor functioning, comorbidity). The two measures provided below are commonly used to assess adaptive behaviors (including communication and socialization, core deficits in ASD) and may provide important information regarding levels of daily functioning of individuals with ASD.'''.''' '''C. Vineland Adaptive Behavior Scales-Second edition (VABS-II)'''&nbsp;– Parent report recommended with careful attention paid to the Daily Living domain. More commonly used with children. '''D. Adaptive Behavior Assessment System, Second Edition (ABAS-II)'''&nbsp;– Parent report recommended with special attention to the Global Adaptive Composite (GAC). More commonly used with adults. {{collapse bottom}} ===[[Evidence based assessment/Process phase|'''Process phase''']]=== The following section contains a brief overview of treatment options for autism and list of process and outcome measures for autism. The section includes benchmarks based on published norms for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the [[Evidence based assessment/Process phase|process phase]] of assessment. For more information of differences between process and outcome measures, see the page on the [[Evidence based assessment/Process phase|process phase of assessment]]. === Process measures === The following section contains a list of process and outcome measures for autism. The section includes benchmarks based on published norms and on those on the spectrum samples for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the [[Evidence based assessment/Process phase|process phase]] of assessment. For more information of differences between process and outcome measures, see the page on the [[Evidence based assessment/Process phase|process phase of assessment]]. {{blockquotetop}} There are many processes that may be considered important when evaluating a child or an adolescent with ASD; however, due to the diversity of the population and symptom expression, there are too many to narrow down. Clinical judgment is recommended when deciding what additional measures should be included (e.g. executive functioning, sensory processing, cognitive flexibility). The two measures provided below are commonly used to assess adaptive behaviors (including communication and socialization, core deficits in ASD) and may provide important information regarding levels of daily functioning of individuals with ASD. {{blockquotebottom}} === Outcome and severity measures === This table includes clinically significant benchmarks for autism specific outcome measures * Information on how to interpret this table can be [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase found here]. * Additionally, these [[Evidence based assessment/Vignettes|vignettes]] might be helpful resources for understanding appropriate adaptation of outcome measures in practice. *''<u>For clinically significant change benchmarks for the CBCL, YSR, and TRF total, externalizing, internalizing, and attention benchmarks,</u>'' [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase&wteswitched=1#Clinically_significant_change_benchmarks_for_widely-used_outcome_measures see here.] {| class="wikitable sortable" border="1" ! colspan="8" |'''<u><big>Clinically significant change benchmarks for ASD outcome measures</big></u>''' |- | colspan="8" style="font-size:110%; text-align:center;" span | <b> <small>Benchmarks Based on Published Norms</small> </b> |- | rowspan="2" style="text-align:center;font-size:130%;" | <b> Measure</b> | rowspan="2" style="text-align:center;font-size:130%;" |<b>Subscale</b> | colspan="3" style="text-align:center;font-size:130%" width="300" |<b> Cut-off scores</b> | colspan="3" style="text-align:center;font-size:120%" |<b> Critical Change <br> (unstandardized scores)</b> |- | style="text-align:center;font-size:110%" | <b> A</b> | style="text-align:center;font-size:110%" | <b> B</b> | style="text-align:center;font-size:110%" | <b> C</b> | style="text-align:center;font-size:110%" | <b> 95%</b> | style="text-align:center;font-size:110%" | <b> 90%</b> | style="text-align:center;font-size:110%" | <b> SE_difference</b> |- | rowspan="1" style="text-align:center;" | '''CBCL T-scores <br> (2001 Norms)''' | style="text-align:right;" | <i> Total</i> | style="text-align:center;"| 49 | style="text-align:center;"| 70 | style="text-align:center;"| 58 | style="text-align:center;"| 5 | style="text-align:center;"| 4 | style="text-align:center;"| 2.4 |- | rowspan="6" style="text-align:center;" | '''Autism Diagnostic Observation Schedule <br> - Generic (ADOS-G)^6,12''' |style="text-align:right;"|''Module 1 Social Affect Total'' |style="text-align:center;"|8.1 |style="text-align:center;"|12.5 |style="text-align:center;"|10.2 |style="text-align:center;"|2.3 |style="text-align:center;"|1.9 |style="text-align:center;"|1.1 |- |style="text-align:right;"|''Module 1 RR Total'' |style="text-align:center;"|0.4 |style="text-align:center;"|4.4 |style="text-align:center;"|2.7 |style="text-align:center;"|1.1 |style="text-align:center;"|0.9 |style="text-align:center;"|0.5 |- |style="text-align:right;"|''Module 2 Social Affect Total'' |style="text-align:center;"|7.7 |style="text-align:center;"|10.4 |style="text-align:center;"|9.1 |style="text-align:center;"|2.0 |style="text-align:center;"|1.7 |style="text-align:center;"|1.0 |- |style="text-align:right;"|''Module 2 RR Total'' |style="text-align:center;"|1.2 |style="text-align:center;"|4.9 |style="text-align:center;"|3.2 |style="text-align:center;"|1.1 |style="text-align:center;"|0.9 |style="text-align:center;"|0.6 |- |style="text-align:right;"|''Module 3 Social Affect Total'' |style="text-align:center;"|3.7 |style="text-align:center;"|9.8 |style="text-align:center;"|7.1 |style="text-align:center;"|2.1 |style="text-align:center;"|1.8 |style="text-align:center;"|1.1 |- |style="text-align:right;"|''Module 3 RR Total'' |style="text-align:center;"|<nowiki>-0.4*</nowiki> |style="text-align:center;"|3.3 |style="text-align:center;"|1.9 |style="text-align:center;"|0.9 |style="text-align:center;"|0.8 |style="text-align:center;"|0.5 |- |style="text-align:center;"|'''Childhood Autism Rating Scale (CARS)<ref>{{cite journal|last1=Coplan|first1=J|last2=Jawad|first2=AF|date=July 2005|title=Modeling clinical outcome of children with autistic spectrum disorders.|journal=Pediatrics|volume=116|issue=1|pages=117-22|pmid=15995041}}</ref><ref name=":0">{{cite journal|last1=Chlebowski|first1=C|last2=Green|first2=JA|last3=Barton|first3=ML|last4=Fein|first4=D|date=July 2010|title=Using the childhood autism rating scale to diagnose autism spectrum disorders.|journal=Journal of autism and developmental disorders|volume=40|issue=7|pages=787-99|pmid=20054630}}</ref>''' |style="text-align:right;"|''Parent Total'' |style="text-align:center;"|23.0 |style="text-align:center;"|18.0 |style="text-align:center;"|18.6 |style="text-align:center;"|1.6 |style="text-align:center;"|1.4 |style="text-align:center;"|0.8 |- |style="text-align:center;"|'''Social Responsiveness Scale (SRS)'''<ref name=":0" />'''<br>Caregiver Report (Appendix B)''' |style="text-align:right;"|''Total'' |style="text-align:center;"|72.7 |style="text-align:center;"|62.8 |style="text-align:center;"|66.8 |style="text-align:center;"|11.3 |style="text-align:center;"|9.5 |style="text-align:center;"|5.8 |} === Treatment === * Please refer to the page on [[wikipedia:Autism_spectrum|Autism Spectrum Disorder]] for more information on available treatment or go to [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/autism/ Effective Child Therapy] for a curated resource on effective treatments for ASD. {{collapse top| Click here for more information on '''''ASD treatment'''''}} '''Behavior and Communication Approaches''' # ''Applied Behavior Analysis (ABA)²⁰'' #*Method of teaching appropriate behaviors by breaking tasks down into small discrete steps and training in a systematic and precise way called discrete trial training (DTT). #*Based on the context that children with ASD have significant difficulties with learning, learning through imitation and listening as typical peer # ''Early Intensive Behavioral Intervention (EIBI)²⁰'' #*Focuses on remediation of deficient language, imitation, pre-academics, self-help and social interaction skills broken down into discrete components, taught on a one-to-one basis in school and/or at home. #*Typically using discrete trial teaching, reinforcement, backward chaining, shaping, extinction, prompting and prompt fading. Parent involvement is essential.<ref name="Peters-Scheffer">{{cite journal|last1=Peters-Scheffer|first1=N|last2=Didden|first2=R|last3=Korzilius|first3=H|last4=Sturmey|first4=P|date=2011|title=A meta-analytic study on the effectiveness of comprehensive ABA-based early intervention programs for children with Autism Spectrum Disorders|journal=Research in Autism Spectrum Disorders|volume=5|issue=1|page=60-69}}</ref> # ''Pivotal Response Training (PRT)²³'' #*Derived from ABA, an approach that teaches the learner to seek out and respond to naturally occurring learning opportunities. #*Goals include the development of communication, language and positive social behaviors and relief from disruptive self-stimulatory behavior.<ref>{{cite journal|last1=Odom|first1=Samuel L.|last2=Collet-Klingenberg|first2=Lana|last3=Rogers|first3=Sally J.|last4=Hatton|first4=Deborah D.|title=Evidence-Based Practices in Interventions for Children and Youth with Autism Spectrum Disorders|journal=Preventing School Failure: Alternative Education for Children and Youth|date=19 May 2010|volume=54|issue=4|pages=275–282|doi=10.1080/10459881003785506}}</ref> # ''Early start Denver Model (ESDM)²¹'' #* A comprehensive early behavioral intervention for infants (as young as 12 months) to preschool- aged children with ASD, integrating applied behavior analysis (ABA) approaches with developmental and relationship-based approaches.<ref name="Dawson">{{cite journal|last1=Dawson|first1=G|last2=Rogers|first2=S|last3=Munson|first3=J|last4=Smith|first4=M|last5=Winter|first5=J|last6=Greenson|first6=J|last7=Donaldson|first7=A|last8=Varley|first8=J|title=Randomized, controlled trial of an intervention for toddlers with autism: the Early Start Denver Model.|journal=Pediatrics|date=January 2010|volume=125|issue=1|pages=e17-23|pmid=19948568}}</ref> # ''Developmental, Individual Differences, Relationship-Based Approach (DIR or “Floortime”)²²'' #*Objectives are to build healthy foundations for social, emotional, and intellectual capacities rather than focusing on skills and isolated behaviors. # ''Treatment and Education of Autistic and Related Communication-Handicapped Children (TEACCH)²⁴'' #*Statewide, community based intervention program that emphasizes environmental organization and visual supports, individualization of goals, and the teaching of independence and developmental skills. #*Teaching strategies are taught within the natural environment and within context. Includes early intervention services through adulthood.<ref>{{cite journal|last1=Dawson|first1=G|last2=Osterling|first2=J|title=Early Intervention in Autism|journal=The Effectiveness of Early Intervention|date=1997|pages=307-326}}</ref> # ''Others (Treatments tackling symptoms not exclusive to ASD)'' #* Cognitive Behavioral Therapy (CBT)<ref name="Kasari">{{cite journal|last1=Kasari|first1=C|last2=Lawton|first2=K|title=New directions in behavioral treatment of autism spectrum disorders.|journal=Current opinion in neurology|date=April 2010|volume=23|issue=2|pages=137-43|pmid=20160648}}</ref> #*Occupational Therapy #*Sensory Integration Therapy #*Speech Therapy #*Picture Exchange Communication System (PECS).<ref>{{cite book|last1=al.]|first1=Lynn Cannon ... [et|title=Unstuck and on target! : an executive function curriculum to improve flexibility for children with autism spectrum disorders|date=2011|publisher=Paul H. Brookes Pub. Co.|location=Baltimore|isbn=9781598572032|edition=Research}}</ref> '''Medication''' * The data on other relevant diagnoses indicate that children and youth are frequently treated with medication under an ASD diagnosis, despite the fact that the target symptoms may be commonly associated with other mental disorders (ADHD, Anxiety, Depression, etc.). * Approximately 70% of children with ASD ages 8 and up receive some form of psychoactive medication. Before recommending medication as a form of treatment, consult a supervisor and a medical doctor.^26,27<ref>{{cite journal|last1=Mandell|first1=DS|last2=Morales|first2=KH|last3=Marcus|first3=SC|last4=Stahmer|first4=AC|last5=Doshi|first5=J|last6=Polsky|first6=DE|date=March 2008|title=Psychotropic medication use among Medicaid-enrolled children with autism spectrum disorders.|journal=Pediatrics|volume=121|issue=3|pages=e441-8|pmid=18310165}}</ref><ref>{{cite journal|last1=Oswald|first1=DP|last2=Sonenklar|first2=NA|date=June 2007|title=Medication use among children with autism spectrum disorders.|journal=Journal of child and adolescent psychopharmacology|volume=17|issue=3|pages=348-55|pmid=17630868}}</ref> {{collapse bottom}} =='''External Resources'''== #[http://apps.who.int/classifications/icd10/browse/2016/en#/F84.0 ICD-10 diagnostic criteria] # [https://en.wikiversity.org/w/index.php?title=Helping_Give_Away_Psychological_Science/Resources/Annotated_List_of_Where_and_How_to_Find_a_Therapist&wteswitched=1#Other_low-cost_options Find-a-Therapist] (a curated list of find-a-therapist websites where you can find a provider) #[https://www.nimh.nih.gov/health/topics/autism-spectrum-disorders-asd/index.shtml NIMH] (information about schizophrenia) #https://www.autismspeaks.org/what-autism/diagnosis/mchat Free online autism screen for toddlers # OMIM (Online Mendelian Inheritance in Man) ##[https://www.omim.org/entry/209850?search=autism&highlight=autism%20autistic 209850] #[http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/autism/ Effective Child Therapy information on Autism Spectrum Disorder] ##Effective Child Therapy is website sponsored by Division 53 of the American Psychological Association (APA), or The [https://sccap53.org Society of Clinical Child and Adolescent Psychology] (SCCAP), in collaboration with the Association for Behavioral and Cognitive Therapies (ABCT). Use for information on symptoms and available treatments. =='''References'''== {{collapse top|Click here for references}} {{Reflist|30em}} # Centers for Disease Control and Prevention. (2012). Prevalence of autism spectrum disorders—Autism and Developmental Disabilities Monitoring Network, 14 Sites, United States, 2008. Morbidity and Mortality Weekly Report, 61 (3), 1–19. # Pedersen, A., Pettygrove, S., Meaney, F. J., Mancilla, K., Gotschall, K., Kessler, D. B., ... & Cunniff, C. (2012). Prevalence of autism spectrum disorders in Hispanic and non-Hispanic white children. Pediatrics, 129(3), e629-e635. # Charman, T., Baird, G., Simonoff, E., Loucas, T., Chandler, S., Meldrum, D., & Pickles, A. (2007). Efficacy of three screening instruments in the identification of autistic-spectrum disorders. The British Journal of Psychiatry, 191(6), 554-559. # Constantino, J.N., Davis, S.A., Todd, R.D., Schindler, M.K., Gross, M.M., Brophy, S.L., et al. Validation of a brief quantitative measure of autistic traits: comparison of the social responsiveness scale with the autism diagnostic interview-revised. J Autism Dev Disord. 2003 Aug;33(4):427-33. # Gotham, K., Pickles, A., & Lord, C. (2009). Standardizing ADOS scores for a measure of severity in autism spectrum disorders. Journal of autism and developmental disorders, 39(5), 693-705. # Robins, D. L., Fein, D., Barton, M. L., & Green, J. A. (2001). The Modified Checklist for Autism in Toddlers: an initial study investigating the early detection of autism and pervasive developmental disorders. Journal of autism and developmental disorders, 31(2), 131-144. # Fombonne, E. (2009). Epidemiology of pervasive developmental disorders.Pediatric research, 65(6), 591-598. # Constantino, J. N., Zhang, Y., Frazier, T., Abbacchi, A. M., & Law, P. (2010). Sibling recurrence and the genetic epidemiology of autism. The American journal of psychiatry, 167(11), 1349. # Durkin, M. S., Maenner, M. J., Meaney, F. J., Levy, S. E., DiGuiseppi, C., Nicholas, J. S., ... & Schieve, L. A. (2010). Socioeconomic inequality in the prevalence of autism spectrum disorder: evidence from a US cross-sectional study. PLoS One, 5(7), e11551. # Humphreys, B. P. (2010). Infants and Toddlers with Autism Spectrum Disorders: Early Identification and Early Intervention. Journal of Early Intervention, 32(75), 75-98. # Bastiaansen, J. A., Meffert, H. Hein, S. Huizinga, P. Ketelaars, C. Pijnenborg, M. ,... de Bildt, A. 2011). Diagnosing autism spectrum disorders in adults: The use of Autism Diagnostic Observation Schedule (ADOS) Module 4 Journal of Autism and Developmental Disorders, 41, 1256–1266 # Kamp-Becker, I., Ghahreman, M., Heinzel-Gutenbrunner, M., Peters, M., Remschmidt, H., & Becker, K. (2013). Evaluation of the revised algorithm of Autism Diagnostic Observation Schedule (ADOS) in the diagnostic investigation of high-functioning children and adolescents with autism spectrum disorders. Autism, 17(1), 87-102. # Hus, V., & Lord, C. (2013). Effects of child characteristics on the Autism Diagnostic Interview-Revised: Implications for use of scores as a measure of ASD severity. Journal of autism and developmental disorders, 43(2), 371-381. # Coplan, J., & Jawad, A. F. (2005). Modeling clinical outcome of children with autistic spectrum disorders. Pediatrics, 116(1), 117-122. # Chlebowski, C., Green, J. A., Barton, M. L., & Fein, D. (2010). Using the childhood autism rating scale to diagnose autism spectrum disorders. Journal of autism and developmental disorders, 40(7), 787-799. # Saulnier, C. A., & Klin, A. (2007). Brief report: social and communication abilities and disabilities in higher functioning individuals with autism and Asperger syndrome. Journal of Autism and Developmental Disorders, 37(4), 788-793 # Fenton, G., D’ardia, C., Valente, D., Del Vecchio, I., Fabrizi, A., & Bernabei, P. (2003). Vineland adaptive behavior profiles in children with autism and moderate to severe developmental delay. Autism, 7(3), 269-287. # Oakland, T., & Harrison, P. L. (Eds.). (2011). Adaptive behavior assessment system-ii: clinical use and interpretation. Academic Press. # Peters-Scheffer, N., Didden, R., Korzilius, H., & Sturmey, P. (2011). A meta-analytic study on the effectiveness of comprehensive ABA-based early intervention programs for children with Autism Spectrum Disorders. Research in Autism Spectrum Disorders, 5(1), 60-69. # Dawson, G., Rogers, S., Munson, J., Smith, M., Winter, J., Greenson, J., ... & Varley, J. (2010). Randomized, controlled trial of an intervention for toddlers with autism: the Early Start Denver Model. Pediatrics, 125(1), e17-e23. # Wieder, S., & Greenspan, S. I. (2003). Climbing the symbolic ladder in the DIR model through floor time/interactive play. Autism, 7(4), 425-435. # Odom, S. L., Collet-Klingenberg, L., Rogers, S. J., & Hatton, D. D. (2010). Evidence-based practices in interventions for children and youth with autism spectrum disorders. Preventing school failure: Alternative education for children and youth, 54(4), 275-282 # Dawson, G., & Osterling, J. (1997). Early intervention in autism. The effectiveness of early intervention, 307-326. # Kasari, C., & Lawton, K. (2010). New directions in behavioral treatment of autism spectrum disorders. Current Opinion in Neurology, 23(2), 137-143. # Mandell, D. S., Morales, K. H., Marcus, S. C., Stahmer, A. C., Doshi, J., & Polsky, D. E. (2008). Psychotropic medication use among Medicaid-enrolled children with autism spectrum disorders. Pediatrics, 121(3), e441-e448. # Oswald, D. P., & Sonenklar, N. A. (2007). Medication use among children with autism spectrum disorders. Journal of child and adolescent psychopharmacology, 17(3), 348-355. [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] {{collapse bottom}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] lebottr74r6spyevyzaf74tvmmmhna2 2419106 2419105 2022-08-25T22:55:19Z Ardenguo 2944162 /* Recommended diagnostic interviews for autism spectrum disorder */ Removed a measure wikitext text/x-wiki <noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{medical disclaimer}} {{:{{BASEPAGENAME}}/Sidebar}} ==[[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio"?''']]== For background information on what assessment portfolios are, click the link in the heading above. Want even 'more' information about this topic? There's an extended version of this page [[Evidence-based assessment/Autism spectrum disorder (assessment portfolio)/extended version|here]]. == [[Evidence based assessment/Preparation phase|'''Preparation phase''']] == === Diagnostic criteria for autism spectrum disorder=== {{blockquotetop}} <big>'''ICD-11 Diagnostic Criteria''':</big> Autism spectrum disorder is characterized by persistent deficits in the ability to initiate and to sustain reciprocal social interaction and social communication, and by a range of restricted, repetitive, and inflexible patterns of behaviour and interests. The onset of the disorder occurs during the developmental period, typically in early childhood, but symptoms may not become fully manifest until later, when social demands exceed limited capacities. Deficits are sufficiently severe to cause impairment in personal, family, social, educational, occupational or other important areas of functioning and are usually a pervasive feature of the individual’s functioning observable in all settings, although they may vary according to social, educational, or other context. Individuals along the spectrum exhibit a full range of intellectual functioning and language abilities. Note: The ICD-11 contains seven subcategories of ASD that can be found in the ICD-11, [https://icd.who.int/browse11/l-m/en#/http%3a%2f%2fid.who.int%2ficd%2fentity%2f120443468 here]. <big>'''ASD encompasses these previous DSM-IV diagnoses''':</big> *Autistic disorder (autism) *Asperger’s disorder *Childhood disintegrative disorder *Pervasive developmental disorder not otherwise specified '''<big>ASD is characterized by:</big>''' # deficits in social communication and social interaction and # restricted repetitive behaviors, interests, and activities (RRBs). Because both components are required for diagnosis of ASD, social communication disorder is diagnosed if no RRBs are present. '''<big>Changes in DSM-5 Criteria</big>''' * The diagnostic criteria for ASD changed from [[DSM-IV]] to [[wikipedia:Diagnostic_and_Statistical_Manual_of_Mental_Disorders#DSM-IV-TR_.282000.29|DSM-5]]. Summaries are available [http://www.dsm5.org/Documents/changes%20from%20dsm-iv-tr%20to%20dsm-5.pdf here] and [[wikipedia:DSM-5|here]]. {{blockquotebottom}} ===Base rates of ASD in children and adolescents in different populations and clinical settings=== {| class="wikitable sortable" border="1" |- ! Demography ! Setting (Reference) ! Base Rate ! Diagnostic Method |- | 11 ADDM sites | Autism and Developmental Disabilities Monitoring (ADDM) Network (2014) - 8 year olds *** | 1.5% (1 per 68) | Diagnosis by doctor based on DSM-IV-TR criteria |- | Epidemiological: 43,283 household surveys | National Health Statistics Report (NHIS; 2014), 3-17 year olds<ref>{{cite journal|last1=Zablotsky|first1=B|last2=Black|first2=LI|last3=Maenner|first3=MJ|last4=Schieve|first4=LA|last5=Blumberg|first5=SJ|title=Estimated Prevalence of Autism and Other Developmental Disabilities Following Questionnaire Changes in the 2014 National Health Interview Survey.|journal=National health statistics reports|date=13 November 2015|issue=87|pages=1-20|pmid=26632847}}</ref> | 2.2% (1 per 45) | DSM-IV-TR |- | 11 ADDM sites: Male/Female Ratio | The Autism and Developmental Disabilities Monitoring (ADDM) Network (2014) – 8 year olds | 1 in 42 boys (2.4%), 1 in 189 girls (.05%) | DSM-IV-TR |- | Came from family registry for those who had children under 18 years old in United States | Interactive Autism Network (IAN): Individual Sibling Recurrence<ref>{{cite journal|last1=Constantino|first1=JN|last2=Zhang|first2=Y|last3=Frazier|first3=T|last4=Abbacchi|first4=AM|last5=Law|first5=P|title=Sibling recurrence and the genetic epidemiology of autism.|journal=The American journal of psychiatry|date=November 2010|volume=167|issue=11|pages=1349-56|pmid=20889652}}</ref> | ASD status occurred in an additional child in 10.9% of families | DSM-IV-TR |- | 11 ADDM sites (Race/ethnicity study) | The Autism and Developmental Disabilities Monitoring (ADDM) Network (2014) – 8 year olds Race/Ethnicity: * Non-Hispanic White * Non-Hispanic Black * Hispanic * Asian | * '''Non-Hispanic White:''' 1 in 63 (1.6%) * '''Non-Hispanic Black:''' 1 in 81 (1.2%) * '''Hispanic:''' 1 in 91 (1.1%) * '''Asian:''' 1 in 81 (1.2%) | DSM-IV-TR |- | | style="text-align:left" | The Autism and Developmental Disabilities Monitoring (ADDM) Network (2010) – 8 year olds <br> :Race/Ethnicity<br> ::- Non-Hispanic White<br> - Non-Hispanic Black<br> - Hispanic<br> - Asian<br> - Other | style="text-align:left" | <br><br> <br>60.3%<br>15.7%<br>17.2%<br>3.3%<br>3.5% | DSM-IV-TR |- | Male/Female Ratio | Epidemiological study: Review of 43 studies<ref>{{Cite journal|last=Kogan|first=M. D.|last2=Blumberg|first2=S. J.|last3=Schieve|first3=L. A.|last4=Boyle|first4=C. A.|last5=Perrin|first5=J. M.|last6=Ghandour|first6=R. M.|last7=Singh|first7=G. K.|last8=Strickland|first8=B. B.|last9=Trevathan|first9=E.|date=2009-11-01|title=Prevalence of Parent-Reported Diagnosis of Autism Spectrum Disorder Among Children in the US, 2007|url=http://pediatrics.aappublications.org/cgi/doi/10.1542/peds.2009-1522|journal=PEDIATRICS|language=en|volume=124|issue=5|pages=1395–1403|doi=10.1542/peds.2009-1522|issn=0031-4005}}</ref> | 4.2% (4.2 male:1 female) | DSM-IV/Rating Scales/Clinical |} ==[[Evidence based assessment/Prediction phase|'''Prediction phase''']]== === Psychometric properties of screening instruments for autism spectrum disorder === The following section contains a list of screening and diagnostic instruments for autism. The section includes administration information, psychometric data, and PDFs or links to the screenings. * Screenings are used as part of the [[Evidence based assessment/Prediction phase|prediction phase]] of assessment; for more information on interpretation of this data, or how screenings fit in to the assessment process, click [[Evidence based assessment/Prediction phase|here.]] * '''''For a list of more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Common_screening_instruments click here.]''''' {| class="wikitable sortable" |- ! Measure (Wikipedia Link) !Format (Reporter) !Age Range !Administration/ Completion Time !Where to Access |- |[[Evidence based assessment/Instruments/Modified checklist for autism in toddlers|Modified Checklist for Autism in Toddlers (M-CHAT)]] |Questionnaire (Parent report) |18-30 months |5-10 minutes | * [https://mfr.osf.io/render?url=https://osf.io/utmxg/?action=download%26mode=render Free printable PDF MCHAT] *[https://www.autismspeaks.org/screen-your-child Free Online MCHAT] |- |[[wikipedia:Autism-spectrum_quotient|Autism Spectrum Quotient (AQ)]] |Questionnaire |16 years and up |10-15 minutes | * [https://psychology-tools.com/autism-spectrum-quotient/ Online version with scoring] * [https://mfr.osf.io/render?url=https://osf.io/4xu3y/?action=download%26mode=render AQ free printable PDF] * [https://mfr.osf.io/render?url=https://osf.io/fqsxm/?action=download%26mode=render Printable scoring guide] |- |[[wikipedia:Childhood_Autism_Rating_Scale|Childhood Autism Rating Scale (CARS)]] |Observation |2 years-adult |5-10 minutes |Not free |- |} === Interpreting autism screening measure scores === * For information on interpreting screening measure scores, [[Evidence based assessment/Prediction phase#Interpreting screening measure scores|'''click here.''']] ==[[Evidence based assessment/Prescription phase|'''Prescription phase''']]== ===Gold standard diagnostic interviews=== * For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews '''click here.'''] ===Recommended diagnostic interviews for autism spectrum disorder=== {| class="wikitable sortable" border="1" ! colspan="3" |Diagnostic instruments for ASD |- Format (Reporter) !Measure !Age Range !Administration/ Completion Time |- |Autism Diagnostic Observation Schedule, Second Edition (ADOS-2) |12 months- 30 months |40-60 minutes |- |Autism Diagnostic Interview, Revised (ADI-R) |18 months- adult | 90-150 minutes |- |Adaptive Behavior Assessment System, Second Edition (ABAS-II) |Birth- 89 years |20-30 minutes |}'''Note:''' '''L''' = Less than adequate; '''A''' = Adequate; <b>G</b> = Good; '''E''' = Excellent; '''U''' = Unavailable; '''NA''' = Not applicable {{collapse top|Click here for more information on the above interviews}} '''A. Autism Diagnostic Observation Schedule, Second Edition (ADOS-2)''' -- &nbsp;The ADOS-2 is a semi-structured, play-based assessment of social and communicative behaviors indicative of autism. There are several different modules that can be used based off of the individual’s speech/communication level. Training is necessary to conduct the ADOS-2. '''B. Autism Diagnostic Interview, Revised (ADI-R) --'''&nbsp;The ADI-R is a caregiver interview that helps to provide a developmental history (ages 4-5) and current functioning level of restricted and repetitive behaviors and social impairment. Training is necessary to conduct the ADI-R. Due to the homogeneity of the population, there are many other process measures that can be used in autism assessments. Clinical judgment is recommended when deciding what additional measures should be included (e.g. executive functioning, sensory processing, cognitive flexibility, motor functioning, comorbidity). The two measures provided below are commonly used to assess adaptive behaviors (including communication and socialization, core deficits in ASD) and may provide important information regarding levels of daily functioning of individuals with ASD.'''.''' '''C. Vineland Adaptive Behavior Scales-Second edition (VABS-II)'''&nbsp;– Parent report recommended with careful attention paid to the Daily Living domain. More commonly used with children. '''D. Adaptive Behavior Assessment System, Second Edition (ABAS-II)'''&nbsp;– Parent report recommended with special attention to the Global Adaptive Composite (GAC). More commonly used with adults. {{collapse bottom}} ===[[Evidence based assessment/Process phase|'''Process phase''']]=== The following section contains a brief overview of treatment options for autism and list of process and outcome measures for autism. The section includes benchmarks based on published norms for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the [[Evidence based assessment/Process phase|process phase]] of assessment. For more information of differences between process and outcome measures, see the page on the [[Evidence based assessment/Process phase|process phase of assessment]]. === Process measures === The following section contains a list of process and outcome measures for autism. The section includes benchmarks based on published norms and on those on the spectrum samples for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the [[Evidence based assessment/Process phase|process phase]] of assessment. For more information of differences between process and outcome measures, see the page on the [[Evidence based assessment/Process phase|process phase of assessment]]. {{blockquotetop}} There are many processes that may be considered important when evaluating a child or an adolescent with ASD; however, due to the diversity of the population and symptom expression, there are too many to narrow down. Clinical judgment is recommended when deciding what additional measures should be included (e.g. executive functioning, sensory processing, cognitive flexibility). The two measures provided below are commonly used to assess adaptive behaviors (including communication and socialization, core deficits in ASD) and may provide important information regarding levels of daily functioning of individuals with ASD. {{blockquotebottom}} === Outcome and severity measures === This table includes clinically significant benchmarks for autism specific outcome measures * Information on how to interpret this table can be [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase found here]. * Additionally, these [[Evidence based assessment/Vignettes|vignettes]] might be helpful resources for understanding appropriate adaptation of outcome measures in practice. *''<u>For clinically significant change benchmarks for the CBCL, YSR, and TRF total, externalizing, internalizing, and attention benchmarks,</u>'' [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase&wteswitched=1#Clinically_significant_change_benchmarks_for_widely-used_outcome_measures see here.] {| class="wikitable sortable" border="1" ! colspan="8" |'''<u><big>Clinically significant change benchmarks for ASD outcome measures</big></u>''' |- | colspan="8" style="font-size:110%; text-align:center;" span | <b> <small>Benchmarks Based on Published Norms</small> </b> |- | rowspan="2" style="text-align:center;font-size:130%;" | <b> Measure</b> | rowspan="2" style="text-align:center;font-size:130%;" |<b>Subscale</b> | colspan="3" style="text-align:center;font-size:130%" width="300" |<b> Cut-off scores</b> | colspan="3" style="text-align:center;font-size:120%" |<b> Critical Change <br> (unstandardized scores)</b> |- | style="text-align:center;font-size:110%" | <b> A</b> | style="text-align:center;font-size:110%" | <b> B</b> | style="text-align:center;font-size:110%" | <b> C</b> | style="text-align:center;font-size:110%" | <b> 95%</b> | style="text-align:center;font-size:110%" | <b> 90%</b> | style="text-align:center;font-size:110%" | <b> SE_difference</b> |- | rowspan="1" style="text-align:center;" | '''CBCL T-scores <br> (2001 Norms)''' | style="text-align:right;" | <i> Total</i> | style="text-align:center;"| 49 | style="text-align:center;"| 70 | style="text-align:center;"| 58 | style="text-align:center;"| 5 | style="text-align:center;"| 4 | style="text-align:center;"| 2.4 |- | rowspan="6" style="text-align:center;" | '''Autism Diagnostic Observation Schedule <br> - Generic (ADOS-G)^6,12''' |style="text-align:right;"|''Module 1 Social Affect Total'' |style="text-align:center;"|8.1 |style="text-align:center;"|12.5 |style="text-align:center;"|10.2 |style="text-align:center;"|2.3 |style="text-align:center;"|1.9 |style="text-align:center;"|1.1 |- |style="text-align:right;"|''Module 1 RR Total'' |style="text-align:center;"|0.4 |style="text-align:center;"|4.4 |style="text-align:center;"|2.7 |style="text-align:center;"|1.1 |style="text-align:center;"|0.9 |style="text-align:center;"|0.5 |- |style="text-align:right;"|''Module 2 Social Affect Total'' |style="text-align:center;"|7.7 |style="text-align:center;"|10.4 |style="text-align:center;"|9.1 |style="text-align:center;"|2.0 |style="text-align:center;"|1.7 |style="text-align:center;"|1.0 |- |style="text-align:right;"|''Module 2 RR Total'' |style="text-align:center;"|1.2 |style="text-align:center;"|4.9 |style="text-align:center;"|3.2 |style="text-align:center;"|1.1 |style="text-align:center;"|0.9 |style="text-align:center;"|0.6 |- |style="text-align:right;"|''Module 3 Social Affect Total'' |style="text-align:center;"|3.7 |style="text-align:center;"|9.8 |style="text-align:center;"|7.1 |style="text-align:center;"|2.1 |style="text-align:center;"|1.8 |style="text-align:center;"|1.1 |- |style="text-align:right;"|''Module 3 RR Total'' |style="text-align:center;"|<nowiki>-0.4*</nowiki> |style="text-align:center;"|3.3 |style="text-align:center;"|1.9 |style="text-align:center;"|0.9 |style="text-align:center;"|0.8 |style="text-align:center;"|0.5 |- |style="text-align:center;"|'''Childhood Autism Rating Scale (CARS)<ref>{{cite journal|last1=Coplan|first1=J|last2=Jawad|first2=AF|date=July 2005|title=Modeling clinical outcome of children with autistic spectrum disorders.|journal=Pediatrics|volume=116|issue=1|pages=117-22|pmid=15995041}}</ref><ref name=":0">{{cite journal|last1=Chlebowski|first1=C|last2=Green|first2=JA|last3=Barton|first3=ML|last4=Fein|first4=D|date=July 2010|title=Using the childhood autism rating scale to diagnose autism spectrum disorders.|journal=Journal of autism and developmental disorders|volume=40|issue=7|pages=787-99|pmid=20054630}}</ref>''' |style="text-align:right;"|''Parent Total'' |style="text-align:center;"|23.0 |style="text-align:center;"|18.0 |style="text-align:center;"|18.6 |style="text-align:center;"|1.6 |style="text-align:center;"|1.4 |style="text-align:center;"|0.8 |- |style="text-align:center;"|'''Social Responsiveness Scale (SRS)'''<ref name=":0" />'''<br>Caregiver Report (Appendix B)''' |style="text-align:right;"|''Total'' |style="text-align:center;"|72.7 |style="text-align:center;"|62.8 |style="text-align:center;"|66.8 |style="text-align:center;"|11.3 |style="text-align:center;"|9.5 |style="text-align:center;"|5.8 |} === Treatment === * Please refer to the page on [[wikipedia:Autism_spectrum|Autism Spectrum Disorder]] for more information on available treatment or go to [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/autism/ Effective Child Therapy] for a curated resource on effective treatments for ASD. {{collapse top| Click here for more information on '''''ASD treatment'''''}} '''Behavior and Communication Approaches''' # ''Applied Behavior Analysis (ABA)²⁰'' #*Method of teaching appropriate behaviors by breaking tasks down into small discrete steps and training in a systematic and precise way called discrete trial training (DTT). #*Based on the context that children with ASD have significant difficulties with learning, learning through imitation and listening as typical peer # ''Early Intensive Behavioral Intervention (EIBI)²⁰'' #*Focuses on remediation of deficient language, imitation, pre-academics, self-help and social interaction skills broken down into discrete components, taught on a one-to-one basis in school and/or at home. #*Typically using discrete trial teaching, reinforcement, backward chaining, shaping, extinction, prompting and prompt fading. Parent involvement is essential.<ref name="Peters-Scheffer">{{cite journal|last1=Peters-Scheffer|first1=N|last2=Didden|first2=R|last3=Korzilius|first3=H|last4=Sturmey|first4=P|date=2011|title=A meta-analytic study on the effectiveness of comprehensive ABA-based early intervention programs for children with Autism Spectrum Disorders|journal=Research in Autism Spectrum Disorders|volume=5|issue=1|page=60-69}}</ref> # ''Pivotal Response Training (PRT)²³'' #*Derived from ABA, an approach that teaches the learner to seek out and respond to naturally occurring learning opportunities. #*Goals include the development of communication, language and positive social behaviors and relief from disruptive self-stimulatory behavior.<ref>{{cite journal|last1=Odom|first1=Samuel L.|last2=Collet-Klingenberg|first2=Lana|last3=Rogers|first3=Sally J.|last4=Hatton|first4=Deborah D.|title=Evidence-Based Practices in Interventions for Children and Youth with Autism Spectrum Disorders|journal=Preventing School Failure: Alternative Education for Children and Youth|date=19 May 2010|volume=54|issue=4|pages=275–282|doi=10.1080/10459881003785506}}</ref> # ''Early start Denver Model (ESDM)²¹'' #* A comprehensive early behavioral intervention for infants (as young as 12 months) to preschool- aged children with ASD, integrating applied behavior analysis (ABA) approaches with developmental and relationship-based approaches.<ref name="Dawson">{{cite journal|last1=Dawson|first1=G|last2=Rogers|first2=S|last3=Munson|first3=J|last4=Smith|first4=M|last5=Winter|first5=J|last6=Greenson|first6=J|last7=Donaldson|first7=A|last8=Varley|first8=J|title=Randomized, controlled trial of an intervention for toddlers with autism: the Early Start Denver Model.|journal=Pediatrics|date=January 2010|volume=125|issue=1|pages=e17-23|pmid=19948568}}</ref> # ''Developmental, Individual Differences, Relationship-Based Approach (DIR or “Floortime”)²²'' #*Objectives are to build healthy foundations for social, emotional, and intellectual capacities rather than focusing on skills and isolated behaviors. # ''Treatment and Education of Autistic and Related Communication-Handicapped Children (TEACCH)²⁴'' #*Statewide, community based intervention program that emphasizes environmental organization and visual supports, individualization of goals, and the teaching of independence and developmental skills. #*Teaching strategies are taught within the natural environment and within context. Includes early intervention services through adulthood.<ref>{{cite journal|last1=Dawson|first1=G|last2=Osterling|first2=J|title=Early Intervention in Autism|journal=The Effectiveness of Early Intervention|date=1997|pages=307-326}}</ref> # ''Others (Treatments tackling symptoms not exclusive to ASD)'' #* Cognitive Behavioral Therapy (CBT)<ref name="Kasari">{{cite journal|last1=Kasari|first1=C|last2=Lawton|first2=K|title=New directions in behavioral treatment of autism spectrum disorders.|journal=Current opinion in neurology|date=April 2010|volume=23|issue=2|pages=137-43|pmid=20160648}}</ref> #*Occupational Therapy #*Sensory Integration Therapy #*Speech Therapy #*Picture Exchange Communication System (PECS).<ref>{{cite book|last1=al.]|first1=Lynn Cannon ... [et|title=Unstuck and on target! : an executive function curriculum to improve flexibility for children with autism spectrum disorders|date=2011|publisher=Paul H. Brookes Pub. Co.|location=Baltimore|isbn=9781598572032|edition=Research}}</ref> '''Medication''' * The data on other relevant diagnoses indicate that children and youth are frequently treated with medication under an ASD diagnosis, despite the fact that the target symptoms may be commonly associated with other mental disorders (ADHD, Anxiety, Depression, etc.). * Approximately 70% of children with ASD ages 8 and up receive some form of psychoactive medication. Before recommending medication as a form of treatment, consult a supervisor and a medical doctor.^26,27<ref>{{cite journal|last1=Mandell|first1=DS|last2=Morales|first2=KH|last3=Marcus|first3=SC|last4=Stahmer|first4=AC|last5=Doshi|first5=J|last6=Polsky|first6=DE|date=March 2008|title=Psychotropic medication use among Medicaid-enrolled children with autism spectrum disorders.|journal=Pediatrics|volume=121|issue=3|pages=e441-8|pmid=18310165}}</ref><ref>{{cite journal|last1=Oswald|first1=DP|last2=Sonenklar|first2=NA|date=June 2007|title=Medication use among children with autism spectrum disorders.|journal=Journal of child and adolescent psychopharmacology|volume=17|issue=3|pages=348-55|pmid=17630868}}</ref> {{collapse bottom}} =='''External Resources'''== #[http://apps.who.int/classifications/icd10/browse/2016/en#/F84.0 ICD-10 diagnostic criteria] # [https://en.wikiversity.org/w/index.php?title=Helping_Give_Away_Psychological_Science/Resources/Annotated_List_of_Where_and_How_to_Find_a_Therapist&wteswitched=1#Other_low-cost_options Find-a-Therapist] (a curated list of find-a-therapist websites where you can find a provider) #[https://www.nimh.nih.gov/health/topics/autism-spectrum-disorders-asd/index.shtml NIMH] (information about schizophrenia) #https://www.autismspeaks.org/what-autism/diagnosis/mchat Free online autism screen for toddlers # OMIM (Online Mendelian Inheritance in Man) ##[https://www.omim.org/entry/209850?search=autism&highlight=autism%20autistic 209850] #[http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/autism/ Effective Child Therapy information on Autism Spectrum Disorder] ##Effective Child Therapy is website sponsored by Division 53 of the American Psychological Association (APA), or The [https://sccap53.org Society of Clinical Child and Adolescent Psychology] (SCCAP), in collaboration with the Association for Behavioral and Cognitive Therapies (ABCT). Use for information on symptoms and available treatments. =='''References'''== {{collapse top|Click here for references}} {{Reflist|30em}} # Centers for Disease Control and Prevention. (2012). Prevalence of autism spectrum disorders—Autism and Developmental Disabilities Monitoring Network, 14 Sites, United States, 2008. Morbidity and Mortality Weekly Report, 61 (3), 1–19. # Pedersen, A., Pettygrove, S., Meaney, F. J., Mancilla, K., Gotschall, K., Kessler, D. B., ... & Cunniff, C. (2012). Prevalence of autism spectrum disorders in Hispanic and non-Hispanic white children. Pediatrics, 129(3), e629-e635. # Charman, T., Baird, G., Simonoff, E., Loucas, T., Chandler, S., Meldrum, D., & Pickles, A. (2007). Efficacy of three screening instruments in the identification of autistic-spectrum disorders. The British Journal of Psychiatry, 191(6), 554-559. # Constantino, J.N., Davis, S.A., Todd, R.D., Schindler, M.K., Gross, M.M., Brophy, S.L., et al. Validation of a brief quantitative measure of autistic traits: comparison of the social responsiveness scale with the autism diagnostic interview-revised. J Autism Dev Disord. 2003 Aug;33(4):427-33. # Gotham, K., Pickles, A., & Lord, C. (2009). Standardizing ADOS scores for a measure of severity in autism spectrum disorders. Journal of autism and developmental disorders, 39(5), 693-705. # Robins, D. L., Fein, D., Barton, M. L., & Green, J. A. (2001). The Modified Checklist for Autism in Toddlers: an initial study investigating the early detection of autism and pervasive developmental disorders. Journal of autism and developmental disorders, 31(2), 131-144. # Fombonne, E. (2009). Epidemiology of pervasive developmental disorders.Pediatric research, 65(6), 591-598. # Constantino, J. N., Zhang, Y., Frazier, T., Abbacchi, A. M., & Law, P. (2010). Sibling recurrence and the genetic epidemiology of autism. The American journal of psychiatry, 167(11), 1349. # Durkin, M. S., Maenner, M. J., Meaney, F. J., Levy, S. E., DiGuiseppi, C., Nicholas, J. S., ... & Schieve, L. A. (2010). Socioeconomic inequality in the prevalence of autism spectrum disorder: evidence from a US cross-sectional study. PLoS One, 5(7), e11551. # Humphreys, B. P. (2010). Infants and Toddlers with Autism Spectrum Disorders: Early Identification and Early Intervention. Journal of Early Intervention, 32(75), 75-98. # Bastiaansen, J. A., Meffert, H. Hein, S. Huizinga, P. Ketelaars, C. Pijnenborg, M. ,... de Bildt, A. 2011). Diagnosing autism spectrum disorders in adults: The use of Autism Diagnostic Observation Schedule (ADOS) Module 4 Journal of Autism and Developmental Disorders, 41, 1256–1266 # Kamp-Becker, I., Ghahreman, M., Heinzel-Gutenbrunner, M., Peters, M., Remschmidt, H., & Becker, K. (2013). Evaluation of the revised algorithm of Autism Diagnostic Observation Schedule (ADOS) in the diagnostic investigation of high-functioning children and adolescents with autism spectrum disorders. Autism, 17(1), 87-102. # Hus, V., & Lord, C. (2013). Effects of child characteristics on the Autism Diagnostic Interview-Revised: Implications for use of scores as a measure of ASD severity. Journal of autism and developmental disorders, 43(2), 371-381. # Coplan, J., & Jawad, A. F. (2005). Modeling clinical outcome of children with autistic spectrum disorders. Pediatrics, 116(1), 117-122. # Chlebowski, C., Green, J. A., Barton, M. L., & Fein, D. (2010). Using the childhood autism rating scale to diagnose autism spectrum disorders. Journal of autism and developmental disorders, 40(7), 787-799. # Saulnier, C. A., & Klin, A. (2007). Brief report: social and communication abilities and disabilities in higher functioning individuals with autism and Asperger syndrome. Journal of Autism and Developmental Disorders, 37(4), 788-793 # Fenton, G., D’ardia, C., Valente, D., Del Vecchio, I., Fabrizi, A., & Bernabei, P. (2003). Vineland adaptive behavior profiles in children with autism and moderate to severe developmental delay. Autism, 7(3), 269-287. # Oakland, T., & Harrison, P. L. (Eds.). (2011). Adaptive behavior assessment system-ii: clinical use and interpretation. Academic Press. # Peters-Scheffer, N., Didden, R., Korzilius, H., & Sturmey, P. (2011). A meta-analytic study on the effectiveness of comprehensive ABA-based early intervention programs for children with Autism Spectrum Disorders. Research in Autism Spectrum Disorders, 5(1), 60-69. # Dawson, G., Rogers, S., Munson, J., Smith, M., Winter, J., Greenson, J., ... & Varley, J. (2010). Randomized, controlled trial of an intervention for toddlers with autism: the Early Start Denver Model. Pediatrics, 125(1), e17-e23. # Wieder, S., & Greenspan, S. I. (2003). Climbing the symbolic ladder in the DIR model through floor time/interactive play. Autism, 7(4), 425-435. # Odom, S. L., Collet-Klingenberg, L., Rogers, S. J., & Hatton, D. D. (2010). Evidence-based practices in interventions for children and youth with autism spectrum disorders. Preventing school failure: Alternative education for children and youth, 54(4), 275-282 # Dawson, G., & Osterling, J. (1997). Early intervention in autism. The effectiveness of early intervention, 307-326. # Kasari, C., & Lawton, K. (2010). New directions in behavioral treatment of autism spectrum disorders. Current Opinion in Neurology, 23(2), 137-143. # Mandell, D. S., Morales, K. H., Marcus, S. C., Stahmer, A. C., Doshi, J., & Polsky, D. E. (2008). Psychotropic medication use among Medicaid-enrolled children with autism spectrum disorders. Pediatrics, 121(3), e441-e448. # Oswald, D. P., & Sonenklar, N. A. (2007). Medication use among children with autism spectrum disorders. Journal of child and adolescent psychopharmacology, 17(3), 348-355. [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] {{collapse bottom}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] evwhj63wymj4g3cf6y5ylmcr0wozxqr 2419119 2419106 2022-08-25T23:20:45Z Ardenguo 2944162 /* Recommended diagnostic interviews for autism spectrum disorder */ removed a legend that is no longer needed wikitext text/x-wiki <noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{medical disclaimer}} {{:{{BASEPAGENAME}}/Sidebar}} ==[[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio"?''']]== For background information on what assessment portfolios are, click the link in the heading above. Want even 'more' information about this topic? There's an extended version of this page [[Evidence-based assessment/Autism spectrum disorder (assessment portfolio)/extended version|here]]. == [[Evidence based assessment/Preparation phase|'''Preparation phase''']] == === Diagnostic criteria for autism spectrum disorder=== {{blockquotetop}} <big>'''ICD-11 Diagnostic Criteria''':</big> Autism spectrum disorder is characterized by persistent deficits in the ability to initiate and to sustain reciprocal social interaction and social communication, and by a range of restricted, repetitive, and inflexible patterns of behaviour and interests. The onset of the disorder occurs during the developmental period, typically in early childhood, but symptoms may not become fully manifest until later, when social demands exceed limited capacities. Deficits are sufficiently severe to cause impairment in personal, family, social, educational, occupational or other important areas of functioning and are usually a pervasive feature of the individual’s functioning observable in all settings, although they may vary according to social, educational, or other context. Individuals along the spectrum exhibit a full range of intellectual functioning and language abilities. Note: The ICD-11 contains seven subcategories of ASD that can be found in the ICD-11, [https://icd.who.int/browse11/l-m/en#/http%3a%2f%2fid.who.int%2ficd%2fentity%2f120443468 here]. <big>'''ASD encompasses these previous DSM-IV diagnoses''':</big> *Autistic disorder (autism) *Asperger’s disorder *Childhood disintegrative disorder *Pervasive developmental disorder not otherwise specified '''<big>ASD is characterized by:</big>''' # deficits in social communication and social interaction and # restricted repetitive behaviors, interests, and activities (RRBs). Because both components are required for diagnosis of ASD, social communication disorder is diagnosed if no RRBs are present. '''<big>Changes in DSM-5 Criteria</big>''' * The diagnostic criteria for ASD changed from [[DSM-IV]] to [[wikipedia:Diagnostic_and_Statistical_Manual_of_Mental_Disorders#DSM-IV-TR_.282000.29|DSM-5]]. Summaries are available [http://www.dsm5.org/Documents/changes%20from%20dsm-iv-tr%20to%20dsm-5.pdf here] and [[wikipedia:DSM-5|here]]. {{blockquotebottom}} ===Base rates of ASD in children and adolescents in different populations and clinical settings=== {| class="wikitable sortable" border="1" |- ! Demography ! Setting (Reference) ! Base Rate ! Diagnostic Method |- | 11 ADDM sites | Autism and Developmental Disabilities Monitoring (ADDM) Network (2014) - 8 year olds *** | 1.5% (1 per 68) | Diagnosis by doctor based on DSM-IV-TR criteria |- | Epidemiological: 43,283 household surveys | National Health Statistics Report (NHIS; 2014), 3-17 year olds<ref>{{cite journal|last1=Zablotsky|first1=B|last2=Black|first2=LI|last3=Maenner|first3=MJ|last4=Schieve|first4=LA|last5=Blumberg|first5=SJ|title=Estimated Prevalence of Autism and Other Developmental Disabilities Following Questionnaire Changes in the 2014 National Health Interview Survey.|journal=National health statistics reports|date=13 November 2015|issue=87|pages=1-20|pmid=26632847}}</ref> | 2.2% (1 per 45) | DSM-IV-TR |- | 11 ADDM sites: Male/Female Ratio | The Autism and Developmental Disabilities Monitoring (ADDM) Network (2014) – 8 year olds | 1 in 42 boys (2.4%), 1 in 189 girls (.05%) | DSM-IV-TR |- | Came from family registry for those who had children under 18 years old in United States | Interactive Autism Network (IAN): Individual Sibling Recurrence<ref>{{cite journal|last1=Constantino|first1=JN|last2=Zhang|first2=Y|last3=Frazier|first3=T|last4=Abbacchi|first4=AM|last5=Law|first5=P|title=Sibling recurrence and the genetic epidemiology of autism.|journal=The American journal of psychiatry|date=November 2010|volume=167|issue=11|pages=1349-56|pmid=20889652}}</ref> | ASD status occurred in an additional child in 10.9% of families | DSM-IV-TR |- | 11 ADDM sites (Race/ethnicity study) | The Autism and Developmental Disabilities Monitoring (ADDM) Network (2014) – 8 year olds Race/Ethnicity: * Non-Hispanic White * Non-Hispanic Black * Hispanic * Asian | * '''Non-Hispanic White:''' 1 in 63 (1.6%) * '''Non-Hispanic Black:''' 1 in 81 (1.2%) * '''Hispanic:''' 1 in 91 (1.1%) * '''Asian:''' 1 in 81 (1.2%) | DSM-IV-TR |- | | style="text-align:left" | The Autism and Developmental Disabilities Monitoring (ADDM) Network (2010) – 8 year olds <br> :Race/Ethnicity<br> ::- Non-Hispanic White<br> - Non-Hispanic Black<br> - Hispanic<br> - Asian<br> - Other | style="text-align:left" | <br><br> <br>60.3%<br>15.7%<br>17.2%<br>3.3%<br>3.5% | DSM-IV-TR |- | Male/Female Ratio | Epidemiological study: Review of 43 studies<ref>{{Cite journal|last=Kogan|first=M. D.|last2=Blumberg|first2=S. J.|last3=Schieve|first3=L. A.|last4=Boyle|first4=C. A.|last5=Perrin|first5=J. M.|last6=Ghandour|first6=R. M.|last7=Singh|first7=G. K.|last8=Strickland|first8=B. B.|last9=Trevathan|first9=E.|date=2009-11-01|title=Prevalence of Parent-Reported Diagnosis of Autism Spectrum Disorder Among Children in the US, 2007|url=http://pediatrics.aappublications.org/cgi/doi/10.1542/peds.2009-1522|journal=PEDIATRICS|language=en|volume=124|issue=5|pages=1395–1403|doi=10.1542/peds.2009-1522|issn=0031-4005}}</ref> | 4.2% (4.2 male:1 female) | DSM-IV/Rating Scales/Clinical |} ==[[Evidence based assessment/Prediction phase|'''Prediction phase''']]== === Psychometric properties of screening instruments for autism spectrum disorder === The following section contains a list of screening and diagnostic instruments for autism. The section includes administration information, psychometric data, and PDFs or links to the screenings. * Screenings are used as part of the [[Evidence based assessment/Prediction phase|prediction phase]] of assessment; for more information on interpretation of this data, or how screenings fit in to the assessment process, click [[Evidence based assessment/Prediction phase|here.]] * '''''For a list of more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Common_screening_instruments click here.]''''' {| class="wikitable sortable" |- ! Measure (Wikipedia Link) !Format (Reporter) !Age Range !Administration/ Completion Time !Where to Access |- |[[Evidence based assessment/Instruments/Modified checklist for autism in toddlers|Modified Checklist for Autism in Toddlers (M-CHAT)]] |Questionnaire (Parent report) |18-30 months |5-10 minutes | * [https://mfr.osf.io/render?url=https://osf.io/utmxg/?action=download%26mode=render Free printable PDF MCHAT] *[https://www.autismspeaks.org/screen-your-child Free Online MCHAT] |- |[[wikipedia:Autism-spectrum_quotient|Autism Spectrum Quotient (AQ)]] |Questionnaire |16 years and up |10-15 minutes | * [https://psychology-tools.com/autism-spectrum-quotient/ Online version with scoring] * [https://mfr.osf.io/render?url=https://osf.io/4xu3y/?action=download%26mode=render AQ free printable PDF] * [https://mfr.osf.io/render?url=https://osf.io/fqsxm/?action=download%26mode=render Printable scoring guide] |- |[[wikipedia:Childhood_Autism_Rating_Scale|Childhood Autism Rating Scale (CARS)]] |Observation |2 years-adult |5-10 minutes |Not free |- |} === Interpreting autism screening measure scores === * For information on interpreting screening measure scores, [[Evidence based assessment/Prediction phase#Interpreting screening measure scores|'''click here.''']] ==[[Evidence based assessment/Prescription phase|'''Prescription phase''']]== ===Gold standard diagnostic interviews=== * For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews '''click here.'''] ===Recommended diagnostic interviews for autism spectrum disorder=== {| class="wikitable sortable" border="1" ! colspan="3" |Diagnostic instruments for ASD |- Format (Reporter) !Measure !Age Range !Administration/ Completion Time |- |Autism Diagnostic Observation Schedule, Second Edition (ADOS-2) |12 months- 30 months |40-60 minutes |- |Autism Diagnostic Interview, Revised (ADI-R) |18 months- adult | 90-150 minutes |- |Adaptive Behavior Assessment System, Second Edition (ABAS-II) |Birth- 89 years |20-30 minutes |} {{collapse top|Click here for more information on the above interviews}} '''A. Autism Diagnostic Observation Schedule, Second Edition (ADOS-2)''' -- &nbsp;The ADOS-2 is a semi-structured, play-based assessment of social and communicative behaviors indicative of autism. There are several different modules that can be used based off of the individual’s speech/communication level. Training is necessary to conduct the ADOS-2. '''B. Autism Diagnostic Interview, Revised (ADI-R) --'''&nbsp;The ADI-R is a caregiver interview that helps to provide a developmental history (ages 4-5) and current functioning level of restricted and repetitive behaviors and social impairment. Training is necessary to conduct the ADI-R. Due to the homogeneity of the population, there are many other process measures that can be used in autism assessments. Clinical judgment is recommended when deciding what additional measures should be included (e.g. executive functioning, sensory processing, cognitive flexibility, motor functioning, comorbidity). The two measures provided below are commonly used to assess adaptive behaviors (including communication and socialization, core deficits in ASD) and may provide important information regarding levels of daily functioning of individuals with ASD.'''.''' '''C. Vineland Adaptive Behavior Scales-Second edition (VABS-II)'''&nbsp;– Parent report recommended with careful attention paid to the Daily Living domain. More commonly used with children. '''D. Adaptive Behavior Assessment System, Second Edition (ABAS-II)'''&nbsp;– Parent report recommended with special attention to the Global Adaptive Composite (GAC). More commonly used with adults. {{collapse bottom}} ===[[Evidence based assessment/Process phase|'''Process phase''']]=== The following section contains a brief overview of treatment options for autism and list of process and outcome measures for autism. The section includes benchmarks based on published norms for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the [[Evidence based assessment/Process phase|process phase]] of assessment. For more information of differences between process and outcome measures, see the page on the [[Evidence based assessment/Process phase|process phase of assessment]]. === Process measures === The following section contains a list of process and outcome measures for autism. The section includes benchmarks based on published norms and on those on the spectrum samples for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the [[Evidence based assessment/Process phase|process phase]] of assessment. For more information of differences between process and outcome measures, see the page on the [[Evidence based assessment/Process phase|process phase of assessment]]. {{blockquotetop}} There are many processes that may be considered important when evaluating a child or an adolescent with ASD; however, due to the diversity of the population and symptom expression, there are too many to narrow down. Clinical judgment is recommended when deciding what additional measures should be included (e.g. executive functioning, sensory processing, cognitive flexibility). The two measures provided below are commonly used to assess adaptive behaviors (including communication and socialization, core deficits in ASD) and may provide important information regarding levels of daily functioning of individuals with ASD. {{blockquotebottom}} === Outcome and severity measures === This table includes clinically significant benchmarks for autism specific outcome measures * Information on how to interpret this table can be [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase found here]. * Additionally, these [[Evidence based assessment/Vignettes|vignettes]] might be helpful resources for understanding appropriate adaptation of outcome measures in practice. *''<u>For clinically significant change benchmarks for the CBCL, YSR, and TRF total, externalizing, internalizing, and attention benchmarks,</u>'' [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase&wteswitched=1#Clinically_significant_change_benchmarks_for_widely-used_outcome_measures see here.] {| class="wikitable sortable" border="1" ! colspan="8" |'''<u><big>Clinically significant change benchmarks for ASD outcome measures</big></u>''' |- | colspan="8" style="font-size:110%; text-align:center;" span | <b> <small>Benchmarks Based on Published Norms</small> </b> |- | rowspan="2" style="text-align:center;font-size:130%;" | <b> Measure</b> | rowspan="2" style="text-align:center;font-size:130%;" |<b>Subscale</b> | colspan="3" style="text-align:center;font-size:130%" width="300" |<b> Cut-off scores</b> | colspan="3" style="text-align:center;font-size:120%" |<b> Critical Change <br> (unstandardized scores)</b> |- | style="text-align:center;font-size:110%" | <b> A</b> | style="text-align:center;font-size:110%" | <b> B</b> | style="text-align:center;font-size:110%" | <b> C</b> | style="text-align:center;font-size:110%" | <b> 95%</b> | style="text-align:center;font-size:110%" | <b> 90%</b> | style="text-align:center;font-size:110%" | <b> SE_difference</b> |- | rowspan="1" style="text-align:center;" | '''CBCL T-scores <br> (2001 Norms)''' | style="text-align:right;" | <i> Total</i> | style="text-align:center;"| 49 | style="text-align:center;"| 70 | style="text-align:center;"| 58 | style="text-align:center;"| 5 | style="text-align:center;"| 4 | style="text-align:center;"| 2.4 |- | rowspan="6" style="text-align:center;" | '''Autism Diagnostic Observation Schedule <br> - Generic (ADOS-G)^6,12''' |style="text-align:right;"|''Module 1 Social Affect Total'' |style="text-align:center;"|8.1 |style="text-align:center;"|12.5 |style="text-align:center;"|10.2 |style="text-align:center;"|2.3 |style="text-align:center;"|1.9 |style="text-align:center;"|1.1 |- |style="text-align:right;"|''Module 1 RR Total'' |style="text-align:center;"|0.4 |style="text-align:center;"|4.4 |style="text-align:center;"|2.7 |style="text-align:center;"|1.1 |style="text-align:center;"|0.9 |style="text-align:center;"|0.5 |- |style="text-align:right;"|''Module 2 Social Affect Total'' |style="text-align:center;"|7.7 |style="text-align:center;"|10.4 |style="text-align:center;"|9.1 |style="text-align:center;"|2.0 |style="text-align:center;"|1.7 |style="text-align:center;"|1.0 |- |style="text-align:right;"|''Module 2 RR Total'' |style="text-align:center;"|1.2 |style="text-align:center;"|4.9 |style="text-align:center;"|3.2 |style="text-align:center;"|1.1 |style="text-align:center;"|0.9 |style="text-align:center;"|0.6 |- |style="text-align:right;"|''Module 3 Social Affect Total'' |style="text-align:center;"|3.7 |style="text-align:center;"|9.8 |style="text-align:center;"|7.1 |style="text-align:center;"|2.1 |style="text-align:center;"|1.8 |style="text-align:center;"|1.1 |- |style="text-align:right;"|''Module 3 RR Total'' |style="text-align:center;"|<nowiki>-0.4*</nowiki> |style="text-align:center;"|3.3 |style="text-align:center;"|1.9 |style="text-align:center;"|0.9 |style="text-align:center;"|0.8 |style="text-align:center;"|0.5 |- |style="text-align:center;"|'''Childhood Autism Rating Scale (CARS)<ref>{{cite journal|last1=Coplan|first1=J|last2=Jawad|first2=AF|date=July 2005|title=Modeling clinical outcome of children with autistic spectrum disorders.|journal=Pediatrics|volume=116|issue=1|pages=117-22|pmid=15995041}}</ref><ref name=":0">{{cite journal|last1=Chlebowski|first1=C|last2=Green|first2=JA|last3=Barton|first3=ML|last4=Fein|first4=D|date=July 2010|title=Using the childhood autism rating scale to diagnose autism spectrum disorders.|journal=Journal of autism and developmental disorders|volume=40|issue=7|pages=787-99|pmid=20054630}}</ref>''' |style="text-align:right;"|''Parent Total'' |style="text-align:center;"|23.0 |style="text-align:center;"|18.0 |style="text-align:center;"|18.6 |style="text-align:center;"|1.6 |style="text-align:center;"|1.4 |style="text-align:center;"|0.8 |- |style="text-align:center;"|'''Social Responsiveness Scale (SRS)'''<ref name=":0" />'''<br>Caregiver Report (Appendix B)''' |style="text-align:right;"|''Total'' |style="text-align:center;"|72.7 |style="text-align:center;"|62.8 |style="text-align:center;"|66.8 |style="text-align:center;"|11.3 |style="text-align:center;"|9.5 |style="text-align:center;"|5.8 |} === Treatment === * Please refer to the page on [[wikipedia:Autism_spectrum|Autism Spectrum Disorder]] for more information on available treatment or go to [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/autism/ Effective Child Therapy] for a curated resource on effective treatments for ASD. {{collapse top| Click here for more information on '''''ASD treatment'''''}} '''Behavior and Communication Approaches''' # ''Applied Behavior Analysis (ABA)²⁰'' #*Method of teaching appropriate behaviors by breaking tasks down into small discrete steps and training in a systematic and precise way called discrete trial training (DTT). #*Based on the context that children with ASD have significant difficulties with learning, learning through imitation and listening as typical peer # ''Early Intensive Behavioral Intervention (EIBI)²⁰'' #*Focuses on remediation of deficient language, imitation, pre-academics, self-help and social interaction skills broken down into discrete components, taught on a one-to-one basis in school and/or at home. #*Typically using discrete trial teaching, reinforcement, backward chaining, shaping, extinction, prompting and prompt fading. Parent involvement is essential.<ref name="Peters-Scheffer">{{cite journal|last1=Peters-Scheffer|first1=N|last2=Didden|first2=R|last3=Korzilius|first3=H|last4=Sturmey|first4=P|date=2011|title=A meta-analytic study on the effectiveness of comprehensive ABA-based early intervention programs for children with Autism Spectrum Disorders|journal=Research in Autism Spectrum Disorders|volume=5|issue=1|page=60-69}}</ref> # ''Pivotal Response Training (PRT)²³'' #*Derived from ABA, an approach that teaches the learner to seek out and respond to naturally occurring learning opportunities. #*Goals include the development of communication, language and positive social behaviors and relief from disruptive self-stimulatory behavior.<ref>{{cite journal|last1=Odom|first1=Samuel L.|last2=Collet-Klingenberg|first2=Lana|last3=Rogers|first3=Sally J.|last4=Hatton|first4=Deborah D.|title=Evidence-Based Practices in Interventions for Children and Youth with Autism Spectrum Disorders|journal=Preventing School Failure: Alternative Education for Children and Youth|date=19 May 2010|volume=54|issue=4|pages=275–282|doi=10.1080/10459881003785506}}</ref> # ''Early start Denver Model (ESDM)²¹'' #* A comprehensive early behavioral intervention for infants (as young as 12 months) to preschool- aged children with ASD, integrating applied behavior analysis (ABA) approaches with developmental and relationship-based approaches.<ref name="Dawson">{{cite journal|last1=Dawson|first1=G|last2=Rogers|first2=S|last3=Munson|first3=J|last4=Smith|first4=M|last5=Winter|first5=J|last6=Greenson|first6=J|last7=Donaldson|first7=A|last8=Varley|first8=J|title=Randomized, controlled trial of an intervention for toddlers with autism: the Early Start Denver Model.|journal=Pediatrics|date=January 2010|volume=125|issue=1|pages=e17-23|pmid=19948568}}</ref> # ''Developmental, Individual Differences, Relationship-Based Approach (DIR or “Floortime”)²²'' #*Objectives are to build healthy foundations for social, emotional, and intellectual capacities rather than focusing on skills and isolated behaviors. # ''Treatment and Education of Autistic and Related Communication-Handicapped Children (TEACCH)²⁴'' #*Statewide, community based intervention program that emphasizes environmental organization and visual supports, individualization of goals, and the teaching of independence and developmental skills. #*Teaching strategies are taught within the natural environment and within context. Includes early intervention services through adulthood.<ref>{{cite journal|last1=Dawson|first1=G|last2=Osterling|first2=J|title=Early Intervention in Autism|journal=The Effectiveness of Early Intervention|date=1997|pages=307-326}}</ref> # ''Others (Treatments tackling symptoms not exclusive to ASD)'' #* Cognitive Behavioral Therapy (CBT)<ref name="Kasari">{{cite journal|last1=Kasari|first1=C|last2=Lawton|first2=K|title=New directions in behavioral treatment of autism spectrum disorders.|journal=Current opinion in neurology|date=April 2010|volume=23|issue=2|pages=137-43|pmid=20160648}}</ref> #*Occupational Therapy #*Sensory Integration Therapy #*Speech Therapy #*Picture Exchange Communication System (PECS).<ref>{{cite book|last1=al.]|first1=Lynn Cannon ... [et|title=Unstuck and on target! : an executive function curriculum to improve flexibility for children with autism spectrum disorders|date=2011|publisher=Paul H. Brookes Pub. Co.|location=Baltimore|isbn=9781598572032|edition=Research}}</ref> '''Medication''' * The data on other relevant diagnoses indicate that children and youth are frequently treated with medication under an ASD diagnosis, despite the fact that the target symptoms may be commonly associated with other mental disorders (ADHD, Anxiety, Depression, etc.). * Approximately 70% of children with ASD ages 8 and up receive some form of psychoactive medication. Before recommending medication as a form of treatment, consult a supervisor and a medical doctor.^26,27<ref>{{cite journal|last1=Mandell|first1=DS|last2=Morales|first2=KH|last3=Marcus|first3=SC|last4=Stahmer|first4=AC|last5=Doshi|first5=J|last6=Polsky|first6=DE|date=March 2008|title=Psychotropic medication use among Medicaid-enrolled children with autism spectrum disorders.|journal=Pediatrics|volume=121|issue=3|pages=e441-8|pmid=18310165}}</ref><ref>{{cite journal|last1=Oswald|first1=DP|last2=Sonenklar|first2=NA|date=June 2007|title=Medication use among children with autism spectrum disorders.|journal=Journal of child and adolescent psychopharmacology|volume=17|issue=3|pages=348-55|pmid=17630868}}</ref> {{collapse bottom}} =='''External Resources'''== #[http://apps.who.int/classifications/icd10/browse/2016/en#/F84.0 ICD-10 diagnostic criteria] # [https://en.wikiversity.org/w/index.php?title=Helping_Give_Away_Psychological_Science/Resources/Annotated_List_of_Where_and_How_to_Find_a_Therapist&wteswitched=1#Other_low-cost_options Find-a-Therapist] (a curated list of find-a-therapist websites where you can find a provider) #[https://www.nimh.nih.gov/health/topics/autism-spectrum-disorders-asd/index.shtml NIMH] (information about schizophrenia) #https://www.autismspeaks.org/what-autism/diagnosis/mchat Free online autism screen for toddlers # OMIM (Online Mendelian Inheritance in Man) ##[https://www.omim.org/entry/209850?search=autism&highlight=autism%20autistic 209850] #[http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/autism/ Effective Child Therapy information on Autism Spectrum Disorder] ##Effective Child Therapy is website sponsored by Division 53 of the American Psychological Association (APA), or The [https://sccap53.org Society of Clinical Child and Adolescent Psychology] (SCCAP), in collaboration with the Association for Behavioral and Cognitive Therapies (ABCT). Use for information on symptoms and available treatments. =='''References'''== {{collapse top|Click here for references}} {{Reflist|30em}} # Centers for Disease Control and Prevention. (2012). Prevalence of autism spectrum disorders—Autism and Developmental Disabilities Monitoring Network, 14 Sites, United States, 2008. Morbidity and Mortality Weekly Report, 61 (3), 1–19. # Pedersen, A., Pettygrove, S., Meaney, F. J., Mancilla, K., Gotschall, K., Kessler, D. B., ... & Cunniff, C. (2012). Prevalence of autism spectrum disorders in Hispanic and non-Hispanic white children. Pediatrics, 129(3), e629-e635. # Charman, T., Baird, G., Simonoff, E., Loucas, T., Chandler, S., Meldrum, D., & Pickles, A. (2007). Efficacy of three screening instruments in the identification of autistic-spectrum disorders. The British Journal of Psychiatry, 191(6), 554-559. # Constantino, J.N., Davis, S.A., Todd, R.D., Schindler, M.K., Gross, M.M., Brophy, S.L., et al. Validation of a brief quantitative measure of autistic traits: comparison of the social responsiveness scale with the autism diagnostic interview-revised. J Autism Dev Disord. 2003 Aug;33(4):427-33. # Gotham, K., Pickles, A., & Lord, C. (2009). Standardizing ADOS scores for a measure of severity in autism spectrum disorders. Journal of autism and developmental disorders, 39(5), 693-705. # Robins, D. L., Fein, D., Barton, M. L., & Green, J. A. (2001). The Modified Checklist for Autism in Toddlers: an initial study investigating the early detection of autism and pervasive developmental disorders. Journal of autism and developmental disorders, 31(2), 131-144. # Fombonne, E. (2009). Epidemiology of pervasive developmental disorders.Pediatric research, 65(6), 591-598. # Constantino, J. N., Zhang, Y., Frazier, T., Abbacchi, A. M., & Law, P. (2010). Sibling recurrence and the genetic epidemiology of autism. The American journal of psychiatry, 167(11), 1349. # Durkin, M. S., Maenner, M. J., Meaney, F. J., Levy, S. E., DiGuiseppi, C., Nicholas, J. S., ... & Schieve, L. A. (2010). Socioeconomic inequality in the prevalence of autism spectrum disorder: evidence from a US cross-sectional study. PLoS One, 5(7), e11551. # Humphreys, B. P. (2010). Infants and Toddlers with Autism Spectrum Disorders: Early Identification and Early Intervention. Journal of Early Intervention, 32(75), 75-98. # Bastiaansen, J. A., Meffert, H. Hein, S. Huizinga, P. Ketelaars, C. Pijnenborg, M. ,... de Bildt, A. 2011). Diagnosing autism spectrum disorders in adults: The use of Autism Diagnostic Observation Schedule (ADOS) Module 4 Journal of Autism and Developmental Disorders, 41, 1256–1266 # Kamp-Becker, I., Ghahreman, M., Heinzel-Gutenbrunner, M., Peters, M., Remschmidt, H., & Becker, K. (2013). Evaluation of the revised algorithm of Autism Diagnostic Observation Schedule (ADOS) in the diagnostic investigation of high-functioning children and adolescents with autism spectrum disorders. Autism, 17(1), 87-102. # Hus, V., & Lord, C. (2013). Effects of child characteristics on the Autism Diagnostic Interview-Revised: Implications for use of scores as a measure of ASD severity. Journal of autism and developmental disorders, 43(2), 371-381. # Coplan, J., & Jawad, A. F. (2005). Modeling clinical outcome of children with autistic spectrum disorders. Pediatrics, 116(1), 117-122. # Chlebowski, C., Green, J. A., Barton, M. L., & Fein, D. (2010). Using the childhood autism rating scale to diagnose autism spectrum disorders. Journal of autism and developmental disorders, 40(7), 787-799. # Saulnier, C. A., & Klin, A. (2007). Brief report: social and communication abilities and disabilities in higher functioning individuals with autism and Asperger syndrome. Journal of Autism and Developmental Disorders, 37(4), 788-793 # Fenton, G., D’ardia, C., Valente, D., Del Vecchio, I., Fabrizi, A., & Bernabei, P. (2003). Vineland adaptive behavior profiles in children with autism and moderate to severe developmental delay. Autism, 7(3), 269-287. # Oakland, T., & Harrison, P. L. (Eds.). (2011). Adaptive behavior assessment system-ii: clinical use and interpretation. Academic Press. # Peters-Scheffer, N., Didden, R., Korzilius, H., & Sturmey, P. (2011). A meta-analytic study on the effectiveness of comprehensive ABA-based early intervention programs for children with Autism Spectrum Disorders. Research in Autism Spectrum Disorders, 5(1), 60-69. # Dawson, G., Rogers, S., Munson, J., Smith, M., Winter, J., Greenson, J., ... & Varley, J. (2010). Randomized, controlled trial of an intervention for toddlers with autism: the Early Start Denver Model. Pediatrics, 125(1), e17-e23. # Wieder, S., & Greenspan, S. I. (2003). Climbing the symbolic ladder in the DIR model through floor time/interactive play. Autism, 7(4), 425-435. # Odom, S. L., Collet-Klingenberg, L., Rogers, S. J., & Hatton, D. D. (2010). Evidence-based practices in interventions for children and youth with autism spectrum disorders. Preventing school failure: Alternative education for children and youth, 54(4), 275-282 # Dawson, G., & Osterling, J. (1997). Early intervention in autism. The effectiveness of early intervention, 307-326. # Kasari, C., & Lawton, K. (2010). New directions in behavioral treatment of autism spectrum disorders. Current Opinion in Neurology, 23(2), 137-143. # Mandell, D. S., Morales, K. H., Marcus, S. C., Stahmer, A. C., Doshi, J., & Polsky, D. E. (2008). Psychotropic medication use among Medicaid-enrolled children with autism spectrum disorders. Pediatrics, 121(3), e441-e448. # Oswald, D. P., & Sonenklar, N. A. (2007). Medication use among children with autism spectrum disorders. Journal of child and adolescent psychopharmacology, 17(3), 348-355. [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] {{collapse bottom}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] 8kvff6638lzh71i3vb9g95oxq6plecw 2419170 2419119 2022-08-26T01:49:22Z Ardenguo 2944162 /* Recommended diagnostic interviews for autism spectrum disorder */ wikitext text/x-wiki <noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{medical disclaimer}} {{:{{BASEPAGENAME}}/Sidebar}} ==[[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio"?''']]== For background information on what assessment portfolios are, click the link in the heading above. Want even 'more' information about this topic? There's an extended version of this page [[Evidence-based assessment/Autism spectrum disorder (assessment portfolio)/extended version|here]]. == [[Evidence based assessment/Preparation phase|'''Preparation phase''']] == === Diagnostic criteria for autism spectrum disorder=== {{blockquotetop}} <big>'''ICD-11 Diagnostic Criteria''':</big> Autism spectrum disorder is characterized by persistent deficits in the ability to initiate and to sustain reciprocal social interaction and social communication, and by a range of restricted, repetitive, and inflexible patterns of behaviour and interests. The onset of the disorder occurs during the developmental period, typically in early childhood, but symptoms may not become fully manifest until later, when social demands exceed limited capacities. Deficits are sufficiently severe to cause impairment in personal, family, social, educational, occupational or other important areas of functioning and are usually a pervasive feature of the individual’s functioning observable in all settings, although they may vary according to social, educational, or other context. Individuals along the spectrum exhibit a full range of intellectual functioning and language abilities. Note: The ICD-11 contains seven subcategories of ASD that can be found in the ICD-11, [https://icd.who.int/browse11/l-m/en#/http%3a%2f%2fid.who.int%2ficd%2fentity%2f120443468 here]. <big>'''ASD encompasses these previous DSM-IV diagnoses''':</big> *Autistic disorder (autism) *Asperger’s disorder *Childhood disintegrative disorder *Pervasive developmental disorder not otherwise specified '''<big>ASD is characterized by:</big>''' # deficits in social communication and social interaction and # restricted repetitive behaviors, interests, and activities (RRBs). Because both components are required for diagnosis of ASD, social communication disorder is diagnosed if no RRBs are present. '''<big>Changes in DSM-5 Criteria</big>''' * The diagnostic criteria for ASD changed from [[DSM-IV]] to [[wikipedia:Diagnostic_and_Statistical_Manual_of_Mental_Disorders#DSM-IV-TR_.282000.29|DSM-5]]. Summaries are available [http://www.dsm5.org/Documents/changes%20from%20dsm-iv-tr%20to%20dsm-5.pdf here] and [[wikipedia:DSM-5|here]]. {{blockquotebottom}} ===Base rates of ASD in children and adolescents in different populations and clinical settings=== {| class="wikitable sortable" border="1" |- ! Demography ! Setting (Reference) ! Base Rate ! Diagnostic Method |- | 11 ADDM sites | Autism and Developmental Disabilities Monitoring (ADDM) Network (2014) - 8 year olds *** | 1.5% (1 per 68) | Diagnosis by doctor based on DSM-IV-TR criteria |- | Epidemiological: 43,283 household surveys | National Health Statistics Report (NHIS; 2014), 3-17 year olds<ref>{{cite journal|last1=Zablotsky|first1=B|last2=Black|first2=LI|last3=Maenner|first3=MJ|last4=Schieve|first4=LA|last5=Blumberg|first5=SJ|title=Estimated Prevalence of Autism and Other Developmental Disabilities Following Questionnaire Changes in the 2014 National Health Interview Survey.|journal=National health statistics reports|date=13 November 2015|issue=87|pages=1-20|pmid=26632847}}</ref> | 2.2% (1 per 45) | DSM-IV-TR |- | 11 ADDM sites: Male/Female Ratio | The Autism and Developmental Disabilities Monitoring (ADDM) Network (2014) – 8 year olds | 1 in 42 boys (2.4%), 1 in 189 girls (.05%) | DSM-IV-TR |- | Came from family registry for those who had children under 18 years old in United States | Interactive Autism Network (IAN): Individual Sibling Recurrence<ref>{{cite journal|last1=Constantino|first1=JN|last2=Zhang|first2=Y|last3=Frazier|first3=T|last4=Abbacchi|first4=AM|last5=Law|first5=P|title=Sibling recurrence and the genetic epidemiology of autism.|journal=The American journal of psychiatry|date=November 2010|volume=167|issue=11|pages=1349-56|pmid=20889652}}</ref> | ASD status occurred in an additional child in 10.9% of families | DSM-IV-TR |- | 11 ADDM sites (Race/ethnicity study) | The Autism and Developmental Disabilities Monitoring (ADDM) Network (2014) – 8 year olds Race/Ethnicity: * Non-Hispanic White * Non-Hispanic Black * Hispanic * Asian | * '''Non-Hispanic White:''' 1 in 63 (1.6%) * '''Non-Hispanic Black:''' 1 in 81 (1.2%) * '''Hispanic:''' 1 in 91 (1.1%) * '''Asian:''' 1 in 81 (1.2%) | DSM-IV-TR |- | | style="text-align:left" | The Autism and Developmental Disabilities Monitoring (ADDM) Network (2010) – 8 year olds <br> :Race/Ethnicity<br> ::- Non-Hispanic White<br> - Non-Hispanic Black<br> - Hispanic<br> - Asian<br> - Other | style="text-align:left" | <br><br> <br>60.3%<br>15.7%<br>17.2%<br>3.3%<br>3.5% | DSM-IV-TR |- | Male/Female Ratio | Epidemiological study: Review of 43 studies<ref>{{Cite journal|last=Kogan|first=M. D.|last2=Blumberg|first2=S. J.|last3=Schieve|first3=L. A.|last4=Boyle|first4=C. A.|last5=Perrin|first5=J. M.|last6=Ghandour|first6=R. M.|last7=Singh|first7=G. K.|last8=Strickland|first8=B. B.|last9=Trevathan|first9=E.|date=2009-11-01|title=Prevalence of Parent-Reported Diagnosis of Autism Spectrum Disorder Among Children in the US, 2007|url=http://pediatrics.aappublications.org/cgi/doi/10.1542/peds.2009-1522|journal=PEDIATRICS|language=en|volume=124|issue=5|pages=1395–1403|doi=10.1542/peds.2009-1522|issn=0031-4005}}</ref> | 4.2% (4.2 male:1 female) | DSM-IV/Rating Scales/Clinical |} ==[[Evidence based assessment/Prediction phase|'''Prediction phase''']]== === Psychometric properties of screening instruments for autism spectrum disorder === The following section contains a list of screening and diagnostic instruments for autism. The section includes administration information, psychometric data, and PDFs or links to the screenings. * Screenings are used as part of the [[Evidence based assessment/Prediction phase|prediction phase]] of assessment; for more information on interpretation of this data, or how screenings fit in to the assessment process, click [[Evidence based assessment/Prediction phase|here.]] * '''''For a list of more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Common_screening_instruments click here.]''''' {| class="wikitable sortable" |- ! Measure (Wikipedia Link) !Format (Reporter) !Age Range !Administration/ Completion Time !Where to Access |- |[[Evidence based assessment/Instruments/Modified checklist for autism in toddlers|Modified Checklist for Autism in Toddlers (M-CHAT)]] |Questionnaire (Parent report) |18-30 months |5-10 minutes | * [https://mfr.osf.io/render?url=https://osf.io/utmxg/?action=download%26mode=render Free printable PDF MCHAT] *[https://www.autismspeaks.org/screen-your-child Free Online MCHAT] |- |[[wikipedia:Autism-spectrum_quotient|Autism Spectrum Quotient (AQ)]] |Questionnaire |16 years and up |10-15 minutes | * [https://psychology-tools.com/autism-spectrum-quotient/ Online version with scoring] * [https://mfr.osf.io/render?url=https://osf.io/4xu3y/?action=download%26mode=render AQ free printable PDF] * [https://mfr.osf.io/render?url=https://osf.io/fqsxm/?action=download%26mode=render Printable scoring guide] |- |[[wikipedia:Childhood_Autism_Rating_Scale|Childhood Autism Rating Scale (CARS)]] |Observation |2 years-adult |5-10 minutes |Not free |- |} === Interpreting autism screening measure scores === * For information on interpreting screening measure scores, [[Evidence based assessment/Prediction phase#Interpreting screening measure scores|'''click here.''']] ==[[Evidence based assessment/Prescription phase|'''Prescription phase''']]== ===Gold standard diagnostic interviews=== * For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews '''click here.'''] ===Recommended diagnostic interviews for autism spectrum disorder=== {| class="wikitable sortable" border="1" ! colspan="3" |Diagnostic instruments for ASD |- Format (Reporter) !Measure !Age Range !Administration/ Completion Time |- |Autism Diagnostic Observation Schedule, Second Edition (ADOS-2) |12 months- 30 months |40-60 minutes |- |Autism Diagnostic Interview, Revised (ADI-R) |18 months- adult | 90-150 minutes |- |Adaptive Behavior Assessment System, Second Edition (ABAS-II) |Birth- 89 years |20-30 minutes |} {{collapse top|More information about the above interviews|expand=yes}} '''A. Autism Diagnostic Observation Schedule, Second Edition (ADOS-2)''' -- &nbsp;The ADOS-2 is a semi-structured, play-based assessment of social and communicative behaviors indicative of autism. There are several different modules that can be used based off of the individual’s speech/communication level. Training is necessary to conduct the ADOS-2. '''B. Autism Diagnostic Interview, Revised (ADI-R) --'''&nbsp;The ADI-R is a caregiver interview that helps to provide a developmental history (ages 4-5) and current functioning level of restricted and repetitive behaviors and social impairment. Training is necessary to conduct the ADI-R. Due to the homogeneity of the population, there are many other process measures that can be used in autism assessments. Clinical judgment is recommended when deciding what additional measures should be included (e.g. executive functioning, sensory processing, cognitive flexibility, motor functioning, comorbidity). The two measures provided below are commonly used to assess adaptive behaviors (including communication and socialization, core deficits in ASD) and may provide important information regarding levels of daily functioning of individuals with ASD.'''.''' '''C. Vineland Adaptive Behavior Scales-Second edition (VABS-II)'''&nbsp;– Parent report recommended with careful attention paid to the Daily Living domain. More commonly used with children. '''D. Adaptive Behavior Assessment System, Second Edition (ABAS-II)'''&nbsp;– Parent report recommended with special attention to the Global Adaptive Composite (GAC). More commonly used with adults. {{collapse bottom}} ===[[Evidence based assessment/Process phase|'''Process phase''']]=== The following section contains a brief overview of treatment options for autism and list of process and outcome measures for autism. The section includes benchmarks based on published norms for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the [[Evidence based assessment/Process phase|process phase]] of assessment. For more information of differences between process and outcome measures, see the page on the [[Evidence based assessment/Process phase|process phase of assessment]]. === Process measures === The following section contains a list of process and outcome measures for autism. The section includes benchmarks based on published norms and on those on the spectrum samples for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the [[Evidence based assessment/Process phase|process phase]] of assessment. For more information of differences between process and outcome measures, see the page on the [[Evidence based assessment/Process phase|process phase of assessment]]. {{blockquotetop}} There are many processes that may be considered important when evaluating a child or an adolescent with ASD; however, due to the diversity of the population and symptom expression, there are too many to narrow down. Clinical judgment is recommended when deciding what additional measures should be included (e.g. executive functioning, sensory processing, cognitive flexibility). The two measures provided below are commonly used to assess adaptive behaviors (including communication and socialization, core deficits in ASD) and may provide important information regarding levels of daily functioning of individuals with ASD. {{blockquotebottom}} === Outcome and severity measures === This table includes clinically significant benchmarks for autism specific outcome measures * Information on how to interpret this table can be [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase found here]. * Additionally, these [[Evidence based assessment/Vignettes|vignettes]] might be helpful resources for understanding appropriate adaptation of outcome measures in practice. *''<u>For clinically significant change benchmarks for the CBCL, YSR, and TRF total, externalizing, internalizing, and attention benchmarks,</u>'' [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase&wteswitched=1#Clinically_significant_change_benchmarks_for_widely-used_outcome_measures see here.] {| class="wikitable sortable" border="1" ! colspan="8" |'''<u><big>Clinically significant change benchmarks for ASD outcome measures</big></u>''' |- | colspan="8" style="font-size:110%; text-align:center;" span | <b> <small>Benchmarks Based on Published Norms</small> </b> |- | rowspan="2" style="text-align:center;font-size:130%;" | <b> Measure</b> | rowspan="2" style="text-align:center;font-size:130%;" |<b>Subscale</b> | colspan="3" style="text-align:center;font-size:130%" width="300" |<b> Cut-off scores</b> | colspan="3" style="text-align:center;font-size:120%" |<b> Critical Change <br> (unstandardized scores)</b> |- | style="text-align:center;font-size:110%" | <b> A</b> | style="text-align:center;font-size:110%" | <b> B</b> | style="text-align:center;font-size:110%" | <b> C</b> | style="text-align:center;font-size:110%" | <b> 95%</b> | style="text-align:center;font-size:110%" | <b> 90%</b> | style="text-align:center;font-size:110%" | <b> SE_difference</b> |- | rowspan="1" style="text-align:center;" | '''CBCL T-scores <br> (2001 Norms)''' | style="text-align:right;" | <i> Total</i> | style="text-align:center;"| 49 | style="text-align:center;"| 70 | style="text-align:center;"| 58 | style="text-align:center;"| 5 | style="text-align:center;"| 4 | style="text-align:center;"| 2.4 |- | rowspan="6" style="text-align:center;" | '''Autism Diagnostic Observation Schedule <br> - Generic (ADOS-G)^6,12''' |style="text-align:right;"|''Module 1 Social Affect Total'' |style="text-align:center;"|8.1 |style="text-align:center;"|12.5 |style="text-align:center;"|10.2 |style="text-align:center;"|2.3 |style="text-align:center;"|1.9 |style="text-align:center;"|1.1 |- |style="text-align:right;"|''Module 1 RR Total'' |style="text-align:center;"|0.4 |style="text-align:center;"|4.4 |style="text-align:center;"|2.7 |style="text-align:center;"|1.1 |style="text-align:center;"|0.9 |style="text-align:center;"|0.5 |- |style="text-align:right;"|''Module 2 Social Affect Total'' |style="text-align:center;"|7.7 |style="text-align:center;"|10.4 |style="text-align:center;"|9.1 |style="text-align:center;"|2.0 |style="text-align:center;"|1.7 |style="text-align:center;"|1.0 |- |style="text-align:right;"|''Module 2 RR Total'' |style="text-align:center;"|1.2 |style="text-align:center;"|4.9 |style="text-align:center;"|3.2 |style="text-align:center;"|1.1 |style="text-align:center;"|0.9 |style="text-align:center;"|0.6 |- |style="text-align:right;"|''Module 3 Social Affect Total'' |style="text-align:center;"|3.7 |style="text-align:center;"|9.8 |style="text-align:center;"|7.1 |style="text-align:center;"|2.1 |style="text-align:center;"|1.8 |style="text-align:center;"|1.1 |- |style="text-align:right;"|''Module 3 RR Total'' |style="text-align:center;"|<nowiki>-0.4*</nowiki> |style="text-align:center;"|3.3 |style="text-align:center;"|1.9 |style="text-align:center;"|0.9 |style="text-align:center;"|0.8 |style="text-align:center;"|0.5 |- |style="text-align:center;"|'''Childhood Autism Rating Scale (CARS)<ref>{{cite journal|last1=Coplan|first1=J|last2=Jawad|first2=AF|date=July 2005|title=Modeling clinical outcome of children with autistic spectrum disorders.|journal=Pediatrics|volume=116|issue=1|pages=117-22|pmid=15995041}}</ref><ref name=":0">{{cite journal|last1=Chlebowski|first1=C|last2=Green|first2=JA|last3=Barton|first3=ML|last4=Fein|first4=D|date=July 2010|title=Using the childhood autism rating scale to diagnose autism spectrum disorders.|journal=Journal of autism and developmental disorders|volume=40|issue=7|pages=787-99|pmid=20054630}}</ref>''' |style="text-align:right;"|''Parent Total'' |style="text-align:center;"|23.0 |style="text-align:center;"|18.0 |style="text-align:center;"|18.6 |style="text-align:center;"|1.6 |style="text-align:center;"|1.4 |style="text-align:center;"|0.8 |- |style="text-align:center;"|'''Social Responsiveness Scale (SRS)'''<ref name=":0" />'''<br>Caregiver Report (Appendix B)''' |style="text-align:right;"|''Total'' |style="text-align:center;"|72.7 |style="text-align:center;"|62.8 |style="text-align:center;"|66.8 |style="text-align:center;"|11.3 |style="text-align:center;"|9.5 |style="text-align:center;"|5.8 |} === Treatment === * Please refer to the page on [[wikipedia:Autism_spectrum|Autism Spectrum Disorder]] for more information on available treatment or go to [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/autism/ Effective Child Therapy] for a curated resource on effective treatments for ASD. {{collapse top| Click here for more information on '''''ASD treatment'''''}} '''Behavior and Communication Approaches''' # ''Applied Behavior Analysis (ABA)²⁰'' #*Method of teaching appropriate behaviors by breaking tasks down into small discrete steps and training in a systematic and precise way called discrete trial training (DTT). #*Based on the context that children with ASD have significant difficulties with learning, learning through imitation and listening as typical peer # ''Early Intensive Behavioral Intervention (EIBI)²⁰'' #*Focuses on remediation of deficient language, imitation, pre-academics, self-help and social interaction skills broken down into discrete components, taught on a one-to-one basis in school and/or at home. #*Typically using discrete trial teaching, reinforcement, backward chaining, shaping, extinction, prompting and prompt fading. Parent involvement is essential.<ref name="Peters-Scheffer">{{cite journal|last1=Peters-Scheffer|first1=N|last2=Didden|first2=R|last3=Korzilius|first3=H|last4=Sturmey|first4=P|date=2011|title=A meta-analytic study on the effectiveness of comprehensive ABA-based early intervention programs for children with Autism Spectrum Disorders|journal=Research in Autism Spectrum Disorders|volume=5|issue=1|page=60-69}}</ref> # ''Pivotal Response Training (PRT)²³'' #*Derived from ABA, an approach that teaches the learner to seek out and respond to naturally occurring learning opportunities. #*Goals include the development of communication, language and positive social behaviors and relief from disruptive self-stimulatory behavior.<ref>{{cite journal|last1=Odom|first1=Samuel L.|last2=Collet-Klingenberg|first2=Lana|last3=Rogers|first3=Sally J.|last4=Hatton|first4=Deborah D.|title=Evidence-Based Practices in Interventions for Children and Youth with Autism Spectrum Disorders|journal=Preventing School Failure: Alternative Education for Children and Youth|date=19 May 2010|volume=54|issue=4|pages=275–282|doi=10.1080/10459881003785506}}</ref> # ''Early start Denver Model (ESDM)²¹'' #* A comprehensive early behavioral intervention for infants (as young as 12 months) to preschool- aged children with ASD, integrating applied behavior analysis (ABA) approaches with developmental and relationship-based approaches.<ref name="Dawson">{{cite journal|last1=Dawson|first1=G|last2=Rogers|first2=S|last3=Munson|first3=J|last4=Smith|first4=M|last5=Winter|first5=J|last6=Greenson|first6=J|last7=Donaldson|first7=A|last8=Varley|first8=J|title=Randomized, controlled trial of an intervention for toddlers with autism: the Early Start Denver Model.|journal=Pediatrics|date=January 2010|volume=125|issue=1|pages=e17-23|pmid=19948568}}</ref> # ''Developmental, Individual Differences, Relationship-Based Approach (DIR or “Floortime”)²²'' #*Objectives are to build healthy foundations for social, emotional, and intellectual capacities rather than focusing on skills and isolated behaviors. # ''Treatment and Education of Autistic and Related Communication-Handicapped Children (TEACCH)²⁴'' #*Statewide, community based intervention program that emphasizes environmental organization and visual supports, individualization of goals, and the teaching of independence and developmental skills. #*Teaching strategies are taught within the natural environment and within context. Includes early intervention services through adulthood.<ref>{{cite journal|last1=Dawson|first1=G|last2=Osterling|first2=J|title=Early Intervention in Autism|journal=The Effectiveness of Early Intervention|date=1997|pages=307-326}}</ref> # ''Others (Treatments tackling symptoms not exclusive to ASD)'' #* Cognitive Behavioral Therapy (CBT)<ref name="Kasari">{{cite journal|last1=Kasari|first1=C|last2=Lawton|first2=K|title=New directions in behavioral treatment of autism spectrum disorders.|journal=Current opinion in neurology|date=April 2010|volume=23|issue=2|pages=137-43|pmid=20160648}}</ref> #*Occupational Therapy #*Sensory Integration Therapy #*Speech Therapy #*Picture Exchange Communication System (PECS).<ref>{{cite book|last1=al.]|first1=Lynn Cannon ... [et|title=Unstuck and on target! : an executive function curriculum to improve flexibility for children with autism spectrum disorders|date=2011|publisher=Paul H. Brookes Pub. Co.|location=Baltimore|isbn=9781598572032|edition=Research}}</ref> '''Medication''' * The data on other relevant diagnoses indicate that children and youth are frequently treated with medication under an ASD diagnosis, despite the fact that the target symptoms may be commonly associated with other mental disorders (ADHD, Anxiety, Depression, etc.). * Approximately 70% of children with ASD ages 8 and up receive some form of psychoactive medication. Before recommending medication as a form of treatment, consult a supervisor and a medical doctor.^26,27<ref>{{cite journal|last1=Mandell|first1=DS|last2=Morales|first2=KH|last3=Marcus|first3=SC|last4=Stahmer|first4=AC|last5=Doshi|first5=J|last6=Polsky|first6=DE|date=March 2008|title=Psychotropic medication use among Medicaid-enrolled children with autism spectrum disorders.|journal=Pediatrics|volume=121|issue=3|pages=e441-8|pmid=18310165}}</ref><ref>{{cite journal|last1=Oswald|first1=DP|last2=Sonenklar|first2=NA|date=June 2007|title=Medication use among children with autism spectrum disorders.|journal=Journal of child and adolescent psychopharmacology|volume=17|issue=3|pages=348-55|pmid=17630868}}</ref> {{collapse bottom}} =='''External Resources'''== #[http://apps.who.int/classifications/icd10/browse/2016/en#/F84.0 ICD-10 diagnostic criteria] # [https://en.wikiversity.org/w/index.php?title=Helping_Give_Away_Psychological_Science/Resources/Annotated_List_of_Where_and_How_to_Find_a_Therapist&wteswitched=1#Other_low-cost_options Find-a-Therapist] (a curated list of find-a-therapist websites where you can find a provider) #[https://www.nimh.nih.gov/health/topics/autism-spectrum-disorders-asd/index.shtml NIMH] (information about schizophrenia) #https://www.autismspeaks.org/what-autism/diagnosis/mchat Free online autism screen for toddlers # OMIM (Online Mendelian Inheritance in Man) ##[https://www.omim.org/entry/209850?search=autism&highlight=autism%20autistic 209850] #[http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/autism/ Effective Child Therapy information on Autism Spectrum Disorder] ##Effective Child Therapy is website sponsored by Division 53 of the American Psychological Association (APA), or The [https://sccap53.org Society of Clinical Child and Adolescent Psychology] (SCCAP), in collaboration with the Association for Behavioral and Cognitive Therapies (ABCT). Use for information on symptoms and available treatments. =='''References'''== {{collapse top|Click here for references}} {{Reflist|30em}} # Centers for Disease Control and Prevention. (2012). Prevalence of autism spectrum disorders—Autism and Developmental Disabilities Monitoring Network, 14 Sites, United States, 2008. Morbidity and Mortality Weekly Report, 61 (3), 1–19. # Pedersen, A., Pettygrove, S., Meaney, F. J., Mancilla, K., Gotschall, K., Kessler, D. B., ... & Cunniff, C. (2012). Prevalence of autism spectrum disorders in Hispanic and non-Hispanic white children. Pediatrics, 129(3), e629-e635. # Charman, T., Baird, G., Simonoff, E., Loucas, T., Chandler, S., Meldrum, D., & Pickles, A. (2007). Efficacy of three screening instruments in the identification of autistic-spectrum disorders. The British Journal of Psychiatry, 191(6), 554-559. # Constantino, J.N., Davis, S.A., Todd, R.D., Schindler, M.K., Gross, M.M., Brophy, S.L., et al. Validation of a brief quantitative measure of autistic traits: comparison of the social responsiveness scale with the autism diagnostic interview-revised. J Autism Dev Disord. 2003 Aug;33(4):427-33. # Gotham, K., Pickles, A., & Lord, C. (2009). Standardizing ADOS scores for a measure of severity in autism spectrum disorders. Journal of autism and developmental disorders, 39(5), 693-705. # Robins, D. L., Fein, D., Barton, M. L., & Green, J. A. (2001). The Modified Checklist for Autism in Toddlers: an initial study investigating the early detection of autism and pervasive developmental disorders. Journal of autism and developmental disorders, 31(2), 131-144. # Fombonne, E. (2009). Epidemiology of pervasive developmental disorders.Pediatric research, 65(6), 591-598. # Constantino, J. N., Zhang, Y., Frazier, T., Abbacchi, A. M., & Law, P. (2010). Sibling recurrence and the genetic epidemiology of autism. The American journal of psychiatry, 167(11), 1349. # Durkin, M. S., Maenner, M. J., Meaney, F. J., Levy, S. E., DiGuiseppi, C., Nicholas, J. S., ... & Schieve, L. A. (2010). Socioeconomic inequality in the prevalence of autism spectrum disorder: evidence from a US cross-sectional study. PLoS One, 5(7), e11551. # Humphreys, B. P. (2010). Infants and Toddlers with Autism Spectrum Disorders: Early Identification and Early Intervention. Journal of Early Intervention, 32(75), 75-98. # Bastiaansen, J. A., Meffert, H. Hein, S. Huizinga, P. Ketelaars, C. Pijnenborg, M. ,... de Bildt, A. 2011). Diagnosing autism spectrum disorders in adults: The use of Autism Diagnostic Observation Schedule (ADOS) Module 4 Journal of Autism and Developmental Disorders, 41, 1256–1266 # Kamp-Becker, I., Ghahreman, M., Heinzel-Gutenbrunner, M., Peters, M., Remschmidt, H., & Becker, K. (2013). Evaluation of the revised algorithm of Autism Diagnostic Observation Schedule (ADOS) in the diagnostic investigation of high-functioning children and adolescents with autism spectrum disorders. Autism, 17(1), 87-102. # Hus, V., & Lord, C. (2013). Effects of child characteristics on the Autism Diagnostic Interview-Revised: Implications for use of scores as a measure of ASD severity. Journal of autism and developmental disorders, 43(2), 371-381. # Coplan, J., & Jawad, A. F. (2005). Modeling clinical outcome of children with autistic spectrum disorders. Pediatrics, 116(1), 117-122. # Chlebowski, C., Green, J. A., Barton, M. L., & Fein, D. (2010). Using the childhood autism rating scale to diagnose autism spectrum disorders. Journal of autism and developmental disorders, 40(7), 787-799. # Saulnier, C. A., & Klin, A. (2007). Brief report: social and communication abilities and disabilities in higher functioning individuals with autism and Asperger syndrome. Journal of Autism and Developmental Disorders, 37(4), 788-793 # Fenton, G., D’ardia, C., Valente, D., Del Vecchio, I., Fabrizi, A., & Bernabei, P. (2003). Vineland adaptive behavior profiles in children with autism and moderate to severe developmental delay. Autism, 7(3), 269-287. # Oakland, T., & Harrison, P. L. (Eds.). (2011). Adaptive behavior assessment system-ii: clinical use and interpretation. Academic Press. # Peters-Scheffer, N., Didden, R., Korzilius, H., & Sturmey, P. (2011). A meta-analytic study on the effectiveness of comprehensive ABA-based early intervention programs for children with Autism Spectrum Disorders. Research in Autism Spectrum Disorders, 5(1), 60-69. # Dawson, G., Rogers, S., Munson, J., Smith, M., Winter, J., Greenson, J., ... & Varley, J. (2010). Randomized, controlled trial of an intervention for toddlers with autism: the Early Start Denver Model. Pediatrics, 125(1), e17-e23. # Wieder, S., & Greenspan, S. I. (2003). Climbing the symbolic ladder in the DIR model through floor time/interactive play. Autism, 7(4), 425-435. # Odom, S. L., Collet-Klingenberg, L., Rogers, S. J., & Hatton, D. D. (2010). Evidence-based practices in interventions for children and youth with autism spectrum disorders. Preventing school failure: Alternative education for children and youth, 54(4), 275-282 # Dawson, G., & Osterling, J. (1997). Early intervention in autism. The effectiveness of early intervention, 307-326. # Kasari, C., & Lawton, K. (2010). New directions in behavioral treatment of autism spectrum disorders. Current Opinion in Neurology, 23(2), 137-143. # Mandell, D. S., Morales, K. H., Marcus, S. C., Stahmer, A. C., Doshi, J., & Polsky, D. E. (2008). Psychotropic medication use among Medicaid-enrolled children with autism spectrum disorders. Pediatrics, 121(3), e441-e448. # Oswald, D. P., & Sonenklar, N. A. (2007). Medication use among children with autism spectrum disorders. Journal of child and adolescent psychopharmacology, 17(3), 348-355. [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] {{collapse bottom}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] gya3xcdmhror42t3annevv83ex5gkvi 2419171 2419170 2022-08-26T01:50:04Z Ardenguo 2944162 /* Treatment */ made the collapsible box expanded by default wikitext text/x-wiki <noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{medical disclaimer}} {{:{{BASEPAGENAME}}/Sidebar}} ==[[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio"?''']]== For background information on what assessment portfolios are, click the link in the heading above. Want even 'more' information about this topic? There's an extended version of this page [[Evidence-based assessment/Autism spectrum disorder (assessment portfolio)/extended version|here]]. == [[Evidence based assessment/Preparation phase|'''Preparation phase''']] == === Diagnostic criteria for autism spectrum disorder=== {{blockquotetop}} <big>'''ICD-11 Diagnostic Criteria''':</big> Autism spectrum disorder is characterized by persistent deficits in the ability to initiate and to sustain reciprocal social interaction and social communication, and by a range of restricted, repetitive, and inflexible patterns of behaviour and interests. The onset of the disorder occurs during the developmental period, typically in early childhood, but symptoms may not become fully manifest until later, when social demands exceed limited capacities. Deficits are sufficiently severe to cause impairment in personal, family, social, educational, occupational or other important areas of functioning and are usually a pervasive feature of the individual’s functioning observable in all settings, although they may vary according to social, educational, or other context. Individuals along the spectrum exhibit a full range of intellectual functioning and language abilities. Note: The ICD-11 contains seven subcategories of ASD that can be found in the ICD-11, [https://icd.who.int/browse11/l-m/en#/http%3a%2f%2fid.who.int%2ficd%2fentity%2f120443468 here]. <big>'''ASD encompasses these previous DSM-IV diagnoses''':</big> *Autistic disorder (autism) *Asperger’s disorder *Childhood disintegrative disorder *Pervasive developmental disorder not otherwise specified '''<big>ASD is characterized by:</big>''' # deficits in social communication and social interaction and # restricted repetitive behaviors, interests, and activities (RRBs). Because both components are required for diagnosis of ASD, social communication disorder is diagnosed if no RRBs are present. '''<big>Changes in DSM-5 Criteria</big>''' * The diagnostic criteria for ASD changed from [[DSM-IV]] to [[wikipedia:Diagnostic_and_Statistical_Manual_of_Mental_Disorders#DSM-IV-TR_.282000.29|DSM-5]]. Summaries are available [http://www.dsm5.org/Documents/changes%20from%20dsm-iv-tr%20to%20dsm-5.pdf here] and [[wikipedia:DSM-5|here]]. {{blockquotebottom}} ===Base rates of ASD in children and adolescents in different populations and clinical settings=== {| class="wikitable sortable" border="1" |- ! Demography ! Setting (Reference) ! Base Rate ! Diagnostic Method |- | 11 ADDM sites | Autism and Developmental Disabilities Monitoring (ADDM) Network (2014) - 8 year olds *** | 1.5% (1 per 68) | Diagnosis by doctor based on DSM-IV-TR criteria |- | Epidemiological: 43,283 household surveys | National Health Statistics Report (NHIS; 2014), 3-17 year olds<ref>{{cite journal|last1=Zablotsky|first1=B|last2=Black|first2=LI|last3=Maenner|first3=MJ|last4=Schieve|first4=LA|last5=Blumberg|first5=SJ|title=Estimated Prevalence of Autism and Other Developmental Disabilities Following Questionnaire Changes in the 2014 National Health Interview Survey.|journal=National health statistics reports|date=13 November 2015|issue=87|pages=1-20|pmid=26632847}}</ref> | 2.2% (1 per 45) | DSM-IV-TR |- | 11 ADDM sites: Male/Female Ratio | The Autism and Developmental Disabilities Monitoring (ADDM) Network (2014) – 8 year olds | 1 in 42 boys (2.4%), 1 in 189 girls (.05%) | DSM-IV-TR |- | Came from family registry for those who had children under 18 years old in United States | Interactive Autism Network (IAN): Individual Sibling Recurrence<ref>{{cite journal|last1=Constantino|first1=JN|last2=Zhang|first2=Y|last3=Frazier|first3=T|last4=Abbacchi|first4=AM|last5=Law|first5=P|title=Sibling recurrence and the genetic epidemiology of autism.|journal=The American journal of psychiatry|date=November 2010|volume=167|issue=11|pages=1349-56|pmid=20889652}}</ref> | ASD status occurred in an additional child in 10.9% of families | DSM-IV-TR |- | 11 ADDM sites (Race/ethnicity study) | The Autism and Developmental Disabilities Monitoring (ADDM) Network (2014) – 8 year olds Race/Ethnicity: * Non-Hispanic White * Non-Hispanic Black * Hispanic * Asian | * '''Non-Hispanic White:''' 1 in 63 (1.6%) * '''Non-Hispanic Black:''' 1 in 81 (1.2%) * '''Hispanic:''' 1 in 91 (1.1%) * '''Asian:''' 1 in 81 (1.2%) | DSM-IV-TR |- | | style="text-align:left" | The Autism and Developmental Disabilities Monitoring (ADDM) Network (2010) – 8 year olds <br> :Race/Ethnicity<br> ::- Non-Hispanic White<br> - Non-Hispanic Black<br> - Hispanic<br> - Asian<br> - Other | style="text-align:left" | <br><br> <br>60.3%<br>15.7%<br>17.2%<br>3.3%<br>3.5% | DSM-IV-TR |- | Male/Female Ratio | Epidemiological study: Review of 43 studies<ref>{{Cite journal|last=Kogan|first=M. D.|last2=Blumberg|first2=S. J.|last3=Schieve|first3=L. A.|last4=Boyle|first4=C. A.|last5=Perrin|first5=J. M.|last6=Ghandour|first6=R. M.|last7=Singh|first7=G. K.|last8=Strickland|first8=B. B.|last9=Trevathan|first9=E.|date=2009-11-01|title=Prevalence of Parent-Reported Diagnosis of Autism Spectrum Disorder Among Children in the US, 2007|url=http://pediatrics.aappublications.org/cgi/doi/10.1542/peds.2009-1522|journal=PEDIATRICS|language=en|volume=124|issue=5|pages=1395–1403|doi=10.1542/peds.2009-1522|issn=0031-4005}}</ref> | 4.2% (4.2 male:1 female) | DSM-IV/Rating Scales/Clinical |} ==[[Evidence based assessment/Prediction phase|'''Prediction phase''']]== === Psychometric properties of screening instruments for autism spectrum disorder === The following section contains a list of screening and diagnostic instruments for autism. The section includes administration information, psychometric data, and PDFs or links to the screenings. * Screenings are used as part of the [[Evidence based assessment/Prediction phase|prediction phase]] of assessment; for more information on interpretation of this data, or how screenings fit in to the assessment process, click [[Evidence based assessment/Prediction phase|here.]] * '''''For a list of more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Common_screening_instruments click here.]''''' {| class="wikitable sortable" |- ! Measure (Wikipedia Link) !Format (Reporter) !Age Range !Administration/ Completion Time !Where to Access |- |[[Evidence based assessment/Instruments/Modified checklist for autism in toddlers|Modified Checklist for Autism in Toddlers (M-CHAT)]] |Questionnaire (Parent report) |18-30 months |5-10 minutes | * [https://mfr.osf.io/render?url=https://osf.io/utmxg/?action=download%26mode=render Free printable PDF MCHAT] *[https://www.autismspeaks.org/screen-your-child Free Online MCHAT] |- |[[wikipedia:Autism-spectrum_quotient|Autism Spectrum Quotient (AQ)]] |Questionnaire |16 years and up |10-15 minutes | * [https://psychology-tools.com/autism-spectrum-quotient/ Online version with scoring] * [https://mfr.osf.io/render?url=https://osf.io/4xu3y/?action=download%26mode=render AQ free printable PDF] * [https://mfr.osf.io/render?url=https://osf.io/fqsxm/?action=download%26mode=render Printable scoring guide] |- |[[wikipedia:Childhood_Autism_Rating_Scale|Childhood Autism Rating Scale (CARS)]] |Observation |2 years-adult |5-10 minutes |Not free |- |} === Interpreting autism screening measure scores === * For information on interpreting screening measure scores, [[Evidence based assessment/Prediction phase#Interpreting screening measure scores|'''click here.''']] ==[[Evidence based assessment/Prescription phase|'''Prescription phase''']]== ===Gold standard diagnostic interviews=== * For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews '''click here.'''] ===Recommended diagnostic interviews for autism spectrum disorder=== {| class="wikitable sortable" border="1" ! colspan="3" |Diagnostic instruments for ASD |- Format (Reporter) !Measure !Age Range !Administration/ Completion Time |- |Autism Diagnostic Observation Schedule, Second Edition (ADOS-2) |12 months- 30 months |40-60 minutes |- |Autism Diagnostic Interview, Revised (ADI-R) |18 months- adult | 90-150 minutes |- |Adaptive Behavior Assessment System, Second Edition (ABAS-II) |Birth- 89 years |20-30 minutes |} {{collapse top|More information about the above interviews|expand=yes}} '''A. Autism Diagnostic Observation Schedule, Second Edition (ADOS-2)''' -- &nbsp;The ADOS-2 is a semi-structured, play-based assessment of social and communicative behaviors indicative of autism. There are several different modules that can be used based off of the individual’s speech/communication level. Training is necessary to conduct the ADOS-2. '''B. Autism Diagnostic Interview, Revised (ADI-R) --'''&nbsp;The ADI-R is a caregiver interview that helps to provide a developmental history (ages 4-5) and current functioning level of restricted and repetitive behaviors and social impairment. Training is necessary to conduct the ADI-R. Due to the homogeneity of the population, there are many other process measures that can be used in autism assessments. Clinical judgment is recommended when deciding what additional measures should be included (e.g. executive functioning, sensory processing, cognitive flexibility, motor functioning, comorbidity). The two measures provided below are commonly used to assess adaptive behaviors (including communication and socialization, core deficits in ASD) and may provide important information regarding levels of daily functioning of individuals with ASD.'''.''' '''C. Vineland Adaptive Behavior Scales-Second edition (VABS-II)'''&nbsp;– Parent report recommended with careful attention paid to the Daily Living domain. More commonly used with children. '''D. Adaptive Behavior Assessment System, Second Edition (ABAS-II)'''&nbsp;– Parent report recommended with special attention to the Global Adaptive Composite (GAC). More commonly used with adults. {{collapse bottom}} ===[[Evidence based assessment/Process phase|'''Process phase''']]=== The following section contains a brief overview of treatment options for autism and list of process and outcome measures for autism. The section includes benchmarks based on published norms for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the [[Evidence based assessment/Process phase|process phase]] of assessment. For more information of differences between process and outcome measures, see the page on the [[Evidence based assessment/Process phase|process phase of assessment]]. === Process measures === The following section contains a list of process and outcome measures for autism. The section includes benchmarks based on published norms and on those on the spectrum samples for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the [[Evidence based assessment/Process phase|process phase]] of assessment. For more information of differences between process and outcome measures, see the page on the [[Evidence based assessment/Process phase|process phase of assessment]]. {{blockquotetop}} There are many processes that may be considered important when evaluating a child or an adolescent with ASD; however, due to the diversity of the population and symptom expression, there are too many to narrow down. Clinical judgment is recommended when deciding what additional measures should be included (e.g. executive functioning, sensory processing, cognitive flexibility). The two measures provided below are commonly used to assess adaptive behaviors (including communication and socialization, core deficits in ASD) and may provide important information regarding levels of daily functioning of individuals with ASD. {{blockquotebottom}} === Outcome and severity measures === This table includes clinically significant benchmarks for autism specific outcome measures * Information on how to interpret this table can be [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase found here]. * Additionally, these [[Evidence based assessment/Vignettes|vignettes]] might be helpful resources for understanding appropriate adaptation of outcome measures in practice. *''<u>For clinically significant change benchmarks for the CBCL, YSR, and TRF total, externalizing, internalizing, and attention benchmarks,</u>'' [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase&wteswitched=1#Clinically_significant_change_benchmarks_for_widely-used_outcome_measures see here.] {| class="wikitable sortable" border="1" ! colspan="8" |'''<u><big>Clinically significant change benchmarks for ASD outcome measures</big></u>''' |- | colspan="8" style="font-size:110%; text-align:center;" span | <b> <small>Benchmarks Based on Published Norms</small> </b> |- | rowspan="2" style="text-align:center;font-size:130%;" | <b> Measure</b> | rowspan="2" style="text-align:center;font-size:130%;" |<b>Subscale</b> | colspan="3" style="text-align:center;font-size:130%" width="300" |<b> Cut-off scores</b> | colspan="3" style="text-align:center;font-size:120%" |<b> Critical Change <br> (unstandardized scores)</b> |- | style="text-align:center;font-size:110%" | <b> A</b> | style="text-align:center;font-size:110%" | <b> B</b> | style="text-align:center;font-size:110%" | <b> C</b> | style="text-align:center;font-size:110%" | <b> 95%</b> | style="text-align:center;font-size:110%" | <b> 90%</b> | style="text-align:center;font-size:110%" | <b> SE_difference</b> |- | rowspan="1" style="text-align:center;" | '''CBCL T-scores <br> (2001 Norms)''' | style="text-align:right;" | <i> Total</i> | style="text-align:center;"| 49 | style="text-align:center;"| 70 | style="text-align:center;"| 58 | style="text-align:center;"| 5 | style="text-align:center;"| 4 | style="text-align:center;"| 2.4 |- | rowspan="6" style="text-align:center;" | '''Autism Diagnostic Observation Schedule <br> - Generic (ADOS-G)^6,12''' |style="text-align:right;"|''Module 1 Social Affect Total'' |style="text-align:center;"|8.1 |style="text-align:center;"|12.5 |style="text-align:center;"|10.2 |style="text-align:center;"|2.3 |style="text-align:center;"|1.9 |style="text-align:center;"|1.1 |- |style="text-align:right;"|''Module 1 RR Total'' |style="text-align:center;"|0.4 |style="text-align:center;"|4.4 |style="text-align:center;"|2.7 |style="text-align:center;"|1.1 |style="text-align:center;"|0.9 |style="text-align:center;"|0.5 |- |style="text-align:right;"|''Module 2 Social Affect Total'' |style="text-align:center;"|7.7 |style="text-align:center;"|10.4 |style="text-align:center;"|9.1 |style="text-align:center;"|2.0 |style="text-align:center;"|1.7 |style="text-align:center;"|1.0 |- |style="text-align:right;"|''Module 2 RR Total'' |style="text-align:center;"|1.2 |style="text-align:center;"|4.9 |style="text-align:center;"|3.2 |style="text-align:center;"|1.1 |style="text-align:center;"|0.9 |style="text-align:center;"|0.6 |- |style="text-align:right;"|''Module 3 Social Affect Total'' |style="text-align:center;"|3.7 |style="text-align:center;"|9.8 |style="text-align:center;"|7.1 |style="text-align:center;"|2.1 |style="text-align:center;"|1.8 |style="text-align:center;"|1.1 |- |style="text-align:right;"|''Module 3 RR Total'' |style="text-align:center;"|<nowiki>-0.4*</nowiki> |style="text-align:center;"|3.3 |style="text-align:center;"|1.9 |style="text-align:center;"|0.9 |style="text-align:center;"|0.8 |style="text-align:center;"|0.5 |- |style="text-align:center;"|'''Childhood Autism Rating Scale (CARS)<ref>{{cite journal|last1=Coplan|first1=J|last2=Jawad|first2=AF|date=July 2005|title=Modeling clinical outcome of children with autistic spectrum disorders.|journal=Pediatrics|volume=116|issue=1|pages=117-22|pmid=15995041}}</ref><ref name=":0">{{cite journal|last1=Chlebowski|first1=C|last2=Green|first2=JA|last3=Barton|first3=ML|last4=Fein|first4=D|date=July 2010|title=Using the childhood autism rating scale to diagnose autism spectrum disorders.|journal=Journal of autism and developmental disorders|volume=40|issue=7|pages=787-99|pmid=20054630}}</ref>''' |style="text-align:right;"|''Parent Total'' |style="text-align:center;"|23.0 |style="text-align:center;"|18.0 |style="text-align:center;"|18.6 |style="text-align:center;"|1.6 |style="text-align:center;"|1.4 |style="text-align:center;"|0.8 |- |style="text-align:center;"|'''Social Responsiveness Scale (SRS)'''<ref name=":0" />'''<br>Caregiver Report (Appendix B)''' |style="text-align:right;"|''Total'' |style="text-align:center;"|72.7 |style="text-align:center;"|62.8 |style="text-align:center;"|66.8 |style="text-align:center;"|11.3 |style="text-align:center;"|9.5 |style="text-align:center;"|5.8 |} === Treatment === * Please refer to the page on [[wikipedia:Autism_spectrum|Autism Spectrum Disorder]] for more information on available treatment or go to [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/autism/ Effective Child Therapy] for a curated resource on effective treatments for ASD. {{collapse top| More information on '''''ASD treatment'''''|expand=yes}} '''Behavior and Communication Approaches''' # ''Applied Behavior Analysis (ABA)²⁰'' #*Method of teaching appropriate behaviors by breaking tasks down into small discrete steps and training in a systematic and precise way called discrete trial training (DTT). #*Based on the context that children with ASD have significant difficulties with learning, learning through imitation and listening as typical peer # ''Early Intensive Behavioral Intervention (EIBI)²⁰'' #*Focuses on remediation of deficient language, imitation, pre-academics, self-help and social interaction skills broken down into discrete components, taught on a one-to-one basis in school and/or at home. #*Typically using discrete trial teaching, reinforcement, backward chaining, shaping, extinction, prompting and prompt fading. Parent involvement is essential.<ref name="Peters-Scheffer">{{cite journal|last1=Peters-Scheffer|first1=N|last2=Didden|first2=R|last3=Korzilius|first3=H|last4=Sturmey|first4=P|date=2011|title=A meta-analytic study on the effectiveness of comprehensive ABA-based early intervention programs for children with Autism Spectrum Disorders|journal=Research in Autism Spectrum Disorders|volume=5|issue=1|page=60-69}}</ref> # ''Pivotal Response Training (PRT)²³'' #*Derived from ABA, an approach that teaches the learner to seek out and respond to naturally occurring learning opportunities. #*Goals include the development of communication, language and positive social behaviors and relief from disruptive self-stimulatory behavior.<ref>{{cite journal|last1=Odom|first1=Samuel L.|last2=Collet-Klingenberg|first2=Lana|last3=Rogers|first3=Sally J.|last4=Hatton|first4=Deborah D.|title=Evidence-Based Practices in Interventions for Children and Youth with Autism Spectrum Disorders|journal=Preventing School Failure: Alternative Education for Children and Youth|date=19 May 2010|volume=54|issue=4|pages=275–282|doi=10.1080/10459881003785506}}</ref> # ''Early start Denver Model (ESDM)²¹'' #* A comprehensive early behavioral intervention for infants (as young as 12 months) to preschool- aged children with ASD, integrating applied behavior analysis (ABA) approaches with developmental and relationship-based approaches.<ref name="Dawson">{{cite journal|last1=Dawson|first1=G|last2=Rogers|first2=S|last3=Munson|first3=J|last4=Smith|first4=M|last5=Winter|first5=J|last6=Greenson|first6=J|last7=Donaldson|first7=A|last8=Varley|first8=J|title=Randomized, controlled trial of an intervention for toddlers with autism: the Early Start Denver Model.|journal=Pediatrics|date=January 2010|volume=125|issue=1|pages=e17-23|pmid=19948568}}</ref> # ''Developmental, Individual Differences, Relationship-Based Approach (DIR or “Floortime”)²²'' #*Objectives are to build healthy foundations for social, emotional, and intellectual capacities rather than focusing on skills and isolated behaviors. # ''Treatment and Education of Autistic and Related Communication-Handicapped Children (TEACCH)²⁴'' #*Statewide, community based intervention program that emphasizes environmental organization and visual supports, individualization of goals, and the teaching of independence and developmental skills. #*Teaching strategies are taught within the natural environment and within context. Includes early intervention services through adulthood.<ref>{{cite journal|last1=Dawson|first1=G|last2=Osterling|first2=J|title=Early Intervention in Autism|journal=The Effectiveness of Early Intervention|date=1997|pages=307-326}}</ref> # ''Others (Treatments tackling symptoms not exclusive to ASD)'' #* Cognitive Behavioral Therapy (CBT)<ref name="Kasari">{{cite journal|last1=Kasari|first1=C|last2=Lawton|first2=K|title=New directions in behavioral treatment of autism spectrum disorders.|journal=Current opinion in neurology|date=April 2010|volume=23|issue=2|pages=137-43|pmid=20160648}}</ref> #*Occupational Therapy #*Sensory Integration Therapy #*Speech Therapy #*Picture Exchange Communication System (PECS).<ref>{{cite book|last1=al.]|first1=Lynn Cannon ... [et|title=Unstuck and on target! : an executive function curriculum to improve flexibility for children with autism spectrum disorders|date=2011|publisher=Paul H. Brookes Pub. Co.|location=Baltimore|isbn=9781598572032|edition=Research}}</ref> '''Medication''' * The data on other relevant diagnoses indicate that children and youth are frequently treated with medication under an ASD diagnosis, despite the fact that the target symptoms may be commonly associated with other mental disorders (ADHD, Anxiety, Depression, etc.). * Approximately 70% of children with ASD ages 8 and up receive some form of psychoactive medication. Before recommending medication as a form of treatment, consult a supervisor and a medical doctor.^26,27<ref>{{cite journal|last1=Mandell|first1=DS|last2=Morales|first2=KH|last3=Marcus|first3=SC|last4=Stahmer|first4=AC|last5=Doshi|first5=J|last6=Polsky|first6=DE|date=March 2008|title=Psychotropic medication use among Medicaid-enrolled children with autism spectrum disorders.|journal=Pediatrics|volume=121|issue=3|pages=e441-8|pmid=18310165}}</ref><ref>{{cite journal|last1=Oswald|first1=DP|last2=Sonenklar|first2=NA|date=June 2007|title=Medication use among children with autism spectrum disorders.|journal=Journal of child and adolescent psychopharmacology|volume=17|issue=3|pages=348-55|pmid=17630868}}</ref> {{collapse bottom}} =='''External Resources'''== #[http://apps.who.int/classifications/icd10/browse/2016/en#/F84.0 ICD-10 diagnostic criteria] # [https://en.wikiversity.org/w/index.php?title=Helping_Give_Away_Psychological_Science/Resources/Annotated_List_of_Where_and_How_to_Find_a_Therapist&wteswitched=1#Other_low-cost_options Find-a-Therapist] (a curated list of find-a-therapist websites where you can find a provider) #[https://www.nimh.nih.gov/health/topics/autism-spectrum-disorders-asd/index.shtml NIMH] (information about schizophrenia) #https://www.autismspeaks.org/what-autism/diagnosis/mchat Free online autism screen for toddlers # OMIM (Online Mendelian Inheritance in Man) ##[https://www.omim.org/entry/209850?search=autism&highlight=autism%20autistic 209850] #[http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/autism/ Effective Child Therapy information on Autism Spectrum Disorder] ##Effective Child Therapy is website sponsored by Division 53 of the American Psychological Association (APA), or The [https://sccap53.org Society of Clinical Child and Adolescent Psychology] (SCCAP), in collaboration with the Association for Behavioral and Cognitive Therapies (ABCT). Use for information on symptoms and available treatments. =='''References'''== {{collapse top|Click here for references}} {{Reflist|30em}} # Centers for Disease Control and Prevention. (2012). Prevalence of autism spectrum disorders—Autism and Developmental Disabilities Monitoring Network, 14 Sites, United States, 2008. Morbidity and Mortality Weekly Report, 61 (3), 1–19. # Pedersen, A., Pettygrove, S., Meaney, F. J., Mancilla, K., Gotschall, K., Kessler, D. B., ... & Cunniff, C. (2012). Prevalence of autism spectrum disorders in Hispanic and non-Hispanic white children. Pediatrics, 129(3), e629-e635. # Charman, T., Baird, G., Simonoff, E., Loucas, T., Chandler, S., Meldrum, D., & Pickles, A. (2007). Efficacy of three screening instruments in the identification of autistic-spectrum disorders. The British Journal of Psychiatry, 191(6), 554-559. # Constantino, J.N., Davis, S.A., Todd, R.D., Schindler, M.K., Gross, M.M., Brophy, S.L., et al. Validation of a brief quantitative measure of autistic traits: comparison of the social responsiveness scale with the autism diagnostic interview-revised. J Autism Dev Disord. 2003 Aug;33(4):427-33. # Gotham, K., Pickles, A., & Lord, C. (2009). Standardizing ADOS scores for a measure of severity in autism spectrum disorders. Journal of autism and developmental disorders, 39(5), 693-705. # Robins, D. L., Fein, D., Barton, M. L., & Green, J. A. (2001). The Modified Checklist for Autism in Toddlers: an initial study investigating the early detection of autism and pervasive developmental disorders. Journal of autism and developmental disorders, 31(2), 131-144. # Fombonne, E. (2009). Epidemiology of pervasive developmental disorders.Pediatric research, 65(6), 591-598. # Constantino, J. N., Zhang, Y., Frazier, T., Abbacchi, A. M., & Law, P. (2010). Sibling recurrence and the genetic epidemiology of autism. The American journal of psychiatry, 167(11), 1349. # Durkin, M. S., Maenner, M. J., Meaney, F. J., Levy, S. E., DiGuiseppi, C., Nicholas, J. S., ... & Schieve, L. A. (2010). Socioeconomic inequality in the prevalence of autism spectrum disorder: evidence from a US cross-sectional study. PLoS One, 5(7), e11551. # Humphreys, B. P. (2010). Infants and Toddlers with Autism Spectrum Disorders: Early Identification and Early Intervention. Journal of Early Intervention, 32(75), 75-98. # Bastiaansen, J. A., Meffert, H. Hein, S. Huizinga, P. Ketelaars, C. Pijnenborg, M. ,... de Bildt, A. 2011). Diagnosing autism spectrum disorders in adults: The use of Autism Diagnostic Observation Schedule (ADOS) Module 4 Journal of Autism and Developmental Disorders, 41, 1256–1266 # Kamp-Becker, I., Ghahreman, M., Heinzel-Gutenbrunner, M., Peters, M., Remschmidt, H., & Becker, K. (2013). Evaluation of the revised algorithm of Autism Diagnostic Observation Schedule (ADOS) in the diagnostic investigation of high-functioning children and adolescents with autism spectrum disorders. Autism, 17(1), 87-102. # Hus, V., & Lord, C. (2013). Effects of child characteristics on the Autism Diagnostic Interview-Revised: Implications for use of scores as a measure of ASD severity. Journal of autism and developmental disorders, 43(2), 371-381. # Coplan, J., & Jawad, A. F. (2005). Modeling clinical outcome of children with autistic spectrum disorders. Pediatrics, 116(1), 117-122. # Chlebowski, C., Green, J. A., Barton, M. L., & Fein, D. (2010). Using the childhood autism rating scale to diagnose autism spectrum disorders. Journal of autism and developmental disorders, 40(7), 787-799. # Saulnier, C. A., & Klin, A. (2007). Brief report: social and communication abilities and disabilities in higher functioning individuals with autism and Asperger syndrome. Journal of Autism and Developmental Disorders, 37(4), 788-793 # Fenton, G., D’ardia, C., Valente, D., Del Vecchio, I., Fabrizi, A., & Bernabei, P. (2003). Vineland adaptive behavior profiles in children with autism and moderate to severe developmental delay. Autism, 7(3), 269-287. # Oakland, T., & Harrison, P. L. (Eds.). (2011). Adaptive behavior assessment system-ii: clinical use and interpretation. Academic Press. # Peters-Scheffer, N., Didden, R., Korzilius, H., & Sturmey, P. (2011). A meta-analytic study on the effectiveness of comprehensive ABA-based early intervention programs for children with Autism Spectrum Disorders. Research in Autism Spectrum Disorders, 5(1), 60-69. # Dawson, G., Rogers, S., Munson, J., Smith, M., Winter, J., Greenson, J., ... & Varley, J. (2010). Randomized, controlled trial of an intervention for toddlers with autism: the Early Start Denver Model. Pediatrics, 125(1), e17-e23. # Wieder, S., & Greenspan, S. I. (2003). Climbing the symbolic ladder in the DIR model through floor time/interactive play. Autism, 7(4), 425-435. # Odom, S. L., Collet-Klingenberg, L., Rogers, S. J., & Hatton, D. D. (2010). Evidence-based practices in interventions for children and youth with autism spectrum disorders. Preventing school failure: Alternative education for children and youth, 54(4), 275-282 # Dawson, G., & Osterling, J. (1997). Early intervention in autism. The effectiveness of early intervention, 307-326. # Kasari, C., & Lawton, K. (2010). New directions in behavioral treatment of autism spectrum disorders. Current Opinion in Neurology, 23(2), 137-143. # Mandell, D. S., Morales, K. H., Marcus, S. C., Stahmer, A. C., Doshi, J., & Polsky, D. E. (2008). Psychotropic medication use among Medicaid-enrolled children with autism spectrum disorders. Pediatrics, 121(3), e441-e448. # Oswald, D. P., & Sonenklar, N. A. (2007). Medication use among children with autism spectrum disorders. Journal of child and adolescent psychopharmacology, 17(3), 348-355. [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] {{collapse bottom}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] l0dmbrc01oh9ucslawryadgfz09416e 2419172 2419171 2022-08-26T01:50:36Z Ardenguo 2944162 /* References */ made references box expanded by default wikitext text/x-wiki <noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{medical disclaimer}} {{:{{BASEPAGENAME}}/Sidebar}} ==[[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio"?''']]== For background information on what assessment portfolios are, click the link in the heading above. Want even 'more' information about this topic? There's an extended version of this page [[Evidence-based assessment/Autism spectrum disorder (assessment portfolio)/extended version|here]]. == [[Evidence based assessment/Preparation phase|'''Preparation phase''']] == === Diagnostic criteria for autism spectrum disorder=== {{blockquotetop}} <big>'''ICD-11 Diagnostic Criteria''':</big> Autism spectrum disorder is characterized by persistent deficits in the ability to initiate and to sustain reciprocal social interaction and social communication, and by a range of restricted, repetitive, and inflexible patterns of behaviour and interests. The onset of the disorder occurs during the developmental period, typically in early childhood, but symptoms may not become fully manifest until later, when social demands exceed limited capacities. Deficits are sufficiently severe to cause impairment in personal, family, social, educational, occupational or other important areas of functioning and are usually a pervasive feature of the individual’s functioning observable in all settings, although they may vary according to social, educational, or other context. Individuals along the spectrum exhibit a full range of intellectual functioning and language abilities. Note: The ICD-11 contains seven subcategories of ASD that can be found in the ICD-11, [https://icd.who.int/browse11/l-m/en#/http%3a%2f%2fid.who.int%2ficd%2fentity%2f120443468 here]. <big>'''ASD encompasses these previous DSM-IV diagnoses''':</big> *Autistic disorder (autism) *Asperger’s disorder *Childhood disintegrative disorder *Pervasive developmental disorder not otherwise specified '''<big>ASD is characterized by:</big>''' # deficits in social communication and social interaction and # restricted repetitive behaviors, interests, and activities (RRBs). Because both components are required for diagnosis of ASD, social communication disorder is diagnosed if no RRBs are present. '''<big>Changes in DSM-5 Criteria</big>''' * The diagnostic criteria for ASD changed from [[DSM-IV]] to [[wikipedia:Diagnostic_and_Statistical_Manual_of_Mental_Disorders#DSM-IV-TR_.282000.29|DSM-5]]. Summaries are available [http://www.dsm5.org/Documents/changes%20from%20dsm-iv-tr%20to%20dsm-5.pdf here] and [[wikipedia:DSM-5|here]]. {{blockquotebottom}} ===Base rates of ASD in children and adolescents in different populations and clinical settings=== {| class="wikitable sortable" border="1" |- ! Demography ! Setting (Reference) ! Base Rate ! Diagnostic Method |- | 11 ADDM sites | Autism and Developmental Disabilities Monitoring (ADDM) Network (2014) - 8 year olds *** | 1.5% (1 per 68) | Diagnosis by doctor based on DSM-IV-TR criteria |- | Epidemiological: 43,283 household surveys | National Health Statistics Report (NHIS; 2014), 3-17 year olds<ref>{{cite journal|last1=Zablotsky|first1=B|last2=Black|first2=LI|last3=Maenner|first3=MJ|last4=Schieve|first4=LA|last5=Blumberg|first5=SJ|title=Estimated Prevalence of Autism and Other Developmental Disabilities Following Questionnaire Changes in the 2014 National Health Interview Survey.|journal=National health statistics reports|date=13 November 2015|issue=87|pages=1-20|pmid=26632847}}</ref> | 2.2% (1 per 45) | DSM-IV-TR |- | 11 ADDM sites: Male/Female Ratio | The Autism and Developmental Disabilities Monitoring (ADDM) Network (2014) – 8 year olds | 1 in 42 boys (2.4%), 1 in 189 girls (.05%) | DSM-IV-TR |- | Came from family registry for those who had children under 18 years old in United States | Interactive Autism Network (IAN): Individual Sibling Recurrence<ref>{{cite journal|last1=Constantino|first1=JN|last2=Zhang|first2=Y|last3=Frazier|first3=T|last4=Abbacchi|first4=AM|last5=Law|first5=P|title=Sibling recurrence and the genetic epidemiology of autism.|journal=The American journal of psychiatry|date=November 2010|volume=167|issue=11|pages=1349-56|pmid=20889652}}</ref> | ASD status occurred in an additional child in 10.9% of families | DSM-IV-TR |- | 11 ADDM sites (Race/ethnicity study) | The Autism and Developmental Disabilities Monitoring (ADDM) Network (2014) – 8 year olds Race/Ethnicity: * Non-Hispanic White * Non-Hispanic Black * Hispanic * Asian | * '''Non-Hispanic White:''' 1 in 63 (1.6%) * '''Non-Hispanic Black:''' 1 in 81 (1.2%) * '''Hispanic:''' 1 in 91 (1.1%) * '''Asian:''' 1 in 81 (1.2%) | DSM-IV-TR |- | | style="text-align:left" | The Autism and Developmental Disabilities Monitoring (ADDM) Network (2010) – 8 year olds <br> :Race/Ethnicity<br> ::- Non-Hispanic White<br> - Non-Hispanic Black<br> - Hispanic<br> - Asian<br> - Other | style="text-align:left" | <br><br> <br>60.3%<br>15.7%<br>17.2%<br>3.3%<br>3.5% | DSM-IV-TR |- | Male/Female Ratio | Epidemiological study: Review of 43 studies<ref>{{Cite journal|last=Kogan|first=M. D.|last2=Blumberg|first2=S. J.|last3=Schieve|first3=L. A.|last4=Boyle|first4=C. A.|last5=Perrin|first5=J. M.|last6=Ghandour|first6=R. M.|last7=Singh|first7=G. K.|last8=Strickland|first8=B. B.|last9=Trevathan|first9=E.|date=2009-11-01|title=Prevalence of Parent-Reported Diagnosis of Autism Spectrum Disorder Among Children in the US, 2007|url=http://pediatrics.aappublications.org/cgi/doi/10.1542/peds.2009-1522|journal=PEDIATRICS|language=en|volume=124|issue=5|pages=1395–1403|doi=10.1542/peds.2009-1522|issn=0031-4005}}</ref> | 4.2% (4.2 male:1 female) | DSM-IV/Rating Scales/Clinical |} ==[[Evidence based assessment/Prediction phase|'''Prediction phase''']]== === Psychometric properties of screening instruments for autism spectrum disorder === The following section contains a list of screening and diagnostic instruments for autism. The section includes administration information, psychometric data, and PDFs or links to the screenings. * Screenings are used as part of the [[Evidence based assessment/Prediction phase|prediction phase]] of assessment; for more information on interpretation of this data, or how screenings fit in to the assessment process, click [[Evidence based assessment/Prediction phase|here.]] * '''''For a list of more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Common_screening_instruments click here.]''''' {| class="wikitable sortable" |- ! Measure (Wikipedia Link) !Format (Reporter) !Age Range !Administration/ Completion Time !Where to Access |- |[[Evidence based assessment/Instruments/Modified checklist for autism in toddlers|Modified Checklist for Autism in Toddlers (M-CHAT)]] |Questionnaire (Parent report) |18-30 months |5-10 minutes | * [https://mfr.osf.io/render?url=https://osf.io/utmxg/?action=download%26mode=render Free printable PDF MCHAT] *[https://www.autismspeaks.org/screen-your-child Free Online MCHAT] |- |[[wikipedia:Autism-spectrum_quotient|Autism Spectrum Quotient (AQ)]] |Questionnaire |16 years and up |10-15 minutes | * [https://psychology-tools.com/autism-spectrum-quotient/ Online version with scoring] * [https://mfr.osf.io/render?url=https://osf.io/4xu3y/?action=download%26mode=render AQ free printable PDF] * [https://mfr.osf.io/render?url=https://osf.io/fqsxm/?action=download%26mode=render Printable scoring guide] |- |[[wikipedia:Childhood_Autism_Rating_Scale|Childhood Autism Rating Scale (CARS)]] |Observation |2 years-adult |5-10 minutes |Not free |- |} === Interpreting autism screening measure scores === * For information on interpreting screening measure scores, [[Evidence based assessment/Prediction phase#Interpreting screening measure scores|'''click here.''']] ==[[Evidence based assessment/Prescription phase|'''Prescription phase''']]== ===Gold standard diagnostic interviews=== * For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews '''click here.'''] ===Recommended diagnostic interviews for autism spectrum disorder=== {| class="wikitable sortable" border="1" ! colspan="3" |Diagnostic instruments for ASD |- Format (Reporter) !Measure !Age Range !Administration/ Completion Time |- |Autism Diagnostic Observation Schedule, Second Edition (ADOS-2) |12 months- 30 months |40-60 minutes |- |Autism Diagnostic Interview, Revised (ADI-R) |18 months- adult | 90-150 minutes |- |Adaptive Behavior Assessment System, Second Edition (ABAS-II) |Birth- 89 years |20-30 minutes |} {{collapse top|More information about the above interviews|expand=yes}} '''A. Autism Diagnostic Observation Schedule, Second Edition (ADOS-2)''' -- &nbsp;The ADOS-2 is a semi-structured, play-based assessment of social and communicative behaviors indicative of autism. There are several different modules that can be used based off of the individual’s speech/communication level. Training is necessary to conduct the ADOS-2. '''B. Autism Diagnostic Interview, Revised (ADI-R) --'''&nbsp;The ADI-R is a caregiver interview that helps to provide a developmental history (ages 4-5) and current functioning level of restricted and repetitive behaviors and social impairment. Training is necessary to conduct the ADI-R. Due to the homogeneity of the population, there are many other process measures that can be used in autism assessments. Clinical judgment is recommended when deciding what additional measures should be included (e.g. executive functioning, sensory processing, cognitive flexibility, motor functioning, comorbidity). The two measures provided below are commonly used to assess adaptive behaviors (including communication and socialization, core deficits in ASD) and may provide important information regarding levels of daily functioning of individuals with ASD.'''.''' '''C. Vineland Adaptive Behavior Scales-Second edition (VABS-II)'''&nbsp;– Parent report recommended with careful attention paid to the Daily Living domain. More commonly used with children. '''D. Adaptive Behavior Assessment System, Second Edition (ABAS-II)'''&nbsp;– Parent report recommended with special attention to the Global Adaptive Composite (GAC). More commonly used with adults. {{collapse bottom}} ===[[Evidence based assessment/Process phase|'''Process phase''']]=== The following section contains a brief overview of treatment options for autism and list of process and outcome measures for autism. The section includes benchmarks based on published norms for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the [[Evidence based assessment/Process phase|process phase]] of assessment. For more information of differences between process and outcome measures, see the page on the [[Evidence based assessment/Process phase|process phase of assessment]]. === Process measures === The following section contains a list of process and outcome measures for autism. The section includes benchmarks based on published norms and on those on the spectrum samples for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the [[Evidence based assessment/Process phase|process phase]] of assessment. For more information of differences between process and outcome measures, see the page on the [[Evidence based assessment/Process phase|process phase of assessment]]. {{blockquotetop}} There are many processes that may be considered important when evaluating a child or an adolescent with ASD; however, due to the diversity of the population and symptom expression, there are too many to narrow down. Clinical judgment is recommended when deciding what additional measures should be included (e.g. executive functioning, sensory processing, cognitive flexibility). The two measures provided below are commonly used to assess adaptive behaviors (including communication and socialization, core deficits in ASD) and may provide important information regarding levels of daily functioning of individuals with ASD. {{blockquotebottom}} === Outcome and severity measures === This table includes clinically significant benchmarks for autism specific outcome measures * Information on how to interpret this table can be [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase found here]. * Additionally, these [[Evidence based assessment/Vignettes|vignettes]] might be helpful resources for understanding appropriate adaptation of outcome measures in practice. *''<u>For clinically significant change benchmarks for the CBCL, YSR, and TRF total, externalizing, internalizing, and attention benchmarks,</u>'' [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase&wteswitched=1#Clinically_significant_change_benchmarks_for_widely-used_outcome_measures see here.] {| class="wikitable sortable" border="1" ! colspan="8" |'''<u><big>Clinically significant change benchmarks for ASD outcome measures</big></u>''' |- | colspan="8" style="font-size:110%; text-align:center;" span | <b> <small>Benchmarks Based on Published Norms</small> </b> |- | rowspan="2" style="text-align:center;font-size:130%;" | <b> Measure</b> | rowspan="2" style="text-align:center;font-size:130%;" |<b>Subscale</b> | colspan="3" style="text-align:center;font-size:130%" width="300" |<b> Cut-off scores</b> | colspan="3" style="text-align:center;font-size:120%" |<b> Critical Change <br> (unstandardized scores)</b> |- | style="text-align:center;font-size:110%" | <b> A</b> | style="text-align:center;font-size:110%" | <b> B</b> | style="text-align:center;font-size:110%" | <b> C</b> | style="text-align:center;font-size:110%" | <b> 95%</b> | style="text-align:center;font-size:110%" | <b> 90%</b> | style="text-align:center;font-size:110%" | <b> SE_difference</b> |- | rowspan="1" style="text-align:center;" | '''CBCL T-scores <br> (2001 Norms)''' | style="text-align:right;" | <i> Total</i> | style="text-align:center;"| 49 | style="text-align:center;"| 70 | style="text-align:center;"| 58 | style="text-align:center;"| 5 | style="text-align:center;"| 4 | style="text-align:center;"| 2.4 |- | rowspan="6" style="text-align:center;" | '''Autism Diagnostic Observation Schedule <br> - Generic (ADOS-G)^6,12''' |style="text-align:right;"|''Module 1 Social Affect Total'' |style="text-align:center;"|8.1 |style="text-align:center;"|12.5 |style="text-align:center;"|10.2 |style="text-align:center;"|2.3 |style="text-align:center;"|1.9 |style="text-align:center;"|1.1 |- |style="text-align:right;"|''Module 1 RR Total'' |style="text-align:center;"|0.4 |style="text-align:center;"|4.4 |style="text-align:center;"|2.7 |style="text-align:center;"|1.1 |style="text-align:center;"|0.9 |style="text-align:center;"|0.5 |- |style="text-align:right;"|''Module 2 Social Affect Total'' |style="text-align:center;"|7.7 |style="text-align:center;"|10.4 |style="text-align:center;"|9.1 |style="text-align:center;"|2.0 |style="text-align:center;"|1.7 |style="text-align:center;"|1.0 |- |style="text-align:right;"|''Module 2 RR Total'' |style="text-align:center;"|1.2 |style="text-align:center;"|4.9 |style="text-align:center;"|3.2 |style="text-align:center;"|1.1 |style="text-align:center;"|0.9 |style="text-align:center;"|0.6 |- |style="text-align:right;"|''Module 3 Social Affect Total'' |style="text-align:center;"|3.7 |style="text-align:center;"|9.8 |style="text-align:center;"|7.1 |style="text-align:center;"|2.1 |style="text-align:center;"|1.8 |style="text-align:center;"|1.1 |- |style="text-align:right;"|''Module 3 RR Total'' |style="text-align:center;"|<nowiki>-0.4*</nowiki> |style="text-align:center;"|3.3 |style="text-align:center;"|1.9 |style="text-align:center;"|0.9 |style="text-align:center;"|0.8 |style="text-align:center;"|0.5 |- |style="text-align:center;"|'''Childhood Autism Rating Scale (CARS)<ref>{{cite journal|last1=Coplan|first1=J|last2=Jawad|first2=AF|date=July 2005|title=Modeling clinical outcome of children with autistic spectrum disorders.|journal=Pediatrics|volume=116|issue=1|pages=117-22|pmid=15995041}}</ref><ref name=":0">{{cite journal|last1=Chlebowski|first1=C|last2=Green|first2=JA|last3=Barton|first3=ML|last4=Fein|first4=D|date=July 2010|title=Using the childhood autism rating scale to diagnose autism spectrum disorders.|journal=Journal of autism and developmental disorders|volume=40|issue=7|pages=787-99|pmid=20054630}}</ref>''' |style="text-align:right;"|''Parent Total'' |style="text-align:center;"|23.0 |style="text-align:center;"|18.0 |style="text-align:center;"|18.6 |style="text-align:center;"|1.6 |style="text-align:center;"|1.4 |style="text-align:center;"|0.8 |- |style="text-align:center;"|'''Social Responsiveness Scale (SRS)'''<ref name=":0" />'''<br>Caregiver Report (Appendix B)''' |style="text-align:right;"|''Total'' |style="text-align:center;"|72.7 |style="text-align:center;"|62.8 |style="text-align:center;"|66.8 |style="text-align:center;"|11.3 |style="text-align:center;"|9.5 |style="text-align:center;"|5.8 |} === Treatment === * Please refer to the page on [[wikipedia:Autism_spectrum|Autism Spectrum Disorder]] for more information on available treatment or go to [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/autism/ Effective Child Therapy] for a curated resource on effective treatments for ASD. {{collapse top| More information on '''''ASD treatment'''''|expand=yes}} '''Behavior and Communication Approaches''' # ''Applied Behavior Analysis (ABA)²⁰'' #*Method of teaching appropriate behaviors by breaking tasks down into small discrete steps and training in a systematic and precise way called discrete trial training (DTT). #*Based on the context that children with ASD have significant difficulties with learning, learning through imitation and listening as typical peer # ''Early Intensive Behavioral Intervention (EIBI)²⁰'' #*Focuses on remediation of deficient language, imitation, pre-academics, self-help and social interaction skills broken down into discrete components, taught on a one-to-one basis in school and/or at home. #*Typically using discrete trial teaching, reinforcement, backward chaining, shaping, extinction, prompting and prompt fading. Parent involvement is essential.<ref name="Peters-Scheffer">{{cite journal|last1=Peters-Scheffer|first1=N|last2=Didden|first2=R|last3=Korzilius|first3=H|last4=Sturmey|first4=P|date=2011|title=A meta-analytic study on the effectiveness of comprehensive ABA-based early intervention programs for children with Autism Spectrum Disorders|journal=Research in Autism Spectrum Disorders|volume=5|issue=1|page=60-69}}</ref> # ''Pivotal Response Training (PRT)²³'' #*Derived from ABA, an approach that teaches the learner to seek out and respond to naturally occurring learning opportunities. #*Goals include the development of communication, language and positive social behaviors and relief from disruptive self-stimulatory behavior.<ref>{{cite journal|last1=Odom|first1=Samuel L.|last2=Collet-Klingenberg|first2=Lana|last3=Rogers|first3=Sally J.|last4=Hatton|first4=Deborah D.|title=Evidence-Based Practices in Interventions for Children and Youth with Autism Spectrum Disorders|journal=Preventing School Failure: Alternative Education for Children and Youth|date=19 May 2010|volume=54|issue=4|pages=275–282|doi=10.1080/10459881003785506}}</ref> # ''Early start Denver Model (ESDM)²¹'' #* A comprehensive early behavioral intervention for infants (as young as 12 months) to preschool- aged children with ASD, integrating applied behavior analysis (ABA) approaches with developmental and relationship-based approaches.<ref name="Dawson">{{cite journal|last1=Dawson|first1=G|last2=Rogers|first2=S|last3=Munson|first3=J|last4=Smith|first4=M|last5=Winter|first5=J|last6=Greenson|first6=J|last7=Donaldson|first7=A|last8=Varley|first8=J|title=Randomized, controlled trial of an intervention for toddlers with autism: the Early Start Denver Model.|journal=Pediatrics|date=January 2010|volume=125|issue=1|pages=e17-23|pmid=19948568}}</ref> # ''Developmental, Individual Differences, Relationship-Based Approach (DIR or “Floortime”)²²'' #*Objectives are to build healthy foundations for social, emotional, and intellectual capacities rather than focusing on skills and isolated behaviors. # ''Treatment and Education of Autistic and Related Communication-Handicapped Children (TEACCH)²⁴'' #*Statewide, community based intervention program that emphasizes environmental organization and visual supports, individualization of goals, and the teaching of independence and developmental skills. #*Teaching strategies are taught within the natural environment and within context. Includes early intervention services through adulthood.<ref>{{cite journal|last1=Dawson|first1=G|last2=Osterling|first2=J|title=Early Intervention in Autism|journal=The Effectiveness of Early Intervention|date=1997|pages=307-326}}</ref> # ''Others (Treatments tackling symptoms not exclusive to ASD)'' #* Cognitive Behavioral Therapy (CBT)<ref name="Kasari">{{cite journal|last1=Kasari|first1=C|last2=Lawton|first2=K|title=New directions in behavioral treatment of autism spectrum disorders.|journal=Current opinion in neurology|date=April 2010|volume=23|issue=2|pages=137-43|pmid=20160648}}</ref> #*Occupational Therapy #*Sensory Integration Therapy #*Speech Therapy #*Picture Exchange Communication System (PECS).<ref>{{cite book|last1=al.]|first1=Lynn Cannon ... [et|title=Unstuck and on target! : an executive function curriculum to improve flexibility for children with autism spectrum disorders|date=2011|publisher=Paul H. Brookes Pub. Co.|location=Baltimore|isbn=9781598572032|edition=Research}}</ref> '''Medication''' * The data on other relevant diagnoses indicate that children and youth are frequently treated with medication under an ASD diagnosis, despite the fact that the target symptoms may be commonly associated with other mental disorders (ADHD, Anxiety, Depression, etc.). * Approximately 70% of children with ASD ages 8 and up receive some form of psychoactive medication. Before recommending medication as a form of treatment, consult a supervisor and a medical doctor.^26,27<ref>{{cite journal|last1=Mandell|first1=DS|last2=Morales|first2=KH|last3=Marcus|first3=SC|last4=Stahmer|first4=AC|last5=Doshi|first5=J|last6=Polsky|first6=DE|date=March 2008|title=Psychotropic medication use among Medicaid-enrolled children with autism spectrum disorders.|journal=Pediatrics|volume=121|issue=3|pages=e441-8|pmid=18310165}}</ref><ref>{{cite journal|last1=Oswald|first1=DP|last2=Sonenklar|first2=NA|date=June 2007|title=Medication use among children with autism spectrum disorders.|journal=Journal of child and adolescent psychopharmacology|volume=17|issue=3|pages=348-55|pmid=17630868}}</ref> {{collapse bottom}} =='''External Resources'''== #[http://apps.who.int/classifications/icd10/browse/2016/en#/F84.0 ICD-10 diagnostic criteria] # [https://en.wikiversity.org/w/index.php?title=Helping_Give_Away_Psychological_Science/Resources/Annotated_List_of_Where_and_How_to_Find_a_Therapist&wteswitched=1#Other_low-cost_options Find-a-Therapist] (a curated list of find-a-therapist websites where you can find a provider) #[https://www.nimh.nih.gov/health/topics/autism-spectrum-disorders-asd/index.shtml NIMH] (information about schizophrenia) #https://www.autismspeaks.org/what-autism/diagnosis/mchat Free online autism screen for toddlers # OMIM (Online Mendelian Inheritance in Man) ##[https://www.omim.org/entry/209850?search=autism&highlight=autism%20autistic 209850] #[http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/autism/ Effective Child Therapy information on Autism Spectrum Disorder] ##Effective Child Therapy is website sponsored by Division 53 of the American Psychological Association (APA), or The [https://sccap53.org Society of Clinical Child and Adolescent Psychology] (SCCAP), in collaboration with the Association for Behavioral and Cognitive Therapies (ABCT). Use for information on symptoms and available treatments. =='''References'''== {{collapse top|References|expand=yes}} {{Reflist|30em}} # Centers for Disease Control and Prevention. (2012). Prevalence of autism spectrum disorders—Autism and Developmental Disabilities Monitoring Network, 14 Sites, United States, 2008. Morbidity and Mortality Weekly Report, 61 (3), 1–19. # Pedersen, A., Pettygrove, S., Meaney, F. J., Mancilla, K., Gotschall, K., Kessler, D. B., ... & Cunniff, C. (2012). Prevalence of autism spectrum disorders in Hispanic and non-Hispanic white children. Pediatrics, 129(3), e629-e635. # Charman, T., Baird, G., Simonoff, E., Loucas, T., Chandler, S., Meldrum, D., & Pickles, A. (2007). Efficacy of three screening instruments in the identification of autistic-spectrum disorders. The British Journal of Psychiatry, 191(6), 554-559. # Constantino, J.N., Davis, S.A., Todd, R.D., Schindler, M.K., Gross, M.M., Brophy, S.L., et al. Validation of a brief quantitative measure of autistic traits: comparison of the social responsiveness scale with the autism diagnostic interview-revised. J Autism Dev Disord. 2003 Aug;33(4):427-33. # Gotham, K., Pickles, A., & Lord, C. (2009). Standardizing ADOS scores for a measure of severity in autism spectrum disorders. Journal of autism and developmental disorders, 39(5), 693-705. # Robins, D. L., Fein, D., Barton, M. L., & Green, J. A. (2001). The Modified Checklist for Autism in Toddlers: an initial study investigating the early detection of autism and pervasive developmental disorders. Journal of autism and developmental disorders, 31(2), 131-144. # Fombonne, E. (2009). Epidemiology of pervasive developmental disorders.Pediatric research, 65(6), 591-598. # Constantino, J. N., Zhang, Y., Frazier, T., Abbacchi, A. M., & Law, P. (2010). Sibling recurrence and the genetic epidemiology of autism. The American journal of psychiatry, 167(11), 1349. # Durkin, M. S., Maenner, M. J., Meaney, F. J., Levy, S. E., DiGuiseppi, C., Nicholas, J. S., ... & Schieve, L. A. (2010). Socioeconomic inequality in the prevalence of autism spectrum disorder: evidence from a US cross-sectional study. PLoS One, 5(7), e11551. # Humphreys, B. P. (2010). Infants and Toddlers with Autism Spectrum Disorders: Early Identification and Early Intervention. Journal of Early Intervention, 32(75), 75-98. # Bastiaansen, J. A., Meffert, H. Hein, S. Huizinga, P. Ketelaars, C. Pijnenborg, M. ,... de Bildt, A. 2011). Diagnosing autism spectrum disorders in adults: The use of Autism Diagnostic Observation Schedule (ADOS) Module 4 Journal of Autism and Developmental Disorders, 41, 1256–1266 # Kamp-Becker, I., Ghahreman, M., Heinzel-Gutenbrunner, M., Peters, M., Remschmidt, H., & Becker, K. (2013). Evaluation of the revised algorithm of Autism Diagnostic Observation Schedule (ADOS) in the diagnostic investigation of high-functioning children and adolescents with autism spectrum disorders. Autism, 17(1), 87-102. # Hus, V., & Lord, C. (2013). Effects of child characteristics on the Autism Diagnostic Interview-Revised: Implications for use of scores as a measure of ASD severity. Journal of autism and developmental disorders, 43(2), 371-381. # Coplan, J., & Jawad, A. F. (2005). Modeling clinical outcome of children with autistic spectrum disorders. Pediatrics, 116(1), 117-122. # Chlebowski, C., Green, J. A., Barton, M. L., & Fein, D. (2010). Using the childhood autism rating scale to diagnose autism spectrum disorders. Journal of autism and developmental disorders, 40(7), 787-799. # Saulnier, C. A., & Klin, A. (2007). Brief report: social and communication abilities and disabilities in higher functioning individuals with autism and Asperger syndrome. Journal of Autism and Developmental Disorders, 37(4), 788-793 # Fenton, G., D’ardia, C., Valente, D., Del Vecchio, I., Fabrizi, A., & Bernabei, P. (2003). Vineland adaptive behavior profiles in children with autism and moderate to severe developmental delay. Autism, 7(3), 269-287. # Oakland, T., & Harrison, P. L. (Eds.). (2011). Adaptive behavior assessment system-ii: clinical use and interpretation. Academic Press. # Peters-Scheffer, N., Didden, R., Korzilius, H., & Sturmey, P. (2011). A meta-analytic study on the effectiveness of comprehensive ABA-based early intervention programs for children with Autism Spectrum Disorders. Research in Autism Spectrum Disorders, 5(1), 60-69. # Dawson, G., Rogers, S., Munson, J., Smith, M., Winter, J., Greenson, J., ... & Varley, J. (2010). Randomized, controlled trial of an intervention for toddlers with autism: the Early Start Denver Model. Pediatrics, 125(1), e17-e23. # Wieder, S., & Greenspan, S. I. (2003). Climbing the symbolic ladder in the DIR model through floor time/interactive play. Autism, 7(4), 425-435. # Odom, S. L., Collet-Klingenberg, L., Rogers, S. J., & Hatton, D. D. (2010). Evidence-based practices in interventions for children and youth with autism spectrum disorders. Preventing school failure: Alternative education for children and youth, 54(4), 275-282 # Dawson, G., & Osterling, J. (1997). Early intervention in autism. The effectiveness of early intervention, 307-326. # Kasari, C., & Lawton, K. (2010). New directions in behavioral treatment of autism spectrum disorders. Current Opinion in Neurology, 23(2), 137-143. # Mandell, D. S., Morales, K. H., Marcus, S. C., Stahmer, A. C., Doshi, J., & Polsky, D. E. (2008). Psychotropic medication use among Medicaid-enrolled children with autism spectrum disorders. Pediatrics, 121(3), e441-e448. # Oswald, D. P., & Sonenklar, N. A. (2007). Medication use among children with autism spectrum disorders. Journal of child and adolescent psychopharmacology, 17(3), 348-355. [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] {{collapse bottom}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] etnjcnimplx67fpt36lvcnlaxg3t0f4 2419225 2419172 2022-08-26T03:07:19Z Ardenguo 2944162 /* Recommended diagnostic interviews for autism spectrum disorder */ Made the collapsible box expanded by default, slightly changed title to be consistent with other portfolios ("about" --> "on") wikitext text/x-wiki <noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{medical disclaimer}} {{:{{BASEPAGENAME}}/Sidebar}} ==[[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio"?''']]== For background information on what assessment portfolios are, click the link in the heading above. Want even 'more' information about this topic? There's an extended version of this page [[Evidence-based assessment/Autism spectrum disorder (assessment portfolio)/extended version|here]]. == [[Evidence based assessment/Preparation phase|'''Preparation phase''']] == === Diagnostic criteria for autism spectrum disorder=== {{blockquotetop}} <big>'''ICD-11 Diagnostic Criteria''':</big> Autism spectrum disorder is characterized by persistent deficits in the ability to initiate and to sustain reciprocal social interaction and social communication, and by a range of restricted, repetitive, and inflexible patterns of behaviour and interests. The onset of the disorder occurs during the developmental period, typically in early childhood, but symptoms may not become fully manifest until later, when social demands exceed limited capacities. Deficits are sufficiently severe to cause impairment in personal, family, social, educational, occupational or other important areas of functioning and are usually a pervasive feature of the individual’s functioning observable in all settings, although they may vary according to social, educational, or other context. Individuals along the spectrum exhibit a full range of intellectual functioning and language abilities. Note: The ICD-11 contains seven subcategories of ASD that can be found in the ICD-11, [https://icd.who.int/browse11/l-m/en#/http%3a%2f%2fid.who.int%2ficd%2fentity%2f120443468 here]. <big>'''ASD encompasses these previous DSM-IV diagnoses''':</big> *Autistic disorder (autism) *Asperger’s disorder *Childhood disintegrative disorder *Pervasive developmental disorder not otherwise specified '''<big>ASD is characterized by:</big>''' # deficits in social communication and social interaction and # restricted repetitive behaviors, interests, and activities (RRBs). Because both components are required for diagnosis of ASD, social communication disorder is diagnosed if no RRBs are present. '''<big>Changes in DSM-5 Criteria</big>''' * The diagnostic criteria for ASD changed from [[DSM-IV]] to [[wikipedia:Diagnostic_and_Statistical_Manual_of_Mental_Disorders#DSM-IV-TR_.282000.29|DSM-5]]. Summaries are available [http://www.dsm5.org/Documents/changes%20from%20dsm-iv-tr%20to%20dsm-5.pdf here] and [[wikipedia:DSM-5|here]]. {{blockquotebottom}} ===Base rates of ASD in children and adolescents in different populations and clinical settings=== {| class="wikitable sortable" border="1" |- ! Demography ! Setting (Reference) ! Base Rate ! Diagnostic Method |- | 11 ADDM sites | Autism and Developmental Disabilities Monitoring (ADDM) Network (2014) - 8 year olds *** | 1.5% (1 per 68) | Diagnosis by doctor based on DSM-IV-TR criteria |- | Epidemiological: 43,283 household surveys | National Health Statistics Report (NHIS; 2014), 3-17 year olds<ref>{{cite journal|last1=Zablotsky|first1=B|last2=Black|first2=LI|last3=Maenner|first3=MJ|last4=Schieve|first4=LA|last5=Blumberg|first5=SJ|title=Estimated Prevalence of Autism and Other Developmental Disabilities Following Questionnaire Changes in the 2014 National Health Interview Survey.|journal=National health statistics reports|date=13 November 2015|issue=87|pages=1-20|pmid=26632847}}</ref> | 2.2% (1 per 45) | DSM-IV-TR |- | 11 ADDM sites: Male/Female Ratio | The Autism and Developmental Disabilities Monitoring (ADDM) Network (2014) – 8 year olds | 1 in 42 boys (2.4%), 1 in 189 girls (.05%) | DSM-IV-TR |- | Came from family registry for those who had children under 18 years old in United States | Interactive Autism Network (IAN): Individual Sibling Recurrence<ref>{{cite journal|last1=Constantino|first1=JN|last2=Zhang|first2=Y|last3=Frazier|first3=T|last4=Abbacchi|first4=AM|last5=Law|first5=P|title=Sibling recurrence and the genetic epidemiology of autism.|journal=The American journal of psychiatry|date=November 2010|volume=167|issue=11|pages=1349-56|pmid=20889652}}</ref> | ASD status occurred in an additional child in 10.9% of families | DSM-IV-TR |- | 11 ADDM sites (Race/ethnicity study) | The Autism and Developmental Disabilities Monitoring (ADDM) Network (2014) – 8 year olds Race/Ethnicity: * Non-Hispanic White * Non-Hispanic Black * Hispanic * Asian | * '''Non-Hispanic White:''' 1 in 63 (1.6%) * '''Non-Hispanic Black:''' 1 in 81 (1.2%) * '''Hispanic:''' 1 in 91 (1.1%) * '''Asian:''' 1 in 81 (1.2%) | DSM-IV-TR |- | | style="text-align:left" | The Autism and Developmental Disabilities Monitoring (ADDM) Network (2010) – 8 year olds <br> :Race/Ethnicity<br> ::- Non-Hispanic White<br> - Non-Hispanic Black<br> - Hispanic<br> - Asian<br> - Other | style="text-align:left" | <br><br> <br>60.3%<br>15.7%<br>17.2%<br>3.3%<br>3.5% | DSM-IV-TR |- | Male/Female Ratio | Epidemiological study: Review of 43 studies<ref>{{Cite journal|last=Kogan|first=M. D.|last2=Blumberg|first2=S. J.|last3=Schieve|first3=L. A.|last4=Boyle|first4=C. A.|last5=Perrin|first5=J. M.|last6=Ghandour|first6=R. M.|last7=Singh|first7=G. K.|last8=Strickland|first8=B. B.|last9=Trevathan|first9=E.|date=2009-11-01|title=Prevalence of Parent-Reported Diagnosis of Autism Spectrum Disorder Among Children in the US, 2007|url=http://pediatrics.aappublications.org/cgi/doi/10.1542/peds.2009-1522|journal=PEDIATRICS|language=en|volume=124|issue=5|pages=1395–1403|doi=10.1542/peds.2009-1522|issn=0031-4005}}</ref> | 4.2% (4.2 male:1 female) | DSM-IV/Rating Scales/Clinical |} ==[[Evidence based assessment/Prediction phase|'''Prediction phase''']]== === Psychometric properties of screening instruments for autism spectrum disorder === The following section contains a list of screening and diagnostic instruments for autism. The section includes administration information, psychometric data, and PDFs or links to the screenings. * Screenings are used as part of the [[Evidence based assessment/Prediction phase|prediction phase]] of assessment; for more information on interpretation of this data, or how screenings fit in to the assessment process, click [[Evidence based assessment/Prediction phase|here.]] * '''''For a list of more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Common_screening_instruments click here.]''''' {| class="wikitable sortable" |- ! Measure (Wikipedia Link) !Format (Reporter) !Age Range !Administration/ Completion Time !Where to Access |- |[[Evidence based assessment/Instruments/Modified checklist for autism in toddlers|Modified Checklist for Autism in Toddlers (M-CHAT)]] |Questionnaire (Parent report) |18-30 months |5-10 minutes | * [https://mfr.osf.io/render?url=https://osf.io/utmxg/?action=download%26mode=render Free printable PDF MCHAT] *[https://www.autismspeaks.org/screen-your-child Free Online MCHAT] |- |[[wikipedia:Autism-spectrum_quotient|Autism Spectrum Quotient (AQ)]] |Questionnaire |16 years and up |10-15 minutes | * [https://psychology-tools.com/autism-spectrum-quotient/ Online version with scoring] * [https://mfr.osf.io/render?url=https://osf.io/4xu3y/?action=download%26mode=render AQ free printable PDF] * [https://mfr.osf.io/render?url=https://osf.io/fqsxm/?action=download%26mode=render Printable scoring guide] |- |[[wikipedia:Childhood_Autism_Rating_Scale|Childhood Autism Rating Scale (CARS)]] |Observation |2 years-adult |5-10 minutes |Not free |- |} === Interpreting autism screening measure scores === * For information on interpreting screening measure scores, [[Evidence based assessment/Prediction phase#Interpreting screening measure scores|'''click here.''']] ==[[Evidence based assessment/Prescription phase|'''Prescription phase''']]== ===Gold standard diagnostic interviews=== * For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews '''click here.'''] ===Recommended diagnostic interviews for autism spectrum disorder=== {| class="wikitable sortable" border="1" ! colspan="3" |Diagnostic instruments for ASD |- Format (Reporter) !Measure !Age Range !Administration/ Completion Time |- |Autism Diagnostic Observation Schedule, Second Edition (ADOS-2) |12 months- 30 months |40-60 minutes |- |Autism Diagnostic Interview, Revised (ADI-R) |18 months- adult | 90-150 minutes |- |Adaptive Behavior Assessment System, Second Edition (ABAS-II) |Birth- 89 years |20-30 minutes |} {{collapse top|More information on the above interviews|expand=yes}} '''A. Autism Diagnostic Observation Schedule, Second Edition (ADOS-2)''' -- &nbsp;The ADOS-2 is a semi-structured, play-based assessment of social and communicative behaviors indicative of autism. There are several different modules that can be used based off of the individual’s speech/communication level. Training is necessary to conduct the ADOS-2. '''B. Autism Diagnostic Interview, Revised (ADI-R) --'''&nbsp;The ADI-R is a caregiver interview that helps to provide a developmental history (ages 4-5) and current functioning level of restricted and repetitive behaviors and social impairment. Training is necessary to conduct the ADI-R. Due to the homogeneity of the population, there are many other process measures that can be used in autism assessments. Clinical judgment is recommended when deciding what additional measures should be included (e.g. executive functioning, sensory processing, cognitive flexibility, motor functioning, comorbidity). The two measures provided below are commonly used to assess adaptive behaviors (including communication and socialization, core deficits in ASD) and may provide important information regarding levels of daily functioning of individuals with ASD.'''.''' '''C. Vineland Adaptive Behavior Scales-Second edition (VABS-II)'''&nbsp;– Parent report recommended with careful attention paid to the Daily Living domain. More commonly used with children. '''D. Adaptive Behavior Assessment System, Second Edition (ABAS-II)'''&nbsp;– Parent report recommended with special attention to the Global Adaptive Composite (GAC). More commonly used with adults. {{collapse bottom}} ===[[Evidence based assessment/Process phase|'''Process phase''']]=== The following section contains a brief overview of treatment options for autism and list of process and outcome measures for autism. The section includes benchmarks based on published norms for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the [[Evidence based assessment/Process phase|process phase]] of assessment. For more information of differences between process and outcome measures, see the page on the [[Evidence based assessment/Process phase|process phase of assessment]]. === Process measures === The following section contains a list of process and outcome measures for autism. The section includes benchmarks based on published norms and on those on the spectrum samples for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the [[Evidence based assessment/Process phase|process phase]] of assessment. For more information of differences between process and outcome measures, see the page on the [[Evidence based assessment/Process phase|process phase of assessment]]. {{blockquotetop}} There are many processes that may be considered important when evaluating a child or an adolescent with ASD; however, due to the diversity of the population and symptom expression, there are too many to narrow down. Clinical judgment is recommended when deciding what additional measures should be included (e.g. executive functioning, sensory processing, cognitive flexibility). The two measures provided below are commonly used to assess adaptive behaviors (including communication and socialization, core deficits in ASD) and may provide important information regarding levels of daily functioning of individuals with ASD. {{blockquotebottom}} === Outcome and severity measures === This table includes clinically significant benchmarks for autism specific outcome measures * Information on how to interpret this table can be [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase found here]. * Additionally, these [[Evidence based assessment/Vignettes|vignettes]] might be helpful resources for understanding appropriate adaptation of outcome measures in practice. *''<u>For clinically significant change benchmarks for the CBCL, YSR, and TRF total, externalizing, internalizing, and attention benchmarks,</u>'' [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase&wteswitched=1#Clinically_significant_change_benchmarks_for_widely-used_outcome_measures see here.] {| class="wikitable sortable" border="1" ! colspan="8" |'''<u><big>Clinically significant change benchmarks for ASD outcome measures</big></u>''' |- | colspan="8" style="font-size:110%; text-align:center;" span | <b> <small>Benchmarks Based on Published Norms</small> </b> |- | rowspan="2" style="text-align:center;font-size:130%;" | <b> Measure</b> | rowspan="2" style="text-align:center;font-size:130%;" |<b>Subscale</b> | colspan="3" style="text-align:center;font-size:130%" width="300" |<b> Cut-off scores</b> | colspan="3" style="text-align:center;font-size:120%" |<b> Critical Change <br> (unstandardized scores)</b> |- | style="text-align:center;font-size:110%" | <b> A</b> | style="text-align:center;font-size:110%" | <b> B</b> | style="text-align:center;font-size:110%" | <b> C</b> | style="text-align:center;font-size:110%" | <b> 95%</b> | style="text-align:center;font-size:110%" | <b> 90%</b> | style="text-align:center;font-size:110%" | <b> SE_difference</b> |- | rowspan="1" style="text-align:center;" | '''CBCL T-scores <br> (2001 Norms)''' | style="text-align:right;" | <i> Total</i> | style="text-align:center;"| 49 | style="text-align:center;"| 70 | style="text-align:center;"| 58 | style="text-align:center;"| 5 | style="text-align:center;"| 4 | style="text-align:center;"| 2.4 |- | rowspan="6" style="text-align:center;" | '''Autism Diagnostic Observation Schedule <br> - Generic (ADOS-G)^6,12''' |style="text-align:right;"|''Module 1 Social Affect Total'' |style="text-align:center;"|8.1 |style="text-align:center;"|12.5 |style="text-align:center;"|10.2 |style="text-align:center;"|2.3 |style="text-align:center;"|1.9 |style="text-align:center;"|1.1 |- |style="text-align:right;"|''Module 1 RR Total'' |style="text-align:center;"|0.4 |style="text-align:center;"|4.4 |style="text-align:center;"|2.7 |style="text-align:center;"|1.1 |style="text-align:center;"|0.9 |style="text-align:center;"|0.5 |- |style="text-align:right;"|''Module 2 Social Affect Total'' |style="text-align:center;"|7.7 |style="text-align:center;"|10.4 |style="text-align:center;"|9.1 |style="text-align:center;"|2.0 |style="text-align:center;"|1.7 |style="text-align:center;"|1.0 |- |style="text-align:right;"|''Module 2 RR Total'' |style="text-align:center;"|1.2 |style="text-align:center;"|4.9 |style="text-align:center;"|3.2 |style="text-align:center;"|1.1 |style="text-align:center;"|0.9 |style="text-align:center;"|0.6 |- |style="text-align:right;"|''Module 3 Social Affect Total'' |style="text-align:center;"|3.7 |style="text-align:center;"|9.8 |style="text-align:center;"|7.1 |style="text-align:center;"|2.1 |style="text-align:center;"|1.8 |style="text-align:center;"|1.1 |- |style="text-align:right;"|''Module 3 RR Total'' |style="text-align:center;"|<nowiki>-0.4*</nowiki> |style="text-align:center;"|3.3 |style="text-align:center;"|1.9 |style="text-align:center;"|0.9 |style="text-align:center;"|0.8 |style="text-align:center;"|0.5 |- |style="text-align:center;"|'''Childhood Autism Rating Scale (CARS)<ref>{{cite journal|last1=Coplan|first1=J|last2=Jawad|first2=AF|date=July 2005|title=Modeling clinical outcome of children with autistic spectrum disorders.|journal=Pediatrics|volume=116|issue=1|pages=117-22|pmid=15995041}}</ref><ref name=":0">{{cite journal|last1=Chlebowski|first1=C|last2=Green|first2=JA|last3=Barton|first3=ML|last4=Fein|first4=D|date=July 2010|title=Using the childhood autism rating scale to diagnose autism spectrum disorders.|journal=Journal of autism and developmental disorders|volume=40|issue=7|pages=787-99|pmid=20054630}}</ref>''' |style="text-align:right;"|''Parent Total'' |style="text-align:center;"|23.0 |style="text-align:center;"|18.0 |style="text-align:center;"|18.6 |style="text-align:center;"|1.6 |style="text-align:center;"|1.4 |style="text-align:center;"|0.8 |- |style="text-align:center;"|'''Social Responsiveness Scale (SRS)'''<ref name=":0" />'''<br>Caregiver Report (Appendix B)''' |style="text-align:right;"|''Total'' |style="text-align:center;"|72.7 |style="text-align:center;"|62.8 |style="text-align:center;"|66.8 |style="text-align:center;"|11.3 |style="text-align:center;"|9.5 |style="text-align:center;"|5.8 |} === Treatment === * Please refer to the page on [[wikipedia:Autism_spectrum|Autism Spectrum Disorder]] for more information on available treatment or go to [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/autism/ Effective Child Therapy] for a curated resource on effective treatments for ASD. {{collapse top| More information on '''''ASD treatment'''''|expand=yes}} '''Behavior and Communication Approaches''' # ''Applied Behavior Analysis (ABA)²⁰'' #*Method of teaching appropriate behaviors by breaking tasks down into small discrete steps and training in a systematic and precise way called discrete trial training (DTT). #*Based on the context that children with ASD have significant difficulties with learning, learning through imitation and listening as typical peer # ''Early Intensive Behavioral Intervention (EIBI)²⁰'' #*Focuses on remediation of deficient language, imitation, pre-academics, self-help and social interaction skills broken down into discrete components, taught on a one-to-one basis in school and/or at home. #*Typically using discrete trial teaching, reinforcement, backward chaining, shaping, extinction, prompting and prompt fading. Parent involvement is essential.<ref name="Peters-Scheffer">{{cite journal|last1=Peters-Scheffer|first1=N|last2=Didden|first2=R|last3=Korzilius|first3=H|last4=Sturmey|first4=P|date=2011|title=A meta-analytic study on the effectiveness of comprehensive ABA-based early intervention programs for children with Autism Spectrum Disorders|journal=Research in Autism Spectrum Disorders|volume=5|issue=1|page=60-69}}</ref> # ''Pivotal Response Training (PRT)²³'' #*Derived from ABA, an approach that teaches the learner to seek out and respond to naturally occurring learning opportunities. #*Goals include the development of communication, language and positive social behaviors and relief from disruptive self-stimulatory behavior.<ref>{{cite journal|last1=Odom|first1=Samuel L.|last2=Collet-Klingenberg|first2=Lana|last3=Rogers|first3=Sally J.|last4=Hatton|first4=Deborah D.|title=Evidence-Based Practices in Interventions for Children and Youth with Autism Spectrum Disorders|journal=Preventing School Failure: Alternative Education for Children and Youth|date=19 May 2010|volume=54|issue=4|pages=275–282|doi=10.1080/10459881003785506}}</ref> # ''Early start Denver Model (ESDM)²¹'' #* A comprehensive early behavioral intervention for infants (as young as 12 months) to preschool- aged children with ASD, integrating applied behavior analysis (ABA) approaches with developmental and relationship-based approaches.<ref name="Dawson">{{cite journal|last1=Dawson|first1=G|last2=Rogers|first2=S|last3=Munson|first3=J|last4=Smith|first4=M|last5=Winter|first5=J|last6=Greenson|first6=J|last7=Donaldson|first7=A|last8=Varley|first8=J|title=Randomized, controlled trial of an intervention for toddlers with autism: the Early Start Denver Model.|journal=Pediatrics|date=January 2010|volume=125|issue=1|pages=e17-23|pmid=19948568}}</ref> # ''Developmental, Individual Differences, Relationship-Based Approach (DIR or “Floortime”)²²'' #*Objectives are to build healthy foundations for social, emotional, and intellectual capacities rather than focusing on skills and isolated behaviors. # ''Treatment and Education of Autistic and Related Communication-Handicapped Children (TEACCH)²⁴'' #*Statewide, community based intervention program that emphasizes environmental organization and visual supports, individualization of goals, and the teaching of independence and developmental skills. #*Teaching strategies are taught within the natural environment and within context. Includes early intervention services through adulthood.<ref>{{cite journal|last1=Dawson|first1=G|last2=Osterling|first2=J|title=Early Intervention in Autism|journal=The Effectiveness of Early Intervention|date=1997|pages=307-326}}</ref> # ''Others (Treatments tackling symptoms not exclusive to ASD)'' #* Cognitive Behavioral Therapy (CBT)<ref name="Kasari">{{cite journal|last1=Kasari|first1=C|last2=Lawton|first2=K|title=New directions in behavioral treatment of autism spectrum disorders.|journal=Current opinion in neurology|date=April 2010|volume=23|issue=2|pages=137-43|pmid=20160648}}</ref> #*Occupational Therapy #*Sensory Integration Therapy #*Speech Therapy #*Picture Exchange Communication System (PECS).<ref>{{cite book|last1=al.]|first1=Lynn Cannon ... [et|title=Unstuck and on target! : an executive function curriculum to improve flexibility for children with autism spectrum disorders|date=2011|publisher=Paul H. Brookes Pub. Co.|location=Baltimore|isbn=9781598572032|edition=Research}}</ref> '''Medication''' * The data on other relevant diagnoses indicate that children and youth are frequently treated with medication under an ASD diagnosis, despite the fact that the target symptoms may be commonly associated with other mental disorders (ADHD, Anxiety, Depression, etc.). * Approximately 70% of children with ASD ages 8 and up receive some form of psychoactive medication. Before recommending medication as a form of treatment, consult a supervisor and a medical doctor.^26,27<ref>{{cite journal|last1=Mandell|first1=DS|last2=Morales|first2=KH|last3=Marcus|first3=SC|last4=Stahmer|first4=AC|last5=Doshi|first5=J|last6=Polsky|first6=DE|date=March 2008|title=Psychotropic medication use among Medicaid-enrolled children with autism spectrum disorders.|journal=Pediatrics|volume=121|issue=3|pages=e441-8|pmid=18310165}}</ref><ref>{{cite journal|last1=Oswald|first1=DP|last2=Sonenklar|first2=NA|date=June 2007|title=Medication use among children with autism spectrum disorders.|journal=Journal of child and adolescent psychopharmacology|volume=17|issue=3|pages=348-55|pmid=17630868}}</ref> {{collapse bottom}} =='''External Resources'''== #[http://apps.who.int/classifications/icd10/browse/2016/en#/F84.0 ICD-10 diagnostic criteria] # [https://en.wikiversity.org/w/index.php?title=Helping_Give_Away_Psychological_Science/Resources/Annotated_List_of_Where_and_How_to_Find_a_Therapist&wteswitched=1#Other_low-cost_options Find-a-Therapist] (a curated list of find-a-therapist websites where you can find a provider) #[https://www.nimh.nih.gov/health/topics/autism-spectrum-disorders-asd/index.shtml NIMH] (information about schizophrenia) #https://www.autismspeaks.org/what-autism/diagnosis/mchat Free online autism screen for toddlers # OMIM (Online Mendelian Inheritance in Man) ##[https://www.omim.org/entry/209850?search=autism&highlight=autism%20autistic 209850] #[http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/autism/ Effective Child Therapy information on Autism Spectrum Disorder] ##Effective Child Therapy is website sponsored by Division 53 of the American Psychological Association (APA), or The [https://sccap53.org Society of Clinical Child and Adolescent Psychology] (SCCAP), in collaboration with the Association for Behavioral and Cognitive Therapies (ABCT). Use for information on symptoms and available treatments. =='''References'''== {{collapse top|References|expand=yes}} {{Reflist|30em}} # Centers for Disease Control and Prevention. (2012). Prevalence of autism spectrum disorders—Autism and Developmental Disabilities Monitoring Network, 14 Sites, United States, 2008. Morbidity and Mortality Weekly Report, 61 (3), 1–19. # Pedersen, A., Pettygrove, S., Meaney, F. J., Mancilla, K., Gotschall, K., Kessler, D. B., ... & Cunniff, C. (2012). Prevalence of autism spectrum disorders in Hispanic and non-Hispanic white children. Pediatrics, 129(3), e629-e635. # Charman, T., Baird, G., Simonoff, E., Loucas, T., Chandler, S., Meldrum, D., & Pickles, A. (2007). Efficacy of three screening instruments in the identification of autistic-spectrum disorders. The British Journal of Psychiatry, 191(6), 554-559. # Constantino, J.N., Davis, S.A., Todd, R.D., Schindler, M.K., Gross, M.M., Brophy, S.L., et al. Validation of a brief quantitative measure of autistic traits: comparison of the social responsiveness scale with the autism diagnostic interview-revised. J Autism Dev Disord. 2003 Aug;33(4):427-33. # Gotham, K., Pickles, A., & Lord, C. (2009). Standardizing ADOS scores for a measure of severity in autism spectrum disorders. Journal of autism and developmental disorders, 39(5), 693-705. # Robins, D. L., Fein, D., Barton, M. L., & Green, J. A. (2001). The Modified Checklist for Autism in Toddlers: an initial study investigating the early detection of autism and pervasive developmental disorders. Journal of autism and developmental disorders, 31(2), 131-144. # Fombonne, E. (2009). Epidemiology of pervasive developmental disorders.Pediatric research, 65(6), 591-598. # Constantino, J. N., Zhang, Y., Frazier, T., Abbacchi, A. M., & Law, P. (2010). Sibling recurrence and the genetic epidemiology of autism. The American journal of psychiatry, 167(11), 1349. # Durkin, M. S., Maenner, M. J., Meaney, F. J., Levy, S. E., DiGuiseppi, C., Nicholas, J. S., ... & Schieve, L. A. (2010). Socioeconomic inequality in the prevalence of autism spectrum disorder: evidence from a US cross-sectional study. PLoS One, 5(7), e11551. # Humphreys, B. P. (2010). Infants and Toddlers with Autism Spectrum Disorders: Early Identification and Early Intervention. Journal of Early Intervention, 32(75), 75-98. # Bastiaansen, J. A., Meffert, H. Hein, S. Huizinga, P. Ketelaars, C. Pijnenborg, M. ,... de Bildt, A. 2011). Diagnosing autism spectrum disorders in adults: The use of Autism Diagnostic Observation Schedule (ADOS) Module 4 Journal of Autism and Developmental Disorders, 41, 1256–1266 # Kamp-Becker, I., Ghahreman, M., Heinzel-Gutenbrunner, M., Peters, M., Remschmidt, H., & Becker, K. (2013). Evaluation of the revised algorithm of Autism Diagnostic Observation Schedule (ADOS) in the diagnostic investigation of high-functioning children and adolescents with autism spectrum disorders. Autism, 17(1), 87-102. # Hus, V., & Lord, C. (2013). Effects of child characteristics on the Autism Diagnostic Interview-Revised: Implications for use of scores as a measure of ASD severity. Journal of autism and developmental disorders, 43(2), 371-381. # Coplan, J., & Jawad, A. F. (2005). Modeling clinical outcome of children with autistic spectrum disorders. Pediatrics, 116(1), 117-122. # Chlebowski, C., Green, J. A., Barton, M. L., & Fein, D. (2010). Using the childhood autism rating scale to diagnose autism spectrum disorders. Journal of autism and developmental disorders, 40(7), 787-799. # Saulnier, C. A., & Klin, A. (2007). Brief report: social and communication abilities and disabilities in higher functioning individuals with autism and Asperger syndrome. Journal of Autism and Developmental Disorders, 37(4), 788-793 # Fenton, G., D’ardia, C., Valente, D., Del Vecchio, I., Fabrizi, A., & Bernabei, P. (2003). Vineland adaptive behavior profiles in children with autism and moderate to severe developmental delay. Autism, 7(3), 269-287. # Oakland, T., & Harrison, P. L. (Eds.). (2011). Adaptive behavior assessment system-ii: clinical use and interpretation. Academic Press. # Peters-Scheffer, N., Didden, R., Korzilius, H., & Sturmey, P. (2011). A meta-analytic study on the effectiveness of comprehensive ABA-based early intervention programs for children with Autism Spectrum Disorders. Research in Autism Spectrum Disorders, 5(1), 60-69. # Dawson, G., Rogers, S., Munson, J., Smith, M., Winter, J., Greenson, J., ... & Varley, J. (2010). Randomized, controlled trial of an intervention for toddlers with autism: the Early Start Denver Model. Pediatrics, 125(1), e17-e23. # Wieder, S., & Greenspan, S. I. (2003). Climbing the symbolic ladder in the DIR model through floor time/interactive play. Autism, 7(4), 425-435. # Odom, S. L., Collet-Klingenberg, L., Rogers, S. J., & Hatton, D. D. (2010). Evidence-based practices in interventions for children and youth with autism spectrum disorders. Preventing school failure: Alternative education for children and youth, 54(4), 275-282 # Dawson, G., & Osterling, J. (1997). Early intervention in autism. The effectiveness of early intervention, 307-326. # Kasari, C., & Lawton, K. (2010). New directions in behavioral treatment of autism spectrum disorders. Current Opinion in Neurology, 23(2), 137-143. # Mandell, D. S., Morales, K. H., Marcus, S. C., Stahmer, A. C., Doshi, J., & Polsky, D. E. (2008). Psychotropic medication use among Medicaid-enrolled children with autism spectrum disorders. Pediatrics, 121(3), e441-e448. # Oswald, D. P., & Sonenklar, N. A. (2007). Medication use among children with autism spectrum disorders. Journal of child and adolescent psychopharmacology, 17(3), 348-355. [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] {{collapse bottom}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] c0gzbseuukjk7jsiyqtsgf3gnuzw5ly 2419283 2419225 2022-08-26T05:04:29Z Ardenguo 2944162 /* Psychometric properties of screening instruments for autism spectrum disorder */ added "Note: Reliability and validity are included in the extended version. This table includes measures with Good or Excellent ratings." wikitext text/x-wiki <noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{medical disclaimer}} {{:{{BASEPAGENAME}}/Sidebar}} ==[[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio"?''']]== For background information on what assessment portfolios are, click the link in the heading above. Want even 'more' information about this topic? There's an extended version of this page [[Evidence-based assessment/Autism spectrum disorder (assessment portfolio)/extended version|here]]. == [[Evidence based assessment/Preparation phase|'''Preparation phase''']] == === Diagnostic criteria for autism spectrum disorder=== {{blockquotetop}} <big>'''ICD-11 Diagnostic Criteria''':</big> Autism spectrum disorder is characterized by persistent deficits in the ability to initiate and to sustain reciprocal social interaction and social communication, and by a range of restricted, repetitive, and inflexible patterns of behaviour and interests. The onset of the disorder occurs during the developmental period, typically in early childhood, but symptoms may not become fully manifest until later, when social demands exceed limited capacities. Deficits are sufficiently severe to cause impairment in personal, family, social, educational, occupational or other important areas of functioning and are usually a pervasive feature of the individual’s functioning observable in all settings, although they may vary according to social, educational, or other context. Individuals along the spectrum exhibit a full range of intellectual functioning and language abilities. Note: The ICD-11 contains seven subcategories of ASD that can be found in the ICD-11, [https://icd.who.int/browse11/l-m/en#/http%3a%2f%2fid.who.int%2ficd%2fentity%2f120443468 here]. <big>'''ASD encompasses these previous DSM-IV diagnoses''':</big> *Autistic disorder (autism) *Asperger’s disorder *Childhood disintegrative disorder *Pervasive developmental disorder not otherwise specified '''<big>ASD is characterized by:</big>''' # deficits in social communication and social interaction and # restricted repetitive behaviors, interests, and activities (RRBs). Because both components are required for diagnosis of ASD, social communication disorder is diagnosed if no RRBs are present. '''<big>Changes in DSM-5 Criteria</big>''' * The diagnostic criteria for ASD changed from [[DSM-IV]] to [[wikipedia:Diagnostic_and_Statistical_Manual_of_Mental_Disorders#DSM-IV-TR_.282000.29|DSM-5]]. Summaries are available [http://www.dsm5.org/Documents/changes%20from%20dsm-iv-tr%20to%20dsm-5.pdf here] and [[wikipedia:DSM-5|here]]. {{blockquotebottom}} ===Base rates of ASD in children and adolescents in different populations and clinical settings=== {| class="wikitable sortable" border="1" |- ! Demography ! Setting (Reference) ! Base Rate ! Diagnostic Method |- | 11 ADDM sites | Autism and Developmental Disabilities Monitoring (ADDM) Network (2014) - 8 year olds *** | 1.5% (1 per 68) | Diagnosis by doctor based on DSM-IV-TR criteria |- | Epidemiological: 43,283 household surveys | National Health Statistics Report (NHIS; 2014), 3-17 year olds<ref>{{cite journal|last1=Zablotsky|first1=B|last2=Black|first2=LI|last3=Maenner|first3=MJ|last4=Schieve|first4=LA|last5=Blumberg|first5=SJ|title=Estimated Prevalence of Autism and Other Developmental Disabilities Following Questionnaire Changes in the 2014 National Health Interview Survey.|journal=National health statistics reports|date=13 November 2015|issue=87|pages=1-20|pmid=26632847}}</ref> | 2.2% (1 per 45) | DSM-IV-TR |- | 11 ADDM sites: Male/Female Ratio | The Autism and Developmental Disabilities Monitoring (ADDM) Network (2014) – 8 year olds | 1 in 42 boys (2.4%), 1 in 189 girls (.05%) | DSM-IV-TR |- | Came from family registry for those who had children under 18 years old in United States | Interactive Autism Network (IAN): Individual Sibling Recurrence<ref>{{cite journal|last1=Constantino|first1=JN|last2=Zhang|first2=Y|last3=Frazier|first3=T|last4=Abbacchi|first4=AM|last5=Law|first5=P|title=Sibling recurrence and the genetic epidemiology of autism.|journal=The American journal of psychiatry|date=November 2010|volume=167|issue=11|pages=1349-56|pmid=20889652}}</ref> | ASD status occurred in an additional child in 10.9% of families | DSM-IV-TR |- | 11 ADDM sites (Race/ethnicity study) | The Autism and Developmental Disabilities Monitoring (ADDM) Network (2014) – 8 year olds Race/Ethnicity: * Non-Hispanic White * Non-Hispanic Black * Hispanic * Asian | * '''Non-Hispanic White:''' 1 in 63 (1.6%) * '''Non-Hispanic Black:''' 1 in 81 (1.2%) * '''Hispanic:''' 1 in 91 (1.1%) * '''Asian:''' 1 in 81 (1.2%) | DSM-IV-TR |- | | style="text-align:left" | The Autism and Developmental Disabilities Monitoring (ADDM) Network (2010) – 8 year olds <br> :Race/Ethnicity<br> ::- Non-Hispanic White<br> - Non-Hispanic Black<br> - Hispanic<br> - Asian<br> - Other | style="text-align:left" | <br><br> <br>60.3%<br>15.7%<br>17.2%<br>3.3%<br>3.5% | DSM-IV-TR |- | Male/Female Ratio | Epidemiological study: Review of 43 studies<ref>{{Cite journal|last=Kogan|first=M. D.|last2=Blumberg|first2=S. J.|last3=Schieve|first3=L. A.|last4=Boyle|first4=C. A.|last5=Perrin|first5=J. M.|last6=Ghandour|first6=R. M.|last7=Singh|first7=G. K.|last8=Strickland|first8=B. B.|last9=Trevathan|first9=E.|date=2009-11-01|title=Prevalence of Parent-Reported Diagnosis of Autism Spectrum Disorder Among Children in the US, 2007|url=http://pediatrics.aappublications.org/cgi/doi/10.1542/peds.2009-1522|journal=PEDIATRICS|language=en|volume=124|issue=5|pages=1395–1403|doi=10.1542/peds.2009-1522|issn=0031-4005}}</ref> | 4.2% (4.2 male:1 female) | DSM-IV/Rating Scales/Clinical |} ==[[Evidence based assessment/Prediction phase|'''Prediction phase''']]== === Psychometric properties of screening instruments for autism spectrum disorder === The following section contains a list of screening and diagnostic instruments for autism. The section includes administration information, psychometric data, and PDFs or links to the screenings. * Screenings are used as part of the [[Evidence based assessment/Prediction phase|prediction phase]] of assessment; for more information on interpretation of this data, or how screenings fit in to the assessment process, click [[Evidence based assessment/Prediction phase|here.]] * '''''For a list of more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Common_screening_instruments click here.]''''' {| class="wikitable sortable" |- ! Measure (Wikipedia Link) !Format (Reporter) !Age Range !Administration/ Completion Time !Where to Access |- |[[Evidence based assessment/Instruments/Modified checklist for autism in toddlers|Modified Checklist for Autism in Toddlers (M-CHAT)]] |Questionnaire (Parent report) |18-30 months |5-10 minutes | * [https://mfr.osf.io/render?url=https://osf.io/utmxg/?action=download%26mode=render Free printable PDF MCHAT] *[https://www.autismspeaks.org/screen-your-child Free Online MCHAT] |- |[[wikipedia:Autism-spectrum_quotient|Autism Spectrum Quotient (AQ)]] |Questionnaire |16 years and up |10-15 minutes | * [https://psychology-tools.com/autism-spectrum-quotient/ Online version with scoring] * [https://mfr.osf.io/render?url=https://osf.io/4xu3y/?action=download%26mode=render AQ free printable PDF] * [https://mfr.osf.io/render?url=https://osf.io/fqsxm/?action=download%26mode=render Printable scoring guide] |- |[[wikipedia:Childhood_Autism_Rating_Scale|Childhood Autism Rating Scale (CARS)]] |Observation |2 years-adult |5-10 minutes |Not free |} '''Note:''' Reliability and validity are included in the extended version (link). This table includes measures with Good or Excellent ratings. === Interpreting autism screening measure scores === * For information on interpreting screening measure scores, [[Evidence based assessment/Prediction phase#Interpreting screening measure scores|'''click here.''']] ==[[Evidence based assessment/Prescription phase|'''Prescription phase''']]== ===Gold standard diagnostic interviews=== * For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews '''click here.'''] ===Recommended diagnostic interviews for autism spectrum disorder=== {| class="wikitable sortable" border="1" ! colspan="3" |Diagnostic instruments for ASD |- Format (Reporter) !Measure !Age Range !Administration/ Completion Time |- |Autism Diagnostic Observation Schedule, Second Edition (ADOS-2) |12 months- 30 months |40-60 minutes |- |Autism Diagnostic Interview, Revised (ADI-R) |18 months- adult | 90-150 minutes |- |Adaptive Behavior Assessment System, Second Edition (ABAS-II) |Birth- 89 years |20-30 minutes |} {{collapse top|More information on the above interviews|expand=yes}} '''A. Autism Diagnostic Observation Schedule, Second Edition (ADOS-2)''' -- &nbsp;The ADOS-2 is a semi-structured, play-based assessment of social and communicative behaviors indicative of autism. There are several different modules that can be used based off of the individual’s speech/communication level. Training is necessary to conduct the ADOS-2. '''B. Autism Diagnostic Interview, Revised (ADI-R) --'''&nbsp;The ADI-R is a caregiver interview that helps to provide a developmental history (ages 4-5) and current functioning level of restricted and repetitive behaviors and social impairment. Training is necessary to conduct the ADI-R. Due to the homogeneity of the population, there are many other process measures that can be used in autism assessments. Clinical judgment is recommended when deciding what additional measures should be included (e.g. executive functioning, sensory processing, cognitive flexibility, motor functioning, comorbidity). The two measures provided below are commonly used to assess adaptive behaviors (including communication and socialization, core deficits in ASD) and may provide important information regarding levels of daily functioning of individuals with ASD.'''.''' '''C. Vineland Adaptive Behavior Scales-Second edition (VABS-II)'''&nbsp;– Parent report recommended with careful attention paid to the Daily Living domain. More commonly used with children. '''D. Adaptive Behavior Assessment System, Second Edition (ABAS-II)'''&nbsp;– Parent report recommended with special attention to the Global Adaptive Composite (GAC). More commonly used with adults. {{collapse bottom}} ===[[Evidence based assessment/Process phase|'''Process phase''']]=== The following section contains a brief overview of treatment options for autism and list of process and outcome measures for autism. The section includes benchmarks based on published norms for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the [[Evidence based assessment/Process phase|process phase]] of assessment. For more information of differences between process and outcome measures, see the page on the [[Evidence based assessment/Process phase|process phase of assessment]]. === Process measures === The following section contains a list of process and outcome measures for autism. The section includes benchmarks based on published norms and on those on the spectrum samples for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the [[Evidence based assessment/Process phase|process phase]] of assessment. For more information of differences between process and outcome measures, see the page on the [[Evidence based assessment/Process phase|process phase of assessment]]. {{blockquotetop}} There are many processes that may be considered important when evaluating a child or an adolescent with ASD; however, due to the diversity of the population and symptom expression, there are too many to narrow down. Clinical judgment is recommended when deciding what additional measures should be included (e.g. executive functioning, sensory processing, cognitive flexibility). The two measures provided below are commonly used to assess adaptive behaviors (including communication and socialization, core deficits in ASD) and may provide important information regarding levels of daily functioning of individuals with ASD. {{blockquotebottom}} === Outcome and severity measures === This table includes clinically significant benchmarks for autism specific outcome measures * Information on how to interpret this table can be [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase found here]. * Additionally, these [[Evidence based assessment/Vignettes|vignettes]] might be helpful resources for understanding appropriate adaptation of outcome measures in practice. *''<u>For clinically significant change benchmarks for the CBCL, YSR, and TRF total, externalizing, internalizing, and attention benchmarks,</u>'' [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase&wteswitched=1#Clinically_significant_change_benchmarks_for_widely-used_outcome_measures see here.] {| class="wikitable sortable" border="1" ! colspan="8" |'''<u><big>Clinically significant change benchmarks for ASD outcome measures</big></u>''' |- | colspan="8" style="font-size:110%; text-align:center;" span | <b> <small>Benchmarks Based on Published Norms</small> </b> |- | rowspan="2" style="text-align:center;font-size:130%;" | <b> Measure</b> | rowspan="2" style="text-align:center;font-size:130%;" |<b>Subscale</b> | colspan="3" style="text-align:center;font-size:130%" width="300" |<b> Cut-off scores</b> | colspan="3" style="text-align:center;font-size:120%" |<b> Critical Change <br> (unstandardized scores)</b> |- | style="text-align:center;font-size:110%" | <b> A</b> | style="text-align:center;font-size:110%" | <b> B</b> | style="text-align:center;font-size:110%" | <b> C</b> | style="text-align:center;font-size:110%" | <b> 95%</b> | style="text-align:center;font-size:110%" | <b> 90%</b> | style="text-align:center;font-size:110%" | <b> SE_difference</b> |- | rowspan="1" style="text-align:center;" | '''CBCL T-scores <br> (2001 Norms)''' | style="text-align:right;" | <i> Total</i> | style="text-align:center;"| 49 | style="text-align:center;"| 70 | style="text-align:center;"| 58 | style="text-align:center;"| 5 | style="text-align:center;"| 4 | style="text-align:center;"| 2.4 |- | rowspan="6" style="text-align:center;" | '''Autism Diagnostic Observation Schedule <br> - Generic (ADOS-G)^6,12''' |style="text-align:right;"|''Module 1 Social Affect Total'' |style="text-align:center;"|8.1 |style="text-align:center;"|12.5 |style="text-align:center;"|10.2 |style="text-align:center;"|2.3 |style="text-align:center;"|1.9 |style="text-align:center;"|1.1 |- |style="text-align:right;"|''Module 1 RR Total'' |style="text-align:center;"|0.4 |style="text-align:center;"|4.4 |style="text-align:center;"|2.7 |style="text-align:center;"|1.1 |style="text-align:center;"|0.9 |style="text-align:center;"|0.5 |- |style="text-align:right;"|''Module 2 Social Affect Total'' |style="text-align:center;"|7.7 |style="text-align:center;"|10.4 |style="text-align:center;"|9.1 |style="text-align:center;"|2.0 |style="text-align:center;"|1.7 |style="text-align:center;"|1.0 |- |style="text-align:right;"|''Module 2 RR Total'' |style="text-align:center;"|1.2 |style="text-align:center;"|4.9 |style="text-align:center;"|3.2 |style="text-align:center;"|1.1 |style="text-align:center;"|0.9 |style="text-align:center;"|0.6 |- |style="text-align:right;"|''Module 3 Social Affect Total'' |style="text-align:center;"|3.7 |style="text-align:center;"|9.8 |style="text-align:center;"|7.1 |style="text-align:center;"|2.1 |style="text-align:center;"|1.8 |style="text-align:center;"|1.1 |- |style="text-align:right;"|''Module 3 RR Total'' |style="text-align:center;"|<nowiki>-0.4*</nowiki> |style="text-align:center;"|3.3 |style="text-align:center;"|1.9 |style="text-align:center;"|0.9 |style="text-align:center;"|0.8 |style="text-align:center;"|0.5 |- |style="text-align:center;"|'''Childhood Autism Rating Scale (CARS)<ref>{{cite journal|last1=Coplan|first1=J|last2=Jawad|first2=AF|date=July 2005|title=Modeling clinical outcome of children with autistic spectrum disorders.|journal=Pediatrics|volume=116|issue=1|pages=117-22|pmid=15995041}}</ref><ref name=":0">{{cite journal|last1=Chlebowski|first1=C|last2=Green|first2=JA|last3=Barton|first3=ML|last4=Fein|first4=D|date=July 2010|title=Using the childhood autism rating scale to diagnose autism spectrum disorders.|journal=Journal of autism and developmental disorders|volume=40|issue=7|pages=787-99|pmid=20054630}}</ref>''' |style="text-align:right;"|''Parent Total'' |style="text-align:center;"|23.0 |style="text-align:center;"|18.0 |style="text-align:center;"|18.6 |style="text-align:center;"|1.6 |style="text-align:center;"|1.4 |style="text-align:center;"|0.8 |- |style="text-align:center;"|'''Social Responsiveness Scale (SRS)'''<ref name=":0" />'''<br>Caregiver Report (Appendix B)''' |style="text-align:right;"|''Total'' |style="text-align:center;"|72.7 |style="text-align:center;"|62.8 |style="text-align:center;"|66.8 |style="text-align:center;"|11.3 |style="text-align:center;"|9.5 |style="text-align:center;"|5.8 |} === Treatment === * Please refer to the page on [[wikipedia:Autism_spectrum|Autism Spectrum Disorder]] for more information on available treatment or go to [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/autism/ Effective Child Therapy] for a curated resource on effective treatments for ASD. {{collapse top| More information on '''''ASD treatment'''''|expand=yes}} '''Behavior and Communication Approaches''' # ''Applied Behavior Analysis (ABA)²⁰'' #*Method of teaching appropriate behaviors by breaking tasks down into small discrete steps and training in a systematic and precise way called discrete trial training (DTT). #*Based on the context that children with ASD have significant difficulties with learning, learning through imitation and listening as typical peer # ''Early Intensive Behavioral Intervention (EIBI)²⁰'' #*Focuses on remediation of deficient language, imitation, pre-academics, self-help and social interaction skills broken down into discrete components, taught on a one-to-one basis in school and/or at home. #*Typically using discrete trial teaching, reinforcement, backward chaining, shaping, extinction, prompting and prompt fading. Parent involvement is essential.<ref name="Peters-Scheffer">{{cite journal|last1=Peters-Scheffer|first1=N|last2=Didden|first2=R|last3=Korzilius|first3=H|last4=Sturmey|first4=P|date=2011|title=A meta-analytic study on the effectiveness of comprehensive ABA-based early intervention programs for children with Autism Spectrum Disorders|journal=Research in Autism Spectrum Disorders|volume=5|issue=1|page=60-69}}</ref> # ''Pivotal Response Training (PRT)²³'' #*Derived from ABA, an approach that teaches the learner to seek out and respond to naturally occurring learning opportunities. #*Goals include the development of communication, language and positive social behaviors and relief from disruptive self-stimulatory behavior.<ref>{{cite journal|last1=Odom|first1=Samuel L.|last2=Collet-Klingenberg|first2=Lana|last3=Rogers|first3=Sally J.|last4=Hatton|first4=Deborah D.|title=Evidence-Based Practices in Interventions for Children and Youth with Autism Spectrum Disorders|journal=Preventing School Failure: Alternative Education for Children and Youth|date=19 May 2010|volume=54|issue=4|pages=275–282|doi=10.1080/10459881003785506}}</ref> # ''Early start Denver Model (ESDM)²¹'' #* A comprehensive early behavioral intervention for infants (as young as 12 months) to preschool- aged children with ASD, integrating applied behavior analysis (ABA) approaches with developmental and relationship-based approaches.<ref name="Dawson">{{cite journal|last1=Dawson|first1=G|last2=Rogers|first2=S|last3=Munson|first3=J|last4=Smith|first4=M|last5=Winter|first5=J|last6=Greenson|first6=J|last7=Donaldson|first7=A|last8=Varley|first8=J|title=Randomized, controlled trial of an intervention for toddlers with autism: the Early Start Denver Model.|journal=Pediatrics|date=January 2010|volume=125|issue=1|pages=e17-23|pmid=19948568}}</ref> # ''Developmental, Individual Differences, Relationship-Based Approach (DIR or “Floortime”)²²'' #*Objectives are to build healthy foundations for social, emotional, and intellectual capacities rather than focusing on skills and isolated behaviors. # ''Treatment and Education of Autistic and Related Communication-Handicapped Children (TEACCH)²⁴'' #*Statewide, community based intervention program that emphasizes environmental organization and visual supports, individualization of goals, and the teaching of independence and developmental skills. #*Teaching strategies are taught within the natural environment and within context. Includes early intervention services through adulthood.<ref>{{cite journal|last1=Dawson|first1=G|last2=Osterling|first2=J|title=Early Intervention in Autism|journal=The Effectiveness of Early Intervention|date=1997|pages=307-326}}</ref> # ''Others (Treatments tackling symptoms not exclusive to ASD)'' #* Cognitive Behavioral Therapy (CBT)<ref name="Kasari">{{cite journal|last1=Kasari|first1=C|last2=Lawton|first2=K|title=New directions in behavioral treatment of autism spectrum disorders.|journal=Current opinion in neurology|date=April 2010|volume=23|issue=2|pages=137-43|pmid=20160648}}</ref> #*Occupational Therapy #*Sensory Integration Therapy #*Speech Therapy #*Picture Exchange Communication System (PECS).<ref>{{cite book|last1=al.]|first1=Lynn Cannon ... [et|title=Unstuck and on target! : an executive function curriculum to improve flexibility for children with autism spectrum disorders|date=2011|publisher=Paul H. Brookes Pub. Co.|location=Baltimore|isbn=9781598572032|edition=Research}}</ref> '''Medication''' * The data on other relevant diagnoses indicate that children and youth are frequently treated with medication under an ASD diagnosis, despite the fact that the target symptoms may be commonly associated with other mental disorders (ADHD, Anxiety, Depression, etc.). * Approximately 70% of children with ASD ages 8 and up receive some form of psychoactive medication. Before recommending medication as a form of treatment, consult a supervisor and a medical doctor.^26,27<ref>{{cite journal|last1=Mandell|first1=DS|last2=Morales|first2=KH|last3=Marcus|first3=SC|last4=Stahmer|first4=AC|last5=Doshi|first5=J|last6=Polsky|first6=DE|date=March 2008|title=Psychotropic medication use among Medicaid-enrolled children with autism spectrum disorders.|journal=Pediatrics|volume=121|issue=3|pages=e441-8|pmid=18310165}}</ref><ref>{{cite journal|last1=Oswald|first1=DP|last2=Sonenklar|first2=NA|date=June 2007|title=Medication use among children with autism spectrum disorders.|journal=Journal of child and adolescent psychopharmacology|volume=17|issue=3|pages=348-55|pmid=17630868}}</ref> {{collapse bottom}} =='''External Resources'''== #[http://apps.who.int/classifications/icd10/browse/2016/en#/F84.0 ICD-10 diagnostic criteria] # [https://en.wikiversity.org/w/index.php?title=Helping_Give_Away_Psychological_Science/Resources/Annotated_List_of_Where_and_How_to_Find_a_Therapist&wteswitched=1#Other_low-cost_options Find-a-Therapist] (a curated list of find-a-therapist websites where you can find a provider) #[https://www.nimh.nih.gov/health/topics/autism-spectrum-disorders-asd/index.shtml NIMH] (information about schizophrenia) #https://www.autismspeaks.org/what-autism/diagnosis/mchat Free online autism screen for toddlers # OMIM (Online Mendelian Inheritance in Man) ##[https://www.omim.org/entry/209850?search=autism&highlight=autism%20autistic 209850] #[http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/autism/ Effective Child Therapy information on Autism Spectrum Disorder] ##Effective Child Therapy is website sponsored by Division 53 of the American Psychological Association (APA), or The [https://sccap53.org Society of Clinical Child and Adolescent Psychology] (SCCAP), in collaboration with the Association for Behavioral and Cognitive Therapies (ABCT). Use for information on symptoms and available treatments. =='''References'''== {{collapse top|References|expand=yes}} {{Reflist|30em}} # Centers for Disease Control and Prevention. (2012). Prevalence of autism spectrum disorders—Autism and Developmental Disabilities Monitoring Network, 14 Sites, United States, 2008. Morbidity and Mortality Weekly Report, 61 (3), 1–19. # Pedersen, A., Pettygrove, S., Meaney, F. J., Mancilla, K., Gotschall, K., Kessler, D. B., ... & Cunniff, C. (2012). Prevalence of autism spectrum disorders in Hispanic and non-Hispanic white children. Pediatrics, 129(3), e629-e635. # Charman, T., Baird, G., Simonoff, E., Loucas, T., Chandler, S., Meldrum, D., & Pickles, A. (2007). Efficacy of three screening instruments in the identification of autistic-spectrum disorders. The British Journal of Psychiatry, 191(6), 554-559. # Constantino, J.N., Davis, S.A., Todd, R.D., Schindler, M.K., Gross, M.M., Brophy, S.L., et al. Validation of a brief quantitative measure of autistic traits: comparison of the social responsiveness scale with the autism diagnostic interview-revised. J Autism Dev Disord. 2003 Aug;33(4):427-33. # Gotham, K., Pickles, A., & Lord, C. (2009). Standardizing ADOS scores for a measure of severity in autism spectrum disorders. Journal of autism and developmental disorders, 39(5), 693-705. # Robins, D. L., Fein, D., Barton, M. L., & Green, J. A. (2001). The Modified Checklist for Autism in Toddlers: an initial study investigating the early detection of autism and pervasive developmental disorders. Journal of autism and developmental disorders, 31(2), 131-144. # Fombonne, E. (2009). Epidemiology of pervasive developmental disorders.Pediatric research, 65(6), 591-598. # Constantino, J. N., Zhang, Y., Frazier, T., Abbacchi, A. M., & Law, P. (2010). Sibling recurrence and the genetic epidemiology of autism. The American journal of psychiatry, 167(11), 1349. # Durkin, M. S., Maenner, M. J., Meaney, F. J., Levy, S. E., DiGuiseppi, C., Nicholas, J. S., ... & Schieve, L. A. (2010). Socioeconomic inequality in the prevalence of autism spectrum disorder: evidence from a US cross-sectional study. PLoS One, 5(7), e11551. # Humphreys, B. P. (2010). Infants and Toddlers with Autism Spectrum Disorders: Early Identification and Early Intervention. Journal of Early Intervention, 32(75), 75-98. # Bastiaansen, J. A., Meffert, H. Hein, S. Huizinga, P. Ketelaars, C. Pijnenborg, M. ,... de Bildt, A. 2011). Diagnosing autism spectrum disorders in adults: The use of Autism Diagnostic Observation Schedule (ADOS) Module 4 Journal of Autism and Developmental Disorders, 41, 1256–1266 # Kamp-Becker, I., Ghahreman, M., Heinzel-Gutenbrunner, M., Peters, M., Remschmidt, H., & Becker, K. (2013). Evaluation of the revised algorithm of Autism Diagnostic Observation Schedule (ADOS) in the diagnostic investigation of high-functioning children and adolescents with autism spectrum disorders. Autism, 17(1), 87-102. # Hus, V., & Lord, C. (2013). Effects of child characteristics on the Autism Diagnostic Interview-Revised: Implications for use of scores as a measure of ASD severity. Journal of autism and developmental disorders, 43(2), 371-381. # Coplan, J., & Jawad, A. F. (2005). Modeling clinical outcome of children with autistic spectrum disorders. Pediatrics, 116(1), 117-122. # Chlebowski, C., Green, J. A., Barton, M. L., & Fein, D. (2010). Using the childhood autism rating scale to diagnose autism spectrum disorders. Journal of autism and developmental disorders, 40(7), 787-799. # Saulnier, C. A., & Klin, A. (2007). Brief report: social and communication abilities and disabilities in higher functioning individuals with autism and Asperger syndrome. Journal of Autism and Developmental Disorders, 37(4), 788-793 # Fenton, G., D’ardia, C., Valente, D., Del Vecchio, I., Fabrizi, A., & Bernabei, P. (2003). Vineland adaptive behavior profiles in children with autism and moderate to severe developmental delay. Autism, 7(3), 269-287. # Oakland, T., & Harrison, P. L. (Eds.). (2011). Adaptive behavior assessment system-ii: clinical use and interpretation. Academic Press. # Peters-Scheffer, N., Didden, R., Korzilius, H., & Sturmey, P. (2011). A meta-analytic study on the effectiveness of comprehensive ABA-based early intervention programs for children with Autism Spectrum Disorders. Research in Autism Spectrum Disorders, 5(1), 60-69. # Dawson, G., Rogers, S., Munson, J., Smith, M., Winter, J., Greenson, J., ... & Varley, J. (2010). Randomized, controlled trial of an intervention for toddlers with autism: the Early Start Denver Model. Pediatrics, 125(1), e17-e23. # Wieder, S., & Greenspan, S. I. (2003). Climbing the symbolic ladder in the DIR model through floor time/interactive play. Autism, 7(4), 425-435. # Odom, S. L., Collet-Klingenberg, L., Rogers, S. J., & Hatton, D. D. (2010). Evidence-based practices in interventions for children and youth with autism spectrum disorders. Preventing school failure: Alternative education for children and youth, 54(4), 275-282 # Dawson, G., & Osterling, J. (1997). Early intervention in autism. The effectiveness of early intervention, 307-326. # Kasari, C., & Lawton, K. (2010). New directions in behavioral treatment of autism spectrum disorders. Current Opinion in Neurology, 23(2), 137-143. # Mandell, D. S., Morales, K. H., Marcus, S. C., Stahmer, A. C., Doshi, J., & Polsky, D. E. (2008). Psychotropic medication use among Medicaid-enrolled children with autism spectrum disorders. Pediatrics, 121(3), e441-e448. # Oswald, D. P., & Sonenklar, N. A. (2007). Medication use among children with autism spectrum disorders. Journal of child and adolescent psychopharmacology, 17(3), 348-355. [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] {{collapse bottom}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] qsk6oiph7t2f5hu8yuh0mb9j9qv5icg 2419284 2419283 2022-08-26T05:06:49Z Ardenguo 2944162 /* Psychometric properties of screening instruments for autism spectrum disorder */ Linked extended version of this page wikitext text/x-wiki <noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{medical disclaimer}} {{:{{BASEPAGENAME}}/Sidebar}} ==[[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio"?''']]== For background information on what assessment portfolios are, click the link in the heading above. Want even 'more' information about this topic? There's an extended version of this page [[Evidence-based assessment/Autism spectrum disorder (assessment portfolio)/extended version|here]]. == [[Evidence based assessment/Preparation phase|'''Preparation phase''']] == === Diagnostic criteria for autism spectrum disorder=== {{blockquotetop}} <big>'''ICD-11 Diagnostic Criteria''':</big> Autism spectrum disorder is characterized by persistent deficits in the ability to initiate and to sustain reciprocal social interaction and social communication, and by a range of restricted, repetitive, and inflexible patterns of behaviour and interests. The onset of the disorder occurs during the developmental period, typically in early childhood, but symptoms may not become fully manifest until later, when social demands exceed limited capacities. Deficits are sufficiently severe to cause impairment in personal, family, social, educational, occupational or other important areas of functioning and are usually a pervasive feature of the individual’s functioning observable in all settings, although they may vary according to social, educational, or other context. Individuals along the spectrum exhibit a full range of intellectual functioning and language abilities. Note: The ICD-11 contains seven subcategories of ASD that can be found in the ICD-11, [https://icd.who.int/browse11/l-m/en#/http%3a%2f%2fid.who.int%2ficd%2fentity%2f120443468 here]. <big>'''ASD encompasses these previous DSM-IV diagnoses''':</big> *Autistic disorder (autism) *Asperger’s disorder *Childhood disintegrative disorder *Pervasive developmental disorder not otherwise specified '''<big>ASD is characterized by:</big>''' # deficits in social communication and social interaction and # restricted repetitive behaviors, interests, and activities (RRBs). Because both components are required for diagnosis of ASD, social communication disorder is diagnosed if no RRBs are present. '''<big>Changes in DSM-5 Criteria</big>''' * The diagnostic criteria for ASD changed from [[DSM-IV]] to [[wikipedia:Diagnostic_and_Statistical_Manual_of_Mental_Disorders#DSM-IV-TR_.282000.29|DSM-5]]. Summaries are available [http://www.dsm5.org/Documents/changes%20from%20dsm-iv-tr%20to%20dsm-5.pdf here] and [[wikipedia:DSM-5|here]]. {{blockquotebottom}} ===Base rates of ASD in children and adolescents in different populations and clinical settings=== {| class="wikitable sortable" border="1" |- ! Demography ! Setting (Reference) ! Base Rate ! Diagnostic Method |- | 11 ADDM sites | Autism and Developmental Disabilities Monitoring (ADDM) Network (2014) - 8 year olds *** | 1.5% (1 per 68) | Diagnosis by doctor based on DSM-IV-TR criteria |- | Epidemiological: 43,283 household surveys | National Health Statistics Report (NHIS; 2014), 3-17 year olds<ref>{{cite journal|last1=Zablotsky|first1=B|last2=Black|first2=LI|last3=Maenner|first3=MJ|last4=Schieve|first4=LA|last5=Blumberg|first5=SJ|title=Estimated Prevalence of Autism and Other Developmental Disabilities Following Questionnaire Changes in the 2014 National Health Interview Survey.|journal=National health statistics reports|date=13 November 2015|issue=87|pages=1-20|pmid=26632847}}</ref> | 2.2% (1 per 45) | DSM-IV-TR |- | 11 ADDM sites: Male/Female Ratio | The Autism and Developmental Disabilities Monitoring (ADDM) Network (2014) – 8 year olds | 1 in 42 boys (2.4%), 1 in 189 girls (.05%) | DSM-IV-TR |- | Came from family registry for those who had children under 18 years old in United States | Interactive Autism Network (IAN): Individual Sibling Recurrence<ref>{{cite journal|last1=Constantino|first1=JN|last2=Zhang|first2=Y|last3=Frazier|first3=T|last4=Abbacchi|first4=AM|last5=Law|first5=P|title=Sibling recurrence and the genetic epidemiology of autism.|journal=The American journal of psychiatry|date=November 2010|volume=167|issue=11|pages=1349-56|pmid=20889652}}</ref> | ASD status occurred in an additional child in 10.9% of families | DSM-IV-TR |- | 11 ADDM sites (Race/ethnicity study) | The Autism and Developmental Disabilities Monitoring (ADDM) Network (2014) – 8 year olds Race/Ethnicity: * Non-Hispanic White * Non-Hispanic Black * Hispanic * Asian | * '''Non-Hispanic White:''' 1 in 63 (1.6%) * '''Non-Hispanic Black:''' 1 in 81 (1.2%) * '''Hispanic:''' 1 in 91 (1.1%) * '''Asian:''' 1 in 81 (1.2%) | DSM-IV-TR |- | | style="text-align:left" | The Autism and Developmental Disabilities Monitoring (ADDM) Network (2010) – 8 year olds <br> :Race/Ethnicity<br> ::- Non-Hispanic White<br> - Non-Hispanic Black<br> - Hispanic<br> - Asian<br> - Other | style="text-align:left" | <br><br> <br>60.3%<br>15.7%<br>17.2%<br>3.3%<br>3.5% | DSM-IV-TR |- | Male/Female Ratio | Epidemiological study: Review of 43 studies<ref>{{Cite journal|last=Kogan|first=M. D.|last2=Blumberg|first2=S. J.|last3=Schieve|first3=L. A.|last4=Boyle|first4=C. A.|last5=Perrin|first5=J. M.|last6=Ghandour|first6=R. M.|last7=Singh|first7=G. K.|last8=Strickland|first8=B. B.|last9=Trevathan|first9=E.|date=2009-11-01|title=Prevalence of Parent-Reported Diagnosis of Autism Spectrum Disorder Among Children in the US, 2007|url=http://pediatrics.aappublications.org/cgi/doi/10.1542/peds.2009-1522|journal=PEDIATRICS|language=en|volume=124|issue=5|pages=1395–1403|doi=10.1542/peds.2009-1522|issn=0031-4005}}</ref> | 4.2% (4.2 male:1 female) | DSM-IV/Rating Scales/Clinical |} ==[[Evidence based assessment/Prediction phase|'''Prediction phase''']]== === Psychometric properties of screening instruments for autism spectrum disorder === The following section contains a list of screening and diagnostic instruments for autism. The section includes administration information, psychometric data, and PDFs or links to the screenings. * Screenings are used as part of the [[Evidence based assessment/Prediction phase|prediction phase]] of assessment; for more information on interpretation of this data, or how screenings fit in to the assessment process, click [[Evidence based assessment/Prediction phase|here.]] * '''''For a list of more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Common_screening_instruments click here.]''''' {| class="wikitable sortable" |- ! Measure (Wikipedia Link) !Format (Reporter) !Age Range !Administration/ Completion Time !Where to Access |- |[[Evidence based assessment/Instruments/Modified checklist for autism in toddlers|Modified Checklist for Autism in Toddlers (M-CHAT)]] |Questionnaire (Parent report) |18-30 months |5-10 minutes | * [https://mfr.osf.io/render?url=https://osf.io/utmxg/?action=download%26mode=render Free printable PDF MCHAT] *[https://www.autismspeaks.org/screen-your-child Free Online MCHAT] |- |[[wikipedia:Autism-spectrum_quotient|Autism Spectrum Quotient (AQ)]] |Questionnaire |16 years and up |10-15 minutes | * [https://psychology-tools.com/autism-spectrum-quotient/ Online version with scoring] * [https://mfr.osf.io/render?url=https://osf.io/4xu3y/?action=download%26mode=render AQ free printable PDF] * [https://mfr.osf.io/render?url=https://osf.io/fqsxm/?action=download%26mode=render Printable scoring guide] |- |[[wikipedia:Childhood_Autism_Rating_Scale|Childhood Autism Rating Scale (CARS)]] |Observation |2 years-adult |5-10 minutes |Not free |} '''Note:''' Reliability and validity are included in the [[Evidence-based assessment/Autism spectrum disorder (assessment portfolio)/extended version|extended versio]]<nowiki/>n. This table includes measures with Good or Excellent ratings. === Interpreting autism screening measure scores === * For information on interpreting screening measure scores, [[Evidence based assessment/Prediction phase#Interpreting screening measure scores|'''click here.''']] ==[[Evidence based assessment/Prescription phase|'''Prescription phase''']]== ===Gold standard diagnostic interviews=== * For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews '''click here.'''] ===Recommended diagnostic interviews for autism spectrum disorder=== {| class="wikitable sortable" border="1" ! colspan="3" |Diagnostic instruments for ASD |- Format (Reporter) !Measure !Age Range !Administration/ Completion Time |- |Autism Diagnostic Observation Schedule, Second Edition (ADOS-2) |12 months- 30 months |40-60 minutes |- |Autism Diagnostic Interview, Revised (ADI-R) |18 months- adult | 90-150 minutes |- |Adaptive Behavior Assessment System, Second Edition (ABAS-II) |Birth- 89 years |20-30 minutes |} {{collapse top|More information on the above interviews|expand=yes}} '''A. Autism Diagnostic Observation Schedule, Second Edition (ADOS-2)''' -- &nbsp;The ADOS-2 is a semi-structured, play-based assessment of social and communicative behaviors indicative of autism. There are several different modules that can be used based off of the individual’s speech/communication level. Training is necessary to conduct the ADOS-2. '''B. Autism Diagnostic Interview, Revised (ADI-R) --'''&nbsp;The ADI-R is a caregiver interview that helps to provide a developmental history (ages 4-5) and current functioning level of restricted and repetitive behaviors and social impairment. Training is necessary to conduct the ADI-R. Due to the homogeneity of the population, there are many other process measures that can be used in autism assessments. Clinical judgment is recommended when deciding what additional measures should be included (e.g. executive functioning, sensory processing, cognitive flexibility, motor functioning, comorbidity). The two measures provided below are commonly used to assess adaptive behaviors (including communication and socialization, core deficits in ASD) and may provide important information regarding levels of daily functioning of individuals with ASD.'''.''' '''C. Vineland Adaptive Behavior Scales-Second edition (VABS-II)'''&nbsp;– Parent report recommended with careful attention paid to the Daily Living domain. More commonly used with children. '''D. Adaptive Behavior Assessment System, Second Edition (ABAS-II)'''&nbsp;– Parent report recommended with special attention to the Global Adaptive Composite (GAC). More commonly used with adults. {{collapse bottom}} ===[[Evidence based assessment/Process phase|'''Process phase''']]=== The following section contains a brief overview of treatment options for autism and list of process and outcome measures for autism. The section includes benchmarks based on published norms for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the [[Evidence based assessment/Process phase|process phase]] of assessment. For more information of differences between process and outcome measures, see the page on the [[Evidence based assessment/Process phase|process phase of assessment]]. === Process measures === The following section contains a list of process and outcome measures for autism. The section includes benchmarks based on published norms and on those on the spectrum samples for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the [[Evidence based assessment/Process phase|process phase]] of assessment. For more information of differences between process and outcome measures, see the page on the [[Evidence based assessment/Process phase|process phase of assessment]]. {{blockquotetop}} There are many processes that may be considered important when evaluating a child or an adolescent with ASD; however, due to the diversity of the population and symptom expression, there are too many to narrow down. Clinical judgment is recommended when deciding what additional measures should be included (e.g. executive functioning, sensory processing, cognitive flexibility). The two measures provided below are commonly used to assess adaptive behaviors (including communication and socialization, core deficits in ASD) and may provide important information regarding levels of daily functioning of individuals with ASD. {{blockquotebottom}} === Outcome and severity measures === This table includes clinically significant benchmarks for autism specific outcome measures * Information on how to interpret this table can be [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase found here]. * Additionally, these [[Evidence based assessment/Vignettes|vignettes]] might be helpful resources for understanding appropriate adaptation of outcome measures in practice. *''<u>For clinically significant change benchmarks for the CBCL, YSR, and TRF total, externalizing, internalizing, and attention benchmarks,</u>'' [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase&wteswitched=1#Clinically_significant_change_benchmarks_for_widely-used_outcome_measures see here.] {| class="wikitable sortable" border="1" ! colspan="8" |'''<u><big>Clinically significant change benchmarks for ASD outcome measures</big></u>''' |- | colspan="8" style="font-size:110%; text-align:center;" span | <b> <small>Benchmarks Based on Published Norms</small> </b> |- | rowspan="2" style="text-align:center;font-size:130%;" | <b> Measure</b> | rowspan="2" style="text-align:center;font-size:130%;" |<b>Subscale</b> | colspan="3" style="text-align:center;font-size:130%" width="300" |<b> Cut-off scores</b> | colspan="3" style="text-align:center;font-size:120%" |<b> Critical Change <br> (unstandardized scores)</b> |- | style="text-align:center;font-size:110%" | <b> A</b> | style="text-align:center;font-size:110%" | <b> B</b> | style="text-align:center;font-size:110%" | <b> C</b> | style="text-align:center;font-size:110%" | <b> 95%</b> | style="text-align:center;font-size:110%" | <b> 90%</b> | style="text-align:center;font-size:110%" | <b> SE_difference</b> |- | rowspan="1" style="text-align:center;" | '''CBCL T-scores <br> (2001 Norms)''' | style="text-align:right;" | <i> Total</i> | style="text-align:center;"| 49 | style="text-align:center;"| 70 | style="text-align:center;"| 58 | style="text-align:center;"| 5 | style="text-align:center;"| 4 | style="text-align:center;"| 2.4 |- | rowspan="6" style="text-align:center;" | '''Autism Diagnostic Observation Schedule <br> - Generic (ADOS-G)^6,12''' |style="text-align:right;"|''Module 1 Social Affect Total'' |style="text-align:center;"|8.1 |style="text-align:center;"|12.5 |style="text-align:center;"|10.2 |style="text-align:center;"|2.3 |style="text-align:center;"|1.9 |style="text-align:center;"|1.1 |- |style="text-align:right;"|''Module 1 RR Total'' |style="text-align:center;"|0.4 |style="text-align:center;"|4.4 |style="text-align:center;"|2.7 |style="text-align:center;"|1.1 |style="text-align:center;"|0.9 |style="text-align:center;"|0.5 |- |style="text-align:right;"|''Module 2 Social Affect Total'' |style="text-align:center;"|7.7 |style="text-align:center;"|10.4 |style="text-align:center;"|9.1 |style="text-align:center;"|2.0 |style="text-align:center;"|1.7 |style="text-align:center;"|1.0 |- |style="text-align:right;"|''Module 2 RR Total'' |style="text-align:center;"|1.2 |style="text-align:center;"|4.9 |style="text-align:center;"|3.2 |style="text-align:center;"|1.1 |style="text-align:center;"|0.9 |style="text-align:center;"|0.6 |- |style="text-align:right;"|''Module 3 Social Affect Total'' |style="text-align:center;"|3.7 |style="text-align:center;"|9.8 |style="text-align:center;"|7.1 |style="text-align:center;"|2.1 |style="text-align:center;"|1.8 |style="text-align:center;"|1.1 |- |style="text-align:right;"|''Module 3 RR Total'' |style="text-align:center;"|<nowiki>-0.4*</nowiki> |style="text-align:center;"|3.3 |style="text-align:center;"|1.9 |style="text-align:center;"|0.9 |style="text-align:center;"|0.8 |style="text-align:center;"|0.5 |- |style="text-align:center;"|'''Childhood Autism Rating Scale (CARS)<ref>{{cite journal|last1=Coplan|first1=J|last2=Jawad|first2=AF|date=July 2005|title=Modeling clinical outcome of children with autistic spectrum disorders.|journal=Pediatrics|volume=116|issue=1|pages=117-22|pmid=15995041}}</ref><ref name=":0">{{cite journal|last1=Chlebowski|first1=C|last2=Green|first2=JA|last3=Barton|first3=ML|last4=Fein|first4=D|date=July 2010|title=Using the childhood autism rating scale to diagnose autism spectrum disorders.|journal=Journal of autism and developmental disorders|volume=40|issue=7|pages=787-99|pmid=20054630}}</ref>''' |style="text-align:right;"|''Parent Total'' |style="text-align:center;"|23.0 |style="text-align:center;"|18.0 |style="text-align:center;"|18.6 |style="text-align:center;"|1.6 |style="text-align:center;"|1.4 |style="text-align:center;"|0.8 |- |style="text-align:center;"|'''Social Responsiveness Scale (SRS)'''<ref name=":0" />'''<br>Caregiver Report (Appendix B)''' |style="text-align:right;"|''Total'' |style="text-align:center;"|72.7 |style="text-align:center;"|62.8 |style="text-align:center;"|66.8 |style="text-align:center;"|11.3 |style="text-align:center;"|9.5 |style="text-align:center;"|5.8 |} === Treatment === * Please refer to the page on [[wikipedia:Autism_spectrum|Autism Spectrum Disorder]] for more information on available treatment or go to [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/autism/ Effective Child Therapy] for a curated resource on effective treatments for ASD. {{collapse top| More information on '''''ASD treatment'''''|expand=yes}} '''Behavior and Communication Approaches''' # ''Applied Behavior Analysis (ABA)²⁰'' #*Method of teaching appropriate behaviors by breaking tasks down into small discrete steps and training in a systematic and precise way called discrete trial training (DTT). #*Based on the context that children with ASD have significant difficulties with learning, learning through imitation and listening as typical peer # ''Early Intensive Behavioral Intervention (EIBI)²⁰'' #*Focuses on remediation of deficient language, imitation, pre-academics, self-help and social interaction skills broken down into discrete components, taught on a one-to-one basis in school and/or at home. #*Typically using discrete trial teaching, reinforcement, backward chaining, shaping, extinction, prompting and prompt fading. Parent involvement is essential.<ref name="Peters-Scheffer">{{cite journal|last1=Peters-Scheffer|first1=N|last2=Didden|first2=R|last3=Korzilius|first3=H|last4=Sturmey|first4=P|date=2011|title=A meta-analytic study on the effectiveness of comprehensive ABA-based early intervention programs for children with Autism Spectrum Disorders|journal=Research in Autism Spectrum Disorders|volume=5|issue=1|page=60-69}}</ref> # ''Pivotal Response Training (PRT)²³'' #*Derived from ABA, an approach that teaches the learner to seek out and respond to naturally occurring learning opportunities. #*Goals include the development of communication, language and positive social behaviors and relief from disruptive self-stimulatory behavior.<ref>{{cite journal|last1=Odom|first1=Samuel L.|last2=Collet-Klingenberg|first2=Lana|last3=Rogers|first3=Sally J.|last4=Hatton|first4=Deborah D.|title=Evidence-Based Practices in Interventions for Children and Youth with Autism Spectrum Disorders|journal=Preventing School Failure: Alternative Education for Children and Youth|date=19 May 2010|volume=54|issue=4|pages=275–282|doi=10.1080/10459881003785506}}</ref> # ''Early start Denver Model (ESDM)²¹'' #* A comprehensive early behavioral intervention for infants (as young as 12 months) to preschool- aged children with ASD, integrating applied behavior analysis (ABA) approaches with developmental and relationship-based approaches.<ref name="Dawson">{{cite journal|last1=Dawson|first1=G|last2=Rogers|first2=S|last3=Munson|first3=J|last4=Smith|first4=M|last5=Winter|first5=J|last6=Greenson|first6=J|last7=Donaldson|first7=A|last8=Varley|first8=J|title=Randomized, controlled trial of an intervention for toddlers with autism: the Early Start Denver Model.|journal=Pediatrics|date=January 2010|volume=125|issue=1|pages=e17-23|pmid=19948568}}</ref> # ''Developmental, Individual Differences, Relationship-Based Approach (DIR or “Floortime”)²²'' #*Objectives are to build healthy foundations for social, emotional, and intellectual capacities rather than focusing on skills and isolated behaviors. # ''Treatment and Education of Autistic and Related Communication-Handicapped Children (TEACCH)²⁴'' #*Statewide, community based intervention program that emphasizes environmental organization and visual supports, individualization of goals, and the teaching of independence and developmental skills. #*Teaching strategies are taught within the natural environment and within context. Includes early intervention services through adulthood.<ref>{{cite journal|last1=Dawson|first1=G|last2=Osterling|first2=J|title=Early Intervention in Autism|journal=The Effectiveness of Early Intervention|date=1997|pages=307-326}}</ref> # ''Others (Treatments tackling symptoms not exclusive to ASD)'' #* Cognitive Behavioral Therapy (CBT)<ref name="Kasari">{{cite journal|last1=Kasari|first1=C|last2=Lawton|first2=K|title=New directions in behavioral treatment of autism spectrum disorders.|journal=Current opinion in neurology|date=April 2010|volume=23|issue=2|pages=137-43|pmid=20160648}}</ref> #*Occupational Therapy #*Sensory Integration Therapy #*Speech Therapy #*Picture Exchange Communication System (PECS).<ref>{{cite book|last1=al.]|first1=Lynn Cannon ... [et|title=Unstuck and on target! : an executive function curriculum to improve flexibility for children with autism spectrum disorders|date=2011|publisher=Paul H. Brookes Pub. Co.|location=Baltimore|isbn=9781598572032|edition=Research}}</ref> '''Medication''' * The data on other relevant diagnoses indicate that children and youth are frequently treated with medication under an ASD diagnosis, despite the fact that the target symptoms may be commonly associated with other mental disorders (ADHD, Anxiety, Depression, etc.). * Approximately 70% of children with ASD ages 8 and up receive some form of psychoactive medication. Before recommending medication as a form of treatment, consult a supervisor and a medical doctor.^26,27<ref>{{cite journal|last1=Mandell|first1=DS|last2=Morales|first2=KH|last3=Marcus|first3=SC|last4=Stahmer|first4=AC|last5=Doshi|first5=J|last6=Polsky|first6=DE|date=March 2008|title=Psychotropic medication use among Medicaid-enrolled children with autism spectrum disorders.|journal=Pediatrics|volume=121|issue=3|pages=e441-8|pmid=18310165}}</ref><ref>{{cite journal|last1=Oswald|first1=DP|last2=Sonenklar|first2=NA|date=June 2007|title=Medication use among children with autism spectrum disorders.|journal=Journal of child and adolescent psychopharmacology|volume=17|issue=3|pages=348-55|pmid=17630868}}</ref> {{collapse bottom}} =='''External Resources'''== #[http://apps.who.int/classifications/icd10/browse/2016/en#/F84.0 ICD-10 diagnostic criteria] # [https://en.wikiversity.org/w/index.php?title=Helping_Give_Away_Psychological_Science/Resources/Annotated_List_of_Where_and_How_to_Find_a_Therapist&wteswitched=1#Other_low-cost_options Find-a-Therapist] (a curated list of find-a-therapist websites where you can find a provider) #[https://www.nimh.nih.gov/health/topics/autism-spectrum-disorders-asd/index.shtml NIMH] (information about schizophrenia) #https://www.autismspeaks.org/what-autism/diagnosis/mchat Free online autism screen for toddlers # OMIM (Online Mendelian Inheritance in Man) ##[https://www.omim.org/entry/209850?search=autism&highlight=autism%20autistic 209850] #[http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/autism/ Effective Child Therapy information on Autism Spectrum Disorder] ##Effective Child Therapy is website sponsored by Division 53 of the American Psychological Association (APA), or The [https://sccap53.org Society of Clinical Child and Adolescent Psychology] (SCCAP), in collaboration with the Association for Behavioral and Cognitive Therapies (ABCT). Use for information on symptoms and available treatments. =='''References'''== {{collapse top|References|expand=yes}} {{Reflist|30em}} # Centers for Disease Control and Prevention. (2012). Prevalence of autism spectrum disorders—Autism and Developmental Disabilities Monitoring Network, 14 Sites, United States, 2008. Morbidity and Mortality Weekly Report, 61 (3), 1–19. # Pedersen, A., Pettygrove, S., Meaney, F. J., Mancilla, K., Gotschall, K., Kessler, D. B., ... & Cunniff, C. (2012). Prevalence of autism spectrum disorders in Hispanic and non-Hispanic white children. Pediatrics, 129(3), e629-e635. # Charman, T., Baird, G., Simonoff, E., Loucas, T., Chandler, S., Meldrum, D., & Pickles, A. (2007). Efficacy of three screening instruments in the identification of autistic-spectrum disorders. The British Journal of Psychiatry, 191(6), 554-559. # Constantino, J.N., Davis, S.A., Todd, R.D., Schindler, M.K., Gross, M.M., Brophy, S.L., et al. Validation of a brief quantitative measure of autistic traits: comparison of the social responsiveness scale with the autism diagnostic interview-revised. J Autism Dev Disord. 2003 Aug;33(4):427-33. # Gotham, K., Pickles, A., & Lord, C. (2009). Standardizing ADOS scores for a measure of severity in autism spectrum disorders. Journal of autism and developmental disorders, 39(5), 693-705. # Robins, D. L., Fein, D., Barton, M. L., & Green, J. A. (2001). The Modified Checklist for Autism in Toddlers: an initial study investigating the early detection of autism and pervasive developmental disorders. Journal of autism and developmental disorders, 31(2), 131-144. # Fombonne, E. (2009). Epidemiology of pervasive developmental disorders.Pediatric research, 65(6), 591-598. # Constantino, J. N., Zhang, Y., Frazier, T., Abbacchi, A. M., & Law, P. (2010). Sibling recurrence and the genetic epidemiology of autism. The American journal of psychiatry, 167(11), 1349. # Durkin, M. S., Maenner, M. J., Meaney, F. J., Levy, S. E., DiGuiseppi, C., Nicholas, J. S., ... & Schieve, L. A. (2010). Socioeconomic inequality in the prevalence of autism spectrum disorder: evidence from a US cross-sectional study. PLoS One, 5(7), e11551. # Humphreys, B. P. (2010). Infants and Toddlers with Autism Spectrum Disorders: Early Identification and Early Intervention. Journal of Early Intervention, 32(75), 75-98. # Bastiaansen, J. A., Meffert, H. Hein, S. Huizinga, P. Ketelaars, C. Pijnenborg, M. ,... de Bildt, A. 2011). Diagnosing autism spectrum disorders in adults: The use of Autism Diagnostic Observation Schedule (ADOS) Module 4 Journal of Autism and Developmental Disorders, 41, 1256–1266 # Kamp-Becker, I., Ghahreman, M., Heinzel-Gutenbrunner, M., Peters, M., Remschmidt, H., & Becker, K. (2013). Evaluation of the revised algorithm of Autism Diagnostic Observation Schedule (ADOS) in the diagnostic investigation of high-functioning children and adolescents with autism spectrum disorders. Autism, 17(1), 87-102. # Hus, V., & Lord, C. (2013). Effects of child characteristics on the Autism Diagnostic Interview-Revised: Implications for use of scores as a measure of ASD severity. Journal of autism and developmental disorders, 43(2), 371-381. # Coplan, J., & Jawad, A. F. (2005). Modeling clinical outcome of children with autistic spectrum disorders. Pediatrics, 116(1), 117-122. # Chlebowski, C., Green, J. A., Barton, M. L., & Fein, D. (2010). Using the childhood autism rating scale to diagnose autism spectrum disorders. Journal of autism and developmental disorders, 40(7), 787-799. # Saulnier, C. A., & Klin, A. (2007). Brief report: social and communication abilities and disabilities in higher functioning individuals with autism and Asperger syndrome. Journal of Autism and Developmental Disorders, 37(4), 788-793 # Fenton, G., D’ardia, C., Valente, D., Del Vecchio, I., Fabrizi, A., & Bernabei, P. (2003). Vineland adaptive behavior profiles in children with autism and moderate to severe developmental delay. Autism, 7(3), 269-287. # Oakland, T., & Harrison, P. L. (Eds.). (2011). Adaptive behavior assessment system-ii: clinical use and interpretation. Academic Press. # Peters-Scheffer, N., Didden, R., Korzilius, H., & Sturmey, P. (2011). A meta-analytic study on the effectiveness of comprehensive ABA-based early intervention programs for children with Autism Spectrum Disorders. Research in Autism Spectrum Disorders, 5(1), 60-69. # Dawson, G., Rogers, S., Munson, J., Smith, M., Winter, J., Greenson, J., ... & Varley, J. (2010). Randomized, controlled trial of an intervention for toddlers with autism: the Early Start Denver Model. Pediatrics, 125(1), e17-e23. # Wieder, S., & Greenspan, S. I. (2003). Climbing the symbolic ladder in the DIR model through floor time/interactive play. Autism, 7(4), 425-435. # Odom, S. L., Collet-Klingenberg, L., Rogers, S. J., & Hatton, D. D. (2010). Evidence-based practices in interventions for children and youth with autism spectrum disorders. Preventing school failure: Alternative education for children and youth, 54(4), 275-282 # Dawson, G., & Osterling, J. (1997). Early intervention in autism. The effectiveness of early intervention, 307-326. # Kasari, C., & Lawton, K. (2010). New directions in behavioral treatment of autism spectrum disorders. Current Opinion in Neurology, 23(2), 137-143. # Mandell, D. S., Morales, K. H., Marcus, S. C., Stahmer, A. C., Doshi, J., & Polsky, D. E. (2008). Psychotropic medication use among Medicaid-enrolled children with autism spectrum disorders. Pediatrics, 121(3), e441-e448. # Oswald, D. P., & Sonenklar, N. A. (2007). Medication use among children with autism spectrum disorders. Journal of child and adolescent psychopharmacology, 17(3), 348-355. [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] {{collapse bottom}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] n7rajgpuxx95grxtefluxsjt5gddsh7 2419285 2419284 2022-08-26T05:07:22Z Ardenguo 2944162 /* Psychometric properties of screening instruments for autism spectrum disorder */ typo wikitext text/x-wiki <noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{medical disclaimer}} {{:{{BASEPAGENAME}}/Sidebar}} ==[[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio"?''']]== For background information on what assessment portfolios are, click the link in the heading above. Want even 'more' information about this topic? There's an extended version of this page [[Evidence-based assessment/Autism spectrum disorder (assessment portfolio)/extended version|here]]. == [[Evidence based assessment/Preparation phase|'''Preparation phase''']] == === Diagnostic criteria for autism spectrum disorder=== {{blockquotetop}} <big>'''ICD-11 Diagnostic Criteria''':</big> Autism spectrum disorder is characterized by persistent deficits in the ability to initiate and to sustain reciprocal social interaction and social communication, and by a range of restricted, repetitive, and inflexible patterns of behaviour and interests. The onset of the disorder occurs during the developmental period, typically in early childhood, but symptoms may not become fully manifest until later, when social demands exceed limited capacities. Deficits are sufficiently severe to cause impairment in personal, family, social, educational, occupational or other important areas of functioning and are usually a pervasive feature of the individual’s functioning observable in all settings, although they may vary according to social, educational, or other context. Individuals along the spectrum exhibit a full range of intellectual functioning and language abilities. Note: The ICD-11 contains seven subcategories of ASD that can be found in the ICD-11, [https://icd.who.int/browse11/l-m/en#/http%3a%2f%2fid.who.int%2ficd%2fentity%2f120443468 here]. <big>'''ASD encompasses these previous DSM-IV diagnoses''':</big> *Autistic disorder (autism) *Asperger’s disorder *Childhood disintegrative disorder *Pervasive developmental disorder not otherwise specified '''<big>ASD is characterized by:</big>''' # deficits in social communication and social interaction and # restricted repetitive behaviors, interests, and activities (RRBs). Because both components are required for diagnosis of ASD, social communication disorder is diagnosed if no RRBs are present. '''<big>Changes in DSM-5 Criteria</big>''' * The diagnostic criteria for ASD changed from [[DSM-IV]] to [[wikipedia:Diagnostic_and_Statistical_Manual_of_Mental_Disorders#DSM-IV-TR_.282000.29|DSM-5]]. Summaries are available [http://www.dsm5.org/Documents/changes%20from%20dsm-iv-tr%20to%20dsm-5.pdf here] and [[wikipedia:DSM-5|here]]. {{blockquotebottom}} ===Base rates of ASD in children and adolescents in different populations and clinical settings=== {| class="wikitable sortable" border="1" |- ! Demography ! Setting (Reference) ! Base Rate ! Diagnostic Method |- | 11 ADDM sites | Autism and Developmental Disabilities Monitoring (ADDM) Network (2014) - 8 year olds *** | 1.5% (1 per 68) | Diagnosis by doctor based on DSM-IV-TR criteria |- | Epidemiological: 43,283 household surveys | National Health Statistics Report (NHIS; 2014), 3-17 year olds<ref>{{cite journal|last1=Zablotsky|first1=B|last2=Black|first2=LI|last3=Maenner|first3=MJ|last4=Schieve|first4=LA|last5=Blumberg|first5=SJ|title=Estimated Prevalence of Autism and Other Developmental Disabilities Following Questionnaire Changes in the 2014 National Health Interview Survey.|journal=National health statistics reports|date=13 November 2015|issue=87|pages=1-20|pmid=26632847}}</ref> | 2.2% (1 per 45) | DSM-IV-TR |- | 11 ADDM sites: Male/Female Ratio | The Autism and Developmental Disabilities Monitoring (ADDM) Network (2014) – 8 year olds | 1 in 42 boys (2.4%), 1 in 189 girls (.05%) | DSM-IV-TR |- | Came from family registry for those who had children under 18 years old in United States | Interactive Autism Network (IAN): Individual Sibling Recurrence<ref>{{cite journal|last1=Constantino|first1=JN|last2=Zhang|first2=Y|last3=Frazier|first3=T|last4=Abbacchi|first4=AM|last5=Law|first5=P|title=Sibling recurrence and the genetic epidemiology of autism.|journal=The American journal of psychiatry|date=November 2010|volume=167|issue=11|pages=1349-56|pmid=20889652}}</ref> | ASD status occurred in an additional child in 10.9% of families | DSM-IV-TR |- | 11 ADDM sites (Race/ethnicity study) | The Autism and Developmental Disabilities Monitoring (ADDM) Network (2014) – 8 year olds Race/Ethnicity: * Non-Hispanic White * Non-Hispanic Black * Hispanic * Asian | * '''Non-Hispanic White:''' 1 in 63 (1.6%) * '''Non-Hispanic Black:''' 1 in 81 (1.2%) * '''Hispanic:''' 1 in 91 (1.1%) * '''Asian:''' 1 in 81 (1.2%) | DSM-IV-TR |- | | style="text-align:left" | The Autism and Developmental Disabilities Monitoring (ADDM) Network (2010) – 8 year olds <br> :Race/Ethnicity<br> ::- Non-Hispanic White<br> - Non-Hispanic Black<br> - Hispanic<br> - Asian<br> - Other | style="text-align:left" | <br><br> <br>60.3%<br>15.7%<br>17.2%<br>3.3%<br>3.5% | DSM-IV-TR |- | Male/Female Ratio | Epidemiological study: Review of 43 studies<ref>{{Cite journal|last=Kogan|first=M. D.|last2=Blumberg|first2=S. J.|last3=Schieve|first3=L. A.|last4=Boyle|first4=C. A.|last5=Perrin|first5=J. M.|last6=Ghandour|first6=R. M.|last7=Singh|first7=G. K.|last8=Strickland|first8=B. B.|last9=Trevathan|first9=E.|date=2009-11-01|title=Prevalence of Parent-Reported Diagnosis of Autism Spectrum Disorder Among Children in the US, 2007|url=http://pediatrics.aappublications.org/cgi/doi/10.1542/peds.2009-1522|journal=PEDIATRICS|language=en|volume=124|issue=5|pages=1395–1403|doi=10.1542/peds.2009-1522|issn=0031-4005}}</ref> | 4.2% (4.2 male:1 female) | DSM-IV/Rating Scales/Clinical |} ==[[Evidence based assessment/Prediction phase|'''Prediction phase''']]== === Psychometric properties of screening instruments for autism spectrum disorder === The following section contains a list of screening and diagnostic instruments for autism. The section includes administration information, psychometric data, and PDFs or links to the screenings. * Screenings are used as part of the [[Evidence based assessment/Prediction phase|prediction phase]] of assessment; for more information on interpretation of this data, or how screenings fit in to the assessment process, click [[Evidence based assessment/Prediction phase|here.]] * '''''For a list of more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Common_screening_instruments click here.]''''' {| class="wikitable sortable" |- ! Measure (Wikipedia Link) !Format (Reporter) !Age Range !Administration/ Completion Time !Where to Access |- |[[Evidence based assessment/Instruments/Modified checklist for autism in toddlers|Modified Checklist for Autism in Toddlers (M-CHAT)]] |Questionnaire (Parent report) |18-30 months |5-10 minutes | * [https://mfr.osf.io/render?url=https://osf.io/utmxg/?action=download%26mode=render Free printable PDF MCHAT] *[https://www.autismspeaks.org/screen-your-child Free Online MCHAT] |- |[[wikipedia:Autism-spectrum_quotient|Autism Spectrum Quotient (AQ)]] |Questionnaire |16 years and up |10-15 minutes | * [https://psychology-tools.com/autism-spectrum-quotient/ Online version with scoring] * [https://mfr.osf.io/render?url=https://osf.io/4xu3y/?action=download%26mode=render AQ free printable PDF] * [https://mfr.osf.io/render?url=https://osf.io/fqsxm/?action=download%26mode=render Printable scoring guide] |- |[[wikipedia:Childhood_Autism_Rating_Scale|Childhood Autism Rating Scale (CARS)]] |Observation |2 years-adult |5-10 minutes |Not free |} '''Note:''' Reliability and validity are included in the [[Evidence-based assessment/Autism spectrum disorder (assessment portfolio)/extended version|extended version]]. This table includes measures with Good or Excellent ratings. === Interpreting autism screening measure scores === * For information on interpreting screening measure scores, [[Evidence based assessment/Prediction phase#Interpreting screening measure scores|'''click here.''']] ==[[Evidence based assessment/Prescription phase|'''Prescription phase''']]== ===Gold standard diagnostic interviews=== * For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews '''click here.'''] ===Recommended diagnostic interviews for autism spectrum disorder=== {| class="wikitable sortable" border="1" ! colspan="3" |Diagnostic instruments for ASD |- Format (Reporter) !Measure !Age Range !Administration/ Completion Time |- |Autism Diagnostic Observation Schedule, Second Edition (ADOS-2) |12 months- 30 months |40-60 minutes |- |Autism Diagnostic Interview, Revised (ADI-R) |18 months- adult | 90-150 minutes |- |Adaptive Behavior Assessment System, Second Edition (ABAS-II) |Birth- 89 years |20-30 minutes |} {{collapse top|More information on the above interviews|expand=yes}} '''A. Autism Diagnostic Observation Schedule, Second Edition (ADOS-2)''' -- &nbsp;The ADOS-2 is a semi-structured, play-based assessment of social and communicative behaviors indicative of autism. There are several different modules that can be used based off of the individual’s speech/communication level. Training is necessary to conduct the ADOS-2. '''B. Autism Diagnostic Interview, Revised (ADI-R) --'''&nbsp;The ADI-R is a caregiver interview that helps to provide a developmental history (ages 4-5) and current functioning level of restricted and repetitive behaviors and social impairment. Training is necessary to conduct the ADI-R. Due to the homogeneity of the population, there are many other process measures that can be used in autism assessments. Clinical judgment is recommended when deciding what additional measures should be included (e.g. executive functioning, sensory processing, cognitive flexibility, motor functioning, comorbidity). The two measures provided below are commonly used to assess adaptive behaviors (including communication and socialization, core deficits in ASD) and may provide important information regarding levels of daily functioning of individuals with ASD.'''.''' '''C. Vineland Adaptive Behavior Scales-Second edition (VABS-II)'''&nbsp;– Parent report recommended with careful attention paid to the Daily Living domain. More commonly used with children. '''D. Adaptive Behavior Assessment System, Second Edition (ABAS-II)'''&nbsp;– Parent report recommended with special attention to the Global Adaptive Composite (GAC). More commonly used with adults. {{collapse bottom}} ===[[Evidence based assessment/Process phase|'''Process phase''']]=== The following section contains a brief overview of treatment options for autism and list of process and outcome measures for autism. The section includes benchmarks based on published norms for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the [[Evidence based assessment/Process phase|process phase]] of assessment. For more information of differences between process and outcome measures, see the page on the [[Evidence based assessment/Process phase|process phase of assessment]]. === Process measures === The following section contains a list of process and outcome measures for autism. The section includes benchmarks based on published norms and on those on the spectrum samples for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the [[Evidence based assessment/Process phase|process phase]] of assessment. For more information of differences between process and outcome measures, see the page on the [[Evidence based assessment/Process phase|process phase of assessment]]. {{blockquotetop}} There are many processes that may be considered important when evaluating a child or an adolescent with ASD; however, due to the diversity of the population and symptom expression, there are too many to narrow down. Clinical judgment is recommended when deciding what additional measures should be included (e.g. executive functioning, sensory processing, cognitive flexibility). The two measures provided below are commonly used to assess adaptive behaviors (including communication and socialization, core deficits in ASD) and may provide important information regarding levels of daily functioning of individuals with ASD. {{blockquotebottom}} === Outcome and severity measures === This table includes clinically significant benchmarks for autism specific outcome measures * Information on how to interpret this table can be [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase found here]. * Additionally, these [[Evidence based assessment/Vignettes|vignettes]] might be helpful resources for understanding appropriate adaptation of outcome measures in practice. *''<u>For clinically significant change benchmarks for the CBCL, YSR, and TRF total, externalizing, internalizing, and attention benchmarks,</u>'' [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase&wteswitched=1#Clinically_significant_change_benchmarks_for_widely-used_outcome_measures see here.] {| class="wikitable sortable" border="1" ! colspan="8" |'''<u><big>Clinically significant change benchmarks for ASD outcome measures</big></u>''' |- | colspan="8" style="font-size:110%; text-align:center;" span | <b> <small>Benchmarks Based on Published Norms</small> </b> |- | rowspan="2" style="text-align:center;font-size:130%;" | <b> Measure</b> | rowspan="2" style="text-align:center;font-size:130%;" |<b>Subscale</b> | colspan="3" style="text-align:center;font-size:130%" width="300" |<b> Cut-off scores</b> | colspan="3" style="text-align:center;font-size:120%" |<b> Critical Change <br> (unstandardized scores)</b> |- | style="text-align:center;font-size:110%" | <b> A</b> | style="text-align:center;font-size:110%" | <b> B</b> | style="text-align:center;font-size:110%" | <b> C</b> | style="text-align:center;font-size:110%" | <b> 95%</b> | style="text-align:center;font-size:110%" | <b> 90%</b> | style="text-align:center;font-size:110%" | <b> SE_difference</b> |- | rowspan="1" style="text-align:center;" | '''CBCL T-scores <br> (2001 Norms)''' | style="text-align:right;" | <i> Total</i> | style="text-align:center;"| 49 | style="text-align:center;"| 70 | style="text-align:center;"| 58 | style="text-align:center;"| 5 | style="text-align:center;"| 4 | style="text-align:center;"| 2.4 |- | rowspan="6" style="text-align:center;" | '''Autism Diagnostic Observation Schedule <br> - Generic (ADOS-G)^6,12''' |style="text-align:right;"|''Module 1 Social Affect Total'' |style="text-align:center;"|8.1 |style="text-align:center;"|12.5 |style="text-align:center;"|10.2 |style="text-align:center;"|2.3 |style="text-align:center;"|1.9 |style="text-align:center;"|1.1 |- |style="text-align:right;"|''Module 1 RR Total'' |style="text-align:center;"|0.4 |style="text-align:center;"|4.4 |style="text-align:center;"|2.7 |style="text-align:center;"|1.1 |style="text-align:center;"|0.9 |style="text-align:center;"|0.5 |- |style="text-align:right;"|''Module 2 Social Affect Total'' |style="text-align:center;"|7.7 |style="text-align:center;"|10.4 |style="text-align:center;"|9.1 |style="text-align:center;"|2.0 |style="text-align:center;"|1.7 |style="text-align:center;"|1.0 |- |style="text-align:right;"|''Module 2 RR Total'' |style="text-align:center;"|1.2 |style="text-align:center;"|4.9 |style="text-align:center;"|3.2 |style="text-align:center;"|1.1 |style="text-align:center;"|0.9 |style="text-align:center;"|0.6 |- |style="text-align:right;"|''Module 3 Social Affect Total'' |style="text-align:center;"|3.7 |style="text-align:center;"|9.8 |style="text-align:center;"|7.1 |style="text-align:center;"|2.1 |style="text-align:center;"|1.8 |style="text-align:center;"|1.1 |- |style="text-align:right;"|''Module 3 RR Total'' |style="text-align:center;"|<nowiki>-0.4*</nowiki> |style="text-align:center;"|3.3 |style="text-align:center;"|1.9 |style="text-align:center;"|0.9 |style="text-align:center;"|0.8 |style="text-align:center;"|0.5 |- |style="text-align:center;"|'''Childhood Autism Rating Scale (CARS)<ref>{{cite journal|last1=Coplan|first1=J|last2=Jawad|first2=AF|date=July 2005|title=Modeling clinical outcome of children with autistic spectrum disorders.|journal=Pediatrics|volume=116|issue=1|pages=117-22|pmid=15995041}}</ref><ref name=":0">{{cite journal|last1=Chlebowski|first1=C|last2=Green|first2=JA|last3=Barton|first3=ML|last4=Fein|first4=D|date=July 2010|title=Using the childhood autism rating scale to diagnose autism spectrum disorders.|journal=Journal of autism and developmental disorders|volume=40|issue=7|pages=787-99|pmid=20054630}}</ref>''' |style="text-align:right;"|''Parent Total'' |style="text-align:center;"|23.0 |style="text-align:center;"|18.0 |style="text-align:center;"|18.6 |style="text-align:center;"|1.6 |style="text-align:center;"|1.4 |style="text-align:center;"|0.8 |- |style="text-align:center;"|'''Social Responsiveness Scale (SRS)'''<ref name=":0" />'''<br>Caregiver Report (Appendix B)''' |style="text-align:right;"|''Total'' |style="text-align:center;"|72.7 |style="text-align:center;"|62.8 |style="text-align:center;"|66.8 |style="text-align:center;"|11.3 |style="text-align:center;"|9.5 |style="text-align:center;"|5.8 |} === Treatment === * Please refer to the page on [[wikipedia:Autism_spectrum|Autism Spectrum Disorder]] for more information on available treatment or go to [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/autism/ Effective Child Therapy] for a curated resource on effective treatments for ASD. {{collapse top| More information on '''''ASD treatment'''''|expand=yes}} '''Behavior and Communication Approaches''' # ''Applied Behavior Analysis (ABA)²⁰'' #*Method of teaching appropriate behaviors by breaking tasks down into small discrete steps and training in a systematic and precise way called discrete trial training (DTT). #*Based on the context that children with ASD have significant difficulties with learning, learning through imitation and listening as typical peer # ''Early Intensive Behavioral Intervention (EIBI)²⁰'' #*Focuses on remediation of deficient language, imitation, pre-academics, self-help and social interaction skills broken down into discrete components, taught on a one-to-one basis in school and/or at home. #*Typically using discrete trial teaching, reinforcement, backward chaining, shaping, extinction, prompting and prompt fading. Parent involvement is essential.<ref name="Peters-Scheffer">{{cite journal|last1=Peters-Scheffer|first1=N|last2=Didden|first2=R|last3=Korzilius|first3=H|last4=Sturmey|first4=P|date=2011|title=A meta-analytic study on the effectiveness of comprehensive ABA-based early intervention programs for children with Autism Spectrum Disorders|journal=Research in Autism Spectrum Disorders|volume=5|issue=1|page=60-69}}</ref> # ''Pivotal Response Training (PRT)²³'' #*Derived from ABA, an approach that teaches the learner to seek out and respond to naturally occurring learning opportunities. #*Goals include the development of communication, language and positive social behaviors and relief from disruptive self-stimulatory behavior.<ref>{{cite journal|last1=Odom|first1=Samuel L.|last2=Collet-Klingenberg|first2=Lana|last3=Rogers|first3=Sally J.|last4=Hatton|first4=Deborah D.|title=Evidence-Based Practices in Interventions for Children and Youth with Autism Spectrum Disorders|journal=Preventing School Failure: Alternative Education for Children and Youth|date=19 May 2010|volume=54|issue=4|pages=275–282|doi=10.1080/10459881003785506}}</ref> # ''Early start Denver Model (ESDM)²¹'' #* A comprehensive early behavioral intervention for infants (as young as 12 months) to preschool- aged children with ASD, integrating applied behavior analysis (ABA) approaches with developmental and relationship-based approaches.<ref name="Dawson">{{cite journal|last1=Dawson|first1=G|last2=Rogers|first2=S|last3=Munson|first3=J|last4=Smith|first4=M|last5=Winter|first5=J|last6=Greenson|first6=J|last7=Donaldson|first7=A|last8=Varley|first8=J|title=Randomized, controlled trial of an intervention for toddlers with autism: the Early Start Denver Model.|journal=Pediatrics|date=January 2010|volume=125|issue=1|pages=e17-23|pmid=19948568}}</ref> # ''Developmental, Individual Differences, Relationship-Based Approach (DIR or “Floortime”)²²'' #*Objectives are to build healthy foundations for social, emotional, and intellectual capacities rather than focusing on skills and isolated behaviors. # ''Treatment and Education of Autistic and Related Communication-Handicapped Children (TEACCH)²⁴'' #*Statewide, community based intervention program that emphasizes environmental organization and visual supports, individualization of goals, and the teaching of independence and developmental skills. #*Teaching strategies are taught within the natural environment and within context. Includes early intervention services through adulthood.<ref>{{cite journal|last1=Dawson|first1=G|last2=Osterling|first2=J|title=Early Intervention in Autism|journal=The Effectiveness of Early Intervention|date=1997|pages=307-326}}</ref> # ''Others (Treatments tackling symptoms not exclusive to ASD)'' #* Cognitive Behavioral Therapy (CBT)<ref name="Kasari">{{cite journal|last1=Kasari|first1=C|last2=Lawton|first2=K|title=New directions in behavioral treatment of autism spectrum disorders.|journal=Current opinion in neurology|date=April 2010|volume=23|issue=2|pages=137-43|pmid=20160648}}</ref> #*Occupational Therapy #*Sensory Integration Therapy #*Speech Therapy #*Picture Exchange Communication System (PECS).<ref>{{cite book|last1=al.]|first1=Lynn Cannon ... [et|title=Unstuck and on target! : an executive function curriculum to improve flexibility for children with autism spectrum disorders|date=2011|publisher=Paul H. Brookes Pub. Co.|location=Baltimore|isbn=9781598572032|edition=Research}}</ref> '''Medication''' * The data on other relevant diagnoses indicate that children and youth are frequently treated with medication under an ASD diagnosis, despite the fact that the target symptoms may be commonly associated with other mental disorders (ADHD, Anxiety, Depression, etc.). * Approximately 70% of children with ASD ages 8 and up receive some form of psychoactive medication. Before recommending medication as a form of treatment, consult a supervisor and a medical doctor.^26,27<ref>{{cite journal|last1=Mandell|first1=DS|last2=Morales|first2=KH|last3=Marcus|first3=SC|last4=Stahmer|first4=AC|last5=Doshi|first5=J|last6=Polsky|first6=DE|date=March 2008|title=Psychotropic medication use among Medicaid-enrolled children with autism spectrum disorders.|journal=Pediatrics|volume=121|issue=3|pages=e441-8|pmid=18310165}}</ref><ref>{{cite journal|last1=Oswald|first1=DP|last2=Sonenklar|first2=NA|date=June 2007|title=Medication use among children with autism spectrum disorders.|journal=Journal of child and adolescent psychopharmacology|volume=17|issue=3|pages=348-55|pmid=17630868}}</ref> {{collapse bottom}} =='''External Resources'''== #[http://apps.who.int/classifications/icd10/browse/2016/en#/F84.0 ICD-10 diagnostic criteria] # [https://en.wikiversity.org/w/index.php?title=Helping_Give_Away_Psychological_Science/Resources/Annotated_List_of_Where_and_How_to_Find_a_Therapist&wteswitched=1#Other_low-cost_options Find-a-Therapist] (a curated list of find-a-therapist websites where you can find a provider) #[https://www.nimh.nih.gov/health/topics/autism-spectrum-disorders-asd/index.shtml NIMH] (information about schizophrenia) #https://www.autismspeaks.org/what-autism/diagnosis/mchat Free online autism screen for toddlers # OMIM (Online Mendelian Inheritance in Man) ##[https://www.omim.org/entry/209850?search=autism&highlight=autism%20autistic 209850] #[http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/autism/ Effective Child Therapy information on Autism Spectrum Disorder] ##Effective Child Therapy is website sponsored by Division 53 of the American Psychological Association (APA), or The [https://sccap53.org Society of Clinical Child and Adolescent Psychology] (SCCAP), in collaboration with the Association for Behavioral and Cognitive Therapies (ABCT). Use for information on symptoms and available treatments. =='''References'''== {{collapse top|References|expand=yes}} {{Reflist|30em}} # Centers for Disease Control and Prevention. (2012). Prevalence of autism spectrum disorders—Autism and Developmental Disabilities Monitoring Network, 14 Sites, United States, 2008. Morbidity and Mortality Weekly Report, 61 (3), 1–19. # Pedersen, A., Pettygrove, S., Meaney, F. J., Mancilla, K., Gotschall, K., Kessler, D. B., ... & Cunniff, C. (2012). Prevalence of autism spectrum disorders in Hispanic and non-Hispanic white children. Pediatrics, 129(3), e629-e635. # Charman, T., Baird, G., Simonoff, E., Loucas, T., Chandler, S., Meldrum, D., & Pickles, A. (2007). Efficacy of three screening instruments in the identification of autistic-spectrum disorders. The British Journal of Psychiatry, 191(6), 554-559. # Constantino, J.N., Davis, S.A., Todd, R.D., Schindler, M.K., Gross, M.M., Brophy, S.L., et al. Validation of a brief quantitative measure of autistic traits: comparison of the social responsiveness scale with the autism diagnostic interview-revised. J Autism Dev Disord. 2003 Aug;33(4):427-33. # Gotham, K., Pickles, A., & Lord, C. (2009). Standardizing ADOS scores for a measure of severity in autism spectrum disorders. Journal of autism and developmental disorders, 39(5), 693-705. # Robins, D. L., Fein, D., Barton, M. L., & Green, J. A. (2001). The Modified Checklist for Autism in Toddlers: an initial study investigating the early detection of autism and pervasive developmental disorders. Journal of autism and developmental disorders, 31(2), 131-144. # Fombonne, E. (2009). Epidemiology of pervasive developmental disorders.Pediatric research, 65(6), 591-598. # Constantino, J. N., Zhang, Y., Frazier, T., Abbacchi, A. M., & Law, P. (2010). Sibling recurrence and the genetic epidemiology of autism. The American journal of psychiatry, 167(11), 1349. # Durkin, M. S., Maenner, M. J., Meaney, F. J., Levy, S. E., DiGuiseppi, C., Nicholas, J. S., ... & Schieve, L. A. (2010). Socioeconomic inequality in the prevalence of autism spectrum disorder: evidence from a US cross-sectional study. PLoS One, 5(7), e11551. # Humphreys, B. P. (2010). Infants and Toddlers with Autism Spectrum Disorders: Early Identification and Early Intervention. Journal of Early Intervention, 32(75), 75-98. # Bastiaansen, J. A., Meffert, H. Hein, S. Huizinga, P. Ketelaars, C. Pijnenborg, M. ,... de Bildt, A. 2011). Diagnosing autism spectrum disorders in adults: The use of Autism Diagnostic Observation Schedule (ADOS) Module 4 Journal of Autism and Developmental Disorders, 41, 1256–1266 # Kamp-Becker, I., Ghahreman, M., Heinzel-Gutenbrunner, M., Peters, M., Remschmidt, H., & Becker, K. (2013). Evaluation of the revised algorithm of Autism Diagnostic Observation Schedule (ADOS) in the diagnostic investigation of high-functioning children and adolescents with autism spectrum disorders. Autism, 17(1), 87-102. # Hus, V., & Lord, C. (2013). Effects of child characteristics on the Autism Diagnostic Interview-Revised: Implications for use of scores as a measure of ASD severity. Journal of autism and developmental disorders, 43(2), 371-381. # Coplan, J., & Jawad, A. F. (2005). Modeling clinical outcome of children with autistic spectrum disorders. Pediatrics, 116(1), 117-122. # Chlebowski, C., Green, J. A., Barton, M. L., & Fein, D. (2010). Using the childhood autism rating scale to diagnose autism spectrum disorders. Journal of autism and developmental disorders, 40(7), 787-799. # Saulnier, C. A., & Klin, A. (2007). Brief report: social and communication abilities and disabilities in higher functioning individuals with autism and Asperger syndrome. Journal of Autism and Developmental Disorders, 37(4), 788-793 # Fenton, G., D’ardia, C., Valente, D., Del Vecchio, I., Fabrizi, A., & Bernabei, P. (2003). Vineland adaptive behavior profiles in children with autism and moderate to severe developmental delay. Autism, 7(3), 269-287. # Oakland, T., & Harrison, P. L. (Eds.). (2011). Adaptive behavior assessment system-ii: clinical use and interpretation. Academic Press. # Peters-Scheffer, N., Didden, R., Korzilius, H., & Sturmey, P. (2011). A meta-analytic study on the effectiveness of comprehensive ABA-based early intervention programs for children with Autism Spectrum Disorders. Research in Autism Spectrum Disorders, 5(1), 60-69. # Dawson, G., Rogers, S., Munson, J., Smith, M., Winter, J., Greenson, J., ... & Varley, J. (2010). Randomized, controlled trial of an intervention for toddlers with autism: the Early Start Denver Model. Pediatrics, 125(1), e17-e23. # Wieder, S., & Greenspan, S. I. (2003). Climbing the symbolic ladder in the DIR model through floor time/interactive play. Autism, 7(4), 425-435. # Odom, S. L., Collet-Klingenberg, L., Rogers, S. J., & Hatton, D. D. (2010). Evidence-based practices in interventions for children and youth with autism spectrum disorders. Preventing school failure: Alternative education for children and youth, 54(4), 275-282 # Dawson, G., & Osterling, J. (1997). Early intervention in autism. The effectiveness of early intervention, 307-326. # Kasari, C., & Lawton, K. (2010). New directions in behavioral treatment of autism spectrum disorders. Current Opinion in Neurology, 23(2), 137-143. # Mandell, D. S., Morales, K. H., Marcus, S. C., Stahmer, A. C., Doshi, J., & Polsky, D. E. (2008). Psychotropic medication use among Medicaid-enrolled children with autism spectrum disorders. Pediatrics, 121(3), e441-e448. # Oswald, D. P., & Sonenklar, N. A. (2007). Medication use among children with autism spectrum disorders. Journal of child and adolescent psychopharmacology, 17(3), 348-355. [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] {{collapse bottom}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] 6mm39t7wnyuudtkul6gjwh3n6wgd5as 2419286 2419285 2022-08-26T05:07:56Z Ardenguo 2944162 /* Recommended diagnostic interviews for autism spectrum disorder */ added "Note: Reliability and validity are included in the extended version. This table includes measures with Good or Excellent ratings." wikitext text/x-wiki <noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{medical disclaimer}} {{:{{BASEPAGENAME}}/Sidebar}} ==[[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio"?''']]== For background information on what assessment portfolios are, click the link in the heading above. Want even 'more' information about this topic? There's an extended version of this page [[Evidence-based assessment/Autism spectrum disorder (assessment portfolio)/extended version|here]]. == [[Evidence based assessment/Preparation phase|'''Preparation phase''']] == === Diagnostic criteria for autism spectrum disorder=== {{blockquotetop}} <big>'''ICD-11 Diagnostic Criteria''':</big> Autism spectrum disorder is characterized by persistent deficits in the ability to initiate and to sustain reciprocal social interaction and social communication, and by a range of restricted, repetitive, and inflexible patterns of behaviour and interests. The onset of the disorder occurs during the developmental period, typically in early childhood, but symptoms may not become fully manifest until later, when social demands exceed limited capacities. Deficits are sufficiently severe to cause impairment in personal, family, social, educational, occupational or other important areas of functioning and are usually a pervasive feature of the individual’s functioning observable in all settings, although they may vary according to social, educational, or other context. Individuals along the spectrum exhibit a full range of intellectual functioning and language abilities. Note: The ICD-11 contains seven subcategories of ASD that can be found in the ICD-11, [https://icd.who.int/browse11/l-m/en#/http%3a%2f%2fid.who.int%2ficd%2fentity%2f120443468 here]. <big>'''ASD encompasses these previous DSM-IV diagnoses''':</big> *Autistic disorder (autism) *Asperger’s disorder *Childhood disintegrative disorder *Pervasive developmental disorder not otherwise specified '''<big>ASD is characterized by:</big>''' # deficits in social communication and social interaction and # restricted repetitive behaviors, interests, and activities (RRBs). Because both components are required for diagnosis of ASD, social communication disorder is diagnosed if no RRBs are present. '''<big>Changes in DSM-5 Criteria</big>''' * The diagnostic criteria for ASD changed from [[DSM-IV]] to [[wikipedia:Diagnostic_and_Statistical_Manual_of_Mental_Disorders#DSM-IV-TR_.282000.29|DSM-5]]. Summaries are available [http://www.dsm5.org/Documents/changes%20from%20dsm-iv-tr%20to%20dsm-5.pdf here] and [[wikipedia:DSM-5|here]]. {{blockquotebottom}} ===Base rates of ASD in children and adolescents in different populations and clinical settings=== {| class="wikitable sortable" border="1" |- ! Demography ! Setting (Reference) ! Base Rate ! Diagnostic Method |- | 11 ADDM sites | Autism and Developmental Disabilities Monitoring (ADDM) Network (2014) - 8 year olds *** | 1.5% (1 per 68) | Diagnosis by doctor based on DSM-IV-TR criteria |- | Epidemiological: 43,283 household surveys | National Health Statistics Report (NHIS; 2014), 3-17 year olds<ref>{{cite journal|last1=Zablotsky|first1=B|last2=Black|first2=LI|last3=Maenner|first3=MJ|last4=Schieve|first4=LA|last5=Blumberg|first5=SJ|title=Estimated Prevalence of Autism and Other Developmental Disabilities Following Questionnaire Changes in the 2014 National Health Interview Survey.|journal=National health statistics reports|date=13 November 2015|issue=87|pages=1-20|pmid=26632847}}</ref> | 2.2% (1 per 45) | DSM-IV-TR |- | 11 ADDM sites: Male/Female Ratio | The Autism and Developmental Disabilities Monitoring (ADDM) Network (2014) – 8 year olds | 1 in 42 boys (2.4%), 1 in 189 girls (.05%) | DSM-IV-TR |- | Came from family registry for those who had children under 18 years old in United States | Interactive Autism Network (IAN): Individual Sibling Recurrence<ref>{{cite journal|last1=Constantino|first1=JN|last2=Zhang|first2=Y|last3=Frazier|first3=T|last4=Abbacchi|first4=AM|last5=Law|first5=P|title=Sibling recurrence and the genetic epidemiology of autism.|journal=The American journal of psychiatry|date=November 2010|volume=167|issue=11|pages=1349-56|pmid=20889652}}</ref> | ASD status occurred in an additional child in 10.9% of families | DSM-IV-TR |- | 11 ADDM sites (Race/ethnicity study) | The Autism and Developmental Disabilities Monitoring (ADDM) Network (2014) – 8 year olds Race/Ethnicity: * Non-Hispanic White * Non-Hispanic Black * Hispanic * Asian | * '''Non-Hispanic White:''' 1 in 63 (1.6%) * '''Non-Hispanic Black:''' 1 in 81 (1.2%) * '''Hispanic:''' 1 in 91 (1.1%) * '''Asian:''' 1 in 81 (1.2%) | DSM-IV-TR |- | | style="text-align:left" | The Autism and Developmental Disabilities Monitoring (ADDM) Network (2010) – 8 year olds <br> :Race/Ethnicity<br> ::- Non-Hispanic White<br> - Non-Hispanic Black<br> - Hispanic<br> - Asian<br> - Other | style="text-align:left" | <br><br> <br>60.3%<br>15.7%<br>17.2%<br>3.3%<br>3.5% | DSM-IV-TR |- | Male/Female Ratio | Epidemiological study: Review of 43 studies<ref>{{Cite journal|last=Kogan|first=M. D.|last2=Blumberg|first2=S. J.|last3=Schieve|first3=L. A.|last4=Boyle|first4=C. A.|last5=Perrin|first5=J. M.|last6=Ghandour|first6=R. M.|last7=Singh|first7=G. K.|last8=Strickland|first8=B. B.|last9=Trevathan|first9=E.|date=2009-11-01|title=Prevalence of Parent-Reported Diagnosis of Autism Spectrum Disorder Among Children in the US, 2007|url=http://pediatrics.aappublications.org/cgi/doi/10.1542/peds.2009-1522|journal=PEDIATRICS|language=en|volume=124|issue=5|pages=1395–1403|doi=10.1542/peds.2009-1522|issn=0031-4005}}</ref> | 4.2% (4.2 male:1 female) | DSM-IV/Rating Scales/Clinical |} ==[[Evidence based assessment/Prediction phase|'''Prediction phase''']]== === Psychometric properties of screening instruments for autism spectrum disorder === The following section contains a list of screening and diagnostic instruments for autism. The section includes administration information, psychometric data, and PDFs or links to the screenings. * Screenings are used as part of the [[Evidence based assessment/Prediction phase|prediction phase]] of assessment; for more information on interpretation of this data, or how screenings fit in to the assessment process, click [[Evidence based assessment/Prediction phase|here.]] * '''''For a list of more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Common_screening_instruments click here.]''''' {| class="wikitable sortable" |- ! Measure (Wikipedia Link) !Format (Reporter) !Age Range !Administration/ Completion Time !Where to Access |- |[[Evidence based assessment/Instruments/Modified checklist for autism in toddlers|Modified Checklist for Autism in Toddlers (M-CHAT)]] |Questionnaire (Parent report) |18-30 months |5-10 minutes | * [https://mfr.osf.io/render?url=https://osf.io/utmxg/?action=download%26mode=render Free printable PDF MCHAT] *[https://www.autismspeaks.org/screen-your-child Free Online MCHAT] |- |[[wikipedia:Autism-spectrum_quotient|Autism Spectrum Quotient (AQ)]] |Questionnaire |16 years and up |10-15 minutes | * [https://psychology-tools.com/autism-spectrum-quotient/ Online version with scoring] * [https://mfr.osf.io/render?url=https://osf.io/4xu3y/?action=download%26mode=render AQ free printable PDF] * [https://mfr.osf.io/render?url=https://osf.io/fqsxm/?action=download%26mode=render Printable scoring guide] |- |[[wikipedia:Childhood_Autism_Rating_Scale|Childhood Autism Rating Scale (CARS)]] |Observation |2 years-adult |5-10 minutes |Not free |} '''Note:''' Reliability and validity are included in the [[Evidence-based assessment/Autism spectrum disorder (assessment portfolio)/extended version|extended version]]. This table includes measures with Good or Excellent ratings. === Interpreting autism screening measure scores === * For information on interpreting screening measure scores, [[Evidence based assessment/Prediction phase#Interpreting screening measure scores|'''click here.''']] ==[[Evidence based assessment/Prescription phase|'''Prescription phase''']]== ===Gold standard diagnostic interviews=== * For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews '''click here.'''] ===Recommended diagnostic interviews for autism spectrum disorder=== {| class="wikitable sortable" border="1" ! colspan="3" |Diagnostic instruments for ASD |- Format (Reporter) !Measure !Age Range !Administration/ Completion Time |- |Autism Diagnostic Observation Schedule, Second Edition (ADOS-2) |12 months- 30 months |40-60 minutes |- |Autism Diagnostic Interview, Revised (ADI-R) |18 months- adult | 90-150 minutes |- |Adaptive Behavior Assessment System, Second Edition (ABAS-II) |Birth- 89 years |20-30 minutes |} '''Note:''' Reliability and validity are included in the [[Evidence-based assessment/Autism spectrum disorder (assessment portfolio)/extended version|extended version]]. This table includes measures with Good or Excellent ratings.{{collapse top|More information on the above interviews|expand=yes}} '''A. Autism Diagnostic Observation Schedule, Second Edition (ADOS-2)''' -- &nbsp;The ADOS-2 is a semi-structured, play-based assessment of social and communicative behaviors indicative of autism. There are several different modules that can be used based off of the individual’s speech/communication level. Training is necessary to conduct the ADOS-2. '''B. Autism Diagnostic Interview, Revised (ADI-R) --'''&nbsp;The ADI-R is a caregiver interview that helps to provide a developmental history (ages 4-5) and current functioning level of restricted and repetitive behaviors and social impairment. Training is necessary to conduct the ADI-R. Due to the homogeneity of the population, there are many other process measures that can be used in autism assessments. Clinical judgment is recommended when deciding what additional measures should be included (e.g. executive functioning, sensory processing, cognitive flexibility, motor functioning, comorbidity). The two measures provided below are commonly used to assess adaptive behaviors (including communication and socialization, core deficits in ASD) and may provide important information regarding levels of daily functioning of individuals with ASD.'''.''' '''C. Vineland Adaptive Behavior Scales-Second edition (VABS-II)'''&nbsp;– Parent report recommended with careful attention paid to the Daily Living domain. More commonly used with children. '''D. Adaptive Behavior Assessment System, Second Edition (ABAS-II)'''&nbsp;– Parent report recommended with special attention to the Global Adaptive Composite (GAC). More commonly used with adults. {{collapse bottom}} ===[[Evidence based assessment/Process phase|'''Process phase''']]=== The following section contains a brief overview of treatment options for autism and list of process and outcome measures for autism. The section includes benchmarks based on published norms for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the [[Evidence based assessment/Process phase|process phase]] of assessment. For more information of differences between process and outcome measures, see the page on the [[Evidence based assessment/Process phase|process phase of assessment]]. === Process measures === The following section contains a list of process and outcome measures for autism. The section includes benchmarks based on published norms and on those on the spectrum samples for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the [[Evidence based assessment/Process phase|process phase]] of assessment. For more information of differences between process and outcome measures, see the page on the [[Evidence based assessment/Process phase|process phase of assessment]]. {{blockquotetop}} There are many processes that may be considered important when evaluating a child or an adolescent with ASD; however, due to the diversity of the population and symptom expression, there are too many to narrow down. Clinical judgment is recommended when deciding what additional measures should be included (e.g. executive functioning, sensory processing, cognitive flexibility). The two measures provided below are commonly used to assess adaptive behaviors (including communication and socialization, core deficits in ASD) and may provide important information regarding levels of daily functioning of individuals with ASD. {{blockquotebottom}} === Outcome and severity measures === This table includes clinically significant benchmarks for autism specific outcome measures * Information on how to interpret this table can be [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase found here]. * Additionally, these [[Evidence based assessment/Vignettes|vignettes]] might be helpful resources for understanding appropriate adaptation of outcome measures in practice. *''<u>For clinically significant change benchmarks for the CBCL, YSR, and TRF total, externalizing, internalizing, and attention benchmarks,</u>'' [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase&wteswitched=1#Clinically_significant_change_benchmarks_for_widely-used_outcome_measures see here.] {| class="wikitable sortable" border="1" ! colspan="8" |'''<u><big>Clinically significant change benchmarks for ASD outcome measures</big></u>''' |- | colspan="8" style="font-size:110%; text-align:center;" span | <b> <small>Benchmarks Based on Published Norms</small> </b> |- | rowspan="2" style="text-align:center;font-size:130%;" | <b> Measure</b> | rowspan="2" style="text-align:center;font-size:130%;" |<b>Subscale</b> | colspan="3" style="text-align:center;font-size:130%" width="300" |<b> Cut-off scores</b> | colspan="3" style="text-align:center;font-size:120%" |<b> Critical Change <br> (unstandardized scores)</b> |- | style="text-align:center;font-size:110%" | <b> A</b> | style="text-align:center;font-size:110%" | <b> B</b> | style="text-align:center;font-size:110%" | <b> C</b> | style="text-align:center;font-size:110%" | <b> 95%</b> | style="text-align:center;font-size:110%" | <b> 90%</b> | style="text-align:center;font-size:110%" | <b> SE_difference</b> |- | rowspan="1" style="text-align:center;" | '''CBCL T-scores <br> (2001 Norms)''' | style="text-align:right;" | <i> Total</i> | style="text-align:center;"| 49 | style="text-align:center;"| 70 | style="text-align:center;"| 58 | style="text-align:center;"| 5 | style="text-align:center;"| 4 | style="text-align:center;"| 2.4 |- | rowspan="6" style="text-align:center;" | '''Autism Diagnostic Observation Schedule <br> - Generic (ADOS-G)^6,12''' |style="text-align:right;"|''Module 1 Social Affect Total'' |style="text-align:center;"|8.1 |style="text-align:center;"|12.5 |style="text-align:center;"|10.2 |style="text-align:center;"|2.3 |style="text-align:center;"|1.9 |style="text-align:center;"|1.1 |- |style="text-align:right;"|''Module 1 RR Total'' |style="text-align:center;"|0.4 |style="text-align:center;"|4.4 |style="text-align:center;"|2.7 |style="text-align:center;"|1.1 |style="text-align:center;"|0.9 |style="text-align:center;"|0.5 |- |style="text-align:right;"|''Module 2 Social Affect Total'' |style="text-align:center;"|7.7 |style="text-align:center;"|10.4 |style="text-align:center;"|9.1 |style="text-align:center;"|2.0 |style="text-align:center;"|1.7 |style="text-align:center;"|1.0 |- |style="text-align:right;"|''Module 2 RR Total'' |style="text-align:center;"|1.2 |style="text-align:center;"|4.9 |style="text-align:center;"|3.2 |style="text-align:center;"|1.1 |style="text-align:center;"|0.9 |style="text-align:center;"|0.6 |- |style="text-align:right;"|''Module 3 Social Affect Total'' |style="text-align:center;"|3.7 |style="text-align:center;"|9.8 |style="text-align:center;"|7.1 |style="text-align:center;"|2.1 |style="text-align:center;"|1.8 |style="text-align:center;"|1.1 |- |style="text-align:right;"|''Module 3 RR Total'' |style="text-align:center;"|<nowiki>-0.4*</nowiki> |style="text-align:center;"|3.3 |style="text-align:center;"|1.9 |style="text-align:center;"|0.9 |style="text-align:center;"|0.8 |style="text-align:center;"|0.5 |- |style="text-align:center;"|'''Childhood Autism Rating Scale (CARS)<ref>{{cite journal|last1=Coplan|first1=J|last2=Jawad|first2=AF|date=July 2005|title=Modeling clinical outcome of children with autistic spectrum disorders.|journal=Pediatrics|volume=116|issue=1|pages=117-22|pmid=15995041}}</ref><ref name=":0">{{cite journal|last1=Chlebowski|first1=C|last2=Green|first2=JA|last3=Barton|first3=ML|last4=Fein|first4=D|date=July 2010|title=Using the childhood autism rating scale to diagnose autism spectrum disorders.|journal=Journal of autism and developmental disorders|volume=40|issue=7|pages=787-99|pmid=20054630}}</ref>''' |style="text-align:right;"|''Parent Total'' |style="text-align:center;"|23.0 |style="text-align:center;"|18.0 |style="text-align:center;"|18.6 |style="text-align:center;"|1.6 |style="text-align:center;"|1.4 |style="text-align:center;"|0.8 |- |style="text-align:center;"|'''Social Responsiveness Scale (SRS)'''<ref name=":0" />'''<br>Caregiver Report (Appendix B)''' |style="text-align:right;"|''Total'' |style="text-align:center;"|72.7 |style="text-align:center;"|62.8 |style="text-align:center;"|66.8 |style="text-align:center;"|11.3 |style="text-align:center;"|9.5 |style="text-align:center;"|5.8 |} === Treatment === * Please refer to the page on [[wikipedia:Autism_spectrum|Autism Spectrum Disorder]] for more information on available treatment or go to [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/autism/ Effective Child Therapy] for a curated resource on effective treatments for ASD. {{collapse top| More information on '''''ASD treatment'''''|expand=yes}} '''Behavior and Communication Approaches''' # ''Applied Behavior Analysis (ABA)²⁰'' #*Method of teaching appropriate behaviors by breaking tasks down into small discrete steps and training in a systematic and precise way called discrete trial training (DTT). #*Based on the context that children with ASD have significant difficulties with learning, learning through imitation and listening as typical peer # ''Early Intensive Behavioral Intervention (EIBI)²⁰'' #*Focuses on remediation of deficient language, imitation, pre-academics, self-help and social interaction skills broken down into discrete components, taught on a one-to-one basis in school and/or at home. #*Typically using discrete trial teaching, reinforcement, backward chaining, shaping, extinction, prompting and prompt fading. Parent involvement is essential.<ref name="Peters-Scheffer">{{cite journal|last1=Peters-Scheffer|first1=N|last2=Didden|first2=R|last3=Korzilius|first3=H|last4=Sturmey|first4=P|date=2011|title=A meta-analytic study on the effectiveness of comprehensive ABA-based early intervention programs for children with Autism Spectrum Disorders|journal=Research in Autism Spectrum Disorders|volume=5|issue=1|page=60-69}}</ref> # ''Pivotal Response Training (PRT)²³'' #*Derived from ABA, an approach that teaches the learner to seek out and respond to naturally occurring learning opportunities. #*Goals include the development of communication, language and positive social behaviors and relief from disruptive self-stimulatory behavior.<ref>{{cite journal|last1=Odom|first1=Samuel L.|last2=Collet-Klingenberg|first2=Lana|last3=Rogers|first3=Sally J.|last4=Hatton|first4=Deborah D.|title=Evidence-Based Practices in Interventions for Children and Youth with Autism Spectrum Disorders|journal=Preventing School Failure: Alternative Education for Children and Youth|date=19 May 2010|volume=54|issue=4|pages=275–282|doi=10.1080/10459881003785506}}</ref> # ''Early start Denver Model (ESDM)²¹'' #* A comprehensive early behavioral intervention for infants (as young as 12 months) to preschool- aged children with ASD, integrating applied behavior analysis (ABA) approaches with developmental and relationship-based approaches.<ref name="Dawson">{{cite journal|last1=Dawson|first1=G|last2=Rogers|first2=S|last3=Munson|first3=J|last4=Smith|first4=M|last5=Winter|first5=J|last6=Greenson|first6=J|last7=Donaldson|first7=A|last8=Varley|first8=J|title=Randomized, controlled trial of an intervention for toddlers with autism: the Early Start Denver Model.|journal=Pediatrics|date=January 2010|volume=125|issue=1|pages=e17-23|pmid=19948568}}</ref> # ''Developmental, Individual Differences, Relationship-Based Approach (DIR or “Floortime”)²²'' #*Objectives are to build healthy foundations for social, emotional, and intellectual capacities rather than focusing on skills and isolated behaviors. # ''Treatment and Education of Autistic and Related Communication-Handicapped Children (TEACCH)²⁴'' #*Statewide, community based intervention program that emphasizes environmental organization and visual supports, individualization of goals, and the teaching of independence and developmental skills. #*Teaching strategies are taught within the natural environment and within context. Includes early intervention services through adulthood.<ref>{{cite journal|last1=Dawson|first1=G|last2=Osterling|first2=J|title=Early Intervention in Autism|journal=The Effectiveness of Early Intervention|date=1997|pages=307-326}}</ref> # ''Others (Treatments tackling symptoms not exclusive to ASD)'' #* Cognitive Behavioral Therapy (CBT)<ref name="Kasari">{{cite journal|last1=Kasari|first1=C|last2=Lawton|first2=K|title=New directions in behavioral treatment of autism spectrum disorders.|journal=Current opinion in neurology|date=April 2010|volume=23|issue=2|pages=137-43|pmid=20160648}}</ref> #*Occupational Therapy #*Sensory Integration Therapy #*Speech Therapy #*Picture Exchange Communication System (PECS).<ref>{{cite book|last1=al.]|first1=Lynn Cannon ... [et|title=Unstuck and on target! : an executive function curriculum to improve flexibility for children with autism spectrum disorders|date=2011|publisher=Paul H. Brookes Pub. Co.|location=Baltimore|isbn=9781598572032|edition=Research}}</ref> '''Medication''' * The data on other relevant diagnoses indicate that children and youth are frequently treated with medication under an ASD diagnosis, despite the fact that the target symptoms may be commonly associated with other mental disorders (ADHD, Anxiety, Depression, etc.). * Approximately 70% of children with ASD ages 8 and up receive some form of psychoactive medication. Before recommending medication as a form of treatment, consult a supervisor and a medical doctor.^26,27<ref>{{cite journal|last1=Mandell|first1=DS|last2=Morales|first2=KH|last3=Marcus|first3=SC|last4=Stahmer|first4=AC|last5=Doshi|first5=J|last6=Polsky|first6=DE|date=March 2008|title=Psychotropic medication use among Medicaid-enrolled children with autism spectrum disorders.|journal=Pediatrics|volume=121|issue=3|pages=e441-8|pmid=18310165}}</ref><ref>{{cite journal|last1=Oswald|first1=DP|last2=Sonenklar|first2=NA|date=June 2007|title=Medication use among children with autism spectrum disorders.|journal=Journal of child and adolescent psychopharmacology|volume=17|issue=3|pages=348-55|pmid=17630868}}</ref> {{collapse bottom}} =='''External Resources'''== #[http://apps.who.int/classifications/icd10/browse/2016/en#/F84.0 ICD-10 diagnostic criteria] # [https://en.wikiversity.org/w/index.php?title=Helping_Give_Away_Psychological_Science/Resources/Annotated_List_of_Where_and_How_to_Find_a_Therapist&wteswitched=1#Other_low-cost_options Find-a-Therapist] (a curated list of find-a-therapist websites where you can find a provider) #[https://www.nimh.nih.gov/health/topics/autism-spectrum-disorders-asd/index.shtml NIMH] (information about schizophrenia) #https://www.autismspeaks.org/what-autism/diagnosis/mchat Free online autism screen for toddlers # OMIM (Online Mendelian Inheritance in Man) ##[https://www.omim.org/entry/209850?search=autism&highlight=autism%20autistic 209850] #[http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/autism/ Effective Child Therapy information on Autism Spectrum Disorder] ##Effective Child Therapy is website sponsored by Division 53 of the American Psychological Association (APA), or The [https://sccap53.org Society of Clinical Child and Adolescent Psychology] (SCCAP), in collaboration with the Association for Behavioral and Cognitive Therapies (ABCT). Use for information on symptoms and available treatments. =='''References'''== {{collapse top|References|expand=yes}} {{Reflist|30em}} # Centers for Disease Control and Prevention. (2012). Prevalence of autism spectrum disorders—Autism and Developmental Disabilities Monitoring Network, 14 Sites, United States, 2008. Morbidity and Mortality Weekly Report, 61 (3), 1–19. # Pedersen, A., Pettygrove, S., Meaney, F. J., Mancilla, K., Gotschall, K., Kessler, D. B., ... & Cunniff, C. (2012). Prevalence of autism spectrum disorders in Hispanic and non-Hispanic white children. Pediatrics, 129(3), e629-e635. # Charman, T., Baird, G., Simonoff, E., Loucas, T., Chandler, S., Meldrum, D., & Pickles, A. (2007). Efficacy of three screening instruments in the identification of autistic-spectrum disorders. The British Journal of Psychiatry, 191(6), 554-559. # Constantino, J.N., Davis, S.A., Todd, R.D., Schindler, M.K., Gross, M.M., Brophy, S.L., et al. Validation of a brief quantitative measure of autistic traits: comparison of the social responsiveness scale with the autism diagnostic interview-revised. J Autism Dev Disord. 2003 Aug;33(4):427-33. # Gotham, K., Pickles, A., & Lord, C. (2009). Standardizing ADOS scores for a measure of severity in autism spectrum disorders. Journal of autism and developmental disorders, 39(5), 693-705. # Robins, D. L., Fein, D., Barton, M. L., & Green, J. A. (2001). The Modified Checklist for Autism in Toddlers: an initial study investigating the early detection of autism and pervasive developmental disorders. Journal of autism and developmental disorders, 31(2), 131-144. # Fombonne, E. (2009). Epidemiology of pervasive developmental disorders.Pediatric research, 65(6), 591-598. # Constantino, J. N., Zhang, Y., Frazier, T., Abbacchi, A. M., & Law, P. (2010). Sibling recurrence and the genetic epidemiology of autism. The American journal of psychiatry, 167(11), 1349. # Durkin, M. S., Maenner, M. J., Meaney, F. J., Levy, S. E., DiGuiseppi, C., Nicholas, J. S., ... & Schieve, L. A. (2010). Socioeconomic inequality in the prevalence of autism spectrum disorder: evidence from a US cross-sectional study. PLoS One, 5(7), e11551. # Humphreys, B. P. (2010). Infants and Toddlers with Autism Spectrum Disorders: Early Identification and Early Intervention. Journal of Early Intervention, 32(75), 75-98. # Bastiaansen, J. A., Meffert, H. Hein, S. Huizinga, P. Ketelaars, C. Pijnenborg, M. ,... de Bildt, A. 2011). Diagnosing autism spectrum disorders in adults: The use of Autism Diagnostic Observation Schedule (ADOS) Module 4 Journal of Autism and Developmental Disorders, 41, 1256–1266 # Kamp-Becker, I., Ghahreman, M., Heinzel-Gutenbrunner, M., Peters, M., Remschmidt, H., & Becker, K. (2013). Evaluation of the revised algorithm of Autism Diagnostic Observation Schedule (ADOS) in the diagnostic investigation of high-functioning children and adolescents with autism spectrum disorders. Autism, 17(1), 87-102. # Hus, V., & Lord, C. (2013). Effects of child characteristics on the Autism Diagnostic Interview-Revised: Implications for use of scores as a measure of ASD severity. Journal of autism and developmental disorders, 43(2), 371-381. # Coplan, J., & Jawad, A. F. (2005). Modeling clinical outcome of children with autistic spectrum disorders. Pediatrics, 116(1), 117-122. # Chlebowski, C., Green, J. A., Barton, M. L., & Fein, D. (2010). Using the childhood autism rating scale to diagnose autism spectrum disorders. Journal of autism and developmental disorders, 40(7), 787-799. # Saulnier, C. A., & Klin, A. (2007). Brief report: social and communication abilities and disabilities in higher functioning individuals with autism and Asperger syndrome. Journal of Autism and Developmental Disorders, 37(4), 788-793 # Fenton, G., D’ardia, C., Valente, D., Del Vecchio, I., Fabrizi, A., & Bernabei, P. (2003). Vineland adaptive behavior profiles in children with autism and moderate to severe developmental delay. Autism, 7(3), 269-287. # Oakland, T., & Harrison, P. L. (Eds.). (2011). Adaptive behavior assessment system-ii: clinical use and interpretation. Academic Press. # Peters-Scheffer, N., Didden, R., Korzilius, H., & Sturmey, P. (2011). A meta-analytic study on the effectiveness of comprehensive ABA-based early intervention programs for children with Autism Spectrum Disorders. Research in Autism Spectrum Disorders, 5(1), 60-69. # Dawson, G., Rogers, S., Munson, J., Smith, M., Winter, J., Greenson, J., ... & Varley, J. (2010). Randomized, controlled trial of an intervention for toddlers with autism: the Early Start Denver Model. Pediatrics, 125(1), e17-e23. # Wieder, S., & Greenspan, S. I. (2003). Climbing the symbolic ladder in the DIR model through floor time/interactive play. Autism, 7(4), 425-435. # Odom, S. L., Collet-Klingenberg, L., Rogers, S. J., & Hatton, D. D. (2010). Evidence-based practices in interventions for children and youth with autism spectrum disorders. Preventing school failure: Alternative education for children and youth, 54(4), 275-282 # Dawson, G., & Osterling, J. (1997). Early intervention in autism. The effectiveness of early intervention, 307-326. # Kasari, C., & Lawton, K. (2010). New directions in behavioral treatment of autism spectrum disorders. Current Opinion in Neurology, 23(2), 137-143. # Mandell, D. S., Morales, K. H., Marcus, S. C., Stahmer, A. C., Doshi, J., & Polsky, D. E. (2008). Psychotropic medication use among Medicaid-enrolled children with autism spectrum disorders. Pediatrics, 121(3), e441-e448. # Oswald, D. P., & Sonenklar, N. A. (2007). Medication use among children with autism spectrum disorders. Journal of child and adolescent psychopharmacology, 17(3), 348-355. [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] {{collapse bottom}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] 1yahjb8wufiveq7d42jda7xzk92x65q 0 207102 2419195 2414563 2022-08-26T02:35:08Z Ardenguo 2944162 /* References */ Made the references box expanded by default wikitext text/x-wiki <noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{medical disclaimer}} {{:{{BASEPAGENAME}}/Sidebar}} == [[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio"?''']] == * For background information on what assessment portfolios are, click the link in the heading above. * Want more information? There's a extended version of this page [[Evidence-based assessment/Conduct disorder/ Extended version|here]]. == '''[[Evidence based assessment/Preparation phase|Preparation phase]]''' == === Diagnostic criteria for Conduct disorder === {{blockquotetop}}'''ICD-11 Diagnostic Criteria''' Conduct-dissocial disorder is characterized by a repetitive and persistent pattern of behaviour in which the basic rights of others or major age-appropriate societal norms, rules, or laws are violated such as aggression towards people or animals; destruction of property; deceitfulness or theft; and serious violations of rules. The behaviour pattern is of sufficient severity to result in significant impairment in personal, family, social, educational, occupational or other important areas of functioning. To be diagnosed, the behaviour pattern must be enduring over a significant period of time (e.g., 12 months or more). Isolated dissocial or criminal acts are thus not in themselves grounds for the diagnosis. Note: The ICD-11 lists 8 additional subcategories of conduct-dissocial disorder. They can be found here. '''Changes in DSM-5''' * The diagnostic criteria for Conduct disorder changed slightly from [[DSM-IV]] to [[w:Diagnostic_and_Statistical_Manual_of_Mental_Disorders#DSM-IV-TR_.282000.29|DSM-5]]. Summaries are available [http://www.dsm5.org/Documents/changes%20from%20dsm-iv-tr%20to%20dsm-5.pdf here]. {{blockquotebottom}} ===Base rates of conduct disorder in different clinical settings and populations=== This section describes the demographic setting of the population(s) sampled, base rates of diagnosis, country/region sampled and the diagnostic method that was used. Using this information, clinicians will be able to anchor the rate of conduct disorder that they are likely to see in their clinical practice. * '''''To see prevalence rates across multiple disorders,''''' [[Evidence based assessment/Preparation phase#Base rates for transdiagnostic comparison|'''''click here.''''']] {| class="wikitable sortable" |- |- ! Demography ! Setting ! Base Rate ! Diagnostic Method |- | All of U.S.A.<ref>{{cite journal|last1=Nock|first1=M. K.|last2=Kazdin|first2=A. E.|last3=Hiripi|first3=E.|last4=Kessler|first4=R. C.|title=Pravalence, subtypes and correlates of DSM-IV conduct disorder in the National Comorbidity Survey Replication|journal=Psychological Medicine|volume=36|page=699-910.}}</ref> | Nationally representative large-scale study (N=9282) - adult retrospective report || 9.5% overall: 12% males, 7% females || CIDI: WHO Composite International Diagnostic Interview (Parent Interview) |- | Western North Carolina<ref>{{cite journal|last1=Costello|first1=E. J.|last2=Mustillo|first2=S.|last3=Erkanli|first3=A.|last4=Keeler|first4=G.|last5=Angold|first5=A.|title=Prevalence and development of psychiatric disorders in adolescence|journal=Arch Gen Psychiatry|volume=60|page=837-844.}}</ref> | The Great Smoky Mountains Study – longitudinal, population-based study of community sample || 9.0% overall: 14% males, 4% females || CAPA: Child and Adolescent Psychiatric Interview (Parent and Youth Interview) |- | California, Division of Juvenile Justice (DJJ)<ref>{{cite journal|last1=Karnik|first1=N. S.|last2=Soller|first2=M.|last3=Redlick|first3=A.|last4=Silverman|first4=M.|last5=Kraemer|first5=H.C.|last6=Steiner|first6=H.|title=Psychiatric disorders among juvenile delinquents incarcerated for nine months|journal=Psychiatric Services|volume=60|page=838-841.}}</ref> | Incarcerated adolescents || 93% males, 92% females || SCID-IV: Structured Clinical Interview for DSM-IV (Youth Interview) |- |All of USA<ref>Kessler RC, Avenevoli S, Costello E, et al. Prevalence, Persistence, and Sociodemographic Correlates of DSM-IV Disorders in the National Comorbidity Survey Replication Adolescent Supplement. ''Arch Gen Psychiatry.'' 2012;69(4):372-380. doi:10.1001/archgenpsychiatry.2011.160</ref> |National Comorbidity Survey Replication Adolescent Supplement –population-based study of adolescents |5.4% Overall |CIDI (Parent Interview) |- | Various locations across USA<ref>{{cite journal|last1=Farrington|first1=D.P.|title=Conduct disorder, aggression, and delinquency|journal=Handbook of adolescent psychology|page=324–345). Hoboken, NJ: Wiley.}}</ref> | Community samples – summary of past findings || 6-16% males, 2-9% females || Varied |- |Urban Midwestern USA<ref name=":0">Kahn RE, Frick PJ, Youngstrom E, Findling RL, Youngstrom JK. The effects of including a callous-unemotional specifier for the diagnosis of conduct disorder. J Child Psychol Psychiatry. 2012;53(3):271–282</ref> |Clinic-referred sample |12.5% overall; 50% of those with CD met criteria for CU traits based on combined-informant report on APSD |KSADS-PL |- |Small metropolitan area in SE USA<ref name=":0" /> |Community based sample |16.2% overall; 32% of those with CD met criteria for CU traits based on combined-informant report on APSD |CSI-4, based on combined-informant report |} '''Note:''' Despite a plethora of studies assessing prevalence of comorbidity of conduct disorder with other disorders (e.g., substance abuse, bipolar, ADHD), searches outlined below did not yield a single study providing a prevalence of conduct disorder alone in an outpatient or community clinic setting. == [[Evidence based assessment/Prediction phase|'''Prediction phase''']] == ===Recommended screening instruments for conduct disorder=== {| class="wikitable" |- ! Measure !Format (Reporter) !Age Range !Administration/ Completion Time !Where to Access |- |[https://store.aseba.org/ ASEBA (Achenbach System of Empirically Based Assessment)] ''not free''<ref>{{Cite journal|last=Paul|first=Howard A.|date=2019-09-18|title=Treatment of Disorders in Childhood and Adolescence|url=http://dx.doi.org/10.1080/07317107.2019.1659554|journal=Child &amp; Family Behavior Therapy|volume=41|issue=4|pages=247–255|doi=10.1080/07317107.2019.1659554|issn=0731-7107}}</ref> |Parent report (CBCL) Youth self-report (YSR) |6-18 (CBCL) 11-18 (YSR) |10-15 minutes |For Purchase |- |[https://www.pearsonclinical.com/education/landing/basc-3.html?orgref=http://www.ani.com/BASC-3&utm_medium=vanity&cmpid=701d0000001ZpG8AAK BASC-2 (Behavior Assessment System for Children, 2nd Edition)] ''not free''<ref>{{Cite journal|last=Paul|first=Howard A.|date=2019-09-18|title=Treatment of Disorders in Childhood and Adolescence|url=http://dx.doi.org/10.1080/07317107.2019.1659554|journal=Child &amp; Family Behavior Therapy|volume=41|issue=4|pages=247–255|doi=10.1080/07317107.2019.1659554|issn=0731-7107}}</ref> |teacher/ parent/ self-report |2:0-21:11 for parent/ teacher; 6:0-college age for self-report |10-20 minutes for parent/ teacher; 30 minutes self-report | |- |[https://www.parinc.com/Products/Pkey/97 ECBI/ SESBI-R (Eyberg Child Behavior Inventory/Sutter-Eyberg Child Behavior Inventory-Revised)] ''not free''<ref>{{Cite journal|last=Paul|first=Howard A.|date=2019-09-18|title=Treatment of Disorders in Childhood and Adolescence|url=http://dx.doi.org/10.1080/07317107.2019.1659554|journal=Child &amp; Family Behavior Therapy|volume=41|issue=4|pages=247–255|doi=10.1080/07317107.2019.1659554|issn=0731-7107}}</ref> |parent/ teacher |2-16 |5 minutes |For Purchase |} == [[Evidence-based assessment/Prescription phase|'''Prescription phase''']] == === Gold standard diagnostic interviews === * For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews click here.] ===Semi-structured and Structured Diagnostic Interviews=== {| class="wikitable" |- ! Measure !Format (Reporter) !Age Range !Administration/ Completion Time !Where to Access |- |Kiddie Schedule for Affective Disorders and Schizophrenia Present and Lifetime Version (KSADS-PL)<ref>{{Cite web|url=http://dx.doi.org/10.1037/t03988-000|title=Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version|last=Kaufman|first=John|last2=Birmaher|first2=Boris|date=1997|website=PsycTESTS Dataset|access-date=2022-08-15|last3=Brent|first3=David|last4=Rao|first4=Uma|last5=Flynn|first5=Cynthia|last6=Moreci|first6=Paula|last7=Williamson|first7=Douglas|last8=Ryan|first8=Neal}}</ref><ref>{{Cite journal|last=Paul|first=Howard A.|date=2019-09-18|title=Treatment of Disorders in Childhood and Adolescence|url=http://dx.doi.org/10.1080/07317107.2019.1659554|journal=Child &amp; Family Behavior Therapy|volume=41|issue=4|pages=247–255|doi=10.1080/07317107.2019.1659554|issn=0731-7107}}</ref> |Structured interview |6-28 |45-75 minutes | |- |[https://osf.io/z6qrh Diagnostic Interview Schedule for Children (DISC)] <ref>{{Cite web|url=http://dx.doi.org/10.1037/t04405-000|title=National Institute of Mental Health Diagnostic Interview Schedule for Children-IV|last=Shaffer|first=David|last2=Fisher|first2=Prudence|date=2000|website=PsycTESTS Dataset|access-date=2022-08-15|last3=Lucas|first3=Christopher P.|last4=Dulcan|first4=Mina K.|last5=Schwab-Stone|first5=Mary E.}}</ref><ref>{{Cite journal|last=Paul|first=Howard A.|date=2019-09-18|title=Treatment of Disorders in Childhood and Adolescence|url=http://dx.doi.org/10.1080/07317107.2019.1659554|journal=Child &amp; Family Behavior Therapy|volume=41|issue=4|pages=247–255|doi=10.1080/07317107.2019.1659554|issn=0731-7107}}</ref> |Structured Interview (Self report and parent) |4-12 |70/ 90-120 | |- |Diagnostic Interview for Children and Adolescents (DICA)<ref>{{Cite journal|last=Reich|first=Wendy|date=2000-01|title=MORE ON THE DICA|url=http://dx.doi.org/10.1097/00004583-200001000-00008|journal=Journal of the American Academy of Child &amp; Adolescent Psychiatry|volume=39|issue=1|pages=14–15|doi=10.1097/00004583-200001000-00008|issn=0890-8567}}</ref><ref>{{Cite journal|last=Paul|first=Howard A.|date=2019-09-18|title=Treatment of Disorders in Childhood and Adolescence|url=http://dx.doi.org/10.1080/07317107.2019.1659554|journal=Child &amp; Family Behavior Therapy|volume=41|issue=4|pages=247–255|doi=10.1080/07317107.2019.1659554|issn=0731-7107}}</ref> |Structured interview |6-18 | | |} ==[[Evidence-based assessment/Process phase|'''Process phase''']]== The following section contains a brief overview of treatment options for Conduct disorder and list of process and outcome measures for Conduct disorder. The section includes benchmarks based on published norms for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the [[Evidence based assessment/Process phase|process phase]] of assessment. For more information of differences between process and outcome measures, see the page on the [[Evidence based assessment/Process phase|process phase of assessment]]. === Outcome and severity measures === This table includes clinically significant benchmarks for Conduct disorder specific outcome measures * Information on how to interpret this table can be [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase found here]. * Additionally, these [[Evidence based assessment/Vignettes|vignettes]] might be helpful resources for understanding appropriate adaptation of outcome measures in practice. * ''<u>For clinically significant change benchmarks for the CBCL, YSR, and TRF total, externalizing, internalizing, and attention benchmarks,</u>'' [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase&wteswitched=1#Clinically_significant_change_benchmarks_for_widely-used_outcome_measures see here.] {{blockquotetop}} '''Statistically significant change benchmarks with common instruments''' {| class="wikitable sortable" border="1" |- | rowspan=1" style="text-align:center;font-size:130%;" | <b> Measure</b> | style="text-align:center;font-size:130%;" | <b> Subscale</b> | colspan="3" style="text-align:center;font-size:130%" width="300" | <b> Cut-off scores*</b> | colspan="3" style="text-align:center;font-size:120%" | <b> Critical Change <br> (unstandardized scores)</b> |- |- | colspan="2" | | style="text-align:center;font-size:110%" | <b> A</b> | style="text-align:center;font-size:110%" | <b> B</b> | style="text-align:center;font-size:110%" | <b> C</b> | style="text-align:center;font-size:110%" | <b> 95%</b> | style="text-align:center;font-size:110%" | <b> 90%</b> | style="text-align:center;font-size:110%" | <b> SE_difference</b> |- | colspan="8" span style="font-size:110%; text-align:center;" | <b> Benchmarks Based on Published Norms</b> |- | style="text-align:center;" | <b> CBCL T-scores <br> (2001 Norms)</b> | style="text-align:right;" | <i> Externalizing</i> | style="text-align:center;"| 49 | style="text-align:center;"| 70 | style="text-align:center;"| 58 | style="text-align:center;"| 7 | style="text-align:center;"| 6 | style="text-align:center;"| 3.4 |- | colspan="8" span style="font-size:110%; text-align:left;" | <b> Conduct Disorder Samples Were Not Found in Searches*</b> |- |} {{blockquotebottom}} '''Note''': “A” = Away from the clinical range, “B” = Back into the nonclinical range, “C” = Closer to the nonclinical than clinical mean '''Search terms''': (1)“antisocial process screening device,” (2) antisocial process screening device AND benchmarks, searches previously mentioned. ==External Resources== See [http://www.effectivechildtherapy.com Effective Child Therapy], a website sponsored by The Society for Child and Adolescent Psychology (APA, Division 53) and the Association for Behavioral and Cognitive Therapies (ABCT), for current summary of evidence-based treatments. *[[Antisocial personality disorder]] *[[Wikipedia:Bullying|Bullying]] *[[Wikipedia:Oppositional defiant disorder|Oppositional defiant disorder]] *[[Wikipedia:Parental alienation|Parental alienation]] *[https://sccap53.org Society of Clinical Child and Adolescent Psychology] *[http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/self-injurious-thoughts-and-behaviors/ EffectiveChildTherapy.Org information on rule-breaking, defiance, and acting out] ==References== {{collapse top|References|expand=yes}} {{Reflist|30em}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] {{collapse bottom}} 3wk8yoacbsqd18ggmc2fo5uxa5b5sos 2419299 2419195 2022-08-26T05:25:18Z Ardenguo 2944162 /* Recommended screening instruments for conduct disorder */ added "Note: Reliability and validity are included in the extended version. This table includes measures with Good or Excellent ratings." wikitext text/x-wiki <noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{medical disclaimer}} {{:{{BASEPAGENAME}}/Sidebar}} == [[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio"?''']] == * For background information on what assessment portfolios are, click the link in the heading above. * Want more information? There's a extended version of this page [[Evidence-based assessment/Conduct disorder/ Extended version|here]]. == '''[[Evidence based assessment/Preparation phase|Preparation phase]]''' == === Diagnostic criteria for Conduct disorder === {{blockquotetop}}'''ICD-11 Diagnostic Criteria''' Conduct-dissocial disorder is characterized by a repetitive and persistent pattern of behaviour in which the basic rights of others or major age-appropriate societal norms, rules, or laws are violated such as aggression towards people or animals; destruction of property; deceitfulness or theft; and serious violations of rules. The behaviour pattern is of sufficient severity to result in significant impairment in personal, family, social, educational, occupational or other important areas of functioning. To be diagnosed, the behaviour pattern must be enduring over a significant period of time (e.g., 12 months or more). Isolated dissocial or criminal acts are thus not in themselves grounds for the diagnosis. Note: The ICD-11 lists 8 additional subcategories of conduct-dissocial disorder. They can be found here. '''Changes in DSM-5''' * The diagnostic criteria for Conduct disorder changed slightly from [[DSM-IV]] to [[w:Diagnostic_and_Statistical_Manual_of_Mental_Disorders#DSM-IV-TR_.282000.29|DSM-5]]. Summaries are available [http://www.dsm5.org/Documents/changes%20from%20dsm-iv-tr%20to%20dsm-5.pdf here]. {{blockquotebottom}} ===Base rates of conduct disorder in different clinical settings and populations=== This section describes the demographic setting of the population(s) sampled, base rates of diagnosis, country/region sampled and the diagnostic method that was used. Using this information, clinicians will be able to anchor the rate of conduct disorder that they are likely to see in their clinical practice. * '''''To see prevalence rates across multiple disorders,''''' [[Evidence based assessment/Preparation phase#Base rates for transdiagnostic comparison|'''''click here.''''']] {| class="wikitable sortable" |- |- ! Demography ! Setting ! Base Rate ! Diagnostic Method |- | All of U.S.A.<ref>{{cite journal|last1=Nock|first1=M. K.|last2=Kazdin|first2=A. E.|last3=Hiripi|first3=E.|last4=Kessler|first4=R. C.|title=Pravalence, subtypes and correlates of DSM-IV conduct disorder in the National Comorbidity Survey Replication|journal=Psychological Medicine|volume=36|page=699-910.}}</ref> | Nationally representative large-scale study (N=9282) - adult retrospective report || 9.5% overall: 12% males, 7% females || CIDI: WHO Composite International Diagnostic Interview (Parent Interview) |- | Western North Carolina<ref>{{cite journal|last1=Costello|first1=E. J.|last2=Mustillo|first2=S.|last3=Erkanli|first3=A.|last4=Keeler|first4=G.|last5=Angold|first5=A.|title=Prevalence and development of psychiatric disorders in adolescence|journal=Arch Gen Psychiatry|volume=60|page=837-844.}}</ref> | The Great Smoky Mountains Study – longitudinal, population-based study of community sample || 9.0% overall: 14% males, 4% females || CAPA: Child and Adolescent Psychiatric Interview (Parent and Youth Interview) |- | California, Division of Juvenile Justice (DJJ)<ref>{{cite journal|last1=Karnik|first1=N. S.|last2=Soller|first2=M.|last3=Redlick|first3=A.|last4=Silverman|first4=M.|last5=Kraemer|first5=H.C.|last6=Steiner|first6=H.|title=Psychiatric disorders among juvenile delinquents incarcerated for nine months|journal=Psychiatric Services|volume=60|page=838-841.}}</ref> | Incarcerated adolescents || 93% males, 92% females || SCID-IV: Structured Clinical Interview for DSM-IV (Youth Interview) |- |All of USA<ref>Kessler RC, Avenevoli S, Costello E, et al. Prevalence, Persistence, and Sociodemographic Correlates of DSM-IV Disorders in the National Comorbidity Survey Replication Adolescent Supplement. ''Arch Gen Psychiatry.'' 2012;69(4):372-380. doi:10.1001/archgenpsychiatry.2011.160</ref> |National Comorbidity Survey Replication Adolescent Supplement –population-based study of adolescents |5.4% Overall |CIDI (Parent Interview) |- | Various locations across USA<ref>{{cite journal|last1=Farrington|first1=D.P.|title=Conduct disorder, aggression, and delinquency|journal=Handbook of adolescent psychology|page=324–345). Hoboken, NJ: Wiley.}}</ref> | Community samples – summary of past findings || 6-16% males, 2-9% females || Varied |- |Urban Midwestern USA<ref name=":0">Kahn RE, Frick PJ, Youngstrom E, Findling RL, Youngstrom JK. The effects of including a callous-unemotional specifier for the diagnosis of conduct disorder. J Child Psychol Psychiatry. 2012;53(3):271–282</ref> |Clinic-referred sample |12.5% overall; 50% of those with CD met criteria for CU traits based on combined-informant report on APSD |KSADS-PL |- |Small metropolitan area in SE USA<ref name=":0" /> |Community based sample |16.2% overall; 32% of those with CD met criteria for CU traits based on combined-informant report on APSD |CSI-4, based on combined-informant report |} '''Note:''' Despite a plethora of studies assessing prevalence of comorbidity of conduct disorder with other disorders (e.g., substance abuse, bipolar, ADHD), searches outlined below did not yield a single study providing a prevalence of conduct disorder alone in an outpatient or community clinic setting. == [[Evidence based assessment/Prediction phase|'''Prediction phase''']] == ===Recommended screening instruments for conduct disorder=== {| class="wikitable" |- ! Measure !Format (Reporter) !Age Range !Administration/ Completion Time !Where to Access |- |[https://store.aseba.org/ ASEBA (Achenbach System of Empirically Based Assessment)] ''not free''<ref>{{Cite journal|last=Paul|first=Howard A.|date=2019-09-18|title=Treatment of Disorders in Childhood and Adolescence|url=http://dx.doi.org/10.1080/07317107.2019.1659554|journal=Child &amp; Family Behavior Therapy|volume=41|issue=4|pages=247–255|doi=10.1080/07317107.2019.1659554|issn=0731-7107}}</ref> |Parent report (CBCL) Youth self-report (YSR) |6-18 (CBCL) 11-18 (YSR) |10-15 minutes |For Purchase |- |[https://www.pearsonclinical.com/education/landing/basc-3.html?orgref=http://www.ani.com/BASC-3&utm_medium=vanity&cmpid=701d0000001ZpG8AAK BASC-2 (Behavior Assessment System for Children, 2nd Edition)] ''not free''<ref>{{Cite journal|last=Paul|first=Howard A.|date=2019-09-18|title=Treatment of Disorders in Childhood and Adolescence|url=http://dx.doi.org/10.1080/07317107.2019.1659554|journal=Child &amp; Family Behavior Therapy|volume=41|issue=4|pages=247–255|doi=10.1080/07317107.2019.1659554|issn=0731-7107}}</ref> |teacher/ parent/ self-report |2:0-21:11 for parent/ teacher; 6:0-college age for self-report |10-20 minutes for parent/ teacher; 30 minutes self-report | |- |[https://www.parinc.com/Products/Pkey/97 ECBI/ SESBI-R (Eyberg Child Behavior Inventory/Sutter-Eyberg Child Behavior Inventory-Revised)] ''not free''<ref>{{Cite journal|last=Paul|first=Howard A.|date=2019-09-18|title=Treatment of Disorders in Childhood and Adolescence|url=http://dx.doi.org/10.1080/07317107.2019.1659554|journal=Child &amp; Family Behavior Therapy|volume=41|issue=4|pages=247–255|doi=10.1080/07317107.2019.1659554|issn=0731-7107}}</ref> |parent/ teacher |2-16 |5 minutes |For Purchase |} '''Note:''' Reliability and validity are included in the extended version. This table includes measures with Good or Excellent ratings. == [[Evidence-based assessment/Prescription phase|'''Prescription phase''']] == === Gold standard diagnostic interviews === * For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews click here.] ===Semi-structured and Structured Diagnostic Interviews=== {| class="wikitable" |- ! Measure !Format (Reporter) !Age Range !Administration/ Completion Time !Where to Access |- |Kiddie Schedule for Affective Disorders and Schizophrenia Present and Lifetime Version (KSADS-PL)<ref>{{Cite web|url=http://dx.doi.org/10.1037/t03988-000|title=Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version|last=Kaufman|first=John|last2=Birmaher|first2=Boris|date=1997|website=PsycTESTS Dataset|access-date=2022-08-15|last3=Brent|first3=David|last4=Rao|first4=Uma|last5=Flynn|first5=Cynthia|last6=Moreci|first6=Paula|last7=Williamson|first7=Douglas|last8=Ryan|first8=Neal}}</ref><ref>{{Cite journal|last=Paul|first=Howard A.|date=2019-09-18|title=Treatment of Disorders in Childhood and Adolescence|url=http://dx.doi.org/10.1080/07317107.2019.1659554|journal=Child &amp; Family Behavior Therapy|volume=41|issue=4|pages=247–255|doi=10.1080/07317107.2019.1659554|issn=0731-7107}}</ref> |Structured interview |6-28 |45-75 minutes | |- |[https://osf.io/z6qrh Diagnostic Interview Schedule for Children (DISC)] <ref>{{Cite web|url=http://dx.doi.org/10.1037/t04405-000|title=National Institute of Mental Health Diagnostic Interview Schedule for Children-IV|last=Shaffer|first=David|last2=Fisher|first2=Prudence|date=2000|website=PsycTESTS Dataset|access-date=2022-08-15|last3=Lucas|first3=Christopher P.|last4=Dulcan|first4=Mina K.|last5=Schwab-Stone|first5=Mary E.}}</ref><ref>{{Cite journal|last=Paul|first=Howard A.|date=2019-09-18|title=Treatment of Disorders in Childhood and Adolescence|url=http://dx.doi.org/10.1080/07317107.2019.1659554|journal=Child &amp; Family Behavior Therapy|volume=41|issue=4|pages=247–255|doi=10.1080/07317107.2019.1659554|issn=0731-7107}}</ref> |Structured Interview (Self report and parent) |4-12 |70/ 90-120 | |- |Diagnostic Interview for Children and Adolescents (DICA)<ref>{{Cite journal|last=Reich|first=Wendy|date=2000-01|title=MORE ON THE DICA|url=http://dx.doi.org/10.1097/00004583-200001000-00008|journal=Journal of the American Academy of Child &amp; Adolescent Psychiatry|volume=39|issue=1|pages=14–15|doi=10.1097/00004583-200001000-00008|issn=0890-8567}}</ref><ref>{{Cite journal|last=Paul|first=Howard A.|date=2019-09-18|title=Treatment of Disorders in Childhood and Adolescence|url=http://dx.doi.org/10.1080/07317107.2019.1659554|journal=Child &amp; Family Behavior Therapy|volume=41|issue=4|pages=247–255|doi=10.1080/07317107.2019.1659554|issn=0731-7107}}</ref> |Structured interview |6-18 | | |} '''Note:''' Reliability and validity are included in the extended version. This table includes measures with Good or Excellent ratings. ==[[Evidence-based assessment/Process phase|'''Process phase''']]== The following section contains a brief overview of treatment options for Conduct disorder and list of process and outcome measures for Conduct disorder. The section includes benchmarks based on published norms for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the [[Evidence based assessment/Process phase|process phase]] of assessment. For more information of differences between process and outcome measures, see the page on the [[Evidence based assessment/Process phase|process phase of assessment]]. === Outcome and severity measures === This table includes clinically significant benchmarks for Conduct disorder specific outcome measures * Information on how to interpret this table can be [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase found here]. * Additionally, these [[Evidence based assessment/Vignettes|vignettes]] might be helpful resources for understanding appropriate adaptation of outcome measures in practice. * ''<u>For clinically significant change benchmarks for the CBCL, YSR, and TRF total, externalizing, internalizing, and attention benchmarks,</u>'' [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase&wteswitched=1#Clinically_significant_change_benchmarks_for_widely-used_outcome_measures see here.] {{blockquotetop}} '''Statistically significant change benchmarks with common instruments''' {| class="wikitable sortable" border="1" |- | rowspan=1" style="text-align:center;font-size:130%;" | <b> Measure</b> | style="text-align:center;font-size:130%;" | <b> Subscale</b> | colspan="3" style="text-align:center;font-size:130%" width="300" | <b> Cut-off scores*</b> | colspan="3" style="text-align:center;font-size:120%" | <b> Critical Change <br> (unstandardized scores)</b> |- |- | colspan="2" | | style="text-align:center;font-size:110%" | <b> A</b> | style="text-align:center;font-size:110%" | <b> B</b> | style="text-align:center;font-size:110%" | <b> C</b> | style="text-align:center;font-size:110%" | <b> 95%</b> | style="text-align:center;font-size:110%" | <b> 90%</b> | style="text-align:center;font-size:110%" | <b> SE_difference</b> |- | colspan="8" span style="font-size:110%; text-align:center;" | <b> Benchmarks Based on Published Norms</b> |- | style="text-align:center;" | <b> CBCL T-scores <br> (2001 Norms)</b> | style="text-align:right;" | <i> Externalizing</i> | style="text-align:center;"| 49 | style="text-align:center;"| 70 | style="text-align:center;"| 58 | style="text-align:center;"| 7 | style="text-align:center;"| 6 | style="text-align:center;"| 3.4 |- | colspan="8" span style="font-size:110%; text-align:left;" | <b> Conduct Disorder Samples Were Not Found in Searches*</b> |- |} {{blockquotebottom}} '''Note''': “A” = Away from the clinical range, “B” = Back into the nonclinical range, “C” = Closer to the nonclinical than clinical mean '''Search terms''': (1)“antisocial process screening device,” (2) antisocial process screening device AND benchmarks, searches previously mentioned. ==External Resources== See [http://www.effectivechildtherapy.com Effective Child Therapy], a website sponsored by The Society for Child and Adolescent Psychology (APA, Division 53) and the Association for Behavioral and Cognitive Therapies (ABCT), for current summary of evidence-based treatments. *[[Antisocial personality disorder]] *[[Wikipedia:Bullying|Bullying]] *[[Wikipedia:Oppositional defiant disorder|Oppositional defiant disorder]] *[[Wikipedia:Parental alienation|Parental alienation]] *[https://sccap53.org Society of Clinical Child and Adolescent Psychology] *[http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/self-injurious-thoughts-and-behaviors/ EffectiveChildTherapy.Org information on rule-breaking, defiance, and acting out] ==References== {{collapse top|References|expand=yes}} {{Reflist|30em}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] {{collapse bottom}} 1ifcwfanjgwhzp34uyjtn9vgutbhcr7 2419314 2419299 2022-08-26T05:36:55Z Ardenguo 2944162 /* Recommended screening instruments for conduct disorder */ linked extended version to "Note: Reliability and validity are included in the extended version. This table includes measures with Good or Excellent ratings." wikitext text/x-wiki <noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{medical disclaimer}} {{:{{BASEPAGENAME}}/Sidebar}} == [[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio"?''']] == * For background information on what assessment portfolios are, click the link in the heading above. * Want more information? There's a extended version of this page [[Evidence-based assessment/Conduct disorder/ Extended version|here]]. == '''[[Evidence based assessment/Preparation phase|Preparation phase]]''' == === Diagnostic criteria for Conduct disorder === {{blockquotetop}}'''ICD-11 Diagnostic Criteria''' Conduct-dissocial disorder is characterized by a repetitive and persistent pattern of behaviour in which the basic rights of others or major age-appropriate societal norms, rules, or laws are violated such as aggression towards people or animals; destruction of property; deceitfulness or theft; and serious violations of rules. The behaviour pattern is of sufficient severity to result in significant impairment in personal, family, social, educational, occupational or other important areas of functioning. To be diagnosed, the behaviour pattern must be enduring over a significant period of time (e.g., 12 months or more). Isolated dissocial or criminal acts are thus not in themselves grounds for the diagnosis. Note: The ICD-11 lists 8 additional subcategories of conduct-dissocial disorder. They can be found here. '''Changes in DSM-5''' * The diagnostic criteria for Conduct disorder changed slightly from [[DSM-IV]] to [[w:Diagnostic_and_Statistical_Manual_of_Mental_Disorders#DSM-IV-TR_.282000.29|DSM-5]]. Summaries are available [http://www.dsm5.org/Documents/changes%20from%20dsm-iv-tr%20to%20dsm-5.pdf here]. {{blockquotebottom}} ===Base rates of conduct disorder in different clinical settings and populations=== This section describes the demographic setting of the population(s) sampled, base rates of diagnosis, country/region sampled and the diagnostic method that was used. Using this information, clinicians will be able to anchor the rate of conduct disorder that they are likely to see in their clinical practice. * '''''To see prevalence rates across multiple disorders,''''' [[Evidence based assessment/Preparation phase#Base rates for transdiagnostic comparison|'''''click here.''''']] {| class="wikitable sortable" |- |- ! Demography ! Setting ! Base Rate ! Diagnostic Method |- | All of U.S.A.<ref>{{cite journal|last1=Nock|first1=M. K.|last2=Kazdin|first2=A. E.|last3=Hiripi|first3=E.|last4=Kessler|first4=R. C.|title=Pravalence, subtypes and correlates of DSM-IV conduct disorder in the National Comorbidity Survey Replication|journal=Psychological Medicine|volume=36|page=699-910.}}</ref> | Nationally representative large-scale study (N=9282) - adult retrospective report || 9.5% overall: 12% males, 7% females || CIDI: WHO Composite International Diagnostic Interview (Parent Interview) |- | Western North Carolina<ref>{{cite journal|last1=Costello|first1=E. J.|last2=Mustillo|first2=S.|last3=Erkanli|first3=A.|last4=Keeler|first4=G.|last5=Angold|first5=A.|title=Prevalence and development of psychiatric disorders in adolescence|journal=Arch Gen Psychiatry|volume=60|page=837-844.}}</ref> | The Great Smoky Mountains Study – longitudinal, population-based study of community sample || 9.0% overall: 14% males, 4% females || CAPA: Child and Adolescent Psychiatric Interview (Parent and Youth Interview) |- | California, Division of Juvenile Justice (DJJ)<ref>{{cite journal|last1=Karnik|first1=N. S.|last2=Soller|first2=M.|last3=Redlick|first3=A.|last4=Silverman|first4=M.|last5=Kraemer|first5=H.C.|last6=Steiner|first6=H.|title=Psychiatric disorders among juvenile delinquents incarcerated for nine months|journal=Psychiatric Services|volume=60|page=838-841.}}</ref> | Incarcerated adolescents || 93% males, 92% females || SCID-IV: Structured Clinical Interview for DSM-IV (Youth Interview) |- |All of USA<ref>Kessler RC, Avenevoli S, Costello E, et al. Prevalence, Persistence, and Sociodemographic Correlates of DSM-IV Disorders in the National Comorbidity Survey Replication Adolescent Supplement. ''Arch Gen Psychiatry.'' 2012;69(4):372-380. doi:10.1001/archgenpsychiatry.2011.160</ref> |National Comorbidity Survey Replication Adolescent Supplement –population-based study of adolescents |5.4% Overall |CIDI (Parent Interview) |- | Various locations across USA<ref>{{cite journal|last1=Farrington|first1=D.P.|title=Conduct disorder, aggression, and delinquency|journal=Handbook of adolescent psychology|page=324–345). Hoboken, NJ: Wiley.}}</ref> | Community samples – summary of past findings || 6-16% males, 2-9% females || Varied |- |Urban Midwestern USA<ref name=":0">Kahn RE, Frick PJ, Youngstrom E, Findling RL, Youngstrom JK. The effects of including a callous-unemotional specifier for the diagnosis of conduct disorder. J Child Psychol Psychiatry. 2012;53(3):271–282</ref> |Clinic-referred sample |12.5% overall; 50% of those with CD met criteria for CU traits based on combined-informant report on APSD |KSADS-PL |- |Small metropolitan area in SE USA<ref name=":0" /> |Community based sample |16.2% overall; 32% of those with CD met criteria for CU traits based on combined-informant report on APSD |CSI-4, based on combined-informant report |} '''Note:''' Despite a plethora of studies assessing prevalence of comorbidity of conduct disorder with other disorders (e.g., substance abuse, bipolar, ADHD), searches outlined below did not yield a single study providing a prevalence of conduct disorder alone in an outpatient or community clinic setting. == [[Evidence based assessment/Prediction phase|'''Prediction phase''']] == ===Recommended screening instruments for conduct disorder=== {| class="wikitable" |- ! Measure !Format (Reporter) !Age Range !Administration/ Completion Time !Where to Access |- |[https://store.aseba.org/ ASEBA (Achenbach System of Empirically Based Assessment)] ''not free''<ref>{{Cite journal|last=Paul|first=Howard A.|date=2019-09-18|title=Treatment of Disorders in Childhood and Adolescence|url=http://dx.doi.org/10.1080/07317107.2019.1659554|journal=Child &amp; Family Behavior Therapy|volume=41|issue=4|pages=247–255|doi=10.1080/07317107.2019.1659554|issn=0731-7107}}</ref> |Parent report (CBCL) Youth self-report (YSR) |6-18 (CBCL) 11-18 (YSR) |10-15 minutes |For Purchase |- |[https://www.pearsonclinical.com/education/landing/basc-3.html?orgref=http://www.ani.com/BASC-3&utm_medium=vanity&cmpid=701d0000001ZpG8AAK BASC-2 (Behavior Assessment System for Children, 2nd Edition)] ''not free''<ref>{{Cite journal|last=Paul|first=Howard A.|date=2019-09-18|title=Treatment of Disorders in Childhood and Adolescence|url=http://dx.doi.org/10.1080/07317107.2019.1659554|journal=Child &amp; Family Behavior Therapy|volume=41|issue=4|pages=247–255|doi=10.1080/07317107.2019.1659554|issn=0731-7107}}</ref> |teacher/ parent/ self-report |2:0-21:11 for parent/ teacher; 6:0-college age for self-report |10-20 minutes for parent/ teacher; 30 minutes self-report | |- |[https://www.parinc.com/Products/Pkey/97 ECBI/ SESBI-R (Eyberg Child Behavior Inventory/Sutter-Eyberg Child Behavior Inventory-Revised)] ''not free''<ref>{{Cite journal|last=Paul|first=Howard A.|date=2019-09-18|title=Treatment of Disorders in Childhood and Adolescence|url=http://dx.doi.org/10.1080/07317107.2019.1659554|journal=Child &amp; Family Behavior Therapy|volume=41|issue=4|pages=247–255|doi=10.1080/07317107.2019.1659554|issn=0731-7107}}</ref> |parent/ teacher |2-16 |5 minutes |For Purchase |} '''Note:''' Reliability and validity are included in the [[Evidence-based assessment/Conduct disorder/ Extended version|extended version]]. This table includes measures with Good or Excellent ratings. == [[Evidence-based assessment/Prescription phase|'''Prescription phase''']] == === Gold standard diagnostic interviews === * For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews click here.] ===Semi-structured and Structured Diagnostic Interviews=== {| class="wikitable" |- ! Measure !Format (Reporter) !Age Range !Administration/ Completion Time !Where to Access |- |Kiddie Schedule for Affective Disorders and Schizophrenia Present and Lifetime Version (KSADS-PL)<ref>{{Cite web|url=http://dx.doi.org/10.1037/t03988-000|title=Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version|last=Kaufman|first=John|last2=Birmaher|first2=Boris|date=1997|website=PsycTESTS Dataset|access-date=2022-08-15|last3=Brent|first3=David|last4=Rao|first4=Uma|last5=Flynn|first5=Cynthia|last6=Moreci|first6=Paula|last7=Williamson|first7=Douglas|last8=Ryan|first8=Neal}}</ref><ref>{{Cite journal|last=Paul|first=Howard A.|date=2019-09-18|title=Treatment of Disorders in Childhood and Adolescence|url=http://dx.doi.org/10.1080/07317107.2019.1659554|journal=Child &amp; Family Behavior Therapy|volume=41|issue=4|pages=247–255|doi=10.1080/07317107.2019.1659554|issn=0731-7107}}</ref> |Structured interview |6-28 |45-75 minutes | |- |[https://osf.io/z6qrh Diagnostic Interview Schedule for Children (DISC)] <ref>{{Cite web|url=http://dx.doi.org/10.1037/t04405-000|title=National Institute of Mental Health Diagnostic Interview Schedule for Children-IV|last=Shaffer|first=David|last2=Fisher|first2=Prudence|date=2000|website=PsycTESTS Dataset|access-date=2022-08-15|last3=Lucas|first3=Christopher P.|last4=Dulcan|first4=Mina K.|last5=Schwab-Stone|first5=Mary E.}}</ref><ref>{{Cite journal|last=Paul|first=Howard A.|date=2019-09-18|title=Treatment of Disorders in Childhood and Adolescence|url=http://dx.doi.org/10.1080/07317107.2019.1659554|journal=Child &amp; Family Behavior Therapy|volume=41|issue=4|pages=247–255|doi=10.1080/07317107.2019.1659554|issn=0731-7107}}</ref> |Structured Interview (Self report and parent) |4-12 |70/ 90-120 | |- |Diagnostic Interview for Children and Adolescents (DICA)<ref>{{Cite journal|last=Reich|first=Wendy|date=2000-01|title=MORE ON THE DICA|url=http://dx.doi.org/10.1097/00004583-200001000-00008|journal=Journal of the American Academy of Child &amp; Adolescent Psychiatry|volume=39|issue=1|pages=14–15|doi=10.1097/00004583-200001000-00008|issn=0890-8567}}</ref><ref>{{Cite journal|last=Paul|first=Howard A.|date=2019-09-18|title=Treatment of Disorders in Childhood and Adolescence|url=http://dx.doi.org/10.1080/07317107.2019.1659554|journal=Child &amp; Family Behavior Therapy|volume=41|issue=4|pages=247–255|doi=10.1080/07317107.2019.1659554|issn=0731-7107}}</ref> |Structured interview |6-18 | | |} '''Note:''' Reliability and validity are included in the [[Evidence-based assessment/Conduct disorder/ Extended version|extended version]]. This table includes measures with Good or Excellent ratings. ==[[Evidence-based assessment/Process phase|'''Process phase''']]== The following section contains a brief overview of treatment options for Conduct disorder and list of process and outcome measures for Conduct disorder. The section includes benchmarks based on published norms for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the [[Evidence based assessment/Process phase|process phase]] of assessment. For more information of differences between process and outcome measures, see the page on the [[Evidence based assessment/Process phase|process phase of assessment]]. === Outcome and severity measures === This table includes clinically significant benchmarks for Conduct disorder specific outcome measures * Information on how to interpret this table can be [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase found here]. * Additionally, these [[Evidence based assessment/Vignettes|vignettes]] might be helpful resources for understanding appropriate adaptation of outcome measures in practice. * ''<u>For clinically significant change benchmarks for the CBCL, YSR, and TRF total, externalizing, internalizing, and attention benchmarks,</u>'' [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase&wteswitched=1#Clinically_significant_change_benchmarks_for_widely-used_outcome_measures see here.] {{blockquotetop}} '''Statistically significant change benchmarks with common instruments''' {| class="wikitable sortable" border="1" |- | rowspan=1" style="text-align:center;font-size:130%;" | <b> Measure</b> | style="text-align:center;font-size:130%;" | <b> Subscale</b> | colspan="3" style="text-align:center;font-size:130%" width="300" | <b> Cut-off scores*</b> | colspan="3" style="text-align:center;font-size:120%" | <b> Critical Change <br> (unstandardized scores)</b> |- |- | colspan="2" | | style="text-align:center;font-size:110%" | <b> A</b> | style="text-align:center;font-size:110%" | <b> B</b> | style="text-align:center;font-size:110%" | <b> C</b> | style="text-align:center;font-size:110%" | <b> 95%</b> | style="text-align:center;font-size:110%" | <b> 90%</b> | style="text-align:center;font-size:110%" | <b> SE_difference</b> |- | colspan="8" span style="font-size:110%; text-align:center;" | <b> Benchmarks Based on Published Norms</b> |- | style="text-align:center;" | <b> CBCL T-scores <br> (2001 Norms)</b> | style="text-align:right;" | <i> Externalizing</i> | style="text-align:center;"| 49 | style="text-align:center;"| 70 | style="text-align:center;"| 58 | style="text-align:center;"| 7 | style="text-align:center;"| 6 | style="text-align:center;"| 3.4 |- | colspan="8" span style="font-size:110%; text-align:left;" | <b> Conduct Disorder Samples Were Not Found in Searches*</b> |- |} {{blockquotebottom}} '''Note''': “A” = Away from the clinical range, “B” = Back into the nonclinical range, “C” = Closer to the nonclinical than clinical mean '''Search terms''': (1)“antisocial process screening device,” (2) antisocial process screening device AND benchmarks, searches previously mentioned. ==External Resources== See [http://www.effectivechildtherapy.com Effective Child Therapy], a website sponsored by The Society for Child and Adolescent Psychology (APA, Division 53) and the Association for Behavioral and Cognitive Therapies (ABCT), for current summary of evidence-based treatments. *[[Antisocial personality disorder]] *[[Wikipedia:Bullying|Bullying]] *[[Wikipedia:Oppositional defiant disorder|Oppositional defiant disorder]] *[[Wikipedia:Parental alienation|Parental alienation]] *[https://sccap53.org Society of Clinical Child and Adolescent Psychology] *[http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/self-injurious-thoughts-and-behaviors/ EffectiveChildTherapy.Org information on rule-breaking, defiance, and acting out] ==References== {{collapse top|References|expand=yes}} {{Reflist|30em}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] {{collapse bottom}} 8tikxlhk34rxmk6zkrzbgqk3hrnmvl9 0 207103 2419209 2414010 2022-08-26T02:44:15Z Ardenguo 2944162 /* Treatment */ Made collapsible box expanded by default wikitext text/x-wiki <noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{medical disclaimer}} {{:{{BASEPAGENAME}}/Sidebar}} ==[[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio"?''']]== * For background information on what assessment portfolios are, click the link in the heading above. Want even 'more' information about this topic? There's an extended version of this page [[Evidence-based assessment/Generalized anxiety disorder (assessment portfolio)/extended version|here]]. ==[[Evidence based assessment/Preparation phase|'''Preparation phase''']]== === Diagnostic criteria for generalized anxiety disorder === {{blockquotetop}} <big>'''ICD-11 Diagnostic Criteria<ref>https://icd.who.int/browse11/l-m/en#/http://id.who.int/icd/entity/1712535455</ref>'''</big> *Generalised anxiety disorder is characterized by marked symptoms of anxiety that persist for at least several months, for more days than not, manifested by either general apprehension (i.e. ‘free-floating anxiety’) or excessive worry focused on multiple everyday events, most often concerning family, health, finances, and school or work, together with additional symptoms such as muscular tension or motor restlessness, sympathetic autonomic over-activity, subjective experience of nervousness, difficulty maintaining concentration, irritability, or sleep disturbance. The symptoms result in significant distress or significant impairment in personal, family, social, educational, occupational, or other important areas of functioning. The symptoms are not a manifestation of another health condition and are not due to the effects of a substance or medication on the central nervous system. '''Changes in DSM-5''' * The diagnostic criteria for generalized anxiety disorder changed slightly from DSM-IV-TR to DSM-5. Summaries are available [https://www.ncbi.nlm.nih.gov/books/NBK519712/table/ch3.t9/?report=objectonly here]. {{blockquotebottom}} === Base rates of GAD in different clinical settings === This section describes the demographic setting of the population(s) sampled, base rates of diagnosis, country/region sampled and the diagnostic method that was used. Using this information, clinicians will be able to anchor the rate of GAD that they are likely to see in their clinical practice. * '''''To see prevalence rates across multiple disorders,''''' [[Evidence based assessment/Preparation phase#Base rates for transdiagnostic comparison|'''''click here.''''']] {| class="wikitable sortable" border="1" |- ! Demography ! Setting ! Base Rate ! Diagnostic Method |- | Adults and adolescences in all of U.S.A. | US National Comorbidity Survey Replication (NCS-R; age > = 13) [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4005415/pdf/nihms-571992.pdf (2012)]<ref name="KesslerEtAl2012" /> |0.9% (age 13-17) 2.9% (age 18-64) 1.2% (age &gt;= 65) 2.0% (age &gt;=13) | Fully-structured Composite International Diagnostic Interview (CIDI Version 3.0) |- | Psychiatric outpatients | Individuals seeking treatment in a Psychiatric Outpatient Clinic (age range not reported) ([https://ajp.psychiatryonline.org/doi/pdf/10.1176/appi.ajp.162.10.1911 2014])<ref name="ZimmermanEtAl2005" /> |21% | Structured Clinical Interview for DSM-IV (SCID) |- | Caucasian youth | Children seeking treatment in a Child &amp; Adolescent Anxiety Diagnostic Clinic (age 7 – 18 years old) ([http://journals.sagepub.com/doi/pdf/10.1177/1073191110375792 2011])<ref name="BrownJacobsenEtAl2011" /> |0.39% (parent report) 0.38% (child report) | Anxiety Disorders Interview Schedule for Children for DSM-IV Spence Children's Anxiety Scale (SCAS) |- | Caucasian, African American, Asian American, and Hispanic population | Collaborative Psychiatric Epidemiology Studies (CPES; age &gt;= 18, data merged from three representative national database) ([https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3135672/pdf/nihms281333.pdf 2011])<ref>{{Cite journal|last=McLean|first=Carmen P.|last2=Asnaani|first2=Anu|last3=Litz|first3=Brett T.|last4=Hofmann|first4=Stefan G.|date=2011-08-01|title=Gender differences in anxiety disorders: Prevalence, course of illness, comorbidity and burden of illness|url=https://www.sciencedirect.com/science/article/pii/S0022395611000458|journal=Journal of Psychiatric Research|language=en|volume=45|issue=8|pages=1027–1035|doi=10.1016/j.jpsychires.2011.03.006|issn=0022-3956|pmc=PMC3135672|pmid=21439576}}</ref> |4.1% (female) 2.1% (male) | World Mental Health Survey Initiative Version of the World Health Organization Composite International Interview (WMH-CIDI) |- | Pennsylvania | Metropolitan Community Sample, all individuals with eating disorders (ages 13 – 65) ([https://ajp.psychiatryonline.org/doi/pdf/10.1176/appi.ajp.161.12.2215 2014])<ref name="KayeEtAl2004" /> |10% | Structured Clinical Interview for DSM-IV (SCID) |- | Adolescents in all of U.S.A. | National Comorbidity Survey Replication Adolescent Supplement (NCS-A; ages 3–18 in the continental U.S) ([https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2946114/pdf/nihms214371.pdf 2011])<ref name="MerikangasEtAl2010" /> |2.2% | World Health Organization Composite International Diagnostic Interview (WHO-CIDI) |- |Adolescents in all of U.S.A |National Comorbidity Survey Replication Adolescent Supplement (NCS-A; ages 3–18 in the continental U.S)<ref name=":3">Kessler, R. C., Avenevoli, S., Costello, E. J., Georgiades, K., Green, J. G., Gruber, M. J., . . . Merikangas, K. R. (2012). Prevalence, persistence, and sociodemographic correlates of DSM-IV disorders in the National Comorbidity Survey Replication Adolescent Supplement. Archives of General Psychiatry, 69(4), 372-380. doi:10.1001/archgenpsychiatry.2011.160</ref> |5.4% |Composite International Diagnostic Interview (CIDI) |- | North Carolina | Rural community sample African American and White youth (ages 13-16) [https://www.ncbi.nlm.nih.gov/pubmed/12365876 (2002)]<ref>{{Cite journal|last=Angold|first=Adrian|last2=Erkanli|first2=Alaattin|last3=Farmer|first3=Elizabeth M. Z.|last4=Fairbank|first4=John A.|last5=Burns|first5=Barbara J.|last6=Keeler|first6=Gordon|last7=Costello|first7=E. Jane|date=October 2002|title=Psychiatric disorder, impairment, and service use in rural African American and white youth|url=https://www.ncbi.nlm.nih.gov/pubmed/12365876|journal=Archives of General Psychiatry|volume=59|issue=10|pages=893–901|issn=0003-990X|pmid=12365876}}</ref> |1.4% | The Child and Adolescent Psychiatric Assessment (CAPA) |- | Texas | Metropolitan Community Sample (ages 11-17) ([https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2736593/pdf/nihms30019.pdf 2007])<ref name="RobertsEtAl2007" /> |0.4% | Diagnostic Interview Schedule for Children, Version IV (DISC-IV) |- | Midwestern Urban | Incarcerated adolescents (ages 10-18)<ref>{{Cite journal|last=ABRAM|first=KAREN M.|last2=CHOE|first2=JEANNE Y.|last3=WASHBURN|first3=JASON J.|last4=TEPLIN|first4=LINDA A.|last5=KING|first5=DEVON C.|last6=DULCAN|first6=MINA K.|title=Suicidal Ideation and Behaviors Among Youths in Juvenile Detention|url=http://linkinghub.elsevier.com/retrieve/pii/S0890856709623121|journal=Journal of the American Academy of Child & Adolescent Psychiatry|volume=47|issue=3|pages=291–300|doi=10.1097/chi.0b013e318160b3ce}}</ref> [http://vb3lk7eb4t.search.serialssolutions.com/?ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=Suicidal+Ideation+and+Behaviors+Among+Youths+in+Juvenile+Detention&rft.jtitle=Journal+of+the+American+Academy+of+Child+%26+Adolescent+Psychiatry&rft.au=ABRAM%2C+KAREN+M.%2C+Ph.D&rft.au=CHOE%2C+JEANNE+Y.%2C+B.A&rft.au=WASHBURN%2C+JASON+J.%2C+Ph.D.%2C+A.B.P.P&rft.au=TEPLIN%2C+LINDA+A.%2C+Ph.D&rft.date=2008&rft.issn=0890-8567&rft.eissn=1527-5418&rft.volume=47&rft.issue=3&rft.spage=291&rft.epage=300&rft_id=info:doi/10.1097%2FCHI.0b013e318160b3ce&rft.externalDocID=1_s2_0_S0890856709623121 (2002)] |1% | Diagnostic Interview Schedule for Children, Version IV (DISC-IV) |- |Non-institutionalized general US population |LGBTQ sample (ages 20-65)<ref>{{Cite journal|last=Bostwick|first=Wendy B.|last2=Boyd|first2=Carol J.|last3=Hughes|first3=Tonda L.|last4=McCabe|first4=Sean Esteban|date=2010-3|title=Dimensions of Sexual Orientation and the Prevalence of Mood and Anxiety Disorders in the United States|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2820045/|journal=American Journal of Public Health|volume=100|issue=3|pages=468–475|doi=10.2105/AJPH.2008.152942|issn=0090-0036|pmc=PMC2820045|pmid=19696380}}</ref> [http://ajph.aphapublications.org/doi/10.2105/AJPH.2008.152942 (2013)] |Women: 14.8% same-sex 22.5% bisexual Men: 16.9% same-sex 11.5% bisexual |The Alcohol Use Disorder and Associated Disabilities Interview Schedule-IV (AUDADIS-IV) |- |Non-institutionalized general US population |Cross-ethnic American population (ages 18+)<ref>{{Cite journal|last=Asnaani|first=Anu|last2=Richey|first2=J. Anthony|last3=Dimaite|first3=Ruta|last4=Hinton|first4=Devon E.|last5=Hofmann|first5=Stefan G.|date=2010-8|title=A Cross-Ethnic Comparison of Lifetime Prevalence Rates of Anxiety Disorders|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2931265/|journal=The Journal of nervous and mental disease|volume=198|issue=8|pages=551–555|doi=10.1097/NMD.0b013e3181ea169f|issn=0022-3018|pmc=PMC2931265|pmid=20699719}}</ref> [https://journals.lww.com/jonmd/Abstract/2010/08000/A_Cross_Ethnic_Comparison_of_Lifetime_Prevalence.4.aspx (2018)] |White 8.6% African Americans 4.9% Hispanic Americans 5.8% Asian Americans 2.4% |World Mental Health Survey Initiative Version of the World Health Organization Composite International Interview (WMH-CIDI) |- |Outpatient clinics worldwide |Samples across multiple studies worldwide (all ages)<ref name=":12">{{Cite journal|last=Rettew|first=David C.|last2=Lynch|first2=Alicia Doyle|last3=Achenbach|first3=Thomas M.|last4=Dumenci|first4=Levent|last5=Ivanova|first5=Masha Y.|date=2009-09|title=Meta-analyses of agreement between diagnoses made from clinical evaluations and standardized diagnostic interviews|url=http://dx.doi.org/10.1002/mpr.289|journal=International Journal of Methods in Psychiatric Research|language=en|volume=18|issue=3|pages=169–184|doi=10.1002/mpr.289|issn=1049-8931}}</ref> |5% |Clinical evaluations |- |Outpatient clinic worldwide |Samples across multiple studies worldwide (all ages)<ref name=":12" /> |10% |Standardized Diagnostic Interviews (SDIs) |- |People during pregnancy and postpartum |Samples across multiple studies worldwide<ref>{{Cite journal|last=Fawcett|first=Emily J.|last2=Fairbrother|first2=Nichole|last3=Cox|first3=Megan L.|last4=White|first4=Ian R.|last5=Fawcett|first5=Jonathan M.|date=2019-07-23|title=The Prevalence of Anxiety Disorders During Pregnancy and the Postpartum Period: A Multivariate Bayesian Meta-Analysis|url=https://www.psychiatrist.com/JCP/article/Pages/2019/v80/18r12527.aspx|journal=The Journal of Clinical Psychiatry|volume=80|issue=4|doi=10.4088/JCP.18r12527|issn=1555-2101|pmc=PMC6839961|pmid=31347796}}</ref> |2.4% |Standardized Diagnostic Interviews (SDIs) |- |Older adults |Samples across in Switzerland, German, Italy, England, Spain, and Israel |3.7% (age 65-69) 3.7% (age 70-74) 2.6% (age 75-79) 2.0% (age >80) |Clinical evaluations |} '''Search terms:''' [General Anxiety Disorder] AND [prevalence OR incidence] in GoogleScholar and PsycINFO == [[Evidence based assessment/Prediction phase|'''Prediction phase''']] == === Psychometric properties of screening instruments for GAD === The following section contains a list of screening and diagnostic instruments for generalized anxiety disorder. The section includes administration information, psychometric data, and PDFs or links to the screenings. * Screenings are used as part of the [[Evidence based assessment/Prediction phase|prediction phase]] of assessment; for more information on interpretation of this data, or how screenings fit in to the assessment process, click [[Evidence based assessment/Prediction phase|here]]. * '''''For a list of more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Psychometric_properties_of_common_screening_instruments click here.]''''' {| class="wikitable sortable" border="1" ! colspan="5" |Screening measures for GAD |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time ! style="width:12em" | Where to Access |- | Penn State Worry Questionnaire (PSWQ)<ref name=":0">{{Cite book|url=https://www.worldcat.org/oclc/314222270|title=A guide to assessments that work|date=2008|publisher=Oxford University Press|author=Hunsley, John |author2=Mash, Eric J.|isbn=9780195310641|location=New York|oclc=314222270}}</ref> | Questionnaire (Adult Version, Child Version) | 18+ (Adult Version), 6-18 (Child Version) | 4 minutes |[http://www.midss.org/content/penn-state-worry-questionnaire-pswq PSWQ homepage] [https://mfr.osf.io/render?url=https://osf.io/s7p38/?action=download%26mode=render PSWQ Adult Version] [https://mfr.osf.io/render?url=https://osf.io/6q8y9/?action=download%26mode=render PSWQ Child Version] [https://mfr.osf.io/render?url=https://osf.io/gx5sr/?action=download%26mode=render PSWC-C Korean] [https://mfr.osf.io/render?url=https://osf.io/hc6n2/?action=download%26mode=render PSWQ-C Danish] [https://mfr.osf.io/render?url=https://osf.io/fwbes/?action=download%26mode=render Scoring the PSWQ-C] |- |[[wikipedia:Screen_for_child_anxiety_related_disorders|Screen for Child Anxiety Related Emotional Disorder (SCARED)]]<ref name=":0" /> | Questionnaire (Child, Parent) | 8-19 | 9 or 16 minutes |[http://www.midss.org/content/screen-child-anxiety-related-disorders-scared SCARED] homepage [[wikipedia:Screen_for_child_anxiety_related_disorders#PDFs_and_automated_scoring_for_SCARED|SCARED English + Translations & Automatic Scoring]] |- |Child Behavior Checklist (CBCL)<ref name=":0" /> |Questionnaire (Parent report) |6-18 |10 minutes |[https://aseba.org/ ASEBA homepage][https://store.aseba.org/ Purchase] |} === Likelihood ratios and AUCs of screening instruments for GAD === * '''''For a list of the likelihood ratios for more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Likelihood_ratios_and_AUCs_of_common_screening_instruments click here.]''''' {| class="wikitable sortable" border="1" ! Screening Measure (Primary Reference) ! Area Under Curve (AUC) ! LR+ (Score) ! LR- (Score) ! Clinical Generalizability !Where to Access |- | Penn State Worry Questionnaire (PSWQ)<ref name=":2">{{Cite journal|last=Fresco|first=David M.|last2=Mennin|first2=Douglas S.|last3=Heimberg|first3=Richard G.|last4=Turk|first4=Cynthia L.|title=Using the Penn State Worry Questionnaire to identify individuals with generalized anxiety disorder: a receiver operating characteristic analysis|url=http://linkinghub.elsevier.com/retrieve/pii/S0005791603000569|journal=Journal of Behavior Therapy and Experimental Psychiatry|volume=34|issue=3-4|pages=283–291|doi=10.1016/j.jbtep.2003.09.001}}</ref> | 0.74 (N=164) | 1.8 (65+) | 0.5 (< 65) | Generalized Anxiety Disorder vs. social anxiety disorder, adults presenting to specialty anxiety clinic |[https://mfr.osf.io/render?url=https://osf.io/s7p38/?action=download%26mode=render PSWQ Adult Version] [https://mfr.osf.io/render?url=https://osf.io/6q8y9/?action=download%26mode=render PSWQ Child Version] |- |[[wikipedia:Screen_for_child_anxiety_related_disorders#PDFs_and_automated_scoring_for_SCARED|Screen for Child Anxiety Related Disorders (SCARED)]]<ref name="BirmaherEtAl1997" /> | .70 (N=243) | 5.0 (+32) | .04 | High: Pure anxiety disorder versus non-anxiety psychiatric disorder, excluding children with disruptive disorder and depression |[http://www.midss.org/content/penn-state-worry-questionnaire-pswq SCARED English + Translations & Automatic Scoring] |- |CBCL Anxious/Depressed Scale T-score<ref>{{Cite journal|last=Eimecke|first=Sylvia D.|last2=Remschmidt|first2=Helmut|last3=Mattejat|first3=Fritz|date=2011-03|title=Utility of the Child Behavior Checklist in screening depressive disorders within clinical samples|url=https://linkinghub.elsevier.com/retrieve/pii/S0165032710005458|journal=Journal of Affective Disorders|language=en|volume=129|issue=1-3|pages=191–197|doi=10.1016/j.jad.2010.08.011}}</ref> |.75 (N = 1445) |1.49 (9+) |.67(9-) |Inpatient and outpatient children and adolescents |[https://store.aseba.org/ Purchase] |} '''Note:''' “LR+” refers to the change in likelihood ratio associated with a positive test score, and “LR-” is the likelihood ratio for a low score. Likelihood ratios of 1 indicate that the test result did not change impressions at all. LRs larger than 10 or smaller than .10 are frequently clinically decisive; 5 or .20 are helpful, and between 2.0 and .5 are small enough that they rarely result in clinically meaningful changes of formulation<ref>Sackett, D. L., Straus, S. E., Richardson, W. S., Rosenberg, W., & Haynes, R. B. (2000). Evidence-based medicine: How to practice and teach EBM. Edinburgh: Churchill Livingstone.</ref>. '''Search terms:''' [General Anxiety Disorder] AND [children OR adolescents OR pediatric] AND [sensitivity OR specificity] in GoogleScholar and PsycINFO === Interpreting depression screening measure scores === * For information on interpreting screening measure scores, click [[Evidence based assessment/Prediction phase#Interpreting screening measure scores|here.]] ==[[Evidence based assessment/Prescription phase|'''Prescription phase''']]== ===Gold standard diagnostic interviews=== * For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews click here.] === Recommended diagnostic instruments for GAD === {| class="wikitable sortable" ! colspan="5" |Diagnostic instruments for GAD |- !Measure !Format (Reporter) !Age Range !Administration/ Completion Time !Where to Access |- |Anxiety Disorders Interview Schedule for Children/Parent<ref name=":1">{{Cite journal|date=2001-08-01|title=Test-Retest Reliability of Anxiety Symptoms and Diagnoses With the Anxiety Disorders Interview Schedule for DSM-IV: Child and Parent Versions|url=https://www.sciencedirect.com/science/article/pii/S0890856709603427|journal=Journal of the American Academy of Child & Adolescent Psychiatry|language=en|volume=40|issue=8|pages=937–944|doi=10.1097/00004583-200108000-00016|issn=0890-8567}}</ref> |Structured Interview (Child (ADIS-C), Parent (ADIS-P)) |6-16<ref>{{Cite journal|last=LYNEHAM|first=HEIDI J.|last2=ABBOTT|first2=MAREE J.|last3=RAPEE|first3=RONALD M.|date=2007-06|title=Interrater Reliability of the Anxiety Disorders Interview Schedule for DSM-IV: Child and Parent Version|url=https://doi.org/10.1097/chi.0b013e3180465a09|journal=Journal of the American Academy of Child &amp; Adolescent Psychiatry|volume=46|issue=6|pages=731–736|doi=10.1097/chi.0b013e3180465a09|issn=0890-8567}}</ref> |Varies |[https://books.google.com/books/about/Anxiety_Disorders_Interview_Schedule_for.html?id=xpR6V3rboxwC Purchase] |- |Anxiety and Related Disorders Interview Schedule for DSM-5 (ADIS-5)<ref name=":0" /> |Structured Interview (Adult) |16+ |Varies |[https://global.oup.com/academic/product/anxiety-and-related-disorders-interview-schedule-for-dsm-5-adis-5---adult-version-9780199325160?cc=us&lang=en& Purchase] |- |Structured Clinical Interview for DSM-5-Clinician Version (SCID-5-CV)<ref>{{Cite journal|last=Shabani|first=Amir|last2=Masoumian|first2=Samira|last3=Zamirinejad|first3=Somayeh|last4=Hejri|first4=Maryam|last5=Pirmorad|first5=Tahereh|last6=Yaghmaeezadeh|first6=Hooman|date=2021-05|title=Psychometric properties of Structured Clinical Interview for DSM‐5 Disorders‐Clinician Version (SCID‐5‐CV)|url=https://onlinelibrary.wiley.com/doi/10.1002/brb3.1894|journal=Brain and Behavior|language=en|volume=11|issue=5|doi=10.1002/brb3.1894|issn=2162-3279|pmc=PMC8119811|pmid=33729681}}</ref> |Structured Interview (Adult ) |16+ |Varies |[https://www.columbiapsychiatry.org/research/research-labs/diagnostic-and-assessment-lab/structured-clinical-interview-dsm-disorders-11 Website and purchase] |- |Generalized Anxiety Disorder Screener (GAD-7)<ref name=":0" /> |Questionnaire (Self-report) |18+ |5 minutes |[https://www.pfizerpcoa.com/general-anxiety-disorder-7-gad-7-screener GAD-7 homepage] [https://osf.io/szmpu GAD-7 PDF] |} ==[[Evidence based assessment/Process phase|'''Process phase''']]== The following section contains a list of process and outcome measures for generalized anxiety disorder. The section includes benchmarks based on published norms for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the [[Evidence based assessment/Process phase|process phase]] of assessment. For more information of differences between process and outcome measures, see the page on the [[Evidence based assessment/Process phase|process phase of assessment]]. === Process measures === === Outcome and severity measures === * This table includes clinically significant benchmarks for '''(insert portfolio name here)''' specific outcome measures * Information on how to interpret this table can be [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase found here]. * Additionally, these [[Evidence based assessment/Vignettes|vignettes]] might be helpful resources for understanding appropriate adaptation of outcome measures in practice. *''<u>For clinically significant change benchmarks for the CBCL, YSR, and TRF total, externalizing, internalizing, and attention benchmarks,</u>'' [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase&wteswitched=1#Clinically_significant_change_benchmarks_for_widely-used_outcome_measures see here.] {| class="wikitable sortable" border="1" | colspan="7" |'''Clinically significant change benchmarks with common instruments for GAD''' |- | rowspan=1" style="text-align:center;font-size:130%;" | <b> Measure</b> | colspan="3" style="text-align:center;font-size:130%" width="300" | <b> Cut-off scores</b> | colspan="3" style="text-align:center;font-size:120%" | <b> Critical Change <br> (unstandardized scores)</b> |- | colspan="7" span style="font-size:110%; text-align:center;" | <b> Benchmarks Based on Published Norms</b> |- | colspan="1" | | style="text-align:center;font-size:110%" | <b> A</b> | style="text-align:center;font-size:110%" | <b> B</b> | style="text-align:center;font-size:110%" | <b> C</b> | style="text-align:center;font-size:110%" | <b> 95%</b> | style="text-align:center;font-size:110%" | <b> 90%</b> | style="text-align:center;font-size:110%" | <b> SE_difference</b> |- | rowspan="1" style="text-align:center;" | <b> GAD-7</b> | style=“text-align:center;”| -1 | style=“text-align:center;”| 1.3 | style=“text-align:center;”| 0.5 | style=“text-align:center;”| 0.6 | style=“text-align:center;”| 0.5 | style=“text-align:center;”| 0.3 |- | rowspan="1" style="text-align:center;" | <b> PSWQ</b> | style=“text-align:center;”| 51 | style=“text-align:center;”| 73 | style=“text-align:center;”| 59 | style=“text-align:center;”| 9 | style=“text-align:center;”| 8 | style=“text-align:center;”| 4.8 |- | rowspan="1" style="text-align:center;" | <b> SCARED </b> | style=“text-align:center;”| 9.9 | style=“text-align:center;”| 18.1 | style=“text-align:center;”| 15.3 | style=“text-align:center;”| 8.9 | style=“text-align:center;”| 7.5 | style=“text-align:center;”| 4.5 |} '''Note:''' “A” = Away from the clinical range, “B” = Back into the nonclinical range, “C” = Closer to the nonclinical than clinical mean. '''Search terms:''' [General Anxiety Disorder] AND [children OR adolescents OR pediatric] AND [clinical significance OR outcomes] in GoogleScholar and PsycINFO === Treatment === {{collapse top| Treatment Information|expand=yes}} Individuals suffering from GAD tend to be high users of outpatient medical care. When treating GAD, physicians should first determine whether pharmacotherapy, psychotherapy, or a combination of the two treatments would be most beneficial to the patient. Literature suggests that treatment of GAD frequently consists of a combination of psychotherapy and pharmacotherapy. Although these therapies have the potential to be effective individually, previous work demonstrates that when combined the degree of clinically significant change increases significantly. Recent studies (e.g., Gorman, 2003<ref name="Gorman2003" />; Walkup et al., 2008<ref name="WalkupEtAl2008" />) have provided evidence to support this claim with the most efficacious medication and behavioral interventions listed below. # '''Medication Interventions''' ## ''Sertraline (Zoloft)'' has been shown to reduce experiences and effects of GAD above and beyond that of placebo conditions. ## ''Pregabalin.'' The mean baseline-to-endpoint decreases in total Hamilton anxiety scale score in the patients given 150 mg/day of pregabalin (–9.2) was significantly greater than the decrease in those given placebo (–6.8)<ref name="PandeEtAl2003" />. ## ''Paroxetine.'' Remission was achieved by 30% of patients in the 20-mg paroxetine groups compared with 20% given placebo. For all three domains of the Sheehan Disability Scale, significantly greater improvement was seen with paroxetine than placebo<ref name="RickelsEtAl2003" />. # '''Behavioral interventions''' ## ''Cognitive behavioral therapy.'' Fourteen 60-minute sessions, which include CBT in anxiety-management skills, followed by behavioral exposure to anxiety-provoking situations have been shown to be effective in treating GAD. A review of studies by Fisher and Durham (1999)<ref name="FisherEtAl1999" /> revealed significant recovery rates at a 6 month follow up after CBT. ## ''Exposure therapy and modeling therapy.'' One meta-analysis found that virtual reality exposure therapy for anxiety disorders had a large effect size (Cohen's d=1.11) compared to controls.<ref>{{Cite journal|last=Powers|first=Mark B.|last2=Emmelkamp|first2=Paul M.G.|title=Virtual reality exposure therapy for anxiety disorders: A meta-analysis|url=https://doi.org/10.1016/j.janxdis.2007.04.006|journal=Journal of Anxiety Disorders|volume=22|issue=3|pages=561–569|doi=10.1016/j.janxdis.2007.04.006}}</ref> ## ''Mindfulness meditation.'' New treatment options such as mindfulness meditation-based stress reduction interventions have also shown to reduce symptoms over the long-term.<ref>{{Cite journal|last=Miller|first=J. J.|last2=Fletcher|first2=K.|last3=Kabat-Zinn|first3=J.|date=May 1995|title=Three-year follow-up and clinical implications of a mindfulness meditation-based stress reduction intervention in the treatment of anxiety disorders|url=https://www.ncbi.nlm.nih.gov/pubmed/7649463|journal=General Hospital Psychiatry|volume=17|issue=3|pages=192–200|issn=0163-8343|pmid=7649463}}</ref> # '''Combination treatment''' ## Previous research suggests that combination therapy that includes components of psychotherapy and pharmacotherapy are the most efficacious in treating GAD. In a study comparing the efficacies GAD treatments, Walkup and colleagues demonstrated a 21-25% improvement of combination therapy over cognitive behavioral therapy or sertraline alone during short-term treatment. These findings suggest that among effective treatments, combination therapy has the potential to provide the best chance for a positive outcome. See Gorman, 2003<ref name="Gorman2003" />; Walkup et al., 2008<ref name="WalkupEtAl2008" />. {{collapse bottom}} * Please refer to the page on [[wikipedia:Generalized_anxiety_disorder|generalized anxiety disorder]] for more information on available treatment or go to [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/fear-worry-and-anxiety/ Effective Child Therapy] for a curated resource on effective treatments for GAD. *For information on conducting Exposure Therapy for anxiety disordered youth, see [https://www.bravepracticeforkids.com/ www.BravePracticeForKids.com] =='''External Resources'''== # [http://apps.who.int/classifications/icd10/browse/2010/en#/F41.1 ICD-10 diagnostic criteria] # [https://en.wikiversity.org/w/index.php?title=Helping_Give_Away_Psychological_Science/Resources/Annotated_List_of_Where_and_How_to_Find_a_Therapist&wteswitched=1#Other_low-cost_options Find-a-Therapist] #*This is a curated list of find-a-therapist websites where you can find a provider # [https://www.nimh.nih.gov/health/topics/anxiety-disorders/index.shtml NIMH] entry about anxiety disorders # OMIM (Online Mendelian Inheritance in Man) #*[https://www.omim.org/entry/607834 607834] # [https://emedicine.medscape.com/article/286227-overview#a2 eMedicine entry about anxiety disorders] #[https://sccap53.org Society of Clinical Child and Adolescent Psychology] #[http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/fear-worry-and-anxiety/ Effective Child Therapy information on Fear, Worry, & Anxiety] #*Effective Child Therapy is website sponsored by Division 53 of the American Psychological Association (APA), or The [https://sccap53.org Society of Clinical Child and Adolescent Psychology] (SCCAP), in collaboration with the Association for Behavioral and Cognitive Therapies (ABCT). Use for information on symptoms and available treatments. #[http://pediatricbipolar.pitt.edu/resources/instruments Links to SCARED Child, Parent, and Adult + Translations] =='''References'''== {{collapse top|Click here for references}} {{Reflist|3|refs= <ref name="BirmaherEtAl1997">{{cite journal|last1=Birmaher|first1=B|last2=Khetarpal|first2=S|last3=Brent|first3=D|last4=Cully|first4=M|last5=Balach|first5=L|last6=Kaufman|first6=J|last7=Neer|first7=SM|title=The Screen for Child Anxiety Related Emotional Disorders (SCARED): scale construction and psychometric characteristics.|journal=Journal of the American Academy of Child and Adolescent Psychiatry|date=April 1997|volume=36|issue=4|pages=545-53|pmid=9100430}}</ref> <ref name="BrownJacobsenEtAl2011">{{cite journal|last1=Brown-Jacobsen|first1=AM|last2=Wallace|first2=DP|last3=Whiteside|first3=SP|title=Multimethod, multi-informant agreement, and positive predictive value in the identification of child anxiety disorders using the SCAS and ADIS-C.|journal=Assessment|date=September 2011|volume=18|issue=3|pages=382-92|pmid=20644080}}</ref> <ref name="CostelloEtAl1996">{{cite journal|last1=Costello|first1=EJ|last2=Angold|first2=A|last3=Burns|first3=BJ|last4=Stangl|first4=DK|last5=Tweed|first5=DL|last6=Erkanli|first6=A|last7=Worthman|first7=CM|title=The Great Smoky Mountains Study of Youth. 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2003|volume=160|issue=3|pages=533-40|pmid=12611835}}</ref> <ref name="RickelsEtAl2003">{{cite journal|last1=Rickels|first1=K|last2=Zaninelli|first2=R|last3=McCafferty|first3=J|last4=Bellew|first4=K|last5=Iyengar|first5=M|last6=Sheehan|first6=D|title=Paroxetine treatment of generalized anxiety disorder: a double-blind, placebo-controlled study.|journal=The American journal of psychiatry|date=April 2003|volume=160|issue=4|pages=749-56|pmid=12668365}}</ref> <ref name="RobertsEtAl2007">{{cite journal|last1=Roberts|first1=RE|last2=Roberts|first2=CR|last3=Xing|first3=Y|title=Rates of DSM-IV psychiatric disorders among adolescents in a large metropolitan area.|journal=Journal of psychiatric research|date=December 2007|volume=41|issue=11|pages=959-67|pmid=17107689}}</ref> <ref name="SeligmanEtAl2004">{{cite journal|last1=Seligman|first1=LD|last2=Ollendick|first2=TH|last3=Langley|first3=AK|last4=Baldacci|first4=HB|title=The utility of measures of child and adolescent anxiety: a meta-analytic review of the Revised Children's Manifest Anxiety Scale, the State-Trait Anxiety Inventory for Children, and the Child Behavior Checklist.|journal=Journal of clinical child and adolescent psychology : the official journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 53|date=September 2004|volume=33|issue=3|pages=557-65|pmid=15271613}}</ref> <ref name="WalkupEtAl2008">{{cite journal|last1=Walkup|first1=JT|last2=Albano|first2=AM|last3=Piacentini|first3=J|last4=Birmaher|first4=B|last5=Compton|first5=SN|last6=Sherrill|first6=JT|last7=Ginsburg|first7=GS|last8=Rynn|first8=MA|last9=McCracken|first9=J|last10=Waslick|first10=B|last11=Iyengar|first11=S|last12=March|first12=JS|last13=Kendall|first13=PC|title=Cognitive behavioral therapy, sertraline, or a combination in childhood anxiety.|journal=The New England journal of medicine|date=25 December 2008|volume=359|issue=26|pages=2753-66|pmid=18974308}}</ref> <ref 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DSM-IV anxiety disorders.|journal=Depression and anxiety|date=2008|volume=25|issue=12|pages=1046-52|pmid=18833579}}</ref> <ref name="WoodEtAl2002">{{cite journal|last1=Wood|first1=JJ|last2=Piacentini|first2=JC|last3=Bergman|first3=RL|last4=McCracken|first4=J|last5=Barrios|first5=V|title=Concurrent validity of the anxiety disorders section of the Anxiety Disorders Interview Schedule for DSM-IV: child and parent versions.|journal=Journal of clinical child and adolescent psychology : the official journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 53|date=September 2002|volume=31|issue=3|pages=335-42|pmid=12149971}}</ref> <ref name="ZimmermanEtAl2005">{{cite journal|last1=Zimmerman|first1=M|last2=Rothschild|first2=L|last3=Chelminski|first3=I|title=The prevalence of DSM-IV personality disorders in psychiatric outpatients.|journal=The American journal of psychiatry|date=October 2005|volume=162|issue=10|pages=1911-8|pmid=16199838}}</ref> }} {{collapse bottom|Click here for references}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] kv3n6zqfbi8wb23sn06ubdpaf2ak3ob 2419210 2419209 2022-08-26T02:44:40Z Ardenguo 2944162 /* References */ Made references box expanded by default wikitext text/x-wiki <noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{medical disclaimer}} {{:{{BASEPAGENAME}}/Sidebar}} ==[[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio"?''']]== * For background information on what assessment portfolios are, click the link in the heading above. Want even 'more' information about this topic? There's an extended version of this page [[Evidence-based assessment/Generalized anxiety disorder (assessment portfolio)/extended version|here]]. ==[[Evidence based assessment/Preparation phase|'''Preparation phase''']]== === Diagnostic criteria for generalized anxiety disorder === {{blockquotetop}} <big>'''ICD-11 Diagnostic Criteria<ref>https://icd.who.int/browse11/l-m/en#/http://id.who.int/icd/entity/1712535455</ref>'''</big> *Generalised anxiety disorder is characterized by marked symptoms of anxiety that persist for at least several months, for more days than not, manifested by either general apprehension (i.e. ‘free-floating anxiety’) or excessive worry focused on multiple everyday events, most often concerning family, health, finances, and school or work, together with additional symptoms such as muscular tension or motor restlessness, sympathetic autonomic over-activity, subjective experience of nervousness, difficulty maintaining concentration, irritability, or sleep disturbance. The symptoms result in significant distress or significant impairment in personal, family, social, educational, occupational, or other important areas of functioning. The symptoms are not a manifestation of another health condition and are not due to the effects of a substance or medication on the central nervous system. '''Changes in DSM-5''' * The diagnostic criteria for generalized anxiety disorder changed slightly from DSM-IV-TR to DSM-5. Summaries are available [https://www.ncbi.nlm.nih.gov/books/NBK519712/table/ch3.t9/?report=objectonly here]. {{blockquotebottom}} === Base rates of GAD in different clinical settings === This section describes the demographic setting of the population(s) sampled, base rates of diagnosis, country/region sampled and the diagnostic method that was used. Using this information, clinicians will be able to anchor the rate of GAD that they are likely to see in their clinical practice. * '''''To see prevalence rates across multiple disorders,''''' [[Evidence based assessment/Preparation phase#Base rates for transdiagnostic comparison|'''''click here.''''']] {| class="wikitable sortable" border="1" |- ! Demography ! Setting ! Base Rate ! Diagnostic Method |- | Adults and adolescences in all of U.S.A. | US National Comorbidity Survey Replication (NCS-R; age > = 13) [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4005415/pdf/nihms-571992.pdf (2012)]<ref name="KesslerEtAl2012" /> |0.9% (age 13-17) 2.9% (age 18-64) 1.2% (age &gt;= 65) 2.0% (age &gt;=13) | Fully-structured Composite International Diagnostic Interview (CIDI Version 3.0) |- | Psychiatric outpatients | Individuals seeking treatment in a Psychiatric Outpatient Clinic (age range not reported) ([https://ajp.psychiatryonline.org/doi/pdf/10.1176/appi.ajp.162.10.1911 2014])<ref name="ZimmermanEtAl2005" /> |21% | Structured Clinical Interview for DSM-IV (SCID) |- | Caucasian youth | Children seeking treatment in a Child &amp; Adolescent Anxiety Diagnostic Clinic (age 7 – 18 years old) ([http://journals.sagepub.com/doi/pdf/10.1177/1073191110375792 2011])<ref name="BrownJacobsenEtAl2011" /> |0.39% (parent report) 0.38% (child report) | Anxiety Disorders Interview Schedule for Children for DSM-IV Spence Children's Anxiety Scale (SCAS) |- | Caucasian, African American, Asian American, and Hispanic population | Collaborative Psychiatric Epidemiology Studies (CPES; age &gt;= 18, data merged from three representative national database) ([https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3135672/pdf/nihms281333.pdf 2011])<ref>{{Cite journal|last=McLean|first=Carmen P.|last2=Asnaani|first2=Anu|last3=Litz|first3=Brett T.|last4=Hofmann|first4=Stefan G.|date=2011-08-01|title=Gender differences in anxiety disorders: Prevalence, course of illness, comorbidity and burden of illness|url=https://www.sciencedirect.com/science/article/pii/S0022395611000458|journal=Journal of Psychiatric Research|language=en|volume=45|issue=8|pages=1027–1035|doi=10.1016/j.jpsychires.2011.03.006|issn=0022-3956|pmc=PMC3135672|pmid=21439576}}</ref> |4.1% (female) 2.1% (male) | World Mental Health Survey Initiative Version of the World Health Organization Composite International Interview (WMH-CIDI) |- | Pennsylvania | Metropolitan Community Sample, all individuals with eating disorders (ages 13 – 65) ([https://ajp.psychiatryonline.org/doi/pdf/10.1176/appi.ajp.161.12.2215 2014])<ref name="KayeEtAl2004" /> |10% | Structured Clinical Interview for DSM-IV (SCID) |- | Adolescents in all of U.S.A. | National Comorbidity Survey Replication Adolescent Supplement (NCS-A; ages 3–18 in the continental U.S) ([https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2946114/pdf/nihms214371.pdf 2011])<ref name="MerikangasEtAl2010" /> |2.2% | World Health Organization Composite International Diagnostic Interview (WHO-CIDI) |- |Adolescents in all of U.S.A |National Comorbidity Survey Replication Adolescent Supplement (NCS-A; ages 3–18 in the continental U.S)<ref name=":3">Kessler, R. C., Avenevoli, S., Costello, E. J., Georgiades, K., Green, J. G., Gruber, M. J., . . . Merikangas, K. R. (2012). Prevalence, persistence, and sociodemographic correlates of DSM-IV disorders in the National Comorbidity Survey Replication Adolescent Supplement. Archives of General Psychiatry, 69(4), 372-380. doi:10.1001/archgenpsychiatry.2011.160</ref> |5.4% |Composite International Diagnostic Interview (CIDI) |- | North Carolina | Rural community sample African American and White youth (ages 13-16) [https://www.ncbi.nlm.nih.gov/pubmed/12365876 (2002)]<ref>{{Cite journal|last=Angold|first=Adrian|last2=Erkanli|first2=Alaattin|last3=Farmer|first3=Elizabeth M. Z.|last4=Fairbank|first4=John A.|last5=Burns|first5=Barbara J.|last6=Keeler|first6=Gordon|last7=Costello|first7=E. Jane|date=October 2002|title=Psychiatric disorder, impairment, and service use in rural African American and white youth|url=https://www.ncbi.nlm.nih.gov/pubmed/12365876|journal=Archives of General Psychiatry|volume=59|issue=10|pages=893–901|issn=0003-990X|pmid=12365876}}</ref> |1.4% | The Child and Adolescent Psychiatric Assessment (CAPA) |- | Texas | Metropolitan Community Sample (ages 11-17) ([https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2736593/pdf/nihms30019.pdf 2007])<ref name="RobertsEtAl2007" /> |0.4% | Diagnostic Interview Schedule for Children, Version IV (DISC-IV) |- | Midwestern Urban | Incarcerated adolescents (ages 10-18)<ref>{{Cite journal|last=ABRAM|first=KAREN M.|last2=CHOE|first2=JEANNE Y.|last3=WASHBURN|first3=JASON J.|last4=TEPLIN|first4=LINDA A.|last5=KING|first5=DEVON C.|last6=DULCAN|first6=MINA K.|title=Suicidal Ideation and Behaviors Among Youths in Juvenile Detention|url=http://linkinghub.elsevier.com/retrieve/pii/S0890856709623121|journal=Journal of the American Academy of Child & Adolescent Psychiatry|volume=47|issue=3|pages=291–300|doi=10.1097/chi.0b013e318160b3ce}}</ref> [http://vb3lk7eb4t.search.serialssolutions.com/?ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=Suicidal+Ideation+and+Behaviors+Among+Youths+in+Juvenile+Detention&rft.jtitle=Journal+of+the+American+Academy+of+Child+%26+Adolescent+Psychiatry&rft.au=ABRAM%2C+KAREN+M.%2C+Ph.D&rft.au=CHOE%2C+JEANNE+Y.%2C+B.A&rft.au=WASHBURN%2C+JASON+J.%2C+Ph.D.%2C+A.B.P.P&rft.au=TEPLIN%2C+LINDA+A.%2C+Ph.D&rft.date=2008&rft.issn=0890-8567&rft.eissn=1527-5418&rft.volume=47&rft.issue=3&rft.spage=291&rft.epage=300&rft_id=info:doi/10.1097%2FCHI.0b013e318160b3ce&rft.externalDocID=1_s2_0_S0890856709623121 (2002)] |1% | Diagnostic Interview Schedule for Children, Version IV (DISC-IV) |- |Non-institutionalized general US population |LGBTQ sample (ages 20-65)<ref>{{Cite journal|last=Bostwick|first=Wendy B.|last2=Boyd|first2=Carol J.|last3=Hughes|first3=Tonda L.|last4=McCabe|first4=Sean Esteban|date=2010-3|title=Dimensions of Sexual Orientation and the Prevalence of Mood and Anxiety Disorders in the United States|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2820045/|journal=American Journal of Public Health|volume=100|issue=3|pages=468–475|doi=10.2105/AJPH.2008.152942|issn=0090-0036|pmc=PMC2820045|pmid=19696380}}</ref> [http://ajph.aphapublications.org/doi/10.2105/AJPH.2008.152942 (2013)] |Women: 14.8% same-sex 22.5% bisexual Men: 16.9% same-sex 11.5% bisexual |The Alcohol Use Disorder and Associated Disabilities Interview Schedule-IV (AUDADIS-IV) |- |Non-institutionalized general US population |Cross-ethnic American population (ages 18+)<ref>{{Cite journal|last=Asnaani|first=Anu|last2=Richey|first2=J. Anthony|last3=Dimaite|first3=Ruta|last4=Hinton|first4=Devon E.|last5=Hofmann|first5=Stefan G.|date=2010-8|title=A Cross-Ethnic Comparison of Lifetime Prevalence Rates of Anxiety Disorders|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2931265/|journal=The Journal of nervous and mental disease|volume=198|issue=8|pages=551–555|doi=10.1097/NMD.0b013e3181ea169f|issn=0022-3018|pmc=PMC2931265|pmid=20699719}}</ref> [https://journals.lww.com/jonmd/Abstract/2010/08000/A_Cross_Ethnic_Comparison_of_Lifetime_Prevalence.4.aspx (2018)] |White 8.6% African Americans 4.9% Hispanic Americans 5.8% Asian Americans 2.4% |World Mental Health Survey Initiative Version of the World Health Organization Composite International Interview (WMH-CIDI) |- |Outpatient clinics worldwide |Samples across multiple studies worldwide (all ages)<ref name=":12">{{Cite journal|last=Rettew|first=David C.|last2=Lynch|first2=Alicia Doyle|last3=Achenbach|first3=Thomas M.|last4=Dumenci|first4=Levent|last5=Ivanova|first5=Masha Y.|date=2009-09|title=Meta-analyses of agreement between diagnoses made from clinical evaluations and standardized diagnostic interviews|url=http://dx.doi.org/10.1002/mpr.289|journal=International Journal of Methods in Psychiatric Research|language=en|volume=18|issue=3|pages=169–184|doi=10.1002/mpr.289|issn=1049-8931}}</ref> |5% |Clinical evaluations |- |Outpatient clinic worldwide |Samples across multiple studies worldwide (all ages)<ref name=":12" /> |10% |Standardized Diagnostic Interviews (SDIs) |- |People during pregnancy and postpartum |Samples across multiple studies worldwide<ref>{{Cite journal|last=Fawcett|first=Emily J.|last2=Fairbrother|first2=Nichole|last3=Cox|first3=Megan L.|last4=White|first4=Ian R.|last5=Fawcett|first5=Jonathan M.|date=2019-07-23|title=The Prevalence of Anxiety Disorders During Pregnancy and the Postpartum Period: A Multivariate Bayesian Meta-Analysis|url=https://www.psychiatrist.com/JCP/article/Pages/2019/v80/18r12527.aspx|journal=The Journal of Clinical Psychiatry|volume=80|issue=4|doi=10.4088/JCP.18r12527|issn=1555-2101|pmc=PMC6839961|pmid=31347796}}</ref> |2.4% |Standardized Diagnostic Interviews (SDIs) |- |Older adults |Samples across in Switzerland, German, Italy, England, Spain, and Israel |3.7% (age 65-69) 3.7% (age 70-74) 2.6% (age 75-79) 2.0% (age >80) |Clinical evaluations |} '''Search terms:''' [General Anxiety Disorder] AND [prevalence OR incidence] in GoogleScholar and PsycINFO == [[Evidence based assessment/Prediction phase|'''Prediction phase''']] == === Psychometric properties of screening instruments for GAD === The following section contains a list of screening and diagnostic instruments for generalized anxiety disorder. The section includes administration information, psychometric data, and PDFs or links to the screenings. * Screenings are used as part of the [[Evidence based assessment/Prediction phase|prediction phase]] of assessment; for more information on interpretation of this data, or how screenings fit in to the assessment process, click [[Evidence based assessment/Prediction phase|here]]. * '''''For a list of more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Psychometric_properties_of_common_screening_instruments click here.]''''' {| class="wikitable sortable" border="1" ! colspan="5" |Screening measures for GAD |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time ! style="width:12em" | Where to Access |- | Penn State Worry Questionnaire (PSWQ)<ref name=":0">{{Cite book|url=https://www.worldcat.org/oclc/314222270|title=A guide to assessments that work|date=2008|publisher=Oxford University Press|author=Hunsley, John |author2=Mash, Eric J.|isbn=9780195310641|location=New York|oclc=314222270}}</ref> | Questionnaire (Adult Version, Child Version) | 18+ (Adult Version), 6-18 (Child Version) | 4 minutes |[http://www.midss.org/content/penn-state-worry-questionnaire-pswq PSWQ homepage] [https://mfr.osf.io/render?url=https://osf.io/s7p38/?action=download%26mode=render PSWQ Adult Version] [https://mfr.osf.io/render?url=https://osf.io/6q8y9/?action=download%26mode=render PSWQ Child Version] [https://mfr.osf.io/render?url=https://osf.io/gx5sr/?action=download%26mode=render PSWC-C Korean] [https://mfr.osf.io/render?url=https://osf.io/hc6n2/?action=download%26mode=render PSWQ-C Danish] [https://mfr.osf.io/render?url=https://osf.io/fwbes/?action=download%26mode=render Scoring the PSWQ-C] |- |[[wikipedia:Screen_for_child_anxiety_related_disorders|Screen for Child Anxiety Related Emotional Disorder (SCARED)]]<ref name=":0" /> | Questionnaire (Child, Parent) | 8-19 | 9 or 16 minutes |[http://www.midss.org/content/screen-child-anxiety-related-disorders-scared SCARED] homepage [[wikipedia:Screen_for_child_anxiety_related_disorders#PDFs_and_automated_scoring_for_SCARED|SCARED English + Translations & Automatic Scoring]] |- |Child Behavior Checklist (CBCL)<ref name=":0" /> |Questionnaire (Parent report) |6-18 |10 minutes |[https://aseba.org/ ASEBA homepage][https://store.aseba.org/ Purchase] |} === Likelihood ratios and AUCs of screening instruments for GAD === * '''''For a list of the likelihood ratios for more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Likelihood_ratios_and_AUCs_of_common_screening_instruments click here.]''''' {| class="wikitable sortable" border="1" ! Screening Measure (Primary Reference) ! Area Under Curve (AUC) ! LR+ (Score) ! LR- (Score) ! Clinical Generalizability !Where to Access |- | Penn State Worry Questionnaire (PSWQ)<ref name=":2">{{Cite journal|last=Fresco|first=David M.|last2=Mennin|first2=Douglas S.|last3=Heimberg|first3=Richard G.|last4=Turk|first4=Cynthia L.|title=Using the Penn State Worry Questionnaire to identify individuals with generalized anxiety disorder: a receiver operating characteristic analysis|url=http://linkinghub.elsevier.com/retrieve/pii/S0005791603000569|journal=Journal of Behavior Therapy and Experimental Psychiatry|volume=34|issue=3-4|pages=283–291|doi=10.1016/j.jbtep.2003.09.001}}</ref> | 0.74 (N=164) | 1.8 (65+) | 0.5 (< 65) | Generalized Anxiety Disorder vs. social anxiety disorder, adults presenting to specialty anxiety clinic |[https://mfr.osf.io/render?url=https://osf.io/s7p38/?action=download%26mode=render PSWQ Adult Version] [https://mfr.osf.io/render?url=https://osf.io/6q8y9/?action=download%26mode=render PSWQ Child Version] |- |[[wikipedia:Screen_for_child_anxiety_related_disorders#PDFs_and_automated_scoring_for_SCARED|Screen for Child Anxiety Related Disorders (SCARED)]]<ref name="BirmaherEtAl1997" /> | .70 (N=243) | 5.0 (+32) | .04 | High: Pure anxiety disorder versus non-anxiety psychiatric disorder, excluding children with disruptive disorder and depression |[http://www.midss.org/content/penn-state-worry-questionnaire-pswq SCARED English + Translations & Automatic Scoring] |- |CBCL Anxious/Depressed Scale T-score<ref>{{Cite journal|last=Eimecke|first=Sylvia D.|last2=Remschmidt|first2=Helmut|last3=Mattejat|first3=Fritz|date=2011-03|title=Utility of the Child Behavior Checklist in screening depressive disorders within clinical samples|url=https://linkinghub.elsevier.com/retrieve/pii/S0165032710005458|journal=Journal of Affective Disorders|language=en|volume=129|issue=1-3|pages=191–197|doi=10.1016/j.jad.2010.08.011}}</ref> |.75 (N = 1445) |1.49 (9+) |.67(9-) |Inpatient and outpatient children and adolescents |[https://store.aseba.org/ Purchase] |} '''Note:''' “LR+” refers to the change in likelihood ratio associated with a positive test score, and “LR-” is the likelihood ratio for a low score. Likelihood ratios of 1 indicate that the test result did not change impressions at all. LRs larger than 10 or smaller than .10 are frequently clinically decisive; 5 or .20 are helpful, and between 2.0 and .5 are small enough that they rarely result in clinically meaningful changes of formulation<ref>Sackett, D. L., Straus, S. E., Richardson, W. S., Rosenberg, W., & Haynes, R. B. (2000). Evidence-based medicine: How to practice and teach EBM. Edinburgh: Churchill Livingstone.</ref>. '''Search terms:''' [General Anxiety Disorder] AND [children OR adolescents OR pediatric] AND [sensitivity OR specificity] in GoogleScholar and PsycINFO === Interpreting depression screening measure scores === * For information on interpreting screening measure scores, click [[Evidence based assessment/Prediction phase#Interpreting screening measure scores|here.]] ==[[Evidence based assessment/Prescription phase|'''Prescription phase''']]== ===Gold standard diagnostic interviews=== * For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews click here.] === Recommended diagnostic instruments for GAD === {| class="wikitable sortable" ! colspan="5" |Diagnostic instruments for GAD |- !Measure !Format (Reporter) !Age Range !Administration/ Completion Time !Where to Access |- |Anxiety Disorders Interview Schedule for Children/Parent<ref name=":1">{{Cite journal|date=2001-08-01|title=Test-Retest Reliability of Anxiety Symptoms and Diagnoses With the Anxiety Disorders Interview Schedule for DSM-IV: Child and Parent Versions|url=https://www.sciencedirect.com/science/article/pii/S0890856709603427|journal=Journal of the American Academy of Child & Adolescent Psychiatry|language=en|volume=40|issue=8|pages=937–944|doi=10.1097/00004583-200108000-00016|issn=0890-8567}}</ref> |Structured Interview (Child (ADIS-C), Parent (ADIS-P)) |6-16<ref>{{Cite journal|last=LYNEHAM|first=HEIDI J.|last2=ABBOTT|first2=MAREE J.|last3=RAPEE|first3=RONALD M.|date=2007-06|title=Interrater Reliability of the Anxiety Disorders Interview Schedule for DSM-IV: Child and Parent Version|url=https://doi.org/10.1097/chi.0b013e3180465a09|journal=Journal of the American Academy of Child &amp; Adolescent Psychiatry|volume=46|issue=6|pages=731–736|doi=10.1097/chi.0b013e3180465a09|issn=0890-8567}}</ref> |Varies |[https://books.google.com/books/about/Anxiety_Disorders_Interview_Schedule_for.html?id=xpR6V3rboxwC Purchase] |- |Anxiety and Related Disorders Interview Schedule for DSM-5 (ADIS-5)<ref name=":0" /> |Structured Interview (Adult) |16+ |Varies |[https://global.oup.com/academic/product/anxiety-and-related-disorders-interview-schedule-for-dsm-5-adis-5---adult-version-9780199325160?cc=us&lang=en& Purchase] |- |Structured Clinical Interview for DSM-5-Clinician Version (SCID-5-CV)<ref>{{Cite journal|last=Shabani|first=Amir|last2=Masoumian|first2=Samira|last3=Zamirinejad|first3=Somayeh|last4=Hejri|first4=Maryam|last5=Pirmorad|first5=Tahereh|last6=Yaghmaeezadeh|first6=Hooman|date=2021-05|title=Psychometric properties of Structured Clinical Interview for DSM‐5 Disorders‐Clinician Version (SCID‐5‐CV)|url=https://onlinelibrary.wiley.com/doi/10.1002/brb3.1894|journal=Brain and Behavior|language=en|volume=11|issue=5|doi=10.1002/brb3.1894|issn=2162-3279|pmc=PMC8119811|pmid=33729681}}</ref> |Structured Interview (Adult ) |16+ |Varies |[https://www.columbiapsychiatry.org/research/research-labs/diagnostic-and-assessment-lab/structured-clinical-interview-dsm-disorders-11 Website and purchase] |- |Generalized Anxiety Disorder Screener (GAD-7)<ref name=":0" /> |Questionnaire (Self-report) |18+ |5 minutes |[https://www.pfizerpcoa.com/general-anxiety-disorder-7-gad-7-screener GAD-7 homepage] [https://osf.io/szmpu GAD-7 PDF] |} ==[[Evidence based assessment/Process phase|'''Process phase''']]== The following section contains a list of process and outcome measures for generalized anxiety disorder. The section includes benchmarks based on published norms for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the [[Evidence based assessment/Process phase|process phase]] of assessment. For more information of differences between process and outcome measures, see the page on the [[Evidence based assessment/Process phase|process phase of assessment]]. === Process measures === === Outcome and severity measures === * This table includes clinically significant benchmarks for '''(insert portfolio name here)''' specific outcome measures * Information on how to interpret this table can be [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase found here]. * Additionally, these [[Evidence based assessment/Vignettes|vignettes]] might be helpful resources for understanding appropriate adaptation of outcome measures in practice. *''<u>For clinically significant change benchmarks for the CBCL, YSR, and TRF total, externalizing, internalizing, and attention benchmarks,</u>'' [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase&wteswitched=1#Clinically_significant_change_benchmarks_for_widely-used_outcome_measures see here.] {| class="wikitable sortable" border="1" | colspan="7" |'''Clinically significant change benchmarks with common instruments for GAD''' |- | rowspan=1" style="text-align:center;font-size:130%;" | <b> Measure</b> | colspan="3" style="text-align:center;font-size:130%" width="300" | <b> Cut-off scores</b> | colspan="3" style="text-align:center;font-size:120%" | <b> Critical Change <br> (unstandardized scores)</b> |- | colspan="7" span style="font-size:110%; text-align:center;" | <b> Benchmarks Based on Published Norms</b> |- | colspan="1" | | style="text-align:center;font-size:110%" | <b> A</b> | style="text-align:center;font-size:110%" | <b> B</b> | style="text-align:center;font-size:110%" | <b> C</b> | style="text-align:center;font-size:110%" | <b> 95%</b> | style="text-align:center;font-size:110%" | <b> 90%</b> | style="text-align:center;font-size:110%" | <b> SE_difference</b> |- | rowspan="1" style="text-align:center;" | <b> GAD-7</b> | style=“text-align:center;”| -1 | style=“text-align:center;”| 1.3 | style=“text-align:center;”| 0.5 | style=“text-align:center;”| 0.6 | style=“text-align:center;”| 0.5 | style=“text-align:center;”| 0.3 |- | rowspan="1" style="text-align:center;" | <b> PSWQ</b> | style=“text-align:center;”| 51 | style=“text-align:center;”| 73 | style=“text-align:center;”| 59 | style=“text-align:center;”| 9 | style=“text-align:center;”| 8 | style=“text-align:center;”| 4.8 |- | rowspan="1" style="text-align:center;" | <b> SCARED </b> | style=“text-align:center;”| 9.9 | style=“text-align:center;”| 18.1 | style=“text-align:center;”| 15.3 | style=“text-align:center;”| 8.9 | style=“text-align:center;”| 7.5 | style=“text-align:center;”| 4.5 |} '''Note:''' “A” = Away from the clinical range, “B” = Back into the nonclinical range, “C” = Closer to the nonclinical than clinical mean. '''Search terms:''' [General Anxiety Disorder] AND [children OR adolescents OR pediatric] AND [clinical significance OR outcomes] in GoogleScholar and PsycINFO === Treatment === {{collapse top| Treatment Information|expand=yes}} Individuals suffering from GAD tend to be high users of outpatient medical care. When treating GAD, physicians should first determine whether pharmacotherapy, psychotherapy, or a combination of the two treatments would be most beneficial to the patient. Literature suggests that treatment of GAD frequently consists of a combination of psychotherapy and pharmacotherapy. Although these therapies have the potential to be effective individually, previous work demonstrates that when combined the degree of clinically significant change increases significantly. Recent studies (e.g., Gorman, 2003<ref name="Gorman2003" />; Walkup et al., 2008<ref name="WalkupEtAl2008" />) have provided evidence to support this claim with the most efficacious medication and behavioral interventions listed below. # '''Medication Interventions''' ## ''Sertraline (Zoloft)'' has been shown to reduce experiences and effects of GAD above and beyond that of placebo conditions. ## ''Pregabalin.'' The mean baseline-to-endpoint decreases in total Hamilton anxiety scale score in the patients given 150 mg/day of pregabalin (–9.2) was significantly greater than the decrease in those given placebo (–6.8)<ref name="PandeEtAl2003" />. ## ''Paroxetine.'' Remission was achieved by 30% of patients in the 20-mg paroxetine groups compared with 20% given placebo. For all three domains of the Sheehan Disability Scale, significantly greater improvement was seen with paroxetine than placebo<ref name="RickelsEtAl2003" />. # '''Behavioral interventions''' ## ''Cognitive behavioral therapy.'' Fourteen 60-minute sessions, which include CBT in anxiety-management skills, followed by behavioral exposure to anxiety-provoking situations have been shown to be effective in treating GAD. A review of studies by Fisher and Durham (1999)<ref name="FisherEtAl1999" /> revealed significant recovery rates at a 6 month follow up after CBT. ## ''Exposure therapy and modeling therapy.'' One meta-analysis found that virtual reality exposure therapy for anxiety disorders had a large effect size (Cohen's d=1.11) compared to controls.<ref>{{Cite journal|last=Powers|first=Mark B.|last2=Emmelkamp|first2=Paul M.G.|title=Virtual reality exposure therapy for anxiety disorders: A meta-analysis|url=https://doi.org/10.1016/j.janxdis.2007.04.006|journal=Journal of Anxiety Disorders|volume=22|issue=3|pages=561–569|doi=10.1016/j.janxdis.2007.04.006}}</ref> ## ''Mindfulness meditation.'' New treatment options such as mindfulness meditation-based stress reduction interventions have also shown to reduce symptoms over the long-term.<ref>{{Cite journal|last=Miller|first=J. J.|last2=Fletcher|first2=K.|last3=Kabat-Zinn|first3=J.|date=May 1995|title=Three-year follow-up and clinical implications of a mindfulness meditation-based stress reduction intervention in the treatment of anxiety disorders|url=https://www.ncbi.nlm.nih.gov/pubmed/7649463|journal=General Hospital Psychiatry|volume=17|issue=3|pages=192–200|issn=0163-8343|pmid=7649463}}</ref> # '''Combination treatment''' ## Previous research suggests that combination therapy that includes components of psychotherapy and pharmacotherapy are the most efficacious in treating GAD. In a study comparing the efficacies GAD treatments, Walkup and colleagues demonstrated a 21-25% improvement of combination therapy over cognitive behavioral therapy or sertraline alone during short-term treatment. These findings suggest that among effective treatments, combination therapy has the potential to provide the best chance for a positive outcome. See Gorman, 2003<ref name="Gorman2003" />; Walkup et al., 2008<ref name="WalkupEtAl2008" />. {{collapse bottom}} * Please refer to the page on [[wikipedia:Generalized_anxiety_disorder|generalized anxiety disorder]] for more information on available treatment or go to [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/fear-worry-and-anxiety/ Effective Child Therapy] for a curated resource on effective treatments for GAD. *For information on conducting Exposure Therapy for anxiety disordered youth, see [https://www.bravepracticeforkids.com/ www.BravePracticeForKids.com] =='''External Resources'''== # [http://apps.who.int/classifications/icd10/browse/2010/en#/F41.1 ICD-10 diagnostic criteria] # [https://en.wikiversity.org/w/index.php?title=Helping_Give_Away_Psychological_Science/Resources/Annotated_List_of_Where_and_How_to_Find_a_Therapist&wteswitched=1#Other_low-cost_options Find-a-Therapist] #*This is a curated list of find-a-therapist websites where you can find a provider # [https://www.nimh.nih.gov/health/topics/anxiety-disorders/index.shtml NIMH] entry about anxiety disorders # OMIM (Online Mendelian Inheritance in Man) #*[https://www.omim.org/entry/607834 607834] # [https://emedicine.medscape.com/article/286227-overview#a2 eMedicine entry about anxiety disorders] #[https://sccap53.org Society of Clinical Child and Adolescent Psychology] #[http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/fear-worry-and-anxiety/ Effective Child Therapy information on Fear, Worry, & Anxiety] #*Effective Child Therapy is website sponsored by Division 53 of the American Psychological Association (APA), or The [https://sccap53.org Society of Clinical Child and Adolescent Psychology] (SCCAP), in collaboration with the Association for Behavioral and Cognitive Therapies (ABCT). Use for information on symptoms and available treatments. #[http://pediatricbipolar.pitt.edu/resources/instruments Links to SCARED Child, Parent, and Adult + Translations] =='''References'''== {{collapse top|References|expand=yes}} {{Reflist|3|refs= <ref name="BirmaherEtAl1997">{{cite journal|last1=Birmaher|first1=B|last2=Khetarpal|first2=S|last3=Brent|first3=D|last4=Cully|first4=M|last5=Balach|first5=L|last6=Kaufman|first6=J|last7=Neer|first7=SM|title=The Screen for Child Anxiety Related Emotional Disorders (SCARED): scale construction and psychometric characteristics.|journal=Journal of the American Academy of Child and Adolescent Psychiatry|date=April 1997|volume=36|issue=4|pages=545-53|pmid=9100430}}</ref> <ref name="BrownJacobsenEtAl2011">{{cite journal|last1=Brown-Jacobsen|first1=AM|last2=Wallace|first2=DP|last3=Whiteside|first3=SP|title=Multimethod, multi-informant agreement, and positive predictive value in the identification of child anxiety disorders using the SCAS and ADIS-C.|journal=Assessment|date=September 2011|volume=18|issue=3|pages=382-92|pmid=20644080}}</ref> <ref name="CostelloEtAl1996">{{cite journal|last1=Costello|first1=EJ|last2=Angold|first2=A|last3=Burns|first3=BJ|last4=Stangl|first4=DK|last5=Tweed|first5=DL|last6=Erkanli|first6=A|last7=Worthman|first7=CM|title=The Great Smoky Mountains Study of Youth. 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DSM-IV anxiety disorders.|journal=Depression and anxiety|date=2008|volume=25|issue=12|pages=1046-52|pmid=18833579}}</ref> <ref name="WoodEtAl2002">{{cite journal|last1=Wood|first1=JJ|last2=Piacentini|first2=JC|last3=Bergman|first3=RL|last4=McCracken|first4=J|last5=Barrios|first5=V|title=Concurrent validity of the anxiety disorders section of the Anxiety Disorders Interview Schedule for DSM-IV: child and parent versions.|journal=Journal of clinical child and adolescent psychology : the official journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 53|date=September 2002|volume=31|issue=3|pages=335-42|pmid=12149971}}</ref> <ref name="ZimmermanEtAl2005">{{cite journal|last1=Zimmerman|first1=M|last2=Rothschild|first2=L|last3=Chelminski|first3=I|title=The prevalence of DSM-IV personality disorders in psychiatric outpatients.|journal=The American journal of psychiatry|date=October 2005|volume=162|issue=10|pages=1911-8|pmid=16199838}}</ref> }} {{collapse bottom|Click here for references}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] kfqm1ykfzv0au5l6jicof4le62vetfn 2419302 2419210 2022-08-26T05:27:33Z Ardenguo 2944162 /* Psychometric properties of screening instruments for GAD */ added "Note: Reliability and validity are included in the extended version. This table includes measures with Good or Excellent ratings." wikitext text/x-wiki <noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{medical disclaimer}} {{:{{BASEPAGENAME}}/Sidebar}} ==[[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio"?''']]== * For background information on what assessment portfolios are, click the link in the heading above. Want even 'more' information about this topic? There's an extended version of this page [[Evidence-based assessment/Generalized anxiety disorder (assessment portfolio)/extended version|here]]. ==[[Evidence based assessment/Preparation phase|'''Preparation phase''']]== === Diagnostic criteria for generalized anxiety disorder === {{blockquotetop}} <big>'''ICD-11 Diagnostic Criteria<ref>https://icd.who.int/browse11/l-m/en#/http://id.who.int/icd/entity/1712535455</ref>'''</big> *Generalised anxiety disorder is characterized by marked symptoms of anxiety that persist for at least several months, for more days than not, manifested by either general apprehension (i.e. ‘free-floating anxiety’) or excessive worry focused on multiple everyday events, most often concerning family, health, finances, and school or work, together with additional symptoms such as muscular tension or motor restlessness, sympathetic autonomic over-activity, subjective experience of nervousness, difficulty maintaining concentration, irritability, or sleep disturbance. The symptoms result in significant distress or significant impairment in personal, family, social, educational, occupational, or other important areas of functioning. The symptoms are not a manifestation of another health condition and are not due to the effects of a substance or medication on the central nervous system. '''Changes in DSM-5''' * The diagnostic criteria for generalized anxiety disorder changed slightly from DSM-IV-TR to DSM-5. Summaries are available [https://www.ncbi.nlm.nih.gov/books/NBK519712/table/ch3.t9/?report=objectonly here]. {{blockquotebottom}} === Base rates of GAD in different clinical settings === This section describes the demographic setting of the population(s) sampled, base rates of diagnosis, country/region sampled and the diagnostic method that was used. Using this information, clinicians will be able to anchor the rate of GAD that they are likely to see in their clinical practice. * '''''To see prevalence rates across multiple disorders,''''' [[Evidence based assessment/Preparation phase#Base rates for transdiagnostic comparison|'''''click here.''''']] {| class="wikitable sortable" border="1" |- ! Demography ! Setting ! Base Rate ! Diagnostic Method |- | Adults and adolescences in all of U.S.A. | US National Comorbidity Survey Replication (NCS-R; age > = 13) [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4005415/pdf/nihms-571992.pdf (2012)]<ref name="KesslerEtAl2012" /> |0.9% (age 13-17) 2.9% (age 18-64) 1.2% (age &gt;= 65) 2.0% (age &gt;=13) | Fully-structured Composite International Diagnostic Interview (CIDI Version 3.0) |- | Psychiatric outpatients | Individuals seeking treatment in a Psychiatric Outpatient Clinic (age range not reported) ([https://ajp.psychiatryonline.org/doi/pdf/10.1176/appi.ajp.162.10.1911 2014])<ref name="ZimmermanEtAl2005" /> |21% | Structured Clinical Interview for DSM-IV (SCID) |- | Caucasian youth | Children seeking treatment in a Child &amp; Adolescent Anxiety Diagnostic Clinic (age 7 – 18 years old) ([http://journals.sagepub.com/doi/pdf/10.1177/1073191110375792 2011])<ref name="BrownJacobsenEtAl2011" /> |0.39% (parent report) 0.38% (child report) | Anxiety Disorders Interview Schedule for Children for DSM-IV Spence Children's Anxiety Scale (SCAS) |- | Caucasian, African American, Asian American, and Hispanic population | Collaborative Psychiatric Epidemiology Studies (CPES; age &gt;= 18, data merged from three representative national database) ([https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3135672/pdf/nihms281333.pdf 2011])<ref>{{Cite journal|last=McLean|first=Carmen P.|last2=Asnaani|first2=Anu|last3=Litz|first3=Brett T.|last4=Hofmann|first4=Stefan G.|date=2011-08-01|title=Gender differences in anxiety disorders: Prevalence, course of illness, comorbidity and burden of illness|url=https://www.sciencedirect.com/science/article/pii/S0022395611000458|journal=Journal of Psychiatric Research|language=en|volume=45|issue=8|pages=1027–1035|doi=10.1016/j.jpsychires.2011.03.006|issn=0022-3956|pmc=PMC3135672|pmid=21439576}}</ref> |4.1% (female) 2.1% (male) | World Mental Health Survey Initiative Version of the World Health Organization Composite International Interview (WMH-CIDI) |- | Pennsylvania | Metropolitan Community Sample, all individuals with eating disorders (ages 13 – 65) ([https://ajp.psychiatryonline.org/doi/pdf/10.1176/appi.ajp.161.12.2215 2014])<ref name="KayeEtAl2004" /> |10% | Structured Clinical Interview for DSM-IV (SCID) |- | Adolescents in all of U.S.A. | National Comorbidity Survey Replication Adolescent Supplement (NCS-A; ages 3–18 in the continental U.S) ([https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2946114/pdf/nihms214371.pdf 2011])<ref name="MerikangasEtAl2010" /> |2.2% | World Health Organization Composite International Diagnostic Interview (WHO-CIDI) |- |Adolescents in all of U.S.A |National Comorbidity Survey Replication Adolescent Supplement (NCS-A; ages 3–18 in the continental U.S)<ref name=":3">Kessler, R. C., Avenevoli, S., Costello, E. J., Georgiades, K., Green, J. G., Gruber, M. J., . . . Merikangas, K. R. (2012). Prevalence, persistence, and sociodemographic correlates of DSM-IV disorders in the National Comorbidity Survey Replication Adolescent Supplement. Archives of General Psychiatry, 69(4), 372-380. doi:10.1001/archgenpsychiatry.2011.160</ref> |5.4% |Composite International Diagnostic Interview (CIDI) |- | North Carolina | Rural community sample African American and White youth (ages 13-16) [https://www.ncbi.nlm.nih.gov/pubmed/12365876 (2002)]<ref>{{Cite journal|last=Angold|first=Adrian|last2=Erkanli|first2=Alaattin|last3=Farmer|first3=Elizabeth M. Z.|last4=Fairbank|first4=John A.|last5=Burns|first5=Barbara J.|last6=Keeler|first6=Gordon|last7=Costello|first7=E. Jane|date=October 2002|title=Psychiatric disorder, impairment, and service use in rural African American and white youth|url=https://www.ncbi.nlm.nih.gov/pubmed/12365876|journal=Archives of General Psychiatry|volume=59|issue=10|pages=893–901|issn=0003-990X|pmid=12365876}}</ref> |1.4% | The Child and Adolescent Psychiatric Assessment (CAPA) |- | Texas | Metropolitan Community Sample (ages 11-17) ([https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2736593/pdf/nihms30019.pdf 2007])<ref name="RobertsEtAl2007" /> |0.4% | Diagnostic Interview Schedule for Children, Version IV (DISC-IV) |- | Midwestern Urban | Incarcerated adolescents (ages 10-18)<ref>{{Cite journal|last=ABRAM|first=KAREN M.|last2=CHOE|first2=JEANNE Y.|last3=WASHBURN|first3=JASON J.|last4=TEPLIN|first4=LINDA A.|last5=KING|first5=DEVON C.|last6=DULCAN|first6=MINA K.|title=Suicidal Ideation and Behaviors Among Youths in Juvenile Detention|url=http://linkinghub.elsevier.com/retrieve/pii/S0890856709623121|journal=Journal of the American Academy of Child & Adolescent Psychiatry|volume=47|issue=3|pages=291–300|doi=10.1097/chi.0b013e318160b3ce}}</ref> [http://vb3lk7eb4t.search.serialssolutions.com/?ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=Suicidal+Ideation+and+Behaviors+Among+Youths+in+Juvenile+Detention&rft.jtitle=Journal+of+the+American+Academy+of+Child+%26+Adolescent+Psychiatry&rft.au=ABRAM%2C+KAREN+M.%2C+Ph.D&rft.au=CHOE%2C+JEANNE+Y.%2C+B.A&rft.au=WASHBURN%2C+JASON+J.%2C+Ph.D.%2C+A.B.P.P&rft.au=TEPLIN%2C+LINDA+A.%2C+Ph.D&rft.date=2008&rft.issn=0890-8567&rft.eissn=1527-5418&rft.volume=47&rft.issue=3&rft.spage=291&rft.epage=300&rft_id=info:doi/10.1097%2FCHI.0b013e318160b3ce&rft.externalDocID=1_s2_0_S0890856709623121 (2002)] |1% | Diagnostic Interview Schedule for Children, Version IV (DISC-IV) |- |Non-institutionalized general US population |LGBTQ sample (ages 20-65)<ref>{{Cite journal|last=Bostwick|first=Wendy B.|last2=Boyd|first2=Carol J.|last3=Hughes|first3=Tonda L.|last4=McCabe|first4=Sean Esteban|date=2010-3|title=Dimensions of Sexual Orientation and the Prevalence of Mood and Anxiety Disorders in the United States|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2820045/|journal=American Journal of Public Health|volume=100|issue=3|pages=468–475|doi=10.2105/AJPH.2008.152942|issn=0090-0036|pmc=PMC2820045|pmid=19696380}}</ref> [http://ajph.aphapublications.org/doi/10.2105/AJPH.2008.152942 (2013)] |Women: 14.8% same-sex 22.5% bisexual Men: 16.9% same-sex 11.5% bisexual |The Alcohol Use Disorder and Associated Disabilities Interview Schedule-IV (AUDADIS-IV) |- |Non-institutionalized general US population |Cross-ethnic American population (ages 18+)<ref>{{Cite journal|last=Asnaani|first=Anu|last2=Richey|first2=J. Anthony|last3=Dimaite|first3=Ruta|last4=Hinton|first4=Devon E.|last5=Hofmann|first5=Stefan G.|date=2010-8|title=A Cross-Ethnic Comparison of Lifetime Prevalence Rates of Anxiety Disorders|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2931265/|journal=The Journal of nervous and mental disease|volume=198|issue=8|pages=551–555|doi=10.1097/NMD.0b013e3181ea169f|issn=0022-3018|pmc=PMC2931265|pmid=20699719}}</ref> [https://journals.lww.com/jonmd/Abstract/2010/08000/A_Cross_Ethnic_Comparison_of_Lifetime_Prevalence.4.aspx (2018)] |White 8.6% African Americans 4.9% Hispanic Americans 5.8% Asian Americans 2.4% |World Mental Health Survey Initiative Version of the World Health Organization Composite International Interview (WMH-CIDI) |- |Outpatient clinics worldwide |Samples across multiple studies worldwide (all ages)<ref name=":12">{{Cite journal|last=Rettew|first=David C.|last2=Lynch|first2=Alicia Doyle|last3=Achenbach|first3=Thomas M.|last4=Dumenci|first4=Levent|last5=Ivanova|first5=Masha Y.|date=2009-09|title=Meta-analyses of agreement between diagnoses made from clinical evaluations and standardized diagnostic interviews|url=http://dx.doi.org/10.1002/mpr.289|journal=International Journal of Methods in Psychiatric Research|language=en|volume=18|issue=3|pages=169–184|doi=10.1002/mpr.289|issn=1049-8931}}</ref> |5% |Clinical evaluations |- |Outpatient clinic worldwide |Samples across multiple studies worldwide (all ages)<ref name=":12" /> |10% |Standardized Diagnostic Interviews (SDIs) |- |People during pregnancy and postpartum |Samples across multiple studies worldwide<ref>{{Cite journal|last=Fawcett|first=Emily J.|last2=Fairbrother|first2=Nichole|last3=Cox|first3=Megan L.|last4=White|first4=Ian R.|last5=Fawcett|first5=Jonathan M.|date=2019-07-23|title=The Prevalence of Anxiety Disorders During Pregnancy and the Postpartum Period: A Multivariate Bayesian Meta-Analysis|url=https://www.psychiatrist.com/JCP/article/Pages/2019/v80/18r12527.aspx|journal=The Journal of Clinical Psychiatry|volume=80|issue=4|doi=10.4088/JCP.18r12527|issn=1555-2101|pmc=PMC6839961|pmid=31347796}}</ref> |2.4% |Standardized Diagnostic Interviews (SDIs) |- |Older adults |Samples across in Switzerland, German, Italy, England, Spain, and Israel |3.7% (age 65-69) 3.7% (age 70-74) 2.6% (age 75-79) 2.0% (age >80) |Clinical evaluations |} '''Search terms:''' [General Anxiety Disorder] AND [prevalence OR incidence] in GoogleScholar and PsycINFO == [[Evidence based assessment/Prediction phase|'''Prediction phase''']] == === Psychometric properties of screening instruments for GAD === The following section contains a list of screening and diagnostic instruments for generalized anxiety disorder. The section includes administration information, psychometric data, and PDFs or links to the screenings. * Screenings are used as part of the [[Evidence based assessment/Prediction phase|prediction phase]] of assessment; for more information on interpretation of this data, or how screenings fit in to the assessment process, click [[Evidence based assessment/Prediction phase|here]]. * '''''For a list of more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Psychometric_properties_of_common_screening_instruments click here.]''''' {| class="wikitable sortable" border="1" ! colspan="5" |Screening measures for GAD |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time ! style="width:12em" | Where to Access |- | Penn State Worry Questionnaire (PSWQ)<ref name=":0">{{Cite book|url=https://www.worldcat.org/oclc/314222270|title=A guide to assessments that work|date=2008|publisher=Oxford University Press|author=Hunsley, John |author2=Mash, Eric J.|isbn=9780195310641|location=New York|oclc=314222270}}</ref> | Questionnaire (Adult Version, Child Version) | 18+ (Adult Version), 6-18 (Child Version) | 4 minutes |[http://www.midss.org/content/penn-state-worry-questionnaire-pswq PSWQ homepage] [https://mfr.osf.io/render?url=https://osf.io/s7p38/?action=download%26mode=render PSWQ Adult Version] [https://mfr.osf.io/render?url=https://osf.io/6q8y9/?action=download%26mode=render PSWQ Child Version] [https://mfr.osf.io/render?url=https://osf.io/gx5sr/?action=download%26mode=render PSWC-C Korean] [https://mfr.osf.io/render?url=https://osf.io/hc6n2/?action=download%26mode=render PSWQ-C Danish] [https://mfr.osf.io/render?url=https://osf.io/fwbes/?action=download%26mode=render Scoring the PSWQ-C] |- |[[wikipedia:Screen_for_child_anxiety_related_disorders|Screen for Child Anxiety Related Emotional Disorder (SCARED)]]<ref name=":0" /> | Questionnaire (Child, Parent) | 8-19 | 9 or 16 minutes |[http://www.midss.org/content/screen-child-anxiety-related-disorders-scared SCARED] homepage [[wikipedia:Screen_for_child_anxiety_related_disorders#PDFs_and_automated_scoring_for_SCARED|SCARED English + Translations & Automatic Scoring]] |- |Child Behavior Checklist (CBCL)<ref name=":0" /> |Questionnaire (Parent report) |6-18 |10 minutes |[https://aseba.org/ ASEBA homepage][https://store.aseba.org/ Purchase] |} '''Note:''' Reliability and validity are included in the extended version. This table includes measures with Good or Excellent ratings. === Likelihood ratios and AUCs of screening instruments for GAD === * '''''For a list of the likelihood ratios for more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Likelihood_ratios_and_AUCs_of_common_screening_instruments click here.]''''' {| class="wikitable sortable" border="1" ! Screening Measure (Primary Reference) ! Area Under Curve (AUC) ! LR+ (Score) ! LR- (Score) ! Clinical Generalizability !Where to Access |- | Penn State Worry Questionnaire (PSWQ)<ref name=":2">{{Cite journal|last=Fresco|first=David M.|last2=Mennin|first2=Douglas S.|last3=Heimberg|first3=Richard G.|last4=Turk|first4=Cynthia L.|title=Using the Penn State Worry Questionnaire to identify individuals with generalized anxiety disorder: a receiver operating characteristic analysis|url=http://linkinghub.elsevier.com/retrieve/pii/S0005791603000569|journal=Journal of Behavior Therapy and Experimental Psychiatry|volume=34|issue=3-4|pages=283–291|doi=10.1016/j.jbtep.2003.09.001}}</ref> | 0.74 (N=164) | 1.8 (65+) | 0.5 (< 65) | Generalized Anxiety Disorder vs. social anxiety disorder, adults presenting to specialty anxiety clinic |[https://mfr.osf.io/render?url=https://osf.io/s7p38/?action=download%26mode=render PSWQ Adult Version] [https://mfr.osf.io/render?url=https://osf.io/6q8y9/?action=download%26mode=render PSWQ Child Version] |- |[[wikipedia:Screen_for_child_anxiety_related_disorders#PDFs_and_automated_scoring_for_SCARED|Screen for Child Anxiety Related Disorders (SCARED)]]<ref name="BirmaherEtAl1997" /> | .70 (N=243) | 5.0 (+32) | .04 | High: Pure anxiety disorder versus non-anxiety psychiatric disorder, excluding children with disruptive disorder and depression |[http://www.midss.org/content/penn-state-worry-questionnaire-pswq SCARED English + Translations & Automatic Scoring] |- |CBCL Anxious/Depressed Scale T-score<ref>{{Cite journal|last=Eimecke|first=Sylvia D.|last2=Remschmidt|first2=Helmut|last3=Mattejat|first3=Fritz|date=2011-03|title=Utility of the Child Behavior Checklist in screening depressive disorders within clinical samples|url=https://linkinghub.elsevier.com/retrieve/pii/S0165032710005458|journal=Journal of Affective Disorders|language=en|volume=129|issue=1-3|pages=191–197|doi=10.1016/j.jad.2010.08.011}}</ref> |.75 (N = 1445) |1.49 (9+) |.67(9-) |Inpatient and outpatient children and adolescents |[https://store.aseba.org/ Purchase] |} '''Note:''' “LR+” refers to the change in likelihood ratio associated with a positive test score, and “LR-” is the likelihood ratio for a low score. Likelihood ratios of 1 indicate that the test result did not change impressions at all. LRs larger than 10 or smaller than .10 are frequently clinically decisive; 5 or .20 are helpful, and between 2.0 and .5 are small enough that they rarely result in clinically meaningful changes of formulation<ref>Sackett, D. L., Straus, S. E., Richardson, W. S., Rosenberg, W., & Haynes, R. B. (2000). Evidence-based medicine: How to practice and teach EBM. Edinburgh: Churchill Livingstone.</ref>. '''Search terms:''' [General Anxiety Disorder] AND [children OR adolescents OR pediatric] AND [sensitivity OR specificity] in GoogleScholar and PsycINFO === Interpreting depression screening measure scores === * For information on interpreting screening measure scores, click [[Evidence based assessment/Prediction phase#Interpreting screening measure scores|here.]] ==[[Evidence based assessment/Prescription phase|'''Prescription phase''']]== ===Gold standard diagnostic interviews=== * For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews click here.] === Recommended diagnostic instruments for GAD === {| class="wikitable sortable" ! colspan="5" |Diagnostic instruments for GAD |- !Measure !Format (Reporter) !Age Range !Administration/ Completion Time !Where to Access |- |Anxiety Disorders Interview Schedule for Children/Parent<ref name=":1">{{Cite journal|date=2001-08-01|title=Test-Retest Reliability of Anxiety Symptoms and Diagnoses With the Anxiety Disorders Interview Schedule for DSM-IV: Child and Parent Versions|url=https://www.sciencedirect.com/science/article/pii/S0890856709603427|journal=Journal of the American Academy of Child & Adolescent Psychiatry|language=en|volume=40|issue=8|pages=937–944|doi=10.1097/00004583-200108000-00016|issn=0890-8567}}</ref> |Structured Interview (Child (ADIS-C), Parent (ADIS-P)) |6-16<ref>{{Cite journal|last=LYNEHAM|first=HEIDI J.|last2=ABBOTT|first2=MAREE J.|last3=RAPEE|first3=RONALD M.|date=2007-06|title=Interrater Reliability of the Anxiety Disorders Interview Schedule for DSM-IV: Child and Parent Version|url=https://doi.org/10.1097/chi.0b013e3180465a09|journal=Journal of the American Academy of Child &amp; Adolescent Psychiatry|volume=46|issue=6|pages=731–736|doi=10.1097/chi.0b013e3180465a09|issn=0890-8567}}</ref> |Varies |[https://books.google.com/books/about/Anxiety_Disorders_Interview_Schedule_for.html?id=xpR6V3rboxwC Purchase] |- |Anxiety and Related Disorders Interview Schedule for DSM-5 (ADIS-5)<ref name=":0" /> |Structured Interview (Adult) |16+ |Varies |[https://global.oup.com/academic/product/anxiety-and-related-disorders-interview-schedule-for-dsm-5-adis-5---adult-version-9780199325160?cc=us&lang=en& Purchase] |- |Structured Clinical Interview for DSM-5-Clinician Version (SCID-5-CV)<ref>{{Cite journal|last=Shabani|first=Amir|last2=Masoumian|first2=Samira|last3=Zamirinejad|first3=Somayeh|last4=Hejri|first4=Maryam|last5=Pirmorad|first5=Tahereh|last6=Yaghmaeezadeh|first6=Hooman|date=2021-05|title=Psychometric properties of Structured Clinical Interview for DSM‐5 Disorders‐Clinician Version (SCID‐5‐CV)|url=https://onlinelibrary.wiley.com/doi/10.1002/brb3.1894|journal=Brain and Behavior|language=en|volume=11|issue=5|doi=10.1002/brb3.1894|issn=2162-3279|pmc=PMC8119811|pmid=33729681}}</ref> |Structured Interview (Adult ) |16+ |Varies |[https://www.columbiapsychiatry.org/research/research-labs/diagnostic-and-assessment-lab/structured-clinical-interview-dsm-disorders-11 Website and purchase] |- |Generalized Anxiety Disorder Screener (GAD-7)<ref name=":0" /> |Questionnaire (Self-report) |18+ |5 minutes |[https://www.pfizerpcoa.com/general-anxiety-disorder-7-gad-7-screener GAD-7 homepage] [https://osf.io/szmpu GAD-7 PDF] |} '''Note:''' Reliability and validity are included in the extended version. This table includes measures with Good or Excellent ratings. ==[[Evidence based assessment/Process phase|'''Process phase''']]== The following section contains a list of process and outcome measures for generalized anxiety disorder. The section includes benchmarks based on published norms for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the [[Evidence based assessment/Process phase|process phase]] of assessment. For more information of differences between process and outcome measures, see the page on the [[Evidence based assessment/Process phase|process phase of assessment]]. === Process measures === === Outcome and severity measures === * This table includes clinically significant benchmarks for '''(insert portfolio name here)''' specific outcome measures * Information on how to interpret this table can be [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase found here]. * Additionally, these [[Evidence based assessment/Vignettes|vignettes]] might be helpful resources for understanding appropriate adaptation of outcome measures in practice. *''<u>For clinically significant change benchmarks for the CBCL, YSR, and TRF total, externalizing, internalizing, and attention benchmarks,</u>'' [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase&wteswitched=1#Clinically_significant_change_benchmarks_for_widely-used_outcome_measures see here.] {| class="wikitable sortable" border="1" | colspan="7" |'''Clinically significant change benchmarks with common instruments for GAD''' |- | rowspan=1" style="text-align:center;font-size:130%;" | <b> Measure</b> | colspan="3" style="text-align:center;font-size:130%" width="300" | <b> Cut-off scores</b> | colspan="3" style="text-align:center;font-size:120%" | <b> Critical Change <br> (unstandardized scores)</b> |- | colspan="7" span style="font-size:110%; text-align:center;" | <b> Benchmarks Based on Published Norms</b> |- | colspan="1" | | style="text-align:center;font-size:110%" | <b> A</b> | style="text-align:center;font-size:110%" | <b> B</b> | style="text-align:center;font-size:110%" | <b> C</b> | style="text-align:center;font-size:110%" | <b> 95%</b> | style="text-align:center;font-size:110%" | <b> 90%</b> | style="text-align:center;font-size:110%" | <b> SE_difference</b> |- | rowspan="1" style="text-align:center;" | <b> GAD-7</b> | style=“text-align:center;”| -1 | style=“text-align:center;”| 1.3 | style=“text-align:center;”| 0.5 | style=“text-align:center;”| 0.6 | style=“text-align:center;”| 0.5 | style=“text-align:center;”| 0.3 |- | rowspan="1" style="text-align:center;" | <b> PSWQ</b> | style=“text-align:center;”| 51 | style=“text-align:center;”| 73 | style=“text-align:center;”| 59 | style=“text-align:center;”| 9 | style=“text-align:center;”| 8 | style=“text-align:center;”| 4.8 |- | rowspan="1" style="text-align:center;" | <b> SCARED </b> | style=“text-align:center;”| 9.9 | style=“text-align:center;”| 18.1 | style=“text-align:center;”| 15.3 | style=“text-align:center;”| 8.9 | style=“text-align:center;”| 7.5 | style=“text-align:center;”| 4.5 |} '''Note:''' “A” = Away from the clinical range, “B” = Back into the nonclinical range, “C” = Closer to the nonclinical than clinical mean. '''Search terms:''' [General Anxiety Disorder] AND [children OR adolescents OR pediatric] AND [clinical significance OR outcomes] in GoogleScholar and PsycINFO === Treatment === {{collapse top| Treatment Information|expand=yes}} Individuals suffering from GAD tend to be high users of outpatient medical care. When treating GAD, physicians should first determine whether pharmacotherapy, psychotherapy, or a combination of the two treatments would be most beneficial to the patient. Literature suggests that treatment of GAD frequently consists of a combination of psychotherapy and pharmacotherapy. Although these therapies have the potential to be effective individually, previous work demonstrates that when combined the degree of clinically significant change increases significantly. Recent studies (e.g., Gorman, 2003<ref name="Gorman2003" />; Walkup et al., 2008<ref name="WalkupEtAl2008" />) have provided evidence to support this claim with the most efficacious medication and behavioral interventions listed below. # '''Medication Interventions''' ## ''Sertraline (Zoloft)'' has been shown to reduce experiences and effects of GAD above and beyond that of placebo conditions. ## ''Pregabalin.'' The mean baseline-to-endpoint decreases in total Hamilton anxiety scale score in the patients given 150 mg/day of pregabalin (–9.2) was significantly greater than the decrease in those given placebo (–6.8)<ref name="PandeEtAl2003" />. ## ''Paroxetine.'' Remission was achieved by 30% of patients in the 20-mg paroxetine groups compared with 20% given placebo. For all three domains of the Sheehan Disability Scale, significantly greater improvement was seen with paroxetine than placebo<ref name="RickelsEtAl2003" />. # '''Behavioral interventions''' ## ''Cognitive behavioral therapy.'' Fourteen 60-minute sessions, which include CBT in anxiety-management skills, followed by behavioral exposure to anxiety-provoking situations have been shown to be effective in treating GAD. A review of studies by Fisher and Durham (1999)<ref name="FisherEtAl1999" /> revealed significant recovery rates at a 6 month follow up after CBT. ## ''Exposure therapy and modeling therapy.'' One meta-analysis found that virtual reality exposure therapy for anxiety disorders had a large effect size (Cohen's d=1.11) compared to controls.<ref>{{Cite journal|last=Powers|first=Mark B.|last2=Emmelkamp|first2=Paul M.G.|title=Virtual reality exposure therapy for anxiety disorders: A meta-analysis|url=https://doi.org/10.1016/j.janxdis.2007.04.006|journal=Journal of Anxiety Disorders|volume=22|issue=3|pages=561–569|doi=10.1016/j.janxdis.2007.04.006}}</ref> ## ''Mindfulness meditation.'' New treatment options such as mindfulness meditation-based stress reduction interventions have also shown to reduce symptoms over the long-term.<ref>{{Cite journal|last=Miller|first=J. J.|last2=Fletcher|first2=K.|last3=Kabat-Zinn|first3=J.|date=May 1995|title=Three-year follow-up and clinical implications of a mindfulness meditation-based stress reduction intervention in the treatment of anxiety disorders|url=https://www.ncbi.nlm.nih.gov/pubmed/7649463|journal=General Hospital Psychiatry|volume=17|issue=3|pages=192–200|issn=0163-8343|pmid=7649463}}</ref> # '''Combination treatment''' ## Previous research suggests that combination therapy that includes components of psychotherapy and pharmacotherapy are the most efficacious in treating GAD. In a study comparing the efficacies GAD treatments, Walkup and colleagues demonstrated a 21-25% improvement of combination therapy over cognitive behavioral therapy or sertraline alone during short-term treatment. These findings suggest that among effective treatments, combination therapy has the potential to provide the best chance for a positive outcome. See Gorman, 2003<ref name="Gorman2003" />; Walkup et al., 2008<ref name="WalkupEtAl2008" />. {{collapse bottom}} * Please refer to the page on [[wikipedia:Generalized_anxiety_disorder|generalized anxiety disorder]] for more information on available treatment or go to [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/fear-worry-and-anxiety/ Effective Child Therapy] for a curated resource on effective treatments for GAD. *For information on conducting Exposure Therapy for anxiety disordered youth, see [https://www.bravepracticeforkids.com/ www.BravePracticeForKids.com] =='''External Resources'''== # [http://apps.who.int/classifications/icd10/browse/2010/en#/F41.1 ICD-10 diagnostic criteria] # [https://en.wikiversity.org/w/index.php?title=Helping_Give_Away_Psychological_Science/Resources/Annotated_List_of_Where_and_How_to_Find_a_Therapist&wteswitched=1#Other_low-cost_options Find-a-Therapist] #*This is a curated list of find-a-therapist websites where you can find a provider # [https://www.nimh.nih.gov/health/topics/anxiety-disorders/index.shtml NIMH] entry about anxiety disorders # OMIM (Online Mendelian Inheritance in Man) #*[https://www.omim.org/entry/607834 607834] # [https://emedicine.medscape.com/article/286227-overview#a2 eMedicine entry about anxiety disorders] #[https://sccap53.org Society of Clinical Child and Adolescent Psychology] #[http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/fear-worry-and-anxiety/ Effective Child Therapy information on Fear, Worry, & Anxiety] #*Effective Child Therapy is website sponsored by Division 53 of the American Psychological Association (APA), or The [https://sccap53.org Society of Clinical Child and Adolescent Psychology] (SCCAP), in collaboration with the Association for Behavioral and Cognitive Therapies (ABCT). Use for information on symptoms and available treatments. #[http://pediatricbipolar.pitt.edu/resources/instruments Links to SCARED Child, Parent, and Adult + Translations] =='''References'''== {{collapse top|References|expand=yes}} {{Reflist|3|refs= <ref name="BirmaherEtAl1997">{{cite journal|last1=Birmaher|first1=B|last2=Khetarpal|first2=S|last3=Brent|first3=D|last4=Cully|first4=M|last5=Balach|first5=L|last6=Kaufman|first6=J|last7=Neer|first7=SM|title=The Screen for Child Anxiety Related Emotional Disorders (SCARED): scale construction and psychometric characteristics.|journal=Journal of the American Academy of Child and Adolescent Psychiatry|date=April 1997|volume=36|issue=4|pages=545-53|pmid=9100430}}</ref> <ref name="BrownJacobsenEtAl2011">{{cite journal|last1=Brown-Jacobsen|first1=AM|last2=Wallace|first2=DP|last3=Whiteside|first3=SP|title=Multimethod, multi-informant agreement, and positive predictive value in the identification of child anxiety disorders using the SCAS and ADIS-C.|journal=Assessment|date=September 2011|volume=18|issue=3|pages=382-92|pmid=20644080}}</ref> <ref name="CostelloEtAl1996">{{cite journal|last1=Costello|first1=EJ|last2=Angold|first2=A|last3=Burns|first3=BJ|last4=Stangl|first4=DK|last5=Tweed|first5=DL|last6=Erkanli|first6=A|last7=Worthman|first7=CM|title=The Great Smoky Mountains Study of Youth. 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DSM-IV anxiety disorders.|journal=Depression and anxiety|date=2008|volume=25|issue=12|pages=1046-52|pmid=18833579}}</ref> <ref name="WoodEtAl2002">{{cite journal|last1=Wood|first1=JJ|last2=Piacentini|first2=JC|last3=Bergman|first3=RL|last4=McCracken|first4=J|last5=Barrios|first5=V|title=Concurrent validity of the anxiety disorders section of the Anxiety Disorders Interview Schedule for DSM-IV: child and parent versions.|journal=Journal of clinical child and adolescent psychology : the official journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 53|date=September 2002|volume=31|issue=3|pages=335-42|pmid=12149971}}</ref> <ref name="ZimmermanEtAl2005">{{cite journal|last1=Zimmerman|first1=M|last2=Rothschild|first2=L|last3=Chelminski|first3=I|title=The prevalence of DSM-IV personality disorders in psychiatric outpatients.|journal=The American journal of psychiatry|date=October 2005|volume=162|issue=10|pages=1911-8|pmid=16199838}}</ref> }} {{collapse bottom|Click here for references}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] qbso812k78jd8c7jt16kg939aoxjyq4 2419315 2419302 2022-08-26T05:37:45Z Ardenguo 2944162 /* Psychometric properties of screening instruments for GAD */ linked extended page to "Note: Reliability and validity are included in the extended version. This table includes measures with Good or Excellent ratings." wikitext text/x-wiki <noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{medical disclaimer}} {{:{{BASEPAGENAME}}/Sidebar}} ==[[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio"?''']]== * For background information on what assessment portfolios are, click the link in the heading above. Want even 'more' information about this topic? There's an extended version of this page [[Evidence-based assessment/Generalized anxiety disorder (assessment portfolio)/extended version|here]]. ==[[Evidence based assessment/Preparation phase|'''Preparation phase''']]== === Diagnostic criteria for generalized anxiety disorder === {{blockquotetop}} <big>'''ICD-11 Diagnostic Criteria<ref>https://icd.who.int/browse11/l-m/en#/http://id.who.int/icd/entity/1712535455</ref>'''</big> *Generalised anxiety disorder is characterized by marked symptoms of anxiety that persist for at least several months, for more days than not, manifested by either general apprehension (i.e. ‘free-floating anxiety’) or excessive worry focused on multiple everyday events, most often concerning family, health, finances, and school or work, together with additional symptoms such as muscular tension or motor restlessness, sympathetic autonomic over-activity, subjective experience of nervousness, difficulty maintaining concentration, irritability, or sleep disturbance. The symptoms result in significant distress or significant impairment in personal, family, social, educational, occupational, or other important areas of functioning. The symptoms are not a manifestation of another health condition and are not due to the effects of a substance or medication on the central nervous system. '''Changes in DSM-5''' * The diagnostic criteria for generalized anxiety disorder changed slightly from DSM-IV-TR to DSM-5. Summaries are available [https://www.ncbi.nlm.nih.gov/books/NBK519712/table/ch3.t9/?report=objectonly here]. {{blockquotebottom}} === Base rates of GAD in different clinical settings === This section describes the demographic setting of the population(s) sampled, base rates of diagnosis, country/region sampled and the diagnostic method that was used. Using this information, clinicians will be able to anchor the rate of GAD that they are likely to see in their clinical practice. * '''''To see prevalence rates across multiple disorders,''''' [[Evidence based assessment/Preparation phase#Base rates for transdiagnostic comparison|'''''click here.''''']] {| class="wikitable sortable" border="1" |- ! Demography ! Setting ! Base Rate ! Diagnostic Method |- | Adults and adolescences in all of U.S.A. | US National Comorbidity Survey Replication (NCS-R; age > = 13) [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4005415/pdf/nihms-571992.pdf (2012)]<ref name="KesslerEtAl2012" /> |0.9% (age 13-17) 2.9% (age 18-64) 1.2% (age &gt;= 65) 2.0% (age &gt;=13) | Fully-structured Composite International Diagnostic Interview (CIDI Version 3.0) |- | Psychiatric outpatients | Individuals seeking treatment in a Psychiatric Outpatient Clinic (age range not reported) ([https://ajp.psychiatryonline.org/doi/pdf/10.1176/appi.ajp.162.10.1911 2014])<ref name="ZimmermanEtAl2005" /> |21% | Structured Clinical Interview for DSM-IV (SCID) |- | Caucasian youth | Children seeking treatment in a Child &amp; Adolescent Anxiety Diagnostic Clinic (age 7 – 18 years old) ([http://journals.sagepub.com/doi/pdf/10.1177/1073191110375792 2011])<ref name="BrownJacobsenEtAl2011" /> |0.39% (parent report) 0.38% (child report) | Anxiety Disorders Interview Schedule for Children for DSM-IV Spence Children's Anxiety Scale (SCAS) |- | Caucasian, African American, Asian American, and Hispanic population | Collaborative Psychiatric Epidemiology Studies (CPES; age &gt;= 18, data merged from three representative national database) ([https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3135672/pdf/nihms281333.pdf 2011])<ref>{{Cite journal|last=McLean|first=Carmen P.|last2=Asnaani|first2=Anu|last3=Litz|first3=Brett T.|last4=Hofmann|first4=Stefan G.|date=2011-08-01|title=Gender differences in anxiety disorders: Prevalence, course of illness, comorbidity and burden of illness|url=https://www.sciencedirect.com/science/article/pii/S0022395611000458|journal=Journal of Psychiatric Research|language=en|volume=45|issue=8|pages=1027–1035|doi=10.1016/j.jpsychires.2011.03.006|issn=0022-3956|pmc=PMC3135672|pmid=21439576}}</ref> |4.1% (female) 2.1% (male) | World Mental Health Survey Initiative Version of the World Health Organization Composite International Interview (WMH-CIDI) |- | Pennsylvania | Metropolitan Community Sample, all individuals with eating disorders (ages 13 – 65) ([https://ajp.psychiatryonline.org/doi/pdf/10.1176/appi.ajp.161.12.2215 2014])<ref name="KayeEtAl2004" /> |10% | Structured Clinical Interview for DSM-IV (SCID) |- | Adolescents in all of U.S.A. | National Comorbidity Survey Replication Adolescent Supplement (NCS-A; ages 3–18 in the continental U.S) ([https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2946114/pdf/nihms214371.pdf 2011])<ref name="MerikangasEtAl2010" /> |2.2% | World Health Organization Composite International Diagnostic Interview (WHO-CIDI) |- |Adolescents in all of U.S.A |National Comorbidity Survey Replication Adolescent Supplement (NCS-A; ages 3–18 in the continental U.S)<ref name=":3">Kessler, R. C., Avenevoli, S., Costello, E. J., Georgiades, K., Green, J. G., Gruber, M. J., . . . Merikangas, K. R. (2012). Prevalence, persistence, and sociodemographic correlates of DSM-IV disorders in the National Comorbidity Survey Replication Adolescent Supplement. Archives of General Psychiatry, 69(4), 372-380. doi:10.1001/archgenpsychiatry.2011.160</ref> |5.4% |Composite International Diagnostic Interview (CIDI) |- | North Carolina | Rural community sample African American and White youth (ages 13-16) [https://www.ncbi.nlm.nih.gov/pubmed/12365876 (2002)]<ref>{{Cite journal|last=Angold|first=Adrian|last2=Erkanli|first2=Alaattin|last3=Farmer|first3=Elizabeth M. Z.|last4=Fairbank|first4=John A.|last5=Burns|first5=Barbara J.|last6=Keeler|first6=Gordon|last7=Costello|first7=E. Jane|date=October 2002|title=Psychiatric disorder, impairment, and service use in rural African American and white youth|url=https://www.ncbi.nlm.nih.gov/pubmed/12365876|journal=Archives of General Psychiatry|volume=59|issue=10|pages=893–901|issn=0003-990X|pmid=12365876}}</ref> |1.4% | The Child and Adolescent Psychiatric Assessment (CAPA) |- | Texas | Metropolitan Community Sample (ages 11-17) ([https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2736593/pdf/nihms30019.pdf 2007])<ref name="RobertsEtAl2007" /> |0.4% | Diagnostic Interview Schedule for Children, Version IV (DISC-IV) |- | Midwestern Urban | Incarcerated adolescents (ages 10-18)<ref>{{Cite journal|last=ABRAM|first=KAREN M.|last2=CHOE|first2=JEANNE Y.|last3=WASHBURN|first3=JASON J.|last4=TEPLIN|first4=LINDA A.|last5=KING|first5=DEVON C.|last6=DULCAN|first6=MINA K.|title=Suicidal Ideation and Behaviors Among Youths in Juvenile Detention|url=http://linkinghub.elsevier.com/retrieve/pii/S0890856709623121|journal=Journal of the American Academy of Child & Adolescent Psychiatry|volume=47|issue=3|pages=291–300|doi=10.1097/chi.0b013e318160b3ce}}</ref> [http://vb3lk7eb4t.search.serialssolutions.com/?ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=Suicidal+Ideation+and+Behaviors+Among+Youths+in+Juvenile+Detention&rft.jtitle=Journal+of+the+American+Academy+of+Child+%26+Adolescent+Psychiatry&rft.au=ABRAM%2C+KAREN+M.%2C+Ph.D&rft.au=CHOE%2C+JEANNE+Y.%2C+B.A&rft.au=WASHBURN%2C+JASON+J.%2C+Ph.D.%2C+A.B.P.P&rft.au=TEPLIN%2C+LINDA+A.%2C+Ph.D&rft.date=2008&rft.issn=0890-8567&rft.eissn=1527-5418&rft.volume=47&rft.issue=3&rft.spage=291&rft.epage=300&rft_id=info:doi/10.1097%2FCHI.0b013e318160b3ce&rft.externalDocID=1_s2_0_S0890856709623121 (2002)] |1% | Diagnostic Interview Schedule for Children, Version IV (DISC-IV) |- |Non-institutionalized general US population |LGBTQ sample (ages 20-65)<ref>{{Cite journal|last=Bostwick|first=Wendy B.|last2=Boyd|first2=Carol J.|last3=Hughes|first3=Tonda L.|last4=McCabe|first4=Sean Esteban|date=2010-3|title=Dimensions of Sexual Orientation and the Prevalence of Mood and Anxiety Disorders in the United States|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2820045/|journal=American Journal of Public Health|volume=100|issue=3|pages=468–475|doi=10.2105/AJPH.2008.152942|issn=0090-0036|pmc=PMC2820045|pmid=19696380}}</ref> [http://ajph.aphapublications.org/doi/10.2105/AJPH.2008.152942 (2013)] |Women: 14.8% same-sex 22.5% bisexual Men: 16.9% same-sex 11.5% bisexual |The Alcohol Use Disorder and Associated Disabilities Interview Schedule-IV (AUDADIS-IV) |- |Non-institutionalized general US population |Cross-ethnic American population (ages 18+)<ref>{{Cite journal|last=Asnaani|first=Anu|last2=Richey|first2=J. Anthony|last3=Dimaite|first3=Ruta|last4=Hinton|first4=Devon E.|last5=Hofmann|first5=Stefan G.|date=2010-8|title=A Cross-Ethnic Comparison of Lifetime Prevalence Rates of Anxiety Disorders|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2931265/|journal=The Journal of nervous and mental disease|volume=198|issue=8|pages=551–555|doi=10.1097/NMD.0b013e3181ea169f|issn=0022-3018|pmc=PMC2931265|pmid=20699719}}</ref> [https://journals.lww.com/jonmd/Abstract/2010/08000/A_Cross_Ethnic_Comparison_of_Lifetime_Prevalence.4.aspx (2018)] |White 8.6% African Americans 4.9% Hispanic Americans 5.8% Asian Americans 2.4% |World Mental Health Survey Initiative Version of the World Health Organization Composite International Interview (WMH-CIDI) |- |Outpatient clinics worldwide |Samples across multiple studies worldwide (all ages)<ref name=":12">{{Cite journal|last=Rettew|first=David C.|last2=Lynch|first2=Alicia Doyle|last3=Achenbach|first3=Thomas M.|last4=Dumenci|first4=Levent|last5=Ivanova|first5=Masha Y.|date=2009-09|title=Meta-analyses of agreement between diagnoses made from clinical evaluations and standardized diagnostic interviews|url=http://dx.doi.org/10.1002/mpr.289|journal=International Journal of Methods in Psychiatric Research|language=en|volume=18|issue=3|pages=169–184|doi=10.1002/mpr.289|issn=1049-8931}}</ref> |5% |Clinical evaluations |- |Outpatient clinic worldwide |Samples across multiple studies worldwide (all ages)<ref name=":12" /> |10% |Standardized Diagnostic Interviews (SDIs) |- |People during pregnancy and postpartum |Samples across multiple studies worldwide<ref>{{Cite journal|last=Fawcett|first=Emily J.|last2=Fairbrother|first2=Nichole|last3=Cox|first3=Megan L.|last4=White|first4=Ian R.|last5=Fawcett|first5=Jonathan M.|date=2019-07-23|title=The Prevalence of Anxiety Disorders During Pregnancy and the Postpartum Period: A Multivariate Bayesian Meta-Analysis|url=https://www.psychiatrist.com/JCP/article/Pages/2019/v80/18r12527.aspx|journal=The Journal of Clinical Psychiatry|volume=80|issue=4|doi=10.4088/JCP.18r12527|issn=1555-2101|pmc=PMC6839961|pmid=31347796}}</ref> |2.4% |Standardized Diagnostic Interviews (SDIs) |- |Older adults |Samples across in Switzerland, German, Italy, England, Spain, and Israel |3.7% (age 65-69) 3.7% (age 70-74) 2.6% (age 75-79) 2.0% (age >80) |Clinical evaluations |} '''Search terms:''' [General Anxiety Disorder] AND [prevalence OR incidence] in GoogleScholar and PsycINFO == [[Evidence based assessment/Prediction phase|'''Prediction phase''']] == === Psychometric properties of screening instruments for GAD === The following section contains a list of screening and diagnostic instruments for generalized anxiety disorder. The section includes administration information, psychometric data, and PDFs or links to the screenings. * Screenings are used as part of the [[Evidence based assessment/Prediction phase|prediction phase]] of assessment; for more information on interpretation of this data, or how screenings fit in to the assessment process, click [[Evidence based assessment/Prediction phase|here]]. * '''''For a list of more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Psychometric_properties_of_common_screening_instruments click here.]''''' {| class="wikitable sortable" border="1" ! colspan="5" |Screening measures for GAD |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time ! style="width:12em" | Where to Access |- | Penn State Worry Questionnaire (PSWQ)<ref name=":0">{{Cite book|url=https://www.worldcat.org/oclc/314222270|title=A guide to assessments that work|date=2008|publisher=Oxford University Press|author=Hunsley, John |author2=Mash, Eric J.|isbn=9780195310641|location=New York|oclc=314222270}}</ref> | Questionnaire (Adult Version, Child Version) | 18+ (Adult Version), 6-18 (Child Version) | 4 minutes |[http://www.midss.org/content/penn-state-worry-questionnaire-pswq PSWQ homepage] [https://mfr.osf.io/render?url=https://osf.io/s7p38/?action=download%26mode=render PSWQ Adult Version] [https://mfr.osf.io/render?url=https://osf.io/6q8y9/?action=download%26mode=render PSWQ Child Version] [https://mfr.osf.io/render?url=https://osf.io/gx5sr/?action=download%26mode=render PSWC-C Korean] [https://mfr.osf.io/render?url=https://osf.io/hc6n2/?action=download%26mode=render PSWQ-C Danish] [https://mfr.osf.io/render?url=https://osf.io/fwbes/?action=download%26mode=render Scoring the PSWQ-C] |- |[[wikipedia:Screen_for_child_anxiety_related_disorders|Screen for Child Anxiety Related Emotional Disorder (SCARED)]]<ref name=":0" /> | Questionnaire (Child, Parent) | 8-19 | 9 or 16 minutes |[http://www.midss.org/content/screen-child-anxiety-related-disorders-scared SCARED] homepage [[wikipedia:Screen_for_child_anxiety_related_disorders#PDFs_and_automated_scoring_for_SCARED|SCARED English + Translations & Automatic Scoring]] |- |Child Behavior Checklist (CBCL)<ref name=":0" /> |Questionnaire (Parent report) |6-18 |10 minutes |[https://aseba.org/ ASEBA homepage][https://store.aseba.org/ Purchase] |} '''Note:''' Reliability and validity are included in the [[Evidence-based assessment/Generalized anxiety disorder (assessment portfolio)/extended version|extended version]]. This table includes measures with Good or Excellent ratings. === Likelihood ratios and AUCs of screening instruments for GAD === * '''''For a list of the likelihood ratios for more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Likelihood_ratios_and_AUCs_of_common_screening_instruments click here.]''''' {| class="wikitable sortable" border="1" ! Screening Measure (Primary Reference) ! Area Under Curve (AUC) ! LR+ (Score) ! LR- (Score) ! Clinical Generalizability !Where to Access |- | Penn State Worry Questionnaire (PSWQ)<ref name=":2">{{Cite journal|last=Fresco|first=David M.|last2=Mennin|first2=Douglas S.|last3=Heimberg|first3=Richard G.|last4=Turk|first4=Cynthia L.|title=Using the Penn State Worry Questionnaire to identify individuals with generalized anxiety disorder: a receiver operating characteristic analysis|url=http://linkinghub.elsevier.com/retrieve/pii/S0005791603000569|journal=Journal of Behavior Therapy and Experimental Psychiatry|volume=34|issue=3-4|pages=283–291|doi=10.1016/j.jbtep.2003.09.001}}</ref> | 0.74 (N=164) | 1.8 (65+) | 0.5 (< 65) | Generalized Anxiety Disorder vs. social anxiety disorder, adults presenting to specialty anxiety clinic |[https://mfr.osf.io/render?url=https://osf.io/s7p38/?action=download%26mode=render PSWQ Adult Version] [https://mfr.osf.io/render?url=https://osf.io/6q8y9/?action=download%26mode=render PSWQ Child Version] |- |[[wikipedia:Screen_for_child_anxiety_related_disorders#PDFs_and_automated_scoring_for_SCARED|Screen for Child Anxiety Related Disorders (SCARED)]]<ref name="BirmaherEtAl1997" /> | .70 (N=243) | 5.0 (+32) | .04 | High: Pure anxiety disorder versus non-anxiety psychiatric disorder, excluding children with disruptive disorder and depression |[http://www.midss.org/content/penn-state-worry-questionnaire-pswq SCARED English + Translations & Automatic Scoring] |- |CBCL Anxious/Depressed Scale T-score<ref>{{Cite journal|last=Eimecke|first=Sylvia D.|last2=Remschmidt|first2=Helmut|last3=Mattejat|first3=Fritz|date=2011-03|title=Utility of the Child Behavior Checklist in screening depressive disorders within clinical samples|url=https://linkinghub.elsevier.com/retrieve/pii/S0165032710005458|journal=Journal of Affective Disorders|language=en|volume=129|issue=1-3|pages=191–197|doi=10.1016/j.jad.2010.08.011}}</ref> |.75 (N = 1445) |1.49 (9+) |.67(9-) |Inpatient and outpatient children and adolescents |[https://store.aseba.org/ Purchase] |} '''Note:''' “LR+” refers to the change in likelihood ratio associated with a positive test score, and “LR-” is the likelihood ratio for a low score. Likelihood ratios of 1 indicate that the test result did not change impressions at all. LRs larger than 10 or smaller than .10 are frequently clinically decisive; 5 or .20 are helpful, and between 2.0 and .5 are small enough that they rarely result in clinically meaningful changes of formulation<ref>Sackett, D. L., Straus, S. E., Richardson, W. S., Rosenberg, W., & Haynes, R. B. (2000). Evidence-based medicine: How to practice and teach EBM. Edinburgh: Churchill Livingstone.</ref>. '''Search terms:''' [General Anxiety Disorder] AND [children OR adolescents OR pediatric] AND [sensitivity OR specificity] in GoogleScholar and PsycINFO === Interpreting depression screening measure scores === * For information on interpreting screening measure scores, click [[Evidence based assessment/Prediction phase#Interpreting screening measure scores|here.]] ==[[Evidence based assessment/Prescription phase|'''Prescription phase''']]== ===Gold standard diagnostic interviews=== * For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews click here.] === Recommended diagnostic instruments for GAD === {| class="wikitable sortable" ! colspan="5" |Diagnostic instruments for GAD |- !Measure !Format (Reporter) !Age Range !Administration/ Completion Time !Where to Access |- |Anxiety Disorders Interview Schedule for Children/Parent<ref name=":1">{{Cite journal|date=2001-08-01|title=Test-Retest Reliability of Anxiety Symptoms and Diagnoses With the Anxiety Disorders Interview Schedule for DSM-IV: Child and Parent Versions|url=https://www.sciencedirect.com/science/article/pii/S0890856709603427|journal=Journal of the American Academy of Child & Adolescent Psychiatry|language=en|volume=40|issue=8|pages=937–944|doi=10.1097/00004583-200108000-00016|issn=0890-8567}}</ref> |Structured Interview (Child (ADIS-C), Parent (ADIS-P)) |6-16<ref>{{Cite journal|last=LYNEHAM|first=HEIDI J.|last2=ABBOTT|first2=MAREE J.|last3=RAPEE|first3=RONALD M.|date=2007-06|title=Interrater Reliability of the Anxiety Disorders Interview Schedule for DSM-IV: Child and Parent Version|url=https://doi.org/10.1097/chi.0b013e3180465a09|journal=Journal of the American Academy of Child &amp; Adolescent Psychiatry|volume=46|issue=6|pages=731–736|doi=10.1097/chi.0b013e3180465a09|issn=0890-8567}}</ref> |Varies |[https://books.google.com/books/about/Anxiety_Disorders_Interview_Schedule_for.html?id=xpR6V3rboxwC Purchase] |- |Anxiety and Related Disorders Interview Schedule for DSM-5 (ADIS-5)<ref name=":0" /> |Structured Interview (Adult) |16+ |Varies |[https://global.oup.com/academic/product/anxiety-and-related-disorders-interview-schedule-for-dsm-5-adis-5---adult-version-9780199325160?cc=us&lang=en& Purchase] |- |Structured Clinical Interview for DSM-5-Clinician Version (SCID-5-CV)<ref>{{Cite journal|last=Shabani|first=Amir|last2=Masoumian|first2=Samira|last3=Zamirinejad|first3=Somayeh|last4=Hejri|first4=Maryam|last5=Pirmorad|first5=Tahereh|last6=Yaghmaeezadeh|first6=Hooman|date=2021-05|title=Psychometric properties of Structured Clinical Interview for DSM‐5 Disorders‐Clinician Version (SCID‐5‐CV)|url=https://onlinelibrary.wiley.com/doi/10.1002/brb3.1894|journal=Brain and Behavior|language=en|volume=11|issue=5|doi=10.1002/brb3.1894|issn=2162-3279|pmc=PMC8119811|pmid=33729681}}</ref> |Structured Interview (Adult ) |16+ |Varies |[https://www.columbiapsychiatry.org/research/research-labs/diagnostic-and-assessment-lab/structured-clinical-interview-dsm-disorders-11 Website and purchase] |- |Generalized Anxiety Disorder Screener (GAD-7)<ref name=":0" /> |Questionnaire (Self-report) |18+ |5 minutes |[https://www.pfizerpcoa.com/general-anxiety-disorder-7-gad-7-screener GAD-7 homepage] [https://osf.io/szmpu GAD-7 PDF] |} '''Note:''' Reliability and validity are included in the [[Evidence-based assessment/Generalized anxiety disorder (assessment portfolio)/extended version|extended version]]. This table includes measures with Good or Excellent ratings. ==[[Evidence based assessment/Process phase|'''Process phase''']]== The following section contains a list of process and outcome measures for generalized anxiety disorder. The section includes benchmarks based on published norms for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the [[Evidence based assessment/Process phase|process phase]] of assessment. For more information of differences between process and outcome measures, see the page on the [[Evidence based assessment/Process phase|process phase of assessment]]. === Process measures === === Outcome and severity measures === * This table includes clinically significant benchmarks for '''(insert portfolio name here)''' specific outcome measures * Information on how to interpret this table can be [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase found here]. * Additionally, these [[Evidence based assessment/Vignettes|vignettes]] might be helpful resources for understanding appropriate adaptation of outcome measures in practice. *''<u>For clinically significant change benchmarks for the CBCL, YSR, and TRF total, externalizing, internalizing, and attention benchmarks,</u>'' [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase&wteswitched=1#Clinically_significant_change_benchmarks_for_widely-used_outcome_measures see here.] {| class="wikitable sortable" border="1" | colspan="7" |'''Clinically significant change benchmarks with common instruments for GAD''' |- | rowspan=1" style="text-align:center;font-size:130%;" | <b> Measure</b> | colspan="3" style="text-align:center;font-size:130%" width="300" | <b> Cut-off scores</b> | colspan="3" style="text-align:center;font-size:120%" | <b> Critical Change <br> (unstandardized scores)</b> |- | colspan="7" span style="font-size:110%; text-align:center;" | <b> Benchmarks Based on Published Norms</b> |- | colspan="1" | | style="text-align:center;font-size:110%" | <b> A</b> | style="text-align:center;font-size:110%" | <b> B</b> | style="text-align:center;font-size:110%" | <b> C</b> | style="text-align:center;font-size:110%" | <b> 95%</b> | style="text-align:center;font-size:110%" | <b> 90%</b> | style="text-align:center;font-size:110%" | <b> SE_difference</b> |- | rowspan="1" style="text-align:center;" | <b> GAD-7</b> | style=“text-align:center;”| -1 | style=“text-align:center;”| 1.3 | style=“text-align:center;”| 0.5 | style=“text-align:center;”| 0.6 | style=“text-align:center;”| 0.5 | style=“text-align:center;”| 0.3 |- | rowspan="1" style="text-align:center;" | <b> PSWQ</b> | style=“text-align:center;”| 51 | style=“text-align:center;”| 73 | style=“text-align:center;”| 59 | style=“text-align:center;”| 9 | style=“text-align:center;”| 8 | style=“text-align:center;”| 4.8 |- | rowspan="1" style="text-align:center;" | <b> SCARED </b> | style=“text-align:center;”| 9.9 | style=“text-align:center;”| 18.1 | style=“text-align:center;”| 15.3 | style=“text-align:center;”| 8.9 | style=“text-align:center;”| 7.5 | style=“text-align:center;”| 4.5 |} '''Note:''' “A” = Away from the clinical range, “B” = Back into the nonclinical range, “C” = Closer to the nonclinical than clinical mean. '''Search terms:''' [General Anxiety Disorder] AND [children OR adolescents OR pediatric] AND [clinical significance OR outcomes] in GoogleScholar and PsycINFO === Treatment === {{collapse top| Treatment Information|expand=yes}} Individuals suffering from GAD tend to be high users of outpatient medical care. When treating GAD, physicians should first determine whether pharmacotherapy, psychotherapy, or a combination of the two treatments would be most beneficial to the patient. Literature suggests that treatment of GAD frequently consists of a combination of psychotherapy and pharmacotherapy. Although these therapies have the potential to be effective individually, previous work demonstrates that when combined the degree of clinically significant change increases significantly. Recent studies (e.g., Gorman, 2003<ref name="Gorman2003" />; Walkup et al., 2008<ref name="WalkupEtAl2008" />) have provided evidence to support this claim with the most efficacious medication and behavioral interventions listed below. # '''Medication Interventions''' ## ''Sertraline (Zoloft)'' has been shown to reduce experiences and effects of GAD above and beyond that of placebo conditions. ## ''Pregabalin.'' The mean baseline-to-endpoint decreases in total Hamilton anxiety scale score in the patients given 150 mg/day of pregabalin (–9.2) was significantly greater than the decrease in those given placebo (–6.8)<ref name="PandeEtAl2003" />. ## ''Paroxetine.'' Remission was achieved by 30% of patients in the 20-mg paroxetine groups compared with 20% given placebo. For all three domains of the Sheehan Disability Scale, significantly greater improvement was seen with paroxetine than placebo<ref name="RickelsEtAl2003" />. # '''Behavioral interventions''' ## ''Cognitive behavioral therapy.'' Fourteen 60-minute sessions, which include CBT in anxiety-management skills, followed by behavioral exposure to anxiety-provoking situations have been shown to be effective in treating GAD. A review of studies by Fisher and Durham (1999)<ref name="FisherEtAl1999" /> revealed significant recovery rates at a 6 month follow up after CBT. ## ''Exposure therapy and modeling therapy.'' One meta-analysis found that virtual reality exposure therapy for anxiety disorders had a large effect size (Cohen's d=1.11) compared to controls.<ref>{{Cite journal|last=Powers|first=Mark B.|last2=Emmelkamp|first2=Paul M.G.|title=Virtual reality exposure therapy for anxiety disorders: A meta-analysis|url=https://doi.org/10.1016/j.janxdis.2007.04.006|journal=Journal of Anxiety Disorders|volume=22|issue=3|pages=561–569|doi=10.1016/j.janxdis.2007.04.006}}</ref> ## ''Mindfulness meditation.'' New treatment options such as mindfulness meditation-based stress reduction interventions have also shown to reduce symptoms over the long-term.<ref>{{Cite journal|last=Miller|first=J. J.|last2=Fletcher|first2=K.|last3=Kabat-Zinn|first3=J.|date=May 1995|title=Three-year follow-up and clinical implications of a mindfulness meditation-based stress reduction intervention in the treatment of anxiety disorders|url=https://www.ncbi.nlm.nih.gov/pubmed/7649463|journal=General Hospital Psychiatry|volume=17|issue=3|pages=192–200|issn=0163-8343|pmid=7649463}}</ref> # '''Combination treatment''' ## Previous research suggests that combination therapy that includes components of psychotherapy and pharmacotherapy are the most efficacious in treating GAD. In a study comparing the efficacies GAD treatments, Walkup and colleagues demonstrated a 21-25% improvement of combination therapy over cognitive behavioral therapy or sertraline alone during short-term treatment. These findings suggest that among effective treatments, combination therapy has the potential to provide the best chance for a positive outcome. See Gorman, 2003<ref name="Gorman2003" />; Walkup et al., 2008<ref name="WalkupEtAl2008" />. {{collapse bottom}} * Please refer to the page on [[wikipedia:Generalized_anxiety_disorder|generalized anxiety disorder]] for more information on available treatment or go to [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/fear-worry-and-anxiety/ Effective Child Therapy] for a curated resource on effective treatments for GAD. *For information on conducting Exposure Therapy for anxiety disordered youth, see [https://www.bravepracticeforkids.com/ www.BravePracticeForKids.com] =='''External Resources'''== # [http://apps.who.int/classifications/icd10/browse/2010/en#/F41.1 ICD-10 diagnostic criteria] # [https://en.wikiversity.org/w/index.php?title=Helping_Give_Away_Psychological_Science/Resources/Annotated_List_of_Where_and_How_to_Find_a_Therapist&wteswitched=1#Other_low-cost_options Find-a-Therapist] #*This is a curated list of find-a-therapist websites where you can find a provider # [https://www.nimh.nih.gov/health/topics/anxiety-disorders/index.shtml NIMH] entry about anxiety disorders # OMIM (Online Mendelian Inheritance in Man) #*[https://www.omim.org/entry/607834 607834] # [https://emedicine.medscape.com/article/286227-overview#a2 eMedicine entry about anxiety disorders] #[https://sccap53.org Society of Clinical Child and Adolescent Psychology] #[http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/fear-worry-and-anxiety/ Effective Child Therapy information on Fear, Worry, & Anxiety] #*Effective Child Therapy is website sponsored by Division 53 of the American Psychological Association (APA), or The [https://sccap53.org Society of Clinical Child and Adolescent Psychology] (SCCAP), in collaboration with the Association for Behavioral and Cognitive Therapies (ABCT). Use for information on symptoms and available treatments. #[http://pediatricbipolar.pitt.edu/resources/instruments Links to SCARED Child, Parent, and Adult + Translations] =='''References'''== {{collapse top|References|expand=yes}} {{Reflist|3|refs= <ref name="BirmaherEtAl1997">{{cite journal|last1=Birmaher|first1=B|last2=Khetarpal|first2=S|last3=Brent|first3=D|last4=Cully|first4=M|last5=Balach|first5=L|last6=Kaufman|first6=J|last7=Neer|first7=SM|title=The Screen for Child Anxiety Related Emotional Disorders (SCARED): scale construction and psychometric characteristics.|journal=Journal of the American Academy of Child and Adolescent Psychiatry|date=April 1997|volume=36|issue=4|pages=545-53|pmid=9100430}}</ref> <ref name="BrownJacobsenEtAl2011">{{cite journal|last1=Brown-Jacobsen|first1=AM|last2=Wallace|first2=DP|last3=Whiteside|first3=SP|title=Multimethod, multi-informant agreement, and positive predictive value in the identification of child anxiety disorders using the SCAS and ADIS-C.|journal=Assessment|date=September 2011|volume=18|issue=3|pages=382-92|pmid=20644080}}</ref> <ref name="CostelloEtAl1996">{{cite journal|last1=Costello|first1=EJ|last2=Angold|first2=A|last3=Burns|first3=BJ|last4=Stangl|first4=DK|last5=Tweed|first5=DL|last6=Erkanli|first6=A|last7=Worthman|first7=CM|title=The Great Smoky Mountains Study of Youth. 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journal|last1=Merikangas|first1=KR|last2=He|first2=JP|last3=Burstein|first3=M|last4=Swanson|first4=SA|last5=Avenevoli|first5=S|last6=Cui|first6=L|last7=Benjet|first7=C|last8=Georgiades|first8=K|last9=Swendsen|first9=J|title=Lifetime prevalence of mental disorders in U.S. adolescents: results from the National Comorbidity Survey Replication--Adolescent Supplement (NCS-A).|journal=Journal of the American Academy of Child and Adolescent Psychiatry|date=October 2010|volume=49|issue=10|pages=980-9|pmid=20855043}}</ref> <ref name="PandeEtAl2003">{{cite journal|last1=Pande|first1=AC|last2=Crockatt|first2=JG|last3=Feltner|first3=DE|last4=Janney|first4=CA|last5=Smith|first5=WT|last6=Weisler|first6=R|last7=Londborg|first7=PD|last8=Bielski|first8=RJ|last9=Zimbroff|first9=DL|last10=Davidson|first10=JR|last11=Liu-Dumaw|first11=M|title=Pregabalin in generalized anxiety disorder: a placebo-controlled trial.|journal=The American journal of psychiatry|date=March 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review of the Revised Children's Manifest Anxiety Scale, the State-Trait Anxiety Inventory for Children, and the Child Behavior Checklist.|journal=Journal of clinical child and adolescent psychology : the official journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 53|date=September 2004|volume=33|issue=3|pages=557-65|pmid=15271613}}</ref> <ref name="WalkupEtAl2008">{{cite journal|last1=Walkup|first1=JT|last2=Albano|first2=AM|last3=Piacentini|first3=J|last4=Birmaher|first4=B|last5=Compton|first5=SN|last6=Sherrill|first6=JT|last7=Ginsburg|first7=GS|last8=Rynn|first8=MA|last9=McCracken|first9=J|last10=Waslick|first10=B|last11=Iyengar|first11=S|last12=March|first12=JS|last13=Kendall|first13=PC|title=Cognitive behavioral therapy, sertraline, or a combination in childhood anxiety.|journal=The New England journal of medicine|date=25 December 2008|volume=359|issue=26|pages=2753-66|pmid=18974308}}</ref> <ref name="WhitakerEtAl1990">{{cite journal|last1=Whitaker|first1=A|last2=Johnson|first2=J|last3=Shaffer|first3=D|last4=Rapoport|first4=JL|last5=Kalikow|first5=K|last6=Walsh|first6=BT|last7=Davies|first7=M|last8=Braiman|first8=S|last9=Dolinsky|first9=A|title=Uncommon troubles in young people: prevalence estimates of selected psychiatric disorders in a nonreferred adolescent population.|journal=Archives of general psychiatry|date=May 1990|volume=47|issue=5|pages=487-96|pmid=2331210}}</ref> <ref name="SpitzerEtAl2006">{{cite journal|last1=Spitzer|first1=RL|last2=Kroenke|first2=K|last3=Williams|first3=JB|last4=Löwe|first4=B|title=A brief measure for assessing generalized anxiety disorder: the GAD-7.|journal=Archives of internal medicine|date=22 May 2006|volume=166|issue=10|pages=1092-7|pmid=16717171}}</ref> <ref name="vanGastelEtAl2008">{{cite journal|last1=van Gastel|first1=W|last2=Ferdinand|first2=RF|title=Screening capacity of the Multidimensional Anxiety Scale for Children (MASC) for DSM-IV anxiety disorders.|journal=Depression and anxiety|date=2008|volume=25|issue=12|pages=1046-52|pmid=18833579}}</ref> <ref name="WoodEtAl2002">{{cite journal|last1=Wood|first1=JJ|last2=Piacentini|first2=JC|last3=Bergman|first3=RL|last4=McCracken|first4=J|last5=Barrios|first5=V|title=Concurrent validity of the anxiety disorders section of the Anxiety Disorders Interview Schedule for DSM-IV: child and parent versions.|journal=Journal of clinical child and adolescent psychology : the official journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 53|date=September 2002|volume=31|issue=3|pages=335-42|pmid=12149971}}</ref> <ref name="ZimmermanEtAl2005">{{cite journal|last1=Zimmerman|first1=M|last2=Rothschild|first2=L|last3=Chelminski|first3=I|title=The prevalence of DSM-IV personality disorders in psychiatric outpatients.|journal=The American journal of psychiatry|date=October 2005|volume=162|issue=10|pages=1911-8|pmid=16199838}}</ref> }} {{collapse bottom|Click here for references}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] 9zy83bbw0txle2m9nd1p33f3965b3bq 0 207104 2419211 2413870 2022-08-26T02:50:58Z Ardenguo 2944162 /* Comparison of screening measures */ Made the collapsible box expanded by default wikitext text/x-wiki <noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{medical disclaimer}} {{:{{BASEPAGENAME}}/Sidebar}} ==[[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio"?''']]== * For background information on what assessment portfolios are, click the link in the heading above. * Want even 'more' information about this topic? There's an extended version of this page [[Evidence-based assessment/Self harm (assessment portfolio)/extended version|here]]. ==[[Evidence based assessment/Preparation phase|'''Preparation phase''']]== It is important to recognize that measures of suicide-related thoughts and behaviors (i.e., suicidal ideation) and non-suicidal self injury (NSSI) are measure distinct constructs. NSSI items often specify a behavior with clarification that the behavior was not undertaken with intent of suicide. This distinction is important when identifying which measure to use to evaluate a client. === Suicidal Ideation === Self-Injurious Thoughts and Behaviors Interview<ref>{{Cite journal|last=Nock|first=Matthew K.|last2=Holmberg|first2=Elizabeth B.|last3=Photos|first3=Valerie I.|last4=Michel|first4=Bethany D.|date=2007|title=Self-Injurious Thoughts and Behaviors Interview: Development, reliability, and validity in an adolescent sample.|url=http://doi.apa.org/getdoi.cfm?doi=10.1037/1040-3590.19.3.309|journal=Psychological Assessment|language=en|volume=19|issue=3|pages=309–317|doi=10.1037/1040-3590.19.3.309|issn=1939-134X}}</ref>. [[w:Suicide|Suicide]] has an article on Wikipedia. === Suicidal Behavior === <br /> === Diagnostic criteria for NSSI === {{blockquotetop}} '''DSM-5 Criteria for NSSI''' * Nonsuicidal self-injury is currently a proposed disorder in need of further research in the ''Diagnostic and Statistical Manual of Mental Disorders'' (DSM-5)<ref name="DSM5" />. * The criteria for NSSI can be found under Conditions for Further Study in DSM-5. '''ICD-11 Criteria for NSSI''' Intentional self-inflicted injury to the body, most commonly cutting, scraping, burning, biting, or hitting, with the expectation that the injury will lead to only minor physical harm. * For ICD-11, self-injury or self-harm is cited as a symptom or sign that is not classified elsewhere {{blockquotebottom}} === Base rates of NSSI in different populations and clinical settings === This section describes the demographic setting of the population(s) sampled, base rates of diagnosis, country/region sampled and the diagnostic method that was used. Using this information, clinicians will be able to anchor the rate of the non-suicidal self injuries (NSSI) that they are likely to see in their clinical practice. * '''''To see prevalence rates across multiple disorders,''''' [[Evidence based assessment/Preparation phase#Base rates for transdiagnostic comparison|'''''click here.''''']] {| class="wikitable sortable" border="1" |- ! Demography !Setting ! Base Rate ! Diagnostic Method ! Reference !Best Recommended For |- | International | Young adult non-clinical sample | 13.4% | Meta-analysis, controlling for methodological differences across studies | Lifetime frequency; Swannell et al., 2014<ref name="SwannellEtAl2014" /> | |- | All of U.S.A. | Adult community sample | 23% | Self-report measure (questions based on proposed DSM-V criteria for NSSI Disorder; FASM) | Lifetime frequency; Andover, 2015<ref name=Andover2014/> | |- | North East | Adolescent inpatient sample | 50% | Self-report measure (ISAS), based on DSM-V criteria for NSSI Disorder | Lifetime frequency; Glenn & Klonsky, 2013<ref name="GlennKlonsky2013"/> | |- | Sweden | Adolescent community sample | 43.4% | Combined self-report measure (FASM) and interview (SITBI) | Lifetime frequency; Zetterqvist et al., 2013<ref name="ZetterqvistetAl2013"/> | |- | U.S.A. | Adult outpatient sample | 11.4% | Chart review, not based on DSM-V criteria | Lifetime frequency; Selby et al., 2012<ref name="SelbyEtAl2012"/> | |- | All of U.S.A. | Adolescent epidemiological | 13.0%-23.2% | Variable assessment methods | Lifetime frequency; Jacobson & Gould, 2007<ref name="Jacobson2007"/> | |- | North East | Adolescent non-clinical sample | 7.5% | Self-report measure | within the last year; Hilt et al., 2008<ref name="HiltEtAl2008"/> | |- | North East | Adolescent inpatient sample | 60% | Self-report measure (FASM) | lifetime frequency; Nock et al., 2006<ref name="NockEtAl2006"/> | |- | United Kingdom | Incarcerated sample | 52% | Self-report measure (FASM) | Gray et al., 2003 | |- |International |Adults from sexual minorities (LGBT) samples |36.53% |Various self-report questionnaires |Liu et al., 2019 | |} '''Search terms:''' [Non-suicidal self-injury or NSSI or Self harm] AND [children OR adolescents] AND [prevalence OR incidence OR epidemiological] in PsychInfo and Google Schola == [[Evidence based assessment/Prediction phase|'''Prediction phase''']] == === Comparison of screening measures === {{collapse top|Descriptions of types of NSSI screenings|expand=yes}} '''Differences between types of NSSI measures''' #''Omnibus Measures'' #* Assess several NSSI domains #* These tests are the most comprehensive compared to other measures #''Functional Measures'' #* Helpful for understanding why people self-injure #* These tests assess motives for, or functions of, NSSI #''Behavioral Measures'' #* Primarily assess one's history of NSSI behaviors #* These measures are useful for assessment methods used and NSSI frequency #''Brief Measures'' #* Include a single item or a few items to assess NSSI #* These may be best when conducting a brief assessment '''Recommendations''' * Omnibus measures are highly recommended over all other types of measures. **''The SITBI'' is the best clinical interview for assessing adolescent NSSI **''The SASII'' was designed to assess NSSI among adults. {{collapse bottom}} === Scope of screening instruments for NSSI === {{collapse top| Click here for cross-screening component analysis}} {| class="wikitable sortable" border="1" |- !Category of Screening ! Instrument ! No. Items ! History ! Methods ! Frequency ! Lethality ! Intent of Functions ! History of Suicidality |- | '''''Omnibus''''' | Suicidal Behaviors Questionnaire (SBQ) | 90 |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] | | |[[File:Green check.png]] |- | '''''Omnibus''''' | Self-Harm Behavior Questionnaire (SHBQ) | 32 |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] | |[[File:Green check.png]] |- |<b>''Functional''</b> | Functional Assessment of Self-Mutilation (FASM) | 22 |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] | |- |<b>''Functional''</b> | Inventory of Statements About Self-Harm (ISAS) | 39 |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] | |[[File:Green check.png]] | |- |<b>''Functional''</b> | Self-Injury Questionnaire (SIQ) | 30 |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] |- |<b>''Functional''</b> | Self-Injury Motivation Scale (SIMS) | 35 | | | | |[[File:Green check.png]] | |- |<b>''Functional''</b> | Self-Harm Reasons Questionnaire (SHRQ) - Revised | 21 |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] | |[[File:Green check.png]] | |- |<b>''Behavioral''</b> | Deliberate Self-Harm Inventory (DSHI) | 17 |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] | | |- |<b>''Behavioral''</b> | Self-Harm Inventory (SHI) | 22 |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] | | |- |<b> ''Brief''</b> | Schedule for Nonadaptive and Adaptive Personality (SNAP) Items | 2 |[[File:Green check.png]] | | | | |[[File:Green check.png]] |- |<b> ''Brief''</b> | Trauma Symptom Inventory (TSI) Item | 1 |[[File:Green check.png]] | |[[File:Green check.png]] | | | |- |} * '''Note:''' SNAP has 375 items in the total measure; TSI has 100 items in the total measure. * '''Search terms:''' [Non-suicidal self-injury or NSSI or Self harm] AND [children OR adolescents] AND [assessment] in PsychINFO and Google ScholarTreatment * '''Sources consulted:''' Klonsky, E. D., & Lewis, S. P. (2014). Assessment of nonsuicidal self-injury. In M. K. Nock, M. K. Nock (Eds.), The Oxford handbook of suicide and self-injury (pp. 337-351). New York, NY, US: Oxford University Press.; Nock (Eds.), Understanding non-suicidal self-injury: Origins, assessment, and treatment. Washington, DC: Am. Psychol. Assoc. {{collapse bottom}} === Psychometric properties of screening instruments of NSSI === The following section contains a list of screening and diagnostic instruments for non-suicidal self-injury. The section includes administration information, psychometric data, and PDFs or links to the screenings. * Screenings are used as part of the [[Evidence based assessment/Prediction phase|prediction phase]] of assessment; for more information on interpretation of this data, or how screenings fit in to the assessment process, click [[Evidence based assessment/Prediction phase|here.]] * ''For a list of more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Psychometric_properties_of_common_screening_instruments '''click here.''']'' {| class="wikitable sortable" border="1" |- ! Instrument (Reference) !Type of screeening !Format (Reporter) !Age Range !Administration Time ! Internal Consistency ! Interrater Reliability ! Test-Retest Reliability ! Construct Validity ! Highly Recommended !Free and Accessible Measures |- | Suicidal Behaviors Questionnaire (SBQ) <ref name="Linehan1981" /> |<b>Omnibus</b> | | | | G | NA | A | G |[[File:Green check.png|link=https://en.wikiversity.org/wiki/File:Green%20check.png|alt=Yes]] | * [https://mfr.osf.io/render?url=https://osf.io/vg2sn/?action=download%26mode=render Printable PDF of SBQ] |- | Self-Harm Behavior Questionnaire (SHBQ) <ref name="GutierrezEtAl2001" /> |<b>Omnibus</b> | | | | G | NA | A | G | |Not free |- | Functional Assessment of Self-Mutilation (FASM)<ref name="LloydRichardsonEtAl1997" /> |<b> Functional</b> | | | | A | NA | U | A | | * [https://mfr.osf.io/render?url=https://osf.io/qps3v/?action=download%26mode=render Printable PDF of the FASM] |- |Inventory of Statements About Self-Harm (ISAS) <ref>http://www2.psych.ubc.ca/~klonsky/publications/ISASmeasure.pdf</ref> |<b> Functional</b> | | | | G | NA | G | G | | * [https://mfr.osf.io/render?url=https://osf.io/ntwkr/?action=download%26mode=render Printable PDF of ISAS] |- | Self-Injury Questionnaire (SIQ) <ref name="SantaMinaEtAl2006" /> ''*Not Free*'' |<b> Functional</b> | | | | G | NA | U | A | |Not free |- | Self-Injury Motivation Scale (SIMS)<ref name="OsuchEtAl1999" /> |<b> Functional</b> | | | | G | NA | U | A | | |- | Self-Harm Reasons Questionnaire (SHRQ) <ref name="LewisEtAl2008" /> |<b> Functional</b> | | | | G | NA | U | A | | |- | Deliberate Self-Harm Inventory (DSHI) <ref name="Gratz2001" /> |<b>Behavioral</b> | | | | G | NA | G | G | | |- | Self-Harm Inventory (SHI) |<b>Behavioral</b> | | | | A | NA | U | A | | |- | SNAP Items<ref name="Clark1996" /> |<b>Brief</b> | | | | NA | NA | U | A | | |- | Trauma Symptom Inventory (TSI) <ref name="Briere1995" /> |<b>Brief</b> | | | | NA | NA | U | A | | |- | Scale for Suicide Ideation (SSI) |<b>Other</b> | | | | G | U | U | G |[[File:Green check.png|link=https://en.wikiversity.org/wiki/File:Green%20check.png|alt=Yes]] | |- | Suicide Behaviors Interview (SBI) |<b>Other</b> | | | | E | E | U | A | | |- | Child Suicide Potential Scales (CSPS) |<b>Other</b> | | | | A | E | U | G |[[File:Green check.png|link=https://en.wikiversity.org/wiki/File:Green%20check.png|alt=Yes]] | |- | Beck Scale for Suicide Ideation (BSI) |<b>Other</b> | | | | E | NA | U | G |[[File:Green check.png|link=https://en.wikiversity.org/wiki/File:Green%20check.png|alt=Yes]] | |- | Suicide Behaviors Questionnaire for Children (SBQ-C) |<b>Other</b> | | | | G | NA | A | A | | |- | Suicide Ideation Questionnaire for Children (SIQ-JR) |<b>Other</b> | | | | G | NA | A | G |[[File:Green check.png|link=https://en.wikiversity.org/wiki/File:Green%20check.png|alt=Yes]] | |- | Suicide Probability Scale (SPS) |<b>Other</b> | | | | E | NA | U | A | | |- | Columbia Suicide Screen (CSS) |<b>Other</b> | | | | G | NA | L | A | | |- | Harkavy Asnis Suicide Scale (HASS) |<b>Other</b> | | | | E | NA | U | G | | |} '''Note:''' '''L''' = Less than adequate; '''A''' = Adequate; '''G''' = Good; '''E''' = Excellent; '''U''' = Unavailable; '''NA''' = Not applicable *<u>Sources consulted:</u> Klonsky, E. D., & Lewis, S. P. (2014). Assessment of nonsuicidal self-injury. In M. K. Nock, M. K. Nock (Eds.) , The Oxford handbook of suicide and self-injury (pp. 337-351). New York, NY, US: Oxford University Press.<ref name="KlonskyLewis2014" />; Nock (Eds.), Understanding non-suicidal self-injury: Origins, assessment, and treatment. Washington, DC: Am. Psychol. Assoc. === Likelihood ratios and AUCs of screening measures for NSSI === *''For a list of the likelihood ratios for more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Likelihood_ratios_and_AUCs_of_common_screening_instruments '''click here.''']'' {| class="wikitable sortable" |- ! Screening Measure (Primary Reference) !! AUC !! LR+ (score) !! LR- (score) !! Clinical Generalizability !Download |- |Child Behavior Checklist (CBCL) Anxious/Depressed Scale T-score<ref name="Achenbach1991">{{cite book|last1=Achenbach|first1=Thomas M.|title=Child behavior checklist for ages 4-18|date=1991|publisher=T.M. Achenbach|location=Burlington, VT|isbn=0938565087|edition=[11th print.]}}</ref>|| .70 (N=470) || 3.78 (60+) || .39 (<60) || High. Large diverse sample with mixed depression sample compared to samples without depression. |Not free |- |} === Interpreting NSSI screening measure scores === * For information on interpreting screening measure scores, click [[Evidence based assessment/Prediction phase#Interpreting screening measure scores|here.]] == [[Evidence based assessment/Prescription phase|'''Prescription phase''']] == ===Gold standard diagnostic interviews=== * For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews '''click here.'''] === Coverage of interviews for NSSI === {{collapse top| Scope of diagnostic interviews for NSSI}} {| class="wikitable sortable" border="1" |- ! Instrument ! No. Items ! History ! Methods ! Frequency ! Lethality ! Intent of Functions ! History of Suicidality |- | colspan="8" style="font-size:110%; text-align:center;" span |<b> Omnibus Measures </b> |- | Suicide Attempt Self-Injury Interview (SASII) | 31 | X | X | X | X | X | X |- | Self-Injurious Thoughts and Behaviors Interview (SITBI) | 169 | X | X | X | X | X | X |} {{collapse bottom}} === Recommended diagnostic instruments for NSSI === {| class="wikitable sortable" ! colspan="11" |Diagnostic instruments for '''NSSI''' ! |- !Instrument (Reference) !Type of screeening !Format (Reporter) !Age Range !Administration Time !Internal Consistency !Interrater Reliability !Test-Retest Reliability !Construct Validity !Content Validity !Highly Recommended !Free and Accessible Measures |- |Beck Scale for Suicidal Ideation (BSI) | |Self-report questionnaire |17+ |5-10 mins | |E | |A |G | |No * Link to purchase [https://www.pearsonclinical.com/psychology/products/100000157/beck-scale-for-suicide-ideation-bss.html] |- |Suicidal Behaviors Questionnaire-Revised (SBQ-R) | |Self-report |18+ |5-10 mins | | | |.87 E |E |Yes |[https://www.integration.samhsa.gov/images/res/SBQ.pdf SBQ-R] |- |Self-Harm Behavior Questionnaire (SHBQ) | |Self-report questionnaire |adolescents |Not Reported | |E | |G |G | | |- |Suicide Attempt Self-Injury Interview (SASII) <ref name="LinehanEtAl2006" /> |<b>Omnibus</b> | | | |G |E |E |G | |[[File:Green check.png|link=https://en.wikiversity.org/wiki/File:Green%20check.png]] |[https://mfr.osf.io/render?url=https://osf.io/zstnj/?action=download%26mode=render SASII] |- |Self Injurious Thoughts and Behaviors Interview (SITBI) <ref name="NockEtAl2007" /> |<b>Omnibus</b> | | | |NA |E |A |G | |[[File:Green check.png|link=https://en.wikiversity.org/wiki/File:Green%20check.png]] |[https://mfr.osf.io/render?url=https://osf.io/hw46c/?action=download%26mode=render SITBI] |- |Suicidal Ideation Questionnaire (SIQ) | |Self-report questionnaire |12-18 years old |10 minutes |NA | | | | | |[https://www.semel.ucla.edu/sites/default/files/pdf/SuicidalIdeationQuestionnaire%28SIQ%29%28Child%29.PDF SIQ] |- |Suicidal Ideation Questionnaire (SIQ-JR) | |Self-report Questionnaire |Middle School aged children |10 minutes |NA | |test-retest: r -0.93 (males) r = .87 (females) | | | |SIQ-[https://www.semel.ucla.edu/sites/default/files/pdf/SuicidalIdeationQuestionnaire%28SIQ%29%28Child%29.PDF JR] |} '''Note:''' '''L''' = Less than adequate; '''A''' = Adequate; '''G''' = Good; '''E''' = Excellent; '''U''' = Unavailable; '''NA''' = Not applicable == [[Evidence based assessment/Process phase|'''Process phase''']] == The following section contains a brief overview of treatment options for depression and list of process and outcome measures for non-suicidal self-injury. The section includes benchmarks based on published norms for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the [[Evidence based assessment/Process phase|process phase]] of assessment. For more information of differences between process and outcome measures, see the page on the [[Evidence based assessment/Process phase|process phase of assessment]]. === Process measures === {{blockquotetop}} {{blockquotebottom}} === Outcome and severity measures === * This table includes clinically significant benchmarks for NSSI specific outcome measures * Information on how to interpret this table can be [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase found here]. * Additionally, these [[Evidence based assessment/Vignettes|vignettes]] might be helpful resources for understanding appropriate adaptation of outcome measures in practice. *''<u>For clinically significant change benchmarks for the CBCL, YSR, and TRF total, externalizing, internalizing, and attention benchmarks,</u>'' [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase&wteswitched=1#Clinically_significant_change_benchmarks_for_widely-used_outcome_measures see here.] {| class="wikitable sortable" border="1" | colspan="8" |'''Clinically significant change benchmarks with common instruments for NSSI''' |- | rowspan="1&quot;" style="text-align:center;font-size:130%;" | <b> Measure</b> | style="text-align:center;font-size:130%;" | <b>Subscale</b> | colspan="3" style="text-align:center;font-size:130%" width="300" | <b> Cut-off scores</b> | colspan="3" style="text-align:center;font-size:120%" | <b> Critical Change <br> (unstandardized scores)</b> |- | colspan="8" span style="font-size:110%; text-align:center;" | <b> Benchmarks Based on Published Norms </b> |- | colspan="2" | | style="text-align:center;font-size:110%" | <b> A</b> | style="text-align:center;font-size:110%" | <b> B</b> | style="text-align:center;font-size:110%" | <b> C</b> | style="text-align:center;font-size:110%" | <b> 95%</b> | style="text-align:center;font-size:110%" | <b> 90%</b> | style="text-align:center;font-size:110%" | <b> SE_difference</b> |- | rowspan="1" style="text-align:center;" | | style="text-align:center;"| | style="text-align:center;"| | style="text-align:center;"| | style="text-align:center;"| | style="text-align:center;"| | style="text-align:center;"| | style="text-align:center;"| |- | rowspan="1" style="text-align:center;" | | style="text-align:right;" | | style="text-align:center;"| | style="text-align:center;"| | style="text-align:center;"| | style="text-align:center;"| | style="text-align:center;"| | style="text-align:center;"| |} === Treatment === * Please refer to the page on [[wikipedia:Nonsuicidal_self-injury_disorder|non-suicidal self injury]] for more information on available treatment for NSSI *Go to [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/self-injurious-thoughts-and-behaviors/ Effective Child Therapy] for a curated resource on effective treatments for NSSI. {{collapse top| Click here for information on treatment for NSSI}} According to Nock (2010)<ref name="Nock2010"/>, no treatment for NSSI could be considered "evidence-based." However, recent years have seen an increase in intervention trials for NSSI. Although limited due to lack of consistency in defining and measuring NSSI, this work could provide insight into potential best practices for treating this condition (Andover, 2015)<ref name=Andover2014/>. # '''Dialectical behavioral therapy (DBT)''' ## Dialectical Behavior Therapy has been shown to be effective in treating individuals with Borderline Personality Disorder (BPD) who engage in NSSI; however it has not been shown to be better than treatment as usual in a sample of individuals without BPD. In the absence of a better option, a DBT approach to treatment is the most evidence based. # '''Cognitive behavioral therapy (CBT)''' ## Few research studies have tested cognitive-behavioral therapy (CBT) as a treatment specifically for NSSI. However, some studies have evaluated the efficacy of CBT trials in treating self-injury with and without suicidal intent. Manual-assisted cognitive therapy (MACT) is a 6-session CBT intervention focusing on functions of deliberate self-harm, emotion regulation, problem-solving skills, and relapse prevention. MACT has demonstrated mixed results for decreasing NSSI frequency and severity among adults (Tyrer et al., 2003<ref name="TyrerEtAl2003" />; Weinberg, Gunderson, Hennen, & Cutter, 2006)<ref name="WeinbergEtAl2006" />. Although MACT may be a promising intervention (Muehlenkamp, 2006)<ref name="Muehlenkamp2006" />, it should be evaluated in future studies. In one adolescent treatment trial, the Adolescent Depression Antidepressant Psychotherapy Trial (ADAPT), a decrease in NSSI behaviors was found at post-treatment for both SSRI and SSRI+CBT groups (Goodyer et al., 2007)<ref name="GoodyerEtAl2007" />, although no differences were found between groups. In sum, findings from efficacy trials of CBT on NSSI outcomes are mixed, and more trials examining CBT as a treatment specifically for NSSI are needed. # '''Pharmacology''' ## Pharmacological interventions are especially scarce. However, one study found that fluoxetine was effective at reducing NSSI frequency in a sample of 22 adults with major depressive disorder and either BPD or schizotypal personality disorder (Markovitz et al, 1991)<ref name="MarkovitzEtAl1991" />. A second trial found that antidepressant medications alone (SSRIs and SNRIs) were as effective as medication plus CBT in reducing NSSI among adolescents with MDD (Brent et al., 2009<ref name="Brent2009" />; Goodyer et al., 2007)<ref name="GoodyerEtAl2007" />. Ziprasidone, an atypical antipsychotic, was found to be more effective in reducing NSSI behaviors among adolescents compared to another neuroleptic medication (Libal et al., 2005)<ref name="LibalEtAl2005" />. Clonidine has also been effective as an intervention for acute NSSI urges and feelings of tension among a sample of patients with BPD (Philipsen et al., 2004)<ref name="PhilipsenEtAl2004" />, although the long-term effects are unknown. # '''Prevention programs''' ## Jacobs, Walsh, McDade, and Pigeon (2009)<ref name="JacobsEtAl2009" /> developed the only known prevention program for NSSI, the Signs of Self-Injury program (SOSI). This school-based prevention program is designed to increase awareness about NSSI among adolescents through psychoeducation about warning signs and symptoms and improvement of help-seeking behaviors and attitudes. One test of effectiveness and acceptance found the program to be feasible and effective at changing attitudes toward NSSI and increasing help-seeking among students (Muehlenkamp et al., 2010)<ref name="MuehlenkampEtAl2010" />. {{collapse bottom}} == '''External resources''' == # [https://en.wikiversity.org/w/index.php?title=Helping_Give_Away_Psychological_Science/Resources/Annotated_List_of_Where_and_How_to_Find_a_Therapist&wteswitched=1#Other_low-cost_options Find-a-Therapist] (a curated list of find-a-therapist websites where you can find a provide #[http://www.selfinjury.bctr.cornell.edu/about-self-injury.html Cornell resource on self-injury] #Effective Child Therapy page for [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/self-injurious-thoughts-and-behaviors/ Self-Injurious Thoughts and Behaviors] ##Effective Child Therapy is website sponsored by Division 53 of the American Psychological Association (APA), or The [https://sccap53.org Society of Clinical Child and Adolescent Psychology (SCCAP)] (SCCAP), in collaboration with the Association for Behavioral and Cognitive Therapies (ABCT). Use for information on symptoms and available treatments. # [[wikipedia:Nonsuicidal_self-injury_disorder|Wikipedia page for non-suicidal self injury]] #[https://mhfa.com.au/sites/mhfa.com.au/files/MHFA_selfinjury_guidelinesA4%202014%20Revised_1.pdf Mental Health First Aid] page on non-suicidal self-injury == '''References''' == {{collapse top|Liu, R. T., Sheehan, A. E., Walsh, R. F., Sanzari, C. M., Cheek, S. M., & Hernandez, E. M. (2019). Prevalence and correlates of non-suicidal self-injury among lesbian, gay, bisexual, and transgender individuals: A systematic review and meta-analysis. 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M.|title=Suicides behaviors questionnaire|date=1981|publisher=University of Washington|location=Seattle}}</ref> <ref name="LloydRichardsonEtAl1997">{{cite journal|last1=Lloyd-Richardson|first1=E. E.|last2=Kelley|first2=M. L.|last3=Hope|first3=T.|title=Self-mutilation in a community sample of adolescents: Descriptive characteristics and provisional prevalence rates|journal=Poster session presented at the Annual Meeting of the Society for Behavioral Medicine|date=April 1997|location=New Orleans, LA}}</ref> <ref name="Muehlenkamp2006">{{cite journal|last1=Muehlenkamp|first1=J. J.|title=Empirically supported treatments and general therapy guidelines for non-suicidal self-injury|journal=Journal of Mental Health Counseling|date=2006|volume=28|pages=166-185}}</ref> }} {{collapse bottom}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] jl30wc8o3kdu0xprvi0a8k64oyr19un 2419212 2419211 2022-08-26T02:51:33Z Ardenguo 2944162 /* Scope of screening instruments for NSSI */ Made the collapsible box expanded by default wikitext text/x-wiki <noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{medical disclaimer}} {{:{{BASEPAGENAME}}/Sidebar}} ==[[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio"?''']]== * For background information on what assessment portfolios are, click the link in the heading above. * Want even 'more' information about this topic? There's an extended version of this page [[Evidence-based assessment/Self harm (assessment portfolio)/extended version|here]]. ==[[Evidence based assessment/Preparation phase|'''Preparation phase''']]== It is important to recognize that measures of suicide-related thoughts and behaviors (i.e., suicidal ideation) and non-suicidal self injury (NSSI) are measure distinct constructs. NSSI items often specify a behavior with clarification that the behavior was not undertaken with intent of suicide. This distinction is important when identifying which measure to use to evaluate a client. === Suicidal Ideation === Self-Injurious Thoughts and Behaviors Interview<ref>{{Cite journal|last=Nock|first=Matthew K.|last2=Holmberg|first2=Elizabeth B.|last3=Photos|first3=Valerie I.|last4=Michel|first4=Bethany D.|date=2007|title=Self-Injurious Thoughts and Behaviors Interview: Development, reliability, and validity in an adolescent sample.|url=http://doi.apa.org/getdoi.cfm?doi=10.1037/1040-3590.19.3.309|journal=Psychological Assessment|language=en|volume=19|issue=3|pages=309–317|doi=10.1037/1040-3590.19.3.309|issn=1939-134X}}</ref>. [[w:Suicide|Suicide]] has an article on Wikipedia. === Suicidal Behavior === <br /> === Diagnostic criteria for NSSI === {{blockquotetop}} '''DSM-5 Criteria for NSSI''' * Nonsuicidal self-injury is currently a proposed disorder in need of further research in the ''Diagnostic and Statistical Manual of Mental Disorders'' (DSM-5)<ref name="DSM5" />. * The criteria for NSSI can be found under Conditions for Further Study in DSM-5. '''ICD-11 Criteria for NSSI''' Intentional self-inflicted injury to the body, most commonly cutting, scraping, burning, biting, or hitting, with the expectation that the injury will lead to only minor physical harm. * For ICD-11, self-injury or self-harm is cited as a symptom or sign that is not classified elsewhere {{blockquotebottom}} === Base rates of NSSI in different populations and clinical settings === This section describes the demographic setting of the population(s) sampled, base rates of diagnosis, country/region sampled and the diagnostic method that was used. Using this information, clinicians will be able to anchor the rate of the non-suicidal self injuries (NSSI) that they are likely to see in their clinical practice. * '''''To see prevalence rates across multiple disorders,''''' [[Evidence based assessment/Preparation phase#Base rates for transdiagnostic comparison|'''''click here.''''']] {| class="wikitable sortable" border="1" |- ! Demography !Setting ! Base Rate ! Diagnostic Method ! Reference !Best Recommended For |- | International | Young adult non-clinical sample | 13.4% | Meta-analysis, controlling for methodological differences across studies | Lifetime frequency; Swannell et al., 2014<ref name="SwannellEtAl2014" /> | |- | All of U.S.A. | Adult community sample | 23% | Self-report measure (questions based on proposed DSM-V criteria for NSSI Disorder; FASM) | Lifetime frequency; Andover, 2015<ref name=Andover2014/> | |- | North East | Adolescent inpatient sample | 50% | Self-report measure (ISAS), based on DSM-V criteria for NSSI Disorder | Lifetime frequency; Glenn & Klonsky, 2013<ref name="GlennKlonsky2013"/> | |- | Sweden | Adolescent community sample | 43.4% | Combined self-report measure (FASM) and interview (SITBI) | Lifetime frequency; Zetterqvist et al., 2013<ref name="ZetterqvistetAl2013"/> | |- | U.S.A. | Adult outpatient sample | 11.4% | Chart review, not based on DSM-V criteria | Lifetime frequency; Selby et al., 2012<ref name="SelbyEtAl2012"/> | |- | All of U.S.A. | Adolescent epidemiological | 13.0%-23.2% | Variable assessment methods | Lifetime frequency; Jacobson & Gould, 2007<ref name="Jacobson2007"/> | |- | North East | Adolescent non-clinical sample | 7.5% | Self-report measure | within the last year; Hilt et al., 2008<ref name="HiltEtAl2008"/> | |- | North East | Adolescent inpatient sample | 60% | Self-report measure (FASM) | lifetime frequency; Nock et al., 2006<ref name="NockEtAl2006"/> | |- | United Kingdom | Incarcerated sample | 52% | Self-report measure (FASM) | Gray et al., 2003 | |- |International |Adults from sexual minorities (LGBT) samples |36.53% |Various self-report questionnaires |Liu et al., 2019 | |} '''Search terms:''' [Non-suicidal self-injury or NSSI or Self harm] AND [children OR adolescents] AND [prevalence OR incidence OR epidemiological] in PsychInfo and Google Schola == [[Evidence based assessment/Prediction phase|'''Prediction phase''']] == === Comparison of screening measures === {{collapse top|Descriptions of types of NSSI screenings|expand=yes}} '''Differences between types of NSSI measures''' #''Omnibus Measures'' #* Assess several NSSI domains #* These tests are the most comprehensive compared to other measures #''Functional Measures'' #* Helpful for understanding why people self-injure #* These tests assess motives for, or functions of, NSSI #''Behavioral Measures'' #* Primarily assess one's history of NSSI behaviors #* These measures are useful for assessment methods used and NSSI frequency #''Brief Measures'' #* Include a single item or a few items to assess NSSI #* These may be best when conducting a brief assessment '''Recommendations''' * Omnibus measures are highly recommended over all other types of measures. **''The SITBI'' is the best clinical interview for assessing adolescent NSSI **''The SASII'' was designed to assess NSSI among adults. {{collapse bottom}} === Scope of screening instruments for NSSI === {{collapse top| Cross-screening component analysis|expand=yes}} {| class="wikitable sortable" border="1" |- !Category of Screening ! Instrument ! No. Items ! History ! Methods ! Frequency ! Lethality ! Intent of Functions ! History of Suicidality |- | '''''Omnibus''''' | Suicidal Behaviors Questionnaire (SBQ) | 90 |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] | | |[[File:Green check.png]] |- | '''''Omnibus''''' | Self-Harm Behavior Questionnaire (SHBQ) | 32 |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] | |[[File:Green check.png]] |- |<b>''Functional''</b> | Functional Assessment of Self-Mutilation (FASM) | 22 |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] | |- |<b>''Functional''</b> | Inventory of Statements About Self-Harm (ISAS) | 39 |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] | |[[File:Green check.png]] | |- |<b>''Functional''</b> | Self-Injury Questionnaire (SIQ) | 30 |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] |- |<b>''Functional''</b> | Self-Injury Motivation Scale (SIMS) | 35 | | | | |[[File:Green check.png]] | |- |<b>''Functional''</b> | Self-Harm Reasons Questionnaire (SHRQ) - Revised | 21 |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] | |[[File:Green check.png]] | |- |<b>''Behavioral''</b> | Deliberate Self-Harm Inventory (DSHI) | 17 |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] | | |- |<b>''Behavioral''</b> | Self-Harm Inventory (SHI) | 22 |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] | | |- |<b> ''Brief''</b> | Schedule for Nonadaptive and Adaptive Personality (SNAP) Items | 2 |[[File:Green check.png]] | | | | |[[File:Green check.png]] |- |<b> ''Brief''</b> | Trauma Symptom Inventory (TSI) Item | 1 |[[File:Green check.png]] | |[[File:Green check.png]] | | | |- |} * '''Note:''' SNAP has 375 items in the total measure; TSI has 100 items in the total measure. * '''Search terms:''' [Non-suicidal self-injury or NSSI or Self harm] AND [children OR adolescents] AND [assessment] in PsychINFO and Google ScholarTreatment * '''Sources consulted:''' Klonsky, E. D., & Lewis, S. P. (2014). Assessment of nonsuicidal self-injury. In M. K. Nock, M. K. Nock (Eds.), The Oxford handbook of suicide and self-injury (pp. 337-351). New York, NY, US: Oxford University Press.; Nock (Eds.), Understanding non-suicidal self-injury: Origins, assessment, and treatment. Washington, DC: Am. Psychol. Assoc. {{collapse bottom}} === Psychometric properties of screening instruments of NSSI === The following section contains a list of screening and diagnostic instruments for non-suicidal self-injury. The section includes administration information, psychometric data, and PDFs or links to the screenings. * Screenings are used as part of the [[Evidence based assessment/Prediction phase|prediction phase]] of assessment; for more information on interpretation of this data, or how screenings fit in to the assessment process, click [[Evidence based assessment/Prediction phase|here.]] * ''For a list of more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Psychometric_properties_of_common_screening_instruments '''click here.''']'' {| class="wikitable sortable" border="1" |- ! Instrument (Reference) !Type of screeening !Format (Reporter) !Age Range !Administration Time ! Internal Consistency ! Interrater Reliability ! Test-Retest Reliability ! Construct Validity ! Highly Recommended !Free and Accessible Measures |- | Suicidal Behaviors Questionnaire (SBQ) <ref name="Linehan1981" /> |<b>Omnibus</b> | | | | G | NA | A | G |[[File:Green check.png|link=https://en.wikiversity.org/wiki/File:Green%20check.png|alt=Yes]] | * [https://mfr.osf.io/render?url=https://osf.io/vg2sn/?action=download%26mode=render Printable PDF of SBQ] |- | Self-Harm Behavior Questionnaire (SHBQ) <ref name="GutierrezEtAl2001" /> |<b>Omnibus</b> | | | | G | NA | A | G | |Not free |- | Functional Assessment of Self-Mutilation (FASM)<ref name="LloydRichardsonEtAl1997" /> |<b> Functional</b> | | | | A | NA | U | A | | * [https://mfr.osf.io/render?url=https://osf.io/qps3v/?action=download%26mode=render Printable PDF of the FASM] |- |Inventory of Statements About Self-Harm (ISAS) <ref>http://www2.psych.ubc.ca/~klonsky/publications/ISASmeasure.pdf</ref> |<b> Functional</b> | | | | G | NA | G | G | | * [https://mfr.osf.io/render?url=https://osf.io/ntwkr/?action=download%26mode=render Printable PDF of ISAS] |- | Self-Injury Questionnaire (SIQ) <ref name="SantaMinaEtAl2006" /> ''*Not Free*'' |<b> Functional</b> | | | | G | NA | U | A | |Not free |- | Self-Injury Motivation Scale (SIMS)<ref name="OsuchEtAl1999" /> |<b> Functional</b> | | | | G | NA | U | A | | |- | Self-Harm Reasons Questionnaire (SHRQ) <ref name="LewisEtAl2008" /> |<b> Functional</b> | | | | G | NA | U | A | | |- | Deliberate Self-Harm Inventory (DSHI) <ref name="Gratz2001" /> |<b>Behavioral</b> | | | | G | NA | G | G | | |- | Self-Harm Inventory (SHI) |<b>Behavioral</b> | | | | A | NA | U | A | | |- | SNAP Items<ref name="Clark1996" /> |<b>Brief</b> | | | | NA | NA | U | A | | |- | Trauma Symptom Inventory (TSI) <ref name="Briere1995" /> |<b>Brief</b> | | | | NA | NA | U | A | | |- | Scale for Suicide Ideation (SSI) |<b>Other</b> | | | | G | U | U | G |[[File:Green check.png|link=https://en.wikiversity.org/wiki/File:Green%20check.png|alt=Yes]] | |- | Suicide Behaviors Interview (SBI) |<b>Other</b> | | | | E | E | U | A | | |- | Child Suicide Potential Scales (CSPS) |<b>Other</b> | | | | A | E | U | G |[[File:Green check.png|link=https://en.wikiversity.org/wiki/File:Green%20check.png|alt=Yes]] | |- | Beck Scale for Suicide Ideation (BSI) |<b>Other</b> | | | | E | NA | U | G |[[File:Green check.png|link=https://en.wikiversity.org/wiki/File:Green%20check.png|alt=Yes]] | |- | Suicide Behaviors Questionnaire for Children (SBQ-C) |<b>Other</b> | | | | G | NA | A | A | | |- | Suicide Ideation Questionnaire for Children (SIQ-JR) |<b>Other</b> | | | | G | NA | A | G |[[File:Green check.png|link=https://en.wikiversity.org/wiki/File:Green%20check.png|alt=Yes]] | |- | Suicide Probability Scale (SPS) |<b>Other</b> | | | | E | NA | U | A | | |- | Columbia Suicide Screen (CSS) |<b>Other</b> | | | | G | NA | L | A | | |- | Harkavy Asnis Suicide Scale (HASS) |<b>Other</b> | | | | E | NA | U | G | | |} '''Note:''' '''L''' = Less than adequate; '''A''' = Adequate; '''G''' = Good; '''E''' = Excellent; '''U''' = Unavailable; '''NA''' = Not applicable *<u>Sources consulted:</u> Klonsky, E. D., & Lewis, S. P. (2014). Assessment of nonsuicidal self-injury. In M. K. Nock, M. K. Nock (Eds.) , The Oxford handbook of suicide and self-injury (pp. 337-351). New York, NY, US: Oxford University Press.<ref name="KlonskyLewis2014" />; Nock (Eds.), Understanding non-suicidal self-injury: Origins, assessment, and treatment. Washington, DC: Am. Psychol. Assoc. === Likelihood ratios and AUCs of screening measures for NSSI === *''For a list of the likelihood ratios for more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Likelihood_ratios_and_AUCs_of_common_screening_instruments '''click here.''']'' {| class="wikitable sortable" |- ! Screening Measure (Primary Reference) !! AUC !! LR+ (score) !! LR- (score) !! Clinical Generalizability !Download |- |Child Behavior Checklist (CBCL) Anxious/Depressed Scale T-score<ref name="Achenbach1991">{{cite book|last1=Achenbach|first1=Thomas M.|title=Child behavior checklist for ages 4-18|date=1991|publisher=T.M. Achenbach|location=Burlington, VT|isbn=0938565087|edition=[11th print.]}}</ref>|| .70 (N=470) || 3.78 (60+) || .39 (<60) || High. Large diverse sample with mixed depression sample compared to samples without depression. |Not free |- |} === Interpreting NSSI screening measure scores === * For information on interpreting screening measure scores, click [[Evidence based assessment/Prediction phase#Interpreting screening measure scores|here.]] == [[Evidence based assessment/Prescription phase|'''Prescription phase''']] == ===Gold standard diagnostic interviews=== * For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews '''click here.'''] === Coverage of interviews for NSSI === {{collapse top| Scope of diagnostic interviews for NSSI}} {| class="wikitable sortable" border="1" |- ! Instrument ! No. Items ! History ! Methods ! Frequency ! Lethality ! Intent of Functions ! History of Suicidality |- | colspan="8" style="font-size:110%; text-align:center;" span |<b> Omnibus Measures </b> |- | Suicide Attempt Self-Injury Interview (SASII) | 31 | X | X | X | X | X | X |- | Self-Injurious Thoughts and Behaviors Interview (SITBI) | 169 | X | X | X | X | X | X |} {{collapse bottom}} === Recommended diagnostic instruments for NSSI === {| class="wikitable sortable" ! colspan="11" |Diagnostic instruments for '''NSSI''' ! |- !Instrument (Reference) !Type of screeening !Format (Reporter) !Age Range !Administration Time !Internal Consistency !Interrater Reliability !Test-Retest Reliability !Construct Validity !Content Validity !Highly Recommended !Free and Accessible Measures |- |Beck Scale for Suicidal Ideation (BSI) | |Self-report questionnaire |17+ |5-10 mins | |E | |A |G | |No * Link to purchase [https://www.pearsonclinical.com/psychology/products/100000157/beck-scale-for-suicide-ideation-bss.html] |- |Suicidal Behaviors Questionnaire-Revised (SBQ-R) | |Self-report |18+ |5-10 mins | | | |.87 E |E |Yes |[https://www.integration.samhsa.gov/images/res/SBQ.pdf SBQ-R] |- |Self-Harm Behavior Questionnaire (SHBQ) | |Self-report questionnaire |adolescents |Not Reported | |E | |G |G | | |- |Suicide Attempt Self-Injury Interview (SASII) <ref name="LinehanEtAl2006" /> |<b>Omnibus</b> | | | |G |E |E |G | |[[File:Green check.png|link=https://en.wikiversity.org/wiki/File:Green%20check.png]] |[https://mfr.osf.io/render?url=https://osf.io/zstnj/?action=download%26mode=render SASII] |- |Self Injurious Thoughts and Behaviors Interview (SITBI) <ref name="NockEtAl2007" /> |<b>Omnibus</b> | | | |NA |E |A |G | |[[File:Green check.png|link=https://en.wikiversity.org/wiki/File:Green%20check.png]] |[https://mfr.osf.io/render?url=https://osf.io/hw46c/?action=download%26mode=render SITBI] |- |Suicidal Ideation Questionnaire (SIQ) | |Self-report questionnaire |12-18 years old |10 minutes |NA | | | | | |[https://www.semel.ucla.edu/sites/default/files/pdf/SuicidalIdeationQuestionnaire%28SIQ%29%28Child%29.PDF SIQ] |- |Suicidal Ideation Questionnaire (SIQ-JR) | |Self-report Questionnaire |Middle School aged children |10 minutes |NA | |test-retest: r -0.93 (males) r = .87 (females) | | | |SIQ-[https://www.semel.ucla.edu/sites/default/files/pdf/SuicidalIdeationQuestionnaire%28SIQ%29%28Child%29.PDF JR] |} '''Note:''' '''L''' = Less than adequate; '''A''' = Adequate; '''G''' = Good; '''E''' = Excellent; '''U''' = Unavailable; '''NA''' = Not applicable == [[Evidence based assessment/Process phase|'''Process phase''']] == The following section contains a brief overview of treatment options for depression and list of process and outcome measures for non-suicidal self-injury. The section includes benchmarks based on published norms for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the [[Evidence based assessment/Process phase|process phase]] of assessment. For more information of differences between process and outcome measures, see the page on the [[Evidence based assessment/Process phase|process phase of assessment]]. === Process measures === {{blockquotetop}} {{blockquotebottom}} === Outcome and severity measures === * This table includes clinically significant benchmarks for NSSI specific outcome measures * Information on how to interpret this table can be [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase found here]. * Additionally, these [[Evidence based assessment/Vignettes|vignettes]] might be helpful resources for understanding appropriate adaptation of outcome measures in practice. *''<u>For clinically significant change benchmarks for the CBCL, YSR, and TRF total, externalizing, internalizing, and attention benchmarks,</u>'' [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase&wteswitched=1#Clinically_significant_change_benchmarks_for_widely-used_outcome_measures see here.] {| class="wikitable sortable" border="1" | colspan="8" |'''Clinically significant change benchmarks with common instruments for NSSI''' |- | rowspan="1&quot;" style="text-align:center;font-size:130%;" | <b> Measure</b> | style="text-align:center;font-size:130%;" | <b>Subscale</b> | colspan="3" style="text-align:center;font-size:130%" width="300" | <b> Cut-off scores</b> | colspan="3" style="text-align:center;font-size:120%" | <b> Critical Change <br> (unstandardized scores)</b> |- | colspan="8" span style="font-size:110%; text-align:center;" | <b> Benchmarks Based on Published Norms </b> |- | colspan="2" | | style="text-align:center;font-size:110%" | <b> A</b> | style="text-align:center;font-size:110%" | <b> B</b> | style="text-align:center;font-size:110%" | <b> C</b> | style="text-align:center;font-size:110%" | <b> 95%</b> | style="text-align:center;font-size:110%" | <b> 90%</b> | style="text-align:center;font-size:110%" | <b> SE_difference</b> |- | rowspan="1" style="text-align:center;" | | style="text-align:center;"| | style="text-align:center;"| | style="text-align:center;"| | style="text-align:center;"| | style="text-align:center;"| | style="text-align:center;"| | style="text-align:center;"| |- | rowspan="1" style="text-align:center;" | | style="text-align:right;" | | style="text-align:center;"| | style="text-align:center;"| | style="text-align:center;"| | style="text-align:center;"| | style="text-align:center;"| | style="text-align:center;"| |} === Treatment === * Please refer to the page on [[wikipedia:Nonsuicidal_self-injury_disorder|non-suicidal self injury]] for more information on available treatment for NSSI *Go to [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/self-injurious-thoughts-and-behaviors/ Effective Child Therapy] for a curated resource on effective treatments for NSSI. {{collapse top| Click here for information on treatment for NSSI}} According to Nock (2010)<ref name="Nock2010"/>, no treatment for NSSI could be considered "evidence-based." However, recent years have seen an increase in intervention trials for NSSI. Although limited due to lack of consistency in defining and measuring NSSI, this work could provide insight into potential best practices for treating this condition (Andover, 2015)<ref name=Andover2014/>. # '''Dialectical behavioral therapy (DBT)''' ## Dialectical Behavior Therapy has been shown to be effective in treating individuals with Borderline Personality Disorder (BPD) who engage in NSSI; however it has not been shown to be better than treatment as usual in a sample of individuals without BPD. In the absence of a better option, a DBT approach to treatment is the most evidence based. # '''Cognitive behavioral therapy (CBT)''' ## Few research studies have tested cognitive-behavioral therapy (CBT) as a treatment specifically for NSSI. However, some studies have evaluated the efficacy of CBT trials in treating self-injury with and without suicidal intent. Manual-assisted cognitive therapy (MACT) is a 6-session CBT intervention focusing on functions of deliberate self-harm, emotion regulation, problem-solving skills, and relapse prevention. MACT has demonstrated mixed results for decreasing NSSI frequency and severity among adults (Tyrer et al., 2003<ref name="TyrerEtAl2003" />; Weinberg, Gunderson, Hennen, & Cutter, 2006)<ref name="WeinbergEtAl2006" />. Although MACT may be a promising intervention (Muehlenkamp, 2006)<ref name="Muehlenkamp2006" />, it should be evaluated in future studies. In one adolescent treatment trial, the Adolescent Depression Antidepressant Psychotherapy Trial (ADAPT), a decrease in NSSI behaviors was found at post-treatment for both SSRI and SSRI+CBT groups (Goodyer et al., 2007)<ref name="GoodyerEtAl2007" />, although no differences were found between groups. In sum, findings from efficacy trials of CBT on NSSI outcomes are mixed, and more trials examining CBT as a treatment specifically for NSSI are needed. # '''Pharmacology''' ## Pharmacological interventions are especially scarce. However, one study found that fluoxetine was effective at reducing NSSI frequency in a sample of 22 adults with major depressive disorder and either BPD or schizotypal personality disorder (Markovitz et al, 1991)<ref name="MarkovitzEtAl1991" />. A second trial found that antidepressant medications alone (SSRIs and SNRIs) were as effective as medication plus CBT in reducing NSSI among adolescents with MDD (Brent et al., 2009<ref name="Brent2009" />; Goodyer et al., 2007)<ref name="GoodyerEtAl2007" />. Ziprasidone, an atypical antipsychotic, was found to be more effective in reducing NSSI behaviors among adolescents compared to another neuroleptic medication (Libal et al., 2005)<ref name="LibalEtAl2005" />. Clonidine has also been effective as an intervention for acute NSSI urges and feelings of tension among a sample of patients with BPD (Philipsen et al., 2004)<ref name="PhilipsenEtAl2004" />, although the long-term effects are unknown. # '''Prevention programs''' ## Jacobs, Walsh, McDade, and Pigeon (2009)<ref name="JacobsEtAl2009" /> developed the only known prevention program for NSSI, the Signs of Self-Injury program (SOSI). This school-based prevention program is designed to increase awareness about NSSI among adolescents through psychoeducation about warning signs and symptoms and improvement of help-seeking behaviors and attitudes. One test of effectiveness and acceptance found the program to be feasible and effective at changing attitudes toward NSSI and increasing help-seeking among students (Muehlenkamp et al., 2010)<ref name="MuehlenkampEtAl2010" />. {{collapse bottom}} == '''External resources''' == # [https://en.wikiversity.org/w/index.php?title=Helping_Give_Away_Psychological_Science/Resources/Annotated_List_of_Where_and_How_to_Find_a_Therapist&wteswitched=1#Other_low-cost_options Find-a-Therapist] (a curated list of find-a-therapist websites where you can find a provide #[http://www.selfinjury.bctr.cornell.edu/about-self-injury.html Cornell resource on self-injury] #Effective Child Therapy page for [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/self-injurious-thoughts-and-behaviors/ Self-Injurious Thoughts and Behaviors] ##Effective Child Therapy is website sponsored by Division 53 of the American Psychological Association (APA), or The [https://sccap53.org Society of Clinical Child and Adolescent Psychology (SCCAP)] (SCCAP), in collaboration with the Association for Behavioral and Cognitive Therapies (ABCT). Use for information on symptoms and available treatments. # [[wikipedia:Nonsuicidal_self-injury_disorder|Wikipedia page for non-suicidal self injury]] #[https://mhfa.com.au/sites/mhfa.com.au/files/MHFA_selfinjury_guidelinesA4%202014%20Revised_1.pdf Mental Health First Aid] page on non-suicidal self-injury == '''References''' == {{collapse top|Liu, R. T., Sheehan, A. E., Walsh, R. F., Sanzari, C. M., Cheek, S. M., & Hernandez, E. M. (2019). Prevalence and correlates of non-suicidal self-injury among lesbian, gay, bisexual, and transgender individuals: A systematic review and meta-analysis. 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M.|title=Suicides behaviors questionnaire|date=1981|publisher=University of Washington|location=Seattle}}</ref> <ref name="LloydRichardsonEtAl1997">{{cite journal|last1=Lloyd-Richardson|first1=E. E.|last2=Kelley|first2=M. L.|last3=Hope|first3=T.|title=Self-mutilation in a community sample of adolescents: Descriptive characteristics and provisional prevalence rates|journal=Poster session presented at the Annual Meeting of the Society for Behavioral Medicine|date=April 1997|location=New Orleans, LA}}</ref> <ref name="Muehlenkamp2006">{{cite journal|last1=Muehlenkamp|first1=J. J.|title=Empirically supported treatments and general therapy guidelines for non-suicidal self-injury|journal=Journal of Mental Health Counseling|date=2006|volume=28|pages=166-185}}</ref> }} {{collapse bottom}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] rx6hik2c7eqce5p07uslp6cc5demqxu 2419213 2419212 2022-08-26T02:53:16Z Ardenguo 2944162 /* Coverage of interviews for NSSI */ Made the collapsible box expanded by default wikitext text/x-wiki <noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{medical disclaimer}} {{:{{BASEPAGENAME}}/Sidebar}} ==[[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio"?''']]== * For background information on what assessment portfolios are, click the link in the heading above. * Want even 'more' information about this topic? There's an extended version of this page [[Evidence-based assessment/Self harm (assessment portfolio)/extended version|here]]. ==[[Evidence based assessment/Preparation phase|'''Preparation phase''']]== It is important to recognize that measures of suicide-related thoughts and behaviors (i.e., suicidal ideation) and non-suicidal self injury (NSSI) are measure distinct constructs. NSSI items often specify a behavior with clarification that the behavior was not undertaken with intent of suicide. This distinction is important when identifying which measure to use to evaluate a client. === Suicidal Ideation === Self-Injurious Thoughts and Behaviors Interview<ref>{{Cite journal|last=Nock|first=Matthew K.|last2=Holmberg|first2=Elizabeth B.|last3=Photos|first3=Valerie I.|last4=Michel|first4=Bethany D.|date=2007|title=Self-Injurious Thoughts and Behaviors Interview: Development, reliability, and validity in an adolescent sample.|url=http://doi.apa.org/getdoi.cfm?doi=10.1037/1040-3590.19.3.309|journal=Psychological Assessment|language=en|volume=19|issue=3|pages=309–317|doi=10.1037/1040-3590.19.3.309|issn=1939-134X}}</ref>. [[w:Suicide|Suicide]] has an article on Wikipedia. === Suicidal Behavior === <br /> === Diagnostic criteria for NSSI === {{blockquotetop}} '''DSM-5 Criteria for NSSI''' * Nonsuicidal self-injury is currently a proposed disorder in need of further research in the ''Diagnostic and Statistical Manual of Mental Disorders'' (DSM-5)<ref name="DSM5" />. * The criteria for NSSI can be found under Conditions for Further Study in DSM-5. '''ICD-11 Criteria for NSSI''' Intentional self-inflicted injury to the body, most commonly cutting, scraping, burning, biting, or hitting, with the expectation that the injury will lead to only minor physical harm. * For ICD-11, self-injury or self-harm is cited as a symptom or sign that is not classified elsewhere {{blockquotebottom}} === Base rates of NSSI in different populations and clinical settings === This section describes the demographic setting of the population(s) sampled, base rates of diagnosis, country/region sampled and the diagnostic method that was used. Using this information, clinicians will be able to anchor the rate of the non-suicidal self injuries (NSSI) that they are likely to see in their clinical practice. * '''''To see prevalence rates across multiple disorders,''''' [[Evidence based assessment/Preparation phase#Base rates for transdiagnostic comparison|'''''click here.''''']] {| class="wikitable sortable" border="1" |- ! Demography !Setting ! Base Rate ! Diagnostic Method ! Reference !Best Recommended For |- | International | Young adult non-clinical sample | 13.4% | Meta-analysis, controlling for methodological differences across studies | Lifetime frequency; Swannell et al., 2014<ref name="SwannellEtAl2014" /> | |- | All of U.S.A. | Adult community sample | 23% | Self-report measure (questions based on proposed DSM-V criteria for NSSI Disorder; FASM) | Lifetime frequency; Andover, 2015<ref name=Andover2014/> | |- | North East | Adolescent inpatient sample | 50% | Self-report measure (ISAS), based on DSM-V criteria for NSSI Disorder | Lifetime frequency; Glenn & Klonsky, 2013<ref name="GlennKlonsky2013"/> | |- | Sweden | Adolescent community sample | 43.4% | Combined self-report measure (FASM) and interview (SITBI) | Lifetime frequency; Zetterqvist et al., 2013<ref name="ZetterqvistetAl2013"/> | |- | U.S.A. | Adult outpatient sample | 11.4% | Chart review, not based on DSM-V criteria | Lifetime frequency; Selby et al., 2012<ref name="SelbyEtAl2012"/> | |- | All of U.S.A. | Adolescent epidemiological | 13.0%-23.2% | Variable assessment methods | Lifetime frequency; Jacobson & Gould, 2007<ref name="Jacobson2007"/> | |- | North East | Adolescent non-clinical sample | 7.5% | Self-report measure | within the last year; Hilt et al., 2008<ref name="HiltEtAl2008"/> | |- | North East | Adolescent inpatient sample | 60% | Self-report measure (FASM) | lifetime frequency; Nock et al., 2006<ref name="NockEtAl2006"/> | |- | United Kingdom | Incarcerated sample | 52% | Self-report measure (FASM) | Gray et al., 2003 | |- |International |Adults from sexual minorities (LGBT) samples |36.53% |Various self-report questionnaires |Liu et al., 2019 | |} '''Search terms:''' [Non-suicidal self-injury or NSSI or Self harm] AND [children OR adolescents] AND [prevalence OR incidence OR epidemiological] in PsychInfo and Google Schola == [[Evidence based assessment/Prediction phase|'''Prediction phase''']] == === Comparison of screening measures === {{collapse top|Descriptions of types of NSSI screenings|expand=yes}} '''Differences between types of NSSI measures''' #''Omnibus Measures'' #* Assess several NSSI domains #* These tests are the most comprehensive compared to other measures #''Functional Measures'' #* Helpful for understanding why people self-injure #* These tests assess motives for, or functions of, NSSI #''Behavioral Measures'' #* Primarily assess one's history of NSSI behaviors #* These measures are useful for assessment methods used and NSSI frequency #''Brief Measures'' #* Include a single item or a few items to assess NSSI #* These may be best when conducting a brief assessment '''Recommendations''' * Omnibus measures are highly recommended over all other types of measures. **''The SITBI'' is the best clinical interview for assessing adolescent NSSI **''The SASII'' was designed to assess NSSI among adults. {{collapse bottom}} === Scope of screening instruments for NSSI === {{collapse top| Cross-screening component analysis|expand=yes}} {| class="wikitable sortable" border="1" |- !Category of Screening ! Instrument ! No. Items ! History ! Methods ! Frequency ! Lethality ! Intent of Functions ! History of Suicidality |- | '''''Omnibus''''' | Suicidal Behaviors Questionnaire (SBQ) | 90 |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] | | |[[File:Green check.png]] |- | '''''Omnibus''''' | Self-Harm Behavior Questionnaire (SHBQ) | 32 |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] | |[[File:Green check.png]] |- |<b>''Functional''</b> | Functional Assessment of Self-Mutilation (FASM) | 22 |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] | |- |<b>''Functional''</b> | Inventory of Statements About Self-Harm (ISAS) | 39 |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] | |[[File:Green check.png]] | |- |<b>''Functional''</b> | Self-Injury Questionnaire (SIQ) | 30 |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] |- |<b>''Functional''</b> | Self-Injury Motivation Scale (SIMS) | 35 | | | | |[[File:Green check.png]] | |- |<b>''Functional''</b> | Self-Harm Reasons Questionnaire (SHRQ) - Revised | 21 |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] | |[[File:Green check.png]] | |- |<b>''Behavioral''</b> | Deliberate Self-Harm Inventory (DSHI) | 17 |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] | | |- |<b>''Behavioral''</b> | Self-Harm Inventory (SHI) | 22 |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] | | |- |<b> ''Brief''</b> | Schedule for Nonadaptive and Adaptive Personality (SNAP) Items | 2 |[[File:Green check.png]] | | | | |[[File:Green check.png]] |- |<b> ''Brief''</b> | Trauma Symptom Inventory (TSI) Item | 1 |[[File:Green check.png]] | |[[File:Green check.png]] | | | |- |} * '''Note:''' SNAP has 375 items in the total measure; TSI has 100 items in the total measure. * '''Search terms:''' [Non-suicidal self-injury or NSSI or Self harm] AND [children OR adolescents] AND [assessment] in PsychINFO and Google ScholarTreatment * '''Sources consulted:''' Klonsky, E. D., & Lewis, S. P. (2014). Assessment of nonsuicidal self-injury. In M. K. Nock, M. K. Nock (Eds.), The Oxford handbook of suicide and self-injury (pp. 337-351). New York, NY, US: Oxford University Press.; Nock (Eds.), Understanding non-suicidal self-injury: Origins, assessment, and treatment. Washington, DC: Am. Psychol. Assoc. {{collapse bottom}} === Psychometric properties of screening instruments of NSSI === The following section contains a list of screening and diagnostic instruments for non-suicidal self-injury. The section includes administration information, psychometric data, and PDFs or links to the screenings. * Screenings are used as part of the [[Evidence based assessment/Prediction phase|prediction phase]] of assessment; for more information on interpretation of this data, or how screenings fit in to the assessment process, click [[Evidence based assessment/Prediction phase|here.]] * ''For a list of more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Psychometric_properties_of_common_screening_instruments '''click here.''']'' {| class="wikitable sortable" border="1" |- ! Instrument (Reference) !Type of screeening !Format (Reporter) !Age Range !Administration Time ! Internal Consistency ! Interrater Reliability ! Test-Retest Reliability ! Construct Validity ! Highly Recommended !Free and Accessible Measures |- | Suicidal Behaviors Questionnaire (SBQ) <ref name="Linehan1981" /> |<b>Omnibus</b> | | | | G | NA | A | G |[[File:Green check.png|link=https://en.wikiversity.org/wiki/File:Green%20check.png|alt=Yes]] | * [https://mfr.osf.io/render?url=https://osf.io/vg2sn/?action=download%26mode=render Printable PDF of SBQ] |- | Self-Harm Behavior Questionnaire (SHBQ) <ref name="GutierrezEtAl2001" /> |<b>Omnibus</b> | | | | G | NA | A | G | |Not free |- | Functional Assessment of Self-Mutilation (FASM)<ref name="LloydRichardsonEtAl1997" /> |<b> Functional</b> | | | | A | NA | U | A | | * [https://mfr.osf.io/render?url=https://osf.io/qps3v/?action=download%26mode=render Printable PDF of the FASM] |- |Inventory of Statements About Self-Harm (ISAS) <ref>http://www2.psych.ubc.ca/~klonsky/publications/ISASmeasure.pdf</ref> |<b> Functional</b> | | | | G | NA | G | G | | * [https://mfr.osf.io/render?url=https://osf.io/ntwkr/?action=download%26mode=render Printable PDF of ISAS] |- | Self-Injury Questionnaire (SIQ) <ref name="SantaMinaEtAl2006" /> ''*Not Free*'' |<b> Functional</b> | | | | G | NA | U | A | |Not free |- | Self-Injury Motivation Scale (SIMS)<ref name="OsuchEtAl1999" /> |<b> Functional</b> | | | | G | NA | U | A | | |- | Self-Harm Reasons Questionnaire (SHRQ) <ref name="LewisEtAl2008" /> |<b> Functional</b> | | | | G | NA | U | A | | |- | Deliberate Self-Harm Inventory (DSHI) <ref name="Gratz2001" /> |<b>Behavioral</b> | | | | G | NA | G | G | | |- | Self-Harm Inventory (SHI) |<b>Behavioral</b> | | | | A | NA | U | A | | |- | SNAP Items<ref name="Clark1996" /> |<b>Brief</b> | | | | NA | NA | U | A | | |- | Trauma Symptom Inventory (TSI) <ref name="Briere1995" /> |<b>Brief</b> | | | | NA | NA | U | A | | |- | Scale for Suicide Ideation (SSI) |<b>Other</b> | | | | G | U | U | G |[[File:Green check.png|link=https://en.wikiversity.org/wiki/File:Green%20check.png|alt=Yes]] | |- | Suicide Behaviors Interview (SBI) |<b>Other</b> | | | | E | E | U | A | | |- | Child Suicide Potential Scales (CSPS) |<b>Other</b> | | | | A | E | U | G |[[File:Green check.png|link=https://en.wikiversity.org/wiki/File:Green%20check.png|alt=Yes]] | |- | Beck Scale for Suicide Ideation (BSI) |<b>Other</b> | | | | E | NA | U | G |[[File:Green check.png|link=https://en.wikiversity.org/wiki/File:Green%20check.png|alt=Yes]] | |- | Suicide Behaviors Questionnaire for Children (SBQ-C) |<b>Other</b> | | | | G | NA | A | A | | |- | Suicide Ideation Questionnaire for Children (SIQ-JR) |<b>Other</b> | | | | G | NA | A | G |[[File:Green check.png|link=https://en.wikiversity.org/wiki/File:Green%20check.png|alt=Yes]] | |- | Suicide Probability Scale (SPS) |<b>Other</b> | | | | E | NA | U | A | | |- | Columbia Suicide Screen (CSS) |<b>Other</b> | | | | G | NA | L | A | | |- | Harkavy Asnis Suicide Scale (HASS) |<b>Other</b> | | | | E | NA | U | G | | |} '''Note:''' '''L''' = Less than adequate; '''A''' = Adequate; '''G''' = Good; '''E''' = Excellent; '''U''' = Unavailable; '''NA''' = Not applicable *<u>Sources consulted:</u> Klonsky, E. D., & Lewis, S. P. (2014). Assessment of nonsuicidal self-injury. In M. K. Nock, M. K. Nock (Eds.) , The Oxford handbook of suicide and self-injury (pp. 337-351). New York, NY, US: Oxford University Press.<ref name="KlonskyLewis2014" />; Nock (Eds.), Understanding non-suicidal self-injury: Origins, assessment, and treatment. Washington, DC: Am. Psychol. Assoc. === Likelihood ratios and AUCs of screening measures for NSSI === *''For a list of the likelihood ratios for more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Likelihood_ratios_and_AUCs_of_common_screening_instruments '''click here.''']'' {| class="wikitable sortable" |- ! Screening Measure (Primary Reference) !! AUC !! LR+ (score) !! LR- (score) !! Clinical Generalizability !Download |- |Child Behavior Checklist (CBCL) Anxious/Depressed Scale T-score<ref name="Achenbach1991">{{cite book|last1=Achenbach|first1=Thomas M.|title=Child behavior checklist for ages 4-18|date=1991|publisher=T.M. Achenbach|location=Burlington, VT|isbn=0938565087|edition=[11th print.]}}</ref>|| .70 (N=470) || 3.78 (60+) || .39 (<60) || High. Large diverse sample with mixed depression sample compared to samples without depression. |Not free |- |} === Interpreting NSSI screening measure scores === * For information on interpreting screening measure scores, click [[Evidence based assessment/Prediction phase#Interpreting screening measure scores|here.]] == [[Evidence based assessment/Prescription phase|'''Prescription phase''']] == ===Gold standard diagnostic interviews=== * For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews '''click here.'''] === Coverage of interviews for NSSI === {{collapse top| Scope of diagnostic interviews for NSSI|expand=yes}} {| class="wikitable sortable" border="1" |- ! Instrument ! No. Items ! History ! Methods ! Frequency ! Lethality ! Intent of Functions ! History of Suicidality |- | colspan="8" style="font-size:110%; text-align:center;" span |<b> Omnibus Measures </b> |- | Suicide Attempt Self-Injury Interview (SASII) | 31 | X | X | X | X | X | X |- | Self-Injurious Thoughts and Behaviors Interview (SITBI) | 169 | X | X | X | X | X | X |} {{collapse bottom}} === Recommended diagnostic instruments for NSSI === {| class="wikitable sortable" ! colspan="11" |Diagnostic instruments for '''NSSI''' ! |- !Instrument (Reference) !Type of screeening !Format (Reporter) !Age Range !Administration Time !Internal Consistency !Interrater Reliability !Test-Retest Reliability !Construct Validity !Content Validity !Highly Recommended !Free and Accessible Measures |- |Beck Scale for Suicidal Ideation (BSI) | |Self-report questionnaire |17+ |5-10 mins | |E | |A |G | |No * Link to purchase [https://www.pearsonclinical.com/psychology/products/100000157/beck-scale-for-suicide-ideation-bss.html] |- |Suicidal Behaviors Questionnaire-Revised (SBQ-R) | |Self-report |18+ |5-10 mins | | | |.87 E |E |Yes |[https://www.integration.samhsa.gov/images/res/SBQ.pdf SBQ-R] |- |Self-Harm Behavior Questionnaire (SHBQ) | |Self-report questionnaire |adolescents |Not Reported | |E | |G |G | | |- |Suicide Attempt Self-Injury Interview (SASII) <ref name="LinehanEtAl2006" /> |<b>Omnibus</b> | | | |G |E |E |G | |[[File:Green check.png|link=https://en.wikiversity.org/wiki/File:Green%20check.png]] |[https://mfr.osf.io/render?url=https://osf.io/zstnj/?action=download%26mode=render SASII] |- |Self Injurious Thoughts and Behaviors Interview (SITBI) <ref name="NockEtAl2007" /> |<b>Omnibus</b> | | | |NA |E |A |G | |[[File:Green check.png|link=https://en.wikiversity.org/wiki/File:Green%20check.png]] |[https://mfr.osf.io/render?url=https://osf.io/hw46c/?action=download%26mode=render SITBI] |- |Suicidal Ideation Questionnaire (SIQ) | |Self-report questionnaire |12-18 years old |10 minutes |NA | | | | | |[https://www.semel.ucla.edu/sites/default/files/pdf/SuicidalIdeationQuestionnaire%28SIQ%29%28Child%29.PDF SIQ] |- |Suicidal Ideation Questionnaire (SIQ-JR) | |Self-report Questionnaire |Middle School aged children |10 minutes |NA | |test-retest: r -0.93 (males) r = .87 (females) | | | |SIQ-[https://www.semel.ucla.edu/sites/default/files/pdf/SuicidalIdeationQuestionnaire%28SIQ%29%28Child%29.PDF JR] |} '''Note:''' '''L''' = Less than adequate; '''A''' = Adequate; '''G''' = Good; '''E''' = Excellent; '''U''' = Unavailable; '''NA''' = Not applicable == [[Evidence based assessment/Process phase|'''Process phase''']] == The following section contains a brief overview of treatment options for depression and list of process and outcome measures for non-suicidal self-injury. The section includes benchmarks based on published norms for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the [[Evidence based assessment/Process phase|process phase]] of assessment. For more information of differences between process and outcome measures, see the page on the [[Evidence based assessment/Process phase|process phase of assessment]]. === Process measures === {{blockquotetop}} {{blockquotebottom}} === Outcome and severity measures === * This table includes clinically significant benchmarks for NSSI specific outcome measures * Information on how to interpret this table can be [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase found here]. * Additionally, these [[Evidence based assessment/Vignettes|vignettes]] might be helpful resources for understanding appropriate adaptation of outcome measures in practice. *''<u>For clinically significant change benchmarks for the CBCL, YSR, and TRF total, externalizing, internalizing, and attention benchmarks,</u>'' [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase&wteswitched=1#Clinically_significant_change_benchmarks_for_widely-used_outcome_measures see here.] {| class="wikitable sortable" border="1" | colspan="8" |'''Clinically significant change benchmarks with common instruments for NSSI''' |- | rowspan="1&quot;" style="text-align:center;font-size:130%;" | <b> Measure</b> | style="text-align:center;font-size:130%;" | <b>Subscale</b> | colspan="3" style="text-align:center;font-size:130%" width="300" | <b> Cut-off scores</b> | colspan="3" style="text-align:center;font-size:120%" | <b> Critical Change <br> (unstandardized scores)</b> |- | colspan="8" span style="font-size:110%; text-align:center;" | <b> Benchmarks Based on Published Norms </b> |- | colspan="2" | | style="text-align:center;font-size:110%" | <b> A</b> | style="text-align:center;font-size:110%" | <b> B</b> | style="text-align:center;font-size:110%" | <b> C</b> | style="text-align:center;font-size:110%" | <b> 95%</b> | style="text-align:center;font-size:110%" | <b> 90%</b> | style="text-align:center;font-size:110%" | <b> SE_difference</b> |- | rowspan="1" style="text-align:center;" | | style="text-align:center;"| | style="text-align:center;"| | style="text-align:center;"| | style="text-align:center;"| | style="text-align:center;"| | style="text-align:center;"| | style="text-align:center;"| |- | rowspan="1" style="text-align:center;" | | style="text-align:right;" | | style="text-align:center;"| | style="text-align:center;"| | style="text-align:center;"| | style="text-align:center;"| | style="text-align:center;"| | style="text-align:center;"| |} === Treatment === * Please refer to the page on [[wikipedia:Nonsuicidal_self-injury_disorder|non-suicidal self injury]] for more information on available treatment for NSSI *Go to [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/self-injurious-thoughts-and-behaviors/ Effective Child Therapy] for a curated resource on effective treatments for NSSI. {{collapse top| Click here for information on treatment for NSSI}} According to Nock (2010)<ref name="Nock2010"/>, no treatment for NSSI could be considered "evidence-based." However, recent years have seen an increase in intervention trials for NSSI. Although limited due to lack of consistency in defining and measuring NSSI, this work could provide insight into potential best practices for treating this condition (Andover, 2015)<ref name=Andover2014/>. # '''Dialectical behavioral therapy (DBT)''' ## Dialectical Behavior Therapy has been shown to be effective in treating individuals with Borderline Personality Disorder (BPD) who engage in NSSI; however it has not been shown to be better than treatment as usual in a sample of individuals without BPD. In the absence of a better option, a DBT approach to treatment is the most evidence based. # '''Cognitive behavioral therapy (CBT)''' ## Few research studies have tested cognitive-behavioral therapy (CBT) as a treatment specifically for NSSI. However, some studies have evaluated the efficacy of CBT trials in treating self-injury with and without suicidal intent. Manual-assisted cognitive therapy (MACT) is a 6-session CBT intervention focusing on functions of deliberate self-harm, emotion regulation, problem-solving skills, and relapse prevention. MACT has demonstrated mixed results for decreasing NSSI frequency and severity among adults (Tyrer et al., 2003<ref name="TyrerEtAl2003" />; Weinberg, Gunderson, Hennen, & Cutter, 2006)<ref name="WeinbergEtAl2006" />. Although MACT may be a promising intervention (Muehlenkamp, 2006)<ref name="Muehlenkamp2006" />, it should be evaluated in future studies. In one adolescent treatment trial, the Adolescent Depression Antidepressant Psychotherapy Trial (ADAPT), a decrease in NSSI behaviors was found at post-treatment for both SSRI and SSRI+CBT groups (Goodyer et al., 2007)<ref name="GoodyerEtAl2007" />, although no differences were found between groups. In sum, findings from efficacy trials of CBT on NSSI outcomes are mixed, and more trials examining CBT as a treatment specifically for NSSI are needed. # '''Pharmacology''' ## Pharmacological interventions are especially scarce. However, one study found that fluoxetine was effective at reducing NSSI frequency in a sample of 22 adults with major depressive disorder and either BPD or schizotypal personality disorder (Markovitz et al, 1991)<ref name="MarkovitzEtAl1991" />. A second trial found that antidepressant medications alone (SSRIs and SNRIs) were as effective as medication plus CBT in reducing NSSI among adolescents with MDD (Brent et al., 2009<ref name="Brent2009" />; Goodyer et al., 2007)<ref name="GoodyerEtAl2007" />. Ziprasidone, an atypical antipsychotic, was found to be more effective in reducing NSSI behaviors among adolescents compared to another neuroleptic medication (Libal et al., 2005)<ref name="LibalEtAl2005" />. Clonidine has also been effective as an intervention for acute NSSI urges and feelings of tension among a sample of patients with BPD (Philipsen et al., 2004)<ref name="PhilipsenEtAl2004" />, although the long-term effects are unknown. # '''Prevention programs''' ## Jacobs, Walsh, McDade, and Pigeon (2009)<ref name="JacobsEtAl2009" /> developed the only known prevention program for NSSI, the Signs of Self-Injury program (SOSI). This school-based prevention program is designed to increase awareness about NSSI among adolescents through psychoeducation about warning signs and symptoms and improvement of help-seeking behaviors and attitudes. One test of effectiveness and acceptance found the program to be feasible and effective at changing attitudes toward NSSI and increasing help-seeking among students (Muehlenkamp et al., 2010)<ref name="MuehlenkampEtAl2010" />. {{collapse bottom}} == '''External resources''' == # [https://en.wikiversity.org/w/index.php?title=Helping_Give_Away_Psychological_Science/Resources/Annotated_List_of_Where_and_How_to_Find_a_Therapist&wteswitched=1#Other_low-cost_options Find-a-Therapist] (a curated list of find-a-therapist websites where you can find a provide #[http://www.selfinjury.bctr.cornell.edu/about-self-injury.html Cornell resource on self-injury] #Effective Child Therapy page for [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/self-injurious-thoughts-and-behaviors/ Self-Injurious Thoughts and Behaviors] ##Effective Child Therapy is website sponsored by Division 53 of the American Psychological Association (APA), or The [https://sccap53.org Society of Clinical Child and Adolescent Psychology (SCCAP)] (SCCAP), in collaboration with the Association for Behavioral and Cognitive Therapies (ABCT). Use for information on symptoms and available treatments. # [[wikipedia:Nonsuicidal_self-injury_disorder|Wikipedia page for non-suicidal self injury]] #[https://mhfa.com.au/sites/mhfa.com.au/files/MHFA_selfinjury_guidelinesA4%202014%20Revised_1.pdf Mental Health First Aid] page on non-suicidal self-injury == '''References''' == {{collapse top|Liu, R. T., Sheehan, A. E., Walsh, R. F., Sanzari, C. M., Cheek, S. M., & Hernandez, E. M. (2019). Prevalence and correlates of non-suicidal self-injury among lesbian, gay, bisexual, and transgender individuals: A systematic review and meta-analysis. 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M.|title=Suicides behaviors questionnaire|date=1981|publisher=University of Washington|location=Seattle}}</ref> <ref name="LloydRichardsonEtAl1997">{{cite journal|last1=Lloyd-Richardson|first1=E. E.|last2=Kelley|first2=M. L.|last3=Hope|first3=T.|title=Self-mutilation in a community sample of adolescents: Descriptive characteristics and provisional prevalence rates|journal=Poster session presented at the Annual Meeting of the Society for Behavioral Medicine|date=April 1997|location=New Orleans, LA}}</ref> <ref name="Muehlenkamp2006">{{cite journal|last1=Muehlenkamp|first1=J. J.|title=Empirically supported treatments and general therapy guidelines for non-suicidal self-injury|journal=Journal of Mental Health Counseling|date=2006|volume=28|pages=166-185}}</ref> }} {{collapse bottom}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] cb1asytbo8d6jca250hteb4mo80kpw9 2419214 2419213 2022-08-26T02:53:54Z Ardenguo 2944162 /* Treatment */ Made the collapsible box expanded by default wikitext text/x-wiki <noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{medical disclaimer}} {{:{{BASEPAGENAME}}/Sidebar}} ==[[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio"?''']]== * For background information on what assessment portfolios are, click the link in the heading above. * Want even 'more' information about this topic? There's an extended version of this page [[Evidence-based assessment/Self harm (assessment portfolio)/extended version|here]]. ==[[Evidence based assessment/Preparation phase|'''Preparation phase''']]== It is important to recognize that measures of suicide-related thoughts and behaviors (i.e., suicidal ideation) and non-suicidal self injury (NSSI) are measure distinct constructs. NSSI items often specify a behavior with clarification that the behavior was not undertaken with intent of suicide. This distinction is important when identifying which measure to use to evaluate a client. === Suicidal Ideation === Self-Injurious Thoughts and Behaviors Interview<ref>{{Cite journal|last=Nock|first=Matthew K.|last2=Holmberg|first2=Elizabeth B.|last3=Photos|first3=Valerie I.|last4=Michel|first4=Bethany D.|date=2007|title=Self-Injurious Thoughts and Behaviors Interview: Development, reliability, and validity in an adolescent sample.|url=http://doi.apa.org/getdoi.cfm?doi=10.1037/1040-3590.19.3.309|journal=Psychological Assessment|language=en|volume=19|issue=3|pages=309–317|doi=10.1037/1040-3590.19.3.309|issn=1939-134X}}</ref>. [[w:Suicide|Suicide]] has an article on Wikipedia. === Suicidal Behavior === <br /> === Diagnostic criteria for NSSI === {{blockquotetop}} '''DSM-5 Criteria for NSSI''' * Nonsuicidal self-injury is currently a proposed disorder in need of further research in the ''Diagnostic and Statistical Manual of Mental Disorders'' (DSM-5)<ref name="DSM5" />. * The criteria for NSSI can be found under Conditions for Further Study in DSM-5. '''ICD-11 Criteria for NSSI''' Intentional self-inflicted injury to the body, most commonly cutting, scraping, burning, biting, or hitting, with the expectation that the injury will lead to only minor physical harm. * For ICD-11, self-injury or self-harm is cited as a symptom or sign that is not classified elsewhere {{blockquotebottom}} === Base rates of NSSI in different populations and clinical settings === This section describes the demographic setting of the population(s) sampled, base rates of diagnosis, country/region sampled and the diagnostic method that was used. Using this information, clinicians will be able to anchor the rate of the non-suicidal self injuries (NSSI) that they are likely to see in their clinical practice. * '''''To see prevalence rates across multiple disorders,''''' [[Evidence based assessment/Preparation phase#Base rates for transdiagnostic comparison|'''''click here.''''']] {| class="wikitable sortable" border="1" |- ! Demography !Setting ! Base Rate ! Diagnostic Method ! Reference !Best Recommended For |- | International | Young adult non-clinical sample | 13.4% | Meta-analysis, controlling for methodological differences across studies | Lifetime frequency; Swannell et al., 2014<ref name="SwannellEtAl2014" /> | |- | All of U.S.A. | Adult community sample | 23% | Self-report measure (questions based on proposed DSM-V criteria for NSSI Disorder; FASM) | Lifetime frequency; Andover, 2015<ref name=Andover2014/> | |- | North East | Adolescent inpatient sample | 50% | Self-report measure (ISAS), based on DSM-V criteria for NSSI Disorder | Lifetime frequency; Glenn & Klonsky, 2013<ref name="GlennKlonsky2013"/> | |- | Sweden | Adolescent community sample | 43.4% | Combined self-report measure (FASM) and interview (SITBI) | Lifetime frequency; Zetterqvist et al., 2013<ref name="ZetterqvistetAl2013"/> | |- | U.S.A. | Adult outpatient sample | 11.4% | Chart review, not based on DSM-V criteria | Lifetime frequency; Selby et al., 2012<ref name="SelbyEtAl2012"/> | |- | All of U.S.A. | Adolescent epidemiological | 13.0%-23.2% | Variable assessment methods | Lifetime frequency; Jacobson & Gould, 2007<ref name="Jacobson2007"/> | |- | North East | Adolescent non-clinical sample | 7.5% | Self-report measure | within the last year; Hilt et al., 2008<ref name="HiltEtAl2008"/> | |- | North East | Adolescent inpatient sample | 60% | Self-report measure (FASM) | lifetime frequency; Nock et al., 2006<ref name="NockEtAl2006"/> | |- | United Kingdom | Incarcerated sample | 52% | Self-report measure (FASM) | Gray et al., 2003 | |- |International |Adults from sexual minorities (LGBT) samples |36.53% |Various self-report questionnaires |Liu et al., 2019 | |} '''Search terms:''' [Non-suicidal self-injury or NSSI or Self harm] AND [children OR adolescents] AND [prevalence OR incidence OR epidemiological] in PsychInfo and Google Schola == [[Evidence based assessment/Prediction phase|'''Prediction phase''']] == === Comparison of screening measures === {{collapse top|Descriptions of types of NSSI screenings|expand=yes}} '''Differences between types of NSSI measures''' #''Omnibus Measures'' #* Assess several NSSI domains #* These tests are the most comprehensive compared to other measures #''Functional Measures'' #* Helpful for understanding why people self-injure #* These tests assess motives for, or functions of, NSSI #''Behavioral Measures'' #* Primarily assess one's history of NSSI behaviors #* These measures are useful for assessment methods used and NSSI frequency #''Brief Measures'' #* Include a single item or a few items to assess NSSI #* These may be best when conducting a brief assessment '''Recommendations''' * Omnibus measures are highly recommended over all other types of measures. **''The SITBI'' is the best clinical interview for assessing adolescent NSSI **''The SASII'' was designed to assess NSSI among adults. {{collapse bottom}} === Scope of screening instruments for NSSI === {{collapse top| Cross-screening component analysis|expand=yes}} {| class="wikitable sortable" border="1" |- !Category of Screening ! Instrument ! No. Items ! History ! Methods ! Frequency ! Lethality ! Intent of Functions ! History of Suicidality |- | '''''Omnibus''''' | Suicidal Behaviors Questionnaire (SBQ) | 90 |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] | | |[[File:Green check.png]] |- | '''''Omnibus''''' | Self-Harm Behavior Questionnaire (SHBQ) | 32 |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] | |[[File:Green check.png]] |- |<b>''Functional''</b> | Functional Assessment of Self-Mutilation (FASM) | 22 |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] | |- |<b>''Functional''</b> | Inventory of Statements About Self-Harm (ISAS) | 39 |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] | |[[File:Green check.png]] | |- |<b>''Functional''</b> | Self-Injury Questionnaire (SIQ) | 30 |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] |- |<b>''Functional''</b> | Self-Injury Motivation Scale (SIMS) | 35 | | | | |[[File:Green check.png]] | |- |<b>''Functional''</b> | Self-Harm Reasons Questionnaire (SHRQ) - Revised | 21 |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] | |[[File:Green check.png]] | |- |<b>''Behavioral''</b> | Deliberate Self-Harm Inventory (DSHI) | 17 |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] | | |- |<b>''Behavioral''</b> | Self-Harm Inventory (SHI) | 22 |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] | | |- |<b> ''Brief''</b> | Schedule for Nonadaptive and Adaptive Personality (SNAP) Items | 2 |[[File:Green check.png]] | | | | |[[File:Green check.png]] |- |<b> ''Brief''</b> | Trauma Symptom Inventory (TSI) Item | 1 |[[File:Green check.png]] | |[[File:Green check.png]] | | | |- |} * '''Note:''' SNAP has 375 items in the total measure; TSI has 100 items in the total measure. * '''Search terms:''' [Non-suicidal self-injury or NSSI or Self harm] AND [children OR adolescents] AND [assessment] in PsychINFO and Google ScholarTreatment * '''Sources consulted:''' Klonsky, E. D., & Lewis, S. P. (2014). Assessment of nonsuicidal self-injury. In M. K. Nock, M. K. Nock (Eds.), The Oxford handbook of suicide and self-injury (pp. 337-351). New York, NY, US: Oxford University Press.; Nock (Eds.), Understanding non-suicidal self-injury: Origins, assessment, and treatment. Washington, DC: Am. Psychol. Assoc. {{collapse bottom}} === Psychometric properties of screening instruments of NSSI === The following section contains a list of screening and diagnostic instruments for non-suicidal self-injury. The section includes administration information, psychometric data, and PDFs or links to the screenings. * Screenings are used as part of the [[Evidence based assessment/Prediction phase|prediction phase]] of assessment; for more information on interpretation of this data, or how screenings fit in to the assessment process, click [[Evidence based assessment/Prediction phase|here.]] * ''For a list of more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Psychometric_properties_of_common_screening_instruments '''click here.''']'' {| class="wikitable sortable" border="1" |- ! Instrument (Reference) !Type of screeening !Format (Reporter) !Age Range !Administration Time ! Internal Consistency ! Interrater Reliability ! Test-Retest Reliability ! Construct Validity ! Highly Recommended !Free and Accessible Measures |- | Suicidal Behaviors Questionnaire (SBQ) <ref name="Linehan1981" /> |<b>Omnibus</b> | | | | G | NA | A | G |[[File:Green check.png|link=https://en.wikiversity.org/wiki/File:Green%20check.png|alt=Yes]] | * [https://mfr.osf.io/render?url=https://osf.io/vg2sn/?action=download%26mode=render Printable PDF of SBQ] |- | Self-Harm Behavior Questionnaire (SHBQ) <ref name="GutierrezEtAl2001" /> |<b>Omnibus</b> | | | | G | NA | A | G | |Not free |- | Functional Assessment of Self-Mutilation (FASM)<ref name="LloydRichardsonEtAl1997" /> |<b> Functional</b> | | | | A | NA | U | A | | * [https://mfr.osf.io/render?url=https://osf.io/qps3v/?action=download%26mode=render Printable PDF of the FASM] |- |Inventory of Statements About Self-Harm (ISAS) <ref>http://www2.psych.ubc.ca/~klonsky/publications/ISASmeasure.pdf</ref> |<b> Functional</b> | | | | G | NA | G | G | | * [https://mfr.osf.io/render?url=https://osf.io/ntwkr/?action=download%26mode=render Printable PDF of ISAS] |- | Self-Injury Questionnaire (SIQ) <ref name="SantaMinaEtAl2006" /> ''*Not Free*'' |<b> Functional</b> | | | | G | NA | U | A | |Not free |- | Self-Injury Motivation Scale (SIMS)<ref name="OsuchEtAl1999" /> |<b> Functional</b> | | | | G | NA | U | A | | |- | Self-Harm Reasons Questionnaire (SHRQ) <ref name="LewisEtAl2008" /> |<b> Functional</b> | | | | G | NA | U | A | | |- | Deliberate Self-Harm Inventory (DSHI) <ref name="Gratz2001" /> |<b>Behavioral</b> | | | | G | NA | G | G | | |- | Self-Harm Inventory (SHI) |<b>Behavioral</b> | | | | A | NA | U | A | | |- | SNAP Items<ref name="Clark1996" /> |<b>Brief</b> | | | | NA | NA | U | A | | |- | Trauma Symptom Inventory (TSI) <ref name="Briere1995" /> |<b>Brief</b> | | | | NA | NA | U | A | | |- | Scale for Suicide Ideation (SSI) |<b>Other</b> | | | | G | U | U | G |[[File:Green check.png|link=https://en.wikiversity.org/wiki/File:Green%20check.png|alt=Yes]] | |- | Suicide Behaviors Interview (SBI) |<b>Other</b> | | | | E | E | U | A | | |- | Child Suicide Potential Scales (CSPS) |<b>Other</b> | | | | A | E | U | G |[[File:Green check.png|link=https://en.wikiversity.org/wiki/File:Green%20check.png|alt=Yes]] | |- | Beck Scale for Suicide Ideation (BSI) |<b>Other</b> | | | | E | NA | U | G |[[File:Green check.png|link=https://en.wikiversity.org/wiki/File:Green%20check.png|alt=Yes]] | |- | Suicide Behaviors Questionnaire for Children (SBQ-C) |<b>Other</b> | | | | G | NA | A | A | | |- | Suicide Ideation Questionnaire for Children (SIQ-JR) |<b>Other</b> | | | | G | NA | A | G |[[File:Green check.png|link=https://en.wikiversity.org/wiki/File:Green%20check.png|alt=Yes]] | |- | Suicide Probability Scale (SPS) |<b>Other</b> | | | | E | NA | U | A | | |- | Columbia Suicide Screen (CSS) |<b>Other</b> | | | | G | NA | L | A | | |- | Harkavy Asnis Suicide Scale (HASS) |<b>Other</b> | | | | E | NA | U | G | | |} '''Note:''' '''L''' = Less than adequate; '''A''' = Adequate; '''G''' = Good; '''E''' = Excellent; '''U''' = Unavailable; '''NA''' = Not applicable *<u>Sources consulted:</u> Klonsky, E. D., & Lewis, S. P. (2014). Assessment of nonsuicidal self-injury. In M. K. Nock, M. K. Nock (Eds.) , The Oxford handbook of suicide and self-injury (pp. 337-351). New York, NY, US: Oxford University Press.<ref name="KlonskyLewis2014" />; Nock (Eds.), Understanding non-suicidal self-injury: Origins, assessment, and treatment. Washington, DC: Am. Psychol. Assoc. === Likelihood ratios and AUCs of screening measures for NSSI === *''For a list of the likelihood ratios for more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Likelihood_ratios_and_AUCs_of_common_screening_instruments '''click here.''']'' {| class="wikitable sortable" |- ! Screening Measure (Primary Reference) !! AUC !! LR+ (score) !! LR- (score) !! Clinical Generalizability !Download |- |Child Behavior Checklist (CBCL) Anxious/Depressed Scale T-score<ref name="Achenbach1991">{{cite book|last1=Achenbach|first1=Thomas M.|title=Child behavior checklist for ages 4-18|date=1991|publisher=T.M. Achenbach|location=Burlington, VT|isbn=0938565087|edition=[11th print.]}}</ref>|| .70 (N=470) || 3.78 (60+) || .39 (<60) || High. Large diverse sample with mixed depression sample compared to samples without depression. |Not free |- |} === Interpreting NSSI screening measure scores === * For information on interpreting screening measure scores, click [[Evidence based assessment/Prediction phase#Interpreting screening measure scores|here.]] == [[Evidence based assessment/Prescription phase|'''Prescription phase''']] == ===Gold standard diagnostic interviews=== * For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews '''click here.'''] === Coverage of interviews for NSSI === {{collapse top| Scope of diagnostic interviews for NSSI|expand=yes}} {| class="wikitable sortable" border="1" |- ! Instrument ! No. Items ! History ! Methods ! Frequency ! Lethality ! Intent of Functions ! History of Suicidality |- | colspan="8" style="font-size:110%; text-align:center;" span |<b> Omnibus Measures </b> |- | Suicide Attempt Self-Injury Interview (SASII) | 31 | X | X | X | X | X | X |- | Self-Injurious Thoughts and Behaviors Interview (SITBI) | 169 | X | X | X | X | X | X |} {{collapse bottom}} === Recommended diagnostic instruments for NSSI === {| class="wikitable sortable" ! colspan="11" |Diagnostic instruments for '''NSSI''' ! |- !Instrument (Reference) !Type of screeening !Format (Reporter) !Age Range !Administration Time !Internal Consistency !Interrater Reliability !Test-Retest Reliability !Construct Validity !Content Validity !Highly Recommended !Free and Accessible Measures |- |Beck Scale for Suicidal Ideation (BSI) | |Self-report questionnaire |17+ |5-10 mins | |E | |A |G | |No * Link to purchase [https://www.pearsonclinical.com/psychology/products/100000157/beck-scale-for-suicide-ideation-bss.html] |- |Suicidal Behaviors Questionnaire-Revised (SBQ-R) | |Self-report |18+ |5-10 mins | | | |.87 E |E |Yes |[https://www.integration.samhsa.gov/images/res/SBQ.pdf SBQ-R] |- |Self-Harm Behavior Questionnaire (SHBQ) | |Self-report questionnaire |adolescents |Not Reported | |E | |G |G | | |- |Suicide Attempt Self-Injury Interview (SASII) <ref name="LinehanEtAl2006" /> |<b>Omnibus</b> | | | |G |E |E |G | |[[File:Green check.png|link=https://en.wikiversity.org/wiki/File:Green%20check.png]] |[https://mfr.osf.io/render?url=https://osf.io/zstnj/?action=download%26mode=render SASII] |- |Self Injurious Thoughts and Behaviors Interview (SITBI) <ref name="NockEtAl2007" /> |<b>Omnibus</b> | | | |NA |E |A |G | |[[File:Green check.png|link=https://en.wikiversity.org/wiki/File:Green%20check.png]] |[https://mfr.osf.io/render?url=https://osf.io/hw46c/?action=download%26mode=render SITBI] |- |Suicidal Ideation Questionnaire (SIQ) | |Self-report questionnaire |12-18 years old |10 minutes |NA | | | | | |[https://www.semel.ucla.edu/sites/default/files/pdf/SuicidalIdeationQuestionnaire%28SIQ%29%28Child%29.PDF SIQ] |- |Suicidal Ideation Questionnaire (SIQ-JR) | |Self-report Questionnaire |Middle School aged children |10 minutes |NA | |test-retest: r -0.93 (males) r = .87 (females) | | | |SIQ-[https://www.semel.ucla.edu/sites/default/files/pdf/SuicidalIdeationQuestionnaire%28SIQ%29%28Child%29.PDF JR] |} '''Note:''' '''L''' = Less than adequate; '''A''' = Adequate; '''G''' = Good; '''E''' = Excellent; '''U''' = Unavailable; '''NA''' = Not applicable == [[Evidence based assessment/Process phase|'''Process phase''']] == The following section contains a brief overview of treatment options for depression and list of process and outcome measures for non-suicidal self-injury. The section includes benchmarks based on published norms for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the [[Evidence based assessment/Process phase|process phase]] of assessment. For more information of differences between process and outcome measures, see the page on the [[Evidence based assessment/Process phase|process phase of assessment]]. === Process measures === {{blockquotetop}} {{blockquotebottom}} === Outcome and severity measures === * This table includes clinically significant benchmarks for NSSI specific outcome measures * Information on how to interpret this table can be [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase found here]. * Additionally, these [[Evidence based assessment/Vignettes|vignettes]] might be helpful resources for understanding appropriate adaptation of outcome measures in practice. *''<u>For clinically significant change benchmarks for the CBCL, YSR, and TRF total, externalizing, internalizing, and attention benchmarks,</u>'' [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase&wteswitched=1#Clinically_significant_change_benchmarks_for_widely-used_outcome_measures see here.] {| class="wikitable sortable" border="1" | colspan="8" |'''Clinically significant change benchmarks with common instruments for NSSI''' |- | rowspan="1&quot;" style="text-align:center;font-size:130%;" | <b> Measure</b> | style="text-align:center;font-size:130%;" | <b>Subscale</b> | colspan="3" style="text-align:center;font-size:130%" width="300" | <b> Cut-off scores</b> | colspan="3" style="text-align:center;font-size:120%" | <b> Critical Change <br> (unstandardized scores)</b> |- | colspan="8" span style="font-size:110%; text-align:center;" | <b> Benchmarks Based on Published Norms </b> |- | colspan="2" | | style="text-align:center;font-size:110%" | <b> A</b> | style="text-align:center;font-size:110%" | <b> B</b> | style="text-align:center;font-size:110%" | <b> C</b> | style="text-align:center;font-size:110%" | <b> 95%</b> | style="text-align:center;font-size:110%" | <b> 90%</b> | style="text-align:center;font-size:110%" | <b> SE_difference</b> |- | rowspan="1" style="text-align:center;" | | style="text-align:center;"| | style="text-align:center;"| | style="text-align:center;"| | style="text-align:center;"| | style="text-align:center;"| | style="text-align:center;"| | style="text-align:center;"| |- | rowspan="1" style="text-align:center;" | | style="text-align:right;" | | style="text-align:center;"| | style="text-align:center;"| | style="text-align:center;"| | style="text-align:center;"| | style="text-align:center;"| | style="text-align:center;"| |} === Treatment === * Please refer to the page on [[wikipedia:Nonsuicidal_self-injury_disorder|non-suicidal self injury]] for more information on available treatment for NSSI *Go to [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/self-injurious-thoughts-and-behaviors/ Effective Child Therapy] for a curated resource on effective treatments for NSSI. {{collapse top| Information on treatment for NSSI|expand=yes}} According to Nock (2010)<ref name="Nock2010"/>, no treatment for NSSI could be considered "evidence-based." However, recent years have seen an increase in intervention trials for NSSI. Although limited due to lack of consistency in defining and measuring NSSI, this work could provide insight into potential best practices for treating this condition (Andover, 2015)<ref name=Andover2014/>. # '''Dialectical behavioral therapy (DBT)''' ## Dialectical Behavior Therapy has been shown to be effective in treating individuals with Borderline Personality Disorder (BPD) who engage in NSSI; however it has not been shown to be better than treatment as usual in a sample of individuals without BPD. In the absence of a better option, a DBT approach to treatment is the most evidence based. # '''Cognitive behavioral therapy (CBT)''' ## Few research studies have tested cognitive-behavioral therapy (CBT) as a treatment specifically for NSSI. However, some studies have evaluated the efficacy of CBT trials in treating self-injury with and without suicidal intent. Manual-assisted cognitive therapy (MACT) is a 6-session CBT intervention focusing on functions of deliberate self-harm, emotion regulation, problem-solving skills, and relapse prevention. MACT has demonstrated mixed results for decreasing NSSI frequency and severity among adults (Tyrer et al., 2003<ref name="TyrerEtAl2003" />; Weinberg, Gunderson, Hennen, & Cutter, 2006)<ref name="WeinbergEtAl2006" />. Although MACT may be a promising intervention (Muehlenkamp, 2006)<ref name="Muehlenkamp2006" />, it should be evaluated in future studies. In one adolescent treatment trial, the Adolescent Depression Antidepressant Psychotherapy Trial (ADAPT), a decrease in NSSI behaviors was found at post-treatment for both SSRI and SSRI+CBT groups (Goodyer et al., 2007)<ref name="GoodyerEtAl2007" />, although no differences were found between groups. In sum, findings from efficacy trials of CBT on NSSI outcomes are mixed, and more trials examining CBT as a treatment specifically for NSSI are needed. # '''Pharmacology''' ## Pharmacological interventions are especially scarce. However, one study found that fluoxetine was effective at reducing NSSI frequency in a sample of 22 adults with major depressive disorder and either BPD or schizotypal personality disorder (Markovitz et al, 1991)<ref name="MarkovitzEtAl1991" />. A second trial found that antidepressant medications alone (SSRIs and SNRIs) were as effective as medication plus CBT in reducing NSSI among adolescents with MDD (Brent et al., 2009<ref name="Brent2009" />; Goodyer et al., 2007)<ref name="GoodyerEtAl2007" />. Ziprasidone, an atypical antipsychotic, was found to be more effective in reducing NSSI behaviors among adolescents compared to another neuroleptic medication (Libal et al., 2005)<ref name="LibalEtAl2005" />. Clonidine has also been effective as an intervention for acute NSSI urges and feelings of tension among a sample of patients with BPD (Philipsen et al., 2004)<ref name="PhilipsenEtAl2004" />, although the long-term effects are unknown. # '''Prevention programs''' ## Jacobs, Walsh, McDade, and Pigeon (2009)<ref name="JacobsEtAl2009" /> developed the only known prevention program for NSSI, the Signs of Self-Injury program (SOSI). This school-based prevention program is designed to increase awareness about NSSI among adolescents through psychoeducation about warning signs and symptoms and improvement of help-seeking behaviors and attitudes. One test of effectiveness and acceptance found the program to be feasible and effective at changing attitudes toward NSSI and increasing help-seeking among students (Muehlenkamp et al., 2010)<ref name="MuehlenkampEtAl2010" />. {{collapse bottom}} == '''External resources''' == # [https://en.wikiversity.org/w/index.php?title=Helping_Give_Away_Psychological_Science/Resources/Annotated_List_of_Where_and_How_to_Find_a_Therapist&wteswitched=1#Other_low-cost_options Find-a-Therapist] (a curated list of find-a-therapist websites where you can find a provide #[http://www.selfinjury.bctr.cornell.edu/about-self-injury.html Cornell resource on self-injury] #Effective Child Therapy page for [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/self-injurious-thoughts-and-behaviors/ Self-Injurious Thoughts and Behaviors] ##Effective Child Therapy is website sponsored by Division 53 of the American Psychological Association (APA), or The [https://sccap53.org Society of Clinical Child and Adolescent Psychology (SCCAP)] (SCCAP), in collaboration with the Association for Behavioral and Cognitive Therapies (ABCT). Use for information on symptoms and available treatments. # [[wikipedia:Nonsuicidal_self-injury_disorder|Wikipedia page for non-suicidal self injury]] #[https://mhfa.com.au/sites/mhfa.com.au/files/MHFA_selfinjury_guidelinesA4%202014%20Revised_1.pdf Mental Health First Aid] page on non-suicidal self-injury == '''References''' == {{collapse top|Liu, R. T., Sheehan, A. E., Walsh, R. F., Sanzari, C. M., Cheek, S. M., & Hernandez, E. M. (2019). Prevalence and correlates of non-suicidal self-injury among lesbian, gay, bisexual, and transgender individuals: A systematic review and meta-analysis. 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Treatment of Self-Injurious Behavior in Adolescent Females|journal=Child and Adolescent Psychopharmacology News|date=June 2005|volume=10|issue=4|pages=1–6|doi=10.1521/capn.2005.10.4.1}}</ref> <ref name="PhilipsenEtAl2004">{{cite journal|last1=Philipsen|first1=A|last2=Richter|first2=H|last3=Schmahl|first3=C|last4=Peters|first4=J|last5=Rüsch|first5=N|last6=Bohus|first6=M|last7=Lieb|first7=K|title=Clonidine in acute aversive inner tension and self-injurious behavior in female patients with borderline personality disorder.|journal=The Journal of clinical psychiatry|date=October 2004|volume=65|issue=10|pages=1414-9|pmid=15491247}}</ref> <ref name="MuehlenkampEtAl2010">{{cite journal|last1=Muehlenkamp|first1=JJ|last2=Walsh|first2=BW|last3=McDade|first3=M|title=Preventing non-suicidal self-injury in adolescents: the signs of self-injury program.|journal=Journal of youth and adolescence|date=March 2010|volume=39|issue=3|pages=306-14|pmid=19756992}}</ref> <ref name="NockEtAl2007">{{cite journal|last1=Nock|first1=MK|last2=Holmberg|first2=EB|last3=Photos|first3=VI|last4=Michel|first4=BD|title=Self-Injurious Thoughts and Behaviors Interview: development, reliability, and validity in an adolescent sample.|journal=Psychological assessment|date=September 2007|volume=19|issue=3|pages=309-17|pmid=17845122}}</ref> <ref name="Gratz2001">{{cite journal|last1=Gratz|first1=K. L.|title=Measurement of deliberate self-harm: Preliminary data on the deliberate self-harm inventory|journal=Journal of Psychopathology and Behavioral Assessment|date=4 December 2001|volume=23|issue=4|pages=253-263|doi=0882-2689/01/1200-0253/0}}</ref> <ref name="DSM5">{{cite book|last1=American Psychiatry Association|title=Diagnostic and statistical manual of mental disorders : DSM-5|date=2013|publisher=American Psychiatric Publishing|location=Washington [etc.]|isbn=9780890425558|edition=5th}}</ref> <ref name="Briere1995">{{cite book|last1=Briere|first1=J|title=Trauma symptom inventory (TSI) professional manual.|date=1995|publisher=Psychological Assessment Resources|location=Odessa, FL}}</ref> <ref name="Clark1996">{{cite book|last1=Clark|first1=L. A.|title=Schedule for adaptive and nonadaptive personality: Manual for administration, scoring, and interpretation|date=1996|publisher=University of Minnesota Press|location=Minneapolis}}</ref> <ref name="JacobsEtAl2009">{{cite book|last1=Jacobs|first1=D|last2=Walsh|first2=B. W.|last3=McCade|first3=M|last4=Pigeon|first4=S|title=Signs of self-injury prevention manual|date=2009|publisher=Screening for Mental Health|location=Wellesley Hills, MA}}</ref> <ref name="KlonskyLewis2014">{{cite book|last1=Klonsky|first1=E. D.|last2=Lewis|first2=S. P.|editor1-last=Nock|editor1-first=M. K.|title=The Oxford handbook of suicide and self-injury|date=2013|publisher=Oxford University Press|location=New York|isbn=9780195388565|pages=337-351|chapter=Assessment of nonsuicidal self-injury}}</ref> <ref name="Linehan1981">{{cite book|last1=Linehan|first1=M. M.|title=Suicides behaviors questionnaire|date=1981|publisher=University of Washington|location=Seattle}}</ref> <ref name="LloydRichardsonEtAl1997">{{cite journal|last1=Lloyd-Richardson|first1=E. E.|last2=Kelley|first2=M. L.|last3=Hope|first3=T.|title=Self-mutilation in a community sample of adolescents: Descriptive characteristics and provisional prevalence rates|journal=Poster session presented at the Annual Meeting of the Society for Behavioral Medicine|date=April 1997|location=New Orleans, LA}}</ref> <ref name="Muehlenkamp2006">{{cite journal|last1=Muehlenkamp|first1=J. J.|title=Empirically supported treatments and general therapy guidelines for non-suicidal self-injury|journal=Journal of Mental Health Counseling|date=2006|volume=28|pages=166-185}}</ref> }} {{collapse bottom}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] c3jwnnx8f3gh6mu78o6q8dl3hot37n2 2419217 2419214 2022-08-26T02:56:37Z Ardenguo 2944162 /* References */ Made the references box expanded by default, the first citation was treated like the title of the box so I changed the title of the box to "References" wikitext text/x-wiki <noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{medical disclaimer}} {{:{{BASEPAGENAME}}/Sidebar}} ==[[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio"?''']]== * For background information on what assessment portfolios are, click the link in the heading above. * Want even 'more' information about this topic? There's an extended version of this page [[Evidence-based assessment/Self harm (assessment portfolio)/extended version|here]]. ==[[Evidence based assessment/Preparation phase|'''Preparation phase''']]== It is important to recognize that measures of suicide-related thoughts and behaviors (i.e., suicidal ideation) and non-suicidal self injury (NSSI) are measure distinct constructs. NSSI items often specify a behavior with clarification that the behavior was not undertaken with intent of suicide. This distinction is important when identifying which measure to use to evaluate a client. === Suicidal Ideation === Self-Injurious Thoughts and Behaviors Interview<ref>{{Cite journal|last=Nock|first=Matthew K.|last2=Holmberg|first2=Elizabeth B.|last3=Photos|first3=Valerie I.|last4=Michel|first4=Bethany D.|date=2007|title=Self-Injurious Thoughts and Behaviors Interview: Development, reliability, and validity in an adolescent sample.|url=http://doi.apa.org/getdoi.cfm?doi=10.1037/1040-3590.19.3.309|journal=Psychological Assessment|language=en|volume=19|issue=3|pages=309–317|doi=10.1037/1040-3590.19.3.309|issn=1939-134X}}</ref>. [[w:Suicide|Suicide]] has an article on Wikipedia. === Suicidal Behavior === <br /> === Diagnostic criteria for NSSI === {{blockquotetop}} '''DSM-5 Criteria for NSSI''' * Nonsuicidal self-injury is currently a proposed disorder in need of further research in the ''Diagnostic and Statistical Manual of Mental Disorders'' (DSM-5)<ref name="DSM5" />. * The criteria for NSSI can be found under Conditions for Further Study in DSM-5. '''ICD-11 Criteria for NSSI''' Intentional self-inflicted injury to the body, most commonly cutting, scraping, burning, biting, or hitting, with the expectation that the injury will lead to only minor physical harm. * For ICD-11, self-injury or self-harm is cited as a symptom or sign that is not classified elsewhere {{blockquotebottom}} === Base rates of NSSI in different populations and clinical settings === This section describes the demographic setting of the population(s) sampled, base rates of diagnosis, country/region sampled and the diagnostic method that was used. Using this information, clinicians will be able to anchor the rate of the non-suicidal self injuries (NSSI) that they are likely to see in their clinical practice. * '''''To see prevalence rates across multiple disorders,''''' [[Evidence based assessment/Preparation phase#Base rates for transdiagnostic comparison|'''''click here.''''']] {| class="wikitable sortable" border="1" |- ! Demography !Setting ! Base Rate ! Diagnostic Method ! Reference !Best Recommended For |- | International | Young adult non-clinical sample | 13.4% | Meta-analysis, controlling for methodological differences across studies | Lifetime frequency; Swannell et al., 2014<ref name="SwannellEtAl2014" /> | |- | All of U.S.A. | Adult community sample | 23% | Self-report measure (questions based on proposed DSM-V criteria for NSSI Disorder; FASM) | Lifetime frequency; Andover, 2015<ref name=Andover2014/> | |- | North East | Adolescent inpatient sample | 50% | Self-report measure (ISAS), based on DSM-V criteria for NSSI Disorder | Lifetime frequency; Glenn & Klonsky, 2013<ref name="GlennKlonsky2013"/> | |- | Sweden | Adolescent community sample | 43.4% | Combined self-report measure (FASM) and interview (SITBI) | Lifetime frequency; Zetterqvist et al., 2013<ref name="ZetterqvistetAl2013"/> | |- | U.S.A. | Adult outpatient sample | 11.4% | Chart review, not based on DSM-V criteria | Lifetime frequency; Selby et al., 2012<ref name="SelbyEtAl2012"/> | |- | All of U.S.A. | Adolescent epidemiological | 13.0%-23.2% | Variable assessment methods | Lifetime frequency; Jacobson & Gould, 2007<ref name="Jacobson2007"/> | |- | North East | Adolescent non-clinical sample | 7.5% | Self-report measure | within the last year; Hilt et al., 2008<ref name="HiltEtAl2008"/> | |- | North East | Adolescent inpatient sample | 60% | Self-report measure (FASM) | lifetime frequency; Nock et al., 2006<ref name="NockEtAl2006"/> | |- | United Kingdom | Incarcerated sample | 52% | Self-report measure (FASM) | Gray et al., 2003 | |- |International |Adults from sexual minorities (LGBT) samples |36.53% |Various self-report questionnaires |Liu et al., 2019 | |} '''Search terms:''' [Non-suicidal self-injury or NSSI or Self harm] AND [children OR adolescents] AND [prevalence OR incidence OR epidemiological] in PsychInfo and Google Schola == [[Evidence based assessment/Prediction phase|'''Prediction phase''']] == === Comparison of screening measures === {{collapse top|Descriptions of types of NSSI screenings|expand=yes}} '''Differences between types of NSSI measures''' #''Omnibus Measures'' #* Assess several NSSI domains #* These tests are the most comprehensive compared to other measures #''Functional Measures'' #* Helpful for understanding why people self-injure #* These tests assess motives for, or functions of, NSSI #''Behavioral Measures'' #* Primarily assess one's history of NSSI behaviors #* These measures are useful for assessment methods used and NSSI frequency #''Brief Measures'' #* Include a single item or a few items to assess NSSI #* These may be best when conducting a brief assessment '''Recommendations''' * Omnibus measures are highly recommended over all other types of measures. **''The SITBI'' is the best clinical interview for assessing adolescent NSSI **''The SASII'' was designed to assess NSSI among adults. {{collapse bottom}} === Scope of screening instruments for NSSI === {{collapse top| Cross-screening component analysis|expand=yes}} {| class="wikitable sortable" border="1" |- !Category of Screening ! Instrument ! No. Items ! History ! Methods ! Frequency ! Lethality ! Intent of Functions ! History of Suicidality |- | '''''Omnibus''''' | Suicidal Behaviors Questionnaire (SBQ) | 90 |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] | | |[[File:Green check.png]] |- | '''''Omnibus''''' | Self-Harm Behavior Questionnaire (SHBQ) | 32 |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] | |[[File:Green check.png]] |- |<b>''Functional''</b> | Functional Assessment of Self-Mutilation (FASM) | 22 |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] | |- |<b>''Functional''</b> | Inventory of Statements About Self-Harm (ISAS) | 39 |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] | |[[File:Green check.png]] | |- |<b>''Functional''</b> | Self-Injury Questionnaire (SIQ) | 30 |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] |- |<b>''Functional''</b> | Self-Injury Motivation Scale (SIMS) | 35 | | | | |[[File:Green check.png]] | |- |<b>''Functional''</b> | Self-Harm Reasons Questionnaire (SHRQ) - Revised | 21 |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] | |[[File:Green check.png]] | |- |<b>''Behavioral''</b> | Deliberate Self-Harm Inventory (DSHI) | 17 |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] | | |- |<b>''Behavioral''</b> | Self-Harm Inventory (SHI) | 22 |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] | | |- |<b> ''Brief''</b> | Schedule for Nonadaptive and Adaptive Personality (SNAP) Items | 2 |[[File:Green check.png]] | | | | |[[File:Green check.png]] |- |<b> ''Brief''</b> | Trauma Symptom Inventory (TSI) Item | 1 |[[File:Green check.png]] | |[[File:Green check.png]] | | | |- |} * '''Note:''' SNAP has 375 items in the total measure; TSI has 100 items in the total measure. * '''Search terms:''' [Non-suicidal self-injury or NSSI or Self harm] AND [children OR adolescents] AND [assessment] in PsychINFO and Google ScholarTreatment * '''Sources consulted:''' Klonsky, E. D., & Lewis, S. P. (2014). Assessment of nonsuicidal self-injury. In M. K. Nock, M. K. Nock (Eds.), The Oxford handbook of suicide and self-injury (pp. 337-351). New York, NY, US: Oxford University Press.; Nock (Eds.), Understanding non-suicidal self-injury: Origins, assessment, and treatment. Washington, DC: Am. Psychol. Assoc. {{collapse bottom}} === Psychometric properties of screening instruments of NSSI === The following section contains a list of screening and diagnostic instruments for non-suicidal self-injury. The section includes administration information, psychometric data, and PDFs or links to the screenings. * Screenings are used as part of the [[Evidence based assessment/Prediction phase|prediction phase]] of assessment; for more information on interpretation of this data, or how screenings fit in to the assessment process, click [[Evidence based assessment/Prediction phase|here.]] * ''For a list of more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Psychometric_properties_of_common_screening_instruments '''click here.''']'' {| class="wikitable sortable" border="1" |- ! Instrument (Reference) !Type of screeening !Format (Reporter) !Age Range !Administration Time ! Internal Consistency ! Interrater Reliability ! Test-Retest Reliability ! Construct Validity ! Highly Recommended !Free and Accessible Measures |- | Suicidal Behaviors Questionnaire (SBQ) <ref name="Linehan1981" /> |<b>Omnibus</b> | | | | G | NA | A | G |[[File:Green check.png|link=https://en.wikiversity.org/wiki/File:Green%20check.png|alt=Yes]] | * [https://mfr.osf.io/render?url=https://osf.io/vg2sn/?action=download%26mode=render Printable PDF of SBQ] |- | Self-Harm Behavior Questionnaire (SHBQ) <ref name="GutierrezEtAl2001" /> |<b>Omnibus</b> | | | | G | NA | A | G | |Not free |- | Functional Assessment of Self-Mutilation (FASM)<ref name="LloydRichardsonEtAl1997" /> |<b> Functional</b> | | | | A | NA | U | A | | * [https://mfr.osf.io/render?url=https://osf.io/qps3v/?action=download%26mode=render Printable PDF of the FASM] |- |Inventory of Statements About Self-Harm (ISAS) <ref>http://www2.psych.ubc.ca/~klonsky/publications/ISASmeasure.pdf</ref> |<b> Functional</b> | | | | G | NA | G | G | | * [https://mfr.osf.io/render?url=https://osf.io/ntwkr/?action=download%26mode=render Printable PDF of ISAS] |- | Self-Injury Questionnaire (SIQ) <ref name="SantaMinaEtAl2006" /> ''*Not Free*'' |<b> Functional</b> | | | | G | NA | U | A | |Not free |- | Self-Injury Motivation Scale (SIMS)<ref name="OsuchEtAl1999" /> |<b> Functional</b> | | | | G | NA | U | A | | |- | Self-Harm Reasons Questionnaire (SHRQ) <ref name="LewisEtAl2008" /> |<b> Functional</b> | | | | G | NA | U | A | | |- | Deliberate Self-Harm Inventory (DSHI) <ref name="Gratz2001" /> |<b>Behavioral</b> | | | | G | NA | G | G | | |- | Self-Harm Inventory (SHI) |<b>Behavioral</b> | | | | A | NA | U | A | | |- | SNAP Items<ref name="Clark1996" /> |<b>Brief</b> | | | | NA | NA | U | A | | |- | Trauma Symptom Inventory (TSI) <ref name="Briere1995" /> |<b>Brief</b> | | | | NA | NA | U | A | | |- | Scale for Suicide Ideation (SSI) |<b>Other</b> | | | | G | U | U | G |[[File:Green check.png|link=https://en.wikiversity.org/wiki/File:Green%20check.png|alt=Yes]] | |- | Suicide Behaviors Interview (SBI) |<b>Other</b> | | | | E | E | U | A | | |- | Child Suicide Potential Scales (CSPS) |<b>Other</b> | | | | A | E | U | G |[[File:Green check.png|link=https://en.wikiversity.org/wiki/File:Green%20check.png|alt=Yes]] | |- | Beck Scale for Suicide Ideation (BSI) |<b>Other</b> | | | | E | NA | U | G |[[File:Green check.png|link=https://en.wikiversity.org/wiki/File:Green%20check.png|alt=Yes]] | |- | Suicide Behaviors Questionnaire for Children (SBQ-C) |<b>Other</b> | | | | G | NA | A | A | | |- | Suicide Ideation Questionnaire for Children (SIQ-JR) |<b>Other</b> | | | | G | NA | A | G |[[File:Green check.png|link=https://en.wikiversity.org/wiki/File:Green%20check.png|alt=Yes]] | |- | Suicide Probability Scale (SPS) |<b>Other</b> | | | | E | NA | U | A | | |- | Columbia Suicide Screen (CSS) |<b>Other</b> | | | | G | NA | L | A | | |- | Harkavy Asnis Suicide Scale (HASS) |<b>Other</b> | | | | E | NA | U | G | | |} '''Note:''' '''L''' = Less than adequate; '''A''' = Adequate; '''G''' = Good; '''E''' = Excellent; '''U''' = Unavailable; '''NA''' = Not applicable *<u>Sources consulted:</u> Klonsky, E. D., & Lewis, S. P. (2014). Assessment of nonsuicidal self-injury. In M. K. Nock, M. K. Nock (Eds.) , The Oxford handbook of suicide and self-injury (pp. 337-351). New York, NY, US: Oxford University Press.<ref name="KlonskyLewis2014" />; Nock (Eds.), Understanding non-suicidal self-injury: Origins, assessment, and treatment. Washington, DC: Am. Psychol. Assoc. === Likelihood ratios and AUCs of screening measures for NSSI === *''For a list of the likelihood ratios for more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Likelihood_ratios_and_AUCs_of_common_screening_instruments '''click here.''']'' {| class="wikitable sortable" |- ! Screening Measure (Primary Reference) !! AUC !! LR+ (score) !! LR- (score) !! Clinical Generalizability !Download |- |Child Behavior Checklist (CBCL) Anxious/Depressed Scale T-score<ref name="Achenbach1991">{{cite book|last1=Achenbach|first1=Thomas M.|title=Child behavior checklist for ages 4-18|date=1991|publisher=T.M. Achenbach|location=Burlington, VT|isbn=0938565087|edition=[11th print.]}}</ref>|| .70 (N=470) || 3.78 (60+) || .39 (<60) || High. Large diverse sample with mixed depression sample compared to samples without depression. |Not free |- |} === Interpreting NSSI screening measure scores === * For information on interpreting screening measure scores, click [[Evidence based assessment/Prediction phase#Interpreting screening measure scores|here.]] == [[Evidence based assessment/Prescription phase|'''Prescription phase''']] == ===Gold standard diagnostic interviews=== * For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews '''click here.'''] === Coverage of interviews for NSSI === {{collapse top| Scope of diagnostic interviews for NSSI|expand=yes}} {| class="wikitable sortable" border="1" |- ! Instrument ! No. Items ! History ! Methods ! Frequency ! Lethality ! Intent of Functions ! History of Suicidality |- | colspan="8" style="font-size:110%; text-align:center;" span |<b> Omnibus Measures </b> |- | Suicide Attempt Self-Injury Interview (SASII) | 31 | X | X | X | X | X | X |- | Self-Injurious Thoughts and Behaviors Interview (SITBI) | 169 | X | X | X | X | X | X |} {{collapse bottom}} === Recommended diagnostic instruments for NSSI === {| class="wikitable sortable" ! colspan="11" |Diagnostic instruments for '''NSSI''' ! |- !Instrument (Reference) !Type of screeening !Format (Reporter) !Age Range !Administration Time !Internal Consistency !Interrater Reliability !Test-Retest Reliability !Construct Validity !Content Validity !Highly Recommended !Free and Accessible Measures |- |Beck Scale for Suicidal Ideation (BSI) | |Self-report questionnaire |17+ |5-10 mins | |E | |A |G | |No * Link to purchase [https://www.pearsonclinical.com/psychology/products/100000157/beck-scale-for-suicide-ideation-bss.html] |- |Suicidal Behaviors Questionnaire-Revised (SBQ-R) | |Self-report |18+ |5-10 mins | | | |.87 E |E |Yes |[https://www.integration.samhsa.gov/images/res/SBQ.pdf SBQ-R] |- |Self-Harm Behavior Questionnaire (SHBQ) | |Self-report questionnaire |adolescents |Not Reported | |E | |G |G | | |- |Suicide Attempt Self-Injury Interview (SASII) <ref name="LinehanEtAl2006" /> |<b>Omnibus</b> | | | |G |E |E |G | |[[File:Green check.png|link=https://en.wikiversity.org/wiki/File:Green%20check.png]] |[https://mfr.osf.io/render?url=https://osf.io/zstnj/?action=download%26mode=render SASII] |- |Self Injurious Thoughts and Behaviors Interview (SITBI) <ref name="NockEtAl2007" /> |<b>Omnibus</b> | | | |NA |E |A |G | |[[File:Green check.png|link=https://en.wikiversity.org/wiki/File:Green%20check.png]] |[https://mfr.osf.io/render?url=https://osf.io/hw46c/?action=download%26mode=render SITBI] |- |Suicidal Ideation Questionnaire (SIQ) | |Self-report questionnaire |12-18 years old |10 minutes |NA | | | | | |[https://www.semel.ucla.edu/sites/default/files/pdf/SuicidalIdeationQuestionnaire%28SIQ%29%28Child%29.PDF SIQ] |- |Suicidal Ideation Questionnaire (SIQ-JR) | |Self-report Questionnaire |Middle School aged children |10 minutes |NA | |test-retest: r -0.93 (males) r = .87 (females) | | | |SIQ-[https://www.semel.ucla.edu/sites/default/files/pdf/SuicidalIdeationQuestionnaire%28SIQ%29%28Child%29.PDF JR] |} '''Note:''' '''L''' = Less than adequate; '''A''' = Adequate; '''G''' = Good; '''E''' = Excellent; '''U''' = Unavailable; '''NA''' = Not applicable == [[Evidence based assessment/Process phase|'''Process phase''']] == The following section contains a brief overview of treatment options for depression and list of process and outcome measures for non-suicidal self-injury. The section includes benchmarks based on published norms for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the [[Evidence based assessment/Process phase|process phase]] of assessment. For more information of differences between process and outcome measures, see the page on the [[Evidence based assessment/Process phase|process phase of assessment]]. === Process measures === {{blockquotetop}} {{blockquotebottom}} === Outcome and severity measures === * This table includes clinically significant benchmarks for NSSI specific outcome measures * Information on how to interpret this table can be [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase found here]. * Additionally, these [[Evidence based assessment/Vignettes|vignettes]] might be helpful resources for understanding appropriate adaptation of outcome measures in practice. *''<u>For clinically significant change benchmarks for the CBCL, YSR, and TRF total, externalizing, internalizing, and attention benchmarks,</u>'' [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase&wteswitched=1#Clinically_significant_change_benchmarks_for_widely-used_outcome_measures see here.] {| class="wikitable sortable" border="1" | colspan="8" |'''Clinically significant change benchmarks with common instruments for NSSI''' |- | rowspan="1&quot;" style="text-align:center;font-size:130%;" | <b> Measure</b> | style="text-align:center;font-size:130%;" | <b>Subscale</b> | colspan="3" style="text-align:center;font-size:130%" width="300" | <b> Cut-off scores</b> | colspan="3" style="text-align:center;font-size:120%" | <b> Critical Change <br> (unstandardized scores)</b> |- | colspan="8" span style="font-size:110%; text-align:center;" | <b> Benchmarks Based on Published Norms </b> |- | colspan="2" | | style="text-align:center;font-size:110%" | <b> A</b> | style="text-align:center;font-size:110%" | <b> B</b> | style="text-align:center;font-size:110%" | <b> C</b> | style="text-align:center;font-size:110%" | <b> 95%</b> | style="text-align:center;font-size:110%" | <b> 90%</b> | style="text-align:center;font-size:110%" | <b> SE_difference</b> |- | rowspan="1" style="text-align:center;" | | style="text-align:center;"| | style="text-align:center;"| | style="text-align:center;"| | style="text-align:center;"| | style="text-align:center;"| | style="text-align:center;"| | style="text-align:center;"| |- | rowspan="1" style="text-align:center;" | | style="text-align:right;" | | style="text-align:center;"| | style="text-align:center;"| | style="text-align:center;"| | style="text-align:center;"| | style="text-align:center;"| | style="text-align:center;"| |} === Treatment === * Please refer to the page on [[wikipedia:Nonsuicidal_self-injury_disorder|non-suicidal self injury]] for more information on available treatment for NSSI *Go to [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/self-injurious-thoughts-and-behaviors/ Effective Child Therapy] for a curated resource on effective treatments for NSSI. {{collapse top| Information on treatment for NSSI|expand=yes}} According to Nock (2010)<ref name="Nock2010"/>, no treatment for NSSI could be considered "evidence-based." However, recent years have seen an increase in intervention trials for NSSI. Although limited due to lack of consistency in defining and measuring NSSI, this work could provide insight into potential best practices for treating this condition (Andover, 2015)<ref name=Andover2014/>. # '''Dialectical behavioral therapy (DBT)''' ## Dialectical Behavior Therapy has been shown to be effective in treating individuals with Borderline Personality Disorder (BPD) who engage in NSSI; however it has not been shown to be better than treatment as usual in a sample of individuals without BPD. In the absence of a better option, a DBT approach to treatment is the most evidence based. # '''Cognitive behavioral therapy (CBT)''' ## Few research studies have tested cognitive-behavioral therapy (CBT) as a treatment specifically for NSSI. However, some studies have evaluated the efficacy of CBT trials in treating self-injury with and without suicidal intent. Manual-assisted cognitive therapy (MACT) is a 6-session CBT intervention focusing on functions of deliberate self-harm, emotion regulation, problem-solving skills, and relapse prevention. MACT has demonstrated mixed results for decreasing NSSI frequency and severity among adults (Tyrer et al., 2003<ref name="TyrerEtAl2003" />; Weinberg, Gunderson, Hennen, & Cutter, 2006)<ref name="WeinbergEtAl2006" />. Although MACT may be a promising intervention (Muehlenkamp, 2006)<ref name="Muehlenkamp2006" />, it should be evaluated in future studies. In one adolescent treatment trial, the Adolescent Depression Antidepressant Psychotherapy Trial (ADAPT), a decrease in NSSI behaviors was found at post-treatment for both SSRI and SSRI+CBT groups (Goodyer et al., 2007)<ref name="GoodyerEtAl2007" />, although no differences were found between groups. In sum, findings from efficacy trials of CBT on NSSI outcomes are mixed, and more trials examining CBT as a treatment specifically for NSSI are needed. # '''Pharmacology''' ## Pharmacological interventions are especially scarce. However, one study found that fluoxetine was effective at reducing NSSI frequency in a sample of 22 adults with major depressive disorder and either BPD or schizotypal personality disorder (Markovitz et al, 1991)<ref name="MarkovitzEtAl1991" />. A second trial found that antidepressant medications alone (SSRIs and SNRIs) were as effective as medication plus CBT in reducing NSSI among adolescents with MDD (Brent et al., 2009<ref name="Brent2009" />; Goodyer et al., 2007)<ref name="GoodyerEtAl2007" />. Ziprasidone, an atypical antipsychotic, was found to be more effective in reducing NSSI behaviors among adolescents compared to another neuroleptic medication (Libal et al., 2005)<ref name="LibalEtAl2005" />. Clonidine has also been effective as an intervention for acute NSSI urges and feelings of tension among a sample of patients with BPD (Philipsen et al., 2004)<ref name="PhilipsenEtAl2004" />, although the long-term effects are unknown. # '''Prevention programs''' ## Jacobs, Walsh, McDade, and Pigeon (2009)<ref name="JacobsEtAl2009" /> developed the only known prevention program for NSSI, the Signs of Self-Injury program (SOSI). This school-based prevention program is designed to increase awareness about NSSI among adolescents through psychoeducation about warning signs and symptoms and improvement of help-seeking behaviors and attitudes. One test of effectiveness and acceptance found the program to be feasible and effective at changing attitudes toward NSSI and increasing help-seeking among students (Muehlenkamp et al., 2010)<ref name="MuehlenkampEtAl2010" />. {{collapse bottom}} == '''External resources''' == # [https://en.wikiversity.org/w/index.php?title=Helping_Give_Away_Psychological_Science/Resources/Annotated_List_of_Where_and_How_to_Find_a_Therapist&wteswitched=1#Other_low-cost_options Find-a-Therapist] (a curated list of find-a-therapist websites where you can find a provide #[http://www.selfinjury.bctr.cornell.edu/about-self-injury.html Cornell resource on self-injury] #Effective Child Therapy page for [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/self-injurious-thoughts-and-behaviors/ Self-Injurious Thoughts and Behaviors] ##Effective Child Therapy is website sponsored by Division 53 of the American Psychological Association (APA), or The [https://sccap53.org Society of Clinical Child and Adolescent Psychology (SCCAP)] (SCCAP), in collaboration with the Association for Behavioral and Cognitive Therapies (ABCT). Use for information on symptoms and available treatments. # [[wikipedia:Nonsuicidal_self-injury_disorder|Wikipedia page for non-suicidal self injury]] #[https://mhfa.com.au/sites/mhfa.com.au/files/MHFA_selfinjury_guidelinesA4%202014%20Revised_1.pdf Mental Health First Aid] page on non-suicidal self-injury =='''References'''== {{collapse top|References|expand=yes}} Liu, R. T., Sheehan, A. E., Walsh, R. F., Sanzari, C. M., Cheek, S. M., & Hernandez, E. M. (2019). Prevalence and correlates of non-suicidal self-injury among lesbian, gay, bisexual, and transgender individuals: A systematic review and meta-analysis. 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M.|title=Suicides behaviors questionnaire|date=1981|publisher=University of Washington|location=Seattle}}</ref> <ref name="LloydRichardsonEtAl1997">{{cite journal|last1=Lloyd-Richardson|first1=E. E.|last2=Kelley|first2=M. L.|last3=Hope|first3=T.|title=Self-mutilation in a community sample of adolescents: Descriptive characteristics and provisional prevalence rates|journal=Poster session presented at the Annual Meeting of the Society for Behavioral Medicine|date=April 1997|location=New Orleans, LA}}</ref> <ref name="Muehlenkamp2006">{{cite journal|last1=Muehlenkamp|first1=J. J.|title=Empirically supported treatments and general therapy guidelines for non-suicidal self-injury|journal=Journal of Mental Health Counseling|date=2006|volume=28|pages=166-185}}</ref> }} {{collapse bottom}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] d7h80vaebmgzh9kv3ai0rho9sgdwnum 2419303 2419217 2022-08-26T05:28:42Z Ardenguo 2944162 /* Psychometric properties of screening instruments of NSSI */ added "Note: Reliability and validity are included in the extended version. This table includes measures with Good or Excellent ratings." wikitext text/x-wiki <noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{medical disclaimer}} {{:{{BASEPAGENAME}}/Sidebar}} ==[[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio"?''']]== * For background information on what assessment portfolios are, click the link in the heading above. * Want even 'more' information about this topic? There's an extended version of this page [[Evidence-based assessment/Self harm (assessment portfolio)/extended version|here]]. ==[[Evidence based assessment/Preparation phase|'''Preparation phase''']]== It is important to recognize that measures of suicide-related thoughts and behaviors (i.e., suicidal ideation) and non-suicidal self injury (NSSI) are measure distinct constructs. NSSI items often specify a behavior with clarification that the behavior was not undertaken with intent of suicide. This distinction is important when identifying which measure to use to evaluate a client. === Suicidal Ideation === Self-Injurious Thoughts and Behaviors Interview<ref>{{Cite journal|last=Nock|first=Matthew K.|last2=Holmberg|first2=Elizabeth B.|last3=Photos|first3=Valerie I.|last4=Michel|first4=Bethany D.|date=2007|title=Self-Injurious Thoughts and Behaviors Interview: Development, reliability, and validity in an adolescent sample.|url=http://doi.apa.org/getdoi.cfm?doi=10.1037/1040-3590.19.3.309|journal=Psychological Assessment|language=en|volume=19|issue=3|pages=309–317|doi=10.1037/1040-3590.19.3.309|issn=1939-134X}}</ref>. [[w:Suicide|Suicide]] has an article on Wikipedia. === Suicidal Behavior === <br /> === Diagnostic criteria for NSSI === {{blockquotetop}} '''DSM-5 Criteria for NSSI''' * Nonsuicidal self-injury is currently a proposed disorder in need of further research in the ''Diagnostic and Statistical Manual of Mental Disorders'' (DSM-5)<ref name="DSM5" />. * The criteria for NSSI can be found under Conditions for Further Study in DSM-5. '''ICD-11 Criteria for NSSI''' Intentional self-inflicted injury to the body, most commonly cutting, scraping, burning, biting, or hitting, with the expectation that the injury will lead to only minor physical harm. * For ICD-11, self-injury or self-harm is cited as a symptom or sign that is not classified elsewhere {{blockquotebottom}} === Base rates of NSSI in different populations and clinical settings === This section describes the demographic setting of the population(s) sampled, base rates of diagnosis, country/region sampled and the diagnostic method that was used. Using this information, clinicians will be able to anchor the rate of the non-suicidal self injuries (NSSI) that they are likely to see in their clinical practice. * '''''To see prevalence rates across multiple disorders,''''' [[Evidence based assessment/Preparation phase#Base rates for transdiagnostic comparison|'''''click here.''''']] {| class="wikitable sortable" border="1" |- ! Demography !Setting ! Base Rate ! Diagnostic Method ! Reference !Best Recommended For |- | International | Young adult non-clinical sample | 13.4% | Meta-analysis, controlling for methodological differences across studies | Lifetime frequency; Swannell et al., 2014<ref name="SwannellEtAl2014" /> | |- | All of U.S.A. | Adult community sample | 23% | Self-report measure (questions based on proposed DSM-V criteria for NSSI Disorder; FASM) | Lifetime frequency; Andover, 2015<ref name=Andover2014/> | |- | North East | Adolescent inpatient sample | 50% | Self-report measure (ISAS), based on DSM-V criteria for NSSI Disorder | Lifetime frequency; Glenn & Klonsky, 2013<ref name="GlennKlonsky2013"/> | |- | Sweden | Adolescent community sample | 43.4% | Combined self-report measure (FASM) and interview (SITBI) | Lifetime frequency; Zetterqvist et al., 2013<ref name="ZetterqvistetAl2013"/> | |- | U.S.A. | Adult outpatient sample | 11.4% | Chart review, not based on DSM-V criteria | Lifetime frequency; Selby et al., 2012<ref name="SelbyEtAl2012"/> | |- | All of U.S.A. | Adolescent epidemiological | 13.0%-23.2% | Variable assessment methods | Lifetime frequency; Jacobson & Gould, 2007<ref name="Jacobson2007"/> | |- | North East | Adolescent non-clinical sample | 7.5% | Self-report measure | within the last year; Hilt et al., 2008<ref name="HiltEtAl2008"/> | |- | North East | Adolescent inpatient sample | 60% | Self-report measure (FASM) | lifetime frequency; Nock et al., 2006<ref name="NockEtAl2006"/> | |- | United Kingdom | Incarcerated sample | 52% | Self-report measure (FASM) | Gray et al., 2003 | |- |International |Adults from sexual minorities (LGBT) samples |36.53% |Various self-report questionnaires |Liu et al., 2019 | |} '''Search terms:''' [Non-suicidal self-injury or NSSI or Self harm] AND [children OR adolescents] AND [prevalence OR incidence OR epidemiological] in PsychInfo and Google Schola == [[Evidence based assessment/Prediction phase|'''Prediction phase''']] == === Comparison of screening measures === {{collapse top|Descriptions of types of NSSI screenings|expand=yes}} '''Differences between types of NSSI measures''' #''Omnibus Measures'' #* Assess several NSSI domains #* These tests are the most comprehensive compared to other measures #''Functional Measures'' #* Helpful for understanding why people self-injure #* These tests assess motives for, or functions of, NSSI #''Behavioral Measures'' #* Primarily assess one's history of NSSI behaviors #* These measures are useful for assessment methods used and NSSI frequency #''Brief Measures'' #* Include a single item or a few items to assess NSSI #* These may be best when conducting a brief assessment '''Recommendations''' * Omnibus measures are highly recommended over all other types of measures. **''The SITBI'' is the best clinical interview for assessing adolescent NSSI **''The SASII'' was designed to assess NSSI among adults. {{collapse bottom}} === Scope of screening instruments for NSSI === {{collapse top| Cross-screening component analysis|expand=yes}} {| class="wikitable sortable" border="1" |- !Category of Screening ! Instrument ! No. Items ! History ! Methods ! Frequency ! Lethality ! Intent of Functions ! History of Suicidality |- | '''''Omnibus''''' | Suicidal Behaviors Questionnaire (SBQ) | 90 |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] | | |[[File:Green check.png]] |- | '''''Omnibus''''' | Self-Harm Behavior Questionnaire (SHBQ) | 32 |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] | |[[File:Green check.png]] |- |<b>''Functional''</b> | Functional Assessment of Self-Mutilation (FASM) | 22 |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] | |- |<b>''Functional''</b> | Inventory of Statements About Self-Harm (ISAS) | 39 |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] | |[[File:Green check.png]] | |- |<b>''Functional''</b> | Self-Injury Questionnaire (SIQ) | 30 |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] |- |<b>''Functional''</b> | Self-Injury Motivation Scale (SIMS) | 35 | | | | |[[File:Green check.png]] | |- |<b>''Functional''</b> | Self-Harm Reasons Questionnaire (SHRQ) - Revised | 21 |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] | |[[File:Green check.png]] | |- |<b>''Behavioral''</b> | Deliberate Self-Harm Inventory (DSHI) | 17 |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] | | |- |<b>''Behavioral''</b> | Self-Harm Inventory (SHI) | 22 |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] | | |- |<b> ''Brief''</b> | Schedule for Nonadaptive and Adaptive Personality (SNAP) Items | 2 |[[File:Green check.png]] | | | | |[[File:Green check.png]] |- |<b> ''Brief''</b> | Trauma Symptom Inventory (TSI) Item | 1 |[[File:Green check.png]] | |[[File:Green check.png]] | | | |- |} * '''Note:''' SNAP has 375 items in the total measure; TSI has 100 items in the total measure. * '''Search terms:''' [Non-suicidal self-injury or NSSI or Self harm] AND [children OR adolescents] AND [assessment] in PsychINFO and Google ScholarTreatment * '''Sources consulted:''' Klonsky, E. D., & Lewis, S. P. (2014). Assessment of nonsuicidal self-injury. In M. K. Nock, M. K. Nock (Eds.), The Oxford handbook of suicide and self-injury (pp. 337-351). New York, NY, US: Oxford University Press.; Nock (Eds.), Understanding non-suicidal self-injury: Origins, assessment, and treatment. Washington, DC: Am. Psychol. Assoc. {{collapse bottom}} === Psychometric properties of screening instruments of NSSI === The following section contains a list of screening and diagnostic instruments for non-suicidal self-injury. The section includes administration information, psychometric data, and PDFs or links to the screenings. * Screenings are used as part of the [[Evidence based assessment/Prediction phase|prediction phase]] of assessment; for more information on interpretation of this data, or how screenings fit in to the assessment process, click [[Evidence based assessment/Prediction phase|here.]] * ''For a list of more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Psychometric_properties_of_common_screening_instruments '''click here.''']'' {| class="wikitable sortable" border="1" |- ! Instrument (Reference) !Type of screeening !Format (Reporter) !Age Range !Administration Time ! Internal Consistency ! Interrater Reliability ! Test-Retest Reliability ! Construct Validity ! Highly Recommended !Free and Accessible Measures |- | Suicidal Behaviors Questionnaire (SBQ) <ref name="Linehan1981" /> |<b>Omnibus</b> | | | | G | NA | A | G |[[File:Green check.png|link=https://en.wikiversity.org/wiki/File:Green%20check.png|alt=Yes]] | * [https://mfr.osf.io/render?url=https://osf.io/vg2sn/?action=download%26mode=render Printable PDF of SBQ] |- | Self-Harm Behavior Questionnaire (SHBQ) <ref name="GutierrezEtAl2001" /> |<b>Omnibus</b> | | | | G | NA | A | G | |Not free |- | Functional Assessment of Self-Mutilation (FASM)<ref name="LloydRichardsonEtAl1997" /> |<b> Functional</b> | | | | A | NA | U | A | | * [https://mfr.osf.io/render?url=https://osf.io/qps3v/?action=download%26mode=render Printable PDF of the FASM] |- |Inventory of Statements About Self-Harm (ISAS) <ref>http://www2.psych.ubc.ca/~klonsky/publications/ISASmeasure.pdf</ref> |<b> Functional</b> | | | | G | NA | G | G | | * [https://mfr.osf.io/render?url=https://osf.io/ntwkr/?action=download%26mode=render Printable PDF of ISAS] |- | Self-Injury Questionnaire (SIQ) <ref name="SantaMinaEtAl2006" /> ''*Not Free*'' |<b> Functional</b> | | | | G | NA | U | A | |Not free |- | Self-Injury Motivation Scale (SIMS)<ref name="OsuchEtAl1999" /> |<b> Functional</b> | | | | G | NA | U | A | | |- | Self-Harm Reasons Questionnaire (SHRQ) <ref name="LewisEtAl2008" /> |<b> Functional</b> | | | | G | NA | U | A | | |- | Deliberate Self-Harm Inventory (DSHI) <ref name="Gratz2001" /> |<b>Behavioral</b> | | | | G | NA | G | G | | |- | Self-Harm Inventory (SHI) |<b>Behavioral</b> | | | | A | NA | U | A | | |- | SNAP Items<ref name="Clark1996" /> |<b>Brief</b> | | | | NA | NA | U | A | | |- | Trauma Symptom Inventory (TSI) <ref name="Briere1995" /> |<b>Brief</b> | | | | NA | NA | U | A | | |- | Scale for Suicide Ideation (SSI) |<b>Other</b> | | | | G | U | U | G |[[File:Green check.png|link=https://en.wikiversity.org/wiki/File:Green%20check.png|alt=Yes]] | |- | Suicide Behaviors Interview (SBI) |<b>Other</b> | | | | E | E | U | A | | |- | Child Suicide Potential Scales (CSPS) |<b>Other</b> | | | | A | E | U | G |[[File:Green check.png|link=https://en.wikiversity.org/wiki/File:Green%20check.png|alt=Yes]] | |- | Beck Scale for Suicide Ideation (BSI) |<b>Other</b> | | | | E | NA | U | G |[[File:Green check.png|link=https://en.wikiversity.org/wiki/File:Green%20check.png|alt=Yes]] | |- | Suicide Behaviors Questionnaire for Children (SBQ-C) |<b>Other</b> | | | | G | NA | A | A | | |- | Suicide Ideation Questionnaire for Children (SIQ-JR) |<b>Other</b> | | | | G | NA | A | G |[[File:Green check.png|link=https://en.wikiversity.org/wiki/File:Green%20check.png|alt=Yes]] | |- | Suicide Probability Scale (SPS) |<b>Other</b> | | | | E | NA | U | A | | |- | Columbia Suicide Screen (CSS) |<b>Other</b> | | | | G | NA | L | A | | |- | Harkavy Asnis Suicide Scale (HASS) |<b>Other</b> | | | | E | NA | U | G | | |} '''Note:''' Reliability and validity are included in the extended version. This table includes measures with Good or Excellent ratings. === Likelihood ratios and AUCs of screening measures for NSSI === *''For a list of the likelihood ratios for more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Likelihood_ratios_and_AUCs_of_common_screening_instruments '''click here.''']'' {| class="wikitable sortable" |- ! Screening Measure (Primary Reference) !! AUC !! LR+ (score) !! LR- (score) !! Clinical Generalizability !Download |- |Child Behavior Checklist (CBCL) Anxious/Depressed Scale T-score<ref name="Achenbach1991">{{cite book|last1=Achenbach|first1=Thomas M.|title=Child behavior checklist for ages 4-18|date=1991|publisher=T.M. Achenbach|location=Burlington, VT|isbn=0938565087|edition=[11th print.]}}</ref>|| .70 (N=470) || 3.78 (60+) || .39 (<60) || High. Large diverse sample with mixed depression sample compared to samples without depression. |Not free |- |} === Interpreting NSSI screening measure scores === * For information on interpreting screening measure scores, click [[Evidence based assessment/Prediction phase#Interpreting screening measure scores|here.]] == [[Evidence based assessment/Prescription phase|'''Prescription phase''']] == ===Gold standard diagnostic interviews=== * For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews '''click here.'''] === Coverage of interviews for NSSI === {{collapse top| Scope of diagnostic interviews for NSSI|expand=yes}} {| class="wikitable sortable" border="1" |- ! Instrument ! No. Items ! History ! Methods ! Frequency ! Lethality ! Intent of Functions ! History of Suicidality |- | colspan="8" style="font-size:110%; text-align:center;" span |<b> Omnibus Measures </b> |- | Suicide Attempt Self-Injury Interview (SASII) | 31 | X | X | X | X | X | X |- | Self-Injurious Thoughts and Behaviors Interview (SITBI) | 169 | X | X | X | X | X | X |} {{collapse bottom}} === Recommended diagnostic instruments for NSSI === {| class="wikitable sortable" ! colspan="11" |Diagnostic instruments for '''NSSI''' ! |- !Instrument (Reference) !Type of screeening !Format (Reporter) !Age Range !Administration Time !Internal Consistency !Interrater Reliability !Test-Retest Reliability !Construct Validity !Content Validity !Highly Recommended !Free and Accessible Measures |- |Beck Scale for Suicidal Ideation (BSI) | |Self-report questionnaire |17+ |5-10 mins | |E | |A |G | |No * Link to purchase [https://www.pearsonclinical.com/psychology/products/100000157/beck-scale-for-suicide-ideation-bss.html] |- |Suicidal Behaviors Questionnaire-Revised (SBQ-R) | |Self-report |18+ |5-10 mins | | | |.87 E |E |Yes |[https://www.integration.samhsa.gov/images/res/SBQ.pdf SBQ-R] |- |Self-Harm Behavior Questionnaire (SHBQ) | |Self-report questionnaire |adolescents |Not Reported | |E | |G |G | | |- |Suicide Attempt Self-Injury Interview (SASII) <ref name="LinehanEtAl2006" /> |<b>Omnibus</b> | | | |G |E |E |G | |[[File:Green check.png|link=https://en.wikiversity.org/wiki/File:Green%20check.png]] |[https://mfr.osf.io/render?url=https://osf.io/zstnj/?action=download%26mode=render SASII] |- |Self Injurious Thoughts and Behaviors Interview (SITBI) <ref name="NockEtAl2007" /> |<b>Omnibus</b> | | | |NA |E |A |G | |[[File:Green check.png|link=https://en.wikiversity.org/wiki/File:Green%20check.png]] |[https://mfr.osf.io/render?url=https://osf.io/hw46c/?action=download%26mode=render SITBI] |- |Suicidal Ideation Questionnaire (SIQ) | |Self-report questionnaire |12-18 years old |10 minutes |NA | | | | | |[https://www.semel.ucla.edu/sites/default/files/pdf/SuicidalIdeationQuestionnaire%28SIQ%29%28Child%29.PDF SIQ] |- |Suicidal Ideation Questionnaire (SIQ-JR) | |Self-report Questionnaire |Middle School aged children |10 minutes |NA | |test-retest: r -0.93 (males) r = .87 (females) | | | |SIQ-[https://www.semel.ucla.edu/sites/default/files/pdf/SuicidalIdeationQuestionnaire%28SIQ%29%28Child%29.PDF JR] |} '''Note:''' Reliability and validity are included in the extended version. This table includes measures with Good or Excellent ratings. == [[Evidence based assessment/Process phase|'''Process phase''']] == The following section contains a brief overview of treatment options for depression and list of process and outcome measures for non-suicidal self-injury. The section includes benchmarks based on published norms for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the [[Evidence based assessment/Process phase|process phase]] of assessment. For more information of differences between process and outcome measures, see the page on the [[Evidence based assessment/Process phase|process phase of assessment]]. === Process measures === {{blockquotetop}} {{blockquotebottom}} === Outcome and severity measures === * This table includes clinically significant benchmarks for NSSI specific outcome measures * Information on how to interpret this table can be [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase found here]. * Additionally, these [[Evidence based assessment/Vignettes|vignettes]] might be helpful resources for understanding appropriate adaptation of outcome measures in practice. *''<u>For clinically significant change benchmarks for the CBCL, YSR, and TRF total, externalizing, internalizing, and attention benchmarks,</u>'' [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase&wteswitched=1#Clinically_significant_change_benchmarks_for_widely-used_outcome_measures see here.] {| class="wikitable sortable" border="1" | colspan="8" |'''Clinically significant change benchmarks with common instruments for NSSI''' |- | rowspan="1&quot;" style="text-align:center;font-size:130%;" | <b> Measure</b> | style="text-align:center;font-size:130%;" | <b>Subscale</b> | colspan="3" style="text-align:center;font-size:130%" width="300" | <b> Cut-off scores</b> | colspan="3" style="text-align:center;font-size:120%" | <b> Critical Change <br> (unstandardized scores)</b> |- | colspan="8" span style="font-size:110%; text-align:center;" | <b> Benchmarks Based on Published Norms </b> |- | colspan="2" | | style="text-align:center;font-size:110%" | <b> A</b> | style="text-align:center;font-size:110%" | <b> B</b> | style="text-align:center;font-size:110%" | <b> C</b> | style="text-align:center;font-size:110%" | <b> 95%</b> | style="text-align:center;font-size:110%" | <b> 90%</b> | style="text-align:center;font-size:110%" | <b> SE_difference</b> |- | rowspan="1" style="text-align:center;" | | style="text-align:center;"| | style="text-align:center;"| | style="text-align:center;"| | style="text-align:center;"| | style="text-align:center;"| | style="text-align:center;"| | style="text-align:center;"| |- | rowspan="1" style="text-align:center;" | | style="text-align:right;" | | style="text-align:center;"| | style="text-align:center;"| | style="text-align:center;"| | style="text-align:center;"| | style="text-align:center;"| | style="text-align:center;"| |} === Treatment === * Please refer to the page on [[wikipedia:Nonsuicidal_self-injury_disorder|non-suicidal self injury]] for more information on available treatment for NSSI *Go to [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/self-injurious-thoughts-and-behaviors/ Effective Child Therapy] for a curated resource on effective treatments for NSSI. {{collapse top| Information on treatment for NSSI|expand=yes}} According to Nock (2010)<ref name="Nock2010"/>, no treatment for NSSI could be considered "evidence-based." However, recent years have seen an increase in intervention trials for NSSI. Although limited due to lack of consistency in defining and measuring NSSI, this work could provide insight into potential best practices for treating this condition (Andover, 2015)<ref name=Andover2014/>. # '''Dialectical behavioral therapy (DBT)''' ## Dialectical Behavior Therapy has been shown to be effective in treating individuals with Borderline Personality Disorder (BPD) who engage in NSSI; however it has not been shown to be better than treatment as usual in a sample of individuals without BPD. In the absence of a better option, a DBT approach to treatment is the most evidence based. # '''Cognitive behavioral therapy (CBT)''' ## Few research studies have tested cognitive-behavioral therapy (CBT) as a treatment specifically for NSSI. However, some studies have evaluated the efficacy of CBT trials in treating self-injury with and without suicidal intent. Manual-assisted cognitive therapy (MACT) is a 6-session CBT intervention focusing on functions of deliberate self-harm, emotion regulation, problem-solving skills, and relapse prevention. MACT has demonstrated mixed results for decreasing NSSI frequency and severity among adults (Tyrer et al., 2003<ref name="TyrerEtAl2003" />; Weinberg, Gunderson, Hennen, & Cutter, 2006)<ref name="WeinbergEtAl2006" />. Although MACT may be a promising intervention (Muehlenkamp, 2006)<ref name="Muehlenkamp2006" />, it should be evaluated in future studies. In one adolescent treatment trial, the Adolescent Depression Antidepressant Psychotherapy Trial (ADAPT), a decrease in NSSI behaviors was found at post-treatment for both SSRI and SSRI+CBT groups (Goodyer et al., 2007)<ref name="GoodyerEtAl2007" />, although no differences were found between groups. In sum, findings from efficacy trials of CBT on NSSI outcomes are mixed, and more trials examining CBT as a treatment specifically for NSSI are needed. # '''Pharmacology''' ## Pharmacological interventions are especially scarce. However, one study found that fluoxetine was effective at reducing NSSI frequency in a sample of 22 adults with major depressive disorder and either BPD or schizotypal personality disorder (Markovitz et al, 1991)<ref name="MarkovitzEtAl1991" />. A second trial found that antidepressant medications alone (SSRIs and SNRIs) were as effective as medication plus CBT in reducing NSSI among adolescents with MDD (Brent et al., 2009<ref name="Brent2009" />; Goodyer et al., 2007)<ref name="GoodyerEtAl2007" />. Ziprasidone, an atypical antipsychotic, was found to be more effective in reducing NSSI behaviors among adolescents compared to another neuroleptic medication (Libal et al., 2005)<ref name="LibalEtAl2005" />. Clonidine has also been effective as an intervention for acute NSSI urges and feelings of tension among a sample of patients with BPD (Philipsen et al., 2004)<ref name="PhilipsenEtAl2004" />, although the long-term effects are unknown. # '''Prevention programs''' ## Jacobs, Walsh, McDade, and Pigeon (2009)<ref name="JacobsEtAl2009" /> developed the only known prevention program for NSSI, the Signs of Self-Injury program (SOSI). This school-based prevention program is designed to increase awareness about NSSI among adolescents through psychoeducation about warning signs and symptoms and improvement of help-seeking behaviors and attitudes. One test of effectiveness and acceptance found the program to be feasible and effective at changing attitudes toward NSSI and increasing help-seeking among students (Muehlenkamp et al., 2010)<ref name="MuehlenkampEtAl2010" />. {{collapse bottom}} == '''External resources''' == # [https://en.wikiversity.org/w/index.php?title=Helping_Give_Away_Psychological_Science/Resources/Annotated_List_of_Where_and_How_to_Find_a_Therapist&wteswitched=1#Other_low-cost_options Find-a-Therapist] (a curated list of find-a-therapist websites where you can find a provide #[http://www.selfinjury.bctr.cornell.edu/about-self-injury.html Cornell resource on self-injury] #Effective Child Therapy page for [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/self-injurious-thoughts-and-behaviors/ Self-Injurious Thoughts and Behaviors] ##Effective Child Therapy is website sponsored by Division 53 of the American Psychological Association (APA), or The [https://sccap53.org Society of Clinical Child and Adolescent Psychology (SCCAP)] (SCCAP), in collaboration with the Association for Behavioral and Cognitive Therapies (ABCT). Use for information on symptoms and available treatments. # [[wikipedia:Nonsuicidal_self-injury_disorder|Wikipedia page for non-suicidal self injury]] #[https://mhfa.com.au/sites/mhfa.com.au/files/MHFA_selfinjury_guidelinesA4%202014%20Revised_1.pdf Mental Health First Aid] page on non-suicidal self-injury =='''References'''== {{collapse top|References|expand=yes}} Liu, R. T., Sheehan, A. E., Walsh, R. F., Sanzari, C. M., Cheek, S. M., & Hernandez, E. M. (2019). Prevalence and correlates of non-suicidal self-injury among lesbian, gay, bisexual, and transgender individuals: A systematic review and meta-analysis. 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M.|title=Suicides behaviors questionnaire|date=1981|publisher=University of Washington|location=Seattle}}</ref> <ref name="LloydRichardsonEtAl1997">{{cite journal|last1=Lloyd-Richardson|first1=E. E.|last2=Kelley|first2=M. L.|last3=Hope|first3=T.|title=Self-mutilation in a community sample of adolescents: Descriptive characteristics and provisional prevalence rates|journal=Poster session presented at the Annual Meeting of the Society for Behavioral Medicine|date=April 1997|location=New Orleans, LA}}</ref> <ref name="Muehlenkamp2006">{{cite journal|last1=Muehlenkamp|first1=J. J.|title=Empirically supported treatments and general therapy guidelines for non-suicidal self-injury|journal=Journal of Mental Health Counseling|date=2006|volume=28|pages=166-185}}</ref> }} {{collapse bottom}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] ak10k96f21oqh5zqubj3nusr1do314o 2419316 2419303 2022-08-26T05:38:39Z Ardenguo 2944162 /* Psychometric properties of screening instruments of NSSI */ linked extended page to "Note: Reliability and validity are included in the extended version. This table includes measures with Good or Excellent ratings." wikitext text/x-wiki <noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{medical disclaimer}} {{:{{BASEPAGENAME}}/Sidebar}} ==[[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio"?''']]== * For background information on what assessment portfolios are, click the link in the heading above. * Want even 'more' information about this topic? There's an extended version of this page [[Evidence-based assessment/Self harm (assessment portfolio)/extended version|here]]. ==[[Evidence based assessment/Preparation phase|'''Preparation phase''']]== It is important to recognize that measures of suicide-related thoughts and behaviors (i.e., suicidal ideation) and non-suicidal self injury (NSSI) are measure distinct constructs. NSSI items often specify a behavior with clarification that the behavior was not undertaken with intent of suicide. This distinction is important when identifying which measure to use to evaluate a client. === Suicidal Ideation === Self-Injurious Thoughts and Behaviors Interview<ref>{{Cite journal|last=Nock|first=Matthew K.|last2=Holmberg|first2=Elizabeth B.|last3=Photos|first3=Valerie I.|last4=Michel|first4=Bethany D.|date=2007|title=Self-Injurious Thoughts and Behaviors Interview: Development, reliability, and validity in an adolescent sample.|url=http://doi.apa.org/getdoi.cfm?doi=10.1037/1040-3590.19.3.309|journal=Psychological Assessment|language=en|volume=19|issue=3|pages=309–317|doi=10.1037/1040-3590.19.3.309|issn=1939-134X}}</ref>. [[w:Suicide|Suicide]] has an article on Wikipedia. === Suicidal Behavior === <br /> === Diagnostic criteria for NSSI === {{blockquotetop}} '''DSM-5 Criteria for NSSI''' * Nonsuicidal self-injury is currently a proposed disorder in need of further research in the ''Diagnostic and Statistical Manual of Mental Disorders'' (DSM-5)<ref name="DSM5" />. * The criteria for NSSI can be found under Conditions for Further Study in DSM-5. '''ICD-11 Criteria for NSSI''' Intentional self-inflicted injury to the body, most commonly cutting, scraping, burning, biting, or hitting, with the expectation that the injury will lead to only minor physical harm. * For ICD-11, self-injury or self-harm is cited as a symptom or sign that is not classified elsewhere {{blockquotebottom}} === Base rates of NSSI in different populations and clinical settings === This section describes the demographic setting of the population(s) sampled, base rates of diagnosis, country/region sampled and the diagnostic method that was used. Using this information, clinicians will be able to anchor the rate of the non-suicidal self injuries (NSSI) that they are likely to see in their clinical practice. * '''''To see prevalence rates across multiple disorders,''''' [[Evidence based assessment/Preparation phase#Base rates for transdiagnostic comparison|'''''click here.''''']] {| class="wikitable sortable" border="1" |- ! Demography !Setting ! Base Rate ! Diagnostic Method ! Reference !Best Recommended For |- | International | Young adult non-clinical sample | 13.4% | Meta-analysis, controlling for methodological differences across studies | Lifetime frequency; Swannell et al., 2014<ref name="SwannellEtAl2014" /> | |- | All of U.S.A. | Adult community sample | 23% | Self-report measure (questions based on proposed DSM-V criteria for NSSI Disorder; FASM) | Lifetime frequency; Andover, 2015<ref name=Andover2014/> | |- | North East | Adolescent inpatient sample | 50% | Self-report measure (ISAS), based on DSM-V criteria for NSSI Disorder | Lifetime frequency; Glenn & Klonsky, 2013<ref name="GlennKlonsky2013"/> | |- | Sweden | Adolescent community sample | 43.4% | Combined self-report measure (FASM) and interview (SITBI) | Lifetime frequency; Zetterqvist et al., 2013<ref name="ZetterqvistetAl2013"/> | |- | U.S.A. | Adult outpatient sample | 11.4% | Chart review, not based on DSM-V criteria | Lifetime frequency; Selby et al., 2012<ref name="SelbyEtAl2012"/> | |- | All of U.S.A. | Adolescent epidemiological | 13.0%-23.2% | Variable assessment methods | Lifetime frequency; Jacobson & Gould, 2007<ref name="Jacobson2007"/> | |- | North East | Adolescent non-clinical sample | 7.5% | Self-report measure | within the last year; Hilt et al., 2008<ref name="HiltEtAl2008"/> | |- | North East | Adolescent inpatient sample | 60% | Self-report measure (FASM) | lifetime frequency; Nock et al., 2006<ref name="NockEtAl2006"/> | |- | United Kingdom | Incarcerated sample | 52% | Self-report measure (FASM) | Gray et al., 2003 | |- |International |Adults from sexual minorities (LGBT) samples |36.53% |Various self-report questionnaires |Liu et al., 2019 | |} '''Search terms:''' [Non-suicidal self-injury or NSSI or Self harm] AND [children OR adolescents] AND [prevalence OR incidence OR epidemiological] in PsychInfo and Google Schola == [[Evidence based assessment/Prediction phase|'''Prediction phase''']] == === Comparison of screening measures === {{collapse top|Descriptions of types of NSSI screenings|expand=yes}} '''Differences between types of NSSI measures''' #''Omnibus Measures'' #* Assess several NSSI domains #* These tests are the most comprehensive compared to other measures #''Functional Measures'' #* Helpful for understanding why people self-injure #* These tests assess motives for, or functions of, NSSI #''Behavioral Measures'' #* Primarily assess one's history of NSSI behaviors #* These measures are useful for assessment methods used and NSSI frequency #''Brief Measures'' #* Include a single item or a few items to assess NSSI #* These may be best when conducting a brief assessment '''Recommendations''' * Omnibus measures are highly recommended over all other types of measures. **''The SITBI'' is the best clinical interview for assessing adolescent NSSI **''The SASII'' was designed to assess NSSI among adults. {{collapse bottom}} === Scope of screening instruments for NSSI === {{collapse top| Cross-screening component analysis|expand=yes}} {| class="wikitable sortable" border="1" |- !Category of Screening ! Instrument ! No. Items ! History ! Methods ! Frequency ! Lethality ! Intent of Functions ! History of Suicidality |- | '''''Omnibus''''' | Suicidal Behaviors Questionnaire (SBQ) | 90 |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] | | |[[File:Green check.png]] |- | '''''Omnibus''''' | Self-Harm Behavior Questionnaire (SHBQ) | 32 |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] | |[[File:Green check.png]] |- |<b>''Functional''</b> | Functional Assessment of Self-Mutilation (FASM) | 22 |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] | |- |<b>''Functional''</b> | Inventory of Statements About Self-Harm (ISAS) | 39 |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] | |[[File:Green check.png]] | |- |<b>''Functional''</b> | Self-Injury Questionnaire (SIQ) | 30 |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] |- |<b>''Functional''</b> | Self-Injury Motivation Scale (SIMS) | 35 | | | | |[[File:Green check.png]] | |- |<b>''Functional''</b> | Self-Harm Reasons Questionnaire (SHRQ) - Revised | 21 |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] | |[[File:Green check.png]] | |- |<b>''Behavioral''</b> | Deliberate Self-Harm Inventory (DSHI) | 17 |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] | | |- |<b>''Behavioral''</b> | Self-Harm Inventory (SHI) | 22 |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] |[[File:Green check.png]] | | |- |<b> ''Brief''</b> | Schedule for Nonadaptive and Adaptive Personality (SNAP) Items | 2 |[[File:Green check.png]] | | | | |[[File:Green check.png]] |- |<b> ''Brief''</b> | Trauma Symptom Inventory (TSI) Item | 1 |[[File:Green check.png]] | |[[File:Green check.png]] | | | |- |} * '''Note:''' SNAP has 375 items in the total measure; TSI has 100 items in the total measure. * '''Search terms:''' [Non-suicidal self-injury or NSSI or Self harm] AND [children OR adolescents] AND [assessment] in PsychINFO and Google ScholarTreatment * '''Sources consulted:''' Klonsky, E. D., & Lewis, S. P. (2014). Assessment of nonsuicidal self-injury. In M. K. Nock, M. K. Nock (Eds.), The Oxford handbook of suicide and self-injury (pp. 337-351). New York, NY, US: Oxford University Press.; Nock (Eds.), Understanding non-suicidal self-injury: Origins, assessment, and treatment. Washington, DC: Am. Psychol. Assoc. {{collapse bottom}} === Psychometric properties of screening instruments of NSSI === The following section contains a list of screening and diagnostic instruments for non-suicidal self-injury. The section includes administration information, psychometric data, and PDFs or links to the screenings. * Screenings are used as part of the [[Evidence based assessment/Prediction phase|prediction phase]] of assessment; for more information on interpretation of this data, or how screenings fit in to the assessment process, click [[Evidence based assessment/Prediction phase|here.]] * ''For a list of more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Psychometric_properties_of_common_screening_instruments '''click here.''']'' {| class="wikitable sortable" border="1" |- ! Instrument (Reference) !Type of screeening !Format (Reporter) !Age Range !Administration Time ! Internal Consistency ! Interrater Reliability ! Test-Retest Reliability ! Construct Validity ! Highly Recommended !Free and Accessible Measures |- | Suicidal Behaviors Questionnaire (SBQ) <ref name="Linehan1981" /> |<b>Omnibus</b> | | | | G | NA | A | G |[[File:Green check.png|link=https://en.wikiversity.org/wiki/File:Green%20check.png|alt=Yes]] | * [https://mfr.osf.io/render?url=https://osf.io/vg2sn/?action=download%26mode=render Printable PDF of SBQ] |- | Self-Harm Behavior Questionnaire (SHBQ) <ref name="GutierrezEtAl2001" /> |<b>Omnibus</b> | | | | G | NA | A | G | |Not free |- | Functional Assessment of Self-Mutilation (FASM)<ref name="LloydRichardsonEtAl1997" /> |<b> Functional</b> | | | | A | NA | U | A | | * [https://mfr.osf.io/render?url=https://osf.io/qps3v/?action=download%26mode=render Printable PDF of the FASM] |- |Inventory of Statements About Self-Harm (ISAS) <ref>http://www2.psych.ubc.ca/~klonsky/publications/ISASmeasure.pdf</ref> |<b> Functional</b> | | | | G | NA | G | G | | * [https://mfr.osf.io/render?url=https://osf.io/ntwkr/?action=download%26mode=render Printable PDF of ISAS] |- | Self-Injury Questionnaire (SIQ) <ref name="SantaMinaEtAl2006" /> ''*Not Free*'' |<b> Functional</b> | | | | G | NA | U | A | |Not free |- | Self-Injury Motivation Scale (SIMS)<ref name="OsuchEtAl1999" /> |<b> Functional</b> | | | | G | NA | U | A | | |- | Self-Harm Reasons Questionnaire (SHRQ) <ref name="LewisEtAl2008" /> |<b> Functional</b> | | | | G | NA | U | A | | |- | Deliberate Self-Harm Inventory (DSHI) <ref name="Gratz2001" /> |<b>Behavioral</b> | | | | G | NA | G | G | | |- | Self-Harm Inventory (SHI) |<b>Behavioral</b> | | | | A | NA | U | A | | |- | SNAP Items<ref name="Clark1996" /> |<b>Brief</b> | | | | NA | NA | U | A | | |- | Trauma Symptom Inventory (TSI) <ref name="Briere1995" /> |<b>Brief</b> | | | | NA | NA | U | A | | |- | Scale for Suicide Ideation (SSI) |<b>Other</b> | | | | G | U | U | G |[[File:Green check.png|link=https://en.wikiversity.org/wiki/File:Green%20check.png|alt=Yes]] | |- | Suicide Behaviors Interview (SBI) |<b>Other</b> | | | | E | E | U | A | | |- | Child Suicide Potential Scales (CSPS) |<b>Other</b> | | | | A | E | U | G |[[File:Green check.png|link=https://en.wikiversity.org/wiki/File:Green%20check.png|alt=Yes]] | |- | Beck Scale for Suicide Ideation (BSI) |<b>Other</b> | | | | E | NA | U | G |[[File:Green check.png|link=https://en.wikiversity.org/wiki/File:Green%20check.png|alt=Yes]] | |- | Suicide Behaviors Questionnaire for Children (SBQ-C) |<b>Other</b> | | | | G | NA | A | A | | |- | Suicide Ideation Questionnaire for Children (SIQ-JR) |<b>Other</b> | | | | G | NA | A | G |[[File:Green check.png|link=https://en.wikiversity.org/wiki/File:Green%20check.png|alt=Yes]] | |- | Suicide Probability Scale (SPS) |<b>Other</b> | | | | E | NA | U | A | | |- | Columbia Suicide Screen (CSS) |<b>Other</b> | | | | G | NA | L | A | | |- | Harkavy Asnis Suicide Scale (HASS) |<b>Other</b> | | | | E | NA | U | G | | |} '''Note:''' Reliability and validity are included in the [[Evidence-based assessment/Self harm (assessment portfolio)/extended version|extended version]]. This table includes measures with Good or Excellent ratings. === Likelihood ratios and AUCs of screening measures for NSSI === *''For a list of the likelihood ratios for more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Likelihood_ratios_and_AUCs_of_common_screening_instruments '''click here.''']'' {| class="wikitable sortable" |- ! Screening Measure (Primary Reference) !! AUC !! LR+ (score) !! LR- (score) !! Clinical Generalizability !Download |- |Child Behavior Checklist (CBCL) Anxious/Depressed Scale T-score<ref name="Achenbach1991">{{cite book|last1=Achenbach|first1=Thomas M.|title=Child behavior checklist for ages 4-18|date=1991|publisher=T.M. Achenbach|location=Burlington, VT|isbn=0938565087|edition=[11th print.]}}</ref>|| .70 (N=470) || 3.78 (60+) || .39 (<60) || High. Large diverse sample with mixed depression sample compared to samples without depression. |Not free |- |} === Interpreting NSSI screening measure scores === * For information on interpreting screening measure scores, click [[Evidence based assessment/Prediction phase#Interpreting screening measure scores|here.]] == [[Evidence based assessment/Prescription phase|'''Prescription phase''']] == ===Gold standard diagnostic interviews=== * For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews '''click here.'''] === Coverage of interviews for NSSI === {{collapse top| Scope of diagnostic interviews for NSSI|expand=yes}} {| class="wikitable sortable" border="1" |- ! Instrument ! No. Items ! History ! Methods ! Frequency ! Lethality ! Intent of Functions ! History of Suicidality |- | colspan="8" style="font-size:110%; text-align:center;" span |<b> Omnibus Measures </b> |- | Suicide Attempt Self-Injury Interview (SASII) | 31 | X | X | X | X | X | X |- | Self-Injurious Thoughts and Behaviors Interview (SITBI) | 169 | X | X | X | X | X | X |} {{collapse bottom}} === Recommended diagnostic instruments for NSSI === {| class="wikitable sortable" ! colspan="11" |Diagnostic instruments for '''NSSI''' ! |- !Instrument (Reference) !Type of screeening !Format (Reporter) !Age Range !Administration Time !Internal Consistency !Interrater Reliability !Test-Retest Reliability !Construct Validity !Content Validity !Highly Recommended !Free and Accessible Measures |- |Beck Scale for Suicidal Ideation (BSI) | |Self-report questionnaire |17+ |5-10 mins | |E | |A |G | |No * Link to purchase [https://www.pearsonclinical.com/psychology/products/100000157/beck-scale-for-suicide-ideation-bss.html] |- |Suicidal Behaviors Questionnaire-Revised (SBQ-R) | |Self-report |18+ |5-10 mins | | | |.87 E |E |Yes |[https://www.integration.samhsa.gov/images/res/SBQ.pdf SBQ-R] |- |Self-Harm Behavior Questionnaire (SHBQ) | |Self-report questionnaire |adolescents |Not Reported | |E | |G |G | | |- |Suicide Attempt Self-Injury Interview (SASII) <ref name="LinehanEtAl2006" /> |<b>Omnibus</b> | | | |G |E |E |G | |[[File:Green check.png|link=https://en.wikiversity.org/wiki/File:Green%20check.png]] |[https://mfr.osf.io/render?url=https://osf.io/zstnj/?action=download%26mode=render SASII] |- |Self Injurious Thoughts and Behaviors Interview (SITBI) <ref name="NockEtAl2007" /> |<b>Omnibus</b> | | | |NA |E |A |G | |[[File:Green check.png|link=https://en.wikiversity.org/wiki/File:Green%20check.png]] |[https://mfr.osf.io/render?url=https://osf.io/hw46c/?action=download%26mode=render SITBI] |- |Suicidal Ideation Questionnaire (SIQ) | |Self-report questionnaire |12-18 years old |10 minutes |NA | | | | | |[https://www.semel.ucla.edu/sites/default/files/pdf/SuicidalIdeationQuestionnaire%28SIQ%29%28Child%29.PDF SIQ] |- |Suicidal Ideation Questionnaire (SIQ-JR) | |Self-report Questionnaire |Middle School aged children |10 minutes |NA | |test-retest: r -0.93 (males) r = .87 (females) | | | |SIQ-[https://www.semel.ucla.edu/sites/default/files/pdf/SuicidalIdeationQuestionnaire%28SIQ%29%28Child%29.PDF JR] |} '''Note:''' Reliability and validity are included in the [[Evidence-based assessment/Self harm (assessment portfolio)/extended version|extended version]]. This table includes measures with Good or Excellent ratings. == [[Evidence based assessment/Process phase|'''Process phase''']] == The following section contains a brief overview of treatment options for depression and list of process and outcome measures for non-suicidal self-injury. The section includes benchmarks based on published norms for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the [[Evidence based assessment/Process phase|process phase]] of assessment. For more information of differences between process and outcome measures, see the page on the [[Evidence based assessment/Process phase|process phase of assessment]]. === Process measures === {{blockquotetop}} {{blockquotebottom}} === Outcome and severity measures === * This table includes clinically significant benchmarks for NSSI specific outcome measures * Information on how to interpret this table can be [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase found here]. * Additionally, these [[Evidence based assessment/Vignettes|vignettes]] might be helpful resources for understanding appropriate adaptation of outcome measures in practice. *''<u>For clinically significant change benchmarks for the CBCL, YSR, and TRF total, externalizing, internalizing, and attention benchmarks,</u>'' [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase&wteswitched=1#Clinically_significant_change_benchmarks_for_widely-used_outcome_measures see here.] {| class="wikitable sortable" border="1" | colspan="8" |'''Clinically significant change benchmarks with common instruments for NSSI''' |- | rowspan="1&quot;" style="text-align:center;font-size:130%;" | <b> Measure</b> | style="text-align:center;font-size:130%;" | <b>Subscale</b> | colspan="3" style="text-align:center;font-size:130%" width="300" | <b> Cut-off scores</b> | colspan="3" style="text-align:center;font-size:120%" | <b> Critical Change <br> (unstandardized scores)</b> |- | colspan="8" span style="font-size:110%; text-align:center;" | <b> Benchmarks Based on Published Norms </b> |- | colspan="2" | | style="text-align:center;font-size:110%" | <b> A</b> | style="text-align:center;font-size:110%" | <b> B</b> | style="text-align:center;font-size:110%" | <b> C</b> | style="text-align:center;font-size:110%" | <b> 95%</b> | style="text-align:center;font-size:110%" | <b> 90%</b> | style="text-align:center;font-size:110%" | <b> SE_difference</b> |- | rowspan="1" style="text-align:center;" | | style="text-align:center;"| | style="text-align:center;"| | style="text-align:center;"| | style="text-align:center;"| | style="text-align:center;"| | style="text-align:center;"| | style="text-align:center;"| |- | rowspan="1" style="text-align:center;" | | style="text-align:right;" | | style="text-align:center;"| | style="text-align:center;"| | style="text-align:center;"| | style="text-align:center;"| | style="text-align:center;"| | style="text-align:center;"| |} === Treatment === * Please refer to the page on [[wikipedia:Nonsuicidal_self-injury_disorder|non-suicidal self injury]] for more information on available treatment for NSSI *Go to [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/self-injurious-thoughts-and-behaviors/ Effective Child Therapy] for a curated resource on effective treatments for NSSI. {{collapse top| Information on treatment for NSSI|expand=yes}} According to Nock (2010)<ref name="Nock2010"/>, no treatment for NSSI could be considered "evidence-based." However, recent years have seen an increase in intervention trials for NSSI. Although limited due to lack of consistency in defining and measuring NSSI, this work could provide insight into potential best practices for treating this condition (Andover, 2015)<ref name=Andover2014/>. # '''Dialectical behavioral therapy (DBT)''' ## Dialectical Behavior Therapy has been shown to be effective in treating individuals with Borderline Personality Disorder (BPD) who engage in NSSI; however it has not been shown to be better than treatment as usual in a sample of individuals without BPD. In the absence of a better option, a DBT approach to treatment is the most evidence based. # '''Cognitive behavioral therapy (CBT)''' ## Few research studies have tested cognitive-behavioral therapy (CBT) as a treatment specifically for NSSI. However, some studies have evaluated the efficacy of CBT trials in treating self-injury with and without suicidal intent. Manual-assisted cognitive therapy (MACT) is a 6-session CBT intervention focusing on functions of deliberate self-harm, emotion regulation, problem-solving skills, and relapse prevention. MACT has demonstrated mixed results for decreasing NSSI frequency and severity among adults (Tyrer et al., 2003<ref name="TyrerEtAl2003" />; Weinberg, Gunderson, Hennen, & Cutter, 2006)<ref name="WeinbergEtAl2006" />. Although MACT may be a promising intervention (Muehlenkamp, 2006)<ref name="Muehlenkamp2006" />, it should be evaluated in future studies. In one adolescent treatment trial, the Adolescent Depression Antidepressant Psychotherapy Trial (ADAPT), a decrease in NSSI behaviors was found at post-treatment for both SSRI and SSRI+CBT groups (Goodyer et al., 2007)<ref name="GoodyerEtAl2007" />, although no differences were found between groups. In sum, findings from efficacy trials of CBT on NSSI outcomes are mixed, and more trials examining CBT as a treatment specifically for NSSI are needed. # '''Pharmacology''' ## Pharmacological interventions are especially scarce. However, one study found that fluoxetine was effective at reducing NSSI frequency in a sample of 22 adults with major depressive disorder and either BPD or schizotypal personality disorder (Markovitz et al, 1991)<ref name="MarkovitzEtAl1991" />. A second trial found that antidepressant medications alone (SSRIs and SNRIs) were as effective as medication plus CBT in reducing NSSI among adolescents with MDD (Brent et al., 2009<ref name="Brent2009" />; Goodyer et al., 2007)<ref name="GoodyerEtAl2007" />. Ziprasidone, an atypical antipsychotic, was found to be more effective in reducing NSSI behaviors among adolescents compared to another neuroleptic medication (Libal et al., 2005)<ref name="LibalEtAl2005" />. Clonidine has also been effective as an intervention for acute NSSI urges and feelings of tension among a sample of patients with BPD (Philipsen et al., 2004)<ref name="PhilipsenEtAl2004" />, although the long-term effects are unknown. # '''Prevention programs''' ## Jacobs, Walsh, McDade, and Pigeon (2009)<ref name="JacobsEtAl2009" /> developed the only known prevention program for NSSI, the Signs of Self-Injury program (SOSI). This school-based prevention program is designed to increase awareness about NSSI among adolescents through psychoeducation about warning signs and symptoms and improvement of help-seeking behaviors and attitudes. One test of effectiveness and acceptance found the program to be feasible and effective at changing attitudes toward NSSI and increasing help-seeking among students (Muehlenkamp et al., 2010)<ref name="MuehlenkampEtAl2010" />. {{collapse bottom}} == '''External resources''' == # [https://en.wikiversity.org/w/index.php?title=Helping_Give_Away_Psychological_Science/Resources/Annotated_List_of_Where_and_How_to_Find_a_Therapist&wteswitched=1#Other_low-cost_options Find-a-Therapist] (a curated list of find-a-therapist websites where you can find a provide #[http://www.selfinjury.bctr.cornell.edu/about-self-injury.html Cornell resource on self-injury] #Effective Child Therapy page for [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/self-injurious-thoughts-and-behaviors/ Self-Injurious Thoughts and Behaviors] ##Effective Child Therapy is website sponsored by Division 53 of the American Psychological Association (APA), or The [https://sccap53.org Society of Clinical Child and Adolescent Psychology (SCCAP)] (SCCAP), in collaboration with the Association for Behavioral and Cognitive Therapies (ABCT). Use for information on symptoms and available treatments. # [[wikipedia:Nonsuicidal_self-injury_disorder|Wikipedia page for non-suicidal self injury]] #[https://mhfa.com.au/sites/mhfa.com.au/files/MHFA_selfinjury_guidelinesA4%202014%20Revised_1.pdf Mental Health First Aid] page on non-suicidal self-injury =='''References'''== {{collapse top|References|expand=yes}} Liu, R. T., Sheehan, A. E., Walsh, R. F., Sanzari, C. M., Cheek, S. M., & Hernandez, E. M. (2019). Prevalence and correlates of non-suicidal self-injury among lesbian, gay, bisexual, and transgender individuals: A systematic review and meta-analysis. 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M.|title=Suicides behaviors questionnaire|date=1981|publisher=University of Washington|location=Seattle}}</ref> <ref name="LloydRichardsonEtAl1997">{{cite journal|last1=Lloyd-Richardson|first1=E. E.|last2=Kelley|first2=M. L.|last3=Hope|first3=T.|title=Self-mutilation in a community sample of adolescents: Descriptive characteristics and provisional prevalence rates|journal=Poster session presented at the Annual Meeting of the Society for Behavioral Medicine|date=April 1997|location=New Orleans, LA}}</ref> <ref name="Muehlenkamp2006">{{cite journal|last1=Muehlenkamp|first1=J. J.|title=Empirically supported treatments and general therapy guidelines for non-suicidal self-injury|journal=Journal of Mental Health Counseling|date=2006|volume=28|pages=166-185}}</ref> }} {{collapse bottom}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] c195cdd9n54v4h07dam72vo5avcg3ij 0 207105 2419220 2413394 2022-08-26T03:01:18Z Ardenguo 2944162 /* References */ Made the references box expanded by default wikitext text/x-wiki Ad<noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{medical disclaimer}} {{:{{BASEPAGENAME}}/Sidebar}} ==[[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio"?''']]== * For background information on what assessment portfolios are, click the link in the heading above. * Want even 'more' information about this topic? There's an extended version of this page [[Evidence-based assessment/Oppositional defiant disorder (assessment portfolio)/extended version|here]]. ==[[Evidence based assessment/Preparation phase|'''Preparation phase''']]== === Diagnostic criteria for oppositional defiant disorder=== {{blockquotetop}} <big>ICD-11 Diagnostic Criteria</big><br> <br> '''General Description:''' Oppositional defiant disorder is a persistent pattern (e.g., 6 months or more) of markedly defiant, disobedient, provocative or spiteful behaviour that occurs more frequently than is typically observed in individuals of comparable age and developmental level and that is not restricted to interaction with siblings. Oppositional defiant disorder may be manifest in prevailing, persistent angry or irritable mood, often accompanied by severe temper outbursts or in headstrong, argumentative and defiant behaviour. The behavior pattern is of sufficient severity to result in significant impairment in personal, family, social, educational, occupational or other important areas of functioning <br> <br> '''Oppositional Defiant Disorder With Chronic Irritability-Anger:''' All definitional requirements for oppositional defiant disorder are met. This form of oppositional defiant disorder is characterized by prevailing, persistent angry or irritable mood that may be present independent of any apparent provocation. The negative mood is often accompanied by regularly occurring severe temper outbursts that are grossly out of proportion in intensity or duration to the provocation. Chronic irritability and anger are characteristic of the individual’s functioning nearly every day, are observable across multiple settings or domains of functioning (e.g., home, school, social relationships), and are not restricted to the individual’s relationship with his/her parents or guardians. The pattern of chronic irritability and anger is not limited to occasional episodes (e.g., developmentally typical irritability) or discrete periods (e.g., irritable mood in the context of manic or depressive episodes). *Note: The ICD-11 lists 3 additional subcategories of oppositional defiant disorder with chronic irritability-anger (i.e., with limited prosocial emotions, with typical prosocial emotions, and unspecified). They can be found [https://icd.who.int/browse11/l-m/en#/http%3a%2f%2fid.who.int%2ficd%2fentity%2f818792113 here]. <br> '''Oppositional Defiant Disorder Without Chronic Irritability-Anger:''' Meets all definitional requirements for oppositional defiant disorder. This form of oppositional defiant disorder is not characterized by prevailing, persistent, angry or irritable mood, but does feature headstrong, argumentative, and defiant behavior. *Note: The ICD-11 lists 3 additional subcategories of oppositional defiant disorder without chronic irritability-anger (i.e., with limited prosocial emotions, with typical prosocial emotions, and unspecified). They can be found [https://icd.who.int/browse11/l-m/en#/http%3a%2f%2fid.who.int%2ficd%2fentity%2f736540987 here]. <br> <big>Changes in DSM-5</big> <br> The diagnostic criteria for ADHD changed slightly from DSM-IV to DSM-5. See the changes [https://www.ncbi.nlm.nih.gov/books/NBK519712/table/ch3.t14/ here]. {{blockquotebottom}}<ref>{{Cite web|url=https://icd.who.int/browse11/l-m/en#/http://id.who.int/icd/entity/1545599508|title=ICD-11 for Mortality and Morbidity Statistics|website=icd.who.int|access-date=2022-07-11}}</ref> ===Base rates of ODD in different clinical settings=== This section describes the demographic setting of the population(s) sampled, base rates of diagnosis, country/region sampled and the diagnostic method that was used. Using this information, clinicians will be able to anchor the rate of ODD that they are likely to see in their clinical practice. * '''''To see prevalence rates across multiple disorders, [[Evidence-based assessment/Preparation phase|click here.]]''''' {|class="wikitable sortable" border="1" |- ! Demography ! Setting !! Base Rate !! Diagnostic Method |- || Various locations across USA | Meta-analysis of 38 studies<ref>Canino G, Polanczyk G, Bauermeister JJ, et al. (2010) Does the prevalence of CD and ODD vary across cultures? Social Psychiatry Epidemiology, 45(7):695–704.</ref> || 3.3% || Varied |- || All of the U.S. | Nationally representative large-scale study (N = 3,119) <ref>Nock, M. K., Kazdin, A. E., Hiripi, E., & Kessler, R. C. (2007). Lifetime prevalence, correlates, and persistence of oppositional defiant disorder: results from the National Comorbidity Survey Replication. ''Journal of Child Psychology and Psychiatry, 48''(7), 703-713.</ref> || 10.2% (overall) 11.2% (males) 9.2% (females) || World Health Organization (WHO) Composite International Diagnostic Interview (CIDI)^r |- |Suburban and urban Colorado |Project to Learn about Youth-Mental health, school-based study for children from kindergarten to high-school (n = 236)<ref name=":1">{{Cite journal|last=Danielson|first=Melissa L.|last2=Bitsko|first2=Rebecca H.|last3=Holbrook|first3=Joseph R.|last4=Charania|first4=Sana N.|last5=Claussen|first5=Angelika H.|last6=McKeown|first6=Robert E.|last7=Cuffe|first7=Steven P.|last8=Owens|first8=Julie Sarno|last9=Evans|first9=Steven W.|date=2021-06-01|title=Community-Based Prevalence of Externalizing and Internalizing Disorders among School-Aged Children and Adolescents in Four Geographically Dispersed School Districts in the United States|url=https://doi.org/10.1007/s10578-020-01027-z|journal=Child Psychiatry & Human Development|language=en|volume=52|issue=3|pages=500–514|doi=10.1007/s10578-020-01027-z|issn=1573-3327|pmc=PMC8016018|pmid=32734339}}</ref> |6.8% |Diagnostic Interview Schedule for Children (DISC) |- |Urban and suburban Florida |Project to Learn about Youth-Mental health, school-based study for children from kindergarten to high-school (n = 289)<ref name=":1" /> |6.9% |Diagnostic Interview Schedule for Children (DISC) |- |Rural and suburban Ohio |Project to Learn about Youth-Mental health, school-based study for children from elementary to high-school (n = 152)<ref name=":1" /> |17.3% |Diagnostic Interview Schedule for Children (DISC) |- |Suburban and rural South Carolina |Project to Learn about Youth-Mental health, school-based study for children from elementary to high-school (n = 270)<ref name=":1" /> |5.7% |Diagnostic Interview Schedule for Children (DISC) |- || Semi-rural North Carolina | Preschool-aged children from pediatric practices (N = 306; age 2 - 5 years old)<ref>Egger, H.L., & Angold, A. (2006). Common emotional and behavioral disorders in preschool children: Presentation, nosology, and epidemiology. ''Journal of Child Psychiatry and Psychology, 47'', 313–337.</ref> || 6.6% || Preschool Age Psychiatric Assessment (PAPA)^p |- || Western North Carolina | The Great Smoky Mountains Study - longitudinal, population-based study of community sample<ref>Costello, E. J., Mustillo, S., Erkanli, A., Keeler, G., & Angold, A. (2003) Prevalence and development of psychiatric disorders in adolescence. ''Arch Gen Psychiatry, 60'', 837-844.</ref> || 2.33% (overall) 3.16% (males) 2.75% (females) || Child and Adolescent Psychiatric Assessment (CAPA)^{p, y} |- || Chicago | Preschool-aged children from inner city schools and pediatric practices (N = 796; age 2 - 5 years old)<ref>Lavigne, J. V., LeBailly, S. A., Hopkins, J., Gouze, K. R., & Binns, H. J. (2009). The prevalence of ADHD, ODD, depression, and anxiety in a community sample of 4-year-olds. ''Journal Of Clinical Child And Adolescent Psychology, 38''(3), 315-328. doi:10.1080/15374410902851382</ref> || 8.3% || Diagnostic Interview Schedule for Children–Parent Scale–Young Child Version (DISC-YC) ^p |- |Germany (Saarbrücken County) |All school-aged children were examined during a routine school-entry medical examination (N = 1676, mean age = 5.7)<ref>{{Cite journal|last=Niemczyk|first=Justine|last2=Equit|first2=Monika|last3=Braun-Bither|first3=Katrin|last4=Klein|first4=Anna-Maria|last5=von Gontard|first5=Alexander|date=2015-07-01|title=Prevalence of incontinence, attention deficit/hyperactivity disorder and oppositional defiant disorder in preschool children|url=https://doi.org/10.1007/s00787-014-0628-6|journal=European Child & Adolescent Psychiatry|language=en|volume=24|issue=7|pages=837–843|doi=10.1007/s00787-014-0628-6|issn=1435-165X}}</ref> |7.3% (males) 5.1%(females) |DISYPS-II |- |South Korea (Seoul) |Children were randomly surveyed across 6 school districts in Seoul (N = 1645, age 6 - 12 years old) |5.8% (males) 4.1%(females) |Diagnostic Interview Schedule for Children–Parent Scale IV (DISC-IV) |} ^p Parent interviewed as part of diagnostic assessment; ^y youth interviewed as part of diagnostic assessment, ^r adult interviewed for retrospective report as part of diagnostic assessment '''Note:''' Mash and Barkley note that prevalence rates of ODD must be qualified, because the definition of ODD has changed at a fast rate, the rates adolescents meeting criteria in any cross-sectional evaluation may be misleading because of the developmental progressions with and between ODD and Conduct Disorder, and categorical definitions of aggressive patterns may reflect arbitrary numbers of constituent estimates. These factors may lead to misleading prevalence rates. In addition, few studies have investigated the prevalence of ODD in preschool-aged children, and early onset of these behaviors is associated with more severe and stable impairment.<ref>Mash, E., & Barkley, R. (Eds.). (2003). ''Child Psychopathology''. 2nd Edition. New York: Guilford Press.</ref> ==[[Evidence based assessment/Prediction phase|'''Prediction phase''']]== The following section contains a list of screening and diagnostic instruments for ODD. The section includes administration information, psychometric data, and PDFs or links to the screenings. * Screenings are used as part of the [[Evidence based assessment/Prediction phase|prediction phase]] of assessment; for more information on interpretation of this data, or how screenings fit in to the assessment process, click [[Evidence based assessment/Prediction phase|here]]. * '''''For a list of more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Psychometric_properties_of_common_screening_instruments click here.]''''' {| class="wikitable sortable" border="1" ! colspan="5" |Screening measures for ODD |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time !Where to access |- |Achenbach System of Empirically Based Assessments (ASEBA): Child Behavior Checklist (CBCL), Youth Self-Report (YSR) |Parent report (CBCL) Youth self-report (YSR) |6-18 (CBCL) 11-18 (YSR) <ref name=":9">{{Cite book|url=https://www.worldcat.org/oclc/1130319849|title=Assessment of disorders in childhood and adolescence|date=2020|others=Eric Arden Youngstrom, Mitchell J. Prinstein, Eric J. Mash, Russell A. Barkley|isbn=978-1-4625-4363-2|edition=Fifth edition|location=New York, NY|oclc=1130319849}}</ref> |10 - 15 minutes<ref name=":9" /> |[https://store.aseba.org/School-Age-6-18-Materials/departments/11/ Purchase] |- |Eyberg Child Behavior Inventory (ECBI) |Parent report |2-16 |5 minutes |[https://www.parinc.com/products/pkey/97 Purchase] |- |Strengths and Difficulties Questionnaire (SDQ) |Parent report |3 - 16 |3 - 5 minutes |[https://www.sdqinfo.org/a0.html SDQ Homepage][https://osf.io/dzk68/?view_only=681e9b648169427b845f313aafa0a169 English PDF][https://www.sdqinfo.org/py/sdqinfo/b0.py Additional languages PDFs] |} '''Note:''' L = Less than adequate; A = Adequate; G = Good; E = Excellent; U = Unavailable; NA = Not applicable === Likelihood ratios and AUCs of screening instruments for ODD === * '''''For a list of the likelihood ratios for more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Likelihood_ratios_and_AUCs_of_common_screening_instruments click here.]''''' {| class="wikitable sortable" border="1" ! Screening Measure (Primary Reference) ! Area Under Curve (AUC) ! LR+ (Score) ! LR- (Score) ! Clinical Generalizability !Where to Access |- |CBCL DSM-Oriented Scales<ref name=":7">Achenbach, T. M. (1991a). ''Manual for the Child Behavior Checklist/4–18 and 1991 Profile''. Burlington , VT : University of Vermont Department of Psychiatry.</ref> |.71 (N=475)<ref name=":3">Ebesutani, C., Bernstein, A., Nakamura, B. J., Chorpita, B. F., Higa-McMillan, C. K., & Weisz, J. R. (2010). Concurrent validity of the child behavior checklist DSM-oriented scales: Correspondence with DSM diagnoses and comparison to syndrome scales. ''Journal of Psychopathology and Behavioral Assessment, 32''(3), 373-384.</ref> | 2.80 (60+ to 70+) <ref name=":4">Warnick, E. M., Bracken, M. B., & Kasl, S. (2008). Screening efficiency of the Child Behavior Checklist and Strengths and Difficulties Questionnaire: a systematic review. ''Child and Adolescent Mental Health, 13''(3), 140-147.</ref> | .52 (60- to 70-)*<ref name=":4" /> |Youth aged 5 - 18 seeking out patient treatment across a variety of settings<ref name=":4" /> |[https://store.aseba.org/School-Age-6-18-Materials/departments/11/ Purchase] |- |SDQ<ref name=":6">{{Cite journal|last=Shabani|first=Amir|last2=Masoumian|first2=Samira|last3=Zamirinejad|first3=Somayeh|last4=Hejri|first4=Maryam|last5=Pirmorad|first5=Tahereh|last6=Yaghmaeezadeh|first6=Hooman|date=2021-05|title=Psychometric properties of Structured Clinical Interview for DSM‐5 Disorders‐Clinician Version (SCID‐5‐CV)|url=https://onlinelibrary.wiley.com/doi/10.1002/brb3.1894|journal=Brain and Behavior|language=en|volume=11|issue=5|doi=10.1002/brb3.1894|issn=2162-3279|pmc=PMC8119811|pmid=33729681}}</ref> | .81 -.88 (N = 18,416)<ref>{{Cite journal|last=Algorta|first=Guillermo Perez|last2=Dodd|first2=Alyson Lamont|last3=Stringaris|first3=Argyris|last4=Youngstrom|first4=Eric A.|date=2016-09|title=Diagnostic efficiency of the SDQ for parents to identify ADHD in the UK: a ROC analysis|url=http://link.springer.com/10.1007/s00787-015-0815-0|journal=European Child & Adolescent Psychiatry|language=en|volume=25|issue=9|pages=949–957|doi=10.1007/s00787-015-0815-0|issn=1018-8827|pmc=PMC4990620|pmid=26762184}}</ref> |7.55 (3+)<ref name=":2">{{Cite journal|last=Goodman|first=Robert|date=2001-11-01|title=Psychometric Properties of the Strengths and Difficulties Questionnaire|url=https://www.jaacap.org/article/S0890-8567(09)60543-8/abstract|journal=Journal of the American Academy of Child & Adolescent Psychiatry|language=English|volume=40|issue=11|pages=1337–1345|doi=10.1097/00004583-200111000-00015|issn=0890-8567|pmid=11699809}}</ref> |.35 (3-)<ref name=":2" /> |Surveyed youth aged 5 - 15 in the UK <ref name=":2" /> |[https://www.sdqinfo.org/a0.html SDQ Homepage][https://osf.io/dzk68/?view_only=681e9b648169427b845f313aafa0a169 English PDF][https://www.sdqinfo.org/py/sdqinfo/b0.py Additional languages PDFs] |- |ECBI- Intensity Scale<ref name=":8">Eyberg, S. M., & Robinson, E. A. (1983). Conduct problem behavior: Standardization of a behavioral rating scale with adolescents. Journal of Clinical Child Psychology, 12 (3), 347-354.</ref> | |6.92 (131+)<ref name=":5">{{Cite journal|last=LYNEHAM|first=HEIDI J.|last2=ABBOTT|first2=MAREE J.|last3=RAPEE|first3=RONALD M.|date=2007-06|title=Interrater Reliability of the Anxiety Disorders Interview Schedule for DSM-IV: Child and Parent Version|url=https://doi.org/10.1097/chi.0b013e3180465a09|journal=Journal of the American Academy of Child &amp; Adolescent Psychiatry|volume=46|issue=6|pages=731–736|doi=10.1097/chi.0b013e3180465a09|issn=0890-8567}}</ref> |.11 (131-)<ref name=":5" /> |Youth aged 7-16 had responses compared to diagnosis<ref name=":5" /> |[https://www.parinc.com/products/pkey/97 Purchase] |} '''Note:''' “LR+” refers to the change in likelihood ratio associated with a positive test score, and “LR-” is the likelihood ratio for a low score. Likelihood ratios of 1 indicate that the test result did not change impressions at all. LRs larger than 10 or smaller than .10 are frequently clinically decisive; 5 or .20 are helpful, and between 2.0 and .5 are small enough that they rarely result in clinically meaningful changes of formulation<ref>Sackett, D. L., Straus, S. E., Richardson, W. S., Rosenberg, W., & Haynes, R. B. (2000). Evidence-based medicine: How to practice and teach EBM. Edinburgh: Churchill Livingstone.</ref>. '''Search terms:''' [Oppositional Defiant Disorder] AND [sensitivity OR specificity] in GoogleScholar and PsychINFO; === Interpreting ODD screening measure scores === * For information on interpreting screening measure scores, click [[Evidence based assessment/Prediction phase#Interpreting screening measure scores|here.]] == [[Evidence based assessment/Prescription phase|'''Prescription phase''']] == === Gold standard diagnostic interviews === * For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews click here.] === Recommended diagnostic instruments for ODD === {| class="wikitable sortable" ! colspan="5" |Diagnostic instruments for ODD |- !Measure !Format (Reporter) !Age Range !Administration/ Completion Time !Where to Access |- |Kiddie Schedule for Affective Disorders and Schizophrenia Present and Lifetime Version (KSADS-PL)<ref>{{Cite web|url=http://dx.doi.org/10.1037/t03988-000|title=Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version|last=Kaufman|first=John|last2=Birmaher|first2=Boris|date=1997|website=PsycTESTS Dataset|access-date=2022-08-04|last3=Brent|first3=David|last4=Rao|first4=Uma|last5=Flynn|first5=Cynthia|last6=Moreci|first6=Paula|last7=Williamson|first7=Douglas|last8=Ryan|first8=Neal}}</ref> |Structured interview |6-28 |45-75 minutes |[https://www.pediatricbipolar.pitt.edu/resources/instruments Website to access] |- |Development and Well-Being Assessment (DAWBA) <ref>{{Cite book|url=https://www.worldcat.org/oclc/1160972551|title=Assessment of disorders in childhood and adolescence|date=2020|others=Eric Arden Youngstrom, Mitchell J. Prinstein, Eric J. Mash, Russell A. Barkley|isbn=978-1-4625-4365-6|edition=Fifth edition|location=New York|oclc=1160972551}}</ref> |Structured (child/adolescent and parent) |11-18 |10-20 minutes for the eating disorder module |English PDF [https://dawba.info/py/dawbainfo/b1.py Additional languages] |- |Diagnostic Interview Schedule for Children (DISC-5)<ref>{{Cite web|url=http://dx.doi.org/10.1037/t04405-000|title=National Institute of Mental Health Diagnostic Interview Schedule for Children-IV|last=Shaffer|first=David|last2=Fisher|first2=Prudence|date=2000|website=PsycTESTS Dataset|access-date=2022-08-04|last3=Lucas|first3=Christopher P.|last4=Dulcan|first4=Mina K.|last5=Schwab-Stone|first5=Mary E.}}</ref> |Structured Interview (Self report and parent) |6-17 |About 20 minutes |[https://telesage.com/netdisc-5/# Coming soon] |} '''Note:''' L = Less than adequate; A = Adequate; G = Good; E = Excellent; U = Unavailable; NA = Not applicable == [[Evidence based assessment/Process phase|'''Process phase''']] == The following section contains a list of process and outcome measures for oppositional defiant disorder. The section includes benchmarks based on published norms for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the [[Evidence based assessment/Process phase|process phase]] of assessment. For more information of differences between process and outcome measures, see the page on the [[Evidence based assessment/Process phase|process phase of assessment]]. === Outcome and severity measures === * This table includes clinically significant benchmarks for generalized anxiety disorder specific outcome measures * Information on how to interpret this table can be [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase found here]. * Additionally, these [[Evidence based assessment/Vignettes|vignettes]] might be helpful resources for understanding appropriate adaptation of outcome measures in practice. * ''<u>For clinically significant change benchmarks for the CBCL, YSR, and TRF total, externalizing, internalizing, and attention benchmarks,</u>'' [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase&wteswitched=1#Clinically_significant_change_benchmarks_for_widely-used_outcome_measures see here.] {| class="wikitable sortable" border="1" |- | rowspan="1&quot;" style="text-align:center;font-size:130%;" | <b> Measure</b> | style="text-align:center;font-size:130%;" | <b> Subscale</b> | colspan="3" style="text-align:center;font-size:130%" width="300" | <b> Cut-off scores</b> | colspan="3" style="text-align:center;font-size:120%" | <b> Critical Change <br> (unstandardized scores)</b> |- | colspan="8" style="font-size:110%; text-align:center;" span | <b> Benchmarks Based on Published Norms</b> |- | colspan="2" | | style="text-align:center;font-size:110%" | <b> A</b> | style="text-align:center;font-size:110%" | <b> B</b> | style="text-align:center;font-size:110%" | <b> C</b> | style="text-align:center;font-size:110%" | <b> 95%</b> | style="text-align:center;font-size:110%" | <b> 90%</b> | style="text-align:center;font-size:110%" | <b> SE_difference</b> |- | rowspan="1" style="text-align:center;" | <b> CBCL T-scores <br> (2001 Norms)</b> | style="text-align:right;" | <i> Externalizing</i> | style="text-align:center;" | 49 | style="text-align:center;" | 70 | style="text-align:center;" | 58 | style="text-align:center;" | 7 | style="text-align:center;" | 6 | style="text-align:center;" | 3.4 |- | rowspan="1" style="text-align:center;" | <b> ECBI Scaled Scores <br> (1983 Norms)</b> | style="text-align:right;" | <i> Intensity</i> | style="text-align:center;" | 80.1 | style="text-align:center;" | 169.5 | style="text-align:center;" | 112.9 | style="text-align:center;" | 9.5 | style="text-align:center;" | 8 | style="text-align:center;" | 4.8 |- | rowspan="1" style="text-align:center;" | <b> ECBI Scaled Scores <br> (1983 Norms)</b> | style="text-align:right;" | <i> Problem</i> | style="text-align:center;" | 3.9 | style="text-align:center;" | 17.7 | style="text-align:center;" | 11.5 | style="text-align:center;" | 2.1 | style="text-align:center;" | 1.8 | style="text-align:center;" | 1.1 |} '''Note:''' “A” = Away from the clinical range, “B” = Back into the nonclinical range, “C” = Closer to the nonclinical than clinical mean. === Process measures=== See Section 1.1 for overview of evidence-based measures to use depending on etiology and symptomatology of Oppositional Defiant Disorder. ==Treatment== ===Behavioral parent training=== Behavioral Parent Training is considered the most effective treatment for childhood disruptive behavior disorders (e.g., Oppositional Defiant Disorder), especially for younger children (i.e., 3-8 year-olds). See http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/rule-breaking-defiance-and-acting-out/ a website sponsored by The Society for Child and Adolescent Psychology (APA, Division 53) and the Association for Behavioral and Cognitive Therapies (ABCT), for current summary of evidence-based treatments. ===Overview of recommendations for assessment and treatment=== See the [https://pathways.nice.org.uk/pathways/antisocial-behaviour-and-conduct-disorders-in-children-and-young-people#content=view-info-category%3Aview-about-menu National Institute for Health and Care Excellence (NICE) Practice Guidelines for Childhood Conduct Disorders], for an overview of recommendations for both assessment and treatment of Oppositional Defiant Disorder. == External Links == *[https://sccap53.org Society of Clinical Child and Adolescent Psychology] *http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/rule-breaking-defiance-and-acting-out/ == References == {{collapse top|References|expand=yes}} {{Reflist|30em}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] {{collapse bottom}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] c1an1j3038t7xqdbgoa5eh0exnrhhk8 2419248 2419220 2022-08-26T03:54:11Z Ardenguo 2944162 /* Prediction phase */ Removed all "Note: L = Less than adequate; A = Adequate; G = Good; E = Excellent; U = Unavailable; NA = Not applicable" because the condensed-version portfolios don't include reliability/validity. wikitext text/x-wiki Ad<noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{medical disclaimer}} {{:{{BASEPAGENAME}}/Sidebar}} ==[[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio"?''']]== * For background information on what assessment portfolios are, click the link in the heading above. * Want even 'more' information about this topic? There's an extended version of this page [[Evidence-based assessment/Oppositional defiant disorder (assessment portfolio)/extended version|here]]. ==[[Evidence based assessment/Preparation phase|'''Preparation phase''']]== === Diagnostic criteria for oppositional defiant disorder=== {{blockquotetop}} <big>ICD-11 Diagnostic Criteria</big><br> <br> '''General Description:''' Oppositional defiant disorder is a persistent pattern (e.g., 6 months or more) of markedly defiant, disobedient, provocative or spiteful behaviour that occurs more frequently than is typically observed in individuals of comparable age and developmental level and that is not restricted to interaction with siblings. Oppositional defiant disorder may be manifest in prevailing, persistent angry or irritable mood, often accompanied by severe temper outbursts or in headstrong, argumentative and defiant behaviour. The behavior pattern is of sufficient severity to result in significant impairment in personal, family, social, educational, occupational or other important areas of functioning <br> <br> '''Oppositional Defiant Disorder With Chronic Irritability-Anger:''' All definitional requirements for oppositional defiant disorder are met. This form of oppositional defiant disorder is characterized by prevailing, persistent angry or irritable mood that may be present independent of any apparent provocation. The negative mood is often accompanied by regularly occurring severe temper outbursts that are grossly out of proportion in intensity or duration to the provocation. Chronic irritability and anger are characteristic of the individual’s functioning nearly every day, are observable across multiple settings or domains of functioning (e.g., home, school, social relationships), and are not restricted to the individual’s relationship with his/her parents or guardians. The pattern of chronic irritability and anger is not limited to occasional episodes (e.g., developmentally typical irritability) or discrete periods (e.g., irritable mood in the context of manic or depressive episodes). *Note: The ICD-11 lists 3 additional subcategories of oppositional defiant disorder with chronic irritability-anger (i.e., with limited prosocial emotions, with typical prosocial emotions, and unspecified). They can be found [https://icd.who.int/browse11/l-m/en#/http%3a%2f%2fid.who.int%2ficd%2fentity%2f818792113 here]. <br> '''Oppositional Defiant Disorder Without Chronic Irritability-Anger:''' Meets all definitional requirements for oppositional defiant disorder. This form of oppositional defiant disorder is not characterized by prevailing, persistent, angry or irritable mood, but does feature headstrong, argumentative, and defiant behavior. *Note: The ICD-11 lists 3 additional subcategories of oppositional defiant disorder without chronic irritability-anger (i.e., with limited prosocial emotions, with typical prosocial emotions, and unspecified). They can be found [https://icd.who.int/browse11/l-m/en#/http%3a%2f%2fid.who.int%2ficd%2fentity%2f736540987 here]. <br> <big>Changes in DSM-5</big> <br> The diagnostic criteria for ADHD changed slightly from DSM-IV to DSM-5. See the changes [https://www.ncbi.nlm.nih.gov/books/NBK519712/table/ch3.t14/ here]. {{blockquotebottom}}<ref>{{Cite web|url=https://icd.who.int/browse11/l-m/en#/http://id.who.int/icd/entity/1545599508|title=ICD-11 for Mortality and Morbidity Statistics|website=icd.who.int|access-date=2022-07-11}}</ref> ===Base rates of ODD in different clinical settings=== This section describes the demographic setting of the population(s) sampled, base rates of diagnosis, country/region sampled and the diagnostic method that was used. Using this information, clinicians will be able to anchor the rate of ODD that they are likely to see in their clinical practice. * '''''To see prevalence rates across multiple disorders, [[Evidence-based assessment/Preparation phase|click here.]]''''' {|class="wikitable sortable" border="1" |- ! Demography ! Setting !! Base Rate !! Diagnostic Method |- || Various locations across USA | Meta-analysis of 38 studies<ref>Canino G, Polanczyk G, Bauermeister JJ, et al. (2010) Does the prevalence of CD and ODD vary across cultures? Social Psychiatry Epidemiology, 45(7):695–704.</ref> || 3.3% || Varied |- || All of the U.S. | Nationally representative large-scale study (N = 3,119) <ref>Nock, M. K., Kazdin, A. E., Hiripi, E., & Kessler, R. C. (2007). Lifetime prevalence, correlates, and persistence of oppositional defiant disorder: results from the National Comorbidity Survey Replication. ''Journal of Child Psychology and Psychiatry, 48''(7), 703-713.</ref> || 10.2% (overall) 11.2% (males) 9.2% (females) || World Health Organization (WHO) Composite International Diagnostic Interview (CIDI)^r |- |Suburban and urban Colorado |Project to Learn about Youth-Mental health, school-based study for children from kindergarten to high-school (n = 236)<ref name=":1">{{Cite journal|last=Danielson|first=Melissa L.|last2=Bitsko|first2=Rebecca H.|last3=Holbrook|first3=Joseph R.|last4=Charania|first4=Sana N.|last5=Claussen|first5=Angelika H.|last6=McKeown|first6=Robert E.|last7=Cuffe|first7=Steven P.|last8=Owens|first8=Julie Sarno|last9=Evans|first9=Steven W.|date=2021-06-01|title=Community-Based Prevalence of Externalizing and Internalizing Disorders among School-Aged Children and Adolescents in Four Geographically Dispersed School Districts in the United States|url=https://doi.org/10.1007/s10578-020-01027-z|journal=Child Psychiatry & Human Development|language=en|volume=52|issue=3|pages=500–514|doi=10.1007/s10578-020-01027-z|issn=1573-3327|pmc=PMC8016018|pmid=32734339}}</ref> |6.8% |Diagnostic Interview Schedule for Children (DISC) |- |Urban and suburban Florida |Project to Learn about Youth-Mental health, school-based study for children from kindergarten to high-school (n = 289)<ref name=":1" /> |6.9% |Diagnostic Interview Schedule for Children (DISC) |- |Rural and suburban Ohio |Project to Learn about Youth-Mental health, school-based study for children from elementary to high-school (n = 152)<ref name=":1" /> |17.3% |Diagnostic Interview Schedule for Children (DISC) |- |Suburban and rural South Carolina |Project to Learn about Youth-Mental health, school-based study for children from elementary to high-school (n = 270)<ref name=":1" /> |5.7% |Diagnostic Interview Schedule for Children (DISC) |- || Semi-rural North Carolina | Preschool-aged children from pediatric practices (N = 306; age 2 - 5 years old)<ref>Egger, H.L., & Angold, A. (2006). Common emotional and behavioral disorders in preschool children: Presentation, nosology, and epidemiology. ''Journal of Child Psychiatry and Psychology, 47'', 313–337.</ref> || 6.6% || Preschool Age Psychiatric Assessment (PAPA)^p |- || Western North Carolina | The Great Smoky Mountains Study - longitudinal, population-based study of community sample<ref>Costello, E. J., Mustillo, S., Erkanli, A., Keeler, G., & Angold, A. (2003) Prevalence and development of psychiatric disorders in adolescence. ''Arch Gen Psychiatry, 60'', 837-844.</ref> || 2.33% (overall) 3.16% (males) 2.75% (females) || Child and Adolescent Psychiatric Assessment (CAPA)^{p, y} |- || Chicago | Preschool-aged children from inner city schools and pediatric practices (N = 796; age 2 - 5 years old)<ref>Lavigne, J. V., LeBailly, S. A., Hopkins, J., Gouze, K. R., & Binns, H. J. (2009). The prevalence of ADHD, ODD, depression, and anxiety in a community sample of 4-year-olds. ''Journal Of Clinical Child And Adolescent Psychology, 38''(3), 315-328. doi:10.1080/15374410902851382</ref> || 8.3% || Diagnostic Interview Schedule for Children–Parent Scale–Young Child Version (DISC-YC) ^p |- |Germany (Saarbrücken County) |All school-aged children were examined during a routine school-entry medical examination (N = 1676, mean age = 5.7)<ref>{{Cite journal|last=Niemczyk|first=Justine|last2=Equit|first2=Monika|last3=Braun-Bither|first3=Katrin|last4=Klein|first4=Anna-Maria|last5=von Gontard|first5=Alexander|date=2015-07-01|title=Prevalence of incontinence, attention deficit/hyperactivity disorder and oppositional defiant disorder in preschool children|url=https://doi.org/10.1007/s00787-014-0628-6|journal=European Child & Adolescent Psychiatry|language=en|volume=24|issue=7|pages=837–843|doi=10.1007/s00787-014-0628-6|issn=1435-165X}}</ref> |7.3% (males) 5.1%(females) |DISYPS-II |- |South Korea (Seoul) |Children were randomly surveyed across 6 school districts in Seoul (N = 1645, age 6 - 12 years old) |5.8% (males) 4.1%(females) |Diagnostic Interview Schedule for Children–Parent Scale IV (DISC-IV) |} ^p Parent interviewed as part of diagnostic assessment; ^y youth interviewed as part of diagnostic assessment, ^r adult interviewed for retrospective report as part of diagnostic assessment '''Note:''' Mash and Barkley note that prevalence rates of ODD must be qualified, because the definition of ODD has changed at a fast rate, the rates adolescents meeting criteria in any cross-sectional evaluation may be misleading because of the developmental progressions with and between ODD and Conduct Disorder, and categorical definitions of aggressive patterns may reflect arbitrary numbers of constituent estimates. These factors may lead to misleading prevalence rates. In addition, few studies have investigated the prevalence of ODD in preschool-aged children, and early onset of these behaviors is associated with more severe and stable impairment.<ref>Mash, E., & Barkley, R. (Eds.). (2003). ''Child Psychopathology''. 2nd Edition. New York: Guilford Press.</ref> ==[[Evidence based assessment/Prediction phase|'''Prediction phase''']]== The following section contains a list of screening and diagnostic instruments for ODD. The section includes administration information, psychometric data, and PDFs or links to the screenings. * Screenings are used as part of the [[Evidence based assessment/Prediction phase|prediction phase]] of assessment; for more information on interpretation of this data, or how screenings fit in to the assessment process, click [[Evidence based assessment/Prediction phase|here]]. * '''''For a list of more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Psychometric_properties_of_common_screening_instruments click here.]''''' {| class="wikitable sortable" border="1" ! colspan="5" |Screening measures for ODD |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time !Where to access |- |Achenbach System of Empirically Based Assessments (ASEBA): Child Behavior Checklist (CBCL), Youth Self-Report (YSR) |Parent report (CBCL) Youth self-report (YSR) |6-18 (CBCL) 11-18 (YSR) <ref name=":9">{{Cite book|url=https://www.worldcat.org/oclc/1130319849|title=Assessment of disorders in childhood and adolescence|date=2020|others=Eric Arden Youngstrom, Mitchell J. Prinstein, Eric J. Mash, Russell A. Barkley|isbn=978-1-4625-4363-2|edition=Fifth edition|location=New York, NY|oclc=1130319849}}</ref> |10 - 15 minutes<ref name=":9" /> |[https://store.aseba.org/School-Age-6-18-Materials/departments/11/ Purchase] |- |Eyberg Child Behavior Inventory (ECBI) |Parent report |2-16 |5 minutes |[https://www.parinc.com/products/pkey/97 Purchase] |- |Strengths and Difficulties Questionnaire (SDQ) |Parent report |3 - 16 |3 - 5 minutes |[https://www.sdqinfo.org/a0.html SDQ Homepage][https://osf.io/dzk68/?view_only=681e9b648169427b845f313aafa0a169 English PDF][https://www.sdqinfo.org/py/sdqinfo/b0.py Additional languages PDFs] |} === Likelihood ratios and AUCs of screening instruments for ODD === * '''''For a list of the likelihood ratios for more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Likelihood_ratios_and_AUCs_of_common_screening_instruments click here.]''''' {| class="wikitable sortable" border="1" ! Screening Measure (Primary Reference) ! Area Under Curve (AUC) ! LR+ (Score) ! LR- (Score) ! Clinical Generalizability !Where to Access |- |CBCL DSM-Oriented Scales<ref name=":7">Achenbach, T. M. (1991a). ''Manual for the Child Behavior Checklist/4–18 and 1991 Profile''. Burlington , VT : University of Vermont Department of Psychiatry.</ref> |.71 (N=475)<ref name=":3">Ebesutani, C., Bernstein, A., Nakamura, B. J., Chorpita, B. F., Higa-McMillan, C. K., & Weisz, J. R. (2010). Concurrent validity of the child behavior checklist DSM-oriented scales: Correspondence with DSM diagnoses and comparison to syndrome scales. ''Journal of Psychopathology and Behavioral Assessment, 32''(3), 373-384.</ref> | 2.80 (60+ to 70+) <ref name=":4">Warnick, E. M., Bracken, M. B., & Kasl, S. (2008). Screening efficiency of the Child Behavior Checklist and Strengths and Difficulties Questionnaire: a systematic review. ''Child and Adolescent Mental Health, 13''(3), 140-147.</ref> | .52 (60- to 70-)*<ref name=":4" /> |Youth aged 5 - 18 seeking out patient treatment across a variety of settings<ref name=":4" /> |[https://store.aseba.org/School-Age-6-18-Materials/departments/11/ Purchase] |- |SDQ<ref name=":6">{{Cite journal|last=Shabani|first=Amir|last2=Masoumian|first2=Samira|last3=Zamirinejad|first3=Somayeh|last4=Hejri|first4=Maryam|last5=Pirmorad|first5=Tahereh|last6=Yaghmaeezadeh|first6=Hooman|date=2021-05|title=Psychometric properties of Structured Clinical Interview for DSM‐5 Disorders‐Clinician Version (SCID‐5‐CV)|url=https://onlinelibrary.wiley.com/doi/10.1002/brb3.1894|journal=Brain and Behavior|language=en|volume=11|issue=5|doi=10.1002/brb3.1894|issn=2162-3279|pmc=PMC8119811|pmid=33729681}}</ref> | .81 -.88 (N = 18,416)<ref>{{Cite journal|last=Algorta|first=Guillermo Perez|last2=Dodd|first2=Alyson Lamont|last3=Stringaris|first3=Argyris|last4=Youngstrom|first4=Eric A.|date=2016-09|title=Diagnostic efficiency of the SDQ for parents to identify ADHD in the UK: a ROC analysis|url=http://link.springer.com/10.1007/s00787-015-0815-0|journal=European Child & Adolescent Psychiatry|language=en|volume=25|issue=9|pages=949–957|doi=10.1007/s00787-015-0815-0|issn=1018-8827|pmc=PMC4990620|pmid=26762184}}</ref> |7.55 (3+)<ref name=":2">{{Cite journal|last=Goodman|first=Robert|date=2001-11-01|title=Psychometric Properties of the Strengths and Difficulties Questionnaire|url=https://www.jaacap.org/article/S0890-8567(09)60543-8/abstract|journal=Journal of the American Academy of Child & Adolescent Psychiatry|language=English|volume=40|issue=11|pages=1337–1345|doi=10.1097/00004583-200111000-00015|issn=0890-8567|pmid=11699809}}</ref> |.35 (3-)<ref name=":2" /> |Surveyed youth aged 5 - 15 in the UK <ref name=":2" /> |[https://www.sdqinfo.org/a0.html SDQ Homepage][https://osf.io/dzk68/?view_only=681e9b648169427b845f313aafa0a169 English PDF][https://www.sdqinfo.org/py/sdqinfo/b0.py Additional languages PDFs] |- |ECBI- Intensity Scale<ref name=":8">Eyberg, S. M., & Robinson, E. A. (1983). Conduct problem behavior: Standardization of a behavioral rating scale with adolescents. Journal of Clinical Child Psychology, 12 (3), 347-354.</ref> | |6.92 (131+)<ref name=":5">{{Cite journal|last=LYNEHAM|first=HEIDI J.|last2=ABBOTT|first2=MAREE J.|last3=RAPEE|first3=RONALD M.|date=2007-06|title=Interrater Reliability of the Anxiety Disorders Interview Schedule for DSM-IV: Child and Parent Version|url=https://doi.org/10.1097/chi.0b013e3180465a09|journal=Journal of the American Academy of Child &amp; Adolescent Psychiatry|volume=46|issue=6|pages=731–736|doi=10.1097/chi.0b013e3180465a09|issn=0890-8567}}</ref> |.11 (131-)<ref name=":5" /> |Youth aged 7-16 had responses compared to diagnosis<ref name=":5" /> |[https://www.parinc.com/products/pkey/97 Purchase] |} '''Note:''' “LR+” refers to the change in likelihood ratio associated with a positive test score, and “LR-” is the likelihood ratio for a low score. Likelihood ratios of 1 indicate that the test result did not change impressions at all. LRs larger than 10 or smaller than .10 are frequently clinically decisive; 5 or .20 are helpful, and between 2.0 and .5 are small enough that they rarely result in clinically meaningful changes of formulation<ref>Sackett, D. L., Straus, S. E., Richardson, W. S., Rosenberg, W., & Haynes, R. B. (2000). Evidence-based medicine: How to practice and teach EBM. Edinburgh: Churchill Livingstone.</ref>. '''Search terms:''' [Oppositional Defiant Disorder] AND [sensitivity OR specificity] in GoogleScholar and PsychINFO; === Interpreting ODD screening measure scores === * For information on interpreting screening measure scores, click [[Evidence based assessment/Prediction phase#Interpreting screening measure scores|here.]] == [[Evidence based assessment/Prescription phase|'''Prescription phase''']] == === Gold standard diagnostic interviews === * For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews click here.] === Recommended diagnostic instruments for ODD === {| class="wikitable sortable" ! colspan="5" |Diagnostic instruments for ODD |- !Measure !Format (Reporter) !Age Range !Administration/ Completion Time !Where to Access |- |Kiddie Schedule for Affective Disorders and Schizophrenia Present and Lifetime Version (KSADS-PL)<ref>{{Cite web|url=http://dx.doi.org/10.1037/t03988-000|title=Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version|last=Kaufman|first=John|last2=Birmaher|first2=Boris|date=1997|website=PsycTESTS Dataset|access-date=2022-08-04|last3=Brent|first3=David|last4=Rao|first4=Uma|last5=Flynn|first5=Cynthia|last6=Moreci|first6=Paula|last7=Williamson|first7=Douglas|last8=Ryan|first8=Neal}}</ref> |Structured interview |6-28 |45-75 minutes |[https://www.pediatricbipolar.pitt.edu/resources/instruments Website to access] |- |Development and Well-Being Assessment (DAWBA) <ref>{{Cite book|url=https://www.worldcat.org/oclc/1160972551|title=Assessment of disorders in childhood and adolescence|date=2020|others=Eric Arden Youngstrom, Mitchell J. Prinstein, Eric J. Mash, Russell A. Barkley|isbn=978-1-4625-4365-6|edition=Fifth edition|location=New York|oclc=1160972551}}</ref> |Structured (child/adolescent and parent) |11-18 |10-20 minutes for the eating disorder module |English PDF [https://dawba.info/py/dawbainfo/b1.py Additional languages] |- |Diagnostic Interview Schedule for Children (DISC-5)<ref>{{Cite web|url=http://dx.doi.org/10.1037/t04405-000|title=National Institute of Mental Health Diagnostic Interview Schedule for Children-IV|last=Shaffer|first=David|last2=Fisher|first2=Prudence|date=2000|website=PsycTESTS Dataset|access-date=2022-08-04|last3=Lucas|first3=Christopher P.|last4=Dulcan|first4=Mina K.|last5=Schwab-Stone|first5=Mary E.}}</ref> |Structured Interview (Self report and parent) |6-17 |About 20 minutes |[https://telesage.com/netdisc-5/# Coming soon] |} == [[Evidence based assessment/Process phase|'''Process phase''']] == The following section contains a list of process and outcome measures for oppositional defiant disorder. The section includes benchmarks based on published norms for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the [[Evidence based assessment/Process phase|process phase]] of assessment. For more information of differences between process and outcome measures, see the page on the [[Evidence based assessment/Process phase|process phase of assessment]]. === Outcome and severity measures === * This table includes clinically significant benchmarks for generalized anxiety disorder specific outcome measures * Information on how to interpret this table can be [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase found here]. * Additionally, these [[Evidence based assessment/Vignettes|vignettes]] might be helpful resources for understanding appropriate adaptation of outcome measures in practice. * ''<u>For clinically significant change benchmarks for the CBCL, YSR, and TRF total, externalizing, internalizing, and attention benchmarks,</u>'' [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase&wteswitched=1#Clinically_significant_change_benchmarks_for_widely-used_outcome_measures see here.] {| class="wikitable sortable" border="1" |- | rowspan="1&quot;" style="text-align:center;font-size:130%;" | <b> Measure</b> | style="text-align:center;font-size:130%;" | <b> Subscale</b> | colspan="3" style="text-align:center;font-size:130%" width="300" | <b> Cut-off scores</b> | colspan="3" style="text-align:center;font-size:120%" | <b> Critical Change <br> (unstandardized scores)</b> |- | colspan="8" style="font-size:110%; text-align:center;" span | <b> Benchmarks Based on Published Norms</b> |- | colspan="2" | | style="text-align:center;font-size:110%" | <b> A</b> | style="text-align:center;font-size:110%" | <b> B</b> | style="text-align:center;font-size:110%" | <b> C</b> | style="text-align:center;font-size:110%" | <b> 95%</b> | style="text-align:center;font-size:110%" | <b> 90%</b> | style="text-align:center;font-size:110%" | <b> SE_difference</b> |- | rowspan="1" style="text-align:center;" | <b> CBCL T-scores <br> (2001 Norms)</b> | style="text-align:right;" | <i> Externalizing</i> | style="text-align:center;" | 49 | style="text-align:center;" | 70 | style="text-align:center;" | 58 | style="text-align:center;" | 7 | style="text-align:center;" | 6 | style="text-align:center;" | 3.4 |- | rowspan="1" style="text-align:center;" | <b> ECBI Scaled Scores <br> (1983 Norms)</b> | style="text-align:right;" | <i> Intensity</i> | style="text-align:center;" | 80.1 | style="text-align:center;" | 169.5 | style="text-align:center;" | 112.9 | style="text-align:center;" | 9.5 | style="text-align:center;" | 8 | style="text-align:center;" | 4.8 |- | rowspan="1" style="text-align:center;" | <b> ECBI Scaled Scores <br> (1983 Norms)</b> | style="text-align:right;" | <i> Problem</i> | style="text-align:center;" | 3.9 | style="text-align:center;" | 17.7 | style="text-align:center;" | 11.5 | style="text-align:center;" | 2.1 | style="text-align:center;" | 1.8 | style="text-align:center;" | 1.1 |} '''Note:''' “A” = Away from the clinical range, “B” = Back into the nonclinical range, “C” = Closer to the nonclinical than clinical mean. === Process measures=== See Section 1.1 for overview of evidence-based measures to use depending on etiology and symptomatology of Oppositional Defiant Disorder. ==Treatment== ===Behavioral parent training=== Behavioral Parent Training is considered the most effective treatment for childhood disruptive behavior disorders (e.g., Oppositional Defiant Disorder), especially for younger children (i.e., 3-8 year-olds). See http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/rule-breaking-defiance-and-acting-out/ a website sponsored by The Society for Child and Adolescent Psychology (APA, Division 53) and the Association for Behavioral and Cognitive Therapies (ABCT), for current summary of evidence-based treatments. ===Overview of recommendations for assessment and treatment=== See the [https://pathways.nice.org.uk/pathways/antisocial-behaviour-and-conduct-disorders-in-children-and-young-people#content=view-info-category%3Aview-about-menu National Institute for Health and Care Excellence (NICE) Practice Guidelines for Childhood Conduct Disorders], for an overview of recommendations for both assessment and treatment of Oppositional Defiant Disorder. == External Links == *[https://sccap53.org Society of Clinical Child and Adolescent Psychology] *http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/rule-breaking-defiance-and-acting-out/ == References == {{collapse top|References|expand=yes}} {{Reflist|30em}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] {{collapse bottom}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] 3aaq0ssk4fzq32eo146ozcux3j8qlmg 2419305 2419248 2022-08-26T05:30:02Z Ardenguo 2944162 /* Prediction phase */ added "Note: Reliability and validity are included in the extended version. This table includes measures with Good or Excellent ratings." wikitext text/x-wiki Ad<noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{medical disclaimer}} {{:{{BASEPAGENAME}}/Sidebar}} ==[[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio"?''']]== * For background information on what assessment portfolios are, click the link in the heading above. * Want even 'more' information about this topic? There's an extended version of this page [[Evidence-based assessment/Oppositional defiant disorder (assessment portfolio)/extended version|here]]. ==[[Evidence based assessment/Preparation phase|'''Preparation phase''']]== === Diagnostic criteria for oppositional defiant disorder=== {{blockquotetop}} <big>ICD-11 Diagnostic Criteria</big><br> <br> '''General Description:''' Oppositional defiant disorder is a persistent pattern (e.g., 6 months or more) of markedly defiant, disobedient, provocative or spiteful behaviour that occurs more frequently than is typically observed in individuals of comparable age and developmental level and that is not restricted to interaction with siblings. Oppositional defiant disorder may be manifest in prevailing, persistent angry or irritable mood, often accompanied by severe temper outbursts or in headstrong, argumentative and defiant behaviour. The behavior pattern is of sufficient severity to result in significant impairment in personal, family, social, educational, occupational or other important areas of functioning <br> <br> '''Oppositional Defiant Disorder With Chronic Irritability-Anger:''' All definitional requirements for oppositional defiant disorder are met. This form of oppositional defiant disorder is characterized by prevailing, persistent angry or irritable mood that may be present independent of any apparent provocation. The negative mood is often accompanied by regularly occurring severe temper outbursts that are grossly out of proportion in intensity or duration to the provocation. Chronic irritability and anger are characteristic of the individual’s functioning nearly every day, are observable across multiple settings or domains of functioning (e.g., home, school, social relationships), and are not restricted to the individual’s relationship with his/her parents or guardians. The pattern of chronic irritability and anger is not limited to occasional episodes (e.g., developmentally typical irritability) or discrete periods (e.g., irritable mood in the context of manic or depressive episodes). *Note: The ICD-11 lists 3 additional subcategories of oppositional defiant disorder with chronic irritability-anger (i.e., with limited prosocial emotions, with typical prosocial emotions, and unspecified). They can be found [https://icd.who.int/browse11/l-m/en#/http%3a%2f%2fid.who.int%2ficd%2fentity%2f818792113 here]. <br> '''Oppositional Defiant Disorder Without Chronic Irritability-Anger:''' Meets all definitional requirements for oppositional defiant disorder. This form of oppositional defiant disorder is not characterized by prevailing, persistent, angry or irritable mood, but does feature headstrong, argumentative, and defiant behavior. *Note: The ICD-11 lists 3 additional subcategories of oppositional defiant disorder without chronic irritability-anger (i.e., with limited prosocial emotions, with typical prosocial emotions, and unspecified). They can be found [https://icd.who.int/browse11/l-m/en#/http%3a%2f%2fid.who.int%2ficd%2fentity%2f736540987 here]. <br> <big>Changes in DSM-5</big> <br> The diagnostic criteria for ADHD changed slightly from DSM-IV to DSM-5. See the changes [https://www.ncbi.nlm.nih.gov/books/NBK519712/table/ch3.t14/ here]. {{blockquotebottom}}<ref>{{Cite web|url=https://icd.who.int/browse11/l-m/en#/http://id.who.int/icd/entity/1545599508|title=ICD-11 for Mortality and Morbidity Statistics|website=icd.who.int|access-date=2022-07-11}}</ref> ===Base rates of ODD in different clinical settings=== This section describes the demographic setting of the population(s) sampled, base rates of diagnosis, country/region sampled and the diagnostic method that was used. Using this information, clinicians will be able to anchor the rate of ODD that they are likely to see in their clinical practice. * '''''To see prevalence rates across multiple disorders, [[Evidence-based assessment/Preparation phase|click here.]]''''' {|class="wikitable sortable" border="1" |- ! Demography ! Setting !! Base Rate !! Diagnostic Method |- || Various locations across USA | Meta-analysis of 38 studies<ref>Canino G, Polanczyk G, Bauermeister JJ, et al. (2010) Does the prevalence of CD and ODD vary across cultures? Social Psychiatry Epidemiology, 45(7):695–704.</ref> || 3.3% || Varied |- || All of the U.S. | Nationally representative large-scale study (N = 3,119) <ref>Nock, M. K., Kazdin, A. E., Hiripi, E., & Kessler, R. C. (2007). Lifetime prevalence, correlates, and persistence of oppositional defiant disorder: results from the National Comorbidity Survey Replication. ''Journal of Child Psychology and Psychiatry, 48''(7), 703-713.</ref> || 10.2% (overall) 11.2% (males) 9.2% (females) || World Health Organization (WHO) Composite International Diagnostic Interview (CIDI)^r |- |Suburban and urban Colorado |Project to Learn about Youth-Mental health, school-based study for children from kindergarten to high-school (n = 236)<ref name=":1">{{Cite journal|last=Danielson|first=Melissa L.|last2=Bitsko|first2=Rebecca H.|last3=Holbrook|first3=Joseph R.|last4=Charania|first4=Sana N.|last5=Claussen|first5=Angelika H.|last6=McKeown|first6=Robert E.|last7=Cuffe|first7=Steven P.|last8=Owens|first8=Julie Sarno|last9=Evans|first9=Steven W.|date=2021-06-01|title=Community-Based Prevalence of Externalizing and Internalizing Disorders among School-Aged Children and Adolescents in Four Geographically Dispersed School Districts in the United States|url=https://doi.org/10.1007/s10578-020-01027-z|journal=Child Psychiatry & Human Development|language=en|volume=52|issue=3|pages=500–514|doi=10.1007/s10578-020-01027-z|issn=1573-3327|pmc=PMC8016018|pmid=32734339}}</ref> |6.8% |Diagnostic Interview Schedule for Children (DISC) |- |Urban and suburban Florida |Project to Learn about Youth-Mental health, school-based study for children from kindergarten to high-school (n = 289)<ref name=":1" /> |6.9% |Diagnostic Interview Schedule for Children (DISC) |- |Rural and suburban Ohio |Project to Learn about Youth-Mental health, school-based study for children from elementary to high-school (n = 152)<ref name=":1" /> |17.3% |Diagnostic Interview Schedule for Children (DISC) |- |Suburban and rural South Carolina |Project to Learn about Youth-Mental health, school-based study for children from elementary to high-school (n = 270)<ref name=":1" /> |5.7% |Diagnostic Interview Schedule for Children (DISC) |- || Semi-rural North Carolina | Preschool-aged children from pediatric practices (N = 306; age 2 - 5 years old)<ref>Egger, H.L., & Angold, A. (2006). Common emotional and behavioral disorders in preschool children: Presentation, nosology, and epidemiology. ''Journal of Child Psychiatry and Psychology, 47'', 313–337.</ref> || 6.6% || Preschool Age Psychiatric Assessment (PAPA)^p |- || Western North Carolina | The Great Smoky Mountains Study - longitudinal, population-based study of community sample<ref>Costello, E. J., Mustillo, S., Erkanli, A., Keeler, G., & Angold, A. (2003) Prevalence and development of psychiatric disorders in adolescence. ''Arch Gen Psychiatry, 60'', 837-844.</ref> || 2.33% (overall) 3.16% (males) 2.75% (females) || Child and Adolescent Psychiatric Assessment (CAPA)^{p, y} |- || Chicago | Preschool-aged children from inner city schools and pediatric practices (N = 796; age 2 - 5 years old)<ref>Lavigne, J. V., LeBailly, S. A., Hopkins, J., Gouze, K. R., & Binns, H. J. (2009). The prevalence of ADHD, ODD, depression, and anxiety in a community sample of 4-year-olds. ''Journal Of Clinical Child And Adolescent Psychology, 38''(3), 315-328. doi:10.1080/15374410902851382</ref> || 8.3% || Diagnostic Interview Schedule for Children–Parent Scale–Young Child Version (DISC-YC) ^p |- |Germany (Saarbrücken County) |All school-aged children were examined during a routine school-entry medical examination (N = 1676, mean age = 5.7)<ref>{{Cite journal|last=Niemczyk|first=Justine|last2=Equit|first2=Monika|last3=Braun-Bither|first3=Katrin|last4=Klein|first4=Anna-Maria|last5=von Gontard|first5=Alexander|date=2015-07-01|title=Prevalence of incontinence, attention deficit/hyperactivity disorder and oppositional defiant disorder in preschool children|url=https://doi.org/10.1007/s00787-014-0628-6|journal=European Child & Adolescent Psychiatry|language=en|volume=24|issue=7|pages=837–843|doi=10.1007/s00787-014-0628-6|issn=1435-165X}}</ref> |7.3% (males) 5.1%(females) |DISYPS-II |- |South Korea (Seoul) |Children were randomly surveyed across 6 school districts in Seoul (N = 1645, age 6 - 12 years old) |5.8% (males) 4.1%(females) |Diagnostic Interview Schedule for Children–Parent Scale IV (DISC-IV) |} ^p Parent interviewed as part of diagnostic assessment; ^y youth interviewed as part of diagnostic assessment, ^r adult interviewed for retrospective report as part of diagnostic assessment '''Note:''' Mash and Barkley note that prevalence rates of ODD must be qualified, because the definition of ODD has changed at a fast rate, the rates adolescents meeting criteria in any cross-sectional evaluation may be misleading because of the developmental progressions with and between ODD and Conduct Disorder, and categorical definitions of aggressive patterns may reflect arbitrary numbers of constituent estimates. These factors may lead to misleading prevalence rates. In addition, few studies have investigated the prevalence of ODD in preschool-aged children, and early onset of these behaviors is associated with more severe and stable impairment.<ref>Mash, E., & Barkley, R. (Eds.). (2003). ''Child Psychopathology''. 2nd Edition. New York: Guilford Press.</ref> ==[[Evidence based assessment/Prediction phase|'''Prediction phase''']]== The following section contains a list of screening and diagnostic instruments for ODD. The section includes administration information, psychometric data, and PDFs or links to the screenings. * Screenings are used as part of the [[Evidence based assessment/Prediction phase|prediction phase]] of assessment; for more information on interpretation of this data, or how screenings fit in to the assessment process, click [[Evidence based assessment/Prediction phase|here]]. * '''''For a list of more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Psychometric_properties_of_common_screening_instruments click here.]''''' {| class="wikitable sortable" border="1" ! colspan="5" |Screening measures for ODD |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time !Where to access |- |Achenbach System of Empirically Based Assessments (ASEBA): Child Behavior Checklist (CBCL), Youth Self-Report (YSR) |Parent report (CBCL) Youth self-report (YSR) |6-18 (CBCL) 11-18 (YSR) <ref name=":9">{{Cite book|url=https://www.worldcat.org/oclc/1130319849|title=Assessment of disorders in childhood and adolescence|date=2020|others=Eric Arden Youngstrom, Mitchell J. Prinstein, Eric J. Mash, Russell A. Barkley|isbn=978-1-4625-4363-2|edition=Fifth edition|location=New York, NY|oclc=1130319849}}</ref> |10 - 15 minutes<ref name=":9" /> |[https://store.aseba.org/School-Age-6-18-Materials/departments/11/ Purchase] |- |Eyberg Child Behavior Inventory (ECBI) |Parent report |2-16 |5 minutes |[https://www.parinc.com/products/pkey/97 Purchase] |- |Strengths and Difficulties Questionnaire (SDQ) |Parent report |3 - 16 |3 - 5 minutes |[https://www.sdqinfo.org/a0.html SDQ Homepage][https://osf.io/dzk68/?view_only=681e9b648169427b845f313aafa0a169 English PDF][https://www.sdqinfo.org/py/sdqinfo/b0.py Additional languages PDFs] |} '''Note:''' Reliability and validity are included in the extended version. This table includes measures with Good or Excellent ratings. === Likelihood ratios and AUCs of screening instruments for ODD === * '''''For a list of the likelihood ratios for more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Likelihood_ratios_and_AUCs_of_common_screening_instruments click here.]''''' {| class="wikitable sortable" border="1" ! Screening Measure (Primary Reference) ! Area Under Curve (AUC) ! LR+ (Score) ! LR- (Score) ! Clinical Generalizability !Where to Access |- |CBCL DSM-Oriented Scales<ref name=":7">Achenbach, T. M. (1991a). ''Manual for the Child Behavior Checklist/4–18 and 1991 Profile''. Burlington , VT : University of Vermont Department of Psychiatry.</ref> |.71 (N=475)<ref name=":3">Ebesutani, C., Bernstein, A., Nakamura, B. J., Chorpita, B. F., Higa-McMillan, C. K., & Weisz, J. R. (2010). Concurrent validity of the child behavior checklist DSM-oriented scales: Correspondence with DSM diagnoses and comparison to syndrome scales. ''Journal of Psychopathology and Behavioral Assessment, 32''(3), 373-384.</ref> | 2.80 (60+ to 70+) <ref name=":4">Warnick, E. M., Bracken, M. B., & Kasl, S. (2008). Screening efficiency of the Child Behavior Checklist and Strengths and Difficulties Questionnaire: a systematic review. ''Child and Adolescent Mental Health, 13''(3), 140-147.</ref> | .52 (60- to 70-)*<ref name=":4" /> |Youth aged 5 - 18 seeking out patient treatment across a variety of settings<ref name=":4" /> |[https://store.aseba.org/School-Age-6-18-Materials/departments/11/ Purchase] |- |SDQ<ref name=":6">{{Cite journal|last=Shabani|first=Amir|last2=Masoumian|first2=Samira|last3=Zamirinejad|first3=Somayeh|last4=Hejri|first4=Maryam|last5=Pirmorad|first5=Tahereh|last6=Yaghmaeezadeh|first6=Hooman|date=2021-05|title=Psychometric properties of Structured Clinical Interview for DSM‐5 Disorders‐Clinician Version (SCID‐5‐CV)|url=https://onlinelibrary.wiley.com/doi/10.1002/brb3.1894|journal=Brain and Behavior|language=en|volume=11|issue=5|doi=10.1002/brb3.1894|issn=2162-3279|pmc=PMC8119811|pmid=33729681}}</ref> | .81 -.88 (N = 18,416)<ref>{{Cite journal|last=Algorta|first=Guillermo Perez|last2=Dodd|first2=Alyson Lamont|last3=Stringaris|first3=Argyris|last4=Youngstrom|first4=Eric A.|date=2016-09|title=Diagnostic efficiency of the SDQ for parents to identify ADHD in the UK: a ROC analysis|url=http://link.springer.com/10.1007/s00787-015-0815-0|journal=European Child & Adolescent Psychiatry|language=en|volume=25|issue=9|pages=949–957|doi=10.1007/s00787-015-0815-0|issn=1018-8827|pmc=PMC4990620|pmid=26762184}}</ref> |7.55 (3+)<ref name=":2">{{Cite journal|last=Goodman|first=Robert|date=2001-11-01|title=Psychometric Properties of the Strengths and Difficulties Questionnaire|url=https://www.jaacap.org/article/S0890-8567(09)60543-8/abstract|journal=Journal of the American Academy of Child & Adolescent Psychiatry|language=English|volume=40|issue=11|pages=1337–1345|doi=10.1097/00004583-200111000-00015|issn=0890-8567|pmid=11699809}}</ref> |.35 (3-)<ref name=":2" /> |Surveyed youth aged 5 - 15 in the UK <ref name=":2" /> |[https://www.sdqinfo.org/a0.html SDQ Homepage][https://osf.io/dzk68/?view_only=681e9b648169427b845f313aafa0a169 English PDF][https://www.sdqinfo.org/py/sdqinfo/b0.py Additional languages PDFs] |- |ECBI- Intensity Scale<ref name=":8">Eyberg, S. M., & Robinson, E. A. (1983). Conduct problem behavior: Standardization of a behavioral rating scale with adolescents. Journal of Clinical Child Psychology, 12 (3), 347-354.</ref> | |6.92 (131+)<ref name=":5">{{Cite journal|last=LYNEHAM|first=HEIDI J.|last2=ABBOTT|first2=MAREE J.|last3=RAPEE|first3=RONALD M.|date=2007-06|title=Interrater Reliability of the Anxiety Disorders Interview Schedule for DSM-IV: Child and Parent Version|url=https://doi.org/10.1097/chi.0b013e3180465a09|journal=Journal of the American Academy of Child &amp; Adolescent Psychiatry|volume=46|issue=6|pages=731–736|doi=10.1097/chi.0b013e3180465a09|issn=0890-8567}}</ref> |.11 (131-)<ref name=":5" /> |Youth aged 7-16 had responses compared to diagnosis<ref name=":5" /> |[https://www.parinc.com/products/pkey/97 Purchase] |} '''Note:''' “LR+” refers to the change in likelihood ratio associated with a positive test score, and “LR-” is the likelihood ratio for a low score. Likelihood ratios of 1 indicate that the test result did not change impressions at all. LRs larger than 10 or smaller than .10 are frequently clinically decisive; 5 or .20 are helpful, and between 2.0 and .5 are small enough that they rarely result in clinically meaningful changes of formulation<ref>Sackett, D. L., Straus, S. E., Richardson, W. S., Rosenberg, W., & Haynes, R. B. (2000). Evidence-based medicine: How to practice and teach EBM. Edinburgh: Churchill Livingstone.</ref>. '''Search terms:''' [Oppositional Defiant Disorder] AND [sensitivity OR specificity] in GoogleScholar and PsychINFO; === Interpreting ODD screening measure scores === * For information on interpreting screening measure scores, click [[Evidence based assessment/Prediction phase#Interpreting screening measure scores|here.]] == [[Evidence based assessment/Prescription phase|'''Prescription phase''']] == === Gold standard diagnostic interviews === * For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews click here.] === Recommended diagnostic instruments for ODD === {| class="wikitable sortable" ! colspan="5" |Diagnostic instruments for ODD |- !Measure !Format (Reporter) !Age Range !Administration/ Completion Time !Where to Access |- |Kiddie Schedule for Affective Disorders and Schizophrenia Present and Lifetime Version (KSADS-PL)<ref>{{Cite web|url=http://dx.doi.org/10.1037/t03988-000|title=Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version|last=Kaufman|first=John|last2=Birmaher|first2=Boris|date=1997|website=PsycTESTS Dataset|access-date=2022-08-04|last3=Brent|first3=David|last4=Rao|first4=Uma|last5=Flynn|first5=Cynthia|last6=Moreci|first6=Paula|last7=Williamson|first7=Douglas|last8=Ryan|first8=Neal}}</ref> |Structured interview |6-28 |45-75 minutes |[https://www.pediatricbipolar.pitt.edu/resources/instruments Website to access] |- |Development and Well-Being Assessment (DAWBA) <ref>{{Cite book|url=https://www.worldcat.org/oclc/1160972551|title=Assessment of disorders in childhood and adolescence|date=2020|others=Eric Arden Youngstrom, Mitchell J. Prinstein, Eric J. Mash, Russell A. Barkley|isbn=978-1-4625-4365-6|edition=Fifth edition|location=New York|oclc=1160972551}}</ref> |Structured (child/adolescent and parent) |11-18 |10-20 minutes for the eating disorder module |English PDF [https://dawba.info/py/dawbainfo/b1.py Additional languages] |- |Diagnostic Interview Schedule for Children (DISC-5)<ref>{{Cite web|url=http://dx.doi.org/10.1037/t04405-000|title=National Institute of Mental Health Diagnostic Interview Schedule for Children-IV|last=Shaffer|first=David|last2=Fisher|first2=Prudence|date=2000|website=PsycTESTS Dataset|access-date=2022-08-04|last3=Lucas|first3=Christopher P.|last4=Dulcan|first4=Mina K.|last5=Schwab-Stone|first5=Mary E.}}</ref> |Structured Interview (Self report and parent) |6-17 |About 20 minutes |[https://telesage.com/netdisc-5/# Coming soon] |} '''Note:''' Reliability and validity are included in the extended version. This table includes measures with Good or Excellent ratings. == [[Evidence based assessment/Process phase|'''Process phase''']] == The following section contains a list of process and outcome measures for oppositional defiant disorder. The section includes benchmarks based on published norms for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the [[Evidence based assessment/Process phase|process phase]] of assessment. For more information of differences between process and outcome measures, see the page on the [[Evidence based assessment/Process phase|process phase of assessment]]. === Outcome and severity measures === * This table includes clinically significant benchmarks for generalized anxiety disorder specific outcome measures * Information on how to interpret this table can be [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase found here]. * Additionally, these [[Evidence based assessment/Vignettes|vignettes]] might be helpful resources for understanding appropriate adaptation of outcome measures in practice. * ''<u>For clinically significant change benchmarks for the CBCL, YSR, and TRF total, externalizing, internalizing, and attention benchmarks,</u>'' [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase&wteswitched=1#Clinically_significant_change_benchmarks_for_widely-used_outcome_measures see here.] {| class="wikitable sortable" border="1" |- | rowspan="1&quot;" style="text-align:center;font-size:130%;" | <b> Measure</b> | style="text-align:center;font-size:130%;" | <b> Subscale</b> | colspan="3" style="text-align:center;font-size:130%" width="300" | <b> Cut-off scores</b> | colspan="3" style="text-align:center;font-size:120%" | <b> Critical Change <br> (unstandardized scores)</b> |- | colspan="8" style="font-size:110%; text-align:center;" span | <b> Benchmarks Based on Published Norms</b> |- | colspan="2" | | style="text-align:center;font-size:110%" | <b> A</b> | style="text-align:center;font-size:110%" | <b> B</b> | style="text-align:center;font-size:110%" | <b> C</b> | style="text-align:center;font-size:110%" | <b> 95%</b> | style="text-align:center;font-size:110%" | <b> 90%</b> | style="text-align:center;font-size:110%" | <b> SE_difference</b> |- | rowspan="1" style="text-align:center;" | <b> CBCL T-scores <br> (2001 Norms)</b> | style="text-align:right;" | <i> Externalizing</i> | style="text-align:center;" | 49 | style="text-align:center;" | 70 | style="text-align:center;" | 58 | style="text-align:center;" | 7 | style="text-align:center;" | 6 | style="text-align:center;" | 3.4 |- | rowspan="1" style="text-align:center;" | <b> ECBI Scaled Scores <br> (1983 Norms)</b> | style="text-align:right;" | <i> Intensity</i> | style="text-align:center;" | 80.1 | style="text-align:center;" | 169.5 | style="text-align:center;" | 112.9 | style="text-align:center;" | 9.5 | style="text-align:center;" | 8 | style="text-align:center;" | 4.8 |- | rowspan="1" style="text-align:center;" | <b> ECBI Scaled Scores <br> (1983 Norms)</b> | style="text-align:right;" | <i> Problem</i> | style="text-align:center;" | 3.9 | style="text-align:center;" | 17.7 | style="text-align:center;" | 11.5 | style="text-align:center;" | 2.1 | style="text-align:center;" | 1.8 | style="text-align:center;" | 1.1 |} '''Note:''' “A” = Away from the clinical range, “B” = Back into the nonclinical range, “C” = Closer to the nonclinical than clinical mean. === Process measures=== See Section 1.1 for overview of evidence-based measures to use depending on etiology and symptomatology of Oppositional Defiant Disorder. ==Treatment== ===Behavioral parent training=== Behavioral Parent Training is considered the most effective treatment for childhood disruptive behavior disorders (e.g., Oppositional Defiant Disorder), especially for younger children (i.e., 3-8 year-olds). See http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/rule-breaking-defiance-and-acting-out/ a website sponsored by The Society for Child and Adolescent Psychology (APA, Division 53) and the Association for Behavioral and Cognitive Therapies (ABCT), for current summary of evidence-based treatments. ===Overview of recommendations for assessment and treatment=== See the [https://pathways.nice.org.uk/pathways/antisocial-behaviour-and-conduct-disorders-in-children-and-young-people#content=view-info-category%3Aview-about-menu National Institute for Health and Care Excellence (NICE) Practice Guidelines for Childhood Conduct Disorders], for an overview of recommendations for both assessment and treatment of Oppositional Defiant Disorder. == External Links == *[https://sccap53.org Society of Clinical Child and Adolescent Psychology] *http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/rule-breaking-defiance-and-acting-out/ == References == {{collapse top|References|expand=yes}} {{Reflist|30em}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] {{collapse bottom}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] fap22amel0vseut5okx1wg3m89jywz4 2419318 2419305 2022-08-26T05:40:15Z Ardenguo 2944162 /* Prediction phase */ linked extended page to "Note: Reliability and validity are included in the extended version. This table includes measures with Good or Excellent ratings." wikitext text/x-wiki Ad<noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{medical disclaimer}} {{:{{BASEPAGENAME}}/Sidebar}} ==[[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio"?''']]== * For background information on what assessment portfolios are, click the link in the heading above. * Want even 'more' information about this topic? There's an extended version of this page [[Evidence-based assessment/Oppositional defiant disorder (assessment portfolio)/extended version|here]]. ==[[Evidence based assessment/Preparation phase|'''Preparation phase''']]== === Diagnostic criteria for oppositional defiant disorder=== {{blockquotetop}} <big>ICD-11 Diagnostic Criteria</big><br> <br> '''General Description:''' Oppositional defiant disorder is a persistent pattern (e.g., 6 months or more) of markedly defiant, disobedient, provocative or spiteful behaviour that occurs more frequently than is typically observed in individuals of comparable age and developmental level and that is not restricted to interaction with siblings. Oppositional defiant disorder may be manifest in prevailing, persistent angry or irritable mood, often accompanied by severe temper outbursts or in headstrong, argumentative and defiant behaviour. The behavior pattern is of sufficient severity to result in significant impairment in personal, family, social, educational, occupational or other important areas of functioning <br> <br> '''Oppositional Defiant Disorder With Chronic Irritability-Anger:''' All definitional requirements for oppositional defiant disorder are met. This form of oppositional defiant disorder is characterized by prevailing, persistent angry or irritable mood that may be present independent of any apparent provocation. The negative mood is often accompanied by regularly occurring severe temper outbursts that are grossly out of proportion in intensity or duration to the provocation. Chronic irritability and anger are characteristic of the individual’s functioning nearly every day, are observable across multiple settings or domains of functioning (e.g., home, school, social relationships), and are not restricted to the individual’s relationship with his/her parents or guardians. The pattern of chronic irritability and anger is not limited to occasional episodes (e.g., developmentally typical irritability) or discrete periods (e.g., irritable mood in the context of manic or depressive episodes). *Note: The ICD-11 lists 3 additional subcategories of oppositional defiant disorder with chronic irritability-anger (i.e., with limited prosocial emotions, with typical prosocial emotions, and unspecified). They can be found [https://icd.who.int/browse11/l-m/en#/http%3a%2f%2fid.who.int%2ficd%2fentity%2f818792113 here]. <br> '''Oppositional Defiant Disorder Without Chronic Irritability-Anger:''' Meets all definitional requirements for oppositional defiant disorder. This form of oppositional defiant disorder is not characterized by prevailing, persistent, angry or irritable mood, but does feature headstrong, argumentative, and defiant behavior. *Note: The ICD-11 lists 3 additional subcategories of oppositional defiant disorder without chronic irritability-anger (i.e., with limited prosocial emotions, with typical prosocial emotions, and unspecified). They can be found [https://icd.who.int/browse11/l-m/en#/http%3a%2f%2fid.who.int%2ficd%2fentity%2f736540987 here]. <br> <big>Changes in DSM-5</big> <br> The diagnostic criteria for ADHD changed slightly from DSM-IV to DSM-5. See the changes [https://www.ncbi.nlm.nih.gov/books/NBK519712/table/ch3.t14/ here]. {{blockquotebottom}}<ref>{{Cite web|url=https://icd.who.int/browse11/l-m/en#/http://id.who.int/icd/entity/1545599508|title=ICD-11 for Mortality and Morbidity Statistics|website=icd.who.int|access-date=2022-07-11}}</ref> ===Base rates of ODD in different clinical settings=== This section describes the demographic setting of the population(s) sampled, base rates of diagnosis, country/region sampled and the diagnostic method that was used. Using this information, clinicians will be able to anchor the rate of ODD that they are likely to see in their clinical practice. * '''''To see prevalence rates across multiple disorders, [[Evidence-based assessment/Preparation phase|click here.]]''''' {|class="wikitable sortable" border="1" |- ! Demography ! Setting !! Base Rate !! Diagnostic Method |- || Various locations across USA | Meta-analysis of 38 studies<ref>Canino G, Polanczyk G, Bauermeister JJ, et al. (2010) Does the prevalence of CD and ODD vary across cultures? Social Psychiatry Epidemiology, 45(7):695–704.</ref> || 3.3% || Varied |- || All of the U.S. | Nationally representative large-scale study (N = 3,119) <ref>Nock, M. K., Kazdin, A. E., Hiripi, E., & Kessler, R. C. (2007). Lifetime prevalence, correlates, and persistence of oppositional defiant disorder: results from the National Comorbidity Survey Replication. ''Journal of Child Psychology and Psychiatry, 48''(7), 703-713.</ref> || 10.2% (overall) 11.2% (males) 9.2% (females) || World Health Organization (WHO) Composite International Diagnostic Interview (CIDI)^r |- |Suburban and urban Colorado |Project to Learn about Youth-Mental health, school-based study for children from kindergarten to high-school (n = 236)<ref name=":1">{{Cite journal|last=Danielson|first=Melissa L.|last2=Bitsko|first2=Rebecca H.|last3=Holbrook|first3=Joseph R.|last4=Charania|first4=Sana N.|last5=Claussen|first5=Angelika H.|last6=McKeown|first6=Robert E.|last7=Cuffe|first7=Steven P.|last8=Owens|first8=Julie Sarno|last9=Evans|first9=Steven W.|date=2021-06-01|title=Community-Based Prevalence of Externalizing and Internalizing Disorders among School-Aged Children and Adolescents in Four Geographically Dispersed School Districts in the United States|url=https://doi.org/10.1007/s10578-020-01027-z|journal=Child Psychiatry & Human Development|language=en|volume=52|issue=3|pages=500–514|doi=10.1007/s10578-020-01027-z|issn=1573-3327|pmc=PMC8016018|pmid=32734339}}</ref> |6.8% |Diagnostic Interview Schedule for Children (DISC) |- |Urban and suburban Florida |Project to Learn about Youth-Mental health, school-based study for children from kindergarten to high-school (n = 289)<ref name=":1" /> |6.9% |Diagnostic Interview Schedule for Children (DISC) |- |Rural and suburban Ohio |Project to Learn about Youth-Mental health, school-based study for children from elementary to high-school (n = 152)<ref name=":1" /> |17.3% |Diagnostic Interview Schedule for Children (DISC) |- |Suburban and rural South Carolina |Project to Learn about Youth-Mental health, school-based study for children from elementary to high-school (n = 270)<ref name=":1" /> |5.7% |Diagnostic Interview Schedule for Children (DISC) |- || Semi-rural North Carolina | Preschool-aged children from pediatric practices (N = 306; age 2 - 5 years old)<ref>Egger, H.L., & Angold, A. (2006). Common emotional and behavioral disorders in preschool children: Presentation, nosology, and epidemiology. ''Journal of Child Psychiatry and Psychology, 47'', 313–337.</ref> || 6.6% || Preschool Age Psychiatric Assessment (PAPA)^p |- || Western North Carolina | The Great Smoky Mountains Study - longitudinal, population-based study of community sample<ref>Costello, E. J., Mustillo, S., Erkanli, A., Keeler, G., & Angold, A. (2003) Prevalence and development of psychiatric disorders in adolescence. ''Arch Gen Psychiatry, 60'', 837-844.</ref> || 2.33% (overall) 3.16% (males) 2.75% (females) || Child and Adolescent Psychiatric Assessment (CAPA)^{p, y} |- || Chicago | Preschool-aged children from inner city schools and pediatric practices (N = 796; age 2 - 5 years old)<ref>Lavigne, J. V., LeBailly, S. A., Hopkins, J., Gouze, K. R., & Binns, H. J. (2009). The prevalence of ADHD, ODD, depression, and anxiety in a community sample of 4-year-olds. ''Journal Of Clinical Child And Adolescent Psychology, 38''(3), 315-328. doi:10.1080/15374410902851382</ref> || 8.3% || Diagnostic Interview Schedule for Children–Parent Scale–Young Child Version (DISC-YC) ^p |- |Germany (Saarbrücken County) |All school-aged children were examined during a routine school-entry medical examination (N = 1676, mean age = 5.7)<ref>{{Cite journal|last=Niemczyk|first=Justine|last2=Equit|first2=Monika|last3=Braun-Bither|first3=Katrin|last4=Klein|first4=Anna-Maria|last5=von Gontard|first5=Alexander|date=2015-07-01|title=Prevalence of incontinence, attention deficit/hyperactivity disorder and oppositional defiant disorder in preschool children|url=https://doi.org/10.1007/s00787-014-0628-6|journal=European Child & Adolescent Psychiatry|language=en|volume=24|issue=7|pages=837–843|doi=10.1007/s00787-014-0628-6|issn=1435-165X}}</ref> |7.3% (males) 5.1%(females) |DISYPS-II |- |South Korea (Seoul) |Children were randomly surveyed across 6 school districts in Seoul (N = 1645, age 6 - 12 years old) |5.8% (males) 4.1%(females) |Diagnostic Interview Schedule for Children–Parent Scale IV (DISC-IV) |} ^p Parent interviewed as part of diagnostic assessment; ^y youth interviewed as part of diagnostic assessment, ^r adult interviewed for retrospective report as part of diagnostic assessment '''Note:''' Mash and Barkley note that prevalence rates of ODD must be qualified, because the definition of ODD has changed at a fast rate, the rates adolescents meeting criteria in any cross-sectional evaluation may be misleading because of the developmental progressions with and between ODD and Conduct Disorder, and categorical definitions of aggressive patterns may reflect arbitrary numbers of constituent estimates. These factors may lead to misleading prevalence rates. In addition, few studies have investigated the prevalence of ODD in preschool-aged children, and early onset of these behaviors is associated with more severe and stable impairment.<ref>Mash, E., & Barkley, R. (Eds.). (2003). ''Child Psychopathology''. 2nd Edition. New York: Guilford Press.</ref> ==[[Evidence based assessment/Prediction phase|'''Prediction phase''']]== The following section contains a list of screening and diagnostic instruments for ODD. The section includes administration information, psychometric data, and PDFs or links to the screenings. * Screenings are used as part of the [[Evidence based assessment/Prediction phase|prediction phase]] of assessment; for more information on interpretation of this data, or how screenings fit in to the assessment process, click [[Evidence based assessment/Prediction phase|here]]. * '''''For a list of more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Psychometric_properties_of_common_screening_instruments click here.]''''' {| class="wikitable sortable" border="1" ! colspan="5" |Screening measures for ODD |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time !Where to access |- |Achenbach System of Empirically Based Assessments (ASEBA): Child Behavior Checklist (CBCL), Youth Self-Report (YSR) |Parent report (CBCL) Youth self-report (YSR) |6-18 (CBCL) 11-18 (YSR) <ref name=":9">{{Cite book|url=https://www.worldcat.org/oclc/1130319849|title=Assessment of disorders in childhood and adolescence|date=2020|others=Eric Arden Youngstrom, Mitchell J. Prinstein, Eric J. Mash, Russell A. Barkley|isbn=978-1-4625-4363-2|edition=Fifth edition|location=New York, NY|oclc=1130319849}}</ref> |10 - 15 minutes<ref name=":9" /> |[https://store.aseba.org/School-Age-6-18-Materials/departments/11/ Purchase] |- |Eyberg Child Behavior Inventory (ECBI) |Parent report |2-16 |5 minutes |[https://www.parinc.com/products/pkey/97 Purchase] |- |Strengths and Difficulties Questionnaire (SDQ) |Parent report |3 - 16 |3 - 5 minutes |[https://www.sdqinfo.org/a0.html SDQ Homepage][https://osf.io/dzk68/?view_only=681e9b648169427b845f313aafa0a169 English PDF][https://www.sdqinfo.org/py/sdqinfo/b0.py Additional languages PDFs] |} '''Note:''' Reliability and validity are included in the [[Evidence-based assessment/Oppositional defiant disorder (assessment portfolio)/extended version|extended version]]. This table includes measures with Good or Excellent ratings. === Likelihood ratios and AUCs of screening instruments for ODD === * '''''For a list of the likelihood ratios for more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Likelihood_ratios_and_AUCs_of_common_screening_instruments click here.]''''' {| class="wikitable sortable" border="1" ! Screening Measure (Primary Reference) ! Area Under Curve (AUC) ! LR+ (Score) ! LR- (Score) ! Clinical Generalizability !Where to Access |- |CBCL DSM-Oriented Scales<ref name=":7">Achenbach, T. M. (1991a). ''Manual for the Child Behavior Checklist/4–18 and 1991 Profile''. Burlington , VT : University of Vermont Department of Psychiatry.</ref> |.71 (N=475)<ref name=":3">Ebesutani, C., Bernstein, A., Nakamura, B. J., Chorpita, B. F., Higa-McMillan, C. K., & Weisz, J. R. (2010). Concurrent validity of the child behavior checklist DSM-oriented scales: Correspondence with DSM diagnoses and comparison to syndrome scales. ''Journal of Psychopathology and Behavioral Assessment, 32''(3), 373-384.</ref> | 2.80 (60+ to 70+) <ref name=":4">Warnick, E. M., Bracken, M. B., & Kasl, S. (2008). Screening efficiency of the Child Behavior Checklist and Strengths and Difficulties Questionnaire: a systematic review. ''Child and Adolescent Mental Health, 13''(3), 140-147.</ref> | .52 (60- to 70-)*<ref name=":4" /> |Youth aged 5 - 18 seeking out patient treatment across a variety of settings<ref name=":4" /> |[https://store.aseba.org/School-Age-6-18-Materials/departments/11/ Purchase] |- |SDQ<ref name=":6">{{Cite journal|last=Shabani|first=Amir|last2=Masoumian|first2=Samira|last3=Zamirinejad|first3=Somayeh|last4=Hejri|first4=Maryam|last5=Pirmorad|first5=Tahereh|last6=Yaghmaeezadeh|first6=Hooman|date=2021-05|title=Psychometric properties of Structured Clinical Interview for DSM‐5 Disorders‐Clinician Version (SCID‐5‐CV)|url=https://onlinelibrary.wiley.com/doi/10.1002/brb3.1894|journal=Brain and Behavior|language=en|volume=11|issue=5|doi=10.1002/brb3.1894|issn=2162-3279|pmc=PMC8119811|pmid=33729681}}</ref> | .81 -.88 (N = 18,416)<ref>{{Cite journal|last=Algorta|first=Guillermo Perez|last2=Dodd|first2=Alyson Lamont|last3=Stringaris|first3=Argyris|last4=Youngstrom|first4=Eric A.|date=2016-09|title=Diagnostic efficiency of the SDQ for parents to identify ADHD in the UK: a ROC analysis|url=http://link.springer.com/10.1007/s00787-015-0815-0|journal=European Child & Adolescent Psychiatry|language=en|volume=25|issue=9|pages=949–957|doi=10.1007/s00787-015-0815-0|issn=1018-8827|pmc=PMC4990620|pmid=26762184}}</ref> |7.55 (3+)<ref name=":2">{{Cite journal|last=Goodman|first=Robert|date=2001-11-01|title=Psychometric Properties of the Strengths and Difficulties Questionnaire|url=https://www.jaacap.org/article/S0890-8567(09)60543-8/abstract|journal=Journal of the American Academy of Child & Adolescent Psychiatry|language=English|volume=40|issue=11|pages=1337–1345|doi=10.1097/00004583-200111000-00015|issn=0890-8567|pmid=11699809}}</ref> |.35 (3-)<ref name=":2" /> |Surveyed youth aged 5 - 15 in the UK <ref name=":2" /> |[https://www.sdqinfo.org/a0.html SDQ Homepage][https://osf.io/dzk68/?view_only=681e9b648169427b845f313aafa0a169 English PDF][https://www.sdqinfo.org/py/sdqinfo/b0.py Additional languages PDFs] |- |ECBI- Intensity Scale<ref name=":8">Eyberg, S. M., & Robinson, E. A. (1983). Conduct problem behavior: Standardization of a behavioral rating scale with adolescents. Journal of Clinical Child Psychology, 12 (3), 347-354.</ref> | |6.92 (131+)<ref name=":5">{{Cite journal|last=LYNEHAM|first=HEIDI J.|last2=ABBOTT|first2=MAREE J.|last3=RAPEE|first3=RONALD M.|date=2007-06|title=Interrater Reliability of the Anxiety Disorders Interview Schedule for DSM-IV: Child and Parent Version|url=https://doi.org/10.1097/chi.0b013e3180465a09|journal=Journal of the American Academy of Child &amp; Adolescent Psychiatry|volume=46|issue=6|pages=731–736|doi=10.1097/chi.0b013e3180465a09|issn=0890-8567}}</ref> |.11 (131-)<ref name=":5" /> |Youth aged 7-16 had responses compared to diagnosis<ref name=":5" /> |[https://www.parinc.com/products/pkey/97 Purchase] |} '''Note:''' “LR+” refers to the change in likelihood ratio associated with a positive test score, and “LR-” is the likelihood ratio for a low score. Likelihood ratios of 1 indicate that the test result did not change impressions at all. LRs larger than 10 or smaller than .10 are frequently clinically decisive; 5 or .20 are helpful, and between 2.0 and .5 are small enough that they rarely result in clinically meaningful changes of formulation<ref>Sackett, D. L., Straus, S. E., Richardson, W. S., Rosenberg, W., & Haynes, R. B. (2000). Evidence-based medicine: How to practice and teach EBM. Edinburgh: Churchill Livingstone.</ref>. '''Search terms:''' [Oppositional Defiant Disorder] AND [sensitivity OR specificity] in GoogleScholar and PsychINFO; === Interpreting ODD screening measure scores === * For information on interpreting screening measure scores, click [[Evidence based assessment/Prediction phase#Interpreting screening measure scores|here.]] == [[Evidence based assessment/Prescription phase|'''Prescription phase''']] == === Gold standard diagnostic interviews === * For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews click here.] === Recommended diagnostic instruments for ODD === {| class="wikitable sortable" ! colspan="5" |Diagnostic instruments for ODD |- !Measure !Format (Reporter) !Age Range !Administration/ Completion Time !Where to Access |- |Kiddie Schedule for Affective Disorders and Schizophrenia Present and Lifetime Version (KSADS-PL)<ref>{{Cite web|url=http://dx.doi.org/10.1037/t03988-000|title=Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version|last=Kaufman|first=John|last2=Birmaher|first2=Boris|date=1997|website=PsycTESTS Dataset|access-date=2022-08-04|last3=Brent|first3=David|last4=Rao|first4=Uma|last5=Flynn|first5=Cynthia|last6=Moreci|first6=Paula|last7=Williamson|first7=Douglas|last8=Ryan|first8=Neal}}</ref> |Structured interview |6-28 |45-75 minutes |[https://www.pediatricbipolar.pitt.edu/resources/instruments Website to access] |- |Development and Well-Being Assessment (DAWBA) <ref>{{Cite book|url=https://www.worldcat.org/oclc/1160972551|title=Assessment of disorders in childhood and adolescence|date=2020|others=Eric Arden Youngstrom, Mitchell J. Prinstein, Eric J. Mash, Russell A. Barkley|isbn=978-1-4625-4365-6|edition=Fifth edition|location=New York|oclc=1160972551}}</ref> |Structured (child/adolescent and parent) |11-18 |10-20 minutes for the eating disorder module |English PDF [https://dawba.info/py/dawbainfo/b1.py Additional languages] |- |Diagnostic Interview Schedule for Children (DISC-5)<ref>{{Cite web|url=http://dx.doi.org/10.1037/t04405-000|title=National Institute of Mental Health Diagnostic Interview Schedule for Children-IV|last=Shaffer|first=David|last2=Fisher|first2=Prudence|date=2000|website=PsycTESTS Dataset|access-date=2022-08-04|last3=Lucas|first3=Christopher P.|last4=Dulcan|first4=Mina K.|last5=Schwab-Stone|first5=Mary E.}}</ref> |Structured Interview (Self report and parent) |6-17 |About 20 minutes |[https://telesage.com/netdisc-5/# Coming soon] |} '''Note:''' Reliability and validity are included in the [[Evidence-based assessment/Oppositional defiant disorder (assessment portfolio)/extended version|extended version]]. This table includes measures with Good or Excellent ratings. == [[Evidence based assessment/Process phase|'''Process phase''']] == The following section contains a list of process and outcome measures for oppositional defiant disorder. The section includes benchmarks based on published norms for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the [[Evidence based assessment/Process phase|process phase]] of assessment. For more information of differences between process and outcome measures, see the page on the [[Evidence based assessment/Process phase|process phase of assessment]]. === Outcome and severity measures === * This table includes clinically significant benchmarks for generalized anxiety disorder specific outcome measures * Information on how to interpret this table can be [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase found here]. * Additionally, these [[Evidence based assessment/Vignettes|vignettes]] might be helpful resources for understanding appropriate adaptation of outcome measures in practice. * ''<u>For clinically significant change benchmarks for the CBCL, YSR, and TRF total, externalizing, internalizing, and attention benchmarks,</u>'' [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase&wteswitched=1#Clinically_significant_change_benchmarks_for_widely-used_outcome_measures see here.] {| class="wikitable sortable" border="1" |- | rowspan="1&quot;" style="text-align:center;font-size:130%;" | <b> Measure</b> | style="text-align:center;font-size:130%;" | <b> Subscale</b> | colspan="3" style="text-align:center;font-size:130%" width="300" | <b> Cut-off scores</b> | colspan="3" style="text-align:center;font-size:120%" | <b> Critical Change <br> (unstandardized scores)</b> |- | colspan="8" style="font-size:110%; text-align:center;" span | <b> Benchmarks Based on Published Norms</b> |- | colspan="2" | | style="text-align:center;font-size:110%" | <b> A</b> | style="text-align:center;font-size:110%" | <b> B</b> | style="text-align:center;font-size:110%" | <b> C</b> | style="text-align:center;font-size:110%" | <b> 95%</b> | style="text-align:center;font-size:110%" | <b> 90%</b> | style="text-align:center;font-size:110%" | <b> SE_difference</b> |- | rowspan="1" style="text-align:center;" | <b> CBCL T-scores <br> (2001 Norms)</b> | style="text-align:right;" | <i> Externalizing</i> | style="text-align:center;" | 49 | style="text-align:center;" | 70 | style="text-align:center;" | 58 | style="text-align:center;" | 7 | style="text-align:center;" | 6 | style="text-align:center;" | 3.4 |- | rowspan="1" style="text-align:center;" | <b> ECBI Scaled Scores <br> (1983 Norms)</b> | style="text-align:right;" | <i> Intensity</i> | style="text-align:center;" | 80.1 | style="text-align:center;" | 169.5 | style="text-align:center;" | 112.9 | style="text-align:center;" | 9.5 | style="text-align:center;" | 8 | style="text-align:center;" | 4.8 |- | rowspan="1" style="text-align:center;" | <b> ECBI Scaled Scores <br> (1983 Norms)</b> | style="text-align:right;" | <i> Problem</i> | style="text-align:center;" | 3.9 | style="text-align:center;" | 17.7 | style="text-align:center;" | 11.5 | style="text-align:center;" | 2.1 | style="text-align:center;" | 1.8 | style="text-align:center;" | 1.1 |} '''Note:''' “A” = Away from the clinical range, “B” = Back into the nonclinical range, “C” = Closer to the nonclinical than clinical mean. === Process measures=== See Section 1.1 for overview of evidence-based measures to use depending on etiology and symptomatology of Oppositional Defiant Disorder. ==Treatment== ===Behavioral parent training=== Behavioral Parent Training is considered the most effective treatment for childhood disruptive behavior disorders (e.g., Oppositional Defiant Disorder), especially for younger children (i.e., 3-8 year-olds). See http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/rule-breaking-defiance-and-acting-out/ a website sponsored by The Society for Child and Adolescent Psychology (APA, Division 53) and the Association for Behavioral and Cognitive Therapies (ABCT), for current summary of evidence-based treatments. ===Overview of recommendations for assessment and treatment=== See the [https://pathways.nice.org.uk/pathways/antisocial-behaviour-and-conduct-disorders-in-children-and-young-people#content=view-info-category%3Aview-about-menu National Institute for Health and Care Excellence (NICE) Practice Guidelines for Childhood Conduct Disorders], for an overview of recommendations for both assessment and treatment of Oppositional Defiant Disorder. == External Links == *[https://sccap53.org Society of Clinical Child and Adolescent Psychology] *http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/rule-breaking-defiance-and-acting-out/ == References == {{collapse top|References|expand=yes}} {{Reflist|30em}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] {{collapse bottom}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] i5ff782nzj8p6wxkj7jrpvfhc71ugv5 0 207106 2419218 2414001 2022-08-26T02:59:56Z Ardenguo 2944162 /* References */ Made the references box expanded by default wikitext text/x-wiki <noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{medical disclaimer}} {{:{{BASEPAGENAME}}/Sidebar}} ==[[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio"?''']]== For background information on what assessment portfolios are, click the link in the heading above. Want even more information about this topic? There's an extended version of this page [[Evidence-based assessment/Obsessive-compulsive disorder (assessment portfolio)/extended version|here]]. ==[[Evidence based assessment/Preparation phase|'''Preparation phase''']]== === Diagnostic criteria for obsessive-compulsive disorder === {{blockquotetop}}'''ICD-11 Criteria''' <ref>{{Cite web|url=http://apps.who.int/classifications/icd10/browse/2016/en#/F40-F48|title=ICD-10 Version:2016|website=apps.who.int|language=en|accessdate=2018-03-01}}</ref> Obsessive-Compulsive Disorder is characterized by the presence of persistent obsessions or compulsions, or most commonly both. Obsessions are repetitive and persistent thoughts, images, or impulses/urges that are intrusive, unwanted, and are commonly associated with anxiety. The individual attempts to ignore or suppress obsessions or to neutralize them by performing compulsions. Compulsions are repetitive behaviors including repetitive mental acts that the individual feels driven to perform in response to an obsession, according to rigid rules, or to achieve a sense of ‘completeness’. In order for obsessive-compulsive disorder to be diagnosed, obsessions and compulsions must be time consuming (e.g., taking more than an hour per day), and result in significant distress or significant impairment in personal, family, social, educational, occupational or other important areas of functioning. Inclusions *anankastic neurosis *obsessive-compulsive neurosis Exclusions *obsessive compulsive behaviour (MB23.4) '''Changes in DSM-5''' * The diagnostic criteria for obsessive-compulsive disorder changed slightly from DSM-IV-TR to DSM-5. Summaries are available [https://en.wikipedia.org/wiki/DSM-5 here]. {{blockquotebottom}} === Base rates of obsessive-compulsive in different populations and clinical settings=== {| class="wikitable sortable" border="1" |- ! Demography ! Setting ! Base Rate ! Diagnostic Method |- |National (U.S.) adult sample (''n''=2073)<ref name="RuscioEtAl2010" /> |National Comorbidity Survey Replication |2.3% |World Health Organization Composite International Diagnostic Interview (CIDI 3.0) |- |U.S. household sample (''n''=18572)<ref name="KarnoEtAl1988" /> |Epidemiological Catchment Area (ECA) Program |1.9-3.3% |Diagnostic Interview Schedule (DIS) |- |Iranian adults (''n''=25180)<ref name="MohammadiEtAl2004" /> |Iranian population-based study |1.8% |DIS |- |NSAL adult study (''n''=5191)<ref name="HimleEtAl2008" /> |African-American and Caribbean Households (U.S.) |1.6% |CIDI Short Form |- |Epidemiological sample (''n''=6616)<ref name="SubramaniamEtAl2012" /> |Singapore Mental Health Study |3.0% |CIDI 3.0 |} '''Search terms:''' [obsessive compulsive disorder OR ocd] AND [prevalence OR incidence] in PsycInfo and PubMed [obsessive compulsive disorder OR ocd] AND [epidemiology] in PsycInfo and PubMed ==[[Evidence based assessment/Prediction phase|'''Prediction phase''']]== ===Recommended screening instruments === The following section contains a list of screening and diagnostic instruments for obsessive-compulsive disorder. {| class="wikitable sortable" border="1" |- ! Screening Instrument ! Format ! Age Range ! Administration Time !Where to Access |- | Children’s Florida Obsessive–Compulsive Inventory (C-FOCI) <ref name=":2">Eric A. Youngstrom, Mitchell J. Prinstein, Eric J. Mash, & Russell A. Barkley. (2020). Assessment of Disorders in Childhood and Adolescence, Fifth Edition: Vol. Fifth edition. The Guilford Press</ref> | Self-report | 7-17 years | 5 mins |[https://iocdf.org/wp-content/uploads/2014/11/Storch-et-al.-CFOCI-Article.pdf C-FOCI] |- |Obsessive–Compulsive Inventory—Child Version (OCI-CV) <ref name=":2" /> | Self-report | 7-17 years | |[https://pubmed.ncbi.nlm.nih.gov/20171333/ OCI-CV] |- | Children’s Obsessional Compulsive Inventory (CHOCI) <ref name=":2" /> | Self-report | 7-17 years | |[https://www.projectimplicit.net/bethany/papers/ShafranFramptonHeymanReynoldsTeachmanRachman2003.pdf CHOCI] |} === Likelihood ratios and AUCs of screening measures for OCD === * '''''For a list of the likelihood ratios for more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Likelihood_ratios_and_AUCs_of_common_screening_instruments click here.]''''' {| class="wikitable sortable" border="1" |- ! Screening Measure (Primary Reference) ! Area Under curve (AUC) and Sample Size ! LR+ (Score) ! LR- ! Clinical generalizability !Download Link |- | Y-BOCS-SR<ref name="SteketeeEtAl1996"/> | 0.75 (''n''=162) | 5.50 (7) | 0.50 | Moderate: OCD among pregnant and postpartum women |[https://static1.squarespace.com/static/58cab82ff5e231f0df8d9cad/t/60945b3af4680c68037f8188/1620335418443/YBOCS-II-SR.pdf Y-BOCS-SR] |- | OCI-R Total<ref name="FoaEtAl2002"/> | 0.81 (''n''=322) | 3.66 (14) | 0.44 | High: OCD (''n''=167) versus other anxiety disorders (n=155) at outpatient anxiety clinic |[https://serene.me.uk/tests/oci.pdf OCI-R Total] |- | OCI-R Total<ref name="FoaEtAl2002"/> | 0.82 (''n''=458) | 2.98 (18) | 0.36 | High: OCD (''n''=215) versus other anxiety disorders (n=243) at outpatient anxiety clinic |[https://serene.me.uk/tests/oci.pdf OCI-R Total] |- |Brown Assessment of Beliefs Scale<ref name=":1">Eisen, J. L., Phillips, K. A., Baer, L., Beer, D. A., & al, e. (1998). The brown assessment of beliefs scale: Reliability and validity. ''The American Journal of Psychiatry, 155''(1), 102-8. Retrieved from <nowiki>http://libproxy.lib.unc.edu/login?url=https://search.proquest.com/docview/220481418?accountid=14244</nowiki></ref> |(''n''=50) | | | |[http://www.veale.co.uk/wp-content/uploads/2010/11/BABS_revised_501.pdf BABS] |- |} *“LR+” refers to the change in likelihood ratio associated with a positive test score, and “LR-” is the likelihood ratio for a low score. Likelihood ratios of 1 indicate that the test result did not change impressions at all. LRs larger than 10 or smaller than .10 are frequently clinically decisive; 5 or .20 are helpful, and between 2.0 and .5 are small enough that they rarely result in clinically meaningful changes of formulation (Sackett et al., 2000). ==[[Evidence based assessment/Prescription phase|'''Prescription phase''']]== ===Gold standard diagnostic interviews=== * For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews click here.] ===Recommended diagnostic interviews for OCD=== {| class="wikitable" |+ !Diagnostic Interview !Format !Age Range/ !Administration Time !Where to Access |- | Anxiety Disorders Interview Schedule<ref>Brown, T.A., Di Nardo, P.A., Barlow, D.H., 1994. Anxiety Disorders Interview Schedule for DSM-IV (ADIS-IV-L). Psychological Corporation, San Antonio, TX.</ref> | Semistructured interview | 6-16 years | 1.5-2 hours |[https://www.sciencedirect.com/science/article/abs/pii/S0887618514001510?via%3Dihub ADIS-IV] |- |[https://mfr.osf.io/render?url=https://osf.io/mnzy2/?action=download%26mode=render Yale-Brown Obsessive Compulsive Scale Symptom Checklist]<ref name=":0">{{Cite journal|last=Steketee|first=G|title=The Yale-Brown Obsessive Compulsive Scale: Interview versus self-report|url=http://linkinghub.elsevier.com/retrieve/pii/0005796796000368|journal=Behaviour Research and Therapy|volume=34|issue=8|pages=675–684|doi=10.1016/0005-7967(96)00036-8}}</ref> | Semistructured interview | 6-17 years | Up to 60 mins |[https://www.ohsu.edu/sites/default/files/2019-06/Y-BOCS-Checklist_0.pdf Y-BOCS] |- | [https://search.proquest.com/docview/220481418/abstract/4AF689339CB14A0APQ/1?accountid=14244 Brown Assessment of Beliefs Scale]<ref name=":1">Eisen, J. L., Phillips, K. A., Baer, L., Beer, D. A., & al, e. (1998). The brown assessment of beliefs scale: Reliability and validity. ''The American Journal of Psychiatry, 155''(1), 102-8. Retrieved from <nowiki>http://libproxy.lib.unc.edu/login?url=https://search.proquest.com/docview/220481418?accountid=14244</nowiki></ref> | Semistructured interview | 16+ years | |[http://www.veale.co.uk/wp-content/uploads/2010/11/BABS_revised_501.pdf BABS] |- |OCD module of the Structured Clinical Interview for DSM-5 (SCID-5) |Semi-structured interview |18+ years |90 mins |[https://www.appi.org/products/structured-clinical-interview-for-dsm-5-scid-5 SCID-5] |} ==[[Evidence based assessment/Process phase|'''Process phase''']]== === Treatments === ==== Cognitive behavioral therapy (CBT) and exposure and response prevention (ERP) ==== *Behavior therapy, specifically ERP, has been established as the treatment of choice for OCD <ref>Whittal M.L., McLean P.D., Söchting I., Koch W.J., Taylor S., Anderson K., Paterson R.'''OCD treatment outcome using behavioral and cognitive approaches''' Paper presented at the meeting of the Association for Advancement of Behavior Therapy, Miami Beach, FL (1997)</ref><ref>{{Cite journal|last=Foa|first=Edna B.|last2=Kozak|first2=Michael J.|title=Beyond the efficacy ceiling? Cognitive behavior therapy in search of theory|url=https://doi.org/10.1016/S0005-7894(97)80019-6|journal=Behavior Therapy|volume=28|issue=4|pages=601–611|doi=10.1016/s0005-7894(97)80019-6}}</ref>. *Therapy incorporates ERP and emphasizes cognitive change. **Therapist will help individual identify anxiety-provoking thoughts and situations. **Therapist will develop a treatment plan and idiographic “fear hierarchy.” **Individuals will learn to encounter situations that invoke anxiety without engaging in rituals used to dispel anxiety (ERP). **Exposures will be done gradually at a pace that is comfortable for the client. **Therapy will include homework assignments and is designed to offer lifelong skills. *Therapy includes verbal techniques such as psychoeducation and cognitive restructuring. *Manuals for reference: **The therapist guide: Mastery of Obsessive-Compulsive Disorder: A Cognitive Behavioral Approach<ref>E. Foa, M. Kozak Mastery of obsessive–compulsive disorder: A cognitive-behavioral approach Graywind Publications (1997)</ref> **Cognitive Therapy of Obsessive-Compulsive Disorder: A Guide for Professionals (Wilhelm & Steketee) **Obsessive Compulsive Disorder: Advances in Psychotherapy <ref>{{Cite book|url=https://www.worldcat.org/oclc/70659789|title=Obsessive compulsive disorder|last=S.|first=Abramowitz, Jonathan|date=2006|publisher=Hogrefe & Huber Publishers|isbn=9780889373167|location=Cambridge, MA|oclc=70659789}}</ref> *Treatment alliance is a predictor of subsequent change in OCD symptoms<ref>Keeley, M. L., Geffken, G. R., Ricketts, E., McNamara, J. P., & Storch, E. A. (2011). The therapeutic alliance in the cognitive behavioral treatment of pediatric obsessive–compulsive disorder. ''Journal of Anxiety Disorders'', ''25''(7), 855-863.</ref>. The therapist should provide a “validating and :encouraging” environment so that clients can tolerate the emotional arousal associated with exposures. ==== Medication ==== *Selective serotonin reuptake inhibitors (SSRIs) are commonly used to treat OCD. *These antidepressants include: **[[wikipedia:Fluvoxamine|fluvoxamine]] **[[wikipedia:Fluoxetine|fluoxetine]] **[[wikipedia:Sertraline|sertraline]] **[[wikipedia:Paroxetine|paroxetine]] **[[wikipedia:Citalopram|citalopram]] **[[wikipedia:Clomipramine|clomipramine]] **[[wikipedia:Escitalopram|escitalopram]] **[[wikipedia:Venlafaxine|venlafaxine]] *High doses (relative to doses prescribed for depression) are needed for individuals with OCD. === Process and outcome measures === ==== Clinically significant change benchmarks with common instruments and mood rating scales ==== {| class="wikitable sortable" border="1" |- | rowspan=1" style="text-align:center;font-size:130%;" | <b> Measure</b> | style="text-align:center;font-size:130%;" | <b> Subscale</b> | colspan="3" style="text-align:center;font-size:130%" width="300" | <b> Cut-off scores</b> | colspan="3" style="text-align:center;font-size:120%" | <b> Critical Change <br> (unstandardized scores)</b> |- | colspan="8" span style="font-size:110%; text-align:center;" | <b> Benchmarks Based on Published Norms</b> |- | colspan="2" | | style="text-align:center;font-size:110%" | <b> A</b> | style="text-align:center;font-size:110%" | <b> B</b> | style="text-align:center;font-size:110%" | <b> C</b> | style="text-align:center;font-size:110%" | <b> 95%</b> | style="text-align:center;font-size:110%" | <b> 90%</b> | style="text-align:center;font-size:110%" | <b> SE_difference</b> |- | rowspan="3" style="text-align:center;" | <b> Yale-Brown Obsessive Compulsive Scale (Y-BOCS-SR)</b> | style="text-align:right;" | <i> Total</i> | style="text-align:center;"| 10.6 | style="text-align:center;"| 14.4 | style="text-align:center;"| 12.6 | style="text-align:center;"| 4.7 | style="text-align:center;"| 3.9 | style="text-align:center;"| 2.4 |- | style="text-align:right;" | <i> Obsessions</i> | style="text-align:center;"| 6.6 | style="text-align:center;"| 7.6 | style="text-align:center;"| 7.0 | style="text-align:center;"| 2.5 | style="text-align:center;"| 2.1 | style="text-align:center;"| 1.3 |- | style="text-align:right;" | <i> Compulsions</i> | style="text-align:center;"| 3.5 | style="text-align:center;"| 8.2 | style="text-align:center;"| 6.1 | style="text-align:center;"| 3.6 | style="text-align:center;"| 3.0 | style="text-align:center;"| 1.8 |- | rowspan="7" style="text-align:center;" | <b> Obsessive-Compulsive Inventory – Revised (OCI-R)</b> | style="text-align:right;" | <i> Total</i> | style="text-align:center;"| 1.0 | style="text-align:center;"| 41.0 | style="text-align:center;"| 23.0 | style="text-align:center;"| 14.8 | style="text-align:center;"| 12.5 | style="text-align:center;"| 7.6 |- | style="text-align:right;" | <i> Washing</i> | style="text-align:center;"| n/a | style="text-align:center;"| 7.4 | style="text-align:center;"| 3.1 | style="text-align:center;"| 3.4 | style="text-align:center;"| 2.9 | style="text-align:center;"| 1.7 |- | style="text-align:right;" | <i> Checking</i> | style="text-align:center;"| n/a | style="text-align:center;"| 8.0 | style="text-align:center;"| 3.7 | style="text-align:center;"| 3.0 | style="text-align:center;"| 2.5 | style="text-align:center;"| 1.5 |- | style="text-align:right;" | <i> Ordering</i> | style="text-align:center;"| n/a | style="text-align:center;"| 10.5 | style="text-align:center;"| 4.6 | style="text-align:center;"| 3.1 | style="text-align:center;"| 2.6 | style="text-align:center;"| 1.6 |- | style="text-align:right;" | <i> Obsessing</i> | style="text-align:center;"| n/a | style="text-align:center;"| 8.3 | style="text-align:center;"| 4.7 | style="text-align:center;"| 3.8 | style="text-align:center;"| 3.2 | style="text-align:center;"| 1.9 |- | style="text-align:right;" | <i> Hoarding</i> | style="text-align:center;"| n/a | style="text-align:center;"| 9.8 | style="text-align:center;"| 4.1 | style="text-align:center;"| 2.8 | style="text-align:center;"| 2.4 | style="text-align:center;"| 1.4 |- | style="text-align:right;" | <i> Neutralizing</i> | style="text-align:center;"| n/a | style="text-align:center;"| 6.2 | style="text-align:center;"| 2.3 | style="text-align:center;"| 3.0 | style="text-align:center;"| 2.5 | style="text-align:center;"| 1.5 |- | rowspan="7" style="text-align:center;" | <b> Dimensional Obsessive Compulsive Scale (DOCS)</b> | style="text-align:right;" | <i> Total</i> | style="text-align:center;"| n/a | style="text-align:center;"| 31.7 | style="text-align:center;"| 19.0 | style="text-align:center;"| 10.3 | style="text-align:center;"| 8.7 | style="text-align:center;"| 5.3 |- | style="text-align:right;" | <i> Contamination</i> | style="text-align:center;"| n/a | style="text-align:center;"| 7.8 | style="text-align:center;"| 3.4 | style="text-align:center;"| 2.4 | style="text-align:center;"| 2.0 | style="text-align:center;"| 1.2 |- | style="text-align:right;" | <i> Responsibility for Harm</i> | style="text-align:center;"| n/a | style="text-align:center;"| 8.7 | style="text-align:center;"| 4.4 | style="text-align:center;"| 2.4 | style="text-align:center;"| 2.0 | style="text-align:center;"| 1.2 |- | style="text-align:right;" | <i> Unacceptable Thoughts</i> | style="text-align:center;"| n/a | style="text-align:center;"| 9.6 | style="text-align:center;"| 5.4 | style="text-align:center;"| 2.5 | style="text-align:center;"| 2.1 | style="text-align:center;"| 1.3 |- | style="text-align:right;" | <i> Symmetry</i> | style="text-align:center;"| n/a | style="text-align:center;"| 7.9 | style="text-align:center;"| 3.6 | style="text-align:center;"| 2.2 | style="text-align:center;"| 1.8 | style="text-align:center;"| 1.1 |- |} === Process measures === *Quality of Life **Sheehan Disability Scale<ref>Sheehan DV, Harnett-Sheehan K, Raj BA. 1996. The measurement of disability. Int Clin Psychopharmacol 11(Suppl 3): 89–95.</ref> **[http://www.jstor.org/stable/pdf/3765819.pdf?refreqid=excelsior%3A9dcc715f829676edec9bc2c7be1478fa Medical Outcomes Study (MOS) 36-Item Short Form (SF-36) Health Survey]<ref>McHorney, C., Ware, J., & Raczek, A. (1993). The MOS 36-Item Short-Form Health Survey (SF-36): II. Psychometric and Clinical Tests of Validity in Measuring Physical and Mental Health Constructs. ''Medical Care,'' ''31''(3), 247-263. Retrieved from <nowiki>http://www.jstor.org/stable/3765819</nowiki></ref> *Compulsions scale of YBOCS *SUDS Ratings == External Links == *[https://sccap53.org Society of Clinical Child and Adolescent Psychology] *[http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/self-injurious-thoughts-and-behaviors/ EffectiveChildTherapy.Org information on rule-breaking, defiance, and acting out] *For information on conducting Exposure Therapy for anxiety disordered youth, see [https://www.bravepracticeforkids.com/ www.BravePracticeForKids.com] == References == {{collapse top|References|expand=yes}} {{Reflist|2|refs= <ref name="EAYfuturedirections"> Youngstrom, E. A. (2013). Future directions in psychological assessment: Combining evidence-based medicine innovations with psychology's historical strengths to enhance utility. Journal of Clinical Child and Adolescent Psychology, 42(1), 139-159. </ref> <ref name="strauss2011"> Strauss, S. E., Glasziou, P., Richardson, W. S., & Haynes, R. B. (2011). Evidence-based medicine: How to practice and teach EBM (4th ed.). New York, NY: Churchill Livingstone. </ref> <ref name="sackett"> Sackett, D. L., Straus, S. E., Richardson, W. S., Rosenberg, W., & Haynes, R. B. (2000). Evidence-based medicine: How to practice and teach EBM. Edinburgh: Churchill Livingstone. </ref> <ref name="RuscioEtAl2010">{{cite journal|last1=Ruscio|first1=AM|last2=Stein|first2=DJ|last3=Chiu|first3=WT|last4=Kessler|first4=RC|title=The epidemiology of obsessive-compulsive disorder in the National Comorbidity Survey Replication.|journal=Molecular psychiatry|date=January 2010|volume=15|issue=1|pages=53-63|pmid=18725912}}</ref> <ref name="KarnoEtAl1988">{{cite journal|last1=Karno|first1=M|last2=Golding|first2=JM|last3=Sorenson|first3=SB|last4=Burnam|first4=MA|title=The epidemiology of obsessive-compulsive disorder in five US communities.|journal=Archives of general psychiatry|date=December 1988|volume=45|issue=12|pages=1094-9|pmid=3264144}}</ref> <ref name="MohammadiEtAl2004">{{cite journal|last1=Mohammadi|first1=MR|last2=Ghanizadeh|first2=A|last3=Rahgozar|first3=M|last4=Noorbala|first4=AA|last5=Davidian|first5=H|last6=Afzali|first6=HM|last7=Naghavi|first7=HR|last8=Yazdi|first8=SA|last9=Saberi|first9=SM|last10=Mesgarpour|first10=B|last11=Akhondzadeh|first11=S|last12=Alaghebandrad|first12=J|last13=Tehranidoost|first13=M|title=Prevalence of obsessive-compulsive disorder in Iran.|journal=BMC psychiatry|date=14 February 2004|volume=4|pages=2|pmid=15018627}}</ref> <ref name="HimleEtAl2008">{{cite journal|last1=Himle|first1=JA|last2=Muroff|first2=JR|last3=Taylor|first3=RJ|last4=Baser|first4=RE|last5=Abelson|first5=JM|last6=Hanna|first6=GL|last7=Abelson|first7=JL|last8=Jackson|first8=JS|title=Obsessive-compulsive disorder among African Americans and blacks of Caribbean descent: results from the National Survey of American Life.|journal=Depression and anxiety|date=2008|volume=25|issue=12|pages=993-1005|pmid=18833577}}</ref> <ref name="SubramaniamEtAl2012">{{cite journal|last1=Subramaniam|first1=M|last2=Abdin|first2=E|last3=Vaingankar|first3=JA|last4=Chong|first4=SA|title=Obsessive--compulsive disorder: prevalence, correlates, help-seeking and quality of life in a multiracial Asian population.|journal=Social psychiatry and psychiatric epidemiology|date=December 2012|volume=47|issue=12|pages=2035-43|pmid=22526825}}</ref> <ref name="LordEtAl2011">{{cite journal|last1=Lord|first1=C|last2=Hall|first2=G|last3=Soares|first3=CN|last4=Steiner|first4=M|title=Physiological stress response in postpartum women with obsessive-compulsive disorder: A pilot study.|journal=Psychoneuroendocrinology|date=January 2011|volume=36|issue=1|pages=133-8|pmid=20537805}}</ref> <ref name="FoaEtAl2002">{{cite journal|last1=Foa|first1=EB|last2=Huppert|first2=JD|last3=Leiberg|first3=S|last4=Langner|first4=R|last5=Kichic|first5=R|last6=Hajcak|first6=G|last7=Salkovskis|first7=PM|title=The Obsessive-Compulsive Inventory: development and validation of a short version.|journal=Psychological assessment|date=December 2002|volume=14|issue=4|pages=485-96|pmid=12501574}}</ref> <ref name="SteketeeEtAl1996">{{cite journal|last1=Steketee|first1=G|last2=Frost|first2=R|last3=Bogart|first3=K|title=The Yale-Brown Obsessive Compulsive Scale: interview versus self-report.|journal=Behaviour research and therapy|date=August 1996|volume=34|issue=8|pages=675-84|pmid=8870295}}</ref> <ref name="AbramowitzDeacon2005">{{cite journal|last1=Abramowitz|first1=Jonathan S.|last2=Deacon|first2=Brett J.|title=Psychometric properties and construct validity of the Obsessive–Compulsive Inventory—Revised: Replication and extension with a clinical sample|journal=Journal of Anxiety Disorders|date=January 2006|volume=20|issue=8|pages=1016–1035|doi=10.1016/j.janxdis.2006.03.001}}</ref> <ref name="AbramowitzEtAl2010">{{cite journal|last1=Abramowitz|first1=JS|last2=Deacon|first2=BJ|last3=Olatunji|first3=BO|last4=Wheaton|first4=MG|last5=Berman|first5=NC|last6=Losardo|first6=D|last7=Timpano|first7=KR|last8=McGrath|first8=PB|last9=Riemann|first9=BC|last10=Adams|first10=T|last11=Björgvinsson|first11=T|last12=Storch|first12=EA|last13=Hale|first13=LR|title=Assessment of obsessive-compulsive symptom dimensions: development and evaluation of the Dimensional Obsessive-Compulsive Scale.|journal=Psychological assessment|date=March 2010|volume=22|issue=1|pages=180-98|pmid=20230164}}</ref> }} {{collapse bottom|Click here for references}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] t48l4n6ao9idtkxakcx0f09xaupqdyd 2419304 2419218 2022-08-26T05:29:18Z Ardenguo 2944162 /* Recommended screening instruments */ added "Note: Reliability and validity are included in the extended version. This table includes measures with Good or Excellent ratings." wikitext text/x-wiki <noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{medical disclaimer}} {{:{{BASEPAGENAME}}/Sidebar}} ==[[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio"?''']]== For background information on what assessment portfolios are, click the link in the heading above. Want even more information about this topic? There's an extended version of this page [[Evidence-based assessment/Obsessive-compulsive disorder (assessment portfolio)/extended version|here]]. ==[[Evidence based assessment/Preparation phase|'''Preparation phase''']]== === Diagnostic criteria for obsessive-compulsive disorder === {{blockquotetop}}'''ICD-11 Criteria''' <ref>{{Cite web|url=http://apps.who.int/classifications/icd10/browse/2016/en#/F40-F48|title=ICD-10 Version:2016|website=apps.who.int|language=en|accessdate=2018-03-01}}</ref> Obsessive-Compulsive Disorder is characterized by the presence of persistent obsessions or compulsions, or most commonly both. Obsessions are repetitive and persistent thoughts, images, or impulses/urges that are intrusive, unwanted, and are commonly associated with anxiety. The individual attempts to ignore or suppress obsessions or to neutralize them by performing compulsions. Compulsions are repetitive behaviors including repetitive mental acts that the individual feels driven to perform in response to an obsession, according to rigid rules, or to achieve a sense of ‘completeness’. In order for obsessive-compulsive disorder to be diagnosed, obsessions and compulsions must be time consuming (e.g., taking more than an hour per day), and result in significant distress or significant impairment in personal, family, social, educational, occupational or other important areas of functioning. Inclusions *anankastic neurosis *obsessive-compulsive neurosis Exclusions *obsessive compulsive behaviour (MB23.4) '''Changes in DSM-5''' * The diagnostic criteria for obsessive-compulsive disorder changed slightly from DSM-IV-TR to DSM-5. Summaries are available [https://en.wikipedia.org/wiki/DSM-5 here]. {{blockquotebottom}} === Base rates of obsessive-compulsive in different populations and clinical settings=== {| class="wikitable sortable" border="1" |- ! Demography ! Setting ! Base Rate ! Diagnostic Method |- |National (U.S.) adult sample (''n''=2073)<ref name="RuscioEtAl2010" /> |National Comorbidity Survey Replication |2.3% |World Health Organization Composite International Diagnostic Interview (CIDI 3.0) |- |U.S. household sample (''n''=18572)<ref name="KarnoEtAl1988" /> |Epidemiological Catchment Area (ECA) Program |1.9-3.3% |Diagnostic Interview Schedule (DIS) |- |Iranian adults (''n''=25180)<ref name="MohammadiEtAl2004" /> |Iranian population-based study |1.8% |DIS |- |NSAL adult study (''n''=5191)<ref name="HimleEtAl2008" /> |African-American and Caribbean Households (U.S.) |1.6% |CIDI Short Form |- |Epidemiological sample (''n''=6616)<ref name="SubramaniamEtAl2012" /> |Singapore Mental Health Study |3.0% |CIDI 3.0 |} '''Search terms:''' [obsessive compulsive disorder OR ocd] AND [prevalence OR incidence] in PsycInfo and PubMed [obsessive compulsive disorder OR ocd] AND [epidemiology] in PsycInfo and PubMed ==[[Evidence based assessment/Prediction phase|'''Prediction phase''']]== ===Recommended screening instruments === The following section contains a list of screening and diagnostic instruments for obsessive-compulsive disorder. {| class="wikitable sortable" border="1" |- ! Screening Instrument ! Format ! Age Range ! Administration Time !Where to Access |- | Children’s Florida Obsessive–Compulsive Inventory (C-FOCI) <ref name=":2">Eric A. Youngstrom, Mitchell J. Prinstein, Eric J. Mash, & Russell A. Barkley. (2020). Assessment of Disorders in Childhood and Adolescence, Fifth Edition: Vol. Fifth edition. The Guilford Press</ref> | Self-report | 7-17 years | 5 mins |[https://iocdf.org/wp-content/uploads/2014/11/Storch-et-al.-CFOCI-Article.pdf C-FOCI] |- |Obsessive–Compulsive Inventory—Child Version (OCI-CV) <ref name=":2" /> | Self-report | 7-17 years | |[https://pubmed.ncbi.nlm.nih.gov/20171333/ OCI-CV] |- | Children’s Obsessional Compulsive Inventory (CHOCI) <ref name=":2" /> | Self-report | 7-17 years | |[https://www.projectimplicit.net/bethany/papers/ShafranFramptonHeymanReynoldsTeachmanRachman2003.pdf CHOCI] |} '''Note:''' Reliability and validity are included in the extended version. This table includes measures with Good or Excellent ratings. === Likelihood ratios and AUCs of screening measures for OCD === * '''''For a list of the likelihood ratios for more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Likelihood_ratios_and_AUCs_of_common_screening_instruments click here.]''''' {| class="wikitable sortable" border="1" |- ! Screening Measure (Primary Reference) ! Area Under curve (AUC) and Sample Size ! LR+ (Score) ! LR- ! Clinical generalizability !Download Link |- | Y-BOCS-SR<ref name="SteketeeEtAl1996"/> | 0.75 (''n''=162) | 5.50 (7) | 0.50 | Moderate: OCD among pregnant and postpartum women |[https://static1.squarespace.com/static/58cab82ff5e231f0df8d9cad/t/60945b3af4680c68037f8188/1620335418443/YBOCS-II-SR.pdf Y-BOCS-SR] |- | OCI-R Total<ref name="FoaEtAl2002"/> | 0.81 (''n''=322) | 3.66 (14) | 0.44 | High: OCD (''n''=167) versus other anxiety disorders (n=155) at outpatient anxiety clinic |[https://serene.me.uk/tests/oci.pdf OCI-R Total] |- | OCI-R Total<ref name="FoaEtAl2002"/> | 0.82 (''n''=458) | 2.98 (18) | 0.36 | High: OCD (''n''=215) versus other anxiety disorders (n=243) at outpatient anxiety clinic |[https://serene.me.uk/tests/oci.pdf OCI-R Total] |- |Brown Assessment of Beliefs Scale<ref name=":1">Eisen, J. L., Phillips, K. A., Baer, L., Beer, D. A., & al, e. (1998). The brown assessment of beliefs scale: Reliability and validity. ''The American Journal of Psychiatry, 155''(1), 102-8. Retrieved from <nowiki>http://libproxy.lib.unc.edu/login?url=https://search.proquest.com/docview/220481418?accountid=14244</nowiki></ref> |(''n''=50) | | | |[http://www.veale.co.uk/wp-content/uploads/2010/11/BABS_revised_501.pdf BABS] |- |} *“LR+” refers to the change in likelihood ratio associated with a positive test score, and “LR-” is the likelihood ratio for a low score. Likelihood ratios of 1 indicate that the test result did not change impressions at all. LRs larger than 10 or smaller than .10 are frequently clinically decisive; 5 or .20 are helpful, and between 2.0 and .5 are small enough that they rarely result in clinically meaningful changes of formulation (Sackett et al., 2000). ==[[Evidence based assessment/Prescription phase|'''Prescription phase''']]== ===Gold standard diagnostic interviews=== * For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews click here.] ===Recommended diagnostic interviews for OCD=== {| class="wikitable" |+ !Diagnostic Interview !Format !Age Range/ !Administration Time !Where to Access |- | Anxiety Disorders Interview Schedule<ref>Brown, T.A., Di Nardo, P.A., Barlow, D.H., 1994. Anxiety Disorders Interview Schedule for DSM-IV (ADIS-IV-L). Psychological Corporation, San Antonio, TX.</ref> | Semistructured interview | 6-16 years | 1.5-2 hours |[https://www.sciencedirect.com/science/article/abs/pii/S0887618514001510?via%3Dihub ADIS-IV] |- |[https://mfr.osf.io/render?url=https://osf.io/mnzy2/?action=download%26mode=render Yale-Brown Obsessive Compulsive Scale Symptom Checklist]<ref name=":0">{{Cite journal|last=Steketee|first=G|title=The Yale-Brown Obsessive Compulsive Scale: Interview versus self-report|url=http://linkinghub.elsevier.com/retrieve/pii/0005796796000368|journal=Behaviour Research and Therapy|volume=34|issue=8|pages=675–684|doi=10.1016/0005-7967(96)00036-8}}</ref> | Semistructured interview | 6-17 years | Up to 60 mins |[https://www.ohsu.edu/sites/default/files/2019-06/Y-BOCS-Checklist_0.pdf Y-BOCS] |- | [https://search.proquest.com/docview/220481418/abstract/4AF689339CB14A0APQ/1?accountid=14244 Brown Assessment of Beliefs Scale]<ref name=":1">Eisen, J. L., Phillips, K. A., Baer, L., Beer, D. A., & al, e. (1998). The brown assessment of beliefs scale: Reliability and validity. ''The American Journal of Psychiatry, 155''(1), 102-8. Retrieved from <nowiki>http://libproxy.lib.unc.edu/login?url=https://search.proquest.com/docview/220481418?accountid=14244</nowiki></ref> | Semistructured interview | 16+ years | |[http://www.veale.co.uk/wp-content/uploads/2010/11/BABS_revised_501.pdf BABS] |- |OCD module of the Structured Clinical Interview for DSM-5 (SCID-5) |Semi-structured interview |18+ years |90 mins |[https://www.appi.org/products/structured-clinical-interview-for-dsm-5-scid-5 SCID-5] |} '''Note:''' Reliability and validity are included in the extended version. This table includes measures with Good or Excellent ratings. ==[[Evidence based assessment/Process phase|'''Process phase''']]== === Treatments === ==== Cognitive behavioral therapy (CBT) and exposure and response prevention (ERP) ==== *Behavior therapy, specifically ERP, has been established as the treatment of choice for OCD <ref>Whittal M.L., McLean P.D., Söchting I., Koch W.J., Taylor S., Anderson K., Paterson R.'''OCD treatment outcome using behavioral and cognitive approaches''' Paper presented at the meeting of the Association for Advancement of Behavior Therapy, Miami Beach, FL (1997)</ref><ref>{{Cite journal|last=Foa|first=Edna B.|last2=Kozak|first2=Michael J.|title=Beyond the efficacy ceiling? Cognitive behavior therapy in search of theory|url=https://doi.org/10.1016/S0005-7894(97)80019-6|journal=Behavior Therapy|volume=28|issue=4|pages=601–611|doi=10.1016/s0005-7894(97)80019-6}}</ref>. *Therapy incorporates ERP and emphasizes cognitive change. **Therapist will help individual identify anxiety-provoking thoughts and situations. **Therapist will develop a treatment plan and idiographic “fear hierarchy.” **Individuals will learn to encounter situations that invoke anxiety without engaging in rituals used to dispel anxiety (ERP). **Exposures will be done gradually at a pace that is comfortable for the client. **Therapy will include homework assignments and is designed to offer lifelong skills. *Therapy includes verbal techniques such as psychoeducation and cognitive restructuring. *Manuals for reference: **The therapist guide: Mastery of Obsessive-Compulsive Disorder: A Cognitive Behavioral Approach<ref>E. Foa, M. Kozak Mastery of obsessive–compulsive disorder: A cognitive-behavioral approach Graywind Publications (1997)</ref> **Cognitive Therapy of Obsessive-Compulsive Disorder: A Guide for Professionals (Wilhelm & Steketee) **Obsessive Compulsive Disorder: Advances in Psychotherapy <ref>{{Cite book|url=https://www.worldcat.org/oclc/70659789|title=Obsessive compulsive disorder|last=S.|first=Abramowitz, Jonathan|date=2006|publisher=Hogrefe & Huber Publishers|isbn=9780889373167|location=Cambridge, MA|oclc=70659789}}</ref> *Treatment alliance is a predictor of subsequent change in OCD symptoms<ref>Keeley, M. L., Geffken, G. R., Ricketts, E., McNamara, J. P., & Storch, E. A. (2011). The therapeutic alliance in the cognitive behavioral treatment of pediatric obsessive–compulsive disorder. ''Journal of Anxiety Disorders'', ''25''(7), 855-863.</ref>. The therapist should provide a “validating and :encouraging” environment so that clients can tolerate the emotional arousal associated with exposures. ==== Medication ==== *Selective serotonin reuptake inhibitors (SSRIs) are commonly used to treat OCD. *These antidepressants include: **[[wikipedia:Fluvoxamine|fluvoxamine]] **[[wikipedia:Fluoxetine|fluoxetine]] **[[wikipedia:Sertraline|sertraline]] **[[wikipedia:Paroxetine|paroxetine]] **[[wikipedia:Citalopram|citalopram]] **[[wikipedia:Clomipramine|clomipramine]] **[[wikipedia:Escitalopram|escitalopram]] **[[wikipedia:Venlafaxine|venlafaxine]] *High doses (relative to doses prescribed for depression) are needed for individuals with OCD. === Process and outcome measures === ==== Clinically significant change benchmarks with common instruments and mood rating scales ==== {| class="wikitable sortable" border="1" |- | rowspan=1" style="text-align:center;font-size:130%;" | <b> Measure</b> | style="text-align:center;font-size:130%;" | <b> Subscale</b> | colspan="3" style="text-align:center;font-size:130%" width="300" | <b> Cut-off scores</b> | colspan="3" style="text-align:center;font-size:120%" | <b> Critical Change <br> (unstandardized scores)</b> |- | colspan="8" span style="font-size:110%; text-align:center;" | <b> Benchmarks Based on Published Norms</b> |- | colspan="2" | | style="text-align:center;font-size:110%" | <b> A</b> | style="text-align:center;font-size:110%" | <b> B</b> | style="text-align:center;font-size:110%" | <b> C</b> | style="text-align:center;font-size:110%" | <b> 95%</b> | style="text-align:center;font-size:110%" | <b> 90%</b> | style="text-align:center;font-size:110%" | <b> SE_difference</b> |- | rowspan="3" style="text-align:center;" | <b> Yale-Brown Obsessive Compulsive Scale (Y-BOCS-SR)</b> | style="text-align:right;" | <i> Total</i> | style="text-align:center;"| 10.6 | style="text-align:center;"| 14.4 | style="text-align:center;"| 12.6 | style="text-align:center;"| 4.7 | style="text-align:center;"| 3.9 | style="text-align:center;"| 2.4 |- | style="text-align:right;" | <i> Obsessions</i> | style="text-align:center;"| 6.6 | style="text-align:center;"| 7.6 | style="text-align:center;"| 7.0 | style="text-align:center;"| 2.5 | style="text-align:center;"| 2.1 | style="text-align:center;"| 1.3 |- | style="text-align:right;" | <i> Compulsions</i> | style="text-align:center;"| 3.5 | style="text-align:center;"| 8.2 | style="text-align:center;"| 6.1 | style="text-align:center;"| 3.6 | style="text-align:center;"| 3.0 | style="text-align:center;"| 1.8 |- | rowspan="7" style="text-align:center;" | <b> Obsessive-Compulsive Inventory – Revised (OCI-R)</b> | style="text-align:right;" | <i> Total</i> | style="text-align:center;"| 1.0 | style="text-align:center;"| 41.0 | style="text-align:center;"| 23.0 | style="text-align:center;"| 14.8 | style="text-align:center;"| 12.5 | style="text-align:center;"| 7.6 |- | style="text-align:right;" | <i> Washing</i> | style="text-align:center;"| n/a | style="text-align:center;"| 7.4 | style="text-align:center;"| 3.1 | style="text-align:center;"| 3.4 | style="text-align:center;"| 2.9 | style="text-align:center;"| 1.7 |- | style="text-align:right;" | <i> Checking</i> | style="text-align:center;"| n/a | style="text-align:center;"| 8.0 | style="text-align:center;"| 3.7 | style="text-align:center;"| 3.0 | style="text-align:center;"| 2.5 | style="text-align:center;"| 1.5 |- | style="text-align:right;" | <i> Ordering</i> | style="text-align:center;"| n/a | style="text-align:center;"| 10.5 | style="text-align:center;"| 4.6 | style="text-align:center;"| 3.1 | style="text-align:center;"| 2.6 | style="text-align:center;"| 1.6 |- | style="text-align:right;" | <i> Obsessing</i> | style="text-align:center;"| n/a | style="text-align:center;"| 8.3 | style="text-align:center;"| 4.7 | style="text-align:center;"| 3.8 | style="text-align:center;"| 3.2 | style="text-align:center;"| 1.9 |- | style="text-align:right;" | <i> Hoarding</i> | style="text-align:center;"| n/a | style="text-align:center;"| 9.8 | style="text-align:center;"| 4.1 | style="text-align:center;"| 2.8 | style="text-align:center;"| 2.4 | style="text-align:center;"| 1.4 |- | style="text-align:right;" | <i> Neutralizing</i> | style="text-align:center;"| n/a | style="text-align:center;"| 6.2 | style="text-align:center;"| 2.3 | style="text-align:center;"| 3.0 | style="text-align:center;"| 2.5 | style="text-align:center;"| 1.5 |- | rowspan="7" style="text-align:center;" | <b> Dimensional Obsessive Compulsive Scale (DOCS)</b> | style="text-align:right;" | <i> Total</i> | style="text-align:center;"| n/a | style="text-align:center;"| 31.7 | style="text-align:center;"| 19.0 | style="text-align:center;"| 10.3 | style="text-align:center;"| 8.7 | style="text-align:center;"| 5.3 |- | style="text-align:right;" | <i> Contamination</i> | style="text-align:center;"| n/a | style="text-align:center;"| 7.8 | style="text-align:center;"| 3.4 | style="text-align:center;"| 2.4 | style="text-align:center;"| 2.0 | style="text-align:center;"| 1.2 |- | style="text-align:right;" | <i> Responsibility for Harm</i> | style="text-align:center;"| n/a | style="text-align:center;"| 8.7 | style="text-align:center;"| 4.4 | style="text-align:center;"| 2.4 | style="text-align:center;"| 2.0 | style="text-align:center;"| 1.2 |- | style="text-align:right;" | <i> Unacceptable Thoughts</i> | style="text-align:center;"| n/a | style="text-align:center;"| 9.6 | style="text-align:center;"| 5.4 | style="text-align:center;"| 2.5 | style="text-align:center;"| 2.1 | style="text-align:center;"| 1.3 |- | style="text-align:right;" | <i> Symmetry</i> | style="text-align:center;"| n/a | style="text-align:center;"| 7.9 | style="text-align:center;"| 3.6 | style="text-align:center;"| 2.2 | style="text-align:center;"| 1.8 | style="text-align:center;"| 1.1 |- |} === Process measures === *Quality of Life **Sheehan Disability Scale<ref>Sheehan DV, Harnett-Sheehan K, Raj BA. 1996. The measurement of disability. Int Clin Psychopharmacol 11(Suppl 3): 89–95.</ref> **[http://www.jstor.org/stable/pdf/3765819.pdf?refreqid=excelsior%3A9dcc715f829676edec9bc2c7be1478fa Medical Outcomes Study (MOS) 36-Item Short Form (SF-36) Health Survey]<ref>McHorney, C., Ware, J., & Raczek, A. (1993). The MOS 36-Item Short-Form Health Survey (SF-36): II. Psychometric and Clinical Tests of Validity in Measuring Physical and Mental Health Constructs. ''Medical Care,'' ''31''(3), 247-263. Retrieved from <nowiki>http://www.jstor.org/stable/3765819</nowiki></ref> *Compulsions scale of YBOCS *SUDS Ratings == External Links == *[https://sccap53.org Society of Clinical Child and Adolescent Psychology] *[http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/self-injurious-thoughts-and-behaviors/ EffectiveChildTherapy.Org information on rule-breaking, defiance, and acting out] *For information on conducting Exposure Therapy for anxiety disordered youth, see [https://www.bravepracticeforkids.com/ www.BravePracticeForKids.com] == References == {{collapse top|References|expand=yes}} {{Reflist|2|refs= <ref name="EAYfuturedirections"> Youngstrom, E. A. (2013). Future directions in psychological assessment: Combining evidence-based medicine innovations with psychology's historical strengths to enhance utility. Journal of Clinical Child and Adolescent Psychology, 42(1), 139-159. </ref> <ref name="strauss2011"> Strauss, S. E., Glasziou, P., Richardson, W. S., & Haynes, R. B. (2011). Evidence-based medicine: How to practice and teach EBM (4th ed.). New York, NY: Churchill Livingstone. </ref> <ref name="sackett"> Sackett, D. L., Straus, S. E., Richardson, W. S., Rosenberg, W., & Haynes, R. B. (2000). Evidence-based medicine: How to practice and teach EBM. Edinburgh: Churchill Livingstone. </ref> <ref name="RuscioEtAl2010">{{cite journal|last1=Ruscio|first1=AM|last2=Stein|first2=DJ|last3=Chiu|first3=WT|last4=Kessler|first4=RC|title=The epidemiology of obsessive-compulsive disorder in the National Comorbidity Survey Replication.|journal=Molecular psychiatry|date=January 2010|volume=15|issue=1|pages=53-63|pmid=18725912}}</ref> <ref name="KarnoEtAl1988">{{cite journal|last1=Karno|first1=M|last2=Golding|first2=JM|last3=Sorenson|first3=SB|last4=Burnam|first4=MA|title=The epidemiology of obsessive-compulsive disorder in five US communities.|journal=Archives of general psychiatry|date=December 1988|volume=45|issue=12|pages=1094-9|pmid=3264144}}</ref> <ref name="MohammadiEtAl2004">{{cite journal|last1=Mohammadi|first1=MR|last2=Ghanizadeh|first2=A|last3=Rahgozar|first3=M|last4=Noorbala|first4=AA|last5=Davidian|first5=H|last6=Afzali|first6=HM|last7=Naghavi|first7=HR|last8=Yazdi|first8=SA|last9=Saberi|first9=SM|last10=Mesgarpour|first10=B|last11=Akhondzadeh|first11=S|last12=Alaghebandrad|first12=J|last13=Tehranidoost|first13=M|title=Prevalence of obsessive-compulsive disorder in Iran.|journal=BMC psychiatry|date=14 February 2004|volume=4|pages=2|pmid=15018627}}</ref> <ref name="HimleEtAl2008">{{cite journal|last1=Himle|first1=JA|last2=Muroff|first2=JR|last3=Taylor|first3=RJ|last4=Baser|first4=RE|last5=Abelson|first5=JM|last6=Hanna|first6=GL|last7=Abelson|first7=JL|last8=Jackson|first8=JS|title=Obsessive-compulsive disorder among African Americans and blacks of Caribbean descent: results from the National Survey of American Life.|journal=Depression and anxiety|date=2008|volume=25|issue=12|pages=993-1005|pmid=18833577}}</ref> <ref name="SubramaniamEtAl2012">{{cite journal|last1=Subramaniam|first1=M|last2=Abdin|first2=E|last3=Vaingankar|first3=JA|last4=Chong|first4=SA|title=Obsessive--compulsive disorder: prevalence, correlates, help-seeking and quality of life in a multiracial Asian population.|journal=Social psychiatry and psychiatric epidemiology|date=December 2012|volume=47|issue=12|pages=2035-43|pmid=22526825}}</ref> <ref name="LordEtAl2011">{{cite journal|last1=Lord|first1=C|last2=Hall|first2=G|last3=Soares|first3=CN|last4=Steiner|first4=M|title=Physiological stress response in postpartum women with obsessive-compulsive disorder: A pilot study.|journal=Psychoneuroendocrinology|date=January 2011|volume=36|issue=1|pages=133-8|pmid=20537805}}</ref> <ref name="FoaEtAl2002">{{cite journal|last1=Foa|first1=EB|last2=Huppert|first2=JD|last3=Leiberg|first3=S|last4=Langner|first4=R|last5=Kichic|first5=R|last6=Hajcak|first6=G|last7=Salkovskis|first7=PM|title=The Obsessive-Compulsive Inventory: development and validation of a short version.|journal=Psychological assessment|date=December 2002|volume=14|issue=4|pages=485-96|pmid=12501574}}</ref> <ref name="SteketeeEtAl1996">{{cite journal|last1=Steketee|first1=G|last2=Frost|first2=R|last3=Bogart|first3=K|title=The Yale-Brown Obsessive Compulsive Scale: interview versus self-report.|journal=Behaviour research and therapy|date=August 1996|volume=34|issue=8|pages=675-84|pmid=8870295}}</ref> <ref name="AbramowitzDeacon2005">{{cite journal|last1=Abramowitz|first1=Jonathan S.|last2=Deacon|first2=Brett J.|title=Psychometric properties and construct validity of the Obsessive–Compulsive Inventory—Revised: Replication and extension with a clinical sample|journal=Journal of Anxiety Disorders|date=January 2006|volume=20|issue=8|pages=1016–1035|doi=10.1016/j.janxdis.2006.03.001}}</ref> <ref name="AbramowitzEtAl2010">{{cite journal|last1=Abramowitz|first1=JS|last2=Deacon|first2=BJ|last3=Olatunji|first3=BO|last4=Wheaton|first4=MG|last5=Berman|first5=NC|last6=Losardo|first6=D|last7=Timpano|first7=KR|last8=McGrath|first8=PB|last9=Riemann|first9=BC|last10=Adams|first10=T|last11=Björgvinsson|first11=T|last12=Storch|first12=EA|last13=Hale|first13=LR|title=Assessment of obsessive-compulsive symptom dimensions: development and evaluation of the Dimensional Obsessive-Compulsive Scale.|journal=Psychological assessment|date=March 2010|volume=22|issue=1|pages=180-98|pmid=20230164}}</ref> }} {{collapse bottom|Click here for references}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] g9a0vtjw74dlkg2yo3pql8qocsiuc3e 2419317 2419304 2022-08-26T05:39:27Z Ardenguo 2944162 /* Recommended screening instruments */ linked extended page to "Note: Reliability and validity are included in the extended version. This table includes measures with Good or Excellent ratings." wikitext text/x-wiki <noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{medical disclaimer}} {{:{{BASEPAGENAME}}/Sidebar}} ==[[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio"?''']]== For background information on what assessment portfolios are, click the link in the heading above. Want even more information about this topic? There's an extended version of this page [[Evidence-based assessment/Obsessive-compulsive disorder (assessment portfolio)/extended version|here]]. ==[[Evidence based assessment/Preparation phase|'''Preparation phase''']]== === Diagnostic criteria for obsessive-compulsive disorder === {{blockquotetop}}'''ICD-11 Criteria''' <ref>{{Cite web|url=http://apps.who.int/classifications/icd10/browse/2016/en#/F40-F48|title=ICD-10 Version:2016|website=apps.who.int|language=en|accessdate=2018-03-01}}</ref> Obsessive-Compulsive Disorder is characterized by the presence of persistent obsessions or compulsions, or most commonly both. Obsessions are repetitive and persistent thoughts, images, or impulses/urges that are intrusive, unwanted, and are commonly associated with anxiety. The individual attempts to ignore or suppress obsessions or to neutralize them by performing compulsions. Compulsions are repetitive behaviors including repetitive mental acts that the individual feels driven to perform in response to an obsession, according to rigid rules, or to achieve a sense of ‘completeness’. In order for obsessive-compulsive disorder to be diagnosed, obsessions and compulsions must be time consuming (e.g., taking more than an hour per day), and result in significant distress or significant impairment in personal, family, social, educational, occupational or other important areas of functioning. Inclusions *anankastic neurosis *obsessive-compulsive neurosis Exclusions *obsessive compulsive behaviour (MB23.4) '''Changes in DSM-5''' * The diagnostic criteria for obsessive-compulsive disorder changed slightly from DSM-IV-TR to DSM-5. Summaries are available [https://en.wikipedia.org/wiki/DSM-5 here]. {{blockquotebottom}} === Base rates of obsessive-compulsive in different populations and clinical settings=== {| class="wikitable sortable" border="1" |- ! Demography ! Setting ! Base Rate ! Diagnostic Method |- |National (U.S.) adult sample (''n''=2073)<ref name="RuscioEtAl2010" /> |National Comorbidity Survey Replication |2.3% |World Health Organization Composite International Diagnostic Interview (CIDI 3.0) |- |U.S. household sample (''n''=18572)<ref name="KarnoEtAl1988" /> |Epidemiological Catchment Area (ECA) Program |1.9-3.3% |Diagnostic Interview Schedule (DIS) |- |Iranian adults (''n''=25180)<ref name="MohammadiEtAl2004" /> |Iranian population-based study |1.8% |DIS |- |NSAL adult study (''n''=5191)<ref name="HimleEtAl2008" /> |African-American and Caribbean Households (U.S.) |1.6% |CIDI Short Form |- |Epidemiological sample (''n''=6616)<ref name="SubramaniamEtAl2012" /> |Singapore Mental Health Study |3.0% |CIDI 3.0 |} '''Search terms:''' [obsessive compulsive disorder OR ocd] AND [prevalence OR incidence] in PsycInfo and PubMed [obsessive compulsive disorder OR ocd] AND [epidemiology] in PsycInfo and PubMed ==[[Evidence based assessment/Prediction phase|'''Prediction phase''']]== ===Recommended screening instruments === The following section contains a list of screening and diagnostic instruments for obsessive-compulsive disorder. {| class="wikitable sortable" border="1" |- ! Screening Instrument ! Format ! Age Range ! Administration Time !Where to Access |- | Children’s Florida Obsessive–Compulsive Inventory (C-FOCI) <ref name=":2">Eric A. Youngstrom, Mitchell J. Prinstein, Eric J. Mash, & Russell A. Barkley. (2020). Assessment of Disorders in Childhood and Adolescence, Fifth Edition: Vol. Fifth edition. The Guilford Press</ref> | Self-report | 7-17 years | 5 mins |[https://iocdf.org/wp-content/uploads/2014/11/Storch-et-al.-CFOCI-Article.pdf C-FOCI] |- |Obsessive–Compulsive Inventory—Child Version (OCI-CV) <ref name=":2" /> | Self-report | 7-17 years | |[https://pubmed.ncbi.nlm.nih.gov/20171333/ OCI-CV] |- | Children’s Obsessional Compulsive Inventory (CHOCI) <ref name=":2" /> | Self-report | 7-17 years | |[https://www.projectimplicit.net/bethany/papers/ShafranFramptonHeymanReynoldsTeachmanRachman2003.pdf CHOCI] |} '''Note:''' Reliability and validity are included in the [[Evidence-based assessment/Obsessive-compulsive disorder (assessment portfolio)/extended version|extended version]]. This table includes measures with Good or Excellent ratings. === Likelihood ratios and AUCs of screening measures for OCD === * '''''For a list of the likelihood ratios for more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Likelihood_ratios_and_AUCs_of_common_screening_instruments click here.]''''' {| class="wikitable sortable" border="1" |- ! Screening Measure (Primary Reference) ! Area Under curve (AUC) and Sample Size ! LR+ (Score) ! LR- ! Clinical generalizability !Download Link |- | Y-BOCS-SR<ref name="SteketeeEtAl1996"/> | 0.75 (''n''=162) | 5.50 (7) | 0.50 | Moderate: OCD among pregnant and postpartum women |[https://static1.squarespace.com/static/58cab82ff5e231f0df8d9cad/t/60945b3af4680c68037f8188/1620335418443/YBOCS-II-SR.pdf Y-BOCS-SR] |- | OCI-R Total<ref name="FoaEtAl2002"/> | 0.81 (''n''=322) | 3.66 (14) | 0.44 | High: OCD (''n''=167) versus other anxiety disorders (n=155) at outpatient anxiety clinic |[https://serene.me.uk/tests/oci.pdf OCI-R Total] |- | OCI-R Total<ref name="FoaEtAl2002"/> | 0.82 (''n''=458) | 2.98 (18) | 0.36 | High: OCD (''n''=215) versus other anxiety disorders (n=243) at outpatient anxiety clinic |[https://serene.me.uk/tests/oci.pdf OCI-R Total] |- |Brown Assessment of Beliefs Scale<ref name=":1">Eisen, J. L., Phillips, K. A., Baer, L., Beer, D. A., & al, e. (1998). The brown assessment of beliefs scale: Reliability and validity. ''The American Journal of Psychiatry, 155''(1), 102-8. Retrieved from <nowiki>http://libproxy.lib.unc.edu/login?url=https://search.proquest.com/docview/220481418?accountid=14244</nowiki></ref> |(''n''=50) | | | |[http://www.veale.co.uk/wp-content/uploads/2010/11/BABS_revised_501.pdf BABS] |- |} *“LR+” refers to the change in likelihood ratio associated with a positive test score, and “LR-” is the likelihood ratio for a low score. Likelihood ratios of 1 indicate that the test result did not change impressions at all. LRs larger than 10 or smaller than .10 are frequently clinically decisive; 5 or .20 are helpful, and between 2.0 and .5 are small enough that they rarely result in clinically meaningful changes of formulation (Sackett et al., 2000). ==[[Evidence based assessment/Prescription phase|'''Prescription phase''']]== ===Gold standard diagnostic interviews=== * For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews click here.] ===Recommended diagnostic interviews for OCD=== {| class="wikitable" |+ !Diagnostic Interview !Format !Age Range/ !Administration Time !Where to Access |- | Anxiety Disorders Interview Schedule<ref>Brown, T.A., Di Nardo, P.A., Barlow, D.H., 1994. Anxiety Disorders Interview Schedule for DSM-IV (ADIS-IV-L). Psychological Corporation, San Antonio, TX.</ref> | Semistructured interview | 6-16 years | 1.5-2 hours |[https://www.sciencedirect.com/science/article/abs/pii/S0887618514001510?via%3Dihub ADIS-IV] |- |[https://mfr.osf.io/render?url=https://osf.io/mnzy2/?action=download%26mode=render Yale-Brown Obsessive Compulsive Scale Symptom Checklist]<ref name=":0">{{Cite journal|last=Steketee|first=G|title=The Yale-Brown Obsessive Compulsive Scale: Interview versus self-report|url=http://linkinghub.elsevier.com/retrieve/pii/0005796796000368|journal=Behaviour Research and Therapy|volume=34|issue=8|pages=675–684|doi=10.1016/0005-7967(96)00036-8}}</ref> | Semistructured interview | 6-17 years | Up to 60 mins |[https://www.ohsu.edu/sites/default/files/2019-06/Y-BOCS-Checklist_0.pdf Y-BOCS] |- | [https://search.proquest.com/docview/220481418/abstract/4AF689339CB14A0APQ/1?accountid=14244 Brown Assessment of Beliefs Scale]<ref name=":1">Eisen, J. L., Phillips, K. A., Baer, L., Beer, D. A., & al, e. (1998). The brown assessment of beliefs scale: Reliability and validity. ''The American Journal of Psychiatry, 155''(1), 102-8. Retrieved from <nowiki>http://libproxy.lib.unc.edu/login?url=https://search.proquest.com/docview/220481418?accountid=14244</nowiki></ref> | Semistructured interview | 16+ years | |[http://www.veale.co.uk/wp-content/uploads/2010/11/BABS_revised_501.pdf BABS] |- |OCD module of the Structured Clinical Interview for DSM-5 (SCID-5) |Semi-structured interview |18+ years |90 mins |[https://www.appi.org/products/structured-clinical-interview-for-dsm-5-scid-5 SCID-5] |} '''Note:''' Reliability and validity are included in the [[Evidence-based assessment/Obsessive-compulsive disorder (assessment portfolio)/extended version|extended version]]. This table includes measures with Good or Excellent ratings. ==[[Evidence based assessment/Process phase|'''Process phase''']]== === Treatments === ==== Cognitive behavioral therapy (CBT) and exposure and response prevention (ERP) ==== *Behavior therapy, specifically ERP, has been established as the treatment of choice for OCD <ref>Whittal M.L., McLean P.D., Söchting I., Koch W.J., Taylor S., Anderson K., Paterson R.'''OCD treatment outcome using behavioral and cognitive approaches''' Paper presented at the meeting of the Association for Advancement of Behavior Therapy, Miami Beach, FL (1997)</ref><ref>{{Cite journal|last=Foa|first=Edna B.|last2=Kozak|first2=Michael J.|title=Beyond the efficacy ceiling? Cognitive behavior therapy in search of theory|url=https://doi.org/10.1016/S0005-7894(97)80019-6|journal=Behavior Therapy|volume=28|issue=4|pages=601–611|doi=10.1016/s0005-7894(97)80019-6}}</ref>. *Therapy incorporates ERP and emphasizes cognitive change. **Therapist will help individual identify anxiety-provoking thoughts and situations. **Therapist will develop a treatment plan and idiographic “fear hierarchy.” **Individuals will learn to encounter situations that invoke anxiety without engaging in rituals used to dispel anxiety (ERP). **Exposures will be done gradually at a pace that is comfortable for the client. **Therapy will include homework assignments and is designed to offer lifelong skills. *Therapy includes verbal techniques such as psychoeducation and cognitive restructuring. *Manuals for reference: **The therapist guide: Mastery of Obsessive-Compulsive Disorder: A Cognitive Behavioral Approach<ref>E. Foa, M. Kozak Mastery of obsessive–compulsive disorder: A cognitive-behavioral approach Graywind Publications (1997)</ref> **Cognitive Therapy of Obsessive-Compulsive Disorder: A Guide for Professionals (Wilhelm & Steketee) **Obsessive Compulsive Disorder: Advances in Psychotherapy <ref>{{Cite book|url=https://www.worldcat.org/oclc/70659789|title=Obsessive compulsive disorder|last=S.|first=Abramowitz, Jonathan|date=2006|publisher=Hogrefe & Huber Publishers|isbn=9780889373167|location=Cambridge, MA|oclc=70659789}}</ref> *Treatment alliance is a predictor of subsequent change in OCD symptoms<ref>Keeley, M. L., Geffken, G. R., Ricketts, E., McNamara, J. P., & Storch, E. A. (2011). The therapeutic alliance in the cognitive behavioral treatment of pediatric obsessive–compulsive disorder. ''Journal of Anxiety Disorders'', ''25''(7), 855-863.</ref>. The therapist should provide a “validating and :encouraging” environment so that clients can tolerate the emotional arousal associated with exposures. ==== Medication ==== *Selective serotonin reuptake inhibitors (SSRIs) are commonly used to treat OCD. *These antidepressants include: **[[wikipedia:Fluvoxamine|fluvoxamine]] **[[wikipedia:Fluoxetine|fluoxetine]] **[[wikipedia:Sertraline|sertraline]] **[[wikipedia:Paroxetine|paroxetine]] **[[wikipedia:Citalopram|citalopram]] **[[wikipedia:Clomipramine|clomipramine]] **[[wikipedia:Escitalopram|escitalopram]] **[[wikipedia:Venlafaxine|venlafaxine]] *High doses (relative to doses prescribed for depression) are needed for individuals with OCD. === Process and outcome measures === ==== Clinically significant change benchmarks with common instruments and mood rating scales ==== {| class="wikitable sortable" border="1" |- | rowspan=1" style="text-align:center;font-size:130%;" | <b> Measure</b> | style="text-align:center;font-size:130%;" | <b> Subscale</b> | colspan="3" style="text-align:center;font-size:130%" width="300" | <b> Cut-off scores</b> | colspan="3" style="text-align:center;font-size:120%" | <b> Critical Change <br> (unstandardized scores)</b> |- | colspan="8" span style="font-size:110%; text-align:center;" | <b> Benchmarks Based on Published Norms</b> |- | colspan="2" | | style="text-align:center;font-size:110%" | <b> A</b> | style="text-align:center;font-size:110%" | <b> B</b> | style="text-align:center;font-size:110%" | <b> C</b> | style="text-align:center;font-size:110%" | <b> 95%</b> | style="text-align:center;font-size:110%" | <b> 90%</b> | style="text-align:center;font-size:110%" | <b> SE_difference</b> |- | rowspan="3" style="text-align:center;" | <b> Yale-Brown Obsessive Compulsive Scale (Y-BOCS-SR)</b> | style="text-align:right;" | <i> Total</i> | style="text-align:center;"| 10.6 | style="text-align:center;"| 14.4 | style="text-align:center;"| 12.6 | style="text-align:center;"| 4.7 | style="text-align:center;"| 3.9 | style="text-align:center;"| 2.4 |- | style="text-align:right;" | <i> Obsessions</i> | style="text-align:center;"| 6.6 | style="text-align:center;"| 7.6 | style="text-align:center;"| 7.0 | style="text-align:center;"| 2.5 | style="text-align:center;"| 2.1 | style="text-align:center;"| 1.3 |- | style="text-align:right;" | <i> Compulsions</i> | style="text-align:center;"| 3.5 | style="text-align:center;"| 8.2 | style="text-align:center;"| 6.1 | style="text-align:center;"| 3.6 | style="text-align:center;"| 3.0 | style="text-align:center;"| 1.8 |- | rowspan="7" style="text-align:center;" | <b> Obsessive-Compulsive Inventory – Revised (OCI-R)</b> | style="text-align:right;" | <i> Total</i> | style="text-align:center;"| 1.0 | style="text-align:center;"| 41.0 | style="text-align:center;"| 23.0 | style="text-align:center;"| 14.8 | style="text-align:center;"| 12.5 | style="text-align:center;"| 7.6 |- | style="text-align:right;" | <i> Washing</i> | style="text-align:center;"| n/a | style="text-align:center;"| 7.4 | style="text-align:center;"| 3.1 | style="text-align:center;"| 3.4 | style="text-align:center;"| 2.9 | style="text-align:center;"| 1.7 |- | style="text-align:right;" | <i> Checking</i> | style="text-align:center;"| n/a | style="text-align:center;"| 8.0 | style="text-align:center;"| 3.7 | style="text-align:center;"| 3.0 | style="text-align:center;"| 2.5 | style="text-align:center;"| 1.5 |- | style="text-align:right;" | <i> Ordering</i> | style="text-align:center;"| n/a | style="text-align:center;"| 10.5 | style="text-align:center;"| 4.6 | style="text-align:center;"| 3.1 | style="text-align:center;"| 2.6 | style="text-align:center;"| 1.6 |- | style="text-align:right;" | <i> Obsessing</i> | style="text-align:center;"| n/a | style="text-align:center;"| 8.3 | style="text-align:center;"| 4.7 | style="text-align:center;"| 3.8 | style="text-align:center;"| 3.2 | style="text-align:center;"| 1.9 |- | style="text-align:right;" | <i> Hoarding</i> | style="text-align:center;"| n/a | style="text-align:center;"| 9.8 | style="text-align:center;"| 4.1 | style="text-align:center;"| 2.8 | style="text-align:center;"| 2.4 | style="text-align:center;"| 1.4 |- | style="text-align:right;" | <i> Neutralizing</i> | style="text-align:center;"| n/a | style="text-align:center;"| 6.2 | style="text-align:center;"| 2.3 | style="text-align:center;"| 3.0 | style="text-align:center;"| 2.5 | style="text-align:center;"| 1.5 |- | rowspan="7" style="text-align:center;" | <b> Dimensional Obsessive Compulsive Scale (DOCS)</b> | style="text-align:right;" | <i> Total</i> | style="text-align:center;"| n/a | style="text-align:center;"| 31.7 | style="text-align:center;"| 19.0 | style="text-align:center;"| 10.3 | style="text-align:center;"| 8.7 | style="text-align:center;"| 5.3 |- | style="text-align:right;" | <i> Contamination</i> | style="text-align:center;"| n/a | style="text-align:center;"| 7.8 | style="text-align:center;"| 3.4 | style="text-align:center;"| 2.4 | style="text-align:center;"| 2.0 | style="text-align:center;"| 1.2 |- | style="text-align:right;" | <i> Responsibility for Harm</i> | style="text-align:center;"| n/a | style="text-align:center;"| 8.7 | style="text-align:center;"| 4.4 | style="text-align:center;"| 2.4 | style="text-align:center;"| 2.0 | style="text-align:center;"| 1.2 |- | style="text-align:right;" | <i> Unacceptable Thoughts</i> | style="text-align:center;"| n/a | style="text-align:center;"| 9.6 | style="text-align:center;"| 5.4 | style="text-align:center;"| 2.5 | style="text-align:center;"| 2.1 | style="text-align:center;"| 1.3 |- | style="text-align:right;" | <i> Symmetry</i> | style="text-align:center;"| n/a | style="text-align:center;"| 7.9 | style="text-align:center;"| 3.6 | style="text-align:center;"| 2.2 | style="text-align:center;"| 1.8 | style="text-align:center;"| 1.1 |- |} === Process measures === *Quality of Life **Sheehan Disability Scale<ref>Sheehan DV, Harnett-Sheehan K, Raj BA. 1996. The measurement of disability. Int Clin Psychopharmacol 11(Suppl 3): 89–95.</ref> **[http://www.jstor.org/stable/pdf/3765819.pdf?refreqid=excelsior%3A9dcc715f829676edec9bc2c7be1478fa Medical Outcomes Study (MOS) 36-Item Short Form (SF-36) Health Survey]<ref>McHorney, C., Ware, J., & Raczek, A. (1993). The MOS 36-Item Short-Form Health Survey (SF-36): II. Psychometric and Clinical Tests of Validity in Measuring Physical and Mental Health Constructs. ''Medical Care,'' ''31''(3), 247-263. Retrieved from <nowiki>http://www.jstor.org/stable/3765819</nowiki></ref> *Compulsions scale of YBOCS *SUDS Ratings == External Links == *[https://sccap53.org Society of Clinical Child and Adolescent Psychology] *[http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/self-injurious-thoughts-and-behaviors/ EffectiveChildTherapy.Org information on rule-breaking, defiance, and acting out] *For information on conducting Exposure Therapy for anxiety disordered youth, see [https://www.bravepracticeforkids.com/ www.BravePracticeForKids.com] == References == {{collapse top|References|expand=yes}} {{Reflist|2|refs= <ref name="EAYfuturedirections"> Youngstrom, E. A. (2013). Future directions in psychological assessment: Combining evidence-based medicine innovations with psychology's historical strengths to enhance utility. Journal of Clinical Child and Adolescent Psychology, 42(1), 139-159. </ref> <ref name="strauss2011"> Strauss, S. E., Glasziou, P., Richardson, W. S., & Haynes, R. B. (2011). Evidence-based medicine: How to practice and teach EBM (4th ed.). New York, NY: Churchill Livingstone. </ref> <ref name="sackett"> Sackett, D. L., Straus, S. E., Richardson, W. S., Rosenberg, W., & Haynes, R. B. (2000). Evidence-based medicine: How to practice and teach EBM. Edinburgh: Churchill Livingstone. </ref> <ref name="RuscioEtAl2010">{{cite journal|last1=Ruscio|first1=AM|last2=Stein|first2=DJ|last3=Chiu|first3=WT|last4=Kessler|first4=RC|title=The epidemiology of obsessive-compulsive disorder in the National Comorbidity Survey Replication.|journal=Molecular psychiatry|date=January 2010|volume=15|issue=1|pages=53-63|pmid=18725912}}</ref> <ref name="KarnoEtAl1988">{{cite journal|last1=Karno|first1=M|last2=Golding|first2=JM|last3=Sorenson|first3=SB|last4=Burnam|first4=MA|title=The epidemiology of obsessive-compulsive disorder in five US communities.|journal=Archives of general psychiatry|date=December 1988|volume=45|issue=12|pages=1094-9|pmid=3264144}}</ref> <ref name="MohammadiEtAl2004">{{cite journal|last1=Mohammadi|first1=MR|last2=Ghanizadeh|first2=A|last3=Rahgozar|first3=M|last4=Noorbala|first4=AA|last5=Davidian|first5=H|last6=Afzali|first6=HM|last7=Naghavi|first7=HR|last8=Yazdi|first8=SA|last9=Saberi|first9=SM|last10=Mesgarpour|first10=B|last11=Akhondzadeh|first11=S|last12=Alaghebandrad|first12=J|last13=Tehranidoost|first13=M|title=Prevalence of obsessive-compulsive disorder in Iran.|journal=BMC psychiatry|date=14 February 2004|volume=4|pages=2|pmid=15018627}}</ref> <ref name="HimleEtAl2008">{{cite journal|last1=Himle|first1=JA|last2=Muroff|first2=JR|last3=Taylor|first3=RJ|last4=Baser|first4=RE|last5=Abelson|first5=JM|last6=Hanna|first6=GL|last7=Abelson|first7=JL|last8=Jackson|first8=JS|title=Obsessive-compulsive disorder among African Americans and blacks of Caribbean descent: results from the National Survey of American Life.|journal=Depression and anxiety|date=2008|volume=25|issue=12|pages=993-1005|pmid=18833577}}</ref> <ref name="SubramaniamEtAl2012">{{cite journal|last1=Subramaniam|first1=M|last2=Abdin|first2=E|last3=Vaingankar|first3=JA|last4=Chong|first4=SA|title=Obsessive--compulsive disorder: prevalence, correlates, help-seeking and quality of life in a multiracial Asian population.|journal=Social psychiatry and psychiatric epidemiology|date=December 2012|volume=47|issue=12|pages=2035-43|pmid=22526825}}</ref> <ref name="LordEtAl2011">{{cite journal|last1=Lord|first1=C|last2=Hall|first2=G|last3=Soares|first3=CN|last4=Steiner|first4=M|title=Physiological stress response in postpartum women with obsessive-compulsive disorder: A pilot study.|journal=Psychoneuroendocrinology|date=January 2011|volume=36|issue=1|pages=133-8|pmid=20537805}}</ref> <ref name="FoaEtAl2002">{{cite journal|last1=Foa|first1=EB|last2=Huppert|first2=JD|last3=Leiberg|first3=S|last4=Langner|first4=R|last5=Kichic|first5=R|last6=Hajcak|first6=G|last7=Salkovskis|first7=PM|title=The Obsessive-Compulsive Inventory: development and validation of a short version.|journal=Psychological assessment|date=December 2002|volume=14|issue=4|pages=485-96|pmid=12501574}}</ref> <ref name="SteketeeEtAl1996">{{cite journal|last1=Steketee|first1=G|last2=Frost|first2=R|last3=Bogart|first3=K|title=The Yale-Brown Obsessive Compulsive Scale: interview versus self-report.|journal=Behaviour research and therapy|date=August 1996|volume=34|issue=8|pages=675-84|pmid=8870295}}</ref> <ref name="AbramowitzDeacon2005">{{cite journal|last1=Abramowitz|first1=Jonathan S.|last2=Deacon|first2=Brett J.|title=Psychometric properties and construct validity of the Obsessive–Compulsive Inventory—Revised: Replication and extension with a clinical sample|journal=Journal of Anxiety Disorders|date=January 2006|volume=20|issue=8|pages=1016–1035|doi=10.1016/j.janxdis.2006.03.001}}</ref> <ref name="AbramowitzEtAl2010">{{cite journal|last1=Abramowitz|first1=JS|last2=Deacon|first2=BJ|last3=Olatunji|first3=BO|last4=Wheaton|first4=MG|last5=Berman|first5=NC|last6=Losardo|first6=D|last7=Timpano|first7=KR|last8=McGrath|first8=PB|last9=Riemann|first9=BC|last10=Adams|first10=T|last11=Björgvinsson|first11=T|last12=Storch|first12=EA|last13=Hale|first13=LR|title=Assessment of obsessive-compulsive symptom dimensions: development and evaluation of the Dimensional Obsessive-Compulsive Scale.|journal=Psychological assessment|date=March 2010|volume=22|issue=1|pages=180-98|pmid=20230164}}</ref> }} {{collapse bottom|Click here for references}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] af505yn4yyfrmowno14xa8so89dqkgk 0 207107 2419185 2401074 2022-08-26T02:04:11Z Ardenguo 2944162 /* Diagnostic criteria for Pediatric Bipolar disorder */ Made the collapsible box expanded by default wikitext text/x-wiki <noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{psychology}}{{Evidence-based assessment}}{{medical disclaimer}} {{:{{BASEPAGENAME}}/Sidebar}} ==[[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio?"''']]== * For background information on what assessment portfolios are, click the link in the heading above. Want even 'more' information about this topic? There's an extended version of this page [[Evidence-based assessment/Bipolar disorder in youth (assessment portfolio)/extended version|here]]. == '''[[Evidence based assessment/Preparation phase|Preparation phase]]''' == === Diagnostic criteria for Pediatric Bipolar disorder === {{collapse top| More information on PBD diagnostic criteria|expand=yes}} *[[w:Bipolar_disorder_in_children|Pediatric bipolar disorder (PBD)]] is characterized by extreme fluctuations in mood or emotional dysregulation that range from mania (as shown by displays or feelings of extreme happiness, unrealistic overachievement, and anger) to depression (as shown by displays or feelings of sadness, changes in appetite or weight, and irritability<ref name="APA"> American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.</ref> <ref name="jamison"> Goodwin, F. K., & Jamison, K. R. (2007). ''Manic-depressive illness.'' (10th edition). New York, NY: Oxford University Press </ref>). *It is important to note that these moods exceed normal responses to life events, represent a change from the individual's normal functioning, and cause problems in daily activities. These mood fluctuations result in a child finding it difficult to live and interact with family, friends and teachers, when it was previously not an issue<ref name="APA" />. *People with [[w:Bipolar_disorder|bipolar disorder]] experience unusually intense emotional states that occur in distinct periods called [[w:Mood_(psychology)|"mood episodes".]] An overly joyful or overexcited state is called a manic episode, and an extremely sad or hopeless state is called a [[w:Major_depressive_episode|depressive episode]]. Sometimes, a mood episode includes symptoms of both [[w:Mania|mania]] and [[w:Depression_(mood)|depression]]. *People with bipolar disorder also may be explosive and irritable during a mood episode.<ref name="APA" /> **Extreme changes in energy, activity, sleep, and behavior go along with these changes in mood. *It is possible for someone with bipolar disorder to experience a long-lasting period of unstable moods rather than discrete episodes of depression or mania.<ref name="jamison" /> <ref name="APA" /> *A person may be having an episode of bipolar disorder if he or she has a number of manic or depressive symptoms for most of the day, nearly every day, for at least one or two weeks. These debilitating symptoms can result in an afflicted individual being unable to function adaptively in several settings. {{collapse bottom}} {{blockquotetop}} '''<big>ICD-10 Criteria</big>''' '''''F31 Bipolar affective disorder''''' *''Note.'' Episodes are demarcated by a switch to an episode of opposite or mixed polarity or by a remission. '''''F31.0 Bipolar affective disorder, current episode hypomanic''''' '''A.''' The current episode meets the criteria for '''Hypomania F30.0''': *'''''(A)''''' The mood is elevated or irritable to a degree that is definitely abnormal for the individual concerned and sustained for at least four consecutive days. *'''''(B)''''' At least three of the following signs must be present, leading to some interference with personal functioning in daily living *# Increased activity or physical restlessness; *# Increased talkativeness; *# Distractibility or difficulty in concentration; *# Decreased need for sleep; *# Increased sexual energy; *# Mild over-spending, or other types of reckless or irresponsible behavior; *# Increased sociability or over-familiarity. *'''''(C)''''' The episode does not meet the criteria for '''F30.1 Mania without psychotic symptoms''', '''F30.2 Mania with psychotic symptoms''', '''F31.- Bipolar affective disorder''', '''F32.- Depressive episode''', '''F34.0 Cyclothymia''', or '''F50.0 Anorexia nervosa'''. *'''''(D)''''' ''Most commonly used exclusion clause.'' The episode is not attributable to '''F10-F19 Psychoactive substance use''' or in the sense of any '''F00-F09 Organic mental disorder'''. '''B.''' There has been at least one other affective episode in the past, meeting the criteria for '''F30.- Hypomanic or Manic episode''', '''F32.Depressive episode''', or '''F38.00 Mixed affective episode.''' <big>'''Changes in DSM-5'''</big> The diagnostic criteria for bipolar disorders changed slightly from [[DSM-IV]] to [[w:Diagnostic_and_Statistical_Manual_of_Mental_Disorders#DSM-IV-TR_.282000.29|DSM-5]]. Summaries are available [http://www.dsm5.org/Documents/changes%20from%20dsm-iv-tr%20to%20dsm-5.pdf here] and [[w:DSM-5|here]]. {{blockquotebottom}} === Base rates of PBD in different clinical settings and populations === This section describes the demographic setting of the population(s) sampled, base rates of diagnosis, country/region sampled and the diagnostic method that was used. Using this information, clinicians will be able to anchor the rates of PBD that they are likely to see in their clinical practices. * '''''To find prevalence rates across multiple disorders,''''' [[Evidence based assessment/Preparation phase#Base rates for transdiagnostic comparison|'''''click here.''''']] {| class="wikitable sortable" border="1" |+ style="text-align: left;" | ''Base rates of BSD in different clinical settings'' |- ! scope="col" | Setting (Reference) ! scope="col" style="white-space: nowrap;"| Base Rate ! scope="col" | Demography ! scope="col" | Diagnostic Method !Recommended for... |- | Rates of Bipolar Disorders in General Population || 0.6% || '''Bipolar I''' in youths age 5 to 18 || Meta-analysis of epidemiological studies, 19 samples, N = 56,103 participants<ref name=":11">{{Cite journal|last=Van Meter|first=Anna|last2=Moreira|first2=Ana Lúcia R.|last3=Youngstrom|first3=Eric|date=2019-04-02|title=Updated Meta-Analysis of Epidemiologic Studies of Pediatric Bipolar Disorder|url=https://www.psychiatrist.com/JCP/article/Pages/2019/v80/18r12180.aspx|journal=The Journal of Clinical Psychiatry|volume=80|issue=3|doi=10.4088/JCP.18r12180|issn=1555-2101}}</ref> |Schools, nonclinical settings. Minimum for outpatient settings. |- | style="border: width: 1px; border-bottom: 3px solid grey; padding: 5px;" |Rates of bipolar spectrum (I, II, cyclothymia, NOS) in general population || style="border: width: 1px; border-bottom: 3px solid grey; padding: 5px;" | 3.9% || style="border: width: 1px; border-bottom: 3px solid grey; padding: 5px;" | '''Bipolar spectrum''' in youths age 5 to 18 years || style="border: width: 1px; border-bottom: 3px solid grey; padding: 5px;" | Meta-regression estimate <ref name=":11" /> |Schools, nonclinical settings. Minimum for outpatient settings. |- | High school epidemiological<br />(Lewinsohn et al., 2000) || 0.6% || Northwestern USA high school || KSADS-PL | |- |Community Mental Health Center<br />(E. A. Youngstrom et al., 2005) || 6% || Midwestern Urban, 80% non-white, low-income || Clinical interview & treatment | |- | General Outpatient Clinic;<br />(Geller, Zimerman, Williams, Delbello, Frazier, et al., 2002) || 6% to 8% || Urban academic research centers || WASH-U-KSADS | |- |County Wards (DCFS)<br />(Naylor, Anderson, Kruesi, & Stoewe, 2002, October) || 11% || State of Illinois || Clinical interview & treatment | |- | Specialty Outpatient Service<br />(Biederman et al., 1996) || 15-17% || New England || KSADS-E | |- |Incarcerated adolescents<br />(Teplin, Abram, McClelland, Dulcan, & Mericle, 2002) || 2% || Midwestern Urban || DISC | |- | Incarcerated adolescents<br />(Pliszka et al., 2000) || 22% || Texas || DISC | |- | Acute psychiatric hospitalizations<br />in 2002-2003 – <u>adolescents</u><br />(Blader & Carlson, 2007) || 21% || All of U.S.A. || Centers for Disease Control survey of discharge diagnoses | |- | Inpatient service<br />(Carlson & Youngstrom, 2003) || 30% manic symptoms,<br /><2% strict BP I || New York City Metro Region || DICA; KSADS | |- |Acute psychiatric hospitalizations<br />in 2002-2003 – <u>children</u><br />(Blader & Carlson, 2007) || 40% || All of U.S.A. || Centers for Disease Control survey of discharge diagnoses | |- |Psychiatric outpatient clinic<br />(Ghanizadeh, Mohammadi, & Yazdanshenas, 2006) || 16-17% || Iran || K-SADS-PL (Farsi) | |- |Inpatient and partial hospitalization programs at a psychiatric treatment center<br />(Pellegrini et al., 1986) || Mania (0%), hypomania (6%) || Richmond, Virginia || DISC | |- |} ^p Parent interviewed as component of diagnostic assessment; ^y youth interviewed as part of diagnostic assessment. ''Note:'' KSADS = Kiddie Schedule for Affective Disorders and Schizophrenia, PL = Present and Lifetime version, WASH-U = Washington University version, -E = Epidemiological version of the KSADS; DISC = Diagnostic Interview Schedule for Children; DICA = Diagnostic Interview for Children and Adolescents. Table modified from Wikiversity. {| class="wikitable sortable" border="1" |- ! Setting ! Base Rate ! Demography ! Diagnostic Method !Best Recommended For |- | Community epidemiological (NCS-A) <ref>{{cite journal|last1=Kessler|first1=Ronald C.|last2=Avenevoli|first2=Shelli|last3=Costello|first3=E. Jane|last4=Georgiades|first4=Katholiki|last5=Green|first5=Jennifer Greif|last6=Gruber|first6=Michael J.|last7=He|first7=Jian-ping|last8=Koretz|first8=Doreen|last9=McLaughlin|first9=Katie A.|last10=Petukhova|first10=Maria|last11=Sampson|first11=Nancy A.|last12=Zaslavsky|first12=Alan M.|last13=Merikangas|first13=Kathleen Ries|title=Prevalence, persistence, and sociodemographic correlates of DSM-IV disorders in the National Comorbidity Survey Replication Adolescent Supplement|journal=Archives of General Psychiatry|date=1 April 2012|volume=69|issue=4|pages=372–380|doi=10.1001/archgenpsychiatry.2011.160|url=http://www.ncbi.nlm.nih.gov/pubmed/22147808|accessdate=26 January 2016|issn=1538-3636}}</ref> | 3.0% | All of U.S.A. | CIDI 3.0 | |- | Community epidemiologic samples<ref>{{cite journal|last1=Van Meter|first1=Anna R.|last2=Moreira|first2=Ana Lúcia R.|last3=Youngstrom|first3=Eric A.|date=1 September 2011|title=Meta-analysis of epidemiologic studies of pediatric bipolar disorder|url=http://www.ncbi.nlm.nih.gov/pubmed/21672501|journal=The Journal of Clinical Psychiatry|volume=72|issue=9|pages=1250–1256|doi=10.4088/JCP.10m06290|issn=1555-2101}}</ref> |mean= 1.8% (95% CI, 1.1%–3.0%), bipolar I (mean =1.2%; 95% CI, 0.7%–1.9%) | U.S.A., Netherlands, U.K., Spain, Mexico, Ireland, New Zealand | Structured and semi-structured diagnostic interviews, Combination of broad and specific diagnostic criteria (Meta-Analysis) |Schools, nonclinical settings. Minimum for outpatient settings. |- |Community mental health center<ref>{{Cite journal|last=Youngstrom|first=Eric A.|last2=Findling|first2=Robert L.|last3=Youngstrom|first3=Jen Kogos|last4=Calabrese|first4=Joseph R.|date=September 2005|title=Toward an evidence-based assessment of pediatric bipolar disorder|url=https://www.ncbi.nlm.nih.gov/pubmed/16026213|journal=Journal of Clinical Child and Adolescent Psychology: The Official Journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 53|volume=34|issue=3|pages=433–448|doi=10.1207/s15374424jccp3403_4|issn=1537-4416|pmid=16026213}}</ref> |6% |U.S.A., Midwestern Urban, 80% non-white, low-income |Parent and youth clinical assessment & treatment | |- |General outpatient clinic<ref name=":1" /> |6-8% |Urban academic research centers |WASH-U-[[w:Kiddie Schedule for Affective Disorders and Schizophrenia|KSAD]]S (parent and youth) | |- |Specialty outpatient service<ref>{{Cite journal|last=Biederman|first=J.|last2=Faraone|first2=S.|last3=Mick|first3=E.|last4=Wozniak|first4=J.|last5=Chen|first5=L.|last6=Ouellette|first6=C.|last7=Marrs|first7=A.|last8=Moore|first8=P.|last9=Garcia|first9=J.|date=August 1996|title=Attention-deficit hyperactivity disorder and juvenile mania: an overlooked comorbidity?|url=https://www.ncbi.nlm.nih.gov/pubmed/8755796|journal=Journal of the American Academy of Child and Adolescent Psychiatry|volume=35|issue=8|pages=997–1008|doi=10.1097/00004583-199608000-00010|issn=0890-8567|pmid=8755796}}</ref> |15-17% |Boston area, U. S. A. |[[w:Kiddie Schedule for Affective Disorders and Schizophrenia|KSADS]]-E | |- | Inpatient Services/Diagnoses<ref>{{Cite journal|last=Holtmann|first=M.|last2=Goth|first2=K.|last3=Wöckel|first3=L.|last4=Poustka|first4=F.|last5=Bölte|first5=S.|date=2008|title=CBCL-pediatric bipolar disorder phenotype: severe ADHD or bipolar disorder?|url=https://www.ncbi.nlm.nih.gov/pubmed/17994189|journal=Journal of Neural Transmission (Vienna, Austria: 1996)|volume=115|issue=2|pages=155–161|doi=10.1007/s00702-007-0823-4|issn=0300-9564|pmid=17994189}}</ref> | 0.3% | All of Germany | [[w:International_Statistical_Classification_of_Diseases_and_Related_Health_Problems|International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10)]] | |- | Community sample<ref>{{cite journal|last1=Olino|first1=Thomas M.|last2=Shankman|first2=Stewart A.|last3=Klein|first3=Daniel N.|last4=Seeley|first4=John R.|last5=Pettit|first5=Jeremy W.|last6=Farmer|first6=Richard F.|last7=Lewinsohn|first7=Peter M.|date=1 September 2012|title=Lifetime rates of psychopathology in single versus multiple diagnostic assessments: Comparison in a community sample of probands and siblings|url=http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3411854/|journal=Journal of psychiatric research|volume=46|issue=9|pages=1217–1222|doi=10.1016/j.jpsychires.2012.05.017|issn=0022-3956}}</ref> | 2.9% | Oregon | LIFE, SCID, DSM-IV | |- | Inpatient service<ref>{{cite journal|last1=Carlson|first1=Gabrielle A.|last2=Youngstrom|first2=Eric A.|date=1 June 2003|title=Clinical implications of pervasive manic symptoms in children|url=http://www.ncbi.nlm.nih.gov/pubmed/12788250|journal=Biological Psychiatry|volume=53|issue=11|pages=1050–1058|issn=0006-3223}}</ref> | 30% manic symptoms, <2% strict BP I | New York City Metro Region | DICA; [[w:Kiddie Schedule for Affective Disorders and Schizophrenia|KSADS]] | |- |NCS-A Clinical Reappraisal Sample<ref name=":3" /> ^{p y} |6.2% and SE=1.7 (bipolar I and II and sub-threshold bipolar spectrum disorder) |U.S.A, NCS-A |[[w:Kiddie Schedule for Affective Disorders and Schizophrenia|K-SADS]], DSM-IV criteria were modified from published version for purpose of the study, broad criteria for not otherwise specified | | |- |NCS-A Clinical Reappraisal Sample<ref name=":3">{{Cite journal|last=Kessler|first=Ronald C.|last2=Avenevoli|first2=Shelli|last3=Green|first3=Jennifer|last4=Gruber|first4=Michael J.|last5=Guyer|first5=Margaret|last6=He|first6=Yulei|last7=Jin|first7=Robert|last8=Kaufman|first8=Joan|last9=Sampson|first9=Nancy A.|date=2009-04|title=National Comorbidity Survey Replication Adolescent Supplement (NCS-A): III. Concordance of DSM-IV/CIDI Diagnoses With Clinical Reassessments|url=http://linkinghub.elsevier.com/retrieve/pii/S0890856709600460|journal=Journal of the American Academy of Child & Adolescent Psychiatry|volume=48|issue=4|pages=386–399|doi=10.1097/chi.0b013e31819a1cbc|issn=0890-8567|pmc=PMC3040100|pmid=19252450}}</ref> ^p ^y |6.6% and SE=1.7 (bipolar I and II and sub-threshold bipolar spectrum disorder) |U.S.A, NCS-A |CIDI, DSM-IV criteria were modified from published version for purpose of the study, broad criteria for not otherwise specified, | |- |National Cross‐sectional epidemiological sample<ref>{{Cite journal|last=Stringaris|first=Argyris|last2=Santosh|first2=Paramala|last3=Leibenluft|first3=Ellen|last4=Goodman|first4=Robert|date=2009-07-22|title=Youth meeting symptom and impairment criteria for mania-like episodes lasting less than four days: an epidemiological enquiry|url=http://doi.wiley.com/10.1111/j.1469-7610.2009.02129.x|journal=Journal of Child Psychology and Psychiatry|language=en|volume=51|issue=1|pages=31–38|doi=10.1111/j.1469-7610.2009.02129.x|issn=0021-9630|pmc=PMC4286871|pmid=19686330}}</ref> ^p ^y |1.2% (bipolar I and II and not otherwise specified) |United Kingdom |DAWBA, DSM-IV criteria, broad criteria for not otherwise specified | |- |Community epidemiological samples<ref>{{Cite journal|last=Benjet|first=Corina|last2=Borges|first2=Guilherme|last3=Medina-Mora|first3=Maria Elena|last4=Zambrano|first4=Joaquin|last5=Aguilar-Gaxiola|first5=Sergio|date=2009-04|title=Youth mental health in a populous city of the developing world: results from the Mexican Adolescent Mental Health Survey|url=http://doi.wiley.com/10.1111/j.1469-7610.2008.01962.x|journal=Journal of Child Psychology and Psychiatry|language=en|volume=50|issue=4|pages=386–395|doi=10.1111/j.1469-7610.2008.01962.x|issn=0021-9630}}</ref> ^y |2.5% (bipolar I and II) |Mexico City |CIDI, DSM-IV Criteria | |- |2-stage epidemiological study<ref>{{Cite journal|last=Lynch|first=Fionnuala|last2=Mills|first2=Carla|last3=Daly|first3=Irenee|last4=Fitzpatrick|first4=Carol|date=2006-08|title=Challenging times: Prevalence of psychiatric disorders and suicidal behaviours in Irish adolescents|url=http://linkinghub.elsevier.com/retrieve/pii/S0140197105001004|journal=Journal of Adolescence|volume=29|issue=4|pages=555–573|doi=10.1016/j.adolescence.2005.08.011|issn=0140-1971}}</ref> ^{p y} |0.0% (bipolar I and II, cyclothymia, not otherwise specified |Ireland |[[w:Kiddie Schedule for Affective Disorders and Schizophrenia|K-SADS]], DSM-IV Criteria | |} ^p:Parent interviewed as component of diagnostic assessment; ^y:Youth interviewed as part of diagnostic assessment. ''Note:'' * KSADS = [[w:Schedule_for_Affective_Disorders_and_Schizophrenia#K-SADS|Kiddie Schedule for Affective Disorders and Schizophrenia]], * WASH-U = Washington University version, -PL = Present and Lifetime Version, -E = Epidemiological version of the KSADS * LIFE = Longitudinal Interval Follow-Up Evaluation, * DICA = Diagnostic Interview for Children and Adolescents *CIDI = Composite International Diagnostic Interview *DAWBA= The Development and Well-Being Assessment == '''[[Evidence based assessment/Prediction phase|Prediction phase]]''' == The following section contains a list of screening and diagnostic instruments for bipolar disorder in youth. This section includes administration information, psychometric data, and PDFs or links to the screenings. === Psychometric properties of screening instruments for pediatric bipolar disorder === * Screenings are used as part of the [[Evidence based assessment/Prediction phase|prediction phase]] of assessment; for more information on interpretation of this data, or how screenings fit in to the assessment process, click [[Evidence based assessment/Prediction phase|here.]] * '''''For a list of more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Common_screening_instruments click here.]''''' {| class="wikitable sortable" border="1" ! colspan="10" |Screening measures for bipolar disorder in youth |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time ! Interrater Reliability ! Test-Retest Reliability ! Construct Validity ! Content Validity ! Highly Recommended !Free and Accessible Measures |- | Children's Depression Inventory <nowiki>*</nowiki>not free | Self-report<ref name=":0">{{Cite web|url=https://www.pearsonclinical.com/psychology/products/100000636/childrens-depression-inventory-2-cdi-2.html|title=Children's Depression Inventory 2™|website=www.pearsonclinical.com|language=en-US|accessdate=2018-03-01}}</ref> | 7-17 | 15-20 minutes<ref name=":0" /> | NA | A | G | G | X |Not free |- | Mood and Feelings Questionnaire (MFQ) | Self-report | 7-18 | 5-10 minutes<ref>{{Cite web|url=http://www.cebc4cw.org/assessment-tool/mood-and-feelings-questionnaire-mfq/|title=CEBC » Assessment Tool › Mood And Feelings Questionnaire Mfq|website=www.cebc4cw.org|language=en|accessdate=2018-03-01}}</ref> | NA | A | G | A | X | *[https://mfr.osf.io/render?url=https://osf.io/enx4b/?action=download%26mode=render MFQ Child Self-Report Long Version] *[https://mfr.osf.io/render?url=https://osf.io/mcg5w/?action=download%26mode=render MFQ Child Self Report Short Version] *[https://mfr.osf.io/render?url=https://osf.io/cw27p/?action=download%26mode=render MFQ Parent Report On Child Long Version] *[https://mfr.osf.io/render?url=https://osf.io/kybr4/?action=download%26mode=render MFQ Parent Report On Child Short Version] |- | 7 Up 7 Down Inventory (7U7D) |Self-report<ref name=":5" /> | 11-86<ref>{{Cite journal|last=Mesman|first=E.|last2=Youngstrom|first2=E.A.|last3=Juliana|first3=N.K.|last4=Nolen|first4=W.A.|last5=Hillegers|first5=M.H.J.|date=2017-01|title=Validation of the Seven Up Seven Down Inventory in bipolar offspring: screening and prediction of mood disorders. Findings from the Dutch Bipolar Offspring Study|url=https://doi.org/10.1016/j.jad.2016.09.024|journal=Journal of Affective Disorders|volume=207|pages=95–101|doi=10.1016/j.jad.2016.09.024|issn=0165-0327}}</ref> |5-8 minutes | NA | | | | | * [https://mfr.osf.io/render?url=https://osf.io/s825e/?action=download%26mode=render 7U7D English] * [https://unc.az1.qualtrics.com/jfe/form/SV_cBlUQk8Y85LHF41 Depression and Bipolar Support Alliance (DBSA): 7U7D '''Online Screener'''] |- | Parent General Behavior-10 Item Version (PGBI-10M)<ref name=":6">{{Cite journal|last=Youngstrom|first=Eric A.|last2=Genzlinger|first2=Jacquelynne E.|last3=Egerton|first3=Gregory A.|last4=Meter|first4=Anna R. Van|title=Multivariate meta-analysis of the discriminative validity of caregiver, youth, and teacher rating scales for pediatric bipolar disorder: Mother knows best about mania.|url=http://dx.doi.org/10.1037/arc0000024|journal=Archives of Scientific Psychology|volume=3|issue=1|pages=112–137|doi=10.1037/arc0000024}}</ref> |Parent-report |5-18<ref name=":7">Youngstrom, E.A., Van Meter, A.R, Frazier, T.W., Youngstrom, J.K., & Findling, R.L. (in press). Developing and validating short forms of the Parent General Behavior Inventory Mania and Depression Scales for rating youth mood symptoms. ''Journal of Clinical Child & Adolescent Psychology.''</ref> |5-8 minutes | | | | | | * [https://mfr.osf.io/render?url=https://osf.io/ub8h7/?action=download%26mode=render Downloadable PDF Parent-Report English] |} '''Note:''' '''L''' = Less than adequate; '''A''' = Adequate; '''G''' = Good; '''E''' = Excellent; '''U''' = Unavailable; '''NA''' = Not applicable === Brief screening tools for PBD=== {{collapse top}} The following are brief screening tools that typically take less than 5 minutes to administer to accurately diagnose pediatric bipolar disorder: # '''''7 Up 7 Down Inventory (7U7D)''''' ## The [http://supp.apa.org/psycarticles/supplemental/a0033975/a0033975_supp.html 7 Up 7 Down Inventory]<ref name=":5">{{cite journal|last1=Youngstrom|first1=Eric A.|last2=Murray|first2=Greg|last3=Johnson|first3=Sheri L.|last4=Findling|first4=Robert L.|title=The 7 up 7 down inventory: a 14-item measure of manic and depressive tendencies carved from the General Behavior Inventory|journal=Psychological Assessment|date=1 December 2013|volume=25|issue=4|pages=1377–1383|doi=10.1037/a0033975|url=https://www.ncbi.nlm.nih.gov/pubmed/23914960|issn=1939-134X}}</ref> is a recently developed and validated questionnaire with 14 items of manic and depressive tendencies carved from the General Behavior Inventory, a well-validated but cumbersome interview. For both mania and depression factors, 7 items produced a psychometrically adequate measure applicable across both aggregate samples. Internal reliability of the Mania scale was .81 (youth) and .83 (adult) and for Depression was .93 (youth) and .95 (adult). ## The 7 Up 7 Down Inventory, along with the accompanying research article, can be [http://supp.apa.org/psycarticles/supplemental/a0033975/a0033975_supp.html found here]. # '''''[https://mfr.osf.io/render?url=https://osf.io/d95nv/?action=download%26mode=render PGBI-10M]'''''<ref>Youngstrom EA, Frazier TW, Demeter C, et al. Developing a 10-item mania scale from the Parent General Behavior Inventory for children and adolescents. J Clin Psychiatry. 2008;69(5):831–839.</ref> ## The [http://www.moodychildtherapy.com/wp-content/uploads/2011/01/PGBI-10M-2-wks.pdf PGBI-10M] (we would like to add another version that is better) is a brief (10 item) instrument derived from the [https://mfr.osf.io/render?url=https://osf.io/3j5r7/?action=download%26mode=render Parent General Behavior Inventory (PGBI)]<ref>{{Cite journal|last=Youngstrom|first=Eric A.|last2=Findling|first2=Robert L.|last3=Danielson|first3=Carla Kmett|last4=Calabrese|first4=Joseph R.|date=2001|title=Discriminative validity of parent report of hypomanic and depressive symptoms on the General Behavior Inventory.|url=http://psycnet.apa.org/doi/10.1037/1040-3590.13.2.267|journal=Psychological Assessment|language=en|volume=13|issue=2|pages=267–276|doi=10.1037/1040-3590.13.2.267|issn=1939-134X}}</ref>, a 73-item mood inventory, to assess [[mania]] in a large sample of outpatients presenting with a variety of different [[DSM-IV]] diagnoses, including frequent comorbid conditions.<ref name=":0">{{cite journal|last1=Youngstrom|first1=E. A.|last2=Findling|first2=R. L.|last3=Danielson|first3=C. K.|last4=Calabrese|first4=J. R.|title=Discriminative validity of parent report of hypomanic and depressive symptoms on the General Behavior Inventory|journal=Psychological Assessment|date=1 June 2001|volume=13|issue=2|pages=267–276|url=http://www.ncbi.nlm.nih.gov/pubmed/11433802|issn=1040-3590}}</ref> ## The 10-item GBI derived from the 73-item P-GBI had good reliability (alpha = .92), was correlated (r = 0.95) with the 28-item scale, and showed significantly better discrimination of bipolar disorders (area under the [[receiver operating characteristic]] [AUROC] curve of 0.856 vs. 0.832 for the 28-item scale, p < .005). The 10-item scale also did well discriminating bipolar disorder from unipolar depression (AUROC = 0.86) and bipolar disorder from [[attention deficit hyperactivity disorder|attention-deficit/hyperactivity disorder]] (AUROC = 0.82) cases. ## The full version of the scale, the Parent-General Behavior Inventory (P-GBI), is a parent-report measure of depressive and hypomanic/biphasic symptoms adapted from the General Behavior Inventory (GBI). ## Classification rates exceed 80%, and receiver operating characteristic analyses showed good diagnostic efficiency for the scales, with areas under the curve greater than .80. Results indicate that clinicians can use the parent-completed GBI to derive clinically meaningful information about mood disorders in youths. {{collapse bottom}} === Likelihood ratios and AUCs of screening measures for bipolar disorder in youth === * '''''For a list of the likelihood ratios for more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Likelihood_ratios_and_AUCs_of_common_screening_instruments click here.]''''' The following table describes the diagnostic likelihood ratios and area under curves for the top pediatric bipolar disorder measures. {| class="wikitable sortable" border="1" |- ! Screening Measure ! AUC (sample size) !Very Low risk range DiLR !Low risk range DiLR !Neutral risk range DiLR !High risk range DiLR !Very High risk range DiLR !DLR+ (score) !DLR- (score) ! Population/Clinical Generalizability !Download |- |[https://mfr.osf.io/render?url=https://osf.io/d3b4h/?action=download%26mode=render Parent General Behavior-10 Item Mania Version (PGBI-10M)]<ref name=":7" /> |.84 (''N''=617) academic sample, .78 community sample (''N''=530)<ref name=":7" /> |.07  (0 to 2.59)  |.41 (2.6 to 6.99) |1.44 (7 to 10.99)  |2.39 (11 to 17.99)  |5.38 (18+) | | |Bipolar spectrum vs. all other diagnoses |[https://mfr.osf.io/render?url=https://osf.io/ub8h7/?action=download%26mode=render Parent Form]<ref>{{Cite web|url=http://www.moodychildtherapy.com|title=Psychoeducational Psychotherapy|website=www.moodychildtherapy.com|language=en-US|access-date=2018-07-20}}</ref> |- |[https://mfr.osf.io/render?url=https://osf.io/eau89/?action=download%26mode=render Parent General Behavior-10 Item Depression Version Form A (PGBI-10Da)]<ref name=":7" /> |.84 (''N''=617) academic sample, .79 community sample (''N''=530)<ref name=":7" /> |.25  (0 to 1.99) |.71 (2 to 5.99)   |1.85 (6 to 9.99)   |4.52 (10 to 14.99) |8.80 (15+)   | | |Bipolar spectrum vs. all other diagnoses | |- |[https://mfr.osf.io/render?url=https://osf.io/eau89/?action=download%26mode=render Parent General Behavior-10 Item Depression Version Form B (PGBI-10Db)]<ref name=":7" /> |.84 (''N''=617) academic sample, .80 community sample (''N''=530)<ref name=":7" /> |.22 (0 to 1.99)    |.71 (2 to 5.99) |2.69 (6 to 10.99)    |5.64 (11 to 14.99)    |8.09 (15+) | | |Bipolar spectrum vs. all other diagnoses | |- |[https://mfr.osf.io/render?url=https://osf.io/hyb3g/?action=download%26mode=render Parent General Behavior Inventory] (P-GBI) (''Hypomanic/Biphasic Section''])<ref name="eay2004">Youngstrom, E. A., Findling, R. L., & Calabrese, J. R. (2004). Effects of adolescent manic symptoms on agreement between youth, parent, and teacher ratings of behavior problems. Journal of Affective Disorders, 82, S5-S16. </ref> | .84 (N=324) | |(<9) | | |(49+) |9.2 |.06 | Bipolar spectrum vs. all other diagnoses | |- | Parent Mood Disorder Questionnaire (P-MDQ)<ref>{{cite journal|last1=Wagner|first1=Karen Dineen|last2=Hirschfeld|first2=Robert M. A.|last3=Emslie|first3=Graham J.|last4=Findling|first4=Robert L.|last5=Gracious|first5=Barbara L.|last6=Reed|first6=Michael L.|date=1 May 2006|title=Validation of the Mood Disorder Questionnaire for bipolar disorders in adolescents|url=http://www.ncbi.nlm.nih.gov/pubmed/16841633|journal=The Journal of Clinical Psychiatry|volume=67|issue=5|pages=827–830|issn=0160-6689}}</ref> | .84 (N=819) | |(TBC) | | |(TBC) |4.64 |.17 | Bipolar spectrum vs. all other diagnoses | * [https://mfr.osf.io/render?url=https://osf.io/wtp7r/?action=download%26mode=render MDQ] |- | Child Mania Rating Scale (Brief) ''(Brief CMRS-P)''<ref name=":2">{{cite journal|last1=Henry|first1=David B.|last2=Pavuluri|first2=Mani N.|last3=Youngstrom|first3=Eric|last4=Birmaher|first4=Boris|date=1 April 2008|title=Accuracy of brief and full forms of the Child Mania Rating Scale|url=http://www.ncbi.nlm.nih.gov/pubmed/?term=18302291|journal=Journal of Clinical Psychology|volume=64|issue=4|pages=368–381|doi=10.1002/jclp.20464|issn=0021-9762}}</ref> | .85 (N=150) | |(<11) | | |(11+) |10.5 |.17 | Bipolar spectrum vs. ADHD | |- | Child Mania Rating Scale (Full) ''(Full CMRS-P)''<ref name=":2" /> | .91 (N=150) | |(<21) | | |(21+) |13.7 |.19 | Bipolar spectrum vs. ADHD | * [https://mfr.osf.io/render?url=https://osf.io/8wv3a/?action=download%26mode=render Downloadable PDF] |- |[https://mfr.osf.io/render?url=https://osf.io/5yzur/?action=download%26mode=render Child Bipolar Questionnaire] ''[https://mfr.osf.io/render?url=https://osf.io/5yzur/?action=download%26mode=render (CBQ-P)]''<ref>{{Cite journal|last=Papolos|first=Demitri|last2=Hennen|first2=John|last3=Cockerham|first3=Melissa S.|last4=Thode|first4=Henry C.|last5=Youngstrom|first5=Eric A.|date=2006-10|title=The child bipolar questionnaire: A dimensional approach to screening for pediatric bipolar disorder|url=https://doi.org/10.1016/j.jad.2006.03.026|journal=Journal of Affective Disorders|volume=95|issue=1-3|pages=149–158|doi=10.1016/j.jad.2006.03.026|issn=0165-0327}}</ref> |.74 (N=497) | | | | | |25.3/ (likelihood ratio +) |/.25 (likelihood ratio -) |Bipolar spectrum vs. all other diagnoses | |} === Interpreting bipolar disorder screening measure scores === For information on interpreting screening measure scores, click [[Evidence based assessment/Prediction phase#Interpreting screening measure scores|here.]] ==[[Evidence based assessment/Prescription phase|'''Prescription phase''']]== ===Gold standard diagnostic interviews=== For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews click here.] {{collapse top|Click here for more details on gold-standard diagnostic interviews}} # '''Kiddie Schedule for Affective Disorders and Schizophrenia-Present and Lifetime (KSADS-PL)''' #* The '''KSADS-PL''' is a semi-structured diagnostic interview that assesses current and past Diagnostic and Statistical Manual of Mental Disorders – Fourth Edition (DSM-IV-TR) Axis I psychopathology in youth<ref name="APA" />. The KSADS-PL diagnostic interviews have good inter-rater (.93 to 1.00) and retest reliability (.77) for mood disorders <ref>{{cite journal|last1=Kaufman|first1=J.|last2=Birmaher|first2=B.|last3=Brent|first3=D.|last4=Rao|first4=U.|last5=Flynn|first5=C.|last6=Moreci|first6=P.|last7=Williamson|first7=D.|last8=Ryan|first8=N.|title=Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (K-SADS-PL): initial reliability and validity data|journal=Journal of the American Academy of Child and Adolescent Psychiatry|date=1 July 1997|volume=36|issue=7|pages=980–988|doi=10.1097/00004583-199707000-00021|url=http://www.ncbi.nlm.nih.gov/pubmed/9204677|issn=0890-8567}}</ref> Here is a link to a PDF of the diagnostic interview for the [http://www.psychiatry.pitt.edu/sites/default/files/Documents/assessments/ksads-pl.pdf Kiddie Schedule for Affective Disorders and Schizophrenia-Present and Lifetime]. # '''Washington University in St. Louis Kiddie Schedule for Affective Disorders and Schizophrenia (WASH-U-KSADS)''' #* The '''[http://www.ncbi.nlm.nih.gov/pubmed/11314571 Washington University in St. Louis Kiddie Schedule for Affective Disorders and Schizophrenia]'''(WASH-U-KSADS)<ref name=":1">{{cite journal|last1=Geller|first1=B.|last2=Zimerman|first2=B.|last3=Williams|first3=M.|last4=Bolhofner|first4=K.|last5=Craney|first5=J. L.|last6=DelBello|first6=M. P.|last7=Soutullo|first7=C.|title=Reliability of the Washington University in St. Louis Kiddie Schedule for Affective Disorders and Schizophrenia (WASH-U-KSADS) mania and rapid cycling sections|journal=Journal of the American Academy of Child and Adolescent Psychiatry|date=1 April 2001|volume=40|issue=4|pages=450–455|doi=10.1097/00004583-200104000-00014|url=http://www.ncbi.nlm.nih.gov/pubmed/11314571|issn=0890-8567}}</ref> was expanded from the 1986 version of the KSADS, which was modified and expanded to include onset and offset of each symptom for both current and lifetime episodes, expanded prepubertal mania and rapid cycling sections, and categories for [[attention deficit hyperactivity disorder]] and other DSM-IV diagnoses. To optimize diagnostic research, skip-outs were minimized. #* The kappa values of comparisons between research nurse and off-site blind best-estimate ratings of mania and rapid cycling sections were excellent (0.74-1.00). High 6-month stability for mania diagnoses (85.7%) and for individual mania items and validity against parental and teacher reports were previously reported.<ref name=":1" /> #* The link to the diagnostic interview for the [http://www.psychiatry.pitt.edu/sites/default/files/Documents/assessments/mrs.pdf Washington University in St. Louis Kiddie Schedule for Affective Disorders and Schizophrenia] can be found [http://www.psychiatry.pitt.edu/sites/default/files/Documents/assessments/mrs.pdf here]. {{collapse bottom}} ===Recommended diagnostic instruments specific for pediatric bipolar disorder=== {| class="wikitable sortable" border="1" ! colspan="10" |Diagnostic instruments for '''(insert portfolio name)''' |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time ! Interrater Reliability ! Test-Retest Reliability ! Construct Validity ! Content Validity ! Highly Recommended !Free and Accessible Measures |- | Children's Depression Rating Scale - Revised (CDRS-R) | Structured Interview<ref name=":4">{{Cite journal|last=Mayes|first=Taryn L.|last2=Bernstein|first2=Ira H.|last3=Haley|first3=Charlotte L.|last4=Kennard|first4=Betsy D.|last5=Emslie|first5=Graham J.|date=2010-12|title=Psychometric Properties of the Children's Depression Rating Scale–Revised in Adolescents|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3003451/|journal=Journal of Child and Adolescent Psychopharmacology|volume=20|issue=6|pages=513–516|doi=10.1089/cap.2010.0063|issn=1044-5463|pmc=PMC3003451|pmid=21186970}}</ref> | 6-12 | 15-20 minutes | G | A | G | G | X | * Link to purchase [https://www.wpspublish.com/store/p/2703/cdrs-r-children-s-depression-rating-scale-revised#purchase-product CDRS-R] *[http://www.opapc.com/uploads/documents/CDRS-R.pdf PDF] (excerpt) |- | | | | | | | | | | |- | | | | | | | | | | |- | | | | | | | | | | |} '''Note:''' '''L''' = Less than adequate; '''A''' = Adequate; '''G''' = Good; '''E''' = Excellent; '''U''' = Unavailable; '''NA''' = Not applicable =='''[[Evidence based assessment/Process phase|Process phase]]'''== The following section contains a list of process and outcome measures for adolescent bipolar spectrum disorder. The section includes benchmarks based on published norms and on mood samples for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the [[Evidence based assessment/Process phase|process phase]] of assessment. For more information on differences between process and outcome measures, see the page on the [[Evidence based assessment/Process phase|process phase of assessment]]. === Process measures === There are many processes that may be considered important when evaluating a child or an adolescent with Bipolar Disorder; however, due to the diversity of the population and symptom expression, there are too many to narrow down. Clinical judgment is recommended when deciding what additional measures should be included (e.g. executive functioning, sensory processing, cognitive flexibility). The measures provided below are commonly used to assess and provide important information regarding levels of daily functioning of individuals with Bipolar Disorder. {{blockquotetop}} '''A. Mood and Energy Thermometer'''- &nbsp; This is an improved and practical way of monitoring complex mood cycles and daily schedules. Given that some clinicians and patients may get confused about different 1 to 10 scales (e.g., a 10 could mean extreme depression, extreme mania, or no depression), the Mood & Energy Thermometer improves the language in communicating (and monitoring) mood. Moreover, many children report their energy levels more accurately than their mood and therefore, energy levels have been incorporated in this mood rating. The Mood & Energy Thermometer that was developed at Western Psychiatric Institute and Clinic (WPIC; and used in about 400 kids) rates mania and increased energy on a 1 to 10 scale, rates depression and tiredness on a -1 to -10 scale, and attempts to form a common language between patients, families, and clinicians. This scale also takes into account time spent depressed and/or manic; for example, -4 would mean “mild depression” and “mild tiredness” present ≥50% of the time, and -3 would mean “mild depression” and “mild tiredness” present < 50% of the time. The inclusion of measuring energy levels is consistent with the DSM-5, because energy level is now included in the DSM-5 as a main mood symptom criterion. Bipolar track patients (whether they had mania, depression, or mixed features) rated their mood and energy levels every day on this scale, and a master’s-level clinician met with them on a daily basis to help them better identify and record their mood symptoms, which has significant clinical value for not only treatment but also to prevent future episodes.<ref name=":3">{{Cite web|url=http://pediatricbipolar.pitt.edu/resources/instruments|title=Instruments {{!}} CABS {{!}} University of Pittsburgh|website=pediatricbipolar.pitt.edu|language=en|access-date=2018-05-31}}</ref> *[https://mfr.osf.io/render?url=https://osf.io/p4a8s/?action=download%26mode=render Mood and Energy Thermometer] *[https://mfr.osf.io/render?url=https://osf.io/upe2a/?action=download%26mode=render Mood and Energy Thermometer with Anger and Anxiety (with recording/monitoring card)] *[https://mfr.osf.io/render?url=https://osf.io/d2fge/?action=download%26mode=render Mood and Energy Thermometer with Anger and Anxiety - Simplified Version] '''B. Life Charts''' * To learn more about how life charts can be used with adolescent depression, [http://www.bipolarnews.org/Life%20Charting%20Description.htm see here] * [https://mfr.osf.io/render?url=https://osf.io/amq6k/?action=download%26mode=render Life Charts for Depression and Bipolar] {{blockquotebottom}} === Outcome and severity measures === * Information on how to interpret this table can be [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase found here]. * Additionally, these [[Evidence based assessment/Vignettes|vignettes]] might be helpful resources for understanding appropriate adaptation of outcome measures in practice. *For clinically significant change benchmarks for the CBCL, YSR, and TRF overall, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase&wteswitched=1#Clinically_significant_change_benchmarks_for_widely-used_outcome_measures see here.] ==== '''Clinically significant change benchmarks with common instruments for bipolar disorder in youth''' ==== {| class="wikitable sortable" | ! colspan="3" |Cut Scores ! colspan="3" |Critical Change (Unstandardized Scores) ![[w:Minimal important difference|Minimal]]<nowiki/>ly [[w:Minimal important difference|Important Difference]] |- !Measure !Away !Back !Closer !95% !90% !SEdifference !(MID) ''d'' ~.5 |- |[[General Behavior Inventory#GBI Short Forms|PGBI-10M]] |1 |9 |6 |6 |5 |3.2 |3 |- |[[Child Mania Rating Scale|CMRS 10]] |<nowiki>--</nowiki> |6 |4 |5 |4 |2.3 |2 |- |[[General Behavior Inventory#GBI Short Forms|PGBI-10Da]] |<nowiki>--</nowiki> |7 |4 |6 |5 |3.0 |3 |- |[[General Behavior Inventory#GBI Short Forms|PGBI-10Db]] |<nowiki>--</nowiki> |7 |4 |6 |5 |2.9 |3 |- |[[General Behavior Inventory#GBI Short Forms|AGBI-10M]] |<nowiki>--</nowiki> |14 |7 |6 |5 |3.1 |3 |- |[[General Behavior Inventory#GBI Short Forms|AGBI-10Da]] |<nowiki>--</nowiki> |18 |7 |6 |5 |3.2 |3 |- |[[General Behavior Inventory#GBI Short Forms|AGBI-10Db]] |<nowiki>--</nowiki> |16 |7 |6 |5 |2.9 |4 |- |[[General Behavior Inventory#GBI Short Forms|7 Up]] |<nowiki>--</nowiki> |8 |4 |4 |4 |2.2 |3 |- |[[General Behavior Inventory#GBI Short Forms|7 Down]] |<nowiki>--</nowiki> |12 |5 |5 |4 |2.3 |3 |- |[[w:Kiddie Schedule for Affective Disorders and Schizophrenia#KSADS%20Mania%20Rating%20Scale%20(KMRS)%20and%20Depression%20Rating%20Scale%20(KDRS)|KMRS]] |19 |19 |19 |3 |3 |1.6 |3 |- |[[w:Kiddie Schedule for Affective Disorders and Schizophrenia#KSADS%20Mania%20Rating%20Scale%20(KMRS)%20and%20Depression%20Rating%20Scale%20(KDRS)|KDRS]] |12 |19 |18 |5 |4 |2.4 |3 |- |CDRS-R Total |<nowiki>--</nowiki> |24 |22 |6 |5 |2.9 |5 |- |YMRS Total |4 |3 |3 |3 |3 |1.8 |3 |} <br /> {| class="wikitable sortable" border="1" |- | colspan="8" style="font-size:110%; text-align:center;" span |<b> Benchmarks Based on Published Norms</b> |- | rowspan="2" style="text-align:center;font-size:130%;" |<b> <big>Measure</big></b> | rowspan="2" style="text-align:center;font-size:130%;" |<b> <big>Subscale</big></b> | colspan="3" style="text-align:center;font-size:130%" width="300" |<b> <big>Cut-off scores</big></b> | colspan="3" style="text-align:center;font-size:120%" |<b> <big>Critical Change <br> (unstandardized scores)</big></b> |- | style="text-align:center;font-size:110%" |<b> A</b> | style="text-align:center;font-size:110%" |<b> B</b> | style="text-align:center;font-size:110%" |<b> C</b> | style="text-align:center;font-size:110%" |<b> 95%</b> | style="text-align:center;font-size:110%" |<b> 90%</b> | style="text-align:center;font-size:110%" |<b> SE_difference</b> |- | rowspan="1" style="text-align:center;" |<b> [http://www.sciencedirect.com/science/article/pii/0272735888900505 Beck Depression Inventory]<ref>{{cite journal|last=Beck|first=AT|title=Psychometric properties of the Beck Depression Inventory: Twenty-five years of evaluation.|journal=Clinical Psychology Review|date=1988|volume=8|issue=1|url=http://www.sciencedirect.com/science/article/pii/0272735888900505|accessdate=10 February 2014}}</ref></b> | style="text-align:right;" |<i> BDI Mixed Depression</i> | style="text-align:center;" | 4 | style="text-align:center;" | 22 | style="text-align:center;" | 15 | style="text-align:center;" | 9 | style="text-align:center;" | 8 | style="text-align:center;" | 4.8 |- |} === Treatment === ==== Psychotherapy ==== [[Psychotherapy|Psychotherapies]] are treatments that help people with a wide variety of mental health concerns. While different forms of psychotherapies for adolescent bipolar disorder aim to remedy different aspects of the disorder, all aim to alleviate symptoms and decrease functional impairment in the client. {| class="wikitable mw-collapsible" |+Overview of Psychotherapies !Therapy !Key components !Duration !Results |- |Child- and Family-Focused Cognitive-Behavioral Therapy | * Develop consistent routines * Learn to regulate emotions * Improve child's self-esteem and parent's self efficacy * Reduce negativity * Build social skills and networks * Teach parents self-care * Family-based problem solving and communication skill building | * 12 weeks long * 60-90 minute weekly sessions | * Decrease intensity of manic episodes * Decrease depressive symptoms in child * Overall improvement in client's functioning |- |Interpersonal and Social Rhythm Therapy | * Develop understanding of disruptions in routine and manic/depressive episodes * Build skills for creating consistent routines, aka, social rhythms * Build self-efficacy and phase out of therapy |Varies dependent on client need | * Increases time between manic/depressive episodes |- |Mindfulness-Based Cognitive Therapy | * Utilizes mindfulness-based practices such as mindfulness meditation * Focus on awareness of client's thoughts, feelings and behaviors * Learn to recognize how to monitor one's own thoughts * Increase self-care practices | * 8 weeks long * 60-120 minute weekly sessions | * Decrease in anxiety symptoms * Decrease in depressive symptoms * Increase mood regulation * Increase attention ability |- |Multi-Family Psychoeducational Psychotherapy |Group therapy using treatment components from: * Psychoeducation * Family Systems therapy * Cognitive-behavioral therapy | * 8 weeks long * 60-90 minute weekly sessions | * Decrease in severity of mood symptoms * Increase in caregiver understanding of child's disorder and how to seek mental health care * Children report feeling more social support from caregivers |} ===== Child- and Family-Focused Cognitive-Behavioral Family (CFF-CBT) ===== ====== Purpose ====== [[File:Cognitive Behavioral Cycle.jpg|thumb|357x357px|Cognitive behavioral cycle]] CFF-CBT was created to address the unique needs of bipolar disorder in children and adolescents with bipolar disorder, including rapid cycling, mixed mood states and comorbid disorders.<ref name=":0">{{Cite journal|last=West|first=Amy E.|last2=Weinstein|first2=Sally M.|last3=Peters|first3=Amy T.|last4=Katz|first4=Andrea C.|last5=Henry|first5=David B.|last6=Cruz|first6=Rick A.|last7=Pavuluri|first7=Mani N.|date=2014-11-01|title=Child- and Family-Focused Cognitive-Behavioral Therapy for Pediatric Bipolar Disorder: A Randomized Clinical Trial|url=https://jaacap.org/article/S0890-8567(14)00617-0/abstract|journal=Journal of the American Academy of Child & Adolescent Psychiatry|language=English|volume=53|issue=11|pages=1168–1178.e1|doi=10.1016/j.jaac.2014.08.013|issn=0890-8567|pmc=PMC4254579|pmid=25440307}}</ref> This treatment has been tested to see if it will help address the high suicide attempt rate among children/adolescents with the disorder, and no significant effects were found. However CFF-CBT has been found to be effective for 7-13 year olds with both clients with and without non-suicidal self-injury behaviors.<ref name=":1">{{Cite journal|last=MacPherson|first=Heather A.|last2=Weinstein|first2=Sally M.|last3=West|first3=Amy E.|date=2018-05-01|title=Non-Suicidal Self-Injury in Pediatric Bipolar Disorder: Clinical Correlates and Impact on Psychosocial Treatment Outcomes|url=https://doi.org/10.1007/s10802-017-0331-4|journal=Journal of Abnormal Child Psychology|language=en|volume=46|issue=4|pages=857–870|doi=10.1007/s10802-017-0331-4|issn=1573-2835}}</ref> Mediators of this intervention include: parenting skills and coping, family flexibility, and family positive reframing.<ref name=":2">{{Cite journal|last=Fristad|first=Mary A.|last2=MacPherson|first2=Heather A.|date=2014-05-01|title=Evidence-Based Psychosocial Treatments for Child and Adolescent Bipolar Spectrum Disorders|url=https://doi.org/10.1080/15374416.2013.822309|journal=Journal of Clinical Child & Adolescent Psychology|volume=43|issue=3|pages=339–355|doi=10.1080/15374416.2013.822309|issn=1537-4416|pmc=PMC3844106|pmid=23927375}}</ref> ====== Intended Population ====== Children aged 7-13 and adolescents aged 13-17 ====== Length of Treatment ====== 12 weekly sessions, with session time ranging from 60 to 90 minutes<ref name=":1" /><ref name=":0" /><ref name=":2" /> ====== Treatment Components ====== CFF-CBT focuses on 7 components comprising of the “RAINBOW” acronym<ref name=":0" />: ''R'': Routine; developing consistency ''A'': Affective regulation; includes psychoeducation on feelings, coping skills, and mood monitoring ''I'': “I can do it!”; this aims to improve self-esteem in the child, as well as self-efficacy in the parent ''N'': “No Negative Thoughts/Live in the Now” ''B'': Be a good friend/balanced life style (building social skills and teaching parents self-care ''O'': Oh, how do we solve this problem? (family-based problem solving and communication skills building) ''W'': Ways to find support (building a network of support) ====== Treatment Outcomes ====== CFF-CBT has shown decreases in mania to a subclinical level, parent-reported youth depressive symptoms, increased involvement/fidelity to treatment, and improvements in the client’s overall, global functioning in comparison to psychotherapy as per usual.<ref name=":1" /> <br /> ===== Interpersonal and Social Rhythm Therapy (IPSRT) ===== ====== Purpose ====== IPSRT is based on the social zeitgeber hypothesis<ref>{{Cite journal|last=Grandin|first=Louisa D.|last2=Alloy|first2=Lauren B.|last3=Abramson|first3=Lyn Y.|date=2006-10|title=The social zeitgeber theory, circadian rhythms, and mood disorders: Review and evaluation|url=https://linkinghub.elsevier.com/retrieve/pii/S0272735806000651|journal=Clinical Psychology Review|language=en|volume=26|issue=6|pages=679–694|doi=10.1016/j.cpr.2006.07.001}}</ref>, which states that regularity in social routines and interpersonal relationships acts as a protective factor for mood disorders. Thus, this treatment focused on maintaining regularity in daily routines, quality of social relationships and social roles, and management of consequences of rhythm disruptions.<ref>{{Cite journal|last=Frank|first=Ellen|last2=Kupfer|first2=David J.|last3=Thase|first3=Michael E.|last4=Mallinger|first4=Alan G.|last5=Swartz|first5=Holly A.|last6=Fagiolini|first6=Andrea M.|last7=Grochocinski|first7=Victoria|last8=Houck|first8=Patricia|last9=Scott|first9=John|date=2005-09-01|title=Two-Year Outcomes for Interpersonal and Social Rhythm Therapy in Individuals With Bipolar I Disorder|url=http://dx.doi.org/10.1001/archpsyc.62.9.996|journal=Archives of General Psychiatry|volume=62|issue=9|pages=996|doi=10.1001/archpsyc.62.9.996|issn=0003-990X}}</ref> ====== Intended Population ====== IPSRT is intended for all individuals with bipolar disorder, and has been found to be effective in adolescents.<ref name=":3">{{Cite journal|last=Crowe|first=Marie|last2=Inder|first2=Maree|last3=Joyce|first3=Peter|last4=Moor|first4=Stephanie|last5=Carter|first5=Janet|last6=Luty|first6=Sue|date=2009-01|title=A developmental approach to the treatment of bipolar disorder: IPSRT with an adolescent|url=http://doi.wiley.com/10.1111/j.1365-2702.2008.02571.x|journal=Journal of Clinical Nursing|language=en|volume=18|issue=1|pages=141–149|doi=10.1111/j.1365-2702.2008.02571.x}}</ref> ====== Length of Treatment ====== Length of treatment varies dependent on client needs.<ref name=":3" /> ====== Treatment Components ====== IPSRT is structured in three phases<ref name=":4">{{Cite web|url=https://www.ipsrt.org/background|title=Interpersonal and Social Rhythm Therapy {{!}} Background|website=www.ipsrt.org|access-date=2019-12-05}}</ref>: # Initial phase: Explores the clients history in order to explore links between disruptions in routines to affective episodes. This stage also includes education on the rationale of the treatment<ref name=":4" /> # Intermediate phase: Focused on reorganizing the client's social rhythms, reinforcing new social rhythms and building confidence in using techniques that are taught in the treatment<ref name=":4" /> # Final phase: Reduction in frequency of visits in order to work towards termination of therapy and self-efficacy<ref name=":4" /> ====== Treatment Outcomes ====== If applied early in the acute phase of bipolar disorder, IPSRT may prolong time to relapse in depressive/manic episodes.<ref name=":5">{{Cite journal|last=Miziou|first=Stella|last2=Tsitsipa|first2=Eirini|last3=Moysidou|first3=Stefania|last4=Karavelas|first4=Vangelis|last5=Dimelis|first5=Dimos|last6=Polyzoidou|first6=Vagia|last7=Fountoulakis|first7=Konstantinos N|date=2015-12|title=Psychosocial treatment and interventions for bipolar disorder: a systematic review|url=http://www.annals-general-psychiatry.com/content/14/1/19|journal=Annals of General Psychiatry|language=en|volume=14|issue=1|pages=19|doi=10.1186/s12991-015-0057-z|issn=1744-859X|pmc=PMC4493813|pmid=26155299}}</ref> ===== Mindfulness-Based Cognitive Therapy (MBCT) ===== ====== Purpose ====== Mindfulness approaches aim to enhance one’s ability to focus their attention on the present moment in a non-judgmental manor.<ref name=":5" /> In treatment for Bipolar Disorder, mindfulness approaches may focus on awareness of the client’s patterns of thoughts, feelings and bodily sensations both specific and non-specific to their experiences related to the disorder.<ref name=":5" /> Moreover, when comorbid with anxiety, bipolar disorder has higher risk of suicide attempts, therefore MBCT aims to decrease these anxiety symptoms.<ref name=":6">{{Cite journal|last=Williams|first=J. Mark G.|last2=Russell|first2=Ian|last3=Russell|first3=Daphne|date=2008-06|title=Mindfulness-based cognitive therapy: Further issues in current evidence and future research.|url=http://doi.apa.org/getdoi.cfm?doi=10.1037/0022-006X.76.3.524|journal=Journal of Consulting and Clinical Psychology|language=en|volume=76|issue=3|pages=524–529|doi=10.1037/0022-006X.76.3.524|issn=1939-2117|pmc=PMC2834575|pmid=18540746}}</ref> ====== Intended Population ====== MBCT is intended for all populations with bipolar disorder.<ref name=":6" /> ====== Length of Treatment ====== MPCT is typically offered in 1-2 hour weekly sessions over an 8-week period in a group setting (Perich et al 2012; Weber et al 2010).<ref>{{Cite journal|last=Perich|first=T.|last2=Manicavasagar|first2=V.|last3=Mitchell|first3=P. B.|last4=Ball|first4=J. R.|last5=Hadzi-Pavlovic|first5=D.|date=2012-12-09|title=A randomized controlled trial of mindfulness-based cognitive therapy for bipolar disorder|url=http://dx.doi.org/10.1111/acps.12033|journal=Acta Psychiatrica Scandinavica|volume=127|issue=5|pages=333–343|doi=10.1111/acps.12033|issn=0001-690X}}</ref><ref name=":7">{{Cite journal|last=Weber|first=B.|last2=Jermann|first2=F.|last3=Gex-Fabry|first3=M.|last4=Nallet|first4=A.|last5=Bondolfi|first5=G.|last6=Aubry|first6=J.-M.|date=2010-10|title=Mindfulness-based cognitive therapy for bipolar disorder: A feasibility trial|url=https://linkinghub.elsevier.com/retrieve/pii/S0924933810000817|journal=European Psychiatry|language=en|volume=25|issue=6|pages=334–337|doi=10.1016/j.eurpsy.2010.03.007}}</ref> Participants are also assigned homework, including varying lengths of meditation practice.<ref name=":7" /> ====== Treatment Components ====== MPCT combines aspects of classical CBT and mindfulness-based stress reduction therapies. The themes addressed in each session are<ref>{{Cite web|url=http://mbct.com/classes.html|title=Classes|website=mbct.com|access-date=2019-12-05}}</ref>: Session 1: Automatic pilot Session 2: Dealing with barriers Session 3: Mindfulness of the breath Session 4: Staying present Session 5: Allowing and letting be Session 6: Thoughts are not facts Session 7: How can I best take care of myself Session 8: Using what has been learned to deal with future moods ====== Treatment Outcomes ====== Treatment outcomes include decreases in anxiety and depressive symptoms and mood regulation in patients with bipolar disorder, but there has been no evidence in prevention of recurrences.<ref name=":5" /><ref name=":6" /> MBCT has also been found to improve attentional readiness, and attenuated activation of non-relevant information processing during attentional readiness, which are usually decreased in individuals with Bipolar Disorder compared to those without.<ref>{{Cite journal|last=Howells|first=Fleur M|last2=Ives-Deliperi|first2=Victoria L|last3=Horn|first3=Neil R|last4=Stein|first4=Dan J|date=2012-02-29|title=Mindfulness based cognitive therapy improves frontal control in bipolar disorder: a pilot EEG study|url=http://dx.doi.org/10.1186/1471-244x-12-15|journal=BMC Psychiatry|volume=12|issue=1|doi=10.1186/1471-244x-12-15|issn=1471-244X}}</ref> <br /> ===== Multi-Family Psychoeducational Psychotherapy (MF-PEP) ===== ====== Purpose ====== MF-PEP is a group-based evidence based treatment for children with bipolar disorder, which is meant to increase the ability for the treatment to be readily implemented into the community.<ref name=":8">{{Cite journal|last=MacPherson|first=Heather A.|last2=Leffler|first2=Jarrod M.|last3=Fristad|first3=Mary A.|date=2014|title=Implementation of Multi-Family Psychoeducational Psychotherapy for Childhood Mood Disorders in an Outpatient Community Setting|url=https://onlinelibrary.wiley.com/doi/abs/10.1111/jmft.12013|journal=Journal of Marital and Family Therapy|language=en|volume=40|issue=2|pages=193–211|doi=10.1111/jmft.12013|issn=1752-0606|pmc=PMC4198302|pmid=24749838}}</ref> While MF-PEP creates a support system within the family for the child through being a family-based intervention, it also serves to increase social support for care givers through being a group-based therapy. ====== Intended Population ====== MF-PEP is intended for children with depressive and bipolar disorders and their caretakers.<ref name=":8" /><ref name=":9">{{Cite journal|last=Fristad|first=Mary A.|last2=Verducci|first2=Joseph S.|last3=Walters|first3=Kimberly|last4=Young|first4=Matthew E.|date=2009-09-01|title=Impact of Multifamily Psychoeducational Psychotherapy in Treating Children Aged 8 to 12 Years With Mood Disorders|url=https://jamanetwork.com/journals/jamapsychiatry/fullarticle/210303|journal=Archives of General Psychiatry|language=en|volume=66|issue=9|pages=1013–1021|doi=10.1001/archgenpsychiatry.2009.112|issn=0003-990X}}</ref> ====== Length of Treatment ====== MF-PEP is an 8-session long treatment, with sessions typically ranging from 60-90 minutes. <ref name=":8" /><ref name=":9" /> ====== Treatment Components ====== MF-PEP combines [[wikipedia:Psychoeducation|psychoeducation]], [[wikipedia:Family_therapy|family systems]], and [[wikipedia:Cognitive_behavioral_therapy|cognitive behavior therapy]] techniques, aiming to target depressive and bipolar disorder symptoms and how these symptoms cause impairment. <ref name=":9" /> In MF-PEP, sessions are delivered in a combination of settings, including all children and parents together, as well as separating all children and caregivers into their own respective groups. <ref name=":9" /> ====== Treatment Outcomes ====== Treatment outcomes for MG-PEP include an increase in caregiver's understanding of the child's disorder, and a decrease in mood symptom severity within the children which has been seen to be maintained through an 18-month follow-up. <ref name=":10">{{Cite journal|last=MacPherson|first=Heather A.|last2=Leffler|first2=Jarrod M.|last3=Fristad|first3=Mary A.|date=2014|title=Implementation of Multi-Family Psychoeducational Psychotherapy for Childhood Mood Disorders in an Outpatient Community Setting|url=https://onlinelibrary.wiley.com/doi/abs/10.1111/jmft.12013|journal=Journal of Marital and Family Therapy|language=en|volume=40|issue=2|pages=193–211|doi=10.1111/jmft.12013|issn=1752-0606|pmc=PMC4198302|pmid=24749838}}</ref> Additionally, MF-PEP has been found to have a positive effect on parent's help-seeking behaviors for mental health care, leading to access to higher-quality services. <ref name=":10" /> Lastly, children report feeling a stronger sense of social support from their caregivers after participating in the intervention.<ref name=":9" /> ===== See Also: ===== * Wikipedia has a page reviewing [[wikipedia:Treatment_of_bipolar_disorder|treatments for bipolar disorder]]. * [http://www.effectivechildtherapy.com Effective Child Therapy] provides a curated list of effective psycho-social treatments for bipolar disorder in youths. * [https://icd.who.int/browse10/2015/en#/F31 ICD-10 Diagnostic Criteria] * [[wikipedia:Bipolar_disorder_in_children|Bipolar disorder in children]] * [https://onlinelibrary.wiley.com/doi/epdf/10.1111/bdi.12556 The International Society for Bipolar Disorders Task Force report on pediatric bipolar disorder: Knowledge to date and directions for future research] * [[wikipedia:Treatment_of_bipolar_disorder|Treatment of bipolar disorder]] =='''External resources'''== {{Infobox disease | name = Pediatric Bipolar Disorder | image = | Caption = Bipolar disorder consists of experiences of mania alternating with depressive episodes | DiseasesDB = 7812 | ICD10 = {{ICD10|F|31||f|30}} | ICD9 = {{ICD9|296.0}}, {{ICD9|296.1}}, {{ICD9|296.4}}, {{ICD9|296.5}}, {{ICD9|296.6}}, {{ICD9|296.7}}, {{ICD9|296.8}} | ICDO = | OMIM = 125480 | OMIM_mult = {{OMIM2|309200}} | MedlinePlus = 000926 | eMedicineSubj = med | eMedicineTopic = 229 | MeshID = D001714 }} #[http://www.nami.org/ National Alliance on Mental Illness] – the nation’s largest grassroots mental health organization dedicated to building better lives for the millions of Americans affected by mental illness. NAMI advocates for access to services, treatment, supports and research and is steadfast in its commitment to raise awareness and build a community for hope for all of those in need.<ref>{{cite web|last=NAMI: National Alliance on Mental Illness.|title=National Alliance on Mental Illness|url=http://www.nami.org/|accessdate=5 February 2014}}</ref> #[http://www.thebalancedmind.org Balanced Mind Foundation] – information, articles, parent support chat rooms.<ref>{{cite web|last=The Balanced Mind.|title=The Balanced Mind Parent Network.|url=http://www.thebalancedmind.org|accessdate=5 February 2014}}</ref> #[http://www.effectivechildtherapy.com Effective Child Therapy] – Information and articles curated by [https://sccap53.org Society of Clinical Child and Adolescent Psychology](SCCAP), a division of the American Psychological Association.<ref>{{cite web|last=Effective Child Therapy|title=Effective Child Therapy: Evidence-based mental health treatment for children and adolescents.|url=http://www.effectivechildtherapy.com|accessdate=5 February 2014}}</ref> ##[http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/severe-mood-swings-and-bipolar-spectrum-disorders/ Effective Child Therapy information: Bipolar Disorder] ##[http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/severe-mood-swings-and-bipolar-spectrum-disorders/ Effective Child Therapy information: Severe Mood Swings and Bipolar Spectrum Disorders] ##[http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/sadness-hopelessness-and-depression/ Effective Child Therapy information: Sadness, Hopelessness, and Depression] #[http://ibpf.org/resources International Bipolar Foundation] – information, help and resources available for caregivers and those afflicted with bipolar disorder.<ref>http://ibpf.org/resources, International Bipolar Foundation, retrieved 27th January 2014. </ref> #[http://www.bipolarnews.org Bipolar Network News] – an online clearinghouse and information on latest treatments, research and psychoeducation about mood disorders.<ref>http://bipolarnews.org/, Bipolar Network News, retrieved 30th January 2014. </ref> #[http://www.depressionalliance.org/ Depression Alliance] – a United Kingdom charity that works to prevent and relieve depression by providing information and support services via supporter services, publications and self-help groups.<ref>Depression Alliance, http://www.depressionalliance.org/, retrieved 30th January 2014. </ref> #[http://www.dbsalliance.org/site/PageServer?pagename=home Depression and Bipolar Support Alliance (DBSA)] – a peer-directed national organization that provides links to resources, support groups, and peer support for individuals and their families suffering from bipolar disorder. ##[https://unc.az1.qualtrics.com/jfe/form/SV_cBlUQk8Y85LHF41 Depression and Bipolar Support Alliance: 7 Up 7 Down Online Screener] #Related Wikipedia Pages ##[[wikipedia:Bipolar_disorder|Bipolar disorder Wikipedia Page]] ##[[wikipedia:Cyclothymia|Cyclothymia Wikipedia Page]] ##[[wikipedia:Mania|Mania Wikipedia Page]] ##[[wikipedia:Depression_(mood)|Depression Wikipedia Page]] #[https://www.massgeneral.org/psychiatry/services/treatmentprograms.aspx?id=1944&display=bipolar Massachusetts General Hospital School Psychiatry Resources for Bipolar Disorder] #The Psych Show with Dr. Ali Mattu videos ##[https://www.youtube.com/watch?v=llOPqKD-s4w How to Cope with Bipolar Disorder] ##[https://www.youtube.com/watch?v=kUHUmeqBZAA Top 10 Bipolar Myths] #[[Evidence Based Psychotherapies for Adolescent Bipolar Disorder]] =='''References'''== {{collapse top|Click here for references}} {{Reflist|30em}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] {{collapse bottom}} 740kjv6pgnv8s88ltfwg5qgs2j22yoq 2419190 2419185 2022-08-26T02:30:50Z Ardenguo 2944162 /* Brief screening tools for PBD */ Made the collapsible box expanded by default wikitext text/x-wiki <noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{psychology}}{{Evidence-based assessment}}{{medical disclaimer}} {{:{{BASEPAGENAME}}/Sidebar}} ==[[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio?"''']]== * For background information on what assessment portfolios are, click the link in the heading above. Want even 'more' information about this topic? There's an extended version of this page [[Evidence-based assessment/Bipolar disorder in youth (assessment portfolio)/extended version|here]]. == '''[[Evidence based assessment/Preparation phase|Preparation phase]]''' == === Diagnostic criteria for Pediatric Bipolar disorder === {{collapse top| More information on PBD diagnostic criteria|expand=yes}} *[[w:Bipolar_disorder_in_children|Pediatric bipolar disorder (PBD)]] is characterized by extreme fluctuations in mood or emotional dysregulation that range from mania (as shown by displays or feelings of extreme happiness, unrealistic overachievement, and anger) to depression (as shown by displays or feelings of sadness, changes in appetite or weight, and irritability<ref name="APA"> American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.</ref> <ref name="jamison"> Goodwin, F. K., & Jamison, K. R. (2007). ''Manic-depressive illness.'' (10th edition). New York, NY: Oxford University Press </ref>). *It is important to note that these moods exceed normal responses to life events, represent a change from the individual's normal functioning, and cause problems in daily activities. These mood fluctuations result in a child finding it difficult to live and interact with family, friends and teachers, when it was previously not an issue<ref name="APA" />. *People with [[w:Bipolar_disorder|bipolar disorder]] experience unusually intense emotional states that occur in distinct periods called [[w:Mood_(psychology)|"mood episodes".]] An overly joyful or overexcited state is called a manic episode, and an extremely sad or hopeless state is called a [[w:Major_depressive_episode|depressive episode]]. Sometimes, a mood episode includes symptoms of both [[w:Mania|mania]] and [[w:Depression_(mood)|depression]]. *People with bipolar disorder also may be explosive and irritable during a mood episode.<ref name="APA" /> **Extreme changes in energy, activity, sleep, and behavior go along with these changes in mood. *It is possible for someone with bipolar disorder to experience a long-lasting period of unstable moods rather than discrete episodes of depression or mania.<ref name="jamison" /> <ref name="APA" /> *A person may be having an episode of bipolar disorder if he or she has a number of manic or depressive symptoms for most of the day, nearly every day, for at least one or two weeks. These debilitating symptoms can result in an afflicted individual being unable to function adaptively in several settings. {{collapse bottom}} {{blockquotetop}} '''<big>ICD-10 Criteria</big>''' '''''F31 Bipolar affective disorder''''' *''Note.'' Episodes are demarcated by a switch to an episode of opposite or mixed polarity or by a remission. '''''F31.0 Bipolar affective disorder, current episode hypomanic''''' '''A.''' The current episode meets the criteria for '''Hypomania F30.0''': *'''''(A)''''' The mood is elevated or irritable to a degree that is definitely abnormal for the individual concerned and sustained for at least four consecutive days. *'''''(B)''''' At least three of the following signs must be present, leading to some interference with personal functioning in daily living *# Increased activity or physical restlessness; *# Increased talkativeness; *# Distractibility or difficulty in concentration; *# Decreased need for sleep; *# Increased sexual energy; *# Mild over-spending, or other types of reckless or irresponsible behavior; *# Increased sociability or over-familiarity. *'''''(C)''''' The episode does not meet the criteria for '''F30.1 Mania without psychotic symptoms''', '''F30.2 Mania with psychotic symptoms''', '''F31.- Bipolar affective disorder''', '''F32.- Depressive episode''', '''F34.0 Cyclothymia''', or '''F50.0 Anorexia nervosa'''. *'''''(D)''''' ''Most commonly used exclusion clause.'' The episode is not attributable to '''F10-F19 Psychoactive substance use''' or in the sense of any '''F00-F09 Organic mental disorder'''. '''B.''' There has been at least one other affective episode in the past, meeting the criteria for '''F30.- Hypomanic or Manic episode''', '''F32.Depressive episode''', or '''F38.00 Mixed affective episode.''' <big>'''Changes in DSM-5'''</big> The diagnostic criteria for bipolar disorders changed slightly from [[DSM-IV]] to [[w:Diagnostic_and_Statistical_Manual_of_Mental_Disorders#DSM-IV-TR_.282000.29|DSM-5]]. Summaries are available [http://www.dsm5.org/Documents/changes%20from%20dsm-iv-tr%20to%20dsm-5.pdf here] and [[w:DSM-5|here]]. {{blockquotebottom}} === Base rates of PBD in different clinical settings and populations === This section describes the demographic setting of the population(s) sampled, base rates of diagnosis, country/region sampled and the diagnostic method that was used. Using this information, clinicians will be able to anchor the rates of PBD that they are likely to see in their clinical practices. * '''''To find prevalence rates across multiple disorders,''''' [[Evidence based assessment/Preparation phase#Base rates for transdiagnostic comparison|'''''click here.''''']] {| class="wikitable sortable" border="1" |+ style="text-align: left;" | ''Base rates of BSD in different clinical settings'' |- ! scope="col" | Setting (Reference) ! scope="col" style="white-space: nowrap;"| Base Rate ! scope="col" | Demography ! scope="col" | Diagnostic Method !Recommended for... |- | Rates of Bipolar Disorders in General Population || 0.6% || '''Bipolar I''' in youths age 5 to 18 || Meta-analysis of epidemiological studies, 19 samples, N = 56,103 participants<ref name=":11">{{Cite journal|last=Van Meter|first=Anna|last2=Moreira|first2=Ana Lúcia R.|last3=Youngstrom|first3=Eric|date=2019-04-02|title=Updated Meta-Analysis of Epidemiologic Studies of Pediatric Bipolar Disorder|url=https://www.psychiatrist.com/JCP/article/Pages/2019/v80/18r12180.aspx|journal=The Journal of Clinical Psychiatry|volume=80|issue=3|doi=10.4088/JCP.18r12180|issn=1555-2101}}</ref> |Schools, nonclinical settings. Minimum for outpatient settings. |- | style="border: width: 1px; border-bottom: 3px solid grey; padding: 5px;" |Rates of bipolar spectrum (I, II, cyclothymia, NOS) in general population || style="border: width: 1px; border-bottom: 3px solid grey; padding: 5px;" | 3.9% || style="border: width: 1px; border-bottom: 3px solid grey; padding: 5px;" | '''Bipolar spectrum''' in youths age 5 to 18 years || style="border: width: 1px; border-bottom: 3px solid grey; padding: 5px;" | Meta-regression estimate <ref name=":11" /> |Schools, nonclinical settings. Minimum for outpatient settings. |- | High school epidemiological<br />(Lewinsohn et al., 2000) || 0.6% || Northwestern USA high school || KSADS-PL | |- |Community Mental Health Center<br />(E. A. Youngstrom et al., 2005) || 6% || Midwestern Urban, 80% non-white, low-income || Clinical interview & treatment | |- | General Outpatient Clinic;<br />(Geller, Zimerman, Williams, Delbello, Frazier, et al., 2002) || 6% to 8% || Urban academic research centers || WASH-U-KSADS | |- |County Wards (DCFS)<br />(Naylor, Anderson, Kruesi, & Stoewe, 2002, October) || 11% || State of Illinois || Clinical interview & treatment | |- | Specialty Outpatient Service<br />(Biederman et al., 1996) || 15-17% || New England || KSADS-E | |- |Incarcerated adolescents<br />(Teplin, Abram, McClelland, Dulcan, & Mericle, 2002) || 2% || Midwestern Urban || DISC | |- | Incarcerated adolescents<br />(Pliszka et al., 2000) || 22% || Texas || DISC | |- | Acute psychiatric hospitalizations<br />in 2002-2003 – <u>adolescents</u><br />(Blader & Carlson, 2007) || 21% || All of U.S.A. || Centers for Disease Control survey of discharge diagnoses | |- | Inpatient service<br />(Carlson & Youngstrom, 2003) || 30% manic symptoms,<br /><2% strict BP I || New York City Metro Region || DICA; KSADS | |- |Acute psychiatric hospitalizations<br />in 2002-2003 – <u>children</u><br />(Blader & Carlson, 2007) || 40% || All of U.S.A. || Centers for Disease Control survey of discharge diagnoses | |- |Psychiatric outpatient clinic<br />(Ghanizadeh, Mohammadi, & Yazdanshenas, 2006) || 16-17% || Iran || K-SADS-PL (Farsi) | |- |Inpatient and partial hospitalization programs at a psychiatric treatment center<br />(Pellegrini et al., 1986) || Mania (0%), hypomania (6%) || Richmond, Virginia || DISC | |- |} ^p Parent interviewed as component of diagnostic assessment; ^y youth interviewed as part of diagnostic assessment. ''Note:'' KSADS = Kiddie Schedule for Affective Disorders and Schizophrenia, PL = Present and Lifetime version, WASH-U = Washington University version, -E = Epidemiological version of the KSADS; DISC = Diagnostic Interview Schedule for Children; DICA = Diagnostic Interview for Children and Adolescents. Table modified from Wikiversity. {| class="wikitable sortable" border="1" |- ! Setting ! Base Rate ! Demography ! Diagnostic Method !Best Recommended For |- | Community epidemiological (NCS-A) <ref>{{cite journal|last1=Kessler|first1=Ronald C.|last2=Avenevoli|first2=Shelli|last3=Costello|first3=E. Jane|last4=Georgiades|first4=Katholiki|last5=Green|first5=Jennifer Greif|last6=Gruber|first6=Michael J.|last7=He|first7=Jian-ping|last8=Koretz|first8=Doreen|last9=McLaughlin|first9=Katie A.|last10=Petukhova|first10=Maria|last11=Sampson|first11=Nancy A.|last12=Zaslavsky|first12=Alan M.|last13=Merikangas|first13=Kathleen Ries|title=Prevalence, persistence, and sociodemographic correlates of DSM-IV disorders in the National Comorbidity Survey Replication Adolescent Supplement|journal=Archives of General Psychiatry|date=1 April 2012|volume=69|issue=4|pages=372–380|doi=10.1001/archgenpsychiatry.2011.160|url=http://www.ncbi.nlm.nih.gov/pubmed/22147808|accessdate=26 January 2016|issn=1538-3636}}</ref> | 3.0% | All of U.S.A. | CIDI 3.0 | |- | Community epidemiologic samples<ref>{{cite journal|last1=Van Meter|first1=Anna R.|last2=Moreira|first2=Ana Lúcia R.|last3=Youngstrom|first3=Eric A.|date=1 September 2011|title=Meta-analysis of epidemiologic studies of pediatric bipolar disorder|url=http://www.ncbi.nlm.nih.gov/pubmed/21672501|journal=The Journal of Clinical Psychiatry|volume=72|issue=9|pages=1250–1256|doi=10.4088/JCP.10m06290|issn=1555-2101}}</ref> |mean= 1.8% (95% CI, 1.1%–3.0%), bipolar I (mean =1.2%; 95% CI, 0.7%–1.9%) | U.S.A., Netherlands, U.K., Spain, Mexico, Ireland, New Zealand | Structured and semi-structured diagnostic interviews, Combination of broad and specific diagnostic criteria (Meta-Analysis) |Schools, nonclinical settings. Minimum for outpatient settings. |- |Community mental health center<ref>{{Cite journal|last=Youngstrom|first=Eric A.|last2=Findling|first2=Robert L.|last3=Youngstrom|first3=Jen Kogos|last4=Calabrese|first4=Joseph R.|date=September 2005|title=Toward an evidence-based assessment of pediatric bipolar disorder|url=https://www.ncbi.nlm.nih.gov/pubmed/16026213|journal=Journal of Clinical Child and Adolescent Psychology: The Official Journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 53|volume=34|issue=3|pages=433–448|doi=10.1207/s15374424jccp3403_4|issn=1537-4416|pmid=16026213}}</ref> |6% |U.S.A., Midwestern Urban, 80% non-white, low-income |Parent and youth clinical assessment & treatment | |- |General outpatient clinic<ref name=":1" /> |6-8% |Urban academic research centers |WASH-U-[[w:Kiddie Schedule for Affective Disorders and Schizophrenia|KSAD]]S (parent and youth) | |- |Specialty outpatient service<ref>{{Cite journal|last=Biederman|first=J.|last2=Faraone|first2=S.|last3=Mick|first3=E.|last4=Wozniak|first4=J.|last5=Chen|first5=L.|last6=Ouellette|first6=C.|last7=Marrs|first7=A.|last8=Moore|first8=P.|last9=Garcia|first9=J.|date=August 1996|title=Attention-deficit hyperactivity disorder and juvenile mania: an overlooked comorbidity?|url=https://www.ncbi.nlm.nih.gov/pubmed/8755796|journal=Journal of the American Academy of Child and Adolescent Psychiatry|volume=35|issue=8|pages=997–1008|doi=10.1097/00004583-199608000-00010|issn=0890-8567|pmid=8755796}}</ref> |15-17% |Boston area, U. S. A. |[[w:Kiddie Schedule for Affective Disorders and Schizophrenia|KSADS]]-E | |- | Inpatient Services/Diagnoses<ref>{{Cite journal|last=Holtmann|first=M.|last2=Goth|first2=K.|last3=Wöckel|first3=L.|last4=Poustka|first4=F.|last5=Bölte|first5=S.|date=2008|title=CBCL-pediatric bipolar disorder phenotype: severe ADHD or bipolar disorder?|url=https://www.ncbi.nlm.nih.gov/pubmed/17994189|journal=Journal of Neural Transmission (Vienna, Austria: 1996)|volume=115|issue=2|pages=155–161|doi=10.1007/s00702-007-0823-4|issn=0300-9564|pmid=17994189}}</ref> | 0.3% | All of Germany | [[w:International_Statistical_Classification_of_Diseases_and_Related_Health_Problems|International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10)]] | |- | Community sample<ref>{{cite journal|last1=Olino|first1=Thomas M.|last2=Shankman|first2=Stewart A.|last3=Klein|first3=Daniel N.|last4=Seeley|first4=John R.|last5=Pettit|first5=Jeremy W.|last6=Farmer|first6=Richard F.|last7=Lewinsohn|first7=Peter M.|date=1 September 2012|title=Lifetime rates of psychopathology in single versus multiple diagnostic assessments: Comparison in a community sample of probands and siblings|url=http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3411854/|journal=Journal of psychiatric research|volume=46|issue=9|pages=1217–1222|doi=10.1016/j.jpsychires.2012.05.017|issn=0022-3956}}</ref> | 2.9% | Oregon | LIFE, SCID, DSM-IV | |- | Inpatient service<ref>{{cite journal|last1=Carlson|first1=Gabrielle A.|last2=Youngstrom|first2=Eric A.|date=1 June 2003|title=Clinical implications of pervasive manic symptoms in children|url=http://www.ncbi.nlm.nih.gov/pubmed/12788250|journal=Biological Psychiatry|volume=53|issue=11|pages=1050–1058|issn=0006-3223}}</ref> | 30% manic symptoms, <2% strict BP I | New York City Metro Region | DICA; [[w:Kiddie Schedule for Affective Disorders and Schizophrenia|KSADS]] | |- |NCS-A Clinical Reappraisal Sample<ref name=":3" /> ^{p y} |6.2% and SE=1.7 (bipolar I and II and sub-threshold bipolar spectrum disorder) |U.S.A, NCS-A |[[w:Kiddie Schedule for Affective Disorders and Schizophrenia|K-SADS]], DSM-IV criteria were modified from published version for purpose of the study, broad criteria for not otherwise specified | | |- |NCS-A Clinical Reappraisal Sample<ref name=":3">{{Cite journal|last=Kessler|first=Ronald C.|last2=Avenevoli|first2=Shelli|last3=Green|first3=Jennifer|last4=Gruber|first4=Michael J.|last5=Guyer|first5=Margaret|last6=He|first6=Yulei|last7=Jin|first7=Robert|last8=Kaufman|first8=Joan|last9=Sampson|first9=Nancy A.|date=2009-04|title=National Comorbidity Survey Replication Adolescent Supplement (NCS-A): III. Concordance of DSM-IV/CIDI Diagnoses With Clinical Reassessments|url=http://linkinghub.elsevier.com/retrieve/pii/S0890856709600460|journal=Journal of the American Academy of Child & Adolescent Psychiatry|volume=48|issue=4|pages=386–399|doi=10.1097/chi.0b013e31819a1cbc|issn=0890-8567|pmc=PMC3040100|pmid=19252450}}</ref> ^p ^y |6.6% and SE=1.7 (bipolar I and II and sub-threshold bipolar spectrum disorder) |U.S.A, NCS-A |CIDI, DSM-IV criteria were modified from published version for purpose of the study, broad criteria for not otherwise specified, | |- |National Cross‐sectional epidemiological sample<ref>{{Cite journal|last=Stringaris|first=Argyris|last2=Santosh|first2=Paramala|last3=Leibenluft|first3=Ellen|last4=Goodman|first4=Robert|date=2009-07-22|title=Youth meeting symptom and impairment criteria for mania-like episodes lasting less than four days: an epidemiological enquiry|url=http://doi.wiley.com/10.1111/j.1469-7610.2009.02129.x|journal=Journal of Child Psychology and Psychiatry|language=en|volume=51|issue=1|pages=31–38|doi=10.1111/j.1469-7610.2009.02129.x|issn=0021-9630|pmc=PMC4286871|pmid=19686330}}</ref> ^p ^y |1.2% (bipolar I and II and not otherwise specified) |United Kingdom |DAWBA, DSM-IV criteria, broad criteria for not otherwise specified | |- |Community epidemiological samples<ref>{{Cite journal|last=Benjet|first=Corina|last2=Borges|first2=Guilherme|last3=Medina-Mora|first3=Maria Elena|last4=Zambrano|first4=Joaquin|last5=Aguilar-Gaxiola|first5=Sergio|date=2009-04|title=Youth mental health in a populous city of the developing world: results from the Mexican Adolescent Mental Health Survey|url=http://doi.wiley.com/10.1111/j.1469-7610.2008.01962.x|journal=Journal of Child Psychology and Psychiatry|language=en|volume=50|issue=4|pages=386–395|doi=10.1111/j.1469-7610.2008.01962.x|issn=0021-9630}}</ref> ^y |2.5% (bipolar I and II) |Mexico City |CIDI, DSM-IV Criteria | |- |2-stage epidemiological study<ref>{{Cite journal|last=Lynch|first=Fionnuala|last2=Mills|first2=Carla|last3=Daly|first3=Irenee|last4=Fitzpatrick|first4=Carol|date=2006-08|title=Challenging times: Prevalence of psychiatric disorders and suicidal behaviours in Irish adolescents|url=http://linkinghub.elsevier.com/retrieve/pii/S0140197105001004|journal=Journal of Adolescence|volume=29|issue=4|pages=555–573|doi=10.1016/j.adolescence.2005.08.011|issn=0140-1971}}</ref> ^{p y} |0.0% (bipolar I and II, cyclothymia, not otherwise specified |Ireland |[[w:Kiddie Schedule for Affective Disorders and Schizophrenia|K-SADS]], DSM-IV Criteria | |} ^p:Parent interviewed as component of diagnostic assessment; ^y:Youth interviewed as part of diagnostic assessment. ''Note:'' * KSADS = [[w:Schedule_for_Affective_Disorders_and_Schizophrenia#K-SADS|Kiddie Schedule for Affective Disorders and Schizophrenia]], * WASH-U = Washington University version, -PL = Present and Lifetime Version, -E = Epidemiological version of the KSADS * LIFE = Longitudinal Interval Follow-Up Evaluation, * DICA = Diagnostic Interview for Children and Adolescents *CIDI = Composite International Diagnostic Interview *DAWBA= The Development and Well-Being Assessment == '''[[Evidence based assessment/Prediction phase|Prediction phase]]''' == The following section contains a list of screening and diagnostic instruments for bipolar disorder in youth. This section includes administration information, psychometric data, and PDFs or links to the screenings. === Psychometric properties of screening instruments for pediatric bipolar disorder === * Screenings are used as part of the [[Evidence based assessment/Prediction phase|prediction phase]] of assessment; for more information on interpretation of this data, or how screenings fit in to the assessment process, click [[Evidence based assessment/Prediction phase|here.]] * '''''For a list of more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Common_screening_instruments click here.]''''' {| class="wikitable sortable" border="1" ! colspan="10" |Screening measures for bipolar disorder in youth |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time ! Interrater Reliability ! Test-Retest Reliability ! Construct Validity ! Content Validity ! Highly Recommended !Free and Accessible Measures |- | Children's Depression Inventory <nowiki>*</nowiki>not free | Self-report<ref name=":0">{{Cite web|url=https://www.pearsonclinical.com/psychology/products/100000636/childrens-depression-inventory-2-cdi-2.html|title=Children's Depression Inventory 2™|website=www.pearsonclinical.com|language=en-US|accessdate=2018-03-01}}</ref> | 7-17 | 15-20 minutes<ref name=":0" /> | NA | A | G | G | X |Not free |- | Mood and Feelings Questionnaire (MFQ) | Self-report | 7-18 | 5-10 minutes<ref>{{Cite web|url=http://www.cebc4cw.org/assessment-tool/mood-and-feelings-questionnaire-mfq/|title=CEBC » Assessment Tool › Mood And Feelings Questionnaire Mfq|website=www.cebc4cw.org|language=en|accessdate=2018-03-01}}</ref> | NA | A | G | A | X | *[https://mfr.osf.io/render?url=https://osf.io/enx4b/?action=download%26mode=render MFQ Child Self-Report Long Version] *[https://mfr.osf.io/render?url=https://osf.io/mcg5w/?action=download%26mode=render MFQ Child Self Report Short Version] *[https://mfr.osf.io/render?url=https://osf.io/cw27p/?action=download%26mode=render MFQ Parent Report On Child Long Version] *[https://mfr.osf.io/render?url=https://osf.io/kybr4/?action=download%26mode=render MFQ Parent Report On Child Short Version] |- | 7 Up 7 Down Inventory (7U7D) |Self-report<ref name=":5" /> | 11-86<ref>{{Cite journal|last=Mesman|first=E.|last2=Youngstrom|first2=E.A.|last3=Juliana|first3=N.K.|last4=Nolen|first4=W.A.|last5=Hillegers|first5=M.H.J.|date=2017-01|title=Validation of the Seven Up Seven Down Inventory in bipolar offspring: screening and prediction of mood disorders. Findings from the Dutch Bipolar Offspring Study|url=https://doi.org/10.1016/j.jad.2016.09.024|journal=Journal of Affective Disorders|volume=207|pages=95–101|doi=10.1016/j.jad.2016.09.024|issn=0165-0327}}</ref> |5-8 minutes | NA | | | | | * [https://mfr.osf.io/render?url=https://osf.io/s825e/?action=download%26mode=render 7U7D English] * [https://unc.az1.qualtrics.com/jfe/form/SV_cBlUQk8Y85LHF41 Depression and Bipolar Support Alliance (DBSA): 7U7D '''Online Screener'''] |- | Parent General Behavior-10 Item Version (PGBI-10M)<ref name=":6">{{Cite journal|last=Youngstrom|first=Eric A.|last2=Genzlinger|first2=Jacquelynne E.|last3=Egerton|first3=Gregory A.|last4=Meter|first4=Anna R. Van|title=Multivariate meta-analysis of the discriminative validity of caregiver, youth, and teacher rating scales for pediatric bipolar disorder: Mother knows best about mania.|url=http://dx.doi.org/10.1037/arc0000024|journal=Archives of Scientific Psychology|volume=3|issue=1|pages=112–137|doi=10.1037/arc0000024}}</ref> |Parent-report |5-18<ref name=":7">Youngstrom, E.A., Van Meter, A.R, Frazier, T.W., Youngstrom, J.K., & Findling, R.L. (in press). Developing and validating short forms of the Parent General Behavior Inventory Mania and Depression Scales for rating youth mood symptoms. ''Journal of Clinical Child & Adolescent Psychology.''</ref> |5-8 minutes | | | | | | * [https://mfr.osf.io/render?url=https://osf.io/ub8h7/?action=download%26mode=render Downloadable PDF Parent-Report English] |} '''Note:''' '''L''' = Less than adequate; '''A''' = Adequate; '''G''' = Good; '''E''' = Excellent; '''U''' = Unavailable; '''NA''' = Not applicable === Brief screening tools for PBD=== {{collapse top|expand=yes}} The following are brief screening tools that typically take less than 5 minutes to administer to accurately diagnose pediatric bipolar disorder: # '''''7 Up 7 Down Inventory (7U7D)''''' ## The [http://supp.apa.org/psycarticles/supplemental/a0033975/a0033975_supp.html 7 Up 7 Down Inventory]<ref name=":5">{{cite journal|last1=Youngstrom|first1=Eric A.|last2=Murray|first2=Greg|last3=Johnson|first3=Sheri L.|last4=Findling|first4=Robert L.|title=The 7 up 7 down inventory: a 14-item measure of manic and depressive tendencies carved from the General Behavior Inventory|journal=Psychological Assessment|date=1 December 2013|volume=25|issue=4|pages=1377–1383|doi=10.1037/a0033975|url=https://www.ncbi.nlm.nih.gov/pubmed/23914960|issn=1939-134X}}</ref> is a recently developed and validated questionnaire with 14 items of manic and depressive tendencies carved from the General Behavior Inventory, a well-validated but cumbersome interview. For both mania and depression factors, 7 items produced a psychometrically adequate measure applicable across both aggregate samples. Internal reliability of the Mania scale was .81 (youth) and .83 (adult) and for Depression was .93 (youth) and .95 (adult). ## The 7 Up 7 Down Inventory, along with the accompanying research article, can be [http://supp.apa.org/psycarticles/supplemental/a0033975/a0033975_supp.html found here]. # '''''[https://mfr.osf.io/render?url=https://osf.io/d95nv/?action=download%26mode=render PGBI-10M]'''''<ref>Youngstrom EA, Frazier TW, Demeter C, et al. Developing a 10-item mania scale from the Parent General Behavior Inventory for children and adolescents. J Clin Psychiatry. 2008;69(5):831–839.</ref> ## The [http://www.moodychildtherapy.com/wp-content/uploads/2011/01/PGBI-10M-2-wks.pdf PGBI-10M] (we would like to add another version that is better) is a brief (10 item) instrument derived from the [https://mfr.osf.io/render?url=https://osf.io/3j5r7/?action=download%26mode=render Parent General Behavior Inventory (PGBI)]<ref>{{Cite journal|last=Youngstrom|first=Eric A.|last2=Findling|first2=Robert L.|last3=Danielson|first3=Carla Kmett|last4=Calabrese|first4=Joseph R.|date=2001|title=Discriminative validity of parent report of hypomanic and depressive symptoms on the General Behavior Inventory.|url=http://psycnet.apa.org/doi/10.1037/1040-3590.13.2.267|journal=Psychological Assessment|language=en|volume=13|issue=2|pages=267–276|doi=10.1037/1040-3590.13.2.267|issn=1939-134X}}</ref>, a 73-item mood inventory, to assess [[mania]] in a large sample of outpatients presenting with a variety of different [[DSM-IV]] diagnoses, including frequent comorbid conditions.<ref name=":0">{{cite journal|last1=Youngstrom|first1=E. A.|last2=Findling|first2=R. L.|last3=Danielson|first3=C. K.|last4=Calabrese|first4=J. R.|title=Discriminative validity of parent report of hypomanic and depressive symptoms on the General Behavior Inventory|journal=Psychological Assessment|date=1 June 2001|volume=13|issue=2|pages=267–276|url=http://www.ncbi.nlm.nih.gov/pubmed/11433802|issn=1040-3590}}</ref> ## The 10-item GBI derived from the 73-item P-GBI had good reliability (alpha = .92), was correlated (r = 0.95) with the 28-item scale, and showed significantly better discrimination of bipolar disorders (area under the [[receiver operating characteristic]] [AUROC] curve of 0.856 vs. 0.832 for the 28-item scale, p < .005). The 10-item scale also did well discriminating bipolar disorder from unipolar depression (AUROC = 0.86) and bipolar disorder from [[attention deficit hyperactivity disorder|attention-deficit/hyperactivity disorder]] (AUROC = 0.82) cases. ## The full version of the scale, the Parent-General Behavior Inventory (P-GBI), is a parent-report measure of depressive and hypomanic/biphasic symptoms adapted from the General Behavior Inventory (GBI). ## Classification rates exceed 80%, and receiver operating characteristic analyses showed good diagnostic efficiency for the scales, with areas under the curve greater than .80. Results indicate that clinicians can use the parent-completed GBI to derive clinically meaningful information about mood disorders in youths. {{collapse bottom}} === Likelihood ratios and AUCs of screening measures for bipolar disorder in youth === * '''''For a list of the likelihood ratios for more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Likelihood_ratios_and_AUCs_of_common_screening_instruments click here.]''''' The following table describes the diagnostic likelihood ratios and area under curves for the top pediatric bipolar disorder measures. {| class="wikitable sortable" border="1" |- ! Screening Measure ! AUC (sample size) !Very Low risk range DiLR !Low risk range DiLR !Neutral risk range DiLR !High risk range DiLR !Very High risk range DiLR !DLR+ (score) !DLR- (score) ! Population/Clinical Generalizability !Download |- |[https://mfr.osf.io/render?url=https://osf.io/d3b4h/?action=download%26mode=render Parent General Behavior-10 Item Mania Version (PGBI-10M)]<ref name=":7" /> |.84 (''N''=617) academic sample, .78 community sample (''N''=530)<ref name=":7" /> |.07  (0 to 2.59)  |.41 (2.6 to 6.99) |1.44 (7 to 10.99)  |2.39 (11 to 17.99)  |5.38 (18+) | | |Bipolar spectrum vs. all other diagnoses |[https://mfr.osf.io/render?url=https://osf.io/ub8h7/?action=download%26mode=render Parent Form]<ref>{{Cite web|url=http://www.moodychildtherapy.com|title=Psychoeducational Psychotherapy|website=www.moodychildtherapy.com|language=en-US|access-date=2018-07-20}}</ref> |- |[https://mfr.osf.io/render?url=https://osf.io/eau89/?action=download%26mode=render Parent General Behavior-10 Item Depression Version Form A (PGBI-10Da)]<ref name=":7" /> |.84 (''N''=617) academic sample, .79 community sample (''N''=530)<ref name=":7" /> |.25  (0 to 1.99) |.71 (2 to 5.99)   |1.85 (6 to 9.99)   |4.52 (10 to 14.99) |8.80 (15+)   | | |Bipolar spectrum vs. all other diagnoses | |- |[https://mfr.osf.io/render?url=https://osf.io/eau89/?action=download%26mode=render Parent General Behavior-10 Item Depression Version Form B (PGBI-10Db)]<ref name=":7" /> |.84 (''N''=617) academic sample, .80 community sample (''N''=530)<ref name=":7" /> |.22 (0 to 1.99)    |.71 (2 to 5.99) |2.69 (6 to 10.99)    |5.64 (11 to 14.99)    |8.09 (15+) | | |Bipolar spectrum vs. all other diagnoses | |- |[https://mfr.osf.io/render?url=https://osf.io/hyb3g/?action=download%26mode=render Parent General Behavior Inventory] (P-GBI) (''Hypomanic/Biphasic Section''])<ref name="eay2004">Youngstrom, E. A., Findling, R. L., & Calabrese, J. R. (2004). Effects of adolescent manic symptoms on agreement between youth, parent, and teacher ratings of behavior problems. Journal of Affective Disorders, 82, S5-S16. </ref> | .84 (N=324) | |(<9) | | |(49+) |9.2 |.06 | Bipolar spectrum vs. all other diagnoses | |- | Parent Mood Disorder Questionnaire (P-MDQ)<ref>{{cite journal|last1=Wagner|first1=Karen Dineen|last2=Hirschfeld|first2=Robert M. A.|last3=Emslie|first3=Graham J.|last4=Findling|first4=Robert L.|last5=Gracious|first5=Barbara L.|last6=Reed|first6=Michael L.|date=1 May 2006|title=Validation of the Mood Disorder Questionnaire for bipolar disorders in adolescents|url=http://www.ncbi.nlm.nih.gov/pubmed/16841633|journal=The Journal of Clinical Psychiatry|volume=67|issue=5|pages=827–830|issn=0160-6689}}</ref> | .84 (N=819) | |(TBC) | | |(TBC) |4.64 |.17 | Bipolar spectrum vs. all other diagnoses | * [https://mfr.osf.io/render?url=https://osf.io/wtp7r/?action=download%26mode=render MDQ] |- | Child Mania Rating Scale (Brief) ''(Brief CMRS-P)''<ref name=":2">{{cite journal|last1=Henry|first1=David B.|last2=Pavuluri|first2=Mani N.|last3=Youngstrom|first3=Eric|last4=Birmaher|first4=Boris|date=1 April 2008|title=Accuracy of brief and full forms of the Child Mania Rating Scale|url=http://www.ncbi.nlm.nih.gov/pubmed/?term=18302291|journal=Journal of Clinical Psychology|volume=64|issue=4|pages=368–381|doi=10.1002/jclp.20464|issn=0021-9762}}</ref> | .85 (N=150) | |(<11) | | |(11+) |10.5 |.17 | Bipolar spectrum vs. ADHD | |- | Child Mania Rating Scale (Full) ''(Full CMRS-P)''<ref name=":2" /> | .91 (N=150) | |(<21) | | |(21+) |13.7 |.19 | Bipolar spectrum vs. ADHD | * [https://mfr.osf.io/render?url=https://osf.io/8wv3a/?action=download%26mode=render Downloadable PDF] |- |[https://mfr.osf.io/render?url=https://osf.io/5yzur/?action=download%26mode=render Child Bipolar Questionnaire] ''[https://mfr.osf.io/render?url=https://osf.io/5yzur/?action=download%26mode=render (CBQ-P)]''<ref>{{Cite journal|last=Papolos|first=Demitri|last2=Hennen|first2=John|last3=Cockerham|first3=Melissa S.|last4=Thode|first4=Henry C.|last5=Youngstrom|first5=Eric A.|date=2006-10|title=The child bipolar questionnaire: A dimensional approach to screening for pediatric bipolar disorder|url=https://doi.org/10.1016/j.jad.2006.03.026|journal=Journal of Affective Disorders|volume=95|issue=1-3|pages=149–158|doi=10.1016/j.jad.2006.03.026|issn=0165-0327}}</ref> |.74 (N=497) | | | | | |25.3/ (likelihood ratio +) |/.25 (likelihood ratio -) |Bipolar spectrum vs. all other diagnoses | |} === Interpreting bipolar disorder screening measure scores === For information on interpreting screening measure scores, click [[Evidence based assessment/Prediction phase#Interpreting screening measure scores|here.]] ==[[Evidence based assessment/Prescription phase|'''Prescription phase''']]== ===Gold standard diagnostic interviews=== For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews click here.] {{collapse top|Click here for more details on gold-standard diagnostic interviews}} # '''Kiddie Schedule for Affective Disorders and Schizophrenia-Present and Lifetime (KSADS-PL)''' #* The '''KSADS-PL''' is a semi-structured diagnostic interview that assesses current and past Diagnostic and Statistical Manual of Mental Disorders – Fourth Edition (DSM-IV-TR) Axis I psychopathology in youth<ref name="APA" />. The KSADS-PL diagnostic interviews have good inter-rater (.93 to 1.00) and retest reliability (.77) for mood disorders <ref>{{cite journal|last1=Kaufman|first1=J.|last2=Birmaher|first2=B.|last3=Brent|first3=D.|last4=Rao|first4=U.|last5=Flynn|first5=C.|last6=Moreci|first6=P.|last7=Williamson|first7=D.|last8=Ryan|first8=N.|title=Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (K-SADS-PL): initial reliability and validity data|journal=Journal of the American Academy of Child and Adolescent Psychiatry|date=1 July 1997|volume=36|issue=7|pages=980–988|doi=10.1097/00004583-199707000-00021|url=http://www.ncbi.nlm.nih.gov/pubmed/9204677|issn=0890-8567}}</ref> Here is a link to a PDF of the diagnostic interview for the [http://www.psychiatry.pitt.edu/sites/default/files/Documents/assessments/ksads-pl.pdf Kiddie Schedule for Affective Disorders and Schizophrenia-Present and Lifetime]. # '''Washington University in St. Louis Kiddie Schedule for Affective Disorders and Schizophrenia (WASH-U-KSADS)''' #* The '''[http://www.ncbi.nlm.nih.gov/pubmed/11314571 Washington University in St. Louis Kiddie Schedule for Affective Disorders and Schizophrenia]'''(WASH-U-KSADS)<ref name=":1">{{cite journal|last1=Geller|first1=B.|last2=Zimerman|first2=B.|last3=Williams|first3=M.|last4=Bolhofner|first4=K.|last5=Craney|first5=J. L.|last6=DelBello|first6=M. P.|last7=Soutullo|first7=C.|title=Reliability of the Washington University in St. Louis Kiddie Schedule for Affective Disorders and Schizophrenia (WASH-U-KSADS) mania and rapid cycling sections|journal=Journal of the American Academy of Child and Adolescent Psychiatry|date=1 April 2001|volume=40|issue=4|pages=450–455|doi=10.1097/00004583-200104000-00014|url=http://www.ncbi.nlm.nih.gov/pubmed/11314571|issn=0890-8567}}</ref> was expanded from the 1986 version of the KSADS, which was modified and expanded to include onset and offset of each symptom for both current and lifetime episodes, expanded prepubertal mania and rapid cycling sections, and categories for [[attention deficit hyperactivity disorder]] and other DSM-IV diagnoses. To optimize diagnostic research, skip-outs were minimized. #* The kappa values of comparisons between research nurse and off-site blind best-estimate ratings of mania and rapid cycling sections were excellent (0.74-1.00). High 6-month stability for mania diagnoses (85.7%) and for individual mania items and validity against parental and teacher reports were previously reported.<ref name=":1" /> #* The link to the diagnostic interview for the [http://www.psychiatry.pitt.edu/sites/default/files/Documents/assessments/mrs.pdf Washington University in St. Louis Kiddie Schedule for Affective Disorders and Schizophrenia] can be found [http://www.psychiatry.pitt.edu/sites/default/files/Documents/assessments/mrs.pdf here]. {{collapse bottom}} ===Recommended diagnostic instruments specific for pediatric bipolar disorder=== {| class="wikitable sortable" border="1" ! colspan="10" |Diagnostic instruments for '''(insert portfolio name)''' |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time ! Interrater Reliability ! Test-Retest Reliability ! Construct Validity ! Content Validity ! Highly Recommended !Free and Accessible Measures |- | Children's Depression Rating Scale - Revised (CDRS-R) | Structured Interview<ref name=":4">{{Cite journal|last=Mayes|first=Taryn L.|last2=Bernstein|first2=Ira H.|last3=Haley|first3=Charlotte L.|last4=Kennard|first4=Betsy D.|last5=Emslie|first5=Graham J.|date=2010-12|title=Psychometric Properties of the Children's Depression Rating Scale–Revised in Adolescents|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3003451/|journal=Journal of Child and Adolescent Psychopharmacology|volume=20|issue=6|pages=513–516|doi=10.1089/cap.2010.0063|issn=1044-5463|pmc=PMC3003451|pmid=21186970}}</ref> | 6-12 | 15-20 minutes | G | A | G | G | X | * Link to purchase [https://www.wpspublish.com/store/p/2703/cdrs-r-children-s-depression-rating-scale-revised#purchase-product CDRS-R] *[http://www.opapc.com/uploads/documents/CDRS-R.pdf PDF] (excerpt) |- | | | | | | | | | | |- | | | | | | | | | | |- | | | | | | | | | | |} '''Note:''' '''L''' = Less than adequate; '''A''' = Adequate; '''G''' = Good; '''E''' = Excellent; '''U''' = Unavailable; '''NA''' = Not applicable =='''[[Evidence based assessment/Process phase|Process phase]]'''== The following section contains a list of process and outcome measures for adolescent bipolar spectrum disorder. The section includes benchmarks based on published norms and on mood samples for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the [[Evidence based assessment/Process phase|process phase]] of assessment. For more information on differences between process and outcome measures, see the page on the [[Evidence based assessment/Process phase|process phase of assessment]]. === Process measures === There are many processes that may be considered important when evaluating a child or an adolescent with Bipolar Disorder; however, due to the diversity of the population and symptom expression, there are too many to narrow down. Clinical judgment is recommended when deciding what additional measures should be included (e.g. executive functioning, sensory processing, cognitive flexibility). The measures provided below are commonly used to assess and provide important information regarding levels of daily functioning of individuals with Bipolar Disorder. {{blockquotetop}} '''A. Mood and Energy Thermometer'''- &nbsp; This is an improved and practical way of monitoring complex mood cycles and daily schedules. Given that some clinicians and patients may get confused about different 1 to 10 scales (e.g., a 10 could mean extreme depression, extreme mania, or no depression), the Mood & Energy Thermometer improves the language in communicating (and monitoring) mood. Moreover, many children report their energy levels more accurately than their mood and therefore, energy levels have been incorporated in this mood rating. The Mood & Energy Thermometer that was developed at Western Psychiatric Institute and Clinic (WPIC; and used in about 400 kids) rates mania and increased energy on a 1 to 10 scale, rates depression and tiredness on a -1 to -10 scale, and attempts to form a common language between patients, families, and clinicians. This scale also takes into account time spent depressed and/or manic; for example, -4 would mean “mild depression” and “mild tiredness” present ≥50% of the time, and -3 would mean “mild depression” and “mild tiredness” present < 50% of the time. The inclusion of measuring energy levels is consistent with the DSM-5, because energy level is now included in the DSM-5 as a main mood symptom criterion. Bipolar track patients (whether they had mania, depression, or mixed features) rated their mood and energy levels every day on this scale, and a master’s-level clinician met with them on a daily basis to help them better identify and record their mood symptoms, which has significant clinical value for not only treatment but also to prevent future episodes.<ref name=":3">{{Cite web|url=http://pediatricbipolar.pitt.edu/resources/instruments|title=Instruments {{!}} CABS {{!}} University of Pittsburgh|website=pediatricbipolar.pitt.edu|language=en|access-date=2018-05-31}}</ref> *[https://mfr.osf.io/render?url=https://osf.io/p4a8s/?action=download%26mode=render Mood and Energy Thermometer] *[https://mfr.osf.io/render?url=https://osf.io/upe2a/?action=download%26mode=render Mood and Energy Thermometer with Anger and Anxiety (with recording/monitoring card)] *[https://mfr.osf.io/render?url=https://osf.io/d2fge/?action=download%26mode=render Mood and Energy Thermometer with Anger and Anxiety - Simplified Version] '''B. Life Charts''' * To learn more about how life charts can be used with adolescent depression, [http://www.bipolarnews.org/Life%20Charting%20Description.htm see here] * [https://mfr.osf.io/render?url=https://osf.io/amq6k/?action=download%26mode=render Life Charts for Depression and Bipolar] {{blockquotebottom}} === Outcome and severity measures === * Information on how to interpret this table can be [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase found here]. * Additionally, these [[Evidence based assessment/Vignettes|vignettes]] might be helpful resources for understanding appropriate adaptation of outcome measures in practice. *For clinically significant change benchmarks for the CBCL, YSR, and TRF overall, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase&wteswitched=1#Clinically_significant_change_benchmarks_for_widely-used_outcome_measures see here.] ==== '''Clinically significant change benchmarks with common instruments for bipolar disorder in youth''' ==== {| class="wikitable sortable" | ! colspan="3" |Cut Scores ! colspan="3" |Critical Change (Unstandardized Scores) ![[w:Minimal important difference|Minimal]]<nowiki/>ly [[w:Minimal important difference|Important Difference]] |- !Measure !Away !Back !Closer !95% !90% !SEdifference !(MID) ''d'' ~.5 |- |[[General Behavior Inventory#GBI Short Forms|PGBI-10M]] |1 |9 |6 |6 |5 |3.2 |3 |- |[[Child Mania Rating Scale|CMRS 10]] |<nowiki>--</nowiki> |6 |4 |5 |4 |2.3 |2 |- |[[General Behavior Inventory#GBI Short Forms|PGBI-10Da]] |<nowiki>--</nowiki> |7 |4 |6 |5 |3.0 |3 |- |[[General Behavior Inventory#GBI Short Forms|PGBI-10Db]] |<nowiki>--</nowiki> |7 |4 |6 |5 |2.9 |3 |- |[[General Behavior Inventory#GBI Short Forms|AGBI-10M]] |<nowiki>--</nowiki> |14 |7 |6 |5 |3.1 |3 |- |[[General Behavior Inventory#GBI Short Forms|AGBI-10Da]] |<nowiki>--</nowiki> |18 |7 |6 |5 |3.2 |3 |- |[[General Behavior Inventory#GBI Short Forms|AGBI-10Db]] |<nowiki>--</nowiki> |16 |7 |6 |5 |2.9 |4 |- |[[General Behavior Inventory#GBI Short Forms|7 Up]] |<nowiki>--</nowiki> |8 |4 |4 |4 |2.2 |3 |- |[[General Behavior Inventory#GBI Short Forms|7 Down]] |<nowiki>--</nowiki> |12 |5 |5 |4 |2.3 |3 |- |[[w:Kiddie Schedule for Affective Disorders and Schizophrenia#KSADS%20Mania%20Rating%20Scale%20(KMRS)%20and%20Depression%20Rating%20Scale%20(KDRS)|KMRS]] |19 |19 |19 |3 |3 |1.6 |3 |- |[[w:Kiddie Schedule for Affective Disorders and Schizophrenia#KSADS%20Mania%20Rating%20Scale%20(KMRS)%20and%20Depression%20Rating%20Scale%20(KDRS)|KDRS]] |12 |19 |18 |5 |4 |2.4 |3 |- |CDRS-R Total |<nowiki>--</nowiki> |24 |22 |6 |5 |2.9 |5 |- |YMRS Total |4 |3 |3 |3 |3 |1.8 |3 |} <br /> {| class="wikitable sortable" border="1" |- | colspan="8" style="font-size:110%; text-align:center;" span |<b> Benchmarks Based on Published Norms</b> |- | rowspan="2" style="text-align:center;font-size:130%;" |<b> <big>Measure</big></b> | rowspan="2" style="text-align:center;font-size:130%;" |<b> <big>Subscale</big></b> | colspan="3" style="text-align:center;font-size:130%" width="300" |<b> <big>Cut-off scores</big></b> | colspan="3" style="text-align:center;font-size:120%" |<b> <big>Critical Change <br> (unstandardized scores)</big></b> |- | style="text-align:center;font-size:110%" |<b> A</b> | style="text-align:center;font-size:110%" |<b> B</b> | style="text-align:center;font-size:110%" |<b> C</b> | style="text-align:center;font-size:110%" |<b> 95%</b> | style="text-align:center;font-size:110%" |<b> 90%</b> | style="text-align:center;font-size:110%" |<b> SE_difference</b> |- | rowspan="1" style="text-align:center;" |<b> [http://www.sciencedirect.com/science/article/pii/0272735888900505 Beck Depression Inventory]<ref>{{cite journal|last=Beck|first=AT|title=Psychometric properties of the Beck Depression Inventory: Twenty-five years of evaluation.|journal=Clinical Psychology Review|date=1988|volume=8|issue=1|url=http://www.sciencedirect.com/science/article/pii/0272735888900505|accessdate=10 February 2014}}</ref></b> | style="text-align:right;" |<i> BDI Mixed Depression</i> | style="text-align:center;" | 4 | style="text-align:center;" | 22 | style="text-align:center;" | 15 | style="text-align:center;" | 9 | style="text-align:center;" | 8 | style="text-align:center;" | 4.8 |- |} === Treatment === ==== Psychotherapy ==== [[Psychotherapy|Psychotherapies]] are treatments that help people with a wide variety of mental health concerns. While different forms of psychotherapies for adolescent bipolar disorder aim to remedy different aspects of the disorder, all aim to alleviate symptoms and decrease functional impairment in the client. {| class="wikitable mw-collapsible" |+Overview of Psychotherapies !Therapy !Key components !Duration !Results |- |Child- and Family-Focused Cognitive-Behavioral Therapy | * Develop consistent routines * Learn to regulate emotions * Improve child's self-esteem and parent's self efficacy * Reduce negativity * Build social skills and networks * Teach parents self-care * Family-based problem solving and communication skill building | * 12 weeks long * 60-90 minute weekly sessions | * Decrease intensity of manic episodes * Decrease depressive symptoms in child * Overall improvement in client's functioning |- |Interpersonal and Social Rhythm Therapy | * Develop understanding of disruptions in routine and manic/depressive episodes * Build skills for creating consistent routines, aka, social rhythms * Build self-efficacy and phase out of therapy |Varies dependent on client need | * Increases time between manic/depressive episodes |- |Mindfulness-Based Cognitive Therapy | * Utilizes mindfulness-based practices such as mindfulness meditation * Focus on awareness of client's thoughts, feelings and behaviors * Learn to recognize how to monitor one's own thoughts * Increase self-care practices | * 8 weeks long * 60-120 minute weekly sessions | * Decrease in anxiety symptoms * Decrease in depressive symptoms * Increase mood regulation * Increase attention ability |- |Multi-Family Psychoeducational Psychotherapy |Group therapy using treatment components from: * Psychoeducation * Family Systems therapy * Cognitive-behavioral therapy | * 8 weeks long * 60-90 minute weekly sessions | * Decrease in severity of mood symptoms * Increase in caregiver understanding of child's disorder and how to seek mental health care * Children report feeling more social support from caregivers |} ===== Child- and Family-Focused Cognitive-Behavioral Family (CFF-CBT) ===== ====== Purpose ====== [[File:Cognitive Behavioral Cycle.jpg|thumb|357x357px|Cognitive behavioral cycle]] CFF-CBT was created to address the unique needs of bipolar disorder in children and adolescents with bipolar disorder, including rapid cycling, mixed mood states and comorbid disorders.<ref name=":0">{{Cite journal|last=West|first=Amy E.|last2=Weinstein|first2=Sally M.|last3=Peters|first3=Amy T.|last4=Katz|first4=Andrea C.|last5=Henry|first5=David B.|last6=Cruz|first6=Rick A.|last7=Pavuluri|first7=Mani N.|date=2014-11-01|title=Child- and Family-Focused Cognitive-Behavioral Therapy for Pediatric Bipolar Disorder: A Randomized Clinical Trial|url=https://jaacap.org/article/S0890-8567(14)00617-0/abstract|journal=Journal of the American Academy of Child & Adolescent Psychiatry|language=English|volume=53|issue=11|pages=1168–1178.e1|doi=10.1016/j.jaac.2014.08.013|issn=0890-8567|pmc=PMC4254579|pmid=25440307}}</ref> This treatment has been tested to see if it will help address the high suicide attempt rate among children/adolescents with the disorder, and no significant effects were found. However CFF-CBT has been found to be effective for 7-13 year olds with both clients with and without non-suicidal self-injury behaviors.<ref name=":1">{{Cite journal|last=MacPherson|first=Heather A.|last2=Weinstein|first2=Sally M.|last3=West|first3=Amy E.|date=2018-05-01|title=Non-Suicidal Self-Injury in Pediatric Bipolar Disorder: Clinical Correlates and Impact on Psychosocial Treatment Outcomes|url=https://doi.org/10.1007/s10802-017-0331-4|journal=Journal of Abnormal Child Psychology|language=en|volume=46|issue=4|pages=857–870|doi=10.1007/s10802-017-0331-4|issn=1573-2835}}</ref> Mediators of this intervention include: parenting skills and coping, family flexibility, and family positive reframing.<ref name=":2">{{Cite journal|last=Fristad|first=Mary A.|last2=MacPherson|first2=Heather A.|date=2014-05-01|title=Evidence-Based Psychosocial Treatments for Child and Adolescent Bipolar Spectrum Disorders|url=https://doi.org/10.1080/15374416.2013.822309|journal=Journal of Clinical Child & Adolescent Psychology|volume=43|issue=3|pages=339–355|doi=10.1080/15374416.2013.822309|issn=1537-4416|pmc=PMC3844106|pmid=23927375}}</ref> ====== Intended Population ====== Children aged 7-13 and adolescents aged 13-17 ====== Length of Treatment ====== 12 weekly sessions, with session time ranging from 60 to 90 minutes<ref name=":1" /><ref name=":0" /><ref name=":2" /> ====== Treatment Components ====== CFF-CBT focuses on 7 components comprising of the “RAINBOW” acronym<ref name=":0" />: ''R'': Routine; developing consistency ''A'': Affective regulation; includes psychoeducation on feelings, coping skills, and mood monitoring ''I'': “I can do it!”; this aims to improve self-esteem in the child, as well as self-efficacy in the parent ''N'': “No Negative Thoughts/Live in the Now” ''B'': Be a good friend/balanced life style (building social skills and teaching parents self-care ''O'': Oh, how do we solve this problem? (family-based problem solving and communication skills building) ''W'': Ways to find support (building a network of support) ====== Treatment Outcomes ====== CFF-CBT has shown decreases in mania to a subclinical level, parent-reported youth depressive symptoms, increased involvement/fidelity to treatment, and improvements in the client’s overall, global functioning in comparison to psychotherapy as per usual.<ref name=":1" /> <br /> ===== Interpersonal and Social Rhythm Therapy (IPSRT) ===== ====== Purpose ====== IPSRT is based on the social zeitgeber hypothesis<ref>{{Cite journal|last=Grandin|first=Louisa D.|last2=Alloy|first2=Lauren B.|last3=Abramson|first3=Lyn Y.|date=2006-10|title=The social zeitgeber theory, circadian rhythms, and mood disorders: Review and evaluation|url=https://linkinghub.elsevier.com/retrieve/pii/S0272735806000651|journal=Clinical Psychology Review|language=en|volume=26|issue=6|pages=679–694|doi=10.1016/j.cpr.2006.07.001}}</ref>, which states that regularity in social routines and interpersonal relationships acts as a protective factor for mood disorders. Thus, this treatment focused on maintaining regularity in daily routines, quality of social relationships and social roles, and management of consequences of rhythm disruptions.<ref>{{Cite journal|last=Frank|first=Ellen|last2=Kupfer|first2=David J.|last3=Thase|first3=Michael E.|last4=Mallinger|first4=Alan G.|last5=Swartz|first5=Holly A.|last6=Fagiolini|first6=Andrea M.|last7=Grochocinski|first7=Victoria|last8=Houck|first8=Patricia|last9=Scott|first9=John|date=2005-09-01|title=Two-Year Outcomes for Interpersonal and Social Rhythm Therapy in Individuals With Bipolar I Disorder|url=http://dx.doi.org/10.1001/archpsyc.62.9.996|journal=Archives of General Psychiatry|volume=62|issue=9|pages=996|doi=10.1001/archpsyc.62.9.996|issn=0003-990X}}</ref> ====== Intended Population ====== IPSRT is intended for all individuals with bipolar disorder, and has been found to be effective in adolescents.<ref name=":3">{{Cite journal|last=Crowe|first=Marie|last2=Inder|first2=Maree|last3=Joyce|first3=Peter|last4=Moor|first4=Stephanie|last5=Carter|first5=Janet|last6=Luty|first6=Sue|date=2009-01|title=A developmental approach to the treatment of bipolar disorder: IPSRT with an adolescent|url=http://doi.wiley.com/10.1111/j.1365-2702.2008.02571.x|journal=Journal of Clinical Nursing|language=en|volume=18|issue=1|pages=141–149|doi=10.1111/j.1365-2702.2008.02571.x}}</ref> ====== Length of Treatment ====== Length of treatment varies dependent on client needs.<ref name=":3" /> ====== Treatment Components ====== IPSRT is structured in three phases<ref name=":4">{{Cite web|url=https://www.ipsrt.org/background|title=Interpersonal and Social Rhythm Therapy {{!}} Background|website=www.ipsrt.org|access-date=2019-12-05}}</ref>: # Initial phase: Explores the clients history in order to explore links between disruptions in routines to affective episodes. This stage also includes education on the rationale of the treatment<ref name=":4" /> # Intermediate phase: Focused on reorganizing the client's social rhythms, reinforcing new social rhythms and building confidence in using techniques that are taught in the treatment<ref name=":4" /> # Final phase: Reduction in frequency of visits in order to work towards termination of therapy and self-efficacy<ref name=":4" /> ====== Treatment Outcomes ====== If applied early in the acute phase of bipolar disorder, IPSRT may prolong time to relapse in depressive/manic episodes.<ref name=":5">{{Cite journal|last=Miziou|first=Stella|last2=Tsitsipa|first2=Eirini|last3=Moysidou|first3=Stefania|last4=Karavelas|first4=Vangelis|last5=Dimelis|first5=Dimos|last6=Polyzoidou|first6=Vagia|last7=Fountoulakis|first7=Konstantinos N|date=2015-12|title=Psychosocial treatment and interventions for bipolar disorder: a systematic review|url=http://www.annals-general-psychiatry.com/content/14/1/19|journal=Annals of General Psychiatry|language=en|volume=14|issue=1|pages=19|doi=10.1186/s12991-015-0057-z|issn=1744-859X|pmc=PMC4493813|pmid=26155299}}</ref> ===== Mindfulness-Based Cognitive Therapy (MBCT) ===== ====== Purpose ====== Mindfulness approaches aim to enhance one’s ability to focus their attention on the present moment in a non-judgmental manor.<ref name=":5" /> In treatment for Bipolar Disorder, mindfulness approaches may focus on awareness of the client’s patterns of thoughts, feelings and bodily sensations both specific and non-specific to their experiences related to the disorder.<ref name=":5" /> Moreover, when comorbid with anxiety, bipolar disorder has higher risk of suicide attempts, therefore MBCT aims to decrease these anxiety symptoms.<ref name=":6">{{Cite journal|last=Williams|first=J. Mark G.|last2=Russell|first2=Ian|last3=Russell|first3=Daphne|date=2008-06|title=Mindfulness-based cognitive therapy: Further issues in current evidence and future research.|url=http://doi.apa.org/getdoi.cfm?doi=10.1037/0022-006X.76.3.524|journal=Journal of Consulting and Clinical Psychology|language=en|volume=76|issue=3|pages=524–529|doi=10.1037/0022-006X.76.3.524|issn=1939-2117|pmc=PMC2834575|pmid=18540746}}</ref> ====== Intended Population ====== MBCT is intended for all populations with bipolar disorder.<ref name=":6" /> ====== Length of Treatment ====== MPCT is typically offered in 1-2 hour weekly sessions over an 8-week period in a group setting (Perich et al 2012; Weber et al 2010).<ref>{{Cite journal|last=Perich|first=T.|last2=Manicavasagar|first2=V.|last3=Mitchell|first3=P. B.|last4=Ball|first4=J. R.|last5=Hadzi-Pavlovic|first5=D.|date=2012-12-09|title=A randomized controlled trial of mindfulness-based cognitive therapy for bipolar disorder|url=http://dx.doi.org/10.1111/acps.12033|journal=Acta Psychiatrica Scandinavica|volume=127|issue=5|pages=333–343|doi=10.1111/acps.12033|issn=0001-690X}}</ref><ref name=":7">{{Cite journal|last=Weber|first=B.|last2=Jermann|first2=F.|last3=Gex-Fabry|first3=M.|last4=Nallet|first4=A.|last5=Bondolfi|first5=G.|last6=Aubry|first6=J.-M.|date=2010-10|title=Mindfulness-based cognitive therapy for bipolar disorder: A feasibility trial|url=https://linkinghub.elsevier.com/retrieve/pii/S0924933810000817|journal=European Psychiatry|language=en|volume=25|issue=6|pages=334–337|doi=10.1016/j.eurpsy.2010.03.007}}</ref> Participants are also assigned homework, including varying lengths of meditation practice.<ref name=":7" /> ====== Treatment Components ====== MPCT combines aspects of classical CBT and mindfulness-based stress reduction therapies. The themes addressed in each session are<ref>{{Cite web|url=http://mbct.com/classes.html|title=Classes|website=mbct.com|access-date=2019-12-05}}</ref>: Session 1: Automatic pilot Session 2: Dealing with barriers Session 3: Mindfulness of the breath Session 4: Staying present Session 5: Allowing and letting be Session 6: Thoughts are not facts Session 7: How can I best take care of myself Session 8: Using what has been learned to deal with future moods ====== Treatment Outcomes ====== Treatment outcomes include decreases in anxiety and depressive symptoms and mood regulation in patients with bipolar disorder, but there has been no evidence in prevention of recurrences.<ref name=":5" /><ref name=":6" /> MBCT has also been found to improve attentional readiness, and attenuated activation of non-relevant information processing during attentional readiness, which are usually decreased in individuals with Bipolar Disorder compared to those without.<ref>{{Cite journal|last=Howells|first=Fleur M|last2=Ives-Deliperi|first2=Victoria L|last3=Horn|first3=Neil R|last4=Stein|first4=Dan J|date=2012-02-29|title=Mindfulness based cognitive therapy improves frontal control in bipolar disorder: a pilot EEG study|url=http://dx.doi.org/10.1186/1471-244x-12-15|journal=BMC Psychiatry|volume=12|issue=1|doi=10.1186/1471-244x-12-15|issn=1471-244X}}</ref> <br /> ===== Multi-Family Psychoeducational Psychotherapy (MF-PEP) ===== ====== Purpose ====== MF-PEP is a group-based evidence based treatment for children with bipolar disorder, which is meant to increase the ability for the treatment to be readily implemented into the community.<ref name=":8">{{Cite journal|last=MacPherson|first=Heather A.|last2=Leffler|first2=Jarrod M.|last3=Fristad|first3=Mary A.|date=2014|title=Implementation of Multi-Family Psychoeducational Psychotherapy for Childhood Mood Disorders in an Outpatient Community Setting|url=https://onlinelibrary.wiley.com/doi/abs/10.1111/jmft.12013|journal=Journal of Marital and Family Therapy|language=en|volume=40|issue=2|pages=193–211|doi=10.1111/jmft.12013|issn=1752-0606|pmc=PMC4198302|pmid=24749838}}</ref> While MF-PEP creates a support system within the family for the child through being a family-based intervention, it also serves to increase social support for care givers through being a group-based therapy. ====== Intended Population ====== MF-PEP is intended for children with depressive and bipolar disorders and their caretakers.<ref name=":8" /><ref name=":9">{{Cite journal|last=Fristad|first=Mary A.|last2=Verducci|first2=Joseph S.|last3=Walters|first3=Kimberly|last4=Young|first4=Matthew E.|date=2009-09-01|title=Impact of Multifamily Psychoeducational Psychotherapy in Treating Children Aged 8 to 12 Years With Mood Disorders|url=https://jamanetwork.com/journals/jamapsychiatry/fullarticle/210303|journal=Archives of General Psychiatry|language=en|volume=66|issue=9|pages=1013–1021|doi=10.1001/archgenpsychiatry.2009.112|issn=0003-990X}}</ref> ====== Length of Treatment ====== MF-PEP is an 8-session long treatment, with sessions typically ranging from 60-90 minutes. <ref name=":8" /><ref name=":9" /> ====== Treatment Components ====== MF-PEP combines [[wikipedia:Psychoeducation|psychoeducation]], [[wikipedia:Family_therapy|family systems]], and [[wikipedia:Cognitive_behavioral_therapy|cognitive behavior therapy]] techniques, aiming to target depressive and bipolar disorder symptoms and how these symptoms cause impairment. <ref name=":9" /> In MF-PEP, sessions are delivered in a combination of settings, including all children and parents together, as well as separating all children and caregivers into their own respective groups. <ref name=":9" /> ====== Treatment Outcomes ====== Treatment outcomes for MG-PEP include an increase in caregiver's understanding of the child's disorder, and a decrease in mood symptom severity within the children which has been seen to be maintained through an 18-month follow-up. <ref name=":10">{{Cite journal|last=MacPherson|first=Heather A.|last2=Leffler|first2=Jarrod M.|last3=Fristad|first3=Mary A.|date=2014|title=Implementation of Multi-Family Psychoeducational Psychotherapy for Childhood Mood Disorders in an Outpatient Community Setting|url=https://onlinelibrary.wiley.com/doi/abs/10.1111/jmft.12013|journal=Journal of Marital and Family Therapy|language=en|volume=40|issue=2|pages=193–211|doi=10.1111/jmft.12013|issn=1752-0606|pmc=PMC4198302|pmid=24749838}}</ref> Additionally, MF-PEP has been found to have a positive effect on parent's help-seeking behaviors for mental health care, leading to access to higher-quality services. <ref name=":10" /> Lastly, children report feeling a stronger sense of social support from their caregivers after participating in the intervention.<ref name=":9" /> ===== See Also: ===== * Wikipedia has a page reviewing [[wikipedia:Treatment_of_bipolar_disorder|treatments for bipolar disorder]]. * [http://www.effectivechildtherapy.com Effective Child Therapy] provides a curated list of effective psycho-social treatments for bipolar disorder in youths. * [https://icd.who.int/browse10/2015/en#/F31 ICD-10 Diagnostic Criteria] * [[wikipedia:Bipolar_disorder_in_children|Bipolar disorder in children]] * [https://onlinelibrary.wiley.com/doi/epdf/10.1111/bdi.12556 The International Society for Bipolar Disorders Task Force report on pediatric bipolar disorder: Knowledge to date and directions for future research] * [[wikipedia:Treatment_of_bipolar_disorder|Treatment of bipolar disorder]] =='''External resources'''== {{Infobox disease | name = Pediatric Bipolar Disorder | image = | Caption = Bipolar disorder consists of experiences of mania alternating with depressive episodes | DiseasesDB = 7812 | ICD10 = {{ICD10|F|31||f|30}} | ICD9 = {{ICD9|296.0}}, {{ICD9|296.1}}, {{ICD9|296.4}}, {{ICD9|296.5}}, {{ICD9|296.6}}, {{ICD9|296.7}}, {{ICD9|296.8}} | ICDO = | OMIM = 125480 | OMIM_mult = {{OMIM2|309200}} | MedlinePlus = 000926 | eMedicineSubj = med | eMedicineTopic = 229 | MeshID = D001714 }} #[http://www.nami.org/ National Alliance on Mental Illness] – the nation’s largest grassroots mental health organization dedicated to building better lives for the millions of Americans affected by mental illness. NAMI advocates for access to services, treatment, supports and research and is steadfast in its commitment to raise awareness and build a community for hope for all of those in need.<ref>{{cite web|last=NAMI: National Alliance on Mental Illness.|title=National Alliance on Mental Illness|url=http://www.nami.org/|accessdate=5 February 2014}}</ref> #[http://www.thebalancedmind.org Balanced Mind Foundation] – information, articles, parent support chat rooms.<ref>{{cite web|last=The Balanced Mind.|title=The Balanced Mind Parent Network.|url=http://www.thebalancedmind.org|accessdate=5 February 2014}}</ref> #[http://www.effectivechildtherapy.com Effective Child Therapy] – Information and articles curated by [https://sccap53.org Society of Clinical Child and Adolescent Psychology](SCCAP), a division of the American Psychological Association.<ref>{{cite web|last=Effective Child Therapy|title=Effective Child Therapy: Evidence-based mental health treatment for children and adolescents.|url=http://www.effectivechildtherapy.com|accessdate=5 February 2014}}</ref> ##[http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/severe-mood-swings-and-bipolar-spectrum-disorders/ Effective Child Therapy information: Bipolar Disorder] ##[http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/severe-mood-swings-and-bipolar-spectrum-disorders/ Effective Child Therapy information: Severe Mood Swings and Bipolar Spectrum Disorders] ##[http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/sadness-hopelessness-and-depression/ Effective Child Therapy information: Sadness, Hopelessness, and Depression] #[http://ibpf.org/resources International Bipolar Foundation] – information, help and resources available for caregivers and those afflicted with bipolar disorder.<ref>http://ibpf.org/resources, International Bipolar Foundation, retrieved 27th January 2014. </ref> #[http://www.bipolarnews.org Bipolar Network News] – an online clearinghouse and information on latest treatments, research and psychoeducation about mood disorders.<ref>http://bipolarnews.org/, Bipolar Network News, retrieved 30th January 2014. </ref> #[http://www.depressionalliance.org/ Depression Alliance] – a United Kingdom charity that works to prevent and relieve depression by providing information and support services via supporter services, publications and self-help groups.<ref>Depression Alliance, http://www.depressionalliance.org/, retrieved 30th January 2014. </ref> #[http://www.dbsalliance.org/site/PageServer?pagename=home Depression and Bipolar Support Alliance (DBSA)] – a peer-directed national organization that provides links to resources, support groups, and peer support for individuals and their families suffering from bipolar disorder. ##[https://unc.az1.qualtrics.com/jfe/form/SV_cBlUQk8Y85LHF41 Depression and Bipolar Support Alliance: 7 Up 7 Down Online Screener] #Related Wikipedia Pages ##[[wikipedia:Bipolar_disorder|Bipolar disorder Wikipedia Page]] ##[[wikipedia:Cyclothymia|Cyclothymia Wikipedia Page]] ##[[wikipedia:Mania|Mania Wikipedia Page]] ##[[wikipedia:Depression_(mood)|Depression Wikipedia Page]] #[https://www.massgeneral.org/psychiatry/services/treatmentprograms.aspx?id=1944&display=bipolar Massachusetts General Hospital School Psychiatry Resources for Bipolar Disorder] #The Psych Show with Dr. Ali Mattu videos ##[https://www.youtube.com/watch?v=llOPqKD-s4w How to Cope with Bipolar Disorder] ##[https://www.youtube.com/watch?v=kUHUmeqBZAA Top 10 Bipolar Myths] #[[Evidence Based Psychotherapies for Adolescent Bipolar Disorder]] =='''References'''== {{collapse top|Click here for references}} {{Reflist|30em}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] {{collapse bottom}} coabizk2l3ozvnpo1mm5d4v3wqndjki 2419191 2419190 2022-08-26T02:32:32Z Ardenguo 2944162 /* Gold standard diagnostic interviews */ Made the collapsible box expanded by default wikitext text/x-wiki <noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{psychology}}{{Evidence-based assessment}}{{medical disclaimer}} {{:{{BASEPAGENAME}}/Sidebar}} ==[[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio?"''']]== * For background information on what assessment portfolios are, click the link in the heading above. Want even 'more' information about this topic? There's an extended version of this page [[Evidence-based assessment/Bipolar disorder in youth (assessment portfolio)/extended version|here]]. == '''[[Evidence based assessment/Preparation phase|Preparation phase]]''' == === Diagnostic criteria for Pediatric Bipolar disorder === {{collapse top| More information on PBD diagnostic criteria|expand=yes}} *[[w:Bipolar_disorder_in_children|Pediatric bipolar disorder (PBD)]] is characterized by extreme fluctuations in mood or emotional dysregulation that range from mania (as shown by displays or feelings of extreme happiness, unrealistic overachievement, and anger) to depression (as shown by displays or feelings of sadness, changes in appetite or weight, and irritability<ref name="APA"> American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.</ref> <ref name="jamison"> Goodwin, F. K., & Jamison, K. R. (2007). ''Manic-depressive illness.'' (10th edition). New York, NY: Oxford University Press </ref>). *It is important to note that these moods exceed normal responses to life events, represent a change from the individual's normal functioning, and cause problems in daily activities. These mood fluctuations result in a child finding it difficult to live and interact with family, friends and teachers, when it was previously not an issue<ref name="APA" />. *People with [[w:Bipolar_disorder|bipolar disorder]] experience unusually intense emotional states that occur in distinct periods called [[w:Mood_(psychology)|"mood episodes".]] An overly joyful or overexcited state is called a manic episode, and an extremely sad or hopeless state is called a [[w:Major_depressive_episode|depressive episode]]. Sometimes, a mood episode includes symptoms of both [[w:Mania|mania]] and [[w:Depression_(mood)|depression]]. *People with bipolar disorder also may be explosive and irritable during a mood episode.<ref name="APA" /> **Extreme changes in energy, activity, sleep, and behavior go along with these changes in mood. *It is possible for someone with bipolar disorder to experience a long-lasting period of unstable moods rather than discrete episodes of depression or mania.<ref name="jamison" /> <ref name="APA" /> *A person may be having an episode of bipolar disorder if he or she has a number of manic or depressive symptoms for most of the day, nearly every day, for at least one or two weeks. These debilitating symptoms can result in an afflicted individual being unable to function adaptively in several settings. {{collapse bottom}} {{blockquotetop}} '''<big>ICD-10 Criteria</big>''' '''''F31 Bipolar affective disorder''''' *''Note.'' Episodes are demarcated by a switch to an episode of opposite or mixed polarity or by a remission. '''''F31.0 Bipolar affective disorder, current episode hypomanic''''' '''A.''' The current episode meets the criteria for '''Hypomania F30.0''': *'''''(A)''''' The mood is elevated or irritable to a degree that is definitely abnormal for the individual concerned and sustained for at least four consecutive days. *'''''(B)''''' At least three of the following signs must be present, leading to some interference with personal functioning in daily living *# Increased activity or physical restlessness; *# Increased talkativeness; *# Distractibility or difficulty in concentration; *# Decreased need for sleep; *# Increased sexual energy; *# Mild over-spending, or other types of reckless or irresponsible behavior; *# Increased sociability or over-familiarity. *'''''(C)''''' The episode does not meet the criteria for '''F30.1 Mania without psychotic symptoms''', '''F30.2 Mania with psychotic symptoms''', '''F31.- Bipolar affective disorder''', '''F32.- Depressive episode''', '''F34.0 Cyclothymia''', or '''F50.0 Anorexia nervosa'''. *'''''(D)''''' ''Most commonly used exclusion clause.'' The episode is not attributable to '''F10-F19 Psychoactive substance use''' or in the sense of any '''F00-F09 Organic mental disorder'''. '''B.''' There has been at least one other affective episode in the past, meeting the criteria for '''F30.- Hypomanic or Manic episode''', '''F32.Depressive episode''', or '''F38.00 Mixed affective episode.''' <big>'''Changes in DSM-5'''</big> The diagnostic criteria for bipolar disorders changed slightly from [[DSM-IV]] to [[w:Diagnostic_and_Statistical_Manual_of_Mental_Disorders#DSM-IV-TR_.282000.29|DSM-5]]. Summaries are available [http://www.dsm5.org/Documents/changes%20from%20dsm-iv-tr%20to%20dsm-5.pdf here] and [[w:DSM-5|here]]. {{blockquotebottom}} === Base rates of PBD in different clinical settings and populations === This section describes the demographic setting of the population(s) sampled, base rates of diagnosis, country/region sampled and the diagnostic method that was used. Using this information, clinicians will be able to anchor the rates of PBD that they are likely to see in their clinical practices. * '''''To find prevalence rates across multiple disorders,''''' [[Evidence based assessment/Preparation phase#Base rates for transdiagnostic comparison|'''''click here.''''']] {| class="wikitable sortable" border="1" |+ style="text-align: left;" | ''Base rates of BSD in different clinical settings'' |- ! scope="col" | Setting (Reference) ! scope="col" style="white-space: nowrap;"| Base Rate ! scope="col" | Demography ! scope="col" | Diagnostic Method !Recommended for... |- | Rates of Bipolar Disorders in General Population || 0.6% || '''Bipolar I''' in youths age 5 to 18 || Meta-analysis of epidemiological studies, 19 samples, N = 56,103 participants<ref name=":11">{{Cite journal|last=Van Meter|first=Anna|last2=Moreira|first2=Ana Lúcia R.|last3=Youngstrom|first3=Eric|date=2019-04-02|title=Updated Meta-Analysis of Epidemiologic Studies of Pediatric Bipolar Disorder|url=https://www.psychiatrist.com/JCP/article/Pages/2019/v80/18r12180.aspx|journal=The Journal of Clinical Psychiatry|volume=80|issue=3|doi=10.4088/JCP.18r12180|issn=1555-2101}}</ref> |Schools, nonclinical settings. Minimum for outpatient settings. |- | style="border: width: 1px; border-bottom: 3px solid grey; padding: 5px;" |Rates of bipolar spectrum (I, II, cyclothymia, NOS) in general population || style="border: width: 1px; border-bottom: 3px solid grey; padding: 5px;" | 3.9% || style="border: width: 1px; border-bottom: 3px solid grey; padding: 5px;" | '''Bipolar spectrum''' in youths age 5 to 18 years || style="border: width: 1px; border-bottom: 3px solid grey; padding: 5px;" | Meta-regression estimate <ref name=":11" /> |Schools, nonclinical settings. Minimum for outpatient settings. |- | High school epidemiological<br />(Lewinsohn et al., 2000) || 0.6% || Northwestern USA high school || KSADS-PL | |- |Community Mental Health Center<br />(E. A. Youngstrom et al., 2005) || 6% || Midwestern Urban, 80% non-white, low-income || Clinical interview & treatment | |- | General Outpatient Clinic;<br />(Geller, Zimerman, Williams, Delbello, Frazier, et al., 2002) || 6% to 8% || Urban academic research centers || WASH-U-KSADS | |- |County Wards (DCFS)<br />(Naylor, Anderson, Kruesi, & Stoewe, 2002, October) || 11% || State of Illinois || Clinical interview & treatment | |- | Specialty Outpatient Service<br />(Biederman et al., 1996) || 15-17% || New England || KSADS-E | |- |Incarcerated adolescents<br />(Teplin, Abram, McClelland, Dulcan, & Mericle, 2002) || 2% || Midwestern Urban || DISC | |- | Incarcerated adolescents<br />(Pliszka et al., 2000) || 22% || Texas || DISC | |- | Acute psychiatric hospitalizations<br />in 2002-2003 – <u>adolescents</u><br />(Blader & Carlson, 2007) || 21% || All of U.S.A. || Centers for Disease Control survey of discharge diagnoses | |- | Inpatient service<br />(Carlson & Youngstrom, 2003) || 30% manic symptoms,<br /><2% strict BP I || New York City Metro Region || DICA; KSADS | |- |Acute psychiatric hospitalizations<br />in 2002-2003 – <u>children</u><br />(Blader & Carlson, 2007) || 40% || All of U.S.A. || Centers for Disease Control survey of discharge diagnoses | |- |Psychiatric outpatient clinic<br />(Ghanizadeh, Mohammadi, & Yazdanshenas, 2006) || 16-17% || Iran || K-SADS-PL (Farsi) | |- |Inpatient and partial hospitalization programs at a psychiatric treatment center<br />(Pellegrini et al., 1986) || Mania (0%), hypomania (6%) || Richmond, Virginia || DISC | |- |} ^p Parent interviewed as component of diagnostic assessment; ^y youth interviewed as part of diagnostic assessment. ''Note:'' KSADS = Kiddie Schedule for Affective Disorders and Schizophrenia, PL = Present and Lifetime version, WASH-U = Washington University version, -E = Epidemiological version of the KSADS; DISC = Diagnostic Interview Schedule for Children; DICA = Diagnostic Interview for Children and Adolescents. Table modified from Wikiversity. {| class="wikitable sortable" border="1" |- ! Setting ! Base Rate ! Demography ! Diagnostic Method !Best Recommended For |- | Community epidemiological (NCS-A) <ref>{{cite journal|last1=Kessler|first1=Ronald C.|last2=Avenevoli|first2=Shelli|last3=Costello|first3=E. Jane|last4=Georgiades|first4=Katholiki|last5=Green|first5=Jennifer Greif|last6=Gruber|first6=Michael J.|last7=He|first7=Jian-ping|last8=Koretz|first8=Doreen|last9=McLaughlin|first9=Katie A.|last10=Petukhova|first10=Maria|last11=Sampson|first11=Nancy A.|last12=Zaslavsky|first12=Alan M.|last13=Merikangas|first13=Kathleen Ries|title=Prevalence, persistence, and sociodemographic correlates of DSM-IV disorders in the National Comorbidity Survey Replication Adolescent Supplement|journal=Archives of General Psychiatry|date=1 April 2012|volume=69|issue=4|pages=372–380|doi=10.1001/archgenpsychiatry.2011.160|url=http://www.ncbi.nlm.nih.gov/pubmed/22147808|accessdate=26 January 2016|issn=1538-3636}}</ref> | 3.0% | All of U.S.A. | CIDI 3.0 | |- | Community epidemiologic samples<ref>{{cite journal|last1=Van Meter|first1=Anna R.|last2=Moreira|first2=Ana Lúcia R.|last3=Youngstrom|first3=Eric A.|date=1 September 2011|title=Meta-analysis of epidemiologic studies of pediatric bipolar disorder|url=http://www.ncbi.nlm.nih.gov/pubmed/21672501|journal=The Journal of Clinical Psychiatry|volume=72|issue=9|pages=1250–1256|doi=10.4088/JCP.10m06290|issn=1555-2101}}</ref> |mean= 1.8% (95% CI, 1.1%–3.0%), bipolar I (mean =1.2%; 95% CI, 0.7%–1.9%) | U.S.A., Netherlands, U.K., Spain, Mexico, Ireland, New Zealand | Structured and semi-structured diagnostic interviews, Combination of broad and specific diagnostic criteria (Meta-Analysis) |Schools, nonclinical settings. Minimum for outpatient settings. |- |Community mental health center<ref>{{Cite journal|last=Youngstrom|first=Eric A.|last2=Findling|first2=Robert L.|last3=Youngstrom|first3=Jen Kogos|last4=Calabrese|first4=Joseph R.|date=September 2005|title=Toward an evidence-based assessment of pediatric bipolar disorder|url=https://www.ncbi.nlm.nih.gov/pubmed/16026213|journal=Journal of Clinical Child and Adolescent Psychology: The Official Journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 53|volume=34|issue=3|pages=433–448|doi=10.1207/s15374424jccp3403_4|issn=1537-4416|pmid=16026213}}</ref> |6% |U.S.A., Midwestern Urban, 80% non-white, low-income |Parent and youth clinical assessment & treatment | |- |General outpatient clinic<ref name=":1" /> |6-8% |Urban academic research centers |WASH-U-[[w:Kiddie Schedule for Affective Disorders and Schizophrenia|KSAD]]S (parent and youth) | |- |Specialty outpatient service<ref>{{Cite journal|last=Biederman|first=J.|last2=Faraone|first2=S.|last3=Mick|first3=E.|last4=Wozniak|first4=J.|last5=Chen|first5=L.|last6=Ouellette|first6=C.|last7=Marrs|first7=A.|last8=Moore|first8=P.|last9=Garcia|first9=J.|date=August 1996|title=Attention-deficit hyperactivity disorder and juvenile mania: an overlooked comorbidity?|url=https://www.ncbi.nlm.nih.gov/pubmed/8755796|journal=Journal of the American Academy of Child and Adolescent Psychiatry|volume=35|issue=8|pages=997–1008|doi=10.1097/00004583-199608000-00010|issn=0890-8567|pmid=8755796}}</ref> |15-17% |Boston area, U. S. A. |[[w:Kiddie Schedule for Affective Disorders and Schizophrenia|KSADS]]-E | |- | Inpatient Services/Diagnoses<ref>{{Cite journal|last=Holtmann|first=M.|last2=Goth|first2=K.|last3=Wöckel|first3=L.|last4=Poustka|first4=F.|last5=Bölte|first5=S.|date=2008|title=CBCL-pediatric bipolar disorder phenotype: severe ADHD or bipolar disorder?|url=https://www.ncbi.nlm.nih.gov/pubmed/17994189|journal=Journal of Neural Transmission (Vienna, Austria: 1996)|volume=115|issue=2|pages=155–161|doi=10.1007/s00702-007-0823-4|issn=0300-9564|pmid=17994189}}</ref> | 0.3% | All of Germany | [[w:International_Statistical_Classification_of_Diseases_and_Related_Health_Problems|International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10)]] | |- | Community sample<ref>{{cite journal|last1=Olino|first1=Thomas M.|last2=Shankman|first2=Stewart A.|last3=Klein|first3=Daniel N.|last4=Seeley|first4=John R.|last5=Pettit|first5=Jeremy W.|last6=Farmer|first6=Richard F.|last7=Lewinsohn|first7=Peter M.|date=1 September 2012|title=Lifetime rates of psychopathology in single versus multiple diagnostic assessments: Comparison in a community sample of probands and siblings|url=http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3411854/|journal=Journal of psychiatric research|volume=46|issue=9|pages=1217–1222|doi=10.1016/j.jpsychires.2012.05.017|issn=0022-3956}}</ref> | 2.9% | Oregon | LIFE, SCID, DSM-IV | |- | Inpatient service<ref>{{cite journal|last1=Carlson|first1=Gabrielle A.|last2=Youngstrom|first2=Eric A.|date=1 June 2003|title=Clinical implications of pervasive manic symptoms in children|url=http://www.ncbi.nlm.nih.gov/pubmed/12788250|journal=Biological Psychiatry|volume=53|issue=11|pages=1050–1058|issn=0006-3223}}</ref> | 30% manic symptoms, <2% strict BP I | New York City Metro Region | DICA; [[w:Kiddie Schedule for Affective Disorders and Schizophrenia|KSADS]] | |- |NCS-A Clinical Reappraisal Sample<ref name=":3" /> ^{p y} |6.2% and SE=1.7 (bipolar I and II and sub-threshold bipolar spectrum disorder) |U.S.A, NCS-A |[[w:Kiddie Schedule for Affective Disorders and Schizophrenia|K-SADS]], DSM-IV criteria were modified from published version for purpose of the study, broad criteria for not otherwise specified | | |- |NCS-A Clinical Reappraisal Sample<ref name=":3">{{Cite journal|last=Kessler|first=Ronald C.|last2=Avenevoli|first2=Shelli|last3=Green|first3=Jennifer|last4=Gruber|first4=Michael J.|last5=Guyer|first5=Margaret|last6=He|first6=Yulei|last7=Jin|first7=Robert|last8=Kaufman|first8=Joan|last9=Sampson|first9=Nancy A.|date=2009-04|title=National Comorbidity Survey Replication Adolescent Supplement (NCS-A): III. Concordance of DSM-IV/CIDI Diagnoses With Clinical Reassessments|url=http://linkinghub.elsevier.com/retrieve/pii/S0890856709600460|journal=Journal of the American Academy of Child & Adolescent Psychiatry|volume=48|issue=4|pages=386–399|doi=10.1097/chi.0b013e31819a1cbc|issn=0890-8567|pmc=PMC3040100|pmid=19252450}}</ref> ^p ^y |6.6% and SE=1.7 (bipolar I and II and sub-threshold bipolar spectrum disorder) |U.S.A, NCS-A |CIDI, DSM-IV criteria were modified from published version for purpose of the study, broad criteria for not otherwise specified, | |- |National Cross‐sectional epidemiological sample<ref>{{Cite journal|last=Stringaris|first=Argyris|last2=Santosh|first2=Paramala|last3=Leibenluft|first3=Ellen|last4=Goodman|first4=Robert|date=2009-07-22|title=Youth meeting symptom and impairment criteria for mania-like episodes lasting less than four days: an epidemiological enquiry|url=http://doi.wiley.com/10.1111/j.1469-7610.2009.02129.x|journal=Journal of Child Psychology and Psychiatry|language=en|volume=51|issue=1|pages=31–38|doi=10.1111/j.1469-7610.2009.02129.x|issn=0021-9630|pmc=PMC4286871|pmid=19686330}}</ref> ^p ^y |1.2% (bipolar I and II and not otherwise specified) |United Kingdom |DAWBA, DSM-IV criteria, broad criteria for not otherwise specified | |- |Community epidemiological samples<ref>{{Cite journal|last=Benjet|first=Corina|last2=Borges|first2=Guilherme|last3=Medina-Mora|first3=Maria Elena|last4=Zambrano|first4=Joaquin|last5=Aguilar-Gaxiola|first5=Sergio|date=2009-04|title=Youth mental health in a populous city of the developing world: results from the Mexican Adolescent Mental Health Survey|url=http://doi.wiley.com/10.1111/j.1469-7610.2008.01962.x|journal=Journal of Child Psychology and Psychiatry|language=en|volume=50|issue=4|pages=386–395|doi=10.1111/j.1469-7610.2008.01962.x|issn=0021-9630}}</ref> ^y |2.5% (bipolar I and II) |Mexico City |CIDI, DSM-IV Criteria | |- |2-stage epidemiological study<ref>{{Cite journal|last=Lynch|first=Fionnuala|last2=Mills|first2=Carla|last3=Daly|first3=Irenee|last4=Fitzpatrick|first4=Carol|date=2006-08|title=Challenging times: Prevalence of psychiatric disorders and suicidal behaviours in Irish adolescents|url=http://linkinghub.elsevier.com/retrieve/pii/S0140197105001004|journal=Journal of Adolescence|volume=29|issue=4|pages=555–573|doi=10.1016/j.adolescence.2005.08.011|issn=0140-1971}}</ref> ^{p y} |0.0% (bipolar I and II, cyclothymia, not otherwise specified |Ireland |[[w:Kiddie Schedule for Affective Disorders and Schizophrenia|K-SADS]], DSM-IV Criteria | |} ^p:Parent interviewed as component of diagnostic assessment; ^y:Youth interviewed as part of diagnostic assessment. ''Note:'' * KSADS = [[w:Schedule_for_Affective_Disorders_and_Schizophrenia#K-SADS|Kiddie Schedule for Affective Disorders and Schizophrenia]], * WASH-U = Washington University version, -PL = Present and Lifetime Version, -E = Epidemiological version of the KSADS * LIFE = Longitudinal Interval Follow-Up Evaluation, * DICA = Diagnostic Interview for Children and Adolescents *CIDI = Composite International Diagnostic Interview *DAWBA= The Development and Well-Being Assessment == '''[[Evidence based assessment/Prediction phase|Prediction phase]]''' == The following section contains a list of screening and diagnostic instruments for bipolar disorder in youth. This section includes administration information, psychometric data, and PDFs or links to the screenings. === Psychometric properties of screening instruments for pediatric bipolar disorder === * Screenings are used as part of the [[Evidence based assessment/Prediction phase|prediction phase]] of assessment; for more information on interpretation of this data, or how screenings fit in to the assessment process, click [[Evidence based assessment/Prediction phase|here.]] * '''''For a list of more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Common_screening_instruments click here.]''''' {| class="wikitable sortable" border="1" ! colspan="10" |Screening measures for bipolar disorder in youth |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time ! Interrater Reliability ! Test-Retest Reliability ! Construct Validity ! Content Validity ! Highly Recommended !Free and Accessible Measures |- | Children's Depression Inventory <nowiki>*</nowiki>not free | Self-report<ref name=":0">{{Cite web|url=https://www.pearsonclinical.com/psychology/products/100000636/childrens-depression-inventory-2-cdi-2.html|title=Children's Depression Inventory 2™|website=www.pearsonclinical.com|language=en-US|accessdate=2018-03-01}}</ref> | 7-17 | 15-20 minutes<ref name=":0" /> | NA | A | G | G | X |Not free |- | Mood and Feelings Questionnaire (MFQ) | Self-report | 7-18 | 5-10 minutes<ref>{{Cite web|url=http://www.cebc4cw.org/assessment-tool/mood-and-feelings-questionnaire-mfq/|title=CEBC » Assessment Tool › Mood And Feelings Questionnaire Mfq|website=www.cebc4cw.org|language=en|accessdate=2018-03-01}}</ref> | NA | A | G | A | X | *[https://mfr.osf.io/render?url=https://osf.io/enx4b/?action=download%26mode=render MFQ Child Self-Report Long Version] *[https://mfr.osf.io/render?url=https://osf.io/mcg5w/?action=download%26mode=render MFQ Child Self Report Short Version] *[https://mfr.osf.io/render?url=https://osf.io/cw27p/?action=download%26mode=render MFQ Parent Report On Child Long Version] *[https://mfr.osf.io/render?url=https://osf.io/kybr4/?action=download%26mode=render MFQ Parent Report On Child Short Version] |- | 7 Up 7 Down Inventory (7U7D) |Self-report<ref name=":5" /> | 11-86<ref>{{Cite journal|last=Mesman|first=E.|last2=Youngstrom|first2=E.A.|last3=Juliana|first3=N.K.|last4=Nolen|first4=W.A.|last5=Hillegers|first5=M.H.J.|date=2017-01|title=Validation of the Seven Up Seven Down Inventory in bipolar offspring: screening and prediction of mood disorders. Findings from the Dutch Bipolar Offspring Study|url=https://doi.org/10.1016/j.jad.2016.09.024|journal=Journal of Affective Disorders|volume=207|pages=95–101|doi=10.1016/j.jad.2016.09.024|issn=0165-0327}}</ref> |5-8 minutes | NA | | | | | * [https://mfr.osf.io/render?url=https://osf.io/s825e/?action=download%26mode=render 7U7D English] * [https://unc.az1.qualtrics.com/jfe/form/SV_cBlUQk8Y85LHF41 Depression and Bipolar Support Alliance (DBSA): 7U7D '''Online Screener'''] |- | Parent General Behavior-10 Item Version (PGBI-10M)<ref name=":6">{{Cite journal|last=Youngstrom|first=Eric A.|last2=Genzlinger|first2=Jacquelynne E.|last3=Egerton|first3=Gregory A.|last4=Meter|first4=Anna R. Van|title=Multivariate meta-analysis of the discriminative validity of caregiver, youth, and teacher rating scales for pediatric bipolar disorder: Mother knows best about mania.|url=http://dx.doi.org/10.1037/arc0000024|journal=Archives of Scientific Psychology|volume=3|issue=1|pages=112–137|doi=10.1037/arc0000024}}</ref> |Parent-report |5-18<ref name=":7">Youngstrom, E.A., Van Meter, A.R, Frazier, T.W., Youngstrom, J.K., & Findling, R.L. (in press). Developing and validating short forms of the Parent General Behavior Inventory Mania and Depression Scales for rating youth mood symptoms. ''Journal of Clinical Child & Adolescent Psychology.''</ref> |5-8 minutes | | | | | | * [https://mfr.osf.io/render?url=https://osf.io/ub8h7/?action=download%26mode=render Downloadable PDF Parent-Report English] |} '''Note:''' '''L''' = Less than adequate; '''A''' = Adequate; '''G''' = Good; '''E''' = Excellent; '''U''' = Unavailable; '''NA''' = Not applicable === Brief screening tools for PBD=== {{collapse top|expand=yes}} The following are brief screening tools that typically take less than 5 minutes to administer to accurately diagnose pediatric bipolar disorder: # '''''7 Up 7 Down Inventory (7U7D)''''' ## The [http://supp.apa.org/psycarticles/supplemental/a0033975/a0033975_supp.html 7 Up 7 Down Inventory]<ref name=":5">{{cite journal|last1=Youngstrom|first1=Eric A.|last2=Murray|first2=Greg|last3=Johnson|first3=Sheri L.|last4=Findling|first4=Robert L.|title=The 7 up 7 down inventory: a 14-item measure of manic and depressive tendencies carved from the General Behavior Inventory|journal=Psychological Assessment|date=1 December 2013|volume=25|issue=4|pages=1377–1383|doi=10.1037/a0033975|url=https://www.ncbi.nlm.nih.gov/pubmed/23914960|issn=1939-134X}}</ref> is a recently developed and validated questionnaire with 14 items of manic and depressive tendencies carved from the General Behavior Inventory, a well-validated but cumbersome interview. For both mania and depression factors, 7 items produced a psychometrically adequate measure applicable across both aggregate samples. Internal reliability of the Mania scale was .81 (youth) and .83 (adult) and for Depression was .93 (youth) and .95 (adult). ## The 7 Up 7 Down Inventory, along with the accompanying research article, can be [http://supp.apa.org/psycarticles/supplemental/a0033975/a0033975_supp.html found here]. # '''''[https://mfr.osf.io/render?url=https://osf.io/d95nv/?action=download%26mode=render PGBI-10M]'''''<ref>Youngstrom EA, Frazier TW, Demeter C, et al. Developing a 10-item mania scale from the Parent General Behavior Inventory for children and adolescents. J Clin Psychiatry. 2008;69(5):831–839.</ref> ## The [http://www.moodychildtherapy.com/wp-content/uploads/2011/01/PGBI-10M-2-wks.pdf PGBI-10M] (we would like to add another version that is better) is a brief (10 item) instrument derived from the [https://mfr.osf.io/render?url=https://osf.io/3j5r7/?action=download%26mode=render Parent General Behavior Inventory (PGBI)]<ref>{{Cite journal|last=Youngstrom|first=Eric A.|last2=Findling|first2=Robert L.|last3=Danielson|first3=Carla Kmett|last4=Calabrese|first4=Joseph R.|date=2001|title=Discriminative validity of parent report of hypomanic and depressive symptoms on the General Behavior Inventory.|url=http://psycnet.apa.org/doi/10.1037/1040-3590.13.2.267|journal=Psychological Assessment|language=en|volume=13|issue=2|pages=267–276|doi=10.1037/1040-3590.13.2.267|issn=1939-134X}}</ref>, a 73-item mood inventory, to assess [[mania]] in a large sample of outpatients presenting with a variety of different [[DSM-IV]] diagnoses, including frequent comorbid conditions.<ref name=":0">{{cite journal|last1=Youngstrom|first1=E. A.|last2=Findling|first2=R. L.|last3=Danielson|first3=C. K.|last4=Calabrese|first4=J. R.|title=Discriminative validity of parent report of hypomanic and depressive symptoms on the General Behavior Inventory|journal=Psychological Assessment|date=1 June 2001|volume=13|issue=2|pages=267–276|url=http://www.ncbi.nlm.nih.gov/pubmed/11433802|issn=1040-3590}}</ref> ## The 10-item GBI derived from the 73-item P-GBI had good reliability (alpha = .92), was correlated (r = 0.95) with the 28-item scale, and showed significantly better discrimination of bipolar disorders (area under the [[receiver operating characteristic]] [AUROC] curve of 0.856 vs. 0.832 for the 28-item scale, p < .005). The 10-item scale also did well discriminating bipolar disorder from unipolar depression (AUROC = 0.86) and bipolar disorder from [[attention deficit hyperactivity disorder|attention-deficit/hyperactivity disorder]] (AUROC = 0.82) cases. ## The full version of the scale, the Parent-General Behavior Inventory (P-GBI), is a parent-report measure of depressive and hypomanic/biphasic symptoms adapted from the General Behavior Inventory (GBI). ## Classification rates exceed 80%, and receiver operating characteristic analyses showed good diagnostic efficiency for the scales, with areas under the curve greater than .80. Results indicate that clinicians can use the parent-completed GBI to derive clinically meaningful information about mood disorders in youths. {{collapse bottom}} === Likelihood ratios and AUCs of screening measures for bipolar disorder in youth === * '''''For a list of the likelihood ratios for more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Likelihood_ratios_and_AUCs_of_common_screening_instruments click here.]''''' The following table describes the diagnostic likelihood ratios and area under curves for the top pediatric bipolar disorder measures. {| class="wikitable sortable" border="1" |- ! Screening Measure ! AUC (sample size) !Very Low risk range DiLR !Low risk range DiLR !Neutral risk range DiLR !High risk range DiLR !Very High risk range DiLR !DLR+ (score) !DLR- (score) ! Population/Clinical Generalizability !Download |- |[https://mfr.osf.io/render?url=https://osf.io/d3b4h/?action=download%26mode=render Parent General Behavior-10 Item Mania Version (PGBI-10M)]<ref name=":7" /> |.84 (''N''=617) academic sample, .78 community sample (''N''=530)<ref name=":7" /> |.07  (0 to 2.59)  |.41 (2.6 to 6.99) |1.44 (7 to 10.99)  |2.39 (11 to 17.99)  |5.38 (18+) | | |Bipolar spectrum vs. all other diagnoses |[https://mfr.osf.io/render?url=https://osf.io/ub8h7/?action=download%26mode=render Parent Form]<ref>{{Cite web|url=http://www.moodychildtherapy.com|title=Psychoeducational Psychotherapy|website=www.moodychildtherapy.com|language=en-US|access-date=2018-07-20}}</ref> |- |[https://mfr.osf.io/render?url=https://osf.io/eau89/?action=download%26mode=render Parent General Behavior-10 Item Depression Version Form A (PGBI-10Da)]<ref name=":7" /> |.84 (''N''=617) academic sample, .79 community sample (''N''=530)<ref name=":7" /> |.25  (0 to 1.99) |.71 (2 to 5.99)   |1.85 (6 to 9.99)   |4.52 (10 to 14.99) |8.80 (15+)   | | |Bipolar spectrum vs. all other diagnoses | |- |[https://mfr.osf.io/render?url=https://osf.io/eau89/?action=download%26mode=render Parent General Behavior-10 Item Depression Version Form B (PGBI-10Db)]<ref name=":7" /> |.84 (''N''=617) academic sample, .80 community sample (''N''=530)<ref name=":7" /> |.22 (0 to 1.99)    |.71 (2 to 5.99) |2.69 (6 to 10.99)    |5.64 (11 to 14.99)    |8.09 (15+) | | |Bipolar spectrum vs. all other diagnoses | |- |[https://mfr.osf.io/render?url=https://osf.io/hyb3g/?action=download%26mode=render Parent General Behavior Inventory] (P-GBI) (''Hypomanic/Biphasic Section''])<ref name="eay2004">Youngstrom, E. A., Findling, R. L., & Calabrese, J. R. (2004). Effects of adolescent manic symptoms on agreement between youth, parent, and teacher ratings of behavior problems. Journal of Affective Disorders, 82, S5-S16. </ref> | .84 (N=324) | |(<9) | | |(49+) |9.2 |.06 | Bipolar spectrum vs. all other diagnoses | |- | Parent Mood Disorder Questionnaire (P-MDQ)<ref>{{cite journal|last1=Wagner|first1=Karen Dineen|last2=Hirschfeld|first2=Robert M. A.|last3=Emslie|first3=Graham J.|last4=Findling|first4=Robert L.|last5=Gracious|first5=Barbara L.|last6=Reed|first6=Michael L.|date=1 May 2006|title=Validation of the Mood Disorder Questionnaire for bipolar disorders in adolescents|url=http://www.ncbi.nlm.nih.gov/pubmed/16841633|journal=The Journal of Clinical Psychiatry|volume=67|issue=5|pages=827–830|issn=0160-6689}}</ref> | .84 (N=819) | |(TBC) | | |(TBC) |4.64 |.17 | Bipolar spectrum vs. all other diagnoses | * [https://mfr.osf.io/render?url=https://osf.io/wtp7r/?action=download%26mode=render MDQ] |- | Child Mania Rating Scale (Brief) ''(Brief CMRS-P)''<ref name=":2">{{cite journal|last1=Henry|first1=David B.|last2=Pavuluri|first2=Mani N.|last3=Youngstrom|first3=Eric|last4=Birmaher|first4=Boris|date=1 April 2008|title=Accuracy of brief and full forms of the Child Mania Rating Scale|url=http://www.ncbi.nlm.nih.gov/pubmed/?term=18302291|journal=Journal of Clinical Psychology|volume=64|issue=4|pages=368–381|doi=10.1002/jclp.20464|issn=0021-9762}}</ref> | .85 (N=150) | |(<11) | | |(11+) |10.5 |.17 | Bipolar spectrum vs. ADHD | |- | Child Mania Rating Scale (Full) ''(Full CMRS-P)''<ref name=":2" /> | .91 (N=150) | |(<21) | | |(21+) |13.7 |.19 | Bipolar spectrum vs. ADHD | * [https://mfr.osf.io/render?url=https://osf.io/8wv3a/?action=download%26mode=render Downloadable PDF] |- |[https://mfr.osf.io/render?url=https://osf.io/5yzur/?action=download%26mode=render Child Bipolar Questionnaire] ''[https://mfr.osf.io/render?url=https://osf.io/5yzur/?action=download%26mode=render (CBQ-P)]''<ref>{{Cite journal|last=Papolos|first=Demitri|last2=Hennen|first2=John|last3=Cockerham|first3=Melissa S.|last4=Thode|first4=Henry C.|last5=Youngstrom|first5=Eric A.|date=2006-10|title=The child bipolar questionnaire: A dimensional approach to screening for pediatric bipolar disorder|url=https://doi.org/10.1016/j.jad.2006.03.026|journal=Journal of Affective Disorders|volume=95|issue=1-3|pages=149–158|doi=10.1016/j.jad.2006.03.026|issn=0165-0327}}</ref> |.74 (N=497) | | | | | |25.3/ (likelihood ratio +) |/.25 (likelihood ratio -) |Bipolar spectrum vs. all other diagnoses | |} === Interpreting bipolar disorder screening measure scores === For information on interpreting screening measure scores, click [[Evidence based assessment/Prediction phase#Interpreting screening measure scores|here.]] ==[[Evidence based assessment/Prescription phase|'''Prescription phase''']]== ===Gold standard diagnostic interviews=== For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews click here.] {{collapse top|More details on gold-standard diagnostic interviews|expand=yes}} # '''Kiddie Schedule for Affective Disorders and Schizophrenia-Present and Lifetime (KSADS-PL)''' #* The '''KSADS-PL''' is a semi-structured diagnostic interview that assesses current and past Diagnostic and Statistical Manual of Mental Disorders – Fourth Edition (DSM-IV-TR) Axis I psychopathology in youth<ref name="APA" />. The KSADS-PL diagnostic interviews have good inter-rater (.93 to 1.00) and retest reliability (.77) for mood disorders <ref>{{cite journal|last1=Kaufman|first1=J.|last2=Birmaher|first2=B.|last3=Brent|first3=D.|last4=Rao|first4=U.|last5=Flynn|first5=C.|last6=Moreci|first6=P.|last7=Williamson|first7=D.|last8=Ryan|first8=N.|title=Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (K-SADS-PL): initial reliability and validity data|journal=Journal of the American Academy of Child and Adolescent Psychiatry|date=1 July 1997|volume=36|issue=7|pages=980–988|doi=10.1097/00004583-199707000-00021|url=http://www.ncbi.nlm.nih.gov/pubmed/9204677|issn=0890-8567}}</ref> Here is a link to a PDF of the diagnostic interview for the [http://www.psychiatry.pitt.edu/sites/default/files/Documents/assessments/ksads-pl.pdf Kiddie Schedule for Affective Disorders and Schizophrenia-Present and Lifetime]. # '''Washington University in St. Louis Kiddie Schedule for Affective Disorders and Schizophrenia (WASH-U-KSADS)''' #* The '''[http://www.ncbi.nlm.nih.gov/pubmed/11314571 Washington University in St. Louis Kiddie Schedule for Affective Disorders and Schizophrenia]'''(WASH-U-KSADS)<ref name=":1">{{cite journal|last1=Geller|first1=B.|last2=Zimerman|first2=B.|last3=Williams|first3=M.|last4=Bolhofner|first4=K.|last5=Craney|first5=J. L.|last6=DelBello|first6=M. P.|last7=Soutullo|first7=C.|title=Reliability of the Washington University in St. Louis Kiddie Schedule for Affective Disorders and Schizophrenia (WASH-U-KSADS) mania and rapid cycling sections|journal=Journal of the American Academy of Child and Adolescent Psychiatry|date=1 April 2001|volume=40|issue=4|pages=450–455|doi=10.1097/00004583-200104000-00014|url=http://www.ncbi.nlm.nih.gov/pubmed/11314571|issn=0890-8567}}</ref> was expanded from the 1986 version of the KSADS, which was modified and expanded to include onset and offset of each symptom for both current and lifetime episodes, expanded prepubertal mania and rapid cycling sections, and categories for [[attention deficit hyperactivity disorder]] and other DSM-IV diagnoses. To optimize diagnostic research, skip-outs were minimized. #* The kappa values of comparisons between research nurse and off-site blind best-estimate ratings of mania and rapid cycling sections were excellent (0.74-1.00). High 6-month stability for mania diagnoses (85.7%) and for individual mania items and validity against parental and teacher reports were previously reported.<ref name=":1" /> #* The link to the diagnostic interview for the [http://www.psychiatry.pitt.edu/sites/default/files/Documents/assessments/mrs.pdf Washington University in St. Louis Kiddie Schedule for Affective Disorders and Schizophrenia] can be found [http://www.psychiatry.pitt.edu/sites/default/files/Documents/assessments/mrs.pdf here]. {{collapse bottom}} ===Recommended diagnostic instruments specific for pediatric bipolar disorder=== {| class="wikitable sortable" border="1" ! colspan="10" |Diagnostic instruments for '''(insert portfolio name)''' |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time ! Interrater Reliability ! Test-Retest Reliability ! Construct Validity ! Content Validity ! Highly Recommended !Free and Accessible Measures |- | Children's Depression Rating Scale - Revised (CDRS-R) | Structured Interview<ref name=":4">{{Cite journal|last=Mayes|first=Taryn L.|last2=Bernstein|first2=Ira H.|last3=Haley|first3=Charlotte L.|last4=Kennard|first4=Betsy D.|last5=Emslie|first5=Graham J.|date=2010-12|title=Psychometric Properties of the Children's Depression Rating Scale–Revised in Adolescents|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3003451/|journal=Journal of Child and Adolescent Psychopharmacology|volume=20|issue=6|pages=513–516|doi=10.1089/cap.2010.0063|issn=1044-5463|pmc=PMC3003451|pmid=21186970}}</ref> | 6-12 | 15-20 minutes | G | A | G | G | X | * Link to purchase [https://www.wpspublish.com/store/p/2703/cdrs-r-children-s-depression-rating-scale-revised#purchase-product CDRS-R] *[http://www.opapc.com/uploads/documents/CDRS-R.pdf PDF] (excerpt) |- | | | | | | | | | | |- | | | | | | | | | | |- | | | | | | | | | | |} '''Note:''' '''L''' = Less than adequate; '''A''' = Adequate; '''G''' = Good; '''E''' = Excellent; '''U''' = Unavailable; '''NA''' = Not applicable =='''[[Evidence based assessment/Process phase|Process phase]]'''== The following section contains a list of process and outcome measures for adolescent bipolar spectrum disorder. The section includes benchmarks based on published norms and on mood samples for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the [[Evidence based assessment/Process phase|process phase]] of assessment. For more information on differences between process and outcome measures, see the page on the [[Evidence based assessment/Process phase|process phase of assessment]]. === Process measures === There are many processes that may be considered important when evaluating a child or an adolescent with Bipolar Disorder; however, due to the diversity of the population and symptom expression, there are too many to narrow down. Clinical judgment is recommended when deciding what additional measures should be included (e.g. executive functioning, sensory processing, cognitive flexibility). The measures provided below are commonly used to assess and provide important information regarding levels of daily functioning of individuals with Bipolar Disorder. {{blockquotetop}} '''A. Mood and Energy Thermometer'''- &nbsp; This is an improved and practical way of monitoring complex mood cycles and daily schedules. Given that some clinicians and patients may get confused about different 1 to 10 scales (e.g., a 10 could mean extreme depression, extreme mania, or no depression), the Mood & Energy Thermometer improves the language in communicating (and monitoring) mood. Moreover, many children report their energy levels more accurately than their mood and therefore, energy levels have been incorporated in this mood rating. The Mood & Energy Thermometer that was developed at Western Psychiatric Institute and Clinic (WPIC; and used in about 400 kids) rates mania and increased energy on a 1 to 10 scale, rates depression and tiredness on a -1 to -10 scale, and attempts to form a common language between patients, families, and clinicians. This scale also takes into account time spent depressed and/or manic; for example, -4 would mean “mild depression” and “mild tiredness” present ≥50% of the time, and -3 would mean “mild depression” and “mild tiredness” present < 50% of the time. The inclusion of measuring energy levels is consistent with the DSM-5, because energy level is now included in the DSM-5 as a main mood symptom criterion. Bipolar track patients (whether they had mania, depression, or mixed features) rated their mood and energy levels every day on this scale, and a master’s-level clinician met with them on a daily basis to help them better identify and record their mood symptoms, which has significant clinical value for not only treatment but also to prevent future episodes.<ref name=":3">{{Cite web|url=http://pediatricbipolar.pitt.edu/resources/instruments|title=Instruments {{!}} CABS {{!}} University of Pittsburgh|website=pediatricbipolar.pitt.edu|language=en|access-date=2018-05-31}}</ref> *[https://mfr.osf.io/render?url=https://osf.io/p4a8s/?action=download%26mode=render Mood and Energy Thermometer] *[https://mfr.osf.io/render?url=https://osf.io/upe2a/?action=download%26mode=render Mood and Energy Thermometer with Anger and Anxiety (with recording/monitoring card)] *[https://mfr.osf.io/render?url=https://osf.io/d2fge/?action=download%26mode=render Mood and Energy Thermometer with Anger and Anxiety - Simplified Version] '''B. Life Charts''' * To learn more about how life charts can be used with adolescent depression, [http://www.bipolarnews.org/Life%20Charting%20Description.htm see here] * [https://mfr.osf.io/render?url=https://osf.io/amq6k/?action=download%26mode=render Life Charts for Depression and Bipolar] {{blockquotebottom}} === Outcome and severity measures === * Information on how to interpret this table can be [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase found here]. * Additionally, these [[Evidence based assessment/Vignettes|vignettes]] might be helpful resources for understanding appropriate adaptation of outcome measures in practice. *For clinically significant change benchmarks for the CBCL, YSR, and TRF overall, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase&wteswitched=1#Clinically_significant_change_benchmarks_for_widely-used_outcome_measures see here.] ==== '''Clinically significant change benchmarks with common instruments for bipolar disorder in youth''' ==== {| class="wikitable sortable" | ! colspan="3" |Cut Scores ! colspan="3" |Critical Change (Unstandardized Scores) ![[w:Minimal important difference|Minimal]]<nowiki/>ly [[w:Minimal important difference|Important Difference]] |- !Measure !Away !Back !Closer !95% !90% !SEdifference !(MID) ''d'' ~.5 |- |[[General Behavior Inventory#GBI Short Forms|PGBI-10M]] |1 |9 |6 |6 |5 |3.2 |3 |- |[[Child Mania Rating Scale|CMRS 10]] |<nowiki>--</nowiki> |6 |4 |5 |4 |2.3 |2 |- |[[General Behavior Inventory#GBI Short Forms|PGBI-10Da]] |<nowiki>--</nowiki> |7 |4 |6 |5 |3.0 |3 |- |[[General Behavior Inventory#GBI Short Forms|PGBI-10Db]] |<nowiki>--</nowiki> |7 |4 |6 |5 |2.9 |3 |- |[[General Behavior Inventory#GBI Short Forms|AGBI-10M]] |<nowiki>--</nowiki> |14 |7 |6 |5 |3.1 |3 |- |[[General Behavior Inventory#GBI Short Forms|AGBI-10Da]] |<nowiki>--</nowiki> |18 |7 |6 |5 |3.2 |3 |- |[[General Behavior Inventory#GBI Short Forms|AGBI-10Db]] |<nowiki>--</nowiki> |16 |7 |6 |5 |2.9 |4 |- |[[General Behavior Inventory#GBI Short Forms|7 Up]] |<nowiki>--</nowiki> |8 |4 |4 |4 |2.2 |3 |- |[[General Behavior Inventory#GBI Short Forms|7 Down]] |<nowiki>--</nowiki> |12 |5 |5 |4 |2.3 |3 |- |[[w:Kiddie Schedule for Affective Disorders and Schizophrenia#KSADS%20Mania%20Rating%20Scale%20(KMRS)%20and%20Depression%20Rating%20Scale%20(KDRS)|KMRS]] |19 |19 |19 |3 |3 |1.6 |3 |- |[[w:Kiddie Schedule for Affective Disorders and Schizophrenia#KSADS%20Mania%20Rating%20Scale%20(KMRS)%20and%20Depression%20Rating%20Scale%20(KDRS)|KDRS]] |12 |19 |18 |5 |4 |2.4 |3 |- |CDRS-R Total |<nowiki>--</nowiki> |24 |22 |6 |5 |2.9 |5 |- |YMRS Total |4 |3 |3 |3 |3 |1.8 |3 |} <br /> {| class="wikitable sortable" border="1" |- | colspan="8" style="font-size:110%; text-align:center;" span |<b> Benchmarks Based on Published Norms</b> |- | rowspan="2" style="text-align:center;font-size:130%;" |<b> <big>Measure</big></b> | rowspan="2" style="text-align:center;font-size:130%;" |<b> <big>Subscale</big></b> | colspan="3" style="text-align:center;font-size:130%" width="300" |<b> <big>Cut-off scores</big></b> | colspan="3" style="text-align:center;font-size:120%" |<b> <big>Critical Change <br> (unstandardized scores)</big></b> |- | style="text-align:center;font-size:110%" |<b> A</b> | style="text-align:center;font-size:110%" |<b> B</b> | style="text-align:center;font-size:110%" |<b> C</b> | style="text-align:center;font-size:110%" |<b> 95%</b> | style="text-align:center;font-size:110%" |<b> 90%</b> | style="text-align:center;font-size:110%" |<b> SE_difference</b> |- | rowspan="1" style="text-align:center;" |<b> [http://www.sciencedirect.com/science/article/pii/0272735888900505 Beck Depression Inventory]<ref>{{cite journal|last=Beck|first=AT|title=Psychometric properties of the Beck Depression Inventory: Twenty-five years of evaluation.|journal=Clinical Psychology Review|date=1988|volume=8|issue=1|url=http://www.sciencedirect.com/science/article/pii/0272735888900505|accessdate=10 February 2014}}</ref></b> | style="text-align:right;" |<i> BDI Mixed Depression</i> | style="text-align:center;" | 4 | style="text-align:center;" | 22 | style="text-align:center;" | 15 | style="text-align:center;" | 9 | style="text-align:center;" | 8 | style="text-align:center;" | 4.8 |- |} === Treatment === ==== Psychotherapy ==== [[Psychotherapy|Psychotherapies]] are treatments that help people with a wide variety of mental health concerns. While different forms of psychotherapies for adolescent bipolar disorder aim to remedy different aspects of the disorder, all aim to alleviate symptoms and decrease functional impairment in the client. {| class="wikitable mw-collapsible" |+Overview of Psychotherapies !Therapy !Key components !Duration !Results |- |Child- and Family-Focused Cognitive-Behavioral Therapy | * Develop consistent routines * Learn to regulate emotions * Improve child's self-esteem and parent's self efficacy * Reduce negativity * Build social skills and networks * Teach parents self-care * Family-based problem solving and communication skill building | * 12 weeks long * 60-90 minute weekly sessions | * Decrease intensity of manic episodes * Decrease depressive symptoms in child * Overall improvement in client's functioning |- |Interpersonal and Social Rhythm Therapy | * Develop understanding of disruptions in routine and manic/depressive episodes * Build skills for creating consistent routines, aka, social rhythms * Build self-efficacy and phase out of therapy |Varies dependent on client need | * Increases time between manic/depressive episodes |- |Mindfulness-Based Cognitive Therapy | * Utilizes mindfulness-based practices such as mindfulness meditation * Focus on awareness of client's thoughts, feelings and behaviors * Learn to recognize how to monitor one's own thoughts * Increase self-care practices | * 8 weeks long * 60-120 minute weekly sessions | * Decrease in anxiety symptoms * Decrease in depressive symptoms * Increase mood regulation * Increase attention ability |- |Multi-Family Psychoeducational Psychotherapy |Group therapy using treatment components from: * Psychoeducation * Family Systems therapy * Cognitive-behavioral therapy | * 8 weeks long * 60-90 minute weekly sessions | * Decrease in severity of mood symptoms * Increase in caregiver understanding of child's disorder and how to seek mental health care * Children report feeling more social support from caregivers |} ===== Child- and Family-Focused Cognitive-Behavioral Family (CFF-CBT) ===== ====== Purpose ====== [[File:Cognitive Behavioral Cycle.jpg|thumb|357x357px|Cognitive behavioral cycle]] CFF-CBT was created to address the unique needs of bipolar disorder in children and adolescents with bipolar disorder, including rapid cycling, mixed mood states and comorbid disorders.<ref name=":0">{{Cite journal|last=West|first=Amy E.|last2=Weinstein|first2=Sally M.|last3=Peters|first3=Amy T.|last4=Katz|first4=Andrea C.|last5=Henry|first5=David B.|last6=Cruz|first6=Rick A.|last7=Pavuluri|first7=Mani N.|date=2014-11-01|title=Child- and Family-Focused Cognitive-Behavioral Therapy for Pediatric Bipolar Disorder: A Randomized Clinical Trial|url=https://jaacap.org/article/S0890-8567(14)00617-0/abstract|journal=Journal of the American Academy of Child & Adolescent Psychiatry|language=English|volume=53|issue=11|pages=1168–1178.e1|doi=10.1016/j.jaac.2014.08.013|issn=0890-8567|pmc=PMC4254579|pmid=25440307}}</ref> This treatment has been tested to see if it will help address the high suicide attempt rate among children/adolescents with the disorder, and no significant effects were found. However CFF-CBT has been found to be effective for 7-13 year olds with both clients with and without non-suicidal self-injury behaviors.<ref name=":1">{{Cite journal|last=MacPherson|first=Heather A.|last2=Weinstein|first2=Sally M.|last3=West|first3=Amy E.|date=2018-05-01|title=Non-Suicidal Self-Injury in Pediatric Bipolar Disorder: Clinical Correlates and Impact on Psychosocial Treatment Outcomes|url=https://doi.org/10.1007/s10802-017-0331-4|journal=Journal of Abnormal Child Psychology|language=en|volume=46|issue=4|pages=857–870|doi=10.1007/s10802-017-0331-4|issn=1573-2835}}</ref> Mediators of this intervention include: parenting skills and coping, family flexibility, and family positive reframing.<ref name=":2">{{Cite journal|last=Fristad|first=Mary A.|last2=MacPherson|first2=Heather A.|date=2014-05-01|title=Evidence-Based Psychosocial Treatments for Child and Adolescent Bipolar Spectrum Disorders|url=https://doi.org/10.1080/15374416.2013.822309|journal=Journal of Clinical Child & Adolescent Psychology|volume=43|issue=3|pages=339–355|doi=10.1080/15374416.2013.822309|issn=1537-4416|pmc=PMC3844106|pmid=23927375}}</ref> ====== Intended Population ====== Children aged 7-13 and adolescents aged 13-17 ====== Length of Treatment ====== 12 weekly sessions, with session time ranging from 60 to 90 minutes<ref name=":1" /><ref name=":0" /><ref name=":2" /> ====== Treatment Components ====== CFF-CBT focuses on 7 components comprising of the “RAINBOW” acronym<ref name=":0" />: ''R'': Routine; developing consistency ''A'': Affective regulation; includes psychoeducation on feelings, coping skills, and mood monitoring ''I'': “I can do it!”; this aims to improve self-esteem in the child, as well as self-efficacy in the parent ''N'': “No Negative Thoughts/Live in the Now” ''B'': Be a good friend/balanced life style (building social skills and teaching parents self-care ''O'': Oh, how do we solve this problem? (family-based problem solving and communication skills building) ''W'': Ways to find support (building a network of support) ====== Treatment Outcomes ====== CFF-CBT has shown decreases in mania to a subclinical level, parent-reported youth depressive symptoms, increased involvement/fidelity to treatment, and improvements in the client’s overall, global functioning in comparison to psychotherapy as per usual.<ref name=":1" /> <br /> ===== Interpersonal and Social Rhythm Therapy (IPSRT) ===== ====== Purpose ====== IPSRT is based on the social zeitgeber hypothesis<ref>{{Cite journal|last=Grandin|first=Louisa D.|last2=Alloy|first2=Lauren B.|last3=Abramson|first3=Lyn Y.|date=2006-10|title=The social zeitgeber theory, circadian rhythms, and mood disorders: Review and evaluation|url=https://linkinghub.elsevier.com/retrieve/pii/S0272735806000651|journal=Clinical Psychology Review|language=en|volume=26|issue=6|pages=679–694|doi=10.1016/j.cpr.2006.07.001}}</ref>, which states that regularity in social routines and interpersonal relationships acts as a protective factor for mood disorders. Thus, this treatment focused on maintaining regularity in daily routines, quality of social relationships and social roles, and management of consequences of rhythm disruptions.<ref>{{Cite journal|last=Frank|first=Ellen|last2=Kupfer|first2=David J.|last3=Thase|first3=Michael E.|last4=Mallinger|first4=Alan G.|last5=Swartz|first5=Holly A.|last6=Fagiolini|first6=Andrea M.|last7=Grochocinski|first7=Victoria|last8=Houck|first8=Patricia|last9=Scott|first9=John|date=2005-09-01|title=Two-Year Outcomes for Interpersonal and Social Rhythm Therapy in Individuals With Bipolar I Disorder|url=http://dx.doi.org/10.1001/archpsyc.62.9.996|journal=Archives of General Psychiatry|volume=62|issue=9|pages=996|doi=10.1001/archpsyc.62.9.996|issn=0003-990X}}</ref> ====== Intended Population ====== IPSRT is intended for all individuals with bipolar disorder, and has been found to be effective in adolescents.<ref name=":3">{{Cite journal|last=Crowe|first=Marie|last2=Inder|first2=Maree|last3=Joyce|first3=Peter|last4=Moor|first4=Stephanie|last5=Carter|first5=Janet|last6=Luty|first6=Sue|date=2009-01|title=A developmental approach to the treatment of bipolar disorder: IPSRT with an adolescent|url=http://doi.wiley.com/10.1111/j.1365-2702.2008.02571.x|journal=Journal of Clinical Nursing|language=en|volume=18|issue=1|pages=141–149|doi=10.1111/j.1365-2702.2008.02571.x}}</ref> ====== Length of Treatment ====== Length of treatment varies dependent on client needs.<ref name=":3" /> ====== Treatment Components ====== IPSRT is structured in three phases<ref name=":4">{{Cite web|url=https://www.ipsrt.org/background|title=Interpersonal and Social Rhythm Therapy {{!}} Background|website=www.ipsrt.org|access-date=2019-12-05}}</ref>: # Initial phase: Explores the clients history in order to explore links between disruptions in routines to affective episodes. This stage also includes education on the rationale of the treatment<ref name=":4" /> # Intermediate phase: Focused on reorganizing the client's social rhythms, reinforcing new social rhythms and building confidence in using techniques that are taught in the treatment<ref name=":4" /> # Final phase: Reduction in frequency of visits in order to work towards termination of therapy and self-efficacy<ref name=":4" /> ====== Treatment Outcomes ====== If applied early in the acute phase of bipolar disorder, IPSRT may prolong time to relapse in depressive/manic episodes.<ref name=":5">{{Cite journal|last=Miziou|first=Stella|last2=Tsitsipa|first2=Eirini|last3=Moysidou|first3=Stefania|last4=Karavelas|first4=Vangelis|last5=Dimelis|first5=Dimos|last6=Polyzoidou|first6=Vagia|last7=Fountoulakis|first7=Konstantinos N|date=2015-12|title=Psychosocial treatment and interventions for bipolar disorder: a systematic review|url=http://www.annals-general-psychiatry.com/content/14/1/19|journal=Annals of General Psychiatry|language=en|volume=14|issue=1|pages=19|doi=10.1186/s12991-015-0057-z|issn=1744-859X|pmc=PMC4493813|pmid=26155299}}</ref> ===== Mindfulness-Based Cognitive Therapy (MBCT) ===== ====== Purpose ====== Mindfulness approaches aim to enhance one’s ability to focus their attention on the present moment in a non-judgmental manor.<ref name=":5" /> In treatment for Bipolar Disorder, mindfulness approaches may focus on awareness of the client’s patterns of thoughts, feelings and bodily sensations both specific and non-specific to their experiences related to the disorder.<ref name=":5" /> Moreover, when comorbid with anxiety, bipolar disorder has higher risk of suicide attempts, therefore MBCT aims to decrease these anxiety symptoms.<ref name=":6">{{Cite journal|last=Williams|first=J. Mark G.|last2=Russell|first2=Ian|last3=Russell|first3=Daphne|date=2008-06|title=Mindfulness-based cognitive therapy: Further issues in current evidence and future research.|url=http://doi.apa.org/getdoi.cfm?doi=10.1037/0022-006X.76.3.524|journal=Journal of Consulting and Clinical Psychology|language=en|volume=76|issue=3|pages=524–529|doi=10.1037/0022-006X.76.3.524|issn=1939-2117|pmc=PMC2834575|pmid=18540746}}</ref> ====== Intended Population ====== MBCT is intended for all populations with bipolar disorder.<ref name=":6" /> ====== Length of Treatment ====== MPCT is typically offered in 1-2 hour weekly sessions over an 8-week period in a group setting (Perich et al 2012; Weber et al 2010).<ref>{{Cite journal|last=Perich|first=T.|last2=Manicavasagar|first2=V.|last3=Mitchell|first3=P. B.|last4=Ball|first4=J. R.|last5=Hadzi-Pavlovic|first5=D.|date=2012-12-09|title=A randomized controlled trial of mindfulness-based cognitive therapy for bipolar disorder|url=http://dx.doi.org/10.1111/acps.12033|journal=Acta Psychiatrica Scandinavica|volume=127|issue=5|pages=333–343|doi=10.1111/acps.12033|issn=0001-690X}}</ref><ref name=":7">{{Cite journal|last=Weber|first=B.|last2=Jermann|first2=F.|last3=Gex-Fabry|first3=M.|last4=Nallet|first4=A.|last5=Bondolfi|first5=G.|last6=Aubry|first6=J.-M.|date=2010-10|title=Mindfulness-based cognitive therapy for bipolar disorder: A feasibility trial|url=https://linkinghub.elsevier.com/retrieve/pii/S0924933810000817|journal=European Psychiatry|language=en|volume=25|issue=6|pages=334–337|doi=10.1016/j.eurpsy.2010.03.007}}</ref> Participants are also assigned homework, including varying lengths of meditation practice.<ref name=":7" /> ====== Treatment Components ====== MPCT combines aspects of classical CBT and mindfulness-based stress reduction therapies. The themes addressed in each session are<ref>{{Cite web|url=http://mbct.com/classes.html|title=Classes|website=mbct.com|access-date=2019-12-05}}</ref>: Session 1: Automatic pilot Session 2: Dealing with barriers Session 3: Mindfulness of the breath Session 4: Staying present Session 5: Allowing and letting be Session 6: Thoughts are not facts Session 7: How can I best take care of myself Session 8: Using what has been learned to deal with future moods ====== Treatment Outcomes ====== Treatment outcomes include decreases in anxiety and depressive symptoms and mood regulation in patients with bipolar disorder, but there has been no evidence in prevention of recurrences.<ref name=":5" /><ref name=":6" /> MBCT has also been found to improve attentional readiness, and attenuated activation of non-relevant information processing during attentional readiness, which are usually decreased in individuals with Bipolar Disorder compared to those without.<ref>{{Cite journal|last=Howells|first=Fleur M|last2=Ives-Deliperi|first2=Victoria L|last3=Horn|first3=Neil R|last4=Stein|first4=Dan J|date=2012-02-29|title=Mindfulness based cognitive therapy improves frontal control in bipolar disorder: a pilot EEG study|url=http://dx.doi.org/10.1186/1471-244x-12-15|journal=BMC Psychiatry|volume=12|issue=1|doi=10.1186/1471-244x-12-15|issn=1471-244X}}</ref> <br /> ===== Multi-Family Psychoeducational Psychotherapy (MF-PEP) ===== ====== Purpose ====== MF-PEP is a group-based evidence based treatment for children with bipolar disorder, which is meant to increase the ability for the treatment to be readily implemented into the community.<ref name=":8">{{Cite journal|last=MacPherson|first=Heather A.|last2=Leffler|first2=Jarrod M.|last3=Fristad|first3=Mary A.|date=2014|title=Implementation of Multi-Family Psychoeducational Psychotherapy for Childhood Mood Disorders in an Outpatient Community Setting|url=https://onlinelibrary.wiley.com/doi/abs/10.1111/jmft.12013|journal=Journal of Marital and Family Therapy|language=en|volume=40|issue=2|pages=193–211|doi=10.1111/jmft.12013|issn=1752-0606|pmc=PMC4198302|pmid=24749838}}</ref> While MF-PEP creates a support system within the family for the child through being a family-based intervention, it also serves to increase social support for care givers through being a group-based therapy. ====== Intended Population ====== MF-PEP is intended for children with depressive and bipolar disorders and their caretakers.<ref name=":8" /><ref name=":9">{{Cite journal|last=Fristad|first=Mary A.|last2=Verducci|first2=Joseph S.|last3=Walters|first3=Kimberly|last4=Young|first4=Matthew E.|date=2009-09-01|title=Impact of Multifamily Psychoeducational Psychotherapy in Treating Children Aged 8 to 12 Years With Mood Disorders|url=https://jamanetwork.com/journals/jamapsychiatry/fullarticle/210303|journal=Archives of General Psychiatry|language=en|volume=66|issue=9|pages=1013–1021|doi=10.1001/archgenpsychiatry.2009.112|issn=0003-990X}}</ref> ====== Length of Treatment ====== MF-PEP is an 8-session long treatment, with sessions typically ranging from 60-90 minutes. <ref name=":8" /><ref name=":9" /> ====== Treatment Components ====== MF-PEP combines [[wikipedia:Psychoeducation|psychoeducation]], [[wikipedia:Family_therapy|family systems]], and [[wikipedia:Cognitive_behavioral_therapy|cognitive behavior therapy]] techniques, aiming to target depressive and bipolar disorder symptoms and how these symptoms cause impairment. <ref name=":9" /> In MF-PEP, sessions are delivered in a combination of settings, including all children and parents together, as well as separating all children and caregivers into their own respective groups. <ref name=":9" /> ====== Treatment Outcomes ====== Treatment outcomes for MG-PEP include an increase in caregiver's understanding of the child's disorder, and a decrease in mood symptom severity within the children which has been seen to be maintained through an 18-month follow-up. <ref name=":10">{{Cite journal|last=MacPherson|first=Heather A.|last2=Leffler|first2=Jarrod M.|last3=Fristad|first3=Mary A.|date=2014|title=Implementation of Multi-Family Psychoeducational Psychotherapy for Childhood Mood Disorders in an Outpatient Community Setting|url=https://onlinelibrary.wiley.com/doi/abs/10.1111/jmft.12013|journal=Journal of Marital and Family Therapy|language=en|volume=40|issue=2|pages=193–211|doi=10.1111/jmft.12013|issn=1752-0606|pmc=PMC4198302|pmid=24749838}}</ref> Additionally, MF-PEP has been found to have a positive effect on parent's help-seeking behaviors for mental health care, leading to access to higher-quality services. <ref name=":10" /> Lastly, children report feeling a stronger sense of social support from their caregivers after participating in the intervention.<ref name=":9" /> ===== See Also: ===== * Wikipedia has a page reviewing [[wikipedia:Treatment_of_bipolar_disorder|treatments for bipolar disorder]]. * [http://www.effectivechildtherapy.com Effective Child Therapy] provides a curated list of effective psycho-social treatments for bipolar disorder in youths. * [https://icd.who.int/browse10/2015/en#/F31 ICD-10 Diagnostic Criteria] * [[wikipedia:Bipolar_disorder_in_children|Bipolar disorder in children]] * [https://onlinelibrary.wiley.com/doi/epdf/10.1111/bdi.12556 The International Society for Bipolar Disorders Task Force report on pediatric bipolar disorder: Knowledge to date and directions for future research] * [[wikipedia:Treatment_of_bipolar_disorder|Treatment of bipolar disorder]] =='''External resources'''== {{Infobox disease | name = Pediatric Bipolar Disorder | image = | Caption = Bipolar disorder consists of experiences of mania alternating with depressive episodes | DiseasesDB = 7812 | ICD10 = {{ICD10|F|31||f|30}} | ICD9 = {{ICD9|296.0}}, {{ICD9|296.1}}, {{ICD9|296.4}}, {{ICD9|296.5}}, {{ICD9|296.6}}, {{ICD9|296.7}}, {{ICD9|296.8}} | ICDO = | OMIM = 125480 | OMIM_mult = {{OMIM2|309200}} | MedlinePlus = 000926 | eMedicineSubj = med | eMedicineTopic = 229 | MeshID = D001714 }} #[http://www.nami.org/ National Alliance on Mental Illness] – the nation’s largest grassroots mental health organization dedicated to building better lives for the millions of Americans affected by mental illness. NAMI advocates for access to services, treatment, supports and research and is steadfast in its commitment to raise awareness and build a community for hope for all of those in need.<ref>{{cite web|last=NAMI: National Alliance on Mental Illness.|title=National Alliance on Mental Illness|url=http://www.nami.org/|accessdate=5 February 2014}}</ref> #[http://www.thebalancedmind.org Balanced Mind Foundation] – information, articles, parent support chat rooms.<ref>{{cite web|last=The Balanced Mind.|title=The Balanced Mind Parent Network.|url=http://www.thebalancedmind.org|accessdate=5 February 2014}}</ref> #[http://www.effectivechildtherapy.com Effective Child Therapy] – Information and articles curated by [https://sccap53.org Society of Clinical Child and Adolescent Psychology](SCCAP), a division of the American Psychological Association.<ref>{{cite web|last=Effective Child Therapy|title=Effective Child Therapy: Evidence-based mental health treatment for children and adolescents.|url=http://www.effectivechildtherapy.com|accessdate=5 February 2014}}</ref> ##[http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/severe-mood-swings-and-bipolar-spectrum-disorders/ Effective Child Therapy information: Bipolar Disorder] ##[http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/severe-mood-swings-and-bipolar-spectrum-disorders/ Effective Child Therapy information: Severe Mood Swings and Bipolar Spectrum Disorders] ##[http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/sadness-hopelessness-and-depression/ Effective Child Therapy information: Sadness, Hopelessness, and Depression] #[http://ibpf.org/resources International Bipolar Foundation] – information, help and resources available for caregivers and those afflicted with bipolar disorder.<ref>http://ibpf.org/resources, International Bipolar Foundation, retrieved 27th January 2014. </ref> #[http://www.bipolarnews.org Bipolar Network News] – an online clearinghouse and information on latest treatments, research and psychoeducation about mood disorders.<ref>http://bipolarnews.org/, Bipolar Network News, retrieved 30th January 2014. </ref> #[http://www.depressionalliance.org/ Depression Alliance] – a United Kingdom charity that works to prevent and relieve depression by providing information and support services via supporter services, publications and self-help groups.<ref>Depression Alliance, http://www.depressionalliance.org/, retrieved 30th January 2014. </ref> #[http://www.dbsalliance.org/site/PageServer?pagename=home Depression and Bipolar Support Alliance (DBSA)] – a peer-directed national organization that provides links to resources, support groups, and peer support for individuals and their families suffering from bipolar disorder. ##[https://unc.az1.qualtrics.com/jfe/form/SV_cBlUQk8Y85LHF41 Depression and Bipolar Support Alliance: 7 Up 7 Down Online Screener] #Related Wikipedia Pages ##[[wikipedia:Bipolar_disorder|Bipolar disorder Wikipedia Page]] ##[[wikipedia:Cyclothymia|Cyclothymia Wikipedia Page]] ##[[wikipedia:Mania|Mania Wikipedia Page]] ##[[wikipedia:Depression_(mood)|Depression Wikipedia Page]] #[https://www.massgeneral.org/psychiatry/services/treatmentprograms.aspx?id=1944&display=bipolar Massachusetts General Hospital School Psychiatry Resources for Bipolar Disorder] #The Psych Show with Dr. Ali Mattu videos ##[https://www.youtube.com/watch?v=llOPqKD-s4w How to Cope with Bipolar Disorder] ##[https://www.youtube.com/watch?v=kUHUmeqBZAA Top 10 Bipolar Myths] #[[Evidence Based Psychotherapies for Adolescent Bipolar Disorder]] =='''References'''== {{collapse top|Click here for references}} {{Reflist|30em}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] {{collapse bottom}} lzzovnby6j8y964vrqz4w4k5q590egw 2419193 2419191 2022-08-26T02:33:12Z Ardenguo 2944162 /* References */ Made the references box expanded by default wikitext text/x-wiki <noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{psychology}}{{Evidence-based assessment}}{{medical disclaimer}} {{:{{BASEPAGENAME}}/Sidebar}} ==[[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio?"''']]== * For background information on what assessment portfolios are, click the link in the heading above. Want even 'more' information about this topic? There's an extended version of this page [[Evidence-based assessment/Bipolar disorder in youth (assessment portfolio)/extended version|here]]. == '''[[Evidence based assessment/Preparation phase|Preparation phase]]''' == === Diagnostic criteria for Pediatric Bipolar disorder === {{collapse top| More information on PBD diagnostic criteria|expand=yes}} *[[w:Bipolar_disorder_in_children|Pediatric bipolar disorder (PBD)]] is characterized by extreme fluctuations in mood or emotional dysregulation that range from mania (as shown by displays or feelings of extreme happiness, unrealistic overachievement, and anger) to depression (as shown by displays or feelings of sadness, changes in appetite or weight, and irritability<ref name="APA"> American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.</ref> <ref name="jamison"> Goodwin, F. K., & Jamison, K. R. (2007). ''Manic-depressive illness.'' (10th edition). New York, NY: Oxford University Press </ref>). *It is important to note that these moods exceed normal responses to life events, represent a change from the individual's normal functioning, and cause problems in daily activities. These mood fluctuations result in a child finding it difficult to live and interact with family, friends and teachers, when it was previously not an issue<ref name="APA" />. *People with [[w:Bipolar_disorder|bipolar disorder]] experience unusually intense emotional states that occur in distinct periods called [[w:Mood_(psychology)|"mood episodes".]] An overly joyful or overexcited state is called a manic episode, and an extremely sad or hopeless state is called a [[w:Major_depressive_episode|depressive episode]]. Sometimes, a mood episode includes symptoms of both [[w:Mania|mania]] and [[w:Depression_(mood)|depression]]. *People with bipolar disorder also may be explosive and irritable during a mood episode.<ref name="APA" /> **Extreme changes in energy, activity, sleep, and behavior go along with these changes in mood. *It is possible for someone with bipolar disorder to experience a long-lasting period of unstable moods rather than discrete episodes of depression or mania.<ref name="jamison" /> <ref name="APA" /> *A person may be having an episode of bipolar disorder if he or she has a number of manic or depressive symptoms for most of the day, nearly every day, for at least one or two weeks. These debilitating symptoms can result in an afflicted individual being unable to function adaptively in several settings. {{collapse bottom}} {{blockquotetop}} '''<big>ICD-10 Criteria</big>''' '''''F31 Bipolar affective disorder''''' *''Note.'' Episodes are demarcated by a switch to an episode of opposite or mixed polarity or by a remission. '''''F31.0 Bipolar affective disorder, current episode hypomanic''''' '''A.''' The current episode meets the criteria for '''Hypomania F30.0''': *'''''(A)''''' The mood is elevated or irritable to a degree that is definitely abnormal for the individual concerned and sustained for at least four consecutive days. *'''''(B)''''' At least three of the following signs must be present, leading to some interference with personal functioning in daily living *# Increased activity or physical restlessness; *# Increased talkativeness; *# Distractibility or difficulty in concentration; *# Decreased need for sleep; *# Increased sexual energy; *# Mild over-spending, or other types of reckless or irresponsible behavior; *# Increased sociability or over-familiarity. *'''''(C)''''' The episode does not meet the criteria for '''F30.1 Mania without psychotic symptoms''', '''F30.2 Mania with psychotic symptoms''', '''F31.- Bipolar affective disorder''', '''F32.- Depressive episode''', '''F34.0 Cyclothymia''', or '''F50.0 Anorexia nervosa'''. *'''''(D)''''' ''Most commonly used exclusion clause.'' The episode is not attributable to '''F10-F19 Psychoactive substance use''' or in the sense of any '''F00-F09 Organic mental disorder'''. '''B.''' There has been at least one other affective episode in the past, meeting the criteria for '''F30.- Hypomanic or Manic episode''', '''F32.Depressive episode''', or '''F38.00 Mixed affective episode.''' <big>'''Changes in DSM-5'''</big> The diagnostic criteria for bipolar disorders changed slightly from [[DSM-IV]] to [[w:Diagnostic_and_Statistical_Manual_of_Mental_Disorders#DSM-IV-TR_.282000.29|DSM-5]]. Summaries are available [http://www.dsm5.org/Documents/changes%20from%20dsm-iv-tr%20to%20dsm-5.pdf here] and [[w:DSM-5|here]]. {{blockquotebottom}} === Base rates of PBD in different clinical settings and populations === This section describes the demographic setting of the population(s) sampled, base rates of diagnosis, country/region sampled and the diagnostic method that was used. Using this information, clinicians will be able to anchor the rates of PBD that they are likely to see in their clinical practices. * '''''To find prevalence rates across multiple disorders,''''' [[Evidence based assessment/Preparation phase#Base rates for transdiagnostic comparison|'''''click here.''''']] {| class="wikitable sortable" border="1" |+ style="text-align: left;" | ''Base rates of BSD in different clinical settings'' |- ! scope="col" | Setting (Reference) ! scope="col" style="white-space: nowrap;"| Base Rate ! scope="col" | Demography ! scope="col" | Diagnostic Method !Recommended for... |- | Rates of Bipolar Disorders in General Population || 0.6% || '''Bipolar I''' in youths age 5 to 18 || Meta-analysis of epidemiological studies, 19 samples, N = 56,103 participants<ref name=":11">{{Cite journal|last=Van Meter|first=Anna|last2=Moreira|first2=Ana Lúcia R.|last3=Youngstrom|first3=Eric|date=2019-04-02|title=Updated Meta-Analysis of Epidemiologic Studies of Pediatric Bipolar Disorder|url=https://www.psychiatrist.com/JCP/article/Pages/2019/v80/18r12180.aspx|journal=The Journal of Clinical Psychiatry|volume=80|issue=3|doi=10.4088/JCP.18r12180|issn=1555-2101}}</ref> |Schools, nonclinical settings. Minimum for outpatient settings. |- | style="border: width: 1px; border-bottom: 3px solid grey; padding: 5px;" |Rates of bipolar spectrum (I, II, cyclothymia, NOS) in general population || style="border: width: 1px; border-bottom: 3px solid grey; padding: 5px;" | 3.9% || style="border: width: 1px; border-bottom: 3px solid grey; padding: 5px;" | '''Bipolar spectrum''' in youths age 5 to 18 years || style="border: width: 1px; border-bottom: 3px solid grey; padding: 5px;" | Meta-regression estimate <ref name=":11" /> |Schools, nonclinical settings. Minimum for outpatient settings. |- | High school epidemiological<br />(Lewinsohn et al., 2000) || 0.6% || Northwestern USA high school || KSADS-PL | |- |Community Mental Health Center<br />(E. A. Youngstrom et al., 2005) || 6% || Midwestern Urban, 80% non-white, low-income || Clinical interview & treatment | |- | General Outpatient Clinic;<br />(Geller, Zimerman, Williams, Delbello, Frazier, et al., 2002) || 6% to 8% || Urban academic research centers || WASH-U-KSADS | |- |County Wards (DCFS)<br />(Naylor, Anderson, Kruesi, & Stoewe, 2002, October) || 11% || State of Illinois || Clinical interview & treatment | |- | Specialty Outpatient Service<br />(Biederman et al., 1996) || 15-17% || New England || KSADS-E | |- |Incarcerated adolescents<br />(Teplin, Abram, McClelland, Dulcan, & Mericle, 2002) || 2% || Midwestern Urban || DISC | |- | Incarcerated adolescents<br />(Pliszka et al., 2000) || 22% || Texas || DISC | |- | Acute psychiatric hospitalizations<br />in 2002-2003 – <u>adolescents</u><br />(Blader & Carlson, 2007) || 21% || All of U.S.A. || Centers for Disease Control survey of discharge diagnoses | |- | Inpatient service<br />(Carlson & Youngstrom, 2003) || 30% manic symptoms,<br /><2% strict BP I || New York City Metro Region || DICA; KSADS | |- |Acute psychiatric hospitalizations<br />in 2002-2003 – <u>children</u><br />(Blader & Carlson, 2007) || 40% || All of U.S.A. || Centers for Disease Control survey of discharge diagnoses | |- |Psychiatric outpatient clinic<br />(Ghanizadeh, Mohammadi, & Yazdanshenas, 2006) || 16-17% || Iran || K-SADS-PL (Farsi) | |- |Inpatient and partial hospitalization programs at a psychiatric treatment center<br />(Pellegrini et al., 1986) || Mania (0%), hypomania (6%) || Richmond, Virginia || DISC | |- |} ^p Parent interviewed as component of diagnostic assessment; ^y youth interviewed as part of diagnostic assessment. ''Note:'' KSADS = Kiddie Schedule for Affective Disorders and Schizophrenia, PL = Present and Lifetime version, WASH-U = Washington University version, -E = Epidemiological version of the KSADS; DISC = Diagnostic Interview Schedule for Children; DICA = Diagnostic Interview for Children and Adolescents. Table modified from Wikiversity. {| class="wikitable sortable" border="1" |- ! Setting ! Base Rate ! Demography ! Diagnostic Method !Best Recommended For |- | Community epidemiological (NCS-A) <ref>{{cite journal|last1=Kessler|first1=Ronald C.|last2=Avenevoli|first2=Shelli|last3=Costello|first3=E. Jane|last4=Georgiades|first4=Katholiki|last5=Green|first5=Jennifer Greif|last6=Gruber|first6=Michael J.|last7=He|first7=Jian-ping|last8=Koretz|first8=Doreen|last9=McLaughlin|first9=Katie A.|last10=Petukhova|first10=Maria|last11=Sampson|first11=Nancy A.|last12=Zaslavsky|first12=Alan M.|last13=Merikangas|first13=Kathleen Ries|title=Prevalence, persistence, and sociodemographic correlates of DSM-IV disorders in the National Comorbidity Survey Replication Adolescent Supplement|journal=Archives of General Psychiatry|date=1 April 2012|volume=69|issue=4|pages=372–380|doi=10.1001/archgenpsychiatry.2011.160|url=http://www.ncbi.nlm.nih.gov/pubmed/22147808|accessdate=26 January 2016|issn=1538-3636}}</ref> | 3.0% | All of U.S.A. | CIDI 3.0 | |- | Community epidemiologic samples<ref>{{cite journal|last1=Van Meter|first1=Anna R.|last2=Moreira|first2=Ana Lúcia R.|last3=Youngstrom|first3=Eric A.|date=1 September 2011|title=Meta-analysis of epidemiologic studies of pediatric bipolar disorder|url=http://www.ncbi.nlm.nih.gov/pubmed/21672501|journal=The Journal of Clinical Psychiatry|volume=72|issue=9|pages=1250–1256|doi=10.4088/JCP.10m06290|issn=1555-2101}}</ref> |mean= 1.8% (95% CI, 1.1%–3.0%), bipolar I (mean =1.2%; 95% CI, 0.7%–1.9%) | U.S.A., Netherlands, U.K., Spain, Mexico, Ireland, New Zealand | Structured and semi-structured diagnostic interviews, Combination of broad and specific diagnostic criteria (Meta-Analysis) |Schools, nonclinical settings. Minimum for outpatient settings. |- |Community mental health center<ref>{{Cite journal|last=Youngstrom|first=Eric A.|last2=Findling|first2=Robert L.|last3=Youngstrom|first3=Jen Kogos|last4=Calabrese|first4=Joseph R.|date=September 2005|title=Toward an evidence-based assessment of pediatric bipolar disorder|url=https://www.ncbi.nlm.nih.gov/pubmed/16026213|journal=Journal of Clinical Child and Adolescent Psychology: The Official Journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 53|volume=34|issue=3|pages=433–448|doi=10.1207/s15374424jccp3403_4|issn=1537-4416|pmid=16026213}}</ref> |6% |U.S.A., Midwestern Urban, 80% non-white, low-income |Parent and youth clinical assessment & treatment | |- |General outpatient clinic<ref name=":1" /> |6-8% |Urban academic research centers |WASH-U-[[w:Kiddie Schedule for Affective Disorders and Schizophrenia|KSAD]]S (parent and youth) | |- |Specialty outpatient service<ref>{{Cite journal|last=Biederman|first=J.|last2=Faraone|first2=S.|last3=Mick|first3=E.|last4=Wozniak|first4=J.|last5=Chen|first5=L.|last6=Ouellette|first6=C.|last7=Marrs|first7=A.|last8=Moore|first8=P.|last9=Garcia|first9=J.|date=August 1996|title=Attention-deficit hyperactivity disorder and juvenile mania: an overlooked comorbidity?|url=https://www.ncbi.nlm.nih.gov/pubmed/8755796|journal=Journal of the American Academy of Child and Adolescent Psychiatry|volume=35|issue=8|pages=997–1008|doi=10.1097/00004583-199608000-00010|issn=0890-8567|pmid=8755796}}</ref> |15-17% |Boston area, U. S. A. |[[w:Kiddie Schedule for Affective Disorders and Schizophrenia|KSADS]]-E | |- | Inpatient Services/Diagnoses<ref>{{Cite journal|last=Holtmann|first=M.|last2=Goth|first2=K.|last3=Wöckel|first3=L.|last4=Poustka|first4=F.|last5=Bölte|first5=S.|date=2008|title=CBCL-pediatric bipolar disorder phenotype: severe ADHD or bipolar disorder?|url=https://www.ncbi.nlm.nih.gov/pubmed/17994189|journal=Journal of Neural Transmission (Vienna, Austria: 1996)|volume=115|issue=2|pages=155–161|doi=10.1007/s00702-007-0823-4|issn=0300-9564|pmid=17994189}}</ref> | 0.3% | All of Germany | [[w:International_Statistical_Classification_of_Diseases_and_Related_Health_Problems|International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10)]] | |- | Community sample<ref>{{cite journal|last1=Olino|first1=Thomas M.|last2=Shankman|first2=Stewart A.|last3=Klein|first3=Daniel N.|last4=Seeley|first4=John R.|last5=Pettit|first5=Jeremy W.|last6=Farmer|first6=Richard F.|last7=Lewinsohn|first7=Peter M.|date=1 September 2012|title=Lifetime rates of psychopathology in single versus multiple diagnostic assessments: Comparison in a community sample of probands and siblings|url=http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3411854/|journal=Journal of psychiatric research|volume=46|issue=9|pages=1217–1222|doi=10.1016/j.jpsychires.2012.05.017|issn=0022-3956}}</ref> | 2.9% | Oregon | LIFE, SCID, DSM-IV | |- | Inpatient service<ref>{{cite journal|last1=Carlson|first1=Gabrielle A.|last2=Youngstrom|first2=Eric A.|date=1 June 2003|title=Clinical implications of pervasive manic symptoms in children|url=http://www.ncbi.nlm.nih.gov/pubmed/12788250|journal=Biological Psychiatry|volume=53|issue=11|pages=1050–1058|issn=0006-3223}}</ref> | 30% manic symptoms, <2% strict BP I | New York City Metro Region | DICA; [[w:Kiddie Schedule for Affective Disorders and Schizophrenia|KSADS]] | |- |NCS-A Clinical Reappraisal Sample<ref name=":3" /> ^{p y} |6.2% and SE=1.7 (bipolar I and II and sub-threshold bipolar spectrum disorder) |U.S.A, NCS-A |[[w:Kiddie Schedule for Affective Disorders and Schizophrenia|K-SADS]], DSM-IV criteria were modified from published version for purpose of the study, broad criteria for not otherwise specified | | |- |NCS-A Clinical Reappraisal Sample<ref name=":3">{{Cite journal|last=Kessler|first=Ronald C.|last2=Avenevoli|first2=Shelli|last3=Green|first3=Jennifer|last4=Gruber|first4=Michael J.|last5=Guyer|first5=Margaret|last6=He|first6=Yulei|last7=Jin|first7=Robert|last8=Kaufman|first8=Joan|last9=Sampson|first9=Nancy A.|date=2009-04|title=National Comorbidity Survey Replication Adolescent Supplement (NCS-A): III. Concordance of DSM-IV/CIDI Diagnoses With Clinical Reassessments|url=http://linkinghub.elsevier.com/retrieve/pii/S0890856709600460|journal=Journal of the American Academy of Child & Adolescent Psychiatry|volume=48|issue=4|pages=386–399|doi=10.1097/chi.0b013e31819a1cbc|issn=0890-8567|pmc=PMC3040100|pmid=19252450}}</ref> ^p ^y |6.6% and SE=1.7 (bipolar I and II and sub-threshold bipolar spectrum disorder) |U.S.A, NCS-A |CIDI, DSM-IV criteria were modified from published version for purpose of the study, broad criteria for not otherwise specified, | |- |National Cross‐sectional epidemiological sample<ref>{{Cite journal|last=Stringaris|first=Argyris|last2=Santosh|first2=Paramala|last3=Leibenluft|first3=Ellen|last4=Goodman|first4=Robert|date=2009-07-22|title=Youth meeting symptom and impairment criteria for mania-like episodes lasting less than four days: an epidemiological enquiry|url=http://doi.wiley.com/10.1111/j.1469-7610.2009.02129.x|journal=Journal of Child Psychology and Psychiatry|language=en|volume=51|issue=1|pages=31–38|doi=10.1111/j.1469-7610.2009.02129.x|issn=0021-9630|pmc=PMC4286871|pmid=19686330}}</ref> ^p ^y |1.2% (bipolar I and II and not otherwise specified) |United Kingdom |DAWBA, DSM-IV criteria, broad criteria for not otherwise specified | |- |Community epidemiological samples<ref>{{Cite journal|last=Benjet|first=Corina|last2=Borges|first2=Guilherme|last3=Medina-Mora|first3=Maria Elena|last4=Zambrano|first4=Joaquin|last5=Aguilar-Gaxiola|first5=Sergio|date=2009-04|title=Youth mental health in a populous city of the developing world: results from the Mexican Adolescent Mental Health Survey|url=http://doi.wiley.com/10.1111/j.1469-7610.2008.01962.x|journal=Journal of Child Psychology and Psychiatry|language=en|volume=50|issue=4|pages=386–395|doi=10.1111/j.1469-7610.2008.01962.x|issn=0021-9630}}</ref> ^y |2.5% (bipolar I and II) |Mexico City |CIDI, DSM-IV Criteria | |- |2-stage epidemiological study<ref>{{Cite journal|last=Lynch|first=Fionnuala|last2=Mills|first2=Carla|last3=Daly|first3=Irenee|last4=Fitzpatrick|first4=Carol|date=2006-08|title=Challenging times: Prevalence of psychiatric disorders and suicidal behaviours in Irish adolescents|url=http://linkinghub.elsevier.com/retrieve/pii/S0140197105001004|journal=Journal of Adolescence|volume=29|issue=4|pages=555–573|doi=10.1016/j.adolescence.2005.08.011|issn=0140-1971}}</ref> ^{p y} |0.0% (bipolar I and II, cyclothymia, not otherwise specified |Ireland |[[w:Kiddie Schedule for Affective Disorders and Schizophrenia|K-SADS]], DSM-IV Criteria | |} ^p:Parent interviewed as component of diagnostic assessment; ^y:Youth interviewed as part of diagnostic assessment. ''Note:'' * KSADS = [[w:Schedule_for_Affective_Disorders_and_Schizophrenia#K-SADS|Kiddie Schedule for Affective Disorders and Schizophrenia]], * WASH-U = Washington University version, -PL = Present and Lifetime Version, -E = Epidemiological version of the KSADS * LIFE = Longitudinal Interval Follow-Up Evaluation, * DICA = Diagnostic Interview for Children and Adolescents *CIDI = Composite International Diagnostic Interview *DAWBA= The Development and Well-Being Assessment == '''[[Evidence based assessment/Prediction phase|Prediction phase]]''' == The following section contains a list of screening and diagnostic instruments for bipolar disorder in youth. This section includes administration information, psychometric data, and PDFs or links to the screenings. === Psychometric properties of screening instruments for pediatric bipolar disorder === * Screenings are used as part of the [[Evidence based assessment/Prediction phase|prediction phase]] of assessment; for more information on interpretation of this data, or how screenings fit in to the assessment process, click [[Evidence based assessment/Prediction phase|here.]] * '''''For a list of more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Common_screening_instruments click here.]''''' {| class="wikitable sortable" border="1" ! colspan="10" |Screening measures for bipolar disorder in youth |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time ! Interrater Reliability ! Test-Retest Reliability ! Construct Validity ! Content Validity ! Highly Recommended !Free and Accessible Measures |- | Children's Depression Inventory <nowiki>*</nowiki>not free | Self-report<ref name=":0">{{Cite web|url=https://www.pearsonclinical.com/psychology/products/100000636/childrens-depression-inventory-2-cdi-2.html|title=Children's Depression Inventory 2™|website=www.pearsonclinical.com|language=en-US|accessdate=2018-03-01}}</ref> | 7-17 | 15-20 minutes<ref name=":0" /> | NA | A | G | G | X |Not free |- | Mood and Feelings Questionnaire (MFQ) | Self-report | 7-18 | 5-10 minutes<ref>{{Cite web|url=http://www.cebc4cw.org/assessment-tool/mood-and-feelings-questionnaire-mfq/|title=CEBC » Assessment Tool › Mood And Feelings Questionnaire Mfq|website=www.cebc4cw.org|language=en|accessdate=2018-03-01}}</ref> | NA | A | G | A | X | *[https://mfr.osf.io/render?url=https://osf.io/enx4b/?action=download%26mode=render MFQ Child Self-Report Long Version] *[https://mfr.osf.io/render?url=https://osf.io/mcg5w/?action=download%26mode=render MFQ Child Self Report Short Version] *[https://mfr.osf.io/render?url=https://osf.io/cw27p/?action=download%26mode=render MFQ Parent Report On Child Long Version] *[https://mfr.osf.io/render?url=https://osf.io/kybr4/?action=download%26mode=render MFQ Parent Report On Child Short Version] |- | 7 Up 7 Down Inventory (7U7D) |Self-report<ref name=":5" /> | 11-86<ref>{{Cite journal|last=Mesman|first=E.|last2=Youngstrom|first2=E.A.|last3=Juliana|first3=N.K.|last4=Nolen|first4=W.A.|last5=Hillegers|first5=M.H.J.|date=2017-01|title=Validation of the Seven Up Seven Down Inventory in bipolar offspring: screening and prediction of mood disorders. Findings from the Dutch Bipolar Offspring Study|url=https://doi.org/10.1016/j.jad.2016.09.024|journal=Journal of Affective Disorders|volume=207|pages=95–101|doi=10.1016/j.jad.2016.09.024|issn=0165-0327}}</ref> |5-8 minutes | NA | | | | | * [https://mfr.osf.io/render?url=https://osf.io/s825e/?action=download%26mode=render 7U7D English] * [https://unc.az1.qualtrics.com/jfe/form/SV_cBlUQk8Y85LHF41 Depression and Bipolar Support Alliance (DBSA): 7U7D '''Online Screener'''] |- | Parent General Behavior-10 Item Version (PGBI-10M)<ref name=":6">{{Cite journal|last=Youngstrom|first=Eric A.|last2=Genzlinger|first2=Jacquelynne E.|last3=Egerton|first3=Gregory A.|last4=Meter|first4=Anna R. Van|title=Multivariate meta-analysis of the discriminative validity of caregiver, youth, and teacher rating scales for pediatric bipolar disorder: Mother knows best about mania.|url=http://dx.doi.org/10.1037/arc0000024|journal=Archives of Scientific Psychology|volume=3|issue=1|pages=112–137|doi=10.1037/arc0000024}}</ref> |Parent-report |5-18<ref name=":7">Youngstrom, E.A., Van Meter, A.R, Frazier, T.W., Youngstrom, J.K., & Findling, R.L. (in press). Developing and validating short forms of the Parent General Behavior Inventory Mania and Depression Scales for rating youth mood symptoms. ''Journal of Clinical Child & Adolescent Psychology.''</ref> |5-8 minutes | | | | | | * [https://mfr.osf.io/render?url=https://osf.io/ub8h7/?action=download%26mode=render Downloadable PDF Parent-Report English] |} '''Note:''' '''L''' = Less than adequate; '''A''' = Adequate; '''G''' = Good; '''E''' = Excellent; '''U''' = Unavailable; '''NA''' = Not applicable === Brief screening tools for PBD=== {{collapse top|expand=yes}} The following are brief screening tools that typically take less than 5 minutes to administer to accurately diagnose pediatric bipolar disorder: # '''''7 Up 7 Down Inventory (7U7D)''''' ## The [http://supp.apa.org/psycarticles/supplemental/a0033975/a0033975_supp.html 7 Up 7 Down Inventory]<ref name=":5">{{cite journal|last1=Youngstrom|first1=Eric A.|last2=Murray|first2=Greg|last3=Johnson|first3=Sheri L.|last4=Findling|first4=Robert L.|title=The 7 up 7 down inventory: a 14-item measure of manic and depressive tendencies carved from the General Behavior Inventory|journal=Psychological Assessment|date=1 December 2013|volume=25|issue=4|pages=1377–1383|doi=10.1037/a0033975|url=https://www.ncbi.nlm.nih.gov/pubmed/23914960|issn=1939-134X}}</ref> is a recently developed and validated questionnaire with 14 items of manic and depressive tendencies carved from the General Behavior Inventory, a well-validated but cumbersome interview. For both mania and depression factors, 7 items produced a psychometrically adequate measure applicable across both aggregate samples. Internal reliability of the Mania scale was .81 (youth) and .83 (adult) and for Depression was .93 (youth) and .95 (adult). ## The 7 Up 7 Down Inventory, along with the accompanying research article, can be [http://supp.apa.org/psycarticles/supplemental/a0033975/a0033975_supp.html found here]. # '''''[https://mfr.osf.io/render?url=https://osf.io/d95nv/?action=download%26mode=render PGBI-10M]'''''<ref>Youngstrom EA, Frazier TW, Demeter C, et al. Developing a 10-item mania scale from the Parent General Behavior Inventory for children and adolescents. J Clin Psychiatry. 2008;69(5):831–839.</ref> ## The [http://www.moodychildtherapy.com/wp-content/uploads/2011/01/PGBI-10M-2-wks.pdf PGBI-10M] (we would like to add another version that is better) is a brief (10 item) instrument derived from the [https://mfr.osf.io/render?url=https://osf.io/3j5r7/?action=download%26mode=render Parent General Behavior Inventory (PGBI)]<ref>{{Cite journal|last=Youngstrom|first=Eric A.|last2=Findling|first2=Robert L.|last3=Danielson|first3=Carla Kmett|last4=Calabrese|first4=Joseph R.|date=2001|title=Discriminative validity of parent report of hypomanic and depressive symptoms on the General Behavior Inventory.|url=http://psycnet.apa.org/doi/10.1037/1040-3590.13.2.267|journal=Psychological Assessment|language=en|volume=13|issue=2|pages=267–276|doi=10.1037/1040-3590.13.2.267|issn=1939-134X}}</ref>, a 73-item mood inventory, to assess [[mania]] in a large sample of outpatients presenting with a variety of different [[DSM-IV]] diagnoses, including frequent comorbid conditions.<ref name=":0">{{cite journal|last1=Youngstrom|first1=E. A.|last2=Findling|first2=R. L.|last3=Danielson|first3=C. K.|last4=Calabrese|first4=J. R.|title=Discriminative validity of parent report of hypomanic and depressive symptoms on the General Behavior Inventory|journal=Psychological Assessment|date=1 June 2001|volume=13|issue=2|pages=267–276|url=http://www.ncbi.nlm.nih.gov/pubmed/11433802|issn=1040-3590}}</ref> ## The 10-item GBI derived from the 73-item P-GBI had good reliability (alpha = .92), was correlated (r = 0.95) with the 28-item scale, and showed significantly better discrimination of bipolar disorders (area under the [[receiver operating characteristic]] [AUROC] curve of 0.856 vs. 0.832 for the 28-item scale, p < .005). The 10-item scale also did well discriminating bipolar disorder from unipolar depression (AUROC = 0.86) and bipolar disorder from [[attention deficit hyperactivity disorder|attention-deficit/hyperactivity disorder]] (AUROC = 0.82) cases. ## The full version of the scale, the Parent-General Behavior Inventory (P-GBI), is a parent-report measure of depressive and hypomanic/biphasic symptoms adapted from the General Behavior Inventory (GBI). ## Classification rates exceed 80%, and receiver operating characteristic analyses showed good diagnostic efficiency for the scales, with areas under the curve greater than .80. Results indicate that clinicians can use the parent-completed GBI to derive clinically meaningful information about mood disorders in youths. {{collapse bottom}} === Likelihood ratios and AUCs of screening measures for bipolar disorder in youth === * '''''For a list of the likelihood ratios for more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Likelihood_ratios_and_AUCs_of_common_screening_instruments click here.]''''' The following table describes the diagnostic likelihood ratios and area under curves for the top pediatric bipolar disorder measures. {| class="wikitable sortable" border="1" |- ! Screening Measure ! AUC (sample size) !Very Low risk range DiLR !Low risk range DiLR !Neutral risk range DiLR !High risk range DiLR !Very High risk range DiLR !DLR+ (score) !DLR- (score) ! Population/Clinical Generalizability !Download |- |[https://mfr.osf.io/render?url=https://osf.io/d3b4h/?action=download%26mode=render Parent General Behavior-10 Item Mania Version (PGBI-10M)]<ref name=":7" /> |.84 (''N''=617) academic sample, .78 community sample (''N''=530)<ref name=":7" /> |.07  (0 to 2.59)  |.41 (2.6 to 6.99) |1.44 (7 to 10.99)  |2.39 (11 to 17.99)  |5.38 (18+) | | |Bipolar spectrum vs. all other diagnoses |[https://mfr.osf.io/render?url=https://osf.io/ub8h7/?action=download%26mode=render Parent Form]<ref>{{Cite web|url=http://www.moodychildtherapy.com|title=Psychoeducational Psychotherapy|website=www.moodychildtherapy.com|language=en-US|access-date=2018-07-20}}</ref> |- |[https://mfr.osf.io/render?url=https://osf.io/eau89/?action=download%26mode=render Parent General Behavior-10 Item Depression Version Form A (PGBI-10Da)]<ref name=":7" /> |.84 (''N''=617) academic sample, .79 community sample (''N''=530)<ref name=":7" /> |.25  (0 to 1.99) |.71 (2 to 5.99)   |1.85 (6 to 9.99)   |4.52 (10 to 14.99) |8.80 (15+)   | | |Bipolar spectrum vs. all other diagnoses | |- |[https://mfr.osf.io/render?url=https://osf.io/eau89/?action=download%26mode=render Parent General Behavior-10 Item Depression Version Form B (PGBI-10Db)]<ref name=":7" /> |.84 (''N''=617) academic sample, .80 community sample (''N''=530)<ref name=":7" /> |.22 (0 to 1.99)    |.71 (2 to 5.99) |2.69 (6 to 10.99)    |5.64 (11 to 14.99)    |8.09 (15+) | | |Bipolar spectrum vs. all other diagnoses | |- |[https://mfr.osf.io/render?url=https://osf.io/hyb3g/?action=download%26mode=render Parent General Behavior Inventory] (P-GBI) (''Hypomanic/Biphasic Section''])<ref name="eay2004">Youngstrom, E. A., Findling, R. L., & Calabrese, J. R. (2004). Effects of adolescent manic symptoms on agreement between youth, parent, and teacher ratings of behavior problems. Journal of Affective Disorders, 82, S5-S16. </ref> | .84 (N=324) | |(<9) | | |(49+) |9.2 |.06 | Bipolar spectrum vs. all other diagnoses | |- | Parent Mood Disorder Questionnaire (P-MDQ)<ref>{{cite journal|last1=Wagner|first1=Karen Dineen|last2=Hirschfeld|first2=Robert M. A.|last3=Emslie|first3=Graham J.|last4=Findling|first4=Robert L.|last5=Gracious|first5=Barbara L.|last6=Reed|first6=Michael L.|date=1 May 2006|title=Validation of the Mood Disorder Questionnaire for bipolar disorders in adolescents|url=http://www.ncbi.nlm.nih.gov/pubmed/16841633|journal=The Journal of Clinical Psychiatry|volume=67|issue=5|pages=827–830|issn=0160-6689}}</ref> | .84 (N=819) | |(TBC) | | |(TBC) |4.64 |.17 | Bipolar spectrum vs. all other diagnoses | * [https://mfr.osf.io/render?url=https://osf.io/wtp7r/?action=download%26mode=render MDQ] |- | Child Mania Rating Scale (Brief) ''(Brief CMRS-P)''<ref name=":2">{{cite journal|last1=Henry|first1=David B.|last2=Pavuluri|first2=Mani N.|last3=Youngstrom|first3=Eric|last4=Birmaher|first4=Boris|date=1 April 2008|title=Accuracy of brief and full forms of the Child Mania Rating Scale|url=http://www.ncbi.nlm.nih.gov/pubmed/?term=18302291|journal=Journal of Clinical Psychology|volume=64|issue=4|pages=368–381|doi=10.1002/jclp.20464|issn=0021-9762}}</ref> | .85 (N=150) | |(<11) | | |(11+) |10.5 |.17 | Bipolar spectrum vs. ADHD | |- | Child Mania Rating Scale (Full) ''(Full CMRS-P)''<ref name=":2" /> | .91 (N=150) | |(<21) | | |(21+) |13.7 |.19 | Bipolar spectrum vs. ADHD | * [https://mfr.osf.io/render?url=https://osf.io/8wv3a/?action=download%26mode=render Downloadable PDF] |- |[https://mfr.osf.io/render?url=https://osf.io/5yzur/?action=download%26mode=render Child Bipolar Questionnaire] ''[https://mfr.osf.io/render?url=https://osf.io/5yzur/?action=download%26mode=render (CBQ-P)]''<ref>{{Cite journal|last=Papolos|first=Demitri|last2=Hennen|first2=John|last3=Cockerham|first3=Melissa S.|last4=Thode|first4=Henry C.|last5=Youngstrom|first5=Eric A.|date=2006-10|title=The child bipolar questionnaire: A dimensional approach to screening for pediatric bipolar disorder|url=https://doi.org/10.1016/j.jad.2006.03.026|journal=Journal of Affective Disorders|volume=95|issue=1-3|pages=149–158|doi=10.1016/j.jad.2006.03.026|issn=0165-0327}}</ref> |.74 (N=497) | | | | | |25.3/ (likelihood ratio +) |/.25 (likelihood ratio -) |Bipolar spectrum vs. all other diagnoses | |} === Interpreting bipolar disorder screening measure scores === For information on interpreting screening measure scores, click [[Evidence based assessment/Prediction phase#Interpreting screening measure scores|here.]] ==[[Evidence based assessment/Prescription phase|'''Prescription phase''']]== ===Gold standard diagnostic interviews=== For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews click here.] {{collapse top|More details on gold-standard diagnostic interviews|expand=yes}} # '''Kiddie Schedule for Affective Disorders and Schizophrenia-Present and Lifetime (KSADS-PL)''' #* The '''KSADS-PL''' is a semi-structured diagnostic interview that assesses current and past Diagnostic and Statistical Manual of Mental Disorders – Fourth Edition (DSM-IV-TR) Axis I psychopathology in youth<ref name="APA" />. The KSADS-PL diagnostic interviews have good inter-rater (.93 to 1.00) and retest reliability (.77) for mood disorders <ref>{{cite journal|last1=Kaufman|first1=J.|last2=Birmaher|first2=B.|last3=Brent|first3=D.|last4=Rao|first4=U.|last5=Flynn|first5=C.|last6=Moreci|first6=P.|last7=Williamson|first7=D.|last8=Ryan|first8=N.|title=Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (K-SADS-PL): initial reliability and validity data|journal=Journal of the American Academy of Child and Adolescent Psychiatry|date=1 July 1997|volume=36|issue=7|pages=980–988|doi=10.1097/00004583-199707000-00021|url=http://www.ncbi.nlm.nih.gov/pubmed/9204677|issn=0890-8567}}</ref> Here is a link to a PDF of the diagnostic interview for the [http://www.psychiatry.pitt.edu/sites/default/files/Documents/assessments/ksads-pl.pdf Kiddie Schedule for Affective Disorders and Schizophrenia-Present and Lifetime]. # '''Washington University in St. Louis Kiddie Schedule for Affective Disorders and Schizophrenia (WASH-U-KSADS)''' #* The '''[http://www.ncbi.nlm.nih.gov/pubmed/11314571 Washington University in St. Louis Kiddie Schedule for Affective Disorders and Schizophrenia]'''(WASH-U-KSADS)<ref name=":1">{{cite journal|last1=Geller|first1=B.|last2=Zimerman|first2=B.|last3=Williams|first3=M.|last4=Bolhofner|first4=K.|last5=Craney|first5=J. L.|last6=DelBello|first6=M. P.|last7=Soutullo|first7=C.|title=Reliability of the Washington University in St. Louis Kiddie Schedule for Affective Disorders and Schizophrenia (WASH-U-KSADS) mania and rapid cycling sections|journal=Journal of the American Academy of Child and Adolescent Psychiatry|date=1 April 2001|volume=40|issue=4|pages=450–455|doi=10.1097/00004583-200104000-00014|url=http://www.ncbi.nlm.nih.gov/pubmed/11314571|issn=0890-8567}}</ref> was expanded from the 1986 version of the KSADS, which was modified and expanded to include onset and offset of each symptom for both current and lifetime episodes, expanded prepubertal mania and rapid cycling sections, and categories for [[attention deficit hyperactivity disorder]] and other DSM-IV diagnoses. To optimize diagnostic research, skip-outs were minimized. #* The kappa values of comparisons between research nurse and off-site blind best-estimate ratings of mania and rapid cycling sections were excellent (0.74-1.00). High 6-month stability for mania diagnoses (85.7%) and for individual mania items and validity against parental and teacher reports were previously reported.<ref name=":1" /> #* The link to the diagnostic interview for the [http://www.psychiatry.pitt.edu/sites/default/files/Documents/assessments/mrs.pdf Washington University in St. Louis Kiddie Schedule for Affective Disorders and Schizophrenia] can be found [http://www.psychiatry.pitt.edu/sites/default/files/Documents/assessments/mrs.pdf here]. {{collapse bottom}} ===Recommended diagnostic instruments specific for pediatric bipolar disorder=== {| class="wikitable sortable" border="1" ! colspan="10" |Diagnostic instruments for '''(insert portfolio name)''' |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time ! Interrater Reliability ! Test-Retest Reliability ! Construct Validity ! Content Validity ! Highly Recommended !Free and Accessible Measures |- | Children's Depression Rating Scale - Revised (CDRS-R) | Structured Interview<ref name=":4">{{Cite journal|last=Mayes|first=Taryn L.|last2=Bernstein|first2=Ira H.|last3=Haley|first3=Charlotte L.|last4=Kennard|first4=Betsy D.|last5=Emslie|first5=Graham J.|date=2010-12|title=Psychometric Properties of the Children's Depression Rating Scale–Revised in Adolescents|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3003451/|journal=Journal of Child and Adolescent Psychopharmacology|volume=20|issue=6|pages=513–516|doi=10.1089/cap.2010.0063|issn=1044-5463|pmc=PMC3003451|pmid=21186970}}</ref> | 6-12 | 15-20 minutes | G | A | G | G | X | * Link to purchase [https://www.wpspublish.com/store/p/2703/cdrs-r-children-s-depression-rating-scale-revised#purchase-product CDRS-R] *[http://www.opapc.com/uploads/documents/CDRS-R.pdf PDF] (excerpt) |- | | | | | | | | | | |- | | | | | | | | | | |- | | | | | | | | | | |} '''Note:''' '''L''' = Less than adequate; '''A''' = Adequate; '''G''' = Good; '''E''' = Excellent; '''U''' = Unavailable; '''NA''' = Not applicable =='''[[Evidence based assessment/Process phase|Process phase]]'''== The following section contains a list of process and outcome measures for adolescent bipolar spectrum disorder. The section includes benchmarks based on published norms and on mood samples for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the [[Evidence based assessment/Process phase|process phase]] of assessment. For more information on differences between process and outcome measures, see the page on the [[Evidence based assessment/Process phase|process phase of assessment]]. === Process measures === There are many processes that may be considered important when evaluating a child or an adolescent with Bipolar Disorder; however, due to the diversity of the population and symptom expression, there are too many to narrow down. Clinical judgment is recommended when deciding what additional measures should be included (e.g. executive functioning, sensory processing, cognitive flexibility). The measures provided below are commonly used to assess and provide important information regarding levels of daily functioning of individuals with Bipolar Disorder. {{blockquotetop}} '''A. Mood and Energy Thermometer'''- &nbsp; This is an improved and practical way of monitoring complex mood cycles and daily schedules. Given that some clinicians and patients may get confused about different 1 to 10 scales (e.g., a 10 could mean extreme depression, extreme mania, or no depression), the Mood & Energy Thermometer improves the language in communicating (and monitoring) mood. Moreover, many children report their energy levels more accurately than their mood and therefore, energy levels have been incorporated in this mood rating. The Mood & Energy Thermometer that was developed at Western Psychiatric Institute and Clinic (WPIC; and used in about 400 kids) rates mania and increased energy on a 1 to 10 scale, rates depression and tiredness on a -1 to -10 scale, and attempts to form a common language between patients, families, and clinicians. This scale also takes into account time spent depressed and/or manic; for example, -4 would mean “mild depression” and “mild tiredness” present ≥50% of the time, and -3 would mean “mild depression” and “mild tiredness” present < 50% of the time. The inclusion of measuring energy levels is consistent with the DSM-5, because energy level is now included in the DSM-5 as a main mood symptom criterion. Bipolar track patients (whether they had mania, depression, or mixed features) rated their mood and energy levels every day on this scale, and a master’s-level clinician met with them on a daily basis to help them better identify and record their mood symptoms, which has significant clinical value for not only treatment but also to prevent future episodes.<ref name=":3">{{Cite web|url=http://pediatricbipolar.pitt.edu/resources/instruments|title=Instruments {{!}} CABS {{!}} University of Pittsburgh|website=pediatricbipolar.pitt.edu|language=en|access-date=2018-05-31}}</ref> *[https://mfr.osf.io/render?url=https://osf.io/p4a8s/?action=download%26mode=render Mood and Energy Thermometer] *[https://mfr.osf.io/render?url=https://osf.io/upe2a/?action=download%26mode=render Mood and Energy Thermometer with Anger and Anxiety (with recording/monitoring card)] *[https://mfr.osf.io/render?url=https://osf.io/d2fge/?action=download%26mode=render Mood and Energy Thermometer with Anger and Anxiety - Simplified Version] '''B. Life Charts''' * To learn more about how life charts can be used with adolescent depression, [http://www.bipolarnews.org/Life%20Charting%20Description.htm see here] * [https://mfr.osf.io/render?url=https://osf.io/amq6k/?action=download%26mode=render Life Charts for Depression and Bipolar] {{blockquotebottom}} === Outcome and severity measures === * Information on how to interpret this table can be [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase found here]. * Additionally, these [[Evidence based assessment/Vignettes|vignettes]] might be helpful resources for understanding appropriate adaptation of outcome measures in practice. *For clinically significant change benchmarks for the CBCL, YSR, and TRF overall, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase&wteswitched=1#Clinically_significant_change_benchmarks_for_widely-used_outcome_measures see here.] ==== '''Clinically significant change benchmarks with common instruments for bipolar disorder in youth''' ==== {| class="wikitable sortable" | ! colspan="3" |Cut Scores ! colspan="3" |Critical Change (Unstandardized Scores) ![[w:Minimal important difference|Minimal]]<nowiki/>ly [[w:Minimal important difference|Important Difference]] |- !Measure !Away !Back !Closer !95% !90% !SEdifference !(MID) ''d'' ~.5 |- |[[General Behavior Inventory#GBI Short Forms|PGBI-10M]] |1 |9 |6 |6 |5 |3.2 |3 |- |[[Child Mania Rating Scale|CMRS 10]] |<nowiki>--</nowiki> |6 |4 |5 |4 |2.3 |2 |- |[[General Behavior Inventory#GBI Short Forms|PGBI-10Da]] |<nowiki>--</nowiki> |7 |4 |6 |5 |3.0 |3 |- |[[General Behavior Inventory#GBI Short Forms|PGBI-10Db]] |<nowiki>--</nowiki> |7 |4 |6 |5 |2.9 |3 |- |[[General Behavior Inventory#GBI Short Forms|AGBI-10M]] |<nowiki>--</nowiki> |14 |7 |6 |5 |3.1 |3 |- |[[General Behavior Inventory#GBI Short Forms|AGBI-10Da]] |<nowiki>--</nowiki> |18 |7 |6 |5 |3.2 |3 |- |[[General Behavior Inventory#GBI Short Forms|AGBI-10Db]] |<nowiki>--</nowiki> |16 |7 |6 |5 |2.9 |4 |- |[[General Behavior Inventory#GBI Short Forms|7 Up]] |<nowiki>--</nowiki> |8 |4 |4 |4 |2.2 |3 |- |[[General Behavior Inventory#GBI Short Forms|7 Down]] |<nowiki>--</nowiki> |12 |5 |5 |4 |2.3 |3 |- |[[w:Kiddie Schedule for Affective Disorders and Schizophrenia#KSADS%20Mania%20Rating%20Scale%20(KMRS)%20and%20Depression%20Rating%20Scale%20(KDRS)|KMRS]] |19 |19 |19 |3 |3 |1.6 |3 |- |[[w:Kiddie Schedule for Affective Disorders and Schizophrenia#KSADS%20Mania%20Rating%20Scale%20(KMRS)%20and%20Depression%20Rating%20Scale%20(KDRS)|KDRS]] |12 |19 |18 |5 |4 |2.4 |3 |- |CDRS-R Total |<nowiki>--</nowiki> |24 |22 |6 |5 |2.9 |5 |- |YMRS Total |4 |3 |3 |3 |3 |1.8 |3 |} <br /> {| class="wikitable sortable" border="1" |- | colspan="8" style="font-size:110%; text-align:center;" span |<b> Benchmarks Based on Published Norms</b> |- | rowspan="2" style="text-align:center;font-size:130%;" |<b> <big>Measure</big></b> | rowspan="2" style="text-align:center;font-size:130%;" |<b> <big>Subscale</big></b> | colspan="3" style="text-align:center;font-size:130%" width="300" |<b> <big>Cut-off scores</big></b> | colspan="3" style="text-align:center;font-size:120%" |<b> <big>Critical Change <br> (unstandardized scores)</big></b> |- | style="text-align:center;font-size:110%" |<b> A</b> | style="text-align:center;font-size:110%" |<b> B</b> | style="text-align:center;font-size:110%" |<b> C</b> | style="text-align:center;font-size:110%" |<b> 95%</b> | style="text-align:center;font-size:110%" |<b> 90%</b> | style="text-align:center;font-size:110%" |<b> SE_difference</b> |- | rowspan="1" style="text-align:center;" |<b> [http://www.sciencedirect.com/science/article/pii/0272735888900505 Beck Depression Inventory]<ref>{{cite journal|last=Beck|first=AT|title=Psychometric properties of the Beck Depression Inventory: Twenty-five years of evaluation.|journal=Clinical Psychology Review|date=1988|volume=8|issue=1|url=http://www.sciencedirect.com/science/article/pii/0272735888900505|accessdate=10 February 2014}}</ref></b> | style="text-align:right;" |<i> BDI Mixed Depression</i> | style="text-align:center;" | 4 | style="text-align:center;" | 22 | style="text-align:center;" | 15 | style="text-align:center;" | 9 | style="text-align:center;" | 8 | style="text-align:center;" | 4.8 |- |} === Treatment === ==== Psychotherapy ==== [[Psychotherapy|Psychotherapies]] are treatments that help people with a wide variety of mental health concerns. While different forms of psychotherapies for adolescent bipolar disorder aim to remedy different aspects of the disorder, all aim to alleviate symptoms and decrease functional impairment in the client. {| class="wikitable mw-collapsible" |+Overview of Psychotherapies !Therapy !Key components !Duration !Results |- |Child- and Family-Focused Cognitive-Behavioral Therapy | * Develop consistent routines * Learn to regulate emotions * Improve child's self-esteem and parent's self efficacy * Reduce negativity * Build social skills and networks * Teach parents self-care * Family-based problem solving and communication skill building | * 12 weeks long * 60-90 minute weekly sessions | * Decrease intensity of manic episodes * Decrease depressive symptoms in child * Overall improvement in client's functioning |- |Interpersonal and Social Rhythm Therapy | * Develop understanding of disruptions in routine and manic/depressive episodes * Build skills for creating consistent routines, aka, social rhythms * Build self-efficacy and phase out of therapy |Varies dependent on client need | * Increases time between manic/depressive episodes |- |Mindfulness-Based Cognitive Therapy | * Utilizes mindfulness-based practices such as mindfulness meditation * Focus on awareness of client's thoughts, feelings and behaviors * Learn to recognize how to monitor one's own thoughts * Increase self-care practices | * 8 weeks long * 60-120 minute weekly sessions | * Decrease in anxiety symptoms * Decrease in depressive symptoms * Increase mood regulation * Increase attention ability |- |Multi-Family Psychoeducational Psychotherapy |Group therapy using treatment components from: * Psychoeducation * Family Systems therapy * Cognitive-behavioral therapy | * 8 weeks long * 60-90 minute weekly sessions | * Decrease in severity of mood symptoms * Increase in caregiver understanding of child's disorder and how to seek mental health care * Children report feeling more social support from caregivers |} ===== Child- and Family-Focused Cognitive-Behavioral Family (CFF-CBT) ===== ====== Purpose ====== [[File:Cognitive Behavioral Cycle.jpg|thumb|357x357px|Cognitive behavioral cycle]] CFF-CBT was created to address the unique needs of bipolar disorder in children and adolescents with bipolar disorder, including rapid cycling, mixed mood states and comorbid disorders.<ref name=":0">{{Cite journal|last=West|first=Amy E.|last2=Weinstein|first2=Sally M.|last3=Peters|first3=Amy T.|last4=Katz|first4=Andrea C.|last5=Henry|first5=David B.|last6=Cruz|first6=Rick A.|last7=Pavuluri|first7=Mani N.|date=2014-11-01|title=Child- and Family-Focused Cognitive-Behavioral Therapy for Pediatric Bipolar Disorder: A Randomized Clinical Trial|url=https://jaacap.org/article/S0890-8567(14)00617-0/abstract|journal=Journal of the American Academy of Child & Adolescent Psychiatry|language=English|volume=53|issue=11|pages=1168–1178.e1|doi=10.1016/j.jaac.2014.08.013|issn=0890-8567|pmc=PMC4254579|pmid=25440307}}</ref> This treatment has been tested to see if it will help address the high suicide attempt rate among children/adolescents with the disorder, and no significant effects were found. However CFF-CBT has been found to be effective for 7-13 year olds with both clients with and without non-suicidal self-injury behaviors.<ref name=":1">{{Cite journal|last=MacPherson|first=Heather A.|last2=Weinstein|first2=Sally M.|last3=West|first3=Amy E.|date=2018-05-01|title=Non-Suicidal Self-Injury in Pediatric Bipolar Disorder: Clinical Correlates and Impact on Psychosocial Treatment Outcomes|url=https://doi.org/10.1007/s10802-017-0331-4|journal=Journal of Abnormal Child Psychology|language=en|volume=46|issue=4|pages=857–870|doi=10.1007/s10802-017-0331-4|issn=1573-2835}}</ref> Mediators of this intervention include: parenting skills and coping, family flexibility, and family positive reframing.<ref name=":2">{{Cite journal|last=Fristad|first=Mary A.|last2=MacPherson|first2=Heather A.|date=2014-05-01|title=Evidence-Based Psychosocial Treatments for Child and Adolescent Bipolar Spectrum Disorders|url=https://doi.org/10.1080/15374416.2013.822309|journal=Journal of Clinical Child & Adolescent Psychology|volume=43|issue=3|pages=339–355|doi=10.1080/15374416.2013.822309|issn=1537-4416|pmc=PMC3844106|pmid=23927375}}</ref> ====== Intended Population ====== Children aged 7-13 and adolescents aged 13-17 ====== Length of Treatment ====== 12 weekly sessions, with session time ranging from 60 to 90 minutes<ref name=":1" /><ref name=":0" /><ref name=":2" /> ====== Treatment Components ====== CFF-CBT focuses on 7 components comprising of the “RAINBOW” acronym<ref name=":0" />: ''R'': Routine; developing consistency ''A'': Affective regulation; includes psychoeducation on feelings, coping skills, and mood monitoring ''I'': “I can do it!”; this aims to improve self-esteem in the child, as well as self-efficacy in the parent ''N'': “No Negative Thoughts/Live in the Now” ''B'': Be a good friend/balanced life style (building social skills and teaching parents self-care ''O'': Oh, how do we solve this problem? (family-based problem solving and communication skills building) ''W'': Ways to find support (building a network of support) ====== Treatment Outcomes ====== CFF-CBT has shown decreases in mania to a subclinical level, parent-reported youth depressive symptoms, increased involvement/fidelity to treatment, and improvements in the client’s overall, global functioning in comparison to psychotherapy as per usual.<ref name=":1" /> <br /> ===== Interpersonal and Social Rhythm Therapy (IPSRT) ===== ====== Purpose ====== IPSRT is based on the social zeitgeber hypothesis<ref>{{Cite journal|last=Grandin|first=Louisa D.|last2=Alloy|first2=Lauren B.|last3=Abramson|first3=Lyn Y.|date=2006-10|title=The social zeitgeber theory, circadian rhythms, and mood disorders: Review and evaluation|url=https://linkinghub.elsevier.com/retrieve/pii/S0272735806000651|journal=Clinical Psychology Review|language=en|volume=26|issue=6|pages=679–694|doi=10.1016/j.cpr.2006.07.001}}</ref>, which states that regularity in social routines and interpersonal relationships acts as a protective factor for mood disorders. Thus, this treatment focused on maintaining regularity in daily routines, quality of social relationships and social roles, and management of consequences of rhythm disruptions.<ref>{{Cite journal|last=Frank|first=Ellen|last2=Kupfer|first2=David J.|last3=Thase|first3=Michael E.|last4=Mallinger|first4=Alan G.|last5=Swartz|first5=Holly A.|last6=Fagiolini|first6=Andrea M.|last7=Grochocinski|first7=Victoria|last8=Houck|first8=Patricia|last9=Scott|first9=John|date=2005-09-01|title=Two-Year Outcomes for Interpersonal and Social Rhythm Therapy in Individuals With Bipolar I Disorder|url=http://dx.doi.org/10.1001/archpsyc.62.9.996|journal=Archives of General Psychiatry|volume=62|issue=9|pages=996|doi=10.1001/archpsyc.62.9.996|issn=0003-990X}}</ref> ====== Intended Population ====== IPSRT is intended for all individuals with bipolar disorder, and has been found to be effective in adolescents.<ref name=":3">{{Cite journal|last=Crowe|first=Marie|last2=Inder|first2=Maree|last3=Joyce|first3=Peter|last4=Moor|first4=Stephanie|last5=Carter|first5=Janet|last6=Luty|first6=Sue|date=2009-01|title=A developmental approach to the treatment of bipolar disorder: IPSRT with an adolescent|url=http://doi.wiley.com/10.1111/j.1365-2702.2008.02571.x|journal=Journal of Clinical Nursing|language=en|volume=18|issue=1|pages=141–149|doi=10.1111/j.1365-2702.2008.02571.x}}</ref> ====== Length of Treatment ====== Length of treatment varies dependent on client needs.<ref name=":3" /> ====== Treatment Components ====== IPSRT is structured in three phases<ref name=":4">{{Cite web|url=https://www.ipsrt.org/background|title=Interpersonal and Social Rhythm Therapy {{!}} Background|website=www.ipsrt.org|access-date=2019-12-05}}</ref>: # Initial phase: Explores the clients history in order to explore links between disruptions in routines to affective episodes. This stage also includes education on the rationale of the treatment<ref name=":4" /> # Intermediate phase: Focused on reorganizing the client's social rhythms, reinforcing new social rhythms and building confidence in using techniques that are taught in the treatment<ref name=":4" /> # Final phase: Reduction in frequency of visits in order to work towards termination of therapy and self-efficacy<ref name=":4" /> ====== Treatment Outcomes ====== If applied early in the acute phase of bipolar disorder, IPSRT may prolong time to relapse in depressive/manic episodes.<ref name=":5">{{Cite journal|last=Miziou|first=Stella|last2=Tsitsipa|first2=Eirini|last3=Moysidou|first3=Stefania|last4=Karavelas|first4=Vangelis|last5=Dimelis|first5=Dimos|last6=Polyzoidou|first6=Vagia|last7=Fountoulakis|first7=Konstantinos N|date=2015-12|title=Psychosocial treatment and interventions for bipolar disorder: a systematic review|url=http://www.annals-general-psychiatry.com/content/14/1/19|journal=Annals of General Psychiatry|language=en|volume=14|issue=1|pages=19|doi=10.1186/s12991-015-0057-z|issn=1744-859X|pmc=PMC4493813|pmid=26155299}}</ref> ===== Mindfulness-Based Cognitive Therapy (MBCT) ===== ====== Purpose ====== Mindfulness approaches aim to enhance one’s ability to focus their attention on the present moment in a non-judgmental manor.<ref name=":5" /> In treatment for Bipolar Disorder, mindfulness approaches may focus on awareness of the client’s patterns of thoughts, feelings and bodily sensations both specific and non-specific to their experiences related to the disorder.<ref name=":5" /> Moreover, when comorbid with anxiety, bipolar disorder has higher risk of suicide attempts, therefore MBCT aims to decrease these anxiety symptoms.<ref name=":6">{{Cite journal|last=Williams|first=J. Mark G.|last2=Russell|first2=Ian|last3=Russell|first3=Daphne|date=2008-06|title=Mindfulness-based cognitive therapy: Further issues in current evidence and future research.|url=http://doi.apa.org/getdoi.cfm?doi=10.1037/0022-006X.76.3.524|journal=Journal of Consulting and Clinical Psychology|language=en|volume=76|issue=3|pages=524–529|doi=10.1037/0022-006X.76.3.524|issn=1939-2117|pmc=PMC2834575|pmid=18540746}}</ref> ====== Intended Population ====== MBCT is intended for all populations with bipolar disorder.<ref name=":6" /> ====== Length of Treatment ====== MPCT is typically offered in 1-2 hour weekly sessions over an 8-week period in a group setting (Perich et al 2012; Weber et al 2010).<ref>{{Cite journal|last=Perich|first=T.|last2=Manicavasagar|first2=V.|last3=Mitchell|first3=P. B.|last4=Ball|first4=J. R.|last5=Hadzi-Pavlovic|first5=D.|date=2012-12-09|title=A randomized controlled trial of mindfulness-based cognitive therapy for bipolar disorder|url=http://dx.doi.org/10.1111/acps.12033|journal=Acta Psychiatrica Scandinavica|volume=127|issue=5|pages=333–343|doi=10.1111/acps.12033|issn=0001-690X}}</ref><ref name=":7">{{Cite journal|last=Weber|first=B.|last2=Jermann|first2=F.|last3=Gex-Fabry|first3=M.|last4=Nallet|first4=A.|last5=Bondolfi|first5=G.|last6=Aubry|first6=J.-M.|date=2010-10|title=Mindfulness-based cognitive therapy for bipolar disorder: A feasibility trial|url=https://linkinghub.elsevier.com/retrieve/pii/S0924933810000817|journal=European Psychiatry|language=en|volume=25|issue=6|pages=334–337|doi=10.1016/j.eurpsy.2010.03.007}}</ref> Participants are also assigned homework, including varying lengths of meditation practice.<ref name=":7" /> ====== Treatment Components ====== MPCT combines aspects of classical CBT and mindfulness-based stress reduction therapies. The themes addressed in each session are<ref>{{Cite web|url=http://mbct.com/classes.html|title=Classes|website=mbct.com|access-date=2019-12-05}}</ref>: Session 1: Automatic pilot Session 2: Dealing with barriers Session 3: Mindfulness of the breath Session 4: Staying present Session 5: Allowing and letting be Session 6: Thoughts are not facts Session 7: How can I best take care of myself Session 8: Using what has been learned to deal with future moods ====== Treatment Outcomes ====== Treatment outcomes include decreases in anxiety and depressive symptoms and mood regulation in patients with bipolar disorder, but there has been no evidence in prevention of recurrences.<ref name=":5" /><ref name=":6" /> MBCT has also been found to improve attentional readiness, and attenuated activation of non-relevant information processing during attentional readiness, which are usually decreased in individuals with Bipolar Disorder compared to those without.<ref>{{Cite journal|last=Howells|first=Fleur M|last2=Ives-Deliperi|first2=Victoria L|last3=Horn|first3=Neil R|last4=Stein|first4=Dan J|date=2012-02-29|title=Mindfulness based cognitive therapy improves frontal control in bipolar disorder: a pilot EEG study|url=http://dx.doi.org/10.1186/1471-244x-12-15|journal=BMC Psychiatry|volume=12|issue=1|doi=10.1186/1471-244x-12-15|issn=1471-244X}}</ref> <br /> ===== Multi-Family Psychoeducational Psychotherapy (MF-PEP) ===== ====== Purpose ====== MF-PEP is a group-based evidence based treatment for children with bipolar disorder, which is meant to increase the ability for the treatment to be readily implemented into the community.<ref name=":8">{{Cite journal|last=MacPherson|first=Heather A.|last2=Leffler|first2=Jarrod M.|last3=Fristad|first3=Mary A.|date=2014|title=Implementation of Multi-Family Psychoeducational Psychotherapy for Childhood Mood Disorders in an Outpatient Community Setting|url=https://onlinelibrary.wiley.com/doi/abs/10.1111/jmft.12013|journal=Journal of Marital and Family Therapy|language=en|volume=40|issue=2|pages=193–211|doi=10.1111/jmft.12013|issn=1752-0606|pmc=PMC4198302|pmid=24749838}}</ref> While MF-PEP creates a support system within the family for the child through being a family-based intervention, it also serves to increase social support for care givers through being a group-based therapy. ====== Intended Population ====== MF-PEP is intended for children with depressive and bipolar disorders and their caretakers.<ref name=":8" /><ref name=":9">{{Cite journal|last=Fristad|first=Mary A.|last2=Verducci|first2=Joseph S.|last3=Walters|first3=Kimberly|last4=Young|first4=Matthew E.|date=2009-09-01|title=Impact of Multifamily Psychoeducational Psychotherapy in Treating Children Aged 8 to 12 Years With Mood Disorders|url=https://jamanetwork.com/journals/jamapsychiatry/fullarticle/210303|journal=Archives of General Psychiatry|language=en|volume=66|issue=9|pages=1013–1021|doi=10.1001/archgenpsychiatry.2009.112|issn=0003-990X}}</ref> ====== Length of Treatment ====== MF-PEP is an 8-session long treatment, with sessions typically ranging from 60-90 minutes. <ref name=":8" /><ref name=":9" /> ====== Treatment Components ====== MF-PEP combines [[wikipedia:Psychoeducation|psychoeducation]], [[wikipedia:Family_therapy|family systems]], and [[wikipedia:Cognitive_behavioral_therapy|cognitive behavior therapy]] techniques, aiming to target depressive and bipolar disorder symptoms and how these symptoms cause impairment. <ref name=":9" /> In MF-PEP, sessions are delivered in a combination of settings, including all children and parents together, as well as separating all children and caregivers into their own respective groups. <ref name=":9" /> ====== Treatment Outcomes ====== Treatment outcomes for MG-PEP include an increase in caregiver's understanding of the child's disorder, and a decrease in mood symptom severity within the children which has been seen to be maintained through an 18-month follow-up. <ref name=":10">{{Cite journal|last=MacPherson|first=Heather A.|last2=Leffler|first2=Jarrod M.|last3=Fristad|first3=Mary A.|date=2014|title=Implementation of Multi-Family Psychoeducational Psychotherapy for Childhood Mood Disorders in an Outpatient Community Setting|url=https://onlinelibrary.wiley.com/doi/abs/10.1111/jmft.12013|journal=Journal of Marital and Family Therapy|language=en|volume=40|issue=2|pages=193–211|doi=10.1111/jmft.12013|issn=1752-0606|pmc=PMC4198302|pmid=24749838}}</ref> Additionally, MF-PEP has been found to have a positive effect on parent's help-seeking behaviors for mental health care, leading to access to higher-quality services. <ref name=":10" /> Lastly, children report feeling a stronger sense of social support from their caregivers after participating in the intervention.<ref name=":9" /> ===== See Also: ===== * Wikipedia has a page reviewing [[wikipedia:Treatment_of_bipolar_disorder|treatments for bipolar disorder]]. * [http://www.effectivechildtherapy.com Effective Child Therapy] provides a curated list of effective psycho-social treatments for bipolar disorder in youths. * [https://icd.who.int/browse10/2015/en#/F31 ICD-10 Diagnostic Criteria] * [[wikipedia:Bipolar_disorder_in_children|Bipolar disorder in children]] * [https://onlinelibrary.wiley.com/doi/epdf/10.1111/bdi.12556 The International Society for Bipolar Disorders Task Force report on pediatric bipolar disorder: Knowledge to date and directions for future research] * [[wikipedia:Treatment_of_bipolar_disorder|Treatment of bipolar disorder]] =='''External resources'''== {{Infobox disease | name = Pediatric Bipolar Disorder | image = | Caption = Bipolar disorder consists of experiences of mania alternating with depressive episodes | DiseasesDB = 7812 | ICD10 = {{ICD10|F|31||f|30}} | ICD9 = {{ICD9|296.0}}, {{ICD9|296.1}}, {{ICD9|296.4}}, {{ICD9|296.5}}, {{ICD9|296.6}}, {{ICD9|296.7}}, {{ICD9|296.8}} | ICDO = | OMIM = 125480 | OMIM_mult = {{OMIM2|309200}} | MedlinePlus = 000926 | eMedicineSubj = med | eMedicineTopic = 229 | MeshID = D001714 }} #[http://www.nami.org/ National Alliance on Mental Illness] – the nation’s largest grassroots mental health organization dedicated to building better lives for the millions of Americans affected by mental illness. NAMI advocates for access to services, treatment, supports and research and is steadfast in its commitment to raise awareness and build a community for hope for all of those in need.<ref>{{cite web|last=NAMI: National Alliance on Mental Illness.|title=National Alliance on Mental Illness|url=http://www.nami.org/|accessdate=5 February 2014}}</ref> #[http://www.thebalancedmind.org Balanced Mind Foundation] – information, articles, parent support chat rooms.<ref>{{cite web|last=The Balanced Mind.|title=The Balanced Mind Parent Network.|url=http://www.thebalancedmind.org|accessdate=5 February 2014}}</ref> #[http://www.effectivechildtherapy.com Effective Child Therapy] – Information and articles curated by [https://sccap53.org Society of Clinical Child and Adolescent Psychology](SCCAP), a division of the American Psychological Association.<ref>{{cite web|last=Effective Child Therapy|title=Effective Child Therapy: Evidence-based mental health treatment for children and adolescents.|url=http://www.effectivechildtherapy.com|accessdate=5 February 2014}}</ref> ##[http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/severe-mood-swings-and-bipolar-spectrum-disorders/ Effective Child Therapy information: Bipolar Disorder] ##[http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/severe-mood-swings-and-bipolar-spectrum-disorders/ Effective Child Therapy information: Severe Mood Swings and Bipolar Spectrum Disorders] ##[http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/sadness-hopelessness-and-depression/ Effective Child Therapy information: Sadness, Hopelessness, and Depression] #[http://ibpf.org/resources International Bipolar Foundation] – information, help and resources available for caregivers and those afflicted with bipolar disorder.<ref>http://ibpf.org/resources, International Bipolar Foundation, retrieved 27th January 2014. </ref> #[http://www.bipolarnews.org Bipolar Network News] – an online clearinghouse and information on latest treatments, research and psychoeducation about mood disorders.<ref>http://bipolarnews.org/, Bipolar Network News, retrieved 30th January 2014. </ref> #[http://www.depressionalliance.org/ Depression Alliance] – a United Kingdom charity that works to prevent and relieve depression by providing information and support services via supporter services, publications and self-help groups.<ref>Depression Alliance, http://www.depressionalliance.org/, retrieved 30th January 2014. </ref> #[http://www.dbsalliance.org/site/PageServer?pagename=home Depression and Bipolar Support Alliance (DBSA)] – a peer-directed national organization that provides links to resources, support groups, and peer support for individuals and their families suffering from bipolar disorder. ##[https://unc.az1.qualtrics.com/jfe/form/SV_cBlUQk8Y85LHF41 Depression and Bipolar Support Alliance: 7 Up 7 Down Online Screener] #Related Wikipedia Pages ##[[wikipedia:Bipolar_disorder|Bipolar disorder Wikipedia Page]] ##[[wikipedia:Cyclothymia|Cyclothymia Wikipedia Page]] ##[[wikipedia:Mania|Mania Wikipedia Page]] ##[[wikipedia:Depression_(mood)|Depression Wikipedia Page]] #[https://www.massgeneral.org/psychiatry/services/treatmentprograms.aspx?id=1944&display=bipolar Massachusetts General Hospital School Psychiatry Resources for Bipolar Disorder] #The Psych Show with Dr. Ali Mattu videos ##[https://www.youtube.com/watch?v=llOPqKD-s4w How to Cope with Bipolar Disorder] ##[https://www.youtube.com/watch?v=kUHUmeqBZAA Top 10 Bipolar Myths] #[[Evidence Based Psychotherapies for Adolescent Bipolar Disorder]] =='''References'''== {{collapse top|References|expand=yes}} {{Reflist|30em}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] {{collapse bottom}} r2p4vbb25jkhkrmds7eqqvxfwsdum8p 2419247 2419193 2022-08-26T03:52:14Z Ardenguo 2944162 /* Psychometric properties of screening instruments for pediatric bipolar disorder */ Removed all "Note: L = Less than adequate; A = Adequate; G = Good; E = Excellent; U = Unavailable; NA = Not applicable" because the condensed-version portfolios don't include reliability/validity. wikitext text/x-wiki <noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{psychology}}{{Evidence-based assessment}}{{medical disclaimer}} {{:{{BASEPAGENAME}}/Sidebar}} ==[[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio?"''']]== * For background information on what assessment portfolios are, click the link in the heading above. Want even 'more' information about this topic? There's an extended version of this page [[Evidence-based assessment/Bipolar disorder in youth (assessment portfolio)/extended version|here]]. == '''[[Evidence based assessment/Preparation phase|Preparation phase]]''' == === Diagnostic criteria for Pediatric Bipolar disorder === {{collapse top| More information on PBD diagnostic criteria|expand=yes}} *[[w:Bipolar_disorder_in_children|Pediatric bipolar disorder (PBD)]] is characterized by extreme fluctuations in mood or emotional dysregulation that range from mania (as shown by displays or feelings of extreme happiness, unrealistic overachievement, and anger) to depression (as shown by displays or feelings of sadness, changes in appetite or weight, and irritability<ref name="APA"> American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.</ref> <ref name="jamison"> Goodwin, F. K., & Jamison, K. R. (2007). ''Manic-depressive illness.'' (10th edition). New York, NY: Oxford University Press </ref>). *It is important to note that these moods exceed normal responses to life events, represent a change from the individual's normal functioning, and cause problems in daily activities. These mood fluctuations result in a child finding it difficult to live and interact with family, friends and teachers, when it was previously not an issue<ref name="APA" />. *People with [[w:Bipolar_disorder|bipolar disorder]] experience unusually intense emotional states that occur in distinct periods called [[w:Mood_(psychology)|"mood episodes".]] An overly joyful or overexcited state is called a manic episode, and an extremely sad or hopeless state is called a [[w:Major_depressive_episode|depressive episode]]. Sometimes, a mood episode includes symptoms of both [[w:Mania|mania]] and [[w:Depression_(mood)|depression]]. *People with bipolar disorder also may be explosive and irritable during a mood episode.<ref name="APA" /> **Extreme changes in energy, activity, sleep, and behavior go along with these changes in mood. *It is possible for someone with bipolar disorder to experience a long-lasting period of unstable moods rather than discrete episodes of depression or mania.<ref name="jamison" /> <ref name="APA" /> *A person may be having an episode of bipolar disorder if he or she has a number of manic or depressive symptoms for most of the day, nearly every day, for at least one or two weeks. These debilitating symptoms can result in an afflicted individual being unable to function adaptively in several settings. {{collapse bottom}} {{blockquotetop}} '''<big>ICD-10 Criteria</big>''' '''''F31 Bipolar affective disorder''''' *''Note.'' Episodes are demarcated by a switch to an episode of opposite or mixed polarity or by a remission. '''''F31.0 Bipolar affective disorder, current episode hypomanic''''' '''A.''' The current episode meets the criteria for '''Hypomania F30.0''': *'''''(A)''''' The mood is elevated or irritable to a degree that is definitely abnormal for the individual concerned and sustained for at least four consecutive days. *'''''(B)''''' At least three of the following signs must be present, leading to some interference with personal functioning in daily living *# Increased activity or physical restlessness; *# Increased talkativeness; *# Distractibility or difficulty in concentration; *# Decreased need for sleep; *# Increased sexual energy; *# Mild over-spending, or other types of reckless or irresponsible behavior; *# Increased sociability or over-familiarity. *'''''(C)''''' The episode does not meet the criteria for '''F30.1 Mania without psychotic symptoms''', '''F30.2 Mania with psychotic symptoms''', '''F31.- Bipolar affective disorder''', '''F32.- Depressive episode''', '''F34.0 Cyclothymia''', or '''F50.0 Anorexia nervosa'''. *'''''(D)''''' ''Most commonly used exclusion clause.'' The episode is not attributable to '''F10-F19 Psychoactive substance use''' or in the sense of any '''F00-F09 Organic mental disorder'''. '''B.''' There has been at least one other affective episode in the past, meeting the criteria for '''F30.- Hypomanic or Manic episode''', '''F32.Depressive episode''', or '''F38.00 Mixed affective episode.''' <big>'''Changes in DSM-5'''</big> The diagnostic criteria for bipolar disorders changed slightly from [[DSM-IV]] to [[w:Diagnostic_and_Statistical_Manual_of_Mental_Disorders#DSM-IV-TR_.282000.29|DSM-5]]. Summaries are available [http://www.dsm5.org/Documents/changes%20from%20dsm-iv-tr%20to%20dsm-5.pdf here] and [[w:DSM-5|here]]. {{blockquotebottom}} === Base rates of PBD in different clinical settings and populations === This section describes the demographic setting of the population(s) sampled, base rates of diagnosis, country/region sampled and the diagnostic method that was used. Using this information, clinicians will be able to anchor the rates of PBD that they are likely to see in their clinical practices. * '''''To find prevalence rates across multiple disorders,''''' [[Evidence based assessment/Preparation phase#Base rates for transdiagnostic comparison|'''''click here.''''']] {| class="wikitable sortable" border="1" |+ style="text-align: left;" | ''Base rates of BSD in different clinical settings'' |- ! scope="col" | Setting (Reference) ! scope="col" style="white-space: nowrap;"| Base Rate ! scope="col" | Demography ! scope="col" | Diagnostic Method !Recommended for... |- | Rates of Bipolar Disorders in General Population || 0.6% || '''Bipolar I''' in youths age 5 to 18 || Meta-analysis of epidemiological studies, 19 samples, N = 56,103 participants<ref name=":11">{{Cite journal|last=Van Meter|first=Anna|last2=Moreira|first2=Ana Lúcia R.|last3=Youngstrom|first3=Eric|date=2019-04-02|title=Updated Meta-Analysis of Epidemiologic Studies of Pediatric Bipolar Disorder|url=https://www.psychiatrist.com/JCP/article/Pages/2019/v80/18r12180.aspx|journal=The Journal of Clinical Psychiatry|volume=80|issue=3|doi=10.4088/JCP.18r12180|issn=1555-2101}}</ref> |Schools, nonclinical settings. Minimum for outpatient settings. |- | style="border: width: 1px; border-bottom: 3px solid grey; padding: 5px;" |Rates of bipolar spectrum (I, II, cyclothymia, NOS) in general population || style="border: width: 1px; border-bottom: 3px solid grey; padding: 5px;" | 3.9% || style="border: width: 1px; border-bottom: 3px solid grey; padding: 5px;" | '''Bipolar spectrum''' in youths age 5 to 18 years || style="border: width: 1px; border-bottom: 3px solid grey; padding: 5px;" | Meta-regression estimate <ref name=":11" /> |Schools, nonclinical settings. Minimum for outpatient settings. |- | High school epidemiological<br />(Lewinsohn et al., 2000) || 0.6% || Northwestern USA high school || KSADS-PL | |- |Community Mental Health Center<br />(E. A. Youngstrom et al., 2005) || 6% || Midwestern Urban, 80% non-white, low-income || Clinical interview & treatment | |- | General Outpatient Clinic;<br />(Geller, Zimerman, Williams, Delbello, Frazier, et al., 2002) || 6% to 8% || Urban academic research centers || WASH-U-KSADS | |- |County Wards (DCFS)<br />(Naylor, Anderson, Kruesi, & Stoewe, 2002, October) || 11% || State of Illinois || Clinical interview & treatment | |- | Specialty Outpatient Service<br />(Biederman et al., 1996) || 15-17% || New England || KSADS-E | |- |Incarcerated adolescents<br />(Teplin, Abram, McClelland, Dulcan, & Mericle, 2002) || 2% || Midwestern Urban || DISC | |- | Incarcerated adolescents<br />(Pliszka et al., 2000) || 22% || Texas || DISC | |- | Acute psychiatric hospitalizations<br />in 2002-2003 – <u>adolescents</u><br />(Blader & Carlson, 2007) || 21% || All of U.S.A. || Centers for Disease Control survey of discharge diagnoses | |- | Inpatient service<br />(Carlson & Youngstrom, 2003) || 30% manic symptoms,<br /><2% strict BP I || New York City Metro Region || DICA; KSADS | |- |Acute psychiatric hospitalizations<br />in 2002-2003 – <u>children</u><br />(Blader & Carlson, 2007) || 40% || All of U.S.A. || Centers for Disease Control survey of discharge diagnoses | |- |Psychiatric outpatient clinic<br />(Ghanizadeh, Mohammadi, & Yazdanshenas, 2006) || 16-17% || Iran || K-SADS-PL (Farsi) | |- |Inpatient and partial hospitalization programs at a psychiatric treatment center<br />(Pellegrini et al., 1986) || Mania (0%), hypomania (6%) || Richmond, Virginia || DISC | |- |} ^p Parent interviewed as component of diagnostic assessment; ^y youth interviewed as part of diagnostic assessment. ''Note:'' KSADS = Kiddie Schedule for Affective Disorders and Schizophrenia, PL = Present and Lifetime version, WASH-U = Washington University version, -E = Epidemiological version of the KSADS; DISC = Diagnostic Interview Schedule for Children; DICA = Diagnostic Interview for Children and Adolescents. Table modified from Wikiversity. {| class="wikitable sortable" border="1" |- ! Setting ! Base Rate ! Demography ! Diagnostic Method !Best Recommended For |- | Community epidemiological (NCS-A) <ref>{{cite journal|last1=Kessler|first1=Ronald C.|last2=Avenevoli|first2=Shelli|last3=Costello|first3=E. Jane|last4=Georgiades|first4=Katholiki|last5=Green|first5=Jennifer Greif|last6=Gruber|first6=Michael J.|last7=He|first7=Jian-ping|last8=Koretz|first8=Doreen|last9=McLaughlin|first9=Katie A.|last10=Petukhova|first10=Maria|last11=Sampson|first11=Nancy A.|last12=Zaslavsky|first12=Alan M.|last13=Merikangas|first13=Kathleen Ries|title=Prevalence, persistence, and sociodemographic correlates of DSM-IV disorders in the National Comorbidity Survey Replication Adolescent Supplement|journal=Archives of General Psychiatry|date=1 April 2012|volume=69|issue=4|pages=372–380|doi=10.1001/archgenpsychiatry.2011.160|url=http://www.ncbi.nlm.nih.gov/pubmed/22147808|accessdate=26 January 2016|issn=1538-3636}}</ref> | 3.0% | All of U.S.A. | CIDI 3.0 | |- | Community epidemiologic samples<ref>{{cite journal|last1=Van Meter|first1=Anna R.|last2=Moreira|first2=Ana Lúcia R.|last3=Youngstrom|first3=Eric A.|date=1 September 2011|title=Meta-analysis of epidemiologic studies of pediatric bipolar disorder|url=http://www.ncbi.nlm.nih.gov/pubmed/21672501|journal=The Journal of Clinical Psychiatry|volume=72|issue=9|pages=1250–1256|doi=10.4088/JCP.10m06290|issn=1555-2101}}</ref> |mean= 1.8% (95% CI, 1.1%–3.0%), bipolar I (mean =1.2%; 95% CI, 0.7%–1.9%) | U.S.A., Netherlands, U.K., Spain, Mexico, Ireland, New Zealand | Structured and semi-structured diagnostic interviews, Combination of broad and specific diagnostic criteria (Meta-Analysis) |Schools, nonclinical settings. Minimum for outpatient settings. |- |Community mental health center<ref>{{Cite journal|last=Youngstrom|first=Eric A.|last2=Findling|first2=Robert L.|last3=Youngstrom|first3=Jen Kogos|last4=Calabrese|first4=Joseph R.|date=September 2005|title=Toward an evidence-based assessment of pediatric bipolar disorder|url=https://www.ncbi.nlm.nih.gov/pubmed/16026213|journal=Journal of Clinical Child and Adolescent Psychology: The Official Journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 53|volume=34|issue=3|pages=433–448|doi=10.1207/s15374424jccp3403_4|issn=1537-4416|pmid=16026213}}</ref> |6% |U.S.A., Midwestern Urban, 80% non-white, low-income |Parent and youth clinical assessment & treatment | |- |General outpatient clinic<ref name=":1" /> |6-8% |Urban academic research centers |WASH-U-[[w:Kiddie Schedule for Affective Disorders and Schizophrenia|KSAD]]S (parent and youth) | |- |Specialty outpatient service<ref>{{Cite journal|last=Biederman|first=J.|last2=Faraone|first2=S.|last3=Mick|first3=E.|last4=Wozniak|first4=J.|last5=Chen|first5=L.|last6=Ouellette|first6=C.|last7=Marrs|first7=A.|last8=Moore|first8=P.|last9=Garcia|first9=J.|date=August 1996|title=Attention-deficit hyperactivity disorder and juvenile mania: an overlooked comorbidity?|url=https://www.ncbi.nlm.nih.gov/pubmed/8755796|journal=Journal of the American Academy of Child and Adolescent Psychiatry|volume=35|issue=8|pages=997–1008|doi=10.1097/00004583-199608000-00010|issn=0890-8567|pmid=8755796}}</ref> |15-17% |Boston area, U. S. A. |[[w:Kiddie Schedule for Affective Disorders and Schizophrenia|KSADS]]-E | |- | Inpatient Services/Diagnoses<ref>{{Cite journal|last=Holtmann|first=M.|last2=Goth|first2=K.|last3=Wöckel|first3=L.|last4=Poustka|first4=F.|last5=Bölte|first5=S.|date=2008|title=CBCL-pediatric bipolar disorder phenotype: severe ADHD or bipolar disorder?|url=https://www.ncbi.nlm.nih.gov/pubmed/17994189|journal=Journal of Neural Transmission (Vienna, Austria: 1996)|volume=115|issue=2|pages=155–161|doi=10.1007/s00702-007-0823-4|issn=0300-9564|pmid=17994189}}</ref> | 0.3% | All of Germany | [[w:International_Statistical_Classification_of_Diseases_and_Related_Health_Problems|International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10)]] | |- | Community sample<ref>{{cite journal|last1=Olino|first1=Thomas M.|last2=Shankman|first2=Stewart A.|last3=Klein|first3=Daniel N.|last4=Seeley|first4=John R.|last5=Pettit|first5=Jeremy W.|last6=Farmer|first6=Richard F.|last7=Lewinsohn|first7=Peter M.|date=1 September 2012|title=Lifetime rates of psychopathology in single versus multiple diagnostic assessments: Comparison in a community sample of probands and siblings|url=http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3411854/|journal=Journal of psychiatric research|volume=46|issue=9|pages=1217–1222|doi=10.1016/j.jpsychires.2012.05.017|issn=0022-3956}}</ref> | 2.9% | Oregon | LIFE, SCID, DSM-IV | |- | Inpatient service<ref>{{cite journal|last1=Carlson|first1=Gabrielle A.|last2=Youngstrom|first2=Eric A.|date=1 June 2003|title=Clinical implications of pervasive manic symptoms in children|url=http://www.ncbi.nlm.nih.gov/pubmed/12788250|journal=Biological Psychiatry|volume=53|issue=11|pages=1050–1058|issn=0006-3223}}</ref> | 30% manic symptoms, <2% strict BP I | New York City Metro Region | DICA; [[w:Kiddie Schedule for Affective Disorders and Schizophrenia|KSADS]] | |- |NCS-A Clinical Reappraisal Sample<ref name=":3" /> ^{p y} |6.2% and SE=1.7 (bipolar I and II and sub-threshold bipolar spectrum disorder) |U.S.A, NCS-A |[[w:Kiddie Schedule for Affective Disorders and Schizophrenia|K-SADS]], DSM-IV criteria were modified from published version for purpose of the study, broad criteria for not otherwise specified | | |- |NCS-A Clinical Reappraisal Sample<ref name=":3">{{Cite journal|last=Kessler|first=Ronald C.|last2=Avenevoli|first2=Shelli|last3=Green|first3=Jennifer|last4=Gruber|first4=Michael J.|last5=Guyer|first5=Margaret|last6=He|first6=Yulei|last7=Jin|first7=Robert|last8=Kaufman|first8=Joan|last9=Sampson|first9=Nancy A.|date=2009-04|title=National Comorbidity Survey Replication Adolescent Supplement (NCS-A): III. Concordance of DSM-IV/CIDI Diagnoses With Clinical Reassessments|url=http://linkinghub.elsevier.com/retrieve/pii/S0890856709600460|journal=Journal of the American Academy of Child & Adolescent Psychiatry|volume=48|issue=4|pages=386–399|doi=10.1097/chi.0b013e31819a1cbc|issn=0890-8567|pmc=PMC3040100|pmid=19252450}}</ref> ^p ^y |6.6% and SE=1.7 (bipolar I and II and sub-threshold bipolar spectrum disorder) |U.S.A, NCS-A |CIDI, DSM-IV criteria were modified from published version for purpose of the study, broad criteria for not otherwise specified, | |- |National Cross‐sectional epidemiological sample<ref>{{Cite journal|last=Stringaris|first=Argyris|last2=Santosh|first2=Paramala|last3=Leibenluft|first3=Ellen|last4=Goodman|first4=Robert|date=2009-07-22|title=Youth meeting symptom and impairment criteria for mania-like episodes lasting less than four days: an epidemiological enquiry|url=http://doi.wiley.com/10.1111/j.1469-7610.2009.02129.x|journal=Journal of Child Psychology and Psychiatry|language=en|volume=51|issue=1|pages=31–38|doi=10.1111/j.1469-7610.2009.02129.x|issn=0021-9630|pmc=PMC4286871|pmid=19686330}}</ref> ^p ^y |1.2% (bipolar I and II and not otherwise specified) |United Kingdom |DAWBA, DSM-IV criteria, broad criteria for not otherwise specified | |- |Community epidemiological samples<ref>{{Cite journal|last=Benjet|first=Corina|last2=Borges|first2=Guilherme|last3=Medina-Mora|first3=Maria Elena|last4=Zambrano|first4=Joaquin|last5=Aguilar-Gaxiola|first5=Sergio|date=2009-04|title=Youth mental health in a populous city of the developing world: results from the Mexican Adolescent Mental Health Survey|url=http://doi.wiley.com/10.1111/j.1469-7610.2008.01962.x|journal=Journal of Child Psychology and Psychiatry|language=en|volume=50|issue=4|pages=386–395|doi=10.1111/j.1469-7610.2008.01962.x|issn=0021-9630}}</ref> ^y |2.5% (bipolar I and II) |Mexico City |CIDI, DSM-IV Criteria | |- |2-stage epidemiological study<ref>{{Cite journal|last=Lynch|first=Fionnuala|last2=Mills|first2=Carla|last3=Daly|first3=Irenee|last4=Fitzpatrick|first4=Carol|date=2006-08|title=Challenging times: Prevalence of psychiatric disorders and suicidal behaviours in Irish adolescents|url=http://linkinghub.elsevier.com/retrieve/pii/S0140197105001004|journal=Journal of Adolescence|volume=29|issue=4|pages=555–573|doi=10.1016/j.adolescence.2005.08.011|issn=0140-1971}}</ref> ^{p y} |0.0% (bipolar I and II, cyclothymia, not otherwise specified |Ireland |[[w:Kiddie Schedule for Affective Disorders and Schizophrenia|K-SADS]], DSM-IV Criteria | |} ^p:Parent interviewed as component of diagnostic assessment; ^y:Youth interviewed as part of diagnostic assessment. ''Note:'' * KSADS = [[w:Schedule_for_Affective_Disorders_and_Schizophrenia#K-SADS|Kiddie Schedule for Affective Disorders and Schizophrenia]], * WASH-U = Washington University version, -PL = Present and Lifetime Version, -E = Epidemiological version of the KSADS * LIFE = Longitudinal Interval Follow-Up Evaluation, * DICA = Diagnostic Interview for Children and Adolescents *CIDI = Composite International Diagnostic Interview *DAWBA= The Development and Well-Being Assessment == '''[[Evidence based assessment/Prediction phase|Prediction phase]]''' == The following section contains a list of screening and diagnostic instruments for bipolar disorder in youth. This section includes administration information, psychometric data, and PDFs or links to the screenings. === Psychometric properties of screening instruments for pediatric bipolar disorder === * Screenings are used as part of the [[Evidence based assessment/Prediction phase|prediction phase]] of assessment; for more information on interpretation of this data, or how screenings fit in to the assessment process, click [[Evidence based assessment/Prediction phase|here.]] * '''''For a list of more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Common_screening_instruments click here.]''''' {| class="wikitable sortable" border="1" ! colspan="10" |Screening measures for bipolar disorder in youth |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time ! Interrater Reliability ! Test-Retest Reliability ! Construct Validity ! Content Validity ! Highly Recommended !Free and Accessible Measures |- | Children's Depression Inventory <nowiki>*</nowiki>not free | Self-report<ref name=":0">{{Cite web|url=https://www.pearsonclinical.com/psychology/products/100000636/childrens-depression-inventory-2-cdi-2.html|title=Children's Depression Inventory 2™|website=www.pearsonclinical.com|language=en-US|accessdate=2018-03-01}}</ref> | 7-17 | 15-20 minutes<ref name=":0" /> | NA | A | G | G | X |Not free |- | Mood and Feelings Questionnaire (MFQ) | Self-report | 7-18 | 5-10 minutes<ref>{{Cite web|url=http://www.cebc4cw.org/assessment-tool/mood-and-feelings-questionnaire-mfq/|title=CEBC » Assessment Tool › Mood And Feelings Questionnaire Mfq|website=www.cebc4cw.org|language=en|accessdate=2018-03-01}}</ref> | NA | A | G | A | X | *[https://mfr.osf.io/render?url=https://osf.io/enx4b/?action=download%26mode=render MFQ Child Self-Report Long Version] *[https://mfr.osf.io/render?url=https://osf.io/mcg5w/?action=download%26mode=render MFQ Child Self Report Short Version] *[https://mfr.osf.io/render?url=https://osf.io/cw27p/?action=download%26mode=render MFQ Parent Report On Child Long Version] *[https://mfr.osf.io/render?url=https://osf.io/kybr4/?action=download%26mode=render MFQ Parent Report On Child Short Version] |- | 7 Up 7 Down Inventory (7U7D) |Self-report<ref name=":5" /> | 11-86<ref>{{Cite journal|last=Mesman|first=E.|last2=Youngstrom|first2=E.A.|last3=Juliana|first3=N.K.|last4=Nolen|first4=W.A.|last5=Hillegers|first5=M.H.J.|date=2017-01|title=Validation of the Seven Up Seven Down Inventory in bipolar offspring: screening and prediction of mood disorders. Findings from the Dutch Bipolar Offspring Study|url=https://doi.org/10.1016/j.jad.2016.09.024|journal=Journal of Affective Disorders|volume=207|pages=95–101|doi=10.1016/j.jad.2016.09.024|issn=0165-0327}}</ref> |5-8 minutes | NA | | | | | * [https://mfr.osf.io/render?url=https://osf.io/s825e/?action=download%26mode=render 7U7D English] * [https://unc.az1.qualtrics.com/jfe/form/SV_cBlUQk8Y85LHF41 Depression and Bipolar Support Alliance (DBSA): 7U7D '''Online Screener'''] |- | Parent General Behavior-10 Item Version (PGBI-10M)<ref name=":6">{{Cite journal|last=Youngstrom|first=Eric A.|last2=Genzlinger|first2=Jacquelynne E.|last3=Egerton|first3=Gregory A.|last4=Meter|first4=Anna R. Van|title=Multivariate meta-analysis of the discriminative validity of caregiver, youth, and teacher rating scales for pediatric bipolar disorder: Mother knows best about mania.|url=http://dx.doi.org/10.1037/arc0000024|journal=Archives of Scientific Psychology|volume=3|issue=1|pages=112–137|doi=10.1037/arc0000024}}</ref> |Parent-report |5-18<ref name=":7">Youngstrom, E.A., Van Meter, A.R, Frazier, T.W., Youngstrom, J.K., & Findling, R.L. (in press). Developing and validating short forms of the Parent General Behavior Inventory Mania and Depression Scales for rating youth mood symptoms. ''Journal of Clinical Child & Adolescent Psychology.''</ref> |5-8 minutes | | | | | | * [https://mfr.osf.io/render?url=https://osf.io/ub8h7/?action=download%26mode=render Downloadable PDF Parent-Report English] |} === Brief screening tools for PBD=== {{collapse top|expand=yes}} The following are brief screening tools that typically take less than 5 minutes to administer to accurately diagnose pediatric bipolar disorder: # '''''7 Up 7 Down Inventory (7U7D)''''' ## The [http://supp.apa.org/psycarticles/supplemental/a0033975/a0033975_supp.html 7 Up 7 Down Inventory]<ref name=":5">{{cite journal|last1=Youngstrom|first1=Eric A.|last2=Murray|first2=Greg|last3=Johnson|first3=Sheri L.|last4=Findling|first4=Robert L.|title=The 7 up 7 down inventory: a 14-item measure of manic and depressive tendencies carved from the General Behavior Inventory|journal=Psychological Assessment|date=1 December 2013|volume=25|issue=4|pages=1377–1383|doi=10.1037/a0033975|url=https://www.ncbi.nlm.nih.gov/pubmed/23914960|issn=1939-134X}}</ref> is a recently developed and validated questionnaire with 14 items of manic and depressive tendencies carved from the General Behavior Inventory, a well-validated but cumbersome interview. For both mania and depression factors, 7 items produced a psychometrically adequate measure applicable across both aggregate samples. Internal reliability of the Mania scale was .81 (youth) and .83 (adult) and for Depression was .93 (youth) and .95 (adult). ## The 7 Up 7 Down Inventory, along with the accompanying research article, can be [http://supp.apa.org/psycarticles/supplemental/a0033975/a0033975_supp.html found here]. # '''''[https://mfr.osf.io/render?url=https://osf.io/d95nv/?action=download%26mode=render PGBI-10M]'''''<ref>Youngstrom EA, Frazier TW, Demeter C, et al. Developing a 10-item mania scale from the Parent General Behavior Inventory for children and adolescents. J Clin Psychiatry. 2008;69(5):831–839.</ref> ## The [http://www.moodychildtherapy.com/wp-content/uploads/2011/01/PGBI-10M-2-wks.pdf PGBI-10M] (we would like to add another version that is better) is a brief (10 item) instrument derived from the [https://mfr.osf.io/render?url=https://osf.io/3j5r7/?action=download%26mode=render Parent General Behavior Inventory (PGBI)]<ref>{{Cite journal|last=Youngstrom|first=Eric A.|last2=Findling|first2=Robert L.|last3=Danielson|first3=Carla Kmett|last4=Calabrese|first4=Joseph R.|date=2001|title=Discriminative validity of parent report of hypomanic and depressive symptoms on the General Behavior Inventory.|url=http://psycnet.apa.org/doi/10.1037/1040-3590.13.2.267|journal=Psychological Assessment|language=en|volume=13|issue=2|pages=267–276|doi=10.1037/1040-3590.13.2.267|issn=1939-134X}}</ref>, a 73-item mood inventory, to assess [[mania]] in a large sample of outpatients presenting with a variety of different [[DSM-IV]] diagnoses, including frequent comorbid conditions.<ref name=":0">{{cite journal|last1=Youngstrom|first1=E. A.|last2=Findling|first2=R. L.|last3=Danielson|first3=C. K.|last4=Calabrese|first4=J. R.|title=Discriminative validity of parent report of hypomanic and depressive symptoms on the General Behavior Inventory|journal=Psychological Assessment|date=1 June 2001|volume=13|issue=2|pages=267–276|url=http://www.ncbi.nlm.nih.gov/pubmed/11433802|issn=1040-3590}}</ref> ## The 10-item GBI derived from the 73-item P-GBI had good reliability (alpha = .92), was correlated (r = 0.95) with the 28-item scale, and showed significantly better discrimination of bipolar disorders (area under the [[receiver operating characteristic]] [AUROC] curve of 0.856 vs. 0.832 for the 28-item scale, p < .005). The 10-item scale also did well discriminating bipolar disorder from unipolar depression (AUROC = 0.86) and bipolar disorder from [[attention deficit hyperactivity disorder|attention-deficit/hyperactivity disorder]] (AUROC = 0.82) cases. ## The full version of the scale, the Parent-General Behavior Inventory (P-GBI), is a parent-report measure of depressive and hypomanic/biphasic symptoms adapted from the General Behavior Inventory (GBI). ## Classification rates exceed 80%, and receiver operating characteristic analyses showed good diagnostic efficiency for the scales, with areas under the curve greater than .80. Results indicate that clinicians can use the parent-completed GBI to derive clinically meaningful information about mood disorders in youths. {{collapse bottom}} === Likelihood ratios and AUCs of screening measures for bipolar disorder in youth === * '''''For a list of the likelihood ratios for more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Likelihood_ratios_and_AUCs_of_common_screening_instruments click here.]''''' The following table describes the diagnostic likelihood ratios and area under curves for the top pediatric bipolar disorder measures. {| class="wikitable sortable" border="1" |- ! Screening Measure ! AUC (sample size) !Very Low risk range DiLR !Low risk range DiLR !Neutral risk range DiLR !High risk range DiLR !Very High risk range DiLR !DLR+ (score) !DLR- (score) ! Population/Clinical Generalizability !Download |- |[https://mfr.osf.io/render?url=https://osf.io/d3b4h/?action=download%26mode=render Parent General Behavior-10 Item Mania Version (PGBI-10M)]<ref name=":7" /> |.84 (''N''=617) academic sample, .78 community sample (''N''=530)<ref name=":7" /> |.07  (0 to 2.59)  |.41 (2.6 to 6.99) |1.44 (7 to 10.99)  |2.39 (11 to 17.99)  |5.38 (18+) | | |Bipolar spectrum vs. all other diagnoses |[https://mfr.osf.io/render?url=https://osf.io/ub8h7/?action=download%26mode=render Parent Form]<ref>{{Cite web|url=http://www.moodychildtherapy.com|title=Psychoeducational Psychotherapy|website=www.moodychildtherapy.com|language=en-US|access-date=2018-07-20}}</ref> |- |[https://mfr.osf.io/render?url=https://osf.io/eau89/?action=download%26mode=render Parent General Behavior-10 Item Depression Version Form A (PGBI-10Da)]<ref name=":7" /> |.84 (''N''=617) academic sample, .79 community sample (''N''=530)<ref name=":7" /> |.25  (0 to 1.99) |.71 (2 to 5.99)   |1.85 (6 to 9.99)   |4.52 (10 to 14.99) |8.80 (15+)   | | |Bipolar spectrum vs. all other diagnoses | |- |[https://mfr.osf.io/render?url=https://osf.io/eau89/?action=download%26mode=render Parent General Behavior-10 Item Depression Version Form B (PGBI-10Db)]<ref name=":7" /> |.84 (''N''=617) academic sample, .80 community sample (''N''=530)<ref name=":7" /> |.22 (0 to 1.99)    |.71 (2 to 5.99) |2.69 (6 to 10.99)    |5.64 (11 to 14.99)    |8.09 (15+) | | |Bipolar spectrum vs. all other diagnoses | |- |[https://mfr.osf.io/render?url=https://osf.io/hyb3g/?action=download%26mode=render Parent General Behavior Inventory] (P-GBI) (''Hypomanic/Biphasic Section''])<ref name="eay2004">Youngstrom, E. A., Findling, R. L., & Calabrese, J. R. (2004). Effects of adolescent manic symptoms on agreement between youth, parent, and teacher ratings of behavior problems. Journal of Affective Disorders, 82, S5-S16. </ref> | .84 (N=324) | |(<9) | | |(49+) |9.2 |.06 | Bipolar spectrum vs. all other diagnoses | |- | Parent Mood Disorder Questionnaire (P-MDQ)<ref>{{cite journal|last1=Wagner|first1=Karen Dineen|last2=Hirschfeld|first2=Robert M. A.|last3=Emslie|first3=Graham J.|last4=Findling|first4=Robert L.|last5=Gracious|first5=Barbara L.|last6=Reed|first6=Michael L.|date=1 May 2006|title=Validation of the Mood Disorder Questionnaire for bipolar disorders in adolescents|url=http://www.ncbi.nlm.nih.gov/pubmed/16841633|journal=The Journal of Clinical Psychiatry|volume=67|issue=5|pages=827–830|issn=0160-6689}}</ref> | .84 (N=819) | |(TBC) | | |(TBC) |4.64 |.17 | Bipolar spectrum vs. all other diagnoses | * [https://mfr.osf.io/render?url=https://osf.io/wtp7r/?action=download%26mode=render MDQ] |- | Child Mania Rating Scale (Brief) ''(Brief CMRS-P)''<ref name=":2">{{cite journal|last1=Henry|first1=David B.|last2=Pavuluri|first2=Mani N.|last3=Youngstrom|first3=Eric|last4=Birmaher|first4=Boris|date=1 April 2008|title=Accuracy of brief and full forms of the Child Mania Rating Scale|url=http://www.ncbi.nlm.nih.gov/pubmed/?term=18302291|journal=Journal of Clinical Psychology|volume=64|issue=4|pages=368–381|doi=10.1002/jclp.20464|issn=0021-9762}}</ref> | .85 (N=150) | |(<11) | | |(11+) |10.5 |.17 | Bipolar spectrum vs. ADHD | |- | Child Mania Rating Scale (Full) ''(Full CMRS-P)''<ref name=":2" /> | .91 (N=150) | |(<21) | | |(21+) |13.7 |.19 | Bipolar spectrum vs. ADHD | * [https://mfr.osf.io/render?url=https://osf.io/8wv3a/?action=download%26mode=render Downloadable PDF] |- |[https://mfr.osf.io/render?url=https://osf.io/5yzur/?action=download%26mode=render Child Bipolar Questionnaire] ''[https://mfr.osf.io/render?url=https://osf.io/5yzur/?action=download%26mode=render (CBQ-P)]''<ref>{{Cite journal|last=Papolos|first=Demitri|last2=Hennen|first2=John|last3=Cockerham|first3=Melissa S.|last4=Thode|first4=Henry C.|last5=Youngstrom|first5=Eric A.|date=2006-10|title=The child bipolar questionnaire: A dimensional approach to screening for pediatric bipolar disorder|url=https://doi.org/10.1016/j.jad.2006.03.026|journal=Journal of Affective Disorders|volume=95|issue=1-3|pages=149–158|doi=10.1016/j.jad.2006.03.026|issn=0165-0327}}</ref> |.74 (N=497) | | | | | |25.3/ (likelihood ratio +) |/.25 (likelihood ratio -) |Bipolar spectrum vs. all other diagnoses | |} === Interpreting bipolar disorder screening measure scores === For information on interpreting screening measure scores, click [[Evidence based assessment/Prediction phase#Interpreting screening measure scores|here.]] ==[[Evidence based assessment/Prescription phase|'''Prescription phase''']]== ===Gold standard diagnostic interviews=== For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews click here.] {{collapse top|More details on gold-standard diagnostic interviews|expand=yes}} # '''Kiddie Schedule for Affective Disorders and Schizophrenia-Present and Lifetime (KSADS-PL)''' #* The '''KSADS-PL''' is a semi-structured diagnostic interview that assesses current and past Diagnostic and Statistical Manual of Mental Disorders – Fourth Edition (DSM-IV-TR) Axis I psychopathology in youth<ref name="APA" />. The KSADS-PL diagnostic interviews have good inter-rater (.93 to 1.00) and retest reliability (.77) for mood disorders <ref>{{cite journal|last1=Kaufman|first1=J.|last2=Birmaher|first2=B.|last3=Brent|first3=D.|last4=Rao|first4=U.|last5=Flynn|first5=C.|last6=Moreci|first6=P.|last7=Williamson|first7=D.|last8=Ryan|first8=N.|title=Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (K-SADS-PL): initial reliability and validity data|journal=Journal of the American Academy of Child and Adolescent Psychiatry|date=1 July 1997|volume=36|issue=7|pages=980–988|doi=10.1097/00004583-199707000-00021|url=http://www.ncbi.nlm.nih.gov/pubmed/9204677|issn=0890-8567}}</ref> Here is a link to a PDF of the diagnostic interview for the [http://www.psychiatry.pitt.edu/sites/default/files/Documents/assessments/ksads-pl.pdf Kiddie Schedule for Affective Disorders and Schizophrenia-Present and Lifetime]. # '''Washington University in St. Louis Kiddie Schedule for Affective Disorders and Schizophrenia (WASH-U-KSADS)''' #* The '''[http://www.ncbi.nlm.nih.gov/pubmed/11314571 Washington University in St. Louis Kiddie Schedule for Affective Disorders and Schizophrenia]'''(WASH-U-KSADS)<ref name=":1">{{cite journal|last1=Geller|first1=B.|last2=Zimerman|first2=B.|last3=Williams|first3=M.|last4=Bolhofner|first4=K.|last5=Craney|first5=J. L.|last6=DelBello|first6=M. P.|last7=Soutullo|first7=C.|title=Reliability of the Washington University in St. Louis Kiddie Schedule for Affective Disorders and Schizophrenia (WASH-U-KSADS) mania and rapid cycling sections|journal=Journal of the American Academy of Child and Adolescent Psychiatry|date=1 April 2001|volume=40|issue=4|pages=450–455|doi=10.1097/00004583-200104000-00014|url=http://www.ncbi.nlm.nih.gov/pubmed/11314571|issn=0890-8567}}</ref> was expanded from the 1986 version of the KSADS, which was modified and expanded to include onset and offset of each symptom for both current and lifetime episodes, expanded prepubertal mania and rapid cycling sections, and categories for [[attention deficit hyperactivity disorder]] and other DSM-IV diagnoses. To optimize diagnostic research, skip-outs were minimized. #* The kappa values of comparisons between research nurse and off-site blind best-estimate ratings of mania and rapid cycling sections were excellent (0.74-1.00). High 6-month stability for mania diagnoses (85.7%) and for individual mania items and validity against parental and teacher reports were previously reported.<ref name=":1" /> #* The link to the diagnostic interview for the [http://www.psychiatry.pitt.edu/sites/default/files/Documents/assessments/mrs.pdf Washington University in St. Louis Kiddie Schedule for Affective Disorders and Schizophrenia] can be found [http://www.psychiatry.pitt.edu/sites/default/files/Documents/assessments/mrs.pdf here]. {{collapse bottom}} ===Recommended diagnostic instruments specific for pediatric bipolar disorder=== {| class="wikitable sortable" border="1" ! colspan="10" |Diagnostic instruments for '''(insert portfolio name)''' |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time ! Interrater Reliability ! Test-Retest Reliability ! Construct Validity ! Content Validity ! Highly Recommended !Free and Accessible Measures |- | Children's Depression Rating Scale - Revised (CDRS-R) | Structured Interview<ref name=":4">{{Cite journal|last=Mayes|first=Taryn L.|last2=Bernstein|first2=Ira H.|last3=Haley|first3=Charlotte L.|last4=Kennard|first4=Betsy D.|last5=Emslie|first5=Graham J.|date=2010-12|title=Psychometric Properties of the Children's Depression Rating Scale–Revised in Adolescents|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3003451/|journal=Journal of Child and Adolescent Psychopharmacology|volume=20|issue=6|pages=513–516|doi=10.1089/cap.2010.0063|issn=1044-5463|pmc=PMC3003451|pmid=21186970}}</ref> | 6-12 | 15-20 minutes | G | A | G | G | X | * Link to purchase [https://www.wpspublish.com/store/p/2703/cdrs-r-children-s-depression-rating-scale-revised#purchase-product CDRS-R] *[http://www.opapc.com/uploads/documents/CDRS-R.pdf PDF] (excerpt) |} =='''[[Evidence based assessment/Process phase|Process phase]]'''== The following section contains a list of process and outcome measures for adolescent bipolar spectrum disorder. The section includes benchmarks based on published norms and on mood samples for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the [[Evidence based assessment/Process phase|process phase]] of assessment. For more information on differences between process and outcome measures, see the page on the [[Evidence based assessment/Process phase|process phase of assessment]]. === Process measures === There are many processes that may be considered important when evaluating a child or an adolescent with Bipolar Disorder; however, due to the diversity of the population and symptom expression, there are too many to narrow down. Clinical judgment is recommended when deciding what additional measures should be included (e.g. executive functioning, sensory processing, cognitive flexibility). The measures provided below are commonly used to assess and provide important information regarding levels of daily functioning of individuals with Bipolar Disorder. {{blockquotetop}} '''A. Mood and Energy Thermometer'''- &nbsp; This is an improved and practical way of monitoring complex mood cycles and daily schedules. Given that some clinicians and patients may get confused about different 1 to 10 scales (e.g., a 10 could mean extreme depression, extreme mania, or no depression), the Mood & Energy Thermometer improves the language in communicating (and monitoring) mood. Moreover, many children report their energy levels more accurately than their mood and therefore, energy levels have been incorporated in this mood rating. The Mood & Energy Thermometer that was developed at Western Psychiatric Institute and Clinic (WPIC; and used in about 400 kids) rates mania and increased energy on a 1 to 10 scale, rates depression and tiredness on a -1 to -10 scale, and attempts to form a common language between patients, families, and clinicians. This scale also takes into account time spent depressed and/or manic; for example, -4 would mean “mild depression” and “mild tiredness” present ≥50% of the time, and -3 would mean “mild depression” and “mild tiredness” present < 50% of the time. The inclusion of measuring energy levels is consistent with the DSM-5, because energy level is now included in the DSM-5 as a main mood symptom criterion. Bipolar track patients (whether they had mania, depression, or mixed features) rated their mood and energy levels every day on this scale, and a master’s-level clinician met with them on a daily basis to help them better identify and record their mood symptoms, which has significant clinical value for not only treatment but also to prevent future episodes.<ref name=":3">{{Cite web|url=http://pediatricbipolar.pitt.edu/resources/instruments|title=Instruments {{!}} CABS {{!}} University of Pittsburgh|website=pediatricbipolar.pitt.edu|language=en|access-date=2018-05-31}}</ref> *[https://mfr.osf.io/render?url=https://osf.io/p4a8s/?action=download%26mode=render Mood and Energy Thermometer] *[https://mfr.osf.io/render?url=https://osf.io/upe2a/?action=download%26mode=render Mood and Energy Thermometer with Anger and Anxiety (with recording/monitoring card)] *[https://mfr.osf.io/render?url=https://osf.io/d2fge/?action=download%26mode=render Mood and Energy Thermometer with Anger and Anxiety - Simplified Version] '''B. Life Charts''' * To learn more about how life charts can be used with adolescent depression, [http://www.bipolarnews.org/Life%20Charting%20Description.htm see here] * [https://mfr.osf.io/render?url=https://osf.io/amq6k/?action=download%26mode=render Life Charts for Depression and Bipolar] {{blockquotebottom}} === Outcome and severity measures === * Information on how to interpret this table can be [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase found here]. * Additionally, these [[Evidence based assessment/Vignettes|vignettes]] might be helpful resources for understanding appropriate adaptation of outcome measures in practice. *For clinically significant change benchmarks for the CBCL, YSR, and TRF overall, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase&wteswitched=1#Clinically_significant_change_benchmarks_for_widely-used_outcome_measures see here.] ==== '''Clinically significant change benchmarks with common instruments for bipolar disorder in youth''' ==== {| class="wikitable sortable" | ! colspan="3" |Cut Scores ! colspan="3" |Critical Change (Unstandardized Scores) ![[w:Minimal important difference|Minimal]]<nowiki/>ly [[w:Minimal important difference|Important Difference]] |- !Measure !Away !Back !Closer !95% !90% !SEdifference !(MID) ''d'' ~.5 |- |[[General Behavior Inventory#GBI Short Forms|PGBI-10M]] |1 |9 |6 |6 |5 |3.2 |3 |- |[[Child Mania Rating Scale|CMRS 10]] |<nowiki>--</nowiki> |6 |4 |5 |4 |2.3 |2 |- |[[General Behavior Inventory#GBI Short Forms|PGBI-10Da]] |<nowiki>--</nowiki> |7 |4 |6 |5 |3.0 |3 |- |[[General Behavior Inventory#GBI Short Forms|PGBI-10Db]] |<nowiki>--</nowiki> |7 |4 |6 |5 |2.9 |3 |- |[[General Behavior Inventory#GBI Short Forms|AGBI-10M]] |<nowiki>--</nowiki> |14 |7 |6 |5 |3.1 |3 |- |[[General Behavior Inventory#GBI Short Forms|AGBI-10Da]] |<nowiki>--</nowiki> |18 |7 |6 |5 |3.2 |3 |- |[[General Behavior Inventory#GBI Short Forms|AGBI-10Db]] |<nowiki>--</nowiki> |16 |7 |6 |5 |2.9 |4 |- |[[General Behavior Inventory#GBI Short Forms|7 Up]] |<nowiki>--</nowiki> |8 |4 |4 |4 |2.2 |3 |- |[[General Behavior Inventory#GBI Short Forms|7 Down]] |<nowiki>--</nowiki> |12 |5 |5 |4 |2.3 |3 |- |[[w:Kiddie Schedule for Affective Disorders and Schizophrenia#KSADS%20Mania%20Rating%20Scale%20(KMRS)%20and%20Depression%20Rating%20Scale%20(KDRS)|KMRS]] |19 |19 |19 |3 |3 |1.6 |3 |- |[[w:Kiddie Schedule for Affective Disorders and Schizophrenia#KSADS%20Mania%20Rating%20Scale%20(KMRS)%20and%20Depression%20Rating%20Scale%20(KDRS)|KDRS]] |12 |19 |18 |5 |4 |2.4 |3 |- |CDRS-R Total |<nowiki>--</nowiki> |24 |22 |6 |5 |2.9 |5 |- |YMRS Total |4 |3 |3 |3 |3 |1.8 |3 |} <br /> {| class="wikitable sortable" border="1" |- | colspan="8" style="font-size:110%; text-align:center;" span |<b> Benchmarks Based on Published Norms</b> |- | rowspan="2" style="text-align:center;font-size:130%;" |<b> <big>Measure</big></b> | rowspan="2" style="text-align:center;font-size:130%;" |<b> <big>Subscale</big></b> | colspan="3" style="text-align:center;font-size:130%" width="300" |<b> <big>Cut-off scores</big></b> | colspan="3" style="text-align:center;font-size:120%" |<b> <big>Critical Change <br> (unstandardized scores)</big></b> |- | style="text-align:center;font-size:110%" |<b> A</b> | style="text-align:center;font-size:110%" |<b> B</b> | style="text-align:center;font-size:110%" |<b> C</b> | style="text-align:center;font-size:110%" |<b> 95%</b> | style="text-align:center;font-size:110%" |<b> 90%</b> | style="text-align:center;font-size:110%" |<b> SE_difference</b> |- | rowspan="1" style="text-align:center;" |<b> [http://www.sciencedirect.com/science/article/pii/0272735888900505 Beck Depression Inventory]<ref>{{cite journal|last=Beck|first=AT|title=Psychometric properties of the Beck Depression Inventory: Twenty-five years of evaluation.|journal=Clinical Psychology Review|date=1988|volume=8|issue=1|url=http://www.sciencedirect.com/science/article/pii/0272735888900505|accessdate=10 February 2014}}</ref></b> | style="text-align:right;" |<i> BDI Mixed Depression</i> | style="text-align:center;" | 4 | style="text-align:center;" | 22 | style="text-align:center;" | 15 | style="text-align:center;" | 9 | style="text-align:center;" | 8 | style="text-align:center;" | 4.8 |- |} === Treatment === ==== Psychotherapy ==== [[Psychotherapy|Psychotherapies]] are treatments that help people with a wide variety of mental health concerns. While different forms of psychotherapies for adolescent bipolar disorder aim to remedy different aspects of the disorder, all aim to alleviate symptoms and decrease functional impairment in the client. {| class="wikitable mw-collapsible" |+Overview of Psychotherapies !Therapy !Key components !Duration !Results |- |Child- and Family-Focused Cognitive-Behavioral Therapy | * Develop consistent routines * Learn to regulate emotions * Improve child's self-esteem and parent's self efficacy * Reduce negativity * Build social skills and networks * Teach parents self-care * Family-based problem solving and communication skill building | * 12 weeks long * 60-90 minute weekly sessions | * Decrease intensity of manic episodes * Decrease depressive symptoms in child * Overall improvement in client's functioning |- |Interpersonal and Social Rhythm Therapy | * Develop understanding of disruptions in routine and manic/depressive episodes * Build skills for creating consistent routines, aka, social rhythms * Build self-efficacy and phase out of therapy |Varies dependent on client need | * Increases time between manic/depressive episodes |- |Mindfulness-Based Cognitive Therapy | * Utilizes mindfulness-based practices such as mindfulness meditation * Focus on awareness of client's thoughts, feelings and behaviors * Learn to recognize how to monitor one's own thoughts * Increase self-care practices | * 8 weeks long * 60-120 minute weekly sessions | * Decrease in anxiety symptoms * Decrease in depressive symptoms * Increase mood regulation * Increase attention ability |- |Multi-Family Psychoeducational Psychotherapy |Group therapy using treatment components from: * Psychoeducation * Family Systems therapy * Cognitive-behavioral therapy | * 8 weeks long * 60-90 minute weekly sessions | * Decrease in severity of mood symptoms * Increase in caregiver understanding of child's disorder and how to seek mental health care * Children report feeling more social support from caregivers |} ===== Child- and Family-Focused Cognitive-Behavioral Family (CFF-CBT) ===== ====== Purpose ====== [[File:Cognitive Behavioral Cycle.jpg|thumb|357x357px|Cognitive behavioral cycle]] CFF-CBT was created to address the unique needs of bipolar disorder in children and adolescents with bipolar disorder, including rapid cycling, mixed mood states and comorbid disorders.<ref name=":0">{{Cite journal|last=West|first=Amy E.|last2=Weinstein|first2=Sally M.|last3=Peters|first3=Amy T.|last4=Katz|first4=Andrea C.|last5=Henry|first5=David B.|last6=Cruz|first6=Rick A.|last7=Pavuluri|first7=Mani N.|date=2014-11-01|title=Child- and Family-Focused Cognitive-Behavioral Therapy for Pediatric Bipolar Disorder: A Randomized Clinical Trial|url=https://jaacap.org/article/S0890-8567(14)00617-0/abstract|journal=Journal of the American Academy of Child & Adolescent Psychiatry|language=English|volume=53|issue=11|pages=1168–1178.e1|doi=10.1016/j.jaac.2014.08.013|issn=0890-8567|pmc=PMC4254579|pmid=25440307}}</ref> This treatment has been tested to see if it will help address the high suicide attempt rate among children/adolescents with the disorder, and no significant effects were found. However CFF-CBT has been found to be effective for 7-13 year olds with both clients with and without non-suicidal self-injury behaviors.<ref name=":1">{{Cite journal|last=MacPherson|first=Heather A.|last2=Weinstein|first2=Sally M.|last3=West|first3=Amy E.|date=2018-05-01|title=Non-Suicidal Self-Injury in Pediatric Bipolar Disorder: Clinical Correlates and Impact on Psychosocial Treatment Outcomes|url=https://doi.org/10.1007/s10802-017-0331-4|journal=Journal of Abnormal Child Psychology|language=en|volume=46|issue=4|pages=857–870|doi=10.1007/s10802-017-0331-4|issn=1573-2835}}</ref> Mediators of this intervention include: parenting skills and coping, family flexibility, and family positive reframing.<ref name=":2">{{Cite journal|last=Fristad|first=Mary A.|last2=MacPherson|first2=Heather A.|date=2014-05-01|title=Evidence-Based Psychosocial Treatments for Child and Adolescent Bipolar Spectrum Disorders|url=https://doi.org/10.1080/15374416.2013.822309|journal=Journal of Clinical Child & Adolescent Psychology|volume=43|issue=3|pages=339–355|doi=10.1080/15374416.2013.822309|issn=1537-4416|pmc=PMC3844106|pmid=23927375}}</ref> ====== Intended Population ====== Children aged 7-13 and adolescents aged 13-17 ====== Length of Treatment ====== 12 weekly sessions, with session time ranging from 60 to 90 minutes<ref name=":1" /><ref name=":0" /><ref name=":2" /> ====== Treatment Components ====== CFF-CBT focuses on 7 components comprising of the “RAINBOW” acronym<ref name=":0" />: ''R'': Routine; developing consistency ''A'': Affective regulation; includes psychoeducation on feelings, coping skills, and mood monitoring ''I'': “I can do it!”; this aims to improve self-esteem in the child, as well as self-efficacy in the parent ''N'': “No Negative Thoughts/Live in the Now” ''B'': Be a good friend/balanced life style (building social skills and teaching parents self-care ''O'': Oh, how do we solve this problem? (family-based problem solving and communication skills building) ''W'': Ways to find support (building a network of support) ====== Treatment Outcomes ====== CFF-CBT has shown decreases in mania to a subclinical level, parent-reported youth depressive symptoms, increased involvement/fidelity to treatment, and improvements in the client’s overall, global functioning in comparison to psychotherapy as per usual.<ref name=":1" /> <br /> ===== Interpersonal and Social Rhythm Therapy (IPSRT) ===== ====== Purpose ====== IPSRT is based on the social zeitgeber hypothesis<ref>{{Cite journal|last=Grandin|first=Louisa D.|last2=Alloy|first2=Lauren B.|last3=Abramson|first3=Lyn Y.|date=2006-10|title=The social zeitgeber theory, circadian rhythms, and mood disorders: Review and evaluation|url=https://linkinghub.elsevier.com/retrieve/pii/S0272735806000651|journal=Clinical Psychology Review|language=en|volume=26|issue=6|pages=679–694|doi=10.1016/j.cpr.2006.07.001}}</ref>, which states that regularity in social routines and interpersonal relationships acts as a protective factor for mood disorders. Thus, this treatment focused on maintaining regularity in daily routines, quality of social relationships and social roles, and management of consequences of rhythm disruptions.<ref>{{Cite journal|last=Frank|first=Ellen|last2=Kupfer|first2=David J.|last3=Thase|first3=Michael E.|last4=Mallinger|first4=Alan G.|last5=Swartz|first5=Holly A.|last6=Fagiolini|first6=Andrea M.|last7=Grochocinski|first7=Victoria|last8=Houck|first8=Patricia|last9=Scott|first9=John|date=2005-09-01|title=Two-Year Outcomes for Interpersonal and Social Rhythm Therapy in Individuals With Bipolar I Disorder|url=http://dx.doi.org/10.1001/archpsyc.62.9.996|journal=Archives of General Psychiatry|volume=62|issue=9|pages=996|doi=10.1001/archpsyc.62.9.996|issn=0003-990X}}</ref> ====== Intended Population ====== IPSRT is intended for all individuals with bipolar disorder, and has been found to be effective in adolescents.<ref name=":3">{{Cite journal|last=Crowe|first=Marie|last2=Inder|first2=Maree|last3=Joyce|first3=Peter|last4=Moor|first4=Stephanie|last5=Carter|first5=Janet|last6=Luty|first6=Sue|date=2009-01|title=A developmental approach to the treatment of bipolar disorder: IPSRT with an adolescent|url=http://doi.wiley.com/10.1111/j.1365-2702.2008.02571.x|journal=Journal of Clinical Nursing|language=en|volume=18|issue=1|pages=141–149|doi=10.1111/j.1365-2702.2008.02571.x}}</ref> ====== Length of Treatment ====== Length of treatment varies dependent on client needs.<ref name=":3" /> ====== Treatment Components ====== IPSRT is structured in three phases<ref name=":4">{{Cite web|url=https://www.ipsrt.org/background|title=Interpersonal and Social Rhythm Therapy {{!}} Background|website=www.ipsrt.org|access-date=2019-12-05}}</ref>: # Initial phase: Explores the clients history in order to explore links between disruptions in routines to affective episodes. This stage also includes education on the rationale of the treatment<ref name=":4" /> # Intermediate phase: Focused on reorganizing the client's social rhythms, reinforcing new social rhythms and building confidence in using techniques that are taught in the treatment<ref name=":4" /> # Final phase: Reduction in frequency of visits in order to work towards termination of therapy and self-efficacy<ref name=":4" /> ====== Treatment Outcomes ====== If applied early in the acute phase of bipolar disorder, IPSRT may prolong time to relapse in depressive/manic episodes.<ref name=":5">{{Cite journal|last=Miziou|first=Stella|last2=Tsitsipa|first2=Eirini|last3=Moysidou|first3=Stefania|last4=Karavelas|first4=Vangelis|last5=Dimelis|first5=Dimos|last6=Polyzoidou|first6=Vagia|last7=Fountoulakis|first7=Konstantinos N|date=2015-12|title=Psychosocial treatment and interventions for bipolar disorder: a systematic review|url=http://www.annals-general-psychiatry.com/content/14/1/19|journal=Annals of General Psychiatry|language=en|volume=14|issue=1|pages=19|doi=10.1186/s12991-015-0057-z|issn=1744-859X|pmc=PMC4493813|pmid=26155299}}</ref> ===== Mindfulness-Based Cognitive Therapy (MBCT) ===== ====== Purpose ====== Mindfulness approaches aim to enhance one’s ability to focus their attention on the present moment in a non-judgmental manor.<ref name=":5" /> In treatment for Bipolar Disorder, mindfulness approaches may focus on awareness of the client’s patterns of thoughts, feelings and bodily sensations both specific and non-specific to their experiences related to the disorder.<ref name=":5" /> Moreover, when comorbid with anxiety, bipolar disorder has higher risk of suicide attempts, therefore MBCT aims to decrease these anxiety symptoms.<ref name=":6">{{Cite journal|last=Williams|first=J. Mark G.|last2=Russell|first2=Ian|last3=Russell|first3=Daphne|date=2008-06|title=Mindfulness-based cognitive therapy: Further issues in current evidence and future research.|url=http://doi.apa.org/getdoi.cfm?doi=10.1037/0022-006X.76.3.524|journal=Journal of Consulting and Clinical Psychology|language=en|volume=76|issue=3|pages=524–529|doi=10.1037/0022-006X.76.3.524|issn=1939-2117|pmc=PMC2834575|pmid=18540746}}</ref> ====== Intended Population ====== MBCT is intended for all populations with bipolar disorder.<ref name=":6" /> ====== Length of Treatment ====== MPCT is typically offered in 1-2 hour weekly sessions over an 8-week period in a group setting (Perich et al 2012; Weber et al 2010).<ref>{{Cite journal|last=Perich|first=T.|last2=Manicavasagar|first2=V.|last3=Mitchell|first3=P. B.|last4=Ball|first4=J. R.|last5=Hadzi-Pavlovic|first5=D.|date=2012-12-09|title=A randomized controlled trial of mindfulness-based cognitive therapy for bipolar disorder|url=http://dx.doi.org/10.1111/acps.12033|journal=Acta Psychiatrica Scandinavica|volume=127|issue=5|pages=333–343|doi=10.1111/acps.12033|issn=0001-690X}}</ref><ref name=":7">{{Cite journal|last=Weber|first=B.|last2=Jermann|first2=F.|last3=Gex-Fabry|first3=M.|last4=Nallet|first4=A.|last5=Bondolfi|first5=G.|last6=Aubry|first6=J.-M.|date=2010-10|title=Mindfulness-based cognitive therapy for bipolar disorder: A feasibility trial|url=https://linkinghub.elsevier.com/retrieve/pii/S0924933810000817|journal=European Psychiatry|language=en|volume=25|issue=6|pages=334–337|doi=10.1016/j.eurpsy.2010.03.007}}</ref> Participants are also assigned homework, including varying lengths of meditation practice.<ref name=":7" /> ====== Treatment Components ====== MPCT combines aspects of classical CBT and mindfulness-based stress reduction therapies. The themes addressed in each session are<ref>{{Cite web|url=http://mbct.com/classes.html|title=Classes|website=mbct.com|access-date=2019-12-05}}</ref>: Session 1: Automatic pilot Session 2: Dealing with barriers Session 3: Mindfulness of the breath Session 4: Staying present Session 5: Allowing and letting be Session 6: Thoughts are not facts Session 7: How can I best take care of myself Session 8: Using what has been learned to deal with future moods ====== Treatment Outcomes ====== Treatment outcomes include decreases in anxiety and depressive symptoms and mood regulation in patients with bipolar disorder, but there has been no evidence in prevention of recurrences.<ref name=":5" /><ref name=":6" /> MBCT has also been found to improve attentional readiness, and attenuated activation of non-relevant information processing during attentional readiness, which are usually decreased in individuals with Bipolar Disorder compared to those without.<ref>{{Cite journal|last=Howells|first=Fleur M|last2=Ives-Deliperi|first2=Victoria L|last3=Horn|first3=Neil R|last4=Stein|first4=Dan J|date=2012-02-29|title=Mindfulness based cognitive therapy improves frontal control in bipolar disorder: a pilot EEG study|url=http://dx.doi.org/10.1186/1471-244x-12-15|journal=BMC Psychiatry|volume=12|issue=1|doi=10.1186/1471-244x-12-15|issn=1471-244X}}</ref> <br /> ===== Multi-Family Psychoeducational Psychotherapy (MF-PEP) ===== ====== Purpose ====== MF-PEP is a group-based evidence based treatment for children with bipolar disorder, which is meant to increase the ability for the treatment to be readily implemented into the community.<ref name=":8">{{Cite journal|last=MacPherson|first=Heather A.|last2=Leffler|first2=Jarrod M.|last3=Fristad|first3=Mary A.|date=2014|title=Implementation of Multi-Family Psychoeducational Psychotherapy for Childhood Mood Disorders in an Outpatient Community Setting|url=https://onlinelibrary.wiley.com/doi/abs/10.1111/jmft.12013|journal=Journal of Marital and Family Therapy|language=en|volume=40|issue=2|pages=193–211|doi=10.1111/jmft.12013|issn=1752-0606|pmc=PMC4198302|pmid=24749838}}</ref> While MF-PEP creates a support system within the family for the child through being a family-based intervention, it also serves to increase social support for care givers through being a group-based therapy. ====== Intended Population ====== MF-PEP is intended for children with depressive and bipolar disorders and their caretakers.<ref name=":8" /><ref name=":9">{{Cite journal|last=Fristad|first=Mary A.|last2=Verducci|first2=Joseph S.|last3=Walters|first3=Kimberly|last4=Young|first4=Matthew E.|date=2009-09-01|title=Impact of Multifamily Psychoeducational Psychotherapy in Treating Children Aged 8 to 12 Years With Mood Disorders|url=https://jamanetwork.com/journals/jamapsychiatry/fullarticle/210303|journal=Archives of General Psychiatry|language=en|volume=66|issue=9|pages=1013–1021|doi=10.1001/archgenpsychiatry.2009.112|issn=0003-990X}}</ref> ====== Length of Treatment ====== MF-PEP is an 8-session long treatment, with sessions typically ranging from 60-90 minutes. <ref name=":8" /><ref name=":9" /> ====== Treatment Components ====== MF-PEP combines [[wikipedia:Psychoeducation|psychoeducation]], [[wikipedia:Family_therapy|family systems]], and [[wikipedia:Cognitive_behavioral_therapy|cognitive behavior therapy]] techniques, aiming to target depressive and bipolar disorder symptoms and how these symptoms cause impairment. <ref name=":9" /> In MF-PEP, sessions are delivered in a combination of settings, including all children and parents together, as well as separating all children and caregivers into their own respective groups. <ref name=":9" /> ====== Treatment Outcomes ====== Treatment outcomes for MG-PEP include an increase in caregiver's understanding of the child's disorder, and a decrease in mood symptom severity within the children which has been seen to be maintained through an 18-month follow-up. <ref name=":10">{{Cite journal|last=MacPherson|first=Heather A.|last2=Leffler|first2=Jarrod M.|last3=Fristad|first3=Mary A.|date=2014|title=Implementation of Multi-Family Psychoeducational Psychotherapy for Childhood Mood Disorders in an Outpatient Community Setting|url=https://onlinelibrary.wiley.com/doi/abs/10.1111/jmft.12013|journal=Journal of Marital and Family Therapy|language=en|volume=40|issue=2|pages=193–211|doi=10.1111/jmft.12013|issn=1752-0606|pmc=PMC4198302|pmid=24749838}}</ref> Additionally, MF-PEP has been found to have a positive effect on parent's help-seeking behaviors for mental health care, leading to access to higher-quality services. <ref name=":10" /> Lastly, children report feeling a stronger sense of social support from their caregivers after participating in the intervention.<ref name=":9" /> ===== See Also: ===== * Wikipedia has a page reviewing [[wikipedia:Treatment_of_bipolar_disorder|treatments for bipolar disorder]]. * [http://www.effectivechildtherapy.com Effective Child Therapy] provides a curated list of effective psycho-social treatments for bipolar disorder in youths. * [https://icd.who.int/browse10/2015/en#/F31 ICD-10 Diagnostic Criteria] * [[wikipedia:Bipolar_disorder_in_children|Bipolar disorder in children]] * [https://onlinelibrary.wiley.com/doi/epdf/10.1111/bdi.12556 The International Society for Bipolar Disorders Task Force report on pediatric bipolar disorder: Knowledge to date and directions for future research] * [[wikipedia:Treatment_of_bipolar_disorder|Treatment of bipolar disorder]] =='''External resources'''== {{Infobox disease | name = Pediatric Bipolar Disorder | image = | Caption = Bipolar disorder consists of experiences of mania alternating with depressive episodes | DiseasesDB = 7812 | ICD10 = {{ICD10|F|31||f|30}} | ICD9 = {{ICD9|296.0}}, {{ICD9|296.1}}, {{ICD9|296.4}}, {{ICD9|296.5}}, {{ICD9|296.6}}, {{ICD9|296.7}}, {{ICD9|296.8}} | ICDO = | OMIM = 125480 | OMIM_mult = {{OMIM2|309200}} | MedlinePlus = 000926 | eMedicineSubj = med | eMedicineTopic = 229 | MeshID = D001714 }} #[http://www.nami.org/ National Alliance on Mental Illness] – the nation’s largest grassroots mental health organization dedicated to building better lives for the millions of Americans affected by mental illness. NAMI advocates for access to services, treatment, supports and research and is steadfast in its commitment to raise awareness and build a community for hope for all of those in need.<ref>{{cite web|last=NAMI: National Alliance on Mental Illness.|title=National Alliance on Mental Illness|url=http://www.nami.org/|accessdate=5 February 2014}}</ref> #[http://www.thebalancedmind.org Balanced Mind Foundation] – information, articles, parent support chat rooms.<ref>{{cite web|last=The Balanced Mind.|title=The Balanced Mind Parent Network.|url=http://www.thebalancedmind.org|accessdate=5 February 2014}}</ref> #[http://www.effectivechildtherapy.com Effective Child Therapy] – Information and articles curated by [https://sccap53.org Society of Clinical Child and Adolescent Psychology](SCCAP), a division of the American Psychological Association.<ref>{{cite web|last=Effective Child Therapy|title=Effective Child Therapy: Evidence-based mental health treatment for children and adolescents.|url=http://www.effectivechildtherapy.com|accessdate=5 February 2014}}</ref> ##[http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/severe-mood-swings-and-bipolar-spectrum-disorders/ Effective Child Therapy information: Bipolar Disorder] ##[http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/severe-mood-swings-and-bipolar-spectrum-disorders/ Effective Child Therapy information: Severe Mood Swings and Bipolar Spectrum Disorders] ##[http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/sadness-hopelessness-and-depression/ Effective Child Therapy information: Sadness, Hopelessness, and Depression] #[http://ibpf.org/resources International Bipolar Foundation] – information, help and resources available for caregivers and those afflicted with bipolar disorder.<ref>http://ibpf.org/resources, International Bipolar Foundation, retrieved 27th January 2014. </ref> #[http://www.bipolarnews.org Bipolar Network News] – an online clearinghouse and information on latest treatments, research and psychoeducation about mood disorders.<ref>http://bipolarnews.org/, Bipolar Network News, retrieved 30th January 2014. </ref> #[http://www.depressionalliance.org/ Depression Alliance] – a United Kingdom charity that works to prevent and relieve depression by providing information and support services via supporter services, publications and self-help groups.<ref>Depression Alliance, http://www.depressionalliance.org/, retrieved 30th January 2014. </ref> #[http://www.dbsalliance.org/site/PageServer?pagename=home Depression and Bipolar Support Alliance (DBSA)] – a peer-directed national organization that provides links to resources, support groups, and peer support for individuals and their families suffering from bipolar disorder. ##[https://unc.az1.qualtrics.com/jfe/form/SV_cBlUQk8Y85LHF41 Depression and Bipolar Support Alliance: 7 Up 7 Down Online Screener] #Related Wikipedia Pages ##[[wikipedia:Bipolar_disorder|Bipolar disorder Wikipedia Page]] ##[[wikipedia:Cyclothymia|Cyclothymia Wikipedia Page]] ##[[wikipedia:Mania|Mania Wikipedia Page]] ##[[wikipedia:Depression_(mood)|Depression Wikipedia Page]] #[https://www.massgeneral.org/psychiatry/services/treatmentprograms.aspx?id=1944&display=bipolar Massachusetts General Hospital School Psychiatry Resources for Bipolar Disorder] #The Psych Show with Dr. Ali Mattu videos ##[https://www.youtube.com/watch?v=llOPqKD-s4w How to Cope with Bipolar Disorder] ##[https://www.youtube.com/watch?v=kUHUmeqBZAA Top 10 Bipolar Myths] #[[Evidence Based Psychotherapies for Adolescent Bipolar Disorder]] =='''References'''== {{collapse top|References|expand=yes}} {{Reflist|30em}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] {{collapse bottom}} 4ar9din832kuejq6hrp4udd0v317ifr 2419298 2419247 2022-08-26T05:24:49Z Ardenguo 2944162 /* Psychometric properties of screening instruments for pediatric bipolar disorder */ added "Note: Reliability and validity are included in the extended version. This table includes measures with Good or Excellent ratings." wikitext text/x-wiki <noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{psychology}}{{Evidence-based assessment}}{{medical disclaimer}} {{:{{BASEPAGENAME}}/Sidebar}} ==[[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio?"''']]== * For background information on what assessment portfolios are, click the link in the heading above. Want even 'more' information about this topic? There's an extended version of this page [[Evidence-based assessment/Bipolar disorder in youth (assessment portfolio)/extended version|here]]. == '''[[Evidence based assessment/Preparation phase|Preparation phase]]''' == === Diagnostic criteria for Pediatric Bipolar disorder === {{collapse top| More information on PBD diagnostic criteria|expand=yes}} *[[w:Bipolar_disorder_in_children|Pediatric bipolar disorder (PBD)]] is characterized by extreme fluctuations in mood or emotional dysregulation that range from mania (as shown by displays or feelings of extreme happiness, unrealistic overachievement, and anger) to depression (as shown by displays or feelings of sadness, changes in appetite or weight, and irritability<ref name="APA"> American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.</ref> <ref name="jamison"> Goodwin, F. K., & Jamison, K. R. (2007). ''Manic-depressive illness.'' (10th edition). New York, NY: Oxford University Press </ref>). *It is important to note that these moods exceed normal responses to life events, represent a change from the individual's normal functioning, and cause problems in daily activities. These mood fluctuations result in a child finding it difficult to live and interact with family, friends and teachers, when it was previously not an issue<ref name="APA" />. *People with [[w:Bipolar_disorder|bipolar disorder]] experience unusually intense emotional states that occur in distinct periods called [[w:Mood_(psychology)|"mood episodes".]] An overly joyful or overexcited state is called a manic episode, and an extremely sad or hopeless state is called a [[w:Major_depressive_episode|depressive episode]]. Sometimes, a mood episode includes symptoms of both [[w:Mania|mania]] and [[w:Depression_(mood)|depression]]. *People with bipolar disorder also may be explosive and irritable during a mood episode.<ref name="APA" /> **Extreme changes in energy, activity, sleep, and behavior go along with these changes in mood. *It is possible for someone with bipolar disorder to experience a long-lasting period of unstable moods rather than discrete episodes of depression or mania.<ref name="jamison" /> <ref name="APA" /> *A person may be having an episode of bipolar disorder if he or she has a number of manic or depressive symptoms for most of the day, nearly every day, for at least one or two weeks. These debilitating symptoms can result in an afflicted individual being unable to function adaptively in several settings. {{collapse bottom}} {{blockquotetop}} '''<big>ICD-10 Criteria</big>''' '''''F31 Bipolar affective disorder''''' *''Note.'' Episodes are demarcated by a switch to an episode of opposite or mixed polarity or by a remission. '''''F31.0 Bipolar affective disorder, current episode hypomanic''''' '''A.''' The current episode meets the criteria for '''Hypomania F30.0''': *'''''(A)''''' The mood is elevated or irritable to a degree that is definitely abnormal for the individual concerned and sustained for at least four consecutive days. *'''''(B)''''' At least three of the following signs must be present, leading to some interference with personal functioning in daily living *# Increased activity or physical restlessness; *# Increased talkativeness; *# Distractibility or difficulty in concentration; *# Decreased need for sleep; *# Increased sexual energy; *# Mild over-spending, or other types of reckless or irresponsible behavior; *# Increased sociability or over-familiarity. *'''''(C)''''' The episode does not meet the criteria for '''F30.1 Mania without psychotic symptoms''', '''F30.2 Mania with psychotic symptoms''', '''F31.- Bipolar affective disorder''', '''F32.- Depressive episode''', '''F34.0 Cyclothymia''', or '''F50.0 Anorexia nervosa'''. *'''''(D)''''' ''Most commonly used exclusion clause.'' The episode is not attributable to '''F10-F19 Psychoactive substance use''' or in the sense of any '''F00-F09 Organic mental disorder'''. '''B.''' There has been at least one other affective episode in the past, meeting the criteria for '''F30.- Hypomanic or Manic episode''', '''F32.Depressive episode''', or '''F38.00 Mixed affective episode.''' <big>'''Changes in DSM-5'''</big> The diagnostic criteria for bipolar disorders changed slightly from [[DSM-IV]] to [[w:Diagnostic_and_Statistical_Manual_of_Mental_Disorders#DSM-IV-TR_.282000.29|DSM-5]]. Summaries are available [http://www.dsm5.org/Documents/changes%20from%20dsm-iv-tr%20to%20dsm-5.pdf here] and [[w:DSM-5|here]]. {{blockquotebottom}} === Base rates of PBD in different clinical settings and populations === This section describes the demographic setting of the population(s) sampled, base rates of diagnosis, country/region sampled and the diagnostic method that was used. Using this information, clinicians will be able to anchor the rates of PBD that they are likely to see in their clinical practices. * '''''To find prevalence rates across multiple disorders,''''' [[Evidence based assessment/Preparation phase#Base rates for transdiagnostic comparison|'''''click here.''''']] {| class="wikitable sortable" border="1" |+ style="text-align: left;" | ''Base rates of BSD in different clinical settings'' |- ! scope="col" | Setting (Reference) ! scope="col" style="white-space: nowrap;"| Base Rate ! scope="col" | Demography ! scope="col" | Diagnostic Method !Recommended for... |- | Rates of Bipolar Disorders in General Population || 0.6% || '''Bipolar I''' in youths age 5 to 18 || Meta-analysis of epidemiological studies, 19 samples, N = 56,103 participants<ref name=":11">{{Cite journal|last=Van Meter|first=Anna|last2=Moreira|first2=Ana Lúcia R.|last3=Youngstrom|first3=Eric|date=2019-04-02|title=Updated Meta-Analysis of Epidemiologic Studies of Pediatric Bipolar Disorder|url=https://www.psychiatrist.com/JCP/article/Pages/2019/v80/18r12180.aspx|journal=The Journal of Clinical Psychiatry|volume=80|issue=3|doi=10.4088/JCP.18r12180|issn=1555-2101}}</ref> |Schools, nonclinical settings. Minimum for outpatient settings. |- | style="border: width: 1px; border-bottom: 3px solid grey; padding: 5px;" |Rates of bipolar spectrum (I, II, cyclothymia, NOS) in general population || style="border: width: 1px; border-bottom: 3px solid grey; padding: 5px;" | 3.9% || style="border: width: 1px; border-bottom: 3px solid grey; padding: 5px;" | '''Bipolar spectrum''' in youths age 5 to 18 years || style="border: width: 1px; border-bottom: 3px solid grey; padding: 5px;" | Meta-regression estimate <ref name=":11" /> |Schools, nonclinical settings. Minimum for outpatient settings. |- | High school epidemiological<br />(Lewinsohn et al., 2000) || 0.6% || Northwestern USA high school || KSADS-PL | |- |Community Mental Health Center<br />(E. A. Youngstrom et al., 2005) || 6% || Midwestern Urban, 80% non-white, low-income || Clinical interview & treatment | |- | General Outpatient Clinic;<br />(Geller, Zimerman, Williams, Delbello, Frazier, et al., 2002) || 6% to 8% || Urban academic research centers || WASH-U-KSADS | |- |County Wards (DCFS)<br />(Naylor, Anderson, Kruesi, & Stoewe, 2002, October) || 11% || State of Illinois || Clinical interview & treatment | |- | Specialty Outpatient Service<br />(Biederman et al., 1996) || 15-17% || New England || KSADS-E | |- |Incarcerated adolescents<br />(Teplin, Abram, McClelland, Dulcan, & Mericle, 2002) || 2% || Midwestern Urban || DISC | |- | Incarcerated adolescents<br />(Pliszka et al., 2000) || 22% || Texas || DISC | |- | Acute psychiatric hospitalizations<br />in 2002-2003 – <u>adolescents</u><br />(Blader & Carlson, 2007) || 21% || All of U.S.A. || Centers for Disease Control survey of discharge diagnoses | |- | Inpatient service<br />(Carlson & Youngstrom, 2003) || 30% manic symptoms,<br /><2% strict BP I || New York City Metro Region || DICA; KSADS | |- |Acute psychiatric hospitalizations<br />in 2002-2003 – <u>children</u><br />(Blader & Carlson, 2007) || 40% || All of U.S.A. || Centers for Disease Control survey of discharge diagnoses | |- |Psychiatric outpatient clinic<br />(Ghanizadeh, Mohammadi, & Yazdanshenas, 2006) || 16-17% || Iran || K-SADS-PL (Farsi) | |- |Inpatient and partial hospitalization programs at a psychiatric treatment center<br />(Pellegrini et al., 1986) || Mania (0%), hypomania (6%) || Richmond, Virginia || DISC | |- |} ^p Parent interviewed as component of diagnostic assessment; ^y youth interviewed as part of diagnostic assessment. ''Note:'' KSADS = Kiddie Schedule for Affective Disorders and Schizophrenia, PL = Present and Lifetime version, WASH-U = Washington University version, -E = Epidemiological version of the KSADS; DISC = Diagnostic Interview Schedule for Children; DICA = Diagnostic Interview for Children and Adolescents. Table modified from Wikiversity. {| class="wikitable sortable" border="1" |- ! Setting ! Base Rate ! Demography ! Diagnostic Method !Best Recommended For |- | Community epidemiological (NCS-A) <ref>{{cite journal|last1=Kessler|first1=Ronald C.|last2=Avenevoli|first2=Shelli|last3=Costello|first3=E. Jane|last4=Georgiades|first4=Katholiki|last5=Green|first5=Jennifer Greif|last6=Gruber|first6=Michael J.|last7=He|first7=Jian-ping|last8=Koretz|first8=Doreen|last9=McLaughlin|first9=Katie A.|last10=Petukhova|first10=Maria|last11=Sampson|first11=Nancy A.|last12=Zaslavsky|first12=Alan M.|last13=Merikangas|first13=Kathleen Ries|title=Prevalence, persistence, and sociodemographic correlates of DSM-IV disorders in the National Comorbidity Survey Replication Adolescent Supplement|journal=Archives of General Psychiatry|date=1 April 2012|volume=69|issue=4|pages=372–380|doi=10.1001/archgenpsychiatry.2011.160|url=http://www.ncbi.nlm.nih.gov/pubmed/22147808|accessdate=26 January 2016|issn=1538-3636}}</ref> | 3.0% | All of U.S.A. | CIDI 3.0 | |- | Community epidemiologic samples<ref>{{cite journal|last1=Van Meter|first1=Anna R.|last2=Moreira|first2=Ana Lúcia R.|last3=Youngstrom|first3=Eric A.|date=1 September 2011|title=Meta-analysis of epidemiologic studies of pediatric bipolar disorder|url=http://www.ncbi.nlm.nih.gov/pubmed/21672501|journal=The Journal of Clinical Psychiatry|volume=72|issue=9|pages=1250–1256|doi=10.4088/JCP.10m06290|issn=1555-2101}}</ref> |mean= 1.8% (95% CI, 1.1%–3.0%), bipolar I (mean =1.2%; 95% CI, 0.7%–1.9%) | U.S.A., Netherlands, U.K., Spain, Mexico, Ireland, New Zealand | Structured and semi-structured diagnostic interviews, Combination of broad and specific diagnostic criteria (Meta-Analysis) |Schools, nonclinical settings. Minimum for outpatient settings. |- |Community mental health center<ref>{{Cite journal|last=Youngstrom|first=Eric A.|last2=Findling|first2=Robert L.|last3=Youngstrom|first3=Jen Kogos|last4=Calabrese|first4=Joseph R.|date=September 2005|title=Toward an evidence-based assessment of pediatric bipolar disorder|url=https://www.ncbi.nlm.nih.gov/pubmed/16026213|journal=Journal of Clinical Child and Adolescent Psychology: The Official Journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 53|volume=34|issue=3|pages=433–448|doi=10.1207/s15374424jccp3403_4|issn=1537-4416|pmid=16026213}}</ref> |6% |U.S.A., Midwestern Urban, 80% non-white, low-income |Parent and youth clinical assessment & treatment | |- |General outpatient clinic<ref name=":1" /> |6-8% |Urban academic research centers |WASH-U-[[w:Kiddie Schedule for Affective Disorders and Schizophrenia|KSAD]]S (parent and youth) | |- |Specialty outpatient service<ref>{{Cite journal|last=Biederman|first=J.|last2=Faraone|first2=S.|last3=Mick|first3=E.|last4=Wozniak|first4=J.|last5=Chen|first5=L.|last6=Ouellette|first6=C.|last7=Marrs|first7=A.|last8=Moore|first8=P.|last9=Garcia|first9=J.|date=August 1996|title=Attention-deficit hyperactivity disorder and juvenile mania: an overlooked comorbidity?|url=https://www.ncbi.nlm.nih.gov/pubmed/8755796|journal=Journal of the American Academy of Child and Adolescent Psychiatry|volume=35|issue=8|pages=997–1008|doi=10.1097/00004583-199608000-00010|issn=0890-8567|pmid=8755796}}</ref> |15-17% |Boston area, U. S. A. |[[w:Kiddie Schedule for Affective Disorders and Schizophrenia|KSADS]]-E | |- | Inpatient Services/Diagnoses<ref>{{Cite journal|last=Holtmann|first=M.|last2=Goth|first2=K.|last3=Wöckel|first3=L.|last4=Poustka|first4=F.|last5=Bölte|first5=S.|date=2008|title=CBCL-pediatric bipolar disorder phenotype: severe ADHD or bipolar disorder?|url=https://www.ncbi.nlm.nih.gov/pubmed/17994189|journal=Journal of Neural Transmission (Vienna, Austria: 1996)|volume=115|issue=2|pages=155–161|doi=10.1007/s00702-007-0823-4|issn=0300-9564|pmid=17994189}}</ref> | 0.3% | All of Germany | [[w:International_Statistical_Classification_of_Diseases_and_Related_Health_Problems|International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10)]] | |- | Community sample<ref>{{cite journal|last1=Olino|first1=Thomas M.|last2=Shankman|first2=Stewart A.|last3=Klein|first3=Daniel N.|last4=Seeley|first4=John R.|last5=Pettit|first5=Jeremy W.|last6=Farmer|first6=Richard F.|last7=Lewinsohn|first7=Peter M.|date=1 September 2012|title=Lifetime rates of psychopathology in single versus multiple diagnostic assessments: Comparison in a community sample of probands and siblings|url=http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3411854/|journal=Journal of psychiatric research|volume=46|issue=9|pages=1217–1222|doi=10.1016/j.jpsychires.2012.05.017|issn=0022-3956}}</ref> | 2.9% | Oregon | LIFE, SCID, DSM-IV | |- | Inpatient service<ref>{{cite journal|last1=Carlson|first1=Gabrielle A.|last2=Youngstrom|first2=Eric A.|date=1 June 2003|title=Clinical implications of pervasive manic symptoms in children|url=http://www.ncbi.nlm.nih.gov/pubmed/12788250|journal=Biological Psychiatry|volume=53|issue=11|pages=1050–1058|issn=0006-3223}}</ref> | 30% manic symptoms, <2% strict BP I | New York City Metro Region | DICA; [[w:Kiddie Schedule for Affective Disorders and Schizophrenia|KSADS]] | |- |NCS-A Clinical Reappraisal Sample<ref name=":3" /> ^{p y} |6.2% and SE=1.7 (bipolar I and II and sub-threshold bipolar spectrum disorder) |U.S.A, NCS-A |[[w:Kiddie Schedule for Affective Disorders and Schizophrenia|K-SADS]], DSM-IV criteria were modified from published version for purpose of the study, broad criteria for not otherwise specified | | |- |NCS-A Clinical Reappraisal Sample<ref name=":3">{{Cite journal|last=Kessler|first=Ronald C.|last2=Avenevoli|first2=Shelli|last3=Green|first3=Jennifer|last4=Gruber|first4=Michael J.|last5=Guyer|first5=Margaret|last6=He|first6=Yulei|last7=Jin|first7=Robert|last8=Kaufman|first8=Joan|last9=Sampson|first9=Nancy A.|date=2009-04|title=National Comorbidity Survey Replication Adolescent Supplement (NCS-A): III. Concordance of DSM-IV/CIDI Diagnoses With Clinical Reassessments|url=http://linkinghub.elsevier.com/retrieve/pii/S0890856709600460|journal=Journal of the American Academy of Child & Adolescent Psychiatry|volume=48|issue=4|pages=386–399|doi=10.1097/chi.0b013e31819a1cbc|issn=0890-8567|pmc=PMC3040100|pmid=19252450}}</ref> ^p ^y |6.6% and SE=1.7 (bipolar I and II and sub-threshold bipolar spectrum disorder) |U.S.A, NCS-A |CIDI, DSM-IV criteria were modified from published version for purpose of the study, broad criteria for not otherwise specified, | |- |National Cross‐sectional epidemiological sample<ref>{{Cite journal|last=Stringaris|first=Argyris|last2=Santosh|first2=Paramala|last3=Leibenluft|first3=Ellen|last4=Goodman|first4=Robert|date=2009-07-22|title=Youth meeting symptom and impairment criteria for mania-like episodes lasting less than four days: an epidemiological enquiry|url=http://doi.wiley.com/10.1111/j.1469-7610.2009.02129.x|journal=Journal of Child Psychology and Psychiatry|language=en|volume=51|issue=1|pages=31–38|doi=10.1111/j.1469-7610.2009.02129.x|issn=0021-9630|pmc=PMC4286871|pmid=19686330}}</ref> ^p ^y |1.2% (bipolar I and II and not otherwise specified) |United Kingdom |DAWBA, DSM-IV criteria, broad criteria for not otherwise specified | |- |Community epidemiological samples<ref>{{Cite journal|last=Benjet|first=Corina|last2=Borges|first2=Guilherme|last3=Medina-Mora|first3=Maria Elena|last4=Zambrano|first4=Joaquin|last5=Aguilar-Gaxiola|first5=Sergio|date=2009-04|title=Youth mental health in a populous city of the developing world: results from the Mexican Adolescent Mental Health Survey|url=http://doi.wiley.com/10.1111/j.1469-7610.2008.01962.x|journal=Journal of Child Psychology and Psychiatry|language=en|volume=50|issue=4|pages=386–395|doi=10.1111/j.1469-7610.2008.01962.x|issn=0021-9630}}</ref> ^y |2.5% (bipolar I and II) |Mexico City |CIDI, DSM-IV Criteria | |- |2-stage epidemiological study<ref>{{Cite journal|last=Lynch|first=Fionnuala|last2=Mills|first2=Carla|last3=Daly|first3=Irenee|last4=Fitzpatrick|first4=Carol|date=2006-08|title=Challenging times: Prevalence of psychiatric disorders and suicidal behaviours in Irish adolescents|url=http://linkinghub.elsevier.com/retrieve/pii/S0140197105001004|journal=Journal of Adolescence|volume=29|issue=4|pages=555–573|doi=10.1016/j.adolescence.2005.08.011|issn=0140-1971}}</ref> ^{p y} |0.0% (bipolar I and II, cyclothymia, not otherwise specified |Ireland |[[w:Kiddie Schedule for Affective Disorders and Schizophrenia|K-SADS]], DSM-IV Criteria | |} ^p:Parent interviewed as component of diagnostic assessment; ^y:Youth interviewed as part of diagnostic assessment. ''Note:'' * KSADS = [[w:Schedule_for_Affective_Disorders_and_Schizophrenia#K-SADS|Kiddie Schedule for Affective Disorders and Schizophrenia]], * WASH-U = Washington University version, -PL = Present and Lifetime Version, -E = Epidemiological version of the KSADS * LIFE = Longitudinal Interval Follow-Up Evaluation, * DICA = Diagnostic Interview for Children and Adolescents *CIDI = Composite International Diagnostic Interview *DAWBA= The Development and Well-Being Assessment == '''[[Evidence based assessment/Prediction phase|Prediction phase]]''' == The following section contains a list of screening and diagnostic instruments for bipolar disorder in youth. This section includes administration information, psychometric data, and PDFs or links to the screenings. === Psychometric properties of screening instruments for pediatric bipolar disorder === * Screenings are used as part of the [[Evidence based assessment/Prediction phase|prediction phase]] of assessment; for more information on interpretation of this data, or how screenings fit in to the assessment process, click [[Evidence based assessment/Prediction phase|here.]] * '''''For a list of more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Common_screening_instruments click here.]''''' {| class="wikitable sortable" border="1" ! colspan="10" |Screening measures for bipolar disorder in youth |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time ! Interrater Reliability ! Test-Retest Reliability ! Construct Validity ! Content Validity ! Highly Recommended !Free and Accessible Measures |- | Children's Depression Inventory <nowiki>*</nowiki>not free | Self-report<ref name=":0">{{Cite web|url=https://www.pearsonclinical.com/psychology/products/100000636/childrens-depression-inventory-2-cdi-2.html|title=Children's Depression Inventory 2™|website=www.pearsonclinical.com|language=en-US|accessdate=2018-03-01}}</ref> | 7-17 | 15-20 minutes<ref name=":0" /> | NA | A | G | G | X |Not free |- | Mood and Feelings Questionnaire (MFQ) | Self-report | 7-18 | 5-10 minutes<ref>{{Cite web|url=http://www.cebc4cw.org/assessment-tool/mood-and-feelings-questionnaire-mfq/|title=CEBC » Assessment Tool › Mood And Feelings Questionnaire Mfq|website=www.cebc4cw.org|language=en|accessdate=2018-03-01}}</ref> | NA | A | G | A | X | *[https://mfr.osf.io/render?url=https://osf.io/enx4b/?action=download%26mode=render MFQ Child Self-Report Long Version] *[https://mfr.osf.io/render?url=https://osf.io/mcg5w/?action=download%26mode=render MFQ Child Self Report Short Version] *[https://mfr.osf.io/render?url=https://osf.io/cw27p/?action=download%26mode=render MFQ Parent Report On Child Long Version] *[https://mfr.osf.io/render?url=https://osf.io/kybr4/?action=download%26mode=render MFQ Parent Report On Child Short Version] |- | 7 Up 7 Down Inventory (7U7D) |Self-report<ref name=":5" /> | 11-86<ref>{{Cite journal|last=Mesman|first=E.|last2=Youngstrom|first2=E.A.|last3=Juliana|first3=N.K.|last4=Nolen|first4=W.A.|last5=Hillegers|first5=M.H.J.|date=2017-01|title=Validation of the Seven Up Seven Down Inventory in bipolar offspring: screening and prediction of mood disorders. Findings from the Dutch Bipolar Offspring Study|url=https://doi.org/10.1016/j.jad.2016.09.024|journal=Journal of Affective Disorders|volume=207|pages=95–101|doi=10.1016/j.jad.2016.09.024|issn=0165-0327}}</ref> |5-8 minutes | NA | | | | | * [https://mfr.osf.io/render?url=https://osf.io/s825e/?action=download%26mode=render 7U7D English] * [https://unc.az1.qualtrics.com/jfe/form/SV_cBlUQk8Y85LHF41 Depression and Bipolar Support Alliance (DBSA): 7U7D '''Online Screener'''] |- | Parent General Behavior-10 Item Version (PGBI-10M)<ref name=":6">{{Cite journal|last=Youngstrom|first=Eric A.|last2=Genzlinger|first2=Jacquelynne E.|last3=Egerton|first3=Gregory A.|last4=Meter|first4=Anna R. Van|title=Multivariate meta-analysis of the discriminative validity of caregiver, youth, and teacher rating scales for pediatric bipolar disorder: Mother knows best about mania.|url=http://dx.doi.org/10.1037/arc0000024|journal=Archives of Scientific Psychology|volume=3|issue=1|pages=112–137|doi=10.1037/arc0000024}}</ref> |Parent-report |5-18<ref name=":7">Youngstrom, E.A., Van Meter, A.R, Frazier, T.W., Youngstrom, J.K., & Findling, R.L. (in press). Developing and validating short forms of the Parent General Behavior Inventory Mania and Depression Scales for rating youth mood symptoms. ''Journal of Clinical Child & Adolescent Psychology.''</ref> |5-8 minutes | | | | | | * [https://mfr.osf.io/render?url=https://osf.io/ub8h7/?action=download%26mode=render Downloadable PDF Parent-Report English] |} '''Note:''' Reliability and validity are included in the extended version. This table includes measures with Good or Excellent ratings. === Brief screening tools for PBD=== {{collapse top|expand=yes}} The following are brief screening tools that typically take less than 5 minutes to administer to accurately diagnose pediatric bipolar disorder: # '''''7 Up 7 Down Inventory (7U7D)''''' ## The [http://supp.apa.org/psycarticles/supplemental/a0033975/a0033975_supp.html 7 Up 7 Down Inventory]<ref name=":5">{{cite journal|last1=Youngstrom|first1=Eric A.|last2=Murray|first2=Greg|last3=Johnson|first3=Sheri L.|last4=Findling|first4=Robert L.|title=The 7 up 7 down inventory: a 14-item measure of manic and depressive tendencies carved from the General Behavior Inventory|journal=Psychological Assessment|date=1 December 2013|volume=25|issue=4|pages=1377–1383|doi=10.1037/a0033975|url=https://www.ncbi.nlm.nih.gov/pubmed/23914960|issn=1939-134X}}</ref> is a recently developed and validated questionnaire with 14 items of manic and depressive tendencies carved from the General Behavior Inventory, a well-validated but cumbersome interview. For both mania and depression factors, 7 items produced a psychometrically adequate measure applicable across both aggregate samples. Internal reliability of the Mania scale was .81 (youth) and .83 (adult) and for Depression was .93 (youth) and .95 (adult). ## The 7 Up 7 Down Inventory, along with the accompanying research article, can be [http://supp.apa.org/psycarticles/supplemental/a0033975/a0033975_supp.html found here]. # '''''[https://mfr.osf.io/render?url=https://osf.io/d95nv/?action=download%26mode=render PGBI-10M]'''''<ref>Youngstrom EA, Frazier TW, Demeter C, et al. Developing a 10-item mania scale from the Parent General Behavior Inventory for children and adolescents. J Clin Psychiatry. 2008;69(5):831–839.</ref> ## The [http://www.moodychildtherapy.com/wp-content/uploads/2011/01/PGBI-10M-2-wks.pdf PGBI-10M] (we would like to add another version that is better) is a brief (10 item) instrument derived from the [https://mfr.osf.io/render?url=https://osf.io/3j5r7/?action=download%26mode=render Parent General Behavior Inventory (PGBI)]<ref>{{Cite journal|last=Youngstrom|first=Eric A.|last2=Findling|first2=Robert L.|last3=Danielson|first3=Carla Kmett|last4=Calabrese|first4=Joseph R.|date=2001|title=Discriminative validity of parent report of hypomanic and depressive symptoms on the General Behavior Inventory.|url=http://psycnet.apa.org/doi/10.1037/1040-3590.13.2.267|journal=Psychological Assessment|language=en|volume=13|issue=2|pages=267–276|doi=10.1037/1040-3590.13.2.267|issn=1939-134X}}</ref>, a 73-item mood inventory, to assess [[mania]] in a large sample of outpatients presenting with a variety of different [[DSM-IV]] diagnoses, including frequent comorbid conditions.<ref name=":0">{{cite journal|last1=Youngstrom|first1=E. A.|last2=Findling|first2=R. L.|last3=Danielson|first3=C. K.|last4=Calabrese|first4=J. R.|title=Discriminative validity of parent report of hypomanic and depressive symptoms on the General Behavior Inventory|journal=Psychological Assessment|date=1 June 2001|volume=13|issue=2|pages=267–276|url=http://www.ncbi.nlm.nih.gov/pubmed/11433802|issn=1040-3590}}</ref> ## The 10-item GBI derived from the 73-item P-GBI had good reliability (alpha = .92), was correlated (r = 0.95) with the 28-item scale, and showed significantly better discrimination of bipolar disorders (area under the [[receiver operating characteristic]] [AUROC] curve of 0.856 vs. 0.832 for the 28-item scale, p < .005). The 10-item scale also did well discriminating bipolar disorder from unipolar depression (AUROC = 0.86) and bipolar disorder from [[attention deficit hyperactivity disorder|attention-deficit/hyperactivity disorder]] (AUROC = 0.82) cases. ## The full version of the scale, the Parent-General Behavior Inventory (P-GBI), is a parent-report measure of depressive and hypomanic/biphasic symptoms adapted from the General Behavior Inventory (GBI). ## Classification rates exceed 80%, and receiver operating characteristic analyses showed good diagnostic efficiency for the scales, with areas under the curve greater than .80. Results indicate that clinicians can use the parent-completed GBI to derive clinically meaningful information about mood disorders in youths. {{collapse bottom}} === Likelihood ratios and AUCs of screening measures for bipolar disorder in youth === * '''''For a list of the likelihood ratios for more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Likelihood_ratios_and_AUCs_of_common_screening_instruments click here.]''''' The following table describes the diagnostic likelihood ratios and area under curves for the top pediatric bipolar disorder measures. {| class="wikitable sortable" border="1" |- ! Screening Measure ! AUC (sample size) !Very Low risk range DiLR !Low risk range DiLR !Neutral risk range DiLR !High risk range DiLR !Very High risk range DiLR !DLR+ (score) !DLR- (score) ! Population/Clinical Generalizability !Download |- |[https://mfr.osf.io/render?url=https://osf.io/d3b4h/?action=download%26mode=render Parent General Behavior-10 Item Mania Version (PGBI-10M)]<ref name=":7" /> |.84 (''N''=617) academic sample, .78 community sample (''N''=530)<ref name=":7" /> |.07  (0 to 2.59)  |.41 (2.6 to 6.99) |1.44 (7 to 10.99)  |2.39 (11 to 17.99)  |5.38 (18+) | | |Bipolar spectrum vs. all other diagnoses |[https://mfr.osf.io/render?url=https://osf.io/ub8h7/?action=download%26mode=render Parent Form]<ref>{{Cite web|url=http://www.moodychildtherapy.com|title=Psychoeducational Psychotherapy|website=www.moodychildtherapy.com|language=en-US|access-date=2018-07-20}}</ref> |- |[https://mfr.osf.io/render?url=https://osf.io/eau89/?action=download%26mode=render Parent General Behavior-10 Item Depression Version Form A (PGBI-10Da)]<ref name=":7" /> |.84 (''N''=617) academic sample, .79 community sample (''N''=530)<ref name=":7" /> |.25  (0 to 1.99) |.71 (2 to 5.99)   |1.85 (6 to 9.99)   |4.52 (10 to 14.99) |8.80 (15+)   | | |Bipolar spectrum vs. all other diagnoses | |- |[https://mfr.osf.io/render?url=https://osf.io/eau89/?action=download%26mode=render Parent General Behavior-10 Item Depression Version Form B (PGBI-10Db)]<ref name=":7" /> |.84 (''N''=617) academic sample, .80 community sample (''N''=530)<ref name=":7" /> |.22 (0 to 1.99)    |.71 (2 to 5.99) |2.69 (6 to 10.99)    |5.64 (11 to 14.99)    |8.09 (15+) | | |Bipolar spectrum vs. all other diagnoses | |- |[https://mfr.osf.io/render?url=https://osf.io/hyb3g/?action=download%26mode=render Parent General Behavior Inventory] (P-GBI) (''Hypomanic/Biphasic Section''])<ref name="eay2004">Youngstrom, E. A., Findling, R. L., & Calabrese, J. R. (2004). Effects of adolescent manic symptoms on agreement between youth, parent, and teacher ratings of behavior problems. Journal of Affective Disorders, 82, S5-S16. </ref> | .84 (N=324) | |(<9) | | |(49+) |9.2 |.06 | Bipolar spectrum vs. all other diagnoses | |- | Parent Mood Disorder Questionnaire (P-MDQ)<ref>{{cite journal|last1=Wagner|first1=Karen Dineen|last2=Hirschfeld|first2=Robert M. A.|last3=Emslie|first3=Graham J.|last4=Findling|first4=Robert L.|last5=Gracious|first5=Barbara L.|last6=Reed|first6=Michael L.|date=1 May 2006|title=Validation of the Mood Disorder Questionnaire for bipolar disorders in adolescents|url=http://www.ncbi.nlm.nih.gov/pubmed/16841633|journal=The Journal of Clinical Psychiatry|volume=67|issue=5|pages=827–830|issn=0160-6689}}</ref> | .84 (N=819) | |(TBC) | | |(TBC) |4.64 |.17 | Bipolar spectrum vs. all other diagnoses | * [https://mfr.osf.io/render?url=https://osf.io/wtp7r/?action=download%26mode=render MDQ] |- | Child Mania Rating Scale (Brief) ''(Brief CMRS-P)''<ref name=":2">{{cite journal|last1=Henry|first1=David B.|last2=Pavuluri|first2=Mani N.|last3=Youngstrom|first3=Eric|last4=Birmaher|first4=Boris|date=1 April 2008|title=Accuracy of brief and full forms of the Child Mania Rating Scale|url=http://www.ncbi.nlm.nih.gov/pubmed/?term=18302291|journal=Journal of Clinical Psychology|volume=64|issue=4|pages=368–381|doi=10.1002/jclp.20464|issn=0021-9762}}</ref> | .85 (N=150) | |(<11) | | |(11+) |10.5 |.17 | Bipolar spectrum vs. ADHD | |- | Child Mania Rating Scale (Full) ''(Full CMRS-P)''<ref name=":2" /> | .91 (N=150) | |(<21) | | |(21+) |13.7 |.19 | Bipolar spectrum vs. ADHD | * [https://mfr.osf.io/render?url=https://osf.io/8wv3a/?action=download%26mode=render Downloadable PDF] |- |[https://mfr.osf.io/render?url=https://osf.io/5yzur/?action=download%26mode=render Child Bipolar Questionnaire] ''[https://mfr.osf.io/render?url=https://osf.io/5yzur/?action=download%26mode=render (CBQ-P)]''<ref>{{Cite journal|last=Papolos|first=Demitri|last2=Hennen|first2=John|last3=Cockerham|first3=Melissa S.|last4=Thode|first4=Henry C.|last5=Youngstrom|first5=Eric A.|date=2006-10|title=The child bipolar questionnaire: A dimensional approach to screening for pediatric bipolar disorder|url=https://doi.org/10.1016/j.jad.2006.03.026|journal=Journal of Affective Disorders|volume=95|issue=1-3|pages=149–158|doi=10.1016/j.jad.2006.03.026|issn=0165-0327}}</ref> |.74 (N=497) | | | | | |25.3/ (likelihood ratio +) |/.25 (likelihood ratio -) |Bipolar spectrum vs. all other diagnoses | |} === Interpreting bipolar disorder screening measure scores === For information on interpreting screening measure scores, click [[Evidence based assessment/Prediction phase#Interpreting screening measure scores|here.]] ==[[Evidence based assessment/Prescription phase|'''Prescription phase''']]== ===Gold standard diagnostic interviews=== For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews click here.] {{collapse top|More details on gold-standard diagnostic interviews|expand=yes}} # '''Kiddie Schedule for Affective Disorders and Schizophrenia-Present and Lifetime (KSADS-PL)''' #* The '''KSADS-PL''' is a semi-structured diagnostic interview that assesses current and past Diagnostic and Statistical Manual of Mental Disorders – Fourth Edition (DSM-IV-TR) Axis I psychopathology in youth<ref name="APA" />. The KSADS-PL diagnostic interviews have good inter-rater (.93 to 1.00) and retest reliability (.77) for mood disorders <ref>{{cite journal|last1=Kaufman|first1=J.|last2=Birmaher|first2=B.|last3=Brent|first3=D.|last4=Rao|first4=U.|last5=Flynn|first5=C.|last6=Moreci|first6=P.|last7=Williamson|first7=D.|last8=Ryan|first8=N.|title=Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (K-SADS-PL): initial reliability and validity data|journal=Journal of the American Academy of Child and Adolescent Psychiatry|date=1 July 1997|volume=36|issue=7|pages=980–988|doi=10.1097/00004583-199707000-00021|url=http://www.ncbi.nlm.nih.gov/pubmed/9204677|issn=0890-8567}}</ref> Here is a link to a PDF of the diagnostic interview for the [http://www.psychiatry.pitt.edu/sites/default/files/Documents/assessments/ksads-pl.pdf Kiddie Schedule for Affective Disorders and Schizophrenia-Present and Lifetime]. # '''Washington University in St. Louis Kiddie Schedule for Affective Disorders and Schizophrenia (WASH-U-KSADS)''' #* The '''[http://www.ncbi.nlm.nih.gov/pubmed/11314571 Washington University in St. Louis Kiddie Schedule for Affective Disorders and Schizophrenia]'''(WASH-U-KSADS)<ref name=":1">{{cite journal|last1=Geller|first1=B.|last2=Zimerman|first2=B.|last3=Williams|first3=M.|last4=Bolhofner|first4=K.|last5=Craney|first5=J. L.|last6=DelBello|first6=M. P.|last7=Soutullo|first7=C.|title=Reliability of the Washington University in St. Louis Kiddie Schedule for Affective Disorders and Schizophrenia (WASH-U-KSADS) mania and rapid cycling sections|journal=Journal of the American Academy of Child and Adolescent Psychiatry|date=1 April 2001|volume=40|issue=4|pages=450–455|doi=10.1097/00004583-200104000-00014|url=http://www.ncbi.nlm.nih.gov/pubmed/11314571|issn=0890-8567}}</ref> was expanded from the 1986 version of the KSADS, which was modified and expanded to include onset and offset of each symptom for both current and lifetime episodes, expanded prepubertal mania and rapid cycling sections, and categories for [[attention deficit hyperactivity disorder]] and other DSM-IV diagnoses. To optimize diagnostic research, skip-outs were minimized. #* The kappa values of comparisons between research nurse and off-site blind best-estimate ratings of mania and rapid cycling sections were excellent (0.74-1.00). High 6-month stability for mania diagnoses (85.7%) and for individual mania items and validity against parental and teacher reports were previously reported.<ref name=":1" /> #* The link to the diagnostic interview for the [http://www.psychiatry.pitt.edu/sites/default/files/Documents/assessments/mrs.pdf Washington University in St. Louis Kiddie Schedule for Affective Disorders and Schizophrenia] can be found [http://www.psychiatry.pitt.edu/sites/default/files/Documents/assessments/mrs.pdf here]. {{collapse bottom}} ===Recommended diagnostic instruments specific for pediatric bipolar disorder=== {| class="wikitable sortable" border="1" ! colspan="10" |Diagnostic instruments for '''(insert portfolio name)''' |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time ! Interrater Reliability ! Test-Retest Reliability ! Construct Validity ! Content Validity ! Highly Recommended !Free and Accessible Measures |- | Children's Depression Rating Scale - Revised (CDRS-R) | Structured Interview<ref name=":4">{{Cite journal|last=Mayes|first=Taryn L.|last2=Bernstein|first2=Ira H.|last3=Haley|first3=Charlotte L.|last4=Kennard|first4=Betsy D.|last5=Emslie|first5=Graham J.|date=2010-12|title=Psychometric Properties of the Children's Depression Rating Scale–Revised in Adolescents|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3003451/|journal=Journal of Child and Adolescent Psychopharmacology|volume=20|issue=6|pages=513–516|doi=10.1089/cap.2010.0063|issn=1044-5463|pmc=PMC3003451|pmid=21186970}}</ref> | 6-12 | 15-20 minutes | G | A | G | G | X | * Link to purchase [https://www.wpspublish.com/store/p/2703/cdrs-r-children-s-depression-rating-scale-revised#purchase-product CDRS-R] *[http://www.opapc.com/uploads/documents/CDRS-R.pdf PDF] (excerpt) |} '''Note:''' Reliability and validity are included in the extended version. This table includes measures with Good or Excellent ratings. =='''[[Evidence based assessment/Process phase|Process phase]]'''== The following section contains a list of process and outcome measures for adolescent bipolar spectrum disorder. The section includes benchmarks based on published norms and on mood samples for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the [[Evidence based assessment/Process phase|process phase]] of assessment. For more information on differences between process and outcome measures, see the page on the [[Evidence based assessment/Process phase|process phase of assessment]]. === Process measures === There are many processes that may be considered important when evaluating a child or an adolescent with Bipolar Disorder; however, due to the diversity of the population and symptom expression, there are too many to narrow down. Clinical judgment is recommended when deciding what additional measures should be included (e.g. executive functioning, sensory processing, cognitive flexibility). The measures provided below are commonly used to assess and provide important information regarding levels of daily functioning of individuals with Bipolar Disorder. {{blockquotetop}} '''A. Mood and Energy Thermometer'''- &nbsp; This is an improved and practical way of monitoring complex mood cycles and daily schedules. Given that some clinicians and patients may get confused about different 1 to 10 scales (e.g., a 10 could mean extreme depression, extreme mania, or no depression), the Mood & Energy Thermometer improves the language in communicating (and monitoring) mood. Moreover, many children report their energy levels more accurately than their mood and therefore, energy levels have been incorporated in this mood rating. The Mood & Energy Thermometer that was developed at Western Psychiatric Institute and Clinic (WPIC; and used in about 400 kids) rates mania and increased energy on a 1 to 10 scale, rates depression and tiredness on a -1 to -10 scale, and attempts to form a common language between patients, families, and clinicians. This scale also takes into account time spent depressed and/or manic; for example, -4 would mean “mild depression” and “mild tiredness” present ≥50% of the time, and -3 would mean “mild depression” and “mild tiredness” present < 50% of the time. The inclusion of measuring energy levels is consistent with the DSM-5, because energy level is now included in the DSM-5 as a main mood symptom criterion. Bipolar track patients (whether they had mania, depression, or mixed features) rated their mood and energy levels every day on this scale, and a master’s-level clinician met with them on a daily basis to help them better identify and record their mood symptoms, which has significant clinical value for not only treatment but also to prevent future episodes.<ref name=":3">{{Cite web|url=http://pediatricbipolar.pitt.edu/resources/instruments|title=Instruments {{!}} CABS {{!}} University of Pittsburgh|website=pediatricbipolar.pitt.edu|language=en|access-date=2018-05-31}}</ref> *[https://mfr.osf.io/render?url=https://osf.io/p4a8s/?action=download%26mode=render Mood and Energy Thermometer] *[https://mfr.osf.io/render?url=https://osf.io/upe2a/?action=download%26mode=render Mood and Energy Thermometer with Anger and Anxiety (with recording/monitoring card)] *[https://mfr.osf.io/render?url=https://osf.io/d2fge/?action=download%26mode=render Mood and Energy Thermometer with Anger and Anxiety - Simplified Version] '''B. Life Charts''' * To learn more about how life charts can be used with adolescent depression, [http://www.bipolarnews.org/Life%20Charting%20Description.htm see here] * [https://mfr.osf.io/render?url=https://osf.io/amq6k/?action=download%26mode=render Life Charts for Depression and Bipolar] {{blockquotebottom}} === Outcome and severity measures === * Information on how to interpret this table can be [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase found here]. * Additionally, these [[Evidence based assessment/Vignettes|vignettes]] might be helpful resources for understanding appropriate adaptation of outcome measures in practice. *For clinically significant change benchmarks for the CBCL, YSR, and TRF overall, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase&wteswitched=1#Clinically_significant_change_benchmarks_for_widely-used_outcome_measures see here.] ==== '''Clinically significant change benchmarks with common instruments for bipolar disorder in youth''' ==== {| class="wikitable sortable" | ! colspan="3" |Cut Scores ! colspan="3" |Critical Change (Unstandardized Scores) ![[w:Minimal important difference|Minimal]]<nowiki/>ly [[w:Minimal important difference|Important Difference]] |- !Measure !Away !Back !Closer !95% !90% !SEdifference !(MID) ''d'' ~.5 |- |[[General Behavior Inventory#GBI Short Forms|PGBI-10M]] |1 |9 |6 |6 |5 |3.2 |3 |- |[[Child Mania Rating Scale|CMRS 10]] |<nowiki>--</nowiki> |6 |4 |5 |4 |2.3 |2 |- |[[General Behavior Inventory#GBI Short Forms|PGBI-10Da]] |<nowiki>--</nowiki> |7 |4 |6 |5 |3.0 |3 |- |[[General Behavior Inventory#GBI Short Forms|PGBI-10Db]] |<nowiki>--</nowiki> |7 |4 |6 |5 |2.9 |3 |- |[[General Behavior Inventory#GBI Short Forms|AGBI-10M]] |<nowiki>--</nowiki> |14 |7 |6 |5 |3.1 |3 |- |[[General Behavior Inventory#GBI Short Forms|AGBI-10Da]] |<nowiki>--</nowiki> |18 |7 |6 |5 |3.2 |3 |- |[[General Behavior Inventory#GBI Short Forms|AGBI-10Db]] |<nowiki>--</nowiki> |16 |7 |6 |5 |2.9 |4 |- |[[General Behavior Inventory#GBI Short Forms|7 Up]] |<nowiki>--</nowiki> |8 |4 |4 |4 |2.2 |3 |- |[[General Behavior Inventory#GBI Short Forms|7 Down]] |<nowiki>--</nowiki> |12 |5 |5 |4 |2.3 |3 |- |[[w:Kiddie Schedule for Affective Disorders and Schizophrenia#KSADS%20Mania%20Rating%20Scale%20(KMRS)%20and%20Depression%20Rating%20Scale%20(KDRS)|KMRS]] |19 |19 |19 |3 |3 |1.6 |3 |- |[[w:Kiddie Schedule for Affective Disorders and Schizophrenia#KSADS%20Mania%20Rating%20Scale%20(KMRS)%20and%20Depression%20Rating%20Scale%20(KDRS)|KDRS]] |12 |19 |18 |5 |4 |2.4 |3 |- |CDRS-R Total |<nowiki>--</nowiki> |24 |22 |6 |5 |2.9 |5 |- |YMRS Total |4 |3 |3 |3 |3 |1.8 |3 |} <br /> {| class="wikitable sortable" border="1" |- | colspan="8" style="font-size:110%; text-align:center;" span |<b> Benchmarks Based on Published Norms</b> |- | rowspan="2" style="text-align:center;font-size:130%;" |<b> <big>Measure</big></b> | rowspan="2" style="text-align:center;font-size:130%;" |<b> <big>Subscale</big></b> | colspan="3" style="text-align:center;font-size:130%" width="300" |<b> <big>Cut-off scores</big></b> | colspan="3" style="text-align:center;font-size:120%" |<b> <big>Critical Change <br> (unstandardized scores)</big></b> |- | style="text-align:center;font-size:110%" |<b> A</b> | style="text-align:center;font-size:110%" |<b> B</b> | style="text-align:center;font-size:110%" |<b> C</b> | style="text-align:center;font-size:110%" |<b> 95%</b> | style="text-align:center;font-size:110%" |<b> 90%</b> | style="text-align:center;font-size:110%" |<b> SE_difference</b> |- | rowspan="1" style="text-align:center;" |<b> [http://www.sciencedirect.com/science/article/pii/0272735888900505 Beck Depression Inventory]<ref>{{cite journal|last=Beck|first=AT|title=Psychometric properties of the Beck Depression Inventory: Twenty-five years of evaluation.|journal=Clinical Psychology Review|date=1988|volume=8|issue=1|url=http://www.sciencedirect.com/science/article/pii/0272735888900505|accessdate=10 February 2014}}</ref></b> | style="text-align:right;" |<i> BDI Mixed Depression</i> | style="text-align:center;" | 4 | style="text-align:center;" | 22 | style="text-align:center;" | 15 | style="text-align:center;" | 9 | style="text-align:center;" | 8 | style="text-align:center;" | 4.8 |- |} === Treatment === ==== Psychotherapy ==== [[Psychotherapy|Psychotherapies]] are treatments that help people with a wide variety of mental health concerns. While different forms of psychotherapies for adolescent bipolar disorder aim to remedy different aspects of the disorder, all aim to alleviate symptoms and decrease functional impairment in the client. {| class="wikitable mw-collapsible" |+Overview of Psychotherapies !Therapy !Key components !Duration !Results |- |Child- and Family-Focused Cognitive-Behavioral Therapy | * Develop consistent routines * Learn to regulate emotions * Improve child's self-esteem and parent's self efficacy * Reduce negativity * Build social skills and networks * Teach parents self-care * Family-based problem solving and communication skill building | * 12 weeks long * 60-90 minute weekly sessions | * Decrease intensity of manic episodes * Decrease depressive symptoms in child * Overall improvement in client's functioning |- |Interpersonal and Social Rhythm Therapy | * Develop understanding of disruptions in routine and manic/depressive episodes * Build skills for creating consistent routines, aka, social rhythms * Build self-efficacy and phase out of therapy |Varies dependent on client need | * Increases time between manic/depressive episodes |- |Mindfulness-Based Cognitive Therapy | * Utilizes mindfulness-based practices such as mindfulness meditation * Focus on awareness of client's thoughts, feelings and behaviors * Learn to recognize how to monitor one's own thoughts * Increase self-care practices | * 8 weeks long * 60-120 minute weekly sessions | * Decrease in anxiety symptoms * Decrease in depressive symptoms * Increase mood regulation * Increase attention ability |- |Multi-Family Psychoeducational Psychotherapy |Group therapy using treatment components from: * Psychoeducation * Family Systems therapy * Cognitive-behavioral therapy | * 8 weeks long * 60-90 minute weekly sessions | * Decrease in severity of mood symptoms * Increase in caregiver understanding of child's disorder and how to seek mental health care * Children report feeling more social support from caregivers |} ===== Child- and Family-Focused Cognitive-Behavioral Family (CFF-CBT) ===== ====== Purpose ====== [[File:Cognitive Behavioral Cycle.jpg|thumb|357x357px|Cognitive behavioral cycle]] CFF-CBT was created to address the unique needs of bipolar disorder in children and adolescents with bipolar disorder, including rapid cycling, mixed mood states and comorbid disorders.<ref name=":0">{{Cite journal|last=West|first=Amy E.|last2=Weinstein|first2=Sally M.|last3=Peters|first3=Amy T.|last4=Katz|first4=Andrea C.|last5=Henry|first5=David B.|last6=Cruz|first6=Rick A.|last7=Pavuluri|first7=Mani N.|date=2014-11-01|title=Child- and Family-Focused Cognitive-Behavioral Therapy for Pediatric Bipolar Disorder: A Randomized Clinical Trial|url=https://jaacap.org/article/S0890-8567(14)00617-0/abstract|journal=Journal of the American Academy of Child & Adolescent Psychiatry|language=English|volume=53|issue=11|pages=1168–1178.e1|doi=10.1016/j.jaac.2014.08.013|issn=0890-8567|pmc=PMC4254579|pmid=25440307}}</ref> This treatment has been tested to see if it will help address the high suicide attempt rate among children/adolescents with the disorder, and no significant effects were found. However CFF-CBT has been found to be effective for 7-13 year olds with both clients with and without non-suicidal self-injury behaviors.<ref name=":1">{{Cite journal|last=MacPherson|first=Heather A.|last2=Weinstein|first2=Sally M.|last3=West|first3=Amy E.|date=2018-05-01|title=Non-Suicidal Self-Injury in Pediatric Bipolar Disorder: Clinical Correlates and Impact on Psychosocial Treatment Outcomes|url=https://doi.org/10.1007/s10802-017-0331-4|journal=Journal of Abnormal Child Psychology|language=en|volume=46|issue=4|pages=857–870|doi=10.1007/s10802-017-0331-4|issn=1573-2835}}</ref> Mediators of this intervention include: parenting skills and coping, family flexibility, and family positive reframing.<ref name=":2">{{Cite journal|last=Fristad|first=Mary A.|last2=MacPherson|first2=Heather A.|date=2014-05-01|title=Evidence-Based Psychosocial Treatments for Child and Adolescent Bipolar Spectrum Disorders|url=https://doi.org/10.1080/15374416.2013.822309|journal=Journal of Clinical Child & Adolescent Psychology|volume=43|issue=3|pages=339–355|doi=10.1080/15374416.2013.822309|issn=1537-4416|pmc=PMC3844106|pmid=23927375}}</ref> ====== Intended Population ====== Children aged 7-13 and adolescents aged 13-17 ====== Length of Treatment ====== 12 weekly sessions, with session time ranging from 60 to 90 minutes<ref name=":1" /><ref name=":0" /><ref name=":2" /> ====== Treatment Components ====== CFF-CBT focuses on 7 components comprising of the “RAINBOW” acronym<ref name=":0" />: ''R'': Routine; developing consistency ''A'': Affective regulation; includes psychoeducation on feelings, coping skills, and mood monitoring ''I'': “I can do it!”; this aims to improve self-esteem in the child, as well as self-efficacy in the parent ''N'': “No Negative Thoughts/Live in the Now” ''B'': Be a good friend/balanced life style (building social skills and teaching parents self-care ''O'': Oh, how do we solve this problem? (family-based problem solving and communication skills building) ''W'': Ways to find support (building a network of support) ====== Treatment Outcomes ====== CFF-CBT has shown decreases in mania to a subclinical level, parent-reported youth depressive symptoms, increased involvement/fidelity to treatment, and improvements in the client’s overall, global functioning in comparison to psychotherapy as per usual.<ref name=":1" /> <br /> ===== Interpersonal and Social Rhythm Therapy (IPSRT) ===== ====== Purpose ====== IPSRT is based on the social zeitgeber hypothesis<ref>{{Cite journal|last=Grandin|first=Louisa D.|last2=Alloy|first2=Lauren B.|last3=Abramson|first3=Lyn Y.|date=2006-10|title=The social zeitgeber theory, circadian rhythms, and mood disorders: Review and evaluation|url=https://linkinghub.elsevier.com/retrieve/pii/S0272735806000651|journal=Clinical Psychology Review|language=en|volume=26|issue=6|pages=679–694|doi=10.1016/j.cpr.2006.07.001}}</ref>, which states that regularity in social routines and interpersonal relationships acts as a protective factor for mood disorders. Thus, this treatment focused on maintaining regularity in daily routines, quality of social relationships and social roles, and management of consequences of rhythm disruptions.<ref>{{Cite journal|last=Frank|first=Ellen|last2=Kupfer|first2=David J.|last3=Thase|first3=Michael E.|last4=Mallinger|first4=Alan G.|last5=Swartz|first5=Holly A.|last6=Fagiolini|first6=Andrea M.|last7=Grochocinski|first7=Victoria|last8=Houck|first8=Patricia|last9=Scott|first9=John|date=2005-09-01|title=Two-Year Outcomes for Interpersonal and Social Rhythm Therapy in Individuals With Bipolar I Disorder|url=http://dx.doi.org/10.1001/archpsyc.62.9.996|journal=Archives of General Psychiatry|volume=62|issue=9|pages=996|doi=10.1001/archpsyc.62.9.996|issn=0003-990X}}</ref> ====== Intended Population ====== IPSRT is intended for all individuals with bipolar disorder, and has been found to be effective in adolescents.<ref name=":3">{{Cite journal|last=Crowe|first=Marie|last2=Inder|first2=Maree|last3=Joyce|first3=Peter|last4=Moor|first4=Stephanie|last5=Carter|first5=Janet|last6=Luty|first6=Sue|date=2009-01|title=A developmental approach to the treatment of bipolar disorder: IPSRT with an adolescent|url=http://doi.wiley.com/10.1111/j.1365-2702.2008.02571.x|journal=Journal of Clinical Nursing|language=en|volume=18|issue=1|pages=141–149|doi=10.1111/j.1365-2702.2008.02571.x}}</ref> ====== Length of Treatment ====== Length of treatment varies dependent on client needs.<ref name=":3" /> ====== Treatment Components ====== IPSRT is structured in three phases<ref name=":4">{{Cite web|url=https://www.ipsrt.org/background|title=Interpersonal and Social Rhythm Therapy {{!}} Background|website=www.ipsrt.org|access-date=2019-12-05}}</ref>: # Initial phase: Explores the clients history in order to explore links between disruptions in routines to affective episodes. This stage also includes education on the rationale of the treatment<ref name=":4" /> # Intermediate phase: Focused on reorganizing the client's social rhythms, reinforcing new social rhythms and building confidence in using techniques that are taught in the treatment<ref name=":4" /> # Final phase: Reduction in frequency of visits in order to work towards termination of therapy and self-efficacy<ref name=":4" /> ====== Treatment Outcomes ====== If applied early in the acute phase of bipolar disorder, IPSRT may prolong time to relapse in depressive/manic episodes.<ref name=":5">{{Cite journal|last=Miziou|first=Stella|last2=Tsitsipa|first2=Eirini|last3=Moysidou|first3=Stefania|last4=Karavelas|first4=Vangelis|last5=Dimelis|first5=Dimos|last6=Polyzoidou|first6=Vagia|last7=Fountoulakis|first7=Konstantinos N|date=2015-12|title=Psychosocial treatment and interventions for bipolar disorder: a systematic review|url=http://www.annals-general-psychiatry.com/content/14/1/19|journal=Annals of General Psychiatry|language=en|volume=14|issue=1|pages=19|doi=10.1186/s12991-015-0057-z|issn=1744-859X|pmc=PMC4493813|pmid=26155299}}</ref> ===== Mindfulness-Based Cognitive Therapy (MBCT) ===== ====== Purpose ====== Mindfulness approaches aim to enhance one’s ability to focus their attention on the present moment in a non-judgmental manor.<ref name=":5" /> In treatment for Bipolar Disorder, mindfulness approaches may focus on awareness of the client’s patterns of thoughts, feelings and bodily sensations both specific and non-specific to their experiences related to the disorder.<ref name=":5" /> Moreover, when comorbid with anxiety, bipolar disorder has higher risk of suicide attempts, therefore MBCT aims to decrease these anxiety symptoms.<ref name=":6">{{Cite journal|last=Williams|first=J. Mark G.|last2=Russell|first2=Ian|last3=Russell|first3=Daphne|date=2008-06|title=Mindfulness-based cognitive therapy: Further issues in current evidence and future research.|url=http://doi.apa.org/getdoi.cfm?doi=10.1037/0022-006X.76.3.524|journal=Journal of Consulting and Clinical Psychology|language=en|volume=76|issue=3|pages=524–529|doi=10.1037/0022-006X.76.3.524|issn=1939-2117|pmc=PMC2834575|pmid=18540746}}</ref> ====== Intended Population ====== MBCT is intended for all populations with bipolar disorder.<ref name=":6" /> ====== Length of Treatment ====== MPCT is typically offered in 1-2 hour weekly sessions over an 8-week period in a group setting (Perich et al 2012; Weber et al 2010).<ref>{{Cite journal|last=Perich|first=T.|last2=Manicavasagar|first2=V.|last3=Mitchell|first3=P. B.|last4=Ball|first4=J. R.|last5=Hadzi-Pavlovic|first5=D.|date=2012-12-09|title=A randomized controlled trial of mindfulness-based cognitive therapy for bipolar disorder|url=http://dx.doi.org/10.1111/acps.12033|journal=Acta Psychiatrica Scandinavica|volume=127|issue=5|pages=333–343|doi=10.1111/acps.12033|issn=0001-690X}}</ref><ref name=":7">{{Cite journal|last=Weber|first=B.|last2=Jermann|first2=F.|last3=Gex-Fabry|first3=M.|last4=Nallet|first4=A.|last5=Bondolfi|first5=G.|last6=Aubry|first6=J.-M.|date=2010-10|title=Mindfulness-based cognitive therapy for bipolar disorder: A feasibility trial|url=https://linkinghub.elsevier.com/retrieve/pii/S0924933810000817|journal=European Psychiatry|language=en|volume=25|issue=6|pages=334–337|doi=10.1016/j.eurpsy.2010.03.007}}</ref> Participants are also assigned homework, including varying lengths of meditation practice.<ref name=":7" /> ====== Treatment Components ====== MPCT combines aspects of classical CBT and mindfulness-based stress reduction therapies. The themes addressed in each session are<ref>{{Cite web|url=http://mbct.com/classes.html|title=Classes|website=mbct.com|access-date=2019-12-05}}</ref>: Session 1: Automatic pilot Session 2: Dealing with barriers Session 3: Mindfulness of the breath Session 4: Staying present Session 5: Allowing and letting be Session 6: Thoughts are not facts Session 7: How can I best take care of myself Session 8: Using what has been learned to deal with future moods ====== Treatment Outcomes ====== Treatment outcomes include decreases in anxiety and depressive symptoms and mood regulation in patients with bipolar disorder, but there has been no evidence in prevention of recurrences.<ref name=":5" /><ref name=":6" /> MBCT has also been found to improve attentional readiness, and attenuated activation of non-relevant information processing during attentional readiness, which are usually decreased in individuals with Bipolar Disorder compared to those without.<ref>{{Cite journal|last=Howells|first=Fleur M|last2=Ives-Deliperi|first2=Victoria L|last3=Horn|first3=Neil R|last4=Stein|first4=Dan J|date=2012-02-29|title=Mindfulness based cognitive therapy improves frontal control in bipolar disorder: a pilot EEG study|url=http://dx.doi.org/10.1186/1471-244x-12-15|journal=BMC Psychiatry|volume=12|issue=1|doi=10.1186/1471-244x-12-15|issn=1471-244X}}</ref> <br /> ===== Multi-Family Psychoeducational Psychotherapy (MF-PEP) ===== ====== Purpose ====== MF-PEP is a group-based evidence based treatment for children with bipolar disorder, which is meant to increase the ability for the treatment to be readily implemented into the community.<ref name=":8">{{Cite journal|last=MacPherson|first=Heather A.|last2=Leffler|first2=Jarrod M.|last3=Fristad|first3=Mary A.|date=2014|title=Implementation of Multi-Family Psychoeducational Psychotherapy for Childhood Mood Disorders in an Outpatient Community Setting|url=https://onlinelibrary.wiley.com/doi/abs/10.1111/jmft.12013|journal=Journal of Marital and Family Therapy|language=en|volume=40|issue=2|pages=193–211|doi=10.1111/jmft.12013|issn=1752-0606|pmc=PMC4198302|pmid=24749838}}</ref> While MF-PEP creates a support system within the family for the child through being a family-based intervention, it also serves to increase social support for care givers through being a group-based therapy. ====== Intended Population ====== MF-PEP is intended for children with depressive and bipolar disorders and their caretakers.<ref name=":8" /><ref name=":9">{{Cite journal|last=Fristad|first=Mary A.|last2=Verducci|first2=Joseph S.|last3=Walters|first3=Kimberly|last4=Young|first4=Matthew E.|date=2009-09-01|title=Impact of Multifamily Psychoeducational Psychotherapy in Treating Children Aged 8 to 12 Years With Mood Disorders|url=https://jamanetwork.com/journals/jamapsychiatry/fullarticle/210303|journal=Archives of General Psychiatry|language=en|volume=66|issue=9|pages=1013–1021|doi=10.1001/archgenpsychiatry.2009.112|issn=0003-990X}}</ref> ====== Length of Treatment ====== MF-PEP is an 8-session long treatment, with sessions typically ranging from 60-90 minutes. <ref name=":8" /><ref name=":9" /> ====== Treatment Components ====== MF-PEP combines [[wikipedia:Psychoeducation|psychoeducation]], [[wikipedia:Family_therapy|family systems]], and [[wikipedia:Cognitive_behavioral_therapy|cognitive behavior therapy]] techniques, aiming to target depressive and bipolar disorder symptoms and how these symptoms cause impairment. <ref name=":9" /> In MF-PEP, sessions are delivered in a combination of settings, including all children and parents together, as well as separating all children and caregivers into their own respective groups. <ref name=":9" /> ====== Treatment Outcomes ====== Treatment outcomes for MG-PEP include an increase in caregiver's understanding of the child's disorder, and a decrease in mood symptom severity within the children which has been seen to be maintained through an 18-month follow-up. <ref name=":10">{{Cite journal|last=MacPherson|first=Heather A.|last2=Leffler|first2=Jarrod M.|last3=Fristad|first3=Mary A.|date=2014|title=Implementation of Multi-Family Psychoeducational Psychotherapy for Childhood Mood Disorders in an Outpatient Community Setting|url=https://onlinelibrary.wiley.com/doi/abs/10.1111/jmft.12013|journal=Journal of Marital and Family Therapy|language=en|volume=40|issue=2|pages=193–211|doi=10.1111/jmft.12013|issn=1752-0606|pmc=PMC4198302|pmid=24749838}}</ref> Additionally, MF-PEP has been found to have a positive effect on parent's help-seeking behaviors for mental health care, leading to access to higher-quality services. <ref name=":10" /> Lastly, children report feeling a stronger sense of social support from their caregivers after participating in the intervention.<ref name=":9" /> ===== See Also: ===== * Wikipedia has a page reviewing [[wikipedia:Treatment_of_bipolar_disorder|treatments for bipolar disorder]]. * [http://www.effectivechildtherapy.com Effective Child Therapy] provides a curated list of effective psycho-social treatments for bipolar disorder in youths. * [https://icd.who.int/browse10/2015/en#/F31 ICD-10 Diagnostic Criteria] * [[wikipedia:Bipolar_disorder_in_children|Bipolar disorder in children]] * [https://onlinelibrary.wiley.com/doi/epdf/10.1111/bdi.12556 The International Society for Bipolar Disorders Task Force report on pediatric bipolar disorder: Knowledge to date and directions for future research] * [[wikipedia:Treatment_of_bipolar_disorder|Treatment of bipolar disorder]] =='''External resources'''== {{Infobox disease | name = Pediatric Bipolar Disorder | image = | Caption = Bipolar disorder consists of experiences of mania alternating with depressive episodes | DiseasesDB = 7812 | ICD10 = {{ICD10|F|31||f|30}} | ICD9 = {{ICD9|296.0}}, {{ICD9|296.1}}, {{ICD9|296.4}}, {{ICD9|296.5}}, {{ICD9|296.6}}, {{ICD9|296.7}}, {{ICD9|296.8}} | ICDO = | OMIM = 125480 | OMIM_mult = {{OMIM2|309200}} | MedlinePlus = 000926 | eMedicineSubj = med | eMedicineTopic = 229 | MeshID = D001714 }} #[http://www.nami.org/ National Alliance on Mental Illness] – the nation’s largest grassroots mental health organization dedicated to building better lives for the millions of Americans affected by mental illness. NAMI advocates for access to services, treatment, supports and research and is steadfast in its commitment to raise awareness and build a community for hope for all of those in need.<ref>{{cite web|last=NAMI: National Alliance on Mental Illness.|title=National Alliance on Mental Illness|url=http://www.nami.org/|accessdate=5 February 2014}}</ref> #[http://www.thebalancedmind.org Balanced Mind Foundation] – information, articles, parent support chat rooms.<ref>{{cite web|last=The Balanced Mind.|title=The Balanced Mind Parent Network.|url=http://www.thebalancedmind.org|accessdate=5 February 2014}}</ref> #[http://www.effectivechildtherapy.com Effective Child Therapy] – Information and articles curated by [https://sccap53.org Society of Clinical Child and Adolescent Psychology](SCCAP), a division of the American Psychological Association.<ref>{{cite web|last=Effective Child Therapy|title=Effective Child Therapy: Evidence-based mental health treatment for children and adolescents.|url=http://www.effectivechildtherapy.com|accessdate=5 February 2014}}</ref> ##[http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/severe-mood-swings-and-bipolar-spectrum-disorders/ Effective Child Therapy information: Bipolar Disorder] ##[http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/severe-mood-swings-and-bipolar-spectrum-disorders/ Effective Child Therapy information: Severe Mood Swings and Bipolar Spectrum Disorders] ##[http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/sadness-hopelessness-and-depression/ Effective Child Therapy information: Sadness, Hopelessness, and Depression] #[http://ibpf.org/resources International Bipolar Foundation] – information, help and resources available for caregivers and those afflicted with bipolar disorder.<ref>http://ibpf.org/resources, International Bipolar Foundation, retrieved 27th January 2014. </ref> #[http://www.bipolarnews.org Bipolar Network News] – an online clearinghouse and information on latest treatments, research and psychoeducation about mood disorders.<ref>http://bipolarnews.org/, Bipolar Network News, retrieved 30th January 2014. </ref> #[http://www.depressionalliance.org/ Depression Alliance] – a United Kingdom charity that works to prevent and relieve depression by providing information and support services via supporter services, publications and self-help groups.<ref>Depression Alliance, http://www.depressionalliance.org/, retrieved 30th January 2014. </ref> #[http://www.dbsalliance.org/site/PageServer?pagename=home Depression and Bipolar Support Alliance (DBSA)] – a peer-directed national organization that provides links to resources, support groups, and peer support for individuals and their families suffering from bipolar disorder. ##[https://unc.az1.qualtrics.com/jfe/form/SV_cBlUQk8Y85LHF41 Depression and Bipolar Support Alliance: 7 Up 7 Down Online Screener] #Related Wikipedia Pages ##[[wikipedia:Bipolar_disorder|Bipolar disorder Wikipedia Page]] ##[[wikipedia:Cyclothymia|Cyclothymia Wikipedia Page]] ##[[wikipedia:Mania|Mania Wikipedia Page]] ##[[wikipedia:Depression_(mood)|Depression Wikipedia Page]] #[https://www.massgeneral.org/psychiatry/services/treatmentprograms.aspx?id=1944&display=bipolar Massachusetts General Hospital School Psychiatry Resources for Bipolar Disorder] #The Psych Show with Dr. Ali Mattu videos ##[https://www.youtube.com/watch?v=llOPqKD-s4w How to Cope with Bipolar Disorder] ##[https://www.youtube.com/watch?v=kUHUmeqBZAA Top 10 Bipolar Myths] #[[Evidence Based Psychotherapies for Adolescent Bipolar Disorder]] =='''References'''== {{collapse top|References|expand=yes}} {{Reflist|30em}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] {{collapse bottom}} 6v7fxcxxsiby834jmw6f8yk6r00631h 2419313 2419298 2022-08-26T05:36:08Z Ardenguo 2944162 /* Prediction phase */ linked extended version to "Note: Reliability and validity are included in the extended version. This table includes measures with Good or Excellent ratings." wikitext text/x-wiki <noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{psychology}}{{Evidence-based assessment}}{{medical disclaimer}} {{:{{BASEPAGENAME}}/Sidebar}} ==[[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio?"''']]== * For background information on what assessment portfolios are, click the link in the heading above. Want even 'more' information about this topic? There's an extended version of this page [[Evidence-based assessment/Bipolar disorder in youth (assessment portfolio)/extended version|here]]. == '''[[Evidence based assessment/Preparation phase|Preparation phase]]''' == === Diagnostic criteria for Pediatric Bipolar disorder === {{collapse top| More information on PBD diagnostic criteria|expand=yes}} *[[w:Bipolar_disorder_in_children|Pediatric bipolar disorder (PBD)]] is characterized by extreme fluctuations in mood or emotional dysregulation that range from mania (as shown by displays or feelings of extreme happiness, unrealistic overachievement, and anger) to depression (as shown by displays or feelings of sadness, changes in appetite or weight, and irritability<ref name="APA"> American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.</ref> <ref name="jamison"> Goodwin, F. K., & Jamison, K. R. (2007). ''Manic-depressive illness.'' (10th edition). New York, NY: Oxford University Press </ref>). *It is important to note that these moods exceed normal responses to life events, represent a change from the individual's normal functioning, and cause problems in daily activities. These mood fluctuations result in a child finding it difficult to live and interact with family, friends and teachers, when it was previously not an issue<ref name="APA" />. *People with [[w:Bipolar_disorder|bipolar disorder]] experience unusually intense emotional states that occur in distinct periods called [[w:Mood_(psychology)|"mood episodes".]] An overly joyful or overexcited state is called a manic episode, and an extremely sad or hopeless state is called a [[w:Major_depressive_episode|depressive episode]]. Sometimes, a mood episode includes symptoms of both [[w:Mania|mania]] and [[w:Depression_(mood)|depression]]. *People with bipolar disorder also may be explosive and irritable during a mood episode.<ref name="APA" /> **Extreme changes in energy, activity, sleep, and behavior go along with these changes in mood. *It is possible for someone with bipolar disorder to experience a long-lasting period of unstable moods rather than discrete episodes of depression or mania.<ref name="jamison" /> <ref name="APA" /> *A person may be having an episode of bipolar disorder if he or she has a number of manic or depressive symptoms for most of the day, nearly every day, for at least one or two weeks. These debilitating symptoms can result in an afflicted individual being unable to function adaptively in several settings. {{collapse bottom}} {{blockquotetop}} '''<big>ICD-10 Criteria</big>''' '''''F31 Bipolar affective disorder''''' *''Note.'' Episodes are demarcated by a switch to an episode of opposite or mixed polarity or by a remission. '''''F31.0 Bipolar affective disorder, current episode hypomanic''''' '''A.''' The current episode meets the criteria for '''Hypomania F30.0''': *'''''(A)''''' The mood is elevated or irritable to a degree that is definitely abnormal for the individual concerned and sustained for at least four consecutive days. *'''''(B)''''' At least three of the following signs must be present, leading to some interference with personal functioning in daily living *# Increased activity or physical restlessness; *# Increased talkativeness; *# Distractibility or difficulty in concentration; *# Decreased need for sleep; *# Increased sexual energy; *# Mild over-spending, or other types of reckless or irresponsible behavior; *# Increased sociability or over-familiarity. *'''''(C)''''' The episode does not meet the criteria for '''F30.1 Mania without psychotic symptoms''', '''F30.2 Mania with psychotic symptoms''', '''F31.- Bipolar affective disorder''', '''F32.- Depressive episode''', '''F34.0 Cyclothymia''', or '''F50.0 Anorexia nervosa'''. *'''''(D)''''' ''Most commonly used exclusion clause.'' The episode is not attributable to '''F10-F19 Psychoactive substance use''' or in the sense of any '''F00-F09 Organic mental disorder'''. '''B.''' There has been at least one other affective episode in the past, meeting the criteria for '''F30.- Hypomanic or Manic episode''', '''F32.Depressive episode''', or '''F38.00 Mixed affective episode.''' <big>'''Changes in DSM-5'''</big> The diagnostic criteria for bipolar disorders changed slightly from [[DSM-IV]] to [[w:Diagnostic_and_Statistical_Manual_of_Mental_Disorders#DSM-IV-TR_.282000.29|DSM-5]]. Summaries are available [http://www.dsm5.org/Documents/changes%20from%20dsm-iv-tr%20to%20dsm-5.pdf here] and [[w:DSM-5|here]]. {{blockquotebottom}} === Base rates of PBD in different clinical settings and populations === This section describes the demographic setting of the population(s) sampled, base rates of diagnosis, country/region sampled and the diagnostic method that was used. Using this information, clinicians will be able to anchor the rates of PBD that they are likely to see in their clinical practices. * '''''To find prevalence rates across multiple disorders,''''' [[Evidence based assessment/Preparation phase#Base rates for transdiagnostic comparison|'''''click here.''''']] {| class="wikitable sortable" border="1" |+ style="text-align: left;" | ''Base rates of BSD in different clinical settings'' |- ! scope="col" | Setting (Reference) ! scope="col" style="white-space: nowrap;"| Base Rate ! scope="col" | Demography ! scope="col" | Diagnostic Method !Recommended for... |- | Rates of Bipolar Disorders in General Population || 0.6% || '''Bipolar I''' in youths age 5 to 18 || Meta-analysis of epidemiological studies, 19 samples, N = 56,103 participants<ref name=":11">{{Cite journal|last=Van Meter|first=Anna|last2=Moreira|first2=Ana Lúcia R.|last3=Youngstrom|first3=Eric|date=2019-04-02|title=Updated Meta-Analysis of Epidemiologic Studies of Pediatric Bipolar Disorder|url=https://www.psychiatrist.com/JCP/article/Pages/2019/v80/18r12180.aspx|journal=The Journal of Clinical Psychiatry|volume=80|issue=3|doi=10.4088/JCP.18r12180|issn=1555-2101}}</ref> |Schools, nonclinical settings. Minimum for outpatient settings. |- | style="border: width: 1px; border-bottom: 3px solid grey; padding: 5px;" |Rates of bipolar spectrum (I, II, cyclothymia, NOS) in general population || style="border: width: 1px; border-bottom: 3px solid grey; padding: 5px;" | 3.9% || style="border: width: 1px; border-bottom: 3px solid grey; padding: 5px;" | '''Bipolar spectrum''' in youths age 5 to 18 years || style="border: width: 1px; border-bottom: 3px solid grey; padding: 5px;" | Meta-regression estimate <ref name=":11" /> |Schools, nonclinical settings. Minimum for outpatient settings. |- | High school epidemiological<br />(Lewinsohn et al., 2000) || 0.6% || Northwestern USA high school || KSADS-PL | |- |Community Mental Health Center<br />(E. A. Youngstrom et al., 2005) || 6% || Midwestern Urban, 80% non-white, low-income || Clinical interview & treatment | |- | General Outpatient Clinic;<br />(Geller, Zimerman, Williams, Delbello, Frazier, et al., 2002) || 6% to 8% || Urban academic research centers || WASH-U-KSADS | |- |County Wards (DCFS)<br />(Naylor, Anderson, Kruesi, & Stoewe, 2002, October) || 11% || State of Illinois || Clinical interview & treatment | |- | Specialty Outpatient Service<br />(Biederman et al., 1996) || 15-17% || New England || KSADS-E | |- |Incarcerated adolescents<br />(Teplin, Abram, McClelland, Dulcan, & Mericle, 2002) || 2% || Midwestern Urban || DISC | |- | Incarcerated adolescents<br />(Pliszka et al., 2000) || 22% || Texas || DISC | |- | Acute psychiatric hospitalizations<br />in 2002-2003 – <u>adolescents</u><br />(Blader & Carlson, 2007) || 21% || All of U.S.A. || Centers for Disease Control survey of discharge diagnoses | |- | Inpatient service<br />(Carlson & Youngstrom, 2003) || 30% manic symptoms,<br /><2% strict BP I || New York City Metro Region || DICA; KSADS | |- |Acute psychiatric hospitalizations<br />in 2002-2003 – <u>children</u><br />(Blader & Carlson, 2007) || 40% || All of U.S.A. || Centers for Disease Control survey of discharge diagnoses | |- |Psychiatric outpatient clinic<br />(Ghanizadeh, Mohammadi, & Yazdanshenas, 2006) || 16-17% || Iran || K-SADS-PL (Farsi) | |- |Inpatient and partial hospitalization programs at a psychiatric treatment center<br />(Pellegrini et al., 1986) || Mania (0%), hypomania (6%) || Richmond, Virginia || DISC | |- |} ^p Parent interviewed as component of diagnostic assessment; ^y youth interviewed as part of diagnostic assessment. ''Note:'' KSADS = Kiddie Schedule for Affective Disorders and Schizophrenia, PL = Present and Lifetime version, WASH-U = Washington University version, -E = Epidemiological version of the KSADS; DISC = Diagnostic Interview Schedule for Children; DICA = Diagnostic Interview for Children and Adolescents. Table modified from Wikiversity. {| class="wikitable sortable" border="1" |- ! Setting ! Base Rate ! Demography ! Diagnostic Method !Best Recommended For |- | Community epidemiological (NCS-A) <ref>{{cite journal|last1=Kessler|first1=Ronald C.|last2=Avenevoli|first2=Shelli|last3=Costello|first3=E. Jane|last4=Georgiades|first4=Katholiki|last5=Green|first5=Jennifer Greif|last6=Gruber|first6=Michael J.|last7=He|first7=Jian-ping|last8=Koretz|first8=Doreen|last9=McLaughlin|first9=Katie A.|last10=Petukhova|first10=Maria|last11=Sampson|first11=Nancy A.|last12=Zaslavsky|first12=Alan M.|last13=Merikangas|first13=Kathleen Ries|title=Prevalence, persistence, and sociodemographic correlates of DSM-IV disorders in the National Comorbidity Survey Replication Adolescent Supplement|journal=Archives of General Psychiatry|date=1 April 2012|volume=69|issue=4|pages=372–380|doi=10.1001/archgenpsychiatry.2011.160|url=http://www.ncbi.nlm.nih.gov/pubmed/22147808|accessdate=26 January 2016|issn=1538-3636}}</ref> | 3.0% | All of U.S.A. | CIDI 3.0 | |- | Community epidemiologic samples<ref>{{cite journal|last1=Van Meter|first1=Anna R.|last2=Moreira|first2=Ana Lúcia R.|last3=Youngstrom|first3=Eric A.|date=1 September 2011|title=Meta-analysis of epidemiologic studies of pediatric bipolar disorder|url=http://www.ncbi.nlm.nih.gov/pubmed/21672501|journal=The Journal of Clinical Psychiatry|volume=72|issue=9|pages=1250–1256|doi=10.4088/JCP.10m06290|issn=1555-2101}}</ref> |mean= 1.8% (95% CI, 1.1%–3.0%), bipolar I (mean =1.2%; 95% CI, 0.7%–1.9%) | U.S.A., Netherlands, U.K., Spain, Mexico, Ireland, New Zealand | Structured and semi-structured diagnostic interviews, Combination of broad and specific diagnostic criteria (Meta-Analysis) |Schools, nonclinical settings. Minimum for outpatient settings. |- |Community mental health center<ref>{{Cite journal|last=Youngstrom|first=Eric A.|last2=Findling|first2=Robert L.|last3=Youngstrom|first3=Jen Kogos|last4=Calabrese|first4=Joseph R.|date=September 2005|title=Toward an evidence-based assessment of pediatric bipolar disorder|url=https://www.ncbi.nlm.nih.gov/pubmed/16026213|journal=Journal of Clinical Child and Adolescent Psychology: The Official Journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 53|volume=34|issue=3|pages=433–448|doi=10.1207/s15374424jccp3403_4|issn=1537-4416|pmid=16026213}}</ref> |6% |U.S.A., Midwestern Urban, 80% non-white, low-income |Parent and youth clinical assessment & treatment | |- |General outpatient clinic<ref name=":1" /> |6-8% |Urban academic research centers |WASH-U-[[w:Kiddie Schedule for Affective Disorders and Schizophrenia|KSAD]]S (parent and youth) | |- |Specialty outpatient service<ref>{{Cite journal|last=Biederman|first=J.|last2=Faraone|first2=S.|last3=Mick|first3=E.|last4=Wozniak|first4=J.|last5=Chen|first5=L.|last6=Ouellette|first6=C.|last7=Marrs|first7=A.|last8=Moore|first8=P.|last9=Garcia|first9=J.|date=August 1996|title=Attention-deficit hyperactivity disorder and juvenile mania: an overlooked comorbidity?|url=https://www.ncbi.nlm.nih.gov/pubmed/8755796|journal=Journal of the American Academy of Child and Adolescent Psychiatry|volume=35|issue=8|pages=997–1008|doi=10.1097/00004583-199608000-00010|issn=0890-8567|pmid=8755796}}</ref> |15-17% |Boston area, U. S. A. |[[w:Kiddie Schedule for Affective Disorders and Schizophrenia|KSADS]]-E | |- | Inpatient Services/Diagnoses<ref>{{Cite journal|last=Holtmann|first=M.|last2=Goth|first2=K.|last3=Wöckel|first3=L.|last4=Poustka|first4=F.|last5=Bölte|first5=S.|date=2008|title=CBCL-pediatric bipolar disorder phenotype: severe ADHD or bipolar disorder?|url=https://www.ncbi.nlm.nih.gov/pubmed/17994189|journal=Journal of Neural Transmission (Vienna, Austria: 1996)|volume=115|issue=2|pages=155–161|doi=10.1007/s00702-007-0823-4|issn=0300-9564|pmid=17994189}}</ref> | 0.3% | All of Germany | [[w:International_Statistical_Classification_of_Diseases_and_Related_Health_Problems|International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10)]] | |- | Community sample<ref>{{cite journal|last1=Olino|first1=Thomas M.|last2=Shankman|first2=Stewart A.|last3=Klein|first3=Daniel N.|last4=Seeley|first4=John R.|last5=Pettit|first5=Jeremy W.|last6=Farmer|first6=Richard F.|last7=Lewinsohn|first7=Peter M.|date=1 September 2012|title=Lifetime rates of psychopathology in single versus multiple diagnostic assessments: Comparison in a community sample of probands and siblings|url=http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3411854/|journal=Journal of psychiatric research|volume=46|issue=9|pages=1217–1222|doi=10.1016/j.jpsychires.2012.05.017|issn=0022-3956}}</ref> | 2.9% | Oregon | LIFE, SCID, DSM-IV | |- | Inpatient service<ref>{{cite journal|last1=Carlson|first1=Gabrielle A.|last2=Youngstrom|first2=Eric A.|date=1 June 2003|title=Clinical implications of pervasive manic symptoms in children|url=http://www.ncbi.nlm.nih.gov/pubmed/12788250|journal=Biological Psychiatry|volume=53|issue=11|pages=1050–1058|issn=0006-3223}}</ref> | 30% manic symptoms, <2% strict BP I | New York City Metro Region | DICA; [[w:Kiddie Schedule for Affective Disorders and Schizophrenia|KSADS]] | |- |NCS-A Clinical Reappraisal Sample<ref name=":3" /> ^{p y} |6.2% and SE=1.7 (bipolar I and II and sub-threshold bipolar spectrum disorder) |U.S.A, NCS-A |[[w:Kiddie Schedule for Affective Disorders and Schizophrenia|K-SADS]], DSM-IV criteria were modified from published version for purpose of the study, broad criteria for not otherwise specified | | |- |NCS-A Clinical Reappraisal Sample<ref name=":3">{{Cite journal|last=Kessler|first=Ronald C.|last2=Avenevoli|first2=Shelli|last3=Green|first3=Jennifer|last4=Gruber|first4=Michael J.|last5=Guyer|first5=Margaret|last6=He|first6=Yulei|last7=Jin|first7=Robert|last8=Kaufman|first8=Joan|last9=Sampson|first9=Nancy A.|date=2009-04|title=National Comorbidity Survey Replication Adolescent Supplement (NCS-A): III. Concordance of DSM-IV/CIDI Diagnoses With Clinical Reassessments|url=http://linkinghub.elsevier.com/retrieve/pii/S0890856709600460|journal=Journal of the American Academy of Child & Adolescent Psychiatry|volume=48|issue=4|pages=386–399|doi=10.1097/chi.0b013e31819a1cbc|issn=0890-8567|pmc=PMC3040100|pmid=19252450}}</ref> ^p ^y |6.6% and SE=1.7 (bipolar I and II and sub-threshold bipolar spectrum disorder) |U.S.A, NCS-A |CIDI, DSM-IV criteria were modified from published version for purpose of the study, broad criteria for not otherwise specified, | |- |National Cross‐sectional epidemiological sample<ref>{{Cite journal|last=Stringaris|first=Argyris|last2=Santosh|first2=Paramala|last3=Leibenluft|first3=Ellen|last4=Goodman|first4=Robert|date=2009-07-22|title=Youth meeting symptom and impairment criteria for mania-like episodes lasting less than four days: an epidemiological enquiry|url=http://doi.wiley.com/10.1111/j.1469-7610.2009.02129.x|journal=Journal of Child Psychology and Psychiatry|language=en|volume=51|issue=1|pages=31–38|doi=10.1111/j.1469-7610.2009.02129.x|issn=0021-9630|pmc=PMC4286871|pmid=19686330}}</ref> ^p ^y |1.2% (bipolar I and II and not otherwise specified) |United Kingdom |DAWBA, DSM-IV criteria, broad criteria for not otherwise specified | |- |Community epidemiological samples<ref>{{Cite journal|last=Benjet|first=Corina|last2=Borges|first2=Guilherme|last3=Medina-Mora|first3=Maria Elena|last4=Zambrano|first4=Joaquin|last5=Aguilar-Gaxiola|first5=Sergio|date=2009-04|title=Youth mental health in a populous city of the developing world: results from the Mexican Adolescent Mental Health Survey|url=http://doi.wiley.com/10.1111/j.1469-7610.2008.01962.x|journal=Journal of Child Psychology and Psychiatry|language=en|volume=50|issue=4|pages=386–395|doi=10.1111/j.1469-7610.2008.01962.x|issn=0021-9630}}</ref> ^y |2.5% (bipolar I and II) |Mexico City |CIDI, DSM-IV Criteria | |- |2-stage epidemiological study<ref>{{Cite journal|last=Lynch|first=Fionnuala|last2=Mills|first2=Carla|last3=Daly|first3=Irenee|last4=Fitzpatrick|first4=Carol|date=2006-08|title=Challenging times: Prevalence of psychiatric disorders and suicidal behaviours in Irish adolescents|url=http://linkinghub.elsevier.com/retrieve/pii/S0140197105001004|journal=Journal of Adolescence|volume=29|issue=4|pages=555–573|doi=10.1016/j.adolescence.2005.08.011|issn=0140-1971}}</ref> ^{p y} |0.0% (bipolar I and II, cyclothymia, not otherwise specified |Ireland |[[w:Kiddie Schedule for Affective Disorders and Schizophrenia|K-SADS]], DSM-IV Criteria | |} ^p:Parent interviewed as component of diagnostic assessment; ^y:Youth interviewed as part of diagnostic assessment. ''Note:'' * KSADS = [[w:Schedule_for_Affective_Disorders_and_Schizophrenia#K-SADS|Kiddie Schedule for Affective Disorders and Schizophrenia]], * WASH-U = Washington University version, -PL = Present and Lifetime Version, -E = Epidemiological version of the KSADS * LIFE = Longitudinal Interval Follow-Up Evaluation, * DICA = Diagnostic Interview for Children and Adolescents *CIDI = Composite International Diagnostic Interview *DAWBA= The Development and Well-Being Assessment == '''[[Evidence based assessment/Prediction phase|Prediction phase]]''' == The following section contains a list of screening and diagnostic instruments for bipolar disorder in youth. This section includes administration information, psychometric data, and PDFs or links to the screenings. === Psychometric properties of screening instruments for pediatric bipolar disorder === * Screenings are used as part of the [[Evidence based assessment/Prediction phase|prediction phase]] of assessment; for more information on interpretation of this data, or how screenings fit in to the assessment process, click [[Evidence based assessment/Prediction phase|here.]] * '''''For a list of more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Common_screening_instruments click here.]''''' {| class="wikitable sortable" border="1" ! colspan="10" |Screening measures for bipolar disorder in youth |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time ! Interrater Reliability ! Test-Retest Reliability ! Construct Validity ! Content Validity ! Highly Recommended !Free and Accessible Measures |- | Children's Depression Inventory <nowiki>*</nowiki>not free | Self-report<ref name=":0">{{Cite web|url=https://www.pearsonclinical.com/psychology/products/100000636/childrens-depression-inventory-2-cdi-2.html|title=Children's Depression Inventory 2™|website=www.pearsonclinical.com|language=en-US|accessdate=2018-03-01}}</ref> | 7-17 | 15-20 minutes<ref name=":0" /> | NA | A | G | G | X |Not free |- | Mood and Feelings Questionnaire (MFQ) | Self-report | 7-18 | 5-10 minutes<ref>{{Cite web|url=http://www.cebc4cw.org/assessment-tool/mood-and-feelings-questionnaire-mfq/|title=CEBC » Assessment Tool › Mood And Feelings Questionnaire Mfq|website=www.cebc4cw.org|language=en|accessdate=2018-03-01}}</ref> | NA | A | G | A | X | *[https://mfr.osf.io/render?url=https://osf.io/enx4b/?action=download%26mode=render MFQ Child Self-Report Long Version] *[https://mfr.osf.io/render?url=https://osf.io/mcg5w/?action=download%26mode=render MFQ Child Self Report Short Version] *[https://mfr.osf.io/render?url=https://osf.io/cw27p/?action=download%26mode=render MFQ Parent Report On Child Long Version] *[https://mfr.osf.io/render?url=https://osf.io/kybr4/?action=download%26mode=render MFQ Parent Report On Child Short Version] |- | 7 Up 7 Down Inventory (7U7D) |Self-report<ref name=":5" /> | 11-86<ref>{{Cite journal|last=Mesman|first=E.|last2=Youngstrom|first2=E.A.|last3=Juliana|first3=N.K.|last4=Nolen|first4=W.A.|last5=Hillegers|first5=M.H.J.|date=2017-01|title=Validation of the Seven Up Seven Down Inventory in bipolar offspring: screening and prediction of mood disorders. Findings from the Dutch Bipolar Offspring Study|url=https://doi.org/10.1016/j.jad.2016.09.024|journal=Journal of Affective Disorders|volume=207|pages=95–101|doi=10.1016/j.jad.2016.09.024|issn=0165-0327}}</ref> |5-8 minutes | NA | | | | | * [https://mfr.osf.io/render?url=https://osf.io/s825e/?action=download%26mode=render 7U7D English] * [https://unc.az1.qualtrics.com/jfe/form/SV_cBlUQk8Y85LHF41 Depression and Bipolar Support Alliance (DBSA): 7U7D '''Online Screener'''] |- | Parent General Behavior-10 Item Version (PGBI-10M)<ref name=":6">{{Cite journal|last=Youngstrom|first=Eric A.|last2=Genzlinger|first2=Jacquelynne E.|last3=Egerton|first3=Gregory A.|last4=Meter|first4=Anna R. Van|title=Multivariate meta-analysis of the discriminative validity of caregiver, youth, and teacher rating scales for pediatric bipolar disorder: Mother knows best about mania.|url=http://dx.doi.org/10.1037/arc0000024|journal=Archives of Scientific Psychology|volume=3|issue=1|pages=112–137|doi=10.1037/arc0000024}}</ref> |Parent-report |5-18<ref name=":7">Youngstrom, E.A., Van Meter, A.R, Frazier, T.W., Youngstrom, J.K., & Findling, R.L. (in press). Developing and validating short forms of the Parent General Behavior Inventory Mania and Depression Scales for rating youth mood symptoms. ''Journal of Clinical Child & Adolescent Psychology.''</ref> |5-8 minutes | | | | | | * [https://mfr.osf.io/render?url=https://osf.io/ub8h7/?action=download%26mode=render Downloadable PDF Parent-Report English] |} '''Note:''' Reliability and validity are included in the [[Evidence-based assessment/Bipolar disorder in youth (assessment portfolio)/extended version|extended version]]. This table includes measures with Good or Excellent ratings. === Brief screening tools for PBD=== {{collapse top|expand=yes}} The following are brief screening tools that typically take less than 5 minutes to administer to accurately diagnose pediatric bipolar disorder: # '''''7 Up 7 Down Inventory (7U7D)''''' ## The [http://supp.apa.org/psycarticles/supplemental/a0033975/a0033975_supp.html 7 Up 7 Down Inventory]<ref name=":5">{{cite journal|last1=Youngstrom|first1=Eric A.|last2=Murray|first2=Greg|last3=Johnson|first3=Sheri L.|last4=Findling|first4=Robert L.|title=The 7 up 7 down inventory: a 14-item measure of manic and depressive tendencies carved from the General Behavior Inventory|journal=Psychological Assessment|date=1 December 2013|volume=25|issue=4|pages=1377–1383|doi=10.1037/a0033975|url=https://www.ncbi.nlm.nih.gov/pubmed/23914960|issn=1939-134X}}</ref> is a recently developed and validated questionnaire with 14 items of manic and depressive tendencies carved from the General Behavior Inventory, a well-validated but cumbersome interview. For both mania and depression factors, 7 items produced a psychometrically adequate measure applicable across both aggregate samples. Internal reliability of the Mania scale was .81 (youth) and .83 (adult) and for Depression was .93 (youth) and .95 (adult). ## The 7 Up 7 Down Inventory, along with the accompanying research article, can be [http://supp.apa.org/psycarticles/supplemental/a0033975/a0033975_supp.html found here]. # '''''[https://mfr.osf.io/render?url=https://osf.io/d95nv/?action=download%26mode=render PGBI-10M]'''''<ref>Youngstrom EA, Frazier TW, Demeter C, et al. Developing a 10-item mania scale from the Parent General Behavior Inventory for children and adolescents. J Clin Psychiatry. 2008;69(5):831–839.</ref> ## The [http://www.moodychildtherapy.com/wp-content/uploads/2011/01/PGBI-10M-2-wks.pdf PGBI-10M] (we would like to add another version that is better) is a brief (10 item) instrument derived from the [https://mfr.osf.io/render?url=https://osf.io/3j5r7/?action=download%26mode=render Parent General Behavior Inventory (PGBI)]<ref>{{Cite journal|last=Youngstrom|first=Eric A.|last2=Findling|first2=Robert L.|last3=Danielson|first3=Carla Kmett|last4=Calabrese|first4=Joseph R.|date=2001|title=Discriminative validity of parent report of hypomanic and depressive symptoms on the General Behavior Inventory.|url=http://psycnet.apa.org/doi/10.1037/1040-3590.13.2.267|journal=Psychological Assessment|language=en|volume=13|issue=2|pages=267–276|doi=10.1037/1040-3590.13.2.267|issn=1939-134X}}</ref>, a 73-item mood inventory, to assess [[mania]] in a large sample of outpatients presenting with a variety of different [[DSM-IV]] diagnoses, including frequent comorbid conditions.<ref name=":0">{{cite journal|last1=Youngstrom|first1=E. A.|last2=Findling|first2=R. L.|last3=Danielson|first3=C. K.|last4=Calabrese|first4=J. R.|title=Discriminative validity of parent report of hypomanic and depressive symptoms on the General Behavior Inventory|journal=Psychological Assessment|date=1 June 2001|volume=13|issue=2|pages=267–276|url=http://www.ncbi.nlm.nih.gov/pubmed/11433802|issn=1040-3590}}</ref> ## The 10-item GBI derived from the 73-item P-GBI had good reliability (alpha = .92), was correlated (r = 0.95) with the 28-item scale, and showed significantly better discrimination of bipolar disorders (area under the [[receiver operating characteristic]] [AUROC] curve of 0.856 vs. 0.832 for the 28-item scale, p < .005). The 10-item scale also did well discriminating bipolar disorder from unipolar depression (AUROC = 0.86) and bipolar disorder from [[attention deficit hyperactivity disorder|attention-deficit/hyperactivity disorder]] (AUROC = 0.82) cases. ## The full version of the scale, the Parent-General Behavior Inventory (P-GBI), is a parent-report measure of depressive and hypomanic/biphasic symptoms adapted from the General Behavior Inventory (GBI). ## Classification rates exceed 80%, and receiver operating characteristic analyses showed good diagnostic efficiency for the scales, with areas under the curve greater than .80. Results indicate that clinicians can use the parent-completed GBI to derive clinically meaningful information about mood disorders in youths. {{collapse bottom}} === Likelihood ratios and AUCs of screening measures for bipolar disorder in youth === * '''''For a list of the likelihood ratios for more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Likelihood_ratios_and_AUCs_of_common_screening_instruments click here.]''''' The following table describes the diagnostic likelihood ratios and area under curves for the top pediatric bipolar disorder measures. {| class="wikitable sortable" border="1" |- ! Screening Measure ! AUC (sample size) !Very Low risk range DiLR !Low risk range DiLR !Neutral risk range DiLR !High risk range DiLR !Very High risk range DiLR !DLR+ (score) !DLR- (score) ! Population/Clinical Generalizability !Download |- |[https://mfr.osf.io/render?url=https://osf.io/d3b4h/?action=download%26mode=render Parent General Behavior-10 Item Mania Version (PGBI-10M)]<ref name=":7" /> |.84 (''N''=617) academic sample, .78 community sample (''N''=530)<ref name=":7" /> |.07  (0 to 2.59)  |.41 (2.6 to 6.99) |1.44 (7 to 10.99)  |2.39 (11 to 17.99)  |5.38 (18+) | | |Bipolar spectrum vs. all other diagnoses |[https://mfr.osf.io/render?url=https://osf.io/ub8h7/?action=download%26mode=render Parent Form]<ref>{{Cite web|url=http://www.moodychildtherapy.com|title=Psychoeducational Psychotherapy|website=www.moodychildtherapy.com|language=en-US|access-date=2018-07-20}}</ref> |- |[https://mfr.osf.io/render?url=https://osf.io/eau89/?action=download%26mode=render Parent General Behavior-10 Item Depression Version Form A (PGBI-10Da)]<ref name=":7" /> |.84 (''N''=617) academic sample, .79 community sample (''N''=530)<ref name=":7" /> |.25  (0 to 1.99) |.71 (2 to 5.99)   |1.85 (6 to 9.99)   |4.52 (10 to 14.99) |8.80 (15+)   | | |Bipolar spectrum vs. all other diagnoses | |- |[https://mfr.osf.io/render?url=https://osf.io/eau89/?action=download%26mode=render Parent General Behavior-10 Item Depression Version Form B (PGBI-10Db)]<ref name=":7" /> |.84 (''N''=617) academic sample, .80 community sample (''N''=530)<ref name=":7" /> |.22 (0 to 1.99)    |.71 (2 to 5.99) |2.69 (6 to 10.99)    |5.64 (11 to 14.99)    |8.09 (15+) | | |Bipolar spectrum vs. all other diagnoses | |- |[https://mfr.osf.io/render?url=https://osf.io/hyb3g/?action=download%26mode=render Parent General Behavior Inventory] (P-GBI) (''Hypomanic/Biphasic Section''])<ref name="eay2004">Youngstrom, E. A., Findling, R. L., & Calabrese, J. R. (2004). Effects of adolescent manic symptoms on agreement between youth, parent, and teacher ratings of behavior problems. Journal of Affective Disorders, 82, S5-S16. </ref> | .84 (N=324) | |(<9) | | |(49+) |9.2 |.06 | Bipolar spectrum vs. all other diagnoses | |- | Parent Mood Disorder Questionnaire (P-MDQ)<ref>{{cite journal|last1=Wagner|first1=Karen Dineen|last2=Hirschfeld|first2=Robert M. A.|last3=Emslie|first3=Graham J.|last4=Findling|first4=Robert L.|last5=Gracious|first5=Barbara L.|last6=Reed|first6=Michael L.|date=1 May 2006|title=Validation of the Mood Disorder Questionnaire for bipolar disorders in adolescents|url=http://www.ncbi.nlm.nih.gov/pubmed/16841633|journal=The Journal of Clinical Psychiatry|volume=67|issue=5|pages=827–830|issn=0160-6689}}</ref> | .84 (N=819) | |(TBC) | | |(TBC) |4.64 |.17 | Bipolar spectrum vs. all other diagnoses | * [https://mfr.osf.io/render?url=https://osf.io/wtp7r/?action=download%26mode=render MDQ] |- | Child Mania Rating Scale (Brief) ''(Brief CMRS-P)''<ref name=":2">{{cite journal|last1=Henry|first1=David B.|last2=Pavuluri|first2=Mani N.|last3=Youngstrom|first3=Eric|last4=Birmaher|first4=Boris|date=1 April 2008|title=Accuracy of brief and full forms of the Child Mania Rating Scale|url=http://www.ncbi.nlm.nih.gov/pubmed/?term=18302291|journal=Journal of Clinical Psychology|volume=64|issue=4|pages=368–381|doi=10.1002/jclp.20464|issn=0021-9762}}</ref> | .85 (N=150) | |(<11) | | |(11+) |10.5 |.17 | Bipolar spectrum vs. ADHD | |- | Child Mania Rating Scale (Full) ''(Full CMRS-P)''<ref name=":2" /> | .91 (N=150) | |(<21) | | |(21+) |13.7 |.19 | Bipolar spectrum vs. ADHD | * [https://mfr.osf.io/render?url=https://osf.io/8wv3a/?action=download%26mode=render Downloadable PDF] |- |[https://mfr.osf.io/render?url=https://osf.io/5yzur/?action=download%26mode=render Child Bipolar Questionnaire] ''[https://mfr.osf.io/render?url=https://osf.io/5yzur/?action=download%26mode=render (CBQ-P)]''<ref>{{Cite journal|last=Papolos|first=Demitri|last2=Hennen|first2=John|last3=Cockerham|first3=Melissa S.|last4=Thode|first4=Henry C.|last5=Youngstrom|first5=Eric A.|date=2006-10|title=The child bipolar questionnaire: A dimensional approach to screening for pediatric bipolar disorder|url=https://doi.org/10.1016/j.jad.2006.03.026|journal=Journal of Affective Disorders|volume=95|issue=1-3|pages=149–158|doi=10.1016/j.jad.2006.03.026|issn=0165-0327}}</ref> |.74 (N=497) | | | | | |25.3/ (likelihood ratio +) |/.25 (likelihood ratio -) |Bipolar spectrum vs. all other diagnoses | |} === Interpreting bipolar disorder screening measure scores === For information on interpreting screening measure scores, click [[Evidence based assessment/Prediction phase#Interpreting screening measure scores|here.]] ==[[Evidence based assessment/Prescription phase|'''Prescription phase''']]== ===Gold standard diagnostic interviews=== For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews click here.] {{collapse top|More details on gold-standard diagnostic interviews|expand=yes}} # '''Kiddie Schedule for Affective Disorders and Schizophrenia-Present and Lifetime (KSADS-PL)''' #* The '''KSADS-PL''' is a semi-structured diagnostic interview that assesses current and past Diagnostic and Statistical Manual of Mental Disorders – Fourth Edition (DSM-IV-TR) Axis I psychopathology in youth<ref name="APA" />. The KSADS-PL diagnostic interviews have good inter-rater (.93 to 1.00) and retest reliability (.77) for mood disorders <ref>{{cite journal|last1=Kaufman|first1=J.|last2=Birmaher|first2=B.|last3=Brent|first3=D.|last4=Rao|first4=U.|last5=Flynn|first5=C.|last6=Moreci|first6=P.|last7=Williamson|first7=D.|last8=Ryan|first8=N.|title=Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (K-SADS-PL): initial reliability and validity data|journal=Journal of the American Academy of Child and Adolescent Psychiatry|date=1 July 1997|volume=36|issue=7|pages=980–988|doi=10.1097/00004583-199707000-00021|url=http://www.ncbi.nlm.nih.gov/pubmed/9204677|issn=0890-8567}}</ref> Here is a link to a PDF of the diagnostic interview for the [http://www.psychiatry.pitt.edu/sites/default/files/Documents/assessments/ksads-pl.pdf Kiddie Schedule for Affective Disorders and Schizophrenia-Present and Lifetime]. # '''Washington University in St. Louis Kiddie Schedule for Affective Disorders and Schizophrenia (WASH-U-KSADS)''' #* The '''[http://www.ncbi.nlm.nih.gov/pubmed/11314571 Washington University in St. Louis Kiddie Schedule for Affective Disorders and Schizophrenia]'''(WASH-U-KSADS)<ref name=":1">{{cite journal|last1=Geller|first1=B.|last2=Zimerman|first2=B.|last3=Williams|first3=M.|last4=Bolhofner|first4=K.|last5=Craney|first5=J. L.|last6=DelBello|first6=M. P.|last7=Soutullo|first7=C.|title=Reliability of the Washington University in St. Louis Kiddie Schedule for Affective Disorders and Schizophrenia (WASH-U-KSADS) mania and rapid cycling sections|journal=Journal of the American Academy of Child and Adolescent Psychiatry|date=1 April 2001|volume=40|issue=4|pages=450–455|doi=10.1097/00004583-200104000-00014|url=http://www.ncbi.nlm.nih.gov/pubmed/11314571|issn=0890-8567}}</ref> was expanded from the 1986 version of the KSADS, which was modified and expanded to include onset and offset of each symptom for both current and lifetime episodes, expanded prepubertal mania and rapid cycling sections, and categories for [[attention deficit hyperactivity disorder]] and other DSM-IV diagnoses. To optimize diagnostic research, skip-outs were minimized. #* The kappa values of comparisons between research nurse and off-site blind best-estimate ratings of mania and rapid cycling sections were excellent (0.74-1.00). High 6-month stability for mania diagnoses (85.7%) and for individual mania items and validity against parental and teacher reports were previously reported.<ref name=":1" /> #* The link to the diagnostic interview for the [http://www.psychiatry.pitt.edu/sites/default/files/Documents/assessments/mrs.pdf Washington University in St. Louis Kiddie Schedule for Affective Disorders and Schizophrenia] can be found [http://www.psychiatry.pitt.edu/sites/default/files/Documents/assessments/mrs.pdf here]. {{collapse bottom}} ===Recommended diagnostic instruments specific for pediatric bipolar disorder=== {| class="wikitable sortable" border="1" ! colspan="10" |Diagnostic instruments for '''(insert portfolio name)''' |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time ! Interrater Reliability ! Test-Retest Reliability ! Construct Validity ! Content Validity ! Highly Recommended !Free and Accessible Measures |- | Children's Depression Rating Scale - Revised (CDRS-R) | Structured Interview<ref name=":4">{{Cite journal|last=Mayes|first=Taryn L.|last2=Bernstein|first2=Ira H.|last3=Haley|first3=Charlotte L.|last4=Kennard|first4=Betsy D.|last5=Emslie|first5=Graham J.|date=2010-12|title=Psychometric Properties of the Children's Depression Rating Scale–Revised in Adolescents|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3003451/|journal=Journal of Child and Adolescent Psychopharmacology|volume=20|issue=6|pages=513–516|doi=10.1089/cap.2010.0063|issn=1044-5463|pmc=PMC3003451|pmid=21186970}}</ref> | 6-12 | 15-20 minutes | G | A | G | G | X | * Link to purchase [https://www.wpspublish.com/store/p/2703/cdrs-r-children-s-depression-rating-scale-revised#purchase-product CDRS-R] *[http://www.opapc.com/uploads/documents/CDRS-R.pdf PDF] (excerpt) |} '''Note:''' Reliability and validity are included in the [[Evidence-based assessment/Bipolar disorder in youth (assessment portfolio)/extended version|extended version]]. This table includes measures with Good or Excellent ratings. =='''[[Evidence based assessment/Process phase|Process phase]]'''== The following section contains a list of process and outcome measures for adolescent bipolar spectrum disorder. The section includes benchmarks based on published norms and on mood samples for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the [[Evidence based assessment/Process phase|process phase]] of assessment. For more information on differences between process and outcome measures, see the page on the [[Evidence based assessment/Process phase|process phase of assessment]]. === Process measures === There are many processes that may be considered important when evaluating a child or an adolescent with Bipolar Disorder; however, due to the diversity of the population and symptom expression, there are too many to narrow down. Clinical judgment is recommended when deciding what additional measures should be included (e.g. executive functioning, sensory processing, cognitive flexibility). The measures provided below are commonly used to assess and provide important information regarding levels of daily functioning of individuals with Bipolar Disorder. {{blockquotetop}} '''A. Mood and Energy Thermometer'''- &nbsp; This is an improved and practical way of monitoring complex mood cycles and daily schedules. Given that some clinicians and patients may get confused about different 1 to 10 scales (e.g., a 10 could mean extreme depression, extreme mania, or no depression), the Mood & Energy Thermometer improves the language in communicating (and monitoring) mood. Moreover, many children report their energy levels more accurately than their mood and therefore, energy levels have been incorporated in this mood rating. The Mood & Energy Thermometer that was developed at Western Psychiatric Institute and Clinic (WPIC; and used in about 400 kids) rates mania and increased energy on a 1 to 10 scale, rates depression and tiredness on a -1 to -10 scale, and attempts to form a common language between patients, families, and clinicians. This scale also takes into account time spent depressed and/or manic; for example, -4 would mean “mild depression” and “mild tiredness” present ≥50% of the time, and -3 would mean “mild depression” and “mild tiredness” present < 50% of the time. The inclusion of measuring energy levels is consistent with the DSM-5, because energy level is now included in the DSM-5 as a main mood symptom criterion. Bipolar track patients (whether they had mania, depression, or mixed features) rated their mood and energy levels every day on this scale, and a master’s-level clinician met with them on a daily basis to help them better identify and record their mood symptoms, which has significant clinical value for not only treatment but also to prevent future episodes.<ref name=":3">{{Cite web|url=http://pediatricbipolar.pitt.edu/resources/instruments|title=Instruments {{!}} CABS {{!}} University of Pittsburgh|website=pediatricbipolar.pitt.edu|language=en|access-date=2018-05-31}}</ref> *[https://mfr.osf.io/render?url=https://osf.io/p4a8s/?action=download%26mode=render Mood and Energy Thermometer] *[https://mfr.osf.io/render?url=https://osf.io/upe2a/?action=download%26mode=render Mood and Energy Thermometer with Anger and Anxiety (with recording/monitoring card)] *[https://mfr.osf.io/render?url=https://osf.io/d2fge/?action=download%26mode=render Mood and Energy Thermometer with Anger and Anxiety - Simplified Version] '''B. Life Charts''' * To learn more about how life charts can be used with adolescent depression, [http://www.bipolarnews.org/Life%20Charting%20Description.htm see here] * [https://mfr.osf.io/render?url=https://osf.io/amq6k/?action=download%26mode=render Life Charts for Depression and Bipolar] {{blockquotebottom}} === Outcome and severity measures === * Information on how to interpret this table can be [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase found here]. * Additionally, these [[Evidence based assessment/Vignettes|vignettes]] might be helpful resources for understanding appropriate adaptation of outcome measures in practice. *For clinically significant change benchmarks for the CBCL, YSR, and TRF overall, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase&wteswitched=1#Clinically_significant_change_benchmarks_for_widely-used_outcome_measures see here.] ==== '''Clinically significant change benchmarks with common instruments for bipolar disorder in youth''' ==== {| class="wikitable sortable" | ! colspan="3" |Cut Scores ! colspan="3" |Critical Change (Unstandardized Scores) ![[w:Minimal important difference|Minimal]]<nowiki/>ly [[w:Minimal important difference|Important Difference]] |- !Measure !Away !Back !Closer !95% !90% !SEdifference !(MID) ''d'' ~.5 |- |[[General Behavior Inventory#GBI Short Forms|PGBI-10M]] |1 |9 |6 |6 |5 |3.2 |3 |- |[[Child Mania Rating Scale|CMRS 10]] |<nowiki>--</nowiki> |6 |4 |5 |4 |2.3 |2 |- |[[General Behavior Inventory#GBI Short Forms|PGBI-10Da]] |<nowiki>--</nowiki> |7 |4 |6 |5 |3.0 |3 |- |[[General Behavior Inventory#GBI Short Forms|PGBI-10Db]] |<nowiki>--</nowiki> |7 |4 |6 |5 |2.9 |3 |- |[[General Behavior Inventory#GBI Short Forms|AGBI-10M]] |<nowiki>--</nowiki> |14 |7 |6 |5 |3.1 |3 |- |[[General Behavior Inventory#GBI Short Forms|AGBI-10Da]] |<nowiki>--</nowiki> |18 |7 |6 |5 |3.2 |3 |- |[[General Behavior Inventory#GBI Short Forms|AGBI-10Db]] |<nowiki>--</nowiki> |16 |7 |6 |5 |2.9 |4 |- |[[General Behavior Inventory#GBI Short Forms|7 Up]] |<nowiki>--</nowiki> |8 |4 |4 |4 |2.2 |3 |- |[[General Behavior Inventory#GBI Short Forms|7 Down]] |<nowiki>--</nowiki> |12 |5 |5 |4 |2.3 |3 |- |[[w:Kiddie Schedule for Affective Disorders and Schizophrenia#KSADS%20Mania%20Rating%20Scale%20(KMRS)%20and%20Depression%20Rating%20Scale%20(KDRS)|KMRS]] |19 |19 |19 |3 |3 |1.6 |3 |- |[[w:Kiddie Schedule for Affective Disorders and Schizophrenia#KSADS%20Mania%20Rating%20Scale%20(KMRS)%20and%20Depression%20Rating%20Scale%20(KDRS)|KDRS]] |12 |19 |18 |5 |4 |2.4 |3 |- |CDRS-R Total |<nowiki>--</nowiki> |24 |22 |6 |5 |2.9 |5 |- |YMRS Total |4 |3 |3 |3 |3 |1.8 |3 |} <br /> {| class="wikitable sortable" border="1" |- | colspan="8" style="font-size:110%; text-align:center;" span |<b> Benchmarks Based on Published Norms</b> |- | rowspan="2" style="text-align:center;font-size:130%;" |<b> <big>Measure</big></b> | rowspan="2" style="text-align:center;font-size:130%;" |<b> <big>Subscale</big></b> | colspan="3" style="text-align:center;font-size:130%" width="300" |<b> <big>Cut-off scores</big></b> | colspan="3" style="text-align:center;font-size:120%" |<b> <big>Critical Change <br> (unstandardized scores)</big></b> |- | style="text-align:center;font-size:110%" |<b> A</b> | style="text-align:center;font-size:110%" |<b> B</b> | style="text-align:center;font-size:110%" |<b> C</b> | style="text-align:center;font-size:110%" |<b> 95%</b> | style="text-align:center;font-size:110%" |<b> 90%</b> | style="text-align:center;font-size:110%" |<b> SE_difference</b> |- | rowspan="1" style="text-align:center;" |<b> [http://www.sciencedirect.com/science/article/pii/0272735888900505 Beck Depression Inventory]<ref>{{cite journal|last=Beck|first=AT|title=Psychometric properties of the Beck Depression Inventory: Twenty-five years of evaluation.|journal=Clinical Psychology Review|date=1988|volume=8|issue=1|url=http://www.sciencedirect.com/science/article/pii/0272735888900505|accessdate=10 February 2014}}</ref></b> | style="text-align:right;" |<i> BDI Mixed Depression</i> | style="text-align:center;" | 4 | style="text-align:center;" | 22 | style="text-align:center;" | 15 | style="text-align:center;" | 9 | style="text-align:center;" | 8 | style="text-align:center;" | 4.8 |- |} === Treatment === ==== Psychotherapy ==== [[Psychotherapy|Psychotherapies]] are treatments that help people with a wide variety of mental health concerns. While different forms of psychotherapies for adolescent bipolar disorder aim to remedy different aspects of the disorder, all aim to alleviate symptoms and decrease functional impairment in the client. {| class="wikitable mw-collapsible" |+Overview of Psychotherapies !Therapy !Key components !Duration !Results |- |Child- and Family-Focused Cognitive-Behavioral Therapy | * Develop consistent routines * Learn to regulate emotions * Improve child's self-esteem and parent's self efficacy * Reduce negativity * Build social skills and networks * Teach parents self-care * Family-based problem solving and communication skill building | * 12 weeks long * 60-90 minute weekly sessions | * Decrease intensity of manic episodes * Decrease depressive symptoms in child * Overall improvement in client's functioning |- |Interpersonal and Social Rhythm Therapy | * Develop understanding of disruptions in routine and manic/depressive episodes * Build skills for creating consistent routines, aka, social rhythms * Build self-efficacy and phase out of therapy |Varies dependent on client need | * Increases time between manic/depressive episodes |- |Mindfulness-Based Cognitive Therapy | * Utilizes mindfulness-based practices such as mindfulness meditation * Focus on awareness of client's thoughts, feelings and behaviors * Learn to recognize how to monitor one's own thoughts * Increase self-care practices | * 8 weeks long * 60-120 minute weekly sessions | * Decrease in anxiety symptoms * Decrease in depressive symptoms * Increase mood regulation * Increase attention ability |- |Multi-Family Psychoeducational Psychotherapy |Group therapy using treatment components from: * Psychoeducation * Family Systems therapy * Cognitive-behavioral therapy | * 8 weeks long * 60-90 minute weekly sessions | * Decrease in severity of mood symptoms * Increase in caregiver understanding of child's disorder and how to seek mental health care * Children report feeling more social support from caregivers |} ===== Child- and Family-Focused Cognitive-Behavioral Family (CFF-CBT) ===== ====== Purpose ====== [[File:Cognitive Behavioral Cycle.jpg|thumb|357x357px|Cognitive behavioral cycle]] CFF-CBT was created to address the unique needs of bipolar disorder in children and adolescents with bipolar disorder, including rapid cycling, mixed mood states and comorbid disorders.<ref name=":0">{{Cite journal|last=West|first=Amy E.|last2=Weinstein|first2=Sally M.|last3=Peters|first3=Amy T.|last4=Katz|first4=Andrea C.|last5=Henry|first5=David B.|last6=Cruz|first6=Rick A.|last7=Pavuluri|first7=Mani N.|date=2014-11-01|title=Child- and Family-Focused Cognitive-Behavioral Therapy for Pediatric Bipolar Disorder: A Randomized Clinical Trial|url=https://jaacap.org/article/S0890-8567(14)00617-0/abstract|journal=Journal of the American Academy of Child & Adolescent Psychiatry|language=English|volume=53|issue=11|pages=1168–1178.e1|doi=10.1016/j.jaac.2014.08.013|issn=0890-8567|pmc=PMC4254579|pmid=25440307}}</ref> This treatment has been tested to see if it will help address the high suicide attempt rate among children/adolescents with the disorder, and no significant effects were found. However CFF-CBT has been found to be effective for 7-13 year olds with both clients with and without non-suicidal self-injury behaviors.<ref name=":1">{{Cite journal|last=MacPherson|first=Heather A.|last2=Weinstein|first2=Sally M.|last3=West|first3=Amy E.|date=2018-05-01|title=Non-Suicidal Self-Injury in Pediatric Bipolar Disorder: Clinical Correlates and Impact on Psychosocial Treatment Outcomes|url=https://doi.org/10.1007/s10802-017-0331-4|journal=Journal of Abnormal Child Psychology|language=en|volume=46|issue=4|pages=857–870|doi=10.1007/s10802-017-0331-4|issn=1573-2835}}</ref> Mediators of this intervention include: parenting skills and coping, family flexibility, and family positive reframing.<ref name=":2">{{Cite journal|last=Fristad|first=Mary A.|last2=MacPherson|first2=Heather A.|date=2014-05-01|title=Evidence-Based Psychosocial Treatments for Child and Adolescent Bipolar Spectrum Disorders|url=https://doi.org/10.1080/15374416.2013.822309|journal=Journal of Clinical Child & Adolescent Psychology|volume=43|issue=3|pages=339–355|doi=10.1080/15374416.2013.822309|issn=1537-4416|pmc=PMC3844106|pmid=23927375}}</ref> ====== Intended Population ====== Children aged 7-13 and adolescents aged 13-17 ====== Length of Treatment ====== 12 weekly sessions, with session time ranging from 60 to 90 minutes<ref name=":1" /><ref name=":0" /><ref name=":2" /> ====== Treatment Components ====== CFF-CBT focuses on 7 components comprising of the “RAINBOW” acronym<ref name=":0" />: ''R'': Routine; developing consistency ''A'': Affective regulation; includes psychoeducation on feelings, coping skills, and mood monitoring ''I'': “I can do it!”; this aims to improve self-esteem in the child, as well as self-efficacy in the parent ''N'': “No Negative Thoughts/Live in the Now” ''B'': Be a good friend/balanced life style (building social skills and teaching parents self-care ''O'': Oh, how do we solve this problem? (family-based problem solving and communication skills building) ''W'': Ways to find support (building a network of support) ====== Treatment Outcomes ====== CFF-CBT has shown decreases in mania to a subclinical level, parent-reported youth depressive symptoms, increased involvement/fidelity to treatment, and improvements in the client’s overall, global functioning in comparison to psychotherapy as per usual.<ref name=":1" /> <br /> ===== Interpersonal and Social Rhythm Therapy (IPSRT) ===== ====== Purpose ====== IPSRT is based on the social zeitgeber hypothesis<ref>{{Cite journal|last=Grandin|first=Louisa D.|last2=Alloy|first2=Lauren B.|last3=Abramson|first3=Lyn Y.|date=2006-10|title=The social zeitgeber theory, circadian rhythms, and mood disorders: Review and evaluation|url=https://linkinghub.elsevier.com/retrieve/pii/S0272735806000651|journal=Clinical Psychology Review|language=en|volume=26|issue=6|pages=679–694|doi=10.1016/j.cpr.2006.07.001}}</ref>, which states that regularity in social routines and interpersonal relationships acts as a protective factor for mood disorders. Thus, this treatment focused on maintaining regularity in daily routines, quality of social relationships and social roles, and management of consequences of rhythm disruptions.<ref>{{Cite journal|last=Frank|first=Ellen|last2=Kupfer|first2=David J.|last3=Thase|first3=Michael E.|last4=Mallinger|first4=Alan G.|last5=Swartz|first5=Holly A.|last6=Fagiolini|first6=Andrea M.|last7=Grochocinski|first7=Victoria|last8=Houck|first8=Patricia|last9=Scott|first9=John|date=2005-09-01|title=Two-Year Outcomes for Interpersonal and Social Rhythm Therapy in Individuals With Bipolar I Disorder|url=http://dx.doi.org/10.1001/archpsyc.62.9.996|journal=Archives of General Psychiatry|volume=62|issue=9|pages=996|doi=10.1001/archpsyc.62.9.996|issn=0003-990X}}</ref> ====== Intended Population ====== IPSRT is intended for all individuals with bipolar disorder, and has been found to be effective in adolescents.<ref name=":3">{{Cite journal|last=Crowe|first=Marie|last2=Inder|first2=Maree|last3=Joyce|first3=Peter|last4=Moor|first4=Stephanie|last5=Carter|first5=Janet|last6=Luty|first6=Sue|date=2009-01|title=A developmental approach to the treatment of bipolar disorder: IPSRT with an adolescent|url=http://doi.wiley.com/10.1111/j.1365-2702.2008.02571.x|journal=Journal of Clinical Nursing|language=en|volume=18|issue=1|pages=141–149|doi=10.1111/j.1365-2702.2008.02571.x}}</ref> ====== Length of Treatment ====== Length of treatment varies dependent on client needs.<ref name=":3" /> ====== Treatment Components ====== IPSRT is structured in three phases<ref name=":4">{{Cite web|url=https://www.ipsrt.org/background|title=Interpersonal and Social Rhythm Therapy {{!}} Background|website=www.ipsrt.org|access-date=2019-12-05}}</ref>: # Initial phase: Explores the clients history in order to explore links between disruptions in routines to affective episodes. This stage also includes education on the rationale of the treatment<ref name=":4" /> # Intermediate phase: Focused on reorganizing the client's social rhythms, reinforcing new social rhythms and building confidence in using techniques that are taught in the treatment<ref name=":4" /> # Final phase: Reduction in frequency of visits in order to work towards termination of therapy and self-efficacy<ref name=":4" /> ====== Treatment Outcomes ====== If applied early in the acute phase of bipolar disorder, IPSRT may prolong time to relapse in depressive/manic episodes.<ref name=":5">{{Cite journal|last=Miziou|first=Stella|last2=Tsitsipa|first2=Eirini|last3=Moysidou|first3=Stefania|last4=Karavelas|first4=Vangelis|last5=Dimelis|first5=Dimos|last6=Polyzoidou|first6=Vagia|last7=Fountoulakis|first7=Konstantinos N|date=2015-12|title=Psychosocial treatment and interventions for bipolar disorder: a systematic review|url=http://www.annals-general-psychiatry.com/content/14/1/19|journal=Annals of General Psychiatry|language=en|volume=14|issue=1|pages=19|doi=10.1186/s12991-015-0057-z|issn=1744-859X|pmc=PMC4493813|pmid=26155299}}</ref> ===== Mindfulness-Based Cognitive Therapy (MBCT) ===== ====== Purpose ====== Mindfulness approaches aim to enhance one’s ability to focus their attention on the present moment in a non-judgmental manor.<ref name=":5" /> In treatment for Bipolar Disorder, mindfulness approaches may focus on awareness of the client’s patterns of thoughts, feelings and bodily sensations both specific and non-specific to their experiences related to the disorder.<ref name=":5" /> Moreover, when comorbid with anxiety, bipolar disorder has higher risk of suicide attempts, therefore MBCT aims to decrease these anxiety symptoms.<ref name=":6">{{Cite journal|last=Williams|first=J. Mark G.|last2=Russell|first2=Ian|last3=Russell|first3=Daphne|date=2008-06|title=Mindfulness-based cognitive therapy: Further issues in current evidence and future research.|url=http://doi.apa.org/getdoi.cfm?doi=10.1037/0022-006X.76.3.524|journal=Journal of Consulting and Clinical Psychology|language=en|volume=76|issue=3|pages=524–529|doi=10.1037/0022-006X.76.3.524|issn=1939-2117|pmc=PMC2834575|pmid=18540746}}</ref> ====== Intended Population ====== MBCT is intended for all populations with bipolar disorder.<ref name=":6" /> ====== Length of Treatment ====== MPCT is typically offered in 1-2 hour weekly sessions over an 8-week period in a group setting (Perich et al 2012; Weber et al 2010).<ref>{{Cite journal|last=Perich|first=T.|last2=Manicavasagar|first2=V.|last3=Mitchell|first3=P. B.|last4=Ball|first4=J. R.|last5=Hadzi-Pavlovic|first5=D.|date=2012-12-09|title=A randomized controlled trial of mindfulness-based cognitive therapy for bipolar disorder|url=http://dx.doi.org/10.1111/acps.12033|journal=Acta Psychiatrica Scandinavica|volume=127|issue=5|pages=333–343|doi=10.1111/acps.12033|issn=0001-690X}}</ref><ref name=":7">{{Cite journal|last=Weber|first=B.|last2=Jermann|first2=F.|last3=Gex-Fabry|first3=M.|last4=Nallet|first4=A.|last5=Bondolfi|first5=G.|last6=Aubry|first6=J.-M.|date=2010-10|title=Mindfulness-based cognitive therapy for bipolar disorder: A feasibility trial|url=https://linkinghub.elsevier.com/retrieve/pii/S0924933810000817|journal=European Psychiatry|language=en|volume=25|issue=6|pages=334–337|doi=10.1016/j.eurpsy.2010.03.007}}</ref> Participants are also assigned homework, including varying lengths of meditation practice.<ref name=":7" /> ====== Treatment Components ====== MPCT combines aspects of classical CBT and mindfulness-based stress reduction therapies. The themes addressed in each session are<ref>{{Cite web|url=http://mbct.com/classes.html|title=Classes|website=mbct.com|access-date=2019-12-05}}</ref>: Session 1: Automatic pilot Session 2: Dealing with barriers Session 3: Mindfulness of the breath Session 4: Staying present Session 5: Allowing and letting be Session 6: Thoughts are not facts Session 7: How can I best take care of myself Session 8: Using what has been learned to deal with future moods ====== Treatment Outcomes ====== Treatment outcomes include decreases in anxiety and depressive symptoms and mood regulation in patients with bipolar disorder, but there has been no evidence in prevention of recurrences.<ref name=":5" /><ref name=":6" /> MBCT has also been found to improve attentional readiness, and attenuated activation of non-relevant information processing during attentional readiness, which are usually decreased in individuals with Bipolar Disorder compared to those without.<ref>{{Cite journal|last=Howells|first=Fleur M|last2=Ives-Deliperi|first2=Victoria L|last3=Horn|first3=Neil R|last4=Stein|first4=Dan J|date=2012-02-29|title=Mindfulness based cognitive therapy improves frontal control in bipolar disorder: a pilot EEG study|url=http://dx.doi.org/10.1186/1471-244x-12-15|journal=BMC Psychiatry|volume=12|issue=1|doi=10.1186/1471-244x-12-15|issn=1471-244X}}</ref> <br /> ===== Multi-Family Psychoeducational Psychotherapy (MF-PEP) ===== ====== Purpose ====== MF-PEP is a group-based evidence based treatment for children with bipolar disorder, which is meant to increase the ability for the treatment to be readily implemented into the community.<ref name=":8">{{Cite journal|last=MacPherson|first=Heather A.|last2=Leffler|first2=Jarrod M.|last3=Fristad|first3=Mary A.|date=2014|title=Implementation of Multi-Family Psychoeducational Psychotherapy for Childhood Mood Disorders in an Outpatient Community Setting|url=https://onlinelibrary.wiley.com/doi/abs/10.1111/jmft.12013|journal=Journal of Marital and Family Therapy|language=en|volume=40|issue=2|pages=193–211|doi=10.1111/jmft.12013|issn=1752-0606|pmc=PMC4198302|pmid=24749838}}</ref> While MF-PEP creates a support system within the family for the child through being a family-based intervention, it also serves to increase social support for care givers through being a group-based therapy. ====== Intended Population ====== MF-PEP is intended for children with depressive and bipolar disorders and their caretakers.<ref name=":8" /><ref name=":9">{{Cite journal|last=Fristad|first=Mary A.|last2=Verducci|first2=Joseph S.|last3=Walters|first3=Kimberly|last4=Young|first4=Matthew E.|date=2009-09-01|title=Impact of Multifamily Psychoeducational Psychotherapy in Treating Children Aged 8 to 12 Years With Mood Disorders|url=https://jamanetwork.com/journals/jamapsychiatry/fullarticle/210303|journal=Archives of General Psychiatry|language=en|volume=66|issue=9|pages=1013–1021|doi=10.1001/archgenpsychiatry.2009.112|issn=0003-990X}}</ref> ====== Length of Treatment ====== MF-PEP is an 8-session long treatment, with sessions typically ranging from 60-90 minutes. <ref name=":8" /><ref name=":9" /> ====== Treatment Components ====== MF-PEP combines [[wikipedia:Psychoeducation|psychoeducation]], [[wikipedia:Family_therapy|family systems]], and [[wikipedia:Cognitive_behavioral_therapy|cognitive behavior therapy]] techniques, aiming to target depressive and bipolar disorder symptoms and how these symptoms cause impairment. <ref name=":9" /> In MF-PEP, sessions are delivered in a combination of settings, including all children and parents together, as well as separating all children and caregivers into their own respective groups. <ref name=":9" /> ====== Treatment Outcomes ====== Treatment outcomes for MG-PEP include an increase in caregiver's understanding of the child's disorder, and a decrease in mood symptom severity within the children which has been seen to be maintained through an 18-month follow-up. <ref name=":10">{{Cite journal|last=MacPherson|first=Heather A.|last2=Leffler|first2=Jarrod M.|last3=Fristad|first3=Mary A.|date=2014|title=Implementation of Multi-Family Psychoeducational Psychotherapy for Childhood Mood Disorders in an Outpatient Community Setting|url=https://onlinelibrary.wiley.com/doi/abs/10.1111/jmft.12013|journal=Journal of Marital and Family Therapy|language=en|volume=40|issue=2|pages=193–211|doi=10.1111/jmft.12013|issn=1752-0606|pmc=PMC4198302|pmid=24749838}}</ref> Additionally, MF-PEP has been found to have a positive effect on parent's help-seeking behaviors for mental health care, leading to access to higher-quality services. <ref name=":10" /> Lastly, children report feeling a stronger sense of social support from their caregivers after participating in the intervention.<ref name=":9" /> ===== See Also: ===== * Wikipedia has a page reviewing [[wikipedia:Treatment_of_bipolar_disorder|treatments for bipolar disorder]]. * [http://www.effectivechildtherapy.com Effective Child Therapy] provides a curated list of effective psycho-social treatments for bipolar disorder in youths. * [https://icd.who.int/browse10/2015/en#/F31 ICD-10 Diagnostic Criteria] * [[wikipedia:Bipolar_disorder_in_children|Bipolar disorder in children]] * [https://onlinelibrary.wiley.com/doi/epdf/10.1111/bdi.12556 The International Society for Bipolar Disorders Task Force report on pediatric bipolar disorder: Knowledge to date and directions for future research] * [[wikipedia:Treatment_of_bipolar_disorder|Treatment of bipolar disorder]] =='''External resources'''== {{Infobox disease | name = Pediatric Bipolar Disorder | image = | Caption = Bipolar disorder consists of experiences of mania alternating with depressive episodes | DiseasesDB = 7812 | ICD10 = {{ICD10|F|31||f|30}} | ICD9 = {{ICD9|296.0}}, {{ICD9|296.1}}, {{ICD9|296.4}}, {{ICD9|296.5}}, {{ICD9|296.6}}, {{ICD9|296.7}}, {{ICD9|296.8}} | ICDO = | OMIM = 125480 | OMIM_mult = {{OMIM2|309200}} | MedlinePlus = 000926 | eMedicineSubj = med | eMedicineTopic = 229 | MeshID = D001714 }} #[http://www.nami.org/ National Alliance on Mental Illness] – the nation’s largest grassroots mental health organization dedicated to building better lives for the millions of Americans affected by mental illness. NAMI advocates for access to services, treatment, supports and research and is steadfast in its commitment to raise awareness and build a community for hope for all of those in need.<ref>{{cite web|last=NAMI: National Alliance on Mental Illness.|title=National Alliance on Mental Illness|url=http://www.nami.org/|accessdate=5 February 2014}}</ref> #[http://www.thebalancedmind.org Balanced Mind Foundation] – information, articles, parent support chat rooms.<ref>{{cite web|last=The Balanced Mind.|title=The Balanced Mind Parent Network.|url=http://www.thebalancedmind.org|accessdate=5 February 2014}}</ref> #[http://www.effectivechildtherapy.com Effective Child Therapy] – Information and articles curated by [https://sccap53.org Society of Clinical Child and Adolescent Psychology](SCCAP), a division of the American Psychological Association.<ref>{{cite web|last=Effective Child Therapy|title=Effective Child Therapy: Evidence-based mental health treatment for children and adolescents.|url=http://www.effectivechildtherapy.com|accessdate=5 February 2014}}</ref> ##[http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/severe-mood-swings-and-bipolar-spectrum-disorders/ Effective Child Therapy information: Bipolar Disorder] ##[http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/severe-mood-swings-and-bipolar-spectrum-disorders/ Effective Child Therapy information: Severe Mood Swings and Bipolar Spectrum Disorders] ##[http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/sadness-hopelessness-and-depression/ Effective Child Therapy information: Sadness, Hopelessness, and Depression] #[http://ibpf.org/resources International Bipolar Foundation] – information, help and resources available for caregivers and those afflicted with bipolar disorder.<ref>http://ibpf.org/resources, International Bipolar Foundation, retrieved 27th January 2014. </ref> #[http://www.bipolarnews.org Bipolar Network News] – an online clearinghouse and information on latest treatments, research and psychoeducation about mood disorders.<ref>http://bipolarnews.org/, Bipolar Network News, retrieved 30th January 2014. </ref> #[http://www.depressionalliance.org/ Depression Alliance] – a United Kingdom charity that works to prevent and relieve depression by providing information and support services via supporter services, publications and self-help groups.<ref>Depression Alliance, http://www.depressionalliance.org/, retrieved 30th January 2014. </ref> #[http://www.dbsalliance.org/site/PageServer?pagename=home Depression and Bipolar Support Alliance (DBSA)] – a peer-directed national organization that provides links to resources, support groups, and peer support for individuals and their families suffering from bipolar disorder. ##[https://unc.az1.qualtrics.com/jfe/form/SV_cBlUQk8Y85LHF41 Depression and Bipolar Support Alliance: 7 Up 7 Down Online Screener] #Related Wikipedia Pages ##[[wikipedia:Bipolar_disorder|Bipolar disorder Wikipedia Page]] ##[[wikipedia:Cyclothymia|Cyclothymia Wikipedia Page]] ##[[wikipedia:Mania|Mania Wikipedia Page]] ##[[wikipedia:Depression_(mood)|Depression Wikipedia Page]] #[https://www.massgeneral.org/psychiatry/services/treatmentprograms.aspx?id=1944&display=bipolar Massachusetts General Hospital School Psychiatry Resources for Bipolar Disorder] #The Psych Show with Dr. Ali Mattu videos ##[https://www.youtube.com/watch?v=llOPqKD-s4w How to Cope with Bipolar Disorder] ##[https://www.youtube.com/watch?v=kUHUmeqBZAA Top 10 Bipolar Myths] #[[Evidence Based Psychotherapies for Adolescent Bipolar Disorder]] =='''References'''== {{collapse top|References|expand=yes}} {{Reflist|30em}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] {{collapse bottom}} aqx6w0wb4jmddmbpfyfy1bowg7ciau7 0 207108 2419085 2414609 2022-08-25T20:34:59Z Emmagch 2806778 /* What is a "portfolio"? */ wikitext text/x-wiki <noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{medical disclaimer}} {{:{{BASEPAGENAME}}/Sidebar}} ==[[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio"?''']]== * For background information on what assessment portfolios are, click the link in the heading above. * Want even 'more' information about this topic? There's an extended version of this page [[Evidence-based assessment/Posttraumatic stress disorder (disorder portfolio)/extended version|'''here''']]. == [[Evidence based assessment/Preparation phase|'''Preparation phase''']] == === Diagnostic criteria for post traumatic stress disorder === ===='''ICD-11 Diagnostic Criteria'''==== {{blockquotetop}} ===='''ICD-11 Criteria'''==== *Post-traumatic stress disorder (PTSD) is a syndrome that develops following exposure to an extremely threatening or horrific event or series of events that is characterized by all of the following: **1) re-experiencing the traumatic event or events in the present in the form of vivid intrusive memories, flashbacks, or nightmares, which are typically accompanied by strong and overwhelming emotions such as fear or horror and strong physical sensations, or feelings of being overwhelmed or immersed in the same intense emotions that were experienced during the traumatic event; **2) avoidance of thoughts and memories of the event or events, or avoidance of activities, situations, or people reminiscent of the event or events **3) persistent perceptions of heightened current threat, for example as indicated by hypervigilance or an enhanced startle reaction to stimuli such as unexpected noises. *The symptoms must persist for at least several weeks and cause significant impairment in personal, family, social, educational, occupational or other important areas of functioning. Additionally, ICD 11 includes a category called "Complex post-traumatic stress disorder," which is described as: *A disorder that may develop following exposure to an event or series of events of an extremely threatening or horrific nature, most commonly prolonged or repetitive events from which escape is difficult or impossible (e.g., torture, slavery, genocide campaigns, prolonged domestic violence, repeated childhood sexual or physical abuse). *The disorder is characterized by the core symptoms of PTSD; that is, all diagnostic requirements for PTSD have been met at some point during the course of the disorder. *In addition, Complex PTSD is characterized by: **1) severe and pervasive problems in affect regulation; **2) persistent beliefs about oneself as diminished, defeated or worthless, accompanied by deep and pervasive feelings of shame, guilt or failure related to the traumatic event **3) persistent difficulties in sustaining relationships and in feeling close to others. The disturbance causes significant impairment in personal, family, social, educational, occupational or other important areas of functioning. {{blockquotebottom}} ===='''Changes in DSM-5'''==== * The diagnostic criteria for post-traumatic stress disorder changed slightly from [[DSM-IV]] to [[w:Diagnostic_and_Statistical_Manual_of_Mental_Disorders#DSM-IV-TR_.282000.29|DSM-5]]. Summaries are available [http://www.dsm5.org/Documents/changes%20from%20dsm-iv-tr%20to%20dsm-5.pdf here] and [[w:DSM-5|here]]. === Developmental sensitivities === {{collapse top| Click for more information}} *Diagnostic thresholds have been lowered for children and adolescents to account for development. *Separate and additional criteria have been added for children age 6 or younger. *Child sexual abuse has been found to have a substantial effect on the development of PTSD.<ref>{{cite journal|last1=Paolucci|first1=Elizabeth ODDONE|last2=Genuis|first2=Mark L.|last3=Violato|first3=Claudio|title=A Meta-Analysis of the Published Research on the Effects of Child Sexual Abuse|journal=The Journal of Psychology|date=January 2001|volume=135|issue=1|pages=17–36|doi=10.1080/00223980109603677}}</ref> *Children with higher exposure to trauma, less social support, and other major life events are more likely to have continued PTSD symptoms 7 months after a trauma.<ref name=":2">{{cite journal |last1=La Greca|first1=A|last2=Silverman|first2=WK|last3=Vernberg|first3=EM|last4=Prinstein|first4=MJ|title=Symptoms of posttraumatic stress in children after Hurricane Andrew: a prospective study.|journal=Journal of consulting and clinical psychology|date=August 1996|volume=64|issue=4|pages=712-23|pmid=8803361}}</ref> 10 months after a trauma, however, only experience of a major life event remained predictive of continuing PTSD symptoms.<ref name=":2" /> *Lack of social support, specifically lack of support by a teacher, was predictive of higher PTSD symptoms among children who had gone through an environmental trauma.<ref name=":2" /> *Children who reported using blame and anger as strategies for coping had higher levels of PTSD symptoms 10 months after a trauma.<ref name=":2" /> *Negative affect in children before a traumatic event was predictive of development of PTSD symptoms after a traumatic event.<ref>{{cite journal|last1=Weems|first1=CF|last2=Pina|first2=AA|last3=Costa|first3=NM|last4=Watts|first4=SE|last5=Taylor|first5=LK|last6=Cannon|first6=MF|title=Predisaster trait anxiety and negative affect predict posttraumatic stress in youths after hurricane Katrina.|journal=Journal of consulting and clinical psychology|date=February 2007|volume=75|issue=1|pages=154-9|doi=10.1037/0022-006X.75.1.154|pmid=17295574}}</ref> [[wikipedia:Posttraumatic_stress_disorder|Posttraumatic stress disorder]] is now more sensitive to development in that diagnostic thresholds have been lowered for children and adolescents. Furthermore, separate and additional criteria have been added for children age 6 years of age or younger. {{collapse bottom}} === Base rates of PTSD in different clinical settings and populations === This section describes the demographic settings of the populations sampled, base rates of PTSD diagnoses, country/region sampled, and the diagnostic methods that were used. Using this information, clinicians will be able to anchor the most appropriate rate of PTSD that they are likely to see in their clinical practice. * '''''To see prevalence rates across multiple disorders,''''' [[Evidence based assessment/Preparation phase#Base rates for transdiagnostic comparison|'''''click here.''''']] {| class="wikitable sortable" border="1" |- ! Demography ! Setting ! Base Rate ! Diagnostic Method |- | United States, nationally representative, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Kessler|first=Ronald C.|last2=Berglund|first2=Patricia|last3=Demler|first3=Olga|last4=Jin|first4=Robert|last5=Merikangas|first5=Kathleen R.|last6=Walters|first6=Ellen E.|date=2005-06-01|title=Lifetime Prevalence and Age-of-Onset Distributions of DSM-IV Disorders in the National Comorbidity Survey Replication|url=http://archpsyc.jamanetwork.com/article.aspx?doi=10.1001/archpsyc.62.6.593|journal=Archives of General Psychiatry|language=en|volume=62|issue=6|doi=10.1001/archpsyc.62.6.593|issn=0003-990X}}</ref> | 6.8% | National Comorbidity Survey - Replication |- | Netherlands, nationally representative, age 18-80 | Non-clinical: Population based<ref>{{Cite journal|last=de Vries|first=Giel-Jan|last2=Olff|first2=Miranda|date=2009-08-01|title=The lifetime prevalence of traumatic events and posttraumatic stress disorder in the Netherlands|url=http://onlinelibrary.wiley.com/doi/10.1002/jts.20429/abstract|journal=Journal of Traumatic Stress|language=en|volume=22|issue=4|pages=259–267|doi=10.1002/jts.20429|issn=1573-6598}}</ref> | 7.4% | Composite International Diagnostic Interview (CIDI) |- | United States, nationally representative, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Pietrzak|first=Robert H.|last2=Goldstein|first2=Risë B.|last3=Southwick|first3=Steven M.|last4=Grant|first4=Bridget F.|title=Prevalence and Axis I comorbidity of full and partial posttraumatic stress disorder in the United States: Results from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions|url=http://linkinghub.elsevier.com/retrieve/pii/S0887618510002288|journal=Journal of Anxiety Disorders|volume=25|issue=3|pages=456–465|doi=10.1016/j.janxdis.2010.11.010}}</ref> | 6.4% | Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions |- | Northern Ireland, representative sample, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Bunting|first=Brendan P.|last2=Ferry|first2=Finola R.|last3=Murphy|first3=Samuel D.|last4=O'Neill|first4=Siobhan M.|last5=Bolton|first5=David|date=2013-02-01|title=Trauma Associated With Civil Conflict and Posttraumatic Stress Disorder: Evidence From the Northern Ireland Study of Health and Stress|url=http://onlinelibrary.wiley.com/doi/10.1002/jts.21766/abstract|journal=Journal of Traumatic Stress|language=en|volume=26|issue=1|pages=134–141|doi=10.1002/jts.21766|issn=1573-6598}}</ref> | 8.8% | Northern Ireland Study of Health and Stress |- | South Africa, nationally representative sample, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Atwoli|first=Lukoye|last2=Stein|first2=Dan J.|last3=Williams|first3=David R.|last4=Mclaughlin|first4=Katie A.|last5=Petukhova|first5=Maria|last6=Kessler|first6=Ronald C.|last7=Koenen|first7=Karestan C.|date=2013-07-03|title=Trauma and posttraumatic stress disorder in South Africa: analysis from the South African Stress and Health Study|url=https://doi.org/10.1186/1471-244X-13-182|journal=BMC Psychiatry|volume=13|pages=182|doi=10.1186/1471-244x-13-182|issn=1471-244X}}</ref> | 2.3% | South African Stress and Health Study, using the Composite International Diagnostic Interview (CIDI) |- | U.S. Army and Marine Soldiers Deployed to Iraq and Afghanistan | U.S. Service Members<ref>{{Cite journal|last=Hoge|first=Charles W.|last2=Castro|first2=Carl A.|last3=Messer|first3=Stephen C.|last4=McGurk|first4=Dennis|last5=Cotting|first5=Dave I.|last6=Koffman|first6=Robert L.|date=2004-07-01|title=Combat Duty in Iraq and Afghanistan, Mental Health Problems, and Barriers to Care|url=http://dx.doi.org/10.1056/NEJMoa040603|journal=New England Journal of Medicine|volume=351|issue=1|pages=13–22|doi=10.1056/nejmoa040603|issn=0028-4793|pmid=15229303}}</ref> |11.5% - 19.5% ♦ | PTSD Checklist |- |United States, nationally representative, ages 13-18 |Non-clinical: Population based<ref>{{Cite journal|last=Merikangas|first=Kathleen Ries|last2=He|first2=Jian-ping|last3=Burstein|first3=Marcy|last4=Swanson|first4=Sonja A.|last5=Avenevoli|first5=Shelli|last6=Cui|first6=Lihong|last7=Benjet|first7=Corina|last8=Georgiades|first8=Katholiki|last9=Swendsen|first9=Joel|title=Lifetime Prevalence of Mental Disorders in U.S. Adolescents: Results from the National Comorbidity Survey Replication–Adolescent Supplement (NCS-A)|url=https://doi.org/10.1016/j.jaac.2010.05.017|journal=Journal of the American Academy of Child & Adolescent Psychiatry|volume=49|issue=10|pages=980–989|doi=10.1016/j.jaac.2010.05.017}}</ref> |5.0% |National Comorbidity Survey Replication—Adolescent Supplement (NCS-A) |} ♦ '''Note''': These rates were using broad PTSD Checklist scoring criteria of being scored positive if subjects reported at least one intrusion symptom, three avoidance symptoms, and two hyperarousal symptom that were categorized as at the moderate level. The 11.5% is for soldiers returning from deployment in Iraq, 19.5% is for soldiers returning from Afghanistan. Another common practice is to use a strict cutoff of 50 on the PCL, above which someone screens positive for PTSD. With this cutoff, rates are 6.2% and 12.9% for Service Members returned from Afghanistan and Iraqi, respectively. ==[[Evidence based assessment/Prediction phase|'''Prediction phase''']]== === Psychometric properties of screening for PTSD === The following section contains a list of screening and diagnostic instruments for PTSD. The section includes administration information, psychometric data, and PDFs or links to the screenings. * Screenings are used as part of the [[Evidence based assessment/Prediction phase|prediction phase]] of assessment; for more information on interpretation of this data, or how screenings fit in to the assessment process, click [[Evidence based assessment/Prediction phase|here.]] * '''''For a list of more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Psychometric_properties_of_common_screening_instruments click here.]''''' {| class="wikitable" |- ! Measure !Format (Reporter) !Age Range !Administration/ Completion Time |- |[https://www.ptsd.va.gov/professional/assessment/adult-sr/ptsd-checklist.asp PCL (PTSD Checklist for DSM-5)] |Self-Report |adult |5-10 minutes |- |[https://adaa.org/sites/default/files/Yusko%20_210.pdf PDS (Post-traumatic Diagnosis Scale)] |Self-Report |adult |10-20 minutes |- | colspan="4" style="font-size:110%; text-align:center;" |'''For Children and Adolescents Specifically''' |- |[https://www.reactionindex.com/index.php/ UCLA PTSD Reaction Index for DSM-5] |Clinician Administered |child, school age, adolescents |20-30 minutes |- |[https://www.aacap.org/App_Themes/AACAP/docs/resource_centers/resources/misc/child_ptsd_symptom_scale.pdf CPSS (Children's PTSD Symptom Scale)] |Self-Report |child |10-20 minutes |- |[https://medicine.tulane.edu/infant-institute Young Child PTSD Checklist (YCPC)] |Parent Report |child |13 items |} '''Note:''' '''L''' = Less than adequate; '''A''' = Adequate; '''G''' = Good; '''E''' = Excellent; '''U''' = Unavailable; '''NA''' = Not applicable === Interpreting PTSD screening measure scores === * For information on interpreting screening measure scores, click [[Evidence based assessment/Prediction phase#Interpreting screening measure scores|here.]] * Also see the page on [https://en.wikipedia.org/wiki/Likelihood_ratios_in_diagnostic_testing likelihood ratios in diagnostic testing] for more information ==[[Evidence based assessment/Prescription phase|'''Prescription phase''']]== ===Gold standard diagnostic interviews=== * For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews click here.] ===Recommended diagnostic interviews for PTSD=== {| class="wikitable sortable" border="1" ! colspan="5" |Diagnostic instruments for PTSD |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time !Where to Access |- | [https://www.ptsd.va.gov/professional/assessment/adult-int/caps.asp CAPS-5 (Clinician Administered PTSD Scale)] | Clinician Administered Interview | adult | 40-60 minutes | |- |PTSD Symptom Scale Interview (PSS-I-5) |Clinician Administered Interview |adult and child version available |24 items | |- | colspan="4" style="font-size:110%; text-align:center;" |'''For Children and Adolescents Specifically''' |- | [https://www.ptsd.va.gov/professional/assessment/child/caps-ca.asp CAPS-CA-5 (Clinician-Administered PTSD Scale for DSM-5 - Child/Adolescent Version)] |Clinician Administered Interview |child |30 items | |- | Children’s PTSD Inventory (CPTSD-I) |Diagnostic Interview | 6-18 years | 50 items | |} '''Note:''' '''L''' = Less than adequate; '''A''' = Adequate; '''G''' = Good; '''E''' = Excellent; '''U''' = Unavailable; '''NA''' = Not applicable ===Severity interviews for PTSD=== {| class="wikitable sortable" border="1" |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time !Where to Access |- | [https://www.kennedykrieger.org/sites/default/files/library/documents/faculty/ksads-dsm-5-screener.pdf Schedule for Affective Disorders and Schizophrenia for School Age Children (K-SADS)] | Diagnostic Interview | 6-18 years | 18 PTSD items | |- | Anxiety Disorders Interview Schedule, Child Version (ADIS-C) | Diagnostic Interview | 7-17 years | 26 PTSD items | |- | Children’s Interview for Psychiatric Symptoms (ChIPS) |Diagnostic Interview |6 – 18 years |31 PTSD items | |- | Diagnostic Infant and Preschool Assessment (DIPA) |Diagnostic Interview | Age 6 and younger | 46 PTSD items | |} '''Note:''' '''L''' = Less than adequate; '''A''' = Adequate; '''G''' = Good; '''E''' = Excellent; '''U''' = Unavailable; '''NA''' = Not applicable ==[[Evidence based assessment/Process phase|'''Process phase''']]== The following section contains a brief overview of treatment options for PTSD and list of process and outcome measures for PTSD. The section includes benchmarks based on published norms for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the [[Evidence based assessment/Process phase|process phase]] of assessment. For more information of differences between process and outcome measures, see the page on the [[Evidence based assessment/Process phase|process phase of assessment]]. === Process measures === * Information coming soon === Outcome and severity measures === This table includes clinically significant benchmarks for PTSD specific outcome measures * Information on how to interpret this table can be [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase found here]. * Additionally, these [[Evidence based assessment/Vignettes|vignettes]] might be helpful resources for understanding appropriate adaptation of outcome measures in practice. * ''<u>For clinically significant change benchmarks for the CBCL, YSR, and TRF total, externalizing, internalizing, and attention benchmarks,</u>'' [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase&wteswitched=1#Clinically_significant_change_benchmarks_for_widely-used_outcome_measures see here.] {| class="wikitable sortable" border="1" | colspan="7" |'''Clinically significant change benchmarks with common instruments for PTSD''' |- | colspan="7" style="font-size:110%; text-align:center;" span |<b> Benchmarks Based on Published Norms</b> |- | rowspan="2" style="text-align:center;font-size:130%;" |<b> Measure</b> | colspan="3" style="text-align:center;font-size:130%" width="300" |<b> Cut-off scores</b> | colspan="3" style="text-align:center;font-size:120%" |<b> Critical Change <br> (unstandardized scores)</b> |- | style="text-align:center;font-size:110%" |<b> A</b> | style="text-align:center;font-size:110%" |<b> B</b> | style="text-align:center;font-size:110%" |<b> C</b> | style="text-align:center;font-size:110%" |<b> 95%</b> | style="text-align:center;font-size:110%" |<b> 90%</b> | style="text-align:center;font-size:110%" |<b> SE_difference</b> |- | rowspan="1" style="text-align:center;" | Primary Care PTSD Screen | style="text-align:center;" | 1.0 | style="text-align:center;" | 3.1 | style="text-align:center;" | 2.0 | style="text-align:center;" | 1.0 | style="text-align:center;" | .8 | style="text-align:center;" | .5 |- | rowspan="1" style="text-align:center;" | PTSD Checklist Scores | style="text-align:center;" | 28.8 | style="text-align:center;" | 40.8 | style="text-align:center;" | 34.9 | style="text-align:center;" | 4.6 | style="text-align:center;" | 3.8 | style="text-align:center;" | 2.3 |- | rowspan="1" style="text-align:center;" | Clinician Administered PTSD Scale | style="text-align:center;" | 28.8 | style="text-align:center;" | 40.8 | style="text-align:center;" | 34.9 | style="text-align:center;" | 8.3 | style="text-align:center;" | 7.0 | style="text-align:center;" | 4.2 |} === Treatment === * Please refer to the Wikipedia page on [[wikipedia:Posttraumatic_stress_disorder|PTSD]] for more information on available treatment for PTSD or go to the [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/post-traumatic-stress-disorder/ Effective Child Therapy] page for for a curated resource on effective treatments for PTSD. {{collapse top| Click here for more information}} '''<big>Behavioral interventions</big>''' Recommended (have ''significant benefit'') <ref name=":0">Department of Veterans Affairs and Department of Defense. . (2010). VA/DoD clinical practice guidelines: management of post-traumatic stress. Washington, D.C.: Veterans Health Administration, Department of Defense.</ref>: # Brief Cognitive Behavioral Therapy (CBT; 4-5 sessions) #* This includes stress inoculation training, trauma-focused therapy including components of cognitive restructuring, Cognitive Processing Therapy (CPT), imaginal, virtual, and in-vivo exposure as in Prolonged Exposure psychotherapy (PE)² #* Patient education is recommended as part of psychotherapy for patients and family members # EMDR may help both acute and chronic PTSD, especially individuals who have trouble with prolonged exposure or have trouble verbalizing their trauma.<ref name=":1">Ursano, R. J., Bell, C., Eth, S., Friedman, M., Norwood, A., Pfefferbaum, B., . . . McIntyre, J. S. (2004). ''Practice guideline for the treatment of patients with acute stress disorder and posttraumatic stress disorder'': American Psychiatric Publ </ref> ## Long term gains require further study. # [https://www.ptsd.va.gov/professional/treat/txessentials/present_centered_therapy.asp Present-Centered Therapy (PCT)] is a non trauma focused treatment for PTSD and a second-line treatment for PTSD<ref>{{Cite web|url=https://www.ptsd.va.gov/professional/treat/txessentials/present_centered_therapy.asp|title=Present-Centered Therapy for PTSD - PTSD: National Center for PTSD|website=www.ptsd.va.gov|language=en|access-date=2022-08-13}}</ref>. Treatments with weaker evidence (have ''some benefit'') <ref name=":0" />: # Patient education, # Imagery rehearsal therapy, # Psychodynamic therapy, # Hypnosis, # Relaxation techniques, # and Group therapy. Treatment with ''unknown benefit'' <ref name=":0" />: # Web-based CBT ## For example Jeane Bosch participated as a study therapist in research study that compared STAIR and present-centered therapy both delivered via telehealth. STAIR stands for Skills Training in Affective and Interpersonal Regulation. It is a skill-focused treatment that was originally developed for survivors of childhood abuse to teach emotion regulation skills as well as tools to help with challenges interpersonal functioning and social relationships and decrease PTSD symptoms<ref>{{Cite web|url=https://istss.org/public-resources/trauma-blog/2015-march-(1)/clinician-s-corner-skills-training-in-affective-an|title=ISTSS - Trauma Blog|website=istss.org|access-date=2022-08-13}}</ref>.<ref>{{Citation|title=Introduction to Telehealth with Dr. Bosch|url=https://www.youtube.com/watch?v=Wn6Vewl42X8|accessdate=2022-08-13|language=en}}</ref> # Acceptance and commitment therapy, # and Dialectical Behavioral Therapy. <big>'''Medication'''</big> *SSRIs are more effective than placebo in treating PTSD.<ref name=":1" /> *There is no evidence to support a medication to prevent the development of PTSD.<ref name=":0" /> **Imipramine, propranolol, prazosin, other antidepressants, anticonvulsants, and atypical antipsychotics have ''unknown benefit.'' **Strongly recommend against the use of benzodiazepines² and typical antipsychotics since they have ''no benefit and potential harm.'' {{collapse bottom}} == '''External resources''' == === For professionals === * [http://www.som.uq.edu.au/ptsd Post Traumatic Stress Disorder Information Resource] from [http://www.uq.edu.au/ The University of Queensland School of Medicine] * [http://www.apa.org/ptsd-guideline/ APA practice parameters for assessment and treatment for PTSD (Updated 2017)] * [http://www.ptsd.va.gov/professional/index.asp Resources for professionals] from [http://www.ptsd.va.gov/index.asp VA National PTSD Center] * [https://www.integration.samhsa.gov/clinical-practice/trauma-informed SAMHSA's Trauma-Informed Care Resources and Training] * [https://www.integration.samhsa.gov/clinical-practice/trauma-informed SAMHSA's Resources on Intimate Partner Violence (IPV) for Clinicians, Patients, Families, and Organizations] === For caregivers === * [http://www.nctsn.org/sites/default/files/assets/pdfs/tips_for_parents_media_final.pdf Tips for parents on shooting media coverage] * [http://www.nctsn.org/sites/default/files/assets/pdfs/parents_guidelines_for_helping_teens_after_the_recent_attacks.pdf Parent guidelines to helping youths after a shooting] * [http://www.nctsn.org/sites/default/files/assets/pdfs/helping_teens_with_traumatic_grief_caregivers_final.pdf Caregiver tips for helping teens with traumatic grief] * [http://www.nctsn.org/sites/default/files/assets/pdfs/10things_schoolage_ctg.pdf Caregiver tips for helping school-age children with traumatic grief] *[http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/post-traumatic-stress-disorder/ EffectiveChildTherapy.Org information on PTSD] *[https://sccap53.org Society of Clinical Child and Adolescent Psychology] === For educators === * [http://www.nctsn.org/sites/default/files/assets/pdfs/pfa_for_schools_appendix_a_teachers.pdf Teacher tips for providing psychological first aid] * [http://www.nctsn.org/sites/default/files/assets/pdfs/helping_youth_after_community_violence_educators.pdf Educator tips for helping youths after a community trauma] === For public === * [https://complicatedgrief.columbia.edu/for-the-public/resources/ Resources for grief and loss] * [http://www.nctsn.org/sites/default/files/assets/pdfs/psychological_information_sheet_two_pager.pdf Psychological impacts of recent shootings] * [http://www.nctsn.org/sites/default/files/assets/pdfs/youth_journalists.pdf Tips to talking to youths about a shooting] * [http://www.nctsn.org/sites/default/files/assets/pdfs/talking_to_children_about_the_shooting.pdf Tips to talking to children about a shooting] * [http://www.nctsn.org/sites/default/files/assets/pdfs/helping_young_children_heal_crisis.pdf Helping young children heal after a crisis] * [http://www.nctsn.org/content/psychological-first-aid-schoolspfa Psychological first aid for schools] * [http://www.nctsn.org/content/psychological-first-aid Resources and manuals on psychological first aid] * [http://www.ptsd.va.gov/public/index.asp Resources for the public] from [http://www.ptsd.va.gov/index.asp VA National PTSD Center] * [https://curlie.org/Health/Mental_Health/Disorders/Anxiety/Post-traumatic_Stress Posttraumatic stress disorder] at Curlie (based on DMOZ) =='''References'''== {{collapse top|Click here for references}} {{Reflist|30em}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] {{collapse bottom}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] tpxjlma9gwa7go2j5da0t6yy5wx5051 2419101 2419085 2022-08-25T22:48:56Z Ardenguo 2944162 /* Recommended diagnostic interviews for PTSD */ removed where to access column for now. Will add back wikitext text/x-wiki <noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{medical disclaimer}} {{:{{BASEPAGENAME}}/Sidebar}} ==[[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio"?''']]== * For background information on what assessment portfolios are, click the link in the heading above. * Want even 'more' information about this topic? There's an extended version of this page [[Evidence-based assessment/Posttraumatic stress disorder (disorder portfolio)/extended version|'''here''']]. == [[Evidence based assessment/Preparation phase|'''Preparation phase''']] == === Diagnostic criteria for post traumatic stress disorder === ===='''ICD-11 Diagnostic Criteria'''==== {{blockquotetop}} ===='''ICD-11 Criteria'''==== *Post-traumatic stress disorder (PTSD) is a syndrome that develops following exposure to an extremely threatening or horrific event or series of events that is characterized by all of the following: **1) re-experiencing the traumatic event or events in the present in the form of vivid intrusive memories, flashbacks, or nightmares, which are typically accompanied by strong and overwhelming emotions such as fear or horror and strong physical sensations, or feelings of being overwhelmed or immersed in the same intense emotions that were experienced during the traumatic event; **2) avoidance of thoughts and memories of the event or events, or avoidance of activities, situations, or people reminiscent of the event or events **3) persistent perceptions of heightened current threat, for example as indicated by hypervigilance or an enhanced startle reaction to stimuli such as unexpected noises. *The symptoms must persist for at least several weeks and cause significant impairment in personal, family, social, educational, occupational or other important areas of functioning. Additionally, ICD 11 includes a category called "Complex post-traumatic stress disorder," which is described as: *A disorder that may develop following exposure to an event or series of events of an extremely threatening or horrific nature, most commonly prolonged or repetitive events from which escape is difficult or impossible (e.g., torture, slavery, genocide campaigns, prolonged domestic violence, repeated childhood sexual or physical abuse). *The disorder is characterized by the core symptoms of PTSD; that is, all diagnostic requirements for PTSD have been met at some point during the course of the disorder. *In addition, Complex PTSD is characterized by: **1) severe and pervasive problems in affect regulation; **2) persistent beliefs about oneself as diminished, defeated or worthless, accompanied by deep and pervasive feelings of shame, guilt or failure related to the traumatic event **3) persistent difficulties in sustaining relationships and in feeling close to others. The disturbance causes significant impairment in personal, family, social, educational, occupational or other important areas of functioning. {{blockquotebottom}} ===='''Changes in DSM-5'''==== * The diagnostic criteria for post-traumatic stress disorder changed slightly from [[DSM-IV]] to [[w:Diagnostic_and_Statistical_Manual_of_Mental_Disorders#DSM-IV-TR_.282000.29|DSM-5]]. Summaries are available [http://www.dsm5.org/Documents/changes%20from%20dsm-iv-tr%20to%20dsm-5.pdf here] and [[w:DSM-5|here]]. === Developmental sensitivities === {{collapse top| Click for more information}} *Diagnostic thresholds have been lowered for children and adolescents to account for development. *Separate and additional criteria have been added for children age 6 or younger. *Child sexual abuse has been found to have a substantial effect on the development of PTSD.<ref>{{cite journal|last1=Paolucci|first1=Elizabeth ODDONE|last2=Genuis|first2=Mark L.|last3=Violato|first3=Claudio|title=A Meta-Analysis of the Published Research on the Effects of Child Sexual Abuse|journal=The Journal of Psychology|date=January 2001|volume=135|issue=1|pages=17–36|doi=10.1080/00223980109603677}}</ref> *Children with higher exposure to trauma, less social support, and other major life events are more likely to have continued PTSD symptoms 7 months after a trauma.<ref name=":2">{{cite journal |last1=La Greca|first1=A|last2=Silverman|first2=WK|last3=Vernberg|first3=EM|last4=Prinstein|first4=MJ|title=Symptoms of posttraumatic stress in children after Hurricane Andrew: a prospective study.|journal=Journal of consulting and clinical psychology|date=August 1996|volume=64|issue=4|pages=712-23|pmid=8803361}}</ref> 10 months after a trauma, however, only experience of a major life event remained predictive of continuing PTSD symptoms.<ref name=":2" /> *Lack of social support, specifically lack of support by a teacher, was predictive of higher PTSD symptoms among children who had gone through an environmental trauma.<ref name=":2" /> *Children who reported using blame and anger as strategies for coping had higher levels of PTSD symptoms 10 months after a trauma.<ref name=":2" /> *Negative affect in children before a traumatic event was predictive of development of PTSD symptoms after a traumatic event.<ref>{{cite journal|last1=Weems|first1=CF|last2=Pina|first2=AA|last3=Costa|first3=NM|last4=Watts|first4=SE|last5=Taylor|first5=LK|last6=Cannon|first6=MF|title=Predisaster trait anxiety and negative affect predict posttraumatic stress in youths after hurricane Katrina.|journal=Journal of consulting and clinical psychology|date=February 2007|volume=75|issue=1|pages=154-9|doi=10.1037/0022-006X.75.1.154|pmid=17295574}}</ref> [[wikipedia:Posttraumatic_stress_disorder|Posttraumatic stress disorder]] is now more sensitive to development in that diagnostic thresholds have been lowered for children and adolescents. Furthermore, separate and additional criteria have been added for children age 6 years of age or younger. {{collapse bottom}} === Base rates of PTSD in different clinical settings and populations === This section describes the demographic settings of the populations sampled, base rates of PTSD diagnoses, country/region sampled, and the diagnostic methods that were used. Using this information, clinicians will be able to anchor the most appropriate rate of PTSD that they are likely to see in their clinical practice. * '''''To see prevalence rates across multiple disorders,''''' [[Evidence based assessment/Preparation phase#Base rates for transdiagnostic comparison|'''''click here.''''']] {| class="wikitable sortable" border="1" |- ! Demography ! Setting ! Base Rate ! Diagnostic Method |- | United States, nationally representative, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Kessler|first=Ronald C.|last2=Berglund|first2=Patricia|last3=Demler|first3=Olga|last4=Jin|first4=Robert|last5=Merikangas|first5=Kathleen R.|last6=Walters|first6=Ellen E.|date=2005-06-01|title=Lifetime Prevalence and Age-of-Onset Distributions of DSM-IV Disorders in the National Comorbidity Survey Replication|url=http://archpsyc.jamanetwork.com/article.aspx?doi=10.1001/archpsyc.62.6.593|journal=Archives of General Psychiatry|language=en|volume=62|issue=6|doi=10.1001/archpsyc.62.6.593|issn=0003-990X}}</ref> | 6.8% | National Comorbidity Survey - Replication |- | Netherlands, nationally representative, age 18-80 | Non-clinical: Population based<ref>{{Cite journal|last=de Vries|first=Giel-Jan|last2=Olff|first2=Miranda|date=2009-08-01|title=The lifetime prevalence of traumatic events and posttraumatic stress disorder in the Netherlands|url=http://onlinelibrary.wiley.com/doi/10.1002/jts.20429/abstract|journal=Journal of Traumatic Stress|language=en|volume=22|issue=4|pages=259–267|doi=10.1002/jts.20429|issn=1573-6598}}</ref> | 7.4% | Composite International Diagnostic Interview (CIDI) |- | United States, nationally representative, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Pietrzak|first=Robert H.|last2=Goldstein|first2=Risë B.|last3=Southwick|first3=Steven M.|last4=Grant|first4=Bridget F.|title=Prevalence and Axis I comorbidity of full and partial posttraumatic stress disorder in the United States: Results from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions|url=http://linkinghub.elsevier.com/retrieve/pii/S0887618510002288|journal=Journal of Anxiety Disorders|volume=25|issue=3|pages=456–465|doi=10.1016/j.janxdis.2010.11.010}}</ref> | 6.4% | Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions |- | Northern Ireland, representative sample, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Bunting|first=Brendan P.|last2=Ferry|first2=Finola R.|last3=Murphy|first3=Samuel D.|last4=O'Neill|first4=Siobhan M.|last5=Bolton|first5=David|date=2013-02-01|title=Trauma Associated With Civil Conflict and Posttraumatic Stress Disorder: Evidence From the Northern Ireland Study of Health and Stress|url=http://onlinelibrary.wiley.com/doi/10.1002/jts.21766/abstract|journal=Journal of Traumatic Stress|language=en|volume=26|issue=1|pages=134–141|doi=10.1002/jts.21766|issn=1573-6598}}</ref> | 8.8% | Northern Ireland Study of Health and Stress |- | South Africa, nationally representative sample, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Atwoli|first=Lukoye|last2=Stein|first2=Dan J.|last3=Williams|first3=David R.|last4=Mclaughlin|first4=Katie A.|last5=Petukhova|first5=Maria|last6=Kessler|first6=Ronald C.|last7=Koenen|first7=Karestan C.|date=2013-07-03|title=Trauma and posttraumatic stress disorder in South Africa: analysis from the South African Stress and Health Study|url=https://doi.org/10.1186/1471-244X-13-182|journal=BMC Psychiatry|volume=13|pages=182|doi=10.1186/1471-244x-13-182|issn=1471-244X}}</ref> | 2.3% | South African Stress and Health Study, using the Composite International Diagnostic Interview (CIDI) |- | U.S. Army and Marine Soldiers Deployed to Iraq and Afghanistan | U.S. Service Members<ref>{{Cite journal|last=Hoge|first=Charles W.|last2=Castro|first2=Carl A.|last3=Messer|first3=Stephen C.|last4=McGurk|first4=Dennis|last5=Cotting|first5=Dave I.|last6=Koffman|first6=Robert L.|date=2004-07-01|title=Combat Duty in Iraq and Afghanistan, Mental Health Problems, and Barriers to Care|url=http://dx.doi.org/10.1056/NEJMoa040603|journal=New England Journal of Medicine|volume=351|issue=1|pages=13–22|doi=10.1056/nejmoa040603|issn=0028-4793|pmid=15229303}}</ref> |11.5% - 19.5% ♦ | PTSD Checklist |- |United States, nationally representative, ages 13-18 |Non-clinical: Population based<ref>{{Cite journal|last=Merikangas|first=Kathleen Ries|last2=He|first2=Jian-ping|last3=Burstein|first3=Marcy|last4=Swanson|first4=Sonja A.|last5=Avenevoli|first5=Shelli|last6=Cui|first6=Lihong|last7=Benjet|first7=Corina|last8=Georgiades|first8=Katholiki|last9=Swendsen|first9=Joel|title=Lifetime Prevalence of Mental Disorders in U.S. Adolescents: Results from the National Comorbidity Survey Replication–Adolescent Supplement (NCS-A)|url=https://doi.org/10.1016/j.jaac.2010.05.017|journal=Journal of the American Academy of Child & Adolescent Psychiatry|volume=49|issue=10|pages=980–989|doi=10.1016/j.jaac.2010.05.017}}</ref> |5.0% |National Comorbidity Survey Replication—Adolescent Supplement (NCS-A) |} ♦ '''Note''': These rates were using broad PTSD Checklist scoring criteria of being scored positive if subjects reported at least one intrusion symptom, three avoidance symptoms, and two hyperarousal symptom that were categorized as at the moderate level. The 11.5% is for soldiers returning from deployment in Iraq, 19.5% is for soldiers returning from Afghanistan. Another common practice is to use a strict cutoff of 50 on the PCL, above which someone screens positive for PTSD. With this cutoff, rates are 6.2% and 12.9% for Service Members returned from Afghanistan and Iraqi, respectively. ==[[Evidence based assessment/Prediction phase|'''Prediction phase''']]== === Psychometric properties of screening for PTSD === The following section contains a list of screening and diagnostic instruments for PTSD. The section includes administration information, psychometric data, and PDFs or links to the screenings. * Screenings are used as part of the [[Evidence based assessment/Prediction phase|prediction phase]] of assessment; for more information on interpretation of this data, or how screenings fit in to the assessment process, click [[Evidence based assessment/Prediction phase|here.]] * '''''For a list of more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Psychometric_properties_of_common_screening_instruments click here.]''''' {| class="wikitable" |- ! Measure !Format (Reporter) !Age Range !Administration/ Completion Time |- |[https://www.ptsd.va.gov/professional/assessment/adult-sr/ptsd-checklist.asp PCL (PTSD Checklist for DSM-5)] |Self-Report |adult |5-10 minutes |- |[https://adaa.org/sites/default/files/Yusko%20_210.pdf PDS (Post-traumatic Diagnosis Scale)] |Self-Report |adult |10-20 minutes |- | colspan="4" style="font-size:110%; text-align:center;" |'''For Children and Adolescents Specifically''' |- |[https://www.reactionindex.com/index.php/ UCLA PTSD Reaction Index for DSM-5] |Clinician Administered |child, school age, adolescents |20-30 minutes |- |[https://www.aacap.org/App_Themes/AACAP/docs/resource_centers/resources/misc/child_ptsd_symptom_scale.pdf CPSS (Children's PTSD Symptom Scale)] |Self-Report |child |10-20 minutes |- |[https://medicine.tulane.edu/infant-institute Young Child PTSD Checklist (YCPC)] |Parent Report |child |13 items |} '''Note:''' '''L''' = Less than adequate; '''A''' = Adequate; '''G''' = Good; '''E''' = Excellent; '''U''' = Unavailable; '''NA''' = Not applicable === Interpreting PTSD screening measure scores === * For information on interpreting screening measure scores, click [[Evidence based assessment/Prediction phase#Interpreting screening measure scores|here.]] * Also see the page on [https://en.wikipedia.org/wiki/Likelihood_ratios_in_diagnostic_testing likelihood ratios in diagnostic testing] for more information ==[[Evidence based assessment/Prescription phase|'''Prescription phase''']]== ===Gold standard diagnostic interviews=== * For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews click here.] ===Recommended diagnostic interviews for PTSD=== {| class="wikitable sortable" border="1" ! colspan="4" |Diagnostic instruments for PTSD |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time |- | [https://www.ptsd.va.gov/professional/assessment/adult-int/caps.asp CAPS-5 (Clinician Administered PTSD Scale)] | Clinician Administered Interview | adult | 40-60 minutes |- |PTSD Symptom Scale Interview (PSS-I-5) |Clinician Administered Interview |adult and child version available |24 items |- | colspan="4" style="font-size:110%; text-align:center;" |'''For Children and Adolescents Specifically''' |- | [https://www.ptsd.va.gov/professional/assessment/child/caps-ca.asp CAPS-CA-5 (Clinician-Administered PTSD Scale for DSM-5 - Child/Adolescent Version)] |Clinician Administered Interview |child |30 items |- | Children’s PTSD Inventory (CPTSD-I) |Diagnostic Interview | 6-18 years | 50 items |} '''Note:''' '''L''' = Less than adequate; '''A''' = Adequate; '''G''' = Good; '''E''' = Excellent; '''U''' = Unavailable; '''NA''' = Not applicable ===Severity interviews for PTSD=== {| class="wikitable sortable" border="1" |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time |- | [https://www.kennedykrieger.org/sites/default/files/library/documents/faculty/ksads-dsm-5-screener.pdf Schedule for Affective Disorders and Schizophrenia for School Age Children (K-SADS)] | Diagnostic Interview | 6-18 years | 18 PTSD items |- | Anxiety Disorders Interview Schedule, Child Version (ADIS-C) | Diagnostic Interview | 7-17 years | 26 PTSD items |- | Children’s Interview for Psychiatric Symptoms (ChIPS) |Diagnostic Interview |6 – 18 years |31 PTSD items |- | Diagnostic Infant and Preschool Assessment (DIPA) |Diagnostic Interview | Age 6 and younger | 46 PTSD items |} '''Note:''' '''L''' = Less than adequate; '''A''' = Adequate; '''G''' = Good; '''E''' = Excellent; '''U''' = Unavailable; '''NA''' = Not applicable ==[[Evidence based assessment/Process phase|'''Process phase''']]== The following section contains a brief overview of treatment options for PTSD and list of process and outcome measures for PTSD. The section includes benchmarks based on published norms for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the [[Evidence based assessment/Process phase|process phase]] of assessment. For more information of differences between process and outcome measures, see the page on the [[Evidence based assessment/Process phase|process phase of assessment]]. === Process measures === * Information coming soon === Outcome and severity measures === This table includes clinically significant benchmarks for PTSD specific outcome measures * Information on how to interpret this table can be [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase found here]. * Additionally, these [[Evidence based assessment/Vignettes|vignettes]] might be helpful resources for understanding appropriate adaptation of outcome measures in practice. * ''<u>For clinically significant change benchmarks for the CBCL, YSR, and TRF total, externalizing, internalizing, and attention benchmarks,</u>'' [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase&wteswitched=1#Clinically_significant_change_benchmarks_for_widely-used_outcome_measures see here.] {| class="wikitable sortable" border="1" | colspan="7" |'''Clinically significant change benchmarks with common instruments for PTSD''' |- | colspan="7" style="font-size:110%; text-align:center;" span |<b> Benchmarks Based on Published Norms</b> |- | rowspan="2" style="text-align:center;font-size:130%;" |<b> Measure</b> | colspan="3" style="text-align:center;font-size:130%" width="300" |<b> Cut-off scores</b> | colspan="3" style="text-align:center;font-size:120%" |<b> Critical Change <br> (unstandardized scores)</b> |- | style="text-align:center;font-size:110%" |<b> A</b> | style="text-align:center;font-size:110%" |<b> B</b> | style="text-align:center;font-size:110%" |<b> C</b> | style="text-align:center;font-size:110%" |<b> 95%</b> | style="text-align:center;font-size:110%" |<b> 90%</b> | style="text-align:center;font-size:110%" |<b> SE_difference</b> |- | rowspan="1" style="text-align:center;" | Primary Care PTSD Screen | style="text-align:center;" | 1.0 | style="text-align:center;" | 3.1 | style="text-align:center;" | 2.0 | style="text-align:center;" | 1.0 | style="text-align:center;" | .8 | style="text-align:center;" | .5 |- | rowspan="1" style="text-align:center;" | PTSD Checklist Scores | style="text-align:center;" | 28.8 | style="text-align:center;" | 40.8 | style="text-align:center;" | 34.9 | style="text-align:center;" | 4.6 | style="text-align:center;" | 3.8 | style="text-align:center;" | 2.3 |- | rowspan="1" style="text-align:center;" | Clinician Administered PTSD Scale | style="text-align:center;" | 28.8 | style="text-align:center;" | 40.8 | style="text-align:center;" | 34.9 | style="text-align:center;" | 8.3 | style="text-align:center;" | 7.0 | style="text-align:center;" | 4.2 |} === Treatment === * Please refer to the Wikipedia page on [[wikipedia:Posttraumatic_stress_disorder|PTSD]] for more information on available treatment for PTSD or go to the [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/post-traumatic-stress-disorder/ Effective Child Therapy] page for for a curated resource on effective treatments for PTSD. {{collapse top| Click here for more information}} '''<big>Behavioral interventions</big>''' Recommended (have ''significant benefit'') <ref name=":0">Department of Veterans Affairs and Department of Defense. . (2010). VA/DoD clinical practice guidelines: management of post-traumatic stress. Washington, D.C.: Veterans Health Administration, Department of Defense.</ref>: # Brief Cognitive Behavioral Therapy (CBT; 4-5 sessions) #* This includes stress inoculation training, trauma-focused therapy including components of cognitive restructuring, Cognitive Processing Therapy (CPT), imaginal, virtual, and in-vivo exposure as in Prolonged Exposure psychotherapy (PE)² #* Patient education is recommended as part of psychotherapy for patients and family members # EMDR may help both acute and chronic PTSD, especially individuals who have trouble with prolonged exposure or have trouble verbalizing their trauma.<ref name=":1">Ursano, R. J., Bell, C., Eth, S., Friedman, M., Norwood, A., Pfefferbaum, B., . . . McIntyre, J. S. (2004). ''Practice guideline for the treatment of patients with acute stress disorder and posttraumatic stress disorder'': American Psychiatric Publ </ref> ## Long term gains require further study. # [https://www.ptsd.va.gov/professional/treat/txessentials/present_centered_therapy.asp Present-Centered Therapy (PCT)] is a non trauma focused treatment for PTSD and a second-line treatment for PTSD<ref>{{Cite web|url=https://www.ptsd.va.gov/professional/treat/txessentials/present_centered_therapy.asp|title=Present-Centered Therapy for PTSD - PTSD: National Center for PTSD|website=www.ptsd.va.gov|language=en|access-date=2022-08-13}}</ref>. Treatments with weaker evidence (have ''some benefit'') <ref name=":0" />: # Patient education, # Imagery rehearsal therapy, # Psychodynamic therapy, # Hypnosis, # Relaxation techniques, # and Group therapy. Treatment with ''unknown benefit'' <ref name=":0" />: # Web-based CBT ## For example Jeane Bosch participated as a study therapist in research study that compared STAIR and present-centered therapy both delivered via telehealth. STAIR stands for Skills Training in Affective and Interpersonal Regulation. It is a skill-focused treatment that was originally developed for survivors of childhood abuse to teach emotion regulation skills as well as tools to help with challenges interpersonal functioning and social relationships and decrease PTSD symptoms<ref>{{Cite web|url=https://istss.org/public-resources/trauma-blog/2015-march-(1)/clinician-s-corner-skills-training-in-affective-an|title=ISTSS - Trauma Blog|website=istss.org|access-date=2022-08-13}}</ref>.<ref>{{Citation|title=Introduction to Telehealth with Dr. Bosch|url=https://www.youtube.com/watch?v=Wn6Vewl42X8|accessdate=2022-08-13|language=en}}</ref> # Acceptance and commitment therapy, # and Dialectical Behavioral Therapy. <big>'''Medication'''</big> *SSRIs are more effective than placebo in treating PTSD.<ref name=":1" /> *There is no evidence to support a medication to prevent the development of PTSD.<ref name=":0" /> **Imipramine, propranolol, prazosin, other antidepressants, anticonvulsants, and atypical antipsychotics have ''unknown benefit.'' **Strongly recommend against the use of benzodiazepines² and typical antipsychotics since they have ''no benefit and potential harm.'' {{collapse bottom}} == '''External resources''' == === For professionals === * [http://www.som.uq.edu.au/ptsd Post Traumatic Stress Disorder Information Resource] from [http://www.uq.edu.au/ The University of Queensland School of Medicine] * [http://www.apa.org/ptsd-guideline/ APA practice parameters for assessment and treatment for PTSD (Updated 2017)] * [http://www.ptsd.va.gov/professional/index.asp Resources for professionals] from [http://www.ptsd.va.gov/index.asp VA National PTSD Center] * [https://www.integration.samhsa.gov/clinical-practice/trauma-informed SAMHSA's Trauma-Informed Care Resources and Training] * [https://www.integration.samhsa.gov/clinical-practice/trauma-informed SAMHSA's Resources on Intimate Partner Violence (IPV) for Clinicians, Patients, Families, and Organizations] === For caregivers === * [http://www.nctsn.org/sites/default/files/assets/pdfs/tips_for_parents_media_final.pdf Tips for parents on shooting media coverage] * [http://www.nctsn.org/sites/default/files/assets/pdfs/parents_guidelines_for_helping_teens_after_the_recent_attacks.pdf Parent guidelines to helping youths after a shooting] * [http://www.nctsn.org/sites/default/files/assets/pdfs/helping_teens_with_traumatic_grief_caregivers_final.pdf Caregiver tips for helping teens with traumatic grief] * [http://www.nctsn.org/sites/default/files/assets/pdfs/10things_schoolage_ctg.pdf Caregiver tips for helping school-age children with traumatic grief] *[http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/post-traumatic-stress-disorder/ EffectiveChildTherapy.Org information on PTSD] *[https://sccap53.org Society of Clinical Child and Adolescent Psychology] === For educators === * [http://www.nctsn.org/sites/default/files/assets/pdfs/pfa_for_schools_appendix_a_teachers.pdf Teacher tips for providing psychological first aid] * [http://www.nctsn.org/sites/default/files/assets/pdfs/helping_youth_after_community_violence_educators.pdf Educator tips for helping youths after a community trauma] === For public === * [https://complicatedgrief.columbia.edu/for-the-public/resources/ Resources for grief and loss] * [http://www.nctsn.org/sites/default/files/assets/pdfs/psychological_information_sheet_two_pager.pdf Psychological impacts of recent shootings] * [http://www.nctsn.org/sites/default/files/assets/pdfs/youth_journalists.pdf Tips to talking to youths about a shooting] * [http://www.nctsn.org/sites/default/files/assets/pdfs/talking_to_children_about_the_shooting.pdf Tips to talking to children about a shooting] * [http://www.nctsn.org/sites/default/files/assets/pdfs/helping_young_children_heal_crisis.pdf Helping young children heal after a crisis] * [http://www.nctsn.org/content/psychological-first-aid-schoolspfa Psychological first aid for schools] * [http://www.nctsn.org/content/psychological-first-aid Resources and manuals on psychological first aid] * [http://www.ptsd.va.gov/public/index.asp Resources for the public] from [http://www.ptsd.va.gov/index.asp VA National PTSD Center] * [https://curlie.org/Health/Mental_Health/Disorders/Anxiety/Post-traumatic_Stress Posttraumatic stress disorder] at Curlie (based on DMOZ) =='''References'''== {{collapse top|Click here for references}} {{Reflist|30em}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] {{collapse bottom}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] ay9xyhwwh0l13rzxcgq9zg9zwlo47m3 2419107 2419101 2022-08-25T23:00:57Z Ardenguo 2944162 /* Psychometric properties of screening for PTSD */ add measures wikitext text/x-wiki <noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{medical disclaimer}} {{:{{BASEPAGENAME}}/Sidebar}} ==[[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio"?''']]== * For background information on what assessment portfolios are, click the link in the heading above. * Want even 'more' information about this topic? There's an extended version of this page [[Evidence-based assessment/Posttraumatic stress disorder (disorder portfolio)/extended version|'''here''']]. == [[Evidence based assessment/Preparation phase|'''Preparation phase''']] == === Diagnostic criteria for post traumatic stress disorder === ===='''ICD-11 Diagnostic Criteria'''==== {{blockquotetop}} ===='''ICD-11 Criteria'''==== *Post-traumatic stress disorder (PTSD) is a syndrome that develops following exposure to an extremely threatening or horrific event or series of events that is characterized by all of the following: **1) re-experiencing the traumatic event or events in the present in the form of vivid intrusive memories, flashbacks, or nightmares, which are typically accompanied by strong and overwhelming emotions such as fear or horror and strong physical sensations, or feelings of being overwhelmed or immersed in the same intense emotions that were experienced during the traumatic event; **2) avoidance of thoughts and memories of the event or events, or avoidance of activities, situations, or people reminiscent of the event or events **3) persistent perceptions of heightened current threat, for example as indicated by hypervigilance or an enhanced startle reaction to stimuli such as unexpected noises. *The symptoms must persist for at least several weeks and cause significant impairment in personal, family, social, educational, occupational or other important areas of functioning. Additionally, ICD 11 includes a category called "Complex post-traumatic stress disorder," which is described as: *A disorder that may develop following exposure to an event or series of events of an extremely threatening or horrific nature, most commonly prolonged or repetitive events from which escape is difficult or impossible (e.g., torture, slavery, genocide campaigns, prolonged domestic violence, repeated childhood sexual or physical abuse). *The disorder is characterized by the core symptoms of PTSD; that is, all diagnostic requirements for PTSD have been met at some point during the course of the disorder. *In addition, Complex PTSD is characterized by: **1) severe and pervasive problems in affect regulation; **2) persistent beliefs about oneself as diminished, defeated or worthless, accompanied by deep and pervasive feelings of shame, guilt or failure related to the traumatic event **3) persistent difficulties in sustaining relationships and in feeling close to others. The disturbance causes significant impairment in personal, family, social, educational, occupational or other important areas of functioning. {{blockquotebottom}} ===='''Changes in DSM-5'''==== * The diagnostic criteria for post-traumatic stress disorder changed slightly from [[DSM-IV]] to [[w:Diagnostic_and_Statistical_Manual_of_Mental_Disorders#DSM-IV-TR_.282000.29|DSM-5]]. Summaries are available [http://www.dsm5.org/Documents/changes%20from%20dsm-iv-tr%20to%20dsm-5.pdf here] and [[w:DSM-5|here]]. === Developmental sensitivities === {{collapse top| Click for more information}} *Diagnostic thresholds have been lowered for children and adolescents to account for development. *Separate and additional criteria have been added for children age 6 or younger. *Child sexual abuse has been found to have a substantial effect on the development of PTSD.<ref>{{cite journal|last1=Paolucci|first1=Elizabeth ODDONE|last2=Genuis|first2=Mark L.|last3=Violato|first3=Claudio|title=A Meta-Analysis of the Published Research on the Effects of Child Sexual Abuse|journal=The Journal of Psychology|date=January 2001|volume=135|issue=1|pages=17–36|doi=10.1080/00223980109603677}}</ref> *Children with higher exposure to trauma, less social support, and other major life events are more likely to have continued PTSD symptoms 7 months after a trauma.<ref name=":2">{{cite journal |last1=La Greca|first1=A|last2=Silverman|first2=WK|last3=Vernberg|first3=EM|last4=Prinstein|first4=MJ|title=Symptoms of posttraumatic stress in children after Hurricane Andrew: a prospective study.|journal=Journal of consulting and clinical psychology|date=August 1996|volume=64|issue=4|pages=712-23|pmid=8803361}}</ref> 10 months after a trauma, however, only experience of a major life event remained predictive of continuing PTSD symptoms.<ref name=":2" /> *Lack of social support, specifically lack of support by a teacher, was predictive of higher PTSD symptoms among children who had gone through an environmental trauma.<ref name=":2" /> *Children who reported using blame and anger as strategies for coping had higher levels of PTSD symptoms 10 months after a trauma.<ref name=":2" /> *Negative affect in children before a traumatic event was predictive of development of PTSD symptoms after a traumatic event.<ref>{{cite journal|last1=Weems|first1=CF|last2=Pina|first2=AA|last3=Costa|first3=NM|last4=Watts|first4=SE|last5=Taylor|first5=LK|last6=Cannon|first6=MF|title=Predisaster trait anxiety and negative affect predict posttraumatic stress in youths after hurricane Katrina.|journal=Journal of consulting and clinical psychology|date=February 2007|volume=75|issue=1|pages=154-9|doi=10.1037/0022-006X.75.1.154|pmid=17295574}}</ref> [[wikipedia:Posttraumatic_stress_disorder|Posttraumatic stress disorder]] is now more sensitive to development in that diagnostic thresholds have been lowered for children and adolescents. Furthermore, separate and additional criteria have been added for children age 6 years of age or younger. {{collapse bottom}} === Base rates of PTSD in different clinical settings and populations === This section describes the demographic settings of the populations sampled, base rates of PTSD diagnoses, country/region sampled, and the diagnostic methods that were used. Using this information, clinicians will be able to anchor the most appropriate rate of PTSD that they are likely to see in their clinical practice. * '''''To see prevalence rates across multiple disorders,''''' [[Evidence based assessment/Preparation phase#Base rates for transdiagnostic comparison|'''''click here.''''']] {| class="wikitable sortable" border="1" |- ! Demography ! Setting ! Base Rate ! Diagnostic Method |- | United States, nationally representative, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Kessler|first=Ronald C.|last2=Berglund|first2=Patricia|last3=Demler|first3=Olga|last4=Jin|first4=Robert|last5=Merikangas|first5=Kathleen R.|last6=Walters|first6=Ellen E.|date=2005-06-01|title=Lifetime Prevalence and Age-of-Onset Distributions of DSM-IV Disorders in the National Comorbidity Survey Replication|url=http://archpsyc.jamanetwork.com/article.aspx?doi=10.1001/archpsyc.62.6.593|journal=Archives of General Psychiatry|language=en|volume=62|issue=6|doi=10.1001/archpsyc.62.6.593|issn=0003-990X}}</ref> | 6.8% | National Comorbidity Survey - Replication |- | Netherlands, nationally representative, age 18-80 | Non-clinical: Population based<ref>{{Cite journal|last=de Vries|first=Giel-Jan|last2=Olff|first2=Miranda|date=2009-08-01|title=The lifetime prevalence of traumatic events and posttraumatic stress disorder in the Netherlands|url=http://onlinelibrary.wiley.com/doi/10.1002/jts.20429/abstract|journal=Journal of Traumatic Stress|language=en|volume=22|issue=4|pages=259–267|doi=10.1002/jts.20429|issn=1573-6598}}</ref> | 7.4% | Composite International Diagnostic Interview (CIDI) |- | United States, nationally representative, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Pietrzak|first=Robert H.|last2=Goldstein|first2=Risë B.|last3=Southwick|first3=Steven M.|last4=Grant|first4=Bridget F.|title=Prevalence and Axis I comorbidity of full and partial posttraumatic stress disorder in the United States: Results from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions|url=http://linkinghub.elsevier.com/retrieve/pii/S0887618510002288|journal=Journal of Anxiety Disorders|volume=25|issue=3|pages=456–465|doi=10.1016/j.janxdis.2010.11.010}}</ref> | 6.4% | Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions |- | Northern Ireland, representative sample, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Bunting|first=Brendan P.|last2=Ferry|first2=Finola R.|last3=Murphy|first3=Samuel D.|last4=O'Neill|first4=Siobhan M.|last5=Bolton|first5=David|date=2013-02-01|title=Trauma Associated With Civil Conflict and Posttraumatic Stress Disorder: Evidence From the Northern Ireland Study of Health and Stress|url=http://onlinelibrary.wiley.com/doi/10.1002/jts.21766/abstract|journal=Journal of Traumatic Stress|language=en|volume=26|issue=1|pages=134–141|doi=10.1002/jts.21766|issn=1573-6598}}</ref> | 8.8% | Northern Ireland Study of Health and Stress |- | South Africa, nationally representative sample, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Atwoli|first=Lukoye|last2=Stein|first2=Dan J.|last3=Williams|first3=David R.|last4=Mclaughlin|first4=Katie A.|last5=Petukhova|first5=Maria|last6=Kessler|first6=Ronald C.|last7=Koenen|first7=Karestan C.|date=2013-07-03|title=Trauma and posttraumatic stress disorder in South Africa: analysis from the South African Stress and Health Study|url=https://doi.org/10.1186/1471-244X-13-182|journal=BMC Psychiatry|volume=13|pages=182|doi=10.1186/1471-244x-13-182|issn=1471-244X}}</ref> | 2.3% | South African Stress and Health Study, using the Composite International Diagnostic Interview (CIDI) |- | U.S. Army and Marine Soldiers Deployed to Iraq and Afghanistan | U.S. Service Members<ref>{{Cite journal|last=Hoge|first=Charles W.|last2=Castro|first2=Carl A.|last3=Messer|first3=Stephen C.|last4=McGurk|first4=Dennis|last5=Cotting|first5=Dave I.|last6=Koffman|first6=Robert L.|date=2004-07-01|title=Combat Duty in Iraq and Afghanistan, Mental Health Problems, and Barriers to Care|url=http://dx.doi.org/10.1056/NEJMoa040603|journal=New England Journal of Medicine|volume=351|issue=1|pages=13–22|doi=10.1056/nejmoa040603|issn=0028-4793|pmid=15229303}}</ref> |11.5% - 19.5% ♦ | PTSD Checklist |- |United States, nationally representative, ages 13-18 |Non-clinical: Population based<ref>{{Cite journal|last=Merikangas|first=Kathleen Ries|last2=He|first2=Jian-ping|last3=Burstein|first3=Marcy|last4=Swanson|first4=Sonja A.|last5=Avenevoli|first5=Shelli|last6=Cui|first6=Lihong|last7=Benjet|first7=Corina|last8=Georgiades|first8=Katholiki|last9=Swendsen|first9=Joel|title=Lifetime Prevalence of Mental Disorders in U.S. Adolescents: Results from the National Comorbidity Survey Replication–Adolescent Supplement (NCS-A)|url=https://doi.org/10.1016/j.jaac.2010.05.017|journal=Journal of the American Academy of Child & Adolescent Psychiatry|volume=49|issue=10|pages=980–989|doi=10.1016/j.jaac.2010.05.017}}</ref> |5.0% |National Comorbidity Survey Replication—Adolescent Supplement (NCS-A) |} ♦ '''Note''': These rates were using broad PTSD Checklist scoring criteria of being scored positive if subjects reported at least one intrusion symptom, three avoidance symptoms, and two hyperarousal symptom that were categorized as at the moderate level. The 11.5% is for soldiers returning from deployment in Iraq, 19.5% is for soldiers returning from Afghanistan. Another common practice is to use a strict cutoff of 50 on the PCL, above which someone screens positive for PTSD. With this cutoff, rates are 6.2% and 12.9% for Service Members returned from Afghanistan and Iraqi, respectively. ==[[Evidence based assessment/Prediction phase|'''Prediction phase''']]== === Psychometric properties of screening for PTSD === The following section contains a list of screening and diagnostic instruments for PTSD. The section includes administration information, psychometric data, and PDFs or links to the screenings. * Screenings are used as part of the [[Evidence based assessment/Prediction phase|prediction phase]] of assessment; for more information on interpretation of this data, or how screenings fit in to the assessment process, click [[Evidence based assessment/Prediction phase|here.]] * '''''For a list of more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Psychometric_properties_of_common_screening_instruments click here.]''''' {| class="wikitable" |- ! Measure !Format (Reporter) !Age Range !Administration/ Completion Time !Where to Access |- |[https://www.ptsd.va.gov/professional/assessment/adult-sr/ptsd-checklist.asp PCL-5 (PTSD Checklist for DSM-5)] |Self-Report |adult |5-10 minutes |[https://www.ptsd.va.gov/professional/assessment/documents/PCL5_Standard_form.PDFPDF PDF] |- |PDS (Post-traumatic Diagnosis Scale) |Self-Report |adult |10-20 minutes | |- | colspan="4" style="font-size:110%; text-align:center;" |'''For Children and Adolescents Specifically''' | |- |[https://www.reactionindex.com/index.php/ UCLA PTSD Reaction Index for DSM-5] |Clinician Administered |child, school age, adolescents |20-30 minutes | |- |[https://www.aacap.org/App_Themes/AACAP/docs/resource_centers/resources/misc/child_ptsd_symptom_scale.pdf CPSS (Children's PTSD Symptom Scale)] |Self-Report |child |10-20 minutes | |- |[https://medicine.tulane.edu/infant-institute Young Child PTSD Checklist (YCPC)] |Parent Report |child |13 items | |} '''Note:''' '''L''' = Less than adequate; '''A''' = Adequate; '''G''' = Good; '''E''' = Excellent; '''U''' = Unavailable; '''NA''' = Not applicable === Interpreting PTSD screening measure scores === * For information on interpreting screening measure scores, click [[Evidence based assessment/Prediction phase#Interpreting screening measure scores|here.]] * Also see the page on [https://en.wikipedia.org/wiki/Likelihood_ratios_in_diagnostic_testing likelihood ratios in diagnostic testing] for more information ==[[Evidence based assessment/Prescription phase|'''Prescription phase''']]== ===Gold standard diagnostic interviews=== * For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews click here.] ===Recommended diagnostic interviews for PTSD=== {| class="wikitable sortable" border="1" ! colspan="4" |Diagnostic instruments for PTSD |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time |- | [https://www.ptsd.va.gov/professional/assessment/adult-int/caps.asp CAPS-5 (Clinician Administered PTSD Scale)] | Clinician Administered Interview | adult | 40-60 minutes |- |PTSD Symptom Scale Interview (PSS-I-5) |Clinician Administered Interview |adult and child version available |24 items |- | colspan="4" style="font-size:110%; text-align:center;" |'''For Children and Adolescents Specifically''' |- | [https://www.ptsd.va.gov/professional/assessment/child/caps-ca.asp CAPS-CA-5 (Clinician-Administered PTSD Scale for DSM-5 - Child/Adolescent Version)] |Clinician Administered Interview |child |30 items |- | Children’s PTSD Inventory (CPTSD-I) |Diagnostic Interview | 6-18 years | 50 items |} '''Note:''' '''L''' = Less than adequate; '''A''' = Adequate; '''G''' = Good; '''E''' = Excellent; '''U''' = Unavailable; '''NA''' = Not applicable ===Severity interviews for PTSD=== {| class="wikitable sortable" border="1" |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time |- | [https://www.kennedykrieger.org/sites/default/files/library/documents/faculty/ksads-dsm-5-screener.pdf Schedule for Affective Disorders and Schizophrenia for School Age Children (K-SADS)] | Diagnostic Interview | 6-18 years | 18 PTSD items |- | Anxiety Disorders Interview Schedule, Child Version (ADIS-C) | Diagnostic Interview | 7-17 years | 26 PTSD items |- | Children’s Interview for Psychiatric Symptoms (ChIPS) |Diagnostic Interview |6 – 18 years |31 PTSD items |- | Diagnostic Infant and Preschool Assessment (DIPA) |Diagnostic Interview | Age 6 and younger | 46 PTSD items |} '''Note:''' '''L''' = Less than adequate; '''A''' = Adequate; '''G''' = Good; '''E''' = Excellent; '''U''' = Unavailable; '''NA''' = Not applicable ==[[Evidence based assessment/Process phase|'''Process phase''']]== The following section contains a brief overview of treatment options for PTSD and list of process and outcome measures for PTSD. The section includes benchmarks based on published norms for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the [[Evidence based assessment/Process phase|process phase]] of assessment. For more information of differences between process and outcome measures, see the page on the [[Evidence based assessment/Process phase|process phase of assessment]]. === Process measures === * Information coming soon === Outcome and severity measures === This table includes clinically significant benchmarks for PTSD specific outcome measures * Information on how to interpret this table can be [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase found here]. * Additionally, these [[Evidence based assessment/Vignettes|vignettes]] might be helpful resources for understanding appropriate adaptation of outcome measures in practice. * ''<u>For clinically significant change benchmarks for the CBCL, YSR, and TRF total, externalizing, internalizing, and attention benchmarks,</u>'' [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase&wteswitched=1#Clinically_significant_change_benchmarks_for_widely-used_outcome_measures see here.] {| class="wikitable sortable" border="1" | colspan="7" |'''Clinically significant change benchmarks with common instruments for PTSD''' |- | colspan="7" style="font-size:110%; text-align:center;" span |<b> Benchmarks Based on Published Norms</b> |- | rowspan="2" style="text-align:center;font-size:130%;" |<b> Measure</b> | colspan="3" style="text-align:center;font-size:130%" width="300" |<b> Cut-off scores</b> | colspan="3" style="text-align:center;font-size:120%" |<b> Critical Change <br> (unstandardized scores)</b> |- | style="text-align:center;font-size:110%" |<b> A</b> | style="text-align:center;font-size:110%" |<b> B</b> | style="text-align:center;font-size:110%" |<b> C</b> | style="text-align:center;font-size:110%" |<b> 95%</b> | style="text-align:center;font-size:110%" |<b> 90%</b> | style="text-align:center;font-size:110%" |<b> SE_difference</b> |- | rowspan="1" style="text-align:center;" | Primary Care PTSD Screen | style="text-align:center;" | 1.0 | style="text-align:center;" | 3.1 | style="text-align:center;" | 2.0 | style="text-align:center;" | 1.0 | style="text-align:center;" | .8 | style="text-align:center;" | .5 |- | rowspan="1" style="text-align:center;" | PTSD Checklist Scores | style="text-align:center;" | 28.8 | style="text-align:center;" | 40.8 | style="text-align:center;" | 34.9 | style="text-align:center;" | 4.6 | style="text-align:center;" | 3.8 | style="text-align:center;" | 2.3 |- | rowspan="1" style="text-align:center;" | Clinician Administered PTSD Scale | style="text-align:center;" | 28.8 | style="text-align:center;" | 40.8 | style="text-align:center;" | 34.9 | style="text-align:center;" | 8.3 | style="text-align:center;" | 7.0 | style="text-align:center;" | 4.2 |} === Treatment === * Please refer to the Wikipedia page on [[wikipedia:Posttraumatic_stress_disorder|PTSD]] for more information on available treatment for PTSD or go to the [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/post-traumatic-stress-disorder/ Effective Child Therapy] page for for a curated resource on effective treatments for PTSD. {{collapse top| Click here for more information}} '''<big>Behavioral interventions</big>''' Recommended (have ''significant benefit'') <ref name=":0">Department of Veterans Affairs and Department of Defense. . (2010). VA/DoD clinical practice guidelines: management of post-traumatic stress. Washington, D.C.: Veterans Health Administration, Department of Defense.</ref>: # Brief Cognitive Behavioral Therapy (CBT; 4-5 sessions) #* This includes stress inoculation training, trauma-focused therapy including components of cognitive restructuring, Cognitive Processing Therapy (CPT), imaginal, virtual, and in-vivo exposure as in Prolonged Exposure psychotherapy (PE)² #* Patient education is recommended as part of psychotherapy for patients and family members # EMDR may help both acute and chronic PTSD, especially individuals who have trouble with prolonged exposure or have trouble verbalizing their trauma.<ref name=":1">Ursano, R. J., Bell, C., Eth, S., Friedman, M., Norwood, A., Pfefferbaum, B., . . . McIntyre, J. S. (2004). ''Practice guideline for the treatment of patients with acute stress disorder and posttraumatic stress disorder'': American Psychiatric Publ </ref> ## Long term gains require further study. # [https://www.ptsd.va.gov/professional/treat/txessentials/present_centered_therapy.asp Present-Centered Therapy (PCT)] is a non trauma focused treatment for PTSD and a second-line treatment for PTSD<ref>{{Cite web|url=https://www.ptsd.va.gov/professional/treat/txessentials/present_centered_therapy.asp|title=Present-Centered Therapy for PTSD - PTSD: National Center for PTSD|website=www.ptsd.va.gov|language=en|access-date=2022-08-13}}</ref>. Treatments with weaker evidence (have ''some benefit'') <ref name=":0" />: # Patient education, # Imagery rehearsal therapy, # Psychodynamic therapy, # Hypnosis, # Relaxation techniques, # and Group therapy. Treatment with ''unknown benefit'' <ref name=":0" />: # Web-based CBT ## For example Jeane Bosch participated as a study therapist in research study that compared STAIR and present-centered therapy both delivered via telehealth. STAIR stands for Skills Training in Affective and Interpersonal Regulation. It is a skill-focused treatment that was originally developed for survivors of childhood abuse to teach emotion regulation skills as well as tools to help with challenges interpersonal functioning and social relationships and decrease PTSD symptoms<ref>{{Cite web|url=https://istss.org/public-resources/trauma-blog/2015-march-(1)/clinician-s-corner-skills-training-in-affective-an|title=ISTSS - Trauma Blog|website=istss.org|access-date=2022-08-13}}</ref>.<ref>{{Citation|title=Introduction to Telehealth with Dr. Bosch|url=https://www.youtube.com/watch?v=Wn6Vewl42X8|accessdate=2022-08-13|language=en}}</ref> # Acceptance and commitment therapy, # and Dialectical Behavioral Therapy. <big>'''Medication'''</big> *SSRIs are more effective than placebo in treating PTSD.<ref name=":1" /> *There is no evidence to support a medication to prevent the development of PTSD.<ref name=":0" /> **Imipramine, propranolol, prazosin, other antidepressants, anticonvulsants, and atypical antipsychotics have ''unknown benefit.'' **Strongly recommend against the use of benzodiazepines² and typical antipsychotics since they have ''no benefit and potential harm.'' {{collapse bottom}} == '''External resources''' == === For professionals === * [http://www.som.uq.edu.au/ptsd Post Traumatic Stress Disorder Information Resource] from [http://www.uq.edu.au/ The University of Queensland School of Medicine] * [http://www.apa.org/ptsd-guideline/ APA practice parameters for assessment and treatment for PTSD (Updated 2017)] * [http://www.ptsd.va.gov/professional/index.asp Resources for professionals] from [http://www.ptsd.va.gov/index.asp VA National PTSD Center] * [https://www.integration.samhsa.gov/clinical-practice/trauma-informed SAMHSA's Trauma-Informed Care Resources and Training] * [https://www.integration.samhsa.gov/clinical-practice/trauma-informed SAMHSA's Resources on Intimate Partner Violence (IPV) for Clinicians, Patients, Families, and Organizations] === For caregivers === * [http://www.nctsn.org/sites/default/files/assets/pdfs/tips_for_parents_media_final.pdf Tips for parents on shooting media coverage] * [http://www.nctsn.org/sites/default/files/assets/pdfs/parents_guidelines_for_helping_teens_after_the_recent_attacks.pdf Parent guidelines to helping youths after a shooting] * [http://www.nctsn.org/sites/default/files/assets/pdfs/helping_teens_with_traumatic_grief_caregivers_final.pdf Caregiver tips for helping teens with traumatic grief] * [http://www.nctsn.org/sites/default/files/assets/pdfs/10things_schoolage_ctg.pdf Caregiver tips for helping school-age children with traumatic grief] *[http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/post-traumatic-stress-disorder/ EffectiveChildTherapy.Org information on PTSD] *[https://sccap53.org Society of Clinical Child and Adolescent Psychology] === For educators === * [http://www.nctsn.org/sites/default/files/assets/pdfs/pfa_for_schools_appendix_a_teachers.pdf Teacher tips for providing psychological first aid] * [http://www.nctsn.org/sites/default/files/assets/pdfs/helping_youth_after_community_violence_educators.pdf Educator tips for helping youths after a community trauma] === For public === * [https://complicatedgrief.columbia.edu/for-the-public/resources/ Resources for grief and loss] * [http://www.nctsn.org/sites/default/files/assets/pdfs/psychological_information_sheet_two_pager.pdf Psychological impacts of recent shootings] * [http://www.nctsn.org/sites/default/files/assets/pdfs/youth_journalists.pdf Tips to talking to youths about a shooting] * [http://www.nctsn.org/sites/default/files/assets/pdfs/talking_to_children_about_the_shooting.pdf Tips to talking to children about a shooting] * [http://www.nctsn.org/sites/default/files/assets/pdfs/helping_young_children_heal_crisis.pdf Helping young children heal after a crisis] * [http://www.nctsn.org/content/psychological-first-aid-schoolspfa Psychological first aid for schools] * [http://www.nctsn.org/content/psychological-first-aid Resources and manuals on psychological first aid] * [http://www.ptsd.va.gov/public/index.asp Resources for the public] from [http://www.ptsd.va.gov/index.asp VA National PTSD Center] * [https://curlie.org/Health/Mental_Health/Disorders/Anxiety/Post-traumatic_Stress Posttraumatic stress disorder] at Curlie (based on DMOZ) =='''References'''== {{collapse top|Click here for references}} {{Reflist|30em}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] {{collapse bottom}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] h68w8ai6a95s1v78y4f5qdgq5nxqxom 2419108 2419107 2022-08-25T23:02:43Z Ardenguo 2944162 /* Psychometric properties of screening for PTSD */ added measures wikitext text/x-wiki <noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{medical disclaimer}} {{:{{BASEPAGENAME}}/Sidebar}} ==[[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio"?''']]== * For background information on what assessment portfolios are, click the link in the heading above. * Want even 'more' information about this topic? There's an extended version of this page [[Evidence-based assessment/Posttraumatic stress disorder (disorder portfolio)/extended version|'''here''']]. == [[Evidence based assessment/Preparation phase|'''Preparation phase''']] == === Diagnostic criteria for post traumatic stress disorder === ===='''ICD-11 Diagnostic Criteria'''==== {{blockquotetop}} ===='''ICD-11 Criteria'''==== *Post-traumatic stress disorder (PTSD) is a syndrome that develops following exposure to an extremely threatening or horrific event or series of events that is characterized by all of the following: **1) re-experiencing the traumatic event or events in the present in the form of vivid intrusive memories, flashbacks, or nightmares, which are typically accompanied by strong and overwhelming emotions such as fear or horror and strong physical sensations, or feelings of being overwhelmed or immersed in the same intense emotions that were experienced during the traumatic event; **2) avoidance of thoughts and memories of the event or events, or avoidance of activities, situations, or people reminiscent of the event or events **3) persistent perceptions of heightened current threat, for example as indicated by hypervigilance or an enhanced startle reaction to stimuli such as unexpected noises. *The symptoms must persist for at least several weeks and cause significant impairment in personal, family, social, educational, occupational or other important areas of functioning. Additionally, ICD 11 includes a category called "Complex post-traumatic stress disorder," which is described as: *A disorder that may develop following exposure to an event or series of events of an extremely threatening or horrific nature, most commonly prolonged or repetitive events from which escape is difficult or impossible (e.g., torture, slavery, genocide campaigns, prolonged domestic violence, repeated childhood sexual or physical abuse). *The disorder is characterized by the core symptoms of PTSD; that is, all diagnostic requirements for PTSD have been met at some point during the course of the disorder. *In addition, Complex PTSD is characterized by: **1) severe and pervasive problems in affect regulation; **2) persistent beliefs about oneself as diminished, defeated or worthless, accompanied by deep and pervasive feelings of shame, guilt or failure related to the traumatic event **3) persistent difficulties in sustaining relationships and in feeling close to others. The disturbance causes significant impairment in personal, family, social, educational, occupational or other important areas of functioning. {{blockquotebottom}} ===='''Changes in DSM-5'''==== * The diagnostic criteria for post-traumatic stress disorder changed slightly from [[DSM-IV]] to [[w:Diagnostic_and_Statistical_Manual_of_Mental_Disorders#DSM-IV-TR_.282000.29|DSM-5]]. Summaries are available [http://www.dsm5.org/Documents/changes%20from%20dsm-iv-tr%20to%20dsm-5.pdf here] and [[w:DSM-5|here]]. === Developmental sensitivities === {{collapse top| Click for more information}} *Diagnostic thresholds have been lowered for children and adolescents to account for development. *Separate and additional criteria have been added for children age 6 or younger. *Child sexual abuse has been found to have a substantial effect on the development of PTSD.<ref>{{cite journal|last1=Paolucci|first1=Elizabeth ODDONE|last2=Genuis|first2=Mark L.|last3=Violato|first3=Claudio|title=A Meta-Analysis of the Published Research on the Effects of Child Sexual Abuse|journal=The Journal of Psychology|date=January 2001|volume=135|issue=1|pages=17–36|doi=10.1080/00223980109603677}}</ref> *Children with higher exposure to trauma, less social support, and other major life events are more likely to have continued PTSD symptoms 7 months after a trauma.<ref name=":2">{{cite journal |last1=La Greca|first1=A|last2=Silverman|first2=WK|last3=Vernberg|first3=EM|last4=Prinstein|first4=MJ|title=Symptoms of posttraumatic stress in children after Hurricane Andrew: a prospective study.|journal=Journal of consulting and clinical psychology|date=August 1996|volume=64|issue=4|pages=712-23|pmid=8803361}}</ref> 10 months after a trauma, however, only experience of a major life event remained predictive of continuing PTSD symptoms.<ref name=":2" /> *Lack of social support, specifically lack of support by a teacher, was predictive of higher PTSD symptoms among children who had gone through an environmental trauma.<ref name=":2" /> *Children who reported using blame and anger as strategies for coping had higher levels of PTSD symptoms 10 months after a trauma.<ref name=":2" /> *Negative affect in children before a traumatic event was predictive of development of PTSD symptoms after a traumatic event.<ref>{{cite journal|last1=Weems|first1=CF|last2=Pina|first2=AA|last3=Costa|first3=NM|last4=Watts|first4=SE|last5=Taylor|first5=LK|last6=Cannon|first6=MF|title=Predisaster trait anxiety and negative affect predict posttraumatic stress in youths after hurricane Katrina.|journal=Journal of consulting and clinical psychology|date=February 2007|volume=75|issue=1|pages=154-9|doi=10.1037/0022-006X.75.1.154|pmid=17295574}}</ref> [[wikipedia:Posttraumatic_stress_disorder|Posttraumatic stress disorder]] is now more sensitive to development in that diagnostic thresholds have been lowered for children and adolescents. Furthermore, separate and additional criteria have been added for children age 6 years of age or younger. {{collapse bottom}} === Base rates of PTSD in different clinical settings and populations === This section describes the demographic settings of the populations sampled, base rates of PTSD diagnoses, country/region sampled, and the diagnostic methods that were used. Using this information, clinicians will be able to anchor the most appropriate rate of PTSD that they are likely to see in their clinical practice. * '''''To see prevalence rates across multiple disorders,''''' [[Evidence based assessment/Preparation phase#Base rates for transdiagnostic comparison|'''''click here.''''']] {| class="wikitable sortable" border="1" |- ! Demography ! Setting ! Base Rate ! Diagnostic Method |- | United States, nationally representative, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Kessler|first=Ronald C.|last2=Berglund|first2=Patricia|last3=Demler|first3=Olga|last4=Jin|first4=Robert|last5=Merikangas|first5=Kathleen R.|last6=Walters|first6=Ellen E.|date=2005-06-01|title=Lifetime Prevalence and Age-of-Onset Distributions of DSM-IV Disorders in the National Comorbidity Survey Replication|url=http://archpsyc.jamanetwork.com/article.aspx?doi=10.1001/archpsyc.62.6.593|journal=Archives of General Psychiatry|language=en|volume=62|issue=6|doi=10.1001/archpsyc.62.6.593|issn=0003-990X}}</ref> | 6.8% | National Comorbidity Survey - Replication |- | Netherlands, nationally representative, age 18-80 | Non-clinical: Population based<ref>{{Cite journal|last=de Vries|first=Giel-Jan|last2=Olff|first2=Miranda|date=2009-08-01|title=The lifetime prevalence of traumatic events and posttraumatic stress disorder in the Netherlands|url=http://onlinelibrary.wiley.com/doi/10.1002/jts.20429/abstract|journal=Journal of Traumatic Stress|language=en|volume=22|issue=4|pages=259–267|doi=10.1002/jts.20429|issn=1573-6598}}</ref> | 7.4% | Composite International Diagnostic Interview (CIDI) |- | United States, nationally representative, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Pietrzak|first=Robert H.|last2=Goldstein|first2=Risë B.|last3=Southwick|first3=Steven M.|last4=Grant|first4=Bridget F.|title=Prevalence and Axis I comorbidity of full and partial posttraumatic stress disorder in the United States: Results from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions|url=http://linkinghub.elsevier.com/retrieve/pii/S0887618510002288|journal=Journal of Anxiety Disorders|volume=25|issue=3|pages=456–465|doi=10.1016/j.janxdis.2010.11.010}}</ref> | 6.4% | Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions |- | Northern Ireland, representative sample, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Bunting|first=Brendan P.|last2=Ferry|first2=Finola R.|last3=Murphy|first3=Samuel D.|last4=O'Neill|first4=Siobhan M.|last5=Bolton|first5=David|date=2013-02-01|title=Trauma Associated With Civil Conflict and Posttraumatic Stress Disorder: Evidence From the Northern Ireland Study of Health and Stress|url=http://onlinelibrary.wiley.com/doi/10.1002/jts.21766/abstract|journal=Journal of Traumatic Stress|language=en|volume=26|issue=1|pages=134–141|doi=10.1002/jts.21766|issn=1573-6598}}</ref> | 8.8% | Northern Ireland Study of Health and Stress |- | South Africa, nationally representative sample, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Atwoli|first=Lukoye|last2=Stein|first2=Dan J.|last3=Williams|first3=David R.|last4=Mclaughlin|first4=Katie A.|last5=Petukhova|first5=Maria|last6=Kessler|first6=Ronald C.|last7=Koenen|first7=Karestan C.|date=2013-07-03|title=Trauma and posttraumatic stress disorder in South Africa: analysis from the South African Stress and Health Study|url=https://doi.org/10.1186/1471-244X-13-182|journal=BMC Psychiatry|volume=13|pages=182|doi=10.1186/1471-244x-13-182|issn=1471-244X}}</ref> | 2.3% | South African Stress and Health Study, using the Composite International Diagnostic Interview (CIDI) |- | U.S. Army and Marine Soldiers Deployed to Iraq and Afghanistan | U.S. Service Members<ref>{{Cite journal|last=Hoge|first=Charles W.|last2=Castro|first2=Carl A.|last3=Messer|first3=Stephen C.|last4=McGurk|first4=Dennis|last5=Cotting|first5=Dave I.|last6=Koffman|first6=Robert L.|date=2004-07-01|title=Combat Duty in Iraq and Afghanistan, Mental Health Problems, and Barriers to Care|url=http://dx.doi.org/10.1056/NEJMoa040603|journal=New England Journal of Medicine|volume=351|issue=1|pages=13–22|doi=10.1056/nejmoa040603|issn=0028-4793|pmid=15229303}}</ref> |11.5% - 19.5% ♦ | PTSD Checklist |- |United States, nationally representative, ages 13-18 |Non-clinical: Population based<ref>{{Cite journal|last=Merikangas|first=Kathleen Ries|last2=He|first2=Jian-ping|last3=Burstein|first3=Marcy|last4=Swanson|first4=Sonja A.|last5=Avenevoli|first5=Shelli|last6=Cui|first6=Lihong|last7=Benjet|first7=Corina|last8=Georgiades|first8=Katholiki|last9=Swendsen|first9=Joel|title=Lifetime Prevalence of Mental Disorders in U.S. Adolescents: Results from the National Comorbidity Survey Replication–Adolescent Supplement (NCS-A)|url=https://doi.org/10.1016/j.jaac.2010.05.017|journal=Journal of the American Academy of Child & Adolescent Psychiatry|volume=49|issue=10|pages=980–989|doi=10.1016/j.jaac.2010.05.017}}</ref> |5.0% |National Comorbidity Survey Replication—Adolescent Supplement (NCS-A) |} ♦ '''Note''': These rates were using broad PTSD Checklist scoring criteria of being scored positive if subjects reported at least one intrusion symptom, three avoidance symptoms, and two hyperarousal symptom that were categorized as at the moderate level. The 11.5% is for soldiers returning from deployment in Iraq, 19.5% is for soldiers returning from Afghanistan. Another common practice is to use a strict cutoff of 50 on the PCL, above which someone screens positive for PTSD. With this cutoff, rates are 6.2% and 12.9% for Service Members returned from Afghanistan and Iraqi, respectively. ==[[Evidence based assessment/Prediction phase|'''Prediction phase''']]== === Psychometric properties of screening for PTSD === The following section contains a list of screening and diagnostic instruments for PTSD. The section includes administration information, psychometric data, and PDFs or links to the screenings. * Screenings are used as part of the [[Evidence based assessment/Prediction phase|prediction phase]] of assessment; for more information on interpretation of this data, or how screenings fit in to the assessment process, click [[Evidence based assessment/Prediction phase|here.]] * '''''For a list of more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Psychometric_properties_of_common_screening_instruments click here.]''''' {| class="wikitable" |- ! Measure !Format (Reporter) !Age Range !Administration/ Completion Time !Where to Access |- |[https://www.ptsd.va.gov/professional/assessment/adult-sr/ptsd-checklist.asp PCL-5 (PTSD Checklist for DSM-5)] |Self-Report |adult |5-10 minutes |[https://www.ptsd.va.gov/professional/assessment/documents/PCL5_Standard_form.PDFPDF PDF] |- |PDS (Post-traumatic Diagnosis Scale) |Self-Report |adult |10-20 minutes | |- | colspan="4" style="font-size:110%; text-align:center;" |'''For Children and Adolescents Specifically''' | |- |[https://www.reactionindex.com/index.php/ UCLA PTSD Reaction Index for DSM-5] |Clinician Administered |child, school age, adolescents |20-30 minutes |[https://www.dellchildrens.net/wp-content/uploads/sites/60/2019/08/UCLA-PTSD-RI-DSM-5.pdf PDF] |- |CPSS (Children's PTSD Symptom Scale) |Self-Report |child |10-20 minutes |[https://www.aacap.org/App_Themes/AACAP/docs/resource_centers/resources/misc/child_ptsd_symptom_scale.pdf PDF] |- |[https://medicine.tulane.edu/infant-institute Young Child PTSD Checklist (YCPC)] |Parent Report |child |13 items | |} '''Note:''' '''L''' = Less than adequate; '''A''' = Adequate; '''G''' = Good; '''E''' = Excellent; '''U''' = Unavailable; '''NA''' = Not applicable === Interpreting PTSD screening measure scores === * For information on interpreting screening measure scores, click [[Evidence based assessment/Prediction phase#Interpreting screening measure scores|here.]] * Also see the page on [https://en.wikipedia.org/wiki/Likelihood_ratios_in_diagnostic_testing likelihood ratios in diagnostic testing] for more information ==[[Evidence based assessment/Prescription phase|'''Prescription phase''']]== ===Gold standard diagnostic interviews=== * For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews click here.] ===Recommended diagnostic interviews for PTSD=== {| class="wikitable sortable" border="1" ! colspan="4" |Diagnostic instruments for PTSD |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time |- | [https://www.ptsd.va.gov/professional/assessment/adult-int/caps.asp CAPS-5 (Clinician Administered PTSD Scale)] | Clinician Administered Interview | adult | 40-60 minutes |- |PTSD Symptom Scale Interview (PSS-I-5) |Clinician Administered Interview |adult and child version available |24 items |- | colspan="4" style="font-size:110%; text-align:center;" |'''For Children and Adolescents Specifically''' |- | [https://www.ptsd.va.gov/professional/assessment/child/caps-ca.asp CAPS-CA-5 (Clinician-Administered PTSD Scale for DSM-5 - Child/Adolescent Version)] |Clinician Administered Interview |child |30 items |- | Children’s PTSD Inventory (CPTSD-I) |Diagnostic Interview | 6-18 years | 50 items |} '''Note:''' '''L''' = Less than adequate; '''A''' = Adequate; '''G''' = Good; '''E''' = Excellent; '''U''' = Unavailable; '''NA''' = Not applicable ===Severity interviews for PTSD=== {| class="wikitable sortable" border="1" |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time |- | [https://www.kennedykrieger.org/sites/default/files/library/documents/faculty/ksads-dsm-5-screener.pdf Schedule for Affective Disorders and Schizophrenia for School Age Children (K-SADS)] | Diagnostic Interview | 6-18 years | 18 PTSD items |- | Anxiety Disorders Interview Schedule, Child Version (ADIS-C) | Diagnostic Interview | 7-17 years | 26 PTSD items |- | Children’s Interview for Psychiatric Symptoms (ChIPS) |Diagnostic Interview |6 – 18 years |31 PTSD items |- | Diagnostic Infant and Preschool Assessment (DIPA) |Diagnostic Interview | Age 6 and younger | 46 PTSD items |} '''Note:''' '''L''' = Less than adequate; '''A''' = Adequate; '''G''' = Good; '''E''' = Excellent; '''U''' = Unavailable; '''NA''' = Not applicable ==[[Evidence based assessment/Process phase|'''Process phase''']]== The following section contains a brief overview of treatment options for PTSD and list of process and outcome measures for PTSD. The section includes benchmarks based on published norms for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the [[Evidence based assessment/Process phase|process phase]] of assessment. For more information of differences between process and outcome measures, see the page on the [[Evidence based assessment/Process phase|process phase of assessment]]. === Process measures === * Information coming soon === Outcome and severity measures === This table includes clinically significant benchmarks for PTSD specific outcome measures * Information on how to interpret this table can be [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase found here]. * Additionally, these [[Evidence based assessment/Vignettes|vignettes]] might be helpful resources for understanding appropriate adaptation of outcome measures in practice. * ''<u>For clinically significant change benchmarks for the CBCL, YSR, and TRF total, externalizing, internalizing, and attention benchmarks,</u>'' [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase&wteswitched=1#Clinically_significant_change_benchmarks_for_widely-used_outcome_measures see here.] {| class="wikitable sortable" border="1" | colspan="7" |'''Clinically significant change benchmarks with common instruments for PTSD''' |- | colspan="7" style="font-size:110%; text-align:center;" span |<b> Benchmarks Based on Published Norms</b> |- | rowspan="2" style="text-align:center;font-size:130%;" |<b> Measure</b> | colspan="3" style="text-align:center;font-size:130%" width="300" |<b> Cut-off scores</b> | colspan="3" style="text-align:center;font-size:120%" |<b> Critical Change <br> (unstandardized scores)</b> |- | style="text-align:center;font-size:110%" |<b> A</b> | style="text-align:center;font-size:110%" |<b> B</b> | style="text-align:center;font-size:110%" |<b> C</b> | style="text-align:center;font-size:110%" |<b> 95%</b> | style="text-align:center;font-size:110%" |<b> 90%</b> | style="text-align:center;font-size:110%" |<b> SE_difference</b> |- | rowspan="1" style="text-align:center;" | Primary Care PTSD Screen | style="text-align:center;" | 1.0 | style="text-align:center;" | 3.1 | style="text-align:center;" | 2.0 | style="text-align:center;" | 1.0 | style="text-align:center;" | .8 | style="text-align:center;" | .5 |- | rowspan="1" style="text-align:center;" | PTSD Checklist Scores | style="text-align:center;" | 28.8 | style="text-align:center;" | 40.8 | style="text-align:center;" | 34.9 | style="text-align:center;" | 4.6 | style="text-align:center;" | 3.8 | style="text-align:center;" | 2.3 |- | rowspan="1" style="text-align:center;" | Clinician Administered PTSD Scale | style="text-align:center;" | 28.8 | style="text-align:center;" | 40.8 | style="text-align:center;" | 34.9 | style="text-align:center;" | 8.3 | style="text-align:center;" | 7.0 | style="text-align:center;" | 4.2 |} === Treatment === * Please refer to the Wikipedia page on [[wikipedia:Posttraumatic_stress_disorder|PTSD]] for more information on available treatment for PTSD or go to the [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/post-traumatic-stress-disorder/ Effective Child Therapy] page for for a curated resource on effective treatments for PTSD. {{collapse top| Click here for more information}} '''<big>Behavioral interventions</big>''' Recommended (have ''significant benefit'') <ref name=":0">Department of Veterans Affairs and Department of Defense. . (2010). VA/DoD clinical practice guidelines: management of post-traumatic stress. Washington, D.C.: Veterans Health Administration, Department of Defense.</ref>: # Brief Cognitive Behavioral Therapy (CBT; 4-5 sessions) #* This includes stress inoculation training, trauma-focused therapy including components of cognitive restructuring, Cognitive Processing Therapy (CPT), imaginal, virtual, and in-vivo exposure as in Prolonged Exposure psychotherapy (PE)² #* Patient education is recommended as part of psychotherapy for patients and family members # EMDR may help both acute and chronic PTSD, especially individuals who have trouble with prolonged exposure or have trouble verbalizing their trauma.<ref name=":1">Ursano, R. J., Bell, C., Eth, S., Friedman, M., Norwood, A., Pfefferbaum, B., . . . McIntyre, J. S. (2004). ''Practice guideline for the treatment of patients with acute stress disorder and posttraumatic stress disorder'': American Psychiatric Publ </ref> ## Long term gains require further study. # [https://www.ptsd.va.gov/professional/treat/txessentials/present_centered_therapy.asp Present-Centered Therapy (PCT)] is a non trauma focused treatment for PTSD and a second-line treatment for PTSD<ref>{{Cite web|url=https://www.ptsd.va.gov/professional/treat/txessentials/present_centered_therapy.asp|title=Present-Centered Therapy for PTSD - PTSD: National Center for PTSD|website=www.ptsd.va.gov|language=en|access-date=2022-08-13}}</ref>. Treatments with weaker evidence (have ''some benefit'') <ref name=":0" />: # Patient education, # Imagery rehearsal therapy, # Psychodynamic therapy, # Hypnosis, # Relaxation techniques, # and Group therapy. Treatment with ''unknown benefit'' <ref name=":0" />: # Web-based CBT ## For example Jeane Bosch participated as a study therapist in research study that compared STAIR and present-centered therapy both delivered via telehealth. STAIR stands for Skills Training in Affective and Interpersonal Regulation. It is a skill-focused treatment that was originally developed for survivors of childhood abuse to teach emotion regulation skills as well as tools to help with challenges interpersonal functioning and social relationships and decrease PTSD symptoms<ref>{{Cite web|url=https://istss.org/public-resources/trauma-blog/2015-march-(1)/clinician-s-corner-skills-training-in-affective-an|title=ISTSS - Trauma Blog|website=istss.org|access-date=2022-08-13}}</ref>.<ref>{{Citation|title=Introduction to Telehealth with Dr. Bosch|url=https://www.youtube.com/watch?v=Wn6Vewl42X8|accessdate=2022-08-13|language=en}}</ref> # Acceptance and commitment therapy, # and Dialectical Behavioral Therapy. <big>'''Medication'''</big> *SSRIs are more effective than placebo in treating PTSD.<ref name=":1" /> *There is no evidence to support a medication to prevent the development of PTSD.<ref name=":0" /> **Imipramine, propranolol, prazosin, other antidepressants, anticonvulsants, and atypical antipsychotics have ''unknown benefit.'' **Strongly recommend against the use of benzodiazepines² and typical antipsychotics since they have ''no benefit and potential harm.'' {{collapse bottom}} == '''External resources''' == === For professionals === * [http://www.som.uq.edu.au/ptsd Post Traumatic Stress Disorder Information Resource] from [http://www.uq.edu.au/ The University of Queensland School of Medicine] * [http://www.apa.org/ptsd-guideline/ APA practice parameters for assessment and treatment for PTSD (Updated 2017)] * [http://www.ptsd.va.gov/professional/index.asp Resources for professionals] from [http://www.ptsd.va.gov/index.asp VA National PTSD Center] * [https://www.integration.samhsa.gov/clinical-practice/trauma-informed SAMHSA's Trauma-Informed Care Resources and Training] * [https://www.integration.samhsa.gov/clinical-practice/trauma-informed SAMHSA's Resources on Intimate Partner Violence (IPV) for Clinicians, Patients, Families, and Organizations] === For caregivers === * [http://www.nctsn.org/sites/default/files/assets/pdfs/tips_for_parents_media_final.pdf Tips for parents on shooting media coverage] * [http://www.nctsn.org/sites/default/files/assets/pdfs/parents_guidelines_for_helping_teens_after_the_recent_attacks.pdf Parent guidelines to helping youths after a shooting] * [http://www.nctsn.org/sites/default/files/assets/pdfs/helping_teens_with_traumatic_grief_caregivers_final.pdf Caregiver tips for helping teens with traumatic grief] * [http://www.nctsn.org/sites/default/files/assets/pdfs/10things_schoolage_ctg.pdf Caregiver tips for helping school-age children with traumatic grief] *[http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/post-traumatic-stress-disorder/ EffectiveChildTherapy.Org information on PTSD] *[https://sccap53.org Society of Clinical Child and Adolescent Psychology] === For educators === * [http://www.nctsn.org/sites/default/files/assets/pdfs/pfa_for_schools_appendix_a_teachers.pdf Teacher tips for providing psychological first aid] * [http://www.nctsn.org/sites/default/files/assets/pdfs/helping_youth_after_community_violence_educators.pdf Educator tips for helping youths after a community trauma] === For public === * [https://complicatedgrief.columbia.edu/for-the-public/resources/ Resources for grief and loss] * [http://www.nctsn.org/sites/default/files/assets/pdfs/psychological_information_sheet_two_pager.pdf Psychological impacts of recent shootings] * [http://www.nctsn.org/sites/default/files/assets/pdfs/youth_journalists.pdf Tips to talking to youths about a shooting] * [http://www.nctsn.org/sites/default/files/assets/pdfs/talking_to_children_about_the_shooting.pdf Tips to talking to children about a shooting] * [http://www.nctsn.org/sites/default/files/assets/pdfs/helping_young_children_heal_crisis.pdf Helping young children heal after a crisis] * [http://www.nctsn.org/content/psychological-first-aid-schoolspfa Psychological first aid for schools] * [http://www.nctsn.org/content/psychological-first-aid Resources and manuals on psychological first aid] * [http://www.ptsd.va.gov/public/index.asp Resources for the public] from [http://www.ptsd.va.gov/index.asp VA National PTSD Center] * [https://curlie.org/Health/Mental_Health/Disorders/Anxiety/Post-traumatic_Stress Posttraumatic stress disorder] at Curlie (based on DMOZ) =='''References'''== {{collapse top|Click here for references}} {{Reflist|30em}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] {{collapse bottom}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] c4jad4c7s6kxojt35v7ccj72vpvmzye 2419109 2419108 2022-08-25T23:04:07Z Ardenguo 2944162 /* Psychometric properties of screening for PTSD */ added measures wikitext text/x-wiki <noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{medical disclaimer}} {{:{{BASEPAGENAME}}/Sidebar}} ==[[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio"?''']]== * For background information on what assessment portfolios are, click the link in the heading above. * Want even 'more' information about this topic? There's an extended version of this page [[Evidence-based assessment/Posttraumatic stress disorder (disorder portfolio)/extended version|'''here''']]. == [[Evidence based assessment/Preparation phase|'''Preparation phase''']] == === Diagnostic criteria for post traumatic stress disorder === ===='''ICD-11 Diagnostic Criteria'''==== {{blockquotetop}} ===='''ICD-11 Criteria'''==== *Post-traumatic stress disorder (PTSD) is a syndrome that develops following exposure to an extremely threatening or horrific event or series of events that is characterized by all of the following: **1) re-experiencing the traumatic event or events in the present in the form of vivid intrusive memories, flashbacks, or nightmares, which are typically accompanied by strong and overwhelming emotions such as fear or horror and strong physical sensations, or feelings of being overwhelmed or immersed in the same intense emotions that were experienced during the traumatic event; **2) avoidance of thoughts and memories of the event or events, or avoidance of activities, situations, or people reminiscent of the event or events **3) persistent perceptions of heightened current threat, for example as indicated by hypervigilance or an enhanced startle reaction to stimuli such as unexpected noises. *The symptoms must persist for at least several weeks and cause significant impairment in personal, family, social, educational, occupational or other important areas of functioning. Additionally, ICD 11 includes a category called "Complex post-traumatic stress disorder," which is described as: *A disorder that may develop following exposure to an event or series of events of an extremely threatening or horrific nature, most commonly prolonged or repetitive events from which escape is difficult or impossible (e.g., torture, slavery, genocide campaigns, prolonged domestic violence, repeated childhood sexual or physical abuse). *The disorder is characterized by the core symptoms of PTSD; that is, all diagnostic requirements for PTSD have been met at some point during the course of the disorder. *In addition, Complex PTSD is characterized by: **1) severe and pervasive problems in affect regulation; **2) persistent beliefs about oneself as diminished, defeated or worthless, accompanied by deep and pervasive feelings of shame, guilt or failure related to the traumatic event **3) persistent difficulties in sustaining relationships and in feeling close to others. The disturbance causes significant impairment in personal, family, social, educational, occupational or other important areas of functioning. {{blockquotebottom}} ===='''Changes in DSM-5'''==== * The diagnostic criteria for post-traumatic stress disorder changed slightly from [[DSM-IV]] to [[w:Diagnostic_and_Statistical_Manual_of_Mental_Disorders#DSM-IV-TR_.282000.29|DSM-5]]. Summaries are available [http://www.dsm5.org/Documents/changes%20from%20dsm-iv-tr%20to%20dsm-5.pdf here] and [[w:DSM-5|here]]. === Developmental sensitivities === {{collapse top| Click for more information}} *Diagnostic thresholds have been lowered for children and adolescents to account for development. *Separate and additional criteria have been added for children age 6 or younger. *Child sexual abuse has been found to have a substantial effect on the development of PTSD.<ref>{{cite journal|last1=Paolucci|first1=Elizabeth ODDONE|last2=Genuis|first2=Mark L.|last3=Violato|first3=Claudio|title=A Meta-Analysis of the Published Research on the Effects of Child Sexual Abuse|journal=The Journal of Psychology|date=January 2001|volume=135|issue=1|pages=17–36|doi=10.1080/00223980109603677}}</ref> *Children with higher exposure to trauma, less social support, and other major life events are more likely to have continued PTSD symptoms 7 months after a trauma.<ref name=":2">{{cite journal |last1=La Greca|first1=A|last2=Silverman|first2=WK|last3=Vernberg|first3=EM|last4=Prinstein|first4=MJ|title=Symptoms of posttraumatic stress in children after Hurricane Andrew: a prospective study.|journal=Journal of consulting and clinical psychology|date=August 1996|volume=64|issue=4|pages=712-23|pmid=8803361}}</ref> 10 months after a trauma, however, only experience of a major life event remained predictive of continuing PTSD symptoms.<ref name=":2" /> *Lack of social support, specifically lack of support by a teacher, was predictive of higher PTSD symptoms among children who had gone through an environmental trauma.<ref name=":2" /> *Children who reported using blame and anger as strategies for coping had higher levels of PTSD symptoms 10 months after a trauma.<ref name=":2" /> *Negative affect in children before a traumatic event was predictive of development of PTSD symptoms after a traumatic event.<ref>{{cite journal|last1=Weems|first1=CF|last2=Pina|first2=AA|last3=Costa|first3=NM|last4=Watts|first4=SE|last5=Taylor|first5=LK|last6=Cannon|first6=MF|title=Predisaster trait anxiety and negative affect predict posttraumatic stress in youths after hurricane Katrina.|journal=Journal of consulting and clinical psychology|date=February 2007|volume=75|issue=1|pages=154-9|doi=10.1037/0022-006X.75.1.154|pmid=17295574}}</ref> [[wikipedia:Posttraumatic_stress_disorder|Posttraumatic stress disorder]] is now more sensitive to development in that diagnostic thresholds have been lowered for children and adolescents. Furthermore, separate and additional criteria have been added for children age 6 years of age or younger. {{collapse bottom}} === Base rates of PTSD in different clinical settings and populations === This section describes the demographic settings of the populations sampled, base rates of PTSD diagnoses, country/region sampled, and the diagnostic methods that were used. Using this information, clinicians will be able to anchor the most appropriate rate of PTSD that they are likely to see in their clinical practice. * '''''To see prevalence rates across multiple disorders,''''' [[Evidence based assessment/Preparation phase#Base rates for transdiagnostic comparison|'''''click here.''''']] {| class="wikitable sortable" border="1" |- ! Demography ! Setting ! Base Rate ! Diagnostic Method |- | United States, nationally representative, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Kessler|first=Ronald C.|last2=Berglund|first2=Patricia|last3=Demler|first3=Olga|last4=Jin|first4=Robert|last5=Merikangas|first5=Kathleen R.|last6=Walters|first6=Ellen E.|date=2005-06-01|title=Lifetime Prevalence and Age-of-Onset Distributions of DSM-IV Disorders in the National Comorbidity Survey Replication|url=http://archpsyc.jamanetwork.com/article.aspx?doi=10.1001/archpsyc.62.6.593|journal=Archives of General Psychiatry|language=en|volume=62|issue=6|doi=10.1001/archpsyc.62.6.593|issn=0003-990X}}</ref> | 6.8% | National Comorbidity Survey - Replication |- | Netherlands, nationally representative, age 18-80 | Non-clinical: Population based<ref>{{Cite journal|last=de Vries|first=Giel-Jan|last2=Olff|first2=Miranda|date=2009-08-01|title=The lifetime prevalence of traumatic events and posttraumatic stress disorder in the Netherlands|url=http://onlinelibrary.wiley.com/doi/10.1002/jts.20429/abstract|journal=Journal of Traumatic Stress|language=en|volume=22|issue=4|pages=259–267|doi=10.1002/jts.20429|issn=1573-6598}}</ref> | 7.4% | Composite International Diagnostic Interview (CIDI) |- | United States, nationally representative, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Pietrzak|first=Robert H.|last2=Goldstein|first2=Risë B.|last3=Southwick|first3=Steven M.|last4=Grant|first4=Bridget F.|title=Prevalence and Axis I comorbidity of full and partial posttraumatic stress disorder in the United States: Results from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions|url=http://linkinghub.elsevier.com/retrieve/pii/S0887618510002288|journal=Journal of Anxiety Disorders|volume=25|issue=3|pages=456–465|doi=10.1016/j.janxdis.2010.11.010}}</ref> | 6.4% | Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions |- | Northern Ireland, representative sample, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Bunting|first=Brendan P.|last2=Ferry|first2=Finola R.|last3=Murphy|first3=Samuel D.|last4=O'Neill|first4=Siobhan M.|last5=Bolton|first5=David|date=2013-02-01|title=Trauma Associated With Civil Conflict and Posttraumatic Stress Disorder: Evidence From the Northern Ireland Study of Health and Stress|url=http://onlinelibrary.wiley.com/doi/10.1002/jts.21766/abstract|journal=Journal of Traumatic Stress|language=en|volume=26|issue=1|pages=134–141|doi=10.1002/jts.21766|issn=1573-6598}}</ref> | 8.8% | Northern Ireland Study of Health and Stress |- | South Africa, nationally representative sample, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Atwoli|first=Lukoye|last2=Stein|first2=Dan J.|last3=Williams|first3=David R.|last4=Mclaughlin|first4=Katie A.|last5=Petukhova|first5=Maria|last6=Kessler|first6=Ronald C.|last7=Koenen|first7=Karestan C.|date=2013-07-03|title=Trauma and posttraumatic stress disorder in South Africa: analysis from the South African Stress and Health Study|url=https://doi.org/10.1186/1471-244X-13-182|journal=BMC Psychiatry|volume=13|pages=182|doi=10.1186/1471-244x-13-182|issn=1471-244X}}</ref> | 2.3% | South African Stress and Health Study, using the Composite International Diagnostic Interview (CIDI) |- | U.S. Army and Marine Soldiers Deployed to Iraq and Afghanistan | U.S. Service Members<ref>{{Cite journal|last=Hoge|first=Charles W.|last2=Castro|first2=Carl A.|last3=Messer|first3=Stephen C.|last4=McGurk|first4=Dennis|last5=Cotting|first5=Dave I.|last6=Koffman|first6=Robert L.|date=2004-07-01|title=Combat Duty in Iraq and Afghanistan, Mental Health Problems, and Barriers to Care|url=http://dx.doi.org/10.1056/NEJMoa040603|journal=New England Journal of Medicine|volume=351|issue=1|pages=13–22|doi=10.1056/nejmoa040603|issn=0028-4793|pmid=15229303}}</ref> |11.5% - 19.5% ♦ | PTSD Checklist |- |United States, nationally representative, ages 13-18 |Non-clinical: Population based<ref>{{Cite journal|last=Merikangas|first=Kathleen Ries|last2=He|first2=Jian-ping|last3=Burstein|first3=Marcy|last4=Swanson|first4=Sonja A.|last5=Avenevoli|first5=Shelli|last6=Cui|first6=Lihong|last7=Benjet|first7=Corina|last8=Georgiades|first8=Katholiki|last9=Swendsen|first9=Joel|title=Lifetime Prevalence of Mental Disorders in U.S. Adolescents: Results from the National Comorbidity Survey Replication–Adolescent Supplement (NCS-A)|url=https://doi.org/10.1016/j.jaac.2010.05.017|journal=Journal of the American Academy of Child & Adolescent Psychiatry|volume=49|issue=10|pages=980–989|doi=10.1016/j.jaac.2010.05.017}}</ref> |5.0% |National Comorbidity Survey Replication—Adolescent Supplement (NCS-A) |} ♦ '''Note''': These rates were using broad PTSD Checklist scoring criteria of being scored positive if subjects reported at least one intrusion symptom, three avoidance symptoms, and two hyperarousal symptom that were categorized as at the moderate level. The 11.5% is for soldiers returning from deployment in Iraq, 19.5% is for soldiers returning from Afghanistan. Another common practice is to use a strict cutoff of 50 on the PCL, above which someone screens positive for PTSD. With this cutoff, rates are 6.2% and 12.9% for Service Members returned from Afghanistan and Iraqi, respectively. ==[[Evidence based assessment/Prediction phase|'''Prediction phase''']]== === Psychometric properties of screening for PTSD === The following section contains a list of screening and diagnostic instruments for PTSD. The section includes administration information, psychometric data, and PDFs or links to the screenings. * Screenings are used as part of the [[Evidence based assessment/Prediction phase|prediction phase]] of assessment; for more information on interpretation of this data, or how screenings fit in to the assessment process, click [[Evidence based assessment/Prediction phase|here.]] * '''''For a list of more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Psychometric_properties_of_common_screening_instruments click here.]''''' {| class="wikitable" |- ! Measure !Format (Reporter) !Age Range !Administration/ Completion Time !Where to Access |- |[https://www.ptsd.va.gov/professional/assessment/adult-sr/ptsd-checklist.asp PCL-5 (PTSD Checklist for DSM-5)] |Self-Report |adult |5-10 minutes |[https://www.ptsd.va.gov/professional/assessment/documents/PCL5_Standard_form.PDFPDF PDF] |- |PDS (Post-traumatic Diagnosis Scale) |Self-Report |adult |10-20 minutes | |- | colspan="4" style="font-size:110%; text-align:center;" |'''For Children and Adolescents Specifically''' | |- |[https://www.reactionindex.com/index.php/ UCLA PTSD Reaction Index for DSM-5] |Clinician Administered |child, school age, adolescents |20-30 minutes |[https://www.dellchildrens.net/wp-content/uploads/sites/60/2019/08/UCLA-PTSD-RI-DSM-5.pdf PDF] |- |CPSS (Children's PTSD Symptom Scale) |Self-Report |child |10-20 minutes |[https://www.aacap.org/App_Themes/AACAP/docs/resource_centers/resources/misc/child_ptsd_symptom_scale.pdf PDF] |- |[https://medicine.tulane.edu/infant-institute Young Child PTSD Checklist (YCPC)] |Parent Report |child |13 items |[https://medicine.tulane.edu/sites/g/files/rdw761/f/YCPC_v5_23_14.pdf PDF] |} '''Note:''' '''L''' = Less than adequate; '''A''' = Adequate; '''G''' = Good; '''E''' = Excellent; '''U''' = Unavailable; '''NA''' = Not applicable === Interpreting PTSD screening measure scores === * For information on interpreting screening measure scores, click [[Evidence based assessment/Prediction phase#Interpreting screening measure scores|here.]] * Also see the page on [https://en.wikipedia.org/wiki/Likelihood_ratios_in_diagnostic_testing likelihood ratios in diagnostic testing] for more information ==[[Evidence based assessment/Prescription phase|'''Prescription phase''']]== ===Gold standard diagnostic interviews=== * For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews click here.] ===Recommended diagnostic interviews for PTSD=== {| class="wikitable sortable" border="1" ! colspan="4" |Diagnostic instruments for PTSD |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time |- | [https://www.ptsd.va.gov/professional/assessment/adult-int/caps.asp CAPS-5 (Clinician Administered PTSD Scale)] | Clinician Administered Interview | adult | 40-60 minutes |- |PTSD Symptom Scale Interview (PSS-I-5) |Clinician Administered Interview |adult and child version available |24 items |- | colspan="4" style="font-size:110%; text-align:center;" |'''For Children and Adolescents Specifically''' |- | [https://www.ptsd.va.gov/professional/assessment/child/caps-ca.asp CAPS-CA-5 (Clinician-Administered PTSD Scale for DSM-5 - Child/Adolescent Version)] |Clinician Administered Interview |child |30 items |- | Children’s PTSD Inventory (CPTSD-I) |Diagnostic Interview | 6-18 years | 50 items |} '''Note:''' '''L''' = Less than adequate; '''A''' = Adequate; '''G''' = Good; '''E''' = Excellent; '''U''' = Unavailable; '''NA''' = Not applicable ===Severity interviews for PTSD=== {| class="wikitable sortable" border="1" |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time |- | [https://www.kennedykrieger.org/sites/default/files/library/documents/faculty/ksads-dsm-5-screener.pdf Schedule for Affective Disorders and Schizophrenia for School Age Children (K-SADS)] | Diagnostic Interview | 6-18 years | 18 PTSD items |- | Anxiety Disorders Interview Schedule, Child Version (ADIS-C) | Diagnostic Interview | 7-17 years | 26 PTSD items |- | Children’s Interview for Psychiatric Symptoms (ChIPS) |Diagnostic Interview |6 – 18 years |31 PTSD items |- | Diagnostic Infant and Preschool Assessment (DIPA) |Diagnostic Interview | Age 6 and younger | 46 PTSD items |} '''Note:''' '''L''' = Less than adequate; '''A''' = Adequate; '''G''' = Good; '''E''' = Excellent; '''U''' = Unavailable; '''NA''' = Not applicable ==[[Evidence based assessment/Process phase|'''Process phase''']]== The following section contains a brief overview of treatment options for PTSD and list of process and outcome measures for PTSD. The section includes benchmarks based on published norms for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the [[Evidence based assessment/Process phase|process phase]] of assessment. For more information of differences between process and outcome measures, see the page on the [[Evidence based assessment/Process phase|process phase of assessment]]. === Process measures === * Information coming soon === Outcome and severity measures === This table includes clinically significant benchmarks for PTSD specific outcome measures * Information on how to interpret this table can be [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase found here]. * Additionally, these [[Evidence based assessment/Vignettes|vignettes]] might be helpful resources for understanding appropriate adaptation of outcome measures in practice. * ''<u>For clinically significant change benchmarks for the CBCL, YSR, and TRF total, externalizing, internalizing, and attention benchmarks,</u>'' [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase&wteswitched=1#Clinically_significant_change_benchmarks_for_widely-used_outcome_measures see here.] {| class="wikitable sortable" border="1" | colspan="7" |'''Clinically significant change benchmarks with common instruments for PTSD''' |- | colspan="7" style="font-size:110%; text-align:center;" span |<b> Benchmarks Based on Published Norms</b> |- | rowspan="2" style="text-align:center;font-size:130%;" |<b> Measure</b> | colspan="3" style="text-align:center;font-size:130%" width="300" |<b> Cut-off scores</b> | colspan="3" style="text-align:center;font-size:120%" |<b> Critical Change <br> (unstandardized scores)</b> |- | style="text-align:center;font-size:110%" |<b> A</b> | style="text-align:center;font-size:110%" |<b> B</b> | style="text-align:center;font-size:110%" |<b> C</b> | style="text-align:center;font-size:110%" |<b> 95%</b> | style="text-align:center;font-size:110%" |<b> 90%</b> | style="text-align:center;font-size:110%" |<b> SE_difference</b> |- | rowspan="1" style="text-align:center;" | Primary Care PTSD Screen | style="text-align:center;" | 1.0 | style="text-align:center;" | 3.1 | style="text-align:center;" | 2.0 | style="text-align:center;" | 1.0 | style="text-align:center;" | .8 | style="text-align:center;" | .5 |- | rowspan="1" style="text-align:center;" | PTSD Checklist Scores | style="text-align:center;" | 28.8 | style="text-align:center;" | 40.8 | style="text-align:center;" | 34.9 | style="text-align:center;" | 4.6 | style="text-align:center;" | 3.8 | style="text-align:center;" | 2.3 |- | rowspan="1" style="text-align:center;" | Clinician Administered PTSD Scale | style="text-align:center;" | 28.8 | style="text-align:center;" | 40.8 | style="text-align:center;" | 34.9 | style="text-align:center;" | 8.3 | style="text-align:center;" | 7.0 | style="text-align:center;" | 4.2 |} === Treatment === * Please refer to the Wikipedia page on [[wikipedia:Posttraumatic_stress_disorder|PTSD]] for more information on available treatment for PTSD or go to the [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/post-traumatic-stress-disorder/ Effective Child Therapy] page for for a curated resource on effective treatments for PTSD. {{collapse top| Click here for more information}} '''<big>Behavioral interventions</big>''' Recommended (have ''significant benefit'') <ref name=":0">Department of Veterans Affairs and Department of Defense. . (2010). VA/DoD clinical practice guidelines: management of post-traumatic stress. Washington, D.C.: Veterans Health Administration, Department of Defense.</ref>: # Brief Cognitive Behavioral Therapy (CBT; 4-5 sessions) #* This includes stress inoculation training, trauma-focused therapy including components of cognitive restructuring, Cognitive Processing Therapy (CPT), imaginal, virtual, and in-vivo exposure as in Prolonged Exposure psychotherapy (PE)² #* Patient education is recommended as part of psychotherapy for patients and family members # EMDR may help both acute and chronic PTSD, especially individuals who have trouble with prolonged exposure or have trouble verbalizing their trauma.<ref name=":1">Ursano, R. J., Bell, C., Eth, S., Friedman, M., Norwood, A., Pfefferbaum, B., . . . McIntyre, J. S. (2004). ''Practice guideline for the treatment of patients with acute stress disorder and posttraumatic stress disorder'': American Psychiatric Publ </ref> ## Long term gains require further study. # [https://www.ptsd.va.gov/professional/treat/txessentials/present_centered_therapy.asp Present-Centered Therapy (PCT)] is a non trauma focused treatment for PTSD and a second-line treatment for PTSD<ref>{{Cite web|url=https://www.ptsd.va.gov/professional/treat/txessentials/present_centered_therapy.asp|title=Present-Centered Therapy for PTSD - PTSD: National Center for PTSD|website=www.ptsd.va.gov|language=en|access-date=2022-08-13}}</ref>. Treatments with weaker evidence (have ''some benefit'') <ref name=":0" />: # Patient education, # Imagery rehearsal therapy, # Psychodynamic therapy, # Hypnosis, # Relaxation techniques, # and Group therapy. Treatment with ''unknown benefit'' <ref name=":0" />: # Web-based CBT ## For example Jeane Bosch participated as a study therapist in research study that compared STAIR and present-centered therapy both delivered via telehealth. STAIR stands for Skills Training in Affective and Interpersonal Regulation. It is a skill-focused treatment that was originally developed for survivors of childhood abuse to teach emotion regulation skills as well as tools to help with challenges interpersonal functioning and social relationships and decrease PTSD symptoms<ref>{{Cite web|url=https://istss.org/public-resources/trauma-blog/2015-march-(1)/clinician-s-corner-skills-training-in-affective-an|title=ISTSS - Trauma Blog|website=istss.org|access-date=2022-08-13}}</ref>.<ref>{{Citation|title=Introduction to Telehealth with Dr. Bosch|url=https://www.youtube.com/watch?v=Wn6Vewl42X8|accessdate=2022-08-13|language=en}}</ref> # Acceptance and commitment therapy, # and Dialectical Behavioral Therapy. <big>'''Medication'''</big> *SSRIs are more effective than placebo in treating PTSD.<ref name=":1" /> *There is no evidence to support a medication to prevent the development of PTSD.<ref name=":0" /> **Imipramine, propranolol, prazosin, other antidepressants, anticonvulsants, and atypical antipsychotics have ''unknown benefit.'' **Strongly recommend against the use of benzodiazepines² and typical antipsychotics since they have ''no benefit and potential harm.'' {{collapse bottom}} == '''External resources''' == === For professionals === * [http://www.som.uq.edu.au/ptsd Post Traumatic Stress Disorder Information Resource] from [http://www.uq.edu.au/ The University of Queensland School of Medicine] * [http://www.apa.org/ptsd-guideline/ APA practice parameters for assessment and treatment for PTSD (Updated 2017)] * [http://www.ptsd.va.gov/professional/index.asp Resources for professionals] from [http://www.ptsd.va.gov/index.asp VA National PTSD Center] * [https://www.integration.samhsa.gov/clinical-practice/trauma-informed SAMHSA's Trauma-Informed Care Resources and Training] * [https://www.integration.samhsa.gov/clinical-practice/trauma-informed SAMHSA's Resources on Intimate Partner Violence (IPV) for Clinicians, Patients, Families, and Organizations] === For caregivers === * [http://www.nctsn.org/sites/default/files/assets/pdfs/tips_for_parents_media_final.pdf Tips for parents on shooting media coverage] * [http://www.nctsn.org/sites/default/files/assets/pdfs/parents_guidelines_for_helping_teens_after_the_recent_attacks.pdf Parent guidelines to helping youths after a shooting] * [http://www.nctsn.org/sites/default/files/assets/pdfs/helping_teens_with_traumatic_grief_caregivers_final.pdf Caregiver tips for helping teens with traumatic grief] * [http://www.nctsn.org/sites/default/files/assets/pdfs/10things_schoolage_ctg.pdf Caregiver tips for helping school-age children with traumatic grief] *[http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/post-traumatic-stress-disorder/ EffectiveChildTherapy.Org information on PTSD] *[https://sccap53.org Society of Clinical Child and Adolescent Psychology] === For educators === * [http://www.nctsn.org/sites/default/files/assets/pdfs/pfa_for_schools_appendix_a_teachers.pdf Teacher tips for providing psychological first aid] * [http://www.nctsn.org/sites/default/files/assets/pdfs/helping_youth_after_community_violence_educators.pdf Educator tips for helping youths after a community trauma] === For public === * [https://complicatedgrief.columbia.edu/for-the-public/resources/ Resources for grief and loss] * [http://www.nctsn.org/sites/default/files/assets/pdfs/psychological_information_sheet_two_pager.pdf Psychological impacts of recent shootings] * [http://www.nctsn.org/sites/default/files/assets/pdfs/youth_journalists.pdf Tips to talking to youths about a shooting] * [http://www.nctsn.org/sites/default/files/assets/pdfs/talking_to_children_about_the_shooting.pdf Tips to talking to children about a shooting] * [http://www.nctsn.org/sites/default/files/assets/pdfs/helping_young_children_heal_crisis.pdf Helping young children heal after a crisis] * [http://www.nctsn.org/content/psychological-first-aid-schoolspfa Psychological first aid for schools] * [http://www.nctsn.org/content/psychological-first-aid Resources and manuals on psychological first aid] * [http://www.ptsd.va.gov/public/index.asp Resources for the public] from [http://www.ptsd.va.gov/index.asp VA National PTSD Center] * [https://curlie.org/Health/Mental_Health/Disorders/Anxiety/Post-traumatic_Stress Posttraumatic stress disorder] at Curlie (based on DMOZ) =='''References'''== {{collapse top|Click here for references}} {{Reflist|30em}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] {{collapse bottom}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] l9ii70gjmpbr5zcklwoxtsdehl81tdq 2419111 2419109 2022-08-25T23:08:10Z Ardenguo 2944162 /* Recommended diagnostic interviews for PTSD */ added link wikitext text/x-wiki <noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{medical disclaimer}} {{:{{BASEPAGENAME}}/Sidebar}} ==[[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio"?''']]== * For background information on what assessment portfolios are, click the link in the heading above. * Want even 'more' information about this topic? There's an extended version of this page [[Evidence-based assessment/Posttraumatic stress disorder (disorder portfolio)/extended version|'''here''']]. == [[Evidence based assessment/Preparation phase|'''Preparation phase''']] == === Diagnostic criteria for post traumatic stress disorder === ===='''ICD-11 Diagnostic Criteria'''==== {{blockquotetop}} ===='''ICD-11 Criteria'''==== *Post-traumatic stress disorder (PTSD) is a syndrome that develops following exposure to an extremely threatening or horrific event or series of events that is characterized by all of the following: **1) re-experiencing the traumatic event or events in the present in the form of vivid intrusive memories, flashbacks, or nightmares, which are typically accompanied by strong and overwhelming emotions such as fear or horror and strong physical sensations, or feelings of being overwhelmed or immersed in the same intense emotions that were experienced during the traumatic event; **2) avoidance of thoughts and memories of the event or events, or avoidance of activities, situations, or people reminiscent of the event or events **3) persistent perceptions of heightened current threat, for example as indicated by hypervigilance or an enhanced startle reaction to stimuli such as unexpected noises. *The symptoms must persist for at least several weeks and cause significant impairment in personal, family, social, educational, occupational or other important areas of functioning. Additionally, ICD 11 includes a category called "Complex post-traumatic stress disorder," which is described as: *A disorder that may develop following exposure to an event or series of events of an extremely threatening or horrific nature, most commonly prolonged or repetitive events from which escape is difficult or impossible (e.g., torture, slavery, genocide campaigns, prolonged domestic violence, repeated childhood sexual or physical abuse). *The disorder is characterized by the core symptoms of PTSD; that is, all diagnostic requirements for PTSD have been met at some point during the course of the disorder. *In addition, Complex PTSD is characterized by: **1) severe and pervasive problems in affect regulation; **2) persistent beliefs about oneself as diminished, defeated or worthless, accompanied by deep and pervasive feelings of shame, guilt or failure related to the traumatic event **3) persistent difficulties in sustaining relationships and in feeling close to others. The disturbance causes significant impairment in personal, family, social, educational, occupational or other important areas of functioning. {{blockquotebottom}} ===='''Changes in DSM-5'''==== * The diagnostic criteria for post-traumatic stress disorder changed slightly from [[DSM-IV]] to [[w:Diagnostic_and_Statistical_Manual_of_Mental_Disorders#DSM-IV-TR_.282000.29|DSM-5]]. Summaries are available [http://www.dsm5.org/Documents/changes%20from%20dsm-iv-tr%20to%20dsm-5.pdf here] and [[w:DSM-5|here]]. === Developmental sensitivities === {{collapse top| Click for more information}} *Diagnostic thresholds have been lowered for children and adolescents to account for development. *Separate and additional criteria have been added for children age 6 or younger. *Child sexual abuse has been found to have a substantial effect on the development of PTSD.<ref>{{cite journal|last1=Paolucci|first1=Elizabeth ODDONE|last2=Genuis|first2=Mark L.|last3=Violato|first3=Claudio|title=A Meta-Analysis of the Published Research on the Effects of Child Sexual Abuse|journal=The Journal of Psychology|date=January 2001|volume=135|issue=1|pages=17–36|doi=10.1080/00223980109603677}}</ref> *Children with higher exposure to trauma, less social support, and other major life events are more likely to have continued PTSD symptoms 7 months after a trauma.<ref name=":2">{{cite journal |last1=La Greca|first1=A|last2=Silverman|first2=WK|last3=Vernberg|first3=EM|last4=Prinstein|first4=MJ|title=Symptoms of posttraumatic stress in children after Hurricane Andrew: a prospective study.|journal=Journal of consulting and clinical psychology|date=August 1996|volume=64|issue=4|pages=712-23|pmid=8803361}}</ref> 10 months after a trauma, however, only experience of a major life event remained predictive of continuing PTSD symptoms.<ref name=":2" /> *Lack of social support, specifically lack of support by a teacher, was predictive of higher PTSD symptoms among children who had gone through an environmental trauma.<ref name=":2" /> *Children who reported using blame and anger as strategies for coping had higher levels of PTSD symptoms 10 months after a trauma.<ref name=":2" /> *Negative affect in children before a traumatic event was predictive of development of PTSD symptoms after a traumatic event.<ref>{{cite journal|last1=Weems|first1=CF|last2=Pina|first2=AA|last3=Costa|first3=NM|last4=Watts|first4=SE|last5=Taylor|first5=LK|last6=Cannon|first6=MF|title=Predisaster trait anxiety and negative affect predict posttraumatic stress in youths after hurricane Katrina.|journal=Journal of consulting and clinical psychology|date=February 2007|volume=75|issue=1|pages=154-9|doi=10.1037/0022-006X.75.1.154|pmid=17295574}}</ref> [[wikipedia:Posttraumatic_stress_disorder|Posttraumatic stress disorder]] is now more sensitive to development in that diagnostic thresholds have been lowered for children and adolescents. Furthermore, separate and additional criteria have been added for children age 6 years of age or younger. {{collapse bottom}} === Base rates of PTSD in different clinical settings and populations === This section describes the demographic settings of the populations sampled, base rates of PTSD diagnoses, country/region sampled, and the diagnostic methods that were used. Using this information, clinicians will be able to anchor the most appropriate rate of PTSD that they are likely to see in their clinical practice. * '''''To see prevalence rates across multiple disorders,''''' [[Evidence based assessment/Preparation phase#Base rates for transdiagnostic comparison|'''''click here.''''']] {| class="wikitable sortable" border="1" |- ! Demography ! Setting ! Base Rate ! Diagnostic Method |- | United States, nationally representative, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Kessler|first=Ronald C.|last2=Berglund|first2=Patricia|last3=Demler|first3=Olga|last4=Jin|first4=Robert|last5=Merikangas|first5=Kathleen R.|last6=Walters|first6=Ellen E.|date=2005-06-01|title=Lifetime Prevalence and Age-of-Onset Distributions of DSM-IV Disorders in the National Comorbidity Survey Replication|url=http://archpsyc.jamanetwork.com/article.aspx?doi=10.1001/archpsyc.62.6.593|journal=Archives of General Psychiatry|language=en|volume=62|issue=6|doi=10.1001/archpsyc.62.6.593|issn=0003-990X}}</ref> | 6.8% | National Comorbidity Survey - Replication |- | Netherlands, nationally representative, age 18-80 | Non-clinical: Population based<ref>{{Cite journal|last=de Vries|first=Giel-Jan|last2=Olff|first2=Miranda|date=2009-08-01|title=The lifetime prevalence of traumatic events and posttraumatic stress disorder in the Netherlands|url=http://onlinelibrary.wiley.com/doi/10.1002/jts.20429/abstract|journal=Journal of Traumatic Stress|language=en|volume=22|issue=4|pages=259–267|doi=10.1002/jts.20429|issn=1573-6598}}</ref> | 7.4% | Composite International Diagnostic Interview (CIDI) |- | United States, nationally representative, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Pietrzak|first=Robert H.|last2=Goldstein|first2=Risë B.|last3=Southwick|first3=Steven M.|last4=Grant|first4=Bridget F.|title=Prevalence and Axis I comorbidity of full and partial posttraumatic stress disorder in the United States: Results from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions|url=http://linkinghub.elsevier.com/retrieve/pii/S0887618510002288|journal=Journal of Anxiety Disorders|volume=25|issue=3|pages=456–465|doi=10.1016/j.janxdis.2010.11.010}}</ref> | 6.4% | Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions |- | Northern Ireland, representative sample, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Bunting|first=Brendan P.|last2=Ferry|first2=Finola R.|last3=Murphy|first3=Samuel D.|last4=O'Neill|first4=Siobhan M.|last5=Bolton|first5=David|date=2013-02-01|title=Trauma Associated With Civil Conflict and Posttraumatic Stress Disorder: Evidence From the Northern Ireland Study of Health and Stress|url=http://onlinelibrary.wiley.com/doi/10.1002/jts.21766/abstract|journal=Journal of Traumatic Stress|language=en|volume=26|issue=1|pages=134–141|doi=10.1002/jts.21766|issn=1573-6598}}</ref> | 8.8% | Northern Ireland Study of Health and Stress |- | South Africa, nationally representative sample, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Atwoli|first=Lukoye|last2=Stein|first2=Dan J.|last3=Williams|first3=David R.|last4=Mclaughlin|first4=Katie A.|last5=Petukhova|first5=Maria|last6=Kessler|first6=Ronald C.|last7=Koenen|first7=Karestan C.|date=2013-07-03|title=Trauma and posttraumatic stress disorder in South Africa: analysis from the South African Stress and Health Study|url=https://doi.org/10.1186/1471-244X-13-182|journal=BMC Psychiatry|volume=13|pages=182|doi=10.1186/1471-244x-13-182|issn=1471-244X}}</ref> | 2.3% | South African Stress and Health Study, using the Composite International Diagnostic Interview (CIDI) |- | U.S. Army and Marine Soldiers Deployed to Iraq and Afghanistan | U.S. Service Members<ref>{{Cite journal|last=Hoge|first=Charles W.|last2=Castro|first2=Carl A.|last3=Messer|first3=Stephen C.|last4=McGurk|first4=Dennis|last5=Cotting|first5=Dave I.|last6=Koffman|first6=Robert L.|date=2004-07-01|title=Combat Duty in Iraq and Afghanistan, Mental Health Problems, and Barriers to Care|url=http://dx.doi.org/10.1056/NEJMoa040603|journal=New England Journal of Medicine|volume=351|issue=1|pages=13–22|doi=10.1056/nejmoa040603|issn=0028-4793|pmid=15229303}}</ref> |11.5% - 19.5% ♦ | PTSD Checklist |- |United States, nationally representative, ages 13-18 |Non-clinical: Population based<ref>{{Cite journal|last=Merikangas|first=Kathleen Ries|last2=He|first2=Jian-ping|last3=Burstein|first3=Marcy|last4=Swanson|first4=Sonja A.|last5=Avenevoli|first5=Shelli|last6=Cui|first6=Lihong|last7=Benjet|first7=Corina|last8=Georgiades|first8=Katholiki|last9=Swendsen|first9=Joel|title=Lifetime Prevalence of Mental Disorders in U.S. Adolescents: Results from the National Comorbidity Survey Replication–Adolescent Supplement (NCS-A)|url=https://doi.org/10.1016/j.jaac.2010.05.017|journal=Journal of the American Academy of Child & Adolescent Psychiatry|volume=49|issue=10|pages=980–989|doi=10.1016/j.jaac.2010.05.017}}</ref> |5.0% |National Comorbidity Survey Replication—Adolescent Supplement (NCS-A) |} ♦ '''Note''': These rates were using broad PTSD Checklist scoring criteria of being scored positive if subjects reported at least one intrusion symptom, three avoidance symptoms, and two hyperarousal symptom that were categorized as at the moderate level. The 11.5% is for soldiers returning from deployment in Iraq, 19.5% is for soldiers returning from Afghanistan. Another common practice is to use a strict cutoff of 50 on the PCL, above which someone screens positive for PTSD. With this cutoff, rates are 6.2% and 12.9% for Service Members returned from Afghanistan and Iraqi, respectively. ==[[Evidence based assessment/Prediction phase|'''Prediction phase''']]== === Psychometric properties of screening for PTSD === The following section contains a list of screening and diagnostic instruments for PTSD. The section includes administration information, psychometric data, and PDFs or links to the screenings. * Screenings are used as part of the [[Evidence based assessment/Prediction phase|prediction phase]] of assessment; for more information on interpretation of this data, or how screenings fit in to the assessment process, click [[Evidence based assessment/Prediction phase|here.]] * '''''For a list of more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Psychometric_properties_of_common_screening_instruments click here.]''''' {| class="wikitable" |- ! Measure !Format (Reporter) !Age Range !Administration/ Completion Time !Where to Access |- |[https://www.ptsd.va.gov/professional/assessment/adult-sr/ptsd-checklist.asp PCL-5 (PTSD Checklist for DSM-5)] |Self-Report |adult |5-10 minutes |[https://www.ptsd.va.gov/professional/assessment/documents/PCL5_Standard_form.PDFPDF PDF] |- |PDS (Post-traumatic Diagnosis Scale) |Self-Report |adult |10-20 minutes | |- | colspan="4" style="font-size:110%; text-align:center;" |'''For Children and Adolescents Specifically''' | |- |[https://www.reactionindex.com/index.php/ UCLA PTSD Reaction Index for DSM-5] |Clinician Administered |child, school age, adolescents |20-30 minutes |[https://www.dellchildrens.net/wp-content/uploads/sites/60/2019/08/UCLA-PTSD-RI-DSM-5.pdf PDF] |- |CPSS (Children's PTSD Symptom Scale) |Self-Report |child |10-20 minutes |[https://www.aacap.org/App_Themes/AACAP/docs/resource_centers/resources/misc/child_ptsd_symptom_scale.pdf PDF] |- |[https://medicine.tulane.edu/infant-institute Young Child PTSD Checklist (YCPC)] |Parent Report |child |13 items |[https://medicine.tulane.edu/sites/g/files/rdw761/f/YCPC_v5_23_14.pdf PDF] |} '''Note:''' '''L''' = Less than adequate; '''A''' = Adequate; '''G''' = Good; '''E''' = Excellent; '''U''' = Unavailable; '''NA''' = Not applicable === Interpreting PTSD screening measure scores === * For information on interpreting screening measure scores, click [[Evidence based assessment/Prediction phase#Interpreting screening measure scores|here.]] * Also see the page on [https://en.wikipedia.org/wiki/Likelihood_ratios_in_diagnostic_testing likelihood ratios in diagnostic testing] for more information ==[[Evidence based assessment/Prescription phase|'''Prescription phase''']]== ===Gold standard diagnostic interviews=== * For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews click here.] ===Recommended diagnostic interviews for PTSD=== {| class="wikitable sortable" border="1" ! colspan="4" |Diagnostic instruments for PTSD ! |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time !Where to Access |- | [https://www.ptsd.va.gov/professional/assessment/adult-int/caps.asp CAPS-5 (Clinician Administered PTSD Scale)] | Clinician Administered Interview | adult | 40-60 minutes | |- |PTSD Symptom Scale Interview (PSS-I-5) |Clinician Administered Interview |adult and child version available |24 items |[http://www.advanced-counseling.com/dl/PSSI-5.pdf PDF] |- | colspan="4" style="font-size:110%; text-align:center;" |'''For Children and Adolescents Specifically''' | |- | [https://www.ptsd.va.gov/professional/assessment/child/caps-ca.asp CAPS-CA-5 (Clinician-Administered PTSD Scale for DSM-5 - Child/Adolescent Version)] |Clinician Administered Interview |child |30 items | |- | Children’s PTSD Inventory (CPTSD-I) |Diagnostic Interview | 6-18 years | 50 items | |} '''Note:''' '''L''' = Less than adequate; '''A''' = Adequate; '''G''' = Good; '''E''' = Excellent; '''U''' = Unavailable; '''NA''' = Not applicable ===Severity interviews for PTSD=== {| class="wikitable sortable" border="1" |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time |- | [https://www.kennedykrieger.org/sites/default/files/library/documents/faculty/ksads-dsm-5-screener.pdf Schedule for Affective Disorders and Schizophrenia for School Age Children (K-SADS)] | Diagnostic Interview | 6-18 years | 18 PTSD items |- | Anxiety Disorders Interview Schedule, Child Version (ADIS-C) | Diagnostic Interview | 7-17 years | 26 PTSD items |- | Children’s Interview for Psychiatric Symptoms (ChIPS) |Diagnostic Interview |6 – 18 years |31 PTSD items |- | Diagnostic Infant and Preschool Assessment (DIPA) |Diagnostic Interview | Age 6 and younger | 46 PTSD items |} '''Note:''' '''L''' = Less than adequate; '''A''' = Adequate; '''G''' = Good; '''E''' = Excellent; '''U''' = Unavailable; '''NA''' = Not applicable ==[[Evidence based assessment/Process phase|'''Process phase''']]== The following section contains a brief overview of treatment options for PTSD and list of process and outcome measures for PTSD. The section includes benchmarks based on published norms for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the [[Evidence based assessment/Process phase|process phase]] of assessment. For more information of differences between process and outcome measures, see the page on the [[Evidence based assessment/Process phase|process phase of assessment]]. === Process measures === * Information coming soon === Outcome and severity measures === This table includes clinically significant benchmarks for PTSD specific outcome measures * Information on how to interpret this table can be [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase found here]. * Additionally, these [[Evidence based assessment/Vignettes|vignettes]] might be helpful resources for understanding appropriate adaptation of outcome measures in practice. * ''<u>For clinically significant change benchmarks for the CBCL, YSR, and TRF total, externalizing, internalizing, and attention benchmarks,</u>'' [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase&wteswitched=1#Clinically_significant_change_benchmarks_for_widely-used_outcome_measures see here.] {| class="wikitable sortable" border="1" | colspan="7" |'''Clinically significant change benchmarks with common instruments for PTSD''' |- | colspan="7" style="font-size:110%; text-align:center;" span |<b> Benchmarks Based on Published Norms</b> |- | rowspan="2" style="text-align:center;font-size:130%;" |<b> Measure</b> | colspan="3" style="text-align:center;font-size:130%" width="300" |<b> Cut-off scores</b> | colspan="3" style="text-align:center;font-size:120%" |<b> Critical Change <br> (unstandardized scores)</b> |- | style="text-align:center;font-size:110%" |<b> A</b> | style="text-align:center;font-size:110%" |<b> B</b> | style="text-align:center;font-size:110%" |<b> C</b> | style="text-align:center;font-size:110%" |<b> 95%</b> | style="text-align:center;font-size:110%" |<b> 90%</b> | style="text-align:center;font-size:110%" |<b> SE_difference</b> |- | rowspan="1" style="text-align:center;" | Primary Care PTSD Screen | style="text-align:center;" | 1.0 | style="text-align:center;" | 3.1 | style="text-align:center;" | 2.0 | style="text-align:center;" | 1.0 | style="text-align:center;" | .8 | style="text-align:center;" | .5 |- | rowspan="1" style="text-align:center;" | PTSD Checklist Scores | style="text-align:center;" | 28.8 | style="text-align:center;" | 40.8 | style="text-align:center;" | 34.9 | style="text-align:center;" | 4.6 | style="text-align:center;" | 3.8 | style="text-align:center;" | 2.3 |- | rowspan="1" style="text-align:center;" | Clinician Administered PTSD Scale | style="text-align:center;" | 28.8 | style="text-align:center;" | 40.8 | style="text-align:center;" | 34.9 | style="text-align:center;" | 8.3 | style="text-align:center;" | 7.0 | style="text-align:center;" | 4.2 |} === Treatment === * Please refer to the Wikipedia page on [[wikipedia:Posttraumatic_stress_disorder|PTSD]] for more information on available treatment for PTSD or go to the [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/post-traumatic-stress-disorder/ Effective Child Therapy] page for for a curated resource on effective treatments for PTSD. {{collapse top| Click here for more information}} '''<big>Behavioral interventions</big>''' Recommended (have ''significant benefit'') <ref name=":0">Department of Veterans Affairs and Department of Defense. . (2010). VA/DoD clinical practice guidelines: management of post-traumatic stress. Washington, D.C.: Veterans Health Administration, Department of Defense.</ref>: # Brief Cognitive Behavioral Therapy (CBT; 4-5 sessions) #* This includes stress inoculation training, trauma-focused therapy including components of cognitive restructuring, Cognitive Processing Therapy (CPT), imaginal, virtual, and in-vivo exposure as in Prolonged Exposure psychotherapy (PE)² #* Patient education is recommended as part of psychotherapy for patients and family members # EMDR may help both acute and chronic PTSD, especially individuals who have trouble with prolonged exposure or have trouble verbalizing their trauma.<ref name=":1">Ursano, R. J., Bell, C., Eth, S., Friedman, M., Norwood, A., Pfefferbaum, B., . . . McIntyre, J. S. (2004). ''Practice guideline for the treatment of patients with acute stress disorder and posttraumatic stress disorder'': American Psychiatric Publ </ref> ## Long term gains require further study. # [https://www.ptsd.va.gov/professional/treat/txessentials/present_centered_therapy.asp Present-Centered Therapy (PCT)] is a non trauma focused treatment for PTSD and a second-line treatment for PTSD<ref>{{Cite web|url=https://www.ptsd.va.gov/professional/treat/txessentials/present_centered_therapy.asp|title=Present-Centered Therapy for PTSD - PTSD: National Center for PTSD|website=www.ptsd.va.gov|language=en|access-date=2022-08-13}}</ref>. Treatments with weaker evidence (have ''some benefit'') <ref name=":0" />: # Patient education, # Imagery rehearsal therapy, # Psychodynamic therapy, # Hypnosis, # Relaxation techniques, # and Group therapy. Treatment with ''unknown benefit'' <ref name=":0" />: # Web-based CBT ## For example Jeane Bosch participated as a study therapist in research study that compared STAIR and present-centered therapy both delivered via telehealth. STAIR stands for Skills Training in Affective and Interpersonal Regulation. It is a skill-focused treatment that was originally developed for survivors of childhood abuse to teach emotion regulation skills as well as tools to help with challenges interpersonal functioning and social relationships and decrease PTSD symptoms<ref>{{Cite web|url=https://istss.org/public-resources/trauma-blog/2015-march-(1)/clinician-s-corner-skills-training-in-affective-an|title=ISTSS - Trauma Blog|website=istss.org|access-date=2022-08-13}}</ref>.<ref>{{Citation|title=Introduction to Telehealth with Dr. Bosch|url=https://www.youtube.com/watch?v=Wn6Vewl42X8|accessdate=2022-08-13|language=en}}</ref> # Acceptance and commitment therapy, # and Dialectical Behavioral Therapy. <big>'''Medication'''</big> *SSRIs are more effective than placebo in treating PTSD.<ref name=":1" /> *There is no evidence to support a medication to prevent the development of PTSD.<ref name=":0" /> **Imipramine, propranolol, prazosin, other antidepressants, anticonvulsants, and atypical antipsychotics have ''unknown benefit.'' **Strongly recommend against the use of benzodiazepines² and typical antipsychotics since they have ''no benefit and potential harm.'' {{collapse bottom}} == '''External resources''' == === For professionals === * [http://www.som.uq.edu.au/ptsd Post Traumatic Stress Disorder Information Resource] from [http://www.uq.edu.au/ The University of Queensland School of Medicine] * [http://www.apa.org/ptsd-guideline/ APA practice parameters for assessment and treatment for PTSD (Updated 2017)] * [http://www.ptsd.va.gov/professional/index.asp Resources for professionals] from [http://www.ptsd.va.gov/index.asp VA National PTSD Center] * [https://www.integration.samhsa.gov/clinical-practice/trauma-informed SAMHSA's Trauma-Informed Care Resources and Training] * [https://www.integration.samhsa.gov/clinical-practice/trauma-informed SAMHSA's Resources on Intimate Partner Violence (IPV) for Clinicians, Patients, Families, and Organizations] === For caregivers === * [http://www.nctsn.org/sites/default/files/assets/pdfs/tips_for_parents_media_final.pdf Tips for parents on shooting media coverage] * [http://www.nctsn.org/sites/default/files/assets/pdfs/parents_guidelines_for_helping_teens_after_the_recent_attacks.pdf Parent guidelines to helping youths after a shooting] * [http://www.nctsn.org/sites/default/files/assets/pdfs/helping_teens_with_traumatic_grief_caregivers_final.pdf Caregiver tips for helping teens with traumatic grief] * [http://www.nctsn.org/sites/default/files/assets/pdfs/10things_schoolage_ctg.pdf Caregiver tips for helping school-age children with traumatic grief] *[http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/post-traumatic-stress-disorder/ EffectiveChildTherapy.Org information on PTSD] *[https://sccap53.org Society of Clinical Child and Adolescent Psychology] === For educators === * [http://www.nctsn.org/sites/default/files/assets/pdfs/pfa_for_schools_appendix_a_teachers.pdf Teacher tips for providing psychological first aid] * [http://www.nctsn.org/sites/default/files/assets/pdfs/helping_youth_after_community_violence_educators.pdf Educator tips for helping youths after a community trauma] === For public === * [https://complicatedgrief.columbia.edu/for-the-public/resources/ Resources for grief and loss] * [http://www.nctsn.org/sites/default/files/assets/pdfs/psychological_information_sheet_two_pager.pdf Psychological impacts of recent shootings] * [http://www.nctsn.org/sites/default/files/assets/pdfs/youth_journalists.pdf Tips to talking to youths about a shooting] * [http://www.nctsn.org/sites/default/files/assets/pdfs/talking_to_children_about_the_shooting.pdf Tips to talking to children about a shooting] * [http://www.nctsn.org/sites/default/files/assets/pdfs/helping_young_children_heal_crisis.pdf Helping young children heal after a crisis] * [http://www.nctsn.org/content/psychological-first-aid-schoolspfa Psychological first aid for schools] * [http://www.nctsn.org/content/psychological-first-aid Resources and manuals on psychological first aid] * [http://www.ptsd.va.gov/public/index.asp Resources for the public] from [http://www.ptsd.va.gov/index.asp VA National PTSD Center] * [https://curlie.org/Health/Mental_Health/Disorders/Anxiety/Post-traumatic_Stress Posttraumatic stress disorder] at Curlie (based on DMOZ) =='''References'''== {{collapse top|Click here for references}} {{Reflist|30em}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] {{collapse bottom}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] n8zjhhqdqm15lt250twzrnlhpad3c8l 2419112 2419111 2022-08-25T23:08:33Z Ardenguo 2944162 /* Psychometric properties of screening for PTSD */ removed a link wikitext text/x-wiki <noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{medical disclaimer}} {{:{{BASEPAGENAME}}/Sidebar}} ==[[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio"?''']]== * For background information on what assessment portfolios are, click the link in the heading above. * Want even 'more' information about this topic? There's an extended version of this page [[Evidence-based assessment/Posttraumatic stress disorder (disorder portfolio)/extended version|'''here''']]. == [[Evidence based assessment/Preparation phase|'''Preparation phase''']] == === Diagnostic criteria for post traumatic stress disorder === ===='''ICD-11 Diagnostic Criteria'''==== {{blockquotetop}} ===='''ICD-11 Criteria'''==== *Post-traumatic stress disorder (PTSD) is a syndrome that develops following exposure to an extremely threatening or horrific event or series of events that is characterized by all of the following: **1) re-experiencing the traumatic event or events in the present in the form of vivid intrusive memories, flashbacks, or nightmares, which are typically accompanied by strong and overwhelming emotions such as fear or horror and strong physical sensations, or feelings of being overwhelmed or immersed in the same intense emotions that were experienced during the traumatic event; **2) avoidance of thoughts and memories of the event or events, or avoidance of activities, situations, or people reminiscent of the event or events **3) persistent perceptions of heightened current threat, for example as indicated by hypervigilance or an enhanced startle reaction to stimuli such as unexpected noises. *The symptoms must persist for at least several weeks and cause significant impairment in personal, family, social, educational, occupational or other important areas of functioning. Additionally, ICD 11 includes a category called "Complex post-traumatic stress disorder," which is described as: *A disorder that may develop following exposure to an event or series of events of an extremely threatening or horrific nature, most commonly prolonged or repetitive events from which escape is difficult or impossible (e.g., torture, slavery, genocide campaigns, prolonged domestic violence, repeated childhood sexual or physical abuse). *The disorder is characterized by the core symptoms of PTSD; that is, all diagnostic requirements for PTSD have been met at some point during the course of the disorder. *In addition, Complex PTSD is characterized by: **1) severe and pervasive problems in affect regulation; **2) persistent beliefs about oneself as diminished, defeated or worthless, accompanied by deep and pervasive feelings of shame, guilt or failure related to the traumatic event **3) persistent difficulties in sustaining relationships and in feeling close to others. The disturbance causes significant impairment in personal, family, social, educational, occupational or other important areas of functioning. {{blockquotebottom}} ===='''Changes in DSM-5'''==== * The diagnostic criteria for post-traumatic stress disorder changed slightly from [[DSM-IV]] to [[w:Diagnostic_and_Statistical_Manual_of_Mental_Disorders#DSM-IV-TR_.282000.29|DSM-5]]. Summaries are available [http://www.dsm5.org/Documents/changes%20from%20dsm-iv-tr%20to%20dsm-5.pdf here] and [[w:DSM-5|here]]. === Developmental sensitivities === {{collapse top| Click for more information}} *Diagnostic thresholds have been lowered for children and adolescents to account for development. *Separate and additional criteria have been added for children age 6 or younger. *Child sexual abuse has been found to have a substantial effect on the development of PTSD.<ref>{{cite journal|last1=Paolucci|first1=Elizabeth ODDONE|last2=Genuis|first2=Mark L.|last3=Violato|first3=Claudio|title=A Meta-Analysis of the Published Research on the Effects of Child Sexual Abuse|journal=The Journal of Psychology|date=January 2001|volume=135|issue=1|pages=17–36|doi=10.1080/00223980109603677}}</ref> *Children with higher exposure to trauma, less social support, and other major life events are more likely to have continued PTSD symptoms 7 months after a trauma.<ref name=":2">{{cite journal |last1=La Greca|first1=A|last2=Silverman|first2=WK|last3=Vernberg|first3=EM|last4=Prinstein|first4=MJ|title=Symptoms of posttraumatic stress in children after Hurricane Andrew: a prospective study.|journal=Journal of consulting and clinical psychology|date=August 1996|volume=64|issue=4|pages=712-23|pmid=8803361}}</ref> 10 months after a trauma, however, only experience of a major life event remained predictive of continuing PTSD symptoms.<ref name=":2" /> *Lack of social support, specifically lack of support by a teacher, was predictive of higher PTSD symptoms among children who had gone through an environmental trauma.<ref name=":2" /> *Children who reported using blame and anger as strategies for coping had higher levels of PTSD symptoms 10 months after a trauma.<ref name=":2" /> *Negative affect in children before a traumatic event was predictive of development of PTSD symptoms after a traumatic event.<ref>{{cite journal|last1=Weems|first1=CF|last2=Pina|first2=AA|last3=Costa|first3=NM|last4=Watts|first4=SE|last5=Taylor|first5=LK|last6=Cannon|first6=MF|title=Predisaster trait anxiety and negative affect predict posttraumatic stress in youths after hurricane Katrina.|journal=Journal of consulting and clinical psychology|date=February 2007|volume=75|issue=1|pages=154-9|doi=10.1037/0022-006X.75.1.154|pmid=17295574}}</ref> [[wikipedia:Posttraumatic_stress_disorder|Posttraumatic stress disorder]] is now more sensitive to development in that diagnostic thresholds have been lowered for children and adolescents. Furthermore, separate and additional criteria have been added for children age 6 years of age or younger. {{collapse bottom}} === Base rates of PTSD in different clinical settings and populations === This section describes the demographic settings of the populations sampled, base rates of PTSD diagnoses, country/region sampled, and the diagnostic methods that were used. Using this information, clinicians will be able to anchor the most appropriate rate of PTSD that they are likely to see in their clinical practice. * '''''To see prevalence rates across multiple disorders,''''' [[Evidence based assessment/Preparation phase#Base rates for transdiagnostic comparison|'''''click here.''''']] {| class="wikitable sortable" border="1" |- ! Demography ! Setting ! Base Rate ! Diagnostic Method |- | United States, nationally representative, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Kessler|first=Ronald C.|last2=Berglund|first2=Patricia|last3=Demler|first3=Olga|last4=Jin|first4=Robert|last5=Merikangas|first5=Kathleen R.|last6=Walters|first6=Ellen E.|date=2005-06-01|title=Lifetime Prevalence and Age-of-Onset Distributions of DSM-IV Disorders in the National Comorbidity Survey Replication|url=http://archpsyc.jamanetwork.com/article.aspx?doi=10.1001/archpsyc.62.6.593|journal=Archives of General Psychiatry|language=en|volume=62|issue=6|doi=10.1001/archpsyc.62.6.593|issn=0003-990X}}</ref> | 6.8% | National Comorbidity Survey - Replication |- | Netherlands, nationally representative, age 18-80 | Non-clinical: Population based<ref>{{Cite journal|last=de Vries|first=Giel-Jan|last2=Olff|first2=Miranda|date=2009-08-01|title=The lifetime prevalence of traumatic events and posttraumatic stress disorder in the Netherlands|url=http://onlinelibrary.wiley.com/doi/10.1002/jts.20429/abstract|journal=Journal of Traumatic Stress|language=en|volume=22|issue=4|pages=259–267|doi=10.1002/jts.20429|issn=1573-6598}}</ref> | 7.4% | Composite International Diagnostic Interview (CIDI) |- | United States, nationally representative, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Pietrzak|first=Robert H.|last2=Goldstein|first2=Risë B.|last3=Southwick|first3=Steven M.|last4=Grant|first4=Bridget F.|title=Prevalence and Axis I comorbidity of full and partial posttraumatic stress disorder in the United States: Results from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions|url=http://linkinghub.elsevier.com/retrieve/pii/S0887618510002288|journal=Journal of Anxiety Disorders|volume=25|issue=3|pages=456–465|doi=10.1016/j.janxdis.2010.11.010}}</ref> | 6.4% | Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions |- | Northern Ireland, representative sample, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Bunting|first=Brendan P.|last2=Ferry|first2=Finola R.|last3=Murphy|first3=Samuel D.|last4=O'Neill|first4=Siobhan M.|last5=Bolton|first5=David|date=2013-02-01|title=Trauma Associated With Civil Conflict and Posttraumatic Stress Disorder: Evidence From the Northern Ireland Study of Health and Stress|url=http://onlinelibrary.wiley.com/doi/10.1002/jts.21766/abstract|journal=Journal of Traumatic Stress|language=en|volume=26|issue=1|pages=134–141|doi=10.1002/jts.21766|issn=1573-6598}}</ref> | 8.8% | Northern Ireland Study of Health and Stress |- | South Africa, nationally representative sample, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Atwoli|first=Lukoye|last2=Stein|first2=Dan J.|last3=Williams|first3=David R.|last4=Mclaughlin|first4=Katie A.|last5=Petukhova|first5=Maria|last6=Kessler|first6=Ronald C.|last7=Koenen|first7=Karestan C.|date=2013-07-03|title=Trauma and posttraumatic stress disorder in South Africa: analysis from the South African Stress and Health Study|url=https://doi.org/10.1186/1471-244X-13-182|journal=BMC Psychiatry|volume=13|pages=182|doi=10.1186/1471-244x-13-182|issn=1471-244X}}</ref> | 2.3% | South African Stress and Health Study, using the Composite International Diagnostic Interview (CIDI) |- | U.S. Army and Marine Soldiers Deployed to Iraq and Afghanistan | U.S. Service Members<ref>{{Cite journal|last=Hoge|first=Charles W.|last2=Castro|first2=Carl A.|last3=Messer|first3=Stephen C.|last4=McGurk|first4=Dennis|last5=Cotting|first5=Dave I.|last6=Koffman|first6=Robert L.|date=2004-07-01|title=Combat Duty in Iraq and Afghanistan, Mental Health Problems, and Barriers to Care|url=http://dx.doi.org/10.1056/NEJMoa040603|journal=New England Journal of Medicine|volume=351|issue=1|pages=13–22|doi=10.1056/nejmoa040603|issn=0028-4793|pmid=15229303}}</ref> |11.5% - 19.5% ♦ | PTSD Checklist |- |United States, nationally representative, ages 13-18 |Non-clinical: Population based<ref>{{Cite journal|last=Merikangas|first=Kathleen Ries|last2=He|first2=Jian-ping|last3=Burstein|first3=Marcy|last4=Swanson|first4=Sonja A.|last5=Avenevoli|first5=Shelli|last6=Cui|first6=Lihong|last7=Benjet|first7=Corina|last8=Georgiades|first8=Katholiki|last9=Swendsen|first9=Joel|title=Lifetime Prevalence of Mental Disorders in U.S. Adolescents: Results from the National Comorbidity Survey Replication–Adolescent Supplement (NCS-A)|url=https://doi.org/10.1016/j.jaac.2010.05.017|journal=Journal of the American Academy of Child & Adolescent Psychiatry|volume=49|issue=10|pages=980–989|doi=10.1016/j.jaac.2010.05.017}}</ref> |5.0% |National Comorbidity Survey Replication—Adolescent Supplement (NCS-A) |} ♦ '''Note''': These rates were using broad PTSD Checklist scoring criteria of being scored positive if subjects reported at least one intrusion symptom, three avoidance symptoms, and two hyperarousal symptom that were categorized as at the moderate level. The 11.5% is for soldiers returning from deployment in Iraq, 19.5% is for soldiers returning from Afghanistan. Another common practice is to use a strict cutoff of 50 on the PCL, above which someone screens positive for PTSD. With this cutoff, rates are 6.2% and 12.9% for Service Members returned from Afghanistan and Iraqi, respectively. ==[[Evidence based assessment/Prediction phase|'''Prediction phase''']]== === Psychometric properties of screening for PTSD === The following section contains a list of screening and diagnostic instruments for PTSD. The section includes administration information, psychometric data, and PDFs or links to the screenings. * Screenings are used as part of the [[Evidence based assessment/Prediction phase|prediction phase]] of assessment; for more information on interpretation of this data, or how screenings fit in to the assessment process, click [[Evidence based assessment/Prediction phase|here.]] * '''''For a list of more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Psychometric_properties_of_common_screening_instruments click here.]''''' {| class="wikitable" |- ! Measure !Format (Reporter) !Age Range !Administration/ Completion Time !Where to Access |- |[https://www.ptsd.va.gov/professional/assessment/adult-sr/ptsd-checklist.asp PCL-5 (PTSD Checklist for DSM-5)] |Self-Report |adult |5-10 minutes |[https://www.ptsd.va.gov/professional/assessment/documents/PCL5_Standard_form.PDFPDF PDF] |- |PDS (Post-traumatic Diagnosis Scale) |Self-Report |adult |10-20 minutes | |- | colspan="4" style="font-size:110%; text-align:center;" |'''For Children and Adolescents Specifically''' | |- |[https://www.reactionindex.com/index.php/ UCLA PTSD Reaction Index for DSM-5] |Clinician Administered |child, school age, adolescents |20-30 minutes |[https://www.dellchildrens.net/wp-content/uploads/sites/60/2019/08/UCLA-PTSD-RI-DSM-5.pdf PDF] |- |CPSS (Children's PTSD Symptom Scale) |Self-Report |child |10-20 minutes |[https://www.aacap.org/App_Themes/AACAP/docs/resource_centers/resources/misc/child_ptsd_symptom_scale.pdf PDF] |- |Young Child PTSD Checklist (YCPC) |Parent Report |child |13 items | |} '''Note:''' '''L''' = Less than adequate; '''A''' = Adequate; '''G''' = Good; '''E''' = Excellent; '''U''' = Unavailable; '''NA''' = Not applicable === Interpreting PTSD screening measure scores === * For information on interpreting screening measure scores, click [[Evidence based assessment/Prediction phase#Interpreting screening measure scores|here.]] * Also see the page on [https://en.wikipedia.org/wiki/Likelihood_ratios_in_diagnostic_testing likelihood ratios in diagnostic testing] for more information ==[[Evidence based assessment/Prescription phase|'''Prescription phase''']]== ===Gold standard diagnostic interviews=== * For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews click here.] ===Recommended diagnostic interviews for PTSD=== {| class="wikitable sortable" border="1" ! colspan="4" |Diagnostic instruments for PTSD |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time |- | [https://www.ptsd.va.gov/professional/assessment/adult-int/caps.asp CAPS-5 (Clinician Administered PTSD Scale)] | Clinician Administered Interview | adult | 40-60 minutes |- |PTSD Symptom Scale Interview (PSS-I-5) |Clinician Administered Interview |adult and child version available |24 items |- | colspan="4" style="font-size:110%; text-align:center;" |'''For Children and Adolescents Specifically''' |- | [https://www.ptsd.va.gov/professional/assessment/child/caps-ca.asp CAPS-CA-5 (Clinician-Administered PTSD Scale for DSM-5 - Child/Adolescent Version)] |Clinician Administered Interview |child |30 items |- | Children’s PTSD Inventory (CPTSD-I) |Diagnostic Interview | 6-18 years | 50 items |} '''Note:''' '''L''' = Less than adequate; '''A''' = Adequate; '''G''' = Good; '''E''' = Excellent; '''U''' = Unavailable; '''NA''' = Not applicable ===Severity interviews for PTSD=== {| class="wikitable sortable" border="1" |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time |- | [https://www.kennedykrieger.org/sites/default/files/library/documents/faculty/ksads-dsm-5-screener.pdf Schedule for Affective Disorders and Schizophrenia for School Age Children (K-SADS)] | Diagnostic Interview | 6-18 years | 18 PTSD items |- | Anxiety Disorders Interview Schedule, Child Version (ADIS-C) | Diagnostic Interview | 7-17 years | 26 PTSD items |- | Children’s Interview for Psychiatric Symptoms (ChIPS) |Diagnostic Interview |6 – 18 years |31 PTSD items |- | Diagnostic Infant and Preschool Assessment (DIPA) |Diagnostic Interview | Age 6 and younger | 46 PTSD items |} '''Note:''' '''L''' = Less than adequate; '''A''' = Adequate; '''G''' = Good; '''E''' = Excellent; '''U''' = Unavailable; '''NA''' = Not applicable ==[[Evidence based assessment/Process phase|'''Process phase''']]== The following section contains a brief overview of treatment options for PTSD and list of process and outcome measures for PTSD. The section includes benchmarks based on published norms for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the [[Evidence based assessment/Process phase|process phase]] of assessment. For more information of differences between process and outcome measures, see the page on the [[Evidence based assessment/Process phase|process phase of assessment]]. === Process measures === * Information coming soon === Outcome and severity measures === This table includes clinically significant benchmarks for PTSD specific outcome measures * Information on how to interpret this table can be [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase found here]. * Additionally, these [[Evidence based assessment/Vignettes|vignettes]] might be helpful resources for understanding appropriate adaptation of outcome measures in practice. * ''<u>For clinically significant change benchmarks for the CBCL, YSR, and TRF total, externalizing, internalizing, and attention benchmarks,</u>'' [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase&wteswitched=1#Clinically_significant_change_benchmarks_for_widely-used_outcome_measures see here.] {| class="wikitable sortable" border="1" | colspan="7" |'''Clinically significant change benchmarks with common instruments for PTSD''' |- | colspan="7" style="font-size:110%; text-align:center;" span |<b> Benchmarks Based on Published Norms</b> |- | rowspan="2" style="text-align:center;font-size:130%;" |<b> Measure</b> | colspan="3" style="text-align:center;font-size:130%" width="300" |<b> Cut-off scores</b> | colspan="3" style="text-align:center;font-size:120%" |<b> Critical Change <br> (unstandardized scores)</b> |- | style="text-align:center;font-size:110%" |<b> A</b> | style="text-align:center;font-size:110%" |<b> B</b> | style="text-align:center;font-size:110%" |<b> C</b> | style="text-align:center;font-size:110%" |<b> 95%</b> | style="text-align:center;font-size:110%" |<b> 90%</b> | style="text-align:center;font-size:110%" |<b> SE_difference</b> |- | rowspan="1" style="text-align:center;" | Primary Care PTSD Screen | style="text-align:center;" | 1.0 | style="text-align:center;" | 3.1 | style="text-align:center;" | 2.0 | style="text-align:center;" | 1.0 | style="text-align:center;" | .8 | style="text-align:center;" | .5 |- | rowspan="1" style="text-align:center;" | PTSD Checklist Scores | style="text-align:center;" | 28.8 | style="text-align:center;" | 40.8 | style="text-align:center;" | 34.9 | style="text-align:center;" | 4.6 | style="text-align:center;" | 3.8 | style="text-align:center;" | 2.3 |- | rowspan="1" style="text-align:center;" | Clinician Administered PTSD Scale | style="text-align:center;" | 28.8 | style="text-align:center;" | 40.8 | style="text-align:center;" | 34.9 | style="text-align:center;" | 8.3 | style="text-align:center;" | 7.0 | style="text-align:center;" | 4.2 |} === Treatment === * Please refer to the Wikipedia page on [[wikipedia:Posttraumatic_stress_disorder|PTSD]] for more information on available treatment for PTSD or go to the [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/post-traumatic-stress-disorder/ Effective Child Therapy] page for for a curated resource on effective treatments for PTSD. {{collapse top| Click here for more information}} '''<big>Behavioral interventions</big>''' Recommended (have ''significant benefit'') <ref name=":0">Department of Veterans Affairs and Department of Defense. . (2010). VA/DoD clinical practice guidelines: management of post-traumatic stress. Washington, D.C.: Veterans Health Administration, Department of Defense.</ref>: # Brief Cognitive Behavioral Therapy (CBT; 4-5 sessions) #* This includes stress inoculation training, trauma-focused therapy including components of cognitive restructuring, Cognitive Processing Therapy (CPT), imaginal, virtual, and in-vivo exposure as in Prolonged Exposure psychotherapy (PE)² #* Patient education is recommended as part of psychotherapy for patients and family members # EMDR may help both acute and chronic PTSD, especially individuals who have trouble with prolonged exposure or have trouble verbalizing their trauma.<ref name=":1">Ursano, R. J., Bell, C., Eth, S., Friedman, M., Norwood, A., Pfefferbaum, B., . . . McIntyre, J. S. (2004). ''Practice guideline for the treatment of patients with acute stress disorder and posttraumatic stress disorder'': American Psychiatric Publ </ref> ## Long term gains require further study. # [https://www.ptsd.va.gov/professional/treat/txessentials/present_centered_therapy.asp Present-Centered Therapy (PCT)] is a non trauma focused treatment for PTSD and a second-line treatment for PTSD<ref>{{Cite web|url=https://www.ptsd.va.gov/professional/treat/txessentials/present_centered_therapy.asp|title=Present-Centered Therapy for PTSD - PTSD: National Center for PTSD|website=www.ptsd.va.gov|language=en|access-date=2022-08-13}}</ref>. Treatments with weaker evidence (have ''some benefit'') <ref name=":0" />: # Patient education, # Imagery rehearsal therapy, # Psychodynamic therapy, # Hypnosis, # Relaxation techniques, # and Group therapy. Treatment with ''unknown benefit'' <ref name=":0" />: # Web-based CBT ## For example Jeane Bosch participated as a study therapist in research study that compared STAIR and present-centered therapy both delivered via telehealth. STAIR stands for Skills Training in Affective and Interpersonal Regulation. It is a skill-focused treatment that was originally developed for survivors of childhood abuse to teach emotion regulation skills as well as tools to help with challenges interpersonal functioning and social relationships and decrease PTSD symptoms<ref>{{Cite web|url=https://istss.org/public-resources/trauma-blog/2015-march-(1)/clinician-s-corner-skills-training-in-affective-an|title=ISTSS - Trauma Blog|website=istss.org|access-date=2022-08-13}}</ref>.<ref>{{Citation|title=Introduction to Telehealth with Dr. Bosch|url=https://www.youtube.com/watch?v=Wn6Vewl42X8|accessdate=2022-08-13|language=en}}</ref> # Acceptance and commitment therapy, # and Dialectical Behavioral Therapy. <big>'''Medication'''</big> *SSRIs are more effective than placebo in treating PTSD.<ref name=":1" /> *There is no evidence to support a medication to prevent the development of PTSD.<ref name=":0" /> **Imipramine, propranolol, prazosin, other antidepressants, anticonvulsants, and atypical antipsychotics have ''unknown benefit.'' **Strongly recommend against the use of benzodiazepines² and typical antipsychotics since they have ''no benefit and potential harm.'' {{collapse bottom}} == '''External resources''' == === For professionals === * [http://www.som.uq.edu.au/ptsd Post Traumatic Stress Disorder Information Resource] from [http://www.uq.edu.au/ The University of Queensland School of Medicine] * [http://www.apa.org/ptsd-guideline/ APA practice parameters for assessment and treatment for PTSD (Updated 2017)] * [http://www.ptsd.va.gov/professional/index.asp Resources for professionals] from [http://www.ptsd.va.gov/index.asp VA National PTSD Center] * [https://www.integration.samhsa.gov/clinical-practice/trauma-informed SAMHSA's Trauma-Informed Care Resources and Training] * [https://www.integration.samhsa.gov/clinical-practice/trauma-informed SAMHSA's Resources on Intimate Partner Violence (IPV) for Clinicians, Patients, Families, and Organizations] === For caregivers === * [http://www.nctsn.org/sites/default/files/assets/pdfs/tips_for_parents_media_final.pdf Tips for parents on shooting media coverage] * [http://www.nctsn.org/sites/default/files/assets/pdfs/parents_guidelines_for_helping_teens_after_the_recent_attacks.pdf Parent guidelines to helping youths after a shooting] * [http://www.nctsn.org/sites/default/files/assets/pdfs/helping_teens_with_traumatic_grief_caregivers_final.pdf Caregiver tips for helping teens with traumatic grief] * [http://www.nctsn.org/sites/default/files/assets/pdfs/10things_schoolage_ctg.pdf Caregiver tips for helping school-age children with traumatic grief] *[http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/post-traumatic-stress-disorder/ EffectiveChildTherapy.Org information on PTSD] *[https://sccap53.org Society of Clinical Child and Adolescent Psychology] === For educators === * [http://www.nctsn.org/sites/default/files/assets/pdfs/pfa_for_schools_appendix_a_teachers.pdf Teacher tips for providing psychological first aid] * [http://www.nctsn.org/sites/default/files/assets/pdfs/helping_youth_after_community_violence_educators.pdf Educator tips for helping youths after a community trauma] === For public === * [https://complicatedgrief.columbia.edu/for-the-public/resources/ Resources for grief and loss] * [http://www.nctsn.org/sites/default/files/assets/pdfs/psychological_information_sheet_two_pager.pdf Psychological impacts of recent shootings] * [http://www.nctsn.org/sites/default/files/assets/pdfs/youth_journalists.pdf Tips to talking to youths about a shooting] * [http://www.nctsn.org/sites/default/files/assets/pdfs/talking_to_children_about_the_shooting.pdf Tips to talking to children about a shooting] * [http://www.nctsn.org/sites/default/files/assets/pdfs/helping_young_children_heal_crisis.pdf Helping young children heal after a crisis] * [http://www.nctsn.org/content/psychological-first-aid-schoolspfa Psychological first aid for schools] * [http://www.nctsn.org/content/psychological-first-aid Resources and manuals on psychological first aid] * [http://www.ptsd.va.gov/public/index.asp Resources for the public] from [http://www.ptsd.va.gov/index.asp VA National PTSD Center] * [https://curlie.org/Health/Mental_Health/Disorders/Anxiety/Post-traumatic_Stress Posttraumatic stress disorder] at Curlie (based on DMOZ) =='''References'''== {{collapse top|Click here for references}} {{Reflist|30em}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] {{collapse bottom}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] sivtutct1h0krdagwwy2rn8h2pr945c 2419113 2419112 2022-08-25T23:09:52Z Ardenguo 2944162 /* Psychometric properties of screening for PTSD */ added link wikitext text/x-wiki <noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{medical disclaimer}} {{:{{BASEPAGENAME}}/Sidebar}} ==[[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio"?''']]== * For background information on what assessment portfolios are, click the link in the heading above. * Want even 'more' information about this topic? There's an extended version of this page [[Evidence-based assessment/Posttraumatic stress disorder (disorder portfolio)/extended version|'''here''']]. == [[Evidence based assessment/Preparation phase|'''Preparation phase''']] == === Diagnostic criteria for post traumatic stress disorder === ===='''ICD-11 Diagnostic Criteria'''==== {{blockquotetop}} ===='''ICD-11 Criteria'''==== *Post-traumatic stress disorder (PTSD) is a syndrome that develops following exposure to an extremely threatening or horrific event or series of events that is characterized by all of the following: **1) re-experiencing the traumatic event or events in the present in the form of vivid intrusive memories, flashbacks, or nightmares, which are typically accompanied by strong and overwhelming emotions such as fear or horror and strong physical sensations, or feelings of being overwhelmed or immersed in the same intense emotions that were experienced during the traumatic event; **2) avoidance of thoughts and memories of the event or events, or avoidance of activities, situations, or people reminiscent of the event or events **3) persistent perceptions of heightened current threat, for example as indicated by hypervigilance or an enhanced startle reaction to stimuli such as unexpected noises. *The symptoms must persist for at least several weeks and cause significant impairment in personal, family, social, educational, occupational or other important areas of functioning. Additionally, ICD 11 includes a category called "Complex post-traumatic stress disorder," which is described as: *A disorder that may develop following exposure to an event or series of events of an extremely threatening or horrific nature, most commonly prolonged or repetitive events from which escape is difficult or impossible (e.g., torture, slavery, genocide campaigns, prolonged domestic violence, repeated childhood sexual or physical abuse). *The disorder is characterized by the core symptoms of PTSD; that is, all diagnostic requirements for PTSD have been met at some point during the course of the disorder. *In addition, Complex PTSD is characterized by: **1) severe and pervasive problems in affect regulation; **2) persistent beliefs about oneself as diminished, defeated or worthless, accompanied by deep and pervasive feelings of shame, guilt or failure related to the traumatic event **3) persistent difficulties in sustaining relationships and in feeling close to others. The disturbance causes significant impairment in personal, family, social, educational, occupational or other important areas of functioning. {{blockquotebottom}} ===='''Changes in DSM-5'''==== * The diagnostic criteria for post-traumatic stress disorder changed slightly from [[DSM-IV]] to [[w:Diagnostic_and_Statistical_Manual_of_Mental_Disorders#DSM-IV-TR_.282000.29|DSM-5]]. Summaries are available [http://www.dsm5.org/Documents/changes%20from%20dsm-iv-tr%20to%20dsm-5.pdf here] and [[w:DSM-5|here]]. === Developmental sensitivities === {{collapse top| Click for more information}} *Diagnostic thresholds have been lowered for children and adolescents to account for development. *Separate and additional criteria have been added for children age 6 or younger. *Child sexual abuse has been found to have a substantial effect on the development of PTSD.<ref>{{cite journal|last1=Paolucci|first1=Elizabeth ODDONE|last2=Genuis|first2=Mark L.|last3=Violato|first3=Claudio|title=A Meta-Analysis of the Published Research on the Effects of Child Sexual Abuse|journal=The Journal of Psychology|date=January 2001|volume=135|issue=1|pages=17–36|doi=10.1080/00223980109603677}}</ref> *Children with higher exposure to trauma, less social support, and other major life events are more likely to have continued PTSD symptoms 7 months after a trauma.<ref name=":2">{{cite journal |last1=La Greca|first1=A|last2=Silverman|first2=WK|last3=Vernberg|first3=EM|last4=Prinstein|first4=MJ|title=Symptoms of posttraumatic stress in children after Hurricane Andrew: a prospective study.|journal=Journal of consulting and clinical psychology|date=August 1996|volume=64|issue=4|pages=712-23|pmid=8803361}}</ref> 10 months after a trauma, however, only experience of a major life event remained predictive of continuing PTSD symptoms.<ref name=":2" /> *Lack of social support, specifically lack of support by a teacher, was predictive of higher PTSD symptoms among children who had gone through an environmental trauma.<ref name=":2" /> *Children who reported using blame and anger as strategies for coping had higher levels of PTSD symptoms 10 months after a trauma.<ref name=":2" /> *Negative affect in children before a traumatic event was predictive of development of PTSD symptoms after a traumatic event.<ref>{{cite journal|last1=Weems|first1=CF|last2=Pina|first2=AA|last3=Costa|first3=NM|last4=Watts|first4=SE|last5=Taylor|first5=LK|last6=Cannon|first6=MF|title=Predisaster trait anxiety and negative affect predict posttraumatic stress in youths after hurricane Katrina.|journal=Journal of consulting and clinical psychology|date=February 2007|volume=75|issue=1|pages=154-9|doi=10.1037/0022-006X.75.1.154|pmid=17295574}}</ref> [[wikipedia:Posttraumatic_stress_disorder|Posttraumatic stress disorder]] is now more sensitive to development in that diagnostic thresholds have been lowered for children and adolescents. Furthermore, separate and additional criteria have been added for children age 6 years of age or younger. {{collapse bottom}} === Base rates of PTSD in different clinical settings and populations === This section describes the demographic settings of the populations sampled, base rates of PTSD diagnoses, country/region sampled, and the diagnostic methods that were used. Using this information, clinicians will be able to anchor the most appropriate rate of PTSD that they are likely to see in their clinical practice. * '''''To see prevalence rates across multiple disorders,''''' [[Evidence based assessment/Preparation phase#Base rates for transdiagnostic comparison|'''''click here.''''']] {| class="wikitable sortable" border="1" |- ! Demography ! Setting ! Base Rate ! Diagnostic Method |- | United States, nationally representative, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Kessler|first=Ronald C.|last2=Berglund|first2=Patricia|last3=Demler|first3=Olga|last4=Jin|first4=Robert|last5=Merikangas|first5=Kathleen R.|last6=Walters|first6=Ellen E.|date=2005-06-01|title=Lifetime Prevalence and Age-of-Onset Distributions of DSM-IV Disorders in the National Comorbidity Survey Replication|url=http://archpsyc.jamanetwork.com/article.aspx?doi=10.1001/archpsyc.62.6.593|journal=Archives of General Psychiatry|language=en|volume=62|issue=6|doi=10.1001/archpsyc.62.6.593|issn=0003-990X}}</ref> | 6.8% | National Comorbidity Survey - Replication |- | Netherlands, nationally representative, age 18-80 | Non-clinical: Population based<ref>{{Cite journal|last=de Vries|first=Giel-Jan|last2=Olff|first2=Miranda|date=2009-08-01|title=The lifetime prevalence of traumatic events and posttraumatic stress disorder in the Netherlands|url=http://onlinelibrary.wiley.com/doi/10.1002/jts.20429/abstract|journal=Journal of Traumatic Stress|language=en|volume=22|issue=4|pages=259–267|doi=10.1002/jts.20429|issn=1573-6598}}</ref> | 7.4% | Composite International Diagnostic Interview (CIDI) |- | United States, nationally representative, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Pietrzak|first=Robert H.|last2=Goldstein|first2=Risë B.|last3=Southwick|first3=Steven M.|last4=Grant|first4=Bridget F.|title=Prevalence and Axis I comorbidity of full and partial posttraumatic stress disorder in the United States: Results from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions|url=http://linkinghub.elsevier.com/retrieve/pii/S0887618510002288|journal=Journal of Anxiety Disorders|volume=25|issue=3|pages=456–465|doi=10.1016/j.janxdis.2010.11.010}}</ref> | 6.4% | Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions |- | Northern Ireland, representative sample, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Bunting|first=Brendan P.|last2=Ferry|first2=Finola R.|last3=Murphy|first3=Samuel D.|last4=O'Neill|first4=Siobhan M.|last5=Bolton|first5=David|date=2013-02-01|title=Trauma Associated With Civil Conflict and Posttraumatic Stress Disorder: Evidence From the Northern Ireland Study of Health and Stress|url=http://onlinelibrary.wiley.com/doi/10.1002/jts.21766/abstract|journal=Journal of Traumatic Stress|language=en|volume=26|issue=1|pages=134–141|doi=10.1002/jts.21766|issn=1573-6598}}</ref> | 8.8% | Northern Ireland Study of Health and Stress |- | South Africa, nationally representative sample, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Atwoli|first=Lukoye|last2=Stein|first2=Dan J.|last3=Williams|first3=David R.|last4=Mclaughlin|first4=Katie A.|last5=Petukhova|first5=Maria|last6=Kessler|first6=Ronald C.|last7=Koenen|first7=Karestan C.|date=2013-07-03|title=Trauma and posttraumatic stress disorder in South Africa: analysis from the South African Stress and Health Study|url=https://doi.org/10.1186/1471-244X-13-182|journal=BMC Psychiatry|volume=13|pages=182|doi=10.1186/1471-244x-13-182|issn=1471-244X}}</ref> | 2.3% | South African Stress and Health Study, using the Composite International Diagnostic Interview (CIDI) |- | U.S. Army and Marine Soldiers Deployed to Iraq and Afghanistan | U.S. Service Members<ref>{{Cite journal|last=Hoge|first=Charles W.|last2=Castro|first2=Carl A.|last3=Messer|first3=Stephen C.|last4=McGurk|first4=Dennis|last5=Cotting|first5=Dave I.|last6=Koffman|first6=Robert L.|date=2004-07-01|title=Combat Duty in Iraq and Afghanistan, Mental Health Problems, and Barriers to Care|url=http://dx.doi.org/10.1056/NEJMoa040603|journal=New England Journal of Medicine|volume=351|issue=1|pages=13–22|doi=10.1056/nejmoa040603|issn=0028-4793|pmid=15229303}}</ref> |11.5% - 19.5% ♦ | PTSD Checklist |- |United States, nationally representative, ages 13-18 |Non-clinical: Population based<ref>{{Cite journal|last=Merikangas|first=Kathleen Ries|last2=He|first2=Jian-ping|last3=Burstein|first3=Marcy|last4=Swanson|first4=Sonja A.|last5=Avenevoli|first5=Shelli|last6=Cui|first6=Lihong|last7=Benjet|first7=Corina|last8=Georgiades|first8=Katholiki|last9=Swendsen|first9=Joel|title=Lifetime Prevalence of Mental Disorders in U.S. Adolescents: Results from the National Comorbidity Survey Replication–Adolescent Supplement (NCS-A)|url=https://doi.org/10.1016/j.jaac.2010.05.017|journal=Journal of the American Academy of Child & Adolescent Psychiatry|volume=49|issue=10|pages=980–989|doi=10.1016/j.jaac.2010.05.017}}</ref> |5.0% |National Comorbidity Survey Replication—Adolescent Supplement (NCS-A) |} ♦ '''Note''': These rates were using broad PTSD Checklist scoring criteria of being scored positive if subjects reported at least one intrusion symptom, three avoidance symptoms, and two hyperarousal symptom that were categorized as at the moderate level. The 11.5% is for soldiers returning from deployment in Iraq, 19.5% is for soldiers returning from Afghanistan. Another common practice is to use a strict cutoff of 50 on the PCL, above which someone screens positive for PTSD. With this cutoff, rates are 6.2% and 12.9% for Service Members returned from Afghanistan and Iraqi, respectively. ==[[Evidence based assessment/Prediction phase|'''Prediction phase''']]== === Psychometric properties of screening for PTSD === The following section contains a list of screening and diagnostic instruments for PTSD. The section includes administration information, psychometric data, and PDFs or links to the screenings. * Screenings are used as part of the [[Evidence based assessment/Prediction phase|prediction phase]] of assessment; for more information on interpretation of this data, or how screenings fit in to the assessment process, click [[Evidence based assessment/Prediction phase|here.]] * '''''For a list of more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Psychometric_properties_of_common_screening_instruments click here.]''''' {| class="wikitable" |- ! Measure !Format (Reporter) !Age Range !Administration/ Completion Time !Where to Access |- |[https://www.ptsd.va.gov/professional/assessment/adult-sr/ptsd-checklist.asp PCL-5 (PTSD Checklist for DSM-5)] |Self-Report |adult |5-10 minutes |[https://www.ptsd.va.gov/professional/assessment/documents/PCL5_Standard_form.PDFPDF PDF] |- |PDS (Post-traumatic Diagnosis Scale) |Self-Report |adult |10-20 minutes | |- | colspan="4" style="font-size:110%; text-align:center;" |'''For Children and Adolescents Specifically''' | |- |[https://www.reactionindex.com/index.php/ UCLA PTSD Reaction Index for DSM-5] |Clinician Administered |child, school age, adolescents |20-30 minutes |[https://www.dellchildrens.net/wp-content/uploads/sites/60/2019/08/UCLA-PTSD-RI-DSM-5.pdf PDF] |- |CPSS (Children's PTSD Symptom Scale) |Self-Report |child |10-20 minutes |[https://www.aacap.org/App_Themes/AACAP/docs/resource_centers/resources/misc/child_ptsd_symptom_scale.pdf PDF] |- |Young Child PTSD Checklist (YCPC) |Parent Report |child |13 items |[https://medicine.tulane.edu/sites/g/files/rdw761/f/YCPC_v5_23_14.pdf PDF] |} '''Note:''' '''L''' = Less than adequate; '''A''' = Adequate; '''G''' = Good; '''E''' = Excellent; '''U''' = Unavailable; '''NA''' = Not applicable === Interpreting PTSD screening measure scores === * For information on interpreting screening measure scores, click [[Evidence based assessment/Prediction phase#Interpreting screening measure scores|here.]] * Also see the page on [https://en.wikipedia.org/wiki/Likelihood_ratios_in_diagnostic_testing likelihood ratios in diagnostic testing] for more information ==[[Evidence based assessment/Prescription phase|'''Prescription phase''']]== ===Gold standard diagnostic interviews=== * For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews click here.] ===Recommended diagnostic interviews for PTSD=== {| class="wikitable sortable" border="1" ! colspan="4" |Diagnostic instruments for PTSD |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time |- | [https://www.ptsd.va.gov/professional/assessment/adult-int/caps.asp CAPS-5 (Clinician Administered PTSD Scale)] | Clinician Administered Interview | adult | 40-60 minutes |- |PTSD Symptom Scale Interview (PSS-I-5) |Clinician Administered Interview |adult and child version available |24 items |- | colspan="4" style="font-size:110%; text-align:center;" |'''For Children and Adolescents Specifically''' |- | [https://www.ptsd.va.gov/professional/assessment/child/caps-ca.asp CAPS-CA-5 (Clinician-Administered PTSD Scale for DSM-5 - Child/Adolescent Version)] |Clinician Administered Interview |child |30 items |- | Children’s PTSD Inventory (CPTSD-I) |Diagnostic Interview | 6-18 years | 50 items |} '''Note:''' '''L''' = Less than adequate; '''A''' = Adequate; '''G''' = Good; '''E''' = Excellent; '''U''' = Unavailable; '''NA''' = Not applicable ===Severity interviews for PTSD=== {| class="wikitable sortable" border="1" |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time |- | [https://www.kennedykrieger.org/sites/default/files/library/documents/faculty/ksads-dsm-5-screener.pdf Schedule for Affective Disorders and Schizophrenia for School Age Children (K-SADS)] | Diagnostic Interview | 6-18 years | 18 PTSD items |- | Anxiety Disorders Interview Schedule, Child Version (ADIS-C) | Diagnostic Interview | 7-17 years | 26 PTSD items |- | Children’s Interview for Psychiatric Symptoms (ChIPS) |Diagnostic Interview |6 – 18 years |31 PTSD items |- | Diagnostic Infant and Preschool Assessment (DIPA) |Diagnostic Interview | Age 6 and younger | 46 PTSD items |} '''Note:''' '''L''' = Less than adequate; '''A''' = Adequate; '''G''' = Good; '''E''' = Excellent; '''U''' = Unavailable; '''NA''' = Not applicable ==[[Evidence based assessment/Process phase|'''Process phase''']]== The following section contains a brief overview of treatment options for PTSD and list of process and outcome measures for PTSD. The section includes benchmarks based on published norms for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the [[Evidence based assessment/Process phase|process phase]] of assessment. For more information of differences between process and outcome measures, see the page on the [[Evidence based assessment/Process phase|process phase of assessment]]. === Process measures === * Information coming soon === Outcome and severity measures === This table includes clinically significant benchmarks for PTSD specific outcome measures * Information on how to interpret this table can be [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase found here]. * Additionally, these [[Evidence based assessment/Vignettes|vignettes]] might be helpful resources for understanding appropriate adaptation of outcome measures in practice. * ''<u>For clinically significant change benchmarks for the CBCL, YSR, and TRF total, externalizing, internalizing, and attention benchmarks,</u>'' [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase&wteswitched=1#Clinically_significant_change_benchmarks_for_widely-used_outcome_measures see here.] {| class="wikitable sortable" border="1" | colspan="7" |'''Clinically significant change benchmarks with common instruments for PTSD''' |- | colspan="7" style="font-size:110%; text-align:center;" span |<b> Benchmarks Based on Published Norms</b> |- | rowspan="2" style="text-align:center;font-size:130%;" |<b> Measure</b> | colspan="3" style="text-align:center;font-size:130%" width="300" |<b> Cut-off scores</b> | colspan="3" style="text-align:center;font-size:120%" |<b> Critical Change <br> (unstandardized scores)</b> |- | style="text-align:center;font-size:110%" |<b> A</b> | style="text-align:center;font-size:110%" |<b> B</b> | style="text-align:center;font-size:110%" |<b> C</b> | style="text-align:center;font-size:110%" |<b> 95%</b> | style="text-align:center;font-size:110%" |<b> 90%</b> | style="text-align:center;font-size:110%" |<b> SE_difference</b> |- | rowspan="1" style="text-align:center;" | Primary Care PTSD Screen | style="text-align:center;" | 1.0 | style="text-align:center;" | 3.1 | style="text-align:center;" | 2.0 | style="text-align:center;" | 1.0 | style="text-align:center;" | .8 | style="text-align:center;" | .5 |- | rowspan="1" style="text-align:center;" | PTSD Checklist Scores | style="text-align:center;" | 28.8 | style="text-align:center;" | 40.8 | style="text-align:center;" | 34.9 | style="text-align:center;" | 4.6 | style="text-align:center;" | 3.8 | style="text-align:center;" | 2.3 |- | rowspan="1" style="text-align:center;" | Clinician Administered PTSD Scale | style="text-align:center;" | 28.8 | style="text-align:center;" | 40.8 | style="text-align:center;" | 34.9 | style="text-align:center;" | 8.3 | style="text-align:center;" | 7.0 | style="text-align:center;" | 4.2 |} === Treatment === * Please refer to the Wikipedia page on [[wikipedia:Posttraumatic_stress_disorder|PTSD]] for more information on available treatment for PTSD or go to the [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/post-traumatic-stress-disorder/ Effective Child Therapy] page for for a curated resource on effective treatments for PTSD. {{collapse top| Click here for more information}} '''<big>Behavioral interventions</big>''' Recommended (have ''significant benefit'') <ref name=":0">Department of Veterans Affairs and Department of Defense. . (2010). VA/DoD clinical practice guidelines: management of post-traumatic stress. Washington, D.C.: Veterans Health Administration, Department of Defense.</ref>: # Brief Cognitive Behavioral Therapy (CBT; 4-5 sessions) #* This includes stress inoculation training, trauma-focused therapy including components of cognitive restructuring, Cognitive Processing Therapy (CPT), imaginal, virtual, and in-vivo exposure as in Prolonged Exposure psychotherapy (PE)² #* Patient education is recommended as part of psychotherapy for patients and family members # EMDR may help both acute and chronic PTSD, especially individuals who have trouble with prolonged exposure or have trouble verbalizing their trauma.<ref name=":1">Ursano, R. J., Bell, C., Eth, S., Friedman, M., Norwood, A., Pfefferbaum, B., . . . McIntyre, J. S. (2004). ''Practice guideline for the treatment of patients with acute stress disorder and posttraumatic stress disorder'': American Psychiatric Publ </ref> ## Long term gains require further study. # [https://www.ptsd.va.gov/professional/treat/txessentials/present_centered_therapy.asp Present-Centered Therapy (PCT)] is a non trauma focused treatment for PTSD and a second-line treatment for PTSD<ref>{{Cite web|url=https://www.ptsd.va.gov/professional/treat/txessentials/present_centered_therapy.asp|title=Present-Centered Therapy for PTSD - PTSD: National Center for PTSD|website=www.ptsd.va.gov|language=en|access-date=2022-08-13}}</ref>. Treatments with weaker evidence (have ''some benefit'') <ref name=":0" />: # Patient education, # Imagery rehearsal therapy, # Psychodynamic therapy, # Hypnosis, # Relaxation techniques, # and Group therapy. Treatment with ''unknown benefit'' <ref name=":0" />: # Web-based CBT ## For example Jeane Bosch participated as a study therapist in research study that compared STAIR and present-centered therapy both delivered via telehealth. STAIR stands for Skills Training in Affective and Interpersonal Regulation. It is a skill-focused treatment that was originally developed for survivors of childhood abuse to teach emotion regulation skills as well as tools to help with challenges interpersonal functioning and social relationships and decrease PTSD symptoms<ref>{{Cite web|url=https://istss.org/public-resources/trauma-blog/2015-march-(1)/clinician-s-corner-skills-training-in-affective-an|title=ISTSS - Trauma Blog|website=istss.org|access-date=2022-08-13}}</ref>.<ref>{{Citation|title=Introduction to Telehealth with Dr. Bosch|url=https://www.youtube.com/watch?v=Wn6Vewl42X8|accessdate=2022-08-13|language=en}}</ref> # Acceptance and commitment therapy, # and Dialectical Behavioral Therapy. <big>'''Medication'''</big> *SSRIs are more effective than placebo in treating PTSD.<ref name=":1" /> *There is no evidence to support a medication to prevent the development of PTSD.<ref name=":0" /> **Imipramine, propranolol, prazosin, other antidepressants, anticonvulsants, and atypical antipsychotics have ''unknown benefit.'' **Strongly recommend against the use of benzodiazepines² and typical antipsychotics since they have ''no benefit and potential harm.'' {{collapse bottom}} == '''External resources''' == === For professionals === * [http://www.som.uq.edu.au/ptsd Post Traumatic Stress Disorder Information Resource] from [http://www.uq.edu.au/ The University of Queensland School of Medicine] * [http://www.apa.org/ptsd-guideline/ APA practice parameters for assessment and treatment for PTSD (Updated 2017)] * [http://www.ptsd.va.gov/professional/index.asp Resources for professionals] from [http://www.ptsd.va.gov/index.asp VA National PTSD Center] * [https://www.integration.samhsa.gov/clinical-practice/trauma-informed SAMHSA's Trauma-Informed Care Resources and Training] * [https://www.integration.samhsa.gov/clinical-practice/trauma-informed SAMHSA's Resources on Intimate Partner Violence (IPV) for Clinicians, Patients, Families, and Organizations] === For caregivers === * [http://www.nctsn.org/sites/default/files/assets/pdfs/tips_for_parents_media_final.pdf Tips for parents on shooting media coverage] * [http://www.nctsn.org/sites/default/files/assets/pdfs/parents_guidelines_for_helping_teens_after_the_recent_attacks.pdf Parent guidelines to helping youths after a shooting] * [http://www.nctsn.org/sites/default/files/assets/pdfs/helping_teens_with_traumatic_grief_caregivers_final.pdf Caregiver tips for helping teens with traumatic grief] * [http://www.nctsn.org/sites/default/files/assets/pdfs/10things_schoolage_ctg.pdf Caregiver tips for helping school-age children with traumatic grief] *[http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/post-traumatic-stress-disorder/ EffectiveChildTherapy.Org information on PTSD] *[https://sccap53.org Society of Clinical Child and Adolescent Psychology] === For educators === * [http://www.nctsn.org/sites/default/files/assets/pdfs/pfa_for_schools_appendix_a_teachers.pdf Teacher tips for providing psychological first aid] * [http://www.nctsn.org/sites/default/files/assets/pdfs/helping_youth_after_community_violence_educators.pdf Educator tips for helping youths after a community trauma] === For public === * [https://complicatedgrief.columbia.edu/for-the-public/resources/ Resources for grief and loss] * [http://www.nctsn.org/sites/default/files/assets/pdfs/psychological_information_sheet_two_pager.pdf Psychological impacts of recent shootings] * [http://www.nctsn.org/sites/default/files/assets/pdfs/youth_journalists.pdf Tips to talking to youths about a shooting] * [http://www.nctsn.org/sites/default/files/assets/pdfs/talking_to_children_about_the_shooting.pdf Tips to talking to children about a shooting] * [http://www.nctsn.org/sites/default/files/assets/pdfs/helping_young_children_heal_crisis.pdf Helping young children heal after a crisis] * [http://www.nctsn.org/content/psychological-first-aid-schoolspfa Psychological first aid for schools] * [http://www.nctsn.org/content/psychological-first-aid Resources and manuals on psychological first aid] * [http://www.ptsd.va.gov/public/index.asp Resources for the public] from [http://www.ptsd.va.gov/index.asp VA National PTSD Center] * [https://curlie.org/Health/Mental_Health/Disorders/Anxiety/Post-traumatic_Stress Posttraumatic stress disorder] at Curlie (based on DMOZ) =='''References'''== {{collapse top|Click here for references}} {{Reflist|30em}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] {{collapse bottom}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] f5vku6xo1tt0tatp3k0wwakjn1ztksv 2419115 2419113 2022-08-25T23:15:11Z Ardenguo 2944162 /* Recommended diagnostic interviews for PTSD */ Added links wikitext text/x-wiki <noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{medical disclaimer}} {{:{{BASEPAGENAME}}/Sidebar}} ==[[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio"?''']]== * For background information on what assessment portfolios are, click the link in the heading above. * Want even 'more' information about this topic? There's an extended version of this page [[Evidence-based assessment/Posttraumatic stress disorder (disorder portfolio)/extended version|'''here''']]. == [[Evidence based assessment/Preparation phase|'''Preparation phase''']] == === Diagnostic criteria for post traumatic stress disorder === ===='''ICD-11 Diagnostic Criteria'''==== {{blockquotetop}} ===='''ICD-11 Criteria'''==== *Post-traumatic stress disorder (PTSD) is a syndrome that develops following exposure to an extremely threatening or horrific event or series of events that is characterized by all of the following: **1) re-experiencing the traumatic event or events in the present in the form of vivid intrusive memories, flashbacks, or nightmares, which are typically accompanied by strong and overwhelming emotions such as fear or horror and strong physical sensations, or feelings of being overwhelmed or immersed in the same intense emotions that were experienced during the traumatic event; **2) avoidance of thoughts and memories of the event or events, or avoidance of activities, situations, or people reminiscent of the event or events **3) persistent perceptions of heightened current threat, for example as indicated by hypervigilance or an enhanced startle reaction to stimuli such as unexpected noises. *The symptoms must persist for at least several weeks and cause significant impairment in personal, family, social, educational, occupational or other important areas of functioning. Additionally, ICD 11 includes a category called "Complex post-traumatic stress disorder," which is described as: *A disorder that may develop following exposure to an event or series of events of an extremely threatening or horrific nature, most commonly prolonged or repetitive events from which escape is difficult or impossible (e.g., torture, slavery, genocide campaigns, prolonged domestic violence, repeated childhood sexual or physical abuse). *The disorder is characterized by the core symptoms of PTSD; that is, all diagnostic requirements for PTSD have been met at some point during the course of the disorder. *In addition, Complex PTSD is characterized by: **1) severe and pervasive problems in affect regulation; **2) persistent beliefs about oneself as diminished, defeated or worthless, accompanied by deep and pervasive feelings of shame, guilt or failure related to the traumatic event **3) persistent difficulties in sustaining relationships and in feeling close to others. The disturbance causes significant impairment in personal, family, social, educational, occupational or other important areas of functioning. {{blockquotebottom}} ===='''Changes in DSM-5'''==== * The diagnostic criteria for post-traumatic stress disorder changed slightly from [[DSM-IV]] to [[w:Diagnostic_and_Statistical_Manual_of_Mental_Disorders#DSM-IV-TR_.282000.29|DSM-5]]. Summaries are available [http://www.dsm5.org/Documents/changes%20from%20dsm-iv-tr%20to%20dsm-5.pdf here] and [[w:DSM-5|here]]. === Developmental sensitivities === {{collapse top| Click for more information}} *Diagnostic thresholds have been lowered for children and adolescents to account for development. *Separate and additional criteria have been added for children age 6 or younger. *Child sexual abuse has been found to have a substantial effect on the development of PTSD.<ref>{{cite journal|last1=Paolucci|first1=Elizabeth ODDONE|last2=Genuis|first2=Mark L.|last3=Violato|first3=Claudio|title=A Meta-Analysis of the Published Research on the Effects of Child Sexual Abuse|journal=The Journal of Psychology|date=January 2001|volume=135|issue=1|pages=17–36|doi=10.1080/00223980109603677}}</ref> *Children with higher exposure to trauma, less social support, and other major life events are more likely to have continued PTSD symptoms 7 months after a trauma.<ref name=":2">{{cite journal |last1=La Greca|first1=A|last2=Silverman|first2=WK|last3=Vernberg|first3=EM|last4=Prinstein|first4=MJ|title=Symptoms of posttraumatic stress in children after Hurricane Andrew: a prospective study.|journal=Journal of consulting and clinical psychology|date=August 1996|volume=64|issue=4|pages=712-23|pmid=8803361}}</ref> 10 months after a trauma, however, only experience of a major life event remained predictive of continuing PTSD symptoms.<ref name=":2" /> *Lack of social support, specifically lack of support by a teacher, was predictive of higher PTSD symptoms among children who had gone through an environmental trauma.<ref name=":2" /> *Children who reported using blame and anger as strategies for coping had higher levels of PTSD symptoms 10 months after a trauma.<ref name=":2" /> *Negative affect in children before a traumatic event was predictive of development of PTSD symptoms after a traumatic event.<ref>{{cite journal|last1=Weems|first1=CF|last2=Pina|first2=AA|last3=Costa|first3=NM|last4=Watts|first4=SE|last5=Taylor|first5=LK|last6=Cannon|first6=MF|title=Predisaster trait anxiety and negative affect predict posttraumatic stress in youths after hurricane Katrina.|journal=Journal of consulting and clinical psychology|date=February 2007|volume=75|issue=1|pages=154-9|doi=10.1037/0022-006X.75.1.154|pmid=17295574}}</ref> [[wikipedia:Posttraumatic_stress_disorder|Posttraumatic stress disorder]] is now more sensitive to development in that diagnostic thresholds have been lowered for children and adolescents. Furthermore, separate and additional criteria have been added for children age 6 years of age or younger. {{collapse bottom}} === Base rates of PTSD in different clinical settings and populations === This section describes the demographic settings of the populations sampled, base rates of PTSD diagnoses, country/region sampled, and the diagnostic methods that were used. Using this information, clinicians will be able to anchor the most appropriate rate of PTSD that they are likely to see in their clinical practice. * '''''To see prevalence rates across multiple disorders,''''' [[Evidence based assessment/Preparation phase#Base rates for transdiagnostic comparison|'''''click here.''''']] {| class="wikitable sortable" border="1" |- ! Demography ! Setting ! Base Rate ! Diagnostic Method |- | United States, nationally representative, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Kessler|first=Ronald C.|last2=Berglund|first2=Patricia|last3=Demler|first3=Olga|last4=Jin|first4=Robert|last5=Merikangas|first5=Kathleen R.|last6=Walters|first6=Ellen E.|date=2005-06-01|title=Lifetime Prevalence and Age-of-Onset Distributions of DSM-IV Disorders in the National Comorbidity Survey Replication|url=http://archpsyc.jamanetwork.com/article.aspx?doi=10.1001/archpsyc.62.6.593|journal=Archives of General Psychiatry|language=en|volume=62|issue=6|doi=10.1001/archpsyc.62.6.593|issn=0003-990X}}</ref> | 6.8% | National Comorbidity Survey - Replication |- | Netherlands, nationally representative, age 18-80 | Non-clinical: Population based<ref>{{Cite journal|last=de Vries|first=Giel-Jan|last2=Olff|first2=Miranda|date=2009-08-01|title=The lifetime prevalence of traumatic events and posttraumatic stress disorder in the Netherlands|url=http://onlinelibrary.wiley.com/doi/10.1002/jts.20429/abstract|journal=Journal of Traumatic Stress|language=en|volume=22|issue=4|pages=259–267|doi=10.1002/jts.20429|issn=1573-6598}}</ref> | 7.4% | Composite International Diagnostic Interview (CIDI) |- | United States, nationally representative, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Pietrzak|first=Robert H.|last2=Goldstein|first2=Risë B.|last3=Southwick|first3=Steven M.|last4=Grant|first4=Bridget F.|title=Prevalence and Axis I comorbidity of full and partial posttraumatic stress disorder in the United States: Results from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions|url=http://linkinghub.elsevier.com/retrieve/pii/S0887618510002288|journal=Journal of Anxiety Disorders|volume=25|issue=3|pages=456–465|doi=10.1016/j.janxdis.2010.11.010}}</ref> | 6.4% | Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions |- | Northern Ireland, representative sample, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Bunting|first=Brendan P.|last2=Ferry|first2=Finola R.|last3=Murphy|first3=Samuel D.|last4=O'Neill|first4=Siobhan M.|last5=Bolton|first5=David|date=2013-02-01|title=Trauma Associated With Civil Conflict and Posttraumatic Stress Disorder: Evidence From the Northern Ireland Study of Health and Stress|url=http://onlinelibrary.wiley.com/doi/10.1002/jts.21766/abstract|journal=Journal of Traumatic Stress|language=en|volume=26|issue=1|pages=134–141|doi=10.1002/jts.21766|issn=1573-6598}}</ref> | 8.8% | Northern Ireland Study of Health and Stress |- | South Africa, nationally representative sample, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Atwoli|first=Lukoye|last2=Stein|first2=Dan J.|last3=Williams|first3=David R.|last4=Mclaughlin|first4=Katie A.|last5=Petukhova|first5=Maria|last6=Kessler|first6=Ronald C.|last7=Koenen|first7=Karestan C.|date=2013-07-03|title=Trauma and posttraumatic stress disorder in South Africa: analysis from the South African Stress and Health Study|url=https://doi.org/10.1186/1471-244X-13-182|journal=BMC Psychiatry|volume=13|pages=182|doi=10.1186/1471-244x-13-182|issn=1471-244X}}</ref> | 2.3% | South African Stress and Health Study, using the Composite International Diagnostic Interview (CIDI) |- | U.S. Army and Marine Soldiers Deployed to Iraq and Afghanistan | U.S. Service Members<ref>{{Cite journal|last=Hoge|first=Charles W.|last2=Castro|first2=Carl A.|last3=Messer|first3=Stephen C.|last4=McGurk|first4=Dennis|last5=Cotting|first5=Dave I.|last6=Koffman|first6=Robert L.|date=2004-07-01|title=Combat Duty in Iraq and Afghanistan, Mental Health Problems, and Barriers to Care|url=http://dx.doi.org/10.1056/NEJMoa040603|journal=New England Journal of Medicine|volume=351|issue=1|pages=13–22|doi=10.1056/nejmoa040603|issn=0028-4793|pmid=15229303}}</ref> |11.5% - 19.5% ♦ | PTSD Checklist |- |United States, nationally representative, ages 13-18 |Non-clinical: Population based<ref>{{Cite journal|last=Merikangas|first=Kathleen Ries|last2=He|first2=Jian-ping|last3=Burstein|first3=Marcy|last4=Swanson|first4=Sonja A.|last5=Avenevoli|first5=Shelli|last6=Cui|first6=Lihong|last7=Benjet|first7=Corina|last8=Georgiades|first8=Katholiki|last9=Swendsen|first9=Joel|title=Lifetime Prevalence of Mental Disorders in U.S. Adolescents: Results from the National Comorbidity Survey Replication–Adolescent Supplement (NCS-A)|url=https://doi.org/10.1016/j.jaac.2010.05.017|journal=Journal of the American Academy of Child & Adolescent Psychiatry|volume=49|issue=10|pages=980–989|doi=10.1016/j.jaac.2010.05.017}}</ref> |5.0% |National Comorbidity Survey Replication—Adolescent Supplement (NCS-A) |} ♦ '''Note''': These rates were using broad PTSD Checklist scoring criteria of being scored positive if subjects reported at least one intrusion symptom, three avoidance symptoms, and two hyperarousal symptom that were categorized as at the moderate level. The 11.5% is for soldiers returning from deployment in Iraq, 19.5% is for soldiers returning from Afghanistan. Another common practice is to use a strict cutoff of 50 on the PCL, above which someone screens positive for PTSD. With this cutoff, rates are 6.2% and 12.9% for Service Members returned from Afghanistan and Iraqi, respectively. ==[[Evidence based assessment/Prediction phase|'''Prediction phase''']]== === Psychometric properties of screening for PTSD === The following section contains a list of screening and diagnostic instruments for PTSD. The section includes administration information, psychometric data, and PDFs or links to the screenings. * Screenings are used as part of the [[Evidence based assessment/Prediction phase|prediction phase]] of assessment; for more information on interpretation of this data, or how screenings fit in to the assessment process, click [[Evidence based assessment/Prediction phase|here.]] * '''''For a list of more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Psychometric_properties_of_common_screening_instruments click here.]''''' {| class="wikitable" |- ! Measure !Format (Reporter) !Age Range !Administration/ Completion Time !Where to Access |- |[https://www.ptsd.va.gov/professional/assessment/adult-sr/ptsd-checklist.asp PCL-5 (PTSD Checklist for DSM-5)] |Self-Report |adult |5-10 minutes |[https://www.ptsd.va.gov/professional/assessment/documents/PCL5_Standard_form.PDFPDF PDF] |- |PDS (Post-traumatic Diagnosis Scale) |Self-Report |adult |10-20 minutes | |- | colspan="4" style="font-size:110%; text-align:center;" |'''For Children and Adolescents Specifically''' | |- |[https://www.reactionindex.com/index.php/ UCLA PTSD Reaction Index for DSM-5] |Clinician Administered |child, school age, adolescents |20-30 minutes |[https://www.dellchildrens.net/wp-content/uploads/sites/60/2019/08/UCLA-PTSD-RI-DSM-5.pdf PDF] |- |CPSS (Children's PTSD Symptom Scale) |Self-Report |child |10-20 minutes |[https://www.aacap.org/App_Themes/AACAP/docs/resource_centers/resources/misc/child_ptsd_symptom_scale.pdf PDF] |- |Young Child PTSD Checklist (YCPC) |Parent Report |child |13 items |[https://medicine.tulane.edu/sites/g/files/rdw761/f/YCPC_v5_23_14.pdf PDF] |} '''Note:''' '''L''' = Less than adequate; '''A''' = Adequate; '''G''' = Good; '''E''' = Excellent; '''U''' = Unavailable; '''NA''' = Not applicable === Interpreting PTSD screening measure scores === * For information on interpreting screening measure scores, click [[Evidence based assessment/Prediction phase#Interpreting screening measure scores|here.]] * Also see the page on [https://en.wikipedia.org/wiki/Likelihood_ratios_in_diagnostic_testing likelihood ratios in diagnostic testing] for more information ==[[Evidence based assessment/Prescription phase|'''Prescription phase''']]== ===Gold standard diagnostic interviews=== * For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews click here.] ===Recommended diagnostic interviews for PTSD=== {| class="wikitable sortable" border="1" ! colspan="4" |Diagnostic instruments for PTSD ! |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time !Where to Access |- | [https://www.ptsd.va.gov/professional/assessment/adult-int/caps.asp CAPS-5 (Clinician Administered PTSD Scale)] | Clinician Administered Interview | adult | 40-60 minutes | |- |PTSD Symptom Scale Interview (PSS-I-5) |Clinician Administered Interview |adult and child version available |24 items |[http://www.advanced-counseling.com/dl/PSSI-5.pdf PDF] |- | colspan="4" style="font-size:110%; text-align:center;" |'''For Children and Adolescents Specifically''' | |- | [https://www.ptsd.va.gov/professional/assessment/child/caps-ca.asp CAPS-CA-5 (Clinician-Administered PTSD Scale for DSM-5 - Child/Adolescent Version)] |Clinician Administered Interview |child |30 items | |- | Children’s PTSD Inventory (CPTSD-I) |Diagnostic Interview | 6-18 years | 50 items |Not Free |} '''Note:''' '''L''' = Less than adequate; '''A''' = Adequate; '''G''' = Good; '''E''' = Excellent; '''U''' = Unavailable; '''NA''' = Not applicable ===Severity interviews for PTSD=== {| class="wikitable sortable" border="1" |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time |- | [https://www.kennedykrieger.org/sites/default/files/library/documents/faculty/ksads-dsm-5-screener.pdf Schedule for Affective Disorders and Schizophrenia for School Age Children (K-SADS)] | Diagnostic Interview | 6-18 years | 18 PTSD items |- | Anxiety Disorders Interview Schedule, Child Version (ADIS-C) | Diagnostic Interview | 7-17 years | 26 PTSD items |- | Children’s Interview for Psychiatric Symptoms (ChIPS) |Diagnostic Interview |6 – 18 years |31 PTSD items |- | Diagnostic Infant and Preschool Assessment (DIPA) |Diagnostic Interview | Age 6 and younger | 46 PTSD items |} '''Note:''' '''L''' = Less than adequate; '''A''' = Adequate; '''G''' = Good; '''E''' = Excellent; '''U''' = Unavailable; '''NA''' = Not applicable ==[[Evidence based assessment/Process phase|'''Process phase''']]== The following section contains a brief overview of treatment options for PTSD and list of process and outcome measures for PTSD. The section includes benchmarks based on published norms for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the [[Evidence based assessment/Process phase|process phase]] of assessment. For more information of differences between process and outcome measures, see the page on the [[Evidence based assessment/Process phase|process phase of assessment]]. === Process measures === * Information coming soon === Outcome and severity measures === This table includes clinically significant benchmarks for PTSD specific outcome measures * Information on how to interpret this table can be [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase found here]. * Additionally, these [[Evidence based assessment/Vignettes|vignettes]] might be helpful resources for understanding appropriate adaptation of outcome measures in practice. * ''<u>For clinically significant change benchmarks for the CBCL, YSR, and TRF total, externalizing, internalizing, and attention benchmarks,</u>'' [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase&wteswitched=1#Clinically_significant_change_benchmarks_for_widely-used_outcome_measures see here.] {| class="wikitable sortable" border="1" | colspan="7" |'''Clinically significant change benchmarks with common instruments for PTSD''' |- | colspan="7" style="font-size:110%; text-align:center;" span |<b> Benchmarks Based on Published Norms</b> |- | rowspan="2" style="text-align:center;font-size:130%;" |<b> Measure</b> | colspan="3" style="text-align:center;font-size:130%" width="300" |<b> Cut-off scores</b> | colspan="3" style="text-align:center;font-size:120%" |<b> Critical Change <br> (unstandardized scores)</b> |- | style="text-align:center;font-size:110%" |<b> A</b> | style="text-align:center;font-size:110%" |<b> B</b> | style="text-align:center;font-size:110%" |<b> C</b> | style="text-align:center;font-size:110%" |<b> 95%</b> | style="text-align:center;font-size:110%" |<b> 90%</b> | style="text-align:center;font-size:110%" |<b> SE_difference</b> |- | rowspan="1" style="text-align:center;" | Primary Care PTSD Screen | style="text-align:center;" | 1.0 | style="text-align:center;" | 3.1 | style="text-align:center;" | 2.0 | style="text-align:center;" | 1.0 | style="text-align:center;" | .8 | style="text-align:center;" | .5 |- | rowspan="1" style="text-align:center;" | PTSD Checklist Scores | style="text-align:center;" | 28.8 | style="text-align:center;" | 40.8 | style="text-align:center;" | 34.9 | style="text-align:center;" | 4.6 | style="text-align:center;" | 3.8 | style="text-align:center;" | 2.3 |- | rowspan="1" style="text-align:center;" | Clinician Administered PTSD Scale | style="text-align:center;" | 28.8 | style="text-align:center;" | 40.8 | style="text-align:center;" | 34.9 | style="text-align:center;" | 8.3 | style="text-align:center;" | 7.0 | style="text-align:center;" | 4.2 |} === Treatment === * Please refer to the Wikipedia page on [[wikipedia:Posttraumatic_stress_disorder|PTSD]] for more information on available treatment for PTSD or go to the [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/post-traumatic-stress-disorder/ Effective Child Therapy] page for for a curated resource on effective treatments for PTSD. {{collapse top| Click here for more information}} '''<big>Behavioral interventions</big>''' Recommended (have ''significant benefit'') <ref name=":0">Department of Veterans Affairs and Department of Defense. . (2010). VA/DoD clinical practice guidelines: management of post-traumatic stress. Washington, D.C.: Veterans Health Administration, Department of Defense.</ref>: # Brief Cognitive Behavioral Therapy (CBT; 4-5 sessions) #* This includes stress inoculation training, trauma-focused therapy including components of cognitive restructuring, Cognitive Processing Therapy (CPT), imaginal, virtual, and in-vivo exposure as in Prolonged Exposure psychotherapy (PE)² #* Patient education is recommended as part of psychotherapy for patients and family members # EMDR may help both acute and chronic PTSD, especially individuals who have trouble with prolonged exposure or have trouble verbalizing their trauma.<ref name=":1">Ursano, R. J., Bell, C., Eth, S., Friedman, M., Norwood, A., Pfefferbaum, B., . . . McIntyre, J. S. (2004). ''Practice guideline for the treatment of patients with acute stress disorder and posttraumatic stress disorder'': American Psychiatric Publ </ref> ## Long term gains require further study. # [https://www.ptsd.va.gov/professional/treat/txessentials/present_centered_therapy.asp Present-Centered Therapy (PCT)] is a non trauma focused treatment for PTSD and a second-line treatment for PTSD<ref>{{Cite web|url=https://www.ptsd.va.gov/professional/treat/txessentials/present_centered_therapy.asp|title=Present-Centered Therapy for PTSD - PTSD: National Center for PTSD|website=www.ptsd.va.gov|language=en|access-date=2022-08-13}}</ref>. Treatments with weaker evidence (have ''some benefit'') <ref name=":0" />: # Patient education, # Imagery rehearsal therapy, # Psychodynamic therapy, # Hypnosis, # Relaxation techniques, # and Group therapy. Treatment with ''unknown benefit'' <ref name=":0" />: # Web-based CBT ## For example Jeane Bosch participated as a study therapist in research study that compared STAIR and present-centered therapy both delivered via telehealth. STAIR stands for Skills Training in Affective and Interpersonal Regulation. It is a skill-focused treatment that was originally developed for survivors of childhood abuse to teach emotion regulation skills as well as tools to help with challenges interpersonal functioning and social relationships and decrease PTSD symptoms<ref>{{Cite web|url=https://istss.org/public-resources/trauma-blog/2015-march-(1)/clinician-s-corner-skills-training-in-affective-an|title=ISTSS - Trauma Blog|website=istss.org|access-date=2022-08-13}}</ref>.<ref>{{Citation|title=Introduction to Telehealth with Dr. Bosch|url=https://www.youtube.com/watch?v=Wn6Vewl42X8|accessdate=2022-08-13|language=en}}</ref> # Acceptance and commitment therapy, # and Dialectical Behavioral Therapy. <big>'''Medication'''</big> *SSRIs are more effective than placebo in treating PTSD.<ref name=":1" /> *There is no evidence to support a medication to prevent the development of PTSD.<ref name=":0" /> **Imipramine, propranolol, prazosin, other antidepressants, anticonvulsants, and atypical antipsychotics have ''unknown benefit.'' **Strongly recommend against the use of benzodiazepines² and typical antipsychotics since they have ''no benefit and potential harm.'' {{collapse bottom}} == '''External resources''' == === For professionals === * [http://www.som.uq.edu.au/ptsd Post Traumatic Stress Disorder Information Resource] from [http://www.uq.edu.au/ The University of Queensland School of Medicine] * [http://www.apa.org/ptsd-guideline/ APA practice parameters for assessment and treatment for PTSD (Updated 2017)] * [http://www.ptsd.va.gov/professional/index.asp Resources for professionals] from [http://www.ptsd.va.gov/index.asp VA National PTSD Center] * [https://www.integration.samhsa.gov/clinical-practice/trauma-informed SAMHSA's Trauma-Informed Care Resources and Training] * [https://www.integration.samhsa.gov/clinical-practice/trauma-informed SAMHSA's Resources on Intimate Partner Violence (IPV) for Clinicians, Patients, Families, and Organizations] === For caregivers === * [http://www.nctsn.org/sites/default/files/assets/pdfs/tips_for_parents_media_final.pdf Tips for parents on shooting media coverage] * [http://www.nctsn.org/sites/default/files/assets/pdfs/parents_guidelines_for_helping_teens_after_the_recent_attacks.pdf Parent guidelines to helping youths after a shooting] * [http://www.nctsn.org/sites/default/files/assets/pdfs/helping_teens_with_traumatic_grief_caregivers_final.pdf Caregiver tips for helping teens with traumatic grief] * [http://www.nctsn.org/sites/default/files/assets/pdfs/10things_schoolage_ctg.pdf Caregiver tips for helping school-age children with traumatic grief] *[http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/post-traumatic-stress-disorder/ EffectiveChildTherapy.Org information on PTSD] *[https://sccap53.org Society of Clinical Child and Adolescent Psychology] === For educators === * [http://www.nctsn.org/sites/default/files/assets/pdfs/pfa_for_schools_appendix_a_teachers.pdf Teacher tips for providing psychological first aid] * [http://www.nctsn.org/sites/default/files/assets/pdfs/helping_youth_after_community_violence_educators.pdf Educator tips for helping youths after a community trauma] === For public === * [https://complicatedgrief.columbia.edu/for-the-public/resources/ Resources for grief and loss] * [http://www.nctsn.org/sites/default/files/assets/pdfs/psychological_information_sheet_two_pager.pdf Psychological impacts of recent shootings] * [http://www.nctsn.org/sites/default/files/assets/pdfs/youth_journalists.pdf Tips to talking to youths about a shooting] * [http://www.nctsn.org/sites/default/files/assets/pdfs/talking_to_children_about_the_shooting.pdf Tips to talking to children about a shooting] * [http://www.nctsn.org/sites/default/files/assets/pdfs/helping_young_children_heal_crisis.pdf Helping young children heal after a crisis] * [http://www.nctsn.org/content/psychological-first-aid-schoolspfa Psychological first aid for schools] * [http://www.nctsn.org/content/psychological-first-aid Resources and manuals on psychological first aid] * [http://www.ptsd.va.gov/public/index.asp Resources for the public] from [http://www.ptsd.va.gov/index.asp VA National PTSD Center] * [https://curlie.org/Health/Mental_Health/Disorders/Anxiety/Post-traumatic_Stress Posttraumatic stress disorder] at Curlie (based on DMOZ) =='''References'''== {{collapse top|Click here for references}} {{Reflist|30em}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] {{collapse bottom}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] 64diwr0x52f5ps9yhwzofcla8epndc5 2419117 2419115 2022-08-25T23:19:05Z Ardenguo 2944162 /* Recommended diagnostic interviews for PTSD */ added assessment request forms wikitext text/x-wiki <noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{medical disclaimer}} {{:{{BASEPAGENAME}}/Sidebar}} ==[[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio"?''']]== * For background information on what assessment portfolios are, click the link in the heading above. * Want even 'more' information about this topic? There's an extended version of this page [[Evidence-based assessment/Posttraumatic stress disorder (disorder portfolio)/extended version|'''here''']]. == [[Evidence based assessment/Preparation phase|'''Preparation phase''']] == === Diagnostic criteria for post traumatic stress disorder === ===='''ICD-11 Diagnostic Criteria'''==== {{blockquotetop}} ===='''ICD-11 Criteria'''==== *Post-traumatic stress disorder (PTSD) is a syndrome that develops following exposure to an extremely threatening or horrific event or series of events that is characterized by all of the following: **1) re-experiencing the traumatic event or events in the present in the form of vivid intrusive memories, flashbacks, or nightmares, which are typically accompanied by strong and overwhelming emotions such as fear or horror and strong physical sensations, or feelings of being overwhelmed or immersed in the same intense emotions that were experienced during the traumatic event; **2) avoidance of thoughts and memories of the event or events, or avoidance of activities, situations, or people reminiscent of the event or events **3) persistent perceptions of heightened current threat, for example as indicated by hypervigilance or an enhanced startle reaction to stimuli such as unexpected noises. *The symptoms must persist for at least several weeks and cause significant impairment in personal, family, social, educational, occupational or other important areas of functioning. Additionally, ICD 11 includes a category called "Complex post-traumatic stress disorder," which is described as: *A disorder that may develop following exposure to an event or series of events of an extremely threatening or horrific nature, most commonly prolonged or repetitive events from which escape is difficult or impossible (e.g., torture, slavery, genocide campaigns, prolonged domestic violence, repeated childhood sexual or physical abuse). *The disorder is characterized by the core symptoms of PTSD; that is, all diagnostic requirements for PTSD have been met at some point during the course of the disorder. *In addition, Complex PTSD is characterized by: **1) severe and pervasive problems in affect regulation; **2) persistent beliefs about oneself as diminished, defeated or worthless, accompanied by deep and pervasive feelings of shame, guilt or failure related to the traumatic event **3) persistent difficulties in sustaining relationships and in feeling close to others. The disturbance causes significant impairment in personal, family, social, educational, occupational or other important areas of functioning. {{blockquotebottom}} ===='''Changes in DSM-5'''==== * The diagnostic criteria for post-traumatic stress disorder changed slightly from [[DSM-IV]] to [[w:Diagnostic_and_Statistical_Manual_of_Mental_Disorders#DSM-IV-TR_.282000.29|DSM-5]]. Summaries are available [http://www.dsm5.org/Documents/changes%20from%20dsm-iv-tr%20to%20dsm-5.pdf here] and [[w:DSM-5|here]]. === Developmental sensitivities === {{collapse top| Click for more information}} *Diagnostic thresholds have been lowered for children and adolescents to account for development. *Separate and additional criteria have been added for children age 6 or younger. *Child sexual abuse has been found to have a substantial effect on the development of PTSD.<ref>{{cite journal|last1=Paolucci|first1=Elizabeth ODDONE|last2=Genuis|first2=Mark L.|last3=Violato|first3=Claudio|title=A Meta-Analysis of the Published Research on the Effects of Child Sexual Abuse|journal=The Journal of Psychology|date=January 2001|volume=135|issue=1|pages=17–36|doi=10.1080/00223980109603677}}</ref> *Children with higher exposure to trauma, less social support, and other major life events are more likely to have continued PTSD symptoms 7 months after a trauma.<ref name=":2">{{cite journal |last1=La Greca|first1=A|last2=Silverman|first2=WK|last3=Vernberg|first3=EM|last4=Prinstein|first4=MJ|title=Symptoms of posttraumatic stress in children after Hurricane Andrew: a prospective study.|journal=Journal of consulting and clinical psychology|date=August 1996|volume=64|issue=4|pages=712-23|pmid=8803361}}</ref> 10 months after a trauma, however, only experience of a major life event remained predictive of continuing PTSD symptoms.<ref name=":2" /> *Lack of social support, specifically lack of support by a teacher, was predictive of higher PTSD symptoms among children who had gone through an environmental trauma.<ref name=":2" /> *Children who reported using blame and anger as strategies for coping had higher levels of PTSD symptoms 10 months after a trauma.<ref name=":2" /> *Negative affect in children before a traumatic event was predictive of development of PTSD symptoms after a traumatic event.<ref>{{cite journal|last1=Weems|first1=CF|last2=Pina|first2=AA|last3=Costa|first3=NM|last4=Watts|first4=SE|last5=Taylor|first5=LK|last6=Cannon|first6=MF|title=Predisaster trait anxiety and negative affect predict posttraumatic stress in youths after hurricane Katrina.|journal=Journal of consulting and clinical psychology|date=February 2007|volume=75|issue=1|pages=154-9|doi=10.1037/0022-006X.75.1.154|pmid=17295574}}</ref> [[wikipedia:Posttraumatic_stress_disorder|Posttraumatic stress disorder]] is now more sensitive to development in that diagnostic thresholds have been lowered for children and adolescents. Furthermore, separate and additional criteria have been added for children age 6 years of age or younger. {{collapse bottom}} === Base rates of PTSD in different clinical settings and populations === This section describes the demographic settings of the populations sampled, base rates of PTSD diagnoses, country/region sampled, and the diagnostic methods that were used. Using this information, clinicians will be able to anchor the most appropriate rate of PTSD that they are likely to see in their clinical practice. * '''''To see prevalence rates across multiple disorders,''''' [[Evidence based assessment/Preparation phase#Base rates for transdiagnostic comparison|'''''click here.''''']] {| class="wikitable sortable" border="1" |- ! Demography ! Setting ! Base Rate ! Diagnostic Method |- | United States, nationally representative, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Kessler|first=Ronald C.|last2=Berglund|first2=Patricia|last3=Demler|first3=Olga|last4=Jin|first4=Robert|last5=Merikangas|first5=Kathleen R.|last6=Walters|first6=Ellen E.|date=2005-06-01|title=Lifetime Prevalence and Age-of-Onset Distributions of DSM-IV Disorders in the National Comorbidity Survey Replication|url=http://archpsyc.jamanetwork.com/article.aspx?doi=10.1001/archpsyc.62.6.593|journal=Archives of General Psychiatry|language=en|volume=62|issue=6|doi=10.1001/archpsyc.62.6.593|issn=0003-990X}}</ref> | 6.8% | National Comorbidity Survey - Replication |- | Netherlands, nationally representative, age 18-80 | Non-clinical: Population based<ref>{{Cite journal|last=de Vries|first=Giel-Jan|last2=Olff|first2=Miranda|date=2009-08-01|title=The lifetime prevalence of traumatic events and posttraumatic stress disorder in the Netherlands|url=http://onlinelibrary.wiley.com/doi/10.1002/jts.20429/abstract|journal=Journal of Traumatic Stress|language=en|volume=22|issue=4|pages=259–267|doi=10.1002/jts.20429|issn=1573-6598}}</ref> | 7.4% | Composite International Diagnostic Interview (CIDI) |- | United States, nationally representative, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Pietrzak|first=Robert H.|last2=Goldstein|first2=Risë B.|last3=Southwick|first3=Steven M.|last4=Grant|first4=Bridget F.|title=Prevalence and Axis I comorbidity of full and partial posttraumatic stress disorder in the United States: Results from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions|url=http://linkinghub.elsevier.com/retrieve/pii/S0887618510002288|journal=Journal of Anxiety Disorders|volume=25|issue=3|pages=456–465|doi=10.1016/j.janxdis.2010.11.010}}</ref> | 6.4% | Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions |- | Northern Ireland, representative sample, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Bunting|first=Brendan P.|last2=Ferry|first2=Finola R.|last3=Murphy|first3=Samuel D.|last4=O'Neill|first4=Siobhan M.|last5=Bolton|first5=David|date=2013-02-01|title=Trauma Associated With Civil Conflict and Posttraumatic Stress Disorder: Evidence From the Northern Ireland Study of Health and Stress|url=http://onlinelibrary.wiley.com/doi/10.1002/jts.21766/abstract|journal=Journal of Traumatic Stress|language=en|volume=26|issue=1|pages=134–141|doi=10.1002/jts.21766|issn=1573-6598}}</ref> | 8.8% | Northern Ireland Study of Health and Stress |- | South Africa, nationally representative sample, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Atwoli|first=Lukoye|last2=Stein|first2=Dan J.|last3=Williams|first3=David R.|last4=Mclaughlin|first4=Katie A.|last5=Petukhova|first5=Maria|last6=Kessler|first6=Ronald C.|last7=Koenen|first7=Karestan C.|date=2013-07-03|title=Trauma and posttraumatic stress disorder in South Africa: analysis from the South African Stress and Health Study|url=https://doi.org/10.1186/1471-244X-13-182|journal=BMC Psychiatry|volume=13|pages=182|doi=10.1186/1471-244x-13-182|issn=1471-244X}}</ref> | 2.3% | South African Stress and Health Study, using the Composite International Diagnostic Interview (CIDI) |- | U.S. Army and Marine Soldiers Deployed to Iraq and Afghanistan | U.S. Service Members<ref>{{Cite journal|last=Hoge|first=Charles W.|last2=Castro|first2=Carl A.|last3=Messer|first3=Stephen C.|last4=McGurk|first4=Dennis|last5=Cotting|first5=Dave I.|last6=Koffman|first6=Robert L.|date=2004-07-01|title=Combat Duty in Iraq and Afghanistan, Mental Health Problems, and Barriers to Care|url=http://dx.doi.org/10.1056/NEJMoa040603|journal=New England Journal of Medicine|volume=351|issue=1|pages=13–22|doi=10.1056/nejmoa040603|issn=0028-4793|pmid=15229303}}</ref> |11.5% - 19.5% ♦ | PTSD Checklist |- |United States, nationally representative, ages 13-18 |Non-clinical: Population based<ref>{{Cite journal|last=Merikangas|first=Kathleen Ries|last2=He|first2=Jian-ping|last3=Burstein|first3=Marcy|last4=Swanson|first4=Sonja A.|last5=Avenevoli|first5=Shelli|last6=Cui|first6=Lihong|last7=Benjet|first7=Corina|last8=Georgiades|first8=Katholiki|last9=Swendsen|first9=Joel|title=Lifetime Prevalence of Mental Disorders in U.S. Adolescents: Results from the National Comorbidity Survey Replication–Adolescent Supplement (NCS-A)|url=https://doi.org/10.1016/j.jaac.2010.05.017|journal=Journal of the American Academy of Child & Adolescent Psychiatry|volume=49|issue=10|pages=980–989|doi=10.1016/j.jaac.2010.05.017}}</ref> |5.0% |National Comorbidity Survey Replication—Adolescent Supplement (NCS-A) |} ♦ '''Note''': These rates were using broad PTSD Checklist scoring criteria of being scored positive if subjects reported at least one intrusion symptom, three avoidance symptoms, and two hyperarousal symptom that were categorized as at the moderate level. The 11.5% is for soldiers returning from deployment in Iraq, 19.5% is for soldiers returning from Afghanistan. Another common practice is to use a strict cutoff of 50 on the PCL, above which someone screens positive for PTSD. With this cutoff, rates are 6.2% and 12.9% for Service Members returned from Afghanistan and Iraqi, respectively. ==[[Evidence based assessment/Prediction phase|'''Prediction phase''']]== === Psychometric properties of screening for PTSD === The following section contains a list of screening and diagnostic instruments for PTSD. The section includes administration information, psychometric data, and PDFs or links to the screenings. * Screenings are used as part of the [[Evidence based assessment/Prediction phase|prediction phase]] of assessment; for more information on interpretation of this data, or how screenings fit in to the assessment process, click [[Evidence based assessment/Prediction phase|here.]] * '''''For a list of more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Psychometric_properties_of_common_screening_instruments click here.]''''' {| class="wikitable" |- ! Measure !Format (Reporter) !Age Range !Administration/ Completion Time !Where to Access |- |[https://www.ptsd.va.gov/professional/assessment/adult-sr/ptsd-checklist.asp PCL-5 (PTSD Checklist for DSM-5)] |Self-Report |adult |5-10 minutes |[https://www.ptsd.va.gov/professional/assessment/documents/PCL5_Standard_form.PDFPDF PDF] |- |PDS (Post-traumatic Diagnosis Scale) |Self-Report |adult |10-20 minutes | |- | colspan="4" style="font-size:110%; text-align:center;" |'''For Children and Adolescents Specifically''' | |- |[https://www.reactionindex.com/index.php/ UCLA PTSD Reaction Index for DSM-5] |Clinician Administered |child, school age, adolescents |20-30 minutes |[https://www.dellchildrens.net/wp-content/uploads/sites/60/2019/08/UCLA-PTSD-RI-DSM-5.pdf PDF] |- |CPSS (Children's PTSD Symptom Scale) |Self-Report |child |10-20 minutes |[https://www.aacap.org/App_Themes/AACAP/docs/resource_centers/resources/misc/child_ptsd_symptom_scale.pdf PDF] |- |Young Child PTSD Checklist (YCPC) |Parent Report |child |13 items |[https://medicine.tulane.edu/sites/g/files/rdw761/f/YCPC_v5_23_14.pdf PDF] |} '''Note:''' '''L''' = Less than adequate; '''A''' = Adequate; '''G''' = Good; '''E''' = Excellent; '''U''' = Unavailable; '''NA''' = Not applicable === Interpreting PTSD screening measure scores === * For information on interpreting screening measure scores, click [[Evidence based assessment/Prediction phase#Interpreting screening measure scores|here.]] * Also see the page on [https://en.wikipedia.org/wiki/Likelihood_ratios_in_diagnostic_testing likelihood ratios in diagnostic testing] for more information ==[[Evidence based assessment/Prescription phase|'''Prescription phase''']]== ===Gold standard diagnostic interviews=== * For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews click here.] ===Recommended diagnostic interviews for PTSD=== {| class="wikitable sortable" border="1" ! colspan="4" |Diagnostic instruments for PTSD ! |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time !Where to Access |- | [https://www.ptsd.va.gov/professional/assessment/adult-int/caps.asp CAPS-5 (Clinician Administered PTSD Scale)] | Clinician Administered Interview | adult | 40-60 minutes |[https://www.ptsd.va.gov/professional/assessment/ncptsd-instrument-request-form.asp Assessment request form] |- |PTSD Symptom Scale Interview (PSS-I-5) |Clinician Administered Interview |adult and child version available |24 items |[http://www.advanced-counseling.com/dl/PSSI-5.pdf PDF] |- | colspan="4" style="font-size:110%; text-align:center;" |'''For Children and Adolescents Specifically''' | |- | [https://www.ptsd.va.gov/professional/assessment/child/caps-ca.asp CAPS-CA-5 (Clinician-Administered PTSD Scale for DSM-5 - Child/Adolescent Version)] |Clinician Administered Interview |child |30 items |[https://www.ptsd.va.gov/professional/assessment/ncptsd-instrument-request-form.asp Assessment request form] |- | Children’s PTSD Inventory (CPTSD-I) |Diagnostic Interview | 6-18 years | 50 items |Not Free |} '''Note:''' '''L''' = Less than adequate; '''A''' = Adequate; '''G''' = Good; '''E''' = Excellent; '''U''' = Unavailable; '''NA''' = Not applicable ===Severity interviews for PTSD=== {| class="wikitable sortable" border="1" |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time |- | [https://www.kennedykrieger.org/sites/default/files/library/documents/faculty/ksads-dsm-5-screener.pdf Schedule for Affective Disorders and Schizophrenia for School Age Children (K-SADS)] | Diagnostic Interview | 6-18 years | 18 PTSD items |- | Anxiety Disorders Interview Schedule, Child Version (ADIS-C) | Diagnostic Interview | 7-17 years | 26 PTSD items |- | Children’s Interview for Psychiatric Symptoms (ChIPS) |Diagnostic Interview |6 – 18 years |31 PTSD items |- | Diagnostic Infant and Preschool Assessment (DIPA) |Diagnostic Interview | Age 6 and younger | 46 PTSD items |} '''Note:''' '''L''' = Less than adequate; '''A''' = Adequate; '''G''' = Good; '''E''' = Excellent; '''U''' = Unavailable; '''NA''' = Not applicable ==[[Evidence based assessment/Process phase|'''Process phase''']]== The following section contains a brief overview of treatment options for PTSD and list of process and outcome measures for PTSD. The section includes benchmarks based on published norms for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the [[Evidence based assessment/Process phase|process phase]] of assessment. For more information of differences between process and outcome measures, see the page on the [[Evidence based assessment/Process phase|process phase of assessment]]. === Process measures === * Information coming soon === Outcome and severity measures === This table includes clinically significant benchmarks for PTSD specific outcome measures * Information on how to interpret this table can be [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase found here]. * Additionally, these [[Evidence based assessment/Vignettes|vignettes]] might be helpful resources for understanding appropriate adaptation of outcome measures in practice. * ''<u>For clinically significant change benchmarks for the CBCL, YSR, and TRF total, externalizing, internalizing, and attention benchmarks,</u>'' [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase&wteswitched=1#Clinically_significant_change_benchmarks_for_widely-used_outcome_measures see here.] {| class="wikitable sortable" border="1" | colspan="7" |'''Clinically significant change benchmarks with common instruments for PTSD''' |- | colspan="7" style="font-size:110%; text-align:center;" span |<b> Benchmarks Based on Published Norms</b> |- | rowspan="2" style="text-align:center;font-size:130%;" |<b> Measure</b> | colspan="3" style="text-align:center;font-size:130%" width="300" |<b> Cut-off scores</b> | colspan="3" style="text-align:center;font-size:120%" |<b> Critical Change <br> (unstandardized scores)</b> |- | style="text-align:center;font-size:110%" |<b> A</b> | style="text-align:center;font-size:110%" |<b> B</b> | style="text-align:center;font-size:110%" |<b> C</b> | style="text-align:center;font-size:110%" |<b> 95%</b> | style="text-align:center;font-size:110%" |<b> 90%</b> | style="text-align:center;font-size:110%" |<b> SE_difference</b> |- | rowspan="1" style="text-align:center;" | Primary Care PTSD Screen | style="text-align:center;" | 1.0 | style="text-align:center;" | 3.1 | style="text-align:center;" | 2.0 | style="text-align:center;" | 1.0 | style="text-align:center;" | .8 | style="text-align:center;" | .5 |- | rowspan="1" style="text-align:center;" | PTSD Checklist Scores | style="text-align:center;" | 28.8 | style="text-align:center;" | 40.8 | style="text-align:center;" | 34.9 | style="text-align:center;" | 4.6 | style="text-align:center;" | 3.8 | style="text-align:center;" | 2.3 |- | rowspan="1" style="text-align:center;" | Clinician Administered PTSD Scale | style="text-align:center;" | 28.8 | style="text-align:center;" | 40.8 | style="text-align:center;" | 34.9 | style="text-align:center;" | 8.3 | style="text-align:center;" | 7.0 | style="text-align:center;" | 4.2 |} === Treatment === * Please refer to the Wikipedia page on [[wikipedia:Posttraumatic_stress_disorder|PTSD]] for more information on available treatment for PTSD or go to the [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/post-traumatic-stress-disorder/ Effective Child Therapy] page for for a curated resource on effective treatments for PTSD. {{collapse top| Click here for more information}} '''<big>Behavioral interventions</big>''' Recommended (have ''significant benefit'') <ref name=":0">Department of Veterans Affairs and Department of Defense. . (2010). VA/DoD clinical practice guidelines: management of post-traumatic stress. Washington, D.C.: Veterans Health Administration, Department of Defense.</ref>: # Brief Cognitive Behavioral Therapy (CBT; 4-5 sessions) #* This includes stress inoculation training, trauma-focused therapy including components of cognitive restructuring, Cognitive Processing Therapy (CPT), imaginal, virtual, and in-vivo exposure as in Prolonged Exposure psychotherapy (PE)² #* Patient education is recommended as part of psychotherapy for patients and family members # EMDR may help both acute and chronic PTSD, especially individuals who have trouble with prolonged exposure or have trouble verbalizing their trauma.<ref name=":1">Ursano, R. J., Bell, C., Eth, S., Friedman, M., Norwood, A., Pfefferbaum, B., . . . McIntyre, J. S. (2004). ''Practice guideline for the treatment of patients with acute stress disorder and posttraumatic stress disorder'': American Psychiatric Publ </ref> ## Long term gains require further study. # [https://www.ptsd.va.gov/professional/treat/txessentials/present_centered_therapy.asp Present-Centered Therapy (PCT)] is a non trauma focused treatment for PTSD and a second-line treatment for PTSD<ref>{{Cite web|url=https://www.ptsd.va.gov/professional/treat/txessentials/present_centered_therapy.asp|title=Present-Centered Therapy for PTSD - PTSD: National Center for PTSD|website=www.ptsd.va.gov|language=en|access-date=2022-08-13}}</ref>. Treatments with weaker evidence (have ''some benefit'') <ref name=":0" />: # Patient education, # Imagery rehearsal therapy, # Psychodynamic therapy, # Hypnosis, # Relaxation techniques, # and Group therapy. Treatment with ''unknown benefit'' <ref name=":0" />: # Web-based CBT ## For example Jeane Bosch participated as a study therapist in research study that compared STAIR and present-centered therapy both delivered via telehealth. STAIR stands for Skills Training in Affective and Interpersonal Regulation. It is a skill-focused treatment that was originally developed for survivors of childhood abuse to teach emotion regulation skills as well as tools to help with challenges interpersonal functioning and social relationships and decrease PTSD symptoms<ref>{{Cite web|url=https://istss.org/public-resources/trauma-blog/2015-march-(1)/clinician-s-corner-skills-training-in-affective-an|title=ISTSS - Trauma Blog|website=istss.org|access-date=2022-08-13}}</ref>.<ref>{{Citation|title=Introduction to Telehealth with Dr. Bosch|url=https://www.youtube.com/watch?v=Wn6Vewl42X8|accessdate=2022-08-13|language=en}}</ref> # Acceptance and commitment therapy, # and Dialectical Behavioral Therapy. <big>'''Medication'''</big> *SSRIs are more effective than placebo in treating PTSD.<ref name=":1" /> *There is no evidence to support a medication to prevent the development of PTSD.<ref name=":0" /> **Imipramine, propranolol, prazosin, other antidepressants, anticonvulsants, and atypical antipsychotics have ''unknown benefit.'' **Strongly recommend against the use of benzodiazepines² and typical antipsychotics since they have ''no benefit and potential harm.'' {{collapse bottom}} == '''External resources''' == === For professionals === * [http://www.som.uq.edu.au/ptsd Post Traumatic Stress Disorder Information Resource] from [http://www.uq.edu.au/ The University of Queensland School of Medicine] * [http://www.apa.org/ptsd-guideline/ APA practice parameters for assessment and treatment for PTSD (Updated 2017)] * [http://www.ptsd.va.gov/professional/index.asp Resources for professionals] from [http://www.ptsd.va.gov/index.asp VA National PTSD Center] * [https://www.integration.samhsa.gov/clinical-practice/trauma-informed SAMHSA's Trauma-Informed Care Resources and Training] * [https://www.integration.samhsa.gov/clinical-practice/trauma-informed SAMHSA's Resources on Intimate Partner Violence (IPV) for Clinicians, Patients, Families, and Organizations] === For caregivers === * [http://www.nctsn.org/sites/default/files/assets/pdfs/tips_for_parents_media_final.pdf Tips for parents on shooting media coverage] * [http://www.nctsn.org/sites/default/files/assets/pdfs/parents_guidelines_for_helping_teens_after_the_recent_attacks.pdf Parent guidelines to helping youths after a shooting] * [http://www.nctsn.org/sites/default/files/assets/pdfs/helping_teens_with_traumatic_grief_caregivers_final.pdf Caregiver tips for helping teens with traumatic grief] * [http://www.nctsn.org/sites/default/files/assets/pdfs/10things_schoolage_ctg.pdf Caregiver tips for helping school-age children with traumatic grief] *[http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/post-traumatic-stress-disorder/ EffectiveChildTherapy.Org information on PTSD] *[https://sccap53.org Society of Clinical Child and Adolescent Psychology] === For educators === * [http://www.nctsn.org/sites/default/files/assets/pdfs/pfa_for_schools_appendix_a_teachers.pdf Teacher tips for providing psychological first aid] * [http://www.nctsn.org/sites/default/files/assets/pdfs/helping_youth_after_community_violence_educators.pdf Educator tips for helping youths after a community trauma] === For public === * [https://complicatedgrief.columbia.edu/for-the-public/resources/ Resources for grief and loss] * [http://www.nctsn.org/sites/default/files/assets/pdfs/psychological_information_sheet_two_pager.pdf Psychological impacts of recent shootings] * [http://www.nctsn.org/sites/default/files/assets/pdfs/youth_journalists.pdf Tips to talking to youths about a shooting] * [http://www.nctsn.org/sites/default/files/assets/pdfs/talking_to_children_about_the_shooting.pdf Tips to talking to children about a shooting] * [http://www.nctsn.org/sites/default/files/assets/pdfs/helping_young_children_heal_crisis.pdf Helping young children heal after a crisis] * [http://www.nctsn.org/content/psychological-first-aid-schoolspfa Psychological first aid for schools] * [http://www.nctsn.org/content/psychological-first-aid Resources and manuals on psychological first aid] * [http://www.ptsd.va.gov/public/index.asp Resources for the public] from [http://www.ptsd.va.gov/index.asp VA National PTSD Center] * [https://curlie.org/Health/Mental_Health/Disorders/Anxiety/Post-traumatic_Stress Posttraumatic stress disorder] at Curlie (based on DMOZ) =='''References'''== {{collapse top|Click here for references}} {{Reflist|30em}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] {{collapse bottom}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] cxivzmxfj9vi8nz5hzbtnso9lv5oku5 2419118 2419117 2022-08-25T23:19:50Z Ardenguo 2944162 /* Severity interviews for PTSD */ removed legends that are no longer needed wikitext text/x-wiki <noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{medical disclaimer}} {{:{{BASEPAGENAME}}/Sidebar}} ==[[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio"?''']]== * For background information on what assessment portfolios are, click the link in the heading above. * Want even 'more' information about this topic? There's an extended version of this page [[Evidence-based assessment/Posttraumatic stress disorder (disorder portfolio)/extended version|'''here''']]. == [[Evidence based assessment/Preparation phase|'''Preparation phase''']] == === Diagnostic criteria for post traumatic stress disorder === ===='''ICD-11 Diagnostic Criteria'''==== {{blockquotetop}} ===='''ICD-11 Criteria'''==== *Post-traumatic stress disorder (PTSD) is a syndrome that develops following exposure to an extremely threatening or horrific event or series of events that is characterized by all of the following: **1) re-experiencing the traumatic event or events in the present in the form of vivid intrusive memories, flashbacks, or nightmares, which are typically accompanied by strong and overwhelming emotions such as fear or horror and strong physical sensations, or feelings of being overwhelmed or immersed in the same intense emotions that were experienced during the traumatic event; **2) avoidance of thoughts and memories of the event or events, or avoidance of activities, situations, or people reminiscent of the event or events **3) persistent perceptions of heightened current threat, for example as indicated by hypervigilance or an enhanced startle reaction to stimuli such as unexpected noises. *The symptoms must persist for at least several weeks and cause significant impairment in personal, family, social, educational, occupational or other important areas of functioning. Additionally, ICD 11 includes a category called "Complex post-traumatic stress disorder," which is described as: *A disorder that may develop following exposure to an event or series of events of an extremely threatening or horrific nature, most commonly prolonged or repetitive events from which escape is difficult or impossible (e.g., torture, slavery, genocide campaigns, prolonged domestic violence, repeated childhood sexual or physical abuse). *The disorder is characterized by the core symptoms of PTSD; that is, all diagnostic requirements for PTSD have been met at some point during the course of the disorder. *In addition, Complex PTSD is characterized by: **1) severe and pervasive problems in affect regulation; **2) persistent beliefs about oneself as diminished, defeated or worthless, accompanied by deep and pervasive feelings of shame, guilt or failure related to the traumatic event **3) persistent difficulties in sustaining relationships and in feeling close to others. The disturbance causes significant impairment in personal, family, social, educational, occupational or other important areas of functioning. {{blockquotebottom}} ===='''Changes in DSM-5'''==== * The diagnostic criteria for post-traumatic stress disorder changed slightly from [[DSM-IV]] to [[w:Diagnostic_and_Statistical_Manual_of_Mental_Disorders#DSM-IV-TR_.282000.29|DSM-5]]. Summaries are available [http://www.dsm5.org/Documents/changes%20from%20dsm-iv-tr%20to%20dsm-5.pdf here] and [[w:DSM-5|here]]. === Developmental sensitivities === {{collapse top| Click for more information}} *Diagnostic thresholds have been lowered for children and adolescents to account for development. *Separate and additional criteria have been added for children age 6 or younger. *Child sexual abuse has been found to have a substantial effect on the development of PTSD.<ref>{{cite journal|last1=Paolucci|first1=Elizabeth ODDONE|last2=Genuis|first2=Mark L.|last3=Violato|first3=Claudio|title=A Meta-Analysis of the Published Research on the Effects of Child Sexual Abuse|journal=The Journal of Psychology|date=January 2001|volume=135|issue=1|pages=17–36|doi=10.1080/00223980109603677}}</ref> *Children with higher exposure to trauma, less social support, and other major life events are more likely to have continued PTSD symptoms 7 months after a trauma.<ref name=":2">{{cite journal |last1=La Greca|first1=A|last2=Silverman|first2=WK|last3=Vernberg|first3=EM|last4=Prinstein|first4=MJ|title=Symptoms of posttraumatic stress in children after Hurricane Andrew: a prospective study.|journal=Journal of consulting and clinical psychology|date=August 1996|volume=64|issue=4|pages=712-23|pmid=8803361}}</ref> 10 months after a trauma, however, only experience of a major life event remained predictive of continuing PTSD symptoms.<ref name=":2" /> *Lack of social support, specifically lack of support by a teacher, was predictive of higher PTSD symptoms among children who had gone through an environmental trauma.<ref name=":2" /> *Children who reported using blame and anger as strategies for coping had higher levels of PTSD symptoms 10 months after a trauma.<ref name=":2" /> *Negative affect in children before a traumatic event was predictive of development of PTSD symptoms after a traumatic event.<ref>{{cite journal|last1=Weems|first1=CF|last2=Pina|first2=AA|last3=Costa|first3=NM|last4=Watts|first4=SE|last5=Taylor|first5=LK|last6=Cannon|first6=MF|title=Predisaster trait anxiety and negative affect predict posttraumatic stress in youths after hurricane Katrina.|journal=Journal of consulting and clinical psychology|date=February 2007|volume=75|issue=1|pages=154-9|doi=10.1037/0022-006X.75.1.154|pmid=17295574}}</ref> [[wikipedia:Posttraumatic_stress_disorder|Posttraumatic stress disorder]] is now more sensitive to development in that diagnostic thresholds have been lowered for children and adolescents. Furthermore, separate and additional criteria have been added for children age 6 years of age or younger. {{collapse bottom}} === Base rates of PTSD in different clinical settings and populations === This section describes the demographic settings of the populations sampled, base rates of PTSD diagnoses, country/region sampled, and the diagnostic methods that were used. Using this information, clinicians will be able to anchor the most appropriate rate of PTSD that they are likely to see in their clinical practice. * '''''To see prevalence rates across multiple disorders,''''' [[Evidence based assessment/Preparation phase#Base rates for transdiagnostic comparison|'''''click here.''''']] {| class="wikitable sortable" border="1" |- ! Demography ! Setting ! Base Rate ! Diagnostic Method |- | United States, nationally representative, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Kessler|first=Ronald C.|last2=Berglund|first2=Patricia|last3=Demler|first3=Olga|last4=Jin|first4=Robert|last5=Merikangas|first5=Kathleen R.|last6=Walters|first6=Ellen E.|date=2005-06-01|title=Lifetime Prevalence and Age-of-Onset Distributions of DSM-IV Disorders in the National Comorbidity Survey Replication|url=http://archpsyc.jamanetwork.com/article.aspx?doi=10.1001/archpsyc.62.6.593|journal=Archives of General Psychiatry|language=en|volume=62|issue=6|doi=10.1001/archpsyc.62.6.593|issn=0003-990X}}</ref> | 6.8% | National Comorbidity Survey - Replication |- | Netherlands, nationally representative, age 18-80 | Non-clinical: Population based<ref>{{Cite journal|last=de Vries|first=Giel-Jan|last2=Olff|first2=Miranda|date=2009-08-01|title=The lifetime prevalence of traumatic events and posttraumatic stress disorder in the Netherlands|url=http://onlinelibrary.wiley.com/doi/10.1002/jts.20429/abstract|journal=Journal of Traumatic Stress|language=en|volume=22|issue=4|pages=259–267|doi=10.1002/jts.20429|issn=1573-6598}}</ref> | 7.4% | Composite International Diagnostic Interview (CIDI) |- | United States, nationally representative, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Pietrzak|first=Robert H.|last2=Goldstein|first2=Risë B.|last3=Southwick|first3=Steven M.|last4=Grant|first4=Bridget F.|title=Prevalence and Axis I comorbidity of full and partial posttraumatic stress disorder in the United States: Results from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions|url=http://linkinghub.elsevier.com/retrieve/pii/S0887618510002288|journal=Journal of Anxiety Disorders|volume=25|issue=3|pages=456–465|doi=10.1016/j.janxdis.2010.11.010}}</ref> | 6.4% | Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions |- | Northern Ireland, representative sample, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Bunting|first=Brendan P.|last2=Ferry|first2=Finola R.|last3=Murphy|first3=Samuel D.|last4=O'Neill|first4=Siobhan M.|last5=Bolton|first5=David|date=2013-02-01|title=Trauma Associated With Civil Conflict and Posttraumatic Stress Disorder: Evidence From the Northern Ireland Study of Health and Stress|url=http://onlinelibrary.wiley.com/doi/10.1002/jts.21766/abstract|journal=Journal of Traumatic Stress|language=en|volume=26|issue=1|pages=134–141|doi=10.1002/jts.21766|issn=1573-6598}}</ref> | 8.8% | Northern Ireland Study of Health and Stress |- | South Africa, nationally representative sample, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Atwoli|first=Lukoye|last2=Stein|first2=Dan J.|last3=Williams|first3=David R.|last4=Mclaughlin|first4=Katie A.|last5=Petukhova|first5=Maria|last6=Kessler|first6=Ronald C.|last7=Koenen|first7=Karestan C.|date=2013-07-03|title=Trauma and posttraumatic stress disorder in South Africa: analysis from the South African Stress and Health Study|url=https://doi.org/10.1186/1471-244X-13-182|journal=BMC Psychiatry|volume=13|pages=182|doi=10.1186/1471-244x-13-182|issn=1471-244X}}</ref> | 2.3% | South African Stress and Health Study, using the Composite International Diagnostic Interview (CIDI) |- | U.S. Army and Marine Soldiers Deployed to Iraq and Afghanistan | U.S. Service Members<ref>{{Cite journal|last=Hoge|first=Charles W.|last2=Castro|first2=Carl A.|last3=Messer|first3=Stephen C.|last4=McGurk|first4=Dennis|last5=Cotting|first5=Dave I.|last6=Koffman|first6=Robert L.|date=2004-07-01|title=Combat Duty in Iraq and Afghanistan, Mental Health Problems, and Barriers to Care|url=http://dx.doi.org/10.1056/NEJMoa040603|journal=New England Journal of Medicine|volume=351|issue=1|pages=13–22|doi=10.1056/nejmoa040603|issn=0028-4793|pmid=15229303}}</ref> |11.5% - 19.5% ♦ | PTSD Checklist |- |United States, nationally representative, ages 13-18 |Non-clinical: Population based<ref>{{Cite journal|last=Merikangas|first=Kathleen Ries|last2=He|first2=Jian-ping|last3=Burstein|first3=Marcy|last4=Swanson|first4=Sonja A.|last5=Avenevoli|first5=Shelli|last6=Cui|first6=Lihong|last7=Benjet|first7=Corina|last8=Georgiades|first8=Katholiki|last9=Swendsen|first9=Joel|title=Lifetime Prevalence of Mental Disorders in U.S. Adolescents: Results from the National Comorbidity Survey Replication–Adolescent Supplement (NCS-A)|url=https://doi.org/10.1016/j.jaac.2010.05.017|journal=Journal of the American Academy of Child & Adolescent Psychiatry|volume=49|issue=10|pages=980–989|doi=10.1016/j.jaac.2010.05.017}}</ref> |5.0% |National Comorbidity Survey Replication—Adolescent Supplement (NCS-A) |} ♦ '''Note''': These rates were using broad PTSD Checklist scoring criteria of being scored positive if subjects reported at least one intrusion symptom, three avoidance symptoms, and two hyperarousal symptom that were categorized as at the moderate level. The 11.5% is for soldiers returning from deployment in Iraq, 19.5% is for soldiers returning from Afghanistan. Another common practice is to use a strict cutoff of 50 on the PCL, above which someone screens positive for PTSD. With this cutoff, rates are 6.2% and 12.9% for Service Members returned from Afghanistan and Iraqi, respectively. ==[[Evidence based assessment/Prediction phase|'''Prediction phase''']]== === Psychometric properties of screening for PTSD === The following section contains a list of screening and diagnostic instruments for PTSD. The section includes administration information, psychometric data, and PDFs or links to the screenings. * Screenings are used as part of the [[Evidence based assessment/Prediction phase|prediction phase]] of assessment; for more information on interpretation of this data, or how screenings fit in to the assessment process, click [[Evidence based assessment/Prediction phase|here.]] * '''''For a list of more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Psychometric_properties_of_common_screening_instruments click here.]''''' {| class="wikitable" |- ! Measure !Format (Reporter) !Age Range !Administration/ Completion Time !Where to Access |- |[https://www.ptsd.va.gov/professional/assessment/adult-sr/ptsd-checklist.asp PCL-5 (PTSD Checklist for DSM-5)] |Self-Report |adult |5-10 minutes |[https://www.ptsd.va.gov/professional/assessment/documents/PCL5_Standard_form.PDFPDF PDF] |- |PDS (Post-traumatic Diagnosis Scale) |Self-Report |adult |10-20 minutes | |- | colspan="4" style="font-size:110%; text-align:center;" |'''For Children and Adolescents Specifically''' | |- |[https://www.reactionindex.com/index.php/ UCLA PTSD Reaction Index for DSM-5] |Clinician Administered |child, school age, adolescents |20-30 minutes |[https://www.dellchildrens.net/wp-content/uploads/sites/60/2019/08/UCLA-PTSD-RI-DSM-5.pdf PDF] |- |CPSS (Children's PTSD Symptom Scale) |Self-Report |child |10-20 minutes |[https://www.aacap.org/App_Themes/AACAP/docs/resource_centers/resources/misc/child_ptsd_symptom_scale.pdf PDF] |- |Young Child PTSD Checklist (YCPC) |Parent Report |child |13 items |[https://medicine.tulane.edu/sites/g/files/rdw761/f/YCPC_v5_23_14.pdf PDF] |} === Interpreting PTSD screening measure scores === * For information on interpreting screening measure scores, click [[Evidence based assessment/Prediction phase#Interpreting screening measure scores|here.]] * Also see the page on [https://en.wikipedia.org/wiki/Likelihood_ratios_in_diagnostic_testing likelihood ratios in diagnostic testing] for more information ==[[Evidence based assessment/Prescription phase|'''Prescription phase''']]== ===Gold standard diagnostic interviews=== * For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews click here.] ===Recommended diagnostic interviews for PTSD=== {| class="wikitable sortable" border="1" ! colspan="4" |Diagnostic instruments for PTSD ! |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time !Where to Access |- | [https://www.ptsd.va.gov/professional/assessment/adult-int/caps.asp CAPS-5 (Clinician Administered PTSD Scale)] | Clinician Administered Interview | adult | 40-60 minutes |[https://www.ptsd.va.gov/professional/assessment/ncptsd-instrument-request-form.asp Assessment request form] |- |PTSD Symptom Scale Interview (PSS-I-5) |Clinician Administered Interview |adult and child version available |24 items |[http://www.advanced-counseling.com/dl/PSSI-5.pdf PDF] |- | colspan="4" style="font-size:110%; text-align:center;" |'''For Children and Adolescents Specifically''' | |- | [https://www.ptsd.va.gov/professional/assessment/child/caps-ca.asp CAPS-CA-5 (Clinician-Administered PTSD Scale for DSM-5 - Child/Adolescent Version)] |Clinician Administered Interview |child |30 items |[https://www.ptsd.va.gov/professional/assessment/ncptsd-instrument-request-form.asp Assessment request form] |- | Children’s PTSD Inventory (CPTSD-I) |Diagnostic Interview | 6-18 years | 50 items |Not Free |} ===Severity interviews for PTSD=== {| class="wikitable sortable" border="1" |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time |- | [https://www.kennedykrieger.org/sites/default/files/library/documents/faculty/ksads-dsm-5-screener.pdf Schedule for Affective Disorders and Schizophrenia for School Age Children (K-SADS)] | Diagnostic Interview | 6-18 years | 18 PTSD items |- | Anxiety Disorders Interview Schedule, Child Version (ADIS-C) | Diagnostic Interview | 7-17 years | 26 PTSD items |- | Children’s Interview for Psychiatric Symptoms (ChIPS) |Diagnostic Interview |6 – 18 years |31 PTSD items |- | Diagnostic Infant and Preschool Assessment (DIPA) |Diagnostic Interview | Age 6 and younger | 46 PTSD items |} ==[[Evidence based assessment/Process phase|'''Process phase''']]== The following section contains a brief overview of treatment options for PTSD and list of process and outcome measures for PTSD. The section includes benchmarks based on published norms for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the [[Evidence based assessment/Process phase|process phase]] of assessment. For more information of differences between process and outcome measures, see the page on the [[Evidence based assessment/Process phase|process phase of assessment]]. === Process measures === * Information coming soon === Outcome and severity measures === This table includes clinically significant benchmarks for PTSD specific outcome measures * Information on how to interpret this table can be [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase found here]. * Additionally, these [[Evidence based assessment/Vignettes|vignettes]] might be helpful resources for understanding appropriate adaptation of outcome measures in practice. * ''<u>For clinically significant change benchmarks for the CBCL, YSR, and TRF total, externalizing, internalizing, and attention benchmarks,</u>'' [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase&wteswitched=1#Clinically_significant_change_benchmarks_for_widely-used_outcome_measures see here.] {| class="wikitable sortable" border="1" | colspan="7" |'''Clinically significant change benchmarks with common instruments for PTSD''' |- | colspan="7" style="font-size:110%; text-align:center;" span |<b> Benchmarks Based on Published Norms</b> |- | rowspan="2" style="text-align:center;font-size:130%;" |<b> Measure</b> | colspan="3" style="text-align:center;font-size:130%" width="300" |<b> Cut-off scores</b> | colspan="3" style="text-align:center;font-size:120%" |<b> Critical Change <br> (unstandardized scores)</b> |- | style="text-align:center;font-size:110%" |<b> A</b> | style="text-align:center;font-size:110%" |<b> B</b> | style="text-align:center;font-size:110%" |<b> C</b> | style="text-align:center;font-size:110%" |<b> 95%</b> | style="text-align:center;font-size:110%" |<b> 90%</b> | style="text-align:center;font-size:110%" |<b> SE_difference</b> |- | rowspan="1" style="text-align:center;" | Primary Care PTSD Screen | style="text-align:center;" | 1.0 | style="text-align:center;" | 3.1 | style="text-align:center;" | 2.0 | style="text-align:center;" | 1.0 | style="text-align:center;" | .8 | style="text-align:center;" | .5 |- | rowspan="1" style="text-align:center;" | PTSD Checklist Scores | style="text-align:center;" | 28.8 | style="text-align:center;" | 40.8 | style="text-align:center;" | 34.9 | style="text-align:center;" | 4.6 | style="text-align:center;" | 3.8 | style="text-align:center;" | 2.3 |- | rowspan="1" style="text-align:center;" | Clinician Administered PTSD Scale | style="text-align:center;" | 28.8 | style="text-align:center;" | 40.8 | style="text-align:center;" | 34.9 | style="text-align:center;" | 8.3 | style="text-align:center;" | 7.0 | style="text-align:center;" | 4.2 |} === Treatment === * Please refer to the Wikipedia page on [[wikipedia:Posttraumatic_stress_disorder|PTSD]] for more information on available treatment for PTSD or go to the [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/post-traumatic-stress-disorder/ Effective Child Therapy] page for for a curated resource on effective treatments for PTSD. {{collapse top| Click here for more information}} '''<big>Behavioral interventions</big>''' Recommended (have ''significant benefit'') <ref name=":0">Department of Veterans Affairs and Department of Defense. . (2010). VA/DoD clinical practice guidelines: management of post-traumatic stress. Washington, D.C.: Veterans Health Administration, Department of Defense.</ref>: # Brief Cognitive Behavioral Therapy (CBT; 4-5 sessions) #* This includes stress inoculation training, trauma-focused therapy including components of cognitive restructuring, Cognitive Processing Therapy (CPT), imaginal, virtual, and in-vivo exposure as in Prolonged Exposure psychotherapy (PE)² #* Patient education is recommended as part of psychotherapy for patients and family members # EMDR may help both acute and chronic PTSD, especially individuals who have trouble with prolonged exposure or have trouble verbalizing their trauma.<ref name=":1">Ursano, R. J., Bell, C., Eth, S., Friedman, M., Norwood, A., Pfefferbaum, B., . . . McIntyre, J. S. (2004). ''Practice guideline for the treatment of patients with acute stress disorder and posttraumatic stress disorder'': American Psychiatric Publ </ref> ## Long term gains require further study. # [https://www.ptsd.va.gov/professional/treat/txessentials/present_centered_therapy.asp Present-Centered Therapy (PCT)] is a non trauma focused treatment for PTSD and a second-line treatment for PTSD<ref>{{Cite web|url=https://www.ptsd.va.gov/professional/treat/txessentials/present_centered_therapy.asp|title=Present-Centered Therapy for PTSD - PTSD: National Center for PTSD|website=www.ptsd.va.gov|language=en|access-date=2022-08-13}}</ref>. Treatments with weaker evidence (have ''some benefit'') <ref name=":0" />: # Patient education, # Imagery rehearsal therapy, # Psychodynamic therapy, # Hypnosis, # Relaxation techniques, # and Group therapy. Treatment with ''unknown benefit'' <ref name=":0" />: # Web-based CBT ## For example Jeane Bosch participated as a study therapist in research study that compared STAIR and present-centered therapy both delivered via telehealth. STAIR stands for Skills Training in Affective and Interpersonal Regulation. It is a skill-focused treatment that was originally developed for survivors of childhood abuse to teach emotion regulation skills as well as tools to help with challenges interpersonal functioning and social relationships and decrease PTSD symptoms<ref>{{Cite web|url=https://istss.org/public-resources/trauma-blog/2015-march-(1)/clinician-s-corner-skills-training-in-affective-an|title=ISTSS - Trauma Blog|website=istss.org|access-date=2022-08-13}}</ref>.<ref>{{Citation|title=Introduction to Telehealth with Dr. Bosch|url=https://www.youtube.com/watch?v=Wn6Vewl42X8|accessdate=2022-08-13|language=en}}</ref> # Acceptance and commitment therapy, # and Dialectical Behavioral Therapy. <big>'''Medication'''</big> *SSRIs are more effective than placebo in treating PTSD.<ref name=":1" /> *There is no evidence to support a medication to prevent the development of PTSD.<ref name=":0" /> **Imipramine, propranolol, prazosin, other antidepressants, anticonvulsants, and atypical antipsychotics have ''unknown benefit.'' **Strongly recommend against the use of benzodiazepines² and typical antipsychotics since they have ''no benefit and potential harm.'' {{collapse bottom}} == '''External resources''' == === For professionals === * [http://www.som.uq.edu.au/ptsd Post Traumatic Stress Disorder Information Resource] from [http://www.uq.edu.au/ The University of Queensland School of Medicine] * [http://www.apa.org/ptsd-guideline/ APA practice parameters for assessment and treatment for PTSD (Updated 2017)] * [http://www.ptsd.va.gov/professional/index.asp Resources for professionals] from [http://www.ptsd.va.gov/index.asp VA National PTSD Center] * [https://www.integration.samhsa.gov/clinical-practice/trauma-informed SAMHSA's Trauma-Informed Care Resources and Training] * [https://www.integration.samhsa.gov/clinical-practice/trauma-informed SAMHSA's Resources on Intimate Partner Violence (IPV) for Clinicians, Patients, Families, and Organizations] === For caregivers === * [http://www.nctsn.org/sites/default/files/assets/pdfs/tips_for_parents_media_final.pdf Tips for parents on shooting media coverage] * [http://www.nctsn.org/sites/default/files/assets/pdfs/parents_guidelines_for_helping_teens_after_the_recent_attacks.pdf Parent guidelines to helping youths after a shooting] * [http://www.nctsn.org/sites/default/files/assets/pdfs/helping_teens_with_traumatic_grief_caregivers_final.pdf Caregiver tips for helping teens with traumatic grief] * [http://www.nctsn.org/sites/default/files/assets/pdfs/10things_schoolage_ctg.pdf Caregiver tips for helping school-age children with traumatic grief] *[http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/post-traumatic-stress-disorder/ EffectiveChildTherapy.Org information on PTSD] *[https://sccap53.org Society of Clinical Child and Adolescent Psychology] === For educators === * [http://www.nctsn.org/sites/default/files/assets/pdfs/pfa_for_schools_appendix_a_teachers.pdf Teacher tips for providing psychological first aid] * [http://www.nctsn.org/sites/default/files/assets/pdfs/helping_youth_after_community_violence_educators.pdf Educator tips for helping youths after a community trauma] === For public === * [https://complicatedgrief.columbia.edu/for-the-public/resources/ Resources for grief and loss] * [http://www.nctsn.org/sites/default/files/assets/pdfs/psychological_information_sheet_two_pager.pdf Psychological impacts of recent shootings] * [http://www.nctsn.org/sites/default/files/assets/pdfs/youth_journalists.pdf Tips to talking to youths about a shooting] * [http://www.nctsn.org/sites/default/files/assets/pdfs/talking_to_children_about_the_shooting.pdf Tips to talking to children about a shooting] * [http://www.nctsn.org/sites/default/files/assets/pdfs/helping_young_children_heal_crisis.pdf Helping young children heal after a crisis] * [http://www.nctsn.org/content/psychological-first-aid-schoolspfa Psychological first aid for schools] * [http://www.nctsn.org/content/psychological-first-aid Resources and manuals on psychological first aid] * [http://www.ptsd.va.gov/public/index.asp Resources for the public] from [http://www.ptsd.va.gov/index.asp VA National PTSD Center] * [https://curlie.org/Health/Mental_Health/Disorders/Anxiety/Post-traumatic_Stress Posttraumatic stress disorder] at Curlie (based on DMOZ) =='''References'''== {{collapse top|Click here for references}} {{Reflist|30em}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] {{collapse bottom}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] sf30nsj3ldb7g9c1br1i6nerexqb5ga 2419122 2419118 2022-08-25T23:24:11Z Ardenguo 2944162 /* Severity interviews for PTSD */ added a link wikitext text/x-wiki <noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{medical disclaimer}} {{:{{BASEPAGENAME}}/Sidebar}} ==[[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio"?''']]== * For background information on what assessment portfolios are, click the link in the heading above. * Want even 'more' information about this topic? There's an extended version of this page [[Evidence-based assessment/Posttraumatic stress disorder (disorder portfolio)/extended version|'''here''']]. == [[Evidence based assessment/Preparation phase|'''Preparation phase''']] == === Diagnostic criteria for post traumatic stress disorder === ===='''ICD-11 Diagnostic Criteria'''==== {{blockquotetop}} ===='''ICD-11 Criteria'''==== *Post-traumatic stress disorder (PTSD) is a syndrome that develops following exposure to an extremely threatening or horrific event or series of events that is characterized by all of the following: **1) re-experiencing the traumatic event or events in the present in the form of vivid intrusive memories, flashbacks, or nightmares, which are typically accompanied by strong and overwhelming emotions such as fear or horror and strong physical sensations, or feelings of being overwhelmed or immersed in the same intense emotions that were experienced during the traumatic event; **2) avoidance of thoughts and memories of the event or events, or avoidance of activities, situations, or people reminiscent of the event or events **3) persistent perceptions of heightened current threat, for example as indicated by hypervigilance or an enhanced startle reaction to stimuli such as unexpected noises. *The symptoms must persist for at least several weeks and cause significant impairment in personal, family, social, educational, occupational or other important areas of functioning. Additionally, ICD 11 includes a category called "Complex post-traumatic stress disorder," which is described as: *A disorder that may develop following exposure to an event or series of events of an extremely threatening or horrific nature, most commonly prolonged or repetitive events from which escape is difficult or impossible (e.g., torture, slavery, genocide campaigns, prolonged domestic violence, repeated childhood sexual or physical abuse). *The disorder is characterized by the core symptoms of PTSD; that is, all diagnostic requirements for PTSD have been met at some point during the course of the disorder. *In addition, Complex PTSD is characterized by: **1) severe and pervasive problems in affect regulation; **2) persistent beliefs about oneself as diminished, defeated or worthless, accompanied by deep and pervasive feelings of shame, guilt or failure related to the traumatic event **3) persistent difficulties in sustaining relationships and in feeling close to others. The disturbance causes significant impairment in personal, family, social, educational, occupational or other important areas of functioning. {{blockquotebottom}} ===='''Changes in DSM-5'''==== * The diagnostic criteria for post-traumatic stress disorder changed slightly from [[DSM-IV]] to [[w:Diagnostic_and_Statistical_Manual_of_Mental_Disorders#DSM-IV-TR_.282000.29|DSM-5]]. Summaries are available [http://www.dsm5.org/Documents/changes%20from%20dsm-iv-tr%20to%20dsm-5.pdf here] and [[w:DSM-5|here]]. === Developmental sensitivities === {{collapse top| Click for more information}} *Diagnostic thresholds have been lowered for children and adolescents to account for development. *Separate and additional criteria have been added for children age 6 or younger. *Child sexual abuse has been found to have a substantial effect on the development of PTSD.<ref>{{cite journal|last1=Paolucci|first1=Elizabeth ODDONE|last2=Genuis|first2=Mark L.|last3=Violato|first3=Claudio|title=A Meta-Analysis of the Published Research on the Effects of Child Sexual Abuse|journal=The Journal of Psychology|date=January 2001|volume=135|issue=1|pages=17–36|doi=10.1080/00223980109603677}}</ref> *Children with higher exposure to trauma, less social support, and other major life events are more likely to have continued PTSD symptoms 7 months after a trauma.<ref name=":2">{{cite journal |last1=La Greca|first1=A|last2=Silverman|first2=WK|last3=Vernberg|first3=EM|last4=Prinstein|first4=MJ|title=Symptoms of posttraumatic stress in children after Hurricane Andrew: a prospective study.|journal=Journal of consulting and clinical psychology|date=August 1996|volume=64|issue=4|pages=712-23|pmid=8803361}}</ref> 10 months after a trauma, however, only experience of a major life event remained predictive of continuing PTSD symptoms.<ref name=":2" /> *Lack of social support, specifically lack of support by a teacher, was predictive of higher PTSD symptoms among children who had gone through an environmental trauma.<ref name=":2" /> *Children who reported using blame and anger as strategies for coping had higher levels of PTSD symptoms 10 months after a trauma.<ref name=":2" /> *Negative affect in children before a traumatic event was predictive of development of PTSD symptoms after a traumatic event.<ref>{{cite journal|last1=Weems|first1=CF|last2=Pina|first2=AA|last3=Costa|first3=NM|last4=Watts|first4=SE|last5=Taylor|first5=LK|last6=Cannon|first6=MF|title=Predisaster trait anxiety and negative affect predict posttraumatic stress in youths after hurricane Katrina.|journal=Journal of consulting and clinical psychology|date=February 2007|volume=75|issue=1|pages=154-9|doi=10.1037/0022-006X.75.1.154|pmid=17295574}}</ref> [[wikipedia:Posttraumatic_stress_disorder|Posttraumatic stress disorder]] is now more sensitive to development in that diagnostic thresholds have been lowered for children and adolescents. Furthermore, separate and additional criteria have been added for children age 6 years of age or younger. {{collapse bottom}} === Base rates of PTSD in different clinical settings and populations === This section describes the demographic settings of the populations sampled, base rates of PTSD diagnoses, country/region sampled, and the diagnostic methods that were used. Using this information, clinicians will be able to anchor the most appropriate rate of PTSD that they are likely to see in their clinical practice. * '''''To see prevalence rates across multiple disorders,''''' [[Evidence based assessment/Preparation phase#Base rates for transdiagnostic comparison|'''''click here.''''']] {| class="wikitable sortable" border="1" |- ! Demography ! Setting ! Base Rate ! Diagnostic Method |- | United States, nationally representative, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Kessler|first=Ronald C.|last2=Berglund|first2=Patricia|last3=Demler|first3=Olga|last4=Jin|first4=Robert|last5=Merikangas|first5=Kathleen R.|last6=Walters|first6=Ellen E.|date=2005-06-01|title=Lifetime Prevalence and Age-of-Onset Distributions of DSM-IV Disorders in the National Comorbidity Survey Replication|url=http://archpsyc.jamanetwork.com/article.aspx?doi=10.1001/archpsyc.62.6.593|journal=Archives of General Psychiatry|language=en|volume=62|issue=6|doi=10.1001/archpsyc.62.6.593|issn=0003-990X}}</ref> | 6.8% | National Comorbidity Survey - Replication |- | Netherlands, nationally representative, age 18-80 | Non-clinical: Population based<ref>{{Cite journal|last=de Vries|first=Giel-Jan|last2=Olff|first2=Miranda|date=2009-08-01|title=The lifetime prevalence of traumatic events and posttraumatic stress disorder in the Netherlands|url=http://onlinelibrary.wiley.com/doi/10.1002/jts.20429/abstract|journal=Journal of Traumatic Stress|language=en|volume=22|issue=4|pages=259–267|doi=10.1002/jts.20429|issn=1573-6598}}</ref> | 7.4% | Composite International Diagnostic Interview (CIDI) |- | United States, nationally representative, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Pietrzak|first=Robert H.|last2=Goldstein|first2=Risë B.|last3=Southwick|first3=Steven M.|last4=Grant|first4=Bridget F.|title=Prevalence and Axis I comorbidity of full and partial posttraumatic stress disorder in the United States: Results from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions|url=http://linkinghub.elsevier.com/retrieve/pii/S0887618510002288|journal=Journal of Anxiety Disorders|volume=25|issue=3|pages=456–465|doi=10.1016/j.janxdis.2010.11.010}}</ref> | 6.4% | Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions |- | Northern Ireland, representative sample, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Bunting|first=Brendan P.|last2=Ferry|first2=Finola R.|last3=Murphy|first3=Samuel D.|last4=O'Neill|first4=Siobhan M.|last5=Bolton|first5=David|date=2013-02-01|title=Trauma Associated With Civil Conflict and Posttraumatic Stress Disorder: Evidence From the Northern Ireland Study of Health and Stress|url=http://onlinelibrary.wiley.com/doi/10.1002/jts.21766/abstract|journal=Journal of Traumatic Stress|language=en|volume=26|issue=1|pages=134–141|doi=10.1002/jts.21766|issn=1573-6598}}</ref> | 8.8% | Northern Ireland Study of Health and Stress |- | South Africa, nationally representative sample, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Atwoli|first=Lukoye|last2=Stein|first2=Dan J.|last3=Williams|first3=David R.|last4=Mclaughlin|first4=Katie A.|last5=Petukhova|first5=Maria|last6=Kessler|first6=Ronald C.|last7=Koenen|first7=Karestan C.|date=2013-07-03|title=Trauma and posttraumatic stress disorder in South Africa: analysis from the South African Stress and Health Study|url=https://doi.org/10.1186/1471-244X-13-182|journal=BMC Psychiatry|volume=13|pages=182|doi=10.1186/1471-244x-13-182|issn=1471-244X}}</ref> | 2.3% | South African Stress and Health Study, using the Composite International Diagnostic Interview (CIDI) |- | U.S. Army and Marine Soldiers Deployed to Iraq and Afghanistan | U.S. Service Members<ref>{{Cite journal|last=Hoge|first=Charles W.|last2=Castro|first2=Carl A.|last3=Messer|first3=Stephen C.|last4=McGurk|first4=Dennis|last5=Cotting|first5=Dave I.|last6=Koffman|first6=Robert L.|date=2004-07-01|title=Combat Duty in Iraq and Afghanistan, Mental Health Problems, and Barriers to Care|url=http://dx.doi.org/10.1056/NEJMoa040603|journal=New England Journal of Medicine|volume=351|issue=1|pages=13–22|doi=10.1056/nejmoa040603|issn=0028-4793|pmid=15229303}}</ref> |11.5% - 19.5% ♦ | PTSD Checklist |- |United States, nationally representative, ages 13-18 |Non-clinical: Population based<ref>{{Cite journal|last=Merikangas|first=Kathleen Ries|last2=He|first2=Jian-ping|last3=Burstein|first3=Marcy|last4=Swanson|first4=Sonja A.|last5=Avenevoli|first5=Shelli|last6=Cui|first6=Lihong|last7=Benjet|first7=Corina|last8=Georgiades|first8=Katholiki|last9=Swendsen|first9=Joel|title=Lifetime Prevalence of Mental Disorders in U.S. Adolescents: Results from the National Comorbidity Survey Replication–Adolescent Supplement (NCS-A)|url=https://doi.org/10.1016/j.jaac.2010.05.017|journal=Journal of the American Academy of Child & Adolescent Psychiatry|volume=49|issue=10|pages=980–989|doi=10.1016/j.jaac.2010.05.017}}</ref> |5.0% |National Comorbidity Survey Replication—Adolescent Supplement (NCS-A) |} ♦ '''Note''': These rates were using broad PTSD Checklist scoring criteria of being scored positive if subjects reported at least one intrusion symptom, three avoidance symptoms, and two hyperarousal symptom that were categorized as at the moderate level. The 11.5% is for soldiers returning from deployment in Iraq, 19.5% is for soldiers returning from Afghanistan. Another common practice is to use a strict cutoff of 50 on the PCL, above which someone screens positive for PTSD. With this cutoff, rates are 6.2% and 12.9% for Service Members returned from Afghanistan and Iraqi, respectively. ==[[Evidence based assessment/Prediction phase|'''Prediction phase''']]== === Psychometric properties of screening for PTSD === The following section contains a list of screening and diagnostic instruments for PTSD. The section includes administration information, psychometric data, and PDFs or links to the screenings. * Screenings are used as part of the [[Evidence based assessment/Prediction phase|prediction phase]] of assessment; for more information on interpretation of this data, or how screenings fit in to the assessment process, click [[Evidence based assessment/Prediction phase|here.]] * '''''For a list of more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Psychometric_properties_of_common_screening_instruments click here.]''''' {| class="wikitable" |- ! Measure !Format (Reporter) !Age Range !Administration/ Completion Time !Where to Access |- |[https://www.ptsd.va.gov/professional/assessment/adult-sr/ptsd-checklist.asp PCL-5 (PTSD Checklist for DSM-5)] |Self-Report |adult |5-10 minutes |[https://www.ptsd.va.gov/professional/assessment/documents/PCL5_Standard_form.PDFPDF PDF] |- |PDS (Post-traumatic Diagnosis Scale) |Self-Report |adult |10-20 minutes | |- | colspan="4" style="font-size:110%; text-align:center;" |'''For Children and Adolescents Specifically''' | |- |[https://www.reactionindex.com/index.php/ UCLA PTSD Reaction Index for DSM-5] |Clinician Administered |child, school age, adolescents |20-30 minutes |[https://www.dellchildrens.net/wp-content/uploads/sites/60/2019/08/UCLA-PTSD-RI-DSM-5.pdf PDF] |- |CPSS (Children's PTSD Symptom Scale) |Self-Report |child |10-20 minutes |[https://www.aacap.org/App_Themes/AACAP/docs/resource_centers/resources/misc/child_ptsd_symptom_scale.pdf PDF] |- |Young Child PTSD Checklist (YCPC) |Parent Report |child |13 items |[https://medicine.tulane.edu/sites/g/files/rdw761/f/YCPC_v5_23_14.pdf PDF] |} === Interpreting PTSD screening measure scores === * For information on interpreting screening measure scores, click [[Evidence based assessment/Prediction phase#Interpreting screening measure scores|here.]] * Also see the page on [https://en.wikipedia.org/wiki/Likelihood_ratios_in_diagnostic_testing likelihood ratios in diagnostic testing] for more information ==[[Evidence based assessment/Prescription phase|'''Prescription phase''']]== ===Gold standard diagnostic interviews=== * For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews click here.] ===Recommended diagnostic interviews for PTSD=== {| class="wikitable sortable" border="1" ! colspan="4" |Diagnostic instruments for PTSD ! |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time !Where to Access |- | [https://www.ptsd.va.gov/professional/assessment/adult-int/caps.asp CAPS-5 (Clinician Administered PTSD Scale)] | Clinician Administered Interview | adult | 40-60 minutes |[https://www.ptsd.va.gov/professional/assessment/ncptsd-instrument-request-form.asp Assessment request form] |- |PTSD Symptom Scale Interview (PSS-I-5) |Clinician Administered Interview |adult and child version available |24 items |[http://www.advanced-counseling.com/dl/PSSI-5.pdf PDF] |- | colspan="4" style="font-size:110%; text-align:center;" |'''For Children and Adolescents Specifically''' | |- | [https://www.ptsd.va.gov/professional/assessment/child/caps-ca.asp CAPS-CA-5 (Clinician-Administered PTSD Scale for DSM-5 - Child/Adolescent Version)] |Clinician Administered Interview |child |30 items |[https://www.ptsd.va.gov/professional/assessment/ncptsd-instrument-request-form.asp Assessment request form] |- | Children’s PTSD Inventory (CPTSD-I) |Diagnostic Interview | 6-18 years | 50 items |Not Free |} ===Severity interviews for PTSD=== {| class="wikitable sortable" border="1" |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time !Where to Access |- | [https://www.kennedykrieger.org/sites/default/files/library/documents/faculty/ksads-dsm-5-screener.pdf Schedule for Affective Disorders and Schizophrenia for School Age Children (K-SADS)] | Diagnostic Interview | 6-18 years | 18 PTSD items | |- | Anxiety Disorders Interview Schedule, Child Version (ADIS-C) | Diagnostic Interview | 7-17 years | 26 PTSD items | |- | Children’s Interview for Psychiatric Symptoms (ChIPS) |Diagnostic Interview |6 – 18 years |31 PTSD items | |- | Diagnostic Infant and Preschool Assessment (DIPA) |Diagnostic Interview | Age 6 and younger | 46 PTSD items |[https://medicine.tulane.edu/sites/g/files/rdw761/f/DIPA-2017-2-14.pdf PDF] |} ==[[Evidence based assessment/Process phase|'''Process phase''']]== The following section contains a brief overview of treatment options for PTSD and list of process and outcome measures for PTSD. The section includes benchmarks based on published norms for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the [[Evidence based assessment/Process phase|process phase]] of assessment. For more information of differences between process and outcome measures, see the page on the [[Evidence based assessment/Process phase|process phase of assessment]]. === Process measures === * Information coming soon === Outcome and severity measures === This table includes clinically significant benchmarks for PTSD specific outcome measures * Information on how to interpret this table can be [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase found here]. * Additionally, these [[Evidence based assessment/Vignettes|vignettes]] might be helpful resources for understanding appropriate adaptation of outcome measures in practice. * ''<u>For clinically significant change benchmarks for the CBCL, YSR, and TRF total, externalizing, internalizing, and attention benchmarks,</u>'' [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase&wteswitched=1#Clinically_significant_change_benchmarks_for_widely-used_outcome_measures see here.] {| class="wikitable sortable" border="1" | colspan="7" |'''Clinically significant change benchmarks with common instruments for PTSD''' |- | colspan="7" style="font-size:110%; text-align:center;" span |<b> Benchmarks Based on Published Norms</b> |- | rowspan="2" style="text-align:center;font-size:130%;" |<b> Measure</b> | colspan="3" style="text-align:center;font-size:130%" width="300" |<b> Cut-off scores</b> | colspan="3" style="text-align:center;font-size:120%" |<b> Critical Change <br> (unstandardized scores)</b> |- | style="text-align:center;font-size:110%" |<b> A</b> | style="text-align:center;font-size:110%" |<b> B</b> | style="text-align:center;font-size:110%" |<b> C</b> | style="text-align:center;font-size:110%" |<b> 95%</b> | style="text-align:center;font-size:110%" |<b> 90%</b> | style="text-align:center;font-size:110%" |<b> SE_difference</b> |- | rowspan="1" style="text-align:center;" | Primary Care PTSD Screen | style="text-align:center;" | 1.0 | style="text-align:center;" | 3.1 | style="text-align:center;" | 2.0 | style="text-align:center;" | 1.0 | style="text-align:center;" | .8 | style="text-align:center;" | .5 |- | rowspan="1" style="text-align:center;" | PTSD Checklist Scores | style="text-align:center;" | 28.8 | style="text-align:center;" | 40.8 | style="text-align:center;" | 34.9 | style="text-align:center;" | 4.6 | style="text-align:center;" | 3.8 | style="text-align:center;" | 2.3 |- | rowspan="1" style="text-align:center;" | Clinician Administered PTSD Scale | style="text-align:center;" | 28.8 | style="text-align:center;" | 40.8 | style="text-align:center;" | 34.9 | style="text-align:center;" | 8.3 | style="text-align:center;" | 7.0 | style="text-align:center;" | 4.2 |} === Treatment === * Please refer to the Wikipedia page on [[wikipedia:Posttraumatic_stress_disorder|PTSD]] for more information on available treatment for PTSD or go to the [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/post-traumatic-stress-disorder/ Effective Child Therapy] page for for a curated resource on effective treatments for PTSD. {{collapse top| Click here for more information}} '''<big>Behavioral interventions</big>''' Recommended (have ''significant benefit'') <ref name=":0">Department of Veterans Affairs and Department of Defense. . (2010). VA/DoD clinical practice guidelines: management of post-traumatic stress. Washington, D.C.: Veterans Health Administration, Department of Defense.</ref>: # Brief Cognitive Behavioral Therapy (CBT; 4-5 sessions) #* This includes stress inoculation training, trauma-focused therapy including components of cognitive restructuring, Cognitive Processing Therapy (CPT), imaginal, virtual, and in-vivo exposure as in Prolonged Exposure psychotherapy (PE)² #* Patient education is recommended as part of psychotherapy for patients and family members # EMDR may help both acute and chronic PTSD, especially individuals who have trouble with prolonged exposure or have trouble verbalizing their trauma.<ref name=":1">Ursano, R. J., Bell, C., Eth, S., Friedman, M., Norwood, A., Pfefferbaum, B., . . . McIntyre, J. S. (2004). ''Practice guideline for the treatment of patients with acute stress disorder and posttraumatic stress disorder'': American Psychiatric Publ </ref> ## Long term gains require further study. # [https://www.ptsd.va.gov/professional/treat/txessentials/present_centered_therapy.asp Present-Centered Therapy (PCT)] is a non trauma focused treatment for PTSD and a second-line treatment for PTSD<ref>{{Cite web|url=https://www.ptsd.va.gov/professional/treat/txessentials/present_centered_therapy.asp|title=Present-Centered Therapy for PTSD - PTSD: National Center for PTSD|website=www.ptsd.va.gov|language=en|access-date=2022-08-13}}</ref>. Treatments with weaker evidence (have ''some benefit'') <ref name=":0" />: # Patient education, # Imagery rehearsal therapy, # Psychodynamic therapy, # Hypnosis, # Relaxation techniques, # and Group therapy. Treatment with ''unknown benefit'' <ref name=":0" />: # Web-based CBT ## For example Jeane Bosch participated as a study therapist in research study that compared STAIR and present-centered therapy both delivered via telehealth. STAIR stands for Skills Training in Affective and Interpersonal Regulation. It is a skill-focused treatment that was originally developed for survivors of childhood abuse to teach emotion regulation skills as well as tools to help with challenges interpersonal functioning and social relationships and decrease PTSD symptoms<ref>{{Cite web|url=https://istss.org/public-resources/trauma-blog/2015-march-(1)/clinician-s-corner-skills-training-in-affective-an|title=ISTSS - Trauma Blog|website=istss.org|access-date=2022-08-13}}</ref>.<ref>{{Citation|title=Introduction to Telehealth with Dr. Bosch|url=https://www.youtube.com/watch?v=Wn6Vewl42X8|accessdate=2022-08-13|language=en}}</ref> # Acceptance and commitment therapy, # and Dialectical Behavioral Therapy. <big>'''Medication'''</big> *SSRIs are more effective than placebo in treating PTSD.<ref name=":1" /> *There is no evidence to support a medication to prevent the development of PTSD.<ref name=":0" /> **Imipramine, propranolol, prazosin, other antidepressants, anticonvulsants, and atypical antipsychotics have ''unknown benefit.'' **Strongly recommend against the use of benzodiazepines² and typical antipsychotics since they have ''no benefit and potential harm.'' {{collapse bottom}} == '''External resources''' == === For professionals === * [http://www.som.uq.edu.au/ptsd Post Traumatic Stress Disorder Information Resource] from [http://www.uq.edu.au/ The University of Queensland School of Medicine] * [http://www.apa.org/ptsd-guideline/ APA practice parameters for assessment and treatment for PTSD (Updated 2017)] * [http://www.ptsd.va.gov/professional/index.asp Resources for professionals] from [http://www.ptsd.va.gov/index.asp VA National PTSD Center] * [https://www.integration.samhsa.gov/clinical-practice/trauma-informed SAMHSA's Trauma-Informed Care Resources and Training] * [https://www.integration.samhsa.gov/clinical-practice/trauma-informed SAMHSA's Resources on Intimate Partner Violence (IPV) for Clinicians, Patients, Families, and Organizations] === For caregivers === * [http://www.nctsn.org/sites/default/files/assets/pdfs/tips_for_parents_media_final.pdf Tips for parents on shooting media coverage] * [http://www.nctsn.org/sites/default/files/assets/pdfs/parents_guidelines_for_helping_teens_after_the_recent_attacks.pdf Parent guidelines to helping youths after a shooting] * [http://www.nctsn.org/sites/default/files/assets/pdfs/helping_teens_with_traumatic_grief_caregivers_final.pdf Caregiver tips for helping teens with traumatic grief] * [http://www.nctsn.org/sites/default/files/assets/pdfs/10things_schoolage_ctg.pdf Caregiver tips for helping school-age children with traumatic grief] *[http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/post-traumatic-stress-disorder/ EffectiveChildTherapy.Org information on PTSD] *[https://sccap53.org Society of Clinical Child and Adolescent Psychology] === For educators === * [http://www.nctsn.org/sites/default/files/assets/pdfs/pfa_for_schools_appendix_a_teachers.pdf Teacher tips for providing psychological first aid] * [http://www.nctsn.org/sites/default/files/assets/pdfs/helping_youth_after_community_violence_educators.pdf Educator tips for helping youths after a community trauma] === For public === * [https://complicatedgrief.columbia.edu/for-the-public/resources/ Resources for grief and loss] * [http://www.nctsn.org/sites/default/files/assets/pdfs/psychological_information_sheet_two_pager.pdf Psychological impacts of recent shootings] * [http://www.nctsn.org/sites/default/files/assets/pdfs/youth_journalists.pdf Tips to talking to youths about a shooting] * [http://www.nctsn.org/sites/default/files/assets/pdfs/talking_to_children_about_the_shooting.pdf Tips to talking to children about a shooting] * [http://www.nctsn.org/sites/default/files/assets/pdfs/helping_young_children_heal_crisis.pdf Helping young children heal after a crisis] * [http://www.nctsn.org/content/psychological-first-aid-schoolspfa Psychological first aid for schools] * [http://www.nctsn.org/content/psychological-first-aid Resources and manuals on psychological first aid] * [http://www.ptsd.va.gov/public/index.asp Resources for the public] from [http://www.ptsd.va.gov/index.asp VA National PTSD Center] * [https://curlie.org/Health/Mental_Health/Disorders/Anxiety/Post-traumatic_Stress Posttraumatic stress disorder] at Curlie (based on DMOZ) =='''References'''== {{collapse top|Click here for references}} {{Reflist|30em}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] {{collapse bottom}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] p5tl7xew08qlmhpyvrj0iotq10m7dtx 2419124 2419122 2022-08-25T23:28:18Z Ardenguo 2944162 /* Severity interviews for PTSD */ removed an interview wikitext text/x-wiki <noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{medical disclaimer}} {{:{{BASEPAGENAME}}/Sidebar}} ==[[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio"?''']]== * For background information on what assessment portfolios are, click the link in the heading above. * Want even 'more' information about this topic? There's an extended version of this page [[Evidence-based assessment/Posttraumatic stress disorder (disorder portfolio)/extended version|'''here''']]. == [[Evidence based assessment/Preparation phase|'''Preparation phase''']] == === Diagnostic criteria for post traumatic stress disorder === ===='''ICD-11 Diagnostic Criteria'''==== {{blockquotetop}} ===='''ICD-11 Criteria'''==== *Post-traumatic stress disorder (PTSD) is a syndrome that develops following exposure to an extremely threatening or horrific event or series of events that is characterized by all of the following: **1) re-experiencing the traumatic event or events in the present in the form of vivid intrusive memories, flashbacks, or nightmares, which are typically accompanied by strong and overwhelming emotions such as fear or horror and strong physical sensations, or feelings of being overwhelmed or immersed in the same intense emotions that were experienced during the traumatic event; **2) avoidance of thoughts and memories of the event or events, or avoidance of activities, situations, or people reminiscent of the event or events **3) persistent perceptions of heightened current threat, for example as indicated by hypervigilance or an enhanced startle reaction to stimuli such as unexpected noises. *The symptoms must persist for at least several weeks and cause significant impairment in personal, family, social, educational, occupational or other important areas of functioning. Additionally, ICD 11 includes a category called "Complex post-traumatic stress disorder," which is described as: *A disorder that may develop following exposure to an event or series of events of an extremely threatening or horrific nature, most commonly prolonged or repetitive events from which escape is difficult or impossible (e.g., torture, slavery, genocide campaigns, prolonged domestic violence, repeated childhood sexual or physical abuse). *The disorder is characterized by the core symptoms of PTSD; that is, all diagnostic requirements for PTSD have been met at some point during the course of the disorder. *In addition, Complex PTSD is characterized by: **1) severe and pervasive problems in affect regulation; **2) persistent beliefs about oneself as diminished, defeated or worthless, accompanied by deep and pervasive feelings of shame, guilt or failure related to the traumatic event **3) persistent difficulties in sustaining relationships and in feeling close to others. The disturbance causes significant impairment in personal, family, social, educational, occupational or other important areas of functioning. {{blockquotebottom}} ===='''Changes in DSM-5'''==== * The diagnostic criteria for post-traumatic stress disorder changed slightly from [[DSM-IV]] to [[w:Diagnostic_and_Statistical_Manual_of_Mental_Disorders#DSM-IV-TR_.282000.29|DSM-5]]. Summaries are available [http://www.dsm5.org/Documents/changes%20from%20dsm-iv-tr%20to%20dsm-5.pdf here] and [[w:DSM-5|here]]. === Developmental sensitivities === {{collapse top| Click for more information}} *Diagnostic thresholds have been lowered for children and adolescents to account for development. *Separate and additional criteria have been added for children age 6 or younger. *Child sexual abuse has been found to have a substantial effect on the development of PTSD.<ref>{{cite journal|last1=Paolucci|first1=Elizabeth ODDONE|last2=Genuis|first2=Mark L.|last3=Violato|first3=Claudio|title=A Meta-Analysis of the Published Research on the Effects of Child Sexual Abuse|journal=The Journal of Psychology|date=January 2001|volume=135|issue=1|pages=17–36|doi=10.1080/00223980109603677}}</ref> *Children with higher exposure to trauma, less social support, and other major life events are more likely to have continued PTSD symptoms 7 months after a trauma.<ref name=":2">{{cite journal |last1=La Greca|first1=A|last2=Silverman|first2=WK|last3=Vernberg|first3=EM|last4=Prinstein|first4=MJ|title=Symptoms of posttraumatic stress in children after Hurricane Andrew: a prospective study.|journal=Journal of consulting and clinical psychology|date=August 1996|volume=64|issue=4|pages=712-23|pmid=8803361}}</ref> 10 months after a trauma, however, only experience of a major life event remained predictive of continuing PTSD symptoms.<ref name=":2" /> *Lack of social support, specifically lack of support by a teacher, was predictive of higher PTSD symptoms among children who had gone through an environmental trauma.<ref name=":2" /> *Children who reported using blame and anger as strategies for coping had higher levels of PTSD symptoms 10 months after a trauma.<ref name=":2" /> *Negative affect in children before a traumatic event was predictive of development of PTSD symptoms after a traumatic event.<ref>{{cite journal|last1=Weems|first1=CF|last2=Pina|first2=AA|last3=Costa|first3=NM|last4=Watts|first4=SE|last5=Taylor|first5=LK|last6=Cannon|first6=MF|title=Predisaster trait anxiety and negative affect predict posttraumatic stress in youths after hurricane Katrina.|journal=Journal of consulting and clinical psychology|date=February 2007|volume=75|issue=1|pages=154-9|doi=10.1037/0022-006X.75.1.154|pmid=17295574}}</ref> [[wikipedia:Posttraumatic_stress_disorder|Posttraumatic stress disorder]] is now more sensitive to development in that diagnostic thresholds have been lowered for children and adolescents. Furthermore, separate and additional criteria have been added for children age 6 years of age or younger. {{collapse bottom}} === Base rates of PTSD in different clinical settings and populations === This section describes the demographic settings of the populations sampled, base rates of PTSD diagnoses, country/region sampled, and the diagnostic methods that were used. Using this information, clinicians will be able to anchor the most appropriate rate of PTSD that they are likely to see in their clinical practice. * '''''To see prevalence rates across multiple disorders,''''' [[Evidence based assessment/Preparation phase#Base rates for transdiagnostic comparison|'''''click here.''''']] {| class="wikitable sortable" border="1" |- ! Demography ! Setting ! Base Rate ! Diagnostic Method |- | United States, nationally representative, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Kessler|first=Ronald C.|last2=Berglund|first2=Patricia|last3=Demler|first3=Olga|last4=Jin|first4=Robert|last5=Merikangas|first5=Kathleen R.|last6=Walters|first6=Ellen E.|date=2005-06-01|title=Lifetime Prevalence and Age-of-Onset Distributions of DSM-IV Disorders in the National Comorbidity Survey Replication|url=http://archpsyc.jamanetwork.com/article.aspx?doi=10.1001/archpsyc.62.6.593|journal=Archives of General Psychiatry|language=en|volume=62|issue=6|doi=10.1001/archpsyc.62.6.593|issn=0003-990X}}</ref> | 6.8% | National Comorbidity Survey - Replication |- | Netherlands, nationally representative, age 18-80 | Non-clinical: Population based<ref>{{Cite journal|last=de Vries|first=Giel-Jan|last2=Olff|first2=Miranda|date=2009-08-01|title=The lifetime prevalence of traumatic events and posttraumatic stress disorder in the Netherlands|url=http://onlinelibrary.wiley.com/doi/10.1002/jts.20429/abstract|journal=Journal of Traumatic Stress|language=en|volume=22|issue=4|pages=259–267|doi=10.1002/jts.20429|issn=1573-6598}}</ref> | 7.4% | Composite International Diagnostic Interview (CIDI) |- | United States, nationally representative, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Pietrzak|first=Robert H.|last2=Goldstein|first2=Risë B.|last3=Southwick|first3=Steven M.|last4=Grant|first4=Bridget F.|title=Prevalence and Axis I comorbidity of full and partial posttraumatic stress disorder in the United States: Results from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions|url=http://linkinghub.elsevier.com/retrieve/pii/S0887618510002288|journal=Journal of Anxiety Disorders|volume=25|issue=3|pages=456–465|doi=10.1016/j.janxdis.2010.11.010}}</ref> | 6.4% | Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions |- | Northern Ireland, representative sample, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Bunting|first=Brendan P.|last2=Ferry|first2=Finola R.|last3=Murphy|first3=Samuel D.|last4=O'Neill|first4=Siobhan M.|last5=Bolton|first5=David|date=2013-02-01|title=Trauma Associated With Civil Conflict and Posttraumatic Stress Disorder: Evidence From the Northern Ireland Study of Health and Stress|url=http://onlinelibrary.wiley.com/doi/10.1002/jts.21766/abstract|journal=Journal of Traumatic Stress|language=en|volume=26|issue=1|pages=134–141|doi=10.1002/jts.21766|issn=1573-6598}}</ref> | 8.8% | Northern Ireland Study of Health and Stress |- | South Africa, nationally representative sample, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Atwoli|first=Lukoye|last2=Stein|first2=Dan J.|last3=Williams|first3=David R.|last4=Mclaughlin|first4=Katie A.|last5=Petukhova|first5=Maria|last6=Kessler|first6=Ronald C.|last7=Koenen|first7=Karestan C.|date=2013-07-03|title=Trauma and posttraumatic stress disorder in South Africa: analysis from the South African Stress and Health Study|url=https://doi.org/10.1186/1471-244X-13-182|journal=BMC Psychiatry|volume=13|pages=182|doi=10.1186/1471-244x-13-182|issn=1471-244X}}</ref> | 2.3% | South African Stress and Health Study, using the Composite International Diagnostic Interview (CIDI) |- | U.S. Army and Marine Soldiers Deployed to Iraq and Afghanistan | U.S. Service Members<ref>{{Cite journal|last=Hoge|first=Charles W.|last2=Castro|first2=Carl A.|last3=Messer|first3=Stephen C.|last4=McGurk|first4=Dennis|last5=Cotting|first5=Dave I.|last6=Koffman|first6=Robert L.|date=2004-07-01|title=Combat Duty in Iraq and Afghanistan, Mental Health Problems, and Barriers to Care|url=http://dx.doi.org/10.1056/NEJMoa040603|journal=New England Journal of Medicine|volume=351|issue=1|pages=13–22|doi=10.1056/nejmoa040603|issn=0028-4793|pmid=15229303}}</ref> |11.5% - 19.5% ♦ | PTSD Checklist |- |United States, nationally representative, ages 13-18 |Non-clinical: Population based<ref>{{Cite journal|last=Merikangas|first=Kathleen Ries|last2=He|first2=Jian-ping|last3=Burstein|first3=Marcy|last4=Swanson|first4=Sonja A.|last5=Avenevoli|first5=Shelli|last6=Cui|first6=Lihong|last7=Benjet|first7=Corina|last8=Georgiades|first8=Katholiki|last9=Swendsen|first9=Joel|title=Lifetime Prevalence of Mental Disorders in U.S. Adolescents: Results from the National Comorbidity Survey Replication–Adolescent Supplement (NCS-A)|url=https://doi.org/10.1016/j.jaac.2010.05.017|journal=Journal of the American Academy of Child & Adolescent Psychiatry|volume=49|issue=10|pages=980–989|doi=10.1016/j.jaac.2010.05.017}}</ref> |5.0% |National Comorbidity Survey Replication—Adolescent Supplement (NCS-A) |} ♦ '''Note''': These rates were using broad PTSD Checklist scoring criteria of being scored positive if subjects reported at least one intrusion symptom, three avoidance symptoms, and two hyperarousal symptom that were categorized as at the moderate level. The 11.5% is for soldiers returning from deployment in Iraq, 19.5% is for soldiers returning from Afghanistan. Another common practice is to use a strict cutoff of 50 on the PCL, above which someone screens positive for PTSD. With this cutoff, rates are 6.2% and 12.9% for Service Members returned from Afghanistan and Iraqi, respectively. ==[[Evidence based assessment/Prediction phase|'''Prediction phase''']]== === Psychometric properties of screening for PTSD === The following section contains a list of screening and diagnostic instruments for PTSD. The section includes administration information, psychometric data, and PDFs or links to the screenings. * Screenings are used as part of the [[Evidence based assessment/Prediction phase|prediction phase]] of assessment; for more information on interpretation of this data, or how screenings fit in to the assessment process, click [[Evidence based assessment/Prediction phase|here.]] * '''''For a list of more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Psychometric_properties_of_common_screening_instruments click here.]''''' {| class="wikitable" |- ! Measure !Format (Reporter) !Age Range !Administration/ Completion Time !Where to Access |- |[https://www.ptsd.va.gov/professional/assessment/adult-sr/ptsd-checklist.asp PCL-5 (PTSD Checklist for DSM-5)] |Self-Report |adult |5-10 minutes |[https://www.ptsd.va.gov/professional/assessment/documents/PCL5_Standard_form.PDFPDF PDF] |- |PDS (Post-traumatic Diagnosis Scale) |Self-Report |adult |10-20 minutes | |- | colspan="4" style="font-size:110%; text-align:center;" |'''For Children and Adolescents Specifically''' | |- |[https://www.reactionindex.com/index.php/ UCLA PTSD Reaction Index for DSM-5] |Clinician Administered |child, school age, adolescents |20-30 minutes |[https://www.dellchildrens.net/wp-content/uploads/sites/60/2019/08/UCLA-PTSD-RI-DSM-5.pdf PDF] |- |CPSS (Children's PTSD Symptom Scale) |Self-Report |child |10-20 minutes |[https://www.aacap.org/App_Themes/AACAP/docs/resource_centers/resources/misc/child_ptsd_symptom_scale.pdf PDF] |- |Young Child PTSD Checklist (YCPC) |Parent Report |child |13 items |[https://medicine.tulane.edu/sites/g/files/rdw761/f/YCPC_v5_23_14.pdf PDF] |} === Interpreting PTSD screening measure scores === * For information on interpreting screening measure scores, click [[Evidence based assessment/Prediction phase#Interpreting screening measure scores|here.]] * Also see the page on [https://en.wikipedia.org/wiki/Likelihood_ratios_in_diagnostic_testing likelihood ratios in diagnostic testing] for more information ==[[Evidence based assessment/Prescription phase|'''Prescription phase''']]== ===Gold standard diagnostic interviews=== * For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews click here.] ===Recommended diagnostic interviews for PTSD=== {| class="wikitable sortable" border="1" ! colspan="4" |Diagnostic instruments for PTSD ! |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time !Where to Access |- | [https://www.ptsd.va.gov/professional/assessment/adult-int/caps.asp CAPS-5 (Clinician Administered PTSD Scale)] | Clinician Administered Interview | adult | 40-60 minutes |[https://www.ptsd.va.gov/professional/assessment/ncptsd-instrument-request-form.asp Assessment request form] |- |PTSD Symptom Scale Interview (PSS-I-5) |Clinician Administered Interview |adult and child version available |24 items |[http://www.advanced-counseling.com/dl/PSSI-5.pdf PDF] |- | colspan="4" style="font-size:110%; text-align:center;" |'''For Children and Adolescents Specifically''' | |- | [https://www.ptsd.va.gov/professional/assessment/child/caps-ca.asp CAPS-CA-5 (Clinician-Administered PTSD Scale for DSM-5 - Child/Adolescent Version)] |Clinician Administered Interview |child |30 items |[https://www.ptsd.va.gov/professional/assessment/ncptsd-instrument-request-form.asp Assessment request form] |- | Children’s PTSD Inventory (CPTSD-I) |Diagnostic Interview | 6-18 years | 50 items |Not Free |} ===Severity interviews for PTSD=== {| class="wikitable sortable" border="1" |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time !Where to Access |- | [https://www.kennedykrieger.org/sites/default/files/library/documents/faculty/ksads-dsm-5-screener.pdf Schedule for Affective Disorders and Schizophrenia for School Age Children (K-SADS)] | Diagnostic Interview | 6-18 years | 18 PTSD items | |- | Anxiety Disorders Interview Schedule, Child Version (ADIS-C) | Diagnostic Interview | 7-17 years | 26 PTSD items | |- | Diagnostic Infant and Preschool Assessment (DIPA) |Diagnostic Interview | Age 6 and younger | 46 PTSD items |[https://medicine.tulane.edu/sites/g/files/rdw761/f/DIPA-2017-2-14.pdf PDF] |} ==[[Evidence based assessment/Process phase|'''Process phase''']]== The following section contains a brief overview of treatment options for PTSD and list of process and outcome measures for PTSD. The section includes benchmarks based on published norms for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the [[Evidence based assessment/Process phase|process phase]] of assessment. For more information of differences between process and outcome measures, see the page on the [[Evidence based assessment/Process phase|process phase of assessment]]. === Process measures === * Information coming soon === Outcome and severity measures === This table includes clinically significant benchmarks for PTSD specific outcome measures * Information on how to interpret this table can be [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase found here]. * Additionally, these [[Evidence based assessment/Vignettes|vignettes]] might be helpful resources for understanding appropriate adaptation of outcome measures in practice. * ''<u>For clinically significant change benchmarks for the CBCL, YSR, and TRF total, externalizing, internalizing, and attention benchmarks,</u>'' [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase&wteswitched=1#Clinically_significant_change_benchmarks_for_widely-used_outcome_measures see here.] {| class="wikitable sortable" border="1" | colspan="7" |'''Clinically significant change benchmarks with common instruments for PTSD''' |- | colspan="7" style="font-size:110%; text-align:center;" span |<b> Benchmarks Based on Published Norms</b> |- | rowspan="2" style="text-align:center;font-size:130%;" |<b> Measure</b> | colspan="3" style="text-align:center;font-size:130%" width="300" |<b> Cut-off scores</b> | colspan="3" style="text-align:center;font-size:120%" |<b> Critical Change <br> (unstandardized scores)</b> |- | style="text-align:center;font-size:110%" |<b> A</b> | style="text-align:center;font-size:110%" |<b> B</b> | style="text-align:center;font-size:110%" |<b> C</b> | style="text-align:center;font-size:110%" |<b> 95%</b> | style="text-align:center;font-size:110%" |<b> 90%</b> | style="text-align:center;font-size:110%" |<b> SE_difference</b> |- | rowspan="1" style="text-align:center;" | Primary Care PTSD Screen | style="text-align:center;" | 1.0 | style="text-align:center;" | 3.1 | style="text-align:center;" | 2.0 | style="text-align:center;" | 1.0 | style="text-align:center;" | .8 | style="text-align:center;" | .5 |- | rowspan="1" style="text-align:center;" | PTSD Checklist Scores | style="text-align:center;" | 28.8 | style="text-align:center;" | 40.8 | style="text-align:center;" | 34.9 | style="text-align:center;" | 4.6 | style="text-align:center;" | 3.8 | style="text-align:center;" | 2.3 |- | rowspan="1" style="text-align:center;" | Clinician Administered PTSD Scale | style="text-align:center;" | 28.8 | style="text-align:center;" | 40.8 | style="text-align:center;" | 34.9 | style="text-align:center;" | 8.3 | style="text-align:center;" | 7.0 | style="text-align:center;" | 4.2 |} === Treatment === * Please refer to the Wikipedia page on [[wikipedia:Posttraumatic_stress_disorder|PTSD]] for more information on available treatment for PTSD or go to the [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/post-traumatic-stress-disorder/ Effective Child Therapy] page for for a curated resource on effective treatments for PTSD. {{collapse top| Click here for more information}} '''<big>Behavioral interventions</big>''' Recommended (have ''significant benefit'') <ref name=":0">Department of Veterans Affairs and Department of Defense. . (2010). VA/DoD clinical practice guidelines: management of post-traumatic stress. Washington, D.C.: Veterans Health Administration, Department of Defense.</ref>: # Brief Cognitive Behavioral Therapy (CBT; 4-5 sessions) #* This includes stress inoculation training, trauma-focused therapy including components of cognitive restructuring, Cognitive Processing Therapy (CPT), imaginal, virtual, and in-vivo exposure as in Prolonged Exposure psychotherapy (PE)² #* Patient education is recommended as part of psychotherapy for patients and family members # EMDR may help both acute and chronic PTSD, especially individuals who have trouble with prolonged exposure or have trouble verbalizing their trauma.<ref name=":1">Ursano, R. J., Bell, C., Eth, S., Friedman, M., Norwood, A., Pfefferbaum, B., . . . McIntyre, J. S. (2004). ''Practice guideline for the treatment of patients with acute stress disorder and posttraumatic stress disorder'': American Psychiatric Publ </ref> ## Long term gains require further study. # [https://www.ptsd.va.gov/professional/treat/txessentials/present_centered_therapy.asp Present-Centered Therapy (PCT)] is a non trauma focused treatment for PTSD and a second-line treatment for PTSD<ref>{{Cite web|url=https://www.ptsd.va.gov/professional/treat/txessentials/present_centered_therapy.asp|title=Present-Centered Therapy for PTSD - PTSD: National Center for PTSD|website=www.ptsd.va.gov|language=en|access-date=2022-08-13}}</ref>. Treatments with weaker evidence (have ''some benefit'') <ref name=":0" />: # Patient education, # Imagery rehearsal therapy, # Psychodynamic therapy, # Hypnosis, # Relaxation techniques, # and Group therapy. Treatment with ''unknown benefit'' <ref name=":0" />: # Web-based CBT ## For example Jeane Bosch participated as a study therapist in research study that compared STAIR and present-centered therapy both delivered via telehealth. STAIR stands for Skills Training in Affective and Interpersonal Regulation. It is a skill-focused treatment that was originally developed for survivors of childhood abuse to teach emotion regulation skills as well as tools to help with challenges interpersonal functioning and social relationships and decrease PTSD symptoms<ref>{{Cite web|url=https://istss.org/public-resources/trauma-blog/2015-march-(1)/clinician-s-corner-skills-training-in-affective-an|title=ISTSS - Trauma Blog|website=istss.org|access-date=2022-08-13}}</ref>.<ref>{{Citation|title=Introduction to Telehealth with Dr. Bosch|url=https://www.youtube.com/watch?v=Wn6Vewl42X8|accessdate=2022-08-13|language=en}}</ref> # Acceptance and commitment therapy, # and Dialectical Behavioral Therapy. <big>'''Medication'''</big> *SSRIs are more effective than placebo in treating PTSD.<ref name=":1" /> *There is no evidence to support a medication to prevent the development of PTSD.<ref name=":0" /> **Imipramine, propranolol, prazosin, other antidepressants, anticonvulsants, and atypical antipsychotics have ''unknown benefit.'' **Strongly recommend against the use of benzodiazepines² and typical antipsychotics since they have ''no benefit and potential harm.'' {{collapse bottom}} == '''External resources''' == === For professionals === * [http://www.som.uq.edu.au/ptsd Post Traumatic Stress Disorder Information Resource] from [http://www.uq.edu.au/ The University of Queensland School of Medicine] * [http://www.apa.org/ptsd-guideline/ APA practice parameters for assessment and treatment for PTSD (Updated 2017)] * [http://www.ptsd.va.gov/professional/index.asp Resources for professionals] from [http://www.ptsd.va.gov/index.asp VA National PTSD Center] * [https://www.integration.samhsa.gov/clinical-practice/trauma-informed SAMHSA's Trauma-Informed Care Resources and Training] * [https://www.integration.samhsa.gov/clinical-practice/trauma-informed SAMHSA's Resources on Intimate Partner Violence (IPV) for Clinicians, Patients, Families, and Organizations] === For caregivers === * [http://www.nctsn.org/sites/default/files/assets/pdfs/tips_for_parents_media_final.pdf Tips for parents on shooting media coverage] * [http://www.nctsn.org/sites/default/files/assets/pdfs/parents_guidelines_for_helping_teens_after_the_recent_attacks.pdf Parent guidelines to helping youths after a shooting] * [http://www.nctsn.org/sites/default/files/assets/pdfs/helping_teens_with_traumatic_grief_caregivers_final.pdf Caregiver tips for helping teens with traumatic grief] * [http://www.nctsn.org/sites/default/files/assets/pdfs/10things_schoolage_ctg.pdf Caregiver tips for helping school-age children with traumatic grief] *[http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/post-traumatic-stress-disorder/ EffectiveChildTherapy.Org information on PTSD] *[https://sccap53.org Society of Clinical Child and Adolescent Psychology] === For educators === * [http://www.nctsn.org/sites/default/files/assets/pdfs/pfa_for_schools_appendix_a_teachers.pdf Teacher tips for providing psychological first aid] * [http://www.nctsn.org/sites/default/files/assets/pdfs/helping_youth_after_community_violence_educators.pdf Educator tips for helping youths after a community trauma] === For public === * [https://complicatedgrief.columbia.edu/for-the-public/resources/ Resources for grief and loss] * [http://www.nctsn.org/sites/default/files/assets/pdfs/psychological_information_sheet_two_pager.pdf Psychological impacts of recent shootings] * [http://www.nctsn.org/sites/default/files/assets/pdfs/youth_journalists.pdf Tips to talking to youths about a shooting] * [http://www.nctsn.org/sites/default/files/assets/pdfs/talking_to_children_about_the_shooting.pdf Tips to talking to children about a shooting] * [http://www.nctsn.org/sites/default/files/assets/pdfs/helping_young_children_heal_crisis.pdf Helping young children heal after a crisis] * [http://www.nctsn.org/content/psychological-first-aid-schoolspfa Psychological first aid for schools] * [http://www.nctsn.org/content/psychological-first-aid Resources and manuals on psychological first aid] * [http://www.ptsd.va.gov/public/index.asp Resources for the public] from [http://www.ptsd.va.gov/index.asp VA National PTSD Center] * [https://curlie.org/Health/Mental_Health/Disorders/Anxiety/Post-traumatic_Stress Posttraumatic stress disorder] at Curlie (based on DMOZ) =='''References'''== {{collapse top|Click here for references}} {{Reflist|30em}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] {{collapse bottom}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] 2m722pvwyiye38m5qvl534fiojs5r18 2419127 2419124 2022-08-25T23:31:28Z Ardenguo 2944162 /* Outcome and severity measures */ added CPSS wikitext text/x-wiki <noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{medical disclaimer}} {{:{{BASEPAGENAME}}/Sidebar}} ==[[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio"?''']]== * For background information on what assessment portfolios are, click the link in the heading above. * Want even 'more' information about this topic? There's an extended version of this page [[Evidence-based assessment/Posttraumatic stress disorder (disorder portfolio)/extended version|'''here''']]. == [[Evidence based assessment/Preparation phase|'''Preparation phase''']] == === Diagnostic criteria for post traumatic stress disorder === ===='''ICD-11 Diagnostic Criteria'''==== {{blockquotetop}} ===='''ICD-11 Criteria'''==== *Post-traumatic stress disorder (PTSD) is a syndrome that develops following exposure to an extremely threatening or horrific event or series of events that is characterized by all of the following: **1) re-experiencing the traumatic event or events in the present in the form of vivid intrusive memories, flashbacks, or nightmares, which are typically accompanied by strong and overwhelming emotions such as fear or horror and strong physical sensations, or feelings of being overwhelmed or immersed in the same intense emotions that were experienced during the traumatic event; **2) avoidance of thoughts and memories of the event or events, or avoidance of activities, situations, or people reminiscent of the event or events **3) persistent perceptions of heightened current threat, for example as indicated by hypervigilance or an enhanced startle reaction to stimuli such as unexpected noises. *The symptoms must persist for at least several weeks and cause significant impairment in personal, family, social, educational, occupational or other important areas of functioning. Additionally, ICD 11 includes a category called "Complex post-traumatic stress disorder," which is described as: *A disorder that may develop following exposure to an event or series of events of an extremely threatening or horrific nature, most commonly prolonged or repetitive events from which escape is difficult or impossible (e.g., torture, slavery, genocide campaigns, prolonged domestic violence, repeated childhood sexual or physical abuse). *The disorder is characterized by the core symptoms of PTSD; that is, all diagnostic requirements for PTSD have been met at some point during the course of the disorder. *In addition, Complex PTSD is characterized by: **1) severe and pervasive problems in affect regulation; **2) persistent beliefs about oneself as diminished, defeated or worthless, accompanied by deep and pervasive feelings of shame, guilt or failure related to the traumatic event **3) persistent difficulties in sustaining relationships and in feeling close to others. The disturbance causes significant impairment in personal, family, social, educational, occupational or other important areas of functioning. {{blockquotebottom}} ===='''Changes in DSM-5'''==== * The diagnostic criteria for post-traumatic stress disorder changed slightly from [[DSM-IV]] to [[w:Diagnostic_and_Statistical_Manual_of_Mental_Disorders#DSM-IV-TR_.282000.29|DSM-5]]. Summaries are available [http://www.dsm5.org/Documents/changes%20from%20dsm-iv-tr%20to%20dsm-5.pdf here] and [[w:DSM-5|here]]. === Developmental sensitivities === {{collapse top| Click for more information}} *Diagnostic thresholds have been lowered for children and adolescents to account for development. *Separate and additional criteria have been added for children age 6 or younger. *Child sexual abuse has been found to have a substantial effect on the development of PTSD.<ref>{{cite journal|last1=Paolucci|first1=Elizabeth ODDONE|last2=Genuis|first2=Mark L.|last3=Violato|first3=Claudio|title=A Meta-Analysis of the Published Research on the Effects of Child Sexual Abuse|journal=The Journal of Psychology|date=January 2001|volume=135|issue=1|pages=17–36|doi=10.1080/00223980109603677}}</ref> *Children with higher exposure to trauma, less social support, and other major life events are more likely to have continued PTSD symptoms 7 months after a trauma.<ref name=":2">{{cite journal |last1=La Greca|first1=A|last2=Silverman|first2=WK|last3=Vernberg|first3=EM|last4=Prinstein|first4=MJ|title=Symptoms of posttraumatic stress in children after Hurricane Andrew: a prospective study.|journal=Journal of consulting and clinical psychology|date=August 1996|volume=64|issue=4|pages=712-23|pmid=8803361}}</ref> 10 months after a trauma, however, only experience of a major life event remained predictive of continuing PTSD symptoms.<ref name=":2" /> *Lack of social support, specifically lack of support by a teacher, was predictive of higher PTSD symptoms among children who had gone through an environmental trauma.<ref name=":2" /> *Children who reported using blame and anger as strategies for coping had higher levels of PTSD symptoms 10 months after a trauma.<ref name=":2" /> *Negative affect in children before a traumatic event was predictive of development of PTSD symptoms after a traumatic event.<ref>{{cite journal|last1=Weems|first1=CF|last2=Pina|first2=AA|last3=Costa|first3=NM|last4=Watts|first4=SE|last5=Taylor|first5=LK|last6=Cannon|first6=MF|title=Predisaster trait anxiety and negative affect predict posttraumatic stress in youths after hurricane Katrina.|journal=Journal of consulting and clinical psychology|date=February 2007|volume=75|issue=1|pages=154-9|doi=10.1037/0022-006X.75.1.154|pmid=17295574}}</ref> [[wikipedia:Posttraumatic_stress_disorder|Posttraumatic stress disorder]] is now more sensitive to development in that diagnostic thresholds have been lowered for children and adolescents. Furthermore, separate and additional criteria have been added for children age 6 years of age or younger. {{collapse bottom}} === Base rates of PTSD in different clinical settings and populations === This section describes the demographic settings of the populations sampled, base rates of PTSD diagnoses, country/region sampled, and the diagnostic methods that were used. Using this information, clinicians will be able to anchor the most appropriate rate of PTSD that they are likely to see in their clinical practice. * '''''To see prevalence rates across multiple disorders,''''' [[Evidence based assessment/Preparation phase#Base rates for transdiagnostic comparison|'''''click here.''''']] {| class="wikitable sortable" border="1" |- ! Demography ! Setting ! Base Rate ! Diagnostic Method |- | United States, nationally representative, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Kessler|first=Ronald C.|last2=Berglund|first2=Patricia|last3=Demler|first3=Olga|last4=Jin|first4=Robert|last5=Merikangas|first5=Kathleen R.|last6=Walters|first6=Ellen E.|date=2005-06-01|title=Lifetime Prevalence and Age-of-Onset Distributions of DSM-IV Disorders in the National Comorbidity Survey Replication|url=http://archpsyc.jamanetwork.com/article.aspx?doi=10.1001/archpsyc.62.6.593|journal=Archives of General Psychiatry|language=en|volume=62|issue=6|doi=10.1001/archpsyc.62.6.593|issn=0003-990X}}</ref> | 6.8% | National Comorbidity Survey - Replication |- | Netherlands, nationally representative, age 18-80 | Non-clinical: Population based<ref>{{Cite journal|last=de Vries|first=Giel-Jan|last2=Olff|first2=Miranda|date=2009-08-01|title=The lifetime prevalence of traumatic events and posttraumatic stress disorder in the Netherlands|url=http://onlinelibrary.wiley.com/doi/10.1002/jts.20429/abstract|journal=Journal of Traumatic Stress|language=en|volume=22|issue=4|pages=259–267|doi=10.1002/jts.20429|issn=1573-6598}}</ref> | 7.4% | Composite International Diagnostic Interview (CIDI) |- | United States, nationally representative, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Pietrzak|first=Robert H.|last2=Goldstein|first2=Risë B.|last3=Southwick|first3=Steven M.|last4=Grant|first4=Bridget F.|title=Prevalence and Axis I comorbidity of full and partial posttraumatic stress disorder in the United States: Results from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions|url=http://linkinghub.elsevier.com/retrieve/pii/S0887618510002288|journal=Journal of Anxiety Disorders|volume=25|issue=3|pages=456–465|doi=10.1016/j.janxdis.2010.11.010}}</ref> | 6.4% | Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions |- | Northern Ireland, representative sample, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Bunting|first=Brendan P.|last2=Ferry|first2=Finola R.|last3=Murphy|first3=Samuel D.|last4=O'Neill|first4=Siobhan M.|last5=Bolton|first5=David|date=2013-02-01|title=Trauma Associated With Civil Conflict and Posttraumatic Stress Disorder: Evidence From the Northern Ireland Study of Health and Stress|url=http://onlinelibrary.wiley.com/doi/10.1002/jts.21766/abstract|journal=Journal of Traumatic Stress|language=en|volume=26|issue=1|pages=134–141|doi=10.1002/jts.21766|issn=1573-6598}}</ref> | 8.8% | Northern Ireland Study of Health and Stress |- | South Africa, nationally representative sample, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Atwoli|first=Lukoye|last2=Stein|first2=Dan J.|last3=Williams|first3=David R.|last4=Mclaughlin|first4=Katie A.|last5=Petukhova|first5=Maria|last6=Kessler|first6=Ronald C.|last7=Koenen|first7=Karestan C.|date=2013-07-03|title=Trauma and posttraumatic stress disorder in South Africa: analysis from the South African Stress and Health Study|url=https://doi.org/10.1186/1471-244X-13-182|journal=BMC Psychiatry|volume=13|pages=182|doi=10.1186/1471-244x-13-182|issn=1471-244X}}</ref> | 2.3% | South African Stress and Health Study, using the Composite International Diagnostic Interview (CIDI) |- | U.S. Army and Marine Soldiers Deployed to Iraq and Afghanistan | U.S. Service Members<ref>{{Cite journal|last=Hoge|first=Charles W.|last2=Castro|first2=Carl A.|last3=Messer|first3=Stephen C.|last4=McGurk|first4=Dennis|last5=Cotting|first5=Dave I.|last6=Koffman|first6=Robert L.|date=2004-07-01|title=Combat Duty in Iraq and Afghanistan, Mental Health Problems, and Barriers to Care|url=http://dx.doi.org/10.1056/NEJMoa040603|journal=New England Journal of Medicine|volume=351|issue=1|pages=13–22|doi=10.1056/nejmoa040603|issn=0028-4793|pmid=15229303}}</ref> |11.5% - 19.5% ♦ | PTSD Checklist |- |United States, nationally representative, ages 13-18 |Non-clinical: Population based<ref>{{Cite journal|last=Merikangas|first=Kathleen Ries|last2=He|first2=Jian-ping|last3=Burstein|first3=Marcy|last4=Swanson|first4=Sonja A.|last5=Avenevoli|first5=Shelli|last6=Cui|first6=Lihong|last7=Benjet|first7=Corina|last8=Georgiades|first8=Katholiki|last9=Swendsen|first9=Joel|title=Lifetime Prevalence of Mental Disorders in U.S. Adolescents: Results from the National Comorbidity Survey Replication–Adolescent Supplement (NCS-A)|url=https://doi.org/10.1016/j.jaac.2010.05.017|journal=Journal of the American Academy of Child & Adolescent Psychiatry|volume=49|issue=10|pages=980–989|doi=10.1016/j.jaac.2010.05.017}}</ref> |5.0% |National Comorbidity Survey Replication—Adolescent Supplement (NCS-A) |} ♦ '''Note''': These rates were using broad PTSD Checklist scoring criteria of being scored positive if subjects reported at least one intrusion symptom, three avoidance symptoms, and two hyperarousal symptom that were categorized as at the moderate level. The 11.5% is for soldiers returning from deployment in Iraq, 19.5% is for soldiers returning from Afghanistan. Another common practice is to use a strict cutoff of 50 on the PCL, above which someone screens positive for PTSD. With this cutoff, rates are 6.2% and 12.9% for Service Members returned from Afghanistan and Iraqi, respectively. ==[[Evidence based assessment/Prediction phase|'''Prediction phase''']]== === Psychometric properties of screening for PTSD === The following section contains a list of screening and diagnostic instruments for PTSD. The section includes administration information, psychometric data, and PDFs or links to the screenings. * Screenings are used as part of the [[Evidence based assessment/Prediction phase|prediction phase]] of assessment; for more information on interpretation of this data, or how screenings fit in to the assessment process, click [[Evidence based assessment/Prediction phase|here.]] * '''''For a list of more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Psychometric_properties_of_common_screening_instruments click here.]''''' {| class="wikitable" |- ! Measure !Format (Reporter) !Age Range !Administration/ Completion Time !Where to Access |- |[https://www.ptsd.va.gov/professional/assessment/adult-sr/ptsd-checklist.asp PCL-5 (PTSD Checklist for DSM-5)] |Self-Report |adult |5-10 minutes |[https://www.ptsd.va.gov/professional/assessment/documents/PCL5_Standard_form.PDFPDF PDF] |- |PDS (Post-traumatic Diagnosis Scale) |Self-Report |adult |10-20 minutes | |- | colspan="4" style="font-size:110%; text-align:center;" |'''For Children and Adolescents Specifically''' | |- |[https://www.reactionindex.com/index.php/ UCLA PTSD Reaction Index for DSM-5] |Clinician Administered |child, school age, adolescents |20-30 minutes |[https://www.dellchildrens.net/wp-content/uploads/sites/60/2019/08/UCLA-PTSD-RI-DSM-5.pdf PDF] |- |CPSS (Children's PTSD Symptom Scale) |Self-Report |child |10-20 minutes |[https://www.aacap.org/App_Themes/AACAP/docs/resource_centers/resources/misc/child_ptsd_symptom_scale.pdf PDF] |- |Young Child PTSD Checklist (YCPC) |Parent Report |child |13 items |[https://medicine.tulane.edu/sites/g/files/rdw761/f/YCPC_v5_23_14.pdf PDF] |} === Interpreting PTSD screening measure scores === * For information on interpreting screening measure scores, click [[Evidence based assessment/Prediction phase#Interpreting screening measure scores|here.]] * Also see the page on [https://en.wikipedia.org/wiki/Likelihood_ratios_in_diagnostic_testing likelihood ratios in diagnostic testing] for more information ==[[Evidence based assessment/Prescription phase|'''Prescription phase''']]== ===Gold standard diagnostic interviews=== * For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews click here.] ===Recommended diagnostic interviews for PTSD=== {| class="wikitable sortable" border="1" ! colspan="4" |Diagnostic instruments for PTSD ! |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time !Where to Access |- | [https://www.ptsd.va.gov/professional/assessment/adult-int/caps.asp CAPS-5 (Clinician Administered PTSD Scale)] | Clinician Administered Interview | adult | 40-60 minutes |[https://www.ptsd.va.gov/professional/assessment/ncptsd-instrument-request-form.asp Assessment request form] |- |PTSD Symptom Scale Interview (PSS-I-5) |Clinician Administered Interview |adult and child version available |24 items |[http://www.advanced-counseling.com/dl/PSSI-5.pdf PDF] |- | colspan="4" style="font-size:110%; text-align:center;" |'''For Children and Adolescents Specifically''' | |- | [https://www.ptsd.va.gov/professional/assessment/child/caps-ca.asp CAPS-CA-5 (Clinician-Administered PTSD Scale for DSM-5 - Child/Adolescent Version)] |Clinician Administered Interview |child |30 items |[https://www.ptsd.va.gov/professional/assessment/ncptsd-instrument-request-form.asp Assessment request form] |- | Children’s PTSD Inventory (CPTSD-I) |Diagnostic Interview | 6-18 years | 50 items |Not Free |} ===Severity interviews for PTSD=== {| class="wikitable sortable" border="1" |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time !Where to Access |- | [https://www.kennedykrieger.org/sites/default/files/library/documents/faculty/ksads-dsm-5-screener.pdf Schedule for Affective Disorders and Schizophrenia for School Age Children (K-SADS)] | Diagnostic Interview | 6-18 years | 18 PTSD items | |- | Anxiety Disorders Interview Schedule, Child Version (ADIS-C) | Diagnostic Interview | 7-17 years | 26 PTSD items | |- | Diagnostic Infant and Preschool Assessment (DIPA) |Diagnostic Interview | Age 6 and younger | 46 PTSD items |[https://medicine.tulane.edu/sites/g/files/rdw761/f/DIPA-2017-2-14.pdf PDF] |} ==[[Evidence based assessment/Process phase|'''Process phase''']]== The following section contains a brief overview of treatment options for PTSD and list of process and outcome measures for PTSD. The section includes benchmarks based on published norms for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the [[Evidence based assessment/Process phase|process phase]] of assessment. For more information of differences between process and outcome measures, see the page on the [[Evidence based assessment/Process phase|process phase of assessment]]. === Process measures === * Information coming soon === Outcome and severity measures === This table includes clinically significant benchmarks for PTSD specific outcome measures * Information on how to interpret this table can be [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase found here]. * Additionally, these [[Evidence based assessment/Vignettes|vignettes]] might be helpful resources for understanding appropriate adaptation of outcome measures in practice. * ''<u>For clinically significant change benchmarks for the CBCL, YSR, and TRF total, externalizing, internalizing, and attention benchmarks,</u>'' [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase&wteswitched=1#Clinically_significant_change_benchmarks_for_widely-used_outcome_measures see here.] {| class="wikitable sortable" border="1" | colspan="7" |'''Clinically significant change benchmarks with common instruments for PTSD''' |- | colspan="7" style="font-size:110%; text-align:center;" span |<b> Benchmarks Based on Published Norms</b> |- | rowspan="2" style="text-align:center;font-size:130%;" |<b> Measure</b> | colspan="3" style="text-align:center;font-size:130%" width="300" |<b> Cut-off scores</b> | colspan="3" style="text-align:center;font-size:120%" |<b> Critical Change <br> (unstandardized scores)</b> |- | style="text-align:center;font-size:110%" |<b> A</b> | style="text-align:center;font-size:110%" |<b> B</b> | style="text-align:center;font-size:110%" |<b> C</b> | style="text-align:center;font-size:110%" |<b> 95%</b> | style="text-align:center;font-size:110%" |<b> 90%</b> | style="text-align:center;font-size:110%" |<b> SE_difference</b> |- | rowspan="1" style="text-align:center;" | Primary Care PTSD Screen | style="text-align:center;" | 1.0 | style="text-align:center;" | 3.1 | style="text-align:center;" | 2.0 | style="text-align:center;" | 1.0 | style="text-align:center;" | .8 | style="text-align:center;" | .5 |- | rowspan="1" style="text-align:center;" | PTSD Checklist Scores | style="text-align:center;" | 28.8 | style="text-align:center;" | 40.8 | style="text-align:center;" | 34.9 | style="text-align:center;" | 4.6 | style="text-align:center;" | 3.8 | style="text-align:center;" | 2.3 |- | rowspan="1" style="text-align:center;" | Clinician Administered PTSD Scale | style="text-align:center;" | 28.8 | style="text-align:center;" | 40.8 | style="text-align:center;" | 34.9 | style="text-align:center;" | 8.3 | style="text-align:center;" | 7.0 | style="text-align:center;" | 4.2 |- |The Child PTSD Symptom Scale (CPSS) | | | | | | |} === Treatment === * Please refer to the Wikipedia page on [[wikipedia:Posttraumatic_stress_disorder|PTSD]] for more information on available treatment for PTSD or go to the [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/post-traumatic-stress-disorder/ Effective Child Therapy] page for for a curated resource on effective treatments for PTSD. {{collapse top| Click here for more information}} '''<big>Behavioral interventions</big>''' Recommended (have ''significant benefit'') <ref name=":0">Department of Veterans Affairs and Department of Defense. . (2010). VA/DoD clinical practice guidelines: management of post-traumatic stress. Washington, D.C.: Veterans Health Administration, Department of Defense.</ref>: # Brief Cognitive Behavioral Therapy (CBT; 4-5 sessions) #* This includes stress inoculation training, trauma-focused therapy including components of cognitive restructuring, Cognitive Processing Therapy (CPT), imaginal, virtual, and in-vivo exposure as in Prolonged Exposure psychotherapy (PE)² #* Patient education is recommended as part of psychotherapy for patients and family members # EMDR may help both acute and chronic PTSD, especially individuals who have trouble with prolonged exposure or have trouble verbalizing their trauma.<ref name=":1">Ursano, R. J., Bell, C., Eth, S., Friedman, M., Norwood, A., Pfefferbaum, B., . . . McIntyre, J. S. (2004). ''Practice guideline for the treatment of patients with acute stress disorder and posttraumatic stress disorder'': American Psychiatric Publ </ref> ## Long term gains require further study. # [https://www.ptsd.va.gov/professional/treat/txessentials/present_centered_therapy.asp Present-Centered Therapy (PCT)] is a non trauma focused treatment for PTSD and a second-line treatment for PTSD<ref>{{Cite web|url=https://www.ptsd.va.gov/professional/treat/txessentials/present_centered_therapy.asp|title=Present-Centered Therapy for PTSD - PTSD: National Center for PTSD|website=www.ptsd.va.gov|language=en|access-date=2022-08-13}}</ref>. Treatments with weaker evidence (have ''some benefit'') <ref name=":0" />: # Patient education, # Imagery rehearsal therapy, # Psychodynamic therapy, # Hypnosis, # Relaxation techniques, # and Group therapy. Treatment with ''unknown benefit'' <ref name=":0" />: # Web-based CBT ## For example Jeane Bosch participated as a study therapist in research study that compared STAIR and present-centered therapy both delivered via telehealth. STAIR stands for Skills Training in Affective and Interpersonal Regulation. It is a skill-focused treatment that was originally developed for survivors of childhood abuse to teach emotion regulation skills as well as tools to help with challenges interpersonal functioning and social relationships and decrease PTSD symptoms<ref>{{Cite web|url=https://istss.org/public-resources/trauma-blog/2015-march-(1)/clinician-s-corner-skills-training-in-affective-an|title=ISTSS - Trauma Blog|website=istss.org|access-date=2022-08-13}}</ref>.<ref>{{Citation|title=Introduction to Telehealth with Dr. Bosch|url=https://www.youtube.com/watch?v=Wn6Vewl42X8|accessdate=2022-08-13|language=en}}</ref> # Acceptance and commitment therapy, # and Dialectical Behavioral Therapy. <big>'''Medication'''</big> *SSRIs are more effective than placebo in treating PTSD.<ref name=":1" /> *There is no evidence to support a medication to prevent the development of PTSD.<ref name=":0" /> **Imipramine, propranolol, prazosin, other antidepressants, anticonvulsants, and atypical antipsychotics have ''unknown benefit.'' **Strongly recommend against the use of benzodiazepines² and typical antipsychotics since they have ''no benefit and potential harm.'' {{collapse bottom}} == '''External resources''' == === For professionals === * [http://www.som.uq.edu.au/ptsd Post Traumatic Stress Disorder Information Resource] from [http://www.uq.edu.au/ The University of Queensland School of Medicine] * [http://www.apa.org/ptsd-guideline/ APA practice parameters for assessment and treatment for PTSD (Updated 2017)] * [http://www.ptsd.va.gov/professional/index.asp Resources for professionals] from [http://www.ptsd.va.gov/index.asp VA National PTSD Center] * [https://www.integration.samhsa.gov/clinical-practice/trauma-informed SAMHSA's Trauma-Informed Care Resources and Training] * [https://www.integration.samhsa.gov/clinical-practice/trauma-informed SAMHSA's Resources on Intimate Partner Violence (IPV) for Clinicians, Patients, Families, and Organizations] === For caregivers === * [http://www.nctsn.org/sites/default/files/assets/pdfs/tips_for_parents_media_final.pdf Tips for parents on shooting media coverage] * [http://www.nctsn.org/sites/default/files/assets/pdfs/parents_guidelines_for_helping_teens_after_the_recent_attacks.pdf Parent guidelines to helping youths after a shooting] * [http://www.nctsn.org/sites/default/files/assets/pdfs/helping_teens_with_traumatic_grief_caregivers_final.pdf Caregiver tips for helping teens with traumatic grief] * [http://www.nctsn.org/sites/default/files/assets/pdfs/10things_schoolage_ctg.pdf Caregiver tips for helping school-age children with traumatic grief] *[http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/post-traumatic-stress-disorder/ EffectiveChildTherapy.Org information on PTSD] *[https://sccap53.org Society of Clinical Child and Adolescent Psychology] === For educators === * [http://www.nctsn.org/sites/default/files/assets/pdfs/pfa_for_schools_appendix_a_teachers.pdf Teacher tips for providing psychological first aid] * [http://www.nctsn.org/sites/default/files/assets/pdfs/helping_youth_after_community_violence_educators.pdf Educator tips for helping youths after a community trauma] === For public === * [https://complicatedgrief.columbia.edu/for-the-public/resources/ Resources for grief and loss] * [http://www.nctsn.org/sites/default/files/assets/pdfs/psychological_information_sheet_two_pager.pdf Psychological impacts of recent shootings] * [http://www.nctsn.org/sites/default/files/assets/pdfs/youth_journalists.pdf Tips to talking to youths about a shooting] * [http://www.nctsn.org/sites/default/files/assets/pdfs/talking_to_children_about_the_shooting.pdf Tips to talking to children about a shooting] * [http://www.nctsn.org/sites/default/files/assets/pdfs/helping_young_children_heal_crisis.pdf Helping young children heal after a crisis] * [http://www.nctsn.org/content/psychological-first-aid-schoolspfa Psychological first aid for schools] * [http://www.nctsn.org/content/psychological-first-aid Resources and manuals on psychological first aid] * [http://www.ptsd.va.gov/public/index.asp Resources for the public] from [http://www.ptsd.va.gov/index.asp VA National PTSD Center] * [https://curlie.org/Health/Mental_Health/Disorders/Anxiety/Post-traumatic_Stress Posttraumatic stress disorder] at Curlie (based on DMOZ) =='''References'''== {{collapse top|Click here for references}} {{Reflist|30em}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] {{collapse bottom}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] odzrji709upwzosgf1x8lx13xkbtpuy 2419128 2419127 2022-08-25T23:32:03Z Ardenguo 2944162 /* Outcome and severity measures */ added link for CPSS wikitext text/x-wiki <noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{medical disclaimer}} {{:{{BASEPAGENAME}}/Sidebar}} ==[[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio"?''']]== * For background information on what assessment portfolios are, click the link in the heading above. * Want even 'more' information about this topic? There's an extended version of this page [[Evidence-based assessment/Posttraumatic stress disorder (disorder portfolio)/extended version|'''here''']]. == [[Evidence based assessment/Preparation phase|'''Preparation phase''']] == === Diagnostic criteria for post traumatic stress disorder === ===='''ICD-11 Diagnostic Criteria'''==== {{blockquotetop}} ===='''ICD-11 Criteria'''==== *Post-traumatic stress disorder (PTSD) is a syndrome that develops following exposure to an extremely threatening or horrific event or series of events that is characterized by all of the following: **1) re-experiencing the traumatic event or events in the present in the form of vivid intrusive memories, flashbacks, or nightmares, which are typically accompanied by strong and overwhelming emotions such as fear or horror and strong physical sensations, or feelings of being overwhelmed or immersed in the same intense emotions that were experienced during the traumatic event; **2) avoidance of thoughts and memories of the event or events, or avoidance of activities, situations, or people reminiscent of the event or events **3) persistent perceptions of heightened current threat, for example as indicated by hypervigilance or an enhanced startle reaction to stimuli such as unexpected noises. *The symptoms must persist for at least several weeks and cause significant impairment in personal, family, social, educational, occupational or other important areas of functioning. Additionally, ICD 11 includes a category called "Complex post-traumatic stress disorder," which is described as: *A disorder that may develop following exposure to an event or series of events of an extremely threatening or horrific nature, most commonly prolonged or repetitive events from which escape is difficult or impossible (e.g., torture, slavery, genocide campaigns, prolonged domestic violence, repeated childhood sexual or physical abuse). *The disorder is characterized by the core symptoms of PTSD; that is, all diagnostic requirements for PTSD have been met at some point during the course of the disorder. *In addition, Complex PTSD is characterized by: **1) severe and pervasive problems in affect regulation; **2) persistent beliefs about oneself as diminished, defeated or worthless, accompanied by deep and pervasive feelings of shame, guilt or failure related to the traumatic event **3) persistent difficulties in sustaining relationships and in feeling close to others. The disturbance causes significant impairment in personal, family, social, educational, occupational or other important areas of functioning. {{blockquotebottom}} ===='''Changes in DSM-5'''==== * The diagnostic criteria for post-traumatic stress disorder changed slightly from [[DSM-IV]] to [[w:Diagnostic_and_Statistical_Manual_of_Mental_Disorders#DSM-IV-TR_.282000.29|DSM-5]]. Summaries are available [http://www.dsm5.org/Documents/changes%20from%20dsm-iv-tr%20to%20dsm-5.pdf here] and [[w:DSM-5|here]]. === Developmental sensitivities === {{collapse top| Click for more information}} *Diagnostic thresholds have been lowered for children and adolescents to account for development. *Separate and additional criteria have been added for children age 6 or younger. *Child sexual abuse has been found to have a substantial effect on the development of PTSD.<ref>{{cite journal|last1=Paolucci|first1=Elizabeth ODDONE|last2=Genuis|first2=Mark L.|last3=Violato|first3=Claudio|title=A Meta-Analysis of the Published Research on the Effects of Child Sexual Abuse|journal=The Journal of Psychology|date=January 2001|volume=135|issue=1|pages=17–36|doi=10.1080/00223980109603677}}</ref> *Children with higher exposure to trauma, less social support, and other major life events are more likely to have continued PTSD symptoms 7 months after a trauma.<ref name=":2">{{cite journal |last1=La Greca|first1=A|last2=Silverman|first2=WK|last3=Vernberg|first3=EM|last4=Prinstein|first4=MJ|title=Symptoms of posttraumatic stress in children after Hurricane Andrew: a prospective study.|journal=Journal of consulting and clinical psychology|date=August 1996|volume=64|issue=4|pages=712-23|pmid=8803361}}</ref> 10 months after a trauma, however, only experience of a major life event remained predictive of continuing PTSD symptoms.<ref name=":2" /> *Lack of social support, specifically lack of support by a teacher, was predictive of higher PTSD symptoms among children who had gone through an environmental trauma.<ref name=":2" /> *Children who reported using blame and anger as strategies for coping had higher levels of PTSD symptoms 10 months after a trauma.<ref name=":2" /> *Negative affect in children before a traumatic event was predictive of development of PTSD symptoms after a traumatic event.<ref>{{cite journal|last1=Weems|first1=CF|last2=Pina|first2=AA|last3=Costa|first3=NM|last4=Watts|first4=SE|last5=Taylor|first5=LK|last6=Cannon|first6=MF|title=Predisaster trait anxiety and negative affect predict posttraumatic stress in youths after hurricane Katrina.|journal=Journal of consulting and clinical psychology|date=February 2007|volume=75|issue=1|pages=154-9|doi=10.1037/0022-006X.75.1.154|pmid=17295574}}</ref> [[wikipedia:Posttraumatic_stress_disorder|Posttraumatic stress disorder]] is now more sensitive to development in that diagnostic thresholds have been lowered for children and adolescents. Furthermore, separate and additional criteria have been added for children age 6 years of age or younger. {{collapse bottom}} === Base rates of PTSD in different clinical settings and populations === This section describes the demographic settings of the populations sampled, base rates of PTSD diagnoses, country/region sampled, and the diagnostic methods that were used. Using this information, clinicians will be able to anchor the most appropriate rate of PTSD that they are likely to see in their clinical practice. * '''''To see prevalence rates across multiple disorders,''''' [[Evidence based assessment/Preparation phase#Base rates for transdiagnostic comparison|'''''click here.''''']] {| class="wikitable sortable" border="1" |- ! Demography ! Setting ! Base Rate ! Diagnostic Method |- | United States, nationally representative, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Kessler|first=Ronald C.|last2=Berglund|first2=Patricia|last3=Demler|first3=Olga|last4=Jin|first4=Robert|last5=Merikangas|first5=Kathleen R.|last6=Walters|first6=Ellen E.|date=2005-06-01|title=Lifetime Prevalence and Age-of-Onset Distributions of DSM-IV Disorders in the National Comorbidity Survey Replication|url=http://archpsyc.jamanetwork.com/article.aspx?doi=10.1001/archpsyc.62.6.593|journal=Archives of General Psychiatry|language=en|volume=62|issue=6|doi=10.1001/archpsyc.62.6.593|issn=0003-990X}}</ref> | 6.8% | National Comorbidity Survey - Replication |- | Netherlands, nationally representative, age 18-80 | Non-clinical: Population based<ref>{{Cite journal|last=de Vries|first=Giel-Jan|last2=Olff|first2=Miranda|date=2009-08-01|title=The lifetime prevalence of traumatic events and posttraumatic stress disorder in the Netherlands|url=http://onlinelibrary.wiley.com/doi/10.1002/jts.20429/abstract|journal=Journal of Traumatic Stress|language=en|volume=22|issue=4|pages=259–267|doi=10.1002/jts.20429|issn=1573-6598}}</ref> | 7.4% | Composite International Diagnostic Interview (CIDI) |- | United States, nationally representative, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Pietrzak|first=Robert H.|last2=Goldstein|first2=Risë B.|last3=Southwick|first3=Steven M.|last4=Grant|first4=Bridget F.|title=Prevalence and Axis I comorbidity of full and partial posttraumatic stress disorder in the United States: Results from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions|url=http://linkinghub.elsevier.com/retrieve/pii/S0887618510002288|journal=Journal of Anxiety Disorders|volume=25|issue=3|pages=456–465|doi=10.1016/j.janxdis.2010.11.010}}</ref> | 6.4% | Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions |- | Northern Ireland, representative sample, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Bunting|first=Brendan P.|last2=Ferry|first2=Finola R.|last3=Murphy|first3=Samuel D.|last4=O'Neill|first4=Siobhan M.|last5=Bolton|first5=David|date=2013-02-01|title=Trauma Associated With Civil Conflict and Posttraumatic Stress Disorder: Evidence From the Northern Ireland Study of Health and Stress|url=http://onlinelibrary.wiley.com/doi/10.1002/jts.21766/abstract|journal=Journal of Traumatic Stress|language=en|volume=26|issue=1|pages=134–141|doi=10.1002/jts.21766|issn=1573-6598}}</ref> | 8.8% | Northern Ireland Study of Health and Stress |- | South Africa, nationally representative sample, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Atwoli|first=Lukoye|last2=Stein|first2=Dan J.|last3=Williams|first3=David R.|last4=Mclaughlin|first4=Katie A.|last5=Petukhova|first5=Maria|last6=Kessler|first6=Ronald C.|last7=Koenen|first7=Karestan C.|date=2013-07-03|title=Trauma and posttraumatic stress disorder in South Africa: analysis from the South African Stress and Health Study|url=https://doi.org/10.1186/1471-244X-13-182|journal=BMC Psychiatry|volume=13|pages=182|doi=10.1186/1471-244x-13-182|issn=1471-244X}}</ref> | 2.3% | South African Stress and Health Study, using the Composite International Diagnostic Interview (CIDI) |- | U.S. Army and Marine Soldiers Deployed to Iraq and Afghanistan | U.S. Service Members<ref>{{Cite journal|last=Hoge|first=Charles W.|last2=Castro|first2=Carl A.|last3=Messer|first3=Stephen C.|last4=McGurk|first4=Dennis|last5=Cotting|first5=Dave I.|last6=Koffman|first6=Robert L.|date=2004-07-01|title=Combat Duty in Iraq and Afghanistan, Mental Health Problems, and Barriers to Care|url=http://dx.doi.org/10.1056/NEJMoa040603|journal=New England Journal of Medicine|volume=351|issue=1|pages=13–22|doi=10.1056/nejmoa040603|issn=0028-4793|pmid=15229303}}</ref> |11.5% - 19.5% ♦ | PTSD Checklist |- |United States, nationally representative, ages 13-18 |Non-clinical: Population based<ref>{{Cite journal|last=Merikangas|first=Kathleen Ries|last2=He|first2=Jian-ping|last3=Burstein|first3=Marcy|last4=Swanson|first4=Sonja A.|last5=Avenevoli|first5=Shelli|last6=Cui|first6=Lihong|last7=Benjet|first7=Corina|last8=Georgiades|first8=Katholiki|last9=Swendsen|first9=Joel|title=Lifetime Prevalence of Mental Disorders in U.S. Adolescents: Results from the National Comorbidity Survey Replication–Adolescent Supplement (NCS-A)|url=https://doi.org/10.1016/j.jaac.2010.05.017|journal=Journal of the American Academy of Child & Adolescent Psychiatry|volume=49|issue=10|pages=980–989|doi=10.1016/j.jaac.2010.05.017}}</ref> |5.0% |National Comorbidity Survey Replication—Adolescent Supplement (NCS-A) |} ♦ '''Note''': These rates were using broad PTSD Checklist scoring criteria of being scored positive if subjects reported at least one intrusion symptom, three avoidance symptoms, and two hyperarousal symptom that were categorized as at the moderate level. The 11.5% is for soldiers returning from deployment in Iraq, 19.5% is for soldiers returning from Afghanistan. Another common practice is to use a strict cutoff of 50 on the PCL, above which someone screens positive for PTSD. With this cutoff, rates are 6.2% and 12.9% for Service Members returned from Afghanistan and Iraqi, respectively. ==[[Evidence based assessment/Prediction phase|'''Prediction phase''']]== === Psychometric properties of screening for PTSD === The following section contains a list of screening and diagnostic instruments for PTSD. The section includes administration information, psychometric data, and PDFs or links to the screenings. * Screenings are used as part of the [[Evidence based assessment/Prediction phase|prediction phase]] of assessment; for more information on interpretation of this data, or how screenings fit in to the assessment process, click [[Evidence based assessment/Prediction phase|here.]] * '''''For a list of more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Psychometric_properties_of_common_screening_instruments click here.]''''' {| class="wikitable" |- ! Measure !Format (Reporter) !Age Range !Administration/ Completion Time !Where to Access |- |[https://www.ptsd.va.gov/professional/assessment/adult-sr/ptsd-checklist.asp PCL-5 (PTSD Checklist for DSM-5)] |Self-Report |adult |5-10 minutes |[https://www.ptsd.va.gov/professional/assessment/documents/PCL5_Standard_form.PDFPDF PDF] |- |PDS (Post-traumatic Diagnosis Scale) |Self-Report |adult |10-20 minutes | |- | colspan="4" style="font-size:110%; text-align:center;" |'''For Children and Adolescents Specifically''' | |- |[https://www.reactionindex.com/index.php/ UCLA PTSD Reaction Index for DSM-5] |Clinician Administered |child, school age, adolescents |20-30 minutes |[https://www.dellchildrens.net/wp-content/uploads/sites/60/2019/08/UCLA-PTSD-RI-DSM-5.pdf PDF] |- |CPSS (Children's PTSD Symptom Scale) |Self-Report |child |10-20 minutes |[https://www.aacap.org/App_Themes/AACAP/docs/resource_centers/resources/misc/child_ptsd_symptom_scale.pdf PDF] |- |Young Child PTSD Checklist (YCPC) |Parent Report |child |13 items |[https://medicine.tulane.edu/sites/g/files/rdw761/f/YCPC_v5_23_14.pdf PDF] |} === Interpreting PTSD screening measure scores === * For information on interpreting screening measure scores, click [[Evidence based assessment/Prediction phase#Interpreting screening measure scores|here.]] * Also see the page on [https://en.wikipedia.org/wiki/Likelihood_ratios_in_diagnostic_testing likelihood ratios in diagnostic testing] for more information ==[[Evidence based assessment/Prescription phase|'''Prescription phase''']]== ===Gold standard diagnostic interviews=== * For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews click here.] ===Recommended diagnostic interviews for PTSD=== {| class="wikitable sortable" border="1" ! colspan="4" |Diagnostic instruments for PTSD ! |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time !Where to Access |- | [https://www.ptsd.va.gov/professional/assessment/adult-int/caps.asp CAPS-5 (Clinician Administered PTSD Scale)] | Clinician Administered Interview | adult | 40-60 minutes |[https://www.ptsd.va.gov/professional/assessment/ncptsd-instrument-request-form.asp Assessment request form] |- |PTSD Symptom Scale Interview (PSS-I-5) |Clinician Administered Interview |adult and child version available |24 items |[http://www.advanced-counseling.com/dl/PSSI-5.pdf PDF] |- | colspan="4" style="font-size:110%; text-align:center;" |'''For Children and Adolescents Specifically''' | |- | [https://www.ptsd.va.gov/professional/assessment/child/caps-ca.asp CAPS-CA-5 (Clinician-Administered PTSD Scale for DSM-5 - Child/Adolescent Version)] |Clinician Administered Interview |child |30 items |[https://www.ptsd.va.gov/professional/assessment/ncptsd-instrument-request-form.asp Assessment request form] |- | Children’s PTSD Inventory (CPTSD-I) |Diagnostic Interview | 6-18 years | 50 items |Not Free |} ===Severity interviews for PTSD=== {| class="wikitable sortable" border="1" |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time !Where to Access |- | [https://www.kennedykrieger.org/sites/default/files/library/documents/faculty/ksads-dsm-5-screener.pdf Schedule for Affective Disorders and Schizophrenia for School Age Children (K-SADS)] | Diagnostic Interview | 6-18 years | 18 PTSD items | |- | Anxiety Disorders Interview Schedule, Child Version (ADIS-C) | Diagnostic Interview | 7-17 years | 26 PTSD items | |- | Diagnostic Infant and Preschool Assessment (DIPA) |Diagnostic Interview | Age 6 and younger | 46 PTSD items |[https://medicine.tulane.edu/sites/g/files/rdw761/f/DIPA-2017-2-14.pdf PDF] |} ==[[Evidence based assessment/Process phase|'''Process phase''']]== The following section contains a brief overview of treatment options for PTSD and list of process and outcome measures for PTSD. The section includes benchmarks based on published norms for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the [[Evidence based assessment/Process phase|process phase]] of assessment. For more information of differences between process and outcome measures, see the page on the [[Evidence based assessment/Process phase|process phase of assessment]]. === Process measures === * Information coming soon === Outcome and severity measures === This table includes clinically significant benchmarks for PTSD specific outcome measures * Information on how to interpret this table can be [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase found here]. * Additionally, these [[Evidence based assessment/Vignettes|vignettes]] might be helpful resources for understanding appropriate adaptation of outcome measures in practice. * ''<u>For clinically significant change benchmarks for the CBCL, YSR, and TRF total, externalizing, internalizing, and attention benchmarks,</u>'' [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase&wteswitched=1#Clinically_significant_change_benchmarks_for_widely-used_outcome_measures see here.] {| class="wikitable sortable" border="1" | colspan="7" |'''Clinically significant change benchmarks with common instruments for PTSD''' |- | colspan="7" style="font-size:110%; text-align:center;" span |<b> Benchmarks Based on Published Norms</b> |- | rowspan="2" style="text-align:center;font-size:130%;" |<b> Measure</b> | colspan="3" style="text-align:center;font-size:130%" width="300" |<b> Cut-off scores</b> | colspan="3" style="text-align:center;font-size:120%" |<b> Critical Change <br> (unstandardized scores)</b> |- | style="text-align:center;font-size:110%" |<b> A</b> | style="text-align:center;font-size:110%" |<b> B</b> | style="text-align:center;font-size:110%" |<b> C</b> | style="text-align:center;font-size:110%" |<b> 95%</b> | style="text-align:center;font-size:110%" |<b> 90%</b> | style="text-align:center;font-size:110%" |<b> SE_difference</b> |- | rowspan="1" style="text-align:center;" | Primary Care PTSD Screen | style="text-align:center;" | 1.0 | style="text-align:center;" | 3.1 | style="text-align:center;" | 2.0 | style="text-align:center;" | 1.0 | style="text-align:center;" | .8 | style="text-align:center;" | .5 |- | rowspan="1" style="text-align:center;" | PTSD Checklist Scores | style="text-align:center;" | 28.8 | style="text-align:center;" | 40.8 | style="text-align:center;" | 34.9 | style="text-align:center;" | 4.6 | style="text-align:center;" | 3.8 | style="text-align:center;" | 2.3 |- | rowspan="1" style="text-align:center;" | Clinician Administered PTSD Scale | style="text-align:center;" | 28.8 | style="text-align:center;" | 40.8 | style="text-align:center;" | 34.9 | style="text-align:center;" | 8.3 | style="text-align:center;" | 7.0 | style="text-align:center;" | 4.2 |- |[https://unc.az1.qualtrics.com/jfe/form/SV_6XPDvzlfkg2SQRf The Child PTSD Symptom Scale (CPSS)] | | | | | | |} === Treatment === * Please refer to the Wikipedia page on [[wikipedia:Posttraumatic_stress_disorder|PTSD]] for more information on available treatment for PTSD or go to the [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/post-traumatic-stress-disorder/ Effective Child Therapy] page for for a curated resource on effective treatments for PTSD. {{collapse top| Click here for more information}} '''<big>Behavioral interventions</big>''' Recommended (have ''significant benefit'') <ref name=":0">Department of Veterans Affairs and Department of Defense. . (2010). VA/DoD clinical practice guidelines: management of post-traumatic stress. Washington, D.C.: Veterans Health Administration, Department of Defense.</ref>: # Brief Cognitive Behavioral Therapy (CBT; 4-5 sessions) #* This includes stress inoculation training, trauma-focused therapy including components of cognitive restructuring, Cognitive Processing Therapy (CPT), imaginal, virtual, and in-vivo exposure as in Prolonged Exposure psychotherapy (PE)² #* Patient education is recommended as part of psychotherapy for patients and family members # EMDR may help both acute and chronic PTSD, especially individuals who have trouble with prolonged exposure or have trouble verbalizing their trauma.<ref name=":1">Ursano, R. J., Bell, C., Eth, S., Friedman, M., Norwood, A., Pfefferbaum, B., . . . McIntyre, J. S. (2004). ''Practice guideline for the treatment of patients with acute stress disorder and posttraumatic stress disorder'': American Psychiatric Publ </ref> ## Long term gains require further study. # [https://www.ptsd.va.gov/professional/treat/txessentials/present_centered_therapy.asp Present-Centered Therapy (PCT)] is a non trauma focused treatment for PTSD and a second-line treatment for PTSD<ref>{{Cite web|url=https://www.ptsd.va.gov/professional/treat/txessentials/present_centered_therapy.asp|title=Present-Centered Therapy for PTSD - PTSD: National Center for PTSD|website=www.ptsd.va.gov|language=en|access-date=2022-08-13}}</ref>. Treatments with weaker evidence (have ''some benefit'') <ref name=":0" />: # Patient education, # Imagery rehearsal therapy, # Psychodynamic therapy, # Hypnosis, # Relaxation techniques, # and Group therapy. Treatment with ''unknown benefit'' <ref name=":0" />: # Web-based CBT ## For example Jeane Bosch participated as a study therapist in research study that compared STAIR and present-centered therapy both delivered via telehealth. STAIR stands for Skills Training in Affective and Interpersonal Regulation. It is a skill-focused treatment that was originally developed for survivors of childhood abuse to teach emotion regulation skills as well as tools to help with challenges interpersonal functioning and social relationships and decrease PTSD symptoms<ref>{{Cite web|url=https://istss.org/public-resources/trauma-blog/2015-march-(1)/clinician-s-corner-skills-training-in-affective-an|title=ISTSS - Trauma Blog|website=istss.org|access-date=2022-08-13}}</ref>.<ref>{{Citation|title=Introduction to Telehealth with Dr. Bosch|url=https://www.youtube.com/watch?v=Wn6Vewl42X8|accessdate=2022-08-13|language=en}}</ref> # Acceptance and commitment therapy, # and Dialectical Behavioral Therapy. <big>'''Medication'''</big> *SSRIs are more effective than placebo in treating PTSD.<ref name=":1" /> *There is no evidence to support a medication to prevent the development of PTSD.<ref name=":0" /> **Imipramine, propranolol, prazosin, other antidepressants, anticonvulsants, and atypical antipsychotics have ''unknown benefit.'' **Strongly recommend against the use of benzodiazepines² and typical antipsychotics since they have ''no benefit and potential harm.'' {{collapse bottom}} == '''External resources''' == === For professionals === * [http://www.som.uq.edu.au/ptsd Post Traumatic Stress Disorder Information Resource] from [http://www.uq.edu.au/ The University of Queensland School of Medicine] * [http://www.apa.org/ptsd-guideline/ APA practice parameters for assessment and treatment for PTSD (Updated 2017)] * [http://www.ptsd.va.gov/professional/index.asp Resources for professionals] from [http://www.ptsd.va.gov/index.asp VA National PTSD Center] * [https://www.integration.samhsa.gov/clinical-practice/trauma-informed SAMHSA's Trauma-Informed Care Resources and Training] * [https://www.integration.samhsa.gov/clinical-practice/trauma-informed SAMHSA's Resources on Intimate Partner Violence (IPV) for Clinicians, Patients, Families, and Organizations] === For caregivers === * [http://www.nctsn.org/sites/default/files/assets/pdfs/tips_for_parents_media_final.pdf Tips for parents on shooting media coverage] * [http://www.nctsn.org/sites/default/files/assets/pdfs/parents_guidelines_for_helping_teens_after_the_recent_attacks.pdf Parent guidelines to helping youths after a shooting] * [http://www.nctsn.org/sites/default/files/assets/pdfs/helping_teens_with_traumatic_grief_caregivers_final.pdf Caregiver tips for helping teens with traumatic grief] * [http://www.nctsn.org/sites/default/files/assets/pdfs/10things_schoolage_ctg.pdf Caregiver tips for helping school-age children with traumatic grief] *[http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/post-traumatic-stress-disorder/ EffectiveChildTherapy.Org information on PTSD] *[https://sccap53.org Society of Clinical Child and Adolescent Psychology] === For educators === * [http://www.nctsn.org/sites/default/files/assets/pdfs/pfa_for_schools_appendix_a_teachers.pdf Teacher tips for providing psychological first aid] * [http://www.nctsn.org/sites/default/files/assets/pdfs/helping_youth_after_community_violence_educators.pdf Educator tips for helping youths after a community trauma] === For public === * [https://complicatedgrief.columbia.edu/for-the-public/resources/ Resources for grief and loss] * [http://www.nctsn.org/sites/default/files/assets/pdfs/psychological_information_sheet_two_pager.pdf Psychological impacts of recent shootings] * [http://www.nctsn.org/sites/default/files/assets/pdfs/youth_journalists.pdf Tips to talking to youths about a shooting] * [http://www.nctsn.org/sites/default/files/assets/pdfs/talking_to_children_about_the_shooting.pdf Tips to talking to children about a shooting] * [http://www.nctsn.org/sites/default/files/assets/pdfs/helping_young_children_heal_crisis.pdf Helping young children heal after a crisis] * [http://www.nctsn.org/content/psychological-first-aid-schoolspfa Psychological first aid for schools] * [http://www.nctsn.org/content/psychological-first-aid Resources and manuals on psychological first aid] * [http://www.ptsd.va.gov/public/index.asp Resources for the public] from [http://www.ptsd.va.gov/index.asp VA National PTSD Center] * [https://curlie.org/Health/Mental_Health/Disorders/Anxiety/Post-traumatic_Stress Posttraumatic stress disorder] at Curlie (based on DMOZ) =='''References'''== {{collapse top|Click here for references}} {{Reflist|30em}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] {{collapse bottom}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] h57d9s9aal0rr7pw2b2zm3ahsltiw1a 2419129 2419128 2022-08-25T23:34:43Z Ardenguo 2944162 /* Outcome and severity measures */ deleted cpss for now. will add back when I have more details about it wikitext text/x-wiki <noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{medical disclaimer}} {{:{{BASEPAGENAME}}/Sidebar}} ==[[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio"?''']]== * For background information on what assessment portfolios are, click the link in the heading above. * Want even 'more' information about this topic? There's an extended version of this page [[Evidence-based assessment/Posttraumatic stress disorder (disorder portfolio)/extended version|'''here''']]. == [[Evidence based assessment/Preparation phase|'''Preparation phase''']] == === Diagnostic criteria for post traumatic stress disorder === ===='''ICD-11 Diagnostic Criteria'''==== {{blockquotetop}} ===='''ICD-11 Criteria'''==== *Post-traumatic stress disorder (PTSD) is a syndrome that develops following exposure to an extremely threatening or horrific event or series of events that is characterized by all of the following: **1) re-experiencing the traumatic event or events in the present in the form of vivid intrusive memories, flashbacks, or nightmares, which are typically accompanied by strong and overwhelming emotions such as fear or horror and strong physical sensations, or feelings of being overwhelmed or immersed in the same intense emotions that were experienced during the traumatic event; **2) avoidance of thoughts and memories of the event or events, or avoidance of activities, situations, or people reminiscent of the event or events **3) persistent perceptions of heightened current threat, for example as indicated by hypervigilance or an enhanced startle reaction to stimuli such as unexpected noises. *The symptoms must persist for at least several weeks and cause significant impairment in personal, family, social, educational, occupational or other important areas of functioning. Additionally, ICD 11 includes a category called "Complex post-traumatic stress disorder," which is described as: *A disorder that may develop following exposure to an event or series of events of an extremely threatening or horrific nature, most commonly prolonged or repetitive events from which escape is difficult or impossible (e.g., torture, slavery, genocide campaigns, prolonged domestic violence, repeated childhood sexual or physical abuse). *The disorder is characterized by the core symptoms of PTSD; that is, all diagnostic requirements for PTSD have been met at some point during the course of the disorder. *In addition, Complex PTSD is characterized by: **1) severe and pervasive problems in affect regulation; **2) persistent beliefs about oneself as diminished, defeated or worthless, accompanied by deep and pervasive feelings of shame, guilt or failure related to the traumatic event **3) persistent difficulties in sustaining relationships and in feeling close to others. The disturbance causes significant impairment in personal, family, social, educational, occupational or other important areas of functioning. {{blockquotebottom}} ===='''Changes in DSM-5'''==== * The diagnostic criteria for post-traumatic stress disorder changed slightly from [[DSM-IV]] to [[w:Diagnostic_and_Statistical_Manual_of_Mental_Disorders#DSM-IV-TR_.282000.29|DSM-5]]. Summaries are available [http://www.dsm5.org/Documents/changes%20from%20dsm-iv-tr%20to%20dsm-5.pdf here] and [[w:DSM-5|here]]. === Developmental sensitivities === {{collapse top| Click for more information}} *Diagnostic thresholds have been lowered for children and adolescents to account for development. *Separate and additional criteria have been added for children age 6 or younger. *Child sexual abuse has been found to have a substantial effect on the development of PTSD.<ref>{{cite journal|last1=Paolucci|first1=Elizabeth ODDONE|last2=Genuis|first2=Mark L.|last3=Violato|first3=Claudio|title=A Meta-Analysis of the Published Research on the Effects of Child Sexual Abuse|journal=The Journal of Psychology|date=January 2001|volume=135|issue=1|pages=17–36|doi=10.1080/00223980109603677}}</ref> *Children with higher exposure to trauma, less social support, and other major life events are more likely to have continued PTSD symptoms 7 months after a trauma.<ref name=":2">{{cite journal |last1=La Greca|first1=A|last2=Silverman|first2=WK|last3=Vernberg|first3=EM|last4=Prinstein|first4=MJ|title=Symptoms of posttraumatic stress in children after Hurricane Andrew: a prospective study.|journal=Journal of consulting and clinical psychology|date=August 1996|volume=64|issue=4|pages=712-23|pmid=8803361}}</ref> 10 months after a trauma, however, only experience of a major life event remained predictive of continuing PTSD symptoms.<ref name=":2" /> *Lack of social support, specifically lack of support by a teacher, was predictive of higher PTSD symptoms among children who had gone through an environmental trauma.<ref name=":2" /> *Children who reported using blame and anger as strategies for coping had higher levels of PTSD symptoms 10 months after a trauma.<ref name=":2" /> *Negative affect in children before a traumatic event was predictive of development of PTSD symptoms after a traumatic event.<ref>{{cite journal|last1=Weems|first1=CF|last2=Pina|first2=AA|last3=Costa|first3=NM|last4=Watts|first4=SE|last5=Taylor|first5=LK|last6=Cannon|first6=MF|title=Predisaster trait anxiety and negative affect predict posttraumatic stress in youths after hurricane Katrina.|journal=Journal of consulting and clinical psychology|date=February 2007|volume=75|issue=1|pages=154-9|doi=10.1037/0022-006X.75.1.154|pmid=17295574}}</ref> [[wikipedia:Posttraumatic_stress_disorder|Posttraumatic stress disorder]] is now more sensitive to development in that diagnostic thresholds have been lowered for children and adolescents. Furthermore, separate and additional criteria have been added for children age 6 years of age or younger. {{collapse bottom}} === Base rates of PTSD in different clinical settings and populations === This section describes the demographic settings of the populations sampled, base rates of PTSD diagnoses, country/region sampled, and the diagnostic methods that were used. Using this information, clinicians will be able to anchor the most appropriate rate of PTSD that they are likely to see in their clinical practice. * '''''To see prevalence rates across multiple disorders,''''' [[Evidence based assessment/Preparation phase#Base rates for transdiagnostic comparison|'''''click here.''''']] {| class="wikitable sortable" border="1" |- ! Demography ! Setting ! Base Rate ! Diagnostic Method |- | United States, nationally representative, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Kessler|first=Ronald C.|last2=Berglund|first2=Patricia|last3=Demler|first3=Olga|last4=Jin|first4=Robert|last5=Merikangas|first5=Kathleen R.|last6=Walters|first6=Ellen E.|date=2005-06-01|title=Lifetime Prevalence and Age-of-Onset Distributions of DSM-IV Disorders in the National Comorbidity Survey Replication|url=http://archpsyc.jamanetwork.com/article.aspx?doi=10.1001/archpsyc.62.6.593|journal=Archives of General Psychiatry|language=en|volume=62|issue=6|doi=10.1001/archpsyc.62.6.593|issn=0003-990X}}</ref> | 6.8% | National Comorbidity Survey - Replication |- | Netherlands, nationally representative, age 18-80 | Non-clinical: Population based<ref>{{Cite journal|last=de Vries|first=Giel-Jan|last2=Olff|first2=Miranda|date=2009-08-01|title=The lifetime prevalence of traumatic events and posttraumatic stress disorder in the Netherlands|url=http://onlinelibrary.wiley.com/doi/10.1002/jts.20429/abstract|journal=Journal of Traumatic Stress|language=en|volume=22|issue=4|pages=259–267|doi=10.1002/jts.20429|issn=1573-6598}}</ref> | 7.4% | Composite International Diagnostic Interview (CIDI) |- | United States, nationally representative, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Pietrzak|first=Robert H.|last2=Goldstein|first2=Risë B.|last3=Southwick|first3=Steven M.|last4=Grant|first4=Bridget F.|title=Prevalence and Axis I comorbidity of full and partial posttraumatic stress disorder in the United States: Results from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions|url=http://linkinghub.elsevier.com/retrieve/pii/S0887618510002288|journal=Journal of Anxiety Disorders|volume=25|issue=3|pages=456–465|doi=10.1016/j.janxdis.2010.11.010}}</ref> | 6.4% | Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions |- | Northern Ireland, representative sample, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Bunting|first=Brendan P.|last2=Ferry|first2=Finola R.|last3=Murphy|first3=Samuel D.|last4=O'Neill|first4=Siobhan M.|last5=Bolton|first5=David|date=2013-02-01|title=Trauma Associated With Civil Conflict and Posttraumatic Stress Disorder: Evidence From the Northern Ireland Study of Health and Stress|url=http://onlinelibrary.wiley.com/doi/10.1002/jts.21766/abstract|journal=Journal of Traumatic Stress|language=en|volume=26|issue=1|pages=134–141|doi=10.1002/jts.21766|issn=1573-6598}}</ref> | 8.8% | Northern Ireland Study of Health and Stress |- | South Africa, nationally representative sample, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Atwoli|first=Lukoye|last2=Stein|first2=Dan J.|last3=Williams|first3=David R.|last4=Mclaughlin|first4=Katie A.|last5=Petukhova|first5=Maria|last6=Kessler|first6=Ronald C.|last7=Koenen|first7=Karestan C.|date=2013-07-03|title=Trauma and posttraumatic stress disorder in South Africa: analysis from the South African Stress and Health Study|url=https://doi.org/10.1186/1471-244X-13-182|journal=BMC Psychiatry|volume=13|pages=182|doi=10.1186/1471-244x-13-182|issn=1471-244X}}</ref> | 2.3% | South African Stress and Health Study, using the Composite International Diagnostic Interview (CIDI) |- | U.S. Army and Marine Soldiers Deployed to Iraq and Afghanistan | U.S. Service Members<ref>{{Cite journal|last=Hoge|first=Charles W.|last2=Castro|first2=Carl A.|last3=Messer|first3=Stephen C.|last4=McGurk|first4=Dennis|last5=Cotting|first5=Dave I.|last6=Koffman|first6=Robert L.|date=2004-07-01|title=Combat Duty in Iraq and Afghanistan, Mental Health Problems, and Barriers to Care|url=http://dx.doi.org/10.1056/NEJMoa040603|journal=New England Journal of Medicine|volume=351|issue=1|pages=13–22|doi=10.1056/nejmoa040603|issn=0028-4793|pmid=15229303}}</ref> |11.5% - 19.5% ♦ | PTSD Checklist |- |United States, nationally representative, ages 13-18 |Non-clinical: Population based<ref>{{Cite journal|last=Merikangas|first=Kathleen Ries|last2=He|first2=Jian-ping|last3=Burstein|first3=Marcy|last4=Swanson|first4=Sonja A.|last5=Avenevoli|first5=Shelli|last6=Cui|first6=Lihong|last7=Benjet|first7=Corina|last8=Georgiades|first8=Katholiki|last9=Swendsen|first9=Joel|title=Lifetime Prevalence of Mental Disorders in U.S. Adolescents: Results from the National Comorbidity Survey Replication–Adolescent Supplement (NCS-A)|url=https://doi.org/10.1016/j.jaac.2010.05.017|journal=Journal of the American Academy of Child & Adolescent Psychiatry|volume=49|issue=10|pages=980–989|doi=10.1016/j.jaac.2010.05.017}}</ref> |5.0% |National Comorbidity Survey Replication—Adolescent Supplement (NCS-A) |} ♦ '''Note''': These rates were using broad PTSD Checklist scoring criteria of being scored positive if subjects reported at least one intrusion symptom, three avoidance symptoms, and two hyperarousal symptom that were categorized as at the moderate level. The 11.5% is for soldiers returning from deployment in Iraq, 19.5% is for soldiers returning from Afghanistan. Another common practice is to use a strict cutoff of 50 on the PCL, above which someone screens positive for PTSD. With this cutoff, rates are 6.2% and 12.9% for Service Members returned from Afghanistan and Iraqi, respectively. ==[[Evidence based assessment/Prediction phase|'''Prediction phase''']]== === Psychometric properties of screening for PTSD === The following section contains a list of screening and diagnostic instruments for PTSD. The section includes administration information, psychometric data, and PDFs or links to the screenings. * Screenings are used as part of the [[Evidence based assessment/Prediction phase|prediction phase]] of assessment; for more information on interpretation of this data, or how screenings fit in to the assessment process, click [[Evidence based assessment/Prediction phase|here.]] * '''''For a list of more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Psychometric_properties_of_common_screening_instruments click here.]''''' {| class="wikitable" |- ! Measure !Format (Reporter) !Age Range !Administration/ Completion Time !Where to Access |- |[https://www.ptsd.va.gov/professional/assessment/adult-sr/ptsd-checklist.asp PCL-5 (PTSD Checklist for DSM-5)] |Self-Report |adult |5-10 minutes |[https://www.ptsd.va.gov/professional/assessment/documents/PCL5_Standard_form.PDFPDF PDF] |- |PDS (Post-traumatic Diagnosis Scale) |Self-Report |adult |10-20 minutes | |- | colspan="4" style="font-size:110%; text-align:center;" |'''For Children and Adolescents Specifically''' | |- |[https://www.reactionindex.com/index.php/ UCLA PTSD Reaction Index for DSM-5] |Clinician Administered |child, school age, adolescents |20-30 minutes |[https://www.dellchildrens.net/wp-content/uploads/sites/60/2019/08/UCLA-PTSD-RI-DSM-5.pdf PDF] |- |CPSS (Children's PTSD Symptom Scale) |Self-Report |child |10-20 minutes |[https://www.aacap.org/App_Themes/AACAP/docs/resource_centers/resources/misc/child_ptsd_symptom_scale.pdf PDF] |- |Young Child PTSD Checklist (YCPC) |Parent Report |child |13 items |[https://medicine.tulane.edu/sites/g/files/rdw761/f/YCPC_v5_23_14.pdf PDF] |} === Interpreting PTSD screening measure scores === * For information on interpreting screening measure scores, click [[Evidence based assessment/Prediction phase#Interpreting screening measure scores|here.]] * Also see the page on [https://en.wikipedia.org/wiki/Likelihood_ratios_in_diagnostic_testing likelihood ratios in diagnostic testing] for more information ==[[Evidence based assessment/Prescription phase|'''Prescription phase''']]== ===Gold standard diagnostic interviews=== * For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews click here.] ===Recommended diagnostic interviews for PTSD=== {| class="wikitable sortable" border="1" ! colspan="4" |Diagnostic instruments for PTSD ! |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time !Where to Access |- | [https://www.ptsd.va.gov/professional/assessment/adult-int/caps.asp CAPS-5 (Clinician Administered PTSD Scale)] | Clinician Administered Interview | adult | 40-60 minutes |[https://www.ptsd.va.gov/professional/assessment/ncptsd-instrument-request-form.asp Assessment request form] |- |PTSD Symptom Scale Interview (PSS-I-5) |Clinician Administered Interview |adult and child version available |24 items |[http://www.advanced-counseling.com/dl/PSSI-5.pdf PDF] |- | colspan="4" style="font-size:110%; text-align:center;" |'''For Children and Adolescents Specifically''' | |- | [https://www.ptsd.va.gov/professional/assessment/child/caps-ca.asp CAPS-CA-5 (Clinician-Administered PTSD Scale for DSM-5 - Child/Adolescent Version)] |Clinician Administered Interview |child |30 items |[https://www.ptsd.va.gov/professional/assessment/ncptsd-instrument-request-form.asp Assessment request form] |- | Children’s PTSD Inventory (CPTSD-I) |Diagnostic Interview | 6-18 years | 50 items |Not Free |} ===Severity interviews for PTSD=== {| class="wikitable sortable" border="1" |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time !Where to Access |- | [https://www.kennedykrieger.org/sites/default/files/library/documents/faculty/ksads-dsm-5-screener.pdf Schedule for Affective Disorders and Schizophrenia for School Age Children (K-SADS)] | Diagnostic Interview | 6-18 years | 18 PTSD items | |- | Anxiety Disorders Interview Schedule, Child Version (ADIS-C) | Diagnostic Interview | 7-17 years | 26 PTSD items | |- | Diagnostic Infant and Preschool Assessment (DIPA) |Diagnostic Interview | Age 6 and younger | 46 PTSD items |[https://medicine.tulane.edu/sites/g/files/rdw761/f/DIPA-2017-2-14.pdf PDF] |} ==[[Evidence based assessment/Process phase|'''Process phase''']]== The following section contains a brief overview of treatment options for PTSD and list of process and outcome measures for PTSD. The section includes benchmarks based on published norms for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the [[Evidence based assessment/Process phase|process phase]] of assessment. For more information of differences between process and outcome measures, see the page on the [[Evidence based assessment/Process phase|process phase of assessment]]. === Process measures === * Information coming soon === Outcome and severity measures === This table includes clinically significant benchmarks for PTSD specific outcome measures * Information on how to interpret this table can be [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase found here]. * Additionally, these [[Evidence based assessment/Vignettes|vignettes]] might be helpful resources for understanding appropriate adaptation of outcome measures in practice. * ''<u>For clinically significant change benchmarks for the CBCL, YSR, and TRF total, externalizing, internalizing, and attention benchmarks,</u>'' [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase&wteswitched=1#Clinically_significant_change_benchmarks_for_widely-used_outcome_measures see here.] {| class="wikitable sortable" border="1" | colspan="7" |'''Clinically significant change benchmarks with common instruments for PTSD''' |- | colspan="7" style="font-size:110%; text-align:center;" span |<b> Benchmarks Based on Published Norms</b> |- | rowspan="2" style="text-align:center;font-size:130%;" |<b> Measure</b> | colspan="3" style="text-align:center;font-size:130%" width="300" |<b> Cut-off scores</b> | colspan="3" style="text-align:center;font-size:120%" |<b> Critical Change <br> (unstandardized scores)</b> |- | style="text-align:center;font-size:110%" |<b> A</b> | style="text-align:center;font-size:110%" |<b> B</b> | style="text-align:center;font-size:110%" |<b> C</b> | style="text-align:center;font-size:110%" |<b> 95%</b> | style="text-align:center;font-size:110%" |<b> 90%</b> | style="text-align:center;font-size:110%" |<b> SE_difference</b> |- | rowspan="1" style="text-align:center;" | Primary Care PTSD Screen | style="text-align:center;" | 1.0 | style="text-align:center;" | 3.1 | style="text-align:center;" | 2.0 | style="text-align:center;" | 1.0 | style="text-align:center;" | .8 | style="text-align:center;" | .5 |- | rowspan="1" style="text-align:center;" | PTSD Checklist Scores | style="text-align:center;" | 28.8 | style="text-align:center;" | 40.8 | style="text-align:center;" | 34.9 | style="text-align:center;" | 4.6 | style="text-align:center;" | 3.8 | style="text-align:center;" | 2.3 |- | rowspan="1" style="text-align:center;" | Clinician Administered PTSD Scale | style="text-align:center;" | 28.8 | style="text-align:center;" | 40.8 | style="text-align:center;" | 34.9 | style="text-align:center;" | 8.3 | style="text-align:center;" | 7.0 | style="text-align:center;" | 4.2 |} === Treatment === * Please refer to the Wikipedia page on [[wikipedia:Posttraumatic_stress_disorder|PTSD]] for more information on available treatment for PTSD or go to the [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/post-traumatic-stress-disorder/ Effective Child Therapy] page for for a curated resource on effective treatments for PTSD. {{collapse top| Click here for more information}} '''<big>Behavioral interventions</big>''' Recommended (have ''significant benefit'') <ref name=":0">Department of Veterans Affairs and Department of Defense. . (2010). VA/DoD clinical practice guidelines: management of post-traumatic stress. Washington, D.C.: Veterans Health Administration, Department of Defense.</ref>: # Brief Cognitive Behavioral Therapy (CBT; 4-5 sessions) #* This includes stress inoculation training, trauma-focused therapy including components of cognitive restructuring, Cognitive Processing Therapy (CPT), imaginal, virtual, and in-vivo exposure as in Prolonged Exposure psychotherapy (PE)² #* Patient education is recommended as part of psychotherapy for patients and family members # EMDR may help both acute and chronic PTSD, especially individuals who have trouble with prolonged exposure or have trouble verbalizing their trauma.<ref name=":1">Ursano, R. J., Bell, C., Eth, S., Friedman, M., Norwood, A., Pfefferbaum, B., . . . McIntyre, J. S. (2004). ''Practice guideline for the treatment of patients with acute stress disorder and posttraumatic stress disorder'': American Psychiatric Publ </ref> ## Long term gains require further study. # [https://www.ptsd.va.gov/professional/treat/txessentials/present_centered_therapy.asp Present-Centered Therapy (PCT)] is a non trauma focused treatment for PTSD and a second-line treatment for PTSD<ref>{{Cite web|url=https://www.ptsd.va.gov/professional/treat/txessentials/present_centered_therapy.asp|title=Present-Centered Therapy for PTSD - PTSD: National Center for PTSD|website=www.ptsd.va.gov|language=en|access-date=2022-08-13}}</ref>. Treatments with weaker evidence (have ''some benefit'') <ref name=":0" />: # Patient education, # Imagery rehearsal therapy, # Psychodynamic therapy, # Hypnosis, # Relaxation techniques, # and Group therapy. Treatment with ''unknown benefit'' <ref name=":0" />: # Web-based CBT ## For example Jeane Bosch participated as a study therapist in research study that compared STAIR and present-centered therapy both delivered via telehealth. STAIR stands for Skills Training in Affective and Interpersonal Regulation. It is a skill-focused treatment that was originally developed for survivors of childhood abuse to teach emotion regulation skills as well as tools to help with challenges interpersonal functioning and social relationships and decrease PTSD symptoms<ref>{{Cite web|url=https://istss.org/public-resources/trauma-blog/2015-march-(1)/clinician-s-corner-skills-training-in-affective-an|title=ISTSS - Trauma Blog|website=istss.org|access-date=2022-08-13}}</ref>.<ref>{{Citation|title=Introduction to Telehealth with Dr. Bosch|url=https://www.youtube.com/watch?v=Wn6Vewl42X8|accessdate=2022-08-13|language=en}}</ref> # Acceptance and commitment therapy, # and Dialectical Behavioral Therapy. <big>'''Medication'''</big> *SSRIs are more effective than placebo in treating PTSD.<ref name=":1" /> *There is no evidence to support a medication to prevent the development of PTSD.<ref name=":0" /> **Imipramine, propranolol, prazosin, other antidepressants, anticonvulsants, and atypical antipsychotics have ''unknown benefit.'' **Strongly recommend against the use of benzodiazepines² and typical antipsychotics since they have ''no benefit and potential harm.'' {{collapse bottom}} == '''External resources''' == === For professionals === * [http://www.som.uq.edu.au/ptsd Post Traumatic Stress Disorder Information Resource] from [http://www.uq.edu.au/ The University of Queensland School of Medicine] * [http://www.apa.org/ptsd-guideline/ APA practice parameters for assessment and treatment for PTSD (Updated 2017)] * [http://www.ptsd.va.gov/professional/index.asp Resources for professionals] from [http://www.ptsd.va.gov/index.asp VA National PTSD Center] * [https://www.integration.samhsa.gov/clinical-practice/trauma-informed SAMHSA's Trauma-Informed Care Resources and Training] * [https://www.integration.samhsa.gov/clinical-practice/trauma-informed SAMHSA's Resources on Intimate Partner Violence (IPV) for Clinicians, Patients, Families, and Organizations] === For caregivers === * [http://www.nctsn.org/sites/default/files/assets/pdfs/tips_for_parents_media_final.pdf Tips for parents on shooting media coverage] * [http://www.nctsn.org/sites/default/files/assets/pdfs/parents_guidelines_for_helping_teens_after_the_recent_attacks.pdf Parent guidelines to helping youths after a shooting] * [http://www.nctsn.org/sites/default/files/assets/pdfs/helping_teens_with_traumatic_grief_caregivers_final.pdf Caregiver tips for helping teens with traumatic grief] * [http://www.nctsn.org/sites/default/files/assets/pdfs/10things_schoolage_ctg.pdf Caregiver tips for helping school-age children with traumatic grief] *[http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/post-traumatic-stress-disorder/ EffectiveChildTherapy.Org information on PTSD] *[https://sccap53.org Society of Clinical Child and Adolescent Psychology] === For educators === * [http://www.nctsn.org/sites/default/files/assets/pdfs/pfa_for_schools_appendix_a_teachers.pdf Teacher tips for providing psychological first aid] * [http://www.nctsn.org/sites/default/files/assets/pdfs/helping_youth_after_community_violence_educators.pdf Educator tips for helping youths after a community trauma] === For public === * [https://complicatedgrief.columbia.edu/for-the-public/resources/ Resources for grief and loss] * [http://www.nctsn.org/sites/default/files/assets/pdfs/psychological_information_sheet_two_pager.pdf Psychological impacts of recent shootings] * [http://www.nctsn.org/sites/default/files/assets/pdfs/youth_journalists.pdf Tips to talking to youths about a shooting] * [http://www.nctsn.org/sites/default/files/assets/pdfs/talking_to_children_about_the_shooting.pdf Tips to talking to children about a shooting] * [http://www.nctsn.org/sites/default/files/assets/pdfs/helping_young_children_heal_crisis.pdf Helping young children heal after a crisis] * [http://www.nctsn.org/content/psychological-first-aid-schoolspfa Psychological first aid for schools] * [http://www.nctsn.org/content/psychological-first-aid Resources and manuals on psychological first aid] * [http://www.ptsd.va.gov/public/index.asp Resources for the public] from [http://www.ptsd.va.gov/index.asp VA National PTSD Center] * [https://curlie.org/Health/Mental_Health/Disorders/Anxiety/Post-traumatic_Stress Posttraumatic stress disorder] at Curlie (based on DMOZ) =='''References'''== {{collapse top|Click here for references}} {{Reflist|30em}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] {{collapse bottom}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] 2m722pvwyiye38m5qvl534fiojs5r18 2419130 2419129 2022-08-25T23:38:12Z Ardenguo 2944162 /* Severity interviews for PTSD */ wikitext text/x-wiki <noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{medical disclaimer}} {{:{{BASEPAGENAME}}/Sidebar}} ==[[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio"?''']]== * For background information on what assessment portfolios are, click the link in the heading above. * Want even 'more' information about this topic? There's an extended version of this page [[Evidence-based assessment/Posttraumatic stress disorder (disorder portfolio)/extended version|'''here''']]. == [[Evidence based assessment/Preparation phase|'''Preparation phase''']] == === Diagnostic criteria for post traumatic stress disorder === ===='''ICD-11 Diagnostic Criteria'''==== {{blockquotetop}} ===='''ICD-11 Criteria'''==== *Post-traumatic stress disorder (PTSD) is a syndrome that develops following exposure to an extremely threatening or horrific event or series of events that is characterized by all of the following: **1) re-experiencing the traumatic event or events in the present in the form of vivid intrusive memories, flashbacks, or nightmares, which are typically accompanied by strong and overwhelming emotions such as fear or horror and strong physical sensations, or feelings of being overwhelmed or immersed in the same intense emotions that were experienced during the traumatic event; **2) avoidance of thoughts and memories of the event or events, or avoidance of activities, situations, or people reminiscent of the event or events **3) persistent perceptions of heightened current threat, for example as indicated by hypervigilance or an enhanced startle reaction to stimuli such as unexpected noises. *The symptoms must persist for at least several weeks and cause significant impairment in personal, family, social, educational, occupational or other important areas of functioning. Additionally, ICD 11 includes a category called "Complex post-traumatic stress disorder," which is described as: *A disorder that may develop following exposure to an event or series of events of an extremely threatening or horrific nature, most commonly prolonged or repetitive events from which escape is difficult or impossible (e.g., torture, slavery, genocide campaigns, prolonged domestic violence, repeated childhood sexual or physical abuse). *The disorder is characterized by the core symptoms of PTSD; that is, all diagnostic requirements for PTSD have been met at some point during the course of the disorder. *In addition, Complex PTSD is characterized by: **1) severe and pervasive problems in affect regulation; **2) persistent beliefs about oneself as diminished, defeated or worthless, accompanied by deep and pervasive feelings of shame, guilt or failure related to the traumatic event **3) persistent difficulties in sustaining relationships and in feeling close to others. The disturbance causes significant impairment in personal, family, social, educational, occupational or other important areas of functioning. {{blockquotebottom}} ===='''Changes in DSM-5'''==== * The diagnostic criteria for post-traumatic stress disorder changed slightly from [[DSM-IV]] to [[w:Diagnostic_and_Statistical_Manual_of_Mental_Disorders#DSM-IV-TR_.282000.29|DSM-5]]. Summaries are available [http://www.dsm5.org/Documents/changes%20from%20dsm-iv-tr%20to%20dsm-5.pdf here] and [[w:DSM-5|here]]. === Developmental sensitivities === {{collapse top| Click for more information}} *Diagnostic thresholds have been lowered for children and adolescents to account for development. *Separate and additional criteria have been added for children age 6 or younger. *Child sexual abuse has been found to have a substantial effect on the development of PTSD.<ref>{{cite journal|last1=Paolucci|first1=Elizabeth ODDONE|last2=Genuis|first2=Mark L.|last3=Violato|first3=Claudio|title=A Meta-Analysis of the Published Research on the Effects of Child Sexual Abuse|journal=The Journal of Psychology|date=January 2001|volume=135|issue=1|pages=17–36|doi=10.1080/00223980109603677}}</ref> *Children with higher exposure to trauma, less social support, and other major life events are more likely to have continued PTSD symptoms 7 months after a trauma.<ref name=":2">{{cite journal |last1=La Greca|first1=A|last2=Silverman|first2=WK|last3=Vernberg|first3=EM|last4=Prinstein|first4=MJ|title=Symptoms of posttraumatic stress in children after Hurricane Andrew: a prospective study.|journal=Journal of consulting and clinical psychology|date=August 1996|volume=64|issue=4|pages=712-23|pmid=8803361}}</ref> 10 months after a trauma, however, only experience of a major life event remained predictive of continuing PTSD symptoms.<ref name=":2" /> *Lack of social support, specifically lack of support by a teacher, was predictive of higher PTSD symptoms among children who had gone through an environmental trauma.<ref name=":2" /> *Children who reported using blame and anger as strategies for coping had higher levels of PTSD symptoms 10 months after a trauma.<ref name=":2" /> *Negative affect in children before a traumatic event was predictive of development of PTSD symptoms after a traumatic event.<ref>{{cite journal|last1=Weems|first1=CF|last2=Pina|first2=AA|last3=Costa|first3=NM|last4=Watts|first4=SE|last5=Taylor|first5=LK|last6=Cannon|first6=MF|title=Predisaster trait anxiety and negative affect predict posttraumatic stress in youths after hurricane Katrina.|journal=Journal of consulting and clinical psychology|date=February 2007|volume=75|issue=1|pages=154-9|doi=10.1037/0022-006X.75.1.154|pmid=17295574}}</ref> [[wikipedia:Posttraumatic_stress_disorder|Posttraumatic stress disorder]] is now more sensitive to development in that diagnostic thresholds have been lowered for children and adolescents. Furthermore, separate and additional criteria have been added for children age 6 years of age or younger. {{collapse bottom}} === Base rates of PTSD in different clinical settings and populations === This section describes the demographic settings of the populations sampled, base rates of PTSD diagnoses, country/region sampled, and the diagnostic methods that were used. Using this information, clinicians will be able to anchor the most appropriate rate of PTSD that they are likely to see in their clinical practice. * '''''To see prevalence rates across multiple disorders,''''' [[Evidence based assessment/Preparation phase#Base rates for transdiagnostic comparison|'''''click here.''''']] {| class="wikitable sortable" border="1" |- ! Demography ! Setting ! Base Rate ! Diagnostic Method |- | United States, nationally representative, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Kessler|first=Ronald C.|last2=Berglund|first2=Patricia|last3=Demler|first3=Olga|last4=Jin|first4=Robert|last5=Merikangas|first5=Kathleen R.|last6=Walters|first6=Ellen E.|date=2005-06-01|title=Lifetime Prevalence and Age-of-Onset Distributions of DSM-IV Disorders in the National Comorbidity Survey Replication|url=http://archpsyc.jamanetwork.com/article.aspx?doi=10.1001/archpsyc.62.6.593|journal=Archives of General Psychiatry|language=en|volume=62|issue=6|doi=10.1001/archpsyc.62.6.593|issn=0003-990X}}</ref> | 6.8% | National Comorbidity Survey - Replication |- | Netherlands, nationally representative, age 18-80 | Non-clinical: Population based<ref>{{Cite journal|last=de Vries|first=Giel-Jan|last2=Olff|first2=Miranda|date=2009-08-01|title=The lifetime prevalence of traumatic events and posttraumatic stress disorder in the Netherlands|url=http://onlinelibrary.wiley.com/doi/10.1002/jts.20429/abstract|journal=Journal of Traumatic Stress|language=en|volume=22|issue=4|pages=259–267|doi=10.1002/jts.20429|issn=1573-6598}}</ref> | 7.4% | Composite International Diagnostic Interview (CIDI) |- | United States, nationally representative, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Pietrzak|first=Robert H.|last2=Goldstein|first2=Risë B.|last3=Southwick|first3=Steven M.|last4=Grant|first4=Bridget F.|title=Prevalence and Axis I comorbidity of full and partial posttraumatic stress disorder in the United States: Results from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions|url=http://linkinghub.elsevier.com/retrieve/pii/S0887618510002288|journal=Journal of Anxiety Disorders|volume=25|issue=3|pages=456–465|doi=10.1016/j.janxdis.2010.11.010}}</ref> | 6.4% | Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions |- | Northern Ireland, representative sample, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Bunting|first=Brendan P.|last2=Ferry|first2=Finola R.|last3=Murphy|first3=Samuel D.|last4=O'Neill|first4=Siobhan M.|last5=Bolton|first5=David|date=2013-02-01|title=Trauma Associated With Civil Conflict and Posttraumatic Stress Disorder: Evidence From the Northern Ireland Study of Health and Stress|url=http://onlinelibrary.wiley.com/doi/10.1002/jts.21766/abstract|journal=Journal of Traumatic Stress|language=en|volume=26|issue=1|pages=134–141|doi=10.1002/jts.21766|issn=1573-6598}}</ref> | 8.8% | Northern Ireland Study of Health and Stress |- | South Africa, nationally representative sample, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Atwoli|first=Lukoye|last2=Stein|first2=Dan J.|last3=Williams|first3=David R.|last4=Mclaughlin|first4=Katie A.|last5=Petukhova|first5=Maria|last6=Kessler|first6=Ronald C.|last7=Koenen|first7=Karestan C.|date=2013-07-03|title=Trauma and posttraumatic stress disorder in South Africa: analysis from the South African Stress and Health Study|url=https://doi.org/10.1186/1471-244X-13-182|journal=BMC Psychiatry|volume=13|pages=182|doi=10.1186/1471-244x-13-182|issn=1471-244X}}</ref> | 2.3% | South African Stress and Health Study, using the Composite International Diagnostic Interview (CIDI) |- | U.S. Army and Marine Soldiers Deployed to Iraq and Afghanistan | U.S. Service Members<ref>{{Cite journal|last=Hoge|first=Charles W.|last2=Castro|first2=Carl A.|last3=Messer|first3=Stephen C.|last4=McGurk|first4=Dennis|last5=Cotting|first5=Dave I.|last6=Koffman|first6=Robert L.|date=2004-07-01|title=Combat Duty in Iraq and Afghanistan, Mental Health Problems, and Barriers to Care|url=http://dx.doi.org/10.1056/NEJMoa040603|journal=New England Journal of Medicine|volume=351|issue=1|pages=13–22|doi=10.1056/nejmoa040603|issn=0028-4793|pmid=15229303}}</ref> |11.5% - 19.5% ♦ | PTSD Checklist |- |United States, nationally representative, ages 13-18 |Non-clinical: Population based<ref>{{Cite journal|last=Merikangas|first=Kathleen Ries|last2=He|first2=Jian-ping|last3=Burstein|first3=Marcy|last4=Swanson|first4=Sonja A.|last5=Avenevoli|first5=Shelli|last6=Cui|first6=Lihong|last7=Benjet|first7=Corina|last8=Georgiades|first8=Katholiki|last9=Swendsen|first9=Joel|title=Lifetime Prevalence of Mental Disorders in U.S. Adolescents: Results from the National Comorbidity Survey Replication–Adolescent Supplement (NCS-A)|url=https://doi.org/10.1016/j.jaac.2010.05.017|journal=Journal of the American Academy of Child & Adolescent Psychiatry|volume=49|issue=10|pages=980–989|doi=10.1016/j.jaac.2010.05.017}}</ref> |5.0% |National Comorbidity Survey Replication—Adolescent Supplement (NCS-A) |} ♦ '''Note''': These rates were using broad PTSD Checklist scoring criteria of being scored positive if subjects reported at least one intrusion symptom, three avoidance symptoms, and two hyperarousal symptom that were categorized as at the moderate level. The 11.5% is for soldiers returning from deployment in Iraq, 19.5% is for soldiers returning from Afghanistan. Another common practice is to use a strict cutoff of 50 on the PCL, above which someone screens positive for PTSD. With this cutoff, rates are 6.2% and 12.9% for Service Members returned from Afghanistan and Iraqi, respectively. ==[[Evidence based assessment/Prediction phase|'''Prediction phase''']]== === Psychometric properties of screening for PTSD === The following section contains a list of screening and diagnostic instruments for PTSD. The section includes administration information, psychometric data, and PDFs or links to the screenings. * Screenings are used as part of the [[Evidence based assessment/Prediction phase|prediction phase]] of assessment; for more information on interpretation of this data, or how screenings fit in to the assessment process, click [[Evidence based assessment/Prediction phase|here.]] * '''''For a list of more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Psychometric_properties_of_common_screening_instruments click here.]''''' {| class="wikitable" |- ! Measure !Format (Reporter) !Age Range !Administration/ Completion Time !Where to Access |- |[https://www.ptsd.va.gov/professional/assessment/adult-sr/ptsd-checklist.asp PCL-5 (PTSD Checklist for DSM-5)] |Self-Report |adult |5-10 minutes |[https://www.ptsd.va.gov/professional/assessment/documents/PCL5_Standard_form.PDFPDF PDF] |- |PDS (Post-traumatic Diagnosis Scale) |Self-Report |adult |10-20 minutes | |- | colspan="4" style="font-size:110%; text-align:center;" |'''For Children and Adolescents Specifically''' | |- |[https://www.reactionindex.com/index.php/ UCLA PTSD Reaction Index for DSM-5] |Clinician Administered |child, school age, adolescents |20-30 minutes |[https://www.dellchildrens.net/wp-content/uploads/sites/60/2019/08/UCLA-PTSD-RI-DSM-5.pdf PDF] |- |CPSS (Children's PTSD Symptom Scale) |Self-Report |child |10-20 minutes |[https://www.aacap.org/App_Themes/AACAP/docs/resource_centers/resources/misc/child_ptsd_symptom_scale.pdf PDF] |- |Young Child PTSD Checklist (YCPC) |Parent Report |child |13 items |[https://medicine.tulane.edu/sites/g/files/rdw761/f/YCPC_v5_23_14.pdf PDF] |} === Interpreting PTSD screening measure scores === * For information on interpreting screening measure scores, click [[Evidence based assessment/Prediction phase#Interpreting screening measure scores|here.]] * Also see the page on [https://en.wikipedia.org/wiki/Likelihood_ratios_in_diagnostic_testing likelihood ratios in diagnostic testing] for more information ==[[Evidence based assessment/Prescription phase|'''Prescription phase''']]== ===Gold standard diagnostic interviews=== * For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews click here.] ===Recommended diagnostic interviews for PTSD=== {| class="wikitable sortable" border="1" ! colspan="4" |Diagnostic instruments for PTSD ! |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time !Where to Access |- | [https://www.ptsd.va.gov/professional/assessment/adult-int/caps.asp CAPS-5 (Clinician Administered PTSD Scale)] | Clinician Administered Interview | adult | 40-60 minutes |[https://www.ptsd.va.gov/professional/assessment/ncptsd-instrument-request-form.asp Assessment request form] |- |PTSD Symptom Scale Interview (PSS-I-5) |Clinician Administered Interview |adult and child version available |24 items |[http://www.advanced-counseling.com/dl/PSSI-5.pdf PDF] |- | colspan="4" style="font-size:110%; text-align:center;" |'''For Children and Adolescents Specifically''' | |- | [https://www.ptsd.va.gov/professional/assessment/child/caps-ca.asp CAPS-CA-5 (Clinician-Administered PTSD Scale for DSM-5 - Child/Adolescent Version)] |Clinician Administered Interview |child |30 items |[https://www.ptsd.va.gov/professional/assessment/ncptsd-instrument-request-form.asp Assessment request form] |- | Children’s PTSD Inventory (CPTSD-I) |Diagnostic Interview | 6-18 years | 50 items |Not Free |} ===Severity interviews for PTSD=== {| class="wikitable sortable" border="1" |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time !Where to Access |- | [https://www.kennedykrieger.org/sites/default/files/library/documents/faculty/ksads-dsm-5-screener.pdf Schedule for Affective Disorders and Schizophrenia for School Age Children (K-SADS)] | Diagnostic Interview | 6-18 years | 18 PTSD items | |- | Anxiety Disorders Interview Schedule, Child Version (ADIS-C) | Diagnostic Interview | 7-17 years | 26 PTSD items |Not free |- | Diagnostic Infant and Preschool Assessment (DIPA) |Diagnostic Interview | Age 6 and younger | 46 PTSD items |[https://medicine.tulane.edu/sites/g/files/rdw761/f/DIPA-2017-2-14.pdf PDF] |} ==[[Evidence based assessment/Process phase|'''Process phase''']]== The following section contains a brief overview of treatment options for PTSD and list of process and outcome measures for PTSD. The section includes benchmarks based on published norms for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the [[Evidence based assessment/Process phase|process phase]] of assessment. For more information of differences between process and outcome measures, see the page on the [[Evidence based assessment/Process phase|process phase of assessment]]. === Process measures === * Information coming soon === Outcome and severity measures === This table includes clinically significant benchmarks for PTSD specific outcome measures * Information on how to interpret this table can be [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase found here]. * Additionally, these [[Evidence based assessment/Vignettes|vignettes]] might be helpful resources for understanding appropriate adaptation of outcome measures in practice. * ''<u>For clinically significant change benchmarks for the CBCL, YSR, and TRF total, externalizing, internalizing, and attention benchmarks,</u>'' [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase&wteswitched=1#Clinically_significant_change_benchmarks_for_widely-used_outcome_measures see here.] {| class="wikitable sortable" border="1" | colspan="7" |'''Clinically significant change benchmarks with common instruments for PTSD''' |- | colspan="7" style="font-size:110%; text-align:center;" span |<b> Benchmarks Based on Published Norms</b> |- | rowspan="2" style="text-align:center;font-size:130%;" |<b> Measure</b> | colspan="3" style="text-align:center;font-size:130%" width="300" |<b> Cut-off scores</b> | colspan="3" style="text-align:center;font-size:120%" |<b> Critical Change <br> (unstandardized scores)</b> |- | style="text-align:center;font-size:110%" |<b> A</b> | style="text-align:center;font-size:110%" |<b> B</b> | style="text-align:center;font-size:110%" |<b> C</b> | style="text-align:center;font-size:110%" |<b> 95%</b> | style="text-align:center;font-size:110%" |<b> 90%</b> | style="text-align:center;font-size:110%" |<b> SE_difference</b> |- | rowspan="1" style="text-align:center;" | Primary Care PTSD Screen | style="text-align:center;" | 1.0 | style="text-align:center;" | 3.1 | style="text-align:center;" | 2.0 | style="text-align:center;" | 1.0 | style="text-align:center;" | .8 | style="text-align:center;" | .5 |- | rowspan="1" style="text-align:center;" | PTSD Checklist Scores | style="text-align:center;" | 28.8 | style="text-align:center;" | 40.8 | style="text-align:center;" | 34.9 | style="text-align:center;" | 4.6 | style="text-align:center;" | 3.8 | style="text-align:center;" | 2.3 |- | rowspan="1" style="text-align:center;" | Clinician Administered PTSD Scale | style="text-align:center;" | 28.8 | style="text-align:center;" | 40.8 | style="text-align:center;" | 34.9 | style="text-align:center;" | 8.3 | style="text-align:center;" | 7.0 | style="text-align:center;" | 4.2 |} === Treatment === * Please refer to the Wikipedia page on [[wikipedia:Posttraumatic_stress_disorder|PTSD]] for more information on available treatment for PTSD or go to the [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/post-traumatic-stress-disorder/ Effective Child Therapy] page for for a curated resource on effective treatments for PTSD. {{collapse top| Click here for more information}} '''<big>Behavioral interventions</big>''' Recommended (have ''significant benefit'') <ref name=":0">Department of Veterans Affairs and Department of Defense. . (2010). VA/DoD clinical practice guidelines: management of post-traumatic stress. Washington, D.C.: Veterans Health Administration, Department of Defense.</ref>: # Brief Cognitive Behavioral Therapy (CBT; 4-5 sessions) #* This includes stress inoculation training, trauma-focused therapy including components of cognitive restructuring, Cognitive Processing Therapy (CPT), imaginal, virtual, and in-vivo exposure as in Prolonged Exposure psychotherapy (PE)² #* Patient education is recommended as part of psychotherapy for patients and family members # EMDR may help both acute and chronic PTSD, especially individuals who have trouble with prolonged exposure or have trouble verbalizing their trauma.<ref name=":1">Ursano, R. J., Bell, C., Eth, S., Friedman, M., Norwood, A., Pfefferbaum, B., . . . McIntyre, J. S. (2004). ''Practice guideline for the treatment of patients with acute stress disorder and posttraumatic stress disorder'': American Psychiatric Publ </ref> ## Long term gains require further study. # [https://www.ptsd.va.gov/professional/treat/txessentials/present_centered_therapy.asp Present-Centered Therapy (PCT)] is a non trauma focused treatment for PTSD and a second-line treatment for PTSD<ref>{{Cite web|url=https://www.ptsd.va.gov/professional/treat/txessentials/present_centered_therapy.asp|title=Present-Centered Therapy for PTSD - PTSD: National Center for PTSD|website=www.ptsd.va.gov|language=en|access-date=2022-08-13}}</ref>. Treatments with weaker evidence (have ''some benefit'') <ref name=":0" />: # Patient education, # Imagery rehearsal therapy, # Psychodynamic therapy, # Hypnosis, # Relaxation techniques, # and Group therapy. Treatment with ''unknown benefit'' <ref name=":0" />: # Web-based CBT ## For example Jeane Bosch participated as a study therapist in research study that compared STAIR and present-centered therapy both delivered via telehealth. STAIR stands for Skills Training in Affective and Interpersonal Regulation. It is a skill-focused treatment that was originally developed for survivors of childhood abuse to teach emotion regulation skills as well as tools to help with challenges interpersonal functioning and social relationships and decrease PTSD symptoms<ref>{{Cite web|url=https://istss.org/public-resources/trauma-blog/2015-march-(1)/clinician-s-corner-skills-training-in-affective-an|title=ISTSS - Trauma Blog|website=istss.org|access-date=2022-08-13}}</ref>.<ref>{{Citation|title=Introduction to Telehealth with Dr. Bosch|url=https://www.youtube.com/watch?v=Wn6Vewl42X8|accessdate=2022-08-13|language=en}}</ref> # Acceptance and commitment therapy, # and Dialectical Behavioral Therapy. <big>'''Medication'''</big> *SSRIs are more effective than placebo in treating PTSD.<ref name=":1" /> *There is no evidence to support a medication to prevent the development of PTSD.<ref name=":0" /> **Imipramine, propranolol, prazosin, other antidepressants, anticonvulsants, and atypical antipsychotics have ''unknown benefit.'' **Strongly recommend against the use of benzodiazepines² and typical antipsychotics since they have ''no benefit and potential harm.'' {{collapse bottom}} == '''External resources''' == === For professionals === * [http://www.som.uq.edu.au/ptsd Post Traumatic Stress Disorder Information Resource] from [http://www.uq.edu.au/ The University of Queensland School of Medicine] * [http://www.apa.org/ptsd-guideline/ APA practice parameters for assessment and treatment for PTSD (Updated 2017)] * [http://www.ptsd.va.gov/professional/index.asp Resources for professionals] from [http://www.ptsd.va.gov/index.asp VA National PTSD Center] * [https://www.integration.samhsa.gov/clinical-practice/trauma-informed SAMHSA's Trauma-Informed Care Resources and Training] * [https://www.integration.samhsa.gov/clinical-practice/trauma-informed SAMHSA's Resources on Intimate Partner Violence (IPV) for Clinicians, Patients, Families, and Organizations] === For caregivers === * [http://www.nctsn.org/sites/default/files/assets/pdfs/tips_for_parents_media_final.pdf Tips for parents on shooting media coverage] * [http://www.nctsn.org/sites/default/files/assets/pdfs/parents_guidelines_for_helping_teens_after_the_recent_attacks.pdf Parent guidelines to helping youths after a shooting] * [http://www.nctsn.org/sites/default/files/assets/pdfs/helping_teens_with_traumatic_grief_caregivers_final.pdf Caregiver tips for helping teens with traumatic grief] * [http://www.nctsn.org/sites/default/files/assets/pdfs/10things_schoolage_ctg.pdf Caregiver tips for helping school-age children with traumatic grief] *[http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/post-traumatic-stress-disorder/ EffectiveChildTherapy.Org information on PTSD] *[https://sccap53.org Society of Clinical Child and Adolescent Psychology] === For educators === * [http://www.nctsn.org/sites/default/files/assets/pdfs/pfa_for_schools_appendix_a_teachers.pdf Teacher tips for providing psychological first aid] * [http://www.nctsn.org/sites/default/files/assets/pdfs/helping_youth_after_community_violence_educators.pdf Educator tips for helping youths after a community trauma] === For public === * [https://complicatedgrief.columbia.edu/for-the-public/resources/ Resources for grief and loss] * [http://www.nctsn.org/sites/default/files/assets/pdfs/psychological_information_sheet_two_pager.pdf Psychological impacts of recent shootings] * [http://www.nctsn.org/sites/default/files/assets/pdfs/youth_journalists.pdf Tips to talking to youths about a shooting] * [http://www.nctsn.org/sites/default/files/assets/pdfs/talking_to_children_about_the_shooting.pdf Tips to talking to children about a shooting] * [http://www.nctsn.org/sites/default/files/assets/pdfs/helping_young_children_heal_crisis.pdf Helping young children heal after a crisis] * [http://www.nctsn.org/content/psychological-first-aid-schoolspfa Psychological first aid for schools] * [http://www.nctsn.org/content/psychological-first-aid Resources and manuals on psychological first aid] * [http://www.ptsd.va.gov/public/index.asp Resources for the public] from [http://www.ptsd.va.gov/index.asp VA National PTSD Center] * [https://curlie.org/Health/Mental_Health/Disorders/Anxiety/Post-traumatic_Stress Posttraumatic stress disorder] at Curlie (based on DMOZ) =='''References'''== {{collapse top|Click here for references}} {{Reflist|30em}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] {{collapse bottom}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] 8iafng95gtfuhelq7u28w3jsr9gc5wb 2419131 2419130 2022-08-25T23:38:41Z Ardenguo 2944162 /* Severity interviews for PTSD */ removed link wikitext text/x-wiki <noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{medical disclaimer}} {{:{{BASEPAGENAME}}/Sidebar}} ==[[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio"?''']]== * For background information on what assessment portfolios are, click the link in the heading above. * Want even 'more' information about this topic? There's an extended version of this page [[Evidence-based assessment/Posttraumatic stress disorder (disorder portfolio)/extended version|'''here''']]. == [[Evidence based assessment/Preparation phase|'''Preparation phase''']] == === Diagnostic criteria for post traumatic stress disorder === ===='''ICD-11 Diagnostic Criteria'''==== {{blockquotetop}} ===='''ICD-11 Criteria'''==== *Post-traumatic stress disorder (PTSD) is a syndrome that develops following exposure to an extremely threatening or horrific event or series of events that is characterized by all of the following: **1) re-experiencing the traumatic event or events in the present in the form of vivid intrusive memories, flashbacks, or nightmares, which are typically accompanied by strong and overwhelming emotions such as fear or horror and strong physical sensations, or feelings of being overwhelmed or immersed in the same intense emotions that were experienced during the traumatic event; **2) avoidance of thoughts and memories of the event or events, or avoidance of activities, situations, or people reminiscent of the event or events **3) persistent perceptions of heightened current threat, for example as indicated by hypervigilance or an enhanced startle reaction to stimuli such as unexpected noises. *The symptoms must persist for at least several weeks and cause significant impairment in personal, family, social, educational, occupational or other important areas of functioning. Additionally, ICD 11 includes a category called "Complex post-traumatic stress disorder," which is described as: *A disorder that may develop following exposure to an event or series of events of an extremely threatening or horrific nature, most commonly prolonged or repetitive events from which escape is difficult or impossible (e.g., torture, slavery, genocide campaigns, prolonged domestic violence, repeated childhood sexual or physical abuse). *The disorder is characterized by the core symptoms of PTSD; that is, all diagnostic requirements for PTSD have been met at some point during the course of the disorder. *In addition, Complex PTSD is characterized by: **1) severe and pervasive problems in affect regulation; **2) persistent beliefs about oneself as diminished, defeated or worthless, accompanied by deep and pervasive feelings of shame, guilt or failure related to the traumatic event **3) persistent difficulties in sustaining relationships and in feeling close to others. The disturbance causes significant impairment in personal, family, social, educational, occupational or other important areas of functioning. {{blockquotebottom}} ===='''Changes in DSM-5'''==== * The diagnostic criteria for post-traumatic stress disorder changed slightly from [[DSM-IV]] to [[w:Diagnostic_and_Statistical_Manual_of_Mental_Disorders#DSM-IV-TR_.282000.29|DSM-5]]. Summaries are available [http://www.dsm5.org/Documents/changes%20from%20dsm-iv-tr%20to%20dsm-5.pdf here] and [[w:DSM-5|here]]. === Developmental sensitivities === {{collapse top| Click for more information}} *Diagnostic thresholds have been lowered for children and adolescents to account for development. *Separate and additional criteria have been added for children age 6 or younger. *Child sexual abuse has been found to have a substantial effect on the development of PTSD.<ref>{{cite journal|last1=Paolucci|first1=Elizabeth ODDONE|last2=Genuis|first2=Mark L.|last3=Violato|first3=Claudio|title=A Meta-Analysis of the Published Research on the Effects of Child Sexual Abuse|journal=The Journal of Psychology|date=January 2001|volume=135|issue=1|pages=17–36|doi=10.1080/00223980109603677}}</ref> *Children with higher exposure to trauma, less social support, and other major life events are more likely to have continued PTSD symptoms 7 months after a trauma.<ref name=":2">{{cite journal |last1=La Greca|first1=A|last2=Silverman|first2=WK|last3=Vernberg|first3=EM|last4=Prinstein|first4=MJ|title=Symptoms of posttraumatic stress in children after Hurricane Andrew: a prospective study.|journal=Journal of consulting and clinical psychology|date=August 1996|volume=64|issue=4|pages=712-23|pmid=8803361}}</ref> 10 months after a trauma, however, only experience of a major life event remained predictive of continuing PTSD symptoms.<ref name=":2" /> *Lack of social support, specifically lack of support by a teacher, was predictive of higher PTSD symptoms among children who had gone through an environmental trauma.<ref name=":2" /> *Children who reported using blame and anger as strategies for coping had higher levels of PTSD symptoms 10 months after a trauma.<ref name=":2" /> *Negative affect in children before a traumatic event was predictive of development of PTSD symptoms after a traumatic event.<ref>{{cite journal|last1=Weems|first1=CF|last2=Pina|first2=AA|last3=Costa|first3=NM|last4=Watts|first4=SE|last5=Taylor|first5=LK|last6=Cannon|first6=MF|title=Predisaster trait anxiety and negative affect predict posttraumatic stress in youths after hurricane Katrina.|journal=Journal of consulting and clinical psychology|date=February 2007|volume=75|issue=1|pages=154-9|doi=10.1037/0022-006X.75.1.154|pmid=17295574}}</ref> [[wikipedia:Posttraumatic_stress_disorder|Posttraumatic stress disorder]] is now more sensitive to development in that diagnostic thresholds have been lowered for children and adolescents. Furthermore, separate and additional criteria have been added for children age 6 years of age or younger. {{collapse bottom}} === Base rates of PTSD in different clinical settings and populations === This section describes the demographic settings of the populations sampled, base rates of PTSD diagnoses, country/region sampled, and the diagnostic methods that were used. Using this information, clinicians will be able to anchor the most appropriate rate of PTSD that they are likely to see in their clinical practice. * '''''To see prevalence rates across multiple disorders,''''' [[Evidence based assessment/Preparation phase#Base rates for transdiagnostic comparison|'''''click here.''''']] {| class="wikitable sortable" border="1" |- ! Demography ! Setting ! Base Rate ! Diagnostic Method |- | United States, nationally representative, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Kessler|first=Ronald C.|last2=Berglund|first2=Patricia|last3=Demler|first3=Olga|last4=Jin|first4=Robert|last5=Merikangas|first5=Kathleen R.|last6=Walters|first6=Ellen E.|date=2005-06-01|title=Lifetime Prevalence and Age-of-Onset Distributions of DSM-IV Disorders in the National Comorbidity Survey Replication|url=http://archpsyc.jamanetwork.com/article.aspx?doi=10.1001/archpsyc.62.6.593|journal=Archives of General Psychiatry|language=en|volume=62|issue=6|doi=10.1001/archpsyc.62.6.593|issn=0003-990X}}</ref> | 6.8% | National Comorbidity Survey - Replication |- | Netherlands, nationally representative, age 18-80 | Non-clinical: Population based<ref>{{Cite journal|last=de Vries|first=Giel-Jan|last2=Olff|first2=Miranda|date=2009-08-01|title=The lifetime prevalence of traumatic events and posttraumatic stress disorder in the Netherlands|url=http://onlinelibrary.wiley.com/doi/10.1002/jts.20429/abstract|journal=Journal of Traumatic Stress|language=en|volume=22|issue=4|pages=259–267|doi=10.1002/jts.20429|issn=1573-6598}}</ref> | 7.4% | Composite International Diagnostic Interview (CIDI) |- | United States, nationally representative, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Pietrzak|first=Robert H.|last2=Goldstein|first2=Risë B.|last3=Southwick|first3=Steven M.|last4=Grant|first4=Bridget F.|title=Prevalence and Axis I comorbidity of full and partial posttraumatic stress disorder in the United States: Results from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions|url=http://linkinghub.elsevier.com/retrieve/pii/S0887618510002288|journal=Journal of Anxiety Disorders|volume=25|issue=3|pages=456–465|doi=10.1016/j.janxdis.2010.11.010}}</ref> | 6.4% | Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions |- | Northern Ireland, representative sample, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Bunting|first=Brendan P.|last2=Ferry|first2=Finola R.|last3=Murphy|first3=Samuel D.|last4=O'Neill|first4=Siobhan M.|last5=Bolton|first5=David|date=2013-02-01|title=Trauma Associated With Civil Conflict and Posttraumatic Stress Disorder: Evidence From the Northern Ireland Study of Health and Stress|url=http://onlinelibrary.wiley.com/doi/10.1002/jts.21766/abstract|journal=Journal of Traumatic Stress|language=en|volume=26|issue=1|pages=134–141|doi=10.1002/jts.21766|issn=1573-6598}}</ref> | 8.8% | Northern Ireland Study of Health and Stress |- | South Africa, nationally representative sample, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Atwoli|first=Lukoye|last2=Stein|first2=Dan J.|last3=Williams|first3=David R.|last4=Mclaughlin|first4=Katie A.|last5=Petukhova|first5=Maria|last6=Kessler|first6=Ronald C.|last7=Koenen|first7=Karestan C.|date=2013-07-03|title=Trauma and posttraumatic stress disorder in South Africa: analysis from the South African Stress and Health Study|url=https://doi.org/10.1186/1471-244X-13-182|journal=BMC Psychiatry|volume=13|pages=182|doi=10.1186/1471-244x-13-182|issn=1471-244X}}</ref> | 2.3% | South African Stress and Health Study, using the Composite International Diagnostic Interview (CIDI) |- | U.S. Army and Marine Soldiers Deployed to Iraq and Afghanistan | U.S. Service Members<ref>{{Cite journal|last=Hoge|first=Charles W.|last2=Castro|first2=Carl A.|last3=Messer|first3=Stephen C.|last4=McGurk|first4=Dennis|last5=Cotting|first5=Dave I.|last6=Koffman|first6=Robert L.|date=2004-07-01|title=Combat Duty in Iraq and Afghanistan, Mental Health Problems, and Barriers to Care|url=http://dx.doi.org/10.1056/NEJMoa040603|journal=New England Journal of Medicine|volume=351|issue=1|pages=13–22|doi=10.1056/nejmoa040603|issn=0028-4793|pmid=15229303}}</ref> |11.5% - 19.5% ♦ | PTSD Checklist |- |United States, nationally representative, ages 13-18 |Non-clinical: Population based<ref>{{Cite journal|last=Merikangas|first=Kathleen Ries|last2=He|first2=Jian-ping|last3=Burstein|first3=Marcy|last4=Swanson|first4=Sonja A.|last5=Avenevoli|first5=Shelli|last6=Cui|first6=Lihong|last7=Benjet|first7=Corina|last8=Georgiades|first8=Katholiki|last9=Swendsen|first9=Joel|title=Lifetime Prevalence of Mental Disorders in U.S. Adolescents: Results from the National Comorbidity Survey Replication–Adolescent Supplement (NCS-A)|url=https://doi.org/10.1016/j.jaac.2010.05.017|journal=Journal of the American Academy of Child & Adolescent Psychiatry|volume=49|issue=10|pages=980–989|doi=10.1016/j.jaac.2010.05.017}}</ref> |5.0% |National Comorbidity Survey Replication—Adolescent Supplement (NCS-A) |} ♦ '''Note''': These rates were using broad PTSD Checklist scoring criteria of being scored positive if subjects reported at least one intrusion symptom, three avoidance symptoms, and two hyperarousal symptom that were categorized as at the moderate level. The 11.5% is for soldiers returning from deployment in Iraq, 19.5% is for soldiers returning from Afghanistan. Another common practice is to use a strict cutoff of 50 on the PCL, above which someone screens positive for PTSD. With this cutoff, rates are 6.2% and 12.9% for Service Members returned from Afghanistan and Iraqi, respectively. ==[[Evidence based assessment/Prediction phase|'''Prediction phase''']]== === Psychometric properties of screening for PTSD === The following section contains a list of screening and diagnostic instruments for PTSD. The section includes administration information, psychometric data, and PDFs or links to the screenings. * Screenings are used as part of the [[Evidence based assessment/Prediction phase|prediction phase]] of assessment; for more information on interpretation of this data, or how screenings fit in to the assessment process, click [[Evidence based assessment/Prediction phase|here.]] * '''''For a list of more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Psychometric_properties_of_common_screening_instruments click here.]''''' {| class="wikitable" |- ! Measure !Format (Reporter) !Age Range !Administration/ Completion Time !Where to Access |- |[https://www.ptsd.va.gov/professional/assessment/adult-sr/ptsd-checklist.asp PCL-5 (PTSD Checklist for DSM-5)] |Self-Report |adult |5-10 minutes |[https://www.ptsd.va.gov/professional/assessment/documents/PCL5_Standard_form.PDFPDF PDF] |- |PDS (Post-traumatic Diagnosis Scale) |Self-Report |adult |10-20 minutes | |- | colspan="4" style="font-size:110%; text-align:center;" |'''For Children and Adolescents Specifically''' | |- |[https://www.reactionindex.com/index.php/ UCLA PTSD Reaction Index for DSM-5] |Clinician Administered |child, school age, adolescents |20-30 minutes |[https://www.dellchildrens.net/wp-content/uploads/sites/60/2019/08/UCLA-PTSD-RI-DSM-5.pdf PDF] |- |CPSS (Children's PTSD Symptom Scale) |Self-Report |child |10-20 minutes |[https://www.aacap.org/App_Themes/AACAP/docs/resource_centers/resources/misc/child_ptsd_symptom_scale.pdf PDF] |- |Young Child PTSD Checklist (YCPC) |Parent Report |child |13 items |[https://medicine.tulane.edu/sites/g/files/rdw761/f/YCPC_v5_23_14.pdf PDF] |} === Interpreting PTSD screening measure scores === * For information on interpreting screening measure scores, click [[Evidence based assessment/Prediction phase#Interpreting screening measure scores|here.]] * Also see the page on [https://en.wikipedia.org/wiki/Likelihood_ratios_in_diagnostic_testing likelihood ratios in diagnostic testing] for more information ==[[Evidence based assessment/Prescription phase|'''Prescription phase''']]== ===Gold standard diagnostic interviews=== * For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews click here.] ===Recommended diagnostic interviews for PTSD=== {| class="wikitable sortable" border="1" ! colspan="4" |Diagnostic instruments for PTSD ! |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time !Where to Access |- | [https://www.ptsd.va.gov/professional/assessment/adult-int/caps.asp CAPS-5 (Clinician Administered PTSD Scale)] | Clinician Administered Interview | adult | 40-60 minutes |[https://www.ptsd.va.gov/professional/assessment/ncptsd-instrument-request-form.asp Assessment request form] |- |PTSD Symptom Scale Interview (PSS-I-5) |Clinician Administered Interview |adult and child version available |24 items |[http://www.advanced-counseling.com/dl/PSSI-5.pdf PDF] |- | colspan="4" style="font-size:110%; text-align:center;" |'''For Children and Adolescents Specifically''' | |- | [https://www.ptsd.va.gov/professional/assessment/child/caps-ca.asp CAPS-CA-5 (Clinician-Administered PTSD Scale for DSM-5 - Child/Adolescent Version)] |Clinician Administered Interview |child |30 items |[https://www.ptsd.va.gov/professional/assessment/ncptsd-instrument-request-form.asp Assessment request form] |- | Children’s PTSD Inventory (CPTSD-I) |Diagnostic Interview | 6-18 years | 50 items |Not Free |} ===Severity interviews for PTSD=== {| class="wikitable sortable" border="1" |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time !Where to Access |- | Schedule for Affective Disorders and Schizophrenia for School Age Children (K-SADS) | Diagnostic Interview | 6-18 years | 18 PTSD items | |- | Anxiety Disorders Interview Schedule, Child Version (ADIS-C) | Diagnostic Interview | 7-17 years | 26 PTSD items |Not free |- | Diagnostic Infant and Preschool Assessment (DIPA) |Diagnostic Interview | Age 6 and younger | 46 PTSD items |[https://medicine.tulane.edu/sites/g/files/rdw761/f/DIPA-2017-2-14.pdf PDF] |} ==[[Evidence based assessment/Process phase|'''Process phase''']]== The following section contains a brief overview of treatment options for PTSD and list of process and outcome measures for PTSD. The section includes benchmarks based on published norms for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the [[Evidence based assessment/Process phase|process phase]] of assessment. For more information of differences between process and outcome measures, see the page on the [[Evidence based assessment/Process phase|process phase of assessment]]. === Process measures === * Information coming soon === Outcome and severity measures === This table includes clinically significant benchmarks for PTSD specific outcome measures * Information on how to interpret this table can be [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase found here]. * Additionally, these [[Evidence based assessment/Vignettes|vignettes]] might be helpful resources for understanding appropriate adaptation of outcome measures in practice. * ''<u>For clinically significant change benchmarks for the CBCL, YSR, and TRF total, externalizing, internalizing, and attention benchmarks,</u>'' [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase&wteswitched=1#Clinically_significant_change_benchmarks_for_widely-used_outcome_measures see here.] {| class="wikitable sortable" border="1" | colspan="7" |'''Clinically significant change benchmarks with common instruments for PTSD''' |- | colspan="7" style="font-size:110%; text-align:center;" span |<b> Benchmarks Based on Published Norms</b> |- | rowspan="2" style="text-align:center;font-size:130%;" |<b> Measure</b> | colspan="3" style="text-align:center;font-size:130%" width="300" |<b> Cut-off scores</b> | colspan="3" style="text-align:center;font-size:120%" |<b> Critical Change <br> (unstandardized scores)</b> |- | style="text-align:center;font-size:110%" |<b> A</b> | style="text-align:center;font-size:110%" |<b> B</b> | style="text-align:center;font-size:110%" |<b> C</b> | style="text-align:center;font-size:110%" |<b> 95%</b> | style="text-align:center;font-size:110%" |<b> 90%</b> | style="text-align:center;font-size:110%" |<b> SE_difference</b> |- | rowspan="1" style="text-align:center;" | Primary Care PTSD Screen | style="text-align:center;" | 1.0 | style="text-align:center;" | 3.1 | style="text-align:center;" | 2.0 | style="text-align:center;" | 1.0 | style="text-align:center;" | .8 | style="text-align:center;" | .5 |- | rowspan="1" style="text-align:center;" | PTSD Checklist Scores | style="text-align:center;" | 28.8 | style="text-align:center;" | 40.8 | style="text-align:center;" | 34.9 | style="text-align:center;" | 4.6 | style="text-align:center;" | 3.8 | style="text-align:center;" | 2.3 |- | rowspan="1" style="text-align:center;" | Clinician Administered PTSD Scale | style="text-align:center;" | 28.8 | style="text-align:center;" | 40.8 | style="text-align:center;" | 34.9 | style="text-align:center;" | 8.3 | style="text-align:center;" | 7.0 | style="text-align:center;" | 4.2 |} === Treatment === * Please refer to the Wikipedia page on [[wikipedia:Posttraumatic_stress_disorder|PTSD]] for more information on available treatment for PTSD or go to the [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/post-traumatic-stress-disorder/ Effective Child Therapy] page for for a curated resource on effective treatments for PTSD. {{collapse top| Click here for more information}} '''<big>Behavioral interventions</big>''' Recommended (have ''significant benefit'') <ref name=":0">Department of Veterans Affairs and Department of Defense. . (2010). VA/DoD clinical practice guidelines: management of post-traumatic stress. Washington, D.C.: Veterans Health Administration, Department of Defense.</ref>: # Brief Cognitive Behavioral Therapy (CBT; 4-5 sessions) #* This includes stress inoculation training, trauma-focused therapy including components of cognitive restructuring, Cognitive Processing Therapy (CPT), imaginal, virtual, and in-vivo exposure as in Prolonged Exposure psychotherapy (PE)² #* Patient education is recommended as part of psychotherapy for patients and family members # EMDR may help both acute and chronic PTSD, especially individuals who have trouble with prolonged exposure or have trouble verbalizing their trauma.<ref name=":1">Ursano, R. J., Bell, C., Eth, S., Friedman, M., Norwood, A., Pfefferbaum, B., . . . McIntyre, J. S. (2004). ''Practice guideline for the treatment of patients with acute stress disorder and posttraumatic stress disorder'': American Psychiatric Publ </ref> ## Long term gains require further study. # [https://www.ptsd.va.gov/professional/treat/txessentials/present_centered_therapy.asp Present-Centered Therapy (PCT)] is a non trauma focused treatment for PTSD and a second-line treatment for PTSD<ref>{{Cite web|url=https://www.ptsd.va.gov/professional/treat/txessentials/present_centered_therapy.asp|title=Present-Centered Therapy for PTSD - PTSD: National Center for PTSD|website=www.ptsd.va.gov|language=en|access-date=2022-08-13}}</ref>. Treatments with weaker evidence (have ''some benefit'') <ref name=":0" />: # Patient education, # Imagery rehearsal therapy, # Psychodynamic therapy, # Hypnosis, # Relaxation techniques, # and Group therapy. Treatment with ''unknown benefit'' <ref name=":0" />: # Web-based CBT ## For example Jeane Bosch participated as a study therapist in research study that compared STAIR and present-centered therapy both delivered via telehealth. STAIR stands for Skills Training in Affective and Interpersonal Regulation. It is a skill-focused treatment that was originally developed for survivors of childhood abuse to teach emotion regulation skills as well as tools to help with challenges interpersonal functioning and social relationships and decrease PTSD symptoms<ref>{{Cite web|url=https://istss.org/public-resources/trauma-blog/2015-march-(1)/clinician-s-corner-skills-training-in-affective-an|title=ISTSS - Trauma Blog|website=istss.org|access-date=2022-08-13}}</ref>.<ref>{{Citation|title=Introduction to Telehealth with Dr. Bosch|url=https://www.youtube.com/watch?v=Wn6Vewl42X8|accessdate=2022-08-13|language=en}}</ref> # Acceptance and commitment therapy, # and Dialectical Behavioral Therapy. <big>'''Medication'''</big> *SSRIs are more effective than placebo in treating PTSD.<ref name=":1" /> *There is no evidence to support a medication to prevent the development of PTSD.<ref name=":0" /> **Imipramine, propranolol, prazosin, other antidepressants, anticonvulsants, and atypical antipsychotics have ''unknown benefit.'' **Strongly recommend against the use of benzodiazepines² and typical antipsychotics since they have ''no benefit and potential harm.'' {{collapse bottom}} == '''External resources''' == === For professionals === * [http://www.som.uq.edu.au/ptsd Post Traumatic Stress Disorder Information Resource] from [http://www.uq.edu.au/ The University of Queensland School of Medicine] * [http://www.apa.org/ptsd-guideline/ APA practice parameters for assessment and treatment for PTSD (Updated 2017)] * [http://www.ptsd.va.gov/professional/index.asp Resources for professionals] from [http://www.ptsd.va.gov/index.asp VA National PTSD Center] * [https://www.integration.samhsa.gov/clinical-practice/trauma-informed SAMHSA's Trauma-Informed Care Resources and Training] * [https://www.integration.samhsa.gov/clinical-practice/trauma-informed SAMHSA's Resources on Intimate Partner Violence (IPV) for Clinicians, Patients, Families, and Organizations] === For caregivers === * [http://www.nctsn.org/sites/default/files/assets/pdfs/tips_for_parents_media_final.pdf Tips for parents on shooting media coverage] * [http://www.nctsn.org/sites/default/files/assets/pdfs/parents_guidelines_for_helping_teens_after_the_recent_attacks.pdf Parent guidelines to helping youths after a shooting] * [http://www.nctsn.org/sites/default/files/assets/pdfs/helping_teens_with_traumatic_grief_caregivers_final.pdf Caregiver tips for helping teens with traumatic grief] * [http://www.nctsn.org/sites/default/files/assets/pdfs/10things_schoolage_ctg.pdf Caregiver tips for helping school-age children with traumatic grief] *[http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/post-traumatic-stress-disorder/ EffectiveChildTherapy.Org information on PTSD] *[https://sccap53.org Society of Clinical Child and Adolescent Psychology] === For educators === * [http://www.nctsn.org/sites/default/files/assets/pdfs/pfa_for_schools_appendix_a_teachers.pdf Teacher tips for providing psychological first aid] * [http://www.nctsn.org/sites/default/files/assets/pdfs/helping_youth_after_community_violence_educators.pdf Educator tips for helping youths after a community trauma] === For public === * [https://complicatedgrief.columbia.edu/for-the-public/resources/ Resources for grief and loss] * [http://www.nctsn.org/sites/default/files/assets/pdfs/psychological_information_sheet_two_pager.pdf Psychological impacts of recent shootings] * [http://www.nctsn.org/sites/default/files/assets/pdfs/youth_journalists.pdf Tips to talking to youths about a shooting] * [http://www.nctsn.org/sites/default/files/assets/pdfs/talking_to_children_about_the_shooting.pdf Tips to talking to children about a shooting] * [http://www.nctsn.org/sites/default/files/assets/pdfs/helping_young_children_heal_crisis.pdf Helping young children heal after a crisis] * [http://www.nctsn.org/content/psychological-first-aid-schoolspfa Psychological first aid for schools] * [http://www.nctsn.org/content/psychological-first-aid Resources and manuals on psychological first aid] * [http://www.ptsd.va.gov/public/index.asp Resources for the public] from [http://www.ptsd.va.gov/index.asp VA National PTSD Center] * [https://curlie.org/Health/Mental_Health/Disorders/Anxiety/Post-traumatic_Stress Posttraumatic stress disorder] at Curlie (based on DMOZ) =='''References'''== {{collapse top|Click here for references}} {{Reflist|30em}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] {{collapse bottom}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] spj6paogpjgli3tf626qdibu06qan7v 2419132 2419131 2022-08-25T23:39:19Z Ardenguo 2944162 /* Severity interviews for PTSD */ added link wikitext text/x-wiki <noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{medical disclaimer}} {{:{{BASEPAGENAME}}/Sidebar}} ==[[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio"?''']]== * For background information on what assessment portfolios are, click the link in the heading above. * Want even 'more' information about this topic? There's an extended version of this page [[Evidence-based assessment/Posttraumatic stress disorder (disorder portfolio)/extended version|'''here''']]. == [[Evidence based assessment/Preparation phase|'''Preparation phase''']] == === Diagnostic criteria for post traumatic stress disorder === ===='''ICD-11 Diagnostic Criteria'''==== {{blockquotetop}} ===='''ICD-11 Criteria'''==== *Post-traumatic stress disorder (PTSD) is a syndrome that develops following exposure to an extremely threatening or horrific event or series of events that is characterized by all of the following: **1) re-experiencing the traumatic event or events in the present in the form of vivid intrusive memories, flashbacks, or nightmares, which are typically accompanied by strong and overwhelming emotions such as fear or horror and strong physical sensations, or feelings of being overwhelmed or immersed in the same intense emotions that were experienced during the traumatic event; **2) avoidance of thoughts and memories of the event or events, or avoidance of activities, situations, or people reminiscent of the event or events **3) persistent perceptions of heightened current threat, for example as indicated by hypervigilance or an enhanced startle reaction to stimuli such as unexpected noises. *The symptoms must persist for at least several weeks and cause significant impairment in personal, family, social, educational, occupational or other important areas of functioning. Additionally, ICD 11 includes a category called "Complex post-traumatic stress disorder," which is described as: *A disorder that may develop following exposure to an event or series of events of an extremely threatening or horrific nature, most commonly prolonged or repetitive events from which escape is difficult or impossible (e.g., torture, slavery, genocide campaigns, prolonged domestic violence, repeated childhood sexual or physical abuse). *The disorder is characterized by the core symptoms of PTSD; that is, all diagnostic requirements for PTSD have been met at some point during the course of the disorder. *In addition, Complex PTSD is characterized by: **1) severe and pervasive problems in affect regulation; **2) persistent beliefs about oneself as diminished, defeated or worthless, accompanied by deep and pervasive feelings of shame, guilt or failure related to the traumatic event **3) persistent difficulties in sustaining relationships and in feeling close to others. The disturbance causes significant impairment in personal, family, social, educational, occupational or other important areas of functioning. {{blockquotebottom}} ===='''Changes in DSM-5'''==== * The diagnostic criteria for post-traumatic stress disorder changed slightly from [[DSM-IV]] to [[w:Diagnostic_and_Statistical_Manual_of_Mental_Disorders#DSM-IV-TR_.282000.29|DSM-5]]. Summaries are available [http://www.dsm5.org/Documents/changes%20from%20dsm-iv-tr%20to%20dsm-5.pdf here] and [[w:DSM-5|here]]. === Developmental sensitivities === {{collapse top| Click for more information}} *Diagnostic thresholds have been lowered for children and adolescents to account for development. *Separate and additional criteria have been added for children age 6 or younger. *Child sexual abuse has been found to have a substantial effect on the development of PTSD.<ref>{{cite journal|last1=Paolucci|first1=Elizabeth ODDONE|last2=Genuis|first2=Mark L.|last3=Violato|first3=Claudio|title=A Meta-Analysis of the Published Research on the Effects of Child Sexual Abuse|journal=The Journal of Psychology|date=January 2001|volume=135|issue=1|pages=17–36|doi=10.1080/00223980109603677}}</ref> *Children with higher exposure to trauma, less social support, and other major life events are more likely to have continued PTSD symptoms 7 months after a trauma.<ref name=":2">{{cite journal |last1=La Greca|first1=A|last2=Silverman|first2=WK|last3=Vernberg|first3=EM|last4=Prinstein|first4=MJ|title=Symptoms of posttraumatic stress in children after Hurricane Andrew: a prospective study.|journal=Journal of consulting and clinical psychology|date=August 1996|volume=64|issue=4|pages=712-23|pmid=8803361}}</ref> 10 months after a trauma, however, only experience of a major life event remained predictive of continuing PTSD symptoms.<ref name=":2" /> *Lack of social support, specifically lack of support by a teacher, was predictive of higher PTSD symptoms among children who had gone through an environmental trauma.<ref name=":2" /> *Children who reported using blame and anger as strategies for coping had higher levels of PTSD symptoms 10 months after a trauma.<ref name=":2" /> *Negative affect in children before a traumatic event was predictive of development of PTSD symptoms after a traumatic event.<ref>{{cite journal|last1=Weems|first1=CF|last2=Pina|first2=AA|last3=Costa|first3=NM|last4=Watts|first4=SE|last5=Taylor|first5=LK|last6=Cannon|first6=MF|title=Predisaster trait anxiety and negative affect predict posttraumatic stress in youths after hurricane Katrina.|journal=Journal of consulting and clinical psychology|date=February 2007|volume=75|issue=1|pages=154-9|doi=10.1037/0022-006X.75.1.154|pmid=17295574}}</ref> [[wikipedia:Posttraumatic_stress_disorder|Posttraumatic stress disorder]] is now more sensitive to development in that diagnostic thresholds have been lowered for children and adolescents. Furthermore, separate and additional criteria have been added for children age 6 years of age or younger. {{collapse bottom}} === Base rates of PTSD in different clinical settings and populations === This section describes the demographic settings of the populations sampled, base rates of PTSD diagnoses, country/region sampled, and the diagnostic methods that were used. Using this information, clinicians will be able to anchor the most appropriate rate of PTSD that they are likely to see in their clinical practice. * '''''To see prevalence rates across multiple disorders,''''' [[Evidence based assessment/Preparation phase#Base rates for transdiagnostic comparison|'''''click here.''''']] {| class="wikitable sortable" border="1" |- ! Demography ! Setting ! Base Rate ! Diagnostic Method |- | United States, nationally representative, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Kessler|first=Ronald C.|last2=Berglund|first2=Patricia|last3=Demler|first3=Olga|last4=Jin|first4=Robert|last5=Merikangas|first5=Kathleen R.|last6=Walters|first6=Ellen E.|date=2005-06-01|title=Lifetime Prevalence and Age-of-Onset Distributions of DSM-IV Disorders in the National Comorbidity Survey Replication|url=http://archpsyc.jamanetwork.com/article.aspx?doi=10.1001/archpsyc.62.6.593|journal=Archives of General Psychiatry|language=en|volume=62|issue=6|doi=10.1001/archpsyc.62.6.593|issn=0003-990X}}</ref> | 6.8% | National Comorbidity Survey - Replication |- | Netherlands, nationally representative, age 18-80 | Non-clinical: Population based<ref>{{Cite journal|last=de Vries|first=Giel-Jan|last2=Olff|first2=Miranda|date=2009-08-01|title=The lifetime prevalence of traumatic events and posttraumatic stress disorder in the Netherlands|url=http://onlinelibrary.wiley.com/doi/10.1002/jts.20429/abstract|journal=Journal of Traumatic Stress|language=en|volume=22|issue=4|pages=259–267|doi=10.1002/jts.20429|issn=1573-6598}}</ref> | 7.4% | Composite International Diagnostic Interview (CIDI) |- | United States, nationally representative, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Pietrzak|first=Robert H.|last2=Goldstein|first2=Risë B.|last3=Southwick|first3=Steven M.|last4=Grant|first4=Bridget F.|title=Prevalence and Axis I comorbidity of full and partial posttraumatic stress disorder in the United States: Results from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions|url=http://linkinghub.elsevier.com/retrieve/pii/S0887618510002288|journal=Journal of Anxiety Disorders|volume=25|issue=3|pages=456–465|doi=10.1016/j.janxdis.2010.11.010}}</ref> | 6.4% | Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions |- | Northern Ireland, representative sample, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Bunting|first=Brendan P.|last2=Ferry|first2=Finola R.|last3=Murphy|first3=Samuel D.|last4=O'Neill|first4=Siobhan M.|last5=Bolton|first5=David|date=2013-02-01|title=Trauma Associated With Civil Conflict and Posttraumatic Stress Disorder: Evidence From the Northern Ireland Study of Health and Stress|url=http://onlinelibrary.wiley.com/doi/10.1002/jts.21766/abstract|journal=Journal of Traumatic Stress|language=en|volume=26|issue=1|pages=134–141|doi=10.1002/jts.21766|issn=1573-6598}}</ref> | 8.8% | Northern Ireland Study of Health and Stress |- | South Africa, nationally representative sample, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Atwoli|first=Lukoye|last2=Stein|first2=Dan J.|last3=Williams|first3=David R.|last4=Mclaughlin|first4=Katie A.|last5=Petukhova|first5=Maria|last6=Kessler|first6=Ronald C.|last7=Koenen|first7=Karestan C.|date=2013-07-03|title=Trauma and posttraumatic stress disorder in South Africa: analysis from the South African Stress and Health Study|url=https://doi.org/10.1186/1471-244X-13-182|journal=BMC Psychiatry|volume=13|pages=182|doi=10.1186/1471-244x-13-182|issn=1471-244X}}</ref> | 2.3% | South African Stress and Health Study, using the Composite International Diagnostic Interview (CIDI) |- | U.S. Army and Marine Soldiers Deployed to Iraq and Afghanistan | U.S. Service Members<ref>{{Cite journal|last=Hoge|first=Charles W.|last2=Castro|first2=Carl A.|last3=Messer|first3=Stephen C.|last4=McGurk|first4=Dennis|last5=Cotting|first5=Dave I.|last6=Koffman|first6=Robert L.|date=2004-07-01|title=Combat Duty in Iraq and Afghanistan, Mental Health Problems, and Barriers to Care|url=http://dx.doi.org/10.1056/NEJMoa040603|journal=New England Journal of Medicine|volume=351|issue=1|pages=13–22|doi=10.1056/nejmoa040603|issn=0028-4793|pmid=15229303}}</ref> |11.5% - 19.5% ♦ | PTSD Checklist |- |United States, nationally representative, ages 13-18 |Non-clinical: Population based<ref>{{Cite journal|last=Merikangas|first=Kathleen Ries|last2=He|first2=Jian-ping|last3=Burstein|first3=Marcy|last4=Swanson|first4=Sonja A.|last5=Avenevoli|first5=Shelli|last6=Cui|first6=Lihong|last7=Benjet|first7=Corina|last8=Georgiades|first8=Katholiki|last9=Swendsen|first9=Joel|title=Lifetime Prevalence of Mental Disorders in U.S. Adolescents: Results from the National Comorbidity Survey Replication–Adolescent Supplement (NCS-A)|url=https://doi.org/10.1016/j.jaac.2010.05.017|journal=Journal of the American Academy of Child & Adolescent Psychiatry|volume=49|issue=10|pages=980–989|doi=10.1016/j.jaac.2010.05.017}}</ref> |5.0% |National Comorbidity Survey Replication—Adolescent Supplement (NCS-A) |} ♦ '''Note''': These rates were using broad PTSD Checklist scoring criteria of being scored positive if subjects reported at least one intrusion symptom, three avoidance symptoms, and two hyperarousal symptom that were categorized as at the moderate level. The 11.5% is for soldiers returning from deployment in Iraq, 19.5% is for soldiers returning from Afghanistan. Another common practice is to use a strict cutoff of 50 on the PCL, above which someone screens positive for PTSD. With this cutoff, rates are 6.2% and 12.9% for Service Members returned from Afghanistan and Iraqi, respectively. ==[[Evidence based assessment/Prediction phase|'''Prediction phase''']]== === Psychometric properties of screening for PTSD === The following section contains a list of screening and diagnostic instruments for PTSD. The section includes administration information, psychometric data, and PDFs or links to the screenings. * Screenings are used as part of the [[Evidence based assessment/Prediction phase|prediction phase]] of assessment; for more information on interpretation of this data, or how screenings fit in to the assessment process, click [[Evidence based assessment/Prediction phase|here.]] * '''''For a list of more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Psychometric_properties_of_common_screening_instruments click here.]''''' {| class="wikitable" |- ! Measure !Format (Reporter) !Age Range !Administration/ Completion Time !Where to Access |- |[https://www.ptsd.va.gov/professional/assessment/adult-sr/ptsd-checklist.asp PCL-5 (PTSD Checklist for DSM-5)] |Self-Report |adult |5-10 minutes |[https://www.ptsd.va.gov/professional/assessment/documents/PCL5_Standard_form.PDFPDF PDF] |- |PDS (Post-traumatic Diagnosis Scale) |Self-Report |adult |10-20 minutes | |- | colspan="4" style="font-size:110%; text-align:center;" |'''For Children and Adolescents Specifically''' | |- |[https://www.reactionindex.com/index.php/ UCLA PTSD Reaction Index for DSM-5] |Clinician Administered |child, school age, adolescents |20-30 minutes |[https://www.dellchildrens.net/wp-content/uploads/sites/60/2019/08/UCLA-PTSD-RI-DSM-5.pdf PDF] |- |CPSS (Children's PTSD Symptom Scale) |Self-Report |child |10-20 minutes |[https://www.aacap.org/App_Themes/AACAP/docs/resource_centers/resources/misc/child_ptsd_symptom_scale.pdf PDF] |- |Young Child PTSD Checklist (YCPC) |Parent Report |child |13 items |[https://medicine.tulane.edu/sites/g/files/rdw761/f/YCPC_v5_23_14.pdf PDF] |} === Interpreting PTSD screening measure scores === * For information on interpreting screening measure scores, click [[Evidence based assessment/Prediction phase#Interpreting screening measure scores|here.]] * Also see the page on [https://en.wikipedia.org/wiki/Likelihood_ratios_in_diagnostic_testing likelihood ratios in diagnostic testing] for more information ==[[Evidence based assessment/Prescription phase|'''Prescription phase''']]== ===Gold standard diagnostic interviews=== * For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews click here.] ===Recommended diagnostic interviews for PTSD=== {| class="wikitable sortable" border="1" ! colspan="4" |Diagnostic instruments for PTSD ! |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time !Where to Access |- | [https://www.ptsd.va.gov/professional/assessment/adult-int/caps.asp CAPS-5 (Clinician Administered PTSD Scale)] | Clinician Administered Interview | adult | 40-60 minutes |[https://www.ptsd.va.gov/professional/assessment/ncptsd-instrument-request-form.asp Assessment request form] |- |PTSD Symptom Scale Interview (PSS-I-5) |Clinician Administered Interview |adult and child version available |24 items |[http://www.advanced-counseling.com/dl/PSSI-5.pdf PDF] |- | colspan="4" style="font-size:110%; text-align:center;" |'''For Children and Adolescents Specifically''' | |- | [https://www.ptsd.va.gov/professional/assessment/child/caps-ca.asp CAPS-CA-5 (Clinician-Administered PTSD Scale for DSM-5 - Child/Adolescent Version)] |Clinician Administered Interview |child |30 items |[https://www.ptsd.va.gov/professional/assessment/ncptsd-instrument-request-form.asp Assessment request form] |- | Children’s PTSD Inventory (CPTSD-I) |Diagnostic Interview | 6-18 years | 50 items |Not Free |} ===Severity interviews for PTSD=== {| class="wikitable sortable" border="1" |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time !Where to Access |- | Schedule for Affective Disorders and Schizophrenia for School Age Children (K-SADS) | Diagnostic Interview | 6-18 years | 18 PTSD items |[https://www.pediatricbipolar.pitt.edu/sites/default/files/KSADS_DSM_5_SCREEN_Final.pdf PDF] |- | Anxiety Disorders Interview Schedule, Child Version (ADIS-C) | Diagnostic Interview | 7-17 years | 26 PTSD items |Not free |- | Diagnostic Infant and Preschool Assessment (DIPA) |Diagnostic Interview | Age 6 and younger | 46 PTSD items |[https://medicine.tulane.edu/sites/g/files/rdw761/f/DIPA-2017-2-14.pdf PDF] |} ==[[Evidence based assessment/Process phase|'''Process phase''']]== The following section contains a brief overview of treatment options for PTSD and list of process and outcome measures for PTSD. The section includes benchmarks based on published norms for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the [[Evidence based assessment/Process phase|process phase]] of assessment. For more information of differences between process and outcome measures, see the page on the [[Evidence based assessment/Process phase|process phase of assessment]]. === Process measures === * Information coming soon === Outcome and severity measures === This table includes clinically significant benchmarks for PTSD specific outcome measures * Information on how to interpret this table can be [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase found here]. * Additionally, these [[Evidence based assessment/Vignettes|vignettes]] might be helpful resources for understanding appropriate adaptation of outcome measures in practice. * ''<u>For clinically significant change benchmarks for the CBCL, YSR, and TRF total, externalizing, internalizing, and attention benchmarks,</u>'' [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase&wteswitched=1#Clinically_significant_change_benchmarks_for_widely-used_outcome_measures see here.] {| class="wikitable sortable" border="1" | colspan="7" |'''Clinically significant change benchmarks with common instruments for PTSD''' |- | colspan="7" style="font-size:110%; text-align:center;" span |<b> Benchmarks Based on Published Norms</b> |- | rowspan="2" style="text-align:center;font-size:130%;" |<b> Measure</b> | colspan="3" style="text-align:center;font-size:130%" width="300" |<b> Cut-off scores</b> | colspan="3" style="text-align:center;font-size:120%" |<b> Critical Change <br> (unstandardized scores)</b> |- | style="text-align:center;font-size:110%" |<b> A</b> | style="text-align:center;font-size:110%" |<b> B</b> | style="text-align:center;font-size:110%" |<b> C</b> | style="text-align:center;font-size:110%" |<b> 95%</b> | style="text-align:center;font-size:110%" |<b> 90%</b> | style="text-align:center;font-size:110%" |<b> SE_difference</b> |- | rowspan="1" style="text-align:center;" | Primary Care PTSD Screen | style="text-align:center;" | 1.0 | style="text-align:center;" | 3.1 | style="text-align:center;" | 2.0 | style="text-align:center;" | 1.0 | style="text-align:center;" | .8 | style="text-align:center;" | .5 |- | rowspan="1" style="text-align:center;" | PTSD Checklist Scores | style="text-align:center;" | 28.8 | style="text-align:center;" | 40.8 | style="text-align:center;" | 34.9 | style="text-align:center;" | 4.6 | style="text-align:center;" | 3.8 | style="text-align:center;" | 2.3 |- | rowspan="1" style="text-align:center;" | Clinician Administered PTSD Scale | style="text-align:center;" | 28.8 | style="text-align:center;" | 40.8 | style="text-align:center;" | 34.9 | style="text-align:center;" | 8.3 | style="text-align:center;" | 7.0 | style="text-align:center;" | 4.2 |} === Treatment === * Please refer to the Wikipedia page on [[wikipedia:Posttraumatic_stress_disorder|PTSD]] for more information on available treatment for PTSD or go to the [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/post-traumatic-stress-disorder/ Effective Child Therapy] page for for a curated resource on effective treatments for PTSD. {{collapse top| Click here for more information}} '''<big>Behavioral interventions</big>''' Recommended (have ''significant benefit'') <ref name=":0">Department of Veterans Affairs and Department of Defense. . (2010). VA/DoD clinical practice guidelines: management of post-traumatic stress. Washington, D.C.: Veterans Health Administration, Department of Defense.</ref>: # Brief Cognitive Behavioral Therapy (CBT; 4-5 sessions) #* This includes stress inoculation training, trauma-focused therapy including components of cognitive restructuring, Cognitive Processing Therapy (CPT), imaginal, virtual, and in-vivo exposure as in Prolonged Exposure psychotherapy (PE)² #* Patient education is recommended as part of psychotherapy for patients and family members # EMDR may help both acute and chronic PTSD, especially individuals who have trouble with prolonged exposure or have trouble verbalizing their trauma.<ref name=":1">Ursano, R. J., Bell, C., Eth, S., Friedman, M., Norwood, A., Pfefferbaum, B., . . . McIntyre, J. S. (2004). ''Practice guideline for the treatment of patients with acute stress disorder and posttraumatic stress disorder'': American Psychiatric Publ </ref> ## Long term gains require further study. # [https://www.ptsd.va.gov/professional/treat/txessentials/present_centered_therapy.asp Present-Centered Therapy (PCT)] is a non trauma focused treatment for PTSD and a second-line treatment for PTSD<ref>{{Cite web|url=https://www.ptsd.va.gov/professional/treat/txessentials/present_centered_therapy.asp|title=Present-Centered Therapy for PTSD - PTSD: National Center for PTSD|website=www.ptsd.va.gov|language=en|access-date=2022-08-13}}</ref>. Treatments with weaker evidence (have ''some benefit'') <ref name=":0" />: # Patient education, # Imagery rehearsal therapy, # Psychodynamic therapy, # Hypnosis, # Relaxation techniques, # and Group therapy. Treatment with ''unknown benefit'' <ref name=":0" />: # Web-based CBT ## For example Jeane Bosch participated as a study therapist in research study that compared STAIR and present-centered therapy both delivered via telehealth. STAIR stands for Skills Training in Affective and Interpersonal Regulation. It is a skill-focused treatment that was originally developed for survivors of childhood abuse to teach emotion regulation skills as well as tools to help with challenges interpersonal functioning and social relationships and decrease PTSD symptoms<ref>{{Cite web|url=https://istss.org/public-resources/trauma-blog/2015-march-(1)/clinician-s-corner-skills-training-in-affective-an|title=ISTSS - Trauma Blog|website=istss.org|access-date=2022-08-13}}</ref>.<ref>{{Citation|title=Introduction to Telehealth with Dr. Bosch|url=https://www.youtube.com/watch?v=Wn6Vewl42X8|accessdate=2022-08-13|language=en}}</ref> # Acceptance and commitment therapy, # and Dialectical Behavioral Therapy. <big>'''Medication'''</big> *SSRIs are more effective than placebo in treating PTSD.<ref name=":1" /> *There is no evidence to support a medication to prevent the development of PTSD.<ref name=":0" /> **Imipramine, propranolol, prazosin, other antidepressants, anticonvulsants, and atypical antipsychotics have ''unknown benefit.'' **Strongly recommend against the use of benzodiazepines² and typical antipsychotics since they have ''no benefit and potential harm.'' {{collapse bottom}} == '''External resources''' == === For professionals === * [http://www.som.uq.edu.au/ptsd Post Traumatic Stress Disorder Information Resource] from [http://www.uq.edu.au/ The University of Queensland School of Medicine] * [http://www.apa.org/ptsd-guideline/ APA practice parameters for assessment and treatment for PTSD (Updated 2017)] * [http://www.ptsd.va.gov/professional/index.asp Resources for professionals] from [http://www.ptsd.va.gov/index.asp VA National PTSD Center] * [https://www.integration.samhsa.gov/clinical-practice/trauma-informed SAMHSA's Trauma-Informed Care Resources and Training] * [https://www.integration.samhsa.gov/clinical-practice/trauma-informed SAMHSA's Resources on Intimate Partner Violence (IPV) for Clinicians, Patients, Families, and Organizations] === For caregivers === * [http://www.nctsn.org/sites/default/files/assets/pdfs/tips_for_parents_media_final.pdf Tips for parents on shooting media coverage] * [http://www.nctsn.org/sites/default/files/assets/pdfs/parents_guidelines_for_helping_teens_after_the_recent_attacks.pdf Parent guidelines to helping youths after a shooting] * [http://www.nctsn.org/sites/default/files/assets/pdfs/helping_teens_with_traumatic_grief_caregivers_final.pdf Caregiver tips for helping teens with traumatic grief] * [http://www.nctsn.org/sites/default/files/assets/pdfs/10things_schoolage_ctg.pdf Caregiver tips for helping school-age children with traumatic grief] *[http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/post-traumatic-stress-disorder/ EffectiveChildTherapy.Org information on PTSD] *[https://sccap53.org Society of Clinical Child and Adolescent Psychology] === For educators === * [http://www.nctsn.org/sites/default/files/assets/pdfs/pfa_for_schools_appendix_a_teachers.pdf Teacher tips for providing psychological first aid] * [http://www.nctsn.org/sites/default/files/assets/pdfs/helping_youth_after_community_violence_educators.pdf Educator tips for helping youths after a community trauma] === For public === * [https://complicatedgrief.columbia.edu/for-the-public/resources/ Resources for grief and loss] * [http://www.nctsn.org/sites/default/files/assets/pdfs/psychological_information_sheet_two_pager.pdf Psychological impacts of recent shootings] * [http://www.nctsn.org/sites/default/files/assets/pdfs/youth_journalists.pdf Tips to talking to youths about a shooting] * [http://www.nctsn.org/sites/default/files/assets/pdfs/talking_to_children_about_the_shooting.pdf Tips to talking to children about a shooting] * [http://www.nctsn.org/sites/default/files/assets/pdfs/helping_young_children_heal_crisis.pdf Helping young children heal after a crisis] * [http://www.nctsn.org/content/psychological-first-aid-schoolspfa Psychological first aid for schools] * [http://www.nctsn.org/content/psychological-first-aid Resources and manuals on psychological first aid] * [http://www.ptsd.va.gov/public/index.asp Resources for the public] from [http://www.ptsd.va.gov/index.asp VA National PTSD Center] * [https://curlie.org/Health/Mental_Health/Disorders/Anxiety/Post-traumatic_Stress Posttraumatic stress disorder] at Curlie (based on DMOZ) =='''References'''== {{collapse top|Click here for references}} {{Reflist|30em}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] {{collapse bottom}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] qwm658ijy2w59rne9lslgppxfz8cwsg 2419133 2419132 2022-08-25T23:42:05Z Ardenguo 2944162 /* Psychometric properties of screening for PTSD */ added how to access for PDS-5 wikitext text/x-wiki <noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{medical disclaimer}} {{:{{BASEPAGENAME}}/Sidebar}} ==[[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio"?''']]== * For background information on what assessment portfolios are, click the link in the heading above. * Want even 'more' information about this topic? There's an extended version of this page [[Evidence-based assessment/Posttraumatic stress disorder (disorder portfolio)/extended version|'''here''']]. == [[Evidence based assessment/Preparation phase|'''Preparation phase''']] == === Diagnostic criteria for post traumatic stress disorder === ===='''ICD-11 Diagnostic Criteria'''==== {{blockquotetop}} ===='''ICD-11 Criteria'''==== *Post-traumatic stress disorder (PTSD) is a syndrome that develops following exposure to an extremely threatening or horrific event or series of events that is characterized by all of the following: **1) re-experiencing the traumatic event or events in the present in the form of vivid intrusive memories, flashbacks, or nightmares, which are typically accompanied by strong and overwhelming emotions such as fear or horror and strong physical sensations, or feelings of being overwhelmed or immersed in the same intense emotions that were experienced during the traumatic event; **2) avoidance of thoughts and memories of the event or events, or avoidance of activities, situations, or people reminiscent of the event or events **3) persistent perceptions of heightened current threat, for example as indicated by hypervigilance or an enhanced startle reaction to stimuli such as unexpected noises. *The symptoms must persist for at least several weeks and cause significant impairment in personal, family, social, educational, occupational or other important areas of functioning. Additionally, ICD 11 includes a category called "Complex post-traumatic stress disorder," which is described as: *A disorder that may develop following exposure to an event or series of events of an extremely threatening or horrific nature, most commonly prolonged or repetitive events from which escape is difficult or impossible (e.g., torture, slavery, genocide campaigns, prolonged domestic violence, repeated childhood sexual or physical abuse). *The disorder is characterized by the core symptoms of PTSD; that is, all diagnostic requirements for PTSD have been met at some point during the course of the disorder. *In addition, Complex PTSD is characterized by: **1) severe and pervasive problems in affect regulation; **2) persistent beliefs about oneself as diminished, defeated or worthless, accompanied by deep and pervasive feelings of shame, guilt or failure related to the traumatic event **3) persistent difficulties in sustaining relationships and in feeling close to others. The disturbance causes significant impairment in personal, family, social, educational, occupational or other important areas of functioning. {{blockquotebottom}} ===='''Changes in DSM-5'''==== * The diagnostic criteria for post-traumatic stress disorder changed slightly from [[DSM-IV]] to [[w:Diagnostic_and_Statistical_Manual_of_Mental_Disorders#DSM-IV-TR_.282000.29|DSM-5]]. Summaries are available [http://www.dsm5.org/Documents/changes%20from%20dsm-iv-tr%20to%20dsm-5.pdf here] and [[w:DSM-5|here]]. === Developmental sensitivities === {{collapse top| Click for more information}} *Diagnostic thresholds have been lowered for children and adolescents to account for development. *Separate and additional criteria have been added for children age 6 or younger. *Child sexual abuse has been found to have a substantial effect on the development of PTSD.<ref>{{cite journal|last1=Paolucci|first1=Elizabeth ODDONE|last2=Genuis|first2=Mark L.|last3=Violato|first3=Claudio|title=A Meta-Analysis of the Published Research on the Effects of Child Sexual Abuse|journal=The Journal of Psychology|date=January 2001|volume=135|issue=1|pages=17–36|doi=10.1080/00223980109603677}}</ref> *Children with higher exposure to trauma, less social support, and other major life events are more likely to have continued PTSD symptoms 7 months after a trauma.<ref name=":2">{{cite journal |last1=La Greca|first1=A|last2=Silverman|first2=WK|last3=Vernberg|first3=EM|last4=Prinstein|first4=MJ|title=Symptoms of posttraumatic stress in children after Hurricane Andrew: a prospective study.|journal=Journal of consulting and clinical psychology|date=August 1996|volume=64|issue=4|pages=712-23|pmid=8803361}}</ref> 10 months after a trauma, however, only experience of a major life event remained predictive of continuing PTSD symptoms.<ref name=":2" /> *Lack of social support, specifically lack of support by a teacher, was predictive of higher PTSD symptoms among children who had gone through an environmental trauma.<ref name=":2" /> *Children who reported using blame and anger as strategies for coping had higher levels of PTSD symptoms 10 months after a trauma.<ref name=":2" /> *Negative affect in children before a traumatic event was predictive of development of PTSD symptoms after a traumatic event.<ref>{{cite journal|last1=Weems|first1=CF|last2=Pina|first2=AA|last3=Costa|first3=NM|last4=Watts|first4=SE|last5=Taylor|first5=LK|last6=Cannon|first6=MF|title=Predisaster trait anxiety and negative affect predict posttraumatic stress in youths after hurricane Katrina.|journal=Journal of consulting and clinical psychology|date=February 2007|volume=75|issue=1|pages=154-9|doi=10.1037/0022-006X.75.1.154|pmid=17295574}}</ref> [[wikipedia:Posttraumatic_stress_disorder|Posttraumatic stress disorder]] is now more sensitive to development in that diagnostic thresholds have been lowered for children and adolescents. Furthermore, separate and additional criteria have been added for children age 6 years of age or younger. {{collapse bottom}} === Base rates of PTSD in different clinical settings and populations === This section describes the demographic settings of the populations sampled, base rates of PTSD diagnoses, country/region sampled, and the diagnostic methods that were used. Using this information, clinicians will be able to anchor the most appropriate rate of PTSD that they are likely to see in their clinical practice. * '''''To see prevalence rates across multiple disorders,''''' [[Evidence based assessment/Preparation phase#Base rates for transdiagnostic comparison|'''''click here.''''']] {| class="wikitable sortable" border="1" |- ! Demography ! Setting ! Base Rate ! Diagnostic Method |- | United States, nationally representative, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Kessler|first=Ronald C.|last2=Berglund|first2=Patricia|last3=Demler|first3=Olga|last4=Jin|first4=Robert|last5=Merikangas|first5=Kathleen R.|last6=Walters|first6=Ellen E.|date=2005-06-01|title=Lifetime Prevalence and Age-of-Onset Distributions of DSM-IV Disorders in the National Comorbidity Survey Replication|url=http://archpsyc.jamanetwork.com/article.aspx?doi=10.1001/archpsyc.62.6.593|journal=Archives of General Psychiatry|language=en|volume=62|issue=6|doi=10.1001/archpsyc.62.6.593|issn=0003-990X}}</ref> | 6.8% | National Comorbidity Survey - Replication |- | Netherlands, nationally representative, age 18-80 | Non-clinical: Population based<ref>{{Cite journal|last=de Vries|first=Giel-Jan|last2=Olff|first2=Miranda|date=2009-08-01|title=The lifetime prevalence of traumatic events and posttraumatic stress disorder in the Netherlands|url=http://onlinelibrary.wiley.com/doi/10.1002/jts.20429/abstract|journal=Journal of Traumatic Stress|language=en|volume=22|issue=4|pages=259–267|doi=10.1002/jts.20429|issn=1573-6598}}</ref> | 7.4% | Composite International Diagnostic Interview (CIDI) |- | United States, nationally representative, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Pietrzak|first=Robert H.|last2=Goldstein|first2=Risë B.|last3=Southwick|first3=Steven M.|last4=Grant|first4=Bridget F.|title=Prevalence and Axis I comorbidity of full and partial posttraumatic stress disorder in the United States: Results from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions|url=http://linkinghub.elsevier.com/retrieve/pii/S0887618510002288|journal=Journal of Anxiety Disorders|volume=25|issue=3|pages=456–465|doi=10.1016/j.janxdis.2010.11.010}}</ref> | 6.4% | Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions |- | Northern Ireland, representative sample, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Bunting|first=Brendan P.|last2=Ferry|first2=Finola R.|last3=Murphy|first3=Samuel D.|last4=O'Neill|first4=Siobhan M.|last5=Bolton|first5=David|date=2013-02-01|title=Trauma Associated With Civil Conflict and Posttraumatic Stress Disorder: Evidence From the Northern Ireland Study of Health and Stress|url=http://onlinelibrary.wiley.com/doi/10.1002/jts.21766/abstract|journal=Journal of Traumatic Stress|language=en|volume=26|issue=1|pages=134–141|doi=10.1002/jts.21766|issn=1573-6598}}</ref> | 8.8% | Northern Ireland Study of Health and Stress |- | South Africa, nationally representative sample, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Atwoli|first=Lukoye|last2=Stein|first2=Dan J.|last3=Williams|first3=David R.|last4=Mclaughlin|first4=Katie A.|last5=Petukhova|first5=Maria|last6=Kessler|first6=Ronald C.|last7=Koenen|first7=Karestan C.|date=2013-07-03|title=Trauma and posttraumatic stress disorder in South Africa: analysis from the South African Stress and Health Study|url=https://doi.org/10.1186/1471-244X-13-182|journal=BMC Psychiatry|volume=13|pages=182|doi=10.1186/1471-244x-13-182|issn=1471-244X}}</ref> | 2.3% | South African Stress and Health Study, using the Composite International Diagnostic Interview (CIDI) |- | U.S. Army and Marine Soldiers Deployed to Iraq and Afghanistan | U.S. Service Members<ref>{{Cite journal|last=Hoge|first=Charles W.|last2=Castro|first2=Carl A.|last3=Messer|first3=Stephen C.|last4=McGurk|first4=Dennis|last5=Cotting|first5=Dave I.|last6=Koffman|first6=Robert L.|date=2004-07-01|title=Combat Duty in Iraq and Afghanistan, Mental Health Problems, and Barriers to Care|url=http://dx.doi.org/10.1056/NEJMoa040603|journal=New England Journal of Medicine|volume=351|issue=1|pages=13–22|doi=10.1056/nejmoa040603|issn=0028-4793|pmid=15229303}}</ref> |11.5% - 19.5% ♦ | PTSD Checklist |- |United States, nationally representative, ages 13-18 |Non-clinical: Population based<ref>{{Cite journal|last=Merikangas|first=Kathleen Ries|last2=He|first2=Jian-ping|last3=Burstein|first3=Marcy|last4=Swanson|first4=Sonja A.|last5=Avenevoli|first5=Shelli|last6=Cui|first6=Lihong|last7=Benjet|first7=Corina|last8=Georgiades|first8=Katholiki|last9=Swendsen|first9=Joel|title=Lifetime Prevalence of Mental Disorders in U.S. Adolescents: Results from the National Comorbidity Survey Replication–Adolescent Supplement (NCS-A)|url=https://doi.org/10.1016/j.jaac.2010.05.017|journal=Journal of the American Academy of Child & Adolescent Psychiatry|volume=49|issue=10|pages=980–989|doi=10.1016/j.jaac.2010.05.017}}</ref> |5.0% |National Comorbidity Survey Replication—Adolescent Supplement (NCS-A) |} ♦ '''Note''': These rates were using broad PTSD Checklist scoring criteria of being scored positive if subjects reported at least one intrusion symptom, three avoidance symptoms, and two hyperarousal symptom that were categorized as at the moderate level. The 11.5% is for soldiers returning from deployment in Iraq, 19.5% is for soldiers returning from Afghanistan. Another common practice is to use a strict cutoff of 50 on the PCL, above which someone screens positive for PTSD. With this cutoff, rates are 6.2% and 12.9% for Service Members returned from Afghanistan and Iraqi, respectively. ==[[Evidence based assessment/Prediction phase|'''Prediction phase''']]== === Psychometric properties of screening for PTSD === The following section contains a list of screening and diagnostic instruments for PTSD. The section includes administration information, psychometric data, and PDFs or links to the screenings. * Screenings are used as part of the [[Evidence based assessment/Prediction phase|prediction phase]] of assessment; for more information on interpretation of this data, or how screenings fit in to the assessment process, click [[Evidence based assessment/Prediction phase|here.]] * '''''For a list of more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Psychometric_properties_of_common_screening_instruments click here.]''''' {| class="wikitable" |- ! Measure !Format (Reporter) !Age Range !Administration/ Completion Time !Where to Access |- |[https://www.ptsd.va.gov/professional/assessment/adult-sr/ptsd-checklist.asp PCL-5 (PTSD Checklist for DSM-5)] |Self-Report |adult |5-10 minutes |[https://www.ptsd.va.gov/professional/assessment/documents/PCL5_Standard_form.PDFPDF PDF] |- |PDS-5 (Post-traumatic Diagnosis Scale) |Self-Report |adult |10-20 minutes |[https://www.ptsd.va.gov/professional/assessment/adult-sr/pds.asp How to request] |- | colspan="4" style="font-size:110%; text-align:center;" |'''For Children and Adolescents Specifically''' | |- |[https://www.reactionindex.com/index.php/ UCLA PTSD Reaction Index for DSM-5] |Clinician Administered |child, school age, adolescents |20-30 minutes |[https://www.dellchildrens.net/wp-content/uploads/sites/60/2019/08/UCLA-PTSD-RI-DSM-5.pdf PDF] |- |CPSS (Children's PTSD Symptom Scale) |Self-Report |child |10-20 minutes |[https://www.aacap.org/App_Themes/AACAP/docs/resource_centers/resources/misc/child_ptsd_symptom_scale.pdf PDF] |- |Young Child PTSD Checklist (YCPC) |Parent Report |child |13 items |[https://medicine.tulane.edu/sites/g/files/rdw761/f/YCPC_v5_23_14.pdf PDF] |} === Interpreting PTSD screening measure scores === * For information on interpreting screening measure scores, click [[Evidence based assessment/Prediction phase#Interpreting screening measure scores|here.]] * Also see the page on [https://en.wikipedia.org/wiki/Likelihood_ratios_in_diagnostic_testing likelihood ratios in diagnostic testing] for more information ==[[Evidence based assessment/Prescription phase|'''Prescription phase''']]== ===Gold standard diagnostic interviews=== * For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews click here.] ===Recommended diagnostic interviews for PTSD=== {| class="wikitable sortable" border="1" ! colspan="4" |Diagnostic instruments for PTSD ! |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time !Where to Access |- | [https://www.ptsd.va.gov/professional/assessment/adult-int/caps.asp CAPS-5 (Clinician Administered PTSD Scale)] | Clinician Administered Interview | adult | 40-60 minutes |[https://www.ptsd.va.gov/professional/assessment/ncptsd-instrument-request-form.asp Assessment request form] |- |PTSD Symptom Scale Interview (PSS-I-5) |Clinician Administered Interview |adult and child version available |24 items |[http://www.advanced-counseling.com/dl/PSSI-5.pdf PDF] |- | colspan="4" style="font-size:110%; text-align:center;" |'''For Children and Adolescents Specifically''' | |- | [https://www.ptsd.va.gov/professional/assessment/child/caps-ca.asp CAPS-CA-5 (Clinician-Administered PTSD Scale for DSM-5 - Child/Adolescent Version)] |Clinician Administered Interview |child |30 items |[https://www.ptsd.va.gov/professional/assessment/ncptsd-instrument-request-form.asp Assessment request form] |- | Children’s PTSD Inventory (CPTSD-I) |Diagnostic Interview | 6-18 years | 50 items |Not Free |} ===Severity interviews for PTSD=== {| class="wikitable sortable" border="1" |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time !Where to Access |- | Schedule for Affective Disorders and Schizophrenia for School Age Children (K-SADS) | Diagnostic Interview | 6-18 years | 18 PTSD items |[https://www.pediatricbipolar.pitt.edu/sites/default/files/KSADS_DSM_5_SCREEN_Final.pdf PDF] |- | Anxiety Disorders Interview Schedule, Child Version (ADIS-C) | Diagnostic Interview | 7-17 years | 26 PTSD items |Not free |- | Diagnostic Infant and Preschool Assessment (DIPA) |Diagnostic Interview | Age 6 and younger | 46 PTSD items |[https://medicine.tulane.edu/sites/g/files/rdw761/f/DIPA-2017-2-14.pdf PDF] |} ==[[Evidence based assessment/Process phase|'''Process phase''']]== The following section contains a brief overview of treatment options for PTSD and list of process and outcome measures for PTSD. The section includes benchmarks based on published norms for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the [[Evidence based assessment/Process phase|process phase]] of assessment. For more information of differences between process and outcome measures, see the page on the [[Evidence based assessment/Process phase|process phase of assessment]]. === Process measures === * Information coming soon === Outcome and severity measures === This table includes clinically significant benchmarks for PTSD specific outcome measures * Information on how to interpret this table can be [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase found here]. * Additionally, these [[Evidence based assessment/Vignettes|vignettes]] might be helpful resources for understanding appropriate adaptation of outcome measures in practice. * ''<u>For clinically significant change benchmarks for the CBCL, YSR, and TRF total, externalizing, internalizing, and attention benchmarks,</u>'' [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase&wteswitched=1#Clinically_significant_change_benchmarks_for_widely-used_outcome_measures see here.] {| class="wikitable sortable" border="1" | colspan="7" |'''Clinically significant change benchmarks with common instruments for PTSD''' |- | colspan="7" style="font-size:110%; text-align:center;" span |<b> Benchmarks Based on Published Norms</b> |- | rowspan="2" style="text-align:center;font-size:130%;" |<b> Measure</b> | colspan="3" style="text-align:center;font-size:130%" width="300" |<b> Cut-off scores</b> | colspan="3" style="text-align:center;font-size:120%" |<b> Critical Change <br> (unstandardized scores)</b> |- | style="text-align:center;font-size:110%" |<b> A</b> | style="text-align:center;font-size:110%" |<b> B</b> | style="text-align:center;font-size:110%" |<b> C</b> | style="text-align:center;font-size:110%" |<b> 95%</b> | style="text-align:center;font-size:110%" |<b> 90%</b> | style="text-align:center;font-size:110%" |<b> SE_difference</b> |- | rowspan="1" style="text-align:center;" | Primary Care PTSD Screen | style="text-align:center;" | 1.0 | style="text-align:center;" | 3.1 | style="text-align:center;" | 2.0 | style="text-align:center;" | 1.0 | style="text-align:center;" | .8 | style="text-align:center;" | .5 |- | rowspan="1" style="text-align:center;" | PTSD Checklist Scores | style="text-align:center;" | 28.8 | style="text-align:center;" | 40.8 | style="text-align:center;" | 34.9 | style="text-align:center;" | 4.6 | style="text-align:center;" | 3.8 | style="text-align:center;" | 2.3 |- | rowspan="1" style="text-align:center;" | Clinician Administered PTSD Scale | style="text-align:center;" | 28.8 | style="text-align:center;" | 40.8 | style="text-align:center;" | 34.9 | style="text-align:center;" | 8.3 | style="text-align:center;" | 7.0 | style="text-align:center;" | 4.2 |} === Treatment === * Please refer to the Wikipedia page on [[wikipedia:Posttraumatic_stress_disorder|PTSD]] for more information on available treatment for PTSD or go to the [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/post-traumatic-stress-disorder/ Effective Child Therapy] page for for a curated resource on effective treatments for PTSD. {{collapse top| Click here for more information}} '''<big>Behavioral interventions</big>''' Recommended (have ''significant benefit'') <ref name=":0">Department of Veterans Affairs and Department of Defense. . (2010). VA/DoD clinical practice guidelines: management of post-traumatic stress. Washington, D.C.: Veterans Health Administration, Department of Defense.</ref>: # Brief Cognitive Behavioral Therapy (CBT; 4-5 sessions) #* This includes stress inoculation training, trauma-focused therapy including components of cognitive restructuring, Cognitive Processing Therapy (CPT), imaginal, virtual, and in-vivo exposure as in Prolonged Exposure psychotherapy (PE)² #* Patient education is recommended as part of psychotherapy for patients and family members # EMDR may help both acute and chronic PTSD, especially individuals who have trouble with prolonged exposure or have trouble verbalizing their trauma.<ref name=":1">Ursano, R. J., Bell, C., Eth, S., Friedman, M., Norwood, A., Pfefferbaum, B., . . . McIntyre, J. S. (2004). ''Practice guideline for the treatment of patients with acute stress disorder and posttraumatic stress disorder'': American Psychiatric Publ </ref> ## Long term gains require further study. # [https://www.ptsd.va.gov/professional/treat/txessentials/present_centered_therapy.asp Present-Centered Therapy (PCT)] is a non trauma focused treatment for PTSD and a second-line treatment for PTSD<ref>{{Cite web|url=https://www.ptsd.va.gov/professional/treat/txessentials/present_centered_therapy.asp|title=Present-Centered Therapy for PTSD - PTSD: National Center for PTSD|website=www.ptsd.va.gov|language=en|access-date=2022-08-13}}</ref>. Treatments with weaker evidence (have ''some benefit'') <ref name=":0" />: # Patient education, # Imagery rehearsal therapy, # Psychodynamic therapy, # Hypnosis, # Relaxation techniques, # and Group therapy. Treatment with ''unknown benefit'' <ref name=":0" />: # Web-based CBT ## For example Jeane Bosch participated as a study therapist in research study that compared STAIR and present-centered therapy both delivered via telehealth. STAIR stands for Skills Training in Affective and Interpersonal Regulation. It is a skill-focused treatment that was originally developed for survivors of childhood abuse to teach emotion regulation skills as well as tools to help with challenges interpersonal functioning and social relationships and decrease PTSD symptoms<ref>{{Cite web|url=https://istss.org/public-resources/trauma-blog/2015-march-(1)/clinician-s-corner-skills-training-in-affective-an|title=ISTSS - Trauma Blog|website=istss.org|access-date=2022-08-13}}</ref>.<ref>{{Citation|title=Introduction to Telehealth with Dr. Bosch|url=https://www.youtube.com/watch?v=Wn6Vewl42X8|accessdate=2022-08-13|language=en}}</ref> # Acceptance and commitment therapy, # and Dialectical Behavioral Therapy. <big>'''Medication'''</big> *SSRIs are more effective than placebo in treating PTSD.<ref name=":1" /> *There is no evidence to support a medication to prevent the development of PTSD.<ref name=":0" /> **Imipramine, propranolol, prazosin, other antidepressants, anticonvulsants, and atypical antipsychotics have ''unknown benefit.'' **Strongly recommend against the use of benzodiazepines² and typical antipsychotics since they have ''no benefit and potential harm.'' {{collapse bottom}} == '''External resources''' == === For professionals === * [http://www.som.uq.edu.au/ptsd Post Traumatic Stress Disorder Information Resource] from [http://www.uq.edu.au/ The University of Queensland School of Medicine] * [http://www.apa.org/ptsd-guideline/ APA practice parameters for assessment and treatment for PTSD (Updated 2017)] * [http://www.ptsd.va.gov/professional/index.asp Resources for professionals] from [http://www.ptsd.va.gov/index.asp VA National PTSD Center] * [https://www.integration.samhsa.gov/clinical-practice/trauma-informed SAMHSA's Trauma-Informed Care Resources and Training] * [https://www.integration.samhsa.gov/clinical-practice/trauma-informed SAMHSA's Resources on Intimate Partner Violence (IPV) for Clinicians, Patients, Families, and Organizations] === For caregivers === * [http://www.nctsn.org/sites/default/files/assets/pdfs/tips_for_parents_media_final.pdf Tips for parents on shooting media coverage] * [http://www.nctsn.org/sites/default/files/assets/pdfs/parents_guidelines_for_helping_teens_after_the_recent_attacks.pdf Parent guidelines to helping youths after a shooting] * [http://www.nctsn.org/sites/default/files/assets/pdfs/helping_teens_with_traumatic_grief_caregivers_final.pdf Caregiver tips for helping teens with traumatic grief] * [http://www.nctsn.org/sites/default/files/assets/pdfs/10things_schoolage_ctg.pdf Caregiver tips for helping school-age children with traumatic grief] *[http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/post-traumatic-stress-disorder/ EffectiveChildTherapy.Org information on PTSD] *[https://sccap53.org Society of Clinical Child and Adolescent Psychology] === For educators === * [http://www.nctsn.org/sites/default/files/assets/pdfs/pfa_for_schools_appendix_a_teachers.pdf Teacher tips for providing psychological first aid] * [http://www.nctsn.org/sites/default/files/assets/pdfs/helping_youth_after_community_violence_educators.pdf Educator tips for helping youths after a community trauma] === For public === * [https://complicatedgrief.columbia.edu/for-the-public/resources/ Resources for grief and loss] * [http://www.nctsn.org/sites/default/files/assets/pdfs/psychological_information_sheet_two_pager.pdf Psychological impacts of recent shootings] * [http://www.nctsn.org/sites/default/files/assets/pdfs/youth_journalists.pdf Tips to talking to youths about a shooting] * [http://www.nctsn.org/sites/default/files/assets/pdfs/talking_to_children_about_the_shooting.pdf Tips to talking to children about a shooting] * [http://www.nctsn.org/sites/default/files/assets/pdfs/helping_young_children_heal_crisis.pdf Helping young children heal after a crisis] * [http://www.nctsn.org/content/psychological-first-aid-schoolspfa Psychological first aid for schools] * [http://www.nctsn.org/content/psychological-first-aid Resources and manuals on psychological first aid] * [http://www.ptsd.va.gov/public/index.asp Resources for the public] from [http://www.ptsd.va.gov/index.asp VA National PTSD Center] * [https://curlie.org/Health/Mental_Health/Disorders/Anxiety/Post-traumatic_Stress Posttraumatic stress disorder] at Curlie (based on DMOZ) =='''References'''== {{collapse top|Click here for references}} {{Reflist|30em}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] {{collapse bottom}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] 9k0zapzekjwgqa4sqb4qtz0bhx6isl9 2419139 2419133 2022-08-26T00:30:20Z Ardenguo 2944162 /* Prediction phase */ added Spanish version of PCL-5 wikitext text/x-wiki <noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{medical disclaimer}} {{:{{BASEPAGENAME}}/Sidebar}} ==[[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio"?''']]== * For background information on what assessment portfolios are, click the link in the heading above. * Want even 'more' information about this topic? There's an extended version of this page [[Evidence-based assessment/Posttraumatic stress disorder (disorder portfolio)/extended version|'''here''']]. == [[Evidence based assessment/Preparation phase|'''Preparation phase''']] == === Diagnostic criteria for post traumatic stress disorder === ===='''ICD-11 Diagnostic Criteria'''==== {{blockquotetop}} ===='''ICD-11 Criteria'''==== *Post-traumatic stress disorder (PTSD) is a syndrome that develops following exposure to an extremely threatening or horrific event or series of events that is characterized by all of the following: **1) re-experiencing the traumatic event or events in the present in the form of vivid intrusive memories, flashbacks, or nightmares, which are typically accompanied by strong and overwhelming emotions such as fear or horror and strong physical sensations, or feelings of being overwhelmed or immersed in the same intense emotions that were experienced during the traumatic event; **2) avoidance of thoughts and memories of the event or events, or avoidance of activities, situations, or people reminiscent of the event or events **3) persistent perceptions of heightened current threat, for example as indicated by hypervigilance or an enhanced startle reaction to stimuli such as unexpected noises. *The symptoms must persist for at least several weeks and cause significant impairment in personal, family, social, educational, occupational or other important areas of functioning. Additionally, ICD 11 includes a category called "Complex post-traumatic stress disorder," which is described as: *A disorder that may develop following exposure to an event or series of events of an extremely threatening or horrific nature, most commonly prolonged or repetitive events from which escape is difficult or impossible (e.g., torture, slavery, genocide campaigns, prolonged domestic violence, repeated childhood sexual or physical abuse). *The disorder is characterized by the core symptoms of PTSD; that is, all diagnostic requirements for PTSD have been met at some point during the course of the disorder. *In addition, Complex PTSD is characterized by: **1) severe and pervasive problems in affect regulation; **2) persistent beliefs about oneself as diminished, defeated or worthless, accompanied by deep and pervasive feelings of shame, guilt or failure related to the traumatic event **3) persistent difficulties in sustaining relationships and in feeling close to others. The disturbance causes significant impairment in personal, family, social, educational, occupational or other important areas of functioning. {{blockquotebottom}} ===='''Changes in DSM-5'''==== * The diagnostic criteria for post-traumatic stress disorder changed slightly from [[DSM-IV]] to [[w:Diagnostic_and_Statistical_Manual_of_Mental_Disorders#DSM-IV-TR_.282000.29|DSM-5]]. Summaries are available [http://www.dsm5.org/Documents/changes%20from%20dsm-iv-tr%20to%20dsm-5.pdf here] and [[w:DSM-5|here]]. === Developmental sensitivities === {{collapse top| Click for more information}} *Diagnostic thresholds have been lowered for children and adolescents to account for development. *Separate and additional criteria have been added for children age 6 or younger. *Child sexual abuse has been found to have a substantial effect on the development of PTSD.<ref>{{cite journal|last1=Paolucci|first1=Elizabeth ODDONE|last2=Genuis|first2=Mark L.|last3=Violato|first3=Claudio|title=A Meta-Analysis of the Published Research on the Effects of Child Sexual Abuse|journal=The Journal of Psychology|date=January 2001|volume=135|issue=1|pages=17–36|doi=10.1080/00223980109603677}}</ref> *Children with higher exposure to trauma, less social support, and other major life events are more likely to have continued PTSD symptoms 7 months after a trauma.<ref name=":2">{{cite journal |last1=La Greca|first1=A|last2=Silverman|first2=WK|last3=Vernberg|first3=EM|last4=Prinstein|first4=MJ|title=Symptoms of posttraumatic stress in children after Hurricane Andrew: a prospective study.|journal=Journal of consulting and clinical psychology|date=August 1996|volume=64|issue=4|pages=712-23|pmid=8803361}}</ref> 10 months after a trauma, however, only experience of a major life event remained predictive of continuing PTSD symptoms.<ref name=":2" /> *Lack of social support, specifically lack of support by a teacher, was predictive of higher PTSD symptoms among children who had gone through an environmental trauma.<ref name=":2" /> *Children who reported using blame and anger as strategies for coping had higher levels of PTSD symptoms 10 months after a trauma.<ref name=":2" /> *Negative affect in children before a traumatic event was predictive of development of PTSD symptoms after a traumatic event.<ref>{{cite journal|last1=Weems|first1=CF|last2=Pina|first2=AA|last3=Costa|first3=NM|last4=Watts|first4=SE|last5=Taylor|first5=LK|last6=Cannon|first6=MF|title=Predisaster trait anxiety and negative affect predict posttraumatic stress in youths after hurricane Katrina.|journal=Journal of consulting and clinical psychology|date=February 2007|volume=75|issue=1|pages=154-9|doi=10.1037/0022-006X.75.1.154|pmid=17295574}}</ref> [[wikipedia:Posttraumatic_stress_disorder|Posttraumatic stress disorder]] is now more sensitive to development in that diagnostic thresholds have been lowered for children and adolescents. Furthermore, separate and additional criteria have been added for children age 6 years of age or younger. {{collapse bottom}} === Base rates of PTSD in different clinical settings and populations === This section describes the demographic settings of the populations sampled, base rates of PTSD diagnoses, country/region sampled, and the diagnostic methods that were used. Using this information, clinicians will be able to anchor the most appropriate rate of PTSD that they are likely to see in their clinical practice. * '''''To see prevalence rates across multiple disorders,''''' [[Evidence based assessment/Preparation phase#Base rates for transdiagnostic comparison|'''''click here.''''']] {| class="wikitable sortable" border="1" |- ! Demography ! Setting ! Base Rate ! Diagnostic Method |- | United States, nationally representative, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Kessler|first=Ronald C.|last2=Berglund|first2=Patricia|last3=Demler|first3=Olga|last4=Jin|first4=Robert|last5=Merikangas|first5=Kathleen R.|last6=Walters|first6=Ellen E.|date=2005-06-01|title=Lifetime Prevalence and Age-of-Onset Distributions of DSM-IV Disorders in the National Comorbidity Survey Replication|url=http://archpsyc.jamanetwork.com/article.aspx?doi=10.1001/archpsyc.62.6.593|journal=Archives of General Psychiatry|language=en|volume=62|issue=6|doi=10.1001/archpsyc.62.6.593|issn=0003-990X}}</ref> | 6.8% | National Comorbidity Survey - Replication |- | Netherlands, nationally representative, age 18-80 | Non-clinical: Population based<ref>{{Cite journal|last=de Vries|first=Giel-Jan|last2=Olff|first2=Miranda|date=2009-08-01|title=The lifetime prevalence of traumatic events and posttraumatic stress disorder in the Netherlands|url=http://onlinelibrary.wiley.com/doi/10.1002/jts.20429/abstract|journal=Journal of Traumatic Stress|language=en|volume=22|issue=4|pages=259–267|doi=10.1002/jts.20429|issn=1573-6598}}</ref> | 7.4% | Composite International Diagnostic Interview (CIDI) |- | United States, nationally representative, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Pietrzak|first=Robert H.|last2=Goldstein|first2=Risë B.|last3=Southwick|first3=Steven M.|last4=Grant|first4=Bridget F.|title=Prevalence and Axis I comorbidity of full and partial posttraumatic stress disorder in the United States: Results from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions|url=http://linkinghub.elsevier.com/retrieve/pii/S0887618510002288|journal=Journal of Anxiety Disorders|volume=25|issue=3|pages=456–465|doi=10.1016/j.janxdis.2010.11.010}}</ref> | 6.4% | Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions |- | Northern Ireland, representative sample, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Bunting|first=Brendan P.|last2=Ferry|first2=Finola R.|last3=Murphy|first3=Samuel D.|last4=O'Neill|first4=Siobhan M.|last5=Bolton|first5=David|date=2013-02-01|title=Trauma Associated With Civil Conflict and Posttraumatic Stress Disorder: Evidence From the Northern Ireland Study of Health and Stress|url=http://onlinelibrary.wiley.com/doi/10.1002/jts.21766/abstract|journal=Journal of Traumatic Stress|language=en|volume=26|issue=1|pages=134–141|doi=10.1002/jts.21766|issn=1573-6598}}</ref> | 8.8% | Northern Ireland Study of Health and Stress |- | South Africa, nationally representative sample, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Atwoli|first=Lukoye|last2=Stein|first2=Dan J.|last3=Williams|first3=David R.|last4=Mclaughlin|first4=Katie A.|last5=Petukhova|first5=Maria|last6=Kessler|first6=Ronald C.|last7=Koenen|first7=Karestan C.|date=2013-07-03|title=Trauma and posttraumatic stress disorder in South Africa: analysis from the South African Stress and Health Study|url=https://doi.org/10.1186/1471-244X-13-182|journal=BMC Psychiatry|volume=13|pages=182|doi=10.1186/1471-244x-13-182|issn=1471-244X}}</ref> | 2.3% | South African Stress and Health Study, using the Composite International Diagnostic Interview (CIDI) |- | U.S. Army and Marine Soldiers Deployed to Iraq and Afghanistan | U.S. Service Members<ref>{{Cite journal|last=Hoge|first=Charles W.|last2=Castro|first2=Carl A.|last3=Messer|first3=Stephen C.|last4=McGurk|first4=Dennis|last5=Cotting|first5=Dave I.|last6=Koffman|first6=Robert L.|date=2004-07-01|title=Combat Duty in Iraq and Afghanistan, Mental Health Problems, and Barriers to Care|url=http://dx.doi.org/10.1056/NEJMoa040603|journal=New England Journal of Medicine|volume=351|issue=1|pages=13–22|doi=10.1056/nejmoa040603|issn=0028-4793|pmid=15229303}}</ref> |11.5% - 19.5% ♦ | PTSD Checklist |- |United States, nationally representative, ages 13-18 |Non-clinical: Population based<ref>{{Cite journal|last=Merikangas|first=Kathleen Ries|last2=He|first2=Jian-ping|last3=Burstein|first3=Marcy|last4=Swanson|first4=Sonja A.|last5=Avenevoli|first5=Shelli|last6=Cui|first6=Lihong|last7=Benjet|first7=Corina|last8=Georgiades|first8=Katholiki|last9=Swendsen|first9=Joel|title=Lifetime Prevalence of Mental Disorders in U.S. Adolescents: Results from the National Comorbidity Survey Replication–Adolescent Supplement (NCS-A)|url=https://doi.org/10.1016/j.jaac.2010.05.017|journal=Journal of the American Academy of Child & Adolescent Psychiatry|volume=49|issue=10|pages=980–989|doi=10.1016/j.jaac.2010.05.017}}</ref> |5.0% |National Comorbidity Survey Replication—Adolescent Supplement (NCS-A) |} ♦ '''Note''': These rates were using broad PTSD Checklist scoring criteria of being scored positive if subjects reported at least one intrusion symptom, three avoidance symptoms, and two hyperarousal symptom that were categorized as at the moderate level. The 11.5% is for soldiers returning from deployment in Iraq, 19.5% is for soldiers returning from Afghanistan. Another common practice is to use a strict cutoff of 50 on the PCL, above which someone screens positive for PTSD. With this cutoff, rates are 6.2% and 12.9% for Service Members returned from Afghanistan and Iraqi, respectively. ==[[Evidence based assessment/Prediction phase|'''Prediction phase''']]== === Psychometric properties of screening for PTSD === The following section contains a list of screening and diagnostic instruments for PTSD. The section includes administration information, psychometric data, and PDFs or links to the screenings. * Screenings are used as part of the [[Evidence based assessment/Prediction phase|prediction phase]] of assessment; for more information on interpretation of this data, or how screenings fit in to the assessment process, click [[Evidence based assessment/Prediction phase|here.]] * '''''For a list of more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Psychometric_properties_of_common_screening_instruments click here.]''''' {| class="wikitable" |- ! Measure !Format (Reporter) !Age Range !Administration/ Completion Time !Where to Access |- |[https://www.ptsd.va.gov/professional/assessment/adult-sr/ptsd-checklist.asp PCL-5 (PTSD Checklist for DSM-5)] |Self-Report |adult |5-10 minutes |[https://www.ptsd.va.gov/professional/assessment/documents/PCL5_Standard_form.PDFPDF PDF][https://unc.az1.qualtrics.com/jfe/form/SV_9nmXgrLPpvhPhgF Online Version (Spanish)] |- |PDS-5 (Post-traumatic Diagnosis Scale) |Self-Report |adult |10-20 minutes |[https://www.ptsd.va.gov/professional/assessment/adult-sr/pds.asp How to request] |- | colspan="4" style="font-size:110%; text-align:center;" |'''For Children and Adolescents Specifically''' | |- |[https://www.reactionindex.com/index.php/ UCLA PTSD Reaction Index for DSM-5] |Clinician Administered |child, school age, adolescents |20-30 minutes |[https://www.dellchildrens.net/wp-content/uploads/sites/60/2019/08/UCLA-PTSD-RI-DSM-5.pdf PDF] |- |CPSS (Children's PTSD Symptom Scale) |Self-Report |child |10-20 minutes |[https://www.aacap.org/App_Themes/AACAP/docs/resource_centers/resources/misc/child_ptsd_symptom_scale.pdf PDF] |- |Young Child PTSD Checklist (YCPC) |Parent Report |child |13 items |[https://medicine.tulane.edu/sites/g/files/rdw761/f/YCPC_v5_23_14.pdf PDF] |} === Interpreting PTSD screening measure scores === * For information on interpreting screening measure scores, click [[Evidence based assessment/Prediction phase#Interpreting screening measure scores|here.]] * Also see the page on [https://en.wikipedia.org/wiki/Likelihood_ratios_in_diagnostic_testing likelihood ratios in diagnostic testing] for more information ==[[Evidence based assessment/Prescription phase|'''Prescription phase''']]== ===Gold standard diagnostic interviews=== * For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews click here.] ===Recommended diagnostic interviews for PTSD=== {| class="wikitable sortable" border="1" ! colspan="4" |Diagnostic instruments for PTSD ! |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time !Where to Access |- | [https://www.ptsd.va.gov/professional/assessment/adult-int/caps.asp CAPS-5 (Clinician Administered PTSD Scale)] | Clinician Administered Interview | adult | 40-60 minutes |[https://www.ptsd.va.gov/professional/assessment/ncptsd-instrument-request-form.asp Assessment request form] |- |PTSD Symptom Scale Interview (PSS-I-5) |Clinician Administered Interview |adult and child version available |24 items |[http://www.advanced-counseling.com/dl/PSSI-5.pdf PDF] |- | colspan="4" style="font-size:110%; text-align:center;" |'''For Children and Adolescents Specifically''' | |- | [https://www.ptsd.va.gov/professional/assessment/child/caps-ca.asp CAPS-CA-5 (Clinician-Administered PTSD Scale for DSM-5 - Child/Adolescent Version)] |Clinician Administered Interview |child |30 items |[https://www.ptsd.va.gov/professional/assessment/ncptsd-instrument-request-form.asp Assessment request form] |- | Children’s PTSD Inventory (CPTSD-I) |Diagnostic Interview | 6-18 years | 50 items |Not Free |} ===Severity interviews for PTSD=== {| class="wikitable sortable" border="1" |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time !Where to Access |- | Schedule for Affective Disorders and Schizophrenia for School Age Children (K-SADS) | Diagnostic Interview | 6-18 years | 18 PTSD items |[https://www.pediatricbipolar.pitt.edu/sites/default/files/KSADS_DSM_5_SCREEN_Final.pdf PDF] |- | Anxiety Disorders Interview Schedule, Child Version (ADIS-C) | Diagnostic Interview | 7-17 years | 26 PTSD items |Not free |- | Diagnostic Infant and Preschool Assessment (DIPA) |Diagnostic Interview | Age 6 and younger | 46 PTSD items |[https://medicine.tulane.edu/sites/g/files/rdw761/f/DIPA-2017-2-14.pdf PDF] |} ==[[Evidence based assessment/Process phase|'''Process phase''']]== The following section contains a brief overview of treatment options for PTSD and list of process and outcome measures for PTSD. The section includes benchmarks based on published norms for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the [[Evidence based assessment/Process phase|process phase]] of assessment. For more information of differences between process and outcome measures, see the page on the [[Evidence based assessment/Process phase|process phase of assessment]]. === Process measures === * Information coming soon === Outcome and severity measures === This table includes clinically significant benchmarks for PTSD specific outcome measures * Information on how to interpret this table can be [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase found here]. * Additionally, these [[Evidence based assessment/Vignettes|vignettes]] might be helpful resources for understanding appropriate adaptation of outcome measures in practice. * ''<u>For clinically significant change benchmarks for the CBCL, YSR, and TRF total, externalizing, internalizing, and attention benchmarks,</u>'' [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase&wteswitched=1#Clinically_significant_change_benchmarks_for_widely-used_outcome_measures see here.] {| class="wikitable sortable" border="1" | colspan="7" |'''Clinically significant change benchmarks with common instruments for PTSD''' |- | colspan="7" style="font-size:110%; text-align:center;" span |<b> Benchmarks Based on Published Norms</b> |- | rowspan="2" style="text-align:center;font-size:130%;" |<b> Measure</b> | colspan="3" style="text-align:center;font-size:130%" width="300" |<b> Cut-off scores</b> | colspan="3" style="text-align:center;font-size:120%" |<b> Critical Change <br> (unstandardized scores)</b> |- | style="text-align:center;font-size:110%" |<b> A</b> | style="text-align:center;font-size:110%" |<b> B</b> | style="text-align:center;font-size:110%" |<b> C</b> | style="text-align:center;font-size:110%" |<b> 95%</b> | style="text-align:center;font-size:110%" |<b> 90%</b> | style="text-align:center;font-size:110%" |<b> SE_difference</b> |- | rowspan="1" style="text-align:center;" | Primary Care PTSD Screen | style="text-align:center;" | 1.0 | style="text-align:center;" | 3.1 | style="text-align:center;" | 2.0 | style="text-align:center;" | 1.0 | style="text-align:center;" | .8 | style="text-align:center;" | .5 |- | rowspan="1" style="text-align:center;" | PTSD Checklist Scores | style="text-align:center;" | 28.8 | style="text-align:center;" | 40.8 | style="text-align:center;" | 34.9 | style="text-align:center;" | 4.6 | style="text-align:center;" | 3.8 | style="text-align:center;" | 2.3 |- | rowspan="1" style="text-align:center;" | Clinician Administered PTSD Scale | style="text-align:center;" | 28.8 | style="text-align:center;" | 40.8 | style="text-align:center;" | 34.9 | style="text-align:center;" | 8.3 | style="text-align:center;" | 7.0 | style="text-align:center;" | 4.2 |} === Treatment === * Please refer to the Wikipedia page on [[wikipedia:Posttraumatic_stress_disorder|PTSD]] for more information on available treatment for PTSD or go to the [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/post-traumatic-stress-disorder/ Effective Child Therapy] page for for a curated resource on effective treatments for PTSD. {{collapse top| Click here for more information}} '''<big>Behavioral interventions</big>''' Recommended (have ''significant benefit'') <ref name=":0">Department of Veterans Affairs and Department of Defense. . (2010). VA/DoD clinical practice guidelines: management of post-traumatic stress. Washington, D.C.: Veterans Health Administration, Department of Defense.</ref>: # Brief Cognitive Behavioral Therapy (CBT; 4-5 sessions) #* This includes stress inoculation training, trauma-focused therapy including components of cognitive restructuring, Cognitive Processing Therapy (CPT), imaginal, virtual, and in-vivo exposure as in Prolonged Exposure psychotherapy (PE)² #* Patient education is recommended as part of psychotherapy for patients and family members # EMDR may help both acute and chronic PTSD, especially individuals who have trouble with prolonged exposure or have trouble verbalizing their trauma.<ref name=":1">Ursano, R. J., Bell, C., Eth, S., Friedman, M., Norwood, A., Pfefferbaum, B., . . . McIntyre, J. S. (2004). ''Practice guideline for the treatment of patients with acute stress disorder and posttraumatic stress disorder'': American Psychiatric Publ </ref> ## Long term gains require further study. # [https://www.ptsd.va.gov/professional/treat/txessentials/present_centered_therapy.asp Present-Centered Therapy (PCT)] is a non trauma focused treatment for PTSD and a second-line treatment for PTSD<ref>{{Cite web|url=https://www.ptsd.va.gov/professional/treat/txessentials/present_centered_therapy.asp|title=Present-Centered Therapy for PTSD - PTSD: National Center for PTSD|website=www.ptsd.va.gov|language=en|access-date=2022-08-13}}</ref>. Treatments with weaker evidence (have ''some benefit'') <ref name=":0" />: # Patient education, # Imagery rehearsal therapy, # Psychodynamic therapy, # Hypnosis, # Relaxation techniques, # and Group therapy. Treatment with ''unknown benefit'' <ref name=":0" />: # Web-based CBT ## For example Jeane Bosch participated as a study therapist in research study that compared STAIR and present-centered therapy both delivered via telehealth. STAIR stands for Skills Training in Affective and Interpersonal Regulation. It is a skill-focused treatment that was originally developed for survivors of childhood abuse to teach emotion regulation skills as well as tools to help with challenges interpersonal functioning and social relationships and decrease PTSD symptoms<ref>{{Cite web|url=https://istss.org/public-resources/trauma-blog/2015-march-(1)/clinician-s-corner-skills-training-in-affective-an|title=ISTSS - Trauma Blog|website=istss.org|access-date=2022-08-13}}</ref>.<ref>{{Citation|title=Introduction to Telehealth with Dr. Bosch|url=https://www.youtube.com/watch?v=Wn6Vewl42X8|accessdate=2022-08-13|language=en}}</ref> # Acceptance and commitment therapy, # and Dialectical Behavioral Therapy. <big>'''Medication'''</big> *SSRIs are more effective than placebo in treating PTSD.<ref name=":1" /> *There is no evidence to support a medication to prevent the development of PTSD.<ref name=":0" /> **Imipramine, propranolol, prazosin, other antidepressants, anticonvulsants, and atypical antipsychotics have ''unknown benefit.'' **Strongly recommend against the use of benzodiazepines² and typical antipsychotics since they have ''no benefit and potential harm.'' {{collapse bottom}} == '''External resources''' == === For professionals === * [http://www.som.uq.edu.au/ptsd Post Traumatic Stress Disorder Information Resource] from [http://www.uq.edu.au/ The University of Queensland School of Medicine] * [http://www.apa.org/ptsd-guideline/ APA practice parameters for assessment and treatment for PTSD (Updated 2017)] * [http://www.ptsd.va.gov/professional/index.asp Resources for professionals] from [http://www.ptsd.va.gov/index.asp VA National PTSD Center] * [https://www.integration.samhsa.gov/clinical-practice/trauma-informed SAMHSA's Trauma-Informed Care Resources and Training] * [https://www.integration.samhsa.gov/clinical-practice/trauma-informed SAMHSA's Resources on Intimate Partner Violence (IPV) for Clinicians, Patients, Families, and Organizations] === For caregivers === * [http://www.nctsn.org/sites/default/files/assets/pdfs/tips_for_parents_media_final.pdf Tips for parents on shooting media coverage] * [http://www.nctsn.org/sites/default/files/assets/pdfs/parents_guidelines_for_helping_teens_after_the_recent_attacks.pdf Parent guidelines to helping youths after a shooting] * [http://www.nctsn.org/sites/default/files/assets/pdfs/helping_teens_with_traumatic_grief_caregivers_final.pdf Caregiver tips for helping teens with traumatic grief] * [http://www.nctsn.org/sites/default/files/assets/pdfs/10things_schoolage_ctg.pdf Caregiver tips for helping school-age children with traumatic grief] *[http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/post-traumatic-stress-disorder/ EffectiveChildTherapy.Org information on PTSD] *[https://sccap53.org Society of Clinical Child and Adolescent Psychology] === For educators === * [http://www.nctsn.org/sites/default/files/assets/pdfs/pfa_for_schools_appendix_a_teachers.pdf Teacher tips for providing psychological first aid] * [http://www.nctsn.org/sites/default/files/assets/pdfs/helping_youth_after_community_violence_educators.pdf Educator tips for helping youths after a community trauma] === For public === * [https://complicatedgrief.columbia.edu/for-the-public/resources/ Resources for grief and loss] * [http://www.nctsn.org/sites/default/files/assets/pdfs/psychological_information_sheet_two_pager.pdf Psychological impacts of recent shootings] * [http://www.nctsn.org/sites/default/files/assets/pdfs/youth_journalists.pdf Tips to talking to youths about a shooting] * [http://www.nctsn.org/sites/default/files/assets/pdfs/talking_to_children_about_the_shooting.pdf Tips to talking to children about a shooting] * [http://www.nctsn.org/sites/default/files/assets/pdfs/helping_young_children_heal_crisis.pdf Helping young children heal after a crisis] * [http://www.nctsn.org/content/psychological-first-aid-schoolspfa Psychological first aid for schools] * [http://www.nctsn.org/content/psychological-first-aid Resources and manuals on psychological first aid] * [http://www.ptsd.va.gov/public/index.asp Resources for the public] from [http://www.ptsd.va.gov/index.asp VA National PTSD Center] * [https://curlie.org/Health/Mental_Health/Disorders/Anxiety/Post-traumatic_Stress Posttraumatic stress disorder] at Curlie (based on DMOZ) =='''References'''== {{collapse top|Click here for references}} {{Reflist|30em}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] {{collapse bottom}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] l76tgnqrsacn9wxzxpuh4rg8lco7m6j 2419141 2419139 2022-08-26T00:31:53Z Ardenguo 2944162 /* Psychometric properties of screening for PTSD */ added online version of CPSS and bullet points wikitext text/x-wiki <noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{medical disclaimer}} {{:{{BASEPAGENAME}}/Sidebar}} ==[[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio"?''']]== * For background information on what assessment portfolios are, click the link in the heading above. * Want even 'more' information about this topic? There's an extended version of this page [[Evidence-based assessment/Posttraumatic stress disorder (disorder portfolio)/extended version|'''here''']]. == [[Evidence based assessment/Preparation phase|'''Preparation phase''']] == === Diagnostic criteria for post traumatic stress disorder === ===='''ICD-11 Diagnostic Criteria'''==== {{blockquotetop}} ===='''ICD-11 Criteria'''==== *Post-traumatic stress disorder (PTSD) is a syndrome that develops following exposure to an extremely threatening or horrific event or series of events that is characterized by all of the following: **1) re-experiencing the traumatic event or events in the present in the form of vivid intrusive memories, flashbacks, or nightmares, which are typically accompanied by strong and overwhelming emotions such as fear or horror and strong physical sensations, or feelings of being overwhelmed or immersed in the same intense emotions that were experienced during the traumatic event; **2) avoidance of thoughts and memories of the event or events, or avoidance of activities, situations, or people reminiscent of the event or events **3) persistent perceptions of heightened current threat, for example as indicated by hypervigilance or an enhanced startle reaction to stimuli such as unexpected noises. *The symptoms must persist for at least several weeks and cause significant impairment in personal, family, social, educational, occupational or other important areas of functioning. Additionally, ICD 11 includes a category called "Complex post-traumatic stress disorder," which is described as: *A disorder that may develop following exposure to an event or series of events of an extremely threatening or horrific nature, most commonly prolonged or repetitive events from which escape is difficult or impossible (e.g., torture, slavery, genocide campaigns, prolonged domestic violence, repeated childhood sexual or physical abuse). *The disorder is characterized by the core symptoms of PTSD; that is, all diagnostic requirements for PTSD have been met at some point during the course of the disorder. *In addition, Complex PTSD is characterized by: **1) severe and pervasive problems in affect regulation; **2) persistent beliefs about oneself as diminished, defeated or worthless, accompanied by deep and pervasive feelings of shame, guilt or failure related to the traumatic event **3) persistent difficulties in sustaining relationships and in feeling close to others. The disturbance causes significant impairment in personal, family, social, educational, occupational or other important areas of functioning. {{blockquotebottom}} ===='''Changes in DSM-5'''==== * The diagnostic criteria for post-traumatic stress disorder changed slightly from [[DSM-IV]] to [[w:Diagnostic_and_Statistical_Manual_of_Mental_Disorders#DSM-IV-TR_.282000.29|DSM-5]]. Summaries are available [http://www.dsm5.org/Documents/changes%20from%20dsm-iv-tr%20to%20dsm-5.pdf here] and [[w:DSM-5|here]]. === Developmental sensitivities === {{collapse top| Click for more information}} *Diagnostic thresholds have been lowered for children and adolescents to account for development. *Separate and additional criteria have been added for children age 6 or younger. *Child sexual abuse has been found to have a substantial effect on the development of PTSD.<ref>{{cite journal|last1=Paolucci|first1=Elizabeth ODDONE|last2=Genuis|first2=Mark L.|last3=Violato|first3=Claudio|title=A Meta-Analysis of the Published Research on the Effects of Child Sexual Abuse|journal=The Journal of Psychology|date=January 2001|volume=135|issue=1|pages=17–36|doi=10.1080/00223980109603677}}</ref> *Children with higher exposure to trauma, less social support, and other major life events are more likely to have continued PTSD symptoms 7 months after a trauma.<ref name=":2">{{cite journal |last1=La Greca|first1=A|last2=Silverman|first2=WK|last3=Vernberg|first3=EM|last4=Prinstein|first4=MJ|title=Symptoms of posttraumatic stress in children after Hurricane Andrew: a prospective study.|journal=Journal of consulting and clinical psychology|date=August 1996|volume=64|issue=4|pages=712-23|pmid=8803361}}</ref> 10 months after a trauma, however, only experience of a major life event remained predictive of continuing PTSD symptoms.<ref name=":2" /> *Lack of social support, specifically lack of support by a teacher, was predictive of higher PTSD symptoms among children who had gone through an environmental trauma.<ref name=":2" /> *Children who reported using blame and anger as strategies for coping had higher levels of PTSD symptoms 10 months after a trauma.<ref name=":2" /> *Negative affect in children before a traumatic event was predictive of development of PTSD symptoms after a traumatic event.<ref>{{cite journal|last1=Weems|first1=CF|last2=Pina|first2=AA|last3=Costa|first3=NM|last4=Watts|first4=SE|last5=Taylor|first5=LK|last6=Cannon|first6=MF|title=Predisaster trait anxiety and negative affect predict posttraumatic stress in youths after hurricane Katrina.|journal=Journal of consulting and clinical psychology|date=February 2007|volume=75|issue=1|pages=154-9|doi=10.1037/0022-006X.75.1.154|pmid=17295574}}</ref> [[wikipedia:Posttraumatic_stress_disorder|Posttraumatic stress disorder]] is now more sensitive to development in that diagnostic thresholds have been lowered for children and adolescents. Furthermore, separate and additional criteria have been added for children age 6 years of age or younger. {{collapse bottom}} === Base rates of PTSD in different clinical settings and populations === This section describes the demographic settings of the populations sampled, base rates of PTSD diagnoses, country/region sampled, and the diagnostic methods that were used. Using this information, clinicians will be able to anchor the most appropriate rate of PTSD that they are likely to see in their clinical practice. * '''''To see prevalence rates across multiple disorders,''''' [[Evidence based assessment/Preparation phase#Base rates for transdiagnostic comparison|'''''click here.''''']] {| class="wikitable sortable" border="1" |- ! Demography ! Setting ! Base Rate ! Diagnostic Method |- | United States, nationally representative, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Kessler|first=Ronald C.|last2=Berglund|first2=Patricia|last3=Demler|first3=Olga|last4=Jin|first4=Robert|last5=Merikangas|first5=Kathleen R.|last6=Walters|first6=Ellen E.|date=2005-06-01|title=Lifetime Prevalence and Age-of-Onset Distributions of DSM-IV Disorders in the National Comorbidity Survey Replication|url=http://archpsyc.jamanetwork.com/article.aspx?doi=10.1001/archpsyc.62.6.593|journal=Archives of General Psychiatry|language=en|volume=62|issue=6|doi=10.1001/archpsyc.62.6.593|issn=0003-990X}}</ref> | 6.8% | National Comorbidity Survey - Replication |- | Netherlands, nationally representative, age 18-80 | Non-clinical: Population based<ref>{{Cite journal|last=de Vries|first=Giel-Jan|last2=Olff|first2=Miranda|date=2009-08-01|title=The lifetime prevalence of traumatic events and posttraumatic stress disorder in the Netherlands|url=http://onlinelibrary.wiley.com/doi/10.1002/jts.20429/abstract|journal=Journal of Traumatic Stress|language=en|volume=22|issue=4|pages=259–267|doi=10.1002/jts.20429|issn=1573-6598}}</ref> | 7.4% | Composite International Diagnostic Interview (CIDI) |- | United States, nationally representative, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Pietrzak|first=Robert H.|last2=Goldstein|first2=Risë B.|last3=Southwick|first3=Steven M.|last4=Grant|first4=Bridget F.|title=Prevalence and Axis I comorbidity of full and partial posttraumatic stress disorder in the United States: Results from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions|url=http://linkinghub.elsevier.com/retrieve/pii/S0887618510002288|journal=Journal of Anxiety Disorders|volume=25|issue=3|pages=456–465|doi=10.1016/j.janxdis.2010.11.010}}</ref> | 6.4% | Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions |- | Northern Ireland, representative sample, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Bunting|first=Brendan P.|last2=Ferry|first2=Finola R.|last3=Murphy|first3=Samuel D.|last4=O'Neill|first4=Siobhan M.|last5=Bolton|first5=David|date=2013-02-01|title=Trauma Associated With Civil Conflict and Posttraumatic Stress Disorder: Evidence From the Northern Ireland Study of Health and Stress|url=http://onlinelibrary.wiley.com/doi/10.1002/jts.21766/abstract|journal=Journal of Traumatic Stress|language=en|volume=26|issue=1|pages=134–141|doi=10.1002/jts.21766|issn=1573-6598}}</ref> | 8.8% | Northern Ireland Study of Health and Stress |- | South Africa, nationally representative sample, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Atwoli|first=Lukoye|last2=Stein|first2=Dan J.|last3=Williams|first3=David R.|last4=Mclaughlin|first4=Katie A.|last5=Petukhova|first5=Maria|last6=Kessler|first6=Ronald C.|last7=Koenen|first7=Karestan C.|date=2013-07-03|title=Trauma and posttraumatic stress disorder in South Africa: analysis from the South African Stress and Health Study|url=https://doi.org/10.1186/1471-244X-13-182|journal=BMC Psychiatry|volume=13|pages=182|doi=10.1186/1471-244x-13-182|issn=1471-244X}}</ref> | 2.3% | South African Stress and Health Study, using the Composite International Diagnostic Interview (CIDI) |- | U.S. Army and Marine Soldiers Deployed to Iraq and Afghanistan | U.S. Service Members<ref>{{Cite journal|last=Hoge|first=Charles W.|last2=Castro|first2=Carl A.|last3=Messer|first3=Stephen C.|last4=McGurk|first4=Dennis|last5=Cotting|first5=Dave I.|last6=Koffman|first6=Robert L.|date=2004-07-01|title=Combat Duty in Iraq and Afghanistan, Mental Health Problems, and Barriers to Care|url=http://dx.doi.org/10.1056/NEJMoa040603|journal=New England Journal of Medicine|volume=351|issue=1|pages=13–22|doi=10.1056/nejmoa040603|issn=0028-4793|pmid=15229303}}</ref> |11.5% - 19.5% ♦ | PTSD Checklist |- |United States, nationally representative, ages 13-18 |Non-clinical: Population based<ref>{{Cite journal|last=Merikangas|first=Kathleen Ries|last2=He|first2=Jian-ping|last3=Burstein|first3=Marcy|last4=Swanson|first4=Sonja A.|last5=Avenevoli|first5=Shelli|last6=Cui|first6=Lihong|last7=Benjet|first7=Corina|last8=Georgiades|first8=Katholiki|last9=Swendsen|first9=Joel|title=Lifetime Prevalence of Mental Disorders in U.S. Adolescents: Results from the National Comorbidity Survey Replication–Adolescent Supplement (NCS-A)|url=https://doi.org/10.1016/j.jaac.2010.05.017|journal=Journal of the American Academy of Child & Adolescent Psychiatry|volume=49|issue=10|pages=980–989|doi=10.1016/j.jaac.2010.05.017}}</ref> |5.0% |National Comorbidity Survey Replication—Adolescent Supplement (NCS-A) |} ♦ '''Note''': These rates were using broad PTSD Checklist scoring criteria of being scored positive if subjects reported at least one intrusion symptom, three avoidance symptoms, and two hyperarousal symptom that were categorized as at the moderate level. The 11.5% is for soldiers returning from deployment in Iraq, 19.5% is for soldiers returning from Afghanistan. Another common practice is to use a strict cutoff of 50 on the PCL, above which someone screens positive for PTSD. With this cutoff, rates are 6.2% and 12.9% for Service Members returned from Afghanistan and Iraqi, respectively. ==[[Evidence based assessment/Prediction phase|'''Prediction phase''']]== === Psychometric properties of screening for PTSD === The following section contains a list of screening and diagnostic instruments for PTSD. The section includes administration information, psychometric data, and PDFs or links to the screenings. * Screenings are used as part of the [[Evidence based assessment/Prediction phase|prediction phase]] of assessment; for more information on interpretation of this data, or how screenings fit in to the assessment process, click [[Evidence based assessment/Prediction phase|here.]] * '''''For a list of more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Psychometric_properties_of_common_screening_instruments click here.]''''' {| class="wikitable" |- ! Measure !Format (Reporter) !Age Range !Administration/ Completion Time !Where to Access |- |[https://www.ptsd.va.gov/professional/assessment/adult-sr/ptsd-checklist.asp PCL-5 (PTSD Checklist for DSM-5)] |Self-Report |adult |5-10 minutes | * [https://www.ptsd.va.gov/professional/assessment/documents/PCL5_Standard_form.PDFPDF PDF] * [https://unc.az1.qualtrics.com/jfe/form/SV_9nmXgrLPpvhPhgF Online Version (Spanish)] |- |PDS-5 (Post-traumatic Diagnosis Scale) |Self-Report |adult |10-20 minutes |[https://www.ptsd.va.gov/professional/assessment/adult-sr/pds.asp How to request] |- | colspan="4" style="font-size:110%; text-align:center;" |'''For Children and Adolescents Specifically''' | |- |[https://www.reactionindex.com/index.php/ UCLA PTSD Reaction Index for DSM-5] |Clinician Administered |child, school age, adolescents |20-30 minutes |[https://www.dellchildrens.net/wp-content/uploads/sites/60/2019/08/UCLA-PTSD-RI-DSM-5.pdf PDF] |- |CPSS (Children's PTSD Symptom Scale) |Self-Report |child |10-20 minutes | * [https://www.aacap.org/App_Themes/AACAP/docs/resource_centers/resources/misc/child_ptsd_symptom_scale.pdf PDF] * [https://unc.az1.qualtrics.com/jfe/form/SV_6XPDvzlfkg2SQRf Online Version] |- |Young Child PTSD Checklist (YCPC) |Parent Report |child |13 items |[https://medicine.tulane.edu/sites/g/files/rdw761/f/YCPC_v5_23_14.pdf PDF] |} === Interpreting PTSD screening measure scores === * For information on interpreting screening measure scores, click [[Evidence based assessment/Prediction phase#Interpreting screening measure scores|here.]] * Also see the page on [https://en.wikipedia.org/wiki/Likelihood_ratios_in_diagnostic_testing likelihood ratios in diagnostic testing] for more information ==[[Evidence based assessment/Prescription phase|'''Prescription phase''']]== ===Gold standard diagnostic interviews=== * For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews click here.] ===Recommended diagnostic interviews for PTSD=== {| class="wikitable sortable" border="1" ! colspan="4" |Diagnostic instruments for PTSD ! |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time !Where to Access |- | [https://www.ptsd.va.gov/professional/assessment/adult-int/caps.asp CAPS-5 (Clinician Administered PTSD Scale)] | Clinician Administered Interview | adult | 40-60 minutes |[https://www.ptsd.va.gov/professional/assessment/ncptsd-instrument-request-form.asp Assessment request form] |- |PTSD Symptom Scale Interview (PSS-I-5) |Clinician Administered Interview |adult and child version available |24 items |[http://www.advanced-counseling.com/dl/PSSI-5.pdf PDF] |- | colspan="4" style="font-size:110%; text-align:center;" |'''For Children and Adolescents Specifically''' | |- | [https://www.ptsd.va.gov/professional/assessment/child/caps-ca.asp CAPS-CA-5 (Clinician-Administered PTSD Scale for DSM-5 - Child/Adolescent Version)] |Clinician Administered Interview |child |30 items |[https://www.ptsd.va.gov/professional/assessment/ncptsd-instrument-request-form.asp Assessment request form] |- | Children’s PTSD Inventory (CPTSD-I) |Diagnostic Interview | 6-18 years | 50 items |Not Free |} ===Severity interviews for PTSD=== {| class="wikitable sortable" border="1" |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time !Where to Access |- | Schedule for Affective Disorders and Schizophrenia for School Age Children (K-SADS) | Diagnostic Interview | 6-18 years | 18 PTSD items |[https://www.pediatricbipolar.pitt.edu/sites/default/files/KSADS_DSM_5_SCREEN_Final.pdf PDF] |- | Anxiety Disorders Interview Schedule, Child Version (ADIS-C) | Diagnostic Interview | 7-17 years | 26 PTSD items |Not free |- | Diagnostic Infant and Preschool Assessment (DIPA) |Diagnostic Interview | Age 6 and younger | 46 PTSD items |[https://medicine.tulane.edu/sites/g/files/rdw761/f/DIPA-2017-2-14.pdf PDF] |} ==[[Evidence based assessment/Process phase|'''Process phase''']]== The following section contains a brief overview of treatment options for PTSD and list of process and outcome measures for PTSD. The section includes benchmarks based on published norms for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the [[Evidence based assessment/Process phase|process phase]] of assessment. For more information of differences between process and outcome measures, see the page on the [[Evidence based assessment/Process phase|process phase of assessment]]. === Process measures === * Information coming soon === Outcome and severity measures === This table includes clinically significant benchmarks for PTSD specific outcome measures * Information on how to interpret this table can be [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase found here]. * Additionally, these [[Evidence based assessment/Vignettes|vignettes]] might be helpful resources for understanding appropriate adaptation of outcome measures in practice. * ''<u>For clinically significant change benchmarks for the CBCL, YSR, and TRF total, externalizing, internalizing, and attention benchmarks,</u>'' [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase&wteswitched=1#Clinically_significant_change_benchmarks_for_widely-used_outcome_measures see here.] {| class="wikitable sortable" border="1" | colspan="7" |'''Clinically significant change benchmarks with common instruments for PTSD''' |- | colspan="7" style="font-size:110%; text-align:center;" span |<b> Benchmarks Based on Published Norms</b> |- | rowspan="2" style="text-align:center;font-size:130%;" |<b> Measure</b> | colspan="3" style="text-align:center;font-size:130%" width="300" |<b> Cut-off scores</b> | colspan="3" style="text-align:center;font-size:120%" |<b> Critical Change <br> (unstandardized scores)</b> |- | style="text-align:center;font-size:110%" |<b> A</b> | style="text-align:center;font-size:110%" |<b> B</b> | style="text-align:center;font-size:110%" |<b> C</b> | style="text-align:center;font-size:110%" |<b> 95%</b> | style="text-align:center;font-size:110%" |<b> 90%</b> | style="text-align:center;font-size:110%" |<b> SE_difference</b> |- | rowspan="1" style="text-align:center;" | Primary Care PTSD Screen | style="text-align:center;" | 1.0 | style="text-align:center;" | 3.1 | style="text-align:center;" | 2.0 | style="text-align:center;" | 1.0 | style="text-align:center;" | .8 | style="text-align:center;" | .5 |- | rowspan="1" style="text-align:center;" | PTSD Checklist Scores | style="text-align:center;" | 28.8 | style="text-align:center;" | 40.8 | style="text-align:center;" | 34.9 | style="text-align:center;" | 4.6 | style="text-align:center;" | 3.8 | style="text-align:center;" | 2.3 |- | rowspan="1" style="text-align:center;" | Clinician Administered PTSD Scale | style="text-align:center;" | 28.8 | style="text-align:center;" | 40.8 | style="text-align:center;" | 34.9 | style="text-align:center;" | 8.3 | style="text-align:center;" | 7.0 | style="text-align:center;" | 4.2 |} === Treatment === * Please refer to the Wikipedia page on [[wikipedia:Posttraumatic_stress_disorder|PTSD]] for more information on available treatment for PTSD or go to the [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/post-traumatic-stress-disorder/ Effective Child Therapy] page for for a curated resource on effective treatments for PTSD. {{collapse top| Click here for more information}} '''<big>Behavioral interventions</big>''' Recommended (have ''significant benefit'') <ref name=":0">Department of Veterans Affairs and Department of Defense. . (2010). VA/DoD clinical practice guidelines: management of post-traumatic stress. Washington, D.C.: Veterans Health Administration, Department of Defense.</ref>: # Brief Cognitive Behavioral Therapy (CBT; 4-5 sessions) #* This includes stress inoculation training, trauma-focused therapy including components of cognitive restructuring, Cognitive Processing Therapy (CPT), imaginal, virtual, and in-vivo exposure as in Prolonged Exposure psychotherapy (PE)² #* Patient education is recommended as part of psychotherapy for patients and family members # EMDR may help both acute and chronic PTSD, especially individuals who have trouble with prolonged exposure or have trouble verbalizing their trauma.<ref name=":1">Ursano, R. J., Bell, C., Eth, S., Friedman, M., Norwood, A., Pfefferbaum, B., . . . McIntyre, J. S. (2004). ''Practice guideline for the treatment of patients with acute stress disorder and posttraumatic stress disorder'': American Psychiatric Publ </ref> ## Long term gains require further study. # [https://www.ptsd.va.gov/professional/treat/txessentials/present_centered_therapy.asp Present-Centered Therapy (PCT)] is a non trauma focused treatment for PTSD and a second-line treatment for PTSD<ref>{{Cite web|url=https://www.ptsd.va.gov/professional/treat/txessentials/present_centered_therapy.asp|title=Present-Centered Therapy for PTSD - PTSD: National Center for PTSD|website=www.ptsd.va.gov|language=en|access-date=2022-08-13}}</ref>. Treatments with weaker evidence (have ''some benefit'') <ref name=":0" />: # Patient education, # Imagery rehearsal therapy, # Psychodynamic therapy, # Hypnosis, # Relaxation techniques, # and Group therapy. Treatment with ''unknown benefit'' <ref name=":0" />: # Web-based CBT ## For example Jeane Bosch participated as a study therapist in research study that compared STAIR and present-centered therapy both delivered via telehealth. STAIR stands for Skills Training in Affective and Interpersonal Regulation. It is a skill-focused treatment that was originally developed for survivors of childhood abuse to teach emotion regulation skills as well as tools to help with challenges interpersonal functioning and social relationships and decrease PTSD symptoms<ref>{{Cite web|url=https://istss.org/public-resources/trauma-blog/2015-march-(1)/clinician-s-corner-skills-training-in-affective-an|title=ISTSS - Trauma Blog|website=istss.org|access-date=2022-08-13}}</ref>.<ref>{{Citation|title=Introduction to Telehealth with Dr. Bosch|url=https://www.youtube.com/watch?v=Wn6Vewl42X8|accessdate=2022-08-13|language=en}}</ref> # Acceptance and commitment therapy, # and Dialectical Behavioral Therapy. <big>'''Medication'''</big> *SSRIs are more effective than placebo in treating PTSD.<ref name=":1" /> *There is no evidence to support a medication to prevent the development of PTSD.<ref name=":0" /> **Imipramine, propranolol, prazosin, other antidepressants, anticonvulsants, and atypical antipsychotics have ''unknown benefit.'' **Strongly recommend against the use of benzodiazepines² and typical antipsychotics since they have ''no benefit and potential harm.'' {{collapse bottom}} == '''External resources''' == === For professionals === * [http://www.som.uq.edu.au/ptsd Post Traumatic Stress Disorder Information Resource] from [http://www.uq.edu.au/ The University of Queensland School of Medicine] * [http://www.apa.org/ptsd-guideline/ APA practice parameters for assessment and treatment for PTSD (Updated 2017)] * [http://www.ptsd.va.gov/professional/index.asp Resources for professionals] from [http://www.ptsd.va.gov/index.asp VA National PTSD Center] * [https://www.integration.samhsa.gov/clinical-practice/trauma-informed SAMHSA's Trauma-Informed Care Resources and Training] * [https://www.integration.samhsa.gov/clinical-practice/trauma-informed SAMHSA's Resources on Intimate Partner Violence (IPV) for Clinicians, Patients, Families, and Organizations] === For caregivers === * [http://www.nctsn.org/sites/default/files/assets/pdfs/tips_for_parents_media_final.pdf Tips for parents on shooting media coverage] * [http://www.nctsn.org/sites/default/files/assets/pdfs/parents_guidelines_for_helping_teens_after_the_recent_attacks.pdf Parent guidelines to helping youths after a shooting] * [http://www.nctsn.org/sites/default/files/assets/pdfs/helping_teens_with_traumatic_grief_caregivers_final.pdf Caregiver tips for helping teens with traumatic grief] * [http://www.nctsn.org/sites/default/files/assets/pdfs/10things_schoolage_ctg.pdf Caregiver tips for helping school-age children with traumatic grief] *[http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/post-traumatic-stress-disorder/ EffectiveChildTherapy.Org information on PTSD] *[https://sccap53.org Society of Clinical Child and Adolescent Psychology] === For educators === * [http://www.nctsn.org/sites/default/files/assets/pdfs/pfa_for_schools_appendix_a_teachers.pdf Teacher tips for providing psychological first aid] * [http://www.nctsn.org/sites/default/files/assets/pdfs/helping_youth_after_community_violence_educators.pdf Educator tips for helping youths after a community trauma] === For public === * [https://complicatedgrief.columbia.edu/for-the-public/resources/ Resources for grief and loss] * [http://www.nctsn.org/sites/default/files/assets/pdfs/psychological_information_sheet_two_pager.pdf Psychological impacts of recent shootings] * [http://www.nctsn.org/sites/default/files/assets/pdfs/youth_journalists.pdf Tips to talking to youths about a shooting] * [http://www.nctsn.org/sites/default/files/assets/pdfs/talking_to_children_about_the_shooting.pdf Tips to talking to children about a shooting] * [http://www.nctsn.org/sites/default/files/assets/pdfs/helping_young_children_heal_crisis.pdf Helping young children heal after a crisis] * [http://www.nctsn.org/content/psychological-first-aid-schoolspfa Psychological first aid for schools] * [http://www.nctsn.org/content/psychological-first-aid Resources and manuals on psychological first aid] * [http://www.ptsd.va.gov/public/index.asp Resources for the public] from [http://www.ptsd.va.gov/index.asp VA National PTSD Center] * [https://curlie.org/Health/Mental_Health/Disorders/Anxiety/Post-traumatic_Stress Posttraumatic stress disorder] at Curlie (based on DMOZ) =='''References'''== {{collapse top|Click here for references}} {{Reflist|30em}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] {{collapse bottom}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] kb4uq06faab7jbshojuf3ufykhjg17a 2419143 2419141 2022-08-26T00:38:55Z Ardenguo 2944162 /* Psychometric properties of screening for PTSD */ Added ASDS wikitext text/x-wiki <noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{medical disclaimer}} {{:{{BASEPAGENAME}}/Sidebar}} ==[[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio"?''']]== * For background information on what assessment portfolios are, click the link in the heading above. * Want even 'more' information about this topic? There's an extended version of this page [[Evidence-based assessment/Posttraumatic stress disorder (disorder portfolio)/extended version|'''here''']]. == [[Evidence based assessment/Preparation phase|'''Preparation phase''']] == === Diagnostic criteria for post traumatic stress disorder === ===='''ICD-11 Diagnostic Criteria'''==== {{blockquotetop}} ===='''ICD-11 Criteria'''==== *Post-traumatic stress disorder (PTSD) is a syndrome that develops following exposure to an extremely threatening or horrific event or series of events that is characterized by all of the following: **1) re-experiencing the traumatic event or events in the present in the form of vivid intrusive memories, flashbacks, or nightmares, which are typically accompanied by strong and overwhelming emotions such as fear or horror and strong physical sensations, or feelings of being overwhelmed or immersed in the same intense emotions that were experienced during the traumatic event; **2) avoidance of thoughts and memories of the event or events, or avoidance of activities, situations, or people reminiscent of the event or events **3) persistent perceptions of heightened current threat, for example as indicated by hypervigilance or an enhanced startle reaction to stimuli such as unexpected noises. *The symptoms must persist for at least several weeks and cause significant impairment in personal, family, social, educational, occupational or other important areas of functioning. Additionally, ICD 11 includes a category called "Complex post-traumatic stress disorder," which is described as: *A disorder that may develop following exposure to an event or series of events of an extremely threatening or horrific nature, most commonly prolonged or repetitive events from which escape is difficult or impossible (e.g., torture, slavery, genocide campaigns, prolonged domestic violence, repeated childhood sexual or physical abuse). *The disorder is characterized by the core symptoms of PTSD; that is, all diagnostic requirements for PTSD have been met at some point during the course of the disorder. *In addition, Complex PTSD is characterized by: **1) severe and pervasive problems in affect regulation; **2) persistent beliefs about oneself as diminished, defeated or worthless, accompanied by deep and pervasive feelings of shame, guilt or failure related to the traumatic event **3) persistent difficulties in sustaining relationships and in feeling close to others. The disturbance causes significant impairment in personal, family, social, educational, occupational or other important areas of functioning. {{blockquotebottom}} ===='''Changes in DSM-5'''==== * The diagnostic criteria for post-traumatic stress disorder changed slightly from [[DSM-IV]] to [[w:Diagnostic_and_Statistical_Manual_of_Mental_Disorders#DSM-IV-TR_.282000.29|DSM-5]]. Summaries are available [http://www.dsm5.org/Documents/changes%20from%20dsm-iv-tr%20to%20dsm-5.pdf here] and [[w:DSM-5|here]]. === Developmental sensitivities === {{collapse top| Click for more information}} *Diagnostic thresholds have been lowered for children and adolescents to account for development. *Separate and additional criteria have been added for children age 6 or younger. *Child sexual abuse has been found to have a substantial effect on the development of PTSD.<ref>{{cite journal|last1=Paolucci|first1=Elizabeth ODDONE|last2=Genuis|first2=Mark L.|last3=Violato|first3=Claudio|title=A Meta-Analysis of the Published Research on the Effects of Child Sexual Abuse|journal=The Journal of Psychology|date=January 2001|volume=135|issue=1|pages=17–36|doi=10.1080/00223980109603677}}</ref> *Children with higher exposure to trauma, less social support, and other major life events are more likely to have continued PTSD symptoms 7 months after a trauma.<ref name=":2">{{cite journal |last1=La Greca|first1=A|last2=Silverman|first2=WK|last3=Vernberg|first3=EM|last4=Prinstein|first4=MJ|title=Symptoms of posttraumatic stress in children after Hurricane Andrew: a prospective study.|journal=Journal of consulting and clinical psychology|date=August 1996|volume=64|issue=4|pages=712-23|pmid=8803361}}</ref> 10 months after a trauma, however, only experience of a major life event remained predictive of continuing PTSD symptoms.<ref name=":2" /> *Lack of social support, specifically lack of support by a teacher, was predictive of higher PTSD symptoms among children who had gone through an environmental trauma.<ref name=":2" /> *Children who reported using blame and anger as strategies for coping had higher levels of PTSD symptoms 10 months after a trauma.<ref name=":2" /> *Negative affect in children before a traumatic event was predictive of development of PTSD symptoms after a traumatic event.<ref>{{cite journal|last1=Weems|first1=CF|last2=Pina|first2=AA|last3=Costa|first3=NM|last4=Watts|first4=SE|last5=Taylor|first5=LK|last6=Cannon|first6=MF|title=Predisaster trait anxiety and negative affect predict posttraumatic stress in youths after hurricane Katrina.|journal=Journal of consulting and clinical psychology|date=February 2007|volume=75|issue=1|pages=154-9|doi=10.1037/0022-006X.75.1.154|pmid=17295574}}</ref> [[wikipedia:Posttraumatic_stress_disorder|Posttraumatic stress disorder]] is now more sensitive to development in that diagnostic thresholds have been lowered for children and adolescents. Furthermore, separate and additional criteria have been added for children age 6 years of age or younger. {{collapse bottom}} === Base rates of PTSD in different clinical settings and populations === This section describes the demographic settings of the populations sampled, base rates of PTSD diagnoses, country/region sampled, and the diagnostic methods that were used. Using this information, clinicians will be able to anchor the most appropriate rate of PTSD that they are likely to see in their clinical practice. * '''''To see prevalence rates across multiple disorders,''''' [[Evidence based assessment/Preparation phase#Base rates for transdiagnostic comparison|'''''click here.''''']] {| class="wikitable sortable" border="1" |- ! Demography ! Setting ! Base Rate ! Diagnostic Method |- | United States, nationally representative, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Kessler|first=Ronald C.|last2=Berglund|first2=Patricia|last3=Demler|first3=Olga|last4=Jin|first4=Robert|last5=Merikangas|first5=Kathleen R.|last6=Walters|first6=Ellen E.|date=2005-06-01|title=Lifetime Prevalence and Age-of-Onset Distributions of DSM-IV Disorders in the National Comorbidity Survey Replication|url=http://archpsyc.jamanetwork.com/article.aspx?doi=10.1001/archpsyc.62.6.593|journal=Archives of General Psychiatry|language=en|volume=62|issue=6|doi=10.1001/archpsyc.62.6.593|issn=0003-990X}}</ref> | 6.8% | National Comorbidity Survey - Replication |- | Netherlands, nationally representative, age 18-80 | Non-clinical: Population based<ref>{{Cite journal|last=de Vries|first=Giel-Jan|last2=Olff|first2=Miranda|date=2009-08-01|title=The lifetime prevalence of traumatic events and posttraumatic stress disorder in the Netherlands|url=http://onlinelibrary.wiley.com/doi/10.1002/jts.20429/abstract|journal=Journal of Traumatic Stress|language=en|volume=22|issue=4|pages=259–267|doi=10.1002/jts.20429|issn=1573-6598}}</ref> | 7.4% | Composite International Diagnostic Interview (CIDI) |- | United States, nationally representative, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Pietrzak|first=Robert H.|last2=Goldstein|first2=Risë B.|last3=Southwick|first3=Steven M.|last4=Grant|first4=Bridget F.|title=Prevalence and Axis I comorbidity of full and partial posttraumatic stress disorder in the United States: Results from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions|url=http://linkinghub.elsevier.com/retrieve/pii/S0887618510002288|journal=Journal of Anxiety Disorders|volume=25|issue=3|pages=456–465|doi=10.1016/j.janxdis.2010.11.010}}</ref> | 6.4% | Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions |- | Northern Ireland, representative sample, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Bunting|first=Brendan P.|last2=Ferry|first2=Finola R.|last3=Murphy|first3=Samuel D.|last4=O'Neill|first4=Siobhan M.|last5=Bolton|first5=David|date=2013-02-01|title=Trauma Associated With Civil Conflict and Posttraumatic Stress Disorder: Evidence From the Northern Ireland Study of Health and Stress|url=http://onlinelibrary.wiley.com/doi/10.1002/jts.21766/abstract|journal=Journal of Traumatic Stress|language=en|volume=26|issue=1|pages=134–141|doi=10.1002/jts.21766|issn=1573-6598}}</ref> | 8.8% | Northern Ireland Study of Health and Stress |- | South Africa, nationally representative sample, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Atwoli|first=Lukoye|last2=Stein|first2=Dan J.|last3=Williams|first3=David R.|last4=Mclaughlin|first4=Katie A.|last5=Petukhova|first5=Maria|last6=Kessler|first6=Ronald C.|last7=Koenen|first7=Karestan C.|date=2013-07-03|title=Trauma and posttraumatic stress disorder in South Africa: analysis from the South African Stress and Health Study|url=https://doi.org/10.1186/1471-244X-13-182|journal=BMC Psychiatry|volume=13|pages=182|doi=10.1186/1471-244x-13-182|issn=1471-244X}}</ref> | 2.3% | South African Stress and Health Study, using the Composite International Diagnostic Interview (CIDI) |- | U.S. Army and Marine Soldiers Deployed to Iraq and Afghanistan | U.S. Service Members<ref>{{Cite journal|last=Hoge|first=Charles W.|last2=Castro|first2=Carl A.|last3=Messer|first3=Stephen C.|last4=McGurk|first4=Dennis|last5=Cotting|first5=Dave I.|last6=Koffman|first6=Robert L.|date=2004-07-01|title=Combat Duty in Iraq and Afghanistan, Mental Health Problems, and Barriers to Care|url=http://dx.doi.org/10.1056/NEJMoa040603|journal=New England Journal of Medicine|volume=351|issue=1|pages=13–22|doi=10.1056/nejmoa040603|issn=0028-4793|pmid=15229303}}</ref> |11.5% - 19.5% ♦ | PTSD Checklist |- |United States, nationally representative, ages 13-18 |Non-clinical: Population based<ref>{{Cite journal|last=Merikangas|first=Kathleen Ries|last2=He|first2=Jian-ping|last3=Burstein|first3=Marcy|last4=Swanson|first4=Sonja A.|last5=Avenevoli|first5=Shelli|last6=Cui|first6=Lihong|last7=Benjet|first7=Corina|last8=Georgiades|first8=Katholiki|last9=Swendsen|first9=Joel|title=Lifetime Prevalence of Mental Disorders in U.S. Adolescents: Results from the National Comorbidity Survey Replication–Adolescent Supplement (NCS-A)|url=https://doi.org/10.1016/j.jaac.2010.05.017|journal=Journal of the American Academy of Child & Adolescent Psychiatry|volume=49|issue=10|pages=980–989|doi=10.1016/j.jaac.2010.05.017}}</ref> |5.0% |National Comorbidity Survey Replication—Adolescent Supplement (NCS-A) |} ♦ '''Note''': These rates were using broad PTSD Checklist scoring criteria of being scored positive if subjects reported at least one intrusion symptom, three avoidance symptoms, and two hyperarousal symptom that were categorized as at the moderate level. The 11.5% is for soldiers returning from deployment in Iraq, 19.5% is for soldiers returning from Afghanistan. Another common practice is to use a strict cutoff of 50 on the PCL, above which someone screens positive for PTSD. With this cutoff, rates are 6.2% and 12.9% for Service Members returned from Afghanistan and Iraqi, respectively. ==[[Evidence based assessment/Prediction phase|'''Prediction phase''']]== === Psychometric properties of screening for PTSD === The following section contains a list of screening and diagnostic instruments for PTSD. The section includes administration information, psychometric data, and PDFs or links to the screenings. * Screenings are used as part of the [[Evidence based assessment/Prediction phase|prediction phase]] of assessment; for more information on interpretation of this data, or how screenings fit in to the assessment process, click [[Evidence based assessment/Prediction phase|here.]] * '''''For a list of more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Psychometric_properties_of_common_screening_instruments click here.]''''' {| class="wikitable" |- ! Measure !Format (Reporter) !Age Range !Administration/ Completion Time !Where to Access |- |[https://www.ptsd.va.gov/professional/assessment/adult-sr/ptsd-checklist.asp PCL-5 (PTSD Checklist for DSM-5)] |Self-Report |adult |5-10 minutes | * [https://www.ptsd.va.gov/professional/assessment/documents/PCL5_Standard_form.PDFPDF PDF] * [https://unc.az1.qualtrics.com/jfe/form/SV_9nmXgrLPpvhPhgF Online version (Spanish)] |- |PDS-5 (Post-traumatic Diagnosis Scale) |Self-Report |adult |10-20 minutes |[https://www.ptsd.va.gov/professional/assessment/adult-sr/pds.asp How to request] |- |Acute Stress Disorder Scale (ASDS) |Self-Report |17-65 years |5-10 minutes |[https://unc.az1.qualtrics.com/jfe/form/SV_5ziLsjw0gstyjJP Online version] |- | colspan="4" style="font-size:110%; text-align:center;" |'''For Children and Adolescents Specifically''' | |- |[https://www.reactionindex.com/index.php/ UCLA PTSD Reaction Index for DSM-5] |Clinician Administered |child, school age, adolescents |20-30 minutes |[https://www.dellchildrens.net/wp-content/uploads/sites/60/2019/08/UCLA-PTSD-RI-DSM-5.pdf PDF] |- |CPSS (Children's PTSD Symptom Scale) |Self-Report |child |10-20 minutes | * [https://www.aacap.org/App_Themes/AACAP/docs/resource_centers/resources/misc/child_ptsd_symptom_scale.pdf PDF] * [https://unc.az1.qualtrics.com/jfe/form/SV_6XPDvzlfkg2SQRf Online version] |- |Young Child PTSD Checklist (YCPC) |Parent Report |child |13 items |[https://medicine.tulane.edu/sites/g/files/rdw761/f/YCPC_v5_23_14.pdf PDF] |} === Interpreting PTSD screening measure scores === * For information on interpreting screening measure scores, click [[Evidence based assessment/Prediction phase#Interpreting screening measure scores|here.]] * Also see the page on [https://en.wikipedia.org/wiki/Likelihood_ratios_in_diagnostic_testing likelihood ratios in diagnostic testing] for more information ==[[Evidence based assessment/Prescription phase|'''Prescription phase''']]== ===Gold standard diagnostic interviews=== * For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews click here.] ===Recommended diagnostic interviews for PTSD=== {| class="wikitable sortable" border="1" ! colspan="4" |Diagnostic instruments for PTSD ! |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time !Where to Access |- | [https://www.ptsd.va.gov/professional/assessment/adult-int/caps.asp CAPS-5 (Clinician Administered PTSD Scale)] | Clinician Administered Interview | adult | 40-60 minutes |[https://www.ptsd.va.gov/professional/assessment/ncptsd-instrument-request-form.asp Assessment request form] |- |PTSD Symptom Scale Interview (PSS-I-5) |Clinician Administered Interview |adult and child version available |24 items |[http://www.advanced-counseling.com/dl/PSSI-5.pdf PDF] |- | colspan="4" style="font-size:110%; text-align:center;" |'''For Children and Adolescents Specifically''' | |- | [https://www.ptsd.va.gov/professional/assessment/child/caps-ca.asp CAPS-CA-5 (Clinician-Administered PTSD Scale for DSM-5 - Child/Adolescent Version)] |Clinician Administered Interview |child |30 items |[https://www.ptsd.va.gov/professional/assessment/ncptsd-instrument-request-form.asp Assessment request form] |- | Children’s PTSD Inventory (CPTSD-I) |Diagnostic Interview | 6-18 years | 50 items |Not Free |} ===Severity interviews for PTSD=== {| class="wikitable sortable" border="1" |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time !Where to Access |- | Schedule for Affective Disorders and Schizophrenia for School Age Children (K-SADS) | Diagnostic Interview | 6-18 years | 18 PTSD items |[https://www.pediatricbipolar.pitt.edu/sites/default/files/KSADS_DSM_5_SCREEN_Final.pdf PDF] |- | Anxiety Disorders Interview Schedule, Child Version (ADIS-C) | Diagnostic Interview | 7-17 years | 26 PTSD items |Not free |- | Diagnostic Infant and Preschool Assessment (DIPA) |Diagnostic Interview | Age 6 and younger | 46 PTSD items |[https://medicine.tulane.edu/sites/g/files/rdw761/f/DIPA-2017-2-14.pdf PDF] |} ==[[Evidence based assessment/Process phase|'''Process phase''']]== The following section contains a brief overview of treatment options for PTSD and list of process and outcome measures for PTSD. The section includes benchmarks based on published norms for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the [[Evidence based assessment/Process phase|process phase]] of assessment. For more information of differences between process and outcome measures, see the page on the [[Evidence based assessment/Process phase|process phase of assessment]]. === Process measures === * Information coming soon === Outcome and severity measures === This table includes clinically significant benchmarks for PTSD specific outcome measures * Information on how to interpret this table can be [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase found here]. * Additionally, these [[Evidence based assessment/Vignettes|vignettes]] might be helpful resources for understanding appropriate adaptation of outcome measures in practice. * ''<u>For clinically significant change benchmarks for the CBCL, YSR, and TRF total, externalizing, internalizing, and attention benchmarks,</u>'' [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase&wteswitched=1#Clinically_significant_change_benchmarks_for_widely-used_outcome_measures see here.] {| class="wikitable sortable" border="1" | colspan="7" |'''Clinically significant change benchmarks with common instruments for PTSD''' |- | colspan="7" style="font-size:110%; text-align:center;" span |<b> Benchmarks Based on Published Norms</b> |- | rowspan="2" style="text-align:center;font-size:130%;" |<b> Measure</b> | colspan="3" style="text-align:center;font-size:130%" width="300" |<b> Cut-off scores</b> | colspan="3" style="text-align:center;font-size:120%" |<b> Critical Change <br> (unstandardized scores)</b> |- | style="text-align:center;font-size:110%" |<b> A</b> | style="text-align:center;font-size:110%" |<b> B</b> | style="text-align:center;font-size:110%" |<b> C</b> | style="text-align:center;font-size:110%" |<b> 95%</b> | style="text-align:center;font-size:110%" |<b> 90%</b> | style="text-align:center;font-size:110%" |<b> SE_difference</b> |- | rowspan="1" style="text-align:center;" | Primary Care PTSD Screen | style="text-align:center;" | 1.0 | style="text-align:center;" | 3.1 | style="text-align:center;" | 2.0 | style="text-align:center;" | 1.0 | style="text-align:center;" | .8 | style="text-align:center;" | .5 |- | rowspan="1" style="text-align:center;" | PTSD Checklist Scores | style="text-align:center;" | 28.8 | style="text-align:center;" | 40.8 | style="text-align:center;" | 34.9 | style="text-align:center;" | 4.6 | style="text-align:center;" | 3.8 | style="text-align:center;" | 2.3 |- | rowspan="1" style="text-align:center;" | Clinician Administered PTSD Scale | style="text-align:center;" | 28.8 | style="text-align:center;" | 40.8 | style="text-align:center;" | 34.9 | style="text-align:center;" | 8.3 | style="text-align:center;" | 7.0 | style="text-align:center;" | 4.2 |} === Treatment === * Please refer to the Wikipedia page on [[wikipedia:Posttraumatic_stress_disorder|PTSD]] for more information on available treatment for PTSD or go to the [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/post-traumatic-stress-disorder/ Effective Child Therapy] page for for a curated resource on effective treatments for PTSD. {{collapse top| Click here for more information}} '''<big>Behavioral interventions</big>''' Recommended (have ''significant benefit'') <ref name=":0">Department of Veterans Affairs and Department of Defense. . (2010). VA/DoD clinical practice guidelines: management of post-traumatic stress. Washington, D.C.: Veterans Health Administration, Department of Defense.</ref>: # Brief Cognitive Behavioral Therapy (CBT; 4-5 sessions) #* This includes stress inoculation training, trauma-focused therapy including components of cognitive restructuring, Cognitive Processing Therapy (CPT), imaginal, virtual, and in-vivo exposure as in Prolonged Exposure psychotherapy (PE)² #* Patient education is recommended as part of psychotherapy for patients and family members # EMDR may help both acute and chronic PTSD, especially individuals who have trouble with prolonged exposure or have trouble verbalizing their trauma.<ref name=":1">Ursano, R. J., Bell, C., Eth, S., Friedman, M., Norwood, A., Pfefferbaum, B., . . . McIntyre, J. S. (2004). ''Practice guideline for the treatment of patients with acute stress disorder and posttraumatic stress disorder'': American Psychiatric Publ </ref> ## Long term gains require further study. # [https://www.ptsd.va.gov/professional/treat/txessentials/present_centered_therapy.asp Present-Centered Therapy (PCT)] is a non trauma focused treatment for PTSD and a second-line treatment for PTSD<ref>{{Cite web|url=https://www.ptsd.va.gov/professional/treat/txessentials/present_centered_therapy.asp|title=Present-Centered Therapy for PTSD - PTSD: National Center for PTSD|website=www.ptsd.va.gov|language=en|access-date=2022-08-13}}</ref>. Treatments with weaker evidence (have ''some benefit'') <ref name=":0" />: # Patient education, # Imagery rehearsal therapy, # Psychodynamic therapy, # Hypnosis, # Relaxation techniques, # and Group therapy. Treatment with ''unknown benefit'' <ref name=":0" />: # Web-based CBT ## For example Jeane Bosch participated as a study therapist in research study that compared STAIR and present-centered therapy both delivered via telehealth. STAIR stands for Skills Training in Affective and Interpersonal Regulation. It is a skill-focused treatment that was originally developed for survivors of childhood abuse to teach emotion regulation skills as well as tools to help with challenges interpersonal functioning and social relationships and decrease PTSD symptoms<ref>{{Cite web|url=https://istss.org/public-resources/trauma-blog/2015-march-(1)/clinician-s-corner-skills-training-in-affective-an|title=ISTSS - Trauma Blog|website=istss.org|access-date=2022-08-13}}</ref>.<ref>{{Citation|title=Introduction to Telehealth with Dr. Bosch|url=https://www.youtube.com/watch?v=Wn6Vewl42X8|accessdate=2022-08-13|language=en}}</ref> # Acceptance and commitment therapy, # and Dialectical Behavioral Therapy. <big>'''Medication'''</big> *SSRIs are more effective than placebo in treating PTSD.<ref name=":1" /> *There is no evidence to support a medication to prevent the development of PTSD.<ref name=":0" /> **Imipramine, propranolol, prazosin, other antidepressants, anticonvulsants, and atypical antipsychotics have ''unknown benefit.'' **Strongly recommend against the use of benzodiazepines² and typical antipsychotics since they have ''no benefit and potential harm.'' {{collapse bottom}} == '''External resources''' == === For professionals === * [http://www.som.uq.edu.au/ptsd Post Traumatic Stress Disorder Information Resource] from [http://www.uq.edu.au/ The University of Queensland School of Medicine] * [http://www.apa.org/ptsd-guideline/ APA practice parameters for assessment and treatment for PTSD (Updated 2017)] * [http://www.ptsd.va.gov/professional/index.asp Resources for professionals] from [http://www.ptsd.va.gov/index.asp VA National PTSD Center] * [https://www.integration.samhsa.gov/clinical-practice/trauma-informed SAMHSA's Trauma-Informed Care Resources and Training] * [https://www.integration.samhsa.gov/clinical-practice/trauma-informed SAMHSA's Resources on Intimate Partner Violence (IPV) for Clinicians, Patients, Families, and Organizations] === For caregivers === * [http://www.nctsn.org/sites/default/files/assets/pdfs/tips_for_parents_media_final.pdf Tips for parents on shooting media coverage] * [http://www.nctsn.org/sites/default/files/assets/pdfs/parents_guidelines_for_helping_teens_after_the_recent_attacks.pdf Parent guidelines to helping youths after a shooting] * [http://www.nctsn.org/sites/default/files/assets/pdfs/helping_teens_with_traumatic_grief_caregivers_final.pdf Caregiver tips for helping teens with traumatic grief] * [http://www.nctsn.org/sites/default/files/assets/pdfs/10things_schoolage_ctg.pdf Caregiver tips for helping school-age children with traumatic grief] *[http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/post-traumatic-stress-disorder/ EffectiveChildTherapy.Org information on PTSD] *[https://sccap53.org Society of Clinical Child and Adolescent Psychology] === For educators === * [http://www.nctsn.org/sites/default/files/assets/pdfs/pfa_for_schools_appendix_a_teachers.pdf Teacher tips for providing psychological first aid] * [http://www.nctsn.org/sites/default/files/assets/pdfs/helping_youth_after_community_violence_educators.pdf Educator tips for helping youths after a community trauma] === For public === * [https://complicatedgrief.columbia.edu/for-the-public/resources/ Resources for grief and loss] * [http://www.nctsn.org/sites/default/files/assets/pdfs/psychological_information_sheet_two_pager.pdf Psychological impacts of recent shootings] * [http://www.nctsn.org/sites/default/files/assets/pdfs/youth_journalists.pdf Tips to talking to youths about a shooting] * [http://www.nctsn.org/sites/default/files/assets/pdfs/talking_to_children_about_the_shooting.pdf Tips to talking to children about a shooting] * [http://www.nctsn.org/sites/default/files/assets/pdfs/helping_young_children_heal_crisis.pdf Helping young children heal after a crisis] * [http://www.nctsn.org/content/psychological-first-aid-schoolspfa Psychological first aid for schools] * [http://www.nctsn.org/content/psychological-first-aid Resources and manuals on psychological first aid] * [http://www.ptsd.va.gov/public/index.asp Resources for the public] from [http://www.ptsd.va.gov/index.asp VA National PTSD Center] * [https://curlie.org/Health/Mental_Health/Disorders/Anxiety/Post-traumatic_Stress Posttraumatic stress disorder] at Curlie (based on DMOZ) =='''References'''== {{collapse top|Click here for references}} {{Reflist|30em}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] {{collapse bottom}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] 0rnhc56l63ueg4onvr2rtnahd7zfz8a 2419144 2419143 2022-08-26T00:41:59Z Ardenguo 2944162 /* Psychometric properties of screening for PTSD */ removed Acute Stress Disorder Scale (ASDS) wikitext text/x-wiki <noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{medical disclaimer}} {{:{{BASEPAGENAME}}/Sidebar}} ==[[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio"?''']]== * For background information on what assessment portfolios are, click the link in the heading above. * Want even 'more' information about this topic? There's an extended version of this page [[Evidence-based assessment/Posttraumatic stress disorder (disorder portfolio)/extended version|'''here''']]. == [[Evidence based assessment/Preparation phase|'''Preparation phase''']] == === Diagnostic criteria for post traumatic stress disorder === ===='''ICD-11 Diagnostic Criteria'''==== {{blockquotetop}} ===='''ICD-11 Criteria'''==== *Post-traumatic stress disorder (PTSD) is a syndrome that develops following exposure to an extremely threatening or horrific event or series of events that is characterized by all of the following: **1) re-experiencing the traumatic event or events in the present in the form of vivid intrusive memories, flashbacks, or nightmares, which are typically accompanied by strong and overwhelming emotions such as fear or horror and strong physical sensations, or feelings of being overwhelmed or immersed in the same intense emotions that were experienced during the traumatic event; **2) avoidance of thoughts and memories of the event or events, or avoidance of activities, situations, or people reminiscent of the event or events **3) persistent perceptions of heightened current threat, for example as indicated by hypervigilance or an enhanced startle reaction to stimuli such as unexpected noises. *The symptoms must persist for at least several weeks and cause significant impairment in personal, family, social, educational, occupational or other important areas of functioning. Additionally, ICD 11 includes a category called "Complex post-traumatic stress disorder," which is described as: *A disorder that may develop following exposure to an event or series of events of an extremely threatening or horrific nature, most commonly prolonged or repetitive events from which escape is difficult or impossible (e.g., torture, slavery, genocide campaigns, prolonged domestic violence, repeated childhood sexual or physical abuse). *The disorder is characterized by the core symptoms of PTSD; that is, all diagnostic requirements for PTSD have been met at some point during the course of the disorder. *In addition, Complex PTSD is characterized by: **1) severe and pervasive problems in affect regulation; **2) persistent beliefs about oneself as diminished, defeated or worthless, accompanied by deep and pervasive feelings of shame, guilt or failure related to the traumatic event **3) persistent difficulties in sustaining relationships and in feeling close to others. The disturbance causes significant impairment in personal, family, social, educational, occupational or other important areas of functioning. {{blockquotebottom}} ===='''Changes in DSM-5'''==== * The diagnostic criteria for post-traumatic stress disorder changed slightly from [[DSM-IV]] to [[w:Diagnostic_and_Statistical_Manual_of_Mental_Disorders#DSM-IV-TR_.282000.29|DSM-5]]. Summaries are available [http://www.dsm5.org/Documents/changes%20from%20dsm-iv-tr%20to%20dsm-5.pdf here] and [[w:DSM-5|here]]. === Developmental sensitivities === {{collapse top| Click for more information}} *Diagnostic thresholds have been lowered for children and adolescents to account for development. *Separate and additional criteria have been added for children age 6 or younger. *Child sexual abuse has been found to have a substantial effect on the development of PTSD.<ref>{{cite journal|last1=Paolucci|first1=Elizabeth ODDONE|last2=Genuis|first2=Mark L.|last3=Violato|first3=Claudio|title=A Meta-Analysis of the Published Research on the Effects of Child Sexual Abuse|journal=The Journal of Psychology|date=January 2001|volume=135|issue=1|pages=17–36|doi=10.1080/00223980109603677}}</ref> *Children with higher exposure to trauma, less social support, and other major life events are more likely to have continued PTSD symptoms 7 months after a trauma.<ref name=":2">{{cite journal |last1=La Greca|first1=A|last2=Silverman|first2=WK|last3=Vernberg|first3=EM|last4=Prinstein|first4=MJ|title=Symptoms of posttraumatic stress in children after Hurricane Andrew: a prospective study.|journal=Journal of consulting and clinical psychology|date=August 1996|volume=64|issue=4|pages=712-23|pmid=8803361}}</ref> 10 months after a trauma, however, only experience of a major life event remained predictive of continuing PTSD symptoms.<ref name=":2" /> *Lack of social support, specifically lack of support by a teacher, was predictive of higher PTSD symptoms among children who had gone through an environmental trauma.<ref name=":2" /> *Children who reported using blame and anger as strategies for coping had higher levels of PTSD symptoms 10 months after a trauma.<ref name=":2" /> *Negative affect in children before a traumatic event was predictive of development of PTSD symptoms after a traumatic event.<ref>{{cite journal|last1=Weems|first1=CF|last2=Pina|first2=AA|last3=Costa|first3=NM|last4=Watts|first4=SE|last5=Taylor|first5=LK|last6=Cannon|first6=MF|title=Predisaster trait anxiety and negative affect predict posttraumatic stress in youths after hurricane Katrina.|journal=Journal of consulting and clinical psychology|date=February 2007|volume=75|issue=1|pages=154-9|doi=10.1037/0022-006X.75.1.154|pmid=17295574}}</ref> [[wikipedia:Posttraumatic_stress_disorder|Posttraumatic stress disorder]] is now more sensitive to development in that diagnostic thresholds have been lowered for children and adolescents. Furthermore, separate and additional criteria have been added for children age 6 years of age or younger. {{collapse bottom}} === Base rates of PTSD in different clinical settings and populations === This section describes the demographic settings of the populations sampled, base rates of PTSD diagnoses, country/region sampled, and the diagnostic methods that were used. Using this information, clinicians will be able to anchor the most appropriate rate of PTSD that they are likely to see in their clinical practice. * '''''To see prevalence rates across multiple disorders,''''' [[Evidence based assessment/Preparation phase#Base rates for transdiagnostic comparison|'''''click here.''''']] {| class="wikitable sortable" border="1" |- ! Demography ! Setting ! Base Rate ! Diagnostic Method |- | United States, nationally representative, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Kessler|first=Ronald C.|last2=Berglund|first2=Patricia|last3=Demler|first3=Olga|last4=Jin|first4=Robert|last5=Merikangas|first5=Kathleen R.|last6=Walters|first6=Ellen E.|date=2005-06-01|title=Lifetime Prevalence and Age-of-Onset Distributions of DSM-IV Disorders in the National Comorbidity Survey Replication|url=http://archpsyc.jamanetwork.com/article.aspx?doi=10.1001/archpsyc.62.6.593|journal=Archives of General Psychiatry|language=en|volume=62|issue=6|doi=10.1001/archpsyc.62.6.593|issn=0003-990X}}</ref> | 6.8% | National Comorbidity Survey - Replication |- | Netherlands, nationally representative, age 18-80 | Non-clinical: Population based<ref>{{Cite journal|last=de Vries|first=Giel-Jan|last2=Olff|first2=Miranda|date=2009-08-01|title=The lifetime prevalence of traumatic events and posttraumatic stress disorder in the Netherlands|url=http://onlinelibrary.wiley.com/doi/10.1002/jts.20429/abstract|journal=Journal of Traumatic Stress|language=en|volume=22|issue=4|pages=259–267|doi=10.1002/jts.20429|issn=1573-6598}}</ref> | 7.4% | Composite International Diagnostic Interview (CIDI) |- | United States, nationally representative, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Pietrzak|first=Robert H.|last2=Goldstein|first2=Risë B.|last3=Southwick|first3=Steven M.|last4=Grant|first4=Bridget F.|title=Prevalence and Axis I comorbidity of full and partial posttraumatic stress disorder in the United States: Results from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions|url=http://linkinghub.elsevier.com/retrieve/pii/S0887618510002288|journal=Journal of Anxiety Disorders|volume=25|issue=3|pages=456–465|doi=10.1016/j.janxdis.2010.11.010}}</ref> | 6.4% | Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions |- | Northern Ireland, representative sample, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Bunting|first=Brendan P.|last2=Ferry|first2=Finola R.|last3=Murphy|first3=Samuel D.|last4=O'Neill|first4=Siobhan M.|last5=Bolton|first5=David|date=2013-02-01|title=Trauma Associated With Civil Conflict and Posttraumatic Stress Disorder: Evidence From the Northern Ireland Study of Health and Stress|url=http://onlinelibrary.wiley.com/doi/10.1002/jts.21766/abstract|journal=Journal of Traumatic Stress|language=en|volume=26|issue=1|pages=134–141|doi=10.1002/jts.21766|issn=1573-6598}}</ref> | 8.8% | Northern Ireland Study of Health and Stress |- | South Africa, nationally representative sample, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Atwoli|first=Lukoye|last2=Stein|first2=Dan J.|last3=Williams|first3=David R.|last4=Mclaughlin|first4=Katie A.|last5=Petukhova|first5=Maria|last6=Kessler|first6=Ronald C.|last7=Koenen|first7=Karestan C.|date=2013-07-03|title=Trauma and posttraumatic stress disorder in South Africa: analysis from the South African Stress and Health Study|url=https://doi.org/10.1186/1471-244X-13-182|journal=BMC Psychiatry|volume=13|pages=182|doi=10.1186/1471-244x-13-182|issn=1471-244X}}</ref> | 2.3% | South African Stress and Health Study, using the Composite International Diagnostic Interview (CIDI) |- | U.S. Army and Marine Soldiers Deployed to Iraq and Afghanistan | U.S. Service Members<ref>{{Cite journal|last=Hoge|first=Charles W.|last2=Castro|first2=Carl A.|last3=Messer|first3=Stephen C.|last4=McGurk|first4=Dennis|last5=Cotting|first5=Dave I.|last6=Koffman|first6=Robert L.|date=2004-07-01|title=Combat Duty in Iraq and Afghanistan, Mental Health Problems, and Barriers to Care|url=http://dx.doi.org/10.1056/NEJMoa040603|journal=New England Journal of Medicine|volume=351|issue=1|pages=13–22|doi=10.1056/nejmoa040603|issn=0028-4793|pmid=15229303}}</ref> |11.5% - 19.5% ♦ | PTSD Checklist |- |United States, nationally representative, ages 13-18 |Non-clinical: Population based<ref>{{Cite journal|last=Merikangas|first=Kathleen Ries|last2=He|first2=Jian-ping|last3=Burstein|first3=Marcy|last4=Swanson|first4=Sonja A.|last5=Avenevoli|first5=Shelli|last6=Cui|first6=Lihong|last7=Benjet|first7=Corina|last8=Georgiades|first8=Katholiki|last9=Swendsen|first9=Joel|title=Lifetime Prevalence of Mental Disorders in U.S. Adolescents: Results from the National Comorbidity Survey Replication–Adolescent Supplement (NCS-A)|url=https://doi.org/10.1016/j.jaac.2010.05.017|journal=Journal of the American Academy of Child & Adolescent Psychiatry|volume=49|issue=10|pages=980–989|doi=10.1016/j.jaac.2010.05.017}}</ref> |5.0% |National Comorbidity Survey Replication—Adolescent Supplement (NCS-A) |} ♦ '''Note''': These rates were using broad PTSD Checklist scoring criteria of being scored positive if subjects reported at least one intrusion symptom, three avoidance symptoms, and two hyperarousal symptom that were categorized as at the moderate level. The 11.5% is for soldiers returning from deployment in Iraq, 19.5% is for soldiers returning from Afghanistan. Another common practice is to use a strict cutoff of 50 on the PCL, above which someone screens positive for PTSD. With this cutoff, rates are 6.2% and 12.9% for Service Members returned from Afghanistan and Iraqi, respectively. ==[[Evidence based assessment/Prediction phase|'''Prediction phase''']]== === Psychometric properties of screening for PTSD === The following section contains a list of screening and diagnostic instruments for PTSD. The section includes administration information, psychometric data, and PDFs or links to the screenings. * Screenings are used as part of the [[Evidence based assessment/Prediction phase|prediction phase]] of assessment; for more information on interpretation of this data, or how screenings fit in to the assessment process, click [[Evidence based assessment/Prediction phase|here.]] * '''''For a list of more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Psychometric_properties_of_common_screening_instruments click here.]''''' {| class="wikitable" |- ! Measure !Format (Reporter) !Age Range !Administration/ Completion Time !Where to Access |- |[https://www.ptsd.va.gov/professional/assessment/adult-sr/ptsd-checklist.asp PCL-5 (PTSD Checklist for DSM-5)] |Self-Report |adult |5-10 minutes | * [https://www.ptsd.va.gov/professional/assessment/documents/PCL5_Standard_form.PDFPDF PDF] * [https://unc.az1.qualtrics.com/jfe/form/SV_9nmXgrLPpvhPhgF Online version (Spanish)] |- |PDS-5 (Post-traumatic Diagnosis Scale) |Self-Report |adult |10-20 minutes |[https://www.ptsd.va.gov/professional/assessment/adult-sr/pds.asp How to request] |- | colspan="4" style="font-size:110%; text-align:center;" |'''For Children and Adolescents Specifically''' | |- |[https://www.reactionindex.com/index.php/ UCLA PTSD Reaction Index for DSM-5] |Clinician Administered |child, school age, adolescents |20-30 minutes |[https://www.dellchildrens.net/wp-content/uploads/sites/60/2019/08/UCLA-PTSD-RI-DSM-5.pdf PDF] |- |CPSS (Children's PTSD Symptom Scale) |Self-Report |child |10-20 minutes | * [https://www.aacap.org/App_Themes/AACAP/docs/resource_centers/resources/misc/child_ptsd_symptom_scale.pdf PDF] * [https://unc.az1.qualtrics.com/jfe/form/SV_6XPDvzlfkg2SQRf Online version] |- |Young Child PTSD Checklist (YCPC) |Parent Report |child |13 items |[https://medicine.tulane.edu/sites/g/files/rdw761/f/YCPC_v5_23_14.pdf PDF] |} === Interpreting PTSD screening measure scores === * For information on interpreting screening measure scores, click [[Evidence based assessment/Prediction phase#Interpreting screening measure scores|here.]] * Also see the page on [https://en.wikipedia.org/wiki/Likelihood_ratios_in_diagnostic_testing likelihood ratios in diagnostic testing] for more information ==[[Evidence based assessment/Prescription phase|'''Prescription phase''']]== ===Gold standard diagnostic interviews=== * For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews click here.] ===Recommended diagnostic interviews for PTSD=== {| class="wikitable sortable" border="1" ! colspan="4" |Diagnostic instruments for PTSD ! |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time !Where to Access |- | [https://www.ptsd.va.gov/professional/assessment/adult-int/caps.asp CAPS-5 (Clinician Administered PTSD Scale)] | Clinician Administered Interview | adult | 40-60 minutes |[https://www.ptsd.va.gov/professional/assessment/ncptsd-instrument-request-form.asp Assessment request form] |- |PTSD Symptom Scale Interview (PSS-I-5) |Clinician Administered Interview |adult and child version available |24 items |[http://www.advanced-counseling.com/dl/PSSI-5.pdf PDF] |- | colspan="4" style="font-size:110%; text-align:center;" |'''For Children and Adolescents Specifically''' | |- | [https://www.ptsd.va.gov/professional/assessment/child/caps-ca.asp CAPS-CA-5 (Clinician-Administered PTSD Scale for DSM-5 - Child/Adolescent Version)] |Clinician Administered Interview |child |30 items |[https://www.ptsd.va.gov/professional/assessment/ncptsd-instrument-request-form.asp Assessment request form] |- | Children’s PTSD Inventory (CPTSD-I) |Diagnostic Interview | 6-18 years | 50 items |Not Free |} ===Severity interviews for PTSD=== {| class="wikitable sortable" border="1" |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time !Where to Access |- | Schedule for Affective Disorders and Schizophrenia for School Age Children (K-SADS) | Diagnostic Interview | 6-18 years | 18 PTSD items |[https://www.pediatricbipolar.pitt.edu/sites/default/files/KSADS_DSM_5_SCREEN_Final.pdf PDF] |- | Anxiety Disorders Interview Schedule, Child Version (ADIS-C) | Diagnostic Interview | 7-17 years | 26 PTSD items |Not free |- | Diagnostic Infant and Preschool Assessment (DIPA) |Diagnostic Interview | Age 6 and younger | 46 PTSD items |[https://medicine.tulane.edu/sites/g/files/rdw761/f/DIPA-2017-2-14.pdf PDF] |} ==[[Evidence based assessment/Process phase|'''Process phase''']]== The following section contains a brief overview of treatment options for PTSD and list of process and outcome measures for PTSD. The section includes benchmarks based on published norms for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the [[Evidence based assessment/Process phase|process phase]] of assessment. For more information of differences between process and outcome measures, see the page on the [[Evidence based assessment/Process phase|process phase of assessment]]. === Process measures === * Information coming soon === Outcome and severity measures === This table includes clinically significant benchmarks for PTSD specific outcome measures * Information on how to interpret this table can be [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase found here]. * Additionally, these [[Evidence based assessment/Vignettes|vignettes]] might be helpful resources for understanding appropriate adaptation of outcome measures in practice. * ''<u>For clinically significant change benchmarks for the CBCL, YSR, and TRF total, externalizing, internalizing, and attention benchmarks,</u>'' [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase&wteswitched=1#Clinically_significant_change_benchmarks_for_widely-used_outcome_measures see here.] {| class="wikitable sortable" border="1" | colspan="7" |'''Clinically significant change benchmarks with common instruments for PTSD''' |- | colspan="7" style="font-size:110%; text-align:center;" span |<b> Benchmarks Based on Published Norms</b> |- | rowspan="2" style="text-align:center;font-size:130%;" |<b> Measure</b> | colspan="3" style="text-align:center;font-size:130%" width="300" |<b> Cut-off scores</b> | colspan="3" style="text-align:center;font-size:120%" |<b> Critical Change <br> (unstandardized scores)</b> |- | style="text-align:center;font-size:110%" |<b> A</b> | style="text-align:center;font-size:110%" |<b> B</b> | style="text-align:center;font-size:110%" |<b> C</b> | style="text-align:center;font-size:110%" |<b> 95%</b> | style="text-align:center;font-size:110%" |<b> 90%</b> | style="text-align:center;font-size:110%" |<b> SE_difference</b> |- | rowspan="1" style="text-align:center;" | Primary Care PTSD Screen | style="text-align:center;" | 1.0 | style="text-align:center;" | 3.1 | style="text-align:center;" | 2.0 | style="text-align:center;" | 1.0 | style="text-align:center;" | .8 | style="text-align:center;" | .5 |- | rowspan="1" style="text-align:center;" | PTSD Checklist Scores | style="text-align:center;" | 28.8 | style="text-align:center;" | 40.8 | style="text-align:center;" | 34.9 | style="text-align:center;" | 4.6 | style="text-align:center;" | 3.8 | style="text-align:center;" | 2.3 |- | rowspan="1" style="text-align:center;" | Clinician Administered PTSD Scale | style="text-align:center;" | 28.8 | style="text-align:center;" | 40.8 | style="text-align:center;" | 34.9 | style="text-align:center;" | 8.3 | style="text-align:center;" | 7.0 | style="text-align:center;" | 4.2 |} === Treatment === * Please refer to the Wikipedia page on [[wikipedia:Posttraumatic_stress_disorder|PTSD]] for more information on available treatment for PTSD or go to the [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/post-traumatic-stress-disorder/ Effective Child Therapy] page for for a curated resource on effective treatments for PTSD. {{collapse top| Click here for more information}} '''<big>Behavioral interventions</big>''' Recommended (have ''significant benefit'') <ref name=":0">Department of Veterans Affairs and Department of Defense. . (2010). VA/DoD clinical practice guidelines: management of post-traumatic stress. Washington, D.C.: Veterans Health Administration, Department of Defense.</ref>: # Brief Cognitive Behavioral Therapy (CBT; 4-5 sessions) #* This includes stress inoculation training, trauma-focused therapy including components of cognitive restructuring, Cognitive Processing Therapy (CPT), imaginal, virtual, and in-vivo exposure as in Prolonged Exposure psychotherapy (PE)² #* Patient education is recommended as part of psychotherapy for patients and family members # EMDR may help both acute and chronic PTSD, especially individuals who have trouble with prolonged exposure or have trouble verbalizing their trauma.<ref name=":1">Ursano, R. J., Bell, C., Eth, S., Friedman, M., Norwood, A., Pfefferbaum, B., . . . McIntyre, J. S. (2004). ''Practice guideline for the treatment of patients with acute stress disorder and posttraumatic stress disorder'': American Psychiatric Publ </ref> ## Long term gains require further study. # [https://www.ptsd.va.gov/professional/treat/txessentials/present_centered_therapy.asp Present-Centered Therapy (PCT)] is a non trauma focused treatment for PTSD and a second-line treatment for PTSD<ref>{{Cite web|url=https://www.ptsd.va.gov/professional/treat/txessentials/present_centered_therapy.asp|title=Present-Centered Therapy for PTSD - PTSD: National Center for PTSD|website=www.ptsd.va.gov|language=en|access-date=2022-08-13}}</ref>. Treatments with weaker evidence (have ''some benefit'') <ref name=":0" />: # Patient education, # Imagery rehearsal therapy, # Psychodynamic therapy, # Hypnosis, # Relaxation techniques, # and Group therapy. Treatment with ''unknown benefit'' <ref name=":0" />: # Web-based CBT ## For example Jeane Bosch participated as a study therapist in research study that compared STAIR and present-centered therapy both delivered via telehealth. STAIR stands for Skills Training in Affective and Interpersonal Regulation. It is a skill-focused treatment that was originally developed for survivors of childhood abuse to teach emotion regulation skills as well as tools to help with challenges interpersonal functioning and social relationships and decrease PTSD symptoms<ref>{{Cite web|url=https://istss.org/public-resources/trauma-blog/2015-march-(1)/clinician-s-corner-skills-training-in-affective-an|title=ISTSS - Trauma Blog|website=istss.org|access-date=2022-08-13}}</ref>.<ref>{{Citation|title=Introduction to Telehealth with Dr. Bosch|url=https://www.youtube.com/watch?v=Wn6Vewl42X8|accessdate=2022-08-13|language=en}}</ref> # Acceptance and commitment therapy, # and Dialectical Behavioral Therapy. <big>'''Medication'''</big> *SSRIs are more effective than placebo in treating PTSD.<ref name=":1" /> *There is no evidence to support a medication to prevent the development of PTSD.<ref name=":0" /> **Imipramine, propranolol, prazosin, other antidepressants, anticonvulsants, and atypical antipsychotics have ''unknown benefit.'' **Strongly recommend against the use of benzodiazepines² and typical antipsychotics since they have ''no benefit and potential harm.'' {{collapse bottom}} == '''External resources''' == === For professionals === * [http://www.som.uq.edu.au/ptsd Post Traumatic Stress Disorder Information Resource] from [http://www.uq.edu.au/ The University of Queensland School of Medicine] * [http://www.apa.org/ptsd-guideline/ APA practice parameters for assessment and treatment for PTSD (Updated 2017)] * [http://www.ptsd.va.gov/professional/index.asp Resources for professionals] from [http://www.ptsd.va.gov/index.asp VA National PTSD Center] * [https://www.integration.samhsa.gov/clinical-practice/trauma-informed SAMHSA's Trauma-Informed Care Resources and Training] * [https://www.integration.samhsa.gov/clinical-practice/trauma-informed SAMHSA's Resources on Intimate Partner Violence (IPV) for Clinicians, Patients, Families, and Organizations] === For caregivers === * [http://www.nctsn.org/sites/default/files/assets/pdfs/tips_for_parents_media_final.pdf Tips for parents on shooting media coverage] * [http://www.nctsn.org/sites/default/files/assets/pdfs/parents_guidelines_for_helping_teens_after_the_recent_attacks.pdf Parent guidelines to helping youths after a shooting] * [http://www.nctsn.org/sites/default/files/assets/pdfs/helping_teens_with_traumatic_grief_caregivers_final.pdf Caregiver tips for helping teens with traumatic grief] * [http://www.nctsn.org/sites/default/files/assets/pdfs/10things_schoolage_ctg.pdf Caregiver tips for helping school-age children with traumatic grief] *[http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/post-traumatic-stress-disorder/ EffectiveChildTherapy.Org information on PTSD] *[https://sccap53.org Society of Clinical Child and Adolescent Psychology] === For educators === * [http://www.nctsn.org/sites/default/files/assets/pdfs/pfa_for_schools_appendix_a_teachers.pdf Teacher tips for providing psychological first aid] * [http://www.nctsn.org/sites/default/files/assets/pdfs/helping_youth_after_community_violence_educators.pdf Educator tips for helping youths after a community trauma] === For public === * [https://complicatedgrief.columbia.edu/for-the-public/resources/ Resources for grief and loss] * [http://www.nctsn.org/sites/default/files/assets/pdfs/psychological_information_sheet_two_pager.pdf Psychological impacts of recent shootings] * [http://www.nctsn.org/sites/default/files/assets/pdfs/youth_journalists.pdf Tips to talking to youths about a shooting] * [http://www.nctsn.org/sites/default/files/assets/pdfs/talking_to_children_about_the_shooting.pdf Tips to talking to children about a shooting] * [http://www.nctsn.org/sites/default/files/assets/pdfs/helping_young_children_heal_crisis.pdf Helping young children heal after a crisis] * [http://www.nctsn.org/content/psychological-first-aid-schoolspfa Psychological first aid for schools] * [http://www.nctsn.org/content/psychological-first-aid Resources and manuals on psychological first aid] * [http://www.ptsd.va.gov/public/index.asp Resources for the public] from [http://www.ptsd.va.gov/index.asp VA National PTSD Center] * [https://curlie.org/Health/Mental_Health/Disorders/Anxiety/Post-traumatic_Stress Posttraumatic stress disorder] at Curlie (based on DMOZ) =='''References'''== {{collapse top|Click here for references}} {{Reflist|30em}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] {{collapse bottom}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] hjwkcl29moszjc8a85cthntsmbb28cv 2419221 2419144 2022-08-26T03:02:26Z Ardenguo 2944162 /* Developmental sensitivities */ Made the collapsible box expanded by default, edited box title wikitext text/x-wiki <noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{medical disclaimer}} {{:{{BASEPAGENAME}}/Sidebar}} ==[[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio"?''']]== * For background information on what assessment portfolios are, click the link in the heading above. * Want even 'more' information about this topic? There's an extended version of this page [[Evidence-based assessment/Posttraumatic stress disorder (disorder portfolio)/extended version|'''here''']]. == [[Evidence based assessment/Preparation phase|'''Preparation phase''']] == === Diagnostic criteria for post traumatic stress disorder === ===='''ICD-11 Diagnostic Criteria'''==== {{blockquotetop}} ===='''ICD-11 Criteria'''==== *Post-traumatic stress disorder (PTSD) is a syndrome that develops following exposure to an extremely threatening or horrific event or series of events that is characterized by all of the following: **1) re-experiencing the traumatic event or events in the present in the form of vivid intrusive memories, flashbacks, or nightmares, which are typically accompanied by strong and overwhelming emotions such as fear or horror and strong physical sensations, or feelings of being overwhelmed or immersed in the same intense emotions that were experienced during the traumatic event; **2) avoidance of thoughts and memories of the event or events, or avoidance of activities, situations, or people reminiscent of the event or events **3) persistent perceptions of heightened current threat, for example as indicated by hypervigilance or an enhanced startle reaction to stimuli such as unexpected noises. *The symptoms must persist for at least several weeks and cause significant impairment in personal, family, social, educational, occupational or other important areas of functioning. Additionally, ICD 11 includes a category called "Complex post-traumatic stress disorder," which is described as: *A disorder that may develop following exposure to an event or series of events of an extremely threatening or horrific nature, most commonly prolonged or repetitive events from which escape is difficult or impossible (e.g., torture, slavery, genocide campaigns, prolonged domestic violence, repeated childhood sexual or physical abuse). *The disorder is characterized by the core symptoms of PTSD; that is, all diagnostic requirements for PTSD have been met at some point during the course of the disorder. *In addition, Complex PTSD is characterized by: **1) severe and pervasive problems in affect regulation; **2) persistent beliefs about oneself as diminished, defeated or worthless, accompanied by deep and pervasive feelings of shame, guilt or failure related to the traumatic event **3) persistent difficulties in sustaining relationships and in feeling close to others. The disturbance causes significant impairment in personal, family, social, educational, occupational or other important areas of functioning. {{blockquotebottom}} ===='''Changes in DSM-5'''==== * The diagnostic criteria for post-traumatic stress disorder changed slightly from [[DSM-IV]] to [[w:Diagnostic_and_Statistical_Manual_of_Mental_Disorders#DSM-IV-TR_.282000.29|DSM-5]]. Summaries are available [http://www.dsm5.org/Documents/changes%20from%20dsm-iv-tr%20to%20dsm-5.pdf here] and [[w:DSM-5|here]]. === Developmental sensitivities === {{collapse top| More information on developmental sensitivities|expand=yes}} *Diagnostic thresholds have been lowered for children and adolescents to account for development. *Separate and additional criteria have been added for children age 6 or younger. *Child sexual abuse has been found to have a substantial effect on the development of PTSD.<ref>{{cite journal|last1=Paolucci|first1=Elizabeth ODDONE|last2=Genuis|first2=Mark L.|last3=Violato|first3=Claudio|title=A Meta-Analysis of the Published Research on the Effects of Child Sexual Abuse|journal=The Journal of Psychology|date=January 2001|volume=135|issue=1|pages=17–36|doi=10.1080/00223980109603677}}</ref> *Children with higher exposure to trauma, less social support, and other major life events are more likely to have continued PTSD symptoms 7 months after a trauma.<ref name=":2">{{cite journal |last1=La Greca|first1=A|last2=Silverman|first2=WK|last3=Vernberg|first3=EM|last4=Prinstein|first4=MJ|title=Symptoms of posttraumatic stress in children after Hurricane Andrew: a prospective study.|journal=Journal of consulting and clinical psychology|date=August 1996|volume=64|issue=4|pages=712-23|pmid=8803361}}</ref> 10 months after a trauma, however, only experience of a major life event remained predictive of continuing PTSD symptoms.<ref name=":2" /> *Lack of social support, specifically lack of support by a teacher, was predictive of higher PTSD symptoms among children who had gone through an environmental trauma.<ref name=":2" /> *Children who reported using blame and anger as strategies for coping had higher levels of PTSD symptoms 10 months after a trauma.<ref name=":2" /> *Negative affect in children before a traumatic event was predictive of development of PTSD symptoms after a traumatic event.<ref>{{cite journal|last1=Weems|first1=CF|last2=Pina|first2=AA|last3=Costa|first3=NM|last4=Watts|first4=SE|last5=Taylor|first5=LK|last6=Cannon|first6=MF|title=Predisaster trait anxiety and negative affect predict posttraumatic stress in youths after hurricane Katrina.|journal=Journal of consulting and clinical psychology|date=February 2007|volume=75|issue=1|pages=154-9|doi=10.1037/0022-006X.75.1.154|pmid=17295574}}</ref> [[wikipedia:Posttraumatic_stress_disorder|Posttraumatic stress disorder]] is now more sensitive to development in that diagnostic thresholds have been lowered for children and adolescents. Furthermore, separate and additional criteria have been added for children age 6 years of age or younger. {{collapse bottom}} === Base rates of PTSD in different clinical settings and populations === This section describes the demographic settings of the populations sampled, base rates of PTSD diagnoses, country/region sampled, and the diagnostic methods that were used. Using this information, clinicians will be able to anchor the most appropriate rate of PTSD that they are likely to see in their clinical practice. * '''''To see prevalence rates across multiple disorders,''''' [[Evidence based assessment/Preparation phase#Base rates for transdiagnostic comparison|'''''click here.''''']] {| class="wikitable sortable" border="1" |- ! Demography ! Setting ! Base Rate ! Diagnostic Method |- | United States, nationally representative, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Kessler|first=Ronald C.|last2=Berglund|first2=Patricia|last3=Demler|first3=Olga|last4=Jin|first4=Robert|last5=Merikangas|first5=Kathleen R.|last6=Walters|first6=Ellen E.|date=2005-06-01|title=Lifetime Prevalence and Age-of-Onset Distributions of DSM-IV Disorders in the National Comorbidity Survey Replication|url=http://archpsyc.jamanetwork.com/article.aspx?doi=10.1001/archpsyc.62.6.593|journal=Archives of General Psychiatry|language=en|volume=62|issue=6|doi=10.1001/archpsyc.62.6.593|issn=0003-990X}}</ref> | 6.8% | National Comorbidity Survey - Replication |- | Netherlands, nationally representative, age 18-80 | Non-clinical: Population based<ref>{{Cite journal|last=de Vries|first=Giel-Jan|last2=Olff|first2=Miranda|date=2009-08-01|title=The lifetime prevalence of traumatic events and posttraumatic stress disorder in the Netherlands|url=http://onlinelibrary.wiley.com/doi/10.1002/jts.20429/abstract|journal=Journal of Traumatic Stress|language=en|volume=22|issue=4|pages=259–267|doi=10.1002/jts.20429|issn=1573-6598}}</ref> | 7.4% | Composite International Diagnostic Interview (CIDI) |- | United States, nationally representative, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Pietrzak|first=Robert H.|last2=Goldstein|first2=Risë B.|last3=Southwick|first3=Steven M.|last4=Grant|first4=Bridget F.|title=Prevalence and Axis I comorbidity of full and partial posttraumatic stress disorder in the United States: Results from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions|url=http://linkinghub.elsevier.com/retrieve/pii/S0887618510002288|journal=Journal of Anxiety Disorders|volume=25|issue=3|pages=456–465|doi=10.1016/j.janxdis.2010.11.010}}</ref> | 6.4% | Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions |- | Northern Ireland, representative sample, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Bunting|first=Brendan P.|last2=Ferry|first2=Finola R.|last3=Murphy|first3=Samuel D.|last4=O'Neill|first4=Siobhan M.|last5=Bolton|first5=David|date=2013-02-01|title=Trauma Associated With Civil Conflict and Posttraumatic Stress Disorder: Evidence From the Northern Ireland Study of Health and Stress|url=http://onlinelibrary.wiley.com/doi/10.1002/jts.21766/abstract|journal=Journal of Traumatic Stress|language=en|volume=26|issue=1|pages=134–141|doi=10.1002/jts.21766|issn=1573-6598}}</ref> | 8.8% | Northern Ireland Study of Health and Stress |- | South Africa, nationally representative sample, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Atwoli|first=Lukoye|last2=Stein|first2=Dan J.|last3=Williams|first3=David R.|last4=Mclaughlin|first4=Katie A.|last5=Petukhova|first5=Maria|last6=Kessler|first6=Ronald C.|last7=Koenen|first7=Karestan C.|date=2013-07-03|title=Trauma and posttraumatic stress disorder in South Africa: analysis from the South African Stress and Health Study|url=https://doi.org/10.1186/1471-244X-13-182|journal=BMC Psychiatry|volume=13|pages=182|doi=10.1186/1471-244x-13-182|issn=1471-244X}}</ref> | 2.3% | South African Stress and Health Study, using the Composite International Diagnostic Interview (CIDI) |- | U.S. Army and Marine Soldiers Deployed to Iraq and Afghanistan | U.S. Service Members<ref>{{Cite journal|last=Hoge|first=Charles W.|last2=Castro|first2=Carl A.|last3=Messer|first3=Stephen C.|last4=McGurk|first4=Dennis|last5=Cotting|first5=Dave I.|last6=Koffman|first6=Robert L.|date=2004-07-01|title=Combat Duty in Iraq and Afghanistan, Mental Health Problems, and Barriers to Care|url=http://dx.doi.org/10.1056/NEJMoa040603|journal=New England Journal of Medicine|volume=351|issue=1|pages=13–22|doi=10.1056/nejmoa040603|issn=0028-4793|pmid=15229303}}</ref> |11.5% - 19.5% ♦ | PTSD Checklist |- |United States, nationally representative, ages 13-18 |Non-clinical: Population based<ref>{{Cite journal|last=Merikangas|first=Kathleen Ries|last2=He|first2=Jian-ping|last3=Burstein|first3=Marcy|last4=Swanson|first4=Sonja A.|last5=Avenevoli|first5=Shelli|last6=Cui|first6=Lihong|last7=Benjet|first7=Corina|last8=Georgiades|first8=Katholiki|last9=Swendsen|first9=Joel|title=Lifetime Prevalence of Mental Disorders in U.S. Adolescents: Results from the National Comorbidity Survey Replication–Adolescent Supplement (NCS-A)|url=https://doi.org/10.1016/j.jaac.2010.05.017|journal=Journal of the American Academy of Child & Adolescent Psychiatry|volume=49|issue=10|pages=980–989|doi=10.1016/j.jaac.2010.05.017}}</ref> |5.0% |National Comorbidity Survey Replication—Adolescent Supplement (NCS-A) |} ♦ '''Note''': These rates were using broad PTSD Checklist scoring criteria of being scored positive if subjects reported at least one intrusion symptom, three avoidance symptoms, and two hyperarousal symptom that were categorized as at the moderate level. The 11.5% is for soldiers returning from deployment in Iraq, 19.5% is for soldiers returning from Afghanistan. Another common practice is to use a strict cutoff of 50 on the PCL, above which someone screens positive for PTSD. With this cutoff, rates are 6.2% and 12.9% for Service Members returned from Afghanistan and Iraqi, respectively. ==[[Evidence based assessment/Prediction phase|'''Prediction phase''']]== === Psychometric properties of screening for PTSD === The following section contains a list of screening and diagnostic instruments for PTSD. The section includes administration information, psychometric data, and PDFs or links to the screenings. * Screenings are used as part of the [[Evidence based assessment/Prediction phase|prediction phase]] of assessment; for more information on interpretation of this data, or how screenings fit in to the assessment process, click [[Evidence based assessment/Prediction phase|here.]] * '''''For a list of more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Psychometric_properties_of_common_screening_instruments click here.]''''' {| class="wikitable" |- ! Measure !Format (Reporter) !Age Range !Administration/ Completion Time !Where to Access |- |[https://www.ptsd.va.gov/professional/assessment/adult-sr/ptsd-checklist.asp PCL-5 (PTSD Checklist for DSM-5)] |Self-Report |adult |5-10 minutes | * [https://www.ptsd.va.gov/professional/assessment/documents/PCL5_Standard_form.PDFPDF PDF] * [https://unc.az1.qualtrics.com/jfe/form/SV_9nmXgrLPpvhPhgF Online version (Spanish)] |- |PDS-5 (Post-traumatic Diagnosis Scale) |Self-Report |adult |10-20 minutes |[https://www.ptsd.va.gov/professional/assessment/adult-sr/pds.asp How to request] |- | colspan="4" style="font-size:110%; text-align:center;" |'''For Children and Adolescents Specifically''' | |- |[https://www.reactionindex.com/index.php/ UCLA PTSD Reaction Index for DSM-5] |Clinician Administered |child, school age, adolescents |20-30 minutes |[https://www.dellchildrens.net/wp-content/uploads/sites/60/2019/08/UCLA-PTSD-RI-DSM-5.pdf PDF] |- |CPSS (Children's PTSD Symptom Scale) |Self-Report |child |10-20 minutes | * [https://www.aacap.org/App_Themes/AACAP/docs/resource_centers/resources/misc/child_ptsd_symptom_scale.pdf PDF] * [https://unc.az1.qualtrics.com/jfe/form/SV_6XPDvzlfkg2SQRf Online version] |- |Young Child PTSD Checklist (YCPC) |Parent Report |child |13 items |[https://medicine.tulane.edu/sites/g/files/rdw761/f/YCPC_v5_23_14.pdf PDF] |} === Interpreting PTSD screening measure scores === * For information on interpreting screening measure scores, click [[Evidence based assessment/Prediction phase#Interpreting screening measure scores|here.]] * Also see the page on [https://en.wikipedia.org/wiki/Likelihood_ratios_in_diagnostic_testing likelihood ratios in diagnostic testing] for more information ==[[Evidence based assessment/Prescription phase|'''Prescription phase''']]== ===Gold standard diagnostic interviews=== * For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews click here.] ===Recommended diagnostic interviews for PTSD=== {| class="wikitable sortable" border="1" ! colspan="4" |Diagnostic instruments for PTSD ! |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time !Where to Access |- | [https://www.ptsd.va.gov/professional/assessment/adult-int/caps.asp CAPS-5 (Clinician Administered PTSD Scale)] | Clinician Administered Interview | adult | 40-60 minutes |[https://www.ptsd.va.gov/professional/assessment/ncptsd-instrument-request-form.asp Assessment request form] |- |PTSD Symptom Scale Interview (PSS-I-5) |Clinician Administered Interview |adult and child version available |24 items |[http://www.advanced-counseling.com/dl/PSSI-5.pdf PDF] |- | colspan="4" style="font-size:110%; text-align:center;" |'''For Children and Adolescents Specifically''' | |- | [https://www.ptsd.va.gov/professional/assessment/child/caps-ca.asp CAPS-CA-5 (Clinician-Administered PTSD Scale for DSM-5 - Child/Adolescent Version)] |Clinician Administered Interview |child |30 items |[https://www.ptsd.va.gov/professional/assessment/ncptsd-instrument-request-form.asp Assessment request form] |- | Children’s PTSD Inventory (CPTSD-I) |Diagnostic Interview | 6-18 years | 50 items |Not Free |} ===Severity interviews for PTSD=== {| class="wikitable sortable" border="1" |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time !Where to Access |- | Schedule for Affective Disorders and Schizophrenia for School Age Children (K-SADS) | Diagnostic Interview | 6-18 years | 18 PTSD items |[https://www.pediatricbipolar.pitt.edu/sites/default/files/KSADS_DSM_5_SCREEN_Final.pdf PDF] |- | Anxiety Disorders Interview Schedule, Child Version (ADIS-C) | Diagnostic Interview | 7-17 years | 26 PTSD items |Not free |- | Diagnostic Infant and Preschool Assessment (DIPA) |Diagnostic Interview | Age 6 and younger | 46 PTSD items |[https://medicine.tulane.edu/sites/g/files/rdw761/f/DIPA-2017-2-14.pdf PDF] |} ==[[Evidence based assessment/Process phase|'''Process phase''']]== The following section contains a brief overview of treatment options for PTSD and list of process and outcome measures for PTSD. The section includes benchmarks based on published norms for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the [[Evidence based assessment/Process phase|process phase]] of assessment. For more information of differences between process and outcome measures, see the page on the [[Evidence based assessment/Process phase|process phase of assessment]]. === Process measures === * Information coming soon === Outcome and severity measures === This table includes clinically significant benchmarks for PTSD specific outcome measures * Information on how to interpret this table can be [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase found here]. * Additionally, these [[Evidence based assessment/Vignettes|vignettes]] might be helpful resources for understanding appropriate adaptation of outcome measures in practice. * ''<u>For clinically significant change benchmarks for the CBCL, YSR, and TRF total, externalizing, internalizing, and attention benchmarks,</u>'' [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase&wteswitched=1#Clinically_significant_change_benchmarks_for_widely-used_outcome_measures see here.] {| class="wikitable sortable" border="1" | colspan="7" |'''Clinically significant change benchmarks with common instruments for PTSD''' |- | colspan="7" style="font-size:110%; text-align:center;" span |<b> Benchmarks Based on Published Norms</b> |- | rowspan="2" style="text-align:center;font-size:130%;" |<b> Measure</b> | colspan="3" style="text-align:center;font-size:130%" width="300" |<b> Cut-off scores</b> | colspan="3" style="text-align:center;font-size:120%" |<b> Critical Change <br> (unstandardized scores)</b> |- | style="text-align:center;font-size:110%" |<b> A</b> | style="text-align:center;font-size:110%" |<b> B</b> | style="text-align:center;font-size:110%" |<b> C</b> | style="text-align:center;font-size:110%" |<b> 95%</b> | style="text-align:center;font-size:110%" |<b> 90%</b> | style="text-align:center;font-size:110%" |<b> SE_difference</b> |- | rowspan="1" style="text-align:center;" | Primary Care PTSD Screen | style="text-align:center;" | 1.0 | style="text-align:center;" | 3.1 | style="text-align:center;" | 2.0 | style="text-align:center;" | 1.0 | style="text-align:center;" | .8 | style="text-align:center;" | .5 |- | rowspan="1" style="text-align:center;" | PTSD Checklist Scores | style="text-align:center;" | 28.8 | style="text-align:center;" | 40.8 | style="text-align:center;" | 34.9 | style="text-align:center;" | 4.6 | style="text-align:center;" | 3.8 | style="text-align:center;" | 2.3 |- | rowspan="1" style="text-align:center;" | Clinician Administered PTSD Scale | style="text-align:center;" | 28.8 | style="text-align:center;" | 40.8 | style="text-align:center;" | 34.9 | style="text-align:center;" | 8.3 | style="text-align:center;" | 7.0 | style="text-align:center;" | 4.2 |} === Treatment === * Please refer to the Wikipedia page on [[wikipedia:Posttraumatic_stress_disorder|PTSD]] for more information on available treatment for PTSD or go to the [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/post-traumatic-stress-disorder/ Effective Child Therapy] page for for a curated resource on effective treatments for PTSD. {{collapse top| Click here for more information}} '''<big>Behavioral interventions</big>''' Recommended (have ''significant benefit'') <ref name=":0">Department of Veterans Affairs and Department of Defense. . (2010). VA/DoD clinical practice guidelines: management of post-traumatic stress. Washington, D.C.: Veterans Health Administration, Department of Defense.</ref>: # Brief Cognitive Behavioral Therapy (CBT; 4-5 sessions) #* This includes stress inoculation training, trauma-focused therapy including components of cognitive restructuring, Cognitive Processing Therapy (CPT), imaginal, virtual, and in-vivo exposure as in Prolonged Exposure psychotherapy (PE)² #* Patient education is recommended as part of psychotherapy for patients and family members # EMDR may help both acute and chronic PTSD, especially individuals who have trouble with prolonged exposure or have trouble verbalizing their trauma.<ref name=":1">Ursano, R. J., Bell, C., Eth, S., Friedman, M., Norwood, A., Pfefferbaum, B., . . . McIntyre, J. S. (2004). ''Practice guideline for the treatment of patients with acute stress disorder and posttraumatic stress disorder'': American Psychiatric Publ </ref> ## Long term gains require further study. # [https://www.ptsd.va.gov/professional/treat/txessentials/present_centered_therapy.asp Present-Centered Therapy (PCT)] is a non trauma focused treatment for PTSD and a second-line treatment for PTSD<ref>{{Cite web|url=https://www.ptsd.va.gov/professional/treat/txessentials/present_centered_therapy.asp|title=Present-Centered Therapy for PTSD - PTSD: National Center for PTSD|website=www.ptsd.va.gov|language=en|access-date=2022-08-13}}</ref>. Treatments with weaker evidence (have ''some benefit'') <ref name=":0" />: # Patient education, # Imagery rehearsal therapy, # Psychodynamic therapy, # Hypnosis, # Relaxation techniques, # and Group therapy. Treatment with ''unknown benefit'' <ref name=":0" />: # Web-based CBT ## For example Jeane Bosch participated as a study therapist in research study that compared STAIR and present-centered therapy both delivered via telehealth. STAIR stands for Skills Training in Affective and Interpersonal Regulation. It is a skill-focused treatment that was originally developed for survivors of childhood abuse to teach emotion regulation skills as well as tools to help with challenges interpersonal functioning and social relationships and decrease PTSD symptoms<ref>{{Cite web|url=https://istss.org/public-resources/trauma-blog/2015-march-(1)/clinician-s-corner-skills-training-in-affective-an|title=ISTSS - Trauma Blog|website=istss.org|access-date=2022-08-13}}</ref>.<ref>{{Citation|title=Introduction to Telehealth with Dr. Bosch|url=https://www.youtube.com/watch?v=Wn6Vewl42X8|accessdate=2022-08-13|language=en}}</ref> # Acceptance and commitment therapy, # and Dialectical Behavioral Therapy. <big>'''Medication'''</big> *SSRIs are more effective than placebo in treating PTSD.<ref name=":1" /> *There is no evidence to support a medication to prevent the development of PTSD.<ref name=":0" /> **Imipramine, propranolol, prazosin, other antidepressants, anticonvulsants, and atypical antipsychotics have ''unknown benefit.'' **Strongly recommend against the use of benzodiazepines² and typical antipsychotics since they have ''no benefit and potential harm.'' {{collapse bottom}} == '''External resources''' == === For professionals === * [http://www.som.uq.edu.au/ptsd Post Traumatic Stress Disorder Information Resource] from [http://www.uq.edu.au/ The University of Queensland School of Medicine] * [http://www.apa.org/ptsd-guideline/ APA practice parameters for assessment and treatment for PTSD (Updated 2017)] * [http://www.ptsd.va.gov/professional/index.asp Resources for professionals] from [http://www.ptsd.va.gov/index.asp VA National PTSD Center] * [https://www.integration.samhsa.gov/clinical-practice/trauma-informed SAMHSA's Trauma-Informed Care Resources and Training] * [https://www.integration.samhsa.gov/clinical-practice/trauma-informed SAMHSA's Resources on Intimate Partner Violence (IPV) for Clinicians, Patients, Families, and Organizations] === For caregivers === * [http://www.nctsn.org/sites/default/files/assets/pdfs/tips_for_parents_media_final.pdf Tips for parents on shooting media coverage] * [http://www.nctsn.org/sites/default/files/assets/pdfs/parents_guidelines_for_helping_teens_after_the_recent_attacks.pdf Parent guidelines to helping youths after a shooting] * [http://www.nctsn.org/sites/default/files/assets/pdfs/helping_teens_with_traumatic_grief_caregivers_final.pdf Caregiver tips for helping teens with traumatic grief] * [http://www.nctsn.org/sites/default/files/assets/pdfs/10things_schoolage_ctg.pdf Caregiver tips for helping school-age children with traumatic grief] *[http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/post-traumatic-stress-disorder/ EffectiveChildTherapy.Org information on PTSD] *[https://sccap53.org Society of Clinical Child and Adolescent Psychology] === For educators === * [http://www.nctsn.org/sites/default/files/assets/pdfs/pfa_for_schools_appendix_a_teachers.pdf Teacher tips for providing psychological first aid] * [http://www.nctsn.org/sites/default/files/assets/pdfs/helping_youth_after_community_violence_educators.pdf Educator tips for helping youths after a community trauma] === For public === * [https://complicatedgrief.columbia.edu/for-the-public/resources/ Resources for grief and loss] * [http://www.nctsn.org/sites/default/files/assets/pdfs/psychological_information_sheet_two_pager.pdf Psychological impacts of recent shootings] * [http://www.nctsn.org/sites/default/files/assets/pdfs/youth_journalists.pdf Tips to talking to youths about a shooting] * [http://www.nctsn.org/sites/default/files/assets/pdfs/talking_to_children_about_the_shooting.pdf Tips to talking to children about a shooting] * [http://www.nctsn.org/sites/default/files/assets/pdfs/helping_young_children_heal_crisis.pdf Helping young children heal after a crisis] * [http://www.nctsn.org/content/psychological-first-aid-schoolspfa Psychological first aid for schools] * [http://www.nctsn.org/content/psychological-first-aid Resources and manuals on psychological first aid] * [http://www.ptsd.va.gov/public/index.asp Resources for the public] from [http://www.ptsd.va.gov/index.asp VA National PTSD Center] * [https://curlie.org/Health/Mental_Health/Disorders/Anxiety/Post-traumatic_Stress Posttraumatic stress disorder] at Curlie (based on DMOZ) =='''References'''== {{collapse top|Click here for references}} {{Reflist|30em}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] {{collapse bottom}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] q7p9jrvnr7s2ai3ywzzyii7v9zi4371 2419222 2419221 2022-08-26T03:04:46Z Ardenguo 2944162 /* Treatment */ made the collapsible box expanded by default, changed box title wikitext text/x-wiki <noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{medical disclaimer}} {{:{{BASEPAGENAME}}/Sidebar}} ==[[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio"?''']]== * For background information on what assessment portfolios are, click the link in the heading above. * Want even 'more' information about this topic? There's an extended version of this page [[Evidence-based assessment/Posttraumatic stress disorder (disorder portfolio)/extended version|'''here''']]. == [[Evidence based assessment/Preparation phase|'''Preparation phase''']] == === Diagnostic criteria for post traumatic stress disorder === ===='''ICD-11 Diagnostic Criteria'''==== {{blockquotetop}} ===='''ICD-11 Criteria'''==== *Post-traumatic stress disorder (PTSD) is a syndrome that develops following exposure to an extremely threatening or horrific event or series of events that is characterized by all of the following: **1) re-experiencing the traumatic event or events in the present in the form of vivid intrusive memories, flashbacks, or nightmares, which are typically accompanied by strong and overwhelming emotions such as fear or horror and strong physical sensations, or feelings of being overwhelmed or immersed in the same intense emotions that were experienced during the traumatic event; **2) avoidance of thoughts and memories of the event or events, or avoidance of activities, situations, or people reminiscent of the event or events **3) persistent perceptions of heightened current threat, for example as indicated by hypervigilance or an enhanced startle reaction to stimuli such as unexpected noises. *The symptoms must persist for at least several weeks and cause significant impairment in personal, family, social, educational, occupational or other important areas of functioning. Additionally, ICD 11 includes a category called "Complex post-traumatic stress disorder," which is described as: *A disorder that may develop following exposure to an event or series of events of an extremely threatening or horrific nature, most commonly prolonged or repetitive events from which escape is difficult or impossible (e.g., torture, slavery, genocide campaigns, prolonged domestic violence, repeated childhood sexual or physical abuse). *The disorder is characterized by the core symptoms of PTSD; that is, all diagnostic requirements for PTSD have been met at some point during the course of the disorder. *In addition, Complex PTSD is characterized by: **1) severe and pervasive problems in affect regulation; **2) persistent beliefs about oneself as diminished, defeated or worthless, accompanied by deep and pervasive feelings of shame, guilt or failure related to the traumatic event **3) persistent difficulties in sustaining relationships and in feeling close to others. The disturbance causes significant impairment in personal, family, social, educational, occupational or other important areas of functioning. {{blockquotebottom}} ===='''Changes in DSM-5'''==== * The diagnostic criteria for post-traumatic stress disorder changed slightly from [[DSM-IV]] to [[w:Diagnostic_and_Statistical_Manual_of_Mental_Disorders#DSM-IV-TR_.282000.29|DSM-5]]. Summaries are available [http://www.dsm5.org/Documents/changes%20from%20dsm-iv-tr%20to%20dsm-5.pdf here] and [[w:DSM-5|here]]. === Developmental sensitivities === {{collapse top| More information on developmental sensitivities|expand=yes}} *Diagnostic thresholds have been lowered for children and adolescents to account for development. *Separate and additional criteria have been added for children age 6 or younger. *Child sexual abuse has been found to have a substantial effect on the development of PTSD.<ref>{{cite journal|last1=Paolucci|first1=Elizabeth ODDONE|last2=Genuis|first2=Mark L.|last3=Violato|first3=Claudio|title=A Meta-Analysis of the Published Research on the Effects of Child Sexual Abuse|journal=The Journal of Psychology|date=January 2001|volume=135|issue=1|pages=17–36|doi=10.1080/00223980109603677}}</ref> *Children with higher exposure to trauma, less social support, and other major life events are more likely to have continued PTSD symptoms 7 months after a trauma.<ref name=":2">{{cite journal |last1=La Greca|first1=A|last2=Silverman|first2=WK|last3=Vernberg|first3=EM|last4=Prinstein|first4=MJ|title=Symptoms of posttraumatic stress in children after Hurricane Andrew: a prospective study.|journal=Journal of consulting and clinical psychology|date=August 1996|volume=64|issue=4|pages=712-23|pmid=8803361}}</ref> 10 months after a trauma, however, only experience of a major life event remained predictive of continuing PTSD symptoms.<ref name=":2" /> *Lack of social support, specifically lack of support by a teacher, was predictive of higher PTSD symptoms among children who had gone through an environmental trauma.<ref name=":2" /> *Children who reported using blame and anger as strategies for coping had higher levels of PTSD symptoms 10 months after a trauma.<ref name=":2" /> *Negative affect in children before a traumatic event was predictive of development of PTSD symptoms after a traumatic event.<ref>{{cite journal|last1=Weems|first1=CF|last2=Pina|first2=AA|last3=Costa|first3=NM|last4=Watts|first4=SE|last5=Taylor|first5=LK|last6=Cannon|first6=MF|title=Predisaster trait anxiety and negative affect predict posttraumatic stress in youths after hurricane Katrina.|journal=Journal of consulting and clinical psychology|date=February 2007|volume=75|issue=1|pages=154-9|doi=10.1037/0022-006X.75.1.154|pmid=17295574}}</ref> [[wikipedia:Posttraumatic_stress_disorder|Posttraumatic stress disorder]] is now more sensitive to development in that diagnostic thresholds have been lowered for children and adolescents. Furthermore, separate and additional criteria have been added for children age 6 years of age or younger. {{collapse bottom}} === Base rates of PTSD in different clinical settings and populations === This section describes the demographic settings of the populations sampled, base rates of PTSD diagnoses, country/region sampled, and the diagnostic methods that were used. Using this information, clinicians will be able to anchor the most appropriate rate of PTSD that they are likely to see in their clinical practice. * '''''To see prevalence rates across multiple disorders,''''' [[Evidence based assessment/Preparation phase#Base rates for transdiagnostic comparison|'''''click here.''''']] {| class="wikitable sortable" border="1" |- ! Demography ! Setting ! Base Rate ! Diagnostic Method |- | United States, nationally representative, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Kessler|first=Ronald C.|last2=Berglund|first2=Patricia|last3=Demler|first3=Olga|last4=Jin|first4=Robert|last5=Merikangas|first5=Kathleen R.|last6=Walters|first6=Ellen E.|date=2005-06-01|title=Lifetime Prevalence and Age-of-Onset Distributions of DSM-IV Disorders in the National Comorbidity Survey Replication|url=http://archpsyc.jamanetwork.com/article.aspx?doi=10.1001/archpsyc.62.6.593|journal=Archives of General Psychiatry|language=en|volume=62|issue=6|doi=10.1001/archpsyc.62.6.593|issn=0003-990X}}</ref> | 6.8% | National Comorbidity Survey - Replication |- | Netherlands, nationally representative, age 18-80 | Non-clinical: Population based<ref>{{Cite journal|last=de Vries|first=Giel-Jan|last2=Olff|first2=Miranda|date=2009-08-01|title=The lifetime prevalence of traumatic events and posttraumatic stress disorder in the Netherlands|url=http://onlinelibrary.wiley.com/doi/10.1002/jts.20429/abstract|journal=Journal of Traumatic Stress|language=en|volume=22|issue=4|pages=259–267|doi=10.1002/jts.20429|issn=1573-6598}}</ref> | 7.4% | Composite International Diagnostic Interview (CIDI) |- | United States, nationally representative, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Pietrzak|first=Robert H.|last2=Goldstein|first2=Risë B.|last3=Southwick|first3=Steven M.|last4=Grant|first4=Bridget F.|title=Prevalence and Axis I comorbidity of full and partial posttraumatic stress disorder in the United States: Results from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions|url=http://linkinghub.elsevier.com/retrieve/pii/S0887618510002288|journal=Journal of Anxiety Disorders|volume=25|issue=3|pages=456–465|doi=10.1016/j.janxdis.2010.11.010}}</ref> | 6.4% | Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions |- | Northern Ireland, representative sample, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Bunting|first=Brendan P.|last2=Ferry|first2=Finola R.|last3=Murphy|first3=Samuel D.|last4=O'Neill|first4=Siobhan M.|last5=Bolton|first5=David|date=2013-02-01|title=Trauma Associated With Civil Conflict and Posttraumatic Stress Disorder: Evidence From the Northern Ireland Study of Health and Stress|url=http://onlinelibrary.wiley.com/doi/10.1002/jts.21766/abstract|journal=Journal of Traumatic Stress|language=en|volume=26|issue=1|pages=134–141|doi=10.1002/jts.21766|issn=1573-6598}}</ref> | 8.8% | Northern Ireland Study of Health and Stress |- | South Africa, nationally representative sample, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Atwoli|first=Lukoye|last2=Stein|first2=Dan J.|last3=Williams|first3=David R.|last4=Mclaughlin|first4=Katie A.|last5=Petukhova|first5=Maria|last6=Kessler|first6=Ronald C.|last7=Koenen|first7=Karestan C.|date=2013-07-03|title=Trauma and posttraumatic stress disorder in South Africa: analysis from the South African Stress and Health Study|url=https://doi.org/10.1186/1471-244X-13-182|journal=BMC Psychiatry|volume=13|pages=182|doi=10.1186/1471-244x-13-182|issn=1471-244X}}</ref> | 2.3% | South African Stress and Health Study, using the Composite International Diagnostic Interview (CIDI) |- | U.S. Army and Marine Soldiers Deployed to Iraq and Afghanistan | U.S. Service Members<ref>{{Cite journal|last=Hoge|first=Charles W.|last2=Castro|first2=Carl A.|last3=Messer|first3=Stephen C.|last4=McGurk|first4=Dennis|last5=Cotting|first5=Dave I.|last6=Koffman|first6=Robert L.|date=2004-07-01|title=Combat Duty in Iraq and Afghanistan, Mental Health Problems, and Barriers to Care|url=http://dx.doi.org/10.1056/NEJMoa040603|journal=New England Journal of Medicine|volume=351|issue=1|pages=13–22|doi=10.1056/nejmoa040603|issn=0028-4793|pmid=15229303}}</ref> |11.5% - 19.5% ♦ | PTSD Checklist |- |United States, nationally representative, ages 13-18 |Non-clinical: Population based<ref>{{Cite journal|last=Merikangas|first=Kathleen Ries|last2=He|first2=Jian-ping|last3=Burstein|first3=Marcy|last4=Swanson|first4=Sonja A.|last5=Avenevoli|first5=Shelli|last6=Cui|first6=Lihong|last7=Benjet|first7=Corina|last8=Georgiades|first8=Katholiki|last9=Swendsen|first9=Joel|title=Lifetime Prevalence of Mental Disorders in U.S. Adolescents: Results from the National Comorbidity Survey Replication–Adolescent Supplement (NCS-A)|url=https://doi.org/10.1016/j.jaac.2010.05.017|journal=Journal of the American Academy of Child & Adolescent Psychiatry|volume=49|issue=10|pages=980–989|doi=10.1016/j.jaac.2010.05.017}}</ref> |5.0% |National Comorbidity Survey Replication—Adolescent Supplement (NCS-A) |} ♦ '''Note''': These rates were using broad PTSD Checklist scoring criteria of being scored positive if subjects reported at least one intrusion symptom, three avoidance symptoms, and two hyperarousal symptom that were categorized as at the moderate level. The 11.5% is for soldiers returning from deployment in Iraq, 19.5% is for soldiers returning from Afghanistan. Another common practice is to use a strict cutoff of 50 on the PCL, above which someone screens positive for PTSD. With this cutoff, rates are 6.2% and 12.9% for Service Members returned from Afghanistan and Iraqi, respectively. ==[[Evidence based assessment/Prediction phase|'''Prediction phase''']]== === Psychometric properties of screening for PTSD === The following section contains a list of screening and diagnostic instruments for PTSD. The section includes administration information, psychometric data, and PDFs or links to the screenings. * Screenings are used as part of the [[Evidence based assessment/Prediction phase|prediction phase]] of assessment; for more information on interpretation of this data, or how screenings fit in to the assessment process, click [[Evidence based assessment/Prediction phase|here.]] * '''''For a list of more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Psychometric_properties_of_common_screening_instruments click here.]''''' {| class="wikitable" |- ! Measure !Format (Reporter) !Age Range !Administration/ Completion Time !Where to Access |- |[https://www.ptsd.va.gov/professional/assessment/adult-sr/ptsd-checklist.asp PCL-5 (PTSD Checklist for DSM-5)] |Self-Report |adult |5-10 minutes | * [https://www.ptsd.va.gov/professional/assessment/documents/PCL5_Standard_form.PDFPDF PDF] * [https://unc.az1.qualtrics.com/jfe/form/SV_9nmXgrLPpvhPhgF Online version (Spanish)] |- |PDS-5 (Post-traumatic Diagnosis Scale) |Self-Report |adult |10-20 minutes |[https://www.ptsd.va.gov/professional/assessment/adult-sr/pds.asp How to request] |- | colspan="4" style="font-size:110%; text-align:center;" |'''For Children and Adolescents Specifically''' | |- |[https://www.reactionindex.com/index.php/ UCLA PTSD Reaction Index for DSM-5] |Clinician Administered |child, school age, adolescents |20-30 minutes |[https://www.dellchildrens.net/wp-content/uploads/sites/60/2019/08/UCLA-PTSD-RI-DSM-5.pdf PDF] |- |CPSS (Children's PTSD Symptom Scale) |Self-Report |child |10-20 minutes | * [https://www.aacap.org/App_Themes/AACAP/docs/resource_centers/resources/misc/child_ptsd_symptom_scale.pdf PDF] * [https://unc.az1.qualtrics.com/jfe/form/SV_6XPDvzlfkg2SQRf Online version] |- |Young Child PTSD Checklist (YCPC) |Parent Report |child |13 items |[https://medicine.tulane.edu/sites/g/files/rdw761/f/YCPC_v5_23_14.pdf PDF] |} === Interpreting PTSD screening measure scores === * For information on interpreting screening measure scores, click [[Evidence based assessment/Prediction phase#Interpreting screening measure scores|here.]] * Also see the page on [https://en.wikipedia.org/wiki/Likelihood_ratios_in_diagnostic_testing likelihood ratios in diagnostic testing] for more information ==[[Evidence based assessment/Prescription phase|'''Prescription phase''']]== ===Gold standard diagnostic interviews=== * For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews click here.] ===Recommended diagnostic interviews for PTSD=== {| class="wikitable sortable" border="1" ! colspan="4" |Diagnostic instruments for PTSD ! |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time !Where to Access |- | [https://www.ptsd.va.gov/professional/assessment/adult-int/caps.asp CAPS-5 (Clinician Administered PTSD Scale)] | Clinician Administered Interview | adult | 40-60 minutes |[https://www.ptsd.va.gov/professional/assessment/ncptsd-instrument-request-form.asp Assessment request form] |- |PTSD Symptom Scale Interview (PSS-I-5) |Clinician Administered Interview |adult and child version available |24 items |[http://www.advanced-counseling.com/dl/PSSI-5.pdf PDF] |- | colspan="4" style="font-size:110%; text-align:center;" |'''For Children and Adolescents Specifically''' | |- | [https://www.ptsd.va.gov/professional/assessment/child/caps-ca.asp CAPS-CA-5 (Clinician-Administered PTSD Scale for DSM-5 - Child/Adolescent Version)] |Clinician Administered Interview |child |30 items |[https://www.ptsd.va.gov/professional/assessment/ncptsd-instrument-request-form.asp Assessment request form] |- | Children’s PTSD Inventory (CPTSD-I) |Diagnostic Interview | 6-18 years | 50 items |Not Free |} ===Severity interviews for PTSD=== {| class="wikitable sortable" border="1" |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time !Where to Access |- | Schedule for Affective Disorders and Schizophrenia for School Age Children (K-SADS) | Diagnostic Interview | 6-18 years | 18 PTSD items |[https://www.pediatricbipolar.pitt.edu/sites/default/files/KSADS_DSM_5_SCREEN_Final.pdf PDF] |- | Anxiety Disorders Interview Schedule, Child Version (ADIS-C) | Diagnostic Interview | 7-17 years | 26 PTSD items |Not free |- | Diagnostic Infant and Preschool Assessment (DIPA) |Diagnostic Interview | Age 6 and younger | 46 PTSD items |[https://medicine.tulane.edu/sites/g/files/rdw761/f/DIPA-2017-2-14.pdf PDF] |} ==[[Evidence based assessment/Process phase|'''Process phase''']]== The following section contains a brief overview of treatment options for PTSD and list of process and outcome measures for PTSD. The section includes benchmarks based on published norms for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the [[Evidence based assessment/Process phase|process phase]] of assessment. For more information of differences between process and outcome measures, see the page on the [[Evidence based assessment/Process phase|process phase of assessment]]. === Process measures === * Information coming soon === Outcome and severity measures === This table includes clinically significant benchmarks for PTSD specific outcome measures * Information on how to interpret this table can be [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase found here]. * Additionally, these [[Evidence based assessment/Vignettes|vignettes]] might be helpful resources for understanding appropriate adaptation of outcome measures in practice. * ''<u>For clinically significant change benchmarks for the CBCL, YSR, and TRF total, externalizing, internalizing, and attention benchmarks,</u>'' [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase&wteswitched=1#Clinically_significant_change_benchmarks_for_widely-used_outcome_measures see here.] {| class="wikitable sortable" border="1" | colspan="7" |'''Clinically significant change benchmarks with common instruments for PTSD''' |- | colspan="7" style="font-size:110%; text-align:center;" span |<b> Benchmarks Based on Published Norms</b> |- | rowspan="2" style="text-align:center;font-size:130%;" |<b> Measure</b> | colspan="3" style="text-align:center;font-size:130%" width="300" |<b> Cut-off scores</b> | colspan="3" style="text-align:center;font-size:120%" |<b> Critical Change <br> (unstandardized scores)</b> |- | style="text-align:center;font-size:110%" |<b> A</b> | style="text-align:center;font-size:110%" |<b> B</b> | style="text-align:center;font-size:110%" |<b> C</b> | style="text-align:center;font-size:110%" |<b> 95%</b> | style="text-align:center;font-size:110%" |<b> 90%</b> | style="text-align:center;font-size:110%" |<b> SE_difference</b> |- | rowspan="1" style="text-align:center;" | Primary Care PTSD Screen | style="text-align:center;" | 1.0 | style="text-align:center;" | 3.1 | style="text-align:center;" | 2.0 | style="text-align:center;" | 1.0 | style="text-align:center;" | .8 | style="text-align:center;" | .5 |- | rowspan="1" style="text-align:center;" | PTSD Checklist Scores | style="text-align:center;" | 28.8 | style="text-align:center;" | 40.8 | style="text-align:center;" | 34.9 | style="text-align:center;" | 4.6 | style="text-align:center;" | 3.8 | style="text-align:center;" | 2.3 |- | rowspan="1" style="text-align:center;" | Clinician Administered PTSD Scale | style="text-align:center;" | 28.8 | style="text-align:center;" | 40.8 | style="text-align:center;" | 34.9 | style="text-align:center;" | 8.3 | style="text-align:center;" | 7.0 | style="text-align:center;" | 4.2 |} === Treatment === * Please refer to the Wikipedia page on [[wikipedia:Posttraumatic_stress_disorder|PTSD]] for more information on available treatment for PTSD or go to the [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/post-traumatic-stress-disorder/ Effective Child Therapy] page for for a curated resource on effective treatments for PTSD. {{collapse top| More information on treatment|expand=yes}} '''<big>Behavioral interventions</big>''' Recommended (have ''significant benefit'') <ref name=":0">Department of Veterans Affairs and Department of Defense. . (2010). VA/DoD clinical practice guidelines: management of post-traumatic stress. Washington, D.C.: Veterans Health Administration, Department of Defense.</ref>: # Brief Cognitive Behavioral Therapy (CBT; 4-5 sessions) #* This includes stress inoculation training, trauma-focused therapy including components of cognitive restructuring, Cognitive Processing Therapy (CPT), imaginal, virtual, and in-vivo exposure as in Prolonged Exposure psychotherapy (PE)² #* Patient education is recommended as part of psychotherapy for patients and family members # EMDR may help both acute and chronic PTSD, especially individuals who have trouble with prolonged exposure or have trouble verbalizing their trauma.<ref name=":1">Ursano, R. J., Bell, C., Eth, S., Friedman, M., Norwood, A., Pfefferbaum, B., . . . McIntyre, J. S. (2004). ''Practice guideline for the treatment of patients with acute stress disorder and posttraumatic stress disorder'': American Psychiatric Publ </ref> ## Long term gains require further study. # [https://www.ptsd.va.gov/professional/treat/txessentials/present_centered_therapy.asp Present-Centered Therapy (PCT)] is a non trauma focused treatment for PTSD and a second-line treatment for PTSD<ref>{{Cite web|url=https://www.ptsd.va.gov/professional/treat/txessentials/present_centered_therapy.asp|title=Present-Centered Therapy for PTSD - PTSD: National Center for PTSD|website=www.ptsd.va.gov|language=en|access-date=2022-08-13}}</ref>. Treatments with weaker evidence (have ''some benefit'') <ref name=":0" />: # Patient education, # Imagery rehearsal therapy, # Psychodynamic therapy, # Hypnosis, # Relaxation techniques, # and Group therapy. Treatment with ''unknown benefit'' <ref name=":0" />: # Web-based CBT ## For example Jeane Bosch participated as a study therapist in research study that compared STAIR and present-centered therapy both delivered via telehealth. STAIR stands for Skills Training in Affective and Interpersonal Regulation. It is a skill-focused treatment that was originally developed for survivors of childhood abuse to teach emotion regulation skills as well as tools to help with challenges interpersonal functioning and social relationships and decrease PTSD symptoms<ref>{{Cite web|url=https://istss.org/public-resources/trauma-blog/2015-march-(1)/clinician-s-corner-skills-training-in-affective-an|title=ISTSS - Trauma Blog|website=istss.org|access-date=2022-08-13}}</ref>.<ref>{{Citation|title=Introduction to Telehealth with Dr. Bosch|url=https://www.youtube.com/watch?v=Wn6Vewl42X8|accessdate=2022-08-13|language=en}}</ref> # Acceptance and commitment therapy, # and Dialectical Behavioral Therapy. <big>'''Medication'''</big> *SSRIs are more effective than placebo in treating PTSD.<ref name=":1" /> *There is no evidence to support a medication to prevent the development of PTSD.<ref name=":0" /> **Imipramine, propranolol, prazosin, other antidepressants, anticonvulsants, and atypical antipsychotics have ''unknown benefit.'' **Strongly recommend against the use of benzodiazepines² and typical antipsychotics since they have ''no benefit and potential harm.'' {{collapse bottom}} == '''External resources''' == === For professionals === * [http://www.som.uq.edu.au/ptsd Post Traumatic Stress Disorder Information Resource] from [http://www.uq.edu.au/ The University of Queensland School of Medicine] * [http://www.apa.org/ptsd-guideline/ APA practice parameters for assessment and treatment for PTSD (Updated 2017)] * [http://www.ptsd.va.gov/professional/index.asp Resources for professionals] from [http://www.ptsd.va.gov/index.asp VA National PTSD Center] * [https://www.integration.samhsa.gov/clinical-practice/trauma-informed SAMHSA's Trauma-Informed Care Resources and Training] * [https://www.integration.samhsa.gov/clinical-practice/trauma-informed SAMHSA's Resources on Intimate Partner Violence (IPV) for Clinicians, Patients, Families, and Organizations] === For caregivers === * [http://www.nctsn.org/sites/default/files/assets/pdfs/tips_for_parents_media_final.pdf Tips for parents on shooting media coverage] * [http://www.nctsn.org/sites/default/files/assets/pdfs/parents_guidelines_for_helping_teens_after_the_recent_attacks.pdf Parent guidelines to helping youths after a shooting] * [http://www.nctsn.org/sites/default/files/assets/pdfs/helping_teens_with_traumatic_grief_caregivers_final.pdf Caregiver tips for helping teens with traumatic grief] * [http://www.nctsn.org/sites/default/files/assets/pdfs/10things_schoolage_ctg.pdf Caregiver tips for helping school-age children with traumatic grief] *[http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/post-traumatic-stress-disorder/ EffectiveChildTherapy.Org information on PTSD] *[https://sccap53.org Society of Clinical Child and Adolescent Psychology] === For educators === * [http://www.nctsn.org/sites/default/files/assets/pdfs/pfa_for_schools_appendix_a_teachers.pdf Teacher tips for providing psychological first aid] * [http://www.nctsn.org/sites/default/files/assets/pdfs/helping_youth_after_community_violence_educators.pdf Educator tips for helping youths after a community trauma] === For public === * [https://complicatedgrief.columbia.edu/for-the-public/resources/ Resources for grief and loss] * [http://www.nctsn.org/sites/default/files/assets/pdfs/psychological_information_sheet_two_pager.pdf Psychological impacts of recent shootings] * [http://www.nctsn.org/sites/default/files/assets/pdfs/youth_journalists.pdf Tips to talking to youths about a shooting] * [http://www.nctsn.org/sites/default/files/assets/pdfs/talking_to_children_about_the_shooting.pdf Tips to talking to children about a shooting] * [http://www.nctsn.org/sites/default/files/assets/pdfs/helping_young_children_heal_crisis.pdf Helping young children heal after a crisis] * [http://www.nctsn.org/content/psychological-first-aid-schoolspfa Psychological first aid for schools] * [http://www.nctsn.org/content/psychological-first-aid Resources and manuals on psychological first aid] * [http://www.ptsd.va.gov/public/index.asp Resources for the public] from [http://www.ptsd.va.gov/index.asp VA National PTSD Center] * [https://curlie.org/Health/Mental_Health/Disorders/Anxiety/Post-traumatic_Stress Posttraumatic stress disorder] at Curlie (based on DMOZ) =='''References'''== {{collapse top|Click here for references}} {{Reflist|30em}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] {{collapse bottom}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] jeegwefv6f0z82zi4c4e4al6zhmc3eb 2419224 2419222 2022-08-26T03:05:42Z Ardenguo 2944162 /* References */ Made the references box expanded by default wikitext text/x-wiki <noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{medical disclaimer}} {{:{{BASEPAGENAME}}/Sidebar}} ==[[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio"?''']]== * For background information on what assessment portfolios are, click the link in the heading above. * Want even 'more' information about this topic? There's an extended version of this page [[Evidence-based assessment/Posttraumatic stress disorder (disorder portfolio)/extended version|'''here''']]. == [[Evidence based assessment/Preparation phase|'''Preparation phase''']] == === Diagnostic criteria for post traumatic stress disorder === ===='''ICD-11 Diagnostic Criteria'''==== {{blockquotetop}} ===='''ICD-11 Criteria'''==== *Post-traumatic stress disorder (PTSD) is a syndrome that develops following exposure to an extremely threatening or horrific event or series of events that is characterized by all of the following: **1) re-experiencing the traumatic event or events in the present in the form of vivid intrusive memories, flashbacks, or nightmares, which are typically accompanied by strong and overwhelming emotions such as fear or horror and strong physical sensations, or feelings of being overwhelmed or immersed in the same intense emotions that were experienced during the traumatic event; **2) avoidance of thoughts and memories of the event or events, or avoidance of activities, situations, or people reminiscent of the event or events **3) persistent perceptions of heightened current threat, for example as indicated by hypervigilance or an enhanced startle reaction to stimuli such as unexpected noises. *The symptoms must persist for at least several weeks and cause significant impairment in personal, family, social, educational, occupational or other important areas of functioning. Additionally, ICD 11 includes a category called "Complex post-traumatic stress disorder," which is described as: *A disorder that may develop following exposure to an event or series of events of an extremely threatening or horrific nature, most commonly prolonged or repetitive events from which escape is difficult or impossible (e.g., torture, slavery, genocide campaigns, prolonged domestic violence, repeated childhood sexual or physical abuse). *The disorder is characterized by the core symptoms of PTSD; that is, all diagnostic requirements for PTSD have been met at some point during the course of the disorder. *In addition, Complex PTSD is characterized by: **1) severe and pervasive problems in affect regulation; **2) persistent beliefs about oneself as diminished, defeated or worthless, accompanied by deep and pervasive feelings of shame, guilt or failure related to the traumatic event **3) persistent difficulties in sustaining relationships and in feeling close to others. The disturbance causes significant impairment in personal, family, social, educational, occupational or other important areas of functioning. {{blockquotebottom}} ===='''Changes in DSM-5'''==== * The diagnostic criteria for post-traumatic stress disorder changed slightly from [[DSM-IV]] to [[w:Diagnostic_and_Statistical_Manual_of_Mental_Disorders#DSM-IV-TR_.282000.29|DSM-5]]. Summaries are available [http://www.dsm5.org/Documents/changes%20from%20dsm-iv-tr%20to%20dsm-5.pdf here] and [[w:DSM-5|here]]. === Developmental sensitivities === {{collapse top| More information on developmental sensitivities|expand=yes}} *Diagnostic thresholds have been lowered for children and adolescents to account for development. *Separate and additional criteria have been added for children age 6 or younger. *Child sexual abuse has been found to have a substantial effect on the development of PTSD.<ref>{{cite journal|last1=Paolucci|first1=Elizabeth ODDONE|last2=Genuis|first2=Mark L.|last3=Violato|first3=Claudio|title=A Meta-Analysis of the Published Research on the Effects of Child Sexual Abuse|journal=The Journal of Psychology|date=January 2001|volume=135|issue=1|pages=17–36|doi=10.1080/00223980109603677}}</ref> *Children with higher exposure to trauma, less social support, and other major life events are more likely to have continued PTSD symptoms 7 months after a trauma.<ref name=":2">{{cite journal |last1=La Greca|first1=A|last2=Silverman|first2=WK|last3=Vernberg|first3=EM|last4=Prinstein|first4=MJ|title=Symptoms of posttraumatic stress in children after Hurricane Andrew: a prospective study.|journal=Journal of consulting and clinical psychology|date=August 1996|volume=64|issue=4|pages=712-23|pmid=8803361}}</ref> 10 months after a trauma, however, only experience of a major life event remained predictive of continuing PTSD symptoms.<ref name=":2" /> *Lack of social support, specifically lack of support by a teacher, was predictive of higher PTSD symptoms among children who had gone through an environmental trauma.<ref name=":2" /> *Children who reported using blame and anger as strategies for coping had higher levels of PTSD symptoms 10 months after a trauma.<ref name=":2" /> *Negative affect in children before a traumatic event was predictive of development of PTSD symptoms after a traumatic event.<ref>{{cite journal|last1=Weems|first1=CF|last2=Pina|first2=AA|last3=Costa|first3=NM|last4=Watts|first4=SE|last5=Taylor|first5=LK|last6=Cannon|first6=MF|title=Predisaster trait anxiety and negative affect predict posttraumatic stress in youths after hurricane Katrina.|journal=Journal of consulting and clinical psychology|date=February 2007|volume=75|issue=1|pages=154-9|doi=10.1037/0022-006X.75.1.154|pmid=17295574}}</ref> [[wikipedia:Posttraumatic_stress_disorder|Posttraumatic stress disorder]] is now more sensitive to development in that diagnostic thresholds have been lowered for children and adolescents. Furthermore, separate and additional criteria have been added for children age 6 years of age or younger. {{collapse bottom}} === Base rates of PTSD in different clinical settings and populations === This section describes the demographic settings of the populations sampled, base rates of PTSD diagnoses, country/region sampled, and the diagnostic methods that were used. Using this information, clinicians will be able to anchor the most appropriate rate of PTSD that they are likely to see in their clinical practice. * '''''To see prevalence rates across multiple disorders,''''' [[Evidence based assessment/Preparation phase#Base rates for transdiagnostic comparison|'''''click here.''''']] {| class="wikitable sortable" border="1" |- ! Demography ! Setting ! Base Rate ! Diagnostic Method |- | United States, nationally representative, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Kessler|first=Ronald C.|last2=Berglund|first2=Patricia|last3=Demler|first3=Olga|last4=Jin|first4=Robert|last5=Merikangas|first5=Kathleen R.|last6=Walters|first6=Ellen E.|date=2005-06-01|title=Lifetime Prevalence and Age-of-Onset Distributions of DSM-IV Disorders in the National Comorbidity Survey Replication|url=http://archpsyc.jamanetwork.com/article.aspx?doi=10.1001/archpsyc.62.6.593|journal=Archives of General Psychiatry|language=en|volume=62|issue=6|doi=10.1001/archpsyc.62.6.593|issn=0003-990X}}</ref> | 6.8% | National Comorbidity Survey - Replication |- | Netherlands, nationally representative, age 18-80 | Non-clinical: Population based<ref>{{Cite journal|last=de Vries|first=Giel-Jan|last2=Olff|first2=Miranda|date=2009-08-01|title=The lifetime prevalence of traumatic events and posttraumatic stress disorder in the Netherlands|url=http://onlinelibrary.wiley.com/doi/10.1002/jts.20429/abstract|journal=Journal of Traumatic Stress|language=en|volume=22|issue=4|pages=259–267|doi=10.1002/jts.20429|issn=1573-6598}}</ref> | 7.4% | Composite International Diagnostic Interview (CIDI) |- | United States, nationally representative, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Pietrzak|first=Robert H.|last2=Goldstein|first2=Risë B.|last3=Southwick|first3=Steven M.|last4=Grant|first4=Bridget F.|title=Prevalence and Axis I comorbidity of full and partial posttraumatic stress disorder in the United States: Results from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions|url=http://linkinghub.elsevier.com/retrieve/pii/S0887618510002288|journal=Journal of Anxiety Disorders|volume=25|issue=3|pages=456–465|doi=10.1016/j.janxdis.2010.11.010}}</ref> | 6.4% | Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions |- | Northern Ireland, representative sample, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Bunting|first=Brendan P.|last2=Ferry|first2=Finola R.|last3=Murphy|first3=Samuel D.|last4=O'Neill|first4=Siobhan M.|last5=Bolton|first5=David|date=2013-02-01|title=Trauma Associated With Civil Conflict and Posttraumatic Stress Disorder: Evidence From the Northern Ireland Study of Health and Stress|url=http://onlinelibrary.wiley.com/doi/10.1002/jts.21766/abstract|journal=Journal of Traumatic Stress|language=en|volume=26|issue=1|pages=134–141|doi=10.1002/jts.21766|issn=1573-6598}}</ref> | 8.8% | Northern Ireland Study of Health and Stress |- | South Africa, nationally representative sample, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Atwoli|first=Lukoye|last2=Stein|first2=Dan J.|last3=Williams|first3=David R.|last4=Mclaughlin|first4=Katie A.|last5=Petukhova|first5=Maria|last6=Kessler|first6=Ronald C.|last7=Koenen|first7=Karestan C.|date=2013-07-03|title=Trauma and posttraumatic stress disorder in South Africa: analysis from the South African Stress and Health Study|url=https://doi.org/10.1186/1471-244X-13-182|journal=BMC Psychiatry|volume=13|pages=182|doi=10.1186/1471-244x-13-182|issn=1471-244X}}</ref> | 2.3% | South African Stress and Health Study, using the Composite International Diagnostic Interview (CIDI) |- | U.S. Army and Marine Soldiers Deployed to Iraq and Afghanistan | U.S. Service Members<ref>{{Cite journal|last=Hoge|first=Charles W.|last2=Castro|first2=Carl A.|last3=Messer|first3=Stephen C.|last4=McGurk|first4=Dennis|last5=Cotting|first5=Dave I.|last6=Koffman|first6=Robert L.|date=2004-07-01|title=Combat Duty in Iraq and Afghanistan, Mental Health Problems, and Barriers to Care|url=http://dx.doi.org/10.1056/NEJMoa040603|journal=New England Journal of Medicine|volume=351|issue=1|pages=13–22|doi=10.1056/nejmoa040603|issn=0028-4793|pmid=15229303}}</ref> |11.5% - 19.5% ♦ | PTSD Checklist |- |United States, nationally representative, ages 13-18 |Non-clinical: Population based<ref>{{Cite journal|last=Merikangas|first=Kathleen Ries|last2=He|first2=Jian-ping|last3=Burstein|first3=Marcy|last4=Swanson|first4=Sonja A.|last5=Avenevoli|first5=Shelli|last6=Cui|first6=Lihong|last7=Benjet|first7=Corina|last8=Georgiades|first8=Katholiki|last9=Swendsen|first9=Joel|title=Lifetime Prevalence of Mental Disorders in U.S. Adolescents: Results from the National Comorbidity Survey Replication–Adolescent Supplement (NCS-A)|url=https://doi.org/10.1016/j.jaac.2010.05.017|journal=Journal of the American Academy of Child & Adolescent Psychiatry|volume=49|issue=10|pages=980–989|doi=10.1016/j.jaac.2010.05.017}}</ref> |5.0% |National Comorbidity Survey Replication—Adolescent Supplement (NCS-A) |} ♦ '''Note''': These rates were using broad PTSD Checklist scoring criteria of being scored positive if subjects reported at least one intrusion symptom, three avoidance symptoms, and two hyperarousal symptom that were categorized as at the moderate level. The 11.5% is for soldiers returning from deployment in Iraq, 19.5% is for soldiers returning from Afghanistan. Another common practice is to use a strict cutoff of 50 on the PCL, above which someone screens positive for PTSD. With this cutoff, rates are 6.2% and 12.9% for Service Members returned from Afghanistan and Iraqi, respectively. ==[[Evidence based assessment/Prediction phase|'''Prediction phase''']]== === Psychometric properties of screening for PTSD === The following section contains a list of screening and diagnostic instruments for PTSD. The section includes administration information, psychometric data, and PDFs or links to the screenings. * Screenings are used as part of the [[Evidence based assessment/Prediction phase|prediction phase]] of assessment; for more information on interpretation of this data, or how screenings fit in to the assessment process, click [[Evidence based assessment/Prediction phase|here.]] * '''''For a list of more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Psychometric_properties_of_common_screening_instruments click here.]''''' {| class="wikitable" |- ! Measure !Format (Reporter) !Age Range !Administration/ Completion Time !Where to Access |- |[https://www.ptsd.va.gov/professional/assessment/adult-sr/ptsd-checklist.asp PCL-5 (PTSD Checklist for DSM-5)] |Self-Report |adult |5-10 minutes | * [https://www.ptsd.va.gov/professional/assessment/documents/PCL5_Standard_form.PDFPDF PDF] * [https://unc.az1.qualtrics.com/jfe/form/SV_9nmXgrLPpvhPhgF Online version (Spanish)] |- |PDS-5 (Post-traumatic Diagnosis Scale) |Self-Report |adult |10-20 minutes |[https://www.ptsd.va.gov/professional/assessment/adult-sr/pds.asp How to request] |- | colspan="4" style="font-size:110%; text-align:center;" |'''For Children and Adolescents Specifically''' | |- |[https://www.reactionindex.com/index.php/ UCLA PTSD Reaction Index for DSM-5] |Clinician Administered |child, school age, adolescents |20-30 minutes |[https://www.dellchildrens.net/wp-content/uploads/sites/60/2019/08/UCLA-PTSD-RI-DSM-5.pdf PDF] |- |CPSS (Children's PTSD Symptom Scale) |Self-Report |child |10-20 minutes | * [https://www.aacap.org/App_Themes/AACAP/docs/resource_centers/resources/misc/child_ptsd_symptom_scale.pdf PDF] * [https://unc.az1.qualtrics.com/jfe/form/SV_6XPDvzlfkg2SQRf Online version] |- |Young Child PTSD Checklist (YCPC) |Parent Report |child |13 items |[https://medicine.tulane.edu/sites/g/files/rdw761/f/YCPC_v5_23_14.pdf PDF] |} === Interpreting PTSD screening measure scores === * For information on interpreting screening measure scores, click [[Evidence based assessment/Prediction phase#Interpreting screening measure scores|here.]] * Also see the page on [https://en.wikipedia.org/wiki/Likelihood_ratios_in_diagnostic_testing likelihood ratios in diagnostic testing] for more information ==[[Evidence based assessment/Prescription phase|'''Prescription phase''']]== ===Gold standard diagnostic interviews=== * For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews click here.] ===Recommended diagnostic interviews for PTSD=== {| class="wikitable sortable" border="1" ! colspan="4" |Diagnostic instruments for PTSD ! |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time !Where to Access |- | [https://www.ptsd.va.gov/professional/assessment/adult-int/caps.asp CAPS-5 (Clinician Administered PTSD Scale)] | Clinician Administered Interview | adult | 40-60 minutes |[https://www.ptsd.va.gov/professional/assessment/ncptsd-instrument-request-form.asp Assessment request form] |- |PTSD Symptom Scale Interview (PSS-I-5) |Clinician Administered Interview |adult and child version available |24 items |[http://www.advanced-counseling.com/dl/PSSI-5.pdf PDF] |- | colspan="4" style="font-size:110%; text-align:center;" |'''For Children and Adolescents Specifically''' | |- | [https://www.ptsd.va.gov/professional/assessment/child/caps-ca.asp CAPS-CA-5 (Clinician-Administered PTSD Scale for DSM-5 - Child/Adolescent Version)] |Clinician Administered Interview |child |30 items |[https://www.ptsd.va.gov/professional/assessment/ncptsd-instrument-request-form.asp Assessment request form] |- | Children’s PTSD Inventory (CPTSD-I) |Diagnostic Interview | 6-18 years | 50 items |Not Free |} ===Severity interviews for PTSD=== {| class="wikitable sortable" border="1" |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time !Where to Access |- | Schedule for Affective Disorders and Schizophrenia for School Age Children (K-SADS) | Diagnostic Interview | 6-18 years | 18 PTSD items |[https://www.pediatricbipolar.pitt.edu/sites/default/files/KSADS_DSM_5_SCREEN_Final.pdf PDF] |- | Anxiety Disorders Interview Schedule, Child Version (ADIS-C) | Diagnostic Interview | 7-17 years | 26 PTSD items |Not free |- | Diagnostic Infant and Preschool Assessment (DIPA) |Diagnostic Interview | Age 6 and younger | 46 PTSD items |[https://medicine.tulane.edu/sites/g/files/rdw761/f/DIPA-2017-2-14.pdf PDF] |} ==[[Evidence based assessment/Process phase|'''Process phase''']]== The following section contains a brief overview of treatment options for PTSD and list of process and outcome measures for PTSD. The section includes benchmarks based on published norms for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the [[Evidence based assessment/Process phase|process phase]] of assessment. For more information of differences between process and outcome measures, see the page on the [[Evidence based assessment/Process phase|process phase of assessment]]. === Process measures === * Information coming soon === Outcome and severity measures === This table includes clinically significant benchmarks for PTSD specific outcome measures * Information on how to interpret this table can be [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase found here]. * Additionally, these [[Evidence based assessment/Vignettes|vignettes]] might be helpful resources for understanding appropriate adaptation of outcome measures in practice. * ''<u>For clinically significant change benchmarks for the CBCL, YSR, and TRF total, externalizing, internalizing, and attention benchmarks,</u>'' [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase&wteswitched=1#Clinically_significant_change_benchmarks_for_widely-used_outcome_measures see here.] {| class="wikitable sortable" border="1" | colspan="7" |'''Clinically significant change benchmarks with common instruments for PTSD''' |- | colspan="7" style="font-size:110%; text-align:center;" span |<b> Benchmarks Based on Published Norms</b> |- | rowspan="2" style="text-align:center;font-size:130%;" |<b> Measure</b> | colspan="3" style="text-align:center;font-size:130%" width="300" |<b> Cut-off scores</b> | colspan="3" style="text-align:center;font-size:120%" |<b> Critical Change <br> (unstandardized scores)</b> |- | style="text-align:center;font-size:110%" |<b> A</b> | style="text-align:center;font-size:110%" |<b> B</b> | style="text-align:center;font-size:110%" |<b> C</b> | style="text-align:center;font-size:110%" |<b> 95%</b> | style="text-align:center;font-size:110%" |<b> 90%</b> | style="text-align:center;font-size:110%" |<b> SE_difference</b> |- | rowspan="1" style="text-align:center;" | Primary Care PTSD Screen | style="text-align:center;" | 1.0 | style="text-align:center;" | 3.1 | style="text-align:center;" | 2.0 | style="text-align:center;" | 1.0 | style="text-align:center;" | .8 | style="text-align:center;" | .5 |- | rowspan="1" style="text-align:center;" | PTSD Checklist Scores | style="text-align:center;" | 28.8 | style="text-align:center;" | 40.8 | style="text-align:center;" | 34.9 | style="text-align:center;" | 4.6 | style="text-align:center;" | 3.8 | style="text-align:center;" | 2.3 |- | rowspan="1" style="text-align:center;" | Clinician Administered PTSD Scale | style="text-align:center;" | 28.8 | style="text-align:center;" | 40.8 | style="text-align:center;" | 34.9 | style="text-align:center;" | 8.3 | style="text-align:center;" | 7.0 | style="text-align:center;" | 4.2 |} === Treatment === * Please refer to the Wikipedia page on [[wikipedia:Posttraumatic_stress_disorder|PTSD]] for more information on available treatment for PTSD or go to the [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/post-traumatic-stress-disorder/ Effective Child Therapy] page for for a curated resource on effective treatments for PTSD. {{collapse top| More information on treatment|expand=yes}} '''<big>Behavioral interventions</big>''' Recommended (have ''significant benefit'') <ref name=":0">Department of Veterans Affairs and Department of Defense. . (2010). VA/DoD clinical practice guidelines: management of post-traumatic stress. Washington, D.C.: Veterans Health Administration, Department of Defense.</ref>: # Brief Cognitive Behavioral Therapy (CBT; 4-5 sessions) #* This includes stress inoculation training, trauma-focused therapy including components of cognitive restructuring, Cognitive Processing Therapy (CPT), imaginal, virtual, and in-vivo exposure as in Prolonged Exposure psychotherapy (PE)² #* Patient education is recommended as part of psychotherapy for patients and family members # EMDR may help both acute and chronic PTSD, especially individuals who have trouble with prolonged exposure or have trouble verbalizing their trauma.<ref name=":1">Ursano, R. J., Bell, C., Eth, S., Friedman, M., Norwood, A., Pfefferbaum, B., . . . McIntyre, J. S. (2004). ''Practice guideline for the treatment of patients with acute stress disorder and posttraumatic stress disorder'': American Psychiatric Publ </ref> ## Long term gains require further study. # [https://www.ptsd.va.gov/professional/treat/txessentials/present_centered_therapy.asp Present-Centered Therapy (PCT)] is a non trauma focused treatment for PTSD and a second-line treatment for PTSD<ref>{{Cite web|url=https://www.ptsd.va.gov/professional/treat/txessentials/present_centered_therapy.asp|title=Present-Centered Therapy for PTSD - PTSD: National Center for PTSD|website=www.ptsd.va.gov|language=en|access-date=2022-08-13}}</ref>. Treatments with weaker evidence (have ''some benefit'') <ref name=":0" />: # Patient education, # Imagery rehearsal therapy, # Psychodynamic therapy, # Hypnosis, # Relaxation techniques, # and Group therapy. Treatment with ''unknown benefit'' <ref name=":0" />: # Web-based CBT ## For example Jeane Bosch participated as a study therapist in research study that compared STAIR and present-centered therapy both delivered via telehealth. STAIR stands for Skills Training in Affective and Interpersonal Regulation. It is a skill-focused treatment that was originally developed for survivors of childhood abuse to teach emotion regulation skills as well as tools to help with challenges interpersonal functioning and social relationships and decrease PTSD symptoms<ref>{{Cite web|url=https://istss.org/public-resources/trauma-blog/2015-march-(1)/clinician-s-corner-skills-training-in-affective-an|title=ISTSS - Trauma Blog|website=istss.org|access-date=2022-08-13}}</ref>.<ref>{{Citation|title=Introduction to Telehealth with Dr. Bosch|url=https://www.youtube.com/watch?v=Wn6Vewl42X8|accessdate=2022-08-13|language=en}}</ref> # Acceptance and commitment therapy, # and Dialectical Behavioral Therapy. <big>'''Medication'''</big> *SSRIs are more effective than placebo in treating PTSD.<ref name=":1" /> *There is no evidence to support a medication to prevent the development of PTSD.<ref name=":0" /> **Imipramine, propranolol, prazosin, other antidepressants, anticonvulsants, and atypical antipsychotics have ''unknown benefit.'' **Strongly recommend against the use of benzodiazepines² and typical antipsychotics since they have ''no benefit and potential harm.'' {{collapse bottom}} == '''External resources''' == === For professionals === * [http://www.som.uq.edu.au/ptsd Post Traumatic Stress Disorder Information Resource] from [http://www.uq.edu.au/ The University of Queensland School of Medicine] * [http://www.apa.org/ptsd-guideline/ APA practice parameters for assessment and treatment for PTSD (Updated 2017)] * [http://www.ptsd.va.gov/professional/index.asp Resources for professionals] from [http://www.ptsd.va.gov/index.asp VA National PTSD Center] * [https://www.integration.samhsa.gov/clinical-practice/trauma-informed SAMHSA's Trauma-Informed Care Resources and Training] * [https://www.integration.samhsa.gov/clinical-practice/trauma-informed SAMHSA's Resources on Intimate Partner Violence (IPV) for Clinicians, Patients, Families, and Organizations] === For caregivers === * [http://www.nctsn.org/sites/default/files/assets/pdfs/tips_for_parents_media_final.pdf Tips for parents on shooting media coverage] * [http://www.nctsn.org/sites/default/files/assets/pdfs/parents_guidelines_for_helping_teens_after_the_recent_attacks.pdf Parent guidelines to helping youths after a shooting] * [http://www.nctsn.org/sites/default/files/assets/pdfs/helping_teens_with_traumatic_grief_caregivers_final.pdf Caregiver tips for helping teens with traumatic grief] * [http://www.nctsn.org/sites/default/files/assets/pdfs/10things_schoolage_ctg.pdf Caregiver tips for helping school-age children with traumatic grief] *[http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/post-traumatic-stress-disorder/ EffectiveChildTherapy.Org information on PTSD] *[https://sccap53.org Society of Clinical Child and Adolescent Psychology] === For educators === * [http://www.nctsn.org/sites/default/files/assets/pdfs/pfa_for_schools_appendix_a_teachers.pdf Teacher tips for providing psychological first aid] * [http://www.nctsn.org/sites/default/files/assets/pdfs/helping_youth_after_community_violence_educators.pdf Educator tips for helping youths after a community trauma] === For public === * [https://complicatedgrief.columbia.edu/for-the-public/resources/ Resources for grief and loss] * [http://www.nctsn.org/sites/default/files/assets/pdfs/psychological_information_sheet_two_pager.pdf Psychological impacts of recent shootings] * [http://www.nctsn.org/sites/default/files/assets/pdfs/youth_journalists.pdf Tips to talking to youths about a shooting] * [http://www.nctsn.org/sites/default/files/assets/pdfs/talking_to_children_about_the_shooting.pdf Tips to talking to children about a shooting] * [http://www.nctsn.org/sites/default/files/assets/pdfs/helping_young_children_heal_crisis.pdf Helping young children heal after a crisis] * [http://www.nctsn.org/content/psychological-first-aid-schoolspfa Psychological first aid for schools] * [http://www.nctsn.org/content/psychological-first-aid Resources and manuals on psychological first aid] * [http://www.ptsd.va.gov/public/index.asp Resources for the public] from [http://www.ptsd.va.gov/index.asp VA National PTSD Center] * [https://curlie.org/Health/Mental_Health/Disorders/Anxiety/Post-traumatic_Stress Posttraumatic stress disorder] at Curlie (based on DMOZ) =='''References'''== {{collapse top|References|expand=yes}} {{Reflist|30em}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] {{collapse bottom}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] 8xz5qvwor109xy24m99hex33pkmc7h2 2419291 2419224 2022-08-26T05:13:03Z Ardenguo 2944162 /* Psychometric properties of screening for PTSD */ Added "Note: Reliability and validity are included in the extended version (link). This table includes measures with Good or Excellent ratings." // added table title wikitext text/x-wiki <noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{medical disclaimer}} {{:{{BASEPAGENAME}}/Sidebar}} ==[[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio"?''']]== * For background information on what assessment portfolios are, click the link in the heading above. * Want even 'more' information about this topic? There's an extended version of this page [[Evidence-based assessment/Posttraumatic stress disorder (disorder portfolio)/extended version|'''here''']]. == [[Evidence based assessment/Preparation phase|'''Preparation phase''']] == === Diagnostic criteria for post traumatic stress disorder === ===='''ICD-11 Diagnostic Criteria'''==== {{blockquotetop}} ===='''ICD-11 Criteria'''==== *Post-traumatic stress disorder (PTSD) is a syndrome that develops following exposure to an extremely threatening or horrific event or series of events that is characterized by all of the following: **1) re-experiencing the traumatic event or events in the present in the form of vivid intrusive memories, flashbacks, or nightmares, which are typically accompanied by strong and overwhelming emotions such as fear or horror and strong physical sensations, or feelings of being overwhelmed or immersed in the same intense emotions that were experienced during the traumatic event; **2) avoidance of thoughts and memories of the event or events, or avoidance of activities, situations, or people reminiscent of the event or events **3) persistent perceptions of heightened current threat, for example as indicated by hypervigilance or an enhanced startle reaction to stimuli such as unexpected noises. *The symptoms must persist for at least several weeks and cause significant impairment in personal, family, social, educational, occupational or other important areas of functioning. Additionally, ICD 11 includes a category called "Complex post-traumatic stress disorder," which is described as: *A disorder that may develop following exposure to an event or series of events of an extremely threatening or horrific nature, most commonly prolonged or repetitive events from which escape is difficult or impossible (e.g., torture, slavery, genocide campaigns, prolonged domestic violence, repeated childhood sexual or physical abuse). *The disorder is characterized by the core symptoms of PTSD; that is, all diagnostic requirements for PTSD have been met at some point during the course of the disorder. *In addition, Complex PTSD is characterized by: **1) severe and pervasive problems in affect regulation; **2) persistent beliefs about oneself as diminished, defeated or worthless, accompanied by deep and pervasive feelings of shame, guilt or failure related to the traumatic event **3) persistent difficulties in sustaining relationships and in feeling close to others. The disturbance causes significant impairment in personal, family, social, educational, occupational or other important areas of functioning. {{blockquotebottom}} ===='''Changes in DSM-5'''==== * The diagnostic criteria for post-traumatic stress disorder changed slightly from [[DSM-IV]] to [[w:Diagnostic_and_Statistical_Manual_of_Mental_Disorders#DSM-IV-TR_.282000.29|DSM-5]]. Summaries are available [http://www.dsm5.org/Documents/changes%20from%20dsm-iv-tr%20to%20dsm-5.pdf here] and [[w:DSM-5|here]]. === Developmental sensitivities === {{collapse top| More information on developmental sensitivities|expand=yes}} *Diagnostic thresholds have been lowered for children and adolescents to account for development. *Separate and additional criteria have been added for children age 6 or younger. *Child sexual abuse has been found to have a substantial effect on the development of PTSD.<ref>{{cite journal|last1=Paolucci|first1=Elizabeth ODDONE|last2=Genuis|first2=Mark L.|last3=Violato|first3=Claudio|title=A Meta-Analysis of the Published Research on the Effects of Child Sexual Abuse|journal=The Journal of Psychology|date=January 2001|volume=135|issue=1|pages=17–36|doi=10.1080/00223980109603677}}</ref> *Children with higher exposure to trauma, less social support, and other major life events are more likely to have continued PTSD symptoms 7 months after a trauma.<ref name=":2">{{cite journal |last1=La Greca|first1=A|last2=Silverman|first2=WK|last3=Vernberg|first3=EM|last4=Prinstein|first4=MJ|title=Symptoms of posttraumatic stress in children after Hurricane Andrew: a prospective study.|journal=Journal of consulting and clinical psychology|date=August 1996|volume=64|issue=4|pages=712-23|pmid=8803361}}</ref> 10 months after a trauma, however, only experience of a major life event remained predictive of continuing PTSD symptoms.<ref name=":2" /> *Lack of social support, specifically lack of support by a teacher, was predictive of higher PTSD symptoms among children who had gone through an environmental trauma.<ref name=":2" /> *Children who reported using blame and anger as strategies for coping had higher levels of PTSD symptoms 10 months after a trauma.<ref name=":2" /> *Negative affect in children before a traumatic event was predictive of development of PTSD symptoms after a traumatic event.<ref>{{cite journal|last1=Weems|first1=CF|last2=Pina|first2=AA|last3=Costa|first3=NM|last4=Watts|first4=SE|last5=Taylor|first5=LK|last6=Cannon|first6=MF|title=Predisaster trait anxiety and negative affect predict posttraumatic stress in youths after hurricane Katrina.|journal=Journal of consulting and clinical psychology|date=February 2007|volume=75|issue=1|pages=154-9|doi=10.1037/0022-006X.75.1.154|pmid=17295574}}</ref> [[wikipedia:Posttraumatic_stress_disorder|Posttraumatic stress disorder]] is now more sensitive to development in that diagnostic thresholds have been lowered for children and adolescents. Furthermore, separate and additional criteria have been added for children age 6 years of age or younger. {{collapse bottom}} === Base rates of PTSD in different clinical settings and populations === This section describes the demographic settings of the populations sampled, base rates of PTSD diagnoses, country/region sampled, and the diagnostic methods that were used. Using this information, clinicians will be able to anchor the most appropriate rate of PTSD that they are likely to see in their clinical practice. * '''''To see prevalence rates across multiple disorders,''''' [[Evidence based assessment/Preparation phase#Base rates for transdiagnostic comparison|'''''click here.''''']] {| class="wikitable sortable" border="1" |- ! Demography ! Setting ! Base Rate ! Diagnostic Method |- | United States, nationally representative, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Kessler|first=Ronald C.|last2=Berglund|first2=Patricia|last3=Demler|first3=Olga|last4=Jin|first4=Robert|last5=Merikangas|first5=Kathleen R.|last6=Walters|first6=Ellen E.|date=2005-06-01|title=Lifetime Prevalence and Age-of-Onset Distributions of DSM-IV Disorders in the National Comorbidity Survey Replication|url=http://archpsyc.jamanetwork.com/article.aspx?doi=10.1001/archpsyc.62.6.593|journal=Archives of General Psychiatry|language=en|volume=62|issue=6|doi=10.1001/archpsyc.62.6.593|issn=0003-990X}}</ref> | 6.8% | National Comorbidity Survey - Replication |- | Netherlands, nationally representative, age 18-80 | Non-clinical: Population based<ref>{{Cite journal|last=de Vries|first=Giel-Jan|last2=Olff|first2=Miranda|date=2009-08-01|title=The lifetime prevalence of traumatic events and posttraumatic stress disorder in the Netherlands|url=http://onlinelibrary.wiley.com/doi/10.1002/jts.20429/abstract|journal=Journal of Traumatic Stress|language=en|volume=22|issue=4|pages=259–267|doi=10.1002/jts.20429|issn=1573-6598}}</ref> | 7.4% | Composite International Diagnostic Interview (CIDI) |- | United States, nationally representative, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Pietrzak|first=Robert H.|last2=Goldstein|first2=Risë B.|last3=Southwick|first3=Steven M.|last4=Grant|first4=Bridget F.|title=Prevalence and Axis I comorbidity of full and partial posttraumatic stress disorder in the United States: Results from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions|url=http://linkinghub.elsevier.com/retrieve/pii/S0887618510002288|journal=Journal of Anxiety Disorders|volume=25|issue=3|pages=456–465|doi=10.1016/j.janxdis.2010.11.010}}</ref> | 6.4% | Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions |- | Northern Ireland, representative sample, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Bunting|first=Brendan P.|last2=Ferry|first2=Finola R.|last3=Murphy|first3=Samuel D.|last4=O'Neill|first4=Siobhan M.|last5=Bolton|first5=David|date=2013-02-01|title=Trauma Associated With Civil Conflict and Posttraumatic Stress Disorder: Evidence From the Northern Ireland Study of Health and Stress|url=http://onlinelibrary.wiley.com/doi/10.1002/jts.21766/abstract|journal=Journal of Traumatic Stress|language=en|volume=26|issue=1|pages=134–141|doi=10.1002/jts.21766|issn=1573-6598}}</ref> | 8.8% | Northern Ireland Study of Health and Stress |- | South Africa, nationally representative sample, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Atwoli|first=Lukoye|last2=Stein|first2=Dan J.|last3=Williams|first3=David R.|last4=Mclaughlin|first4=Katie A.|last5=Petukhova|first5=Maria|last6=Kessler|first6=Ronald C.|last7=Koenen|first7=Karestan C.|date=2013-07-03|title=Trauma and posttraumatic stress disorder in South Africa: analysis from the South African Stress and Health Study|url=https://doi.org/10.1186/1471-244X-13-182|journal=BMC Psychiatry|volume=13|pages=182|doi=10.1186/1471-244x-13-182|issn=1471-244X}}</ref> | 2.3% | South African Stress and Health Study, using the Composite International Diagnostic Interview (CIDI) |- | U.S. Army and Marine Soldiers Deployed to Iraq and Afghanistan | U.S. Service Members<ref>{{Cite journal|last=Hoge|first=Charles W.|last2=Castro|first2=Carl A.|last3=Messer|first3=Stephen C.|last4=McGurk|first4=Dennis|last5=Cotting|first5=Dave I.|last6=Koffman|first6=Robert L.|date=2004-07-01|title=Combat Duty in Iraq and Afghanistan, Mental Health Problems, and Barriers to Care|url=http://dx.doi.org/10.1056/NEJMoa040603|journal=New England Journal of Medicine|volume=351|issue=1|pages=13–22|doi=10.1056/nejmoa040603|issn=0028-4793|pmid=15229303}}</ref> |11.5% - 19.5% ♦ | PTSD Checklist |- |United States, nationally representative, ages 13-18 |Non-clinical: Population based<ref>{{Cite journal|last=Merikangas|first=Kathleen Ries|last2=He|first2=Jian-ping|last3=Burstein|first3=Marcy|last4=Swanson|first4=Sonja A.|last5=Avenevoli|first5=Shelli|last6=Cui|first6=Lihong|last7=Benjet|first7=Corina|last8=Georgiades|first8=Katholiki|last9=Swendsen|first9=Joel|title=Lifetime Prevalence of Mental Disorders in U.S. Adolescents: Results from the National Comorbidity Survey Replication–Adolescent Supplement (NCS-A)|url=https://doi.org/10.1016/j.jaac.2010.05.017|journal=Journal of the American Academy of Child & Adolescent Psychiatry|volume=49|issue=10|pages=980–989|doi=10.1016/j.jaac.2010.05.017}}</ref> |5.0% |National Comorbidity Survey Replication—Adolescent Supplement (NCS-A) |} ♦ '''Note''': These rates were using broad PTSD Checklist scoring criteria of being scored positive if subjects reported at least one intrusion symptom, three avoidance symptoms, and two hyperarousal symptom that were categorized as at the moderate level. The 11.5% is for soldiers returning from deployment in Iraq, 19.5% is for soldiers returning from Afghanistan. Another common practice is to use a strict cutoff of 50 on the PCL, above which someone screens positive for PTSD. With this cutoff, rates are 6.2% and 12.9% for Service Members returned from Afghanistan and Iraqi, respectively. ==[[Evidence based assessment/Prediction phase|'''Prediction phase''']]== === Psychometric properties of screening for PTSD === The following section contains a list of screening and diagnostic instruments for PTSD. The section includes administration information, psychometric data, and PDFs or links to the screenings. * Screenings are used as part of the [[Evidence based assessment/Prediction phase|prediction phase]] of assessment; for more information on interpretation of this data, or how screenings fit in to the assessment process, click [[Evidence based assessment/Prediction phase|here.]] * '''''For a list of more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Psychometric_properties_of_common_screening_instruments click here.]''''' {| class="wikitable" ! colspan="5" |Screening measures for '''PTSD''' |- ! Measure !Format (Reporter) !Age Range !Administration/ Completion Time !Where to Access |- |[https://www.ptsd.va.gov/professional/assessment/adult-sr/ptsd-checklist.asp PCL-5 (PTSD Checklist for DSM-5)] |Self-Report |adult |5-10 minutes | * [https://www.ptsd.va.gov/professional/assessment/documents/PCL5_Standard_form.PDFPDF PDF] * [https://unc.az1.qualtrics.com/jfe/form/SV_9nmXgrLPpvhPhgF Online version (Spanish)] |- |PDS-5 (Post-traumatic Diagnosis Scale) |Self-Report |adult |10-20 minutes |[https://www.ptsd.va.gov/professional/assessment/adult-sr/pds.asp How to request] |- | colspan="4" style="font-size:110%; text-align:center;" |'''For Children and Adolescents Specifically''' | |- |[https://www.reactionindex.com/index.php/ UCLA PTSD Reaction Index for DSM-5] |Clinician Administered |child, school age, adolescents |20-30 minutes |[https://www.dellchildrens.net/wp-content/uploads/sites/60/2019/08/UCLA-PTSD-RI-DSM-5.pdf PDF] |- |CPSS (Children's PTSD Symptom Scale) |Self-Report |child |10-20 minutes | * [https://www.aacap.org/App_Themes/AACAP/docs/resource_centers/resources/misc/child_ptsd_symptom_scale.pdf PDF] * [https://unc.az1.qualtrics.com/jfe/form/SV_6XPDvzlfkg2SQRf Online version] |- |Young Child PTSD Checklist (YCPC) |Parent Report |child |13 items |[https://medicine.tulane.edu/sites/g/files/rdw761/f/YCPC_v5_23_14.pdf PDF] |} '''Note:''' Reliability and validity are included in the extended version (link). This table includes measures with Good or Excellent ratings. === Interpreting PTSD screening measure scores === * For information on interpreting screening measure scores, click [[Evidence based assessment/Prediction phase#Interpreting screening measure scores|here.]] * Also see the page on [https://en.wikipedia.org/wiki/Likelihood_ratios_in_diagnostic_testing likelihood ratios in diagnostic testing] for more information ==[[Evidence based assessment/Prescription phase|'''Prescription phase''']]== ===Gold standard diagnostic interviews=== * For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews click here.] ===Recommended diagnostic interviews for PTSD=== {| class="wikitable sortable" border="1" ! colspan="4" |Diagnostic instruments for PTSD ! |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time !Where to Access |- | [https://www.ptsd.va.gov/professional/assessment/adult-int/caps.asp CAPS-5 (Clinician Administered PTSD Scale)] | Clinician Administered Interview | adult | 40-60 minutes |[https://www.ptsd.va.gov/professional/assessment/ncptsd-instrument-request-form.asp Assessment request form] |- |PTSD Symptom Scale Interview (PSS-I-5) |Clinician Administered Interview |adult and child version available |24 items |[http://www.advanced-counseling.com/dl/PSSI-5.pdf PDF] |- | colspan="4" style="font-size:110%; text-align:center;" |'''For Children and Adolescents Specifically''' | |- | [https://www.ptsd.va.gov/professional/assessment/child/caps-ca.asp CAPS-CA-5 (Clinician-Administered PTSD Scale for DSM-5 - Child/Adolescent Version)] |Clinician Administered Interview |child |30 items |[https://www.ptsd.va.gov/professional/assessment/ncptsd-instrument-request-form.asp Assessment request form] |- | Children’s PTSD Inventory (CPTSD-I) |Diagnostic Interview | 6-18 years | 50 items |Not Free |} ===Severity interviews for PTSD=== {| class="wikitable sortable" border="1" |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time !Where to Access |- | Schedule for Affective Disorders and Schizophrenia for School Age Children (K-SADS) | Diagnostic Interview | 6-18 years | 18 PTSD items |[https://www.pediatricbipolar.pitt.edu/sites/default/files/KSADS_DSM_5_SCREEN_Final.pdf PDF] |- | Anxiety Disorders Interview Schedule, Child Version (ADIS-C) | Diagnostic Interview | 7-17 years | 26 PTSD items |Not free |- | Diagnostic Infant and Preschool Assessment (DIPA) |Diagnostic Interview | Age 6 and younger | 46 PTSD items |[https://medicine.tulane.edu/sites/g/files/rdw761/f/DIPA-2017-2-14.pdf PDF] |} ==[[Evidence based assessment/Process phase|'''Process phase''']]== The following section contains a brief overview of treatment options for PTSD and list of process and outcome measures for PTSD. The section includes benchmarks based on published norms for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the [[Evidence based assessment/Process phase|process phase]] of assessment. For more information of differences between process and outcome measures, see the page on the [[Evidence based assessment/Process phase|process phase of assessment]]. === Process measures === * Information coming soon === Outcome and severity measures === This table includes clinically significant benchmarks for PTSD specific outcome measures * Information on how to interpret this table can be [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase found here]. * Additionally, these [[Evidence based assessment/Vignettes|vignettes]] might be helpful resources for understanding appropriate adaptation of outcome measures in practice. * ''<u>For clinically significant change benchmarks for the CBCL, YSR, and TRF total, externalizing, internalizing, and attention benchmarks,</u>'' [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase&wteswitched=1#Clinically_significant_change_benchmarks_for_widely-used_outcome_measures see here.] {| class="wikitable sortable" border="1" | colspan="7" |'''Clinically significant change benchmarks with common instruments for PTSD''' |- | colspan="7" style="font-size:110%; text-align:center;" span |<b> Benchmarks Based on Published Norms</b> |- | rowspan="2" style="text-align:center;font-size:130%;" |<b> Measure</b> | colspan="3" style="text-align:center;font-size:130%" width="300" |<b> Cut-off scores</b> | colspan="3" style="text-align:center;font-size:120%" |<b> Critical Change <br> (unstandardized scores)</b> |- | style="text-align:center;font-size:110%" |<b> A</b> | style="text-align:center;font-size:110%" |<b> B</b> | style="text-align:center;font-size:110%" |<b> C</b> | style="text-align:center;font-size:110%" |<b> 95%</b> | style="text-align:center;font-size:110%" |<b> 90%</b> | style="text-align:center;font-size:110%" |<b> SE_difference</b> |- | rowspan="1" style="text-align:center;" | Primary Care PTSD Screen | style="text-align:center;" | 1.0 | style="text-align:center;" | 3.1 | style="text-align:center;" | 2.0 | style="text-align:center;" | 1.0 | style="text-align:center;" | .8 | style="text-align:center;" | .5 |- | rowspan="1" style="text-align:center;" | PTSD Checklist Scores | style="text-align:center;" | 28.8 | style="text-align:center;" | 40.8 | style="text-align:center;" | 34.9 | style="text-align:center;" | 4.6 | style="text-align:center;" | 3.8 | style="text-align:center;" | 2.3 |- | rowspan="1" style="text-align:center;" | Clinician Administered PTSD Scale | style="text-align:center;" | 28.8 | style="text-align:center;" | 40.8 | style="text-align:center;" | 34.9 | style="text-align:center;" | 8.3 | style="text-align:center;" | 7.0 | style="text-align:center;" | 4.2 |} === Treatment === * Please refer to the Wikipedia page on [[wikipedia:Posttraumatic_stress_disorder|PTSD]] for more information on available treatment for PTSD or go to the [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/post-traumatic-stress-disorder/ Effective Child Therapy] page for for a curated resource on effective treatments for PTSD. {{collapse top| More information on treatment|expand=yes}} '''<big>Behavioral interventions</big>''' Recommended (have ''significant benefit'') <ref name=":0">Department of Veterans Affairs and Department of Defense. . (2010). VA/DoD clinical practice guidelines: management of post-traumatic stress. Washington, D.C.: Veterans Health Administration, Department of Defense.</ref>: # Brief Cognitive Behavioral Therapy (CBT; 4-5 sessions) #* This includes stress inoculation training, trauma-focused therapy including components of cognitive restructuring, Cognitive Processing Therapy (CPT), imaginal, virtual, and in-vivo exposure as in Prolonged Exposure psychotherapy (PE)² #* Patient education is recommended as part of psychotherapy for patients and family members # EMDR may help both acute and chronic PTSD, especially individuals who have trouble with prolonged exposure or have trouble verbalizing their trauma.<ref name=":1">Ursano, R. J., Bell, C., Eth, S., Friedman, M., Norwood, A., Pfefferbaum, B., . . . McIntyre, J. S. (2004). ''Practice guideline for the treatment of patients with acute stress disorder and posttraumatic stress disorder'': American Psychiatric Publ </ref> ## Long term gains require further study. # [https://www.ptsd.va.gov/professional/treat/txessentials/present_centered_therapy.asp Present-Centered Therapy (PCT)] is a non trauma focused treatment for PTSD and a second-line treatment for PTSD<ref>{{Cite web|url=https://www.ptsd.va.gov/professional/treat/txessentials/present_centered_therapy.asp|title=Present-Centered Therapy for PTSD - PTSD: National Center for PTSD|website=www.ptsd.va.gov|language=en|access-date=2022-08-13}}</ref>. Treatments with weaker evidence (have ''some benefit'') <ref name=":0" />: # Patient education, # Imagery rehearsal therapy, # Psychodynamic therapy, # Hypnosis, # Relaxation techniques, # and Group therapy. Treatment with ''unknown benefit'' <ref name=":0" />: # Web-based CBT ## For example Jeane Bosch participated as a study therapist in research study that compared STAIR and present-centered therapy both delivered via telehealth. STAIR stands for Skills Training in Affective and Interpersonal Regulation. It is a skill-focused treatment that was originally developed for survivors of childhood abuse to teach emotion regulation skills as well as tools to help with challenges interpersonal functioning and social relationships and decrease PTSD symptoms<ref>{{Cite web|url=https://istss.org/public-resources/trauma-blog/2015-march-(1)/clinician-s-corner-skills-training-in-affective-an|title=ISTSS - Trauma Blog|website=istss.org|access-date=2022-08-13}}</ref>.<ref>{{Citation|title=Introduction to Telehealth with Dr. Bosch|url=https://www.youtube.com/watch?v=Wn6Vewl42X8|accessdate=2022-08-13|language=en}}</ref> # Acceptance and commitment therapy, # and Dialectical Behavioral Therapy. <big>'''Medication'''</big> *SSRIs are more effective than placebo in treating PTSD.<ref name=":1" /> *There is no evidence to support a medication to prevent the development of PTSD.<ref name=":0" /> **Imipramine, propranolol, prazosin, other antidepressants, anticonvulsants, and atypical antipsychotics have ''unknown benefit.'' **Strongly recommend against the use of benzodiazepines² and typical antipsychotics since they have ''no benefit and potential harm.'' {{collapse bottom}} == '''External resources''' == === For professionals === * [http://www.som.uq.edu.au/ptsd Post Traumatic Stress Disorder Information Resource] from [http://www.uq.edu.au/ The University of Queensland School of Medicine] * [http://www.apa.org/ptsd-guideline/ APA practice parameters for assessment and treatment for PTSD (Updated 2017)] * [http://www.ptsd.va.gov/professional/index.asp Resources for professionals] from [http://www.ptsd.va.gov/index.asp VA National PTSD Center] * [https://www.integration.samhsa.gov/clinical-practice/trauma-informed SAMHSA's Trauma-Informed Care Resources and Training] * [https://www.integration.samhsa.gov/clinical-practice/trauma-informed SAMHSA's Resources on Intimate Partner Violence (IPV) for Clinicians, Patients, Families, and Organizations] === For caregivers === * [http://www.nctsn.org/sites/default/files/assets/pdfs/tips_for_parents_media_final.pdf Tips for parents on shooting media coverage] * [http://www.nctsn.org/sites/default/files/assets/pdfs/parents_guidelines_for_helping_teens_after_the_recent_attacks.pdf Parent guidelines to helping youths after a shooting] * [http://www.nctsn.org/sites/default/files/assets/pdfs/helping_teens_with_traumatic_grief_caregivers_final.pdf Caregiver tips for helping teens with traumatic grief] * [http://www.nctsn.org/sites/default/files/assets/pdfs/10things_schoolage_ctg.pdf Caregiver tips for helping school-age children with traumatic grief] *[http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/post-traumatic-stress-disorder/ EffectiveChildTherapy.Org information on PTSD] *[https://sccap53.org Society of Clinical Child and Adolescent Psychology] === For educators === * [http://www.nctsn.org/sites/default/files/assets/pdfs/pfa_for_schools_appendix_a_teachers.pdf Teacher tips for providing psychological first aid] * [http://www.nctsn.org/sites/default/files/assets/pdfs/helping_youth_after_community_violence_educators.pdf Educator tips for helping youths after a community trauma] === For public === * [https://complicatedgrief.columbia.edu/for-the-public/resources/ Resources for grief and loss] * [http://www.nctsn.org/sites/default/files/assets/pdfs/psychological_information_sheet_two_pager.pdf Psychological impacts of recent shootings] * [http://www.nctsn.org/sites/default/files/assets/pdfs/youth_journalists.pdf Tips to talking to youths about a shooting] * [http://www.nctsn.org/sites/default/files/assets/pdfs/talking_to_children_about_the_shooting.pdf Tips to talking to children about a shooting] * [http://www.nctsn.org/sites/default/files/assets/pdfs/helping_young_children_heal_crisis.pdf Helping young children heal after a crisis] * [http://www.nctsn.org/content/psychological-first-aid-schoolspfa Psychological first aid for schools] * [http://www.nctsn.org/content/psychological-first-aid Resources and manuals on psychological first aid] * [http://www.ptsd.va.gov/public/index.asp Resources for the public] from [http://www.ptsd.va.gov/index.asp VA National PTSD Center] * [https://curlie.org/Health/Mental_Health/Disorders/Anxiety/Post-traumatic_Stress Posttraumatic stress disorder] at Curlie (based on DMOZ) =='''References'''== {{collapse top|References|expand=yes}} {{Reflist|30em}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] {{collapse bottom}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] pz4f6r2hpks630dgy2uxra8ghisi3x6 2419293 2419291 2022-08-26T05:14:26Z Ardenguo 2944162 /* Prediction phase */ added more "Note: Reliability and validity are included in the extended version. This table includes measures with Good or Excellent ratings." notes. // Linked extended version in the notes wikitext text/x-wiki <noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{medical disclaimer}} {{:{{BASEPAGENAME}}/Sidebar}} ==[[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio"?''']]== * For background information on what assessment portfolios are, click the link in the heading above. * Want even 'more' information about this topic? There's an extended version of this page [[Evidence-based assessment/Posttraumatic stress disorder (disorder portfolio)/extended version|'''here''']]. == [[Evidence based assessment/Preparation phase|'''Preparation phase''']] == === Diagnostic criteria for post traumatic stress disorder === ===='''ICD-11 Diagnostic Criteria'''==== {{blockquotetop}} ===='''ICD-11 Criteria'''==== *Post-traumatic stress disorder (PTSD) is a syndrome that develops following exposure to an extremely threatening or horrific event or series of events that is characterized by all of the following: **1) re-experiencing the traumatic event or events in the present in the form of vivid intrusive memories, flashbacks, or nightmares, which are typically accompanied by strong and overwhelming emotions such as fear or horror and strong physical sensations, or feelings of being overwhelmed or immersed in the same intense emotions that were experienced during the traumatic event; **2) avoidance of thoughts and memories of the event or events, or avoidance of activities, situations, or people reminiscent of the event or events **3) persistent perceptions of heightened current threat, for example as indicated by hypervigilance or an enhanced startle reaction to stimuli such as unexpected noises. *The symptoms must persist for at least several weeks and cause significant impairment in personal, family, social, educational, occupational or other important areas of functioning. Additionally, ICD 11 includes a category called "Complex post-traumatic stress disorder," which is described as: *A disorder that may develop following exposure to an event or series of events of an extremely threatening or horrific nature, most commonly prolonged or repetitive events from which escape is difficult or impossible (e.g., torture, slavery, genocide campaigns, prolonged domestic violence, repeated childhood sexual or physical abuse). *The disorder is characterized by the core symptoms of PTSD; that is, all diagnostic requirements for PTSD have been met at some point during the course of the disorder. *In addition, Complex PTSD is characterized by: **1) severe and pervasive problems in affect regulation; **2) persistent beliefs about oneself as diminished, defeated or worthless, accompanied by deep and pervasive feelings of shame, guilt or failure related to the traumatic event **3) persistent difficulties in sustaining relationships and in feeling close to others. The disturbance causes significant impairment in personal, family, social, educational, occupational or other important areas of functioning. {{blockquotebottom}} ===='''Changes in DSM-5'''==== * The diagnostic criteria for post-traumatic stress disorder changed slightly from [[DSM-IV]] to [[w:Diagnostic_and_Statistical_Manual_of_Mental_Disorders#DSM-IV-TR_.282000.29|DSM-5]]. Summaries are available [http://www.dsm5.org/Documents/changes%20from%20dsm-iv-tr%20to%20dsm-5.pdf here] and [[w:DSM-5|here]]. === Developmental sensitivities === {{collapse top| More information on developmental sensitivities|expand=yes}} *Diagnostic thresholds have been lowered for children and adolescents to account for development. *Separate and additional criteria have been added for children age 6 or younger. *Child sexual abuse has been found to have a substantial effect on the development of PTSD.<ref>{{cite journal|last1=Paolucci|first1=Elizabeth ODDONE|last2=Genuis|first2=Mark L.|last3=Violato|first3=Claudio|title=A Meta-Analysis of the Published Research on the Effects of Child Sexual Abuse|journal=The Journal of Psychology|date=January 2001|volume=135|issue=1|pages=17–36|doi=10.1080/00223980109603677}}</ref> *Children with higher exposure to trauma, less social support, and other major life events are more likely to have continued PTSD symptoms 7 months after a trauma.<ref name=":2">{{cite journal |last1=La Greca|first1=A|last2=Silverman|first2=WK|last3=Vernberg|first3=EM|last4=Prinstein|first4=MJ|title=Symptoms of posttraumatic stress in children after Hurricane Andrew: a prospective study.|journal=Journal of consulting and clinical psychology|date=August 1996|volume=64|issue=4|pages=712-23|pmid=8803361}}</ref> 10 months after a trauma, however, only experience of a major life event remained predictive of continuing PTSD symptoms.<ref name=":2" /> *Lack of social support, specifically lack of support by a teacher, was predictive of higher PTSD symptoms among children who had gone through an environmental trauma.<ref name=":2" /> *Children who reported using blame and anger as strategies for coping had higher levels of PTSD symptoms 10 months after a trauma.<ref name=":2" /> *Negative affect in children before a traumatic event was predictive of development of PTSD symptoms after a traumatic event.<ref>{{cite journal|last1=Weems|first1=CF|last2=Pina|first2=AA|last3=Costa|first3=NM|last4=Watts|first4=SE|last5=Taylor|first5=LK|last6=Cannon|first6=MF|title=Predisaster trait anxiety and negative affect predict posttraumatic stress in youths after hurricane Katrina.|journal=Journal of consulting and clinical psychology|date=February 2007|volume=75|issue=1|pages=154-9|doi=10.1037/0022-006X.75.1.154|pmid=17295574}}</ref> [[wikipedia:Posttraumatic_stress_disorder|Posttraumatic stress disorder]] is now more sensitive to development in that diagnostic thresholds have been lowered for children and adolescents. Furthermore, separate and additional criteria have been added for children age 6 years of age or younger. {{collapse bottom}} === Base rates of PTSD in different clinical settings and populations === This section describes the demographic settings of the populations sampled, base rates of PTSD diagnoses, country/region sampled, and the diagnostic methods that were used. Using this information, clinicians will be able to anchor the most appropriate rate of PTSD that they are likely to see in their clinical practice. * '''''To see prevalence rates across multiple disorders,''''' [[Evidence based assessment/Preparation phase#Base rates for transdiagnostic comparison|'''''click here.''''']] {| class="wikitable sortable" border="1" |- ! Demography ! Setting ! Base Rate ! Diagnostic Method |- | United States, nationally representative, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Kessler|first=Ronald C.|last2=Berglund|first2=Patricia|last3=Demler|first3=Olga|last4=Jin|first4=Robert|last5=Merikangas|first5=Kathleen R.|last6=Walters|first6=Ellen E.|date=2005-06-01|title=Lifetime Prevalence and Age-of-Onset Distributions of DSM-IV Disorders in the National Comorbidity Survey Replication|url=http://archpsyc.jamanetwork.com/article.aspx?doi=10.1001/archpsyc.62.6.593|journal=Archives of General Psychiatry|language=en|volume=62|issue=6|doi=10.1001/archpsyc.62.6.593|issn=0003-990X}}</ref> | 6.8% | National Comorbidity Survey - Replication |- | Netherlands, nationally representative, age 18-80 | Non-clinical: Population based<ref>{{Cite journal|last=de Vries|first=Giel-Jan|last2=Olff|first2=Miranda|date=2009-08-01|title=The lifetime prevalence of traumatic events and posttraumatic stress disorder in the Netherlands|url=http://onlinelibrary.wiley.com/doi/10.1002/jts.20429/abstract|journal=Journal of Traumatic Stress|language=en|volume=22|issue=4|pages=259–267|doi=10.1002/jts.20429|issn=1573-6598}}</ref> | 7.4% | Composite International Diagnostic Interview (CIDI) |- | United States, nationally representative, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Pietrzak|first=Robert H.|last2=Goldstein|first2=Risë B.|last3=Southwick|first3=Steven M.|last4=Grant|first4=Bridget F.|title=Prevalence and Axis I comorbidity of full and partial posttraumatic stress disorder in the United States: Results from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions|url=http://linkinghub.elsevier.com/retrieve/pii/S0887618510002288|journal=Journal of Anxiety Disorders|volume=25|issue=3|pages=456–465|doi=10.1016/j.janxdis.2010.11.010}}</ref> | 6.4% | Wave 2 National Epidemiologic Survey on Alcohol and Related Conditions |- | Northern Ireland, representative sample, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Bunting|first=Brendan P.|last2=Ferry|first2=Finola R.|last3=Murphy|first3=Samuel D.|last4=O'Neill|first4=Siobhan M.|last5=Bolton|first5=David|date=2013-02-01|title=Trauma Associated With Civil Conflict and Posttraumatic Stress Disorder: Evidence From the Northern Ireland Study of Health and Stress|url=http://onlinelibrary.wiley.com/doi/10.1002/jts.21766/abstract|journal=Journal of Traumatic Stress|language=en|volume=26|issue=1|pages=134–141|doi=10.1002/jts.21766|issn=1573-6598}}</ref> | 8.8% | Northern Ireland Study of Health and Stress |- | South Africa, nationally representative sample, age 18 and older | Non-clinical: Population based<ref>{{Cite journal|last=Atwoli|first=Lukoye|last2=Stein|first2=Dan J.|last3=Williams|first3=David R.|last4=Mclaughlin|first4=Katie A.|last5=Petukhova|first5=Maria|last6=Kessler|first6=Ronald C.|last7=Koenen|first7=Karestan C.|date=2013-07-03|title=Trauma and posttraumatic stress disorder in South Africa: analysis from the South African Stress and Health Study|url=https://doi.org/10.1186/1471-244X-13-182|journal=BMC Psychiatry|volume=13|pages=182|doi=10.1186/1471-244x-13-182|issn=1471-244X}}</ref> | 2.3% | South African Stress and Health Study, using the Composite International Diagnostic Interview (CIDI) |- | U.S. Army and Marine Soldiers Deployed to Iraq and Afghanistan | U.S. Service Members<ref>{{Cite journal|last=Hoge|first=Charles W.|last2=Castro|first2=Carl A.|last3=Messer|first3=Stephen C.|last4=McGurk|first4=Dennis|last5=Cotting|first5=Dave I.|last6=Koffman|first6=Robert L.|date=2004-07-01|title=Combat Duty in Iraq and Afghanistan, Mental Health Problems, and Barriers to Care|url=http://dx.doi.org/10.1056/NEJMoa040603|journal=New England Journal of Medicine|volume=351|issue=1|pages=13–22|doi=10.1056/nejmoa040603|issn=0028-4793|pmid=15229303}}</ref> |11.5% - 19.5% ♦ | PTSD Checklist |- |United States, nationally representative, ages 13-18 |Non-clinical: Population based<ref>{{Cite journal|last=Merikangas|first=Kathleen Ries|last2=He|first2=Jian-ping|last3=Burstein|first3=Marcy|last4=Swanson|first4=Sonja A.|last5=Avenevoli|first5=Shelli|last6=Cui|first6=Lihong|last7=Benjet|first7=Corina|last8=Georgiades|first8=Katholiki|last9=Swendsen|first9=Joel|title=Lifetime Prevalence of Mental Disorders in U.S. Adolescents: Results from the National Comorbidity Survey Replication–Adolescent Supplement (NCS-A)|url=https://doi.org/10.1016/j.jaac.2010.05.017|journal=Journal of the American Academy of Child & Adolescent Psychiatry|volume=49|issue=10|pages=980–989|doi=10.1016/j.jaac.2010.05.017}}</ref> |5.0% |National Comorbidity Survey Replication—Adolescent Supplement (NCS-A) |} ♦ '''Note''': These rates were using broad PTSD Checklist scoring criteria of being scored positive if subjects reported at least one intrusion symptom, three avoidance symptoms, and two hyperarousal symptom that were categorized as at the moderate level. The 11.5% is for soldiers returning from deployment in Iraq, 19.5% is for soldiers returning from Afghanistan. Another common practice is to use a strict cutoff of 50 on the PCL, above which someone screens positive for PTSD. With this cutoff, rates are 6.2% and 12.9% for Service Members returned from Afghanistan and Iraqi, respectively. ==[[Evidence based assessment/Prediction phase|'''Prediction phase''']]== === Psychometric properties of screening for PTSD === The following section contains a list of screening and diagnostic instruments for PTSD. The section includes administration information, psychometric data, and PDFs or links to the screenings. * Screenings are used as part of the [[Evidence based assessment/Prediction phase|prediction phase]] of assessment; for more information on interpretation of this data, or how screenings fit in to the assessment process, click [[Evidence based assessment/Prediction phase|here.]] * '''''For a list of more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Psychometric_properties_of_common_screening_instruments click here.]''''' {| class="wikitable" ! colspan="5" |Screening measures for '''PTSD''' |- ! Measure !Format (Reporter) !Age Range !Administration/ Completion Time !Where to Access |- |[https://www.ptsd.va.gov/professional/assessment/adult-sr/ptsd-checklist.asp PCL-5 (PTSD Checklist for DSM-5)] |Self-Report |adult |5-10 minutes | * [https://www.ptsd.va.gov/professional/assessment/documents/PCL5_Standard_form.PDFPDF PDF] * [https://unc.az1.qualtrics.com/jfe/form/SV_9nmXgrLPpvhPhgF Online version (Spanish)] |- |PDS-5 (Post-traumatic Diagnosis Scale) |Self-Report |adult |10-20 minutes |[https://www.ptsd.va.gov/professional/assessment/adult-sr/pds.asp How to request] |- | colspan="4" style="font-size:110%; text-align:center;" |'''For Children and Adolescents Specifically''' | |- |[https://www.reactionindex.com/index.php/ UCLA PTSD Reaction Index for DSM-5] |Clinician Administered |child, school age, adolescents |20-30 minutes |[https://www.dellchildrens.net/wp-content/uploads/sites/60/2019/08/UCLA-PTSD-RI-DSM-5.pdf PDF] |- |CPSS (Children's PTSD Symptom Scale) |Self-Report |child |10-20 minutes | * [https://www.aacap.org/App_Themes/AACAP/docs/resource_centers/resources/misc/child_ptsd_symptom_scale.pdf PDF] * [https://unc.az1.qualtrics.com/jfe/form/SV_6XPDvzlfkg2SQRf Online version] |- |Young Child PTSD Checklist (YCPC) |Parent Report |child |13 items |[https://medicine.tulane.edu/sites/g/files/rdw761/f/YCPC_v5_23_14.pdf PDF] |} '''Note:''' Reliability and validity are included in the [[Evidence-based assessment/Posttraumatic stress disorder (disorder portfolio)/extended version|extended version]]. This table includes measures with Good or Excellent ratings. === Interpreting PTSD screening measure scores === * For information on interpreting screening measure scores, click [[Evidence based assessment/Prediction phase#Interpreting screening measure scores|here.]] * Also see the page on [https://en.wikipedia.org/wiki/Likelihood_ratios_in_diagnostic_testing likelihood ratios in diagnostic testing] for more information ==[[Evidence based assessment/Prescription phase|'''Prescription phase''']]== ===Gold standard diagnostic interviews=== * For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews click here.] ===Recommended diagnostic interviews for PTSD=== {| class="wikitable sortable" border="1" ! colspan="4" |Diagnostic instruments for PTSD ! |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time !Where to Access |- | [https://www.ptsd.va.gov/professional/assessment/adult-int/caps.asp CAPS-5 (Clinician Administered PTSD Scale)] | Clinician Administered Interview | adult | 40-60 minutes |[https://www.ptsd.va.gov/professional/assessment/ncptsd-instrument-request-form.asp Assessment request form] |- |PTSD Symptom Scale Interview (PSS-I-5) |Clinician Administered Interview |adult and child version available |24 items |[http://www.advanced-counseling.com/dl/PSSI-5.pdf PDF] |- | colspan="4" style="font-size:110%; text-align:center;" |'''For Children and Adolescents Specifically''' | |- | [https://www.ptsd.va.gov/professional/assessment/child/caps-ca.asp CAPS-CA-5 (Clinician-Administered PTSD Scale for DSM-5 - Child/Adolescent Version)] |Clinician Administered Interview |child |30 items |[https://www.ptsd.va.gov/professional/assessment/ncptsd-instrument-request-form.asp Assessment request form] |- | Children’s PTSD Inventory (CPTSD-I) |Diagnostic Interview | 6-18 years | 50 items |Not Free |} '''Note:''' Reliability and validity are included in the [[Evidence-based assessment/Posttraumatic stress disorder (disorder portfolio)/extended version|extended version]]. This table includes measures with Good or Excellent ratings. ===Severity interviews for PTSD=== {| class="wikitable sortable" border="1" |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time !Where to Access |- | Schedule for Affective Disorders and Schizophrenia for School Age Children (K-SADS) | Diagnostic Interview | 6-18 years | 18 PTSD items |[https://www.pediatricbipolar.pitt.edu/sites/default/files/KSADS_DSM_5_SCREEN_Final.pdf PDF] |- | Anxiety Disorders Interview Schedule, Child Version (ADIS-C) | Diagnostic Interview | 7-17 years | 26 PTSD items |Not free |- | Diagnostic Infant and Preschool Assessment (DIPA) |Diagnostic Interview | Age 6 and younger | 46 PTSD items |[https://medicine.tulane.edu/sites/g/files/rdw761/f/DIPA-2017-2-14.pdf PDF] |} '''Note:''' Reliability and validity are included in the [[Evidence-based assessment/Posttraumatic stress disorder (disorder portfolio)/extended version|extended version]]. This table includes measures with Good or Excellent ratings. ==[[Evidence based assessment/Process phase|'''Process phase''']]== The following section contains a brief overview of treatment options for PTSD and list of process and outcome measures for PTSD. The section includes benchmarks based on published norms for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the [[Evidence based assessment/Process phase|process phase]] of assessment. For more information of differences between process and outcome measures, see the page on the [[Evidence based assessment/Process phase|process phase of assessment]]. === Process measures === * Information coming soon === Outcome and severity measures === This table includes clinically significant benchmarks for PTSD specific outcome measures * Information on how to interpret this table can be [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase found here]. * Additionally, these [[Evidence based assessment/Vignettes|vignettes]] might be helpful resources for understanding appropriate adaptation of outcome measures in practice. * ''<u>For clinically significant change benchmarks for the CBCL, YSR, and TRF total, externalizing, internalizing, and attention benchmarks,</u>'' [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase&wteswitched=1#Clinically_significant_change_benchmarks_for_widely-used_outcome_measures see here.] {| class="wikitable sortable" border="1" | colspan="7" |'''Clinically significant change benchmarks with common instruments for PTSD''' |- | colspan="7" style="font-size:110%; text-align:center;" span |<b> Benchmarks Based on Published Norms</b> |- | rowspan="2" style="text-align:center;font-size:130%;" |<b> Measure</b> | colspan="3" style="text-align:center;font-size:130%" width="300" |<b> Cut-off scores</b> | colspan="3" style="text-align:center;font-size:120%" |<b> Critical Change <br> (unstandardized scores)</b> |- | style="text-align:center;font-size:110%" |<b> A</b> | style="text-align:center;font-size:110%" |<b> B</b> | style="text-align:center;font-size:110%" |<b> C</b> | style="text-align:center;font-size:110%" |<b> 95%</b> | style="text-align:center;font-size:110%" |<b> 90%</b> | style="text-align:center;font-size:110%" |<b> SE_difference</b> |- | rowspan="1" style="text-align:center;" | Primary Care PTSD Screen | style="text-align:center;" | 1.0 | style="text-align:center;" | 3.1 | style="text-align:center;" | 2.0 | style="text-align:center;" | 1.0 | style="text-align:center;" | .8 | style="text-align:center;" | .5 |- | rowspan="1" style="text-align:center;" | PTSD Checklist Scores | style="text-align:center;" | 28.8 | style="text-align:center;" | 40.8 | style="text-align:center;" | 34.9 | style="text-align:center;" | 4.6 | style="text-align:center;" | 3.8 | style="text-align:center;" | 2.3 |- | rowspan="1" style="text-align:center;" | Clinician Administered PTSD Scale | style="text-align:center;" | 28.8 | style="text-align:center;" | 40.8 | style="text-align:center;" | 34.9 | style="text-align:center;" | 8.3 | style="text-align:center;" | 7.0 | style="text-align:center;" | 4.2 |} === Treatment === * Please refer to the Wikipedia page on [[wikipedia:Posttraumatic_stress_disorder|PTSD]] for more information on available treatment for PTSD or go to the [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/post-traumatic-stress-disorder/ Effective Child Therapy] page for for a curated resource on effective treatments for PTSD. {{collapse top| More information on treatment|expand=yes}} '''<big>Behavioral interventions</big>''' Recommended (have ''significant benefit'') <ref name=":0">Department of Veterans Affairs and Department of Defense. . (2010). VA/DoD clinical practice guidelines: management of post-traumatic stress. Washington, D.C.: Veterans Health Administration, Department of Defense.</ref>: # Brief Cognitive Behavioral Therapy (CBT; 4-5 sessions) #* This includes stress inoculation training, trauma-focused therapy including components of cognitive restructuring, Cognitive Processing Therapy (CPT), imaginal, virtual, and in-vivo exposure as in Prolonged Exposure psychotherapy (PE)² #* Patient education is recommended as part of psychotherapy for patients and family members # EMDR may help both acute and chronic PTSD, especially individuals who have trouble with prolonged exposure or have trouble verbalizing their trauma.<ref name=":1">Ursano, R. J., Bell, C., Eth, S., Friedman, M., Norwood, A., Pfefferbaum, B., . . . McIntyre, J. S. (2004). ''Practice guideline for the treatment of patients with acute stress disorder and posttraumatic stress disorder'': American Psychiatric Publ </ref> ## Long term gains require further study. # [https://www.ptsd.va.gov/professional/treat/txessentials/present_centered_therapy.asp Present-Centered Therapy (PCT)] is a non trauma focused treatment for PTSD and a second-line treatment for PTSD<ref>{{Cite web|url=https://www.ptsd.va.gov/professional/treat/txessentials/present_centered_therapy.asp|title=Present-Centered Therapy for PTSD - PTSD: National Center for PTSD|website=www.ptsd.va.gov|language=en|access-date=2022-08-13}}</ref>. Treatments with weaker evidence (have ''some benefit'') <ref name=":0" />: # Patient education, # Imagery rehearsal therapy, # Psychodynamic therapy, # Hypnosis, # Relaxation techniques, # and Group therapy. Treatment with ''unknown benefit'' <ref name=":0" />: # Web-based CBT ## For example Jeane Bosch participated as a study therapist in research study that compared STAIR and present-centered therapy both delivered via telehealth. STAIR stands for Skills Training in Affective and Interpersonal Regulation. It is a skill-focused treatment that was originally developed for survivors of childhood abuse to teach emotion regulation skills as well as tools to help with challenges interpersonal functioning and social relationships and decrease PTSD symptoms<ref>{{Cite web|url=https://istss.org/public-resources/trauma-blog/2015-march-(1)/clinician-s-corner-skills-training-in-affective-an|title=ISTSS - Trauma Blog|website=istss.org|access-date=2022-08-13}}</ref>.<ref>{{Citation|title=Introduction to Telehealth with Dr. Bosch|url=https://www.youtube.com/watch?v=Wn6Vewl42X8|accessdate=2022-08-13|language=en}}</ref> # Acceptance and commitment therapy, # and Dialectical Behavioral Therapy. <big>'''Medication'''</big> *SSRIs are more effective than placebo in treating PTSD.<ref name=":1" /> *There is no evidence to support a medication to prevent the development of PTSD.<ref name=":0" /> **Imipramine, propranolol, prazosin, other antidepressants, anticonvulsants, and atypical antipsychotics have ''unknown benefit.'' **Strongly recommend against the use of benzodiazepines² and typical antipsychotics since they have ''no benefit and potential harm.'' {{collapse bottom}} == '''External resources''' == === For professionals === * [http://www.som.uq.edu.au/ptsd Post Traumatic Stress Disorder Information Resource] from [http://www.uq.edu.au/ The University of Queensland School of Medicine] * [http://www.apa.org/ptsd-guideline/ APA practice parameters for assessment and treatment for PTSD (Updated 2017)] * [http://www.ptsd.va.gov/professional/index.asp Resources for professionals] from [http://www.ptsd.va.gov/index.asp VA National PTSD Center] * [https://www.integration.samhsa.gov/clinical-practice/trauma-informed SAMHSA's Trauma-Informed Care Resources and Training] * [https://www.integration.samhsa.gov/clinical-practice/trauma-informed SAMHSA's Resources on Intimate Partner Violence (IPV) for Clinicians, Patients, Families, and Organizations] === For caregivers === * [http://www.nctsn.org/sites/default/files/assets/pdfs/tips_for_parents_media_final.pdf Tips for parents on shooting media coverage] * [http://www.nctsn.org/sites/default/files/assets/pdfs/parents_guidelines_for_helping_teens_after_the_recent_attacks.pdf Parent guidelines to helping youths after a shooting] * [http://www.nctsn.org/sites/default/files/assets/pdfs/helping_teens_with_traumatic_grief_caregivers_final.pdf Caregiver tips for helping teens with traumatic grief] * [http://www.nctsn.org/sites/default/files/assets/pdfs/10things_schoolage_ctg.pdf Caregiver tips for helping school-age children with traumatic grief] *[http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/post-traumatic-stress-disorder/ EffectiveChildTherapy.Org information on PTSD] *[https://sccap53.org Society of Clinical Child and Adolescent Psychology] === For educators === * [http://www.nctsn.org/sites/default/files/assets/pdfs/pfa_for_schools_appendix_a_teachers.pdf Teacher tips for providing psychological first aid] * [http://www.nctsn.org/sites/default/files/assets/pdfs/helping_youth_after_community_violence_educators.pdf Educator tips for helping youths after a community trauma] === For public === * [https://complicatedgrief.columbia.edu/for-the-public/resources/ Resources for grief and loss] * [http://www.nctsn.org/sites/default/files/assets/pdfs/psychological_information_sheet_two_pager.pdf Psychological impacts of recent shootings] * [http://www.nctsn.org/sites/default/files/assets/pdfs/youth_journalists.pdf Tips to talking to youths about a shooting] * [http://www.nctsn.org/sites/default/files/assets/pdfs/talking_to_children_about_the_shooting.pdf Tips to talking to children about a shooting] * [http://www.nctsn.org/sites/default/files/assets/pdfs/helping_young_children_heal_crisis.pdf Helping young children heal after a crisis] * [http://www.nctsn.org/content/psychological-first-aid-schoolspfa Psychological first aid for schools] * [http://www.nctsn.org/content/psychological-first-aid Resources and manuals on psychological first aid] * [http://www.ptsd.va.gov/public/index.asp Resources for the public] from [http://www.ptsd.va.gov/index.asp VA National PTSD Center] * [https://curlie.org/Health/Mental_Health/Disorders/Anxiety/Post-traumatic_Stress Posttraumatic stress disorder] at Curlie (based on DMOZ) =='''References'''== {{collapse top|References|expand=yes}} {{Reflist|30em}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] {{collapse bottom}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] 5d1sjxfy5bb5yvhv4azggbsj5mwahck 0 207109 2419230 2410646 2022-08-26T03:10:39Z Ardenguo 2944162 /* Likelihood ratios and AUCs of screening measures for social anxiety disorder */ Made the collapsible box expanded by default wikitext text/x-wiki .<noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{medical disclaimer}} {{:{{BASEPAGENAME}}/Sidebar}} ==[[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio"?''']]== * For background information on what assessment portfolios are, click the link in the heading above. * Want even 'more' information about this topic? There's an extended version of this page [[Evidence-based assessment/Social anxiety disorder (disorder portfolio)/extended version|here]]. == [[Evidence based assessment/Preparation phase|'''Preparation phase''']] == === Diagnostic criteria for phobic anxiety disorders === {{blockquotetop}} <big>'''ICD-11 Diagnostic Criteria for Social Anxiety Disorder'''</big> *Social anxiety disorder is characterized by marked and excessive fear or anxiety that consistently occurs in one or more social situations such as social interactions (e.g., having a conversation), being observed (e.g., eating or drinking), or performing in front of others (e.g., giving a speech). The individual is concerned that he or she will act in a way, or show anxiety symptoms, that will be negatively evaluated by others. The social situations are consistently avoided or else endured with intense fear or anxiety. The symptoms persist for at least several months and are sufficiently severe to result in significant distress or significant impairment in personal, family, social, educational, occupational, or other important areas of functioning. <big>'''Changes in DSM-5'''</big> * The diagnostic criteria for simple phobia changed slightly from [[DSM-IV]] to [[w:Diagnostic_and_Statistical_Manual_of_Mental_Disorders#DSM-IV-TR_.282000.29|DSM-5]]. Summaries are available [http://www.dsm5.org/Documents/changes%20from%20dsm-iv-tr%20to%20dsm-5.pdf here] and [[w:DSM-5|here]]. {{blockquotebottom}} ===Base rates of social phobia in different clinical settings=== This section describes the demographic setting of the population(s) sampled, base rates of diagnosis, country/region sampled and the diagnostic method that was used. Using this information, clinicians will be able to anchor the rate of social anxiety disorder they are likely to see in their clinical practice. * '''''To see prevalence rates across multiple disorders,''''' [[Evidence based assessment/Preparation phase#Base rates for transdiagnostic comparison|'''''click here.''''']] {|class="wikitable sortable" border="1" |- ! Demography ! Setting ! Base Rate ! Diagnostic Method |- | Rhode Island<ref>{{Cite journal|last=Zimmerman|first=Mark|last2=Morgan|first2=Theresa A.|last3=Young|first3=Diane|last4=Chelminski|first4=Iwona|last5=Dalrymple|first5=Kristy|last6=Walsh|first6=Emily|date=December 2015|title=Does Borderline Personality Disorder Manifest Itself Differently in Patients With Bipolar Disorder and Major Depressive Disorder?|url=http://www.ncbi.nlm.nih.gov/pubmed/25248008|journal=Journal of Personality Disorders|volume=29|issue=6|pages=847–853|doi=10.1521/pedi_2014_28_169|issn=1943-2763|pmid=25248008}}</ref> | The Rhode Island Methods to Improve Diagnostic Assessment and Services (MIDAS) project. Psychiatric outpatient practice sample (n=859) | 27.8% | SIDP-IV |- | Oakland, California<ref>{{cite journal|last1=Olfson|first1=M|last2=Kroenke|first2=K|last3=Wang|first3=S|last4=Blanco|first4=C|date=March 2014|title=Trends in office-based mental health care provided by psychiatrists and primary care physicians.|journal=The Journal of clinical psychiatry|volume=75|issue=3|pages=247-53|pmid=24717378}}</ref> | Representative probability within primary care group sample ages 18-70 (n=1001) | 3% | SCID |- | All of U.S.A.<ref>{{cite journal|last1=Ruscio|first1=AM|last2=Brown|first2=TA|last3=Chiu|first3=WT|last4=Sareen|first4=J|last5=Stein|first5=MB|last6=Kessler|first6=RC|date=January 2008|title=Social fears and social phobia in the USA: results from the National Comorbidity Survey Replication.|journal=Psychological medicine|volume=38|issue=1|pages=15-28|pmid=17976249}}</ref> |National Comorbidity Survey Replication (NCS-R). Nationally representative household survey, community sample of adults ages 18+ (n=9282) | 12.1% (lifetime) 7.1% (12-month) | WHO-CIDI Clinical Interview |- | All of U.S.A.<ref>{{cite journal|last1=Kessler|first1=RC|last2=Avenevoli|first2=S|last3=McLaughlin|first3=KA|last4=Green|first4=JG|last5=Lakoma|first5=MD|last6=Petukhova|first6=M|last7=Pine|first7=DS|last8=Sampson|first8=NA|last9=Zaslavsky|first9=AM|date=September 2012|title=Lifetime co-morbidity of DSM-IV disorders in the US National Comorbidity Survey Replication Adolescent Supplement (NCS-A).|journal=Psychological medicine|volume=42|issue=9|pages=1997-2010|pmid=22273480|last10=Merikangas|first10=KR}}</ref> | NCS Adolescent Supplement (NCS-A) for ages 13 to 17. Community sample, (n=6243). | Females 11.2% Males 6.2% Total 8.6% | WHO-CIDI Clinical Interview, modified to simplify language and use examples relevant to adolescents. |- | Western North Carolina.<ref>{{cite journal|last1=Mustillo|first1=S|last2=Worthman|first2=C|last3=Erkanli|first3=A|last4=Keeler|first4=G|last5=Angold|first5=A|last6=Costello|first6=EJ|date=April 2003|title=Obesity and psychiatric disorder: developmental trajectories.|journal=Pediatrics|volume=111|issue=4 Pt 1|pages=851-9|pmid=12671123}}</ref> | The Great Smoky Mountains Study (GSMS). Longitudinal, community sample of children ages 9 to 16 (n=6674) | Females 0.8% Males 0.3% Total 0.5% | CAPA |- | Houston, Texas metropolitan area. | Teen Health 2000 (TH2K). Community sample in large, metropolitan area, ages 11 to 17 (n=4,175) | 1.6% | DISC-IV |- | Puerto Rico<ref>{{cite journal|last1=Ortega|first1=AN|last2=Goodwin|first2=RD|last3=McQuaid|first3=EL|last4=Canino|first4=G|date=NaN|title=Parental mental health, childhood psychiatric disorders, and asthma attacks in island Puerto Rican youth.|journal=Ambulatory pediatrics : the official journal of the Ambulatory Pediatric Association|volume=4|issue=4|pages=308-15|pmid=15264963}}</ref> | Representative household probability community sample, ages 4 to 17 (n=1886). | 2.8% | DISC-IV |- | Children referred to Anxiety Disorders clinic.<ref>{{cite journal|last1=Verduin|first1=TL|last2=Kendall|first2=PC|date=June 2003|title=Differential occurrence of comorbidity within childhood anxiety disorders.|journal=Journal of clinical child and adolescent psychology : the official journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 53|volume=32|issue=2|pages=290-5|pmid=12679288}}</ref> | Child and Adolescent Anxiety Disorders outpatient research clinic, ages 8 to 13 with anxiety disorder diagnosis (n=199) | 20% | ADIS-C/P |- | All of U.S.A. – clinical settings<ref>{{cite journal|last1=Rettew|first1=DC|last2=Lynch|first2=AD|last3=Achenbach|first3=TM|last4=Dumenci|first4=L|last5=Ivanova|first5=MY|date=September 2009|title=Meta-analyses of agreement between diagnoses made from clinical evaluations and standardized diagnostic interviews.|journal=International journal of methods in psychiatric research|volume=18|issue=3|pages=169-84|pmid=19701924}}</ref> | Meta-analysis of data collected across multiple clinical settings, 1995-2006 (n=15,967) | 20% (SDI) 6% (unstructured interview) |Structured or Semi-Structure Diagnostic Interviews and unstructured clinical interviews. |- |Metanalysis of outpatient clinics<ref name=":12">{{Cite journal|last=Rettew|first=David C.|last2=Lynch|first2=Alicia Doyle|last3=Achenbach|first3=Thomas M.|last4=Dumenci|first4=Levent|last5=Ivanova|first5=Masha Y.|date=2009-09|title=Meta-analyses of agreement between diagnoses made from clinical evaluations and standardized diagnostic interviews|url=http://dx.doi.org/10.1002/mpr.289|journal=International Journal of Methods in Psychiatric Research|language=en|volume=18|issue=3|pages=169–184|doi=10.1002/mpr.289|issn=1049-8931}}</ref> |Outpatient clinic |6% (DAU | |- |Metanalysis of outpatient clinics)<ref name=":13">{{Cite journal|last=Rettew|first=David C.|last2=Lynch|first2=Alicia Doyle|last3=Achenbach|first3=Thomas M.|last4=Dumenci|first4=Levent|last5=Ivanova|first5=Masha Y.|date=2009-09|title=Meta-analyses of agreement between diagnoses made from clinical evaluations and standardized diagnostic interviews|url=http://dx.doi.org/10.1002/mpr.289|journal=International Journal of Methods in Psychiatric Research|language=en|volume=18|issue=3|pages=169–184|doi=10.1002/mpr.289|issn=1049-8931}}</ref> |Outpatient clinic |20% (SDI) | |- |Intended to apply to the entire United States <ref name=":3">Kessler, R. C., Avenevoli, S., Costello, E. J., Georgiades, K., Green, J. G., Gruber, M. J., . . . Merikangas, K. R. (2012). Prevalence, persistence, and sociodemographic correlates of DSM-IV disorders in the National Comorbidity Survey Replication Adolescent Supplement. Archives of General Psychiatry, 69(4), 372-380. doi:10.1001/archgenpsychiatry.2011.160</ref> |General Population |9% | |} '''Note:''' WHO-CIDI = World Health Organization Composite International Diagnostic Interview; NCS-A (lifetime prevalence); CAPA= Children and Adolescent Psychiatric Assessment (3-month prevalence); DISC-IV = Diagnostic Interview Schedule for Children, Version 4 (12-month prevalence); ADIS-C/P=Anxiety Disorders Interview Schedule for Children/Parents; SIDP-IV = Structured Interview for DSM-IV Personality; SCID=Structured Clinical Interview for DSM-IV; SDIs included in Rettew et al. (2009): CIDI, DAWBA, DICA, DISC, DIS, MINI, K-SADS-PL, SCAN-2, SCID, SCID-II. * Higher rates of social anxiety disorder are found in females than in males, with more pronounced differences in adolescence. Prevalence rates in children and adolescents are comparable to those in adults. Onset is typically in early adolescence (DSM-5, 2013). ==[[Evidence based assessment/Prediction phase|'''Prediction phase''']]== === Psychometric properties of screening instruments for social anxiety disorder === The following section contains a list of screening and diagnostic instruments for social anxiety disorder. The section includes administration information, psychometric data, and PDFs or links to the screenings. * Screenings are used as part of the [[Evidence based assessment/Prediction phase|prediction phase]] of assessment; for more information on interpretation of this data, or how screenings fit in to the assessment process, click [[Evidence based assessment/Prediction phase|here.]] * ''For a list of more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Psychometric_properties_of_common_screening_instruments '''click here.''']'' {| class="wikitable" |- ! Measure !Format (Reporter) !Age Range !Administration/ Completion Time !Where to Access |- |[https://osf.io/2y3cq Liebowitz Social Anxiety Scale (LSAS)]<ref>{{Cite journal|last=Heimberg|first=R. G.|last2=Horner|first2=K. J.|last3=Juster|first3=H. R.|last4=Safren|first4=S. A.|last5=Brown|first5=E. J.|last6=Schneier|first6=F. R.|last7=Liebowitz|first7=M. R.|date=1999-1|title=Psychometric properties of the Liebowitz Social Anxiety Scale|url=https://www.ncbi.nlm.nih.gov/pubmed/10077308|journal=Psychological Medicine|volume=29|issue=1|pages=199–212|issn=0033-2917|pmid=10077308}}</ref> |Questionnaire (clinician administered, self-report) |7 years-adult |15 minutes | *[http://nationalsocialanxietycenter.com/liebowitz-sa-scale/ Online questionnaire with scoring] *[https://osf.io/2y3cq Printable PDF] |- |[https://osf.io/svn9x Social Phobia Inventory (SPIN)]<ref>{{Cite journal|last=Connor|first=Kathryn M.|last2=Davidson|first2=Jonathan R. T.|last3=Churchill|first3=L. Erik|last4=Sherwood|first4=Andrew|last5=Weisler|first5=Richard H.|last6=Foa|first6=Edna|date=2000/04|title=Psychometric properties of the Social Phobia Inventory (SPIN): New self-rating scale|url=https://www.cambridge.org/core/journals/the-british-journal-of-psychiatry/article/psychometric-properties-of-the-social-phobia-inventory-spin/9E4A3EE20D2B1A6C222CDB5807AC086A|journal=The British Journal of Psychiatry|language=en|volume=176|issue=4|pages=379–386|doi=10.1192/bjp.176.4.379|issn=0007-1250}}</ref> |Questionnaire (self-report) |12 years-adult |5-10 minutes | * [https://joyable.com/spin_snapshots/new Online questionnaire with scoring] * [https://psychology-tools.com/spin/ Online questionnaire with scoring] * [https://osf.io/svn9x Printable PDF] |- |Social Phobia and Anxiety Inventory (SPAI)<ref>{{Cite journal|last=Garcia-Lopez|first=Luis Joaquin|last2=Hidalgo|first2=Maria D.|last3=Beidel|first3=Deborah C.|last4=Olivares|first4=Jose|last5=Turner†|first5=Samuel|date=2008-01-01|title=Brief Form of the Social Phobia and Anxiety Inventory (SPAI-B) for Adolescents|url=http://dx.doi.org/10.1027/1015-5759.14.3.150|journal=European Journal of Psychological Assessment|volume=24|issue=3|pages=150–156|doi=10.1027/1015-5759.14.3.150|issn=1015-5759}}</ref> *not free |Questionnaire (self-report) |14 years-adult |20-30 minutes |Purchase [https://shop.acer.org/social-phobia-and-anxiety-inventory-spai.html here] |- | colspan="5" style="font-size:110%; text-align:center;" |'''For Children and Adolescents Specifically''' |- |- |[https://osf.io/s3fu2 Revised Children’s Anxiety and Depression Scale (RCADS)] |Questionnaire (Child) |6-18 years |12 minutes | *[http://www.corc.uk.net/outcome-experience-measures/revised-childrens-anxiety-and-depression-scale-and-subscales/ RCADS homepage] '''PDFs for RCADS''' * [https://osf.io/s3fu2 RCADS Child Self-reported (6-18 years)] * [https://mfr.osf.io/render?url=https://osf.io/fp9mk/?action=download%26mode=render RCADS Parent-reported] *[https://mfr.osf.io/render?url=https://osf.io/vy7ta/?action=download%26mode=render Child Scoring Aid] *[https://mfr.osf.io/render?url=https://osf.io/t4bz6/?action=download%26mode=render Parent Scoring Aid] '''Subscales''' *[https://mfr.osf.io/render?url=https://osf.io/ectpf/?action=download%26mode=render Social Anxiety Self-reported] *[https://mfr.osf.io/render?url=https://osf.io/pu6rn/?action=download%26mode=render Social Anxiety Parent-reported] '''Translations''' * [https://mfr.osf.io/render?url=https://osf.io/qsjh9/?action=download%26mode=render User Guide] |- |Social Phobia and Anxiety Inventory for Children (SPAIC) *not free |Questionnaire |8-14 years |20-30 minutes |Purchase [https://eprovide.mapi-trust.org/instruments/social-phobia-and-anxiety-inventory-for-children#coas_member_access_content here] |} '''Note:''' Reliability and validity are included in the extended version [[Evidence-based assessment/Social anxiety disorder (disorder portfolio)/extended version|here]]. This table includes measures with Good or Excellent ratings. === Likelihood ratios and AUCs of screening measures for social anxiety disorder === * ''For a list of the likelihood ratios for more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Likelihood_ratios_and_AUCs_of_common_screening_instruments '''click here.''']'' {| class="wikitable sortable" border="1" |- ! Screening Measure (Primary Reference) ! AUC (Sample Size) ! DiLR+ (Score) ! DiLR- (Score) !Clinical Generalizability !Where to Access |- |Liebowitz Social Anxiety Scale (LSAS) <ref>{{cite journal|last1=Liebowitz|first1=MR|title=Social phobia.|journal=Modern problems of pharmacopsychiatry|date=1987|volume=22|pages=141-73|pmid=2885745}}</ref> <ref>{{cite journal|last1=Mennin|first1=DS|last2=Fresco|first2=DM|last3=Heimberg|first3=RG|last4=Schneier|first4=FR|last5=Davies|first5=SO|last6=Liebowitz|first6=MR|date=2002|title=Screening for social anxiety disorder in the clinical setting: using the Liebowitz Social Anxiety Scale.|journal=Journal of anxiety disorders|volume=16|issue=6|pages=661-73|pmid=12405524}}</ref> and <ref>{{cite journal|last1=Santos|first1=LF|last2=Loureiro|first2=SR|last3=Crippa|first3=JA|last4=Osório|first4=FL|date=2015|title=Can the Liebowitz Social Anxiety Scale - self-report version be used to differentiate clinical and non-clinical SAD groups among Brazilians?|journal=PloS one|volume=10|issue=3|pages=e0121437|pmid=25811489}}</ref> | 0.94 - differentiating from subclinical patients 0.98 - differentiating from healthy controls | Not reported | Not reported | |[https://osf.io/2y3cq Printable PDF] |- |Overall Anxiety Severity And Impairment Scale (OASIS)<ref>{{Cite journal|last=Campbell-Sills|first=Laura|last2=Norman|first2=Sonya B.|last3=Craske|first3=Michelle G.|last4=Sullivan|first4=Greer|last5=Lang|first5=Ariel J.|last6=Chavira|first6=Denise A.|last7=Bystritsky|first7=Alexander|last8=Sherbourne|first8=Cathy|last9=Roy-Byrne|first9=Peter|date=2009-1|title=Validation of a Brief Measure of Anxiety-Related Severity and Impairment: The Overall Anxiety Severity and Impairment Scale (OASIS)|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2629402/|journal=Journal of affective disorders|volume=112|issue=1-3|pages=92–101|doi=10.1016/j.jad.2008.03.014|issn=0165-0327|pmc=PMC2629402|pmid=18486238}}</ref> |.87<ref name=":0">{{Cite journal|last=Campbell-Sills|first=Laura|last2=Norman|first2=Sonya B.|last3=Craske|first3=Michelle G.|last4=Sullivan|first4=Greer|last5=Lang|first5=Ariel J.|last6=Chavira|first6=Denise A.|last7=Bystritsky|first7=Alexander|last8=Sherbourne|first8=Cathy|last9=Roy-Byrne|first9=Peter|date=2009-1|title=Validation of a Brief Measure of Anxiety-Related Severity and Impairment: The Overall Anxiety Severity and Impairment Scale (OASIS)|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2629402/|journal=Journal of affective disorders|volume=112|issue=1-3|pages=92–101|doi=10.1016/j.jad.2008.03.014|issn=0165-0327|pmc=PMC2629402|pmid=18486238}}</ref> |3.07 (> or = cut score 8) {| class="wikitable sortable" border="1" |Cut-score of ≥ 8 to be optimal given that it successfully classified 87% of the sample with the most favorable balance of sensitivity (89%) and specificity (71%) |} <ref name=":0" /> |Not reported |Unknown<ref name=":0" /> |[https://osf.io/bkvj2 Printable PDF] |- |Social Phobia and Anxiety Inventory for Children (SPAI-C) <br> (Beidel, Turner, & Morris, 1995) <ref>{{cite journal|last1=Inderbitzen-Nolan|first1=H|last2=Davies|first2=CA|last3=McKeon|first3=ND|date=2004|title=Investigating the construct validity of the SPAI-C: comparing the sensitivity and specificity of the SPAI-C and the SAS-A.|journal=Journal of anxiety disorders|volume=18|issue=4|pages=547-60|pmid=15149713}}</ref> and <ref>{{cite journal|last1=Viana|first1=AG|last2=Rabian|first2=B|last3=Beidel|first3=DC|date=June 2008|title=Self-report measures in the study of comorbidity in children and adolescents with social phobia: research and clinical utility.|journal=Journal of anxiety disorders|volume=22|issue=5|pages=781-92|pmid=17888622}}</ref> |.65 (n=172) |3.55 (18+) |.47 | |Purchase [https://shop.acer.org/spai-quickscore-form-pkg-25.html here] |- |Screen for Child Anxiety and Related Emotional Disorders (SCARED)<br><ref>{{cite journal|last1=Birmaher|first1=B|last2=Khetarpal|first2=S|last3=Brent|first3=D|last4=Cully|first4=M|last5=Balach|first5=L|last6=Kaufman|first6=J|last7=Neer|first7=SM|title=The Screen for Child Anxiety Related Emotional Disorders (SCARED): scale construction and psychometric characteristics.|journal=Journal of the American Academy of Child and Adolescent Psychiatry|date=April 1997|volume=36|issue=4|pages=545-53|pmid=9100430}}</ref><ref>{{cite journal|last1=Desousa|first1=DA|last2=Salum|first2=GA|last3=Isolan|first3=LR|last4=Manfro|first4=GG|date=June 2013|title=Sensitivity and specificity of the Screen for Child Anxiety Related Emotional Disorders (SCARED): a community-based study.|journal=Child psychiatry and human development|volume=44|issue=3|pages=391-9|pmid=22961135}}</ref> |.72 (n=119) |1.9 (27+) |.50 | |Printable [https://osf.io/z4da3 PDF] |- |} {{collapse top| Notes about the above table|expand=yes}} * '''Note:''' All studies used some version of ADIS-C, K-SADS or CAS administered by trained raters. “LR+” refers to the change in likelihood ratio associated with a positive test score, and “LR-” is the likelihood ratio for a low score. Likelihood ratios of 1 indicate that the test result did not change impressions at all. LRs larger than 10 or smaller than .10 are frequently clinically decisive; 5 or .20 are helpful, and between 2.0 and .5 are small enough that they rarely result in clinically meaningful changes of formulation (Sackett et al., 2000). AUC guidelines according to Swets and Pickett (1982)<ref>{{cite journal|last1=Song|first1=HH|title=Analysis of correlated ROC areas in diagnostic testing.|journal=Biometrics|date=March 1997|volume=53|issue=1|pages=370-82|pmid=9147602}}</ref>: .50 to .70 (low accuracy), .70 to .90 (moderate accuracy), and greater than .90 (high accuracy). * '''Note:''' Silverman & Ollendick (2005)<ref>{{cite journal|last1=Silverman|first1=WK|last2=Ollendick|first2=TH|title=Evidence-based assessment of anxiety and its disorders in children and adolescents.|journal=Journal of clinical child and adolescent psychology : the official journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 53|date=September 2005|volume=34|issue=3|pages=380-411|pmid=16026211}}</ref> suggest that the SPAI-C is the better instrument for identifying those children and adolescents who most likely meet DSM-IV criteria for social phobia, but that this measure may miss some adolescents who would meet criteria for social phobia. Child and Adolescent Social Anxiety Disorder Jacqueline Nesi 7 Although the MASC has evidence to support it, the current evidence only applies to screening for GAD in girls and anxiety comorbidities (p.404). Thus, for both of these measures, another assessment method is to be used as well, such as an interview schedule (pp 401-5). The SCARED, MASC, and FSSC-R may be helpful to discriminate between youth with social phobia versus other anxiety disorders (p. 404). {{collapse bottom}} === Interpreting social anxiety disorder screening measure scores === * For information on interpreting screening measure scores, click [[Evidence based assessment/Prediction phase#Interpreting screening measure scores|here.]] * Also see the page on [https://en.wikipedia.org/wiki/Likelihood_ratios_in_diagnostic_testing likelihood ratios in diagnostic testing] for more information ==[[Evidence based assessment/Prescription phase|'''Prescription phase''']]== ===Gold standard diagnostic interviews=== * For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews click here.] ===Recommended diagnostic interviews for social anxiety disorder=== {| class="wikitable sortable" border="1" ! colspan="5" |Diagnostic instruments for social anxiety disorder |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time !Where to Access |- | Anxiety Disorders Interview Schedule (ADIS)<ref>{{Cite journal|date=2018-06|editor-last=Hunsley|editor-first=John|editor2-last=Mash|editor2-first=Eric J.|title=A Guide to Assessments That Work|url=http://dx.doi.org/10.1093/med-psych/9780190492243.001.0001|journal=Oxford Clinical Psychology|doi=10.1093/med-psych/9780190492243.001.0001}}</ref> | Interview (clinician) | 7 years-adult | 90 minutes |Purchase [https://global.oup.com/academic/product/anxiety-and-related-disorders-interview-schedule-for-dsm-5-adis-5---adult-version-9780199325160?cc=gb&lang=en& here] |- |Structured Clinical Interview for DSM (SCID)<ref>{{Cite journal|date=2018-06|editor-last=Hunsley|editor-first=John|editor2-last=Mash|editor2-first=Eric J.|title=A Guide to Assessments That Work|url=http://dx.doi.org/10.1093/med-psych/9780190492243.001.0001|journal=Oxford Clinical Psychology|doi=10.1093/med-psych/9780190492243.001.0001}}</ref> |Semi-structured Interview |Adults (Ages 18+) |1-2 hours | -Available for purchase from [https://www.appi.org/products/structured-clinical-interview-for-dsm-5-scid-5 APA Publishing] (Note: Not free) |} '''Note:''' Reliability and validity are included in the extended version [[Evidence-based assessment/Social anxiety disorder (disorder portfolio)/extended version|here]]. This table includes measures with Good or Excellent ratings. ==[[Evidence based assessment/Process phase|'''Process phase''']]== The following section contains a brief overview of treatment options for social anxiety disorder and list of process and outcome measures for social anxiety disorder. The section includes benchmarks based on published norms for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the [[Evidence based assessment/Process phase|process phase]] of assessment. For more information of differences between process and outcome measures, see the page on the [[Evidence based assessment/Process phase|process phase of assessment]]. === Process measures === === Outcome and severity measures === This table includes clinically significant benchmarks for social anxiety disorder specific outcome measures * Information on how to interpret this table can be [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase '''found here''']. * Additionally, these [[Evidence based assessment/Vignettes|'''vignettes''']] might be helpful resources for understanding appropriate adaptation of outcome measures in practice. *''<u>For clinically significant change benchmarks for the CBCL, YSR, and TRF total, externalizing, internalizing, and attention benchmarks,</u>'' [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase&wteswitched=1#Clinically_significant_change_benchmarks_for_widely-used_outcome_measures '''see here.'''] {| class="wikitable sortable" border="1" |- | colspan="8" style="font-size:110%; text-align:center;" span |'''Benchmarks Based on Non-Referred Sample of Adolescents (Anderson et al., 2009)''' |- | rowspan="2" style="text-align:center;font-size:130%;" | <b> Measure</b> | rowspan="2" style="text-align:center;font-size:130%;" | <b> Subscale</b> | colspan="3" style="text-align:center;font-size:130%" width="300" | <b> Cut-off scores</b> | colspan="3" style="text-align:center;font-size:120%" | <b> Critical Change <br> (unstandardized scores)</b> |- | style="text-align:center;font-size:110%" | <b> A</b> | style="text-align:center;font-size:110%" |<b> B</b> | style="text-align:center;font-size:110%" |<b> C</b> | style="text-align:center;font-size:110%" |<b> 95%</b> | style="text-align:center;font-size:110%" |<b> 90%</b> | style="text-align:center;font-size:110%" |<b> SE_difference</b> |- | rowspan="2" style="text-align:center;" |'''MASC (2009)''' | style="text-align:center;" |<i> Total</i> | style="text-align:center;" | 15.9 | style="text-align:center;" | 63.8 | style="text-align:center;" | 38.9 | style="text-align:center;" | 11.9 | style="text-align:center;" | 10.0 | style="text-align:center;" | 6.1 |- | style="text-align:center;" |<i> Social Anxiety Scale</i> | style="text-align:center;" | 3.5 | style="text-align:center;" | 19.9 | style="text-align:center;" | 11.8 | style="text-align:center;" | 7.8 | style="text-align:center;" | 6.6 | style="text-align:center;" | 4.0 |- | rowspan="1" style="text-align:center;" |'''SPAI-C (2009)''' | style="text-align:center;" | <i> Total</i> | style="text-align:center;" | 3.3 | style="text-align:center;" | 26.6 | style="text-align:center;" | 15.9 | style="text-align:center;" | 7.5 | style="text-align:center;" | 6.3 | style="text-align:center;" | 3.8 |- |} {| class="wikitable sortable" border="1" |- | colspan="8" style="font-size:110%; text-align:center;" span |'''Benchmarks Based on Published Norms''' |- | rowspan="2" |<b> <big>Measure</big></b> | rowspan="2" |<b> <big>Subscale</big></b> | colspan="3" |<b> <big>Cut-off scores</big></b> | colspan="3" |<b> <big>Critical Change <br> (unstandardized scores)</big></b> |- |<b> <big>A</big></b> |<b> <big>B</big></b> |<b> <big>C</big></b> |<b> <big>95%</big></b> |<b> <big>90%</big></b> |<b> <big>SE_difference</big></b> |- | rowspan="2" style="text-align:center;" |'''CBCL T-Scores (2001 Norms)''' | style="text-align:center;" |<i> Total</i> | style="text-align:center;" | 49 | style="text-align:center;" | 70 | style="text-align:center;" | 58 | style="text-align:center;" | 5 | style="text-align:center;" | 4 | style="text-align:center;" | 2.4 |- | style="text-align:center;" |<i> Internalizing</i> | style="text-align:center;" | n/a | style="text-align:center;" | 70 | style="text-align:center;" | 56 | style="text-align:center;" | 9 | style="text-align:center;" | 7 | style="text-align:center;" | 4.5 |- | rowspan="2" style="text-align:center;" |'''TRF T-Scores (2001 Norms)''' | style="text-align:center;" |<i> Total</i> | style="text-align:center;" | n/a | style="text-align:center;" | 70 | style="text-align:center;" | 57 | style="text-align:center;" | 5 | style="text-align:center;" | 4 | style="text-align:center;" | 2.3 |- | style="text-align:center;" |<i> Internalizing</i> | style="text-align:center;" | n/a | style="text-align:center;" | 70 | style="text-align:center;" | 55 | style="text-align:center;" | 9 | style="text-align:center;" | 7 | style="text-align:center;" | 4.4 |- | rowspan="2" style="text-align:center;" |'''YSR T-Scores (2001 Norms)''' | style="text-align:center;" |<i> Total</i> | style="text-align:center;" | n/a | style="text-align:center;" | 70 | style="text-align:center;" | 54 | style="text-align:center;" | 7 | style="text-align:center;" | 6 | style="text-align:center;" | 3.3 |- | style="text-align:center;" |<i> Internalizing</i> | style="text-align:center;" | n/a | style="text-align:center;" | 70 | style="text-align:center;" | 54 | style="text-align:center;" | 9 | style="text-align:center;" | 8 | style="text-align:center;" | 4.8 |} '''<big>Note:</big>''' '''''A''''' = Away from the clinical range; '''''B'''''= Back into the nonclinical range; and '''''C''''' = Closer to the nonclinical than clinical mean. === Treatment === {{collapse top| Click here for information of therapy for social anxiety}} According to ''Effective Child Therapy,'' no “Well-Established” treatments have been empirically validated for Social Phobia. * However, group Cognitive Behavioral Therapy, or Group CBT, for Anxiety has been identified as “Probably Efficacious” in treating Social Phobia. *According to Effective Child Therapy, the “Probably Efficacious” distinction marks a treatment as having “strong research support” but lacking the criteria that at least two large-scale randomized controlled trials have been conducted by “independent investigatory teams working at different research settings.” This prevents the treatment from moving into the “Well-Established” group. *Currently, however, CBT is identified as the most promising treatment for childhood and adolescent social phobia. '''Cognitive Behavioral Therapy''' * ''Effective Child Therapy'' identifies the following core components of CBT for anxious youth, including those with Social Phobia: Emotions Education and Relaxation. * Parents and child are taught about the interrelated physiological, cognitive, and behavioral components of anxiety. * Activities help demonstrate different emotions, body postures, and cognitive and physiological correlates. Progressive relaxation training helps anxious children develop awareness and control over their own physiological and muscular responses to anxiety. '''Cognitive restructuring''' * Cognitive restructuring helps children identify and replace distorted cognitions with more adaptive beliefs. * Basic cognitive strategies include identifying and reducing negative self-talk, generating positive self-statements, thought stopping, thought challenging (weighing evidence for and against), testing both dysfunctional and adaptive beliefs, and creating a coping plan for feared situations. '''Imaginal and in-vivo exposure''' * The goals of exposures are to encourage approach behavior by positioning the child in a previously feared or challenging situation. * The child attempts to complete tasks in a graded "fear hierarchy" such that the child experiences early success before attempting greater challenges. * During individual exposures, a child is encouraged to use any number of coping skills, including relaxation exercises, coping thoughts (challenging anxious thoughts with more positive, realistic thoughts), concrete problem-solving, or rehearsal of desirable skills. '''Parent Interventions''' * Parents may have their own preconceptions about the threatening nature of anxiety and they may not know how best to encourage a child to cope with anxiety. * CBT provides parents education about the risks of continued avoidance and guidance in managing their own anxiety * CBT may also impart basic parenting strategies (e.g., positive/negative reinforcement, planned ignoring, modeling, reward planning) to facilitate the practice of therapy skills in the home. Sources: Effective Child Therapy page on [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/fear-worry-and-anxiety/ Fear, Worry & Anxiety] {{collapse bottom}}Please refer to the Wikipedia page on [[wikipedia:Social_anxiety|Social Anxiety Disorder]] for more information on available treatment for social anxiety or go to [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/fear-worry-and-anxiety/ Effective Child Therapy] for a curated resource on effective treatments for anxiety disorders. *For information on conducting Exposure Therapy for anxiety disordered youth, see [https://www.bravepracticeforkids.com/ www.BravePracticeForKids.com] =='''External resources'''== # [http://apps.who.int/classifications/icd10/browse/2010/en#/F40 ICD-10 diagnostic criteria] # [https://en.wikiversity.org/w/index.php?title=Helping_Give_Away_Psychological_Science/Resources/Annotated_List_of_Where_and_How_to_Find_a_Therapist Find-a-Therapist] #* A curated list of find-a-therapist websites where you can find a provider # [https://www.nimh.nih.gov/health/topics/anxiety-disorders/index.shtml NIMH] #* Go to this resource for more information on anxiety disorders # OMIM (Online Mendelian Inheritance in Man) #* [http://omim.org/entry/607834?search=anxiety&highlight=anxiety Entry for anxiety] # [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/fear-worry-and-anxiety/ Effective Child Therapy page for '''Fear, Worry, & Anxiety'''] #* Effective Child Therapy is website sponsored by Division 53 of the American Psychological Association (APA), or The Society for Clinical Child and Adolescent Psychology (SCCAP), in collaboration with the Association for Behavioral and Cognitive Therapies (ABCT). Use for information on symptoms and available treatments. # [https://sccap53.org Society of Clinical Child and Adolescent Psychology] # [https://mfr.osf.io/render?url=https://osf.io/t7b4d/?action=download%26mode=render Behavioral Health Virtual Resource] #* This resource has free PDFs of anxiety screenings, as well as information on diagnosing and treating different anxiety disorders # [https://www.abctcentral.org/eStore/ www.abctcentral.org]  #* This is a website sponsored by the Association for Behavioral and Cognitive Therapies. #* Use the “Find a Therapist” option to search for local therapists using CBT, an effective treatment for Social Anxiety. #[https://www.bravepracticeforkids.com/ '''www.BravePracticeForKids.com'''] #*This website, created by Dr. Emily Becker-Haimes at the University of Pennsylvania, has information on conducting [[wikipedia:Exposure_therapy|Exposure Therapy]] for anxiety disordered youth. =='''References'''== {{collapse top|Click here for references}} {{Reflist|30em}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] {{collapse bottom}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] j8zzqm8kucfdadshv21gxfcq72c6h7x 2419232 2419230 2022-08-26T03:11:24Z Ardenguo 2944162 /* Treatment */ Made the collapsible box expanded by default, fixed a typo wikitext text/x-wiki .<noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{medical disclaimer}} {{:{{BASEPAGENAME}}/Sidebar}} ==[[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio"?''']]== * For background information on what assessment portfolios are, click the link in the heading above. * Want even 'more' information about this topic? There's an extended version of this page [[Evidence-based assessment/Social anxiety disorder (disorder portfolio)/extended version|here]]. == [[Evidence based assessment/Preparation phase|'''Preparation phase''']] == === Diagnostic criteria for phobic anxiety disorders === {{blockquotetop}} <big>'''ICD-11 Diagnostic Criteria for Social Anxiety Disorder'''</big> *Social anxiety disorder is characterized by marked and excessive fear or anxiety that consistently occurs in one or more social situations such as social interactions (e.g., having a conversation), being observed (e.g., eating or drinking), or performing in front of others (e.g., giving a speech). The individual is concerned that he or she will act in a way, or show anxiety symptoms, that will be negatively evaluated by others. The social situations are consistently avoided or else endured with intense fear or anxiety. The symptoms persist for at least several months and are sufficiently severe to result in significant distress or significant impairment in personal, family, social, educational, occupational, or other important areas of functioning. <big>'''Changes in DSM-5'''</big> * The diagnostic criteria for simple phobia changed slightly from [[DSM-IV]] to [[w:Diagnostic_and_Statistical_Manual_of_Mental_Disorders#DSM-IV-TR_.282000.29|DSM-5]]. Summaries are available [http://www.dsm5.org/Documents/changes%20from%20dsm-iv-tr%20to%20dsm-5.pdf here] and [[w:DSM-5|here]]. {{blockquotebottom}} ===Base rates of social phobia in different clinical settings=== This section describes the demographic setting of the population(s) sampled, base rates of diagnosis, country/region sampled and the diagnostic method that was used. Using this information, clinicians will be able to anchor the rate of social anxiety disorder they are likely to see in their clinical practice. * '''''To see prevalence rates across multiple disorders,''''' [[Evidence based assessment/Preparation phase#Base rates for transdiagnostic comparison|'''''click here.''''']] {|class="wikitable sortable" border="1" |- ! Demography ! Setting ! Base Rate ! Diagnostic Method |- | Rhode Island<ref>{{Cite journal|last=Zimmerman|first=Mark|last2=Morgan|first2=Theresa A.|last3=Young|first3=Diane|last4=Chelminski|first4=Iwona|last5=Dalrymple|first5=Kristy|last6=Walsh|first6=Emily|date=December 2015|title=Does Borderline Personality Disorder Manifest Itself Differently in Patients With Bipolar Disorder and Major Depressive Disorder?|url=http://www.ncbi.nlm.nih.gov/pubmed/25248008|journal=Journal of Personality Disorders|volume=29|issue=6|pages=847–853|doi=10.1521/pedi_2014_28_169|issn=1943-2763|pmid=25248008}}</ref> | The Rhode Island Methods to Improve Diagnostic Assessment and Services (MIDAS) project. Psychiatric outpatient practice sample (n=859) | 27.8% | SIDP-IV |- | Oakland, California<ref>{{cite journal|last1=Olfson|first1=M|last2=Kroenke|first2=K|last3=Wang|first3=S|last4=Blanco|first4=C|date=March 2014|title=Trends in office-based mental health care provided by psychiatrists and primary care physicians.|journal=The Journal of clinical psychiatry|volume=75|issue=3|pages=247-53|pmid=24717378}}</ref> | Representative probability within primary care group sample ages 18-70 (n=1001) | 3% | SCID |- | All of U.S.A.<ref>{{cite journal|last1=Ruscio|first1=AM|last2=Brown|first2=TA|last3=Chiu|first3=WT|last4=Sareen|first4=J|last5=Stein|first5=MB|last6=Kessler|first6=RC|date=January 2008|title=Social fears and social phobia in the USA: results from the National Comorbidity Survey Replication.|journal=Psychological medicine|volume=38|issue=1|pages=15-28|pmid=17976249}}</ref> |National Comorbidity Survey Replication (NCS-R). Nationally representative household survey, community sample of adults ages 18+ (n=9282) | 12.1% (lifetime) 7.1% (12-month) | WHO-CIDI Clinical Interview |- | All of U.S.A.<ref>{{cite journal|last1=Kessler|first1=RC|last2=Avenevoli|first2=S|last3=McLaughlin|first3=KA|last4=Green|first4=JG|last5=Lakoma|first5=MD|last6=Petukhova|first6=M|last7=Pine|first7=DS|last8=Sampson|first8=NA|last9=Zaslavsky|first9=AM|date=September 2012|title=Lifetime co-morbidity of DSM-IV disorders in the US National Comorbidity Survey Replication Adolescent Supplement (NCS-A).|journal=Psychological medicine|volume=42|issue=9|pages=1997-2010|pmid=22273480|last10=Merikangas|first10=KR}}</ref> | NCS Adolescent Supplement (NCS-A) for ages 13 to 17. Community sample, (n=6243). | Females 11.2% Males 6.2% Total 8.6% | WHO-CIDI Clinical Interview, modified to simplify language and use examples relevant to adolescents. |- | Western North Carolina.<ref>{{cite journal|last1=Mustillo|first1=S|last2=Worthman|first2=C|last3=Erkanli|first3=A|last4=Keeler|first4=G|last5=Angold|first5=A|last6=Costello|first6=EJ|date=April 2003|title=Obesity and psychiatric disorder: developmental trajectories.|journal=Pediatrics|volume=111|issue=4 Pt 1|pages=851-9|pmid=12671123}}</ref> | The Great Smoky Mountains Study (GSMS). Longitudinal, community sample of children ages 9 to 16 (n=6674) | Females 0.8% Males 0.3% Total 0.5% | CAPA |- | Houston, Texas metropolitan area. | Teen Health 2000 (TH2K). Community sample in large, metropolitan area, ages 11 to 17 (n=4,175) | 1.6% | DISC-IV |- | Puerto Rico<ref>{{cite journal|last1=Ortega|first1=AN|last2=Goodwin|first2=RD|last3=McQuaid|first3=EL|last4=Canino|first4=G|date=NaN|title=Parental mental health, childhood psychiatric disorders, and asthma attacks in island Puerto Rican youth.|journal=Ambulatory pediatrics : the official journal of the Ambulatory Pediatric Association|volume=4|issue=4|pages=308-15|pmid=15264963}}</ref> | Representative household probability community sample, ages 4 to 17 (n=1886). | 2.8% | DISC-IV |- | Children referred to Anxiety Disorders clinic.<ref>{{cite journal|last1=Verduin|first1=TL|last2=Kendall|first2=PC|date=June 2003|title=Differential occurrence of comorbidity within childhood anxiety disorders.|journal=Journal of clinical child and adolescent psychology : the official journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 53|volume=32|issue=2|pages=290-5|pmid=12679288}}</ref> | Child and Adolescent Anxiety Disorders outpatient research clinic, ages 8 to 13 with anxiety disorder diagnosis (n=199) | 20% | ADIS-C/P |- | All of U.S.A. – clinical settings<ref>{{cite journal|last1=Rettew|first1=DC|last2=Lynch|first2=AD|last3=Achenbach|first3=TM|last4=Dumenci|first4=L|last5=Ivanova|first5=MY|date=September 2009|title=Meta-analyses of agreement between diagnoses made from clinical evaluations and standardized diagnostic interviews.|journal=International journal of methods in psychiatric research|volume=18|issue=3|pages=169-84|pmid=19701924}}</ref> | Meta-analysis of data collected across multiple clinical settings, 1995-2006 (n=15,967) | 20% (SDI) 6% (unstructured interview) |Structured or Semi-Structure Diagnostic Interviews and unstructured clinical interviews. |- |Metanalysis of outpatient clinics<ref name=":12">{{Cite journal|last=Rettew|first=David C.|last2=Lynch|first2=Alicia Doyle|last3=Achenbach|first3=Thomas M.|last4=Dumenci|first4=Levent|last5=Ivanova|first5=Masha Y.|date=2009-09|title=Meta-analyses of agreement between diagnoses made from clinical evaluations and standardized diagnostic interviews|url=http://dx.doi.org/10.1002/mpr.289|journal=International Journal of Methods in Psychiatric Research|language=en|volume=18|issue=3|pages=169–184|doi=10.1002/mpr.289|issn=1049-8931}}</ref> |Outpatient clinic |6% (DAU | |- |Metanalysis of outpatient clinics)<ref name=":13">{{Cite journal|last=Rettew|first=David C.|last2=Lynch|first2=Alicia Doyle|last3=Achenbach|first3=Thomas M.|last4=Dumenci|first4=Levent|last5=Ivanova|first5=Masha Y.|date=2009-09|title=Meta-analyses of agreement between diagnoses made from clinical evaluations and standardized diagnostic interviews|url=http://dx.doi.org/10.1002/mpr.289|journal=International Journal of Methods in Psychiatric Research|language=en|volume=18|issue=3|pages=169–184|doi=10.1002/mpr.289|issn=1049-8931}}</ref> |Outpatient clinic |20% (SDI) | |- |Intended to apply to the entire United States <ref name=":3">Kessler, R. C., Avenevoli, S., Costello, E. J., Georgiades, K., Green, J. G., Gruber, M. J., . . . Merikangas, K. R. (2012). Prevalence, persistence, and sociodemographic correlates of DSM-IV disorders in the National Comorbidity Survey Replication Adolescent Supplement. Archives of General Psychiatry, 69(4), 372-380. doi:10.1001/archgenpsychiatry.2011.160</ref> |General Population |9% | |} '''Note:''' WHO-CIDI = World Health Organization Composite International Diagnostic Interview; NCS-A (lifetime prevalence); CAPA= Children and Adolescent Psychiatric Assessment (3-month prevalence); DISC-IV = Diagnostic Interview Schedule for Children, Version 4 (12-month prevalence); ADIS-C/P=Anxiety Disorders Interview Schedule for Children/Parents; SIDP-IV = Structured Interview for DSM-IV Personality; SCID=Structured Clinical Interview for DSM-IV; SDIs included in Rettew et al. (2009): CIDI, DAWBA, DICA, DISC, DIS, MINI, K-SADS-PL, SCAN-2, SCID, SCID-II. * Higher rates of social anxiety disorder are found in females than in males, with more pronounced differences in adolescence. Prevalence rates in children and adolescents are comparable to those in adults. Onset is typically in early adolescence (DSM-5, 2013). ==[[Evidence based assessment/Prediction phase|'''Prediction phase''']]== === Psychometric properties of screening instruments for social anxiety disorder === The following section contains a list of screening and diagnostic instruments for social anxiety disorder. The section includes administration information, psychometric data, and PDFs or links to the screenings. * Screenings are used as part of the [[Evidence based assessment/Prediction phase|prediction phase]] of assessment; for more information on interpretation of this data, or how screenings fit in to the assessment process, click [[Evidence based assessment/Prediction phase|here.]] * ''For a list of more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Psychometric_properties_of_common_screening_instruments '''click here.''']'' {| class="wikitable" |- ! Measure !Format (Reporter) !Age Range !Administration/ Completion Time !Where to Access |- |[https://osf.io/2y3cq Liebowitz Social Anxiety Scale (LSAS)]<ref>{{Cite journal|last=Heimberg|first=R. G.|last2=Horner|first2=K. J.|last3=Juster|first3=H. R.|last4=Safren|first4=S. A.|last5=Brown|first5=E. J.|last6=Schneier|first6=F. R.|last7=Liebowitz|first7=M. R.|date=1999-1|title=Psychometric properties of the Liebowitz Social Anxiety Scale|url=https://www.ncbi.nlm.nih.gov/pubmed/10077308|journal=Psychological Medicine|volume=29|issue=1|pages=199–212|issn=0033-2917|pmid=10077308}}</ref> |Questionnaire (clinician administered, self-report) |7 years-adult |15 minutes | *[http://nationalsocialanxietycenter.com/liebowitz-sa-scale/ Online questionnaire with scoring] *[https://osf.io/2y3cq Printable PDF] |- |[https://osf.io/svn9x Social Phobia Inventory (SPIN)]<ref>{{Cite journal|last=Connor|first=Kathryn M.|last2=Davidson|first2=Jonathan R. T.|last3=Churchill|first3=L. Erik|last4=Sherwood|first4=Andrew|last5=Weisler|first5=Richard H.|last6=Foa|first6=Edna|date=2000/04|title=Psychometric properties of the Social Phobia Inventory (SPIN): New self-rating scale|url=https://www.cambridge.org/core/journals/the-british-journal-of-psychiatry/article/psychometric-properties-of-the-social-phobia-inventory-spin/9E4A3EE20D2B1A6C222CDB5807AC086A|journal=The British Journal of Psychiatry|language=en|volume=176|issue=4|pages=379–386|doi=10.1192/bjp.176.4.379|issn=0007-1250}}</ref> |Questionnaire (self-report) |12 years-adult |5-10 minutes | * [https://joyable.com/spin_snapshots/new Online questionnaire with scoring] * [https://psychology-tools.com/spin/ Online questionnaire with scoring] * [https://osf.io/svn9x Printable PDF] |- |Social Phobia and Anxiety Inventory (SPAI)<ref>{{Cite journal|last=Garcia-Lopez|first=Luis Joaquin|last2=Hidalgo|first2=Maria D.|last3=Beidel|first3=Deborah C.|last4=Olivares|first4=Jose|last5=Turner†|first5=Samuel|date=2008-01-01|title=Brief Form of the Social Phobia and Anxiety Inventory (SPAI-B) for Adolescents|url=http://dx.doi.org/10.1027/1015-5759.14.3.150|journal=European Journal of Psychological Assessment|volume=24|issue=3|pages=150–156|doi=10.1027/1015-5759.14.3.150|issn=1015-5759}}</ref> *not free |Questionnaire (self-report) |14 years-adult |20-30 minutes |Purchase [https://shop.acer.org/social-phobia-and-anxiety-inventory-spai.html here] |- | colspan="5" style="font-size:110%; text-align:center;" |'''For Children and Adolescents Specifically''' |- |- |[https://osf.io/s3fu2 Revised Children’s Anxiety and Depression Scale (RCADS)] |Questionnaire (Child) |6-18 years |12 minutes | *[http://www.corc.uk.net/outcome-experience-measures/revised-childrens-anxiety-and-depression-scale-and-subscales/ RCADS homepage] '''PDFs for RCADS''' * [https://osf.io/s3fu2 RCADS Child Self-reported (6-18 years)] * [https://mfr.osf.io/render?url=https://osf.io/fp9mk/?action=download%26mode=render RCADS Parent-reported] *[https://mfr.osf.io/render?url=https://osf.io/vy7ta/?action=download%26mode=render Child Scoring Aid] *[https://mfr.osf.io/render?url=https://osf.io/t4bz6/?action=download%26mode=render Parent Scoring Aid] '''Subscales''' *[https://mfr.osf.io/render?url=https://osf.io/ectpf/?action=download%26mode=render Social Anxiety Self-reported] *[https://mfr.osf.io/render?url=https://osf.io/pu6rn/?action=download%26mode=render Social Anxiety Parent-reported] '''Translations''' * [https://mfr.osf.io/render?url=https://osf.io/qsjh9/?action=download%26mode=render User Guide] |- |Social Phobia and Anxiety Inventory for Children (SPAIC) *not free |Questionnaire |8-14 years |20-30 minutes |Purchase [https://eprovide.mapi-trust.org/instruments/social-phobia-and-anxiety-inventory-for-children#coas_member_access_content here] |} '''Note:''' Reliability and validity are included in the extended version [[Evidence-based assessment/Social anxiety disorder (disorder portfolio)/extended version|here]]. This table includes measures with Good or Excellent ratings. === Likelihood ratios and AUCs of screening measures for social anxiety disorder === * ''For a list of the likelihood ratios for more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Likelihood_ratios_and_AUCs_of_common_screening_instruments '''click here.''']'' {| class="wikitable sortable" border="1" |- ! Screening Measure (Primary Reference) ! AUC (Sample Size) ! DiLR+ (Score) ! DiLR- (Score) !Clinical Generalizability !Where to Access |- |Liebowitz Social Anxiety Scale (LSAS) <ref>{{cite journal|last1=Liebowitz|first1=MR|title=Social phobia.|journal=Modern problems of pharmacopsychiatry|date=1987|volume=22|pages=141-73|pmid=2885745}}</ref> <ref>{{cite journal|last1=Mennin|first1=DS|last2=Fresco|first2=DM|last3=Heimberg|first3=RG|last4=Schneier|first4=FR|last5=Davies|first5=SO|last6=Liebowitz|first6=MR|date=2002|title=Screening for social anxiety disorder in the clinical setting: using the Liebowitz Social Anxiety Scale.|journal=Journal of anxiety disorders|volume=16|issue=6|pages=661-73|pmid=12405524}}</ref> and <ref>{{cite journal|last1=Santos|first1=LF|last2=Loureiro|first2=SR|last3=Crippa|first3=JA|last4=Osório|first4=FL|date=2015|title=Can the Liebowitz Social Anxiety Scale - self-report version be used to differentiate clinical and non-clinical SAD groups among Brazilians?|journal=PloS one|volume=10|issue=3|pages=e0121437|pmid=25811489}}</ref> | 0.94 - differentiating from subclinical patients 0.98 - differentiating from healthy controls | Not reported | Not reported | |[https://osf.io/2y3cq Printable PDF] |- |Overall Anxiety Severity And Impairment Scale (OASIS)<ref>{{Cite journal|last=Campbell-Sills|first=Laura|last2=Norman|first2=Sonya B.|last3=Craske|first3=Michelle G.|last4=Sullivan|first4=Greer|last5=Lang|first5=Ariel J.|last6=Chavira|first6=Denise A.|last7=Bystritsky|first7=Alexander|last8=Sherbourne|first8=Cathy|last9=Roy-Byrne|first9=Peter|date=2009-1|title=Validation of a Brief Measure of Anxiety-Related Severity and Impairment: The Overall Anxiety Severity and Impairment Scale (OASIS)|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2629402/|journal=Journal of affective disorders|volume=112|issue=1-3|pages=92–101|doi=10.1016/j.jad.2008.03.014|issn=0165-0327|pmc=PMC2629402|pmid=18486238}}</ref> |.87<ref name=":0">{{Cite journal|last=Campbell-Sills|first=Laura|last2=Norman|first2=Sonya B.|last3=Craske|first3=Michelle G.|last4=Sullivan|first4=Greer|last5=Lang|first5=Ariel J.|last6=Chavira|first6=Denise A.|last7=Bystritsky|first7=Alexander|last8=Sherbourne|first8=Cathy|last9=Roy-Byrne|first9=Peter|date=2009-1|title=Validation of a Brief Measure of Anxiety-Related Severity and Impairment: The Overall Anxiety Severity and Impairment Scale (OASIS)|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2629402/|journal=Journal of affective disorders|volume=112|issue=1-3|pages=92–101|doi=10.1016/j.jad.2008.03.014|issn=0165-0327|pmc=PMC2629402|pmid=18486238}}</ref> |3.07 (> or = cut score 8) {| class="wikitable sortable" border="1" |Cut-score of ≥ 8 to be optimal given that it successfully classified 87% of the sample with the most favorable balance of sensitivity (89%) and specificity (71%) |} <ref name=":0" /> |Not reported |Unknown<ref name=":0" /> |[https://osf.io/bkvj2 Printable PDF] |- |Social Phobia and Anxiety Inventory for Children (SPAI-C) <br> (Beidel, Turner, & Morris, 1995) <ref>{{cite journal|last1=Inderbitzen-Nolan|first1=H|last2=Davies|first2=CA|last3=McKeon|first3=ND|date=2004|title=Investigating the construct validity of the SPAI-C: comparing the sensitivity and specificity of the SPAI-C and the SAS-A.|journal=Journal of anxiety disorders|volume=18|issue=4|pages=547-60|pmid=15149713}}</ref> and <ref>{{cite journal|last1=Viana|first1=AG|last2=Rabian|first2=B|last3=Beidel|first3=DC|date=June 2008|title=Self-report measures in the study of comorbidity in children and adolescents with social phobia: research and clinical utility.|journal=Journal of anxiety disorders|volume=22|issue=5|pages=781-92|pmid=17888622}}</ref> |.65 (n=172) |3.55 (18+) |.47 | |Purchase [https://shop.acer.org/spai-quickscore-form-pkg-25.html here] |- |Screen for Child Anxiety and Related Emotional Disorders (SCARED)<br><ref>{{cite journal|last1=Birmaher|first1=B|last2=Khetarpal|first2=S|last3=Brent|first3=D|last4=Cully|first4=M|last5=Balach|first5=L|last6=Kaufman|first6=J|last7=Neer|first7=SM|title=The Screen for Child Anxiety Related Emotional Disorders (SCARED): scale construction and psychometric characteristics.|journal=Journal of the American Academy of Child and Adolescent Psychiatry|date=April 1997|volume=36|issue=4|pages=545-53|pmid=9100430}}</ref><ref>{{cite journal|last1=Desousa|first1=DA|last2=Salum|first2=GA|last3=Isolan|first3=LR|last4=Manfro|first4=GG|date=June 2013|title=Sensitivity and specificity of the Screen for Child Anxiety Related Emotional Disorders (SCARED): a community-based study.|journal=Child psychiatry and human development|volume=44|issue=3|pages=391-9|pmid=22961135}}</ref> |.72 (n=119) |1.9 (27+) |.50 | |Printable [https://osf.io/z4da3 PDF] |- |} {{collapse top| Notes about the above table|expand=yes}} * '''Note:''' All studies used some version of ADIS-C, K-SADS or CAS administered by trained raters. “LR+” refers to the change in likelihood ratio associated with a positive test score, and “LR-” is the likelihood ratio for a low score. Likelihood ratios of 1 indicate that the test result did not change impressions at all. LRs larger than 10 or smaller than .10 are frequently clinically decisive; 5 or .20 are helpful, and between 2.0 and .5 are small enough that they rarely result in clinically meaningful changes of formulation (Sackett et al., 2000). AUC guidelines according to Swets and Pickett (1982)<ref>{{cite journal|last1=Song|first1=HH|title=Analysis of correlated ROC areas in diagnostic testing.|journal=Biometrics|date=March 1997|volume=53|issue=1|pages=370-82|pmid=9147602}}</ref>: .50 to .70 (low accuracy), .70 to .90 (moderate accuracy), and greater than .90 (high accuracy). * '''Note:''' Silverman & Ollendick (2005)<ref>{{cite journal|last1=Silverman|first1=WK|last2=Ollendick|first2=TH|title=Evidence-based assessment of anxiety and its disorders in children and adolescents.|journal=Journal of clinical child and adolescent psychology : the official journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 53|date=September 2005|volume=34|issue=3|pages=380-411|pmid=16026211}}</ref> suggest that the SPAI-C is the better instrument for identifying those children and adolescents who most likely meet DSM-IV criteria for social phobia, but that this measure may miss some adolescents who would meet criteria for social phobia. Child and Adolescent Social Anxiety Disorder Jacqueline Nesi 7 Although the MASC has evidence to support it, the current evidence only applies to screening for GAD in girls and anxiety comorbidities (p.404). Thus, for both of these measures, another assessment method is to be used as well, such as an interview schedule (pp 401-5). The SCARED, MASC, and FSSC-R may be helpful to discriminate between youth with social phobia versus other anxiety disorders (p. 404). {{collapse bottom}} === Interpreting social anxiety disorder screening measure scores === * For information on interpreting screening measure scores, click [[Evidence based assessment/Prediction phase#Interpreting screening measure scores|here.]] * Also see the page on [https://en.wikipedia.org/wiki/Likelihood_ratios_in_diagnostic_testing likelihood ratios in diagnostic testing] for more information ==[[Evidence based assessment/Prescription phase|'''Prescription phase''']]== ===Gold standard diagnostic interviews=== * For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews click here.] ===Recommended diagnostic interviews for social anxiety disorder=== {| class="wikitable sortable" border="1" ! colspan="5" |Diagnostic instruments for social anxiety disorder |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time !Where to Access |- | Anxiety Disorders Interview Schedule (ADIS)<ref>{{Cite journal|date=2018-06|editor-last=Hunsley|editor-first=John|editor2-last=Mash|editor2-first=Eric J.|title=A Guide to Assessments That Work|url=http://dx.doi.org/10.1093/med-psych/9780190492243.001.0001|journal=Oxford Clinical Psychology|doi=10.1093/med-psych/9780190492243.001.0001}}</ref> | Interview (clinician) | 7 years-adult | 90 minutes |Purchase [https://global.oup.com/academic/product/anxiety-and-related-disorders-interview-schedule-for-dsm-5-adis-5---adult-version-9780199325160?cc=gb&lang=en& here] |- |Structured Clinical Interview for DSM (SCID)<ref>{{Cite journal|date=2018-06|editor-last=Hunsley|editor-first=John|editor2-last=Mash|editor2-first=Eric J.|title=A Guide to Assessments That Work|url=http://dx.doi.org/10.1093/med-psych/9780190492243.001.0001|journal=Oxford Clinical Psychology|doi=10.1093/med-psych/9780190492243.001.0001}}</ref> |Semi-structured Interview |Adults (Ages 18+) |1-2 hours | -Available for purchase from [https://www.appi.org/products/structured-clinical-interview-for-dsm-5-scid-5 APA Publishing] (Note: Not free) |} '''Note:''' Reliability and validity are included in the extended version [[Evidence-based assessment/Social anxiety disorder (disorder portfolio)/extended version|here]]. This table includes measures with Good or Excellent ratings. ==[[Evidence based assessment/Process phase|'''Process phase''']]== The following section contains a brief overview of treatment options for social anxiety disorder and list of process and outcome measures for social anxiety disorder. The section includes benchmarks based on published norms for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the [[Evidence based assessment/Process phase|process phase]] of assessment. For more information of differences between process and outcome measures, see the page on the [[Evidence based assessment/Process phase|process phase of assessment]]. === Process measures === === Outcome and severity measures === This table includes clinically significant benchmarks for social anxiety disorder specific outcome measures * Information on how to interpret this table can be [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase '''found here''']. * Additionally, these [[Evidence based assessment/Vignettes|'''vignettes''']] might be helpful resources for understanding appropriate adaptation of outcome measures in practice. *''<u>For clinically significant change benchmarks for the CBCL, YSR, and TRF total, externalizing, internalizing, and attention benchmarks,</u>'' [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase&wteswitched=1#Clinically_significant_change_benchmarks_for_widely-used_outcome_measures '''see here.'''] {| class="wikitable sortable" border="1" |- | colspan="8" style="font-size:110%; text-align:center;" span |'''Benchmarks Based on Non-Referred Sample of Adolescents (Anderson et al., 2009)''' |- | rowspan="2" style="text-align:center;font-size:130%;" | <b> Measure</b> | rowspan="2" style="text-align:center;font-size:130%;" | <b> Subscale</b> | colspan="3" style="text-align:center;font-size:130%" width="300" | <b> Cut-off scores</b> | colspan="3" style="text-align:center;font-size:120%" | <b> Critical Change <br> (unstandardized scores)</b> |- | style="text-align:center;font-size:110%" | <b> A</b> | style="text-align:center;font-size:110%" |<b> B</b> | style="text-align:center;font-size:110%" |<b> C</b> | style="text-align:center;font-size:110%" |<b> 95%</b> | style="text-align:center;font-size:110%" |<b> 90%</b> | style="text-align:center;font-size:110%" |<b> SE_difference</b> |- | rowspan="2" style="text-align:center;" |'''MASC (2009)''' | style="text-align:center;" |<i> Total</i> | style="text-align:center;" | 15.9 | style="text-align:center;" | 63.8 | style="text-align:center;" | 38.9 | style="text-align:center;" | 11.9 | style="text-align:center;" | 10.0 | style="text-align:center;" | 6.1 |- | style="text-align:center;" |<i> Social Anxiety Scale</i> | style="text-align:center;" | 3.5 | style="text-align:center;" | 19.9 | style="text-align:center;" | 11.8 | style="text-align:center;" | 7.8 | style="text-align:center;" | 6.6 | style="text-align:center;" | 4.0 |- | rowspan="1" style="text-align:center;" |'''SPAI-C (2009)''' | style="text-align:center;" | <i> Total</i> | style="text-align:center;" | 3.3 | style="text-align:center;" | 26.6 | style="text-align:center;" | 15.9 | style="text-align:center;" | 7.5 | style="text-align:center;" | 6.3 | style="text-align:center;" | 3.8 |- |} {| class="wikitable sortable" border="1" |- | colspan="8" style="font-size:110%; text-align:center;" span |'''Benchmarks Based on Published Norms''' |- | rowspan="2" |<b> <big>Measure</big></b> | rowspan="2" |<b> <big>Subscale</big></b> | colspan="3" |<b> <big>Cut-off scores</big></b> | colspan="3" |<b> <big>Critical Change <br> (unstandardized scores)</big></b> |- |<b> <big>A</big></b> |<b> <big>B</big></b> |<b> <big>C</big></b> |<b> <big>95%</big></b> |<b> <big>90%</big></b> |<b> <big>SE_difference</big></b> |- | rowspan="2" style="text-align:center;" |'''CBCL T-Scores (2001 Norms)''' | style="text-align:center;" |<i> Total</i> | style="text-align:center;" | 49 | style="text-align:center;" | 70 | style="text-align:center;" | 58 | style="text-align:center;" | 5 | style="text-align:center;" | 4 | style="text-align:center;" | 2.4 |- | style="text-align:center;" |<i> Internalizing</i> | style="text-align:center;" | n/a | style="text-align:center;" | 70 | style="text-align:center;" | 56 | style="text-align:center;" | 9 | style="text-align:center;" | 7 | style="text-align:center;" | 4.5 |- | rowspan="2" style="text-align:center;" |'''TRF T-Scores (2001 Norms)''' | style="text-align:center;" |<i> Total</i> | style="text-align:center;" | n/a | style="text-align:center;" | 70 | style="text-align:center;" | 57 | style="text-align:center;" | 5 | style="text-align:center;" | 4 | style="text-align:center;" | 2.3 |- | style="text-align:center;" |<i> Internalizing</i> | style="text-align:center;" | n/a | style="text-align:center;" | 70 | style="text-align:center;" | 55 | style="text-align:center;" | 9 | style="text-align:center;" | 7 | style="text-align:center;" | 4.4 |- | rowspan="2" style="text-align:center;" |'''YSR T-Scores (2001 Norms)''' | style="text-align:center;" |<i> Total</i> | style="text-align:center;" | n/a | style="text-align:center;" | 70 | style="text-align:center;" | 54 | style="text-align:center;" | 7 | style="text-align:center;" | 6 | style="text-align:center;" | 3.3 |- | style="text-align:center;" |<i> Internalizing</i> | style="text-align:center;" | n/a | style="text-align:center;" | 70 | style="text-align:center;" | 54 | style="text-align:center;" | 9 | style="text-align:center;" | 8 | style="text-align:center;" | 4.8 |} '''<big>Note:</big>''' '''''A''''' = Away from the clinical range; '''''B'''''= Back into the nonclinical range; and '''''C''''' = Closer to the nonclinical than clinical mean. === Treatment === {{collapse top| Information on therapy for social anxiety|expand=yes}} According to ''Effective Child Therapy,'' no “Well-Established” treatments have been empirically validated for Social Phobia. * However, group Cognitive Behavioral Therapy, or Group CBT, for Anxiety has been identified as “Probably Efficacious” in treating Social Phobia. *According to Effective Child Therapy, the “Probably Efficacious” distinction marks a treatment as having “strong research support” but lacking the criteria that at least two large-scale randomized controlled trials have been conducted by “independent investigatory teams working at different research settings.” This prevents the treatment from moving into the “Well-Established” group. *Currently, however, CBT is identified as the most promising treatment for childhood and adolescent social phobia. '''Cognitive Behavioral Therapy''' * ''Effective Child Therapy'' identifies the following core components of CBT for anxious youth, including those with Social Phobia: Emotions Education and Relaxation. * Parents and child are taught about the interrelated physiological, cognitive, and behavioral components of anxiety. * Activities help demonstrate different emotions, body postures, and cognitive and physiological correlates. Progressive relaxation training helps anxious children develop awareness and control over their own physiological and muscular responses to anxiety. '''Cognitive restructuring''' * Cognitive restructuring helps children identify and replace distorted cognitions with more adaptive beliefs. * Basic cognitive strategies include identifying and reducing negative self-talk, generating positive self-statements, thought stopping, thought challenging (weighing evidence for and against), testing both dysfunctional and adaptive beliefs, and creating a coping plan for feared situations. '''Imaginal and in-vivo exposure''' * The goals of exposures are to encourage approach behavior by positioning the child in a previously feared or challenging situation. * The child attempts to complete tasks in a graded "fear hierarchy" such that the child experiences early success before attempting greater challenges. * During individual exposures, a child is encouraged to use any number of coping skills, including relaxation exercises, coping thoughts (challenging anxious thoughts with more positive, realistic thoughts), concrete problem-solving, or rehearsal of desirable skills. '''Parent Interventions''' * Parents may have their own preconceptions about the threatening nature of anxiety and they may not know how best to encourage a child to cope with anxiety. * CBT provides parents education about the risks of continued avoidance and guidance in managing their own anxiety * CBT may also impart basic parenting strategies (e.g., positive/negative reinforcement, planned ignoring, modeling, reward planning) to facilitate the practice of therapy skills in the home. Sources: Effective Child Therapy page on [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/fear-worry-and-anxiety/ Fear, Worry & Anxiety] {{collapse bottom}}Please refer to the Wikipedia page on [[wikipedia:Social_anxiety|Social Anxiety Disorder]] for more information on available treatment for social anxiety or go to [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/fear-worry-and-anxiety/ Effective Child Therapy] for a curated resource on effective treatments for anxiety disorders. *For information on conducting Exposure Therapy for anxiety disordered youth, see [https://www.bravepracticeforkids.com/ www.BravePracticeForKids.com] =='''External resources'''== # [http://apps.who.int/classifications/icd10/browse/2010/en#/F40 ICD-10 diagnostic criteria] # [https://en.wikiversity.org/w/index.php?title=Helping_Give_Away_Psychological_Science/Resources/Annotated_List_of_Where_and_How_to_Find_a_Therapist Find-a-Therapist] #* A curated list of find-a-therapist websites where you can find a provider # [https://www.nimh.nih.gov/health/topics/anxiety-disorders/index.shtml NIMH] #* Go to this resource for more information on anxiety disorders # OMIM (Online Mendelian Inheritance in Man) #* [http://omim.org/entry/607834?search=anxiety&highlight=anxiety Entry for anxiety] # [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/fear-worry-and-anxiety/ Effective Child Therapy page for '''Fear, Worry, & Anxiety'''] #* Effective Child Therapy is website sponsored by Division 53 of the American Psychological Association (APA), or The Society for Clinical Child and Adolescent Psychology (SCCAP), in collaboration with the Association for Behavioral and Cognitive Therapies (ABCT). Use for information on symptoms and available treatments. # [https://sccap53.org Society of Clinical Child and Adolescent Psychology] # [https://mfr.osf.io/render?url=https://osf.io/t7b4d/?action=download%26mode=render Behavioral Health Virtual Resource] #* This resource has free PDFs of anxiety screenings, as well as information on diagnosing and treating different anxiety disorders # [https://www.abctcentral.org/eStore/ www.abctcentral.org]  #* This is a website sponsored by the Association for Behavioral and Cognitive Therapies. #* Use the “Find a Therapist” option to search for local therapists using CBT, an effective treatment for Social Anxiety. #[https://www.bravepracticeforkids.com/ '''www.BravePracticeForKids.com'''] #*This website, created by Dr. Emily Becker-Haimes at the University of Pennsylvania, has information on conducting [[wikipedia:Exposure_therapy|Exposure Therapy]] for anxiety disordered youth. =='''References'''== {{collapse top|Click here for references}} {{Reflist|30em}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] {{collapse bottom}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] fnrdht83oq6s79c8o4gji64eyfaulqr 2419233 2419232 2022-08-26T03:11:47Z Ardenguo 2944162 /* References */ Made the references box expanded by default wikitext text/x-wiki .<noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{medical disclaimer}} {{:{{BASEPAGENAME}}/Sidebar}} ==[[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio"?''']]== * For background information on what assessment portfolios are, click the link in the heading above. * Want even 'more' information about this topic? There's an extended version of this page [[Evidence-based assessment/Social anxiety disorder (disorder portfolio)/extended version|here]]. == [[Evidence based assessment/Preparation phase|'''Preparation phase''']] == === Diagnostic criteria for phobic anxiety disorders === {{blockquotetop}} <big>'''ICD-11 Diagnostic Criteria for Social Anxiety Disorder'''</big> *Social anxiety disorder is characterized by marked and excessive fear or anxiety that consistently occurs in one or more social situations such as social interactions (e.g., having a conversation), being observed (e.g., eating or drinking), or performing in front of others (e.g., giving a speech). The individual is concerned that he or she will act in a way, or show anxiety symptoms, that will be negatively evaluated by others. The social situations are consistently avoided or else endured with intense fear or anxiety. The symptoms persist for at least several months and are sufficiently severe to result in significant distress or significant impairment in personal, family, social, educational, occupational, or other important areas of functioning. <big>'''Changes in DSM-5'''</big> * The diagnostic criteria for simple phobia changed slightly from [[DSM-IV]] to [[w:Diagnostic_and_Statistical_Manual_of_Mental_Disorders#DSM-IV-TR_.282000.29|DSM-5]]. Summaries are available [http://www.dsm5.org/Documents/changes%20from%20dsm-iv-tr%20to%20dsm-5.pdf here] and [[w:DSM-5|here]]. {{blockquotebottom}} ===Base rates of social phobia in different clinical settings=== This section describes the demographic setting of the population(s) sampled, base rates of diagnosis, country/region sampled and the diagnostic method that was used. Using this information, clinicians will be able to anchor the rate of social anxiety disorder they are likely to see in their clinical practice. * '''''To see prevalence rates across multiple disorders,''''' [[Evidence based assessment/Preparation phase#Base rates for transdiagnostic comparison|'''''click here.''''']] {|class="wikitable sortable" border="1" |- ! Demography ! Setting ! Base Rate ! Diagnostic Method |- | Rhode Island<ref>{{Cite journal|last=Zimmerman|first=Mark|last2=Morgan|first2=Theresa A.|last3=Young|first3=Diane|last4=Chelminski|first4=Iwona|last5=Dalrymple|first5=Kristy|last6=Walsh|first6=Emily|date=December 2015|title=Does Borderline Personality Disorder Manifest Itself Differently in Patients With Bipolar Disorder and Major Depressive Disorder?|url=http://www.ncbi.nlm.nih.gov/pubmed/25248008|journal=Journal of Personality Disorders|volume=29|issue=6|pages=847–853|doi=10.1521/pedi_2014_28_169|issn=1943-2763|pmid=25248008}}</ref> | The Rhode Island Methods to Improve Diagnostic Assessment and Services (MIDAS) project. Psychiatric outpatient practice sample (n=859) | 27.8% | SIDP-IV |- | Oakland, California<ref>{{cite journal|last1=Olfson|first1=M|last2=Kroenke|first2=K|last3=Wang|first3=S|last4=Blanco|first4=C|date=March 2014|title=Trends in office-based mental health care provided by psychiatrists and primary care physicians.|journal=The Journal of clinical psychiatry|volume=75|issue=3|pages=247-53|pmid=24717378}}</ref> | Representative probability within primary care group sample ages 18-70 (n=1001) | 3% | SCID |- | All of U.S.A.<ref>{{cite journal|last1=Ruscio|first1=AM|last2=Brown|first2=TA|last3=Chiu|first3=WT|last4=Sareen|first4=J|last5=Stein|first5=MB|last6=Kessler|first6=RC|date=January 2008|title=Social fears and social phobia in the USA: results from the National Comorbidity Survey Replication.|journal=Psychological medicine|volume=38|issue=1|pages=15-28|pmid=17976249}}</ref> |National Comorbidity Survey Replication (NCS-R). Nationally representative household survey, community sample of adults ages 18+ (n=9282) | 12.1% (lifetime) 7.1% (12-month) | WHO-CIDI Clinical Interview |- | All of U.S.A.<ref>{{cite journal|last1=Kessler|first1=RC|last2=Avenevoli|first2=S|last3=McLaughlin|first3=KA|last4=Green|first4=JG|last5=Lakoma|first5=MD|last6=Petukhova|first6=M|last7=Pine|first7=DS|last8=Sampson|first8=NA|last9=Zaslavsky|first9=AM|date=September 2012|title=Lifetime co-morbidity of DSM-IV disorders in the US National Comorbidity Survey Replication Adolescent Supplement (NCS-A).|journal=Psychological medicine|volume=42|issue=9|pages=1997-2010|pmid=22273480|last10=Merikangas|first10=KR}}</ref> | NCS Adolescent Supplement (NCS-A) for ages 13 to 17. Community sample, (n=6243). | Females 11.2% Males 6.2% Total 8.6% | WHO-CIDI Clinical Interview, modified to simplify language and use examples relevant to adolescents. |- | Western North Carolina.<ref>{{cite journal|last1=Mustillo|first1=S|last2=Worthman|first2=C|last3=Erkanli|first3=A|last4=Keeler|first4=G|last5=Angold|first5=A|last6=Costello|first6=EJ|date=April 2003|title=Obesity and psychiatric disorder: developmental trajectories.|journal=Pediatrics|volume=111|issue=4 Pt 1|pages=851-9|pmid=12671123}}</ref> | The Great Smoky Mountains Study (GSMS). Longitudinal, community sample of children ages 9 to 16 (n=6674) | Females 0.8% Males 0.3% Total 0.5% | CAPA |- | Houston, Texas metropolitan area. | Teen Health 2000 (TH2K). Community sample in large, metropolitan area, ages 11 to 17 (n=4,175) | 1.6% | DISC-IV |- | Puerto Rico<ref>{{cite journal|last1=Ortega|first1=AN|last2=Goodwin|first2=RD|last3=McQuaid|first3=EL|last4=Canino|first4=G|date=NaN|title=Parental mental health, childhood psychiatric disorders, and asthma attacks in island Puerto Rican youth.|journal=Ambulatory pediatrics : the official journal of the Ambulatory Pediatric Association|volume=4|issue=4|pages=308-15|pmid=15264963}}</ref> | Representative household probability community sample, ages 4 to 17 (n=1886). | 2.8% | DISC-IV |- | Children referred to Anxiety Disorders clinic.<ref>{{cite journal|last1=Verduin|first1=TL|last2=Kendall|first2=PC|date=June 2003|title=Differential occurrence of comorbidity within childhood anxiety disorders.|journal=Journal of clinical child and adolescent psychology : the official journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 53|volume=32|issue=2|pages=290-5|pmid=12679288}}</ref> | Child and Adolescent Anxiety Disorders outpatient research clinic, ages 8 to 13 with anxiety disorder diagnosis (n=199) | 20% | ADIS-C/P |- | All of U.S.A. – clinical settings<ref>{{cite journal|last1=Rettew|first1=DC|last2=Lynch|first2=AD|last3=Achenbach|first3=TM|last4=Dumenci|first4=L|last5=Ivanova|first5=MY|date=September 2009|title=Meta-analyses of agreement between diagnoses made from clinical evaluations and standardized diagnostic interviews.|journal=International journal of methods in psychiatric research|volume=18|issue=3|pages=169-84|pmid=19701924}}</ref> | Meta-analysis of data collected across multiple clinical settings, 1995-2006 (n=15,967) | 20% (SDI) 6% (unstructured interview) |Structured or Semi-Structure Diagnostic Interviews and unstructured clinical interviews. |- |Metanalysis of outpatient clinics<ref name=":12">{{Cite journal|last=Rettew|first=David C.|last2=Lynch|first2=Alicia Doyle|last3=Achenbach|first3=Thomas M.|last4=Dumenci|first4=Levent|last5=Ivanova|first5=Masha Y.|date=2009-09|title=Meta-analyses of agreement between diagnoses made from clinical evaluations and standardized diagnostic interviews|url=http://dx.doi.org/10.1002/mpr.289|journal=International Journal of Methods in Psychiatric Research|language=en|volume=18|issue=3|pages=169–184|doi=10.1002/mpr.289|issn=1049-8931}}</ref> |Outpatient clinic |6% (DAU | |- |Metanalysis of outpatient clinics)<ref name=":13">{{Cite journal|last=Rettew|first=David C.|last2=Lynch|first2=Alicia Doyle|last3=Achenbach|first3=Thomas M.|last4=Dumenci|first4=Levent|last5=Ivanova|first5=Masha Y.|date=2009-09|title=Meta-analyses of agreement between diagnoses made from clinical evaluations and standardized diagnostic interviews|url=http://dx.doi.org/10.1002/mpr.289|journal=International Journal of Methods in Psychiatric Research|language=en|volume=18|issue=3|pages=169–184|doi=10.1002/mpr.289|issn=1049-8931}}</ref> |Outpatient clinic |20% (SDI) | |- |Intended to apply to the entire United States <ref name=":3">Kessler, R. C., Avenevoli, S., Costello, E. J., Georgiades, K., Green, J. G., Gruber, M. J., . . . Merikangas, K. R. (2012). Prevalence, persistence, and sociodemographic correlates of DSM-IV disorders in the National Comorbidity Survey Replication Adolescent Supplement. Archives of General Psychiatry, 69(4), 372-380. doi:10.1001/archgenpsychiatry.2011.160</ref> |General Population |9% | |} '''Note:''' WHO-CIDI = World Health Organization Composite International Diagnostic Interview; NCS-A (lifetime prevalence); CAPA= Children and Adolescent Psychiatric Assessment (3-month prevalence); DISC-IV = Diagnostic Interview Schedule for Children, Version 4 (12-month prevalence); ADIS-C/P=Anxiety Disorders Interview Schedule for Children/Parents; SIDP-IV = Structured Interview for DSM-IV Personality; SCID=Structured Clinical Interview for DSM-IV; SDIs included in Rettew et al. (2009): CIDI, DAWBA, DICA, DISC, DIS, MINI, K-SADS-PL, SCAN-2, SCID, SCID-II. * Higher rates of social anxiety disorder are found in females than in males, with more pronounced differences in adolescence. Prevalence rates in children and adolescents are comparable to those in adults. Onset is typically in early adolescence (DSM-5, 2013). ==[[Evidence based assessment/Prediction phase|'''Prediction phase''']]== === Psychometric properties of screening instruments for social anxiety disorder === The following section contains a list of screening and diagnostic instruments for social anxiety disorder. The section includes administration information, psychometric data, and PDFs or links to the screenings. * Screenings are used as part of the [[Evidence based assessment/Prediction phase|prediction phase]] of assessment; for more information on interpretation of this data, or how screenings fit in to the assessment process, click [[Evidence based assessment/Prediction phase|here.]] * ''For a list of more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Psychometric_properties_of_common_screening_instruments '''click here.''']'' {| class="wikitable" |- ! Measure !Format (Reporter) !Age Range !Administration/ Completion Time !Where to Access |- |[https://osf.io/2y3cq Liebowitz Social Anxiety Scale (LSAS)]<ref>{{Cite journal|last=Heimberg|first=R. G.|last2=Horner|first2=K. J.|last3=Juster|first3=H. R.|last4=Safren|first4=S. A.|last5=Brown|first5=E. J.|last6=Schneier|first6=F. R.|last7=Liebowitz|first7=M. R.|date=1999-1|title=Psychometric properties of the Liebowitz Social Anxiety Scale|url=https://www.ncbi.nlm.nih.gov/pubmed/10077308|journal=Psychological Medicine|volume=29|issue=1|pages=199–212|issn=0033-2917|pmid=10077308}}</ref> |Questionnaire (clinician administered, self-report) |7 years-adult |15 minutes | *[http://nationalsocialanxietycenter.com/liebowitz-sa-scale/ Online questionnaire with scoring] *[https://osf.io/2y3cq Printable PDF] |- |[https://osf.io/svn9x Social Phobia Inventory (SPIN)]<ref>{{Cite journal|last=Connor|first=Kathryn M.|last2=Davidson|first2=Jonathan R. T.|last3=Churchill|first3=L. Erik|last4=Sherwood|first4=Andrew|last5=Weisler|first5=Richard H.|last6=Foa|first6=Edna|date=2000/04|title=Psychometric properties of the Social Phobia Inventory (SPIN): New self-rating scale|url=https://www.cambridge.org/core/journals/the-british-journal-of-psychiatry/article/psychometric-properties-of-the-social-phobia-inventory-spin/9E4A3EE20D2B1A6C222CDB5807AC086A|journal=The British Journal of Psychiatry|language=en|volume=176|issue=4|pages=379–386|doi=10.1192/bjp.176.4.379|issn=0007-1250}}</ref> |Questionnaire (self-report) |12 years-adult |5-10 minutes | * [https://joyable.com/spin_snapshots/new Online questionnaire with scoring] * [https://psychology-tools.com/spin/ Online questionnaire with scoring] * [https://osf.io/svn9x Printable PDF] |- |Social Phobia and Anxiety Inventory (SPAI)<ref>{{Cite journal|last=Garcia-Lopez|first=Luis Joaquin|last2=Hidalgo|first2=Maria D.|last3=Beidel|first3=Deborah C.|last4=Olivares|first4=Jose|last5=Turner†|first5=Samuel|date=2008-01-01|title=Brief Form of the Social Phobia and Anxiety Inventory (SPAI-B) for Adolescents|url=http://dx.doi.org/10.1027/1015-5759.14.3.150|journal=European Journal of Psychological Assessment|volume=24|issue=3|pages=150–156|doi=10.1027/1015-5759.14.3.150|issn=1015-5759}}</ref> *not free |Questionnaire (self-report) |14 years-adult |20-30 minutes |Purchase [https://shop.acer.org/social-phobia-and-anxiety-inventory-spai.html here] |- | colspan="5" style="font-size:110%; text-align:center;" |'''For Children and Adolescents Specifically''' |- |- |[https://osf.io/s3fu2 Revised Children’s Anxiety and Depression Scale (RCADS)] |Questionnaire (Child) |6-18 years |12 minutes | *[http://www.corc.uk.net/outcome-experience-measures/revised-childrens-anxiety-and-depression-scale-and-subscales/ RCADS homepage] '''PDFs for RCADS''' * [https://osf.io/s3fu2 RCADS Child Self-reported (6-18 years)] * [https://mfr.osf.io/render?url=https://osf.io/fp9mk/?action=download%26mode=render RCADS Parent-reported] *[https://mfr.osf.io/render?url=https://osf.io/vy7ta/?action=download%26mode=render Child Scoring Aid] *[https://mfr.osf.io/render?url=https://osf.io/t4bz6/?action=download%26mode=render Parent Scoring Aid] '''Subscales''' *[https://mfr.osf.io/render?url=https://osf.io/ectpf/?action=download%26mode=render Social Anxiety Self-reported] *[https://mfr.osf.io/render?url=https://osf.io/pu6rn/?action=download%26mode=render Social Anxiety Parent-reported] '''Translations''' * [https://mfr.osf.io/render?url=https://osf.io/qsjh9/?action=download%26mode=render User Guide] |- |Social Phobia and Anxiety Inventory for Children (SPAIC) *not free |Questionnaire |8-14 years |20-30 minutes |Purchase [https://eprovide.mapi-trust.org/instruments/social-phobia-and-anxiety-inventory-for-children#coas_member_access_content here] |} '''Note:''' Reliability and validity are included in the extended version [[Evidence-based assessment/Social anxiety disorder (disorder portfolio)/extended version|here]]. This table includes measures with Good or Excellent ratings. === Likelihood ratios and AUCs of screening measures for social anxiety disorder === * ''For a list of the likelihood ratios for more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Likelihood_ratios_and_AUCs_of_common_screening_instruments '''click here.''']'' {| class="wikitable sortable" border="1" |- ! Screening Measure (Primary Reference) ! AUC (Sample Size) ! DiLR+ (Score) ! DiLR- (Score) !Clinical Generalizability !Where to Access |- |Liebowitz Social Anxiety Scale (LSAS) <ref>{{cite journal|last1=Liebowitz|first1=MR|title=Social phobia.|journal=Modern problems of pharmacopsychiatry|date=1987|volume=22|pages=141-73|pmid=2885745}}</ref> <ref>{{cite journal|last1=Mennin|first1=DS|last2=Fresco|first2=DM|last3=Heimberg|first3=RG|last4=Schneier|first4=FR|last5=Davies|first5=SO|last6=Liebowitz|first6=MR|date=2002|title=Screening for social anxiety disorder in the clinical setting: using the Liebowitz Social Anxiety Scale.|journal=Journal of anxiety disorders|volume=16|issue=6|pages=661-73|pmid=12405524}}</ref> and <ref>{{cite journal|last1=Santos|first1=LF|last2=Loureiro|first2=SR|last3=Crippa|first3=JA|last4=Osório|first4=FL|date=2015|title=Can the Liebowitz Social Anxiety Scale - self-report version be used to differentiate clinical and non-clinical SAD groups among Brazilians?|journal=PloS one|volume=10|issue=3|pages=e0121437|pmid=25811489}}</ref> | 0.94 - differentiating from subclinical patients 0.98 - differentiating from healthy controls | Not reported | Not reported | |[https://osf.io/2y3cq Printable PDF] |- |Overall Anxiety Severity And Impairment Scale (OASIS)<ref>{{Cite journal|last=Campbell-Sills|first=Laura|last2=Norman|first2=Sonya B.|last3=Craske|first3=Michelle G.|last4=Sullivan|first4=Greer|last5=Lang|first5=Ariel J.|last6=Chavira|first6=Denise A.|last7=Bystritsky|first7=Alexander|last8=Sherbourne|first8=Cathy|last9=Roy-Byrne|first9=Peter|date=2009-1|title=Validation of a Brief Measure of Anxiety-Related Severity and Impairment: The Overall Anxiety Severity and Impairment Scale (OASIS)|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2629402/|journal=Journal of affective disorders|volume=112|issue=1-3|pages=92–101|doi=10.1016/j.jad.2008.03.014|issn=0165-0327|pmc=PMC2629402|pmid=18486238}}</ref> |.87<ref name=":0">{{Cite journal|last=Campbell-Sills|first=Laura|last2=Norman|first2=Sonya B.|last3=Craske|first3=Michelle G.|last4=Sullivan|first4=Greer|last5=Lang|first5=Ariel J.|last6=Chavira|first6=Denise A.|last7=Bystritsky|first7=Alexander|last8=Sherbourne|first8=Cathy|last9=Roy-Byrne|first9=Peter|date=2009-1|title=Validation of a Brief Measure of Anxiety-Related Severity and Impairment: The Overall Anxiety Severity and Impairment Scale (OASIS)|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2629402/|journal=Journal of affective disorders|volume=112|issue=1-3|pages=92–101|doi=10.1016/j.jad.2008.03.014|issn=0165-0327|pmc=PMC2629402|pmid=18486238}}</ref> |3.07 (> or = cut score 8) {| class="wikitable sortable" border="1" |Cut-score of ≥ 8 to be optimal given that it successfully classified 87% of the sample with the most favorable balance of sensitivity (89%) and specificity (71%) |} <ref name=":0" /> |Not reported |Unknown<ref name=":0" /> |[https://osf.io/bkvj2 Printable PDF] |- |Social Phobia and Anxiety Inventory for Children (SPAI-C) <br> (Beidel, Turner, & Morris, 1995) <ref>{{cite journal|last1=Inderbitzen-Nolan|first1=H|last2=Davies|first2=CA|last3=McKeon|first3=ND|date=2004|title=Investigating the construct validity of the SPAI-C: comparing the sensitivity and specificity of the SPAI-C and the SAS-A.|journal=Journal of anxiety disorders|volume=18|issue=4|pages=547-60|pmid=15149713}}</ref> and <ref>{{cite journal|last1=Viana|first1=AG|last2=Rabian|first2=B|last3=Beidel|first3=DC|date=June 2008|title=Self-report measures in the study of comorbidity in children and adolescents with social phobia: research and clinical utility.|journal=Journal of anxiety disorders|volume=22|issue=5|pages=781-92|pmid=17888622}}</ref> |.65 (n=172) |3.55 (18+) |.47 | |Purchase [https://shop.acer.org/spai-quickscore-form-pkg-25.html here] |- |Screen for Child Anxiety and Related Emotional Disorders (SCARED)<br><ref>{{cite journal|last1=Birmaher|first1=B|last2=Khetarpal|first2=S|last3=Brent|first3=D|last4=Cully|first4=M|last5=Balach|first5=L|last6=Kaufman|first6=J|last7=Neer|first7=SM|title=The Screen for Child Anxiety Related Emotional Disorders (SCARED): scale construction and psychometric characteristics.|journal=Journal of the American Academy of Child and Adolescent Psychiatry|date=April 1997|volume=36|issue=4|pages=545-53|pmid=9100430}}</ref><ref>{{cite journal|last1=Desousa|first1=DA|last2=Salum|first2=GA|last3=Isolan|first3=LR|last4=Manfro|first4=GG|date=June 2013|title=Sensitivity and specificity of the Screen for Child Anxiety Related Emotional Disorders (SCARED): a community-based study.|journal=Child psychiatry and human development|volume=44|issue=3|pages=391-9|pmid=22961135}}</ref> |.72 (n=119) |1.9 (27+) |.50 | |Printable [https://osf.io/z4da3 PDF] |- |} {{collapse top| Notes about the above table|expand=yes}} * '''Note:''' All studies used some version of ADIS-C, K-SADS or CAS administered by trained raters. “LR+” refers to the change in likelihood ratio associated with a positive test score, and “LR-” is the likelihood ratio for a low score. Likelihood ratios of 1 indicate that the test result did not change impressions at all. LRs larger than 10 or smaller than .10 are frequently clinically decisive; 5 or .20 are helpful, and between 2.0 and .5 are small enough that they rarely result in clinically meaningful changes of formulation (Sackett et al., 2000). AUC guidelines according to Swets and Pickett (1982)<ref>{{cite journal|last1=Song|first1=HH|title=Analysis of correlated ROC areas in diagnostic testing.|journal=Biometrics|date=March 1997|volume=53|issue=1|pages=370-82|pmid=9147602}}</ref>: .50 to .70 (low accuracy), .70 to .90 (moderate accuracy), and greater than .90 (high accuracy). * '''Note:''' Silverman & Ollendick (2005)<ref>{{cite journal|last1=Silverman|first1=WK|last2=Ollendick|first2=TH|title=Evidence-based assessment of anxiety and its disorders in children and adolescents.|journal=Journal of clinical child and adolescent psychology : the official journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 53|date=September 2005|volume=34|issue=3|pages=380-411|pmid=16026211}}</ref> suggest that the SPAI-C is the better instrument for identifying those children and adolescents who most likely meet DSM-IV criteria for social phobia, but that this measure may miss some adolescents who would meet criteria for social phobia. Child and Adolescent Social Anxiety Disorder Jacqueline Nesi 7 Although the MASC has evidence to support it, the current evidence only applies to screening for GAD in girls and anxiety comorbidities (p.404). Thus, for both of these measures, another assessment method is to be used as well, such as an interview schedule (pp 401-5). The SCARED, MASC, and FSSC-R may be helpful to discriminate between youth with social phobia versus other anxiety disorders (p. 404). {{collapse bottom}} === Interpreting social anxiety disorder screening measure scores === * For information on interpreting screening measure scores, click [[Evidence based assessment/Prediction phase#Interpreting screening measure scores|here.]] * Also see the page on [https://en.wikipedia.org/wiki/Likelihood_ratios_in_diagnostic_testing likelihood ratios in diagnostic testing] for more information ==[[Evidence based assessment/Prescription phase|'''Prescription phase''']]== ===Gold standard diagnostic interviews=== * For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews click here.] ===Recommended diagnostic interviews for social anxiety disorder=== {| class="wikitable sortable" border="1" ! colspan="5" |Diagnostic instruments for social anxiety disorder |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time !Where to Access |- | Anxiety Disorders Interview Schedule (ADIS)<ref>{{Cite journal|date=2018-06|editor-last=Hunsley|editor-first=John|editor2-last=Mash|editor2-first=Eric J.|title=A Guide to Assessments That Work|url=http://dx.doi.org/10.1093/med-psych/9780190492243.001.0001|journal=Oxford Clinical Psychology|doi=10.1093/med-psych/9780190492243.001.0001}}</ref> | Interview (clinician) | 7 years-adult | 90 minutes |Purchase [https://global.oup.com/academic/product/anxiety-and-related-disorders-interview-schedule-for-dsm-5-adis-5---adult-version-9780199325160?cc=gb&lang=en& here] |- |Structured Clinical Interview for DSM (SCID)<ref>{{Cite journal|date=2018-06|editor-last=Hunsley|editor-first=John|editor2-last=Mash|editor2-first=Eric J.|title=A Guide to Assessments That Work|url=http://dx.doi.org/10.1093/med-psych/9780190492243.001.0001|journal=Oxford Clinical Psychology|doi=10.1093/med-psych/9780190492243.001.0001}}</ref> |Semi-structured Interview |Adults (Ages 18+) |1-2 hours | -Available for purchase from [https://www.appi.org/products/structured-clinical-interview-for-dsm-5-scid-5 APA Publishing] (Note: Not free) |} '''Note:''' Reliability and validity are included in the extended version [[Evidence-based assessment/Social anxiety disorder (disorder portfolio)/extended version|here]]. This table includes measures with Good or Excellent ratings. ==[[Evidence based assessment/Process phase|'''Process phase''']]== The following section contains a brief overview of treatment options for social anxiety disorder and list of process and outcome measures for social anxiety disorder. The section includes benchmarks based on published norms for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the [[Evidence based assessment/Process phase|process phase]] of assessment. For more information of differences between process and outcome measures, see the page on the [[Evidence based assessment/Process phase|process phase of assessment]]. === Process measures === === Outcome and severity measures === This table includes clinically significant benchmarks for social anxiety disorder specific outcome measures * Information on how to interpret this table can be [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase '''found here''']. * Additionally, these [[Evidence based assessment/Vignettes|'''vignettes''']] might be helpful resources for understanding appropriate adaptation of outcome measures in practice. *''<u>For clinically significant change benchmarks for the CBCL, YSR, and TRF total, externalizing, internalizing, and attention benchmarks,</u>'' [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase&wteswitched=1#Clinically_significant_change_benchmarks_for_widely-used_outcome_measures '''see here.'''] {| class="wikitable sortable" border="1" |- | colspan="8" style="font-size:110%; text-align:center;" span |'''Benchmarks Based on Non-Referred Sample of Adolescents (Anderson et al., 2009)''' |- | rowspan="2" style="text-align:center;font-size:130%;" | <b> Measure</b> | rowspan="2" style="text-align:center;font-size:130%;" | <b> Subscale</b> | colspan="3" style="text-align:center;font-size:130%" width="300" | <b> Cut-off scores</b> | colspan="3" style="text-align:center;font-size:120%" | <b> Critical Change <br> (unstandardized scores)</b> |- | style="text-align:center;font-size:110%" | <b> A</b> | style="text-align:center;font-size:110%" |<b> B</b> | style="text-align:center;font-size:110%" |<b> C</b> | style="text-align:center;font-size:110%" |<b> 95%</b> | style="text-align:center;font-size:110%" |<b> 90%</b> | style="text-align:center;font-size:110%" |<b> SE_difference</b> |- | rowspan="2" style="text-align:center;" |'''MASC (2009)''' | style="text-align:center;" |<i> Total</i> | style="text-align:center;" | 15.9 | style="text-align:center;" | 63.8 | style="text-align:center;" | 38.9 | style="text-align:center;" | 11.9 | style="text-align:center;" | 10.0 | style="text-align:center;" | 6.1 |- | style="text-align:center;" |<i> Social Anxiety Scale</i> | style="text-align:center;" | 3.5 | style="text-align:center;" | 19.9 | style="text-align:center;" | 11.8 | style="text-align:center;" | 7.8 | style="text-align:center;" | 6.6 | style="text-align:center;" | 4.0 |- | rowspan="1" style="text-align:center;" |'''SPAI-C (2009)''' | style="text-align:center;" | <i> Total</i> | style="text-align:center;" | 3.3 | style="text-align:center;" | 26.6 | style="text-align:center;" | 15.9 | style="text-align:center;" | 7.5 | style="text-align:center;" | 6.3 | style="text-align:center;" | 3.8 |- |} {| class="wikitable sortable" border="1" |- | colspan="8" style="font-size:110%; text-align:center;" span |'''Benchmarks Based on Published Norms''' |- | rowspan="2" |<b> <big>Measure</big></b> | rowspan="2" |<b> <big>Subscale</big></b> | colspan="3" |<b> <big>Cut-off scores</big></b> | colspan="3" |<b> <big>Critical Change <br> (unstandardized scores)</big></b> |- |<b> <big>A</big></b> |<b> <big>B</big></b> |<b> <big>C</big></b> |<b> <big>95%</big></b> |<b> <big>90%</big></b> |<b> <big>SE_difference</big></b> |- | rowspan="2" style="text-align:center;" |'''CBCL T-Scores (2001 Norms)''' | style="text-align:center;" |<i> Total</i> | style="text-align:center;" | 49 | style="text-align:center;" | 70 | style="text-align:center;" | 58 | style="text-align:center;" | 5 | style="text-align:center;" | 4 | style="text-align:center;" | 2.4 |- | style="text-align:center;" |<i> Internalizing</i> | style="text-align:center;" | n/a | style="text-align:center;" | 70 | style="text-align:center;" | 56 | style="text-align:center;" | 9 | style="text-align:center;" | 7 | style="text-align:center;" | 4.5 |- | rowspan="2" style="text-align:center;" |'''TRF T-Scores (2001 Norms)''' | style="text-align:center;" |<i> Total</i> | style="text-align:center;" | n/a | style="text-align:center;" | 70 | style="text-align:center;" | 57 | style="text-align:center;" | 5 | style="text-align:center;" | 4 | style="text-align:center;" | 2.3 |- | style="text-align:center;" |<i> Internalizing</i> | style="text-align:center;" | n/a | style="text-align:center;" | 70 | style="text-align:center;" | 55 | style="text-align:center;" | 9 | style="text-align:center;" | 7 | style="text-align:center;" | 4.4 |- | rowspan="2" style="text-align:center;" |'''YSR T-Scores (2001 Norms)''' | style="text-align:center;" |<i> Total</i> | style="text-align:center;" | n/a | style="text-align:center;" | 70 | style="text-align:center;" | 54 | style="text-align:center;" | 7 | style="text-align:center;" | 6 | style="text-align:center;" | 3.3 |- | style="text-align:center;" |<i> Internalizing</i> | style="text-align:center;" | n/a | style="text-align:center;" | 70 | style="text-align:center;" | 54 | style="text-align:center;" | 9 | style="text-align:center;" | 8 | style="text-align:center;" | 4.8 |} '''<big>Note:</big>''' '''''A''''' = Away from the clinical range; '''''B'''''= Back into the nonclinical range; and '''''C''''' = Closer to the nonclinical than clinical mean. === Treatment === {{collapse top| Information on therapy for social anxiety|expand=yes}} According to ''Effective Child Therapy,'' no “Well-Established” treatments have been empirically validated for Social Phobia. * However, group Cognitive Behavioral Therapy, or Group CBT, for Anxiety has been identified as “Probably Efficacious” in treating Social Phobia. *According to Effective Child Therapy, the “Probably Efficacious” distinction marks a treatment as having “strong research support” but lacking the criteria that at least two large-scale randomized controlled trials have been conducted by “independent investigatory teams working at different research settings.” This prevents the treatment from moving into the “Well-Established” group. *Currently, however, CBT is identified as the most promising treatment for childhood and adolescent social phobia. '''Cognitive Behavioral Therapy''' * ''Effective Child Therapy'' identifies the following core components of CBT for anxious youth, including those with Social Phobia: Emotions Education and Relaxation. * Parents and child are taught about the interrelated physiological, cognitive, and behavioral components of anxiety. * Activities help demonstrate different emotions, body postures, and cognitive and physiological correlates. Progressive relaxation training helps anxious children develop awareness and control over their own physiological and muscular responses to anxiety. '''Cognitive restructuring''' * Cognitive restructuring helps children identify and replace distorted cognitions with more adaptive beliefs. * Basic cognitive strategies include identifying and reducing negative self-talk, generating positive self-statements, thought stopping, thought challenging (weighing evidence for and against), testing both dysfunctional and adaptive beliefs, and creating a coping plan for feared situations. '''Imaginal and in-vivo exposure''' * The goals of exposures are to encourage approach behavior by positioning the child in a previously feared or challenging situation. * The child attempts to complete tasks in a graded "fear hierarchy" such that the child experiences early success before attempting greater challenges. * During individual exposures, a child is encouraged to use any number of coping skills, including relaxation exercises, coping thoughts (challenging anxious thoughts with more positive, realistic thoughts), concrete problem-solving, or rehearsal of desirable skills. '''Parent Interventions''' * Parents may have their own preconceptions about the threatening nature of anxiety and they may not know how best to encourage a child to cope with anxiety. * CBT provides parents education about the risks of continued avoidance and guidance in managing their own anxiety * CBT may also impart basic parenting strategies (e.g., positive/negative reinforcement, planned ignoring, modeling, reward planning) to facilitate the practice of therapy skills in the home. Sources: Effective Child Therapy page on [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/fear-worry-and-anxiety/ Fear, Worry & Anxiety] {{collapse bottom}}Please refer to the Wikipedia page on [[wikipedia:Social_anxiety|Social Anxiety Disorder]] for more information on available treatment for social anxiety or go to [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/fear-worry-and-anxiety/ Effective Child Therapy] for a curated resource on effective treatments for anxiety disorders. *For information on conducting Exposure Therapy for anxiety disordered youth, see [https://www.bravepracticeforkids.com/ www.BravePracticeForKids.com] =='''External resources'''== # [http://apps.who.int/classifications/icd10/browse/2010/en#/F40 ICD-10 diagnostic criteria] # [https://en.wikiversity.org/w/index.php?title=Helping_Give_Away_Psychological_Science/Resources/Annotated_List_of_Where_and_How_to_Find_a_Therapist Find-a-Therapist] #* A curated list of find-a-therapist websites where you can find a provider # [https://www.nimh.nih.gov/health/topics/anxiety-disorders/index.shtml NIMH] #* Go to this resource for more information on anxiety disorders # OMIM (Online Mendelian Inheritance in Man) #* [http://omim.org/entry/607834?search=anxiety&highlight=anxiety Entry for anxiety] # [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/fear-worry-and-anxiety/ Effective Child Therapy page for '''Fear, Worry, & Anxiety'''] #* Effective Child Therapy is website sponsored by Division 53 of the American Psychological Association (APA), or The Society for Clinical Child and Adolescent Psychology (SCCAP), in collaboration with the Association for Behavioral and Cognitive Therapies (ABCT). Use for information on symptoms and available treatments. # [https://sccap53.org Society of Clinical Child and Adolescent Psychology] # [https://mfr.osf.io/render?url=https://osf.io/t7b4d/?action=download%26mode=render Behavioral Health Virtual Resource] #* This resource has free PDFs of anxiety screenings, as well as information on diagnosing and treating different anxiety disorders # [https://www.abctcentral.org/eStore/ www.abctcentral.org]  #* This is a website sponsored by the Association for Behavioral and Cognitive Therapies. #* Use the “Find a Therapist” option to search for local therapists using CBT, an effective treatment for Social Anxiety. #[https://www.bravepracticeforkids.com/ '''www.BravePracticeForKids.com'''] #*This website, created by Dr. Emily Becker-Haimes at the University of Pennsylvania, has information on conducting [[wikipedia:Exposure_therapy|Exposure Therapy]] for anxiety disordered youth. =='''References'''== {{collapse top|References|expand=yes}} {{Reflist|30em}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] {{collapse bottom}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] 8z5de6j1ho206g99jaa5kgj58721cgm 0 207111 2419226 2413393 2022-08-26T03:07:47Z Ardenguo 2944162 /* References */ Made the references box expanded by default wikitext text/x-wiki <noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{medical disclaimer}} {{:{{BASEPAGENAME}}/Sidebar}} ==[[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio"?''']]== For background information on what assessment portfolios are, click the link in the heading above. Want even 'more' information about this topic? There's an extended version of this page [[Evidence-based assessment/Schizophrenia (disorder portfolio)/extended version|here]]. == [[Evidence based assessment/Preparation phase|'''Preparation phase''']] == === Diagnostic Criteria for Schizophrenia === {{blockquotetop}} <big>'''ICD-11 Diagnostic Criteria'''</big> *<big>'''Schizophrenia'''</big> **Schizophrenia is characterized by disturbances in multiple mental modalities, including thinking (e.g., delusions, disorganization in the form of thought), perception (e.g., hallucinations), self-experience (e.g., the experience that one's feelings, impulses, thoughts, or behaviour are under the control of an external force), cognition (e.g., impaired attention, verbal memory, and social cognition), volition (e.g., loss of motivation), affect (e.g., blunted emotional expression), and behaviour (e.g.,behaviour that appears bizarre or purposeless, unpredictable or inappropriate emotional responses that interfere with the organization of behaviour). Psychomotor disturbances, including catatonia, may be present. Persistent delusions, persistent hallucinations, thought disorder, and experiences of influence, passivity, or control are considered core symptoms. Symptoms must have persisted for at least one month in order for a diagnosis of schizophrenia to be assigned. The symptoms are not a manifestation of another health condition (e.g., a brain tumour) and are not due to the effect of a substance or medication on the central nervous system (e.g., corticosteroids), including withdrawal (e.g., alcohol withdrawal). *<big>'''Schizophrenia, First Episode'''</big> **Schizophrenia, first episode should be used to identify individuals experiencing symptoms that meet the diagnostic requirements for Schizophrenia (including duration) but who have never before experienced an episode during which diagnostic requirements for Schizophrenia were met. ***Note: The ICD-11 lists 3 additional subcategories of schizophrenia, first episode. They can be found [https://icd.who.int/browse11/l-m/en#/http%3a%2f%2fid.who.int%2ficd%2fentity%2f625636921 here]. *<big>'''Schizophrenia, Multiple Episodes'''</big> **Schizophrenia, multiple episode should be used to identify individuals experiencing symptoms that meet the diagnostic requirements for Schizophrenia (including duration) and who have also previously experienced episodes during which diagnostic requirements were met, with substantial remission of symptoms between episodes. Some attenuated symptoms may remain during periods of remission, and remissions may have occurred in response to medication or other treatment. ***Note: The ICD-11 lists 3 additional subcategories of schizophrenia, multiple episodes. They can be found [https://icd.who.int/browse11/l-m/en#/http%3a%2f%2fid.who.int%2ficd%2fentity%2f1150025154 here]. '''Changes in DSM-5''' The diagnostic criteria for schizophrenia spectrum and other psychotic disorders changed slightly from DSM-IV to DSM-5. A summary is available [https://en.wikipedia.org/wiki/DSM-5#Section_II:_diagnostic_criteria_and_codes here]. {{blockquotebottom}} === Base rates of schizophrenia in different populations and clinical settings === {| class="wikitable sortable" |- ! Demography ! Setting !! Base Rate !! Diagnostic Method |- | 48 contiguous US states | Non-institutionalized civilians<ref name="KesslerEtAl1994" /> || 0.5% || CIDI, SCID |- | Urban settings in 5 states (MD, NC, CN, CA, MO) | Community sample<ref name="RobinsRegiers1991" /> || 1.3% || DIS |- | All Federal Penitentiaries in Quebec-incarcerated and inmates currently hospitalized involuntarily | Inmates with severe mental disorders<ref name="DumaisEtAl2010" /> || 23.5% incarcerated†, 69.7% hospitalized involuntarily† || SCID |- || New Jersey | Patients presenting for inpatient and ambulatory services<ref name="MinskyEtAl2003" /> || *African-American (males – 19.1%, females – 11.3%) *Latino (males – 9.4%, females – 6.2%) *European-American (males – 9.9%, females – 6.1%) * (Rates are for all psychotic disorders – authors note this was “mostly schizophrenia”) | BASIC-32 |- | Global – 44 countries | General population (community, inpatient, and outpatient)<ref>{{Cite journal|last=Saha|first=Sukanta|last2=Chant|first2=David|last3=Welham|first3=Joy|last4=McGrath|first4=John|date=May 2005|title=A systematic review of the prevalence of schizophrenia|url=https://www.ncbi.nlm.nih.gov/pubmed/15916472|journal=PLoS medicine|volume=2|issue=5|pages=e141|doi=10.1371/journal.pmed.0020141|issn=1549-1676|pmc=PMC1140952|pmid=15916472}}</ref> ||0.7% || Clinical interview |- | Finland | General population<ref>{{Cite journal|last=Perälä|first=Jonna|last2=Suvisaari|first2=Jaana|last3=Saarni|first3=Samuli I.|last4=Kuoppasalmi|first4=Kimmo|last5=Isometsä|first5=Erkki|last6=Pirkola|first6=Sami|last7=Partonen|first7=Timo|last8=Tuulio-Henriksson|first8=Annamari|last9=Hintikka|first9=Jukka|date=January 2007|title=Lifetime prevalence of psychotic and bipolar I disorders in a general population|url=https://www.ncbi.nlm.nih.gov/pubmed/17199051|journal=Archives of General Psychiatry|volume=64|issue=1|pages=19–28|doi=10.1001/archpsyc.64.1.19|issn=0003-990X|pmid=17199051}}</ref> || 0.87% || CIDI, SCID |- | San Diego County | County Mental Health Service Users<ref name="FolsomEtAl2005" /> || 54% - homeless individuals || Chart Diagnosis |- || Maryland | Inpatient service<ref>{{Cite journal|last=Brown|first=Samuel L.|date=2001-06-01|title=Variations in Utilization and Cost of Inpatient Psychiatric Services Among Adults in Maryland|url=https://ps.psychiatryonline.org/doi/abs/10.1176/appi.ps.52.6.841|journal=Psychiatric Services|volume=52|issue=6|pages=841–843|doi=10.1176/appi.ps.52.6.841|issn=1075-2730}}</ref> || *39% - non-homeless *8.4% - 65 years and up *17% - 19-64 years || Psychiatrist Diagnosis |- | USA (Note: Medicaid rate was calculated using California Medi-Cal rates as a proxy) | Insurance claimants in 2002<ref name="WuEtAl2006" /> || Medicaid – 1.66%, Uninsured – 1.02%, Medicare – 0.83%, Privately insured – 0.13%, Veterans (through VA) – 1.41% || Physician diagnosis |} †Rates reflect schizophrenia spectrum disorders. '''Note:''' DIS = Diagnostic Interview Schedule, CIDI = Composite International Diagnostic Interview, SCID = Structured Diagnostic Interview for DSM, BASIC-32 = Behavior and Symptoms Identification Scale '''Search terms:''' [Schizophrenia] AND [prevalence OR incidence], [Schizophrenia] AND [Prevalence] AND [Outpatient OR inpatient] in PsycINFO, Medline, and PubMed ==[[Evidence based assessment/Prediction phase|'''Prediction phase''']]== ===Recommended screening instruments === The following section contains a list of screening and diagnostic instruments for schizophrenia. {| class="wikitable" |+ !Screening Instrument !Format !Age Range !Administration Time !Where to Access |- |Structured Interview for Psychosis-Risk Syndrome (SIPS) <ref name=":0">{{Cite book|url=https://www.worldcat.org/oclc/897376853|title=The assessment of psychosis : a reference book and rating scales for research and practice|author=Waters, Flavie |author2=Stephane, Massoud|isbn=9781315885605|location=New York, NY|oclc=897376853}}</ref> |Structured interview by a clinician or experienced rater |Pre-clinical adolescents and adults |2-3 hours | -Available from PRIME clinic at Yale University, contact Dr. Barbara Walsh at 203-974-7052 -[http://www.easacommunity.org/PDF/SIPS_5-5_032514&#x5B;1&#x5D;%20correct.pdf PDF Version] |- |Bonn Scale for the Assessment of Basic Symptoms (BSABS)<ref name=":0" /> |Semi-structured interview by a clinician or experienced rater |Pre-clinical, residual, and at-risk adolescents and adults |2-3 hours | -Available from [https://www.amazon.com/BSABS-Scale-Assessment-Basic-Symptoms/dp/3832271732 Amazon] -Available from publisher [https://www.shaker.de/de/index.asp?lang=de Shaker Verlag] |- | colspan="5" style="font-size:110%; text-align:center;" |'''For Children and Adolescents Specifically''' |- |Strengths and Difficulties Questionnaire (SDQ) <ref>{{Cite journal|last=Goodman|first=Robert|last2=Ford|first2=Tamsin|last3=Simmons|first3=Helen|last4=Gatward|first4=Rebecca|last5=Meltzer|first5=Howart|date=2000-12|title=Using the Strengths and Difficulties Questionnaire (SDQ) to screen for child psychiatric disorders in a community sample|url=https://www.cambridge.org/core/product/identifier/S0007125000156065/type/journal_article|journal=British Journal of Psychiatry|language=en|volume=177|issue=6|pages=534–539|doi=10.1192/bjp.177.6.534|issn=0007-1250}}</ref> |Parent/teacher-report, self-report, rate items |Ages 2+ |5-25 minutes | -Available from [https://www.sdqinfo.org/py/sdqinfo/b3.py?language=Englishqz(USA) Youth In Mind] -[https://osf.io/dzk68/?view_only=681e9b648169427b845f313aafa0a169 PDF Version] |} === Likelihood ratios and AUCs of screening measures for schizophrenia === * '''''For a list of the likelihood ratios for more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Likelihood_ratios_and_AUCs_of_common_screening_instruments click here.]''''' {| class="wikitable" |- ! scope="col" style="width: 225px;" | Screening Measure (Primary Reference) ! scope="col" style="width: 100px;" | AUC ! scope="col" style="width: 100px;" | LR+ (Score) ! scope="col" style="width: 100px;" | LR- (Score) ! scope="col" style="width: 225px;"| Clinical generalizability !Where to Access |- | Psychiatric Diagnostic Screening Questionnaire – PDSQ (Zimmerman & Mattia, 2001a; Zimmerman & Sheeran, 2004)<ref name=ZimmermanMattia2001/><ref>{{Cite journal|last=Zimmerman|first=Mark|last2=Sheeran|first2=Thomas|date=2003-03|title=Screening for principal versus comorbid conditions in psychiatric outpatients with the Psychiatric Diagnostic Screening Questionnaire|url=https://pubmed.ncbi.nlm.nih.gov/12674730|journal=Psychological Assessment|volume=15|issue=1|pages=110–114|doi=10.1037/1040-3590.15.1.110|issn=1040-3590|pmid=12674730}}</ref>‡ || .92 (N = 799) || 2.7 (Subscale cutoff score = 1) || .33 (Subscale cutoff score = 1) || Low – can distinguish psychotic disorders from non-psychotic disorders but cannot distinguish schizophrenia from other psychotic disorders (ex: MDD with psychosis) |Not free |- | Structured Interview for Prodromal Syndromes – SIPS (Miller et al., 1999, 2003)<ref name=MillerEtAl1999/> <ref>{{Cite journal|last=Miller|first=Tandy J.|last2=McGlashan|first2=Thomas H.|last3=Rosen|first3=Joanna L.|last4=Cadenhead|first4=Kristen|last5=Cannon|first5=Tyrone|last6=Ventura|first6=Joseph|last7=McFarlane|first7=William|last8=Perkins|first8=Diana O.|last9=Pearlson|first9=Godfrey D.|date=2003|title=Prodromal assessment with the structured interview for prodromal syndromes and the scale of prodromal symptoms: predictive validity, interrater reliability, and training to reliability|url=https://pubmed.ncbi.nlm.nih.gov/14989408|journal=Schizophrenia Bulletin|volume=29|issue=4|pages=703–715|doi=10.1093/oxfordjournals.schbul.a007040|issn=0586-7614|pmid=14989408}}</ref>|| Not given (N = 34) || 3.5 (not given) || 0 (not given) || Moderate – has some predictive validity (46% of those identified as prodromal by the SIPS developed schizophrenia psychosis within 6 mo.) |[https://mfr.osf.io/render?url=https://osf.io/scxyh/?action=download%26mode=render SIPS] |- | Bonn Scale for the Assessment of basic Symptoms – BSABS (Gross, 1989; Klosterkotter, Hellmich, Steinmeyer, Schultze-Lutter, 2001)<ref name=Gross1989/><ref>{{Cite journal|last=Klosterkötter|first=J.|last2=Hellmich|first2=M.|last3=Steinmeyer|first3=E. M.|last4=Schultze-Lutter|first4=F.|date=2001-02|title=Diagnosing schizophrenia in the initial prodromal phase|url=https://pubmed.ncbi.nlm.nih.gov/11177117|journal=Archives of General Psychiatry|volume=58|issue=2|pages=158–164|doi=10.1001/archpsyc.58.2.158|issn=0003-990X|pmid=11177117}}</ref>• *Cluster 1 = thought, language, perception, and motor disturbances *Cluster 2 = impaired bodily sensations *Cluster 3 = impaired tolerance to normal stress *Cluster 4 = disorders of emotion and affect including impaired thought, energy, concentration, and memory *Cluster 5 = increased emotional reactivity, impaired ability to maintain or initiate social contacts, and disturbances in nonverbal expression || (N = 160) *C1 = 0.81 *C2 = 0.50 *C3 = 0.52 *C4 = 0.57 *C5 = 0.58 || Overall = 2.4 (>=1) *C1 = 3.1 *C2 = 0.48 *C3 = 0.97 *C4 = 1.1 *C5 = 1.4 (*) || Overall = 0.03 (>=1) *C1 = 0.52 *C2 = 1.0 *C3 = 0.77 *C4 = 0.5 *C5 = 0.70 (*) || Moderate - has some predictive validity for individuals who are in prodromal period of schizophrenia overall, cluster 1 has best predictive accuracy and may be most useful. |Available from [https://www.amazon.com/BSABS-Scale-Assessment-Basic-Symptoms/dp/3832271732 Amazon] Available from publisher [https://www.shaker.de/de/index.asp?lang=de Shaker Verlag] |- |Symptom Severity Scale of the DSM5<ref>{{Cite journal|last=Ritsner|first=Michael S.|last2=Mar|first2=Maria|last3=Arbitman|first3=Marina|last4=Grinshpoon|first4=Alexander|date=2013-06-30|title=Symptom severity scale of the DSM5 for schizophrenia, and other psychotic disorders: diagnostic validity and clinical feasibility|url=https://www.sciencedirect.com/science/article/pii/S0165178113001042|journal=Psychiatry Research|language=en|volume=208|issue=1|pages=1–8|doi=10.1016/j.psychres.2013.02.029|issn=0165-1781}}</ref> |0.85 (N=314) |3.53 |0.35 |Medium: Schizophrenia versus all other psychotic disorders, but has not been studied in a variety of populations with schizophrenia as it is a relatively new measure. |[https://mfr.osf.io/render?url=https://osf.io/7hwmy/?action=download%26mode=render DSM 5 Scale] |- |Positive and Negative Syndrome Scale (PANSS)<ref>{{Cite journal|last=Kay|first=S. R.|last2=Fiszbein|first2=A.|last3=Opler|first3=L. A.|date=1987-01-01|title=The Positive and Negative Syndrome Scale (PANSS) for Schizophrenia|url=https://academic.oup.com/schizophreniabulletin/article-lookup/doi/10.1093/schbul/13.2.261|journal=Schizophrenia Bulletin|language=en|volume=13|issue=2|pages=261–276|doi=10.1093/schbul/13.2.261|issn=0586-7614}}</ref><ref>{{Cite journal|last=Ritsner|first=Michael S.|last2=Mar|first2=Maria|last3=Arbitman|first3=Marina|last4=Grinshpoon|first4=Alexander|date=2013-06-30|title=Symptom severity scale of the DSM5 for schizophrenia, and other psychotic disorders: diagnostic validity and clinical feasibility|url=https://www.sciencedirect.com/science/article/pii/S0165178113001042|journal=Psychiatry Research|language=en|volume=208|issue=1|pages=1–8|doi=10.1016/j.psychres.2013.02.029|issn=0165-1781}}</ref> |0.91 (N=314) |N/A |N/A |Note: 45 minute clinical interview. Requires training. Attached to appendix. |Not free |} '''Note:''' ‡ Used the SCID administered by trained raters. • Used Present State Examination 9 and psychiatrist diagnosis. (*) Cutoff score for all clusters was 15% of symptoms in that cluster present (for cluster 1= 5/35 symptoms) *“LR+” refers to the change in likelihood ratio associated with a positive test score, and “LR-” is the likelihood ratio for a low score. Likelihood ratios of 1 indicate that the test result did not change impressions at all. LRs larger than 10 or smaller than .10 are frequently clinically decisive; 5 or .20 are helpful, and between 2.0 and .5 are small enough that they rarely result in clinically meaningful changes of formulation (Sackett et al., 2000). '''Search terms:''' [schizophrenia] AND [sensitivity OR specificity] AND [differential diagnosis] AND [<nowiki/>[[wikipedia:Prodrome|prodrome]]] in MedLine and PsycINFO === Interpreting schizophrenia screening measure scores === * For information on interpreting screening measure scores, click [[Evidence based assessment/Prediction phase#Interpreting screening measure scores|here.]] ==[[Evidence based assessment/Prescription phase|'''Prescription phase''']]== ===Gold standard diagnostic interviews=== For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews click here.] ===Recommended diagnostic interviews for schizophrenia=== {| class="wikitable" |+ !Diagnostic Interview !Format !Age Range/ !Administration Time !Where to Access |- |Structured Clinical Interview for DSM-V (SCID)<ref>{{Cite web|url=https://www.appi.org/products/structured-clinical-interview-for-dsm-5-scid-5|title=Structured Clinical Interview for DSM-5 (SCID-5)|website=www.appi.org|accessdate=2018-03-08}}</ref><ref>{{Cite journal|date=2018-06|editor-last=Hunsley|editor-first=John|editor2-last=Mash|editor2-first=Eric J.|title=A Guide to Assessments That Work|url=http://dx.doi.org/10.1093/med-psych/9780190492243.001.0001|journal=Oxford Clinical Psychology|doi=10.1093/med-psych/9780190492243.001.0001}}</ref> |Semi-structured interview to be administered by a clinician or an experienced rater |Adults (Ages 18+) |Varies, 43.0±30.6 minutes | -Available for purchase from [https://www.appi.org/products/structured-clinical-interview-for-dsm-5-scid-5 APA Publishing] (Note: Not free) -Modified [https://mfr.osf.io/render?url=https://osf.io/x9smc/?action=download%26mode=render] (not most recent version, SCID-I) -Located on Penn Lab, See Appendix 1 for schizophrenia modules |- |Mini-International Neuropsychiatric Interview (MINI)<ref>{{Cite journal|last=Sheehan|first=D. V.|last2=Lecrubier|first2=Y.|last3=Sheehan|first3=K. H.|last4=Amorim|first4=P.|last5=Janavs|first5=J.|last6=Weiller|first6=E.|last7=Hergueta|first7=T.|last8=Baker|first8=R.|last9=Dunbar|first9=G. C.|date=1998|title=The Mini-International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10|url=https://pubmed.ncbi.nlm.nih.gov/9881538|journal=The Journal of Clinical Psychiatry|volume=59 Suppl 20|pages=22–33;quiz 34–57|issn=0160-6689|pmid=9881538}}</ref><ref>{{Cite book|url=https://www.worldcat.org/oclc/897376853|title=The assessment of psychosis : a reference book and rating scales for research and practice|date=2015|others=Flavie Waters, Massoud Stephane|isbn=978-1-134-62869-8|location=New York, NY|oclc=897376853}}</ref> |Structured interview to be administer by a mental health professional with extensive training |Adults, also a children and adolescent version available |Mean 18.7 minutes | -Available on the [https://harmresearch.org/mini-international-neuropsychiatric-interview-mini/ Harm Research Institute] for purchase |- |- | colspan="5" style="font-size:110%; text-align:center;" |'''For Children and Adolescents Specifically''' |- |[[wikipedia:Kiddie_Schedule_for_Affective_Disorders_and_Schizophrenia|Kiddie Schedule for Affective Disorders and Schizophrenia Present and Lifetime Version (KSADS-PL DSM-V)]]<ref>Eric A. Youngstrom, Mitchell J. Prinstein, Eric J. Mash, & Russell A. Barkley. (2020). ''Assessment of Disorders in Childhood and Adolescence, Fifth Edition: Vol. Fifth edition''. The Guilford Press.</ref> |Semi-structured interview to be administered by a health care provider or highly trained clinical researcher |Ages 6-18 |45-75 minutes |[https://www.kennedykrieger.org/sites/default/files/library/documents/faculty/ksads-dsm-5-screener.pdf PDF Version] |} ==[[Evidence based assessment/Process phase|'''Process phase''']]== The following section contains a list of process and outcome measures for schizophrenia. The section includes benchmarks based on published norms and on mood samples for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the [[Evidence based assessment/Process phase|process phase]] of assessment. For more information of differences between process and outcome measures, see the page on the [[Evidence based assessment/Process phase|process phase of assessment]]. === Severity and outcome === * Information on how to interpret this table can be [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase found here]. *''<u>For clinically significant change benchmarks for the CBCL, YSR, and TRF total, externalizing, internalizing, and attention benchmarks,</u>'' [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase&wteswitched=1#Clinically_significant_change_benchmarks_for_widely-used_outcome_measures see here.] ==== Clinically significant change benchmarks with common instruments for schizophrenia ==== {| class="wikitable sortable" border="1" |- | rowspan=1" style="text-align:center;font-size:130%;" | <b> Measure</b> | style="text-align:center;font-size:130%;" | '''Scale'''<b></b> | colspan="3" style="text-align:center;font-size:130%" width="300" | <b> Cut Scores*</b> | colspan="3" style="text-align:center;font-size:120%" | <b> Critical Change <br> (Unstandardized Scores)</b> |- | colspan="2" | | style="text-align:center;font-size:110%" | <b> A</b> | style="text-align:center;font-size:110%" | <b> B</b> | style="text-align:center;font-size:110%" | <b> C</b> | style="text-align:center;font-size:110%" | <b> 95%</b> | style="text-align:center;font-size:110%" | <b> 90%</b> | style="text-align:center;font-size:110%" | <b> SE_difference</b> |- | colspan="8" span style="font-size:110%; text-align:center;" | <b> Benchmarks Based on Published Norms for Samples with Schizophrenia</b> |- | rowspan="3" style="text-align:center;" | <i> Positive and Negative Syndrome Scale <br> (1987 Norms)</i> | style="text-align:center;" | PANSS Positive Scale | style="text-align:center;"| 6 | style="text-align:center;"| n/a | style="text-align:center;"| n/a | style="text-align:center;"| 8.8 | style="text-align:center;"| 7.4 | style="text-align:center;"| 4.5 |- | rowspan="1" style="text-align:center;" | PANSS Negative Scale <br> | style="text-align:center;"| 8.8 | style="text-align:center;"| n/a | style="text-align:center;"| n/a | style="text-align:center;"| 7.0 | style="text-align:center;"| 5.9 | style="text-align:center;"| 3.6 |- | rowspan="1" style="text-align:center;" | PANSS General Psychopathology Scale <br> | style="text-align:center;"| 18.8 | style="text-align:center;"| n/a | style="text-align:center;"| n/a | style="text-align:center;"| 9.5 | style="text-align:center;"| 8.0 | style="text-align:center;"| 4.8 |- | rowspan="2" style="text-align:center;" | <i> Scale for the Assessment of Positive Symptoms (SAPS) and Negative Symptoms (SANS) <br> (1991 Norms)</i> | style="text-align:center;" | SAPS | style="text-align:center;"| -6.9 | style="text-align:center;"| n/a | style="text-align:center;"| n/a | style="text-align:center;"| 13.4 | style="text-align:center;"| 11.3 | style="text-align:center;"| 6.8 |- | rowspan="1" style="text-align:center;" | SANS <br> | style="text-align:center;"| 0.6 | style="text-align:center;"| n/a | style="text-align:center;"| n/a | style="text-align:center;"| 13.9 | style="text-align:center;"| 11.7 | style="text-align:center;"| 7.1 |- | rowspan="1" style="text-align:center;"| ''Social Skills (Social Functioning Scale)'' | |90.9 |268.7 |102.1 |7.2 |6.0 |3.6 |- | rowspan="1" style="text-align:center;"|''Brief Psychiatric Rating Scale (BPRS)'' | | | | | | | |} '''Note:''' “A” = Away from the clinical range, “B” = Back into the nonclinical range, “C” = Closer to the nonclinical than clinical mean. '''Note:'''&nbsp;Clinical significance may be limited for use in schizophrenia as the disorder is currently incurable and the extent to which a return to normal functioning may be less common. For this reason, some investigators have used methods other than those proposed by Jacobson and Truax (1991) to develop cut-off points (Jacobson et al. 1999). * Example: Positive and Negative Syndrome Scale (PANSS) cut-off scores of 40, 45 and 50 have been mentioned for clinically significant change for schizophrenia patients in hospital settings (Schennach et al. 2015). '''Search terms:''' [schizophrenia] AND [clinical significance OR outcomes OR change] AND [PANSS OR SWLS] in MedLine and PsycINFO === Treatment === See [[wikipedia:Management_of_schizophrenia|Management of Schizophrenia]]. ==External Resources== #[https://icd.who.int/browse11/l-m/en#/http%3a%2f%2fid.who.int%2ficd%2fentity%2f1683919430 ICD-11 diagnostic criteria] # [https://en.wikiversity.org/w/index.php?title=Helping_Give_Away_Psychological_Science/Resources/Annotated_List_of_Where_and_How_to_Find_a_Therapist&wteswitched=1#Other_low-cost_options Find-a-Therapist] (a curated list of find-a-therapist websites where you can find a provider) #[https://www.nimh.nih.gov/health/topics/schizophrenia/index.shtml NIMH] (information about schizophrenia) # OMIM (Online Mendelian Inheritance in Man) ##[https://www.omim.org/entry/181500?search=schizophrenia&highlight=schizophrenia 181500] == Web-based resources == '''Online Support Group'''&nbsp;for Family Members & Individuals with Schizophrenia [http://www.schizophrenia.com/coping.html Website] '''Chatrooms'''&nbsp;for Individuals with Schizophrenia: *http://www.schizophrenia-online.com/ *http://theircvillage.com/chat/ '''[http://www.schizophrenia.com General Information&nbsp;about Schizophrenia]''' == References == {{collapse top| References|expand=yes}} {{Reflist|2|refs= <ref name=KesslerEtAl1994>{{cite journal|last1=Kessler|first1=RC|last2=McGonagle|first2=KA|last3=Zhao|first3=S|last4=Nelson|first4=CB|last5=Hughes|first5=M|last6=Eshleman|first6=S|last7=Wittchen|first7=HU|last8=Kendler|first8=KS|title=Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States. Results from the National Comorbidity Survey.|journal=Archives of general psychiatry|date=January 1994|volume=51|issue=1|pages=8-19|pmid=8279933}}</ref> <ref name=RobinsRegiers1991>{{cite book |editor=Robins, Lee N. |editor2=Freedman, Darrel A. |title=Psychiatric disorders in America : the epidemiologic catchment area study |date=1991 |publisher=Free Press |location=New York |isbn=9780029265710}}</ref> <ref name=DumaisEtAl2010>{{cite journal|last1=Dumais|first1=A|last2=Côté|first2=G|last3=Lesage|first3=A|title=Clinical and sociodemographic profiles of male inmates with severe mental illness: a comparison with voluntarily and involuntarily hospitalized patients.|journal=Canadian journal of psychiatry. Revue canadienne de psychiatrie|date=March 2010|volume=55|issue=3|pages=172-9|pmid=20370968}}</ref> <ref name=MinskyEtAl2003>{{cite journal|last1=Minsky|first1=S|last2=Vega|first2=W|last3=Miskimen|first3=T|last4=Gara|first4=M|last5=Escobar|first5=J|title=Diagnostic patterns in Latino, African American, and European American psychiatric patients.|journal=Archives of general psychiatry|date=June 2003|volume=60|issue=6|pages=637-44|pmid=12796227}}</ref> <ref name=PeralaEtAl2007>{{cite journal|last1=Perälä|first1=J|last2=Suvisaari|first2=J|last3=Saarni|first3=SI|last4=Kuoppasalmi|first4=K|last5=Isometsä|first5=E|last6=Pirkola|first6=S|last7=Partonen|first7=T|last8=Tuulio-Henriksson|first8=A|last9=Hintikka|first9=J|last10=Kieseppä|first10=T|last11=Härkänen|first11=T|last12=Koskinen|first12=S|last13=Lönnqvist|first13=J|title=Lifetime prevalence of psychotic and bipolar I disorders in a general population.|journal=Archives of general psychiatry|date=January 2007|volume=64|issue=1|pages=19-28|pmid=17199051}}</ref> <ref name=FolsomEtAl2005>{{cite journal|last1=Folsom|first1=DP|last2=Hawthorne|first2=W|last3=Lindamer|first3=L|last4=Gilmer|first4=T|last5=Bailey|first5=A|last6=Golshan|first6=S|last7=Garcia|first7=P|last8=Unützer|first8=J|last9=Hough|first9=R|last10=Jeste|first10=DV|title=Prevalence and risk factors for homelessness and utilization of mental health services among 10,340 patients with serious mental illness in a large public mental health system.|journal=The American journal of psychiatry|date=February 2005|volume=162|issue=2|pages=370-6|pmid=15677603}}</ref> <ref name=WuEtAl2006>{{cite journal|last1=Wu|first1=EQ|last2=Shi|first2=L|last3=Birnbaum|first3=H|last4=Hudson|first4=T|last5=Kessler|first5=R|title=Annual prevalence of diagnosed schizophrenia in the USA: a claims data analysis approach.|journal=Psychological medicine|date=November 2006|volume=36|issue=11|pages=1535-40|pmid=16907994}}</ref> <ref name=ZimmermanMattia2001>{{cite journal|last1=Zimmerman|first1=M|last2=Mattia|first2=JI|title=The Psychiatric Diagnostic Screening Questionnaire: development, reliability and validity.|journal=Comprehensive psychiatry|date=2001|volume=42|issue=3|pages=175-89|pmid=11349235}}</ref> <ref name=ZimmermanSheeran2003>{{cite journal|last1=Zimmerman|first1=M|last2=Sheeran|first2=T|title=Screening for principal versus comorbid conditions in psychiatric outpatients with the Psychiatric Diagnostic Screening Questionnaire.|journal=Psychological assessment|date=March 2003|volume=15|issue=1|pages=110-4|pmid=12674730}}</ref> <ref name=MillerEtAl1999>{{cite journal|last1=Miller|first1=TJ|last2=McGlashan|first2=TH|last3=Woods|first3=SW|last4=Stein|first4=K|last5=Driesen|first5=N|last6=Corcoran|first6=CM|last7=Hoffman|first7=R|last8=Davidson|first8=L|title=Symptom assessment in schizophrenic prodromal states.|journal=The Psychiatric quarterly|date=1999|volume=70|issue=4|pages=273-87|pmid=10587984}}</ref> <ref name=MillerEtAl2003>{{cite journal|last1=Miller|first1=TJ|last2=McGlashan|first2=TH|last3=Rosen|first3=JL|last4=Cadenhead|first4=K|last5=Cannon|first5=T|last6=Ventura|first6=J|last7=McFarlane|first7=W|last8=Perkins|first8=DO|last9=Pearlson|first9=GD|last10=Woods|first10=SW|title=Prodromal assessment with the structured interview for prodromal syndromes and the scale of prodromal symptoms: predictive validity, interrater reliability, and training to reliability.|journal=Schizophrenia bulletin|date=2003|volume=29|issue=4|pages=703-15|pmid=14989408}}</ref> <ref name=Gross1989>{{cite journal|last1=Gross|first1=G|title=The 'basic' symptoms of schizophrenia.|journal=The British journal of psychiatry. Supplement|date=November 1989|issue=7|pages=21-5; discussion 37-40|pmid=2695138}}</ref> <ref name=KlosterkotterEtAl2001>{{cite journal|last1=Klosterkötter|first1=J|last2=Hellmich|first2=M|last3=Steinmeyer|first3=EM|last4=Schultze-Lutter|first4=F|title=Diagnosing schizophrenia in the initial prodromal phase.|journal=Archives of general psychiatry|date=February 2001|volume=58|issue=2|pages=158-64|pmid=11177117}}</ref> }} {{collapse bottom}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] luk3zfrx5a097bnuvn14afgffy9kwo9 2419306 2419226 2022-08-26T05:30:40Z Ardenguo 2944162 /* Recommended screening instruments */ added "Note: Reliability and validity are included in the extended version. This table includes measures with Good or Excellent ratings." wikitext text/x-wiki <noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{medical disclaimer}} {{:{{BASEPAGENAME}}/Sidebar}} ==[[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio"?''']]== For background information on what assessment portfolios are, click the link in the heading above. Want even 'more' information about this topic? There's an extended version of this page [[Evidence-based assessment/Schizophrenia (disorder portfolio)/extended version|here]]. == [[Evidence based assessment/Preparation phase|'''Preparation phase''']] == === Diagnostic Criteria for Schizophrenia === {{blockquotetop}} <big>'''ICD-11 Diagnostic Criteria'''</big> *<big>'''Schizophrenia'''</big> **Schizophrenia is characterized by disturbances in multiple mental modalities, including thinking (e.g., delusions, disorganization in the form of thought), perception (e.g., hallucinations), self-experience (e.g., the experience that one's feelings, impulses, thoughts, or behaviour are under the control of an external force), cognition (e.g., impaired attention, verbal memory, and social cognition), volition (e.g., loss of motivation), affect (e.g., blunted emotional expression), and behaviour (e.g.,behaviour that appears bizarre or purposeless, unpredictable or inappropriate emotional responses that interfere with the organization of behaviour). Psychomotor disturbances, including catatonia, may be present. Persistent delusions, persistent hallucinations, thought disorder, and experiences of influence, passivity, or control are considered core symptoms. Symptoms must have persisted for at least one month in order for a diagnosis of schizophrenia to be assigned. The symptoms are not a manifestation of another health condition (e.g., a brain tumour) and are not due to the effect of a substance or medication on the central nervous system (e.g., corticosteroids), including withdrawal (e.g., alcohol withdrawal). *<big>'''Schizophrenia, First Episode'''</big> **Schizophrenia, first episode should be used to identify individuals experiencing symptoms that meet the diagnostic requirements for Schizophrenia (including duration) but who have never before experienced an episode during which diagnostic requirements for Schizophrenia were met. ***Note: The ICD-11 lists 3 additional subcategories of schizophrenia, first episode. They can be found [https://icd.who.int/browse11/l-m/en#/http%3a%2f%2fid.who.int%2ficd%2fentity%2f625636921 here]. *<big>'''Schizophrenia, Multiple Episodes'''</big> **Schizophrenia, multiple episode should be used to identify individuals experiencing symptoms that meet the diagnostic requirements for Schizophrenia (including duration) and who have also previously experienced episodes during which diagnostic requirements were met, with substantial remission of symptoms between episodes. Some attenuated symptoms may remain during periods of remission, and remissions may have occurred in response to medication or other treatment. ***Note: The ICD-11 lists 3 additional subcategories of schizophrenia, multiple episodes. They can be found [https://icd.who.int/browse11/l-m/en#/http%3a%2f%2fid.who.int%2ficd%2fentity%2f1150025154 here]. '''Changes in DSM-5''' The diagnostic criteria for schizophrenia spectrum and other psychotic disorders changed slightly from DSM-IV to DSM-5. A summary is available [https://en.wikipedia.org/wiki/DSM-5#Section_II:_diagnostic_criteria_and_codes here]. {{blockquotebottom}} === Base rates of schizophrenia in different populations and clinical settings === {| class="wikitable sortable" |- ! Demography ! Setting !! Base Rate !! Diagnostic Method |- | 48 contiguous US states | Non-institutionalized civilians<ref name="KesslerEtAl1994" /> || 0.5% || CIDI, SCID |- | Urban settings in 5 states (MD, NC, CN, CA, MO) | Community sample<ref name="RobinsRegiers1991" /> || 1.3% || DIS |- | All Federal Penitentiaries in Quebec-incarcerated and inmates currently hospitalized involuntarily | Inmates with severe mental disorders<ref name="DumaisEtAl2010" /> || 23.5% incarcerated†, 69.7% hospitalized involuntarily† || SCID |- || New Jersey | Patients presenting for inpatient and ambulatory services<ref name="MinskyEtAl2003" /> || *African-American (males – 19.1%, females – 11.3%) *Latino (males – 9.4%, females – 6.2%) *European-American (males – 9.9%, females – 6.1%) * (Rates are for all psychotic disorders – authors note this was “mostly schizophrenia”) | BASIC-32 |- | Global – 44 countries | General population (community, inpatient, and outpatient)<ref>{{Cite journal|last=Saha|first=Sukanta|last2=Chant|first2=David|last3=Welham|first3=Joy|last4=McGrath|first4=John|date=May 2005|title=A systematic review of the prevalence of schizophrenia|url=https://www.ncbi.nlm.nih.gov/pubmed/15916472|journal=PLoS medicine|volume=2|issue=5|pages=e141|doi=10.1371/journal.pmed.0020141|issn=1549-1676|pmc=PMC1140952|pmid=15916472}}</ref> ||0.7% || Clinical interview |- | Finland | General population<ref>{{Cite journal|last=Perälä|first=Jonna|last2=Suvisaari|first2=Jaana|last3=Saarni|first3=Samuli I.|last4=Kuoppasalmi|first4=Kimmo|last5=Isometsä|first5=Erkki|last6=Pirkola|first6=Sami|last7=Partonen|first7=Timo|last8=Tuulio-Henriksson|first8=Annamari|last9=Hintikka|first9=Jukka|date=January 2007|title=Lifetime prevalence of psychotic and bipolar I disorders in a general population|url=https://www.ncbi.nlm.nih.gov/pubmed/17199051|journal=Archives of General Psychiatry|volume=64|issue=1|pages=19–28|doi=10.1001/archpsyc.64.1.19|issn=0003-990X|pmid=17199051}}</ref> || 0.87% || CIDI, SCID |- | San Diego County | County Mental Health Service Users<ref name="FolsomEtAl2005" /> || 54% - homeless individuals || Chart Diagnosis |- || Maryland | Inpatient service<ref>{{Cite journal|last=Brown|first=Samuel L.|date=2001-06-01|title=Variations in Utilization and Cost of Inpatient Psychiatric Services Among Adults in Maryland|url=https://ps.psychiatryonline.org/doi/abs/10.1176/appi.ps.52.6.841|journal=Psychiatric Services|volume=52|issue=6|pages=841–843|doi=10.1176/appi.ps.52.6.841|issn=1075-2730}}</ref> || *39% - non-homeless *8.4% - 65 years and up *17% - 19-64 years || Psychiatrist Diagnosis |- | USA (Note: Medicaid rate was calculated using California Medi-Cal rates as a proxy) | Insurance claimants in 2002<ref name="WuEtAl2006" /> || Medicaid – 1.66%, Uninsured – 1.02%, Medicare – 0.83%, Privately insured – 0.13%, Veterans (through VA) – 1.41% || Physician diagnosis |} †Rates reflect schizophrenia spectrum disorders. '''Note:''' DIS = Diagnostic Interview Schedule, CIDI = Composite International Diagnostic Interview, SCID = Structured Diagnostic Interview for DSM, BASIC-32 = Behavior and Symptoms Identification Scale '''Search terms:''' [Schizophrenia] AND [prevalence OR incidence], [Schizophrenia] AND [Prevalence] AND [Outpatient OR inpatient] in PsycINFO, Medline, and PubMed ==[[Evidence based assessment/Prediction phase|'''Prediction phase''']]== ===Recommended screening instruments === The following section contains a list of screening and diagnostic instruments for schizophrenia. {| class="wikitable" |+ !Screening Instrument !Format !Age Range !Administration Time !Where to Access |- |Structured Interview for Psychosis-Risk Syndrome (SIPS) <ref name=":0">{{Cite book|url=https://www.worldcat.org/oclc/897376853|title=The assessment of psychosis : a reference book and rating scales for research and practice|author=Waters, Flavie |author2=Stephane, Massoud|isbn=9781315885605|location=New York, NY|oclc=897376853}}</ref> |Structured interview by a clinician or experienced rater |Pre-clinical adolescents and adults |2-3 hours | -Available from PRIME clinic at Yale University, contact Dr. Barbara Walsh at 203-974-7052 -[http://www.easacommunity.org/PDF/SIPS_5-5_032514&#x5B;1&#x5D;%20correct.pdf PDF Version] |- |Bonn Scale for the Assessment of Basic Symptoms (BSABS)<ref name=":0" /> |Semi-structured interview by a clinician or experienced rater |Pre-clinical, residual, and at-risk adolescents and adults |2-3 hours | -Available from [https://www.amazon.com/BSABS-Scale-Assessment-Basic-Symptoms/dp/3832271732 Amazon] -Available from publisher [https://www.shaker.de/de/index.asp?lang=de Shaker Verlag] |- | colspan="5" style="font-size:110%; text-align:center;" |'''For Children and Adolescents Specifically''' |- |Strengths and Difficulties Questionnaire (SDQ) <ref>{{Cite journal|last=Goodman|first=Robert|last2=Ford|first2=Tamsin|last3=Simmons|first3=Helen|last4=Gatward|first4=Rebecca|last5=Meltzer|first5=Howart|date=2000-12|title=Using the Strengths and Difficulties Questionnaire (SDQ) to screen for child psychiatric disorders in a community sample|url=https://www.cambridge.org/core/product/identifier/S0007125000156065/type/journal_article|journal=British Journal of Psychiatry|language=en|volume=177|issue=6|pages=534–539|doi=10.1192/bjp.177.6.534|issn=0007-1250}}</ref> |Parent/teacher-report, self-report, rate items |Ages 2+ |5-25 minutes | -Available from [https://www.sdqinfo.org/py/sdqinfo/b3.py?language=Englishqz(USA) Youth In Mind] -[https://osf.io/dzk68/?view_only=681e9b648169427b845f313aafa0a169 PDF Version] |} '''Note:''' Reliability and validity are included in the extended version. This table includes measures with Good or Excellent ratings. === Likelihood ratios and AUCs of screening measures for schizophrenia === * '''''For a list of the likelihood ratios for more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Likelihood_ratios_and_AUCs_of_common_screening_instruments click here.]''''' {| class="wikitable" |- ! scope="col" style="width: 225px;" | Screening Measure (Primary Reference) ! scope="col" style="width: 100px;" | AUC ! scope="col" style="width: 100px;" | LR+ (Score) ! scope="col" style="width: 100px;" | LR- (Score) ! scope="col" style="width: 225px;"| Clinical generalizability !Where to Access |- | Psychiatric Diagnostic Screening Questionnaire – PDSQ (Zimmerman & Mattia, 2001a; Zimmerman & Sheeran, 2004)<ref name=ZimmermanMattia2001/><ref>{{Cite journal|last=Zimmerman|first=Mark|last2=Sheeran|first2=Thomas|date=2003-03|title=Screening for principal versus comorbid conditions in psychiatric outpatients with the Psychiatric Diagnostic Screening Questionnaire|url=https://pubmed.ncbi.nlm.nih.gov/12674730|journal=Psychological Assessment|volume=15|issue=1|pages=110–114|doi=10.1037/1040-3590.15.1.110|issn=1040-3590|pmid=12674730}}</ref>‡ || .92 (N = 799) || 2.7 (Subscale cutoff score = 1) || .33 (Subscale cutoff score = 1) || Low – can distinguish psychotic disorders from non-psychotic disorders but cannot distinguish schizophrenia from other psychotic disorders (ex: MDD with psychosis) |Not free |- | Structured Interview for Prodromal Syndromes – SIPS (Miller et al., 1999, 2003)<ref name=MillerEtAl1999/> <ref>{{Cite journal|last=Miller|first=Tandy J.|last2=McGlashan|first2=Thomas H.|last3=Rosen|first3=Joanna L.|last4=Cadenhead|first4=Kristen|last5=Cannon|first5=Tyrone|last6=Ventura|first6=Joseph|last7=McFarlane|first7=William|last8=Perkins|first8=Diana O.|last9=Pearlson|first9=Godfrey D.|date=2003|title=Prodromal assessment with the structured interview for prodromal syndromes and the scale of prodromal symptoms: predictive validity, interrater reliability, and training to reliability|url=https://pubmed.ncbi.nlm.nih.gov/14989408|journal=Schizophrenia Bulletin|volume=29|issue=4|pages=703–715|doi=10.1093/oxfordjournals.schbul.a007040|issn=0586-7614|pmid=14989408}}</ref>|| Not given (N = 34) || 3.5 (not given) || 0 (not given) || Moderate – has some predictive validity (46% of those identified as prodromal by the SIPS developed schizophrenia psychosis within 6 mo.) |[https://mfr.osf.io/render?url=https://osf.io/scxyh/?action=download%26mode=render SIPS] |- | Bonn Scale for the Assessment of basic Symptoms – BSABS (Gross, 1989; Klosterkotter, Hellmich, Steinmeyer, Schultze-Lutter, 2001)<ref name=Gross1989/><ref>{{Cite journal|last=Klosterkötter|first=J.|last2=Hellmich|first2=M.|last3=Steinmeyer|first3=E. M.|last4=Schultze-Lutter|first4=F.|date=2001-02|title=Diagnosing schizophrenia in the initial prodromal phase|url=https://pubmed.ncbi.nlm.nih.gov/11177117|journal=Archives of General Psychiatry|volume=58|issue=2|pages=158–164|doi=10.1001/archpsyc.58.2.158|issn=0003-990X|pmid=11177117}}</ref>• *Cluster 1 = thought, language, perception, and motor disturbances *Cluster 2 = impaired bodily sensations *Cluster 3 = impaired tolerance to normal stress *Cluster 4 = disorders of emotion and affect including impaired thought, energy, concentration, and memory *Cluster 5 = increased emotional reactivity, impaired ability to maintain or initiate social contacts, and disturbances in nonverbal expression || (N = 160) *C1 = 0.81 *C2 = 0.50 *C3 = 0.52 *C4 = 0.57 *C5 = 0.58 || Overall = 2.4 (>=1) *C1 = 3.1 *C2 = 0.48 *C3 = 0.97 *C4 = 1.1 *C5 = 1.4 (*) || Overall = 0.03 (>=1) *C1 = 0.52 *C2 = 1.0 *C3 = 0.77 *C4 = 0.5 *C5 = 0.70 (*) || Moderate - has some predictive validity for individuals who are in prodromal period of schizophrenia overall, cluster 1 has best predictive accuracy and may be most useful. |Available from [https://www.amazon.com/BSABS-Scale-Assessment-Basic-Symptoms/dp/3832271732 Amazon] Available from publisher [https://www.shaker.de/de/index.asp?lang=de Shaker Verlag] |- |Symptom Severity Scale of the DSM5<ref>{{Cite journal|last=Ritsner|first=Michael S.|last2=Mar|first2=Maria|last3=Arbitman|first3=Marina|last4=Grinshpoon|first4=Alexander|date=2013-06-30|title=Symptom severity scale of the DSM5 for schizophrenia, and other psychotic disorders: diagnostic validity and clinical feasibility|url=https://www.sciencedirect.com/science/article/pii/S0165178113001042|journal=Psychiatry Research|language=en|volume=208|issue=1|pages=1–8|doi=10.1016/j.psychres.2013.02.029|issn=0165-1781}}</ref> |0.85 (N=314) |3.53 |0.35 |Medium: Schizophrenia versus all other psychotic disorders, but has not been studied in a variety of populations with schizophrenia as it is a relatively new measure. |[https://mfr.osf.io/render?url=https://osf.io/7hwmy/?action=download%26mode=render DSM 5 Scale] |- |Positive and Negative Syndrome Scale (PANSS)<ref>{{Cite journal|last=Kay|first=S. R.|last2=Fiszbein|first2=A.|last3=Opler|first3=L. A.|date=1987-01-01|title=The Positive and Negative Syndrome Scale (PANSS) for Schizophrenia|url=https://academic.oup.com/schizophreniabulletin/article-lookup/doi/10.1093/schbul/13.2.261|journal=Schizophrenia Bulletin|language=en|volume=13|issue=2|pages=261–276|doi=10.1093/schbul/13.2.261|issn=0586-7614}}</ref><ref>{{Cite journal|last=Ritsner|first=Michael S.|last2=Mar|first2=Maria|last3=Arbitman|first3=Marina|last4=Grinshpoon|first4=Alexander|date=2013-06-30|title=Symptom severity scale of the DSM5 for schizophrenia, and other psychotic disorders: diagnostic validity and clinical feasibility|url=https://www.sciencedirect.com/science/article/pii/S0165178113001042|journal=Psychiatry Research|language=en|volume=208|issue=1|pages=1–8|doi=10.1016/j.psychres.2013.02.029|issn=0165-1781}}</ref> |0.91 (N=314) |N/A |N/A |Note: 45 minute clinical interview. Requires training. Attached to appendix. |Not free |} '''Note:''' ‡ Used the SCID administered by trained raters. • Used Present State Examination 9 and psychiatrist diagnosis. (*) Cutoff score for all clusters was 15% of symptoms in that cluster present (for cluster 1= 5/35 symptoms) *“LR+” refers to the change in likelihood ratio associated with a positive test score, and “LR-” is the likelihood ratio for a low score. Likelihood ratios of 1 indicate that the test result did not change impressions at all. LRs larger than 10 or smaller than .10 are frequently clinically decisive; 5 or .20 are helpful, and between 2.0 and .5 are small enough that they rarely result in clinically meaningful changes of formulation (Sackett et al., 2000). '''Search terms:''' [schizophrenia] AND [sensitivity OR specificity] AND [differential diagnosis] AND [<nowiki/>[[wikipedia:Prodrome|prodrome]]] in MedLine and PsycINFO === Interpreting schizophrenia screening measure scores === * For information on interpreting screening measure scores, click [[Evidence based assessment/Prediction phase#Interpreting screening measure scores|here.]] ==[[Evidence based assessment/Prescription phase|'''Prescription phase''']]== ===Gold standard diagnostic interviews=== For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews click here.] ===Recommended diagnostic interviews for schizophrenia=== {| class="wikitable" |+ !Diagnostic Interview !Format !Age Range/ !Administration Time !Where to Access |- |Structured Clinical Interview for DSM-V (SCID)<ref>{{Cite web|url=https://www.appi.org/products/structured-clinical-interview-for-dsm-5-scid-5|title=Structured Clinical Interview for DSM-5 (SCID-5)|website=www.appi.org|accessdate=2018-03-08}}</ref><ref>{{Cite journal|date=2018-06|editor-last=Hunsley|editor-first=John|editor2-last=Mash|editor2-first=Eric J.|title=A Guide to Assessments That Work|url=http://dx.doi.org/10.1093/med-psych/9780190492243.001.0001|journal=Oxford Clinical Psychology|doi=10.1093/med-psych/9780190492243.001.0001}}</ref> |Semi-structured interview to be administered by a clinician or an experienced rater |Adults (Ages 18+) |Varies, 43.0±30.6 minutes | -Available for purchase from [https://www.appi.org/products/structured-clinical-interview-for-dsm-5-scid-5 APA Publishing] (Note: Not free) -Modified [https://mfr.osf.io/render?url=https://osf.io/x9smc/?action=download%26mode=render] (not most recent version, SCID-I) -Located on Penn Lab, See Appendix 1 for schizophrenia modules |- |Mini-International Neuropsychiatric Interview (MINI)<ref>{{Cite journal|last=Sheehan|first=D. V.|last2=Lecrubier|first2=Y.|last3=Sheehan|first3=K. H.|last4=Amorim|first4=P.|last5=Janavs|first5=J.|last6=Weiller|first6=E.|last7=Hergueta|first7=T.|last8=Baker|first8=R.|last9=Dunbar|first9=G. C.|date=1998|title=The Mini-International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10|url=https://pubmed.ncbi.nlm.nih.gov/9881538|journal=The Journal of Clinical Psychiatry|volume=59 Suppl 20|pages=22–33;quiz 34–57|issn=0160-6689|pmid=9881538}}</ref><ref>{{Cite book|url=https://www.worldcat.org/oclc/897376853|title=The assessment of psychosis : a reference book and rating scales for research and practice|date=2015|others=Flavie Waters, Massoud Stephane|isbn=978-1-134-62869-8|location=New York, NY|oclc=897376853}}</ref> |Structured interview to be administer by a mental health professional with extensive training |Adults, also a children and adolescent version available |Mean 18.7 minutes | -Available on the [https://harmresearch.org/mini-international-neuropsychiatric-interview-mini/ Harm Research Institute] for purchase |- |- | colspan="5" style="font-size:110%; text-align:center;" |'''For Children and Adolescents Specifically''' |- |[[wikipedia:Kiddie_Schedule_for_Affective_Disorders_and_Schizophrenia|Kiddie Schedule for Affective Disorders and Schizophrenia Present and Lifetime Version (KSADS-PL DSM-V)]]<ref>Eric A. Youngstrom, Mitchell J. Prinstein, Eric J. Mash, & Russell A. Barkley. (2020). ''Assessment of Disorders in Childhood and Adolescence, Fifth Edition: Vol. Fifth edition''. The Guilford Press.</ref> |Semi-structured interview to be administered by a health care provider or highly trained clinical researcher |Ages 6-18 |45-75 minutes |[https://www.kennedykrieger.org/sites/default/files/library/documents/faculty/ksads-dsm-5-screener.pdf PDF Version] |} '''Note:''' Reliability and validity are included in the extended version. This table includes measures with Good or Excellent ratings. ==[[Evidence based assessment/Process phase|'''Process phase''']]== The following section contains a list of process and outcome measures for schizophrenia. The section includes benchmarks based on published norms and on mood samples for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the [[Evidence based assessment/Process phase|process phase]] of assessment. For more information of differences between process and outcome measures, see the page on the [[Evidence based assessment/Process phase|process phase of assessment]]. === Severity and outcome === * Information on how to interpret this table can be [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase found here]. *''<u>For clinically significant change benchmarks for the CBCL, YSR, and TRF total, externalizing, internalizing, and attention benchmarks,</u>'' [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase&wteswitched=1#Clinically_significant_change_benchmarks_for_widely-used_outcome_measures see here.] ==== Clinically significant change benchmarks with common instruments for schizophrenia ==== {| class="wikitable sortable" border="1" |- | rowspan=1" style="text-align:center;font-size:130%;" | <b> Measure</b> | style="text-align:center;font-size:130%;" | '''Scale'''<b></b> | colspan="3" style="text-align:center;font-size:130%" width="300" | <b> Cut Scores*</b> | colspan="3" style="text-align:center;font-size:120%" | <b> Critical Change <br> (Unstandardized Scores)</b> |- | colspan="2" | | style="text-align:center;font-size:110%" | <b> A</b> | style="text-align:center;font-size:110%" | <b> B</b> | style="text-align:center;font-size:110%" | <b> C</b> | style="text-align:center;font-size:110%" | <b> 95%</b> | style="text-align:center;font-size:110%" | <b> 90%</b> | style="text-align:center;font-size:110%" | <b> SE_difference</b> |- | colspan="8" span style="font-size:110%; text-align:center;" | <b> Benchmarks Based on Published Norms for Samples with Schizophrenia</b> |- | rowspan="3" style="text-align:center;" | <i> Positive and Negative Syndrome Scale <br> (1987 Norms)</i> | style="text-align:center;" | PANSS Positive Scale | style="text-align:center;"| 6 | style="text-align:center;"| n/a | style="text-align:center;"| n/a | style="text-align:center;"| 8.8 | style="text-align:center;"| 7.4 | style="text-align:center;"| 4.5 |- | rowspan="1" style="text-align:center;" | PANSS Negative Scale <br> | style="text-align:center;"| 8.8 | style="text-align:center;"| n/a | style="text-align:center;"| n/a | style="text-align:center;"| 7.0 | style="text-align:center;"| 5.9 | style="text-align:center;"| 3.6 |- | rowspan="1" style="text-align:center;" | PANSS General Psychopathology Scale <br> | style="text-align:center;"| 18.8 | style="text-align:center;"| n/a | style="text-align:center;"| n/a | style="text-align:center;"| 9.5 | style="text-align:center;"| 8.0 | style="text-align:center;"| 4.8 |- | rowspan="2" style="text-align:center;" | <i> Scale for the Assessment of Positive Symptoms (SAPS) and Negative Symptoms (SANS) <br> (1991 Norms)</i> | style="text-align:center;" | SAPS | style="text-align:center;"| -6.9 | style="text-align:center;"| n/a | style="text-align:center;"| n/a | style="text-align:center;"| 13.4 | style="text-align:center;"| 11.3 | style="text-align:center;"| 6.8 |- | rowspan="1" style="text-align:center;" | SANS <br> | style="text-align:center;"| 0.6 | style="text-align:center;"| n/a | style="text-align:center;"| n/a | style="text-align:center;"| 13.9 | style="text-align:center;"| 11.7 | style="text-align:center;"| 7.1 |- | rowspan="1" style="text-align:center;"| ''Social Skills (Social Functioning Scale)'' | |90.9 |268.7 |102.1 |7.2 |6.0 |3.6 |- | rowspan="1" style="text-align:center;"|''Brief Psychiatric Rating Scale (BPRS)'' | | | | | | | |} '''Note:''' “A” = Away from the clinical range, “B” = Back into the nonclinical range, “C” = Closer to the nonclinical than clinical mean. '''Note:'''&nbsp;Clinical significance may be limited for use in schizophrenia as the disorder is currently incurable and the extent to which a return to normal functioning may be less common. For this reason, some investigators have used methods other than those proposed by Jacobson and Truax (1991) to develop cut-off points (Jacobson et al. 1999). * Example: Positive and Negative Syndrome Scale (PANSS) cut-off scores of 40, 45 and 50 have been mentioned for clinically significant change for schizophrenia patients in hospital settings (Schennach et al. 2015). '''Search terms:''' [schizophrenia] AND [clinical significance OR outcomes OR change] AND [PANSS OR SWLS] in MedLine and PsycINFO === Treatment === See [[wikipedia:Management_of_schizophrenia|Management of Schizophrenia]]. ==External Resources== #[https://icd.who.int/browse11/l-m/en#/http%3a%2f%2fid.who.int%2ficd%2fentity%2f1683919430 ICD-11 diagnostic criteria] # [https://en.wikiversity.org/w/index.php?title=Helping_Give_Away_Psychological_Science/Resources/Annotated_List_of_Where_and_How_to_Find_a_Therapist&wteswitched=1#Other_low-cost_options Find-a-Therapist] (a curated list of find-a-therapist websites where you can find a provider) #[https://www.nimh.nih.gov/health/topics/schizophrenia/index.shtml NIMH] (information about schizophrenia) # OMIM (Online Mendelian Inheritance in Man) ##[https://www.omim.org/entry/181500?search=schizophrenia&highlight=schizophrenia 181500] == Web-based resources == '''Online Support Group'''&nbsp;for Family Members & Individuals with Schizophrenia [http://www.schizophrenia.com/coping.html Website] '''Chatrooms'''&nbsp;for Individuals with Schizophrenia: *http://www.schizophrenia-online.com/ *http://theircvillage.com/chat/ '''[http://www.schizophrenia.com General Information&nbsp;about Schizophrenia]''' == References == {{collapse top| References|expand=yes}} {{Reflist|2|refs= <ref name=KesslerEtAl1994>{{cite journal|last1=Kessler|first1=RC|last2=McGonagle|first2=KA|last3=Zhao|first3=S|last4=Nelson|first4=CB|last5=Hughes|first5=M|last6=Eshleman|first6=S|last7=Wittchen|first7=HU|last8=Kendler|first8=KS|title=Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States. Results from the National Comorbidity Survey.|journal=Archives of general psychiatry|date=January 1994|volume=51|issue=1|pages=8-19|pmid=8279933}}</ref> <ref name=RobinsRegiers1991>{{cite book |editor=Robins, Lee N. |editor2=Freedman, Darrel A. |title=Psychiatric disorders in America : the epidemiologic catchment area study |date=1991 |publisher=Free Press |location=New York |isbn=9780029265710}}</ref> <ref name=DumaisEtAl2010>{{cite journal|last1=Dumais|first1=A|last2=Côté|first2=G|last3=Lesage|first3=A|title=Clinical and sociodemographic profiles of male inmates with severe mental illness: a comparison with voluntarily and involuntarily hospitalized patients.|journal=Canadian journal of psychiatry. Revue canadienne de psychiatrie|date=March 2010|volume=55|issue=3|pages=172-9|pmid=20370968}}</ref> <ref name=MinskyEtAl2003>{{cite journal|last1=Minsky|first1=S|last2=Vega|first2=W|last3=Miskimen|first3=T|last4=Gara|first4=M|last5=Escobar|first5=J|title=Diagnostic patterns in Latino, African American, and European American psychiatric patients.|journal=Archives of general psychiatry|date=June 2003|volume=60|issue=6|pages=637-44|pmid=12796227}}</ref> <ref name=PeralaEtAl2007>{{cite journal|last1=Perälä|first1=J|last2=Suvisaari|first2=J|last3=Saarni|first3=SI|last4=Kuoppasalmi|first4=K|last5=Isometsä|first5=E|last6=Pirkola|first6=S|last7=Partonen|first7=T|last8=Tuulio-Henriksson|first8=A|last9=Hintikka|first9=J|last10=Kieseppä|first10=T|last11=Härkänen|first11=T|last12=Koskinen|first12=S|last13=Lönnqvist|first13=J|title=Lifetime prevalence of psychotic and bipolar I disorders in a general population.|journal=Archives of general psychiatry|date=January 2007|volume=64|issue=1|pages=19-28|pmid=17199051}}</ref> <ref name=FolsomEtAl2005>{{cite journal|last1=Folsom|first1=DP|last2=Hawthorne|first2=W|last3=Lindamer|first3=L|last4=Gilmer|first4=T|last5=Bailey|first5=A|last6=Golshan|first6=S|last7=Garcia|first7=P|last8=Unützer|first8=J|last9=Hough|first9=R|last10=Jeste|first10=DV|title=Prevalence and risk factors for homelessness and utilization of mental health services among 10,340 patients with serious mental illness in a large public mental health system.|journal=The American journal of psychiatry|date=February 2005|volume=162|issue=2|pages=370-6|pmid=15677603}}</ref> <ref name=WuEtAl2006>{{cite journal|last1=Wu|first1=EQ|last2=Shi|first2=L|last3=Birnbaum|first3=H|last4=Hudson|first4=T|last5=Kessler|first5=R|title=Annual prevalence of diagnosed schizophrenia in the USA: a claims data analysis approach.|journal=Psychological medicine|date=November 2006|volume=36|issue=11|pages=1535-40|pmid=16907994}}</ref> <ref name=ZimmermanMattia2001>{{cite journal|last1=Zimmerman|first1=M|last2=Mattia|first2=JI|title=The Psychiatric Diagnostic Screening Questionnaire: development, reliability and validity.|journal=Comprehensive psychiatry|date=2001|volume=42|issue=3|pages=175-89|pmid=11349235}}</ref> <ref name=ZimmermanSheeran2003>{{cite journal|last1=Zimmerman|first1=M|last2=Sheeran|first2=T|title=Screening for principal versus comorbid conditions in psychiatric outpatients with the Psychiatric Diagnostic Screening Questionnaire.|journal=Psychological assessment|date=March 2003|volume=15|issue=1|pages=110-4|pmid=12674730}}</ref> <ref name=MillerEtAl1999>{{cite journal|last1=Miller|first1=TJ|last2=McGlashan|first2=TH|last3=Woods|first3=SW|last4=Stein|first4=K|last5=Driesen|first5=N|last6=Corcoran|first6=CM|last7=Hoffman|first7=R|last8=Davidson|first8=L|title=Symptom assessment in schizophrenic prodromal states.|journal=The Psychiatric quarterly|date=1999|volume=70|issue=4|pages=273-87|pmid=10587984}}</ref> <ref name=MillerEtAl2003>{{cite journal|last1=Miller|first1=TJ|last2=McGlashan|first2=TH|last3=Rosen|first3=JL|last4=Cadenhead|first4=K|last5=Cannon|first5=T|last6=Ventura|first6=J|last7=McFarlane|first7=W|last8=Perkins|first8=DO|last9=Pearlson|first9=GD|last10=Woods|first10=SW|title=Prodromal assessment with the structured interview for prodromal syndromes and the scale of prodromal symptoms: predictive validity, interrater reliability, and training to reliability.|journal=Schizophrenia bulletin|date=2003|volume=29|issue=4|pages=703-15|pmid=14989408}}</ref> <ref name=Gross1989>{{cite journal|last1=Gross|first1=G|title=The 'basic' symptoms of schizophrenia.|journal=The British journal of psychiatry. Supplement|date=November 1989|issue=7|pages=21-5; discussion 37-40|pmid=2695138}}</ref> <ref name=KlosterkotterEtAl2001>{{cite journal|last1=Klosterkötter|first1=J|last2=Hellmich|first2=M|last3=Steinmeyer|first3=EM|last4=Schultze-Lutter|first4=F|title=Diagnosing schizophrenia in the initial prodromal phase.|journal=Archives of general psychiatry|date=February 2001|volume=58|issue=2|pages=158-64|pmid=11177117}}</ref> }} {{collapse bottom}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] e19n0m1k4yyzli0mokd1d5wqseer88i 2419319 2419306 2022-08-26T05:41:00Z Ardenguo 2944162 /* Recommended screening instruments */ linked extended page to "Note: Reliability and validity are included in the extended version. This table includes measures with Good or Excellent ratings." wikitext text/x-wiki <noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{medical disclaimer}} {{:{{BASEPAGENAME}}/Sidebar}} ==[[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio"?''']]== For background information on what assessment portfolios are, click the link in the heading above. Want even 'more' information about this topic? There's an extended version of this page [[Evidence-based assessment/Schizophrenia (disorder portfolio)/extended version|here]]. == [[Evidence based assessment/Preparation phase|'''Preparation phase''']] == === Diagnostic Criteria for Schizophrenia === {{blockquotetop}} <big>'''ICD-11 Diagnostic Criteria'''</big> *<big>'''Schizophrenia'''</big> **Schizophrenia is characterized by disturbances in multiple mental modalities, including thinking (e.g., delusions, disorganization in the form of thought), perception (e.g., hallucinations), self-experience (e.g., the experience that one's feelings, impulses, thoughts, or behaviour are under the control of an external force), cognition (e.g., impaired attention, verbal memory, and social cognition), volition (e.g., loss of motivation), affect (e.g., blunted emotional expression), and behaviour (e.g.,behaviour that appears bizarre or purposeless, unpredictable or inappropriate emotional responses that interfere with the organization of behaviour). Psychomotor disturbances, including catatonia, may be present. Persistent delusions, persistent hallucinations, thought disorder, and experiences of influence, passivity, or control are considered core symptoms. Symptoms must have persisted for at least one month in order for a diagnosis of schizophrenia to be assigned. The symptoms are not a manifestation of another health condition (e.g., a brain tumour) and are not due to the effect of a substance or medication on the central nervous system (e.g., corticosteroids), including withdrawal (e.g., alcohol withdrawal). *<big>'''Schizophrenia, First Episode'''</big> **Schizophrenia, first episode should be used to identify individuals experiencing symptoms that meet the diagnostic requirements for Schizophrenia (including duration) but who have never before experienced an episode during which diagnostic requirements for Schizophrenia were met. ***Note: The ICD-11 lists 3 additional subcategories of schizophrenia, first episode. They can be found [https://icd.who.int/browse11/l-m/en#/http%3a%2f%2fid.who.int%2ficd%2fentity%2f625636921 here]. *<big>'''Schizophrenia, Multiple Episodes'''</big> **Schizophrenia, multiple episode should be used to identify individuals experiencing symptoms that meet the diagnostic requirements for Schizophrenia (including duration) and who have also previously experienced episodes during which diagnostic requirements were met, with substantial remission of symptoms between episodes. Some attenuated symptoms may remain during periods of remission, and remissions may have occurred in response to medication or other treatment. ***Note: The ICD-11 lists 3 additional subcategories of schizophrenia, multiple episodes. They can be found [https://icd.who.int/browse11/l-m/en#/http%3a%2f%2fid.who.int%2ficd%2fentity%2f1150025154 here]. '''Changes in DSM-5''' The diagnostic criteria for schizophrenia spectrum and other psychotic disorders changed slightly from DSM-IV to DSM-5. A summary is available [https://en.wikipedia.org/wiki/DSM-5#Section_II:_diagnostic_criteria_and_codes here]. {{blockquotebottom}} === Base rates of schizophrenia in different populations and clinical settings === {| class="wikitable sortable" |- ! Demography ! Setting !! Base Rate !! Diagnostic Method |- | 48 contiguous US states | Non-institutionalized civilians<ref name="KesslerEtAl1994" /> || 0.5% || CIDI, SCID |- | Urban settings in 5 states (MD, NC, CN, CA, MO) | Community sample<ref name="RobinsRegiers1991" /> || 1.3% || DIS |- | All Federal Penitentiaries in Quebec-incarcerated and inmates currently hospitalized involuntarily | Inmates with severe mental disorders<ref name="DumaisEtAl2010" /> || 23.5% incarcerated†, 69.7% hospitalized involuntarily† || SCID |- || New Jersey | Patients presenting for inpatient and ambulatory services<ref name="MinskyEtAl2003" /> || *African-American (males – 19.1%, females – 11.3%) *Latino (males – 9.4%, females – 6.2%) *European-American (males – 9.9%, females – 6.1%) * (Rates are for all psychotic disorders – authors note this was “mostly schizophrenia”) | BASIC-32 |- | Global – 44 countries | General population (community, inpatient, and outpatient)<ref>{{Cite journal|last=Saha|first=Sukanta|last2=Chant|first2=David|last3=Welham|first3=Joy|last4=McGrath|first4=John|date=May 2005|title=A systematic review of the prevalence of schizophrenia|url=https://www.ncbi.nlm.nih.gov/pubmed/15916472|journal=PLoS medicine|volume=2|issue=5|pages=e141|doi=10.1371/journal.pmed.0020141|issn=1549-1676|pmc=PMC1140952|pmid=15916472}}</ref> ||0.7% || Clinical interview |- | Finland | General population<ref>{{Cite journal|last=Perälä|first=Jonna|last2=Suvisaari|first2=Jaana|last3=Saarni|first3=Samuli I.|last4=Kuoppasalmi|first4=Kimmo|last5=Isometsä|first5=Erkki|last6=Pirkola|first6=Sami|last7=Partonen|first7=Timo|last8=Tuulio-Henriksson|first8=Annamari|last9=Hintikka|first9=Jukka|date=January 2007|title=Lifetime prevalence of psychotic and bipolar I disorders in a general population|url=https://www.ncbi.nlm.nih.gov/pubmed/17199051|journal=Archives of General Psychiatry|volume=64|issue=1|pages=19–28|doi=10.1001/archpsyc.64.1.19|issn=0003-990X|pmid=17199051}}</ref> || 0.87% || CIDI, SCID |- | San Diego County | County Mental Health Service Users<ref name="FolsomEtAl2005" /> || 54% - homeless individuals || Chart Diagnosis |- || Maryland | Inpatient service<ref>{{Cite journal|last=Brown|first=Samuel L.|date=2001-06-01|title=Variations in Utilization and Cost of Inpatient Psychiatric Services Among Adults in Maryland|url=https://ps.psychiatryonline.org/doi/abs/10.1176/appi.ps.52.6.841|journal=Psychiatric Services|volume=52|issue=6|pages=841–843|doi=10.1176/appi.ps.52.6.841|issn=1075-2730}}</ref> || *39% - non-homeless *8.4% - 65 years and up *17% - 19-64 years || Psychiatrist Diagnosis |- | USA (Note: Medicaid rate was calculated using California Medi-Cal rates as a proxy) | Insurance claimants in 2002<ref name="WuEtAl2006" /> || Medicaid – 1.66%, Uninsured – 1.02%, Medicare – 0.83%, Privately insured – 0.13%, Veterans (through VA) – 1.41% || Physician diagnosis |} †Rates reflect schizophrenia spectrum disorders. '''Note:''' DIS = Diagnostic Interview Schedule, CIDI = Composite International Diagnostic Interview, SCID = Structured Diagnostic Interview for DSM, BASIC-32 = Behavior and Symptoms Identification Scale '''Search terms:''' [Schizophrenia] AND [prevalence OR incidence], [Schizophrenia] AND [Prevalence] AND [Outpatient OR inpatient] in PsycINFO, Medline, and PubMed ==[[Evidence based assessment/Prediction phase|'''Prediction phase''']]== ===Recommended screening instruments === The following section contains a list of screening and diagnostic instruments for schizophrenia. {| class="wikitable" |+ !Screening Instrument !Format !Age Range !Administration Time !Where to Access |- |Structured Interview for Psychosis-Risk Syndrome (SIPS) <ref name=":0">{{Cite book|url=https://www.worldcat.org/oclc/897376853|title=The assessment of psychosis : a reference book and rating scales for research and practice|author=Waters, Flavie |author2=Stephane, Massoud|isbn=9781315885605|location=New York, NY|oclc=897376853}}</ref> |Structured interview by a clinician or experienced rater |Pre-clinical adolescents and adults |2-3 hours | -Available from PRIME clinic at Yale University, contact Dr. Barbara Walsh at 203-974-7052 -[http://www.easacommunity.org/PDF/SIPS_5-5_032514&#x5B;1&#x5D;%20correct.pdf PDF Version] |- |Bonn Scale for the Assessment of Basic Symptoms (BSABS)<ref name=":0" /> |Semi-structured interview by a clinician or experienced rater |Pre-clinical, residual, and at-risk adolescents and adults |2-3 hours | -Available from [https://www.amazon.com/BSABS-Scale-Assessment-Basic-Symptoms/dp/3832271732 Amazon] -Available from publisher [https://www.shaker.de/de/index.asp?lang=de Shaker Verlag] |- | colspan="5" style="font-size:110%; text-align:center;" |'''For Children and Adolescents Specifically''' |- |Strengths and Difficulties Questionnaire (SDQ) <ref>{{Cite journal|last=Goodman|first=Robert|last2=Ford|first2=Tamsin|last3=Simmons|first3=Helen|last4=Gatward|first4=Rebecca|last5=Meltzer|first5=Howart|date=2000-12|title=Using the Strengths and Difficulties Questionnaire (SDQ) to screen for child psychiatric disorders in a community sample|url=https://www.cambridge.org/core/product/identifier/S0007125000156065/type/journal_article|journal=British Journal of Psychiatry|language=en|volume=177|issue=6|pages=534–539|doi=10.1192/bjp.177.6.534|issn=0007-1250}}</ref> |Parent/teacher-report, self-report, rate items |Ages 2+ |5-25 minutes | -Available from [https://www.sdqinfo.org/py/sdqinfo/b3.py?language=Englishqz(USA) Youth In Mind] -[https://osf.io/dzk68/?view_only=681e9b648169427b845f313aafa0a169 PDF Version] |} '''Note:''' Reliability and validity are included in the [[Evidence-based assessment/Schizophrenia (disorder portfolio)/extended version|extended version]]. This table includes measures with Good or Excellent ratings. === Likelihood ratios and AUCs of screening measures for schizophrenia === * '''''For a list of the likelihood ratios for more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Likelihood_ratios_and_AUCs_of_common_screening_instruments click here.]''''' {| class="wikitable" |- ! scope="col" style="width: 225px;" | Screening Measure (Primary Reference) ! scope="col" style="width: 100px;" | AUC ! scope="col" style="width: 100px;" | LR+ (Score) ! scope="col" style="width: 100px;" | LR- (Score) ! scope="col" style="width: 225px;"| Clinical generalizability !Where to Access |- | Psychiatric Diagnostic Screening Questionnaire – PDSQ (Zimmerman & Mattia, 2001a; Zimmerman & Sheeran, 2004)<ref name=ZimmermanMattia2001/><ref>{{Cite journal|last=Zimmerman|first=Mark|last2=Sheeran|first2=Thomas|date=2003-03|title=Screening for principal versus comorbid conditions in psychiatric outpatients with the Psychiatric Diagnostic Screening Questionnaire|url=https://pubmed.ncbi.nlm.nih.gov/12674730|journal=Psychological Assessment|volume=15|issue=1|pages=110–114|doi=10.1037/1040-3590.15.1.110|issn=1040-3590|pmid=12674730}}</ref>‡ || .92 (N = 799) || 2.7 (Subscale cutoff score = 1) || .33 (Subscale cutoff score = 1) || Low – can distinguish psychotic disorders from non-psychotic disorders but cannot distinguish schizophrenia from other psychotic disorders (ex: MDD with psychosis) |Not free |- | Structured Interview for Prodromal Syndromes – SIPS (Miller et al., 1999, 2003)<ref name=MillerEtAl1999/> <ref>{{Cite journal|last=Miller|first=Tandy J.|last2=McGlashan|first2=Thomas H.|last3=Rosen|first3=Joanna L.|last4=Cadenhead|first4=Kristen|last5=Cannon|first5=Tyrone|last6=Ventura|first6=Joseph|last7=McFarlane|first7=William|last8=Perkins|first8=Diana O.|last9=Pearlson|first9=Godfrey D.|date=2003|title=Prodromal assessment with the structured interview for prodromal syndromes and the scale of prodromal symptoms: predictive validity, interrater reliability, and training to reliability|url=https://pubmed.ncbi.nlm.nih.gov/14989408|journal=Schizophrenia Bulletin|volume=29|issue=4|pages=703–715|doi=10.1093/oxfordjournals.schbul.a007040|issn=0586-7614|pmid=14989408}}</ref>|| Not given (N = 34) || 3.5 (not given) || 0 (not given) || Moderate – has some predictive validity (46% of those identified as prodromal by the SIPS developed schizophrenia psychosis within 6 mo.) |[https://mfr.osf.io/render?url=https://osf.io/scxyh/?action=download%26mode=render SIPS] |- | Bonn Scale for the Assessment of basic Symptoms – BSABS (Gross, 1989; Klosterkotter, Hellmich, Steinmeyer, Schultze-Lutter, 2001)<ref name=Gross1989/><ref>{{Cite journal|last=Klosterkötter|first=J.|last2=Hellmich|first2=M.|last3=Steinmeyer|first3=E. M.|last4=Schultze-Lutter|first4=F.|date=2001-02|title=Diagnosing schizophrenia in the initial prodromal phase|url=https://pubmed.ncbi.nlm.nih.gov/11177117|journal=Archives of General Psychiatry|volume=58|issue=2|pages=158–164|doi=10.1001/archpsyc.58.2.158|issn=0003-990X|pmid=11177117}}</ref>• *Cluster 1 = thought, language, perception, and motor disturbances *Cluster 2 = impaired bodily sensations *Cluster 3 = impaired tolerance to normal stress *Cluster 4 = disorders of emotion and affect including impaired thought, energy, concentration, and memory *Cluster 5 = increased emotional reactivity, impaired ability to maintain or initiate social contacts, and disturbances in nonverbal expression || (N = 160) *C1 = 0.81 *C2 = 0.50 *C3 = 0.52 *C4 = 0.57 *C5 = 0.58 || Overall = 2.4 (>=1) *C1 = 3.1 *C2 = 0.48 *C3 = 0.97 *C4 = 1.1 *C5 = 1.4 (*) || Overall = 0.03 (>=1) *C1 = 0.52 *C2 = 1.0 *C3 = 0.77 *C4 = 0.5 *C5 = 0.70 (*) || Moderate - has some predictive validity for individuals who are in prodromal period of schizophrenia overall, cluster 1 has best predictive accuracy and may be most useful. |Available from [https://www.amazon.com/BSABS-Scale-Assessment-Basic-Symptoms/dp/3832271732 Amazon] Available from publisher [https://www.shaker.de/de/index.asp?lang=de Shaker Verlag] |- |Symptom Severity Scale of the DSM5<ref>{{Cite journal|last=Ritsner|first=Michael S.|last2=Mar|first2=Maria|last3=Arbitman|first3=Marina|last4=Grinshpoon|first4=Alexander|date=2013-06-30|title=Symptom severity scale of the DSM5 for schizophrenia, and other psychotic disorders: diagnostic validity and clinical feasibility|url=https://www.sciencedirect.com/science/article/pii/S0165178113001042|journal=Psychiatry Research|language=en|volume=208|issue=1|pages=1–8|doi=10.1016/j.psychres.2013.02.029|issn=0165-1781}}</ref> |0.85 (N=314) |3.53 |0.35 |Medium: Schizophrenia versus all other psychotic disorders, but has not been studied in a variety of populations with schizophrenia as it is a relatively new measure. |[https://mfr.osf.io/render?url=https://osf.io/7hwmy/?action=download%26mode=render DSM 5 Scale] |- |Positive and Negative Syndrome Scale (PANSS)<ref>{{Cite journal|last=Kay|first=S. R.|last2=Fiszbein|first2=A.|last3=Opler|first3=L. A.|date=1987-01-01|title=The Positive and Negative Syndrome Scale (PANSS) for Schizophrenia|url=https://academic.oup.com/schizophreniabulletin/article-lookup/doi/10.1093/schbul/13.2.261|journal=Schizophrenia Bulletin|language=en|volume=13|issue=2|pages=261–276|doi=10.1093/schbul/13.2.261|issn=0586-7614}}</ref><ref>{{Cite journal|last=Ritsner|first=Michael S.|last2=Mar|first2=Maria|last3=Arbitman|first3=Marina|last4=Grinshpoon|first4=Alexander|date=2013-06-30|title=Symptom severity scale of the DSM5 for schizophrenia, and other psychotic disorders: diagnostic validity and clinical feasibility|url=https://www.sciencedirect.com/science/article/pii/S0165178113001042|journal=Psychiatry Research|language=en|volume=208|issue=1|pages=1–8|doi=10.1016/j.psychres.2013.02.029|issn=0165-1781}}</ref> |0.91 (N=314) |N/A |N/A |Note: 45 minute clinical interview. Requires training. Attached to appendix. |Not free |} '''Note:''' ‡ Used the SCID administered by trained raters. • Used Present State Examination 9 and psychiatrist diagnosis. (*) Cutoff score for all clusters was 15% of symptoms in that cluster present (for cluster 1= 5/35 symptoms) *“LR+” refers to the change in likelihood ratio associated with a positive test score, and “LR-” is the likelihood ratio for a low score. Likelihood ratios of 1 indicate that the test result did not change impressions at all. LRs larger than 10 or smaller than .10 are frequently clinically decisive; 5 or .20 are helpful, and between 2.0 and .5 are small enough that they rarely result in clinically meaningful changes of formulation (Sackett et al., 2000). '''Search terms:''' [schizophrenia] AND [sensitivity OR specificity] AND [differential diagnosis] AND [<nowiki/>[[wikipedia:Prodrome|prodrome]]] in MedLine and PsycINFO === Interpreting schizophrenia screening measure scores === * For information on interpreting screening measure scores, click [[Evidence based assessment/Prediction phase#Interpreting screening measure scores|here.]] ==[[Evidence based assessment/Prescription phase|'''Prescription phase''']]== ===Gold standard diagnostic interviews=== For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews click here.] ===Recommended diagnostic interviews for schizophrenia=== {| class="wikitable" |+ !Diagnostic Interview !Format !Age Range/ !Administration Time !Where to Access |- |Structured Clinical Interview for DSM-V (SCID)<ref>{{Cite web|url=https://www.appi.org/products/structured-clinical-interview-for-dsm-5-scid-5|title=Structured Clinical Interview for DSM-5 (SCID-5)|website=www.appi.org|accessdate=2018-03-08}}</ref><ref>{{Cite journal|date=2018-06|editor-last=Hunsley|editor-first=John|editor2-last=Mash|editor2-first=Eric J.|title=A Guide to Assessments That Work|url=http://dx.doi.org/10.1093/med-psych/9780190492243.001.0001|journal=Oxford Clinical Psychology|doi=10.1093/med-psych/9780190492243.001.0001}}</ref> |Semi-structured interview to be administered by a clinician or an experienced rater |Adults (Ages 18+) |Varies, 43.0±30.6 minutes | -Available for purchase from [https://www.appi.org/products/structured-clinical-interview-for-dsm-5-scid-5 APA Publishing] (Note: Not free) -Modified [https://mfr.osf.io/render?url=https://osf.io/x9smc/?action=download%26mode=render] (not most recent version, SCID-I) -Located on Penn Lab, See Appendix 1 for schizophrenia modules |- |Mini-International Neuropsychiatric Interview (MINI)<ref>{{Cite journal|last=Sheehan|first=D. V.|last2=Lecrubier|first2=Y.|last3=Sheehan|first3=K. H.|last4=Amorim|first4=P.|last5=Janavs|first5=J.|last6=Weiller|first6=E.|last7=Hergueta|first7=T.|last8=Baker|first8=R.|last9=Dunbar|first9=G. C.|date=1998|title=The Mini-International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10|url=https://pubmed.ncbi.nlm.nih.gov/9881538|journal=The Journal of Clinical Psychiatry|volume=59 Suppl 20|pages=22–33;quiz 34–57|issn=0160-6689|pmid=9881538}}</ref><ref>{{Cite book|url=https://www.worldcat.org/oclc/897376853|title=The assessment of psychosis : a reference book and rating scales for research and practice|date=2015|others=Flavie Waters, Massoud Stephane|isbn=978-1-134-62869-8|location=New York, NY|oclc=897376853}}</ref> |Structured interview to be administer by a mental health professional with extensive training |Adults, also a children and adolescent version available |Mean 18.7 minutes | -Available on the [https://harmresearch.org/mini-international-neuropsychiatric-interview-mini/ Harm Research Institute] for purchase |- |- | colspan="5" style="font-size:110%; text-align:center;" |'''For Children and Adolescents Specifically''' |- |[[wikipedia:Kiddie_Schedule_for_Affective_Disorders_and_Schizophrenia|Kiddie Schedule for Affective Disorders and Schizophrenia Present and Lifetime Version (KSADS-PL DSM-V)]]<ref>Eric A. Youngstrom, Mitchell J. Prinstein, Eric J. Mash, & Russell A. Barkley. (2020). ''Assessment of Disorders in Childhood and Adolescence, Fifth Edition: Vol. Fifth edition''. The Guilford Press.</ref> |Semi-structured interview to be administered by a health care provider or highly trained clinical researcher |Ages 6-18 |45-75 minutes |[https://www.kennedykrieger.org/sites/default/files/library/documents/faculty/ksads-dsm-5-screener.pdf PDF Version] |} '''Note:''' Reliability and validity are included in the [[Evidence-based assessment/Schizophrenia (disorder portfolio)/extended version|extended version]]. This table includes measures with Good or Excellent ratings. ==[[Evidence based assessment/Process phase|'''Process phase''']]== The following section contains a list of process and outcome measures for schizophrenia. The section includes benchmarks based on published norms and on mood samples for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the [[Evidence based assessment/Process phase|process phase]] of assessment. For more information of differences between process and outcome measures, see the page on the [[Evidence based assessment/Process phase|process phase of assessment]]. === Severity and outcome === * Information on how to interpret this table can be [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase found here]. *''<u>For clinically significant change benchmarks for the CBCL, YSR, and TRF total, externalizing, internalizing, and attention benchmarks,</u>'' [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase&wteswitched=1#Clinically_significant_change_benchmarks_for_widely-used_outcome_measures see here.] ==== Clinically significant change benchmarks with common instruments for schizophrenia ==== {| class="wikitable sortable" border="1" |- | rowspan=1" style="text-align:center;font-size:130%;" | <b> Measure</b> | style="text-align:center;font-size:130%;" | '''Scale'''<b></b> | colspan="3" style="text-align:center;font-size:130%" width="300" | <b> Cut Scores*</b> | colspan="3" style="text-align:center;font-size:120%" | <b> Critical Change <br> (Unstandardized Scores)</b> |- | colspan="2" | | style="text-align:center;font-size:110%" | <b> A</b> | style="text-align:center;font-size:110%" | <b> B</b> | style="text-align:center;font-size:110%" | <b> C</b> | style="text-align:center;font-size:110%" | <b> 95%</b> | style="text-align:center;font-size:110%" | <b> 90%</b> | style="text-align:center;font-size:110%" | <b> SE_difference</b> |- | colspan="8" span style="font-size:110%; text-align:center;" | <b> Benchmarks Based on Published Norms for Samples with Schizophrenia</b> |- | rowspan="3" style="text-align:center;" | <i> Positive and Negative Syndrome Scale <br> (1987 Norms)</i> | style="text-align:center;" | PANSS Positive Scale | style="text-align:center;"| 6 | style="text-align:center;"| n/a | style="text-align:center;"| n/a | style="text-align:center;"| 8.8 | style="text-align:center;"| 7.4 | style="text-align:center;"| 4.5 |- | rowspan="1" style="text-align:center;" | PANSS Negative Scale <br> | style="text-align:center;"| 8.8 | style="text-align:center;"| n/a | style="text-align:center;"| n/a | style="text-align:center;"| 7.0 | style="text-align:center;"| 5.9 | style="text-align:center;"| 3.6 |- | rowspan="1" style="text-align:center;" | PANSS General Psychopathology Scale <br> | style="text-align:center;"| 18.8 | style="text-align:center;"| n/a | style="text-align:center;"| n/a | style="text-align:center;"| 9.5 | style="text-align:center;"| 8.0 | style="text-align:center;"| 4.8 |- | rowspan="2" style="text-align:center;" | <i> Scale for the Assessment of Positive Symptoms (SAPS) and Negative Symptoms (SANS) <br> (1991 Norms)</i> | style="text-align:center;" | SAPS | style="text-align:center;"| -6.9 | style="text-align:center;"| n/a | style="text-align:center;"| n/a | style="text-align:center;"| 13.4 | style="text-align:center;"| 11.3 | style="text-align:center;"| 6.8 |- | rowspan="1" style="text-align:center;" | SANS <br> | style="text-align:center;"| 0.6 | style="text-align:center;"| n/a | style="text-align:center;"| n/a | style="text-align:center;"| 13.9 | style="text-align:center;"| 11.7 | style="text-align:center;"| 7.1 |- | rowspan="1" style="text-align:center;"| ''Social Skills (Social Functioning Scale)'' | |90.9 |268.7 |102.1 |7.2 |6.0 |3.6 |- | rowspan="1" style="text-align:center;"|''Brief Psychiatric Rating Scale (BPRS)'' | | | | | | | |} '''Note:''' “A” = Away from the clinical range, “B” = Back into the nonclinical range, “C” = Closer to the nonclinical than clinical mean. '''Note:'''&nbsp;Clinical significance may be limited for use in schizophrenia as the disorder is currently incurable and the extent to which a return to normal functioning may be less common. For this reason, some investigators have used methods other than those proposed by Jacobson and Truax (1991) to develop cut-off points (Jacobson et al. 1999). * Example: Positive and Negative Syndrome Scale (PANSS) cut-off scores of 40, 45 and 50 have been mentioned for clinically significant change for schizophrenia patients in hospital settings (Schennach et al. 2015). '''Search terms:''' [schizophrenia] AND [clinical significance OR outcomes OR change] AND [PANSS OR SWLS] in MedLine and PsycINFO === Treatment === See [[wikipedia:Management_of_schizophrenia|Management of Schizophrenia]]. ==External Resources== #[https://icd.who.int/browse11/l-m/en#/http%3a%2f%2fid.who.int%2ficd%2fentity%2f1683919430 ICD-11 diagnostic criteria] # [https://en.wikiversity.org/w/index.php?title=Helping_Give_Away_Psychological_Science/Resources/Annotated_List_of_Where_and_How_to_Find_a_Therapist&wteswitched=1#Other_low-cost_options Find-a-Therapist] (a curated list of find-a-therapist websites where you can find a provider) #[https://www.nimh.nih.gov/health/topics/schizophrenia/index.shtml NIMH] (information about schizophrenia) # OMIM (Online Mendelian Inheritance in Man) ##[https://www.omim.org/entry/181500?search=schizophrenia&highlight=schizophrenia 181500] == Web-based resources == '''Online Support Group'''&nbsp;for Family Members & Individuals with Schizophrenia [http://www.schizophrenia.com/coping.html Website] '''Chatrooms'''&nbsp;for Individuals with Schizophrenia: *http://www.schizophrenia-online.com/ *http://theircvillage.com/chat/ '''[http://www.schizophrenia.com General Information&nbsp;about Schizophrenia]''' == References == {{collapse top| References|expand=yes}} {{Reflist|2|refs= <ref name=KesslerEtAl1994>{{cite journal|last1=Kessler|first1=RC|last2=McGonagle|first2=KA|last3=Zhao|first3=S|last4=Nelson|first4=CB|last5=Hughes|first5=M|last6=Eshleman|first6=S|last7=Wittchen|first7=HU|last8=Kendler|first8=KS|title=Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States. Results from the National Comorbidity Survey.|journal=Archives of general psychiatry|date=January 1994|volume=51|issue=1|pages=8-19|pmid=8279933}}</ref> <ref name=RobinsRegiers1991>{{cite book |editor=Robins, Lee N. |editor2=Freedman, Darrel A. |title=Psychiatric disorders in America : the epidemiologic catchment area study |date=1991 |publisher=Free Press |location=New York |isbn=9780029265710}}</ref> <ref name=DumaisEtAl2010>{{cite journal|last1=Dumais|first1=A|last2=Côté|first2=G|last3=Lesage|first3=A|title=Clinical and sociodemographic profiles of male inmates with severe mental illness: a comparison with voluntarily and involuntarily hospitalized patients.|journal=Canadian journal of psychiatry. Revue canadienne de psychiatrie|date=March 2010|volume=55|issue=3|pages=172-9|pmid=20370968}}</ref> <ref name=MinskyEtAl2003>{{cite journal|last1=Minsky|first1=S|last2=Vega|first2=W|last3=Miskimen|first3=T|last4=Gara|first4=M|last5=Escobar|first5=J|title=Diagnostic patterns in Latino, African American, and European American psychiatric patients.|journal=Archives of general psychiatry|date=June 2003|volume=60|issue=6|pages=637-44|pmid=12796227}}</ref> <ref name=PeralaEtAl2007>{{cite journal|last1=Perälä|first1=J|last2=Suvisaari|first2=J|last3=Saarni|first3=SI|last4=Kuoppasalmi|first4=K|last5=Isometsä|first5=E|last6=Pirkola|first6=S|last7=Partonen|first7=T|last8=Tuulio-Henriksson|first8=A|last9=Hintikka|first9=J|last10=Kieseppä|first10=T|last11=Härkänen|first11=T|last12=Koskinen|first12=S|last13=Lönnqvist|first13=J|title=Lifetime prevalence of psychotic and bipolar I disorders in a general population.|journal=Archives of general psychiatry|date=January 2007|volume=64|issue=1|pages=19-28|pmid=17199051}}</ref> <ref name=FolsomEtAl2005>{{cite journal|last1=Folsom|first1=DP|last2=Hawthorne|first2=W|last3=Lindamer|first3=L|last4=Gilmer|first4=T|last5=Bailey|first5=A|last6=Golshan|first6=S|last7=Garcia|first7=P|last8=Unützer|first8=J|last9=Hough|first9=R|last10=Jeste|first10=DV|title=Prevalence and risk factors for homelessness and utilization of mental health services among 10,340 patients with serious mental illness in a large public mental health system.|journal=The American journal of psychiatry|date=February 2005|volume=162|issue=2|pages=370-6|pmid=15677603}}</ref> <ref name=WuEtAl2006>{{cite journal|last1=Wu|first1=EQ|last2=Shi|first2=L|last3=Birnbaum|first3=H|last4=Hudson|first4=T|last5=Kessler|first5=R|title=Annual prevalence of diagnosed schizophrenia in the USA: a claims data analysis approach.|journal=Psychological medicine|date=November 2006|volume=36|issue=11|pages=1535-40|pmid=16907994}}</ref> <ref name=ZimmermanMattia2001>{{cite journal|last1=Zimmerman|first1=M|last2=Mattia|first2=JI|title=The Psychiatric Diagnostic Screening Questionnaire: development, reliability and validity.|journal=Comprehensive psychiatry|date=2001|volume=42|issue=3|pages=175-89|pmid=11349235}}</ref> <ref name=ZimmermanSheeran2003>{{cite journal|last1=Zimmerman|first1=M|last2=Sheeran|first2=T|title=Screening for principal versus comorbid conditions in psychiatric outpatients with the Psychiatric Diagnostic Screening Questionnaire.|journal=Psychological assessment|date=March 2003|volume=15|issue=1|pages=110-4|pmid=12674730}}</ref> <ref name=MillerEtAl1999>{{cite journal|last1=Miller|first1=TJ|last2=McGlashan|first2=TH|last3=Woods|first3=SW|last4=Stein|first4=K|last5=Driesen|first5=N|last6=Corcoran|first6=CM|last7=Hoffman|first7=R|last8=Davidson|first8=L|title=Symptom assessment in schizophrenic prodromal states.|journal=The Psychiatric quarterly|date=1999|volume=70|issue=4|pages=273-87|pmid=10587984}}</ref> <ref name=MillerEtAl2003>{{cite journal|last1=Miller|first1=TJ|last2=McGlashan|first2=TH|last3=Rosen|first3=JL|last4=Cadenhead|first4=K|last5=Cannon|first5=T|last6=Ventura|first6=J|last7=McFarlane|first7=W|last8=Perkins|first8=DO|last9=Pearlson|first9=GD|last10=Woods|first10=SW|title=Prodromal assessment with the structured interview for prodromal syndromes and the scale of prodromal symptoms: predictive validity, interrater reliability, and training to reliability.|journal=Schizophrenia bulletin|date=2003|volume=29|issue=4|pages=703-15|pmid=14989408}}</ref> <ref name=Gross1989>{{cite journal|last1=Gross|first1=G|title=The 'basic' symptoms of schizophrenia.|journal=The British journal of psychiatry. Supplement|date=November 1989|issue=7|pages=21-5; discussion 37-40|pmid=2695138}}</ref> <ref name=KlosterkotterEtAl2001>{{cite journal|last1=Klosterkötter|first1=J|last2=Hellmich|first2=M|last3=Steinmeyer|first3=EM|last4=Schultze-Lutter|first4=F|title=Diagnosing schizophrenia in the initial prodromal phase.|journal=Archives of general psychiatry|date=February 2001|volume=58|issue=2|pages=158-64|pmid=11177117}}</ref> }} {{collapse bottom}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] l0suoortgl3z36wpnn1gppot7n0685h 0 207112 2419228 2411979 2022-08-26T03:09:15Z Ardenguo 2944162 /* Diagnostic criteria for phobic anxiety disorders */ Made the collapsible box expanded by default wikitext text/x-wiki <noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{medical disclaimer}} {{:{{BASEPAGENAME}}/Sidebar}} ==[[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio"?''']]== * For background information on what assessment portfolios are, click the link in the heading above. * Want more information? There's an extended version of this page [[Evidence-based assessment/Simple phobia/Extended version|here]]. == [[Evidence based assessment/Preparation phase|'''Preparation phase''']] == === Diagnostic criteria for phobic anxiety disorders === {{collapse top| ICD-11 and DSM-5 Diagnostic Information|expand=yes}} {{blockquotetop}} '''ICD-11 Diagnostic Criteria''' Specific phobia is characterized by a marked and excessive fear or anxiety that consistently occurs when exposed to one or more specific objects or situations (e.g., proximity to certain animals, flying, heights, closed spaces, sight of blood or injury) and that is out of proportion to actual danger. The phobic objects or situations are avoided or else endured with intense fear or anxiety. Symptoms persist for at least several months and are sufficiently severe to result in significant distress or significant impairment in personal, family, social, educational, occupational, or other important areas of functioning. '''Inclusions''' *Simple phobia *Acrophobia *Claustrophobia '''Exclusions''' *Body dysmorphic disorder *Hypochondriasis '''Changes in DSM-5''' The diagnostic criteria for simple phobia changed slightly from [[DSM-IV]] to [[w:Diagnostic_and_Statistical_Manual_of_Mental_Disorders#DSM-IV-TR_.282000.29|DSM-5]]. Summaries are available [http://www.dsm5.org/Documents/changes%20from%20dsm-iv-tr%20to%20dsm-5.pdf here] and [[w:DSM-5|here]]. {{blockquotebottom}} {{Collapse bottom}} === Base rates of simple phobia in different populations and clinical settings === This section describes the demographic setting of the population(s) sampled, base rates of diagnosis, country/region sampled and the diagnostic method that was used. Using this information, clinicians will be able to anchor the rate of simple phobia that they are likely to see in their clinical practice. * '''''To see prevalence rates across multiple disorders,''''' [[Evidence based assessment/Preparation phase#Base rates for transdiagnostic comparison|'''''click here.''''']] {| class="wikitable" |- ! Demography ! Setting !! Base Rate !! Diagnostic Method |- | California<ref name="VegaEtAl1998" /> | Mexican-American Prevalence and Service Survey (MAPSS) – adults 18+, all specific phobias || 7.4% || CIDI/DSM-III-R |- | All of US<ref name="KesslerEtAl2005a" /> | NCS replication, adults 18+, 12-month prevalence || 8.7% || CIDI/DSM-IV |- | All of US<ref name="KesslerEtAl2005b" /> | National Comorbidity Survey (NCS); non-institutionalized adults between 18-54, all specific phobias || 11.3% || CIDI/DSM-III-R |- | All of US<ref name="StinsonEtAl2007" /> | National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), adults 18+, all specific phobias || 9.4% || AUDADIS-IV/DSM-IV |- | New Haven, CT<ref name="RobinsEtAl1984" /> | Adults 18+, all specific phobias || 7.8% || Clinical interview/DSM-III |- | Baltimore, MD<ref name="RobinsEtAl1984" /> | Adults 18+, all specific phobias || 23.3% || Clinical interview/DSM-III |- | St. Louis, MI<ref name="RobinsEtAl1984" /> | Adults 18+, all specific phobias || 11.1% || Clinical interview/DSM-III |- | All of US<ref name="GrantEtAl2004" /> | National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), adults 18+, all Specific Phobias || 7.14% || AUDADIS-IV/DSM-IV |- || All of US | Different age groups, all specific phobias || Community Prevalence: 7-9% Children: 5% 13- to 17- year olds: 16% Older Adults: 3-5% Note: Females are more frequently affected than males at a rate of 2:1 | DSM-V |- |Varied<ref name=":12">{{Cite journal|last=Rettew|first=David C.|last2=Lynch|first2=Alicia Doyle|last3=Achenbach|first3=Thomas M.|last4=Dumenci|first4=Levent|last5=Ivanova|first5=Masha Y.|date=2009-09|title=Meta-analyses of agreement between diagnoses made from clinical evaluations and standardized diagnostic interviews|url=http://dx.doi.org/10.1002/mpr.289|journal=International Journal of Methods in Psychiatric Research|language=en|volume=18|issue=3|pages=169–184|doi=10.1002/mpr.289|issn=1049-8931}}</ref> |Outpatient clinic (DAU) |6% (specific) |Varied |- |Varied<ref name=":13">{{Cite journal|last=Rettew|first=David C.|last2=Lynch|first2=Alicia Doyle|last3=Achenbach|first3=Thomas M.|last4=Dumenci|first4=Levent|last5=Ivanova|first5=Masha Y.|date=2009-09|title=Meta-analyses of agreement between diagnoses made from clinical evaluations and standardized diagnostic interviews|url=http://dx.doi.org/10.1002/mpr.289|journal=International Journal of Methods in Psychiatric Research|language=en|volume=18|issue=3|pages=169–184|doi=10.1002/mpr.289|issn=1049-8931}}</ref> |Outpatient clinic (SDI) |15% (specific) |Varied |- |Varied<ref name=":3">Kessler, R. C., Avenevoli, S., Costello, E. J., Georgiades, K., Green, J. G., Gruber, M. J., . . . Merikangas, K. R. (2012). Prevalence, persistence, and sociodemographic correlates of DSM-IV disorders in the National Comorbidity Survey Replication Adolescent Supplement. Archives of General Psychiatry, 69(4), 372-380. doi:10.1001/archgenpsychiatry.2011.160</ref> |General Population |19% specific |Varied |} ==[[Evidence based assessment/Prediction phase|'''Prediction phase''']]== === Psychometric properties of screening instruments for simple phobia === The following section contains a list of screening and diagnostic instruments for simple phobia. The section includes administration information, psychometric data, and PDFs or links to the screenings. * Screenings are used as part of the [[Evidence based assessment/Prediction phase|prediction phase]] of assessment; for more information on interpretation of this data, or how screenings fit in to the assessment process, click [[Evidence based assessment/Prediction phase|here]]. * '''''For a list of more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Psychometric_properties_of_common_screening_instruments click here.]''''' {| class="wikitable sortable" ! colspan="5" |Screening measures for simple phobia |- ! Measure !Format (Reporter) !Age Range !Administration/ Completion Time !Where to access |- |Fear Survey Schedule for Children-Revised (FSSC-R) |Questionnaire (self-report) |7-16 years |19-20 minutes |[https://onlinelibrary.wiley.com/doi/pdf/10.1002/9780470713334.app3 Yes (article PDF link)] |- |Fear of Spiders Questionnaire (FSQ) |Questionnaire (self-report) |13 years-adult |5 minutes |[https://www.sciencedirect.com/science/article/pii/000579169400072T Yes (article PDF link)] |- |Disgust Scale |Questionnaire (self-report) |16 years-adult |8 minutes |[http://people.stern.nyu.edu/jhaidt/disgustscale.html Yes (Questionnaire homepage and PDF)] |- |Revised Children’s Anxiety and Depression Scale (RCADS) |Questionnaire (Child) |6-18 |12 minutes | *[http://www.corc.uk.net/outcome-experience-measures/revised-childrens-anxiety-and-depression-scale-and-subscales/ RCADS homepage] '''PDFs for RCADS''' *[https://mfr.osf.io/render?url=https://osf.io/s3fu2/?action=download%26mode=render RCADS Child Self-reported (8-18 years)] *[https://mfr.osf.io/render?url=https://osf.io/fp9mk/?action=download%26mode=render RCADS Parent-reported] *[https://mfr.osf.io/render?url=https://osf.io/vy7ta/?action=download%26mode=render Child Scoring Aid] *[https://mfr.osf.io/render?url=https://osf.io/t4bz6/?action=download%26mode=render Parent Scoring Aid] '''Subscales''' *[https://mfr.osf.io/render?url=https://osf.io/ectpf/?action=download%26mode=render Social Anxiety/Phobia Self-reported] *[https://mfr.osf.io/render?url=https://osf.io/pu6rn/?action=download%26mode=render Social Anxiety/Phobia Parent-reported] *[https://mfr.osf.io/render?url=https://osf.io/4gc8d/?action=download%26mode=render Panic Self-Report] *[https://mfr.osf.io/render?url=https://osf.io/nhcsu/?action=download%26mode=render Panic Parent-Report] '''Translations''' '''[https://mfr.osf.io/render?url=https://osf.io/qsjh9/?action=download%26mode=render User Guide]''' |} '''Note:''' Reliability and validity are included in the extended version (link). This table includes measures with Good or Excellent ratings. === Likelihood ratios and AUCs of screening measures for simple phobia === * ''For a list of the likelihood ratios for more broadly reaching screening instruments,'' [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Likelihood_ratios_and_AUCs_of_common_screening_instruments '''''click here.'''''] {| class="wikitable" |- ! Screening Measure (Primary Reference) !! AUC and Sample Size !! LR+ (Score) !! LR- (Score) !! Clinical generalizability |- | Specific Phobia of Vomiting Inventory (SPOVI)<ref name="VealeEtAl2012" />|| 0.944 (N = 185) || 24.3 (10+) || 0.03 (<10) || High: able to distinguish between phobics and controls |- | The Claustrophobia Scale (CS) - Anxiety Subscale (Rachman and Taylor, 1993) <ref name="Ost2007" />|| --- (N = 285) || 49.0 (24+) || 0.0002 (<24) || High: able to distinguish between phobics and controls |- | The Claustrophobia Scale (CS) - Avoidance Subscale (Rachman and Taylor, 1993)<ref name="Ost2007" />|| --- (N = 285) || 19.2 (9+) || 0.0004 (<9) || High: able to distinguish between phobics and controls |} '''Search terms:''' [specific phobia] AND [sensitivity OR specificity] in Google Scholar and PsycINFO === Interpreting specific phobia screening measure scores === * For information on interpreting screening measure scores, click [[Evidence based assessment/Prediction phase#Interpreting screening measure scores|here.]] ==[[Evidence based assessment/Prescription phase|'''Prescription phase''']]== ===Gold standard diagnostic interviews=== For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews click here.] === Recommended diagnostic instruments for simple phobia === {| class="wikitable sortable" ! colspan="5" |Diagnostic instruments for simple phobia |- !Measure !Format (Reporter) !Age Range !Administration/ Completion Time !Where to access |- |Anxiety Disorders Interview Schedule for Children (ADIS-C)<ref name=":1">{{Cite journal|date=2001-08-01|title=Test-Retest Reliability of Anxiety Symptoms and Diagnoses With the Anxiety Disorders Interview Schedule for DSM-IV: Child and Parent Versions|url=https://www.sciencedirect.com/science/article/pii/S0890856709603427|journal=Journal of the American Academy of Child & Adolescent Psychiatry|language=en|volume=40|issue=8|pages=937–944|doi=10.1097/00004583-200108000-00016|issn=0890-8567}}</ref> |Child |6 years-adult |90 minutes | * [https://books.google.com/books/about/Anxiety_Disorders_Interview_Schedule_for.html?id=xpR6V3rboxwC Purchase] |- |Anxiety Disorders Interview Schedule for Children (ADIS-P)<ref name=":1" /> |Parent |6 years-adult |90 minutes | * [https://books.google.com/books/about/Anxiety_Disorders_Interview_Schedule_for.html?id=xpR6V3rboxwC Purchase] |- |Diagnostic Interview Schedule for Children and Adolescents (DICA) |Interview (clinician) |6-17 years |1-2 hours | |} '''Note:''' Reliability and validity are included in the extended version (link). This table includes measures with Good or Excellent ratings. ==[[Evidence based assessment/Process phase|'''Process phase''']]== The following section contains a list of process and outcome measures for simple phobia. The section includes benchmarks based on published norms for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the [[Evidence based assessment/Process phase|process phase]] of assessment. For more information of differences between process and outcome measures, see the page on the [[Evidence based assessment/Process phase|process phase of assessment]]. === Process measures === {{blockquotetop}} Two types of ''behavioral approach tests'' (BAT) can be used to observe patients in typically avoided situations. # A '''progressive BAT''' gradually exposes the patient to a fear-inducing situation in a step-by-step manner, and responses to each step are recorded. # A '''selective BAT''' allows the clinician to select one or more challenges from the patient’s hierarchy, and the patient is to complete each challenge to induce a phobic response and rate the inducing fear. {{blockquotebottom}} === Outcome and severity measures === This table includes clinically significant benchmarks for simple phobia specific outcome measures * Information on how to interpret this table can be [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase found here]. * Additionally, these [[Evidence based assessment/Vignettes|vignettes]] might be helpful resources for understanding appropriate adaptation of outcome measures in practice. *''<u>For clinically significant change benchmarks for the CBCL, YSR, and TRF total, externalizing, internalizing, and attention benchmarks,</u>'' [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase&wteswitched=1#Clinically_significant_change_benchmarks_for_widely-used_outcome_measures see here.] {| class="wikitable" ! colspan="8" |Clinically significant change benchmarks (based on published norms) |- ! rowspan="2" |<big>Measure</big> ! rowspan="2" |<big>Subscale</big>!! colspan="3" |<big>Cut-off scores</big>!! colspan="3" |'''<big>Critical Change</big>''' '''<big>(unstandardized scores)</big>''' |- !<big>A</big> !<big>B</big> !<big>C</big> !<big>95%</big> !<big>90%</big> !<big>SE_difference</big> |- | Dental Cognitions Questionnaire (1995 Norms)<ref name="deJonghEtAl1995" /> | || 9.1 || 16.4 || 41.2 || 4.2 || 3.6 || 2.2 |- | The Claustrophobia Questionnaire (2001 Norms) - Total<ref name="RadomskyEtAl02001" /> | || 18.6 || 67.7 || 41.2 || 11. || 9.4 || 5.7 |- | The Claustrophobia Questionnaire (2001 Norms) - Suffocation<ref name="RadomskyEtAl02001" /> | || 7.0 || 24.9 || 16.2 || 5.0 || 4.3 || 2.6 |- | The Claustrophobia Questionnaire (2001 Norms) - Restriction<ref name="RadomskyEtAl02001" /> | || 8.4 || 45.5 || 24.3 || 6.9 || 5.8 || 3.5 |- |Spider Phobia Questionnaire (1996 Norms)<ref name="MulkensEtAl1996" /> | || 15.1 || 20.7 || 17.3 || 3.0 || 2.5 || 1.5 |- |Anxiety Disorder Interview Schedule (ADIS) | || 5.9 || 4.4 || 5.2 || 0.2 || 0.2 || 0.1 |- |Fear Survey Schedule for Children-Revised (FSSC-R) | || 77.8 || 159 || 118.4 || 6.3 || 5.3 || 3.2 |} '''Note:''' “A” = Away from the clinical range, “B” = Back into the nonclinical range, “C” = Closer to the nonclinical than clinical mean. '''Search terms:''' [specific phobia] AND [adults] AND [clinical significance OR outcomes] in Google Scholar and PsycINFO === Treatment === Two treatments of specific phobia treatment include ''in-vivo exposure'' and ''virtual reality therapy''. The former is most effective in specific phobias by hierarchically exposing the client to the fear-inducing stimulus and measuring anxiety response. The latter therapy is most effective in driving and height fears by using computer-generated, interactive virtual environments that the clinician manipulates. * Please refer to the page on [[wikipedia:Phobia|simple phobia]] for more information on available treatment or go to [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/fear-worry-and-anxiety/ Effective Child Therapy] for a curated resource on effective treatments for simple phobia. *For information on conducting Exposure Therapy for anxiety disordered youth, see [https://www.bravepracticeforkids.com/ www.BravePracticeForKids.com] =='''External Resources'''== # [http://apps.who.int/classifications/icd10/browse/2010/en#/F40 ICD-10 diagnostic criteria] # [https://en.wikiversity.org/w/index.php?title=Helping_Give_Away_Psychological_Science/Resources/Annotated_List_of_Where_and_How_to_Find_a_Therapist Find-a-Therapist] (a curated list of find-a-therapist websites where you can find a provider) # [https://www.nimh.nih.gov/health/topics/anxiety-disorders/index.shtml NIMH] entry about anxiety disorders # [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/fear-worry-and-anxiety/ Effective Child Therapy](guide about anxiety symptoms, treatment, and more) # OMIM (Online Mendelian Inheritance in Man) for simple phobia ## [https://www.omim.org/entry/608251?search=phobia&highlight=phobic%20phobia 608251] # [https://emedicine.medscape.com/article/288016-overview eMedicine entry about phobic disorders] #[https://sccap53.org Society of Clinical Child and Adolescent Psychology] #[http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/fear-worry-and-anxiety/ EffectiveChildTherapy.Org information on fear, worry, and anxiety] #For information on conducting Exposure Therapy for anxiety disordered youth, see [https://www.bravepracticeforkids.com/ www.BravePracticeForKids.com] == '''References''' == {{collapse top| Click here for references}} {{Reflist|2|refs= <ref name=VegaEtAl1998>{{cite journal|last1=Vega|first1=WA|last2=Kolody|first2=B|last3=Aguilar-Gaxiola|first3=S|last4=Alderete|first4=E|last5=Catalano|first5=R|last6=Caraveo-Anduaga|first6=J|title=Lifetime prevalence of DSM-III-R psychiatric disorders among urban and rural Mexican Americans in California.|journal=Archives of general psychiatry|date=September 1998|volume=55|issue=9|pages=771-8|pmid=9736002}}</ref> <ref name=KesslerEtAl2005a>{{cite journal|last1=Kessler|first1=RC|last2=Berglund|first2=P|last3=Demler|first3=O|last4=Jin|first4=R|last5=Merikangas|first5=KR|last6=Walters|first6=EE|title=Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication.|journal=Archives of general psychiatry|date=June 2005|volume=62|issue=6|pages=593-602|pmid=15939837}}</ref> <ref name=KesslerEtAl2005b>{{cite journal|last1=Kessler|first1=RC|last2=Chiu|first2=WT|last3=Demler|first3=O|last4=Merikangas|first4=KR|last5=Walters|first5=EE|title=Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication.|journal=Archives of general psychiatry|date=June 2005|volume=62|issue=6|pages=617-27|pmid=15939839}}</ref> <ref name=StinsonEtAl2007>{{cite journal|last1=Stinson|first1=FS|last2=Dawson|first2=DA|last3=Patricia Chou|first3=S|last4=Smith|first4=S|last5=Goldstein|first5=RB|last6=June Ruan|first6=W|last7=Grant|first7=BF|title=The epidemiology of DSM-IV specific phobia in the USA: results from the National Epidemiologic Survey on Alcohol and Related Conditions.|journal=Psychological medicine|date=July 2007|volume=37|issue=7|pages=1047-59|pmid=17335637}}</ref> <ref name=RobinsEtAl1984>{{cite journal|last1=Robins|first1=LN|last2=Helzer|first2=JE|last3=Weissman|first3=MM|last4=Orvaschel|first4=H|last5=Gruenberg|first5=E|last6=Burke JD|first6=Jr|last7=Regier|first7=DA|title=Lifetime prevalence of specific psychiatric disorders in three sites.|journal=Archives of general psychiatry|date=October 1984|volume=41|issue=10|pages=949-58|pmid=6332590}}</ref> <ref name=GrantEtAl2004>{{cite journal|last1=Grant|first1=BF|last2=Stinson|first2=FS|last3=Dawson|first3=DA|last4=Chou|first4=SP|last5=Dufour|first5=MC|last6=Compton|first6=W|last7=Pickering|first7=RP|last8=Kaplan|first8=K|title=Prevalence and co-occurrence of substance use disorders and independent mood and anxiety disorders: results from the National Epidemiologic Survey on Alcohol and Related Conditions.|journal=Archives of general psychiatry|date=August 2004|volume=61|issue=8|pages=807-16|pmid=15289279}}</ref> <ref name=Ost2007>{{cite journal|last1=Ost|first1=LG|title=The claustrophobia scale: a psychometric evaluation.|journal=Behaviour research and therapy|date=May 2007|volume=45|issue=5|pages=1053-64|pmid=17303070}}</ref> <ref name=VealeEtAl2012>{{cite journal|last1=Veale|first1=David|last2=Ellison|first2=Nell|last3=Boschen|first3=Mark J.|last4=Costa|first4=Ana|last5=Whelan|first5=Chantelle|last6=Muccio|first6=Francesca|last7=Henry|first7=Kareina|title=Development of an Inventory to Measure Specific Phobia of Vomiting (Emetophobia)|journal=Cognitive Therapy and Research|date=18 December 2012|volume=37|issue=3|pages=595–604|doi=10.1007/s10608-012-9495-y}}</ref> <ref name=deJonghEtAl1995>{{cite journal|last1=de Jongh|first1=A|last2=Muris|first2=P|last3=Schoenmakers|first3=N|last4=ter Horst|first4=G|title=Negative cognitions of dental phobics: reliability and validity of the dental cognitions questionnaire.|journal=Behaviour research and therapy|date=June 1995|volume=33|issue=5|pages=507-15|pmid=7598671}}</ref> <ref name=MulkensEtAl1996>{{cite journal|last1=Mulkens|first1=SA|last2=de Jong|first2=PJ|last3=Merckelbach|first3=H|title=Disgust and spider phobia.|journal=Journal of abnormal psychology|date=August 1996|volume=105|issue=3|pages=464-8|pmid=8772018}}</ref> <ref name=RadomskyEtAl02001>{{cite journal|last1=Radomsky|first1=AS|last2=Rachman|first2=S|last3=Thordarson|first3=DS|last4=McIsaac|first4=HK|last5=Teachman|first5=BA|title=The Claustrophobia Questionnaire.|journal=Journal of anxiety disorders|date=2001|volume=15|issue=4|pages=287-97|pmid=11474815}}</ref> }} {{collapse bottom}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] 6ew8wnpwcz2ugkg7nbu88cmj4s6j3ph 2419229 2419228 2022-08-26T03:09:43Z Ardenguo 2944162 /* References */ Made the references box expanded by default wikitext text/x-wiki <noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{medical disclaimer}} {{:{{BASEPAGENAME}}/Sidebar}} ==[[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio"?''']]== * For background information on what assessment portfolios are, click the link in the heading above. * Want more information? There's an extended version of this page [[Evidence-based assessment/Simple phobia/Extended version|here]]. == [[Evidence based assessment/Preparation phase|'''Preparation phase''']] == === Diagnostic criteria for phobic anxiety disorders === {{collapse top| ICD-11 and DSM-5 Diagnostic Information|expand=yes}} {{blockquotetop}} '''ICD-11 Diagnostic Criteria''' Specific phobia is characterized by a marked and excessive fear or anxiety that consistently occurs when exposed to one or more specific objects or situations (e.g., proximity to certain animals, flying, heights, closed spaces, sight of blood or injury) and that is out of proportion to actual danger. The phobic objects or situations are avoided or else endured with intense fear or anxiety. Symptoms persist for at least several months and are sufficiently severe to result in significant distress or significant impairment in personal, family, social, educational, occupational, or other important areas of functioning. '''Inclusions''' *Simple phobia *Acrophobia *Claustrophobia '''Exclusions''' *Body dysmorphic disorder *Hypochondriasis '''Changes in DSM-5''' The diagnostic criteria for simple phobia changed slightly from [[DSM-IV]] to [[w:Diagnostic_and_Statistical_Manual_of_Mental_Disorders#DSM-IV-TR_.282000.29|DSM-5]]. Summaries are available [http://www.dsm5.org/Documents/changes%20from%20dsm-iv-tr%20to%20dsm-5.pdf here] and [[w:DSM-5|here]]. {{blockquotebottom}} {{Collapse bottom}} === Base rates of simple phobia in different populations and clinical settings === This section describes the demographic setting of the population(s) sampled, base rates of diagnosis, country/region sampled and the diagnostic method that was used. Using this information, clinicians will be able to anchor the rate of simple phobia that they are likely to see in their clinical practice. * '''''To see prevalence rates across multiple disorders,''''' [[Evidence based assessment/Preparation phase#Base rates for transdiagnostic comparison|'''''click here.''''']] {| class="wikitable" |- ! Demography ! Setting !! Base Rate !! Diagnostic Method |- | California<ref name="VegaEtAl1998" /> | Mexican-American Prevalence and Service Survey (MAPSS) – adults 18+, all specific phobias || 7.4% || CIDI/DSM-III-R |- | All of US<ref name="KesslerEtAl2005a" /> | NCS replication, adults 18+, 12-month prevalence || 8.7% || CIDI/DSM-IV |- | All of US<ref name="KesslerEtAl2005b" /> | National Comorbidity Survey (NCS); non-institutionalized adults between 18-54, all specific phobias || 11.3% || CIDI/DSM-III-R |- | All of US<ref name="StinsonEtAl2007" /> | National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), adults 18+, all specific phobias || 9.4% || AUDADIS-IV/DSM-IV |- | New Haven, CT<ref name="RobinsEtAl1984" /> | Adults 18+, all specific phobias || 7.8% || Clinical interview/DSM-III |- | Baltimore, MD<ref name="RobinsEtAl1984" /> | Adults 18+, all specific phobias || 23.3% || Clinical interview/DSM-III |- | St. Louis, MI<ref name="RobinsEtAl1984" /> | Adults 18+, all specific phobias || 11.1% || Clinical interview/DSM-III |- | All of US<ref name="GrantEtAl2004" /> | National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), adults 18+, all Specific Phobias || 7.14% || AUDADIS-IV/DSM-IV |- || All of US | Different age groups, all specific phobias || Community Prevalence: 7-9% Children: 5% 13- to 17- year olds: 16% Older Adults: 3-5% Note: Females are more frequently affected than males at a rate of 2:1 | DSM-V |- |Varied<ref name=":12">{{Cite journal|last=Rettew|first=David C.|last2=Lynch|first2=Alicia Doyle|last3=Achenbach|first3=Thomas M.|last4=Dumenci|first4=Levent|last5=Ivanova|first5=Masha Y.|date=2009-09|title=Meta-analyses of agreement between diagnoses made from clinical evaluations and standardized diagnostic interviews|url=http://dx.doi.org/10.1002/mpr.289|journal=International Journal of Methods in Psychiatric Research|language=en|volume=18|issue=3|pages=169–184|doi=10.1002/mpr.289|issn=1049-8931}}</ref> |Outpatient clinic (DAU) |6% (specific) |Varied |- |Varied<ref name=":13">{{Cite journal|last=Rettew|first=David C.|last2=Lynch|first2=Alicia Doyle|last3=Achenbach|first3=Thomas M.|last4=Dumenci|first4=Levent|last5=Ivanova|first5=Masha Y.|date=2009-09|title=Meta-analyses of agreement between diagnoses made from clinical evaluations and standardized diagnostic interviews|url=http://dx.doi.org/10.1002/mpr.289|journal=International Journal of Methods in Psychiatric Research|language=en|volume=18|issue=3|pages=169–184|doi=10.1002/mpr.289|issn=1049-8931}}</ref> |Outpatient clinic (SDI) |15% (specific) |Varied |- |Varied<ref name=":3">Kessler, R. C., Avenevoli, S., Costello, E. J., Georgiades, K., Green, J. G., Gruber, M. J., . . . Merikangas, K. R. (2012). Prevalence, persistence, and sociodemographic correlates of DSM-IV disorders in the National Comorbidity Survey Replication Adolescent Supplement. Archives of General Psychiatry, 69(4), 372-380. doi:10.1001/archgenpsychiatry.2011.160</ref> |General Population |19% specific |Varied |} ==[[Evidence based assessment/Prediction phase|'''Prediction phase''']]== === Psychometric properties of screening instruments for simple phobia === The following section contains a list of screening and diagnostic instruments for simple phobia. The section includes administration information, psychometric data, and PDFs or links to the screenings. * Screenings are used as part of the [[Evidence based assessment/Prediction phase|prediction phase]] of assessment; for more information on interpretation of this data, or how screenings fit in to the assessment process, click [[Evidence based assessment/Prediction phase|here]]. * '''''For a list of more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Psychometric_properties_of_common_screening_instruments click here.]''''' {| class="wikitable sortable" ! colspan="5" |Screening measures for simple phobia |- ! Measure !Format (Reporter) !Age Range !Administration/ Completion Time !Where to access |- |Fear Survey Schedule for Children-Revised (FSSC-R) |Questionnaire (self-report) |7-16 years |19-20 minutes |[https://onlinelibrary.wiley.com/doi/pdf/10.1002/9780470713334.app3 Yes (article PDF link)] |- |Fear of Spiders Questionnaire (FSQ) |Questionnaire (self-report) |13 years-adult |5 minutes |[https://www.sciencedirect.com/science/article/pii/000579169400072T Yes (article PDF link)] |- |Disgust Scale |Questionnaire (self-report) |16 years-adult |8 minutes |[http://people.stern.nyu.edu/jhaidt/disgustscale.html Yes (Questionnaire homepage and PDF)] |- |Revised Children’s Anxiety and Depression Scale (RCADS) |Questionnaire (Child) |6-18 |12 minutes | *[http://www.corc.uk.net/outcome-experience-measures/revised-childrens-anxiety-and-depression-scale-and-subscales/ RCADS homepage] '''PDFs for RCADS''' *[https://mfr.osf.io/render?url=https://osf.io/s3fu2/?action=download%26mode=render RCADS Child Self-reported (8-18 years)] *[https://mfr.osf.io/render?url=https://osf.io/fp9mk/?action=download%26mode=render RCADS Parent-reported] *[https://mfr.osf.io/render?url=https://osf.io/vy7ta/?action=download%26mode=render Child Scoring Aid] *[https://mfr.osf.io/render?url=https://osf.io/t4bz6/?action=download%26mode=render Parent Scoring Aid] '''Subscales''' *[https://mfr.osf.io/render?url=https://osf.io/ectpf/?action=download%26mode=render Social Anxiety/Phobia Self-reported] *[https://mfr.osf.io/render?url=https://osf.io/pu6rn/?action=download%26mode=render Social Anxiety/Phobia Parent-reported] *[https://mfr.osf.io/render?url=https://osf.io/4gc8d/?action=download%26mode=render Panic Self-Report] *[https://mfr.osf.io/render?url=https://osf.io/nhcsu/?action=download%26mode=render Panic Parent-Report] '''Translations''' '''[https://mfr.osf.io/render?url=https://osf.io/qsjh9/?action=download%26mode=render User Guide]''' |} '''Note:''' Reliability and validity are included in the extended version (link). This table includes measures with Good or Excellent ratings. === Likelihood ratios and AUCs of screening measures for simple phobia === * ''For a list of the likelihood ratios for more broadly reaching screening instruments,'' [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Likelihood_ratios_and_AUCs_of_common_screening_instruments '''''click here.'''''] {| class="wikitable" |- ! Screening Measure (Primary Reference) !! AUC and Sample Size !! LR+ (Score) !! LR- (Score) !! Clinical generalizability |- | Specific Phobia of Vomiting Inventory (SPOVI)<ref name="VealeEtAl2012" />|| 0.944 (N = 185) || 24.3 (10+) || 0.03 (<10) || High: able to distinguish between phobics and controls |- | The Claustrophobia Scale (CS) - Anxiety Subscale (Rachman and Taylor, 1993) <ref name="Ost2007" />|| --- (N = 285) || 49.0 (24+) || 0.0002 (<24) || High: able to distinguish between phobics and controls |- | The Claustrophobia Scale (CS) - Avoidance Subscale (Rachman and Taylor, 1993)<ref name="Ost2007" />|| --- (N = 285) || 19.2 (9+) || 0.0004 (<9) || High: able to distinguish between phobics and controls |} '''Search terms:''' [specific phobia] AND [sensitivity OR specificity] in Google Scholar and PsycINFO === Interpreting specific phobia screening measure scores === * For information on interpreting screening measure scores, click [[Evidence based assessment/Prediction phase#Interpreting screening measure scores|here.]] ==[[Evidence based assessment/Prescription phase|'''Prescription phase''']]== ===Gold standard diagnostic interviews=== For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews click here.] === Recommended diagnostic instruments for simple phobia === {| class="wikitable sortable" ! colspan="5" |Diagnostic instruments for simple phobia |- !Measure !Format (Reporter) !Age Range !Administration/ Completion Time !Where to access |- |Anxiety Disorders Interview Schedule for Children (ADIS-C)<ref name=":1">{{Cite journal|date=2001-08-01|title=Test-Retest Reliability of Anxiety Symptoms and Diagnoses With the Anxiety Disorders Interview Schedule for DSM-IV: Child and Parent Versions|url=https://www.sciencedirect.com/science/article/pii/S0890856709603427|journal=Journal of the American Academy of Child & Adolescent Psychiatry|language=en|volume=40|issue=8|pages=937–944|doi=10.1097/00004583-200108000-00016|issn=0890-8567}}</ref> |Child |6 years-adult |90 minutes | * [https://books.google.com/books/about/Anxiety_Disorders_Interview_Schedule_for.html?id=xpR6V3rboxwC Purchase] |- |Anxiety Disorders Interview Schedule for Children (ADIS-P)<ref name=":1" /> |Parent |6 years-adult |90 minutes | * [https://books.google.com/books/about/Anxiety_Disorders_Interview_Schedule_for.html?id=xpR6V3rboxwC Purchase] |- |Diagnostic Interview Schedule for Children and Adolescents (DICA) |Interview (clinician) |6-17 years |1-2 hours | |} '''Note:''' Reliability and validity are included in the extended version (link). This table includes measures with Good or Excellent ratings. ==[[Evidence based assessment/Process phase|'''Process phase''']]== The following section contains a list of process and outcome measures for simple phobia. The section includes benchmarks based on published norms for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the [[Evidence based assessment/Process phase|process phase]] of assessment. For more information of differences between process and outcome measures, see the page on the [[Evidence based assessment/Process phase|process phase of assessment]]. === Process measures === {{blockquotetop}} Two types of ''behavioral approach tests'' (BAT) can be used to observe patients in typically avoided situations. # A '''progressive BAT''' gradually exposes the patient to a fear-inducing situation in a step-by-step manner, and responses to each step are recorded. # A '''selective BAT''' allows the clinician to select one or more challenges from the patient’s hierarchy, and the patient is to complete each challenge to induce a phobic response and rate the inducing fear. {{blockquotebottom}} === Outcome and severity measures === This table includes clinically significant benchmarks for simple phobia specific outcome measures * Information on how to interpret this table can be [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase found here]. * Additionally, these [[Evidence based assessment/Vignettes|vignettes]] might be helpful resources for understanding appropriate adaptation of outcome measures in practice. *''<u>For clinically significant change benchmarks for the CBCL, YSR, and TRF total, externalizing, internalizing, and attention benchmarks,</u>'' [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase&wteswitched=1#Clinically_significant_change_benchmarks_for_widely-used_outcome_measures see here.] {| class="wikitable" ! colspan="8" |Clinically significant change benchmarks (based on published norms) |- ! rowspan="2" |<big>Measure</big> ! rowspan="2" |<big>Subscale</big>!! colspan="3" |<big>Cut-off scores</big>!! colspan="3" |'''<big>Critical Change</big>''' '''<big>(unstandardized scores)</big>''' |- !<big>A</big> !<big>B</big> !<big>C</big> !<big>95%</big> !<big>90%</big> !<big>SE_difference</big> |- | Dental Cognitions Questionnaire (1995 Norms)<ref name="deJonghEtAl1995" /> | || 9.1 || 16.4 || 41.2 || 4.2 || 3.6 || 2.2 |- | The Claustrophobia Questionnaire (2001 Norms) - Total<ref name="RadomskyEtAl02001" /> | || 18.6 || 67.7 || 41.2 || 11. || 9.4 || 5.7 |- | The Claustrophobia Questionnaire (2001 Norms) - Suffocation<ref name="RadomskyEtAl02001" /> | || 7.0 || 24.9 || 16.2 || 5.0 || 4.3 || 2.6 |- | The Claustrophobia Questionnaire (2001 Norms) - Restriction<ref name="RadomskyEtAl02001" /> | || 8.4 || 45.5 || 24.3 || 6.9 || 5.8 || 3.5 |- |Spider Phobia Questionnaire (1996 Norms)<ref name="MulkensEtAl1996" /> | || 15.1 || 20.7 || 17.3 || 3.0 || 2.5 || 1.5 |- |Anxiety Disorder Interview Schedule (ADIS) | || 5.9 || 4.4 || 5.2 || 0.2 || 0.2 || 0.1 |- |Fear Survey Schedule for Children-Revised (FSSC-R) | || 77.8 || 159 || 118.4 || 6.3 || 5.3 || 3.2 |} '''Note:''' “A” = Away from the clinical range, “B” = Back into the nonclinical range, “C” = Closer to the nonclinical than clinical mean. '''Search terms:''' [specific phobia] AND [adults] AND [clinical significance OR outcomes] in Google Scholar and PsycINFO === Treatment === Two treatments of specific phobia treatment include ''in-vivo exposure'' and ''virtual reality therapy''. The former is most effective in specific phobias by hierarchically exposing the client to the fear-inducing stimulus and measuring anxiety response. The latter therapy is most effective in driving and height fears by using computer-generated, interactive virtual environments that the clinician manipulates. * Please refer to the page on [[wikipedia:Phobia|simple phobia]] for more information on available treatment or go to [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/fear-worry-and-anxiety/ Effective Child Therapy] for a curated resource on effective treatments for simple phobia. *For information on conducting Exposure Therapy for anxiety disordered youth, see [https://www.bravepracticeforkids.com/ www.BravePracticeForKids.com] =='''External Resources'''== # [http://apps.who.int/classifications/icd10/browse/2010/en#/F40 ICD-10 diagnostic criteria] # [https://en.wikiversity.org/w/index.php?title=Helping_Give_Away_Psychological_Science/Resources/Annotated_List_of_Where_and_How_to_Find_a_Therapist Find-a-Therapist] (a curated list of find-a-therapist websites where you can find a provider) # [https://www.nimh.nih.gov/health/topics/anxiety-disorders/index.shtml NIMH] entry about anxiety disorders # [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/fear-worry-and-anxiety/ Effective Child Therapy](guide about anxiety symptoms, treatment, and more) # OMIM (Online Mendelian Inheritance in Man) for simple phobia ## [https://www.omim.org/entry/608251?search=phobia&highlight=phobic%20phobia 608251] # [https://emedicine.medscape.com/article/288016-overview eMedicine entry about phobic disorders] #[https://sccap53.org Society of Clinical Child and Adolescent Psychology] #[http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/fear-worry-and-anxiety/ EffectiveChildTherapy.Org information on fear, worry, and anxiety] #For information on conducting Exposure Therapy for anxiety disordered youth, see [https://www.bravepracticeforkids.com/ www.BravePracticeForKids.com] == '''References''' == {{collapse top| References|expand=yes}} {{Reflist|2|refs= <ref name=VegaEtAl1998>{{cite journal|last1=Vega|first1=WA|last2=Kolody|first2=B|last3=Aguilar-Gaxiola|first3=S|last4=Alderete|first4=E|last5=Catalano|first5=R|last6=Caraveo-Anduaga|first6=J|title=Lifetime prevalence of DSM-III-R psychiatric disorders among urban and rural Mexican Americans in California.|journal=Archives of general psychiatry|date=September 1998|volume=55|issue=9|pages=771-8|pmid=9736002}}</ref> <ref name=KesslerEtAl2005a>{{cite journal|last1=Kessler|first1=RC|last2=Berglund|first2=P|last3=Demler|first3=O|last4=Jin|first4=R|last5=Merikangas|first5=KR|last6=Walters|first6=EE|title=Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication.|journal=Archives of general psychiatry|date=June 2005|volume=62|issue=6|pages=593-602|pmid=15939837}}</ref> <ref name=KesslerEtAl2005b>{{cite journal|last1=Kessler|first1=RC|last2=Chiu|first2=WT|last3=Demler|first3=O|last4=Merikangas|first4=KR|last5=Walters|first5=EE|title=Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication.|journal=Archives of general psychiatry|date=June 2005|volume=62|issue=6|pages=617-27|pmid=15939839}}</ref> <ref name=StinsonEtAl2007>{{cite journal|last1=Stinson|first1=FS|last2=Dawson|first2=DA|last3=Patricia Chou|first3=S|last4=Smith|first4=S|last5=Goldstein|first5=RB|last6=June Ruan|first6=W|last7=Grant|first7=BF|title=The epidemiology of DSM-IV specific phobia in the USA: results from the National Epidemiologic Survey on Alcohol and Related Conditions.|journal=Psychological medicine|date=July 2007|volume=37|issue=7|pages=1047-59|pmid=17335637}}</ref> <ref name=RobinsEtAl1984>{{cite journal|last1=Robins|first1=LN|last2=Helzer|first2=JE|last3=Weissman|first3=MM|last4=Orvaschel|first4=H|last5=Gruenberg|first5=E|last6=Burke JD|first6=Jr|last7=Regier|first7=DA|title=Lifetime prevalence of specific psychiatric disorders in three sites.|journal=Archives of general psychiatry|date=October 1984|volume=41|issue=10|pages=949-58|pmid=6332590}}</ref> <ref name=GrantEtAl2004>{{cite journal|last1=Grant|first1=BF|last2=Stinson|first2=FS|last3=Dawson|first3=DA|last4=Chou|first4=SP|last5=Dufour|first5=MC|last6=Compton|first6=W|last7=Pickering|first7=RP|last8=Kaplan|first8=K|title=Prevalence and co-occurrence of substance use disorders and independent mood and anxiety disorders: results from the National Epidemiologic Survey on Alcohol and Related Conditions.|journal=Archives of general psychiatry|date=August 2004|volume=61|issue=8|pages=807-16|pmid=15289279}}</ref> <ref name=Ost2007>{{cite journal|last1=Ost|first1=LG|title=The claustrophobia scale: a psychometric evaluation.|journal=Behaviour research and therapy|date=May 2007|volume=45|issue=5|pages=1053-64|pmid=17303070}}</ref> <ref name=VealeEtAl2012>{{cite journal|last1=Veale|first1=David|last2=Ellison|first2=Nell|last3=Boschen|first3=Mark J.|last4=Costa|first4=Ana|last5=Whelan|first5=Chantelle|last6=Muccio|first6=Francesca|last7=Henry|first7=Kareina|title=Development of an Inventory to Measure Specific Phobia of Vomiting (Emetophobia)|journal=Cognitive Therapy and Research|date=18 December 2012|volume=37|issue=3|pages=595–604|doi=10.1007/s10608-012-9495-y}}</ref> <ref name=deJonghEtAl1995>{{cite journal|last1=de Jongh|first1=A|last2=Muris|first2=P|last3=Schoenmakers|first3=N|last4=ter Horst|first4=G|title=Negative cognitions of dental phobics: reliability and validity of the dental cognitions questionnaire.|journal=Behaviour research and therapy|date=June 1995|volume=33|issue=5|pages=507-15|pmid=7598671}}</ref> <ref name=MulkensEtAl1996>{{cite journal|last1=Mulkens|first1=SA|last2=de Jong|first2=PJ|last3=Merckelbach|first3=H|title=Disgust and spider phobia.|journal=Journal of abnormal psychology|date=August 1996|volume=105|issue=3|pages=464-8|pmid=8772018}}</ref> <ref name=RadomskyEtAl02001>{{cite journal|last1=Radomsky|first1=AS|last2=Rachman|first2=S|last3=Thordarson|first3=DS|last4=McIsaac|first4=HK|last5=Teachman|first5=BA|title=The Claustrophobia Questionnaire.|journal=Journal of anxiety disorders|date=2001|volume=15|issue=4|pages=287-97|pmid=11474815}}</ref> }} {{collapse bottom}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] bhhj1u23ixh37nozzmxmqywi8xoayqr 2419235 2419229 2022-08-26T03:12:20Z Ardenguo 2944162 /* References */ wikitext text/x-wiki <noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{medical disclaimer}} {{:{{BASEPAGENAME}}/Sidebar}} ==[[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio"?''']]== * For background information on what assessment portfolios are, click the link in the heading above. * Want more information? There's an extended version of this page [[Evidence-based assessment/Simple phobia/Extended version|here]]. == [[Evidence based assessment/Preparation phase|'''Preparation phase''']] == === Diagnostic criteria for phobic anxiety disorders === {{collapse top| ICD-11 and DSM-5 Diagnostic Information|expand=yes}} {{blockquotetop}} '''ICD-11 Diagnostic Criteria''' Specific phobia is characterized by a marked and excessive fear or anxiety that consistently occurs when exposed to one or more specific objects or situations (e.g., proximity to certain animals, flying, heights, closed spaces, sight of blood or injury) and that is out of proportion to actual danger. The phobic objects or situations are avoided or else endured with intense fear or anxiety. Symptoms persist for at least several months and are sufficiently severe to result in significant distress or significant impairment in personal, family, social, educational, occupational, or other important areas of functioning. '''Inclusions''' *Simple phobia *Acrophobia *Claustrophobia '''Exclusions''' *Body dysmorphic disorder *Hypochondriasis '''Changes in DSM-5''' The diagnostic criteria for simple phobia changed slightly from [[DSM-IV]] to [[w:Diagnostic_and_Statistical_Manual_of_Mental_Disorders#DSM-IV-TR_.282000.29|DSM-5]]. Summaries are available [http://www.dsm5.org/Documents/changes%20from%20dsm-iv-tr%20to%20dsm-5.pdf here] and [[w:DSM-5|here]]. {{blockquotebottom}} {{Collapse bottom}} === Base rates of simple phobia in different populations and clinical settings === This section describes the demographic setting of the population(s) sampled, base rates of diagnosis, country/region sampled and the diagnostic method that was used. Using this information, clinicians will be able to anchor the rate of simple phobia that they are likely to see in their clinical practice. * '''''To see prevalence rates across multiple disorders,''''' [[Evidence based assessment/Preparation phase#Base rates for transdiagnostic comparison|'''''click here.''''']] {| class="wikitable" |- ! Demography ! Setting !! Base Rate !! Diagnostic Method |- | California<ref name="VegaEtAl1998" /> | Mexican-American Prevalence and Service Survey (MAPSS) – adults 18+, all specific phobias || 7.4% || CIDI/DSM-III-R |- | All of US<ref name="KesslerEtAl2005a" /> | NCS replication, adults 18+, 12-month prevalence || 8.7% || CIDI/DSM-IV |- | All of US<ref name="KesslerEtAl2005b" /> | National Comorbidity Survey (NCS); non-institutionalized adults between 18-54, all specific phobias || 11.3% || CIDI/DSM-III-R |- | All of US<ref name="StinsonEtAl2007" /> | National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), adults 18+, all specific phobias || 9.4% || AUDADIS-IV/DSM-IV |- | New Haven, CT<ref name="RobinsEtAl1984" /> | Adults 18+, all specific phobias || 7.8% || Clinical interview/DSM-III |- | Baltimore, MD<ref name="RobinsEtAl1984" /> | Adults 18+, all specific phobias || 23.3% || Clinical interview/DSM-III |- | St. Louis, MI<ref name="RobinsEtAl1984" /> | Adults 18+, all specific phobias || 11.1% || Clinical interview/DSM-III |- | All of US<ref name="GrantEtAl2004" /> | National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), adults 18+, all Specific Phobias || 7.14% || AUDADIS-IV/DSM-IV |- || All of US | Different age groups, all specific phobias || Community Prevalence: 7-9% Children: 5% 13- to 17- year olds: 16% Older Adults: 3-5% Note: Females are more frequently affected than males at a rate of 2:1 | DSM-V |- |Varied<ref name=":12">{{Cite journal|last=Rettew|first=David C.|last2=Lynch|first2=Alicia Doyle|last3=Achenbach|first3=Thomas M.|last4=Dumenci|first4=Levent|last5=Ivanova|first5=Masha Y.|date=2009-09|title=Meta-analyses of agreement between diagnoses made from clinical evaluations and standardized diagnostic interviews|url=http://dx.doi.org/10.1002/mpr.289|journal=International Journal of Methods in Psychiatric Research|language=en|volume=18|issue=3|pages=169–184|doi=10.1002/mpr.289|issn=1049-8931}}</ref> |Outpatient clinic (DAU) |6% (specific) |Varied |- |Varied<ref name=":13">{{Cite journal|last=Rettew|first=David C.|last2=Lynch|first2=Alicia Doyle|last3=Achenbach|first3=Thomas M.|last4=Dumenci|first4=Levent|last5=Ivanova|first5=Masha Y.|date=2009-09|title=Meta-analyses of agreement between diagnoses made from clinical evaluations and standardized diagnostic interviews|url=http://dx.doi.org/10.1002/mpr.289|journal=International Journal of Methods in Psychiatric Research|language=en|volume=18|issue=3|pages=169–184|doi=10.1002/mpr.289|issn=1049-8931}}</ref> |Outpatient clinic (SDI) |15% (specific) |Varied |- |Varied<ref name=":3">Kessler, R. C., Avenevoli, S., Costello, E. J., Georgiades, K., Green, J. G., Gruber, M. J., . . . Merikangas, K. R. (2012). Prevalence, persistence, and sociodemographic correlates of DSM-IV disorders in the National Comorbidity Survey Replication Adolescent Supplement. Archives of General Psychiatry, 69(4), 372-380. doi:10.1001/archgenpsychiatry.2011.160</ref> |General Population |19% specific |Varied |} ==[[Evidence based assessment/Prediction phase|'''Prediction phase''']]== === Psychometric properties of screening instruments for simple phobia === The following section contains a list of screening and diagnostic instruments for simple phobia. The section includes administration information, psychometric data, and PDFs or links to the screenings. * Screenings are used as part of the [[Evidence based assessment/Prediction phase|prediction phase]] of assessment; for more information on interpretation of this data, or how screenings fit in to the assessment process, click [[Evidence based assessment/Prediction phase|here]]. * '''''For a list of more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Psychometric_properties_of_common_screening_instruments click here.]''''' {| class="wikitable sortable" ! colspan="5" |Screening measures for simple phobia |- ! Measure !Format (Reporter) !Age Range !Administration/ Completion Time !Where to access |- |Fear Survey Schedule for Children-Revised (FSSC-R) |Questionnaire (self-report) |7-16 years |19-20 minutes |[https://onlinelibrary.wiley.com/doi/pdf/10.1002/9780470713334.app3 Yes (article PDF link)] |- |Fear of Spiders Questionnaire (FSQ) |Questionnaire (self-report) |13 years-adult |5 minutes |[https://www.sciencedirect.com/science/article/pii/000579169400072T Yes (article PDF link)] |- |Disgust Scale |Questionnaire (self-report) |16 years-adult |8 minutes |[http://people.stern.nyu.edu/jhaidt/disgustscale.html Yes (Questionnaire homepage and PDF)] |- |Revised Children’s Anxiety and Depression Scale (RCADS) |Questionnaire (Child) |6-18 |12 minutes | *[http://www.corc.uk.net/outcome-experience-measures/revised-childrens-anxiety-and-depression-scale-and-subscales/ RCADS homepage] '''PDFs for RCADS''' *[https://mfr.osf.io/render?url=https://osf.io/s3fu2/?action=download%26mode=render RCADS Child Self-reported (8-18 years)] *[https://mfr.osf.io/render?url=https://osf.io/fp9mk/?action=download%26mode=render RCADS Parent-reported] *[https://mfr.osf.io/render?url=https://osf.io/vy7ta/?action=download%26mode=render Child Scoring Aid] *[https://mfr.osf.io/render?url=https://osf.io/t4bz6/?action=download%26mode=render Parent Scoring Aid] '''Subscales''' *[https://mfr.osf.io/render?url=https://osf.io/ectpf/?action=download%26mode=render Social Anxiety/Phobia Self-reported] *[https://mfr.osf.io/render?url=https://osf.io/pu6rn/?action=download%26mode=render Social Anxiety/Phobia Parent-reported] *[https://mfr.osf.io/render?url=https://osf.io/4gc8d/?action=download%26mode=render Panic Self-Report] *[https://mfr.osf.io/render?url=https://osf.io/nhcsu/?action=download%26mode=render Panic Parent-Report] '''Translations''' '''[https://mfr.osf.io/render?url=https://osf.io/qsjh9/?action=download%26mode=render User Guide]''' |} '''Note:''' Reliability and validity are included in the extended version (link). This table includes measures with Good or Excellent ratings. === Likelihood ratios and AUCs of screening measures for simple phobia === * ''For a list of the likelihood ratios for more broadly reaching screening instruments,'' [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Likelihood_ratios_and_AUCs_of_common_screening_instruments '''''click here.'''''] {| class="wikitable" |- ! Screening Measure (Primary Reference) !! AUC and Sample Size !! LR+ (Score) !! LR- (Score) !! Clinical generalizability |- | Specific Phobia of Vomiting Inventory (SPOVI)<ref name="VealeEtAl2012" />|| 0.944 (N = 185) || 24.3 (10+) || 0.03 (<10) || High: able to distinguish between phobics and controls |- | The Claustrophobia Scale (CS) - Anxiety Subscale (Rachman and Taylor, 1993) <ref name="Ost2007" />|| --- (N = 285) || 49.0 (24+) || 0.0002 (<24) || High: able to distinguish between phobics and controls |- | The Claustrophobia Scale (CS) - Avoidance Subscale (Rachman and Taylor, 1993)<ref name="Ost2007" />|| --- (N = 285) || 19.2 (9+) || 0.0004 (<9) || High: able to distinguish between phobics and controls |} '''Search terms:''' [specific phobia] AND [sensitivity OR specificity] in Google Scholar and PsycINFO === Interpreting specific phobia screening measure scores === * For information on interpreting screening measure scores, click [[Evidence based assessment/Prediction phase#Interpreting screening measure scores|here.]] ==[[Evidence based assessment/Prescription phase|'''Prescription phase''']]== ===Gold standard diagnostic interviews=== For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews click here.] === Recommended diagnostic instruments for simple phobia === {| class="wikitable sortable" ! colspan="5" |Diagnostic instruments for simple phobia |- !Measure !Format (Reporter) !Age Range !Administration/ Completion Time !Where to access |- |Anxiety Disorders Interview Schedule for Children (ADIS-C)<ref name=":1">{{Cite journal|date=2001-08-01|title=Test-Retest Reliability of Anxiety Symptoms and Diagnoses With the Anxiety Disorders Interview Schedule for DSM-IV: Child and Parent Versions|url=https://www.sciencedirect.com/science/article/pii/S0890856709603427|journal=Journal of the American Academy of Child & Adolescent Psychiatry|language=en|volume=40|issue=8|pages=937–944|doi=10.1097/00004583-200108000-00016|issn=0890-8567}}</ref> |Child |6 years-adult |90 minutes | * [https://books.google.com/books/about/Anxiety_Disorders_Interview_Schedule_for.html?id=xpR6V3rboxwC Purchase] |- |Anxiety Disorders Interview Schedule for Children (ADIS-P)<ref name=":1" /> |Parent |6 years-adult |90 minutes | * [https://books.google.com/books/about/Anxiety_Disorders_Interview_Schedule_for.html?id=xpR6V3rboxwC Purchase] |- |Diagnostic Interview Schedule for Children and Adolescents (DICA) |Interview (clinician) |6-17 years |1-2 hours | |} '''Note:''' Reliability and validity are included in the extended version (link). This table includes measures with Good or Excellent ratings. ==[[Evidence based assessment/Process phase|'''Process phase''']]== The following section contains a list of process and outcome measures for simple phobia. The section includes benchmarks based on published norms for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the [[Evidence based assessment/Process phase|process phase]] of assessment. For more information of differences between process and outcome measures, see the page on the [[Evidence based assessment/Process phase|process phase of assessment]]. === Process measures === {{blockquotetop}} Two types of ''behavioral approach tests'' (BAT) can be used to observe patients in typically avoided situations. # A '''progressive BAT''' gradually exposes the patient to a fear-inducing situation in a step-by-step manner, and responses to each step are recorded. # A '''selective BAT''' allows the clinician to select one or more challenges from the patient’s hierarchy, and the patient is to complete each challenge to induce a phobic response and rate the inducing fear. {{blockquotebottom}} === Outcome and severity measures === This table includes clinically significant benchmarks for simple phobia specific outcome measures * Information on how to interpret this table can be [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase found here]. * Additionally, these [[Evidence based assessment/Vignettes|vignettes]] might be helpful resources for understanding appropriate adaptation of outcome measures in practice. *''<u>For clinically significant change benchmarks for the CBCL, YSR, and TRF total, externalizing, internalizing, and attention benchmarks,</u>'' [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase&wteswitched=1#Clinically_significant_change_benchmarks_for_widely-used_outcome_measures see here.] {| class="wikitable" ! colspan="8" |Clinically significant change benchmarks (based on published norms) |- ! rowspan="2" |<big>Measure</big> ! rowspan="2" |<big>Subscale</big>!! colspan="3" |<big>Cut-off scores</big>!! colspan="3" |'''<big>Critical Change</big>''' '''<big>(unstandardized scores)</big>''' |- !<big>A</big> !<big>B</big> !<big>C</big> !<big>95%</big> !<big>90%</big> !<big>SE_difference</big> |- | Dental Cognitions Questionnaire (1995 Norms)<ref name="deJonghEtAl1995" /> | || 9.1 || 16.4 || 41.2 || 4.2 || 3.6 || 2.2 |- | The Claustrophobia Questionnaire (2001 Norms) - Total<ref name="RadomskyEtAl02001" /> | || 18.6 || 67.7 || 41.2 || 11. || 9.4 || 5.7 |- | The Claustrophobia Questionnaire (2001 Norms) - Suffocation<ref name="RadomskyEtAl02001" /> | || 7.0 || 24.9 || 16.2 || 5.0 || 4.3 || 2.6 |- | The Claustrophobia Questionnaire (2001 Norms) - Restriction<ref name="RadomskyEtAl02001" /> | || 8.4 || 45.5 || 24.3 || 6.9 || 5.8 || 3.5 |- |Spider Phobia Questionnaire (1996 Norms)<ref name="MulkensEtAl1996" /> | || 15.1 || 20.7 || 17.3 || 3.0 || 2.5 || 1.5 |- |Anxiety Disorder Interview Schedule (ADIS) | || 5.9 || 4.4 || 5.2 || 0.2 || 0.2 || 0.1 |- |Fear Survey Schedule for Children-Revised (FSSC-R) | || 77.8 || 159 || 118.4 || 6.3 || 5.3 || 3.2 |} '''Note:''' “A” = Away from the clinical range, “B” = Back into the nonclinical range, “C” = Closer to the nonclinical than clinical mean. '''Search terms:''' [specific phobia] AND [adults] AND [clinical significance OR outcomes] in Google Scholar and PsycINFO === Treatment === Two treatments of specific phobia treatment include ''in-vivo exposure'' and ''virtual reality therapy''. The former is most effective in specific phobias by hierarchically exposing the client to the fear-inducing stimulus and measuring anxiety response. The latter therapy is most effective in driving and height fears by using computer-generated, interactive virtual environments that the clinician manipulates. * Please refer to the page on [[wikipedia:Phobia|simple phobia]] for more information on available treatment or go to [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/fear-worry-and-anxiety/ Effective Child Therapy] for a curated resource on effective treatments for simple phobia. *For information on conducting Exposure Therapy for anxiety disordered youth, see [https://www.bravepracticeforkids.com/ www.BravePracticeForKids.com] =='''External Resources'''== # [http://apps.who.int/classifications/icd10/browse/2010/en#/F40 ICD-10 diagnostic criteria] # [https://en.wikiversity.org/w/index.php?title=Helping_Give_Away_Psychological_Science/Resources/Annotated_List_of_Where_and_How_to_Find_a_Therapist Find-a-Therapist] (a curated list of find-a-therapist websites where you can find a provider) # [https://www.nimh.nih.gov/health/topics/anxiety-disorders/index.shtml NIMH] entry about anxiety disorders # [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/fear-worry-and-anxiety/ Effective Child Therapy](guide about anxiety symptoms, treatment, and more) # OMIM (Online Mendelian Inheritance in Man) for simple phobia ## [https://www.omim.org/entry/608251?search=phobia&highlight=phobic%20phobia 608251] # [https://emedicine.medscape.com/article/288016-overview eMedicine entry about phobic disorders] #[https://sccap53.org Society of Clinical Child and Adolescent Psychology] #[http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/fear-worry-and-anxiety/ EffectiveChildTherapy.Org information on fear, worry, and anxiety] #For information on conducting Exposure Therapy for anxiety disordered youth, see [https://www.bravepracticeforkids.com/ www.BravePracticeForKids.com] == '''References''' == {{collapse top|References|expand=yes}} {{Reflist|2|refs= <ref name=VegaEtAl1998>{{cite journal|last1=Vega|first1=WA|last2=Kolody|first2=B|last3=Aguilar-Gaxiola|first3=S|last4=Alderete|first4=E|last5=Catalano|first5=R|last6=Caraveo-Anduaga|first6=J|title=Lifetime prevalence of DSM-III-R psychiatric disorders among urban and rural Mexican Americans in California.|journal=Archives of general psychiatry|date=September 1998|volume=55|issue=9|pages=771-8|pmid=9736002}}</ref> <ref name=KesslerEtAl2005a>{{cite journal|last1=Kessler|first1=RC|last2=Berglund|first2=P|last3=Demler|first3=O|last4=Jin|first4=R|last5=Merikangas|first5=KR|last6=Walters|first6=EE|title=Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication.|journal=Archives of general psychiatry|date=June 2005|volume=62|issue=6|pages=593-602|pmid=15939837}}</ref> <ref name=KesslerEtAl2005b>{{cite journal|last1=Kessler|first1=RC|last2=Chiu|first2=WT|last3=Demler|first3=O|last4=Merikangas|first4=KR|last5=Walters|first5=EE|title=Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication.|journal=Archives of general psychiatry|date=June 2005|volume=62|issue=6|pages=617-27|pmid=15939839}}</ref> <ref name=StinsonEtAl2007>{{cite journal|last1=Stinson|first1=FS|last2=Dawson|first2=DA|last3=Patricia Chou|first3=S|last4=Smith|first4=S|last5=Goldstein|first5=RB|last6=June Ruan|first6=W|last7=Grant|first7=BF|title=The epidemiology of DSM-IV specific phobia in the USA: results from the National Epidemiologic Survey on Alcohol and Related Conditions.|journal=Psychological medicine|date=July 2007|volume=37|issue=7|pages=1047-59|pmid=17335637}}</ref> <ref name=RobinsEtAl1984>{{cite journal|last1=Robins|first1=LN|last2=Helzer|first2=JE|last3=Weissman|first3=MM|last4=Orvaschel|first4=H|last5=Gruenberg|first5=E|last6=Burke JD|first6=Jr|last7=Regier|first7=DA|title=Lifetime prevalence of specific psychiatric disorders in three sites.|journal=Archives of general psychiatry|date=October 1984|volume=41|issue=10|pages=949-58|pmid=6332590}}</ref> <ref name=GrantEtAl2004>{{cite journal|last1=Grant|first1=BF|last2=Stinson|first2=FS|last3=Dawson|first3=DA|last4=Chou|first4=SP|last5=Dufour|first5=MC|last6=Compton|first6=W|last7=Pickering|first7=RP|last8=Kaplan|first8=K|title=Prevalence and co-occurrence of substance use disorders and independent mood and anxiety disorders: results from the National Epidemiologic Survey on Alcohol and Related Conditions.|journal=Archives of general psychiatry|date=August 2004|volume=61|issue=8|pages=807-16|pmid=15289279}}</ref> <ref name=Ost2007>{{cite journal|last1=Ost|first1=LG|title=The claustrophobia scale: a psychometric evaluation.|journal=Behaviour research and therapy|date=May 2007|volume=45|issue=5|pages=1053-64|pmid=17303070}}</ref> <ref name=VealeEtAl2012>{{cite journal|last1=Veale|first1=David|last2=Ellison|first2=Nell|last3=Boschen|first3=Mark J.|last4=Costa|first4=Ana|last5=Whelan|first5=Chantelle|last6=Muccio|first6=Francesca|last7=Henry|first7=Kareina|title=Development of an Inventory to Measure Specific Phobia of Vomiting (Emetophobia)|journal=Cognitive Therapy and Research|date=18 December 2012|volume=37|issue=3|pages=595–604|doi=10.1007/s10608-012-9495-y}}</ref> <ref name=deJonghEtAl1995>{{cite journal|last1=de Jongh|first1=A|last2=Muris|first2=P|last3=Schoenmakers|first3=N|last4=ter Horst|first4=G|title=Negative cognitions of dental phobics: reliability and validity of the dental cognitions questionnaire.|journal=Behaviour research and therapy|date=June 1995|volume=33|issue=5|pages=507-15|pmid=7598671}}</ref> <ref name=MulkensEtAl1996>{{cite journal|last1=Mulkens|first1=SA|last2=de Jong|first2=PJ|last3=Merckelbach|first3=H|title=Disgust and spider phobia.|journal=Journal of abnormal psychology|date=August 1996|volume=105|issue=3|pages=464-8|pmid=8772018}}</ref> <ref name=RadomskyEtAl02001>{{cite journal|last1=Radomsky|first1=AS|last2=Rachman|first2=S|last3=Thordarson|first3=DS|last4=McIsaac|first4=HK|last5=Teachman|first5=BA|title=The Claustrophobia Questionnaire.|journal=Journal of anxiety disorders|date=2001|volume=15|issue=4|pages=287-97|pmid=11474815}}</ref> }} {{collapse bottom}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] m27mcxc5acrr43xtco8v0jkdmultia7 2419307 2419235 2022-08-26T05:31:39Z Ardenguo 2944162 /* Prediction phase */ fixed typos in "Note: Reliability and validity are included in the extended version. This table includes measures with Good or Excellent ratings." note wikitext text/x-wiki <noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{medical disclaimer}} {{:{{BASEPAGENAME}}/Sidebar}} ==[[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio"?''']]== * For background information on what assessment portfolios are, click the link in the heading above. * Want more information? There's an extended version of this page [[Evidence-based assessment/Simple phobia/Extended version|here]]. == [[Evidence based assessment/Preparation phase|'''Preparation phase''']] == === Diagnostic criteria for phobic anxiety disorders === {{collapse top| ICD-11 and DSM-5 Diagnostic Information|expand=yes}} {{blockquotetop}} '''ICD-11 Diagnostic Criteria''' Specific phobia is characterized by a marked and excessive fear or anxiety that consistently occurs when exposed to one or more specific objects or situations (e.g., proximity to certain animals, flying, heights, closed spaces, sight of blood or injury) and that is out of proportion to actual danger. The phobic objects or situations are avoided or else endured with intense fear or anxiety. Symptoms persist for at least several months and are sufficiently severe to result in significant distress or significant impairment in personal, family, social, educational, occupational, or other important areas of functioning. '''Inclusions''' *Simple phobia *Acrophobia *Claustrophobia '''Exclusions''' *Body dysmorphic disorder *Hypochondriasis '''Changes in DSM-5''' The diagnostic criteria for simple phobia changed slightly from [[DSM-IV]] to [[w:Diagnostic_and_Statistical_Manual_of_Mental_Disorders#DSM-IV-TR_.282000.29|DSM-5]]. Summaries are available [http://www.dsm5.org/Documents/changes%20from%20dsm-iv-tr%20to%20dsm-5.pdf here] and [[w:DSM-5|here]]. {{blockquotebottom}} {{Collapse bottom}} === Base rates of simple phobia in different populations and clinical settings === This section describes the demographic setting of the population(s) sampled, base rates of diagnosis, country/region sampled and the diagnostic method that was used. Using this information, clinicians will be able to anchor the rate of simple phobia that they are likely to see in their clinical practice. * '''''To see prevalence rates across multiple disorders,''''' [[Evidence based assessment/Preparation phase#Base rates for transdiagnostic comparison|'''''click here.''''']] {| class="wikitable" |- ! Demography ! Setting !! Base Rate !! Diagnostic Method |- | California<ref name="VegaEtAl1998" /> | Mexican-American Prevalence and Service Survey (MAPSS) – adults 18+, all specific phobias || 7.4% || CIDI/DSM-III-R |- | All of US<ref name="KesslerEtAl2005a" /> | NCS replication, adults 18+, 12-month prevalence || 8.7% || CIDI/DSM-IV |- | All of US<ref name="KesslerEtAl2005b" /> | National Comorbidity Survey (NCS); non-institutionalized adults between 18-54, all specific phobias || 11.3% || CIDI/DSM-III-R |- | All of US<ref name="StinsonEtAl2007" /> | National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), adults 18+, all specific phobias || 9.4% || AUDADIS-IV/DSM-IV |- | New Haven, CT<ref name="RobinsEtAl1984" /> | Adults 18+, all specific phobias || 7.8% || Clinical interview/DSM-III |- | Baltimore, MD<ref name="RobinsEtAl1984" /> | Adults 18+, all specific phobias || 23.3% || Clinical interview/DSM-III |- | St. Louis, MI<ref name="RobinsEtAl1984" /> | Adults 18+, all specific phobias || 11.1% || Clinical interview/DSM-III |- | All of US<ref name="GrantEtAl2004" /> | National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), adults 18+, all Specific Phobias || 7.14% || AUDADIS-IV/DSM-IV |- || All of US | Different age groups, all specific phobias || Community Prevalence: 7-9% Children: 5% 13- to 17- year olds: 16% Older Adults: 3-5% Note: Females are more frequently affected than males at a rate of 2:1 | DSM-V |- |Varied<ref name=":12">{{Cite journal|last=Rettew|first=David C.|last2=Lynch|first2=Alicia Doyle|last3=Achenbach|first3=Thomas M.|last4=Dumenci|first4=Levent|last5=Ivanova|first5=Masha Y.|date=2009-09|title=Meta-analyses of agreement between diagnoses made from clinical evaluations and standardized diagnostic interviews|url=http://dx.doi.org/10.1002/mpr.289|journal=International Journal of Methods in Psychiatric Research|language=en|volume=18|issue=3|pages=169–184|doi=10.1002/mpr.289|issn=1049-8931}}</ref> |Outpatient clinic (DAU) |6% (specific) |Varied |- |Varied<ref name=":13">{{Cite journal|last=Rettew|first=David C.|last2=Lynch|first2=Alicia Doyle|last3=Achenbach|first3=Thomas M.|last4=Dumenci|first4=Levent|last5=Ivanova|first5=Masha Y.|date=2009-09|title=Meta-analyses of agreement between diagnoses made from clinical evaluations and standardized diagnostic interviews|url=http://dx.doi.org/10.1002/mpr.289|journal=International Journal of Methods in Psychiatric Research|language=en|volume=18|issue=3|pages=169–184|doi=10.1002/mpr.289|issn=1049-8931}}</ref> |Outpatient clinic (SDI) |15% (specific) |Varied |- |Varied<ref name=":3">Kessler, R. C., Avenevoli, S., Costello, E. J., Georgiades, K., Green, J. G., Gruber, M. J., . . . Merikangas, K. R. (2012). Prevalence, persistence, and sociodemographic correlates of DSM-IV disorders in the National Comorbidity Survey Replication Adolescent Supplement. Archives of General Psychiatry, 69(4), 372-380. doi:10.1001/archgenpsychiatry.2011.160</ref> |General Population |19% specific |Varied |} ==[[Evidence based assessment/Prediction phase|'''Prediction phase''']]== === Psychometric properties of screening instruments for simple phobia === The following section contains a list of screening and diagnostic instruments for simple phobia. The section includes administration information, psychometric data, and PDFs or links to the screenings. * Screenings are used as part of the [[Evidence based assessment/Prediction phase|prediction phase]] of assessment; for more information on interpretation of this data, or how screenings fit in to the assessment process, click [[Evidence based assessment/Prediction phase|here]]. * '''''For a list of more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Psychometric_properties_of_common_screening_instruments click here.]''''' {| class="wikitable sortable" ! colspan="5" |Screening measures for simple phobia |- ! Measure !Format (Reporter) !Age Range !Administration/ Completion Time !Where to access |- |Fear Survey Schedule for Children-Revised (FSSC-R) |Questionnaire (self-report) |7-16 years |19-20 minutes |[https://onlinelibrary.wiley.com/doi/pdf/10.1002/9780470713334.app3 Yes (article PDF link)] |- |Fear of Spiders Questionnaire (FSQ) |Questionnaire (self-report) |13 years-adult |5 minutes |[https://www.sciencedirect.com/science/article/pii/000579169400072T Yes (article PDF link)] |- |Disgust Scale |Questionnaire (self-report) |16 years-adult |8 minutes |[http://people.stern.nyu.edu/jhaidt/disgustscale.html Yes (Questionnaire homepage and PDF)] |- |Revised Children’s Anxiety and Depression Scale (RCADS) |Questionnaire (Child) |6-18 |12 minutes | *[http://www.corc.uk.net/outcome-experience-measures/revised-childrens-anxiety-and-depression-scale-and-subscales/ RCADS homepage] '''PDFs for RCADS''' *[https://mfr.osf.io/render?url=https://osf.io/s3fu2/?action=download%26mode=render RCADS Child Self-reported (8-18 years)] *[https://mfr.osf.io/render?url=https://osf.io/fp9mk/?action=download%26mode=render RCADS Parent-reported] *[https://mfr.osf.io/render?url=https://osf.io/vy7ta/?action=download%26mode=render Child Scoring Aid] *[https://mfr.osf.io/render?url=https://osf.io/t4bz6/?action=download%26mode=render Parent Scoring Aid] '''Subscales''' *[https://mfr.osf.io/render?url=https://osf.io/ectpf/?action=download%26mode=render Social Anxiety/Phobia Self-reported] *[https://mfr.osf.io/render?url=https://osf.io/pu6rn/?action=download%26mode=render Social Anxiety/Phobia Parent-reported] *[https://mfr.osf.io/render?url=https://osf.io/4gc8d/?action=download%26mode=render Panic Self-Report] *[https://mfr.osf.io/render?url=https://osf.io/nhcsu/?action=download%26mode=render Panic Parent-Report] '''Translations''' '''[https://mfr.osf.io/render?url=https://osf.io/qsjh9/?action=download%26mode=render User Guide]''' |} '''Note:''' Reliability and validity are included in the extended version. This table includes measures with Good or Excellent ratings. === Likelihood ratios and AUCs of screening measures for simple phobia === * ''For a list of the likelihood ratios for more broadly reaching screening instruments,'' [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Likelihood_ratios_and_AUCs_of_common_screening_instruments '''''click here.'''''] {| class="wikitable" |- ! Screening Measure (Primary Reference) !! AUC and Sample Size !! LR+ (Score) !! LR- (Score) !! Clinical generalizability |- | Specific Phobia of Vomiting Inventory (SPOVI)<ref name="VealeEtAl2012" />|| 0.944 (N = 185) || 24.3 (10+) || 0.03 (<10) || High: able to distinguish between phobics and controls |- | The Claustrophobia Scale (CS) - Anxiety Subscale (Rachman and Taylor, 1993) <ref name="Ost2007" />|| --- (N = 285) || 49.0 (24+) || 0.0002 (<24) || High: able to distinguish between phobics and controls |- | The Claustrophobia Scale (CS) - Avoidance Subscale (Rachman and Taylor, 1993)<ref name="Ost2007" />|| --- (N = 285) || 19.2 (9+) || 0.0004 (<9) || High: able to distinguish between phobics and controls |} '''Search terms:''' [specific phobia] AND [sensitivity OR specificity] in Google Scholar and PsycINFO === Interpreting specific phobia screening measure scores === * For information on interpreting screening measure scores, click [[Evidence based assessment/Prediction phase#Interpreting screening measure scores|here.]] ==[[Evidence based assessment/Prescription phase|'''Prescription phase''']]== ===Gold standard diagnostic interviews=== For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews click here.] === Recommended diagnostic instruments for simple phobia === {| class="wikitable sortable" ! colspan="5" |Diagnostic instruments for simple phobia |- !Measure !Format (Reporter) !Age Range !Administration/ Completion Time !Where to access |- |Anxiety Disorders Interview Schedule for Children (ADIS-C)<ref name=":1">{{Cite journal|date=2001-08-01|title=Test-Retest Reliability of Anxiety Symptoms and Diagnoses With the Anxiety Disorders Interview Schedule for DSM-IV: Child and Parent Versions|url=https://www.sciencedirect.com/science/article/pii/S0890856709603427|journal=Journal of the American Academy of Child & Adolescent Psychiatry|language=en|volume=40|issue=8|pages=937–944|doi=10.1097/00004583-200108000-00016|issn=0890-8567}}</ref> |Child |6 years-adult |90 minutes | * [https://books.google.com/books/about/Anxiety_Disorders_Interview_Schedule_for.html?id=xpR6V3rboxwC Purchase] |- |Anxiety Disorders Interview Schedule for Children (ADIS-P)<ref name=":1" /> |Parent |6 years-adult |90 minutes | * [https://books.google.com/books/about/Anxiety_Disorders_Interview_Schedule_for.html?id=xpR6V3rboxwC Purchase] |- |Diagnostic Interview Schedule for Children and Adolescents (DICA) |Interview (clinician) |6-17 years |1-2 hours | |} '''Note:''' Reliability and validity are included in the extended version. This table includes measures with Good or Excellent ratings. ==[[Evidence based assessment/Process phase|'''Process phase''']]== The following section contains a list of process and outcome measures for simple phobia. The section includes benchmarks based on published norms for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the [[Evidence based assessment/Process phase|process phase]] of assessment. For more information of differences between process and outcome measures, see the page on the [[Evidence based assessment/Process phase|process phase of assessment]]. === Process measures === {{blockquotetop}} Two types of ''behavioral approach tests'' (BAT) can be used to observe patients in typically avoided situations. # A '''progressive BAT''' gradually exposes the patient to a fear-inducing situation in a step-by-step manner, and responses to each step are recorded. # A '''selective BAT''' allows the clinician to select one or more challenges from the patient’s hierarchy, and the patient is to complete each challenge to induce a phobic response and rate the inducing fear. {{blockquotebottom}} === Outcome and severity measures === This table includes clinically significant benchmarks for simple phobia specific outcome measures * Information on how to interpret this table can be [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase found here]. * Additionally, these [[Evidence based assessment/Vignettes|vignettes]] might be helpful resources for understanding appropriate adaptation of outcome measures in practice. *''<u>For clinically significant change benchmarks for the CBCL, YSR, and TRF total, externalizing, internalizing, and attention benchmarks,</u>'' [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase&wteswitched=1#Clinically_significant_change_benchmarks_for_widely-used_outcome_measures see here.] {| class="wikitable" ! colspan="8" |Clinically significant change benchmarks (based on published norms) |- ! rowspan="2" |<big>Measure</big> ! rowspan="2" |<big>Subscale</big>!! colspan="3" |<big>Cut-off scores</big>!! colspan="3" |'''<big>Critical Change</big>''' '''<big>(unstandardized scores)</big>''' |- !<big>A</big> !<big>B</big> !<big>C</big> !<big>95%</big> !<big>90%</big> !<big>SE_difference</big> |- | Dental Cognitions Questionnaire (1995 Norms)<ref name="deJonghEtAl1995" /> | || 9.1 || 16.4 || 41.2 || 4.2 || 3.6 || 2.2 |- | The Claustrophobia Questionnaire (2001 Norms) - Total<ref name="RadomskyEtAl02001" /> | || 18.6 || 67.7 || 41.2 || 11. || 9.4 || 5.7 |- | The Claustrophobia Questionnaire (2001 Norms) - Suffocation<ref name="RadomskyEtAl02001" /> | || 7.0 || 24.9 || 16.2 || 5.0 || 4.3 || 2.6 |- | The Claustrophobia Questionnaire (2001 Norms) - Restriction<ref name="RadomskyEtAl02001" /> | || 8.4 || 45.5 || 24.3 || 6.9 || 5.8 || 3.5 |- |Spider Phobia Questionnaire (1996 Norms)<ref name="MulkensEtAl1996" /> | || 15.1 || 20.7 || 17.3 || 3.0 || 2.5 || 1.5 |- |Anxiety Disorder Interview Schedule (ADIS) | || 5.9 || 4.4 || 5.2 || 0.2 || 0.2 || 0.1 |- |Fear Survey Schedule for Children-Revised (FSSC-R) | || 77.8 || 159 || 118.4 || 6.3 || 5.3 || 3.2 |} '''Note:''' “A” = Away from the clinical range, “B” = Back into the nonclinical range, “C” = Closer to the nonclinical than clinical mean. '''Search terms:''' [specific phobia] AND [adults] AND [clinical significance OR outcomes] in Google Scholar and PsycINFO === Treatment === Two treatments of specific phobia treatment include ''in-vivo exposure'' and ''virtual reality therapy''. The former is most effective in specific phobias by hierarchically exposing the client to the fear-inducing stimulus and measuring anxiety response. The latter therapy is most effective in driving and height fears by using computer-generated, interactive virtual environments that the clinician manipulates. * Please refer to the page on [[wikipedia:Phobia|simple phobia]] for more information on available treatment or go to [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/fear-worry-and-anxiety/ Effective Child Therapy] for a curated resource on effective treatments for simple phobia. *For information on conducting Exposure Therapy for anxiety disordered youth, see [https://www.bravepracticeforkids.com/ www.BravePracticeForKids.com] =='''External Resources'''== # [http://apps.who.int/classifications/icd10/browse/2010/en#/F40 ICD-10 diagnostic criteria] # [https://en.wikiversity.org/w/index.php?title=Helping_Give_Away_Psychological_Science/Resources/Annotated_List_of_Where_and_How_to_Find_a_Therapist Find-a-Therapist] (a curated list of find-a-therapist websites where you can find a provider) # [https://www.nimh.nih.gov/health/topics/anxiety-disorders/index.shtml NIMH] entry about anxiety disorders # [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/fear-worry-and-anxiety/ Effective Child Therapy](guide about anxiety symptoms, treatment, and more) # OMIM (Online Mendelian Inheritance in Man) for simple phobia ## [https://www.omim.org/entry/608251?search=phobia&highlight=phobic%20phobia 608251] # [https://emedicine.medscape.com/article/288016-overview eMedicine entry about phobic disorders] #[https://sccap53.org Society of Clinical Child and Adolescent Psychology] #[http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/fear-worry-and-anxiety/ EffectiveChildTherapy.Org information on fear, worry, and anxiety] #For information on conducting Exposure Therapy for anxiety disordered youth, see [https://www.bravepracticeforkids.com/ www.BravePracticeForKids.com] == '''References''' == {{collapse top|References|expand=yes}} {{Reflist|2|refs= <ref name=VegaEtAl1998>{{cite journal|last1=Vega|first1=WA|last2=Kolody|first2=B|last3=Aguilar-Gaxiola|first3=S|last4=Alderete|first4=E|last5=Catalano|first5=R|last6=Caraveo-Anduaga|first6=J|title=Lifetime prevalence of DSM-III-R psychiatric disorders among urban and rural Mexican Americans in California.|journal=Archives of general psychiatry|date=September 1998|volume=55|issue=9|pages=771-8|pmid=9736002}}</ref> <ref name=KesslerEtAl2005a>{{cite journal|last1=Kessler|first1=RC|last2=Berglund|first2=P|last3=Demler|first3=O|last4=Jin|first4=R|last5=Merikangas|first5=KR|last6=Walters|first6=EE|title=Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication.|journal=Archives of general psychiatry|date=June 2005|volume=62|issue=6|pages=593-602|pmid=15939837}}</ref> <ref name=KesslerEtAl2005b>{{cite journal|last1=Kessler|first1=RC|last2=Chiu|first2=WT|last3=Demler|first3=O|last4=Merikangas|first4=KR|last5=Walters|first5=EE|title=Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication.|journal=Archives of general psychiatry|date=June 2005|volume=62|issue=6|pages=617-27|pmid=15939839}}</ref> <ref name=StinsonEtAl2007>{{cite journal|last1=Stinson|first1=FS|last2=Dawson|first2=DA|last3=Patricia Chou|first3=S|last4=Smith|first4=S|last5=Goldstein|first5=RB|last6=June Ruan|first6=W|last7=Grant|first7=BF|title=The epidemiology of DSM-IV specific phobia in the USA: results from the National Epidemiologic Survey on Alcohol and Related Conditions.|journal=Psychological medicine|date=July 2007|volume=37|issue=7|pages=1047-59|pmid=17335637}}</ref> <ref name=RobinsEtAl1984>{{cite journal|last1=Robins|first1=LN|last2=Helzer|first2=JE|last3=Weissman|first3=MM|last4=Orvaschel|first4=H|last5=Gruenberg|first5=E|last6=Burke JD|first6=Jr|last7=Regier|first7=DA|title=Lifetime prevalence of specific psychiatric disorders in three sites.|journal=Archives of general psychiatry|date=October 1984|volume=41|issue=10|pages=949-58|pmid=6332590}}</ref> <ref name=GrantEtAl2004>{{cite journal|last1=Grant|first1=BF|last2=Stinson|first2=FS|last3=Dawson|first3=DA|last4=Chou|first4=SP|last5=Dufour|first5=MC|last6=Compton|first6=W|last7=Pickering|first7=RP|last8=Kaplan|first8=K|title=Prevalence and co-occurrence of substance use disorders and independent mood and anxiety disorders: results from the National Epidemiologic Survey on Alcohol and Related Conditions.|journal=Archives of general psychiatry|date=August 2004|volume=61|issue=8|pages=807-16|pmid=15289279}}</ref> <ref name=Ost2007>{{cite journal|last1=Ost|first1=LG|title=The claustrophobia scale: a psychometric evaluation.|journal=Behaviour research and therapy|date=May 2007|volume=45|issue=5|pages=1053-64|pmid=17303070}}</ref> <ref name=VealeEtAl2012>{{cite journal|last1=Veale|first1=David|last2=Ellison|first2=Nell|last3=Boschen|first3=Mark J.|last4=Costa|first4=Ana|last5=Whelan|first5=Chantelle|last6=Muccio|first6=Francesca|last7=Henry|first7=Kareina|title=Development of an Inventory to Measure Specific Phobia of Vomiting (Emetophobia)|journal=Cognitive Therapy and Research|date=18 December 2012|volume=37|issue=3|pages=595–604|doi=10.1007/s10608-012-9495-y}}</ref> <ref name=deJonghEtAl1995>{{cite journal|last1=de Jongh|first1=A|last2=Muris|first2=P|last3=Schoenmakers|first3=N|last4=ter Horst|first4=G|title=Negative cognitions of dental phobics: reliability and validity of the dental cognitions questionnaire.|journal=Behaviour research and therapy|date=June 1995|volume=33|issue=5|pages=507-15|pmid=7598671}}</ref> <ref name=MulkensEtAl1996>{{cite journal|last1=Mulkens|first1=SA|last2=de Jong|first2=PJ|last3=Merckelbach|first3=H|title=Disgust and spider phobia.|journal=Journal of abnormal psychology|date=August 1996|volume=105|issue=3|pages=464-8|pmid=8772018}}</ref> <ref name=RadomskyEtAl02001>{{cite journal|last1=Radomsky|first1=AS|last2=Rachman|first2=S|last3=Thordarson|first3=DS|last4=McIsaac|first4=HK|last5=Teachman|first5=BA|title=The Claustrophobia Questionnaire.|journal=Journal of anxiety disorders|date=2001|volume=15|issue=4|pages=287-97|pmid=11474815}}</ref> }} {{collapse bottom}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] mb2w8aaajzwcsak8a9l7hqcrh0c5mck 2419320 2419307 2022-08-26T05:41:49Z Ardenguo 2944162 /* Psychometric properties of screening instruments for simple phobia */ linked extended page to "Note: Reliability and validity are included in the extended version. This table includes measures with Good or Excellent ratings." wikitext text/x-wiki <noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{medical disclaimer}} {{:{{BASEPAGENAME}}/Sidebar}} ==[[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio"?''']]== * For background information on what assessment portfolios are, click the link in the heading above. * Want more information? There's an extended version of this page [[Evidence-based assessment/Simple phobia/Extended version|here]]. == [[Evidence based assessment/Preparation phase|'''Preparation phase''']] == === Diagnostic criteria for phobic anxiety disorders === {{collapse top| ICD-11 and DSM-5 Diagnostic Information|expand=yes}} {{blockquotetop}} '''ICD-11 Diagnostic Criteria''' Specific phobia is characterized by a marked and excessive fear or anxiety that consistently occurs when exposed to one or more specific objects or situations (e.g., proximity to certain animals, flying, heights, closed spaces, sight of blood or injury) and that is out of proportion to actual danger. The phobic objects or situations are avoided or else endured with intense fear or anxiety. Symptoms persist for at least several months and are sufficiently severe to result in significant distress or significant impairment in personal, family, social, educational, occupational, or other important areas of functioning. '''Inclusions''' *Simple phobia *Acrophobia *Claustrophobia '''Exclusions''' *Body dysmorphic disorder *Hypochondriasis '''Changes in DSM-5''' The diagnostic criteria for simple phobia changed slightly from [[DSM-IV]] to [[w:Diagnostic_and_Statistical_Manual_of_Mental_Disorders#DSM-IV-TR_.282000.29|DSM-5]]. Summaries are available [http://www.dsm5.org/Documents/changes%20from%20dsm-iv-tr%20to%20dsm-5.pdf here] and [[w:DSM-5|here]]. {{blockquotebottom}} {{Collapse bottom}} === Base rates of simple phobia in different populations and clinical settings === This section describes the demographic setting of the population(s) sampled, base rates of diagnosis, country/region sampled and the diagnostic method that was used. Using this information, clinicians will be able to anchor the rate of simple phobia that they are likely to see in their clinical practice. * '''''To see prevalence rates across multiple disorders,''''' [[Evidence based assessment/Preparation phase#Base rates for transdiagnostic comparison|'''''click here.''''']] {| class="wikitable" |- ! Demography ! Setting !! Base Rate !! Diagnostic Method |- | California<ref name="VegaEtAl1998" /> | Mexican-American Prevalence and Service Survey (MAPSS) – adults 18+, all specific phobias || 7.4% || CIDI/DSM-III-R |- | All of US<ref name="KesslerEtAl2005a" /> | NCS replication, adults 18+, 12-month prevalence || 8.7% || CIDI/DSM-IV |- | All of US<ref name="KesslerEtAl2005b" /> | National Comorbidity Survey (NCS); non-institutionalized adults between 18-54, all specific phobias || 11.3% || CIDI/DSM-III-R |- | All of US<ref name="StinsonEtAl2007" /> | National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), adults 18+, all specific phobias || 9.4% || AUDADIS-IV/DSM-IV |- | New Haven, CT<ref name="RobinsEtAl1984" /> | Adults 18+, all specific phobias || 7.8% || Clinical interview/DSM-III |- | Baltimore, MD<ref name="RobinsEtAl1984" /> | Adults 18+, all specific phobias || 23.3% || Clinical interview/DSM-III |- | St. Louis, MI<ref name="RobinsEtAl1984" /> | Adults 18+, all specific phobias || 11.1% || Clinical interview/DSM-III |- | All of US<ref name="GrantEtAl2004" /> | National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), adults 18+, all Specific Phobias || 7.14% || AUDADIS-IV/DSM-IV |- || All of US | Different age groups, all specific phobias || Community Prevalence: 7-9% Children: 5% 13- to 17- year olds: 16% Older Adults: 3-5% Note: Females are more frequently affected than males at a rate of 2:1 | DSM-V |- |Varied<ref name=":12">{{Cite journal|last=Rettew|first=David C.|last2=Lynch|first2=Alicia Doyle|last3=Achenbach|first3=Thomas M.|last4=Dumenci|first4=Levent|last5=Ivanova|first5=Masha Y.|date=2009-09|title=Meta-analyses of agreement between diagnoses made from clinical evaluations and standardized diagnostic interviews|url=http://dx.doi.org/10.1002/mpr.289|journal=International Journal of Methods in Psychiatric Research|language=en|volume=18|issue=3|pages=169–184|doi=10.1002/mpr.289|issn=1049-8931}}</ref> |Outpatient clinic (DAU) |6% (specific) |Varied |- |Varied<ref name=":13">{{Cite journal|last=Rettew|first=David C.|last2=Lynch|first2=Alicia Doyle|last3=Achenbach|first3=Thomas M.|last4=Dumenci|first4=Levent|last5=Ivanova|first5=Masha Y.|date=2009-09|title=Meta-analyses of agreement between diagnoses made from clinical evaluations and standardized diagnostic interviews|url=http://dx.doi.org/10.1002/mpr.289|journal=International Journal of Methods in Psychiatric Research|language=en|volume=18|issue=3|pages=169–184|doi=10.1002/mpr.289|issn=1049-8931}}</ref> |Outpatient clinic (SDI) |15% (specific) |Varied |- |Varied<ref name=":3">Kessler, R. C., Avenevoli, S., Costello, E. J., Georgiades, K., Green, J. G., Gruber, M. J., . . . Merikangas, K. R. (2012). Prevalence, persistence, and sociodemographic correlates of DSM-IV disorders in the National Comorbidity Survey Replication Adolescent Supplement. Archives of General Psychiatry, 69(4), 372-380. doi:10.1001/archgenpsychiatry.2011.160</ref> |General Population |19% specific |Varied |} ==[[Evidence based assessment/Prediction phase|'''Prediction phase''']]== === Psychometric properties of screening instruments for simple phobia === The following section contains a list of screening and diagnostic instruments for simple phobia. The section includes administration information, psychometric data, and PDFs or links to the screenings. * Screenings are used as part of the [[Evidence based assessment/Prediction phase|prediction phase]] of assessment; for more information on interpretation of this data, or how screenings fit in to the assessment process, click [[Evidence based assessment/Prediction phase|here]]. * '''''For a list of more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Psychometric_properties_of_common_screening_instruments click here.]''''' {| class="wikitable sortable" ! colspan="5" |Screening measures for simple phobia |- ! Measure !Format (Reporter) !Age Range !Administration/ Completion Time !Where to access |- |Fear Survey Schedule for Children-Revised (FSSC-R) |Questionnaire (self-report) |7-16 years |19-20 minutes |[https://onlinelibrary.wiley.com/doi/pdf/10.1002/9780470713334.app3 Yes (article PDF link)] |- |Fear of Spiders Questionnaire (FSQ) |Questionnaire (self-report) |13 years-adult |5 minutes |[https://www.sciencedirect.com/science/article/pii/000579169400072T Yes (article PDF link)] |- |Disgust Scale |Questionnaire (self-report) |16 years-adult |8 minutes |[http://people.stern.nyu.edu/jhaidt/disgustscale.html Yes (Questionnaire homepage and PDF)] |- |Revised Children’s Anxiety and Depression Scale (RCADS) |Questionnaire (Child) |6-18 |12 minutes | *[http://www.corc.uk.net/outcome-experience-measures/revised-childrens-anxiety-and-depression-scale-and-subscales/ RCADS homepage] '''PDFs for RCADS''' *[https://mfr.osf.io/render?url=https://osf.io/s3fu2/?action=download%26mode=render RCADS Child Self-reported (8-18 years)] *[https://mfr.osf.io/render?url=https://osf.io/fp9mk/?action=download%26mode=render RCADS Parent-reported] *[https://mfr.osf.io/render?url=https://osf.io/vy7ta/?action=download%26mode=render Child Scoring Aid] *[https://mfr.osf.io/render?url=https://osf.io/t4bz6/?action=download%26mode=render Parent Scoring Aid] '''Subscales''' *[https://mfr.osf.io/render?url=https://osf.io/ectpf/?action=download%26mode=render Social Anxiety/Phobia Self-reported] *[https://mfr.osf.io/render?url=https://osf.io/pu6rn/?action=download%26mode=render Social Anxiety/Phobia Parent-reported] *[https://mfr.osf.io/render?url=https://osf.io/4gc8d/?action=download%26mode=render Panic Self-Report] *[https://mfr.osf.io/render?url=https://osf.io/nhcsu/?action=download%26mode=render Panic Parent-Report] '''Translations''' '''[https://mfr.osf.io/render?url=https://osf.io/qsjh9/?action=download%26mode=render User Guide]''' |} '''Note:''' Reliability and validity are included in the [[Evidence-based assessment/Simple phobia/Extended version|extended version]]. This table includes measures with Good or Excellent ratings. === Likelihood ratios and AUCs of screening measures for simple phobia === * ''For a list of the likelihood ratios for more broadly reaching screening instruments,'' [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Likelihood_ratios_and_AUCs_of_common_screening_instruments '''''click here.'''''] {| class="wikitable" |- ! Screening Measure (Primary Reference) !! AUC and Sample Size !! LR+ (Score) !! LR- (Score) !! Clinical generalizability |- | Specific Phobia of Vomiting Inventory (SPOVI)<ref name="VealeEtAl2012" />|| 0.944 (N = 185) || 24.3 (10+) || 0.03 (<10) || High: able to distinguish between phobics and controls |- | The Claustrophobia Scale (CS) - Anxiety Subscale (Rachman and Taylor, 1993) <ref name="Ost2007" />|| --- (N = 285) || 49.0 (24+) || 0.0002 (<24) || High: able to distinguish between phobics and controls |- | The Claustrophobia Scale (CS) - Avoidance Subscale (Rachman and Taylor, 1993)<ref name="Ost2007" />|| --- (N = 285) || 19.2 (9+) || 0.0004 (<9) || High: able to distinguish between phobics and controls |} '''Search terms:''' [specific phobia] AND [sensitivity OR specificity] in Google Scholar and PsycINFO === Interpreting specific phobia screening measure scores === * For information on interpreting screening measure scores, click [[Evidence based assessment/Prediction phase#Interpreting screening measure scores|here.]] ==[[Evidence based assessment/Prescription phase|'''Prescription phase''']]== ===Gold standard diagnostic interviews=== For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews click here.] === Recommended diagnostic instruments for simple phobia === {| class="wikitable sortable" ! colspan="5" |Diagnostic instruments for simple phobia |- !Measure !Format (Reporter) !Age Range !Administration/ Completion Time !Where to access |- |Anxiety Disorders Interview Schedule for Children (ADIS-C)<ref name=":1">{{Cite journal|date=2001-08-01|title=Test-Retest Reliability of Anxiety Symptoms and Diagnoses With the Anxiety Disorders Interview Schedule for DSM-IV: Child and Parent Versions|url=https://www.sciencedirect.com/science/article/pii/S0890856709603427|journal=Journal of the American Academy of Child & Adolescent Psychiatry|language=en|volume=40|issue=8|pages=937–944|doi=10.1097/00004583-200108000-00016|issn=0890-8567}}</ref> |Child |6 years-adult |90 minutes | * [https://books.google.com/books/about/Anxiety_Disorders_Interview_Schedule_for.html?id=xpR6V3rboxwC Purchase] |- |Anxiety Disorders Interview Schedule for Children (ADIS-P)<ref name=":1" /> |Parent |6 years-adult |90 minutes | * [https://books.google.com/books/about/Anxiety_Disorders_Interview_Schedule_for.html?id=xpR6V3rboxwC Purchase] |- |Diagnostic Interview Schedule for Children and Adolescents (DICA) |Interview (clinician) |6-17 years |1-2 hours | |} '''Note:''' Reliability and validity are included in the [[Evidence-based assessment/Simple phobia/Extended version|extended version]]. This table includes measures with Good or Excellent ratings. ==[[Evidence based assessment/Process phase|'''Process phase''']]== The following section contains a list of process and outcome measures for simple phobia. The section includes benchmarks based on published norms for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the [[Evidence based assessment/Process phase|process phase]] of assessment. For more information of differences between process and outcome measures, see the page on the [[Evidence based assessment/Process phase|process phase of assessment]]. === Process measures === {{blockquotetop}} Two types of ''behavioral approach tests'' (BAT) can be used to observe patients in typically avoided situations. # A '''progressive BAT''' gradually exposes the patient to a fear-inducing situation in a step-by-step manner, and responses to each step are recorded. # A '''selective BAT''' allows the clinician to select one or more challenges from the patient’s hierarchy, and the patient is to complete each challenge to induce a phobic response and rate the inducing fear. {{blockquotebottom}} === Outcome and severity measures === This table includes clinically significant benchmarks for simple phobia specific outcome measures * Information on how to interpret this table can be [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase found here]. * Additionally, these [[Evidence based assessment/Vignettes|vignettes]] might be helpful resources for understanding appropriate adaptation of outcome measures in practice. *''<u>For clinically significant change benchmarks for the CBCL, YSR, and TRF total, externalizing, internalizing, and attention benchmarks,</u>'' [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase&wteswitched=1#Clinically_significant_change_benchmarks_for_widely-used_outcome_measures see here.] {| class="wikitable" ! colspan="8" |Clinically significant change benchmarks (based on published norms) |- ! rowspan="2" |<big>Measure</big> ! rowspan="2" |<big>Subscale</big>!! colspan="3" |<big>Cut-off scores</big>!! colspan="3" |'''<big>Critical Change</big>''' '''<big>(unstandardized scores)</big>''' |- !<big>A</big> !<big>B</big> !<big>C</big> !<big>95%</big> !<big>90%</big> !<big>SE_difference</big> |- | Dental Cognitions Questionnaire (1995 Norms)<ref name="deJonghEtAl1995" /> | || 9.1 || 16.4 || 41.2 || 4.2 || 3.6 || 2.2 |- | The Claustrophobia Questionnaire (2001 Norms) - Total<ref name="RadomskyEtAl02001" /> | || 18.6 || 67.7 || 41.2 || 11. || 9.4 || 5.7 |- | The Claustrophobia Questionnaire (2001 Norms) - Suffocation<ref name="RadomskyEtAl02001" /> | || 7.0 || 24.9 || 16.2 || 5.0 || 4.3 || 2.6 |- | The Claustrophobia Questionnaire (2001 Norms) - Restriction<ref name="RadomskyEtAl02001" /> | || 8.4 || 45.5 || 24.3 || 6.9 || 5.8 || 3.5 |- |Spider Phobia Questionnaire (1996 Norms)<ref name="MulkensEtAl1996" /> | || 15.1 || 20.7 || 17.3 || 3.0 || 2.5 || 1.5 |- |Anxiety Disorder Interview Schedule (ADIS) | || 5.9 || 4.4 || 5.2 || 0.2 || 0.2 || 0.1 |- |Fear Survey Schedule for Children-Revised (FSSC-R) | || 77.8 || 159 || 118.4 || 6.3 || 5.3 || 3.2 |} '''Note:''' “A” = Away from the clinical range, “B” = Back into the nonclinical range, “C” = Closer to the nonclinical than clinical mean. '''Search terms:''' [specific phobia] AND [adults] AND [clinical significance OR outcomes] in Google Scholar and PsycINFO === Treatment === Two treatments of specific phobia treatment include ''in-vivo exposure'' and ''virtual reality therapy''. The former is most effective in specific phobias by hierarchically exposing the client to the fear-inducing stimulus and measuring anxiety response. The latter therapy is most effective in driving and height fears by using computer-generated, interactive virtual environments that the clinician manipulates. * Please refer to the page on [[wikipedia:Phobia|simple phobia]] for more information on available treatment or go to [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/fear-worry-and-anxiety/ Effective Child Therapy] for a curated resource on effective treatments for simple phobia. *For information on conducting Exposure Therapy for anxiety disordered youth, see [https://www.bravepracticeforkids.com/ www.BravePracticeForKids.com] =='''External Resources'''== # [http://apps.who.int/classifications/icd10/browse/2010/en#/F40 ICD-10 diagnostic criteria] # [https://en.wikiversity.org/w/index.php?title=Helping_Give_Away_Psychological_Science/Resources/Annotated_List_of_Where_and_How_to_Find_a_Therapist Find-a-Therapist] (a curated list of find-a-therapist websites where you can find a provider) # [https://www.nimh.nih.gov/health/topics/anxiety-disorders/index.shtml NIMH] entry about anxiety disorders # [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/fear-worry-and-anxiety/ Effective Child Therapy](guide about anxiety symptoms, treatment, and more) # OMIM (Online Mendelian Inheritance in Man) for simple phobia ## [https://www.omim.org/entry/608251?search=phobia&highlight=phobic%20phobia 608251] # [https://emedicine.medscape.com/article/288016-overview eMedicine entry about phobic disorders] #[https://sccap53.org Society of Clinical Child and Adolescent Psychology] #[http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/fear-worry-and-anxiety/ EffectiveChildTherapy.Org information on fear, worry, and anxiety] #For information on conducting Exposure Therapy for anxiety disordered youth, see [https://www.bravepracticeforkids.com/ www.BravePracticeForKids.com] == '''References''' == {{collapse top|References|expand=yes}} {{Reflist|2|refs= <ref name=VegaEtAl1998>{{cite journal|last1=Vega|first1=WA|last2=Kolody|first2=B|last3=Aguilar-Gaxiola|first3=S|last4=Alderete|first4=E|last5=Catalano|first5=R|last6=Caraveo-Anduaga|first6=J|title=Lifetime prevalence of DSM-III-R psychiatric disorders among urban and rural Mexican Americans in California.|journal=Archives of general psychiatry|date=September 1998|volume=55|issue=9|pages=771-8|pmid=9736002}}</ref> <ref name=KesslerEtAl2005a>{{cite journal|last1=Kessler|first1=RC|last2=Berglund|first2=P|last3=Demler|first3=O|last4=Jin|first4=R|last5=Merikangas|first5=KR|last6=Walters|first6=EE|title=Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication.|journal=Archives of general psychiatry|date=June 2005|volume=62|issue=6|pages=593-602|pmid=15939837}}</ref> <ref name=KesslerEtAl2005b>{{cite journal|last1=Kessler|first1=RC|last2=Chiu|first2=WT|last3=Demler|first3=O|last4=Merikangas|first4=KR|last5=Walters|first5=EE|title=Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication.|journal=Archives of general psychiatry|date=June 2005|volume=62|issue=6|pages=617-27|pmid=15939839}}</ref> <ref name=StinsonEtAl2007>{{cite journal|last1=Stinson|first1=FS|last2=Dawson|first2=DA|last3=Patricia Chou|first3=S|last4=Smith|first4=S|last5=Goldstein|first5=RB|last6=June Ruan|first6=W|last7=Grant|first7=BF|title=The epidemiology of DSM-IV specific phobia in the USA: results from the National Epidemiologic Survey on Alcohol and Related Conditions.|journal=Psychological medicine|date=July 2007|volume=37|issue=7|pages=1047-59|pmid=17335637}}</ref> <ref name=RobinsEtAl1984>{{cite journal|last1=Robins|first1=LN|last2=Helzer|first2=JE|last3=Weissman|first3=MM|last4=Orvaschel|first4=H|last5=Gruenberg|first5=E|last6=Burke JD|first6=Jr|last7=Regier|first7=DA|title=Lifetime prevalence of specific psychiatric disorders in three sites.|journal=Archives of general psychiatry|date=October 1984|volume=41|issue=10|pages=949-58|pmid=6332590}}</ref> <ref name=GrantEtAl2004>{{cite journal|last1=Grant|first1=BF|last2=Stinson|first2=FS|last3=Dawson|first3=DA|last4=Chou|first4=SP|last5=Dufour|first5=MC|last6=Compton|first6=W|last7=Pickering|first7=RP|last8=Kaplan|first8=K|title=Prevalence and co-occurrence of substance use disorders and independent mood and anxiety disorders: results from the National Epidemiologic Survey on Alcohol and Related Conditions.|journal=Archives of general psychiatry|date=August 2004|volume=61|issue=8|pages=807-16|pmid=15289279}}</ref> <ref name=Ost2007>{{cite journal|last1=Ost|first1=LG|title=The claustrophobia scale: a psychometric evaluation.|journal=Behaviour research and therapy|date=May 2007|volume=45|issue=5|pages=1053-64|pmid=17303070}}</ref> <ref name=VealeEtAl2012>{{cite journal|last1=Veale|first1=David|last2=Ellison|first2=Nell|last3=Boschen|first3=Mark J.|last4=Costa|first4=Ana|last5=Whelan|first5=Chantelle|last6=Muccio|first6=Francesca|last7=Henry|first7=Kareina|title=Development of an Inventory to Measure Specific Phobia of Vomiting (Emetophobia)|journal=Cognitive Therapy and Research|date=18 December 2012|volume=37|issue=3|pages=595–604|doi=10.1007/s10608-012-9495-y}}</ref> <ref name=deJonghEtAl1995>{{cite journal|last1=de Jongh|first1=A|last2=Muris|first2=P|last3=Schoenmakers|first3=N|last4=ter Horst|first4=G|title=Negative cognitions of dental phobics: reliability and validity of the dental cognitions questionnaire.|journal=Behaviour research and therapy|date=June 1995|volume=33|issue=5|pages=507-15|pmid=7598671}}</ref> <ref name=MulkensEtAl1996>{{cite journal|last1=Mulkens|first1=SA|last2=de Jong|first2=PJ|last3=Merckelbach|first3=H|title=Disgust and spider phobia.|journal=Journal of abnormal psychology|date=August 1996|volume=105|issue=3|pages=464-8|pmid=8772018}}</ref> <ref name=RadomskyEtAl02001>{{cite journal|last1=Radomsky|first1=AS|last2=Rachman|first2=S|last3=Thordarson|first3=DS|last4=McIsaac|first4=HK|last5=Teachman|first5=BA|title=The Claustrophobia Questionnaire.|journal=Journal of anxiety disorders|date=2001|volume=15|issue=4|pages=287-97|pmid=11474815}}</ref> }} {{collapse bottom}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] 43enixix6uksj7q5l03jrip3tcoo9ui 0 207113 2419236 2413362 2022-08-26T03:12:58Z Ardenguo 2944162 /* References */ Made the references box expanded by default, fixed the box title wikitext text/x-wiki <noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{medical disclaimer}} {{:{{BASEPAGENAME}}/Sidebar}} ==[[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio?"''']]== For background information on what assessment portfolios are, click the link in the heading above. Want even 'more' information about this topic? There's an extended version of this page [[Evidence-based assessment/Substance use disorder (disorder portfolio)/extended version|here]]. == [[Evidence-based assessment/Preparation phase|'''Preparation Phase''']] == {{blockquotetop}} <big>'''Diagnostic Criteria for Substance Use Disorder'''</big> <big>'''ICD-11 Diagnostic Criteria for Substance Use Disorder'''</big> *Disorders due to substance use and addictive behaviours are mental and behavioural disorders that develop as a result of the use of predominantly psychoactive substances, including medications, or specific repetitive rewarding and reinforcing behaviours. **Note: The ICD-11 lists 20 additional subcategories of Substance Use Disorder. They can be found [https://icd.who.int/browse11/l-m/en#/http://id.who.int/icd/entity/1602669465 here]. <big>'''DSM Diagnostic Criteria for Substance Use Disorder'''</big> *Substance use disorder is a DSM disorder in the Substance-Related and Addictive Disorders chapter. It is characterized by the use of substances in a manner that leads to clinically significant impairment or distress. * The diagnostic criteria for Substance Use Disorder disorder changed slightly from [[DSM-IV]] to [[w:Diagnostic_and_Statistical_Manual_of_Mental_Disorders#DSM-IV-TR_.282000.29|DSM-5]]. Summaries are available [http://www.dsm5.org/Documents/changes%20from%20dsm-iv-tr%20to%20dsm-5.pdf here]. {{blockquotebottom}} === Base rates of SUD in different populations and clinical settings === {| class="wikitable sortable" border="1" |- ! Setting ! Base Rate ! Demography ! Diagnostic Method |- | General population of North Carolina, aged 12 or older | 6.7% | North Carolina | National Survey on Drug Use and Health (NSDUH), 2009 to 2013 |- | 43,093 individuals, 18+ years old collected between 2001 and 2002<ref>Hasin DS, Grant BF. The National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) Waves 1 and 2: review and summary of findings. Soc Psychiatry Psychiatr Epidemiol. 2015 Nov;50(11):1609-40. doi: 10.1007/s00127-015-1088-0. Epub 2015 Jul 26. PMID: 26210739.</ref> | 17.8 (0.5) Alcohol Abuse; 12.5 (0.4) Alcohol Dependence; 7.7 (0.2) Drug Abuse; 2.6 (0.1) Drug Dependence | United States General Adult Population: National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) (Grant et al., 2007) | National Institute on Alcohol Abuse and Alcoholism Alcohol Use Disorder and Associated Disabilities Interview Schedule- DSM IV Version (AUDADIS-IV) |- | 9,282 adults, 18+ years old ; collected between 2001 and 2003<ref>{{cite journal|last1=Kessler|first1=RC|last2=Green|first2=JG|last3=Gruber|first3=MJ|last4=Sampson|first4=NA|last5=Bromet|first5=E|last6=Cuitan|first6=M|last7=Furukawa|first7=TA|last8=Gureje|first8=O|last9=Hinkov|first9=H|date=June 2010|title=Screening for serious mental illness in the general population with the K6 screening scale: results from the WHO World Mental Health (WMH) survey initiative.|journal=International journal of methods in psychiatric research|volume=19 Suppl 1|pages=4-22|pmid=20527002|last10=Hu|first10=CY|last11=Lara|first11=C|last12=Lee|first12=S|last13=Mneimneh|first13=Z|last14=Myer|first14=L|last15=Oakley-Browne|first15=M|last16=Posada-Villa|first16=J|last17=Sagar|first17=R|last18=Viana|first18=MC|last19=Zaslavsky|first19=AM}}</ref> | 13.2 (0.6) Alcohol Abuse; 5.4 (0.3) Alcohol Dependence; 7.9 (0.4) Drug Abuse; 3.0 (0.2) Drug Dependence | United States General Adult Population: National Comorbidity Survey Replication (NCS-R) | World Mental Health Survey Initiative Version of the World Health Organization Composite International Diagnostic Interview (WMH-CIDI) which generates DSM-IV and International Classification of Diseases, 10th revision diagnoses |- | Urban General Medicine Practice, low-income primary care patients, 75% Hispanic<ref>{{cite journal|last1=Olfson|first1=M|last2=Shea|first2=S|last3=Feder|first3=A|last4=Fuentes|first4=M|last5=Nomura|first5=Y|last6=Gameroff|first6=M|last7=Weissman|first7=MM|date=NaN|title=Prevalence of anxiety, depression, and substance use disorders in an urban general medicine practice.|journal=Archives of family medicine|volume=9|issue=9|pages=876-83|pmid=11031395}}</ref> | 7.9% | New York | Patient Health Questionnaire |- | Incarcerated females<ref>{{cite journal|last1=Teplin|first1=LA|last2=Abram|first2=KM|last3=McClelland|first3=GM|date=June 1996|title=Prevalence of psychiatric disorders among incarcerated women. I. Pretrial jail detainees.|journal=Archives of general psychiatry|volume=53|issue=6|pages=505-12|pmid=8639033}}</ref> | 70.2% | Chicago prison - 40 % African American, 33% White, 25 % Hispanic | National Institute of Mental Health Diagnostic Interview Schedule Version 11I-R (NIMH DIS-III-R) |- |Incarcerated females (updated) (Proctor 2012) | 70% dependent | Minnesota State Prison System- 801 females, 18-58 years old, 57.7% Caucasian, 21.5% African American, 13.2% Native American |Substance Use Disorder Diagnostic Schedule-IV (SUDDS-IV) |- | Incarcerated male youths<ref>{{cite journal|last1=Wasserman|first1=GA|last2=McReynolds|first2=LS|last3=Lucas|first3=CP|last4=Fisher|first4=P|last5=Santos|first5=L|date=March 2002|title=The voice DISC-IV with incarcerated male youths: prevalence of disorder.|journal=Journal of the American Academy of Child and Adolescent Psychiatry|volume=41|issue=3|pages=314-21|pmid=11886026}}</ref> | 56.4% | Texas state prison – 45 % African American, 33% White, 20% Hispanic |Structured Clinical Interview for DSM IV – Substance Use Disorders Module |- | Individuals with schizophrenia across settings<ref>{{cite journal|last1=Regier|first1=DA|last2=Farmer|first2=ME|last3=Rae|first3=DS|last4=Locke|first4=BZ|last5=Keith|first5=SJ|last6=Judd|first6=LL|last7=Goodwin|first7=FK|date=21 November 1990|title=Comorbidity of mental disorders with alcohol and other drug abuse. Results from the Epidemiologic Catchment Area (ECA) Study.|journal=JAMA|volume=264|issue=19|pages=2511-8|pmid=2232018}}</ref> | 47% | New Haven, CT; Baltimore, MD; St. Louis, MO; Durham, NC; Los Angeles, CA | National Institute of Mental Health (NIMH) Diagnostic Interview Schedule |- | HIV+ men in community health clinics<ref>{{cite journal|last1=Dew|first1=MA|last2=Becker|first2=JT|last3=Sanchez|first3=J|last4=Caldararo|first4=R|last5=Lopez|first5=OL|last6=Wess|first6=J|last7=Dorst|first7=SK|last8=Banks|first8=G|date=March 1997|title=Prevalence and predictors of depressive, anxiety and substance use disorders in HIV-infected and uninfected men: a longitudinal evaluation.|journal=Psychological medicine|volume=27|issue=2|pages=395-409|pmid=9089832}}</ref> | 24.4% | Alleghany County, PA | Structured Clinical Interview for DSM-III-R |- | Internal medicine inpatients<ref>{{cite journal|last1=Hansen|first1=MS|last2=Fink|first2=P|last3=Frydenberg|first3=M|last4=Oxhøj|first4=M|last5=Søndergaard|first5=L|last6=Munk-Jørgensen|first6=P|date=April 2001|title=Mental disorders among internal medical inpatients: prevalence, detection, and treatment status.|journal=Journal of psychosomatic research|volume=50|issue=4|pages=199-204|pmid=11369025}}</ref> | 10.9% | Denmark | Symptom Check List (SCL-8) |} == [[Evidence based assessment/Prediction phase|'''Prediction phase''']] == === Recommended screening instruments for SUD === {| class="wikitable sortable" |- ! Measure !Format (Reporter) !Age Range !Administration/ Completion Time !Where to Access |- |Drug Use Screening Inventory-Revised (DUSI-R) <ref>{{Cite journal|last=Tarter|first=Ralph E.|last2=Kirisci|first2=Levent|date=1997-01-01|title=The Drug Use Screening Inventory for Adults: Psychometric Structure and Discriminative Sensitivity|url=http://dx.doi.org/10.3109/00952999709040942|journal=The American Journal of Drug and Alcohol Abuse|volume=23|issue=2|pages=207–219|doi=10.3109/00952999709040942|issn=0095-2990}}</ref><ref>{{Cite journal|date=2018-06|editor-last=Hunsley|editor-first=John|editor2-last=Mash|editor2-first=Eric J.|title=A Guide to Assessments That Work|url=http://dx.doi.org/10.1093/med-psych/9780190492243.001.0001|journal=Oxford Clinical Psychology|doi=10.1093/med-psych/9780190492243.001.0001}}</ref> |Self-report |Teen and adult versions |20 minutes |Contact Dr. Ralph Tarter at tarter@pitt.edu |- |Drug Abuse Screening Test (DAST)<ref>{{Cite journal|last=Yudko|first=Errol|last2=Lozhkina|first2=Olga|last3=Fouts|first3=Adriana|date=2007-03|title=A comprehensive review of the psychometric properties of the Drug Abuse Screening Test|url=http://dx.doi.org/10.1016/j.jsat.2006.08.002|journal=Journal of Substance Abuse Treatment|volume=32|issue=2|pages=189–198|doi=10.1016/j.jsat.2006.08.002|issn=0740-5472}}</ref><ref>{{Cite journal|last=Yudko|first=Errol|last2=Lozhkina|first2=Olga|last3=Fouts|first3=Adriana|date=2007-03|title=A comprehensive review of the psychometric properties of the Drug Abuse Screening Test|url=http://dx.doi.org/10.1016/j.jsat.2006.08.002|journal=Journal of Substance Abuse Treatment|volume=32|issue=2|pages=189–198|doi=10.1016/j.jsat.2006.08.002|issn=0740-5472}}</ref> |Self-report |Adolescents and Adults |10 minutes or less |[https://osf.io/23mwt/?view_only=1924fe3e90334b11bb1e099a691b2ffb PDF] |- |Alcohol Use Disorders Identification Test (AUDIT) <ref>{{Cite journal|last=Whittaker|first=Anne|date=2015-05|title=Guidelines for the Identification and Management of Substance Use and Substance Use Disorders in Pregnancy By World Health Organization Geneva, Switzerland: WHO Press, 2014ISBN: 9789241548731, 224 pp. Available free online http://www.who.int/substance_abu|url=http://dx.doi.org/10.1111/dar.12212|journal=Drug and Alcohol Review|volume=34|issue=3|pages=340–341|doi=10.1111/dar.12212|issn=0959-5236}}</ref><ref>{{Cite journal|last=de Meneses-Gaya|first=Carolina|last2=Zuardi|first2=Antonio Waldo|last3=Loureiro|first3=Sonia Regina|last4=Crippa|first4=José Alexandre S.|date=2009-01|title=Alcohol Use Disorders Identification Test (AUDIT): An updated systematic review of psychometric properties.|url=http://doi.apa.org/getdoi.cfm?doi=10.3922/j.psns.2009.1.12|journal=Psychology & Neuroscience|language=en|volume=2|issue=1|pages=83–97|doi=10.3922/j.psns.2009.1.12|issn=1983-3288}}</ref><ref>{{Cite journal|last=Strobbe|first=Stephen|date=2014-06|title=Prevention and Screening, Brief Intervention, and Referral to Treatment for Substance Use in Primary Care|url=http://dx.doi.org/10.1016/j.pop.2014.02.002|journal=Primary Care: Clinics in Office Practice|volume=41|issue=2|pages=185–213|doi=10.1016/j.pop.2014.02.002|issn=0095-4543}}</ref> |Self-report or interview |18+ |10 minutes or less |[https://nida.nih.gov/sites/default/files/audit.pdf PDF] |} '''Note:''' Reliability and validity are included in the extended version [[Evidence-based assessment/Substance use disorder (disorder portfolio)/extended version|here]]. This table includes measures with Good or Excellent ratings. === Likelihood ratios and AUCs of screening measures for '''(insert portfolio name)''' === * '''''For a list of the likelihood ratios for more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Likelihood_ratios_and_AUCs_of_common_screening_instruments click here.]''''' {| class="wikitable sortable" border="1" |- ! Screening Measure (Primary Reference) ! AUC ! LR+ (Score) ! LR- (Score) ! Clinical Generalizability |- | [https://osf.io/gq86m/?view_only=628c7440cb5e4cbead514916f342a8cf Kessler 6 Screening Scale (K6)] <ref>{{cite journal|last1=Kessler|first1=RC|last2=Green|first2=JG|last3=Gruber|first3=MJ|last4=Sampson|first4=NA|last5=Bromet|first5=E|last6=Cuitan|first6=M|last7=Furukawa|first7=TA|last8=Gureje|first8=O|last9=Hinkov|first9=H|last10=Hu|first10=CY|last11=Lara|first11=C|last12=Lee|first12=S|last13=Mneimneh|first13=Z|last14=Myer|first14=L|last15=Oakley-Browne|first15=M|last16=Posada-Villa|first16=J|last17=Sagar|first17=R|last18=Viana|first18=MC|last19=Zaslavsky|first19=AM|title=Screening for serious mental illness in the general population with the K6 screening scale: results from the WHO World Mental Health (WMH) survey initiative.|journal=International journal of methods in psychiatric research|date=June 2010|volume=19 Suppl 1|pages=4-22|pmid=20527002}}</ref><ref>Swartz, J. A., & Lurigio, A. J. (2006). Screening for serious mental illness in populations with co-occurring substance use disorders: Performance of the K6 scale. Journal of substance abuse treatment, 31(3), 287-296</ref> | 0.84 (N=41,770) | 3.96 (13+) | 0.296 (0-12) | High: The sample of 41,770 was drawn from initial surveys that were carried out in 14 countries. |- | [https://osf.io/czhgd Alcohol, Smoking and Substance Involvement Screening Test (ASSIST)]<ref>{{cite journal|last1=Humeniuk|first1=R|last2=Ali|first2=R|last3=Babor|first3=TF|last4=Farrell|first4=M|last5=Formigoni|first5=ML|last6=Jittiwutikarn|first6=J|last7=de Lacerda|first7=RB|last8=Ling|first8=W|last9=Marsden|first9=J|last10=Monteiro|first10=M|last11=Nhiwatiwa|first11=S|last12=Pal|first12=H|last13=Poznyak|first13=V|last14=Simon|first14=S|title=Validation of the Alcohol, Smoking And Substance Involvement Screening Test (ASSIST).|journal=Addiction (Abingdon, England)|date=June 2008|volume=103|issue=6|pages=1039-47|pmid=18373724}}</ref> | 0.84 (N=1,047) | 2.76 | 0.28 | High: The sample of 1,047 participants was drawn from drug treatment and primary health care settings in Australia, Brazil, India, Thailand, the United Kingdom, the U.S. and Zimbabwe. |- | [https://osf.io/nk5vx/?view_only=348d7f1ee5e741f8a6657233403dda66 Drug Use Disorders Identification Test (DUDIT)]<ref>{{Cite journal|last=Voluse|first=Andrew C.|last2=Gioia|first2=Christopher J.|last3=Sobell|first3=Linda Carter|last4=Dum|first4=Mariam|last5=Sobell|first5=Mark B.|last6=Simco|first6=Edward R.|title=Psychometric properties of the Drug Use Disorders Identification Test (DUDIT) with substance abusers in outpatient and residential treatment|url=https://doi.org/10.1016/j.addbeh.2011.07.030|journal=Addictive Behaviors|volume=37|issue=1|pages=36–41|doi=10.1016/j.addbeh.2011.07.030}}</ref> |0.95 (N=153) | 6 |0.12 | High: 153 participants from outpatient and residential substance use treatment programs |} '''Note:''' “LR+” refers to the change in likelihood ratio associated with a positive test score, and “LR-” is the likelihood ratio for a low score. Likelihood ratios of 1 indicate that the test result did not change impressions at all. LRs larger than 10 or smaller than 0.1 are frequently clinically decisive; 5 or 0.2 are helpful, and between 2.0 and 0.5 are small enough that they rarely result in clinically meaningful changes of formulation (Sackett et al., 2000). ''' Search terms''': [substance use OR substance use disorders] AND [sensitivity OR specificity] in Google Scholar and PsycINFO =='''[[Evidence-based assessment/Prescription phase|Prescription phase]]'''== ===Gold standard diagnostic interviews=== * For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews click here.] ===Recommended diagnostic interviews for substance use disorder=== {| class="wikitable sortable" border="1" ! colspan="5" |Diagnostic instruments for '''substance use disorder''' |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time !Where to Access |- |The Alcohol Use Disorder and Associated Disabilities Interview Schedule (AUDADIS)<ref>{{Cite journal|last=Samet|first=Sharon|last2=Waxman|first2=Rachel|last3=Hatzenbuehler|first3=Mark|last4=Hasin|first4=Deborah|date=2007-12|title=Addressing Addiction: Concepts and Instruments|url=http://dx.doi.org/10.1151/ascp074119|journal=Addiction Science &amp; Clinical Practice|volume=4|issue=1|pages=19–31|doi=10.1151/ascp074119|issn=1940-0632}}</ref><ref>{{Cite journal|last=Üstün|first=B|last2=Compton|first2=W|last3=Mager|first3=D|last4=Babor|first4=T|last5=Baiyewu|first5=O|last6=Chatterji|first6=S|last7=Cottler|first7=L|last8=Göğüş|first8=A|last9=Mavreas|first9=V|date=1997-09|title=WHO Study on the reliability and validity of the alcohol and drug use disorder instruments: overview of methods and results|url=http://dx.doi.org/10.1016/s0376-8716(97)00087-2|journal=Drug and Alcohol Dependence|volume=47|issue=3|pages=161–169|doi=10.1016/s0376-8716(97)00087-2|issn=0376-8716}}</ref> |Structured interview |18+ |Varies |[https://www.niaaa.nih.gov/research/nesarc-iii/questionnaire NIAAA] |- |The Psychiatric Research Interview for Substance and Mental Disorders (PRISM)<ref>{{Cite journal|last=Samet|first=Sharon|last2=Waxman|first2=Rachel|last3=Hatzenbuehler|first3=Mark|last4=Hasin|first4=Deborah|date=2007-12|title=Addressing Addiction: Concepts and Instruments|url=http://dx.doi.org/10.1151/ascp074119|journal=Addiction Science &amp; Clinical Practice|volume=4|issue=1|pages=19–31|doi=10.1151/ascp074119|issn=1940-0632}}</ref> |Semi-structured |18+ |45 minutes to 2 hours |[https://www.columbiapsychiatry.org/profile/deborah-hasin-phd Columbia Psychiatry] |- | Structured Clinical Interview for DSM-V (SCID)<ref>{{Cite journal|last=Samet|first=Sharon|last2=Waxman|first2=Rachel|last3=Hatzenbuehler|first3=Mark|last4=Hasin|first4=Deborah|date=2007-12|title=Addressing Addiction: Concepts and Instruments|url=http://dx.doi.org/10.1151/ascp074119|journal=Addiction Science &amp; Clinical Practice|volume=4|issue=1|pages=19–31|doi=10.1151/ascp074119|issn=1940-0632}}</ref> |Semi-structured interview by trained clinician |18+ |1-2 hours | -Available for purchase from [https://www.appi.org/products/structured-clinical-interview-for-dsm-5-scid-5 APA Publishing] (Note: Not free) -Modified [https://mfr.osf.io/render?url=https://osf.io/x9smc/?action=download%26mode=render] (not most recent version, SCID-I) | |- | [https://osf.io/7dh4s Global Appraisal of Individual Needs- Initial (GAIN-I) ($1.00 license fee per project for use of Beta version)] <ref>{{Cite journal|date=2018-06|editor-last=Hunsley|editor-first=John|editor2-last=Mash|editor2-first=Eric J.|title=A Guide to Assessments That Work|url=http://dx.doi.org/10.1093/med-psych/9780190492243.001.0001|journal=Oxford Clinical Psychology|doi=10.1093/med-psych/9780190492243.001.0001}}</ref> |Semi-structured interview |12+ |1.5 to 2.5 hours |[https://chestnut.app.box.com/v/GAIN-I-Materials Materials][https://osf.io/7dh4s PDF] |- |Composite International Diagnostic Interview (CIDI)<ref>{{Cite journal|last=Üstün|first=B|last2=Compton|first2=W|last3=Mager|first3=D|last4=Babor|first4=T|last5=Baiyewu|first5=O|last6=Chatterji|first6=S|last7=Cottler|first7=L|last8=Göğüş|first8=A|last9=Mavreas|first9=V|date=1997-09|title=WHO Study on the reliability and validity of the alcohol and drug use disorder instruments: overview of methods and results|url=http://dx.doi.org/10.1016/s0376-8716(97)00087-2|journal=Drug and Alcohol Dependence|volume=47|issue=3|pages=161–169|doi=10.1016/s0376-8716(97)00087-2|issn=0376-8716}}</ref> |Structured interview by trained non-clinician |18+ |45 minutes to an hour |[https://www.hcp.med.harvard.edu/wmhcidi/download-the-who-wmh-cidi-instruments/ WHO] |} '''Note:''' Reliability and validity are included in the extended version (link). This table includes measures with Good or Excellent ratings. == '''[[Evidence-based assessment/Process phase|Process phase]]''' == === Outcome and severity measures === This table includes clinically significant benchmarks for '''(insert portfolio name here)''' specific outcome measures * Information on how to interpret this table can be [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase found here]. * Additionally, these [[Evidence based assessment/Vignettes|vignettes]] might be helpful resources for understanding appropriate adaptation of outcome measures in practice. *''<u>For clinically significant change benchmarks for the CBCL, YSR, and TRF total, externalizing, internalizing, and attention benchmarks,</u>'' [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase&wteswitched=1#Clinically_significant_change_benchmarks_for_widely-used_outcome_measures see here.] Clinically significant change benchmarks with common instruments and mood rating scales {| class="wikitable sortable" border="1" | colspan="7" | ==== '''Clinically significant change benchmarks with common instruments and mood rating scales''' ==== |- | style="text-align:center;font-size:120%" width="300" | | colspan="3" style="text-align:center;font-size:120%" width="300" | <b> Cut* Scores</b> | colspan="3" style="text-align:center;font-size:120%" | <b> Critical Change <br> (Unstandardized Scores)</b> |- | style="text-align:center;font-size:130%;" | <b> Measure</b> | style="text-align:center;font-size:110%" | <b> A</b> | style="text-align:center;font-size:110%" | <b> B</b> | style="text-align:center;font-size:110%" | <b> C</b> | style="text-align:center;font-size:110%" | <b> 95%</b> | style="text-align:center;font-size:110%" | <b> 90%</b> | style="text-align:center;font-size:110%" | <b> SE_difference</b> |- | colspan="7" style="font-size:110%; text-align:center;" span | <b> Benchmarks Based on Published Norms</b> |- | style="text-align:center;font-size:100%;" | ''[https://osf.io/wn3rb Rutgers Alcohol Problem Index]''<ref name="Roberts">{{cite journal|last1=Roberts|first1=LJ|last2=Neal|first2=DJ|last3=Kivlahan|first3=DR|last4=Baer|first4=JS|last5=Marlatt|first5=GA|title=Individual drinking changes following a brief intervention among college students: clinical significance in an indicated preventive context.|journal=Journal of consulting and clinical psychology|date=June 2000|volume=68|issue=3|pages=500-5|pmid=10883566}}</ref> <ref name="White1989">{{cite journal|last1=White|first1=HR|last2=Labouvie|first2=EW|title=Towards the assessment of adolescent problem drinking.|journal=Journal of studies on alcohol|date=January 1989|volume=50|issue=1|pages=30-7|pmid=2927120}}</ref> | style="text-align:center;font-size:100%;" span |0.8 | style="text-align:center;font-size:100%;" span | 4.9 | style="text-align:center;font-size:100%;" span | 4.0 | style="text-align:center;font-size:100%;" span | 4.1 | style="text-align:center;font-size:100%;" span | 3.5 | style="text-align:center;font-size:100%;" span | 2.1 |- | style="text-align:center;font-size:100%;" | ''[https://osf.io/vudep Alcohol Dependence Scale (ADS)]''<ref name="Roberts" /> [https://osf.io/vudep (copyrighted)] | style="text-align:center;font-size:100%;" span | 1.2 | style="text-align:center;font-size:100%;" span | 9.9 | style="text-align:center;font-size:100%;" span | 7.8 | style="text-align:center;font-size:100%;" span | 1.4 | style="text-align:center;font-size:100%;" span | 1.2 | style="text-align:center;font-size:100%;" span | 0.7 |- | style="text-align:center;font-size:100%;" | ''[https://osf.io/23mwt/?view_only=1924fe3e90334b11bb1e099a691b2ffb Drug Abuse Screening Test (DAST)]'' <ref>{{cite journal|last1=Skinner|first1=HA|title=The drug abuse screening test.|journal=Addictive behaviors|date=1982|volume=7|issue=4|pages=363-71|pmid=7183189}}</ref> | style="text-align:center;font-size:100%;" span | 0.1 | style="text-align:center;font-size:100%;" span | 2.6 | style="text-align:center;font-size:100%;" span | 1.8 | style="text-align:center;font-size:100%;" span | 1.6 | style="text-align:center;font-size:100%;" span | 1.3 | style="text-align:center;font-size:100%;" span | 0.8 |} '''Note:''' "A" = Away from the clinical range, "B" = Back into the nonclinical range, "C" = Closer to the nonclinical than clinical mean. '''Search terms''': [substance use OR substance use disorder] AND [clinical significance OR outcomes] in Google Scholar and PsycINFO === Treatment === In the United States, according to SAMHSA, of the 8.9 million adults with a dual diagnosis, 44% received some form of treatment in the past year. Given the frequent co-occurrence of mood disorders and substance use disorders, the recommended first step in treatment is for clinicians to deliver a comprehensive screening evaluation that will inform their treatment approach. There are a host of empirically supported treatments for substance use disorders, though medication interventions and psychotherapy are most common. ==== Medication ==== Specifically, medications have been shown to be most effective in the treatment of alcohol and opioid dependence. Naltrexone (50 mg/day) administered for 12 weeks has been shown to decrease cravings for alcohol and the number of days in which alcohol was consumed.<ref>{{cite journal|last1=Volpicelli|first1=JR|last2=Alterman|first2=AI|last3=Hayashida|first3=M|last4=O'Brien|first4=CP|date=November 1992|title=Naltrexone in the treatment of alcohol dependence.|journal=Archives of general psychiatry|volume=49|issue=11|pages=876-80|pmid=1345133}}</ref> Disulfiram (250 mg/day), administered for one year, has been shown to help reduce drinking frequency after relapse.<ref>{{cite journal|last1=Chick|first1=J|last2=Gough|first2=K|last3=Falkowski|first3=W|last4=Kershaw|first4=P|last5=Hore|first5=B|last6=Mehta|first6=B|last7=Ritson|first7=B|last8=Ropner|first8=R|last9=Torley|first9=D|date=July 1992|title=Disulfiram treatment of alcoholism.|journal=The British journal of psychiatry : the journal of mental science|volume=161|pages=84-9|pmid=1638335}}</ref><ref name="Fuller1986">{{cite journal|last1=Fuller|first1=RK|last2=Branchey|first2=L|last3=Brightwell|first3=DR|last4=Derman|first4=RM|last5=Emrick|first5=CD|last6=Iber|first6=FL|last7=James|first7=KE|last8=Lacoursiere|first8=RB|last9=Lee|first9=KK|date=19 September 1986|title=Disulfiram treatment of alcoholism. A Veterans Administration cooperative study.|journal=JAMA|volume=256|issue=11|pages=1449-55|pmid=3528541|last10=Lowenstam|first10=I}}</ref> In the context of opioid dependence, Methadone has been the gold standard medication treatment for over 30 years. According to numerous studies, patients on higher doses of methadone (>50mg/day) report less illicit opioid use, as well as increased retention rates in treatment.<ref>{{cite journal|last1=Farrell|first1=M|last2=Ward|first2=J|last3=Mattick|first3=R|last4=Hall|first4=W|last5=Stimson|first5=G|last6=Des Jarlais|first6=D|last7=Gossop|first7=M|last8=Strang|first8=J|date=1994.|title=Methadone maintenance treatment in opiate dependence: a review.|journal=British Medical Journal|volume=309|issue=6960|page=997}}</ref> Buprenorphine is an alternative to Methadone to treat opioid dependence and research similarly supports its clinical efficacy. Buprenorphine (60 mg/day) has been shown to bring about improved retention rates, as well as reduced illicit opioid use. ==== Therapy ==== * Cognitive Behavioral Therapies ** While medication serves as an effective intervention for some with drug dependence, behavioral interventions are also empirically supported. A number of studies suggest that CBT is an effective intervention for substance use. In a 2010 review, McHugh, Hearon and Otto<ref>{{cite journal|last1=McHugh|first1=RK|last2=Hearon|first2=BA|last3=Otto|first3=MW|date=September 2010|title=Cognitive behavioral therapy for substance use disorders.|journal=The Psychiatric clinics of North America|volume=33|issue=3|pages=511-25|pmid=20599130}}</ref> found that CBT for substance use, which synthesizes cognitive and motivational elements, as well as skills-building interventions, is effective both as a stand-alone treatment and when combined with other treatments. Acceptance and Commitment Therapy (ACT) has also been used to treat substance-using populations with encouraging results. Specifically, Lanza and Menéndez<ref>{{cite journal|last1=Villagrá Lanza|first1=P|last2=González Menéndez|first2=A|date=2013|title=Acceptance and Commitment Therapy for drug abuse in incarcerated women.|journal=Psicothema|volume=25|issue=3|pages=307-12|pmid=23910743}}</ref> employed a 16-session ACT in the treatment of incarcerated females. In this population, abstinence rates, as well as anxiety sensitivity and other comorbid psychopathology showed improvement. Another behavior intervention that has been successfully implemented is Mindfulness Therapy for Substance Use.<ref>{{cite journal|last1=Marcus|first1=Marianne T.|last2=Zgierska|first2=Aleksandra|date=27 October 2009|title=Mindfulness-Based Therapies for Substance Use Disorders: Part 1|journal=Substance Abuse|volume=30|issue=4|pages=263–265|doi=10.1080/08897070903250027}}</ref> Research indicates that this modality is effective across a range of populations through use of methods that help patients to develop nonreactive, acceptance behaviors. * Contingency Management ** One common technique implemented as a treatment method across psychiatric disorders is contingency management, wherein the problematic behavior of the individual is closely monitored and reinforcers are delivered contingent upon detection of a target behavior.<ref>{{cite book|title=Contingency management for adolescent substance abuse : a practitioner's guide|last1=al.]|first1=Scott W. Henggeler ... [et|date=2012|publisher=Guilford Press|isbn=1462502474|location=New York, NY}}</ref> In the case of substance use, abstinence is monitored via urine screens or other objective methods and the patient is rewarded for abstinence through prizes or vouchers, which are conversely withheld in the event that the patient does not remain abstinent as determined by urine screening or related methods. Recent work has demonstrated that contingency management can be an effective method for delaying time to first use after treatment and achieving short-term sobriety in individuals with substance use disorders. However, the effects of this intervention seem to be contingent upon the magnitude of the reward, and effects are not evident long-term.<ref>{{cite journal|last1=Petry|first1=NM|last2=Alessi|first2=SM|last3=Barry|first3=D|last4=Carroll|first4=KM|date=June 2015|title=Standard magnitude prize reinforcers can be as efficacious as larger magnitude reinforcers in cocaine-dependent methadone patients.|journal=Journal of consulting and clinical psychology|volume=83|issue=3|pages=464-72|pmid=25198284}}</ref> * Motivational Interviewing ** Motivational Interviewing is a treatment option that seems to be particularly useful for individuals who are ambivalent about changing behavior. This type of intervention requires the therapist to build a collaborative relationship with the patient, using empathic and non-confrontational approaches to help the patient enhance personal motivation to change.<ref>{{cite book|title=Motivational interviewing : helping people change|last1=Miller|first1=William R.|last2=Rollnick|first2=Stephen|date=2013|publisher=Guilford Press|isbn=1609182278|edition=3rd|location=New York, NY}}</ref> Finally, behavioral activation therapy attempts to address comorbid diagnoses commonly occurring with substance use disorders (i.e., depression) in an attempt to improve outcomes for individuals who may be harder to treat. This technique aims to increase positive reinforcers and decrease intensity and occurrences of negative consequences and life events. This treatment approach has been effective in reducing severity of depression and anxiety symptoms, and increasing enjoyment and reward value of posttreatment activities as compared to treatment as usual.<ref>{{cite journal|last1=Daughters|first1=SB|last2=Braun|first2=AR|last3=Sargeant|first3=MN|last4=Reynolds|first4=EK|last5=Hopko|first5=DR|last6=Blanco|first6=C|last7=Lejuez|first7=CW|date=January 2008|title=Effectiveness of a brief behavioral treatment for inner-city illicit drug users with elevated depressive symptoms: the life enhancement treatment for substance use (LETS Act!).|journal=The Journal of clinical psychiatry|volume=69|issue=1|pages=122-9|pmid=18312046}}</ref> ==Web based resources== * '''[http://www.drugabuse.gov National Institute on Drug Abuse]''' * '''[http://www.samhsa.gov/treatment/ Substance Abuse and Mental Health Services Administration (SAMHSA)]''' * '''[http://www.addictionrecoveryguide.org/ The Addiction Recovery Guide]''' * [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/drug-and-alcohol-abuse/ EffectiveChildTherapy.Org information on Substance Abuse] * [https://sccap53.org Society of Clinical Child and Adolescent Psychology] ==References== {{collapse top|References|expand=yes}} {{reflist|2}} # {{collapse bottom}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] er5vkd5hesxsy12td9k0d4jm6xzk3wc 2419309 2419236 2022-08-26T05:33:00Z Ardenguo 2944162 /* Recommended diagnostic interviews for substance use disorder */ linked extended version of this page to "Note: Reliability and validity are included in the extended version here. This table includes measures with Good or Excellent ratings." wikitext text/x-wiki <noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{medical disclaimer}} {{:{{BASEPAGENAME}}/Sidebar}} ==[[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio?"''']]== For background information on what assessment portfolios are, click the link in the heading above. Want even 'more' information about this topic? There's an extended version of this page [[Evidence-based assessment/Substance use disorder (disorder portfolio)/extended version|here]]. == [[Evidence-based assessment/Preparation phase|'''Preparation Phase''']] == {{blockquotetop}} <big>'''Diagnostic Criteria for Substance Use Disorder'''</big> <big>'''ICD-11 Diagnostic Criteria for Substance Use Disorder'''</big> *Disorders due to substance use and addictive behaviours are mental and behavioural disorders that develop as a result of the use of predominantly psychoactive substances, including medications, or specific repetitive rewarding and reinforcing behaviours. **Note: The ICD-11 lists 20 additional subcategories of Substance Use Disorder. They can be found [https://icd.who.int/browse11/l-m/en#/http://id.who.int/icd/entity/1602669465 here]. <big>'''DSM Diagnostic Criteria for Substance Use Disorder'''</big> *Substance use disorder is a DSM disorder in the Substance-Related and Addictive Disorders chapter. It is characterized by the use of substances in a manner that leads to clinically significant impairment or distress. * The diagnostic criteria for Substance Use Disorder disorder changed slightly from [[DSM-IV]] to [[w:Diagnostic_and_Statistical_Manual_of_Mental_Disorders#DSM-IV-TR_.282000.29|DSM-5]]. Summaries are available [http://www.dsm5.org/Documents/changes%20from%20dsm-iv-tr%20to%20dsm-5.pdf here]. {{blockquotebottom}} === Base rates of SUD in different populations and clinical settings === {| class="wikitable sortable" border="1" |- ! Setting ! Base Rate ! Demography ! Diagnostic Method |- | General population of North Carolina, aged 12 or older | 6.7% | North Carolina | National Survey on Drug Use and Health (NSDUH), 2009 to 2013 |- | 43,093 individuals, 18+ years old collected between 2001 and 2002<ref>Hasin DS, Grant BF. The National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) Waves 1 and 2: review and summary of findings. Soc Psychiatry Psychiatr Epidemiol. 2015 Nov;50(11):1609-40. doi: 10.1007/s00127-015-1088-0. Epub 2015 Jul 26. PMID: 26210739.</ref> | 17.8 (0.5) Alcohol Abuse; 12.5 (0.4) Alcohol Dependence; 7.7 (0.2) Drug Abuse; 2.6 (0.1) Drug Dependence | United States General Adult Population: National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) (Grant et al., 2007) | National Institute on Alcohol Abuse and Alcoholism Alcohol Use Disorder and Associated Disabilities Interview Schedule- DSM IV Version (AUDADIS-IV) |- | 9,282 adults, 18+ years old ; collected between 2001 and 2003<ref>{{cite journal|last1=Kessler|first1=RC|last2=Green|first2=JG|last3=Gruber|first3=MJ|last4=Sampson|first4=NA|last5=Bromet|first5=E|last6=Cuitan|first6=M|last7=Furukawa|first7=TA|last8=Gureje|first8=O|last9=Hinkov|first9=H|date=June 2010|title=Screening for serious mental illness in the general population with the K6 screening scale: results from the WHO World Mental Health (WMH) survey initiative.|journal=International journal of methods in psychiatric research|volume=19 Suppl 1|pages=4-22|pmid=20527002|last10=Hu|first10=CY|last11=Lara|first11=C|last12=Lee|first12=S|last13=Mneimneh|first13=Z|last14=Myer|first14=L|last15=Oakley-Browne|first15=M|last16=Posada-Villa|first16=J|last17=Sagar|first17=R|last18=Viana|first18=MC|last19=Zaslavsky|first19=AM}}</ref> | 13.2 (0.6) Alcohol Abuse; 5.4 (0.3) Alcohol Dependence; 7.9 (0.4) Drug Abuse; 3.0 (0.2) Drug Dependence | United States General Adult Population: National Comorbidity Survey Replication (NCS-R) | World Mental Health Survey Initiative Version of the World Health Organization Composite International Diagnostic Interview (WMH-CIDI) which generates DSM-IV and International Classification of Diseases, 10th revision diagnoses |- | Urban General Medicine Practice, low-income primary care patients, 75% Hispanic<ref>{{cite journal|last1=Olfson|first1=M|last2=Shea|first2=S|last3=Feder|first3=A|last4=Fuentes|first4=M|last5=Nomura|first5=Y|last6=Gameroff|first6=M|last7=Weissman|first7=MM|date=NaN|title=Prevalence of anxiety, depression, and substance use disorders in an urban general medicine practice.|journal=Archives of family medicine|volume=9|issue=9|pages=876-83|pmid=11031395}}</ref> | 7.9% | New York | Patient Health Questionnaire |- | Incarcerated females<ref>{{cite journal|last1=Teplin|first1=LA|last2=Abram|first2=KM|last3=McClelland|first3=GM|date=June 1996|title=Prevalence of psychiatric disorders among incarcerated women. I. Pretrial jail detainees.|journal=Archives of general psychiatry|volume=53|issue=6|pages=505-12|pmid=8639033}}</ref> | 70.2% | Chicago prison - 40 % African American, 33% White, 25 % Hispanic | National Institute of Mental Health Diagnostic Interview Schedule Version 11I-R (NIMH DIS-III-R) |- |Incarcerated females (updated) (Proctor 2012) | 70% dependent | Minnesota State Prison System- 801 females, 18-58 years old, 57.7% Caucasian, 21.5% African American, 13.2% Native American |Substance Use Disorder Diagnostic Schedule-IV (SUDDS-IV) |- | Incarcerated male youths<ref>{{cite journal|last1=Wasserman|first1=GA|last2=McReynolds|first2=LS|last3=Lucas|first3=CP|last4=Fisher|first4=P|last5=Santos|first5=L|date=March 2002|title=The voice DISC-IV with incarcerated male youths: prevalence of disorder.|journal=Journal of the American Academy of Child and Adolescent Psychiatry|volume=41|issue=3|pages=314-21|pmid=11886026}}</ref> | 56.4% | Texas state prison – 45 % African American, 33% White, 20% Hispanic |Structured Clinical Interview for DSM IV – Substance Use Disorders Module |- | Individuals with schizophrenia across settings<ref>{{cite journal|last1=Regier|first1=DA|last2=Farmer|first2=ME|last3=Rae|first3=DS|last4=Locke|first4=BZ|last5=Keith|first5=SJ|last6=Judd|first6=LL|last7=Goodwin|first7=FK|date=21 November 1990|title=Comorbidity of mental disorders with alcohol and other drug abuse. Results from the Epidemiologic Catchment Area (ECA) Study.|journal=JAMA|volume=264|issue=19|pages=2511-8|pmid=2232018}}</ref> | 47% | New Haven, CT; Baltimore, MD; St. Louis, MO; Durham, NC; Los Angeles, CA | National Institute of Mental Health (NIMH) Diagnostic Interview Schedule |- | HIV+ men in community health clinics<ref>{{cite journal|last1=Dew|first1=MA|last2=Becker|first2=JT|last3=Sanchez|first3=J|last4=Caldararo|first4=R|last5=Lopez|first5=OL|last6=Wess|first6=J|last7=Dorst|first7=SK|last8=Banks|first8=G|date=March 1997|title=Prevalence and predictors of depressive, anxiety and substance use disorders in HIV-infected and uninfected men: a longitudinal evaluation.|journal=Psychological medicine|volume=27|issue=2|pages=395-409|pmid=9089832}}</ref> | 24.4% | Alleghany County, PA | Structured Clinical Interview for DSM-III-R |- | Internal medicine inpatients<ref>{{cite journal|last1=Hansen|first1=MS|last2=Fink|first2=P|last3=Frydenberg|first3=M|last4=Oxhøj|first4=M|last5=Søndergaard|first5=L|last6=Munk-Jørgensen|first6=P|date=April 2001|title=Mental disorders among internal medical inpatients: prevalence, detection, and treatment status.|journal=Journal of psychosomatic research|volume=50|issue=4|pages=199-204|pmid=11369025}}</ref> | 10.9% | Denmark | Symptom Check List (SCL-8) |} == [[Evidence based assessment/Prediction phase|'''Prediction phase''']] == === Recommended screening instruments for SUD === {| class="wikitable sortable" |- ! Measure !Format (Reporter) !Age Range !Administration/ Completion Time !Where to Access |- |Drug Use Screening Inventory-Revised (DUSI-R) <ref>{{Cite journal|last=Tarter|first=Ralph E.|last2=Kirisci|first2=Levent|date=1997-01-01|title=The Drug Use Screening Inventory for Adults: Psychometric Structure and Discriminative Sensitivity|url=http://dx.doi.org/10.3109/00952999709040942|journal=The American Journal of Drug and Alcohol Abuse|volume=23|issue=2|pages=207–219|doi=10.3109/00952999709040942|issn=0095-2990}}</ref><ref>{{Cite journal|date=2018-06|editor-last=Hunsley|editor-first=John|editor2-last=Mash|editor2-first=Eric J.|title=A Guide to Assessments That Work|url=http://dx.doi.org/10.1093/med-psych/9780190492243.001.0001|journal=Oxford Clinical Psychology|doi=10.1093/med-psych/9780190492243.001.0001}}</ref> |Self-report |Teen and adult versions |20 minutes |Contact Dr. Ralph Tarter at tarter@pitt.edu |- |Drug Abuse Screening Test (DAST)<ref>{{Cite journal|last=Yudko|first=Errol|last2=Lozhkina|first2=Olga|last3=Fouts|first3=Adriana|date=2007-03|title=A comprehensive review of the psychometric properties of the Drug Abuse Screening Test|url=http://dx.doi.org/10.1016/j.jsat.2006.08.002|journal=Journal of Substance Abuse Treatment|volume=32|issue=2|pages=189–198|doi=10.1016/j.jsat.2006.08.002|issn=0740-5472}}</ref><ref>{{Cite journal|last=Yudko|first=Errol|last2=Lozhkina|first2=Olga|last3=Fouts|first3=Adriana|date=2007-03|title=A comprehensive review of the psychometric properties of the Drug Abuse Screening Test|url=http://dx.doi.org/10.1016/j.jsat.2006.08.002|journal=Journal of Substance Abuse Treatment|volume=32|issue=2|pages=189–198|doi=10.1016/j.jsat.2006.08.002|issn=0740-5472}}</ref> |Self-report |Adolescents and Adults |10 minutes or less |[https://osf.io/23mwt/?view_only=1924fe3e90334b11bb1e099a691b2ffb PDF] |- |Alcohol Use Disorders Identification Test (AUDIT) <ref>{{Cite journal|last=Whittaker|first=Anne|date=2015-05|title=Guidelines for the Identification and Management of Substance Use and Substance Use Disorders in Pregnancy By World Health Organization Geneva, Switzerland: WHO Press, 2014ISBN: 9789241548731, 224 pp. Available free online http://www.who.int/substance_abu|url=http://dx.doi.org/10.1111/dar.12212|journal=Drug and Alcohol Review|volume=34|issue=3|pages=340–341|doi=10.1111/dar.12212|issn=0959-5236}}</ref><ref>{{Cite journal|last=de Meneses-Gaya|first=Carolina|last2=Zuardi|first2=Antonio Waldo|last3=Loureiro|first3=Sonia Regina|last4=Crippa|first4=José Alexandre S.|date=2009-01|title=Alcohol Use Disorders Identification Test (AUDIT): An updated systematic review of psychometric properties.|url=http://doi.apa.org/getdoi.cfm?doi=10.3922/j.psns.2009.1.12|journal=Psychology & Neuroscience|language=en|volume=2|issue=1|pages=83–97|doi=10.3922/j.psns.2009.1.12|issn=1983-3288}}</ref><ref>{{Cite journal|last=Strobbe|first=Stephen|date=2014-06|title=Prevention and Screening, Brief Intervention, and Referral to Treatment for Substance Use in Primary Care|url=http://dx.doi.org/10.1016/j.pop.2014.02.002|journal=Primary Care: Clinics in Office Practice|volume=41|issue=2|pages=185–213|doi=10.1016/j.pop.2014.02.002|issn=0095-4543}}</ref> |Self-report or interview |18+ |10 minutes or less |[https://nida.nih.gov/sites/default/files/audit.pdf PDF] |} '''Note:''' Reliability and validity are included in the extended version [[Evidence-based assessment/Substance use disorder (disorder portfolio)/extended version|here]]. This table includes measures with Good or Excellent ratings. === Likelihood ratios and AUCs of screening measures for '''(insert portfolio name)''' === * '''''For a list of the likelihood ratios for more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Likelihood_ratios_and_AUCs_of_common_screening_instruments click here.]''''' {| class="wikitable sortable" border="1" |- ! Screening Measure (Primary Reference) ! AUC ! LR+ (Score) ! LR- (Score) ! Clinical Generalizability |- | [https://osf.io/gq86m/?view_only=628c7440cb5e4cbead514916f342a8cf Kessler 6 Screening Scale (K6)] <ref>{{cite journal|last1=Kessler|first1=RC|last2=Green|first2=JG|last3=Gruber|first3=MJ|last4=Sampson|first4=NA|last5=Bromet|first5=E|last6=Cuitan|first6=M|last7=Furukawa|first7=TA|last8=Gureje|first8=O|last9=Hinkov|first9=H|last10=Hu|first10=CY|last11=Lara|first11=C|last12=Lee|first12=S|last13=Mneimneh|first13=Z|last14=Myer|first14=L|last15=Oakley-Browne|first15=M|last16=Posada-Villa|first16=J|last17=Sagar|first17=R|last18=Viana|first18=MC|last19=Zaslavsky|first19=AM|title=Screening for serious mental illness in the general population with the K6 screening scale: results from the WHO World Mental Health (WMH) survey initiative.|journal=International journal of methods in psychiatric research|date=June 2010|volume=19 Suppl 1|pages=4-22|pmid=20527002}}</ref><ref>Swartz, J. A., & Lurigio, A. J. (2006). Screening for serious mental illness in populations with co-occurring substance use disorders: Performance of the K6 scale. Journal of substance abuse treatment, 31(3), 287-296</ref> | 0.84 (N=41,770) | 3.96 (13+) | 0.296 (0-12) | High: The sample of 41,770 was drawn from initial surveys that were carried out in 14 countries. |- | [https://osf.io/czhgd Alcohol, Smoking and Substance Involvement Screening Test (ASSIST)]<ref>{{cite journal|last1=Humeniuk|first1=R|last2=Ali|first2=R|last3=Babor|first3=TF|last4=Farrell|first4=M|last5=Formigoni|first5=ML|last6=Jittiwutikarn|first6=J|last7=de Lacerda|first7=RB|last8=Ling|first8=W|last9=Marsden|first9=J|last10=Monteiro|first10=M|last11=Nhiwatiwa|first11=S|last12=Pal|first12=H|last13=Poznyak|first13=V|last14=Simon|first14=S|title=Validation of the Alcohol, Smoking And Substance Involvement Screening Test (ASSIST).|journal=Addiction (Abingdon, England)|date=June 2008|volume=103|issue=6|pages=1039-47|pmid=18373724}}</ref> | 0.84 (N=1,047) | 2.76 | 0.28 | High: The sample of 1,047 participants was drawn from drug treatment and primary health care settings in Australia, Brazil, India, Thailand, the United Kingdom, the U.S. and Zimbabwe. |- | [https://osf.io/nk5vx/?view_only=348d7f1ee5e741f8a6657233403dda66 Drug Use Disorders Identification Test (DUDIT)]<ref>{{Cite journal|last=Voluse|first=Andrew C.|last2=Gioia|first2=Christopher J.|last3=Sobell|first3=Linda Carter|last4=Dum|first4=Mariam|last5=Sobell|first5=Mark B.|last6=Simco|first6=Edward R.|title=Psychometric properties of the Drug Use Disorders Identification Test (DUDIT) with substance abusers in outpatient and residential treatment|url=https://doi.org/10.1016/j.addbeh.2011.07.030|journal=Addictive Behaviors|volume=37|issue=1|pages=36–41|doi=10.1016/j.addbeh.2011.07.030}}</ref> |0.95 (N=153) | 6 |0.12 | High: 153 participants from outpatient and residential substance use treatment programs |} '''Note:''' “LR+” refers to the change in likelihood ratio associated with a positive test score, and “LR-” is the likelihood ratio for a low score. Likelihood ratios of 1 indicate that the test result did not change impressions at all. LRs larger than 10 or smaller than 0.1 are frequently clinically decisive; 5 or 0.2 are helpful, and between 2.0 and 0.5 are small enough that they rarely result in clinically meaningful changes of formulation (Sackett et al., 2000). ''' Search terms''': [substance use OR substance use disorders] AND [sensitivity OR specificity] in Google Scholar and PsycINFO =='''[[Evidence-based assessment/Prescription phase|Prescription phase]]'''== ===Gold standard diagnostic interviews=== * For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews click here.] ===Recommended diagnostic interviews for substance use disorder=== {| class="wikitable sortable" border="1" ! colspan="5" |Diagnostic instruments for '''substance use disorder''' |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time !Where to Access |- |The Alcohol Use Disorder and Associated Disabilities Interview Schedule (AUDADIS)<ref>{{Cite journal|last=Samet|first=Sharon|last2=Waxman|first2=Rachel|last3=Hatzenbuehler|first3=Mark|last4=Hasin|first4=Deborah|date=2007-12|title=Addressing Addiction: Concepts and Instruments|url=http://dx.doi.org/10.1151/ascp074119|journal=Addiction Science &amp; Clinical Practice|volume=4|issue=1|pages=19–31|doi=10.1151/ascp074119|issn=1940-0632}}</ref><ref>{{Cite journal|last=Üstün|first=B|last2=Compton|first2=W|last3=Mager|first3=D|last4=Babor|first4=T|last5=Baiyewu|first5=O|last6=Chatterji|first6=S|last7=Cottler|first7=L|last8=Göğüş|first8=A|last9=Mavreas|first9=V|date=1997-09|title=WHO Study on the reliability and validity of the alcohol and drug use disorder instruments: overview of methods and results|url=http://dx.doi.org/10.1016/s0376-8716(97)00087-2|journal=Drug and Alcohol Dependence|volume=47|issue=3|pages=161–169|doi=10.1016/s0376-8716(97)00087-2|issn=0376-8716}}</ref> |Structured interview |18+ |Varies |[https://www.niaaa.nih.gov/research/nesarc-iii/questionnaire NIAAA] |- |The Psychiatric Research Interview for Substance and Mental Disorders (PRISM)<ref>{{Cite journal|last=Samet|first=Sharon|last2=Waxman|first2=Rachel|last3=Hatzenbuehler|first3=Mark|last4=Hasin|first4=Deborah|date=2007-12|title=Addressing Addiction: Concepts and Instruments|url=http://dx.doi.org/10.1151/ascp074119|journal=Addiction Science &amp; Clinical Practice|volume=4|issue=1|pages=19–31|doi=10.1151/ascp074119|issn=1940-0632}}</ref> |Semi-structured |18+ |45 minutes to 2 hours |[https://www.columbiapsychiatry.org/profile/deborah-hasin-phd Columbia Psychiatry] |- | Structured Clinical Interview for DSM-V (SCID)<ref>{{Cite journal|last=Samet|first=Sharon|last2=Waxman|first2=Rachel|last3=Hatzenbuehler|first3=Mark|last4=Hasin|first4=Deborah|date=2007-12|title=Addressing Addiction: Concepts and Instruments|url=http://dx.doi.org/10.1151/ascp074119|journal=Addiction Science &amp; Clinical Practice|volume=4|issue=1|pages=19–31|doi=10.1151/ascp074119|issn=1940-0632}}</ref> |Semi-structured interview by trained clinician |18+ |1-2 hours | -Available for purchase from [https://www.appi.org/products/structured-clinical-interview-for-dsm-5-scid-5 APA Publishing] (Note: Not free) -Modified [https://mfr.osf.io/render?url=https://osf.io/x9smc/?action=download%26mode=render] (not most recent version, SCID-I) | |- | [https://osf.io/7dh4s Global Appraisal of Individual Needs- Initial (GAIN-I) ($1.00 license fee per project for use of Beta version)] <ref>{{Cite journal|date=2018-06|editor-last=Hunsley|editor-first=John|editor2-last=Mash|editor2-first=Eric J.|title=A Guide to Assessments That Work|url=http://dx.doi.org/10.1093/med-psych/9780190492243.001.0001|journal=Oxford Clinical Psychology|doi=10.1093/med-psych/9780190492243.001.0001}}</ref> |Semi-structured interview |12+ |1.5 to 2.5 hours |[https://chestnut.app.box.com/v/GAIN-I-Materials Materials][https://osf.io/7dh4s PDF] |- |Composite International Diagnostic Interview (CIDI)<ref>{{Cite journal|last=Üstün|first=B|last2=Compton|first2=W|last3=Mager|first3=D|last4=Babor|first4=T|last5=Baiyewu|first5=O|last6=Chatterji|first6=S|last7=Cottler|first7=L|last8=Göğüş|first8=A|last9=Mavreas|first9=V|date=1997-09|title=WHO Study on the reliability and validity of the alcohol and drug use disorder instruments: overview of methods and results|url=http://dx.doi.org/10.1016/s0376-8716(97)00087-2|journal=Drug and Alcohol Dependence|volume=47|issue=3|pages=161–169|doi=10.1016/s0376-8716(97)00087-2|issn=0376-8716}}</ref> |Structured interview by trained non-clinician |18+ |45 minutes to an hour |[https://www.hcp.med.harvard.edu/wmhcidi/download-the-who-wmh-cidi-instruments/ WHO] |} '''Note:''' Reliability and validity are included in the extended version [[Evidence-based assessment/Substance use disorder (disorder portfolio)/extended version|here]]. This table includes measures with Good or Excellent ratings. == '''[[Evidence-based assessment/Process phase|Process phase]]''' == === Outcome and severity measures === This table includes clinically significant benchmarks for '''(insert portfolio name here)''' specific outcome measures * Information on how to interpret this table can be [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase found here]. * Additionally, these [[Evidence based assessment/Vignettes|vignettes]] might be helpful resources for understanding appropriate adaptation of outcome measures in practice. *''<u>For clinically significant change benchmarks for the CBCL, YSR, and TRF total, externalizing, internalizing, and attention benchmarks,</u>'' [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase&wteswitched=1#Clinically_significant_change_benchmarks_for_widely-used_outcome_measures see here.] Clinically significant change benchmarks with common instruments and mood rating scales {| class="wikitable sortable" border="1" | colspan="7" | ==== '''Clinically significant change benchmarks with common instruments and mood rating scales''' ==== |- | style="text-align:center;font-size:120%" width="300" | | colspan="3" style="text-align:center;font-size:120%" width="300" | <b> Cut* Scores</b> | colspan="3" style="text-align:center;font-size:120%" | <b> Critical Change <br> (Unstandardized Scores)</b> |- | style="text-align:center;font-size:130%;" | <b> Measure</b> | style="text-align:center;font-size:110%" | <b> A</b> | style="text-align:center;font-size:110%" | <b> B</b> | style="text-align:center;font-size:110%" | <b> C</b> | style="text-align:center;font-size:110%" | <b> 95%</b> | style="text-align:center;font-size:110%" | <b> 90%</b> | style="text-align:center;font-size:110%" | <b> SE_difference</b> |- | colspan="7" style="font-size:110%; text-align:center;" span | <b> Benchmarks Based on Published Norms</b> |- | style="text-align:center;font-size:100%;" | ''[https://osf.io/wn3rb Rutgers Alcohol Problem Index]''<ref name="Roberts">{{cite journal|last1=Roberts|first1=LJ|last2=Neal|first2=DJ|last3=Kivlahan|first3=DR|last4=Baer|first4=JS|last5=Marlatt|first5=GA|title=Individual drinking changes following a brief intervention among college students: clinical significance in an indicated preventive context.|journal=Journal of consulting and clinical psychology|date=June 2000|volume=68|issue=3|pages=500-5|pmid=10883566}}</ref> <ref name="White1989">{{cite journal|last1=White|first1=HR|last2=Labouvie|first2=EW|title=Towards the assessment of adolescent problem drinking.|journal=Journal of studies on alcohol|date=January 1989|volume=50|issue=1|pages=30-7|pmid=2927120}}</ref> | style="text-align:center;font-size:100%;" span |0.8 | style="text-align:center;font-size:100%;" span | 4.9 | style="text-align:center;font-size:100%;" span | 4.0 | style="text-align:center;font-size:100%;" span | 4.1 | style="text-align:center;font-size:100%;" span | 3.5 | style="text-align:center;font-size:100%;" span | 2.1 |- | style="text-align:center;font-size:100%;" | ''[https://osf.io/vudep Alcohol Dependence Scale (ADS)]''<ref name="Roberts" /> [https://osf.io/vudep (copyrighted)] | style="text-align:center;font-size:100%;" span | 1.2 | style="text-align:center;font-size:100%;" span | 9.9 | style="text-align:center;font-size:100%;" span | 7.8 | style="text-align:center;font-size:100%;" span | 1.4 | style="text-align:center;font-size:100%;" span | 1.2 | style="text-align:center;font-size:100%;" span | 0.7 |- | style="text-align:center;font-size:100%;" | ''[https://osf.io/23mwt/?view_only=1924fe3e90334b11bb1e099a691b2ffb Drug Abuse Screening Test (DAST)]'' <ref>{{cite journal|last1=Skinner|first1=HA|title=The drug abuse screening test.|journal=Addictive behaviors|date=1982|volume=7|issue=4|pages=363-71|pmid=7183189}}</ref> | style="text-align:center;font-size:100%;" span | 0.1 | style="text-align:center;font-size:100%;" span | 2.6 | style="text-align:center;font-size:100%;" span | 1.8 | style="text-align:center;font-size:100%;" span | 1.6 | style="text-align:center;font-size:100%;" span | 1.3 | style="text-align:center;font-size:100%;" span | 0.8 |} '''Note:''' "A" = Away from the clinical range, "B" = Back into the nonclinical range, "C" = Closer to the nonclinical than clinical mean. '''Search terms''': [substance use OR substance use disorder] AND [clinical significance OR outcomes] in Google Scholar and PsycINFO === Treatment === In the United States, according to SAMHSA, of the 8.9 million adults with a dual diagnosis, 44% received some form of treatment in the past year. Given the frequent co-occurrence of mood disorders and substance use disorders, the recommended first step in treatment is for clinicians to deliver a comprehensive screening evaluation that will inform their treatment approach. There are a host of empirically supported treatments for substance use disorders, though medication interventions and psychotherapy are most common. ==== Medication ==== Specifically, medications have been shown to be most effective in the treatment of alcohol and opioid dependence. Naltrexone (50 mg/day) administered for 12 weeks has been shown to decrease cravings for alcohol and the number of days in which alcohol was consumed.<ref>{{cite journal|last1=Volpicelli|first1=JR|last2=Alterman|first2=AI|last3=Hayashida|first3=M|last4=O'Brien|first4=CP|date=November 1992|title=Naltrexone in the treatment of alcohol dependence.|journal=Archives of general psychiatry|volume=49|issue=11|pages=876-80|pmid=1345133}}</ref> Disulfiram (250 mg/day), administered for one year, has been shown to help reduce drinking frequency after relapse.<ref>{{cite journal|last1=Chick|first1=J|last2=Gough|first2=K|last3=Falkowski|first3=W|last4=Kershaw|first4=P|last5=Hore|first5=B|last6=Mehta|first6=B|last7=Ritson|first7=B|last8=Ropner|first8=R|last9=Torley|first9=D|date=July 1992|title=Disulfiram treatment of alcoholism.|journal=The British journal of psychiatry : the journal of mental science|volume=161|pages=84-9|pmid=1638335}}</ref><ref name="Fuller1986">{{cite journal|last1=Fuller|first1=RK|last2=Branchey|first2=L|last3=Brightwell|first3=DR|last4=Derman|first4=RM|last5=Emrick|first5=CD|last6=Iber|first6=FL|last7=James|first7=KE|last8=Lacoursiere|first8=RB|last9=Lee|first9=KK|date=19 September 1986|title=Disulfiram treatment of alcoholism. A Veterans Administration cooperative study.|journal=JAMA|volume=256|issue=11|pages=1449-55|pmid=3528541|last10=Lowenstam|first10=I}}</ref> In the context of opioid dependence, Methadone has been the gold standard medication treatment for over 30 years. According to numerous studies, patients on higher doses of methadone (>50mg/day) report less illicit opioid use, as well as increased retention rates in treatment.<ref>{{cite journal|last1=Farrell|first1=M|last2=Ward|first2=J|last3=Mattick|first3=R|last4=Hall|first4=W|last5=Stimson|first5=G|last6=Des Jarlais|first6=D|last7=Gossop|first7=M|last8=Strang|first8=J|date=1994.|title=Methadone maintenance treatment in opiate dependence: a review.|journal=British Medical Journal|volume=309|issue=6960|page=997}}</ref> Buprenorphine is an alternative to Methadone to treat opioid dependence and research similarly supports its clinical efficacy. Buprenorphine (60 mg/day) has been shown to bring about improved retention rates, as well as reduced illicit opioid use. ==== Therapy ==== * Cognitive Behavioral Therapies ** While medication serves as an effective intervention for some with drug dependence, behavioral interventions are also empirically supported. A number of studies suggest that CBT is an effective intervention for substance use. In a 2010 review, McHugh, Hearon and Otto<ref>{{cite journal|last1=McHugh|first1=RK|last2=Hearon|first2=BA|last3=Otto|first3=MW|date=September 2010|title=Cognitive behavioral therapy for substance use disorders.|journal=The Psychiatric clinics of North America|volume=33|issue=3|pages=511-25|pmid=20599130}}</ref> found that CBT for substance use, which synthesizes cognitive and motivational elements, as well as skills-building interventions, is effective both as a stand-alone treatment and when combined with other treatments. Acceptance and Commitment Therapy (ACT) has also been used to treat substance-using populations with encouraging results. Specifically, Lanza and Menéndez<ref>{{cite journal|last1=Villagrá Lanza|first1=P|last2=González Menéndez|first2=A|date=2013|title=Acceptance and Commitment Therapy for drug abuse in incarcerated women.|journal=Psicothema|volume=25|issue=3|pages=307-12|pmid=23910743}}</ref> employed a 16-session ACT in the treatment of incarcerated females. In this population, abstinence rates, as well as anxiety sensitivity and other comorbid psychopathology showed improvement. Another behavior intervention that has been successfully implemented is Mindfulness Therapy for Substance Use.<ref>{{cite journal|last1=Marcus|first1=Marianne T.|last2=Zgierska|first2=Aleksandra|date=27 October 2009|title=Mindfulness-Based Therapies for Substance Use Disorders: Part 1|journal=Substance Abuse|volume=30|issue=4|pages=263–265|doi=10.1080/08897070903250027}}</ref> Research indicates that this modality is effective across a range of populations through use of methods that help patients to develop nonreactive, acceptance behaviors. * Contingency Management ** One common technique implemented as a treatment method across psychiatric disorders is contingency management, wherein the problematic behavior of the individual is closely monitored and reinforcers are delivered contingent upon detection of a target behavior.<ref>{{cite book|title=Contingency management for adolescent substance abuse : a practitioner's guide|last1=al.]|first1=Scott W. Henggeler ... [et|date=2012|publisher=Guilford Press|isbn=1462502474|location=New York, NY}}</ref> In the case of substance use, abstinence is monitored via urine screens or other objective methods and the patient is rewarded for abstinence through prizes or vouchers, which are conversely withheld in the event that the patient does not remain abstinent as determined by urine screening or related methods. Recent work has demonstrated that contingency management can be an effective method for delaying time to first use after treatment and achieving short-term sobriety in individuals with substance use disorders. However, the effects of this intervention seem to be contingent upon the magnitude of the reward, and effects are not evident long-term.<ref>{{cite journal|last1=Petry|first1=NM|last2=Alessi|first2=SM|last3=Barry|first3=D|last4=Carroll|first4=KM|date=June 2015|title=Standard magnitude prize reinforcers can be as efficacious as larger magnitude reinforcers in cocaine-dependent methadone patients.|journal=Journal of consulting and clinical psychology|volume=83|issue=3|pages=464-72|pmid=25198284}}</ref> * Motivational Interviewing ** Motivational Interviewing is a treatment option that seems to be particularly useful for individuals who are ambivalent about changing behavior. This type of intervention requires the therapist to build a collaborative relationship with the patient, using empathic and non-confrontational approaches to help the patient enhance personal motivation to change.<ref>{{cite book|title=Motivational interviewing : helping people change|last1=Miller|first1=William R.|last2=Rollnick|first2=Stephen|date=2013|publisher=Guilford Press|isbn=1609182278|edition=3rd|location=New York, NY}}</ref> Finally, behavioral activation therapy attempts to address comorbid diagnoses commonly occurring with substance use disorders (i.e., depression) in an attempt to improve outcomes for individuals who may be harder to treat. This technique aims to increase positive reinforcers and decrease intensity and occurrences of negative consequences and life events. This treatment approach has been effective in reducing severity of depression and anxiety symptoms, and increasing enjoyment and reward value of posttreatment activities as compared to treatment as usual.<ref>{{cite journal|last1=Daughters|first1=SB|last2=Braun|first2=AR|last3=Sargeant|first3=MN|last4=Reynolds|first4=EK|last5=Hopko|first5=DR|last6=Blanco|first6=C|last7=Lejuez|first7=CW|date=January 2008|title=Effectiveness of a brief behavioral treatment for inner-city illicit drug users with elevated depressive symptoms: the life enhancement treatment for substance use (LETS Act!).|journal=The Journal of clinical psychiatry|volume=69|issue=1|pages=122-9|pmid=18312046}}</ref> ==Web based resources== * '''[http://www.drugabuse.gov National Institute on Drug Abuse]''' * '''[http://www.samhsa.gov/treatment/ Substance Abuse and Mental Health Services Administration (SAMHSA)]''' * '''[http://www.addictionrecoveryguide.org/ The Addiction Recovery Guide]''' * [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/drug-and-alcohol-abuse/ EffectiveChildTherapy.Org information on Substance Abuse] * [https://sccap53.org Society of Clinical Child and Adolescent Psychology] ==References== {{collapse top|References|expand=yes}} {{reflist|2}} # {{collapse bottom}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] hhvddtklb0k6zp7ayj6beglly7oxquh 1 219835 2419103 2410559 2022-08-25T22:51:17Z Eyoungstrom 1933979 added stub table wikitext text/x-wiki {{Talk header}} == ADHD in Adults == This is a topic that definitely needs attention. Per conversations with John Rush, there is a high level decision about whether adult versus youth assessment should be split into separate pages. Even with that up for discussion, there is a need to gather resources for adult assessment. Here's a start of a few to consider: ASRS v1.1 was developed by Kessler and co. with the copyright assigned to the World Health Organization. Here's a [https://www.hcp.med.harvard.edu/ncs/asrs.php link] to the page for it at Harvard. The open questions with it include: # Is there a collateral/other report version? # Are there better norms than the 2005 estimate on that site (which was a weighted estimate using a clinical sample)? # Any information about sensitivity to treatment effects? # Has anyone ROCed it against the NCS-R or other structured diagnostic interviews? ## The anchor publication<ref>{{Cite journal|last=Kessler|first=Ronald C.|last2=Adler|first2=Lenard|last3=Ames|first3=Minnie|last4=Demler|first4=Olga|last5=Faraone|first5=Steve|last6=Hiripi|first6=Eva|last7=Howes|first7=Mary J.|last8=Jin|first8=Robert|last9=Secnik|first9=Kristina|date=2005-02|title=The World Health Organization adult ADHD self-report scale (ASRS): a short screening scale for use in the general population|url=https://www.cambridge.org/core/product/identifier/S0033291704002892/type/journal_article|journal=Psychological Medicine|language=en|volume=35|issue=2|pages=245–256|doi=10.1017/S0033291704002892|issn=0033-2917}}</ref> presents ROC results in Table 2. ## Ustun et al. 2017 create a short form of the DSM-5 version. ## There is a Spanish translation validated by Richarte et al. 2017.<ref>{{Cite journal|last=Richarte|first=Vanesa|last2=Corrales|first2=Montserrat|last3=Pozuelo|first3=Marian|last4=Serra-Pla|first4=Juanfran|last5=Ibáñez|first5=Pol|last6=Calvo|first6=Eva|last7=Corominas|first7=Margarida|last8=Bosch|first8=Rosa|last9=Casas|first9=Miquel|date=2017-10|title=Validación al español de la ADHD Rating Scale (ADHD-RS) en adultos: relevancia de los subtipos clínicos|url=https://linkinghub.elsevier.com/retrieve/pii/S1888989117300897|journal=Revista de Psiquiatría y Salud Mental|language=es|volume=10|issue=4|pages=185–191|doi=10.1016/j.rpsm.2017.06.003}}</ref> The [https://www.caddra.ca/etoolkit-forms/ CADDRA website] is a Canadian nonprofit organization that has a set of several interesting measures on it, including two by M.D. Weiss that were new to me (the second being a very detailed functioning one), as well as some prototype clinical transfer forms that could be interesting models. Open questions here: # Has Weiss published any research on these? ## If not, any data? ## Any interest in sharing? # What do expert clinicians think of the medication form, the transfer form, etc? The [https://chadd.org/for-professionals/clinical-practice-tools-quick-links/ CHADD website] lists several tools, including a DSM-5 version of the 6 item ASRS v 1.1 validated in the Ustan et al. (2017) JAMA Psychiatry paper.<ref>{{Cite journal|last=Ustun|first=Berk|last2=Adler|first2=Lenard A.|last3=Rudin|first3=Cynthia|last4=Faraone|first4=Stephen V.|last5=Spencer|first5=Thomas J.|last6=Berglund|first6=Patricia|last7=Gruber|first7=Michael J.|last8=Kessler|first8=Ronald C.|date=2017-05-01|title=The World Health Organization Adult Attention-Deficit/Hyperactivity Disorder Self-Report Screening Scale for DSM-5|url=https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2616166|journal=JAMA Psychiatry|language=en|volume=74|issue=5|pages=520|doi=10.1001/jamapsychiatry.2017.0298|issn=2168-622X|pmc=PMC5470397|pmid=28384801}}</ref> ===Severity interviews for ADHD=== {| class="wikitable sortable" border="1" |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time !Where to Access |- | colspan="5" style="font-size:110%; text-align:center;" span |'''Youth''' |- | | | |- | |- | colspan="5" style="font-size:110%; text-align:center;" span |'''Adults''' |- | | | |- | | | | | |- | | | | | |} '''Note:''' '''L''' = Less than adequate; '''A''' = Adequate; '''G''' = Good; '''E''' = Excellent; '''U''' = Unavailable; '''NA''' = Not applicable <ref>{{Cite web|url=https://en.wikiversity.org/wiki/Evidence-based_assessment/Reliability#Evaluating_norms_and_reliability|title=Evidence-based assessment/Reliability - Wikiversity|website=en.wikiversity.org|access-date=2020-11-13}}</ref> == ICD-11 == Should the Diagnosis section also include ICD-11 criteria for [[w:Hyperkinetic disorder|Hyperkinetic disorder]]? —[[User:ShelleyAdams|ShelleyAdams]] ([[User talk:ShelleyAdams|discuss]] • [[Special:Contributions/ShelleyAdams|contribs]]) 14:09, 5 February 2017 (UTC) == DBD == Pelham wrote a DBD scale that covered DSM-IV symptoms of ADHD, ODD, CD; Waschbush says that it is public domain; worth looking at systematically across the three disorders. If valid, could be worth adding to all three, and also building Wp Page, Wv Page, Qualtrics.... Worth comparing PCARES battery to TOC, chapter recommendations, portfolio list. [[User:Eyoungstrom|Eyoungstrom]] ([[User talk:Eyoungstrom|discuss]] • [[Special:Contributions/Eyoungstrom|contribs]]) 17:45, 5 October 2018 (UTC) == Summer 2022 Audit == === Preparation phase === ==== Diagnostic Criteria of ADHD in youth ==== ==== Base rates of youth ADHD in different populations and clinical settings ==== do we need a column for 'best recommended for' if none of them have a check? [[User:Hope Holloway|Hope Holloway]] ([[User talk:Hope Holloway|discuss]] • [[Special:Contributions/Hope Holloway|contribs]]) 14:32, 13 June 2022 (UTC) === Prediction phase === ==== Psychometric properties of screening instruments for youth ADHD ==== ==== Screening and diagnostic instruments for attention deficit hyperactivity disorder ==== do we have the rest of the information to fill out this table? [[User:Hope Holloway|Hope Holloway]] ([[User talk:Hope Holloway|discuss]] • [[Special:Contributions/Hope Holloway|contribs]]) 14:33, 13 June 2022 (UTC) Conners 3, Vanderbilt, BASC = top 3 ==== Likelihood ratios and AUCs of screening measures for (insert portfolio name) ==== need to change this name to include portfolio name [[User:Hope Holloway|Hope Holloway]] ([[User talk:Hope Holloway|discuss]] • [[Special:Contributions/Hope Holloway|contribs]]) 14:24, 13 June 2022 (UTC) do we need a download column on the table if it's empty? [[User:Hope Holloway|Hope Holloway]] ([[User talk:Hope Holloway|discuss]] • [[Special:Contributions/Hope Holloway|contribs]]) 14:43, 13 June 2022 (UTC) ==== Interpreting ADHD screening measure scores ==== === Prescription phase === ==== Gold standard diagnostic interviews ==== link broken to PDFs [[User:Hope Holloway|Hope Holloway]] ([[User talk:Hope Holloway|discuss]] • [[Special:Contributions/Hope Holloway|contribs]]) 14:24, 13 June 2022 (UTC) ==== Recommended diagnostic interviews for ADHD ==== ==== Severity interviews for ADHD ==== need to change depression instrument placeholders [[User:Hope Holloway|Hope Holloway]] ([[User talk:Hope Holloway|discuss]] • [[Special:Contributions/Hope Holloway|contribs]]) 14:24, 13 June 2022 (UTC) need to remove extra rows on the tables [[User:Hope Holloway|Hope Holloway]] ([[User talk:Hope Holloway|discuss]] • [[Special:Contributions/Hope Holloway|contribs]]) 14:24, 13 June 2022 (UTC) === Process phase === ==== Process measures ==== ==== Outcome and severity measures ==== see here link just leads to table below [[User:Hope Holloway|Hope Holloway]] ([[User talk:Hope Holloway|discuss]] • [[Special:Contributions/Hope Holloway|contribs]]) 14:24, 13 June 2022 (UTC) ==== Treatment ==== last link is external- should this be noted or changed? [[User:Hope Holloway|Hope Holloway]] ([[User talk:Hope Holloway|discuss]] • [[Special:Contributions/Hope Holloway|contribs]]) 01:48, 14 June 2022 (UTC) === External Links === last four links lead to FIU broken page [[User:Hope Holloway|Hope Holloway]] ([[User talk:Hope Holloway|discuss]] • [[Special:Contributions/Hope Holloway|contribs]]) 14:24, 13 June 2022 (UTC) === References === i4lowez0cu22uzddkg7vchz6jj7z5pf 2419104 2419103 2022-08-25T22:51:55Z Maddiegray11 2936309 Making note to add adult interviews wikitext text/x-wiki {{Talk header}} == ADHD in Adults == This is a topic that definitely needs attention. Per conversations with John Rush, there is a high level decision about whether adult versus youth assessment should be split into separate pages. Even with that up for discussion, there is a need to gather resources for adult assessment. Here's a start of a few to consider: ASRS v1.1 was developed by Kessler and co. with the copyright assigned to the World Health Organization. Here's a [https://www.hcp.med.harvard.edu/ncs/asrs.php link] to the page for it at Harvard. The open questions with it include: # Is there a collateral/other report version? # Are there better norms than the 2005 estimate on that site (which was a weighted estimate using a clinical sample)? # Any information about sensitivity to treatment effects? # Has anyone ROCed it against the NCS-R or other structured diagnostic interviews? ## The anchor publication<ref>{{Cite journal|last=Kessler|first=Ronald C.|last2=Adler|first2=Lenard|last3=Ames|first3=Minnie|last4=Demler|first4=Olga|last5=Faraone|first5=Steve|last6=Hiripi|first6=Eva|last7=Howes|first7=Mary J.|last8=Jin|first8=Robert|last9=Secnik|first9=Kristina|date=2005-02|title=The World Health Organization adult ADHD self-report scale (ASRS): a short screening scale for use in the general population|url=https://www.cambridge.org/core/product/identifier/S0033291704002892/type/journal_article|journal=Psychological Medicine|language=en|volume=35|issue=2|pages=245–256|doi=10.1017/S0033291704002892|issn=0033-2917}}</ref> presents ROC results in Table 2. ## Ustun et al. 2017 create a short form of the DSM-5 version. ## There is a Spanish translation validated by Richarte et al. 2017.<ref>{{Cite journal|last=Richarte|first=Vanesa|last2=Corrales|first2=Montserrat|last3=Pozuelo|first3=Marian|last4=Serra-Pla|first4=Juanfran|last5=Ibáñez|first5=Pol|last6=Calvo|first6=Eva|last7=Corominas|first7=Margarida|last8=Bosch|first8=Rosa|last9=Casas|first9=Miquel|date=2017-10|title=Validación al español de la ADHD Rating Scale (ADHD-RS) en adultos: relevancia de los subtipos clínicos|url=https://linkinghub.elsevier.com/retrieve/pii/S1888989117300897|journal=Revista de Psiquiatría y Salud Mental|language=es|volume=10|issue=4|pages=185–191|doi=10.1016/j.rpsm.2017.06.003}}</ref> The [https://www.caddra.ca/etoolkit-forms/ CADDRA website] is a Canadian nonprofit organization that has a set of several interesting measures on it, including two by M.D. Weiss that were new to me (the second being a very detailed functioning one), as well as some prototype clinical transfer forms that could be interesting models. Open questions here: # Has Weiss published any research on these? ## If not, any data? ## Any interest in sharing? # What do expert clinicians think of the medication form, the transfer form, etc? The [https://chadd.org/for-professionals/clinical-practice-tools-quick-links/ CHADD website] lists several tools, including a DSM-5 version of the 6 item ASRS v 1.1 validated in the Ustan et al. (2017) JAMA Psychiatry paper.<ref>{{Cite journal|last=Ustun|first=Berk|last2=Adler|first2=Lenard A.|last3=Rudin|first3=Cynthia|last4=Faraone|first4=Stephen V.|last5=Spencer|first5=Thomas J.|last6=Berglund|first6=Patricia|last7=Gruber|first7=Michael J.|last8=Kessler|first8=Ronald C.|date=2017-05-01|title=The World Health Organization Adult Attention-Deficit/Hyperactivity Disorder Self-Report Screening Scale for DSM-5|url=https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2616166|journal=JAMA Psychiatry|language=en|volume=74|issue=5|pages=520|doi=10.1001/jamapsychiatry.2017.0298|issn=2168-622X|pmc=PMC5470397|pmid=28384801}}</ref> ===Severity interviews for ADHD=== {| class="wikitable sortable" border="1" |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time !Where to Access |- | colspan="5" style="font-size:110%; text-align:center;" span |'''Youth''' |- | | | |- | |- | colspan="5" style="font-size:110%; text-align:center;" span |'''Adults''' |- | | | |- | | | | | |- | | | | | |} '''Note:''' '''L''' = Less than adequate; '''A''' = Adequate; '''G''' = Good; '''E''' = Excellent; '''U''' = Unavailable; '''NA''' = Not applicable <ref>{{Cite web|url=https://en.wikiversity.org/wiki/Evidence-based_assessment/Reliability#Evaluating_norms_and_reliability|title=Evidence-based assessment/Reliability - Wikiversity|website=en.wikiversity.org|access-date=2020-11-13}}</ref> == ICD-11 == Should the Diagnosis section also include ICD-11 criteria for [[w:Hyperkinetic disorder|Hyperkinetic disorder]]? —[[User:ShelleyAdams|ShelleyAdams]] ([[User talk:ShelleyAdams|discuss]] • [[Special:Contributions/ShelleyAdams|contribs]]) 14:09, 5 February 2017 (UTC) == DBD == Pelham wrote a DBD scale that covered DSM-IV symptoms of ADHD, ODD, CD; Waschbush says that it is public domain; worth looking at systematically across the three disorders. If valid, could be worth adding to all three, and also building Wp Page, Wv Page, Qualtrics.... Worth comparing PCARES battery to TOC, chapter recommendations, portfolio list. [[User:Eyoungstrom|Eyoungstrom]] ([[User talk:Eyoungstrom|discuss]] • [[Special:Contributions/Eyoungstrom|contribs]]) 17:45, 5 October 2018 (UTC) == Summer 2022 Audit == === Preparation phase === ==== Diagnostic Criteria of ADHD in youth ==== ==== Base rates of youth ADHD in different populations and clinical settings ==== do we need a column for 'best recommended for' if none of them have a check? [[User:Hope Holloway|Hope Holloway]] ([[User talk:Hope Holloway|discuss]] • [[Special:Contributions/Hope Holloway|contribs]]) 14:32, 13 June 2022 (UTC) === Prediction phase === ==== Psychometric properties of screening instruments for youth ADHD ==== ==== Screening and diagnostic instruments for attention deficit hyperactivity disorder ==== do we have the rest of the information to fill out this table? [[User:Hope Holloway|Hope Holloway]] ([[User talk:Hope Holloway|discuss]] • [[Special:Contributions/Hope Holloway|contribs]]) 14:33, 13 June 2022 (UTC) Conners 3, Vanderbilt, BASC = top 3 ==== Likelihood ratios and AUCs of screening measures for (insert portfolio name) ==== need to change this name to include portfolio name [[User:Hope Holloway|Hope Holloway]] ([[User talk:Hope Holloway|discuss]] • [[Special:Contributions/Hope Holloway|contribs]]) 14:24, 13 June 2022 (UTC) do we need a download column on the table if it's empty? [[User:Hope Holloway|Hope Holloway]] ([[User talk:Hope Holloway|discuss]] • [[Special:Contributions/Hope Holloway|contribs]]) 14:43, 13 June 2022 (UTC) ==== Interpreting ADHD screening measure scores ==== === Prescription phase === ==== Gold standard diagnostic interviews ==== link broken to PDFs [[User:Hope Holloway|Hope Holloway]] ([[User talk:Hope Holloway|discuss]] • [[Special:Contributions/Hope Holloway|contribs]]) 14:24, 13 June 2022 (UTC) ==== Recommended diagnostic interviews for ADHD ==== Taking out adult section and will look in A Guide to Assessments That Work by Hunsley & Mash ==== Severity interviews for ADHD ==== need to change depression instrument placeholders [[User:Hope Holloway|Hope Holloway]] ([[User talk:Hope Holloway|discuss]] • [[Special:Contributions/Hope Holloway|contribs]]) 14:24, 13 June 2022 (UTC) need to remove extra rows on the tables [[User:Hope Holloway|Hope Holloway]] ([[User talk:Hope Holloway|discuss]] • [[Special:Contributions/Hope Holloway|contribs]]) 14:24, 13 June 2022 (UTC) === Process phase === ==== Process measures ==== ==== Outcome and severity measures ==== see here link just leads to table below [[User:Hope Holloway|Hope Holloway]] ([[User talk:Hope Holloway|discuss]] • [[Special:Contributions/Hope Holloway|contribs]]) 14:24, 13 June 2022 (UTC) ==== Treatment ==== last link is external- should this be noted or changed? [[User:Hope Holloway|Hope Holloway]] ([[User talk:Hope Holloway|discuss]] • [[Special:Contributions/Hope Holloway|contribs]]) 01:48, 14 June 2022 (UTC) === External Links === last four links lead to FIU broken page [[User:Hope Holloway|Hope Holloway]] ([[User talk:Hope Holloway|discuss]] • [[Special:Contributions/Hope Holloway|contribs]]) 14:24, 13 June 2022 (UTC) === References === 9h73gzrmppfkbsg7u00195ps8qy2fnv 0 223757 2419078 2410811 2022-08-25T17:54:00Z 62.143.77.131 Add objection wikitext text/x-wiki {{Wikidebate}} {{Philosophy}} Most people assume that there's an objective reality in which all of us exist, with facts that are universally true and more than just a matter of opinion. However, others argue that there is no such thing as objective reality, that everything is subjective and that anything can be questioned or legitimately disagreed with, even facts that used to have near-universal agreement. So who is right about the nature of reality? Is there an objective reality that we are all a part of? Does objective reality truly exist? == Definitions == * '''Subjective reality''' means that something is actual depending on the mind. For example: someone walks by a flower and experiences the beauty of the flower. Would you say that the experience of beauty is dependent or independent of the mind? Would the experience of the form in general of the flower be dependent on the mind? * '''Objective reality''' means that something is actual (so it exists) independent of the mind. For example: while no one is nearby, a meteor crashes into a car, putting it on flames, leaving only a pile of ashes. Are any of these events depending on some mind? It is actually hard to state a purely objective reality example, as one needs to describe it in concepts that are interpreted by the mind. You see the difficulty? Anything related to experience, like form, weight, heat, color, beauty, etc, etc is dependent on a mind. So we could say, that objective reality is formless. Only when observed by a mind, there is form. This has lots of similarities with a computer rendered game. The scenario is there, but unless it is rendered on the screen, it is formless. So objective reality is here, but unless it is 'rendered' on consciousness, it is formless. == Objective reality exists == === Arguments for === * {{Argument for}} Humans have physically similar brains and nervous systems. These similarities result in similar interpretations of similar stimuli. The fact that two people, located side by side, and looking in the same direction, describe similarly what they see, reasonably indicates that they are reacting to a single external reality. In the case of hallucinations, radical differences in two people's descriptions of a single aspect of a presumed single external reality, can occur. Some such differences can repeatably be demonstrated to coincide with chemical or structural differences in one nervous system as compared to the other. When such demonstrably dissimilar chemistry or structure are returned to similar states, the re-emergence of the similar descriptions are likely to return as well. Again, this fact is reasonably attributable to there being a single external reality, and multiple various internal realities whose differences are a result of various nervous systems functioning with various abilities, structures, chemistries, locations, experience and knowledge. ** {{Objection}} Does agreement of description necessarily imply objectivity? Imagine if half of humankind saw the color "green" as the color "red". Regardless of how true this scenario is, note that there would be a clear subjectivity of how we view the environment. Half the population would see a different color than the other half. We would no longer agree, and couldn't agree. **{{Objection}} Is it necessarily true that we share a physical brain structure? Certainly, according to science, this is very true, but that says nothing about the existence of an objective reality, because where science comes from is perceived, whether directly by us or through the measurements and assumptions we make, which is an inherently subjective process. This argument takes subjective ideas to be objective, and draws assumptions from them. * {{Argument for}} There is no evidence that objective reality doesn't exist, so [[Wikipedia:Occam's razor|Occam's razor]] suggests we ought to accept it as the simplest possible explanation for reality. ** {{Objection}} If a particle or set of particles in quantum physics can be in 2 different contradictory states at the same time, as in the [[Wikipedia:Schrödinger's cat|Schrödinger's cat]] paradox, that could be considered evidence to the contrary. *** {{Objection}} Quantum physics might seem contradictory, and in fact it is with traditional logic, but if one uses [[Wikipedia:Quantum logic|quantum logic]], which theoretical physicists have developed and which is the same as traditional logic other than abandoning the law of commutativity, there are not any contradictions in it at all. ** {{Objection}} Occam's Razor is not necessarily true, it is just a general guideline to help people guess the most likely answer to a question. It's still wrong sometimes. In the case of objective reality, at best it proves that it's "more likely" to exist than not, whatever that means. **{{Objection}} The concept of "simple" is subjective due to the subjectivity of the construction of definitions, so it cannot be used to prove the existence of objectivity, which requires the definitions to be true regardless of perspective (or lack of perspective). * {{Argument for}} The theory that we all exist in an objective reality is the best theory anyone has ever come up with to describe the conditions in which we appear to exist, so unless anyone comes up with a better theory we should stick with it. ** {{Objection}} We don't necessarily need to assume anything at all regarding reality and whether or not an objective reality exists. We can remain agnostic on the subject until there is sufficient evidence to prove things one way or the other. *** {{Objection}} Being agnostic on the subject is not a position against the existence of objective reality, but instead a neutral position that doesn't take either side in the argument. I have not entirely made up my mind 100% sure either way on objective reality myself, but I am about 99% sure that objective reality exists. I could call myself agnostic on the subject too, but those of us who are agnostic on the subject ought to lean in favor of whatever seems to be the most probable explanation. ** {{Objection}} This just assumes that it exists for the sake of ease (similar to the Occam's Razor proof above). As with that one, I point out that "best" is subjective in nature, and what you consider "best" may be different from what I consider "best". I too, think that there exists an objective reality, but to assume it just exists is just circumventing the purpose of debating this. That is not to say that you cannot have your own opinion on this matter, only that your opinion is not sufficient for a proof. * {{Argument for}} All realities exist, including both objective and subjective realities, which exist as parallel realities or as a kind of multiverse. In other words, the philosophy of {{W|modal realism}} is correct. ** {{Objection}} Modal realism is too radical of a multiverse theory to take seriously. It proposes that all proposed fictional worlds (not just proposed real worlds) actually exist. *** {{Objection}} This is an attempt to shame people into not believing the argument. Sometimes radical viewpoints turn out to be true. ** {{Objection}} This doesn't prove objective reality, because it doesn't prove that all realities exist. If all realities existed, then objective reality would exist too, but it isn't necessarily true that all realities exist. * {{Argument for}} If objective truth doesn't exist, that fact would be in and of itself an objective truth, disproving itself. ** {{Objection}} This only proves the existence of an objective truth, not of an objective reality. No argument is given to prove that an objective truth implies an objective reality. * {{Argument for}} Some facts have no non-objective interpretation, and are universally accepted as objectively true. Example: ''The Statue of Liberty exists in Upper New York Bay.'' There is no alternative, subjective interpretation possible. ** {{Objection}} The statue and location are known by other names in other languages. There are no universally agreed names for anything. *** {{Objection}} Changing the name of the statue or location does not change the fact that everyone can perceive that the statue does indeed exist in objective reality. ****{{Objection}} Blind people can not see the statue in the same way. Nor can people who have lost their sense of touch feel the statue in the same way. Our perception depends on our available biological configuration as it were. *{{Argument for}} Since our realities all interact and we are able to independently observe the same things and do experiments that have reproducible results, clearly we are all part of the same reality. ** {{Objection}} Not necessarily, you could be a figment of my imagination, or we could both be figments of somebody else's imagination. ***{{Objection}} The human mind is not creative enough to imagine the reality we find ourselves in. **{{Objection}} Maybe nobody exists at all and everything is imaginary. *** {{Objection}} If we are all imagined by a specific entity, then that entity is part of objective reality. *** {{Objection}} As Descartes said, "I think, therefore I am." **** {{Objection}} "I think, therefore I am" is a logical fallacy because fictional characters in a story can say that, but it doesn't turn them into real people. ***** {{Objection}} Simply because a fictional representation of an actual phenomena is presented to the reader does not invalidate it as an actual phenomena outside the fiction. ****{{Objection}} The idea that "I think therefore I am" is based off of a certain assumption: that the "I" in question really does think. I'm sure that just about anyone will say that they have subjective (though objective can be argued) proof to themselves that they indeed do think, simply by being able to wonder if they do. But in this case, sentience is being questioned, and thus the ability to fulfil the criteria of thinking in the first place is as well. === Arguments against === * {{Argument against}} Starting from an objective perspective, the objective world exists and the subjective one does not. "Feelings", for instance, exist only as neuron firing patterns and not as they are felt subjectively, because that would not fit into the objective world view. Similarly, starting from a subjective perspective, the objective reality does not exist. Objects exist only as their perceptions and affects on subjective reality, not as a thing-in-itself. Because I surely perceive from a subjective perspective, I assert the denial of an objective reality. So both realities are mutually exclusive. Any starting perception would deny the other reality's existence. * {{Argument against}} The existence of an objective reality has never been proven, and all of what we think of reality could just be something similar to the Matrix or a computer simulation or we could all just be characters in someone's dream. ** {{Objection}} Those are all unlikely scenarios which are similarly unproven. **{{Objection}} Even if the Matrix scenario were real, the Matrix itself exists within a larger reality that actually is objective, and in that reality, the people who exist in the Matrix all have physical bodies hooked up to the Matrix, so even if the Matrix turned out to be real, we would still be living in an objective reality. Similarly with the other scenarios. * {{Argument against}} There are multiple possible scenarios in which objective reality is wrong, and only one in which it is correct. If we assign an equal level of probability to each one, objective reality is actually highly unlikely. ** {{Objection}} There is no rational basis for assigning an equal level of probability to the idea that we are all living in the Matrix just like in that movie and the idea that we all actually exist in one single objective reality. *** {{Objection}} Simply because a scenario makes "the most sense" does not mean that it is correct (see refutations to "Occam's Razor" above). Similarly, just because a scenario is unlikely/unproven, does not mean that it is false (just look to the numerous unproven conjectures in mathematics as an example - both the ones that are currently unproven but seem to be true, and the ones that used to seem true but are now proven to be false). **{{Objection}} As a matter of fact, probability shouldn't really be assigned here; this is to prove whether or not an objective reality exists, not if we can ever find such an objective reality. The two arguments are different (though one directly proves the other). * {{Argument against}} Reality nowadays is just too ridiculous to be true. Too many practically unbelievable things keep being reported as factual. ** {{Objection}} This reflects a failure of imagination on the part of the human mind to understand and accept objective reality. It does not disprove objective reality. As the saying goes, "Truth is stranger than fiction." This would seem to indicate that, if reality seems incredibly ridiculous and weird, it probably really is real, since it is many times weirder than anything the limited capacity of the human imagination could possibly think up using only the creativity of a single finite mortal human mind. *** {{Objection}} Multiple people can work together to create a very intricate and detailed narrative that runs counter to reality. Who is to say that the most popular narrative used to describe what people call "objective reality" is not similarly false, with its elaborate complexity and absurdity the result of the cooperation of many people? **** {{Objection}} There is a major qualitative difference between double-blind peer-reviewed scientific studies with reproducible results and conspiracy theories or tall tales that are simply made up. Your argument deliberately ignores this in order to equate the two and dismiss both of them. * {{Argument against}} We all live in our own subjective realities. The human mind is not capable of being truly objective. Therefore, the entire idea of a single objective reality is purely speculative, an assumption that, while popular, is not necessary. ** {{Objection}} Why must there exist only one objective reality? This has not been proven (though it is not particularly relevant to the point of the argument). **{{Objection}} This isn't about the necessity of believing whether or not an objective reality exists, this is about whether or not an objective reality exists. * {{Argument against}} {{W|Postmodernism}} is one of many philosophies that does not believe in any objective reality and successfully undermines the idea of objective reality. ** {{Objection}} Postmodernism is rather absurd, either sheer nihilism or some form of relativism, disbelieving in things that are obvious facts. *** {{Objection}} "Obvious" is subjective - though saying that doesn't take much away from the argument. I will preface my objection by stating that I have not personally researched postmodernism in depth, so I do not know what facts are exactly disbelieved by postmodernism. That said, postmodernism is built upon skepticism of facts in general, which is understandable, considering that our facts come from what we observe, and our perspectives are subjective. Thus, disbelief of facts in general is not particularly absurd. As an example, flat-earth was assumed to be fact for an incredibly long time (and by some people, it still is assumed to be true), but was eventually disproved. There's no reason that any of our present facts won't have the same thing happen to them either. ** {{Objection}} Postmodernism has not been proven. *** {{Objection}} Postmodernism doesn't have to be 'proven'. **** {{Objection}} In the context of this debate, postmodernism, as a matter of fact, does need to be proven. The argument is assuming that postmodernism is true, but does not prove that the ideas and beliefs expressed by postmodernism are factual. As of right now, there is no particular reason for me to believe that postmodernism is "true" - that is, the concepts that form postmodernism are objectively true. * {{Argument against}} Again one must consider using which parameters is objective reality to be understood. How is it perceived or measured. To be truly objective, objective reality must be perceived and measured without any limits or filters. Because any such limitations arise from a subjective viewpoint. For example, humans perceive 0.0035% of the entire electromagnetic spectrum. But the entire electromagnetic spectrum must be included in an understanding of objective reality. Any scientific instrument is likewise circumscribed in its ability to measure everything. Therefore what is objective must be unlimited - everything that is possible. And that means the whole universe without limits. All of it including dark matter, dark energy etc. And such an understanding is only theoretically possible for the whole universe itself to have. We humans are permanently in subjective reality, as are all conscious life forms. ** {{Objection}} Objective reality must exist independent of subjective reality. Just because we do not or cannot perceive it, does not mean it does not exist. * {{Argument against}} As it is impossible to see the world, that is the eyes are like cameras only receiving light, they supposedly get two images, somehow these images get merged as one and then projected as "the world around us". The same can be said of all the senses. And, this sense of world includes the body which is external to that which sees it. ** {{Objection}} What does this say about the existence of an objective reality? Is an objective reality necessarily perceived? It certainly isn't by the definition above, and it certainly isn't by my definition. * {{Argument against}} The fact that objective reality is a debatable concept makes objective reality subjective. ** {{Objection}} Debating its existence does not make its existence subjective, it just means that we do not have enough evidence (and may never have the evidence) to prove that it exists. For instance, debating if the twin prime conjecture is true does not disprove it, only shows that we do not have enough information to currently prove it. ** {{Objection}} Debatability does not imply subjectivity. A debate could be caused by a mistaken interlocutor, with the debated subject nevertheless being objective. * {{Argument against}} Recent physics experiments suggest objective reality isn't real but directly relative to individual perceptions, and is basically a subjectively manifested, consciously perceived, and somewhat mutually agreed upon collective manifestation.<ref>{{Cite web |url=https://www.technologyreview.com/2019/03/12/136684/a-quantum-experiment-suggests-theres-no-such-thing-as-objective-reality/ |title=A quantum experiment suggests there's no such thing as objective reality |website=MIT Technology Review |language=en |access-date=2021-10-03}}</ref><ref>{{Cite web |url=https://interestingengineering.com/new-physics-experiment-indicates-no-objective-reality |title=New Physics Experiment Indicates There's No Objective Reality |date=2021-08-30 |website=interestingengineering.com |language=en-US |access-date=2021-10-03}}</ref> ** {{Objection}} The experiment that the article refers to has tested the Wigner's friend thought experiment where the friend's "measurement" seems to not be a proper observation (which would collapse the wavefunction) and instead is a unitary action on the state being measured, and the results of the experiment (unsurprisingly) reflect that. The result simply means that it doesn't matter which observer collapses the wavefunction as long as they are all entangled, but that was never debated in the first place. In day-to-day scenarios we deal with situations where (we assume) the quantum system has already collapsed, which is why we don't see most quantum effects in daily life and why things like the Schrodinger's cat never happen. This "subjectivity" in the experiment only holds for unobserved quantum systems. == See also == * [[Does God exist?]] * [[Do humans have free will?]] == Notes and references == {{Reflist}} [[Category:Philosophy]] iz0zwf0tic2gqr87pfz77wppjxhv8mr 0 232983 2419087 2410048 2022-08-25T21:53:50Z Maddiegray11 2936309 /* Psychometric properties of screening instruments for adult bipolar disorder */ Added additional citations wikitext text/x-wiki <noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{medical disclaimer}} {{psychology}} {{Template:evidence-based assessment}} {{:{{BASEPAGENAME}}/Sidebar}} ==[[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio"?''']]== * For background information on what assessment portfolios are, click the link in the heading above. * Want even 'more' information about this topic? There's an extended version of this page [[Evidence-based assessment/Bipolar disorder in adults (assessment portfolio)/extended version|here]]. == [[Evidence based assessment/Preparation phase|'''Preparation phase''']] == === Diagnostic criteria for bipolar disorder in adults === Bipolar Disorder (BP) is characterized by extreme fluctuations in mood (or emotional dysregulation that ranges from mania (as shown by displays or feelings of extreme happiness, unrealistic overachievement and anger), to depression (as shown by displays or feelings of sadness, changes in appetite or weight and irritability.<ref name=":1" /> It has a lifetime risk of about 1%, with heritability estimated at up to 80%.<ref>{{Cite journal|last=Purcell|first=Shaun M.|last2=Wray|first2=Naomi R.|last3=Stone|first3=Jennifer L.|last4=Visscher|first4=Peter M.|last5=O'Donovan|first5=Michael C.|last6=Sullivan|first6=Patrick F.|last7=Sklar|first7=Pamela|last8=(Leader)|first8=Shaun M. Purcell|last9=Stone|first9=Jennifer L.|date=2009/08|title=Common polygenic variation contributes to risk of schizophrenia and bipolar disorder|url=http://www.nature.com/doifinder/10.1038/nature08185|journal=Nature|language=En|volume=460|issue=7256|doi=10.1038/nature08185|issn=1476-4687}}</ref> It is important to note that these moods exceed normal responses to life events, represent a change from the individual's normal functioning, and cause problems in daily activities. {{blockquotetop}} <big>'''ICD-11 Diagnostic Criteria'''</big> *Bipolar Type I Disorder **Bipolar type I disorder is an episodic mood disorder defined by the occurrence of one or more manic or mixed episodes. A manic episode is an extreme mood state lasting at least one week unless shortened by a treatment intervention characterized by euphoria, irritability, or expansiveness, and by increased activity or a subjective experience of increased energy, accompanied by other characteristic symptoms such as rapid or pressured speech, flight of ideas, increased self-esteem or grandiosity, decreased need for sleep, distractibility, impulsive or reckless behavior, and rapid changes among different mood states (i.e., mood lability). A mixed episode is characterized by either a mixture or very rapid alternation between prominent manic and depressive symptoms on most days during a period of at least 2 weeks. Although the diagnosis can be made based on evidence of a single manic or mixed episode, typically manic or mixed episodes alternate with depressive episodes over the course of the disorder. ***Note: The ICD-11 lists 18 additional subcategories of Bipolar type I disorder. They can be found [https://icd.who.int/browse11/l-m/en#/http://id.who.int/icd/entity/1456478153 here]. *Bipolar Type II Disorder **Bipolar type II disorder is an episodic mood disorder defined by the occurrence of one or more hypomanic episodes and at least one depressive episode. A hypomanic episode is a persistent mood state characterized by euphoria, irritability, or expansiveness, and excessive psychomotor activation or increased energy, accompanied by other characteristic symptoms such as grandiosity, decreased need for sleep, pressured speech, flight of ideas, distractibility, and impulsive or reckless behavior lasting for at least several days. The symptoms represent a change from the individual’s typical behavior and are not severe enough to cause marked impairment in functioning. A depressive episode is characterized by a period of almost daily depressed mood or diminished interest in activities lasting at least 2 weeks accompanied by other symptoms such as changes in appetite or sleep, psychomotor agitation or retardation, fatigue, feelings of worthless or excessive or inappropriate guilt, feelings or hopelessness, difficulty concentrating, and suicidality. There is no history of manic or mixed Episodes. ***Note: The ICD-11 lists 13 additional subcategories of Bipolar type II disorder. They can be found [https://icd.who.int/browse11/l-m/en#/http%3a%2f%2fid.who.int%2ficd%2fentity%2f199053300 here]. '''Changes in DSM-5''' * The diagnostic criteria for '''Bipolar Disorder''' changed slightly from [[DSM-IV]] to [[w:Diagnostic_and_Statistical_Manual_of_Mental_Disorders#DSM-IV-TR_.282000.29|DSM-5]]. Summaries are available [http://www.dsm5.org/Documents/changes%20from%20dsm-iv-tr%20to%20dsm-5.pdf here] and [[w:DSM-5|here]]. {{blockquotebottom}} === Base rates of BD in different clinical settings and populations === This section describes the demographic setting of the population(s) sampled, base rates of diagnosis, country/region sampled, and the diagnostic method that was used. Using this information, clinicians will be able to anchor the rate of adolescent depression that they are likely to see in their clinical practice. * '''''To see prevalence rates across multiple disorders,''''' [[Evidence based assessment/Preparation phase#Base rates for transdiagnostic comparison|'''''click here.''''']] {| class="wikitable" |'''Demography''' |'''Setting''' |'''Base Rate''' |'''Diagnostic Method''' |- |United States, Canada, Puerto Rico, Germany, Taiwan, Korea, New Zealand <ref>{{Cite journal|last=Weissman|first=Myrna M.|last2=Bland|first2=Roger C.|last3=Canino|first3=Glorisa J.|last4=Faravelli|first4=Carlo|last5=Greenwald|first5=Steven|last6=Hwu|first6=Hai-Gwo|last7=Joyce|first7=Peter R.|last8=Karam|first8=Eile G.|last9=Lee|first9=Chung-Kyoon|date=1996-07-24|title=Cross-National Epidemiology of Major Depression and Bipolar Disorder|url=https://doi.org/10.1001/jama.1996.03540040037030|journal=JAMA|volume=276|issue=4|pages=293–299|doi=10.1001/jama.1996.03540040037030|issn=0098-7484}}</ref> |Community Epidemiological Samples |0.3 - 1.5% |Structured and semi-structured diagnostic interviews |- |United States<ref>{{Cite journal|last=Merikangas|first=Kathleen R.|last2=Akiskal|first2=Hagop S.|last3=Angst|first3=Jules|last4=Greenberg|first4=Paul E.|last5=Hirschfeld|first5=Robert M. A.|last6=Petukhova|first6=Maria|last7=Kessler|first7=Ronald C.|date=2007-05-01|title=Lifetime and 12-Month Prevalence of Bipolar Spectrum Disorder in the National Comorbidity Survey Replication|url=https://jamanetwork.com/journals/jamapsychiatry/fullarticle/482285|journal=Archives of General Psychiatry|language=en|volume=64|issue=5|pages=543–552|doi=10.1001/archpsyc.64.5.543|issn=0003-990X}}</ref> |Community Epidemiological Samples |BPI - 1%; BPII - 1.1%; Subthreshold BP - 2.4% |World Health Organisation Composite International Diagnostic Interview |- |United States<ref>{{Cite journal|last=LEWINSOHN|first=PETER M.|last2=KLEIN|first2=DANIEL N.|last3=SEELEY|first3=JOHN R.|title=Bipolar Disorders in a Community Sample of Older Adolescents: Prevalence, Phenomenology, Comorbidity, and Course|url=http://linkinghub.elsevier.com/retrieve/pii/S089085670963731X|journal=Journal of the American Academy of Child & Adolescent Psychiatry|volume=34|issue=4|pages=454–463|doi=10.1097/00004583-199504000-00012}}</ref> |Community samples (older adolescents) |1% |K-SADS Semi-Structured Interview |- |United States<ref>{{Cite journal|last=Judd|first=Lewis L.|last2=Akiskal|first2=Hagop S.|title=The prevalence and disability of bipolar spectrum disorders in the US population: re-analysis of the ECA database taking into account subthreshold cases|url=https://doi.org/10.1016/S0165-0327(02)00332-4|journal=Journal of Affective Disorders|volume=73|issue=1-2|pages=123–131|doi=10.1016/s0165-0327(02)00332-4}}</ref> |US National Epidemiological Catchment Area (ECA) database |0.8 - 5.1% (manic and subthreshold mania) |Diagnostic Interview Schedule (DIS) |- |United States<ref>{{Cite journal|last=Kessler|first=R. C.|last2=Rubinow|first2=D. R.|last3=Holmes|first3=C.|last4=Abelson|first4=J. M.|last5=Zhao|first5=S.|date=1997/09|title=The epidemiology of DSM-III-R bipolar I disorder in a general population survey|url=https://www.cambridge.org/core/journals/psychological-medicine/article/epidemiology-of-dsmiiir-bipolar-i-disorder-in-a-general-population-survey/950D518D15F64E2059F1033558615A9A|journal=Psychological Medicine|language=en|volume=27|issue=5|pages=1079–1089|issn=1469-8978}}</ref> |US National Comorbidity Survey (NCS) |0-4% (small community sample; reappraisal study) |World Health Organisation Composite International Diagnostic Interview |- |United States and other countries<ref>{{Cite book|url=https://www.worldcat.org/oclc/830807378|title=Diagnostic and statistical manual of mental disorders : DSM-5.|date=2013|publisher=American Psychiatric Association., American Psychiatric Association. DSM-5 Task Force.|isbn=9780890425541|edition=5th|location=Arlington, VA|oclc=830807378}}</ref> |Community sample |BPI - 0.6%; BPII-  1.8%;  Cyclothymia - 0.4-1% |Unspecified |- |United States, Europe, Asia<ref>{{Cite journal|last=Merikangas|first=Kathleen R.|last2=Jin|first2=Robert|last3=He|first3=Jian-Ping|last4=Kessler|first4=Ronald C.|last5=Lee|first5=Sing|last6=Sampson|first6=Nancy A.|last7=Viana|first7=Maria Carmen|last8=Andrade|first8=Laura Helena|last9=Hu|first9=Chiyi|date=2011-03-07|title=Prevalence and Correlates of Bipolar Spectrum Disorder in the World Mental Health Survey Initiative|url=http://archpsyc.jamanetwork.com/article.aspx?doi=10.1001/archgenpsychiatry.2011.12|journal=Archives of General Psychiatry|language=en|volume=68|issue=3|doi=10.1001/archgenpsychiatry.2011.12|issn=0003-990X}}</ref> |Community Samples |BPI - 0.6%; BPII - 0.4%; Subthreshold BP - 1.4%; Bipolar Spectrum Disorder - 2.4% |World Health Organisation Composite International Diagnostic Interview |- |United States<ref>{{Cite journal|last=Grant|first=Bridget F.|last2=Stinson|first2=Frederick S.|last3=Hasin|first3=Deborah S.|last4=Dawson|first4=Deborah A.|last5=Chou|first5=S. Patricia|last6=Ruan|first6=W. June|last7=Huang|first7=Boji|date=October 2005|title=Prevalence, correlates, and comorbidity of bipolar I disorder and axis I and II disorders: results from the National Epidemiologic Survey on Alcohol and Related Conditions|url=https://www.ncbi.nlm.nih.gov/pubmed/16259532|journal=The Journal of Clinical Psychiatry|volume=66|issue=10|pages=1205–1215|issn=0160-6689|pmid=16259532}}</ref> |National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) |BPI - 3.3% |The Alcohol Use Disorder and Associated Disabilities Interview Schedule-IV (AUDADIS-IV) |- |United States<ref>{{Cite journal|last=Das|first=Amar K.|date=2005-02-23|title=Screening for Bipolar Disorder in a Primary Care Practice|url=http://jama.jamanetwork.com/article.aspx?doi=10.1001/jama.293.8.956|journal=JAMA|language=en|volume=293|issue=8|doi=10.1001/jama.293.8.956|issn=0098-7484}}</ref> |Outpatient Clinic Sample |9.8% |Review of medical records, questionnaire data |- |United States<ref>{{cite journal|last1=Hirschfeld|first1=RM|last2=Cass|first2=AR|last3=Holt|first3=DC|last4=Carlson|first4=CA|date=2005|title=Screening for bipolar disorder in patients treated for depression in a family medicine clinic.|journal=The Journal of the American Board of Family Practice|volume=18|issue=4|pages=233-9|pmid=15994469}}</ref> |Outpatient Clinic Sample |21.3% |MDQ, SCID |} ==[[Evidence based assessment/Prediction phase|'''Prediction phase''']]== === Psychometric properties of screening instruments for adult bipolar disorder === The following section contains a list of screening and diagnostic instruments for adult bipolar disorder. The section includes administration information, psychometric data, and PDFs or links to the screenings. * Screenings are used as part of the [[Evidence based assessment/Prediction phase|prediction phase]] of assessment; for more information on interpretation of this data, or how screenings fit in to the assessment process, click [[Evidence based assessment/Prediction phase|here.]] * '''''For a list of more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Psychometric_properties_of_common_screening_instruments click here.]''''' {| class="wikitable" |- ! Measure !Format (Reporter) !Age Range !Administration/ Completion Time !Where to Access |- |[[wikipedia:Hypomania_Checklist|HCL-32 (Hypomania Checklist)]]<ref name="Carvalho" /><ref>{{Cite journal|last=Feng|first=Yuan|last2=Wang|first2=Yuan-Yuan|last3=Huang|first3=Wei|last4=Ungvari|first4=Gabor S.|last5=Ng|first5=Chee H.|last6=Wang|first6=Gang|last7=Yuan|first7=Zhen|last8=Xiang|first8=Yu-Tao|date=2017-06-01|title=Comparison of the 32-item Hypomania Checklist, the 33-item Hypomania Checklist, and the Mood Disorders Questionnaire for bipolar disorder|url=http://onlinelibrary.wiley.com/doi/10.1111/pcn.12506/abstract|journal=Psychiatry and Clinical Neurosciences|language=en|volume=71|issue=6|pages=403–408|doi=10.1111/pcn.12506|issn=1440-1819}}</ref> |Self-report |Adult |10-15 minutes | * [https://mfr.osf.io/render?url=https://osf.io/2veyc/?action=download%26mode=render Self-report] |- |[[wikipedia:Bipolar_Spectrum_Diagnostic_Scale|BSDS (Bipolar Spectrum Diagnostic Scale)]]<ref>{{Cite journal|date=2018-06|editor-last=Hunsley|editor-first=John|editor2-last=Mash|editor2-first=Eric J.|title=A Guide to Assessments That Work|url=http://dx.doi.org/10.1093/med-psych/9780190492243.001.0001|journal=Oxford Clinical Psychology|doi=10.1093/med-psych/9780190492243.001.0001}}</ref><ref name="Carvalho" /> |Self-report |Adult |15 minutes | * [http://psycheducation.org/diagnosis/the-bipolar-spectrum-diagnostic-scale/ Online version] * [https://mfr.osf.io/render?url=https://osf.io/w9qet/?action=download%26mode=render Downloadable PDF Version (English)] |- |[[wikipedia:General_Behavior_Inventory|GBI (General Behavior Inventory)]]<ref>{{Cite journal|date=2018-06|editor-last=Hunsley|editor-first=John|editor2-last=Mash|editor2-first=Eric J.|title=A Guide to Assessments That Work|url=http://dx.doi.org/10.1093/med-psych/9780190492243.001.0001|journal=Oxford Clinical Psychology|doi=10.1093/med-psych/9780190492243.001.0001}}</ref> |Self-report |Adult |15-20 minutes | * [https://mfr.osf.io/render?url=https://osf.io/j6rce/?action=download%26mode=render Downloadable PDF Self-Report English] * [https://mfr.osf.io/render?url=https://osf.io/27nwg/?action=download%26mode=render Scoring instructions and information] |- |[[wikipedia:Mood_Disorder_Questionnaire|MDQ (Mood Disorder Questionnaire)]]<ref name="Carvalho" /> |Self-report |Adult |5 minutes | * [https://mfr.osf.io/render?url=https://osf.io/sb5xw/?action=download%26mode=render Adult Self-Report (Long, English)] * [https://mfr.osf.io/render?url=https://osf.io/xa7v6/?action=download%26mode=render Adult Self-Report (Short, English)] * |} '''Note:''' '''L''' = Less than adequate; '''A''' = Adequate; '''G''' = Good; '''E''' = Excellent; '''U''' = Unavailable; '''NA''' = Not applicable === Likelihood ratios and AUCs of screening measures for bipolar disorder in adults === * '''''For a list of the likelihood ratios for more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Likelihood_ratios_and_AUCs_of_common_screening_instruments click here.]''''' {| class="wikitable sortable" !'''Screening Measure (Primary Reference)''' !'''Area Under Curve (AUC) and sample size''' !'''DiLR+ (score)''' !DiLR- (score) !'''Population''' |- |[[wikipedia:Bipolar_Spectrum_Diagnostic_Scale|BSDS (Bipolar Spectrum Diagnostic Scale)]] <ref name="Carvalho" /> |0.81 |(13) <ref name = Carvalho>{{cite journal|last1=Carvalho|first1=André F.|last2=Takwoingi|first2=Yemisi|last3=Sales|first3=Paulo Marcelo G.|last4=Soczynska|first4=Joanna K.|last5=Köhler|first5=Cristiano A.|last6=Freitas|first6=Thiago H.|last7=Quevedo|first7=João|last8=Hyphantis|first8=Thomas N.|last9=McIntyre|first9=Roger S.|last10=Vieta|first10=Eduard|title=Screening for bipolar spectrum disorders: A comprehensive meta-analysis of accuracy studies|journal=Journal of Affective Disorders|date=February 2015|volume=172|pages=337–346|doi=https://doi.org/10.1016/j.jad.2014.10.024}}</ref> |0.36 (4.93) |Clinical |- |[[wikipedia:Hypomania_Checklist|HCL-32 (Hypomania Checklist)]]<ref name="Carvalho" /> |0.80 |(14)<ref name="Carvalho" /> |0.28 (2.45) |Clinical |- |[[wikipedia:Mood_Disorder_Questionnaire|MDQ (Mood Disorder Questionnaire)]]<ref name="Carvalho" /> |0.78 |(7)<ref name="Carvalho" /> |0.22 (5.4) |Clinical |- |General Behavior Inventory (GBI) | | | | |} '''Note:''' Area Under Curve (AUC, or AUROC) is equal to the probability that a classifier will rank a randomly chosen positive diagnosis of Bipolar Disorder higher than a randomly chosen negative diagnosis of Bipolar Disorder[15]. ==[[Evidence based assessment/Prescription phase|'''Prescription phase''']]== ===Gold standard diagnostic interviews=== * For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews click here.] ===Recommended diagnostic interviews for adult bipolar disorder=== {| class="wikitable sortable" border="1" ! colspan="5" |Diagnostic instruments for BPSD |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time !Where to Access |- | Structured Clinical Interview for DSM-5 (SCID)<ref>{{Cite journal|last=Miller|first=Christopher J.|last2=Johnson|first2=Sheri L.|last3=Eisner|first3=Lori|date=2009-06|title=Assessment tools for adult bipolar disorder.|url=http://doi.apa.org/getdoi.cfm?doi=10.1111/j.1468-2850.2009.01158.x|journal=Clinical Psychology: Science and Practice|language=en|volume=16|issue=2|pages=188–201|doi=10.1111/j.1468-2850.2009.01158.x|issn=1468-2850|pmc=PMC2847794|pmid=20360999}}</ref><ref>{{Cite journal|date=2018-06|editor-last=Hunsley|editor-first=John|editor2-last=Mash|editor2-first=Eric J.|title=A Guide to Assessments That Work|url=http://dx.doi.org/10.1093/med-psych/9780190492243.001.0001|journal=Oxford Clinical Psychology|doi=10.1093/med-psych/9780190492243.001.0001}}</ref> | Semistructured interview | 18+ | 1-2 hours |Available for purchase from [https://www.appi.org/products/structured-clinical-interview-for-dsm-5-scid-5 APA Publishing] |- | Schedule for Affective Disorders and Schizophrenia (SADS)<ref>{{Cite journal|date=2018-06|editor-last=Hunsley|editor-first=John|editor2-last=Mash|editor2-first=Eric J.|title=A Guide to Assessments That Work|url=http://dx.doi.org/10.1093/med-psych/9780190492243.001.0001|journal=Oxford Clinical Psychology|doi=10.1093/med-psych/9780190492243.001.0001}}</ref><ref>{{Cite journal|last=Miller|first=Christopher J.|last2=Johnson|first2=Sheri L.|last3=Eisner|first3=Lori|date=2009-06|title=Assessment tools for adult bipolar disorder.|url=http://doi.apa.org/getdoi.cfm?doi=10.1111/j.1468-2850.2009.01158.x|journal=Clinical Psychology: Science and Practice|language=en|volume=16|issue=2|pages=188–201|doi=10.1111/j.1468-2850.2009.01158.x|issn=1468-2850|pmc=PMC2847794|pmid=20360999}}</ref><ref>{{Cite journal|last=Endicott|first=Jean|date=1978-07-01|title=A Diagnostic Interview: The Schedule for Affective Disorders and Schizophrenia|url=http://archpsyc.jamanetwork.com/article.aspx?doi=10.1001/archpsyc.1978.01770310043002|journal=Archives of General Psychiatry|language=en|volume=35|issue=7|pages=837|doi=10.1001/archpsyc.1978.01770310043002|issn=0003-990X}}</ref> | Semistructured interview | 18+ | 1-2 hours |[https://jamanetwork.com/journals/jamapsychiatry/article-abstract/491947 (Endicott & Spitzer, 1978)] |} ==[[Evidence based assessment/Process phase|'''Process phase''']]== The following section contains a list of process and outcome measures for bipolar disorder in adults. The section includes benchmarks based on published norms and on mood samples for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the [[Evidence based assessment/Process phase|process phase]] of assessment. For more information of differences between process and outcome measures, see the page on the [[Evidence based assessment/Process phase|process phase of assessment]]. === Outcome and severity measures === This table includes clinically significant benchmarks for adult bipolar disorder specific outcome measures * Information on how to interpret this table can be [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase '''found here''']. * Additionally, these [[Evidence based assessment/Vignettes|vignettes]] might be helpful resources for understanding appropriate adaptation of outcome measures in practice. *''<u>For clinically significant change benchmarks for the CBCL, YSR, and TRF total, externalizing, internalizing, and attention benchmarks,</u>'' [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase&wteswitched=1#Clinically_significant_change_benchmarks_for_widely-used_outcome_measures '''see here.'''] {| class="wikitable sortable" border="1" | colspan="8" |'''Clinically significant change benchmarks with common instruments for bipolar disorder''' |- | colspan="8" span style="font-size:110%; text-align:center;" | <b> Benchmarks Based on Published Norms </b> |- | rowspan="2" style="text-align:center;font-size:130%;" |<b> Measure</b> | rowspan="2" style="text-align:center;font-size:130%;" | <b>Subscale</b> | colspan="3" style="text-align:center;font-size:130%" width="300" | <b> Cut-off scores</b> | colspan="3" style="text-align:center;font-size:120%" | <b> Critical Change <br> (unstandardized scores)</b> |- | style="text-align:center;font-size:110%" | <b> A</b> | style="text-align:center;font-size:110%" |<b> B</b> | style="text-align:center;font-size:110%" |<b> C</b> | style="text-align:center;font-size:110%" |<b> 95%</b> | style="text-align:center;font-size:110%" |<b> 90%</b> | style="text-align:center;font-size:110%" |<b> SE_difference</b> |- | rowspan="1" style="text-align:center;" |<b> CBCL T-scores <br> (2001 Norms)</b> | style="text-align:right;" |<i> Total</i> | style="text-align:center;" | 49 | style="text-align:center;" | 70 | style="text-align:center;" | 58 | style="text-align:center;" | 5 | style="text-align:center;" | 4 | style="text-align:center;" | 2.4 |- | rowspan="1" style="text-align:center;" | '''Mania Rating Scale (MAS)''' | style="text-align:center;" | | style="text-align:center;" | | style="text-align:center;" | | style="text-align:center;" | | style="text-align:center;" | | style="text-align:center;" | | style="text-align:center;" | |- |'''The Schedule for Affective Disorders and Schizophrenia-Change Version (SADS-C)''' | | | | | | | |} === Treatment === * Please refer to the page on [https://en.wikipedia.org/wiki/Bipolar_disorder bipolar disorder] for more information on available treatment for bipolar disorder or go to the Effective Child Therapy pages for [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/severe-mood-swings-and-bipolar-spectrum-disorders/| Severe Mood Swings & Bipolar Spectrum Disorders] * [https://reacttoolkit.uk/ Relatives Education and Coping Toolkit (REACT)] is currently freely available at https://reacttoolkit.uk/. This is a resource/project of [https://www.lancaster.ac.uk/health-and-medicine/research/spectrum/ The Sprectrum Centre for Mental Health Research] from Lancaster University. A team of clinicians, researchers and relatives of people with psychosis or bipolar disorder at Lancaster, Liverpool and London have developed the Relatives Education and Coping Toolkit (REACT). REACT provides [https://www.nice.org.uk/ National Institute for Health and Care Excellence (NICE)] recommended information and support to relatives and friends of people with mental health problems associated with psychosis or bipolar disorder through a digital, peer-supported, self-management toolkit.<ref>Lobban, A. F., Robinson, H. A., Appelbe, D., Barraclough, J., Bedson, E., Collinge, E., Dodd, S., Flowers, S., Honary, M., Johnson, S., Caixeiro Mateus, M. D. C., Mezes, B., Minns, V., Murray, E., Walker, A. J., Williamson, P., Wintermeyer, C., & Jones, S. H. (2017). Protocol for an online randomised controlled trial to evaluate the clinical and cost-effectiveness of a peer-supported self-management intervention for relatives of people with psychosis or bipolar disorder: Relatives Education And Coping Toolkit (REACT). BMJ Open, 7, [016965]. <nowiki>https://doi.org/10.1136/bmjopen-2017-016965</nowiki></ref><ref>Lobban, F., Akers, N., Appelbe, D., Chapman, L., Collinge, L., Dodd, S., Flowers, S., Hollingsworth, B., Johnson, S., Jones, S. H., Mateus, C., Mezes, B., Murray, E., Panagaki, K., Rainford, N., Robinson, H., Rosala-Hallas, A., Sellwood, W., Walker, A., & Williamson, P. (2020). Clinical effectiveness of a web-based peer-supported self-management intervention for relatives of people with psychosis or bipolar (REACT): online, observer-blind, randomised controlled superiority trial. BMC Psychiatry, 20(1), [160]. <nowiki>https://doi.org/10.1186/s12888-020-02545-9</nowiki></ref><ref>{{Cite journal|last=F|first=Lobban|last2=N|first2=Akers|last3=D|first3=Appelbe|last4=R|first4=Iraci Capuccinello|last5=L|first5=Chapman|last6=L|first6=Collinge|last7=S|first7=Dodd|last8=S|first8=Flowers|last9=B|first9=Hollingsworth|date=2020-07-01|title=A web-based, peer-supported self-management intervention to reduce distress in relatives of people with psychosis or bipolar disorder: the REACT RCT|url=https://www.journalslibrary.nihr.ac.uk/hta/hta24320|journal=Health Technology Assessment|language=EN|volume=24|issue=32|doi=10.3310/hta24320|issn=2046-4924|pmc=PMC7355407|pmid=32608353}}</ref> ** The team at Spectrum Centre also conducted a study linked to REACT called IMPART which looked at what would happen if they tried to deliver REACT as part of routine clinical care in Early Intervention Teams in the [https://www.nhs.uk/ United Kingdom's National Health Service (NHS)]. This study identified key factors that impact implementation and may be useful for informing implementation plans for other digital health interventions.<ref>{{Cite journal|last=Lobban|first=Fiona|last2=Appelbe|first2=Duncan|last3=Appleton|first3=Victoria|last4=Billsborough|first4=Julie|last5=Fisher|first5=Naomi Ruth|last6=Foster|first6=Sheena|last7=Gill|first7=Bethany|last8=Glentworth|first8=David|last9=Harrop|first9=Chris|date=2020-03-17|title=IMPlementation of An online Relatives’ Toolkit for psychosis or bipolar (IMPART study): iterative multiple case study to identify key factors impacting on staff uptake and use|url=https://doi.org/10.1186/s12913-020-5002-4|journal=BMC Health Services Research|volume=20|issue=1|pages=219|doi=10.1186/s12913-020-5002-4|issn=1472-6963|pmc=PMC7077000|pmid=32183787}}</ref> ** '''[https://www.lancaster.ac.uk/health-and-medicine/research/spectrum/ RECOVERY TOOLKIT]''' #eRecoveryToolkit, #RecoveryBD, #PersonalRecovery is freely accessible at https://www.lancaster.ac.uk/health-and-medicine/research/spectrum/. Inspired from a greater body of work around recovery, people with lived experience of bipolar disorder and researchers at [https://www.lancaster.ac.uk/health-and-medicine/research/spectrum/ Spectrum Centre] have created a multi-media recovery toolkit. The aim of the toolkit is to provide accessible information and promote discussion around personal discovery in order to understand and aid people’s recovery journeys. The toolkit contains an animation, an e-booklet and video narratives of relatives and clinicians.<ref>Beck, A. K., Baker, A., Jones, S. H., Lobban, A. F., Kay-Lambkin, F., Attia, J., & Banfield, M. (2018). Exploring the feasibility and acceptability of a recovery-focused group therapy intervention for adults with bipolar disorder: trial protocol. BMJ Open, 8, [e019203]. <nowiki>https://doi.org/10.1136/bmjopen-2017-019203</nowiki></ref> {| cellspacing="0" style="width:238px;" | style="width:45px; height:45px; background:#d1f3f5; color:#49dae9; text-align:center;" vertical-align="center" align="center"| '''<span style="font-size:24pt;">t</span>''' | style="background:#b7eef0; color:black; font-size:8pt; padding:4pt; line-height:1.25em;"| This user tweets on '''[[w:Twitter|Twitter]]''' as [http://twitter.com/_REACTTOOLKIT REACTTOOLKIT]. |} == '''External resources''' == # [http://apps.who.int/classifications/icd10/browse/2015/en#/F31 ICD-10 diagnostic criteria] # [https://en.wikiversity.org/w/index.php?title=Helping_Give_Away_Psychological_Science/Resources/Annotated_List_of_Where_and_How_to_Find_a_Therapist&wteswitched=1#Other_low-cost_options Find-a-Therapist] (a curated list of find-a-therapist websites where you can find a provider) # OMIM (Online Mendelian Inheritance in Man) ## [http://omim.org/entry/125480 125480] ## [http://omim.org/entry/611536 611536] ## [http://omim.org/entry/309200 309200,] ## [http://omim.org/entry/611535 611535] ## [http://omim.org/entry/603663 603663] # [https://emedicine.medscape.com/article/286342-overview eMedicine information] # [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/severe-mood-swings-and-bipolar-spectrum-disorders/ Effective Child Therapy information on Bipolar Disorder] #*Effective Child Therapy is website sponsored by Division 53 of the American Psychological Association (APA), or [https://sccap53.org The Society of Clinical Child and Adolescent Psychology](SCCAP), in collaboration with the Association for Behavioral and Cognitive Therapies (ABCT). Use for information on symptoms and available treatments. # The Psych Show with Dr. Ali Mattu videos (geared towards public; might send to client) ##[https://www.youtube.com/watch?v=llOPqKD-s4w How to Cope with Bipolar Disorder] ## [https://www.youtube.com/watch?v=kUHUmeqBZAA Top 10 Bipolar Myths] == '''References''' == {{collapse top|Click here for references}} {{Reflist|30em}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] {{collapse bottom}} pv4emfw8ap0mmpub76j2j6oys5uq1ab 2419095 2419087 2022-08-25T22:34:11Z Maddiegray11 2936309 /* Psychometric properties of screening instruments for adult bipolar disorder */ switched order wikitext text/x-wiki <noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{medical disclaimer}} {{psychology}} {{Template:evidence-based assessment}} {{:{{BASEPAGENAME}}/Sidebar}} ==[[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio"?''']]== * For background information on what assessment portfolios are, click the link in the heading above. * Want even 'more' information about this topic? There's an extended version of this page [[Evidence-based assessment/Bipolar disorder in adults (assessment portfolio)/extended version|here]]. == [[Evidence based assessment/Preparation phase|'''Preparation phase''']] == === Diagnostic criteria for bipolar disorder in adults === Bipolar Disorder (BP) is characterized by extreme fluctuations in mood (or emotional dysregulation that ranges from mania (as shown by displays or feelings of extreme happiness, unrealistic overachievement and anger), to depression (as shown by displays or feelings of sadness, changes in appetite or weight and irritability.<ref name=":1" /> It has a lifetime risk of about 1%, with heritability estimated at up to 80%.<ref>{{Cite journal|last=Purcell|first=Shaun M.|last2=Wray|first2=Naomi R.|last3=Stone|first3=Jennifer L.|last4=Visscher|first4=Peter M.|last5=O'Donovan|first5=Michael C.|last6=Sullivan|first6=Patrick F.|last7=Sklar|first7=Pamela|last8=(Leader)|first8=Shaun M. Purcell|last9=Stone|first9=Jennifer L.|date=2009/08|title=Common polygenic variation contributes to risk of schizophrenia and bipolar disorder|url=http://www.nature.com/doifinder/10.1038/nature08185|journal=Nature|language=En|volume=460|issue=7256|doi=10.1038/nature08185|issn=1476-4687}}</ref> It is important to note that these moods exceed normal responses to life events, represent a change from the individual's normal functioning, and cause problems in daily activities. {{blockquotetop}} <big>'''ICD-11 Diagnostic Criteria'''</big> *Bipolar Type I Disorder **Bipolar type I disorder is an episodic mood disorder defined by the occurrence of one or more manic or mixed episodes. A manic episode is an extreme mood state lasting at least one week unless shortened by a treatment intervention characterized by euphoria, irritability, or expansiveness, and by increased activity or a subjective experience of increased energy, accompanied by other characteristic symptoms such as rapid or pressured speech, flight of ideas, increased self-esteem or grandiosity, decreased need for sleep, distractibility, impulsive or reckless behavior, and rapid changes among different mood states (i.e., mood lability). A mixed episode is characterized by either a mixture or very rapid alternation between prominent manic and depressive symptoms on most days during a period of at least 2 weeks. Although the diagnosis can be made based on evidence of a single manic or mixed episode, typically manic or mixed episodes alternate with depressive episodes over the course of the disorder. ***Note: The ICD-11 lists 18 additional subcategories of Bipolar type I disorder. They can be found [https://icd.who.int/browse11/l-m/en#/http://id.who.int/icd/entity/1456478153 here]. *Bipolar Type II Disorder **Bipolar type II disorder is an episodic mood disorder defined by the occurrence of one or more hypomanic episodes and at least one depressive episode. A hypomanic episode is a persistent mood state characterized by euphoria, irritability, or expansiveness, and excessive psychomotor activation or increased energy, accompanied by other characteristic symptoms such as grandiosity, decreased need for sleep, pressured speech, flight of ideas, distractibility, and impulsive or reckless behavior lasting for at least several days. The symptoms represent a change from the individual’s typical behavior and are not severe enough to cause marked impairment in functioning. A depressive episode is characterized by a period of almost daily depressed mood or diminished interest in activities lasting at least 2 weeks accompanied by other symptoms such as changes in appetite or sleep, psychomotor agitation or retardation, fatigue, feelings of worthless or excessive or inappropriate guilt, feelings or hopelessness, difficulty concentrating, and suicidality. There is no history of manic or mixed Episodes. ***Note: The ICD-11 lists 13 additional subcategories of Bipolar type II disorder. They can be found [https://icd.who.int/browse11/l-m/en#/http%3a%2f%2fid.who.int%2ficd%2fentity%2f199053300 here]. '''Changes in DSM-5''' * The diagnostic criteria for '''Bipolar Disorder''' changed slightly from [[DSM-IV]] to [[w:Diagnostic_and_Statistical_Manual_of_Mental_Disorders#DSM-IV-TR_.282000.29|DSM-5]]. Summaries are available [http://www.dsm5.org/Documents/changes%20from%20dsm-iv-tr%20to%20dsm-5.pdf here] and [[w:DSM-5|here]]. {{blockquotebottom}} === Base rates of BD in different clinical settings and populations === This section describes the demographic setting of the population(s) sampled, base rates of diagnosis, country/region sampled, and the diagnostic method that was used. Using this information, clinicians will be able to anchor the rate of adolescent depression that they are likely to see in their clinical practice. * '''''To see prevalence rates across multiple disorders,''''' [[Evidence based assessment/Preparation phase#Base rates for transdiagnostic comparison|'''''click here.''''']] {| class="wikitable" |'''Demography''' |'''Setting''' |'''Base Rate''' |'''Diagnostic Method''' |- |United States, Canada, Puerto Rico, Germany, Taiwan, Korea, New Zealand <ref>{{Cite journal|last=Weissman|first=Myrna M.|last2=Bland|first2=Roger C.|last3=Canino|first3=Glorisa J.|last4=Faravelli|first4=Carlo|last5=Greenwald|first5=Steven|last6=Hwu|first6=Hai-Gwo|last7=Joyce|first7=Peter R.|last8=Karam|first8=Eile G.|last9=Lee|first9=Chung-Kyoon|date=1996-07-24|title=Cross-National Epidemiology of Major Depression and Bipolar Disorder|url=https://doi.org/10.1001/jama.1996.03540040037030|journal=JAMA|volume=276|issue=4|pages=293–299|doi=10.1001/jama.1996.03540040037030|issn=0098-7484}}</ref> |Community Epidemiological Samples |0.3 - 1.5% |Structured and semi-structured diagnostic interviews |- |United States<ref>{{Cite journal|last=Merikangas|first=Kathleen R.|last2=Akiskal|first2=Hagop S.|last3=Angst|first3=Jules|last4=Greenberg|first4=Paul E.|last5=Hirschfeld|first5=Robert M. A.|last6=Petukhova|first6=Maria|last7=Kessler|first7=Ronald C.|date=2007-05-01|title=Lifetime and 12-Month Prevalence of Bipolar Spectrum Disorder in the National Comorbidity Survey Replication|url=https://jamanetwork.com/journals/jamapsychiatry/fullarticle/482285|journal=Archives of General Psychiatry|language=en|volume=64|issue=5|pages=543–552|doi=10.1001/archpsyc.64.5.543|issn=0003-990X}}</ref> |Community Epidemiological Samples |BPI - 1%; BPII - 1.1%; Subthreshold BP - 2.4% |World Health Organisation Composite International Diagnostic Interview |- |United States<ref>{{Cite journal|last=LEWINSOHN|first=PETER M.|last2=KLEIN|first2=DANIEL N.|last3=SEELEY|first3=JOHN R.|title=Bipolar Disorders in a Community Sample of Older Adolescents: Prevalence, Phenomenology, Comorbidity, and Course|url=http://linkinghub.elsevier.com/retrieve/pii/S089085670963731X|journal=Journal of the American Academy of Child & Adolescent Psychiatry|volume=34|issue=4|pages=454–463|doi=10.1097/00004583-199504000-00012}}</ref> |Community samples (older adolescents) |1% |K-SADS Semi-Structured Interview |- |United States<ref>{{Cite journal|last=Judd|first=Lewis L.|last2=Akiskal|first2=Hagop S.|title=The prevalence and disability of bipolar spectrum disorders in the US population: re-analysis of the ECA database taking into account subthreshold cases|url=https://doi.org/10.1016/S0165-0327(02)00332-4|journal=Journal of Affective Disorders|volume=73|issue=1-2|pages=123–131|doi=10.1016/s0165-0327(02)00332-4}}</ref> |US National Epidemiological Catchment Area (ECA) database |0.8 - 5.1% (manic and subthreshold mania) |Diagnostic Interview Schedule (DIS) |- |United States<ref>{{Cite journal|last=Kessler|first=R. C.|last2=Rubinow|first2=D. R.|last3=Holmes|first3=C.|last4=Abelson|first4=J. M.|last5=Zhao|first5=S.|date=1997/09|title=The epidemiology of DSM-III-R bipolar I disorder in a general population survey|url=https://www.cambridge.org/core/journals/psychological-medicine/article/epidemiology-of-dsmiiir-bipolar-i-disorder-in-a-general-population-survey/950D518D15F64E2059F1033558615A9A|journal=Psychological Medicine|language=en|volume=27|issue=5|pages=1079–1089|issn=1469-8978}}</ref> |US National Comorbidity Survey (NCS) |0-4% (small community sample; reappraisal study) |World Health Organisation Composite International Diagnostic Interview |- |United States and other countries<ref>{{Cite book|url=https://www.worldcat.org/oclc/830807378|title=Diagnostic and statistical manual of mental disorders : DSM-5.|date=2013|publisher=American Psychiatric Association., American Psychiatric Association. DSM-5 Task Force.|isbn=9780890425541|edition=5th|location=Arlington, VA|oclc=830807378}}</ref> |Community sample |BPI - 0.6%; BPII-  1.8%;  Cyclothymia - 0.4-1% |Unspecified |- |United States, Europe, Asia<ref>{{Cite journal|last=Merikangas|first=Kathleen R.|last2=Jin|first2=Robert|last3=He|first3=Jian-Ping|last4=Kessler|first4=Ronald C.|last5=Lee|first5=Sing|last6=Sampson|first6=Nancy A.|last7=Viana|first7=Maria Carmen|last8=Andrade|first8=Laura Helena|last9=Hu|first9=Chiyi|date=2011-03-07|title=Prevalence and Correlates of Bipolar Spectrum Disorder in the World Mental Health Survey Initiative|url=http://archpsyc.jamanetwork.com/article.aspx?doi=10.1001/archgenpsychiatry.2011.12|journal=Archives of General Psychiatry|language=en|volume=68|issue=3|doi=10.1001/archgenpsychiatry.2011.12|issn=0003-990X}}</ref> |Community Samples |BPI - 0.6%; BPII - 0.4%; Subthreshold BP - 1.4%; Bipolar Spectrum Disorder - 2.4% |World Health Organisation Composite International Diagnostic Interview |- |United States<ref>{{Cite journal|last=Grant|first=Bridget F.|last2=Stinson|first2=Frederick S.|last3=Hasin|first3=Deborah S.|last4=Dawson|first4=Deborah A.|last5=Chou|first5=S. Patricia|last6=Ruan|first6=W. June|last7=Huang|first7=Boji|date=October 2005|title=Prevalence, correlates, and comorbidity of bipolar I disorder and axis I and II disorders: results from the National Epidemiologic Survey on Alcohol and Related Conditions|url=https://www.ncbi.nlm.nih.gov/pubmed/16259532|journal=The Journal of Clinical Psychiatry|volume=66|issue=10|pages=1205–1215|issn=0160-6689|pmid=16259532}}</ref> |National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) |BPI - 3.3% |The Alcohol Use Disorder and Associated Disabilities Interview Schedule-IV (AUDADIS-IV) |- |United States<ref>{{Cite journal|last=Das|first=Amar K.|date=2005-02-23|title=Screening for Bipolar Disorder in a Primary Care Practice|url=http://jama.jamanetwork.com/article.aspx?doi=10.1001/jama.293.8.956|journal=JAMA|language=en|volume=293|issue=8|doi=10.1001/jama.293.8.956|issn=0098-7484}}</ref> |Outpatient Clinic Sample |9.8% |Review of medical records, questionnaire data |- |United States<ref>{{cite journal|last1=Hirschfeld|first1=RM|last2=Cass|first2=AR|last3=Holt|first3=DC|last4=Carlson|first4=CA|date=2005|title=Screening for bipolar disorder in patients treated for depression in a family medicine clinic.|journal=The Journal of the American Board of Family Practice|volume=18|issue=4|pages=233-9|pmid=15994469}}</ref> |Outpatient Clinic Sample |21.3% |MDQ, SCID |} ==[[Evidence based assessment/Prediction phase|'''Prediction phase''']]== === Psychometric properties of screening instruments for adult bipolar disorder === The following section contains a list of screening and diagnostic instruments for adult bipolar disorder. The section includes administration information, psychometric data, and PDFs or links to the screenings. * Screenings are used as part of the [[Evidence based assessment/Prediction phase|prediction phase]] of assessment; for more information on interpretation of this data, or how screenings fit in to the assessment process, click [[Evidence based assessment/Prediction phase|here.]] * '''''For a list of more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Psychometric_properties_of_common_screening_instruments click here.]''''' {| class="wikitable" |- ! Measure !Format (Reporter) !Age Range !Administration/ Completion Time !Where to Access |- |[[wikipedia:General_Behavior_Inventory|GBI (General Behavior Inventory)]]<ref>{{Cite journal|date=2018-06|editor-last=Hunsley|editor-first=John|editor2-last=Mash|editor2-first=Eric J.|title=A Guide to Assessments That Work|url=http://dx.doi.org/10.1093/med-psych/9780190492243.001.0001|journal=Oxford Clinical Psychology|doi=10.1093/med-psych/9780190492243.001.0001}}</ref> |Self-report |Adult |15-20 minutes | * [https://mfr.osf.io/render?url=https://osf.io/j6rce/?action=download%26mode=render Downloadable PDF Self-Report English] * [https://mfr.osf.io/render?url=https://osf.io/27nwg/?action=download%26mode=render Scoring instructions and information] |- |[[wikipedia:Mood_Disorder_Questionnaire|MDQ (Mood Disorder Questionnaire)]]<ref name="Carvalho" /> |Self-report |Adult |5 minutes | * [https://mfr.osf.io/render?url=https://osf.io/sb5xw/?action=download%26mode=render Adult Self-Report (Long, English)] * [https://mfr.osf.io/render?url=https://osf.io/xa7v6/?action=download%26mode=render Adult Self-Report (Short, English)] * |- |[[wikipedia:Bipolar_Spectrum_Diagnostic_Scale|BSDS (Bipolar Spectrum Diagnostic Scale)]]<ref>{{Cite journal|date=2018-06|editor-last=Hunsley|editor-first=John|editor2-last=Mash|editor2-first=Eric J.|title=A Guide to Assessments That Work|url=http://dx.doi.org/10.1093/med-psych/9780190492243.001.0001|journal=Oxford Clinical Psychology|doi=10.1093/med-psych/9780190492243.001.0001}}</ref><ref name="Carvalho" /> |Self-report |Adult |15 minutes | * [http://psycheducation.org/diagnosis/the-bipolar-spectrum-diagnostic-scale/ Online version] * [https://mfr.osf.io/render?url=https://osf.io/w9qet/?action=download%26mode=render Downloadable PDF Version (English)] |- |[[wikipedia:Hypomania_Checklist|HCL-32 (Hypomania Checklist)]]<ref name="Carvalho" /><ref>{{Cite journal|last=Feng|first=Yuan|last2=Wang|first2=Yuan-Yuan|last3=Huang|first3=Wei|last4=Ungvari|first4=Gabor S.|last5=Ng|first5=Chee H.|last6=Wang|first6=Gang|last7=Yuan|first7=Zhen|last8=Xiang|first8=Yu-Tao|date=2017-06-01|title=Comparison of the 32-item Hypomania Checklist, the 33-item Hypomania Checklist, and the Mood Disorders Questionnaire for bipolar disorder|url=http://onlinelibrary.wiley.com/doi/10.1111/pcn.12506/abstract|journal=Psychiatry and Clinical Neurosciences|language=en|volume=71|issue=6|pages=403–408|doi=10.1111/pcn.12506|issn=1440-1819}}</ref> |Self-report |Adult |10-15 minutes | * [https://mfr.osf.io/render?url=https://osf.io/2veyc/?action=download%26mode=render Self-report] |} '''Note:''' '''L''' = Less than adequate; '''A''' = Adequate; '''G''' = Good; '''E''' = Excellent; '''U''' = Unavailable; '''NA''' = Not applicable === Likelihood ratios and AUCs of screening measures for bipolar disorder in adults === * '''''For a list of the likelihood ratios for more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Likelihood_ratios_and_AUCs_of_common_screening_instruments click here.]''''' {| class="wikitable sortable" !'''Screening Measure (Primary Reference)''' !'''Area Under Curve (AUC) and sample size''' !'''DiLR+ (score)''' !DiLR- (score) !'''Population''' |- |[[wikipedia:Bipolar_Spectrum_Diagnostic_Scale|BSDS (Bipolar Spectrum Diagnostic Scale)]] <ref name="Carvalho" /> |0.81 |(13) <ref name = Carvalho>{{cite journal|last1=Carvalho|first1=André F.|last2=Takwoingi|first2=Yemisi|last3=Sales|first3=Paulo Marcelo G.|last4=Soczynska|first4=Joanna K.|last5=Köhler|first5=Cristiano A.|last6=Freitas|first6=Thiago H.|last7=Quevedo|first7=João|last8=Hyphantis|first8=Thomas N.|last9=McIntyre|first9=Roger S.|last10=Vieta|first10=Eduard|title=Screening for bipolar spectrum disorders: A comprehensive meta-analysis of accuracy studies|journal=Journal of Affective Disorders|date=February 2015|volume=172|pages=337–346|doi=https://doi.org/10.1016/j.jad.2014.10.024}}</ref> |0.36 (4.93) |Clinical |- |[[wikipedia:Hypomania_Checklist|HCL-32 (Hypomania Checklist)]]<ref name="Carvalho" /> |0.80 |(14)<ref name="Carvalho" /> |0.28 (2.45) |Clinical |- |[[wikipedia:Mood_Disorder_Questionnaire|MDQ (Mood Disorder Questionnaire)]]<ref name="Carvalho" /> |0.78 |(7)<ref name="Carvalho" /> |0.22 (5.4) |Clinical |- |General Behavior Inventory (GBI) | | | | |} '''Note:''' Area Under Curve (AUC, or AUROC) is equal to the probability that a classifier will rank a randomly chosen positive diagnosis of Bipolar Disorder higher than a randomly chosen negative diagnosis of Bipolar Disorder[15]. ==[[Evidence based assessment/Prescription phase|'''Prescription phase''']]== ===Gold standard diagnostic interviews=== * For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews click here.] ===Recommended diagnostic interviews for adult bipolar disorder=== {| class="wikitable sortable" border="1" ! colspan="5" |Diagnostic instruments for BPSD |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time !Where to Access |- | Structured Clinical Interview for DSM-5 (SCID)<ref>{{Cite journal|last=Miller|first=Christopher J.|last2=Johnson|first2=Sheri L.|last3=Eisner|first3=Lori|date=2009-06|title=Assessment tools for adult bipolar disorder.|url=http://doi.apa.org/getdoi.cfm?doi=10.1111/j.1468-2850.2009.01158.x|journal=Clinical Psychology: Science and Practice|language=en|volume=16|issue=2|pages=188–201|doi=10.1111/j.1468-2850.2009.01158.x|issn=1468-2850|pmc=PMC2847794|pmid=20360999}}</ref><ref>{{Cite journal|date=2018-06|editor-last=Hunsley|editor-first=John|editor2-last=Mash|editor2-first=Eric J.|title=A Guide to Assessments That Work|url=http://dx.doi.org/10.1093/med-psych/9780190492243.001.0001|journal=Oxford Clinical Psychology|doi=10.1093/med-psych/9780190492243.001.0001}}</ref> | Semistructured interview | 18+ | 1-2 hours |Available for purchase from [https://www.appi.org/products/structured-clinical-interview-for-dsm-5-scid-5 APA Publishing] |- | Schedule for Affective Disorders and Schizophrenia (SADS)<ref>{{Cite journal|date=2018-06|editor-last=Hunsley|editor-first=John|editor2-last=Mash|editor2-first=Eric J.|title=A Guide to Assessments That Work|url=http://dx.doi.org/10.1093/med-psych/9780190492243.001.0001|journal=Oxford Clinical Psychology|doi=10.1093/med-psych/9780190492243.001.0001}}</ref><ref>{{Cite journal|last=Miller|first=Christopher J.|last2=Johnson|first2=Sheri L.|last3=Eisner|first3=Lori|date=2009-06|title=Assessment tools for adult bipolar disorder.|url=http://doi.apa.org/getdoi.cfm?doi=10.1111/j.1468-2850.2009.01158.x|journal=Clinical Psychology: Science and Practice|language=en|volume=16|issue=2|pages=188–201|doi=10.1111/j.1468-2850.2009.01158.x|issn=1468-2850|pmc=PMC2847794|pmid=20360999}}</ref><ref>{{Cite journal|last=Endicott|first=Jean|date=1978-07-01|title=A Diagnostic Interview: The Schedule for Affective Disorders and Schizophrenia|url=http://archpsyc.jamanetwork.com/article.aspx?doi=10.1001/archpsyc.1978.01770310043002|journal=Archives of General Psychiatry|language=en|volume=35|issue=7|pages=837|doi=10.1001/archpsyc.1978.01770310043002|issn=0003-990X}}</ref> | Semistructured interview | 18+ | 1-2 hours |[https://jamanetwork.com/journals/jamapsychiatry/article-abstract/491947 (Endicott & Spitzer, 1978)] |} ==[[Evidence based assessment/Process phase|'''Process phase''']]== The following section contains a list of process and outcome measures for bipolar disorder in adults. The section includes benchmarks based on published norms and on mood samples for several outcome and severity measures, as well as information about commonly used process measures. Process and outcome measures are used as part of the [[Evidence based assessment/Process phase|process phase]] of assessment. For more information of differences between process and outcome measures, see the page on the [[Evidence based assessment/Process phase|process phase of assessment]]. === Outcome and severity measures === This table includes clinically significant benchmarks for adult bipolar disorder specific outcome measures * Information on how to interpret this table can be [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase '''found here''']. * Additionally, these [[Evidence based assessment/Vignettes|vignettes]] might be helpful resources for understanding appropriate adaptation of outcome measures in practice. *''<u>For clinically significant change benchmarks for the CBCL, YSR, and TRF total, externalizing, internalizing, and attention benchmarks,</u>'' [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Process_phase&wteswitched=1#Clinically_significant_change_benchmarks_for_widely-used_outcome_measures '''see here.'''] {| class="wikitable sortable" border="1" | colspan="8" |'''Clinically significant change benchmarks with common instruments for bipolar disorder''' |- | colspan="8" span style="font-size:110%; text-align:center;" | <b> Benchmarks Based on Published Norms </b> |- | rowspan="2" style="text-align:center;font-size:130%;" |<b> Measure</b> | rowspan="2" style="text-align:center;font-size:130%;" | <b>Subscale</b> | colspan="3" style="text-align:center;font-size:130%" width="300" | <b> Cut-off scores</b> | colspan="3" style="text-align:center;font-size:120%" | <b> Critical Change <br> (unstandardized scores)</b> |- | style="text-align:center;font-size:110%" | <b> A</b> | style="text-align:center;font-size:110%" |<b> B</b> | style="text-align:center;font-size:110%" |<b> C</b> | style="text-align:center;font-size:110%" |<b> 95%</b> | style="text-align:center;font-size:110%" |<b> 90%</b> | style="text-align:center;font-size:110%" |<b> SE_difference</b> |- | rowspan="1" style="text-align:center;" |<b> CBCL T-scores <br> (2001 Norms)</b> | style="text-align:right;" |<i> Total</i> | style="text-align:center;" | 49 | style="text-align:center;" | 70 | style="text-align:center;" | 58 | style="text-align:center;" | 5 | style="text-align:center;" | 4 | style="text-align:center;" | 2.4 |- | rowspan="1" style="text-align:center;" | '''Mania Rating Scale (MAS)''' | style="text-align:center;" | | style="text-align:center;" | | style="text-align:center;" | | style="text-align:center;" | | style="text-align:center;" | | style="text-align:center;" | | style="text-align:center;" | |- |'''The Schedule for Affective Disorders and Schizophrenia-Change Version (SADS-C)''' | | | | | | | |} === Treatment === * Please refer to the page on [https://en.wikipedia.org/wiki/Bipolar_disorder bipolar disorder] for more information on available treatment for bipolar disorder or go to the Effective Child Therapy pages for [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/severe-mood-swings-and-bipolar-spectrum-disorders/| Severe Mood Swings & Bipolar Spectrum Disorders] * [https://reacttoolkit.uk/ Relatives Education and Coping Toolkit (REACT)] is currently freely available at https://reacttoolkit.uk/. This is a resource/project of [https://www.lancaster.ac.uk/health-and-medicine/research/spectrum/ The Sprectrum Centre for Mental Health Research] from Lancaster University. A team of clinicians, researchers and relatives of people with psychosis or bipolar disorder at Lancaster, Liverpool and London have developed the Relatives Education and Coping Toolkit (REACT). REACT provides [https://www.nice.org.uk/ National Institute for Health and Care Excellence (NICE)] recommended information and support to relatives and friends of people with mental health problems associated with psychosis or bipolar disorder through a digital, peer-supported, self-management toolkit.<ref>Lobban, A. F., Robinson, H. A., Appelbe, D., Barraclough, J., Bedson, E., Collinge, E., Dodd, S., Flowers, S., Honary, M., Johnson, S., Caixeiro Mateus, M. D. C., Mezes, B., Minns, V., Murray, E., Walker, A. J., Williamson, P., Wintermeyer, C., & Jones, S. H. (2017). Protocol for an online randomised controlled trial to evaluate the clinical and cost-effectiveness of a peer-supported self-management intervention for relatives of people with psychosis or bipolar disorder: Relatives Education And Coping Toolkit (REACT). BMJ Open, 7, [016965]. <nowiki>https://doi.org/10.1136/bmjopen-2017-016965</nowiki></ref><ref>Lobban, F., Akers, N., Appelbe, D., Chapman, L., Collinge, L., Dodd, S., Flowers, S., Hollingsworth, B., Johnson, S., Jones, S. H., Mateus, C., Mezes, B., Murray, E., Panagaki, K., Rainford, N., Robinson, H., Rosala-Hallas, A., Sellwood, W., Walker, A., & Williamson, P. (2020). Clinical effectiveness of a web-based peer-supported self-management intervention for relatives of people with psychosis or bipolar (REACT): online, observer-blind, randomised controlled superiority trial. BMC Psychiatry, 20(1), [160]. <nowiki>https://doi.org/10.1186/s12888-020-02545-9</nowiki></ref><ref>{{Cite journal|last=F|first=Lobban|last2=N|first2=Akers|last3=D|first3=Appelbe|last4=R|first4=Iraci Capuccinello|last5=L|first5=Chapman|last6=L|first6=Collinge|last7=S|first7=Dodd|last8=S|first8=Flowers|last9=B|first9=Hollingsworth|date=2020-07-01|title=A web-based, peer-supported self-management intervention to reduce distress in relatives of people with psychosis or bipolar disorder: the REACT RCT|url=https://www.journalslibrary.nihr.ac.uk/hta/hta24320|journal=Health Technology Assessment|language=EN|volume=24|issue=32|doi=10.3310/hta24320|issn=2046-4924|pmc=PMC7355407|pmid=32608353}}</ref> ** The team at Spectrum Centre also conducted a study linked to REACT called IMPART which looked at what would happen if they tried to deliver REACT as part of routine clinical care in Early Intervention Teams in the [https://www.nhs.uk/ United Kingdom's National Health Service (NHS)]. This study identified key factors that impact implementation and may be useful for informing implementation plans for other digital health interventions.<ref>{{Cite journal|last=Lobban|first=Fiona|last2=Appelbe|first2=Duncan|last3=Appleton|first3=Victoria|last4=Billsborough|first4=Julie|last5=Fisher|first5=Naomi Ruth|last6=Foster|first6=Sheena|last7=Gill|first7=Bethany|last8=Glentworth|first8=David|last9=Harrop|first9=Chris|date=2020-03-17|title=IMPlementation of An online Relatives’ Toolkit for psychosis or bipolar (IMPART study): iterative multiple case study to identify key factors impacting on staff uptake and use|url=https://doi.org/10.1186/s12913-020-5002-4|journal=BMC Health Services Research|volume=20|issue=1|pages=219|doi=10.1186/s12913-020-5002-4|issn=1472-6963|pmc=PMC7077000|pmid=32183787}}</ref> ** '''[https://www.lancaster.ac.uk/health-and-medicine/research/spectrum/ RECOVERY TOOLKIT]''' #eRecoveryToolkit, #RecoveryBD, #PersonalRecovery is freely accessible at https://www.lancaster.ac.uk/health-and-medicine/research/spectrum/. Inspired from a greater body of work around recovery, people with lived experience of bipolar disorder and researchers at [https://www.lancaster.ac.uk/health-and-medicine/research/spectrum/ Spectrum Centre] have created a multi-media recovery toolkit. The aim of the toolkit is to provide accessible information and promote discussion around personal discovery in order to understand and aid people’s recovery journeys. The toolkit contains an animation, an e-booklet and video narratives of relatives and clinicians.<ref>Beck, A. K., Baker, A., Jones, S. H., Lobban, A. F., Kay-Lambkin, F., Attia, J., & Banfield, M. (2018). Exploring the feasibility and acceptability of a recovery-focused group therapy intervention for adults with bipolar disorder: trial protocol. BMJ Open, 8, [e019203]. <nowiki>https://doi.org/10.1136/bmjopen-2017-019203</nowiki></ref> {| cellspacing="0" style="width:238px;" | style="width:45px; height:45px; background:#d1f3f5; color:#49dae9; text-align:center;" vertical-align="center" align="center"| '''<span style="font-size:24pt;">t</span>''' | style="background:#b7eef0; color:black; font-size:8pt; padding:4pt; line-height:1.25em;"| This user tweets on '''[[w:Twitter|Twitter]]''' as [http://twitter.com/_REACTTOOLKIT REACTTOOLKIT]. |} == '''External resources''' == # [http://apps.who.int/classifications/icd10/browse/2015/en#/F31 ICD-10 diagnostic criteria] # [https://en.wikiversity.org/w/index.php?title=Helping_Give_Away_Psychological_Science/Resources/Annotated_List_of_Where_and_How_to_Find_a_Therapist&wteswitched=1#Other_low-cost_options Find-a-Therapist] (a curated list of find-a-therapist websites where you can find a provider) # OMIM (Online Mendelian Inheritance in Man) ## [http://omim.org/entry/125480 125480] ## [http://omim.org/entry/611536 611536] ## [http://omim.org/entry/309200 309200,] ## [http://omim.org/entry/611535 611535] ## [http://omim.org/entry/603663 603663] # [https://emedicine.medscape.com/article/286342-overview eMedicine information] # [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/severe-mood-swings-and-bipolar-spectrum-disorders/ Effective Child Therapy information on Bipolar Disorder] #*Effective Child Therapy is website sponsored by Division 53 of the American Psychological Association (APA), or [https://sccap53.org The Society of Clinical Child and Adolescent Psychology](SCCAP), in collaboration with the Association for Behavioral and Cognitive Therapies (ABCT). Use for information on symptoms and available treatments. # The Psych Show with Dr. Ali Mattu videos (geared towards public; might send to client) ##[https://www.youtube.com/watch?v=llOPqKD-s4w How to Cope with Bipolar Disorder] ## [https://www.youtube.com/watch?v=kUHUmeqBZAA Top 10 Bipolar Myths] == '''References''' == {{collapse top|Click here for references}} {{Reflist|30em}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] {{collapse bottom}} rl5fytadbc04jnkmdk4hkobr7ujbgdl 2419110 2419095 2022-08-25T23:08:01Z Maddiegray11 2936309 /* Process phase */ removed outcome measure and process measure section wikitext text/x-wiki <noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{medical disclaimer}} {{psychology}} {{Template:evidence-based assessment}} {{:{{BASEPAGENAME}}/Sidebar}} ==[[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio"?''']]== * For background information on what assessment portfolios are, click the link in the heading above. * Want even 'more' information about this topic? There's an extended version of this page [[Evidence-based assessment/Bipolar disorder in adults (assessment portfolio)/extended version|here]]. == [[Evidence based assessment/Preparation phase|'''Preparation phase''']] == === Diagnostic criteria for bipolar disorder in adults === Bipolar Disorder (BP) is characterized by extreme fluctuations in mood (or emotional dysregulation that ranges from mania (as shown by displays or feelings of extreme happiness, unrealistic overachievement and anger), to depression (as shown by displays or feelings of sadness, changes in appetite or weight and irritability.<ref name=":1" /> It has a lifetime risk of about 1%, with heritability estimated at up to 80%.<ref>{{Cite journal|last=Purcell|first=Shaun M.|last2=Wray|first2=Naomi R.|last3=Stone|first3=Jennifer L.|last4=Visscher|first4=Peter M.|last5=O'Donovan|first5=Michael C.|last6=Sullivan|first6=Patrick F.|last7=Sklar|first7=Pamela|last8=(Leader)|first8=Shaun M. Purcell|last9=Stone|first9=Jennifer L.|date=2009/08|title=Common polygenic variation contributes to risk of schizophrenia and bipolar disorder|url=http://www.nature.com/doifinder/10.1038/nature08185|journal=Nature|language=En|volume=460|issue=7256|doi=10.1038/nature08185|issn=1476-4687}}</ref> It is important to note that these moods exceed normal responses to life events, represent a change from the individual's normal functioning, and cause problems in daily activities. {{blockquotetop}} <big>'''ICD-11 Diagnostic Criteria'''</big> *Bipolar Type I Disorder **Bipolar type I disorder is an episodic mood disorder defined by the occurrence of one or more manic or mixed episodes. A manic episode is an extreme mood state lasting at least one week unless shortened by a treatment intervention characterized by euphoria, irritability, or expansiveness, and by increased activity or a subjective experience of increased energy, accompanied by other characteristic symptoms such as rapid or pressured speech, flight of ideas, increased self-esteem or grandiosity, decreased need for sleep, distractibility, impulsive or reckless behavior, and rapid changes among different mood states (i.e., mood lability). A mixed episode is characterized by either a mixture or very rapid alternation between prominent manic and depressive symptoms on most days during a period of at least 2 weeks. Although the diagnosis can be made based on evidence of a single manic or mixed episode, typically manic or mixed episodes alternate with depressive episodes over the course of the disorder. ***Note: The ICD-11 lists 18 additional subcategories of Bipolar type I disorder. They can be found [https://icd.who.int/browse11/l-m/en#/http://id.who.int/icd/entity/1456478153 here]. *Bipolar Type II Disorder **Bipolar type II disorder is an episodic mood disorder defined by the occurrence of one or more hypomanic episodes and at least one depressive episode. A hypomanic episode is a persistent mood state characterized by euphoria, irritability, or expansiveness, and excessive psychomotor activation or increased energy, accompanied by other characteristic symptoms such as grandiosity, decreased need for sleep, pressured speech, flight of ideas, distractibility, and impulsive or reckless behavior lasting for at least several days. The symptoms represent a change from the individual’s typical behavior and are not severe enough to cause marked impairment in functioning. A depressive episode is characterized by a period of almost daily depressed mood or diminished interest in activities lasting at least 2 weeks accompanied by other symptoms such as changes in appetite or sleep, psychomotor agitation or retardation, fatigue, feelings of worthless or excessive or inappropriate guilt, feelings or hopelessness, difficulty concentrating, and suicidality. There is no history of manic or mixed Episodes. ***Note: The ICD-11 lists 13 additional subcategories of Bipolar type II disorder. They can be found [https://icd.who.int/browse11/l-m/en#/http%3a%2f%2fid.who.int%2ficd%2fentity%2f199053300 here]. '''Changes in DSM-5''' * The diagnostic criteria for '''Bipolar Disorder''' changed slightly from [[DSM-IV]] to [[w:Diagnostic_and_Statistical_Manual_of_Mental_Disorders#DSM-IV-TR_.282000.29|DSM-5]]. Summaries are available [http://www.dsm5.org/Documents/changes%20from%20dsm-iv-tr%20to%20dsm-5.pdf here] and [[w:DSM-5|here]]. {{blockquotebottom}} === Base rates of BD in different clinical settings and populations === This section describes the demographic setting of the population(s) sampled, base rates of diagnosis, country/region sampled, and the diagnostic method that was used. Using this information, clinicians will be able to anchor the rate of adolescent depression that they are likely to see in their clinical practice. * '''''To see prevalence rates across multiple disorders,''''' [[Evidence based assessment/Preparation phase#Base rates for transdiagnostic comparison|'''''click here.''''']] {| class="wikitable" |'''Demography''' |'''Setting''' |'''Base Rate''' |'''Diagnostic Method''' |- |United States, Canada, Puerto Rico, Germany, Taiwan, Korea, New Zealand <ref>{{Cite journal|last=Weissman|first=Myrna M.|last2=Bland|first2=Roger C.|last3=Canino|first3=Glorisa J.|last4=Faravelli|first4=Carlo|last5=Greenwald|first5=Steven|last6=Hwu|first6=Hai-Gwo|last7=Joyce|first7=Peter R.|last8=Karam|first8=Eile G.|last9=Lee|first9=Chung-Kyoon|date=1996-07-24|title=Cross-National Epidemiology of Major Depression and Bipolar Disorder|url=https://doi.org/10.1001/jama.1996.03540040037030|journal=JAMA|volume=276|issue=4|pages=293–299|doi=10.1001/jama.1996.03540040037030|issn=0098-7484}}</ref> |Community Epidemiological Samples |0.3 - 1.5% |Structured and semi-structured diagnostic interviews |- |United States<ref>{{Cite journal|last=Merikangas|first=Kathleen R.|last2=Akiskal|first2=Hagop S.|last3=Angst|first3=Jules|last4=Greenberg|first4=Paul E.|last5=Hirschfeld|first5=Robert M. A.|last6=Petukhova|first6=Maria|last7=Kessler|first7=Ronald C.|date=2007-05-01|title=Lifetime and 12-Month Prevalence of Bipolar Spectrum Disorder in the National Comorbidity Survey Replication|url=https://jamanetwork.com/journals/jamapsychiatry/fullarticle/482285|journal=Archives of General Psychiatry|language=en|volume=64|issue=5|pages=543–552|doi=10.1001/archpsyc.64.5.543|issn=0003-990X}}</ref> |Community Epidemiological Samples |BPI - 1%; BPII - 1.1%; Subthreshold BP - 2.4% |World Health Organisation Composite International Diagnostic Interview |- |United States<ref>{{Cite journal|last=LEWINSOHN|first=PETER M.|last2=KLEIN|first2=DANIEL N.|last3=SEELEY|first3=JOHN R.|title=Bipolar Disorders in a Community Sample of Older Adolescents: Prevalence, Phenomenology, Comorbidity, and Course|url=http://linkinghub.elsevier.com/retrieve/pii/S089085670963731X|journal=Journal of the American Academy of Child & Adolescent Psychiatry|volume=34|issue=4|pages=454–463|doi=10.1097/00004583-199504000-00012}}</ref> |Community samples (older adolescents) |1% |K-SADS Semi-Structured Interview |- |United States<ref>{{Cite journal|last=Judd|first=Lewis L.|last2=Akiskal|first2=Hagop S.|title=The prevalence and disability of bipolar spectrum disorders in the US population: re-analysis of the ECA database taking into account subthreshold cases|url=https://doi.org/10.1016/S0165-0327(02)00332-4|journal=Journal of Affective Disorders|volume=73|issue=1-2|pages=123–131|doi=10.1016/s0165-0327(02)00332-4}}</ref> |US National Epidemiological Catchment Area (ECA) database |0.8 - 5.1% (manic and subthreshold mania) |Diagnostic Interview Schedule (DIS) |- |United States<ref>{{Cite journal|last=Kessler|first=R. C.|last2=Rubinow|first2=D. R.|last3=Holmes|first3=C.|last4=Abelson|first4=J. M.|last5=Zhao|first5=S.|date=1997/09|title=The epidemiology of DSM-III-R bipolar I disorder in a general population survey|url=https://www.cambridge.org/core/journals/psychological-medicine/article/epidemiology-of-dsmiiir-bipolar-i-disorder-in-a-general-population-survey/950D518D15F64E2059F1033558615A9A|journal=Psychological Medicine|language=en|volume=27|issue=5|pages=1079–1089|issn=1469-8978}}</ref> |US National Comorbidity Survey (NCS) |0-4% (small community sample; reappraisal study) |World Health Organisation Composite International Diagnostic Interview |- |United States and other countries<ref>{{Cite book|url=https://www.worldcat.org/oclc/830807378|title=Diagnostic and statistical manual of mental disorders : DSM-5.|date=2013|publisher=American Psychiatric Association., American Psychiatric Association. DSM-5 Task Force.|isbn=9780890425541|edition=5th|location=Arlington, VA|oclc=830807378}}</ref> |Community sample |BPI - 0.6%; BPII-  1.8%;  Cyclothymia - 0.4-1% |Unspecified |- |United States, Europe, Asia<ref>{{Cite journal|last=Merikangas|first=Kathleen R.|last2=Jin|first2=Robert|last3=He|first3=Jian-Ping|last4=Kessler|first4=Ronald C.|last5=Lee|first5=Sing|last6=Sampson|first6=Nancy A.|last7=Viana|first7=Maria Carmen|last8=Andrade|first8=Laura Helena|last9=Hu|first9=Chiyi|date=2011-03-07|title=Prevalence and Correlates of Bipolar Spectrum Disorder in the World Mental Health Survey Initiative|url=http://archpsyc.jamanetwork.com/article.aspx?doi=10.1001/archgenpsychiatry.2011.12|journal=Archives of General Psychiatry|language=en|volume=68|issue=3|doi=10.1001/archgenpsychiatry.2011.12|issn=0003-990X}}</ref> |Community Samples |BPI - 0.6%; BPII - 0.4%; Subthreshold BP - 1.4%; Bipolar Spectrum Disorder - 2.4% |World Health Organisation Composite International Diagnostic Interview |- |United States<ref>{{Cite journal|last=Grant|first=Bridget F.|last2=Stinson|first2=Frederick S.|last3=Hasin|first3=Deborah S.|last4=Dawson|first4=Deborah A.|last5=Chou|first5=S. Patricia|last6=Ruan|first6=W. June|last7=Huang|first7=Boji|date=October 2005|title=Prevalence, correlates, and comorbidity of bipolar I disorder and axis I and II disorders: results from the National Epidemiologic Survey on Alcohol and Related Conditions|url=https://www.ncbi.nlm.nih.gov/pubmed/16259532|journal=The Journal of Clinical Psychiatry|volume=66|issue=10|pages=1205–1215|issn=0160-6689|pmid=16259532}}</ref> |National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) |BPI - 3.3% |The Alcohol Use Disorder and Associated Disabilities Interview Schedule-IV (AUDADIS-IV) |- |United States<ref>{{Cite journal|last=Das|first=Amar K.|date=2005-02-23|title=Screening for Bipolar Disorder in a Primary Care Practice|url=http://jama.jamanetwork.com/article.aspx?doi=10.1001/jama.293.8.956|journal=JAMA|language=en|volume=293|issue=8|doi=10.1001/jama.293.8.956|issn=0098-7484}}</ref> |Outpatient Clinic Sample |9.8% |Review of medical records, questionnaire data |- |United States<ref>{{cite journal|last1=Hirschfeld|first1=RM|last2=Cass|first2=AR|last3=Holt|first3=DC|last4=Carlson|first4=CA|date=2005|title=Screening for bipolar disorder in patients treated for depression in a family medicine clinic.|journal=The Journal of the American Board of Family Practice|volume=18|issue=4|pages=233-9|pmid=15994469}}</ref> |Outpatient Clinic Sample |21.3% |MDQ, SCID |} ==[[Evidence based assessment/Prediction phase|'''Prediction phase''']]== === Psychometric properties of screening instruments for adult bipolar disorder === The following section contains a list of screening and diagnostic instruments for adult bipolar disorder. The section includes administration information, psychometric data, and PDFs or links to the screenings. * Screenings are used as part of the [[Evidence based assessment/Prediction phase|prediction phase]] of assessment; for more information on interpretation of this data, or how screenings fit in to the assessment process, click [[Evidence based assessment/Prediction phase|here.]] * '''''For a list of more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Psychometric_properties_of_common_screening_instruments click here.]''''' {| class="wikitable" |- ! Measure !Format (Reporter) !Age Range !Administration/ Completion Time !Where to Access |- |[[wikipedia:General_Behavior_Inventory|GBI (General Behavior Inventory)]]<ref>{{Cite journal|date=2018-06|editor-last=Hunsley|editor-first=John|editor2-last=Mash|editor2-first=Eric J.|title=A Guide to Assessments That Work|url=http://dx.doi.org/10.1093/med-psych/9780190492243.001.0001|journal=Oxford Clinical Psychology|doi=10.1093/med-psych/9780190492243.001.0001}}</ref> |Self-report |Adult |15-20 minutes | * [https://mfr.osf.io/render?url=https://osf.io/j6rce/?action=download%26mode=render Downloadable PDF Self-Report English] * [https://mfr.osf.io/render?url=https://osf.io/27nwg/?action=download%26mode=render Scoring instructions and information] |- |[[wikipedia:Mood_Disorder_Questionnaire|MDQ (Mood Disorder Questionnaire)]]<ref name="Carvalho" /> |Self-report |Adult |5 minutes | * [https://mfr.osf.io/render?url=https://osf.io/sb5xw/?action=download%26mode=render Adult Self-Report (Long, English)] * [https://mfr.osf.io/render?url=https://osf.io/xa7v6/?action=download%26mode=render Adult Self-Report (Short, English)] * |- |[[wikipedia:Bipolar_Spectrum_Diagnostic_Scale|BSDS (Bipolar Spectrum Diagnostic Scale)]]<ref>{{Cite journal|date=2018-06|editor-last=Hunsley|editor-first=John|editor2-last=Mash|editor2-first=Eric J.|title=A Guide to Assessments That Work|url=http://dx.doi.org/10.1093/med-psych/9780190492243.001.0001|journal=Oxford Clinical Psychology|doi=10.1093/med-psych/9780190492243.001.0001}}</ref><ref name="Carvalho" /> |Self-report |Adult |15 minutes | * [http://psycheducation.org/diagnosis/the-bipolar-spectrum-diagnostic-scale/ Online version] * [https://mfr.osf.io/render?url=https://osf.io/w9qet/?action=download%26mode=render Downloadable PDF Version (English)] |- |[[wikipedia:Hypomania_Checklist|HCL-32 (Hypomania Checklist)]]<ref name="Carvalho" /><ref>{{Cite journal|last=Feng|first=Yuan|last2=Wang|first2=Yuan-Yuan|last3=Huang|first3=Wei|last4=Ungvari|first4=Gabor S.|last5=Ng|first5=Chee H.|last6=Wang|first6=Gang|last7=Yuan|first7=Zhen|last8=Xiang|first8=Yu-Tao|date=2017-06-01|title=Comparison of the 32-item Hypomania Checklist, the 33-item Hypomania Checklist, and the Mood Disorders Questionnaire for bipolar disorder|url=http://onlinelibrary.wiley.com/doi/10.1111/pcn.12506/abstract|journal=Psychiatry and Clinical Neurosciences|language=en|volume=71|issue=6|pages=403–408|doi=10.1111/pcn.12506|issn=1440-1819}}</ref> |Self-report |Adult |10-15 minutes | * [https://mfr.osf.io/render?url=https://osf.io/2veyc/?action=download%26mode=render Self-report] |} '''Note:''' '''L''' = Less than adequate; '''A''' = Adequate; '''G''' = Good; '''E''' = Excellent; '''U''' = Unavailable; '''NA''' = Not applicable === Likelihood ratios and AUCs of screening measures for bipolar disorder in adults === * '''''For a list of the likelihood ratios for more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Likelihood_ratios_and_AUCs_of_common_screening_instruments click here.]''''' {| class="wikitable sortable" !'''Screening Measure (Primary Reference)''' !'''Area Under Curve (AUC) and sample size''' !'''DiLR+ (score)''' !DiLR- (score) !'''Population''' |- |[[wikipedia:Bipolar_Spectrum_Diagnostic_Scale|BSDS (Bipolar Spectrum Diagnostic Scale)]] <ref name="Carvalho" /> |0.81 |(13) <ref name = Carvalho>{{cite journal|last1=Carvalho|first1=André F.|last2=Takwoingi|first2=Yemisi|last3=Sales|first3=Paulo Marcelo G.|last4=Soczynska|first4=Joanna K.|last5=Köhler|first5=Cristiano A.|last6=Freitas|first6=Thiago H.|last7=Quevedo|first7=João|last8=Hyphantis|first8=Thomas N.|last9=McIntyre|first9=Roger S.|last10=Vieta|first10=Eduard|title=Screening for bipolar spectrum disorders: A comprehensive meta-analysis of accuracy studies|journal=Journal of Affective Disorders|date=February 2015|volume=172|pages=337–346|doi=https://doi.org/10.1016/j.jad.2014.10.024}}</ref> |0.36 (4.93) |Clinical |- |[[wikipedia:Hypomania_Checklist|HCL-32 (Hypomania Checklist)]]<ref name="Carvalho" /> |0.80 |(14)<ref name="Carvalho" /> |0.28 (2.45) |Clinical |- |[[wikipedia:Mood_Disorder_Questionnaire|MDQ (Mood Disorder Questionnaire)]]<ref name="Carvalho" /> |0.78 |(7)<ref name="Carvalho" /> |0.22 (5.4) |Clinical |- |General Behavior Inventory (GBI) | | | | |} '''Note:''' Area Under Curve (AUC, or AUROC) is equal to the probability that a classifier will rank a randomly chosen positive diagnosis of Bipolar Disorder higher than a randomly chosen negative diagnosis of Bipolar Disorder[15]. ==[[Evidence based assessment/Prescription phase|'''Prescription phase''']]== ===Gold standard diagnostic interviews=== * For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews click here.] ===Recommended diagnostic interviews for adult bipolar disorder=== {| class="wikitable sortable" border="1" ! colspan="5" |Diagnostic instruments for BPSD |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time !Where to Access |- | Structured Clinical Interview for DSM-5 (SCID)<ref>{{Cite journal|last=Miller|first=Christopher J.|last2=Johnson|first2=Sheri L.|last3=Eisner|first3=Lori|date=2009-06|title=Assessment tools for adult bipolar disorder.|url=http://doi.apa.org/getdoi.cfm?doi=10.1111/j.1468-2850.2009.01158.x|journal=Clinical Psychology: Science and Practice|language=en|volume=16|issue=2|pages=188–201|doi=10.1111/j.1468-2850.2009.01158.x|issn=1468-2850|pmc=PMC2847794|pmid=20360999}}</ref><ref>{{Cite journal|date=2018-06|editor-last=Hunsley|editor-first=John|editor2-last=Mash|editor2-first=Eric J.|title=A Guide to Assessments That Work|url=http://dx.doi.org/10.1093/med-psych/9780190492243.001.0001|journal=Oxford Clinical Psychology|doi=10.1093/med-psych/9780190492243.001.0001}}</ref> | Semistructured interview | 18+ | 1-2 hours |Available for purchase from [https://www.appi.org/products/structured-clinical-interview-for-dsm-5-scid-5 APA Publishing] |- | Schedule for Affective Disorders and Schizophrenia (SADS)<ref>{{Cite journal|date=2018-06|editor-last=Hunsley|editor-first=John|editor2-last=Mash|editor2-first=Eric J.|title=A Guide to Assessments That Work|url=http://dx.doi.org/10.1093/med-psych/9780190492243.001.0001|journal=Oxford Clinical Psychology|doi=10.1093/med-psych/9780190492243.001.0001}}</ref><ref>{{Cite journal|last=Miller|first=Christopher J.|last2=Johnson|first2=Sheri L.|last3=Eisner|first3=Lori|date=2009-06|title=Assessment tools for adult bipolar disorder.|url=http://doi.apa.org/getdoi.cfm?doi=10.1111/j.1468-2850.2009.01158.x|journal=Clinical Psychology: Science and Practice|language=en|volume=16|issue=2|pages=188–201|doi=10.1111/j.1468-2850.2009.01158.x|issn=1468-2850|pmc=PMC2847794|pmid=20360999}}</ref><ref>{{Cite journal|last=Endicott|first=Jean|date=1978-07-01|title=A Diagnostic Interview: The Schedule for Affective Disorders and Schizophrenia|url=http://archpsyc.jamanetwork.com/article.aspx?doi=10.1001/archpsyc.1978.01770310043002|journal=Archives of General Psychiatry|language=en|volume=35|issue=7|pages=837|doi=10.1001/archpsyc.1978.01770310043002|issn=0003-990X}}</ref> | Semistructured interview | 18+ | 1-2 hours |[https://jamanetwork.com/journals/jamapsychiatry/article-abstract/491947 (Endicott & Spitzer, 1978)] |} ==[[Evidence based assessment/Process phase|'''Process phase''']]== === Treatment === * Please refer to the page on [https://en.wikipedia.org/wiki/Bipolar_disorder bipolar disorder] for more information on available treatment for bipolar disorder or go to the Effective Child Therapy pages for [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/severe-mood-swings-and-bipolar-spectrum-disorders/| Severe Mood Swings & Bipolar Spectrum Disorders] * [https://reacttoolkit.uk/ Relatives Education and Coping Toolkit (REACT)] is currently freely available at https://reacttoolkit.uk/. This is a resource/project of [https://www.lancaster.ac.uk/health-and-medicine/research/spectrum/ The Sprectrum Centre for Mental Health Research] from Lancaster University. A team of clinicians, researchers and relatives of people with psychosis or bipolar disorder at Lancaster, Liverpool and London have developed the Relatives Education and Coping Toolkit (REACT). REACT provides [https://www.nice.org.uk/ National Institute for Health and Care Excellence (NICE)] recommended information and support to relatives and friends of people with mental health problems associated with psychosis or bipolar disorder through a digital, peer-supported, self-management toolkit.<ref>Lobban, A. F., Robinson, H. A., Appelbe, D., Barraclough, J., Bedson, E., Collinge, E., Dodd, S., Flowers, S., Honary, M., Johnson, S., Caixeiro Mateus, M. D. C., Mezes, B., Minns, V., Murray, E., Walker, A. J., Williamson, P., Wintermeyer, C., & Jones, S. H. (2017). Protocol for an online randomised controlled trial to evaluate the clinical and cost-effectiveness of a peer-supported self-management intervention for relatives of people with psychosis or bipolar disorder: Relatives Education And Coping Toolkit (REACT). BMJ Open, 7, [016965]. <nowiki>https://doi.org/10.1136/bmjopen-2017-016965</nowiki></ref><ref>Lobban, F., Akers, N., Appelbe, D., Chapman, L., Collinge, L., Dodd, S., Flowers, S., Hollingsworth, B., Johnson, S., Jones, S. H., Mateus, C., Mezes, B., Murray, E., Panagaki, K., Rainford, N., Robinson, H., Rosala-Hallas, A., Sellwood, W., Walker, A., & Williamson, P. (2020). Clinical effectiveness of a web-based peer-supported self-management intervention for relatives of people with psychosis or bipolar (REACT): online, observer-blind, randomised controlled superiority trial. BMC Psychiatry, 20(1), [160]. <nowiki>https://doi.org/10.1186/s12888-020-02545-9</nowiki></ref><ref>{{Cite journal|last=F|first=Lobban|last2=N|first2=Akers|last3=D|first3=Appelbe|last4=R|first4=Iraci Capuccinello|last5=L|first5=Chapman|last6=L|first6=Collinge|last7=S|first7=Dodd|last8=S|first8=Flowers|last9=B|first9=Hollingsworth|date=2020-07-01|title=A web-based, peer-supported self-management intervention to reduce distress in relatives of people with psychosis or bipolar disorder: the REACT RCT|url=https://www.journalslibrary.nihr.ac.uk/hta/hta24320|journal=Health Technology Assessment|language=EN|volume=24|issue=32|doi=10.3310/hta24320|issn=2046-4924|pmc=PMC7355407|pmid=32608353}}</ref> ** The team at Spectrum Centre also conducted a study linked to REACT called IMPART which looked at what would happen if they tried to deliver REACT as part of routine clinical care in Early Intervention Teams in the [https://www.nhs.uk/ United Kingdom's National Health Service (NHS)]. This study identified key factors that impact implementation and may be useful for informing implementation plans for other digital health interventions.<ref>{{Cite journal|last=Lobban|first=Fiona|last2=Appelbe|first2=Duncan|last3=Appleton|first3=Victoria|last4=Billsborough|first4=Julie|last5=Fisher|first5=Naomi Ruth|last6=Foster|first6=Sheena|last7=Gill|first7=Bethany|last8=Glentworth|first8=David|last9=Harrop|first9=Chris|date=2020-03-17|title=IMPlementation of An online Relatives’ Toolkit for psychosis or bipolar (IMPART study): iterative multiple case study to identify key factors impacting on staff uptake and use|url=https://doi.org/10.1186/s12913-020-5002-4|journal=BMC Health Services Research|volume=20|issue=1|pages=219|doi=10.1186/s12913-020-5002-4|issn=1472-6963|pmc=PMC7077000|pmid=32183787}}</ref> ** '''[https://www.lancaster.ac.uk/health-and-medicine/research/spectrum/ RECOVERY TOOLKIT]''' #eRecoveryToolkit, #RecoveryBD, #PersonalRecovery is freely accessible at https://www.lancaster.ac.uk/health-and-medicine/research/spectrum/. Inspired from a greater body of work around recovery, people with lived experience of bipolar disorder and researchers at [https://www.lancaster.ac.uk/health-and-medicine/research/spectrum/ Spectrum Centre] have created a multi-media recovery toolkit. The aim of the toolkit is to provide accessible information and promote discussion around personal discovery in order to understand and aid people’s recovery journeys. The toolkit contains an animation, an e-booklet and video narratives of relatives and clinicians.<ref>Beck, A. K., Baker, A., Jones, S. H., Lobban, A. F., Kay-Lambkin, F., Attia, J., & Banfield, M. (2018). Exploring the feasibility and acceptability of a recovery-focused group therapy intervention for adults with bipolar disorder: trial protocol. BMJ Open, 8, [e019203]. <nowiki>https://doi.org/10.1136/bmjopen-2017-019203</nowiki></ref> {| cellspacing="0" style="width:238px;" | style="width:45px; height:45px; background:#d1f3f5; color:#49dae9; text-align:center;" vertical-align="center" align="center"| '''<span style="font-size:24pt;">t</span>''' | style="background:#b7eef0; color:black; font-size:8pt; padding:4pt; line-height:1.25em;"| This user tweets on '''[[w:Twitter|Twitter]]''' as [http://twitter.com/_REACTTOOLKIT REACTTOOLKIT]. |} == '''External resources''' == # [http://apps.who.int/classifications/icd10/browse/2015/en#/F31 ICD-10 diagnostic criteria] # [https://en.wikiversity.org/w/index.php?title=Helping_Give_Away_Psychological_Science/Resources/Annotated_List_of_Where_and_How_to_Find_a_Therapist&wteswitched=1#Other_low-cost_options Find-a-Therapist] (a curated list of find-a-therapist websites where you can find a provider) # OMIM (Online Mendelian Inheritance in Man) ## [http://omim.org/entry/125480 125480] ## [http://omim.org/entry/611536 611536] ## [http://omim.org/entry/309200 309200,] ## [http://omim.org/entry/611535 611535] ## [http://omim.org/entry/603663 603663] # [https://emedicine.medscape.com/article/286342-overview eMedicine information] # [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/severe-mood-swings-and-bipolar-spectrum-disorders/ Effective Child Therapy information on Bipolar Disorder] #*Effective Child Therapy is website sponsored by Division 53 of the American Psychological Association (APA), or [https://sccap53.org The Society of Clinical Child and Adolescent Psychology](SCCAP), in collaboration with the Association for Behavioral and Cognitive Therapies (ABCT). Use for information on symptoms and available treatments. # The Psych Show with Dr. Ali Mattu videos (geared towards public; might send to client) ##[https://www.youtube.com/watch?v=llOPqKD-s4w How to Cope with Bipolar Disorder] ## [https://www.youtube.com/watch?v=kUHUmeqBZAA Top 10 Bipolar Myths] == '''References''' == {{collapse top|Click here for references}} {{Reflist|30em}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] {{collapse bottom}} mh5ptx1wu5zjjur06jwy3lcnyp1ww1l 2419182 2419110 2022-08-26T02:01:03Z Ardenguo 2944162 /* References */ Made the references box expanded by default wikitext text/x-wiki <noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{medical disclaimer}} {{psychology}} {{Template:evidence-based assessment}} {{:{{BASEPAGENAME}}/Sidebar}} ==[[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio"?''']]== * For background information on what assessment portfolios are, click the link in the heading above. * Want even 'more' information about this topic? There's an extended version of this page [[Evidence-based assessment/Bipolar disorder in adults (assessment portfolio)/extended version|here]]. == [[Evidence based assessment/Preparation phase|'''Preparation phase''']] == === Diagnostic criteria for bipolar disorder in adults === Bipolar Disorder (BP) is characterized by extreme fluctuations in mood (or emotional dysregulation that ranges from mania (as shown by displays or feelings of extreme happiness, unrealistic overachievement and anger), to depression (as shown by displays or feelings of sadness, changes in appetite or weight and irritability.<ref name=":1" /> It has a lifetime risk of about 1%, with heritability estimated at up to 80%.<ref>{{Cite journal|last=Purcell|first=Shaun M.|last2=Wray|first2=Naomi R.|last3=Stone|first3=Jennifer L.|last4=Visscher|first4=Peter M.|last5=O'Donovan|first5=Michael C.|last6=Sullivan|first6=Patrick F.|last7=Sklar|first7=Pamela|last8=(Leader)|first8=Shaun M. Purcell|last9=Stone|first9=Jennifer L.|date=2009/08|title=Common polygenic variation contributes to risk of schizophrenia and bipolar disorder|url=http://www.nature.com/doifinder/10.1038/nature08185|journal=Nature|language=En|volume=460|issue=7256|doi=10.1038/nature08185|issn=1476-4687}}</ref> It is important to note that these moods exceed normal responses to life events, represent a change from the individual's normal functioning, and cause problems in daily activities. {{blockquotetop}} <big>'''ICD-11 Diagnostic Criteria'''</big> *Bipolar Type I Disorder **Bipolar type I disorder is an episodic mood disorder defined by the occurrence of one or more manic or mixed episodes. A manic episode is an extreme mood state lasting at least one week unless shortened by a treatment intervention characterized by euphoria, irritability, or expansiveness, and by increased activity or a subjective experience of increased energy, accompanied by other characteristic symptoms such as rapid or pressured speech, flight of ideas, increased self-esteem or grandiosity, decreased need for sleep, distractibility, impulsive or reckless behavior, and rapid changes among different mood states (i.e., mood lability). A mixed episode is characterized by either a mixture or very rapid alternation between prominent manic and depressive symptoms on most days during a period of at least 2 weeks. Although the diagnosis can be made based on evidence of a single manic or mixed episode, typically manic or mixed episodes alternate with depressive episodes over the course of the disorder. ***Note: The ICD-11 lists 18 additional subcategories of Bipolar type I disorder. They can be found [https://icd.who.int/browse11/l-m/en#/http://id.who.int/icd/entity/1456478153 here]. *Bipolar Type II Disorder **Bipolar type II disorder is an episodic mood disorder defined by the occurrence of one or more hypomanic episodes and at least one depressive episode. A hypomanic episode is a persistent mood state characterized by euphoria, irritability, or expansiveness, and excessive psychomotor activation or increased energy, accompanied by other characteristic symptoms such as grandiosity, decreased need for sleep, pressured speech, flight of ideas, distractibility, and impulsive or reckless behavior lasting for at least several days. The symptoms represent a change from the individual’s typical behavior and are not severe enough to cause marked impairment in functioning. A depressive episode is characterized by a period of almost daily depressed mood or diminished interest in activities lasting at least 2 weeks accompanied by other symptoms such as changes in appetite or sleep, psychomotor agitation or retardation, fatigue, feelings of worthless or excessive or inappropriate guilt, feelings or hopelessness, difficulty concentrating, and suicidality. There is no history of manic or mixed Episodes. ***Note: The ICD-11 lists 13 additional subcategories of Bipolar type II disorder. They can be found [https://icd.who.int/browse11/l-m/en#/http%3a%2f%2fid.who.int%2ficd%2fentity%2f199053300 here]. '''Changes in DSM-5''' * The diagnostic criteria for '''Bipolar Disorder''' changed slightly from [[DSM-IV]] to [[w:Diagnostic_and_Statistical_Manual_of_Mental_Disorders#DSM-IV-TR_.282000.29|DSM-5]]. Summaries are available [http://www.dsm5.org/Documents/changes%20from%20dsm-iv-tr%20to%20dsm-5.pdf here] and [[w:DSM-5|here]]. {{blockquotebottom}} === Base rates of BD in different clinical settings and populations === This section describes the demographic setting of the population(s) sampled, base rates of diagnosis, country/region sampled, and the diagnostic method that was used. Using this information, clinicians will be able to anchor the rate of adolescent depression that they are likely to see in their clinical practice. * '''''To see prevalence rates across multiple disorders,''''' [[Evidence based assessment/Preparation phase#Base rates for transdiagnostic comparison|'''''click here.''''']] {| class="wikitable" |'''Demography''' |'''Setting''' |'''Base Rate''' |'''Diagnostic Method''' |- |United States, Canada, Puerto Rico, Germany, Taiwan, Korea, New Zealand <ref>{{Cite journal|last=Weissman|first=Myrna M.|last2=Bland|first2=Roger C.|last3=Canino|first3=Glorisa J.|last4=Faravelli|first4=Carlo|last5=Greenwald|first5=Steven|last6=Hwu|first6=Hai-Gwo|last7=Joyce|first7=Peter R.|last8=Karam|first8=Eile G.|last9=Lee|first9=Chung-Kyoon|date=1996-07-24|title=Cross-National Epidemiology of Major Depression and Bipolar Disorder|url=https://doi.org/10.1001/jama.1996.03540040037030|journal=JAMA|volume=276|issue=4|pages=293–299|doi=10.1001/jama.1996.03540040037030|issn=0098-7484}}</ref> |Community Epidemiological Samples |0.3 - 1.5% |Structured and semi-structured diagnostic interviews |- |United States<ref>{{Cite journal|last=Merikangas|first=Kathleen R.|last2=Akiskal|first2=Hagop S.|last3=Angst|first3=Jules|last4=Greenberg|first4=Paul E.|last5=Hirschfeld|first5=Robert M. A.|last6=Petukhova|first6=Maria|last7=Kessler|first7=Ronald C.|date=2007-05-01|title=Lifetime and 12-Month Prevalence of Bipolar Spectrum Disorder in the National Comorbidity Survey Replication|url=https://jamanetwork.com/journals/jamapsychiatry/fullarticle/482285|journal=Archives of General Psychiatry|language=en|volume=64|issue=5|pages=543–552|doi=10.1001/archpsyc.64.5.543|issn=0003-990X}}</ref> |Community Epidemiological Samples |BPI - 1%; BPII - 1.1%; Subthreshold BP - 2.4% |World Health Organisation Composite International Diagnostic Interview |- |United States<ref>{{Cite journal|last=LEWINSOHN|first=PETER M.|last2=KLEIN|first2=DANIEL N.|last3=SEELEY|first3=JOHN R.|title=Bipolar Disorders in a Community Sample of Older Adolescents: Prevalence, Phenomenology, Comorbidity, and Course|url=http://linkinghub.elsevier.com/retrieve/pii/S089085670963731X|journal=Journal of the American Academy of Child & Adolescent Psychiatry|volume=34|issue=4|pages=454–463|doi=10.1097/00004583-199504000-00012}}</ref> |Community samples (older adolescents) |1% |K-SADS Semi-Structured Interview |- |United States<ref>{{Cite journal|last=Judd|first=Lewis L.|last2=Akiskal|first2=Hagop S.|title=The prevalence and disability of bipolar spectrum disorders in the US population: re-analysis of the ECA database taking into account subthreshold cases|url=https://doi.org/10.1016/S0165-0327(02)00332-4|journal=Journal of Affective Disorders|volume=73|issue=1-2|pages=123–131|doi=10.1016/s0165-0327(02)00332-4}}</ref> |US National Epidemiological Catchment Area (ECA) database |0.8 - 5.1% (manic and subthreshold mania) |Diagnostic Interview Schedule (DIS) |- |United States<ref>{{Cite journal|last=Kessler|first=R. C.|last2=Rubinow|first2=D. R.|last3=Holmes|first3=C.|last4=Abelson|first4=J. M.|last5=Zhao|first5=S.|date=1997/09|title=The epidemiology of DSM-III-R bipolar I disorder in a general population survey|url=https://www.cambridge.org/core/journals/psychological-medicine/article/epidemiology-of-dsmiiir-bipolar-i-disorder-in-a-general-population-survey/950D518D15F64E2059F1033558615A9A|journal=Psychological Medicine|language=en|volume=27|issue=5|pages=1079–1089|issn=1469-8978}}</ref> |US National Comorbidity Survey (NCS) |0-4% (small community sample; reappraisal study) |World Health Organisation Composite International Diagnostic Interview |- |United States and other countries<ref>{{Cite book|url=https://www.worldcat.org/oclc/830807378|title=Diagnostic and statistical manual of mental disorders : DSM-5.|date=2013|publisher=American Psychiatric Association., American Psychiatric Association. DSM-5 Task Force.|isbn=9780890425541|edition=5th|location=Arlington, VA|oclc=830807378}}</ref> |Community sample |BPI - 0.6%; BPII-  1.8%;  Cyclothymia - 0.4-1% |Unspecified |- |United States, Europe, Asia<ref>{{Cite journal|last=Merikangas|first=Kathleen R.|last2=Jin|first2=Robert|last3=He|first3=Jian-Ping|last4=Kessler|first4=Ronald C.|last5=Lee|first5=Sing|last6=Sampson|first6=Nancy A.|last7=Viana|first7=Maria Carmen|last8=Andrade|first8=Laura Helena|last9=Hu|first9=Chiyi|date=2011-03-07|title=Prevalence and Correlates of Bipolar Spectrum Disorder in the World Mental Health Survey Initiative|url=http://archpsyc.jamanetwork.com/article.aspx?doi=10.1001/archgenpsychiatry.2011.12|journal=Archives of General Psychiatry|language=en|volume=68|issue=3|doi=10.1001/archgenpsychiatry.2011.12|issn=0003-990X}}</ref> |Community Samples |BPI - 0.6%; BPII - 0.4%; Subthreshold BP - 1.4%; Bipolar Spectrum Disorder - 2.4% |World Health Organisation Composite International Diagnostic Interview |- |United States<ref>{{Cite journal|last=Grant|first=Bridget F.|last2=Stinson|first2=Frederick S.|last3=Hasin|first3=Deborah S.|last4=Dawson|first4=Deborah A.|last5=Chou|first5=S. Patricia|last6=Ruan|first6=W. June|last7=Huang|first7=Boji|date=October 2005|title=Prevalence, correlates, and comorbidity of bipolar I disorder and axis I and II disorders: results from the National Epidemiologic Survey on Alcohol and Related Conditions|url=https://www.ncbi.nlm.nih.gov/pubmed/16259532|journal=The Journal of Clinical Psychiatry|volume=66|issue=10|pages=1205–1215|issn=0160-6689|pmid=16259532}}</ref> |National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) |BPI - 3.3% |The Alcohol Use Disorder and Associated Disabilities Interview Schedule-IV (AUDADIS-IV) |- |United States<ref>{{Cite journal|last=Das|first=Amar K.|date=2005-02-23|title=Screening for Bipolar Disorder in a Primary Care Practice|url=http://jama.jamanetwork.com/article.aspx?doi=10.1001/jama.293.8.956|journal=JAMA|language=en|volume=293|issue=8|doi=10.1001/jama.293.8.956|issn=0098-7484}}</ref> |Outpatient Clinic Sample |9.8% |Review of medical records, questionnaire data |- |United States<ref>{{cite journal|last1=Hirschfeld|first1=RM|last2=Cass|first2=AR|last3=Holt|first3=DC|last4=Carlson|first4=CA|date=2005|title=Screening for bipolar disorder in patients treated for depression in a family medicine clinic.|journal=The Journal of the American Board of Family Practice|volume=18|issue=4|pages=233-9|pmid=15994469}}</ref> |Outpatient Clinic Sample |21.3% |MDQ, SCID |} ==[[Evidence based assessment/Prediction phase|'''Prediction phase''']]== === Psychometric properties of screening instruments for adult bipolar disorder === The following section contains a list of screening and diagnostic instruments for adult bipolar disorder. The section includes administration information, psychometric data, and PDFs or links to the screenings. * Screenings are used as part of the [[Evidence based assessment/Prediction phase|prediction phase]] of assessment; for more information on interpretation of this data, or how screenings fit in to the assessment process, click [[Evidence based assessment/Prediction phase|here.]] * '''''For a list of more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Psychometric_properties_of_common_screening_instruments click here.]''''' {| class="wikitable" |- ! Measure !Format (Reporter) !Age Range !Administration/ Completion Time !Where to Access |- |[[wikipedia:General_Behavior_Inventory|GBI (General Behavior Inventory)]]<ref>{{Cite journal|date=2018-06|editor-last=Hunsley|editor-first=John|editor2-last=Mash|editor2-first=Eric J.|title=A Guide to Assessments That Work|url=http://dx.doi.org/10.1093/med-psych/9780190492243.001.0001|journal=Oxford Clinical Psychology|doi=10.1093/med-psych/9780190492243.001.0001}}</ref> |Self-report |Adult |15-20 minutes | * [https://mfr.osf.io/render?url=https://osf.io/j6rce/?action=download%26mode=render Downloadable PDF Self-Report English] * [https://mfr.osf.io/render?url=https://osf.io/27nwg/?action=download%26mode=render Scoring instructions and information] |- |[[wikipedia:Mood_Disorder_Questionnaire|MDQ (Mood Disorder Questionnaire)]]<ref name="Carvalho" /> |Self-report |Adult |5 minutes | * [https://mfr.osf.io/render?url=https://osf.io/sb5xw/?action=download%26mode=render Adult Self-Report (Long, English)] * [https://mfr.osf.io/render?url=https://osf.io/xa7v6/?action=download%26mode=render Adult Self-Report (Short, English)] * |- |[[wikipedia:Bipolar_Spectrum_Diagnostic_Scale|BSDS (Bipolar Spectrum Diagnostic Scale)]]<ref>{{Cite journal|date=2018-06|editor-last=Hunsley|editor-first=John|editor2-last=Mash|editor2-first=Eric J.|title=A Guide to Assessments That Work|url=http://dx.doi.org/10.1093/med-psych/9780190492243.001.0001|journal=Oxford Clinical Psychology|doi=10.1093/med-psych/9780190492243.001.0001}}</ref><ref name="Carvalho" /> |Self-report |Adult |15 minutes | * [http://psycheducation.org/diagnosis/the-bipolar-spectrum-diagnostic-scale/ Online version] * [https://mfr.osf.io/render?url=https://osf.io/w9qet/?action=download%26mode=render Downloadable PDF Version (English)] |- |[[wikipedia:Hypomania_Checklist|HCL-32 (Hypomania Checklist)]]<ref name="Carvalho" /><ref>{{Cite journal|last=Feng|first=Yuan|last2=Wang|first2=Yuan-Yuan|last3=Huang|first3=Wei|last4=Ungvari|first4=Gabor S.|last5=Ng|first5=Chee H.|last6=Wang|first6=Gang|last7=Yuan|first7=Zhen|last8=Xiang|first8=Yu-Tao|date=2017-06-01|title=Comparison of the 32-item Hypomania Checklist, the 33-item Hypomania Checklist, and the Mood Disorders Questionnaire for bipolar disorder|url=http://onlinelibrary.wiley.com/doi/10.1111/pcn.12506/abstract|journal=Psychiatry and Clinical Neurosciences|language=en|volume=71|issue=6|pages=403–408|doi=10.1111/pcn.12506|issn=1440-1819}}</ref> |Self-report |Adult |10-15 minutes | * [https://mfr.osf.io/render?url=https://osf.io/2veyc/?action=download%26mode=render Self-report] |} '''Note:''' '''L''' = Less than adequate; '''A''' = Adequate; '''G''' = Good; '''E''' = Excellent; '''U''' = Unavailable; '''NA''' = Not applicable === Likelihood ratios and AUCs of screening measures for bipolar disorder in adults === * '''''For a list of the likelihood ratios for more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Likelihood_ratios_and_AUCs_of_common_screening_instruments click here.]''''' {| class="wikitable sortable" !'''Screening Measure (Primary Reference)''' !'''Area Under Curve (AUC) and sample size''' !'''DiLR+ (score)''' !DiLR- (score) !'''Population''' |- |[[wikipedia:Bipolar_Spectrum_Diagnostic_Scale|BSDS (Bipolar Spectrum Diagnostic Scale)]] <ref name="Carvalho" /> |0.81 |(13) <ref name = Carvalho>{{cite journal|last1=Carvalho|first1=André F.|last2=Takwoingi|first2=Yemisi|last3=Sales|first3=Paulo Marcelo G.|last4=Soczynska|first4=Joanna K.|last5=Köhler|first5=Cristiano A.|last6=Freitas|first6=Thiago H.|last7=Quevedo|first7=João|last8=Hyphantis|first8=Thomas N.|last9=McIntyre|first9=Roger S.|last10=Vieta|first10=Eduard|title=Screening for bipolar spectrum disorders: A comprehensive meta-analysis of accuracy studies|journal=Journal of Affective Disorders|date=February 2015|volume=172|pages=337–346|doi=https://doi.org/10.1016/j.jad.2014.10.024}}</ref> |0.36 (4.93) |Clinical |- |[[wikipedia:Hypomania_Checklist|HCL-32 (Hypomania Checklist)]]<ref name="Carvalho" /> |0.80 |(14)<ref name="Carvalho" /> |0.28 (2.45) |Clinical |- |[[wikipedia:Mood_Disorder_Questionnaire|MDQ (Mood Disorder Questionnaire)]]<ref name="Carvalho" /> |0.78 |(7)<ref name="Carvalho" /> |0.22 (5.4) |Clinical |- |General Behavior Inventory (GBI) | | | | |} '''Note:''' Area Under Curve (AUC, or AUROC) is equal to the probability that a classifier will rank a randomly chosen positive diagnosis of Bipolar Disorder higher than a randomly chosen negative diagnosis of Bipolar Disorder[15]. ==[[Evidence based assessment/Prescription phase|'''Prescription phase''']]== ===Gold standard diagnostic interviews=== * For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews click here.] ===Recommended diagnostic interviews for adult bipolar disorder=== {| class="wikitable sortable" border="1" ! colspan="5" |Diagnostic instruments for BPSD |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time !Where to Access |- | Structured Clinical Interview for DSM-5 (SCID)<ref>{{Cite journal|last=Miller|first=Christopher J.|last2=Johnson|first2=Sheri L.|last3=Eisner|first3=Lori|date=2009-06|title=Assessment tools for adult bipolar disorder.|url=http://doi.apa.org/getdoi.cfm?doi=10.1111/j.1468-2850.2009.01158.x|journal=Clinical Psychology: Science and Practice|language=en|volume=16|issue=2|pages=188–201|doi=10.1111/j.1468-2850.2009.01158.x|issn=1468-2850|pmc=PMC2847794|pmid=20360999}}</ref><ref>{{Cite journal|date=2018-06|editor-last=Hunsley|editor-first=John|editor2-last=Mash|editor2-first=Eric J.|title=A Guide to Assessments That Work|url=http://dx.doi.org/10.1093/med-psych/9780190492243.001.0001|journal=Oxford Clinical Psychology|doi=10.1093/med-psych/9780190492243.001.0001}}</ref> | Semistructured interview | 18+ | 1-2 hours |Available for purchase from [https://www.appi.org/products/structured-clinical-interview-for-dsm-5-scid-5 APA Publishing] |- | Schedule for Affective Disorders and Schizophrenia (SADS)<ref>{{Cite journal|date=2018-06|editor-last=Hunsley|editor-first=John|editor2-last=Mash|editor2-first=Eric J.|title=A Guide to Assessments That Work|url=http://dx.doi.org/10.1093/med-psych/9780190492243.001.0001|journal=Oxford Clinical Psychology|doi=10.1093/med-psych/9780190492243.001.0001}}</ref><ref>{{Cite journal|last=Miller|first=Christopher J.|last2=Johnson|first2=Sheri L.|last3=Eisner|first3=Lori|date=2009-06|title=Assessment tools for adult bipolar disorder.|url=http://doi.apa.org/getdoi.cfm?doi=10.1111/j.1468-2850.2009.01158.x|journal=Clinical Psychology: Science and Practice|language=en|volume=16|issue=2|pages=188–201|doi=10.1111/j.1468-2850.2009.01158.x|issn=1468-2850|pmc=PMC2847794|pmid=20360999}}</ref><ref>{{Cite journal|last=Endicott|first=Jean|date=1978-07-01|title=A Diagnostic Interview: The Schedule for Affective Disorders and Schizophrenia|url=http://archpsyc.jamanetwork.com/article.aspx?doi=10.1001/archpsyc.1978.01770310043002|journal=Archives of General Psychiatry|language=en|volume=35|issue=7|pages=837|doi=10.1001/archpsyc.1978.01770310043002|issn=0003-990X}}</ref> | Semistructured interview | 18+ | 1-2 hours |[https://jamanetwork.com/journals/jamapsychiatry/article-abstract/491947 (Endicott & Spitzer, 1978)] |} ==[[Evidence based assessment/Process phase|'''Process phase''']]== === Treatment === * Please refer to the page on [https://en.wikipedia.org/wiki/Bipolar_disorder bipolar disorder] for more information on available treatment for bipolar disorder or go to the Effective Child Therapy pages for [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/severe-mood-swings-and-bipolar-spectrum-disorders/| Severe Mood Swings & Bipolar Spectrum Disorders] * [https://reacttoolkit.uk/ Relatives Education and Coping Toolkit (REACT)] is currently freely available at https://reacttoolkit.uk/. This is a resource/project of [https://www.lancaster.ac.uk/health-and-medicine/research/spectrum/ The Sprectrum Centre for Mental Health Research] from Lancaster University. A team of clinicians, researchers and relatives of people with psychosis or bipolar disorder at Lancaster, Liverpool and London have developed the Relatives Education and Coping Toolkit (REACT). REACT provides [https://www.nice.org.uk/ National Institute for Health and Care Excellence (NICE)] recommended information and support to relatives and friends of people with mental health problems associated with psychosis or bipolar disorder through a digital, peer-supported, self-management toolkit.<ref>Lobban, A. F., Robinson, H. A., Appelbe, D., Barraclough, J., Bedson, E., Collinge, E., Dodd, S., Flowers, S., Honary, M., Johnson, S., Caixeiro Mateus, M. D. C., Mezes, B., Minns, V., Murray, E., Walker, A. J., Williamson, P., Wintermeyer, C., & Jones, S. H. (2017). Protocol for an online randomised controlled trial to evaluate the clinical and cost-effectiveness of a peer-supported self-management intervention for relatives of people with psychosis or bipolar disorder: Relatives Education And Coping Toolkit (REACT). BMJ Open, 7, [016965]. <nowiki>https://doi.org/10.1136/bmjopen-2017-016965</nowiki></ref><ref>Lobban, F., Akers, N., Appelbe, D., Chapman, L., Collinge, L., Dodd, S., Flowers, S., Hollingsworth, B., Johnson, S., Jones, S. H., Mateus, C., Mezes, B., Murray, E., Panagaki, K., Rainford, N., Robinson, H., Rosala-Hallas, A., Sellwood, W., Walker, A., & Williamson, P. (2020). Clinical effectiveness of a web-based peer-supported self-management intervention for relatives of people with psychosis or bipolar (REACT): online, observer-blind, randomised controlled superiority trial. BMC Psychiatry, 20(1), [160]. <nowiki>https://doi.org/10.1186/s12888-020-02545-9</nowiki></ref><ref>{{Cite journal|last=F|first=Lobban|last2=N|first2=Akers|last3=D|first3=Appelbe|last4=R|first4=Iraci Capuccinello|last5=L|first5=Chapman|last6=L|first6=Collinge|last7=S|first7=Dodd|last8=S|first8=Flowers|last9=B|first9=Hollingsworth|date=2020-07-01|title=A web-based, peer-supported self-management intervention to reduce distress in relatives of people with psychosis or bipolar disorder: the REACT RCT|url=https://www.journalslibrary.nihr.ac.uk/hta/hta24320|journal=Health Technology Assessment|language=EN|volume=24|issue=32|doi=10.3310/hta24320|issn=2046-4924|pmc=PMC7355407|pmid=32608353}}</ref> ** The team at Spectrum Centre also conducted a study linked to REACT called IMPART which looked at what would happen if they tried to deliver REACT as part of routine clinical care in Early Intervention Teams in the [https://www.nhs.uk/ United Kingdom's National Health Service (NHS)]. This study identified key factors that impact implementation and may be useful for informing implementation plans for other digital health interventions.<ref>{{Cite journal|last=Lobban|first=Fiona|last2=Appelbe|first2=Duncan|last3=Appleton|first3=Victoria|last4=Billsborough|first4=Julie|last5=Fisher|first5=Naomi Ruth|last6=Foster|first6=Sheena|last7=Gill|first7=Bethany|last8=Glentworth|first8=David|last9=Harrop|first9=Chris|date=2020-03-17|title=IMPlementation of An online Relatives’ Toolkit for psychosis or bipolar (IMPART study): iterative multiple case study to identify key factors impacting on staff uptake and use|url=https://doi.org/10.1186/s12913-020-5002-4|journal=BMC Health Services Research|volume=20|issue=1|pages=219|doi=10.1186/s12913-020-5002-4|issn=1472-6963|pmc=PMC7077000|pmid=32183787}}</ref> ** '''[https://www.lancaster.ac.uk/health-and-medicine/research/spectrum/ RECOVERY TOOLKIT]''' #eRecoveryToolkit, #RecoveryBD, #PersonalRecovery is freely accessible at https://www.lancaster.ac.uk/health-and-medicine/research/spectrum/. Inspired from a greater body of work around recovery, people with lived experience of bipolar disorder and researchers at [https://www.lancaster.ac.uk/health-and-medicine/research/spectrum/ Spectrum Centre] have created a multi-media recovery toolkit. The aim of the toolkit is to provide accessible information and promote discussion around personal discovery in order to understand and aid people’s recovery journeys. The toolkit contains an animation, an e-booklet and video narratives of relatives and clinicians.<ref>Beck, A. K., Baker, A., Jones, S. H., Lobban, A. F., Kay-Lambkin, F., Attia, J., & Banfield, M. (2018). Exploring the feasibility and acceptability of a recovery-focused group therapy intervention for adults with bipolar disorder: trial protocol. BMJ Open, 8, [e019203]. <nowiki>https://doi.org/10.1136/bmjopen-2017-019203</nowiki></ref> {| cellspacing="0" style="width:238px;" | style="width:45px; height:45px; background:#d1f3f5; color:#49dae9; text-align:center;" vertical-align="center" align="center"| '''<span style="font-size:24pt;">t</span>''' | style="background:#b7eef0; color:black; font-size:8pt; padding:4pt; line-height:1.25em;"| This user tweets on '''[[w:Twitter|Twitter]]''' as [http://twitter.com/_REACTTOOLKIT REACTTOOLKIT]. |} == '''External resources''' == # [http://apps.who.int/classifications/icd10/browse/2015/en#/F31 ICD-10 diagnostic criteria] # [https://en.wikiversity.org/w/index.php?title=Helping_Give_Away_Psychological_Science/Resources/Annotated_List_of_Where_and_How_to_Find_a_Therapist&wteswitched=1#Other_low-cost_options Find-a-Therapist] (a curated list of find-a-therapist websites where you can find a provider) # OMIM (Online Mendelian Inheritance in Man) ## [http://omim.org/entry/125480 125480] ## [http://omim.org/entry/611536 611536] ## [http://omim.org/entry/309200 309200,] ## [http://omim.org/entry/611535 611535] ## [http://omim.org/entry/603663 603663] # [https://emedicine.medscape.com/article/286342-overview eMedicine information] # [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/severe-mood-swings-and-bipolar-spectrum-disorders/ Effective Child Therapy information on Bipolar Disorder] #*Effective Child Therapy is website sponsored by Division 53 of the American Psychological Association (APA), or [https://sccap53.org The Society of Clinical Child and Adolescent Psychology](SCCAP), in collaboration with the Association for Behavioral and Cognitive Therapies (ABCT). Use for information on symptoms and available treatments. # The Psych Show with Dr. Ali Mattu videos (geared towards public; might send to client) ##[https://www.youtube.com/watch?v=llOPqKD-s4w How to Cope with Bipolar Disorder] ## [https://www.youtube.com/watch?v=kUHUmeqBZAA Top 10 Bipolar Myths] == '''References''' == {{collapse top|References|expand=yes}} {{Reflist|30em}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] {{collapse bottom}} cbzyanb1kk1289xv917wqkuc3viwap1 2419183 2419182 2022-08-26T02:01:40Z Ardenguo 2944162 Undo revision 2419182 by [[Special:Contributions/Ardenguo|Ardenguo]] ([[User talk:Ardenguo|talk]]) wikitext text/x-wiki <noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{medical disclaimer}} {{psychology}} {{Template:evidence-based assessment}} {{:{{BASEPAGENAME}}/Sidebar}} ==[[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio"?''']]== * For background information on what assessment portfolios are, click the link in the heading above. * Want even 'more' information about this topic? There's an extended version of this page [[Evidence-based assessment/Bipolar disorder in adults (assessment portfolio)/extended version|here]]. == [[Evidence based assessment/Preparation phase|'''Preparation phase''']] == === Diagnostic criteria for bipolar disorder in adults === Bipolar Disorder (BP) is characterized by extreme fluctuations in mood (or emotional dysregulation that ranges from mania (as shown by displays or feelings of extreme happiness, unrealistic overachievement and anger), to depression (as shown by displays or feelings of sadness, changes in appetite or weight and irritability.<ref name=":1" /> It has a lifetime risk of about 1%, with heritability estimated at up to 80%.<ref>{{Cite journal|last=Purcell|first=Shaun M.|last2=Wray|first2=Naomi R.|last3=Stone|first3=Jennifer L.|last4=Visscher|first4=Peter M.|last5=O'Donovan|first5=Michael C.|last6=Sullivan|first6=Patrick F.|last7=Sklar|first7=Pamela|last8=(Leader)|first8=Shaun M. Purcell|last9=Stone|first9=Jennifer L.|date=2009/08|title=Common polygenic variation contributes to risk of schizophrenia and bipolar disorder|url=http://www.nature.com/doifinder/10.1038/nature08185|journal=Nature|language=En|volume=460|issue=7256|doi=10.1038/nature08185|issn=1476-4687}}</ref> It is important to note that these moods exceed normal responses to life events, represent a change from the individual's normal functioning, and cause problems in daily activities. {{blockquotetop}} <big>'''ICD-11 Diagnostic Criteria'''</big> *Bipolar Type I Disorder **Bipolar type I disorder is an episodic mood disorder defined by the occurrence of one or more manic or mixed episodes. A manic episode is an extreme mood state lasting at least one week unless shortened by a treatment intervention characterized by euphoria, irritability, or expansiveness, and by increased activity or a subjective experience of increased energy, accompanied by other characteristic symptoms such as rapid or pressured speech, flight of ideas, increased self-esteem or grandiosity, decreased need for sleep, distractibility, impulsive or reckless behavior, and rapid changes among different mood states (i.e., mood lability). A mixed episode is characterized by either a mixture or very rapid alternation between prominent manic and depressive symptoms on most days during a period of at least 2 weeks. Although the diagnosis can be made based on evidence of a single manic or mixed episode, typically manic or mixed episodes alternate with depressive episodes over the course of the disorder. ***Note: The ICD-11 lists 18 additional subcategories of Bipolar type I disorder. They can be found [https://icd.who.int/browse11/l-m/en#/http://id.who.int/icd/entity/1456478153 here]. *Bipolar Type II Disorder **Bipolar type II disorder is an episodic mood disorder defined by the occurrence of one or more hypomanic episodes and at least one depressive episode. A hypomanic episode is a persistent mood state characterized by euphoria, irritability, or expansiveness, and excessive psychomotor activation or increased energy, accompanied by other characteristic symptoms such as grandiosity, decreased need for sleep, pressured speech, flight of ideas, distractibility, and impulsive or reckless behavior lasting for at least several days. The symptoms represent a change from the individual’s typical behavior and are not severe enough to cause marked impairment in functioning. A depressive episode is characterized by a period of almost daily depressed mood or diminished interest in activities lasting at least 2 weeks accompanied by other symptoms such as changes in appetite or sleep, psychomotor agitation or retardation, fatigue, feelings of worthless or excessive or inappropriate guilt, feelings or hopelessness, difficulty concentrating, and suicidality. There is no history of manic or mixed Episodes. ***Note: The ICD-11 lists 13 additional subcategories of Bipolar type II disorder. They can be found [https://icd.who.int/browse11/l-m/en#/http%3a%2f%2fid.who.int%2ficd%2fentity%2f199053300 here]. '''Changes in DSM-5''' * The diagnostic criteria for '''Bipolar Disorder''' changed slightly from [[DSM-IV]] to [[w:Diagnostic_and_Statistical_Manual_of_Mental_Disorders#DSM-IV-TR_.282000.29|DSM-5]]. Summaries are available [http://www.dsm5.org/Documents/changes%20from%20dsm-iv-tr%20to%20dsm-5.pdf here] and [[w:DSM-5|here]]. {{blockquotebottom}} === Base rates of BD in different clinical settings and populations === This section describes the demographic setting of the population(s) sampled, base rates of diagnosis, country/region sampled, and the diagnostic method that was used. Using this information, clinicians will be able to anchor the rate of adolescent depression that they are likely to see in their clinical practice. * '''''To see prevalence rates across multiple disorders,''''' [[Evidence based assessment/Preparation phase#Base rates for transdiagnostic comparison|'''''click here.''''']] {| class="wikitable" |'''Demography''' |'''Setting''' |'''Base Rate''' |'''Diagnostic Method''' |- |United States, Canada, Puerto Rico, Germany, Taiwan, Korea, New Zealand <ref>{{Cite journal|last=Weissman|first=Myrna M.|last2=Bland|first2=Roger C.|last3=Canino|first3=Glorisa J.|last4=Faravelli|first4=Carlo|last5=Greenwald|first5=Steven|last6=Hwu|first6=Hai-Gwo|last7=Joyce|first7=Peter R.|last8=Karam|first8=Eile G.|last9=Lee|first9=Chung-Kyoon|date=1996-07-24|title=Cross-National Epidemiology of Major Depression and Bipolar Disorder|url=https://doi.org/10.1001/jama.1996.03540040037030|journal=JAMA|volume=276|issue=4|pages=293–299|doi=10.1001/jama.1996.03540040037030|issn=0098-7484}}</ref> |Community Epidemiological Samples |0.3 - 1.5% |Structured and semi-structured diagnostic interviews |- |United States<ref>{{Cite journal|last=Merikangas|first=Kathleen R.|last2=Akiskal|first2=Hagop S.|last3=Angst|first3=Jules|last4=Greenberg|first4=Paul E.|last5=Hirschfeld|first5=Robert M. A.|last6=Petukhova|first6=Maria|last7=Kessler|first7=Ronald C.|date=2007-05-01|title=Lifetime and 12-Month Prevalence of Bipolar Spectrum Disorder in the National Comorbidity Survey Replication|url=https://jamanetwork.com/journals/jamapsychiatry/fullarticle/482285|journal=Archives of General Psychiatry|language=en|volume=64|issue=5|pages=543–552|doi=10.1001/archpsyc.64.5.543|issn=0003-990X}}</ref> |Community Epidemiological Samples |BPI - 1%; BPII - 1.1%; Subthreshold BP - 2.4% |World Health Organisation Composite International Diagnostic Interview |- |United States<ref>{{Cite journal|last=LEWINSOHN|first=PETER M.|last2=KLEIN|first2=DANIEL N.|last3=SEELEY|first3=JOHN R.|title=Bipolar Disorders in a Community Sample of Older Adolescents: Prevalence, Phenomenology, Comorbidity, and Course|url=http://linkinghub.elsevier.com/retrieve/pii/S089085670963731X|journal=Journal of the American Academy of Child & Adolescent Psychiatry|volume=34|issue=4|pages=454–463|doi=10.1097/00004583-199504000-00012}}</ref> |Community samples (older adolescents) |1% |K-SADS Semi-Structured Interview |- |United States<ref>{{Cite journal|last=Judd|first=Lewis L.|last2=Akiskal|first2=Hagop S.|title=The prevalence and disability of bipolar spectrum disorders in the US population: re-analysis of the ECA database taking into account subthreshold cases|url=https://doi.org/10.1016/S0165-0327(02)00332-4|journal=Journal of Affective Disorders|volume=73|issue=1-2|pages=123–131|doi=10.1016/s0165-0327(02)00332-4}}</ref> |US National Epidemiological Catchment Area (ECA) database |0.8 - 5.1% (manic and subthreshold mania) |Diagnostic Interview Schedule (DIS) |- |United States<ref>{{Cite journal|last=Kessler|first=R. C.|last2=Rubinow|first2=D. R.|last3=Holmes|first3=C.|last4=Abelson|first4=J. M.|last5=Zhao|first5=S.|date=1997/09|title=The epidemiology of DSM-III-R bipolar I disorder in a general population survey|url=https://www.cambridge.org/core/journals/psychological-medicine/article/epidemiology-of-dsmiiir-bipolar-i-disorder-in-a-general-population-survey/950D518D15F64E2059F1033558615A9A|journal=Psychological Medicine|language=en|volume=27|issue=5|pages=1079–1089|issn=1469-8978}}</ref> |US National Comorbidity Survey (NCS) |0-4% (small community sample; reappraisal study) |World Health Organisation Composite International Diagnostic Interview |- |United States and other countries<ref>{{Cite book|url=https://www.worldcat.org/oclc/830807378|title=Diagnostic and statistical manual of mental disorders : DSM-5.|date=2013|publisher=American Psychiatric Association., American Psychiatric Association. DSM-5 Task Force.|isbn=9780890425541|edition=5th|location=Arlington, VA|oclc=830807378}}</ref> |Community sample |BPI - 0.6%; BPII-  1.8%;  Cyclothymia - 0.4-1% |Unspecified |- |United States, Europe, Asia<ref>{{Cite journal|last=Merikangas|first=Kathleen R.|last2=Jin|first2=Robert|last3=He|first3=Jian-Ping|last4=Kessler|first4=Ronald C.|last5=Lee|first5=Sing|last6=Sampson|first6=Nancy A.|last7=Viana|first7=Maria Carmen|last8=Andrade|first8=Laura Helena|last9=Hu|first9=Chiyi|date=2011-03-07|title=Prevalence and Correlates of Bipolar Spectrum Disorder in the World Mental Health Survey Initiative|url=http://archpsyc.jamanetwork.com/article.aspx?doi=10.1001/archgenpsychiatry.2011.12|journal=Archives of General Psychiatry|language=en|volume=68|issue=3|doi=10.1001/archgenpsychiatry.2011.12|issn=0003-990X}}</ref> |Community Samples |BPI - 0.6%; BPII - 0.4%; Subthreshold BP - 1.4%; Bipolar Spectrum Disorder - 2.4% |World Health Organisation Composite International Diagnostic Interview |- |United States<ref>{{Cite journal|last=Grant|first=Bridget F.|last2=Stinson|first2=Frederick S.|last3=Hasin|first3=Deborah S.|last4=Dawson|first4=Deborah A.|last5=Chou|first5=S. Patricia|last6=Ruan|first6=W. June|last7=Huang|first7=Boji|date=October 2005|title=Prevalence, correlates, and comorbidity of bipolar I disorder and axis I and II disorders: results from the National Epidemiologic Survey on Alcohol and Related Conditions|url=https://www.ncbi.nlm.nih.gov/pubmed/16259532|journal=The Journal of Clinical Psychiatry|volume=66|issue=10|pages=1205–1215|issn=0160-6689|pmid=16259532}}</ref> |National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) |BPI - 3.3% |The Alcohol Use Disorder and Associated Disabilities Interview Schedule-IV (AUDADIS-IV) |- |United States<ref>{{Cite journal|last=Das|first=Amar K.|date=2005-02-23|title=Screening for Bipolar Disorder in a Primary Care Practice|url=http://jama.jamanetwork.com/article.aspx?doi=10.1001/jama.293.8.956|journal=JAMA|language=en|volume=293|issue=8|doi=10.1001/jama.293.8.956|issn=0098-7484}}</ref> |Outpatient Clinic Sample |9.8% |Review of medical records, questionnaire data |- |United States<ref>{{cite journal|last1=Hirschfeld|first1=RM|last2=Cass|first2=AR|last3=Holt|first3=DC|last4=Carlson|first4=CA|date=2005|title=Screening for bipolar disorder in patients treated for depression in a family medicine clinic.|journal=The Journal of the American Board of Family Practice|volume=18|issue=4|pages=233-9|pmid=15994469}}</ref> |Outpatient Clinic Sample |21.3% |MDQ, SCID |} ==[[Evidence based assessment/Prediction phase|'''Prediction phase''']]== === Psychometric properties of screening instruments for adult bipolar disorder === The following section contains a list of screening and diagnostic instruments for adult bipolar disorder. The section includes administration information, psychometric data, and PDFs or links to the screenings. * Screenings are used as part of the [[Evidence based assessment/Prediction phase|prediction phase]] of assessment; for more information on interpretation of this data, or how screenings fit in to the assessment process, click [[Evidence based assessment/Prediction phase|here.]] * '''''For a list of more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Psychometric_properties_of_common_screening_instruments click here.]''''' {| class="wikitable" |- ! Measure !Format (Reporter) !Age Range !Administration/ Completion Time !Where to Access |- |[[wikipedia:General_Behavior_Inventory|GBI (General Behavior Inventory)]]<ref>{{Cite journal|date=2018-06|editor-last=Hunsley|editor-first=John|editor2-last=Mash|editor2-first=Eric J.|title=A Guide to Assessments That Work|url=http://dx.doi.org/10.1093/med-psych/9780190492243.001.0001|journal=Oxford Clinical Psychology|doi=10.1093/med-psych/9780190492243.001.0001}}</ref> |Self-report |Adult |15-20 minutes | * [https://mfr.osf.io/render?url=https://osf.io/j6rce/?action=download%26mode=render Downloadable PDF Self-Report English] * [https://mfr.osf.io/render?url=https://osf.io/27nwg/?action=download%26mode=render Scoring instructions and information] |- |[[wikipedia:Mood_Disorder_Questionnaire|MDQ (Mood Disorder Questionnaire)]]<ref name="Carvalho" /> |Self-report |Adult |5 minutes | * [https://mfr.osf.io/render?url=https://osf.io/sb5xw/?action=download%26mode=render Adult Self-Report (Long, English)] * [https://mfr.osf.io/render?url=https://osf.io/xa7v6/?action=download%26mode=render Adult Self-Report (Short, English)] * |- |[[wikipedia:Bipolar_Spectrum_Diagnostic_Scale|BSDS (Bipolar Spectrum Diagnostic Scale)]]<ref>{{Cite journal|date=2018-06|editor-last=Hunsley|editor-first=John|editor2-last=Mash|editor2-first=Eric J.|title=A Guide to Assessments That Work|url=http://dx.doi.org/10.1093/med-psych/9780190492243.001.0001|journal=Oxford Clinical Psychology|doi=10.1093/med-psych/9780190492243.001.0001}}</ref><ref name="Carvalho" /> |Self-report |Adult |15 minutes | * [http://psycheducation.org/diagnosis/the-bipolar-spectrum-diagnostic-scale/ Online version] * [https://mfr.osf.io/render?url=https://osf.io/w9qet/?action=download%26mode=render Downloadable PDF Version (English)] |- |[[wikipedia:Hypomania_Checklist|HCL-32 (Hypomania Checklist)]]<ref name="Carvalho" /><ref>{{Cite journal|last=Feng|first=Yuan|last2=Wang|first2=Yuan-Yuan|last3=Huang|first3=Wei|last4=Ungvari|first4=Gabor S.|last5=Ng|first5=Chee H.|last6=Wang|first6=Gang|last7=Yuan|first7=Zhen|last8=Xiang|first8=Yu-Tao|date=2017-06-01|title=Comparison of the 32-item Hypomania Checklist, the 33-item Hypomania Checklist, and the Mood Disorders Questionnaire for bipolar disorder|url=http://onlinelibrary.wiley.com/doi/10.1111/pcn.12506/abstract|journal=Psychiatry and Clinical Neurosciences|language=en|volume=71|issue=6|pages=403–408|doi=10.1111/pcn.12506|issn=1440-1819}}</ref> |Self-report |Adult |10-15 minutes | * [https://mfr.osf.io/render?url=https://osf.io/2veyc/?action=download%26mode=render Self-report] |} '''Note:''' '''L''' = Less than adequate; '''A''' = Adequate; '''G''' = Good; '''E''' = Excellent; '''U''' = Unavailable; '''NA''' = Not applicable === Likelihood ratios and AUCs of screening measures for bipolar disorder in adults === * '''''For a list of the likelihood ratios for more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Likelihood_ratios_and_AUCs_of_common_screening_instruments click here.]''''' {| class="wikitable sortable" !'''Screening Measure (Primary Reference)''' !'''Area Under Curve (AUC) and sample size''' !'''DiLR+ (score)''' !DiLR- (score) !'''Population''' |- |[[wikipedia:Bipolar_Spectrum_Diagnostic_Scale|BSDS (Bipolar Spectrum Diagnostic Scale)]] <ref name="Carvalho" /> |0.81 |(13) <ref name = Carvalho>{{cite journal|last1=Carvalho|first1=André F.|last2=Takwoingi|first2=Yemisi|last3=Sales|first3=Paulo Marcelo G.|last4=Soczynska|first4=Joanna K.|last5=Köhler|first5=Cristiano A.|last6=Freitas|first6=Thiago H.|last7=Quevedo|first7=João|last8=Hyphantis|first8=Thomas N.|last9=McIntyre|first9=Roger S.|last10=Vieta|first10=Eduard|title=Screening for bipolar spectrum disorders: A comprehensive meta-analysis of accuracy studies|journal=Journal of Affective Disorders|date=February 2015|volume=172|pages=337–346|doi=https://doi.org/10.1016/j.jad.2014.10.024}}</ref> |0.36 (4.93) |Clinical |- |[[wikipedia:Hypomania_Checklist|HCL-32 (Hypomania Checklist)]]<ref name="Carvalho" /> |0.80 |(14)<ref name="Carvalho" /> |0.28 (2.45) |Clinical |- |[[wikipedia:Mood_Disorder_Questionnaire|MDQ (Mood Disorder Questionnaire)]]<ref name="Carvalho" /> |0.78 |(7)<ref name="Carvalho" /> |0.22 (5.4) |Clinical |- |General Behavior Inventory (GBI) | | | | |} '''Note:''' Area Under Curve (AUC, or AUROC) is equal to the probability that a classifier will rank a randomly chosen positive diagnosis of Bipolar Disorder higher than a randomly chosen negative diagnosis of Bipolar Disorder[15]. ==[[Evidence based assessment/Prescription phase|'''Prescription phase''']]== ===Gold standard diagnostic interviews=== * For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews click here.] ===Recommended diagnostic interviews for adult bipolar disorder=== {| class="wikitable sortable" border="1" ! colspan="5" |Diagnostic instruments for BPSD |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time !Where to Access |- | Structured Clinical Interview for DSM-5 (SCID)<ref>{{Cite journal|last=Miller|first=Christopher J.|last2=Johnson|first2=Sheri L.|last3=Eisner|first3=Lori|date=2009-06|title=Assessment tools for adult bipolar disorder.|url=http://doi.apa.org/getdoi.cfm?doi=10.1111/j.1468-2850.2009.01158.x|journal=Clinical Psychology: Science and Practice|language=en|volume=16|issue=2|pages=188–201|doi=10.1111/j.1468-2850.2009.01158.x|issn=1468-2850|pmc=PMC2847794|pmid=20360999}}</ref><ref>{{Cite journal|date=2018-06|editor-last=Hunsley|editor-first=John|editor2-last=Mash|editor2-first=Eric J.|title=A Guide to Assessments That Work|url=http://dx.doi.org/10.1093/med-psych/9780190492243.001.0001|journal=Oxford Clinical Psychology|doi=10.1093/med-psych/9780190492243.001.0001}}</ref> | Semistructured interview | 18+ | 1-2 hours |Available for purchase from [https://www.appi.org/products/structured-clinical-interview-for-dsm-5-scid-5 APA Publishing] |- | Schedule for Affective Disorders and Schizophrenia (SADS)<ref>{{Cite journal|date=2018-06|editor-last=Hunsley|editor-first=John|editor2-last=Mash|editor2-first=Eric J.|title=A Guide to Assessments That Work|url=http://dx.doi.org/10.1093/med-psych/9780190492243.001.0001|journal=Oxford Clinical Psychology|doi=10.1093/med-psych/9780190492243.001.0001}}</ref><ref>{{Cite journal|last=Miller|first=Christopher J.|last2=Johnson|first2=Sheri L.|last3=Eisner|first3=Lori|date=2009-06|title=Assessment tools for adult bipolar disorder.|url=http://doi.apa.org/getdoi.cfm?doi=10.1111/j.1468-2850.2009.01158.x|journal=Clinical Psychology: Science and Practice|language=en|volume=16|issue=2|pages=188–201|doi=10.1111/j.1468-2850.2009.01158.x|issn=1468-2850|pmc=PMC2847794|pmid=20360999}}</ref><ref>{{Cite journal|last=Endicott|first=Jean|date=1978-07-01|title=A Diagnostic Interview: The Schedule for Affective Disorders and Schizophrenia|url=http://archpsyc.jamanetwork.com/article.aspx?doi=10.1001/archpsyc.1978.01770310043002|journal=Archives of General Psychiatry|language=en|volume=35|issue=7|pages=837|doi=10.1001/archpsyc.1978.01770310043002|issn=0003-990X}}</ref> | Semistructured interview | 18+ | 1-2 hours |[https://jamanetwork.com/journals/jamapsychiatry/article-abstract/491947 (Endicott & Spitzer, 1978)] |} ==[[Evidence based assessment/Process phase|'''Process phase''']]== === Treatment === * Please refer to the page on [https://en.wikipedia.org/wiki/Bipolar_disorder bipolar disorder] for more information on available treatment for bipolar disorder or go to the Effective Child Therapy pages for [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/severe-mood-swings-and-bipolar-spectrum-disorders/| Severe Mood Swings & Bipolar Spectrum Disorders] * [https://reacttoolkit.uk/ Relatives Education and Coping Toolkit (REACT)] is currently freely available at https://reacttoolkit.uk/. This is a resource/project of [https://www.lancaster.ac.uk/health-and-medicine/research/spectrum/ The Sprectrum Centre for Mental Health Research] from Lancaster University. A team of clinicians, researchers and relatives of people with psychosis or bipolar disorder at Lancaster, Liverpool and London have developed the Relatives Education and Coping Toolkit (REACT). REACT provides [https://www.nice.org.uk/ National Institute for Health and Care Excellence (NICE)] recommended information and support to relatives and friends of people with mental health problems associated with psychosis or bipolar disorder through a digital, peer-supported, self-management toolkit.<ref>Lobban, A. F., Robinson, H. A., Appelbe, D., Barraclough, J., Bedson, E., Collinge, E., Dodd, S., Flowers, S., Honary, M., Johnson, S., Caixeiro Mateus, M. D. C., Mezes, B., Minns, V., Murray, E., Walker, A. J., Williamson, P., Wintermeyer, C., & Jones, S. H. (2017). Protocol for an online randomised controlled trial to evaluate the clinical and cost-effectiveness of a peer-supported self-management intervention for relatives of people with psychosis or bipolar disorder: Relatives Education And Coping Toolkit (REACT). BMJ Open, 7, [016965]. <nowiki>https://doi.org/10.1136/bmjopen-2017-016965</nowiki></ref><ref>Lobban, F., Akers, N., Appelbe, D., Chapman, L., Collinge, L., Dodd, S., Flowers, S., Hollingsworth, B., Johnson, S., Jones, S. H., Mateus, C., Mezes, B., Murray, E., Panagaki, K., Rainford, N., Robinson, H., Rosala-Hallas, A., Sellwood, W., Walker, A., & Williamson, P. (2020). Clinical effectiveness of a web-based peer-supported self-management intervention for relatives of people with psychosis or bipolar (REACT): online, observer-blind, randomised controlled superiority trial. BMC Psychiatry, 20(1), [160]. <nowiki>https://doi.org/10.1186/s12888-020-02545-9</nowiki></ref><ref>{{Cite journal|last=F|first=Lobban|last2=N|first2=Akers|last3=D|first3=Appelbe|last4=R|first4=Iraci Capuccinello|last5=L|first5=Chapman|last6=L|first6=Collinge|last7=S|first7=Dodd|last8=S|first8=Flowers|last9=B|first9=Hollingsworth|date=2020-07-01|title=A web-based, peer-supported self-management intervention to reduce distress in relatives of people with psychosis or bipolar disorder: the REACT RCT|url=https://www.journalslibrary.nihr.ac.uk/hta/hta24320|journal=Health Technology Assessment|language=EN|volume=24|issue=32|doi=10.3310/hta24320|issn=2046-4924|pmc=PMC7355407|pmid=32608353}}</ref> ** The team at Spectrum Centre also conducted a study linked to REACT called IMPART which looked at what would happen if they tried to deliver REACT as part of routine clinical care in Early Intervention Teams in the [https://www.nhs.uk/ United Kingdom's National Health Service (NHS)]. This study identified key factors that impact implementation and may be useful for informing implementation plans for other digital health interventions.<ref>{{Cite journal|last=Lobban|first=Fiona|last2=Appelbe|first2=Duncan|last3=Appleton|first3=Victoria|last4=Billsborough|first4=Julie|last5=Fisher|first5=Naomi Ruth|last6=Foster|first6=Sheena|last7=Gill|first7=Bethany|last8=Glentworth|first8=David|last9=Harrop|first9=Chris|date=2020-03-17|title=IMPlementation of An online Relatives’ Toolkit for psychosis or bipolar (IMPART study): iterative multiple case study to identify key factors impacting on staff uptake and use|url=https://doi.org/10.1186/s12913-020-5002-4|journal=BMC Health Services Research|volume=20|issue=1|pages=219|doi=10.1186/s12913-020-5002-4|issn=1472-6963|pmc=PMC7077000|pmid=32183787}}</ref> ** '''[https://www.lancaster.ac.uk/health-and-medicine/research/spectrum/ RECOVERY TOOLKIT]''' #eRecoveryToolkit, #RecoveryBD, #PersonalRecovery is freely accessible at https://www.lancaster.ac.uk/health-and-medicine/research/spectrum/. Inspired from a greater body of work around recovery, people with lived experience of bipolar disorder and researchers at [https://www.lancaster.ac.uk/health-and-medicine/research/spectrum/ Spectrum Centre] have created a multi-media recovery toolkit. The aim of the toolkit is to provide accessible information and promote discussion around personal discovery in order to understand and aid people’s recovery journeys. The toolkit contains an animation, an e-booklet and video narratives of relatives and clinicians.<ref>Beck, A. K., Baker, A., Jones, S. H., Lobban, A. F., Kay-Lambkin, F., Attia, J., & Banfield, M. (2018). Exploring the feasibility and acceptability of a recovery-focused group therapy intervention for adults with bipolar disorder: trial protocol. BMJ Open, 8, [e019203]. <nowiki>https://doi.org/10.1136/bmjopen-2017-019203</nowiki></ref> {| cellspacing="0" style="width:238px;" | style="width:45px; height:45px; background:#d1f3f5; color:#49dae9; text-align:center;" vertical-align="center" align="center"| '''<span style="font-size:24pt;">t</span>''' | style="background:#b7eef0; color:black; font-size:8pt; padding:4pt; line-height:1.25em;"| This user tweets on '''[[w:Twitter|Twitter]]''' as [http://twitter.com/_REACTTOOLKIT REACTTOOLKIT]. |} == '''External resources''' == # [http://apps.who.int/classifications/icd10/browse/2015/en#/F31 ICD-10 diagnostic criteria] # [https://en.wikiversity.org/w/index.php?title=Helping_Give_Away_Psychological_Science/Resources/Annotated_List_of_Where_and_How_to_Find_a_Therapist&wteswitched=1#Other_low-cost_options Find-a-Therapist] (a curated list of find-a-therapist websites where you can find a provider) # OMIM (Online Mendelian Inheritance in Man) ## [http://omim.org/entry/125480 125480] ## [http://omim.org/entry/611536 611536] ## [http://omim.org/entry/309200 309200,] ## [http://omim.org/entry/611535 611535] ## [http://omim.org/entry/603663 603663] # [https://emedicine.medscape.com/article/286342-overview eMedicine information] # [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/severe-mood-swings-and-bipolar-spectrum-disorders/ Effective Child Therapy information on Bipolar Disorder] #*Effective Child Therapy is website sponsored by Division 53 of the American Psychological Association (APA), or [https://sccap53.org The Society of Clinical Child and Adolescent Psychology](SCCAP), in collaboration with the Association for Behavioral and Cognitive Therapies (ABCT). Use for information on symptoms and available treatments. # The Psych Show with Dr. Ali Mattu videos (geared towards public; might send to client) ##[https://www.youtube.com/watch?v=llOPqKD-s4w How to Cope with Bipolar Disorder] ## [https://www.youtube.com/watch?v=kUHUmeqBZAA Top 10 Bipolar Myths] == '''References''' == {{collapse top|Click here for references}} {{Reflist|30em}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] {{collapse bottom}} mh5ptx1wu5zjjur06jwy3lcnyp1ww1l 2419184 2419183 2022-08-26T02:02:12Z Ardenguo 2944162 /* References */ Made the references box expanded by default wikitext text/x-wiki <noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{medical disclaimer}} {{psychology}} {{Template:evidence-based assessment}} {{:{{BASEPAGENAME}}/Sidebar}} ==[[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio"?''']]== * For background information on what assessment portfolios are, click the link in the heading above. * Want even 'more' information about this topic? There's an extended version of this page [[Evidence-based assessment/Bipolar disorder in adults (assessment portfolio)/extended version|here]]. == [[Evidence based assessment/Preparation phase|'''Preparation phase''']] == === Diagnostic criteria for bipolar disorder in adults === Bipolar Disorder (BP) is characterized by extreme fluctuations in mood (or emotional dysregulation that ranges from mania (as shown by displays or feelings of extreme happiness, unrealistic overachievement and anger), to depression (as shown by displays or feelings of sadness, changes in appetite or weight and irritability.<ref name=":1" /> It has a lifetime risk of about 1%, with heritability estimated at up to 80%.<ref>{{Cite journal|last=Purcell|first=Shaun M.|last2=Wray|first2=Naomi R.|last3=Stone|first3=Jennifer L.|last4=Visscher|first4=Peter M.|last5=O'Donovan|first5=Michael C.|last6=Sullivan|first6=Patrick F.|last7=Sklar|first7=Pamela|last8=(Leader)|first8=Shaun M. Purcell|last9=Stone|first9=Jennifer L.|date=2009/08|title=Common polygenic variation contributes to risk of schizophrenia and bipolar disorder|url=http://www.nature.com/doifinder/10.1038/nature08185|journal=Nature|language=En|volume=460|issue=7256|doi=10.1038/nature08185|issn=1476-4687}}</ref> It is important to note that these moods exceed normal responses to life events, represent a change from the individual's normal functioning, and cause problems in daily activities. {{blockquotetop}} <big>'''ICD-11 Diagnostic Criteria'''</big> *Bipolar Type I Disorder **Bipolar type I disorder is an episodic mood disorder defined by the occurrence of one or more manic or mixed episodes. A manic episode is an extreme mood state lasting at least one week unless shortened by a treatment intervention characterized by euphoria, irritability, or expansiveness, and by increased activity or a subjective experience of increased energy, accompanied by other characteristic symptoms such as rapid or pressured speech, flight of ideas, increased self-esteem or grandiosity, decreased need for sleep, distractibility, impulsive or reckless behavior, and rapid changes among different mood states (i.e., mood lability). A mixed episode is characterized by either a mixture or very rapid alternation between prominent manic and depressive symptoms on most days during a period of at least 2 weeks. Although the diagnosis can be made based on evidence of a single manic or mixed episode, typically manic or mixed episodes alternate with depressive episodes over the course of the disorder. ***Note: The ICD-11 lists 18 additional subcategories of Bipolar type I disorder. They can be found [https://icd.who.int/browse11/l-m/en#/http://id.who.int/icd/entity/1456478153 here]. *Bipolar Type II Disorder **Bipolar type II disorder is an episodic mood disorder defined by the occurrence of one or more hypomanic episodes and at least one depressive episode. A hypomanic episode is a persistent mood state characterized by euphoria, irritability, or expansiveness, and excessive psychomotor activation or increased energy, accompanied by other characteristic symptoms such as grandiosity, decreased need for sleep, pressured speech, flight of ideas, distractibility, and impulsive or reckless behavior lasting for at least several days. The symptoms represent a change from the individual’s typical behavior and are not severe enough to cause marked impairment in functioning. A depressive episode is characterized by a period of almost daily depressed mood or diminished interest in activities lasting at least 2 weeks accompanied by other symptoms such as changes in appetite or sleep, psychomotor agitation or retardation, fatigue, feelings of worthless or excessive or inappropriate guilt, feelings or hopelessness, difficulty concentrating, and suicidality. There is no history of manic or mixed Episodes. ***Note: The ICD-11 lists 13 additional subcategories of Bipolar type II disorder. They can be found [https://icd.who.int/browse11/l-m/en#/http%3a%2f%2fid.who.int%2ficd%2fentity%2f199053300 here]. '''Changes in DSM-5''' * The diagnostic criteria for '''Bipolar Disorder''' changed slightly from [[DSM-IV]] to [[w:Diagnostic_and_Statistical_Manual_of_Mental_Disorders#DSM-IV-TR_.282000.29|DSM-5]]. Summaries are available [http://www.dsm5.org/Documents/changes%20from%20dsm-iv-tr%20to%20dsm-5.pdf here] and [[w:DSM-5|here]]. {{blockquotebottom}} === Base rates of BD in different clinical settings and populations === This section describes the demographic setting of the population(s) sampled, base rates of diagnosis, country/region sampled, and the diagnostic method that was used. Using this information, clinicians will be able to anchor the rate of adolescent depression that they are likely to see in their clinical practice. * '''''To see prevalence rates across multiple disorders,''''' [[Evidence based assessment/Preparation phase#Base rates for transdiagnostic comparison|'''''click here.''''']] {| class="wikitable" |'''Demography''' |'''Setting''' |'''Base Rate''' |'''Diagnostic Method''' |- |United States, Canada, Puerto Rico, Germany, Taiwan, Korea, New Zealand <ref>{{Cite journal|last=Weissman|first=Myrna M.|last2=Bland|first2=Roger C.|last3=Canino|first3=Glorisa J.|last4=Faravelli|first4=Carlo|last5=Greenwald|first5=Steven|last6=Hwu|first6=Hai-Gwo|last7=Joyce|first7=Peter R.|last8=Karam|first8=Eile G.|last9=Lee|first9=Chung-Kyoon|date=1996-07-24|title=Cross-National Epidemiology of Major Depression and Bipolar Disorder|url=https://doi.org/10.1001/jama.1996.03540040037030|journal=JAMA|volume=276|issue=4|pages=293–299|doi=10.1001/jama.1996.03540040037030|issn=0098-7484}}</ref> |Community Epidemiological Samples |0.3 - 1.5% |Structured and semi-structured diagnostic interviews |- |United States<ref>{{Cite journal|last=Merikangas|first=Kathleen R.|last2=Akiskal|first2=Hagop S.|last3=Angst|first3=Jules|last4=Greenberg|first4=Paul E.|last5=Hirschfeld|first5=Robert M. A.|last6=Petukhova|first6=Maria|last7=Kessler|first7=Ronald C.|date=2007-05-01|title=Lifetime and 12-Month Prevalence of Bipolar Spectrum Disorder in the National Comorbidity Survey Replication|url=https://jamanetwork.com/journals/jamapsychiatry/fullarticle/482285|journal=Archives of General Psychiatry|language=en|volume=64|issue=5|pages=543–552|doi=10.1001/archpsyc.64.5.543|issn=0003-990X}}</ref> |Community Epidemiological Samples |BPI - 1%; BPII - 1.1%; Subthreshold BP - 2.4% |World Health Organisation Composite International Diagnostic Interview |- |United States<ref>{{Cite journal|last=LEWINSOHN|first=PETER M.|last2=KLEIN|first2=DANIEL N.|last3=SEELEY|first3=JOHN R.|title=Bipolar Disorders in a Community Sample of Older Adolescents: Prevalence, Phenomenology, Comorbidity, and Course|url=http://linkinghub.elsevier.com/retrieve/pii/S089085670963731X|journal=Journal of the American Academy of Child & Adolescent Psychiatry|volume=34|issue=4|pages=454–463|doi=10.1097/00004583-199504000-00012}}</ref> |Community samples (older adolescents) |1% |K-SADS Semi-Structured Interview |- |United States<ref>{{Cite journal|last=Judd|first=Lewis L.|last2=Akiskal|first2=Hagop S.|title=The prevalence and disability of bipolar spectrum disorders in the US population: re-analysis of the ECA database taking into account subthreshold cases|url=https://doi.org/10.1016/S0165-0327(02)00332-4|journal=Journal of Affective Disorders|volume=73|issue=1-2|pages=123–131|doi=10.1016/s0165-0327(02)00332-4}}</ref> |US National Epidemiological Catchment Area (ECA) database |0.8 - 5.1% (manic and subthreshold mania) |Diagnostic Interview Schedule (DIS) |- |United States<ref>{{Cite journal|last=Kessler|first=R. C.|last2=Rubinow|first2=D. R.|last3=Holmes|first3=C.|last4=Abelson|first4=J. M.|last5=Zhao|first5=S.|date=1997/09|title=The epidemiology of DSM-III-R bipolar I disorder in a general population survey|url=https://www.cambridge.org/core/journals/psychological-medicine/article/epidemiology-of-dsmiiir-bipolar-i-disorder-in-a-general-population-survey/950D518D15F64E2059F1033558615A9A|journal=Psychological Medicine|language=en|volume=27|issue=5|pages=1079–1089|issn=1469-8978}}</ref> |US National Comorbidity Survey (NCS) |0-4% (small community sample; reappraisal study) |World Health Organisation Composite International Diagnostic Interview |- |United States and other countries<ref>{{Cite book|url=https://www.worldcat.org/oclc/830807378|title=Diagnostic and statistical manual of mental disorders : DSM-5.|date=2013|publisher=American Psychiatric Association., American Psychiatric Association. DSM-5 Task Force.|isbn=9780890425541|edition=5th|location=Arlington, VA|oclc=830807378}}</ref> |Community sample |BPI - 0.6%; BPII-  1.8%;  Cyclothymia - 0.4-1% |Unspecified |- |United States, Europe, Asia<ref>{{Cite journal|last=Merikangas|first=Kathleen R.|last2=Jin|first2=Robert|last3=He|first3=Jian-Ping|last4=Kessler|first4=Ronald C.|last5=Lee|first5=Sing|last6=Sampson|first6=Nancy A.|last7=Viana|first7=Maria Carmen|last8=Andrade|first8=Laura Helena|last9=Hu|first9=Chiyi|date=2011-03-07|title=Prevalence and Correlates of Bipolar Spectrum Disorder in the World Mental Health Survey Initiative|url=http://archpsyc.jamanetwork.com/article.aspx?doi=10.1001/archgenpsychiatry.2011.12|journal=Archives of General Psychiatry|language=en|volume=68|issue=3|doi=10.1001/archgenpsychiatry.2011.12|issn=0003-990X}}</ref> |Community Samples |BPI - 0.6%; BPII - 0.4%; Subthreshold BP - 1.4%; Bipolar Spectrum Disorder - 2.4% |World Health Organisation Composite International Diagnostic Interview |- |United States<ref>{{Cite journal|last=Grant|first=Bridget F.|last2=Stinson|first2=Frederick S.|last3=Hasin|first3=Deborah S.|last4=Dawson|first4=Deborah A.|last5=Chou|first5=S. Patricia|last6=Ruan|first6=W. June|last7=Huang|first7=Boji|date=October 2005|title=Prevalence, correlates, and comorbidity of bipolar I disorder and axis I and II disorders: results from the National Epidemiologic Survey on Alcohol and Related Conditions|url=https://www.ncbi.nlm.nih.gov/pubmed/16259532|journal=The Journal of Clinical Psychiatry|volume=66|issue=10|pages=1205–1215|issn=0160-6689|pmid=16259532}}</ref> |National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) |BPI - 3.3% |The Alcohol Use Disorder and Associated Disabilities Interview Schedule-IV (AUDADIS-IV) |- |United States<ref>{{Cite journal|last=Das|first=Amar K.|date=2005-02-23|title=Screening for Bipolar Disorder in a Primary Care Practice|url=http://jama.jamanetwork.com/article.aspx?doi=10.1001/jama.293.8.956|journal=JAMA|language=en|volume=293|issue=8|doi=10.1001/jama.293.8.956|issn=0098-7484}}</ref> |Outpatient Clinic Sample |9.8% |Review of medical records, questionnaire data |- |United States<ref>{{cite journal|last1=Hirschfeld|first1=RM|last2=Cass|first2=AR|last3=Holt|first3=DC|last4=Carlson|first4=CA|date=2005|title=Screening for bipolar disorder in patients treated for depression in a family medicine clinic.|journal=The Journal of the American Board of Family Practice|volume=18|issue=4|pages=233-9|pmid=15994469}}</ref> |Outpatient Clinic Sample |21.3% |MDQ, SCID |} ==[[Evidence based assessment/Prediction phase|'''Prediction phase''']]== === Psychometric properties of screening instruments for adult bipolar disorder === The following section contains a list of screening and diagnostic instruments for adult bipolar disorder. The section includes administration information, psychometric data, and PDFs or links to the screenings. * Screenings are used as part of the [[Evidence based assessment/Prediction phase|prediction phase]] of assessment; for more information on interpretation of this data, or how screenings fit in to the assessment process, click [[Evidence based assessment/Prediction phase|here.]] * '''''For a list of more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Psychometric_properties_of_common_screening_instruments click here.]''''' {| class="wikitable" |- ! Measure !Format (Reporter) !Age Range !Administration/ Completion Time !Where to Access |- |[[wikipedia:General_Behavior_Inventory|GBI (General Behavior Inventory)]]<ref>{{Cite journal|date=2018-06|editor-last=Hunsley|editor-first=John|editor2-last=Mash|editor2-first=Eric J.|title=A Guide to Assessments That Work|url=http://dx.doi.org/10.1093/med-psych/9780190492243.001.0001|journal=Oxford Clinical Psychology|doi=10.1093/med-psych/9780190492243.001.0001}}</ref> |Self-report |Adult |15-20 minutes | * [https://mfr.osf.io/render?url=https://osf.io/j6rce/?action=download%26mode=render Downloadable PDF Self-Report English] * [https://mfr.osf.io/render?url=https://osf.io/27nwg/?action=download%26mode=render Scoring instructions and information] |- |[[wikipedia:Mood_Disorder_Questionnaire|MDQ (Mood Disorder Questionnaire)]]<ref name="Carvalho" /> |Self-report |Adult |5 minutes | * [https://mfr.osf.io/render?url=https://osf.io/sb5xw/?action=download%26mode=render Adult Self-Report (Long, English)] * [https://mfr.osf.io/render?url=https://osf.io/xa7v6/?action=download%26mode=render Adult Self-Report (Short, English)] * |- |[[wikipedia:Bipolar_Spectrum_Diagnostic_Scale|BSDS (Bipolar Spectrum Diagnostic Scale)]]<ref>{{Cite journal|date=2018-06|editor-last=Hunsley|editor-first=John|editor2-last=Mash|editor2-first=Eric J.|title=A Guide to Assessments That Work|url=http://dx.doi.org/10.1093/med-psych/9780190492243.001.0001|journal=Oxford Clinical Psychology|doi=10.1093/med-psych/9780190492243.001.0001}}</ref><ref name="Carvalho" /> |Self-report |Adult |15 minutes | * [http://psycheducation.org/diagnosis/the-bipolar-spectrum-diagnostic-scale/ Online version] * [https://mfr.osf.io/render?url=https://osf.io/w9qet/?action=download%26mode=render Downloadable PDF Version (English)] |- |[[wikipedia:Hypomania_Checklist|HCL-32 (Hypomania Checklist)]]<ref name="Carvalho" /><ref>{{Cite journal|last=Feng|first=Yuan|last2=Wang|first2=Yuan-Yuan|last3=Huang|first3=Wei|last4=Ungvari|first4=Gabor S.|last5=Ng|first5=Chee H.|last6=Wang|first6=Gang|last7=Yuan|first7=Zhen|last8=Xiang|first8=Yu-Tao|date=2017-06-01|title=Comparison of the 32-item Hypomania Checklist, the 33-item Hypomania Checklist, and the Mood Disorders Questionnaire for bipolar disorder|url=http://onlinelibrary.wiley.com/doi/10.1111/pcn.12506/abstract|journal=Psychiatry and Clinical Neurosciences|language=en|volume=71|issue=6|pages=403–408|doi=10.1111/pcn.12506|issn=1440-1819}}</ref> |Self-report |Adult |10-15 minutes | * [https://mfr.osf.io/render?url=https://osf.io/2veyc/?action=download%26mode=render Self-report] |} '''Note:''' '''L''' = Less than adequate; '''A''' = Adequate; '''G''' = Good; '''E''' = Excellent; '''U''' = Unavailable; '''NA''' = Not applicable === Likelihood ratios and AUCs of screening measures for bipolar disorder in adults === * '''''For a list of the likelihood ratios for more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Likelihood_ratios_and_AUCs_of_common_screening_instruments click here.]''''' {| class="wikitable sortable" !'''Screening Measure (Primary Reference)''' !'''Area Under Curve (AUC) and sample size''' !'''DiLR+ (score)''' !DiLR- (score) !'''Population''' |- |[[wikipedia:Bipolar_Spectrum_Diagnostic_Scale|BSDS (Bipolar Spectrum Diagnostic Scale)]] <ref name="Carvalho" /> |0.81 |(13) <ref name = Carvalho>{{cite journal|last1=Carvalho|first1=André F.|last2=Takwoingi|first2=Yemisi|last3=Sales|first3=Paulo Marcelo G.|last4=Soczynska|first4=Joanna K.|last5=Köhler|first5=Cristiano A.|last6=Freitas|first6=Thiago H.|last7=Quevedo|first7=João|last8=Hyphantis|first8=Thomas N.|last9=McIntyre|first9=Roger S.|last10=Vieta|first10=Eduard|title=Screening for bipolar spectrum disorders: A comprehensive meta-analysis of accuracy studies|journal=Journal of Affective Disorders|date=February 2015|volume=172|pages=337–346|doi=https://doi.org/10.1016/j.jad.2014.10.024}}</ref> |0.36 (4.93) |Clinical |- |[[wikipedia:Hypomania_Checklist|HCL-32 (Hypomania Checklist)]]<ref name="Carvalho" /> |0.80 |(14)<ref name="Carvalho" /> |0.28 (2.45) |Clinical |- |[[wikipedia:Mood_Disorder_Questionnaire|MDQ (Mood Disorder Questionnaire)]]<ref name="Carvalho" /> |0.78 |(7)<ref name="Carvalho" /> |0.22 (5.4) |Clinical |- |General Behavior Inventory (GBI) | | | | |} '''Note:''' Area Under Curve (AUC, or AUROC) is equal to the probability that a classifier will rank a randomly chosen positive diagnosis of Bipolar Disorder higher than a randomly chosen negative diagnosis of Bipolar Disorder[15]. ==[[Evidence based assessment/Prescription phase|'''Prescription phase''']]== ===Gold standard diagnostic interviews=== * For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews click here.] ===Recommended diagnostic interviews for adult bipolar disorder=== {| class="wikitable sortable" border="1" ! colspan="5" |Diagnostic instruments for BPSD |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time !Where to Access |- | Structured Clinical Interview for DSM-5 (SCID)<ref>{{Cite journal|last=Miller|first=Christopher J.|last2=Johnson|first2=Sheri L.|last3=Eisner|first3=Lori|date=2009-06|title=Assessment tools for adult bipolar disorder.|url=http://doi.apa.org/getdoi.cfm?doi=10.1111/j.1468-2850.2009.01158.x|journal=Clinical Psychology: Science and Practice|language=en|volume=16|issue=2|pages=188–201|doi=10.1111/j.1468-2850.2009.01158.x|issn=1468-2850|pmc=PMC2847794|pmid=20360999}}</ref><ref>{{Cite journal|date=2018-06|editor-last=Hunsley|editor-first=John|editor2-last=Mash|editor2-first=Eric J.|title=A Guide to Assessments That Work|url=http://dx.doi.org/10.1093/med-psych/9780190492243.001.0001|journal=Oxford Clinical Psychology|doi=10.1093/med-psych/9780190492243.001.0001}}</ref> | Semistructured interview | 18+ | 1-2 hours |Available for purchase from [https://www.appi.org/products/structured-clinical-interview-for-dsm-5-scid-5 APA Publishing] |- | Schedule for Affective Disorders and Schizophrenia (SADS)<ref>{{Cite journal|date=2018-06|editor-last=Hunsley|editor-first=John|editor2-last=Mash|editor2-first=Eric J.|title=A Guide to Assessments That Work|url=http://dx.doi.org/10.1093/med-psych/9780190492243.001.0001|journal=Oxford Clinical Psychology|doi=10.1093/med-psych/9780190492243.001.0001}}</ref><ref>{{Cite journal|last=Miller|first=Christopher J.|last2=Johnson|first2=Sheri L.|last3=Eisner|first3=Lori|date=2009-06|title=Assessment tools for adult bipolar disorder.|url=http://doi.apa.org/getdoi.cfm?doi=10.1111/j.1468-2850.2009.01158.x|journal=Clinical Psychology: Science and Practice|language=en|volume=16|issue=2|pages=188–201|doi=10.1111/j.1468-2850.2009.01158.x|issn=1468-2850|pmc=PMC2847794|pmid=20360999}}</ref><ref>{{Cite journal|last=Endicott|first=Jean|date=1978-07-01|title=A Diagnostic Interview: The Schedule for Affective Disorders and Schizophrenia|url=http://archpsyc.jamanetwork.com/article.aspx?doi=10.1001/archpsyc.1978.01770310043002|journal=Archives of General Psychiatry|language=en|volume=35|issue=7|pages=837|doi=10.1001/archpsyc.1978.01770310043002|issn=0003-990X}}</ref> | Semistructured interview | 18+ | 1-2 hours |[https://jamanetwork.com/journals/jamapsychiatry/article-abstract/491947 (Endicott & Spitzer, 1978)] |} ==[[Evidence based assessment/Process phase|'''Process phase''']]== === Treatment === * Please refer to the page on [https://en.wikipedia.org/wiki/Bipolar_disorder bipolar disorder] for more information on available treatment for bipolar disorder or go to the Effective Child Therapy pages for [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/severe-mood-swings-and-bipolar-spectrum-disorders/| Severe Mood Swings & Bipolar Spectrum Disorders] * [https://reacttoolkit.uk/ Relatives Education and Coping Toolkit (REACT)] is currently freely available at https://reacttoolkit.uk/. This is a resource/project of [https://www.lancaster.ac.uk/health-and-medicine/research/spectrum/ The Sprectrum Centre for Mental Health Research] from Lancaster University. A team of clinicians, researchers and relatives of people with psychosis or bipolar disorder at Lancaster, Liverpool and London have developed the Relatives Education and Coping Toolkit (REACT). REACT provides [https://www.nice.org.uk/ National Institute for Health and Care Excellence (NICE)] recommended information and support to relatives and friends of people with mental health problems associated with psychosis or bipolar disorder through a digital, peer-supported, self-management toolkit.<ref>Lobban, A. F., Robinson, H. A., Appelbe, D., Barraclough, J., Bedson, E., Collinge, E., Dodd, S., Flowers, S., Honary, M., Johnson, S., Caixeiro Mateus, M. D. C., Mezes, B., Minns, V., Murray, E., Walker, A. J., Williamson, P., Wintermeyer, C., & Jones, S. H. (2017). Protocol for an online randomised controlled trial to evaluate the clinical and cost-effectiveness of a peer-supported self-management intervention for relatives of people with psychosis or bipolar disorder: Relatives Education And Coping Toolkit (REACT). BMJ Open, 7, [016965]. <nowiki>https://doi.org/10.1136/bmjopen-2017-016965</nowiki></ref><ref>Lobban, F., Akers, N., Appelbe, D., Chapman, L., Collinge, L., Dodd, S., Flowers, S., Hollingsworth, B., Johnson, S., Jones, S. H., Mateus, C., Mezes, B., Murray, E., Panagaki, K., Rainford, N., Robinson, H., Rosala-Hallas, A., Sellwood, W., Walker, A., & Williamson, P. (2020). Clinical effectiveness of a web-based peer-supported self-management intervention for relatives of people with psychosis or bipolar (REACT): online, observer-blind, randomised controlled superiority trial. BMC Psychiatry, 20(1), [160]. <nowiki>https://doi.org/10.1186/s12888-020-02545-9</nowiki></ref><ref>{{Cite journal|last=F|first=Lobban|last2=N|first2=Akers|last3=D|first3=Appelbe|last4=R|first4=Iraci Capuccinello|last5=L|first5=Chapman|last6=L|first6=Collinge|last7=S|first7=Dodd|last8=S|first8=Flowers|last9=B|first9=Hollingsworth|date=2020-07-01|title=A web-based, peer-supported self-management intervention to reduce distress in relatives of people with psychosis or bipolar disorder: the REACT RCT|url=https://www.journalslibrary.nihr.ac.uk/hta/hta24320|journal=Health Technology Assessment|language=EN|volume=24|issue=32|doi=10.3310/hta24320|issn=2046-4924|pmc=PMC7355407|pmid=32608353}}</ref> ** The team at Spectrum Centre also conducted a study linked to REACT called IMPART which looked at what would happen if they tried to deliver REACT as part of routine clinical care in Early Intervention Teams in the [https://www.nhs.uk/ United Kingdom's National Health Service (NHS)]. This study identified key factors that impact implementation and may be useful for informing implementation plans for other digital health interventions.<ref>{{Cite journal|last=Lobban|first=Fiona|last2=Appelbe|first2=Duncan|last3=Appleton|first3=Victoria|last4=Billsborough|first4=Julie|last5=Fisher|first5=Naomi Ruth|last6=Foster|first6=Sheena|last7=Gill|first7=Bethany|last8=Glentworth|first8=David|last9=Harrop|first9=Chris|date=2020-03-17|title=IMPlementation of An online Relatives’ Toolkit for psychosis or bipolar (IMPART study): iterative multiple case study to identify key factors impacting on staff uptake and use|url=https://doi.org/10.1186/s12913-020-5002-4|journal=BMC Health Services Research|volume=20|issue=1|pages=219|doi=10.1186/s12913-020-5002-4|issn=1472-6963|pmc=PMC7077000|pmid=32183787}}</ref> ** '''[https://www.lancaster.ac.uk/health-and-medicine/research/spectrum/ RECOVERY TOOLKIT]''' #eRecoveryToolkit, #RecoveryBD, #PersonalRecovery is freely accessible at https://www.lancaster.ac.uk/health-and-medicine/research/spectrum/. Inspired from a greater body of work around recovery, people with lived experience of bipolar disorder and researchers at [https://www.lancaster.ac.uk/health-and-medicine/research/spectrum/ Spectrum Centre] have created a multi-media recovery toolkit. The aim of the toolkit is to provide accessible information and promote discussion around personal discovery in order to understand and aid people’s recovery journeys. The toolkit contains an animation, an e-booklet and video narratives of relatives and clinicians.<ref>Beck, A. K., Baker, A., Jones, S. H., Lobban, A. F., Kay-Lambkin, F., Attia, J., & Banfield, M. (2018). Exploring the feasibility and acceptability of a recovery-focused group therapy intervention for adults with bipolar disorder: trial protocol. BMJ Open, 8, [e019203]. <nowiki>https://doi.org/10.1136/bmjopen-2017-019203</nowiki></ref> {| cellspacing="0" style="width:238px;" | style="width:45px; height:45px; background:#d1f3f5; color:#49dae9; text-align:center;" vertical-align="center" align="center"| '''<span style="font-size:24pt;">t</span>''' | style="background:#b7eef0; color:black; font-size:8pt; padding:4pt; line-height:1.25em;"| This user tweets on '''[[w:Twitter|Twitter]]''' as [http://twitter.com/_REACTTOOLKIT REACTTOOLKIT]. |} == '''External resources''' == # [http://apps.who.int/classifications/icd10/browse/2015/en#/F31 ICD-10 diagnostic criteria] # [https://en.wikiversity.org/w/index.php?title=Helping_Give_Away_Psychological_Science/Resources/Annotated_List_of_Where_and_How_to_Find_a_Therapist&wteswitched=1#Other_low-cost_options Find-a-Therapist] (a curated list of find-a-therapist websites where you can find a provider) # OMIM (Online Mendelian Inheritance in Man) ## [http://omim.org/entry/125480 125480] ## [http://omim.org/entry/611536 611536] ## [http://omim.org/entry/309200 309200,] ## [http://omim.org/entry/611535 611535] ## [http://omim.org/entry/603663 603663] # [https://emedicine.medscape.com/article/286342-overview eMedicine information] # [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/severe-mood-swings-and-bipolar-spectrum-disorders/ Effective Child Therapy information on Bipolar Disorder] #*Effective Child Therapy is website sponsored by Division 53 of the American Psychological Association (APA), or [https://sccap53.org The Society of Clinical Child and Adolescent Psychology](SCCAP), in collaboration with the Association for Behavioral and Cognitive Therapies (ABCT). Use for information on symptoms and available treatments. # The Psych Show with Dr. Ali Mattu videos (geared towards public; might send to client) ##[https://www.youtube.com/watch?v=llOPqKD-s4w How to Cope with Bipolar Disorder] ## [https://www.youtube.com/watch?v=kUHUmeqBZAA Top 10 Bipolar Myths] == '''References''' == {{collapse top|Click here for references|expand=yes}} {{Reflist|30em}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] {{collapse bottom}} 79d6bs8ho0an2hm6yv5cn9ua4h27iuu 2419205 2419184 2022-08-26T02:40:16Z Ardenguo 2944162 /* References */ fixed box title wikitext text/x-wiki <noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{medical disclaimer}} {{psychology}} {{Template:evidence-based assessment}} {{:{{BASEPAGENAME}}/Sidebar}} ==[[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio"?''']]== * For background information on what assessment portfolios are, click the link in the heading above. * Want even 'more' information about this topic? There's an extended version of this page [[Evidence-based assessment/Bipolar disorder in adults (assessment portfolio)/extended version|here]]. == [[Evidence based assessment/Preparation phase|'''Preparation phase''']] == === Diagnostic criteria for bipolar disorder in adults === Bipolar Disorder (BP) is characterized by extreme fluctuations in mood (or emotional dysregulation that ranges from mania (as shown by displays or feelings of extreme happiness, unrealistic overachievement and anger), to depression (as shown by displays or feelings of sadness, changes in appetite or weight and irritability.<ref name=":1" /> It has a lifetime risk of about 1%, with heritability estimated at up to 80%.<ref>{{Cite journal|last=Purcell|first=Shaun M.|last2=Wray|first2=Naomi R.|last3=Stone|first3=Jennifer L.|last4=Visscher|first4=Peter M.|last5=O'Donovan|first5=Michael C.|last6=Sullivan|first6=Patrick F.|last7=Sklar|first7=Pamela|last8=(Leader)|first8=Shaun M. Purcell|last9=Stone|first9=Jennifer L.|date=2009/08|title=Common polygenic variation contributes to risk of schizophrenia and bipolar disorder|url=http://www.nature.com/doifinder/10.1038/nature08185|journal=Nature|language=En|volume=460|issue=7256|doi=10.1038/nature08185|issn=1476-4687}}</ref> It is important to note that these moods exceed normal responses to life events, represent a change from the individual's normal functioning, and cause problems in daily activities. {{blockquotetop}} <big>'''ICD-11 Diagnostic Criteria'''</big> *Bipolar Type I Disorder **Bipolar type I disorder is an episodic mood disorder defined by the occurrence of one or more manic or mixed episodes. A manic episode is an extreme mood state lasting at least one week unless shortened by a treatment intervention characterized by euphoria, irritability, or expansiveness, and by increased activity or a subjective experience of increased energy, accompanied by other characteristic symptoms such as rapid or pressured speech, flight of ideas, increased self-esteem or grandiosity, decreased need for sleep, distractibility, impulsive or reckless behavior, and rapid changes among different mood states (i.e., mood lability). A mixed episode is characterized by either a mixture or very rapid alternation between prominent manic and depressive symptoms on most days during a period of at least 2 weeks. Although the diagnosis can be made based on evidence of a single manic or mixed episode, typically manic or mixed episodes alternate with depressive episodes over the course of the disorder. ***Note: The ICD-11 lists 18 additional subcategories of Bipolar type I disorder. They can be found [https://icd.who.int/browse11/l-m/en#/http://id.who.int/icd/entity/1456478153 here]. *Bipolar Type II Disorder **Bipolar type II disorder is an episodic mood disorder defined by the occurrence of one or more hypomanic episodes and at least one depressive episode. A hypomanic episode is a persistent mood state characterized by euphoria, irritability, or expansiveness, and excessive psychomotor activation or increased energy, accompanied by other characteristic symptoms such as grandiosity, decreased need for sleep, pressured speech, flight of ideas, distractibility, and impulsive or reckless behavior lasting for at least several days. The symptoms represent a change from the individual’s typical behavior and are not severe enough to cause marked impairment in functioning. A depressive episode is characterized by a period of almost daily depressed mood or diminished interest in activities lasting at least 2 weeks accompanied by other symptoms such as changes in appetite or sleep, psychomotor agitation or retardation, fatigue, feelings of worthless or excessive or inappropriate guilt, feelings or hopelessness, difficulty concentrating, and suicidality. There is no history of manic or mixed Episodes. ***Note: The ICD-11 lists 13 additional subcategories of Bipolar type II disorder. They can be found [https://icd.who.int/browse11/l-m/en#/http%3a%2f%2fid.who.int%2ficd%2fentity%2f199053300 here]. '''Changes in DSM-5''' * The diagnostic criteria for '''Bipolar Disorder''' changed slightly from [[DSM-IV]] to [[w:Diagnostic_and_Statistical_Manual_of_Mental_Disorders#DSM-IV-TR_.282000.29|DSM-5]]. Summaries are available [http://www.dsm5.org/Documents/changes%20from%20dsm-iv-tr%20to%20dsm-5.pdf here] and [[w:DSM-5|here]]. {{blockquotebottom}} === Base rates of BD in different clinical settings and populations === This section describes the demographic setting of the population(s) sampled, base rates of diagnosis, country/region sampled, and the diagnostic method that was used. Using this information, clinicians will be able to anchor the rate of adolescent depression that they are likely to see in their clinical practice. * '''''To see prevalence rates across multiple disorders,''''' [[Evidence based assessment/Preparation phase#Base rates for transdiagnostic comparison|'''''click here.''''']] {| class="wikitable" |'''Demography''' |'''Setting''' |'''Base Rate''' |'''Diagnostic Method''' |- |United States, Canada, Puerto Rico, Germany, Taiwan, Korea, New Zealand <ref>{{Cite journal|last=Weissman|first=Myrna M.|last2=Bland|first2=Roger C.|last3=Canino|first3=Glorisa J.|last4=Faravelli|first4=Carlo|last5=Greenwald|first5=Steven|last6=Hwu|first6=Hai-Gwo|last7=Joyce|first7=Peter R.|last8=Karam|first8=Eile G.|last9=Lee|first9=Chung-Kyoon|date=1996-07-24|title=Cross-National Epidemiology of Major Depression and Bipolar Disorder|url=https://doi.org/10.1001/jama.1996.03540040037030|journal=JAMA|volume=276|issue=4|pages=293–299|doi=10.1001/jama.1996.03540040037030|issn=0098-7484}}</ref> |Community Epidemiological Samples |0.3 - 1.5% |Structured and semi-structured diagnostic interviews |- |United States<ref>{{Cite journal|last=Merikangas|first=Kathleen R.|last2=Akiskal|first2=Hagop S.|last3=Angst|first3=Jules|last4=Greenberg|first4=Paul E.|last5=Hirschfeld|first5=Robert M. A.|last6=Petukhova|first6=Maria|last7=Kessler|first7=Ronald C.|date=2007-05-01|title=Lifetime and 12-Month Prevalence of Bipolar Spectrum Disorder in the National Comorbidity Survey Replication|url=https://jamanetwork.com/journals/jamapsychiatry/fullarticle/482285|journal=Archives of General Psychiatry|language=en|volume=64|issue=5|pages=543–552|doi=10.1001/archpsyc.64.5.543|issn=0003-990X}}</ref> |Community Epidemiological Samples |BPI - 1%; BPII - 1.1%; Subthreshold BP - 2.4% |World Health Organisation Composite International Diagnostic Interview |- |United States<ref>{{Cite journal|last=LEWINSOHN|first=PETER M.|last2=KLEIN|first2=DANIEL N.|last3=SEELEY|first3=JOHN R.|title=Bipolar Disorders in a Community Sample of Older Adolescents: Prevalence, Phenomenology, Comorbidity, and Course|url=http://linkinghub.elsevier.com/retrieve/pii/S089085670963731X|journal=Journal of the American Academy of Child & Adolescent Psychiatry|volume=34|issue=4|pages=454–463|doi=10.1097/00004583-199504000-00012}}</ref> |Community samples (older adolescents) |1% |K-SADS Semi-Structured Interview |- |United States<ref>{{Cite journal|last=Judd|first=Lewis L.|last2=Akiskal|first2=Hagop S.|title=The prevalence and disability of bipolar spectrum disorders in the US population: re-analysis of the ECA database taking into account subthreshold cases|url=https://doi.org/10.1016/S0165-0327(02)00332-4|journal=Journal of Affective Disorders|volume=73|issue=1-2|pages=123–131|doi=10.1016/s0165-0327(02)00332-4}}</ref> |US National Epidemiological Catchment Area (ECA) database |0.8 - 5.1% (manic and subthreshold mania) |Diagnostic Interview Schedule (DIS) |- |United States<ref>{{Cite journal|last=Kessler|first=R. C.|last2=Rubinow|first2=D. R.|last3=Holmes|first3=C.|last4=Abelson|first4=J. M.|last5=Zhao|first5=S.|date=1997/09|title=The epidemiology of DSM-III-R bipolar I disorder in a general population survey|url=https://www.cambridge.org/core/journals/psychological-medicine/article/epidemiology-of-dsmiiir-bipolar-i-disorder-in-a-general-population-survey/950D518D15F64E2059F1033558615A9A|journal=Psychological Medicine|language=en|volume=27|issue=5|pages=1079–1089|issn=1469-8978}}</ref> |US National Comorbidity Survey (NCS) |0-4% (small community sample; reappraisal study) |World Health Organisation Composite International Diagnostic Interview |- |United States and other countries<ref>{{Cite book|url=https://www.worldcat.org/oclc/830807378|title=Diagnostic and statistical manual of mental disorders : DSM-5.|date=2013|publisher=American Psychiatric Association., American Psychiatric Association. DSM-5 Task Force.|isbn=9780890425541|edition=5th|location=Arlington, VA|oclc=830807378}}</ref> |Community sample |BPI - 0.6%; BPII-  1.8%;  Cyclothymia - 0.4-1% |Unspecified |- |United States, Europe, Asia<ref>{{Cite journal|last=Merikangas|first=Kathleen R.|last2=Jin|first2=Robert|last3=He|first3=Jian-Ping|last4=Kessler|first4=Ronald C.|last5=Lee|first5=Sing|last6=Sampson|first6=Nancy A.|last7=Viana|first7=Maria Carmen|last8=Andrade|first8=Laura Helena|last9=Hu|first9=Chiyi|date=2011-03-07|title=Prevalence and Correlates of Bipolar Spectrum Disorder in the World Mental Health Survey Initiative|url=http://archpsyc.jamanetwork.com/article.aspx?doi=10.1001/archgenpsychiatry.2011.12|journal=Archives of General Psychiatry|language=en|volume=68|issue=3|doi=10.1001/archgenpsychiatry.2011.12|issn=0003-990X}}</ref> |Community Samples |BPI - 0.6%; BPII - 0.4%; Subthreshold BP - 1.4%; Bipolar Spectrum Disorder - 2.4% |World Health Organisation Composite International Diagnostic Interview |- |United States<ref>{{Cite journal|last=Grant|first=Bridget F.|last2=Stinson|first2=Frederick S.|last3=Hasin|first3=Deborah S.|last4=Dawson|first4=Deborah A.|last5=Chou|first5=S. Patricia|last6=Ruan|first6=W. June|last7=Huang|first7=Boji|date=October 2005|title=Prevalence, correlates, and comorbidity of bipolar I disorder and axis I and II disorders: results from the National Epidemiologic Survey on Alcohol and Related Conditions|url=https://www.ncbi.nlm.nih.gov/pubmed/16259532|journal=The Journal of Clinical Psychiatry|volume=66|issue=10|pages=1205–1215|issn=0160-6689|pmid=16259532}}</ref> |National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) |BPI - 3.3% |The Alcohol Use Disorder and Associated Disabilities Interview Schedule-IV (AUDADIS-IV) |- |United States<ref>{{Cite journal|last=Das|first=Amar K.|date=2005-02-23|title=Screening for Bipolar Disorder in a Primary Care Practice|url=http://jama.jamanetwork.com/article.aspx?doi=10.1001/jama.293.8.956|journal=JAMA|language=en|volume=293|issue=8|doi=10.1001/jama.293.8.956|issn=0098-7484}}</ref> |Outpatient Clinic Sample |9.8% |Review of medical records, questionnaire data |- |United States<ref>{{cite journal|last1=Hirschfeld|first1=RM|last2=Cass|first2=AR|last3=Holt|first3=DC|last4=Carlson|first4=CA|date=2005|title=Screening for bipolar disorder in patients treated for depression in a family medicine clinic.|journal=The Journal of the American Board of Family Practice|volume=18|issue=4|pages=233-9|pmid=15994469}}</ref> |Outpatient Clinic Sample |21.3% |MDQ, SCID |} ==[[Evidence based assessment/Prediction phase|'''Prediction phase''']]== === Psychometric properties of screening instruments for adult bipolar disorder === The following section contains a list of screening and diagnostic instruments for adult bipolar disorder. The section includes administration information, psychometric data, and PDFs or links to the screenings. * Screenings are used as part of the [[Evidence based assessment/Prediction phase|prediction phase]] of assessment; for more information on interpretation of this data, or how screenings fit in to the assessment process, click [[Evidence based assessment/Prediction phase|here.]] * '''''For a list of more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Psychometric_properties_of_common_screening_instruments click here.]''''' {| class="wikitable" |- ! Measure !Format (Reporter) !Age Range !Administration/ Completion Time !Where to Access |- |[[wikipedia:General_Behavior_Inventory|GBI (General Behavior Inventory)]]<ref>{{Cite journal|date=2018-06|editor-last=Hunsley|editor-first=John|editor2-last=Mash|editor2-first=Eric J.|title=A Guide to Assessments That Work|url=http://dx.doi.org/10.1093/med-psych/9780190492243.001.0001|journal=Oxford Clinical Psychology|doi=10.1093/med-psych/9780190492243.001.0001}}</ref> |Self-report |Adult |15-20 minutes | * [https://mfr.osf.io/render?url=https://osf.io/j6rce/?action=download%26mode=render Downloadable PDF Self-Report English] * [https://mfr.osf.io/render?url=https://osf.io/27nwg/?action=download%26mode=render Scoring instructions and information] |- |[[wikipedia:Mood_Disorder_Questionnaire|MDQ (Mood Disorder Questionnaire)]]<ref name="Carvalho" /> |Self-report |Adult |5 minutes | * [https://mfr.osf.io/render?url=https://osf.io/sb5xw/?action=download%26mode=render Adult Self-Report (Long, English)] * [https://mfr.osf.io/render?url=https://osf.io/xa7v6/?action=download%26mode=render Adult Self-Report (Short, English)] * |- |[[wikipedia:Bipolar_Spectrum_Diagnostic_Scale|BSDS (Bipolar Spectrum Diagnostic Scale)]]<ref>{{Cite journal|date=2018-06|editor-last=Hunsley|editor-first=John|editor2-last=Mash|editor2-first=Eric J.|title=A Guide to Assessments That Work|url=http://dx.doi.org/10.1093/med-psych/9780190492243.001.0001|journal=Oxford Clinical Psychology|doi=10.1093/med-psych/9780190492243.001.0001}}</ref><ref name="Carvalho" /> |Self-report |Adult |15 minutes | * [http://psycheducation.org/diagnosis/the-bipolar-spectrum-diagnostic-scale/ Online version] * [https://mfr.osf.io/render?url=https://osf.io/w9qet/?action=download%26mode=render Downloadable PDF Version (English)] |- |[[wikipedia:Hypomania_Checklist|HCL-32 (Hypomania Checklist)]]<ref name="Carvalho" /><ref>{{Cite journal|last=Feng|first=Yuan|last2=Wang|first2=Yuan-Yuan|last3=Huang|first3=Wei|last4=Ungvari|first4=Gabor S.|last5=Ng|first5=Chee H.|last6=Wang|first6=Gang|last7=Yuan|first7=Zhen|last8=Xiang|first8=Yu-Tao|date=2017-06-01|title=Comparison of the 32-item Hypomania Checklist, the 33-item Hypomania Checklist, and the Mood Disorders Questionnaire for bipolar disorder|url=http://onlinelibrary.wiley.com/doi/10.1111/pcn.12506/abstract|journal=Psychiatry and Clinical Neurosciences|language=en|volume=71|issue=6|pages=403–408|doi=10.1111/pcn.12506|issn=1440-1819}}</ref> |Self-report |Adult |10-15 minutes | * [https://mfr.osf.io/render?url=https://osf.io/2veyc/?action=download%26mode=render Self-report] |} '''Note:''' '''L''' = Less than adequate; '''A''' = Adequate; '''G''' = Good; '''E''' = Excellent; '''U''' = Unavailable; '''NA''' = Not applicable === Likelihood ratios and AUCs of screening measures for bipolar disorder in adults === * '''''For a list of the likelihood ratios for more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Likelihood_ratios_and_AUCs_of_common_screening_instruments click here.]''''' {| class="wikitable sortable" !'''Screening Measure (Primary Reference)''' !'''Area Under Curve (AUC) and sample size''' !'''DiLR+ (score)''' !DiLR- (score) !'''Population''' |- |[[wikipedia:Bipolar_Spectrum_Diagnostic_Scale|BSDS (Bipolar Spectrum Diagnostic Scale)]] <ref name="Carvalho" /> |0.81 |(13) <ref name = Carvalho>{{cite journal|last1=Carvalho|first1=André F.|last2=Takwoingi|first2=Yemisi|last3=Sales|first3=Paulo Marcelo G.|last4=Soczynska|first4=Joanna K.|last5=Köhler|first5=Cristiano A.|last6=Freitas|first6=Thiago H.|last7=Quevedo|first7=João|last8=Hyphantis|first8=Thomas N.|last9=McIntyre|first9=Roger S.|last10=Vieta|first10=Eduard|title=Screening for bipolar spectrum disorders: A comprehensive meta-analysis of accuracy studies|journal=Journal of Affective Disorders|date=February 2015|volume=172|pages=337–346|doi=https://doi.org/10.1016/j.jad.2014.10.024}}</ref> |0.36 (4.93) |Clinical |- |[[wikipedia:Hypomania_Checklist|HCL-32 (Hypomania Checklist)]]<ref name="Carvalho" /> |0.80 |(14)<ref name="Carvalho" /> |0.28 (2.45) |Clinical |- |[[wikipedia:Mood_Disorder_Questionnaire|MDQ (Mood Disorder Questionnaire)]]<ref name="Carvalho" /> |0.78 |(7)<ref name="Carvalho" /> |0.22 (5.4) |Clinical |- |General Behavior Inventory (GBI) | | | | |} '''Note:''' Area Under Curve (AUC, or AUROC) is equal to the probability that a classifier will rank a randomly chosen positive diagnosis of Bipolar Disorder higher than a randomly chosen negative diagnosis of Bipolar Disorder[15]. ==[[Evidence based assessment/Prescription phase|'''Prescription phase''']]== ===Gold standard diagnostic interviews=== * For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews click here.] ===Recommended diagnostic interviews for adult bipolar disorder=== {| class="wikitable sortable" border="1" ! colspan="5" |Diagnostic instruments for BPSD |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time !Where to Access |- | Structured Clinical Interview for DSM-5 (SCID)<ref>{{Cite journal|last=Miller|first=Christopher J.|last2=Johnson|first2=Sheri L.|last3=Eisner|first3=Lori|date=2009-06|title=Assessment tools for adult bipolar disorder.|url=http://doi.apa.org/getdoi.cfm?doi=10.1111/j.1468-2850.2009.01158.x|journal=Clinical Psychology: Science and Practice|language=en|volume=16|issue=2|pages=188–201|doi=10.1111/j.1468-2850.2009.01158.x|issn=1468-2850|pmc=PMC2847794|pmid=20360999}}</ref><ref>{{Cite journal|date=2018-06|editor-last=Hunsley|editor-first=John|editor2-last=Mash|editor2-first=Eric J.|title=A Guide to Assessments That Work|url=http://dx.doi.org/10.1093/med-psych/9780190492243.001.0001|journal=Oxford Clinical Psychology|doi=10.1093/med-psych/9780190492243.001.0001}}</ref> | Semistructured interview | 18+ | 1-2 hours |Available for purchase from [https://www.appi.org/products/structured-clinical-interview-for-dsm-5-scid-5 APA Publishing] |- | Schedule for Affective Disorders and Schizophrenia (SADS)<ref>{{Cite journal|date=2018-06|editor-last=Hunsley|editor-first=John|editor2-last=Mash|editor2-first=Eric J.|title=A Guide to Assessments That Work|url=http://dx.doi.org/10.1093/med-psych/9780190492243.001.0001|journal=Oxford Clinical Psychology|doi=10.1093/med-psych/9780190492243.001.0001}}</ref><ref>{{Cite journal|last=Miller|first=Christopher J.|last2=Johnson|first2=Sheri L.|last3=Eisner|first3=Lori|date=2009-06|title=Assessment tools for adult bipolar disorder.|url=http://doi.apa.org/getdoi.cfm?doi=10.1111/j.1468-2850.2009.01158.x|journal=Clinical Psychology: Science and Practice|language=en|volume=16|issue=2|pages=188–201|doi=10.1111/j.1468-2850.2009.01158.x|issn=1468-2850|pmc=PMC2847794|pmid=20360999}}</ref><ref>{{Cite journal|last=Endicott|first=Jean|date=1978-07-01|title=A Diagnostic Interview: The Schedule for Affective Disorders and Schizophrenia|url=http://archpsyc.jamanetwork.com/article.aspx?doi=10.1001/archpsyc.1978.01770310043002|journal=Archives of General Psychiatry|language=en|volume=35|issue=7|pages=837|doi=10.1001/archpsyc.1978.01770310043002|issn=0003-990X}}</ref> | Semistructured interview | 18+ | 1-2 hours |[https://jamanetwork.com/journals/jamapsychiatry/article-abstract/491947 (Endicott & Spitzer, 1978)] |} ==[[Evidence based assessment/Process phase|'''Process phase''']]== === Treatment === * Please refer to the page on [https://en.wikipedia.org/wiki/Bipolar_disorder bipolar disorder] for more information on available treatment for bipolar disorder or go to the Effective Child Therapy pages for [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/severe-mood-swings-and-bipolar-spectrum-disorders/| Severe Mood Swings & Bipolar Spectrum Disorders] * [https://reacttoolkit.uk/ Relatives Education and Coping Toolkit (REACT)] is currently freely available at https://reacttoolkit.uk/. This is a resource/project of [https://www.lancaster.ac.uk/health-and-medicine/research/spectrum/ The Sprectrum Centre for Mental Health Research] from Lancaster University. A team of clinicians, researchers and relatives of people with psychosis or bipolar disorder at Lancaster, Liverpool and London have developed the Relatives Education and Coping Toolkit (REACT). REACT provides [https://www.nice.org.uk/ National Institute for Health and Care Excellence (NICE)] recommended information and support to relatives and friends of people with mental health problems associated with psychosis or bipolar disorder through a digital, peer-supported, self-management toolkit.<ref>Lobban, A. F., Robinson, H. A., Appelbe, D., Barraclough, J., Bedson, E., Collinge, E., Dodd, S., Flowers, S., Honary, M., Johnson, S., Caixeiro Mateus, M. D. C., Mezes, B., Minns, V., Murray, E., Walker, A. J., Williamson, P., Wintermeyer, C., & Jones, S. H. (2017). Protocol for an online randomised controlled trial to evaluate the clinical and cost-effectiveness of a peer-supported self-management intervention for relatives of people with psychosis or bipolar disorder: Relatives Education And Coping Toolkit (REACT). BMJ Open, 7, [016965]. <nowiki>https://doi.org/10.1136/bmjopen-2017-016965</nowiki></ref><ref>Lobban, F., Akers, N., Appelbe, D., Chapman, L., Collinge, L., Dodd, S., Flowers, S., Hollingsworth, B., Johnson, S., Jones, S. H., Mateus, C., Mezes, B., Murray, E., Panagaki, K., Rainford, N., Robinson, H., Rosala-Hallas, A., Sellwood, W., Walker, A., & Williamson, P. (2020). Clinical effectiveness of a web-based peer-supported self-management intervention for relatives of people with psychosis or bipolar (REACT): online, observer-blind, randomised controlled superiority trial. BMC Psychiatry, 20(1), [160]. <nowiki>https://doi.org/10.1186/s12888-020-02545-9</nowiki></ref><ref>{{Cite journal|last=F|first=Lobban|last2=N|first2=Akers|last3=D|first3=Appelbe|last4=R|first4=Iraci Capuccinello|last5=L|first5=Chapman|last6=L|first6=Collinge|last7=S|first7=Dodd|last8=S|first8=Flowers|last9=B|first9=Hollingsworth|date=2020-07-01|title=A web-based, peer-supported self-management intervention to reduce distress in relatives of people with psychosis or bipolar disorder: the REACT RCT|url=https://www.journalslibrary.nihr.ac.uk/hta/hta24320|journal=Health Technology Assessment|language=EN|volume=24|issue=32|doi=10.3310/hta24320|issn=2046-4924|pmc=PMC7355407|pmid=32608353}}</ref> ** The team at Spectrum Centre also conducted a study linked to REACT called IMPART which looked at what would happen if they tried to deliver REACT as part of routine clinical care in Early Intervention Teams in the [https://www.nhs.uk/ United Kingdom's National Health Service (NHS)]. This study identified key factors that impact implementation and may be useful for informing implementation plans for other digital health interventions.<ref>{{Cite journal|last=Lobban|first=Fiona|last2=Appelbe|first2=Duncan|last3=Appleton|first3=Victoria|last4=Billsborough|first4=Julie|last5=Fisher|first5=Naomi Ruth|last6=Foster|first6=Sheena|last7=Gill|first7=Bethany|last8=Glentworth|first8=David|last9=Harrop|first9=Chris|date=2020-03-17|title=IMPlementation of An online Relatives’ Toolkit for psychosis or bipolar (IMPART study): iterative multiple case study to identify key factors impacting on staff uptake and use|url=https://doi.org/10.1186/s12913-020-5002-4|journal=BMC Health Services Research|volume=20|issue=1|pages=219|doi=10.1186/s12913-020-5002-4|issn=1472-6963|pmc=PMC7077000|pmid=32183787}}</ref> ** '''[https://www.lancaster.ac.uk/health-and-medicine/research/spectrum/ RECOVERY TOOLKIT]''' #eRecoveryToolkit, #RecoveryBD, #PersonalRecovery is freely accessible at https://www.lancaster.ac.uk/health-and-medicine/research/spectrum/. Inspired from a greater body of work around recovery, people with lived experience of bipolar disorder and researchers at [https://www.lancaster.ac.uk/health-and-medicine/research/spectrum/ Spectrum Centre] have created a multi-media recovery toolkit. The aim of the toolkit is to provide accessible information and promote discussion around personal discovery in order to understand and aid people’s recovery journeys. The toolkit contains an animation, an e-booklet and video narratives of relatives and clinicians.<ref>Beck, A. K., Baker, A., Jones, S. H., Lobban, A. F., Kay-Lambkin, F., Attia, J., & Banfield, M. (2018). Exploring the feasibility and acceptability of a recovery-focused group therapy intervention for adults with bipolar disorder: trial protocol. BMJ Open, 8, [e019203]. <nowiki>https://doi.org/10.1136/bmjopen-2017-019203</nowiki></ref> {| cellspacing="0" style="width:238px;" | style="width:45px; height:45px; background:#d1f3f5; color:#49dae9; text-align:center;" vertical-align="center" align="center"| '''<span style="font-size:24pt;">t</span>''' | style="background:#b7eef0; color:black; font-size:8pt; padding:4pt; line-height:1.25em;"| This user tweets on '''[[w:Twitter|Twitter]]''' as [http://twitter.com/_REACTTOOLKIT REACTTOOLKIT]. |} == '''External resources''' == # [http://apps.who.int/classifications/icd10/browse/2015/en#/F31 ICD-10 diagnostic criteria] # [https://en.wikiversity.org/w/index.php?title=Helping_Give_Away_Psychological_Science/Resources/Annotated_List_of_Where_and_How_to_Find_a_Therapist&wteswitched=1#Other_low-cost_options Find-a-Therapist] (a curated list of find-a-therapist websites where you can find a provider) # OMIM (Online Mendelian Inheritance in Man) ## [http://omim.org/entry/125480 125480] ## [http://omim.org/entry/611536 611536] ## [http://omim.org/entry/309200 309200,] ## [http://omim.org/entry/611535 611535] ## [http://omim.org/entry/603663 603663] # [https://emedicine.medscape.com/article/286342-overview eMedicine information] # [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/severe-mood-swings-and-bipolar-spectrum-disorders/ Effective Child Therapy information on Bipolar Disorder] #*Effective Child Therapy is website sponsored by Division 53 of the American Psychological Association (APA), or [https://sccap53.org The Society of Clinical Child and Adolescent Psychology](SCCAP), in collaboration with the Association for Behavioral and Cognitive Therapies (ABCT). Use for information on symptoms and available treatments. # The Psych Show with Dr. Ali Mattu videos (geared towards public; might send to client) ##[https://www.youtube.com/watch?v=llOPqKD-s4w How to Cope with Bipolar Disorder] ## [https://www.youtube.com/watch?v=kUHUmeqBZAA Top 10 Bipolar Myths] == '''References''' == {{collapse top|References|expand=yes}} {{Reflist|30em}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] {{collapse bottom}} cbzyanb1kk1289xv917wqkuc3viwap1 2419246 2419205 2022-08-26T03:50:54Z Ardenguo 2944162 /* Psychometric properties of screening instruments for adult bipolar disorder */ Removed all "Note: L = Less than adequate; A = Adequate; G = Good; E = Excellent; U = Unavailable; NA = Not applicable" because the condensed-version portfolios don't include reliability/validity. wikitext text/x-wiki <noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{medical disclaimer}} {{psychology}} {{Template:evidence-based assessment}} {{:{{BASEPAGENAME}}/Sidebar}} ==[[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio"?''']]== * For background information on what assessment portfolios are, click the link in the heading above. * Want even 'more' information about this topic? There's an extended version of this page [[Evidence-based assessment/Bipolar disorder in adults (assessment portfolio)/extended version|here]]. == [[Evidence based assessment/Preparation phase|'''Preparation phase''']] == === Diagnostic criteria for bipolar disorder in adults === Bipolar Disorder (BP) is characterized by extreme fluctuations in mood (or emotional dysregulation that ranges from mania (as shown by displays or feelings of extreme happiness, unrealistic overachievement and anger), to depression (as shown by displays or feelings of sadness, changes in appetite or weight and irritability.<ref name=":1" /> It has a lifetime risk of about 1%, with heritability estimated at up to 80%.<ref>{{Cite journal|last=Purcell|first=Shaun M.|last2=Wray|first2=Naomi R.|last3=Stone|first3=Jennifer L.|last4=Visscher|first4=Peter M.|last5=O'Donovan|first5=Michael C.|last6=Sullivan|first6=Patrick F.|last7=Sklar|first7=Pamela|last8=(Leader)|first8=Shaun M. Purcell|last9=Stone|first9=Jennifer L.|date=2009/08|title=Common polygenic variation contributes to risk of schizophrenia and bipolar disorder|url=http://www.nature.com/doifinder/10.1038/nature08185|journal=Nature|language=En|volume=460|issue=7256|doi=10.1038/nature08185|issn=1476-4687}}</ref> It is important to note that these moods exceed normal responses to life events, represent a change from the individual's normal functioning, and cause problems in daily activities. {{blockquotetop}} <big>'''ICD-11 Diagnostic Criteria'''</big> *Bipolar Type I Disorder **Bipolar type I disorder is an episodic mood disorder defined by the occurrence of one or more manic or mixed episodes. A manic episode is an extreme mood state lasting at least one week unless shortened by a treatment intervention characterized by euphoria, irritability, or expansiveness, and by increased activity or a subjective experience of increased energy, accompanied by other characteristic symptoms such as rapid or pressured speech, flight of ideas, increased self-esteem or grandiosity, decreased need for sleep, distractibility, impulsive or reckless behavior, and rapid changes among different mood states (i.e., mood lability). A mixed episode is characterized by either a mixture or very rapid alternation between prominent manic and depressive symptoms on most days during a period of at least 2 weeks. Although the diagnosis can be made based on evidence of a single manic or mixed episode, typically manic or mixed episodes alternate with depressive episodes over the course of the disorder. ***Note: The ICD-11 lists 18 additional subcategories of Bipolar type I disorder. They can be found [https://icd.who.int/browse11/l-m/en#/http://id.who.int/icd/entity/1456478153 here]. *Bipolar Type II Disorder **Bipolar type II disorder is an episodic mood disorder defined by the occurrence of one or more hypomanic episodes and at least one depressive episode. A hypomanic episode is a persistent mood state characterized by euphoria, irritability, or expansiveness, and excessive psychomotor activation or increased energy, accompanied by other characteristic symptoms such as grandiosity, decreased need for sleep, pressured speech, flight of ideas, distractibility, and impulsive or reckless behavior lasting for at least several days. The symptoms represent a change from the individual’s typical behavior and are not severe enough to cause marked impairment in functioning. A depressive episode is characterized by a period of almost daily depressed mood or diminished interest in activities lasting at least 2 weeks accompanied by other symptoms such as changes in appetite or sleep, psychomotor agitation or retardation, fatigue, feelings of worthless or excessive or inappropriate guilt, feelings or hopelessness, difficulty concentrating, and suicidality. There is no history of manic or mixed Episodes. ***Note: The ICD-11 lists 13 additional subcategories of Bipolar type II disorder. They can be found [https://icd.who.int/browse11/l-m/en#/http%3a%2f%2fid.who.int%2ficd%2fentity%2f199053300 here]. '''Changes in DSM-5''' * The diagnostic criteria for '''Bipolar Disorder''' changed slightly from [[DSM-IV]] to [[w:Diagnostic_and_Statistical_Manual_of_Mental_Disorders#DSM-IV-TR_.282000.29|DSM-5]]. Summaries are available [http://www.dsm5.org/Documents/changes%20from%20dsm-iv-tr%20to%20dsm-5.pdf here] and [[w:DSM-5|here]]. {{blockquotebottom}} === Base rates of BD in different clinical settings and populations === This section describes the demographic setting of the population(s) sampled, base rates of diagnosis, country/region sampled, and the diagnostic method that was used. Using this information, clinicians will be able to anchor the rate of adolescent depression that they are likely to see in their clinical practice. * '''''To see prevalence rates across multiple disorders,''''' [[Evidence based assessment/Preparation phase#Base rates for transdiagnostic comparison|'''''click here.''''']] {| class="wikitable" |'''Demography''' |'''Setting''' |'''Base Rate''' |'''Diagnostic Method''' |- |United States, Canada, Puerto Rico, Germany, Taiwan, Korea, New Zealand <ref>{{Cite journal|last=Weissman|first=Myrna M.|last2=Bland|first2=Roger C.|last3=Canino|first3=Glorisa J.|last4=Faravelli|first4=Carlo|last5=Greenwald|first5=Steven|last6=Hwu|first6=Hai-Gwo|last7=Joyce|first7=Peter R.|last8=Karam|first8=Eile G.|last9=Lee|first9=Chung-Kyoon|date=1996-07-24|title=Cross-National Epidemiology of Major Depression and Bipolar Disorder|url=https://doi.org/10.1001/jama.1996.03540040037030|journal=JAMA|volume=276|issue=4|pages=293–299|doi=10.1001/jama.1996.03540040037030|issn=0098-7484}}</ref> |Community Epidemiological Samples |0.3 - 1.5% |Structured and semi-structured diagnostic interviews |- |United States<ref>{{Cite journal|last=Merikangas|first=Kathleen R.|last2=Akiskal|first2=Hagop S.|last3=Angst|first3=Jules|last4=Greenberg|first4=Paul E.|last5=Hirschfeld|first5=Robert M. A.|last6=Petukhova|first6=Maria|last7=Kessler|first7=Ronald C.|date=2007-05-01|title=Lifetime and 12-Month Prevalence of Bipolar Spectrum Disorder in the National Comorbidity Survey Replication|url=https://jamanetwork.com/journals/jamapsychiatry/fullarticle/482285|journal=Archives of General Psychiatry|language=en|volume=64|issue=5|pages=543–552|doi=10.1001/archpsyc.64.5.543|issn=0003-990X}}</ref> |Community Epidemiological Samples |BPI - 1%; BPII - 1.1%; Subthreshold BP - 2.4% |World Health Organisation Composite International Diagnostic Interview |- |United States<ref>{{Cite journal|last=LEWINSOHN|first=PETER M.|last2=KLEIN|first2=DANIEL N.|last3=SEELEY|first3=JOHN R.|title=Bipolar Disorders in a Community Sample of Older Adolescents: Prevalence, Phenomenology, Comorbidity, and Course|url=http://linkinghub.elsevier.com/retrieve/pii/S089085670963731X|journal=Journal of the American Academy of Child & Adolescent Psychiatry|volume=34|issue=4|pages=454–463|doi=10.1097/00004583-199504000-00012}}</ref> |Community samples (older adolescents) |1% |K-SADS Semi-Structured Interview |- |United States<ref>{{Cite journal|last=Judd|first=Lewis L.|last2=Akiskal|first2=Hagop S.|title=The prevalence and disability of bipolar spectrum disorders in the US population: re-analysis of the ECA database taking into account subthreshold cases|url=https://doi.org/10.1016/S0165-0327(02)00332-4|journal=Journal of Affective Disorders|volume=73|issue=1-2|pages=123–131|doi=10.1016/s0165-0327(02)00332-4}}</ref> |US National Epidemiological Catchment Area (ECA) database |0.8 - 5.1% (manic and subthreshold mania) |Diagnostic Interview Schedule (DIS) |- |United States<ref>{{Cite journal|last=Kessler|first=R. C.|last2=Rubinow|first2=D. R.|last3=Holmes|first3=C.|last4=Abelson|first4=J. M.|last5=Zhao|first5=S.|date=1997/09|title=The epidemiology of DSM-III-R bipolar I disorder in a general population survey|url=https://www.cambridge.org/core/journals/psychological-medicine/article/epidemiology-of-dsmiiir-bipolar-i-disorder-in-a-general-population-survey/950D518D15F64E2059F1033558615A9A|journal=Psychological Medicine|language=en|volume=27|issue=5|pages=1079–1089|issn=1469-8978}}</ref> |US National Comorbidity Survey (NCS) |0-4% (small community sample; reappraisal study) |World Health Organisation Composite International Diagnostic Interview |- |United States and other countries<ref>{{Cite book|url=https://www.worldcat.org/oclc/830807378|title=Diagnostic and statistical manual of mental disorders : DSM-5.|date=2013|publisher=American Psychiatric Association., American Psychiatric Association. DSM-5 Task Force.|isbn=9780890425541|edition=5th|location=Arlington, VA|oclc=830807378}}</ref> |Community sample |BPI - 0.6%; BPII-  1.8%;  Cyclothymia - 0.4-1% |Unspecified |- |United States, Europe, Asia<ref>{{Cite journal|last=Merikangas|first=Kathleen R.|last2=Jin|first2=Robert|last3=He|first3=Jian-Ping|last4=Kessler|first4=Ronald C.|last5=Lee|first5=Sing|last6=Sampson|first6=Nancy A.|last7=Viana|first7=Maria Carmen|last8=Andrade|first8=Laura Helena|last9=Hu|first9=Chiyi|date=2011-03-07|title=Prevalence and Correlates of Bipolar Spectrum Disorder in the World Mental Health Survey Initiative|url=http://archpsyc.jamanetwork.com/article.aspx?doi=10.1001/archgenpsychiatry.2011.12|journal=Archives of General Psychiatry|language=en|volume=68|issue=3|doi=10.1001/archgenpsychiatry.2011.12|issn=0003-990X}}</ref> |Community Samples |BPI - 0.6%; BPII - 0.4%; Subthreshold BP - 1.4%; Bipolar Spectrum Disorder - 2.4% |World Health Organisation Composite International Diagnostic Interview |- |United States<ref>{{Cite journal|last=Grant|first=Bridget F.|last2=Stinson|first2=Frederick S.|last3=Hasin|first3=Deborah S.|last4=Dawson|first4=Deborah A.|last5=Chou|first5=S. Patricia|last6=Ruan|first6=W. June|last7=Huang|first7=Boji|date=October 2005|title=Prevalence, correlates, and comorbidity of bipolar I disorder and axis I and II disorders: results from the National Epidemiologic Survey on Alcohol and Related Conditions|url=https://www.ncbi.nlm.nih.gov/pubmed/16259532|journal=The Journal of Clinical Psychiatry|volume=66|issue=10|pages=1205–1215|issn=0160-6689|pmid=16259532}}</ref> |National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) |BPI - 3.3% |The Alcohol Use Disorder and Associated Disabilities Interview Schedule-IV (AUDADIS-IV) |- |United States<ref>{{Cite journal|last=Das|first=Amar K.|date=2005-02-23|title=Screening for Bipolar Disorder in a Primary Care Practice|url=http://jama.jamanetwork.com/article.aspx?doi=10.1001/jama.293.8.956|journal=JAMA|language=en|volume=293|issue=8|doi=10.1001/jama.293.8.956|issn=0098-7484}}</ref> |Outpatient Clinic Sample |9.8% |Review of medical records, questionnaire data |- |United States<ref>{{cite journal|last1=Hirschfeld|first1=RM|last2=Cass|first2=AR|last3=Holt|first3=DC|last4=Carlson|first4=CA|date=2005|title=Screening for bipolar disorder in patients treated for depression in a family medicine clinic.|journal=The Journal of the American Board of Family Practice|volume=18|issue=4|pages=233-9|pmid=15994469}}</ref> |Outpatient Clinic Sample |21.3% |MDQ, SCID |} ==[[Evidence based assessment/Prediction phase|'''Prediction phase''']]== === Psychometric properties of screening instruments for adult bipolar disorder === The following section contains a list of screening and diagnostic instruments for adult bipolar disorder. The section includes administration information, psychometric data, and PDFs or links to the screenings. * Screenings are used as part of the [[Evidence based assessment/Prediction phase|prediction phase]] of assessment; for more information on interpretation of this data, or how screenings fit in to the assessment process, click [[Evidence based assessment/Prediction phase|here.]] * '''''For a list of more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Psychometric_properties_of_common_screening_instruments click here.]''''' {| class="wikitable" |- ! Measure !Format (Reporter) !Age Range !Administration/ Completion Time !Where to Access |- |[[wikipedia:General_Behavior_Inventory|GBI (General Behavior Inventory)]]<ref>{{Cite journal|date=2018-06|editor-last=Hunsley|editor-first=John|editor2-last=Mash|editor2-first=Eric J.|title=A Guide to Assessments That Work|url=http://dx.doi.org/10.1093/med-psych/9780190492243.001.0001|journal=Oxford Clinical Psychology|doi=10.1093/med-psych/9780190492243.001.0001}}</ref> |Self-report |Adult |15-20 minutes | * [https://mfr.osf.io/render?url=https://osf.io/j6rce/?action=download%26mode=render Downloadable PDF Self-Report English] * [https://mfr.osf.io/render?url=https://osf.io/27nwg/?action=download%26mode=render Scoring instructions and information] |- |[[wikipedia:Mood_Disorder_Questionnaire|MDQ (Mood Disorder Questionnaire)]]<ref name="Carvalho" /> |Self-report |Adult |5 minutes | * [https://mfr.osf.io/render?url=https://osf.io/sb5xw/?action=download%26mode=render Adult Self-Report (Long, English)] * [https://mfr.osf.io/render?url=https://osf.io/xa7v6/?action=download%26mode=render Adult Self-Report (Short, English)] * |- |[[wikipedia:Bipolar_Spectrum_Diagnostic_Scale|BSDS (Bipolar Spectrum Diagnostic Scale)]]<ref>{{Cite journal|date=2018-06|editor-last=Hunsley|editor-first=John|editor2-last=Mash|editor2-first=Eric J.|title=A Guide to Assessments That Work|url=http://dx.doi.org/10.1093/med-psych/9780190492243.001.0001|journal=Oxford Clinical Psychology|doi=10.1093/med-psych/9780190492243.001.0001}}</ref><ref name="Carvalho" /> |Self-report |Adult |15 minutes | * [http://psycheducation.org/diagnosis/the-bipolar-spectrum-diagnostic-scale/ Online version] * [https://mfr.osf.io/render?url=https://osf.io/w9qet/?action=download%26mode=render Downloadable PDF Version (English)] |- |[[wikipedia:Hypomania_Checklist|HCL-32 (Hypomania Checklist)]]<ref name="Carvalho" /><ref>{{Cite journal|last=Feng|first=Yuan|last2=Wang|first2=Yuan-Yuan|last3=Huang|first3=Wei|last4=Ungvari|first4=Gabor S.|last5=Ng|first5=Chee H.|last6=Wang|first6=Gang|last7=Yuan|first7=Zhen|last8=Xiang|first8=Yu-Tao|date=2017-06-01|title=Comparison of the 32-item Hypomania Checklist, the 33-item Hypomania Checklist, and the Mood Disorders Questionnaire for bipolar disorder|url=http://onlinelibrary.wiley.com/doi/10.1111/pcn.12506/abstract|journal=Psychiatry and Clinical Neurosciences|language=en|volume=71|issue=6|pages=403–408|doi=10.1111/pcn.12506|issn=1440-1819}}</ref> |Self-report |Adult |10-15 minutes | * [https://mfr.osf.io/render?url=https://osf.io/2veyc/?action=download%26mode=render Self-report] |} === Likelihood ratios and AUCs of screening measures for bipolar disorder in adults === * '''''For a list of the likelihood ratios for more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Likelihood_ratios_and_AUCs_of_common_screening_instruments click here.]''''' {| class="wikitable sortable" !'''Screening Measure (Primary Reference)''' !'''Area Under Curve (AUC) and sample size''' !'''DiLR+ (score)''' !DiLR- (score) !'''Population''' |- |[[wikipedia:Bipolar_Spectrum_Diagnostic_Scale|BSDS (Bipolar Spectrum Diagnostic Scale)]] <ref name="Carvalho" /> |0.81 |(13) <ref name = Carvalho>{{cite journal|last1=Carvalho|first1=André F.|last2=Takwoingi|first2=Yemisi|last3=Sales|first3=Paulo Marcelo G.|last4=Soczynska|first4=Joanna K.|last5=Köhler|first5=Cristiano A.|last6=Freitas|first6=Thiago H.|last7=Quevedo|first7=João|last8=Hyphantis|first8=Thomas N.|last9=McIntyre|first9=Roger S.|last10=Vieta|first10=Eduard|title=Screening for bipolar spectrum disorders: A comprehensive meta-analysis of accuracy studies|journal=Journal of Affective Disorders|date=February 2015|volume=172|pages=337–346|doi=https://doi.org/10.1016/j.jad.2014.10.024}}</ref> |0.36 (4.93) |Clinical |- |[[wikipedia:Hypomania_Checklist|HCL-32 (Hypomania Checklist)]]<ref name="Carvalho" /> |0.80 |(14)<ref name="Carvalho" /> |0.28 (2.45) |Clinical |- |[[wikipedia:Mood_Disorder_Questionnaire|MDQ (Mood Disorder Questionnaire)]]<ref name="Carvalho" /> |0.78 |(7)<ref name="Carvalho" /> |0.22 (5.4) |Clinical |- |General Behavior Inventory (GBI) | | | | |} '''Note:''' Area Under Curve (AUC, or AUROC) is equal to the probability that a classifier will rank a randomly chosen positive diagnosis of Bipolar Disorder higher than a randomly chosen negative diagnosis of Bipolar Disorder[15]. ==[[Evidence based assessment/Prescription phase|'''Prescription phase''']]== ===Gold standard diagnostic interviews=== * For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews click here.] ===Recommended diagnostic interviews for adult bipolar disorder=== {| class="wikitable sortable" border="1" ! colspan="5" |Diagnostic instruments for BPSD |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time !Where to Access |- | Structured Clinical Interview for DSM-5 (SCID)<ref>{{Cite journal|last=Miller|first=Christopher J.|last2=Johnson|first2=Sheri L.|last3=Eisner|first3=Lori|date=2009-06|title=Assessment tools for adult bipolar disorder.|url=http://doi.apa.org/getdoi.cfm?doi=10.1111/j.1468-2850.2009.01158.x|journal=Clinical Psychology: Science and Practice|language=en|volume=16|issue=2|pages=188–201|doi=10.1111/j.1468-2850.2009.01158.x|issn=1468-2850|pmc=PMC2847794|pmid=20360999}}</ref><ref>{{Cite journal|date=2018-06|editor-last=Hunsley|editor-first=John|editor2-last=Mash|editor2-first=Eric J.|title=A Guide to Assessments That Work|url=http://dx.doi.org/10.1093/med-psych/9780190492243.001.0001|journal=Oxford Clinical Psychology|doi=10.1093/med-psych/9780190492243.001.0001}}</ref> | Semistructured interview | 18+ | 1-2 hours |Available for purchase from [https://www.appi.org/products/structured-clinical-interview-for-dsm-5-scid-5 APA Publishing] |- | Schedule for Affective Disorders and Schizophrenia (SADS)<ref>{{Cite journal|date=2018-06|editor-last=Hunsley|editor-first=John|editor2-last=Mash|editor2-first=Eric J.|title=A Guide to Assessments That Work|url=http://dx.doi.org/10.1093/med-psych/9780190492243.001.0001|journal=Oxford Clinical Psychology|doi=10.1093/med-psych/9780190492243.001.0001}}</ref><ref>{{Cite journal|last=Miller|first=Christopher J.|last2=Johnson|first2=Sheri L.|last3=Eisner|first3=Lori|date=2009-06|title=Assessment tools for adult bipolar disorder.|url=http://doi.apa.org/getdoi.cfm?doi=10.1111/j.1468-2850.2009.01158.x|journal=Clinical Psychology: Science and Practice|language=en|volume=16|issue=2|pages=188–201|doi=10.1111/j.1468-2850.2009.01158.x|issn=1468-2850|pmc=PMC2847794|pmid=20360999}}</ref><ref>{{Cite journal|last=Endicott|first=Jean|date=1978-07-01|title=A Diagnostic Interview: The Schedule for Affective Disorders and Schizophrenia|url=http://archpsyc.jamanetwork.com/article.aspx?doi=10.1001/archpsyc.1978.01770310043002|journal=Archives of General Psychiatry|language=en|volume=35|issue=7|pages=837|doi=10.1001/archpsyc.1978.01770310043002|issn=0003-990X}}</ref> | Semistructured interview | 18+ | 1-2 hours |[https://jamanetwork.com/journals/jamapsychiatry/article-abstract/491947 (Endicott & Spitzer, 1978)] |} ==[[Evidence based assessment/Process phase|'''Process phase''']]== === Treatment === * Please refer to the page on [https://en.wikipedia.org/wiki/Bipolar_disorder bipolar disorder] for more information on available treatment for bipolar disorder or go to the Effective Child Therapy pages for [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/severe-mood-swings-and-bipolar-spectrum-disorders/| Severe Mood Swings & Bipolar Spectrum Disorders] * [https://reacttoolkit.uk/ Relatives Education and Coping Toolkit (REACT)] is currently freely available at https://reacttoolkit.uk/. This is a resource/project of [https://www.lancaster.ac.uk/health-and-medicine/research/spectrum/ The Sprectrum Centre for Mental Health Research] from Lancaster University. A team of clinicians, researchers and relatives of people with psychosis or bipolar disorder at Lancaster, Liverpool and London have developed the Relatives Education and Coping Toolkit (REACT). REACT provides [https://www.nice.org.uk/ National Institute for Health and Care Excellence (NICE)] recommended information and support to relatives and friends of people with mental health problems associated with psychosis or bipolar disorder through a digital, peer-supported, self-management toolkit.<ref>Lobban, A. F., Robinson, H. A., Appelbe, D., Barraclough, J., Bedson, E., Collinge, E., Dodd, S., Flowers, S., Honary, M., Johnson, S., Caixeiro Mateus, M. D. C., Mezes, B., Minns, V., Murray, E., Walker, A. J., Williamson, P., Wintermeyer, C., & Jones, S. H. (2017). Protocol for an online randomised controlled trial to evaluate the clinical and cost-effectiveness of a peer-supported self-management intervention for relatives of people with psychosis or bipolar disorder: Relatives Education And Coping Toolkit (REACT). BMJ Open, 7, [016965]. <nowiki>https://doi.org/10.1136/bmjopen-2017-016965</nowiki></ref><ref>Lobban, F., Akers, N., Appelbe, D., Chapman, L., Collinge, L., Dodd, S., Flowers, S., Hollingsworth, B., Johnson, S., Jones, S. H., Mateus, C., Mezes, B., Murray, E., Panagaki, K., Rainford, N., Robinson, H., Rosala-Hallas, A., Sellwood, W., Walker, A., & Williamson, P. (2020). Clinical effectiveness of a web-based peer-supported self-management intervention for relatives of people with psychosis or bipolar (REACT): online, observer-blind, randomised controlled superiority trial. BMC Psychiatry, 20(1), [160]. <nowiki>https://doi.org/10.1186/s12888-020-02545-9</nowiki></ref><ref>{{Cite journal|last=F|first=Lobban|last2=N|first2=Akers|last3=D|first3=Appelbe|last4=R|first4=Iraci Capuccinello|last5=L|first5=Chapman|last6=L|first6=Collinge|last7=S|first7=Dodd|last8=S|first8=Flowers|last9=B|first9=Hollingsworth|date=2020-07-01|title=A web-based, peer-supported self-management intervention to reduce distress in relatives of people with psychosis or bipolar disorder: the REACT RCT|url=https://www.journalslibrary.nihr.ac.uk/hta/hta24320|journal=Health Technology Assessment|language=EN|volume=24|issue=32|doi=10.3310/hta24320|issn=2046-4924|pmc=PMC7355407|pmid=32608353}}</ref> ** The team at Spectrum Centre also conducted a study linked to REACT called IMPART which looked at what would happen if they tried to deliver REACT as part of routine clinical care in Early Intervention Teams in the [https://www.nhs.uk/ United Kingdom's National Health Service (NHS)]. This study identified key factors that impact implementation and may be useful for informing implementation plans for other digital health interventions.<ref>{{Cite journal|last=Lobban|first=Fiona|last2=Appelbe|first2=Duncan|last3=Appleton|first3=Victoria|last4=Billsborough|first4=Julie|last5=Fisher|first5=Naomi Ruth|last6=Foster|first6=Sheena|last7=Gill|first7=Bethany|last8=Glentworth|first8=David|last9=Harrop|first9=Chris|date=2020-03-17|title=IMPlementation of An online Relatives’ Toolkit for psychosis or bipolar (IMPART study): iterative multiple case study to identify key factors impacting on staff uptake and use|url=https://doi.org/10.1186/s12913-020-5002-4|journal=BMC Health Services Research|volume=20|issue=1|pages=219|doi=10.1186/s12913-020-5002-4|issn=1472-6963|pmc=PMC7077000|pmid=32183787}}</ref> ** '''[https://www.lancaster.ac.uk/health-and-medicine/research/spectrum/ RECOVERY TOOLKIT]''' #eRecoveryToolkit, #RecoveryBD, #PersonalRecovery is freely accessible at https://www.lancaster.ac.uk/health-and-medicine/research/spectrum/. Inspired from a greater body of work around recovery, people with lived experience of bipolar disorder and researchers at [https://www.lancaster.ac.uk/health-and-medicine/research/spectrum/ Spectrum Centre] have created a multi-media recovery toolkit. The aim of the toolkit is to provide accessible information and promote discussion around personal discovery in order to understand and aid people’s recovery journeys. The toolkit contains an animation, an e-booklet and video narratives of relatives and clinicians.<ref>Beck, A. K., Baker, A., Jones, S. H., Lobban, A. F., Kay-Lambkin, F., Attia, J., & Banfield, M. (2018). Exploring the feasibility and acceptability of a recovery-focused group therapy intervention for adults with bipolar disorder: trial protocol. BMJ Open, 8, [e019203]. <nowiki>https://doi.org/10.1136/bmjopen-2017-019203</nowiki></ref> {| cellspacing="0" style="width:238px;" | style="width:45px; height:45px; background:#d1f3f5; color:#49dae9; text-align:center;" vertical-align="center" align="center"| '''<span style="font-size:24pt;">t</span>''' | style="background:#b7eef0; color:black; font-size:8pt; padding:4pt; line-height:1.25em;"| This user tweets on '''[[w:Twitter|Twitter]]''' as [http://twitter.com/_REACTTOOLKIT REACTTOOLKIT]. |} == '''External resources''' == # [http://apps.who.int/classifications/icd10/browse/2015/en#/F31 ICD-10 diagnostic criteria] # [https://en.wikiversity.org/w/index.php?title=Helping_Give_Away_Psychological_Science/Resources/Annotated_List_of_Where_and_How_to_Find_a_Therapist&wteswitched=1#Other_low-cost_options Find-a-Therapist] (a curated list of find-a-therapist websites where you can find a provider) # OMIM (Online Mendelian Inheritance in Man) ## [http://omim.org/entry/125480 125480] ## [http://omim.org/entry/611536 611536] ## [http://omim.org/entry/309200 309200,] ## [http://omim.org/entry/611535 611535] ## [http://omim.org/entry/603663 603663] # [https://emedicine.medscape.com/article/286342-overview eMedicine information] # [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/severe-mood-swings-and-bipolar-spectrum-disorders/ Effective Child Therapy information on Bipolar Disorder] #*Effective Child Therapy is website sponsored by Division 53 of the American Psychological Association (APA), or [https://sccap53.org The Society of Clinical Child and Adolescent Psychology](SCCAP), in collaboration with the Association for Behavioral and Cognitive Therapies (ABCT). Use for information on symptoms and available treatments. # The Psych Show with Dr. Ali Mattu videos (geared towards public; might send to client) ##[https://www.youtube.com/watch?v=llOPqKD-s4w How to Cope with Bipolar Disorder] ## [https://www.youtube.com/watch?v=kUHUmeqBZAA Top 10 Bipolar Myths] == '''References''' == {{collapse top|References|expand=yes}} {{Reflist|30em}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] {{collapse bottom}} 7vpiw80z6m0mk2q31r406948dm6tgv0 2419297 2419246 2022-08-26T05:23:34Z Ardenguo 2944162 /* Psychometric properties of screening instruments for adult bipolar disorder */ added "Note: Reliability and validity are included in the extended version. This table includes measures with Good or Excellent ratings." wikitext text/x-wiki <noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{medical disclaimer}} {{psychology}} {{Template:evidence-based assessment}} {{:{{BASEPAGENAME}}/Sidebar}} ==[[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio"?''']]== * For background information on what assessment portfolios are, click the link in the heading above. * Want even 'more' information about this topic? There's an extended version of this page [[Evidence-based assessment/Bipolar disorder in adults (assessment portfolio)/extended version|here]]. == [[Evidence based assessment/Preparation phase|'''Preparation phase''']] == === Diagnostic criteria for bipolar disorder in adults === Bipolar Disorder (BP) is characterized by extreme fluctuations in mood (or emotional dysregulation that ranges from mania (as shown by displays or feelings of extreme happiness, unrealistic overachievement and anger), to depression (as shown by displays or feelings of sadness, changes in appetite or weight and irritability.<ref name=":1" /> It has a lifetime risk of about 1%, with heritability estimated at up to 80%.<ref>{{Cite journal|last=Purcell|first=Shaun M.|last2=Wray|first2=Naomi R.|last3=Stone|first3=Jennifer L.|last4=Visscher|first4=Peter M.|last5=O'Donovan|first5=Michael C.|last6=Sullivan|first6=Patrick F.|last7=Sklar|first7=Pamela|last8=(Leader)|first8=Shaun M. Purcell|last9=Stone|first9=Jennifer L.|date=2009/08|title=Common polygenic variation contributes to risk of schizophrenia and bipolar disorder|url=http://www.nature.com/doifinder/10.1038/nature08185|journal=Nature|language=En|volume=460|issue=7256|doi=10.1038/nature08185|issn=1476-4687}}</ref> It is important to note that these moods exceed normal responses to life events, represent a change from the individual's normal functioning, and cause problems in daily activities. {{blockquotetop}} <big>'''ICD-11 Diagnostic Criteria'''</big> *Bipolar Type I Disorder **Bipolar type I disorder is an episodic mood disorder defined by the occurrence of one or more manic or mixed episodes. A manic episode is an extreme mood state lasting at least one week unless shortened by a treatment intervention characterized by euphoria, irritability, or expansiveness, and by increased activity or a subjective experience of increased energy, accompanied by other characteristic symptoms such as rapid or pressured speech, flight of ideas, increased self-esteem or grandiosity, decreased need for sleep, distractibility, impulsive or reckless behavior, and rapid changes among different mood states (i.e., mood lability). A mixed episode is characterized by either a mixture or very rapid alternation between prominent manic and depressive symptoms on most days during a period of at least 2 weeks. Although the diagnosis can be made based on evidence of a single manic or mixed episode, typically manic or mixed episodes alternate with depressive episodes over the course of the disorder. ***Note: The ICD-11 lists 18 additional subcategories of Bipolar type I disorder. They can be found [https://icd.who.int/browse11/l-m/en#/http://id.who.int/icd/entity/1456478153 here]. *Bipolar Type II Disorder **Bipolar type II disorder is an episodic mood disorder defined by the occurrence of one or more hypomanic episodes and at least one depressive episode. A hypomanic episode is a persistent mood state characterized by euphoria, irritability, or expansiveness, and excessive psychomotor activation or increased energy, accompanied by other characteristic symptoms such as grandiosity, decreased need for sleep, pressured speech, flight of ideas, distractibility, and impulsive or reckless behavior lasting for at least several days. The symptoms represent a change from the individual’s typical behavior and are not severe enough to cause marked impairment in functioning. A depressive episode is characterized by a period of almost daily depressed mood or diminished interest in activities lasting at least 2 weeks accompanied by other symptoms such as changes in appetite or sleep, psychomotor agitation or retardation, fatigue, feelings of worthless or excessive or inappropriate guilt, feelings or hopelessness, difficulty concentrating, and suicidality. There is no history of manic or mixed Episodes. ***Note: The ICD-11 lists 13 additional subcategories of Bipolar type II disorder. They can be found [https://icd.who.int/browse11/l-m/en#/http%3a%2f%2fid.who.int%2ficd%2fentity%2f199053300 here]. '''Changes in DSM-5''' * The diagnostic criteria for '''Bipolar Disorder''' changed slightly from [[DSM-IV]] to [[w:Diagnostic_and_Statistical_Manual_of_Mental_Disorders#DSM-IV-TR_.282000.29|DSM-5]]. Summaries are available [http://www.dsm5.org/Documents/changes%20from%20dsm-iv-tr%20to%20dsm-5.pdf here] and [[w:DSM-5|here]]. {{blockquotebottom}} === Base rates of BD in different clinical settings and populations === This section describes the demographic setting of the population(s) sampled, base rates of diagnosis, country/region sampled, and the diagnostic method that was used. Using this information, clinicians will be able to anchor the rate of adolescent depression that they are likely to see in their clinical practice. * '''''To see prevalence rates across multiple disorders,''''' [[Evidence based assessment/Preparation phase#Base rates for transdiagnostic comparison|'''''click here.''''']] {| class="wikitable" |'''Demography''' |'''Setting''' |'''Base Rate''' |'''Diagnostic Method''' |- |United States, Canada, Puerto Rico, Germany, Taiwan, Korea, New Zealand <ref>{{Cite journal|last=Weissman|first=Myrna M.|last2=Bland|first2=Roger C.|last3=Canino|first3=Glorisa J.|last4=Faravelli|first4=Carlo|last5=Greenwald|first5=Steven|last6=Hwu|first6=Hai-Gwo|last7=Joyce|first7=Peter R.|last8=Karam|first8=Eile G.|last9=Lee|first9=Chung-Kyoon|date=1996-07-24|title=Cross-National Epidemiology of Major Depression and Bipolar Disorder|url=https://doi.org/10.1001/jama.1996.03540040037030|journal=JAMA|volume=276|issue=4|pages=293–299|doi=10.1001/jama.1996.03540040037030|issn=0098-7484}}</ref> |Community Epidemiological Samples |0.3 - 1.5% |Structured and semi-structured diagnostic interviews |- |United States<ref>{{Cite journal|last=Merikangas|first=Kathleen R.|last2=Akiskal|first2=Hagop S.|last3=Angst|first3=Jules|last4=Greenberg|first4=Paul E.|last5=Hirschfeld|first5=Robert M. A.|last6=Petukhova|first6=Maria|last7=Kessler|first7=Ronald C.|date=2007-05-01|title=Lifetime and 12-Month Prevalence of Bipolar Spectrum Disorder in the National Comorbidity Survey Replication|url=https://jamanetwork.com/journals/jamapsychiatry/fullarticle/482285|journal=Archives of General Psychiatry|language=en|volume=64|issue=5|pages=543–552|doi=10.1001/archpsyc.64.5.543|issn=0003-990X}}</ref> |Community Epidemiological Samples |BPI - 1%; BPII - 1.1%; Subthreshold BP - 2.4% |World Health Organisation Composite International Diagnostic Interview |- |United States<ref>{{Cite journal|last=LEWINSOHN|first=PETER M.|last2=KLEIN|first2=DANIEL N.|last3=SEELEY|first3=JOHN R.|title=Bipolar Disorders in a Community Sample of Older Adolescents: Prevalence, Phenomenology, Comorbidity, and Course|url=http://linkinghub.elsevier.com/retrieve/pii/S089085670963731X|journal=Journal of the American Academy of Child & Adolescent Psychiatry|volume=34|issue=4|pages=454–463|doi=10.1097/00004583-199504000-00012}}</ref> |Community samples (older adolescents) |1% |K-SADS Semi-Structured Interview |- |United States<ref>{{Cite journal|last=Judd|first=Lewis L.|last2=Akiskal|first2=Hagop S.|title=The prevalence and disability of bipolar spectrum disorders in the US population: re-analysis of the ECA database taking into account subthreshold cases|url=https://doi.org/10.1016/S0165-0327(02)00332-4|journal=Journal of Affective Disorders|volume=73|issue=1-2|pages=123–131|doi=10.1016/s0165-0327(02)00332-4}}</ref> |US National Epidemiological Catchment Area (ECA) database |0.8 - 5.1% (manic and subthreshold mania) |Diagnostic Interview Schedule (DIS) |- |United States<ref>{{Cite journal|last=Kessler|first=R. C.|last2=Rubinow|first2=D. R.|last3=Holmes|first3=C.|last4=Abelson|first4=J. M.|last5=Zhao|first5=S.|date=1997/09|title=The epidemiology of DSM-III-R bipolar I disorder in a general population survey|url=https://www.cambridge.org/core/journals/psychological-medicine/article/epidemiology-of-dsmiiir-bipolar-i-disorder-in-a-general-population-survey/950D518D15F64E2059F1033558615A9A|journal=Psychological Medicine|language=en|volume=27|issue=5|pages=1079–1089|issn=1469-8978}}</ref> |US National Comorbidity Survey (NCS) |0-4% (small community sample; reappraisal study) |World Health Organisation Composite International Diagnostic Interview |- |United States and other countries<ref>{{Cite book|url=https://www.worldcat.org/oclc/830807378|title=Diagnostic and statistical manual of mental disorders : DSM-5.|date=2013|publisher=American Psychiatric Association., American Psychiatric Association. DSM-5 Task Force.|isbn=9780890425541|edition=5th|location=Arlington, VA|oclc=830807378}}</ref> |Community sample |BPI - 0.6%; BPII-  1.8%;  Cyclothymia - 0.4-1% |Unspecified |- |United States, Europe, Asia<ref>{{Cite journal|last=Merikangas|first=Kathleen R.|last2=Jin|first2=Robert|last3=He|first3=Jian-Ping|last4=Kessler|first4=Ronald C.|last5=Lee|first5=Sing|last6=Sampson|first6=Nancy A.|last7=Viana|first7=Maria Carmen|last8=Andrade|first8=Laura Helena|last9=Hu|first9=Chiyi|date=2011-03-07|title=Prevalence and Correlates of Bipolar Spectrum Disorder in the World Mental Health Survey Initiative|url=http://archpsyc.jamanetwork.com/article.aspx?doi=10.1001/archgenpsychiatry.2011.12|journal=Archives of General Psychiatry|language=en|volume=68|issue=3|doi=10.1001/archgenpsychiatry.2011.12|issn=0003-990X}}</ref> |Community Samples |BPI - 0.6%; BPII - 0.4%; Subthreshold BP - 1.4%; Bipolar Spectrum Disorder - 2.4% |World Health Organisation Composite International Diagnostic Interview |- |United States<ref>{{Cite journal|last=Grant|first=Bridget F.|last2=Stinson|first2=Frederick S.|last3=Hasin|first3=Deborah S.|last4=Dawson|first4=Deborah A.|last5=Chou|first5=S. Patricia|last6=Ruan|first6=W. June|last7=Huang|first7=Boji|date=October 2005|title=Prevalence, correlates, and comorbidity of bipolar I disorder and axis I and II disorders: results from the National Epidemiologic Survey on Alcohol and Related Conditions|url=https://www.ncbi.nlm.nih.gov/pubmed/16259532|journal=The Journal of Clinical Psychiatry|volume=66|issue=10|pages=1205–1215|issn=0160-6689|pmid=16259532}}</ref> |National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) |BPI - 3.3% |The Alcohol Use Disorder and Associated Disabilities Interview Schedule-IV (AUDADIS-IV) |- |United States<ref>{{Cite journal|last=Das|first=Amar K.|date=2005-02-23|title=Screening for Bipolar Disorder in a Primary Care Practice|url=http://jama.jamanetwork.com/article.aspx?doi=10.1001/jama.293.8.956|journal=JAMA|language=en|volume=293|issue=8|doi=10.1001/jama.293.8.956|issn=0098-7484}}</ref> |Outpatient Clinic Sample |9.8% |Review of medical records, questionnaire data |- |United States<ref>{{cite journal|last1=Hirschfeld|first1=RM|last2=Cass|first2=AR|last3=Holt|first3=DC|last4=Carlson|first4=CA|date=2005|title=Screening for bipolar disorder in patients treated for depression in a family medicine clinic.|journal=The Journal of the American Board of Family Practice|volume=18|issue=4|pages=233-9|pmid=15994469}}</ref> |Outpatient Clinic Sample |21.3% |MDQ, SCID |} ==[[Evidence based assessment/Prediction phase|'''Prediction phase''']]== === Psychometric properties of screening instruments for adult bipolar disorder === The following section contains a list of screening and diagnostic instruments for adult bipolar disorder. The section includes administration information, psychometric data, and PDFs or links to the screenings. * Screenings are used as part of the [[Evidence based assessment/Prediction phase|prediction phase]] of assessment; for more information on interpretation of this data, or how screenings fit in to the assessment process, click [[Evidence based assessment/Prediction phase|here.]] * '''''For a list of more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Psychometric_properties_of_common_screening_instruments click here.]''''' {| class="wikitable" |- ! Measure !Format (Reporter) !Age Range !Administration/ Completion Time !Where to Access |- |[[wikipedia:General_Behavior_Inventory|GBI (General Behavior Inventory)]]<ref>{{Cite journal|date=2018-06|editor-last=Hunsley|editor-first=John|editor2-last=Mash|editor2-first=Eric J.|title=A Guide to Assessments That Work|url=http://dx.doi.org/10.1093/med-psych/9780190492243.001.0001|journal=Oxford Clinical Psychology|doi=10.1093/med-psych/9780190492243.001.0001}}</ref> |Self-report |Adult |15-20 minutes | * [https://mfr.osf.io/render?url=https://osf.io/j6rce/?action=download%26mode=render Downloadable PDF Self-Report English] * [https://mfr.osf.io/render?url=https://osf.io/27nwg/?action=download%26mode=render Scoring instructions and information] |- |[[wikipedia:Mood_Disorder_Questionnaire|MDQ (Mood Disorder Questionnaire)]]<ref name="Carvalho" /> |Self-report |Adult |5 minutes | * [https://mfr.osf.io/render?url=https://osf.io/sb5xw/?action=download%26mode=render Adult Self-Report (Long, English)] * [https://mfr.osf.io/render?url=https://osf.io/xa7v6/?action=download%26mode=render Adult Self-Report (Short, English)] * |- |[[wikipedia:Bipolar_Spectrum_Diagnostic_Scale|BSDS (Bipolar Spectrum Diagnostic Scale)]]<ref>{{Cite journal|date=2018-06|editor-last=Hunsley|editor-first=John|editor2-last=Mash|editor2-first=Eric J.|title=A Guide to Assessments That Work|url=http://dx.doi.org/10.1093/med-psych/9780190492243.001.0001|journal=Oxford Clinical Psychology|doi=10.1093/med-psych/9780190492243.001.0001}}</ref><ref name="Carvalho" /> |Self-report |Adult |15 minutes | * [http://psycheducation.org/diagnosis/the-bipolar-spectrum-diagnostic-scale/ Online version] * [https://mfr.osf.io/render?url=https://osf.io/w9qet/?action=download%26mode=render Downloadable PDF Version (English)] |- |[[wikipedia:Hypomania_Checklist|HCL-32 (Hypomania Checklist)]]<ref name="Carvalho" /><ref>{{Cite journal|last=Feng|first=Yuan|last2=Wang|first2=Yuan-Yuan|last3=Huang|first3=Wei|last4=Ungvari|first4=Gabor S.|last5=Ng|first5=Chee H.|last6=Wang|first6=Gang|last7=Yuan|first7=Zhen|last8=Xiang|first8=Yu-Tao|date=2017-06-01|title=Comparison of the 32-item Hypomania Checklist, the 33-item Hypomania Checklist, and the Mood Disorders Questionnaire for bipolar disorder|url=http://onlinelibrary.wiley.com/doi/10.1111/pcn.12506/abstract|journal=Psychiatry and Clinical Neurosciences|language=en|volume=71|issue=6|pages=403–408|doi=10.1111/pcn.12506|issn=1440-1819}}</ref> |Self-report |Adult |10-15 minutes | * [https://mfr.osf.io/render?url=https://osf.io/2veyc/?action=download%26mode=render Self-report] |} '''Note:''' Reliability and validity are included in the extended version. This table includes measures with Good or Excellent ratings. === Likelihood ratios and AUCs of screening measures for bipolar disorder in adults === * '''''For a list of the likelihood ratios for more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Likelihood_ratios_and_AUCs_of_common_screening_instruments click here.]''''' {| class="wikitable sortable" !'''Screening Measure (Primary Reference)''' !'''Area Under Curve (AUC) and sample size''' !'''DiLR+ (score)''' !DiLR- (score) !'''Population''' |- |[[wikipedia:Bipolar_Spectrum_Diagnostic_Scale|BSDS (Bipolar Spectrum Diagnostic Scale)]] <ref name="Carvalho" /> |0.81 |(13) <ref name = Carvalho>{{cite journal|last1=Carvalho|first1=André F.|last2=Takwoingi|first2=Yemisi|last3=Sales|first3=Paulo Marcelo G.|last4=Soczynska|first4=Joanna K.|last5=Köhler|first5=Cristiano A.|last6=Freitas|first6=Thiago H.|last7=Quevedo|first7=João|last8=Hyphantis|first8=Thomas N.|last9=McIntyre|first9=Roger S.|last10=Vieta|first10=Eduard|title=Screening for bipolar spectrum disorders: A comprehensive meta-analysis of accuracy studies|journal=Journal of Affective Disorders|date=February 2015|volume=172|pages=337–346|doi=https://doi.org/10.1016/j.jad.2014.10.024}}</ref> |0.36 (4.93) |Clinical |- |[[wikipedia:Hypomania_Checklist|HCL-32 (Hypomania Checklist)]]<ref name="Carvalho" /> |0.80 |(14)<ref name="Carvalho" /> |0.28 (2.45) |Clinical |- |[[wikipedia:Mood_Disorder_Questionnaire|MDQ (Mood Disorder Questionnaire)]]<ref name="Carvalho" /> |0.78 |(7)<ref name="Carvalho" /> |0.22 (5.4) |Clinical |- |General Behavior Inventory (GBI) | | | | |} '''Note:''' Area Under Curve (AUC, or AUROC) is equal to the probability that a classifier will rank a randomly chosen positive diagnosis of Bipolar Disorder higher than a randomly chosen negative diagnosis of Bipolar Disorder[15]. ==[[Evidence based assessment/Prescription phase|'''Prescription phase''']]== ===Gold standard diagnostic interviews=== * For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews click here.] ===Recommended diagnostic interviews for adult bipolar disorder=== {| class="wikitable sortable" border="1" ! colspan="5" |Diagnostic instruments for BPSD |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time !Where to Access |- | Structured Clinical Interview for DSM-5 (SCID)<ref>{{Cite journal|last=Miller|first=Christopher J.|last2=Johnson|first2=Sheri L.|last3=Eisner|first3=Lori|date=2009-06|title=Assessment tools for adult bipolar disorder.|url=http://doi.apa.org/getdoi.cfm?doi=10.1111/j.1468-2850.2009.01158.x|journal=Clinical Psychology: Science and Practice|language=en|volume=16|issue=2|pages=188–201|doi=10.1111/j.1468-2850.2009.01158.x|issn=1468-2850|pmc=PMC2847794|pmid=20360999}}</ref><ref>{{Cite journal|date=2018-06|editor-last=Hunsley|editor-first=John|editor2-last=Mash|editor2-first=Eric J.|title=A Guide to Assessments That Work|url=http://dx.doi.org/10.1093/med-psych/9780190492243.001.0001|journal=Oxford Clinical Psychology|doi=10.1093/med-psych/9780190492243.001.0001}}</ref> | Semistructured interview | 18+ | 1-2 hours |Available for purchase from [https://www.appi.org/products/structured-clinical-interview-for-dsm-5-scid-5 APA Publishing] |- | Schedule for Affective Disorders and Schizophrenia (SADS)<ref>{{Cite journal|date=2018-06|editor-last=Hunsley|editor-first=John|editor2-last=Mash|editor2-first=Eric J.|title=A Guide to Assessments That Work|url=http://dx.doi.org/10.1093/med-psych/9780190492243.001.0001|journal=Oxford Clinical Psychology|doi=10.1093/med-psych/9780190492243.001.0001}}</ref><ref>{{Cite journal|last=Miller|first=Christopher J.|last2=Johnson|first2=Sheri L.|last3=Eisner|first3=Lori|date=2009-06|title=Assessment tools for adult bipolar disorder.|url=http://doi.apa.org/getdoi.cfm?doi=10.1111/j.1468-2850.2009.01158.x|journal=Clinical Psychology: Science and Practice|language=en|volume=16|issue=2|pages=188–201|doi=10.1111/j.1468-2850.2009.01158.x|issn=1468-2850|pmc=PMC2847794|pmid=20360999}}</ref><ref>{{Cite journal|last=Endicott|first=Jean|date=1978-07-01|title=A Diagnostic Interview: The Schedule for Affective Disorders and Schizophrenia|url=http://archpsyc.jamanetwork.com/article.aspx?doi=10.1001/archpsyc.1978.01770310043002|journal=Archives of General Psychiatry|language=en|volume=35|issue=7|pages=837|doi=10.1001/archpsyc.1978.01770310043002|issn=0003-990X}}</ref> | Semistructured interview | 18+ | 1-2 hours |[https://jamanetwork.com/journals/jamapsychiatry/article-abstract/491947 (Endicott & Spitzer, 1978)] |} '''Note:''' Reliability and validity are included in the extended version. This table includes measures with Good or Excellent ratings. ==[[Evidence based assessment/Process phase|'''Process phase''']]== === Treatment === * Please refer to the page on [https://en.wikipedia.org/wiki/Bipolar_disorder bipolar disorder] for more information on available treatment for bipolar disorder or go to the Effective Child Therapy pages for [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/severe-mood-swings-and-bipolar-spectrum-disorders/| Severe Mood Swings & Bipolar Spectrum Disorders] * [https://reacttoolkit.uk/ Relatives Education and Coping Toolkit (REACT)] is currently freely available at https://reacttoolkit.uk/. This is a resource/project of [https://www.lancaster.ac.uk/health-and-medicine/research/spectrum/ The Sprectrum Centre for Mental Health Research] from Lancaster University. A team of clinicians, researchers and relatives of people with psychosis or bipolar disorder at Lancaster, Liverpool and London have developed the Relatives Education and Coping Toolkit (REACT). REACT provides [https://www.nice.org.uk/ National Institute for Health and Care Excellence (NICE)] recommended information and support to relatives and friends of people with mental health problems associated with psychosis or bipolar disorder through a digital, peer-supported, self-management toolkit.<ref>Lobban, A. F., Robinson, H. A., Appelbe, D., Barraclough, J., Bedson, E., Collinge, E., Dodd, S., Flowers, S., Honary, M., Johnson, S., Caixeiro Mateus, M. D. C., Mezes, B., Minns, V., Murray, E., Walker, A. J., Williamson, P., Wintermeyer, C., & Jones, S. H. (2017). Protocol for an online randomised controlled trial to evaluate the clinical and cost-effectiveness of a peer-supported self-management intervention for relatives of people with psychosis or bipolar disorder: Relatives Education And Coping Toolkit (REACT). BMJ Open, 7, [016965]. <nowiki>https://doi.org/10.1136/bmjopen-2017-016965</nowiki></ref><ref>Lobban, F., Akers, N., Appelbe, D., Chapman, L., Collinge, L., Dodd, S., Flowers, S., Hollingsworth, B., Johnson, S., Jones, S. H., Mateus, C., Mezes, B., Murray, E., Panagaki, K., Rainford, N., Robinson, H., Rosala-Hallas, A., Sellwood, W., Walker, A., & Williamson, P. (2020). Clinical effectiveness of a web-based peer-supported self-management intervention for relatives of people with psychosis or bipolar (REACT): online, observer-blind, randomised controlled superiority trial. BMC Psychiatry, 20(1), [160]. <nowiki>https://doi.org/10.1186/s12888-020-02545-9</nowiki></ref><ref>{{Cite journal|last=F|first=Lobban|last2=N|first2=Akers|last3=D|first3=Appelbe|last4=R|first4=Iraci Capuccinello|last5=L|first5=Chapman|last6=L|first6=Collinge|last7=S|first7=Dodd|last8=S|first8=Flowers|last9=B|first9=Hollingsworth|date=2020-07-01|title=A web-based, peer-supported self-management intervention to reduce distress in relatives of people with psychosis or bipolar disorder: the REACT RCT|url=https://www.journalslibrary.nihr.ac.uk/hta/hta24320|journal=Health Technology Assessment|language=EN|volume=24|issue=32|doi=10.3310/hta24320|issn=2046-4924|pmc=PMC7355407|pmid=32608353}}</ref> ** The team at Spectrum Centre also conducted a study linked to REACT called IMPART which looked at what would happen if they tried to deliver REACT as part of routine clinical care in Early Intervention Teams in the [https://www.nhs.uk/ United Kingdom's National Health Service (NHS)]. This study identified key factors that impact implementation and may be useful for informing implementation plans for other digital health interventions.<ref>{{Cite journal|last=Lobban|first=Fiona|last2=Appelbe|first2=Duncan|last3=Appleton|first3=Victoria|last4=Billsborough|first4=Julie|last5=Fisher|first5=Naomi Ruth|last6=Foster|first6=Sheena|last7=Gill|first7=Bethany|last8=Glentworth|first8=David|last9=Harrop|first9=Chris|date=2020-03-17|title=IMPlementation of An online Relatives’ Toolkit for psychosis or bipolar (IMPART study): iterative multiple case study to identify key factors impacting on staff uptake and use|url=https://doi.org/10.1186/s12913-020-5002-4|journal=BMC Health Services Research|volume=20|issue=1|pages=219|doi=10.1186/s12913-020-5002-4|issn=1472-6963|pmc=PMC7077000|pmid=32183787}}</ref> ** '''[https://www.lancaster.ac.uk/health-and-medicine/research/spectrum/ RECOVERY TOOLKIT]''' #eRecoveryToolkit, #RecoveryBD, #PersonalRecovery is freely accessible at https://www.lancaster.ac.uk/health-and-medicine/research/spectrum/. Inspired from a greater body of work around recovery, people with lived experience of bipolar disorder and researchers at [https://www.lancaster.ac.uk/health-and-medicine/research/spectrum/ Spectrum Centre] have created a multi-media recovery toolkit. The aim of the toolkit is to provide accessible information and promote discussion around personal discovery in order to understand and aid people’s recovery journeys. The toolkit contains an animation, an e-booklet and video narratives of relatives and clinicians.<ref>Beck, A. K., Baker, A., Jones, S. H., Lobban, A. F., Kay-Lambkin, F., Attia, J., & Banfield, M. (2018). Exploring the feasibility and acceptability of a recovery-focused group therapy intervention for adults with bipolar disorder: trial protocol. BMJ Open, 8, [e019203]. <nowiki>https://doi.org/10.1136/bmjopen-2017-019203</nowiki></ref> {| cellspacing="0" style="width:238px;" | style="width:45px; height:45px; background:#d1f3f5; color:#49dae9; text-align:center;" vertical-align="center" align="center"| '''<span style="font-size:24pt;">t</span>''' | style="background:#b7eef0; color:black; font-size:8pt; padding:4pt; line-height:1.25em;"| This user tweets on '''[[w:Twitter|Twitter]]''' as [http://twitter.com/_REACTTOOLKIT REACTTOOLKIT]. |} == '''External resources''' == # [http://apps.who.int/classifications/icd10/browse/2015/en#/F31 ICD-10 diagnostic criteria] # [https://en.wikiversity.org/w/index.php?title=Helping_Give_Away_Psychological_Science/Resources/Annotated_List_of_Where_and_How_to_Find_a_Therapist&wteswitched=1#Other_low-cost_options Find-a-Therapist] (a curated list of find-a-therapist websites where you can find a provider) # OMIM (Online Mendelian Inheritance in Man) ## [http://omim.org/entry/125480 125480] ## [http://omim.org/entry/611536 611536] ## [http://omim.org/entry/309200 309200,] ## [http://omim.org/entry/611535 611535] ## [http://omim.org/entry/603663 603663] # [https://emedicine.medscape.com/article/286342-overview eMedicine information] # [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/severe-mood-swings-and-bipolar-spectrum-disorders/ Effective Child Therapy information on Bipolar Disorder] #*Effective Child Therapy is website sponsored by Division 53 of the American Psychological Association (APA), or [https://sccap53.org The Society of Clinical Child and Adolescent Psychology](SCCAP), in collaboration with the Association for Behavioral and Cognitive Therapies (ABCT). Use for information on symptoms and available treatments. # The Psych Show with Dr. Ali Mattu videos (geared towards public; might send to client) ##[https://www.youtube.com/watch?v=llOPqKD-s4w How to Cope with Bipolar Disorder] ## [https://www.youtube.com/watch?v=kUHUmeqBZAA Top 10 Bipolar Myths] == '''References''' == {{collapse top|References|expand=yes}} {{Reflist|30em}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] {{collapse bottom}} cl6ophedrpay1fbi50i1off4r6reji2 2419312 2419297 2022-08-26T05:34:57Z Ardenguo 2944162 /* Prediction phase */ linked extended version to "Note: Reliability and validity are included in the extended version. This table includes measures with Good or Excellent ratings." wikitext text/x-wiki <noinclude>{{Helping Give Away Psychological Science Banner}}</noinclude> {{medical disclaimer}} {{psychology}} {{Template:evidence-based assessment}} {{:{{BASEPAGENAME}}/Sidebar}} ==[[Evidence based assessment/Portfolio template/What is a "portfolio"|'''What is a "portfolio"?''']]== * For background information on what assessment portfolios are, click the link in the heading above. * Want even 'more' information about this topic? There's an extended version of this page [[Evidence-based assessment/Bipolar disorder in adults (assessment portfolio)/extended version|here]]. == [[Evidence based assessment/Preparation phase|'''Preparation phase''']] == === Diagnostic criteria for bipolar disorder in adults === Bipolar Disorder (BP) is characterized by extreme fluctuations in mood (or emotional dysregulation that ranges from mania (as shown by displays or feelings of extreme happiness, unrealistic overachievement and anger), to depression (as shown by displays or feelings of sadness, changes in appetite or weight and irritability.<ref name=":1" /> It has a lifetime risk of about 1%, with heritability estimated at up to 80%.<ref>{{Cite journal|last=Purcell|first=Shaun M.|last2=Wray|first2=Naomi R.|last3=Stone|first3=Jennifer L.|last4=Visscher|first4=Peter M.|last5=O'Donovan|first5=Michael C.|last6=Sullivan|first6=Patrick F.|last7=Sklar|first7=Pamela|last8=(Leader)|first8=Shaun M. Purcell|last9=Stone|first9=Jennifer L.|date=2009/08|title=Common polygenic variation contributes to risk of schizophrenia and bipolar disorder|url=http://www.nature.com/doifinder/10.1038/nature08185|journal=Nature|language=En|volume=460|issue=7256|doi=10.1038/nature08185|issn=1476-4687}}</ref> It is important to note that these moods exceed normal responses to life events, represent a change from the individual's normal functioning, and cause problems in daily activities. {{blockquotetop}} <big>'''ICD-11 Diagnostic Criteria'''</big> *Bipolar Type I Disorder **Bipolar type I disorder is an episodic mood disorder defined by the occurrence of one or more manic or mixed episodes. A manic episode is an extreme mood state lasting at least one week unless shortened by a treatment intervention characterized by euphoria, irritability, or expansiveness, and by increased activity or a subjective experience of increased energy, accompanied by other characteristic symptoms such as rapid or pressured speech, flight of ideas, increased self-esteem or grandiosity, decreased need for sleep, distractibility, impulsive or reckless behavior, and rapid changes among different mood states (i.e., mood lability). A mixed episode is characterized by either a mixture or very rapid alternation between prominent manic and depressive symptoms on most days during a period of at least 2 weeks. Although the diagnosis can be made based on evidence of a single manic or mixed episode, typically manic or mixed episodes alternate with depressive episodes over the course of the disorder. ***Note: The ICD-11 lists 18 additional subcategories of Bipolar type I disorder. They can be found [https://icd.who.int/browse11/l-m/en#/http://id.who.int/icd/entity/1456478153 here]. *Bipolar Type II Disorder **Bipolar type II disorder is an episodic mood disorder defined by the occurrence of one or more hypomanic episodes and at least one depressive episode. A hypomanic episode is a persistent mood state characterized by euphoria, irritability, or expansiveness, and excessive psychomotor activation or increased energy, accompanied by other characteristic symptoms such as grandiosity, decreased need for sleep, pressured speech, flight of ideas, distractibility, and impulsive or reckless behavior lasting for at least several days. The symptoms represent a change from the individual’s typical behavior and are not severe enough to cause marked impairment in functioning. A depressive episode is characterized by a period of almost daily depressed mood or diminished interest in activities lasting at least 2 weeks accompanied by other symptoms such as changes in appetite or sleep, psychomotor agitation or retardation, fatigue, feelings of worthless or excessive or inappropriate guilt, feelings or hopelessness, difficulty concentrating, and suicidality. There is no history of manic or mixed Episodes. ***Note: The ICD-11 lists 13 additional subcategories of Bipolar type II disorder. They can be found [https://icd.who.int/browse11/l-m/en#/http%3a%2f%2fid.who.int%2ficd%2fentity%2f199053300 here]. '''Changes in DSM-5''' * The diagnostic criteria for '''Bipolar Disorder''' changed slightly from [[DSM-IV]] to [[w:Diagnostic_and_Statistical_Manual_of_Mental_Disorders#DSM-IV-TR_.282000.29|DSM-5]]. Summaries are available [http://www.dsm5.org/Documents/changes%20from%20dsm-iv-tr%20to%20dsm-5.pdf here] and [[w:DSM-5|here]]. {{blockquotebottom}} === Base rates of BD in different clinical settings and populations === This section describes the demographic setting of the population(s) sampled, base rates of diagnosis, country/region sampled, and the diagnostic method that was used. Using this information, clinicians will be able to anchor the rate of adolescent depression that they are likely to see in their clinical practice. * '''''To see prevalence rates across multiple disorders,''''' [[Evidence based assessment/Preparation phase#Base rates for transdiagnostic comparison|'''''click here.''''']] {| class="wikitable" |'''Demography''' |'''Setting''' |'''Base Rate''' |'''Diagnostic Method''' |- |United States, Canada, Puerto Rico, Germany, Taiwan, Korea, New Zealand <ref>{{Cite journal|last=Weissman|first=Myrna M.|last2=Bland|first2=Roger C.|last3=Canino|first3=Glorisa J.|last4=Faravelli|first4=Carlo|last5=Greenwald|first5=Steven|last6=Hwu|first6=Hai-Gwo|last7=Joyce|first7=Peter R.|last8=Karam|first8=Eile G.|last9=Lee|first9=Chung-Kyoon|date=1996-07-24|title=Cross-National Epidemiology of Major Depression and Bipolar Disorder|url=https://doi.org/10.1001/jama.1996.03540040037030|journal=JAMA|volume=276|issue=4|pages=293–299|doi=10.1001/jama.1996.03540040037030|issn=0098-7484}}</ref> |Community Epidemiological Samples |0.3 - 1.5% |Structured and semi-structured diagnostic interviews |- |United States<ref>{{Cite journal|last=Merikangas|first=Kathleen R.|last2=Akiskal|first2=Hagop S.|last3=Angst|first3=Jules|last4=Greenberg|first4=Paul E.|last5=Hirschfeld|first5=Robert M. A.|last6=Petukhova|first6=Maria|last7=Kessler|first7=Ronald C.|date=2007-05-01|title=Lifetime and 12-Month Prevalence of Bipolar Spectrum Disorder in the National Comorbidity Survey Replication|url=https://jamanetwork.com/journals/jamapsychiatry/fullarticle/482285|journal=Archives of General Psychiatry|language=en|volume=64|issue=5|pages=543–552|doi=10.1001/archpsyc.64.5.543|issn=0003-990X}}</ref> |Community Epidemiological Samples |BPI - 1%; BPII - 1.1%; Subthreshold BP - 2.4% |World Health Organisation Composite International Diagnostic Interview |- |United States<ref>{{Cite journal|last=LEWINSOHN|first=PETER M.|last2=KLEIN|first2=DANIEL N.|last3=SEELEY|first3=JOHN R.|title=Bipolar Disorders in a Community Sample of Older Adolescents: Prevalence, Phenomenology, Comorbidity, and Course|url=http://linkinghub.elsevier.com/retrieve/pii/S089085670963731X|journal=Journal of the American Academy of Child & Adolescent Psychiatry|volume=34|issue=4|pages=454–463|doi=10.1097/00004583-199504000-00012}}</ref> |Community samples (older adolescents) |1% |K-SADS Semi-Structured Interview |- |United States<ref>{{Cite journal|last=Judd|first=Lewis L.|last2=Akiskal|first2=Hagop S.|title=The prevalence and disability of bipolar spectrum disorders in the US population: re-analysis of the ECA database taking into account subthreshold cases|url=https://doi.org/10.1016/S0165-0327(02)00332-4|journal=Journal of Affective Disorders|volume=73|issue=1-2|pages=123–131|doi=10.1016/s0165-0327(02)00332-4}}</ref> |US National Epidemiological Catchment Area (ECA) database |0.8 - 5.1% (manic and subthreshold mania) |Diagnostic Interview Schedule (DIS) |- |United States<ref>{{Cite journal|last=Kessler|first=R. C.|last2=Rubinow|first2=D. R.|last3=Holmes|first3=C.|last4=Abelson|first4=J. M.|last5=Zhao|first5=S.|date=1997/09|title=The epidemiology of DSM-III-R bipolar I disorder in a general population survey|url=https://www.cambridge.org/core/journals/psychological-medicine/article/epidemiology-of-dsmiiir-bipolar-i-disorder-in-a-general-population-survey/950D518D15F64E2059F1033558615A9A|journal=Psychological Medicine|language=en|volume=27|issue=5|pages=1079–1089|issn=1469-8978}}</ref> |US National Comorbidity Survey (NCS) |0-4% (small community sample; reappraisal study) |World Health Organisation Composite International Diagnostic Interview |- |United States and other countries<ref>{{Cite book|url=https://www.worldcat.org/oclc/830807378|title=Diagnostic and statistical manual of mental disorders : DSM-5.|date=2013|publisher=American Psychiatric Association., American Psychiatric Association. DSM-5 Task Force.|isbn=9780890425541|edition=5th|location=Arlington, VA|oclc=830807378}}</ref> |Community sample |BPI - 0.6%; BPII-  1.8%;  Cyclothymia - 0.4-1% |Unspecified |- |United States, Europe, Asia<ref>{{Cite journal|last=Merikangas|first=Kathleen R.|last2=Jin|first2=Robert|last3=He|first3=Jian-Ping|last4=Kessler|first4=Ronald C.|last5=Lee|first5=Sing|last6=Sampson|first6=Nancy A.|last7=Viana|first7=Maria Carmen|last8=Andrade|first8=Laura Helena|last9=Hu|first9=Chiyi|date=2011-03-07|title=Prevalence and Correlates of Bipolar Spectrum Disorder in the World Mental Health Survey Initiative|url=http://archpsyc.jamanetwork.com/article.aspx?doi=10.1001/archgenpsychiatry.2011.12|journal=Archives of General Psychiatry|language=en|volume=68|issue=3|doi=10.1001/archgenpsychiatry.2011.12|issn=0003-990X}}</ref> |Community Samples |BPI - 0.6%; BPII - 0.4%; Subthreshold BP - 1.4%; Bipolar Spectrum Disorder - 2.4% |World Health Organisation Composite International Diagnostic Interview |- |United States<ref>{{Cite journal|last=Grant|first=Bridget F.|last2=Stinson|first2=Frederick S.|last3=Hasin|first3=Deborah S.|last4=Dawson|first4=Deborah A.|last5=Chou|first5=S. Patricia|last6=Ruan|first6=W. June|last7=Huang|first7=Boji|date=October 2005|title=Prevalence, correlates, and comorbidity of bipolar I disorder and axis I and II disorders: results from the National Epidemiologic Survey on Alcohol and Related Conditions|url=https://www.ncbi.nlm.nih.gov/pubmed/16259532|journal=The Journal of Clinical Psychiatry|volume=66|issue=10|pages=1205–1215|issn=0160-6689|pmid=16259532}}</ref> |National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) |BPI - 3.3% |The Alcohol Use Disorder and Associated Disabilities Interview Schedule-IV (AUDADIS-IV) |- |United States<ref>{{Cite journal|last=Das|first=Amar K.|date=2005-02-23|title=Screening for Bipolar Disorder in a Primary Care Practice|url=http://jama.jamanetwork.com/article.aspx?doi=10.1001/jama.293.8.956|journal=JAMA|language=en|volume=293|issue=8|doi=10.1001/jama.293.8.956|issn=0098-7484}}</ref> |Outpatient Clinic Sample |9.8% |Review of medical records, questionnaire data |- |United States<ref>{{cite journal|last1=Hirschfeld|first1=RM|last2=Cass|first2=AR|last3=Holt|first3=DC|last4=Carlson|first4=CA|date=2005|title=Screening for bipolar disorder in patients treated for depression in a family medicine clinic.|journal=The Journal of the American Board of Family Practice|volume=18|issue=4|pages=233-9|pmid=15994469}}</ref> |Outpatient Clinic Sample |21.3% |MDQ, SCID |} ==[[Evidence based assessment/Prediction phase|'''Prediction phase''']]== === Psychometric properties of screening instruments for adult bipolar disorder === The following section contains a list of screening and diagnostic instruments for adult bipolar disorder. The section includes administration information, psychometric data, and PDFs or links to the screenings. * Screenings are used as part of the [[Evidence based assessment/Prediction phase|prediction phase]] of assessment; for more information on interpretation of this data, or how screenings fit in to the assessment process, click [[Evidence based assessment/Prediction phase|here.]] * '''''For a list of more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Psychometric_properties_of_common_screening_instruments click here.]''''' {| class="wikitable" |- ! Measure !Format (Reporter) !Age Range !Administration/ Completion Time !Where to Access |- |[[wikipedia:General_Behavior_Inventory|GBI (General Behavior Inventory)]]<ref>{{Cite journal|date=2018-06|editor-last=Hunsley|editor-first=John|editor2-last=Mash|editor2-first=Eric J.|title=A Guide to Assessments That Work|url=http://dx.doi.org/10.1093/med-psych/9780190492243.001.0001|journal=Oxford Clinical Psychology|doi=10.1093/med-psych/9780190492243.001.0001}}</ref> |Self-report |Adult |15-20 minutes | * [https://mfr.osf.io/render?url=https://osf.io/j6rce/?action=download%26mode=render Downloadable PDF Self-Report English] * [https://mfr.osf.io/render?url=https://osf.io/27nwg/?action=download%26mode=render Scoring instructions and information] |- |[[wikipedia:Mood_Disorder_Questionnaire|MDQ (Mood Disorder Questionnaire)]]<ref name="Carvalho" /> |Self-report |Adult |5 minutes | * [https://mfr.osf.io/render?url=https://osf.io/sb5xw/?action=download%26mode=render Adult Self-Report (Long, English)] * [https://mfr.osf.io/render?url=https://osf.io/xa7v6/?action=download%26mode=render Adult Self-Report (Short, English)] * |- |[[wikipedia:Bipolar_Spectrum_Diagnostic_Scale|BSDS (Bipolar Spectrum Diagnostic Scale)]]<ref>{{Cite journal|date=2018-06|editor-last=Hunsley|editor-first=John|editor2-last=Mash|editor2-first=Eric J.|title=A Guide to Assessments That Work|url=http://dx.doi.org/10.1093/med-psych/9780190492243.001.0001|journal=Oxford Clinical Psychology|doi=10.1093/med-psych/9780190492243.001.0001}}</ref><ref name="Carvalho" /> |Self-report |Adult |15 minutes | * [http://psycheducation.org/diagnosis/the-bipolar-spectrum-diagnostic-scale/ Online version] * [https://mfr.osf.io/render?url=https://osf.io/w9qet/?action=download%26mode=render Downloadable PDF Version (English)] |- |[[wikipedia:Hypomania_Checklist|HCL-32 (Hypomania Checklist)]]<ref name="Carvalho" /><ref>{{Cite journal|last=Feng|first=Yuan|last2=Wang|first2=Yuan-Yuan|last3=Huang|first3=Wei|last4=Ungvari|first4=Gabor S.|last5=Ng|first5=Chee H.|last6=Wang|first6=Gang|last7=Yuan|first7=Zhen|last8=Xiang|first8=Yu-Tao|date=2017-06-01|title=Comparison of the 32-item Hypomania Checklist, the 33-item Hypomania Checklist, and the Mood Disorders Questionnaire for bipolar disorder|url=http://onlinelibrary.wiley.com/doi/10.1111/pcn.12506/abstract|journal=Psychiatry and Clinical Neurosciences|language=en|volume=71|issue=6|pages=403–408|doi=10.1111/pcn.12506|issn=1440-1819}}</ref> |Self-report |Adult |10-15 minutes | * [https://mfr.osf.io/render?url=https://osf.io/2veyc/?action=download%26mode=render Self-report] |} '''Note:''' Reliability and validity are included in the [[Evidence-based assessment/Bipolar disorder in adults (assessment portfolio)/extended version|extended version]]. This table includes measures with Good or Excellent ratings. === Likelihood ratios and AUCs of screening measures for bipolar disorder in adults === * '''''For a list of the likelihood ratios for more broadly reaching screening instruments, [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prediction_phase&wteswitched=1#Likelihood_ratios_and_AUCs_of_common_screening_instruments click here.]''''' {| class="wikitable sortable" !'''Screening Measure (Primary Reference)''' !'''Area Under Curve (AUC) and sample size''' !'''DiLR+ (score)''' !DiLR- (score) !'''Population''' |- |[[wikipedia:Bipolar_Spectrum_Diagnostic_Scale|BSDS (Bipolar Spectrum Diagnostic Scale)]] <ref name="Carvalho" /> |0.81 |(13) <ref name = Carvalho>{{cite journal|last1=Carvalho|first1=André F.|last2=Takwoingi|first2=Yemisi|last3=Sales|first3=Paulo Marcelo G.|last4=Soczynska|first4=Joanna K.|last5=Köhler|first5=Cristiano A.|last6=Freitas|first6=Thiago H.|last7=Quevedo|first7=João|last8=Hyphantis|first8=Thomas N.|last9=McIntyre|first9=Roger S.|last10=Vieta|first10=Eduard|title=Screening for bipolar spectrum disorders: A comprehensive meta-analysis of accuracy studies|journal=Journal of Affective Disorders|date=February 2015|volume=172|pages=337–346|doi=https://doi.org/10.1016/j.jad.2014.10.024}}</ref> |0.36 (4.93) |Clinical |- |[[wikipedia:Hypomania_Checklist|HCL-32 (Hypomania Checklist)]]<ref name="Carvalho" /> |0.80 |(14)<ref name="Carvalho" /> |0.28 (2.45) |Clinical |- |[[wikipedia:Mood_Disorder_Questionnaire|MDQ (Mood Disorder Questionnaire)]]<ref name="Carvalho" /> |0.78 |(7)<ref name="Carvalho" /> |0.22 (5.4) |Clinical |- |General Behavior Inventory (GBI) | | | | |} '''Note:''' Area Under Curve (AUC, or AUROC) is equal to the probability that a classifier will rank a randomly chosen positive diagnosis of Bipolar Disorder higher than a randomly chosen negative diagnosis of Bipolar Disorder[15]. ==[[Evidence based assessment/Prescription phase|'''Prescription phase''']]== ===Gold standard diagnostic interviews=== * For a list of broad reaching diagnostic interviews sortable by disorder with PDFs (if applicable), [https://en.wikiversity.org/w/index.php?title=Evidence_based_assessment/Prescription_phase&wteswitched=1#Common_Diagnostic_Interviews click here.] ===Recommended diagnostic interviews for adult bipolar disorder=== {| class="wikitable sortable" border="1" ! colspan="5" |Diagnostic instruments for BPSD |- ! Measure ! Format (Reporter) ! Age Range ! Administration/ Completion Time !Where to Access |- | Structured Clinical Interview for DSM-5 (SCID)<ref>{{Cite journal|last=Miller|first=Christopher J.|last2=Johnson|first2=Sheri L.|last3=Eisner|first3=Lori|date=2009-06|title=Assessment tools for adult bipolar disorder.|url=http://doi.apa.org/getdoi.cfm?doi=10.1111/j.1468-2850.2009.01158.x|journal=Clinical Psychology: Science and Practice|language=en|volume=16|issue=2|pages=188–201|doi=10.1111/j.1468-2850.2009.01158.x|issn=1468-2850|pmc=PMC2847794|pmid=20360999}}</ref><ref>{{Cite journal|date=2018-06|editor-last=Hunsley|editor-first=John|editor2-last=Mash|editor2-first=Eric J.|title=A Guide to Assessments That Work|url=http://dx.doi.org/10.1093/med-psych/9780190492243.001.0001|journal=Oxford Clinical Psychology|doi=10.1093/med-psych/9780190492243.001.0001}}</ref> | Semistructured interview | 18+ | 1-2 hours |Available for purchase from [https://www.appi.org/products/structured-clinical-interview-for-dsm-5-scid-5 APA Publishing] |- | Schedule for Affective Disorders and Schizophrenia (SADS)<ref>{{Cite journal|date=2018-06|editor-last=Hunsley|editor-first=John|editor2-last=Mash|editor2-first=Eric J.|title=A Guide to Assessments That Work|url=http://dx.doi.org/10.1093/med-psych/9780190492243.001.0001|journal=Oxford Clinical Psychology|doi=10.1093/med-psych/9780190492243.001.0001}}</ref><ref>{{Cite journal|last=Miller|first=Christopher J.|last2=Johnson|first2=Sheri L.|last3=Eisner|first3=Lori|date=2009-06|title=Assessment tools for adult bipolar disorder.|url=http://doi.apa.org/getdoi.cfm?doi=10.1111/j.1468-2850.2009.01158.x|journal=Clinical Psychology: Science and Practice|language=en|volume=16|issue=2|pages=188–201|doi=10.1111/j.1468-2850.2009.01158.x|issn=1468-2850|pmc=PMC2847794|pmid=20360999}}</ref><ref>{{Cite journal|last=Endicott|first=Jean|date=1978-07-01|title=A Diagnostic Interview: The Schedule for Affective Disorders and Schizophrenia|url=http://archpsyc.jamanetwork.com/article.aspx?doi=10.1001/archpsyc.1978.01770310043002|journal=Archives of General Psychiatry|language=en|volume=35|issue=7|pages=837|doi=10.1001/archpsyc.1978.01770310043002|issn=0003-990X}}</ref> | Semistructured interview | 18+ | 1-2 hours |[https://jamanetwork.com/journals/jamapsychiatry/article-abstract/491947 (Endicott & Spitzer, 1978)] |} '''Note:''' Reliability and validity are included in the [[Evidence-based assessment/Bipolar disorder in adults (assessment portfolio)/extended version|extended version]]. This table includes measures with Good or Excellent ratings. ==[[Evidence based assessment/Process phase|'''Process phase''']]== === Treatment === * Please refer to the page on [https://en.wikipedia.org/wiki/Bipolar_disorder bipolar disorder] for more information on available treatment for bipolar disorder or go to the Effective Child Therapy pages for [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/severe-mood-swings-and-bipolar-spectrum-disorders/| Severe Mood Swings & Bipolar Spectrum Disorders] * [https://reacttoolkit.uk/ Relatives Education and Coping Toolkit (REACT)] is currently freely available at https://reacttoolkit.uk/. This is a resource/project of [https://www.lancaster.ac.uk/health-and-medicine/research/spectrum/ The Sprectrum Centre for Mental Health Research] from Lancaster University. A team of clinicians, researchers and relatives of people with psychosis or bipolar disorder at Lancaster, Liverpool and London have developed the Relatives Education and Coping Toolkit (REACT). REACT provides [https://www.nice.org.uk/ National Institute for Health and Care Excellence (NICE)] recommended information and support to relatives and friends of people with mental health problems associated with psychosis or bipolar disorder through a digital, peer-supported, self-management toolkit.<ref>Lobban, A. F., Robinson, H. A., Appelbe, D., Barraclough, J., Bedson, E., Collinge, E., Dodd, S., Flowers, S., Honary, M., Johnson, S., Caixeiro Mateus, M. D. C., Mezes, B., Minns, V., Murray, E., Walker, A. J., Williamson, P., Wintermeyer, C., & Jones, S. H. (2017). Protocol for an online randomised controlled trial to evaluate the clinical and cost-effectiveness of a peer-supported self-management intervention for relatives of people with psychosis or bipolar disorder: Relatives Education And Coping Toolkit (REACT). BMJ Open, 7, [016965]. <nowiki>https://doi.org/10.1136/bmjopen-2017-016965</nowiki></ref><ref>Lobban, F., Akers, N., Appelbe, D., Chapman, L., Collinge, L., Dodd, S., Flowers, S., Hollingsworth, B., Johnson, S., Jones, S. H., Mateus, C., Mezes, B., Murray, E., Panagaki, K., Rainford, N., Robinson, H., Rosala-Hallas, A., Sellwood, W., Walker, A., & Williamson, P. (2020). Clinical effectiveness of a web-based peer-supported self-management intervention for relatives of people with psychosis or bipolar (REACT): online, observer-blind, randomised controlled superiority trial. BMC Psychiatry, 20(1), [160]. <nowiki>https://doi.org/10.1186/s12888-020-02545-9</nowiki></ref><ref>{{Cite journal|last=F|first=Lobban|last2=N|first2=Akers|last3=D|first3=Appelbe|last4=R|first4=Iraci Capuccinello|last5=L|first5=Chapman|last6=L|first6=Collinge|last7=S|first7=Dodd|last8=S|first8=Flowers|last9=B|first9=Hollingsworth|date=2020-07-01|title=A web-based, peer-supported self-management intervention to reduce distress in relatives of people with psychosis or bipolar disorder: the REACT RCT|url=https://www.journalslibrary.nihr.ac.uk/hta/hta24320|journal=Health Technology Assessment|language=EN|volume=24|issue=32|doi=10.3310/hta24320|issn=2046-4924|pmc=PMC7355407|pmid=32608353}}</ref> ** The team at Spectrum Centre also conducted a study linked to REACT called IMPART which looked at what would happen if they tried to deliver REACT as part of routine clinical care in Early Intervention Teams in the [https://www.nhs.uk/ United Kingdom's National Health Service (NHS)]. This study identified key factors that impact implementation and may be useful for informing implementation plans for other digital health interventions.<ref>{{Cite journal|last=Lobban|first=Fiona|last2=Appelbe|first2=Duncan|last3=Appleton|first3=Victoria|last4=Billsborough|first4=Julie|last5=Fisher|first5=Naomi Ruth|last6=Foster|first6=Sheena|last7=Gill|first7=Bethany|last8=Glentworth|first8=David|last9=Harrop|first9=Chris|date=2020-03-17|title=IMPlementation of An online Relatives’ Toolkit for psychosis or bipolar (IMPART study): iterative multiple case study to identify key factors impacting on staff uptake and use|url=https://doi.org/10.1186/s12913-020-5002-4|journal=BMC Health Services Research|volume=20|issue=1|pages=219|doi=10.1186/s12913-020-5002-4|issn=1472-6963|pmc=PMC7077000|pmid=32183787}}</ref> ** '''[https://www.lancaster.ac.uk/health-and-medicine/research/spectrum/ RECOVERY TOOLKIT]''' #eRecoveryToolkit, #RecoveryBD, #PersonalRecovery is freely accessible at https://www.lancaster.ac.uk/health-and-medicine/research/spectrum/. Inspired from a greater body of work around recovery, people with lived experience of bipolar disorder and researchers at [https://www.lancaster.ac.uk/health-and-medicine/research/spectrum/ Spectrum Centre] have created a multi-media recovery toolkit. The aim of the toolkit is to provide accessible information and promote discussion around personal discovery in order to understand and aid people’s recovery journeys. The toolkit contains an animation, an e-booklet and video narratives of relatives and clinicians.<ref>Beck, A. K., Baker, A., Jones, S. H., Lobban, A. F., Kay-Lambkin, F., Attia, J., & Banfield, M. (2018). Exploring the feasibility and acceptability of a recovery-focused group therapy intervention for adults with bipolar disorder: trial protocol. BMJ Open, 8, [e019203]. <nowiki>https://doi.org/10.1136/bmjopen-2017-019203</nowiki></ref> {| cellspacing="0" style="width:238px;" | style="width:45px; height:45px; background:#d1f3f5; color:#49dae9; text-align:center;" vertical-align="center" align="center"| '''<span style="font-size:24pt;">t</span>''' | style="background:#b7eef0; color:black; font-size:8pt; padding:4pt; line-height:1.25em;"| This user tweets on '''[[w:Twitter|Twitter]]''' as [http://twitter.com/_REACTTOOLKIT REACTTOOLKIT]. |} == '''External resources''' == # [http://apps.who.int/classifications/icd10/browse/2015/en#/F31 ICD-10 diagnostic criteria] # [https://en.wikiversity.org/w/index.php?title=Helping_Give_Away_Psychological_Science/Resources/Annotated_List_of_Where_and_How_to_Find_a_Therapist&wteswitched=1#Other_low-cost_options Find-a-Therapist] (a curated list of find-a-therapist websites where you can find a provider) # OMIM (Online Mendelian Inheritance in Man) ## [http://omim.org/entry/125480 125480] ## [http://omim.org/entry/611536 611536] ## [http://omim.org/entry/309200 309200,] ## [http://omim.org/entry/611535 611535] ## [http://omim.org/entry/603663 603663] # [https://emedicine.medscape.com/article/286342-overview eMedicine information] # [http://effectivechildtherapy.org/concerns-symptoms-disorders/disorders/severe-mood-swings-and-bipolar-spectrum-disorders/ Effective Child Therapy information on Bipolar Disorder] #*Effective Child Therapy is website sponsored by Division 53 of the American Psychological Association (APA), or [https://sccap53.org The Society of Clinical Child and Adolescent Psychology](SCCAP), in collaboration with the Association for Behavioral and Cognitive Therapies (ABCT). Use for information on symptoms and available treatments. # The Psych Show with Dr. Ali Mattu videos (geared towards public; might send to client) ##[https://www.youtube.com/watch?v=llOPqKD-s4w How to Cope with Bipolar Disorder] ## [https://www.youtube.com/watch?v=kUHUmeqBZAA Top 10 Bipolar Myths] == '''References''' == {{collapse top|References|expand=yes}} {{Reflist|30em}} [[Category:Psychological disorder portfolios|{{SUBPAGENAME}}]] {{collapse bottom}} cyvenvz3888xwb6mmcr9heq2hyche4z 1 232987 2419099 2401064 2022-08-25T22:44:42Z Eyoungstrom 1933979 Reviewed and next actions wikitext text/x-wiki ====== Discussion page template [[User:JBondareva3x7|JBondareva3x7]] ([[User talk:JBondareva3x7|discuss]] • [[Special:Contributions/JBondareva3x7|contribs]]) 17:12, 18 June 2022 (UTC) ====== ==Reviewed== Reviewed by Eyoungstrom on 8.25.2022 -- formatting looks good [] Replace PDF links with link to OSF.io version. [[User:Eyoungstrom|Eyoungstrom]] ([[User talk:Eyoungstrom|discuss]] • [[Special:Contributions/Eyoungstrom|contribs]]) 22:44, 25 August 2022 (UTC) == Audit Log: 20__ == ''Please adjust to the given year and type any comments/edit ideas you have under the given section they apply to. Then please sign your name using four tildas (~) If replicated for another audit, please copy this template and paste above, adjusting the year. This ensures those edits are seen first.'' === Overall === * ==== What is a "portfolio"? ==== * ==== Preparation Phase ==== * ==== Prediction Phase ==== * ==== Prescription Phase ==== * ==== Process Phase ==== * ==== External Resources ==== * ==== References ==== * == Questions? == ''Please type any questions you have under the given section they apply to. Then please sign your name using four tildas (~)'' === Overall === * ==== What is a "portfolio"? ==== * ==== Preparation Phase ==== * ==== Prediction Phase ==== * ==== Prescription Phase ==== * ==== Process Phase ==== * ==== External Resources ==== * ==== References ==== * == Comments == ''Please type any questions you have under the given section they apply to. Then please sign your name using four tildas (~)'' === Overall === * ==== What is a "portfolio"? ==== * ==== Preparation Phase ==== * ==== Prediction Phase ==== * ==== Prescription Phase ==== * ==== Process Phase ==== * ==== External Resources ==== * ==== References ==== * == Summer 2022 Audit == === Preparation Phase === ==== Diagnostic criteria for anorexia nervosa ==== I know it was only a text revision, but we are sure that there's no changes in the DSM-5 tr right? It might be worth noting even if there aren't any, just to make sure the audience knows our page is up-to-date. [[User:JBondareva3x7|JBondareva3x7]] ([[User talk:JBondareva3x7|discuss]] • [[Special:Contributions/JBondareva3x7|contribs]]) 03:44, 31 May 2022 (UTC) :also was wondering about this - need to decide what up-to-date sources to use [[User:Nattuin|Nattuin]] ([[User talk:Nattuin|discuss]] • [[Special:Contributions/Nattuin|contribs]]) 18:21, 31 May 2022 (UTC) ::There were some very slight changes made to the diagnosis in DSM-5 TR. I found a source that provides the changes, and I can share that with you all. [[User:Aherman012|Aherman012]] ([[User talk:Aherman012|discuss]] • [[Special:Contributions/Aherman012|contribs]]) 15:45, 2 June 2022 (UTC) example of discuss comment--[[User:Nattuin|Nattuin]] ([[User talk:Nattuin|discuss]] • [[Special:Contributions/Nattuin|contribs]]) 20:16, 31 May 2022 (UTC) ==== Base rates of anorexia nervosa in different populations and clinical settings ==== The opener references adolescent depression instead of anorexia I think. --[[User:Maddiegray11|Maddiegray11]] ([[User talk:Maddiegray11|discuss]] • [[Special:Contributions/Maddiegray11|contribs]]) 20:26, 31 May 2022 (UTC) I think there has to be a way to link to pages describing the differences between prevalence rates and the diagnostic methods used and such. Like there has to be other sources we can link to that better explain how that all works so that anyone accessing this page is never left confused, but can click on a new link and find an answer to any question of "what is that" [[User:JBondareva3x7|JBondareva3x7]] ([[User talk:JBondareva3x7|discuss]] • [[Special:Contributions/JBondareva3x7|contribs]]) 03:51, 31 May 2022 (UTC) Is "military" clinical or non-clinical? It's not listed. [[User:JBondareva3x7|JBondareva3x7]] ([[User talk:JBondareva3x7|discuss]] • [[Special:Contributions/JBondareva3x7|contribs]]) 03:51, 31 May 2022 (UTC) Also can we change this table so we're able sort by each column, ascending/descending? It'd make it more user-friendly. Plus there's no "Best recommended for" so that needs work. [[User:JBondareva3x7|JBondareva3x7]] ([[User talk:JBondareva3x7|discuss]] • [[Special:Contributions/JBondareva3x7|contribs]]) 03:51, 31 May 2022 (UTC) :It may also be worth giving people the primary prevalence and base rates for the general population, and then organizing by various identities (e.g., gender identity differences, racial/ethnic identity differences, clinical populations, military populations). [[User:Aherman012|Aherman012]] ([[User talk:Aherman012|discuss]] • [[Special:Contributions/Aherman012|contribs]]) 15:58, 2 June 2022 (UTC) Diversity wise, it'd be great to see some statistics for the prevalence rates in other minorities such as native americans? It'd also be great to have more on the other continents. I'm not sure if there are any statistics we are able to use on that though. [[User:JBondareva3x7|JBondareva3x7]] ([[User talk:JBondareva3x7|discuss]] • [[Special:Contributions/JBondareva3x7|contribs]]) 03:51, 31 May 2022 (UTC) :I agree! It may also be worth editing some of the language we have on there to be person-first language. [[User:Aherman012|Aherman012]] ([[User talk:Aherman012|discuss]] • [[Special:Contributions/Aherman012|contribs]]) 16:01, 2 June 2022 (UTC) Shouldn't we specify that the first section is on north america rather than having it implied? [[User:JBondareva3x7|JBondareva3x7]] ([[User talk:JBondareva3x7|discuss]] • [[Special:Contributions/JBondareva3x7|contribs]]) 03:51, 31 May 2022 (UTC) === Prediction Phase === ==== Psychometric properties of screening instruments for anorexia nervosa ==== Do we have anything more on the age ranges on these screenings? If we have no information we probably shouldn't include that column. [[User:JBondareva3x7|JBondareva3x7]] ([[User talk:JBondareva3x7|discuss]] • [[Special:Contributions/JBondareva3x7|contribs]]) 03:56, 31 May 2022 (UTC) What does the X denote? I know it's probably just not highly recommended, but it seems confusing amongst the rest of the letters. [[User:JBondareva3x7|JBondareva3x7]] ([[User talk:JBondareva3x7|discuss]] • [[Special:Contributions/JBondareva3x7|contribs]]) 03:56, 31 May 2022 (UTC) Should we possibly put a note as to why inter-rater reliability isn't applicable for those two? [[User:JBondareva3x7|JBondareva3x7]] ([[User talk:JBondareva3x7|discuss]] • [[Special:Contributions/JBondareva3x7|contribs]]) 03:56, 31 May 2022 (UTC) ==== Likelihood ratios and AUCs of screening instruments for anorexia nervosa ==== Definitely needs more download links. [[User:JBondareva3x7|JBondareva3x7]] ([[User talk:JBondareva3x7|discuss]] • [[Special:Contributions/JBondareva3x7|contribs]]) 04:06, 31 May 2022 (UTC) Could we possibly make the subheadings like "Biological & Physical Measures" or "REDS-C1" collapsible for easier reading? [[User:JBondareva3x7|JBondareva3x7]] ([[User talk:JBondareva3x7|discuss]] • [[Special:Contributions/JBondareva3x7|contribs]]) 04:06, 31 May 2022 (UTC) Some of these use the DSM-IV-tr or DSM-IV, is this cause for concern? [[User:JBondareva3x7|JBondareva3x7]] ([[User talk:JBondareva3x7|discuss]] • [[Special:Contributions/JBondareva3x7|contribs]]) 04:06, 31 May 2022 (UTC) The "EDI-3 - Drive for Thinness Subscale (Garner, 2004); Lehmann et al., 2013" lacks any clinical generalizability, definitely needs to be added. [[User:JBondareva3x7|JBondareva3x7]] ([[User talk:JBondareva3x7|discuss]] • [[Special:Contributions/JBondareva3x7|contribs]]) 04:06, 31 May 2022 (UTC) Perhaps we could make a separate column for whether eating disorders were separated? [[User:JBondareva3x7|JBondareva3x7]] ([[User talk:JBondareva3x7|discuss]] • [[Special:Contributions/JBondareva3x7|contribs]]) 04:06, 31 May 2022 (UTC) Why do only three of the sections on the bottom have "low-moderate" or "moderate" ratings? Shouldn't that be standardized within all of the clinical generalizability boxes? [[User:JBondareva3x7|JBondareva3x7]] ([[User talk:JBondareva3x7|discuss]] • [[Special:Contributions/JBondareva3x7|contribs]]) 04:06, 31 May 2022 (UTC) ==== Interpreting anorexia nervosa screening measure scores ==== === Prescription Phase === ==== Gold standard diagnostic interviews ==== ==== Recommended diagnostic interviews for anorexia nervosa ==== This is an empty accordion. Needs more info. [[User:JBondareva3x7|JBondareva3x7]] ([[User talk:JBondareva3x7|discuss]] • [[Special:Contributions/JBondareva3x7|contribs]]) 04:10, 31 May 2022 (UTC) ==== Severity interviews for anorexia nervosa ==== I'm not sure this should still be called placeholder example...? Also that accordion is empty. [[User:JBondareva3x7|JBondareva3x7]] ([[User talk:JBondareva3x7|discuss]] • [[Special:Contributions/JBondareva3x7|contribs]]) 04:12, 31 May 2022 (UTC) === Process phase === ==== Process measures ==== ==== Outcome and severity measures ==== ==== Treatment ==== == To-dos == Drop suggestions and next to-dos in their respective sections. For each section, please add four tildes (<nowiki>~~~~</nowiki>). This is to add a timestamp and your username next to your suggestion. === Demographic information === In the "base rates" table under demographics, why is the "Best Recommended For" column empty? -- Jeremiah Consider cutting down the first table. Many of the rows highlight similar data, and it's good to be thorough, but the detail seems excessive. Add clinical community base rates -EAC === Diagnosis === In the "Screening and Diagnostic Instruments" table under Diagnosis, the "Age Range" Column is empty alongside the majority of the "Completion Time" column. --[[User:Ithaker|Ithaker]] ([[User talk:Ithaker|discuss]] • [[Special:Contributions/Ithaker|contribs]]) 22:56, 1 February 2018 (UTC) DSM Criteria needs to be removed Section about psychometric properties of assessments for anorexia is way too long. There are articles listed that are outdated, but have not been removed even though the newer articles are already listed. This section should really focus on only the best assessments for anorexia.--[[User:Rkang101|Rkang101]] ([[User talk:Rkang101|discuss]] • [[Special:Contributions/Rkang101|contribs]]) 22:19, 8 March 2018 (UTC) Not sure if the EDE if correctly linked Add age range to diagnostic table ===Treatment === There are articles that can be found that can help support many of the statements made. Also, remember to format the citations the way Wikiversity wants them to be [[User:Ashl4|Ashl4]] ([[User talk:Ashl4|discuss]] • [[Special:Contributions/Ashl4|contribs]]) 22:23, 8 March 2018 (UTC) === Process and outcome measures === Insert citations into the process measures sections. May need to flesh this out more. [[User:Ashl4|Ashl4]] ([[User talk:Ashl4|discuss]] • [[Special:Contributions/Ashl4|contribs]]) 22:24, 8 March 2018 (UTC) There is a reference to an appendix at the end that needs to be taken out. There is a citation that is done incorrectly towards the end. --[[User:Rkang101|Rkang101]] ([[User talk:Rkang101|discuss]] • [[Special:Contributions/Rkang101|contribs]]) 22:28, 8 March 2018 (UTC) g4nhc4m842fl1fxd1qsq34l6cxeqtia 0 238778 2419364 1957865 2022-08-26T07:25:23Z Jtneill 10242 + categories wikitext text/x-wiki {{title|Insular cortex and emotion:<br>What role does the insular cortex play in emotion?}} {{MECR3|1=https://youtu.be/b7v2LONn_M8}} __TOC__ ==Overview== [[File:Insula animation small.gif|alt=|thumb|150x150px|''Figure 1. insular cortex placement'']] The insular cortex (IC) is part of the prefrontal cortex (PFC) of the brain (see figure 1). &nbsp;The primary role of the IC is monitoring bodily feelings both physical and psychological. It then communicates that information to other regions of the brain (Reeve, 2018). &nbsp;The IC is important in the formation of emotion because it uses physical feelings to create emotional feelings.&nbsp; There are currently significant amounts of research aimed at improving the understanding the functionality of the IC.&nbsp; The IC uses various sensory processes and sensory memory, to guide an appropriate response based on many inputs (Hurtado, García, & Puerto, 2016). In events where all stimuli are not accessible, the individual is incapable of making an accurate decision. &nbsp;If key information is missed, the individual will act in a way that is socially inappropriate.&nbsp; The most relatable bodily sensations the IC uses are the sensations of heart, stomach and taste. The IC monitors and alters sensations (Caria et al. 2007). Most sub-regions of the brain have a unique function. The IC has two primary sub-regions which work together and also independently, which are, posterior insular cortex (pIC) and the anterior insular cortex (aIC).&nbsp; This chapter will investigate the ICs influences in the formation of emotion.&nbsp; The IC, not only monitors these sensations but also relates any these changes to regions that can make appropriate alterations to keep the organism alive. == Theory and research == As studies of the IC have only been around in the last few decades, new research often finds evidence that proves old research considerably wrong. Initially it was believed that the entire IC is always activated together; however, in the last decade there is increasing evidence that sub regions of the IC work independently.&nbsp; As technology improves, smaller areas of the brain can be studied in greater detail, which increases the rate of understanding of the brain. &nbsp;There are no two brains that are identical in [[wikipedia:Neuron|neural]] connections in the world, which makes comparing brains not very useful as there are far too many variables.&nbsp; Finger-print studies are now used to allow the ability to qualitatively describe a single individual's functional repertoire of the brain (Uddin et al. 2014, pp 20 – 21).&nbsp; Small subsections of the IC communicate effectively with other regions of the brain. Uddin (2014) studied the neural activity of the aIC or pIC when a participant is completing certain tasks in a Functional Magnetic [[wikipedia:Functional_magnetic_resonance_imaging|Resonances Imaging (fMRI)]] procedure. It showed there is distinctive simultaneous activity from only small subsections, which means the whole IC does not always activate together. It was concluded the IC has three functional sub-regions with their own distinct functionality, the dorsal anterior IC, ventral anterior IC and posterior IC. This study is significant as it explains different regions are more independent; For example, the pIC co-activates with regions such as the [[wikipedia:Primary_somatosensory_cortex|somatosensory cortex]] (Moraga-Amaro & Stehberg, 2012). ===Drugs influence the insular cortex's ability to form emotion=== The IC is one of the most interconnected regions of the brain and is needed to feed sensory information to the limbic region to ultimately form emotion, which results in vulnerabilities to manipulation and misinterpretation (García, Simón, & Puerto, 2013). &nbsp;All drugs alter the brain in different ways, however, some drugs like illicit ones can cause permanent changes through altering the neurochemistry in the brain. This can cause changes in personality and emotion. Studies slightly differ in exact regions of activation on connectivity that is affected, however the trend overall is very similar. The IC monitors the body, so when a drug is introduced it must adjust the body and its understanding of the body. &nbsp;The aIC has a significant number of pathways to the amygdala in comparison to other regions, which increases the likelihood of the amygdala also becoming affected by a drug. Selective serotonin reuptakes inhibitor (SSRI) directly affect the amygdala and mildly affect the IC in emotion formation process, such as Escitalopram (Arce, 2008). === Some sensations are more influential than others === [[Motivation and emotion/Book/2018/Chronic pain and maladaptive behaviour|Pain is a strong motivator]] in how an individual acts. During a painful experience, the pIC activates at the same time as the [[wikipedia:Anterior_cingulate_cortex|cingulete cortex (CC)]]; the CC is located just in front of the [[wikipedia:Corpus_callosum|corpus callosum.]] The CC is involved in motivation, action and learning. &nbsp;The IC activates when the body feels pain, to establish the type and location (Lenoir, Algoet & Mouraux, 2018). It then sends the processed information to other regions of the brain to find a way stop or avoid the pain. There is a considerable number of studies to investigate ways to alter the IC’s perception of pain.&nbsp; A study by Barthas et al. (2015) investigated how the IC monitors emotional and physical sensations, and more specifically the long term resulting damage on neurological activity. &nbsp;Rats in the study had surgically created lesions in the anterior CC, to create [[wikipedia:Neuropathic_pain|neuropathic pain]] (nerve pain). &nbsp;The study made two interesting findings, firstly the pIC has no direct relationship to emotion; instead it activates the somatosensory cortex and other regions of the brain. Secondly, they found evidence that chronic and severe pain can cause long term and possibly permanent changes in pathways between pIC and the anterior region of the CC (Barthas et al, 2015). === Subconscious to conscious === The brain processes large amounts of information on a [[wikipedia:Subconscious|subconscious]] level, while only a very small percentage becomes conscious; as the brain can not process all information on a conscious level effectively. Sensory input in the brain is prioritised such that important information has a lower ''[https://study.com/academy/lesson/response-latency-definition-lesson.html latency]''. Priority of latency is dependent on interoception, which is the monitory process of sensory output in the body such as temperature and pain. Pain has a low latency and is dealt with immediately (Sridharan, Levitin & Menon, 2008).&nbsp; The aIC&nbsp;is considered as being discriminate against positive emotion in speech. A study by Chen, Lee & Cheng (2014) researched this theory using recorded voices; the recordings varied from monotone voices to happy, disgust and anger. The study established that there is a higher frequency of activation with the disgust voices, which suggests disgust is an emotional response the IC recognises. The study stated that further research is needed to establish whether the activation is only with certain negative voices and stimuli, for example when an individual is angry. [[File:Amygdala.jpg|thumb|''Figure 2.'' Amygdala|alt=]] {| class="wikitable" |+Summarised process of the insular cortex's involvement of emotion formation !Stage !Unconscious to conscious |- |1 |Sensory input. |- |2 |Drug influence (if any). |- |3 |Introspection. |- |4 |Sensory information to IC. |- |5 |Sensory information to appropriate region i.e. limbic region. |- |6 |Emotional reaction. |} {{RoundBoxTop}} ===Social information processing following resection of the insular cortex=== A study by Olivier Boucher and Colleagues As research continues to understand the functions of the IC, it is becoming more evident the IC is needed in the process of turning basic stimuli such as a facial expression into an emotion. If an individual sees their friend has an angry expression they will feel upset or anger themselves, dependent on the situation. A study by Broucher (2015) investigated how much influence the IC has over the formation of emotion from physical stimuli. The study has three conditions; Group 1: epileptic individuals, who have complete partial removal of IC; Group 2: individuals with no brain damage or surgery and Group 3: epileptic individuals with partial removal of the temporal lobe. All participants underwent a battery of tests of emotional intelligence and recognition of emotion (Broucher et al. 2015). In one exercise the participants were shown faces with various expressions and they were asked to identify the emotion displayed. Group 1 scored lower than the other groups; in particular they had difficulties in recognition of fear, surprise and happiness. Group 3 showed lower scores in recognition of fear. In another exercise where the expressions of the participant are noted, it was evident Group 1 have difficulty displaying some emotions such as anger (Broucher et al. 2015). It is evident in this study that the IC does discriminate against certain emotions; however, the study concluded the results indicate the IC recognises a greater range of emotions than previously thought. Notably, Group 3 had equally as low scores as Group 1, for questions of semantic memory. It was concluded, the reason Group 3 scored low, is most likely a result of damage to the limbic region during surgery (Boucher et al. 2015). {{RoundBoxBottom}} === The insular cortex and the amygdala need each other === The amygdala (see figure 2) is very close in space to the IC and is involved in the [[Motivation and emotion/Book/2014/Fight, flight, freeze system and emotion|Fight or Flight or Freeze Response as a coping mechanism]] for a stressful situations. The amygdala is well recognised as the part of the brain that deals with stress. When the body is in a high emotional state, the brain takes in and remembers more information. A study by Beldjoud, Barsegyan and Roozendaal (2015) investigated whether the higher levels of stress increase memory through first injecting synthesised [https://pubchem.ncbi.nlm.nih.gov/compound/norepinephrine#section=Top norepinephrine] directly in rats and to ensure a stressed state, immediately the&nbsp; rats were taught a maze.&nbsp; The control group learnt the maze without the injection of noradrenergine. The test group learnt the maze faster than the control group, which is evidence that the amygdala and the IC must be communicating because the IC uses the stressed state more effectively ( Beldjoud, Barsegyan & Roozendaal, 2015). The IC and amygdala must have a significant activation together for this process to take place. == Autism Spectrum Disorder == There are many disorders and illnesses the IC is involved in. [[Motivation and emotion/Book/2016/Restricted interests and anxiety in children with autistic spectrum disorders|Autism Spectrum Disorder (ASD)]] affects large areas of the brain and is a life long disorder. Autistic individuals have difficulties with comprehension and communication skills, due in part to low connectivity from the IC to the limbic region. &nbsp;This results in deficits in comprehension and communication due to difficulties with reading facial expressions, which is referred to as ''Imitation''. (Colombi et al. 2009). The severity of the disorder can be vastly different for each person, and as such, the spectrum concept works as a measure.&nbsp; An individual on the lower end is highly affected by the disorder and is likely to be unable to speak and will find many situations confusing; whereas an individual on the higher end is average to highly intelligent with difficulty interacting in some social situations (Nuske, Vivanti, & Dissanayake, 2013). ASD patients have difficulty with S''alience'' monitoring because information that is important in a social setting is missed or incorrectly interpreted. This results in situations where people on the spectrum miss social cues such as sarcasm, because tone of voice and subtle social stimuli can be missed all together (Uddin, 2015). It is widely accepted the aIC is more affected than the pIC (Uddin & Menon, 2009).&nbsp; A common misconception of ASD patients is an inability to feel empathy. A study of individuals with ASD showed that amygdala reactivity is close to typical function. This indicates that while ASD allows recognition of emotion, empathetic responses are limited due to impaired imitation abilities (Dapretto et al. 2006). An autistic individual can feel empathy, but has difficulty communicating an empathetic response. == Test your knowledge so far == Choose the correct answers and click "Submit":<quiz display="simple"> {What is the main functions of the IC? (May be multiple answers). |type="()"} - Monitors only sense of touch. - Directly transfers sensory information to emotion. + Part of the process of forming an emotional response. {What region of the brain is the insular cortex located?. |type="()"} - Limbic + PFC - Temporal {What is the current trend in research? |type="()"} +Researchers are finding more emotions the IC recognises. - Autistic people don't try hard enough to communicate. -IC only does what other regions do anyway. </quiz> == Improvements in current research == Currently it is understood that the IC is highly involved in using previous experiences as a bench mark to react to a situation. There{{gr}} IC may hold a the reason into why negative memories are highly influential. Further research needs to investigates why the IC favours certain memories over others. Currently it is understood that different stimuli is needed to form emotion in different regions of the brain. The current understanding is the IC recognises negative tones in speech, while in facial expression the IC tends to notice more positive emotions. Further research will benefit by understanding exactly what these differences and why. Psychological disorders can alter salience, for example individuals with [[Schizophrenia (disorder portfolio)|Schizophrenia]] have weaker [[Motivation and emotion/Book/2016/Cortical activation patterns and emotion|pathways]] between the aIC and the anterior CC due to higher levels of Dopamine, which causes delusions (White, Joseph, Francis & Liddle, 2010). ==Conclusion== The IC is critical in the brain as it is a method to keep unimportant stimuli in the subconscious. &nbsp;When the IC does not process information correctly, an individual is unable to comprehend and respond to a situation. &nbsp;The IC notices emotions other regions of the brain do not, such as happiness. &nbsp;The IC is needed to interpret the basic stimuli of a situation, such as sound and facial expressions. An individual can live a functional life with emotions, but without the IC they will not have a full range because basic stimuli needed to form emotions will not be noticed. ==See also== *[[Motivation and emotion/Book/2018/Anterior cingulate cortex and emotion|Anterior cingulate cortex and emotion]] (Book chapter, 2018) *[[Motivation and emotion/Book/2016/Emotional hijacking|Emotional hijacking]] (Book chapter, 2016) *[[wikipedia:Insular_cortex|Insular cortex]] (Wikipedia) *[[Motivation and emotion/Book/2015/Stress physiology|Stress physiology]] (Book chapter, 2015) *[[Motivation_and_emotion/Book/2010/Depression_and_motivation|Depression and motivation]] (Book chapter, 2010) ==References== {{Hanging indent|1= Arce, E., Simmons, A. N., Lovero, K. L., Stein, M. B., & Paulus, M. P. (2008). Escitalopram effects on insula and amygdala BOLD activation during emotional processing. Psychopharmacology, 196(4), 661-672. Boucher, O., Rouleau, I., Lassonde, M., Lepore, F., Bouthillier, A., & Nguyen, D. (2015). Social information processing following resection of the insular cortex. Neuropsychologia, 71 Colombi, C., Liebal, K., Tomasello, M., Young, G., Warneken, F., & Rogers, S. J. (2009). Examining correlates of cooperation in autism: Imitation, joint attention, and understanding intentions. Autism, 13(2), 143-163. Caria, A., Veit, R., Sitaram, R., Lotze, M., Weiskopf, N., Grodd, W., & Birbaumer, N. (2007). Regulation of anterior insular cortex activity using real-time fMRI. ''Neuroimage'', ''35''(3), 1238-1246. Dapretto, M., Davies, M. S., Pfeifer, J. H., Scott, A. A., Sigman, M., Bookheimer, S. Y., & Iacoboni, M. (2006). Understanding emotions in others: mirror neuron dysfunction in children with autism spectrum disorders. ''Nature neuroscience'', ''9''(1), 28. García, R., Simón, M. J., & Puerto, A. (2013). Conditioned place preference induced by electrical stimulation of the insular cortex: effects of naloxone. ''Experimental brain research'', ''226''(2), 165-174. Hurtado, M. M., García, R., & Puerto, A. (2016). Tolerance to repeated rewarding electrical stimulation of the insular cortex. ''Brain research'', ''1630'', 64-72. Memory loss online. (2004). Figure 2, Amygdala. Retrieved from https://en.wikiversity.org/wiki/File:Amygdala.jpg Moraga-Amaro, R., & Stehberg, J. (2012). The insular cortex and the amygdala: shared functions and interactions. In The Amygdala-A Discrete Multitasking Manager. InTech. Nuske, H. J., Vivanti, G., & Dissanayake, C. (2013). Are emotion impairments unique to, universal, or specific in autism spectrum disorder? A comprehensive review. ''Cognition & Emotion'', ''27''(6), 1042-1061. Reeve, J. (2018). ''Understanding motivation and emotion'' (7th ed.). Hoboken, NJ: Wiley. Sridharan, D., Levitin, D. J., & Menon, V. (2008). A critical role for the right fronto-insular cortex in switching between central-executive and default-mode networks. Proceedings of the National Academy of Sciences, 105(34). Turel, O., He, Q., Brevers, D., & Bechara, A. (2018). Delay discounting mediates the association between posterior insular cortex volume and social media addiction symptoms. ''Cognitive, Affective, & Behavioral Neuroscience'', 1-11. Uddin, L. Q. (2015). Salience processing and insular cortical function and dysfunction. ''Nature Reviews Neuroscience'', ''16''(1), 55. Uddin, L. Q., & Menon, V. (2009). The anterior insula in autism: under-connected and under-examined. ''Neuroscience & Biobehavioral Reviews'', ''33''(8), 1198-1203. Uddin, L. Q., Kinnison, J., Pessoa, L., & Anderson, M. L. (2014). Beyond the tripartite cognition–emotion–interoception model of the human insular cortex. ''Journal of cognitive neuroscience'', ''26''(1), 16-27. White, T. P., Joseph, V., Francis, S. T., & Liddle, P. F. (2010). Aberrant salience network (bilateral insula and anterior cingulate cortex) connectivity during information processing in schizophrenia. Schizophrenia research. Wikimedia commons. (2010). figure 1, insular cortex placement. Database Centre for Life Science. Retrieved from https://commons.wikimedia.org/wiki/File:Insula_animation_small.gif }} ==External links== [https://www.autismspectrum.org.au/content/what-autism Autism] [http://www.stressstop.com/stress-tips/articles/fight-flight-or-freeze-response-to-stress.php More information on the Fight Flight or Freeze response.] [https://www.understood.org/en/learning-attention-issues/child-learning-disabilities/sensory-processing-issues/interoception-and-sensory-processing-issues-what-you-need-to-know More in depth information of Interoception] [[Category:{{#titleparts:{{PAGENAME}}|3}}]] [[Category:Motivation and emotion/Book/Cortex]] [[Category:Motivation and emotion/Book/Emotion]] 8b571vx2edw10ctbex4mw7g65n87wkd 0 239073 2419459 2200407 2022-08-26T09:51:28Z Jtneill 10242 Adjust categories wikitext text/x-wiki {{title|Goal setting techniques:<br>How do different goal setting techniques influence motivation and goal success?}} {{MECR3|1=https://www.youtube.com/watch?v=AX-yD99nQSU}} __TOC__ ==Overview== [[Goal setting]] is a commonly used intervention for individuals needing to increase their [[motivation]]. A goal setting technique is a method or structure used to prompt individuals to consider the essential elements of goal setting theories when setting their goals. By addressing the steps that need to be taken to reach an end state (the goal), goal setting strategies improve an individual's chance at achieving their goal. By addressing each component of the goal setting process, goals can be better directed to suit the individual and the situation, leading to improved motivation and stronger goal success. There are two types of goals that should be considered when setting goals and these are performance goals and mastery goals. A performance goal relies on a measurable outcome such as running 10 seconds faster over a distance whereas a mastery goal relies on overall improvement and a focus on learning, for example, developing a new skill of painting. This chapter brings together different types of goal setting research so the effects goal setting has on motivation and success can be easily identified. By providing a background to goal setting theory, an explanation of the essential structures needed and an outline of the common techniques used in the goal setting process, guidance can be provided on where to start and what to consider and avoid when setting a goal in order to have the best outcome. == Underlying theories of goal setting == {{expand}} === Achievement goal theory === Achievement goals are competence-based aims that are developed within different settings and there are two types; performance goals or mastery goals. Roberts (2001) explains that achievement motivation is when goals function to motivate the intended activity. Dweck & Leggett’s’ [[Achievement motivation|Achievement Motivation]] Model (1988) shows how theories of intelligence have a strong influence on the type of goals that people set and demonstrates that the perceived ability an individual has strongly influences their motivation and in turn, their behaviour. [[File:Stages-of-change.png|thumb|261x261px|''Figure 1''. Stages of Change Developed from the TTM]] === Transtheoretical model === The [[wikipedia:Transtheoretical_model|Transtheoretical Model]] (TTM) is used to identify the stages that an individual will go through when acting on a new behaviour, in particular health behaviours. Developed by Prochaska and Di Clemente (2005) the model outlines six stages of change; (1) pre-contemplation, (2) contemplation, (3) preparation, (4) action, (5) maintenance and (6) termination. It is important to highlight that individuals can move to and from each stage over time, accepting for both progress and relapse. The influence of self-efficacy is shown through perceived ability, behavioural control and decisional balance explains how pros and cons change throughout different stages. By considering the foundations of behavioural change that the TTM highlights, goal setting programs can be more effectively developed. === Direct mechanist theory === Direct Mechanist Theory, developed by [[wikipedia:Edwin_Locke|Locke]] & Latham, shows that goal setting is effective as it provides a focus for effort, thoughts and preparations, leading to an increase in long term persistence. By identifying the mechanisms through which goal setting influences performance, we can use this knowledge to manipulate and adjust the way that we set and structure goals. The four mechanisms and their application are listed in Table 1. ''Table 1'': Goal Setting Mechanisms and Their Application {| class="wikitable" !Goal Mechanism !Application |- |Goals direct attention and motivation |By focusing attention and effort toward goal-relevant activities and away from goal irrelevant activities productivity can be improved. |- |Goals have an energising function |High goals lead to greater effort than low goals. This influences the outcome of tasks that involve physical effort (such as running), those requiring repeated performance of cognitive tasks (such as work in a cooperate setting). The measurement of subjective effort and physiological indicators of effort can be used when setting and tracking goals. |- |Goals affect persistence |When individuals are in control of the time they spend on a task, harder goals have a prolonged effort showing that there is a trade-off between time and intensity of effort. For example, an individual may work fast and intensely for a short period or slowly and less intensely for a long period, but it would be unsustainable to work intensely and fast for a long period of time. |- |Goals lead to action |By stimulating arousal, and increasing discovery and the use of relevant knowledge, it is demonstrated that actions are the result of cognition and motivation. |} ==Ways to structure goals == [[File:Goal setting difficulty and performance relationship.png|thumb|287x287px|''Figure 2.'' Goal difficulty and performance relationship]] {{expand}} ===Difficulty=== Goal difficulty and performance have a linear relationship, such that when goal difficulty increases so does performance (Locke & Latham, 1990). One reason for this is that goal difficulty energises the performer, increasing their effort and persistence. Another reason is that a difficult goal directs attention, decreasing the chance that the individual will get distracted, bored, tired or frustrated. Setting difficult goals can be a challenge in itself as the right amount of difficulty needs to be achieved so that the performer is not over or under worked. For example, if the goal is too easy they may lose interest quickly or not take steps to improve their performance and if the goal is too difficult they may experience failure. This is important to consider as repeated failure can result in lowered self-confidence and motivation as well as decreased performance. Goal difficulty should be specifically tailored to the individual in order to achieve the best outcome. The relationship between goal difficulty and performance can be shown in Figure 1. === Specific and measurable === Research has shown that specific goals lead to improved performance when compared to open ended goals. Goal specificity assists in drawing attention towards what needs to be achieved by reducing ambiguity in thoughts and variability in performance (Klein, Whitener & Ilgen 1990, Locke). By directing attention, strategic planning can be enabled and the steps that need to be taken can be identified. This concept is easily applied to goals in an exercise setting, for example, if a coach in a field sport told their team to aim for completed passes, the players will have something to aim for on the field compared to if their coach advised them to “try their best”. Specific goals also have the ability to be easily measured, leading to improved motivation when striving for goals, when goals are achieved, and if needed, when goals are not reached (Schut & Stam, 1994). When a goal is achieved the individual gains a sense of accomplishment and now has the ability to set a new goal and strive for something greater. Without being able to measure goals, the sense of attainment is not likely to occur. This concept also applies when an individual does not achieve their goal and they need to regroup to attempt again (Locke and Latham, 2006). This is shown in the athlete/coach example used above, because a goal is measurable the athletes can understand if they have or have not succeeded in completing passes and can then use this knowledge to adapt their performance accordingly. [[File:Congruency flow chart 2.png|left|thumb|234x234px|''Figure 3''. Key aspects to consider when setting congruent goals]] ===Congruency === Goals that reflect an individual’s interests, needs, values and preferences are known as self-congruent goals and goals that neglect those constructs are known as self-discrepant goals. Self-congruent goals tap into the notion of [[intrinsic motivation]], which explains that for intrinsic motivation to occur an individual’s psychological needs must be satisfied (Sheldon & Elliot, 1999). These needs can be satisfied when autonomy, competence and relatedness are all addressed. Since people who are intrinsically motivated perform well and enjoy what they are doing it is essential that this intrinsic motivation is aimed for when setting goals. This can be achieved through goal setting by using the individual to set goals that relate to personal interest, personal preferences and their values. Setting goals for others can lead to goals that are controlling and pressure inducing. This can interfere with an individual’s autonomy by impacting intrinsic motivation, cognitive flexibility and creativity. As shown by Koestner et al. (2002), individuals that{{gr}} set self-congruent goals had better performance due to their motivation being intrinsic, increased energy, stronger persistence and better directed attention. == How to maintain goals over time == {{expand}} === Short-term and long-term goals === Goal proximity affects the persistence and [[Intrinsic and extrinsic motivation|intrinsic motivation]] of both short- and long-term goals. It has been shown that there is no significant difference in performance among individual’s{{gr}} with short-term, long-term or a combination of both types of goals. However, it has been shown that both short- and long- term goals are essential in maintaining high levels of motivation over time (Weinberg et al., 1985). Short-term goals are important as they can provide feedback regarding progress towards long-term goals, provide immediate focus, and repeated commitment-boosting reinforcement once they are attained. Since long-term goals do not immediately provide these effects, setting short-term goals can assist in achieving long-term goals. Short-term goals also allow for the adjustment of future goals based on the attainment or distrainment{{huh}} or{{sp}} goals. Long term goals are important as they provide the direction and final destination for an individual. Long-term goals that follow the concepts of self-congruency provide intrinsic motivation, and as previously discussed, intrinsic motivation leads to increased energy, persistence and attention (Vallerand et al., 1985). The relationship between short- and long-term goals can be compared to a staircase, the present level is the bottom of the stair case, the short-term goals are the steps and once those short-term goals have been achieved, the long-term goal at the top can be reached. === Feedback === [[File:Jimmy Carter jogging.jpg|thumb|252x252px|''Figure 4.'' Using feedback to adjust or disengage goals improves long-term performance. ]] [[Feedback]] is essential in goal setting to track performance and assists in the development of emotional importance. Firstly, both goals and feedback are required to maximise an individual’s performance and without feedback, tracking goals and adjusting them over time would be near impossible (Bandura & Cervone, 1983). The correlation between goals and feedback helps to create an emotionally engaging and meaningful condition. This is because goal attainment leads to emotional satisfaction and goal failure leads to emotional dissatisfaction, both of which can motivators for further progress (Bandura, 1991). Take an example of a child learning maths in school, they have received positive feedback regarding their results and their feelings of competence and self-achievement have increased. This will motivate them to continue to work towards new and more difficult goals. This is known as the discrepancy-creation process. A similar effect, known as the discrepancy-reduction process, occurs when negative feedback is received, where dissatisfaction and unease stimulate greater effort in the future. It is particularly important when setting goals to consider goal difficulty, specificity and congruency, as when these constructs are misaligned the benefits of feedback cannot be utilised and time spent striving for improved motivation or performance will be wasted. === Goal disengagement === Leading on from feedback, it is important to recognise when a goal becomes unattainable and should be adjusted or abandoned. Knowing when to stop or change a goal path is important to ensure motivation and performance is maintained overtime. The attainability of a goal may change over time for many reasons, some common examples include goal conflict, injury and hardship. Goals can also be unattainable due to an issue when originally structuring the goal, such as difficulty or lack of congruency. Goal disengagement, defined as the reduction of effort and goal commitment and is the opposite of goal adoption or goal setting (Wrosch et al., 2003). When individuals have an unattainable goal there are usually three ways in which they will direct their effort. One method is to maintain effort and commitment and the second is to give up effort and maintain commitment, both of which have potential for developing psychological or physiological stress. The third option, to give up both effort and commitment, is seen as the most beneficial situation as it opens up space for new, alternative and stronger goals to be set and strived for. This avoids burn out and promotes wellbeing, increasing the potential for success and decreasing the risk of harm. == Common issues when setting goals == {{expand}} === Lack of engagement === Ensuring goals are engaging is essential in goal setting because if an individual is not engaged, they are not motivated and their goals are less likely to be reached. As previously mentioned, goals work best when they are set by the individual, are attainable yet challenging and give reward over time (through feedback). If these aspects are not achieved the individual may loose interest and the goal may be ignored. In addition, research by Wood, Mento & Locke (1987) showed that typical goal setting procedures work best when tasks are uninteresting and require a straightforward procedure by generating motivation that the task itself does not. An opposing argument by Bandura & Wood (1989) explained that highly structured methods of goal setting do not work as well for goals that involve problem solving or require creativity. These activities respond well to mastery goals rather than performance goals, as the nature of the tasks stimulates the generation of effort, attention and planning on their own. For example, an individual may aim to mastery the art of learning to paint, provided this goal is self-congruent, challenging and allows for change and measurement over time, it has the potential to be a strong goal. To ensure that goal setting is engaging, it is important to consider the type of goal someone is trying to achieve in conjunction with the methods and structures that are used in the goal setting process. === Goal conflict === Goal conflict is the degree to which individuals feel that their multiple goals are incompatible (Locke et. al., 1994) and can impact goal setting in three primary ways. These include when externally imposed goals conflict personal goals, when multiple goals are asked of a single task and when there are several outcomes with multiple goals (Slocum et al., 2002). Goal conflict is found to have an influence on performance through its relationship with goal commitment. Goal commitment, which is a person’s determination or attachment to a goal, is a leading factor in determining their strength to overcome challenges and to avoid abandoning or lowering a goal over time. This directly relates to the strength of one’s motivation. An example of goal conflict can be seen when a mother attends university, both striving to be successful parent and a successful student are difficult goals in their nature. By considering her intrinsic motivations, and monitoring potential goal conflict, the mother can plan and adjust her goals over time to ensure she is successful. If goals are set with consideration to goal structures and maintenance over time, motivation can be maintained and goal conflict can be avoided. == Goal setting strategies == [[File:SMART-goals.png|thumb|365x365px|''Figure 5.'' The SMART goal structure can be used to prompt individuals to consider goal setting constructs.]] {{expand}} === SMART goals === The [[wikipedia:SMART_criteria|SMART Goals]] framework is a practical way to use the concepts of difficulty, specificity and congruency. It is believed that the concept was originally developed by George Doran in 1981 and it works by separating the concepts of goal setting into five sections so that goals can be shaped with the best chance of success. By keeping in mind these mechanisms, goals can be developed to influence performance and these goals can be well aligned with the intended outcomes. The acronym SMART stands for Specific, Measurable, Attainable, Relevant and Timely. The SMART structure is most commonly used in project management, employee-performance management and personal development. Since this is a popular method in goal setting it is important to understand its benefits and flaws. ==== Benefits ==== By following the SMART framework individuals can set structured goals giving them a better chance of goal success. The SMART structure gives individuals guidance to set self-congruent goals, as goals that an individual sets themselves are more likely to be achieved compared to externally set goals. By following the structure individuals can ensure their goals include the key structures of goal setting such as specificity, measurability and difficulty (attainability). Furthermore, the SMART structure prompts the individual to ensure that their goals are relevant to what they are attempting to achieve and that there is a time restraint. For example, a young male setting a fitness goal to lift heavier weights should set a specific and measurable target, such as add five kilograms to each lift. By ensuring that the target is attainable they are more likely to experience the discrepancy-creation process which will motivate them to achieve future goals. By adding a time frame to this goal, for example three weeks, motivation increases and potential goal disengagement can be managed. The SMART structure is a great balance between providing guidance for goal setting but allowing individuals to tailor their goals. ==== Flaws ==== The SMART structure, while great for addressing constructs of typical goal setting,has issues as using the model can lead to goals that are too rigid or oversimplified. Firstly, the SMART structure does not work well for mastery goals, such as learning to paint or learn to surf, as these types of goals are loosely measured and do not follow a strict time schedule (Ames & Archer, 1988). If the SMART structure was followed for a mastery goal the individual may have increased anxiety and unrealistic levels of goal attainment leading to decreased motivation and early goal disengagement. Secondly, not all personality types respond well to structured goal setting. Research by Phillips and Gully (1997) highlighted that those with a focus on performance goal orientation will respond well to specific targets whereas those who prefer to learn holistically will respond better to mastery goals. Thus, those who respond well to targets should use the SMART structure to guide their goal setting and others should refer to the concept of mastery goals below to ensure they have the best chance at achieving their goal outcomes. In addition to this, the SMART structure could be improved by accounting for feedback over time and goal conflict. The underlying research behind SMART goals is hard to find as the concept has been predominantly developed through pop-psychology and is primarily published in management blogs. SMART goals make sense when tied to Locke and Latham's goal setting theory and SMART goals have been proven in certain contexts to be beneficial but it is important to recognise that the structure itself has not been developed or tested through a sound scientific realm. === Grow model === Like the SMART structure, the [[wikipedia:GROW_model|GROW model]] is an acronym designed to prompt the individual to account for multiple factors when setting goals to promote goal success. Often used for goal setting, problem solving and coaching, the GROW model channels intrinsic motivation and aims to improve performance by increasing knowledge and awareness. GROW stands for Goal, Reality Obstacles/Options and Way forward. The stages of the GROW model are outlined below in Table 2. ''Table 2:'' The stages of the GROW model and their application {| class="wikitable" !Stage !Application |- |Goal |This is the final stage that the individual is aiming for. A clear and well-defined goal should be outlined here. |- |Reality |This is the current stage that the individual is in. The issues, challenges and distance from the end goal should be identified here. |- |Obstacles Options |The challenges that the individual may face should be recognised so that they can be planned and accounted for. The ways in which obstacles can be tackled should be addressed to ensure the best chances of success. |- |Way Forward |Once the obstacles/options have been outlined, a plan to progress from reality, past obstacles to the end goal should be identified. |} The GROW model is a great structure to ensure progress can be achieved over time, and assists to identify an end goal as well as smaller challenges, that can be developed into short term goals, that may arise on the track to the long term goal. The GROW model however does not directly address the basic structures of goal setting such as congruency, specify and difficulty. For goal setting to be successful when using the GROW model these aspects should be used within each stage. === Open-ended structure === [[File:Playing with the kids DVIDS173572.jpg|thumb|''Figure 6.'' Setting mastery goals can help decrease pressure leading to more enjoyment. ]] Mastery goals focus on achieving a level of competence through self-improvement or skill development by encouraging the individual to strive for task-related improvement or mastery of a skill. Research by Seijts and Latham (2001) demonstrated that specific and difficult goals do not always lead to improved performance and simply urging people to try their best can result in a positive outcome. Compared to performance goals, mastery goals are not strictly measured, this can assist in decreasing pressure on the individual and opening up the potential for functional over-reaching, where the individual may surpass the level of achievement they were expecting (Poortvliet, 2016). Goals that are better suited to this open-ended structure are often creative goals and are dependent on situational motivation. For example, an athlete may aim to have more fun within their games or a musician may want to learn to play a new instrument. &nbsp;Mastery goals also aim to avoid the issue of tunnel vision, where focusing on reaching a goal suppresses the acquisition of the skills required to reach the goal, ultimately leading to goal failure. By removing the specific target, individuals have a better chance to learn and strive for achievement at their self-directed pace. It should be noted that both mastery and performance goals can be used together and that they can assist in achieving goals dependent on the situation and the individual. ==Conclusion== The best way to influence motivation and ensure goal success is to assess if the individual or situation is best suited to a performance or mastery goal and once that is known, the type of goal should be matched with a goal setting technique such as SMART goals, the GROW model or using an open-ended structure. It is important that the techniques used consider the basic structural components of goal setting; difficulty, specificity, measurability and congruency, in order to maintain or improve motivation over time. Once the goals have been set, it is important to ensure that both short-term and long-term goals are in synergy, and feedback is incorporated throughout the process. By highlighting the importance of goal disengagement and the effect that a lack of engagement and goal conflict can have, issues can be addressed promptly to minimise their negative influence on motivation and goal success. Whilst the research supporting goal setting theory is strong, improvements should be made in developing clear and useful literature so that the structural components of goal setting can be easily applied ensuring novice goal setters have an easy to follow structure. == Quiz questions == To to test your knowledge on goal setting attempt the quiz below. <quiz display="simple"> What are two common issues people come across when setting and striving for goals? |type="()"} - setting really fun goals - experiencing a challenge + having goal conflict and being disengaged - setting more than one goal at a time {What does the acronym SMART stand for? |type="()"} - Specific, Meaningful, Achievable, Real, Targeted + Specific, Measurable, Attainable, Relevant, Timely - Stable, Marvellous, Awesome, Realistic, Terrific - Sad, Mean, Angry, Rash, Terrible {True or False: To be successful, goal setting should consider different structural elements and utilise different frameworks depending on their circumstances.} + True - False </quiz> ==See also== *[[Motivation and emotion/Book/2014/Achievement goal orientation and academic motivation|Achievement goal orientation and academic motivation]] (Book chapter, 2014) *[[Motivation and emotion/Book/2014/Goal conflict and emotion|Goal conflict and emotion]] (Book chapter, 2014) *[[Motivation and emotion/Book/2013/Goal setting|Goal setting]] (Book chapter, 2013) *[[Motivation and emotion/Book/2011/Goal-setting and happiness|Goal setting and happiness]] (Book chapter, 2011) ==References== {{Hanging indent|1= Ames, C., & Archer, J. (1988). Achievement goals in the classroom: Students' learning strategies and motivation processes. Journal of educational psychology, 80(3), 260. Bandura, A. (1991). Self-regulation of motivation through anticipatory and self-reactive mechanisms. In Perspectives on motivation: Nebraska symposium on motivation (Vol. 38, pp. 69-164). Bandura, A., & Cervone, D. (1983). Self-evaluative and self-efficacy mechanisms governing the motivational effects of goal systems. Journal of personality and social psychology, 45(5), 1017.&nbsp; &nbsp; Bandura, A., & Wood, R. (1989). Effect of perceived controllability and performance standards on self-regulation of complex decision making. Journal of personality and social psychology, 56(5), 805. Doran, G. T. (1981). "There's a S.M.A.R.T. way to write management's goals and objectives". Management Review. AMA FORUM. 70(11): 35–36. Dweck, C. S., & Leggett, E. L. (1988). A social-cognitive approach to motivation and personality. Psychological Review, 95(2), 256.&nbsp; &nbsp; Klein, H. J., Whitener, E. M., & Ilgen, D. R. (1990). The role of goal specificity in the goal-setting process. Motivation and Emotion, 14(3), 179-193. Koestner, R., Lekes, N., Powers, T. A., & Chicoine, E. (2002). Attaining personal goals: self-concordance plus implementation intentions equals success. Journal of personality and social psychology, 83(1), 231. Locke, E. A., & Latham, G. P. (1990). A theory of goal setting & task performance. Prentice-Hall, Inc. Locke, E. A., & Latham, G. P. (2002). Building a practically useful theory of goal setting and task motivation: A 35-year odyssey. American psychologist, 57(9), 705. Latham, G. P., & Locke, E. A. (2006). Enhancing the benefits and overcoming the pitfalls of goal setting. Organizational dynamics, 35(4), 332-340. Locke, E. A., Smith, K. G., Erez, M., Chah, D. O., & Schaffer, A. (1994). The effects of intra-individual goal conflict on performance. Journal of Management, 20(1), 67-91. Phillips, J. M., & Gully, S. M. (1997). Role of goal orientation, ability, need for achievement, and locus of control in the self-efficacy and goal--setting process. Journal of applied psychology, 82(5), 792. Poortvliet, P. M. (2016). Mastery Goals. Encyclopedia of Personality and Individual Differences, 1-4.&nbsp; &nbsp; Prochaska, J. O., & DiClemente, C. C. (2005). The transtheoretical approach. Handbook of psychotherapy integration, 2, 147-171. Roberts, G. C. (2001). Advances in motivation in sport and exercise. Human Kinetics.&nbsp; &nbsp; Schut, H. A., & Stam, H. J. (1994). Goals in rehabilitation teamwork. Disability and rehabilitation, 16(4), 223-226. Seijts, G. H., & Latham, G. P. (2001). The effect of distal learning, outcome, and proximal goals on a moderately complex task. Journal of Organizational Behavior: The International Journal of Industrial, Occupational and Organizational Psychology and Behavior, 22(3), 291-307. Sheldon, K. M., & Elliot, A. J. (1999). Goal striving, need satisfaction, and longitudinal well-being: the self-concordance model. Journal of personality and social psychology, 76(3), 482. Slocum Jr, J. W., Cron, W. L., & Brown, S. P. (2002). The effect of goal conflict on performance. Journal of Leadership & Organizational Studies, 9(1), 77-89. Vallerand, R. J., Deci, E. L., & Ryan, R. M. (1985). Intrinsic motivation in sport. in K.B Pandolf (Ed.), Exercise and sport science reviews (Vol. 15, pp. 389-425). New York: Macmillan. Weinberg, R., Bruya, L., & Jackson, A. (1985). The effects of goal proximity and goal specificity on endurance performance. Journal of Sport Psychology, 7(3), 296-305. Wrosch, C., Scheier, M. F., Carver, C. S., & Schulz, R. (2003). The importance of goal disengagement in adaptive self-regulation: When giving up is beneficial. Self and Identity, 2(1), 1-20. Wood, R. E., Mento, A. J., & Locke, E. A. (1987). Task complexity as a moderator of goal effects: A meta-analysis. Journal of applied psychology, 72(3), 416. }} ==External links== * Ted Talk: John Dooer's [https://www.ted.com/talks/john_doerr_why_the_secret_to_success_is_setting_the_right_goals Why the secret to success is setting the right goals] (ted.com) *Key Article: Locke and Latham's [http://journals.sagepub.com/doi/pdf/10.1111/j.1467-8721.2006.00449.x New Directions in Goal Setting] (journals.sagepub.com) *YouTube: DescisionSkills' [https://www.youtube.com/watch?v=1-SvuFIQjK8 SMART Goals - quick overview] (youtube.com) *Suggested extra Ted Talk: Dan Pink [https://www.youtube.com/watch?v=rrkrvAUbU9Y the puzzle of motivation] (ted.com) [[Category:{{#titleparts:{{PAGENAME}}|3}}]] [[Category:Motivation and emotion/Book/Goal setting]] cmmo6sbuw3tlowtqs8tte3qdmlq6awu 0 239095 2419360 2405689 2022-08-26T07:24:16Z Jtneill 10242 + categories wikitext text/x-wiki {{title|Anterior cingulate cortex and emotion:<br>What is the role of the anterior cingulate cortex in emotion?}} {{MECR3|1=https://www.youtube.com/watch?v=3F4HS6Eo5q8&feature=youtu.be}} __TOC__ ==Overview== {{robelbox|theme=6|title=Example case study}} <div style="{{Robelbox/pad}}"> Barry is a 34-year-old male who sustained extensive damage in the anterior cingulate cortex during a car accident. Prior to the car accident, Barry was attentive, empathetic and expressed his emotions openly. After his accident, Barry shows emotional flatness and reduced goal orientation. This emotional flatness is evident when Fabian, an old work colleague, visits Barry in hospital. Upon asking Barry of his plans after recovery, Fabian notices Barry's attention wanders and his verbal responses lack direction. Fabian expresses some concern to Barry, however, Barry fails to detect any emotional problems. </div> {{Robelbox/close}} We detect changes in ourselves and others every day. These changes, or errors, are identified as something that is different than the usual or expected. Physically, a loose stepping stone or a change in temperature are considered errors. Emotionally, errors are detected through [[Feeling|feelings]] or social situations when a reaction is different to expected. We use error feedback to adjust, and behave in ways that are meaningful and adaptive. The [[wikipedia:Anterior_cingulate_cortex|anterior cingulate cortex]] (ACC) is crucial in modulating and mediating errors to facilitate our reward-based learning mechanisms (Stevens, Hurley, & Taber, 2011). <br> <br> {| cellpadding="10" cellspacing="5" style="top: center; width: 70%; background-color: LightSkyBlue; margin-left: auto; margin-right: auto" | style="width: 40%; background-color: AliceBlue; border: 1px solid #777777; vertical-align: top; -moz-border-radius-topleft: 10px; -moz-border-radius-bottomleft: 10px; -moz-border-radius-topright: 10px; -moz-border-radius-bottomright: 10px; height: 10px;" |{{center top}} '''“It is how we behave when we receive feedback, that determines who we are as a person”''' - Manuel Saint-Victor (M.D) {{center bottom}} |} <br> {{RoundBoxTop}} '''Focus Questions''' # What is the anterior cingulate cortex? # What is the role of the anterior cingulate cortex in emotion? # How does the anterior cingulate cortex function to improve our lives? {{RoundBoxBottom}} ==The anterior cingulate cortex== [[File:Anterior cingulate gyrus animation.gif|right|200px|thumb|''Figure 1''. The anterior cingulate cortex of left hemisphere highlighted in red.]] The ACC is the brain's frontal cingulate cortex division consisting of [[wikipedia:Cytoarchitecture|cytoarchitecture]] Brodmann areas 24, 32, & 33 (Allman, Hakeen, Erwin, Nimchinsky, & Hof, 2006). Located within the medial wall of each cerebral hemisphere (see Figure 1), the ACCs adjacent and superior to the [[wikipedia:Corpus_callosum|corpus callosum]] (Stevens et al., 2011). The function of the ACC is primarily linked to visceromotor, endocrine, skeletal-motor, and higher cognitive controls such as reward-anticipation, morality, and [[emotion]] (Palomero-Gallagher, Vogt, Schleicher, Mayberg, & Zilles, 2008; Stevens et al., 2011). ===Neuroanatomy and physiology=== The complex anatomy of the ACC is divided into two major areas: dorsal-posterior and ventral-anterior. The dorsal-posterior position is referred to as the caudal or dorsal ACC (Stevens et al., 2011), or if using Vogt's conventional system, the middle cingulate cortex (MCC) (Palomero-Gallagher et al., 2008). The ventral-anterior position is referred to as the rostral or ventral ACC (Stevens et al., 2011), or if using Vogt’s, the ACC (Palomero-Gallagher et al., 2008). The two major areas of the ACC are further subdivided. The caudal or dorsal ACC (or MCC) is divided into posterior and anterior regions, and the rostral or ventral ACC (or ACC) is divided into the pregenual and subgenual regions (Stevens et al., 2011). ==== The Stroop task ==== The ACC is divided between [[cognition]] and emotion (Allman et al., 2006). The dorsal ACC (or MCC) has associations with cognition, and the ventral ACC has associations with emotion (Allman et al., 2006). This segregation can be confirmed using different versions of the [[wikipedia:Stroop_effect|Stroop effect]] task. The Stroop task measures delays in subject responses when presented with confounding or conflicting information (Macleod, 1991). In the counting (cognitive) Stroop task, words are presented multiple times as numbers and the participant reports the number of words (Song et al., 2017). In the emotional Stroop task, the participant is given a mix of emotional and neutral words and reports the colour of the word (Song et al., 2017). Activation of the dorsal ACC correlates with the counting Stroop, and activation of the ventral ACC correlates with the emotional Stroop (Allman et al., 2006; Song et al., 2017). ====Spindle neurons==== [[File:Spindle-cell.png|right|200px|thumb|''Figure 2''. Drawing of a normal pyramidal cell (left) and Spindle-cell (right)]] Von Economo neurons (VENs), or [[wikipedia:Spindle_neuron|spindle neurons]] (see Figure 2), are projection-neurons found abundantly in layer-V of the human ACC and insular cortex (Allman et al., 2006; Allman et al., 2011; Stevens et al., 2011). Activation contributes to coordination, problem-solving, and emotional self-control (Allman et al., 2006; Allman et al., 2011). At birth, VENs cannot be discerned. At approximately four months old, VENs develop widespread connections throughout the ACC and [[wikipedia:Insular_cortex|insular cortex]] in the human brain (Allman et al., 2006; Allman et al., 2011). VENs may be a recent evolutionary specialisation as they are responsible for intuitive awareness and perceptual recognition in animals with increased brain size and complex social cognition (Allman et al., 2006; Allman et al., 2011). This theory is supported by varying distributions of VEN density among species, allowing for rapid relay of socially relevant information over long distances in the brain (Allman et al., 2006; Nimchinsky et al., 1999). [[wikipedia:Phylogenetics|Phylogenetics]] can identify a difference in biochemical specificity within VEN (Stimpson et al., 2011). A study by Stimpson et al. (2011) used phylogenetic staining to show the difference in biochemical specificity within VENs. Stimpson et al. state the difference in ACC protein expression of VENs suggests humans evolved biochemical specialisations for interoceptive (gut-based emotion) sensitivity. ==The role of the anterior cingulate cortex in emotion== {{robelbox|theme=6|title=Example Scenario 1}} <div style="{{Robelbox/pad}}"> Imagine you're a university student and notice a flyer offering $50 for participation in a psychological study. You feel uneasy but need the money and attend the experiment. Prior to commencement, you're connected to brain measuring equipment that makes you even more uncomfortable. The experimenter asks if you’d like to proceed so you take a moment to think. You convince yourself it's safe and suppress your fears. The experiment is completed and you receive the reward of $50. Feeling good about the outcome, you leave feeling relieved and consider participating in future experiments. </div> {{Robelbox/close}} [[File:Tutorial emotions.png|right|300px|thumb|''Figure 3''. Emotions connected via cognition]] [[Emotion]] is a complex, subjective, and expressive experience categorised by physiological reactions and mental states of mind (Pessoa, 2008). Although no consensus has been reached in scientific literature, brain regions responsible for both emotion and cognitive control are suggested to share the neural circuitry responsible for conflict resolution between cognition and emotion (Pessoa, 2008; Song et al., 2017). Areas with higher degrees of connectivity such as the ACC have a role in integrating the cognitive neuronal circuitry for affect regulation (see Figure 3) (Pessoa, 2008; Stevens et al., 2011) <br> ===Activation by emotion=== The ACC may be thought of as an interface between cognition and emotion (Allman et al., 2006). Each anatomical division may perform unique roles (see Table 1), however, there is also overlap between divisions allowing for the complexity of the ACC to integrate cognition and emotions with other cortical areas (Stevens et al., 2011). <br> Table 1<br> ''Divisions of ACC activated by emotion'' {| class="wikitable" |- !Division of ACC !Activates in response to !Part of division !Other commonly used acronyms |+ |anterior Middle Cingulate Cortex (aMCC) |Emotional appraisals, cognitive control, conflict monitoring, and error detection |Caudal or dorsal ACC or MCC |acACC or adACC |+ |posterior Middle Cingulate Cortex (pMCC) |Action selection, fear associated with faces, and learned fear |Caudal or dorsal ACC or MCC |pcACC or pdACC |+ |pregenual Anterior Cingulate Cortex (pgACC) |Affective processing, emotion regulation, and simple emotions |Rostral or ventral ACC |pACC |+ |subgenual Anterior Cingulate Cortex (sgACC) |Emotional reward value, emotional conflict evaluation, and simple emotions |Rostral or ventral ACC |sACC |} ==== Anterior and posterior caudal/dorsal ACC (or MCC) ==== The MCC activates predominantly to cognitive evaluations and emotional conflict (Pessoa, 2008; Stevens et al., 2011). A study by Vogt, Berger, and Derbyshire (2003) monitored the regulation of 45 total emotions. Within the anterior middle cingulate cortex (aMCC), Vogt found six locations activated in response to fearful faces. Additionally, meta-analyses show the aMCC is responsive to associations of [[wikipedia:Fear|fear]] (Phan, Wager, Taylor, & Liberzon, 2002). As aMCC activation corresponds to non-habitual responses in threatening situations, Shackman et al. (2011) proposed an adaptive model based on cognitive control theories. According to the adaptive control hypothesis, [[pain]] and negative affect engages a cognitive bias during uncertainty to derive an optimal solution similar to [[reinforcement learning]] (Shackman et al., 2011). Overall, the aMCC activates in response to: emotional appraisals, cognitive control, conflict monitoring, and error detection (Stevens et al., 2011). Studies of the posterior middle cingulate cortex (pMCC) show greater involvement with motor system processing when compared with the aMCC (Palomero-Gallagher, 2008). Further evidence segregating the subdivisions using receptor analysis indicates the pMCC is denser with gamma-aminobutyric acid ([[wikipedia:GABAB_receptor|GABA)]] inhibitory receptors type-B that are synonymous with motor regions (Vogt et al., 2003). There is, however, no consistent involvement with the pMCC and simple emotions. A study by Vogt et al. (2003) found only one of the ten activations in response to fearful faces was linked with the pMCC. Additionally, Vogt et al. identified two activation sites for [[wikipedia:Anger|anger]] evoked diffusion within the pMCC. The association with motor processing and the marginal connectivity to fearful stimuli suggests the pMCCs role in mediating action response expressions to fear (Etkin, Egner, & Kalish, 2011; Stevens et al., 2011). Overall, the pMCC activates in response to: action selection, fear associated with faces, and learned fear (Stevens et al., 2011). ==== Pregenual and subgenual regions of the ACC ==== The ventral ACC activates predominantly to affective processing (Pessoa, 2008; Stevens et al., 2011). Imaging studies show that the pregenual ACC (pgACC) is widely connected to areas that evaluate internal/external stimuli (Yu et al., 2011). If the stimuli’s evaluated as motivational, the pgACC contributes to evoking an emotional reaction (Etkin et al., 2011; Stevens et al., 2011). A study by Beauregard, Levesque, and Bourgouin (2001) observed pgACC activity in participants actively inhibiting emotions in response to erotic stimuli. The limbic areas that typically respond were suppressed, indicating the pgACC contributes to top-down emotional regulation (Beauregard, Levesque, & Bourgouin, 2001). Projections from thalamic nuclei to the pgACC have been identified that contribute to pain related affect (Vogt et al., 2005), however, fewer are received when compared with the aMCC (Stevens et al., 2011). In the simple emotions study performed by Vogt et al. (2003), ten pgACC sites were activated in response to [[happiness]] in addition to low levels of ventral activity in response to sadness. When the results were localised, pain, happiness, fear, and sadness were independent of one another (Vogt et al., 2003). Overall, the pgACC activates in response to: affective processing, emotion regulation, and simple emotions. Imaging studies show an anti-correlation between the pgACC and subgenual ACC (sgACC) (Stevens et al., 2011; Yu et al., 2011). The sgACC is sparsely connected to areas involving affective processing, however, there are reciprocal connections with the [[wikipedia:Limbic_system|limbic system]] and autonomic centres (Etkins et al., 2011; Yu et al., 2011). Assessment and evaluation is shown to activate the sgACC during choices based on reward value (Stevens et al., 2011). When reward-based options are encountered, activation correlates with reward-based motivational, cognitive, and contextual variables (Stevens et al., 2011). Activation of the sgACC is also correlated with inhibition of fear, and emotional conflict-regulation (Etkin et al., 2011). A study by Etkin, Egner, Peraza, Kandel & Hirsch (2006) showed participants made delayed responses when presented with incongruent word labels and facial expressions. The sgACC was activated during the emotional conflict distinguishing itself in times of conflict regulation (Etkin et al., 2006). Like the pgACC, the sgACC contributes to simple emotions (Allman et al., 2006; Stevens et al., 2011; Vogt et al., 2003). The sgACC activates more sites in response to sadness than does the pgACC (Stevens et al., 2011). The contrary is true for happiness, such that the sgACC activates less (Stevens et al., 2011). In studies using [[wikipedia:Positron_emission_tomography|positron-emission tomography]], the sgACC is activated when subjects imagined situations relating to either anger or sadness (Allman et al., 2006). Overall, the sgACC activates in response to: emotional reward value, emotional conflict evaluation, and simple emotions. ==How the anterior cingulate cortex functions to improve our emotional lives== {{robelbox|theme=6|title=Example Scenario 2}} <div style="{{Robelbox/pad}}"> Imagine you are in a team-based hiking exercise with some strangers. You’re feeling motivated and decide to take some of the team’s heavier gear, but carrying the gear becomes strenuous after a couple of hours. Although you keep the pace, you become distracted as you feel your heart beat and breathing rate change. One of your team-mates senses this change and offers support. </div> {{Robelbox/close}} Our emotions are on a constant continuum mediated and modulated by regions of the brain such as the ACC (Murphy, Brewer, Catmur, & Bird, 2017). To function effectively and to improve our emotional behaviours, the ACC performs an integral role regulating internal states available to awareness such as ones own heart rhythm (Ernst et al., 2013). By understanding the internal states of ourselves and others through experimental and clinical literature we can appreciate how the ACC functions to improve our emotional lives. === Theory of mind: interoception === [[File:Interoception and the body.png|right|200px|thumb|''Figure 4''. Interoception and the body.]] Having a [[wikipedia:Theory_of_mind|theory of mind]] is referred to as having an understanding in another’s beliefs, intentions, and feelings achieved through exteroceptive, proprioceptive, and interoceptive signals (Ondobaka, Kilner, & Friston, 2017). The processing of internal visceral and automatic information (see Figure 4) informs an individual of intentions and beliefs that guide behaviour (Ondobaka et al., 2017). By becoming more self aware of our own bodily states and others, we are able to make critical top-down decisions to become more adaptive as both individuals and group members (Thom et al., 2014). ==== Interoception ==== [[wikipedia:Interoception|Interoception]] is the subjective awareness of the body's internal physiological states such as heart rate, temperature and hunger (Murphy et al., 2017; Thom et al., 2004). Interoception is a foundation for self-awareness and socio-affective abilities involving emotion and a contributor to higher order social cognition (Murphy et al., 2017). Although research is still unclear, emotional experiences are both mediated and modulated by interoceptive awareness (Ernst, et al., 2013). Along with the insular cortex and somatosensory afferent transmission, the ACC is credited to be a primary component for interoceptive awareness (Ernst, et al., 2013; Khalsa, Rudrauf, Feinstein, & Tranel, 2009; Murphy et al., 2017). Accurately perceiving internal states is important for general health, and atypical interoceptive sensitivity is found to be associated with physical health disorders such as diabetes and obesity (Werner, Jung, Duschek, & Schandry, 2009). A model proposed by Quattrocki and Friston (2014) suggests a failure of interoceptive sensitivity prevents contextualisation of internal and external emotional signals resulting in an impoverished sense of self and social difficulties. ==== Adventure racers and the interoceptive model ==== [[File:Katora-dani Mount Kongo(Kongosanchi)1.jpg|right|200px|thumb|''Figure 5''. Hiking as a team successfully requires the use of interoception.]] For safety and performance reasons, it is important to be aware of one's physiological state and others emotions during activities such as hiking (see Figure 5). Individuals who respond well to high-degree [[wikipedia:Stressor|stressors]] are theorised to have an improved and well-contextualised interoceptive sense (Paulus et al., 2009). High stressors impair cognitive function, alter emotional regulation, and result in interpersonal challenges (Paulus et al., 2009; Richardson, 2017). Although high levels of stress can be detrimental, individuals are able to recover, adapt to, and even thrive under these conditions (Southwick, Vythilingam, & Charney, 2005). A study by Thom et al. (2014) used [[Functional Magnetic Resonance Imaging|functional magnetic resonance imaging]] to examine changes of adventure racers in brain regions contributing to emotional processing and social awareness such as the insular, amygdala, and ACC. Thom et al. found greater activation in the right insular and the dorsal ACC when compared to control groups, and suggested adventure racers utilise these regions to process emotions in others more effectively possibly-being advantageous under stressful team-based conditions. Results by Thom et al. provide context to the modulation of neural circuitry that contributes to optimal performance under stressful conditions, and also supports the MCCs role in emotional appraisal (Stevens et al., 2011). ==== Atypical interoception ==== Atypical interoception contributes to risky behaviours, psychopathy, and affective disorders with modified insular and ACC functions (Ernst et al, 2013). [[wikipedia:Alexithymia|Alexithymia]] is a condition involving difficulties identifying and describing emotions characterised by atypical interoceptive sensitivity, maladaptive coping mechanisms, and neuroticism (Ernst et al., 2013; Murphy et al., 2017). Ernst et al. (2013) examined the involvement of the insular and the ACC with alexithymics by investigating their relationships with the excitatory neurotransmitter [[wikipedia:Glutamic_acid|glutamate]], and the inhibitory neurotransmitter GABA. Using proton magnetic resonance spectroscopy, high insular levels of glutamate, and high ventral ACC levels of GABA were detected in alexithymics (Ernst et al., 2013). Ernst et al. suggests increases of dorsal ACC activity may represent emotional suppression resulting from glutamate mediated insular activity. This leads to GABA mediated inhibition of the ventral ACC, displayed through emotional flatness (Ernst et al., 2013). === Improving negative emotions === [[File:Alaska Guardsmen teach drug awareness, coping strategies to cadets 141104-Z-CA180-043.jpg|right|200px|thumb|''Figure 6''. Alaska Guardsmen teach drug awareness and coping strategies to cadets.]] Negative emotions are associated with activation of the ACC which modulates behaviour (Stevens et al., 2011). Tikasz et al. (2016) showed hyper-activation of the ACC among violent men with schizophrenia in response to negative stimuli when compared with healthy control participants. To the contrary, disorders such as depression and post-traumatic stress disorder display below normal activation in the sgACC and aMCC (Stevens et al., 2011). A study by Ohmatsu et al. (2014) explored ACC modulation through pedal exercise. Using [[Electroencephalography|electroencephalograph]] measures, Ohmatsu et al. found decreases in negative emotion linked with the ACC and increases in positive emotion linked with the serotonin system. Exercise is not the only modulator of the ACC. coping mechanisms play a significant role in negative emotions (see Figure 6). A study by Perlman and Pelphrey (2010) found children faced with a challenging task possessing greater coping strategies had increased dorsal ACC activity. Temperamental children, however, had increased ventral ACC activity when challenged suggesting reduced cognition and higher reliance on emotions during difficulties (Perlman and Pelphrey, 2010). These findings indicate activation of the ACC varies on a continuum like basis and may be modulated through exercise and well-developed coping strategies. ==Conclusion== The ACC consists of specialised spindle shaped cells that provide the neural circuitry for complex cognitive and emotional functions{{example}}. Divided into two major divisions and four subdivisions, the ACC acts as an interface between cognition and emotion with other brain regions. The subdivisions of the ACC activate in response to emotional appraisals, emotional conflict evaluation, error detection, affect processing, reward value, and simple emotions{{example}. Emotional experiences are both mediated and modulated by interoceptive awareness{{example}}. Thus, accurately perceiving internal states is vital for making top-down decisions to become more adaptive as an individual or a team member. Negative emotions, while unpleasant, are regulated by the ACC and may be reduced through exercise and effective coping strategies. {{RoundBoxTop|theme=2}} '''The take-home message: '''By identifying how you respond to unexpected changes, you can influence your emotional reactions to adapt to your environment. {{RoundBoxBottom}} ==Quiz questions== Test your knowledge of this topic by answering multiple choice questions. Choose the correct answer and click "Submit": <nowiki/><quiz display="simple"> {Which region of the anterior cingulate cortex is associated with cognition more than emotion? |type="()"} - Rostral - Inferior + Dorsal - Ventral - Posterior </quiz><quiz display="simple"> {Which of the following roles does the anterior cingulate cortex have in emotion? |type="()"} - Responsible for the perception of emotions + Integrates neural circuitry for affect regulation - Decision making in response to emotions - Synthesis of neurotransmitters responsible for activating emotion - Consists of spindle neurons (present in all great apes) that transmit solely negative emotions. </quiz><quiz display="simple"> {How does the anterior cingulate cortex function to improve our emotional lives? |type="()"} - Allows us to forget emotionally charged events - Provides us with the ability to exert cognitive control over decision making - Responsible for arousal, alertness, and awakening the brain in response to sensory information + Plays an important role in emotional awareness - Evaluates the unlearned emotional value of internal body states </quiz> ==See also== *[[wikipedia:Alexithymia|Alexithymia]] (Wikipedia) *[[w:Anterior cingulate cortex|Anterior cingulate cortex]] (Wikipedia) * [[w:Emotion|Emotion]] (Wikipedia) *[[Motivation and emotion/Book/2018/Emotion suppression|Emotion suppression]] (Book chapter, 2018) *[[wikipedia:Insular_cortex|Insular cortex]] (Wikipedia) *[[Motivation and emotion/Book/2018/Insular cortex and emotion|Insular cortex and emotion]] (Book chapter, 2018) *[[wikipedia:Spindle_neuron|Spindle neuron]] (Wikipedia) *[[Motivation and emotion/Book/2011/Stress and emotional health|Stress and emotional health]] (Book chapter, 2011) ==References.== {{Hanging indent|1 = Allman, J. M., Hakeem, A., Erwin, J. M., Nimchinsky, E., & Hof, P. (2006). The anterior cingulate cortex: The evolution of an interface between emotion and cognition. ''Annals New York Academy of Sciences'', ''935''. 107-117. https://doi.org/10.1111/j.1749-6632.2001.tb03476.x Allman, J. M., Tetreault, N. A., Hakeem, A. Y., Manaye, K. F., Semendeferi, K., Erwin, J. M., … Hof, P. R. (2011). The von Economo neurons in fronto-insular and anterior cingulate cortex. ''Annals of the New York Academy of Sciences'', ''1225'', 59-71. https://doi.org/10.1111/j.1749-6632.2011.06011.x Beauregard, M., Levesque, J., & Bourgouin, P. (2001). Neural correlates of conscious self-regulation of emotion. ''The Journal of Neuroscience'', ''21'', 6993-7000. Ernst, J., Boker, H., Hattenschwiler, J., Schupbach, D., Northoff, G., Seifritz, E., & Grimm, S. (2013). The association of interoceptive awareness and alexithymia with neurotransmitter concentrations in insula and anterior cingulate. ''Social Cognitive and Affective Neuroscience'', ''9''(6), 1-7. https://doi.org/10.1093/scan/nst058 Etkin, A., Egner, T., & Kalisch, R. (2011). Emotional processing in anterior cingulate and medial prefrontal cortex. ''Trends in Cognitive Sciences'', ''15'', 85-93. https://doi.org/10.1016/j.tics.2010.11.004 Etkin, A., Egner, T., Peraza, D. M., Kandel, E. R., & Hirsch, J. (2006). Resolving emotional conflict: a role for the rostral anterior cingulate cortex in modulating activity in the amygdala. ''Neuron'', ''51'', 871-882. https://doi.org/10.1016/j.neuron.2006.07.029 Khalsa, S. S., Rudrauf, D., Feinstein, J. S., & Tranel, D. (2009). The pathways of interoceptive awareness. ''Nature Neuroscience'', ''12'', 1494-1496. https://doi.org/10.1038/nn.2411 MacLeod, C. M. (1991). Half a century of research on the Stroop effect: an integrative review. ''Psychological bulletin'', ''109'', 163-203. https://doi.org/10.1037/0033-2909.109.2.163 Murphy, J., Brewer, R., Catmur, C., & Bird, G. (2017). Interoception and psychopathology: A developmental neuroscience perspective. ''Development of Cognitive Neuroscience'', ''23'', 45-56. https://doi.org/10.1016/j.dcn.2016.12.006 Nimchinsky, E. A., Gillissen, E., Allman, J. M., Perl, D. P., Erwin, J. M., & Hof, P. R. (1999). A neuronal morphologic type unique to humans and great apes. ''Proceedings of the National Academy of Sciences of the United States of America'', ''96'', 5268-5273. Ohmatsu, S., Nakano, H., Tominaga, T., Terakawa, Y., Murata, T., & Morioka, S. (2014). Activation of the serotonergic system by pedaling exercise changes anterior cingulate cortex activity and improves negative emotion. ''Behavioural Brain Research'', ''270'', 112-117. https://doi.org/10.1016/j.bbr.2014.04.017 Ondobaka, S., Kilner, J., & Friston, K. (2017). The role of interoceptive inference in theory of mind. ''Brain Cognition'', ''112'', 64-68. https://doi.org/10.1016/j.bandc.2015.08.002 Paulus, M. P., Potterat, E. G., Taylor, M. K., Van Orden, K. F., Bauman, J., Momen, N. … Swain, J. L. (2009). A neuroscience approach to optimizing brain resources for human performance in extreme environments. ''Neuroscience and Biobehavioral Reviews'', ''33'', 1080-1088. https://doi.org/10.1016/j.neubiorev.2009.05.003 Perlman, S. B., & Pelphrey, K. A. (2010). Regulatory Brain Development: Balancing Emotion and Cognition. ''Social Neuroscience'', ''5'', 533-542. https://doi.org/10.1080/17470911003683219 Pessoa, L. (2008). On the relationship between emotion and cognition. ''Nature Reviews Neuroscience'', ''9'', 148-158. https://doi.org/10.1038/nrn2317 Phan, K. L., Wager, T. Taylor, S. F., & Liberzon, I. (2002). Functional neuroanatomy of emotion: A meta-analysis of emotion activation studies in PET and fMRI. ''Neuroimage'', ''16'', 331-348. https://doi.org/10.1006/nimg.2002.1087 Quattrocki, E., & Friston, K. (2014). Autism: oxytocin and interoception. ''Neuroscience and Biobehavioural Reviews'', ''47'', 410-430. https://doi.org/10.1016/j.neubiorev.2014.09.012 Richardson, C. M. E. (2017). Emotion regulation in the context of daily stress: Impact on daily affect. ''Personality and Individual Differences'', ''112'', 150-156. https://doi.org/10.1016/j.paid.2017.02.058 Shackman, A. J., Salomons, T. V., Slagter, H. A., Fox, A. S., Winter, J. J., & Davidson, R. J. (2011). The integration of negative affect, pain and cognitive control in the cingulate cortex. ''Nature Reviews Neuroscience'', ''12'', 154-167. https://doi.org/10.1038/nrn2994 Song, S., Zilverstand, A., Song, H., Uquillas, F. D. O., Wang, Y., Xie, C., … Zou, Z. (2017). The influence of emotional interference on cognitive control: A meta-analysis of neuroimaging studies using the emotional Stroop task. ''Scientific Reports'', ''7''(2088), 1-9. https://doi.org/10.1038/s41598-017-02266-2 Southwick, S. M., Vythilingam, M., & Charney, D. S. (2005). The psychobiology of depression and resilience to stress: Implications for prevention and treatment. ''Annual Review of Clinical Psychology'', ''1'', 255-91. https://doi.org/10.1146/annurev.clinpsy.1.102803.143948 Stevens, F. L., Hurley, R. A., & Taber, K. H. (2011). Anterior Cingulate Cortex: Unique Role in Cognition and Emotion. ''The Journal of Neuropsychiatry and Clinical Neurosciences'', ''23'', 121-125. https://doi.org/10.1176/jnp.23.2.jnp121 Stimpson, C. D., Tetreault, N. A., Allman, J. M., Jacobs, B., Butti, C., Hof, P. R., Sherwood, C. C. (2011). Biochemical specificity of von Economo neurons in hominoids. ''American Journal of Human Biology'', ''23'', 22-28. https://doi.org/10.1002/ajhb.21135 Thom, N. J., Johnson, D. C., Flagan, T., Simmons, A. N., Kotturi, S. A., Van Orden, K. F., Potterat, E. G., Swain, J. L., & Paulus, M. P. (2014). Detecting emotion in others: increased insula and decreased medial prefrontal cortex activation during emotion processing in elite adventure racers. ''Social Cognitive and Affective Neuroscience'', ''9'', 225-231. https://doi.org/10.1093/scan/nss127 Tikasz, A., Potvin, S., Lungo, O., Joyal, C. C., Hodgins, S., Mendrek, A., & Dumais, A. (2016). Anterior cingulate hyperactivations during negative emotion processing among men with schizophrenia and a history of violent behavior. ''Neuropsychiatric Disease and Treatment'', ''15'', 1397-410. https://doi.org/10.2147/NDT.S107545 Vogt, B. A., Berger, G. R., & Derbyshire, S. W. G. (2003). Structural and Functional Dichotomy of Human Midcingulate Cortex. ''European Journal of Neuroscience'', ''18'', 3134-3144. https://doi.org/10.1038/nrn1704 Werner, N. S., Jung, K., Duschek, S., & Schandry, R. (2009). Enhanced cardiac perception is associated with benefits in decision-making. ''Psychophysiology'', ''46'', 1123-1129. https://doi.org/10.1111/j.1469-8986.2009.00855.x Yu, C., Zhou, Y., Liu, Y., Jiang, T., Dong, H., Zhang, Y., Walter, M. (2011). Functional segregation of the human cingulate cortex is confirmed by functional connectivity based neuroanatomical parcellation. ''NeuroImage'', ''54'', 2571-2581. https://doi.org/10.1016/j.neuroimage.2010.11.018 }} ==External links== * [https://www.youtube.com/watch?v=KsSv1KzdiWU How our brains feel emotion] (big think video) * [https://www.youtube.com/watch?v=_ahYaCGVr00 Manual Saint-Victor M.D. explains what the anterior cingulate cortex is] (youtube video) * [https://faculty.washington.edu/chudler/java/ready.html Stroop task: take it here!] (external site) [[Category:{{#titleparts:{{PAGENAME}}|3}}]] [[Category:Motivation and emotion/Book/Cortex]] [[Category:Motivation and emotion/Book/Emotion]] 8zn8z6yjexgkaop7egy6xz1by7fufnt 0 247473 2419076 2371360 2022-08-25T17:40:15Z 98.46.7.66 /* Lesson Summary */ Original text stated a "delay" attribute, but this doesn't exist. While there are more attributes than "async" and "defer", I assume the intention was to write "defer" here. wikitext text/x-wiki <noinclude>{{{{NAMESPACE}}:{{BASEPAGENAME}}/Sidebar}}</noinclude> This lesson introduces the JavaScript programming language and environments. __TOC__ == Objectives and Skills == Objectives and skills for this lesson include:<ref>[https://www.microsoft.com/en-us/learning/exam-98-382.aspx Microsoft: Exam 98-382 Introduction to Programming Using JavaScript]</ref> * Apply JavaScript best practices ** Comments; indentations; naming conventions; noscript; constants; reserved keywords; debugger keyword; setting breakpoints; console.log * Evaluate the use of inline and external scripts ** When to use, how to use, and what happens when both are used == Readings == # [[Wikibooks: JavaScript/Introduction]] # [[Wikibooks: JavaScript/First program]] # [[Wikibooks: JavaScript/Placing the code]] == Multimedia == # [https://www.youtube.com/watch?v=xpZLS6R91rQ YouTube: JavaScript Tutorial for Beginners - 01 - Introduction] # [https://www.youtube.com/watch?v=tkw8QXIcmU4 YouTube: JavaScript Tutorial for Beginners - 02 - Statements] # [https://www.youtube.com/watch?v=r--dRuIiV7A YouTube: JavaScript Tutorial for Beginners - 05 - Using an external file] # [https://www.youtube.com/watch?v=efN50MBOSvc YouTube: JavaScript - Output] # [https://www.youtube.com/watch?v=yUyJ1gcaraM YouTube: Beginner JavaScript Tutorial - 2 - Comments and Statements] # [https://www.youtube.com/watch?v=q9jAFZjPFHo YouTube: JavaScript - How to use the console in a browser] # [https://www.youtube.com/watch?v=CCZ2pHpJe2U YouTube: noscript Tag - JavaScript Programming] # [https://www.youtube.com/watch?v=fP2IUZXF0sk YouTube: Using Alert & Console.log in JavaScript] # [https://www.youtube.com/watch?v=HzWf-EeE3uI YouTube: Clean Code: Formatting and Comments] # [https://www.youtube.com/watch?v=SFZXXUY_MHg YouTube: Javascript The innerHTML property] #[https://youtu.be/cCrfL84DkEk YouTube: The difference between Script, Script Async and Script Defer] == Examples == * [https://www.w3schools.com/js/js_intro.asp W3Schools: JavaScript Introduction] * [https://www.w3schools.com/js/js_comments.asp W3Schools: JavaScript Comments] * [https://www.w3schools.com/js/js_output.asp W3Schools: JavaScript Output] * [https://www.w3schools.com/js/js_whereto.asp W3Schools: JavaScript Where To] * [https://www.w3schools.com/tags/tag_noscript.asp W3Schools: HTML noscript tag] * [https://www.w3schools.com/jsref/tryit.asp?filename=tryjsref_node_textcontent_innerhtml_innertext W3Schools: Difference between innerText and innerHTML] *[https://www.w3schools.com/jsref/met_win_alert.asp W3Schools: Window Alert()] *[https://www.w3schools.com/jsref/met_doc_write.asp W3Schools: DOM write() Method] *[https://www.w3schools.com/jsref/met_document_getelementbyid.asp W3Schools: GetElementById()] * [[/Example Code/]] == Activities == # Create a web page that uses JavaScript to display <code>Hello <name>!</code>, where <code><name></code> is your name. Test JavaScript output in a variety of ways: #* Use <code>document.write()</code> #* Use <code>window.alert()</code> #* Use <code>document.getElementById().innerText</code> or <code>document.getElementById().innerHTML</code> #* Use <code>console.log()</code><br>&nbsp;&nbsp;&nbsp;&nbsp;Use your browser's built-in [[Wikipedia:Web development tools|web development tools]] to view console output. #**To open the console panel in Chrome press Ctrl+Shift+J (or Command+Option+J on Mac).<ref>[https://developers.google.com/web/tools/chrome-devtools Chrome DevTools]/</ref> #**To open the console panel in Firefox press Ctrl+Shift+J (or Command+Shift+J on a Mac).<ref>[https://developer.mozilla.org/en-US/docs/Tools/Browser_Console MDNː Browser Console]</ref> #**To open the console panel in Internet Explorer press F12 and then Ctrl+2.<ref>[https://msdn.microsoft.com/en-us/ie/dn322041(v=vs.94) MSDNː Using keyboard shortcuts]</ref> #**To open the console panel in Safari press Option-Command-I in the Develop Menu and click on the Console tab.<ref>[https://support.apple.com/guide/safari-developer/safari-developer-tools-overview-dev073038698/mac Safari Developer Helpː Developer Tools overview]</ref> # Using the Hello program above, test JavaScript code placement in a variety of ways: #* Use <code><script></code> in <code><head></code> for the <code>document.write()</code> #* Use <code><script></code> in <code><body></code> for the <code>window.alert()</code> #* Use <code><script src=...></code> in <code><head></code> or <code><body></code> for the <code>document.getElementById().innerText</code> or <code>document.getElementById().innerHTML</code> and <code>console.log()</code> # Add comments to the external JavaScript src code above, describing the program. # Add a <code><noscript></code> section to the Hello html page above, displaying an appropriate message to users who have JavaScript disabled. Disable JavaScript in your browser to test the noscript section, then re-enable JavaScript. # Research best practices for where to place JavaScript code and how to format and structure it (style guides). # Research the difference between <code><script async ...></code> and <code><script defer ...></code>. == Lesson Summary == * JavaScript, often abbreviated as JS, is a high-level, interpreted programming language that conforms to the ECMAScript specification.<ref>[[Wikipedia: JavaScript]]</ref> * JavaScript comments are created using either <code>//</code> for single-line comments or <code>/* ... */</code> for block comments.<ref>[https://developer.mozilla.org/en-US/docs/Web/JavaScript/Guide/Grammar_and_types#Basics MDN: JavaScript Guide]</ref> * The HTML <code><noscript></code> element defines a section of HTML to be inserted if a script type on the page is unsupported or if scripting is currently turned off in the browser.<ref>[https://developer.mozilla.org/en-US/docs/Web/HTML/Element/noscript MDN: noscript]</ref> * The HTML <code><script></code> element is used to embed or reference executable code, and is typically used to embed or refer to JavaScript code.<ref>[https://developer.mozilla.org/en-US/docs/Web/HTML/Element/script MDN: script]</ref> * <code><script src="..."></code> specifies the URI of an external script and is used as an alternative to embedding a script directly within a document.<ref>[https://developer.mozilla.org/en-US/docs/Web/HTML/Element/script MDN: script]</ref> * JavaScript scripts required during the loading of the page are added to the document head section.<ref>[https://developer.mozilla.org/en-US/docs/Learn/HTML/Howto/Author_fast-loading_HTML_pages MDN: Author Fast-Loading HTML Pages]</ref> * JavaScript scripts not required during the loading of the page are added at the end of the document body section.<ref>[https://developer.mozilla.org/en-US/docs/Learn/HTML/Howto/Author_fast-loading_HTML_pages MDN: Author Fast-Loading HTML Pages]</ref> * JavaScript's best practice is to use external JavaScript files and load them at the end of the document body section.<ref>[https://developer.mozilla.org/en-US/docs/Learn/HTML/Howto/Use_JavaScript_within_a_webpage MDN: Use JavaScript Within a Webpage]</ref> Alternatively, external JavaScript files may be added at the end of the document head section and loaded asynchronously using the <code>async</code> or <code>defer</code> attributes.<ref>[https://developer.mozilla.org/en-US/docs/Web/HTML/Element/script MDN: script]</ref> * The <code>async</code> attribute indicates that the browser should, if possible, load the script asynchronously. The script is executed as soon as it is loaded.<ref>[https://developer.mozilla.org/en-US/docs/Web/HTML/Element/script MDN: script]</ref> * The <code>defer</code> attribute indicates that the browser should, if possible, load the script asynchronously. The script is executed after the document has been parsed.<ref>[https://developer.mozilla.org/en-US/docs/Web/HTML/Element/script MDN: script]</ref> * The <code>Document.write()</code> method writes a string of text to a document stream.<ref>[https://developer.mozilla.org/en-US/docs/Web/API/Document/write MDN: Document.write]</ref> * The <code>Window.alert()</code> method displays an alert dialog with the optional specified content and an OK button.<ref>[https://developer.mozilla.org/en-US/docs/Web/API/Window/alert MDN: Window.alert]</ref> * The <code>document.getElementById()</code> method returns an Element object representing the element whose id property matches the specified string.<ref>[https://developer.mozilla.org/en-US/docs/Web/API/Document/getElementById MDN: Document.getElementById]</ref> * The Element <code>innerHTML</code> property gets or sets the HTML or XML markup contained within the element.<ref>[https://developer.mozilla.org/en-US/docs/Web/API/Element/innerHTML MDN: innerHTML]</ref> * The HTMLElement <code>innerText</code> property represents the text content of a node and its descendants.<ref>[https://developer.mozilla.org/en-US/docs/Web/API/HTMLElement/innerText MDN: innerText]</ref> * The <code>console.log()</code> method outputs a message to the web console.<ref>[https://developer.mozilla.org/en-US/docs/Web/API/Console/log MDN: console.log]</ref> == Key Terms == ;Console :Is an object which provides access to the browser debugging console. We can open a console in web browser by using: Ctrl + Shift + K for windows and Command + Option + K for Mac. The console object provides us with several different methods, like :log(), error(), warn(), clear(),time(), etc. <ref>{{Cite web|url= https://www.geeksforgeeks.org/console-in-javascript/#:~:text=In%20javascript%2C%20the%20console%20is,error()</ref> ;JavaScript :The proprietary name of a high-level, object-oriented scripting language used especially to create interactive applications running over the internet.<ref>{{Cite web|url=https://www.dictionary.com/browse/javascript|title=Definition of JavaScript {{!}} Dictionary.com|website=www.dictionary.com|language=en|access-date=2021-01-22}}</ref> ;comments :Used in programming languages, it allows the programmer to explain the code in a more understandable way to others. In JavaScript, there are two types of comments that can be created which includes single-line comments and block comments.<ref>{{Cite web|url=https://www.w3schools.com/js/js_comments.asp|title=JavaScript Comments|website=www.w3schools.com|access-date=2020-08-26}}</ref> ;ECMAScript :A scripting-language specification, standardized by Ecma International, which was created to standardize JavaScript and foster multiple independent implementations.<ref>[[Wikipedia: EMCAScript]]</ref> ;external script :A script file that is attached to the HTML using the <script> element. Example - &lt;script src='myscript.js'&gt;.{{source}} ;Nonscript Tag :The <noscript> tag defines an alternate content to be displayed to users that have disabled scripts in their browser or have a browser that doesn't support script. The <noscript> element can be used in both <head> and <body>. <ref>{{Cite web|url= https://developer.mozilla.org/en-US/docs/Web/HTML/Element/noscript</ref> ;statement :A command that performs an action. An example being, alert("string"), where alert prints the string within the parenthesis.{{source}} == Review Questions == * What are three different ways to implement JavaScript into an HTML file? * What can you do with <code>document.getElementById()</code> in JavaScript? * How do you create a windowed message with JavaScript? * How do you embed JavaScript code in an HTML file? * What is <code><noscript></code> used for? *Why is linking to external scripts considered the best practice for script placement? *Where is the best place to put <script></script> for faster loading webpages? *What is the difference between defer and async? == See Also == * [[Wikipedia: JavaScript]] * [[Wikipedia: Input/output]] * [https://grasshopper.codes/ Grasshopper: JavaScript Coding App for Beginners] * [https://google.github.io/styleguide/jsguide.html Google: JavaScript Style Guide] * [https://developers.google.com/speed/docs/insights/v5/get-started Google: Get Started with the PageSpeed Insights API] * [https://javascript.info/script-async-defer JavaScript Info: Scripts: async, defer] * [https://www.codecademy.com/learn/introduction-to-javascript Codecademy: Introduction to Javascript] * [https://www.learn-js.org/ Javascript Learning Resource] * [https://javascript.info/ The Modern Javascript Tutorial] * [https://learnjavascript.online/ Learn Javascript Online] * [https://www.geeksforgeeks.org/understanding-basic-javascript-codes/?ref=lbp Geeks for Geeks: Understanding basic JavaScript codes] *[https://www.w3schools.com/js/default.asp W3Schools: JavaScript] == References == {{reflist}} <noinclude>{{subpage navbar}}</noinclude> {{CourseCat}} gdebt61f6yrss1gqwqieqjiykw3bw4p 0 252948 2419365 2212125 2022-08-26T07:26:25Z Jtneill 10242 Adjust categories wikitext text/x-wiki {{title|The dorsolateral prefrontal cortex and long-term goal pursuit:<br>What role does the dorsolateral prefrontal cortex play in pursuing long-term goals? }} {{MECR3|1=https://www.youtube.com/watch?v=jrUoq0gbzj0&feature=youtu.be}} __TOC__ == Overview == {{RoundBoxTop|theme=2}} "FOR THE ONE HUNDREDTH TIME, LIAM - GET UP OFF THE COUCH AND CLEAN YOUR ROOM, YOU SAID YOU WOULD KEEP IT CLEAN!" Ah. Mum is yelling at me again. I often wonder why I'm so useless. If only there was some way to understand why I can't pursue any long-term goals. "Sorry mum, I'll make sure to keep it clean". {{RoundBoxBottom}} Long-term goals are a major contributor to our daily functioning. They direct our actions, give us a sense of purpose, and shape our attitudes towards objects, people and circumstances. It is therefore critical we understand the importance in creating and achieving long term goals. Unfortunately it is easier said than done. There are numerous complexities in the cognitive functioning required to achieve long-term goals. This chapter examines: #The role of the dorsolateral prefrontal cortex #Typical functioning of the human brain #How to achieve long-term goal pursuits #Intrinsic motivation #Potential enhancements of the dorsolateral prefrontal cortex == Frontal lobe == [[File:Frontal lobe - animation.gif|alt=|thumb|172x172px|''Figure 1''. The frontal lobe]] The frontal lobe is one of four major lobes in the human brain and is located at the front of each hemisphere. The frontal lobe is distinguished from the parietal lobe by the [[wikipedia:Central_sulcus|central sulcus]], and separated from the temporal lobe by the [[wikipedia:Lateral_sulcus|lateral sulcus]] (Fuster, 2015). The frontal lobe is further divided into functional areas. The primary motor cortex, premotor cortex, frontal eye fields, Broca’s area and the prefrontal cortex are the major functional areas within the frontal lobe. === Prefrontal cortex === The [[wikipedia:Prefrontal_cortex|prefrontal cortex]] (PFC) covers the front-most part of the frontal lobe. The PFC is involved in personality expression, social behaviour, planning complex cognitive behaviour, and decision making (Fuster, 2015). The activity of the PFC is complex with researchers concluding that the PFC is responsible for [[wikipedia:Executive_functions|executive functioning]]. The ability to differentiate among conflicting thoughts, separating differences between good and bad, better and best, and same and different, consequences, goal pursuits, expectations, and social norms is controlled by such executive functioning in the PFC (Fuster, 2015). Fuster (2015) emphasised the functioning of the PFC in interpreting and representing information not readily available in the environment. The ability to represent information to pursue goals underlies all higher executive functioning. There have been several theories explaining the process the PFC undertakes utilising executive functioning. Top-down processing, the [[wikipedia:Arthur_P._Shimamura|Dynamic Filtering Theory]] and the Integrative Theory of Prefrontal Cortex Function further explain the role of executive functioning in goal-pursuits. The prefrontal cortex can be separated into two functionally different regions: the [[wikipedia:Ventromedial_prefrontal_cortex|ventromedial prefrontal cortex]] (vmPFC) and the [[wikipedia:Lateral_prefrontal_cortex|lateral prefrontal cortex]] (LPFC). From these two regions, the LPFC can be delineated into the [[wikipedia:Dorsolateral_prefrontal_cortex|dorsolateral]] (DLPFC) and ventrolateral (vl-PFC) areas, and the vmPFC can be delineated into the medial (mPFC) and ventral (vPFC) areas. Each of these areas are highly interconnected with areas of the brain responsible for attention, cognition, action and emotion (Fuster, 2015; Sturm, Haase & Lavenson, 2016). {| class="wikitable" |+Table. 1 ''Subdivisions of the Prefrontal Cortex'' | colspan="2" |Lateral | colspan="2" |Ventromedial |- |Dorsolateral |Ventrolateral |Medial |Ventral |} === Dorsolateral prefrontal cortex: === [[File:Prefrontal cortex.png|thumb|''Figure 2.'' Sections of the frontal lobe|217x217px]] The DLPFC is a functional structure, rather than an anatomical structure, located in the middle frontal gyrus in humans. The DLPFC is a key structure responsible for many executive functions (Fuster, 2015; Striedter, 2005). Although not exclusively responsible, the DLPFC is required in all complex mental activity. The DLPFC is involved in planning, organisation, inhibition and abstract reasoning and several other executive functions (Fuster, 2015; Striedter, 2005). The DLPFC contains neural circuitry responsible for integrated responses such as sensory input, retaining [[wikipedia:Short-term_memory|short-term memory]] and motor signalling (Striedter, 2005). The DLPFC contains several connections to other cortices such as the temporal cortex, posterior parietal cortex, the premotor cortex and the retrosplenial cortex that allow the DLPFC to regulate brain activity, as well as be regulated by these cortices (Fuster, 2015). &nbsp; {{Robelbox|theme=5|width=40%|title=Quiz Question|iconwidth=48px|icon=Nuvola_apps_korganizer.svg}}<div style="{{Robelbox/pad}}"> <quiz display=simple> {True or False? Attention is a function of the dorsolateral prefrontal cortex} |type="()"} + True - False </quiz> </div> {{Robelbox-close}} ==Dorsolateral prefrontal cortex and goal-setting== The DLPFC is responsible for all new goal-directed sequences in activities involving behaviour, language, and reasoning (Fuster, 2015; Collins, 2008; Striedter, 2005). In the pursuit of goals, humans utilise prefrontal networks and interconnections in order to generate a plan of action, or schema (Fuster, 2015; Collins, 2008). This highly complex process is reliant on many cortical and subcortical brain regions that according to researchers the DLPFC initiates {{missing}} (Fuster 2015; Blumenfeld & Ranganath, 2007). The DLPFC is responsible for the structuring of behaviour and cognition in attaining biological and cognitive goals (Blumenfeld & Ranganath, 2007; Collins 2008). As the DLPFC is at least partially responsible for integrated neuronal responses involving sensory input, retaining short-term memory, and motor signalling researchers have explained two further functions attributable to the role of the DLPFC and pursing{{sp}} goals. First, a ''retrospective'' function of short-term memory and the second, a ''prospective'' function of preparatory set (or expectation). These two functions share overlapping networks of the DLPFC and have been theorised to bridge time between sensory and motor events. Such bridging enables humans to maintain long term goals and achieve them through the control of motor output and sensory input. === The dorsolateral prefrontal cortex and working memory === Fuster (2015) concluded that the DLPFC is critically involved in forms of working memory in order to achieve a goal. The evidence primarily comes from two methodologies: selective inactivation of the DLPFC and single-cell recording. Smith and Jonides (1999) measured the activation of the DLPFC during working memory and concluded that an activation in the DLPFC supports mobilisation for future action. In order to measure the executive role of the DLPFC in goal pursuits, researchers analysed how managing expectation and memory occur on a neuronal level. Researchers monitored the progressive increase of cell discharge and slow surface-negative potentials of subjects before a stimulus-contingent act. This indicates that memory and expectation can function simultaneously (Smith & Jonides, 1999). Such activity of cells manifests in the human ability to focus attention on a motor act to ensure efficient execution. [[File:Phineas Gage injury - animation.gif|thumb|''Figure 3.'' A 3D rendering of Phineas Gage's brain injury.]] Current research further acknowledges the role of the DLPFC in working memory. Kobayashi (2009) analysed the influences of rewards on activity in the DLPFC in monkeys. Kobayashi (2009) concluded that DLPFC neurons are sensitive to many aspects of reward: quantity, quality, availability, and delay. Kobayashi theorised two potential possibilities for the high sensitivity of reward on the DLPFC: first, that the DLPFC receives reward information from the [[wikipedia:Orbitofrontal_cortex|orbitofrontal cortex]], and the second is the response of [[wikipedia:Dopaminergic_pathways|mesencephalic dopamine neurons]] located in the DLPFC. Understanding the role of working memory and short-term goals on the DLPFC is critical for evaluating the role of the DLPFC and long-term goal pursuits according to Woolley and Fishbach (2016). The DLPFC has a role in the assessment of a [[wikipedia:Cost–benefit_analysis|cost-benefit analysis]], and immediate rewards greater influence cost-benefit analyses. For instance, individuals attempting to lose weight may join a gym with the long-term goal to lose weight. As there is a major delay between consistent exercise and losing weight, individuals are likely to give up on their weight-loss journey. There is a tendency to evaluate the cost of time and energy against their final goal of losing weight. Such cost-benefit analysis acknowledges a major delay between reaching the reward of their goal. Conversely, when individuals can incrementally reward themselves, a cost-benefit analysis is undertaken with the benefit (or reward) having shorter delays, resulting in higher motivation of the individual. It is therefore critical to acknowledge the role of the DLPFC’s dopamine reward circuits, involving mesencephalic dopamine neurons, in planning and achieving short-term goals and the effect of achievement on long-term goals (Ballard et al., 2011). As the DLPFC is largely responsible for many executive functions,{{gr}} it plays a pivotal role in mechanisms of self-control (Mansouri, Koechlin, Rosa & Buckley, 2017; Fishbach & Trope, 2005). Fishbach and Trope (2005) investigated how self-control over the attention and valuation of delayed rewards affected immediate temptation. Such self-control dilemmas focus on the role of perception of sensory information to influence motivation (Fishbach & Trope, 2005). For instance, a student who debates between studying (long-term reward) or partying (short-term reward) is more likely to study if they consider the delayed rewards of studying (obtained degree) against the delayed rewards of partying (likely to be none), instead of the immediate rewards for each possibility. Executive functioning relating to self-control suggests that intrinsic motivation plays a significant role in long-term goal pursuits. {{RoundBoxTop|theme=1}} The year is 1848, Phineas Gage is about to become a legend in the psychology community. While packing a hole full of gun powder with an iron rod, the powder detonated and the iron rod was launched into Gage's head. Unbelievably, Gage survived the incident. After the incident, Gage was unlike he was earlier, his personality had changed. His misfortune became the ground work for understanding the location of particular functions of the brain (Garcia-Molina, 2012). {{RoundBoxBottom}} ==Goal-setting theory== Edwin Locke (1968) generated a theory measuring the effects of setting goals on performance. Consistent findings show that individuals who set specific, difficult goals, performed better than those with vague, less difficult goals. More recently, Locke and Latham (2002) have revisited goal-setting theory and have updated five basic principles in order to best achieve long-term goals: 1. &nbsp; &nbsp;'''Clarity''': Goals must be clear and specific. 2. &nbsp; &nbsp;'''Challenge''': There must be a decent level of difficulty in order to motivate individuals to strive for goals. 3. &nbsp; &nbsp;'''Commitment''': There must be deliberate effort to meet the goal. 4. &nbsp; &nbsp;'''Feedback''': Receiving information on how to best progress toward your goal influences achieving long-term goals. 5. &nbsp; '''Task Complexity''': If the task is difficult, ensure a realistic time-frame has been given to achieve and overcome obstacles. {{Robelbox|theme=5|width=40%|title=Quiz Question|iconwidth=48px|icon=Nuvola_apps_korganizer.svg}}<div style="{{Robelbox/pad}}"> <quiz display=simple> {True or False? It is necessary to receive feedback in order to best achieve your goal.} |type="()"} + True - False </quiz> </div> {{Robelbox-close}} == Motivation == Motivation can be divided into two different types of motivation: Intrinsic and Extrinsic motivation. As the purpose of this chapter is to evaluate the role of the DLPFC in long-term goal pursuits, this chapter will only display intrinsic motivation. === Intrinsic motivation === Intrinsic motivation is a behaviour that is driven by internal drives. Instead of external pressures or desires to be motivated, there is an emphasis on interest or enjoyment of the task itself (internal drives). Individuals who are intrinsically motivated are more likely to engage in a task willingly in order to improve their skills, and are more likely to achieve long term goals (Richard & Edward, 2000). The DLPFC has a strong relationship with the dorsal anterior cingulate cortex (dACC) as both areas are responsible for monitoring errors and in behavioural adaptation. Such functioning plays a critical role in &nbsp;long-term goal pursuit (Ng, 2018). As per Locke’s Goal-Setting Theory (1968), it is most beneficial for individuals to ''understand'' particular obstacles or difficulties, as well as have the ''perceived ability'' to complete a task when pursuing goals. Dopamine is considered a key substrate of intrinsic motivation in goal-setting (Ballard et al., 2011; Ng, 2018). Attentiveness and behavioural engagement are two functions of dopamine that directly impact the functioning of intrinsic motivation (Ng, 2018). Dopamine enables the successful behaviour in accordance with goals (Ng, 2019; Ott & Nieder, 2019). There is a great reliance on the dopamine systems in the prefrontal cortex, utilising the Dopamine Reward Circuit, to regulate functioning (Ballard et al., 2011). {{Robelbox|theme=5|width=40%|title=Quiz Question|iconwidth=48px|icon=Nuvola_apps_korganizer.svg}}<div style="{{Robelbox/pad}}"> <quiz display=simple> {True or False? Intrinsic motivation refers to motivators such as enjoyment} |type="()"} + True - False </quiz> </div> {{Robelbox-close}} == Enhancements of the functioning of the DLPFC == Research has demonstrated that obscurities in the DLPFC are present in those diagnosed with mental illnesses such as schizophrenia. As a result, new information pertaining to the correction of neuronal processes is being sought after by researchers. === Natural enhancements === Kumari et al. (2011) conducted a study to measure the rate of increased activation of connections in the prefrontal brain region associated with psychotic symptoms. Kumari et al. (2011) used a functional MRI (fMRI) to see how patients processed black and white images of facial expressions such as fear and anger. The fMRI initially showed how particular increased activation of connections in the prefrontal brain region was associated with psychotic symptoms such as delusions. Patients were then required to undergo six months of [[wikipedia:Cognitive_behavioral_therapy|cognitive behavioural therapy]] (CBT). After the six months, an fMRI showed that there was heightened activity between the DLPFC and the amygdala. This heightened activity demonstrated a reduction in threat processing when viewing different facial expressions. The CBT also induced greater connectivity between the dorsolateral prefrontal cortex and the post-central gyrus in the parietal lobe. This associated contributed to either full or partial remission of psychotic symptoms. Unfortunately, this study also had several limitations. The study has been criticised for having a high potential for a type II error as there was a high attrition rate. Furthermore, the generalisability of the results into clinical practice is poor as facial affective processing tasks are not common place in clinical practice. Despite such limitations, the results cannot be ignored and more research should be conducted regarding brain connectivity changes associated with psychotherapy, and how this may help long-term recovery from mental illness. More specifically, changes in the DLPFC’s executive functioning and cross-cortical communication must be researched === Artificial enhancements === Beyond natural enhancements to the DLPFC, a lot of research has been conducted regarding medication and transcranial direct current stimulation. Recently there has been a push in research regarding the side effects and the role of medication on the frontal lobe. ==== Guanfacine ==== Current medications such as guanfacine are currently being prescribed to individuals with ADHD (Attention Deficit Hyperactivity Disorder) (Cruz, 2010). [[wikipedia:Guanfacine|Guanfacine]] focuses on the inhibition of impulsive choices through the strengthening of attention and behaviour affecting neurons in the DLPFC (Cruz, 2010). Guanfacine strengthens prefrontal cortical synaptic connectivity and enhances neuronal firing. Guanfacine has the potential to influence long-term goal pursuit through the benefits of executive functioning influencing attention. Unfortunately there are several side effects. Common side effects includes sleepiness, constipation, drowsiness and constipation. More severe side effects can include anxiety, low blood pressure, and depression (Cruz, 2010). ==== Modafinil ==== [[wikipedia:Modafinil|Modafinil]] is another medication often used to enhance motivation of individuals diagnosed with disorders relating to motivation (Robertson & Hellriegal, 2003). Modafinil has been the target of several studies, with a focus on the effect of modafinil on dopamine and brain functioning. Zolkowska et al. (2009) found that modafinil significantly affects the dopamine transporter and acts as a [[wikipedia:Dopamine_reuptake_inhibitor|dopamine reuptake inhibitor]], which are known to help in the treatment of ADHD and narcolepsy. Modafinil is known as an atypical dopamine reuptake inhibitor as there is low potential for substance abuse (Zolkowska et al., 2009). By altering dopamine functioning in the DLPFC, executive functioning decisions change and have potential to influence long-term goal pursuits. Unfortunately much like guanfacine there are several negative side effects of modafinil including: headache, anxiousness, back pain, nausea, and sleep problems (Robertson & Hellriegal, 2003). There is also a lot of inconclusive research on the rate of addiction for the long-term use of modafinil. ==== Transcranial direct current stimulation ==== Javadi and Walsh (2012) analysed whether [[wikipedia:Transcranial_direct-current_stimulation|transcranial direct current stimulation]] (tDCS) affects the human working memory. Anodal and cathodal stimulation was applied over the left DLPFC. During encoding of information, anodal stimulation of the left DLPFC improved memory, whereas cathodal stimulation of the same area impaired memory performance. The results of the study indicated that active stimulation of the left DLPFC can lead to an enhancement of memorisation. Such short-term memory effects have the potential to influence long-term goal pursuits. With each artificial enhancement, more information needs to be done measuring the effects of both medication and tDCS on long-term goal pursuits (Yang, Gao, Shi, Ye & Chen, 2017). Although information can be inferred from the functioning of the DLPFC, more conclusive research is needed. Furthermore, the side effects of medication may prove too great to warrant&nbsp;further investigation.&nbsp; {{Robelbox|theme=5|width=40%|title=Quiz Question|iconwidth=48px|icon=Nuvola_apps_korganizer.svg}}<div style="{{Robelbox/pad}}"> <quiz display=simple> {True or False? Modafinil is considered a dopamine reuptake inhibitor.} |type="()"} + True - False </quiz> </div> {{Robelbox-close}} ==Future direction for research == Future direction for research needs to focus on long-term goal pursuits. There is little research on the relationship between the DLPFC and long-term goal pursuits. As the DLPFC is at least partially responsible for executive functioning and relies on communicating with several other cortices to function, research would benefit from further conceptualising the DLPFC. Analysing the role of the DLPFC and long-term goal pursuits may oversimplify numerous processes of executive functioning. Future research could also consider the clinical significance of changes to the DLPFC. Current research on the relationship of CBT and the DLPFC is interesting and may prove clinically beneficial for patients. More research should measure the neuronal changes resulting from CBT. Future research may also consider the combined effect of medication and CBT on the DLPFC and how this may effect disorders such as schizophrenia and ADHD. ==Conclusion== The role of the DLPFC in long-term goal pursuits is complex and involves various cross-cortical functioning. The biggest predictors of achieving long-term goals are identified as achieving short-term goals, reward systems, and cognitive differences in executive functioning. It is therefore imperative to analyse the relationship the DLPFC has with these variables. Currently, it is understood that long-term goals involve various cortices and sub-cortices. Research currently draws inferences as to how the DLPFC effects long-term goal pursuits. These inferences are based on the functions of the DLPFC, and therefore research is concerned with the effect of a particular function on long-term goals. These functions occur cross-cortically adding to the complexity in conclusively suggesting the role of the DLPFC in long-term goal pursuits. More conclusive longitudinal studies must be conducted analysing the role of the DLPFC in order to conclusively report the role of the DLPFC in long-term goal pursuits. ==See also== [[Motivation]] (Wikiversity) [[Human brain|Frontal Lobe]] (Wikiversity) [[Motivation and emotion/Book/2013/Dopamine and emotion|Dopamine and emotion]] (Wikiversity) [[Motivation and emotion/Book/2017/tDCS and motivation|Transcranial Direct Current Stimulation]] (Wikiversity) [[Motivation and emotion/Book/2018/Goal setting techniques|Goal-Setting Techniques]] (Wikiversity) == References == {{Hanging indent |1= Ballard, I., Murty, V., Carter, R., MacInnes, J., Huettel, S., & Adcock, R. (2011). Dorsolateral prefrontal cortex drives mesolimbic dopaminergic regions to initiate motivated behaviour. ''Journal of Neuroscience.'' https://doi.org/10.1523/jneurosci.0895-11.2011 Blumenfeld, R., & Ranganath, C. (2007). Prefrontal cortex and long-term memory encoding: An integrative review of findings from neuropsychology and neuroimaging. ''The Neuroscientist, 13'', 280-291. doi: 10.1177/1073858407299290 Collins, M. L. (2008). ''Handbook of developmental cognitive neuroscience''. MIT press. Cruz, M. P. (2010). Guanfacine extended-release tablets (Intuniv), a nonstimulant selective alpha2a-adrenergic receptor agonist for attention-deficit/hyperactivity disorder. ''Pharmacy and Therapeutics, 35'', 448. Fishbach, A., & Trope, Y. (2005). The substitutability of external control and self-control. ''Journal of Experimental Social Psychology, 41'', 256-270. doi: https://doi.org/10.1016/j.jesp.2004.07.002 Fuster, J. (2015). ''The prefrontal cortex''. Academic Press. García-Molina, A. (2012). Phineas Gage and the enigma of the prefrontal cortex. ''Neurología (English Edition), 27'', 370-375. Doi: https://doi.org/10.1016/j.nrleng.2010.03.002 Javadi, A. H., & Walsh, V. (2012). Transcranial direct current stimulation (tDCS) of the left dorsolateral prefrontal cortex modulates declarative memory. ''Brain stimulation, 5'', 231-241. Doi: https://doi.org/10.1016/j.brs.2011.06.007 Kobayashi, S. (2009). Reward neurophysiology and primate cerebral cortex. Doi: https://doi.org/10.1016/B978-008045046-9.01559-X Kumari, V., Fannon, D., Peters, E. R., Ffytche, D. H., Sumich, A. L., Premkumar, P., ... & Kuipers, E. (2011). Neural changes following cognitive behaviour therapy for psychosis: a longitudinal study. ''Brain, 134''. doi: https://doi.org/10.1093/brain/awr154 Locke, E. A., & Latham, G. P. (2002). Building a practically useful theory of goal setting and task motivation: A 35-year odyssey. ''American psychologist, 57'', 705. Mansouri, F. A., Koechlin, E., Rosa, M. G., & Buckley, M. J. (2017). Managing competing goals—a key role for the frontopolar cortex. ''Nature Reviews Neuroscience, 18'', 645. Doi:https://doi.org/10.1038/nrn.2017.111 Ng, B. (2018). The neuroscience of growth mindset and intrinsic motivation. ''Brain sciences, 8'', 20. Doi: https://doi.org/10.3390/brainsci8020020 Ott, T., & Nieder, A. (2019). Dopamine and cognitive control in prefrontal cortex. ''Trends in cognitive sciences''. doi :https://doi.org/10.1016/j.tics.2018.12.006 Robertson, P., & Hellriegel, E. T. (2003). Clinical pharmacokinetic profile of modafinil. ''Clinical pharmacokinetics, 42'', 123-137. Doi:10.2165/00003088-200342020-00002 Ryan, R. M., & Deci, E. L. (2000). Intrinsic and extrinsic motivations: Classic definitions and new directions. ''Contemporary educational psychology, 25'', 54-67.doi:10.1006/ceps.1999.1020 Smith, E. E., & Jonides, J. (1999). Storage and executive processes in the frontal lobes. ''Science, 283'', 1657-1661. doi:http://dx.doi.org/10.1126/science.283.5408.1657 Striedter, G. F. (2005). ''Principles of brain evolution''. Sinauer Associates. Sturm, V. E., Haase, C. M., & Levenson, R. W. (2016). Emotional dysfunction in psychopathology and neuropathology: Neural and genetic pathways. ''In Genomics, Circuits, and Pathways in Clinical Neuropsychiatry''. Academic Press. doi: https://doi.org/10.1016/B978-0-12-800105-9.00022-6 Woolley, K., & Fishbach, A. (2017). Immediate rewards predict adherence to long-term goals. ''Personality and Social Psychology Bulletin, 43'', 151-162. Doi: 10.1177/0146167216676480 Yang, X., Gao, M., Shi, J., Ye, H., & Chen, S. (2017). Modulating the activity of the DLPFC and OFC has distinct effects on risk and ambiguity decision-making: A tDCS Study. ''Frontiers in psychology, 8'', 1417. doi:10.3389/fpsyg.2017.01417 Zolkowska, D., Jain, R., Rothman, R. B., Partilla, J. S., Roth, B. L., Setola, V., & Baumann, M. H. (2009). Evidence for the involvement of dopamine transporters in behavioral stimulant effects of modafinil. ''Journal of Pharmacology and Experimental Therapeutics, 329'', 738-746. doi: https://doi.org/10.1124/jpet.108.146142 }} ==External links== [https://www.jneurosci.org/content/31/28/10340.full Study on the DLPFC and motivation] [https://www.youtube.com/watch?v=iuIisjRIcVI Tedx Talk on vision, goals and willpower.] [[Category:{{#titleparts:{{PAGENAME}}|3}}]] [[Category:Motivation and emotion/Book/Cortex]] [[Category:Motivation and emotion/Book/Goal pursuit]] ljlj69j2p65r4knhinm75euhmguyciq 0 259407 2419137 2418854 2022-08-26T00:06:46Z WikiJournalBot 2938943 Automated Bot List Update wikitext text/x-wiki <noinclude>{{WikiJMed top menu}} {{col-begin}} {{col-break}} </noinclude> {{Issue header|year = 2020 |volume = 7 |issue = 1 }} {{WikiJournalBotList}} {{Article info|Q=Q99496970|image=Visual abstract- Viewer interaction with YouTube videos intended to educate patients about post-hysterectomy recovery.png}} {{Article info|Q=Q99440266|image=Extraction machine.gif}} {{Article info|Q=Q96317242|image=Bland-altman plot of three clinicians' ratings of burn size, using two different methods.png}} {{Article info|Q=Q99676980|image="Crisis" combines the characters for "Danger" and "Opportunity"-Simplified & Traditional Chinese.png}} {{Article info|Q=Q99440073|image=Emotional and Psychological Impact of Interpreting for Clients with Traumatic Histories on interpreters - Flow diagram.svg}} {{Article info|Q=Q89093122|image=Hep D Epidemiology Figure 1.svg}} {{ListEnd}} <noinclude>{{col-break}} {{WikiJMed right menu}} {{col-end}} [[category:{{ROOTPAGENAME}} issues]] </noinclude> ft7h1sul2qrm9t1q5bedl5xtnnivhv5 0 265013 2419446 2417473 2022-08-26T09:36:12Z Jtneill 10242 + categories wikitext text/x-wiki {{title|Volunteer tourism motivation<br>What motivates volunteer tourism?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== [[File:TEACHING MATH.jpg|thumb|''Figure 1.'' Image of a volunteer tourist teaching math in Mali.]] You are underway {{smile}}! This template provides tips for [[Motivation and emotion/Assessment/Topic|topic development]]. Gradually remove these suggestions as you develop the chapter. Also consult the [[Motivation and emotion/Assessment/Chapter|author guidelines]]. At the top of the chapter, the title and sub-title should match the ''exact'' wording and casing as shown in the {{Motivation and emotion/Book}}. The sub-titles all end with a question mark. This Overview section should be concise but consist of several paragraphs which engage the reader, illustrate the problem, and outline how psychological science can help. {{RoundBoxTop|theme=3}} '''Focus questions:''' * What is the first focus question? * What is the second focus question? * What is the third focus question? {{RoundBoxBottom}} == What is Volunteer Tourism? == The Tourism Industry consists of XYZ and is worth an estimated X to the global economy. Tourism sectors and sub-sectors structure. * Volunteer Tourism sector: history, stats * Stakeholders involved in Volunteer Tourism (Tourism Organisations, Communities, Tourism Agents, Volunteers) == Communities and Tourism Operators == What motivates Communities and TOs to offer/promote VT? * The business of Volunteer Tourism - A marketing gimmick? Labour shortage solution? Green-washing? Economics? Global community harmony? * Pros and Cons of offering Volunteer Tourism * Community perspective. Pros and Cons: Awareness, cross cultural understanding, global community {{tip| Insert case study of Volunteer Tourism operator/Community here }} == Understanding Volunteer Tourists == Demographics of VTs and reasons for participation * Push/pull motivation, eudaimonic motivations. Selfish (personal) or Selfless (interpersonal). * Benefits of volunteerism: Physiological, generosity, morality, globalisation === Physiological view of motivation === * The neuroscience of motivation * Feel good hormones: Oxytocin, Vasopressin === Intrinsic and Extrinsic motivation for trip planning === * Explanations, definitions, relevance to volunteer tourism * Are some voluntourists more likely to be autonomously motivated than others? (students for credit vs independent volunteers) * [[wikipedia:Altruism|Altruism]] types: Reciprocal Altruism, Genetic Altruism, Pure Altruism, Group Selected Altruism === Psychological needs during volunteer tourism experience === * Autonomy, competence, relatedness == Research and 'Voluntourist' models == Might have own section, or be woven into other sections where relevant. * Shallow, Intermediate and Deep (McGehee, Clemmons & Lee, 2009) * Vanguards, Pragmatists and Questers (Callanan & Thomas, 2005) * VOLUNtourists and volunTOURISTS (Daldeniz & Hampton, 2011) * Peace & Justice Motive (Everingham, Young, Wearing & Lyons, 2021; Nadeau & Lord, 2017)) * Warm-Glow Effect (Hartmann, Eisend, Apaolaza & D'Souza, 2017) {{tip|* Why does understanding specific motivation and/or emotion theories and research help? }} == Ethical considerations == Volunteers: The dark side of altruism: [[wikipedia:Ethnocentrism|Ethnocentrism]], patronising Tourism Operators: Exploitation, profiteering, unethical and illegal practices. == Conclusion == The Conclusion is arguably the most important section. It should be possible for someone to read the [[#Overview|Overview]] and the Conclusion and still get a good idea of the topic. {{tip|Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? }} ==See also== * [[wikipedia:Altruism|Altruism]] (Wikipedia) * [[wikipedia:International_volunteering|International Volunteering]] (Wikipedia) * [[Motivation and emotion/Book/2015/Travel motivation|Travel motivation: What motivates people to seek out travel experiences?]] (Book chapter, 2015) * [[Motivation and emotion/Book/2016/Volunteering motivation: Altruism or egoism?|Volunteering motivation: Altruism or egoism?]] (Book chapter, 2016) * [[Motivation and emotion/Book/2019/Volunteer tourism motivation|Volunteer tourism motivation]] (Book chapter, 2019) ==References== {{Hanging indent|1= Andereck, K., McGehee, N. G., Lee, S., & Clemmons, D. (2012). Experience Expectations of Prospective Volunteer Tourists. Journal of travel research, 51(2), 130-141. https://doi.org/10.1177/0047287511400610 Daldeniz, B., & Hampton, M. P. (2011). VOLUNtourists versus volunTOURISTS: A true dichotomy or merely a differing perception? In (pp. 54-65). Routledge. https://doi.org/10.4324/9780203854266-12 Everingham, P., Young, T. N., Wearing, S. L., & Lyons, K. (2022). A diverse economies approach for promoting peace and justice in volunteer tourism. Journal of sustainable tourism, 30(2-3), 618-636. https://doi.org/10.1080/09669582.2021.1924179 Gard McGehee, N. (2002). Alternative tourism and social movements. Annals of tourism research, 29(1), 124-143. https://doi.org/10.1016/S0160-7383(01)00027-5 Hartmann, P., Eisend, M., Apaolaza, V., & D'Souza, C. (2017). Warm glow vs. altruistic values: How important is intrinsic emotional reward in proenvironmental behavior? Journal of Environmental Psychology, 52, 43-55. https://doi.org/https://doi.org/10.1016/j.jenvp.2017.05.006 }} ==External links== [[Category:{{#titleparts:{{PAGENAME}}|3}}]] *[https://www.youtube.com/watch?v=E16iOaAP4SQ Documentary 'The Voluntourist': Is voluntourism doing more harm than good?] (YouTube) == Template Information Below == == Main headings == How you are going to structure the chapter? Aim for three to six main headings between the [[#Overview|Overview]] and [[#Conclusion|Conclusion]]. {{tip|Suggestions for this section: * For the [[Motivation and emotion/Assessment/Topic|topic development]], provide at least 3 bullet-points about key content per section. Include key citations. * For the [[Motivation and emotion/Assessment/Chapter|book chapter]], expand the bullet points into paragraphs. * If a section has a lot of content, arrange it into two to five sub-headings such as in the [[#Interactive learning features|interactive learning features section]]. Avoid having sections with only one sub-heading. }} ==Learning features== What brings an online book chapter to life are its interactive learning features. Case studies, feature boxes, figures, links, tables, and quiz questions can be used throughout the chapter. ===Case studies=== Case studies describe real-world examples of concepts in action. Case studies can be real or fictional. A case could be used multiple times during a chapter to illustrate different theories or stages. It is often helpful to present case studies using [[#Feature boxes|feature boxes]]. ===Boxes=== Boxes can be used to highlight content, but don't overuse them. There are many different ways of creating boxes (e.g., see [[Help:Pretty boxes|Pretty boxes]]). Possible uses include: * Focus questions * Case studies or examples * Quiz questions * Take-home messages {{RoundBoxTop|theme=3}} ;Feature box example * Shaded background * Coloured border {{RoundBoxBottom}} ===Figures=== [[File:Monkey-typing.jpg|right|205px|thumb|''Figure 1''. Example image with descriptive caption.]] Use figures to illustrate concepts, add interest, and provide examples. Figures can be used to show photographs, drawings, diagrams, graphs, etcetera. Figures can be embedded throughout the chapter, starting with the Overview section. Figures should be captioned (using a number and a description) in order to explain their relevance to the text. Possible images can be found at [[commons:|Wikimedia Commons]]. Images can also be uploaded if they are licensed for re-use or if you created the image. Each figure should be referred to at least once in the main text (e.g., see Figure 1). ===Links=== Where key words are first used, make them into [[Help:Links|interwiki links]] such as Wikipedia links to articles about famous people (e.g., [[w:Sigmund Freud|Sigmund Freud]] and key concepts (e.g., [[w:Dreams|dreams]]) and links to book chapters about related topics (e.g., would you like to learn about how to overcome [[Motivation and emotion/Book/2020/Writer's block|writer's block]]?). ===Tables=== Tables can be an effective way to organise and summarise information. Tables should be captioned (using APA style) to explain their relevance to the text. Plus each table should be referred to at least once in the main text (e.g., see Table 1 and Table 2). Here are some [[Motivation and emotion/Wikiversity/Tables|example 3 x 3 tables]] which could be adapted. ===Quizzes=== Quizzes are a direct way to engage readers. But don't make quizzes too hard or long. It is better to have one or two review questions per major section than a long quiz at the end. Try to quiz conceptual understanding, rather than trivia. Here are some simple quiz questions which could be adapted. Choose the correct answers and click "Submit": <quiz display=simple> {Quizzes are an interactive learning feature: |type="()"} + True - False {Long quizzes are a good idea: |type="()"} - True + False </quiz> To learn about different types of quiz questions, see [[Help:Quiz|Quiz]]. [[Category:{{#titleparts:{{PAGENAME}}|3}}]] [[Category:Motivation and emotion/Book/Tourism]] [[Category:Motivation and emotion/Book/Volunteering]] bjimy45e7x5ns0ngo80wckgs5db2r18 0 266881 2419430 2372316 2022-08-26T09:14:54Z Alec.cortez 2947555 added question mark wikitext text/x-wiki {{title|Hypomania and motivation:<br>What are the motivational characteristics of hypomania?}} {{MECR3|1=https://www.youtube.com/watch?v=0kkDtangp6A&feature=youtu.be}} __TOC__ ==Overview-== “What is hypomania?” is a common question that many people query about in our world today. This question will be discussed throughout this chapter, bringing to life the motivational characteristics and psychological theoretical explanations that come along side of it. Knowing the answer to this question may be beneficial to you, or a loved one, now or in the future. It is important to treat hypomania as it can have negative, crucial long term effects, for example if you or a loved one experienced the motivational characteristic hypersexuality, it may result in sexually transmitted infections (Kusumakar, 2009). Hypomania can be defined as a mild form of mania characterized by elation and hyperactivity. Hypomania is a mood state that can be characterized by its abnormally revved-up state of mind that can influence an individual’s mood, thoughts, and behavior (Kusumakar, 2009). Throughout this book chapter you will discover and become familiar with what hypomania is, explore the motivational characteristics and the motivational theory and research behind these characteristics. {{RoundBoxTop|theme=1}}Case Study- Sarah is a 42-year-old married woman who has a long history of both depressive and hypomanic episodes. Across the years she has had{{gr}}multiple diagnoses including major depression, borderline personality disorder, and most recently, bipolar disorder. A review of symptoms indicated that she indeed have multiple episodes of depression beginning in her late teens, but that clear hypomanic episodes later emerged. Her elevated interpersonal conflict, hyper-sexuality and alcohol use during her hypomanic episodes led to the provisional borderline diagnosis, but in the context of her full history, bipolar disorder appears the best diagnosis. Sarah notes that she is not currently in a relationship and that she feels alienated from her family. She has been taking mood stabilizers for the last year, but continues to have low level symptoms of depression. In the past, she has gone off her medication multiple times, but at present she says she is “tired of being in trouble all the time” and wants to try individual psychotherapy. SYMPTOMS: Alcohol Use Depression Elevated Mood Impulsivity Mania/Hypomania Mood Cycles Risky Behaviors {{RoundBoxBottom}} {{RoundBoxTop|theme=7}}Focus questions 1. What is hypomania? 2. What are the motivational characteristic's of hypomania? 3. What are the motivational causations of hypomania? 4. What is motivation? 5. How do motivation theories and studies link to the motivational characteristics of hypomania? {{RoundBoxBottom}} ==What is hypomania? == Hypomania is often defined as a condition that is similar to mania; but less severe. Hypomania can be separated from mania as a condition as when as individual experiences hypomania there is no great functional impairment whereas, when an individual experiences mania, there is great potential for a significant functional impairment (Benazzi, 2017). The DSM-5{{ic|https://en.wikipedia.org/wiki/DSM-5}} criteria suggests that the typical hypomania period is four days or longer and that, on the days that hypomania is occurring, it is typical for the elevated mood to be portrayed the majority of time for this period (Benazzi, 2017). Hypomania is a feature of many disorders such as bipolar I and bipolar II, depression and also cyclothymia. When an individual is diagnosed with bipolar disorder, they often experience hypomanic as well as manic episodes. Cyclothymia, or sometimes called; cyclothymic disorder, is an uncommon mood disorder (Jonathan Savitz, 2008). An individual with cyclothymia may experience both depression and  emotional ups and downs that can affect their wellbeing but is not as severe as those in bipolar I or II disorder (Kusumakar, 2009). There is also a range of conditions that co-occur with bipolar disorder, hence may be experienced with hypomania, for example, anxiety disorders, eating disorders, heart disease, diabetes and obesity  (Kusumakar, 2009). {{RoundBoxTop|theme=6}} ;Personal quotes from Shelby Manoukian. "It’s racing thoughts, it’s tossing and turning in your bed. It’s ripping your room apart at 1 in the morning" "Hypomania feels like you are in a room full of people, and every single one of them is trying to communicate to you" "It’s like having 10,000 web browsers open at once" {{RoundBoxBottom}} === What are the motivational causes associated with hypomania? === Firstly^{(colloquial?)}, alcohol and substance abuse can be a motivational causation of hypomania, drug and alcohol use ^(repetition) can make hypomania symptoms more severe (Goldberg, 2010). Stimulant drugs can also be dangerous for people experiencing hypomania as they often exaggerate the negative motivational characteristics including elevated mood and decreased sleep needs. Secondly, another non-clinical motivational causation of hypomania is changes in an individual’s sleep patterns, whether it’s the case that the individual is sleeping too much, battling insomnia, or experiencing sleeplessness (Kusumakar, 2009). Thirdly, the intake of caffeine has been evidently proven to be a motivational causation of hypomania (MD, 2015). Individuals with disorders such as bipolar are a lot more delicate to any substance that imitates that of an amphetamine, it encourages high levels of dopamine in the brain, which then encourages restlessness and anxiety, and finally influencing hypomania or mania (MD, 2015). === What are the motivational characteristics of hypomania? === ''<u>Confidence:</u>'' when an individual experiences hypomania they may have an inflated self-esteem and regard themselves quite highly. An example of this could be, telling friends or family how great one is or asking for a pay raise in work even when it might not be granted (Stanton, 2018). ''<u>Decreased need for sleep:</u>'' this is when three hours of sleep may seem reasonable, influenced by uncontrolled restlessness (Goldberg, 2010). ''<u>Racing thoughts/ talkativeness:</u>'' an in individual in a hypomania episode may not be able to help but think about a million things at once, they may struggle to communicate with others as they may be talking to fast or jumping from one subject to the other (Stanton, 2018). ''<u>Overindulgent participation in pleasurable activities:</u>'' often during hypomania experiences an individual may be hypersexual or may take part in impulse activities such as spending excessive amount of money on a shopping spree. ''<u>Distractible/ill-tempered:</u>'' during a hypomanic episode, an individual may struggle to pay attention and to prioritize correctly. They may also have a shorter temper fuse than usual; belligerence may be experienced (Stanton, 2018). == What is motivation? == Motivation can be described as the reason behind the drive that initiates a person to behave the way that they do (Locke & Schattke, 2018). A persons motivation may be encouraged by outside forces (extrinsic motivation) or from within themselves (intrinsic motivation). Intrinsic motivation can be referred to as taking part in an activity because of want, interest and enjoyment where as extrinsic motivation can be referred to as taking part in an activity knowing previously there is potential to gain reward or avoid punishment or consequence (Locke & Schattke, 2018). === Reinforcement Theory of Motivation === The reinforcement theory of motivation was presented by BF Skinner along with his associates. This theory explores what happens to an individual when he/she takes some action. BF Skinner holds the belief that the external environment should be designed effectively and positively to further motivate. Positive reinforcement identifies that behaviours that are met with positive outcomes, for example rewards, hoping to encourage similar behaviour again (Wikipedia, 2020). A study that relates to this theory and encourages to explore the motivational characteristics of hypomania points out the differences in the neural processing of motivational information in individuals vulnerable to hypomania [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3474792/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3474792] (Liam Mason, 2012). This study recruited 49 right-handed individuals (male and female) that were studying at the University of Manchester. Three groups were formed, low, medium and high self reported hypomania traits, this was measured using the Hypomanic Personality Scale. Participants played a computerised card game, learning the reward possibilities of three different cues (Liam Mason, 2012). Responses were measured using the feedback-related negativity (FRN), an effective element presented in motivational outcome evaluation and reinforcement learning. The hypomania-prone group depicted results that showed reduced FRN for both outcomes (Liam Mason, 2012). This result was focused on rewards, consistent with recent electrophysiological evidence of hypersensitivity to sudden reward and clinical account that mania has a correlation to reward hypersensitivity. Results also depicted that the result of reduced FRN for losses intertwines with the reduced punishment sensitivity hypothesis of a range of disorders and may help to explain some of the motivational characteristics of hypomania, such as unrestrained spending sprees, substance use and unprotected sex (Liam Mason, 2012). === Maslow’s Need Hierarchy Theory of Motivation === Abraham Maslow (1908 - 1970) was a psychology professor, Maslow was the first professor to found the Humanistic Psychology discipline. It was in 1943 his paper "''A Theory of Human Motivation''" was published, where first portrayed his hierarchy motivation theory of needs. Maslow’s need hierarchy theory is a well known theory of motivation. Maslow's theory focuses on human needs (Wikipedia, 2020). Maslow identifies all human needs and further classifies them into a hierarchical manner from the lower to the higher order. The human needs were grouped into five categories; physiological, safety, social, esteem and self actualization needs. Maslow believed that if the lower needs on the hierarchy have not been met, a person will automatically try satisfy those needs before trying to satisfy those needs which are on top of the hierarchy (Wikipedia, 2020). A study that relates to this theory is the 'Hypomanic Personality, Stability of Self‐Esteem and Response Styles to Negative Mood' https://onlinelibrary-wiley-com.ezproxy.canberra.edu.au/doi/10.1002/cpp.780 (Tai, 2011). This study helps to explore the motivational characteristics of hypomania by bringing to life Maslow's need of esteem as the aim of the study is to depict the dysfunctional self‐schematic processes, abnormal coping styles and stability of self‐esteem in relation to subclinical hypomania (Tai, 2011). Three studies were conducted, the Hypomanic Personality Scale (HPS) was measured in study one, and the Dysfunctional Attitude Scale was measured in study two and three. One hundred and thirty‐six Manchester University students were recruited in the screening phase of the study, in the second phase, three groups of participants were invited to participate on the basis of their scores in the upper, lower and mid quintiles of the range of HPS scores (Tai, 2011). Participants were asked to complete a self esteem diary, they were asked to complete two Rosenberg (1965) scales each day for a period of 1 week at two separate times of the day. The second questionnaire for each day introduced a collection of life events and attributional questions, the participants were then asked to recall the most positive event and the most negative event they could remember happening each day. Results depicted that people with high hypomania scores portrayed greater fluctuations in self‐esteem than people with medium or low scores on the HPS (Tai, 2011). Results also showed that participants that scored high on both the HPS and the DAS were like to experience hypomania and bipolar symptoms (motivational characteristics). These participants also showed other indications of bipolar traits, in particular high levels of risk‐taking, rumination and negative affect. It was concluded in results of all studies that vulnerability to bipolar/hypomania symptoms and characteristics is robustly associated with unstable self‐esteem (Tai, 2011). == Hypomania motivational characteristics and motivation- Theoretical basis == A theoretical basis is crucial in understanding both the cause of hypomania and the motivational characteristics that surround it. Numerous theories have been offered to aid in justifying the motivational characteristics that are brought to life during a hypomania episode. === Theory of mind === The theory of mind explores the ability to comprehend your own mental wellbeing and the mental states of others around you and also the capacity to recognize those mental states of others that may diverge from your own (SarahTerriena, 2014). Another one’s state of mind may consist of their intentions, aspirations, emotions, knowledge, and principles. There are many benefits that surround this theory for example, it develops social skills, encourages problem/conflict solving and aids in rationally predicting the behaviour of those around us (SarahTerriena, 2014). During a hypomanic episode alteration of social relationship can be clarified by the impairment of the functioning of theory of mind. Scarcity in theory of mind could be a significant motivational characteristic marker of a hypomanic episode (SarahTerriena, 2014).    === '''Reinforcement Sensitivity Theory''' === The reinforcement sensitivity theory offers three brain-behavioral systems. These brain-behavioral systems motivate individual differences in sensitivity to three factors; reward, punishment, and motivation (Kasey Stanton, 2018). The reinforcement sensitivity theory has been depicted to analyze and forecast anxiety, impulsivity, and extraversion (Kristy-Elizabeth M. Parker, 2007). As discussed above, when an individual experiences hypomania, along with many of the motivational characteristics, distractible/ill-tempered is a significant factor often. This may involve the individual having a shorter temper fuse and becoming aggressive easily (Kasey Stanton, 2018). The reinforcement sensitivity theory in relation to this motivational characteristic depicts that upbeat and involuntary aggression experienced by an individual is motivated by a sequence of anxiety and rapid, approach-motivational personality traits (Kristy-Elizabeth M. Parker, 2007). [[File:Deus sleeping.png|thumb|''Figure 2''. Motivational characteristic, sleep disturbance.]] === Cognitive Behavioral ^(spelling) Theory === Cognitive behavioral therapy is a type of psychological treatment. It has been evidently portrayed to be significantly effective when trying to treat a wide variety of conditions, disorders and mental illnesses, for example depression, anxiety disorders, alcohol and drug use problems, marital problems, eating disorders and severe mental illness (Kaplan, 2013). It converges on altering dysfunctional emotions, behaviors, and thoughts by cross examining gloomy or irrational beliefs. This therapy highly regards the idea that an individuals thoughts and insights encourages their behavior (Kaplan, 2013). Sleep disturbance and restlessness is a major motivational characteristic of hypomania experiences. Findings have indicated that both stimulus control and sleep restriction are highly persuasive and are often depicted through cognitive behavioral therapy. This further presents regularizing ^(spelling) bedtimes and rise times often are sufficient to bring about improvements in sleep (Kaplan, 2013). === Intrinsic motivation === Intrinsic motivation refers to the act of doing something knowing there may be no external rewards, this act may be driven out of interest or excitement (Locke, 2019). This act is out of choice, there is no pressure that comes along with it, no limits or rewards. Goals that are driven from intrinsic motivation often derive from within leaving the results to satisfy your basic psychological needs for autonomy, competence, and relatedness. An example of intrinsic motivation could be reading a book on holidays because you are interested in the storyline and it relaxes you, instead of reading a book for the reward of receiving a successful grade. A second example of intrinsic motivation could be learning French as a new language because you find it intriguing instead of learning it because your current job requires it (Locke, 2019). It has been hypothesised that those who experience increased creativity and hypomania do so because of an intrinsic motivation, this becomes evident in the peer reviewed article 'The link between hypomania risk and creativity: The role of heightened behavioral activation system (BAS) sensitivity' https://www.sciencedirect.com/science/article/abs/pii/S0165032716319668 (Na Kim, 2017). This study explored whether heightened behavioral activation system (BAS) sensitivity had any correlation to the relationship between bipolar/hypomania and creativity. The main goal of this study was to investigate the relationship between hypomania risk, BAS sensitivity and creativity (Na Kim, 2017). It was hypothesised that BAS sensitivity would be associated with creativity as well as hypomania risk and (hypo)manic symptoms. This study also investigated if BAS sensitivity mediated the correlation between hypomania risk and creativity to further examine the relationship. Universitiy students in South Korea were recruited for this study, 543 in total (Na Kim, 2017). The Hypomanic Personality Scale (HPS) was used to measure and further identify people at risk for (hypo)mania and bipolar. To measure individual differences the Behavioral Activation System (BAS) and the Adjective Checklist Creative Personality Scale was used. Results portrayed that hypomania risk indirectly enhances everyday creativity within an individual through BAS sensitivity. Results also depicted that the BAS-relevant personality trait, the tendency to set high aspiring goals, might give reason for the link between Bipolar and creativity (Na Kim, 2017). === Extrinsic motivation === Extrinsic motivation refers to behavior that is driven by external factors, this type of motivation arises from outside a person. It is an environmentally-created reason to engage in an action or activity (Locke, 2019). These external factors are often a reward or avoidance of negative outcomes such as money, fame and grades. People who experience hypomania episodes and bi polar disorder often set higher goals in laboratory tasks than other people, thus having a higher drive for these external factors (Locke, 2019). An example of extrinsic motivation could be; an army instructor barks orders and commands to get recruits’ immediate compliance, the recruits motivation is driven by the knowledge that if they do not comply immediate punishment will be rewarded, such as extra harsh physical training (Locke, 2019). Extrinsic motivation in relation to the motivational characteristic's of hypomania is depicted in the peer reviewed article 'Extreme Goal Setting and Vulnerability to Mania Among Undiagnosed Young Adults' https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2829854/ (Sheri L. John, 2006). This article explores whether persons vulnerable to disorders such as bi polar and episodes of hypomania and mania set elevated goals in their lives. This study depicts that people with bipolar disorder and others vulnerable to this disorder or other experiences such as hypomania and mania appear to set high goals and focus greatly on achievement (Sheri L. John, 2006). Two studies were conducted, both recruited a range of young adults that were studying at the University of Miami. Results portrayed that a scale of lifetime vulnerability to hypomania characteristics had a strong correlation to three types of high motivational goals, including popular fame, political influence, and financial success (Sheri L. John, 2006). == A significant motivational characteristic of hypomania- Caffeine ^(rephrase?) == Caffeine is a great contributor of hypomania episodes as it has strong relationship with the motivational characteristic of hypomania; sleep disturbance. Caffeine often disrupts bipolar patients sleep cycles, contributing to episodes of mania and hypomania (Young, 2020). For a long time now, professionals have been aware that bipolar patients are adversely affected by caffeine, they have stated that it created insomnia. Caffeine can be seen as a motivational characteristic of hypomania as it can help trigger or escalate a mania or hypomania episode (Young, 2020). A study that explores caffeine as a motivational characteristic of hypomania is 'The impact of caffeine consumption on clinical symptoms in patients with bipolar disorder: A systematic review' https://onlinelibrary-wiley-com.ezproxy.canberra.edu.au/doi/10.1111/bdi.12990 (Young, 2020). A systematic review was conducted to access the impact of this characteristic, PubMed, Embase and PsycINFO were searched, further analyzing and recording all data on individuals with bipolar and those who experience hypomania/mania (Young, 2020). The measure of caffeine was compared with illness severity holding symptoms of hypomania, mania, depression, psychosis, anxiety and sleep. 1678 records and studies were reviewed, including 10 case reports, 1 retrospective cohort study, 5 cross‐sectional studies, 1 interventional study (Young, 2020). Results portrayed that the findings of this study depict the relationship between the quantities of caffeine that individuals with bipolar consume and the severity of symptoms and motivational characteristics experienced. Results showed an acute increase in caffeine consumption encourages the occurrence of hypomanic episodes in patients with bipolar, affecting sleep patterns and further preceding other motivational characteristics of the condition such as; restlessness, nervousness, excitement, insomnia and rambling flow of thought and speech (Young, 2020). ==Quiz== Choose the correct answers and click "Submit": <quiz display="simple"> {Which of the following is not a type of motivation? |type="()"} - extrinsic motivation - intrinsic motivation - introjected motivation - identified regulation motivation +introverted regulation motivation {Which of the following is not a motivational characteristic of hypomania? |type="()"} - Confidence - Racing thoughts + Decreased appetite - Sleep disturbance - Talkativeness </quiz> ==Conclusion== Hypomania is a mood state that can be characterized by its abnormally revved-up state of mind that can influence an individual’s mood, thoughts, and behavior. It is important to treat hypomania as it can have negative, crucial long term effects. It can be concluded from the above research and studies that hypomania has many motivational characteristics such as; reduced need for sleep, confidence, aspiring goals, ill- temper, racing thoughts and many more (Liam Mason, 2012). Motivation of these motivational characteristics can have both extrinsic and intrinsic factors (Locke, 2019). High ambitious goals, high expectations, unstable self-esteem and caffeine can encourage to motivate the above characteristics. There is a range of theories and research that make this evident, some of these theories are; the reinforcement theory and Maslow's hierarchy of needs (Liam Mason, 2012). == References == Liam Mason, N. O. (2012). Better Than I Thought: Positive Evaluation Bias in Hypomania. ''US National Library of Medicine, 7''(10), 775-782. Locke, E. A. (2019). Intrinsic and extrinsic motivation: Time for expansion and clarification. ''American Physchological Association, 5''(4), 277-290. Na Kim, S.-M. (2017). The link between hypomania risk and creativity: The role of heightened behavioral activation system (BAS) sensitivity. ''Journal of Affective Disorders, 215'', 9-14. Sheri L. John, C. S. (2006). Extreme Goal Setting and Vulnerability to Mania Among Undiagnosed Young Adults. ''HHS Public Access, 30''(3), 377-395. Tai, R. P.‐G. (2011, October). Hypomanic Personality, Stability of Self‐Esteem and Response Styles to Negative Mood. ''Clinical Psychology & Psychotherapy, 18''(5), 397-410. Wikipedia. (2020). ''Maslow's hierarchy of needs''. Retrieved from Wikipedia. Wikipedia. (2020, November). ''Reinforcement theory''. Retrieved from Wikipedia: <nowiki>https://en.wikipedia.org/wiki/Reinforcement_theory</nowiki> Young, S. F. (2020). The impact of caffeine consumption on clinical symptoms in patients with bipolar disorder: A systematic review. ''Bipolar Disorders'', 367-382.{{Hanging indent|1= Goldberg, G. S. (2010, December ). Hypomania: hype or mania? ''Bipolar Disorders, 12''(8), 758-763. Kaplan, K. A. (2013). Behavioral treatment of insomnia in bipolar disorder. ''The American Journal of Psychiatry, 107''(17), 716-720. Kasey Stanton, D. W. (2018, Decemeber). Unique and Transdiagnostic Symptoms of Hypomania/Mania and Unipolar Depression. ''Clinical Psychological Science, 7''(3), 471-487. Kristy-Elizabeth M. Parker, N. F. (2007, August). The Impact of Reinforcement Sensitivity Theory on Aggressive Behavior. ''The Journal of Interpersonal Violence''. Kusumakar, V. D. (2009). Bipolar disorder: A clinician's guide to treatment management. In D. J. Bond, ''Bipolar disorder: A clinician's guide to treatment management'' (pp. 1-17). Routledge/Taylor & Francis Group. MD, J. T. (2015, June). Caffeine‐induced mania in a patient with caffeine use disorder: A case report. ''The American Journal of Addictions, 24''(4), 289-291. SarahTerriena, N. S. (2014, March). Theory of mind and hypomanic traits in general population. ''Psychiatry Research, 215''(3), 694-699. Shaw, D. M. (2017). Pharmacologic Treatment of Hypomania and Mania. ''Psychiatric Annals, 17''(5), 316-323. }} ==External links== https://www.sciencedirect.com/science/article/abs/pii/S0165032716319668 https://onlinelibrary-wiley-com.ezproxy.canberra.edu.au/doi/10.1111/bdi.12990 https://psycnet.apa.org/record/2018-46072-001 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2829854/ [[Category:{{#titleparts:{{PAGENAME}}|3}}]] [[Category:Motivation and emotion/Book/Motivation]] [[Category:Motivation and emotion/Book/Psychopathology]] l6iurrv4q8j5a243aytdxezfk1a96uq 2419436 2419430 2022-08-26T09:20:55Z Alec.cortez 2947555 /* Overview- */ wikitext text/x-wiki {{title|Hypomania and motivation:<br>What are the motivational characteristics of hypomania?}} {{MECR3|1=https://www.youtube.com/watch?v=0kkDtangp6A&feature=youtu.be}} __TOC__ ==Overview-== “What is hypomania?” Is a common question that many people query about in our world today. This question will be discussed throughout this chapter, bringing to life the motivational characteristics and psychological theoretical explanations that come along side of it. Knowing the answer to this question may be beneficial to you, or a loved one, now or in the future. It is important to treat hypomania as it can have negative, crucial long term effects, for example if you or a loved one experienced the motivational characteristic hypersexuality, it may result in sexually transmitted infections (Kusumakar, 2009). Hypomania can be defined as a mild form of mania characterized by elation and hyperactivity. Hypomania is a mood state that can be characterized by its abnormally revved-up state of mind that can influence an individual’s mood, thoughts, and behavior (Kusumakar, 2009). Throughout this book chapter you will discover and become familiar with what hypomania is, explore the motivational characteristics and the motivational theory and research behind these characteristics. {{RoundBoxTop|theme=1}}Case Study- Sarah is a 42-year-old married woman who has a long history of both depressive and hypomanic episodes. Across the years she has had{{gr}}multiple diagnoses including major depression, borderline personality disorder, and most recently, bipolar disorder. A review of symptoms indicated that she indeed have multiple episodes of depression beginning in her late teens, but that clear hypomanic episodes later emerged. Her elevated interpersonal conflict, hyper-sexuality and alcohol use during her hypomanic episodes led to the provisional borderline diagnosis, but in the context of her full history, bipolar disorder appears the best diagnosis. Sarah notes that she is not currently in a relationship and that she feels alienated from her family. She has been taking mood stabilizers for the last year, but continues to have low level symptoms of depression. In the past, she has gone off her medication multiple times, but at present she says she is “tired of being in trouble all the time” and wants to try individual psychotherapy. SYMPTOMS: Alcohol Use Depression Elevated Mood Impulsivity Mania/Hypomania Mood Cycles Risky Behaviors {{RoundBoxBottom}} {{RoundBoxTop|theme=7}}Focus questions 1. What is hypomania? 2. What are the motivational characteristic's of hypomania? 3. What are the motivational causations of hypomania? 4. What is motivation? 5. How do motivation theories and studies link to the motivational characteristics of hypomania? {{RoundBoxBottom}} ==What is hypomania? == Hypomania is often defined as a condition that is similar to mania; but less severe. Hypomania can be separated from mania as a condition as when as individual experiences hypomania there is no great functional impairment whereas, when an individual experiences mania, there is great potential for a significant functional impairment (Benazzi, 2017). The DSM-5{{ic|https://en.wikipedia.org/wiki/DSM-5}} criteria suggests that the typical hypomania period is four days or longer and that, on the days that hypomania is occurring, it is typical for the elevated mood to be portrayed the majority of time for this period (Benazzi, 2017). Hypomania is a feature of many disorders such as bipolar I and bipolar II, depression and also cyclothymia. When an individual is diagnosed with bipolar disorder, they often experience hypomanic as well as manic episodes. Cyclothymia, or sometimes called; cyclothymic disorder, is an uncommon mood disorder (Jonathan Savitz, 2008). An individual with cyclothymia may experience both depression and  emotional ups and downs that can affect their wellbeing but is not as severe as those in bipolar I or II disorder (Kusumakar, 2009). There is also a range of conditions that co-occur with bipolar disorder, hence may be experienced with hypomania, for example, anxiety disorders, eating disorders, heart disease, diabetes and obesity  (Kusumakar, 2009). {{RoundBoxTop|theme=6}} ;Personal quotes from Shelby Manoukian. "It’s racing thoughts, it’s tossing and turning in your bed. It’s ripping your room apart at 1 in the morning" "Hypomania feels like you are in a room full of people, and every single one of them is trying to communicate to you" "It’s like having 10,000 web browsers open at once" {{RoundBoxBottom}} === What are the motivational causes associated with hypomania? === Firstly^{(colloquial?)}, alcohol and substance abuse can be a motivational causation of hypomania, drug and alcohol use ^(repetition) can make hypomania symptoms more severe (Goldberg, 2010). Stimulant drugs can also be dangerous for people experiencing hypomania as they often exaggerate the negative motivational characteristics including elevated mood and decreased sleep needs. Secondly, another non-clinical motivational causation of hypomania is changes in an individual’s sleep patterns, whether it’s the case that the individual is sleeping too much, battling insomnia, or experiencing sleeplessness (Kusumakar, 2009). Thirdly, the intake of caffeine has been evidently proven to be a motivational causation of hypomania (MD, 2015). Individuals with disorders such as bipolar are a lot more delicate to any substance that imitates that of an amphetamine, it encourages high levels of dopamine in the brain, which then encourages restlessness and anxiety, and finally influencing hypomania or mania (MD, 2015). === What are the motivational characteristics of hypomania? === ''<u>Confidence:</u>'' when an individual experiences hypomania they may have an inflated self-esteem and regard themselves quite highly. An example of this could be, telling friends or family how great one is or asking for a pay raise in work even when it might not be granted (Stanton, 2018). ''<u>Decreased need for sleep:</u>'' this is when three hours of sleep may seem reasonable, influenced by uncontrolled restlessness (Goldberg, 2010). ''<u>Racing thoughts/ talkativeness:</u>'' an in individual in a hypomania episode may not be able to help but think about a million things at once, they may struggle to communicate with others as they may be talking to fast or jumping from one subject to the other (Stanton, 2018). ''<u>Overindulgent participation in pleasurable activities:</u>'' often during hypomania experiences an individual may be hypersexual or may take part in impulse activities such as spending excessive amount of money on a shopping spree. ''<u>Distractible/ill-tempered:</u>'' during a hypomanic episode, an individual may struggle to pay attention and to prioritize correctly. They may also have a shorter temper fuse than usual; belligerence may be experienced (Stanton, 2018). == What is motivation? == Motivation can be described as the reason behind the drive that initiates a person to behave the way that they do (Locke & Schattke, 2018). A persons motivation may be encouraged by outside forces (extrinsic motivation) or from within themselves (intrinsic motivation). Intrinsic motivation can be referred to as taking part in an activity because of want, interest and enjoyment where as extrinsic motivation can be referred to as taking part in an activity knowing previously there is potential to gain reward or avoid punishment or consequence (Locke & Schattke, 2018). === Reinforcement Theory of Motivation === The reinforcement theory of motivation was presented by BF Skinner along with his associates. This theory explores what happens to an individual when he/she takes some action. BF Skinner holds the belief that the external environment should be designed effectively and positively to further motivate. Positive reinforcement identifies that behaviours that are met with positive outcomes, for example rewards, hoping to encourage similar behaviour again (Wikipedia, 2020). A study that relates to this theory and encourages to explore the motivational characteristics of hypomania points out the differences in the neural processing of motivational information in individuals vulnerable to hypomania [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3474792/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3474792] (Liam Mason, 2012). This study recruited 49 right-handed individuals (male and female) that were studying at the University of Manchester. Three groups were formed, low, medium and high self reported hypomania traits, this was measured using the Hypomanic Personality Scale. Participants played a computerised card game, learning the reward possibilities of three different cues (Liam Mason, 2012). Responses were measured using the feedback-related negativity (FRN), an effective element presented in motivational outcome evaluation and reinforcement learning. The hypomania-prone group depicted results that showed reduced FRN for both outcomes (Liam Mason, 2012). This result was focused on rewards, consistent with recent electrophysiological evidence of hypersensitivity to sudden reward and clinical account that mania has a correlation to reward hypersensitivity. Results also depicted that the result of reduced FRN for losses intertwines with the reduced punishment sensitivity hypothesis of a range of disorders and may help to explain some of the motivational characteristics of hypomania, such as unrestrained spending sprees, substance use and unprotected sex (Liam Mason, 2012). === Maslow’s Need Hierarchy Theory of Motivation === Abraham Maslow (1908 - 1970) was a psychology professor, Maslow was the first professor to found the Humanistic Psychology discipline. It was in 1943 his paper "''A Theory of Human Motivation''" was published, where first portrayed his hierarchy motivation theory of needs. Maslow’s need hierarchy theory is a well known theory of motivation. Maslow's theory focuses on human needs (Wikipedia, 2020). Maslow identifies all human needs and further classifies them into a hierarchical manner from the lower to the higher order. The human needs were grouped into five categories; physiological, safety, social, esteem and self actualization needs. Maslow believed that if the lower needs on the hierarchy have not been met, a person will automatically try satisfy those needs before trying to satisfy those needs which are on top of the hierarchy (Wikipedia, 2020). A study that relates to this theory is the 'Hypomanic Personality, Stability of Self‐Esteem and Response Styles to Negative Mood' https://onlinelibrary-wiley-com.ezproxy.canberra.edu.au/doi/10.1002/cpp.780 (Tai, 2011). This study helps to explore the motivational characteristics of hypomania by bringing to life Maslow's need of esteem as the aim of the study is to depict the dysfunctional self‐schematic processes, abnormal coping styles and stability of self‐esteem in relation to subclinical hypomania (Tai, 2011). Three studies were conducted, the Hypomanic Personality Scale (HPS) was measured in study one, and the Dysfunctional Attitude Scale was measured in study two and three. One hundred and thirty‐six Manchester University students were recruited in the screening phase of the study, in the second phase, three groups of participants were invited to participate on the basis of their scores in the upper, lower and mid quintiles of the range of HPS scores (Tai, 2011). Participants were asked to complete a self esteem diary, they were asked to complete two Rosenberg (1965) scales each day for a period of 1 week at two separate times of the day. The second questionnaire for each day introduced a collection of life events and attributional questions, the participants were then asked to recall the most positive event and the most negative event they could remember happening each day. Results depicted that people with high hypomania scores portrayed greater fluctuations in self‐esteem than people with medium or low scores on the HPS (Tai, 2011). Results also showed that participants that scored high on both the HPS and the DAS were like to experience hypomania and bipolar symptoms (motivational characteristics). These participants also showed other indications of bipolar traits, in particular high levels of risk‐taking, rumination and negative affect. It was concluded in results of all studies that vulnerability to bipolar/hypomania symptoms and characteristics is robustly associated with unstable self‐esteem (Tai, 2011). == Hypomania motivational characteristics and motivation- Theoretical basis == A theoretical basis is crucial in understanding both the cause of hypomania and the motivational characteristics that surround it. Numerous theories have been offered to aid in justifying the motivational characteristics that are brought to life during a hypomania episode. === Theory of mind === The theory of mind explores the ability to comprehend your own mental wellbeing and the mental states of others around you and also the capacity to recognize those mental states of others that may diverge from your own (SarahTerriena, 2014). Another one’s state of mind may consist of their intentions, aspirations, emotions, knowledge, and principles. There are many benefits that surround this theory for example, it develops social skills, encourages problem/conflict solving and aids in rationally predicting the behaviour of those around us (SarahTerriena, 2014). During a hypomanic episode alteration of social relationship can be clarified by the impairment of the functioning of theory of mind. Scarcity in theory of mind could be a significant motivational characteristic marker of a hypomanic episode (SarahTerriena, 2014).    === '''Reinforcement Sensitivity Theory''' === The reinforcement sensitivity theory offers three brain-behavioral systems. These brain-behavioral systems motivate individual differences in sensitivity to three factors; reward, punishment, and motivation (Kasey Stanton, 2018). The reinforcement sensitivity theory has been depicted to analyze and forecast anxiety, impulsivity, and extraversion (Kristy-Elizabeth M. Parker, 2007). As discussed above, when an individual experiences hypomania, along with many of the motivational characteristics, distractible/ill-tempered is a significant factor often. This may involve the individual having a shorter temper fuse and becoming aggressive easily (Kasey Stanton, 2018). The reinforcement sensitivity theory in relation to this motivational characteristic depicts that upbeat and involuntary aggression experienced by an individual is motivated by a sequence of anxiety and rapid, approach-motivational personality traits (Kristy-Elizabeth M. Parker, 2007). [[File:Deus sleeping.png|thumb|''Figure 2''. Motivational characteristic, sleep disturbance.]] === Cognitive Behavioral ^(spelling) Theory === Cognitive behavioral therapy is a type of psychological treatment. It has been evidently portrayed to be significantly effective when trying to treat a wide variety of conditions, disorders and mental illnesses, for example depression, anxiety disorders, alcohol and drug use problems, marital problems, eating disorders and severe mental illness (Kaplan, 2013). It converges on altering dysfunctional emotions, behaviors, and thoughts by cross examining gloomy or irrational beliefs. This therapy highly regards the idea that an individuals thoughts and insights encourages their behavior (Kaplan, 2013). Sleep disturbance and restlessness is a major motivational characteristic of hypomania experiences. Findings have indicated that both stimulus control and sleep restriction are highly persuasive and are often depicted through cognitive behavioral therapy. This further presents regularizing ^(spelling) bedtimes and rise times often are sufficient to bring about improvements in sleep (Kaplan, 2013). === Intrinsic motivation === Intrinsic motivation refers to the act of doing something knowing there may be no external rewards, this act may be driven out of interest or excitement (Locke, 2019). This act is out of choice, there is no pressure that comes along with it, no limits or rewards. Goals that are driven from intrinsic motivation often derive from within leaving the results to satisfy your basic psychological needs for autonomy, competence, and relatedness. An example of intrinsic motivation could be reading a book on holidays because you are interested in the storyline and it relaxes you, instead of reading a book for the reward of receiving a successful grade. A second example of intrinsic motivation could be learning French as a new language because you find it intriguing instead of learning it because your current job requires it (Locke, 2019). It has been hypothesised that those who experience increased creativity and hypomania do so because of an intrinsic motivation, this becomes evident in the peer reviewed article 'The link between hypomania risk and creativity: The role of heightened behavioral activation system (BAS) sensitivity' https://www.sciencedirect.com/science/article/abs/pii/S0165032716319668 (Na Kim, 2017). This study explored whether heightened behavioral activation system (BAS) sensitivity had any correlation to the relationship between bipolar/hypomania and creativity. The main goal of this study was to investigate the relationship between hypomania risk, BAS sensitivity and creativity (Na Kim, 2017). It was hypothesised that BAS sensitivity would be associated with creativity as well as hypomania risk and (hypo)manic symptoms. This study also investigated if BAS sensitivity mediated the correlation between hypomania risk and creativity to further examine the relationship. Universitiy students in South Korea were recruited for this study, 543 in total (Na Kim, 2017). The Hypomanic Personality Scale (HPS) was used to measure and further identify people at risk for (hypo)mania and bipolar. To measure individual differences the Behavioral Activation System (BAS) and the Adjective Checklist Creative Personality Scale was used. Results portrayed that hypomania risk indirectly enhances everyday creativity within an individual through BAS sensitivity. Results also depicted that the BAS-relevant personality trait, the tendency to set high aspiring goals, might give reason for the link between Bipolar and creativity (Na Kim, 2017). === Extrinsic motivation === Extrinsic motivation refers to behavior that is driven by external factors, this type of motivation arises from outside a person. It is an environmentally-created reason to engage in an action or activity (Locke, 2019). These external factors are often a reward or avoidance of negative outcomes such as money, fame and grades. People who experience hypomania episodes and bi polar disorder often set higher goals in laboratory tasks than other people, thus having a higher drive for these external factors (Locke, 2019). An example of extrinsic motivation could be; an army instructor barks orders and commands to get recruits’ immediate compliance, the recruits motivation is driven by the knowledge that if they do not comply immediate punishment will be rewarded, such as extra harsh physical training (Locke, 2019). Extrinsic motivation in relation to the motivational characteristic's of hypomania is depicted in the peer reviewed article 'Extreme Goal Setting and Vulnerability to Mania Among Undiagnosed Young Adults' https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2829854/ (Sheri L. John, 2006). This article explores whether persons vulnerable to disorders such as bi polar and episodes of hypomania and mania set elevated goals in their lives. This study depicts that people with bipolar disorder and others vulnerable to this disorder or other experiences such as hypomania and mania appear to set high goals and focus greatly on achievement (Sheri L. John, 2006). Two studies were conducted, both recruited a range of young adults that were studying at the University of Miami. Results portrayed that a scale of lifetime vulnerability to hypomania characteristics had a strong correlation to three types of high motivational goals, including popular fame, political influence, and financial success (Sheri L. John, 2006). == A significant motivational characteristic of hypomania- Caffeine ^(rephrase?) == Caffeine is a great contributor of hypomania episodes as it has strong relationship with the motivational characteristic of hypomania; sleep disturbance. Caffeine often disrupts bipolar patients sleep cycles, contributing to episodes of mania and hypomania (Young, 2020). For a long time now, professionals have been aware that bipolar patients are adversely affected by caffeine, they have stated that it created insomnia. Caffeine can be seen as a motivational characteristic of hypomania as it can help trigger or escalate a mania or hypomania episode (Young, 2020). A study that explores caffeine as a motivational characteristic of hypomania is 'The impact of caffeine consumption on clinical symptoms in patients with bipolar disorder: A systematic review' https://onlinelibrary-wiley-com.ezproxy.canberra.edu.au/doi/10.1111/bdi.12990 (Young, 2020). A systematic review was conducted to access the impact of this characteristic, PubMed, Embase and PsycINFO were searched, further analyzing and recording all data on individuals with bipolar and those who experience hypomania/mania (Young, 2020). The measure of caffeine was compared with illness severity holding symptoms of hypomania, mania, depression, psychosis, anxiety and sleep. 1678 records and studies were reviewed, including 10 case reports, 1 retrospective cohort study, 5 cross‐sectional studies, 1 interventional study (Young, 2020). Results portrayed that the findings of this study depict the relationship between the quantities of caffeine that individuals with bipolar consume and the severity of symptoms and motivational characteristics experienced. Results showed an acute increase in caffeine consumption encourages the occurrence of hypomanic episodes in patients with bipolar, affecting sleep patterns and further preceding other motivational characteristics of the condition such as; restlessness, nervousness, excitement, insomnia and rambling flow of thought and speech (Young, 2020). ==Quiz== Choose the correct answers and click "Submit": <quiz display="simple"> {Which of the following is not a type of motivation? |type="()"} - extrinsic motivation - intrinsic motivation - introjected motivation - identified regulation motivation +introverted regulation motivation {Which of the following is not a motivational characteristic of hypomania? |type="()"} - Confidence - Racing thoughts + Decreased appetite - Sleep disturbance - Talkativeness </quiz> ==Conclusion== Hypomania is a mood state that can be characterized by its abnormally revved-up state of mind that can influence an individual’s mood, thoughts, and behavior. It is important to treat hypomania as it can have negative, crucial long term effects. It can be concluded from the above research and studies that hypomania has many motivational characteristics such as; reduced need for sleep, confidence, aspiring goals, ill- temper, racing thoughts and many more (Liam Mason, 2012). Motivation of these motivational characteristics can have both extrinsic and intrinsic factors (Locke, 2019). High ambitious goals, high expectations, unstable self-esteem and caffeine can encourage to motivate the above characteristics. There is a range of theories and research that make this evident, some of these theories are; the reinforcement theory and Maslow's hierarchy of needs (Liam Mason, 2012). == References == Liam Mason, N. O. (2012). Better Than I Thought: Positive Evaluation Bias in Hypomania. ''US National Library of Medicine, 7''(10), 775-782. Locke, E. A. (2019). Intrinsic and extrinsic motivation: Time for expansion and clarification. ''American Physchological Association, 5''(4), 277-290. Na Kim, S.-M. (2017). The link between hypomania risk and creativity: The role of heightened behavioral activation system (BAS) sensitivity. ''Journal of Affective Disorders, 215'', 9-14. Sheri L. John, C. S. (2006). Extreme Goal Setting and Vulnerability to Mania Among Undiagnosed Young Adults. ''HHS Public Access, 30''(3), 377-395. Tai, R. P.‐G. (2011, October). Hypomanic Personality, Stability of Self‐Esteem and Response Styles to Negative Mood. ''Clinical Psychology & Psychotherapy, 18''(5), 397-410. Wikipedia. (2020). ''Maslow's hierarchy of needs''. Retrieved from Wikipedia. Wikipedia. (2020, November). ''Reinforcement theory''. Retrieved from Wikipedia: <nowiki>https://en.wikipedia.org/wiki/Reinforcement_theory</nowiki> Young, S. F. (2020). The impact of caffeine consumption on clinical symptoms in patients with bipolar disorder: A systematic review. ''Bipolar Disorders'', 367-382.{{Hanging indent|1= Goldberg, G. S. (2010, December ). Hypomania: hype or mania? ''Bipolar Disorders, 12''(8), 758-763. Kaplan, K. A. (2013). Behavioral treatment of insomnia in bipolar disorder. ''The American Journal of Psychiatry, 107''(17), 716-720. Kasey Stanton, D. W. (2018, Decemeber). Unique and Transdiagnostic Symptoms of Hypomania/Mania and Unipolar Depression. ''Clinical Psychological Science, 7''(3), 471-487. Kristy-Elizabeth M. Parker, N. F. (2007, August). The Impact of Reinforcement Sensitivity Theory on Aggressive Behavior. ''The Journal of Interpersonal Violence''. Kusumakar, V. D. (2009). Bipolar disorder: A clinician's guide to treatment management. In D. J. Bond, ''Bipolar disorder: A clinician's guide to treatment management'' (pp. 1-17). Routledge/Taylor & Francis Group. MD, J. T. (2015, June). Caffeine‐induced mania in a patient with caffeine use disorder: A case report. ''The American Journal of Addictions, 24''(4), 289-291. SarahTerriena, N. S. (2014, March). Theory of mind and hypomanic traits in general population. ''Psychiatry Research, 215''(3), 694-699. Shaw, D. M. (2017). Pharmacologic Treatment of Hypomania and Mania. ''Psychiatric Annals, 17''(5), 316-323. }} ==External links== https://www.sciencedirect.com/science/article/abs/pii/S0165032716319668 https://onlinelibrary-wiley-com.ezproxy.canberra.edu.au/doi/10.1111/bdi.12990 https://psycnet.apa.org/record/2018-46072-001 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2829854/ [[Category:{{#titleparts:{{PAGENAME}}|3}}]] [[Category:Motivation and emotion/Book/Motivation]] [[Category:Motivation and emotion/Book/Psychopathology]] 6tffsokkhuc19nsi7fcjl1m9xmk43a0 0 266883 2419208 2418288 2022-08-26T02:43:42Z WUser1307 2948261 /* Application of ERG theory */ wikitext text/x-wiki ----</noinclude>{{title|ERG Theory; What is Alderfer's ERG theory?}}{{MECR3|https://yourlinkgoeshere.com}} == Overview == The ERG model was created by Clayton Alderfer and was based on [[What Matters/Maslow’s Hierarchy of Needs|Maslow's Hierarchy of Needs.]] This model stands for Existence, Relatedness and Growth, It is a three factor model based on the theory of motivation. Alderfer's ERG theory explains that individuals can be motivated by multiple levels of need at the same time, and that the level the level which is most important to them can change over time. These levels of motivation can move upwards or downwards at anytime making the individuals priorities fluid. {{RoundBoxTop|theme=3}} '''Focus questions:''' * What are the three components to the ERG theory? * How can this theory be used? * How does this theory affect motivation? {{RoundBoxBottom}}{{tip|Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Provide an example or case study. * Conclude with Focus questions to guide the chapter.}} [[File:Alderfer's ERG Theory.svg|thumb|Figure 1. Alderfer's ERG Theory]] == Main headings == '''What are the three tiers of the ERG theory?''' Similar to Maslows Heirarch of Needs, the ERG theory suggests that a person has three main core groups of needs. As with life, these needs shift and change over depending on priorities and life in general. The first level is Existence and is categorised as a physiological need, also refered to as existence need. This entails categories such as food, water, shelter, and feeling safe. If you are unable to satisfy your existence needs then you are unable to move forward and reach your higher needs. For example, if you do not have enough food and don't have access to source any, then your life is in immediate peril and sourcing food will occupy most of your thoughts, at the expense of almost all of your other needs. The second level is Relatedness and refers to our need to relate to other people and develop relationships. While it is not a survival need, human needs good relationships and interactions in order to be happy and content. The third level is Growth and refers to our need of personal development, to be creative and perform meaningful work. This growth allows us to explore our day to day lives to see what potential may be in our environment. [[File:Maslow hierarchy of needs.jpg|thumb|Maslow's Hierarchy ]] '''What is Frustration-Regression Principle?''' The ERG theory proposes that if a higher level need is not satisfied, a person may regress backwards to a lower level in order to fulfil their lower needs first. For example, if an ambitious employee is not given growth opportunities or duties which utilise their knowledge and skillset, then their motivation will drop. This will result in them becoming frustrated and focusing on their relatedness goals instead, which would involve forming relationships with other colleagues and socialising with the team more. '''How to apply The ERG theory in real life scenarios''' Application of ERG theory There are many applications that ERG theory has been applied too. Development (Arnolds & Boshoff, 2002; Poulou & Norwich, 2019) Job performance/productivity (Arnolds & Boshoff, 2002; Caulton, 2012) Travel (Bláfoss Ingvardson et al., 2020) Leadership (Sosik et al., 2013) === Case studies === A study conducted in 2019 analysed the motivation factor under The ERG Theory. The study used university students to see what motivated them to participate during events. Results indicated that between existence, growth, and relatedness, using growth as motivation was the most successful method in getting the students to participate. Similarly, a 2012 study looked into job satisfaction and how to identify incentives in the work place. Their data revealed that extrinsic values are the primary influencer of human needs. === Quizzes === Let's test your knowledge! Choose the correct answers and click "Submit":<quiz display="simple"> {What does the R in the ERG Theory, stand for? |type="()"} + Relatable - Relatedness {What is the ERG theory based on?: |type="()"} - Needs + Desires </quiz>{{RoundBoxTop|theme=3}} Take home messages * {{RoundBoxBottom}} == Conclusion == The Conclusion is arguably the most important section. It should be possible for someone to read the [[User:WUser1307#Overview|Overview]] and the Conclusion and still get a good idea of the topic.{{tip|Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages?}} * == References == List the cited references in [[wikipedia:APA style|APA style]] (7th ed.) or [[wikipedia:Wikipedia:Citing sources|wiki style]]. APA style example: Har, C.O. (2018). A CASE STUDY OF ALDERFERS’ THEORY OF MOTIVATION ON COLLEGE STUDENTS VOLUNTEERING IN EVENTS. https://nfct.co.uk/wp-content/uploads/journal/published_paper/volume-3/issue-3/eJYQc2F6.pdf {{Hanging indent|Blair, R. J. R. (2004). The roles of orbital frontal cortex in the modulation of antisocial behavior. ''Brain and Cognition'', ''55''(1), 198–208. https://doi.org/10.1016/S0278-2626(03)00276-8 Buckholtz, J. W., & Meyer-Lindenberg, A. (2008). MAOA and the neurogenetic architecture of human aggression. ''Trends in Neurosciences'', ''31''(3), 120–129. https://doi.org/10.1016/j.tins.2007.12.006 Eckardt, M., File, S., Gessa, G., Grant, K., Guerri, C., Hoffman, P., & Tabakoff, B. (1998). Effects of moderate alcohol consumption on the central nervous system. ''Alcoholism, Clinical and Experimental Research'', ''22''(5), 998–1040. https://doi.org/10.1111/j.1530-0277.1998.tb03695.x}}https://worldofwork.io/2019/02/alderfers-erg-theory-of-motivation/ == External links == *[[Motivation and emotion/Book/2011/Social needs|Basic Social Needs]] (Wikiversity, 2011) * [[Motivation and emotion/Book/2022/Physiological needs|Physiological Needs]] (Wikiversity 2022) * [[Motivation and emotion/Lectures/Psychological needs and implicit motives|Psychological Needs and Implicit Motivations]] (Wikiversity, 2021) * [[Motivation and emotion/Book/2022/Psychological distress|Psychological Stress]] (Book Chapter, 2022) * [[Motivation and emotion/Book/2022/Reward system, motivation, and emotion|Reward System, Motivation, and Emotion]] (Book Chapter, 2022) * [[Motivation and emotion/Textbook/Motivation/Self-actualisation#Maslow Hierarchy of needs and ERG theory of motivational forces in organisations|Self Actualisation]] (Wikiversity, 2021) __TOC__ ==References== {{Hanging indent|1= Alderfer, C. P., Kaplan, R. E., & Smith, K. K. (1974). The effect of variations in relatedness need satisfaction on relatedness desires. ''Administrative Science Quarterly, 19''(4), 507–532. https://doi-org.ezproxy.canberra.edu.au/10.2307/2391808 Arnolds, C. A., & Boshoff, C. (2002). Compensation, esteem valence and job performance: An empirical assessment of Alderfer’s ERG theory. ''The International Journal of Human Resource Management, 13''(4), 697–719. https://doi-org.ezproxy.canberra.edu.au/10.1080/09585190210125868 Bláfoss Ingvardson, J., Kaplan, S., de Abreu e Silva, J., di Ciommo, F., Shiftan, Y., & Nielsen, O. (2020). Existence, relatedness and growth needs as mediators between mode choice and travel satisfaction: evidence from Denmark. ''Transportation (Dordrecht), 47''(1), 337–358. https://doi.org/10.1007/s11116-018-9886-3 Caulton, J. R. (2012). The development and use of the theory of ERG: A literature review. ''Emerging Leadership Journeys, 5''(1), 2-8. David Snow. (2019). The Big Picture: How the New Use of an Old Theory will Enhance Leaders’ Perspective on Management. ''The Journal of Applied Business and Economics, 21''(1), 117–130. https://doi.org/10.33423/jabe.v21i1.662 Poulou, M., & Norwich, B. (2019). Adolescent students’ psychological needs: Development of an existence, relatedness, and growth needs scale. ''International Journal of School & Educational Psychology: IJSEP Supplemental Issue 2019, 7''(sup1), 75–83. https://doi.org/10.1080/21683603.2018.1479320 Sosik, J. J., Chun, J. U., Blair, A. L., & Fitzgerald, N. A. (2013). Possible selves in the lives of transformational faith community leaders. ''Psychology of Religion and Spirituality, 5''(4), 283–293. https://doi-org.ezproxy.canberra.edu.au/10.1037/a0032646}} * [[Category:{{#titleparts:{{PAGENAME}}|3}}]] [[Category:Motivation and emotion/Book/Motivation]] [[Category:Motivation and emotion/Book/Needs/Psychological]] 4gglfz5sm5qe8qw95ist1zpsyglwvwl 2419310 2419208 2022-08-26T05:33:47Z WUser1307 2948261 wikitext text/x-wiki ----</noinclude>{{title|ERG Theory; What is Alderfer's ERG theory?}}{{MECR3|https://yourlinkgoeshere.com}} == Overview == The ERG model was created by Clayton Alderfer and was based on [[What Matters/Maslow’s Hierarchy of Needs|Maslow's Hierarchy of Needs.]] This model stands for Existence, Relatedness and Growth, It is a three factor model based on the theory of motivation. Alderfer's ERG theory explains that individuals can be motivated by multiple levels of need at the same time, and that the level the level which is most important to them can change over time. These levels of motivation can move upwards or downwards at anytime making the individuals priorities fluid. {{RoundBoxTop|theme=3}} '''Focus questions:''' * What are the three components to the ERG theory? * How can this theory be used? * How does this theory affect motivation? {{RoundBoxBottom}}{{tip|Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Provide an example or case study. * Conclude with Focus questions to guide the chapter.}} [[File:Alderfer's ERG Theory.svg|thumb|Figure 1. Alderfer's ERG Theory]] == Main headings == '''What are the three tiers of the ERG theory?''' Similar to Maslows Heirarch of Needs, the ERG theory suggests that a person has three main core groups of needs. As with life, these needs shift and change over depending on priorities and life in general. The first level is Existence and is categorised as a physiological need, also refered to as existence need. This entails categories such as food, water, shelter, and feeling safe. If you are unable to satisfy your existence needs then you are unable to move forward and reach your higher needs. For example, if you do not have enough food and don't have access to source any, then your life is in immediate peril and sourcing food will occupy most of your thoughts, at the expense of almost all of your other needs. The second level is Relatedness and refers to our need to relate to other people and develop relationships. While it is not a survival need, human needs good relationships and interactions in order to be happy and content. The third level is Growth and refers to our need of personal development, to be creative and perform meaningful work. This growth allows us to explore our day to day lives to see what potential may be in our environment. [[File:Maslow hierarchy of needs.jpg|thumb|Maslow's Hierarchy ]] '''What is Frustration-Regression Principle?''' The ERG theory proposes that if a higher level need is not satisfied, a person may regress backwards to a lower level in order to fulfil their lower needs first. For example, if an ambitious employee is not given growth opportunities or duties which utilise their knowledge and skillset, then their motivation will drop. This will result in them becoming frustrated and focusing on their relatedness goals instead, which would involve forming relationships with other colleagues and socialising with the team more. '''How to apply The ERG theory in real life scenarios''' Application of ERG theory There are many applications that ERG theory has been applied too. Development (Arnolds & Boshoff, 2002; Poulou & Norwich, 2019) Job performance/productivity (Arnolds & Boshoff, 2002; Caulton, 2012) Travel (Bláfoss Ingvardson et al., 2020) Leadership (Sosik et al., 2013) '''Psychological Science behind the ERG theory''' === Case studies === A study conducted in 2019 analysed the motivation factor under The ERG Theory. The study used university students to see what motivated them to participate during events. Results indicated that between existence, growth, and relatedness, using growth as motivation was the most successful method in getting the students to participate. Similarly, a 2012 study looked into job satisfaction and how to identify incentives in the work place. Their data revealed that extrinsic values are the primary influencer of human needs. === Quizzes === Let's test your knowledge! Choose the correct answers and click "Submit":<quiz display="simple"> {What does the R in the ERG Theory, stand for? |type="()"} + Relatable - Relatedness {What is the ERG theory based on?: |type="()"} - Needs + Desires </quiz>{{RoundBoxTop|theme=3}} Take home messages * {{RoundBoxBottom}} == Conclusion == The Conclusion is arguably the most important section. It should be possible for someone to read the [[User:WUser1307#Overview|Overview]] and the Conclusion and still get a good idea of the topic.{{tip|Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages?}} * == References == List the cited references in [[wikipedia:APA style|APA style]] (7th ed.) or [[wikipedia:Wikipedia:Citing sources|wiki style]]. APA style example: Har, C.O. (2018). A CASE STUDY OF ALDERFERS’ THEORY OF MOTIVATION ON COLLEGE STUDENTS VOLUNTEERING IN EVENTS. https://nfct.co.uk/wp-content/uploads/journal/published_paper/volume-3/issue-3/eJYQc2F6.pdf {{Hanging indent|Blair, R. J. R. (2004). The roles of orbital frontal cortex in the modulation of antisocial behavior. ''Brain and Cognition'', ''55''(1), 198–208. https://doi.org/10.1016/S0278-2626(03)00276-8 Buckholtz, J. W., & Meyer-Lindenberg, A. (2008). MAOA and the neurogenetic architecture of human aggression. ''Trends in Neurosciences'', ''31''(3), 120–129. https://doi.org/10.1016/j.tins.2007.12.006 Eckardt, M., File, S., Gessa, G., Grant, K., Guerri, C., Hoffman, P., & Tabakoff, B. (1998). Effects of moderate alcohol consumption on the central nervous system. ''Alcoholism, Clinical and Experimental Research'', ''22''(5), 998–1040. https://doi.org/10.1111/j.1530-0277.1998.tb03695.x}}https://worldofwork.io/2019/02/alderfers-erg-theory-of-motivation/ == External links == *[[Motivation and emotion/Book/2011/Social needs|Basic Social Needs]] (Wikiversity, 2011) * [[Motivation and emotion/Book/2022/Physiological needs|Physiological Needs]] (Wikiversity 2022) * [[Motivation and emotion/Lectures/Psychological needs and implicit motives|Psychological Needs and Implicit Motivations]] (Wikiversity, 2021) * [[Motivation and emotion/Book/2022/Psychological distress|Psychological Stress]] (Book Chapter, 2022) * [[Motivation and emotion/Book/2022/Reward system, motivation, and emotion|Reward System, Motivation, and Emotion]] (Book Chapter, 2022) * [[Motivation and emotion/Textbook/Motivation/Self-actualisation#Maslow Hierarchy of needs and ERG theory of motivational forces in organisations|Self Actualisation]] (Wikiversity, 2021) __TOC__ ==References== {{Hanging indent|1= Alderfer, C. P., Kaplan, R. E., & Smith, K. K. (1974). The effect of variations in relatedness need satisfaction on relatedness desires. ''Administrative Science Quarterly, 19''(4), 507–532. https://doi-org.ezproxy.canberra.edu.au/10.2307/2391808 Arnolds, C. A., & Boshoff, C. (2002). Compensation, esteem valence and job performance: An empirical assessment of Alderfer’s ERG theory. ''The International Journal of Human Resource Management, 13''(4), 697–719. https://doi-org.ezproxy.canberra.edu.au/10.1080/09585190210125868 Bláfoss Ingvardson, J., Kaplan, S., de Abreu e Silva, J., di Ciommo, F., Shiftan, Y., & Nielsen, O. (2020). Existence, relatedness and growth needs as mediators between mode choice and travel satisfaction: evidence from Denmark. ''Transportation (Dordrecht), 47''(1), 337–358. https://doi.org/10.1007/s11116-018-9886-3 Caulton, J. R. (2012). The development and use of the theory of ERG: A literature review. ''Emerging Leadership Journeys, 5''(1), 2-8. David Snow. (2019). The Big Picture: How the New Use of an Old Theory will Enhance Leaders’ Perspective on Management. ''The Journal of Applied Business and Economics, 21''(1), 117–130. https://doi.org/10.33423/jabe.v21i1.662 Poulou, M., & Norwich, B. (2019). Adolescent students’ psychological needs: Development of an existence, relatedness, and growth needs scale. ''International Journal of School & Educational Psychology: IJSEP Supplemental Issue 2019, 7''(sup1), 75–83. https://doi.org/10.1080/21683603.2018.1479320 Sosik, J. J., Chun, J. U., Blair, A. L., & Fitzgerald, N. A. (2013). Possible selves in the lives of transformational faith community leaders. ''Psychology of Religion and Spirituality, 5''(4), 283–293. https://doi-org.ezproxy.canberra.edu.au/10.1037/a0032646}} * [[Category:{{#titleparts:{{PAGENAME}}|3}}]] [[Category:Motivation and emotion/Book/Motivation]] [[Category:Motivation and emotion/Book/Needs/Psychological]] nr73jp90s277sfohj2n2vsm76mo4c49 0 267282 2419327 2336573 2022-08-26T06:25:49Z 2001:8003:1D93:6900:F935:74C:FFD5:730 added colon wikitext text/x-wiki {{title|Action identification theory:<br>What is it and how can it be applied?}} {{MECR3|1=https://youtu.be/veSzkP4Iu8w}} __TOC__ ==Overview== If you were to be asked, "What are you doing right now?", what would your response be? Reading a book? Learning about ways to improve your motivational life? Killing some time? Looking at a screen? As individuals, we all have different ways of identifying the same act of reading a book (see ''Figure 1.''), and this applies to virtually all identifiable actions (Mange, Senemeaud and Michinov, 2013). [[File:George Handley (44107812914).jpg|thumb|''Figure 1.'' A person reading a book. |center]] This realm of possibility with regards to action identification is the basis of the theory by the same name. Action Identification Theory (AIT) posits that while there are a variety of possible identifications for a particular action, they can be consistently organised into a hierarchy of lower versus higher level identities (Vallacher & Wenger, 1987). Despite there being many different interpretations of an action, people are able to know what they have done, what they are doing and what they intend to do. How this occurs is also a focus of AIT, which provides an understanding of why people are motivated to perform certain actions as it relates to the identit(ies){{gr}} that they give to them. {{RoundBoxTop|theme=11}} '''Focus questions:''' * What is Action Identification Theory? * What are the Levels of Identification? * What are the three Principles of Action Identification Theory? * What are some potential applications of Action Identification Theory? {{RoundBoxBottom}} ==What is AIT?== Humans are attuned to actions and are able to easily and quickly identify them on the basis of minimal motion cues (Kozak, Marsh & Wegner, 2006). AIT provides a connection between the little things we do and the larger meanings we have in mind. The theory extends to topics beyond mental control to personality, self-concept, social influence and conflict resolution. It was influenced by several other theories from the time, such as [[wikipedia:Cybernetics|cybernetic models of action]] and unitization in behaviour perception. The fundamental question of: 'What is an action?' can be identified in many ways (Vallacher & Wegner, 2012). {{RoundBoxTop|theme=11}} ;Example 1 Driving to work can be identified as: operating a vehicle, moving through the city, attending work, or performing a routine. {{RoundBoxBottom}} The ambiguity of action interpretation is the basis of this theory, which strives to understand the relationship between mind and action. ===Levels of identification=== The mind is designed to identify or create patterns in the world, and actions accumulate meaning because we impose patterns on specific behaviours (Vallacher & Wegner, 2012). The way to find a consistent metric by which to judge action identification is by viewing the identities in a hierarchal manner. Whether a particular identity is considered high or low depends on the identity with which it is compared against (Vallacher & Wegner, 1989). {{RoundBoxTop|theme=11}}A is higher if A is achieved by doing B. {{RoundBoxBottom}} ==== Lower-level identification ==== Lower-level identities in the hierarchy specify how the action is performed (McIntyre et al., 2004). This includes the details and specifics of an action, which are generally attributable to motor skills (Vallacher & Wegner, 2012). Additionally, low-level identifiers have been found to have less flexibility and higher impulsivity. ==== Higher-level identification ==== Higher-level actions can be performed by doing a lower-level action, but not vice-versa (McIntyre et al., 2004). This is how the identities are defined; if one action leads to the completion of another, the latter is a higher-level identity and the former is lower. Lower-level identification is specific but the higher-levels provide an overview of the action: why, what its implications are. In essence, the higher levels provide meaning to the behaviour. {{RoundBoxTop|theme=11}} ;Case Study 1 Jacob Speil is a 28 year old man who drives his car to work. In the morning he wakes up, gets out of bed, brushes his teeth, takes a shower, changes into his work clothes, makes himself breakfast, eats breakfast, gets into his car, takes the shortest route to his workplace for a large pharmaceutical company, parks his car, works all day, then drives his car back home. Jacob Speil is a 28 year old man who drives his car to work. He values following a routine, as it is a healthy and essential practice for achieving efficiency. He works for a large pharmaceutical company where he hopes to work hard enough to one day buy his mother a house. He diligently attends work every day and works hard to secure his future. Which of these two identifications of Jacob's day is low-level and which is high-level? {{RoundBoxBottom}} ==== Level-indeterminate ==== Some act identities are not hierarchal and therefore have a level-indeterminate relation to one another. For example, "being rude" and "being constructive" are both higher-level identities for "criticising someone", however they do not share an obvious hierarchal relationship. Factor analysis helps to narrow down the different identities into manageable hierarchies based on the strength of loadings for each identity (Vallacher & Wegner, 2012). {{RoundBoxTop|theme=11}} ;Example 2 A cricket player may be playing a match of cricket in order to "demonstrate his cricket prowess". Upon performing poorly as a batsman, he might change the identity to a lower, "demonstrating his bowling prowess", and upon performing poorly in his first over as a bowler, he may move to an even lower-level identity of "pitching the ball in line with the wicket". After successfully completing an over, he may once again move to the higher-level identity of "demonstrating his bowling prowess", and after further successes, eventually to "demonstrating his cricket prowess". {{RoundBoxBottom}} == Theoretical principles == After understanding that actions can have multiple hierarchal identities, the natural query is, how do individuals pick one level over another to identify their current, past and future actions? Additionally, once an action is identified, what factors influence its maintenance, or alternatively, its re-identification? To answer these core questions and others, Vallacher and Wegner (2012) proposed three theoretical principles which moderate these identifications: Table 1. ''The three theoretical principles of Action Identification Theory.'' {| class="wikitable" ! No. ! Principle |- | One | Action is maintained with respect to its prepotent identity |- | Two | When both a lower- and a higher-level act identity are available, there is a tendency for the higher-level identity to become prepotent |- | Three | When an action cannot be performed in terms of its prepotent identity, there is a tendency for a lower level identity to become prepotent |} === Principle One === Principle One states that the prepotent identity, or the prominent identity, dictates the maintenance of the action. This means that the identity provides a frame of reference for performing the action, a criterion to assess how well the action has been performed, and functions as an intention to initiate an action. This makes the prepotent identity wholly responsible for all aspects of the action, and because actions can be identified at different levels, the implication is that people can maintain action at different levels.{{fact}}{{example}} {{RoundBoxTop|theme=11}} The key word for Principle 1 is Governance, because the prepotent identity governs all other aspects of the action. {{RoundBoxBottom}} === Principle Two === Principle Two states that when there is an option between a lower- and a higher-level act identity, people tend to make the higher-level identity prepotent. This principle essentially argues that people tend to apply broader effects and meanings to their actions, which is an idea that has been suggested before by different schools of thought such as [[wikipedia:Gestalt_psychology|Gestalt]] psychology. This principle enables people to adopt one of many plausible identities, which in turn motivates them to take action. Without the ability to distinguish and choose, people would waste their time entertaining a multitude of different possible identities in a given situation.{{fact}}{{example}} {{RoundBoxTop|theme=11}} The key word for Principle 2 is Efficiency. Principle 2 allows for efficiency by reducing the time spent negotiating the identity of an action.{{RoundBoxBottom}} === Principle Three === Principle Three in effect adds a "disclaimer" to Principle 2. If Principle 2 was the only basis for action identification, people would successively pick higher-level identities until their minds were populated by fantasies, hopes and fears. Rudimentary acts would hold disproportionate amounts of meaning, leading to increased mental stress. This is why Principle 3 is essential, as it provides a caveat for when the action cannot be performed in terms of it's prepotent identity. In this case, there is a tendency for a lower-level identity to become prepotent. This allows for fluid movement between the levels when the prepotent identity isn't feasible.{{fact}}{{example}} {{RoundBoxTop|theme=11}} The key word for Principle 3 is Disclaimer, as it provides an alternative to the principle that the higher-level identity is always chosen over a lower-level identity. {{RoundBoxBottom}} === Quiz === <quiz display="simple"> {Which of the following is the key word for Principle 3? |type="()"} + Disclaimer - Disappear - Efficiency - Travel {Which of the following is the key word for Principle 2? |type="()"} - Governance - Disclaimer + Efficiency - Travel {Janet likes to spend money. She particularly enjoys buying trinkets from the antique store, however her mum simply sees it as wasting money. Which identification is higher? |type="()"} - Enjoys buying trinkets + Sees it as wasting money </quiz> === Emergence of new action === In the context of the three principles, one conclusion becomes clear: Low-level identification occurs out of necessity, and is a relatively unstable state, as one is expected to return to a higher-level identity once it is feasible to do so. When the processes interact with one another in accordance with the three principles, there is also a possibility of an emergence of new action. This possibility exists in relation to low-level identities, as this state is the most unstable. After moving to a low-level identity, there is a possibility of being exposed to new high-level meanings for their behaviour, or new high-level identities. In essence, there is potential for one lower-level identity to have many different high-level identities, which can be explored upon moving to a low-level identity and reevaluating the context of the action. This disruption may lead to a higher-level identity that is significantly different than the high-level identity with which the person began their action. If it is significantly different, there is a possibility of setting an entirely different action into motion. However, emergence of new action is unlikely to occur if the person is able to maintain action at a high level, because they will not find the need to move to a lower-level identity, which is where the change from one identity to another happens (Wegner & Vallacher, 1984).{{example}} ==Applications of AIT== {{expand}} === Behavior modification form === The Behavior Identification Form (BIF) was created by Vallacher and Wegner to test a variable titled "levels of personal agency", where high-level agents tend to view their actions in more abstract terms, and low-level agents tend to view their actions in more defined and specific terms (Vallacher & Wegner, 1989). Studies utilising the BIF attempt to answer questions about topics ranging from education to addiction. Three of the prominent domains of study will be discussed here: perception, performance, and Optimal Identification. === Perception === The interactions between AIT and perception have been observed in a number of recent studies, as well as some dated ones. A 2015 study explored the role of the level of identification of pain in chronic pain patients' meaning in life (Robinson & Morley, 2015). Despite being limited by a reliable-but-novel measure for the identification of pain as well as a small sample size of 47, the results showed that higher-level identification of pain was related to greater meaning in life{{expand}}. This suggests that adopting a more abstract perspective when dealing with obstacles in life could be an effective way of maintaining or enhancing meaning of life and therefore significance of existence (see Steger, 2009). AIT could also give meaning to differences in actions across cultures. A 2013 study found that at the individual level, Americans were more likely than Japanese to identify the goal (high-level) as opposed to the process (low-level) of the action (Miyamoto et al., 2013). A follow-up study found that cultural differences pervade to a collective level; American media presents more goal-oriented information as opposed to process-oriented information than Japanese media (Miyamoto et al., 2013). While repeat studies are essential to providing a concrete conclusion, findings like this show that patterns of perception of action may have a cultural mediation, providing advantages and disadvantages to the individual in different professional domains in life. This is because different domains, as evidenced by a study that investigated the identification level of 237 students of different academic majors, have different levels of identification. High-levels of personal agency (measured by BIF) is associated with majors that emphasise distal consequences such as nursing with the emphasis on well-being of patient, and low-levels seem to be associated with majors that de-emphasise distal consequences such as mathematics majors who focus on procedural processes (Bishop & Thomas, 2000). The implication that cultural differences in perception may indirectly influence professional competence is an important one, however, in a more direct approach to perception, a 2009 study by Libby, Shaeffer and Eibach found that picturing actions from a 3rd person perspective causes people to represent actions more abstractly, and representing actions more abstractly causes people to see them from the third-person perspective. While a follow up study found a unidirectional as opposed to the bidirectional causal relationship found by Libby and colleagues (Hart-Smith & Moulds, 2019), the finding that changing visual perspective has an effect on identification level is a significant one. === Performance === Action identification and its association with performance is a considerably important interaction, as well as a major focus of the applicational literature. One interesting application was undertaken in the context of video games. Using a modified version of the BIF, the researchers found {{how}} that those who thought of their in-game actions in high-level terms performed better compared to those who viewed the actions more concretely (Ewell, Hamilton and Guadagno, 2018). While the generalisability of this finding is limited to video game related applications, and the measure was novel, there are other studies which favour high- over low-level identification when it comes to performance. An example of this is the pilot study undertaken by Vallacher and Wenger to test the psychometric properties of the BIF (1989). In addition to finding excellent reliability and validity for the measure, the study also found {{how}} that in it's robust sample of 1,404 subjects, low-level agents agents reported greater impulsiveness and lower stability in behaviour as well as low self-motivation (Vallacher & Wegner, 1989), suggesting that they persist less in behaviour when faced with opposing goals which are pronounced by action context. The result of this is that overall performance is lowered due to lowered consistency and persistence. This finding is mirrored by studies on the treatment of habits, which characterise disorders such as obsessive-compulsive disorder (Belyachi & Van der Linden, 2017) and substance addiction. A 2017 review of obsessive-compulsive checking studies found that low-level identification leads to behavioural dysregulation (e.g. repetition, doubts about completion), and checking proneness is related to low-level identification (Belyachi & Van der Linden, 2017). The idea that low-level identification has negative effects on performance, therefore, appears to be well evidenced, however there are exceptions to these findings. One such exception was found in a study examining alcohol addiction. The researchers found {{how}} that high-level identification is less effective than low-level identification at reducing habit behaviour (Schellhas et al., 2016). The researchers hypothesised that this may be due to the fact that it is essential to monitor problem behaviours when attempting to reduce them, and monitoring is the essence of low-level identification. Where high-level identification tempts rationalisation and compromise, low-level identification disallows the consideration of these things. While these findings must primarily be considered in the context of problematic alcohol consumption, they have potential to be extrapolated to other habitual behaviours. === Optimal identification === The concept of optimal identification was hypothesised as a natural response to the understanding that low-level identification is an unstable state, and movement between levels is a natural and adaptive process (Vallacher & Wegner, 1984). With regards to an action, there is an optimal level of identification that is reached as a compromise between an unteneble{{sp}} high-level identity and a mastered low-level identity, and this is the optimal level of identification for that behaviour (Vallacher & Wegner, 2012){{example}}. This understanding is essential to applying AIT to our motivational lives, as it directly calls for compromise between levels, as opposed to monitored continual movement between levels, which can be exhausting and demotivating{{fact}}. The importance of proper application of AIT was voiced by Johnson and Scott in their article focusing on "learning agility". They proposed that AIT principles are at the core of improving learning agility (the ability to quickly understand a situation and move across ideas flexibly), as there needs to be an understanding not just of what the problem is, but how to apply previous contextual experience to solving it (Johnson & Scott, 2012). This means that understanding optimal identification is essential to improving learning agility, as the optimal level reflects a compromise between previous concerns for comprehensive understanding of the action (high-level) and knowing how to effectively maintain the action (low-level) (Dickerson, 1995). Another article that refers to the importance of experience is by Michaels, Parkin and Wegner (2013). While they stress the importance of time and experience in finding the optimal level, they also stress that identification is a dynamic process, not a static one (Michaels, Parkin and Wegner, 2013). This means that when applying prior experiences to present problems, it is important to use the optimal level as the starting point to having a dynamic movement between the levels.{{example}} ==Conclusion== <nowiki>AIT is a cognitive model that functions on the basis that an action has multiple identities, that these identities can be arranged into a relative hierarchy for any given action, and that the movement between them is dictated by three interactive principles. The interaction between these principles has the potential to lead to an emergence of new action due to an inherent instability in the low-level identities. The three identities can be easily remembered with the words Governance, Efficiency, and Disclaimer respectively. The application of the theory varies in the {{what} literature, with the main realms of focus being perception, performance and optimal identification. Perception appears to have a strong, sometimes causal relationship with action-identification. High-level identification is favoured when it comes to perception as it can lead to increased perceived meaning of life. Action identification is also mediated by culture, where from an individual to a collectivist level, there is evidence of cultural influence on differences in high- versus low-level identification. These cultural differences have the potential to provide indirect advantages or disadvantages in a professional context. While the majority of the application on performance suggests that high-level identification is preferable, there is evidence of the contextual role of low-level identification as demonstrated by studies on problematic habits. Optimal identification is the compromise between low- and high-level identities which is essential to applying AIT in practical settings. Experience is an important factor in applying the theory, and this experience is further enhanced with the understanding of the contextual optimal identification level.</nowiki> ==See also== * [[Motivation and emotion/Book/2014/Achievement goal orientation and academic motivation|Achievement goal orientation]] (Book Chapter, 2014) * [[wikipedia:Action_(philosophy)|Action]] (Wikipedia) * [[Motivation and emotion/Book/2015/Altruism versus selfishness|Altruism vs Selfishness]] (Book Chapter, 2015) * [[Motivation and emotion/Book/2019/Choice theory|Choice Theory]] (Book chapter, 2019) * [[Motivation and emotion/Book/2015/Mastery motivation|Mastery Motivation]] (Book chapter, 2015) *[[Perception]] (Wikipedia) ==References== {{Hanging indent|1= Belayachi, S., & Linden, M. V. (2017). The Cognitive Heterogeneity of Obsessive-Compulsive Checking. Journal of Cognitive Education and Psychology, 16(1), 9-22. doi:https://doi.org/10.1891/1945-8959.16.1.9 Bishop DI, Thomas RW, Peper BM. Levels of Personal Agency among Academic Majors. Psychological Reports. 2000;86(1):221-224. doi:https://doi.org/10.2466/pr0.2000.86.1.221 Dickerson AE. Action Identification May Explain Why the Doing of Activities in Occupational Therapy Effects Positive Changes in Clients. British Journal of Occupational Therapy. 1995;58(11):461-464. doi:https://doi.org/10.1177/030802269505801104 Ewell, Patrick & Hamilton, James & Guadagno, Rosanna. (2018). How do videogame players identify their actions? Integrating Action Identification Theory and videogame play via the Behavior Identification Form-Gamer. Computers in Human Behavior. 81. 10.1016/j.chb.2017.12.019. Fointiat V, Pelt A. Do I Know What I'm Doing? Cognitive Dissonance and Action Identification Theory. Span J Psychol. 2015 Nov 27;18:E97. doi: https://doi.org/10.1017/sjp.2015.93. Gray K. How to Map Theory: Reliable Methods Are Fruitless Without Rigorous Theory. Perspectives on Psychological Science. 2017;12(5):731-741. doi: https://doi.org/10.1177/1745691617691949 Hart-Smith L, Moulds ML. Abstract processing and observer vantage perspective in dysphoria. J Exp Psychol Appl. 2019 Jun;25(2):177-191. doi: https://doi.org/10.1037/xap0000172. Johnson, R., & Scott, B. (2012). Learning Agility Requires Proper Action Identification. Industrial and Organizational Psychology, 5(3), 309-312. doi:https://doi.org/10.1111/j.1754-9434.2012.01452.x Libby, L. K., Shaeffer, E. M., & Eibach, R. P. (2009). Seeing meaning in action: A bidirectional link between visual perspective and action identification level. Journal of Experimental Psychology: General, 138(4), 503–516. https://doi.org/10.1037/a0016795 Mange, J., Sénémeaud, C., & Michinov, N. (2013). Jotting down notes or preparing for the future? Action identification and academic performance. Social Psychology of Education: An International Journal, 16(1), 151–164. https://doi.org/10.1007/s11218-012-9205-3 Michaels, J. L., Parkin, S. S., & Vallacher, R. R. (2013). Destiny is in the details: Action identification in the construction and destruction of meaning. In J. A. Hicks & C. Routledge (Eds.), The experience of meaning in life: Classical perspectives, emerging themes, and controversies (p. 103–115). Springer Science + Business Media. https://doi.org/10.1007/978-94-007-6527-6_8 Miyamoto Y, Knoepfler CA, Ishii K, Ji LJ. Cultural variation in the focus on goals versus processes of actions. Pers Soc Psychol Bull. 2013 Jun;39(6):707-19. doi: https://doi.org/10.1177/0146167213483579. Robinson, Helen & Morley, Stephen. (2013). Action Identification and Meaning in Life in Chronic Pain. Unpublished manuscript for comment. doi: https://doi.org/9.10.1016/j.sjpain.2015.04.024. Schellhas, Laura & Ostafin, Brian & Palfai, Tibor & Jong, Peter. (2016). How to think about your drink: Action-identification mediates the relation between mindfulness and dyscontrolled drinking. Addictive Behaviors. 56. doi:https://doi.org/10.1016/j.addbeh.2016.01.007. Steger, M. F. (2009). Meaning in life. In S. J. Lopez & C. R. Snyder (Eds.), Oxford library of psychology. Oxford handbook of positive psychology (p. 679–687). Oxford University Press. Vallacher, R. & Wegner, D. (2012). Action identification theory. In P. A. Van LangeA. W. Kruglanski & E. T. Higgins Handbook of theories of social psychology: volume 1 (Vol. 1, pp. 327-348). London: SAGE Publications Ltd doi: 10.4135/9781446249215.n17 Vallacher, R. R., Wegner, D. M., & Frederick, J. (1987). The presentation of self through action identification. Social Cognition, 5(3), 301–322. https://doi.org/10.1521/soco.1987.5.3.301 Vallacher, Robin & Wegner, Daniel. (1989). Levels of Personal Agency: Individual Variation in Action Identification. Journal of Personality and Social Psychology. 57. 660-671. https://doi.org/10.1037/0022-3514.57.4.660. Wegner, D. M., Vallacher, R. R., Macomber, G., Wood, R., & Arps, K. (1984). The emergence of action. Journal of Personality and Social Psychology, 46(2), 269–279. https://doi.org/10.1037/0022-3514.46.2.269 }} ==External links== * [http://psychology.iresearchnet.com/social-psychology/social-psychology-theories/action-identification-theory/ Action Identification Theory] (IResearchNet.com) * [http://www.sjdm.org/dmidi/Behavior_Identification_Form.html#:~:text=Behavior%20Identification%20Form%20(BIF)&text=The%20BIF%20was%20designed%20to,of%20construals%20of%20different%20behaviors.&text=High%2Dlevel%20construals%20emphasize%20why,the%20meanings%20of%20the%20action. Behavior Identification Form] (sjdm.org) * [https://www.acrwebsite.org/volumes/7489/volumes/v20/NA-20%20--%3E%20For%20real%20life%20applications%20and%20case%20study%20generation Consumer application] (Association for Consumer Research) * [https://cdn2.hubspot.net/hubfs/525299/Blog%20/Blog%20(EN)/Action%20Identification%20Theory%20Infographic.pdf Guide to AIT] (hubspot.net) * [https://link.springer.com/article/10.3758/s13421-011-0124-x Unitization] (SpringerLink) [[Category:{{#titleparts:{{PAGENAME}}|3}}]] [[Category:Motivation and emotion/Book/Cognitive]] 0dl6a7bxglh8z3bs23ifxkfx3jd1eb1 0 267284 2419052 2418949 2022-08-25T12:02:25Z DenniseSoleymani 2947584 Set up a draft structure with headings, ideas for key points and resource links wikitext text/x-wiki {{title|DMT and spirituality:<br>How can DMT facilitate spiritual experiences?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== == What is DMT? == * Psychedelic * Molecule found throughout the natural world * Mimics neurotransmitter serotonin * Difference between DMT and 5-MeO-DMT === Chemical composition === [[File:DMT.svg|alt=Chemical composition of DMT|thumb|''Figure 1.'' Chemical composition of N,N-Dimethyltryptamine]] * DMT, 5-MeO-DMT and serotonin * === Dosage and timeline === * Ingested in brew (often with ayahuasca) or smoked * Breakthrough doses * Effects kick in immediately and only last a few minutes, usually no more than 10mins * If taken with ayahuasca, takes about 45 mins to take effect and trip can last several hours * [https://psychonautwiki.org/wiki/Responsible_drug_use#General Harm reduction] === Subjective experiences === * Near death experiences * Visuals * Emotions * Entities * 'Waiting room' * Breakthrough == History == Although only new to western world, there has been evidence of traditional use and shamanic rituals with DMT === Ancient tradition === * DMT in ayahuasca ceremonies * Toads === Universal connections === * Indigenous groups throughout Amazon region * Ancient Egypt * Artistic correlations === Western Discovery === * Synthesised in 1931 by Manske * Discovery in plants * Discovery of hallucinogenic properties == Spirituality == Understanding of what classifies as spirituality has shifted throughout history === What is Spirituality? === * Religion * God * Supernatural realm * Meaning of life * Modern spirituality === Spirituality and emotion === * William James * === Ego Death === * Jung * Buddhism == Pineal Gland == Structure within the brain that has historical significance and meaning rooted in spirituality. DMT is anecdotally said to be released in the pineal gland through mindful activation, during birth and after death. === Structure and function === * Endocrine gland * Calcification * Natural release of DMT * Melatonin * Light sensitivity - third eye === Spiritual, cultural and philosophical significance === * Eye of Horus * Tibetan book of the dead * Descartes == Risks == Although there are limited to no physical risks associated with DMT and no lethal dosage, consideration should be taken with possible harmful effects === Negative experiences === * Traumatising visuals * Bad trips * Cut with other drugs === Mental health === * Potential trigger for underlying conditions * Psychosis ==Conclusion== ==See also== [[wikipedia:Ego_death|Ego death]] (Wikipedia) [[wikipedia:Near-death_experience#:~:text=Researchers%20have%20identified%20the%20common,of%20egotic%20and%20spatiotemporal%20boundaries.|Near-death experience]] (Wikipedia) [[wikipedia:Pineal_gland#Function|Pineal gland]] (Wikipedia) ==References== List the cited references in [[w:APA style|APA style]] (7th ed.) or [[w:Wikipedia:Citing sources|wiki style]]. APA style example: {{Hanging indent|1= Blair, R. J. R. (2004). The roles of orbital frontal cortex in the modulation of antisocial behavior. ''Brain and Cognition'', ''55''(1), 198–208. https://doi.org/10.1016/S0278-2626(03)00276-8 Buckholtz, J. W., & Meyer-Lindenberg, A. (2008). MAOA and the neurogenetic architecture of human aggression. ''Trends in Neurosciences'', ''31''(3), 120–129. https://doi.org/10.1016/j.tins.2007.12.006 Eckardt, M., File, S., Gessa, G., Grant, K., Guerri, C., Hoffman, P., & Tabakoff, B. (1998). Effects of moderate alcohol consumption on the central nervous system. ''Alcoholism, Clinical and Experimental Research'', ''22''(5), 998–1040. https://doi.org/10.1111/j.1530-0277.1998.tb03695.x }} ==External links== [https://www.youtube.com/watch?v=LFnCwXPjSCk&ab_channel=TEDxTalks DMT and the Psychedelic Renaissance | Nick Glynos | TEDxUofM] (Youtube) [https://www.youtube.com/watch?v=PB5xwyBSRug&ab_channel=SBSTheFeed DMT: The Hallucinogenic Drug Produced In the Brain] (Youtube) [[Category:{{#titleparts:{{PAGENAME}}|3}}]] 4ciitixqmakw1krcug7lwpubkz34p02 2419069 2419052 2022-08-25T15:19:31Z DenniseSoleymani 2947584 Added brief overview and a reference wikitext text/x-wiki {{title|DMT and spirituality:<br>How can DMT facilitate spiritual experiences?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== The pursuit of understanding the nature of reality has been fundamental to the human experience. What are the origins of life? What happens after death? What is the meaning of existence? Do I have a purpose in the world? In the search to answer these questions, there is often a direction towards an aspect of [[wikipedia:Spirituality|spirituality]] to provide some knowledge and comfort. [[wikipedia:N,N-Dimethyltryptamine|DMT]], is a psychedelic drug that can offer a pathway to having a [[wikipedia:Religious_experience|spiritual experience]] through an altered state of [[wikipedia:Consciousness|consciousness]]. == What is DMT? == * Psychedelic * Molecule found throughout the natural world * Mimics neurotransmitter serotonin * Difference between DMT and 5-MeO-DMT === Chemical composition === [[File:DMT.svg|alt=Chemical composition of DMT|thumb|''Figure 1.'' Chemical composition of N,N-Dimethyltryptamine]] * DMT, 5-MeO-DMT and serotonin * === Dosage and timeline === * Ingested in brew (often with ayahuasca) or smoked * Breakthrough doses * Effects kick in immediately and only last a few minutes, usually no more than 10mins * If taken with ayahuasca, takes about 45 mins to take effect and trip can last several hours * [https://psychonautwiki.org/wiki/Responsible_drug_use#General Harm reduction] === Subjective experiences === * Near death experiences * Visuals * Emotions * Entities * 'Waiting room' * Breakthrough == History == Although only new to western world, there has been evidence of traditional use and shamanic rituals with DMT === Ancient tradition === * DMT in ayahuasca ceremonies * Toads === Universal connections === * Indigenous groups throughout Amazon region * Ancient Egypt * Artistic correlations * Across cultures and throughout history, there are correlations in descriptive features of near-death experiences (Greyson and Khanna, 2014). === Western Discovery === * Synthesised in 1931 by Manske * Discovery in plants * Discovery of hallucinogenic properties == Spirituality == Understanding of what classifies as spirituality has shifted throughout history === What is Spirituality? === * Religion * God * Supernatural realm * Meaning of life * Modern spirituality === Spirituality and emotion === * William James *Traumatic experiences such as a near-death experience are associated with spiritual growth (Greyson and Khanna, 2014). === Ego Death === * Jung * Buddhism == Pineal Gland == Structure within the brain that has historical significance and meaning rooted in spirituality. DMT is anecdotally said to be released in the pineal gland through mindful activation, during birth and after death. === Structure and function === * Endocrine gland * Calcification * Natural release of DMT * Melatonin * Light sensitivity - third eye === Spiritual, cultural and philosophical significance === * Eye of Horus * Tibetan book of the dead * Descartes == Risks == Although there are limited to no physical risks associated with DMT and no lethal dosage, consideration should be taken with possible harmful effects === Negative experiences === * Traumatising visuals * Bad trips * Cut with other drugs === Mental health === * Potential trigger for underlying conditions * Psychosis ==Conclusion== ==See also== [[wikipedia:Ego_death|Ego death]] (Wikipedia) [[wikipedia:Near-death_experience|Near-death experience]] (Wikipedia) [[wikipedia:Pineal_gland|Pineal gland]] (Wikipedia) [[Motivation and emotion/Book/2021/Psilocybin and spirituality|Psilocybin and spirituality]] (Wikiversity) ==References== List the cited references in [[w:APA style|APA style]] (7th ed.) or [[w:Wikipedia:Citing sources|wiki style]]. APA style example: {{Hanging indent|1= Greyson, & Khanna, S. (2014). Spiritual Transformation After Near-Death Experiences. Spirituality in Clinical Practice (Washington, D.C.), 1(1), 43–55. https://doi.org/10.1037/scp0000010 }} ==External links== [https://www.youtube.com/watch?v=LFnCwXPjSCk&ab_channel=TEDxTalks DMT and the Psychedelic Renaissance | Nick Glynos | TEDxUofM] (Youtube) [https://www.youtube.com/watch?v=PB5xwyBSRug&ab_channel=SBSTheFeed DMT: The Hallucinogenic Drug Produced In the Brain] (Youtube) [[Category:{{#titleparts:{{PAGENAME}}|3}}]] c0v09xwdatjt3r8ovjvi2ohd2g8oci3 2419071 2419069 2022-08-25T15:31:56Z DenniseSoleymani 2947584 Add focus questions wikitext text/x-wiki {{title|DMT and spirituality:<br>How can DMT facilitate spiritual experiences?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== The pursuit of understanding the nature of reality has been fundamental to the human experience. What are the origins of life? What happens after death? What is the meaning of existence? Do I have a purpose in the world? In the search to answer these questions, there is often a direction towards an aspect of [[wikipedia:Spirituality|spirituality]] to provide some knowledge and comfort. [[wikipedia:N,N-Dimethyltryptamine|DMT]], is a psychedelic drug that can offer a pathway to having a [[wikipedia:Religious_experience|spiritual experience]] through an altered state of [[wikipedia:Consciousness|consciousness]]. {{RoundBoxTop|theme=1}} '''Focus questions:''' * What is the relationship between DMT and spiritual experiences? * How do DMT and spiritual experiences affect emotions? * Are there benefits in having a spiritual experience through the use of DMT? {{RoundBoxBottom}} == What is DMT? == * Psychedelic * Molecule found throughout the natural world * Mimics neurotransmitter serotonin * Difference between DMT and 5-MeO-DMT === Chemical composition === [[File:DMT.svg|alt=Chemical composition of DMT|thumb|''Figure 1.'' Chemical composition of N,N-Dimethyltryptamine]] * DMT, 5-MeO-DMT and serotonin * === Dosage and timeline === * Ingested in brew (often with ayahuasca) or smoked * Breakthrough doses * Effects kick in immediately and only last a few minutes, usually no more than 10mins * If taken with ayahuasca, takes about 45 mins to take effect and trip can last several hours * [https://psychonautwiki.org/wiki/Responsible_drug_use#General Harm reduction] === Subjective experiences === * Near death experiences * Visuals * Emotions * Entities * 'Waiting room' * Breakthrough == History == Although only new to western world, there has been evidence of traditional use and shamanic rituals with DMT === Ancient tradition === * DMT in ayahuasca ceremonies * Toads === Universal connections === * Indigenous groups throughout Amazon region * Ancient Egypt * Artistic correlations * Across cultures and throughout history, there are correlations in descriptive features of near-death experiences (Greyson and Khanna, 2014). === Western Discovery === * Synthesised in 1931 by Manske * Discovery in plants * Discovery of hallucinogenic properties == Spirituality == Understanding of what classifies as spirituality has shifted throughout history === What is Spirituality? === * Religion * God * Supernatural realm * Meaning of life * Modern spirituality === Spirituality and emotion === * William James *Traumatic experiences such as a near-death experience are associated with spiritual growth (Greyson and Khanna, 2014). === Ego Death === * Jung * Buddhism == Pineal Gland == Structure within the brain that has historical significance and meaning rooted in spirituality. DMT is anecdotally said to be released in the pineal gland through mindful activation, during birth and after death. === Structure and function === * Endocrine gland * Calcification * Natural release of DMT * Melatonin * Light sensitivity - third eye === Spiritual, cultural and philosophical significance === * Eye of Horus * Tibetan book of the dead * Descartes == Risks == Although there are limited to no physical risks associated with DMT and no lethal dosage, consideration should be taken with possible harmful effects === Negative experiences === * Traumatising visuals * Bad trips * Cut with other drugs === Mental health === * Potential trigger for underlying conditions * Psychosis ==Conclusion== ==See also== [[wikipedia:Ego_death|Ego death]] (Wikipedia) [[wikipedia:Near-death_experience|Near-death experience]] (Wikipedia) [[wikipedia:Pineal_gland|Pineal gland]] (Wikipedia) [[Motivation and emotion/Book/2021/Psilocybin and spirituality|Psilocybin and spirituality]] (Wikiversity) ==References== List the cited references in [[w:APA style|APA style]] (7th ed.) or [[w:Wikipedia:Citing sources|wiki style]]. APA style example: {{Hanging indent|1= Greyson, & Khanna, S. (2014). Spiritual Transformation After Near-Death Experiences. Spirituality in Clinical Practice (Washington, D.C.), 1(1), 43–55. https://doi.org/10.1037/scp0000010 }} ==External links== [https://www.youtube.com/watch?v=LFnCwXPjSCk&ab_channel=TEDxTalks DMT and the Psychedelic Renaissance | Nick Glynos | TEDxUofM] (Youtube) [https://www.youtube.com/watch?v=PB5xwyBSRug&ab_channel=SBSTheFeed DMT: The Hallucinogenic Drug Produced In the Brain] (Youtube) [[Category:{{#titleparts:{{PAGENAME}}|3}}]] egc4b3dvsr6il95usq21437cydkl532 2419075 2419071 2022-08-25T17:05:34Z DenniseSoleymani 2947584 Added references and a few more key points wikitext text/x-wiki {{title|DMT and spirituality:<br>How can DMT facilitate spiritual experiences?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== The pursuit of understanding the nature of reality has been fundamental to the human experience. What are the origins of life? What happens after death? What is the meaning of existence? Do I have a purpose in the world? In the search to answer these questions, there is often a direction towards an aspect of [[wikipedia:Spirituality|spirituality]] to provide some knowledge and comfort. [[wikipedia:N,N-Dimethyltryptamine|DMT]], is a psychedelic drug that can offer a pathway to having a [[wikipedia:Religious_experience|spiritual experience]] through an altered state of [[wikipedia:Consciousness|consciousness]]. {{RoundBoxTop|theme=1}} '''Focus questions:''' * What is the relationship between DMT and spiritual experiences? * How do DMT and spiritual experiences affect emotions? * Are there benefits in having a spiritual experience through the use of DMT? {{RoundBoxBottom}} == What is DMT? == * Psychedelic * Molecule found throughout the natural world * Mimics neurotransmitter serotonin * Difference between DMT and 5-MeO-DMT === Chemical composition === [[File:DMT.svg|alt=Chemical composition of DMT|thumb|''Figure 1.'' Chemical composition of N,N-Dimethyltryptamine]]endogenous hallucinogen N, N-dimethyltryptamine * DMT, 5-MeO-DMT and serotonin * === Dosage and timeline === * Ingested in brew (often with ayahuasca) or smoked * Breakthrough doses * Effects kick in immediately and only last a few minutes, usually no more than 10mins * If taken with ayahuasca, takes about 45 mins to take effect and trip can last several hours * [https://psychonautwiki.org/wiki/Responsible_drug_use#General Harm reduction] === Subjective experiences === * Near death experiences * Visuals * Emotions * Entities * 'Waiting room' * Breakthrough === Physiological effects === * serotonergic modulator (Barker, 2018) * endogenous and possesses the properties of a neurotransmitter (Barker, 2018) * biochemical and physiological activity to an extent correlated with binding of DMT to family of serotonin receptors (Barker, 2018) == History == Although only new to western world, there has been evidence of traditional use and shamanic rituals with DMT === Ancient tradition === * DMT in ayahuasca ceremonies * Toads * Findings of a 1,000-year-old ritual bundle in the Andes with chemical residues psychoactive plants including DMT suggest evidence of advanced botanical knowledge practiced in shamanic rituals (Miller et al., 2019). * === Universal connections === * Indigenous groups throughout Amazon region * Ancient Egypt * Artistic correlations * Across cultures and throughout history, there are correlations in descriptive features of near-death experiences (Greyson and Khanna, 2014). * Strassman described similarities between the psychedelic experience and what Buddhists call "[[wikipedia:Bodhicitta|bodhicitta]]" === Western Discovery === * Synthesised in 1931 by chemist Richard Manske but was not used for pharmacological effects on humans (Barker, 2018). * Natural occurance of DMT in plants was discovered in 1946 by microbiologist Oswaldo Gonçalves de Lima (Barker, 2018). * In 1956 Stephen Szara, a Hungarian chemist and psychiatrist, bridged the link between the chemical and its use, after extracting DMT from the Mimosa hostilis plant and administering the extract to himself intramuscularly Barker, 2018). == Spirituality == Understanding of what classifies as spirituality has shifted throughout history === What is Spirituality? === * Religion * God * Supernatural realm * Meaning of life * Modern spirituality * William James believed that spiritual experiences are dependant on the subconscious thoughts becoming part of the conscious (Carhart-Harris, 2014). === Spirituality and emotion === * *Traumatic experiences such as a near-death experience are associated with spiritual growth (Greyson and Khanna, 2014). === Ego Death === * Jung * Buddhism == Pineal Gland == Structure within the brain that has historical significance and meaning rooted in spirituality. DMT is anecdotally said to be released in the pineal gland through mindful activation, during birth and after death. === Structure and function === * Endocrine gland * Calcification * Natural release of DMT * Melatonin * Light sensitivity - third eye === Spiritual, cultural and philosophical significance === * Eye of Horus * Tibetan book of the dead * Descartes == Risks == Although there are limited to no physical risks associated with DMT and no lethal dosage, consideration should be taken with possible harmful effects === Negative experiences === * Traumatising visuals * Bad trips * Cut with other drugs === Mental health === * Potential trigger for underlying conditions * Psychosis ==Conclusion== * Spiritual experiences can be facilitated by DMT due to the related characteristics of the stages of DMT (particularly the "breakthrough") and near-death-experiences that induce similar perceptions and emotions (St John, 2016). ==See also== [[wikipedia:Ego_death|Ego death]] (Wikipedia) [[wikipedia:Near-death_experience|Near-death experience]] (Wikipedia) [[wikipedia:Pineal_gland|Pineal gland]] (Wikipedia) [[Motivation and emotion/Book/2021/Psilocybin and spirituality|Psilocybin and spirituality]] (Wikiversity) ==References== {{Hanging indent|1= Barker. (2018). N, N-dimethyltryptamine (DMT), an endogenous hallucinogen: Past, present, and future research to determine its role and function. Frontiers in Neuroscience, 12, 536–536. https://doi.org/10.3389/fnins.2018.00536 Carhart-Harris, Leech, R., Hellyer, P. J., Shanahan, M., Feilding, A., Tagliazucchi, E., Chialvo, D. R., & Nutt, D. (2014). The entropic brain: A theory of conscious states informed by neuroimaging research with psychedelic drugs. Frontiers in Human Neuroscience, 8(1), 20–20. https://doi.org/10.3389/fnhum.2014.00020 Greyson, & Khanna, S. (2014). Spiritual Transformation After Near-Death Experiences. Spirituality in Clinical Practice (Washington, D.C.), 1(1), 43–55. https://doi.org/10.1037/scp0000010 Miller, Albarracin-Jordan, J., Moore, C., & Capriles, J. M. (2019). Chemical evidence for the use of multiple psychotropic plants in a 1,000-year-old ritual bundle from South America. Proceedings of the National Academy of Sciences - PNAS, 116(23), 11207–11212. https://doi.org/10.1073/pnas.1902174116 St John, G. (2016). The DMT gland: The pineal, the spirit molecule, and popular culture. International Journal for the Study of New Religions, 7(2), 153–174. https://doi.org/10.1558/ijsnr.v7i2.31949 }} ==External links== [https://www.youtube.com/watch?v=LFnCwXPjSCk&ab_channel=TEDxTalks DMT and the Psychedelic Renaissance | Nick Glynos | TEDxUofM] (Youtube) [https://www.youtube.com/watch?v=PB5xwyBSRug&ab_channel=SBSTheFeed DMT: The Hallucinogenic Drug Produced In the Brain] (Youtube) [[Category:{{#titleparts:{{PAGENAME}}|3}}]] jkyoy7u94iql3arve3qv1usmdlu37ih 2419135 2419075 2022-08-26T00:01:41Z DenniseSoleymani 2947584 Conclusion and edit points wikitext text/x-wiki {{title|DMT and spirituality:<br>How can DMT facilitate spiritual experiences?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== The pursuit of understanding the nature of reality has been fundamental to the human experience. What are the origins of life? What happens after death? What is the meaning of existence? Do I have a purpose in the world? In the search to answer these questions, there is often a direction towards an aspect of [[wikipedia:Spirituality|spirituality]] to provide some knowledge and comfort. [[wikipedia:N,N-Dimethyltryptamine|DMT]], is a psychedelic drug that can offer a pathway to having a [[wikipedia:Religious_experience|spiritual experience]] through an altered state of [[wikipedia:Consciousness|consciousness]]. {{RoundBoxTop|theme=1}} '''Focus questions:''' * What is the relationship between DMT and spiritual experiences? * How do DMT and spiritual experiences affect emotions? * Are there benefits in having a spiritual experience through the use of DMT? {{RoundBoxBottom}} == What is DMT? == * DMT (N,N-Dimethyltryptamine or N,N, DMT) is a endogenous hallucinogen that is used recreationally and as an [[wikipedia:Entheogen|entheogen]], eliciting out-of body encounters and profound dream states (St John, 2016). DMT psychoactive [[wikipedia:Alkaloid|alkaloid]] that can be found in plants, animals and humans. * Mimics neurotransmitter serotonin * Difference between DMT and 5-MeO-DMT === Chemical composition === [[File:DMT.svg|alt=Chemical composition of DMT|thumb|''Figure 1.'' Chemical composition of N,N-Dimethyltryptamine]]C₁₂H₁₆N₂ endogenous hallucinogen N, N-dimethyltryptamine * Structural similarity between DMT, 5-MeO-DMT, serotonin and melatonin *Requires a monoamine oxidase inhibitor (MAOI) to make it active when ingested orally === Dosage and timeline === * Ingested in brew (often with ayahuasca) or smoked * Breakthrough doses * Effects kick in immediately and only last a few minutes, usually no more than 10mins * If taken with ayahuasca, takes about 45 mins to take effect and trip can last several hours * [https://psychonautwiki.org/wiki/Responsible_drug_use#General Harm reduction] === Subjective experiences === * Near death experiences * Visuals * Auditory buzzing/ringing * Emotions * Entities (e.g. elves, angels, demons, aliens) * 'Waiting room' * Breakthrough === Physiological effects === * serotonergic modulator (Barker, 2018) * endogenous and possesses the properties of a neurotransmitter (Barker, 2018) * biochemical and physiological activity to an extent correlated with binding of DMT to family of serotonin receptors (Barker, 2018) == History == Although only new to western world, there has been evidence of traditional use and shamanic rituals with DMT === Ancient tradition === * DMT in ayahuasca ceremonies * Toads * Findings of a 1,000-year-old ritual bundle in the Andes with chemical residues psychoactive plants including DMT suggest evidence of advanced botanical knowledge practiced in shamanic rituals (Miller et al., 2019). * === Universal connections === * Indigenous groups throughout Amazon region * Artistic correlations (assumptions that * Across cultures and throughout history, there are correlations in descriptive features of near-death experiences (Greyson and Khanna, 2014). * Strassman described similarities between the psychedelic experience and what Buddhists call "[[wikipedia:Bodhicitta|bodhicitta]]" === Western Discovery === * Synthesised in 1931 by chemist Richard Manske but was not used for pharmacological effects on humans (Barker, 2018). * Natural occurance of DMT in plants was discovered in 1946 by microbiologist Oswaldo Gonçalves de Lima (Barker, 2018). * In 1956 Stephen Szara, a Hungarian chemist and psychiatrist, bridged the link between the chemical and its use, after extracting DMT from the Mimosa hostilis plant and administering the extract to himself intramuscularly (Barker, 2018). == Spirituality == Understanding of what classifies as spirituality has shifted throughout history. Spirituality has expanded its meaning beyond traditional interpretations of religion and believing in a 'God' or 'Creator'. Spirituality can influence and induce emotions... === What is Spirituality? === * Religion * God * Supernatural realm * Meaning of life * Modern spirituality * William James believed that spiritual experiences are dependant on the subconscious thoughts becoming part of the conscious (Carhart-Harris, 2014). === Spirituality and emotion === *Traumatic experiences such as a near-death experience are associated with spiritual growth (Greyson and Khanna, 2014). === Ego Death === * Jung * Buddhism == Pineal Gland == Structure within the brain that has historical significance and meaning rooted in spirituality. DMT is anecdotally said to be released in the pineal gland through mindful activation, during birth and after death. === Structure and function === * Endocrine gland * Calcification * Natural release of DMT * Melatonin * Light sensitivity - third eye === Spiritual, cultural and philosophical significance === * Eye of Horus * Tibetan book of the dead * Descartes == Risks == Although there are limited to no physical risks associated with DMT and no lethal dosage, consideration should be taken with possible harmful effects === Negative experiences === * Traumatising visuals * Bad trips * Cut with other drugs === Mental health === * Potential trigger for underlying conditions * Psychosis ==Conclusion== * Spiritual experiences can be facilitated by DMT due to the related characteristics of the stages of DMT (particularly the "breakthrough") and near-death-experiences that induce similar perceptions and emotions (St John, 2016). * Having a spiritual experience on DMT can have therapeutic advantages * Direction of future studies/research ==See also== [[wikipedia:Ego_death|Ego death]] (Wikipedia) [[wikipedia:Near-death_experience|Near-death experience]] (Wikipedia) [[wikipedia:Pineal_gland|Pineal gland]] (Wikipedia) [[Motivation and emotion/Book/2021/Psilocybin and spirituality|Psilocybin and spirituality]] (Wikiversity) ==References== {{Hanging indent|1= Barker. (2018). N, N-dimethyltryptamine (DMT), an endogenous hallucinogen: Past, present, and future research to determine its role and function. Frontiers in Neuroscience, 12, 536–536. https://doi.org/10.3389/fnins.2018.00536 Carhart-Harris, Leech, R., Hellyer, P. J., Shanahan, M., Feilding, A., Tagliazucchi, E., Chialvo, D. R., & Nutt, D. (2014). The entropic brain: A theory of conscious states informed by neuroimaging research with psychedelic drugs. Frontiers in Human Neuroscience, 8(1), 20–20. https://doi.org/10.3389/fnhum.2014.00020 Greyson, & Khanna, S. (2014). Spiritual Transformation After Near-Death Experiences. Spirituality in Clinical Practice (Washington, D.C.), 1(1), 43–55. https://doi.org/10.1037/scp0000010 Miller, Albarracin-Jordan, J., Moore, C., & Capriles, J. M. (2019). Chemical evidence for the use of multiple psychotropic plants in a 1,000-year-old ritual bundle from South America. Proceedings of the National Academy of Sciences - PNAS, 116(23), 11207–11212. https://doi.org/10.1073/pnas.1902174116 St John, G. (2016). The DMT gland: The pineal, the spirit molecule, and popular culture. International Journal for the Study of New Religions, 7(2), 153–174. https://doi.org/10.1558/ijsnr.v7i2.31949 }} ==External links== [https://www.youtube.com/watch?v=LFnCwXPjSCk&ab_channel=TEDxTalks DMT and the Psychedelic Renaissance | Nick Glynos | TEDxUofM] (Youtube) [https://www.youtube.com/watch?v=PB5xwyBSRug&ab_channel=SBSTheFeed DMT: The Hallucinogenic Drug Produced In the Brain] (Youtube) [[Category:{{#titleparts:{{PAGENAME}}|3}}]] oobqze307xz6b62bjo5va8pf6oz5jd5 0 275012 2419070 2416529 2022-08-25T15:24:21Z Platos Cave (physics) 2562653 wikitext text/x-wiki '''Natural Planck units as geometrical objects''' [[w:Planck units |Planck unit]] theories use basic units for mass, length, time and charge, and operate at the Planck scale. In a geometrical Planck theory, these basic units are assigned geometrical objects (''MLTA'') rather than numerical values, the advantage being that the geometries themselves can encode the function of the unit, for example the object for length (''L'') will encode the function of ''length'', the geometrical ''L'' is 1 unit of (Planck) length, such that, unlike numerical models, a dimensioned descriptive (i.e.: ''kg, m, s, A'', ... ) is not required. The geometry of the objects are selected whereby they may interact with each other (the mass object for example is not independent of the length and the time objects). This permits a mathematical unit relationship linking the objects, and so a physical universe can be constructed [[w:Lego |Lego-style]] by combining the ''MLTA'' objects to form more complex objects such as electrons (i.e.: by embedding ''L'' and ''A'' into the geometry of the electron, the electron can have wavelength and charge). === Geometrical objects === Base units for mass <math>M</math>, length <math>L</math>, time <math>T</math>, and ampere <math>A</math> can be constructed from the geometry of 2 [[w:dimensionless physical constant | dimensionless physical constants]], the (inverse) [[w:fine-structure constant | fine structure constant '''α''']] = 137.035 999 139 and [[v:Simulation_argument_(coding_Planck_units)#Omega | Omega]] '''Ω''' = 2.007 134 949 636 <ref>Macleod, M.J. {{Cite journal |title= Programming Planck units from a mathematical electron; a Simulation Hypothesis |journal=Eur. Phys. J. Plus |volume=113 |pages=278 |date=22 March 2018 | doi=10.1140/epjp/i2018-12094-x }}</ref>. Being independent of any numerical system and of any system of units, these MLTA units would qualify as "natural units"; {{bq|''...ihre Bedeutung für alle Zeiten und für alle, auch außerirdische und außermenschliche Kulturen notwendig behalten und welche daher als »natürliche Maßeinheiten« bezeichnet werden können...'' ...These necessarily retain their meaning for all times and for all civilizations, even extraterrestrial and non-human ones, and can therefore be designated as "natural units"... -Max Planck <ref>Planck (1899), p. 479.</ref><ref name="TOM">*Tomilin, K. A., 1999, "[http://www.ihst.ru/personal/tomilin/papers/tomil.pdf Natural Systems of Units: To the Centenary Anniversary of the Planck System]", 287–296.</ref>}} ==== Objects ==== Each object is assigned a specific geometry, embedded in this geometry is the object function (attribute) and a numerical value (a '''unit number''') whereby relationships between the objects can be defined; {| class="wikitable" |+Geometrical units ! Attribute ! Geometrical object ! Unit number |- | mass | <math>M = (1)</math> | <math>n = 15</math> |- | time | <math>T = (\pi)</math> | <math>n = -30</math> |- | [[v:Sqrt_Planck_momentum | sqrt(momentum)]] | <math>P = (\Omega)</math> | <math>n = 16</math> |- | velocity | <math>V = (2\pi\Omega^2)</math> | <math>n = 17</math> |- | length | <math>L = (2\pi^2\Omega^2)</math> | <math>n = -13</math> |- | ampere | <math>A = \frac{16 V^3}{\alpha P^3} = (\frac{2^7 \pi^3 \Omega^3}{\alpha})</math> | <math>n = 3</math> |} ==== Scalars ==== As alpha and Omega have numerical solutions, we can assign to MLTA numerical values, i.e.: ''V'' = 2πΩ² = 25.3123819. To translate from geometrical objects to a numerical system of units requires scalars ('''kltpva'''). For example, scalars for the SI units; :If we use '''k''' to convert '''M''' to the SI Planck mass <math>m_P</math> (M = 1k = <math>m_P</math>), then '''k''' = 0.2176728e-7kg :Using scalar '''v''' = 11843707.905m/s gives ''c = V*v'' = 299792458m/s :Using '''v''' = 7359.3232155miles/s gives ''c = V*v'' = 186282miles/s {| class="wikitable" |+Geometrical units ! Attribute ! Geometrical object ! Scalar ! Unit uⁿ |- | mass | <math>M = (1)</math> | k | <math>unit = u^{15}</math> |- | time | <math>T = (\pi)</math> | t | <math>unit = u^{-30}</math> |- | [[v:Sqrt_Planck_momentum | sqrt(momentum)]] | <math>P = (\Omega)</math> | p | <math>unit = u^{16}</math> |- | velocity | <math>V = (2\pi\Omega^2)</math> | v | <math>unit = u^{17}</math> |- | length | <math>L = TV = (2\pi^2\Omega^2)</math> | l | <math>unit = u^{-13}</math> |- | ampere | <math>A = \frac{16 V^3}{\alpha P^3} = (\frac{2^7 \pi^3 \Omega^3}{\alpha})</math> | a | <math>unit = u^3</math> |} ===== Scalar relationships ===== Because the scalars also include the unit, whether ''kg'', or ''m/s'', or ''miles/s'' ... they follow the same unit number relationship. This means that we can find ratios where the scalars cancel. Here are examples ('''units = 1'''), as such '''only 2 numerical scalars are required''', for example, if we know '''a''' and '''l''' then we know '''t''' ('''t = a³l³'''), and from '''l''' and '''t''' we know '''k'''. :<math>\frac{u^{3*3} u^{-13*3}}{u^{-30}}\;(\frac{a^3 l^3}{t}) = \frac{u^{-13*15}}{u^{15*9} u^{-30*11}} \;(\frac{l^{15}}{k^9 t^{11}}) = \;...\; =1</math> And so, if we know any 2 constants, then we can solve the scalars for those constants, and from those 2 scalars we can solve the Planck units, and from these the dimensioned physical constants. This will apply to any set of units. In this example, to maintain integer exponents, a scalar ''p'' is defined in terms of a scalar ''r''. :<math>r = \sqrt{p} = \sqrt{\Omega},\; unit \;u^{16/2=8}</math> The SI Planck units are known with a low precision, conversely 2 of the CODATA 2014 physical constants have been assigned exact numerical values; ''c'' and permeability of vacuum ''μ₀''. Scalars ''r'' and ''v'' were chosen as they can be derived directly from ''V = c'' and ''μ₀'' = 4π/10^7 (see table [[v:Planck_units_(geometrical)#Physical_constants_(as_geometrical_formulas) |geometrical physical constants]] below). Using α = 137.035 999 139 (CODATA 2014), Ω = 2.007 134 949 636... :<math>v = \frac{c}{2 \pi \Omega^2}= 11 843 707.905 ...,\; units = m/s</math> :<math>r^7 = \frac{2^{11} \pi^5 \Omega^4 \mu_0}{\alpha};\; r = 0.712 562 514 304 ...,\; units = (\frac{kg.m}{s})^{1/4}</math> This gives scalars ''klta'' ([[v:Planck_units_(geometrical)#u_as_sqrt(velocity/mass)) |for derivation of units kg, m, s, A from r, v]]); :<math>k = \frac{r^4}{v}</math> = 0.217 672 817 580... ''x'' 10^-7kg, <math>\;\;\;u^{15} = \frac{(u^8)^4}{u^{17}}</math> :<math>l = \frac{r^9}{v^5}</math> = 0.203 220 869 487... ''x'' 10^-36m, <math>\;\;\;u^{-13} = \frac{(u^8)^9}{(u^{17})^5}</math> :<math>t = \frac{r^9}{v^6}</math> = 0.171 585 512 841... ''x'' 10^-43s, <math>\;\;\;u^{-30} = \frac{(u^8)^9}{(u^{17})^6}</math> :<math>a = \frac{v^3}{r^6}</math> = 0.126 918 588 592... ''x'' 10²³A, <math>\;\;\;u^{3} = \frac{(u^{17})^3}{(u^8)^6}</math> ===== Natural units MLTPA ===== Regardless of which system of units we use, alien or terrestrial, any combination of constants where '''scalars = 1''' (i.e.: the scalars overlap and cancel) will give the same numerical result, they will default to the MLTPA objects. This implies that these objects are Planck's 'natural' units, i.e.: that '''all possible systems of units''' are based on these objects, and so, given that these are dimensionless geometrical objects, they can be construed as evidence of a mathematical universe. The following are examples of '''units = scalars = 1''' ratios using SI units <ref>Macleod, Malcolm J. {{Cite journal |title= Do the physical constants embed evidence of a simulation universe at the Planck scale? |journal=RG | doi=10.13140/RG.2.2.15874.15041/2 }}</ref>. Note: the geometry <math>\color{red}(\Omega^{15})^n\color{black}</math> (integer n ≥ 0) is common to all (units = 1) ratios that include an Omega term. ====== m_P, l_p, t_p ====== In this ratio, the MLT units and ''klt'' scalars both cancel; units = scalars = 1, reverting to the base MLT objects. Setting the scalars ''klt'' for SI Planck units; :k = 0.217 672 817 580... ''x'' 10^-7kg :l = 0.203 220 869 487... ''x'' 10^-36m :t = 0.171 585 512 841... ''x'' 10^-43s :<math>\frac{L^{15}}{M^{9} T^{11}} = \frac{(2\pi^2\Omega^2)^{15}}{(1)^{9} (\pi)^{11}} (\frac{l^{15}}{k^9 t^{11}}) = \frac{l_p^{15}}{m_P^{9} t_p^{11}} </math> (CODATA 2018 mean) The ''klt'' scalars cancel, leaving; :<math>\frac{L^{15}}{M^{9} T^{11}} = \frac{(2\pi^2\Omega^2)^{15}}{(1)^{9} (\pi)^{11}} (\frac{l^{15}}{k^9 t^{11}}) = 2^{15} \pi^{19} \color{red}(\Omega^{15})^2\color{black} = </math>{{font color|blue|yellow|'''0.109 293... 10²⁴ '''}}, <math>(\frac{l^{15}}{k^9 t^{11}}) = 1, \;\frac{u^{-13*15}}{u^{15*9} u^{-30*11}} = 1</math> Solving for the SI units; :<math>\frac{l_p^{15}}{m_P^{9} t_p^{11}} = \frac{(1.616255e-35)^{15}}{(2.176434e-8)^{9} (5.391247e-44)^{11}} = </math> {{font color|blue|yellow| '''0.109 485... 10²⁴'''}} ====== A, l_p, t_p ====== :a = 0.126 918 588 592... ''x'' 10²³A :<math>\frac{A^3 L^3}{T} = (\frac{2^7 \pi^3 \Omega^3}{\alpha})^3 \frac{(2\pi^2\Omega^2)^3}{(\pi)} (\frac{a^3 l^3}{t}) = \frac{2^{24} \pi^{14} \color{red}(\Omega^{15})^1\color{black}}{\alpha^3} = </math> {{font color|green|yellow| '''0.205 571... 10¹³'''}}, <math>(\frac{a^3 l^3}{t}) = 1,\; \frac{u^{3*3} u^{-13*3}}{u^{-30}} = 1</math> :<math>\frac{(e / t_p)^3 l_p^3}{t_p} = \frac{(1.602176634e-19/5.391247e-44)^3 (1.616255e-35)^3}{(5.391247e-44)} = </math> {{font color|green|yellow| '''0.205 543... 10¹³'''}}, <math>units = \frac{(C/s)^3 m^3}{s} </math> The Planck units are known with low precision, and so by defining the 3 most accurately known dimensioned constants in [[v:Planck_units_(geometrical)#Physical_constants_(as_geometrical_formulas) |terms of these objects]] (c, R = Rydberg constant, <math>\mu_0</math>; CODATA 2014 mean values), we can test to greater precision; ====== c, μ₀, R ====== :<math>\frac{(c^*)^{35}}{(\mu_0^*)^9 (R^*)^7} = (2 \pi \Omega^2 v)^{35}/(\frac{\alpha r^7}{2^{11} \pi^5 \Omega^4})^9 .(\frac{v^5} {2^{23} 3^3 \pi^{11} \alpha^5 \Omega^{17} r^9})^7 = 2^{295} \pi^{157} 3^{21} \alpha^{26} \color{red}(\Omega^{15})^{15}\color{black} = </math> {{font color|red|yellow| '''0.326 103 528 6170... 10³⁰¹'''}}, <math>\frac{(u^{17})^{35}}{(u^{56})^9 (u^{13})^7} = 1, \;(v^{35})/(r^7)^9 (\frac{v^5}{r^9})^7 = 1</math> :<math>\frac{c^{35}}{\mu_0^9 R^7} = \frac{(299792458)^{35}}{(4 \pi/10^7)^9 (10973731.568160)^7} = </math> {{font color|red|yellow| '''0.326 103 528 6170... 10³⁰¹'''}}, <math>units = \frac{m^{33}A^{18}}{s^{17}kg^9} == \frac{(u^{-13})^{33} (u^{3})^{18}}{(u^{-30})^{17} (u^{15})^9} = 1</math> The [[w:2019 redefinition of SI base units | 2019 SI unit revision]] assigned exact numerical values to 4 constants (c, e, k_B, h). {{see also |Planck units (geometrical)#2019 SI unit revision}} From the table [[v:Planck_units_(geometrical)#Physical_constants_(as_geometrical_formulas) |geometrical physical constants]], we get geometrical formulas and scalars for; :<math>h^* = 2 \pi MVL = 2^3 \pi^4 \Omega^4 \frac{r^{13}}{v^5},\; u^{15+17-13 = 19}</math> :<math>e^* = AT = \frac{2^7 \pi^4 \Omega^3}{\alpha}\frac{r^3}{v^3},\; u^{3-30 = -27}</math> :<math>k_B^*= 2 \pi MV/A = \frac{\alpha}{2^5 \pi \Omega} \frac{r^{10}}{v^3},\; u^{17+15-3 = 29}</math> ====== c, e, k_B, h ====== :<math>\frac{(k_B^*) (e^*) (c^*)}{(h^*)} = (\frac{\alpha}{2^5 \pi \Omega} \frac{r^{10}}{v^3}) (\frac{2^7 \pi^4 \Omega^3}{\alpha} \frac{r^3}{v^3}) (2 \pi \Omega^2 v) / (2^3 \pi^4 \Omega^4 \frac{r^{13}}{v^5}) </math> = {{font color|blue|yellow|'''1.0'''}}, <math>\frac{ (u^{29}) (u^{-27}) (u^{17}) }{ (u^{19}) } = 1,\; (\frac{r^{10}}{v^3}) (\frac{r^3}{v^3}) (v) / (\frac{r^{13}}{v^5}) = 1</math> :<math>\frac{k_B e c}{h} = </math> {{font color|blue|yellow|'''1.000 8254'''}}, <math>units = \frac{m C}{s^2 K} == \frac{(u^{-13}) (u^{-27})}{(u^{-30})^2 (u^{20})} = 1</math> ====== c, h, e ====== :<math>\frac{(h^*)^3}{(e^*)^{13} (c^*)^{24}} = (2^3 \pi^4 \Omega^4 \frac{r^{13}}{v^5})^3/(\frac{2^7 \pi^4 \Omega^3 r^3}{\alpha v^3})^7.(2\pi\Omega^2 v)^{24} = \frac{\alpha^{13}}{2^{106} \pi^{64} (\color{red}\Omega^{15})^5\color{black}} = </math> {{font color|green|yellow| '''0.228 473 759... 10^-58'''}}, <math>\frac{(u^{19})^{3}}{(u^{-27})^{13} (u^{17})^{24}} = 1, \;(\frac{r^{13}}{v^5})^3 / (\frac{r^3}{v^3})^{13} (v^{24}) = 1</math> :<math>\frac{h^3}{e^{13} c^{24}} = </math> {{font color|green|yellow| '''0.228 473 639... 10^-58'''}}, <math>units = \frac{kg^3 s^{21}}{m^{18} C^{13}} == \frac{(u^{15})^3 (u^{-30})^{21}}{(u^{-13})^{18} (u^{-27})^{13}} = 1</math> ====== m_e, λ_e ====== :<math>\sigma_{e} = \frac{3 \alpha^2 A L}{2\pi^2} = {2^7 3 \pi^3 \alpha \Omega^5}\frac{r^3}{v^2},\; u^{-10}</math> :<math>f_e = \frac{\sigma_{e}^3}{2 T} = 2^{20} 3^3 \pi^8 \alpha^3 (\color{red}\Omega^{15})\color{black},\; \frac{(u^{-10})^3}{u^{-30}} =1,\; (\frac{r^3}{v^2})^3 \frac{v^6}{r^9} = 1</math> :<math>(m_e^*) = \frac{M}{f_e} = \color{blue}9.109\;382\;3227 \;10^{-31}\color{black}\;u^{15}</math> :<math>(m_e^*) = \frac{2^3 \pi^5 (h^*)}{3^3 \alpha^6 (e^*)^3 (c^*)^5} = \frac{1}{2^{20} \pi^8 3^3 \alpha^3 (\color{red}\Omega^{15})\color{black}} \frac{r^4 u^{15}}{v} = \color{blue}9.109\;382\;3227 \;10^{-31}\color{black}\;u^{15}</math> :<math>m_e = \color{blue}9.109\;383\;7015... \;10^{-31}\color{black}\;kg</math> :<math>(\lambda_e^*) = 2 \pi L f_e = \color{purple}2.426\;310\;238\;667 \;10^{-12}\color{black}\;u^{-13}</math> :<math>\lambda_e = \frac{h}{m_e c} = \color{purple}2.426 \;310 \;238 \;67 \;10^{-12}\color{black}\;m</math> ====== c, e, m_e ====== :<math>(m_e^*)= \frac{M}{f_e}, \;f_e = 2^{20} 3^3 \pi^8 \alpha^3 (\color{red}\Omega^{15})^1\color{black} </math>, units = scalars = 1 ([[v:Planck_units_(geometrical)#Electron_formula |m_e formula]]) :<math>\frac{(c^*)^9 (e^*)^4}{(m_e^*)^3} = 2^{97} \pi^{49} 3^9 \alpha^5 (\color{red}\Omega^{15})^5\color{black} = </math> {{font color|red|yellow| '''0.170 514 368... 10⁹²'''}}, <math>\frac{(u^{17})^9 (u^{-27})^4}{(u^{15})^3} = 1,\; (v^9) (\frac{r^3}{v^3})^4 / (\frac{r^4}{v})^3 = 1</math> :<math>\frac{c^9 e^4}{m_e^3} = </math> {{font color|red|yellow| '''0.170 514 342... 10⁹²'''}}, <math>units = \frac{m^9 C^4}{s^9 kg^3} == \frac{(u^{-13})^9 (u^{-27})^4}{(u^{-30})^9 (u^{15})^3} = 1</math> ====== k_B, c, e, m_e ====== :<math>\frac{(k_B^*)}{(e^*)^2 (m_e^*) (c^*)^4} = \frac{3^3 \alpha^6}{2^3 \pi^5} = </math> {{font color|blue|yellow| '''73 035 235 897.'''}}, <math>\frac{(u^{29})}{(u^{-27})^2 (u^{15}) (u^{17})^4} = 1,\; (\frac{r^{10}}{v^3}) / (\frac{r^3}{v^3})^2 (\frac{r^4}{v}) (v)^4 = 1</math> :<math>\frac{k_B}{e^2 m_e c^4} = </math> {{font color|blue|yellow| '''73 095 507 858.'''}}, <math>units = \frac{s^2}{m^2 K C^2} == \frac{(u^{-30})^2}{(u^{-13})^2 (u^{20}) (u^{-27})^2} = 1</math> ====== m_P, t_p, ε₀ ====== These 3 constants, Planck mass, Planck time and the vacuum permittivity have no Omega term. :<math>\frac{M^4 (\epsilon_0^*)}{T} = (1) (\frac{2^9 \pi^3}{\alpha}) / (\pi) = \frac{2^9 \pi^2}{\alpha} = </math> {{font color|green|yellow| '''36.875'''}}, <math>\frac{(u^{15})^4 (u^{-90})}{(u^{-30})} = 1,\; (\frac{r^4}{v})^4 (\frac{1}{r^7 v^2}) / (\frac{r^9}{v^6}) = 1</math> :<math>\frac{m_p^4 (\epsilon_0)}{t_p} = </math> {{font color|green|yellow| '''36.850'''}}, <math>units = \frac{kg^4}{s} \frac{s^4 A^2}{m^3 kg} = \frac{kg^3 A^2 s^3}{m^3} == \frac{(u^{15})^3 (u^{3})^2 (u^{-30})^3}{(u^{-13})^3} = 1</math> ====== G, h, c, e, m_e, K_B ====== :<math>\frac{(h^*) (c^*)^2 (e^*) (m_e^*)}{(G^*)^2 (k_B^*)} = (m_e^*) (\frac{2^{11} \pi^3}{\alpha^2}) = </math> {{font color|red|yellow| '''0.1415... 10^-21'''}}, <math>\frac{ (u^{19}) (u^{17})^2 (u^{-27}) (u^{15}) }{ (u^{6})^2 (u^{29}) } = 1,\; (\frac{r^{13}}{v^5}) v^2 (\frac{r^{3}}{v^3})(\frac{r^{4}}{v^1}) / (\frac{r^5}{v^2})^2 (\frac{r^{10}}{v^3}) = 1</math> :<math>\frac{h c^2 e m_e}{G^2 k_B} = </math> {{font color|red|yellow| '''0.1413... 10^-21'''}}, <math>units = \frac{kg^3 s^3 C K}{m^4} == \frac{(u^{15})^3 (u^{-30})^3 (u^{-27}) (u^{20}) }{(u^{-13})^4} = 1</math> ====== α ====== :<math>\frac{2 (h^*)}{(\mu_0^*) (e^*)^2 (c^*)} = 2({2^3 \pi^4 \Omega^4})/(\frac{\alpha}{2^{11} \pi^5 \Omega^4})(\frac{2^{7} \pi^4 \Omega^3}{\alpha})^2(2 \pi \Omega^2) = \color{blue}\alpha \color{black},\; \frac{u^{19}}{u^{56} (u^{-27})^2 u^{17}} = 1,\; (\frac{r^{13}}{v^5})(\frac{1}{r^7})(\frac{v^6}{r^6})(\frac{1}{v}) = 1</math> Note: The above will apply to any combinations of constants (alien or terrestrial) where '''scalars = 1'''. {| class="wikitable" |+Table of dimensioned physical constants ! CODATA 2014 <ref>[http://www.codata.org/] | CODATA, The Committee on Data for Science and Technology | (2014)</ref> ! SI unit ! Natural constant* (scalars = 1) ! unit number* |- | ''c'' = 299 792 458 (exact) | <math>\frac{m}{s}</math> | ''c*'' = V = 25.3123819329 | 17 |- | ''h'' = 6.626 070 040(81) e-34 | <math>\frac{kg \;m^2}{s}</math> | ''h*'' = <math>2 \pi M V L</math> = 12647.240312 | 19 |- | ''G'' = 6.674 08(31) e-11 | <math>\frac{m^3}{kg \;s^2}</math> | ''G*'' = <math>\frac{V^2 L}{M}</math> = 50950.554778 | 6 |- | ''e'' = 1.602 176 620 8(98) e-19 | <math>C = A s</math> | ''e*'' = <math>A T</math> = 735.706358485 | -27 |- | ''k_B'' = 1.380 648 52(79) e-23 | <math>\frac{kg \;m^2}{s^2 \;K}</math> | ''k_B*'' = <math>\frac{2 \pi V M}{A}</math> = 0.679138336 | 29 |} ===== SI Planck unit scalars ===== :<math>M = m_P = (1)k;\; k = m_P = .217\;672\;817\;58... \;10^{-7},\; u^{15}\; (kg)</math> :<math>T = t_p = {\pi}t;\; t = \frac{t_p}{\pi} = .171\;585\;512\;84... 10^{-43},\; u^{-30}\; (s)</math> :<math>L = l_p = {2\pi^2\Omega^2}l;\; l = \frac{l_p}{2\pi^2\Omega^2} = .203\;220\;869\;48... 10^{-36},\; u^{-13}\; (m)</math> :<math>V = c = {2\pi\Omega^2}v;\; v = \frac{c}{2\pi\Omega^2} = 11\;843\;707.905... ,\; u^{17}\; (m/s)</math> :<math>A = e/t_p = (\frac{2^7 \pi^3 \Omega^3}{\alpha})a = .126\;918\;588\;59... 10^{23},\; u^{3}\; (A)</math> ====== MT to LPVA ====== In this example LPVA are derived from MT. The formulas for MT; :<math>M = (1)k,\; unit = u^{15}</math> :<math>T = (\pi) t,\; unit = u^{-30}</math> Replacing scalars ''pvla'' with ''kt'' :<math>P = (\Omega)\;\frac{k^{12/15}}{t^{2/15}},\; unit = u^{12/15*15-2/15*(-30)=16}</math> :<math>V = \frac{2 \pi P^2}{M} = (2 \pi \Omega^2)\; \frac{k^{9/15}}{t^{4/15}},\; unit = u^{9/15*15-4/15*(-30)=17} </math> :<math>L = T V = (2 \pi^2 \Omega^2) \; k^{9/15} t^{11/15},\; unit = u^{9/15*15+11/15*(-30)=-13}</math> :<math>A = \frac{2^4 V^3}{\alpha P^3} = \left(\frac{2^7 \pi^3 \Omega^3}{\alpha}\right)\; \frac{1}{k^{3/5} t^{2/5}},\; unit = u^{9/15*(-15)+6/15*30=3} </math> ====== PV to MTLA ====== In this example MLTA are derived from PV. The formulas for PV; :<math>P = (\Omega)p,\; unit = u^{16}</math> :<math>V = (2\pi\Omega^2)v,\; unit = u^{17}</math> Replacing scalars ''klta'' with ''pv'' :<math>M = \frac{2\pi P^2}{V} = (1)\frac{p^2}{v},\; unit = u^{16*2-17=15} </math> :<math>T = (\pi) \frac{p^{9/2}}{v^6},\; unit = u^{16*9/2-17*6=-30} </math> :<math>L = T V = (2\pi^2\Omega^2)\frac{p^{9/2}}{v^5},\; unit = u^{16*9/2-17*5=-13}</math> :<math>A = \frac{2^4 V^3}{\alpha P^3} = (\frac{2^7 \pi^3 \Omega^3}{\alpha})\frac{v^3}{p^3},\; unit = u^{17*3-16*3=3}</math> ==== Physical constants (as geometrical formulas) ==== note: <math>\color{red}(u^{15})^n\color{black}</math> constants have no Omega term. {| class="wikitable" |+Dimensioned constants; geometrical vs CODATA 2014 ! Constant ! In Planck units ! Geometrical object ! SI calculated (r, v, Ω, α^*) ! SI CODATA 2014 <ref>[http://www.codata.org/] | CODATA, The Committee on Data for Science and Technology | (2014)</ref> |- | [[w:Speed of light | Speed of light]] | V | <math>c^* = (2\pi\Omega^2)v,\;u^{17} </math> | ''c^*'' = 299 792 458, unit = u¹⁷ | ''c'' = 299 792 458 (exact) |- | [[w:Fine structure constant | Fine structure constant]] | | | ''α^*'' = 137.035 999 139 (mean) | ''α'' = 137.035 999 139(31) |- | [[w:Rydberg constant | Rydberg constant]] | <math>R^* = (\frac{m_e}{4 \pi L \alpha^2 M})</math> | <math>R^* = \frac{1}{2^{23} 3^3 \pi^{11} \alpha^5 \Omega^{17}}\frac{v^5}{r^9},\;u^{13} </math> | ''R^*'' = 10 973 731.568 508, unit = u¹³ | ''R'' = 10 973 731.568 508(65) |- | [[w:Vacuum permeability | Vacuum permeability]] | <math>\mu_0^* = \frac{4 \pi V^2 M}{\alpha L A^2}</math> | <math>\mu_0^* = \frac{\alpha}{2^{11} \pi^5 \Omega^4} r^7,\; u^{17*2+15+13-6=7*8=56}</math> | ''μ₀^*'' = 4π/10^7, unit = u⁵⁶ | ''μ₀'' = 4π/10^7 (exact) |- | [[w:Vacuum permittivity | Vacuum permittivity]] | <math>\epsilon_0^* = \frac{1}{\mu_0^* (c^*)^2}</math> | <math>\epsilon_0^* = \frac{2^9 \pi^3}{\alpha}\frac{1}{r^7 v^2},\; \color{red}1/(u^{15})^6\color{black} = u^{-90}</math> | | |- | [[w:Planck constant | Planck constant]] | <math>h^* = 2 \pi M V L</math> | <math>h^* = 2^3 \pi^4 \Omega^4 \frac{r^{13}}{v^5},\; u^{15+17-13 = 8*13-17*5 = 19}</math> | ''h^*'' = 6.626 069 134 e-34, unit = u¹⁹ | ''h'' = 6.626 070 040(81) e-34 |- | [[w:Gravitational constant | Gravitational constant]] | <math>G^* = \frac{V^2 L}{M}</math> | <math>G^* = 2^3 \pi^4 \Omega^6 \frac{r^5}{v^2},\; u^{34-13-15 = 8*5-17*2 = 6}</math> | ''G^*'' = 6.672 497 192 29 e11, unit = u⁶ | ''G'' = 6.674 08(31) e-11 |- | [[w:Elementary charge | Elementary charge]] | <math>e^* = A T</math> | <math>e^* = \frac{2^7 \pi^4 \Omega^3}{\alpha}\frac{r^3}{v^3},\; u^{3-30=3*8-17*3=-27}</math> | ''e^*'' = 1.602 176 511 30 e-19, unit = u^-27 | ''e'' = 1.602 176 620 8(98) e-19 |- | [[w:Boltzmann constant | Boltzmann constant]] | <math>k_B^* = \frac{2 \pi V M}{A}</math> | <math>k_B^* = \frac{\alpha}{2^5 \pi \Omega} \frac{r^{10}}{v^3},\; u^{17+15-3=10*8-17*3=29}</math> | ''k_B^*'' = 1.379 510 147 52 e-23, unit = u²⁹ | ''k_B'' = 1.380 648 52(79) e-23 |- | [[w:Electron mass | Electron mass]] | | <math>m_e^* = \frac{M}{f_e},\; u^{15}</math> | ''m_e^*'' = 9.109 382 312 56 e-31, unit = u¹⁵ | ''m_e'' = 9.109 383 56(11) e-31 |- | [[w:Classical electron radius | Classical electron radius]] | | <math>\lambda_e^* = 2\pi L f_e,\; u^{-13}</math> | ''λ_e^*'' = 2.426 310 2366 e-12, unit = u^-13 | ''λ_e'' = 2.426 310 236 7(11) e-12 |- | [[w:Planck temperature | Planck temperature]] | <math>T_p^* = \frac{A V}{\pi}</math> | <math>T_p^* = \frac{2^7 \pi^3 \Omega^5}{\alpha} \frac{v^4}{r^6} ,\; u^{3+17=17*4-6*8=20} </math> | ''T_p^*'' = 1.418 145 219 e32, unit = u²⁰ | ''T_p'' = 1.416 784(16) e32 |- | [[w:Planck mass | Planck mass]] | M | <math>m_P^* = (1)\frac{r^4}{v} ,\; \color{red}(u^{15})^1\color{black}</math> | ''m_P^*'' = .217 672 817 580 e-7, unit = u¹⁵ | ''m_P'' = .217 647 0(51) e-7 |- | [[w:Planck length | Planck length]] | L | <math>l_p^* = (2\pi^2\Omega^2)\frac{r^9}{v^5},\;u^{-13} </math> | ''l_p^*'' = .161 603 660 096 e-34, unit = u^-13 | ''l_p'' = .161 622 9(38) e-34 |- | [[w:Planck time | Planck time]] | T | <math>t_p^* = (\pi)\frac{r^9}{v^6} ,\; \color{red}1/(u^{15})^2\color{black} </math> | ''t_p^*'' = 5.390 517 866 e-44, unit = u^-30 | ''t_p'' = 5.391 247(60) e-44 |- | [[w:Ampere | Ampere]] | <math>A = \frac{16 V^3}{\alpha P^3}</math> | <math>A^* = \frac{2^7\pi^3\Omega^3}{\alpha}\frac{v^3}{r^6} ,\; u^3 </math> | A^* = 0.297 221 e25, unit = u³ | ''e/t_p'' = 0.297 181 e25 |- | [[w:Quantum Hall effect | Von Klitzing constant ]] | <math>R_K^* = (\frac{h}{e^2})^*</math> | <math>R_K^* = \frac{\alpha^2}{2^{11} \pi^4 \Omega^2} r^7 v ,\; u^{73}</math> | ''R_K^*'' = 25812.807 455 59, unit = u⁷³ | ''R_K'' = 25812.807 455 5(59) |- | [[w:Gyromagnetic ratio | Gyromagnetic ratio]] | | <math>\gamma_e/2\pi = \frac{g l_p^* m_P^*}{2 k_B^* m_e^*},\; unit = u^{-42}</math> | ''γ_e/2π^*'' = 28024.953 55, unit = u^-42 | ''γ_e/2π'' = 28024.951 64(17) |} Note that ''r, v, Ω, α'' are dimensionless numbers, however when we replace ''u''ⁿ with the SI unit equivalents (''u''¹⁵ → kg, ''u''^-13 → m, ''u''^-30 → s, ...), the ''geometrical objects'' (i.e.: ''c^*'' = 2πΩ²v = 299792458, units = u¹⁷) become '''indistinguishable''' from their respective ''physical constants'' (i.e.: ''c'' = 299792458, units = m/s). If this mathematical relationship can therefore be identified within the SI units themselves, then we have an argument for a Planck scale mathematical universe <ref>[https://codingthecosmos.com/planck-scale.html Planck scale mathematical universe model]</ref>. ===== Electron formula ===== {{main|Electron (mathematical)}} Although the Planck units MLTA are embedded within the electron formula ''f_e'', this formula is both unit-less and non scalable (units = 1, scalars = 1). Furthermore it is the geometry of 2 dimensionless physical constants and so can also be defined as a dimensionless physical constant (if units = scalars = 1, then that constant will be independent of any numerical system and of any system of units, and so would qualify as a "natural unit"). :<math>f_e = 4\pi^2(2^6 3 \pi^2 \alpha \Omega^5)^3 = .23895453...x10^{23}</math> AL as an ampere-meter (ampere-length) are the units for a [[w:magnetic monopole | magnetic monopole]]. :<math>T = \pi \frac{r^9}{v^6},\; u^{-30}</math> :<math>\sigma_{e} = \frac{3 \alpha^2 A L}{2\pi^2} = {2^7 3 \pi^3 \alpha \Omega^5}\frac{r^3}{v^2},\; u^{-10}</math> :<math>f_e = \frac{\sigma_{e}^3}{2 T} = \frac{(2^7 3 \pi^3 \alpha \Omega^5)^3}{2\pi},\; units = \frac{(u^{-10})^3}{u^{-30}} = 1, scalars = (\frac{r^3}{v^2})^3 \frac{v^6}{r^9} = 1</math> The electron has dimensioned parameters, however the dimensions derive from the Planck units, ''f_e'' is a mathematical function that dictates how these Planck objects are applied, it does not have dimension units of its own, consequently there is no physical electron. [[w:electron mass | electron mass]] <math>m_e = \frac{M}{f_e}</math> (M = [[w:Planck mass | Planck mass]]) [[w:Compton wavelength | electron wavelength]] <math>\lambda_e = 2\pi L f_e</math> (L = [[w:Planck length | Planck length]]) [[w:elementary charge | elementary charge]] <math>e = A.T</math> ===== Fine structure constant ===== The Sommerfeld [[w:fine-structure constant | fine structure constant alpha]] is a dimensionless physical constant, the CODATA 2018 inverse alpha = 137.035999084. :<math>\frac{2 (h^*)}{(\mu_0^*) (e^*)^2 (c^*)} = 2({2^3 \pi^4 \Omega^4})/(\frac{\alpha}{2^{11} \pi^5 \Omega^4})(\frac{2^{7} \pi^4 \Omega^3}{\alpha})^2(2 \pi \Omega^2) = \color{blue}\alpha \color{black},\; \frac{u^{19}}{u^{56} (u^{-27})^2 u^{17}} = 1,\; (\frac{r^{13}}{v^5})(\frac{1}{r^7})(\frac{v^6}{r^6})(\frac{1}{v}) = 1</math> ===== Omega ===== The most precise of the experimentally measured constants is the Rydberg ''R = 10973731.568508(65) 1/m''. Here ''c, μ₀, R'' are combined into a unit-less ratio; :<math>\frac{(c^*)^{35}}{(\mu_0^*)^9 (R^*)^7} = (2 \pi \Omega^2)^{35}/(\frac{\alpha}{2^{11} \pi^5 \Omega^4})^9 .(\frac{1} {2^{23} 3^3 \pi^{11} \alpha^5 \Omega^{17}})^7,\;units = \frac{(u^{17})^{35}}{(u^{56})^9 (u^{13})^7} = 1</math> We can now define ''Ω'' using the geometries for (''c^*, μ₀^*, R^*'') and then solve by replacing (''c^*, μ₀^*, R^*'') with the numerical (''c, μ₀, R''). :<math>\Omega^{225}=\frac{(c^*)^{35}}{2^{295} 3^{21} \pi^{157} (\mu_0^*)^9 (R^*)^7 \alpha^{26}}, \;units = 1</math> :<math>\Omega = 2.007\;134\;949\;636...,\; units = 1</math> (CODATA 2014 mean values) :<math>\Omega = 2.007\;134\;949\;687...,\; units = 1</math> (CODATA 2018 mean values) There is a close natural number for ''Ω'' that is a square root implying that ''Ω'' can have a plus or a minus solution and this agrees with theory. This solution would however re-classify Omega as a mathematical constant (as being derivable from other mathematical constants). :<math>\Omega = \sqrt{ \left(\frac{\pi^e}{e^{(e-1)}}\right)} = 2.007\;134\;9543... </math> ===== G, h, e, m_e, k_B ===== As geometrical objects, the physical constants (''G, h, e, m_e, k_B'') can also be defined using the geometrical formulas for (''c^*, μ₀^*, R^*'') and solved using the numerical (mean) values for (''c, μ₀, R, α''). For example; :<math>{(h^*)}^3 = (2^3 \pi^4 \Omega^4 \frac{r^{13} u^{19}}{v^5})^3 = \frac{3^{19} \pi^{12} \Omega^{12} r^{39}}{v^{15}},\; u = 57</math> ... '''and''' ... <math>\frac{2\pi^{10} {(\mu_0^*)}^3} {3^6 {(c^*)}^5 \alpha^{13} {(R^*)}^2} = \frac{3^{19} \pi^{12} \Omega^{12} r^{39}}{v^{15}},\; u = 57</math> {| class="wikitable" |+Calculated from (R, c, μ₀, α) columns 2, 3, 4 vs CODATA 2014 columns 5, 6 ! Constant ! Formula ! Units ! Calculated from (R, c, μ₀, α) ! CODATA 2014 <ref>[http://www.codata.org/] | CODATA, The Committee on Data for Science and Technology | (2014)</ref> ! Units |- | [[w:Planck constant | Planck constant]] | <math>{(h^*)}^3 = \frac{2\pi^{10} {\mu_0}^3} {3^6 {c}^5 \alpha^{13} {R}^2}</math> | <math>\frac{kg^3}{A^6 s}</math>, u = 57 | ''h^*'' = 6.626 069 134 e-34, u = 19 | ''h'' = 6.626 070 040(81) e-34 | <math>\frac{kg \;m^2}{s}</math>, u = 19 |- | [[w:Gravitational constant | Gravitational constant]] | <math>{(G^*)}^5 = \frac{\pi^3 {\mu_0}}{2^{20} 3^6 \alpha^{11} {R}^2}</math> | <math>\frac{kg\; m^3}{A^2 s^2}</math>, u = 30 | ''G^*'' = 6.672 497 192 29 e11, u = 6 | ''G'' = 6.674 08(31) e-11 | <math>\frac{m^3}{kg \;s^2}</math>, u = 6 |- | [[w:Elementary charge | Elementary charge]] | <math>{(e^*)}^3 = \frac{4 \pi^5}{3^3 {c}^4 \alpha^8 {R}}</math> | <math>\frac{s^4}{A^3}</math>, u = -81 | ''e^*'' = 1.602 176 511 30 e-19, u = -27 | ''e'' = 1.602 176 620 8(98) e-19 | <math>A s</math>, u = -27 |- | [[w:Boltzmann constant | Boltzmann constant]] | <math>{(k_B^*)}^3 = \frac{\pi^5 {\mu_0}^3}{3^3 2 {c}^4 \alpha^5 {R}}</math> | <math>\frac{kg^3}{s^2 A^6}</math>, u = 87 | ''k_B^*'' = 1.379 510 147 52 e-23, u = 29 | ''k_B'' = 1.380 648 52(79) e-23 | <math>\frac{kg \;m^2}{s^2 \;K}</math>, u = 29 |- | [[w:Electron mass | Electron mass]] | <math>{(m_e^*)}^3 = \frac{16 \pi^{10} {R} {\mu_0}^3}{3^6 {c}^8 \alpha^7}</math> | <math>\frac{kg^3 s^2}{m^6 A^6}</math>, u = 45 | '' m_e^*'' = 9.109 382 312 56 e-31, u = 15 | ''m_e'' = 9.109 383 56(11) e-31 | <math>kg</math>, u = 15 |- | [[w:Gyromagnetic ratio | Gyromagnetic ratio]] | <math>({(\gamma_e^*)/2\pi})^3 = \frac{g_e^3 3^3 c^4}{2^8 \pi^8 \alpha \mu_0^3 R_\infty^2}</math> | <math>\frac{m^3 s^2 A^6}{kg^3}</math>, u = -126 | ''(γ_e^*/2π)'' = 28024.953 55, u = -42 | ''γ_e/2π'' = 28024.951 64(17) | <math>\frac{A\;s}{kg}</math>, u = -42 |- | [[w:Planck mass | Planck mass]] | <math>({m_P^*})^{15} = \frac{2^{25} \pi^{13} {\mu_0}^6}{3^6 c^5 \alpha^{16} R^2}</math> | <math>\frac{kg^6 m^3}{s^7 A^{12}}</math>, u = 225 | ''m_P^*'' = 0.217 672 817 580 e-7, u = 15 | ''m_P'' = 0.217 647 0(51) e-7 | <math>kg</math>, u = 15 |- | [[w:Planck length | Planck length]] | <math>({l_p^*})^{15} = \frac{\pi^{22} {\mu_0}^9}{2^{35} 3^{24} \alpha^{49} c^{35} R^8}</math> | <math>\frac{kg^9 s^{17}}{m^{18}A^{18}}</math>, u = -195 | ''l_p^*'' = 0.161 603 660 096 e-34, u = -13 | ''l_p'' = 0.161 622 9(38) e-34 | <math>m</math>, u = -13 |} ==== 2019 SI unit revision ==== Following the 26th General Conference on Weights and Measures ([[w:2019 redefinition of SI base units|2019 redefinition of SI base units]]) are fixed the numerical values of the 4 physical constants (''h, c, e, k_B''). In the context of this model however only 2 base units may be assigned by committee as the rest are then numerically fixed by default and so the revision may lead to unintended consequences. {| class="wikitable" |+Physical constants ! Constant ! CODATA 2018 <ref>[http://www.codata.org/] | CODATA, The Committee on Data for Science and Technology | (2018)</ref> |- | [[w:Speed of light | Speed of light]] | ''c'' = 299 792 458 (exact) |- | [[w:Planck constant | Planck constant]] | ''h'' = 6.626 070 15 e-34 (exact) |- | [[w:Elementary charge | Elementary charge]] | ''e'' = 1.602 176 634 e-19 (exact) |- | [[w:Boltzmann constant | Boltzmann constant]] | ''k_B'' = 1.380 649 e-23 (exact) |- | [[w:Fine structure constant | Fine structure constant]] | ''α'' = 137.035 999 084(21) |- | [[w:Rydberg constant | Rydberg constant]] | ''R'' = 10973 731.568 160(21) |- | [[w:Electron mass | Electron mass]] | ''m_e'' = 9.109 383 7015(28) e-31 |- | [[w:Vacuum permeability | Vacuum permeability]] | ''μ₀'' = 1.256 637 062 12(19) e-6 |- | [[w:Quantum_Hall_effect#Applications | Von Klitzing constant]] | ''R_K'' = 25812.807 45 (exact) |} For example, if we solve using the above formulas; <math>R^* = \frac{4 \pi^5}{3^3 c^4 \alpha^8 e^3} = 10973\;729.082\;465</math> <math>{(m_e^*)}^3 = \frac{2^4 \pi^{10} R \mu_0^3}{3^6 c^8 \alpha^7},\;m_e^* = 9.109\;382\;3259 \;10^{-31}</math> <math>{(\mu_0^*)}^3 = \frac{3^6 h^3 c^5 \alpha^{13} R^2}{2 \pi^{10}},\;\mu_0^* = 1.256\;637\;251\;88\;10^{-6}</math> <math>{(h^*)}^3 = \frac{2 \pi^{10} \mu_0^3}{3^6 c^5 \alpha^{13} R^2},\;h^* = 6.626\;069\;149\;10^{-34}</math> <math>{(e^*)}^3 = \frac{4 \pi^5}{3^3 c^4 \alpha^8 R},\; e^* = 1.602\;176\;513\;10^{-19}</math> ==== u as sqrt(velocity/mass) ==== We find there is a single base unit '''u''' from which the other units and numerical values can be derived. This base unit incorporates [[v:Sqrt_Planck_momentum |MLT as square roots]]. =====''u = √{L/M.T}''===== :<math>u,\; units = \sqrt{\frac{L}{M T}} = \sqrt{u^{-13-15+30=2}} = u^1</math> Setting: :<math>x,\;units = \sqrt{\frac{M^9 T^{11}}{L^{15}}} = u^0, units = 1, scalars = 1</math> :<math>y,\;units = M^2T = u^0, units = 1, scalars <> 1</math> Gives; :<math>u^3 = \frac{L^{3/2}}{M^{3/2} T^{3/2}} = A,\; (ampere)</math> :<math>u^6 (y) = \frac{L^3}{T^2 M},\; (G)</math> :<math>u^{13} (xy) = \frac{1}{L},\; (1/l_p)</math> :<math>u^{15} (xy^2) = M,\; (m_P)</math> :<math>u^{17} (xy^2) = V,\; (c)</math> :<math>u^{19} (xy^3) = \frac{ML^2}{T},\; (h)</math> :<math>u^{20} (xy^2) = \frac{L^{5/2}}{M^{3/2} T^{5/2}} = AV,\;(T_P)</math> :<math>u^{27} (x^2y^3) = \frac{M^{3/2}\sqrt{T}}{L^{3/2}} = 1/AT,\; (1/e)</math> :<math>u^{29} (x^2y^4) = \frac{M^{5/2}\sqrt{T}}{\sqrt{L}} = ML/AT,\; (k_B)</math> :<math>u^{30} (x^2 y^3) = \frac{1}{T},\; (1/t_p)</math> :<math>u^{56} (x^4 y^7) = \frac{M^4 T}{L^2},\;(\mu_0)</math> :<math>u^{90} (x^6 y^{11}) = \frac{M^4}{T} </math> ===== ''β'' (unit = ''u'') ===== ''i'' (from ''x'') and ''j'' (from ''y''). :<math>R = \sqrt{P} = \sqrt{\Omega} r,\; units = u^8</math> :<math>\beta = \frac{V}{R^2} = \frac{2\pi R^2}{M} = \frac{A^{1/3} \alpha^{1/3}}{2} \;..., \; unit = u</math> :<math>i = \frac{1}{2\pi {(2\pi \Omega)}^{15}},\; units = 1, scalars = 1</math> :<math>j = \frac{r^{17}}{v^8} = k^2t = \frac{k^8}{r^{15}} ...,\; unit = \frac{u^{17*8}}{u^{8*17}} = u^{15*2}u^{-30} ... = 1,\; units = 1, scalars <> 1</math> For example; the constants solved in terms of (''r, v'') :<math>\beta = \frac{V}{R^2} = \frac{2\pi \Omega^2 v}{\Omega r^2} = \frac{2\pi \Omega v}{r^2},\; u^1 = u</math> :<math>A = \beta^3 (\frac{2^4}{\alpha}) = \frac{2^7 \pi^3 \Omega^3}{\alpha}\frac{v^3}{r^6},\; u^3</math> :<math>G = \frac{\beta^6}{2^3 \pi^2} (j) = 2^3 \pi^4 \Omega^6 \frac{r^5}{v^2},\; u^6</math> :<math>L^{-1} = 4\pi \beta^{13} (ij) = \frac{1}{2\pi^2 \Omega^2} \frac{v^5}{r^9},\; u^{13}</math> :<math>M = 2\pi \beta^{15} (ij^2) = \frac{r^4}{v},\; u^{15}</math> :<math>P = \beta^{16} (ij^2) = \Omega r^2,\; u^{16}</math> :<math>V = \beta^{17} (ij^2) = 2\pi \Omega^2 v,\; u^{17}</math> :<math>h = \pi \beta^{19} (ij^3) = 8\pi^4 \Omega^4 \frac{r^{13}}{v^5},\; u^{19}</math> :<math>T_P^* =\frac{2^3 \beta^{20}}{\pi \alpha} (ij^2) = \frac{2^7 \pi^3 \Omega^5}{\alpha} \frac{v^4}{r^6} ,\; u^{20} </math> :<math>e^{-1} = \frac{\alpha \pi \beta^{27} (i^2j^3)}{4} = \frac{\alpha}{128\pi^4 \Omega^3} \frac{v^3}{r^{3}},\; u^{27} </math> :<math>k_B = \frac{\alpha \pi^2 \beta^{29}(i^2j^4)}{4} = \frac{\alpha}{32 \pi \Omega} \frac{r^{10}}{v^3},\; u^{29}</math> :<math>T^{-1} = 4\pi \beta^{30} (i^2 j^3) = \frac{1}{\pi}\frac{v^6}{r^9},\; u^{30}</math> :<math>\mu_0^* = \frac{\pi^3 \alpha \beta^{56}}{2^3} (i^4 j^7) = \frac{\alpha}{2^{11} \pi^5 \Omega^4} r^7,\; u^{56}</math> :<math>\epsilon_0^{*-1} = \mu_0^* (c^*)^2 = \frac{\pi^3 \alpha \beta^{90}}{2^3} (i^6 j^{11}) = \frac{\alpha}{2^9 \pi^3} v^2 r^7,\; u^{90} </math> ===== limit ''j'' ===== The SI values for ''j'' suggest a limit (numerical boundary) to the values the SI constants can have. :<math>j = \frac{r^{17}}{v^8} = k^2 t = \frac{k^{17/4}}{v^{15/4}} = ... </math> gives a range from 0.812997... ''x''10^-59 to 0.123... ''x''10⁶⁰ In SI terms unit ''β'' can be derived via these ratio; :<math>a^{1/3} = \frac{v}{r^2} = \frac{1}{t^{2/15}k^{1/5}} = \frac{\sqrt{v}}{\sqrt{k}} ... = 23326079.1...; unit = u</math> ===== Rydberg formula ===== The [[w:Rydberg_formula |Rydberg formula]] can now be re-written in terms of amperes <math>A^2</math> :<math>\frac{hc}{2\pi \alpha^2} = \frac{j^2 A^2}{2^8 2\pi t_p}</math> ==== External links ==== * [[v:electron_(mathematical) | Mathematical electron]] * [[v:Relativity_(Planck) | Programming relativity at the Planck scale]] * [[v:Quantum_gravity_(Planck) | Programming gravity at the Planck scale]] * [[v:Black-hole_(Planck) | Programming the cosmic microwave background at the Planck scale]] * [[v:Sqrt_Planck_momentum | The sqrt of Planck momentum]] * [[v:God_(programmer) | The Programmer God]] * [[w:Simulation_hypothesis | The Simulation hypothesis]] * [https://codingthecosmos.com/ Programming at the Planck scale using geometrical objects] -Malcolm Macleod's website * [http://www.simulation-argument.com/ Simulation Argument] -Nick Bostrom's website * [https://www.amazon.com/Our-Mathematical-Universe-Ultimate-Reality/dp/0307599809 Our Mathematical Universe: My Quest for the Ultimate Nature of Reality] -Max Tegmark * [https://dx.doi.org/10.2139/ssrn.2531429 The mathematical electron model in a Planck scale universe] -(article) * [https://link.springer.com/article/10.1134/S0202289308020011/ Dirac-Kerr-Newman black-hole electron] -Alexander Burinskii (article) ==== References ==== {{Reflist}} [[Category: Physics]] [[Category: Philosophy of science]] sb3bqstek6quwo8ltgk6wxoqunayrm9 0 276132 2419237 2418992 2022-08-26T03:16:52Z SunandaUC 2947974 wikitext text/x-wiki {{METP}} == See also == *[[Motivation and emotion/Book/2020/Bewilderment|Bewilderment]] (Book chapter, 2020)[https://en.wikiversity.org/w/index.php?title=User:SunandaUC&action=edit&redlink=1 yolo] fiv7fgo4c6wde6nd9osad3u4gxwnsy1 2419240 2419237 2022-08-26T03:25:37Z SunandaUC 2947974 wikitext text/x-wiki {{METP}} == See also == [[Motivation and emotion/Book/2020/Bewilderment|Bewilderment]] (Book chapter, 2020) nr9yjc2lf1gp83ko5kdmmod6ruzkgct 2419266 2419240 2022-08-26T04:36:04Z SunandaUC 2947974 wikitext text/x-wiki {{METP}} == See also == [[Motivation and emotion/Book/2020/Bewilderment|Bewilderment]] (Book chapter, 2020) {{title|Bewilderment:<br>What is bewilderment and how can it be dealt with?}} {{MECR3|1=https://www.youtube.com/watch?v=oNi1zpbp_Z4}} __TOC__ ==Overview== Many people experience some level of confusion on a common basis, however complete and utter confusion and perplexity can be quite unusual. This feeling can be defined as bewilderment. The synonyms of bewilderment include bafflement, discombobulation, confusion and puzzlement (Merriam Dictionary, 1828). Bewilderment is an intense [[emotion]] that everyone may experience at some point in their life. Bewilderment can be distressing to those who experience it. Although bewilderment can seen as an emotion everyone would want to avoid, it is inevitable that we will all experience it one day, therefore it is important to understand the methods we can adopt to reduce the effects of bewilderment. Experiencing bewilderment may uncover concepts or ideas that we do not know and have not have thought of previously. It is important to understand how bewilderment can occur and how to manage it's effects for when it occurs. {{RoundBoxTop|theme=6}} '''Quote from Jalaluddin Rumi''' "Sell your cleverness and buy bewilderment" {{RoundBoxBottom}} {{RoundBoxTop|theme=2}}'''Focus questions:''' * What is bewilderment? * What are the causes of bewilderment? * What are the effects of bewilderment? * How can bewilderment be dealt with and what are the solutions? {{RoundBoxBottom}} ==What is bewilderment?== [[File:Confused man.jpg|thumb|''Figure 1.'' Depiction of a person experiencing bewilderment]] === Definition of bewilderment === Bewilderment is a short-lived [[emotion]] that is commonly associated with other emotions such as being confused, perplexed, puzzled, baffled, disorientated, oblivious or lost. The [[mwod:bewilderment|Merriam-Webster dictionary]] (1828) defines bewilderment as the quality or state of being lost, perplexed, or confused: the quality or state of being bewildered. Bewilderment in considered to be the opposite of certainty and orientated. Bewilderment is often described as an unpleasant emotion or feeling that is experienced when a person has no notion or understanding of what is happening in a particular situation. Although bewilderment can be harmless, it can cause a person to feel distressed, disturbed and upset. This can be due to the person having no recollection or certainty of the particular situation, therefore the person may lose confidence within themselves and their abilities, which can be daunting and frightening. Bewilderment can be experienced by anyone at any stage of life due to various reasons. Bewilderment can occur in an individual fortuitously due to health reasons and mistakes; or by the hands of another individual, however bewilderment can also be caused intentionally. Although it can be seen in a negative light, bewilderment may also cause a sudden sense of clarity (Akbari, 2019). This can be due to receiving or discovering new information. Akbari (2019) states that bewilderment is essential for the search for insight and knowledge. Bewilderment can be a necessary first step in the process of reaching greater clarity. {{RoundBoxTop|theme=5}} '''Case study example''' Holly has never hiked at this particular mountain before so she took a map with her. Holly believed she had taken the right path whilst on her hike. However, half way through her hike she realises that the path she has taken was the wrong path as she has not passed landmarks that she should have that are displayed on her map. Holly feels lost and confused about her current location as she was sure she took the right path at the start of her hike. The initial emotion Holly is feeling can be defined as bewilderment. {{RoundBoxBottom}} === Causes of bewilderment === Bewilderment can be caused by chance, mistakes, our own fault or the fault or intentions of others. There are multiple causes of bewilderment including: * Alcohol and/ or drug intoxication * Mental illness (e.g. dementia or manic episodes) * Head trauma or a head injury (e.g. concussion) * Receiving or discovering information that they may not understand, have heard of previously or have no notion of * Ageing or reduction in physiological brain functions * Fatigue * Sudden realisation of an event, situation, object, item or another individual === History of bewilderment === The word bewilderment was coined in 1789. However, bewilderment stems from the word [https://dictionary.cambridge.org/dictionary/english/bewilder bewilder], meaning, to confuse someone (Cambridge Advanced Learner's Dictionary & Thesaurus, 1995) which was coined in the 1680's. For hundreds of years, bewilderment has been able to define the intense feeling of complete confusion, disorientation and feeling perplexed. Bewilderment has been used in various forms of media and literature throughout the years. In 2016, a mystery and thriller movie named [[imdbtitle:5911152|Bewilderment]] was developed. Bewilderment has often been a topic throughout poetry as well. For example, a 1998 poem also by the name ''[https://www.asu.edu/pipercwcenter/how2journal/archive/online_archive/v1_1_1999/fhbewild.html 'Bewilderment']'' written by [https://www.poetryfoundation.org/poets/fanny-howe Fanny Howe] which explores and analyses the concepts of bewilderment. {{RoundBoxTop|theme=6}} '''Quote from Fanny Howe''' "Bewilderment circumnambulates, believing that at the center of errant or circular movement, is the axis of reality." {{RoundBoxBottom}} == Effects of bewilderment == As bewilderment is an intense emotion, it can cause many effects to an individual that experiences it, both psychologically and physically. These effects can differ between individuals who experience bewilderment, with some only feeling the psychological effects and not the physical effects. The severity of the effects can also differ between people and the level of bewilderment they are experiencing (HealthDirect, 2020). === Long-term effects === Although long-term effects of bewilderment can be rare, individuals who are more susceptible to feeling bewilderment can develop psychological effects that stay with them long after feeling bewilderment. Bewilderment's long-term effects can be the result of an individual's fear of the unknown or fear of losing their mental and psychological abilities. These psychological effects can include: * [[Anxiety]] * Chronic [[Stress (psychological)|Stress]] * Reduction in self-confidence * [[wikipedia:Depression_(mood)|Depression]] {{RoundBoxTop|theme=5}} '''Case study example''' Ned experiences bewilderment on a regular basis. This is frightening for Ned as he believes that his mental capacities are reducing, therefore, leaving him with gaps in his memories. As a result of this fear, Ned has experienced regular symptoms of anxiety and heightened stress levels. {{RoundBoxBottom}} [[File:Epinephrine.svg|thumb|''Figure 2.'' Chemical compound of Epinephrine, a common hormone produced when experiencing bewilderment ]] === Short-term effects === Short-term effects are more commonly felt whilst experiencing bewilderment and can produce similar symptoms to panic, [[wikipedia:Stress|stress]], [[anxiety]] or [[wikipedia:Fear|fear]]. This can be the result of an individual feeling frightened, alarmed and nervous when experiencing the emotion of bewilderment. When an individual experiences bewilderment, their body can release the hormones [[wikipedia:Adrenocorticotropic_hormone|adrenocorticotropic]], epinephrine (also known as [[wikipedia:Adrenaline|adrenaline]]) and [[wikipedia:Cortisol|cortisol]] into their bloodstream. These hormones can trigger a person's natural survival instincts such as the 'fight or flight' response and produces effects listed in ''Table 1.'' In severe cases of bewilderment, an individual may experience a panic attack due to the sudden increase in hormones throughout their bloodstream. A panic attack can be defined as a brief episode of intense anxiety (Better Health Channel, 2020). A panic attack can also trigger the 'fight or flight' response. However, it is important to note the not everyone who experiences bewilderment will experience these effects or may only receive mild symptoms of bewilderment. <blockquote>Table 1. ''Short-term physical and psychological effects of bewilderment.'' </blockquote>{{center top}} {| border=1 cellspacing=0 cellpadding=5 |- ! Physical ! Psychological |- | Perspiration | Confusion |- | Quickened pulse/ palpitations | Self-doubt |- | Clammy skin | Fear of lack of control |- | Irregular breathing | Feeling out of touch with reality |- | Light-headed feeling | Heightened anxiety and stress levels |} {{center bottom}} {{RoundBoxTop|theme=5}} '''Case study example''' Helen just received information that her husband is having an affair. Helen feels bewildered as she had no idea of the affair. Helen begins to feel her breathing change, beginning to perspire and experience confusion and anxiety. After a short while, Helen then experiences a panic attack. {{RoundBoxBottom}} [[File:Severe nail and cuticle bitting.jpg|thumb|''Figure 3.'' Nail biting, a common form of fiddling when experiencing stress or confusion ]] === Signs of bewilderment in other people === Although bewilderment is an internal emotion, there can be some signs that others are experiencing it. Knowing the signs of bewilderment may assist others in comforting the individual it is happening to. These signs can include: * Slurred or abnormal speech * Fidgeting or fiddling * Sudden change in mood or emotion * Perspiration * Irregular breathing * Need to sit down or lean against something * Difficulties in listening (Healthline, 2020) {{RoundBoxTop|theme=5}}'''Case study example''' Austin just told Matilda about a rumour involving herself. Austin noticed that he is now having trouble communicating with Matilda as she seems to be mentally distant from their conversation. Austin also notices that Matilda is fiddling with the ring on her finger. Austin believes that Matilda is experiencing the emotion of bewilderment. {{RoundBoxBottom}} == Genealogical bewilderment == The term [[wikipedia:Genealogical_bewilderment|genealogical bewilderment]] refers to potential identity issues that can occur in children that have been adopted, fostered or conceived by an assisted reproductive technology procedure. These procedures can include gamete (egg or sperm) donations or using a surrogate mother to gestate the fetus till birth. The term genealogical bewilderment was first coined by [https://bpspsychub.onlinelibrary.wiley.com/doi/abs/10.1111/j.2044-8341.1964.tb01981.x Wellisch] in 1952 (Sants, 1964). Wellisch was interested in studying how genealogical bewilderment can present itself in children who are experiencing adoption stress. Wellish (1952), defines that a genealogical bewildered child has little to no knowledge of their biological parent or parents which results in a state of confusion and uncertainty. Ultimately, this can fundamentally effect the child's sense of security and effect their mental health as they begin to question their genetic makeup, ancestry and heritage. Genealogical bewilderment is prevalent in children with different racial features than their adoptive or foster parents. This is due to their potential desires in discovering the customs and culture of their biological parent or parents. {{RoundBoxTop|theme=6}} '''Quote from Wellisch, 1952''' "Knowledge of and definite relationship to his genealogy is ... necessary for a child to build up his complete body image and world picture. It is an inalienable and entitled right of every person. There is an urge, a call, in everybody to follow and fulfill the tradition of his family, race, nation, and the religious community into which he was born. The loss of this tradition is a deprivation which may result in the stunting of emotional development." {{RoundBoxBottom}} == Bewilderment in theory == === James-Lange theory of emotion === The [[wikipedia:James–Lange_theory|James-Lange theory of emotion]], developed by psychologists William James (1884) and Carl Lange (1887), was one of the first hypothesised explanations of the origins of emotions in modern psychology. The theory suggests that witnessing an emotion-inducing external stimulus (can also been known as an arousal) can create a physiological response to those experiencing it. Examples of these physiological responses can include a quickened pulse, perspiration, and irregular breathing. An emotional response is then developed depending on how the individual interprets the physiological response (Cherry, 2020). The James-Lange theory of emotion has also been known as the peripheral theory of emotion due to the bodily responses being controlled by the peripheral nervous system. The central nervous system then interprets these bodily responses to create an emotion. The James-Lange theory of emotion suggests that the emotion of bewilderment can occur due to a physiological response to an external stimulus. For example, a person discovers new information and their heart begins to pound in their chest. This person then cognitively interprets this bodily feeling as the emotion of bewilderment. Figure 4. ''Diagram of the events of the James-Lange theory of emotion'' <blockquote> External Stimulus (Arousal) → Physiological Response → Emotion </blockquote> === Cannon-Bard theory of emotion === The [[wikipedia:Cannon–Bard_theory|Cannon-Bard theory of emotion]] argues that an emotion-inducing external stimulus almost simultaneously develops an physiological response and an emotion (Cherry, 2020). The theory suggests that emotional responses usually occur instantly whilst physiological responses take one to two seconds after the stimulus has been presented. Cannon (1927) and Bard (1934) argue that although emotional and physiological responses occur mostly simultaneously, they are separate and independent from each other. The Cannon-Bard theory of emotion can also be known as the thalamic theory of emotion due the thalamus role in transmitting a signal to the amygdala (part of the brain responsible for emotional processing) and the autonomic nervous system (Cherry, 2020). The autonomic nervous system is responsible for the physiological responses to the stimulus. In relation to bewilderment, the Cannon-Bard theory suggests the emotion of bewilderment and the physiological responses that an individual can experience from bewilderment occur almost simultaneously due to an emotion-inducing stimulus. For example, an individual begins to feel lost and disorientated whilst hiking. The begin to feel bewildered and their heart-rate immediately increases. Figure 5. ''Diagram of the events of the Cannon-Bard theory of emotion''<blockquote> External Stimulus (Arousal) → Physiological Response + Emotion</blockquote> ==How bewilderment can be dealt with== As bewilderment can be a negative and distressing emotion, it is common for people to resist it by either stopping the emotion prematurely or have certain methods of preventing it all together. It is important to note that bewilderment can feel 'crippling' to some who feel it whilst others consider it to be a passing and somewhat, mildly irritating emotion. However, completely blocking out an entire emotion is not a simple task. An individual that wishes to resist feeling bewilderment can either adopt short-term or long-term solution to manage or treat the effects of bewilderment. [[File:Kamal yoga school (3).jpg|thumb|''Figure 6.'' Yoga is considered to be a relaxing exercise that could decrease the effects of bewilderment ]] === Everyday personal solutions === A beneficial and easy way for a person to prevent or minimize the feeling of bewilderment would be to change some aspects in their day-to-day lifestyle. Some approaches to resist bewilderment include: * Participate in frequent exercise * Do not ingest copious amounts of alcohol * Eat a healthy and balanced diet * Sleeping the suggested healthy amount of sleep per night (approximately 8-10 hours per night) * Avoid recreational drugs By adopting these solutions, the intense emotion of bewilderment may be reduced significantly and may also occur less frequently. === Managing and treating bewilderment === As previously stated, treating a somewhat short-lived emotion is difficult to achieve, therefore, it would be beneficial to receive methods of managing the effects of bewilderment when it is felt. Some of these methods may include: * Taking slow and deep breaths * Counting (e.g. counting your breaths or fingers) * Talk to others about the emotion when it arises (including helplines such as [https://www.beyondblue.org.au/ Beyond Blue]) * Partake in a form of exercise * Distracted from the emotion (e.g. by reading a magazine) These short-term methods of managing the effects of bewilderment can assist a person in distress as they can distract the person. This can therefore reduce the intensity of the effects of bewilderment and can provide instant assistance. Adopting long-term methods for avoiding bewilderment can be difficult, therefore, it would be useful to seek assistance from professionals such as general practitioners, counsellors, psychologists and psychiatrists. These professionals will most likely suggest psychotherapy treatments such as cognitive behavioural therapy (CBT). ==== Cognitive behavioural therapy ==== [[wikipedia:Cognitive_behavioral_therapy|Cognitive behaviour therapy]] (CBT) is a form of psychotherapy that helps you recognise unhelpful or negative thoughts and behavior patterns (Healthline, 2020). CBT can help an individual in identifying and analysing the emotions that they are feeling. CBT allows a person to reorganise and learn how to deal with negative emotions and thoughts in a more positive way by adopting healthy behaviour patterns, therefore, improving emotional regulation. CBT can help people struggling with the effects of bewilderment long-term as it provides the patients with a healthy way of coping with the negative effects of bewilderment. == Interactive learning == {{RoundBoxTop|theme=1}} ''' Quiz ''' <quiz display="simple"> {Which of the following is not a effect or symptom of bewilderment? |type="()"} - Perspiration - Increased heart rate - Fidgeting + Coughing {Which of the following is not a a form of treatment for reducing the effects of bewilderment? |type="()"} - CBT + Ignoring the feeling - Counting - Speaking to another person </quiz> {{RoundBoxBottom}} == Conclusion == Bewilderment can be a defined as a state of complete confusion and disorientation. Bewilderment can be daunting and distressing emotion to feel and may cause other mental disorders such as stress and anxiety. The emotion of bewilderment can most commonly produce short-term physiological effects such as perspiration, quickened pulse and irregular breathing. Bewilderment has the potential to create long-term cognitive effects which can include anxiety. There are a variety of ways in which an individuals can deal with the effects of bewilderment, initially and in the long run. These can include simple solutions such as living a healthy and active lifestyle and confiding within another person (including professionals such as counsellors and psychologists). However, a long-term beneficial form of treatment to prevent or minimise the effects of bewilderment is to partake in cognitive behavioural therapy (CBT). CBT allows a person to be able to identify the emotion whilst providing healthy coping mechanisms. With these measurements in place, bewilderment can become a passing and harmless emotion. Without bewilderment, it can become difficult to reach a greater clarity and breakthroughs (Akbari, 2019). ==See also== # [[Motivation and emotion/Textbook/Motivation/Anxiety|Anxiety]] (Book chapter, 2010) # [[Motivation and emotion/Book/2018/Anxiety neurobiology|Anxiety neurobiology]] (Book chapter, 2018) # [[wikipedia:Cognitive_behavioral_therapy|Cognitive behavioural therapy]] (Wikipedia) # [[Motivation and emotion/Book/2015/Cortisol and stress|Cortisol and stress]] (Book chapter, 2015) # [[Motivation and emotion/Book/2011/Fear|Fear]] (Book chapter, 2011) # [[Motivation and emotion/Book/2011/Handling stress|Handling stress]] (Book chapter, 2011) ==References== {{Hanging indent|1= Akbari, S. C. (2019). From Bewilderment to Clarity. Historical Studies. https://www.ias.edu/ideas/bewilderment-clarity Betterhealth (2020). Cognitive Behaviour Therapy. https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/cognitive-behaviour-therapy Beyondblue. (2020). "Beyond Blue." https://www.beyondblue.org.au/ Dimas, J. (2019). 15 Life Lessons From Rumi. Dwell in Magic. https://jessicadimas.com/life-lessons-from-rumi/ Howe, F. (1998). Bewilderment. https://www.asu.edu/pipercwcenter/how2journal/archive/online_archive/v1_1_1999/fhbewild.html#:~:text=Bewilderment%20is%20an%20enchantment%20that,being%20completely%20lost%20by%20choice! Kasper, H., Bloemer, J. and Driessen, P.H. (2010), Coping with confusion: The case of the Dutch mobile phone market, Managing Service Quality: An International Journal, Vol. 20 No. 2, pp. 140-160. https://doi.org/10.1108/09604521011027570 Khanagha, S., Ramezan Zadeh, M., Mihalache, O., & Volberda, H. (2018). Embracing Bewilderment: Responding to technological disruption in heterogeneous market environments. ''Journal of Management Studies'', ''55''(7), 1078–1121. Lee H. Yearley. (2010). ETHICS OF BEWILDERMENT. ''The Journal of Religious Ethics'', ''38''(3), 436–460. https://doi.org/10.1111/j.1467-9795.2010.00438. Lewis, J. (2019). Reflections: Dialectic of Bewilderment. ''Eighteenth-Century Fiction'', ''31''(3), 575–595. Medical News Today. (2020). Fear: What Happens In The Brain And Body?. https://www.medicalnewstoday.com/articles/323492#Triggering-the-response Sants, H. J. (1964). Genealogical bewilderment in children with substitute parents. British Journal of Medical Science. 37, 133. https://doi.org/10.1111/j.2044-8341.1964.tb01981.x }} ==External links== * [http://blog.pshares.org/index.php/the-poetics-of-bewilderment/ The poetics of bewilderment] (2020) [[Category:{{#titleparts:{{PAGENAME}}|3}}]] [[Category:Motivation and emotion/Book/Negative emotion]] 7k60vh8ye1v7ywcwsxjk1yfx6bi4ok7 2419277 2419266 2022-08-26T04:49:58Z SunandaUC 2947974 Did the layout for the page wikitext text/x-wiki {{title|Bewilderment:<br>What is bewilderment and how can it be dealt with?}} {{MECR3|1=https://www.youtube.com/watch?v=oNi1zpbp_Z4}} __TOC__ ==Overview== ==What is bewilderment?== === Definition of bewilderment === === Causes of bewilderment === === History of bewilderment === == Figures and tables == == Effects of bewilderment == == Treatment of Bewildermnet == == Conclusion == == References == == External Links o29ty1c6rlbxnwdb2qi9hvevhhhn0ac 2419278 2419277 2022-08-26T04:50:55Z SunandaUC 2947974 /* Did the layout wikitext text/x-wiki {{title|Bewilderment:<br>What is bewilderment and how can it be dealt with?}} {{MECR3|1=https://www.youtube.com/watch?v=oNi1zpbp_Z4}} __TOC__ ==Overview== ==What is bewilderment?== == Definition of bewilderment == == Causes of bewilderment == == History of bewilderment == == Figures and tables == == Effects of bewilderment == == Treatment of Bewildermnet == == Conclusion == == References == == External Links == cwbvol59kk0oxgustqo8ratilufdrqy 2419322 2419278 2022-08-26T05:52:33Z SunandaUC 2947974 wikitext text/x-wiki {{title|Bewilderment:<br>What is bewilderment and how can it be dealt with?}} {{MECR3|1=https://www.youtube.com/watch?v=oNi1zpbp_Z4}} __TOC__ ==Overview== ==What is bewilderment?== == Definition of bewilderment == == Causes of bewilderment == == History of bewilderment == == Figures and tables == == Case studies == == Effects of bewilderment == == Treatment of Bewildermnet == == Conclusion == == Quiz == == References == == External Links == la1eawrxnwmpbtvbv8gdl766763rx6q 0 276136 2419056 2419039 2022-08-25T12:44:17Z Rwilliams12 2947623 /* Future Research Direction: Endocannabinoid System as a Therapeutic Tool for Anxiety-related Disorders */ wikitext text/x-wiki {{METP}} {{title|Endocannabinoid system and emotion:<br>What is the role of the endocannabinoid system in emotion? }} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== The [[wikipedia:Endocannabinoid_system|endocannabinoid system]] is critical in the emotional, cognitive and physical homeostasis within the human body. The endocannabinoid system is defined as a widespread neuromodulatory system that plays a significant role in central nervous system (CNS) development, synaptic plasticity and recognising endogenous and environmental stimuli (Lu & Mackie, 2015). Endocannabinoids and their receptors are densely packed together and located throughout the entirety of the human body; in the organs, conncective tissues, in the brain, glands and in the immune systems cells (Alger, 2013; Kendall & Yudowski, 2016). Additionally, research into the endocannabinoid system and the pharmacology of endocannabinoids began in the late 1940's, several decades before cannabinoids were detected in [[Should cannabis be legal?|canabis]] (also known as [[marijuana]]) (Pertwee, 2006). Since the first discovery in the 1940's, endocannabinoids were quickly discovered to be very useful and efficient in pharmacological medicines in order to treat drug addictions, regulating anxiety, stress, and as a therapeutic tool to improve emotional regulation and processes (Litvin, Phan, Hill, Pfaff, & McEwen, 2013; Marco & Laviola, 2013). Throughout the chapter, the endocannabinoid system will be presented and discussed in depth with assistance from credible research. Firstly, the endocannabinoid system will be discussed, outlining the systems history, impacts and significance in the psychology field. Additionally, discussing physiological processes of the endocannabinoid system and the main receptors involved. Next, the chapter will delve into basic emotions, highlighting core emotions related to the endocannabinoid system and the impact on emotional processing and regulation of an individual. Lastly the chapter will outline future directions of research. {{RoundBoxTop|theme=3}} '''Focus questions:''' * What is the endocannabinoid system? * What is emotion? * How does the endocannabinoid system and emotions interact?{{RoundBoxBottom}} ==What is the Endocannabinoid System?== * The endocannabinoid system is a complex cell signalling system that serves various protective roles in pathophysiological conditions (Chanda, Neumann, & Glatz, 2019). *The endocannabinoid system is significant in relation to emotions across the human lifespan, emotional regulation and processing (Marco & Laviola, 2013). === Physiological processes of the Endocannabinoid System === * The endogenous cannabinoid system or, the endocannabinoid system (ECS) is comprised of endogenous cannabinoids (endocannabinoids), cannabinoid receptors, and the enzymes responsible for the synthesis and degradation of endocannabinoids (Lu & Mackie, 2015). Explain further with diagram and how the daily functioning of the ECS works in detail. *Physiological processes of the ECS in relation to emotional processing and regulation, cannabinoids effect of "bliss" on the human body but also could be contributing to anxiety, depression and psychosis states (Moreira & Lutz, 2008). ==== ''CB1 Receptors'' ==== * CB1 is densely located and packed in the neocortex, hippocampus, basal ganglia, amygdala, striatum, cerebellum, and hypothalamus. These major brain regions mediate a wide variety of high-order behavioural functions, including learning and memory, executive function decision making, sensory and motor responsiveness, and emotional reactions, as well as feeding and other homeostatic processes (Alger, 2013). *Key role in the central nervous system, flight, fight or freeze responses, anxiety and arousal levels particularly (Litvin et. al., 2013). *If deficient in CB1 receptors- talk in more detail about lack of this- Deficiency of CB1 receptor signaling is associated with anhedonia, anxiety, and persistence of negative memories. CB1 receptor-endocannabinoid signaling is activated by stress and functions to buffer or dampen the behavioral and endocrine effects of acute stress (Hillard, 2016). ==== ''CB2 Receptors'' ==== * CB2 receptor is mainly associated with the internal workings of the immune system and immune modulation (Alger, 2013; Christino, Bisogno & Di Marzo, 2020) * Unlike CB1 receptors, CB2 receptors are less densely packed within the body and expressed in the microglia in conditions such as: alzheimers (AD), multiple sclerosis (MS) and schizophrenia (Christino, Bisogno & Di Marzo, 2020). * In comparison to the CB1 receptors, CB2 has an unclear link to emotional processing and regulation, however more research is needed in this area for a deeper understanding of how CB2 can be a therapeutic aid for neurological disorders in the future (Chanda, Neumann, & Glatz, 2019). [[File:Anxiety cloud.png|thumb|Fig 1. Emotions of Fear, Anxiety and Stress represented as a cloud]] == What is Emotion? == * There is no clear dictionary aligned definition of "[[emotion]]". The term is taken for granted in itself and, most often, emotion is defined with reference to a list: anger, disgust, fear, joy, sadness, and surprise (Cabanac, 2002). Cabanac (2002) proposes that emotion is any mental experience with high intensity and high hedonic content (pleasure/displeasure) and later explores emotion and the interrelated concept of consciousness in his 2009 research. * Orthony (2022) proposes that for decades the concept of basic emotions are "placed into lists and tables". That despite decades of challenges to the idea that a small number of emotions enjoys the special status of "basic emotions,” the idea continues to have considerable influence in psychology and beyond. However, different theorists have proposed substantially different lists of basic emotions, which suggests that there exists no stable criterion of basicness. To some extent, the basic-emotions enterprise is bedeviled by an overreliance on English affective terms, but there also lurks a more serious problem—the lack of agreement as to what emotions are. * Modern emotion theories typically try to account for the observations that emotions are triggered by events of some significance or relevance to an organism, that they encompass a coordinated set of changes in brain and body, and that they appear adaptive in the sense that they are directed towards coping with whatever challenge was posed by the triggering event (Adolphs, 2010). === Focus emotions: Fear and Anxiety === *Fear is stated to be a core emotion in relation to the endocannabinoid system, as it is directly correlated with feelings of anxiety and a "flight response" (Moreira & Lutz, 2008). *Fear is triggered by external, not internal stimuli and is triggered by the amygdala (a complex part of the temporal lobe of the brain) which is stated to access past fearful experiences in order to develop a fear response (Hyman, 1998). Fear and anxiety are demonstrated to be closely related as the amygdala is not only provoked when an external, unpleasant stimuli is presented and is also activated in the presence of anxiety and phobia related stimuli (Alger, 2013). *Cannabinoid receptors are densely located in brain areas involved in emotional states, including amygdala, hypocampus and other limbic sites. Effects on anxiety are thought to be mediated mainly by CB1 receptors but possibly also by CB2 and GPR55 receptors (Ashton & Moore, 2011). == Endocannabinoid System and Emotions == *The interaction between the endocannabinoid system (ECS) and emotions is depicted to be closely related - expand on concept more... *The endocannabinoid systemoperates act mainly as an undercurrent of brain activity below the level of consciousness but the tone of the system, ‘endocannabinoid tone’, influences conscious perceptions and affects mood and behaviour and their physical accompaniments (Ashton & Moore, 2011). === The Effect of Fear and Anxiety on the Endocannabinoid System === * By understanding the link between fear and anxiety in the human body, the better the understanding of how fear and anxiety function within the endocannabinoid system (ECS). *Hyman (1998) proposes a relationship between the amygdala's effect on a fear response in an individual and how fear can increase anxiety, and anxiety can increase a fear response in patients who have a lesion in their amygdala. Thus, those patients are more likely to experience stronger feelings of fear and anxiety to external stimuli. *The effect of fear and anxiety on the endocannabinoid system is related to an internal coping mechanism, in which an individual must adapt to their environment in order to survive (Lutz, Marsicano, Maldonaldo, & Hillard, 2015). *ECB signalling seems to determine the value of fear-evoking stimuli and to tune appropriate behavioural responses, which are essential for the organism’s long-term viability, homeostasis and stress resilience; and dysregulation of eCB signalling can lead to psychiatric disorders (Lutz, Marsicano, Maldonaldo, & Hillard, 2015). ==== ''Positive interaction of anxiety and the endocannabinoid system'' ==== * The relationship between anxiety states and behaviours and the endocannabinoid system (ECS) is directy correlated to the use of cannabis. Cannabis is demonstrated to have "euphoric effects" and "highs", which increases an individuals need for socialisation and connection, thus decreasing anxiety behaviours (Lutz, Marsicano, Maldonaldo, & Hillard, 2015; Hillard, 2014). * Use example of report where individual reported to feel "relaxed" and "calm" even though she deals with Generalised Anxiety Disorder (GAD) on a daily basis (Bossong et al., 2013) ==== ''Negative interaction of anxiety and the endocannabinoid system'' ==== * In opposing studies, it was found that anxiety behaviour and thought patterns can be actually increased in a maladaptive manner, rather than it assisting an individual. * Draw on studies from; Jenneriches et al., (2016)- talk about reliability of study however, as most of study was performed on mice. === Role of Endocannabinoid system in Emotional Regulation and Processing === * Acute emotional processing is vital to interpersonal relationships and daily social interactions with others. Without strong emotional processing skills, individuals are more likely to inherit or become subject to major depressive disorder (MPD), bipolar disorder (BPD) and schizophrenia (Bossong, Jager, Kahn, Ramsey, & Jansma 2013). * expand on further research in this area and the importance of the endocannabinoid systems role in emotional regulation and processing == Future Research Direction: Endocannabinoid System as a Therapeutic Tool for Anxiety-related Disorders == * The endocannabinoid system as a therapeutic tool for anxiety-related disorders is still a new topic in scope, with limited research in implementing cannabinoids as an aid for reducing anxiety in particular (Alger, 2013). * The endocannabinoid system appears to play a pivotal role in the regulation of emotional states and may constitute a novel pharmacological target for anti-anxiety therapy- cognitive behavioural therapy (CBT) and talk therapy (Lu & Mackie, 2015; Moreira & Lutz, 2008) ==Conclusion== {{tip|Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? }} * ==References== {{Hanging indent|1= Adolphs. (2010). Emotion. Current Biology, 20(13), R549–R552. https://doi.org/10.1016/j.cub.2010.05.046 Alger, B. (2013). Getting high on the endocannabinoid system. Cerebrum, 14, 1-11. doi: PMC3997295 Ashton, & Moore, P. B. (2011). Endocannabinoid system dysfunction in mood and related disorders. Acta Psychiatrica Scandinavica, 124(4), 250–261. https://doi.org/10.1111/j.1600-0447.2011.01687.x Bossong, van Hell, H. H., Jager, G., Kahn, R. S., Ramsey, N. F., & Jansma, J. M. (2013). The endocannabinoid system and emotional processing: A pharmacological fMRI study with ∆9-tetrahydrocannabinol. European Neuropsychopharmacology, 23(12), 1687–1697. https://doi.org/10.1016/j.euroneuro.2013.06.009 Cabanac, Cabanac, A. J., & Parent, A. (2009). The emergence of consciousness in phylogeny. Behavioural Brain Research, 198(2), 267–272. https://doi.org/10.1016/j.bbr.2008.11.028 Cabanac. (2002). What is emotion? Behavioural Processes, 60(2), 69–83. https://doi.org/10.1016/S0376-6357(02)00078-5 Chanda, Neumann, D., & Glatz, J. F. C. (2019). The endocannabinoid system: Overview of an emerging multi-faceted therapeutic target. Prostaglandins, Leukotrienes and Essential Fatty Acids, 140, 51–56. https://doi.org/10.1016/j.plefa.2018.11.016 Cristino, Bisogno, T., & Di Marzo, V. (2020). Cannabinoids and the expanded endocannabinoid system in neurological disorders. Nature Reviews. Neurology, 16(1), 9–29. https://doi.org/10.1038/s41582-019-0284- Hillard. (2014). Stress regulates endocannabinoid-CB1 receptor signaling. Seminars in Immunology, 26(5), 380–388. https://doi.org/10.1016/j.smim.2014.04.001 Hyman. (1998). Neurobiology A new image for fear and emotion. Nature (London), 393(6684), 417–418. https://doi.org/10.1038/30855 Jenniches, I., Ternes, S., Albayram, O., Otte, D., Bach, K., & Bindila, L. et al. (2016). Anxiety, Stress, and Fear Response in Mice With Reduced Endocannabinoid Levels. Biological Psychiatry, 79(10), 858-868. doi: 10.1016/j.biopsych.2015.03.033 Lu, H., & Mackie, K. (2016). An introduction to the endogenous cannabinoid system. Biol Psychiatry, 79(7). doi: 10.1016/j.biopsych.2015.07.028. Kendall, & Yudowski, G. A. (2016). Cannabinoid Receptors in the Central Nervous System: Their Signaling and Roles in Disease. Frontiers in Cellular Neuroscience, 10, 294–294. https://doi.org/10.3389/fncel.2016.00294 Litvin, Phan, A., Hill, M. N., Pfaff, D. W., & McEwen, B. S. (2013). CB1 receptor signaling regulates social anxiety and memory. Genes, Brain and Behavior, 12(5), 479–489. https://doi.org/10.1111/gbb.12045 Lu, & Mackie, K. (2015). An Introduction to the Endogenous Cannabinoid System. Biological Psychiatry (1969), 79(7), 516–525. https://doi.org/10.1016/j.biopsych.2015.07.028 Lutz, Marsicano, G., Maldonado, R., & Hillard, C. J. (2015). The endocannabinoid system in guarding against fear, anxiety and stress. Nature Reviews. Neuroscience, 16(12), 705–718. https://doi.org/10.1038/nrn4036 Marco, & Laviola, G. (2012). The endocannabinoid system in the regulation of emotions throughout lifespan: a discussion on therapeutic perspectives. Journal of Psychopharmacology (Oxford), 26(1), 150–163. https://doi.org/10.1177/0269881111408459 Moreira, & Lutz, B. (2008). The endocannabinoid system: emotion, learning and addiction. Addiction Biology, 13(2), 196–212. https://doi.org/10.1111/j.1369-1600.2008.00104.x Ortony. (2022). Are All “Basic Emotions” Emotions? A Problem for the (Basic) Emotions Construct. Perspectives on Psychological Science, 17(1), 41–61. https://doi.org/10.1177/1745691620985415 Pertwee. (2006). Cannabinoid pharmacology: the first 66 years. British Journal of Pharmacology, 147(S1), S163–S171. https://doi.org/10.1038/sj.bjp.0706406 }} {{tip|Suggestions for this section: * Important aspects for APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except first letter and proper names, ending in a full-stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full-stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't actually read or consulted}} ==External links== Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] ==See also== * [[Motivation and emotion/Book/2020/Endocannabinoid system and emotion|Endocannabinoid system and emotion]] (Book chapter, 2020) - u3216457 62e40j7etfctnpt11y4g8xa3duuotqz 2419057 2419056 2022-08-25T13:02:58Z Rwilliams12 2947623 /* Conclusion */ wikitext text/x-wiki {{METP}} {{title|Endocannabinoid system and emotion:<br>What is the role of the endocannabinoid system in emotion? }} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== The [[wikipedia:Endocannabinoid_system|endocannabinoid system]] is critical in the emotional, cognitive and physical homeostasis within the human body. The endocannabinoid system is defined as a widespread neuromodulatory system that plays a significant role in central nervous system (CNS) development, synaptic plasticity and recognising endogenous and environmental stimuli (Lu & Mackie, 2015). Endocannabinoids and their receptors are densely packed together and located throughout the entirety of the human body; in the organs, conncective tissues, in the brain, glands and in the immune systems cells (Alger, 2013; Kendall & Yudowski, 2016). Additionally, research into the endocannabinoid system and the pharmacology of endocannabinoids began in the late 1940's, several decades before cannabinoids were detected in [[Should cannabis be legal?|canabis]] (also known as [[marijuana]]) (Pertwee, 2006). Since the first discovery in the 1940's, endocannabinoids were quickly discovered to be very useful and efficient in pharmacological medicines in order to treat drug addictions, regulating anxiety, stress, and as a therapeutic tool to improve emotional regulation and processes (Litvin, Phan, Hill, Pfaff, & McEwen, 2013; Marco & Laviola, 2013). Throughout the chapter, the endocannabinoid system will be presented and discussed in depth with assistance from credible research. Firstly, the endocannabinoid system will be discussed, outlining the systems history, impacts and significance in the psychology field. Additionally, discussing physiological processes of the endocannabinoid system and the main receptors involved. Next, the chapter will delve into basic emotions, highlighting core emotions related to the endocannabinoid system and the impact on emotional processing and regulation of an individual. Lastly the chapter will outline future directions of research. {{RoundBoxTop|theme=3}} '''Focus questions:''' * What is the endocannabinoid system? * What is emotion? * How does the endocannabinoid system and emotions interact?{{RoundBoxBottom}} ==What is the Endocannabinoid System?== * The endocannabinoid system is a complex cell signalling system that serves various protective roles in pathophysiological conditions (Chanda, Neumann, & Glatz, 2019). *The endocannabinoid system is significant in relation to emotions across the human lifespan, emotional regulation and processing (Marco & Laviola, 2013). [[File:Endocannabinoid system and major brain regions.png|thumb|fig. 1 endocannabinoid system and the major brain regions]] === Physiological processes of the Endocannabinoid System === * The endogenous cannabinoid system or, the endocannabinoid system (ECS) is comprised of endogenous cannabinoids (endocannabinoids), cannabinoid receptors, and the enzymes responsible for the synthesis and degradation of endocannabinoids (Lu & Mackie, 2015). Explain further with diagram and how the daily functioning of the ECS works in detail. *Physiological processes of the ECS in relation to emotional processing and regulation, cannabinoids effect of "bliss" on the human body but also could be contributing to anxiety, depression and psychosis states (Moreira & Lutz, 2008). ==== ''CB1 Receptors'' ==== * CB1 is densely located and packed in the neocortex, hippocampus, basal ganglia, amygdala, striatum, cerebellum, and hypothalamus. These major brain regions mediate a wide variety of high-order behavioural functions, including learning and memory, executive function decision making, sensory and motor responsiveness, and emotional reactions, as well as feeding and other homeostatic processes (Alger, 2013). *Key role in the central nervous system, flight, fight or freeze responses, anxiety and arousal levels particularly (Litvin et. al., 2013). *If deficient in CB1 receptors- talk in more detail about lack of this- Deficiency of CB1 receptor signaling is associated with anhedonia, anxiety, and persistence of negative memories. CB1 receptor-endocannabinoid signaling is activated by stress and functions to buffer or dampen the behavioral and endocrine effects of acute stress (Hillard, 2016). ==== ''CB2 Receptors'' ==== * CB2 receptor is mainly associated with the internal workings of the immune system and immune modulation (Alger, 2013; Christino, Bisogno & Di Marzo, 2020) * Unlike CB1 receptors, CB2 receptors are less densely packed within the body and expressed in the microglia in conditions such as: alzheimers (AD), multiple sclerosis (MS) and schizophrenia (Christino, Bisogno & Di Marzo, 2020). * In comparison to the CB1 receptors, CB2 has an unclear link to emotional processing and regulation, however more research is needed in this area for a deeper understanding of how CB2 can be a therapeutic aid for neurological disorders in the future (Chanda, Neumann, & Glatz, 2019). [[File:Anxiety cloud.png|thumb|fig 2. emotions of fear, anxiety and stress represented as a cloud]] == What is Emotion? == * There is no clear dictionary aligned definition of "[[emotion]]". The term is taken for granted in itself and, most often, emotion is defined with reference to a list: anger, disgust, fear, joy, sadness, and surprise (Cabanac, 2002). Cabanac (2002) proposes that emotion is any mental experience with high intensity and high hedonic content (pleasure/displeasure) and later explores emotion and the interrelated concept of consciousness in his 2009 research. * Orthony (2022) proposes that for decades the concept of basic emotions are "placed into lists and tables". That despite decades of challenges to the idea that a small number of emotions enjoys the special status of "basic emotions,” the idea continues to have considerable influence in psychology and beyond. However, different theorists have proposed substantially different lists of basic emotions, which suggests that there exists no stable criterion of basicness. To some extent, the basic-emotions enterprise is bedeviled by an overreliance on English affective terms, but there also lurks a more serious problem—the lack of agreement as to what emotions are. * Modern emotion theories typically try to account for the observations that emotions are triggered by events of some significance or relevance to an organism, that they encompass a coordinated set of changes in brain and body, and that they appear adaptive in the sense that they are directed towards coping with whatever challenge was posed by the triggering event (Adolphs, 2010). === Focus emotions: Fear and Anxiety === *Fear is stated to be a core emotion in relation to the endocannabinoid system, as it is directly correlated with feelings of anxiety and a "flight response" (Moreira & Lutz, 2008). *Fear is triggered by external, not internal stimuli and is triggered by the amygdala (a complex part of the temporal lobe of the brain) which is stated to access past fearful experiences in order to develop a fear response (Hyman, 1998). Fear and anxiety are demonstrated to be closely related as the amygdala is not only provoked when an external, unpleasant stimuli is presented and is also activated in the presence of anxiety and phobia related stimuli (Alger, 2013). *Cannabinoid receptors are densely located in brain areas involved in emotional states, including amygdala, hypocampus and other limbic sites. Effects on anxiety are thought to be mediated mainly by CB1 receptors but possibly also by CB2 and GPR55 receptors (Ashton & Moore, 2011). == Endocannabinoid System and Emotions == *The interaction between the endocannabinoid system (ECS) and emotions is depicted to be closely related - expand on concept more... *The endocannabinoid systemoperates act mainly as an undercurrent of brain activity below the level of consciousness but the tone of the system, ‘endocannabinoid tone’, influences conscious perceptions and affects mood and behaviour and their physical accompaniments (Ashton & Moore, 2011). === The Effect of Fear and Anxiety on the Endocannabinoid System === * By understanding the link between fear and anxiety in the human body, the better the understanding of how fear and anxiety function within the endocannabinoid system (ECS). *Hyman (1998) proposes a relationship between the amygdala's effect on a fear response in an individual and how fear can increase anxiety, and anxiety can increase a fear response in patients who have a lesion in their amygdala. Thus, those patients are more likely to experience stronger feelings of fear and anxiety to external stimuli. *The effect of fear and anxiety on the endocannabinoid system is related to an internal coping mechanism, in which an individual must adapt to their environment in order to survive (Lutz, Marsicano, Maldonaldo, & Hillard, 2015). *ECB signalling seems to determine the value of fear-evoking stimuli and to tune appropriate behavioural responses, which are essential for the organism’s long-term viability, homeostasis and stress resilience; and dysregulation of eCB signalling can lead to psychiatric disorders (Lutz, Marsicano, Maldonaldo, & Hillard, 2015). ==== ''Positive interaction of anxiety and the endocannabinoid system'' ==== * The relationship between anxiety states and behaviours and the endocannabinoid system (ECS) is directy correlated to the use of cannabis. Cannabis is demonstrated to have "euphoric effects" and "highs", which increases an individuals need for socialisation and connection, thus decreasing anxiety behaviours (Lutz, Marsicano, Maldonaldo, & Hillard, 2015; Hillard, 2014). * Use example of report where individual reported to feel "relaxed" and "calm" even though she deals with Generalised Anxiety Disorder (GAD) on a daily basis (Bossong et al., 2013) ==== ''Negative interaction of anxiety and the endocannabinoid system'' ==== * In opposing studies, it was found that anxiety behaviour and thought patterns can be actually increased in a maladaptive manner, rather than it assisting an individual. * Draw on studies from; Jenneriches et al., (2016)- talk about reliability of study however, as most of study was performed on mice. === Role of Endocannabinoid system in Emotional Regulation and Processing === * Acute emotional processing is vital to interpersonal relationships and daily social interactions with others. Without strong emotional processing skills, individuals are more likely to inherit or become subject to major depressive disorder (MPD), bipolar disorder (BPD) and schizophrenia (Bossong, Jager, Kahn, Ramsey, & Jansma 2013). * expand on further research in this area and the importance of the endocannabinoid systems role in emotional regulation and processing == Future Research Direction: Endocannabinoid System as a Therapeutic Tool for Anxiety-related Disorders == * The endocannabinoid system as a therapeutic tool for anxiety-related disorders is still a new topic in scope, with limited research in implementing cannabinoids as an aid for reducing anxiety in particular (Alger, 2013). * The endocannabinoid system appears to play a pivotal role in the regulation of emotional states and may constitute a novel pharmacological target for anti-anxiety therapy- cognitive behavioural therapy (CBT) and talk therapy (Lu & Mackie, 2015; Moreira & Lutz, 2008) ==Conclusion== {{tip|Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? }} * ==References== {{Hanging indent|1= Adolphs. (2010). Emotion. Current Biology, 20(13), R549–R552. https://doi.org/10.1016/j.cub.2010.05.046 Alger, B. (2013). Getting high on the endocannabinoid system. Cerebrum, 14, 1-11. doi: PMC3997295 Ashton, & Moore, P. B. (2011). Endocannabinoid system dysfunction in mood and related disorders. Acta Psychiatrica Scandinavica, 124(4), 250–261. https://doi.org/10.1111/j.1600-0447.2011.01687.x Bossong, van Hell, H. H., Jager, G., Kahn, R. S., Ramsey, N. F., & Jansma, J. M. (2013). The endocannabinoid system and emotional processing: A pharmacological fMRI study with ∆9-tetrahydrocannabinol. European Neuropsychopharmacology, 23(12), 1687–1697. https://doi.org/10.1016/j.euroneuro.2013.06.009 Cabanac, Cabanac, A. J., & Parent, A. (2009). The emergence of consciousness in phylogeny. Behavioural Brain Research, 198(2), 267–272. https://doi.org/10.1016/j.bbr.2008.11.028 Cabanac. (2002). What is emotion? Behavioural Processes, 60(2), 69–83. https://doi.org/10.1016/S0376-6357(02)00078-5 Chanda, Neumann, D., & Glatz, J. F. C. (2019). The endocannabinoid system: Overview of an emerging multi-faceted therapeutic target. Prostaglandins, Leukotrienes and Essential Fatty Acids, 140, 51–56. https://doi.org/10.1016/j.plefa.2018.11.016 Cristino, Bisogno, T., & Di Marzo, V. (2020). Cannabinoids and the expanded endocannabinoid system in neurological disorders. Nature Reviews. Neurology, 16(1), 9–29. https://doi.org/10.1038/s41582-019-0284- Hillard. (2014). Stress regulates endocannabinoid-CB1 receptor signaling. Seminars in Immunology, 26(5), 380–388. https://doi.org/10.1016/j.smim.2014.04.001 Hyman. (1998). Neurobiology A new image for fear and emotion. Nature (London), 393(6684), 417–418. https://doi.org/10.1038/30855 Jenniches, I., Ternes, S., Albayram, O., Otte, D., Bach, K., & Bindila, L. et al. (2016). Anxiety, Stress, and Fear Response in Mice With Reduced Endocannabinoid Levels. Biological Psychiatry, 79(10), 858-868. doi: 10.1016/j.biopsych.2015.03.033 Lu, H., & Mackie, K. (2016). An introduction to the endogenous cannabinoid system. Biol Psychiatry, 79(7). doi: 10.1016/j.biopsych.2015.07.028. Kendall, & Yudowski, G. A. (2016). Cannabinoid Receptors in the Central Nervous System: Their Signaling and Roles in Disease. Frontiers in Cellular Neuroscience, 10, 294–294. https://doi.org/10.3389/fncel.2016.00294 Litvin, Phan, A., Hill, M. N., Pfaff, D. W., & McEwen, B. S. (2013). CB1 receptor signaling regulates social anxiety and memory. Genes, Brain and Behavior, 12(5), 479–489. https://doi.org/10.1111/gbb.12045 Lu, & Mackie, K. (2015). An Introduction to the Endogenous Cannabinoid System. Biological Psychiatry (1969), 79(7), 516–525. https://doi.org/10.1016/j.biopsych.2015.07.028 Lutz, Marsicano, G., Maldonado, R., & Hillard, C. J. (2015). The endocannabinoid system in guarding against fear, anxiety and stress. Nature Reviews. Neuroscience, 16(12), 705–718. https://doi.org/10.1038/nrn4036 Marco, & Laviola, G. (2012). The endocannabinoid system in the regulation of emotions throughout lifespan: a discussion on therapeutic perspectives. Journal of Psychopharmacology (Oxford), 26(1), 150–163. https://doi.org/10.1177/0269881111408459 Moreira, & Lutz, B. (2008). The endocannabinoid system: emotion, learning and addiction. Addiction Biology, 13(2), 196–212. https://doi.org/10.1111/j.1369-1600.2008.00104.x Ortony. (2022). Are All “Basic Emotions” Emotions? A Problem for the (Basic) Emotions Construct. Perspectives on Psychological Science, 17(1), 41–61. https://doi.org/10.1177/1745691620985415 Pertwee. (2006). Cannabinoid pharmacology: the first 66 years. British Journal of Pharmacology, 147(S1), S163–S171. https://doi.org/10.1038/sj.bjp.0706406 }} {{tip|Suggestions for this section: * Important aspects for APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except first letter and proper names, ending in a full-stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full-stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't actually read or consulted}} ==External links== Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] ==See also== * [[Motivation and emotion/Book/2020/Endocannabinoid system and emotion|Endocannabinoid system and emotion]] (Book chapter, 2020) - u3216457 pominybd6glykfqu1o68gt0r2agjbbi 2419058 2419057 2022-08-25T13:09:18Z Rwilliams12 2947623 /* References */ wikitext text/x-wiki {{METP}} {{title|Endocannabinoid system and emotion:<br>What is the role of the endocannabinoid system in emotion? }} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== The [[wikipedia:Endocannabinoid_system|endocannabinoid system]] is critical in the emotional, cognitive and physical homeostasis within the human body. The endocannabinoid system is defined as a widespread neuromodulatory system that plays a significant role in central nervous system (CNS) development, synaptic plasticity and recognising endogenous and environmental stimuli (Lu & Mackie, 2015). Endocannabinoids and their receptors are densely packed together and located throughout the entirety of the human body; in the organs, conncective tissues, in the brain, glands and in the immune systems cells (Alger, 2013; Kendall & Yudowski, 2016). Additionally, research into the endocannabinoid system and the pharmacology of endocannabinoids began in the late 1940's, several decades before cannabinoids were detected in [[Should cannabis be legal?|canabis]] (also known as [[marijuana]]) (Pertwee, 2006). Since the first discovery in the 1940's, endocannabinoids were quickly discovered to be very useful and efficient in pharmacological medicines in order to treat drug addictions, regulating anxiety, stress, and as a therapeutic tool to improve emotional regulation and processes (Litvin, Phan, Hill, Pfaff, & McEwen, 2013; Marco & Laviola, 2013). Throughout the chapter, the endocannabinoid system will be presented and discussed in depth with assistance from credible research. Firstly, the endocannabinoid system will be discussed, outlining the systems history, impacts and significance in the psychology field. Additionally, discussing physiological processes of the endocannabinoid system and the main receptors involved. Next, the chapter will delve into basic emotions, highlighting core emotions related to the endocannabinoid system and the impact on emotional processing and regulation of an individual. Lastly the chapter will outline future directions of research. {{RoundBoxTop|theme=3}} '''Focus questions:''' * What is the endocannabinoid system? * What is emotion? * How does the endocannabinoid system and emotions interact?{{RoundBoxBottom}} ==What is the Endocannabinoid System?== * The endocannabinoid system is a complex cell signalling system that serves various protective roles in pathophysiological conditions (Chanda, Neumann, & Glatz, 2019). *The endocannabinoid system is significant in relation to emotions across the human lifespan, emotional regulation and processing (Marco & Laviola, 2013). [[File:Endocannabinoid system and major brain regions.png|thumb|fig. 1 endocannabinoid system and the major brain regions]] === Physiological processes of the Endocannabinoid System === * The endogenous cannabinoid system or, the endocannabinoid system (ECS) is comprised of endogenous cannabinoids (endocannabinoids), cannabinoid receptors, and the enzymes responsible for the synthesis and degradation of endocannabinoids (Lu & Mackie, 2015). Explain further with diagram and how the daily functioning of the ECS works in detail. *Physiological processes of the ECS in relation to emotional processing and regulation, cannabinoids effect of "bliss" on the human body but also could be contributing to anxiety, depression and psychosis states (Moreira & Lutz, 2008). ==== ''CB1 Receptors'' ==== * CB1 is densely located and packed in the neocortex, hippocampus, basal ganglia, amygdala, striatum, cerebellum, and hypothalamus. These major brain regions mediate a wide variety of high-order behavioural functions, including learning and memory, executive function decision making, sensory and motor responsiveness, and emotional reactions, as well as feeding and other homeostatic processes (Alger, 2013). *Key role in the central nervous system, flight, fight or freeze responses, anxiety and arousal levels particularly (Litvin et. al., 2013). *If deficient in CB1 receptors- talk in more detail about lack of this- Deficiency of CB1 receptor signaling is associated with anhedonia, anxiety, and persistence of negative memories. CB1 receptor-endocannabinoid signaling is activated by stress and functions to buffer or dampen the behavioral and endocrine effects of acute stress (Hillard, 2016). ==== ''CB2 Receptors'' ==== * CB2 receptor is mainly associated with the internal workings of the immune system and immune modulation (Alger, 2013; Christino, Bisogno & Di Marzo, 2020) * Unlike CB1 receptors, CB2 receptors are less densely packed within the body and expressed in the microglia in conditions such as: alzheimers (AD), multiple sclerosis (MS) and schizophrenia (Christino, Bisogno & Di Marzo, 2020). * In comparison to the CB1 receptors, CB2 has an unclear link to emotional processing and regulation, however more research is needed in this area for a deeper understanding of how CB2 can be a therapeutic aid for neurological disorders in the future (Chanda, Neumann, & Glatz, 2019). [[File:Anxiety cloud.png|thumb|fig 2. emotions of fear, anxiety and stress represented as a cloud]] == What is Emotion? == * There is no clear dictionary aligned definition of "[[emotion]]". The term is taken for granted in itself and, most often, emotion is defined with reference to a list: anger, disgust, fear, joy, sadness, and surprise (Cabanac, 2002). Cabanac (2002) proposes that emotion is any mental experience with high intensity and high hedonic content (pleasure/displeasure) and later explores emotion and the interrelated concept of consciousness in his 2009 research. * Orthony (2022) proposes that for decades the concept of basic emotions are "placed into lists and tables". That despite decades of challenges to the idea that a small number of emotions enjoys the special status of "basic emotions,” the idea continues to have considerable influence in psychology and beyond. However, different theorists have proposed substantially different lists of basic emotions, which suggests that there exists no stable criterion of basicness. To some extent, the basic-emotions enterprise is bedeviled by an overreliance on English affective terms, but there also lurks a more serious problem—the lack of agreement as to what emotions are. * Modern emotion theories typically try to account for the observations that emotions are triggered by events of some significance or relevance to an organism, that they encompass a coordinated set of changes in brain and body, and that they appear adaptive in the sense that they are directed towards coping with whatever challenge was posed by the triggering event (Adolphs, 2010). === Focus emotions: Fear and Anxiety === *Fear is stated to be a core emotion in relation to the endocannabinoid system, as it is directly correlated with feelings of anxiety and a "flight response" (Moreira & Lutz, 2008). *Fear is triggered by external, not internal stimuli and is triggered by the amygdala (a complex part of the temporal lobe of the brain) which is stated to access past fearful experiences in order to develop a fear response (Hyman, 1998). Fear and anxiety are demonstrated to be closely related as the amygdala is not only provoked when an external, unpleasant stimuli is presented and is also activated in the presence of anxiety and phobia related stimuli (Alger, 2013). *Cannabinoid receptors are densely located in brain areas involved in emotional states, including amygdala, hypocampus and other limbic sites. Effects on anxiety are thought to be mediated mainly by CB1 receptors but possibly also by CB2 and GPR55 receptors (Ashton & Moore, 2011). == Endocannabinoid System and Emotions == *The interaction between the endocannabinoid system (ECS) and emotions is depicted to be closely related - expand on concept more... *The endocannabinoid systemoperates act mainly as an undercurrent of brain activity below the level of consciousness but the tone of the system, ‘endocannabinoid tone’, influences conscious perceptions and affects mood and behaviour and their physical accompaniments (Ashton & Moore, 2011). === The Effect of Fear and Anxiety on the Endocannabinoid System === * By understanding the link between fear and anxiety in the human body, the better the understanding of how fear and anxiety function within the endocannabinoid system (ECS). *Hyman (1998) proposes a relationship between the amygdala's effect on a fear response in an individual and how fear can increase anxiety, and anxiety can increase a fear response in patients who have a lesion in their amygdala. Thus, those patients are more likely to experience stronger feelings of fear and anxiety to external stimuli. *The effect of fear and anxiety on the endocannabinoid system is related to an internal coping mechanism, in which an individual must adapt to their environment in order to survive (Lutz, Marsicano, Maldonaldo, & Hillard, 2015). *ECB signalling seems to determine the value of fear-evoking stimuli and to tune appropriate behavioural responses, which are essential for the organism’s long-term viability, homeostasis and stress resilience; and dysregulation of eCB signalling can lead to psychiatric disorders (Lutz, Marsicano, Maldonaldo, & Hillard, 2015). ==== ''Positive interaction of anxiety and the endocannabinoid system'' ==== * The relationship between anxiety states and behaviours and the endocannabinoid system (ECS) is directy correlated to the use of cannabis. Cannabis is demonstrated to have "euphoric effects" and "highs", which increases an individuals need for socialisation and connection, thus decreasing anxiety behaviours (Lutz, Marsicano, Maldonaldo, & Hillard, 2015; Hillard, 2014). * Use example of report where individual reported to feel "relaxed" and "calm" even though she deals with Generalised Anxiety Disorder (GAD) on a daily basis (Bossong et al., 2013) ==== ''Negative interaction of anxiety and the endocannabinoid system'' ==== * In opposing studies, it was found that anxiety behaviour and thought patterns can be actually increased in a maladaptive manner, rather than it assisting an individual. * Draw on studies from; Jenneriches et al., (2016)- talk about reliability of study however, as most of study was performed on mice. === Role of Endocannabinoid system in Emotional Regulation and Processing === * Acute emotional processing is vital to interpersonal relationships and daily social interactions with others. Without strong emotional processing skills, individuals are more likely to inherit or become subject to major depressive disorder (MPD), bipolar disorder (BPD) and schizophrenia (Bossong, Jager, Kahn, Ramsey, & Jansma 2013). * expand on further research in this area and the importance of the endocannabinoid systems role in emotional regulation and processing == Future Research Direction: Endocannabinoid System as a Therapeutic Tool for Anxiety-related Disorders == * The endocannabinoid system as a therapeutic tool for anxiety-related disorders is still a new topic in scope, with limited research in implementing cannabinoids as an aid for reducing anxiety in particular (Alger, 2013). * The endocannabinoid system appears to play a pivotal role in the regulation of emotional states and may constitute a novel pharmacological target for anti-anxiety therapy- cognitive behavioural therapy (CBT) and talk therapy (Lu & Mackie, 2015; Moreira & Lutz, 2008) ==Conclusion== {{tip|Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? }} * ==References== {{Hanging indent|1= Adolphs. (2010). Emotion. Current Biology, 20(13), R549–R552. https://doi.org/10.1016/j.cub.2010.05.046 Alger, B. (2013). Getting high on the endocannabinoid system. Cerebrum, 14, 1-11. doi:PMC3997295 Ashton, & Moore, P. B. (2011). Endocannabinoid system dysfunction in mood and related disorders. Acta Psychiatrica Scandinavica, 124(4), 250–261. https://doi.org/10.1111/j.1600-0447.2011.01687.x Bossong, van Hell, H. H., Jager, G., Kahn, R. S., Ramsey, N. F., & Jansma, J. M. (2013). The endocannabinoid system and emotional processing: A pharmacological fMRI study with ∆9-tetrahydrocannabinol. European Neuropsychopharmacology, 23(12), 1687–1697. https://doi.org/10.1016/j.euroneuro.2013.06.009 Cabanac, Cabanac, A. J., & Parent, A. (2009). The emergence of consciousness in phylogeny. Behavioural Brain Research, 198(2), 267–272. https://doi.org/10.1016/j.bbr.2008.11.028 Cabanac. (2002). What is emotion? Behavioural Processes, 60(2), 69–83. https://doi.org/10.1016/S0376-6357(02)00078-5 Chanda, Neumann, D., & Glatz, J. F. C. (2019). The endocannabinoid system: Overview of an emerging multi-faceted therapeutic target. Prostaglandins, Leukotrienes and Essential Fatty Acids, 140, 51–56. https://doi.org/10.1016/j.plefa.2018.11.016 Cristino, Bisogno, T., & Di Marzo, V. (2020). Cannabinoids and the expanded endocannabinoid system in neurological disorders. Nature Reviews. Neurology, 16(1), 9–29. https://doi.org/10.1038/s41582-019-0284- Hillard. (2014). Stress regulates endocannabinoid-CB1 receptor signaling. Seminars in Immunology, 26(5), 380–388. https://doi.org/10.1016/j.smim.2014.04.001 Hyman. (1998). Neurobiology A new image for fear and emotion. Nature (London), 393(6684), 417–418. https://doi.org/10.1038/30855 Jenniches, I., Ternes, S., Albayram, O., Otte, D., Bach, K., & Bindila, L. et al. (2016). Anxiety, Stress, and Fear Response in Mice With Reduced Endocannabinoid Levels. Biological Psychiatry, 79(10), 858-868. doi: 10.1016/j.biopsych.2015.03.033 Lu, H., & Mackie, K. (2016). An introduction to the endogenous cannabinoid system. Biol Psychiatry, 79(7). doi: 10.1016/j.biopsych.2015.07.028. Kendall, & Yudowski, G. A. (2016). Cannabinoid Receptors in the Central Nervous System: Their Signaling and Roles in Disease. Frontiers in Cellular Neuroscience, 10, 294–294. https://doi.org/10.3389/fncel.2016.00294 Litvin, Phan, A., Hill, M. N., Pfaff, D. W., & McEwen, B. S. (2013). CB1 receptor signaling regulates social anxiety and memory. Genes, Brain and Behavior, 12(5), 479–489. https://doi.org/10.1111/gbb.12045 Lu, & Mackie, K. (2015). An Introduction to the Endogenous Cannabinoid System. Biological Psychiatry (1969), 79(7), 516–525. https://doi.org/10.1016/j.biopsych.2015.07.028 Lutz, Marsicano, G., Maldonado, R., & Hillard, C. J. (2015). The endocannabinoid system in guarding against fear, anxiety and stress. Nature Reviews. Neuroscience, 16(12), 705–718. https://doi.org/10.1038/nrn4036 Marco, & Laviola, G. (2012). The endocannabinoid system in the regulation of emotions throughout lifespan: a discussion on therapeutic perspectives. Journal of Psychopharmacology (Oxford), 26(1), 150–163. https://doi.org/10.1177/0269881111408459 Moreira, & Lutz, B. (2008). The endocannabinoid system: emotion, learning and addiction. Addiction Biology, 13(2), 196–212. https://doi.org/10.1111/j.1369-1600.2008.00104.x Ortony. (2022). Are All “Basic Emotions” Emotions? A Problem for the (Basic) Emotions Construct. Perspectives on Psychological Science, 17(1), 41–61. https://doi.org/10.1177/1745691620985415 Pertwee. (2006). Cannabinoid pharmacology: the first 66 years. British Journal of Pharmacology, 147(S1), S163–S171. https://doi.org/10.1038/sj.bjp.0706406 }} {{tip|Suggestions for this section: * Important aspects for APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except first letter and proper names, ending in a full-stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full-stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't actually read or consulted}} ==External links== [https://theconversation.com/the-runners-high-may-result-from-molecules-called-cannabinoids-the-bodys-own-version-of-thc-and-cbd-170796 Runners High and the Endocannabinoid System] [https://www.ted.com/talks/ruth_ross_demystifying_the_endocannabinoid_system/transcript?language=en Demystifying the Endocannabinoid System - Ted Talk] {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] ==See also== * [[Motivation and emotion/Book/2020/Endocannabinoid system and emotion|Endocannabinoid system and emotion]] (Book chapter, 2020) - u3216457 81obrvewswy8urwq4cb0g0bx5qxoglu 2419059 2419058 2022-08-25T13:50:20Z Rwilliams12 2947623 /* See also */ wikitext text/x-wiki {{METP}} {{title|Endocannabinoid system and emotion:<br>What is the role of the endocannabinoid system in emotion? }} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== The [[wikipedia:Endocannabinoid_system|endocannabinoid system]] is critical in the emotional, cognitive and physical homeostasis within the human body. The endocannabinoid system is defined as a widespread neuromodulatory system that plays a significant role in central nervous system (CNS) development, synaptic plasticity and recognising endogenous and environmental stimuli (Lu & Mackie, 2015). Endocannabinoids and their receptors are densely packed together and located throughout the entirety of the human body; in the organs, conncective tissues, in the brain, glands and in the immune systems cells (Alger, 2013; Kendall & Yudowski, 2016). Additionally, research into the endocannabinoid system and the pharmacology of endocannabinoids began in the late 1940's, several decades before cannabinoids were detected in [[Should cannabis be legal?|canabis]] (also known as [[marijuana]]) (Pertwee, 2006). Since the first discovery in the 1940's, endocannabinoids were quickly discovered to be very useful and efficient in pharmacological medicines in order to treat drug addictions, regulating anxiety, stress, and as a therapeutic tool to improve emotional regulation and processes (Litvin, Phan, Hill, Pfaff, & McEwen, 2013; Marco & Laviola, 2013). Throughout the chapter, the endocannabinoid system will be presented and discussed in depth with assistance from credible research. Firstly, the endocannabinoid system will be discussed, outlining the systems history, impacts and significance in the psychology field. Additionally, discussing physiological processes of the endocannabinoid system and the main receptors involved. Next, the chapter will delve into basic emotions, highlighting core emotions related to the endocannabinoid system and the impact on emotional processing and regulation of an individual. Lastly the chapter will outline future directions of research. {{RoundBoxTop|theme=3}} '''Focus questions:''' * What is the endocannabinoid system? * What is emotion? * How does the endocannabinoid system and emotions interact?{{RoundBoxBottom}} ==What is the Endocannabinoid System?== * The endocannabinoid system is a complex cell signalling system that serves various protective roles in pathophysiological conditions (Chanda, Neumann, & Glatz, 2019). *The endocannabinoid system is significant in relation to emotions across the human lifespan, emotional regulation and processing (Marco & Laviola, 2013). [[File:Endocannabinoid system and major brain regions.png|thumb|fig. 1 endocannabinoid system and the major brain regions]] === Physiological processes of the Endocannabinoid System === * The endogenous cannabinoid system or, the endocannabinoid system (ECS) is comprised of endogenous cannabinoids (endocannabinoids), cannabinoid receptors, and the enzymes responsible for the synthesis and degradation of endocannabinoids (Lu & Mackie, 2015). Explain further with diagram and how the daily functioning of the ECS works in detail. *Physiological processes of the ECS in relation to emotional processing and regulation, cannabinoids effect of "bliss" on the human body but also could be contributing to anxiety, depression and psychosis states (Moreira & Lutz, 2008). ==== ''CB1 Receptors'' ==== * CB1 is densely located and packed in the neocortex, hippocampus, basal ganglia, amygdala, striatum, cerebellum, and hypothalamus. These major brain regions mediate a wide variety of high-order behavioural functions, including learning and memory, executive function decision making, sensory and motor responsiveness, and emotional reactions, as well as feeding and other homeostatic processes (Alger, 2013). *Key role in the central nervous system, flight, fight or freeze responses, anxiety and arousal levels particularly (Litvin et. al., 2013). *If deficient in CB1 receptors- talk in more detail about lack of this- Deficiency of CB1 receptor signaling is associated with anhedonia, anxiety, and persistence of negative memories. CB1 receptor-endocannabinoid signaling is activated by stress and functions to buffer or dampen the behavioral and endocrine effects of acute stress (Hillard, 2016). ==== ''CB2 Receptors'' ==== * CB2 receptor is mainly associated with the internal workings of the immune system and immune modulation (Alger, 2013; Christino, Bisogno & Di Marzo, 2020) * Unlike CB1 receptors, CB2 receptors are less densely packed within the body and expressed in the microglia in conditions such as: alzheimers (AD), multiple sclerosis (MS) and schizophrenia (Christino, Bisogno & Di Marzo, 2020). * In comparison to the CB1 receptors, CB2 has an unclear link to emotional processing and regulation, however more research is needed in this area for a deeper understanding of how CB2 can be a therapeutic aid for neurological disorders in the future (Chanda, Neumann, & Glatz, 2019). [[File:Anxiety cloud.png|thumb|fig 2. emotions of fear, anxiety and stress represented as a cloud]] == What is Emotion? == * There is no clear dictionary aligned definition of "[[emotion]]". The term is taken for granted in itself and, most often, emotion is defined with reference to a list: anger, disgust, fear, joy, sadness, and surprise (Cabanac, 2002). Cabanac (2002) proposes that emotion is any mental experience with high intensity and high hedonic content (pleasure/displeasure) and later explores emotion and the interrelated concept of consciousness in his 2009 research. * Orthony (2022) proposes that for decades the concept of basic emotions are "placed into lists and tables". That despite decades of challenges to the idea that a small number of emotions enjoys the special status of "basic emotions,” the idea continues to have considerable influence in psychology and beyond. However, different theorists have proposed substantially different lists of basic emotions, which suggests that there exists no stable criterion of basicness. To some extent, the basic-emotions enterprise is bedeviled by an overreliance on English affective terms, but there also lurks a more serious problem—the lack of agreement as to what emotions are. * Modern emotion theories typically try to account for the observations that emotions are triggered by events of some significance or relevance to an organism, that they encompass a coordinated set of changes in brain and body, and that they appear adaptive in the sense that they are directed towards coping with whatever challenge was posed by the triggering event (Adolphs, 2010). === Focus emotions: Fear and Anxiety === *Fear is stated to be a core emotion in relation to the endocannabinoid system, as it is directly correlated with feelings of anxiety and a "flight response" (Moreira & Lutz, 2008). *Fear is triggered by external, not internal stimuli and is triggered by the amygdala (a complex part of the temporal lobe of the brain) which is stated to access past fearful experiences in order to develop a fear response (Hyman, 1998). Fear and anxiety are demonstrated to be closely related as the amygdala is not only provoked when an external, unpleasant stimuli is presented and is also activated in the presence of anxiety and phobia related stimuli (Alger, 2013). *Cannabinoid receptors are densely located in brain areas involved in emotional states, including amygdala, hypocampus and other limbic sites. Effects on anxiety are thought to be mediated mainly by CB1 receptors but possibly also by CB2 and GPR55 receptors (Ashton & Moore, 2011). == Endocannabinoid System and Emotions == *The interaction between the endocannabinoid system (ECS) and emotions is depicted to be closely related - expand on concept more... *The endocannabinoid systemoperates act mainly as an undercurrent of brain activity below the level of consciousness but the tone of the system, ‘endocannabinoid tone’, influences conscious perceptions and affects mood and behaviour and their physical accompaniments (Ashton & Moore, 2011). === The Effect of Fear and Anxiety on the Endocannabinoid System === * By understanding the link between fear and anxiety in the human body, the better the understanding of how fear and anxiety function within the endocannabinoid system (ECS). *Hyman (1998) proposes a relationship between the amygdala's effect on a fear response in an individual and how fear can increase anxiety, and anxiety can increase a fear response in patients who have a lesion in their amygdala. Thus, those patients are more likely to experience stronger feelings of fear and anxiety to external stimuli. *The effect of fear and anxiety on the endocannabinoid system is related to an internal coping mechanism, in which an individual must adapt to their environment in order to survive (Lutz, Marsicano, Maldonaldo, & Hillard, 2015). *ECB signalling seems to determine the value of fear-evoking stimuli and to tune appropriate behavioural responses, which are essential for the organism’s long-term viability, homeostasis and stress resilience; and dysregulation of eCB signalling can lead to psychiatric disorders (Lutz, Marsicano, Maldonaldo, & Hillard, 2015). ==== ''Positive interaction of anxiety and the endocannabinoid system'' ==== * The relationship between anxiety states and behaviours and the endocannabinoid system (ECS) is directy correlated to the use of cannabis. Cannabis is demonstrated to have "euphoric effects" and "highs", which increases an individuals need for socialisation and connection, thus decreasing anxiety behaviours (Lutz, Marsicano, Maldonaldo, & Hillard, 2015; Hillard, 2014). * Use example of report where individual reported to feel "relaxed" and "calm" even though she deals with Generalised Anxiety Disorder (GAD) on a daily basis (Bossong et al., 2013) ==== ''Negative interaction of anxiety and the endocannabinoid system'' ==== * In opposing studies, it was found that anxiety behaviour and thought patterns can be actually increased in a maladaptive manner, rather than it assisting an individual. * Draw on studies from; Jenneriches et al., (2016)- talk about reliability of study however, as most of study was performed on mice. === Role of Endocannabinoid system in Emotional Regulation and Processing === * Acute emotional processing is vital to interpersonal relationships and daily social interactions with others. Without strong emotional processing skills, individuals are more likely to inherit or become subject to major depressive disorder (MPD), bipolar disorder (BPD) and schizophrenia (Bossong, Jager, Kahn, Ramsey, & Jansma 2013). * expand on further research in this area and the importance of the endocannabinoid systems role in emotional regulation and processing == Future Research Direction: Endocannabinoid System as a Therapeutic Tool for Anxiety-related Disorders == * The endocannabinoid system as a therapeutic tool for anxiety-related disorders is still a new topic in scope, with limited research in implementing cannabinoids as an aid for reducing anxiety in particular (Alger, 2013). * The endocannabinoid system appears to play a pivotal role in the regulation of emotional states and may constitute a novel pharmacological target for anti-anxiety therapy- cognitive behavioural therapy (CBT) and talk therapy (Lu & Mackie, 2015; Moreira & Lutz, 2008) ==Conclusion== {{tip|Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? }} * ==References== {{Hanging indent|1= Adolphs. (2010). Emotion. Current Biology, 20(13), R549–R552. https://doi.org/10.1016/j.cub.2010.05.046 Alger, B. (2013). Getting high on the endocannabinoid system. Cerebrum, 14, 1-11. doi:PMC3997295 Ashton, & Moore, P. B. (2011). Endocannabinoid system dysfunction in mood and related disorders. Acta Psychiatrica Scandinavica, 124(4), 250–261. https://doi.org/10.1111/j.1600-0447.2011.01687.x Bossong, van Hell, H. H., Jager, G., Kahn, R. S., Ramsey, N. F., & Jansma, J. M. (2013). The endocannabinoid system and emotional processing: A pharmacological fMRI study with ∆9-tetrahydrocannabinol. European Neuropsychopharmacology, 23(12), 1687–1697. https://doi.org/10.1016/j.euroneuro.2013.06.009 Cabanac, Cabanac, A. J., & Parent, A. (2009). The emergence of consciousness in phylogeny. Behavioural Brain Research, 198(2), 267–272. https://doi.org/10.1016/j.bbr.2008.11.028 Cabanac. (2002). What is emotion? Behavioural Processes, 60(2), 69–83. https://doi.org/10.1016/S0376-6357(02)00078-5 Chanda, Neumann, D., & Glatz, J. F. C. (2019). The endocannabinoid system: Overview of an emerging multi-faceted therapeutic target. Prostaglandins, Leukotrienes and Essential Fatty Acids, 140, 51–56. https://doi.org/10.1016/j.plefa.2018.11.016 Cristino, Bisogno, T., & Di Marzo, V. (2020). Cannabinoids and the expanded endocannabinoid system in neurological disorders. Nature Reviews. Neurology, 16(1), 9–29. https://doi.org/10.1038/s41582-019-0284- Hillard. (2014). Stress regulates endocannabinoid-CB1 receptor signaling. Seminars in Immunology, 26(5), 380–388. https://doi.org/10.1016/j.smim.2014.04.001 Hyman. (1998). Neurobiology A new image for fear and emotion. Nature (London), 393(6684), 417–418. https://doi.org/10.1038/30855 Jenniches, I., Ternes, S., Albayram, O., Otte, D., Bach, K., & Bindila, L. et al. (2016). Anxiety, Stress, and Fear Response in Mice With Reduced Endocannabinoid Levels. Biological Psychiatry, 79(10), 858-868. doi: 10.1016/j.biopsych.2015.03.033 Lu, H., & Mackie, K. (2016). An introduction to the endogenous cannabinoid system. Biol Psychiatry, 79(7). doi: 10.1016/j.biopsych.2015.07.028. Kendall, & Yudowski, G. A. (2016). Cannabinoid Receptors in the Central Nervous System: Their Signaling and Roles in Disease. Frontiers in Cellular Neuroscience, 10, 294–294. https://doi.org/10.3389/fncel.2016.00294 Litvin, Phan, A., Hill, M. N., Pfaff, D. W., & McEwen, B. S. (2013). CB1 receptor signaling regulates social anxiety and memory. Genes, Brain and Behavior, 12(5), 479–489. https://doi.org/10.1111/gbb.12045 Lu, & Mackie, K. (2015). An Introduction to the Endogenous Cannabinoid System. Biological Psychiatry (1969), 79(7), 516–525. https://doi.org/10.1016/j.biopsych.2015.07.028 Lutz, Marsicano, G., Maldonado, R., & Hillard, C. J. (2015). The endocannabinoid system in guarding against fear, anxiety and stress. Nature Reviews. Neuroscience, 16(12), 705–718. https://doi.org/10.1038/nrn4036 Marco, & Laviola, G. (2012). The endocannabinoid system in the regulation of emotions throughout lifespan: a discussion on therapeutic perspectives. Journal of Psychopharmacology (Oxford), 26(1), 150–163. https://doi.org/10.1177/0269881111408459 Moreira, & Lutz, B. (2008). The endocannabinoid system: emotion, learning and addiction. Addiction Biology, 13(2), 196–212. https://doi.org/10.1111/j.1369-1600.2008.00104.x Ortony. (2022). Are All “Basic Emotions” Emotions? A Problem for the (Basic) Emotions Construct. Perspectives on Psychological Science, 17(1), 41–61. https://doi.org/10.1177/1745691620985415 Pertwee. (2006). Cannabinoid pharmacology: the first 66 years. British Journal of Pharmacology, 147(S1), S163–S171. https://doi.org/10.1038/sj.bjp.0706406 }} {{tip|Suggestions for this section: * Important aspects for APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except first letter and proper names, ending in a full-stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full-stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't actually read or consulted}} ==External links== [https://theconversation.com/the-runners-high-may-result-from-molecules-called-cannabinoids-the-bodys-own-version-of-thc-and-cbd-170796 Runners High and the Endocannabinoid System] [https://www.ted.com/talks/ruth_ross_demystifying_the_endocannabinoid_system/transcript?language=en Demystifying the Endocannabinoid System - Ted Talk] {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] ==See also== * [[Motivation and emotion/Book/2020/Endocannabinoid system and emotion|Endocannabinoid system and emotion]] (Book chapter, 2020) hd0p8mqk3gdgfr78dcgk02xsnh3ucgh 0 276140 2419399 2417757 2022-08-26T08:25:58Z Alec.cortez 2947555 /* See also */ wikitext text/x-wiki {{title|Chapter title:<br>Subtitle?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== You are underway {{smile}}! This template provides tips for [[Motivation and emotion/Assessment/Topic|topic development]]. Gradually remove these suggestions as you develop the chapter. Also consult the [[Motivation and emotion/Assessment/Chapter|author guidelines]]. At the top of the chapter, the title and sub-title should match the ''exact'' wording and casing as shown in the {{Motivation and emotion/Book}}. The sub-titles all end with a question mark. This Overview section should be concise but consist of several paragraphs which engage the reader, illustrate the problem, and outline how psychological science can help. {{RoundBoxTop|theme=3}} '''Focus questions:''' * What is the first focus question? * What is the second focus question? * What is the third focus question? {{RoundBoxBottom}} {{tip| Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Provide an example or case study. * Conclude with Focus questions to guide the chapter. }} ==Main headings== How you are going to structure the chapter? Aim for three to six main headings between the [[#Overview|Overview]] and [[#Conclusion|Conclusion]]. {{tip|Suggestions for this section: * For the [[Motivation and emotion/Assessment/Topic|topic development]], provide at least 3 bullet-points about key content per section. Include key citations. * For the [[Motivation and emotion/Assessment/Chapter|book chapter]], expand the bullet points into paragraphs. * If a section has a lot of content, arrange it into two to five sub-headings such as in the [[#Interactive learning features|interactive learning features section]]. Avoid having sections with only one sub-heading. }} ==Learning features== What brings an online book chapter to life are its interactive learning features. Case studies, feature boxes, figures, links, tables, and quiz questions can be used throughout the chapter. ===Case studies=== Case studies describe real-world examples of concepts in action. Case studies can be real or fictional. A case could be used multiple times during a chapter to illustrate different theories or stages. It is often helpful to present case studies using [[#Feature boxes|feature boxes]]. ===Boxes=== Boxes can be used to highlight content, but don't overuse them. There are many different ways of creating boxes (e.g., see [[Help:Pretty boxes|Pretty boxes]]). Possible uses include: * Focus questions * Case studies or examples * Quiz questions * Take-home messages {{RoundBoxTop|theme=3}} ;Feature box example * Shaded background * Coloured border {{RoundBoxBottom}} ===Figures=== [[File:Monkey-typing.jpg|right|205px|thumb|''Figure 1''. Example image with descriptive caption.]] Use figures to illustrate concepts, add interest, and provide examples. Figures can be used to show photographs, drawings, diagrams, graphs, etcetera. Figures can be embedded throughout the chapter, starting with the Overview section. Figures should be captioned (using a number and a description) in order to explain their relevance to the text. Possible images can be found at [[commons:|Wikimedia Commons]]. Images can also be uploaded if they are licensed for re-use or if you created the image. Each figure should be referred to at least once in the main text (e.g., see Figure 1). ===Links=== Where key words are first used, make them into [[Help:Links|interwiki links]] such as Wikipedia links to articles about famous people (e.g., [[w:Sigmund Freud|Sigmund Freud]] and key concepts (e.g., [[w:Dreams|dreams]]) and links to book chapters about related topics (e.g., would you like to learn about how to overcome [[Motivation and emotion/Book/2020/Writer's block|writer's block]]?). ===Tables=== Tables can be an effective way to organise and summarise information. Tables should be captioned (using APA style) to explain their relevance to the text. Plus each table should be referred to at least once in the main text (e.g., see Table 1 and Table 2). Here are some [[Motivation and emotion/Wikiversity/Tables|example 3 x 3 tables]] which could be adapted. ===Quizzes=== Quizzes are a direct way to engage readers. But don't make quizzes too hard or long. It is better to have one or two review questions per major section than a long quiz at the end. Try to quiz conceptual understanding, rather than trivia. Here are some simple quiz questions which could be adapted. Choose the correct answers and click "Submit": <quiz display=simple> {Quizzes are an interactive learning feature: |type="()"} + True - False {Long quizzes are a good idea: |type="()"} - True + False </quiz> To learn about different types of quiz questions, see [[Help:Quiz|Quiz]]. ==Conclusion== The Conclusion is arguably the most important section. It should be possible for someone to read the [[#Overview|Overview]] and the Conclusion and still get a good idea of the topic. {{tip|Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? }} ==See also== Provide up to half-a-dozen [[Help:Contents/Links#Interwiki_links|internal (wiki) links]] to relevant Wikiversity pages (esp. related [[Motivation and emotion/Book|motivation and emotion book chapters]]) and [[w:|Wikipedia articles]]. For example: * [[w: Hypomania|Hypomania]] (Wikipedia) * [[Motivation and emotion/Book/2020/Hypomania and motivation|Hypomania and emotion]] (Book chapter, 2020) * [[Evidence-based assessment/Instruments/Young Mania Rating Scale|Young mania assessment scale]] (Wikiversity) {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== List the cited references in [[w:APA style|APA style]] (7th ed.) or [[w:Wikipedia:Citing sources|wiki style]]. APA style example: {{Hanging indent|1= Blair, R. J. R. (2004). The roles of orbital frontal cortex in the modulation of antisocial behavior. ''Brain and Cognition'', ''55''(1), 198–208. https://doi.org/10.1016/S0278-2626(03)00276-8 Buckholtz, J. W., & Meyer-Lindenberg, A. (2008). MAOA and the neurogenetic architecture of human aggression. ''Trends in Neurosciences'', ''31''(3), 120–129. https://doi.org/10.1016/j.tins.2007.12.006 Eckardt, M., File, S., Gessa, G., Grant, K., Guerri, C., Hoffman, P., & Tabakoff, B. (1998). Effects of moderate alcohol consumption on the central nervous system. ''Alcoholism, Clinical and Experimental Research'', ''22''(5), 998–1040. https://doi.org/10.1111/j.1530-0277.1998.tb03695.x }} {{tip|Suggestions for this section: * Important aspects for APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except first letter and proper names, ending in a full-stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full-stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't actually read or consulted }} ==External links== Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * [https://students.unimelb.edu.au/academic-skills/explore-our-resources/essay-writing/six-top-tips-for-writing-a-great-essay Six top tips for writing a great essay] (University of Melbourne) * [http://www.skillsyouneed.com/write/structure.html The importance of structure] (skillsyouneed.com) {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] {{METP}} ==See also== * [[Motivation and emotion/Book/2020/Hypomania and emotion|Hypomania and emotion]] (Book chapter, 2020) cbag9l8keeaw7y3emlmeevv57fravm5 2419402 2419399 2022-08-26T08:37:07Z Alec.cortez 2947555 /* See also */ wikitext text/x-wiki {{title|Chapter title:<br>Subtitle?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== You are underway {{smile}}! This template provides tips for [[Motivation and emotion/Assessment/Topic|topic development]]. Gradually remove these suggestions as you develop the chapter. Also consult the [[Motivation and emotion/Assessment/Chapter|author guidelines]]. At the top of the chapter, the title and sub-title should match the ''exact'' wording and casing as shown in the {{Motivation and emotion/Book}}. The sub-titles all end with a question mark. This Overview section should be concise but consist of several paragraphs which engage the reader, illustrate the problem, and outline how psychological science can help. {{RoundBoxTop|theme=3}} '''Focus questions:''' * What is the first focus question? * What is the second focus question? * What is the third focus question? {{RoundBoxBottom}} {{tip| Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Provide an example or case study. * Conclude with Focus questions to guide the chapter. }} ==Main headings== How you are going to structure the chapter? Aim for three to six main headings between the [[#Overview|Overview]] and [[#Conclusion|Conclusion]]. {{tip|Suggestions for this section: * For the [[Motivation and emotion/Assessment/Topic|topic development]], provide at least 3 bullet-points about key content per section. Include key citations. * For the [[Motivation and emotion/Assessment/Chapter|book chapter]], expand the bullet points into paragraphs. * If a section has a lot of content, arrange it into two to five sub-headings such as in the [[#Interactive learning features|interactive learning features section]]. Avoid having sections with only one sub-heading. }} ==Learning features== What brings an online book chapter to life are its interactive learning features. Case studies, feature boxes, figures, links, tables, and quiz questions can be used throughout the chapter. ===Case studies=== Case studies describe real-world examples of concepts in action. Case studies can be real or fictional. A case could be used multiple times during a chapter to illustrate different theories or stages. It is often helpful to present case studies using [[#Feature boxes|feature boxes]]. ===Boxes=== Boxes can be used to highlight content, but don't overuse them. There are many different ways of creating boxes (e.g., see [[Help:Pretty boxes|Pretty boxes]]). Possible uses include: * Focus questions * Case studies or examples * Quiz questions * Take-home messages {{RoundBoxTop|theme=3}} ;Feature box example * Shaded background * Coloured border {{RoundBoxBottom}} ===Figures=== [[File:Monkey-typing.jpg|right|205px|thumb|''Figure 1''. Example image with descriptive caption.]] Use figures to illustrate concepts, add interest, and provide examples. Figures can be used to show photographs, drawings, diagrams, graphs, etcetera. Figures can be embedded throughout the chapter, starting with the Overview section. Figures should be captioned (using a number and a description) in order to explain their relevance to the text. Possible images can be found at [[commons:|Wikimedia Commons]]. Images can also be uploaded if they are licensed for re-use or if you created the image. Each figure should be referred to at least once in the main text (e.g., see Figure 1). ===Links=== Where key words are first used, make them into [[Help:Links|interwiki links]] such as Wikipedia links to articles about famous people (e.g., [[w:Sigmund Freud|Sigmund Freud]] and key concepts (e.g., [[w:Dreams|dreams]]) and links to book chapters about related topics (e.g., would you like to learn about how to overcome [[Motivation and emotion/Book/2020/Writer's block|writer's block]]?). ===Tables=== Tables can be an effective way to organise and summarise information. Tables should be captioned (using APA style) to explain their relevance to the text. Plus each table should be referred to at least once in the main text (e.g., see Table 1 and Table 2). Here are some [[Motivation and emotion/Wikiversity/Tables|example 3 x 3 tables]] which could be adapted. ===Quizzes=== Quizzes are a direct way to engage readers. But don't make quizzes too hard or long. It is better to have one or two review questions per major section than a long quiz at the end. Try to quiz conceptual understanding, rather than trivia. Here are some simple quiz questions which could be adapted. Choose the correct answers and click "Submit": <quiz display=simple> {Quizzes are an interactive learning feature: |type="()"} + True - False {Long quizzes are a good idea: |type="()"} - True + False </quiz> To learn about different types of quiz questions, see [[Help:Quiz|Quiz]]. ==Conclusion== The Conclusion is arguably the most important section. It should be possible for someone to read the [[#Overview|Overview]] and the Conclusion and still get a good idea of the topic. {{tip|Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? }} ==See also== Provide up to half-a-dozen [[Help:Contents/Links#Interwiki_links|internal (wiki) links]] to relevant Wikiversity pages (esp. related [[Motivation and emotion/Book|motivation and emotion book chapters]]) and [[w:|Wikipedia articles]]. For example: * [https://icd.who.int/browse11/l-m/en#/http%3a%2f%2fid.who.int%2ficd%2fentity%2f613065957 Bipolar or related mood disorders] (International Classification of Disease (ICD-11), World Health Organisation). * [[w: Hypomania|Hypomania]] (Wikipedia) * [[Motivation and emotion/Book/2020/Hypomania and motivation|Hypomania and emotion]] (Book chapter, 2020) * [[Evidence-based assessment/Instruments/Young Mania Rating Scale|Young mania assessment scale]] (Wikiversity) {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== List the cited references in [[w:APA style|APA style]] (7th ed.) or [[w:Wikipedia:Citing sources|wiki style]]. APA style example: {{Hanging indent|1= Blair, R. J. R. (2004). The roles of orbital frontal cortex in the modulation of antisocial behavior. ''Brain and Cognition'', ''55''(1), 198–208. https://doi.org/10.1016/S0278-2626(03)00276-8 Buckholtz, J. W., & Meyer-Lindenberg, A. (2008). MAOA and the neurogenetic architecture of human aggression. ''Trends in Neurosciences'', ''31''(3), 120–129. https://doi.org/10.1016/j.tins.2007.12.006 Eckardt, M., File, S., Gessa, G., Grant, K., Guerri, C., Hoffman, P., & Tabakoff, B. (1998). Effects of moderate alcohol consumption on the central nervous system. ''Alcoholism, Clinical and Experimental Research'', ''22''(5), 998–1040. https://doi.org/10.1111/j.1530-0277.1998.tb03695.x }} {{tip|Suggestions for this section: * Important aspects for APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except first letter and proper names, ending in a full-stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full-stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't actually read or consulted }} ==External links== Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * [https://students.unimelb.edu.au/academic-skills/explore-our-resources/essay-writing/six-top-tips-for-writing-a-great-essay Six top tips for writing a great essay] (University of Melbourne) * [http://www.skillsyouneed.com/write/structure.html The importance of structure] (skillsyouneed.com) {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] {{METP}} ==See also== * [[Motivation and emotion/Book/2020/Hypomania and emotion|Hypomania and emotion]] (Book chapter, 2020) bjmi5t65t5dc0z91br1gh29evbnzbzc 2419404 2419402 2022-08-26T08:39:46Z Alec.cortez 2947555 /* See also */ wikitext text/x-wiki {{title|Chapter title:<br>Subtitle?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== You are underway {{smile}}! This template provides tips for [[Motivation and emotion/Assessment/Topic|topic development]]. Gradually remove these suggestions as you develop the chapter. Also consult the [[Motivation and emotion/Assessment/Chapter|author guidelines]]. At the top of the chapter, the title and sub-title should match the ''exact'' wording and casing as shown in the {{Motivation and emotion/Book}}. The sub-titles all end with a question mark. This Overview section should be concise but consist of several paragraphs which engage the reader, illustrate the problem, and outline how psychological science can help. {{RoundBoxTop|theme=3}} '''Focus questions:''' * What is the first focus question? * What is the second focus question? * What is the third focus question? {{RoundBoxBottom}} {{tip| Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Provide an example or case study. * Conclude with Focus questions to guide the chapter. }} ==Main headings== How you are going to structure the chapter? Aim for three to six main headings between the [[#Overview|Overview]] and [[#Conclusion|Conclusion]]. {{tip|Suggestions for this section: * For the [[Motivation and emotion/Assessment/Topic|topic development]], provide at least 3 bullet-points about key content per section. Include key citations. * For the [[Motivation and emotion/Assessment/Chapter|book chapter]], expand the bullet points into paragraphs. * If a section has a lot of content, arrange it into two to five sub-headings such as in the [[#Interactive learning features|interactive learning features section]]. Avoid having sections with only one sub-heading. }} ==Learning features== What brings an online book chapter to life are its interactive learning features. Case studies, feature boxes, figures, links, tables, and quiz questions can be used throughout the chapter. ===Case studies=== Case studies describe real-world examples of concepts in action. Case studies can be real or fictional. A case could be used multiple times during a chapter to illustrate different theories or stages. It is often helpful to present case studies using [[#Feature boxes|feature boxes]]. ===Boxes=== Boxes can be used to highlight content, but don't overuse them. There are many different ways of creating boxes (e.g., see [[Help:Pretty boxes|Pretty boxes]]). Possible uses include: * Focus questions * Case studies or examples * Quiz questions * Take-home messages {{RoundBoxTop|theme=3}} ;Feature box example * Shaded background * Coloured border {{RoundBoxBottom}} ===Figures=== [[File:Monkey-typing.jpg|right|205px|thumb|''Figure 1''. Example image with descriptive caption.]] Use figures to illustrate concepts, add interest, and provide examples. Figures can be used to show photographs, drawings, diagrams, graphs, etcetera. Figures can be embedded throughout the chapter, starting with the Overview section. Figures should be captioned (using a number and a description) in order to explain their relevance to the text. Possible images can be found at [[commons:|Wikimedia Commons]]. Images can also be uploaded if they are licensed for re-use or if you created the image. Each figure should be referred to at least once in the main text (e.g., see Figure 1). ===Links=== Where key words are first used, make them into [[Help:Links|interwiki links]] such as Wikipedia links to articles about famous people (e.g., [[w:Sigmund Freud|Sigmund Freud]] and key concepts (e.g., [[w:Dreams|dreams]]) and links to book chapters about related topics (e.g., would you like to learn about how to overcome [[Motivation and emotion/Book/2020/Writer's block|writer's block]]?). ===Tables=== Tables can be an effective way to organise and summarise information. Tables should be captioned (using APA style) to explain their relevance to the text. Plus each table should be referred to at least once in the main text (e.g., see Table 1 and Table 2). Here are some [[Motivation and emotion/Wikiversity/Tables|example 3 x 3 tables]] which could be adapted. ===Quizzes=== Quizzes are a direct way to engage readers. But don't make quizzes too hard or long. It is better to have one or two review questions per major section than a long quiz at the end. Try to quiz conceptual understanding, rather than trivia. Here are some simple quiz questions which could be adapted. Choose the correct answers and click "Submit": <quiz display=simple> {Quizzes are an interactive learning feature: |type="()"} + True - False {Long quizzes are a good idea: |type="()"} - True + False </quiz> To learn about different types of quiz questions, see [[Help:Quiz|Quiz]]. ==Conclusion== The Conclusion is arguably the most important section. It should be possible for someone to read the [[#Overview|Overview]] and the Conclusion and still get a good idea of the topic. {{tip|Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? }} ==See also== Provide up to half-a-dozen [[Help:Contents/Links#Interwiki_links|internal (wiki) links]] to relevant Wikiversity pages (esp. related [[Motivation and emotion/Book|motivation and emotion book chapters]]) and [[w:|Wikipedia articles]]. For example: * [[w: Hypomania|Hypomania]] (Wikipedia) * [[Motivation and emotion/Book/2020/Hypomania and motivation|Hypomania and emotion]] (Book chapter, 2020) * [[Evidence-based assessment/Instruments/Young Mania Rating Scale|Young mania assessment scale]] (Wikiversity) {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== List the cited references in [[w:APA style|APA style]] (7th ed.) or [[w:Wikipedia:Citing sources|wiki style]]. APA style example: {{Hanging indent|1= Blair, R. J. R. (2004). The roles of orbital frontal cortex in the modulation of antisocial behavior. ''Brain and Cognition'', ''55''(1), 198–208. https://doi.org/10.1016/S0278-2626(03)00276-8 Buckholtz, J. W., & Meyer-Lindenberg, A. (2008). MAOA and the neurogenetic architecture of human aggression. ''Trends in Neurosciences'', ''31''(3), 120–129. https://doi.org/10.1016/j.tins.2007.12.006 Eckardt, M., File, S., Gessa, G., Grant, K., Guerri, C., Hoffman, P., & Tabakoff, B. (1998). Effects of moderate alcohol consumption on the central nervous system. ''Alcoholism, Clinical and Experimental Research'', ''22''(5), 998–1040. https://doi.org/10.1111/j.1530-0277.1998.tb03695.x }} {{tip|Suggestions for this section: * Important aspects for APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except first letter and proper names, ending in a full-stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full-stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't actually read or consulted }} ==External links== Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * [https://icd.who.int/browse11/l-m/en#/http%3a%2f%2fid.who.int%2ficd%2fentity%2f613065957 Bipolar or related mood disorders] (International Classification of Disease (ICD-11), World Health Organisation). {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] t4tp1hympxsu393ckgh766n9kf99cko 2419407 2419404 2022-08-26T08:42:24Z Alec.cortez 2947555 /* External links */ wikitext text/x-wiki {{title|Chapter title:<br>Subtitle?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== You are underway {{smile}}! This template provides tips for [[Motivation and emotion/Assessment/Topic|topic development]]. Gradually remove these suggestions as you develop the chapter. Also consult the [[Motivation and emotion/Assessment/Chapter|author guidelines]]. At the top of the chapter, the title and sub-title should match the ''exact'' wording and casing as shown in the {{Motivation and emotion/Book}}. The sub-titles all end with a question mark. This Overview section should be concise but consist of several paragraphs which engage the reader, illustrate the problem, and outline how psychological science can help. {{RoundBoxTop|theme=3}} '''Focus questions:''' * What is the first focus question? * What is the second focus question? * What is the third focus question? {{RoundBoxBottom}} {{tip| Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Provide an example or case study. * Conclude with Focus questions to guide the chapter. }} ==Main headings== How you are going to structure the chapter? Aim for three to six main headings between the [[#Overview|Overview]] and [[#Conclusion|Conclusion]]. {{tip|Suggestions for this section: * For the [[Motivation and emotion/Assessment/Topic|topic development]], provide at least 3 bullet-points about key content per section. Include key citations. * For the [[Motivation and emotion/Assessment/Chapter|book chapter]], expand the bullet points into paragraphs. * If a section has a lot of content, arrange it into two to five sub-headings such as in the [[#Interactive learning features|interactive learning features section]]. Avoid having sections with only one sub-heading. }} ==Learning features== What brings an online book chapter to life are its interactive learning features. Case studies, feature boxes, figures, links, tables, and quiz questions can be used throughout the chapter. ===Case studies=== Case studies describe real-world examples of concepts in action. Case studies can be real or fictional. A case could be used multiple times during a chapter to illustrate different theories or stages. It is often helpful to present case studies using [[#Feature boxes|feature boxes]]. ===Boxes=== Boxes can be used to highlight content, but don't overuse them. There are many different ways of creating boxes (e.g., see [[Help:Pretty boxes|Pretty boxes]]). Possible uses include: * Focus questions * Case studies or examples * Quiz questions * Take-home messages {{RoundBoxTop|theme=3}} ;Feature box example * Shaded background * Coloured border {{RoundBoxBottom}} ===Figures=== [[File:Monkey-typing.jpg|right|205px|thumb|''Figure 1''. Example image with descriptive caption.]] Use figures to illustrate concepts, add interest, and provide examples. Figures can be used to show photographs, drawings, diagrams, graphs, etcetera. Figures can be embedded throughout the chapter, starting with the Overview section. Figures should be captioned (using a number and a description) in order to explain their relevance to the text. Possible images can be found at [[commons:|Wikimedia Commons]]. Images can also be uploaded if they are licensed for re-use or if you created the image. Each figure should be referred to at least once in the main text (e.g., see Figure 1). ===Links=== Where key words are first used, make them into [[Help:Links|interwiki links]] such as Wikipedia links to articles about famous people (e.g., [[w:Sigmund Freud|Sigmund Freud]] and key concepts (e.g., [[w:Dreams|dreams]]) and links to book chapters about related topics (e.g., would you like to learn about how to overcome [[Motivation and emotion/Book/2020/Writer's block|writer's block]]?). ===Tables=== Tables can be an effective way to organise and summarise information. Tables should be captioned (using APA style) to explain their relevance to the text. Plus each table should be referred to at least once in the main text (e.g., see Table 1 and Table 2). Here are some [[Motivation and emotion/Wikiversity/Tables|example 3 x 3 tables]] which could be adapted. ===Quizzes=== Quizzes are a direct way to engage readers. But don't make quizzes too hard or long. It is better to have one or two review questions per major section than a long quiz at the end. Try to quiz conceptual understanding, rather than trivia. Here are some simple quiz questions which could be adapted. Choose the correct answers and click "Submit": <quiz display=simple> {Quizzes are an interactive learning feature: |type="()"} + True - False {Long quizzes are a good idea: |type="()"} - True + False </quiz> To learn about different types of quiz questions, see [[Help:Quiz|Quiz]]. ==Conclusion== The Conclusion is arguably the most important section. It should be possible for someone to read the [[#Overview|Overview]] and the Conclusion and still get a good idea of the topic. {{tip|Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? }} ==See also== Provide up to half-a-dozen [[Help:Contents/Links#Interwiki_links|internal (wiki) links]] to relevant Wikiversity pages (esp. related [[Motivation and emotion/Book|motivation and emotion book chapters]]) and [[w:|Wikipedia articles]]. For example: * [[w: Hypomania|Hypomania]] (Wikipedia) * [[Motivation and emotion/Book/2020/Hypomania and motivation|Hypomania and emotion]] (Book chapter, 2020) * [[Evidence-based assessment/Instruments/Young Mania Rating Scale|Young mania assessment scale]] (Wikiversity) {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== List the cited references in [[w:APA style|APA style]] (7th ed.) or [[w:Wikipedia:Citing sources|wiki style]]. APA style example: {{Hanging indent|1= Blair, R. J. R. (2004). The roles of orbital frontal cortex in the modulation of antisocial behavior. ''Brain and Cognition'', ''55''(1), 198–208. https://doi.org/10.1016/S0278-2626(03)00276-8 Buckholtz, J. W., & Meyer-Lindenberg, A. (2008). MAOA and the neurogenetic architecture of human aggression. ''Trends in Neurosciences'', ''31''(3), 120–129. https://doi.org/10.1016/j.tins.2007.12.006 Eckardt, M., File, S., Gessa, G., Grant, K., Guerri, C., Hoffman, P., & Tabakoff, B. (1998). Effects of moderate alcohol consumption on the central nervous system. ''Alcoholism, Clinical and Experimental Research'', ''22''(5), 998–1040. https://doi.org/10.1111/j.1530-0277.1998.tb03695.x }} {{tip|Suggestions for this section: * Important aspects for APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except first letter and proper names, ending in a full-stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full-stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't actually read or consulted }} ==External links== Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * [https://icd.who.int/browse11/l-m/en#/http%3a%2f%2fid.who.int%2ficd%2fentity%2f613065957 Bipolar or related mood disorders] (International Classification of Disease (ICD-11), World Health Organisation). * [https://www.ncbi.nlm.nih.gov/books/NBK519704/table/ch3.t9/ DSM IV and DSM V comparison] (National library of medicine) {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] q4p49pydpcv4mr7xjm85xtg13xclcrt 2419416 2419407 2022-08-26T08:50:33Z Alec.cortez 2947555 /* External links */ wikitext text/x-wiki {{title|Chapter title:<br>Subtitle?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== You are underway {{smile}}! This template provides tips for [[Motivation and emotion/Assessment/Topic|topic development]]. Gradually remove these suggestions as you develop the chapter. Also consult the [[Motivation and emotion/Assessment/Chapter|author guidelines]]. At the top of the chapter, the title and sub-title should match the ''exact'' wording and casing as shown in the {{Motivation and emotion/Book}}. The sub-titles all end with a question mark. This Overview section should be concise but consist of several paragraphs which engage the reader, illustrate the problem, and outline how psychological science can help. {{RoundBoxTop|theme=3}} '''Focus questions:''' * What is the first focus question? * What is the second focus question? * What is the third focus question? {{RoundBoxBottom}} {{tip| Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Provide an example or case study. * Conclude with Focus questions to guide the chapter. }} ==Main headings== How you are going to structure the chapter? Aim for three to six main headings between the [[#Overview|Overview]] and [[#Conclusion|Conclusion]]. {{tip|Suggestions for this section: * For the [[Motivation and emotion/Assessment/Topic|topic development]], provide at least 3 bullet-points about key content per section. Include key citations. * For the [[Motivation and emotion/Assessment/Chapter|book chapter]], expand the bullet points into paragraphs. * If a section has a lot of content, arrange it into two to five sub-headings such as in the [[#Interactive learning features|interactive learning features section]]. Avoid having sections with only one sub-heading. }} ==Learning features== What brings an online book chapter to life are its interactive learning features. Case studies, feature boxes, figures, links, tables, and quiz questions can be used throughout the chapter. ===Case studies=== Case studies describe real-world examples of concepts in action. Case studies can be real or fictional. A case could be used multiple times during a chapter to illustrate different theories or stages. It is often helpful to present case studies using [[#Feature boxes|feature boxes]]. ===Boxes=== Boxes can be used to highlight content, but don't overuse them. There are many different ways of creating boxes (e.g., see [[Help:Pretty boxes|Pretty boxes]]). Possible uses include: * Focus questions * Case studies or examples * Quiz questions * Take-home messages {{RoundBoxTop|theme=3}} ;Feature box example * Shaded background * Coloured border {{RoundBoxBottom}} ===Figures=== [[File:Monkey-typing.jpg|right|205px|thumb|''Figure 1''. Example image with descriptive caption.]] Use figures to illustrate concepts, add interest, and provide examples. Figures can be used to show photographs, drawings, diagrams, graphs, etcetera. Figures can be embedded throughout the chapter, starting with the Overview section. Figures should be captioned (using a number and a description) in order to explain their relevance to the text. Possible images can be found at [[commons:|Wikimedia Commons]]. Images can also be uploaded if they are licensed for re-use or if you created the image. Each figure should be referred to at least once in the main text (e.g., see Figure 1). ===Links=== Where key words are first used, make them into [[Help:Links|interwiki links]] such as Wikipedia links to articles about famous people (e.g., [[w:Sigmund Freud|Sigmund Freud]] and key concepts (e.g., [[w:Dreams|dreams]]) and links to book chapters about related topics (e.g., would you like to learn about how to overcome [[Motivation and emotion/Book/2020/Writer's block|writer's block]]?). ===Tables=== Tables can be an effective way to organise and summarise information. Tables should be captioned (using APA style) to explain their relevance to the text. Plus each table should be referred to at least once in the main text (e.g., see Table 1 and Table 2). Here are some [[Motivation and emotion/Wikiversity/Tables|example 3 x 3 tables]] which could be adapted. ===Quizzes=== Quizzes are a direct way to engage readers. But don't make quizzes too hard or long. It is better to have one or two review questions per major section than a long quiz at the end. Try to quiz conceptual understanding, rather than trivia. Here are some simple quiz questions which could be adapted. Choose the correct answers and click "Submit": <quiz display=simple> {Quizzes are an interactive learning feature: |type="()"} + True - False {Long quizzes are a good idea: |type="()"} - True + False </quiz> To learn about different types of quiz questions, see [[Help:Quiz|Quiz]]. ==Conclusion== The Conclusion is arguably the most important section. It should be possible for someone to read the [[#Overview|Overview]] and the Conclusion and still get a good idea of the topic. {{tip|Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? }} ==See also== Provide up to half-a-dozen [[Help:Contents/Links#Interwiki_links|internal (wiki) links]] to relevant Wikiversity pages (esp. related [[Motivation and emotion/Book|motivation and emotion book chapters]]) and [[w:|Wikipedia articles]]. For example: * [[w: Hypomania|Hypomania]] (Wikipedia) * [[Motivation and emotion/Book/2020/Hypomania and motivation|Hypomania and emotion]] (Book chapter, 2020) * [[Evidence-based assessment/Instruments/Young Mania Rating Scale|Young mania assessment scale]] (Wikiversity) {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== List the cited references in [[w:APA style|APA style]] (7th ed.) or [[w:Wikipedia:Citing sources|wiki style]]. APA style example: {{Hanging indent|1= Blair, R. J. R. (2004). The roles of orbital frontal cortex in the modulation of antisocial behavior. ''Brain and Cognition'', ''55''(1), 198–208. https://doi.org/10.1016/S0278-2626(03)00276-8 Buckholtz, J. W., & Meyer-Lindenberg, A. (2008). MAOA and the neurogenetic architecture of human aggression. ''Trends in Neurosciences'', ''31''(3), 120–129. https://doi.org/10.1016/j.tins.2007.12.006 Eckardt, M., File, S., Gessa, G., Grant, K., Guerri, C., Hoffman, P., & Tabakoff, B. (1998). Effects of moderate alcohol consumption on the central nervous system. ''Alcoholism, Clinical and Experimental Research'', ''22''(5), 998–1040. https://doi.org/10.1111/j.1530-0277.1998.tb03695.x }} {{tip|Suggestions for this section: * Important aspects for APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except first letter and proper names, ending in a full-stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full-stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't actually read or consulted }} ==External links== Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * [https://psychiatry.org/dsm5 American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders] (DSM-5) * [https://icd.who.int/browse11/l-m/en#/http%3a%2f%2fid.who.int%2ficd%2fentity%2f613065957 Bipolar or related mood disorders] (International Classification of Disease (ICD-11), World Health Organisation). * [https://www.ncbi.nlm.nih.gov/books/NBK519704/table/ch3.t9/ DSM IV and DSM V comparison] (National library of medicine) * [https://my.clevelandclinic.org/health/diseases/21774-hypomania Hypomania] (Cleveland clinic) {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] ptsqo9sar48x3rgvxlwnd0h02uhhzd9 2419421 2419416 2022-08-26T09:01:45Z Alec.cortez 2947555 /* Overview */ wikitext text/x-wiki {{title|Chapter title:<br>Subtitle?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== [[File:Bipolar disorder subtypes comparison between Bipolar I, II disorder and Cyclothymia.svg|alt=Figure 1: Graph depicting hypomania related disorders|thumb|Figure 1: Graph depicting bipolar disorder subtypes and relationship to hypomania.]] You are underway {{smile}}! This template provides tips for [[Motivation and emotion/Assessment/Topic|topic development]]. Gradually remove these suggestions as you develop the chapter. Also consult the [[Motivation and emotion/Assessment/Chapter|author guidelines]]. At the top of the chapter, the title and sub-title should match the ''exact'' wording and casing as shown in the {{Motivation and emotion/Book}}. The sub-titles all end with a question mark. This Overview section should be concise but consist of several paragraphs which engage the reader, illustrate the problem, and outline how psychological science can help. '''add focus questions''' {{RoundBoxTop|theme=3}} '''Focus questions:''' * What is the first focus question? * What is the second focus question? * What is the third focus question? {{RoundBoxBottom}} {{tip| Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Provide an example or case study. * Conclude with Focus questions to guide the chapter. }} ==Main headings== How you are going to structure the chapter? Aim for three to six main headings between the [[#Overview|Overview]] and [[#Conclusion|Conclusion]]. {{tip|Suggestions for this section: * For the [[Motivation and emotion/Assessment/Topic|topic development]], provide at least 3 bullet-points about key content per section. Include key citations. * For the [[Motivation and emotion/Assessment/Chapter|book chapter]], expand the bullet points into paragraphs. * If a section has a lot of content, arrange it into two to five sub-headings such as in the [[#Interactive learning features|interactive learning features section]]. Avoid having sections with only one sub-heading. }} ==Learning features== What brings an online book chapter to life are its interactive learning features. Case studies, feature boxes, figures, links, tables, and quiz questions can be used throughout the chapter. ===Case studies=== Case studies describe real-world examples of concepts in action. Case studies can be real or fictional. A case could be used multiple times during a chapter to illustrate different theories or stages. It is often helpful to present case studies using [[#Feature boxes|feature boxes]]. ===Boxes=== Boxes can be used to highlight content, but don't overuse them. There are many different ways of creating boxes (e.g., see [[Help:Pretty boxes|Pretty boxes]]). Possible uses include: * Focus questions * Case studies or examples * Quiz questions * Take-home messages {{RoundBoxTop|theme=3}} ;Feature box example * Shaded background * Coloured border {{RoundBoxBottom}} ===Figures=== [[File:Monkey-typing.jpg|right|205px|thumb|''Figure 1''. Example image with descriptive caption.]] Use figures to illustrate concepts, add interest, and provide examples. Figures can be used to show photographs, drawings, diagrams, graphs, etcetera. Figures can be embedded throughout the chapter, starting with the Overview section. Figures should be captioned (using a number and a description) in order to explain their relevance to the text. Possible images can be found at [[commons:|Wikimedia Commons]]. Images can also be uploaded if they are licensed for re-use or if you created the image. Each figure should be referred to at least once in the main text (e.g., see Figure 1). ===Links=== Where key words are first used, make them into [[Help:Links|interwiki links]] such as Wikipedia links to articles about famous people (e.g., [[w:Sigmund Freud|Sigmund Freud]] and key concepts (e.g., [[w:Dreams|dreams]]) and links to book chapters about related topics (e.g., would you like to learn about how to overcome [[Motivation and emotion/Book/2020/Writer's block|writer's block]]?). ===Tables=== Tables can be an effective way to organise and summarise information. Tables should be captioned (using APA style) to explain their relevance to the text. Plus each table should be referred to at least once in the main text (e.g., see Table 1 and Table 2). Here are some [[Motivation and emotion/Wikiversity/Tables|example 3 x 3 tables]] which could be adapted. ===Quizzes=== Quizzes are a direct way to engage readers. But don't make quizzes too hard or long. It is better to have one or two review questions per major section than a long quiz at the end. Try to quiz conceptual understanding, rather than trivia. Here are some simple quiz questions which could be adapted. Choose the correct answers and click "Submit": <quiz display=simple> {Quizzes are an interactive learning feature: |type="()"} + True - False {Long quizzes are a good idea: |type="()"} - True + False </quiz> To learn about different types of quiz questions, see [[Help:Quiz|Quiz]]. ==Conclusion== The Conclusion is arguably the most important section. It should be possible for someone to read the [[#Overview|Overview]] and the Conclusion and still get a good idea of the topic. {{tip|Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? }} ==See also== Provide up to half-a-dozen [[Help:Contents/Links#Interwiki_links|internal (wiki) links]] to relevant Wikiversity pages (esp. related [[Motivation and emotion/Book|motivation and emotion book chapters]]) and [[w:|Wikipedia articles]]. For example: * [[w: Hypomania|Hypomania]] (Wikipedia) * [[Motivation and emotion/Book/2020/Hypomania and motivation|Hypomania and emotion]] (Book chapter, 2020) * [[Evidence-based assessment/Instruments/Young Mania Rating Scale|Young mania assessment scale]] (Wikiversity) {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== List the cited references in [[w:APA style|APA style]] (7th ed.) or [[w:Wikipedia:Citing sources|wiki style]]. APA style example: {{Hanging indent|1= Blair, R. J. R. (2004). The roles of orbital frontal cortex in the modulation of antisocial behavior. ''Brain and Cognition'', ''55''(1), 198–208. https://doi.org/10.1016/S0278-2626(03)00276-8 Buckholtz, J. W., & Meyer-Lindenberg, A. (2008). MAOA and the neurogenetic architecture of human aggression. ''Trends in Neurosciences'', ''31''(3), 120–129. https://doi.org/10.1016/j.tins.2007.12.006 Eckardt, M., File, S., Gessa, G., Grant, K., Guerri, C., Hoffman, P., & Tabakoff, B. (1998). Effects of moderate alcohol consumption on the central nervous system. ''Alcoholism, Clinical and Experimental Research'', ''22''(5), 998–1040. https://doi.org/10.1111/j.1530-0277.1998.tb03695.x }} {{tip|Suggestions for this section: * Important aspects for APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except first letter and proper names, ending in a full-stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full-stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't actually read or consulted }} ==External links== Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * [https://psychiatry.org/dsm5 American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders] (DSM-5) * [https://icd.who.int/browse11/l-m/en#/http%3a%2f%2fid.who.int%2ficd%2fentity%2f613065957 Bipolar or related mood disorders] (International Classification of Disease (ICD-11), World Health Organisation). * [https://www.ncbi.nlm.nih.gov/books/NBK519704/table/ch3.t9/ DSM IV and DSM V comparison] (National library of medicine) * [https://my.clevelandclinic.org/health/diseases/21774-hypomania Hypomania] (Cleveland clinic) {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] 4eq82ijtmahsaxkhab3o4bni3tapm50 2 276312 2419281 2417105 2022-08-26T04:59:58Z U3189442 - K.Ryan 2924719 Book Chapter Title and Link wikitext text/x-wiki [[File:Sunflower in Canada and the Bee1.JPG|thumb|250x250px|''Figure 1.'' An illustration of my favourite flower (Laslovarga, 2013).<ref>{{Citation|title=English: Sunflower in Canada, Ontario|url=https://commons.wikimedia.org/wiki/File:Sunflower_in_Canada_and_the_Bee1.JPG|date=2013-07-27|accessdate=2021-08-29|last=Laslovarga}}</ref>]] == About Me == Hi, my name is Kate and I am 23 years old. I am in my third year of study at the [https://www.canberra.edu.au/ University of Canberra]. I have completed a Diploma of Health and I am currently studying a Bachelor of Science in Psychology. I am doing two majors: Counselling and Forensic and Legal Studies (Psychology). I am currently using my degree in the field of Out of Home Care, providing healthcare and social assistance for foster children. I am employed full-time as a Behaviour Support Practitioner for Everyday CareSouth within the Southern Tablelands region. == Book Chapter == I am enrolled in the [[Motivation and emotion|Motivation and Emotion]] ''(7124)'' unit for Semester 2, 2022. I am completing a Book Chapter on the emotionality experienced by Indigenous Australians [[Motivation and emotion/Book/2022/Indigenous Australian emotionality]]. == Social Contributions == == Links == LinkedIn https://www.linkedin.com/in/katelyn-ryan-17411b21b/ YouTube Channel https://www.youtube.com/channel/UCT713liQh_yZ8le1mZrcWxw <references /> ttmqa07i3p9s3r1x4tc3qxix4tz2lii 2419287 2419281 2022-08-26T05:09:20Z U3189442 - K.Ryan 2924719 wikitext text/x-wiki [[File:Sunflower in Canada and the Bee1.JPG|thumb|250x250px|''Figure 1.'' An illustration of my favourite flower (Laslovarga, 2013).<ref>{{Citation|title=English: Sunflower in Canada, Ontario|url=https://commons.wikimedia.org/wiki/File:Sunflower_in_Canada_and_the_Bee1.JPG|date=2013-07-27|accessdate=2021-08-29|last=Laslovarga}}</ref>]] == About Me == Hi, my name is Kate and I am 23 years old. I am in my third year of study at the [https://www.canberra.edu.au/ University of Canberra]. I have completed a Diploma of Health and I am currently studying a Bachelor of Science in Psychology. I am doing two majors: Counselling and Forensic and Legal Studies (Psychology). I am currently using my degree in the field of Out of Home Care, providing healthcare and social assistance for foster children. I am employed full-time as a Behaviour Support Practitioner for Everyday CareSouth within the Southern Tablelands region. == Hobbies == At this stage, my focus has been my work in Out of Home Care and finishing my Bachelor of Psychology. However, to ensure that I have a positive work life balance I enjoy driving adventures, playing tennis, learning piano, building my makeup artistry business and drawing. == Book Chapter == I am enrolled in the [[Motivation and emotion|Motivation and Emotion]] ''(7124)'' unit for Semester 2, 2022. I am completing a Book Chapter on the emotionality experienced by Indigenous Australians [[Motivation and emotion/Book/2022/Indigenous Australian emotionality]]. == Social Contributions == == Links == LinkedIn https://www.linkedin.com/in/katelyn-ryan-17411b21b/ YouTube Channel https://www.youtube.com/channel/UCT713liQh_yZ8le1mZrcWxw <references /> bn1wkkozzg4pu0y6oieisn19knmbxtm 0 276575 2419455 2411202 2022-08-26T09:46:28Z Jtneill 10242 + categories wikitext text/x-wiki {{title|Religiosity and coping:<br>How does religiosity help people to cope?}} {{MECR3| Multimedia link goes here}} __TOC__ == Overview == [[File:Major religions distribution.png|thumb|342x342px|A relevant(ish) image to show I can add images for assessment purposes]] * Brief introduction into religion * Brief intriduction to [[Coping (psychology)|coping]] * Show how religion ties into coping == History of religion == * Definition of religion *Theory that gods were created to help solve the lack of control humans have on nature *Not all religions are based around gods *Explain how godless religions are still highly based on ways to cope with something == Coping == * Reliogosity and coping with failure * Religiostity and coping with fear * Religiosity and coping with immortality Krägeloh, C., Chai, P., Shepherd, D. and Billington, R., 2010. How Religious Coping is Used Relative to Other Coping Strategies Depends on the Individual’s Level of Religiosity and Spirituality. ''Journal of Religion and Health'', 51(4), pp.1137-1151. == Coping skills == * Does religiosity foster growth learning? * Does religiosity promote mindfulness? * Does Religiosity promote efficacy? * Does religiosity promote goal congruence? * Does religiosity promote learned helplessness? == Conclusion == Summary of everything == See also == [[Motivation and emotion/Book/2014/Religiosity and mental health|Religiosity and mental health]] [[Motivation and emotion/Book/2020/Coping and emotion|Coping and emotion]] == References == {{Hanging indent| Krägeloh, C., Chai, P., Shepherd, D. and Billington, R. (2010). How religious coping is used relative to other coping strategies depends on the individual’s level of religiosity and spirituality. ''Journal of Religion and Health'', ''51''(4), 1137-1151. https://doi.org/10.1007/s10943-010-9416-x Lechner, C., Silbereisen, R., Tomasik, M. and Wasilewski, J. (2010). Getting going and letting go: Religiosity fosters opportunity-congruent coping with work-related uncertainties. ''International Journal of Psychology'','' 50''(3), 205-214. https://doi.org/10.1002/ijop.12093 Nie, F., (2019). Religion and self-efficacy: a multilevel approach. ''Mental Health, Religion & Culture'', ''22''(3), 279-292. https://doi.org/10.1080/13674676.2019.1612337 }} == External links == [https://www.livescience.com/52197-religion-mental-health-brain.html God Help Us? How Religion is Good (And Bad) For Mental Health] [[Category:{{#titleparts:{{PAGENAME}}|3}}]] [[Category:Motivation and emotion/Book/Coping]] [[Category:Motivation and emotion/Book/Religiosity]] jsca05zt5ycm3phy7s32nzh4aqoj7ct 0 277078 2419452 2412762 2022-08-26T09:41:43Z Jtneill 10242 wikitext text/x-wiki {{title|Post traumatic stress disorder and emotion<br>What is the relationship between post traumatic stress disorder and emotion?}} {{MECR3|1=https://youtu.be/pxBQLFLei70}} __TOC__ ==Overview== You are underway {{smile}}! This template provides tips for [[Motivation and emotion/Assessment/Topic|topic development]]. Gradually remove these suggestions as you develop the chapter. Also consult the [[Motivation and emotion/Assessment/Chapter|author guidelines]]. At the top of the chapter, the title and sub-title should match the ''exact'' wording and casing as shown in the {{Motivation and emotion/Book}}. The sub-titles all end with a question mark. This Overview section should be concise but consist of several paragraphs which serve to engage the reader, illustrate the problem, and outline how psychological science can help. {{RoundBoxTop|theme=3}} '''Focus questions:''' * What is the first focus question? * What is the second focus question? * What is the third focus question? {{RoundBoxBottom}} {{tip| Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Provide an example or case study. * Conclude with Focus questions to guide the chapter. }} ==1st main heading== How you are going to structure the chapter? Aim for three to six main headings between the Overview and Conclusion. {{tip|Suggestions for this section: * For the [[Motivation and emotion/Assessment/Topic|topic development]], provide at least 3 bullet-points about key content per section. Include key citations. * For the [[Motivation and emotion/Assessment/Chapter|book chapter]], expand the bullet points into paragraphs. * If a section has a lot of content, arrange it into two to five sub-headings such as in the [[#Interactive learning features|interactive learning features section]]. Avoid having sections with only one sub-heading. }} ==Interactive learning features== What brings an online book chapter to life, compared to an essay, are its interactive learning features. Case studies, feature boxes, figures, links, tables, and quiz questions can be used throughout the chapter. ===Case studies=== Case studies describe real-world examples of concepts in action. Case studies can be real or fictional. A case could be used multiple times during a chapter to illustrate different theories or stages. It is often helpful to present case studies using [[#Feature boxes|feature boxes]]. ===Feature boxes=== Feature boxes can be used to highlight content, but don't overuse them. There are many different ways of creating feature boxes (e.g., see [[Help:Pretty boxes|Pretty boxes]]). Possible uses include: * Focus questions * Case studies or examples * Quiz questions * Take-home messages {{RoundBoxTop|theme=3}} ;Feature box example * Shaded background * Coloured border {{RoundBoxBottom}} ===Figures=== [[File:Monkey-typing.jpg|right|205px|thumb|''Figure 1''. Example image with descriptive caption.]] Use figures to illustrate concepts, add interest, and provide examples. Figures can be used to show photographs, drawings, diagrams, graphs, etcetera. Figures can be embedded throughout the chapter, starting with the Overview section. Figures should be captioned (using a number and a description) in order to explain their relevance to the text. Possible images can be found at [[commons:|Wikimedia Commons]]. Images can also be uploaded if they are licensed for re-use or if you created the image. Each figure should be referred to at least once in the main text (e.g., see Figure 1). ===Links=== Where key words are first used, make them into [[Help:Links|interwiki links]] such as Wikipedia links to articles about famous people (e.g., [[w:Sigmund Freud|Sigmund Freud]] and key concepts (e.g., [[w:Dreams|dreams]]) and links to book chapters about related topics (e.g., would you like to learn about how to overcome [[Motivation and emotion/Book/2020/Writer's block|writer's block]]?). ===Tables=== Tables can be an effective way to organise and summarise information. Tables should be captioned (using APA style) to explain their relevance to the text. Plus each table should be referred to at least once in the main text (e.g., see Table 1 and Table 2). Here are some example 3 x 3 tables which could be adapted: Table 1. ''Example of a Table with an APA Style Caption'' {| align=center border=1 cellspacing=0 cellpadding=5 ! '''Children''' ! '''Gather''' ! '''Round''' |- | Mary | had | a |- | little | lamb | it's |- | fleece | was | white |} Table 2. ''Another Example of a Table with an APA Style Caption'' <div align="center"> {| class="wikitable" ! '''Nursery''' ! '''Rhyme''' ! '''Time''' |- | Incy | Wincy | spider |- | climbed | up | the |- | water | spout | down |} </div> Table 3. ''Example of a Sortable Table with an APA Style Caption'' <div align="center"> {| class="wikitable sortable" |- ! Fruit ! Price/kg ! Popularity |- | Tomatoes | style="text-align:right;" | $6.00 | 1st |- | Bananas | style="text-align:right;" | $5.00 | 2nd |- | Watermelon | style="text-align:right;" | $2.99 | 3rd |- | Oranges | style="text-align:right;" | $3.85 | 4th |- | Apples | style="text-align:right;" | $4.95 | 5th |- | Grapes | style="text-align:right;" | $9.50 | 6th |- | Mangoes | style="text-align:right;" | $12.00 | 7th |- | Avocados | style="text-align:right;" | $12.00 | 8th |} </div> ===Quizzes=== Quizzes are a direct way to engage readers. But don't make quizzes too hard or long. It is better to have one or two review questions per major section than a long quiz at the end. Try to quiz conceptual understanding, rather than trivia. Here are some simple quiz questions which could be adapted. Choose the correct answers and click "Submit": <quiz display=simple> {Quizzes are an interactive learning feature: |type="()"} + True - False {Long quizzes are a good idea: |type="()"} - True + False </quiz> To learn about different types of quiz questions, see [[Help:Quiz|Quiz]]. ==Working notes== It could be useful to have a temporary section for working notes during the topic development and chapter drafting. This section will be ignored when the topic development is marked, but remove it before finalising the book chapter. ==Conclusion== The Conclusion is arguably the most important section. It should be possible for someone to read only the Overview and the Conclusion and still get a good idea of the topic. {{tip|Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? }} ==See also== * [[Motivation and emotion/Book/2013/Emotional impacts of sexual assault|Emotional impacts of sexual assault]] (Book chapter, 2013) * [[wikipedia:Post-traumatic_stress_disorder|Post-traumatic stress disorder]] (Wikipedia) * [[Motivation and emotion/Book/2020/Survivor guilt|Survivor guilt]] (Book chapter, 2020)In this section, provide up to half-a-dozen [[Help:Contents/Links#Interwiki_links|internal (wiki) links]] to relevant Wikiversity pages (esp. related [[Motivation and emotion/Book|motivation and emotion book chapters]]) and [[w:|Wikipedia articles]]. For example: * [[Motivation and emotion/Book/2016/Anorexia nervosa and extrinsic motivation|Anorexia nervosa and extrinsic motivation]] (Book chapter, 2016) * [[w:David McClelland|David McClelland]] (Wikipedia) * [[Motivation and emotion/Book/2018/Loss aversion|Loss aversion]] (Book chapter, 2018) * [[w:Maslow's hierarchy of needs|Maslow's hierarchy of needs]] (Wikipedia) {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== In this section, list the cited references in [[w:APA style|APA style]] (7th ed.). For example: {{Hanging indent|1= Blair, R. J. R. (2004). The roles of orbital frontal cortex in the modulation of antisocial behavior. ''Brain and Cognition'', ''55''(1), 198–208. https://doi.org/10.1016/S0278-2626(03)00276-8 Buckholtz, J. W., & Meyer-Lindenberg, A. (2008). MAOA and the neurogenetic architecture of human aggression. ''Trends in Neurosciences'', ''31''(3), 120–129. https://doi.org/10.1016/j.tins.2007.12.006 Eckardt, M., File, S., Gessa, G., Grant, K., Guerri, C., Hoffman, P., & Tabakoff, B. (1998). Effects of moderate alcohol consumption on the central nervous system. ''Alcoholism, Clinical and Experimental Research'', ''22''(5), 998–1040. https://doi.org/10.1111/j.1530-0277.1998.tb03695.x }} {{tip|Suggestions for this section: * Important aspects include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except first letter and proper names, ending in a full-stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by a en-dash(–), followed by a full-stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't actually read or consulted }} ==External links== In this section, provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant external resources such as presentations, news articles, and professional sites. For example: * [https://students.unimelb.edu.au/academic-skills/explore-our-resources/essay-writing/six-top-tips-for-writing-a-great-essay Six top tips for writing a great essay] (University of Melbourne) * [http://www.skillsyouneed.com/write/structure.html The importance of structure] (skillsyouneed.com) {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] [[Category:Motivation and emotion/Book/Trauma]] 5970epdg5zhkdjqg4ashc5fb2fa43mc 2419453 2419452 2022-08-26T09:42:57Z Jtneill 10242 + category wikitext text/x-wiki {{title|Post traumatic stress disorder and emotion<br>What is the relationship between post traumatic stress disorder and emotion?}} {{MECR3|1=https://youtu.be/pxBQLFLei70}} __TOC__ ==Overview== You are underway {{smile}}! This template provides tips for [[Motivation and emotion/Assessment/Topic|topic development]]. Gradually remove these suggestions as you develop the chapter. Also consult the [[Motivation and emotion/Assessment/Chapter|author guidelines]]. At the top of the chapter, the title and sub-title should match the ''exact'' wording and casing as shown in the {{Motivation and emotion/Book}}. The sub-titles all end with a question mark. This Overview section should be concise but consist of several paragraphs which serve to engage the reader, illustrate the problem, and outline how psychological science can help. {{RoundBoxTop|theme=3}} '''Focus questions:''' * What is the first focus question? * What is the second focus question? * What is the third focus question? {{RoundBoxBottom}} {{tip| Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Provide an example or case study. * Conclude with Focus questions to guide the chapter. }} ==1st main heading== How you are going to structure the chapter? Aim for three to six main headings between the Overview and Conclusion. {{tip|Suggestions for this section: * For the [[Motivation and emotion/Assessment/Topic|topic development]], provide at least 3 bullet-points about key content per section. Include key citations. * For the [[Motivation and emotion/Assessment/Chapter|book chapter]], expand the bullet points into paragraphs. * If a section has a lot of content, arrange it into two to five sub-headings such as in the [[#Interactive learning features|interactive learning features section]]. Avoid having sections with only one sub-heading. }} ==Interactive learning features== What brings an online book chapter to life, compared to an essay, are its interactive learning features. Case studies, feature boxes, figures, links, tables, and quiz questions can be used throughout the chapter. ===Case studies=== Case studies describe real-world examples of concepts in action. Case studies can be real or fictional. A case could be used multiple times during a chapter to illustrate different theories or stages. It is often helpful to present case studies using [[#Feature boxes|feature boxes]]. ===Feature boxes=== Feature boxes can be used to highlight content, but don't overuse them. There are many different ways of creating feature boxes (e.g., see [[Help:Pretty boxes|Pretty boxes]]). Possible uses include: * Focus questions * Case studies or examples * Quiz questions * Take-home messages {{RoundBoxTop|theme=3}} ;Feature box example * Shaded background * Coloured border {{RoundBoxBottom}} ===Figures=== [[File:Monkey-typing.jpg|right|205px|thumb|''Figure 1''. Example image with descriptive caption.]] Use figures to illustrate concepts, add interest, and provide examples. Figures can be used to show photographs, drawings, diagrams, graphs, etcetera. Figures can be embedded throughout the chapter, starting with the Overview section. Figures should be captioned (using a number and a description) in order to explain their relevance to the text. Possible images can be found at [[commons:|Wikimedia Commons]]. Images can also be uploaded if they are licensed for re-use or if you created the image. Each figure should be referred to at least once in the main text (e.g., see Figure 1). ===Links=== Where key words are first used, make them into [[Help:Links|interwiki links]] such as Wikipedia links to articles about famous people (e.g., [[w:Sigmund Freud|Sigmund Freud]] and key concepts (e.g., [[w:Dreams|dreams]]) and links to book chapters about related topics (e.g., would you like to learn about how to overcome [[Motivation and emotion/Book/2020/Writer's block|writer's block]]?). ===Tables=== Tables can be an effective way to organise and summarise information. Tables should be captioned (using APA style) to explain their relevance to the text. Plus each table should be referred to at least once in the main text (e.g., see Table 1 and Table 2). Here are some example 3 x 3 tables which could be adapted: Table 1. ''Example of a Table with an APA Style Caption'' {| align=center border=1 cellspacing=0 cellpadding=5 ! '''Children''' ! '''Gather''' ! '''Round''' |- | Mary | had | a |- | little | lamb | it's |- | fleece | was | white |} Table 2. ''Another Example of a Table with an APA Style Caption'' <div align="center"> {| class="wikitable" ! '''Nursery''' ! '''Rhyme''' ! '''Time''' |- | Incy | Wincy | spider |- | climbed | up | the |- | water | spout | down |} </div> Table 3. ''Example of a Sortable Table with an APA Style Caption'' <div align="center"> {| class="wikitable sortable" |- ! Fruit ! Price/kg ! Popularity |- | Tomatoes | style="text-align:right;" | $6.00 | 1st |- | Bananas | style="text-align:right;" | $5.00 | 2nd |- | Watermelon | style="text-align:right;" | $2.99 | 3rd |- | Oranges | style="text-align:right;" | $3.85 | 4th |- | Apples | style="text-align:right;" | $4.95 | 5th |- | Grapes | style="text-align:right;" | $9.50 | 6th |- | Mangoes | style="text-align:right;" | $12.00 | 7th |- | Avocados | style="text-align:right;" | $12.00 | 8th |} </div> ===Quizzes=== Quizzes are a direct way to engage readers. But don't make quizzes too hard or long. It is better to have one or two review questions per major section than a long quiz at the end. Try to quiz conceptual understanding, rather than trivia. Here are some simple quiz questions which could be adapted. Choose the correct answers and click "Submit": <quiz display=simple> {Quizzes are an interactive learning feature: |type="()"} + True - False {Long quizzes are a good idea: |type="()"} - True + False </quiz> To learn about different types of quiz questions, see [[Help:Quiz|Quiz]]. ==Working notes== It could be useful to have a temporary section for working notes during the topic development and chapter drafting. This section will be ignored when the topic development is marked, but remove it before finalising the book chapter. ==Conclusion== The Conclusion is arguably the most important section. It should be possible for someone to read only the Overview and the Conclusion and still get a good idea of the topic. {{tip|Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? }} ==See also== * [[Motivation and emotion/Book/2013/Emotional impacts of sexual assault|Emotional impacts of sexual assault]] (Book chapter, 2013) * [[wikipedia:Post-traumatic_stress_disorder|Post-traumatic stress disorder]] (Wikipedia) * [[Motivation and emotion/Book/2020/Survivor guilt|Survivor guilt]] (Book chapter, 2020)In this section, provide up to half-a-dozen [[Help:Contents/Links#Interwiki_links|internal (wiki) links]] to relevant Wikiversity pages (esp. related [[Motivation and emotion/Book|motivation and emotion book chapters]]) and [[w:|Wikipedia articles]]. For example: * [[Motivation and emotion/Book/2016/Anorexia nervosa and extrinsic motivation|Anorexia nervosa and extrinsic motivation]] (Book chapter, 2016) * [[w:David McClelland|David McClelland]] (Wikipedia) * [[Motivation and emotion/Book/2018/Loss aversion|Loss aversion]] (Book chapter, 2018) * [[w:Maslow's hierarchy of needs|Maslow's hierarchy of needs]] (Wikipedia) {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== In this section, list the cited references in [[w:APA style|APA style]] (7th ed.). For example: {{Hanging indent|1= Blair, R. J. R. (2004). The roles of orbital frontal cortex in the modulation of antisocial behavior. ''Brain and Cognition'', ''55''(1), 198–208. https://doi.org/10.1016/S0278-2626(03)00276-8 Buckholtz, J. W., & Meyer-Lindenberg, A. (2008). MAOA and the neurogenetic architecture of human aggression. ''Trends in Neurosciences'', ''31''(3), 120–129. https://doi.org/10.1016/j.tins.2007.12.006 Eckardt, M., File, S., Gessa, G., Grant, K., Guerri, C., Hoffman, P., & Tabakoff, B. (1998). Effects of moderate alcohol consumption on the central nervous system. ''Alcoholism, Clinical and Experimental Research'', ''22''(5), 998–1040. https://doi.org/10.1111/j.1530-0277.1998.tb03695.x }} {{tip|Suggestions for this section: * Important aspects include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except first letter and proper names, ending in a full-stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by a en-dash(–), followed by a full-stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't actually read or consulted }} ==External links== In this section, provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant external resources such as presentations, news articles, and professional sites. For example: * [https://students.unimelb.edu.au/academic-skills/explore-our-resources/essay-writing/six-top-tips-for-writing-a-great-essay Six top tips for writing a great essay] (University of Melbourne) * [http://www.skillsyouneed.com/write/structure.html The importance of structure] (skillsyouneed.com) {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] [[Category:Motivation and emotion/Book/Psychopathology]] [[Category:Motivation and emotion/Book/Trauma]] o1j4zy9f1q9vsj9n78ajmx9jsuhdedj 0 277132 2419406 2418974 2022-08-26T08:41:26Z 137.92.213.132 wikitext text/x-wiki {{title|Task initiation:<br>What are the challenges with task initiation and how to get get started?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==<big>Overview</big>== Have you ever feel so hard to get started on task? Have you ever feel you wanted to complete a task but you do not feel motivated to complete it? This is a common experiences that individual experienced. In this chapter, we will explore the challenge in task initiation and how motivational play role that drive individual to complete the tasks. {{tip| Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Provide an example or case study. * Conclude with Focus questions to guide the chapter. }} {{RoundBoxTop|theme=3}} '''Focus questions:''' - What is Task Initiation? - What are the challenges in task initiation? - How role does motivation play in task initiation? {{RoundBoxBottom}} ==<big>Understanding Task initiation and Motivation</big> == === '''<big>What is Task Initiation?</big>''' === Task initiation refers to the ability to start a task. It includes the ability to overcoming procrastination and getting started on task. Task initiation is a critical life skill that individual will be utilised throughout their life span. === '''<big>What is Motivation?</big>''' === {{tip|Suggestions for this section: * For the [[Motivation and emotion/Assessment/Topic|topic development]], provide at least 3 bullet-points about key content per section. Include key citations. * For the [[Motivation and emotion/Assessment/Chapter|book chapter]], expand the bullet points into paragraphs. * If a section has a lot of content, arrange it into two to five sub-headings such as in the [[#Interactive learning features|interactive learning features section]]. Avoid having sections with only one sub-heading. }} == <big>What role does Motivation plays in Task Initiation?</big> == == <big>Motivational Theories</big> == == <big>What are the challenges with Task Initiation?</big> == ==How do we get started? What Motivate us to complete the task? == == Test yourself == <div align="center"></div>Quizzes are a direct way to engage readers. But don't make quizzes too hard or long. It is better to have one or two review questions per major section than a long quiz at the end. Try to quiz conceptual understanding, rather than trivia. Here are some simple quiz questions which could be adapted. Choose the correct answers and click "Submit": <quiz display=simple> {Quizzes are an interactive learning feature: |type="()"} + True - False {Long quizzes are a good idea: |type="()"} - True + False </quiz> To learn about different types of quiz questions, see [[Help:Quiz|Quiz]]. ==Conclusion== The Conclusion is arguably the most important section. It should be possible for someone to read only the Overview and the Conclusion and still get a good idea of the topic. {{tip|Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? }} ==See also== In this section, provide up to half-a-dozen [[Help:Contents/Links#Interwiki_links|internal (wiki) links]] to relevant Wikiversity pages (esp. related [[Motivation and emotion/Book|motivation and emotion book chapters]]) and [[w:|Wikipedia articles]]. For example: * [[Motivation and emotion/Book/2016/Anorexia nervosa and extrinsic motivation|Anorexia nervosa and extrinsic motivation]] (Book chapter, 2016) * [[w:David McClelland|David McClelland]] (Wikipedia) * [[Motivation and emotion/Book/2018/Loss aversion|Loss aversion]] (Book chapter, 2018) * [[w:Maslow's hierarchy of needs|Maslow's hierarchy of needs]] (Wikipedia) {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== In this section, list the cited references in [[w:APA style|APA style]] (7th ed.). For example: {{Hanging indent|1= Blair, R. J. R. (2004). The roles of orbital frontal cortex in the modulation of antisocial behavior. ''Brain and Cognition'', ''55''(1), 198–208. https://doi.org/10.1016/S0278-2626(03)00276-8 Buckholtz, J. W., & Meyer-Lindenberg, A. (2008). MAOA and the neurogenetic architecture of human aggression. ''Trends in Neurosciences'', ''31''(3), 120–129. https://doi.org/10.1016/j.tins.2007.12.006 Eckardt, M., File, S., Gessa, G., Grant, K., Guerri, C., Hoffman, P., & Tabakoff, B. (1998). Effects of moderate alcohol consumption on the central nervous system. ''Alcoholism, Clinical and Experimental Research'', ''22''(5), 998–1040. https://doi.org/10.1111/j.1530-0277.1998.tb03695.x }} {{tip|Suggestions for this section: * Important aspects include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except first letter and proper names, ending in a full-stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by a en-dash(–), followed by a full-stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't actually read or consulted }} ==External links== In this section, provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant external resources such as presentations, news articles, and professional sites. For example: * [https://students.unimelb.edu.au/academic-skills/explore-our-resources/essay-writing/six-top-tips-for-writing-a-great-essay Six top tips for writing a great essay] (University of Melbourne) * [http://www.skillsyouneed.com/write/structure.html The importance of structure] (skillsyouneed.com) {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] [[Category:Motivation and emotion/Book/Goal striving]] tr1b1n5mjm52x6c06b9wrusxlt5z1g2 0 277657 2419331 2419008 2022-08-26T06:41:42Z Jtneill 10242 Fix user name wikitext text/x-wiki {{/Banner}} ==Motivation == # [[/Academic help-seeking/]] - What are the barriers and enablers of AHS and how can AHS be fostered? - [[User:Ibm4444|Ibm4444]] # [[/Academic self-regulation/]] - What is academic self-regulation, why does it matter, and how can it be fostered? - [[User:U3216563|U3216563]] # [[/Actively open-minded thinking/]] - How can AOT be used to improve human performance? - [[User:Teermeej Hossain|Teermeej Hossain]] # [[/Active transport motivation/]] - What motivates use of active transport and how can people be encouraged to use it? - [[User:MyUserName|MyUserName]] # [[/ADHD and motivation/]] - How does ADHD impact on motivation and what can be done about it? - [[User:U3222363|U3222363]] # [[/Antidepressants and motivation/]] - What are the effects of popular antidepressants on motivation? - [[User:MyUserName|MyUserName]] # [[/Approach motivation/]] - What is approach motivation and how does it lead to behaviour? - [[User:U3189370|U3189370]] # [[/Behavioural economics and motivation/]] - What aspects of motivation theory are useful in behavioural economics? - [[User:U3141987|U3141987]] # [[/Behavioural model of health services/]] - What is the BMHS and how can it be used? - [[User:SoSilverLibby|SoSilverLibby]] # [[/Beneficence as a psychological need/]] - What is beneficence and what are its implications as a psychological need? - [[User:CaitlinEmc|CaitlinEmc]] # [[/Brief motivational interviewing as a health intervention/]] - How can brief motivational interviewing be used as a health intervention? - [[User:MyUserName|MyUserName]] # [[/Cannabis use and dopamine/]] - What is the impact of cannabis use on dopamine in the brain? - [[User:U3246310|U3246310]] # [[/Childhood trauma and subsequent drug use/]] - How does psychological trauma influence subsequent drug use? - [[User:U3210431|U3210431]] # [[/Choice overload/]] - What is choice overload? What is the optimal amount of choice? - [[User:GeorgiaFairweather|GeorgiaFairweather]] # [[/Chunking and goal pursuit/]] - How does chunking affect goal pursuit? - [[User:Giovannihbartlett|Giovannihbartlett]] # [[/Cognitive entrenchment/]] - What is cognitive entrenchment and how can it be avoided? - [[User:JimmyOC1985|JimmyOC1985]] # [[/Climate change helplessness/]] - How does learned helpless impact motivation to engage in behaviours to limit climate change? - [[User:U3193000|U3193000]] # [[/Closeness communication bias/]] - What is the CCB, why does it occur, and how can it be overcome? - [[User:U3215103|U3215103]] # [[/Commitment bias/]] - What motivates escalation of commitment even it does not lead to desirably outcomes? - [[User:U3203936|U3203936]] # [[/Comprehensive action determination model/]] - What is the CADM and how can it be applied to understanding human motivation? - [[User:MyUserName|MyUserName]] # [[/Conspiracy theory motivation/]] - What motivates people to believe in conspiracy theories? - [[User:KingMob221|KingMob221]] # [[/Construal level theory/]] - What is construal level theory and how can it be applied? - [[User:MyUserName|MyUserName]] # [[/Courage motivation/]] - What is courage, what motivates courage, and how can courage be enhanced? -[[User:Hanarose123|Hanarose123]] # [[/Death drive/]] - What is the death drive and how can it be negotiated? - [[User:U3086459|U3086459]] # [[/Discounts and consumer purchase behaviour/]] - What role do discounts play in consumer purchase behaviour? - [[User:MyUserName|MyUserName]] # [[/Drugs-violence nexus and motivation/|Drugs-violence nexus and motivation]] - What is the role of motivation in the drugs-violence nexus? - [[Atu3202070|Atu3202070]] # [[/Domestic energy conservation motivation/]] - How can domestic energy conservation and reduced consumption be motivated and behaviour changed? - [[User:MyUserName|MyUserName]] # [[/Episodic future thinking and delay discounting/]] - What is the relationship between between EFT and DD? - [[User:MyUserName|MyUserName]] # [[/Episodic memory and planning/]] - What role does episodic memory play in planning? - [[User:MyUserName|MyUserName]] # [[/Equity theory/]] - What is equity theory and how can it be applied? - [[EKS2001|EKS2001]] # [[/ERG theory/]] - What is Alderfer's ERG theory? - [[User:Wuser1307|Wuser1307]] # [[/Environmental volunteering motivation/]] - What motivates environmental volunteering? - [[User:Somer Gellatly|Somer Gellatly]] # [[/Frame of reference and motivation/]] - How does frame of reference affect motivation? - [[User:MyUserName|MyUserName]] # [[/Freedom and motivation/]] - What is the effect of freedom on motivation? - [[User:MyUserName|MyUserName]] # [[/Fully functioning person/]] - What is a FFP and how can full functioning be developed? - [[User:Sebastian Armstrong|Sebastian Armstrong]] # [[/Functional fixedness/]] - What is functional fixedness and how can it be overcome? - [[User:U3214117|U3214117]] # [[/Functional imagery training/]] - What is FIT and how can it be applied? - [[User:Btarmstrong24|Btarmstrong24]] # [[/Gamification and work motivation/]] - How can gamification enhance work motivation? - [[User:U3211125|U3211125]] # [[/Giving up goals/]] - When should we give up goals and when should we persist? - [[User:U3161584|U3161584]] # [[/Green prescription motivation/]] - What motivates green prescription compliance? - [[User:Earthxangel|Earthxangel]] # [[/Grit and achievement/]] - How does grit affect achievement? - [[User:AnaStuart|AnaStuart]] # [[/Health belief model/]] - What is the HBM and how can it be used to enhance motivation for health-promoting behaviour? - [[User:Dee320|Dee320]] # [[/Help-seeking among boys/]] - What are the barriers to help-seeking for boys and what motivates them to seek help? - [[User:BradMcGrath|BradMcGrath]] # [[/Hidden costs of reward/]] - What are the hidden costs of motivating by reward? - [[User:SLoCE|SLoCE]] # [[/Hijack hypothesis of drug addiction/]] - What is the hijack hypothesis, what is the evidence, and how does it help to understand drug addiction? - [[User:U3218292|U3218292]] # [[/Honesty motivation/]] - What motivates honesty? - [[User:U3200859|U3200859]] # [[/Humour, leadership, and work/]] - What role does humour play in effective leadership in the workplace? - [[User:U3210264|U3210264]] # [[/IKEA effect/]] - What is the IKEA effect and how can it be applied? - [[MyUsername|MyUserName]] # [[/Intertemporal choice/]] - What are intertemporal choices and how can they be effectively negotiated? - [[User:MyUserName|MyUserName]] # [[/Kindness motivation/]] - What motivates kindness? - [[User:U3205429|U3205429]] # [[/Motivational music and exercise/]] - How can music be used to help motivate exercise? - [[User:U3183466|U3183466]] # [[/Non-residential energy conservation motivation/]] - How can non-residential building energy conservation and reduced consumption be motivated and behaviour changed? - [[User:MyUserName|MyUserName]] # [[/Novelty-variety as a psychological need/]] - What is novelty-variety and what are its implications as a psychological need? - [[User:MyUserName|MyUserName]] # [[/Nucleus accumbens and motivation/]] - What role does the nucleus accumbens play in motivation? - [[User:U3213250|U3213250]] # [[/Perfectionism/]] - What motivates perfectionism? Is perfectionism good or bad? How can it be managed? - [[User:AEMOR|AEMOR]] # [[/Physiological needs/]] - How do human's physiological needs affect motivation? - [[User:U3203655|U3203655]] # [[/Protection motivation theory and COVID-19/]] - How does PMT apply to managing COVID-19? - [[User:U3200956|U3200956]] # [[/Relative deprivation and motivation/]] - What is the effect of relative deprivation on motivation? - [[User:U3191574 (PHP)|U3191574 (PHP)]] # [[/Retrospective regret/]] - What is the motivational role of retrospective regret? - [[User:Will-U3214082|Will-U3214082]] # [[/Revenge motivation/]] - What motivates revenge and how does it affect us? - [[User:U3216654|U3216654]] # [[/Self-actualisation and motivation/]] - What motivates self-actualisation? - [[User:MyUserName|MyUserName]] # [[/Self-efficacy and academic achievement/]] - What role does self-efficacy play in academic achievement? - [[User:U943292|U943292]] # [[/Self-efficacy and achievement/]] - What role does self-efficacy play in achievement outcomes? - [[User:U3216513mt|U3216513mt]] # [[/Self-help/]] - What is self-help and what motivates people to engage in it? - [[User:Cedevlin9|Cedevlin9]] # [[/Sexual harassment at work motivation/]] - What motivates sexual harassment at work and what can be done about it? - [[User:U3037979|U3037979]] # [[/Signature strengths/]] - What are signature strengths and how can they be applied? - [[User:MyUserName|MyUserName]] # [[/Social cure/]] - What is the social cure and how can it be applied? - [[User:U3215976|U3215976]] # [[/Staff retention motivation/]] - How can organisations and managers help to motivate long-term retention of employees? - [[User:MyUserName|MyUserName]] # [[/System justification theory/]] - What is SJT, how does it affect our lives, and what can be done about it? - [[User:MyUserName|MyUserName]] # [[/Stretch goals/]] - What are stretch goals? Do they work? - [[User:MyUserName|MyUserName]] # [[/Sublimation/]] - What is sublimation and how can it be fostered? - [[User:Emily.desilva|Emily.desilva]] # [[/Survival needs and motivation/]] - What are survival needs and how do they influence motivation? - [[User:U3148161|U3148161]] # [[/Task initiation/]] - What are the challenges with task initiation and how to get get started? - [[User:StormSar|StormSar]] # [[/Theoretical domains framework/]] - What is the TDF and how can be used to guide behaviour change? - [[User:MyUserName|MyUserName]] # [[/Time and motivation/]] - What is the effect of time on motivation? - [[User:Lturner2311|Lturner2311]] # [[/Time management/]] - How can one's time be managed effectively? - [[User:CNK.20|CNK.20]] # [[/To-do lists/]] - Are to-do lists a good idea? What are their pros and cons? How can they be used effectively? - [[User:U3207458|U3207458]] # [[/Treatment motivation in juvenile delinquency/]] - What is the role of treatment motivation for juvenile delinquency and how can it be enhanced? - [[User:MyUserName|MyUserName]] # [[/Uncertainty avoidance/]] - What is uncertainty avoidance, why does it occur, and what are its consequences? - [[User:Franklin Brightt|Franklin Brightt]] # [[/Urgency bias and productivity/]] - What is the impact of urgency bias on productivity and what can be done about it? - [[User:Jnoth|Jnoth]] # [[/Vocational identity/]] - What is vocational identity and how does it develop? - [[User:MyUserName|MyUserName]] # [[/Volunteer tourism motivation/]] - What motivates volunteer tourism? - [[User:U962051|U962051]] # [[/Wanting and liking/]] - What are the similarities and differences between wanting and liking, and what are the implications? - [[User:U3201643|U3201643]] # [[/Work breaks, well-being, and productivity/]] - How do work breaks affect well-being and productivity? - [[User:U3215603|U3215603]] # [[/Work and flow/]] - What characteristics of work can produce flow and how can flow at work be fostered? - [[User:U3213441|U3213441]] ==Emotion== # [[/Animal emotion/]] - What is the emotional experience of animals? - [[User:U3216502|U3216502]] # [[/Attributions and emotion/]] - How do attributions affect emotion? - [[User:MyUserName|MyUserName]] # [[/Autonomous sensory meridian response and emotion/]] - What emotions are involved in ASMR experiences and why do they occur? - [[User:U3186959|U3186959]] # [[/Benzodiazepines and emotion/]] - What are the effects of benzodiazepines on emotion? - [[User:FulaAjeo22|FulaAjeo22]] # [[/Bewilderment/]] - What is bewilderment and how can it be dealt with? - [[User:SunandaUC|SunandaUC]] # [[/Burnout/]] - What is burnout and how can be it be managed and prevented? - [[User:U3202788|U3202788]] # [[/Cognitive dissonance reduction/]] - What strategies do people use to reduce cognitive dissonance and how effective are they? - [[User:Tatjurate|Tatjurate]] # [[/Colonisation and emotion in Australia/]] - What are the emotional responses to colonisation in Australia? - [[User:Micabaker1|Micabaker1]] # [[/Compassion/]] - What is compassion, what are its pros and cons, and how can it be fostered? - [[User:U3203545|U3203545]] # [[/Compassion fatigue in mental health professionals/]] - What causes compassion fatigue in MH professionals and how can it be prevented? - [[User:U3055143|U3055143]] # [[/Connection to country and well-being/]] - What is the relationship between connection to country and well-being? - [[User:MyUserName|MyUserName]] # [[/Contempt/]] - What is contempt, what causes it, and how can it be managed? - [[User:U3202788|U3219905]] # [[/Core emotions/]] - What are the core emotions and what is their function? U3203140 # [[/Creative arts and trauma/]] - How can creative arts help in dealing with trauma? - [[User:SashaBrooksby|SashaBrooksby]] # [[/Cultural influences on shame, guilt, and pride/]] - How does culture influence shame, guilt, and pride? - [[User:Tamika Afeaki|Tamika Afeaki]] # [[/Default mode network and the self/]] - What is the relationship between the DMN and the self? - [[User:MyUserName|MyUserName]] # [[/Difficult conversations and emotion/]] - What communication and emotional skills are needed to successfully negotiate difficult conversations? - [[User:U3158968|U3158968]] # [[/Disappointment/]] - What is disappointment, what causes it, and how can it be managed? - [[User:U3216256|U3216256]] # [[/DMT and spirituality/]] - How can DMT facilitate spiritual experiences? - [[User:DenniseSoleymani|DenniseSoleymani]] # [[/Durability bias in affective forecasting/]] - What role does durability bias play in affective forecasting? - [[User:MyUserName|MyUserName]] # [[/Ecological grief/]] - What is ecological grief and what can be done about it? - [[User:Brewerjr|Brewerjr]] # [[/Ecopsychology and stress/]] - How can ecopsychology help to explain and deal with stress? - [[User:MyUserName|MyUserName]] # [[/Embarrassment/]] - What is embarrassment, what causes it, and how can it be managed? - [[User:U3190353|U3190353]] # [[/Emotional development in adolescence/]] - How does emotionality develop during adolescence? - [[User:U3230861|U3230861]] # [[/Emotional intelligence training/]] - How can emotional intelligence be trained? - [[User:Eimilerous22|Eimilerous22]] # [[/Emotion knowledge/]] - What is emotion knowledge and how can it be developed? - [[User:GabbieUC|GabbieUC]] # [[/Emotion across the lifespan/]] - How does emotion develop across the lifespan? - [[User:MyUserName|MyUserName]] # [[/Endocannabinoid system and emotion/]] - What is the role of the endocannabinoid system in emotion? - [[User:RWilliams12|Rwilliams12]] # [[/Environmental grief/]] - What is eco-grief, its causes and consequences, and what can be done? - [[User:Gabrielle Eagling|Gabrielle Eagling]] # [[/Exercise and endocannabinoids/]] - What is the relationship between exercise and the endocannabinoid system? - [[User:U3216963|U3216963]] # [[/Expressive suppression and emotion regulation/]] - What is the role of expressive suppression in emotion regulation? - [[User:U3131472|U3131472]] # [[/Fairness and emotion/]] - What is the relation between fairness and emotion? - [[User:U3246554|U3246554]] # [[/Fatigue and emotion/]] - What is the effect of fatigue on emotion and what can be done about it? - [[User:Lewis.Kusk|Lewis.Kusk]] # [[/Fear/]] - What is fear, what causes it, and how can it be managed? - [[User:Icantchooseone|Icantchooseone]] # [[/Fear of working out/]] - What is FOWO and how can it be overcome? - [[User:U3216963|U3216963]] # [[/Flourishing in the elderly/]] - How can psychological flourishing be supported in the elderly? - [[User:MyUserName|MyUserName]] # [[/Fundamental attribution error and emotion/]] - What is the relationship between the FAE and emotion? - [[User:U3196624|U3196624]] # [[/Gratitude and subjective wellbeing/]] - What is the relationship between gratitude and subjective wellbeing? - [[User:U3214260|U3214260]] # [[/Gloatrage/]] - What is gloatrage, what causes it, and what are its consequences? - [[User:MyUserName|MyUserName]] # [[/Heart rate variability and emotion regulation/]] - What is the relationship between HRV and emotion regulation? - [[User:U3213568|U3213568]] # [[/Hedonic adaptation prevention model/]] - What is the HAP model and how can it be applied? - [[User:Lyndel Lemon|Lyndel Lemon]] # [[/Humility/]] - What is humility, what causes it, and is it desirable? - [[User:U3195233|U3195233]] # [[/Hypomania and emotion/]] - What are the emotional characteristics of hypomania? - [[User:Alec.cortez|Alec.cortez]] # [[/Impact bias/]] - What is impact bias, what causes it, what are its consequences, and how can it be avoided? - [[User:MyUserName|MyUserName]] # [[Indigenous Australian emotionality]] - In what ways is emotionality experienced by Indigenous Australian people? - [[User:U3189442 - K.Ryan|U3189442 - K.Ryan]] # [[/Indigenous Australian mindfulness/]] - How has Indigenous Australian culture traditionally conceived of, and practiced, mindfulness? - [[User:MyUserName|MyUserName]] # [[/Inspiration/]] - What is inspiration, what causes it, what are its consequences, and how can it be fostered? - [[User:U3230861|U3227354]] # [[/Insular cortex and emotion/]] - What role does the insular cortex play in emotion? - [[User:U3190094|U3190094]] # [[/Interoception and emotion/]] - What is the relationship between interoception and emotion? - [[User:U3203265|U3203265]] # [[/Kama muta/]] - What is kama muta, what are its effects, and how can it be fostered? - [[User:U3183521|U3183521]] # [[/Linguistic relativism and emotion/]] - What is the role of linguistic relativism in emotion? - [[User:U3119310|U3119310]] # [[/Menstrual cycle mood disorders/]] - What causes menstrual cycle mood disorders and how can they be managed? - [[User:U3217109|U3217109]] # [[/Mental toughness in the workplace/]] - What can mental toughness be useful in the workplace? How can it be developed? - [[User:MyUserName|MyUserName]] # [[/Mindfulness and creativity/]] - How can mindfulness enhance creativity? - [[User:CaityDcr1603|CaityDcr1603]] # [[/Mindful self-care/]] - What is mindful self-care, why does it matter, and how can it be developed? - [[User:Clairelogan|Clairelogan]] # [[/Mixed emotions/]] - What are mixed emotions, what causes them, and how can they be managed? - [[User:U3210490|U3210490]] # [[/Mudita/]] - What is mudita and how can it be developed? -[[User:Inandonit365|Inandonit365]] # [[/Natural disasters and emotion/]] - How do people respond emotionally to natural disasters and how can they be supported? - [[User:U3148366_Chris|U3148366_Chris]] # [[/Nature therapy/]] - What is nature therapy and how can it be applied? - [[User:Ana028|Ana028]] # [[/Narcissism and emotion/]] - What is the relationship between narcissism and emotion? - [[User:A Super Villain|A Super Villain]] # [[/Narrative therapy and emotion/]] - What is the role of emotion in narrative therapy? - [[User:MyUserName|MyUserName]] # [[/Needle fear/]] - How does needle fear develop, what are its consequences, and what can be done about it? - [[User:U3166273|U3166273]] # [[/Neuroimaging and mood disorders/]] - How can neuroimaging assist in diagnosing and treating mood disorders? - [[User:Jdebear|Jdebear]] # [[/Occupational violence, emotion, and coping/]] - What are the emotional impacts of occupational violence and how can employees cope? - [[User:MyUserName|MyUserName]] # [[/Positivity ratio/]] - What is the positivity ratio and what are its implications? - [[User:MyUserName|MyUserName]] # [[/Post-traumatic stress disorder and emotion/]] - What is the effect of PTSD on emotion? - [[User:JorjaFive|JorjaFive]] # [[/Psychological distress/]] - What is PD, what are the main types, and how can they be managed? - [[User:U3190773|U3190773]] # [[/Psychological trauma/]] - What causes psychological trauma, what are the consequences, and how can people recover from psychological trauma? - [[User:U3195332|U3195332]] # [[/Psilocybin assisted psychotherapy/]] - How can psilocybin be used to assist psychotherapy? - [[User:U3083720|U3083720]] # [[/Psilocybin assisted therapy and depression/]] – How can psilocybin assisted therapy help to treat depression? - [[User:U3191488|U3191488]] # [[/Rational compassion/]] - What is rational compassion and how can it be cultivated? - [[User:MyUserName|MyUserName]] # [[/Reflected glory/]] - What is reflected glory and what are its pros and cons? - [[User:MyUserName|MyUserName]] # [[/Religiosity and coping/]] - What is the relationship between religiosity and coping? - [[User:Noah O'Brien|Noah O'Brien]] # [[/Resentment/]] - What is resentment, what causes it, and what are its consequences? - [[User:U3216389|U3216389]] # [[/Risk-as-feelings/]] - What is the emotional experience of risk and how does it influence decision-making and behaviour? - [[User:BenjiD'Ange|BenjiD'Ange]] # [[/Self-esteem and culture/]] - What are the cultural influences on self-esteem? - [[User:Jingru shao 0906|Jingru shao0906]] # [[/Smiling and emotion/]] - What is the relationship between smiling and emotion? - [[User:U3200902|U3200902]] # [[/Social media and suicide prevention/]] - How can social media be used to help prevent suicide? - [[User:JaimeTegan|JaimeTegan]] # [[/Sorry business/]] - What is sorry business and what role does it play in Indigenous communities in Australia? - [[User:Isaacem13|Isaacem13]] # [[/Stress control mindset/]] - What is a SCM, why does it matter, and how can it be cultivated? - [[User:MyUserName|MyUserName]] # [[/Suffering as emotion/]] - What is the emotional experience of suffering and how can people cope with suffering? - [[User:Brookewin|Brookewin]] # [[/Telemental health/]] - What are the pros and cons of TMH and what are the key ingredients for effective TMH practices? - [[User:U3025906|U3025906]] # [[/Topophilia/]] - What is topophilia, how does it develop, and what are the psychological impacts? - [[User:RSPMeredith|RSPMeredith]] # [[/Trauma and emotion/]] - What is the effect of trauma on emotion? - [[User:MyUserName|MyUserName]] # [[/Triumph/]] - What is triumph, what causes it, and how can it be managed? - [[User:Bill.miosge|Bill.miosge]] # [[/Unemployment and mental health/]]: What is the relationship between unemployment and mental health? - [[User:Tiarnawilson01|Tiarnawilson01]] # [[/Viewing natural scenes and emotion/]] - What is the effect of viewing natural scenes on emotion and how can this be applied? - [[User:MyUserName|MyUserName]] # [[/Wave metaphor for emotion/]] - In what respects is an ocean wave a helpful metaphor for understanding human emotions? - [[User:Jamieepiper|Jamieepiper]] # [[/Window of tolerance/]] - What is the window of tolerance and how can it be applied? - [[User:U3223109|U3223109]] # [[/Workplace mental health training/]] - What is WMHT, what techniques are used, and what are the impacts? - [[User:ArtOfHappiness|ArtOfHappiness]] # [[/Video conferencing fatigue/]] - What is video conferencing fatigue, what causes it, what are its consequences, and what can be done about it? - [[User:u3211603|U3211603]] ==Motivation and emotion== # [[/Financial investing, motivation, and emotion/]] - What role does motivation and emotion play in financial investing? - [[User:U3217287|U3217287]] # [[/Hostage negotiation, motivation, and emotion/]] - What role does motivation and emotion play in hostage negotiation? - [[User:U3213549|U3213549]] # [[/Money priming, motivation, and emotion/]] - What is the effect of money priming on motivation and emotion? - [[User:Molzaroid|Molzaroid]] # [[/Motivational dimensional model of affect/]] - What is the motivational dimensional model of affect and what are its implications? - [[User:MyUserName|MyUserName]] # [[/Napping, motivation, and emotion/]] - What are the motivational and emotional effects of napping? - [[User:U3207862|U3207862]] # [[/Overchoice, emotion, and motivation/]] - What are the emotional and motivational effects of overchoice? - [[User:MyUserName|MyUserName]] # [[/Patience and impatience/]] - What are the psychological causes and consequences of patience and impatience? - [[User:U3100193|U3100193]] # [[/Reward system, motivation, and emotion/]] - What role does the reward system play in motivation and emotion? - [[User:U3162201|U3162201]] [[Category:Motivation and emotion/Book/2022]] ps8k5p7loaucknwmbrd0szubj4olxwn 2419336 2419331 2022-08-26T06:51:39Z Jtneill 10242 wikitext text/x-wiki {{/Banner}} ==Motivation == # [[/Academic help-seeking/]] - What are the barriers and enablers of AHS and how can AHS be fostered? - [[User:Ibm4444|Ibm4444]] # [[/Academic self-regulation/]] - What is academic self-regulation, why does it matter, and how can it be fostered? - [[User:U3216563|U3216563]] # [[/Actively open-minded thinking/]] - How can AOT be used to improve human performance? - [[User:Teermeej Hossain|Teermeej Hossain]] # [[/Active transport motivation/]] - What motivates use of active transport and how can people be encouraged to use it? - [[User:MyUserName|MyUserName]] # [[/ADHD and motivation/]] - How does ADHD impact on motivation and what can be done about it? - [[User:U3222363|U3222363]] # [[/Antidepressants and motivation/]] - What are the effects of popular antidepressants on motivation? - [[User:MyUserName|MyUserName]] # [[/Approach motivation/]] - What is approach motivation and how does it lead to behaviour? - [[User:U3189370|U3189370]] # [[/Behavioural economics and motivation/]] - What aspects of motivation theory are useful in behavioural economics? - [[User:U3141987|U3141987]] # [[/Behavioural model of health services/]] - What is the BMHS and how can it be used? - [[User:SoSilverLibby|SoSilverLibby]] # [[/Beneficence as a psychological need/]] - What is beneficence and what are its implications as a psychological need? - [[User:CaitlinEmc|CaitlinEmc]] # [[/Brief motivational interviewing as a health intervention/]] - How can brief motivational interviewing be used as a health intervention? - [[User:MyUserName|MyUserName]] # [[/Cannabis use and dopamine/]] - What is the impact of cannabis use on dopamine in the brain? - [[User:U3246310|U3246310]] # [[/Childhood trauma and subsequent drug use/]] - How does psychological trauma influence subsequent drug use? - [[User:U3210431|U3210431]] # [[/Choice overload/]] - What is choice overload? What is the optimal amount of choice? - [[User:GeorgiaFairweather|GeorgiaFairweather]] # [[/Chunking and goal pursuit/]] - How does chunking affect goal pursuit? - [[User:Giovannihbartlett|Giovannihbartlett]] # [[/Cognitive entrenchment/]] - What is cognitive entrenchment and how can it be avoided? - [[User:JimmyOC1985|JimmyOC1985]] # [[/Climate change helplessness/]] - How does learned helpless impact motivation to engage in behaviours to limit climate change? - [[User:U3193000|U3193000]] # [[/Closeness communication bias/]] - What is the CCB, why does it occur, and how can it be overcome? - [[User:U3215103|U3215103]] # [[/Commitment bias/]] - What motivates escalation of commitment even it does not lead to desirably outcomes? - [[User:U3203936|U3203936]] # [[/Comprehensive action determination model/]] - What is the CADM and how can it be applied to understanding human motivation? - [[User:MyUserName|MyUserName]] # [[/Conspiracy theory motivation/]] - What motivates people to believe in conspiracy theories? - [[User:KingMob221|KingMob221]] # [[/Construal level theory/]] - What is construal level theory and how can it be applied? - [[User:MyUserName|MyUserName]] # [[/Courage motivation/]] - What is courage, what motivates courage, and how can courage be enhanced? -[[User:Hanarose123|Hanarose123]] # [[/Death drive/]] - What is the death drive and how can it be negotiated? - [[User:U3086459|U3086459]] # [[/Discounts and consumer purchase behaviour/]] - What role do discounts play in consumer purchase behaviour? - [[User:MyUserName|MyUserName]] # [[/Drugs-violence nexus and motivation/|Drugs-violence nexus and motivation]] - What is the role of motivation in the drugs-violence nexus? - [[Atu3202070|Atu3202070]] # [[/Domestic energy conservation motivation/]] - How can domestic energy conservation and reduced consumption be motivated and behaviour changed? - [[User:MyUserName|MyUserName]] # [[/Episodic future thinking and delay discounting/]] - What is the relationship between between EFT and DD? - [[User:MyUserName|MyUserName]] # [[/Episodic memory and planning/]] - What role does episodic memory play in planning? - [[User:MyUserName|MyUserName]] # [[/Equity theory/]] - What is equity theory and how can it be applied? - [[EKS2001|EKS2001]] # [[/ERG theory/]] - What is Alderfer's ERG theory? - [[User:Wuser1307|Wuser1307]] # [[/Environmental volunteering motivation/]] - What motivates environmental volunteering? - [[User:Somer Gellatly|Somer Gellatly]] # [[/Frame of reference and motivation/]] - How does frame of reference affect motivation? - [[User:MyUserName|MyUserName]] # [[/Freedom and motivation/]] - What is the effect of freedom on motivation? - [[User:MyUserName|MyUserName]] # [[/Fully functioning person/]] - What is a FFP and how can full functioning be developed? - [[User:Sebastian Armstrong|Sebastian Armstrong]] # [[/Functional fixedness/]] - What is functional fixedness and how can it be overcome? - [[User:U3214117|U3214117]] # [[/Functional imagery training/]] - What is FIT and how can it be applied? - [[User:Btarmstrong24|Btarmstrong24]] # [[/Gamification and work motivation/]] - How can gamification enhance work motivation? - [[User:U3211125|U3211125]] # [[/Giving up goals/]] - When should we give up goals and when should we persist? - [[User:U3161584|U3161584]] # [[/Green prescription motivation/]] - What motivates green prescription compliance? - [[User:Earthxangel|Earthxangel]] # [[/Grit and achievement/]] - How does grit affect achievement? - [[User:AnaStuart|AnaStuart]] # [[/Health belief model/]] - What is the HBM and how can it be used to enhance motivation for health-promoting behaviour? - [[User:Dee320|Dee320]] # [[/Help-seeking among boys/]] - What are the barriers to help-seeking for boys and what motivates them to seek help? - [[User:BradMcGrath|BradMcGrath]] # [[/Hidden costs of reward/]] - What are the hidden costs of motivating by reward? - [[User:SLoCE|SLoCE]] # [[/Hijack hypothesis of drug addiction/]] - What is the hijack hypothesis, what is the evidence, and how does it help to understand drug addiction? - [[User:U3218292|U3218292]] # [[/Honesty motivation/]] - What motivates honesty? - [[User:U3200859|U3200859]] # [[/Humour, leadership, and work/]] - What role does humour play in effective leadership in the workplace? - [[User:U3210264|U3210264]] # [[/IKEA effect/]] - What is the IKEA effect and how can it be applied? - [[MyUsername|MyUserName]] # [[/Intertemporal choice/]] - What are intertemporal choices and how can they be effectively negotiated? - [[User:MyUserName|MyUserName]] # [[/Kindness motivation/]] - What motivates kindness? - [[User:U3205429|U3205429]] # [[/Motivational music and exercise/]] - How can music be used to help motivate exercise? - [[User:U3183466|U3183466]] # [[/Non-residential energy conservation motivation/]] - How can non-residential building energy conservation and reduced consumption be motivated and behaviour changed? - [[User:MyUserName|MyUserName]] # [[/Novelty-variety as a psychological need/]] - What is novelty-variety and what are its implications as a psychological need? - [[User:MyUserName|MyUserName]] # [[/Nucleus accumbens and motivation/]] - What role does the nucleus accumbens play in motivation? - [[User:U3213250|U3213250]] # [[/Perfectionism/]] - What motivates perfectionism? Is perfectionism good or bad? How can it be managed? - [[User:AEMOR|AEMOR]] # [[/Physiological needs/]] - How do human's physiological needs affect motivation? - [[User:U3203655|U3203655]] # [[/Protection motivation theory and COVID-19/]] - How does PMT apply to managing COVID-19? - [[User:U3200956|U3200956]] # [[/Relative deprivation and motivation/]] - What is the effect of relative deprivation on motivation? - [[User:U3191574 (PHP)|U3191574 (PHP)]] # [[/Retrospective regret/]] - What is the motivational role of retrospective regret? - [[User:Will-U3214082|Will-U3214082]] # [[/Revenge motivation/]] - What motivates revenge and how does it affect us? - [[User:U3216654|U3216654]] # [[/Self-actualisation and motivation/]] - What motivates self-actualisation? - [[User:MyUserName|MyUserName]] # [[/Self-efficacy and academic achievement/]] - What role does self-efficacy play in academic achievement? - [[User:U943292|U943292]] # [[/Self-efficacy and achievement/]] - What role does self-efficacy play in achievement outcomes? - [[User:U3216513mt|U3216513mt]] # [[/Self-help/]] - What is self-help and what motivates people to engage in it? - [[User:Cedevlin9|Cedevlin9]] # [[/Sexual harassment at work motivation/]] - What motivates sexual harassment at work and what can be done about it? - [[User:U3037979|U3037979]] # [[/Signature strengths/]] - What are signature strengths and how can they be applied? - [[User:MyUserName|MyUserName]] # [[/Social cure/]] - What is the social cure and how can it be applied? - [[User:U3215976|U3215976]] # [[/Staff retention motivation/]] - How can organisations and managers help to motivate long-term retention of employees? - [[User:MyUserName|MyUserName]] # [[/System justification theory/]] - What is SJT, how does it affect our lives, and what can be done about it? - [[User:MyUserName|MyUserName]] # [[/Stretch goals/]] - What are stretch goals? Do they work? - [[User:MyUserName|MyUserName]] # [[/Sublimation/]] - What is sublimation and how can it be fostered? - [[User:Emily.desilva|Emily.desilva]] # [[/Survival needs and motivation/]] - What are survival needs and how do they influence motivation? - [[User:U3148161|U3148161]] # [[/Task initiation/]] - What are the challenges with task initiation and how to get get started? - [[User:StormSar|StormSar]] # [[/Theoretical domains framework/]] - What is the TDF and how can be used to guide behaviour change? - [[User:MyUserName|MyUserName]] # [[/Time and motivation/]] - What is the effect of time on motivation? - [[User:Lturner2311|Lturner2311]] # [[/Time management/]] - How can one's time be managed effectively? - [[User:CNK.20|CNK.20]] # [[/To-do lists/]] - Are to-do lists a good idea? What are their pros and cons? How can they be used effectively? - [[User:U3207458|U3207458]] # [[/Treatment motivation in juvenile delinquency/]] - What is the role of treatment motivation for juvenile delinquency and how can it be enhanced? - [[User:MyUserName|MyUserName]] # [[/Uncertainty avoidance/]] - What is uncertainty avoidance, why does it occur, and what are its consequences? - [[User:Franklin Brightt|Franklin Brightt]] # [[/Urgency bias and productivity/]] - What is the impact of urgency bias on productivity and what can be done about it? - [[User:Jnoth|Jnoth]] # [[/Vocational identity/]] - What is vocational identity and how does it develop? - [[User:MyUserName|MyUserName]] # [[/Volunteer tourism motivation/]] - What motivates volunteer tourism? - [[User:U962051|U962051]] # [[/Wanting and liking/]] - What are the similarities and differences between wanting and liking, and what are the implications? - [[User:U3201643|U3201643]] # [[/Work breaks, well-being, and productivity/]] - How do work breaks affect well-being and productivity? - [[User:U3215603|U3215603]] # [[/Work and flow/]] - What characteristics of work can produce flow and how can flow at work be fostered? - [[User:U3213441|U3213441]] ==Emotion== # [[/Animal emotion/]] - What is the emotional experience of animals? - [[User:U3216502|U3216502]] # [[/Attributions and emotion/]] - How do attributions affect emotion? - [[User:MyUserName|MyUserName]] # [[/Autonomous sensory meridian response and emotion/]] - What emotions are involved in ASMR experiences and why do they occur? - [[User:U3186959|U3186959]] # [[/Benzodiazepines and emotion/]] - What are the effects of benzodiazepines on emotion? - [[User:FulaAjeo22|FulaAjeo22]] # [[/Bewilderment/]] - What is bewilderment and how can it be dealt with? - [[User:SunandaUC|SunandaUC]] # [[/Burnout/]] - What is burnout and how can be it be managed and prevented? - [[User:U3202788|U3202788]] # [[/Cognitive dissonance reduction/]] - What strategies do people use to reduce cognitive dissonance and how effective are they? - [[User:Tatjurate|Tatjurate]] # [[/Colonisation and emotion in Australia/]] - What are the emotional responses to colonisation in Australia? - [[User:Micabaker1|Micabaker1]] # [[/Compassion/]] - What is compassion, what are its pros and cons, and how can it be fostered? - [[User:U3203545|U3203545]] # [[/Compassion fatigue in mental health professionals/]] - What causes compassion fatigue in MH professionals and how can it be prevented? - [[User:U3055143|U3055143]] # [[/Connection to country and well-being/]] - What is the relationship between connection to country and well-being? - [[User:MyUserName|MyUserName]] # [[/Contempt/]] - What is contempt, what causes it, and how can it be managed? - [[User:U3202788|U3219905]] # [[/Core emotions/]] - What are the core emotions and what is their function? U3203140 # [[/Creative arts and trauma/]] - How can creative arts help in dealing with trauma? - [[User:SashaBrooksby|SashaBrooksby]] # [[/Cultural influences on shame, guilt, and pride/]] - How does culture influence shame, guilt, and pride? - [[User:Tamika Afeaki|Tamika Afeaki]] # [[/Default mode network and the self/]] - What is the relationship between the DMN and the self? - [[User:MyUserName|MyUserName]] # [[/Difficult conversations and emotion/]] - What communication and emotional skills are needed to successfully negotiate difficult conversations? - [[User:U3158968|U3158968]] # [[/Disappointment/]] - What is disappointment, what causes it, and how can it be managed? - [[User:U3216256|U3216256]] # [[/DMT and spirituality/]] - How can DMT facilitate spiritual experiences? - [[User:DenniseSoleymani|DenniseSoleymani]] # [[/Durability bias in affective forecasting/]] - What role does durability bias play in affective forecasting? - [[User:MyUserName|MyUserName]] # [[/Ecological grief/]] - What is ecological grief and what can be done about it? - [[User:Brewerjr|Brewerjr]] # [[/Ecopsychology and stress/]] - How can ecopsychology help to explain and deal with stress? - [[User:MyUserName|MyUserName]] # [[/Embarrassment/]] - What is embarrassment, what causes it, and how can it be managed? - [[User:U3190353|U3190353]] # [[/Emotional development in adolescence/]] - How does emotionality develop during adolescence? - [[User:U3230861|U3230861]] # [[/Emotional intelligence training/]] - How can emotional intelligence be trained? - [[User:Eimilerous22|Eimilerous22]] # [[/Emotion knowledge/]] - What is emotion knowledge and how can it be developed? - [[User:GabbieUC|GabbieUC]] # [[/Emotion across the lifespan/]] - How does emotion develop across the lifespan? - [[User:MyUserName|MyUserName]] # [[/Endocannabinoid system and emotion/]] - What is the role of the endocannabinoid system in emotion? - [[User:RWilliams12|Rwilliams12]] # [[/Environmental grief/]] - What is eco-grief, its causes and consequences, and what can be done? - [[User:Gabrielle Eagling|Gabrielle Eagling]] # [[/Exercise and endocannabinoids/]] - What is the relationship between exercise and the endocannabinoid system? - [[User:U3216963|U3216963]] # [[/Expressive suppression and emotion regulation/]] - What is the role of expressive suppression in emotion regulation? - [[User:U3131472|U3131472]] # [[/Fairness and emotion/]] - What is the relation between fairness and emotion? - [[User:U3246554|U3246554]] # [[/Fatigue and emotion/]] - What is the effect of fatigue on emotion and what can be done about it? - [[User:Lewis.Kusk|Lewis.Kusk]] # [[/Fear/]] - What is fear, what causes it, and how can it be managed? - [[User:Icantchooseone|Icantchooseone]] # [[/Fear of working out/]] - What is FOWO and how can it be overcome? - [[User:U3216963|U3216963]] # [[/Flourishing in the elderly/]] - How can psychological flourishing be supported in the elderly? - [[User:MyUserName|MyUserName]] # [[/Fundamental attribution error and emotion/]] - What is the relationship between the FAE and emotion? - [[User:U3196624|U3196624]] # [[/Gratitude and subjective wellbeing/]] - What is the relationship between gratitude and subjective wellbeing? - [[User:U3214260|U3214260]] # [[/Gloatrage/]] - What is gloatrage, what causes it, and what are its consequences? - [[User:MyUserName|MyUserName]] # [[/Heart rate variability and emotion regulation/]] - What is the relationship between HRV and emotion regulation? - [[User:U3213568|U3213568]] # [[/Hedonic adaptation prevention model/]] - What is the HAP model and how can it be applied? - [[User:Lyndel Lemon|Lyndel Lemon]] # [[/Humility/]] - What is humility, what causes it, and is it desirable? - [[User:U3195233|U3195233]] # [[/Hypomania and emotion/]] - What are the emotional characteristics of hypomania? - [[User:Alec.cortez|Alec.cortez]] # [[/Impact bias/]] - What is impact bias, what causes it, what are its consequences, and how can it be avoided? - [[User:MyUserName|MyUserName]] # [[Indigenous Australian emotionality]] - In what ways is emotionality experienced by Indigenous Australian people? - [[User:U3189442 - K.Ryan|U3189442 - K.Ryan]] # [[/Indigenous Australian mindfulness/]] - How has Indigenous Australian culture traditionally conceived of, and practiced, mindfulness? - [[User:MyUserName|MyUserName]] # [[/Inspiration/]] - What is inspiration, what causes it, what are its consequences, and how can it be fostered? - [[User:U3230861|U3227354]] # [[/Insular cortex and emotion/]] - What role does the insular cortex play in emotion? - [[User:U3190094|U3190094]] # [[/Interoception and emotion/]] - What is the relationship between interoception and emotion? - [[User:U3203265|U3203265]] # [[/Kama muta/]] - What is kama muta, what are its effects, and how can it be fostered? - [[User:U3183521|U3183521]] # [[/Linguistic relativism and emotion/]] - What is the role of linguistic relativism in emotion? - [[User:U3119310|U3119310]] # [[/Menstrual cycle mood disorders/]] - What causes menstrual cycle mood disorders and how can they be managed? - [[User:U3217109|U3217109]] # [[/Mental toughness in the workplace/]] - What can mental toughness be useful in the workplace? How can it be developed? - [[User:MyUserName|MyUserName]] # [[/Mindfulness and creativity/]] - How can mindfulness enhance creativity? - [[User:CaityDcr1603|CaityDcr1603]] # [[/Mindful self-care/]] - What is mindful self-care, why does it matter, and how can it be developed? - [[User:Clairelogan|Clairelogan]] # [[/Mixed emotions/]] - What are mixed emotions, what causes them, and how can they be managed? - [[User:U3210490|U3210490]] # [[/Mudita/]] - What is mudita and how can it be developed? - [[User:Inandonit365|Inandonit365]] # [[/Natural disasters and emotion/]] - How do people respond emotionally to natural disasters and how can they be supported? - [[User:U3148366_Chris|U3148366_Chris]] # [[/Nature therapy/]] - What is nature therapy and how can it be applied? - [[User:Ana028|Ana028]] # [[/Narcissism and emotion/]] - What is the relationship between narcissism and emotion? - [[User:A Super Villain|A Super Villain]] # [[/Narrative therapy and emotion/]] - What is the role of emotion in narrative therapy? - [[User:MyUserName|MyUserName]] # [[/Needle fear/]] - How does needle fear develop, what are its consequences, and what can be done about it? - [[User:U3166273|U3166273]] # [[/Neuroimaging and mood disorders/]] - How can neuroimaging assist in diagnosing and treating mood disorders? - [[User:Jdebear|Jdebear]] # [[/Occupational violence, emotion, and coping/]] - What are the emotional impacts of occupational violence and how can employees cope? - [[User:MyUserName|MyUserName]] # [[/Positivity ratio/]] - What is the positivity ratio and what are its implications? - [[User:MyUserName|MyUserName]] # [[/Post-traumatic stress disorder and emotion/]] - What is the effect of PTSD on emotion? - [[User:JorjaFive|JorjaFive]] # [[/Psychological distress/]] - What is PD, what are the main types, and how can they be managed? - [[User:U3190773|U3190773]] # [[/Psychological trauma/]] - What causes psychological trauma, what are the consequences, and how can people recover from psychological trauma? - [[User:U3195332|U3195332]] # [[/Psilocybin assisted psychotherapy/]] - How can psilocybin be used to assist psychotherapy? - [[User:U3083720|U3083720]] # [[/Psilocybin assisted therapy and depression/]] – How can psilocybin assisted therapy help to treat depression? - [[User:U3191488|U3191488]] # [[/Rational compassion/]] - What is rational compassion and how can it be cultivated? - [[User:MyUserName|MyUserName]] # [[/Reflected glory/]] - What is reflected glory and what are its pros and cons? - [[User:MyUserName|MyUserName]] # [[/Religiosity and coping/]] - What is the relationship between religiosity and coping? - [[User:Noah O'Brien|Noah O'Brien]] # [[/Resentment/]] - What is resentment, what causes it, and what are its consequences? - [[User:U3216389|U3216389]] # [[/Risk-as-feelings/]] - What is the emotional experience of risk and how does it influence decision-making and behaviour? - [[User:BenjiD'Ange|BenjiD'Ange]] # [[/Self-esteem and culture/]] - What are the cultural influences on self-esteem? - [[User:Jingru shao 0906|Jingru shao0906]] # [[/Smiling and emotion/]] - What is the relationship between smiling and emotion? - [[User:U3200902|U3200902]] # [[/Social media and suicide prevention/]] - How can social media be used to help prevent suicide? - [[User:JaimeTegan|JaimeTegan]] # [[/Sorry business/]] - What is sorry business and what role does it play in Indigenous communities in Australia? - [[User:Isaacem13|Isaacem13]] # [[/Stress control mindset/]] - What is a SCM, why does it matter, and how can it be cultivated? - [[User:MyUserName|MyUserName]] # [[/Suffering as emotion/]] - What is the emotional experience of suffering and how can people cope with suffering? - [[User:Brookewin|Brookewin]] # [[/Telemental health/]] - What are the pros and cons of TMH and what are the key ingredients for effective TMH practices? - [[User:U3025906|U3025906]] # [[/Topophilia/]] - What is topophilia, how does it develop, and what are the psychological impacts? - [[User:RSPMeredith|RSPMeredith]] # [[/Trauma and emotion/]] - What is the effect of trauma on emotion? - [[User:MyUserName|MyUserName]] # [[/Triumph/]] - What is triumph, what causes it, and how can it be managed? - [[User:Bill.miosge|Bill.miosge]] # [[/Unemployment and mental health/]]: What is the relationship between unemployment and mental health? - [[User:Tiarnawilson01|Tiarnawilson01]] # [[/Viewing natural scenes and emotion/]] - What is the effect of viewing natural scenes on emotion and how can this be applied? - [[User:MyUserName|MyUserName]] # [[/Wave metaphor for emotion/]] - In what respects is an ocean wave a helpful metaphor for understanding human emotions? - [[User:Jamieepiper|Jamieepiper]] # [[/Window of tolerance/]] - What is the window of tolerance and how can it be applied? - [[User:U3223109|U3223109]] # [[/Workplace mental health training/]] - What is WMHT, what techniques are used, and what are the impacts? - [[User:ArtOfHappiness|ArtOfHappiness]] # [[/Video conferencing fatigue/]] - What is video conferencing fatigue, what causes it, what are its consequences, and what can be done about it? - [[User:u3211603|U3211603]] ==Motivation and emotion== # [[/Financial investing, motivation, and emotion/]] - What role does motivation and emotion play in financial investing? - [[User:U3217287|U3217287]] # [[/Hostage negotiation, motivation, and emotion/]] - What role does motivation and emotion play in hostage negotiation? - [[User:U3213549|U3213549]] # [[/Money priming, motivation, and emotion/]] - What is the effect of money priming on motivation and emotion? - [[User:Molzaroid|Molzaroid]] # [[/Motivational dimensional model of affect/]] - What is the motivational dimensional model of affect and what are its implications? - [[User:MyUserName|MyUserName]] # [[/Napping, motivation, and emotion/]] - What are the motivational and emotional effects of napping? - [[User:U3207862|U3207862]] # [[/Overchoice, emotion, and motivation/]] - What are the emotional and motivational effects of overchoice? - [[User:MyUserName|MyUserName]] # [[/Patience and impatience/]] - What are the psychological causes and consequences of patience and impatience? - [[User:U3100193|U3100193]] # [[/Reward system, motivation, and emotion/]] - What role does the reward system play in motivation and emotion? - [[User:U3162201|U3162201]] [[Category:Motivation and emotion/Book/2022]] 8jf6tvchn8mgr0nd40s4jp0e37fwa69 2419368 2419336 2022-08-26T07:35:12Z SunandaUC 2947974 changed topics wikitext text/x-wiki {{/Banner}} ==Motivation == # [[/Academic help-seeking/]] - What are the barriers and enablers of AHS and how can AHS be fostered? - [[User:Ibm4444|Ibm4444]] # [[/Academic self-regulation/]] - What is academic self-regulation, why does it matter, and how can it be fostered? - [[User:U3216563|U3216563]] # [[/Actively open-minded thinking/]] - How can AOT be used to improve human performance? - [[User:Teermeej Hossain|Teermeej Hossain]] # [[/Active transport motivation/]] - What motivates use of active transport and how can people be encouraged to use it? - [[User:MyUserName|MyUserName]] # [[/ADHD and motivation/]] - How does ADHD impact on motivation and what can be done about it? - [[User:U3222363|U3222363]] # [[/Antidepressants and motivation/]] - What are the effects of popular antidepressants on motivation? - [[User:MyUserName|MyUserName]] # [[/Approach motivation/]] - What is approach motivation and how does it lead to behaviour? - [[User:U3189370|U3189370]] # [[/Behavioural economics and motivation/]] - What aspects of motivation theory are useful in behavioural economics? - [[User:U3141987|U3141987]] # [[/Behavioural model of health services/]] - What is the BMHS and how can it be used? - [[User:SoSilverLibby|SoSilverLibby]] # [[/Beneficence as a psychological need/]] - What is beneficence and what are its implications as a psychological need? - [[User:CaitlinEmc|CaitlinEmc]] # [[/Brief motivational interviewing as a health intervention/]] - How can brief motivational interviewing be used as a health intervention? - [[User:MyUserName|MyUserName]] # [[/Cannabis use and dopamine/]] - What is the impact of cannabis use on dopamine in the brain? - [[User:U3246310|U3246310]] # [[/Childhood trauma and subsequent drug use/]] - How does psychological trauma influence subsequent drug use? - [[User:U3210431|U3210431]] # [[/Choice overload/]] - What is choice overload? What is the optimal amount of choice? - [[User:GeorgiaFairweather|GeorgiaFairweather]] # [[/Chunking and goal pursuit/]] - How does chunking affect goal pursuit? - [[User:Giovannihbartlett|Giovannihbartlett]] # [[/Cognitive entrenchment/]] - What is cognitive entrenchment and how can it be avoided? - [[User:JimmyOC1985|JimmyOC1985]] # [[/Climate change helplessness/]] - How does learned helpless impact motivation to engage in behaviours to limit climate change? - [[User:U3193000|U3193000]] # [[/Closeness communication bias/]] - What is the CCB, why does it occur, and how can it be overcome? - [[User:U3215103|U3215103]] # [[/Commitment bias/]] - What motivates escalation of commitment even it does not lead to desirably outcomes? - [[User:U3203936|U3203936]] # [[/Comprehensive action determination model/]] - What is the CADM and how can it be applied to understanding human motivation? - [[User:MyUserName|MyUserName]] # [[/Conspiracy theory motivation/]] - What motivates people to believe in conspiracy theories? - [[User:KingMob221|KingMob221]] # [[/Construal level theory/]] - What is construal level theory and how can it be applied? - [[User:MyUserName|MyUserName]] # [[/Courage motivation/]] - What is courage, what motivates courage, and how can courage be enhanced? -[[User:Hanarose123|Hanarose123]] # [[/Death drive/]] - What is the death drive and how can it be negotiated? - [[User:U3086459|U3086459]] # [[/Discounts and consumer purchase behaviour/]] - What role do discounts play in consumer purchase behaviour? - SunandaUC # [[/Drugs-violence nexus and motivation/|Drugs-violence nexus and motivation]] - What is the role of motivation in the drugs-violence nexus? - [[Atu3202070|Atu3202070]] # [[/Domestic energy conservation motivation/]] - How can domestic energy conservation and reduced consumption be motivated and behaviour changed? - [[User:MyUserName|MyUserName]] # [[/Episodic future thinking and delay discounting/]] - What is the relationship between between EFT and DD? - [[User:MyUserName|MyUserName]] # [[/Episodic memory and planning/]] - What role does episodic memory play in planning? - [[User:MyUserName|MyUserName]] # [[/Equity theory/]] - What is equity theory and how can it be applied? - [[EKS2001|EKS2001]] # [[/ERG theory/]] - What is Alderfer's ERG theory? - [[User:Wuser1307|Wuser1307]] # [[/Environmental volunteering motivation/]] - What motivates environmental volunteering? - [[User:Somer Gellatly|Somer Gellatly]] # [[/Frame of reference and motivation/]] - How does frame of reference affect motivation? - [[User:MyUserName|MyUserName]] # [[/Freedom and motivation/]] - What is the effect of freedom on motivation? - [[User:MyUserName|MyUserName]] # [[/Fully functioning person/]] - What is a FFP and how can full functioning be developed? - [[User:Sebastian Armstrong|Sebastian Armstrong]] # [[/Functional fixedness/]] - What is functional fixedness and how can it be overcome? - [[User:U3214117|U3214117]] # [[/Functional imagery training/]] - What is FIT and how can it be applied? - [[User:Btarmstrong24|Btarmstrong24]] # [[/Gamification and work motivation/]] - How can gamification enhance work motivation? - [[User:U3211125|U3211125]] # [[/Giving up goals/]] - When should we give up goals and when should we persist? - [[User:U3161584|U3161584]] # [[/Green prescription motivation/]] - What motivates green prescription compliance? - [[User:Earthxangel|Earthxangel]] # [[/Grit and achievement/]] - How does grit affect achievement? - [[User:AnaStuart|AnaStuart]] # [[/Health belief model/]] - What is the HBM and how can it be used to enhance motivation for health-promoting behaviour? - [[User:Dee320|Dee320]] # [[/Help-seeking among boys/]] - What are the barriers to help-seeking for boys and what motivates them to seek help? - [[User:BradMcGrath|BradMcGrath]] # [[/Hidden costs of reward/]] - What are the hidden costs of motivating by reward? - [[User:SLoCE|SLoCE]] # [[/Hijack hypothesis of drug addiction/]] - What is the hijack hypothesis, what is the evidence, and how does it help to understand drug addiction? - [[User:U3218292|U3218292]] # [[/Honesty motivation/]] - What motivates honesty? - [[User:U3200859|U3200859]] # [[/Humour, leadership, and work/]] - What role does humour play in effective leadership in the workplace? - [[User:U3210264|U3210264]] # [[/IKEA effect/]] - What is the IKEA effect and how can it be applied? - [[MyUsername|MyUserName]] # [[/Intertemporal choice/]] - What are intertemporal choices and how can they be effectively negotiated? - [[User:MyUserName|MyUserName]] # [[/Kindness motivation/]] - What motivates kindness? - [[User:U3205429|U3205429]] # [[/Motivational music and exercise/]] - How can music be used to help motivate exercise? - [[User:U3183466|U3183466]] # [[/Non-residential energy conservation motivation/]] - How can non-residential building energy conservation and reduced consumption be motivated and behaviour changed? - [[User:MyUserName|MyUserName]] # [[/Novelty-variety as a psychological need/]] - What is novelty-variety and what are its implications as a psychological need? - [[User:MyUserName|MyUserName]] # [[/Nucleus accumbens and motivation/]] - What role does the nucleus accumbens play in motivation? - [[User:U3213250|U3213250]] # [[/Perfectionism/]] - What motivates perfectionism? Is perfectionism good or bad? How can it be managed? - [[User:AEMOR|AEMOR]] # [[/Physiological needs/]] - How do human's physiological needs affect motivation? - [[User:U3203655|U3203655]] # [[/Protection motivation theory and COVID-19/]] - How does PMT apply to managing COVID-19? - [[User:U3200956|U3200956]] # [[/Relative deprivation and motivation/]] - What is the effect of relative deprivation on motivation? - [[User:U3191574 (PHP)|U3191574 (PHP)]] # [[/Retrospective regret/]] - What is the motivational role of retrospective regret? - [[User:Will-U3214082|Will-U3214082]] # [[/Revenge motivation/]] - What motivates revenge and how does it affect us? - [[User:U3216654|U3216654]] # [[/Self-actualisation and motivation/]] - What motivates self-actualisation? - [[User:MyUserName|MyUserName]] # [[/Self-efficacy and academic achievement/]] - What role does self-efficacy play in academic achievement? - [[User:U943292|U943292]] # [[/Self-efficacy and achievement/]] - What role does self-efficacy play in achievement outcomes? - [[User:U3216513mt|U3216513mt]] # [[/Self-help/]] - What is self-help and what motivates people to engage in it? - [[User:Cedevlin9|Cedevlin9]] # [[/Sexual harassment at work motivation/]] - What motivates sexual harassment at work and what can be done about it? - [[User:U3037979|U3037979]] # [[/Signature strengths/]] - What are signature strengths and how can they be applied? - [[User:MyUserName|MyUserName]] # [[/Social cure/]] - What is the social cure and how can it be applied? - [[User:U3215976|U3215976]] # [[/Staff retention motivation/]] - How can organisations and managers help to motivate long-term retention of employees? - [[User:MyUserName|MyUserName]] # [[/System justification theory/]] - What is SJT, how does it affect our lives, and what can be done about it? - [[User:MyUserName|MyUserName]] # [[/Stretch goals/]] - What are stretch goals? Do they work? - [[User:MyUserName|MyUserName]] # [[/Sublimation/]] - What is sublimation and how can it be fostered? - [[User:Emily.desilva|Emily.desilva]] # [[/Survival needs and motivation/]] - What are survival needs and how do they influence motivation? - [[User:U3148161|U3148161]] # [[/Task initiation/]] - What are the challenges with task initiation and how to get get started? - [[User:StormSar|StormSar]] # [[/Theoretical domains framework/]] - What is the TDF and how can be used to guide behaviour change? - [[User:MyUserName|MyUserName]] # [[/Time and motivation/]] - What is the effect of time on motivation? - [[User:Lturner2311|Lturner2311]] # [[/Time management/]] - How can one's time be managed effectively? - [[User:CNK.20|CNK.20]] # [[/To-do lists/]] - Are to-do lists a good idea? What are their pros and cons? How can they be used effectively? - [[User:U3207458|U3207458]] # [[/Treatment motivation in juvenile delinquency/]] - What is the role of treatment motivation for juvenile delinquency and how can it be enhanced? - [[User:MyUserName|MyUserName]] # [[/Uncertainty avoidance/]] - What is uncertainty avoidance, why does it occur, and what are its consequences? - [[User:Franklin Brightt|Franklin Brightt]] # [[/Urgency bias and productivity/]] - What is the impact of urgency bias on productivity and what can be done about it? - [[User:Jnoth|Jnoth]] # [[/Vocational identity/]] - What is vocational identity and how does it develop? - [[User:MyUserName|MyUserName]] # [[/Volunteer tourism motivation/]] - What motivates volunteer tourism? - [[User:U962051|U962051]] # [[/Wanting and liking/]] - What are the similarities and differences between wanting and liking, and what are the implications? - [[User:U3201643|U3201643]] # [[/Work breaks, well-being, and productivity/]] - How do work breaks affect well-being and productivity? - [[User:U3215603|U3215603]] # [[/Work and flow/]] - What characteristics of work can produce flow and how can flow at work be fostered? - [[User:U3213441|U3213441]] ==Emotion== # [[/Animal emotion/]] - What is the emotional experience of animals? - [[User:U3216502|U3216502]] # [[/Attributions and emotion/]] - How do attributions affect emotion? - [[User:MyUserName|MyUserName]] # [[/Autonomous sensory meridian response and emotion/]] - What emotions are involved in ASMR experiences and why do they occur? - [[User:U3186959|U3186959]] # [[/Benzodiazepines and emotion/]] - What are the effects of benzodiazepines on emotion? - [[User:FulaAjeo22|FulaAjeo22]] # [[/Bewilderment/]] - What is bewilderment and how can it be dealt with? - Myusername # [[/Burnout/]] - What is burnout and how can be it be managed and prevented? - [[User:U3202788|U3202788]] # [[/Cognitive dissonance reduction/]] - What strategies do people use to reduce cognitive dissonance and how effective are they? - [[User:Tatjurate|Tatjurate]] # [[/Colonisation and emotion in Australia/]] - What are the emotional responses to colonisation in Australia? - [[User:Micabaker1|Micabaker1]] # [[/Compassion/]] - What is compassion, what are its pros and cons, and how can it be fostered? - [[User:U3203545|U3203545]] # [[/Compassion fatigue in mental health professionals/]] - What causes compassion fatigue in MH professionals and how can it be prevented? - [[User:U3055143|U3055143]] # [[/Connection to country and well-being/]] - What is the relationship between connection to country and well-being? - [[User:MyUserName|MyUserName]] # [[/Contempt/]] - What is contempt, what causes it, and how can it be managed? - [[User:U3202788|U3219905]] # [[/Core emotions/]] - What are the core emotions and what is their function? U3203140 # [[/Creative arts and trauma/]] - How can creative arts help in dealing with trauma? - [[User:SashaBrooksby|SashaBrooksby]] # [[/Cultural influences on shame, guilt, and pride/]] - How does culture influence shame, guilt, and pride? - [[User:Tamika Afeaki|Tamika Afeaki]] # [[/Default mode network and the self/]] - What is the relationship between the DMN and the self? - [[User:MyUserName|MyUserName]] # [[/Difficult conversations and emotion/]] - What communication and emotional skills are needed to successfully negotiate difficult conversations? - [[User:U3158968|U3158968]] # [[/Disappointment/]] - What is disappointment, what causes it, and how can it be managed? - [[User:U3216256|U3216256]] # [[/DMT and spirituality/]] - How can DMT facilitate spiritual experiences? - [[User:DenniseSoleymani|DenniseSoleymani]] # [[/Durability bias in affective forecasting/]] - What role does durability bias play in affective forecasting? - [[User:MyUserName|MyUserName]] # [[/Ecological grief/]] - What is ecological grief and what can be done about it? - [[User:Brewerjr|Brewerjr]] # [[/Ecopsychology and stress/]] - How can ecopsychology help to explain and deal with stress? - [[User:MyUserName|MyUserName]] # [[/Embarrassment/]] - What is embarrassment, what causes it, and how can it be managed? - [[User:U3190353|U3190353]] # [[/Emotional development in adolescence/]] - How does emotionality develop during adolescence? - [[User:U3230861|U3230861]] # [[/Emotional intelligence training/]] - How can emotional intelligence be trained? - [[User:Eimilerous22|Eimilerous22]] # [[/Emotion knowledge/]] - What is emotion knowledge and how can it be developed? - [[User:GabbieUC|GabbieUC]] # [[/Emotion across the lifespan/]] - How does emotion develop across the lifespan? - [[User:MyUserName|MyUserName]] # [[/Endocannabinoid system and emotion/]] - What is the role of the endocannabinoid system in emotion? - [[User:RWilliams12|Rwilliams12]] # [[/Environmental grief/]] - What is eco-grief, its causes and consequences, and what can be done? - [[User:Gabrielle Eagling|Gabrielle Eagling]] # [[/Exercise and endocannabinoids/]] - What is the relationship between exercise and the endocannabinoid system? - [[User:U3216963|U3216963]] # [[/Expressive suppression and emotion regulation/]] - What is the role of expressive suppression in emotion regulation? - [[User:U3131472|U3131472]] # [[/Fairness and emotion/]] - What is the relation between fairness and emotion? - [[User:U3246554|U3246554]] # [[/Fatigue and emotion/]] - What is the effect of fatigue on emotion and what can be done about it? - [[User:Lewis.Kusk|Lewis.Kusk]] # [[/Fear/]] - What is fear, what causes it, and how can it be managed? - [[User:Icantchooseone|Icantchooseone]] # [[/Fear of working out/]] - What is FOWO and how can it be overcome? - [[User:U3216963|U3216963]] # [[/Flourishing in the elderly/]] - How can psychological flourishing be supported in the elderly? - [[User:MyUserName|MyUserName]] # [[/Fundamental attribution error and emotion/]] - What is the relationship between the FAE and emotion? - [[User:U3196624|U3196624]] # [[/Gratitude and subjective wellbeing/]] - What is the relationship between gratitude and subjective wellbeing? - [[User:U3214260|U3214260]] # [[/Gloatrage/]] - What is gloatrage, what causes it, and what are its consequences? - [[User:MyUserName|MyUserName]] # [[/Heart rate variability and emotion regulation/]] - What is the relationship between HRV and emotion regulation? - [[User:U3213568|U3213568]] # [[/Hedonic adaptation prevention model/]] - What is the HAP model and how can it be applied? - [[User:Lyndel Lemon|Lyndel Lemon]] # [[/Humility/]] - What is humility, what causes it, and is it desirable? - [[User:U3195233|U3195233]] # [[/Hypomania and emotion/]] - What are the emotional characteristics of hypomania? - [[User:Alec.cortez|Alec.cortez]] # [[/Impact bias/]] - What is impact bias, what causes it, what are its consequences, and how can it be avoided? - [[User:MyUserName|MyUserName]] # [[Indigenous Australian emotionality]] - In what ways is emotionality experienced by Indigenous Australian people? - [[User:U3189442 - K.Ryan|U3189442 - K.Ryan]] # [[/Indigenous Australian mindfulness/]] - How has Indigenous Australian culture traditionally conceived of, and practiced, mindfulness? - [[User:MyUserName|MyUserName]] # [[/Inspiration/]] - What is inspiration, what causes it, what are its consequences, and how can it be fostered? - [[User:U3230861|U3227354]] # [[/Insular cortex and emotion/]] - What role does the insular cortex play in emotion? - [[User:U3190094|U3190094]] # [[/Interoception and emotion/]] - What is the relationship between interoception and emotion? - [[User:U3203265|U3203265]] # [[/Kama muta/]] - What is kama muta, what are its effects, and how can it be fostered? - [[User:U3183521|U3183521]] # [[/Linguistic relativism and emotion/]] - What is the role of linguistic relativism in emotion? - [[User:U3119310|U3119310]] # [[/Menstrual cycle mood disorders/]] - What causes menstrual cycle mood disorders and how can they be managed? - [[User:U3217109|U3217109]] # [[/Mental toughness in the workplace/]] - What can mental toughness be useful in the workplace? How can it be developed? - [[User:MyUserName|MyUserName]] # [[/Mindfulness and creativity/]] - How can mindfulness enhance creativity? - [[User:CaityDcr1603|CaityDcr1603]] # [[/Mindful self-care/]] - What is mindful self-care, why does it matter, and how can it be developed? - [[User:Clairelogan|Clairelogan]] # [[/Mixed emotions/]] - What are mixed emotions, what causes them, and how can they be managed? - [[User:U3210490|U3210490]] # [[/Mudita/]] - What is mudita and how can it be developed? - [[User:Inandonit365|Inandonit365]] # [[/Natural disasters and emotion/]] - How do people respond emotionally to natural disasters and how can they be supported? - [[User:U3148366_Chris|U3148366_Chris]] # [[/Nature therapy/]] - What is nature therapy and how can it be applied? - [[User:Ana028|Ana028]] # [[/Narcissism and emotion/]] - What is the relationship between narcissism and emotion? - [[User:A Super Villain|A Super Villain]] # [[/Narrative therapy and emotion/]] - What is the role of emotion in narrative therapy? - [[User:MyUserName|MyUserName]] # [[/Needle fear/]] - How does needle fear develop, what are its consequences, and what can be done about it? - [[User:U3166273|U3166273]] # [[/Neuroimaging and mood disorders/]] - How can neuroimaging assist in diagnosing and treating mood disorders? - [[User:Jdebear|Jdebear]] # [[/Occupational violence, emotion, and coping/]] - What are the emotional impacts of occupational violence and how can employees cope? - [[User:MyUserName|MyUserName]] # [[/Positivity ratio/]] - What is the positivity ratio and what are its implications? - [[User:MyUserName|MyUserName]] # [[/Post-traumatic stress disorder and emotion/]] - What is the effect of PTSD on emotion? - [[User:JorjaFive|JorjaFive]] # [[/Psychological distress/]] - What is PD, what are the main types, and how can they be managed? - [[User:U3190773|U3190773]] # [[/Psychological trauma/]] - What causes psychological trauma, what are the consequences, and how can people recover from psychological trauma? - [[User:U3195332|U3195332]] # [[/Psilocybin assisted psychotherapy/]] - How can psilocybin be used to assist psychotherapy? - [[User:U3083720|U3083720]] # [[/Psilocybin assisted therapy and depression/]] – How can psilocybin assisted therapy help to treat depression? - [[User:U3191488|U3191488]] # [[/Rational compassion/]] - What is rational compassion and how can it be cultivated? - [[User:MyUserName|MyUserName]] # [[/Reflected glory/]] - What is reflected glory and what are its pros and cons? - [[User:MyUserName|MyUserName]] # [[/Religiosity and coping/]] - What is the relationship between religiosity and coping? - [[User:Noah O'Brien|Noah O'Brien]] # [[/Resentment/]] - What is resentment, what causes it, and what are its consequences? - [[User:U3216389|U3216389]] # [[/Risk-as-feelings/]] - What is the emotional experience of risk and how does it influence decision-making and behaviour? - [[User:BenjiD'Ange|BenjiD'Ange]] # [[/Self-esteem and culture/]] - What are the cultural influences on self-esteem? - [[User:Jingru shao 0906|Jingru shao0906]] # [[/Smiling and emotion/]] - What is the relationship between smiling and emotion? - [[User:U3200902|U3200902]] # [[/Social media and suicide prevention/]] - How can social media be used to help prevent suicide? - [[User:JaimeTegan|JaimeTegan]] # [[/Sorry business/]] - What is sorry business and what role does it play in Indigenous communities in Australia? - [[User:Isaacem13|Isaacem13]] # [[/Stress control mindset/]] - What is a SCM, why does it matter, and how can it be cultivated? - [[User:MyUserName|MyUserName]] # [[/Suffering as emotion/]] - What is the emotional experience of suffering and how can people cope with suffering? - [[User:Brookewin|Brookewin]] # [[/Telemental health/]] - What are the pros and cons of TMH and what are the key ingredients for effective TMH practices? - [[User:U3025906|U3025906]] # [[/Topophilia/]] - What is topophilia, how does it develop, and what are the psychological impacts? - [[User:RSPMeredith|RSPMeredith]] # [[/Trauma and emotion/]] - What is the effect of trauma on emotion? - [[User:MyUserName|MyUserName]] # [[/Triumph/]] - What is triumph, what causes it, and how can it be managed? - [[User:Bill.miosge|Bill.miosge]] # [[/Unemployment and mental health/]]: What is the relationship between unemployment and mental health? - [[User:Tiarnawilson01|Tiarnawilson01]] # [[/Viewing natural scenes and emotion/]] - What is the effect of viewing natural scenes on emotion and how can this be applied? - [[User:MyUserName|MyUserName]] # [[/Wave metaphor for emotion/]] - In what respects is an ocean wave a helpful metaphor for understanding human emotions? - [[User:Jamieepiper|Jamieepiper]] # [[/Window of tolerance/]] - What is the window of tolerance and how can it be applied? - [[User:U3223109|U3223109]] # [[/Workplace mental health training/]] - What is WMHT, what techniques are used, and what are the impacts? - [[User:ArtOfHappiness|ArtOfHappiness]] # [[/Video conferencing fatigue/]] - What is video conferencing fatigue, what causes it, what are its consequences, and what can be done about it? - [[User:u3211603|U3211603]] ==Motivation and emotion== # [[/Financial investing, motivation, and emotion/]] - What role does motivation and emotion play in financial investing? - [[User:U3217287|U3217287]] # [[/Hostage negotiation, motivation, and emotion/]] - What role does motivation and emotion play in hostage negotiation? - [[User:U3213549|U3213549]] # [[/Money priming, motivation, and emotion/]] - What is the effect of money priming on motivation and emotion? - [[User:Molzaroid|Molzaroid]] # [[/Motivational dimensional model of affect/]] - What is the motivational dimensional model of affect and what are its implications? - [[User:MyUserName|MyUserName]] # [[/Napping, motivation, and emotion/]] - What are the motivational and emotional effects of napping? - [[User:U3207862|U3207862]] # [[/Overchoice, emotion, and motivation/]] - What are the emotional and motivational effects of overchoice? - [[User:MyUserName|MyUserName]] # [[/Patience and impatience/]] - What are the psychological causes and consequences of patience and impatience? - [[User:U3100193|U3100193]] # [[/Reward system, motivation, and emotion/]] - What role does the reward system play in motivation and emotion? - [[User:U3162201|U3162201]] [[Category:Motivation and emotion/Book/2022]] 25a0q10g6cad6tck450huk6jj2cwhuz 2419370 2419368 2022-08-26T07:37:05Z Jtneill 10242 Triumph - change sub-title wikitext text/x-wiki {{/Banner}} ==Motivation == # [[/Academic help-seeking/]] - What are the barriers and enablers of AHS and how can AHS be fostered? - [[User:Ibm4444|Ibm4444]] # [[/Academic self-regulation/]] - What is academic self-regulation, why does it matter, and how can it be fostered? - [[User:U3216563|U3216563]] # [[/Actively open-minded thinking/]] - How can AOT be used to improve human performance? - [[User:Teermeej Hossain|Teermeej Hossain]] # [[/Active transport motivation/]] - What motivates use of active transport and how can people be encouraged to use it? - [[User:MyUserName|MyUserName]] # [[/ADHD and motivation/]] - How does ADHD impact on motivation and what can be done about it? - [[User:U3222363|U3222363]] # [[/Antidepressants and motivation/]] - What are the effects of popular antidepressants on motivation? - [[User:MyUserName|MyUserName]] # [[/Approach motivation/]] - What is approach motivation and how does it lead to behaviour? - [[User:U3189370|U3189370]] # [[/Behavioural economics and motivation/]] - What aspects of motivation theory are useful in behavioural economics? - [[User:U3141987|U3141987]] # [[/Behavioural model of health services/]] - What is the BMHS and how can it be used? - [[User:SoSilverLibby|SoSilverLibby]] # [[/Beneficence as a psychological need/]] - What is beneficence and what are its implications as a psychological need? - [[User:CaitlinEmc|CaitlinEmc]] # [[/Brief motivational interviewing as a health intervention/]] - How can brief motivational interviewing be used as a health intervention? - [[User:MyUserName|MyUserName]] # [[/Cannabis use and dopamine/]] - What is the impact of cannabis use on dopamine in the brain? - [[User:U3246310|U3246310]] # [[/Childhood trauma and subsequent drug use/]] - How does psychological trauma influence subsequent drug use? - [[User:U3210431|U3210431]] # [[/Choice overload/]] - What is choice overload? What is the optimal amount of choice? - [[User:GeorgiaFairweather|GeorgiaFairweather]] # [[/Chunking and goal pursuit/]] - How does chunking affect goal pursuit? - [[User:Giovannihbartlett|Giovannihbartlett]] # [[/Cognitive entrenchment/]] - What is cognitive entrenchment and how can it be avoided? - [[User:JimmyOC1985|JimmyOC1985]] # [[/Climate change helplessness/]] - How does learned helpless impact motivation to engage in behaviours to limit climate change? - [[User:U3193000|U3193000]] # [[/Closeness communication bias/]] - What is the CCB, why does it occur, and how can it be overcome? - [[User:U3215103|U3215103]] # [[/Commitment bias/]] - What motivates escalation of commitment even it does not lead to desirably outcomes? - [[User:U3203936|U3203936]] # [[/Comprehensive action determination model/]] - What is the CADM and how can it be applied to understanding human motivation? - [[User:MyUserName|MyUserName]] # [[/Conspiracy theory motivation/]] - What motivates people to believe in conspiracy theories? - [[User:KingMob221|KingMob221]] # [[/Construal level theory/]] - What is construal level theory and how can it be applied? - [[User:MyUserName|MyUserName]] # [[/Courage motivation/]] - What is courage, what motivates courage, and how can courage be enhanced? -[[User:Hanarose123|Hanarose123]] # [[/Death drive/]] - What is the death drive and how can it be negotiated? - [[User:U3086459|U3086459]] # [[/Discounts and consumer purchase behaviour/]] - What role do discounts play in consumer purchase behaviour? - SunandaUC # [[/Drugs-violence nexus and motivation/|Drugs-violence nexus and motivation]] - What is the role of motivation in the drugs-violence nexus? - [[Atu3202070|Atu3202070]] # [[/Domestic energy conservation motivation/]] - How can domestic energy conservation and reduced consumption be motivated and behaviour changed? - [[User:MyUserName|MyUserName]] # [[/Episodic future thinking and delay discounting/]] - What is the relationship between between EFT and DD? - [[User:MyUserName|MyUserName]] # [[/Episodic memory and planning/]] - What role does episodic memory play in planning? - [[User:MyUserName|MyUserName]] # [[/Equity theory/]] - What is equity theory and how can it be applied? - [[EKS2001|EKS2001]] # [[/ERG theory/]] - What is Alderfer's ERG theory? - [[User:Wuser1307|Wuser1307]] # [[/Environmental volunteering motivation/]] - What motivates environmental volunteering? - [[User:Somer Gellatly|Somer Gellatly]] # [[/Frame of reference and motivation/]] - How does frame of reference affect motivation? - [[User:MyUserName|MyUserName]] # [[/Freedom and motivation/]] - What is the effect of freedom on motivation? - [[User:MyUserName|MyUserName]] # [[/Fully functioning person/]] - What is a FFP and how can full functioning be developed? - [[User:Sebastian Armstrong|Sebastian Armstrong]] # [[/Functional fixedness/]] - What is functional fixedness and how can it be overcome? - [[User:U3214117|U3214117]] # [[/Functional imagery training/]] - What is FIT and how can it be applied? - [[User:Btarmstrong24|Btarmstrong24]] # [[/Gamification and work motivation/]] - How can gamification enhance work motivation? - [[User:U3211125|U3211125]] # [[/Giving up goals/]] - When should we give up goals and when should we persist? - [[User:U3161584|U3161584]] # [[/Green prescription motivation/]] - What motivates green prescription compliance? - [[User:Earthxangel|Earthxangel]] # [[/Grit and achievement/]] - How does grit affect achievement? - [[User:AnaStuart|AnaStuart]] # [[/Health belief model/]] - What is the HBM and how can it be used to enhance motivation for health-promoting behaviour? - [[User:Dee320|Dee320]] # [[/Help-seeking among boys/]] - What are the barriers to help-seeking for boys and what motivates them to seek help? - [[User:BradMcGrath|BradMcGrath]] # [[/Hidden costs of reward/]] - What are the hidden costs of motivating by reward? - [[User:SLoCE|SLoCE]] # [[/Hijack hypothesis of drug addiction/]] - What is the hijack hypothesis, what is the evidence, and how does it help to understand drug addiction? - [[User:U3218292|U3218292]] # [[/Honesty motivation/]] - What motivates honesty? - [[User:U3200859|U3200859]] # [[/Humour, leadership, and work/]] - What role does humour play in effective leadership in the workplace? - [[User:U3210264|U3210264]] # [[/IKEA effect/]] - What is the IKEA effect and how can it be applied? - [[MyUsername|MyUserName]] # [[/Intertemporal choice/]] - What are intertemporal choices and how can they be effectively negotiated? - [[User:MyUserName|MyUserName]] # [[/Kindness motivation/]] - What motivates kindness? - [[User:U3205429|U3205429]] # [[/Motivational music and exercise/]] - How can music be used to help motivate exercise? - [[User:U3183466|U3183466]] # [[/Non-residential energy conservation motivation/]] - How can non-residential building energy conservation and reduced consumption be motivated and behaviour changed? - [[User:MyUserName|MyUserName]] # [[/Novelty-variety as a psychological need/]] - What is novelty-variety and what are its implications as a psychological need? - [[User:MyUserName|MyUserName]] # [[/Nucleus accumbens and motivation/]] - What role does the nucleus accumbens play in motivation? - [[User:U3213250|U3213250]] # [[/Perfectionism/]] - What motivates perfectionism? Is perfectionism good or bad? How can it be managed? - [[User:AEMOR|AEMOR]] # [[/Physiological needs/]] - How do human's physiological needs affect motivation? - [[User:U3203655|U3203655]] # [[/Protection motivation theory and COVID-19/]] - How does PMT apply to managing COVID-19? - [[User:U3200956|U3200956]] # [[/Relative deprivation and motivation/]] - What is the effect of relative deprivation on motivation? - [[User:U3191574 (PHP)|U3191574 (PHP)]] # [[/Retrospective regret/]] - What is the motivational role of retrospective regret? - [[User:Will-U3214082|Will-U3214082]] # [[/Revenge motivation/]] - What motivates revenge and how does it affect us? - [[User:U3216654|U3216654]] # [[/Self-actualisation and motivation/]] - What motivates self-actualisation? - [[User:MyUserName|MyUserName]] # [[/Self-efficacy and academic achievement/]] - What role does self-efficacy play in academic achievement? - [[User:U943292|U943292]] # [[/Self-efficacy and achievement/]] - What role does self-efficacy play in achievement outcomes? - [[User:U3216513mt|U3216513mt]] # [[/Self-help/]] - What is self-help and what motivates people to engage in it? - [[User:Cedevlin9|Cedevlin9]] # [[/Sexual harassment at work motivation/]] - What motivates sexual harassment at work and what can be done about it? - [[User:U3037979|U3037979]] # [[/Signature strengths/]] - What are signature strengths and how can they be applied? - [[User:MyUserName|MyUserName]] # [[/Social cure/]] - What is the social cure and how can it be applied? - [[User:U3215976|U3215976]] # [[/Staff retention motivation/]] - How can organisations and managers help to motivate long-term retention of employees? - [[User:MyUserName|MyUserName]] # [[/System justification theory/]] - What is SJT, how does it affect our lives, and what can be done about it? - [[User:MyUserName|MyUserName]] # [[/Stretch goals/]] - What are stretch goals? Do they work? - [[User:MyUserName|MyUserName]] # [[/Sublimation/]] - What is sublimation and how can it be fostered? - [[User:Emily.desilva|Emily.desilva]] # [[/Survival needs and motivation/]] - What are survival needs and how do they influence motivation? - [[User:U3148161|U3148161]] # [[/Task initiation/]] - What are the challenges with task initiation and how to get get started? - [[User:StormSar|StormSar]] # [[/Theoretical domains framework/]] - What is the TDF and how can be used to guide behaviour change? - [[User:MyUserName|MyUserName]] # [[/Time and motivation/]] - What is the effect of time on motivation? - [[User:Lturner2311|Lturner2311]] # [[/Time management/]] - How can one's time be managed effectively? - [[User:CNK.20|CNK.20]] # [[/To-do lists/]] - Are to-do lists a good idea? What are their pros and cons? How can they be used effectively? - [[User:U3207458|U3207458]] # [[/Treatment motivation in juvenile delinquency/]] - What is the role of treatment motivation for juvenile delinquency and how can it be enhanced? - [[User:MyUserName|MyUserName]] # [[/Uncertainty avoidance/]] - What is uncertainty avoidance, why does it occur, and what are its consequences? - [[User:Franklin Brightt|Franklin Brightt]] # [[/Urgency bias and productivity/]] - What is the impact of urgency bias on productivity and what can be done about it? - [[User:Jnoth|Jnoth]] # [[/Vocational identity/]] - What is vocational identity and how does it develop? - [[User:MyUserName|MyUserName]] # [[/Volunteer tourism motivation/]] - What motivates volunteer tourism? - [[User:U962051|U962051]] # [[/Wanting and liking/]] - What are the similarities and differences between wanting and liking, and what are the implications? - [[User:U3201643|U3201643]] # [[/Work breaks, well-being, and productivity/]] - How do work breaks affect well-being and productivity? - [[User:U3215603|U3215603]] # [[/Work and flow/]] - What characteristics of work can produce flow and how can flow at work be fostered? - [[User:U3213441|U3213441]] ==Emotion== # [[/Animal emotion/]] - What is the emotional experience of animals? - [[User:U3216502|U3216502]] # [[/Attributions and emotion/]] - How do attributions affect emotion? - [[User:MyUserName|MyUserName]] # [[/Autonomous sensory meridian response and emotion/]] - What emotions are involved in ASMR experiences and why do they occur? - [[User:U3186959|U3186959]] # [[/Benzodiazepines and emotion/]] - What are the effects of benzodiazepines on emotion? - [[User:FulaAjeo22|FulaAjeo22]] # [[/Bewilderment/]] - What is bewilderment and how can it be dealt with? - Myusername # [[/Burnout/]] - What is burnout and how can be it be managed and prevented? - [[User:U3202788|U3202788]] # [[/Cognitive dissonance reduction/]] - What strategies do people use to reduce cognitive dissonance and how effective are they? - [[User:Tatjurate|Tatjurate]] # [[/Colonisation and emotion in Australia/]] - What are the emotional responses to colonisation in Australia? - [[User:Micabaker1|Micabaker1]] # [[/Compassion/]] - What is compassion, what are its pros and cons, and how can it be fostered? - [[User:U3203545|U3203545]] # [[/Compassion fatigue in mental health professionals/]] - What causes compassion fatigue in MH professionals and how can it be prevented? - [[User:U3055143|U3055143]] # [[/Connection to country and well-being/]] - What is the relationship between connection to country and well-being? - [[User:MyUserName|MyUserName]] # [[/Contempt/]] - What is contempt, what causes it, and how can it be managed? - [[User:U3202788|U3219905]] # [[/Core emotions/]] - What are the core emotions and what is their function? U3203140 # [[/Creative arts and trauma/]] - How can creative arts help in dealing with trauma? - [[User:SashaBrooksby|SashaBrooksby]] # [[/Cultural influences on shame, guilt, and pride/]] - How does culture influence shame, guilt, and pride? - [[User:Tamika Afeaki|Tamika Afeaki]] # [[/Default mode network and the self/]] - What is the relationship between the DMN and the self? - [[User:MyUserName|MyUserName]] # [[/Difficult conversations and emotion/]] - What communication and emotional skills are needed to successfully negotiate difficult conversations? - [[User:U3158968|U3158968]] # [[/Disappointment/]] - What is disappointment, what causes it, and how can it be managed? - [[User:U3216256|U3216256]] # [[/DMT and spirituality/]] - How can DMT facilitate spiritual experiences? - [[User:DenniseSoleymani|DenniseSoleymani]] # [[/Durability bias in affective forecasting/]] - What role does durability bias play in affective forecasting? - [[User:MyUserName|MyUserName]] # [[/Ecological grief/]] - What is ecological grief and what can be done about it? - [[User:Brewerjr|Brewerjr]] # [[/Ecopsychology and stress/]] - How can ecopsychology help to explain and deal with stress? - [[User:MyUserName|MyUserName]] # [[/Embarrassment/]] - What is embarrassment, what causes it, and how can it be managed? - [[User:U3190353|U3190353]] # [[/Emotional development in adolescence/]] - How does emotionality develop during adolescence? - [[User:U3230861|U3230861]] # [[/Emotional intelligence training/]] - How can emotional intelligence be trained? - [[User:Eimilerous22|Eimilerous22]] # [[/Emotion knowledge/]] - What is emotion knowledge and how can it be developed? - [[User:GabbieUC|GabbieUC]] # [[/Emotion across the lifespan/]] - How does emotion develop across the lifespan? - [[User:MyUserName|MyUserName]] # [[/Endocannabinoid system and emotion/]] - What is the role of the endocannabinoid system in emotion? - [[User:RWilliams12|Rwilliams12]] # [[/Environmental grief/]] - What is eco-grief, its causes and consequences, and what can be done? - [[User:Gabrielle Eagling|Gabrielle Eagling]] # [[/Exercise and endocannabinoids/]] - What is the relationship between exercise and the endocannabinoid system? - [[User:U3216963|U3216963]] # [[/Expressive suppression and emotion regulation/]] - What is the role of expressive suppression in emotion regulation? - [[User:U3131472|U3131472]] # [[/Fairness and emotion/]] - What is the relation between fairness and emotion? - [[User:U3246554|U3246554]] # [[/Fatigue and emotion/]] - What is the effect of fatigue on emotion and what can be done about it? - [[User:Lewis.Kusk|Lewis.Kusk]] # [[/Fear/]] - What is fear, what causes it, and how can it be managed? - [[User:Icantchooseone|Icantchooseone]] # [[/Fear of working out/]] - What is FOWO and how can it be overcome? - [[User:U3216963|U3216963]] # [[/Flourishing in the elderly/]] - How can psychological flourishing be supported in the elderly? - [[User:MyUserName|MyUserName]] # [[/Fundamental attribution error and emotion/]] - What is the relationship between the FAE and emotion? - [[User:U3196624|U3196624]] # [[/Gratitude and subjective wellbeing/]] - What is the relationship between gratitude and subjective wellbeing? - [[User:U3214260|U3214260]] # [[/Gloatrage/]] - What is gloatrage, what causes it, and what are its consequences? - [[User:MyUserName|MyUserName]] # [[/Heart rate variability and emotion regulation/]] - What is the relationship between HRV and emotion regulation? - [[User:U3213568|U3213568]] # [[/Hedonic adaptation prevention model/]] - What is the HAP model and how can it be applied? - [[User:Lyndel Lemon|Lyndel Lemon]] # [[/Humility/]] - What is humility, what causes it, and is it desirable? - [[User:U3195233|U3195233]] # [[/Hypomania and emotion/]] - What are the emotional characteristics of hypomania? - [[User:Alec.cortez|Alec.cortez]] # [[/Impact bias/]] - What is impact bias, what causes it, what are its consequences, and how can it be avoided? - [[User:MyUserName|MyUserName]] # [[Indigenous Australian emotionality]] - In what ways is emotionality experienced by Indigenous Australian people? - [[User:U3189442 - K.Ryan|U3189442 - K.Ryan]] # [[/Indigenous Australian mindfulness/]] - How has Indigenous Australian culture traditionally conceived of, and practiced, mindfulness? - [[User:MyUserName|MyUserName]] # [[/Inspiration/]] - What is inspiration, what causes it, what are its consequences, and how can it be fostered? - [[User:U3230861|U3227354]] # [[/Insular cortex and emotion/]] - What role does the insular cortex play in emotion? - [[User:U3190094|U3190094]] # [[/Interoception and emotion/]] - What is the relationship between interoception and emotion? - [[User:U3203265|U3203265]] # [[/Kama muta/]] - What is kama muta, what are its effects, and how can it be fostered? - [[User:U3183521|U3183521]] # [[/Linguistic relativism and emotion/]] - What is the role of linguistic relativism in emotion? - [[User:U3119310|U3119310]] # [[/Menstrual cycle mood disorders/]] - What causes menstrual cycle mood disorders and how can they be managed? - [[User:U3217109|U3217109]] # [[/Mental toughness in the workplace/]] - What can mental toughness be useful in the workplace? How can it be developed? - [[User:MyUserName|MyUserName]] # [[/Mindfulness and creativity/]] - How can mindfulness enhance creativity? - [[User:CaityDcr1603|CaityDcr1603]] # [[/Mindful self-care/]] - What is mindful self-care, why does it matter, and how can it be developed? - [[User:Clairelogan|Clairelogan]] # [[/Mixed emotions/]] - What are mixed emotions, what causes them, and how can they be managed? - [[User:U3210490|U3210490]] # [[/Mudita/]] - What is mudita and how can it be developed? - [[User:Inandonit365|Inandonit365]] # [[/Natural disasters and emotion/]] - How do people respond emotionally to natural disasters and how can they be supported? - [[User:U3148366_Chris|U3148366_Chris]] # [[/Nature therapy/]] - What is nature therapy and how can it be applied? - [[User:Ana028|Ana028]] # [[/Narcissism and emotion/]] - What is the relationship between narcissism and emotion? - [[User:A Super Villain|A Super Villain]] # [[/Narrative therapy and emotion/]] - What is the role of emotion in narrative therapy? - [[User:MyUserName|MyUserName]] # [[/Needle fear/]] - How does needle fear develop, what are its consequences, and what can be done about it? - [[User:U3166273|U3166273]] # [[/Neuroimaging and mood disorders/]] - How can neuroimaging assist in diagnosing and treating mood disorders? - [[User:Jdebear|Jdebear]] # [[/Occupational violence, emotion, and coping/]] - What are the emotional impacts of occupational violence and how can employees cope? - [[User:MyUserName|MyUserName]] # [[/Positivity ratio/]] - What is the positivity ratio and what are its implications? - [[User:MyUserName|MyUserName]] # [[/Post-traumatic stress disorder and emotion/]] - What is the effect of PTSD on emotion? - [[User:JorjaFive|JorjaFive]] # [[/Psychological distress/]] - What is PD, what are the main types, and how can they be managed? - [[User:U3190773|U3190773]] # [[/Psychological trauma/]] - What causes psychological trauma, what are the consequences, and how can people recover from psychological trauma? - [[User:U3195332|U3195332]] # [[/Psilocybin assisted psychotherapy/]] - How can psilocybin be used to assist psychotherapy? - [[User:U3083720|U3083720]] # [[/Psilocybin assisted therapy and depression/]] – How can psilocybin assisted therapy help to treat depression? - [[User:U3191488|U3191488]] # [[/Rational compassion/]] - What is rational compassion and how can it be cultivated? - [[User:MyUserName|MyUserName]] # [[/Reflected glory/]] - What is reflected glory and what are its pros and cons? - [[User:MyUserName|MyUserName]] # [[/Religiosity and coping/]] - What is the relationship between religiosity and coping? - [[User:Noah O'Brien|Noah O'Brien]] # [[/Resentment/]] - What is resentment, what causes it, and what are its consequences? - [[User:U3216389|U3216389]] # [[/Risk-as-feelings/]] - What is the emotional experience of risk and how does it influence decision-making and behaviour? - [[User:BenjiD'Ange|BenjiD'Ange]] # [[/Self-esteem and culture/]] - What are the cultural influences on self-esteem? - [[User:Jingru shao 0906|Jingru shao0906]] # [[/Smiling and emotion/]] - What is the relationship between smiling and emotion? - [[User:U3200902|U3200902]] # [[/Social media and suicide prevention/]] - How can social media be used to help prevent suicide? - [[User:JaimeTegan|JaimeTegan]] # [[/Sorry business/]] - What is sorry business and what role does it play in Indigenous communities in Australia? - [[User:Isaacem13|Isaacem13]] # [[/Stress control mindset/]] - What is a SCM, why does it matter, and how can it be cultivated? - [[User:MyUserName|MyUserName]] # [[/Suffering as emotion/]] - What is the emotional experience of suffering and how can people cope with suffering? - [[User:Brookewin|Brookewin]] # [[/Telemental health/]] - What are the pros and cons of TMH and what are the key ingredients for effective TMH practices? - [[User:U3025906|U3025906]] # [[/Topophilia/]] - What is topophilia, how does it develop, and what are the psychological impacts? - [[User:RSPMeredith|RSPMeredith]] # [[/Trauma and emotion/]] - What is the effect of trauma on emotion? - [[User:MyUserName|MyUserName]] # [[/Triumph/]] - What is triumph, what causes it, and what are its impacts? - [[User:Bill.miosge|Bill.miosge]] # [[/Unemployment and mental health/]]: What is the relationship between unemployment and mental health? - [[User:Tiarnawilson01|Tiarnawilson01]] # [[/Viewing natural scenes and emotion/]] - What is the effect of viewing natural scenes on emotion and how can this be applied? - [[User:MyUserName|MyUserName]] # [[/Wave metaphor for emotion/]] - In what respects is an ocean wave a helpful metaphor for understanding human emotions? - [[User:Jamieepiper|Jamieepiper]] # [[/Window of tolerance/]] - What is the window of tolerance and how can it be applied? - [[User:U3223109|U3223109]] # [[/Workplace mental health training/]] - What is WMHT, what techniques are used, and what are the impacts? - [[User:ArtOfHappiness|ArtOfHappiness]] # [[/Video conferencing fatigue/]] - What is video conferencing fatigue, what causes it, what are its consequences, and what can be done about it? - [[User:u3211603|U3211603]] ==Motivation and emotion== # [[/Financial investing, motivation, and emotion/]] - What role does motivation and emotion play in financial investing? - [[User:U3217287|U3217287]] # [[/Hostage negotiation, motivation, and emotion/]] - What role does motivation and emotion play in hostage negotiation? - [[User:U3213549|U3213549]] # [[/Money priming, motivation, and emotion/]] - What is the effect of money priming on motivation and emotion? - [[User:Molzaroid|Molzaroid]] # [[/Motivational dimensional model of affect/]] - What is the motivational dimensional model of affect and what are its implications? - [[User:MyUserName|MyUserName]] # [[/Napping, motivation, and emotion/]] - What are the motivational and emotional effects of napping? - [[User:U3207862|U3207862]] # [[/Overchoice, emotion, and motivation/]] - What are the emotional and motivational effects of overchoice? - [[User:MyUserName|MyUserName]] # [[/Patience and impatience/]] - What are the psychological causes and consequences of patience and impatience? - [[User:U3100193|U3100193]] # [[/Reward system, motivation, and emotion/]] - What role does the reward system play in motivation and emotion? - [[User:U3162201|U3162201]] [[Category:Motivation and emotion/Book/2022]] arvbag2c8qoohoahiit0aflemgc9s2r 2419372 2419370 2022-08-26T07:38:58Z SunandaUC 2947974 wikitext text/x-wiki {{/Banner}} ==Motivation == # [[/Academic help-seeking/]] - What are the barriers and enablers of AHS and how can AHS be fostered? - [[User:Ibm4444|Ibm4444]] # [[/Academic self-regulation/]] - What is academic self-regulation, why does it matter, and how can it be fostered? - [[User:U3216563|U3216563]] # [[/Actively open-minded thinking/]] - How can AOT be used to improve human performance? - [[User:Teermeej Hossain|Teermeej Hossain]] # [[/Active transport motivation/]] - What motivates use of active transport and how can people be encouraged to use it? - [[User:MyUserName|MyUserName]] # [[/ADHD and motivation/]] - How does ADHD impact on motivation and what can be done about it? - [[User:U3222363|U3222363]] # [[/Antidepressants and motivation/]] - What are the effects of popular antidepressants on motivation? - [[User:MyUserName|MyUserName]] # [[/Approach motivation/]] - What is approach motivation and how does it lead to behaviour? - [[User:U3189370|U3189370]] # [[/Behavioural economics and motivation/]] - What aspects of motivation theory are useful in behavioural economics? - [[User:U3141987|U3141987]] # [[/Behavioural model of health services/]] - What is the BMHS and how can it be used? - [[User:SoSilverLibby|SoSilverLibby]] # [[/Beneficence as a psychological need/]] - What is beneficence and what are its implications as a psychological need? - [[User:CaitlinEmc|CaitlinEmc]] # [[/Brief motivational interviewing as a health intervention/]] - How can brief motivational interviewing be used as a health intervention? - [[User:MyUserName|MyUserName]] # [[/Cannabis use and dopamine/]] - What is the impact of cannabis use on dopamine in the brain? - [[User:U3246310|U3246310]] # [[/Childhood trauma and subsequent drug use/]] - How does psychological trauma influence subsequent drug use? - [[User:U3210431|U3210431]] # [[/Choice overload/]] - What is choice overload? What is the optimal amount of choice? - [[User:GeorgiaFairweather|GeorgiaFairweather]] # [[/Chunking and goal pursuit/]] - How does chunking affect goal pursuit? - [[User:Giovannihbartlett|Giovannihbartlett]] # [[/Cognitive entrenchment/]] - What is cognitive entrenchment and how can it be avoided? - [[User:JimmyOC1985|JimmyOC1985]] # [[/Climate change helplessness/]] - How does learned helpless impact motivation to engage in behaviours to limit climate change? - [[User:U3193000|U3193000]] # [[/Closeness communication bias/]] - What is the CCB, why does it occur, and how can it be overcome? - [[User:U3215103|U3215103]] # [[/Commitment bias/]] - What motivates escalation of commitment even it does not lead to desirably outcomes? - [[User:U3203936|U3203936]] # [[/Comprehensive action determination model/]] - What is the CADM and how can it be applied to understanding human motivation? - [[User:MyUserName|MyUserName]] # [[/Conspiracy theory motivation/]] - What motivates people to believe in conspiracy theories? - [[User:KingMob221|KingMob221]] # [[/Construal level theory/]] - What is construal level theory and how can it be applied? - [[User:MyUserName|MyUserName]] # [[/Courage motivation/]] - What is courage, what motivates courage, and how can courage be enhanced? -[[User:Hanarose123|Hanarose123]] # [[/Death drive/]] - What is the death drive and how can it be negotiated? - [[User:U3086459|U3086459]] # [[/Discounts and consumer purchase behaviour/]] - What role do discounts play in consumer purchase behaviour? - [[User:SunandaUC|SunandaUC]] # [[/Drugs-violence nexus and motivation/|Drugs-violence nexus and motivation]] - What is the role of motivation in the drugs-violence nexus? - [[Atu3202070|Atu3202070]] # [[/Domestic energy conservation motivation/]] - How can domestic energy conservation and reduced consumption be motivated and behaviour changed? - [[User:MyUserName|MyUserName]] # [[/Episodic future thinking and delay discounting/]] - What is the relationship between between EFT and DD? - [[User:MyUserName|MyUserName]] # [[/Episodic memory and planning/]] - What role does episodic memory play in planning? - [[User:MyUserName|MyUserName]] # [[/Equity theory/]] - What is equity theory and how can it be applied? - [[EKS2001|EKS2001]] # [[/ERG theory/]] - What is Alderfer's ERG theory? - [[User:Wuser1307|Wuser1307]] # [[/Environmental volunteering motivation/]] - What motivates environmental volunteering? - [[User:Somer Gellatly|Somer Gellatly]] # [[/Frame of reference and motivation/]] - How does frame of reference affect motivation? - [[User:MyUserName|MyUserName]] # [[/Freedom and motivation/]] - What is the effect of freedom on motivation? - [[User:MyUserName|MyUserName]] # [[/Fully functioning person/]] - What is a FFP and how can full functioning be developed? - [[User:Sebastian Armstrong|Sebastian Armstrong]] # [[/Functional fixedness/]] - What is functional fixedness and how can it be overcome? - [[User:U3214117|U3214117]] # [[/Functional imagery training/]] - What is FIT and how can it be applied? - [[User:Btarmstrong24|Btarmstrong24]] # [[/Gamification and work motivation/]] - How can gamification enhance work motivation? - [[User:U3211125|U3211125]] # [[/Giving up goals/]] - When should we give up goals and when should we persist? - [[User:U3161584|U3161584]] # [[/Green prescription motivation/]] - What motivates green prescription compliance? - [[User:Earthxangel|Earthxangel]] # [[/Grit and achievement/]] - How does grit affect achievement? - [[User:AnaStuart|AnaStuart]] # [[/Health belief model/]] - What is the HBM and how can it be used to enhance motivation for health-promoting behaviour? - [[User:Dee320|Dee320]] # [[/Help-seeking among boys/]] - What are the barriers to help-seeking for boys and what motivates them to seek help? - [[User:BradMcGrath|BradMcGrath]] # [[/Hidden costs of reward/]] - What are the hidden costs of motivating by reward? - [[User:SLoCE|SLoCE]] # [[/Hijack hypothesis of drug addiction/]] - What is the hijack hypothesis, what is the evidence, and how does it help to understand drug addiction? - [[User:U3218292|U3218292]] # [[/Honesty motivation/]] - What motivates honesty? - [[User:U3200859|U3200859]] # [[/Humour, leadership, and work/]] - What role does humour play in effective leadership in the workplace? - [[User:U3210264|U3210264]] # [[/IKEA effect/]] - What is the IKEA effect and how can it be applied? - [[MyUsername|MyUserName]] # [[/Intertemporal choice/]] - What are intertemporal choices and how can they be effectively negotiated? - [[User:MyUserName|MyUserName]] # [[/Kindness motivation/]] - What motivates kindness? - [[User:U3205429|U3205429]] # [[/Motivational music and exercise/]] - How can music be used to help motivate exercise? - [[User:U3183466|U3183466]] # [[/Non-residential energy conservation motivation/]] - How can non-residential building energy conservation and reduced consumption be motivated and behaviour changed? - [[User:MyUserName|MyUserName]] # [[/Novelty-variety as a psychological need/]] - What is novelty-variety and what are its implications as a psychological need? - [[User:MyUserName|MyUserName]] # [[/Nucleus accumbens and motivation/]] - What role does the nucleus accumbens play in motivation? - [[User:U3213250|U3213250]] # [[/Perfectionism/]] - What motivates perfectionism? Is perfectionism good or bad? How can it be managed? - [[User:AEMOR|AEMOR]] # [[/Physiological needs/]] - How do human's physiological needs affect motivation? - [[User:U3203655|U3203655]] # [[/Protection motivation theory and COVID-19/]] - How does PMT apply to managing COVID-19? - [[User:U3200956|U3200956]] # [[/Relative deprivation and motivation/]] - What is the effect of relative deprivation on motivation? - [[User:U3191574 (PHP)|U3191574 (PHP)]] # [[/Retrospective regret/]] - What is the motivational role of retrospective regret? - [[User:Will-U3214082|Will-U3214082]] # [[/Revenge motivation/]] - What motivates revenge and how does it affect us? - [[User:U3216654|U3216654]] # [[/Self-actualisation and motivation/]] - What motivates self-actualisation? - [[User:MyUserName|MyUserName]] # [[/Self-efficacy and academic achievement/]] - What role does self-efficacy play in academic achievement? - [[User:U943292|U943292]] # [[/Self-efficacy and achievement/]] - What role does self-efficacy play in achievement outcomes? - [[User:U3216513mt|U3216513mt]] # [[/Self-help/]] - What is self-help and what motivates people to engage in it? - [[User:Cedevlin9|Cedevlin9]] # [[/Sexual harassment at work motivation/]] - What motivates sexual harassment at work and what can be done about it? - [[User:U3037979|U3037979]] # [[/Signature strengths/]] - What are signature strengths and how can they be applied? - [[User:MyUserName|MyUserName]] # [[/Social cure/]] - What is the social cure and how can it be applied? - [[User:U3215976|U3215976]] # [[/Staff retention motivation/]] - How can organisations and managers help to motivate long-term retention of employees? - [[User:MyUserName|MyUserName]] # [[/System justification theory/]] - What is SJT, how does it affect our lives, and what can be done about it? - [[User:MyUserName|MyUserName]] # [[/Stretch goals/]] - What are stretch goals? Do they work? - [[User:MyUserName|MyUserName]] # [[/Sublimation/]] - What is sublimation and how can it be fostered? - [[User:Emily.desilva|Emily.desilva]] # [[/Survival needs and motivation/]] - What are survival needs and how do they influence motivation? - [[User:U3148161|U3148161]] # [[/Task initiation/]] - What are the challenges with task initiation and how to get get started? - [[User:StormSar|StormSar]] # [[/Theoretical domains framework/]] - What is the TDF and how can be used to guide behaviour change? - [[User:MyUserName|MyUserName]] # [[/Time and motivation/]] - What is the effect of time on motivation? - [[User:Lturner2311|Lturner2311]] # [[/Time management/]] - How can one's time be managed effectively? - [[User:CNK.20|CNK.20]] # [[/To-do lists/]] - Are to-do lists a good idea? What are their pros and cons? How can they be used effectively? - [[User:U3207458|U3207458]] # [[/Treatment motivation in juvenile delinquency/]] - What is the role of treatment motivation for juvenile delinquency and how can it be enhanced? - [[User:MyUserName|MyUserName]] # [[/Uncertainty avoidance/]] - What is uncertainty avoidance, why does it occur, and what are its consequences? - [[User:Franklin Brightt|Franklin Brightt]] # [[/Urgency bias and productivity/]] - What is the impact of urgency bias on productivity and what can be done about it? - [[User:Jnoth|Jnoth]] # [[/Vocational identity/]] - What is vocational identity and how does it develop? - [[User:MyUserName|MyUserName]] # [[/Volunteer tourism motivation/]] - What motivates volunteer tourism? - [[User:U962051|U962051]] # [[/Wanting and liking/]] - What are the similarities and differences between wanting and liking, and what are the implications? - [[User:U3201643|U3201643]] # [[/Work breaks, well-being, and productivity/]] - How do work breaks affect well-being and productivity? - [[User:U3215603|U3215603]] # [[/Work and flow/]] - What characteristics of work can produce flow and how can flow at work be fostered? - [[User:U3213441|U3213441]] ==Emotion== # [[/Animal emotion/]] - What is the emotional experience of animals? - [[User:U3216502|U3216502]] # [[/Attributions and emotion/]] - How do attributions affect emotion? - [[User:MyUserName|MyUserName]] # [[/Autonomous sensory meridian response and emotion/]] - What emotions are involved in ASMR experiences and why do they occur? - [[User:U3186959|U3186959]] # [[/Benzodiazepines and emotion/]] - What are the effects of benzodiazepines on emotion? - [[User:FulaAjeo22|FulaAjeo22]] # [[/Bewilderment/]] - What is bewilderment and how can it be dealt with? - Myusername # [[/Burnout/]] - What is burnout and how can be it be managed and prevented? - [[User:U3202788|U3202788]] # [[/Cognitive dissonance reduction/]] - What strategies do people use to reduce cognitive dissonance and how effective are they? - [[User:Tatjurate|Tatjurate]] # [[/Colonisation and emotion in Australia/]] - What are the emotional responses to colonisation in Australia? - [[User:Micabaker1|Micabaker1]] # [[/Compassion/]] - What is compassion, what are its pros and cons, and how can it be fostered? - [[User:U3203545|U3203545]] # [[/Compassion fatigue in mental health professionals/]] - What causes compassion fatigue in MH professionals and how can it be prevented? - [[User:U3055143|U3055143]] # [[/Connection to country and well-being/]] - What is the relationship between connection to country and well-being? - [[User:MyUserName|MyUserName]] # [[/Contempt/]] - What is contempt, what causes it, and how can it be managed? - [[User:U3202788|U3219905]] # [[/Core emotions/]] - What are the core emotions and what is their function? U3203140 # [[/Creative arts and trauma/]] - How can creative arts help in dealing with trauma? - [[User:SashaBrooksby|SashaBrooksby]] # [[/Cultural influences on shame, guilt, and pride/]] - How does culture influence shame, guilt, and pride? - [[User:Tamika Afeaki|Tamika Afeaki]] # [[/Default mode network and the self/]] - What is the relationship between the DMN and the self? - [[User:MyUserName|MyUserName]] # [[/Difficult conversations and emotion/]] - What communication and emotional skills are needed to successfully negotiate difficult conversations? - [[User:U3158968|U3158968]] # [[/Disappointment/]] - What is disappointment, what causes it, and how can it be managed? - [[User:U3216256|U3216256]] # [[/DMT and spirituality/]] - How can DMT facilitate spiritual experiences? - [[User:DenniseSoleymani|DenniseSoleymani]] # [[/Durability bias in affective forecasting/]] - What role does durability bias play in affective forecasting? - [[User:MyUserName|MyUserName]] # [[/Ecological grief/]] - What is ecological grief and what can be done about it? - [[User:Brewerjr|Brewerjr]] # [[/Ecopsychology and stress/]] - How can ecopsychology help to explain and deal with stress? - [[User:MyUserName|MyUserName]] # [[/Embarrassment/]] - What is embarrassment, what causes it, and how can it be managed? - [[User:U3190353|U3190353]] # [[/Emotional development in adolescence/]] - How does emotionality develop during adolescence? - [[User:U3230861|U3230861]] # [[/Emotional intelligence training/]] - How can emotional intelligence be trained? - [[User:Eimilerous22|Eimilerous22]] # [[/Emotion knowledge/]] - What is emotion knowledge and how can it be developed? - [[User:GabbieUC|GabbieUC]] # [[/Emotion across the lifespan/]] - How does emotion develop across the lifespan? - [[User:MyUserName|MyUserName]] # [[/Endocannabinoid system and emotion/]] - What is the role of the endocannabinoid system in emotion? - [[User:RWilliams12|Rwilliams12]] # [[/Environmental grief/]] - What is eco-grief, its causes and consequences, and what can be done? - [[User:Gabrielle Eagling|Gabrielle Eagling]] # [[/Exercise and endocannabinoids/]] - What is the relationship between exercise and the endocannabinoid system? - [[User:U3216963|U3216963]] # [[/Expressive suppression and emotion regulation/]] - What is the role of expressive suppression in emotion regulation? - [[User:U3131472|U3131472]] # [[/Fairness and emotion/]] - What is the relation between fairness and emotion? - [[User:U3246554|U3246554]] # [[/Fatigue and emotion/]] - What is the effect of fatigue on emotion and what can be done about it? - [[User:Lewis.Kusk|Lewis.Kusk]] # [[/Fear/]] - What is fear, what causes it, and how can it be managed? - [[User:Icantchooseone|Icantchooseone]] # [[/Fear of working out/]] - What is FOWO and how can it be overcome? - [[User:U3216963|U3216963]] # [[/Flourishing in the elderly/]] - How can psychological flourishing be supported in the elderly? - [[User:MyUserName|MyUserName]] # [[/Fundamental attribution error and emotion/]] - What is the relationship between the FAE and emotion? - [[User:U3196624|U3196624]] # [[/Gratitude and subjective wellbeing/]] - What is the relationship between gratitude and subjective wellbeing? - [[User:U3214260|U3214260]] # [[/Gloatrage/]] - What is gloatrage, what causes it, and what are its consequences? - [[User:MyUserName|MyUserName]] # [[/Heart rate variability and emotion regulation/]] - What is the relationship between HRV and emotion regulation? - [[User:U3213568|U3213568]] # [[/Hedonic adaptation prevention model/]] - What is the HAP model and how can it be applied? - [[User:Lyndel Lemon|Lyndel Lemon]] # [[/Humility/]] - What is humility, what causes it, and is it desirable? - [[User:U3195233|U3195233]] # [[/Hypomania and emotion/]] - What are the emotional characteristics of hypomania? - [[User:Alec.cortez|Alec.cortez]] # [[/Impact bias/]] - What is impact bias, what causes it, what are its consequences, and how can it be avoided? - [[User:MyUserName|MyUserName]] # [[Indigenous Australian emotionality]] - In what ways is emotionality experienced by Indigenous Australian people? - [[User:U3189442 - K.Ryan|U3189442 - K.Ryan]] # [[/Indigenous Australian mindfulness/]] - How has Indigenous Australian culture traditionally conceived of, and practiced, mindfulness? - [[User:MyUserName|MyUserName]] # [[/Inspiration/]] - What is inspiration, what causes it, what are its consequences, and how can it be fostered? - [[User:U3230861|U3227354]] # [[/Insular cortex and emotion/]] - What role does the insular cortex play in emotion? - [[User:U3190094|U3190094]] # [[/Interoception and emotion/]] - What is the relationship between interoception and emotion? - [[User:U3203265|U3203265]] # [[/Kama muta/]] - What is kama muta, what are its effects, and how can it be fostered? - [[User:U3183521|U3183521]] # [[/Linguistic relativism and emotion/]] - What is the role of linguistic relativism in emotion? - [[User:U3119310|U3119310]] # [[/Menstrual cycle mood disorders/]] - What causes menstrual cycle mood disorders and how can they be managed? - [[User:U3217109|U3217109]] # [[/Mental toughness in the workplace/]] - What can mental toughness be useful in the workplace? How can it be developed? - [[User:MyUserName|MyUserName]] # [[/Mindfulness and creativity/]] - How can mindfulness enhance creativity? - [[User:CaityDcr1603|CaityDcr1603]] # [[/Mindful self-care/]] - What is mindful self-care, why does it matter, and how can it be developed? - [[User:Clairelogan|Clairelogan]] # [[/Mixed emotions/]] - What are mixed emotions, what causes them, and how can they be managed? - [[User:U3210490|U3210490]] # [[/Mudita/]] - What is mudita and how can it be developed? - [[User:Inandonit365|Inandonit365]] # [[/Natural disasters and emotion/]] - How do people respond emotionally to natural disasters and how can they be supported? - [[User:U3148366_Chris|U3148366_Chris]] # [[/Nature therapy/]] - What is nature therapy and how can it be applied? - [[User:Ana028|Ana028]] # [[/Narcissism and emotion/]] - What is the relationship between narcissism and emotion? - [[User:A Super Villain|A Super Villain]] # [[/Narrative therapy and emotion/]] - What is the role of emotion in narrative therapy? - [[User:MyUserName|MyUserName]] # [[/Needle fear/]] - How does needle fear develop, what are its consequences, and what can be done about it? - [[User:U3166273|U3166273]] # [[/Neuroimaging and mood disorders/]] - How can neuroimaging assist in diagnosing and treating mood disorders? - [[User:Jdebear|Jdebear]] # [[/Occupational violence, emotion, and coping/]] - What are the emotional impacts of occupational violence and how can employees cope? - [[User:MyUserName|MyUserName]] # [[/Positivity ratio/]] - What is the positivity ratio and what are its implications? - [[User:MyUserName|MyUserName]] # [[/Post-traumatic stress disorder and emotion/]] - What is the effect of PTSD on emotion? - [[User:JorjaFive|JorjaFive]] # [[/Psychological distress/]] - What is PD, what are the main types, and how can they be managed? - [[User:U3190773|U3190773]] # [[/Psychological trauma/]] - What causes psychological trauma, what are the consequences, and how can people recover from psychological trauma? - [[User:U3195332|U3195332]] # [[/Psilocybin assisted psychotherapy/]] - How can psilocybin be used to assist psychotherapy? - [[User:U3083720|U3083720]] # [[/Psilocybin assisted therapy and depression/]] – How can psilocybin assisted therapy help to treat depression? - [[User:U3191488|U3191488]] # [[/Rational compassion/]] - What is rational compassion and how can it be cultivated? - [[User:MyUserName|MyUserName]] # [[/Reflected glory/]] - What is reflected glory and what are its pros and cons? - [[User:MyUserName|MyUserName]] # [[/Religiosity and coping/]] - What is the relationship between religiosity and coping? - [[User:Noah O'Brien|Noah O'Brien]] # [[/Resentment/]] - What is resentment, what causes it, and what are its consequences? - [[User:U3216389|U3216389]] # [[/Risk-as-feelings/]] - What is the emotional experience of risk and how does it influence decision-making and behaviour? - [[User:BenjiD'Ange|BenjiD'Ange]] # [[/Self-esteem and culture/]] - What are the cultural influences on self-esteem? - [[User:Jingru shao 0906|Jingru shao0906]] # [[/Smiling and emotion/]] - What is the relationship between smiling and emotion? - [[User:U3200902|U3200902]] # [[/Social media and suicide prevention/]] - How can social media be used to help prevent suicide? - [[User:JaimeTegan|JaimeTegan]] # [[/Sorry business/]] - What is sorry business and what role does it play in Indigenous communities in Australia? - [[User:Isaacem13|Isaacem13]] # [[/Stress control mindset/]] - What is a SCM, why does it matter, and how can it be cultivated? - [[User:MyUserName|MyUserName]] # [[/Suffering as emotion/]] - What is the emotional experience of suffering and how can people cope with suffering? - [[User:Brookewin|Brookewin]] # [[/Telemental health/]] - What are the pros and cons of TMH and what are the key ingredients for effective TMH practices? - [[User:U3025906|U3025906]] # [[/Topophilia/]] - What is topophilia, how does it develop, and what are the psychological impacts? - [[User:RSPMeredith|RSPMeredith]] # [[/Trauma and emotion/]] - What is the effect of trauma on emotion? - [[User:MyUserName|MyUserName]] # [[/Triumph/]] - What is triumph, what causes it, and what are its impacts? - [[User:Bill.miosge|Bill.miosge]] # [[/Unemployment and mental health/]]: What is the relationship between unemployment and mental health? - [[User:Tiarnawilson01|Tiarnawilson01]] # [[/Viewing natural scenes and emotion/]] - What is the effect of viewing natural scenes on emotion and how can this be applied? - [[User:MyUserName|MyUserName]] # [[/Wave metaphor for emotion/]] - In what respects is an ocean wave a helpful metaphor for understanding human emotions? - [[User:Jamieepiper|Jamieepiper]] # [[/Window of tolerance/]] - What is the window of tolerance and how can it be applied? - [[User:U3223109|U3223109]] # [[/Workplace mental health training/]] - What is WMHT, what techniques are used, and what are the impacts? - [[User:ArtOfHappiness|ArtOfHappiness]] # [[/Video conferencing fatigue/]] - What is video conferencing fatigue, what causes it, what are its consequences, and what can be done about it? - [[User:u3211603|U3211603]] ==Motivation and emotion== # [[/Financial investing, motivation, and emotion/]] - What role does motivation and emotion play in financial investing? - [[User:U3217287|U3217287]] # [[/Hostage negotiation, motivation, and emotion/]] - What role does motivation and emotion play in hostage negotiation? - [[User:U3213549|U3213549]] # [[/Money priming, motivation, and emotion/]] - What is the effect of money priming on motivation and emotion? - [[User:Molzaroid|Molzaroid]] # [[/Motivational dimensional model of affect/]] - What is the motivational dimensional model of affect and what are its implications? - [[User:MyUserName|MyUserName]] # [[/Napping, motivation, and emotion/]] - What are the motivational and emotional effects of napping? - [[User:U3207862|U3207862]] # [[/Overchoice, emotion, and motivation/]] - What are the emotional and motivational effects of overchoice? - [[User:MyUserName|MyUserName]] # [[/Patience and impatience/]] - What are the psychological causes and consequences of patience and impatience? - [[User:U3100193|U3100193]] # [[/Reward system, motivation, and emotion/]] - What role does the reward system play in motivation and emotion? - [[User:U3162201|U3162201]] [[Category:Motivation and emotion/Book/2022]] fnfrfbwpxqh0gv6glaff40r264m76gr 2419440 2419372 2022-08-26T09:32:35Z Jtneill 10242 wikitext text/x-wiki {{/Banner}} ==Motivation == # [[/Academic help-seeking/]] - What are the barriers and enablers of AHS and how can AHS be fostered? - [[User:Ibm4444|Ibm4444]] # [[/Academic self-regulation/]] - What is academic self-regulation, why does it matter, and how can it be fostered? - [[User:U3216563|U3216563]] # [[/Actively open-minded thinking/]] - How can AOT be used to improve human performance? - [[User:Teermeej Hossain|Teermeej Hossain]] # [[/Active transport motivation/]] - What motivates use of active transport and how can people be encouraged to use it? - [[User:MyUserName|MyUserName]] # [[/ADHD and motivation/]] - How does ADHD impact on motivation and what can be done about it? - [[User:U3222363|U3222363]] # [[/Antidepressants and motivation/]] - What are the effects of popular antidepressants on motivation? - [[User:MyUserName|MyUserName]] # [[/Approach motivation/]] - What is approach motivation and how does it lead to behaviour? - [[User:U3189370|U3189370]] # [[/Behavioural economics and motivation/]] - What aspects of motivation theory are useful in behavioural economics? - [[User:U3141987|U3141987]] # [[/Behavioural model of health services/]] - What is the BMHS and how can it be used? - [[User:SoSilverLibby|SoSilverLibby]] # [[/Beneficence as a psychological need/]] - What is beneficence and what are its implications as a psychological need? - [[User:CaitlinEmc|CaitlinEmc]] # [[/Brief motivational interviewing as a health intervention/]] - How can brief motivational interviewing be used as a health intervention? - [[User:MyUserName|MyUserName]] # [[/Cannabis use and dopamine/]] - What is the impact of cannabis use on dopamine in the brain? - [[User:U3246310|U3246310]] # [[/Childhood trauma and subsequent drug use/]] - How does psychological trauma influence subsequent drug use? - [[User:U3210431|U3210431]] # [[/Choice overload/]] - What is choice overload? What is the optimal amount of choice? - [[User:GeorgiaFairweather|GeorgiaFairweather]] # [[/Chunking and goal pursuit/]] - How does chunking affect goal pursuit? - [[User:Giovannihbartlett|Giovannihbartlett]] # [[/Cognitive entrenchment/]] - What is cognitive entrenchment and how can it be avoided? - [[User:JimmyOC1985|JimmyOC1985]] # [[/Climate change helplessness/]] - How does learned helpless impact motivation to engage in behaviours to limit climate change? - [[User:U3193000|U3193000]] # [[/Closeness communication bias/]] - What is the CCB, why does it occur, and how can it be overcome? - [[User:U3215103|U3215103]] # [[/Commitment bias/]] - What motivates escalation of commitment even it does not lead to desirably outcomes? - [[User:U3203936|U3203936]] # [[/Comprehensive action determination model/]] - What is the CADM and how can it be applied to understanding human motivation? - [[User:MyUserName|MyUserName]] # [[/Conspiracy theory motivation/]] - What motivates people to believe in conspiracy theories? - [[User:KingMob221|KingMob221]] # [[/Construal level theory/]] - What is construal level theory and how can it be applied? - [[User:MyUserName|MyUserName]] # [[/Courage motivation/]] - What is courage, what motivates courage, and how can courage be enhanced? -[[User:Hanarose123|Hanarose123]] # [[/Death drive/]] - What is the death drive and how can it be negotiated? - [[User:U3086459|U3086459]] # [[/Discounts and consumer purchase behaviour/]] - What role do discounts play in consumer purchase behaviour? - [[User:SunandaUC|SunandaUC]] # [[/Drugs-violence nexus and motivation/|Drugs-violence nexus and motivation]] - What is the role of motivation in the drugs-violence nexus? - [[Atu3202070|Atu3202070]] # [[/Domestic energy conservation motivation/]] - How can domestic energy conservation and reduced consumption be motivated and behaviour changed? - [[User:MyUserName|MyUserName]] # [[/Episodic future thinking and delay discounting/]] - What is the relationship between between EFT and DD? - [[User:MyUserName|MyUserName]] # [[/Episodic memory and planning/]] - What role does episodic memory play in planning? - [[User:MyUserName|MyUserName]] # [[/Equity theory/]] - What is equity theory and how can it be applied? - [[EKS2001|EKS2001]] # [[/ERG theory/]] - What is Alderfer's ERG theory? - [[User:Wuser1307|Wuser1307]] # [[/Environmental volunteering motivation/]] - What motivates environmental volunteering? - [[User:Somer Gellatly|Somer Gellatly]] # [[/Frame of reference and motivation/]] - How does frame of reference affect motivation? - [[User:MyUserName|MyUserName]] # [[/Freedom and motivation/]] - What is the effect of freedom on motivation? - [[User:MyUserName|MyUserName]] # [[/Fully functioning person/]] - What is a FFP and how can full functioning be developed? - [[User:Sebastian Armstrong|Sebastian Armstrong]] # [[/Functional fixedness/]] - What is functional fixedness and how can it be overcome? - [[User:U3214117|U3214117]] # [[/Functional imagery training/]] - What is FIT and how can it be applied? - [[User:Btarmstrong24|Btarmstrong24]] # [[/Gamification and work motivation/]] - How can gamification enhance work motivation? - [[User:U3211125|U3211125]] # [[/Giving up goals/]] - When should we give up goals and when should we persist? - [[User:U3161584|U3161584]] # [[/Green prescription motivation/]] - What motivates green prescription compliance? - [[User:Earthxangel|Earthxangel]] # [[/Grit and achievement/]] - How does grit affect achievement? - [[User:AnaStuart|AnaStuart]] # [[/Health belief model/]] - What is the HBM and how can it be used to enhance motivation for health-promoting behaviour? - [[User:Dee320|Dee320]] # [[/Help-seeking among boys/]] - What are the barriers to help-seeking for boys and what motivates them to seek help? - [[User:BradMcGrath|BradMcGrath]] # [[/Hidden costs of reward/]] - What are the hidden costs of motivating by reward? - [[User:SLoCE|SLoCE]] # [[/Hijack hypothesis of drug addiction/]] - What is the hijack hypothesis, what is the evidence, and how does it help to understand drug addiction? - [[User:U3218292|U3218292]] # [[/Honesty motivation/]] - What motivates honesty? - [[User:U3200859|U3200859]] # [[/Humour, leadership, and work/]] - What role does humour play in effective leadership in the workplace? - [[User:U3210264|U3210264]] # [[/IKEA effect/]] - What is the IKEA effect and how can it be applied? - [[MyUsername|MyUserName]] # [[/Intertemporal choice/]] - What are intertemporal choices and how can they be effectively negotiated? - [[User:MyUserName|MyUserName]] # [[/Kindness motivation/]] - What motivates kindness? - [[User:U3205429|U3205429]] # [[/Motivational music and exercise/]] - How can music be used to help motivate exercise? - [[User:U3183466|U3183466]] # [[/Non-residential energy conservation motivation/]] - How can non-residential building energy conservation and reduced consumption be motivated and behaviour changed? - [[User:MyUserName|MyUserName]] # [[/Novelty-variety as a psychological need/]] - What is novelty-variety and what are its implications as a psychological need? - [[User:MyUserName|MyUserName]] # [[/Nucleus accumbens and motivation/]] - What role does the nucleus accumbens play in motivation? - [[User:U3213250|U3213250]] # [[/Perfectionism/]] - What motivates perfectionism? Is perfectionism good or bad? How can it be managed? - [[User:AEMOR|AEMOR]] # [[/Physiological needs/]] - How do human's physiological needs affect motivation? - [[User:U3203655|U3203655]] # [[/Protection motivation theory and COVID-19/]] - How does PMT apply to managing COVID-19? - [[User:U3200956|U3200956]] # [[/Relative deprivation and motivation/]] - What is the effect of relative deprivation on motivation? - [[User:U3191574 (PHP)|U3191574 (PHP)]] # [[/Retrospective regret/]] - What is the motivational role of retrospective regret? - [[User:Will-U3214082|Will-U3214082]] # [[/Revenge motivation/]] - What motivates revenge and how does it affect us? - [[User:U3216654|U3216654]] # [[/Self-actualisation and motivation/]] - What motivates self-actualisation? - [[User:MyUserName|MyUserName]] # [[/Self-efficacy and academic achievement/]] - What role does self-efficacy play in academic achievement? - [[User:U943292|U943292]] # [[/Self-efficacy and achievement/]] - What role does self-efficacy play in achievement outcomes? - [[User:U3216513mt|U3216513mt]] # [[/Self-help/]] - What is self-help and what motivates people to engage in it? - [[User:Cedevlin9|Cedevlin9]] # [[/Sexual harassment at work motivation/]] - What motivates sexual harassment at work and what can be done about it? - [[User:U3037979|U3037979]] # [[/Signature strengths/]] - What are signature strengths and how can they be applied? - [[User:MyUserName|MyUserName]] # [[/Social cure/]] - What is the social cure and how can it be applied? - [[User:U3215976|U3215976]] # [[/Staff retention motivation/]] - How can organisations and managers help to motivate long-term retention of employees? - [[User:MyUserName|MyUserName]] # [[/System justification theory/]] - What is SJT, how does it affect our lives, and what can be done about it? - [[User:MyUserName|MyUserName]] # [[/Stretch goals/]] - What are stretch goals? Do they work? - [[User:MyUserName|MyUserName]] # [[/Sublimation/]] - What is sublimation and how can it be fostered? - [[User:Emily.desilva|Emily.desilva]] # [[/Survival needs and motivation/]] - What are survival needs and how do they influence motivation? - [[User:U3148161|U3148161]] # [[/Task initiation/]] - What are the challenges with task initiation and how to get get started? - [[User:StormSar|StormSar]] # [[/Theoretical domains framework/]] - What is the TDF and how can be used to guide behaviour change? - [[User:MyUserName|MyUserName]] # [[/Time and motivation/]] - What is the effect of time on motivation? - [[User:Lturner2311|Lturner2311]] # [[/Time management/]] - How can one's time be managed effectively? - [[User:CNK.20|CNK.20]] # [[/To-do lists/]] - Are to-do lists a good idea? What are their pros and cons? How can they be used effectively? - [[User:U3207458|U3207458]] # [[/Treatment motivation in juvenile delinquency/]] - What is the role of treatment motivation for juvenile delinquency and how can it be enhanced? - [[User:MyUserName|MyUserName]] # [[/Uncertainty avoidance/]] - What is uncertainty avoidance, why does it occur, and what are its consequences? - [[User:Franklin Brightt|Franklin Brightt]] # [[/Urgency bias and productivity/]] - What is the impact of urgency bias on productivity and what can be done about it? - [[User:Jnoth|Jnoth]] # [[/Vocational identity/]] - What is vocational identity and how does it develop? - [[User:MyUserName|MyUserName]] # [[/Volunteer tourism motivation/]] - What motivates volunteer tourism? - [[User:U962051|U962051]] # [[/Wanting and liking/]] - What are the similarities and differences between wanting and liking, and what are the implications? - [[User:U3201643|U3201643]] # [[/Work breaks, well-being, and productivity/]] - How do work breaks affect well-being and productivity? - [[User:U3215603|U3215603]] # [[/Work and flow/]] - What characteristics of work can produce flow and how can flow at work be fostered? - [[User:U3213441|U3213441]] ==Emotion== # [[/Animal emotion/]] - What is the emotional experience of animals? - [[User:U3216502|U3216502]] # [[/Attributions and emotion/]] - How do attributions affect emotion? - [[User:MyUserName|MyUserName]] # [[/Autonomous sensory meridian response and emotion/]] - What emotions are involved in ASMR experiences and why do they occur? - [[User:U3186959|U3186959]] # [[/Benzodiazepines and emotion/]] - What are the effects of benzodiazepines on emotion? - [[User:FulaAjeo22|FulaAjeo22]] # [[/Bewilderment/]] - What is bewilderment and how can it be dealt with? - [[User:MyUserName|MyUserName]] # [[/Burnout/]] - What is burnout and how can be it be managed and prevented? - [[User:U3202788|U3202788]] # [[/Cognitive dissonance reduction/]] - What strategies do people use to reduce cognitive dissonance and how effective are they? - [[User:Tatjurate|Tatjurate]] # [[/Colonisation and emotion in Australia/]] - What are the emotional responses to colonisation in Australia? - [[User:Micabaker1|Micabaker1]] # [[/Compassion/]] - What is compassion, what are its pros and cons, and how can it be fostered? - [[User:U3203545|U3203545]] # [[/Compassion fatigue in mental health professionals/]] - What causes compassion fatigue in MH professionals and how can it be prevented? - [[User:U3055143|U3055143]] # [[/Connection to country and well-being/]] - What is the relationship between connection to country and well-being? - [[User:MyUserName|MyUserName]] # [[/Contempt/]] - What is contempt, what causes it, and how can it be managed? - [[User:U3202788|U3219905]] # [[/Core emotions/]] - What are the core emotions and what is their function? U3203140 # [[/Creative arts and trauma/]] - How can creative arts help in dealing with trauma? - [[User:SashaBrooksby|SashaBrooksby]] # [[/Cultural influences on shame, guilt, and pride/]] - How does culture influence shame, guilt, and pride? - [[User:Tamika Afeaki|Tamika Afeaki]] # [[/Default mode network and the self/]] - What is the relationship between the DMN and the self? - [[User:MyUserName|MyUserName]] # [[/Difficult conversations and emotion/]] - What communication and emotional skills are needed to successfully negotiate difficult conversations? - [[User:U3158968|U3158968]] # [[/Disappointment/]] - What is disappointment, what causes it, and how can it be managed? - [[User:U3216256|U3216256]] # [[/DMT and spirituality/]] - How can DMT facilitate spiritual experiences? - [[User:DenniseSoleymani|DenniseSoleymani]] # [[/Durability bias in affective forecasting/]] - What role does durability bias play in affective forecasting? - [[User:MyUserName|MyUserName]] # [[/Ecological grief/]] - What is ecological grief and what can be done about it? - [[User:Brewerjr|Brewerjr]] # [[/Ecopsychology and stress/]] - How can ecopsychology help to explain and deal with stress? - [[User:MyUserName|MyUserName]] # [[/Embarrassment/]] - What is embarrassment, what causes it, and how can it be managed? - [[User:U3190353|U3190353]] # [[/Emotional development in adolescence/]] - How does emotionality develop during adolescence? - [[User:U3230861|U3230861]] # [[/Emotional intelligence training/]] - How can emotional intelligence be trained? - [[User:Eimilerous22|Eimilerous22]] # [[/Emotion knowledge/]] - What is emotion knowledge and how can it be developed? - [[User:GabbieUC|GabbieUC]] # [[/Emotion across the lifespan/]] - How does emotion develop across the lifespan? - [[User:MyUserName|MyUserName]] # [[/Endocannabinoid system and emotion/]] - What is the role of the endocannabinoid system in emotion? - [[User:RWilliams12|Rwilliams12]] # [[/Environmental grief/]] - What is eco-grief, its causes and consequences, and what can be done? - [[User:Gabrielle Eagling|Gabrielle Eagling]] # [[/Exercise and endocannabinoids/]] - What is the relationship between exercise and the endocannabinoid system? - [[User:U3216963|U3216963]] # [[/Expressive suppression and emotion regulation/]] - What is the role of expressive suppression in emotion regulation? - [[User:U3131472|U3131472]] # [[/Fairness and emotion/]] - What is the relation between fairness and emotion? - [[User:U3246554|U3246554]] # [[/Fatigue and emotion/]] - What is the effect of fatigue on emotion and what can be done about it? - [[User:Lewis.Kusk|Lewis.Kusk]] # [[/Fear/]] - What is fear, what causes it, and how can it be managed? - [[User:Icantchooseone|Icantchooseone]] # [[/Fear of working out/]] - What is FOWO and how can it be overcome? - [[User:U3216963|U3216963]] # [[/Flourishing in the elderly/]] - How can psychological flourishing be supported in the elderly? - [[User:MyUserName|MyUserName]] # [[/Fundamental attribution error and emotion/]] - What is the relationship between the FAE and emotion? - [[User:U3196624|U3196624]] # [[/Gratitude and subjective wellbeing/]] - What is the relationship between gratitude and subjective wellbeing? - [[User:U3214260|U3214260]] # [[/Gloatrage/]] - What is gloatrage, what causes it, and what are its consequences? - [[User:MyUserName|MyUserName]] # [[/Heart rate variability and emotion regulation/]] - What is the relationship between HRV and emotion regulation? - [[User:U3213568|U3213568]] # [[/Hedonic adaptation prevention model/]] - What is the HAP model and how can it be applied? - [[User:Lyndel Lemon|Lyndel Lemon]] # [[/Humility/]] - What is humility, what causes it, and is it desirable? - [[User:U3195233|U3195233]] # [[/Hypomania and emotion/]] - What are the emotional characteristics of hypomania? - [[User:Alec.cortez|Alec.cortez]] # [[/Impact bias/]] - What is impact bias, what causes it, what are its consequences, and how can it be avoided? - [[User:MyUserName|MyUserName]] # [[Indigenous Australian emotionality]] - In what ways is emotionality experienced by Indigenous Australian people? - [[User:U3189442 - K.Ryan|U3189442 - K.Ryan]] # [[/Indigenous Australian mindfulness/]] - How has Indigenous Australian culture traditionally conceived of, and practiced, mindfulness? - [[User:MyUserName|MyUserName]] # [[/Inspiration/]] - What is inspiration, what causes it, what are its consequences, and how can it be fostered? - [[User:U3230861|U3227354]] # [[/Insular cortex and emotion/]] - What role does the insular cortex play in emotion? - [[User:U3190094|U3190094]] # [[/Interoception and emotion/]] - What is the relationship between interoception and emotion? - [[User:U3203265|U3203265]] # [[/Kama muta/]] - What is kama muta, what are its effects, and how can it be fostered? - [[User:U3183521|U3183521]] # [[/Linguistic relativism and emotion/]] - What is the role of linguistic relativism in emotion? - [[User:U3119310|U3119310]] # [[/Menstrual cycle mood disorders/]] - What causes menstrual cycle mood disorders and how can they be managed? - [[User:U3217109|U3217109]] # [[/Mental toughness in the workplace/]] - What can mental toughness be useful in the workplace? How can it be developed? - [[User:MyUserName|MyUserName]] # [[/Mindfulness and creativity/]] - How can mindfulness enhance creativity? - [[User:CaityDcr1603|CaityDcr1603]] # [[/Mindful self-care/]] - What is mindful self-care, why does it matter, and how can it be developed? - [[User:Clairelogan|Clairelogan]] # [[/Mixed emotions/]] - What are mixed emotions, what causes them, and how can they be managed? - [[User:U3210490|U3210490]] # [[/Mudita/]] - What is mudita and how can it be developed? - [[User:Inandonit365|Inandonit365]] # [[/Natural disasters and emotion/]] - How do people respond emotionally to natural disasters and how can they be supported? - [[User:U3148366_Chris|U3148366_Chris]] # [[/Nature therapy/]] - What is nature therapy and how can it be applied? - [[User:Ana028|Ana028]] # [[/Narcissism and emotion/]] - What is the relationship between narcissism and emotion? - [[User:A Super Villain|A Super Villain]] # [[/Narrative therapy and emotion/]] - What is the role of emotion in narrative therapy? - [[User:MyUserName|MyUserName]] # [[/Needle fear/]] - How does needle fear develop, what are its consequences, and what can be done about it? - [[User:U3166273|U3166273]] # [[/Neuroimaging and mood disorders/]] - How can neuroimaging assist in diagnosing and treating mood disorders? - [[User:Jdebear|Jdebear]] # [[/Occupational violence, emotion, and coping/]] - What are the emotional impacts of occupational violence and how can employees cope? - [[User:MyUserName|MyUserName]] # [[/Positivity ratio/]] - What is the positivity ratio and what are its implications? - [[User:MyUserName|MyUserName]] # [[/Post-traumatic stress disorder and emotion/]] - What is the effect of PTSD on emotion? - [[User:JorjaFive|JorjaFive]] # [[/Psychological distress/]] - What is PD, what are the main types, and how can they be managed? - [[User:U3190773|U3190773]] # [[/Psychological trauma/]] - What causes psychological trauma, what are the consequences, and how can people recover from psychological trauma? - [[User:U3195332|U3195332]] # [[/Psilocybin assisted psychotherapy/]] - How can psilocybin be used to assist psychotherapy? - [[User:U3083720|U3083720]] # [[/Psilocybin assisted therapy and depression/]] – How can psilocybin assisted therapy help to treat depression? - [[User:U3191488|U3191488]] # [[/Rational compassion/]] - What is rational compassion and how can it be cultivated? - [[User:MyUserName|MyUserName]] # [[/Reflected glory/]] - What is reflected glory and what are its pros and cons? - [[User:MyUserName|MyUserName]] # [[/Religiosity and coping/]] - What is the relationship between religiosity and coping? - [[User:Noah O'Brien|Noah O'Brien]] # [[/Resentment/]] - What is resentment, what causes it, and what are its consequences? - [[User:U3216389|U3216389]] # [[/Risk-as-feelings/]] - What is the emotional experience of risk and how does it influence decision-making and behaviour? - [[User:BenjiD'Ange|BenjiD'Ange]] # [[/Self-esteem and culture/]] - What are the cultural influences on self-esteem? - [[User:Jingru shao 0906|Jingru shao0906]] # [[/Smiling and emotion/]] - What is the relationship between smiling and emotion? - [[User:U3200902|U3200902]] # [[/Social media and suicide prevention/]] - How can social media be used to help prevent suicide? - [[User:JaimeTegan|JaimeTegan]] # [[/Sorry business/]] - What is sorry business and what role does it play in Indigenous communities in Australia? - [[User:Isaacem13|Isaacem13]] # [[/Stress control mindset/]] - What is a SCM, why does it matter, and how can it be cultivated? - [[User:MyUserName|MyUserName]] # [[/Suffering as emotion/]] - What is the emotional experience of suffering and how can people cope with suffering? - [[User:Brookewin|Brookewin]] # [[/Telemental health/]] - What are the pros and cons of TMH and what are the key ingredients for effective TMH practices? - [[User:U3025906|U3025906]] # [[/Topophilia/]] - What is topophilia, how does it develop, and what are the psychological impacts? - [[User:RSPMeredith|RSPMeredith]] # [[/Trauma and emotion/]] - What is the effect of trauma on emotion? - [[User:MyUserName|MyUserName]] # [[/Triumph/]] - What is triumph, what causes it, and what are its impacts? - [[User:Bill.miosge|Bill.miosge]] # [[/Unemployment and mental health/]]: What is the relationship between unemployment and mental health? - [[User:Tiarnawilson01|Tiarnawilson01]] # [[/Viewing natural scenes and emotion/]] - What is the effect of viewing natural scenes on emotion and how can this be applied? - [[User:MyUserName|MyUserName]] # [[/Wave metaphor for emotion/]] - In what respects is an ocean wave a helpful metaphor for understanding human emotions? - [[User:Jamieepiper|Jamieepiper]] # [[/Window of tolerance/]] - What is the window of tolerance and how can it be applied? - [[User:U3223109|U3223109]] # [[/Workplace mental health training/]] - What is WMHT, what techniques are used, and what are the impacts? - [[User:ArtOfHappiness|ArtOfHappiness]] # [[/Video conferencing fatigue/]] - What is video conferencing fatigue, what causes it, what are its consequences, and what can be done about it? - [[User:u3211603|U3211603]] ==Motivation and emotion== # [[/Financial investing, motivation, and emotion/]] - What role does motivation and emotion play in financial investing? - [[User:U3217287|U3217287]] # [[/Hostage negotiation, motivation, and emotion/]] - What role does motivation and emotion play in hostage negotiation? - [[User:U3213549|U3213549]] # [[/Money priming, motivation, and emotion/]] - What is the effect of money priming on motivation and emotion? - [[User:Molzaroid|Molzaroid]] # [[/Motivational dimensional model of affect/]] - What is the motivational dimensional model of affect and what are its implications? - [[User:MyUserName|MyUserName]] # [[/Napping, motivation, and emotion/]] - What are the motivational and emotional effects of napping? - [[User:U3207862|U3207862]] # [[/Overchoice, emotion, and motivation/]] - What are the emotional and motivational effects of overchoice? - [[User:MyUserName|MyUserName]] # [[/Patience and impatience/]] - What are the psychological causes and consequences of patience and impatience? - [[User:U3100193|U3100193]] # [[/Reward system, motivation, and emotion/]] - What role does the reward system play in motivation and emotion? - [[User:U3162201|U3162201]] [[Category:Motivation and emotion/Book/2022]] jnx19n5988y00g49yhphytkiziiibqq 2 277688 2419262 2409352 2022-08-26T04:30:29Z Jtwsaddress42 234843 wikitext text/x-wiki {{User:Jtwsaddress42/Bibliography}} '''[[User:Jtwsaddress42/People_D|<big>D</big>]]''' {{RoundBoxTop|theme=2}} {{User:Jtwsaddress42/Bibliography/Daley, Allison}} * {{cite journal | last= Dalton | first= John | year= 1808 | title= A New System of Chemical Philosophy | publisher= Philosophical Library | publication-date= 1964 | isbn= 978-0-802-20336-6 | url= https://www.google.com/books/edition/_/QcWLAAAAIAAJ?hl=en&sa=X&ved=2ahUKEwixitCfpdr0AhWeLDQIHYo7AcwQ8fIDegQIAxBa }} * {{cite journal | last1= Damasio | first1= A.R. | last2= Damasio | first2= H. | year= 1992 | title= Brain and language | journal= Scientific American | volume= 267 | number= 3 | pages= 88-95 | publication-date= September 1992 | pmid= 1502527 | doi= 10.1038/scientificamerican0992-88 | url= https://www.scientificamerican.com/article/brain-and-language/ }} * {{cite journal | last1= Danchin | first1= Etienne G.J. | last2= Gouret | first2= Philippe | last3= Pontarotti | first3= Pierre | year= 2006 | title= Eleven Ancestral Gene Families Lost in Mammals and Vertebrates While Otherwise Universally Conserved in Animals | journal= BMC Evolutionary Biology | volume= 6 | pages= 5 | publication-date= January 18, 2006 | pmid= 16420703 | pmc= 1382263 | doi= 10.1186/1471-2148-6-5 | url= https://bmcecolevol.biomedcentral.com/articles/10.1186/1471-2148-6-5 }} * {{cite AV media | last= Darnell Jr. | first= James | year= 2017 | title= James E. Darnell, Jr., M.D. - Oral History Excerpts | series= The Rockefeller University Oral History Project | publisher= The Rockefeller University | medium= Interviewed May and June 2017 | publication-date= December 11, 2018 | url= https://www.rockefeller.edu/about/history/oral-history-project/interview-james-e-darnell-jr/ }} [[File:High-contrast-camera-video.svg|24px|video]] (0:09:35) {{User:Jtwsaddress42/Bibliography/Darwin,_Charles}} {{User:Jtwsaddress42/Bibliography/Davidson, Eric H.}} {{User:Jtwsaddress42/Bibliography/Davies, Paul C.W.}} * {{cite AV media | last= Davis | first= Burt | year= 2017 | title= Erika Cremer and her pioneering work on GC | series= Personal Interview | publisher= Video History of Catalysis | publication-date= June 2, 2017 | url= https://www.youtube.com/watch?v=pzKSMvVS1DU&list=PLGDXP6WJ9yLPY11RbIH82HirpByEA69nB }} [[File:High-contrast-camera-video.svg|24px|video]] (0:15:21) * {{cite book | last= Davis | first= Mike | year= 1998 | title= Ecology of Fear - Los Angeles And The Imagination Of Destruction | publisher= Vintage Books | publication-date= 1999 | isbn= 978-0-375-70607-3 | url= https://www.google.com/books/edition/_/t4E_3-6nJq0C?hl=en&sa=X&ved=2ahUKEwiSjPOYrtr0AhW_GjQIHexZBOsQ8fIDegQICRAK }} * {{cite book | last=Dawkins | first= Richard | year= 1976 | title= The Selfish Gene | publisher= Oxford University Press | publication-date= 1989 | isbn= 978-0-192-86092-7 | url= https://www.google.com/books/edition/The_Selfish_Gene/WkHO9HI7koEC?hl=en&gbpv=0 }} {{User:Jtwsaddress42/Bibliography/Deamer, David W.}} {{User:Jtwsaddress42/Bibliography/De Camilli, Pietro}} {{User:Jtwsaddress42/Bibliography/De Duve, Christian}} * {{cite journal | last1=de Haan | first1= J.W. | last2= van de Ven | first2= L.J.M. | year= 1971 | title= Z-E Conformational Isomerism Of Nerol, Geraniol And Their Acetates | journal= Tetrahedron Letters | volume= 12 | number= 29 | pages= 2703-2706 | publication-date= 1971 | doi= 10.1016/S0040-4039(01)96957-6 | url= https://www.sciencedirect.com/science/article/abs/pii/S0040403901969576?via%3Dihub }} * {{cite journal | last1=De Kloet | first1= E. Ronald | last2= Vreugdenhil | first2= Erno | last3= Oitzl | first3= Melly S. | last4= Joels | first4= Marian | year= 1998 | title= Brain Corticosteroid Receptor Balance In Health And Disease | journal= Endocrine Reviews | volume= 19 | number= 3 | pages= 269-301 | publication-date= June 1, 1998 | pmid= 9626555 | doi= 10.1210/edrv.19.3.0331 | url= https://academic.oup.com/edrv/article/19/3/269/2530808 }} * {{cite journal | last1= Dehal | first1= Paramvir | last2= Boore | first2= Jeffrey L. | year= 2005 | title= Two Rounds of Whole Genome Duplication in the Ancestral Vertebrate | journal= PLOS Biology | volume= 3 | number= 10 | pages= e314 | doi=10.1371/journal.pbio.0030314 | pmid= 16128622 | pmc= 1197285 | doi-access= free }} {{User:Jtwsaddress42/Bibliography/Demeke, Damtew}} * {{cite AV media | last= Dement | first= William C. | year= 2004 | title= History Of Neuroscience - William C. Dement | publisher= Society For Neuroscience | medium= Recorded July 21-22, 2004 | publication-date= July 5, 2012 | url= https://www.sfn.org/about/history-of-neuroscience/autobiographical-videos/dement,-william-c }} [[File:High-contrast-camera-video.svg|24px|video]] (0:56:39) * {{cite book | last= Dennett | first= Daniel C. | year= 1996 | title= Kinds Of Minds: Towards An Understanding Of Consciousness | publisher= Basic Books | publication-date= June 12, 1997 | isbn= 978-0-465-07351-1 | url= https://www.basicbooks.com/titles/daniel-c-dennett/kinds-of-minds/9780465073511/ }} * {{cite book | last= De Pomerai | first= David | year= 1990 | title= From Gene to Animal: An Introduction to the Molecular Biology of Animal Development | edition= 2 | publisher= Cambridge University Press | publication-date= December 13, 1990 | isbn= 978-0-521-38856-6 | url= https://www.google.com/books/edition/_/hzk4AAAAIAAJ?hl=en&sa=X&ved=2ahUKEwiK3PbbqvryAhVSJzQIHa1vANoQre8FegQIChAI }} * {{cite book | last= De Robertis | first= Eddy M. | year= 1994 | chapter= The Homeobox in Cell Differentiation and Evolution | title= Guidebook to the Homeobox Genes | pages= 13-23 | editor= Dennis Duboule | publisher= A Sambrook &amp; Tooze Publication at Oxford University Press | publication-date= January 15, 1994 | isbn= 978-0-198-59939-5 | url= https://www.google.com/books/edition/_/VtsotAEACAAJ?hl=en&sa=X&ved=2ahUKEwiGvuWur_ryAhUTJzQIHRTyDg4Qre8FegQICRAC }} {{User:Jtwsaddress42/Bibliography/Descartes,_René}} * {{cite journal | last1= Deslongchamps | first1= Pierre | last2= Rowan | first2= Daryl D. | last3= Pothier | first3= Normand | last4= Sauve | first4= Gilles | last5= Saunders | first5= John K. | year= 1981 | title= 1,7-Dioxaspiro[5.5]undecanes - An Excellent System For The Study Of Stereoelectronic Effects (Anomeric And Exo-Anomeric Effects) In Acetals | journal= Canadian Journal Of Chemistry | volume= 59 | number= 7 | pages= 1105-1121 | publication-date= April 1981 | doi= 10.1139/v81-260 | url= https://cdnsciencepub.com/doi/10.1139/v81-260 }} * {{cite AV media | last= D'Esposito | first= Mark | year= 2007 | title= Neural Mechanisms of Working Memory | publisher= 2007 Brain Network Dynamics Conference | medium= Conference on Brain Network Dynamics held at the University of California at Berkeley on January 26-27, 2007 | publication-date= February 4, 2007 | url= https://archive.org/details/Brain_Network_Dynamics_2007-12-Mark-DEsposito }} [[File:High-contrast-camera-video.svg|24px|video]] (0:30:37) * {{cite journal | last= Deuchar | first= Elizabeth M. | year= 1970 | title= Diffusion in Embryogenesis | journal= Nature | volume= 225 | number= 5233 | pages= 671 | publication-date= February 14, 1970 | pmid= 16056680 | doi= 10.1038/225671b0 | url= https://www.nature.com/articles/225671b0 }} {{User:Jtwsaddress42/Bibliography/D'Eustachio, Peter G.}} * {{cite journal | last= Devor | first= Anna | year= 2000 | title= Is The Cerebellum Like Cerebellar-Like Structures? | journal= Brain Research Reviews | volume= 34 | pages= 149-156 | publication-date= 2000 | pmid= 11113505 | doi= 10.1016/s0165-0173(00)00045-x | url= https://www.sciencedirect.com/science/article/abs/pii/S016501730000045X?via%3Dihub }} * {{cite book | last= Dewey | first= John | year= 1920 | title= Reconstruction in Philosophy | publisher= Beacon Press | publication-date= 1948 | isbn= 978-0-807-01585-8 | url= https://www.google.com/books/edition/_/SQMxAWL381UC?hl=en&sa=X&ved=2ahUKEwjr17qXjJT1AhVhDjQIHcAdBvMQ8fIDegQIAxBW }} * {{cite journal | last1= De Zeeuw | first1= C.I. | last2= Simpson | first2= J.I. | last3= Hoogenraad | first3= C.C. | last4= Galjart | first4= N. | last5= Koekkoek | first5= S.K | last6= Ruigrok | first6= T.J. | year= 1998 | title= Microcircuitry and Function of the Inferior Olive | journal= Trends in Neurosciences | volume= 21 | number= 9 | pages= 391-400 | publication-date= September 1, 1998 | pmid= 9735947 | doi= 10.1016/s0166-2236(98)01310-1 | url= https://www.cell.com/trends/neurosciences/fulltext/S0166-2236(98)01310-1?_returnURL=https%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS0166223698013101%3Fshowall%3Dtrue }} * {{cite book | last1= Diamond | first1= Marian C. | last2= Scheibel | first2= Arnold B. | last3= Elson | first3= Lawrence M. | year= 1985 | title= The Human Brain Coloring Book | publisher= HarperCollins | publication-date= November 27, 1985 | isbn= QM 455.D5 1985 | url= https://www.google.com/books/edition/The_Human_Brain_Colrng_Bk_Smpl_Only_/VFzYPgAACAAJ?kptab=editions&sa=X&ved=2ahUKEwiuiq_4jZT1AhXiPn0KHY76CTsQmBZ6BAgEEAc }} * {{cite AV media | last= Diatchenko | first= Luda | year= 2022 | title= Reconstruction of the Pathophysiology of Chronic Pain from Genome-wide Studies | publisher= NIH VideoCast | medium= McGill University | publication-date= February 9, 2022 | url= https://videocast.nih.gov/watch=44205 }} [https://oir.nih.gov/wals NIH Director’s Wednesday Afternoon Lecture Series] [[File:High-contrast-camera-video.svg|24px|video]] (1:08:44) * {{cite journal | last1= Dickinson | first1= D.P. | last2= Machnicki | first2= M. | last3= Ali | first3= M.M. | last4= Zhang | first4= Z. | last5= Sohal | first5= G.S. | year= 2004 | title= Ventrally emigrating neural tube (VENT) cells: a second neural tube-derived cell population. | journal= Journal of Anatomy | volume= 205 | number= 2 | pages= 79-98 | publication-date= August 2004 | pmid= 15291792 | pmc= 1571334 | doi= 10.1111/j.0021-8782.2004.00319.x | url= https://onlinelibrary.wiley.com/doi/10.1111/j.0021-8782.2004.00319.x }} * {{cite journal | last1= Dillon | first1= J. | last2= Nakanishi | first2= K. | year= 1974 | title= Use Of Copper Hexafluoroacetylacetonate For The Determination Of The Absolute Configuration Of Alcohols | journal= Journal Of The American Chemistry Society | volume= 96 | number= 12 | pages= 4055-4057 | publication-date= June 12, 1974 | doi= 10.1021/ja00819a076 | url= https://pubs.acs.org/doi/10.1021/ja00819a076 }} {{User:Jtwsaddress42/Bibliography/Dobzhansky, Theodosius}} {{User:Jtwsaddress42/Bibliography/Doherty, Elizabeth A.}} * {{cite book | last= Domjan | first= Michael | year= 2002 | chapter= Cognitive Modulation Of Sexual Behavior | title= [https://direct.mit.edu/books/oa-edited-volume/2392/The-Cognitive-AnimalEmpirical-and-Theoretical The Cognitive Animal: Empirical And Theoretical Perspectives On Animal Cognition] | editor= Marc Bekoff, Colin Allen, and Gordon M. Burghardt | number= 12 | pages= 89-9 | publisher= MIT Press | isbn= 978-0-262-52322-6 | doi= 10.7551/mitpress/1885.003.0015 | url= https://direct.mit.edu/books/oa-edited-volume/2392/chapter/625470/Cognitive-Modulation-of-Sexual-Behavior }} * {{cite journal | last= Donald | first= Merlin | year= 1991 | title= Origins Of The Modern Mind - Three Stages In The Evolution Of Culture And Cognition | publisher= Harvard University Press | publication-date= March 15, 1993 | isbn= 978-0-674-64484-7 | url= https://www.hup.harvard.edu/catalog.php?isbn=9780674644847&content=reviews }} * {{cite book | last= Donald | first= Merlin | year= 2001 | title= A Mind So Rare - The Evolution Of Human Consciousness | publisher= W.W. Norton &amp; Company | publication-date= 2002 | isbn= 978-0-393-32319-1 | url= https://www.google.com/books/edition/A_Mind_So_Rare/Zx-MG6kpf-cC?hl=en }} * {{cite journal | last1= Doubell | first1= Timothy P. | last2= Skaliora | first2= Irini | last3= Baron | first3= Jerome | last4= King | first4= Andrew J. | year= 2003 | title= Functional Connectivity between the Superficial and Deeper Layers of the Superior Colliculus: An Anatomical Substrate for Sensorimotor Integration | journal= Journal of Neuroscience | volume= 23 | number= 16 | pages= 6596-6607 | publication-date= July 23, 2003 | pmid= 12878701 | pmc= 6740636 | doi= 10.1523/JNEUROSCI.23-16-06596.2003 | url= https://www.jneurosci.org/content/23/16/6596.long }} {{User:Jtwsaddress42/Bibliography/Doudna, Jennifer A.}} * {{cite book | last1= Drews | first1= Ulrich | last2= Rothenburger | first2= Astried | last3= Gay | first3= Rüdiger | year= 1995 | title= Color Atlas of Embryology - Color plates by Astried Rothenburger and Rüdiger Gay | translator= David B. Meyer | publisher= Thieme Flexibook, TMP| location= New York | isbn= 0-86577-544-3 | url= https://www.thieme.com/books-main/product/2466-color-atlas-of-embryology }} {{User:Jtwsaddress42/Bibliography/Drobner, E.}} {{User:Jtwsaddress42/Bibliography/Drubin, David}} * {{cite journal | last= Duboule | first= Denis | year= 2007 | title= The rise and fall of Hox gene clusters | journal= Development | volume= 134 | number= 14 | pages= 2549-2560 | pmid= 17553908 | doi= 10.1242/dev.001065 | url= https://journals.biologists.com/dev/article/134/14/2549/52799/The-rise-and-fall-of-Hox-gene-clusters }} {{User:Jtwsaddress42/Bibliography/Dubrovsky, Bernardo}} {{User:Jtwsaddress42/Bibliography/Dunning, Brian}} * {{cite journal | last1= Dworkin | first1= Jason P. | last2= Lazcano | first2= Antonio | last3= Miller, | first3= Stanley L. | year= 2003 | title= The Roads To And From The RNA World< | journal= Journal of Theoretical Biology | volume= 222 | number= 1 | pages= 127-134 | publication-date= May 7, 2003 | pmid= 12699739 | doi= 10.1016/s0022-5193(03)00020-1 | url= https://www.sciencedirect.com/science/article/abs/pii/S0022519303000201?via%3Dihub }} * {{cite AV media | last= Dyer | first= Jayme | year= 2015 | title= Knowing Where to Go: How Cells Drive Without Eyes | series= iBiology - Cell Biology Lectures | publisher= Massachusetts Institute of Technology (MIT) | publication-date= October 12, 2015 | url= https://www.youtube.com/watch?v=oZWEWbvlVdE&list=PLB91F93681E0E0DB1&index=69 }} [[File:High-contrast-camera-video.svg|24px|video]] (0:34:56) * {{cite book | last= Dyson | first= Freeman J. | year= 1985 | title= Origins of Life | edition= 2 | publisher= Cambridge University Press | publication-date= 1999 | isbn= 978-0-511-54630-3 | doi= 10.1017/CBO9780511546303 | url= https://www.cambridge.org/core/books/origins-of-life/B0B8C13086C4DA8CF98A0A65E29BDB62#fndtn-information }} {{RoundBoxBottom}} {{User:Jtwsaddress42/Includes/Notes_&_Citations}} {{User:Jtwsaddress42/Navigation/Footer Navbar}} {{User:Jtwsaddress42/Includes/Categories}} 4nuw6p3ea4xm4nkeqc70fa6yb9semqh 0 279841 2419264 2417265 2022-08-26T04:33:50Z 137.92.227.15 /* What is Climate Change> */ wikitext text/x-wiki {{title|Climate change helplessness - Motivation and Emotion}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== You are underway {{smile}}! This template provides tips for [[Motivation and emotion/Assessment/Topic|topic development]]. Gradually remove these suggestions as you develop the chapter. Also consult the [[Motivation and emotion/Assessment/Chapter|author guidelines]]. At the top of the chapter, the title and sub-title should match the ''exact'' wording and casing as shown in the {{Motivation and emotion/Book}}. The sub-titles all end with a question mark. This Overview section should be concise but consist of several paragraphs which engage the reader, illustrate the problem, and outline how psychological science can help. {{RoundBoxTop|theme=3}} '''Focus questions:''' * What is the first focus question? * What is the second focus question? * What is the third focus question? {{RoundBoxBottom}} {{tip| Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Provide an example or case study. * Conclude with Focus questions to guide the chapter. }} ==What is Climate Change?== How you are going to structure the chapter? Aim for three to six main headings between the [[#Overview|Overview]] and [[#Conclusion|Conclusion]]. == What is Helplessness? == ss{{tip|Suggestions for this section: * For the [[Motivation and emotion/Assessment/Topic|topic development]], provide at least 3 bullet-points about key content per section. Include key citations. * For the [[Motivation and emotion/Assessment/Chapter|book chapter]], expand the bullet points into paragraphs. * If a section has a lot of content, arrange it into two to five sub-headings such as in the [[#Interactive learning features|interactive learning features section]]. Avoid having sections with only one sub-heading. }} ==Learning features== What brings an online book chapter to life are its interactive learning features. Case studies, feature boxes, figures, links, tables, and quiz questions can be used throughout the chapter. ===Case studies=== Case studies describe real-world examples of concepts in action. Case studies can be real or fictional. A case could be used multiple times during a chapter to illustrate different theories or stages. It is often helpful to present case studies using [[#Feature boxes|feature boxes]]. ===Boxes=== Boxes can be used to highlight content, but don't overuse them. There are many different ways of creating boxes (e.g., see [[Help:Pretty boxes|Pretty boxes]]). Possible uses include: * Focus questions * Case studies or examples * Quiz questions * Take-home messages {{RoundBoxTop|theme=3}} ;Feature box example * Shaded background * Coloured border {{RoundBoxBottom}} ===Figures=== [[File:Monkey-typing.jpg|right|205px|thumb|''Figure 1''. Example image with descriptive caption.]] Use figures to illustrate concepts, add interest, and provide examples. Figures can be used to show photographs, drawings, diagrams, graphs, etcetera. Figures can be embedded throughout the chapter, starting with the Overview section. Figures should be captioned (using a number and a description) in order to explain their relevance to the text. Possible images can be found at [[commons:|Wikimedia Commons]]. Images can also be uploaded if they are licensed for re-use or if you created the image. Each figure should be referred to at least once in the main text (e.g., see Figure 1). ===Links=== Where key words are first used, make them into [[Help:Links|interwiki links]] such as Wikipedia links to articles about famous people (e.g., [[w:Sigmund Freud|Sigmund Freud]] and key concepts (e.g., [[w:Dreams|dreams]]) and links to book chapters about related topics (e.g., would you like to learn about how to overcome [[Motivation and emotion/Book/2020/Writer's block|writer's block]]?). ===Tables=== Tables can be an effective way to organise and summarise information. Tables should be captioned (using APA style) to explain their relevance to the text. Plus each table should be referred to at least once in the main text (e.g., see Table 1 and Table 2). Here are some [[Motivation and emotion/Wikiversity/Tables|example 3 x 3 tables]] which could be adapted. ===Quizzes=== Quizzes are a direct way to engage readers. But don't make quizzes too hard or long. It is better to have one or two review questions per major section than a long quiz at the end. Try to quiz conceptual understanding, rather than trivia. Here are some simple quiz questions which could be adapted. Choose the correct answers and click "Submit": <quiz display=simple> {Quizzes are an interactive learning feature: |type="()"} + True - False {Long quizzes are a good idea: |type="()"} - True + False </quiz> To learn about different types of quiz questions, see [[Help:Quiz|Quiz]]. ==Conclusion== The Conclusion is arguably the most important section. It should be possible for someone to read the [[#Overview|Overview]] and the Conclusion and still get a good idea of the topic. {{tip|Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? }} ==See also== Provide up to half-a-dozen [[Help:Contents/Links#Interwiki_links|internal (wiki) links]] to relevant Wikiversity pages (esp. related [[Motivation and emotion/Book|motivation and emotion book chapters]]) and [[w:|Wikipedia articles]]. For example: * [[Motivation and emotion/Book/2016/Anorexia nervosa and extrinsic motivation|Anorexia nervosa and extrinsic motivation]] (Book chapter, 2016) * [[w:David McClelland|David McClelland]] (Wikipedia) * [[Motivation and emotion/Book/2018/Loss aversion|Loss aversion]] (Book chapter, 2018) * [[w:Maslow's hierarchy of needs|Maslow's hierarchy of needs]] (Wikipedia) {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== List the cited references in [[w:APA style|APA style]] (7th ed.) or [[w:Wikipedia:Citing sources|wiki style]]. APA style example: {{Hanging indent|1= Blair, R. J. R. (2004). The roles of orbital frontal cortex in the modulation of antisocial behavior. ''Brain and Cognition'', ''55''(1), 198–208. https://doi.org/10.1016/S0278-2626(03)00276-8 Buckholtz, J. W., & Meyer-Lindenberg, A. (2008). MAOA and the neurogenetic architecture of human aggression. ''Trends in Neurosciences'', ''31''(3), 120–129. https://doi.org/10.1016/j.tins.2007.12.006 Eckardt, M., File, S., Gessa, G., Grant, K., Guerri, C., Hoffman, P., & Tabakoff, B. (1998). Effects of moderate alcohol consumption on the central nervous system. ''Alcoholism, Clinical and Experimental Research'', ''22''(5), 998–1040. https://doi.org/10.1111/j.1530-0277.1998.tb03695.x }} {{tip|Suggestions for this section: * Important aspects for APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except first letter and proper names, ending in a full-stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full-stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't actually read or consulted }} ==External links== Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * [https://students.unimelb.edu.au/academic-skills/explore-our-resources/essay-writing/six-top-tips-for-writing-a-great-essay Six top tips for writing a great essay] (University of Melbourne) * [http://www.skillsyouneed.com/write/structure.html The importance of structure] (skillsyouneed.com) {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] {{METP}} ==See also== * [[Motivation and emotion/Book/2021/Climate change helplessness|Climate change helplessness]] (Book chapter, 2021) n2eepcz2xtvb8isnib2xpcueu23vv1v 2419271 2419264 2022-08-26T04:39:17Z 137.92.227.15 /* Overview */ wikitext text/x-wiki {{title|Climate change helplessness - How does learned helpless impact motivation to engage in behaviours to limit climate change? }} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== You are underway {{smile}}! This template provides tips for [[Motivation and emotion/Assessment/Topic|topic development]]. Gradually remove these suggestions as you develop the chapter. Also consult the [[Motivation and emotion/Assessment/Chapter|author guidelines]]. At the top of the chapter, the title and sub-title should match the ''exact'' wording and casing as shown in the {{Motivation and emotion/Book}}. The sub-titles all end with a question mark. This Overview section should be concise but consist of several paragraphs which engage the reader, illustrate the problem, and outline how psychological science can help. {{RoundBoxTop|theme=3}} '''Focus questions:''' * What is the first focus question? * What is the second focus question? * What is the third focus question? {{RoundBoxBottom}} {{tip| Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Provide an example or case study. * Conclude with Focus questions to guide the chapter. }} ==What is Climate Change?== How you are going to structure the chapter? Aim for three to six main headings between the [[#Overview|Overview]] and [[#Conclusion|Conclusion]]. === Behaviours that limit climate change === == What is Helplessness? == ss === Learned helplessness === {{tip|Suggestions for this section: * For the [[Motivation and emotion/Assessment/Topic|topic development]], provide at least 3 bullet-points about key content per section. Include key citations. * For the [[Motivation and emotion/Assessment/Chapter|book chapter]], expand the bullet points into paragraphs. * If a section has a lot of content, arrange it into two to five sub-headings such as in the [[#Interactive learning features|interactive learning features section]]. Avoid having sections with only one sub-heading. }} ==Learning features== What brings an online book chapter to life are its interactive learning features. Case studies, feature boxes, figures, links, tables, and quiz questions can be used throughout the chapter. ===Case studies=== Case studies describe real-world examples of concepts in action. Case studies can be real or fictional. A case could be used multiple times during a chapter to illustrate different theories or stages. It is often helpful to present case studies using [[#Feature boxes|feature boxes]]. ===Boxes=== Boxes can be used to highlight content, but don't overuse them. There are many different ways of creating boxes (e.g., see [[Help:Pretty boxes|Pretty boxes]]). Possible uses include: * Focus questions * Case studies or examples * Quiz questions * Take-home messages {{RoundBoxTop|theme=3}} ;Feature box example * Shaded background * Coloured border {{RoundBoxBottom}} ===Figures=== [[File:Monkey-typing.jpg|right|205px|thumb|''Figure 1''. Example image with descriptive caption.]] Use figures to illustrate concepts, add interest, and provide examples. Figures can be used to show photographs, drawings, diagrams, graphs, etcetera. Figures can be embedded throughout the chapter, starting with the Overview section. Figures should be captioned (using a number and a description) in order to explain their relevance to the text. Possible images can be found at [[commons:|Wikimedia Commons]]. Images can also be uploaded if they are licensed for re-use or if you created the image. Each figure should be referred to at least once in the main text (e.g., see Figure 1). ===Links=== Where key words are first used, make them into [[Help:Links|interwiki links]] such as Wikipedia links to articles about famous people (e.g., [[w:Sigmund Freud|Sigmund Freud]] and key concepts (e.g., [[w:Dreams|dreams]]) and links to book chapters about related topics (e.g., would you like to learn about how to overcome [[Motivation and emotion/Book/2020/Writer's block|writer's block]]?). ===Tables=== Tables can be an effective way to organise and summarise information. Tables should be captioned (using APA style) to explain their relevance to the text. Plus each table should be referred to at least once in the main text (e.g., see Table 1 and Table 2). Here are some [[Motivation and emotion/Wikiversity/Tables|example 3 x 3 tables]] which could be adapted. ===Quizzes=== Quizzes are a direct way to engage readers. But don't make quizzes too hard or long. It is better to have one or two review questions per major section than a long quiz at the end. Try to quiz conceptual understanding, rather than trivia. Here are some simple quiz questions which could be adapted. Choose the correct answers and click "Submit": <quiz display=simple> {Quizzes are an interactive learning feature: |type="()"} + True - False {Long quizzes are a good idea: |type="()"} - True + False </quiz> To learn about different types of quiz questions, see [[Help:Quiz|Quiz]]. ==Conclusion== The Conclusion is arguably the most important section. It should be possible for someone to read the [[#Overview|Overview]] and the Conclusion and still get a good idea of the topic. {{tip|Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? }} ==See also== Provide up to half-a-dozen [[Help:Contents/Links#Interwiki_links|internal (wiki) links]] to relevant Wikiversity pages (esp. related [[Motivation and emotion/Book|motivation and emotion book chapters]]) and [[w:|Wikipedia articles]]. For example: * [[Motivation and emotion/Book/2016/Anorexia nervosa and extrinsic motivation|Anorexia nervosa and extrinsic motivation]] (Book chapter, 2016) * [[w:David McClelland|David McClelland]] (Wikipedia) * [[Motivation and emotion/Book/2018/Loss aversion|Loss aversion]] (Book chapter, 2018) * [[w:Maslow's hierarchy of needs|Maslow's hierarchy of needs]] (Wikipedia) {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== List the cited references in [[w:APA style|APA style]] (7th ed.) or [[w:Wikipedia:Citing sources|wiki style]]. APA style example: {{Hanging indent|1= Blair, R. J. R. (2004). The roles of orbital frontal cortex in the modulation of antisocial behavior. ''Brain and Cognition'', ''55''(1), 198–208. https://doi.org/10.1016/S0278-2626(03)00276-8 Buckholtz, J. W., & Meyer-Lindenberg, A. (2008). MAOA and the neurogenetic architecture of human aggression. ''Trends in Neurosciences'', ''31''(3), 120–129. https://doi.org/10.1016/j.tins.2007.12.006 Eckardt, M., File, S., Gessa, G., Grant, K., Guerri, C., Hoffman, P., & Tabakoff, B. (1998). Effects of moderate alcohol consumption on the central nervous system. ''Alcoholism, Clinical and Experimental Research'', ''22''(5), 998–1040. https://doi.org/10.1111/j.1530-0277.1998.tb03695.x }} {{tip|Suggestions for this section: * Important aspects for APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except first letter and proper names, ending in a full-stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full-stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't actually read or consulted }} ==External links== Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * [https://students.unimelb.edu.au/academic-skills/explore-our-resources/essay-writing/six-top-tips-for-writing-a-great-essay Six top tips for writing a great essay] (University of Melbourne) * [http://www.skillsyouneed.com/write/structure.html The importance of structure] (skillsyouneed.com) {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] {{METP}} ==See also== * [[Motivation and emotion/Book/2021/Climate change helplessness|Climate change helplessness]] (Book chapter, 2021) 727qh7snw4bslhadltols4uyog53xft 2419332 2419271 2022-08-26T06:46:47Z Jtneill 10242 + categories wikitext text/x-wiki {{title|Climate change helplessness:<br>How does learned helpless impact motivation to engage in behaviours to limit climate change?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== You are underway {{smile}}! This template provides tips for [[Motivation and emotion/Assessment/Topic|topic development]]. Gradually remove these suggestions as you develop the chapter. Also consult the [[Motivation and emotion/Assessment/Chapter|author guidelines]]. At the top of the chapter, the title and sub-title should match the ''exact'' wording and casing as shown in the {{Motivation and emotion/Book}}. The sub-titles all end with a question mark. This Overview section should be concise but consist of several paragraphs which engage the reader, illustrate the problem, and outline how psychological science can help. {{RoundBoxTop|theme=3}} '''Focus questions:''' * What is the first focus question? * What is the second focus question? * What is the third focus question? {{RoundBoxBottom}} {{tip| Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Provide an example or case study. * Conclude with Focus questions to guide the chapter. }} ==What is Climate Change?== How you are going to structure the chapter? Aim for three to six main headings between the [[#Overview|Overview]] and [[#Conclusion|Conclusion]]. === Behaviours that limit climate change === == What is Helplessness? == ss === Learned helplessness === {{tip|Suggestions for this section: * For the [[Motivation and emotion/Assessment/Topic|topic development]], provide at least 3 bullet-points about key content per section. Include key citations. * For the [[Motivation and emotion/Assessment/Chapter|book chapter]], expand the bullet points into paragraphs. * If a section has a lot of content, arrange it into two to five sub-headings such as in the [[#Interactive learning features|interactive learning features section]]. Avoid having sections with only one sub-heading. }} ==Learning features== What brings an online book chapter to life are its interactive learning features. Case studies, feature boxes, figures, links, tables, and quiz questions can be used throughout the chapter. ===Case studies=== Case studies describe real-world examples of concepts in action. Case studies can be real or fictional. A case could be used multiple times during a chapter to illustrate different theories or stages. It is often helpful to present case studies using [[#Feature boxes|feature boxes]]. ===Boxes=== Boxes can be used to highlight content, but don't overuse them. There are many different ways of creating boxes (e.g., see [[Help:Pretty boxes|Pretty boxes]]). Possible uses include: * Focus questions * Case studies or examples * Quiz questions * Take-home messages {{RoundBoxTop|theme=3}} ;Feature box example * Shaded background * Coloured border {{RoundBoxBottom}} ===Figures=== [[File:Monkey-typing.jpg|right|205px|thumb|''Figure 1''. Example image with descriptive caption.]] Use figures to illustrate concepts, add interest, and provide examples. Figures can be used to show photographs, drawings, diagrams, graphs, etcetera. Figures can be embedded throughout the chapter, starting with the Overview section. Figures should be captioned (using a number and a description) in order to explain their relevance to the text. Possible images can be found at [[commons:|Wikimedia Commons]]. Images can also be uploaded if they are licensed for re-use or if you created the image. Each figure should be referred to at least once in the main text (e.g., see Figure 1). ===Links=== Where key words are first used, make them into [[Help:Links|interwiki links]] such as Wikipedia links to articles about famous people (e.g., [[w:Sigmund Freud|Sigmund Freud]] and key concepts (e.g., [[w:Dreams|dreams]]) and links to book chapters about related topics (e.g., would you like to learn about how to overcome [[Motivation and emotion/Book/2020/Writer's block|writer's block]]?). ===Tables=== Tables can be an effective way to organise and summarise information. Tables should be captioned (using APA style) to explain their relevance to the text. Plus each table should be referred to at least once in the main text (e.g., see Table 1 and Table 2). Here are some [[Motivation and emotion/Wikiversity/Tables|example 3 x 3 tables]] which could be adapted. ===Quizzes=== Quizzes are a direct way to engage readers. But don't make quizzes too hard or long. It is better to have one or two review questions per major section than a long quiz at the end. Try to quiz conceptual understanding, rather than trivia. Here are some simple quiz questions which could be adapted. Choose the correct answers and click "Submit": <quiz display=simple> {Quizzes are an interactive learning feature: |type="()"} + True - False {Long quizzes are a good idea: |type="()"} - True + False </quiz> To learn about different types of quiz questions, see [[Help:Quiz|Quiz]]. ==Conclusion== The Conclusion is arguably the most important section. It should be possible for someone to read the [[#Overview|Overview]] and the Conclusion and still get a good idea of the topic. {{tip|Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? }} ==See also== * [[Motivation and emotion/Book/2021/Climate change helplessness|Climate change helplessness]] (Book chapter, 2021) Provide up to half-a-dozen [[Help:Contents/Links#Interwiki_links|internal (wiki) links]] to relevant Wikiversity pages (esp. related [[Motivation and emotion/Book|motivation and emotion book chapters]]) and [[w:|Wikipedia articles]]. For example: * [[Motivation and emotion/Book/2016/Anorexia nervosa and extrinsic motivation|Anorexia nervosa and extrinsic motivation]] (Book chapter, 2016) * [[w:David McClelland|David McClelland]] (Wikipedia) * [[Motivation and emotion/Book/2018/Loss aversion|Loss aversion]] (Book chapter, 2018) * [[w:Maslow's hierarchy of needs|Maslow's hierarchy of needs]] (Wikipedia) {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== List the cited references in [[w:APA style|APA style]] (7th ed.) or [[w:Wikipedia:Citing sources|wiki style]]. APA style example: {{Hanging indent|1= Blair, R. J. R. (2004). The roles of orbital frontal cortex in the modulation of antisocial behavior. ''Brain and Cognition'', ''55''(1), 198–208. https://doi.org/10.1016/S0278-2626(03)00276-8 Buckholtz, J. W., & Meyer-Lindenberg, A. (2008). MAOA and the neurogenetic architecture of human aggression. ''Trends in Neurosciences'', ''31''(3), 120–129. https://doi.org/10.1016/j.tins.2007.12.006 Eckardt, M., File, S., Gessa, G., Grant, K., Guerri, C., Hoffman, P., & Tabakoff, B. (1998). Effects of moderate alcohol consumption on the central nervous system. ''Alcoholism, Clinical and Experimental Research'', ''22''(5), 998–1040. https://doi.org/10.1111/j.1530-0277.1998.tb03695.x }} {{tip|Suggestions for this section: * Important aspects for APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except first letter and proper names, ending in a full-stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full-stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't actually read or consulted }} ==External links== Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * [https://students.unimelb.edu.au/academic-skills/explore-our-resources/essay-writing/six-top-tips-for-writing-a-great-essay Six top tips for writing a great essay] (University of Melbourne) * [http://www.skillsyouneed.com/write/structure.html The importance of structure] (skillsyouneed.com) {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] [[Category:Motivation and emotion/Book/Climate change]] [[Category:Motivation and emotion/Book/Helplessness]] dmg1djgc24mofo2cky0skhafixuq5kt 2419340 2419332 2022-08-26T07:01:52Z U3215976 2947554 Spelling fix in the main title. wikitext text/x-wiki {{title|Climate change helplessness:<br>How does learned helplessness impact motivation to engage in behaviours to limit climate change?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== You are underway {{smile}}! This template provides tips for [[Motivation and emotion/Assessment/Topic|topic development]]. Gradually remove these suggestions as you develop the chapter. Also consult the [[Motivation and emotion/Assessment/Chapter|author guidelines]]. At the top of the chapter, the title and sub-title should match the ''exact'' wording and casing as shown in the {{Motivation and emotion/Book}}. The sub-titles all end with a question mark. This Overview section should be concise but consist of several paragraphs which engage the reader, illustrate the problem, and outline how psychological science can help. {{RoundBoxTop|theme=3}} '''Focus questions:''' * What is the first focus question? * What is the second focus question? * What is the third focus question? {{RoundBoxBottom}} {{tip| Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Provide an example or case study. * Conclude with Focus questions to guide the chapter. }} ==What is Climate Change?== How you are going to structure the chapter? Aim for three to six main headings between the [[#Overview|Overview]] and [[#Conclusion|Conclusion]]. === Behaviours that limit climate change === == What is Helplessness? == ss === Learned helplessness === {{tip|Suggestions for this section: * For the [[Motivation and emotion/Assessment/Topic|topic development]], provide at least 3 bullet-points about key content per section. Include key citations. * For the [[Motivation and emotion/Assessment/Chapter|book chapter]], expand the bullet points into paragraphs. * If a section has a lot of content, arrange it into two to five sub-headings such as in the [[#Interactive learning features|interactive learning features section]]. Avoid having sections with only one sub-heading. }} ==Learning features== What brings an online book chapter to life are its interactive learning features. Case studies, feature boxes, figures, links, tables, and quiz questions can be used throughout the chapter. ===Case studies=== Case studies describe real-world examples of concepts in action. Case studies can be real or fictional. A case could be used multiple times during a chapter to illustrate different theories or stages. It is often helpful to present case studies using [[#Feature boxes|feature boxes]]. ===Boxes=== Boxes can be used to highlight content, but don't overuse them. There are many different ways of creating boxes (e.g., see [[Help:Pretty boxes|Pretty boxes]]). Possible uses include: * Focus questions * Case studies or examples * Quiz questions * Take-home messages {{RoundBoxTop|theme=3}} ;Feature box example * Shaded background * Coloured border {{RoundBoxBottom}} ===Figures=== [[File:Monkey-typing.jpg|right|205px|thumb|''Figure 1''. Example image with descriptive caption.]] Use figures to illustrate concepts, add interest, and provide examples. Figures can be used to show photographs, drawings, diagrams, graphs, etcetera. Figures can be embedded throughout the chapter, starting with the Overview section. Figures should be captioned (using a number and a description) in order to explain their relevance to the text. Possible images can be found at [[commons:|Wikimedia Commons]]. Images can also be uploaded if they are licensed for re-use or if you created the image. Each figure should be referred to at least once in the main text (e.g., see Figure 1). ===Links=== Where key words are first used, make them into [[Help:Links|interwiki links]] such as Wikipedia links to articles about famous people (e.g., [[w:Sigmund Freud|Sigmund Freud]] and key concepts (e.g., [[w:Dreams|dreams]]) and links to book chapters about related topics (e.g., would you like to learn about how to overcome [[Motivation and emotion/Book/2020/Writer's block|writer's block]]?). ===Tables=== Tables can be an effective way to organise and summarise information. Tables should be captioned (using APA style) to explain their relevance to the text. Plus each table should be referred to at least once in the main text (e.g., see Table 1 and Table 2). Here are some [[Motivation and emotion/Wikiversity/Tables|example 3 x 3 tables]] which could be adapted. ===Quizzes=== Quizzes are a direct way to engage readers. But don't make quizzes too hard or long. It is better to have one or two review questions per major section than a long quiz at the end. Try to quiz conceptual understanding, rather than trivia. Here are some simple quiz questions which could be adapted. Choose the correct answers and click "Submit": <quiz display=simple> {Quizzes are an interactive learning feature: |type="()"} + True - False {Long quizzes are a good idea: |type="()"} - True + False </quiz> To learn about different types of quiz questions, see [[Help:Quiz|Quiz]]. ==Conclusion== The Conclusion is arguably the most important section. It should be possible for someone to read the [[#Overview|Overview]] and the Conclusion and still get a good idea of the topic. {{tip|Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? }} ==See also== * [[Motivation and emotion/Book/2021/Climate change helplessness|Climate change helplessness]] (Book chapter, 2021) Provide up to half-a-dozen [[Help:Contents/Links#Interwiki_links|internal (wiki) links]] to relevant Wikiversity pages (esp. related [[Motivation and emotion/Book|motivation and emotion book chapters]]) and [[w:|Wikipedia articles]]. For example: * [[Motivation and emotion/Book/2016/Anorexia nervosa and extrinsic motivation|Anorexia nervosa and extrinsic motivation]] (Book chapter, 2016) * [[w:David McClelland|David McClelland]] (Wikipedia) * [[Motivation and emotion/Book/2018/Loss aversion|Loss aversion]] (Book chapter, 2018) * [[w:Maslow's hierarchy of needs|Maslow's hierarchy of needs]] (Wikipedia) {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== List the cited references in [[w:APA style|APA style]] (7th ed.) or [[w:Wikipedia:Citing sources|wiki style]]. APA style example: {{Hanging indent|1= Blair, R. J. R. (2004). The roles of orbital frontal cortex in the modulation of antisocial behavior. ''Brain and Cognition'', ''55''(1), 198–208. https://doi.org/10.1016/S0278-2626(03)00276-8 Buckholtz, J. W., & Meyer-Lindenberg, A. (2008). MAOA and the neurogenetic architecture of human aggression. ''Trends in Neurosciences'', ''31''(3), 120–129. https://doi.org/10.1016/j.tins.2007.12.006 Eckardt, M., File, S., Gessa, G., Grant, K., Guerri, C., Hoffman, P., & Tabakoff, B. (1998). Effects of moderate alcohol consumption on the central nervous system. ''Alcoholism, Clinical and Experimental Research'', ''22''(5), 998–1040. https://doi.org/10.1111/j.1530-0277.1998.tb03695.x }} {{tip|Suggestions for this section: * Important aspects for APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except first letter and proper names, ending in a full-stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full-stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't actually read or consulted }} ==External links== Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * [https://students.unimelb.edu.au/academic-skills/explore-our-resources/essay-writing/six-top-tips-for-writing-a-great-essay Six top tips for writing a great essay] (University of Melbourne) * [http://www.skillsyouneed.com/write/structure.html The importance of structure] (skillsyouneed.com) {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] [[Category:Motivation and emotion/Book/Climate change]] [[Category:Motivation and emotion/Book/Helplessness]] 0vw2gozwqjlhxhk5kv9p1gnbz3oqi9v 2419344 2419340 2022-08-26T07:08:23Z U3215976 2947554 /* Behaviours that limit climate change */ wikitext text/x-wiki {{title|Climate change helplessness:<br>How does learned helplessness impact motivation to engage in behaviours to limit climate change?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== You are underway {{smile}}! This template provides tips for [[Motivation and emotion/Assessment/Topic|topic development]]. Gradually remove these suggestions as you develop the chapter. Also consult the [[Motivation and emotion/Assessment/Chapter|author guidelines]]. At the top of the chapter, the title and sub-title should match the ''exact'' wording and casing as shown in the {{Motivation and emotion/Book}}. The sub-titles all end with a question mark. This Overview section should be concise but consist of several paragraphs which engage the reader, illustrate the problem, and outline how psychological science can help. {{RoundBoxTop|theme=3}} '''Focus questions:''' * What is the first focus question? * What is the second focus question? * What is the third focus question? {{RoundBoxBottom}} {{tip| Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Provide an example or case study. * Conclude with Focus questions to guide the chapter. }} ==What is Climate Change?== How you are going to structure the chapter? Aim for three to six main headings between the [[#Overview|Overview]] and [[#Conclusion|Conclusion]]. === Behaviours that limit climate change === == What is Helplessness? == == Impacts of learned helplessness on Motivation == ss === Learned helplessness === {{tip|Suggestions for this section: * For the [[Motivation and emotion/Assessment/Topic|topic development]], provide at least 3 bullet-points about key content per section. Include key citations. * For the [[Motivation and emotion/Assessment/Chapter|book chapter]], expand the bullet points into paragraphs. * If a section has a lot of content, arrange it into two to five sub-headings such as in the [[#Interactive learning features|interactive learning features section]]. Avoid having sections with only one sub-heading. }} ==Learning features== What brings an online book chapter to life are its interactive learning features. Case studies, feature boxes, figures, links, tables, and quiz questions can be used throughout the chapter. ===Case studies=== Case studies describe real-world examples of concepts in action. Case studies can be real or fictional. A case could be used multiple times during a chapter to illustrate different theories or stages. It is often helpful to present case studies using [[#Feature boxes|feature boxes]]. ===Boxes=== Boxes can be used to highlight content, but don't overuse them. There are many different ways of creating boxes (e.g., see [[Help:Pretty boxes|Pretty boxes]]). Possible uses include: * Focus questions * Case studies or examples * Quiz questions * Take-home messages {{RoundBoxTop|theme=3}} ;Feature box example * Shaded background * Coloured border {{RoundBoxBottom}} ===Figures=== [[File:Monkey-typing.jpg|right|205px|thumb|''Figure 1''. Example image with descriptive caption.]] Use figures to illustrate concepts, add interest, and provide examples. Figures can be used to show photographs, drawings, diagrams, graphs, etcetera. Figures can be embedded throughout the chapter, starting with the Overview section. Figures should be captioned (using a number and a description) in order to explain their relevance to the text. Possible images can be found at [[commons:|Wikimedia Commons]]. Images can also be uploaded if they are licensed for re-use or if you created the image. Each figure should be referred to at least once in the main text (e.g., see Figure 1). ===Links=== Where key words are first used, make them into [[Help:Links|interwiki links]] such as Wikipedia links to articles about famous people (e.g., [[w:Sigmund Freud|Sigmund Freud]] and key concepts (e.g., [[w:Dreams|dreams]]) and links to book chapters about related topics (e.g., would you like to learn about how to overcome [[Motivation and emotion/Book/2020/Writer's block|writer's block]]?). ===Tables=== Tables can be an effective way to organise and summarise information. Tables should be captioned (using APA style) to explain their relevance to the text. Plus each table should be referred to at least once in the main text (e.g., see Table 1 and Table 2). Here are some [[Motivation and emotion/Wikiversity/Tables|example 3 x 3 tables]] which could be adapted. ===Quizzes=== Quizzes are a direct way to engage readers. But don't make quizzes too hard or long. It is better to have one or two review questions per major section than a long quiz at the end. Try to quiz conceptual understanding, rather than trivia. Here are some simple quiz questions which could be adapted. Choose the correct answers and click "Submit": <quiz display=simple> {Quizzes are an interactive learning feature: |type="()"} + True - False {Long quizzes are a good idea: |type="()"} - True + False </quiz> To learn about different types of quiz questions, see [[Help:Quiz|Quiz]]. ==Conclusion== The Conclusion is arguably the most important section. It should be possible for someone to read the [[#Overview|Overview]] and the Conclusion and still get a good idea of the topic. {{tip|Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? }} ==See also== * [[Motivation and emotion/Book/2021/Climate change helplessness|Climate change helplessness]] (Book chapter, 2021) Provide up to half-a-dozen [[Help:Contents/Links#Interwiki_links|internal (wiki) links]] to relevant Wikiversity pages (esp. related [[Motivation and emotion/Book|motivation and emotion book chapters]]) and [[w:|Wikipedia articles]]. For example: * [[Motivation and emotion/Book/2016/Anorexia nervosa and extrinsic motivation|Anorexia nervosa and extrinsic motivation]] (Book chapter, 2016) * [[w:David McClelland|David McClelland]] (Wikipedia) * [[Motivation and emotion/Book/2018/Loss aversion|Loss aversion]] (Book chapter, 2018) * [[w:Maslow's hierarchy of needs|Maslow's hierarchy of needs]] (Wikipedia) {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== List the cited references in [[w:APA style|APA style]] (7th ed.) or [[w:Wikipedia:Citing sources|wiki style]]. APA style example: {{Hanging indent|1= Blair, R. J. R. (2004). The roles of orbital frontal cortex in the modulation of antisocial behavior. ''Brain and Cognition'', ''55''(1), 198–208. https://doi.org/10.1016/S0278-2626(03)00276-8 Buckholtz, J. W., & Meyer-Lindenberg, A. (2008). MAOA and the neurogenetic architecture of human aggression. ''Trends in Neurosciences'', ''31''(3), 120–129. https://doi.org/10.1016/j.tins.2007.12.006 Eckardt, M., File, S., Gessa, G., Grant, K., Guerri, C., Hoffman, P., & Tabakoff, B. (1998). Effects of moderate alcohol consumption on the central nervous system. ''Alcoholism, Clinical and Experimental Research'', ''22''(5), 998–1040. https://doi.org/10.1111/j.1530-0277.1998.tb03695.x }} {{tip|Suggestions for this section: * Important aspects for APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except first letter and proper names, ending in a full-stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full-stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't actually read or consulted }} ==External links== Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * [https://students.unimelb.edu.au/academic-skills/explore-our-resources/essay-writing/six-top-tips-for-writing-a-great-essay Six top tips for writing a great essay] (University of Melbourne) * [http://www.skillsyouneed.com/write/structure.html The importance of structure] (skillsyouneed.com) {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] [[Category:Motivation and emotion/Book/Climate change]] [[Category:Motivation and emotion/Book/Helplessness]] fc9qxb4szxd9rma7ocwdkm9tstgh7w1 2419347 2419344 2022-08-26T07:11:26Z U3215976 2947554 Potential Focus Questions wikitext text/x-wiki {{title|Climate change helplessness:<br>How does learned helplessness impact motivation to engage in behaviours to limit climate change?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== You are underway {{smile}}! This template provides tips for [[Motivation and emotion/Assessment/Topic|topic development]]. Gradually remove these suggestions as you develop the chapter. Also consult the [[Motivation and emotion/Assessment/Chapter|author guidelines]]. At the top of the chapter, the title and sub-title should match the ''exact'' wording and casing as shown in the {{Motivation and emotion/Book}}. The sub-titles all end with a question mark. This Overview section should be concise but consist of several paragraphs which engage the reader, illustrate the problem, and outline how psychological science can help. {{RoundBoxTop|theme=3}} '''Focus questions:''' * What causes learned helplessness? * What are the impacts of learned helplessness on motivation? * What effect does learned helplessness have on positive climate behaviors? {{RoundBoxBottom}} {{tip| Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Provide an example or case study. * Conclude with Focus questions to guide the chapter. }} ==What is Climate Change?== How you are going to structure the chapter? Aim for three to six main headings between the [[#Overview|Overview]] and [[#Conclusion|Conclusion]]. === Behaviours that limit climate change === == What is Helplessness? == == Impacts of learned helplessness on Motivation == ss === Learned helplessness === {{tip|Suggestions for this section: * For the [[Motivation and emotion/Assessment/Topic|topic development]], provide at least 3 bullet-points about key content per section. Include key citations. * For the [[Motivation and emotion/Assessment/Chapter|book chapter]], expand the bullet points into paragraphs. * If a section has a lot of content, arrange it into two to five sub-headings such as in the [[#Interactive learning features|interactive learning features section]]. Avoid having sections with only one sub-heading. }} ==Learning features== What brings an online book chapter to life are its interactive learning features. Case studies, feature boxes, figures, links, tables, and quiz questions can be used throughout the chapter. ===Case studies=== Case studies describe real-world examples of concepts in action. Case studies can be real or fictional. A case could be used multiple times during a chapter to illustrate different theories or stages. It is often helpful to present case studies using [[#Feature boxes|feature boxes]]. ===Boxes=== Boxes can be used to highlight content, but don't overuse them. There are many different ways of creating boxes (e.g., see [[Help:Pretty boxes|Pretty boxes]]). Possible uses include: * Focus questions * Case studies or examples * Quiz questions * Take-home messages {{RoundBoxTop|theme=3}} ;Feature box example * Shaded background * Coloured border {{RoundBoxBottom}} ===Figures=== [[File:Monkey-typing.jpg|right|205px|thumb|''Figure 1''. Example image with descriptive caption.]] Use figures to illustrate concepts, add interest, and provide examples. Figures can be used to show photographs, drawings, diagrams, graphs, etcetera. Figures can be embedded throughout the chapter, starting with the Overview section. Figures should be captioned (using a number and a description) in order to explain their relevance to the text. Possible images can be found at [[commons:|Wikimedia Commons]]. Images can also be uploaded if they are licensed for re-use or if you created the image. Each figure should be referred to at least once in the main text (e.g., see Figure 1). ===Links=== Where key words are first used, make them into [[Help:Links|interwiki links]] such as Wikipedia links to articles about famous people (e.g., [[w:Sigmund Freud|Sigmund Freud]] and key concepts (e.g., [[w:Dreams|dreams]]) and links to book chapters about related topics (e.g., would you like to learn about how to overcome [[Motivation and emotion/Book/2020/Writer's block|writer's block]]?). ===Tables=== Tables can be an effective way to organise and summarise information. Tables should be captioned (using APA style) to explain their relevance to the text. Plus each table should be referred to at least once in the main text (e.g., see Table 1 and Table 2). Here are some [[Motivation and emotion/Wikiversity/Tables|example 3 x 3 tables]] which could be adapted. ===Quizzes=== Quizzes are a direct way to engage readers. But don't make quizzes too hard or long. It is better to have one or two review questions per major section than a long quiz at the end. Try to quiz conceptual understanding, rather than trivia. Here are some simple quiz questions which could be adapted. Choose the correct answers and click "Submit": <quiz display=simple> {Quizzes are an interactive learning feature: |type="()"} + True - False {Long quizzes are a good idea: |type="()"} - True + False </quiz> To learn about different types of quiz questions, see [[Help:Quiz|Quiz]]. ==Conclusion== The Conclusion is arguably the most important section. It should be possible for someone to read the [[#Overview|Overview]] and the Conclusion and still get a good idea of the topic. {{tip|Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? }} ==See also== * [[Motivation and emotion/Book/2021/Climate change helplessness|Climate change helplessness]] (Book chapter, 2021) Provide up to half-a-dozen [[Help:Contents/Links#Interwiki_links|internal (wiki) links]] to relevant Wikiversity pages (esp. related [[Motivation and emotion/Book|motivation and emotion book chapters]]) and [[w:|Wikipedia articles]]. For example: * [[Motivation and emotion/Book/2016/Anorexia nervosa and extrinsic motivation|Anorexia nervosa and extrinsic motivation]] (Book chapter, 2016) * [[w:David McClelland|David McClelland]] (Wikipedia) * [[Motivation and emotion/Book/2018/Loss aversion|Loss aversion]] (Book chapter, 2018) * [[w:Maslow's hierarchy of needs|Maslow's hierarchy of needs]] (Wikipedia) {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== List the cited references in [[w:APA style|APA style]] (7th ed.) or [[w:Wikipedia:Citing sources|wiki style]]. APA style example: {{Hanging indent|1= Blair, R. J. R. (2004). The roles of orbital frontal cortex in the modulation of antisocial behavior. ''Brain and Cognition'', ''55''(1), 198–208. https://doi.org/10.1016/S0278-2626(03)00276-8 Buckholtz, J. W., & Meyer-Lindenberg, A. (2008). MAOA and the neurogenetic architecture of human aggression. ''Trends in Neurosciences'', ''31''(3), 120–129. https://doi.org/10.1016/j.tins.2007.12.006 Eckardt, M., File, S., Gessa, G., Grant, K., Guerri, C., Hoffman, P., & Tabakoff, B. (1998). Effects of moderate alcohol consumption on the central nervous system. ''Alcoholism, Clinical and Experimental Research'', ''22''(5), 998–1040. https://doi.org/10.1111/j.1530-0277.1998.tb03695.x }} {{tip|Suggestions for this section: * Important aspects for APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except first letter and proper names, ending in a full-stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full-stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't actually read or consulted }} ==External links== Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * [https://students.unimelb.edu.au/academic-skills/explore-our-resources/essay-writing/six-top-tips-for-writing-a-great-essay Six top tips for writing a great essay] (University of Melbourne) * [http://www.skillsyouneed.com/write/structure.html The importance of structure] (skillsyouneed.com) {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] [[Category:Motivation and emotion/Book/Climate change]] [[Category:Motivation and emotion/Book/Helplessness]] 76pd53fwbt4yna5rcnud4ir8h2b6jfi 0 279846 2419188 2418697 2022-08-26T02:25:57Z U3216563 2947577 Heading Casing edit wikitext text/x-wiki {{METP}} [[File:Christian herald and signs of our times (1895) (14785180155).jpg|alt=Picture of civilians donating clothes and supplies to Volunteer Distributors|thumb|Figure 1. Volunteer Distributors receiving clothing and supplies across Ne-Braska and Kansas]] {{title|Chapter title:<br>Subtitle?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== * Define beneficence and it's correlation to psychological well-being * Briefly outline self determination theory * Briefly explain how beneficence impacts both the beneficence and the giver's well-being * Briefly explain different effects of beneficence in relationships & community * Explain how beneficence can contribute to an individual's motivation You are underway {{smile}}! This template provides tips for [[Motivation and emotion/Assessment/Topic|topic development]]. Gradually remove these suggestions as you develop the chapter. Also consult the [[Motivation and emotion/Assessment/Chapter|author guidelines]]. At the top of the chapter, the title and sub-title should match the ''exact'' wording and casing as shown in the {{Motivation and emotion/Book}}. The sub-titles all end with a question mark. This Overview section should be concise but consist of several paragraphs which engage the reader, illustrate the problem, and outline how psychological science can help. {{RoundBoxTop|theme=3}} '''Focus questions:''' * What is the first focus question? * What is the second focus question? * What is the third focus question? {{RoundBoxBottom}} {{tip| Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Provide an example or case study. * Conclude with Focus questions to guide the chapter. }} ==What is Beneficence?== * Giving to others ** Charity ** Friends How you are going to structure the chapter? Aim for three to six main headings between the [[#Overview|Overview]] and [[#Conclusion|Conclusion]]. == Beneficence as a Motivator == === Extrinsic Motivation === === Intrinsic Motivation === {{tip|Suggestions for this section: * For the [[Motivation and emotion/Assessment/Topic|topic development]], provide at least 3 bullet-points about key content per section. Include key citations. * For the [[Motivation and emotion/Assessment/Chapter|book chapter]], expand the bullet points into paragraphs. * If a section has a lot of content, arrange it into two to five sub-headings such as in the [[#Interactive learning features|interactive learning features section]]. Avoid having sections with only one sub-heading. }} ==Self-determination theory== * Self-determination theory ** Theory suggests people become self-determined when their universal psychological needs are met{{citation needed}} * Like physical needs, these psychological needs are considered an objective phenomena where deprivation or satisfaction of needs have significant and measurable effects on the individual. * Conceptualise needs at the psychological level Key assumptions of the theory * People are actively directed towards growth{{citation needed}}. Taking in new experiences and gaining skills are essential for developing a sense of self What brings an online book chapter to life are its interactive learning features. Case studies, feature boxes, figures, links, tables, and quiz questions can be used throughout the chapter. ===Autonomy=== Autonomy: feel in control of behaviours and goals{{citation needed}} Case studies describe real-world examples of concepts in action. Case studies can be real or fictional. A case could be used multiple times during a chapter to illustrate different theories or stages. It is often helpful to present case studies using [[#Feature boxes|feature boxes]]. ===Competence=== Competence: gain mastery of tasks and learn different skills Boxes can be used to highlight content, but don't overuse them. There are many different ways of creating boxes (e.g., see [[Help:Pretty boxes|Pretty boxes]]). Possible uses include: * Focus questions * Case studies or examples * Quiz questions * Take-home messages {{RoundBoxTop|theme=3}} ;Feature box example * Shaded background * Coloured border {{RoundBoxBottom}} ===Relatedness=== Connection or relatedness: experience a sense of belonging and attachment to other people{{citation needed}} [[File:Monkey-typing.jpg|right|205px|thumb|''Figure 1''. Example image with descriptive caption.]] Use figures to illustrate concepts, add interest, and provide examples. Figures can be used to show photographs, drawings, diagrams, graphs, etcetera. Figures can be embedded throughout the chapter, starting with the Overview section. Figures should be captioned (using a number and a description) in order to explain their relevance to the text. Possible images can be found at [[commons:|Wikimedia Commons]]. Images can also be uploaded if they are licensed for re-use or if you created the image. Each figure should be referred to at least once in the main text (e.g., see Figure 1). == Beneficence in Different Settings == Where key words are first used, make them into [[Help:Links|interwiki links]] such as Wikipedia links to articles about famous people (e.g., [[w:Sigmund Freud|Sigmund Freud]] and key concepts (e.g., [[w:Dreams|dreams]]) and links to book chapters about related topics (e.g., would you like to learn about how to overcome [[Motivation and emotion/Book/2020/Writer's block|writer's block]]?). ===Community=== Tables can be an effective way to organise and summarise information. Tables should be captioned (using APA style) to explain their relevance to the text. Plus each table should be referred to at least once in the main text (e.g., see Table 1 and Table 2). Here are some [[Motivation and emotion/Wikiversity/Tables|example 3 x 3 tables]] which could be adapted. ===Relationships=== Quizzes are a direct way to engage readers. But don't make quizzes too hard or long. It is better to have one or two review questions per major section than a long quiz at the end. Try to quiz conceptual understanding, rather than trivia. Here are some simple quiz questions which could be adapted. Choose the correct answers and click "Submit": ==== Kants' System of Duties ==== <quiz display=simple> {Quizzes are an interactive learning feature: |type="()"} + True - False {Long quizzes are a good idea: |type="()"} - True + False </quiz> To learn about different types of quiz questions, see [[Help:Quiz|Quiz]]. == Beneficence on Mental Well-Being == * beneficence and the giver impact * beneficence impact on ego, self esteem, confidence * can beneficence be selfish and/or addicting * can people adapt to beneficence ** start expecting it ** generational? ==== Maslow's Hierarchy of Needs ==== ==== Cognitive Perspective ==== ==Conclusion== The Conclusion is arguably the most important section. It should be possible for someone to read the [[#Overview|Overview]] and the Conclusion and still get a good idea of the topic. {{tip|Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? }} ==See also== Provide up to half-a-dozen [[Help:Contents/Links#Interwiki_links|internal (wiki) links]] to relevant Wikiversity pages (esp. related [[Motivation and emotion/Book|motivation and emotion book chapters]]) and [[w:|Wikipedia articles]]. For example: * [[Motivation and emotion/Book/2016/Anorexia nervosa and extrinsic motivation|Anorexia nervosa and extrinsic motivation]] (Book chapter, 2016) * [[w:David McClelland|David McClelland]] (Wikipedia) * [[Motivation and emotion/Book/2018/Loss aversion|Loss aversion]] (Book chapter, 2018) * [[w:Maslow's hierarchy of needs|Maslow's hierarchy of needs]] (Wikipedia) {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== List the cited references in [[w:APA style|APA style]] (7th ed.) or [[w:Wikipedia:Citing sources|wiki style]]. APA style example: {{Hanging indent|1= Blair, R. J. R. (2004). The roles of orbital frontal cortex in the modulation of antisocial behavior. ''Brain and Cognition'', ''55''(1), 198–208. https://doi.org/10.1016/S0278-2626(03)00276-8 Buckholtz, J. W., & Meyer-Lindenberg, A. (2008). MAOA and the neurogenetic architecture of human aggression. ''Trends in Neurosciences'', ''31''(3), 120–129. https://doi.org/10.1016/j.tins.2007.12.006 Eckardt, M., File, S., Gessa, G., Grant, K., Guerri, C., Hoffman, P., & Tabakoff, B. (1998). Effects of moderate alcohol consumption on the central nervous system. ''Alcoholism, Clinical and Experimental Research'', ''22''(5), 998–1040. https://doi.org/10.1111/j.1530-0277.1998.tb03695.x }} {{tip|Suggestions for this section: * Important aspects for APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except first letter and proper names, ending in a full-stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full-stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't actually read or consulted }} ==External links== Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * [https://students.unimelb.edu.au/academic-skills/explore-our-resources/essay-writing/six-top-tips-for-writing-a-great-essay Six top tips for writing a great essay] (University of Melbourne) * [http://www.skillsyouneed.com/write/structure.html The importance of structure] (skillsyouneed.com) {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] ==See also== * [[Motivation and emotion/Book/2021/Beneficence as a psychological need|Beneficence as a psychological need]] (Book chapter, 2021) [[User:CaitlinEmc]] == Social Contributions == # [https://en.wikiversity.org/w/index.php?title=Motivation_and_emotion/Book/2021/Cognitive_dissonance_and_motivation&curid=276123&diff=2416011&oldid=2394580 Created heading instead of single sub-heading] k266mhonkmfweoz33d64dbovkzostso 2419276 2419188 2022-08-26T04:49:05Z CaitlinEmc 2947627 /* What is Beneficence? */ wikitext text/x-wiki {{METP}} [[File:Christian herald and signs of our times (1895) (14785180155).jpg|alt=Picture of civilians donating clothes and supplies to Volunteer Distributors|thumb|Figure 1. Volunteer Distributors receiving clothing and supplies across Ne-Braska and Kansas]] {{title|Chapter title:<br>Subtitle?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== * Define beneficence and it's correlation to psychological well-being * Briefly outline self determination theory * Briefly explain how beneficence impacts both the beneficence and the giver's well-being * Briefly explain different effects of beneficence in relationships & community * Explain how beneficence can contribute to an individual's motivation You are underway {{smile}}! This template provides tips for [[Motivation and emotion/Assessment/Topic|topic development]]. Gradually remove these suggestions as you develop the chapter. Also consult the [[Motivation and emotion/Assessment/Chapter|author guidelines]]. At the top of the chapter, the title and sub-title should match the ''exact'' wording and casing as shown in the {{Motivation and emotion/Book}}. The sub-titles all end with a question mark. This Overview section should be concise but consist of several paragraphs which engage the reader, illustrate the problem, and outline how psychological science can help. {{RoundBoxTop|theme=3}} '''Focus questions:''' * What is the first focus question? * What is the second focus question? * What is the third focus question? {{RoundBoxBottom}} {{tip| Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Provide an example or case study. * Conclude with Focus questions to guide the chapter. }} ==What is Beneficence?== Beneficence is defined as an act of charity, mercy and kindness. Beneficence involves the connotation of doing good for others, including moral obligation (Kinsinger, 2009). Beneficence involves acts of kindness, generosity, charity, love and humanity. Often individuals will embody internal virtue for acts of charity as a moral obligation. * How you are going to structure the chapter? Aim for three to six main headings between the [[#Overview|Overview]] and [[#Conclusion|Conclusion]]. == Beneficence as a Motivator == === Extrinsic Motivation === === Intrinsic Motivation === {{tip|Suggestions for this section: * For the [[Motivation and emotion/Assessment/Topic|topic development]], provide at least 3 bullet-points about key content per section. Include key citations. * For the [[Motivation and emotion/Assessment/Chapter|book chapter]], expand the bullet points into paragraphs. * If a section has a lot of content, arrange it into two to five sub-headings such as in the [[#Interactive learning features|interactive learning features section]]. Avoid having sections with only one sub-heading. }} ==Self-determination theory== * Self-determination theory ** Theory suggests people become self-determined when their universal psychological needs are met{{citation needed}} * Like physical needs, these psychological needs are considered an objective phenomena where deprivation or satisfaction of needs have significant and measurable effects on the individual. * Conceptualise needs at the psychological level Key assumptions of the theory * People are actively directed towards growth{{citation needed}}. Taking in new experiences and gaining skills are essential for developing a sense of self What brings an online book chapter to life are its interactive learning features. Case studies, feature boxes, figures, links, tables, and quiz questions can be used throughout the chapter. ===Autonomy=== Autonomy: feel in control of behaviours and goals{{citation needed}} Case studies describe real-world examples of concepts in action. Case studies can be real or fictional. A case could be used multiple times during a chapter to illustrate different theories or stages. It is often helpful to present case studies using [[#Feature boxes|feature boxes]]. ===Competence=== Competence: gain mastery of tasks and learn different skills Boxes can be used to highlight content, but don't overuse them. There are many different ways of creating boxes (e.g., see [[Help:Pretty boxes|Pretty boxes]]). Possible uses include: * Focus questions * Case studies or examples * Quiz questions * Take-home messages {{RoundBoxTop|theme=3}} ;Feature box example * Shaded background * Coloured border {{RoundBoxBottom}} ===Relatedness=== Connection or relatedness: experience a sense of belonging and attachment to other people{{citation needed}} [[File:Monkey-typing.jpg|right|205px|thumb|''Figure 1''. Example image with descriptive caption.]] Use figures to illustrate concepts, add interest, and provide examples. Figures can be used to show photographs, drawings, diagrams, graphs, etcetera. Figures can be embedded throughout the chapter, starting with the Overview section. Figures should be captioned (using a number and a description) in order to explain their relevance to the text. Possible images can be found at [[commons:|Wikimedia Commons]]. Images can also be uploaded if they are licensed for re-use or if you created the image. Each figure should be referred to at least once in the main text (e.g., see Figure 1). == Beneficence in Different Settings == Where key words are first used, make them into [[Help:Links|interwiki links]] such as Wikipedia links to articles about famous people (e.g., [[w:Sigmund Freud|Sigmund Freud]] and key concepts (e.g., [[w:Dreams|dreams]]) and links to book chapters about related topics (e.g., would you like to learn about how to overcome [[Motivation and emotion/Book/2020/Writer's block|writer's block]]?). ===Community=== Tables can be an effective way to organise and summarise information. Tables should be captioned (using APA style) to explain their relevance to the text. Plus each table should be referred to at least once in the main text (e.g., see Table 1 and Table 2). Here are some [[Motivation and emotion/Wikiversity/Tables|example 3 x 3 tables]] which could be adapted. ===Relationships=== Quizzes are a direct way to engage readers. But don't make quizzes too hard or long. It is better to have one or two review questions per major section than a long quiz at the end. Try to quiz conceptual understanding, rather than trivia. Here are some simple quiz questions which could be adapted. Choose the correct answers and click "Submit": ==== Kants' System of Duties ==== <quiz display=simple> {Quizzes are an interactive learning feature: |type="()"} + True - False {Long quizzes are a good idea: |type="()"} - True + False </quiz> To learn about different types of quiz questions, see [[Help:Quiz|Quiz]]. == Beneficence on Mental Well-Being == * beneficence and the giver impact * beneficence impact on ego, self esteem, confidence * can beneficence be selfish and/or addicting * can people adapt to beneficence ** start expecting it ** generational? ==== Maslow's Hierarchy of Needs ==== ==== Cognitive Perspective ==== ==Conclusion== The Conclusion is arguably the most important section. It should be possible for someone to read the [[#Overview|Overview]] and the Conclusion and still get a good idea of the topic. {{tip|Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? }} ==See also== Provide up to half-a-dozen [[Help:Contents/Links#Interwiki_links|internal (wiki) links]] to relevant Wikiversity pages (esp. related [[Motivation and emotion/Book|motivation and emotion book chapters]]) and [[w:|Wikipedia articles]]. For example: * [[Motivation and emotion/Book/2016/Anorexia nervosa and extrinsic motivation|Anorexia nervosa and extrinsic motivation]] (Book chapter, 2016) * [[w:David McClelland|David McClelland]] (Wikipedia) * [[Motivation and emotion/Book/2018/Loss aversion|Loss aversion]] (Book chapter, 2018) * [[w:Maslow's hierarchy of needs|Maslow's hierarchy of needs]] (Wikipedia) {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== List the cited references in [[w:APA style|APA style]] (7th ed.) or [[w:Wikipedia:Citing sources|wiki style]]. APA style example: {{Hanging indent|1= Blair, R. J. R. (2004). The roles of orbital frontal cortex in the modulation of antisocial behavior. ''Brain and Cognition'', ''55''(1), 198–208. https://doi.org/10.1016/S0278-2626(03)00276-8 Buckholtz, J. W., & Meyer-Lindenberg, A. (2008). MAOA and the neurogenetic architecture of human aggression. ''Trends in Neurosciences'', ''31''(3), 120–129. https://doi.org/10.1016/j.tins.2007.12.006 Eckardt, M., File, S., Gessa, G., Grant, K., Guerri, C., Hoffman, P., & Tabakoff, B. (1998). Effects of moderate alcohol consumption on the central nervous system. ''Alcoholism, Clinical and Experimental Research'', ''22''(5), 998–1040. https://doi.org/10.1111/j.1530-0277.1998.tb03695.x }} {{tip|Suggestions for this section: * Important aspects for APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except first letter and proper names, ending in a full-stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full-stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't actually read or consulted }} ==External links== Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * [https://students.unimelb.edu.au/academic-skills/explore-our-resources/essay-writing/six-top-tips-for-writing-a-great-essay Six top tips for writing a great essay] (University of Melbourne) * [http://www.skillsyouneed.com/write/structure.html The importance of structure] (skillsyouneed.com) {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] ==See also== * [[Motivation and emotion/Book/2021/Beneficence as a psychological need|Beneficence as a psychological need]] (Book chapter, 2021) [[User:CaitlinEmc]] == Social Contributions == # [https://en.wikiversity.org/w/index.php?title=Motivation_and_emotion/Book/2021/Cognitive_dissonance_and_motivation&curid=276123&diff=2416011&oldid=2394580 Created heading instead of single sub-heading] jsjtm70xb8qg7p1tmzl26ro0j9s7btt 0 279853 2419330 2349050 2022-08-26T06:40:19Z Jtneill 10242 wikitext text/x-wiki __NOTOC__ <!-- Title - Box --> {{RoundBoxTop|theme=10}} <div style="text-align: center;"> <!-- Book title --> {{title|[[Motivation and emotion/Book/2022|<big><big>Motivation and emotion</big></big>]]:}} <!-- Book sub-title and year --> <span style="color: purple; font-size: large; font-weight: bold;"> Understanding and improving our motivational and emotional lives using psychological science (2022) </span> </div> {{RoundBoxBottom}} <!-- Guidelines - Box --> <!-- ---------------------------------- ---> <!-- Guidelines box start --> <!-- ---------------------------------- ---> <div style="clear: both; margin-left: auto; padding:0px; border: 1px solid #aaa; margin-right: auto; cursor: pointer" class="NavFrame"> <!-- Guidelines --> <div class="NavHead" style="background:Plum;"><big><big>'''Guidelines'''</big></big></div> <div class="NavContent" style="display:none" align=left> {| cellpadding="15" cellspacing="5" style=": center; width: 60%; background-color: Inherit; margin-left: auto; margin-right: auto" | style="width: 50%; background-color: Plum; border: 1px solid #777777; vertical-align: top; -moz-border-radius-topleft: 8px; -moz-border-radius-bottomleft: 8px; -moz-border-radius-topright: 8px; -moz-border-radius-bottomright: 8px; height: 10px;" | <!-- ---------------------------------- ---> <!-- Sign up box --> <!-- ---------------------------------- ---> {| class="messagebox" |- | [[File:2Arrows.svg|30px]] | Available topics are followed by '''[[User:MyUserName|MyUserName]]'''. To sign up to a topic: # [[Wikiversity:Why create an account|Register a Wikiversity account]] # Click "Edit source" (or "Edit") # Replace <code><nowiki>[[User:MyUserName|MyUserName]]</nowiki></code> with your Wikiversity username<br>e.g., <code><nowiki>[[User:Jtneill|Jtneill]]</nowiki></code> # Click "Publish" Or email the [[Motivation and emotion/About/Support|unit convener]] to negotiate a topic. |} <!-- ---------------------------------- ---> <!-- Welcome - Post-initial 1 --> <!-- ---------------------------------- ---> This assessment exercise is explained in Lecture [[Motivation and emotion/Lectures/Introduction|01]] and [[Motivation and emotion/Lectures/Historical development and assessment skills|02]] and Tutorial [[Motivation and emotion/Tutorials/Topic selection|01]] and [[Motivation and emotion/Tutorials/Wiki editing|02]]. <!-- ---------------------------------- ---> <!-- Will more topics be added? --> <!-- ---------------------------------- Will more topics be added? Yes, but you are also encouraged to propose topics. To get some ideas, look through chapters written in [[Motivation and emotion/Book|previous years]] and see these [[Motivation and emotion/Book/Ideas for topics|links]]. ---> <!-- ---------------------------------- ---> <!-- Guidelines --> <!-- ---------------------------------- ---> Authors, please consult the detailed [[Motivation and emotion/Assessment/Topic|topic development]] and [[Motivation and emotion/Assessment/Chapter|book chapter]] guidelines. <!-- ---------------------------------- ---> <!-- Count down --> <!-- ---------------------------------- ---> <!-- Was due 18/10 09:00 {{countdown |year = 2022 |month = 10 |day = 17 |hour = 23 |minute = 0 |second = 0 |event = chapters are due }} --> |} </div></div> <!-- For readers - Box --> <!-- ---------------------------------- ---> <!-- For readers collapse box start --> <!-- ---------------------------------- ---> <div style="clear: both; margin-left: auto; padding:0px; border: 1px solid #aaa; margin-right: auto; cursor: pointer" class="NavFrame"> <!-- For readers --> <div class="NavHead" style="background:Plum;"><big><big>'''For readers'''</big></big></div> <div class="NavContent" style="display:none" align=left> {| cellpadding="15" cellspacing="5" style=": center; width: 60%; background-color: Inherit; margin-left: auto; margin-right: auto" | style="width: 50%; background-color: Plum; border: 1px solid #777777; vertical-align: top; -moz-border-radius-topleft: 8px; -moz-border-radius-bottomleft: 8px; -moz-border-radius-topright: 8px; -moz-border-radius-bottomright: 8px; height: 10px;" | <!-- ---------------------------------- ---> <!-- Massive transformation --> <!-- ---------------------------------- ---> These pages are undergoing a massive transformation. Approx. 150 [[emerging scholar]]s who are studying [[Motivation and emotion|motivation and emotion]] at the [[University of Canberra]] will each author a freely available online book chapter about how some aspect of our motivational and emotional lives can be better understood and improved. Feel free to comment or contribute. |} </div></div> <noinclude>[[Category:Motivation and emotion|{{SUBPAGENAME}}]]</noinclude> 199gm1bdrgv94npho1b80jc6rnazksi 0 280326 2419100 2417237 2022-08-25T22:46:15Z Jtneill 10242 + category wikitext text/x-wiki {{title|To-do lists:<br>Are to-do lists a good idea? What are their pros and cons? How can they be used effectively?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== [[File:To Do List Scene Vector.svg|alt=A top view scene of someone checking off all four items on a to-do list. The scene happens on a brown wooden desk, where we there is also a gray keyboard, an eraser, a smartphone and a notebook|thumb|Figure 1. A scene of someone checking off their to-do list]] You are underway {{smile}}! This template provides tips for [[Motivation and emotion/Assessment/Topic|topic development]]. Gradually remove these suggestions as you develop the chapter. Also consult the [[Motivation and emotion/Assessment/Chapter|author guidelines]]. At the top of the chapter, the title and sub-title should match the ''exact'' wording and casing as shown in the {{Motivation and emotion/Book}}. The sub-titles all end with a question mark. This Overview section should be concise but consist of several paragraphs which engage the reader, illustrate the problem, and outline how psychological science can help.{{tip| Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Provide an example or case study. * Conclude with Focus questions to guide the chapter. }} {{RoundBoxTop|theme=3}} '''Focus questions:''' * Are to-do lists a good idea? * What are their pros and cons? * How can they be used effectively? {{RoundBoxBottom}} ==What are to-do lists?== How you are going to structure the chapter? Aim for three to six main headings between the [[#Overview|Overview]] and [[#Conclusion|Conclusion]]. {{tip|Suggestions for this section: * For the [[Motivation and emotion/Assessment/Topic|topic development]], provide at least 3 bullet-points about key content per section. Include key citations. * For the [[Motivation and emotion/Assessment/Chapter|book chapter]], expand the bullet points into paragraphs. * If a section has a lot of content, arrange it into two to five sub-headings such as in the [[#Interactive learning features|interactive learning features section]]. Avoid having sections with only one sub-heading. }} == Heading 2 == == Heading 3 == == Conclusion == The Conclusion is arguably the most important section. It should be possible for someone to read the [[#Overview|Overview]] and the Conclusion and still get a good idea of the topic. {{tip|Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? }} ==References== List the cited references in [[w:APA style|APA style]] (7th ed.) or [[w:Wikipedia:Citing sources|wiki style]]. APA style example: {{Hanging indent|1= Blair, R. J. R. (2004). The roles of orbital frontal cortex in the modulation of antisocial behavior. ''Brain and Cognition'', ''55''(1), 198–208. https://doi.org/10.1016/S0278-2626(03)00276-8 Buckholtz, J. W., & Meyer-Lindenberg, A. (2008). MAOA and the neurogenetic architecture of human aggression. ''Trends in Neurosciences'', ''31''(3), 120–129. https://doi.org/10.1016/j.tins.2007.12.006 Eckardt, M., File, S., Gessa, G., Grant, K., Guerri, C., Hoffman, P., & Tabakoff, B. (1998). Effects of moderate alcohol consumption on the central nervous system. ''Alcoholism, Clinical and Experimental Research'', ''22''(5), 998–1040. https://doi.org/10.1111/j.1530-0277.1998.tb03695.x }} {{tip|Suggestions for this section: * Important aspects for APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except first letter and proper names, ending in a full-stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full-stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't actually read or consulted }} ==External links== * [https://friday.app/p/to-do-list-anxiety How Do You Solve To-Do List Anxiety? How To Overcome It & Get Things Done] (Friday) [[Category:{{#titleparts:{{PAGENAME}}|3}}]] ==See also== * [[Motivation and emotion/Book/2021/To-do lists|To-do lists]] (Book chapter, 2021) ==Learning features== What brings an online book chapter to life are its interactive learning features. Case studies, feature boxes, figures, links, tables, and quiz questions can be used throughout the chapter. ===Case studies=== Case studies describe real-world examples of concepts in action. Case studies can be real or fictional. A case could be used multiple times during a chapter to illustrate different theories or stages. It is often helpful to present case studies using [[#Feature boxes|feature boxes]]. ===Boxes=== Boxes can be used to highlight content, but don't overuse them. There are many different ways of creating boxes (e.g., see [[Help:Pretty boxes|Pretty boxes]]). Possible uses include: * Focus questions * Case studies or examples * Quiz questions * Take-home messages {{RoundBoxTop|theme=3}} ;Feature box example * Shaded background * Coloured border {{RoundBoxBottom}} ===Figures=== [[File:Monkey-typing.jpg|right|205px|thumb|''Figure 1''. Example image with descriptive caption.]] Use figures to illustrate concepts, add interest, and provide examples. Figures can be used to show photographs, drawings, diagrams, graphs, etcetera. Figures can be embedded throughout the chapter, starting with the Overview section. Figures should be captioned (using a number and a description) in order to explain their relevance to the text. Possible images can be found at [[commons:|Wikimedia Commons]]. Images can also be uploaded if they are licensed for re-use or if you created the image. Each figure should be referred to at least once in the main text (e.g., see Figure 1). ===Links=== Where key words are first used, make them into [[Help:Links|interwiki links]] such as Wikipedia links to articles about famous people (e.g., [[w:Sigmund Freud|Sigmund Freud]] and key concepts (e.g., [[w:Dreams|dreams]]) and links to book chapters about related topics (e.g., would you like to learn about how to overcome [[Motivation and emotion/Book/2020/Writer's block|writer's block]]?). ===Tables=== Tables can be an effective way to organise and summarise information. Tables should be captioned (using APA style) to explain their relevance to the text. Plus each table should be referred to at least once in the main text (e.g., see Table 1 and Table 2). Here are some [[Motivation and emotion/Wikiversity/Tables|example 3 x 3 tables]] which could be adapted. ===Quizzes=== Quizzes are a direct way to engage readers. But don't make quizzes too hard or long. It is better to have one or two review questions per major section than a long quiz at the end. Try to quiz conceptual understanding, rather than trivia. Here are some simple quiz questions which could be adapted. Choose the correct answers and click "Submit": <quiz display=simple> {Quizzes are an interactive learning feature: |type="()"} + True - False {Long quizzes are a good idea: |type="()"} - True + False </quiz> To learn about different types of quiz questions, see [[Help:Quiz|Quiz]]. [[Category:{{#titleparts:{{PAGENAME}}|3}}]] [[Category:Motivation and emotion/Book/Goal setting]] ra7l8tu3xoglyjbkh4590v4857881dh 0 280327 2419461 2416441 2022-08-26T09:56:33Z Jtneill 10242 + categories wikitext text/x-wiki {{title|Chapter title:<br>Subtitle?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== You are underway {{smile}}! This template provides tips for [[Motivation and emotion/Assessment/Topic|topic development]]. Gradually remove these suggestions as you develop the chapter. Also consult the [[Motivation and emotion/Assessment/Chapter|author guidelines]]. At the top of the chapter, the title and sub-title should match the ''exact'' wording and casing as shown in the {{Motivation and emotion/Book}}. The sub-titles all end with a question mark. This Overview section should be concise but consist of several paragraphs which engage the reader, illustrate the problem, and outline how psychological science can help. {{RoundBoxTop|theme=3}} '''Focus questions:''' * What is the first focus question? * What is the second focus question? * What is the third focus question? {{RoundBoxBottom}} {{tip| Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Provide an example or case study. * Conclude with Focus questions to guide the chapter. }} ==Main headings== How you are going to structure the chapter? Aim for three to six main headings between the [[#Overview|Overview]] and [[#Conclusion|Conclusion]]. {{tip|Suggestions for this section: * For the [[Motivation and emotion/Assessment/Topic|topic development]], provide at least 3 bullet-points about key content per section. Include key citations. * For the [[Motivation and emotion/Assessment/Chapter|book chapter]], expand the bullet points into paragraphs. * If a section has a lot of content, arrange it into two to five sub-headings such as in the [[#Interactive learning features|interactive learning features section]]. Avoid having sections with only one sub-heading. }} ==Learning features== What brings an online book chapter to life are its interactive learning features. Case studies, feature boxes, figures, links, tables, and quiz questions can be used throughout the chapter. ===Case studies=== Case studies describe real-world examples of concepts in action. Case studies can be real or fictional. A case could be used multiple times during a chapter to illustrate different theories or stages. It is often helpful to present case studies using [[#Feature boxes|feature boxes]]. ===Boxes=== Boxes can be used to highlight content, but don't overuse them. There are many different ways of creating boxes (e.g., see [[Help:Pretty boxes|Pretty boxes]]). Possible uses include: * Focus questions * Case studies or examples * Quiz questions * Take-home messages {{RoundBoxTop|theme=3}} ;Feature box example * Shaded background * Coloured border {{RoundBoxBottom}} ===Figures=== [[File:Monkey-typing.jpg|right|205px|thumb|''Figure 1''. Example image with descriptive caption.]] Use figures to illustrate concepts, add interest, and provide examples. Figures can be used to show photographs, drawings, diagrams, graphs, etcetera. Figures can be embedded throughout the chapter, starting with the Overview section. Figures should be captioned (using a number and a description) in order to explain their relevance to the text. Possible images can be found at [[commons:|Wikimedia Commons]]. Images can also be uploaded if they are licensed for re-use or if you created the image. Each figure should be referred to at least once in the main text (e.g., see Figure 1). ===Links=== Where key words are first used, make them into [[Help:Links|interwiki links]] such as Wikipedia links to articles about famous people (e.g., [[w:Sigmund Freud|Sigmund Freud]] and key concepts (e.g., [[w:Dreams|dreams]]) and links to book chapters about related topics (e.g., would you like to learn about how to overcome [[Motivation and emotion/Book/2020/Writer's block|writer's block]]?). ===Tables=== Tables can be an effective way to organise and summarise information. Tables should be captioned (using APA style) to explain their relevance to the text. Plus each table should be referred to at least once in the main text (e.g., see Table 1 and Table 2). Here are some [[Motivation and emotion/Wikiversity/Tables|example 3 x 3 tables]] which could be adapted. ===Quizzes=== Quizzes are a direct way to engage readers. But don't make quizzes too hard or long. It is better to have one or two review questions per major section than a long quiz at the end. Try to quiz conceptual understanding, rather than trivia. Here are some simple quiz questions which could be adapted. Choose the correct answers and click "Submit": <quiz display=simple> {Quizzes are an interactive learning feature: |type="()"} + True - False {Long quizzes are a good idea: |type="()"} - True + False </quiz> To learn about different types of quiz questions, see [[Help:Quiz|Quiz]]. ==Conclusion== The Conclusion is arguably the most important section. It should be possible for someone to read the [[#Overview|Overview]] and the Conclusion and still get a good idea of the topic. {{tip|Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? }} ==See also== * [[Motivation and emotion/Book/2021/Creative arts and trauma|Creative arts and trauma]] (Book chapter, 2021) Provide up to half-a-dozen [[Help:Contents/Links#Interwiki_links|internal (wiki) links]] to relevant Wikiversity pages (esp. related [[Motivation and emotion/Book|motivation and emotion book chapters]]) and [[w:|Wikipedia articles]]. For example: * [[Motivation and emotion/Book/2016/Anorexia nervosa and extrinsic motivation|Anorexia nervosa and extrinsic motivation]] (Book chapter, 2016) * [[w:David McClelland|David McClelland]] (Wikipedia) * [[Motivation and emotion/Book/2018/Loss aversion|Loss aversion]] (Book chapter, 2018) * [[w:Maslow's hierarchy of needs|Maslow's hierarchy of needs]] (Wikipedia) {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== List the cited references in [[w:APA style|APA style]] (7th ed.) or [[w:Wikipedia:Citing sources|wiki style]]. APA style example: {{Hanging indent|1= Blair, R. J. R. (2004). The roles of orbital frontal cortex in the modulation of antisocial behavior. ''Brain and Cognition'', ''55''(1), 198–208. https://doi.org/10.1016/S0278-2626(03)00276-8 Buckholtz, J. W., & Meyer-Lindenberg, A. (2008). MAOA and the neurogenetic architecture of human aggression. ''Trends in Neurosciences'', ''31''(3), 120–129. https://doi.org/10.1016/j.tins.2007.12.006 Eckardt, M., File, S., Gessa, G., Grant, K., Guerri, C., Hoffman, P., & Tabakoff, B. (1998). Effects of moderate alcohol consumption on the central nervous system. ''Alcoholism, Clinical and Experimental Research'', ''22''(5), 998–1040. https://doi.org/10.1111/j.1530-0277.1998.tb03695.x }} {{tip|Suggestions for this section: * Important aspects for APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except first letter and proper names, ending in a full-stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full-stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't actually read or consulted }} ==External links== Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * [https://students.unimelb.edu.au/academic-skills/explore-our-resources/essay-writing/six-top-tips-for-writing-a-great-essay Six top tips for writing a great essay] (University of Melbourne) * [http://www.skillsyouneed.com/write/structure.html The importance of structure] (skillsyouneed.com) {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] [[Category:Motivation and emotion/Book/Creativity]] [[Category:Motivation and emotion/Book/Trauma]] ghildr61yb8asikwp894xmhv0ttaxxg 0 280329 2419460 2418946 2022-08-26T09:52:06Z Jtneill 10242 + category wikitext text/x-wiki {{title|Approach motivation:<br>What is approach motivation and how does it lead to behaviour?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== There are a great number of psychological theories that seek to explain the nuances of [[w:motivation|motivation]]. In this chapter, I will outline the concept of approach motivation and how it directs behaviour, as well as how it may be applied practically. [[File:The Great Wall of China at Jinshanling-edit.jpg|thumb|''Figure 1.'' People often desire travel and are motivated to explore the world. Seeing sights such as the Great Wall of China is an example of approach motivation.]] * Be concise, but use a few paragraphs * Engage the reader - why is this relevant to them? What makes this interesting or worth knowing? * Illustrate the problem - what makes us want to engage with situations? To take risks, try new things? What makes us recognise and value the potential good that could come from seeing something out? Approach motivation can be used to explain these experiences. * Outline how psychological science can help - understanding and applying approach motivation and related theories can help people to practice courageous behaviour, overcome fears, grow as individuals, and bring more joy into their lives. {{RoundBoxTop|theme=3}} '''Focus questions:''' * What is approach motivation? * What theories and perspectives explain approach motivation? * How does it lead to behaviour? * How might we apply this concept? {{RoundBoxBottom}} {{tip| Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Provide an example or case study. * Conclude with Focus questions to guide the chapter. }} == Defining approach motivation == Approach behaviour, also known as appetitive behaviour, originates from - Approach motivation, then, is the - Lewin (1935) defined it as, "...the energization of behavior by, or the direction of behavior ''toward, positive'' [desired] ''stimuli'' (objects, events, possibilities), whereas avoidance motivation may be defined as the energization of behavior by, or the direction of behavior ''away from'', ''negative'' [undesired] ''stimuli'' (objects, events, possibilities).” - a Dynamic Theory of Personality == Physiological underpinnings == [[File:Dopamine Pathways.png|thumb|270x270px|''Figure 2.'' Image of reward system and dopamine pathways in the brain.]] === The reward system === The [[w:reward system|reward system]] * Dopamine Learning, addiction == Associated theories == === Achievement Goal Theory === Elliot (1997) === Achievement Motivation Theory === McClelland (1961) === Broaden-and-build Theory === Fredrickson (1998) The [[w:Broaden-and-build|broaden-and-build]] theory === Regulatory Focus Theory === Higgins (1987) === Reinforcer Sensitivity Theory === Gray (1982) == Research == * == Application == * Courage * Fears * Personal development * Joy (broaden-and-build) * Learning * Addiction ==Conclusion== * Overview and conclusion should be enough for a reader to get a good idea of the topic * In short, what is approach motivation and how does it lead to behaviour? * What theories and perspectives explain approach motivation? * How can we apply it? / What are the practical, take-home messages? ==See also== * [[Motivation and emotion/Book/2021/Approach motivation|Approach motivation]] (Book chapter, 2021) Provide up to half-a-dozen [[Help:Contents/Links#Interwiki_links|internal (wiki) links]] to relevant Wikiversity pages (esp. related [[Motivation and emotion/Book|motivation and emotion book chapters]]) and [[w:|Wikipedia articles]]. For example: * [[Motivation and emotion/Book/2021/Approach motivation|Approach motivation]] (Book chapter, 2021) * [[w:Reward system|Reward system]] (Wikipedia) * [[w:David McClelland|David McClelland]] (Wikipedia) ==References== {{Hanging indent|1= Elliot. (2006). The hierarchical model of approach-avoidance motivation. Motivation and Emotion, 30(2), 111–116. https://doi.org/10.1007/s11031-006-9028-7 Gable, & Dreisbach, G. (2021). Approach motivation and positive affect. Current Opinion in Behavioral Sciences, 39, 203–208. https://doi.org/10.1016/j.cobeha.2021.03.030 Harmon-Jones, Harmon-Jones, C., & Price, T. F. (2013). What is Approach Motivation? Emotion Review, 5(3), 291–295. https://doi.org/10.1177/1754073913477509 Monni, Olivier, E., Morin, A. J. S., Olivetti Belardinelli, M., Mulvihill, K., & Scalas, L. F. (2020). Approach and avoidance in Gray’s, Higgins’, and Elliot’s perspectives: A theoretical comparison and integration of approach-avoidance in motivated behavior. Personality and Individual Differences, 166, 110163–. https://doi.org/10.1016/j.paid.2020.110163 Wimmer, Lackner, H. K., Papousek, I., & Paechter, M. (2018). Goal orientations and activation of approach versus avoidance motivation while awaiting an achievement situation in the laboratory. Frontiers in Psychology, 9, 1552–1552. https://doi.org/10.3389/fpsyg.2018.01552 }} ==External links== Up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. * [https://www.youtube.com/watch?v=fbuHLgMj4Ck&ab_channel=PsychExamReview Conscious and unconscious, approach and avoidance motivation] PsychExamReview (YouTube) [[Category:{{#titleparts:{{PAGENAME}}|3}}]] [[Category:Motivation and emotion/Book/Motivation]] 5e1mel793kj4qsafqv01jytdyv68h06 0 281095 2419420 2419050 2022-08-26T09:01:37Z Hamish84 1362807 /* Truth. */ Text and images wikitext text/x-wiki = <ref>'''William Shakespeare''' (bapt. 26 April 1564 – 23 April 1616</ref>A message. = What humanity needs is not any individual approach but a governance powerful body of excellence that has modern technology, knowledge, and freedom they can use to disseminate clear information. Clear information about a new language structure of absolutes beneficial to an International forum, and eventually to reach a Universal status.Its benefits reach toward conceptual language on a planet that speaks more than 7,000 languages. No matter the language spoken the concepts of: Air - Food - Water are recognised. The overall development of conceptual language can only be beneficial and will be as appropriate to Absolutes definitions. Reaching for the Stars might show us the way. Universal Language of Absolutes. "A very grand title but it took many years to explain its value" = Our history. = Born in Scotland in 1927 left school at 14 years of age. Married at 21 years of age and we had two children. We emigrated to New Zealand in 1953 and lived there for approximately thirty years. During our stay there I did a Liberal Studies Course at Canterbury University Christchurch and graduated. We have since had ten books published through Google books on the subject matter at hand and my wife Jean Caldwell McMillan is the co-author to most of the work presented here. My wife Jean was an avid reader of many works on philosophy and psychology. She was influenced by the works of Erich Fromm. Jean died 9th of January 2011. To refresh the original purpose of  our  earlier writings my wife and I  went on an odyssey  looking for any data, ancient or otherwise, on human consciousness, specifically related to Alzheimer’s disease. Now at 95 years of age (well past my used by date) it may well be that I am a candidate with a focus on my own pending dementia. If so, then the theory and the method I now write about is holding it at bay. To address the health of my mind in this way could be the catalyst that retains its own functional activity. The creation of a  semantic template is well documented below. No semantic definition of absolutes or principles can be ill-defined. They are always interconnected, interdependent and infinite. Each configuration constructed by anyone has meaning particular to them, although its value is universal. That  is why it is never personal property! [[File:JimNJean.png|center|thumb|228x228px|Jim and Jean]] = The Beginning. = "The road's half traveled when you know the way" [[File:Tree lined path - geograph.org.uk - 2269906.jpg|center|thumb]] Oxford dictionary definitions: Principle: "A fundamental truth used as a basis of reasoning". Absolute: " Complete - Entire - Perfect - Pure. These particular dictionary given definitions offers us guidelines to ‘existing conditions’ necessary for complementary understanding, and experience. We can only examine that which is real, basic evidence, that is fundamentally true, and we must ‘use’ it, to establish that which is reasonable. The general consensus is that there are no Absolutes. The following material is set out to show the very reverse is true and that everything that is is Absolute. Establish that there are no dichotomies that will leave the primary terms alone to create a semantic template. There are no dichotomies. Mythical dichotomies distort Reality. Everything is: The computer you use today has always existed, it is the arrangement of particles that have materialized it. The subject matter "Universal Language of Absolutes' is promoted to provide a new understanding of spoken language. This understanding was initially constructed by the cognitive experiences of both my wife and myself many years ago. Just like the principle of a jigsaw puzzle, meaning lies significantly in the fact that all pieces of the puzzle are interdependent and interconnected. When completed they provide a picture of the whole. We have endeavoured to produce a picture of the evolutionary process of language in human history because the evolution of language prefixes all modes of thought in human culture. The material directs the reader towards a new view that all that evolves is in a vertical direction, not the linear direction commonly understood. Human consciousness is of itself the phenomenon of evolution and to recognize its existence is part of the process. Shakespeare expressed this succinctly through the voice of Juliet who proclaimed, “a rose by any other name- would smell as sweet.” [[File:Comestible rose in the Laquenexy orchard garden, Moselle, France (01).jpg|thumb|center|237x237px]] === Conceptual language. === My wife and I recognized how profound the extension of this observation would mean conceptually. Of all the languages spoken on this planet, it would be fair to say that all of them would contain the properties of, air, food, and water conceptually, etc. This is a form of consciousness equality that is available to us all. It points to the reality of our constant relation to each other and our existence. We can never exist in a world of individuality, but only in relation to the consciousness of one another. Consequently, that exceptional experience can only be shared superficially. We cannot ‘know’ any other life experiences other than our own introspection. <gallery> File:Einstein 1921 by F Schmutzer - restoration.jpg </gallery>" ''Albert Einstein 1921. We experience our thoughts and feelings as something separate from the rest. A kind of optical delusion of consciousness. This delusion is a kind of prison for us, restricting us to our personal desires and to affection for a few persons nearest to us."'' ''Albert Einstein, in One Home, One Family, One Future,p.99'' Einstein came very close. In reality, every human being has a backpack from the day they were conceived. In the backpack every experience in their mother’s womb is experienced. At birth and throughout their lives, everything that happens to them in life is registered and creates their personality. That life with all its experiences can never be known to anyone else, consequently, we can never “know” another person. It creates equality of consciousness that we must understand. We can know details about a person, but that is all. That life is sacrosanct. Who we are really goes beyond normal human experience and into the realm of the Absolute. Werner Karl Heisenberg (physicist). The Heisenberg Uncertainty Principle. As a young layman with no knowledge of Heisenberg but interested in principles it seemed to me that the Uncertainty Principle was just a contradiction in terms. In later years I found that Heraclitus describes life as being in a state of flux a replica of the Uncertainty Principle which in fact can be defined as an absolute state. Within the context of knowing who we are and the backpack we carry our life in, we can never know each individual life as that life experience is singularly their own and sacrosanct. It now seems that the Heisenberg Uncertainty Principle can fall into the category of being an Absolute. Evolution proceeds in advance of our need to evolve. In our pure active state, we are.There is no static end (an abomination) - only beginning. As we cannot know what tomorrow will bring, living with expectations is rather futile. Nature has its own agenda. Zen Koan recorded 1228: 'An instant realization sees endless time. Endless time is as one moment. When one comprehends the endless moment He, or she, realizes the person who is seeing it.' We do not own Space. We do not own Time We do not own Energy We do not own Matter [[File:Universum.jpg|center|thumb]] "What we call the beginning is often the end And to make an end is to make a beginning. The end is where we start from We shall not cease from exploration And the end of all our exploring Will be to arrive where we started And know the place for the first time" T.S Eliot = Everything is in scale. = The present moment is the point in which Eternity has placed us – we all live in that moment, and whether we like it or not, we exist in it, experience it, have knowledge of it, and we all share it, measure by measure. There are no dichotomies. Illusion is a measure of Reality, as Stupidity is a measure of Intelligence If one keeps measuring illusion it is an attempted downward spiral to nothingness.There is no opposite to Reality – that illusion is a measure of Reality. There is no such thing as ‘nothing’ in the elemental construction of Homo sapiens. All the innate ‘something’s’ are the fundamentals of our being human and all our experiences. The correct use, and understanding of who we are, is an extension therefrom. Does it require any interpretation on anyones part to say ‘we are? Any attempted denial of that statement would be perverse use of the language, and delusional. === Try saying ‘we are not” === ‘We are’ is the foundation of all affirmation, and within that spectrum, we can know, and be. ‘We are’ is self-evident Truth. We can neither know, nor experience what isn’t. Eternity is the here and now, that is why it is possible to explain the experience of Eternity. Nothing is ever lost in Time. We are located in a vast Universe. ‘twas a moment’s pause,- All that took place within me came and went As in a moment; yet with Time it dwells, And grateful memory, as a thing divine. Wordsworth Prelude, Book V111 We already know – the ''basic'' condition that must exist for us to re-cognise. It is at that moment of pure affirmation, when all that is, is manifest. Unless there was mutual identity we could not know anything. It is why we are urged to evacuate the Platonic cave. Sadly most prefer the shadows rather than confront who they are. We already know – the basic condition that must exist for us to recognise. It is at that moment of pure affirmation, when all that is, is manifest. == Lost Shadows == [[File:People Shadow.JPG|left|thumb]] The shadows move Lost in confusion Lost in despair Imagination shrouds the real Looking back Looking forward Is this the Centre? James Brines. = Basic Principles. = We are all in the business of living and attempting to understand the principles involved in that human process up to the end of life. The implicit principles necessary for life eventually disappear and all measurable criteria pronounce a body to be devoid of life. Throughout historical agreement we know what that means, and we act accordingly on *common knowledge*. We know that dying is a necessary factor of life. It is a Natural law that if we live - we also die. Natural law is Universal, for us to *know* that a body lives; we also *know* that a body’s life will end. Albeit that reports tell us that today millions of people die of disease, starvation, wars, we of necessity accept that as the ongoing reality because again we are universally connected and know the results of such carnage. Because it is in our realm of common knowledge we have graveyards, crematoriums, undertakers, doctors who pronounce bodies to have died. We understand the consequences of leaving such bodies unburied, the diseases that would prevail. Again, please explore the definition of principle (Universal principle) and try to go to the limitations of the definition without using mythical dichotomies. [[File:( A great picture of outer space ).jpg|center|thumb]] Principle: A fundamental truth used as a basis of reasoning. All of these questions are based on singularity (the Cartesian dogma) If Descartes had only introduced inclusion into his musings (they were taken as conservative singularity) he may have realized the difficulty of addressing thought as reality. He then may have quite easily concluded that universally - *We are!!* That pronouncement is inclusive, and conclusive in every way, *we are - and we know!!* Because my knowledge is not a private, personal piece of property concerning principles, but Universal (Archimedes et al), then that innate knowledge has completeness we can share. Whatever identical resonance we may be able to share (concerning completeness), that can only be accomplished by understanding the principles involved and their constant relationship to each of us. Clearly the plethora of present and past discoveries establishes the existence of that which is fundamentally true, and the foundation for law. The principles are established, and always have been, we are in the business of making them transparent and complete. However tenuous the link we are all connected through communication, the air we breathe, the ground we walk on, the universe we live in, the common principles we live by. We all must have sustenance to survive, or we will not live. (See above) <nowiki>*</nowiki>There is nothing else to experience.* When we actively explore the reality of anything, all principles involved in that exploration are complementary, and honest, and we understand the wasteful divisive mythology that people attempt to attach to them. We cannot */partially know/* the truth, it must be complete. Dichotomies attempt to deny the existence of truth, and are misleading. How do we more reasonably completely know anything? The complexity of language systems with contemporary usage requires new and creative structures to provide clear information. Internal and external reasoning capacities can only develop in concert with Man’s recognition of the principles that essentially form our lives. The inevitability of human consciousness rising beyond its historical beginnings posits a future outside our normal perceptions, and  a factual reality that points to the existence of new perceptions that are infinite.   It is natural to know when we are no longer trapped in any mythical ideologies that gives credence to dichotomies that stifle the recognition of simple principles. There was no cause for knowledge to be established - it has always existed.* Ask yourself - ‘how do you know to ask any questions at all?’ There is no hidden dimension or mystical world. The only philosophical reality is ‘that which is’. To access that we need a new structure to explore ‘knowledge’, a new transformational language. Real knowledge is not amassed information, nor is it the establishment of dogmas, isms, or mythical belief systems. [[File:FAIR data principles.jpg|center|thumb]] Basic principles are the source and foundation of all /*knowledge*/. Until that is recognized, extension from mythical sources only leads to a denial of one’s own senses. Trying to conceive of a contemporary world without principles is to posit a world without reason, or intelligence. The principle of pure knowledge (Truth) could be said to exist in another dimension given the present state of human understanding. To progress that mistaken belief there would be strong support in the need for a comparative reality. Curiously it seems that philosophy (the seeking of knowledge) constantly discounts any knowledge that does not come within the sphere of established philosophy, and the comparative reality dictum. That consequence profoundly distils the purity of any experience and alienates the observer in their confrontation of that which is real. The measure of that ‘comparative reality’ knowledge bounded by dichotomies is so restrictive that it lies in a mythical dimension where denial of its very purpose is the order of the day. Evidently it will not allow doubt to undermine its own denials. A basic principle of Nature is /*knowledge*/ and it constantly communicates innately in every living structure. How to grow, develop, and disseminate. Knowledge is reciprocal truth that depends on our relationship and the recognition of principles operating. Knowledge (unlike information) is not stored in an individual box; it is ubiquitously manifest in everything we do. Knowledge is the experience of a positive reality, and its true construction is a dependable source of secure information (not to be misused). We daily have the opportunity of witnessing ‘knowledge’ in action as expressed by the ‘the principles of knowledge’, namely the principles themselves. The questions lie in a continuing mythical belief in a mystical unknown (the Cartesian stance) which because of its non-existence can never be known. It is a belief that is detrimental (because it attempts to deny all existing factual knowledge) to dealing with Nature and Reality and the fundamental necessity of our relationship with them. Making that relationship transparent is our basic obligation and the ongoing evolutionary activity. Although there is an obvious avoidance to address the definition of principle itself, it is a factor that must be paid attention to, to realize that ‘common knowledge’ is the only reality that exists. Amazingly although there is avoidance of principles - truth - reason etc, there is acceptance of the Cartesian dogma,. Paradoxically this determined acceptance of Descartes supports the reality of innate knowledge existing (I think - therefore I am) which establishes for him innate knowledge; however mistaken he is concerning the interpretation of his experience. = Leverage. = Long before I read of Archimedes and his various principle discoveries I was using the principle of leverage in a variety of ways, prying lids off boxes, moving articles with a lever well beyond my physical strength to do so without said lever, and I knew how to do it. Transferring that knowledge to a student or apprentice is relatively easy because innately they also /*know*/ how to do it. Every aspect of human industry uses the principle in a myriad of ways because it is our obligation to constantly progress the principle and confirm the constant utilization of knowledge. We wholeheartedly adopted Archimedes principles (et al) because we recognized their fundamental utility. It is preposterous to question the widespread /*factual knowledge*/ of all principles, more especially so when we cannot escape their ubiquitous daily existence in all our lives - Nature and Reality do not lie. [[File:Archimedes'-Lever.png|center|thumb]] One may abstain from admitting their existence. To do so is simply attempting the impossible, and is devoid of all reason. Real knowledge has been put into the realm of the mystical unknowable even to the point that knowledge practitioners go to the outer extremes and deny the gift of their natural senses. With their adherence to what they consider is knowledge they become captive automatons to any prescription for life that is expressed in that ’knowledge medium’, which then becomes the authority. When ’knowledge’ is addressed as having a collective source in Universal principles then we have the potential to experience its complete reality (microcosm - macrocosm) without any imaginary, or divisive comparative content. There is then a re-orientation process toward our true being and recognition of our own reality in relation to the natural processes we share. Real knowledge is elementary and Natural. We know, because that which is knowable is constantly expressed by the principles involved. We all share those principles and can correctly infer the most simple and obvious truths. All social life functions by our adherence to the implicit laws operating within them. Seeking experimental contradiction to a fact of life offers us nothing but proof which is the establishing of ‘complete knowledge’ however ‘more reasonably’ one wishes to extend the exercise. The construction of new philosophies must seek a mandate to fully explore the relationship between experience and innate knowledge as the foundation for pure knowledge to emerge. To repeat, knowledge or truth do not reside in any individual domain, nor are they the private possession of any human being. We know, because ’knowledge’ is an innate natural possession that we constantly share - otherwise civilization could not exist. == Knowledge: Evident facts about mutual standards that provide us with security. == We do not become human beings because we can ‘think’; we become more human because we learn to conform to the implicit principles in Nature and Reality. Denying them - denies our being. It is natural to know. There was no cause for knowledge to be established - it has always existed. Knowledge is an evolutionary process. Human beings developed from primitive innate instinctual knowledge to contemporary cultures. Some know more than others through experience, and make that knowledge transparent. Insistence on how we can ’completely’ know is an ephemeral philosophical question that attempts to deny that we can have ’knowledge’ at all, as you understand it. Knowing that we ’know’ the inherent completeness of everything through the existence of principles, is the natural catalyst to make ’that which is’ transparent. Heraclitus: "No man steps in the same river twice " He believed in the "Unity of Opposites (Absolutes). He cried for the needless unconsciousness of mankind.. “Exploration of a mythical dichotomy below for the purpose of establishing principles. Principles that are not a 'mind' construct, but the very essence of our being. Independence, is the curious and dangerous malady where humanity has lionized negative mythology in denial of its own reality. The human fundamental reality has at its base the simple natural law that we are dependent beings. From conception, the human embryo is entirely dependent on the health and well-being of its mother to provide it adequate healthy sustenance to enable its entry into the world. That form of innate dependability the human species carries with it throughout its spectrum of life. Every aspect of human activity is premised on the availability of air, food, and water without which the organism cannot survive (this would be an incontrovertible 'more reasonable' truism or an Absolute). In a perverse way, that which is our natural state has become the target for what appears to be open defiance of the laws that govern our behavior. When a basic premise is either used mistakenly, or deliberately, its consequences can be socially far reaching, for any deviation however far it is extended is a distortion of the truth, and a denial of who we are. The erroneous conclusion through exercising responsibility that we can confer independence to our actions has gained a distorting and ubiquitous influence which paradoxically undermines the very responsibility practiced. Within the context of being dependent we can correctly be responsible for our own actions but with the surety of knowledge that that responsibility is contingent on the measure of life giving forces available that we are dependent on. The mythical dichotomy 'independence' connotes with the myth of separateness, division, alienation, and the force of these particular myths is expressed in wars, genocide, criminality. Alarmingly the mythological term has become a residual in our lexicon and is used more widely with acclaim than its true counterpart. To uphold delusional 'independence' as a value to strive for erodes our human heritage by diverting useless energy toward a dubious goal, and consequences that leave us questioning our means of arrival. Sadly it is a loss of being with the paradoxical view that the energy expended will deliver up a personal reality. The cult of independent individuality with its mythical ideology based on personal intimacy is now taken for granted, which then passes into the acceptance of the spurious dichotomy as a tangible reality. This in turn disposes the adherents to discredit the very essence of their being, and in the process dehumanizes many cultures. The presumption of independent individuality leading hopefully to a superior future is in fact counter-productive to the purpose, and leads eventually to corrupt power, and subsequently the invention of immoral policies that continue the negative spiral, which in the end has no ethical base to extend from. The alienation from our substantial being creates inevitable tension anxiety, and the need to somehow relieve that anxiety with any artificial means available. = Responsibility. = Being responsible for any social activity would best be enacted with regard to the effect it will have (directly or indirectly) on the lives of those who are dependent on a beneficial outcome. To recognize with some significance the basic structure of our being in turn significantly increases the measure of our understanding of human relationships. Being dependent is not a mental construct choice - it is a state of being, and there can be no being-ness without at least one other being, there is then the possibility that the principle of true egalitarianism becomes the manifest reality. Being-ness can only be identified and expressed in relationship. [[File:Togetherness - Wiki Conference India - CGC - Mohali 2016-08-06 7666.JPG|center|thumb]] This is why the cult of 'independence' is eventually so socially destructive, as it creates that alienation which attempts to deny each real human need, and leads to a depravation of honesty. Human relationships between children and adults where independence is the accepted norm is severely undermined when the educational process predominantly teaches an unnatural form of living (either intentionally or unintentionally). The educational process is then reduced to the adoption of a fiction, which in turn puts at risk any educational program. The effect of interpreting mythical dichotomies as described here is symptomatically ascribed to the existence of all other principles that govern life. The construction of any ethological debate should not be premised on comparative perspectives, based on human thought, but rather on the issues that we can recognize as being universally compatible, therein lies the common denominator point of extension. The focus of attention on comparative perspectives denies justice to 'what is'. To contemplate the 'right or wrong' of any circumstance is a deviation from the truth. The correctness of any debate (however minute the finding), is the justifiable extension, and the only true trajectory we are morally obliged to travel. Truth is not defined, nor experienced by comparison, but by 'what we are'. An orange is to an orange, what an orange is to an orange. To define correctly there should be careful and disciplined action toward establishing 'true factors' that we constantly use to promote reasonable standards. = Time. = In that moment of time, we have the potential to merge on an equal basis with the reality that exists, and to know what true interaction is. That is the point of 'direct experience'. It is then that we know the truth about ourselves and the beauty of this Universe which also reveals to us the folly of our present conditioning. In that experience, it becomes very clear that all so called cerebral activity has nothing to do with reality. The fundamental repository of our knowledge and relationship with life is our being-ness, which is not located inside a mental box to be analyzed, accepted, or discarded at will, but the very privileged natural gift of being. What some scholars deal with is the appearance of life prescribed by the illusion of comparative perspective which functions on the basis of dichotomous ideology. It is in effect a denial of our humanity to conclude that all things that exist [from our perspective] exist only in the mind, that is, they are purely notional. It compounds the denial of 'what is', and an extraordinary refusal to observe transparent life. It should be noted that there is ample contemporary exposure to the Cartesian doctrine, and in this regard, I would refer you to the works of Professor Gilbert Ryle, notably his publication The Concept of Mind.<ref>{{Cite journal|date=1977|title=Professor Gilbert Ryle|url=http://dx.doi.org/10.1093/mind/lxxxvi.341.1-s|journal=Mind|volume=LXXXVI|issue=341|pages=1–s-1|doi=10.1093/mind/lxxxvi.341.1-s|issn=0026-4423}}</ref> The heuristic principle applies throughout when establishing our connectedness with reality. It is only through our contact with reality that we can discover, and equate with the mutual structure of the principles that govern all existence. Have already noted that it is also a peculiar form of arrogance that presumes that life is only a notional existence beyond the boundaries of the 'mind in a box' assertion. It would be foolish of anyone to assert that ice cream has a cold smooth satisfying texture and taste on a warm summers day unless they had actually experienced it, preferably on more than one occasion. For anyone who has never enjoyed that experience, it would be foolish of them to discount the very numerous accounts of such an experience that is available just because they had not been party to that event. From a logical point of view, given the avowed experiences of ice cream eaters, we could reasonably ascertain the validity of each experience by documenting their separate opinions. Each participant would have 'direct experience' in the consumption of ice cream, which at that point in time has the potential for that participant to experience the full measure of that factual reality. We have the natural capacity to experience coldness, smoothness, which equates with the reality that exists, and the potential for those realities to unify. It is not a question of how to get outside of our minds (mind in a box position); we are constantly outside our so-called minds performing acts of transparency throughout our entire existence. The belief that our constant engagement with reality can never be based on a rational acceptance of 'what is', is at the least, very sad. The Platonic Cave shadows are a metaphor for the (mind in a box) syndrome. [[File:An Illustration of The Allegory of the Cave, from Plato’s Republic.jpg|center|thumb]] The need to reach simple, and obvious conclusions and accept them for the reality they are provides the opportunity to engage the complete reality of the moment. It is indeed going too far beyond the reality of the moment searching for philosophical profoundness which does not exist, that fails to establish the constant principles that always operate. Pure principles are not amorphous shadowy ideals; they are represented in everything that exists. The only way we can equate our inner knowledge of reality is through direct experience of its truth. [[File:JUL Soul Iris.png|center|thumb]] Within that context then, life cannot take on a notional existence but is an existence that is very real, and that we continually share through our innate knowledge. That our so-called minds are defined by comparison - incompleteness - dualism would have extreme difficulty in pursuing the proposition that we are defined by our direct relationship with reality which is expressed in our innate ability to directly interact with 'what is'. The reality of interconnection, and interaction, are not idealistic concepts of a notional nature, but actual and consistent transparent realities. We do not live in a shadowy world that is hidden from our direct experience, but we are constantly engaged in the process of life, and we do not have the right, nor the choice, to deny it. The man whose book is filled with quotations has been said to creep along the shore of authors as if he were afraid to trust himself to the free compass of reasoning. I would rather defend such authors by a different allusion and ask whether honey is the worse for being gathered from many flowers. Anonymous, quoted in Tryon Edwards (1853) The World’s Laconics: Or, The Best Thoughts of the Best Authors. p. 232 == Create your own semantic template. == That will consist of an alphabetical list of Absolutes that are all interdependent and interconnected. Their unifying construction creates a ‘new’ consciousness meaning. That ‘meaning’ is yours specifically. The greatest knowledge you can ever have is your own! [[File:Knowledge belongs to all of us. 2030 Wikimedia.jpg|center|thumb]] That meaning also creates its own moral construction that cannot be misused . The semantic template is available to everyone, and its dissemination is our responsibility. “Consider that the language structure, concepts, and definitions now in use no longer always deliver, accurate, reasonable, and responsible information. Indeed at times, they can be quite ambiguous. The statement ‘mutual agreement’, and its physical manifestation in whatever form, is its own dialectic, and will carry within it all other principles necessary for the activity to proceed. Given the Socratic assertion that if something is true then it cannot lead to false consequences no matter how circular any argument may be. Then extrapolating the statement into extended definitions must only lead to a better understanding of the inherent truths available. This can promote recognition of the underlying essence of all things, which can become more real than our conventional understanding of Reality. There is a contemporary need to find new definitions, new paradigms to explore the concepts that govern our existence. Examples of principles and how to define them without dichotomies, just add conjunctions to create any sentence. Communication. Truth. Standard. Proof. Express. Contribute. Mutual. Direction. Advance. Comfort. Organize. Certain. Immediate. Interest. Improve. Present. Constructive. Gain. Trust. Progress. Source. Knowledge. Basic. Original Reality. Awareness.Freedom. Purpose. Connect. Understand. Support. Peace. Cause. Unity. Ability. Rights. Honest. Discover. Positive. Energy. Balance. Good. Courage. Willing.  Control. Use. Association.  Observe. Reason. Easy. Wealth. Simple. Law. Increase. Order. Flow.Co-operation. Exact. Quality. Accuracy. Strength. Responsible. Operating. Creative. Measure. Recognition. Accept. Constant. Obligation. Include. Dependence. Relationship. Value. Success. Principle. Equality. Stable. Share. Love. Sustenance. Action. Identity. Intelligence. Education. Secure. Facts. Agreement. Information. For. Rules.Clear. Yield. Example: Success = Securing facts through responsible co-operation and using constructive knowledge to develop your success. There are no dichotomies! Any principle is correctly defined by any two other principles. You create a new language. Using conjunctions you can write your own book. Where a circular argument is based on an untruth, then it cannot lead to a truth. The reverse of that is that when the truth is established, it cannot be denied. Establishing ‘mutual agreement’ as a center from which we can reach out for extended knowledge in its ever-evolving radius, is not a limitation, or a stop, it is only a beginning! When any concept is truly established the superficial exemplification ceases to dominate, and we can truly experience the apparent essence of ‘what is’. Paradoxically to resource innate knowledge, we must recognize our profound ignorance of Nature, and Reality. Completeness does not lie in individuality. This is an extreme form of monastic expectation. There can be no individuality (or completeness) unless there is at least one other individual. This is the true foundation of completeness. Whenever we are privileged to experience that instantaneous essence of one other, then we know in that moment that we experience ourselves. It is complete complementation with the knowledge paradoxically that it is an endless process. There are many paradoxes we live within that strain our conventional views of what is ‘more reasonable’. Any true relationship experience is not based on a causality premise, but on an experience that is necessarily complementation. Individuality in terms of completeness is a fundamental circular argument back to one, which in its form of denial excludes any form of reasonable argument to the contrary. It is a non sequitur, which denies the pressure of facts that are in abundance, despite the evidence of their reality. To observe ‘mutual agreement’ is looking at things as they are. True observation of ‘mutual agreement’ in action is observing essence transparency – it is knowing ‘who we are’. That form of recognition is essence duplication. The proposition that we can observe the Truth may well be the highest attainment of Realities properties, for Truth is knowledge. Consider the hypothesis of a human entity (an individual) being born in a black space with no other form of life in that environment. How could there be Agreement? How could there be Intelligence? How could there be Understanding? How could there be Recognition? How could there be Love? How could there be Law? How could there be Reason? [[File:Knowledge-Reid-Highsmith.jpeg|center|thumb]] All of the above principles are the transparent manifestation of Nature and Realities properties that are constantly evolving. They are ethical imperatives, and we have developed the positive properties of language to establish them for our use. We can only be defined through relationship principles for they offer us the best hope to recognize the factors that lead to complementation. There is a fundamental need to grasp simple common-sense essentials. The Here and Now is not a temporary transitional time phase that we move in and out of. It is a constant certainty that is essential to recognize, so that our focus of attention has a foundation. Centrism can imply a fixation, which also implies vulnerability, which can be perfectly true if it does not lead to extension. To understand who we are, it is essential that we recognize and become aware of the very principles that we operate from. They encapsulate all the measure of any human societies ethics, morals, and laws, which is a continuous evolutionary educational process within which the realization of its total essence is always available. To use the doctrine that reason is a reliable tool to discover Truth – therefore ‘mutual agreement’ in the context ‘correct information’ translates to the Truth to reason! Evolution is a constant dynamic process. The human phenomena of ‘who we are’ is only understood in our union with each other, and ‘what is’. The paradox again is that there never is any separation. Separation is a mythical non-existent. The principles that are our necessities have continuous expansion properties that as humans we are privileged to assist their propagation. [[File:Making Scholarly Articles Findable- Towards Ensuring F of FAIR Data Principles, John Samuel, WikidatCon 2021.pdf|center|thumb]] The human constellation in its evolutionary march must use these fundamental principles to ensure continuity. To maintain coherence and consistency our source is centered in the principles and factors that we have interpreted from our association with Nature, and Reality. Whatever we write that is of any consequence, or at any other time, is written with the hope that stronger interpreters than us overtake what we present. To ‘see’ Reality as we have seen, and be intoxicated by it, as we have been, will ensure its progression.” == Discovery == The consciousness whole is the sum of all its parts and experiences. As we are all on an evolutionary path, our life and knowledge hopefully develop in the right direction. The exploration took us through a plethora of data and opinions about reality from authorities on science, religion, philosophy and metaphysics. Nowhere could we find a definitive conclusive argument, or agreement, that met our needs. For us, the question came down to “Is there anything at all that provides some form of construction, and certainty?” Something that has its own inherent ethical standards. The alternative proposition to that is a nihilistic “nothingness”. A pathological proposition that makes no sense. Heraclitus’s “unity of opposites” seemed the most promising. Our understanding of that now made dichotomies a semantic illusion. If achieved in a mindful way it is the act of uniting them, providing a conscious correct experience of ‘what is’. We live our lives with secondary knowledge that everything that is – is always interconnected and interdependent. Yet our illusory experience belies that form of knowledge. It is here that we understood Heraclitus and his “unity of opposites”. Mentally uniting opposites replaces the existing illusion of their existence – there are no dichotomies! [[File:Heraclitus, Johannes Moreelse.jpg|center|thumb]] Once the illusion is gone a new solution manifests that is peculiar to the mindfulness operator, and belongs to a higher form of consciousness. Heraclitus was known as “The Weeping Philosopher”. He wept for the needless unconsciousness of mankind when the ‘unity of opposites” was always available. He was also known as Heraclitus The Obscure. A title we suspect that came about because the successful conclusion to uniting opposites and replacing the illusion, opened a door to a new dimension. Semantic description at this time may not have been available. This brings us to the ancient Yin and Yang symbol of the ‘unity of opposites’. As separate entities in Chinese philosophy, they are complementary, and in fusion they represent the whole. So as dichotomies they don’t exist. [[File:Ying and Yang Street Art - panoramio.jpg|center|thumb]] The whole is the elemental answer to any fusion of opposites, whatever that may be. Symbolize a line as being infinite in the sense that any line can be categorised as being infinite. Apply an infinite number of points in any line. Intersect any line through any point by another line then we have a specific identifiable point at the intersection, which at that point in time has an infinite quality, yet constant and complete. Any such point has Matter, Energy, Space, and Time, the epitome of the microcosm. We may locate a Reality point that establishes the Truth. Conventional mechanical ‘thought processes’ deal with dichotomies that are based on a comparative perspective ideology, and consequently, skew any real experience of that which is real. We must use correct ‘measuring sticks’ to secure proper standards, but from the point of view that there is a belief in dichotomies, it will always be a compelling argument that aspects of reality can be contradictory. The element of denial within human historical memory accumulates to establishing dichotomies as being real. We are defined not by how ‘different’ we are, but by our commonality of existence. When we locate that Reality point we will then know that the definition in itself has a whole, and complete explanation of ‘reason” in all possible senses. All the reality we can deal with is here, and now. There is no possibility that ‘infinite regress’ (an imagined reality) is any part of our immediate experience. Infinite regress through thought processes, deals with questionable imponderables. It is a descending spiral, which further removes one from reality, which only produces illusion, and correct meanings are always deferred. It is making a holy virtue out of complexity. The epitome of completeness is the active realization of the operational principle. [[File:Brick house 09.jpg|center|thumb]] Conclusion: A brick – a house. Each complete in themselves. A house is not composed of one single brick, but each brick in its composition is complete, and whole in itself in that it has matter, energy, space, and time. In that context, it is a microscopic whole which has implicit within it the macrocosmic whole, a house. We cannot define that which isn’t. We constantly use negative dichotomous terms in language, which are in essence factually indefinable, and therefore non-existent, but they are used as though we can support a view as to their existence. At this time we constantly use mythical concepts as though they had real substance. That erroneous belief in turn diminishes that which is real and compounds the problem of recognition of Reality. The flat earth society no doubt had to be persuaded of the mythical nature of their beliefs. This dictates that we must research ‘that which is” to achieve an understanding that supports that reality. Separation is the mythical measure we use in an attempt to justify the real identity of either ‘relationship’ or ‘completion’, but it has no substance in fact.That we are connected, that we are related, that we are communicating, that we agree that ‘mutual agreement’ exists, all of these factors fall into the category of ‘that which is. There is nothing that is real that is not immediately available to us, there is ‘mutual agreement’. Attempting to view true relationships as having a necessary separation link, or dichotomy is a clear misunderstanding of the nature and completeness of all that we are related to. == Connectedness. == A relationship is defined as we are by the measure of contact (especially homo sapiens) that is apparent. It would be true to say that I have a measure of relationship with everyone who reads this material. No matter how tenuous the link we have a measure of relationship with all life – we are related! Depending on the strength of that relationship defines ‘who we are’. ‘Who we are’ is not defined by any spurious separation from life, quite simply because we cannot be separated from it, we are engaged in it at every moment in time. Any attempt to establish ‘separation’ as a reality is an attempt to deny ‘who we are’, and another exercise in futility! Again artificial interioralisation of concepts or principles leads only to a denial of their external reality. We are all connected by the very simple fact that we all exist on this planet. It is a very simple axiom that all life on this planet is supported by the conditional properties this planet provides. It is also a very simple, and more reasonable axiom to conclude that no matter how tenuous the link that all life in this regard has very concrete and definitive forms of relationship. We all must breathe, we all must eat, and we all must drink, and if you need any further certainty of ‘completion’ relationships, we certainly, all must die! [[File:Universal Theories.jpg|center|thumb]] To set in qualifications from the premise that there is a ‘separate mind’ (a kind of Platonic cave) to get outside of. This premise precludes either in part or in whole the evidence and experience of Nature, and Reality, within which our beingness is located. It would all be beyond our grasp if indeed our conventional concepts of consciousness was adhered to, which in effect attempts to deny us that direct ‘relationship’ to ‘what is’, and the completeness of that experience. Knowing or being and solipsistic theories advise that we cannot truly know each others experience, nor can we penetrate others experience, but in the democratic recognition that we know and have our being in relationship, and the mutual, and natural convergence of everything there is. Homo sapiens (race, color, or creed aside) necessarily conduct themselves in ways that extend recognition, and understanding at every level, without the constant need of ‘completion’ recognition that is inherent in all our interrelated actions. The flat earth society eventually moved on to a realization that their visionary scope was shrunken, and severely limited. They were deprived of a planetary (never mind a universal) relationship that one can only imagine severely curtailed the very expansion of consciousness necessary for humanity to progress. We have evolved some little way because of our understanding of the natural relationship. The centered in the mind condition - which connotes with the separation ideology - screams to be released from that mythology, and engage itself directly in real relationship with everything that is. = Relationship. = Separation is the mythical tool we attempt to use to maintain a false continuity of an imaginary individuality that does not exist. The taking for granted conditional mythologies (the flat earth society) engage the victims in what can best be described as serious problems in recognizing the very limitations that restrict their development. We must learn to view wholes, which equates with viewing ‘completeness’. The whole is greater than the sum of its parts, but the parts are not necessarily separate conceptual parts. We can ‘see’ the whole when we are able to identify the factors that constitute their existence as a complete reality. That which is complete in Law = Agreements that produce secure and dependent outcomes. We know in essence the concept of ‘completeness’, and we demonstrate the evidence in myriad ways. Each act is a microcosm of the whole – view from the other end of the telescope! In the traffic analogy the driver, and all other drivers, conform to the law by driving off when the light turns green. There is an implicit agreement about the value of traffic laws, and traffic lights that control the flow of traffic. At that moment there is a complete relationship understanding of those values. The ‘complete’ or ‘wholesome’ activity of motorists waiting at traffic lights for the green signal to go, and they then move off, validates all the factors implicit within the properties of ‘mutual agreement’. [[File:ParkStreetTraffic2.jpg|center|thumb]] Whatever we communicate for the benefit of future generations should not be based on mythical assumptions, but should be based on necessary factors. It is ordinary life that portrays all the dignity, honor, and the complementary wonder of the human species. We are here – we are present – we are communicating. We have an obligation (which we necessarily fulfill) to make transparent the basic principles that govern our existence. That, which is factual, provides us with a correct motive for behavior, and we do a disservice to Reality when we attempt to deny it. We exist and live in a world where acts of ‘completeness’ expressed in one form as ‘mutual agreement’, are continually enacted. It is the form of expression, and continuance of processes that we constantly use to arrive at reasonable solutions, and we employ factors that are necessary to provide us with a clear, and unambiguous understanding. They motivate reasonable behavior toward activity that we can accept as being a logical process. == Natural Experience: == No form of life can exist in and of itself, it is brought into existence through a relationship with its own environment, or its species. The obvious egotistical monistic nature of oneness (if there was such an entity) could not leave any room for the realization of anything that might disturb its comfort zone. There is no real knowledge where any concentration is on the “I am” syndrome. "No man is an island, entire of itself; Every man is a piece of the continent, a part of the main." - John Donne, 'No Man Is An Island, Meditation XVII - Devotion Upon Emergent Occasion.<ref>{{Cite book|url=http://worldcat.org/oclc/40682518|title="No man is an island" John Donne.|last=1572-1631.|first=Donne, John,|date=(1999 [printing])|publisher=Souvenir|isbn=0-285-62874-7|oclc=40682518}}</ref> [[File:Uros people residence on floating island, Lake Titicaca Peru.jpg|center|thumb]] “We are’ is an inclusive affirmation that deals with “what is’. There is no constructive dialogue, no real understanding, without a relationship. Based on personal experience, we are a distinct, and unique species born of Nature and Reality that has combined to provide us with the innate ability to recognize the very properties that created us, and utilize them through an evolutionary process toward ever-increasing transparency. That transparency can only become available through a matching process between innate knowledge, and the reality we share, a reality that is our heritage. We like all other forms of life are the product of Nature, and subject to its laws, and principles. Necessity created a language that evaluated Reality, and provided us with guidelines to emulate its constant properties. The measure, and quality of knowledge is dependent on the realization of ‘what is’. The crux of correct knowledge is to know the base that we function from. The principles that are implicit within Nature, and Reality we have now translated through the evolved language systems with symbols and definitions that we now use to share the experience. When principles are fundamentally true and recognized for what they are, misguided belief systems will evaporate. To ask what is the source of the principles we present is ipso facto to ask what is the source of Nature, and Reality, and we repeat, that is an exercise in futility, but that does not mean that we cannot recognize that which is natural to us, and express it, as best we can through language. The experience of ‘who we are’ is the Ultimate transparency that transcends all doubt, or denial. We can know with an understanding that is pure and indisputable, that is the motivational drive for evolutionary continuance. To understand who we are we must address Nature, and Reality, and ask ‘what is’ Here, and Now, with an understanding of the dichotomies that exist in language. The ‘Eureka’ moments, epiphanies, enlightenments, etc, are all evolutionary evidence of who we are, and when we can translate them into principles, and concepts, then the assertions of an Archimedes (and many others) are recognized, and properly used. Through Nature, and Reality we can establish what Truth is! Is it true to say that most people conform to the rules of the road? It would be more reasonable to assert that the answer is yes! Consequently, we can say that we have ‘Mutual agreement’, and ‘Co-operative Understanding’ as observable realities. There is no conceptual source through Time, or history where there is an end. There is only ‘beginning’. Here and Now is always the ‘beginning’, and a more reasonable platform to explore than any exploration into the past concerning our true identity. [[File:The spray is beginning to hit now (27283410383).jpg|center|thumb]] Contemporary terms like Absolute, Complete, Positive we use to match our conditional understanding of ‘what is’. When we use contemporary conditional language to address concepts like Truth, Knowledge, Understanding, they are limited by the measure of our progression, but we use them all as stepping-stones. Language is a constantly evolving process. When we agree that there is ‘some certainty’ and ‘limited knowledge’ you have agreed to the concepts of certainty and knowledge as factors that are part of our natural reality. All of us function within the framework of certainty, and knowledge, to some degree. Given that we agree to their existence, these are the factors that can lead us to the experience of ‘who we are’. They are a part of us that can lead us to recognition of ‘what is’, and make a transparent reality of the very things we do on a daily basis. We do not need absolute and certain knowledge to perform everyday tasks, but those performances are structured contemporarily because of our advanced understanding of the things we do, based on our own innate reality. To honestly perceive the consistency of ‘what is’ (to be interdependent, and mutually connected) in interaction, can and does promote the visible reality of ‘who we are’. That visible evidence translates into the knowledge of our complete presence. We know with certainty that our beingness is of pure essence, and from that experience, we are obliged to formulate, as best we can, the structures that are responsible for making that transparent (witness the explosion of human progression, without the necessity in Time of experiencing fully ‘who we are’). To take a more reasonable stand please observe the multiplicity of human action where interdependence, and connection naturally proliferate. To realize that we are ‘interdependent, and mutually connected’ is the realization of a consistent fundamental truth – ‘what is’. Through identifying ‘what is’ as an internal reality we can make transparent the factors that are our natural construct. It is only through sharing this reality that we recognize it! [[File:Turtle togetherness.JPG|center|thumb]] These factors are not based on any ideology, belief systems, or opinions; they are composed of the Reality that is available to us all. We are unique in that we have the opportunity to be able to use their value in the manner that is implicit within their structure. That use is evidence of our understanding of Reality. What could have happened without the assertion that traffic lights are a safe way to control crossroads, or the assertion that the rules of the road are beneficial for our safety? Any true experience, epiphany, enlightenment, etc, of ‘who we are’ provides fundamental, and indisputable knowledge of that Reality. Applying the recognized principles provided by Nature, and Reality consistently advances the evolutionary process, hence we have Science, Philosophy, Religion, Education, Art, and Law. When there is a Pure Realization of who ‘we are’ through relationship recognition, it is unquestionably the recognition of the encapsulated, and innate principles we all share, and there is no place for the dissolving of another Real identity through that recognition. Indeed it is a privileged insight into the epitome of purity. Nature and Reality can give us direction and guidance to our human existence, and we repeat, it is an exercise in futility to seek any cause to their beginnings. We have proffered the concept of two as a basis from which human reality can be ‘experienced’. To recognize through, and equate with the true substance, and essence of one other is to automatically experience the totality of ‘who we are’ in full measure. This does not mean that the terms ‘totality’ and ‘full measure’ convey an ‘end’ to ‘what is’. We have consistently offered recognizable facts (not assertions) that are part of our natural human activity, and give correct direction and meaning to our basic essence. We do function within the structure of ‘mutual agreement’, and we do communicate and ‘make known’ – basic obligations. These are evident simple examples of innate knowledge, and our understanding of ‘what is’ made transparent. To repeat we could not recognize anything without innate knowledge. All knowledge is a continual matching process 1 + 1 = 2. toward the realization of ‘who we are’ the development of language structures that correctly establish basic reality as it is, provides continuous knowledge that makes transparent the very nature of that reality. It is vitally important to recognize that we have active communal agreements concerning the existence of basic principles and concepts that form the very foundation of our lives. Constant change and movement in Space-Time - Energy - Matter are applicable absolutes to be recognised, which equates to evolution. There never will be a static property involved in the evolution advance. Evolution encompasses its own absolute properties to provide cognitive connection confirmation. The evolution of conceptual language exists to provide natural equality and to promote cognition between language states. No matter the languages spoken the concepts of air - food- water is the same and can provide a gateway to explore the future dynamics of human relationships. === Knowing. === Knowing what all the truth is is not some miraculous state of perception. Nor is it a high academic achievement of amassed information. It is simply an objective common-sense view of ‘what is” and in reality what must be. It is what must be for life to function within the principles that exist that are its natural foundation. We are always of necessity the living expression of a reality that must be experienced in the whole. Our recognition of the same principles operating universally is also our recognition of who we are. That proliferate ‘sameness’ is an evident easily recognizable identity. When a child is afraid of an imaginary monster in the dark, we generally do not accuse them of being absurd, or that they are lying. Appeasement comes with an explanation of reality at that level which is truthful. An explanation, which the child can grow up with, and find comfort. It is simply introducing a child to a level of truth that is more real to them. In every instance, the only reality that ever exists is truth. However, distorted it may be expressed. One of the major distortions as the result of thought processes is to consider that we can manufacture something other than the reality that exists. The ‘fact’ that you recognize contradictory or absurd statements is that behind them there is a measure of truth. The habitual liar lives in a world in which he or she imagines that truth is something they can manufacture. [[File:Ten Top Teaching Tips.pdf|center|thumb]] Where human ‘thought’ constructs its reality in terms of dichotomies it can never deal with the truth because it continually makes those comparative perception judgments. Those judgments are always in question because again they cannot deal with reality as it is. No matter how absurd or contradictory any statement is, that is the measure of truth expressed. Ergo whatever it is that is expressed, or made manifest, is the truth to some degree. Ergo everything that is, is the truth. It is our responsibility to recognize it for what it is. It may be appropriate to review previous observations on dichotomies and gradient scale. Consistently we have contended that there are no dichotomies, which then properly puts each principle into the category of an absolute. To identify ‘truth’ as an absolute in that category then everything that is must have a measure of truth. It is a very simple and sensible approach to establish ‘what is’. It is the means of identifying a reality that must have truth as a base – whatever it is, and however nonsensical it may appear. All principles have an elementary gradient scale that we must use to identify knowledge that is honest. That gradation scale knows no dichotomies. Dichotomies are always the imaginary properties of pseudo subjective reasoning. Necessary factors establish that gradient scale where only objective realities exist to furnish a healthy subjective reason with truth, and so we learn to apply the conjunction to address reality for what it is. Truth comes in an abundant variety of ways in its commonality – and therein lays its overall ‘complete’ power, despite any denial to the contrary. Embedded knowledge as we see it is neither experience nor knowledge without principle content. A person may be well educated in all aspects of the geography of a beautiful South Sea island, but have no practical experience at all of its beauty. Being clever about a subject does not necessarily equate to an understanding of the subject. Nor should it lend itself to posing as adjudicators on a proposition preset we imagine by the same adjudicators, or essentially the same school of embedded thought processes. Long before human evolution, the principle of leverage has always existed in all Nature (as have all other principles, wherever there is space – time – energy – matter). Our adaptation to the existence of principles has added to the sum total of ‘knowledge’ as we know it, including the concept of knowledge itself. That form of ‘knowledge’, and our ‘knowing’ is natural and not any personal or esoteric acquisition. Just as a fish knows what its natural habitat is, or a bird to fly in the air, the human species uses all available principles it recognizes to add to its knowledge (already said). Any valid theory of knowledge must have as its base constructive definitive principles to support it, and it is evident that our accumulated common knowledge equates to our common experience. No matter how erudite or convoluted any argument may be, if in the end it is reduced to inane observations that have no factual basis in principle, then it is time to abandon them. Do try to consider the sort of ‘mind’ processes that offers us up a world that knows nothing but separation. How can we possibly evaluate what ‘wholesomeness’ really is? How can we possibly evaluate ‘who we are’? How can there be any theory of knowledge without addressing Nature or our innate and biological relationship with it? Any attempt to debate ‘who we are’ and the completeness of that concept must have some sense of reality on the real meaning of ‘completeness’, and some understanding of the principles that are the nucleus of human society. To wrap any argument around a non-existent concept that can never be realized is apropos to attaching oneself to a system of belief in things that do not exist. One can make ponderous and convoluted statements about those beliefs but in reality, they are morally and ethically misguided. The ability to correlate correct definitions to the reality of life offers up that direct link to the truths that are common to us all. It corrects the presumptive notion that there can be ‘different’ perspectives on the same reality. There can be ‘differences’ but there can not be ‘different’ measuring sticks for the same reality. No matter the multiplicity of perspectives, they can never alter the core principle of ‘what is’. Historically evolutionary progress can best be measured by the adoption of recognized principles. Reality at whatever level we find it can only be understood by addressing ‘what is’. Nothing can be understood by attempting to relegate it to a non-entity through questionable theories of ‘knowledge’, which in essence negate the very content of knowledge itself. The perpetuation of any theory of knowledge, which cannot recognize the principles that are its foundation, can only be a shadow of its own reality. Construct the ‘necessary factors’ around the skeleton and a body will take form [[File:Balinese food @ The Uma.jpg|center|thumb]] If any particular theory of knowledge cannot identify simple truths, how can we possibly question how anyone ‘knows’? A dichotomy is the human attempt to deny the existence of a whole reality of a principle. We have the principle of leverage and its necessary gradient scale. Mutual agreements of a consistent reality, at a communal level, are a passive form of the Eureka moment, which recognizes fundamental principles that relates to truth. In every social structure, there are varying degrees of recognition, which determine social use. The mosaics of differences, which make up the rich pattern of life, are a testament to human creativity. Principles offer up a form of predictability in which our brain forms knowledge through the process of interaction. The experience accumulated through each moment, forms exponentially in use, or becomes transparent immediately in a Eureka moment, in which we know. Real knowledge is through the constant interaction with natural principles, much more than the transference of divided embedded information. The problem we face is that ‘knowing’ or ‘how we know” is never a personal possession. Any theory of knowledge no matter how in that respect, is true interaction. Peeling a potato and ‘knowing’ it, is rewarding enough! All principles are the repository of pure erudite knowledge. We recognize Universal principles in play at all times in Nature and its by-product – human societies. The correlation between determined interdependence to objective reality requires our intellect to ‘honestly observe ‘what is’, and assimilate that subjectively. Then the equality of the external and the internal becomes a reality and we ‘know’. Knowledge is the process of natural action, reaction, and interaction. It is nonsensical to ask how do we ‘know’.Every moment in time is complete because it must contain all the principles that form its nucleus. It can only be like that to facilitate the immediate experience of Eternity, or the wholesomeness of any of its principles. On the gradient scale of experience, we all exist somewhere on that scale. It is called life. === Relevant: === That which is relevant can be consistent with interconnectedness and a gradient scale of knowledge. What it cannot do is confuse the relationship that correct gradient scales of principles have in reality. [[File:Time is Relevant (5485513402).jpg|center|thumb|Time is Relevant]] . Hot and cold would be on a temperature scale. Leverage could only be measured by its own scale. The domestic cat is the same animal species as a wild lion. The domestic dog is the same animal species as a wolf . Gradient scales are the natural human mechanisms used to recognize constant principles. They ensure the human perspective is aligned correctly to identify ‘what is’. The distorted human perspective is the result of human thought processes unable to establish constants that must exist in each moment of time. The problem with embedded information is that it becomes stultified and it can stifle healthy reaction. The injection of recognizable principles invigorates and brings new life that offers countless avenues for human energy to be released. More importantly, those energies are used to enhance the evolutionary process. We are collectively gifted with the potential to elevate life itself. We can correctly use such information by transforming its content so that its inherent truth is made recognizable. It would be impossible for life to function if it was composed of ‘different’ opposite realities. All theories of knowledge are in essence interconnected and can only contain validity when the principles that are the coalescent mechanisms are recognized. The unification of the truth that must exist in any theory needs to be harvested and used to offer up a body of ‘knowledge’ that has commonality of meaning. The identification of principles, truth, knowledge, and their subsequent establishment can only be achieved through direct interaction with Nature and life. Gifted with life we have an obligation to demonstrate its capacity to use every resource to sustain and nourish its own environment. [[File:Beauty of nature 8.jpg|center|thumb]] We all know through the constant natural process of action – re-action – interaction. Depending on the quality of that process, knowledge will take its appropriate place on the gradient scale. That we ‘know’ is natural. It is not some extraordinary esoteric attainment, posited by a body of theories that, by their very nature, look for difficulties where none exists. Universal belief systems based on mythologies can have an entrenched view of good principles being established because of their beliefs. Indeed the perpetuation of the beliefs throughout history offers a dynamic that is counterproductive to the ‘realization’ of principles that are necessarily true. Principles used in this approximate way, paradoxically hold no real meaning, and in fact, impose unhealthy dysfunctionality. When there is a critical change toward establishing correct principles, it is axiomatic that the diffusion of mythologies becomes an automatic process. True interaction lies in the knowledge that correct action is its own reward Any other interpretation is less than tangible. The accuracy in interpreting basic principles, and the alternate knowledge implicit in the interpretation, will always establish the primary principle sought. Archimedes et al. Truth can be found in the oddest places. [[File:Archimede bain.jpg|center|thumb]] Archimedes cognition on how to weigh metals in water through displacement. === Truth. === Language is the construct of human action and the word “truth” seems to hold pride of place by the power of its usage and the meanings it evokes. It is preferable if we could turn our attention to the unity of principles (including truth) that are the construct of every language we use. By uniting the principal terms we can elevate the meanings we desire. Reasonable constructs and the correct duality of established principles always lead toward meaning. It is the only form of meaning that leads to its own extension. [[File:Welcome to Wikipedia booklet, UK version.pdf|center|thumb|287x287px]] All principles have reciprocal value one to the other. No foundation principle can stand alone. They can only exist in a union, one with the other, the source of reciprocity. All absolutes are universal. There is no hierarchy beyond the meanings they evoke in their joint construction. The binary connotations, however, one may express them, provide a constant reality beyond conventional consciousness. That experience is the immediate reward through disciplined application of their use. That discipline takes the form in all human action (such as the bathing scene above) disposed toward the correct functionality of basic principles. The daily connections we make always include the distinct possibility of their recognition, when we make those connections in a mindful state. From any common sense, or ‘more reasonable’ position, it would be more productive to view reality as possessing at every level the same innate values or principles consistent with our ability to measure, or recognize them. To view reality as having ‘different’, or antagonistic properties, is simply a misguided view of ‘what is’. That form of perspective is counter productive when it attempts to establish mythical dichotomies as realities in their own right. When the realities of principles are made transparent, we can then ‘more reasonably’ make use of them to further their basic existence. Here we use reason to exemplify their necessary function, and once established it becomes (if necessary), ‘more reasonable’ to locate them in all things. ‘More reasonable’ seems to have the particular philosophical motivation, not toward simple, sensible, and reasonable evidence, but more likely toward that ‘immaterialism’ ideology, and continually seeking for an elusive protracted answer is hardly ‘more reasonable'. Since we are apparently confined to a human perspective, we must settle with the latter position: the apparent state of representation of the world. The de-materializing of any object through the practice of ‘perceptual illusion’ is an attempt to deny the reality that exists. Where perceptual illusions are concerned, innate direct communion with that which is, suspends the effect of such illusions. All the properties in a chair are recognized as the reality that exists. That is materialism. A chair does have the principles of form, design, structure, colour, substance, etc. However it is analysed – it is a quantifiable reality. The reason could easily be defined, and validated, as the correct application of common sense. More expressions of common sense can only endorse the completeness of any concept. A true experience of reality does not require endless explanations as to its ‘wholeness’. It just is. Truth is in reality a network of implicit principles in which it is the predominant energy in each of them. They are identifiable by their interdependent nature (see network below) not the least of which is common sense. Dictionary given definitions of ‘truth’ place it in a very common sense acceptable category. One of which is ‘accuracy of representation’. Note how the two definitions in this paragraph coalesce. The human drive toward recognizing and understanding the place of principles (constants) correlates to the energy we expend on questioning ‘who we are". The constant principles of action, reaction, interaction, are the automated natural impulse toward ‘establishing’ a human reality, and human identity. The process of evolving within that process has an egalitarian dynamic that powers it. In essence, it is a natural gift that we must accept. Each life and its identity contains all its personal experiences which can never be known to anyone else. In a sense, we can never “know” another person. Their life is sacrosanct. We can know a lot '''about them''', and there it ends. Truth is at the top of the gradient scale that measures the veracity of all things that are complete and related and paradoxically all reality is the truth. It gets back squarely to ‘who we are” and where we exist on that scale. To view gradient scales as having no truth to their structures is denying truth itself. For the entire interconnected, interdependent network of principles, each of them has a gradient scale whereby each measure expresses truth in its own manner. All forms of leverage, from the minuscule to the lever that will move the world, are in of themselves, true and exact at that point. It is the only way we can recognize their existence, and use that complete truth at that time, to move up the scale. Time is the relative measuring stick that determines the amount of knowledge we can absorb. Consider the advanced extensions to the Archimedes principle of leverage throughout time. Network scale example. Truth Knowledge Common sense Responsibility Reason Understanding Intelligence All interdependent, and interconnected with all other principles and absolutes. No ‘thought processes’ or ‘mind’ constructs can create reality. All we can ever do to gain knowledge is ‘act’ react’ and ‘interact’ within the confines of our immediate reality. The quality of that action is determined by the nature of available information. When there is freedom from embedded thought processes, there is a natural human ability to relate to the existence of truth as it is expressed in reality, and our brain records it accordingly. Thus, the principles of civilized societies evolve. Where there are predominant belief systems, the implicit energy will naturally direct itself toward human standards that blend all ethics together. That implicit energy will find its true home in the principles it seeks. The connected strength of those principles offers sanctity of experience that demands no sacrifice. Everything that is, must of necessity, have a true comparative value (not a distorted dichotomy value) for honest recognition to be realized. which is to ‘know’. All things are relative but only within their own true scale. It is the process by which we can identify reality, as it is. Principles cannot operate on any scale practicing negative discrimination. Thus a healthy individual can be at the top of the scale and someone with various health issues can be near the bottom of the scale. But that is how healthy they are. There can be no relativity when ‘mind’ or ‘thought processes’ believe in mythical dichotomies. When human perception is distorted by such beliefs, they create a false reality and deny access to the true state. Where there is a network of connected basic standards that are universal, then it is possible to use them and be nourished accordingly. The scale of natural human progression provides recognizable evidence that we are constantly developing. Reality is the direct and conclusive evidence of possibilities realized. Therefore, the reality is always the source of all possibilities where truth exists. When the truth is used as the universal measure of ‘what is" there can be no discord as to its accuracy. It can only measure the principles that are implicit in everything there is, its natural milieu! Truth can only deal with ‘something’, it cannot measure an imaginative negative counterpart. Truth is the constant implicit property in every universal scale of principles. Thus, reality becomes transparent. Have writ large on the value of distorted comparative perception judgments. The standard of correct knowledge always carries with it, its own appraisal. Where principles are concerned there is an obvious scale of identification (e.g., leverage and the numerous references) that is all-inclusive and provides us with evidence of its existence. We could say with some truth, that the industrial crane has more leverage than a child’s see-saw, but we cannot deny the truth at the lower level or the reason applied. Where principles are concerned, truth is not a possibility, it is a constant reality (e.g., leverage). When mythological dichotomies are recognized and established for what they are, the process of ‘ironing’ them out and experiencing their constant reality will translate into the reality, which they are, and used accordingly. To evoke that new sense of reality, the mechanisms of ‘selective immaterialism’ need to be dismantled. Where human experience is presented with something it does not understand and is unable to appreciate the principles involved, the reaction can invoke a sense of fear. That condition can be a primary breeding ground to establish a language of dichotomies and put a selective name to something it does not deserve. The diffusion of a false singular dichotomy into the natural healthy state of the common good puts responsibility into its proper place. Within the process of diffusion, there is the natural and equal absorption of our true reality. The transition between separation and inclusion will be a seamless process because it is our natural state. Objectivity and Commonsense: Explore the plethora of principles - truths - constants that are the mark and phenomena of Homo sapiens. We cannot have any doubt about our existence in this present reality. The truth of reality is and can be experienced wholly and completely by anyone at any point in time. All human progress is the result of such experiences, manifest in principles throughout time and their subsequent ‘use’ evolves exponentially. The overwhelming evidence is our reality, now. A simple analogy of objectivity and commonsense. Somewhere in our early development, someone put the ingredients of a loaf of bread together, somehow baked it, and hey presto, the first experience of a loaf of bread. It is now a form of sustenance, which feeds billions of people. We no longer need to experience that ‘truth’ that ‘knowledge’. It is unnecessary because it is subjective assimilation and the act of external and internal activity. [[File:Banana bread loaf, October 2008.jpg|center|thumb]] Because ‘our’ brain functions in a manner that can identify the natural elements it exists in –space, time, energy, matter, we learn to ‘know’ and recognize ‘completely’ a child’s see-saw. Knowing is a natural evolutionary function. The quality of ‘knowing’ has its own natural determinants which of necessity contain the measure of principles required for universal recognition. An Archimedes insight (or anyone else’s) could not become a universal reality unless those determinants were in play. I know the very same way we all know – by experience via action, reaction, and interaction. Truth persists and what Archimedes experienced was true and complete. Any experience of any truth, principle, or constant can be as ‘complete’ within a grain of sand, or knowledge of a pyramid. All experience of that nature is an experience in ‘time’, and when it is the truth, we use it accordingly. There is no mechanical translation, or opinion of ‘necessary factors’ as they are constant universals. That, which is ‘complete’, is transparent universal knowledge e.g., the principle of leverage. The precision of terms must include ‘necessary factors’. Necessary factors translate into a common universal language so there is no loss of meaning. [[File:Freedom of Expression 3 (38007871132).jpg|center|thumb|Freedom of expression]] All truth – principles-constants – absolutes, that stands the test of time we use accordingly. Thus, human societies evolve, and we evolve without the necessity of having to re-experience any of the principles we recognize and establish. That simply would not be a ‘natural’ commonsense proposition and an entire waste of unnecessary energy. The truth of any principle at any point in time, and at that point in time, can be experienced completely by anyone. Whatever it may be if the principle is established – from then on, it will evolve. There are some misguided notions that ‘truth’ ‘knowledge’ and ‘experience’ have some secret value that is unattainable by ordinary experience. It is a ‘natural’ evolutionary reality that what we ‘know’ becomes useful. We have a mutual responsibility to recognize, use and honor the principles, which are the common property we share. = Human consciousness. = [[File:Lane past Coombshead Farm - geograph.org.uk - 589598.jpg|center|thumb|369x369px|"The roads half travelled when you know the way"]] [[File:Sombrero Galaxy in infrared light (Hubble Space Telescope and Spitzer Space Telescope).jpg|center|300x300px]] === The Universe === ''<big>We do not own Space</big>'' ''<big>We do not own Time</big>'' ''<big>We do not own Energy</big>'' ''<big>We do not own Matter</big>'' The human capacity to understand the question of sovereignty or ownership of Space - Time - Energy - or Matter can only be accepted when any basis of dispute includes two dispositions - human and spiritual indigenous ties throughtout history. With the evolutionary appearance of indigenous peoples throughout this planet, their way of life should make it paramount that their existence be recognised as a natural law that has providence! Their culture and way of life has its own identity in which Space - Time - Energy - Matter is expressed as they experience it. That proof also lies in the existence of caves thousands of years old, and the existence their art and culture. So the constructs defined below are a new approach to understanding the concept of ‘knowledge’ and its proper place in an evolutionary expanding universe. Knowledge acquisition requires appropriate recognition through action, reaction, interaction, in which proper perception and comsciousnessvalues are applied. That form of construction requires the dismantling of previously embedded information. This requires a new direction to formulate a sound basis from which to extend. Construction of an analytical methodology to establish a form of ‘knowledge’ that is best suited to distinguish in a contemporary reality. A reality that adequately conforms to common notions of that which is true, and can only exist without any false relation to that which does not exist. All science needs the certainty that established absolutes provide. A pragmatic construction of real knowledge would propose that all reality expresses a form of evidence or proof and that the observer and the observed contain innate properties necessary to establish a foundational agreement. That form of agreement would necessarily function on the basis that everything that is – is truth. Any other interpretation would be a disconnect from reality, and the interdependent correspondence that must exist for true recognition of any absolute. Controversy will always emerge when the discourse on bifurcation and the introduction of non-existent dichotomies are used as arguments to be explored. Pragmatism would say that the human species would need basic properties to formulate any form of reliable epistemological analysis to explain and simplify the reality that forms their existence. That reality could well be recognized initially as the absolutes of space-time - energy-matter, through innate perceptual data that corresponds to an outward structure that is constantly evolving. That which is absolute is the determinative factor in establishing the existence of truth. When a chair, is a chair, is a chair, its recognition is established when we ‘commonly’ apply subjective and objective measures to that which is truly external to that which is truly internal. That which does exist becomes ‘common’ knowledge, and accepted as being true. Thus, the distinction between a priori knowledge and a posteriori knowledge no longer exists. Where there is consensus, everything is. The formulation of absolute criteria that offers ‘simplicity’ as a tool to measure all and everything, dispenses with the confusion of ‘difficulties’ historical philosophies engage in. It also offers an observable synthesis that clarifies the confusion. Within the combined properties of those absolutes then everything potentially would be. Everything that is by that definition is original, ipso facto, everything that has no false relationship, and therefore true (no dichotomies). Given contemporary human development, it would be ‘common’ pragmatism to accept the proposition that we exist within the absolutes of space-time – energy-matter. Within those absolutes and their innate properties, it would also be pragmatic to assert that ‘everything then is’ (whatever everything may be). Pragmatism would also dictate that ‘everything that is, is its own form of truth, and must contain available constructs of meaning. Therefore knowledge and understanding would be obtainable to that common experience, and at whatever level that experience is activated it is in interdependent unison with the source. The continuing establishment of basic absolute principles (their generalities and their specifics) forms our reason. 1+1= 2 is a ‘simple’ but true universal constant generality. That form of generality is used because we recognize the specific principles of a balanced equation that adds up and makes sense. Simple generalities with their inclusive specifics form the foundation of human reason and its constant evolution. Simplicity is the bane of a ‘mind’ that must have difficulties. = Availability. = The unifying feature that makes ‘knowledge’ available to us all, are the innate universal principles in all things. Archimedes established the principle of leverage. To paraphrase - ‘give me a lever, and I will move the world’. Once the law is established it can then be put to good use. The principle of leverage is manifest in countless ways, and put to good use! The principle of leverage is a constant available to us all, and always has been. Through his application Archimedes conveyed his insight in practical terms, and made aware of the principle and the laws governing it. We now use those laws. We no longer need to philosophise on its existence as a truth. Similarly whenever 2+2 = 4.  Whatever we use to make the equation – apples, oranges, bricks, the mathematical equation is a constant, and the principle of correctness applies. Here 2+2 =4 is empirical proof that the principle of correctness and agreement exist. Principle, or law: ‘a fundamental truth used as a basis of reasoning’.           If it were otherwise we could not measure anything. That which appears abstract then, requires no implausible argument as to its non-existence. Such is the nature of all universal principles, they exist whether the notion of a ‘mind’ can perceive their existence, or not. Because ‘thought’ does not create the reality of principles – universals- truth, it cannot from its mythical standpoint understand the simplicity of a Reality where ‘everything is’, nor the simple and factual conclusion – how could it be otherwise! Where ‘everything is’ evidently encompasses the whole evolutionary dimension. It is not an ideological enclosed static that stultifies expansion of an unfolding Reality. Any pure knowledge experience that ‘everything is’ ,(quite apart from the common-sense truth of the statement) is to experience the Absolute in any immediate part of anything that exists, which establishes its own truth forever. To examine a road code of law with that knowledge, and view the actions of drivers at traffic lights, it is more than reasonable to conclude with some conviction that there is  to some degree, Agreement – Knowledge – Understanding, and Conformity to that code of law. It becomes a ‘more reasonable’ proposition within Reality to understand that that code of law is multiplied exponentially, and the principles practised,  wherever drivers, motorcars, and traffic lights exist. It is the nature of the type of knowledge we are measuring that determines the measure of reason that can be applied to any given form of Reality. We can conclude that 2+2 = 4 is a reasonable mathematical calculation that contains the principles of Agreement – Understanding – Conformity. Given the accepted knowledge of these innate principles we can with more reason apply such a calculation Universally. Knowing is agreement with ‘what is’. Knowledge is not the attempted denial of any existing reality. That is a contradiction in terms. Mechanistic observation is akin to viewing from the outside, a straw in a glass of water. The straw always looks bent, but when removed from the glass we realise it is straight. To claim an experience of that which is Absolute, is not a claim of an experience from a higher domain, or an  isolated incident – it is common-place, numbered by just how many we are. Attempting to denigrate such experience is denying the everyday actions that contain the innate principles of a constant Reality. All life functions within the constraints of the laws that are the constructs of Nature and Reality. All life is an expression of the Absolute. It is when that expression is realised, not only in an instinctive sense, but in a real sense, that we penetrate reality beyond a comparative framework of mythology. To claim that you ‘know’ intrinsically what the principle of leverage is, or the principle behind the mathematical equation 2+2=4 is to claim experience of the Absolute. The Absolute is not some abstract esoteric truth – it is that which is immediate. Whether in awareness or not, we constantly comply, to some degree, with the laws of a constant reality. Therein lies the difficulty for a comparative framework mythology – the Absolute is everything! = Basic Equation. = However much the simplicity of the equation is, it contains the properties of correctness – balance – equality – mutual identity – meaning, which in its ‘simplicity’ presages all future mathematical equations. In that universal meaning, there is particular knowledge of consistent truth. That form of ‘simple’ consistency, creates its own natural equilibrium, and its ‘usefulness’ evolves exponentially up the reality scale. Here is where we need to give proper credence to ‘that which is’. All generalities have profound and specific principles as their ‘common’ identity, which are absolute. Unless those components are recognized, both objectively and subjectively, they are reduced to a comparative value spectrum (using dichotomies) as a misguided ‘simplistic’ factor. Deductive reasoning is then deprived of all value, and leads to the inevitable spurious question ‘how do we know? Given the above criteria to establish a correct basis for knowledge that is recognizable, and of a kind that can be used universally, ‘simplicity’ can be recognized as a tool that promotes its own established formula. That which we constantly use. Everything is the truth with regard to the methodology. How that truth or generality is expressed denotes the measure of the principle that is at its core, and forms that measure of reasoning we enjoy. Fortunately, although the truth is an innate property, it is not a ‘personal’ property per se, nor is the ‘experience’ of its reality. Its natural evolution is progressive. In that progression we are in common, the beneficent recipients that ‘evidently’ conform to its constant existence. Philosophical dissertations have become a monopolistic form of opinions that always seem to presume the ‘rightness’ of difficulties in establishing the source of our being, and are unable to put in ‘simple’ terms the question of ‘who we are’. There comes with that the denial of evidence that permeates human history, which establishes the principles of our ‘common’ reality. Those opinions carry with them a colossal library of questionable erudition that becomes embedded, using questionable values to support their argument. The most distinguished opponent of such arguments (Ludwig Wittgenstein 1889-1951<ref>{{Cite book|url=http://worldcat.org/oclc/1203018418|title=Tractatus logico-philosophicus|last=author.|first=Wittgenstein, Ludwig, 1889-1951,|isbn=978-1-78527-656-9|oclc=1203018418}}</ref>) proposed that language logic was a necessary tool to dismantle the convoluted ‘mind’ propositions that have permeated the philosophical hierarchy. Those ‘mind’ propositions only served to construct meaningless concepts as to ‘who we are’. Although he gained prominence in philosophical circles, his work was directed more toward academia. In his Tractatus Logico – Philosophies he quotes: “The limits of my language mean the limits of my world - What cannot be shown cannot be said”, and “There can be no representation of the logic of facts”. Having a belief in mystical truths that were inexpressible, his statements above are indicative of the embedded language of dichotomies. His form of ‘knowledge’ ‘philosophy’ gave (without question) the concept of ‘mind’ credence to formulate its own logic to clarify its own form of reasoning. Wittgenstein, by not recognizing within the language the distortion that dichotomies create, was unable to approach the evident constructs of true meaning that lie within the interdependent relationship of absolutes, and their constant existence. Evidential reality is all there ever is. The ‘meaning’ or ‘knowledge’ that becomes evident in reality is ‘commonly’ accepted and used accordingly. To repeat, the evidential reality is all there ever is. In that regard, the exponential drive toward ‘difficulties’ amassed a historical discourse of misinformation, which is used to address the very ‘difficulties’ created by spurious value systems. In effect, dealing with ‘nothingness’. We have managed to turn ‘truth’ into a problem, into a difficulty, when the truth is simplicity itself. An oxymoron of gargantuan proportions. This contemporary malady solidifies a diversion that discounts the reality of continuous progression. Progression in which ‘common sense’ is a motivating principle that promotes human evolution. The consistency of specific principles allows us to achieve correspondence. Real knowledge is not a fabrication of convoluted prescriptions. It is the ‘coalescence’ of ‘what is’ to internal reality. That established, evolutionary progress is assured, and reality factors are recognized for what they are. True meaning can best be attained by the interaction and interdependence of natural principles and so recognized as such. That meaning which contains all the specific components of reality is experienced as ‘true knowledge’, measure by measure by anyone. That form of ‘experience’ is not a ‘mind’ process, but a very natural state of realization consistent with our level of action, reaction, and interaction. A correct and pragmatically form of knowledge-seeking foundational answers to perennial questions would seek a direct passage to our ‘commonality’, the beacon that offers guidance. Consider the quantity and quality of knowledge we all pursue that has meaning and usefulness. To posit the notion that there are no dichotomies is a cataclysmic proposition that seems nonsensical to established embedded constructs of knowledge. Constructs of knowledge that offer only confusion, and continually pose impossible questions, whose absence would provide clarity. That absence of confusion would dispel and dismantle a reality of ‘mind’, which functions on its own selection of problems. To address reality as having only absolute constructs dispels the confusion of duality and its inability to ‘use’ relativism in its proper fashion. All general absolutes contain specific principles representing facts; the essential properties that confirm reality. This reference directs the observer to observe, and go beyond the restrictions of a ‘mind’ governed by dualism, monism, or any other spurious form of philosophy that distorts the very reality it exists in. Where there are no dichotomies, all we can deal with is ‘what is’, and the logic of ‘necessary factors’ thus destroying the possible inclusion of anything described as a “paradox”. = Pure Experience. = To design a chair our brain requires to exercise the qualities and properties necessary for its manifestation e.g., strength, balance , design, functionality etc, etc. A chair, is a chair, is a chair, the product of innate knowledge.   If we did address any tentative agreement that ‘I’  is a ‘fiction’, could not our ‘conscious experience’ of that ‘fiction’ be just as fictitious. It would follow that whatever perception of Reality we experience must also be fiction. Our contention, as always, has been that ’I think - therefore I am’ by Descartes is the greater fiction for reasons already explained. To consider to whatever degree that we can function on the basis of a fictional ’I’ precludes any attempt to honestly address ’who we are’. Saying that ‘conscious perspectives’ are limited and inconsistent with apparent reality are quite correct. It then brings into question the validity of ‘conscious perspectives’ to guide us toward ‘what is’. The entangled fictional relationship between ‘mind’ ‘I’ ‘thought’ ‘consciousness’ impose formidable barriers to that which is evident. Base observations on the construct and interpretation of what ‘knowledge’ is. Human experience is limited by its mechanical interpretation of Reality, especially ‘cogito ergo sum’. If everything that is, is its own measure of Reality (the differences) then everything must be measured, at whatever level, as being that part of the whole with all principles intact, making that measure available to be experienced as the Absolute. With absolutes there is no antagonism. We cannot exist or experience anything without a Universal complementary source of identification. It is notable that within the structure of Cartesian dualism, Descartes' personal address to innate knowledge he attributed to ‘thought’ which he identified as being distinct from his body. How different Western philosophy may have been if his attribution had been toward his brain and the existence and evidence of other physical entities that functioned every bit as efficiently as he did. The premise that Descartes operated from ‘never to accept anything as true’, was simply a wrong ended approach which brought him into conflict with his passing acceptance of innate knowledge, that the idea of God was innate to his being. To view the proposition that ‘everything is true’ allows reason to seek and identify that measure of truth. No quest can be productively based on cynicism or denial, nor adherence to belief systems that separate experience, knowledge, and Reality. We have the obligation to question whatever reality has placed before us , but if we constantly deny its existence and attempt to ‘disappear’ it from our experience, then we are in danger of never experiencing that reality. Not experiencing Reality as it is, is equivalent to not experiencing ‘who we are’, and is indeed the only human source and validity of truth, although Descartes held the erroneous belief that such knowledge was independent of any experience. That belief we suspect was some form of impetus toward his ’cogito ergo sum’.                   Knowledge and experience are co-existing ‘necessary factors’ So long as anyone believes that human experience is based solely on indirect conscious interpretation (mechanical disposition), therefore any ‘knowledge’ derived from experience will be incomplete. Clearly it is the quality of ‘knowledge’ that one experiences (e.g., Archimedes) that leads to a common certainty of evidence realised through direct experience. That quality of knowledge can be available when we observe directly the activity of drivers at traffic lights with the knowledge that it is a very common activity recognized internationally. In every case we can logically pronounce the premises to be true, therefore we have a conclusion that is also true - whether that conclusion is defined as Mutual Agreement, or Common Acceptance, it does not matter - they are mutual principles. It is this form of logical knowledge of innate principles that is the precursor to knowledge of the Absolute logically defined within all reason for ‘what it is’ . Where the basic premise is true that there is ‘Mutual Agreement’ between a multiplicity of drivers at traffic lights then we can with certainty conclude that the same principles exist Universally. We can also draw concrete conclusions, and establish knowledge, that it is not ‘absolutely necessary’ to experience by observation the multiplicity of drivers conforming to their particular road code. We have already established that knowledge. Knowledge and experience are not separate philosophical theories. One cannot be without the other.. Everyone has the potential to experience the Absolute paradoxically, in part or in whole. Everything that is, must contain the properties of the Absolute, otherwise nothing could be. To ask questions about human experience based solely and inevitably on our interpretation of ‘knowledge’, and co-existing with that, its particular meaning in human existence. So long as we can only deal with our conscious interpretation as representing Reality then we derive functionally less meaning than we are entitled to. When we see other humans consistently using levers to open crates then we can recognize a ‘social intelligence’ operating which equates to understanding that is not based on opinion, but is a clear expression of human activity that has correspondence. All of the principles involved in that experience can coalesce to provide that form of Reality that requires no interpretation. It becomes recognizable knowledge. How we understand that knowledge is through the realisation and identification of the principles involved, which become immediately transparent. The Absolute could be categorised as a knowledge experience that encompasses all and everything. Whatever is manifest is that measure (complete in itself) of the Whole with all its principles intact. Where there are at least two actions that are identical we can reach a common-sense conclusion that a definitive principle is operating. When that corresponds with innate knowledge then we have the complete cycle. The definition itself is language opening the door to an experience of Reality. No one can know in isolation. An imaginary ‘I’ restricts any experience of who “we are”,  and is not a necessary part of human experience.   Explaining experience beyond imaginary thought processes requires a definitive language that deals with the principles of Reality itself. Pure experience. The world-wide disposition that has no grounding in Nature and Reality becomes captive to any mythical fear that  offers a target to give some form of direction or stability. There is nothing more simple than to make Reality transparent - its evidence abounds. We can pronounce the principle properties that provide guidelines to its existence whereby the reality is made apparent. = Expansion. = To address concerns on ‘negativity’. Negativity is in essence the inability to establish a measure of Reality. Mechanistic processes of denial are the attempt to understand and make transparent that which is apparently unexplainable, and resolve a condition whose energy is driven toward finding that core of affirmation. The evolutionary principle from all available evidence is that human beings as a species progress. This seems a paradoxical contradiction to the embedded proposition that we can never know the ‘truth’. The consequence of such a traditional premise is that denial and negativity both hold paramount positions. We are conditioned to accept the premise that there is in fact no premise that will enable us to go beyond presently accepted norms of experience. We are conditioned to accept that the ‘truth’ is inexpressible. The evolution of the human species is constantly subject to contemporary ingrained social habits, which give some kind of credence to that particular point of existence. Indirect conscious interpretation classifies itself as a solid perspective to govern and justify human activity, which in many historical ways has proved disastrous.                   Our continued intention is to expose detrimental barriers to the realisation of ‘who we are’, and in that process establish a smoother, more realistic approach to ‘who we are’. The Archimedes legacy. When we establish knowledge of something that exists through a multiplicity of experience and evidence, then from every reasonable standard we can establish that it is true, ergo that which is true is Absolute. The principle of leverage is well grounded in social intelligence, and our natural knowledge of that does not need erudite explanations of its presence, nor any ‘conscious interpretation’ to realise its existence, or its practice. Evolution eventually removes restrictive passages to direct experience, the very purpose of evolution. The principle of leverage is not a matter of opinion, it is the realisation of actuality and our continued ‘more reasonable’ response each time the principle is applied. Children learn to speak their language primarily through experience without any direct, or indirect conscious interpretation, and so, universally we ‘know’ the most powerful means to communicate. Were we to move 50 miles in any compass direction from the town we live in, there is a certain predictability that we will meet others who speak the same English language that we do. If in that experience we find that these premises we have drawn about our travels were true, then the conclusion we would come to in particular, is that when we communicate we make known what we know. …………………………………………………………. '''Please note the date:''' '''Oct 2005.''' I am offering up this older material below to provide insight as to the progression of this work. There may well be some duplication to date. During this period my wife and I worked in collaboration to ensure an equality of experience. = Stepping Stones 1. = There is nothing other than what is – there is no hidden Reality that we need to seek, it embraces us at every turn. The Archimedes experience is the pure experience of Ultimate Reality, which provides indisputable knowledge. Reality is the source of complete knowledge, it is the constant source that has provided us with all human development, from the writings of William Shakespeare, to the computer development of Bill Gates. What they have produced is now an evident part of our reality that we can engage in. We can experience ‘mutual agreement’ through epiphanies, insights, enlightenment , understanding, Eureka moments etc, they are all one and the same. Implicit within the macrocosm is the microcosm – it cannot be otherwise. The more we conform within the microcosm the more we begin to appreciate that Reality contains everything, and that we can realise through experience its manifestation. Each Eureka moment is that personal point of experience that connects us with the Truth. The principle of leverage was always available, it took an Archimedes to explain it to us. Each Eureka moment necessarily engages with the reality of complete knowledge, and utilises its share at that time. When we have complete knowledge of who we are in that personal moment, then we understand that these, egalitarian properties, are rightfully shared by everyone and that we have experienced that which is infinite. It does not mean that the process of evolution is over – it has only just begun. It does mean that we can no longer continue coasting through this existence in a near comatose state. If there is a hypnotic fixation in holding the principles of Reality as being separate, and different, then the potential realisation of their immediate unity, and communion, becomes problematic. Knowledge, and experience are one and the same – they are not different!! Experience = Immediate knowledge of basic reality that is factually correct, and that we can reasonably use. Knowledge = Immediate experience of secure, and accurate information that is constantly stable, and sustains principles. Reality = Complete Knowledge. As the microcosmic part of the total macrocosm we are immersed in reality. The real question should be, ‘how can one not know Reality, or ‘who we are’. Mutual agreement is evident when we know we can go to the bank, and deal with money transactions. Mutual agreement is evident when we know we can go to the supermarket and exchange money for goods. Mutual agreement is evident when we know we can send our children to school to enhance their education. Evident proof is validation of what is – it is not a matter of anyone’s opinion, nor is it an assumption of ours. Neither do we assume, or offer any opinion, on the Universal Reality that there is ‘mutual agreement’ that we need air, food, and water to sustain us. Evident proof is also the basis for the mechanics toward realisation of ‘complete knowledge ‘ of who we are. Reality can be realised through concentration on its basic principles. We use language to express our understanding of who we are.It is relatively easy, it is reasonable, and it is responsible. We convey through language our measure of intelligence, and to the best of our ability conform to the basic rule of communication – ‘we make known’ Implicit within that exercise is ‘mutual agreement’. We may differ in some specifics, but we meet the basic obligation of communication – ‘we make known’, and always we progress to some degree. Simultaneity is one of the constant principles that we all share and they come from Here, Now, the Present, where they have always been. Everything is. Our being is always engaged in the present, and we each have an obligation to understand our relationship to what is. The present is the only point of contact we can ever have with Reality. To some degree or another, each one of us is directly connected to Reality (we do not have any choice in the matter), and we can potentially evaluate ‘what is’ through the utilisation, and examination of factual reality. We are the microcosmic part of that Universal Macrocosm, and because we already have that innate information it is a matching process when we have a Eureka moment, an epiphany, an understanding beyond question. Nothing enters our minds - we already know! Everyone has innate knowledge of the principle of leverage. It requires correct examination of ‘what is’ for realisation to occur. It is then a relief to have ‘mutual agreement’ on the things we would wish to make transparent to others. To use a traffic analogy, it is evident that there is ‘en masse’ mutual agreement when we know to drive off when the traffic light turns green. Mutual agreement is translated into people obeying traffic rules (otherwise chaos). Two cars, two drivers, sitting directly alongside each other at traffic lights, discuss their understanding of their Road Code in this particular position, and what they should do. When the light turns green there are a myriad of principles that apply when they drive off simultaneously. They have both demonstrated their ‘complete knowledge’ of the significance of the green light from this perspective. There is Mutual Agreement. There is Predictable Conformity. There is Common Ground. Each one complements the other. They are both right. One more remove: From an outsider’s point of view – they both know! The green light could be categorised as a Eureka moment, it sets in play all the above principles, whether the drivers are aware of it or not. From the perspective of two outside objective observers who know the traffic rules, if asked, did the two drivers at the lights obey the rules – the answer would be yes, there would be mutual agreement. They have complete knowledge of this particular circumstance concerning drivers, and green lights. Could it be that certain schools of thought are curtailed by a questionable refusal to recognize what is, and have a preference for creating a difficulty where none exists! No one can examine what isn’t! There is no such thing as ‘nothing’. Something is – what is it? A Scottish engineer functions on the same principles as an Italian Pope. Because Archimedes was prominent as a mathematician, his realisation of the principle of leverage, and his understanding of the difference in water displacement between silver and gold was widely reported. This does not mean that realisation of ‘what is’ is an exclusive experience. As said previously Archimedes did not realise something new – it has always existed, and all forms of life would have utilised the leverage principle to some degree or another (watch a bird build a nest). At that time there were probably many thousands of people who had some understanding of the principle, but Archimedes was the one who made statements about it. As in any Eureka moment, we can experience infinity and who we are. It is mutual agreement (an understanding) between the part, and the whole. It is when the principles are in unison Eureka! Reality is there to be examined, and experienced, it is not separate from us, nor should we try to make it so. = Stepping stones 2. = Knowledge is not conditional by the activities of what may be called ‘thought’ or ‘consciousness processes’. Real knowledge is that which is available to all, and to be shared by all. It cannot be contained by the ‘experiencer’ and then not ‘known’ by the accident of experience. It is the actual innate experience itself which conclusively establishes the truth. It can only deal in the truth which is its modus operandi of dissemination. For me to say that ‘everything is’, is a statement of fact which cannot be denied, and an intellectual dishonesty to attempt to deny the evidence by philosophical machinations. Hostility toward the truth leads inevitably toward attempted negation - looking for nothingness! ‘Being here’ demands its own recognition - attempting to deny it is simply perverse. Knowledge is the realisation of ‘what is’.. Rene Descartes ‘I think - therefore I am ‘did no service to human evolution, or education. It established in Western societies especially, the culture of individualism, with the precursor that so-called ‘thought’ was the inward evidence for existence, and for the following unfortunate claim that we have a ‘mind’, or to use the euphemism, a soul! Experience is true knowledge. When that experience marries up with its innate counterpart then recognition is realised (cognition). In simple terms, a light goes on in the brain. There can be no real knowledge without truth. All thought qualifies experience and attempts to reduce truth to near nothingness which is a widespread conditional activity. We cannot manufacture knowledge, or the principles which are its properties. No matter the amount of correct information anyone can ingest, it does not become knowledge until there is tripartite coalescence between inherent knowledge - ingested correct information - and ‘what is’. Then we truly recognize that which is Absolute. Within Nature we have the distinct privilege of evolving in a Universe that can only recognize the attributes of social cohesion. Knowledge is not anyone’s personal possession. Whatever measure of experience we may have of it, it is only available as a Universal sharing experience to be beneficially used. Human activity whereby we witness people using tools for leverage, or drivers at traffic lights obeying the rules of the road, are observable markers that contain the properties for understanding our own reality. Unless seen for what they are, they are only mechanical platitudes with an equally mechanical response. We could rightly claim that that at least is some response, but of no real value. The natural process that operates when we see that which is innate, overrides any erudite explanation from an academic base however intellectual its original source. ‘Thinking’ for oneself cannot make judgments about a ‘natural’ experience. When we see human duplicate functions in operation then we are in communion, and at another level we recognize who we are. When we actively see the activities of the human brain in action we are not dealing with any internal ‘will - o’ - the wisp’ that no one can ever experience. We exercise that prerogative (human activity) at every moment in time, but quite apparently without that focus of attention that denotes realistic recognition. To seek identity in sectarian, or secular belief systems to overcome the contemporary feeling of loss of identity leads to the acceptance of anything that offers some form of stability. That is then used to strengthen that which is euphemistically addressed as the ’self’. To retain that security the acceptance of information transmitted throughout generations, is absorbed into the culture, and defended to the death against those who would question that belief system. The greatest knowledge we can ever have is our own and it has the potential to transcend all else and provide insight into infinity. The most tragic human condition is the lack of experience of identity in a multiplicity of identities in which we all share. The real problem is not one of ‘identity’, but a lack of ’communion’. Whether we like it or not, whether we are aware of it or not, the principle of ’communion’ must always exist to some degree for evolution to proceed. It is within the experience of that principle that we understand the fallaciousness of that much heralded ‘self’ which draws down so much energy in an attempt to establish itself as a reality. Within positive language structure possibilities (no dichotomies), there should be the disposition toward the realisation that our relationships to cognize into ‘communion’ must be addressed as specifically dependent. Social attempts to be ‘independent’ are the very remove from reality and signify reduction attempts toward nothingness. Adherence to, and the cultivation of faith and belief systems give little elbow room for any factual occurrence to be anything other than a comparison to the myths that are held. The cultural and educational socialisation of generations of children must carry with it, its historical belief systems that overwhelm the natural instincts. Observe an animal out of its natural habitat and locked in a cage for its entire life. It would be a salutary exercise if we could dispense with the term ‘mind’ from our vocabulary and magnify the use of the word brain to promote a realistic discussion on ‘who we are’. My action of levering open a wooden crate and knowledge of it is one and the same. Our remarkable brain functions like that, the purpose of a brain, the natural repository of innate knowledge. The assertion of principles is critical to avoid all activity being submerged by questioning their very existence, and being unable to see directly. It would be a rarity today, if anyone using a lever to pry open a wooden crate would have the same enormity of experience that Archimedes had, nor the need to make pronouncements about it. It has all been done prior to our awareness of its value with the accompanying data attached. Our brain knows the value of a lever and activates our body accordingly when needed. It could be categorised as evolutionary transmission. The observance of someone prying open a crate with a lever, or drivers conforming to the road code at traffic lights, is a function of the brain in action, not a mythical entity in a singular locality that denies its own senses. When the brain is not burdened by distorted belief systems it then has the potential to experience ’that which is’, which is always constant. When we understand the function of a lever, or the presence of traffic lights, then we can activate the principles involved because we already know how! The negative impact in the use of dichotomies in language lies in their distraction from the truth, as our brain processes the words we use in relation to Reality. The tendency to attempt to separate inherent truths through the words we use disrupts that natural correspondence necessary for identification. A chair, is a chair, is a chair. = Stepping stones 3. = Where principles are concerned the constituent linkages in language are identity markers to that which is real - reference points. Without dichotomies there is no separation, or ambiguity between what we experience, and ‘what is’. Philosophy in its attempt to address something through denial is an elementary confusion. To say that that is a chair, and then attempt to deny it invoking philosophical theorems concerning the human ability to experience it, is a severe contradiction on the existence of the object , and the observer. When this form of contradiction is then taken as a constant, it then precludes any common-sense and definitive answer to the existence of a chair. '''For philosophers, George Orwell’s ’to see what is in front of one’s nose needs a constant struggle’ would be apt.''' Real concepts cannot exist in any mythology, therefore all that we experience is inevitably the truth that is there to beproperly categorised for what it is. The proper use of language in this context will identify whatever it is to correspond with present reality. Misuse of language (dichotomies and mythologies) leads only to the acceptance of a fractured state where nothing is whole and represents confusion. The dissipation of the supposed problem is never realised. Fiction has been elevated to the status of an accepted reality. Very early evolutionary physical dangers allowed the development of fictions that offered some form of imaginary protection beyond limited physical ability. That contemporary humanity endorses the mythology of ‘I’ is testament to the psychological fear that still exists and requires its proper recognition. Emphasis must be placed in the relationship between language and reality for understanding to proceed. The persistence of dichotomies has their own persistent confusion which then promotes a false reality through misleading information. Microcosm and macrocosm are one and the same in a Universe where ‘everything is’. Isolated viewpoints are exactly that, and are unable to view the expanse in which we are encompassed. We must learn to view reality through both ends of the same telescope. When we understand the extensive scope of ‘truth’, then we know that its values and properties do not change - which relates to ‘completeness’. Philosophical, ideological, and intellectual endeavour , try to shape the structure of ‘what is’ based on pre-dispositional knowledge, which can only ask the same questions, and look for the same answers. Not to experience that which is absolute or whole is the normal result of the confusion of language which has no correspondence to that which is real. To discuss with a philosopher the possibility that ’mind’ per se does not exist, and to dissolve it as a concept would place them in a realistic position, would indeed be a difficult proposition. The strength of that difficulty lies in another imaginary concept, that that ‘mind’ represents ’I’, and it is anathema to that fiction to consider its own demise! = Stepping stones 4. = There are no dichotomies. Everything is, and everything that is, is complete, everything is an Absolute complete Reality. You are experiencing your measure of that reality. It cannot be otherwise that you are experiencing that measure of completeness. When we come to terms with it we have the innate capacity to see the Absolute in a grain of sand. That is knowledge. Belief in dichotomies is the mythical barrier to that particular experience - which is only denial, supported by erudite protestations that human construct dichotomies exist. At a mechanical level Intelligence and Stupidity appear to be separate identifiable conditions, and they appear to be antagonistic. Stupidity is in Reality a measure of the Intelligence which is always constant. If someone was in a state of mythical utter and complete stupidity we would not attempt any form of emancipation from that condition. We know that that is misguided and proceed with techniques to advance intelligence. Consider the proposition that there are no dichotomies, and within that possibility all questions become irrelevant. Presuming that there are no dichotomies allows the process of establishing ‘necessary factors’ to proceed, and allows each measure of wholesomeness to be realised. Experience is the criteria for knowledge. Some Reality experiences were simply transposed into particular belief systems and elevated into a pseudo spiritual dimension, or a philosophical conundrum. Where there is a belief in a divisive fiction (dichotomies) there is automatic mechanistic restriction to that which is Real. There is a capacity beyond ego and intellect which can commune with ‘what is’, and recognize its properties. Reality is constant. Within the accepted comparative framework there is the view of principles as having different divisive categories e.g., as above, Intelligence and Stupidity, and classify them within ‘thought’ structure as dichotomies and give credence to them as being an antagonistic reality. The consequence of that, is, that one is always a remove from recognizing the structural properties of immediate existence. Any construct of knowledge necessary to evaluate ’what is’ will address the properties (principles) that are the constituent constant markers available in that which is the microcosm and the macrocosm. That identity (the Absolute) is found in any sphere of Reality.Everything is - and everything that is, must be experienced for what it is, and not for what anyone denies it to be. There is no mythical human construction that can deny ’what is”. Everything is - without dichotomies. To repeat, we do not have the ability to create ‘nothingness’ - ‘that which is’ has no imaginary comparative human construct. To attempt to deal with such constructs, and give credence to them is always the denial of ‘what is’, and adherence to ‘thought’ processes whose only purpose is to cement that activity. Indeed realising that the concepts of dichotomies are human mythical constructs, denying true perspective, is the beginning of insight. The dissipation of such processes through addressing the principles of Reality allows us the potential to experience directly ‘what is’, in simple terms -the truth! Intelligence is a ‘necessary factor’. Addressing stupidity is a denial of reality at whatever level we find it. Intelligence and Stupidity are not antagonistic, they are one and the same principle with measurable degrees of existence. Only from a comparative framework standpoint is credence given to any mythical form. The above observation is not negating the process, it is questioning the markers which evolve into imaginary separation (trapped in a comparative framework mythology). That particular process can and does create a false mythical reality that appears divisive. We cannot exist within a divisive reality! Reality must be complete for us to recognize its existence. Where there are no dichotomies within the premise that ‘everything is’, there exists no antagonistic position. The distinction between human constructs of positive and negative are matters of mythical perspective wherein no experience of the Absolute is available. It is because the human ’mind’ per se places its own construction on its immediate experience, and must have its particular interpretation based on what it considers ’knowledge’. There is a difference between ’mechanical knowledge’, and ’pure knowledge’. From the mechanical knowledge standpoint which can only deal ‘in indirect conscious interpretation’, it is quite correct to say that that form of knowledge is incomplete, and it always will be. Pure knowledge experienced via our brain knows no separation, nor antagonism, and is responsible for our ability to recognize the actions of others who may pry open wooden crates with a lever, or drive off uniformly at traffic lights. Within that cohesive activity it precludes ’a matter of opinion’ and by themselves can become subjects of a pure knowledge experience. To repeat, it is a form of ’communion’ with ’what is’, and available to all. Where drivers at traffic lights universally conform to their particular road code, and where universally there is a language which identifies their activity as Mutual Agreement, or any other logical definition, we can concur with the common-sense conclusion that we have universally established that within language and common activity, there is indeed a truth formed. The coalescence between universal language and universal activity are the logical constructs that create civilizations. There is a vast social network of common activity that solidifies the logic into an honest and persuasive conclusion that confirms innate common principles –knowledge. = Stepping stones 5. = The Art of making sense of everything. How to understand principles. # Principle. A fundamental truth or proposition that serves as the foundation for a system of belief or behaviour or for a chain of reasoning. # All principles are interdependent, interconnected, and infinite. # Each one is dependent on the other two. Examples of a principles template and how to define them without dichotomies. Communication. Truth. Standard. Proof. Express. Contribute. Mutual. Direction. Advance. Comfort. Organize. Certain. Immediate. Interest. Improve. Present. Constructive. Gain. Trust. Progress. Source. Knowledge. Basic. Original Reality. Awareness.Freedom. Purpose. Connect. Understand. Support. Peace. Cause. Unity. Ability. Rights. Honest. Discover. Positive. Energy. Balance. Good. Courage. Willing.  Control. Use. Association.  Observe. Reason. Easy. Wealth. Simple. Law. Increase. Order. Flow.Co-operation. Exact. Quality. Accuracy. Strength. Responsible. Operating. Creative. Measure. Recognition. Accept. Constant. Obligation. Include. Dependence. Relationship. Value. Success. Principle. Equality. Stable. Share. Love. Sustenance. Action. Identity. Intelligence. Education. Secure. Facts. Agreement. Information. For. Rules.Clear. Yield. Example: Success = Securing facts                = Responsible co-operation               = Constructive knowledge So success by definition is : Securing facts through constructive knowledge and cooperating  responsibly. All definitions of success from your template are infinite. You will find your own suitable definition. ==== There are no dichotomies! ==== Any principle is correctly defined by any two other principles. You create a new language of Absolutes. Using conjunctions you can write your own book. The man whose book is filled with quotations has been said to creep along the shore of authors as if he were afraid to trust himself to the free compass of reasoning. I would rather defend such authors by a different allusion and ask whether honey is the worse for being gathered from many flowers. Anonymous, quoted in Tryon Edwards (1853) The World’s Laconics: Or, The Best Thoughts of the Best Authors. p. 232 Amen to that! “One is not born, but rather becomes a woman” Simone de Beauvoir. “Time does not change us. It just unfolds us” Max Frisch. We experience ourselves our thoughts and feelings as something separate from the rest. A kind of optical delusion of consciousness. This delusion is a kind of prison for us, restricting us to our personal desires and to affection for a few persons nearest to us. Albert Einstein, in One Home, One Family, One Future. = Who we are. =   It is notable that within the structure of Cartesian dualism, Descartes' personal address to innate knowledge he attributed to ‘thought’ which he identified as being distinct from his body. How different Western philosophy may have been if his attribution had been toward his brain and the existence and evidence of other physical entities that functioned every bit as efficiently as he did. The premise that Descartes operated from ‘never to accept anything as true’, was simply a wrong ended approach which brought him into conflict with his passing acceptance of innate knowledge, that the idea of God was innate to his being. To view the proposition that ‘everything is true’ allows reason to seek and identify that measure of truth. No quest can be productively based on cynicism or denial, nor adherence to belief systems that separate experience, knowledge, and Reality. We have the obligation to question whatever reality has placed before us , but if we constantly deny its existence and attempt to ‘disappear’ it from our experience, then we are in danger of never experiencing that reality for what it is..   For anyone to say that ‘everything is’ is a simple linguistic absolute that no amount of ‘more reasonable’ requests (above) can deny. Those requests only appear to be governed by the difficulties of ‘mental complexities’, and embedded ideologies. To accept that ‘everything is’ as an absolute, is a realistic basis to establish any reality, and comprises the basis for reason to be activated. If there is ‘nothing’, nothing can be achieved. Within that which is Absolute there are no dichotomies. Therefore there are no antagonistic positions available. Everything that is, is a measure of the Absolute.  We are always in the present, everyone and everything. Instant elementary ‘knowledge’ which we all share, and must admit to. In being alive, we do not have the ability to not be here, and we do not have the ability to not know! To have a problem in addressing what Truth and Knowledge are, to the point of denying their existence, then that problem exists well below the scale of Reality. To repeat knowledge is not the proprietary right of any individual, it is enshrined in the principle of agreement that we mutually exercise to establish its own reality. The reality of experience is not, nor ever will be, a personal possession that we can have and hold. Its reality becomes more alive when we see the same activity being practised by others. Then we know we are sharing that reality, and that experience. We cannot "have" the principles that exist, but when we undrestand them then we are obliged to use them with integrity. That form of integrity in any language, is an added foundation stone to any belief system Mechanistic ‘I’ has no concept or understanding of ‘pure knowledge’. Only when we break free of the myth that some clarity becomes apparent, and we have the opportunity to engage with what is real. Philosophy it appears to me is constrained by individual ‘thought’ processes, which (without experience) cannot escape from that individuality. Those ‘thought’ processes conjure up a human history of inflexible, and impossible propositions which only serve to protect that individuality. Descartes ‘cogito ergo sum’ has compounded the difficulties by strengthening the incorrect premise of a false individuality. ‘I’ is a phantom consciousness much like a phantom pain experienced after a limb is amputated. The brain registers the pain signifying that something should be there. Likewise our brain has that same relationship with Nature and Reality. It is analogous to our brain dealing with a ‘phantom reality’ knowing that something is missing but is continuing to evolve to establish the whole. There exists a ‘phantom chasm’ between our brain and Reality and an understanding of its properties. We are robbed of real meaning. Evidence, recognition, and the truth are the principles it uses to reform. Within their structure is the meaning of reforms. Nature does not impose any morality on us, the principles implied in morality are there for us to understand and use. Our brain has the capacity, once reality is correctly examined, to recognize ‘that which is’. Once realised it becomes embedded. That ‘phantom consciousness’ is an experience removed from its proper environment. It takes its proper place when we experience reality for ‘what it is’, which provides the totality of meaning. True experience allows us entry to the quality of knowledge that is a continuous reality. So long as anyone believes that human experience is based solely on indirect conscious interpretation (mechanical disposition), any ‘knowledge’ derived from that experience will be incomplete. That form of philosophical negative conclusion can come down to not believing that Reality exists (a chair is not a chair, is not a chair etc,), or that our experience of ourselves and others is real, and discount any other form of knowledge that threatens that belief. There is an intellectual dishonesty in denying the existence of principles. Hostility towards the truth leads inevitably to negativity. Being here demands, not denial, but the right to be recognized. We are the recipients of a ubiquitous communication system – making known. We can only understand that which we know. We make known all the time. Knowledge of Reality – Truth – the Absolute is a collective inclusive experience of the principles we share, and never the property of any individual. To ‘know’ ‘who we are’ is an inclusive experience of the principles involved. Never ‘cogito ergo sum’.   Philosophers in investigating the nature of knowledge and the Universe, firmly established for themselves that the source of reason and logic was located in a mythical concept ‘the mind’. From the wrong basis evolved elaborate and metaphysical constructions which removed the investigations further, and further, from the truth. To comprehend the material world, and give it credibility, the recognition of implicit principles is paramount. We need to construct a language that provides that form of recognition. Any philosophical theory of ‘mind’ that will deny the evident structure of solid objects is misguided by the injection of a mythical entity (mind) that determines that seeing solid objects is a ‘perceptual illusion’. That form of determination is singularly narcissistic, empowered by the self-induced threat that venturing into a ‘materialistic’ world is a loss of that illusory self, and all the belief systems it has constructed to protect it. That erroneous established view that not addressing ‘materialism’ as a profound Reality, and as only a ‘perceptual illusion, is compounded by the belief that that form of illusion is implicit in every human view available. We cannot manufacture knowledge that leads to a mechanistic understanding of ‘what is’ , nor the principles which are its properties – however much dogma is practised. We can only aspire to relate to ‘necessary factors’ that are the implicit fundamentals of existence. For me to use a lever to open a crate is a form of communion with Archimedes through the principle he enunciated. It is now not ‘necessary’ for me to go through the same experience as Archimedes to establish that ‘necessary factor’ or ‘principle’. It is now common-place, and common-sense to utilise the principle. The extract below provides some explanation of the brain processes in action Universally, and coincides with any reasoning on the observance of the leverage principle, and the actions of motorists conforming to the Road Code wherever traffic lights exist. ''The right-to-left shift of mental control looked increasingly like a universal phenomenon, capturing the essence of every learning process on every time scale, from hours to years. An individual faced with a truly novel situation or problem tackles it mostly with the right hemisphere. But once the situation becomes familiar and is mastered, the dominant role of the left hemisphere becomes evident. It looked like the empowering patterns capturing the essence of the situations (or rather the whole class of similar situations) were, once formed, stored in the left hemisphere. (The Wisdom Paradox. Professor Elkhonon Goldberg. P202)<ref>{{Cite journal|last=Vandermeulen|first=Jo|date=2008-08|title=Verstand komt met de jaren|url=http://dx.doi.org/10.1007/bf03077135|journal=Neuropraxis|volume=12|issue=4|pages=137–139|doi=10.1007/bf03077135|issn=1387-5817}}</ref>'' = Limitations. = However limited our view of connectedness is, or however tenuous the reality our experience is, ‘everything is’, and everything is connected. Innate knowledge and the fundamental nature of Man is the prior source of knowledge that seeks and identifies that connectedness. Attempting to address what we don’t know is that mythical infinite regress toward that parallel mythical ‘nothingness’. To always address what we know establishes Reality. To establish knowledge of principles, start from ‘we are here’. The natural principles within the diversity of human culture and activity when recognized as mutual ‘necessary factors’ will have the effect of enhancing and directing vital energy toward the very process of  the communion we seek, and the gradual penetration of a reality that always exists. Knowledge of Reality is not ‘different’ in other locales. The fundamental principles are the same. Addressing ‘what is’ instead of denying ‘what is’ is the basic construction of real knowledge. Within the structure of the Absolute we are all the same with a magnificent differential in our expression of the principles of necessity. That expression is our ongoing effort toward its own experience which gives it life and meaning. That experience in turn exposes us to an immediate Reality that is in communion with the fundamental structure of our being. All that we can contribute toward that is 50%, the other half is in our momentary relationship with Reality – then we know! That form of knowledge is always available through that form of experience, and it always comes in the form of confirmation which reforms. Until that experience our prior condition appears mechanistic, without direction, or understanding. Reality, life, is not mechanistic. We are the recipients of innate principles with the constant potential to experience those principles in action (Archimedes et al). Dogmas, ideologies, are the restrictive practices used to blur the recognition of principles operating to a level that understanding of that common and constant activity is virtually denied. Our natural capital (principles) is degraded to the point that their factual evidence is reduced even to the point that they are categorised as a ‘perceptual illusion”. We can trust facts 2+2=4. Simplicity has its own majesty. Anything circumscribed by reason requires control of our emotions. To comprehend the material world, bring it alive, and give it credibility, the recognition of its implicit principles is paramount. We need to construct the language that provides evidence of that Reality. Any philosophical theory of ‘mind’ that will deny the evident structure of solid objects, is misinformed by the injection of that mythical entity (mind) that determines that seeing solid objects is a ‘perceptual illusion’. That form of determination is singularly narcissistic, empowered by the self-induced threat that venturing into a ‘materialistic’ world is a loss of that illusory self, and all the belief systems it has constructed to protect it. The erroneous established view that not addressing ‘materialism’ as a profound reality, and as only a ‘perceptual illusion’, is paradoxically compounded by the belief that that form of illusion is implicit in every other human view available, thus it then makes its own sense, form and justification to the illusion! The evident question we must ask, ‘how does a ‘mind’ conclude that ‘immaterialism’ exists universally? Surely it is a simple but massive contradiction in terms. If there is nothing there but ‘perceptual illusion’, how can you attribute it to other ‘minds’. The oxymoronic effect of narcissism is that it is the very denial of ‘who we are’. Man is not composed of an overwhelming self-love. That mythical embedded belief cannot consider the possibility of underlying principles that are the real life force of Man in his relationship with Reality. The truth of that, is that humankind (in spite of itself), evolves towards its own Reality. The only human values that exist, lie in Man’s recognition of the principles involved that provide human direction. Our ‘material brain’ is a product of Nature's evolutionary process, and has innate within it the same principles that exist in all matter. That ‘which is’, is the truth, and our brain evolves to process that at every level, and we constantly manifest that in every action we take – whether we like it or not. The fundamental similarities between human beings is that we are not only evidently human, but that we also function and construct societies that we recognize as beneficial to our immediate well-being. All social function is determined by our brain capacity and its ability to postulate the relationship it has with Universal principles. = Illusion. = Considering that we can contradict things is an illusion. We can never contradict the truth. We do not have the ability to create proprietary constructs of reality. That ‘which is’, can only make its basic properties transparent to us through direct experience. Imaginary concepts must in the end conform to a measurable construct that we can identify. Within the structure of any philosophical theory of ‘knowledge’ it must contain the basic elements of truth at all times, or there is nothing!! To say that ‘everything is’ is motivated by pure reason experience as an objective, and subjective reality and as an axiomatic grammatical premise that no amount of mental acrobatics can deny. We can only deal with ‘something’, whatever it may be. There is no metaphysical construct that can provide evidence that ‘nothing’ exists, outside a mythical mind. Explaining experience beyond ‘thought’ processes requires a definitive language that deals with the reality itself. We all Know. It is innate. The ‘difference’ between us is only the measure of the knowledge that is made manifest, and that knowledge continually proliferates. The ‘individual perspective’, and the illusory ‘I’ which dominates, is the barrier to any relation to ‘what is’, and the malady of never experiencing the truth directly!   Truth, knowledge, agreement are the abundant and embedded Absolutes that form the structure of human evolution. That we constantly utilise and improve on their use is evidence of their reality, and the material transparency within every social structure. The survival and proliferation of such realities should be the evidence to establish that ‘that which is’ is Absolute. When we focus our ‘perspective’, opinion, or a hypothetical consideration of a space, time, or identity to question a Universally accepted fact, it is hardly a categorical argument to dismiss that which is true as nonsensical. Any denial that 2+2=4 is a fundamental truth hardly takes into account that the reality of such basics are vital to the success of higher mathematics. Unless the basics are continually correct, and evidently so, then no correct solutions could evolve. We know that within any basic structural ‘use’ that the calculation is correct. We commonly accept its correctness as an embedded reality. All forms of lower or higher mathematics would have the axiomatic principle of ‘correctness’ as their basis to extend from. Also, they would have as an axiom that the reverse is true. The 2+2=4 is, in its reality, the epitome of balance and construction. The 2+2 reality forms its correct conclusion when the principles of mathematics are propounded and they conform to transparent truth and arrive at 4. Only when it ‘adds up’, does it become a truth that we all recognize. Our greatest ignorance is taking for granted the proliferation of such truths through an ideological blinkered perspective. Because truth takes a commonplace form it is no less fundamental. Unless there is correct knowledge as to the existence of fundamental truth, that ‘which is’, goes unrecognised. That form of truth must be applicable to all. Truth exists in everything – it is an evidential reality. Searching for an esoteric truth is chasing shadows. Every truth is a ‘necessary factor’, and fundamental to our existence. Because of the imposed limited perspectives (via education, ideology, beliefs) that which is evidently true, and transparent, is delegated to a position of simple practicality with conditions placed on it which further deletes its substance, and we have the awful predilection of conforming to the attempted destruction of that which is true. Do we have a problem with seeing something, which is correct, as also being true? All truths are fundamental. They are not subject to attempted denial because of any diminished realisation at any point in time. Where there is reasonable evidence of balance, equity, and agreement we can conclude that a truth exists. Once innate information of that truth becomes transparent, it becomes an embedded useful human utility that must have some measure of fundamental truth as their starting point. From any common-sense, or ‘more reasonable’ position, it would be more productive to view reality as possessing at every level the same innate values or principles consistent with our ability to measure, or recognize them. To view reality as having ‘different’, or antagonistic properties, is simply a misguided view of ‘what is’.  That form of perspective is counter productive when it attempts to establish mythical dichotomies as realities in their own right. When the reality of principles are made transparent, we can then ‘more reasonably’ make use of them to further their basic existence. Here we use reason to exemplify their necessary function, and once established it becomes (if necessary), ‘more reasonable’ to locate them in all things. The dematerialization of any object through the practice of ‘perceptual illusion’ is an attempt to deny the reality that exists. Where perceptual illusions are concerned, innate direct communion with that which is, suspends the effect of such illusions. All the properties in a chair are recognized as the reality that exists. That is materialism. A chair does have the principles of form, design, structure, colour, substance etc.  However it is analysed – it is a quantifiable reality.   = Human representation. When we understand the validity and existence of principles in all things, it is easy to understand that ideological dogmas are never the foundation for real knowledge, or that direct experience of ‘what is’. Our real perspective is not some individualistic experience that confines us, it is that expanse in which we exist that offers us the view of that expanse. Everyone has the potential to go beyond their ‘apparent’ human perspective limitations. Shifting our sense of perception toward that which is basic, paradoxically extends the experience of that which is true. Let general knowledge be directed toward the performance that identifies the measure of principles that are enacted. Therein lies the production of knowledge that offers a sustainable growth of that vital universal aspect of knowledge, where, reason and truth, can prevail. Any correct definition is language itself, opening the door to that reality experience which is critical. Only when we know and experience that the same reality (with all its principles intact) exists for all of us can we then recognize the mythical distinctions that are taken as being real. The majestic experience of that reality goes well beyond historical beliefs. Exploring simple ‘necessities’ is not based on any sacred text, but the privilege of recognizing a sensible evolutionary path through life. Whatever may be in the future, is implicit in the material world now, and it has always been so. 0ikp578wiey31lewzyctv7vzk7qgkr8 3 281941 2419055 2418858 2022-08-25T12:44:01Z Octfx 2937292 /* WikiJournalBot removes image */ Reply wikitext text/x-wiki {{Robelbox|theme=9|title=Welcome!|width=100%}} <div style="{{Robelbox/pad}}"> '''Hello and [[Wikiversity:Welcome|Welcome]] to [[Wikiversity:What is Wikiversity|Wikiversity]] Octfx!''' You can [[Wikiversity:Contact|contact us]] with [[Wikiversity:Questions|questions]] at the [[Wikiversity:Colloquium|colloquium]] or [[User talk:Dave Braunschweig|me personally]] when you need [[Help:Contents|help]]. Please remember to [[Wikiversity:Signature|sign and date]] your finished comments when [[Wikiversity:Who are Wikiversity participants?|participating]] in [[Wikiversity:Talk page|discussions]]. The signature icon [[File:OOjs UI icon signature-ltr.svg]] above the edit window makes it simple. 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You only need to [[Wikiversity:Be bold|be bold]] to contribute and to experiment with the [[wikiversity:sandbox|sandbox]] or [[special:mypage|your userpage]]. See you around Wikiversity! --[[User:Dave Braunschweig|Dave Braunschweig]] ([[User talk:Dave Braunschweig|discuss]] • [[Special:Contributions/Dave Braunschweig|contribs]]) 16:02, 22 February 2022 (UTC)</div> <!-- Template:Welcome --> {{Robelbox/close}} == WikiJournalBot removes image == Hello, I saw that you're the creator for [[User:WikiJournalBot]]. On yesterday, I [https://en.wikiversity.org/w/index.php?title=WikiJournal_of_Medicine/Volume_9_Issue_1&diff=prev&oldid=2405630 added an image to the template] but when the bot update the list, it [https://en.wikiversity.org/w/index.php?title=WikiJournal_of_Medicine/Volume_9_Issue_1&diff=next&oldid=2405630 overwritten my change]. Is that expected behaviour? (pinging {{u|Evolution and evolvability}} as well). [[User:OhanaUnited|<b><span style="color: #0000FF;">OhanaUnited</span></b>]][[User talk:OhanaUnited|<b><span style="color: green;">^{Talk page}</span></b>]] 04:53, 12 July 2022 (UTC) :Hi @[[User:OhanaUnited|OhanaUnited]]! The bot fetches all data from the corresponding Wikidata entry. To have the image displayed, you'd need to add it [https://www.wikidata.org/wiki/Q100400590 here]. There is currently no functionality that checks manually added content in the template. :/ [[User:Octfx|Octfx]] ([[User talk:Octfx|discuss]] • [[Special:Contributions/Octfx|contribs]]) 11:05, 12 July 2022 (UTC) ::Thanks very much for that information. I'll keep that in mind in the future. [[User:OhanaUnited|<b><span style="color: #0000FF;">OhanaUnited</span></b>]][[User talk:OhanaUnited|<b><span style="color: green;">^{Talk page}</span></b>]] 14:02, 12 July 2022 (UTC) ::: {{u|Evolution and evolvability}} The bot is constantly changing the publication order [https://en.wikiversity.org/w/index.php?title=WikiJournal_of_Medicine/Volume_7_Issue_1&action=history out of sequence]. Every time I undo it, the bot reverts my change. [[User:OhanaUnited|<b><span style="color: #0000FF;">OhanaUnited</span></b>]][[User talk:OhanaUnited|<b><span style="color: green;">^{Talk page}</span></b>]] 05:08, 25 August 2022 (UTC) ::::Hey OhanaUnited, thanks for your message. The bot runs on a daily schedule and updates pages based on Wikidata. Publications from a journal / issue / volume are ordered by their respective publication date. For the page in question, the following query is used: [https://query.wikidata.org/#SELECT%20DISTINCT%20%3Fitem%20%3FitemLabel%20%3Fimage%20%3Fpages%20%3Fpublication%20WHERE%20%7B%0A%20%20SERVICE%20wikibase%3Alabel%20%7B%20bd%3AserviceParam%20wikibase%3Alanguage%20%22%5BAUTO_LANGUAGE%5D%22.%20%7D%0A%20%20%7B%0A%20%20%20%20SELECT%20DISTINCT%20%3Fitem%20%3Fimage%20%3Fpages%20%3Fpublication%20WHERE%20%7B%0A%20%20%20%20%20%20%23%20Instances%20of%20%27scholarly_article%27%0A%20%20%20%20%20%20%3Fitem%20p%3AP31%20%3Fstatement0.%0A%20%20%20%20%20%20%3Fstatement0%20%28ps%3AP31%2F%28wdt%3AP279%2a%29%29%20wd%3AQ13442814.%0A%20%20%20%20%20%20%23%20From%20a%20given%20journal%0A%20%20%20%20%20%20%3Fitem%20p%3AP1433%20%3Fstatement1.%0A%20%20%20%20%20%20%3Fstatement1%20%28ps%3AP1433%2F%28wdt%3AP279%2a%29%29%20wd%3AQ24657325.%0A%20%20%20%20%20%20%23%20Filter%20by%20volume%20and%20issue%0A%20%20%20%20%20%20%3Fitem%20p%3AP478%20%3Fstatement2.%0A%20%20%20%20%20%20%3Fstatement2%20%28ps%3AP478%29%20%227%22.%0A%20%20%20%20%20%20%3Fitem%20p%3AP433%20%3Fstatement3.%0A%20%20%20%20%20%20%3Fstatement3%20%28ps%3AP433%29%20%221%22.%0A%20%20%20%20%20%20OPTIONAL%7B%3Fitem%20wdt%3AP18%20%3Fimage%20.%7D%0A%20%20%20%20%20%20OPTIONAL%7B%3Fitem%20wdt%3AP304%20%3Fpages%20.%7D%0A%20%20%20%20%20%20OPTIONAL%7B%3Fitem%20wdt%3AP577%20%3Fpublication%20.%7D%0A%20%20%20%20%7D%0A%20%20%20%20LIMIT%20100%0A%20%20%7D%0A%7D%0AORDER%20BY%20DESC%28%3Fpublication%29%20DESC%28xsd%3Ainteger%28%3Fpages%29%29 Wikidata Query Service]. ::::I've checked the page history and the order of publication seems to match that of the query. Are you using another metric? Maybe we can update the bots logic? [[User:Octfx|Octfx]] ([[User talk:Octfx|discuss]] • [[Special:Contributions/Octfx|contribs]]) 12:44, 25 August 2022 (UTC) kevi8y9slt7n0pszedcv2p49w68l2vk 0 283461 2419152 2418853 2022-08-26T01:01:09Z KingMob221 2947327 /* Overview */ First sentence. wikitext text/x-wiki {{MECR3|1=https://yourlinkgoeshere.com}} [[File:NOS-USA.png|thumb|Figure 1. Novus Ordo Seculorum - image on the US $1 bill considered by some as evidence of Illuminati influence in the US history.]] {{title|Conspiracy theory motivation:<br>What motivates people to believe in conspiracy theories?}} __TOC__ ==Overview== Conspiratorial thinking is deeply linked to psychological tendencies shared by all humans. {{RoundBoxTop|theme=3}} '''Focus questions:''' * What is the first focus question? * What is the second focus question? * What is the third focus question? {{RoundBoxBottom}} {{tip| Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Provide an example or case study. * Conclude with Focus questions to guide the chapter. }} ==Defining a conspiracy theory== A [[w:Conspiracy theory|conspiracy theory]] is an attempt to explain a malevolent phenomenon or event by means of reference to an elite and powerful group, organisation or secret society despite alternative, more grounded explanations being available ("Conspiracy Theory", 2022). When defining a conspiracy theory, it is important to note its difference to just a conspiracy. Conspiracies are clandestine activities between two or more powerful groups which are supported to have occurred by expert historical and scientific evidence (Douglas et al., 2019). == Psychopathology == === Schizotypy === == Evolutionary Origins == == Illusory Pattern Perception == == Prevention == {{tip|Suggestions for this section: * For the [[Motivation and emotion/Assessment/Topic|topic development]], provide at least 3 bullet-points about key content per section. Include key citations. * For the [[Motivation and emotion/Assessment/Chapter|book chapter]], expand the bullet points into paragraphs. * If a section has a lot of content, arrange it into two to five sub-headings such as in the [[#Interactive learning features|interactive learning features section]]. Avoid having sections with only one sub-heading. }} ==Learning features== What brings an online book chapter to life are its interactive learning features. Case studies, feature boxes, figures, links, tables, and quiz questions can be used throughout the chapter. ===Case studies=== Case studies describe real-world examples of concepts in action. Case studies can be real or fictional. A case could be used multiple times during a chapter to illustrate different theories or stages. It is often helpful to present case studies using [[#Feature boxes|feature boxes]]. ===Boxes=== Boxes can be used to highlight content, but don't overuse them. There are many different ways of creating boxes (e.g., see [[Help:Pretty boxes|Pretty boxes]]). Possible uses include: * Focus questions * Case studies or examples * Quiz questions * Take-home messages {{RoundBoxTop|theme=3}} ;Feature box example * Shaded background * Coloured border {{RoundBoxBottom}} ===Figures=== [[File:Monkey-typing.jpg|right|205px|thumb|''Figure 1''. Example image with descriptive caption.]] Use figures to illustrate concepts, add interest, and provide examples. Figures can be used to show photographs, drawings, diagrams, graphs, etcetera. Figures can be embedded throughout the chapter, starting with the Overview section. Figures should be captioned (using a number and a description) in order to explain their relevance to the text. Possible images can be found at [[commons:|Wikimedia Commons]]. Images can also be uploaded if they are licensed for re-use or if you created the image. Each figure should be referred to at least once in the main text (e.g., see Figure 1). ===Links=== Where key words are first used, make them into [[Help:Links|interwiki links]] such as Wikipedia links to articles about famous people (e.g., [[w:Sigmund Freud|Sigmund Freud]] and key concepts (e.g., [[w:Dreams|dreams]]) and links to book chapters about related topics (e.g., would you like to learn about how to overcome [[Motivation and emotion/Book/2020/Writer's block|writer's block]]?). ===Tables=== Tables can be an effective way to organise and summarise information. Tables should be captioned (using APA style) to explain their relevance to the text. Plus each table should be referred to at least once in the main text (e.g., see Table 1 and Table 2). Here are some [[Motivation and emotion/Wikiversity/Tables|example 3 x 3 tables]] which could be adapted. ===Quizzes=== Quizzes are a direct way to engage readers. But don't make quizzes too hard or long. It is better to have one or two review questions per major section than a long quiz at the end. Try to quiz conceptual understanding, rather than trivia. Here are some simple quiz questions which could be adapted. Choose the correct answers and click "Submit": <quiz display=simple> {Quizzes are an interactive learning feature: |type="()"} + True - False {Long quizzes are a good idea: |type="()"} - True + False </quiz> To learn about different types of quiz questions, see [[Help:Quiz|Quiz]]. ==Conclusion== The Conclusion is arguably the most important section. It should be possible for someone to read the [[#Overview|Overview]] and the Conclusion and still get a good idea of the topic. {{tip|Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? }} ==See also== * [[Motivation and emotion/Book/2020/Conspiracy theory motivation|Conspiracy theory motivation]] (Book chapter, 2020) Provide up to half-a-dozen [[Help:Contents/Links#Interwiki_links|internal (wiki) links]] to relevant Wikiversity pages (esp. related [[Motivation and emotion/Book|motivation and emotion book chapters]]) and [[w:|Wikipedia articles]]. For example: * [[Motivation and emotion/Book/2016/Anorexia nervosa and extrinsic motivation|Anorexia nervosa and extrinsic motivation]] (Book chapter, 2016) * [[w:David McClelland|David McClelland]] (Wikipedia) * [[Motivation and emotion/Book/2018/Loss aversion|Loss aversion]] (Book chapter, 2018) * [[w:Maslow's hierarchy of needs|Maslow's hierarchy of needs]] (Wikipedia) {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== Conspiracy Theory. (2022, August 22). In ''Wikipedia''. https://en.wikipedia.org/w/index.php?title=Conspiracy_theory&oldid=1105990766 {{Hanging indent|1= Douglas, K. M., Uscinksi, J. E., Sutton, R. M., Cichocka, A., Nefes, T., Ang, C. S., & Deravi, F. (2019). Understanding conspiracy theories. ''Advances in Political Psychology, 40''(1), 3-35. 10.1111/pops.12568}} {{tip|Suggestions for this section: * Important aspects for APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except first letter and proper names, ending in a full-stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full-stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't actually read or consulted }} ==External links== Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * [https://students.unimelb.edu.au/academic-skills/explore-our-resources/essay-writing/six-top-tips-for-writing-a-great-essay Six top tips for writing a great essay] (University of Melbourne) * [http://www.skillsyouneed.com/write/structure.html The importance of structure] (skillsyouneed.com) {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] aa7exwfg9h09pn8y5qo4c35uwrx5ywh 2419231 2419152 2022-08-26T03:11:21Z KingMob221 2947327 /* Learning features */ wikitext text/x-wiki {{MECR3|1=https://yourlinkgoeshere.com}} [[File:NOS-USA.png|thumb|Figure 1. Novus Ordo Seculorum - image on the US $1 bill considered by some as evidence of Illuminati influence in the US history.]] {{title|Conspiracy theory motivation:<br>What motivates people to believe in conspiracy theories?}} __TOC__ ==Overview== Conspiratorial thinking is deeply linked to psychological tendencies shared by all humans. ==Defining a conspiracy theory== A [[w:Conspiracy theory|conspiracy theory]] is an attempt to explain a malevolent phenomenon or event by means of reference to an elite and powerful group, organisation or secret society despite alternative, more grounded explanations being available ("Conspiracy Theory", 2022). When defining a conspiracy theory, it is important to note its difference to just a conspiracy. Conspiracies are clandestine activities between two or more powerful groups which are supported to have occurred by expert historical and scientific evidence (Douglas et al., 2019). == Psychopathology == === Schizotypy === == Evolutionary Origins == == Illusory Pattern Perception == == Prevention == ==QAnon== [[File:QAnon.svg|thumb|Figure . QAnon symbol based off the US flag.]] ==Conclusion== ==See also== * [[Motivation and emotion/Book/2020/Conspiracy theory motivation|Conspiracy theory motivation]] (Book chapter, 2020) Provide up to half-a-dozen [[Help:Contents/Links#Interwiki_links|internal (wiki) links]] to relevant Wikiversity pages (esp. related [[Motivation and emotion/Book|motivation and emotion book chapters]]) and [[w:|Wikipedia articles]]. For example: * [[Motivation and emotion/Book/2016/Anorexia nervosa and extrinsic motivation|Anorexia nervosa and extrinsic motivation]] (Book chapter, 2016) * [[w:David McClelland|David McClelland]] (Wikipedia) * [[Motivation and emotion/Book/2018/Loss aversion|Loss aversion]] (Book chapter, 2018) * [[w:Maslow's hierarchy of needs|Maslow's hierarchy of needs]] (Wikipedia) {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== Conspiracy Theory. (2022, August 22). In ''Wikipedia''. https://en.wikipedia.org/w/index.php?title=Conspiracy_theory&oldid=1105990766 {{Hanging indent|1= Douglas, K. M., Uscinksi, J. E., Sutton, R. M., Cichocka, A., Nefes, T., Ang, C. S., & Deravi, F. (2019). Understanding conspiracy theories. ''Advances in Political Psychology, 40''(1), 3-35. 10.1111/pops.12568}} {{tip|Suggestions for this section: * Important aspects for APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except first letter and proper names, ending in a full-stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full-stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't actually read or consulted }} ==External links== Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * [https://students.unimelb.edu.au/academic-skills/explore-our-resources/essay-writing/six-top-tips-for-writing-a-great-essay Six top tips for writing a great essay] (University of Melbourne) * [http://www.skillsyouneed.com/write/structure.html The importance of structure] (skillsyouneed.com) {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] 8s3rtfzre23vi29xmj8td00ugisl61b 2419348 2419231 2022-08-26T07:13:40Z Jtneill 10242 + category wikitext text/x-wiki {{title|Conspiracy theory motivation:<br>What motivates people to believe in conspiracy theories?}}{{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== [[File:NOS-USA.png|thumb|Figure 1. Novus Ordo Seculorum - image on the US $1 bill considered by some as evidence of Illuminati influence in the US history.]] Conspiratorial thinking is deeply linked to psychological tendencies shared by all humans. ==Defining a conspiracy theory== A [[w:Conspiracy theory|conspiracy theory]] is an attempt to explain a malevolent phenomenon or event by means of reference to an elite and powerful group, organisation or secret society despite alternative, more grounded explanations being available ("Conspiracy Theory", 2022). When defining a conspiracy theory, it is important to note its difference to just a conspiracy. Conspiracies are clandestine activities between two or more powerful groups which are supported to have occurred by expert historical and scientific evidence (Douglas et al., 2019). == Psychopathology == === Schizotypy === == Evolutionary Origins == == Illusory Pattern Perception == == Prevention == ==QAnon== [[File:QAnon.svg|thumb|Figure . QAnon symbol based off the US flag.]] ==Conclusion== ==See also== * [[Motivation and emotion/Book/2020/Conspiracy theory motivation|Conspiracy theory motivation]] (Book chapter, 2020) Provide up to half-a-dozen [[Help:Contents/Links#Interwiki_links|internal (wiki) links]] to relevant Wikiversity pages (esp. related [[Motivation and emotion/Book|motivation and emotion book chapters]]) and [[w:|Wikipedia articles]]. For example: * [[Motivation and emotion/Book/2016/Anorexia nervosa and extrinsic motivation|Anorexia nervosa and extrinsic motivation]] (Book chapter, 2016) * [[w:David McClelland|David McClelland]] (Wikipedia) * [[Motivation and emotion/Book/2018/Loss aversion|Loss aversion]] (Book chapter, 2018) * [[w:Maslow's hierarchy of needs|Maslow's hierarchy of needs]] (Wikipedia) {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== Conspiracy Theory. (2022, August 22). In ''Wikipedia''. https://en.wikipedia.org/w/index.php?title=Conspiracy_theory&oldid=1105990766 {{Hanging indent|1= Douglas, K. M., Uscinksi, J. E., Sutton, R. M., Cichocka, A., Nefes, T., Ang, C. S., & Deravi, F. (2019). Understanding conspiracy theories. ''Advances in Political Psychology, 40''(1), 3-35. 10.1111/pops.12568}} {{tip|Suggestions for this section: * Important aspects for APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except first letter and proper names, ending in a full-stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full-stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't actually read or consulted }} ==External links== Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * [https://students.unimelb.edu.au/academic-skills/explore-our-resources/essay-writing/six-top-tips-for-writing-a-great-essay Six top tips for writing a great essay] (University of Melbourne) * [http://www.skillsyouneed.com/write/structure.html The importance of structure] (skillsyouneed.com) {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] [[Category:Motivation and emotion/Book/Cognitive]] 82tq4idzsxzae7sbkm6z7pxfsyt4xf3 3 283895 2419060 2418948 2022-08-25T14:06:09Z OhanaUnited 18921 /* WikiJournal Preprints/A Phonological Analysis of Selected Nigerian Undergraduates Renditions */ Reply wikitext text/x-wiki {{Robelbox|theme=9|title=Welcome!|width=100%}} <div style="{{Robelbox/pad}}"> '''Hello and [[Wikiversity:Welcome|Welcome]] to [[Wikiversity:What is Wikiversity|Wikiversity]] Margob28!''' You can [[Wikiversity:Contact|contact us]] with [[Wikiversity:Questions|questions]] at the [[Wikiversity:Colloquium|colloquium]] or [[User talk:Dave Braunschweig|me personally]] when you need [[Help:Contents|help]]. Please remember to [[Wikiversity:Signature|sign and date]] your finished comments when [[Wikiversity:Who are Wikiversity participants?|participating]] in [[Wikiversity:Talk page|discussions]]. The signature icon [[File:OOjs UI icon signature-ltr.svg]] above the edit window makes it simple. All users are expected to abide by our [[Wikiversity:Privacy policy|Privacy]], [[Wikiversity:Civility|Civility]], and the [[Foundation:Terms of Use|Terms of Use]] policies while at Wikiversity. To [[Wikiversity:Introduction|get started]], you may <!-- The Left column --> <div style="width:50.0%; float:left"> * [[Help:guides|Take a guided tour]] and learn [[Help:Editing|to edit]]. * Visit a (kind of) [[Wikiversity:Random|random project]]. * [[Wikiversity:Browse|Browse]] Wikiversity, or visit a portal corresponding to your educational level: [[Portal: Pre-school Education|pre-school]], [[Portal: Primary Education|primary]], [[Portal:Secondary Education|secondary]], [[Portal:Tertiary Education|tertiary]], [[Portal:Non-formal Education|non-formal education]]. * Find out about [[Wikiversity:Research|research]] activities on Wikiversity. * [[Wikiversity:Introduction explore|Explore]] Wikiversity with the links to your left. </div> <!-- The Right column --> <div style="width:50.0%; float:left"> * Enable VisualEditor under [[Special:Preferences#mw-prefsection-betafeatures|Beta]] settings to make article editing easier. * Read an [[Wikiversity:Wikiversity teachers|introduction for teachers]] and find out [[Help:How to write an educational resource|how to write an educational resource]] for Wikiversity. * Give [[Wikiversity:Feedback|feedback]] about your initial observations. * Discuss Wikiversity issues or ask questions at the [[Wikiversity:Colloquium|colloquium]]. * [[Wikiversity:Chat|Chat]] with other Wikiversitans on [[:freenode:wikiversity|<kbd>#wikiversity</kbd>]]. </div> <br clear="both"/> You do not need to be an educator to edit. You only need to [[Wikiversity:Be bold|be bold]] to contribute and to experiment with the [[wikiversity:sandbox|sandbox]] or [[special:mypage|your userpage]]. See you around Wikiversity! --[[User:Dave Braunschweig|Dave Braunschweig]] ([[User talk:Dave Braunschweig|discuss]] • [[Special:Contributions/Dave Braunschweig|contribs]]) 12:44, 19 May 2022 (UTC)</div> <!-- Template:Welcome --> {{Robelbox/close}} == Nigerian English Varieties == As a non-native context, Nigeria has several taxonomy of English Varieties spoken within the Nigerian speech community. [[User:Margob28|Margob28]] ([[User talk:Margob28|discuss]] • [[Special:Contributions/Margob28|contribs]]) 22:01, 12 August 2022 (UTC) == [[WikiJournal Preprints/A Phonological Analysis of Selected Nigerian Undergraduates Renditions]] == Thank you for your submission. I was wondering if you have a Word or PDF version that you can upload to Commons (or email to us)? This is to ensure that the syllables, IPA, phoneme and others are presented accurately on the wiki page. Thanks. [[User:OhanaUnited|<b><span style="color: #0000FF;">OhanaUnited</span></b>]][[User talk:OhanaUnited|<b><span style="color: green;">^{Talk page}</span></b>]] 05:17, 25 August 2022 (UTC) Thank you. Please, provide an email address where I could send the word version or preferably provide a guide on how to get the article uploaded on wiki commons. Thank you. [[User:Margob28|Margob28]] ([[User talk:Margob28|discuss]] • [[Special:Contributions/Margob28|contribs]]) 07:37, 25 August 2022 (UTC) :You can follow the steps in [[commons:Special:UploadWizard|Commons' Upload Wizard]] to upload a word document. Be sure to include "draft" in the file name when you are uploading. [[User:OhanaUnited|<b><span style="color: #0000FF;">OhanaUnited</span></b>]][[User talk:OhanaUnited|<b><span style="color: green;">^{Talk page}</span></b>]] 14:06, 25 August 2022 (UTC) qvizb0cke4udkogdtsllo1cr2fehqa7 2419077 2419060 2022-08-25T17:47:57Z Margob28 2943256 wikitext text/x-wiki {{Robelbox|theme=9|title=Welcome!|width=100%}} <div style="{{Robelbox/pad}}"> '''Hello and [[Wikiversity:Welcome|Welcome]] to [[Wikiversity:What is Wikiversity|Wikiversity]] Margob28!''' You can [[Wikiversity:Contact|contact us]] with [[Wikiversity:Questions|questions]] at the [[Wikiversity:Colloquium|colloquium]] or [[User talk:Dave Braunschweig|me personally]] when you need [[Help:Contents|help]]. Please remember to [[Wikiversity:Signature|sign and date]] your finished comments when [[Wikiversity:Who are Wikiversity participants?|participating]] in [[Wikiversity:Talk page|discussions]]. The signature icon [[File:OOjs UI icon signature-ltr.svg]] above the edit window makes it simple. All users are expected to abide by our [[Wikiversity:Privacy policy|Privacy]], [[Wikiversity:Civility|Civility]], and the [[Foundation:Terms of Use|Terms of Use]] policies while at Wikiversity. To [[Wikiversity:Introduction|get started]], you may <!-- The Left column --> <div style="width:50.0%; float:left"> * [[Help:guides|Take a guided tour]] and learn [[Help:Editing|to edit]]. * Visit a (kind of) [[Wikiversity:Random|random project]]. * [[Wikiversity:Browse|Browse]] Wikiversity, or visit a portal corresponding to your educational level: [[Portal: Pre-school Education|pre-school]], [[Portal: Primary Education|primary]], [[Portal:Secondary Education|secondary]], [[Portal:Tertiary Education|tertiary]], [[Portal:Non-formal Education|non-formal education]]. * Find out about [[Wikiversity:Research|research]] activities on Wikiversity. * [[Wikiversity:Introduction explore|Explore]] Wikiversity with the links to your left. </div> <!-- The Right column --> <div style="width:50.0%; float:left"> * Enable VisualEditor under [[Special:Preferences#mw-prefsection-betafeatures|Beta]] settings to make article editing easier. * Read an [[Wikiversity:Wikiversity teachers|introduction for teachers]] and find out [[Help:How to write an educational resource|how to write an educational resource]] for Wikiversity. * Give [[Wikiversity:Feedback|feedback]] about your initial observations. * Discuss Wikiversity issues or ask questions at the [[Wikiversity:Colloquium|colloquium]]. * [[Wikiversity:Chat|Chat]] with other Wikiversitans on [[:freenode:wikiversity|<kbd>#wikiversity</kbd>]]. </div> <br clear="both"/> You do not need to be an educator to edit. You only need to [[Wikiversity:Be bold|be bold]] to contribute and to experiment with the [[wikiversity:sandbox|sandbox]] or [[special:mypage|your userpage]]. See you around Wikiversity! --[[User:Dave Braunschweig|Dave Braunschweig]] ([[User talk:Dave Braunschweig|discuss]] • [[Special:Contributions/Dave Braunschweig|contribs]]) 12:44, 19 May 2022 (UTC)</div> <!-- Template:Welcome --> {{Robelbox/close}} == Nigerian English Varieties == As a non-native context, Nigeria has several taxonomy of English Varieties spoken within the Nigerian speech community. [[User:Margob28|Margob28]] ([[User talk:Margob28|discuss]] • [[Special:Contributions/Margob28|contribs]]) 22:01, 12 August 2022 (UTC) == [[WikiJournal Preprints/A Phonological Analysis of Selected Nigerian Undergraduates Renditions]] == Thank you for your submission. I was wondering if you have a Word or PDF version that you can upload to Commons (or email to us)? This is to ensure that the syllables, IPA, phoneme and others are presented accurately on the wiki page. Thanks. [[User:OhanaUnited|<b><span style="color: #0000FF;">OhanaUnited</span></b>]][[User talk:OhanaUnited|<b><span style="color: green;">^{Talk page}</span></b>]] 05:17, 25 August 2022 (UTC) Thank you. Please, provide an email address where I could send the word version or preferably provide a guide on how to get the article uploaded on wiki commons. Thank you. [[User:Margob28|Margob28]] ([[User talk:Margob28|discuss]] • [[Special:Contributions/Margob28|contribs]]) 07:37, 25 August 2022 (UTC) :You can follow the steps in [[commons:Special:UploadWizard|Commons' Upload Wizard]] to upload a word document. Be sure to include "draft" in the file name when you are uploading. [[User:OhanaUnited|<b><span style="color: #0000FF;">OhanaUnited</span></b>]][[User talk:OhanaUnited|<b><span style="color: green;">^{Talk page}</span></b>]] 14:06, 25 August 2022 (UTC) Thank you once again. I will do that. [[User:Margob28|Margob28]] ([[User talk:Margob28|discuss]] • [[Special:Contributions/Margob28|contribs]]) 17:47, 25 August 2022 (UTC) 7bo0zw9qyfct5dtbc2wq5hx143qh5m8 2 285229 2419126 2418177 2022-08-25T23:30:40Z U3216256 2942574 Added social contribution wikitext text/x-wiki == About me == Hello everyone, My name is [https://portfolio.canberra.edu.au/view/view.php?t=rufMvX4S27FDnj9lZR85 Ebony] and I am a second year Bachelor of Science in Psychology student at the ''University of Canberra''. I am excited to contribute to the 2022 [[Motivation and emotion/Book/2022|Motivation and Emotion]] Book. As a first-generation University student, I am passionate about education and bringing awareness to issues that first-generation students face. == Hobbies == University related: * [https://clubs.canberra.edu.au/Clubs/CLSS CLSS Treasurer] * UCPS President (2021) Other hobbies: * Knitting/Crocheting * Baking * Reading - Mostly fiction, such as novels by Terry Pratchett, Neil Gaiman, and A. A. Milne ([https://www.goodreads.com/book/show/1333202.The_Red_House_Mystery The Red House Mystery]). == The book chapter I am working on == [[Motivation and emotion/Book/2022/Disappointment|Disappointment: What is disappointment, what causes disappointment, and how can disappointment be managed?]] == Social contributions == # [https://en.wikiversity.org/w/index.php?title=Talk:Motivation_and_emotion/Book/2022/Work_and_flow&diff=2411657&oldid=2411646 13:29, 4 August 2022: Suggested multiple resources that could be used for the Work and Flow chapter] # [https://en.wikiversity.org/w/index.php?title=Motivation+and+emotion%2FBook%2F2022%2FTime+Management&date-range-to=&tagfilter=&action=history 13:39, 4 August 2022: Added the Motivation and Emotion quick start template to the Time Management chapter] # [https://en.wikiversity.org/w/index.php?title=Motivation_and_emotion/Book/2022/Time_and_motivation&action=history 13:44, 4 August 2022: Added the Motivation and Emotion quick start template to the Time and Motivation chapter] # [https://en.wikiversity.org/w/index.php?title=Motivation_and_emotion/Book/2022/Wave_metaphor_for_emotion&oldid=2412979 13:58, 10 August 2022: Added the Motivation and Emotion quick start template to the Wave metaphor for emotion chapter] # [https://en.wikiversity.org/w/index.php?title=Motivation_and_emotion/Book/2022/Suffering_as_emotion&oldid=2412994 14:02, 10 August 2022: Added the Motivation and Emotion quick start template to the Suffering as emotion chapter] #[https://en.wikiversity.org/w/index.php?title=Motivation_and_emotion/Book/2022/Kindness_motivation&action=history 10:06, 17 August 2022: Added the Motivation and Emotion quick start template to the Kindness motivation chapter] #[https://en.wikiversity.org/w/index.php?title=Talk:Motivation_and_emotion/Book/2022/Kindness_motivation&action=history 10:15, 17 August 2022: Suggested multiple resources that could be used for the Kindness motivation chapter (discussion page)] #[https://en.wikiversity.org/w/index.php?title=Talk:Motivation_and_emotion/Book/2022/Psychological_distress&action=history 19:00, 18 August 2022: Suggested multiple resources that could be used for the Psychological distress chapter (discussion page)] #[https://en.wikiversity.org/w/index.php?title=Motivation_and_emotion%2FBook%2F2022%2FPsychological_distress&action=historysubmit&type=revision&diff=2416094&oldid=2413286 19:08, 18 August 2022: Added title and subtitle to Psychological distress chapter] #[https://en.wikiversity.org/w/index.php?title=Motivation_and_emotion%2FBook%2F2022%2FAcademic_help-seeking&type=revision&diff=2416096&oldid=2415946 19:12, 18 August 2022: Added title and subtitle to Academic help-seeking chapter] #[https://en.wikiversity.org/w/index.php?title=Motivation_and_emotion%2FBook%2F2022%2FCognitive_dissonance_reduction&type=revision&diff=2416439&oldid=2416437 15:00, 19 August 2022: Added the Motivation and Emotion quick start template to the Cognitive dissonance reduction chapter] #[https://en.wikiversity.org/w/index.php?title=Motivation_and_emotion%2FBook%2F2022%2FCognitive_dissonance_reduction&type=revision&diff=2416439&oldid=2416437 15:01, 19 August 2022: Added title and subtitle to Cognitive dissonance reduction chapter] #[https://en.wikiversity.org/w/index.php?title=Motivation_and_emotion%2FBook%2F2022%2FCreative_arts_and_trauma&type=revision&diff=2416441&oldid=2360767 15:05, 19 August 2022: Added the Motivation and Emotion quick start template to the Creative arts and trauma chapter] #[https://en.wikiversity.org/w/index.php?title=Talk%3AMotivation_and_emotion%2FBook%2F2022%2FSelf-esteem_and_culture&type=revision&diff=2416443&oldid=2364684 15:13, 19 August 2022: Suggested multiple resources that could be used for the Self-esteem and culture chapter (discussion page)] #[https://en.wikiversity.org/w/index.php?title=Talk:Motivation_and_emotion/Book/2022/Fully_functioning_person&action=history 10:25, 20 August 2022: Suggested multiple resources that could be useful for the Carl Rogers section in the Fully functioning person chapter (discussion page)] #[https://en.wikiversity.org/w/index.php?title=Motivation_and_emotion%2FBook%2F2022%2FBehavioural_economics_and_motivation&type=revision&diff=2417748&oldid=2417474 16:54, 23 August 2022: Added 'citation needed' clarification template to the introduction of Behavioural economics and motivation chapter] #[https://en.wikiversity.org/w/index.php?title=Motivation_and_emotion%2FBook%2F2022%2FBeneficence_as_a_psychological_need&type=revision&diff=2417751&oldid=2416013 16:58, 23 August 2022: Added 'citation needed' clarification template to various parts of Beneficence as a psychological need chapter] #[https://en.wikiversity.org/w/index.php?title=Motivation_and_emotion%2FBook%2F2022%2FWindow_of_tolerance&type=revision&diff=2417754&oldid=2417715 17:09, 23 August 2022: Added clarification templates to various parts of the Window to tolerance chapter] #[https://en.wikiversity.org/w/index.php?title=Talk:Motivation_and_emotion/Book/2022/Reward_system,_motivation,_and_emotion&action=history 17:20, 24 August 2022: Suggested multiple resources that could be useful for the Reward systems, motivation, and emotion chapter] #[https://en.wikiversity.org/w/index.php?title=Talk:Motivation_and_emotion/Book/2022/Unemployment_and_mental_health&action=history 09:29, 26 August 2022: Suggested multiple resources that could be useful for the Unemployment and mental health chapter (discussion page)] o9arasmxm5bsms0e1di34qch20i7qb9 2 285352 2419478 2417261 2022-08-26T11:00:16Z U3213549 2946564 /* Social contributions */ wikitext text/x-wiki == About me == Hi there! My name is Georgie, I am in the third year of my Bachelor of Science (Psychology) degree, majoring in Counselling Studies at [https://www.canberra.edu.au/ The University of Canberra]! I am currently creating a book chapter about the role motivations and emotions play in hostage negotiation. == Hobbies == * Baking * Going out for brunch * Dancing * Listening to Harry styles == Book chapter == I am currently working on a book chapter for my unit Motivation and Emotion. My chapter focuses on the role that motivation and emotion play in hostage negotiation. Social contributions are more than welcome, my chapter can be found here; [[Motivation and emotion/Book/2022/Hostage negotiation, motivation, and emotion|Hostage negotiation, motivation, and emotion]] for ''[[Motivation and emotion|Motivation and Emotion]]'' == Social contributions == [https://en.wikiversity.org/w/index.php?title=Talk:Motivation_and_emotion/Book/2022/Courage_motivation,_motivation,_and_emotion&action=history Added a source to the 2022 book chapter "Courage motivation"] this was done help develop a background on the topic (05:34pm, 24 Aug, 2022) aairwbakdslqn2p4sjl6ykd6vihwnws 0 285380 2419062 2418474 2022-08-25T14:12:52Z Young1lim 21186 /* Handling Series of Data */ wikitext text/x-wiki === Introduction === * Overview ([[Media:C01.Intro1.Overview.1.A.20170925.pdf |A.pdf]], [[Media:C01.Intro1.Overview.1.B.20170901.pdf |B.pdf]], [[Media:C01.Intro1.Overview.1.C.20170904.pdf |C.pdf]]) * Number System ([[Media:C01.Intro2.Number.1.A.20171023.pdf |A.pdf]], [[Media:C01.Intro2.Number.1.B.20170909.pdf |B.pdf]], [[Media:C01.Intro2.Number.1.C.20170914.pdf |C.pdf]]) * Memory System ([[Media:C01.Intro2.Memory.1.A.20170907.pdf |A.pdf]], [[Media:C01.Intro3.Memory.1.B.20170909.pdf |B.pdf]], [[Media:C01.Intro3.Memory.1.C.20170914.pdf |C.pdf]]) === Handling Repetition === * Control ([[Media:C02.Repeat1.Control.1.A.20170925.pdf |A.pdf]], [[Media:C02.Repeat1.Control.1.B.20170918.pdf |B.pdf]], [[Media:C02.Repeat1.Control.1.C.20170926.pdf |C.pdf]]) * Loop ([[Media:C02.Repeat2.Loop.1.A.20170925.pdf |A.pdf]], [[Media:C02.Repeat2.Loop.1.B.20170918.pdf |B.pdf]]) === Handling a Big Work === * Function Overview ([[Media:C03.Func1.Overview.1.A.20171030.pdf |A.pdf]], [[Media:C03.Func1.Oerview.1.B.20161022.pdf |B.pdf]]) * Functions & Variables ([[Media:C03.Func2.Variable.1.A.20161222.pdf |A.pdf]], [[Media:C03.Func2.Variable.1.B.20161222.pdf |B.pdf]]) * Functions & Pointers ([[Media:C03.Func3.Pointer.1.A.20161122.pdf |A.pdf]], [[Media:C03.Func3.Pointer.1.B.20161122.pdf |B.pdf]]) * Functions & Recursions ([[Media:C03.Func4.Recursion.1.A.20161214.pdf |A.pdf]], [[Media:C03.Func4.Recursion.1.B.20161214.pdf |B.pdf]]) === Handling Series of Data === ==== Background ==== * Background ([[Media:C04.Series0.Background.1.A.20180727.pdf |A.pdf]]) ==== Basics ==== * Arrays ([[Media:C04.Series1.Array.1.A.20220825.pdf |A.pdf]], [[Media:C04.Series1.Array.1.B.20161115.pdf |B.pdf]]) * Pointers ([[Media:C04.Series2.Pointer.1.A.20180726.pdf |A.pdf]], [[Media:C04.Series2.Pointer.1.B.20161115.pdf |B.pdf]]) * Array Pointers ([[Media:C04.Series3.ArrayPointer.1.A.20220825.pdf |A.pdf]], [[Media:C04.Series3.ArrayPointer.1.B.20181203.pdf |B.pdf]]) * Multi-dimensional Arrays ([[Media:C04.Series4.MultiDim.1.A.20220418.pdf |A.pdf]], [[Media:C04.Series4.MultiDim.1.B.11.pdf |B.pdf]]) * Array Access Methods ([[Media:C04.Series4.ArrayAccess.1.A.20190511.pdf |A.pdf]], [[Media:C04.Series3.ArrayPointer.1.B.20181203.pdf |B.pdf]]) * Structures ([[Media:C04.Series3.Structure.1.A.20171204.pdf |A.pdf]], [[Media:C04.Series2.Structure.1.B.20161130.pdf |B.pdf]]) ==== Applications ==== * Applications of Arrays ([[Media:C04.Series1App.Array.1.A.20220825.pdf |A.pdf]]) * Applications of Pointers ([[Media:C04.Series7.AppPoint.1.A.20200424.pdf |A.pdf]]) * Applications of Array Pointers ([[Media:C04.Series3App.ArrayPointer.1.A.2022024.pdf |A.pdf]]) * Applications of Multi-dimensional Arrays ([[Media:C04.Series4App.MultiDim.1.A.20210719.pdf |A.pdf]]) * Applications of Array Access Methods ([[Media:C04.Series9.AppArrAcess.1.A.20190511.pdf |A.pdf]]) * Applications of Structures ([[Media:C04.Series6.AppStruct.1.A.20190423.pdf |A.pdf]]) ==== Examples ==== * Spreadsheet Example Programs :: Example 1 ([[Media:C04.Series7.Example.1.A.20171213.pdf |A.pdf]], [[Media:C04.Series7.Example.1.C.20171213.pdf |C.pdf]]) :: Example 2 ([[Media:C04.Series7.Example.2.A.20171213.pdf |A.pdf]], [[Media:C04.Series7.Example.2.C.20171213.pdf |C.pdf]]) :: Example 3 ([[Media:C04.Series7.Example.3.A.20171213.pdf |A.pdf]], [[Media:C04.Series7.Example.3.C.20171213.pdf |C.pdf]]) :: Bubble Sort ([[Media:C04.Series7.BubbleSort.1.A.20171211.pdf |A.pdf]]) === Handling Various Kinds of Data === * Types ([[Media:C05.Data1.Type.1.A.20180217.pdf |A.pdf]], [[Media:C05.Data1.Type.1.B.20161212.pdf |B.pdf]]) * Typecasts ([[Media:C05.Data2.TypeCast.1.A.20180217.pdf |A.pdf]], [[Media:C05.Data2.TypeCast.1.B.20161216.pdf |A.pdf]]) * Operators ([[Media:C05.Data3.Operators.1.A.20161219.pdf |A.pdf]], [[Media:C05.Data3.Operators.1.B.20161216.pdf |B.pdf]]) * Files ([[Media:C05.Data4.File.1.A.20161124.pdf |A.pdf]], [[Media:C05.Data4.File.1.B.20161212.pdf |B.pdf]]) === Handling Low Level Operations === * Bitwise Operations ([[Media:BitOp.1.B.20161214.pdf |A.pdf]], [[Media:BitOp.1.B.20161203.pdf |B.pdf]]) * Bit Field ([[Media:BitField.1.A.20161214.pdf |A.pdf]], [[Media:BitField.1.B.20161202.pdf |B.pdf]]) * Union ([[Media:Union.1.A.20161221.pdf |A.pdf]], [[Media:Union.1.B.20161111.pdf |B.pdf]]) * Accessing IO Registers ([[Media:IO.1.A.20141215.pdf |A.pdf]], [[Media:IO.1.B.20161217.pdf |B.pdf]]) === Declarations === * Type Specifiers and Qualifiers ([[Media:C07.Spec1.Type.1.A.20171004.pdf |pdf]]) * Storage Class Specifiers ([[Media:C07.Spec2.Storage.1.A.20171009.pdf |pdf]]) * Scope === Class Notes === * TOC ([[Media:TOC.20171007.pdf |TOC.pdf]]) * Day01 ([[Media:Day01.A.20171007.pdf |A.pdf]], [[Media:Day01.B.20171209.pdf |B.pdf]], [[Media:Day01.C.20171211.pdf |C.pdf]]) ...... Introduction (1) Standard Library * Day02 ([[Media:Day02.A.20171007.pdf |A.pdf]], [[Media:Day02.B.20171209.pdf |B.pdf]], [[Media:Day02.C.20171209.pdf |C.pdf]]) ...... Introduction (2) Basic Elements * Day03 ([[Media:Day03.A.20171007.pdf |A.pdf]], [[Media:Day03.B.20170908.pdf |B.pdf]], [[Media:Day03.C.20171209.pdf |C.pdf]]) ...... Introduction (3) Numbers * Day04 ([[Media:Day04.A.20171007.pdf |A.pdf]], [[Media:Day04.B.20170915.pdf |B.pdf]], [[Media:Day04.C.20171209.pdf |C.pdf]]) ...... Structured Programming (1) Flowcharts * Day05 ([[Media:Day05.A.20171007.pdf |A.pdf]], [[Media:Day05.B.20170915.pdf |B.pdf]], [[Media:Day05.C.20171209.pdf |C.pdf]]) ...... Structured Programming (2) Conditions and Loops * Day06 ([[Media:Day06.A.20171007.pdf |A.pdf]], [[Media:Day06.B.20170923.pdf |B.pdf]], [[Media:Day06.C.20171209.pdf |C.pdf]]) ...... Program Control * Day07 ([[Media:Day07.A.20171007.pdf |A.pdf]], [[Media:Day07.B.20170926.pdf |B.pdf]], [[Media:Day07.C.20171209.pdf |C.pdf]]) ...... Function (1) Definitions * Day08 ([[Media:Day08.A.20171028.pdf |A.pdf]], [[Media:Day08.B.20171016.pdf |B.pdf]], [[Media:Day08.C.20171209.pdf |C.pdf]]) ...... Function (2) Storage Class and Scope * Day09 ([[Media:Day09.A.20171007.pdf |A.pdf]], [[Media:Day09.B.20171017.pdf |B.pdf]], [[Media:Day09.C.20171209.pdf |C.pdf]]) ...... Function (3) Recursion * Day10 ([[Media:Day10.A.20171209.pdf |A.pdf]], [[Media:Day10.B.20171017.pdf |B.pdf]], [[Media:Day10.C.20171209.pdf |C.pdf]]) ...... Arrays (1) Definitions * Day11 ([[Media:Day11.A.20171024.pdf |A.pdf]], [[Media:Day11.B.20171017.pdf |B.pdf]], [[Media:Day11.C.20171212.pdf |C.pdf]]) ...... Arrays (2) Applications * Day12 ([[Media:Day12.A.20171024.pdf |A.pdf]], [[Media:Day12.B.20171020.pdf |B.pdf]], [[Media:Day12.C.20171209.pdf |C.pdf]]) ...... Pointers (1) Definitions * Day13 ([[Media:Day13.A.20171025.pdf |A.pdf]], [[Media:Day13.B.20171024.pdf |B.pdf]], [[Media:Day13.C.20171209.pdf |C.pdf]]) ...... Pointers (2) Applications * Day14 ([[Media:Day14.A.20171226.pdf |A.pdf]], [[Media:Day14.B.20171101.pdf |B.pdf]], [[Media:Day14.C.20171209.pdf |C.pdf]]) ...... C String (1) * Day15 ([[Media:Day15.A.20171209.pdf |A.pdf]], [[Media:Day15.B.20171124.pdf |B.pdf]], [[Media:Day15.C.20171209.pdf |C.pdf]]) ...... C String (2) * Day16 ([[Media:Day16.A.20171208.pdf |A.pdf]], [[Media:Day16.B.20171114.pdf |B.pdf]], [[Media:Day16.C.20171209.pdf |C.pdf]]) ...... C Formatted IO * Day17 ([[Media:Day17.A.20171031.pdf |A.pdf]], [[Media:Day17.B.20171111.pdf |B.pdf]], [[Media:Day17.C.20171209.pdf |C.pdf]]) ...... Structure (1) Definitions * Day18 ([[Media:Day18.A.20171206.pdf |A.pdf]], [[Media:Day18.B.20171128.pdf |B.pdf]], [[Media:Day18.C.20171212.pdf |C.pdf]]) ...... Structure (2) Applications * Day19 ([[Media:Day19.A.20171205.pdf |A.pdf]], [[Media:Day19.B.20171121.pdf |B.pdf]], [[Media:Day19.C.20171209.pdf |C.pdf]]) ...... Union, Bitwise Operators, Enum * Day20 ([[Media:Day20.A.20171205.pdf |A.pdf]], [[Media:Day20.B.20171201.pdf |B.pdf]], [[Media:Day20.C.20171212.pdf |C.pdf]]) ...... Linked List * Day21 ([[Media:Day21.A.20171206.pdf |A.pdf]], [[Media:Day21.B.20171208.pdf |B.pdf]], [[Media:Day21.C.20171212.pdf |C.pdf]]) ...... File Processing * Day22 ([[Media:Day22.A.20171212.pdf |A.pdf]], [[Media:Day22.B.20171213.pdf |B.pdf]], [[Media:Day22.C.20171212.pdf |C.pdf]]) ...... Preprocessing <!----------------------------------------------------------------------> </br> See also https://cprogramex.wordpress.com/ == '''Old Materials '''== until 201201 * Intro.Overview.1.A ([[Media:C.Intro.Overview.1.A.20120107.pdf |pdf]]) * Intro.Memory.1.A ([[Media:C.Intro.Memory.1.A.20120107.pdf |pdf]]) * Intro.Number.1.A ([[Media:C.Intro.Number.1.A.20120107.pdf |pdf]]) * Repeat.Control.1.A ([[Media:C.Repeat.Control.1.A.20120109.pdf |pdf]]) * Repeat.Loop.1.A ([[Media:C.Repeat.Loop.1.A.20120113.pdf |pdf]]) * Work.Function.1.A ([[Media:C.Work.Function.1.A.20120117.pdf |pdf]]) * Work.Scope.1.A ([[Media:C.Work.Scope.1.A.20120117.pdf |pdf]]) * Series.Array.1.A ([[Media:Series.Array.1.A.20110718.pdf |pdf]]) * Series.Pointer.1.A ([[Media:Series.Pointer.1.A.20110719.pdf |pdf]]) * Series.Structure.1.A ([[Media:Series.Structure.1.A.20110805.pdf |pdf]]) * Data.Type.1.A ([[Media:C05.Data2.TypeCast.1.A.20130813.pdf |pdf]]) * Data.TypeCast.1.A ([[Media:Data.TypeCast.1.A.pdf |pdf]]) * Data.Operators.1.A ([[Media:Data.Operators.1.A.20110712.pdf |pdf]]) <br> until 201107 * Intro.1.A ([[Media:Intro.1.A.pdf |pdf]]) * Control.1.A ([[Media:Control.1.A.20110706.pdf |pdf]]) * Iteration.1.A ([[Media:Iteration.1.A.pdf |pdf]]) * Function.1.A ([[Media:Function.1.A.20110705.pdf |pdf]]) * Variable.1.A ([[Media:Variable.1.A.20110708.pdf |pdf]]) * Operators.1.A ([[Media:Operators.1.A.20110712.pdf |pdf]]) * Pointer.1.A ([[Media:Pointer.1.A.pdf |pdf]]) * Pointer.2.A ([[Media:Pointer.2.A.pdf |pdf]]) * Array.1.A ([[Media:Array.1.A.pdf |pdf]]) * Type.1.A ([[Media:Type.1.A.pdf |pdf]]) * Structure.1.A ([[Media:Structure.1.A.pdf |pdf]]) go to [ [[C programming in plain view]] ] [[Category:C programming]] </br> bp730pj1028bu7w95y5czaakk68602o 2 285655 2419239 2408909 2022-08-26T03:24:53Z Jtwsaddress42 234843 wikitext text/x-wiki '''Domestic Governance''' {{RoundBoxTop|theme=3}} * <u>[https://www.au.org Americans United (AU)]</u> - [[w:Americans_United_for_Separation_of_Church_and_State|Americans United for Separation of Church and State (AU)]] is a nonprofit organization comprised of religious believers and non-believers that advocate for a separation of church and state. The separation protects the integrity of both institutions as well as our right to freedom of thought, belief, and expression. [https://www.youtube.com/user/audotorg YouTube Channel] [[File:High-contrast-camera-video.svg|24px|video]] ** [https://www.au.org/the-latest/church-state/ Church & State] - The magazine of Americans United. * <u>[https://ballotpedia.org/Main_Page Ballotpedia]</u> - [[w:Ballotpedia|Ballotpedia]] is the digital encyclopedia of American politics and elections. [[File:Ballotpedia logo.png|120px|Ballotpedia logo]] [https://www.youtube.com/channel/UC0u04Fuq2qLUmYK12rVXFfQ YouTube Channel] [[File:High-contrast-camera-video.svg|24px|video]] * <u>[https://www.c-span.org/ Cable-Satellite Public Affairs Network (C-SPAN)]</u> - [[w:C-SPAN|C-SPAN]] programs three public affairs television networks covering Capitol Hill, the White House and national politics. [https://www.youtube.com/c/C-SPAN YouTube Channel] [[File:High-contrast-camera-video.svg|24px|video]] ** Livestreams - [https://www.c-span.org/networks/?channel=c-span C-SPAN] [[File:High-contrast-camera-video.svg|24px|video]] - [https://www.c-span.org/networks/?channel=c-span-2 C-SPAN 2] [[File:High-contrast-camera-video.svg|24px|video]] - [https://www.c-span.org/networks/?channel=c-span-3 C-SPAN 3] [[File:High-contrast-camera-video.svg|24px|video]] * <u>[https://www.justice.gov/usao-dc/capitol-breach-investigation-resource-page Department of Justice Capitol Breach Investigation Resource Page]</u> - [[w:United_States_Department_of_Justice|US Department of Justice]] investigation of the January 6th capitol breach and [[w:Criminal_charges_in_the_2021_United_States_Capitol_attack|criminal charges filed]]. ** [https://libguides.union.edu/c.php?g=1126166&p=8215213 January 6 Storming of the Capitol - DOJ Investigation] - [[w:Union_College#History|Union College]] Schaffer Library documentation of the government investigation of the Capitol breach on Wednesday, January 6, 2021. * <u>[https://federalnewsnetwork.com/ Federal News Network]</u> - News concerning U.S. Federal Government programs with an emphasis on employee and management issues. ** [https://federalnewsnetwork.com/category/defense-main/defense-news/ Defense News] - Department of Defense (DOD) news and analysis. [https://federalnewsnetwork.com/category/radio-interviews/on-dod/on-dod-podcasts/ On DOD Podcast] ** [https://federalnewsnetwork.com/category/technology-main/ Technology News] - Federal Chief Information Officers (CIO) technology news and analysis. [https://federalnewsnetwork.com/category/radio-interviews/federal-tech-talk/ Federal Tech Talk Podcast] * <u>[https://www.igs.berkeley.edu/ Institute of Governmental Studies (IGS)]</u> - [[w:Institute of Governmental Studies|Institute of Governmental Studies (IGS)]] at the University of California, Berkeley (UCB). [https://www.youtube.com/channel/UC7RtXRYTGK916ASlntRbMmg/featured YouTube Channel] [[File:High-contrast-camera-video.svg|24px|video]] * <u>[https://january6th.house.gov/ Select Committee to Investigate the January 6th Attack on the American Capitol]</u> - The US House of Representatives [[w:https://en.wikipedia.org/wiki/United_States_House_Select_Committee_on_the_January_6_Attack|Select Committee to Investigate the January 6th Attack on the American Capitol]] proceedings, media releases, and reports. [https://www.c-span.org/organization/?139816/Select-Committee-Investigate-January-6th-Attack-United-States-Capitol C-SPAN Video Library] [[File:High-contrast-camera-video.svg|24px|video]] [https://www.youtube.com/c/January6thCmte/featured YouTube Channel] [[File:High-contrast-camera-video.svg|24px|video]] ** [https://libguides.union.edu/c.php?g=1126166 January 6 Storming of the Capitol - Select Committee] - [[w:Union_College#History|Union College]] Schaffer Library documentation of the government investigation of the Capitol breach on Wednesday, January 6, 2021. {{RoundBoxBottom}} qywyvadn7f2m1axg1z3cbgn6upcvwmk 2419242 2419239 2022-08-26T03:34:15Z Jtwsaddress42 234843 wikitext text/x-wiki '''Domestic Governance''' {{RoundBoxTop|theme=3}} * <u>[https://www.au.org Americans United (AU)]</u> - [[w:Americans_United_for_Separation_of_Church_and_State|Americans United for Separation of Church and State (AU)]] is a nonprofit organization comprised of religious believers and non-believers that advocate for a separation of church and state. The separation protects the integrity of both institutions as well as our right to freedom of thought, belief, and expression. [https://www.youtube.com/user/audotorg YouTube Channel] [[File:High-contrast-camera-video.svg|24px|video]] ** [https://www.au.org/the-latest/church-state/ Church & State] - The magazine of Americans United. * <u>[https://ballotpedia.org/Main_Page Ballotpedia]</u> - [[w:Ballotpedia|Ballotpedia]] is the digital encyclopedia of American politics and elections. [[File:Ballotpedia logo.png|80px|Ballotpedia logo]] [https://www.youtube.com/channel/UC0u04Fuq2qLUmYK12rVXFfQ YouTube Channel] [[File:High-contrast-camera-video.svg|24px|video]] * <u>[https://www.c-span.org/ Cable-Satellite Public Affairs Network (C-SPAN)]</u> - [[w:C-SPAN|C-SPAN]] programs three public affairs television networks covering Capitol Hill, the White House and national politics. [[File:C-SPAN Logo (2019).svg|48px|C-SPAN_Logo_(2019)]] [https://www.youtube.com/c/C-SPAN YouTube Channel] [[File:High-contrast-camera-video.svg|24px|video]] ** Livestreams - [https://www.c-span.org/networks/?channel=c-span C-SPAN] [[File:C-SPAN Logo (2019).svg|48px|C-SPAN_Logo_(2019)]] [[File:High-contrast-camera-video.svg|24px|video]] - [https://www.c-span.org/networks/?channel=c-span-2 C-SPAN 2] [[File:C-SPAN Logo (2019).svg|48px|C-SPAN_Logo_(2019)]] [[File:High-contrast-camera-video.svg|24px|video]] - [https://www.c-span.org/networks/?channel=c-span-3 C-SPAN 3] [[File:C-SPAN Logo (2019).svg|48px|C-SPAN_Logo_(2019)]] [[File:High-contrast-camera-video.svg|24px|video]] * <u>[https://www.justice.gov/usao-dc/capitol-breach-investigation-resource-page Department of Justice Capitol Breach Investigation Resource Page]</u> - [[w:United_States_Department_of_Justice|US Department of Justice]] investigation of the January 6th capitol breach and [[w:Criminal_charges_in_the_2021_United_States_Capitol_attack|criminal charges filed]]. [[File:Seal of the United States Department of Justice.svg|24px|Seal of the United States Department of Justice]] ** [https://libguides.union.edu/c.php?g=1126166&p=8215213 January 6 Storming of the Capitol - DOJ Investigation] - [[w:Union_College#History|Union College]] Schaffer Library documentation of the government investigation of the Capitol breach on Wednesday, January 6, 2021. * <u>[https://federalnewsnetwork.com/ Federal News Network]</u> - News concerning U.S. Federal Government programs with an emphasis on employee and management issues. ** [https://federalnewsnetwork.com/category/defense-main/defense-news/ Defense News] - Department of Defense (DOD) news and analysis. [https://federalnewsnetwork.com/category/radio-interviews/on-dod/on-dod-podcasts/ On DOD Podcast] ** [https://federalnewsnetwork.com/category/technology-main/ Technology News] - Federal Chief Information Officers (CIO) technology news and analysis. [https://federalnewsnetwork.com/category/radio-interviews/federal-tech-talk/ Federal Tech Talk Podcast] * <u>[https://www.igs.berkeley.edu/ Institute of Governmental Studies (IGS)]</u> - [[w:Institute of Governmental Studies|Institute of Governmental Studies (IGS)]] at the University of California, Berkeley (UCB). [https://www.youtube.com/channel/UC7RtXRYTGK916ASlntRbMmg/featured YouTube Channel] [[File:High-contrast-camera-video.svg|24px|video]] * <u>[https://january6th.house.gov/ Select Committee to Investigate the January 6th Attack on the American Capitol]</u> - The US House of Representatives [[w:https://en.wikipedia.org/wiki/United_States_House_Select_Committee_on_the_January_6_Attack|Select Committee to Investigate the January 6th Attack on the American Capitol]] proceedings, media releases, and reports. [https://www.c-span.org/organization/?139816/Select-Committee-Investigate-January-6th-Attack-United-States-Capitol C-SPAN Video Library] [[File:C-SPAN Logo (2019).svg|48px|C-SPAN_Logo_(2019)]] [[File:High-contrast-camera-video.svg|24px|video]] [https://www.youtube.com/c/January6thCmte/featured YouTube Channel] [[File:High-contrast-camera-video.svg|24px|video]] ** [https://libguides.union.edu/c.php?g=1126166 January 6 Storming of the Capitol - Select Committee] - [[w:Union_College#History|Union College]] Schaffer Library documentation of the government investigation of the Capitol breach on Wednesday, January 6, 2021. {{RoundBoxBottom}} ql93vid9s84k8o6jdcjjvemn109xh88 2 285665 2419175 2408943 2022-08-26T01:56:06Z Jtwsaddress42 234843 wikitext text/x-wiki '''National Institutes''' {{RoundBoxTop|theme=3}} * <u>[https://www.nih.gov/ National Institutes of Health (NIH)]</u> - National Institutes of Health (NIH) is the biomedical research agency of the U.S. Department of Health and Human Services (HHS). [[File:NIH 2013 logo vertical.svg|24px|NIH_2013_logo_vertical]] [https://www.youtube.com/user/NIHOD YouTube Channel] [[File:High-contrast-camera-video.svg|24px|video]] ** [https://videocast.nih.gov/PastEvents NIH Conferences] - NIH VideoCast Conference Seminars. [[File:NIH 2013 logo vertical.svg|24px|NIH_2013_logo_vertical]] [https://www.youtube.com/playlist?list=PL01FB357E817A6C7A YouTube Playlist] [[File:High-contrast-camera-video.svg|24px|video]] ** [https://oir.nih.gov/wals NIH Director’s Wednesday Afternoon Lecture Series (WALS)] - NIH Director’s Wednesday Afternoon Lecture Series (WALS). [[File:NIH 2013 logo vertical.svg|24px|NIH_2013_logo_vertical]] [https://www.youtube.com/playlist?list=PL1F9CE65D2F87D4A7 YouTube Playlist] [[File:High-contrast-camera-video.svg|24px|video]] ** [https://videocast.nih.gov/ NIH VideoCast] - NIH VideoCasting broadcasts and records live seminars, conferences and meetings concerning biomedical and health-related research. [[File:NIH 2013 logo vertical.svg|24px|NIH_2013_logo_vertical]] [https://www.youtube.com/c/NIHVideoCast YouTube Channel] [[File:High-contrast-camera-video.svg|24px|video]] ** [https://nnlm.gov/ Network of the National Library of Medicine (NNLM)] - Network of the National Library of Medicine (NNLM) is comprised of academic health sciences libraries, hospital, pharmaceutical and other special biomedical libraries, public libraries, information centers and community-based organizations associated with the NIH.[[File:US-NationalNetworkOfLibrariesOfMedicine-Logo.svg|24px|US-NationalNetworkOfLibrariesOfMedicine-Logo]] [https://www.youtube.com/c/NnlmGov YouTube Channel] [[File:High-contrast-camera-video.svg|24px|video]] ** [https://pubchem.ncbi.nlm.nih.gov/ PubChem] - Established in 2004, PubChem is an open chemistry database at the National Institutes of Health (NIH). [[File:PubChem logo.svg|64px|PubChem_logo]] * <u>[https://www.rigb.org/ Royal Institute (Ri)]</u> - The [[w:Royal_Institution|Royal Institution (Ri)]] was founded in March 1799 with the aim of introducing new technologies and teaching science to the general public. Its [[w:Royal_Charter|Royal Charter]] was granted in 1800. [https://www.youtube.com/c/TheRoyalInstitution YouTube Channel] [[File:High-contrast-camera-video.svg|24px|video]] ** [https://www.youtube.com/playlist?list=PLbnrZHfNEDZyGeNsqVL3jmXMpJbNcPXsC Ri Biology - YouTube Playlist] [[File:High-contrast-camera-video.svg|24px|video]] ** [https://www.youtube.com/playlist?list=PLbnrZHfNEDZwT_sW6joezEWrkVYX8dPa3 Ri Brain - YouTube Playlist] [[File:High-contrast-camera-video.svg|24px|video]] ** [https://www.youtube.com/playlist?list=PLbnrZHfNEDZyngelPt7HxmXYGOiBqaogX Ri Chemistry - YouTube Playlist] [[File:High-contrast-camera-video.svg|24px|video]] ** [https://www.youtube.com/playlist?list=PLbnrZHfNEDZzxswBf5WhzbIDTInJOgCIP Ri Physics - YouTube Playlist] [[File:High-contrast-camera-video.svg|24px|video]] ** [https://www.youtube.com/playlist?list=PLbnrZHfNEDZxEvWydldVLllk_bA8_rs2a Ri Medicine - YouTube Playlist] [[File:High-contrast-camera-video.svg|24px|video]] ** [https://www.youtube.com/playlist?list=PLbnrZHfNEDZyDfeVsNBMNDUu-o5j9_QMb Ri Mathematics - YouTube Playlist] [[File:High-contrast-camera-video.svg|24px|video]] {{RoundBoxBottom}} f5lnj2mymykpgnwwp6fyxqdb2d8c4qs 2 285667 2419169 2410422 2022-08-26T01:45:06Z Jtwsaddress42 234843 wikitext text/x-wiki '''Science News & Interviews''' {{RoundBoxTop|theme=3}} * <u>[https://www.americanscientist.org/ American Scientist]</u> - American Scientist is the illustrative, award-winning magazine of Sigma Xi, The Scientific Research Society. [https://www.youtube.com/c/AmericanscientistOrg YouTube Channel] [[File:High-contrast-camera-video.svg|24px|video]] * <u>[https://www.cbc.ca/ideas/episodes/2009/01/02/how-to-think-about-science-part-1---24-listen/ How To Think About Science]</u> - [[w:Ideas_(radio_show)|CBC Ideas]] with [[w:Paul_Kennedy_(host)|Paul Kennedy]] - [[w:David_Cayley|David Cayley]] conducts 24 informative interviews on how to think about science with a variety of philosophers and scientists. [[File:CBC Radio-Canada logo.svg|128px|CBC Radio]] * <u>[https://www.nih.gov/news-events NIH News & Events]</u> - News and media event releases from National Institutes of Health (NIH) at the U.S. Department of Health & Human Services. [https://www.youtube.com/user/nihod YouTube Channel] [[File:High-contrast-camera-video.svg|24px|video]] * <u>[https://www.quantamagazine.org/ Quanta Magazine]</u> - Quanta Magazine is an editorially independent online publication launched by the Simons Foundation to enhance public understanding of science. [https://www.youtube.com/c/QuantaScienceChannel YouTube Channel] [[File:High-contrast-camera-video.svg|24px|video]] ** [https://www.quantamagazine.org/archive/ Archive] - Quanta Magazine article archive. * <u>[https://www.sciencefriday.com/ Science Friday]</u> - [[w:Science Friday|Science Friday]], hosted by [[w:Ira Flatow|Ira Flatow]], is an award-winning producer of high quality, fact-checked, and trustworthy science news and educational programming. [https://www.sciencefriday.com/science-friday-podcasts/ Podcasts] [https://www.youtube.com/c/scifri/featured YouTube Channel] [[File:High-contrast-camera-video.svg|24px|video]] * <u>[https://www.the-scientist.com/ The Scientist]</u> - [[w:The_Scientist_(magazine)|The Scientist]] is a monthly publication dedicated to covering a wide range of topics central to the study of cell and molecular biology, genetics, and other life-science fields. * <u>[https://users.cg.tuwien.ac.at/zsolnai/gfx/two-minute-papers-awesome-research-for-everyone/ Two Minute Papers - What a Time to be Alive]</u> - by Károly Zsolnai-Fehér, Vienna University of Technology, Research Unit of Computer Graphics discussing AI and computing technologies. [https://www.youtube.com/c/K%C3%A1rolyZsolnai/featured YouTube Channel] [[File:High-contrast-camera-video.svg|24px|video]] {{RoundBoxBottom}} otws7odfi7ls53vmenrz0sqpbbx9b6l 2419180 2419169 2022-08-26T01:59:25Z Jtwsaddress42 234843 wikitext text/x-wiki '''Science News & Interviews''' {{RoundBoxTop|theme=3}} * <u>[https://www.americanscientist.org/ American Scientist]</u> - American Scientist is the illustrative, award-winning magazine of Sigma Xi, The Scientific Research Society. [https://www.youtube.com/c/AmericanscientistOrg YouTube Channel] [[File:High-contrast-camera-video.svg|24px|video]] * <u>[https://www.cbc.ca/ideas/episodes/2009/01/02/how-to-think-about-science-part-1---24-listen/ How To Think About Science]</u> - [[w:Ideas_(radio_show)|CBC Ideas]] with [[w:Paul_Kennedy_(host)|Paul Kennedy]] - [[w:David_Cayley|David Cayley]] conducts 24 informative interviews on how to think about science with a variety of philosophers and scientists. [[File:CBC Radio-Canada logo.svg|128px|CBC Radio]] * <u>[https://www.nih.gov/news-events NIH News & Events]</u> - News and media event releases from National Institutes of Health (NIH) at the U.S. Department of Health & Human Services. [[File:NIH 2013 logo vertical.svg|24px|NIH_2013_logo_vertical]] [https://www.youtube.com/user/nihod YouTube Channel] [[File:High-contrast-camera-video.svg|24px|video]] * <u>[https://www.quantamagazine.org/ Quanta Magazine]</u> - Quanta Magazine is an editorially independent online publication launched by the Simons Foundation to enhance public understanding of science. [https://www.youtube.com/c/QuantaScienceChannel YouTube Channel] [[File:High-contrast-camera-video.svg|24px|video]] ** [https://www.quantamagazine.org/archive/ Archive] - Quanta Magazine article archive. * <u>[https://www.sciencefriday.com/ Science Friday]</u> - [[w:Science Friday|Science Friday]], hosted by [[w:Ira Flatow|Ira Flatow]], is an award-winning producer of high quality, fact-checked, and trustworthy science news and educational programming. [https://www.sciencefriday.com/science-friday-podcasts/ Podcasts] [https://www.youtube.com/c/scifri/featured YouTube Channel] [[File:High-contrast-camera-video.svg|24px|video]] * <u>[https://www.the-scientist.com/ The Scientist]</u> - [[w:The_Scientist_(magazine)|The Scientist]] is a monthly publication dedicated to covering a wide range of topics central to the study of cell and molecular biology, genetics, and other life-science fields. * <u>[https://users.cg.tuwien.ac.at/zsolnai/gfx/two-minute-papers-awesome-research-for-everyone/ Two Minute Papers - What a Time to be Alive]</u> - by Károly Zsolnai-Fehér, Vienna University of Technology, Research Unit of Computer Graphics discussing AI and computing technologies. [https://www.youtube.com/c/K%C3%A1rolyZsolnai/featured YouTube Channel] [[File:High-contrast-camera-video.svg|24px|video]] {{RoundBoxBottom}} 5rokbrfjemrluhywj1sa5fsqusjpy3v 2 285670 2419186 2409322 2022-08-26T02:09:50Z Jtwsaddress42 234843 wikitext text/x-wiki '''Geopolitics, History & International Relations''' {{RoundBoxTop|theme=3}} * <u>[https://www.csis.org/ Center for Strategic & International Studies (CSIS)]</u> - The Center for Strategic and International Studies (CSIS) is a bipartisan, nonprofit policy research organization. [https://www.youtube.com/c/csisdc/featured YouTube Channel] [[File:High-contrast-camera-video.svg|24px|video]] ** [https://www.csis.org/programs/brzezinski-institute-geostrategy Brzezinski Institute on Geostrategy] - Examines the unique interaction of history, geography, and strategy. ** [https://www.csis.org/podcasts CSIS Podcasts] - CSIS regularly produces original expert-guided podcasts on a range of critical issues. * <u>[https://www.youtube.com/c/CaspianReport/about CaspianReport]</u> - CaspianReport explores how geography influences politics, economics, and history. [https://www.youtube.com/channel/UCwnKziETDbHJtx78nIkfYug YouTube Channel] [[File:High-contrast-camera-video.svg|24px|video]] ** [https://www.youtube.com/playlist?list=PLD6AC8E04915265CA CaspianReport Geopolitics - YouTube Playlist] [[File:High-contrast-camera-video.svg|24px|video]] * <u>[https://www.cfg.polis.cam.ac.uk/ Centre for Geopolitics (CfG)]</u> - In the Department of Politics and International Studies at the University of Cambridge. [https://www.youtube.com/c/CentreforGeopolitics/featured YouTube Channel] [[File:High-contrast-camera-video.svg|24px|video]] ** [https://www.youtube.com/playlist?list=PLgZg-9ZL0h85g1Jt3Aj5D-Ydj5t2Jcl1K On Geopolitics - YouTube Playlist] - Podcast series hosted by Suzanne Raine and Ali Ansari. [[File:High-contrast-camera-video.svg|24px|video]] * <u>[https://www.eui.eu/en/academic-units/robert-schuman-centre-for-advanced-studies European University Institute (EUI) - Robert Schuman Centre for Advanced Studies (RSCAS)]</u> - The Robert Schuman Centre for Advanced Studies (RSCAS) is an inter-disciplinary research centre at the heart of the European University Institute (EUI). [https://www.youtube.com/c/TheRobertSchumanCentreforAdvancedStudies/featured YouTube Channel] [[File:High-contrast-camera-video.svg|24px|video]] * <u>[https://www.youtube.com/c/Geopoliticus/about Geopoliticus]</u> - Understanding Geopolitics, History and Theory. [https://www.youtube.com/c/Geopoliticus YouTube Channel] [[File:High-contrast-camera-video.svg|24px|video]] * <u>[https://www.youtube.com/c/GoodTimesBadTimes/about Good Times Bad Times]</u> - Explores global issues from the fields of geopolitics, international relations, economy, technology. [https://www.youtube.com/c/GoodTimesBadTimes/featured YouTube Channel] [[File:High-contrast-camera-video.svg|24px|video]] * <u>[https://www.youtube.com/c/HistoryMarche/about HistoryMarche]</u> - Animated videos about Geopolitical History. [https://www.youtube.com/c/HistoryMarche YouTube Channel] [[File:High-contrast-camera-video.svg|24px|video]] * <u>[https://www.icrc.org/en International Committee of the Red Cross (ICRC)]</u> - Founded in 1863, The ICRC works around the world helping people affected by conflict and armed violence, and promoting the rules of war. ** [https://www.icrc.org/en/who-we-are/history History of the ICRC] - The development of humanitarian action, the Geneva Conventions and the Red Cross and Red Crescent Movement. ** [https://casebook.icrc.org/ How does law protect in war?] - The ICRC [https://casebook.icrc.org/About%20the%20Online%20Casebook Online Casebook] project on the legal aspects of modern warfare. ** [https://casebook.icrc.org/law/fundamentals-ihl Fundamentals of International Humanitarian Law (IHL)] - The ICRC Casebook project on international humanitarian law. * <u>[https://www.youtube.com/c/Knowledgia/about Knowledgia]</u> - Animated videos about Geopolitical History. [https://www.youtube.com/c/Knowledgia YouTube Channel] [[File:High-contrast-camera-video.svg|24px|video]] * <u>[https://nipp.org/ National Institute for Public Policy (Nipp)]</u> - Founded in 1981, National Institute for Public Policy (Nipp) is a non-profit public education organization that focuses on a wide spectrum of rapidly evolving foreign policy and international issues. ** [https://nipp.org/information-series/ Information Series] - The ''Information Series'' focuses on contemporary strategic issues affecting U.S. foreign and defense policy. It is a forum for promoting critical thinking on the evolving international security environment and how the dynamic geo-strategic landscape affects U.S. national security. * <u>[https://nsarchive.gwu.edu/ National Security Archive (nsarchive)]</u> - Founded in 1985 by journalists and scholars to check rising government secrecy, the National Security Archive combines a unique range of functions: investigative journalism center, research institute on international affairs, library and archive of declassified U.S. documents. ** [https://nsarchive2.gwu.edu/index.html National Security Archive’s legacy site] [[File:High-contrast-camera-video.svg|24px|video]] [https://www.youtube.com/user/nsarchive/featured YouTube Channel] [[File:High-contrast-camera-video.svg|24px|video]] * <u>[https://quincyinst.org/about/ Quincy Institute For Responsible Statecraft]</u> - The Quincy Institute promotes ideas that move U.S. foreign policy away from endless war and toward vigorous diplomacy in the pursuit of international peace. ** [https://responsiblestatecraft.org/about/ Responsible Statecraft] - Responsible Statecraft is the online magazine of the Quincy Institute for Responsible Statecraft. * <u>[https://www.rusi.org/ Royal United Services Institute (RUSI)]</u> - [[w:Royal United Services Institute|Royal United Services Institute (RUSI)]] undertakes research, encourage debate, and provide options on critical issues in national and international defence and security.[[File:RUSI, the Royal United Services Institute for Defence and Security Studies logo.png|64px|RUSI,_the_Royal_United_Services_Institute_for_Defence_and_Security_Studies_logo]] [https://www.youtube.com/c/RusiOrg YouTube Channel] [[File:High-contrast-camera-video.svg|24px|video]] * <u>[https://www.state.gov/ U.S. Department of State]</u> - The role of the U.S. Department of State is to protect and promote U.S. security, prosperity, and democratic values and shape an international environment. [[File:U.S. Department of State official seal.svg|24px|U.S. Department of State official seal]] [https://www.youtube.com/c/StateDept YouTube Channel] [[File:High-contrast-camera-video.svg|24px|video]] ** [https://history.state.gov/ Office of the Historian, Foreign Service Institute] - The Office of the Historian is responsible, under law, for the preparation and publication of the official documentary history of U.S. foreign policy in the Foreign Relations of the United States series. {{RoundBoxBottom}} a221yovggn63qooa3668cwrh1o1mobd 2419187 2419186 2022-08-26T02:14:55Z Jtwsaddress42 234843 wikitext text/x-wiki '''Geopolitics, History & International Relations''' {{RoundBoxTop|theme=3}} * <u>[https://www.csis.org/ Center for Strategic & International Studies (CSIS)]</u> - The Center for Strategic and International Studies (CSIS) is a bipartisan, nonprofit policy research organization. [[File:CSIS logo blue.svg|120px|CSIS logo blue]] [https://www.youtube.com/c/csisdc/featured YouTube Channel] [[File:High-contrast-camera-video.svg|24px|video]] ** [https://www.csis.org/programs/brzezinski-institute-geostrategy Brzezinski Institute on Geostrategy] - Examines the unique interaction of history, geography, and strategy. [[File:CSIS logo blue.svg|120px|CSIS logo blue]] ** [https://www.csis.org/podcasts CSIS Podcasts] - CSIS regularly produces original expert-guided podcasts on a range of critical issues. [[File:CSIS logo blue.svg|120px|CSIS logo blue]] * <u>[https://www.youtube.com/c/CaspianReport/about CaspianReport]</u> - CaspianReport explores how geography influences politics, economics, and history. [https://www.youtube.com/channel/UCwnKziETDbHJtx78nIkfYug YouTube Channel] [[File:High-contrast-camera-video.svg|24px|video]] ** [https://www.youtube.com/playlist?list=PLD6AC8E04915265CA CaspianReport Geopolitics - YouTube Playlist] [[File:High-contrast-camera-video.svg|24px|video]] * <u>[https://www.cfg.polis.cam.ac.uk/ Centre for Geopolitics (CfG)]</u> - In the Department of Politics and International Studies at the University of Cambridge. [https://www.youtube.com/c/CentreforGeopolitics/featured YouTube Channel] [[File:High-contrast-camera-video.svg|24px|video]] ** [https://www.youtube.com/playlist?list=PLgZg-9ZL0h85g1Jt3Aj5D-Ydj5t2Jcl1K On Geopolitics - YouTube Playlist] - Podcast series hosted by Suzanne Raine and Ali Ansari. [[File:High-contrast-camera-video.svg|24px|video]] * <u>[https://www.eui.eu/en/academic-units/robert-schuman-centre-for-advanced-studies European University Institute (EUI) - Robert Schuman Centre for Advanced Studies (RSCAS)]</u> - The Robert Schuman Centre for Advanced Studies (RSCAS) is an inter-disciplinary research centre at the heart of the European University Institute (EUI). [https://www.youtube.com/c/TheRobertSchumanCentreforAdvancedStudies/featured YouTube Channel] [[File:High-contrast-camera-video.svg|24px|video]] * <u>[https://www.youtube.com/c/Geopoliticus/about Geopoliticus]</u> - Understanding Geopolitics, History and Theory. [https://www.youtube.com/c/Geopoliticus YouTube Channel] [[File:High-contrast-camera-video.svg|24px|video]] * <u>[https://www.youtube.com/c/GoodTimesBadTimes/about Good Times Bad Times]</u> - Explores global issues from the fields of geopolitics, international relations, economy, technology. [https://www.youtube.com/c/GoodTimesBadTimes/featured YouTube Channel] [[File:High-contrast-camera-video.svg|24px|video]] * <u>[https://www.youtube.com/c/HistoryMarche/about HistoryMarche]</u> - Animated videos about Geopolitical History. [https://www.youtube.com/c/HistoryMarche YouTube Channel] [[File:High-contrast-camera-video.svg|24px|video]] * <u>[https://www.icrc.org/en International Committee of the Red Cross (ICRC)]</u> - Founded in 1863, The ICRC works around the world helping people affected by conflict and armed violence, and promoting the rules of war. ** [https://www.icrc.org/en/who-we-are/history History of the ICRC] - The development of humanitarian action, the Geneva Conventions and the Red Cross and Red Crescent Movement. ** [https://casebook.icrc.org/ How does law protect in war?] - The ICRC [https://casebook.icrc.org/About%20the%20Online%20Casebook Online Casebook] project on the legal aspects of modern warfare. ** [https://casebook.icrc.org/law/fundamentals-ihl Fundamentals of International Humanitarian Law (IHL)] - The ICRC Casebook project on international humanitarian law. * <u>[https://www.youtube.com/c/Knowledgia/about Knowledgia]</u> - Animated videos about Geopolitical History. [https://www.youtube.com/c/Knowledgia YouTube Channel] [[File:High-contrast-camera-video.svg|24px|video]] * <u>[https://nipp.org/ National Institute for Public Policy (Nipp)]</u> - Founded in 1981, National Institute for Public Policy (Nipp) is a non-profit public education organization that focuses on a wide spectrum of rapidly evolving foreign policy and international issues. ** [https://nipp.org/information-series/ Information Series] - The ''Information Series'' focuses on contemporary strategic issues affecting U.S. foreign and defense policy. It is a forum for promoting critical thinking on the evolving international security environment and how the dynamic geo-strategic landscape affects U.S. national security. * <u>[https://nsarchive.gwu.edu/ National Security Archive (nsarchive)]</u> - Founded in 1985 by journalists and scholars to check rising government secrecy, the National Security Archive combines a unique range of functions: investigative journalism center, research institute on international affairs, library and archive of declassified U.S. documents. ** [https://nsarchive2.gwu.edu/index.html National Security Archive’s legacy site] [[File:High-contrast-camera-video.svg|24px|video]] [https://www.youtube.com/user/nsarchive/featured YouTube Channel] [[File:High-contrast-camera-video.svg|24px|video]] * <u>[https://quincyinst.org/about/ Quincy Institute For Responsible Statecraft]</u> - The Quincy Institute promotes ideas that move U.S. foreign policy away from endless war and toward vigorous diplomacy in the pursuit of international peace. ** [https://responsiblestatecraft.org/about/ Responsible Statecraft] - Responsible Statecraft is the online magazine of the Quincy Institute for Responsible Statecraft. * <u>[https://www.rusi.org/ Royal United Services Institute (RUSI)]</u> - [[w:Royal United Services Institute|Royal United Services Institute (RUSI)]] undertakes research, encourage debate, and provide options on critical issues in national and international defence and security.[[File:RUSI, the Royal United Services Institute for Defence and Security Studies logo.png|64px|RUSI,_the_Royal_United_Services_Institute_for_Defence_and_Security_Studies_logo]] [https://www.youtube.com/c/RusiOrg YouTube Channel] [[File:High-contrast-camera-video.svg|24px|video]] * <u>[https://www.state.gov/ U.S. Department of State]</u> - The role of the U.S. Department of State is to protect and promote U.S. security, prosperity, and democratic values and shape an international environment. [[File:U.S. Department of State official seal.svg|24px|U.S. Department of State official seal]] [https://www.youtube.com/c/StateDept YouTube Channel] [[File:High-contrast-camera-video.svg|24px|video]] ** [https://history.state.gov/ Office of the Historian, Foreign Service Institute] - The Office of the Historian is responsible, under law, for the preparation and publication of the official documentary history of U.S. foreign policy in the Foreign Relations of the United States series. {{RoundBoxBottom}} s25wpcr3suqd44q5v22r3hxxwrvyv3f 2419215 2419187 2022-08-26T02:55:15Z Jtwsaddress42 234843 wikitext text/x-wiki '''Geopolitics, History & International Relations''' {{RoundBoxTop|theme=3}} * <u>[https://www.csis.org/ Center for Strategic & International Studies (CSIS)]</u> - The [[w:Center for Strategic and International Studies|Center for Strategic and International Studies (CSIS)]] is a bipartisan, nonprofit policy research organization. [[File:CSIS logo blue.svg|120px|CSIS logo blue]] [https://www.youtube.com/c/csisdc/featured YouTube Channel] [[File:High-contrast-camera-video.svg|24px|video]] ** [https://www.csis.org/programs/brzezinski-institute-geostrategy Brzezinski Institute on Geostrategy] - Examines the unique interaction of history, geography, and strategy. [[File:CSIS logo blue.svg|120px|CSIS logo blue]] ** [https://www.csis.org/podcasts CSIS Podcasts] - CSIS regularly produces original expert-guided podcasts on a range of critical issues. [[File:CSIS logo blue.svg|120px|CSIS logo blue]] * <u>[https://www.youtube.com/c/CaspianReport/about CaspianReport]</u> - CaspianReport explores how geography influences politics, economics, and history. [https://www.youtube.com/channel/UCwnKziETDbHJtx78nIkfYug YouTube Channel] [[File:High-contrast-camera-video.svg|24px|video]] ** [https://www.youtube.com/playlist?list=PLD6AC8E04915265CA CaspianReport Geopolitics - YouTube Playlist] [[File:High-contrast-camera-video.svg|24px|video]] * <u>[https://www.cfg.polis.cam.ac.uk/ Centre for Geopolitics (CfG)]</u> - In the [[w:Department of Politics and International Studies, University of Cambridge|Department of Politics and International Studies]] at the University of Cambridge. [https://www.youtube.com/c/CentreforGeopolitics/featured YouTube Channel] [[File:High-contrast-camera-video.svg|24px|video]] ** [https://www.youtube.com/playlist?list=PLgZg-9ZL0h85g1Jt3Aj5D-Ydj5t2Jcl1K On Geopolitics - YouTube Playlist] - Podcast series hosted by Suzanne Raine and Ali Ansari. [[File:High-contrast-camera-video.svg|24px|video]] * <u>[https://www.eui.eu/en/academic-units/robert-schuman-centre-for-advanced-studies European University Institute (EUI) - Robert Schuman Centre for Advanced Studies (RSCAS)]</u> - The [[w:European_University_Institute#Robert_Schuman_Centre_for_Advanced_Studies|Robert Schuman Centre for Advanced Studies (RSCAS)]] is an inter-disciplinary research centre at the heart of the [[w:European_University_Institute|European University Institute (EUI)]]. [[File:New Logo EUI 2021 SVG.svg|36px|New_Logo_EUI_2021_SVG]] [https://www.youtube.com/c/TheRobertSchumanCentreforAdvancedStudies/featured YouTube Channel] [[File:High-contrast-camera-video.svg|24px|video]] * <u>[https://www.youtube.com/c/Geopoliticus/about Geopoliticus]</u> - Understanding Geopolitics, History and Theory. [https://www.youtube.com/c/Geopoliticus YouTube Channel] [[File:High-contrast-camera-video.svg|24px|video]] * <u>[https://www.youtube.com/c/GoodTimesBadTimes/about Good Times Bad Times]</u> - Explores global issues from the fields of geopolitics, international relations, economy, technology. [https://www.youtube.com/c/GoodTimesBadTimes/featured YouTube Channel] [[File:High-contrast-camera-video.svg|24px|video]] * <u>[https://www.youtube.com/c/HistoryMarche/about HistoryMarche]</u> - Animated videos about Geopolitical History. [https://www.youtube.com/c/HistoryMarche YouTube Channel] [[File:High-contrast-camera-video.svg|24px|video]] * <u>[https://www.icrc.org/en International Committee of the Red Cross (ICRC)]</u> - Founded in 1863, The [[w:International Committee of the Red Cross|International Committee of the Red Cross (ICRC)]] works around the world helping people affected by conflict and armed violence, and promoting the rules of war. [[File:Flag of the ICRC.svg|24px|Flag of the ICRC]] ** [https://www.icrc.org/en/who-we-are/history History of the ICRC] - The development of humanitarian action, the [[w:Geneva Conventions|Geneva Conventions]] and the Red Cross and Red Crescent Movement. [[File:Flag of the ICRC.svg|24px|Flag of the ICRC]] ** [https://casebook.icrc.org/ How does law protect in war?] - The ICRC [https://casebook.icrc.org/About%20the%20Online%20Casebook Online Casebook] project on the legal aspects of modern warfare. ** [https://casebook.icrc.org/law/fundamentals-ihl Fundamentals of International Humanitarian Law (IHL)] - The ICRC Casebook project on international humanitarian law. * <u>[https://www.youtube.com/c/Knowledgia/about Knowledgia]</u> - Animated videos about Geopolitical History. [https://www.youtube.com/c/Knowledgia YouTube Channel] [[File:High-contrast-camera-video.svg|24px|video]] * <u>[https://nipp.org/ National Institute for Public Policy (Nipp)]</u> - Founded in 1981, National Institute for Public Policy (Nipp) is a non-profit public education organization that focuses on a wide spectrum of rapidly evolving foreign policy and international issues. ** [https://nipp.org/information-series/ Information Series] - The ''Information Series'' focuses on contemporary strategic issues affecting U.S. foreign and defense policy. It is a forum for promoting critical thinking on the evolving international security environment and how the dynamic geo-strategic landscape affects U.S. national security. * <u>[https://nsarchive.gwu.edu/ National Security Archive (nsarchive)]</u> - Founded in 1985 by journalists and scholars to check rising government secrecy, the National Security Archive combines a unique range of functions: investigative journalism center, research institute on international affairs, library and archive of declassified U.S. documents. ** [https://nsarchive2.gwu.edu/index.html National Security Archive’s legacy site] [[File:High-contrast-camera-video.svg|24px|video]] [https://www.youtube.com/user/nsarchive/featured YouTube Channel] [[File:High-contrast-camera-video.svg|24px|video]] * <u>[https://quincyinst.org/about/ Quincy Institute For Responsible Statecraft]</u> - The Quincy Institute promotes ideas that move U.S. foreign policy away from endless war and toward vigorous diplomacy in the pursuit of international peace. ** [https://responsiblestatecraft.org/about/ Responsible Statecraft] - Responsible Statecraft is the online magazine of the Quincy Institute for Responsible Statecraft. * <u>[https://www.rusi.org/ Royal United Services Institute (RUSI)]</u> - [[w:Royal United Services Institute|Royal United Services Institute (RUSI)]] undertakes research, encourage debate, and provide options on critical issues in national and international defence and security.[[File:RUSI, the Royal United Services Institute for Defence and Security Studies logo.png|64px|RUSI,_the_Royal_United_Services_Institute_for_Defence_and_Security_Studies_logo]] [https://www.youtube.com/c/RusiOrg YouTube Channel] [[File:High-contrast-camera-video.svg|24px|video]] * <u>[https://www.state.gov/ U.S. Department of State]</u> - The role of the U.S. Department of State is to protect and promote U.S. security, prosperity, and democratic values and shape an international environment. [[File:U.S. Department of State official seal.svg|24px|U.S. Department of State official seal]] [https://www.youtube.com/c/StateDept YouTube Channel] [[File:High-contrast-camera-video.svg|24px|video]] ** [https://history.state.gov/ Office of the Historian, Foreign Service Institute] - The Office of the Historian is responsible, under law, for the preparation and publication of the official documentary history of U.S. foreign policy in the Foreign Relations of the United States series. {{RoundBoxBottom}} bc9g7nmel40wca0lvmqf0t1b88wl89f 2419223 2419215 2022-08-26T03:05:25Z Jtwsaddress42 234843 wikitext text/x-wiki '''Geopolitics, History & International Relations''' {{RoundBoxTop|theme=3}} * <u>[https://www.csis.org/ Center for Strategic & International Studies (CSIS)]</u> - The [[w:Center for Strategic and International Studies|Center for Strategic and International Studies (CSIS)]] is a bipartisan, nonprofit policy research organization. [[File:CSIS logo blue.svg|120px|CSIS logo blue]] [https://www.youtube.com/c/csisdc/featured YouTube Channel] [[File:High-contrast-camera-video.svg|24px|video]] ** [https://www.csis.org/programs/brzezinski-institute-geostrategy Brzezinski Institute on Geostrategy] - Examines the unique interaction of history, geography, and strategy. [[File:CSIS logo blue.svg|120px|CSIS logo blue]] ** [https://www.csis.org/podcasts CSIS Podcasts] - CSIS regularly produces original expert-guided podcasts on a range of critical issues. [[File:CSIS logo blue.svg|120px|CSIS logo blue]] * <u>[https://www.youtube.com/c/CaspianReport/about CaspianReport]</u> - CaspianReport explores how geography influences politics, economics, and history. [https://www.youtube.com/channel/UCwnKziETDbHJtx78nIkfYug YouTube Channel] [[File:High-contrast-camera-video.svg|24px|video]] ** [https://www.youtube.com/playlist?list=PLD6AC8E04915265CA CaspianReport Geopolitics - YouTube Playlist] [[File:High-contrast-camera-video.svg|24px|video]] * <u>[https://www.cfg.polis.cam.ac.uk/ Centre for Geopolitics (CfG)]</u> - In the [[w:Department of Politics and International Studies, University of Cambridge|Department of Politics and International Studies]] at the University of Cambridge. [https://www.youtube.com/c/CentreforGeopolitics/featured YouTube Channel] [[File:High-contrast-camera-video.svg|24px|video]] ** [https://www.youtube.com/playlist?list=PLgZg-9ZL0h85g1Jt3Aj5D-Ydj5t2Jcl1K On Geopolitics - YouTube Playlist] - Podcast series hosted by Suzanne Raine and Ali Ansari. [[File:High-contrast-camera-video.svg|24px|video]] * <u>[https://www.eui.eu/en/academic-units/robert-schuman-centre-for-advanced-studies European University Institute (EUI) - Robert Schuman Centre for Advanced Studies (RSCAS)]</u> - The [[w:European_University_Institute#Robert_Schuman_Centre_for_Advanced_Studies|Robert Schuman Centre for Advanced Studies (RSCAS)]] is an inter-disciplinary research centre at the heart of the [[w:European_University_Institute|European University Institute (EUI)]]. [[File:New Logo EUI 2021 SVG.svg|36px|New_Logo_EUI_2021_SVG]] [https://www.youtube.com/c/TheRobertSchumanCentreforAdvancedStudies/featured YouTube Channel] [[File:High-contrast-camera-video.svg|24px|video]] * <u>[https://www.youtube.com/c/Geopoliticus/about Geopoliticus]</u> - Understanding Geopolitics, History and Theory. [https://www.youtube.com/c/Geopoliticus YouTube Channel] [[File:High-contrast-camera-video.svg|24px|video]] * <u>[https://www.youtube.com/c/GoodTimesBadTimes/about Good Times Bad Times]</u> - Explores global issues from the fields of geopolitics, international relations, economy, technology. [https://www.youtube.com/c/GoodTimesBadTimes/featured YouTube Channel] [[File:High-contrast-camera-video.svg|24px|video]] * <u>[https://www.youtube.com/c/HistoryMarche/about HistoryMarche]</u> - Animated videos about Geopolitical History. [https://www.youtube.com/c/HistoryMarche YouTube Channel] [[File:High-contrast-camera-video.svg|24px|video]] * <u>[https://www.icrc.org/en International Committee of the Red Cross (ICRC)]</u> - Founded in 1863, The [[w:International Committee of the Red Cross|International Committee of the Red Cross (ICRC)]] works around the world helping people affected by conflict and armed violence, and promoting the rules of war. [[File:Flag of the ICRC.svg|24px|Flag of the ICRC]] ** [https://www.icrc.org/en/who-we-are/history History of the ICRC] - The development of humanitarian action, the [[w:Geneva Conventions|Geneva Conventions]] and the Red Cross and Red Crescent Movement. [[File:Flag of the ICRC.svg|24px|Flag of the ICRC]] ** [https://casebook.icrc.org/ How does law protect in war?] - The ICRC [https://casebook.icrc.org/About%20the%20Online%20Casebook Online Casebook] project on the legal aspects of modern warfare. ** [https://casebook.icrc.org/law/fundamentals-ihl Fundamentals of International Humanitarian Law (IHL)] - The ICRC Casebook project on international humanitarian law. * <u>[https://www.youtube.com/c/Knowledgia/about Knowledgia]</u> - Animated videos about Geopolitical History. [https://www.youtube.com/c/Knowledgia YouTube Channel] [[File:High-contrast-camera-video.svg|24px|video]] * <u>[https://nipp.org/ National Institute for Public Policy (Nipp)]</u> - Founded in 1981, National Institute for Public Policy (Nipp) is a non-profit public education organization that focuses on a wide spectrum of rapidly evolving foreign policy and international issues. ** [https://nipp.org/information-series/ Information Series] - The ''Information Series'' focuses on contemporary strategic issues affecting U.S. foreign and defense policy. It is a forum for promoting critical thinking on the evolving international security environment and how the dynamic geo-strategic landscape affects U.S. national security. * <u>[https://nsarchive.gwu.edu/ National Security Archive (nsarchive)]</u> - Founded in 1985 by journalists and scholars to check rising government secrecy, the [[w:National Security Archive|National Security Archive]] combines a unique range of functions: investigative journalism center, research institute on international affairs, library and archive of declassified U.S. documents. [[File:National Security Archive.png|24px|National Security Archive]] ** [https://nsarchive2.gwu.edu/index.html National Security Archive’s legacy site] [[File:National Security Archive.png|24px|National Security Archive]] [[File:High-contrast-camera-video.svg|24px|video]] [https://www.youtube.com/user/nsarchive/featured YouTube Channel] [[File:High-contrast-camera-video.svg|24px|video]] * <u>[https://quincyinst.org/about/ Quincy Institute For Responsible Statecraft]</u> - The [[w:Quincy Institute for Responsible Statecraft|Quincy Institute for Responsible Statecraft]] promotes ideas that move U.S. foreign policy away from endless war and toward vigorous diplomacy in the pursuit of international peace. ** [https://responsiblestatecraft.org/about/ Responsible Statecraft] - Responsible Statecraft is the online magazine of the Quincy Institute for Responsible Statecraft. * <u>[https://www.rusi.org/ Royal United Services Institute (RUSI)]</u> - [[w:Royal United Services Institute|Royal United Services Institute (RUSI)]] undertakes research, encourage debate, and provide options on critical issues in national and international defence and security.[[File:RUSI, the Royal United Services Institute for Defence and Security Studies logo.png|64px|RUSI,_the_Royal_United_Services_Institute_for_Defence_and_Security_Studies_logo]] [https://www.youtube.com/c/RusiOrg YouTube Channel] [[File:High-contrast-camera-video.svg|24px|video]] * <u>[https://www.state.gov/ U.S. Department of State]</u> - The role of the U.S. Department of State is to protect and promote U.S. security, prosperity, and democratic values and shape an international environment. [[File:U.S. Department of State official seal.svg|24px|U.S. Department of State official seal]] [https://www.youtube.com/c/StateDept YouTube Channel] [[File:High-contrast-camera-video.svg|24px|video]] ** [https://history.state.gov/ Office of the Historian, Foreign Service Institute] - The Office of the Historian is responsible, under law, for the preparation and publication of the official documentary history of U.S. foreign policy in the Foreign Relations of the United States series. {{RoundBoxBottom}} r3oun61ghe3zjdbfd0xrzzm99v54eqr 2419234 2419223 2022-08-26T03:11:53Z Jtwsaddress42 234843 wikitext text/x-wiki '''Geopolitics, History & International Relations''' {{RoundBoxTop|theme=3}} * <u>[https://www.csis.org/ Center for Strategic & International Studies (CSIS)]</u> - The [[w:Center for Strategic and International Studies|Center for Strategic and International Studies (CSIS)]] is a bipartisan, nonprofit policy research organization. [[File:CSIS logo blue.svg|120px|CSIS logo blue]] [https://www.youtube.com/c/csisdc/featured YouTube Channel] [[File:High-contrast-camera-video.svg|24px|video]] ** [https://www.csis.org/programs/brzezinski-institute-geostrategy Brzezinski Institute on Geostrategy] - Examines the unique interaction of history, geography, and strategy. [[File:CSIS logo blue.svg|120px|CSIS logo blue]] ** [https://www.csis.org/podcasts CSIS Podcasts] - CSIS regularly produces original expert-guided podcasts on a range of critical issues. [[File:CSIS logo blue.svg|120px|CSIS logo blue]] * <u>[https://www.youtube.com/c/CaspianReport/about CaspianReport]</u> - CaspianReport explores how geography influences politics, economics, and history. [https://www.youtube.com/channel/UCwnKziETDbHJtx78nIkfYug YouTube Channel] [[File:High-contrast-camera-video.svg|24px|video]] ** [https://www.youtube.com/playlist?list=PLD6AC8E04915265CA CaspianReport Geopolitics - YouTube Playlist] [[File:High-contrast-camera-video.svg|24px|video]] * <u>[https://www.cfg.polis.cam.ac.uk/ Centre for Geopolitics (CfG)]</u> - In the [[w:Department of Politics and International Studies, University of Cambridge|Department of Politics and International Studies]] at the University of Cambridge. [https://www.youtube.com/c/CentreforGeopolitics/featured YouTube Channel] [[File:High-contrast-camera-video.svg|24px|video]] ** [https://www.youtube.com/playlist?list=PLgZg-9ZL0h85g1Jt3Aj5D-Ydj5t2Jcl1K On Geopolitics - YouTube Playlist] - Podcast series hosted by Suzanne Raine and Ali Ansari. [[File:High-contrast-camera-video.svg|24px|video]] * <u>[https://www.eui.eu/en/academic-units/robert-schuman-centre-for-advanced-studies European University Institute (EUI) - Robert Schuman Centre for Advanced Studies (RSCAS)]</u> - The [[w:European_University_Institute#Robert_Schuman_Centre_for_Advanced_Studies|Robert Schuman Centre for Advanced Studies (RSCAS)]] is an inter-disciplinary research centre at the heart of the [[w:European_University_Institute|European University Institute (EUI)]]. [[File:New Logo EUI 2021 SVG.svg|36px|New_Logo_EUI_2021_SVG]] [https://www.youtube.com/c/TheRobertSchumanCentreforAdvancedStudies/featured YouTube Channel] [[File:High-contrast-camera-video.svg|24px|video]] * <u>[https://www.youtube.com/c/Geopoliticus/about Geopoliticus]</u> - Understanding Geopolitics, History and Theory. [https://www.youtube.com/c/Geopoliticus YouTube Channel] [[File:High-contrast-camera-video.svg|24px|video]] * <u>[https://www.youtube.com/c/GoodTimesBadTimes/about Good Times Bad Times]</u> - Explores global issues from the fields of geopolitics, international relations, economy, technology. [https://www.youtube.com/c/GoodTimesBadTimes/featured YouTube Channel] [[File:High-contrast-camera-video.svg|24px|video]] * <u>[https://www.youtube.com/c/HistoryMarche/about HistoryMarche]</u> - Animated videos about Geopolitical History. [https://www.youtube.com/c/HistoryMarche YouTube Channel] [[File:High-contrast-camera-video.svg|24px|video]] * <u>[https://www.icrc.org/en International Committee of the Red Cross (ICRC)]</u> - Founded in 1863, The [[w:International Committee of the Red Cross|International Committee of the Red Cross (ICRC)]] works around the world helping people affected by conflict and armed violence, and promoting the rules of war. [[File:Flag of the ICRC.svg|24px|Flag of the ICRC]] ** [https://www.icrc.org/en/who-we-are/history History of the ICRC] - The development of humanitarian action, the [[w:Geneva Conventions|Geneva Conventions]] and the Red Cross and Red Crescent Movement. [[File:Flag of the ICRC.svg|24px|Flag of the ICRC]] ** [https://casebook.icrc.org/ How does law protect in war?] - The ICRC [https://casebook.icrc.org/About%20the%20Online%20Casebook Online Casebook] project on the legal aspects of modern warfare. ** [https://casebook.icrc.org/law/fundamentals-ihl Fundamentals of International Humanitarian Law (IHL)] - The ICRC Casebook project on international humanitarian law. * <u>[https://www.youtube.com/c/Knowledgia/about Knowledgia]</u> - Animated videos about Geopolitical History. [https://www.youtube.com/c/Knowledgia YouTube Channel] [[File:High-contrast-camera-video.svg|24px|video]] * <u>[https://nipp.org/ National Institute for Public Policy (Nipp)]</u> - Founded in 1981, National Institute for Public Policy (Nipp) is a non-profit public education organization that focuses on a wide spectrum of rapidly evolving foreign policy and international issues. ** [https://nipp.org/information-series/ Information Series] - The ''Information Series'' focuses on contemporary strategic issues affecting U.S. foreign and defense policy. It is a forum for promoting critical thinking on the evolving international security environment and how the dynamic geo-strategic landscape affects U.S. national security. * <u>[https://nsarchive.gwu.edu/ National Security Archive (nsarchive)]</u> - Founded in 1985 by journalists and scholars to check rising government secrecy, the [[w:National Security Archive|National Security Archive]] combines a unique range of functions: investigative journalism center, research institute on international affairs, library and archive of declassified U.S. documents. [[File:National Security Archive.png|24px|National Security Archive]] ** [https://nsarchive2.gwu.edu/index.html National Security Archive’s legacy site] [[File:National Security Archive.png|24px|National Security Archive]] [[File:High-contrast-camera-video.svg|24px|video]] [https://www.youtube.com/user/nsarchive/featured YouTube Channel] [[File:High-contrast-camera-video.svg|24px|video]] * <u>[https://quincyinst.org/about/ Quincy Institute For Responsible Statecraft]</u> - The [[w:Quincy Institute for Responsible Statecraft|Quincy Institute for Responsible Statecraft]] promotes ideas that move U.S. foreign policy away from endless war and toward vigorous diplomacy in the pursuit of international peace. ** [https://responsiblestatecraft.org/about/ Responsible Statecraft] - Responsible Statecraft is the online magazine of the Quincy Institute for Responsible Statecraft. * <u>[https://www.rusi.org/ Royal United Services Institute (RUSI)]</u> - [[w:Royal United Services Institute|Royal United Services Institute (RUSI)]] undertakes research, encourage debate, and provide options on critical issues in national and international defence and security.[[File:RUSI, the Royal United Services Institute for Defence and Security Studies logo.png|64px|RUSI,_the_Royal_United_Services_Institute_for_Defence_and_Security_Studies_logo]] [https://www.youtube.com/c/RusiOrg YouTube Channel] [[File:High-contrast-camera-video.svg|24px|video]] * <u>[https://www.state.gov/ U.S. Department of State]</u> - The role of the [[w:United States Department of State|United States Department of State]] is to protect and promote U.S. security, prosperity, and democratic values and shape an international environment. [[File:U.S. Department of State official seal.svg|24px|U.S. Department of State official seal]] [https://www.youtube.com/c/StateDept YouTube Channel] [[File:High-contrast-camera-video.svg|24px|video]] ** [https://history.state.gov/ Office of the Historian, Foreign Service Institute] - The [[w:Office of the Historian|Office of the Historian]] is responsible, under law, for the preparation and publication of the official documentary history of U.S. foreign policy in the [[w:Foreign Relations of the United States (book series)|Foreign Relations of the United States (FRUS) series]]. {{RoundBoxBottom}} 0hxutkygvobz1g07llgr4zgjwspl002 2 285901 2419468 2412789 2022-08-26T10:32:57Z Gabrielle Eagling 2947522 wikitext text/x-wiki == About Me == I am [https://portfolio.canberra.edu.au/user/view.php?id=48613 Gabrielle Eagling] . I am a student at the ''University of Canberra'', and I am in my third and final year of studying a Bachelor of Science in Psychology. I am contributing to the 2022 [[Motivation and emotion/Book/2022|Motivation and Emotion Book]]. I live in Canberra and am passionate about helping vulnerable populations access appropriate and timely mental health care supports. I hope to be able to continue to do this as I work towards becoming a Clinical Psychologist. == Hobbies == - Pilates - Gardening - Reading == Book Chapter == [[Motivation and emotion/Book/2022/Environmental grief#Main headings|Environmental Grief]] - What is eco-grief, what are its causes and consequences, and what can be done? == Professional Profiles: == [https://www.linkedin.com/in/gabrielle-eagling-556913126/ My LinkedIn Profile] izng5wpdff3txkv1sio0qhqqzykz4ar 2419469 2419468 2022-08-26T10:34:05Z Gabrielle Eagling 2947522 wikitext text/x-wiki == About Me == I am [https://portfolio.canberra.edu.au/user/view.php?id=48613 Gabrielle Eagling] . I am a student at the ''University of Canberra'', and I am in my third and final year of studying a Bachelor of Science in Psychology. I am contributing to the 2022 [[Motivation and emotion/Book/2022|Motivation and Emotion Book]]. I live in Canberra and am passionate about helping vulnerable populations access appropriate and timely mental health care supports. I hope to be able to continue to do this as I work towards becoming a Clinical Psychologist. == Hobbies == - Pilates - Gardening - Reading == Book Chapter == [[Motivation and emotion/Book/2022/Environmental grief#Main headings|Environmental Grief]] - What is eco-grief, what are its causes and consequences, and what can be done? == Professional Profiles: == [https://www.linkedin.com/in/gabrielle-eagling-556913126/ My LinkedIn Profile] == Social Contributions == kis2pq4v70mkfpz544qlirgdy3y3ldh 2419470 2419469 2022-08-26T10:37:32Z Gabrielle Eagling 2947522 /* Hobbies */ wikitext text/x-wiki == About Me == I am [https://portfolio.canberra.edu.au/user/view.php?id=48613 Gabrielle Eagling] . I am a student at the ''University of Canberra'', and I am in my third and final year of studying a Bachelor of Science in Psychology. I am contributing to the 2022 [[Motivation and emotion/Book/2022|Motivation and Emotion Book]]. I live in Canberra and am passionate about helping vulnerable populations access appropriate and timely mental health care supports. I hope to be able to continue to do this as I work towards becoming a Clinical Psychologist. == Hobbies == - [https://www.self.com/story/5-things-to-know-before-you-take-pilates-classes Pilates] - Gardening - Reading == Book Chapter == [[Motivation and emotion/Book/2022/Environmental grief#Main headings|Environmental Grief]] - What is eco-grief, what are its causes and consequences, and what can be done? == Professional Profiles: == [https://www.linkedin.com/in/gabrielle-eagling-556913126/ My LinkedIn Profile] == Social Contributions == fo7p1gjqzcum325svbkrhsp2hl0eo1x 2419471 2419470 2022-08-26T10:37:49Z Gabrielle Eagling 2947522 /* Professional Profiles: */ wikitext text/x-wiki == About Me == I am [https://portfolio.canberra.edu.au/user/view.php?id=48613 Gabrielle Eagling] . I am a student at the ''University of Canberra'', and I am in my third and final year of studying a Bachelor of Science in Psychology. I am contributing to the 2022 [[Motivation and emotion/Book/2022|Motivation and Emotion Book]]. I live in Canberra and am passionate about helping vulnerable populations access appropriate and timely mental health care supports. I hope to be able to continue to do this as I work towards becoming a Clinical Psychologist. == Hobbies == - [https://www.self.com/story/5-things-to-know-before-you-take-pilates-classes Pilates] - Gardening - Reading == Book Chapter == [[Motivation and emotion/Book/2022/Environmental grief#Main headings|Environmental Grief]] - What is eco-grief, what are its causes and consequences, and what can be done? == Professional Profiles == [https://www.linkedin.com/in/gabrielle-eagling-556913126/ My LinkedIn Profile] == Social Contributions == 8uk2hlvs6pkwl6ruodo5tfxnzm6tt30 0 285908 2419114 2418698 2022-08-25T23:11:17Z 137.92.210.157 /* What causes disappointment? */ wikitext text/x-wiki {{title|Disappointment<br>What is disappointment, what causes it, and how can it be managed?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== [[File:Wayuu woman with sad face in the market buying.jpg|alt=Older woman with a disappointed look on her face in a busy market place.|thumb|''Figure 1.'' Person expressing disappointment through facial features]] * Example (case study) of disappointment - include statistics on frequency of occurrence (Van Dijk & Zeelenberg, 2002) * Define [[wikipedia:Emotion|emotions]], what emotions involve. (Reeve, 2018; Izard, 2010) Reference Figure 1 * Overview of what the chapter explores * Note on emotion research (Ramachandran & Jalal, 2017) {{RoundBoxTop|theme=13}} '''Key questions:''' * What is disappointment? * What are the major theories of disappointment? * What causes disappointment? * How can disappointment be managed? {{RoundBoxBottom}} ==What is disappointment?== * [[wikipedia:Disappointment|Disappointment]] occurs when the outcome that has occurred is not as good as the outcome that could have occurred, or when your expectations are not met (Zeelenberg et al., 1998a). * Disappointment involves feeling powerless, a tendency to remove oneself from the situation, and a desire to do nothing (van Dijk et al., 1999). * Disappointment is a complex emotion (Ramachandran & Jalal, 2017). * The types of disappointment will be discussed. * === Types of disappointment === * Disappointment can be categorised as outcome-related or person-related. * Outcome-related disappointment (ORD) occurs when the expected pleasurable outcome has not occurred (van Dijk & Zeelenberg, 2002). * Person-related disappointment (PRD) occurs when you attribute the undesirable outcome to a person (you blame them for the 'bad' outcome) (van Dijk & Zeelenberg, 2002). *Case study: Disappointment in organisations: Position 1: I am disappointing, Position 2: I am disappointed, Position 3: I disappoint (Clancy et al., 2012). === Emotions similar to disappointment === * [[wikipedia:Regret|Regret]] is a negative emotion that occurs when you know that the outcome that occurred could have been better if you made a different choice (Zeelenberg et al., 1998a). "Regret stems from bad decisions" (Zeelenberg et al., 1998a). Regret and disappointment are generally researched together. * [[wikipedia:Anger|Anger]] is a simple negative emotion that occurs when you cannot achieve your goals and you blame someone or something else for it (Lelieveld et al., 2011). Anger can be the result of disappointment (van Dijk et al., 1999). * [[wiktionary:disillusionment|Disillusionment]] is a complex negative emotion that occurs when you realise that what you believe or know is false (Maher et al., 2020). Disappointment is a key feature of disillusionment. {{Robelbox|theme={{{theme|2}}}|title=Emotions similar to disappointment}} <div style="{{Robelbox/pad}}"> '''Regret''' : [https://en.wikipedia.org/wiki/Regret Regret] is a negative emotion that occurs when you know that the outcome that occurred could have been better if you made a different choice (Zeelenberg et al., 1998a). "Regret stems from bad decisions" (Zeelenberg et al., 1998a). '''Anger''' : [https://en.wikipedia.org/wiki/Anger Anger] is a simple negative emotion that occurs when you cannot achieve your goals and you blame someone or something else for it (Lelieveld et al., 2011). Anger can be the result of disappointment (van Dijk et al., 1999). '''Disillusionment''' : [https://en.wiktionary.org/wiki/disillusionment Disillusionment] is a complex negative emotion that occurs when you realise that what you believe or know is false (Maher et al., 2020). Disappointment is a key feature of disillusionment. </div> {{Robelbox/close}} Test yourself:<quiz display="simple"> {Mary's boss received a complaint from a customer about Mary. Mary was made aware of the complaint and then fired. Mary is likely to experience: |type="()"} + Person-related disappointment - Outcome-related disappointment {Alex is trying to get a snack from a vending machine. Alex put their money into the vending machine and typed in the code for lemonade. The vending machine did not give Alex lemonade, and took their money. Alex is likely to experience: |type="()"} - Person-related disappointment + Outcome-related disappointment </quiz> == Theories of disappointment == *The two major theories of disappointment are Bell's theory of disappointment and Loomes and Sudgen's theory of disappointment (Zeelenberg et al., 2000; Zeelenberg et al., 1998b). * Both theories are similar (Zeelenberg et al., 2000; Zeelenberg et al., 1998b). Loomes and Sugden's theory came about due to their research and theory of regret (Loomes & Sugden, 1986). * A key assumption is that decision makers anticipate emotions and take them into account when making a decision (Zeleenberg et al., 2000; Zeleenberg et al., 1998b). * There may have been a rivalry between the theorists; Looms and Sugden (1986)'s paper was revised for unknown reasons but D.Bell provided comments and suggestions to their paper so that it could be published . === Bell's theory of disappointment (1985) === * "Disappointment... is a psychological reaction to an outcome that does not match up with expectations" (Bell, 1985, p.1). * Disappointment is based on probability/math and there is a specific formula that can predict it (Bell, 1985). Probability work based on winning amounts of money in various different lotteries. * Disappointment = d(px+(1-p)y-y) = dp(x-y), where d>=0 is a constant reflecting how a unit of disappointment affects the decision maker, p= probability of winning, x= value a, and y=value b (at least as desirable/preferred as x). * Psychological satisfaction is negative for disappointment. * van Dijk and van der Pligt (1997) conducted five experiments which confirmed Bell's theory; where the experience of disappointment is primarily determined by by the probability of the outcome. It is theorised that individuals who experience disappointment focus on the features of the situation which caused the disappointment - one of the features could be the probability with which the disappointing outcome occurred (van Dijk & van der Pligt, 1997). === Loomes and Sugden's theory of disappointment (1986) === * "When considering any uncertain prospect, an individual forms some ''prior expectation''... if that consequence falls short of the prior expectation... the individual... experiences some degree of disappointment" (Loomes & Sugden, 1986, p.271). * Disappointment can be mapped out with mathematical formula but is more robust than basic probability - there are other factors that contribute to disappointment (Loomes & Sugden, 1986). * Loomes and Sugden (1986) acknowledge that they share the same 'basic intuition' about disappointment as Bell (1985), but they model it differently. They later acknowledge that their theories are in fact similar, but credit Bell (1985) with the 'basic' idea of disappointment which their theory builds upon (Loomes & Sugden, 1987). "It is suggested that if an individual chooses some action... [they] form some prior expectation about that action. ...After the uncertainty is resolved, the individual experiences one particular consequence, which may be better or worse than the prior expectation", with worse leading to disappointment (Loomes & Sugden, 1987). Insert quiz on the theories of disappointment == What causes disappointment? == * Disappointment occurs when expectations are not met (Chua et al., 2009). * Neuropsychology of disappointment: Multiple brain regions have shown to be important to disappointment and decision making, namely the anterior insula, and various regions of the prefrontal cortex (Chua et al., 2009: Mohr et al., 2010: Kalat, 2019). * The brain regions that have shown to be important in decision making/disappointment will be discussed. * Some of the brain regions that are active during disappointment are also active during regret (Chua et al., 2009). === Insula (cortex) === [[File:Insula structure.png|alt=Structure of the three sections of the insula|thumb|''Figure 2.'' Insula]] * The insula has been labeled as a 'subcortical' and 'cortical' structure by Reeve (2018), as the anterior region is more aligned with the cortical brain and the posterior region is more aligned with the subcortical brain. Physically, it is a cortical structure. * The anterior ínsula monitors, evaluates, and consciously represents the subjective feelings that arise from bodily states that the posterior insula monitors and is aware of (Reeve, 2018). The insula is involved in most subjective feelings, positive and negative; where the right anterior insula processes negative emotions (Reeve, 2018). * The insula is responsible for knowing what actions are caused by the self and what actions are not, as well as learning/processing risk and uncertainty (Reeve, 2018). * When individuals experience disappointment their anterior insula is activated (Chua et al., 2009). See figure 2. * The anterior insula is active in the presence of potential loss and is a part of the brain known for processing emotions such as disappointment (Mohr et al., 2010). === Prefrontal cortex === [[File:Prefrontal cortex (left) animation.gif|alt=Rotating skull containing left Prefrontal cortex. The prefrontal cortex is highlighted |thumb|''Figure 3.'' Left hemisphere prefrontal cortex]] [[File:Cortical midline structures.png|thumb|''Figure 4.'' Brain image highlighting various cortical regions, including the ventromedial prefrontal cortex (VMPFC), dorsomedial prefrontal cortex (DMPFC), and the orbitofrontal cortex (OFC/MOPFC).]] * Prefrontal cortex - middle 'zone': <u>emotional reactions</u>, cognitive control, and working memory (Kalat, 2019). * Prefrontal cortex - anterior (front): decision making, evaluating which course will provide the best outcome, probability of achieving a good outcome (Kalat, 2019). * Left prefrontal cortex [PFC] signals positive emotions and the right PFC signals negative and avoidance emotion (Reeve, 2018). * Prefrontal cortex - see figure 3. * The ventromedial prefrontal cortex [VMPFC] learns what choices are more beneficial for the individual and adjusts decision making accordingly (Kalat, 2019). It also monitors confidence in one's decisions (Kalat, 2019). Individuals with damage to their VMPFC tend to make impulsive decisions based on probability, rather than making considered decisions based on reality (Kalat, 2019). *Orbitofrontal cortex [OFC]- responds to information from the VMPFC based on how the expected reward compares to other possible choices (Kalat, 2019). The OFC changes and updates the expected outcomes of actions based on current circumstances (Kalat, 2019). *When individuals experience disappointment their dorsomedial prefrontal cortex [DMPFC] is activated (Chua et al., 2009). *See figure 4 for VMPFC, OFC, and DMPFC. Insert Quiz on brain regions and how they contribute to decision-making/disappointment. ==How can disappointment be managed?== * Disappointment can be managed by lowering expectations (van Dijk et al., 2003). The ventromedial prefrontal cortex monitors how confident you should be about a decision (Kalat, 2019). * Mistaken expectations lower overall [[wikipedia:Well-being|wellbeing]], therefore having lower expectations can improve wellbeing (de Meza & Dawson, 2021). * Disappointment can be managed by successfully living up to expectations; where individuals intensify their efforts to attain a certain outcome so as not to experience disappointment (Zeleenberg et al., 2000). * 'Don't get your hopes up', acknowledge that disappointment can still occur when you know the probability of the outcome (e.g., you know the outcome is unlikely and you still feel a little disappointed when you achieve the expected outcome). === The benefits of disappointment === * Expressing disappointment encourages higher levels of cooperation in others (Olekalns & Druckman, 2014). * Expressing disappointment can lead to helping behaviour in others (Johnson & Connelly, 2014). * Disappointment (from yourself or others) can lead you to work harder in the future or work harder 'now' to avoid disappointment (Zeleenberg et al., 2000). * disappointment means you care, and disappointment is a message that needs to be interpreted (Grainger, 1991). === The downsides to disappointment === * Disappointment doesn't feel good! It can involve feelings of powerlessness and wanting to do nothing (Zeleenberg et al., 2000). * Disappointment can taint relationships, leading to blaming or [[wikipedia:Scapegoating|scapegoating]] (Clancy et al., 2012). * Mistaken expectations lower overall [[wikipedia:Well-being|wellbeing]] (de Meza & Dawson, 2021). * Disappointment can lead to other negative emotions, such as anger (van Dijk et al., 1999). Insert quiz on managing disappointment. - Turn benefits and downsides of disappointment into a pros and cons table ==Conclusion== * Restate what disappointment is, the types of disappointment, and emotions similar to disappointment. * Go over the theories of disappointment. - disappointment started as math (something calculable/precise, like chemistry) but has moved on to focus on subjective experiences. * Restate the causes of disappointment. * Restate how disappointment can be managed. * Take home message: everybody experiences disappointment, but there are things you can do to minimise experiencing it and you can even take advantage of it. == See also == * [[wikipedia:Disappointment|Disappointment]] (Wikipedia) * [[Motivation and emotion/Book/2016/Regret|Regret]] (Book chapter, 2016) * [[Motivation and emotion/Book/2011/Anger|Anger]] (Book chapter, 2011) ==References== {{Hanging indent|1= Bell, D. E. (1985). Disappointment in decision making under uncertainty. 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The impact of probability and magnitude of outcome on disappointment and elation. ''Organizational Behavior and Human Decision Processes, 69''(3), 277–284. https://doi.org/10.1006/obhd.1997.2688 van Dijk, W. W., & Zeelenberg, M. (2002). What do we talk about when we talk about disappointment? Distinguishing outcome-related disappointment from person-related disappointment. ''Cognition and Emotion, 16''(6), 787–807. https://doi.org/10.1080/02699930143000563 van Dijk, W. W., Zeelenberg, M., & van der Pligt, J. (1999). Not having what you want versus having what you do not want: The impact of type of negative outcome on the experience of disappointment and related emotions. ''Cognition and Emotion, 13''(2), 129–148. https://doi.org/10.1080/026999399379302 van Dijk, W. W., Zeelenberg, M., & van der Pligt, J. (2003). Blessed are those who expect nothing: Lowering expectations as a way of avoiding disappointment. ''Journal of Economic Psychology, 24''(4), 505–516. https://doi.org/10.1016/S0167-4870(02)00211-8 Zeelenberg, M., van Dijk, W. W., Manstead, A. S. R., & van der Pligt, J. (1998a). The experience of regret and disappointment. ''Cognition and Emotion, 12''(2), 221–230. https://doi.org/10.1080/026999398379727 Zeelenberg, M., van Dijk, W. W., Manstead, A. S. R., & van der Pligt, J. (2000). On bad decisions and disconfirmed expectancies: The psychology of regret and disappointment. ''Cognition and Emotion, 14''(4), 521–541. https://doi.org/10.1080/026999300402781 Zeelenberg, M., van Dijk, W. W., van der Pligt, J., Manstead, A. S. ., van Empelen, P., & Reinderman, D. (1998b). Emotional reactions to the outcomes of decisions: The role of counterfactual thought in the experience of regret and disappointment. ''Organizational Behavior and Human Decision Processes, 75''(2), 117–141. https://doi.org/10.1006/obhd.1998.2784 }} ==External links== * [https://www.youtube.com/watch?v=8KgUFMN7aJQ The value of disappointment] (TEDxPCC) * [https://www.youtube.com/watch?v=gAMbkJk6gnE Feeling all the feels: Crash course psychology #25] (YouTube) * [https://www.ted.com/talks/dan_gilbert_why_we_make_bad_decisions Why we make bad decisions] (TED.com) qsxbv9jx2eb83j0zdkys43qamqjwp38 0 285911 2419425 2418923 2022-08-26T09:05:33Z 159.196.150.70 Removed uneccessary template element. wikitext text/x-wiki {{title|Retrospective Regret:<br>What is the motivational function of regretting our past actions?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== Also consult [[Motivation and emotion/Assessment/Chapter|author guidelines]]. This Overview section should be concise but consist of several paragraphs which engage the reader, illustrate the problem, and outline how psychological science can help.{{RoundBoxTop|theme=3}} '''Focus questions:''' * What is retrospective regret? * How does retrospective regret affect motivation? * How can the current understanding of retrospective regret be utilised in clinical settings? {{RoundBoxBottom}} {{tip| Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Provide an example or case study. * Conclude with Focus questions to guide the chapter. }} == Defining retrospective regret == {{tip|Suggestions for this section: * For the [[Motivation and emotion/Assessment/Topic|topic development]], provide at least 3 bullet-points about key content per section. Include key citations. * For the [[Motivation and emotion/Assessment/Chapter|book chapter]], expand the bullet points into paragraphs. * If a section has a lot of content, arrange it into two to five sub-headings such as in the [[#Interactive learning features|interactive learning features section]]. Avoid having sections with only one sub-heading. }} * Regret is generally defined as negative emotion emerging from the cognitive experience of believing a situation may have resulted in more beneficial outcomes if different actions were taken (Zeelenberg, 2010). * There are various types of regret including (represented in table): ** Anticapitory ** Retrospective ** Action ** In-action (Gilovich, Medvec, & Kahneman 1998). * Operational definition of retrospective regret (Beike, Markman, & Kahneman, 1998; Summerville, 2011). == History of research on retrospection and regret == * . * . * . == Current theories of retrospective regret == * . * . * . * Figure here (descriptive diagram describing a model). == The motivational role of retrospective regret == * . * . * . * Figure here (descriptive diagram delineating affect of retrospective regret on motivation). === Developing a functional model of retrospective regret. === == Clinical applications of current models of retrospective regret == * . * . * . ==Learning features== What brings an online book chapter to life are its interactive learning features. Case studies, feature boxes, figures, links, tables, and quiz questions can be used throughout the chapter. ===Case studies=== Case studies describe real-world examples of concepts in action. Case studies can be real or fictional. A case could be used multiple times during a chapter to illustrate different theories or stages. It is often helpful to present case studies using [[#Feature boxes|feature boxes]]. ===Boxes=== Boxes can be used to highlight content, but don't overuse them. There are many different ways of creating boxes (e.g., see [[Help:Pretty boxes|Pretty boxes]]). Possible uses include: * Focus questions * Case studies or examples * Quiz questions * Take-home messages {{RoundBoxTop|theme=3}} ;Feature box example * Shaded background * Coloured border {{RoundBoxBottom}} ===Figures=== [[File:Monkey-typing.jpg|right|205px|thumb|''Figure 1''. Example image with descriptive caption.]] Use figures to illustrate concepts, add interest, and provide examples. Figures can be used to show photographs, drawings, diagrams, graphs, etcetera. Figures can be embedded throughout the chapter, starting with the Overview section. Figures should be captioned (using a number and a description) in order to explain their relevance to the text. Possible images can be found at [[commons:|Wikimedia Commons]]. Images can also be uploaded if they are licensed for re-use or if you created the image. Each figure should be referred to at least once in the main text (e.g., see Figure 1). ===Links=== Where key words are first used, make them into [[Help:Links|interwiki links]] such as Wikipedia links to articles about famous people (e.g., [[w:Sigmund Freud|Sigmund Freud]] and key concepts (e.g., [[w:Dreams|dreams]]) and links to book chapters about related topics (e.g., would you like to learn about how to overcome [[Motivation and emotion/Book/2020/Writer's block|writer's block]]?). ===Tables=== Tables can be an effective way to organise and summarise information. Tables should be captioned (using APA style) to explain their relevance to the text. Plus each table should be referred to at least once in the main text (e.g., see Table 1 and Table 2). Here are some [[Motivation and emotion/Wikiversity/Tables|example 3 x 3 tables]] which could be adapted. ===Quizzes=== Quizzes are a direct way to engage readers. But don't make quizzes too hard or long. It is better to have one or two review questions per major section than a long quiz at the end. Try to quiz conceptual understanding, rather than trivia. Here are some simple quiz questions which could be adapted. Choose the correct answers and click "Submit": <quiz display=simple> {Quizzes are an interactive learning feature: |type="()"} + True - False {Long quizzes are a good idea: |type="()"} - True + False </quiz> To learn about different types of quiz questions, see [[Help:Quiz|Quiz]]. ==Conclusion== The Conclusion is arguably the most important section. It should be possible for someone to read the [[#Overview|Overview]] and the Conclusion and still get a good idea of the topic. {{tip|Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? }} ==See also== Provide up to half-a-dozen [[Help:Contents/Links#Interwiki_links|internal (wiki) links]] to relevant Wikiversity pages (esp. related [[Motivation and emotion/Book|motivation and emotion book chapters]]) and [[w:|Wikipedia articles]]. For example: * [[Motivation and emotion/Book/2016/Anorexia nervosa and extrinsic motivation|Anorexia nervosa and extrinsic motivation]] (Book chapter, 2016) * [[w:David McClelland|David McClelland]] (Wikipedia) * [[Motivation and emotion/Book/2018/Loss aversion|Loss aversion]] (Book chapter, 2018) * [[w:Maslow's hierarchy of needs|Maslow's hierarchy of needs]] (Wikipedia) {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== List the cited references in [[w:APA style|APA style]] (7th ed.) or [[w:Wikipedia:Citing sources|wiki style]]. APA style example: {{Hanging indent|1= Blair, R. J. R. (2004). The roles of orbital frontal cortex in the modulation of antisocial behavior. ''Brain and Cognition'', ''55''(1), 198–208. https://doi.org/10.1016/S0278-2626(03)00276-8 Buckholtz, J. W., & Meyer-Lindenberg, A. (2008). MAOA and the neurogenetic architecture of human aggression. ''Trends in Neurosciences'', ''31''(3), 120–129. https://doi.org/10.1016/j.tins.2007.12.006 Eckardt, M., File, S., Gessa, G., Grant, K., Guerri, C., Hoffman, P., & Tabakoff, B. (1998). Effects of moderate alcohol consumption on the central nervous system. ''Alcoholism, Clinical and Experimental Research'', ''22''(5), 998–1040. https://doi.org/10.1111/j.1530-0277.1998.tb03695.x }} {{tip|Suggestions for this section: * Important aspects for APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except first letter and proper names, ending in a full-stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full-stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't actually read or consulted }} ==External links== Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * [https://students.unimelb.edu.au/academic-skills/explore-our-resources/essay-writing/six-top-tips-for-writing-a-great-essay Six top tips for writing a great essay] (University of Melbourne) * [http://www.skillsyouneed.com/write/structure.html The importance of structure] (skillsyouneed.com) {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] nddoilnpw7qvyhz8fcj0ylpuk91g4pc 2419433 2419425 2022-08-26T09:17:52Z 159.196.150.70 wikitext text/x-wiki {{title|Retrospective Regret:<br>What is the motivational function of regretting our past actions?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== Also consult [[Motivation and emotion/Assessment/Chapter|author guidelines]]. This Overview section should be concise but consist of several paragraphs which engage the reader, illustrate the problem, and outline how psychological science can help.{{RoundBoxTop|theme=3}} '''Focus questions:''' * What is retrospective regret? * How does retrospective regret affect motivation? * How can the current understanding of retrospective regret be utilised in clinical settings? {{RoundBoxBottom}} {{tip| Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Provide an example or case study. * Conclude with Focus questions to guide the chapter. }} == Defining retrospective regret == {{tip|Suggestions for this section: * For the [[Motivation and emotion/Assessment/Topic|topic development]], provide at least 3 bullet-points about key content per section. Include key citations. * For the [[Motivation and emotion/Assessment/Chapter|book chapter]], expand the bullet points into paragraphs. * If a section has a lot of content, arrange it into two to five sub-headings such as in the [[#Interactive learning features|interactive learning features section]]. Avoid having sections with only one sub-heading. }} * Regret is generally defined as negative emotion emerging from the cognitive experience of believing a situation may have resulted in more beneficial outcomes if different actions were taken (Zeelenberg, 2010). * There are various types of regret including: ** Anticapitory ** Retrospective ** Action ** In-action (Gilovich, Medvec, & Kahneman 1998). * PLACEHOLDER ELEMENT (Include table outling definitons and crossovers here) * An operational definition of retrospective regret is the experience of regret arising from reflection on actions or in-actions which occured in the past (Beike, Markman, & Kahneman, 1998; Summerville, 2011). ** expansion on this point - key word being reflection. == History of research on retrospection and regret == * . * . * . == Current theories of retrospective regret == * . * . * . * Figure here (descriptive diagram describing a model). == The motivational role of retrospective regret == * . * . * . * Figure here (descriptive diagram delineating affect of retrospective regret on motivation). === Developing a functional model of retrospective regret. === == Clinical applications of current models of retrospective regret == * . * . * . ==Learning features== What brings an online book chapter to life are its interactive learning features. Case studies, feature boxes, figures, links, tables, and quiz questions can be used throughout the chapter. ===Case studies=== Case studies describe real-world examples of concepts in action. Case studies can be real or fictional. A case could be used multiple times during a chapter to illustrate different theories or stages. It is often helpful to present case studies using [[#Feature boxes|feature boxes]]. ===Boxes=== Boxes can be used to highlight content, but don't overuse them. There are many different ways of creating boxes (e.g., see [[Help:Pretty boxes|Pretty boxes]]). Possible uses include: * Focus questions * Case studies or examples * Quiz questions * Take-home messages {{RoundBoxTop|theme=3}} ;Feature box example * Shaded background * Coloured border {{RoundBoxBottom}} ===Figures=== [[File:Monkey-typing.jpg|right|205px|thumb|''Figure 1''. Example image with descriptive caption.]] Use figures to illustrate concepts, add interest, and provide examples. Figures can be used to show photographs, drawings, diagrams, graphs, etcetera. Figures can be embedded throughout the chapter, starting with the Overview section. Figures should be captioned (using a number and a description) in order to explain their relevance to the text. Possible images can be found at [[commons:|Wikimedia Commons]]. Images can also be uploaded if they are licensed for re-use or if you created the image. Each figure should be referred to at least once in the main text (e.g., see Figure 1). ===Links=== Where key words are first used, make them into [[Help:Links|interwiki links]] such as Wikipedia links to articles about famous people (e.g., [[w:Sigmund Freud|Sigmund Freud]] and key concepts (e.g., [[w:Dreams|dreams]]) and links to book chapters about related topics (e.g., would you like to learn about how to overcome [[Motivation and emotion/Book/2020/Writer's block|writer's block]]?). ===Tables=== Tables can be an effective way to organise and summarise information. Tables should be captioned (using APA style) to explain their relevance to the text. Plus each table should be referred to at least once in the main text (e.g., see Table 1 and Table 2). Here are some [[Motivation and emotion/Wikiversity/Tables|example 3 x 3 tables]] which could be adapted. ===Quizzes=== Quizzes are a direct way to engage readers. But don't make quizzes too hard or long. It is better to have one or two review questions per major section than a long quiz at the end. Try to quiz conceptual understanding, rather than trivia. Here are some simple quiz questions which could be adapted. Choose the correct answers and click "Submit": <quiz display=simple> {Quizzes are an interactive learning feature: |type="()"} + True - False {Long quizzes are a good idea: |type="()"} - True + False </quiz> To learn about different types of quiz questions, see [[Help:Quiz|Quiz]]. ==Conclusion== The Conclusion is arguably the most important section. It should be possible for someone to read the [[#Overview|Overview]] and the Conclusion and still get a good idea of the topic. {{tip|Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? }} ==See also== Provide up to half-a-dozen [[Help:Contents/Links#Interwiki_links|internal (wiki) links]] to relevant Wikiversity pages (esp. related [[Motivation and emotion/Book|motivation and emotion book chapters]]) and [[w:|Wikipedia articles]]. For example: * [[Motivation and emotion/Book/2016/Anorexia nervosa and extrinsic motivation|Anorexia nervosa and extrinsic motivation]] (Book chapter, 2016) * [[w:David McClelland|David McClelland]] (Wikipedia) * [[Motivation and emotion/Book/2018/Loss aversion|Loss aversion]] (Book chapter, 2018) * [[w:Maslow's hierarchy of needs|Maslow's hierarchy of needs]] (Wikipedia) {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== List the cited references in [[w:APA style|APA style]] (7th ed.) or [[w:Wikipedia:Citing sources|wiki style]]. APA style example: {{Hanging indent|1= Blair, R. J. R. (2004). The roles of orbital frontal cortex in the modulation of antisocial behavior. ''Brain and Cognition'', ''55''(1), 198–208. https://doi.org/10.1016/S0278-2626(03)00276-8 Buckholtz, J. W., & Meyer-Lindenberg, A. (2008). MAOA and the neurogenetic architecture of human aggression. ''Trends in Neurosciences'', ''31''(3), 120–129. https://doi.org/10.1016/j.tins.2007.12.006 Eckardt, M., File, S., Gessa, G., Grant, K., Guerri, C., Hoffman, P., & Tabakoff, B. (1998). Effects of moderate alcohol consumption on the central nervous system. ''Alcoholism, Clinical and Experimental Research'', ''22''(5), 998–1040. https://doi.org/10.1111/j.1530-0277.1998.tb03695.x }} {{tip|Suggestions for this section: * Important aspects for APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except first letter and proper names, ending in a full-stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full-stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't actually read or consulted }} ==External links== Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * [https://students.unimelb.edu.au/academic-skills/explore-our-resources/essay-writing/six-top-tips-for-writing-a-great-essay Six top tips for writing a great essay] (University of Melbourne) * [http://www.skillsyouneed.com/write/structure.html The importance of structure] (skillsyouneed.com) {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] prks7d5kqrnhc95dvzv45ka23ogw8pz 0 285912 2419097 2418898 2022-08-25T22:40:40Z Jtneill 10242 + category wikitext text/x-wiki {{title|Honesty motivation:<br>What motivates honesty?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== You are underway {{smile}}! What motivates honesty? This template provides tips for [[Motivation and emotion/Assessment/Topic|topic development]]. Gradually remove these suggestions as you develop the chapter. Also consult the [[Motivation and emotion/Assessment/Chapter|author guidelines]]. At the top of the chapter, the title and sub-title should match the ''exact'' wording and casing as shown in the {{Motivation and emotion/Book}}. The sub-titles all end with a question mark. This Overview section should be concise but consist of several paragraphs which engage the reader, illustrate the problem, and outline how psychological science can help. {{RoundBoxTop|theme=3}} '''Focus questions:''' * What is the first focus question? * What is the second focus question? * What is the third focus question? {{RoundBoxBottom}} {{tip| Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Provide an example or case study. * Conclude with Focus questions to guide the chapter. }} ==Main headings== How you are going to structure the chapter? Aim for three to six main headings between the [[#Overview|Overview]] and [[#Conclusion|Conclusion]]. {{tip|Suggestions for this section: * For the [[Motivation and emotion/Assessment/Topic|topic development]], provide at least 3 bullet-points about key content per section. Include key citations. * For the [[Motivation and emotion/Assessment/Chapter|book chapter]], expand the bullet points into paragraphs. * If a section has a lot of content, arrange it into two to five sub-headings such as in the [[#Interactive learning features|interactive learning features section]]. Avoid having sections with only one sub-heading. }} ==Learning features== What brings an online book chapter to life are its interactive learning features. Case studies, feature boxes, figures, links, tables, and quiz questions can be used throughout the chapter. ===Case studies=== Case studies describe real-world examples of concepts in action. Case studies can be real or fictional. A case could be used multiple times during a chapter to illustrate different theories or stages. It is often helpful to present case studies using [[#Feature boxes|feature boxes]]. ===Boxes=== Boxes can be used to highlight content, but don't overuse them. There are many different ways of creating boxes (e.g., see [[Help:Pretty boxes|Pretty boxes]]). Possible uses include: * Focus questions * Case studies or examples * Quiz questions * Take-home messages {{RoundBoxTop|theme=3}} ;Feature box example * Shaded background * Coloured border {{RoundBoxBottom}} ===Figures=== [[File:Monkey-typing.jpg|right|205px|thumb|''Figure 1''. Example image with descriptive caption.]] Use figures to illustrate concepts, add interest, and provide examples. Figures can be used to show photographs, drawings, diagrams, graphs, etcetera. Figures can be embedded throughout the chapter, starting with the Overview section. Figures should be captioned (using a number and a description) in order to explain their relevance to the text. Possible images can be found at [[commons:|Wikimedia Commons]]. Images can also be uploaded if they are licensed for re-use or if you created the image. Each figure should be referred to at least once in the main text (e.g., see Figure 1). ===Links=== Where key words are first used, make them into [[Help:Links|interwiki links]] such as Wikipedia links to articles about famous people (e.g., [[w:Sigmund Freud|Sigmund Freud]] and key concepts (e.g., [[w:Dreams|dreams]]) and links to book chapters about related topics (e.g., would you like to learn about how to overcome [[Motivation and emotion/Book/2020/Writer's block|writer's block]]?). ===Tables=== Tables can be an effective way to organise and summarise information. Tables should be captioned (using APA style) to explain their relevance to the text. Plus each table should be referred to at least once in the main text (e.g., see Table 1 and Table 2). Here are some [[Motivation and emotion/Wikiversity/Tables|example 3 x 3 tables]] which could be adapted. ===Quizzes=== Quizzes are a direct way to engage readers. But don't make quizzes too hard or long. It is better to have one or two review questions per major section than a long quiz at the end. Try to quiz conceptual understanding, rather than trivia. Here are some simple quiz questions which could be adapted. Choose the correct answers and click "Submit": <quiz display=simple> {Quizzes are an interactive learning feature: |type="()"} + True - False {Long quizzes are a good idea: |type="()"} - True + False </quiz> To learn about different types of quiz questions, see [[Help:Quiz|Quiz]]. ==Conclusion== The Conclusion is arguably the most important section. It should be possible for someone to read the [[#Overview|Overview]] and the Conclusion and still get a good idea of the topic. {{tip|Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? }} ==See also== Provide up to half-a-dozen [[Help:Contents/Links#Interwiki_links|internal (wiki) links]] to relevant Wikiversity pages (esp. related [[Motivation and emotion/Book|motivation and emotion book chapters]]) and [[w:|Wikipedia articles]]. For example: * [[Motivation and emotion/Book/2016/Anorexia nervosa and extrinsic motivation|Anorexia nervosa and extrinsic motivation]] (Book chapter, 2016) * [[w:David McClelland|David McClelland]] (Wikipedia) * [[Motivation and emotion/Book/2018/Loss aversion|Loss aversion]] (Book chapter, 2018) * [[w:Maslow's hierarchy of needs|Maslow's hierarchy of needs]] (Wikipedia) {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== List the cited references in [[w:APA style|APA style]] (7th ed.) or [[w:Wikipedia:Citing sources|wiki style]]. APA style example: {{Hanging indent|1= Blair, R. J. R. (2004). The roles of orbital frontal cortex in the modulation of antisocial behavior. ''Brain and Cognition'', ''55''(1), 198–208. https://doi.org/10.1016/S0278-2626(03)00276-8 Buckholtz, J. W., & Meyer-Lindenberg, A. (2008). MAOA and the neurogenetic architecture of human aggression. ''Trends in Neurosciences'', ''31''(3), 120–129. https://doi.org/10.1016/j.tins.2007.12.006 Eckardt, M., File, S., Gessa, G., Grant, K., Guerri, C., Hoffman, P., & Tabakoff, B. (1998). Effects of moderate alcohol consumption on the central nervous system. ''Alcoholism, Clinical and Experimental Research'', ''22''(5), 998–1040. https://doi.org/10.1111/j.1530-0277.1998.tb03695.x }} {{tip|Suggestions for this section: * Important aspects for APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except first letter and proper names, ending in a full-stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full-stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't actually read or consulted }} ==External links== Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * [https://students.unimelb.edu.au/academic-skills/explore-our-resources/essay-writing/six-top-tips-for-writing-a-great-essay Six top tips for writing a great essay] (University of Melbourne) * [http://www.skillsyouneed.com/write/structure.html The importance of structure] (skillsyouneed.com) {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] [[Category:Motivation and emotion/Book/Honesty]] 34kdvpk5bfz0o5hxl9fz023bc6o11y4 0 285916 2419326 2418186 2022-08-26T06:23:57Z U3223109 2947538 Additional reference added wikitext text/x-wiki {{title|Window of tolerance:<br>What is the window of tolerance and how can it be applied? }} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ =='''Overview'''== [[File:Dan Seigel Quote.png|thumb|Figure 1. Direct quote by Dr. Dan Siegel (Siegal, 2020, p343) discussing the consequences of arousal moving outside of our window of tolerance. ]] The window of tolerance is an explanatory component of [[Motivation and emotion/Book/2013/Emotional self-regulation|emotion regulation]]. It describes an optimal zone of [[wikipedia:Arousal|emotional arousal]] from which we can process stimuli and function effectively (Siegel, 2020). Effective functioning allows us to regulate our emotions when facing distress; it also allows us to take action when our [[wikipedia:Autonomic_nervous_system|autonomic nervous system]] increases in activity in response to a potential threat or traumatic experience (Corrigan, et al. 2010). * Expand on emotion regulation * What does it mean to function effectively * Expand on the physiology behind autonomic nervous system function? When we fall outside of this zone we may experience ([[wikipedia:Emotional_dysregulation|emotional dysregulation]] or) [https://www.verywellmind.com/what-is-dysregulation-5073868#:~:text=Luis%20Pelaez%20Inc-,What%20Is%20Dysregulation%3F,anger%2C%20irritability%2C%20and%20frustration. dysregulation]. This can be a warning sign that we are not functioning effectively, and that our autonomic nervous system is beginning to experience an increase in arousal intensity. Siegel (2020) acknowledges that arousal intensity is expressed in two ways: 1. Hyper arousal ([[wikipedia:Sympathetic_nervous_system|sympathetic nervous system activation]], [[wikipedia:Fight-or-flight_response|fight or flight response]]); 2. Hypo arousal ([[wikipedia:Parasympathetic_nervous_system|parasympathetic nervous system activation]], freeze response). As a result of this increased arousal intensity, cognitions and behaviours may become disrupted (see Figure 1). To maintain effective functioning we aim to expand, or stay within the boundaries of, our optimal zone of arousal - the window of tolerance. * Discuss Siegal's perspective on arousal intensity * Expand on fight or flight response (sympathetic) * Expand on freeze response (parasympathetic) {{RoundBoxTop|theme=3}} '''Thought-provoking questions''' * What does it feel like when I am within my window of tolerance? * Have I ever experienced a state of arousal (hyper or hypo)? * How do I recognise when I am becoming dysregulated? * What can I do to expand my window of tolerance? <i>Keep these questions in mind as you read through this chapter.</i> {{RoundBoxBottom}} =='''Window of tolerance'''== * Expanded definition of the window of tolerance * Optimal zone of arousal * Feeling present in the moment * Ability to self-soothe and regulate emotions * Include a window of tolerance quiz ** What does it feel like? *** Chaotic and confusing *** Capable and calm *** Present in the moment *** Stuck in survival mode {{RoundBoxTop|theme=3}} ;Case study * Utilise feature boxes in this section * Use an example of someone with lived-experience of trauma * This will help to explain how trauma impacts our window of tolerance {{RoundBoxBottom}} == '''Dysregulation''' == * Define dysregulation * Identify citations for neuroscientific explanations of dysregulation * Explain symptoms of emotional dysregulation * Include a dysregulation quiz ** What does it feel like? * OR include a case study ** Sam is beginning to fall out of their window of tolerance ** They are feeling increasingly more irritable, anxious, agitated as time goes on ** They notice they have little tolerance for disruptions ** They are starting to feel overwhelmed == '''Arousal''' == * Briefly define arousal * Identify how it comes to be * Identify peer-reviewed, evidence-based research on the neuroscience behind arousal * Explain the basic differences between the two forms of arousal ** In terms of overwhelmed and underwhelmed === Hyper arousal === * Identify the symptoms of hyper arousal * Acknowledge the difficulties this may cause the individuals who experience it ** Identify the impacts of fight or flight response on emotional eating/obesity (Schnepper et al. 2020) === Hypo arousal === * Identify the symptoms of hypo arousal * Acknowledge the difficulties this may cause the individuals who experience it == '''Application''' == * Identify how the window of tolerance can be applied in practice * Who may benefit from this concept? * How can they benefit? === Psychotherapy === * How can the window of tolerance be applied in [[wikipedia:Psychotherapy|psychotherapeutic]] practices? * Who is involved? ** Psychologists ** Counsellors ** Social Workers * What are the benefits? * Are there any risks? === Psychoeducation === * How can the window of tolerance be applied in [[wikipedia:Psychoeducation|psychoeducational]] practices? * Who is involved? ** Mental health workers ** Disability support workers ** Allied health professionals ** Teachers/Educators ** General Practitioners * What are the benefits? * Are there any risks? === Self-help === * Self healing * Self education * Self validation * How can the window of tolerance be applied in [[wikipedia:Self-healing|self healing]] practices? ** Distributing this information to the general public ** Access for all * Who is involved? ** People seeking additional support ** People seeking information on their experiences ** People looking to improve their self awareness ** People who are trying to better understand themselves/their experiences ** People who are trying to change their behaviours * What are the benefits? ** Are there benefits for people being able to access this information? ** Provides a deeper understanding of how and why we behave the way we do ** Validates the experience of dysregulation ** Opens up the opportunity for behaviour change * Are there any risks? == '''Conclusion''' == * What is the window of tolerance? ** Discuss optimal zone of arousal, dysregulation, hyper- & hypo arousal, etc ** What does it feel like to be in each state? * How can it be applied? ** Who can benefit from using this concept? ** How can they benefit? (Evidence-based) ** What exactly are the benefits? (Back up with research) * What are the answers to the thought-provoking/focus questions? =='''See also'''== * [[Motivation and emotion/Book/2019/Affect regulation theory|Affect regulation theory]] (Book chapter, 2019) * [[Motivation and emotion/Book/2013/Emotional self-regulation|Emotional self-regulation]] (Book chapter, 2013) =='''References'''== {{Hanging indent|1= Corrigan, F. M., Fisher, J. J., Nutt, D. (2010) Autonomic dysregulation and the Window of Tolerance model of the effects of complex emotional trauma. Journal of Psychopharmacology (Oxford), 25(1), 17–25. https://doi.org/10.1177/0269881109354930 Seigel, D. J. (2020) The developing mind (3rd edition): How relationships and the brain interact to shape who we are. Guilford Publications. Seigel, D. J. (2020) The developing mind (3rd edition): How relationships and the brain interact to shape who we are. p343. Guilford Publications. Schnepper, R., Georgii, C., Eichin, K., Arend, A.-K., Wilhelm, F. H., Vogele, C., Lutz, A. P. . (2020). Fight, Flight, – Or Grab a Bite! Trait Emotional and Restrained Eating Style Predicts Food Cue Responding Under Negative Emotions. Frontiers in Behavioral Neuroscience (14), 91–91. https://doi.org/10.3389/fnbeh.2020.00091 }} =='''Resources'''== === Internal links === *[[wikipedia:Arousal|Arousal]] (Wikipedia) *[[wikipedia:Autonomic_nervous_system|Autonomic nervous system]] (Wikipedia) *[[wikipedia:Emotional_dysregulation|Emotional dysregulation]] (Wikipedia) *[[Motivation and emotion/Book/2013/Emotional self-regulation|Emotion self-regulation]] (Book chapter, 2013) * [[wikipedia:Fight-or-flight_response|Fight or flight response]] (Wikipedia) * [[wikipedia:Parasympathetic_nervous_system|Parasympathetic nervous system]] (Wikipedia) * [[wikipedia:Psychotherapy|Psychotherapy]] (Wikipedia) * [[wikipedia:Psychoeducation|Psychoeducation]] (Wikipedia) * [[wikipedia:Self-healing|Self-healing]] (Wikipedia) * [[wikipedia:Sympathetic_nervous_system|Sympathetic nervous system]] (Wikipedia) * === External links === * [https://www.verywellmind.com/what-is-dysregulation-5073868#:~:text=Luis%20Pelaez%20Inc-,What%20Is%20Dysregulation%3F,anger%2C%20irritability%2C%20and%20frustration. What is dysregulation?] (verywellmind.com) [[Category:{{#titleparts:{{PAGENAME}}|3}}]] rcqeajisl168dpu48lfzqgoj9iy7gdd 0 285924 2419088 2416677 2022-08-25T22:16:54Z Jtneill 10242 + categories wikitext text/x-wiki {{title|Environmental grief:<br>What is eco-grief, its causes and consequences, and what can be done}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== - Definition of environmental grief - concise illustration of the problem - what is the problem, why is it important - A brief history of the term - outline how psychological science can help - conclude with examining the three focus questions that will guide the chapter === Case study === - case study of environmental grief and how it has affected the individual in their day to day emotional state {{RoundBoxTop|theme=3}} '''Focus questions:''' * What is the first focus question? * What is the second focus question? * What is the third focus question? {{RoundBoxBottom}} === Emerging theories === - Main theories surrounding Environmental grief - How can specific emotion theories and research help? == Grief and the human brain == - How does grief shape, change and rewire the human brain? ==The causes of environmental grief == - What do grief and distress look at, how are they similar and how are they different? - How do they relate to the Environment? == The consequences == - What are the consequences of environmental grief? == Is environmental grief generational? == - Look at if Environmental grief is only emerging in the younger generations, or is it something that has always been around and is now only just being recognised? == Interventions that target environmental grief == [[File:2019 Black Summer Bushfires from Blue Mountains, New South Wales 06.jpg|thumb|355x355px|''Figure 1''. Black Summer Bushfires from the Blue Mountains, NSW ]] - What are the major interventions surrounding Environmental Grief - Use links, Figures etc. - Use figures to illustrate concepts, add interest, and provide examples. Figures can be used to show photographs, drawings, diagrams, graphs, etcetera. Figures can be embedded throughout the chapter, starting with the Overview section. Figures should be captioned (using a number and a description) in order to explain their relevance to the text. Possible images can be found at [[commons:|Wikimedia Commons]]. Images can also be uploaded if they are licensed for re-use or if you created the image. Each figure should be referred to at least once in the main text (e.g., see Figure 1). ===Tables=== Tables can be an effective way to organise and summarise information. Tables should be captioned (using APA style) to explain their relevance to the text. Plus each table should be referred to at least once in the main text (e.g., see Table 1 and Table 2). Here are some [[Motivation and emotion/Wikiversity/Tables|example 3 x 3 tables]] which could be adapted. == Conclusion == Based on psychological theory and research, what is the answer to the question? - What are the answers to the focus questions? - What are the practical, take home messages? ==See also== * [[wikipedia:Ecological_grief#:~:text=Ecological%20grief%20(or%20eco%2Dgrief,environmental%20destruction%20or%20climate%20change.|Ecological Grief]] (Wikipedia) * [[Motivation and emotion/Book/2022/Ecological grief|Eco-grief]] (Book Chapter, 2022) * [[wikipedia:Grief|Grief]] (Wikipedia) * [[w:Maslow's hierarchy of needs|Maslow's hierarchy of needs]] (Wikipedia) * [[Motivation and emotion/Book/2022/Viewing natural scenes and emotion|Viewing Natural Scenes and Emotion]] (Book Chapter, 2022) ==References== ==External links== Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * [https://students.unimelb.edu.au/academic-skills/explore-our-resources/essay-writing/six-top-tips-for-writing-a-great-essay Six top tips for writing a great essay] (University of Melbourne) * [http://www.skillsyouneed.com/write/structure.html The importance of structure] (skillsyouneed.com) {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] [[Category:Motivation and emotion/Book/Environment]] [[Category:Motivation and emotion/Book/Grief]] kmk6jhlwr75srblcrumb4qjr5p4bl1p 2419467 2419088 2022-08-26T10:24:21Z Gabrielle Eagling 2947522 /* Overview */ wikitext text/x-wiki {{title|Environmental grief:<br>What is eco-grief, its causes and consequences, and what can be done}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== Environmental grief, also known as eco-grief, or eco-anxiety, is when “''people experience climate grief when they notice or anticipate the loss of ‘species, ecosystems and meaningful landscapes due to acute or chronic environmental change”'' (Cunsolo & Ellis, 2018, p. 1). - concise illustration of the problem - what is the problem, why is it important - A brief history of the term - outline how psychological science can help - conclude with examining the three focus questions that will guide the chapter === Case study === - case study of environmental grief and how it has affected the individual in their day to day emotional state {{RoundBoxTop|theme=3}} '''Focus questions:''' * What is the first focus question? * What is the second focus question? * What is the third focus question? {{RoundBoxBottom}} === Emerging theories === - Main theories surrounding Environmental grief - How can specific emotion theories and research help? == Grief and the human brain == - How does grief shape, change and rewire the human brain? ==The causes of environmental grief == - What do grief and distress look at, how are they similar and how are they different? - How do they relate to the Environment? == The consequences == - What are the consequences of environmental grief? == Is environmental grief generational? == - Look at if Environmental grief is only emerging in the younger generations, or is it something that has always been around and is now only just being recognised? == Interventions that target environmental grief == [[File:2019 Black Summer Bushfires from Blue Mountains, New South Wales 06.jpg|thumb|355x355px|''Figure 1''. Black Summer Bushfires from the Blue Mountains, NSW ]] - What are the major interventions surrounding Environmental Grief - Use links, Figures etc. == Conclusion == Based on psychological theory and research, what is the answer to the question? - What are the answers to the focus questions? - What are the practical, take home messages? ==See also== * [[wikipedia:Ecological_grief#:~:text=Ecological%20grief%20(or%20eco%2Dgrief,environmental%20destruction%20or%20climate%20change.|Ecological Grief]] (Wikipedia) * [[Motivation and emotion/Book/2022/Ecological grief|Eco-grief]] (Book Chapter, 2022) * [[wikipedia:Grief|Grief]] (Wikipedia) * [[w:Maslow's hierarchy of needs|Maslow's hierarchy of needs]] (Wikipedia) * [[Motivation and emotion/Book/2022/Viewing natural scenes and emotion|Viewing Natural Scenes and Emotion]] (Book Chapter, 2022) ==References== Cunsolo, A., & Ellis, N. R. (2018). Ecological grief as a mental health response to climate change-related loss. ''Nature Climate Change'', ''8''(4), 275–281. <nowiki>https://doi.org/10.1038/s41558-018-0092-2</nowiki> Ojala, M., Cunsolo, A., Ogunbode, C., & Middleton, J. (2021). Anxiety, Worry, and Grief in a Time of Environmental and Climate Crisis: A Narrative Review. ''Annual Review of Environment and Resources'', ''46'', 35–58. <nowiki>https://doi.org/10.1146/annurev-environ-012220-022716</nowiki> Winerman, A. (2019). Mourning the land. ''<nowiki>Https://Www.Apa.Org</nowiki>'', ''50''(5), 24. ==External links== [https://www.nature.com/articles/s41558-018-0092-2 Ecological grief as a mental health response to climate change-related loss] [[Category:{{#titleparts:{{PAGENAME}}|3}}]] [[Category:Motivation and emotion/Book/Environment]] [[Category:Motivation and emotion/Book/Grief]] rw6n4eecwitcvtkmu319nhobz7ekndq 2419472 2419467 2022-08-26T10:41:34Z Gabrielle Eagling 2947522 /* External links */ wikitext text/x-wiki {{title|Environmental grief:<br>What is eco-grief, its causes and consequences, and what can be done}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== Environmental grief, also known as eco-grief, or eco-anxiety, is when “''people experience climate grief when they notice or anticipate the loss of ‘species, ecosystems and meaningful landscapes due to acute or chronic environmental change”'' (Cunsolo & Ellis, 2018, p. 1). - concise illustration of the problem - what is the problem, why is it important - A brief history of the term - outline how psychological science can help - conclude with examining the three focus questions that will guide the chapter === Case study === - case study of environmental grief and how it has affected the individual in their day to day emotional state {{RoundBoxTop|theme=3}} '''Focus questions:''' * What is the first focus question? * What is the second focus question? * What is the third focus question? {{RoundBoxBottom}} === Emerging theories === - Main theories surrounding Environmental grief - How can specific emotion theories and research help? == Grief and the human brain == - How does grief shape, change and rewire the human brain? ==The causes of environmental grief == - What do grief and distress look at, how are they similar and how are they different? - How do they relate to the Environment? == The consequences == - What are the consequences of environmental grief? == Is environmental grief generational? == - Look at if Environmental grief is only emerging in the younger generations, or is it something that has always been around and is now only just being recognised? == Interventions that target environmental grief == [[File:2019 Black Summer Bushfires from Blue Mountains, New South Wales 06.jpg|thumb|355x355px|''Figure 1''. Black Summer Bushfires from the Blue Mountains, NSW ]] - What are the major interventions surrounding Environmental Grief - Use links, Figures etc. == Conclusion == Based on psychological theory and research, what is the answer to the question? - What are the answers to the focus questions? - What are the practical, take home messages? ==See also== * [[wikipedia:Ecological_grief#:~:text=Ecological%20grief%20(or%20eco%2Dgrief,environmental%20destruction%20or%20climate%20change.|Ecological Grief]] (Wikipedia) * [[Motivation and emotion/Book/2022/Ecological grief|Eco-grief]] (Book Chapter, 2022) * [[wikipedia:Grief|Grief]] (Wikipedia) * [[w:Maslow's hierarchy of needs|Maslow's hierarchy of needs]] (Wikipedia) * [[Motivation and emotion/Book/2022/Viewing natural scenes and emotion|Viewing Natural Scenes and Emotion]] (Book Chapter, 2022) ==References== Cunsolo, A., & Ellis, N. R. (2018). Ecological grief as a mental health response to climate change-related loss. ''Nature Climate Change'', ''8''(4), 275–281. <nowiki>https://doi.org/10.1038/s41558-018-0092-2</nowiki> Ojala, M., Cunsolo, A., Ogunbode, C., & Middleton, J. (2021). Anxiety, Worry, and Grief in a Time of Environmental and Climate Crisis: A Narrative Review. ''Annual Review of Environment and Resources'', ''46'', 35–58. <nowiki>https://doi.org/10.1146/annurev-environ-012220-022716</nowiki> Winerman, A. (2019). Mourning the land. ''<nowiki>Https://Www.Apa.Org</nowiki>'', ''50''(5), 24. ==External links== [https://www.nature.com/articles/s41558-018-0092-2 Ecological grief as a mental health response to climate change-related loss] [https://www.lifeline.org.au/ Lifeline] [[Category:{{#titleparts:{{PAGENAME}}|3}}]] [[Category:Motivation and emotion/Book/Environment]] [[Category:Motivation and emotion/Book/Grief]] k9nvp45g8ts4jo7aw09v80kagldgcg1 2419473 2419472 2022-08-26T10:50:03Z Gabrielle Eagling 2947522 /* Overview */ wikitext text/x-wiki {{title|Environmental grief:<br>What is eco-grief, its causes and consequences, and what can be done}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== Environmental grief, also known as eco-grief, or eco-anxiety, is when “''people experience climate grief when they notice or anticipate the loss of ‘species, ecosystems and meaningful landscapes due to acute or chronic environmental change”'' (Cunsolo & Ellis, 2018, p. 1). - concise illustration of the problem - what is the problem, why is it important - A brief history of the term - outline how psychological science can help - conclude with examining the three focus questions that will guide the chapter {{RoundBoxTop|theme=3}} '''Focus questions:''' * What are the main theories surrounding environmental grief? * What are the consequences of environmental grief? * Is environmental grief generational? {{RoundBoxBottom}} === Case study === - case study of environmental grief and how it has affected the individual in their day to day emotional state === Emerging theories === - Main theories surrounding Environmental grief - How can specific emotion theories and research help? == Grief and the human brain == - How does grief shape, change and rewire the human brain? ==The causes of environmental grief == - What do grief and distress look at, how are they similar and how are they different? - How do they relate to the Environment? == The consequences == - What are the consequences of environmental grief? == Is environmental grief generational? == - Look at if Environmental grief is only emerging in the younger generations, or is it something that has always been around and is now only just being recognised? == Interventions that target environmental grief == [[File:2019 Black Summer Bushfires from Blue Mountains, New South Wales 06.jpg|thumb|355x355px|''Figure 1''. Black Summer Bushfires from the Blue Mountains, NSW ]] - What are the major interventions surrounding Environmental Grief - Use links, Figures etc. == Conclusion == Based on psychological theory and research, what is the answer to the question? - What are the answers to the focus questions? - What are the practical, take home messages? ==See also== * [[wikipedia:Ecological_grief#:~:text=Ecological%20grief%20(or%20eco%2Dgrief,environmental%20destruction%20or%20climate%20change.|Ecological Grief]] (Wikipedia) * [[Motivation and emotion/Book/2022/Ecological grief|Eco-grief]] (Book Chapter, 2022) * [[wikipedia:Grief|Grief]] (Wikipedia) * [[w:Maslow's hierarchy of needs|Maslow's hierarchy of needs]] (Wikipedia) * [[Motivation and emotion/Book/2022/Viewing natural scenes and emotion|Viewing Natural Scenes and Emotion]] (Book Chapter, 2022) ==References== Cunsolo, A., & Ellis, N. R. (2018). Ecological grief as a mental health response to climate change-related loss. ''Nature Climate Change'', ''8''(4), 275–281. <nowiki>https://doi.org/10.1038/s41558-018-0092-2</nowiki> Ojala, M., Cunsolo, A., Ogunbode, C., & Middleton, J. (2021). Anxiety, Worry, and Grief in a Time of Environmental and Climate Crisis: A Narrative Review. ''Annual Review of Environment and Resources'', ''46'', 35–58. <nowiki>https://doi.org/10.1146/annurev-environ-012220-022716</nowiki> Winerman, A. (2019). Mourning the land. ''<nowiki>Https://Www.Apa.Org</nowiki>'', ''50''(5), 24. ==External links== [https://www.nature.com/articles/s41558-018-0092-2 Ecological grief as a mental health response to climate change-related loss] [https://www.lifeline.org.au/ Lifeline] [[Category:{{#titleparts:{{PAGENAME}}|3}}]] [[Category:Motivation and emotion/Book/Environment]] [[Category:Motivation and emotion/Book/Grief]] rr74gqx2oj0lnev4fw0gr2zp9ji53io 2419475 2419473 2022-08-26T10:54:06Z Gabrielle Eagling 2947522 /* The causes of environmental grief */ wikitext text/x-wiki {{title|Environmental grief:<br>What is eco-grief, its causes and consequences, and what can be done}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== Environmental grief, also known as eco-grief, or eco-anxiety, is when “''people experience climate grief when they notice or anticipate the loss of ‘species, ecosystems and meaningful landscapes due to acute or chronic environmental change”'' (Cunsolo & Ellis, 2018, p. 1). * Concise illustration of the problem - what is the problem, why is it important * A brief history of the term * Outline how psychological science can help * Conclude with examining the three focus questions that will guide the chapter {{RoundBoxTop|theme=3}} '''Focus questions:''' * What are the main theories surrounding environmental grief? * What are the consequences of environmental grief? * Is environmental grief generational? {{RoundBoxBottom}} === Case study === * case study of environmental grief and how it has affected the individual in their day to day emotional state === Emerging theories === * Main theories surrounding Environmental grief * How can specific emotion theories and research help? == Grief and the human brain == * How does grief shape, change and rewire the human brain? ==The causes of environmental grief == * What do grief and distress look at, how are they similar and how are they different? * How do they relate to the Environment? == The consequences == * What are the consequences of environmental grief? == Is environmental grief generational? == * Look at if Environmental grief is only emerging in the younger generations, or is it something that has always been around and is now only just being recognised? == Interventions that target environmental grief == [[File:2019 Black Summer Bushfires from Blue Mountains, New South Wales 06.jpg|thumb|355x355px|''Figure 1''. Black Summer Bushfires from the Blue Mountains, NSW ]] * What are the major interventions surrounding Environmental Grief * Use links, Figures etc. == Conclusion == Based on psychological theory and research, what is the answer to the question? * What are the answers to the focus questions? * What are the practical, take home messages? ==See also== * [[wikipedia:Ecological_grief#:~:text=Ecological%20grief%20(or%20eco%2Dgrief,environmental%20destruction%20or%20climate%20change.|Ecological Grief]] (Wikipedia) * [[Motivation and emotion/Book/2022/Ecological grief|Eco-grief]] (Book Chapter, 2022) * [[wikipedia:Grief|Grief]] (Wikipedia) * [[w:Maslow's hierarchy of needs|Maslow's hierarchy of needs]] (Wikipedia) * [[Motivation and emotion/Book/2022/Viewing natural scenes and emotion|Viewing Natural Scenes and Emotion]] (Book Chapter, 2022) ==References== Cunsolo, A., & Ellis, N. R. (2018). Ecological grief as a mental health response to climate change-related loss. ''Nature Climate Change'', ''8''(4), 275–281. <nowiki>https://doi.org/10.1038/s41558-018-0092-2</nowiki> Ojala, M., Cunsolo, A., Ogunbode, C., & Middleton, J. (2021). Anxiety, Worry, and Grief in a Time of Environmental and Climate Crisis: A Narrative Review. ''Annual Review of Environment and Resources'', ''46'', 35–58. <nowiki>https://doi.org/10.1146/annurev-environ-012220-022716</nowiki> Winerman, A. (2019). Mourning the land. ''<nowiki>Https://Www.Apa.Org</nowiki>'', ''50''(5), 24. ==External links== [https://www.nature.com/articles/s41558-018-0092-2 Ecological grief as a mental health response to climate change-related loss] [https://www.lifeline.org.au/ Lifeline] [[Category:{{#titleparts:{{PAGENAME}}|3}}]] [[Category:Motivation and emotion/Book/Environment]] [[Category:Motivation and emotion/Book/Grief]] n1ef7ew8kbm72kfyqz9ui8ob51x8run 2419479 2419475 2022-08-26T11:08:42Z Gabrielle Eagling 2947522 /* Overview */ wikitext text/x-wiki {{title|Environmental grief:<br>What is eco-grief, its causes and consequences, and what can be done}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== [[File:NSW Fire Smoke on Jan 4, 2020.jpg|thumb|368x368px|NSW bushfire smoke, January 2020 ]] Environmental grief, also known as eco-grief, or eco-anxiety, is when “''people experience climate grief when they notice or anticipate the loss of ‘species, ecosystems and meaningful landscapes due to acute or chronic environmental change”'' (Cunsolo & Ellis, 2018, p. 1). * Concise illustration of the problem - what is the problem, why is it important * A brief history of the term * Outline how psychological science can help * Conclude with examining the three focus questions that will guide the chapter {{RoundBoxTop|theme=3}} '''Focus questions:''' * What are the main theories surrounding environmental grief? * What are the consequences of environmental grief? * Is environmental grief generational? {{RoundBoxBottom}} === Case study === * case study of environmental grief and how it has affected the individual in their day to day emotional state === Emerging theories === * Main theories surrounding Environmental grief * How can specific emotion theories and research help? == Grief and the human brain == * How does grief shape, change and rewire the human brain? ==The causes of environmental grief == * What do grief and distress look at, how are they similar and how are they different? * How do they relate to the Environment? == The consequences == * What are the consequences of environmental grief? == Is environmental grief generational? == * Look at if Environmental grief is only emerging in the younger generations, or is it something that has always been around and is now only just being recognised? == Interventions that target environmental grief == [[File:2019 Black Summer Bushfires from Blue Mountains, New South Wales 06.jpg|thumb|355x355px|''Figure 1''. Black Summer Bushfires from the Blue Mountains, NSW ]] * What are the major interventions surrounding Environmental Grief * Use links, Figures etc. == Conclusion == Based on psychological theory and research, what is the answer to the question? * What are the answers to the focus questions? * What are the practical, take home messages? ==See also== * [[wikipedia:Ecological_grief#:~:text=Ecological%20grief%20(or%20eco%2Dgrief,environmental%20destruction%20or%20climate%20change.|Ecological Grief]] (Wikipedia) * [[Motivation and emotion/Book/2022/Ecological grief|Eco-grief]] (Book Chapter, 2022) * [[wikipedia:Grief|Grief]] (Wikipedia) * [[w:Maslow's hierarchy of needs|Maslow's hierarchy of needs]] (Wikipedia) * [[Motivation and emotion/Book/2022/Viewing natural scenes and emotion|Viewing Natural Scenes and Emotion]] (Book Chapter, 2022) ==References== Cunsolo, A., & Ellis, N. R. (2018). Ecological grief as a mental health response to climate change-related loss. ''Nature Climate Change'', ''8''(4), 275–281. <nowiki>https://doi.org/10.1038/s41558-018-0092-2</nowiki> Ojala, M., Cunsolo, A., Ogunbode, C., & Middleton, J. (2021). Anxiety, Worry, and Grief in a Time of Environmental and Climate Crisis: A Narrative Review. ''Annual Review of Environment and Resources'', ''46'', 35–58. <nowiki>https://doi.org/10.1146/annurev-environ-012220-022716</nowiki> Winerman, A. (2019). Mourning the land. ''<nowiki>Https://Www.Apa.Org</nowiki>'', ''50''(5), 24. ==External links== [https://www.nature.com/articles/s41558-018-0092-2 Ecological grief as a mental health response to climate change-related loss] [https://www.lifeline.org.au/ Lifeline] [[Category:{{#titleparts:{{PAGENAME}}|3}}]] [[Category:Motivation and emotion/Book/Environment]] [[Category:Motivation and emotion/Book/Grief]] s1we5gg46x1psklyjg81bkayaqasbb9 2419480 2419479 2022-08-26T11:11:21Z Gabrielle Eagling 2947522 wikitext text/x-wiki {{title|Environmental grief:<br>What is eco-grief, its causes and consequences, and what can be done}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== [[File:NSW Fire Smoke on Jan 4, 2020.jpg|thumb|368x368px|''Figure 1.'' NSW bushfire smoke, January 2020 ]] Environmental grief, also known as eco-grief, or eco-anxiety, is when “''people experience climate grief when they notice or anticipate the loss of ‘species, ecosystems and meaningful landscapes due to acute or chronic environmental change”'' (Cunsolo & Ellis, 2018, p. 1). * Concise illustration of the problem - what is the problem, why is it important * A brief history of the term * Outline how psychological science can help * Conclude with examining the three focus questions that will guide the chapter {{RoundBoxTop|theme=3}} '''Focus questions:''' * What are the main theories surrounding environmental grief? * What are the consequences of environmental grief? * Is environmental grief generational? {{RoundBoxBottom}} === Case study === * case study of environmental grief and how it has affected the individual in their day to day emotional state === Emerging theories === * Main theories surrounding Environmental grief * How can specific emotion theories and research help? == Grief and the human brain == * How does grief shape, change and rewire the human brain? ==The causes of environmental grief == * What do grief and distress look at, how are they similar and how are they different? * How do they relate to the Environment? == The consequences == * What are the consequences of environmental grief? == Is environmental grief generational? == * Look at if Environmental grief is only emerging in the younger generations, or is it something that has always been around and is now only just being recognised? == Interventions that target environmental grief == [[File:2019 Black Summer Bushfires from Blue Mountains, New South Wales 06.jpg|thumb|355x355px|''Figure 2''. Black Summer Bushfires from the Blue Mountains, NSW ]] * What are the major interventions surrounding Environmental Grief * Use links, Figures etc. == Conclusion == Based on psychological theory and research, what is the answer to the question? * What are the answers to the focus questions? * What are the practical, take home messages? ==See also== * [[wikipedia:Ecological_grief#:~:text=Ecological%20grief%20(or%20eco%2Dgrief,environmental%20destruction%20or%20climate%20change.|Ecological Grief]] (Wikipedia) * [[Motivation and emotion/Book/2022/Ecological grief|Eco-grief]] (Book Chapter, 2022) * [[wikipedia:Grief|Grief]] (Wikipedia) * [[w:Maslow's hierarchy of needs|Maslow's hierarchy of needs]] (Wikipedia) * [[Motivation and emotion/Book/2022/Viewing natural scenes and emotion|Viewing Natural Scenes and Emotion]] (Book Chapter, 2022) ==References== Cunsolo, A., & Ellis, N. R. (2018). Ecological grief as a mental health response to climate change-related loss. ''Nature Climate Change'', ''8''(4), 275–281. <nowiki>https://doi.org/10.1038/s41558-018-0092-2</nowiki> Ojala, M., Cunsolo, A., Ogunbode, C., & Middleton, J. (2021). Anxiety, Worry, and Grief in a Time of Environmental and Climate Crisis: A Narrative Review. ''Annual Review of Environment and Resources'', ''46'', 35–58. <nowiki>https://doi.org/10.1146/annurev-environ-012220-022716</nowiki> Winerman, A. (2019). Mourning the land. ''<nowiki>Https://Www.Apa.Org</nowiki>'', ''50''(5), 24. ==External links== [https://www.nature.com/articles/s41558-018-0092-2 Ecological grief as a mental health response to climate change-related loss] [https://www.lifeline.org.au/ Lifeline] [[Category:{{#titleparts:{{PAGENAME}}|3}}]] [[Category:Motivation and emotion/Book/Environment]] [[Category:Motivation and emotion/Book/Grief]] rq3l9wwrick4u2rs8msskznkfvlq9pq 0 285926 2419173 2419017 2022-08-26T01:53:10Z U3216563 2947577 adding to plan wikitext text/x-wiki {{title|Academic self-regulation<br>What is academic self-regulation, why does it matter, and how can it be fostered?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== * Define Self-regulation and its correlation to psychological well-being * explain how self-regultation can contribute to an individuals motivation == Academic Self-regulation == * What is it? * How can motivation theories and research assist ASR ==Background == * History of academic self-regulation * Key theorist and concepts * Relevant studies in detail or information that associated academic self regaltion to motivation and emotion --> THEORY ==Application == * How does academic self regulation apply to human behaviours and motivation * Why does it matter * ASR as a motivator --> CASE STUDY ===Figure=== == Impacts and Benefits of Academic Self-Regulation == Self regulation in different aspects in life * Social/community * Relationships * Work What is the importance ==Conclusion== * Recape the the answer to the question * Take home messages * Future implication/how can it be fostered ==See also== Provide up to half-a-dozen [[Help:Contents/Links#Interwiki_links|internal (wiki) links]] to relevant Wikiversity pages (esp. related [[Motivation and emotion/Book|motivation and emotion book chapters]]) and [[w:|Wikipedia articles]]. For example: * [[w:David McClelland|David McClelland]] (Wikipedia) * [[w:Maslow's hierarchy of needs|Maslow's hierarchy of needs]] (Wikipedia) References List the cited references in [[w:APA style|APA style]] (7th ed.) or [[w:Wikipedia:Citing sources|wiki style]]. APA style example: {{Hanging indent|1= Blair, R. J. R. (2004). The roles of orbital frontal cortex in the modulation of antisocial behavior. ''Brain and Cognition'', ''55''(1), 198–208. https://doi.org/10.1016/S0278-2626(03)00276-8 Buckholtz, J. W., & Meyer-Lindenberg, A. (2008). MAOA and the neurogenetic architecture of human aggression. ''Trends in Neurosciences'', ''31''(3), 120–129. https://doi.org/10.1016/j.tins.2007.12.006 Eckardt, M., File, S., Gessa, G., Grant, K., Guerri, C., Hoffman, P., & Tabakoff, B. (1998). Effects of moderate alcohol consumption on the central nervous system. ''Alcoholism, Clinical and Experimental Research'', ''22''(5), 998–1040. https://doi.org/10.1111/j.1530-0277.1998.tb03695.x }} {{tip|Suggestions for this section: * Important aspects for APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except first letter and proper names, ending in a full-stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full-stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't actually read or consulted }} ==External links== Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * [https://students.unimelb.edu.au/academic-skills/explore-our-resources/essay-writing/six-top-tips-for-writing-a-great-essay Six top tips for writing a great essay] (University of Melbourne) * [http://www.skillsyouneed.com/write/structure.html The importance of structure] (skillsyouneed.com) {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] [[Category:Motivation and emotion/Book/Education]] [[Category:Motivation and emotion/Book/Self-regulation]] lt4chv9ksgmphaica8zb9ojhik2cdun 2419189 2419173 2022-08-26T02:26:47Z U3216563 2947577 adding headings wikitext text/x-wiki {{title|Academic self-regulation<br>What is academic self-regulation, why does it matter, and how can it be fostered?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== * Define Self-regulation and its correlation to psychological well-being * explain how self-regultation can contribute to an individuals motivation == Academic Self-regulation == * What is it? * How can motivation theories and research assist ASR ==Background == * History of academic self-regulation * Key theorist and concepts * Relevant studies in detail or information that associated academic self regaltion to motivation and emotion --> THEORY ==Application of Academic Self-regualtion == * How does academic self regulation apply to human behaviours and motivation * parts of the brain that affect motivations - self reuldation Educational strategies Intervention strategies Personal Strategies == Adopting Academic Self-reuglated Strategies == - motivation - emotions - metacognition --> CASE STUDY ===Figure=== == Impacts and Benefits of Academic Self-Regulation == Self regulation in different aspects in life * Social/community * Relationships * Work What is the importance ==Conclusion== * Recape the the answer to the question * Take home messages * Future implication ==See also== * [[w: E-learning (theory)|E-learning (theory)]] (Wikipedia) * [[w: Self-regulated learning|Self-regulated learning]] (Wikipedia) * [[w: academic achievement|Academic achievement]] (Wikipedia) * [[w: Self-regulation theory|Self-regulation Theory]] (Wikipedia) * [[w: self-determination theory|Self-determination Theory]] (Wikipedia) * [[Motivation and emotion/Book/2013/Emotional self-regulation|Emotional self-regulation]] (Book chapter, 2013) References List the cited references in [[w:APA style|APA style]] (7th ed.) or [[w:Wikipedia:Citing sources|wiki style]]. APA style example: {{Hanging indent|1= Blair, R. J. R. (2004). The roles of orbital frontal cortex in the modulation of antisocial behavior. ''Brain and Cognition'', ''55''(1), 198–208. https://doi.org/10.1016/S0278-2626(03)00276-8 Buckholtz, J. W., & Meyer-Lindenberg, A. (2008). MAOA and the neurogenetic architecture of human aggression. ''Trends in Neurosciences'', ''31''(3), 120–129. https://doi.org/10.1016/j.tins.2007.12.006 Eckardt, M., File, S., Gessa, G., Grant, K., Guerri, C., Hoffman, P., & Tabakoff, B. (1998). Effects of moderate alcohol consumption on the central nervous system. ''Alcoholism, Clinical and Experimental Research'', ''22''(5), 998–1040. https://doi.org/10.1111/j.1530-0277.1998.tb03695.x }} {{tip|Suggestions for this section: * Important aspects for APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except first letter and proper names, ending in a full-stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full-stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't actually read or consulted }} ==External links== Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * [https://students.unimelb.edu.au/academic-skills/explore-our-resources/essay-writing/six-top-tips-for-writing-a-great-essay Six top tips for writing a great essay] (University of Melbourne) * [http://www.skillsyouneed.com/write/structure.html The importance of structure] (skillsyouneed.com) {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] [[Category:Motivation and emotion/Book/Education]] [[Category:Motivation and emotion/Book/Self-regulation]] hylhtee592s7hosjco70wub6z2yun6e 2419219 2419189 2022-08-26T03:00:36Z U3216563 2947577 /* Overview */ added figure 1 wikitext text/x-wiki {{title|Academic self-regulation<br>What is academic self-regulation, why does it matter, and how can it be fostered?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== * Define Self-regulation and its correlation to psychological well-being * Explain how self-regultation can contribute to an individuals motivation == Academic Self-regulation == [[File:Section 2 self regulated learning model.png|thumb|561x561px|''Figure 1.'' Theoretical perspectives that shape and regulate Academic self-regualtion]] - WHat is it? - How can motivation theories and research assist ASR === Background/Models === * History of academic self-regulation * Key theorist and concepts * Relevant studies in detail or information that associated academic self regaltion to motivation and emotion --> THEORY == Adopting Academic Self-reuglated Strategies == - motivation - emotions - metacognition ===Figure=== ==Application of Academic Self-regualtion == * How does academic self regulation apply to human behaviours and motivation * parts of the brain that affect motivations - self reuldation Educational strategies Intervention strategies Personal Strategies == Impacts and Benefits of Academic Self-Regulation == Self regulation in different aspects in life * Social/community * Relationships * Work What is the importance ==Conclusion== * Recape the the answer to the question * Take home messages * Future implication ==See also== * [[w: E-learning (theory)|E-learning (theory)]] (Wikipedia) * [[w: Self-regulated learning|Self-regulated learning]] (Wikipedia) * [[w: academic achievement|Academic achievement]] (Wikipedia) * [[w: Self-regulation theory|Self-regulation Theory]] (Wikipedia) * [[w: self-determination theory|Self-determination Theory]] (Wikipedia) * [[Motivation and emotion/Book/2013/Emotional self-regulation|Emotional self-regulation]] (Book chapter, 2013) References {{tip|Suggestions for this section: * Important aspects for APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except first letter and proper names, ending in a full-stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full-stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't actually read or consulted }} ==External links== {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] [[Category:Motivation and emotion/Book/Education]] [[Category:Motivation and emotion/Book/Self-regulation]] nvrurjuflgd8ruwufyybfelut9k6fbf 2419241 2419219 2022-08-26T03:33:47Z U3216563 2947577 /* Figure */ External links wikitext text/x-wiki {{title|Academic self-regulation<br>What is academic self-regulation, why does it matter, and how can it be fostered?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== * Define Self-regulation and its correlation to psychological well-being * Explain how self-regultation can contribute to an individuals motivation == Academic Self-regulation == [[File:Section 2 self regulated learning model.png|thumb|561x561px|''Figure 1.'' Theoretical perspectives that shape and regulate Academic self-regualtion]] - WHat is it? - How can motivation theories and research assist ASR === Background/Models === * History of academic self-regulation * Key theorist and concepts * Relevant studies in detail or information that associated academic self regaltion to motivation and emotion --> THEORY == Adopting Academic Self-reuglated Strategies == - motivation - emotions - metacognition ==Application of Academic Self-regualtion == * How does academic self regulation apply to human behaviours and motivation * parts of the brain that affect motivations - self reuldation Educational strategies Intervention strategies Personal Strategies == Impacts and Benefits of Academic Self-Regulation == Self regulation in different aspects in life * Social/community * Relationships * Work What is the importance ==Conclusion== * Recape the the answer to the question * Take home messages * Future implication ==See also== * [[w: E-learning (theory)|E-learning (theory)]] (Wikipedia) * [[w: Self-regulated learning|Self-regulated learning]] (Wikipedia) * [[w: academic achievement|Academic achievement]] (Wikipedia) * [[w: Self-regulation theory|Self-regulation Theory]] (Wikipedia) * [[w: self-determination theory|Self-determination Theory]] (Wikipedia) * [[Motivation and emotion/Book/2013/Emotional self-regulation|Emotional self-regulation]] (Book chapter, 2013) References {{tip|Suggestions for this section: * Important aspects for APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except first letter and proper names, ending in a full-stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full-stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't actually read or consulted }} ==External links== * [https://www.youtube.com/watch?v=oP-okrJ3wsE Promoting Student's Self-refulated Learning (Informative Video)] * [https://www.youtube.com/watch?v=A64J2eEZ4Os Motivation, Self-regulation and Learning How to Learn (Informative Video)]<br /> {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] [[Category:Motivation and emotion/Book/Education]] [[Category:Motivation and emotion/Book/Self-regulation]] 2hcu5329pj2cwwrq6w6s78fz1594jxn 2419252 2419241 2022-08-26T04:11:07Z U3216563 2947577 references wikitext text/x-wiki {{title|Academic self-regulation<br>What is academic self-regulation, why does it matter, and how can it be fostered?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== * Define Self-regulation and its correlation to psychological well-being * Explain how self-regulation can contribute to an individual's motivation == Academic Self-regulation == [[File:Section 2 self regulated learning model.png|thumb|561x561px|''Figure 1.'' Theoretical perspectives that shape and regulate Academic self-regualtion]] - What is it? - How can motivation theories and research assist ASR === Background/Models === * History of academic self-regulation * Key theorists and concepts * Relevant studies in detail or information that associated academic self regulation to motivation and emotion --> THEORY == Adopting Academic Self-regulated Strategies == - motivation - emotions - metacognition ==Application of Academic Self-regualtion == * How does academic self-regulation apply to human behaviours and motivation * parts of the brain that affect motivations - self regulation Educational strategies Intervention strategies Personal Strategies == Impacts and Benefits of Academic Self-Regulation == Self-regulation in different aspects of life * Social/community * Relationships * Work What is the importance? ==Conclusion== * Recipe the the answer to the question * Take home messages * Future implication ==See also== * [[w: E-learning (theory)|E-learning (theory)]] (Wikipedia) * [[w: Self-regulated learning|Self-regulated learning]] (Wikipedia) * [[w: academic achievement|Academic achievement]] (Wikipedia) * [[w: Self-regulation theory|Self-regulation Theory]] (Wikipedia) * [[w: self-determination theory|Self-determination Theory]] (Wikipedia) * [[Motivation and emotion/Book/2013/Emotional self-regulation|Emotional self-regulation]] (Book chapter, 2013) == References == {{Hanging indent|Lee, W., Lee, M. J., & Bong, M. (2014). Testing interest and self-efficacy as predictors of academic self-regulation and achievement. ''Contemporary Educational Psychology'', 39(2), 86-99.}}{{Hanging indent|McClelland, M. M., John Geldhof, G., Cameron, C.E. and Wanless, S.B. (2015). Development and Self-Regulation. ''Journal of Child Psychology and Developmental Science'', R.M. Lerner (Ed.). https://doi.org/10.1002/9781118963418.childpsy114}}{{Hanging indent|Sahranavard, S., Miri, M. R., & Salehiniya, H. (2018). The relationship between self-regulation and educational performance in students. ''Journal of Education and Health Promotion'', 7, 154. https://doi.org/10.4103/jehp.jehp_93_18}}{{tip|Suggestions for this section: * Important aspects of APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except for first letter and proper names, ending in a full stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't read or consulted }} ==External links== * [https://www.youtube.com/watch?v=oP-okrJ3wsE Promoting Student's Self-regulated Learning (Informative Video)] * [https://www.youtube.com/watch?v=A64J2eEZ4Os Motivation, Self-regulation and Learning How to Learn (Informative Video)]<br /> {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] [[Category:Motivation and emotion/Book/Education]] [[Category:Motivation and emotion/Book/Self-regulation]] 7wt00hk5bvkmlrute8k61ee3bokhiiz 2419253 2419252 2022-08-26T04:11:50Z U3216563 2947577 /* References */ wikitext text/x-wiki {{title|Academic self-regulation<br>What is academic self-regulation, why does it matter, and how can it be fostered?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== * Define Self-regulation and its correlation to psychological well-being * Explain how self-regulation can contribute to an individual's motivation == Academic Self-regulation == [[File:Section 2 self regulated learning model.png|thumb|561x561px|''Figure 1.'' Theoretical perspectives that shape and regulate Academic self-regualtion]] - What is it? - How can motivation theories and research assist ASR === Background/Models === * History of academic self-regulation * Key theorists and concepts * Relevant studies in detail or information that associated academic self regulation to motivation and emotion --> THEORY == Adopting Academic Self-regulated Strategies == - motivation - emotions - metacognition ==Application of Academic Self-regualtion == * How does academic self-regulation apply to human behaviours and motivation * parts of the brain that affect motivations - self regulation Educational strategies Intervention strategies Personal Strategies == Impacts and Benefits of Academic Self-Regulation == Self-regulation in different aspects of life * Social/community * Relationships * Work What is the importance? ==Conclusion== * Recipe the the answer to the question * Take home messages * Future implication ==See also== * [[w: E-learning (theory)|E-learning (theory)]] (Wikipedia) * [[w: Self-regulated learning|Self-regulated learning]] (Wikipedia) * [[w: academic achievement|Academic achievement]] (Wikipedia) * [[w: Self-regulation theory|Self-regulation Theory]] (Wikipedia) * [[w: self-determination theory|Self-determination Theory]] (Wikipedia) * [[Motivation and emotion/Book/2013/Emotional self-regulation|Emotional self-regulation]] (Book chapter, 2013) == References == {{Hanging indent|Lee, W., Lee, M. J., & Bong, M. (2014). Testing interest and self-efficacy as predictors of academic self-regulation and achievement. ''Contemporary Educational Psychology'', 39(2), 86-99. https://doi.org/10.1016/j.cedpsych.2014.02.002}}{{Hanging indent|McClelland, M. M., John Geldhof, G., Cameron, C.E. and Wanless, S.B. (2015). Development and Self-Regulation. ''Journal of Child Psychology and Developmental Science'', R.M. Lerner (Ed.). https://doi.org/10.1002/9781118963418.childpsy114}}{{Hanging indent|Sahranavard, S., Miri, M. R., & Salehiniya, H. (2018). The relationship between self-regulation and educational performance in students. ''Journal of Education and Health Promotion'', 7, 154. https://doi.org/10.4103/jehp.jehp_93_18}}{{tip|Suggestions for this section: * Important aspects of APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except for first letter and proper names, ending in a full stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't read or consulted }} ==External links== * [https://www.youtube.com/watch?v=oP-okrJ3wsE Promoting Student's Self-regulated Learning (Informative Video)] * [https://www.youtube.com/watch?v=A64J2eEZ4Os Motivation, Self-regulation and Learning How to Learn (Informative Video)]<br /> {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] [[Category:Motivation and emotion/Book/Education]] [[Category:Motivation and emotion/Book/Self-regulation]] kce0tjamjy8qmz3ftjawwzm3ew7y7zr 2419255 2419253 2022-08-26T04:22:12Z U3216563 2947577 /* Academic Self-regulation */ final touches wikitext text/x-wiki {{title|Academic self-regulation<br>What is academic self-regulation, why does it matter, and how can it be fostered?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== * Define Self-regulation and its correlation to psychological well-being * Explain how self-regulation can contribute to an individual's motivation == Academic Self-regulation == [[File:Section 2 self regulated learning model.png|thumb|561x561px|''Figure 1.'' Theoretical perspectives that shape and regulate Academic self-regualtion]] - What is it? - How can motivation theories and research assist ASR === Models in figure (create these 3 within the figure as subheadingings) === * Key theorists and concepts * Relevant studies in detail or information that associated academic self regulation to motivation and emotion --> insert case study here == Adopting Academic Self-regulated Strategies == === Motivation === Here talk about academic motivation and how this relates to intrinic, extrinsic amotivation concepts === Emotions === Here talk about how emotions can increase adacemic self-regulation === Metacognition === Here talk about how planing, goal setting, regulating is all important to academic self-regulated motivation ==Applying Academic Self-regualtion Strategies == * How does academic self-regulation apply to human behaviours and motivation * parts of the brain that affect motivations - self regulation === Educational strategies === === Personal Strategies === <nowiki>***</nowiki>with these two subheadings - include empiricial research and study findings to describe and explore the application in our everyday lives** == Impacts and Benefits of Academic Self-Regulation == Self-regulation in different aspects of life * Social/community * Relationships * Work What is the importance? ==Conclusion== * Recipe the the answer to the question * Take home messages * Future implication ==See also== * [[w: E-learning (theory)|E-learning (theory)]] (Wikipedia) * [[w: Self-regulated learning|Self-regulated learning]] (Wikipedia) * [[w: academic achievement|Academic achievement]] (Wikipedia) * [[w: Self-regulation theory|Self-regulation Theory]] (Wikipedia) * [[w: self-determination theory|Self-determination Theory]] (Wikipedia) * [[Motivation and emotion/Book/2013/Emotional self-regulation|Emotional self-regulation]] (Book chapter, 2013) == References == {{Hanging indent|Lee, W., Lee, M. J., & Bong, M. (2014). Testing interest and self-efficacy as predictors of academic self-regulation and achievement. ''Contemporary Educational Psychology'', 39(2), 86-99. https://doi.org/10.1016/j.cedpsych.2014.02.002}}{{Hanging indent|McClelland, M. M., John Geldhof, G., Cameron, C.E. and Wanless, S.B. (2015). Development and Self-Regulation. ''Journal of Child Psychology and Developmental Science'', R.M. Lerner (Ed.). https://doi.org/10.1002/9781118963418.childpsy114}}{{Hanging indent|Sahranavard, S., Miri, M. R., & Salehiniya, H. (2018). The relationship between self-regulation and educational performance in students. ''Journal of Education and Health Promotion'', 7, 154. https://doi.org/10.4103/jehp.jehp_93_18}}{{tip|Suggestions for this section: * Important aspects of APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except for first letter and proper names, ending in a full stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't read or consulted }} ==External links== * [https://www.youtube.com/watch?v=oP-okrJ3wsE Promoting Student's Self-regulated Learning (Informative Video)] * [https://www.youtube.com/watch?v=A64J2eEZ4Os Motivation, Self-regulation and Learning How to Learn (Informative Video)]<br /> {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] [[Category:Motivation and emotion/Book/Education]] [[Category:Motivation and emotion/Book/Self-regulation]] jbuli6oi6qry6v0ut38iifcrh2ofsd9 2419256 2419255 2022-08-26T04:22:53Z U3216563 2947577 /* Impacts and Benefits of Academic Self-Regulation */ wikitext text/x-wiki {{title|Academic self-regulation<br>What is academic self-regulation, why does it matter, and how can it be fostered?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== * Define Self-regulation and its correlation to psychological well-being * Explain how self-regulation can contribute to an individual's motivation == Academic Self-regulation == [[File:Section 2 self regulated learning model.png|thumb|561x561px|''Figure 1.'' Theoretical perspectives that shape and regulate Academic self-regualtion]] - What is it? - How can motivation theories and research assist ASR === Models in figure (create these 3 within the figure as subheadingings) === * Key theorists and concepts * Relevant studies in detail or information that associated academic self regulation to motivation and emotion --> insert case study here == Adopting Academic Self-regulated Strategies == === Motivation === Here talk about academic motivation and how this relates to intrinic, extrinsic amotivation concepts === Emotions === Here talk about how emotions can increase adacemic self-regulation === Metacognition === Here talk about how planing, goal setting, regulating is all important to academic self-regulated motivation ==Applying Academic Self-regualtion Strategies == * How does academic self-regulation apply to human behaviours and motivation * parts of the brain that affect motivations - self regulation === Educational strategies === === Personal Strategies === <nowiki>***</nowiki>with these two subheadings - include empiricial research and study findings to describe and explore the application in our everyday lives** == Impacts and Benefits of Academic Self-regulation == Self-regulation in different aspects of life * Social/community * Relationships * Work What is the importance? ==Conclusion== * Recipe the the answer to the question * Take home messages * Future implication ==See also== * [[w: E-learning (theory)|E-learning (theory)]] (Wikipedia) * [[w: Self-regulated learning|Self-regulated learning]] (Wikipedia) * [[w: academic achievement|Academic achievement]] (Wikipedia) * [[w: Self-regulation theory|Self-regulation Theory]] (Wikipedia) * [[w: self-determination theory|Self-determination Theory]] (Wikipedia) * [[Motivation and emotion/Book/2013/Emotional self-regulation|Emotional self-regulation]] (Book chapter, 2013) == References == {{Hanging indent|Lee, W., Lee, M. J., & Bong, M. (2014). Testing interest and self-efficacy as predictors of academic self-regulation and achievement. ''Contemporary Educational Psychology'', 39(2), 86-99. https://doi.org/10.1016/j.cedpsych.2014.02.002}}{{Hanging indent|McClelland, M. M., John Geldhof, G., Cameron, C.E. and Wanless, S.B. (2015). Development and Self-Regulation. ''Journal of Child Psychology and Developmental Science'', R.M. Lerner (Ed.). https://doi.org/10.1002/9781118963418.childpsy114}}{{Hanging indent|Sahranavard, S., Miri, M. R., & Salehiniya, H. (2018). The relationship between self-regulation and educational performance in students. ''Journal of Education and Health Promotion'', 7, 154. https://doi.org/10.4103/jehp.jehp_93_18}}{{tip|Suggestions for this section: * Important aspects of APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except for first letter and proper names, ending in a full stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't read or consulted }} ==External links== * [https://www.youtube.com/watch?v=oP-okrJ3wsE Promoting Student's Self-regulated Learning (Informative Video)] * [https://www.youtube.com/watch?v=A64J2eEZ4Os Motivation, Self-regulation and Learning How to Learn (Informative Video)]<br /> {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] [[Category:Motivation and emotion/Book/Education]] [[Category:Motivation and emotion/Book/Self-regulation]] 5fwjmtpt1s3dpl15acsjbubeya9t4m9 2419257 2419256 2022-08-26T04:24:29Z U3216563 2947577 wikitext text/x-wiki {{title|Academic self-regulation<br>What is academic self-regulation, why does it matter, and how can it be fostered?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== * Define Self-regulation and its correlation to psychological well-being * Explain how self-regulation can contribute to an individual's motivation == Academic Self-regulation == [[File:Section 2 self regulated learning model.png|thumb|561x561px|''Figure 1.'' Theoretical perspectives that shape and regulate Academic self-regualtion]] - What is it? - How can motivation theories and research assist ASR === Models in figure (create these 3 within the figure as subheadingings) === * Key theorists and concepts * Relevant studies in detail or information that associated academic self regulation with motivation and emotion --> insert case study here == Adopting Academic Self-regulated Strategies == === Motivation === Here talk about academic motivation and how this relates to intrinsic, extrinsic amotivation concepts === Emotions === Here talk about how emotions can increase adacemic self-regulation === Metacognition === Here talk about how planning, goal setting, and regulating are all important to academic self-regulated motivation ==Applying Academic Self-regualtion Strategies == * How does academic self-regulation apply to human behaviours and motivation * parts of the brain that affect motivations - self-regulation === Educational strategies === === Personal Strategies === <nowiki>***</nowiki>with these two subheadings - include empirical research and study findings to describe and explore the application in our everyday lives** == Impacts and Benefits of Academic Self-regulation == Self-regulation in different aspects of life * Social/community * Relationships * Work What is the importance? ==Conclusion== * Recipe the answer to the question * Take home messages * Future implication ==See also== * [[w: E-learning (theory)|E-learning (theory)]] (Wikipedia) * [[w: Self-regulated learning|Self-regulated learning]] (Wikipedia) * [[w: academic achievement|Academic achievement]] (Wikipedia) * [[w: Self-regulation theory|Self-regulation Theory]] (Wikipedia) * [[w: self-determination theory|Self-determination Theory]] (Wikipedia) * [[Motivation and emotion/Book/2013/Emotional self-regulation|Emotional self-regulation]] (Book chapter, 2013) == References == {{Hanging indent|Lee, W., Lee, M. J., & Bong, M. (2014). Testing interest and self-efficacy as predictors of academic self-regulation and achievement. ''Contemporary Educational Psychology'', 39(2), 86-99. https://doi.org/10.1016/j.cedpsych.2014.02.002}}{{Hanging indent|McClelland, M. M., John Geldhof, G., Cameron, C.E. and Wanless, S.B. (2015). Development and Self-Regulation. ''Journal of Child Psychology and Developmental Science'', R.M. Lerner (Ed.). https://doi.org/10.1002/9781118963418.childpsy114}}{{Hanging indent|Sahranavard, S., Miri, M. R., & Salehiniya, H. (2018). The relationship between self-regulation and educational performance in students. ''Journal of Education and Health Promotion'', 7, 154. https://doi.org/10.4103/jehp.jehp_93_18}}{{tip|Suggestions for this section: * Important aspects of APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except for first letter and proper names, ending in a full stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't read or consulted }} ==External links== * [https://www.youtube.com/watch?v=oP-okrJ3wsE Promoting Student's Self-regulated Learning (Informative Video)] * [https://www.youtube.com/watch?v=A64J2eEZ4Os Motivation, Self-regulation and Learning How to Learn (Informative Video)]<br /> {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] [[Category:Motivation and emotion/Book/Education]] [[Category:Motivation and emotion/Book/Self-regulation]] 7uyu1gap9hagxvdps4l9rkfuq4xzgzp 2419263 2419257 2022-08-26T04:31:38Z U3216563 2947577 /* Overview */ wikitext text/x-wiki {{title|Academic self-regulation<br>What is academic self-regulation, why does it matter, and how can it be fostered?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== * Define Self-regulation and its correlation to psychological well-being * Explain how self-regulation can contribute to an individual's motivation Example: Academic self-regulation is an essential predictor to academic achievement, self efficacy and a healthier well-being and is characterised by by deep emotional and motivational engagment during the statges or learning (Provide relevant reference here and a further internal link for the word Academic sel-regulation). == Academic Self-regulation == [[File:Section 2 self regulated learning model.png|thumb|561x561px|''Figure 1.'' Theoretical perspectives that shape and regulate Academic self-regualtion]] - What is it? - How can motivation theories and research assist ASR === Models in figure (create these 3 within the figure as subheadingings) === * Key theorists and concepts * Relevant studies in detail or information that associated academic self regulation with motivation and emotion --> insert case study here == Adopting Academic Self-regulated Strategies == === Motivation === Here talk about academic motivation and how this relates to intrinsic, extrinsic amotivation concepts === Emotions === Here talk about how emotions can increase adacemic self-regulation === Metacognition === Here talk about how planning, goal setting, and regulating are all important to academic self-regulated motivation ==Applying Academic Self-regualtion Strategies == * How does academic self-regulation apply to human behaviours and motivation * parts of the brain that affect motivations - self-regulation === Educational strategies === === Personal Strategies === <nowiki>***</nowiki>with these two subheadings - include empirical research and study findings to describe and explore the application in our everyday lives** == Impacts and Benefits of Academic Self-regulation == Self-regulation in different aspects of life * Social/community * Relationships * Work What is the importance? ==Conclusion== * Recipe the answer to the question * Take home messages * Future implication ==See also== * [[w: E-learning (theory)|E-learning (theory)]] (Wikipedia) * [[w: Self-regulated learning|Self-regulated learning]] (Wikipedia) * [[w: academic achievement|Academic achievement]] (Wikipedia) * [[w: Self-regulation theory|Self-regulation Theory]] (Wikipedia) * [[w: self-determination theory|Self-determination Theory]] (Wikipedia) * [[Motivation and emotion/Book/2013/Emotional self-regulation|Emotional self-regulation]] (Book chapter, 2013) == References == {{Hanging indent|Lee, W., Lee, M. J., & Bong, M. (2014). Testing interest and self-efficacy as predictors of academic self-regulation and achievement. ''Contemporary Educational Psychology'', 39(2), 86-99. https://doi.org/10.1016/j.cedpsych.2014.02.002}}{{Hanging indent|McClelland, M. M., John Geldhof, G., Cameron, C.E. and Wanless, S.B. (2015). Development and Self-Regulation. ''Journal of Child Psychology and Developmental Science'', R.M. Lerner (Ed.). https://doi.org/10.1002/9781118963418.childpsy114}}{{Hanging indent|Sahranavard, S., Miri, M. R., & Salehiniya, H. (2018). The relationship between self-regulation and educational performance in students. ''Journal of Education and Health Promotion'', 7, 154. https://doi.org/10.4103/jehp.jehp_93_18}}{{tip|Suggestions for this section: * Important aspects of APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except for first letter and proper names, ending in a full stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't read or consulted }} ==External links== * [https://www.youtube.com/watch?v=oP-okrJ3wsE Promoting Student's Self-regulated Learning (Informative Video)] * [https://www.youtube.com/watch?v=A64J2eEZ4Os Motivation, Self-regulation and Learning How to Learn (Informative Video)]<br /> {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] [[Category:Motivation and emotion/Book/Education]] [[Category:Motivation and emotion/Book/Self-regulation]] 1k3x04fst18ym0i0rwfc8huiq3fjgsn 2419392 2419263 2022-08-26T08:02:41Z 203.214.72.56 /* References */ wikitext text/x-wiki {{title|Academic self-regulation<br>What is academic self-regulation, why does it matter, and how can it be fostered?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== * Define Self-regulation and its correlation to psychological well-being * Explain how self-regulation can contribute to an individual's motivation Example: Academic self-regulation is an essential predictor to academic achievement, self efficacy and a healthier well-being and is characterised by by deep emotional and motivational engagment during the statges or learning (Provide relevant reference here and a further internal link for the word Academic sel-regulation). == Academic Self-regulation == [[File:Section 2 self regulated learning model.png|thumb|561x561px|''Figure 1.'' Theoretical perspectives that shape and regulate Academic self-regualtion]] - What is it? - How can motivation theories and research assist ASR === Models in figure (create these 3 within the figure as subheadingings) === * Key theorists and concepts * Relevant studies in detail or information that associated academic self regulation with motivation and emotion --> insert case study here == Adopting Academic Self-regulated Strategies == === Motivation === Here talk about academic motivation and how this relates to intrinsic, extrinsic amotivation concepts === Emotions === Here talk about how emotions can increase adacemic self-regulation === Metacognition === Here talk about how planning, goal setting, and regulating are all important to academic self-regulated motivation ==Applying Academic Self-regualtion Strategies == * How does academic self-regulation apply to human behaviours and motivation * parts of the brain that affect motivations - self-regulation === Educational strategies === === Personal Strategies === <nowiki>***</nowiki>with these two subheadings - include empirical research and study findings to describe and explore the application in our everyday lives** == Impacts and Benefits of Academic Self-regulation == Self-regulation in different aspects of life * Social/community * Relationships * Work What is the importance? ==Conclusion== * Recipe the answer to the question * Take home messages * Future implication ==See also== * [[w: E-learning (theory)|E-learning (theory)]] (Wikipedia) * [[w: Self-regulated learning|Self-regulated learning]] (Wikipedia) * [[w: academic achievement|Academic achievement]] (Wikipedia) * [[w: Self-regulation theory|Self-regulation Theory]] (Wikipedia) * [[w: self-determination theory|Self-determination Theory]] (Wikipedia) * [[Motivation and emotion/Book/2013/Emotional self-regulation|Emotional self-regulation]] (Book chapter, 2013) == References == {{Hanging indent|Lee, W., Lee, M. J., & Bong, M. (2014). Testing interest and self-efficacy as predictors of academic self-regulation and achievement. ''Journal of Contemporary Educational Psychology'', 39(2), 86-99. https://doi.org/10.1016/j.cedpsych.2014.02.002}}{{Hanging indent|McClelland, M. M., John Geldhof, G., Cameron, C.E. and Wanless, S.B. (2015). Development and Self-Regulation. ''Journal of Child Psychology and Developmental Science'', R.M. Lerner (Ed.). https://doi.org/10.1002/9781118963418.childpsy114}}{{Hanging indent|Sahranavard, S., Miri, M. R., & Salehiniya, H. (2018). The relationship between self-regulation and educational performance in students. ''Journal of Education and Health Promotion'', 7, 154. https://doi.org/10.4103/jehp.jehp_93_18}}{{tip|Suggestions for this section: * Important aspects of APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except for first letter and proper names, ending in a full stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't read or consulted }} ==External links== * [https://www.youtube.com/watch?v=oP-okrJ3wsE Promoting Student's Self-regulated Learning (Informative Video)] * [https://www.youtube.com/watch?v=A64J2eEZ4Os Motivation, Self-regulation and Learning How to Learn (Informative Video)]<br /> {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] [[Category:Motivation and emotion/Book/Education]] [[Category:Motivation and emotion/Book/Self-regulation]] 2e84fc85rtwt4uamgrsyo6okmrp6ete 0 285927 2419341 2418984 2022-08-26T07:03:59Z Icantchooseone 2947542 /* Conclusion */ wikitext text/x-wiki {{title|Fear:<br>What is fear, what causes it, and how can it be managed?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== * [[File:Fear has big eyes.jpg|thumb|333x333px|Figure 2. Fear has big eyes.]]definition of fear (fundamental life task: threat or danger present) ** expression of fear (facial expression, heart rate, sweat level) ** types of fear ** coping function (protect, avoid) * outline the similarities and differences between fear and anxiety * outline the cause of fear (psychologically, biologically and socially) * overview of fear and phobia * strategies to manage fear (in and out of clinical setting) Fear can offer both advantage and disadvantage in everyday life. Understand the meaning and causation of fear can lead to course of action that helps to manage fear. {{RoundBoxTop|theme=3}} '''Focus questions:''' * What is fear? * What is the difference between fear and anxiety? * What causes fear? * When does fear lead to phobia? * How can fear be managed? {{RoundBoxBottom}} == What is fear? == * what is the definition of fear? ** fear is one of the human basic emotions (Gu et al., 2019) ** fear defined by ethologist (Steimer, 2002) ** fear as a motivator (Bates, 2014) == The difference between fear and anxiety == * Are fear and anxiety truly distinct? (Daniel-Watanabe & Fletcher, 2021) * Neurobehavioral perspectives on the distinction between fear and anxiety (Perusini & Fanselow, 2015) * Fear and anxiety as separable emotions (Perkins et al., 2007) * Interaction between fear and anxiety (Meulders et al., 2012) == What causes fear? == * genetic and environmental cause of fear (Sundet et al., 2003) * the hierarchic structure of fears (Taylor, 1998) * the cause for fear will be looked at from multiple perspective: physiological, social, and psychological - respectively. === Physiological perspective === * fear response starts in the amygdala - fight or flight (Ressler, 2010) * explicit fear processing activate the pulvinar and parahippocampal gyrus (Tao et al., 2021) * release stress hormones and sympathetic nervous system (Steimer, 2002) * James-Lange theory () * fear serve an adaptive role for survival - Darwin's theory (Mobbs, 2015) - from evolutionary (preprogrammed fear) === Social perspective === * are we born with fear of learn it overtime? (Debiec & Olsson, 2017) * Bandura's social learning theory (Olsson & Phelps, 2007) * cultural evolution of fear (Tudor, 2003) changing due to social experience, circumstances. ** example: the fear of air siren back then (during war time) compare to modern days. === Psychological perspective === * Pavlovian fear conditioning (Hadley et al., 2011) * fear is caused by particular perceived threat related stimuli - physically and psychologically (Rapee, 1997) * cognitive appraisal theory () == When does fear become a phobia? == * what is phobia? (Eaton, 2018) * fear becomes excessive beyond that which is justified by external threat (Du et al., 2008) * phobia as the psychology of irrational fear (Milosevic & McCabe, 2015) * neurobiology of fear and specific phobias (Garcia, 2017) == How can fear be managed? == * fear can become an obstacle in everyday life if it is not regulated. === Within everyday life === ==== Mindfulness ==== * mindfulness exercise and fear extinction (Kummar, 2017) * the effects of mindfulness and fear inducing stimuli on avoidance behaviour (Carlin & Ahrens, 2014) ==== Self-control instruction ==== * fear reduction using self-control instruction with home-based practice (Graziano et al., 1979) * systematic desensitisation (Goldfield, 1971) * will power is more than a metaphor (Galliot et al., 2007) === Within clinical settings === * there are number of treatment that can be used within a clinical setting to help manage fear before and when it becomes a phobia. * this book chapter will be focusing on the most two common therapeutic techniques of cognitive behavioural therapy and exposure therapy. ==== Cognitive behavioural therapy ==== * case study report of cancer survivor on fear of recurrence (Montel, 2010) * treating fear in anxiety disorders (Kaczkurkin, 2015) * NMDA receptor and fear extinction (Davis, 2022) * reducing fear-avoidance-beliefs among individuals with chronic pain (Lohnberg, 2007) ==== Exposure therapy ==== * face your fear (Frankland & Josselyn, 2018) * an inhibitory approach (Craske et al., 2014) ==Conclusion== * Summaries key points - answer focus questions listed in overview. **The pros and cons of fear. **Fear can be distinguished from anxiety **There are many factors that are involved in producing fear. **When fear is not recognised regulated, it can become overwhelming and potentially lead to phobia. **Fear is normal and can be treated with self help and/or professional help. *take home messages **fear is not always a problem, fear serves to protect and prevent human from danger. **fear can become a problem when it is interfering with one's life, but it can be managed whether at home or at a clinic. == Recap quizzes == <quiz display="simple"> {Fear induce risk taking behaviour |type="()"} + True - False {It is possible to manage fear with mindfulness techniques |type="()"} - True + False </quiz>The Conclusion is arguably the most important section. It should be possible for someone to read the [[#Overview|Overview]] and the Conclusion and still get a good idea of the topic. {{tip|Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? }} ==See also== * [[w:Fear|Fear]] (Wikipedia) * [[w:Fear of falling|Fear of falling]] (Wikipedia) {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== {{Hanging indent|1= Gu, S., Wang, F., Patel, N. P., Bourgeois, J. A., & Huang, J. H. (2019). A model for basic emotions using observations of behaviour in Drosophila. ''Frontiers in Psychology'', 781. https://doi.org/10.3389/fpsyg.2019.00781 Perusini, J. N., & Fanselow, M. S. (2015). Neurobehavioural perspectives on the distinction between fear and anxiety. ''Learning and Memory'', ''22''(9), 417-425. http://www.learnmem.org/cgi/doi/10.1101/lm.039180.115 Steimer, T. (2002). The biology of fear-and anxiety-related behaviours. ''Dialogues in Clinical Neuroscience'', ''4''(3), 231– 249. https://doi.org/10.31887/dcns.2002.4.3/tsteimer }} {{tip|Suggestions for this section: * Important aspects for APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except first letter and proper names, ending in a full-stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full-stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't actually read or consulted }} ==External links== * [https://www.verywellmind.com/the-psychology-of-fear-2671696#:~:text=Coping-,What%20Is%20Fear%3F,danger%20is%20physical%20or%20psychological. Fear: Definition, Symptoms, Traits, Causes, Treatment] (Very Well Mind) * [https://www.psychologytoday.com/au/blog/meditation-modern-life/202011/learning-let-go-fears Learning to let go of fears] (Psychology Today) {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] [[Category:Motivation and emotion/Book/Fear]] 4jwmzd1hq407byna0ugyf23d1k4jzjy 0 285929 2419091 2413100 2022-08-25T22:28:23Z Jtneill 10242 + categories wikitext text/x-wiki {{title|Mindful Self-Care:<br>Subtitle?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== You are underway {{smile}}! This template provides tips for [[Motivation and emotion/Assessment/Topic|topic development]]. Gradually remove these suggestions as you develop the chapter. Also consult the [[Motivation and emotion/Assessment/Chapter|author guidelines]]. At the top of the chapter, the title and sub-title should match the ''exact'' wording and casing as shown in the {{Motivation and emotion/Book}}. The sub-titles all end with a question mark. This Overview section should be concise but consist of several paragraphs which engage the reader, illustrate the problem, and outline how psychological science can help. {{RoundBoxTop|theme=3}} '''Focus questions:''' * What is the first focus question? * What is the second focus question? * What is the third focus question? {{RoundBoxBottom}} {{tip| Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Provide an example or case study. * Conclude with Focus questions to guide the chapter. }} ==Main headings== How you are going to structure the chapter? Aim for three to six main headings between the [[#Overview|Overview]] and [[#Conclusion|Conclusion]]. {{tip|Suggestions for this section: * For the [[Motivation and emotion/Assessment/Topic|topic development]], provide at least 3 bullet-points about key content per section. Include key citations. * For the [[Motivation and emotion/Assessment/Chapter|book chapter]], expand the bullet points into paragraphs. * If a section has a lot of content, arrange it into two to five sub-headings such as in the [[#Interactive learning features|interactive learning features section]]. Avoid having sections with only one sub-heading. }} ==Learning features== What brings an online book chapter to life are its interactive learning features. Case studies, feature boxes, figures, links, tables, and quiz questions can be used throughout the chapter. ===Case studies=== Case studies describe real-world examples of concepts in action. Case studies can be real or fictional. A case could be used multiple times during a chapter to illustrate different theories or stages. It is often helpful to present case studies using [[#Feature boxes|feature boxes]]. ===Boxes=== Boxes can be used to highlight content, but don't overuse them. There are many different ways of creating boxes (e.g., see [[Help:Pretty boxes|Pretty boxes]]). Possible uses include: * Focus questions * Case studies or examples * Quiz questions * Take-home messages {{RoundBoxTop|theme=3}} ;Feature box example * Shaded background * Coloured border {{RoundBoxBottom}} ===Figures=== [[File:Monkey-typing.jpg|right|205px|thumb|''Figure 1''. Example image with descriptive caption.]] Use figures to illustrate concepts, add interest, and provide examples. Figures can be used to show photographs, drawings, diagrams, graphs, etcetera. Figures can be embedded throughout the chapter, starting with the Overview section. Figures should be captioned (using a number and a description) in order to explain their relevance to the text. Possible images can be found at [[commons:|Wikimedia Commons]]. Images can also be uploaded if they are licensed for re-use or if you created the image. Each figure should be referred to at least once in the main text (e.g., see Figure 1). ===Links=== Where key words are first used, make them into [[Help:Links|interwiki links]] such as Wikipedia links to articles about famous people (e.g., [[w:Sigmund Freud|Sigmund Freud]] and key concepts (e.g., [[w:Dreams|dreams]]) and links to book chapters about related topics (e.g., would you like to learn about how to overcome [[Motivation and emotion/Book/2020/Writer's block|writer's block]]?). ===Tables=== Tables can be an effective way to organise and summarise information. Tables should be captioned (using APA style) to explain their relevance to the text. Plus each table should be referred to at least once in the main text (e.g., see Table 1 and Table 2). Here are some [[Motivation and emotion/Wikiversity/Tables|example 3 x 3 tables]] which could be adapted. ===Quizzes=== Quizzes are a direct way to engage readers. But don't make quizzes too hard or long. It is better to have one or two review questions per major section than a long quiz at the end. Try to quiz conceptual understanding, rather than trivia. Here are some simple quiz questions which could be adapted. Choose the correct answers and click "Submit": <quiz display=simple> {Quizzes are an interactive learning feature: |type="()"} + True - False {Long quizzes are a good idea: |type="()"} - True + False </quiz> To learn about different types of quiz questions, see [[Help:Quiz|Quiz]]. ==Conclusion== The Conclusion is arguably the most important section. It should be possible for someone to read the [[#Overview|Overview]] and the Conclusion and still get a good idea of the topic. {{tip|Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? }} ==See also== Provide up to half-a-dozen [[Help:Contents/Links#Interwiki_links|internal (wiki) links]] to relevant Wikiversity pages (esp. related [[Motivation and emotion/Book|motivation and emotion book chapters]]) and [[w:|Wikipedia articles]]. For example: * [[Motivation and emotion/Book/2016/Anorexia nervosa and extrinsic motivation|Anorexia nervosa and extrinsic motivation]] (Book chapter, 2016) * [[w:David McClelland|David McClelland]] (Wikipedia) * [[Motivation and emotion/Book/2018/Loss aversion|Loss aversion]] (Book chapter, 2018) * [[w:Maslow's hierarchy of needs|Maslow's hierarchy of needs]] (Wikipedia) {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== List the cited references in [[w:APA style|APA style]] (7th ed.) or [[w:Wikipedia:Citing sources|wiki style]]. APA style example: {{Hanging indent|1= Blair, R. J. R. (2004). The roles of orbital frontal cortex in the modulation of antisocial behavior. ''Brain and Cognition'', ''55''(1), 198–208. https://doi.org/10.1016/S0278-2626(03)00276-8 Buckholtz, J. W., & Meyer-Lindenberg, A. (2008). MAOA and the neurogenetic architecture of human aggression. ''Trends in Neurosciences'', ''31''(3), 120–129. https://doi.org/10.1016/j.tins.2007.12.006 Eckardt, M., File, S., Gessa, G., Grant, K., Guerri, C., Hoffman, P., & Tabakoff, B. (1998). Effects of moderate alcohol consumption on the central nervous system. ''Alcoholism, Clinical and Experimental Research'', ''22''(5), 998–1040. https://doi.org/10.1111/j.1530-0277.1998.tb03695.x }} {{tip|Suggestions for this section: * Important aspects for APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except first letter and proper names, ending in a full-stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full-stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't actually read or consulted }} ==External links== Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * [https://students.unimelb.edu.au/academic-skills/explore-our-resources/essay-writing/six-top-tips-for-writing-a-great-essay Six top tips for writing a great essay] (University of Melbourne) * [http://www.skillsyouneed.com/write/structure.html The importance of structure] (skillsyouneed.com) {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] [[Category:Motivation and emotion/Book/Mindfulness]] [[Category:Motivation and emotion/Book/Self-care]] 2gymtc2z9clyoxj2v63yrthuqqhrmov 2 285932 2419196 2419015 2022-08-26T02:36:20Z U3216563 2947577 added social contributions wikitext text/x-wiki == About Me == Hello, My name is Kristina and I am in my third year Undergrade Degree in Bachelor of Science in Pscyhology paired with a Major in Counselling studies at the [https://www.canberra.edu.au/ University of Canberra]. My goal at the end of my studying journey is to become a Clinical Psychologist, where I will be trained in the assessment and diagnosis of mental health illnesses and pshycological problems that individuals may face. This will enable me to provide advice in clinical and compensational areas in which will guid individuals to better themselves in all aspects of life. == Hobbies == * Sports (Rugby League) * Playing instruments * Baking * Gyming == Book Chapter == [[Motivation and emotion/Book/2022/Academic self-regulation|Academic self-regulation]] - What is academic self-regulation, why does it matter, and how can it be fostered? == Social Contribution == # Created user page and added in book chapter: [[Motivation and emotion/Book/2022/Conspiracy theory motivation|Conspiracy theory motivation]] - [[User:KingMob221|KingMob221]] # Edited user page by creating consistency between headings and grammar: [[Motivation and emotion/Book/2022/Survival needs and motivation|Survival needs and motivation]] - [[User:U3148161|U3148161]]__TOC__ # Heading casing edit: [https://en.wikiversity.org/w/index.php?title=Motivation_and_emotion%2FBook%2F2022%2FBeneficence_as_a_psychological_need&type=revision&diff=2419188&oldid=2418697 Beneficence as a psychological need - CaitlinEmc] #Feedback comment on profile: [https://en.wikiversity.org/w/index.php?title=Talk%3AMotivation_and_emotion%2FBook%2F2022%2FFully_functioning_person&type=revision&diff=2419192&oldid=2417499 Fully functioning person - Sebastian Armstrong] 9fpjscihe45zcm72utdm75faz5qzzsy 2419198 2419196 2022-08-26T02:36:50Z U3216563 2947577 /* Social Contribution */ wikitext text/x-wiki == About Me == Hello, My name is Kristina and I am in my third year Undergrade Degree in Bachelor of Science in Pscyhology paired with a Major in Counselling studies at the [https://www.canberra.edu.au/ University of Canberra]. My goal at the end of my studying journey is to become a Clinical Psychologist, where I will be trained in the assessment and diagnosis of mental health illnesses and pshycological problems that individuals may face. This will enable me to provide advice in clinical and compensational areas in which will guid individuals to better themselves in all aspects of life. == Hobbies == * Sports (Rugby League) * Playing instruments * Baking * Gyming == Book Chapter == [[Motivation and emotion/Book/2022/Academic self-regulation|Academic self-regulation]] - What is academic self-regulation, why does it matter, and how can it be fostered? == Social Contribution == # Created user page and added in book chapter: [[Motivation and emotion/Book/2022/Conspiracy theory motivation|Conspiracy theory motivation]] - [[User:KingMob221|KingMob221]] # __TOC__Edited user page by creating consistency between headings and grammar: [[Motivation and emotion/Book/2022/Survival needs and motivation|Survival needs and motivation]] - [[User:U3148161|U3148161]] # Heading casing edit: [https://en.wikiversity.org/w/index.php?title=Motivation_and_emotion%2FBook%2F2022%2FBeneficence_as_a_psychological_need&type=revision&diff=2419188&oldid=2418697 Beneficence as a psychological need - CaitlinEmc] #Feedback comment on profile: [https://en.wikiversity.org/w/index.php?title=Talk%3AMotivation_and_emotion%2FBook%2F2022%2FFully_functioning_person&type=revision&diff=2419192&oldid=2417499 Fully functioning person - Sebastian Armstrong] 5bzzefnyaw0hgcm48r0vwqto0sadta0 2419199 2419198 2022-08-26T02:37:16Z U3216563 2947577 /* Social Contribution */ wikitext text/x-wiki == About Me == Hello, My name is Kristina and I am in my third year Undergrade Degree in Bachelor of Science in Pscyhology paired with a Major in Counselling studies at the [https://www.canberra.edu.au/ University of Canberra]. My goal at the end of my studying journey is to become a Clinical Psychologist, where I will be trained in the assessment and diagnosis of mental health illnesses and pshycological problems that individuals may face. This will enable me to provide advice in clinical and compensational areas in which will guid individuals to better themselves in all aspects of life. == Hobbies == * Sports (Rugby League) * Playing instruments * Baking * Gyming == Book Chapter == [[Motivation and emotion/Book/2022/Academic self-regulation|Academic self-regulation]] - What is academic self-regulation, why does it matter, and how can it be fostered? == Social Contribution == # Created user page and added in book chapter: [[Motivation and emotion/Book/2022/Conspiracy theory motivation|Conspiracy theory motivation]] - [[User:KingMob221|KingMob221]]__TOC__ # Edited user page by creating consistency between headings and grammar: [[Motivation and emotion/Book/2022/Survival needs and motivation|Survival needs and motivation]] - [[User:U3148161|U3148161]] # Heading casing edit: [https://en.wikiversity.org/w/index.php?title=Motivation_and_emotion%2FBook%2F2022%2FBeneficence_as_a_psychological_need&type=revision&diff=2419188&oldid=2418697 Beneficence as a psychological need - CaitlinEmc] #Feedback comment on profile: [https://en.wikiversity.org/w/index.php?title=Talk%3AMotivation_and_emotion%2FBook%2F2022%2FFully_functioning_person&type=revision&diff=2419192&oldid=2417499 Fully functioning person - Sebastian Armstrong] reqrb05kj7ansf5y5be8mhq32gjewzq 2419200 2419199 2022-08-26T02:37:28Z U3216563 2947577 /* Social Contribution */ wikitext text/x-wiki == About Me == Hello, My name is Kristina and I am in my third year Undergrade Degree in Bachelor of Science in Pscyhology paired with a Major in Counselling studies at the [https://www.canberra.edu.au/ University of Canberra]. My goal at the end of my studying journey is to become a Clinical Psychologist, where I will be trained in the assessment and diagnosis of mental health illnesses and pshycological problems that individuals may face. This will enable me to provide advice in clinical and compensational areas in which will guid individuals to better themselves in all aspects of life. == Hobbies == * Sports (Rugby League) * Playing instruments * Baking * Gyming == Book Chapter == [[Motivation and emotion/Book/2022/Academic self-regulation|Academic self-regulation]] - What is academic self-regulation, why does it matter, and how can it be fostered? == Social Contribution == # __TOC__Created user page and added in book chapter: [[Motivation and emotion/Book/2022/Conspiracy theory motivation|Conspiracy theory motivation]] - [[User:KingMob221|KingMob221]] # Edited user page by creating consistency between headings and grammar: [[Motivation and emotion/Book/2022/Survival needs and motivation|Survival needs and motivation]] - [[User:U3148161|U3148161]] # Heading casing edit: [https://en.wikiversity.org/w/index.php?title=Motivation_and_emotion%2FBook%2F2022%2FBeneficence_as_a_psychological_need&type=revision&diff=2419188&oldid=2418697 Beneficence as a psychological need - CaitlinEmc] #Feedback comment on profile: [https://en.wikiversity.org/w/index.php?title=Talk%3AMotivation_and_emotion%2FBook%2F2022%2FFully_functioning_person&type=revision&diff=2419192&oldid=2417499 Fully functioning person - Sebastian Armstrong] 6gz1j2tmnwz625jwkvwp6f4gvo978iq 2419201 2419200 2022-08-26T02:38:25Z U3216563 2947577 /* Social Contribution */ wikitext text/x-wiki == About Me == Hello, My name is Kristina and I am in my third year Undergrade Degree in Bachelor of Science in Pscyhology paired with a Major in Counselling studies at the [https://www.canberra.edu.au/ University of Canberra]. My goal at the end of my studying journey is to become a Clinical Psychologist, where I will be trained in the assessment and diagnosis of mental health illnesses and pshycological problems that individuals may face. This will enable me to provide advice in clinical and compensational areas in which will guid individuals to better themselves in all aspects of life. == Hobbies == * Sports (Rugby League) * Playing instruments * Baking * Gyming == Book Chapter == [[Motivation and emotion/Book/2022/Academic self-regulation|Academic self-regulation]] - What is academic self-regulation, why does it matter, and how can it be fostered? == Social Contribution == # __TOC__Created user page and added in book chapter: [[Motivation and emotion/Book/2022/Conspiracy theory motivation|Conspiracy theory motivation]] - [[User:KingMob221|KingMob221]] # Edited user page by creating consistency between headings and grammar: [[Motivation and emotion/Book/2022/Survival needs and motivation|Survival needs and motivation]] - [[User:U3148161|U3148161]] # Heading casing edit: [https://en.wikiversity.org/w/index.php?title=Motivation_and_emotion%2FBook%2F2022%2FBeneficence_as_a_psychological_need&type=revision&diff=2419188&oldid=2418697 Beneficence as a psychological need - CaitlinEmc] #Feedback comment on profile: [https://en.wikiversity.org/w/index.php?title=Talk%3AMotivation_and_emotion%2FBook%2F2022%2FFully_functioning_person&type=revision&diff=2419192&oldid=2417499 Fully functioning person - Sebastian Armstrong]__TOC__ jlr648f7mm5gl10a71gj44zsd3d7bky 2419202 2419201 2022-08-26T02:38:39Z U3216563 2947577 /* Social Contribution */ wikitext text/x-wiki == About Me == Hello, My name is Kristina and I am in my third year Undergrade Degree in Bachelor of Science in Pscyhology paired with a Major in Counselling studies at the [https://www.canberra.edu.au/ University of Canberra]. My goal at the end of my studying journey is to become a Clinical Psychologist, where I will be trained in the assessment and diagnosis of mental health illnesses and pshycological problems that individuals may face. This will enable me to provide advice in clinical and compensational areas in which will guid individuals to better themselves in all aspects of life. == Hobbies == * Sports (Rugby League) * Playing instruments * Baking * Gyming == Book Chapter == [[Motivation and emotion/Book/2022/Academic self-regulation|Academic self-regulation]] - What is academic self-regulation, why does it matter, and how can it be fostered? __TOC__ __TOC__ ibkphef740rwkvt515aodwm6uspuv00 2419203 2419202 2022-08-26T02:38:59Z U3216563 2947577 Replaced content with " __TOC__ __TOC__" wikitext text/x-wiki __TOC__ __TOC__ nlijjaja9a023ttoucnw4dkc45fbzqe 2419204 2419203 2022-08-26T02:39:09Z U3216563 2947577 wikitext text/x-wiki __TOC__ __TOC__ == About Me == Hello, My name is Kristina and I am in my third year Undergrade Degree in Bachelor of Science in Pscyhology paired with a Major in Counselling studies at the [https://www.canberra.edu.au/ University of Canberra]. My goal at the end of my studying journey is to become a Clinical Psychologist, where I will be trained in the assessment and diagnosis of mental health illnesses and pshycological problems that individuals may face. This will enable me to provide advice in clinical and compensational areas in which will guid individuals to better themselves in all aspects of life. == Hobbies == * Sports (Rugby League) * Playing instruments * Baking * Gyming == Book Chapter == [[Motivation and emotion/Book/2022/Academic self-regulation|Academic self-regulation]] - What is academic self-regulation, why does it matter, and how can it be fostered? == Social Contribution == # Created user page and added in book chapter: [[Motivation and emotion/Book/2022/Conspiracy theory motivation|Conspiracy theory motivation]] - [[User:KingMob221|KingMob221]] # Edited user page by creating consistency between headings and grammar: [[Motivation and emotion/Book/2022/Survival needs and motivation|Survival needs and motivation]] - [[User:U3148161|U3148161]] # Heading casing edit: [https://en.wikiversity.org/w/index.php?title=Motivation_and_emotion%2FBook%2F2022%2FBeneficence_as_a_psychological_need&type=revision&diff=2419188&oldid=2418697 Beneficence as a psychological need - CaitlinEmc] # Feedback comment on profile: [https://en.wikiversity.org/w/index.php?title=Talk%3AMotivation_and_emotion%2FBook%2F2022%2FFully_functioning_person&type=revision&diff=2419192&oldid=2417499 Fully functioning person - Sebastian Armstrong] mghghdiwzgokeu9txgrwfiabsmf6178 2419265 2419204 2022-08-26T04:34:15Z U3216563 2947577 grammar editing wikitext text/x-wiki __TOC__ __TOC__ == About Me == Hello, My name is Kristina and I am in my third year of Undergrad Degree in a Bachelor of Science in Psychology paired with a Major in Counselling studies at the [https://www.canberra.edu.au/ University of Canberra]. My goal at the end of my studying journey is to become a Clinical Psychologist, where I will be trained in the assessment and diagnosis of mental health illnesses and psychological problems that individuals may face. This will enable me to provide advice in clinical and compensational areas which will guide individuals to better themselves in all aspects of life. == Hobbies == * Sports (Rugby League) * Playing instruments * Baking * Gyming == Book Chapter == [[Motivation and emotion/Book/2022/Academic self-regulation|Academic self-regulation]] - What is academic self-regulation, why does it matter, and how can it be fostered? == Social Contribution == # Created user page and added in book chapter: [[Motivation and emotion/Book/2022/Conspiracy theory motivation|Conspiracy theory motivation]] - [[User:KingMob221|KingMob221]] # Edited user page by creating consistency between headings and grammar: [[Motivation and emotion/Book/2022/Survival needs and motivation|Survival needs and motivation]] - [[User:U3148161|U3148161]] # Heading casing edit: [https://en.wikiversity.org/w/index.php?title=Motivation_and_emotion%2FBook%2F2022%2FBeneficence_as_a_psychological_need&type=revision&diff=2419188&oldid=2418697 Beneficence as a psychological need - CaitlinEmc] # Feedback comment on profile: [https://en.wikiversity.org/w/index.php?title=Talk%3AMotivation_and_emotion%2FBook%2F2022%2FFully_functioning_person&type=revision&diff=2419192&oldid=2417499 Fully functioning person - Sebastian Armstrong] bodkwkmk4ebnli2vweouu6k7kmmrqjx 0 285934 2419345 2417653 2022-08-26T07:09:27Z 2001:8003:1D93:6900:F935:74C:FFD5:730 /* Overview */ wikitext text/x-wiki {{title| Benzodiazepines and emotion:<br> What are the effects of benzodiazepines on emotion?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== [[File:Diazepam tablets.jpeg|thumb|268x268px|Figure 1. Diazepam is one of the medication categorised as benzodiazepines ]] Have you used something you believed at the time have no harm and later realised it has more risk (harm) than good? Well although many people believe benzodiazepines (BZD) can do no harms, physician have serious concern about misuse and abuse of these drugs by patients. Many doctors and psychiatrics are still wondering why benzodiazepines are still prescribe for patients despite all risk associate the drugs. BZD are mainly prescribed to patients with anxiety, panic disorder, insomnia and other emotional related disorders. This book chapter will discuss the effects of BZD on emotion, biological, cognitive, psychological aspects of BZD. Additional, book chapter will touch on pathophysiology of anxiety, theories, and interventions. {{RoundBoxTop|theme=3}} '''Focus questions:''' * What are benzodiazepines use for? * What roles does benzodiazepines play on emotions? * Can people management their emotions without benzodiazepines? {{RoundBoxBottom}} [[File:Benzodiazepine.svg|thumb|''Figure 2''. Description of benzodiazepines |169x169px]] ==What are benzodiazepines?== [[wikipedia:Benzodiazepine|Benzodiazepines]] (BZD) also known as CNS depressants- The purpose of BZD is to calm down the body and firing activities in the brain. Originally, the drugs are advised for short-term use due to its effectiveness. Moreover, Physicians quickly released that BZD have negative side effects but also risk of dependences, tolerances and withdrawal effects. Table 1. summarising the effects, commonly prescribed BZD, roles of BZD in clinical aspects and form BZD are administered. {| class="wikitable" |+ ! colspan="4" | |- | === Effects of benzodiazepines === | === Benzodiazepines commonly prescribed === | === Clinical aspect of benzodiazepines === | === Routes === |- | * Sedative effects * Hypnotic effects * Anxiolytic effects | * Alprazolam * Lorazepam * Temazepam * Diazepam * Midazolam and more | * Anxiety * Seizure * Insomnia * Panic attack * Before procedure (surgery) * Alcohol withdrawal | * IV - intravenous * IM - intramuscular * Rectal - through anus * Oral - through mouth |} {{tip|Suggestions for this section: * For the [[Motivation and emotion/Assessment/Topic|topic development]], provide at least 3 bullet-points about key content per section. Include key citations. * For the [[Motivation and emotion/Assessment/Chapter|book chapter]], expand the bullet points into paragraphs. * If a section has a lot of content, arrange it into two to five sub-headings such as in the [[#Interactive learning features|interactive learning features section]]. Avoid having sections with only one sub-heading. }} * '''Pharmacological aspect of BZD''' Gamma-aminobutyric acid (GABA) also known as neurotransmitters is the primary inhibitory in the brain (central nervous system). Benzodiazepines amplifies GABA effects by inhibitory neurotransmitter (Lydiard, 2003). == What is emotion? == Emotion is very complex patterns of reaction which involved behavioural, psychological, biological, physiological and environmental elements. It's the way people response to their environment or stimuli based on their experiences, perceptions or cultural understanding. According Charles Darwin, emotion is innate in all species, humans and animals all have emotions, for example a baby cry when their mother living and happy when she come back or dog back when show stranger. Benzodiazepines are prescribed to help patients that struggles with negatives emotions and its purpose is to calm and relax patients especially anxiety, panic disorder and insomnia ( difficulty sleeping). == What is the effects of benzodiazepines on emotions == * Impaired threat processing * Generalised fear of threat * Reduce total alertness response * Lack of ability to recognised facial expressions ==== Effects of benzodiazepines on behavioural and neurophysiological aspects ==== * Impaired psychomotor activities and motor control * Impaired memory functions especially working and verbal memory * Decreased alertness on environmental threat * Increased reaction times as well as decrease reaction time when for BNZ * Driving impairments ( Stone, Corea, Brown, Spurgin, Stikic, Johnson, & Berka, 2015) ===== Effects of BZD on social cognition ===== * Activities in amygdala reduce - this part of the brain is responsible in guiding behaviour and processes knowledge about vital stimuli for survival. Amygdala also contributes to area of cognitive processing such as attention, memory, decision making, and research found this part of the brain critical in facial expression especially negative emotions such as fear (Adolphs, 1999). Studies also found that patients with damaged amygdala are unlikely to recognized emotions associated with fear and anger. However, benzodiazepines play critical roles by producing calming effects during endless though in the brain which are mostly negative emotions (Zald,2003). * Reduction in emotional processing ability - * Affect motivation and emotion * Deficit in social cognition due to emotional suppression * Alleviate anxiety symptoms and improve social cognitions impairment (Haime, Watson, Crellin, Marston, Joyce, & Moncrieff, 2021). === Issues related with dependence, withdrawal and tolerance from benzodiazepines: === * Increased level of anxiety * Insomnia- difficulty with sleep or falling a sleep * Lack of appetite - lack of motivation to seek for food or eat food * Weight lose - losing weight without trying * Perception disturbance * Tremor * Irritability * Nausea * Panic attacks * Headache * Sweating * Problem with concentration (Petursson,1994). == Pathophysiology of anxiety and other emotional related disorders == == Theories == * Darwin biological and genetic theory on emotion * Psychological cognitive theory == Recommendation for interventions == '''Cognitive behavioural therapy''' - Cognitive behavioral therapy (CBD) has been practice for many years and it’s a type of therapy that focus in psychological aspects of treatment and it has been significantly effective in many areas such as anxiety disorders, depression, alcohol and drugs problems, mental problems ,eating disorder, or OCD. CBD is considered more effective than BZD because it focuses on long -term effects, help patients change their thinking patterns e.g., focusing on positive than negative, learn health coping strategies, face the issue instead of avoiding them and help patients focus on current situation rather than the cause of the problem while BZD emphases in short-term benefits, does not tackle the issue lead to use of BZD, no  coping method and has problematic effects when instructions are not followed (Barlow, Allen, & Choate, (2016) '''Psychological therapy''' - (also known as talking therapy) It involves talking to professionals about your problems, and the therapist provide a safe environment where the therapist listen and the patients do most of the talking, it help patients understand their thoughts and behaviour, help patients come to resolution on how to manage and  recognised the symptoms of mental illness in early stage and how to seek for help (Paterson, Karatzias, Dickson, Harper, Dougall, & Hutton, (2018) '''Life styles -''' == conclusion == The Conclusion is arguably the most important section. It should be possible for someone to read the [[#Overview|Overview]] and the Conclusion and still get a good idea of the topic. {{tip|Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? }} ==See also== # [[wikipedia:Benzodiazepine|Benzodiazepine]] (Wikipedia) # [[Motivation and emotion/Book/2020/Methamphetamine and emotion|Methamphetamine and emotion]] (Book chapter, 2020) # [[Motivation and emotion/Book/2019/Opioid system and human emotion|Opioid system and human emotion]] (Book chapter, 2019) == '''References''' == Barlow, D. H., Allen, L. B., & Choate, M. L. (2016).Toward a unified treatment for emotional disorders–republished article. ''Behavior therapy'', ''47''(6), 838-853. https://doi.org/10.1016/j.beth.2016.11.005 Paterson, C., Karatzias, T., Dickson, A., Harper, S., Dougall, N., & Hutton, P. (2018). Psychological therapy for inpatients receiving acute mental health care: A systematic review and meta‐analysis of controlled trials. ''British Journal of Clinical Psychology'', ''57''(4), 453-472. https://doi.org/10.1111/bjc.12182 Zald, D. H. (2003). The human amygdala and the emotional evaluation of sensory stimuli. ''Brain Research Reviews'', ''41''(1), 88-123. https://doi.org/10.1111/1467-9280.00224 ==External links== * [https://www.youtube.com/watch?v=mLmfLhs0ehk Benzodiazepines (Benzos) Pharmacology: Anxiety Medication Sedative Nursing NCLEX] ( YouTube) * [https://f1000research.com/articles/11-790 Effects of concomitant benzodiazepines and antidepressants long-term use on perspective-taking] (new article on benzodiazepines and emotion) Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * [https://students.unimelb.edu.au/academic-skills/explore-our-resources/essay-writing/six-top-tips-for-writing-a-great-essay Six top tips for writing a great essay] (University of Melbourne) * [http://www.skillsyouneed.com/write/structure.html The importance of structure] (skillsyouneed.com) {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]]" l0b12puj8pjq6uox94sb7nvtyod2kew 2419352 2419345 2022-08-26T07:15:58Z Ajeofula22 2947179 removing subheadings wikitext text/x-wiki {{title| Benzodiazepines and emotion:<br> What are the effects of benzodiazepines on emotion?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== [[File:Diazepam tablets.jpeg|thumb|268x268px|Figure 1. Diazepam is one of the medication categorised as benzodiazepines ]] Have you used something you believed at the time have no harm and later realised it has more risk (harm) than good? Well although many people believe benzodiazepines (BZD) can do no harms, physician have serious concern about misuse and abuse of these drugs by patients. Many doctors and psychiatrics are still wondering why benzodiazepines are still prescribe for patients despite all risk associate the drugs. BZD are mainly prescribed to patients with anxiety, panic disorder, insomnia and other emotional related disorders. This book chapter will discuss the effects of BZD on emotion, biological, cognitive, psychological aspects of BZD. Additional, book chapter will touch on pathophysiology of anxiety, theories, and interventions. {{RoundBoxTop|theme=3}} '''Focus questions:''' * What are benzodiazepines use for? * What roles does benzodiazepines play on emotions? * Can people management their emotions without benzodiazepines? {{RoundBoxBottom}} [[File:Benzodiazepine.svg|thumb|''Figure 2''. Description of benzodiazepines |169x169px]] ==What are benzodiazepines?== [[wikipedia:Benzodiazepine|Benzodiazepines]] (BZD) also known as CNS depressants- The purpose of BZD is to calm down the body and firing activities in the brain. Originally, the drugs are advised for short-term use due to its effectiveness. Moreover, Physicians quickly released that BZD have negative side effects but also risk of dependences, tolerances and withdrawal effects. Table 1. summarising the effects, commonly prescribed BZD, roles of BZD in clinical aspects and form BZD are administered. {| class="wikitable" |+ ! colspan="4" | |- |'''Effects of benzodiazepines''' |'''Benzodiazepines commonly prescribed''' |'''Clinical aspect of benzodiazepines''' |'''Routes''' |- | * Sedative effects * Hypnotic effects * Anxiolytic effects | * Alprazolam * Lorazepam * Temazepam * Diazepam * Midazolam and more | * Anxiety * Seizure * Insomnia * Panic attack * Before procedure (surgery) * Alcohol withdrawal | * IV - intravenous * IM - intramuscular * Rectal - through anus * Oral - through mouth |} {{tip|Suggestions for this section: * For the [[Motivation and emotion/Assessment/Topic|topic development]], provide at least 3 bullet-points about key content per section. Include key citations. * For the [[Motivation and emotion/Assessment/Chapter|book chapter]], expand the bullet points into paragraphs. * If a section has a lot of content, arrange it into two to five sub-headings such as in the [[#Interactive learning features|interactive learning features section]]. Avoid having sections with only one sub-heading. }} * '''Pharmacological aspect of BZD''' Gamma-aminobutyric acid (GABA) also known as neurotransmitters is the primary inhibitory in the brain (central nervous system). Benzodiazepines amplifies GABA effects by inhibitory neurotransmitter (Lydiard, 2003). == What is emotion? == Emotion is very complex patterns of reaction which involved behavioural, psychological, biological, physiological and environmental elements. It's the way people response to their environment or stimuli based on their experiences, perceptions or cultural understanding. According Charles Darwin, emotion is innate in all species, humans and animals all have emotions, for example a baby cry when their mother living and happy when she come back or dog back when show stranger. Benzodiazepines are prescribed to help patients that struggles with negatives emotions and its purpose is to calm and relax patients especially anxiety, panic disorder and insomnia ( difficulty sleeping). == What is the effects of benzodiazepines on emotions == * Impaired threat processing * Generalised fear of threat * Reduce total alertness response * Lack of ability to recognised facial expressions ==== Effects of benzodiazepines on behavioural and neurophysiological aspects ==== * Impaired psychomotor activities and motor control * Impaired memory functions especially working and verbal memory * Decreased alertness on environmental threat * Increased reaction times as well as decrease reaction time when for BNZ * Driving impairments ( Stone, Corea, Brown, Spurgin, Stikic, Johnson, & Berka, 2015) ===== Effects of BZD on social cognition ===== * Activities in amygdala reduce - this part of the brain is responsible in guiding behaviour and processes knowledge about vital stimuli for survival. Amygdala also contributes to area of cognitive processing such as attention, memory, decision making, and research found this part of the brain critical in facial expression especially negative emotions such as fear (Adolphs, 1999). Studies also found that patients with damaged amygdala are unlikely to recognized emotions associated with fear and anger. However, benzodiazepines play critical roles by producing calming effects during endless though in the brain which are mostly negative emotions (Zald,2003). * Reduction in emotional processing ability - * Affect motivation and emotion * Deficit in social cognition due to emotional suppression * Alleviate anxiety symptoms and improve social cognitions impairment (Haime, Watson, Crellin, Marston, Joyce, & Moncrieff, 2021). === Issues related with dependence, withdrawal and tolerance from benzodiazepines: === * Increased level of anxiety * Insomnia- difficulty with sleep or falling a sleep * Lack of appetite - lack of motivation to seek for food or eat food * Weight lose - losing weight without trying * Perception disturbance * Tremor * Irritability * Nausea * Panic attacks * Headache * Sweating * Problem with concentration (Petursson,1994). == Pathophysiology of anxiety and other emotional related disorders == == Theories == * Darwin biological and genetic theory on emotion * Psychological cognitive theory == Recommendation for interventions == '''Cognitive behavioural therapy''' - Cognitive behavioral therapy (CBD) has been practice for many years and it’s a type of therapy that focus in psychological aspects of treatment and it has been significantly effective in many areas such as anxiety disorders, depression, alcohol and drugs problems, mental problems ,eating disorder, or OCD. CBD is considered more effective than BZD because it focuses on long -term effects, help patients change their thinking patterns e.g., focusing on positive than negative, learn health coping strategies, face the issue instead of avoiding them and help patients focus on current situation rather than the cause of the problem while BZD emphases in short-term benefits, does not tackle the issue lead to use of BZD, no  coping method and has problematic effects when instructions are not followed (Barlow, Allen, & Choate, (2016) '''Psychological therapy''' - (also known as talking therapy) It involves talking to professionals about your problems, and the therapist provide a safe environment where the therapist listen and the patients do most of the talking, it help patients understand their thoughts and behaviour, help patients come to resolution on how to manage and  recognised the symptoms of mental illness in early stage and how to seek for help (Paterson, Karatzias, Dickson, Harper, Dougall, & Hutton, (2018) '''Life styles -''' == conclusion == The Conclusion is arguably the most important section. It should be possible for someone to read the [[#Overview|Overview]] and the Conclusion and still get a good idea of the topic. {{tip|Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? }} ==See also== # [[wikipedia:Benzodiazepine|Benzodiazepine]] (Wikipedia) # [[Motivation and emotion/Book/2020/Methamphetamine and emotion|Methamphetamine and emotion]] (Book chapter, 2020) # [[Motivation and emotion/Book/2019/Opioid system and human emotion|Opioid system and human emotion]] (Book chapter, 2019) == '''References''' == Barlow, D. H., Allen, L. B., & Choate, M. L. (2016).Toward a unified treatment for emotional disorders–republished article. ''Behavior therapy'', ''47''(6), 838-853. https://doi.org/10.1016/j.beth.2016.11.005 Paterson, C., Karatzias, T., Dickson, A., Harper, S., Dougall, N., & Hutton, P. (2018). Psychological therapy for inpatients receiving acute mental health care: A systematic review and meta‐analysis of controlled trials. ''British Journal of Clinical Psychology'', ''57''(4), 453-472. https://doi.org/10.1111/bjc.12182 Zald, D. H. (2003). The human amygdala and the emotional evaluation of sensory stimuli. ''Brain Research Reviews'', ''41''(1), 88-123. https://doi.org/10.1111/1467-9280.00224 ==External links== * [https://www.youtube.com/watch?v=mLmfLhs0ehk Benzodiazepines (Benzos) Pharmacology: Anxiety Medication Sedative Nursing NCLEX] ( YouTube) * [https://f1000research.com/articles/11-790 Effects of concomitant benzodiazepines and antidepressants long-term use on perspective-taking] (new article on benzodiazepines and emotion) Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * [https://students.unimelb.edu.au/academic-skills/explore-our-resources/essay-writing/six-top-tips-for-writing-a-great-essay Six top tips for writing a great essay] (University of Melbourne) * [http://www.skillsyouneed.com/write/structure.html The importance of structure] (skillsyouneed.com) {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]]" gwwhucx7iyl0rfw1s9yv0cfwycftk0u 2419363 2419352 2022-08-26T07:25:03Z Ajeofula22 2947179 /* Overview */ wikitext text/x-wiki {{title| Benzodiazepines and emotion:<br> What are the effects of benzodiazepines on emotion?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== [[File:Diazepam tablets.jpeg|thumb|268x268px|Figure 1. Diazepam is one of the medication categorised as benzodiazepines ]] Have you used something you believed at the time have no harm and later realised it has more risk (harm) than good? Well although many people believe benzodiazepines (BZD) can do no harms, physician have serious concern about misuse and abuse of these drugs by patients. Many doctors and psychiatrics are still wondering why benzodiazepines are still prescribe for patients despite all risk associate the drugs. BZD are mainly prescribed to patients with anxiety, panic disorder, insomnia and other emotional related disorders. This book chapter will discuss the effects of BZD on emotion, biological, cognitive, psychological aspects of BZD. Additional, book chapter will touch on pathophysiology of anxiety, theories, and interventions. {{RoundBoxTop|theme=3}} '''Focus questions:''' * What are benzodiazepines use for? * What roles does benzodiazepines play on emotions? * Can people management their emotions without benzodiazepines? {{RoundBoxBottom}} [[File:Benzodiazepine.svg|thumb|''Figure 2''. Description of benzodiazepines |169x169px]] ==What are benzodiazepines?== [[wikipedia:Benzodiazepine|Benzodiazepines]] (BZD) also known as CNS depressants- The purpose of BZD is to calm down the body and firing activities in the brain. Originally, the drugs are advised for short-term use due to its effectiveness. Moreover, Physicians quickly released that BZD have negative side effects but also risk of dependences, tolerances and withdrawal effects === '''Anxiety''' === === Panic disorder === === Insomnia === === Other related emotional disorders === === Pharmacological aspects of BZD and brain regions === ==== Cerebral cortex ==== ==== Thalamus ==== ==== Limbic system ==== Table 1. summarising the effects, commonly prescribed BZD, roles of BZD in clinical aspects and form BZD are administered. {| class="wikitable" |+ ! colspan="4" | |- |'''Effects of benzodiazepines''' |'''Benzodiazepines commonly prescribed''' |'''Clinical aspect of benzodiazepines''' |'''Routes''' |- | * Sedative effects * Hypnotic effects * Anxiolytic effects | * Alprazolam * Lorazepam * Temazepam * Diazepam * Midazolam and more | * Anxiety * Seizure * Insomnia * Panic attack * Before procedure (surgery) * Alcohol withdrawal | * IV - intravenous * IM - intramuscular * Rectal - through anus * Oral - through mouth |} {{tip|Suggestions for this section: * For the [[Motivation and emotion/Assessment/Topic|topic development]], provide at least 3 bullet-points about key content per section. Include key citations. * For the [[Motivation and emotion/Assessment/Chapter|book chapter]], expand the bullet points into paragraphs. * If a section has a lot of content, arrange it into two to five sub-headings such as in the [[#Interactive learning features|interactive learning features section]]. Avoid having sections with only one sub-heading. }} * '''Pharmacological aspect of BZD''' Gamma-aminobutyric acid (GABA) also known as neurotransmitters is the primary inhibitory in the brain (central nervous system). Benzodiazepines amplifies GABA effects by inhibitory neurotransmitter (Lydiard, 2003). == What is emotion? == Emotion is very complex patterns of reaction which involved behavioural, psychological, biological, physiological and environmental elements. It's the way people response to their environment or stimuli based on their experiences, perceptions or cultural understanding. According Charles Darwin, emotion is innate in all species, humans and animals all have emotions, for example a baby cry when their mother living and happy when she come back or dog back when show stranger. Benzodiazepines are prescribed to help patients that struggles with negatives emotions and its purpose is to calm and relax patients especially anxiety, panic disorder and insomnia ( difficulty sleeping). == What is the effects of benzodiazepines on emotions == * Impaired threat processing * Generalised fear of threat * Reduce total alertness response * Lack of ability to recognised facial expressions ==== Effects of benzodiazepines on behavioural and neurophysiological aspects ==== * Impaired psychomotor activities and motor control * Impaired memory functions especially working and verbal memory * Decreased alertness on environmental threat * Increased reaction times as well as decrease reaction time when for BNZ * Driving impairments ( Stone, Corea, Brown, Spurgin, Stikic, Johnson, & Berka, 2015) ===== Effects of BZD on social cognition ===== * Activities in amygdala reduce - this part of the brain is responsible in guiding behaviour and processes knowledge about vital stimuli for survival. Amygdala also contributes to area of cognitive processing such as attention, memory, decision making, and research found this part of the brain critical in facial expression especially negative emotions such as fear (Adolphs, 1999). Studies also found that patients with damaged amygdala are unlikely to recognized emotions associated with fear and anger. However, benzodiazepines play critical roles by producing calming effects during endless though in the brain which are mostly negative emotions (Zald,2003). * Reduction in emotional processing ability - * Affect motivation and emotion * Deficit in social cognition due to emotional suppression * Alleviate anxiety symptoms and improve social cognitions impairment (Haime, Watson, Crellin, Marston, Joyce, & Moncrieff, 2021). === Issues related with dependence, withdrawal and tolerance from benzodiazepines: === * Increased level of anxiety * Insomnia- difficulty with sleep or falling a sleep * Lack of appetite - lack of motivation to seek for food or eat food * Weight lose - losing weight without trying * Perception disturbance * Tremor * Irritability * Nausea * Panic attacks * Headache * Sweating * Problem with concentration (Petursson,1994). == Pathophysiology of anxiety and other emotional related disorders == == Theories == * Darwin biological and genetic theory on emotion * Psychological cognitive theory == Recommendation for interventions == '''Cognitive behavioural therapy''' - Cognitive behavioral therapy (CBD) has been practice for many years and it’s a type of therapy that focus in psychological aspects of treatment and it has been significantly effective in many areas such as anxiety disorders, depression, alcohol and drugs problems, mental problems ,eating disorder, or OCD. CBD is considered more effective than BZD because it focuses on long -term effects, help patients change their thinking patterns e.g., focusing on positive than negative, learn health coping strategies, face the issue instead of avoiding them and help patients focus on current situation rather than the cause of the problem while BZD emphases in short-term benefits, does not tackle the issue lead to use of BZD, no  coping method and has problematic effects when instructions are not followed (Barlow, Allen, & Choate, (2016) '''Psychological therapy''' - (also known as talking therapy) It involves talking to professionals about your problems, and the therapist provide a safe environment where the therapist listen and the patients do most of the talking, it help patients understand their thoughts and behaviour, help patients come to resolution on how to manage and  recognised the symptoms of mental illness in early stage and how to seek for help (Paterson, Karatzias, Dickson, Harper, Dougall, & Hutton, (2018) '''Life styles -''' == conclusion == The Conclusion is arguably the most important section. It should be possible for someone to read the [[#Overview|Overview]] and the Conclusion and still get a good idea of the topic. {{tip|Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? }} ==See also== # [[wikipedia:Benzodiazepine|Benzodiazepine]] (Wikipedia) # [[Motivation and emotion/Book/2020/Methamphetamine and emotion|Methamphetamine and emotion]] (Book chapter, 2020) # [[Motivation and emotion/Book/2019/Opioid system and human emotion|Opioid system and human emotion]] (Book chapter, 2019) == '''References''' == Barlow, D. H., Allen, L. B., & Choate, M. L. (2016).Toward a unified treatment for emotional disorders–republished article. ''Behavior therapy'', ''47''(6), 838-853. https://doi.org/10.1016/j.beth.2016.11.005 Paterson, C., Karatzias, T., Dickson, A., Harper, S., Dougall, N., & Hutton, P. (2018). Psychological therapy for inpatients receiving acute mental health care: A systematic review and meta‐analysis of controlled trials. ''British Journal of Clinical Psychology'', ''57''(4), 453-472. https://doi.org/10.1111/bjc.12182 Zald, D. H. (2003). The human amygdala and the emotional evaluation of sensory stimuli. ''Brain Research Reviews'', ''41''(1), 88-123. https://doi.org/10.1111/1467-9280.00224 ==External links== * [https://www.youtube.com/watch?v=mLmfLhs0ehk Benzodiazepines (Benzos) Pharmacology: Anxiety Medication Sedative Nursing NCLEX] ( YouTube) * [https://f1000research.com/articles/11-790 Effects of concomitant benzodiazepines and antidepressants long-term use on perspective-taking] (new article on benzodiazepines and emotion) Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * [https://students.unimelb.edu.au/academic-skills/explore-our-resources/essay-writing/six-top-tips-for-writing-a-great-essay Six top tips for writing a great essay] (University of Melbourne) * [http://www.skillsyouneed.com/write/structure.html The importance of structure] (skillsyouneed.com) {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]]" 8fulpvrq4dkwv1qo2h50pxj4j21qewd 2419376 2419363 2022-08-26T07:43:07Z Ajeofula22 2947179 /* Insomnia */ wikitext text/x-wiki {{title| Benzodiazepines and emotion:<br> What are the effects of benzodiazepines on emotion?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== [[File:Diazepam tablets.jpeg|thumb|268x268px|Figure 1. Diazepam is one of the medication categorised as benzodiazepines ]] Have you used something you believed at the time have no harm and later realised it has more risk (harm) than good? Well although many people believe benzodiazepines (BZD) can do no harms, physician have serious concern about misuse and abuse of these drugs by patients. Many doctors and psychiatrics are still wondering why benzodiazepines are still prescribe for patients despite all risk associate the drugs. BZD are mainly prescribed to patients with anxiety, panic disorder, insomnia and other emotional related disorders. This book chapter will discuss the effects of BZD on emotion, biological, cognitive, psychological aspects of BZD. Additional, book chapter will touch on pathophysiology of anxiety, theories, and interventions. {{RoundBoxTop|theme=3}} '''Focus questions:''' * What are benzodiazepines use for? * What roles does benzodiazepines play on emotions? * Can people management their emotions without benzodiazepines? {{RoundBoxBottom}} [[File:Benzodiazepine.svg|thumb|''Figure 2''. Description of benzodiazepines |169x169px]] ==What are benzodiazepines?== [[wikipedia:Benzodiazepine|Benzodiazepines]] (BZD) also known as CNS depressants- The purpose of BZD is to calm down the body and firing activities in the brain. Originally, the drugs are advised for short-term use due to its effectiveness. Moreover, Physicians quickly released that BZD have negative side effects but also risk of dependences, tolerances and withdrawal effects * '''Anxiety''' * '''Panic disorder''' * '''Insomnia''' * '''Other related emotional disorders''' === Pharmacological aspects of BZD and brain regions === Gamma-aminobutyric acid (GABA) also known as neurotransmitters is the primary inhibitory in the brain (central nervous system). Benzodiazepines amplifies GABA effects by inhibitory neurotransmitter (Lydiard, 2003). ==== Cerebral cortex ==== ==== Thalamus ==== ==== Limbic system ==== === Table 1. summarising the effects, commonly prescribed BZD, roles of BZD in clinical aspects and form BZD are administered. === {| class="wikitable" |+ ! colspan="4" | |- |'''Effects of benzodiazepines''' |'''Benzodiazepines commonly prescribed''' |'''Clinical aspect of benzodiazepines''' |'''Routes''' |- | * Sedative effects * Hypnotic effects * Anxiolytic effects | * Alprazolam * Lorazepam * Temazepam * Diazepam * Midazolam and more | * Anxiety * Seizure * Insomnia * Panic attack * Before procedure (surgery) * Alcohol withdrawal | * IV - intravenous * IM - intramuscular * Rectal - through anus * Oral - through mouth |} {{tip|Suggestions for this section: * For the [[Motivation and emotion/Assessment/Topic|topic development]], provide at least 3 bullet-points about key content per section. Include key citations. * For the [[Motivation and emotion/Assessment/Chapter|book chapter]], expand the bullet points into paragraphs. * If a section has a lot of content, arrange it into two to five sub-headings such as in the [[#Interactive learning features|interactive learning features section]]. Avoid having sections with only one sub-heading. }} == What is emotion? == Emotion is very complex patterns of reaction which involved behavioural, psychological, biological, physiological and environmental elements. It's the way people response to their environment or stimuli based on their experiences, perceptions or cultural understanding. According Charles Darwin, emotion is innate in all species, humans and animals all have emotions, for example a baby cry when their mother living and happy when she come back or dog back when show stranger. Benzodiazepines are prescribed to help patients that struggles with negatives emotions and its purpose is to calm and relax patients especially anxiety, panic disorder and insomnia ( difficulty sleeping). == What is the effects of benzodiazepines on emotions == * Impaired threat processing * Generalised fear of threat * Reduce total alertness response * Lack of ability to recognised facial expressions ==== Effects of benzodiazepines on behavioural and neurophysiological aspects ==== * Impaired psychomotor activities and motor control * Impaired memory functions especially working and verbal memory * Decreased alertness on environmental threat * Increased reaction times as well as decrease reaction time when for BNZ * Driving impairments ( Stone, Corea, Brown, Spurgin, Stikic, Johnson, & Berka, 2015) ===== Effects of BZD on social cognition ===== * Activities in amygdala reduce - this part of the brain is responsible in guiding behaviour and processes knowledge about vital stimuli for survival. Amygdala also contributes to area of cognitive processing such as attention, memory, decision making, and research found this part of the brain critical in facial expression especially negative emotions such as fear (Adolphs, 1999). Studies also found that patients with damaged amygdala are unlikely to recognized emotions associated with fear and anger. However, benzodiazepines play critical roles by producing calming effects during endless though in the brain which are mostly negative emotions (Zald,2003). * Long-term use of BZD cause decline in cognition functioning ability (Barker, Greenwood, Jackson, & Crowe, 2004). * Reduction in emotional processing ability - * Affect motivation and emotion * Deficit in social cognition due to emotional suppression * Alleviate anxiety symptoms and improve social cognitions impairment (Haime, Watson, Crellin, Marston, Joyce, & Moncrieff, 2021). === Issues related with dependence, withdrawal and tolerance from benzodiazepines: === * Increased level of anxiety * Insomnia- difficulty with sleep or falling a sleep * Lack of appetite - lack of motivation to seek for food or eat food * Weight lose - losing weight without trying * Perception disturbance * Tremor * Irritability * Nausea * Panic attacks * Headache * Sweating * Problem with concentration (Petursson,1994). == Adverse effects of BZD == * Withdrawal * Dependence == Theories == * Darwin biological and genetic theory on emotion * Psychological cognitive theory == Recommendation for interventions == '''Cognitive behavioural therapy''' - Cognitive behavioral therapy (CBD) has been practice for many years, focuses in psychological aspects of treatment and it has been significantly effective in many areas such as anxiety disorders, depression, alcohol and drugs problems, mental problems ,eating disorder, or OCD. CBD is considered more effective than BZD because it focuses on long -term effects, help patients change their thinking patterns e.g., focusing on positive than negative aspects of the behaviour, learn health coping strategies, face the issue instead of avoiding them and help patients focus on current situation rather than the cause of the problem while BZD emphases in short-term benefits, does not tackle the issue lead to use of BZD, no  coping method and has problematic effects when instructions are not followed (Barlow, Allen, & Choate, (2016) '''Psychological therapy''' - (also known as talking therapy) It involves talking to professionals about your problems, and the therapist provide a safe environment where the therapist listen and the patients do most of the talking, it help patients understand their thoughts and behaviour, help patients come to resolution on how to manage and  recognised the symptoms of mental illness in early stage and how to seek for help (Paterson, Karatzias, Dickson, Harper, Dougall, & Hutton, (2018) '''Life styles -''' '''self-management techniques''' - Meditation - Relaxation - Exercise - Support network == conclusion == The Conclusion is arguably the most important section. It should be possible for someone to read the [[#Overview|Overview]] and the Conclusion and still get a good idea of the topic. {{tip|Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? }} ==See also== # [[wikipedia:Benzodiazepine|Benzodiazepine]] (Wikipedia) # [[Motivation and emotion/Book/2020/Methamphetamine and emotion|Methamphetamine and emotion]] (Book chapter, 2020) # [[Motivation and emotion/Book/2019/Opioid system and human emotion|Opioid system and human emotion]] (Book chapter, 2019) == '''References''' == Barlow, D. H., Allen, L. B., & Choate, M. L. (2016).Toward a unified treatment for emotional disorders–republished article. ''Behavior therapy'', ''47''(6), 838-853. https://doi.org/10.1016/j.beth.2016.11.005 Paterson, C., Karatzias, T., Dickson, A., Harper, S., Dougall, N., & Hutton, P. (2018). Psychological therapy for inpatients receiving acute mental health care: A systematic review and meta‐analysis of controlled trials. ''British Journal of Clinical Psychology'', ''57''(4), 453-472. https://doi.org/10.1111/bjc.12182 Zald, D. H. (2003). The human amygdala and the emotional evaluation of sensory stimuli. ''Brain Research Reviews'', ''41''(1), 88-123. https://doi.org/10.1111/1467-9280.00224 ==External links== * [https://www.youtube.com/watch?v=mLmfLhs0ehk Benzodiazepines (Benzos) Pharmacology: Anxiety Medication Sedative Nursing NCLEX] ( YouTube) * [https://f1000research.com/articles/11-790 Effects of concomitant benzodiazepines and antidepressants long-term use on perspective-taking] (new article on benzodiazepines and emotion) Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * [https://students.unimelb.edu.au/academic-skills/explore-our-resources/essay-writing/six-top-tips-for-writing-a-great-essay Six top tips for writing a great essay] (University of Melbourne) * [http://www.skillsyouneed.com/write/structure.html The importance of structure] (skillsyouneed.com) {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]]" j8j8o3d7mwinxkwtil8ipel6zs2df5k 2419380 2419376 2022-08-26T07:46:11Z Ajeofula22 2947179 /* What are benzodiazepines? */ wikitext text/x-wiki {{title| Benzodiazepines and emotion:<br> What are the effects of benzodiazepines on emotion?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== [[File:Diazepam tablets.jpeg|thumb|268x268px|Figure 1. Diazepam is one of the medication categorised as benzodiazepines ]] Have you used something you believed at the time have no harm and later realised it has more risk (harm) than good? Well although many people believe benzodiazepines (BZD) can do no harms, physician have serious concern about misuse and abuse of these drugs by patients. Many doctors and psychiatrics are still wondering why benzodiazepines are still prescribe for patients despite all risk associate the drugs. BZD are mainly prescribed to patients with anxiety, panic disorder, insomnia and other emotional related disorders. This book chapter will discuss the effects of BZD on emotion, biological, cognitive, psychological aspects of BZD. Additional, book chapter will touch on pathophysiology of anxiety, theories, and interventions. {{RoundBoxTop|theme=3}} '''Focus questions:''' * What are benzodiazepines use for? * What roles does benzodiazepines play on emotions? * Can people management their emotions without benzodiazepines? {{RoundBoxBottom}} [[File:Benzodiazepine.svg|thumb|''Figure 2''. Description of benzodiazepines |169x169px]] ==What are benzodiazepines?== [[wikipedia:Benzodiazepine|Benzodiazepines]] (BZD) also known as CNS depressants- The purpose of BZD is to calm down the body and firing activities in the brain. Originally, the drugs are advised for short-term use due to its effectiveness. Moreover, Physicians quickly released that BZD have negative side effects but also risk of dependences, tolerances and withdrawal effects * '''Anxiety''' * '''Panic disorder''' * '''Insomnia''' * '''Other related emotional disorders''' === Pharmacological aspects of BZD and brain regions === Gamma-aminobutyric acid (GABA) also known as neurotransmitters is the primary inhibitory in the brain (central nervous system). Benzodiazepines amplifies GABA effects by inhibitory neurotransmitter (Lydiard, 2003). ==== Cerebral cortex ==== ==== Thalamus ==== ==== Limbic system ==== === Table 1. summarising the effects, commonly prescribed BZD, roles of BZD in clinical aspects and form BZD are administered. === {| class="wikitable" |+ ! colspan="4" | |- |'''Effects of benzodiazepines''' |'''Benzodiazepines commonly prescribed''' |'''Clinical aspect of benzodiazepines''' |'''Routes''' |- | * Sedative effects * Hypnotic effects * Anxiolytic effects | * Alprazolam * Lorazepam * Temazepam * Diazepam * Midazolam and more | * Anxiety * Seizure * Insomnia * Panic attack * Before procedure (surgery) * Alcohol withdrawal | * IV - intravenous * IM - intramuscular * Rectal - through anus * Oral - through mouth |} {{tip|Suggestions for this section: * For the [[Motivation and emotion/Assessment/Topic|topic development]], provide at least 3 bullet-points about key content per section. Include key citations. * For the [[Motivation and emotion/Assessment/Chapter|book chapter]], expand the bullet points into paragraphs. * If a section has a lot of content, arrange it into two to five sub-headings such as in the [[#Interactive learning features|interactive learning features section]]. Avoid having sections with only one sub-heading. }} == What is emotion? == Emotion is very complex patterns of reaction which involved behavioural, psychological, biological, physiological and environmental elements. It's the way people response to their environment or stimuli based on their experiences, perceptions or cultural understanding. According Charles Darwin, emotion is innate in all species, humans and animals all have emotions, for example a baby cry when their mother living and happy when she come back or dog back when show stranger. Benzodiazepines are prescribed to help patients that struggles with negatives emotions and its purpose is to calm and relax patients especially anxiety, panic disorder and insomnia ( difficulty sleeping). == What is the effects of benzodiazepines on emotions == * Impaired threat processing * Generalised fear of threat * Reduce total alertness response * Lack of ability to recognised facial expressions ==== Effects of benzodiazepines on behavioural and neurophysiological aspects ==== * Impaired psychomotor activities and motor control * Impaired memory functions especially working and verbal memory * Decreased alertness on environmental threat * Increased reaction times as well as decrease reaction time when for BNZ * Driving impairments ( Stone, Corea, Brown, Spurgin, Stikic, Johnson, & Berka, 2015) ===== Effects of BZD on social cognition ===== * Activities in amygdala reduce - this part of the brain is responsible in guiding behaviour and processes knowledge about vital stimuli for survival. Amygdala also contributes to area of cognitive processing such as attention, memory, decision making, and research found this part of the brain critical in facial expression especially negative emotions such as fear (Adolphs, 1999). Studies also found that patients with damaged amygdala are unlikely to recognized emotions associated with fear and anger. However, benzodiazepines play critical roles by producing calming effects during endless though in the brain which are mostly negative emotions (Zald,2003). * Long-term use of BZD cause decline in cognition functioning ability (Barker, Greenwood, Jackson, & Crowe, 2004). * Reduction in emotional processing ability - * Affect motivation and emotion * Deficit in social cognition due to emotional suppression * Alleviate anxiety symptoms and improve social cognitions impairment (Haime, Watson, Crellin, Marston, Joyce, & Moncrieff, 2021). === Issues related with dependence, withdrawal and tolerance from benzodiazepines: === * Increased level of anxiety * Insomnia- difficulty with sleep or falling a sleep * Lack of appetite - lack of motivation to seek for food or eat food * Weight lose - losing weight without trying * Perception disturbance * Tremor * Irritability * Nausea * Panic attacks * Headache * Sweating * Problem with concentration (Petursson,1994). == Adverse effects of BZD == * Withdrawal * Dependence == Theories == * Darwin biological and genetic theory on emotion * Psychological cognitive theory == Recommendation for interventions == '''Cognitive behavioural therapy''' - Cognitive behavioral therapy (CBD) has been practice for many years, focuses in psychological aspects of treatment and it has been significantly effective in many areas such as anxiety disorders, depression, alcohol and drugs problems, mental problems ,eating disorder, or OCD. CBD is considered more effective than BZD because it focuses on long -term effects, help patients change their thinking patterns e.g., focusing on positive than negative aspects of the behaviour, learn health coping strategies, face the issue instead of avoiding them and help patients focus on current situation rather than the cause of the problem while BZD emphases in short-term benefits, does not tackle the issue lead to use of BZD, no  coping method and has problematic effects when instructions are not followed (Barlow, Allen, & Choate, (2016) '''Psychological therapy''' - (also known as talking therapy) It involves talking to professionals about your problems, and the therapist provide a safe environment where the therapist listen and the patients do most of the talking, it help patients understand their thoughts and behaviour, help patients come to resolution on how to manage and  recognised the symptoms of mental illness in early stage and how to seek for help (Paterson, Karatzias, Dickson, Harper, Dougall, & Hutton, (2018) '''Life styles -''' '''self-management techniques''' - Meditation - Relaxation - Exercise - Support network == conclusion == The Conclusion is arguably the most important section. It should be possible for someone to read the [[#Overview|Overview]] and the Conclusion and still get a good idea of the topic. {{tip|Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? }} ==See also== # [[wikipedia:Benzodiazepine|Benzodiazepine]] (Wikipedia) # [[Motivation and emotion/Book/2020/Methamphetamine and emotion|Methamphetamine and emotion]] (Book chapter, 2020) # [[Motivation and emotion/Book/2019/Opioid system and human emotion|Opioid system and human emotion]] (Book chapter, 2019) == '''References''' == Barlow, D. H., Allen, L. B., & Choate, M. L. (2016).Toward a unified treatment for emotional disorders–republished article. ''Behavior therapy'', ''47''(6), 838-853. https://doi.org/10.1016/j.beth.2016.11.005 Paterson, C., Karatzias, T., Dickson, A., Harper, S., Dougall, N., & Hutton, P. (2018). Psychological therapy for inpatients receiving acute mental health care: A systematic review and meta‐analysis of controlled trials. ''British Journal of Clinical Psychology'', ''57''(4), 453-472. https://doi.org/10.1111/bjc.12182 Zald, D. H. (2003). The human amygdala and the emotional evaluation of sensory stimuli. ''Brain Research Reviews'', ''41''(1), 88-123. https://doi.org/10.1111/1467-9280.00224 ==External links== * [https://www.youtube.com/watch?v=mLmfLhs0ehk Benzodiazepines (Benzos) Pharmacology: Anxiety Medication Sedative Nursing NCLEX] ( YouTube) * [https://f1000research.com/articles/11-790 Effects of concomitant benzodiazepines and antidepressants long-term use on perspective-taking] (new article on benzodiazepines and emotion) Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * [https://students.unimelb.edu.au/academic-skills/explore-our-resources/essay-writing/six-top-tips-for-writing-a-great-essay Six top tips for writing a great essay] (University of Melbourne) * [http://www.skillsyouneed.com/write/structure.html The importance of structure] (skillsyouneed.com) {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]]" 6exa27jwzhvk01w7wswy1g3z0f3k6e7 2419384 2419380 2022-08-26T07:49:37Z Ajeofula22 2947179 /* What are benzodiazepines? */ wikitext text/x-wiki {{title| Benzodiazepines and emotion:<br> What are the effects of benzodiazepines on emotion?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== [[File:Diazepam tablets.jpeg|thumb|268x268px|Figure 1. Diazepam is one of the medication categorised as benzodiazepines ]] Have you used something you believed at the time have no harm and later realised it has more risk (harm) than good? Well although many people believe benzodiazepines (BZD) can do no harms, physician have serious concern about misuse and abuse of these drugs by patients. Many doctors and psychiatrics are still wondering why benzodiazepines are still prescribe for patients despite all risk associate the drugs. BZD are mainly prescribed to patients with anxiety, panic disorder, insomnia and other emotional related disorders. This book chapter will discuss the effects of BZD on emotion, biological, cognitive, psychological aspects of BZD. Additional, book chapter will touch on pathophysiology of anxiety, theories, and interventions. {{RoundBoxTop|theme=3}} '''Focus questions:''' * What are benzodiazepines? * What roles does benzodiazepines play on emotions? * Can people management their emotions without benzodiazepines? {{RoundBoxBottom}} [[File:Benzodiazepine.svg|thumb|''Figure 2''. Description of benzodiazepines |169x169px]] ==What are benzodiazepines?== [[wikipedia:Benzodiazepine|Benzodiazepines]] (BZD) also known as CNS depressants- The purpose of BZD is to calm down the body and firing activities in the brain. Originally, the drugs are advised for short-term use due to its effectiveness. Moreover, Physicians quickly released that BZD have negative side effects but also risk of dependences, tolerances and withdrawal effects * '''Anxiety''' * '''Panic disorder''' * '''Insomnia''' * '''Other related emotional disorders''' === Pharmacological aspects of BZD and brain regions === Gamma-aminobutyric acid (GABA) also known as neurotransmitters is the primary inhibitory in the brain (central nervous system). Benzodiazepines amplifies GABA effects by inhibitory neurotransmitter (Lydiard, 2003). ==== Cerebral cortex ==== ==== Thalamus ==== ==== Limbic system ==== === Table 1. summarising the effects, commonly prescribed BZD, roles of BZD in clinical aspects and form BZD are administered. === {| class="wikitable" |+ ! colspan="4" | |- |'''Effects of benzodiazepines''' |'''Benzodiazepines commonly prescribed''' |'''Clinical aspect of benzodiazepines''' |'''Routes''' |- | * Sedative effects * Hypnotic effects * Anxiolytic effects | * Alprazolam * Lorazepam * Temazepam * Diazepam * Midazolam and more | * Anxiety * Seizure * Insomnia * Panic attack * Before procedure (surgery) * Alcohol withdrawal | * IV - intravenous * IM - intramuscular * Rectal - through anus * Oral - through mouth |} {{tip|Suggestions for this section: * For the [[Motivation and emotion/Assessment/Topic|topic development]], provide at least 3 bullet-points about key content per section. Include key citations. * For the [[Motivation and emotion/Assessment/Chapter|book chapter]], expand the bullet points into paragraphs. * If a section has a lot of content, arrange it into two to five sub-headings such as in the [[#Interactive learning features|interactive learning features section]]. Avoid having sections with only one sub-heading. }} == What is emotion? == Emotion is very complex patterns of reaction which involved behavioural, psychological, biological, physiological and environmental elements. It's the way people response to their environment or stimuli based on their experiences, perceptions or cultural understanding. According Charles Darwin, emotion is innate in all species, humans and animals all have emotions, for example a baby cry when their mother living and happy when she come back or dog back when show stranger. Benzodiazepines are prescribed to help patients that struggles with negatives emotions and its purpose is to calm and relax patients especially anxiety, panic disorder and insomnia ( difficulty sleeping). == What is the effects of benzodiazepines on emotions == * Impaired threat processing * Generalised fear of threat * Reduce total alertness response * Lack of ability to recognised facial expressions ==== Effects of benzodiazepines on behavioural and neurophysiological aspects ==== * Impaired psychomotor activities and motor control * Impaired memory functions especially working and verbal memory * Decreased alertness on environmental threat * Increased reaction times as well as decrease reaction time when for BNZ * Driving impairments ( Stone, Corea, Brown, Spurgin, Stikic, Johnson, & Berka, 2015) ===== Effects of BZD on social cognition ===== * Activities in amygdala reduce - this part of the brain is responsible in guiding behaviour and processes knowledge about vital stimuli for survival. Amygdala also contributes to area of cognitive processing such as attention, memory, decision making, and research found this part of the brain critical in facial expression especially negative emotions such as fear (Adolphs, 1999). Studies also found that patients with damaged amygdala are unlikely to recognized emotions associated with fear and anger. However, benzodiazepines play critical roles by producing calming effects during endless though in the brain which are mostly negative emotions (Zald,2003). * Long-term use of BZD cause decline in cognition functioning ability (Barker, Greenwood, Jackson, & Crowe, 2004). * Reduction in emotional processing ability - * Affect motivation and emotion * Deficit in social cognition due to emotional suppression * Alleviate anxiety symptoms and improve social cognitions impairment (Haime, Watson, Crellin, Marston, Joyce, & Moncrieff, 2021). === Issues related with dependence, withdrawal and tolerance from benzodiazepines: === * Increased level of anxiety * Insomnia- difficulty with sleep or falling a sleep * Lack of appetite - lack of motivation to seek for food or eat food * Weight lose - losing weight without trying * Perception disturbance * Tremor * Irritability * Nausea * Panic attacks * Headache * Sweating * Problem with concentration (Petursson,1994). == Adverse effects of BZD == * Withdrawal * Dependence == Theories == * Darwin biological and genetic theory on emotion * Psychological cognitive theory == Recommendation for interventions == '''Cognitive behavioural therapy''' - Cognitive behavioral therapy (CBD) has been practice for many years, focuses in psychological aspects of treatment and it has been significantly effective in many areas such as anxiety disorders, depression, alcohol and drugs problems, mental problems ,eating disorder, or OCD. CBD is considered more effective than BZD because it focuses on long -term effects, help patients change their thinking patterns e.g., focusing on positive than negative aspects of the behaviour, learn health coping strategies, face the issue instead of avoiding them and help patients focus on current situation rather than the cause of the problem while BZD emphases in short-term benefits, does not tackle the issue lead to use of BZD, no  coping method and has problematic effects when instructions are not followed (Barlow, Allen, & Choate, (2016) '''Psychological therapy''' - (also known as talking therapy) It involves talking to professionals about your problems, and the therapist provide a safe environment where the therapist listen and the patients do most of the talking, it help patients understand their thoughts and behaviour, help patients come to resolution on how to manage and  recognised the symptoms of mental illness in early stage and how to seek for help (Paterson, Karatzias, Dickson, Harper, Dougall, & Hutton, (2018) '''Life styles -''' '''self-management techniques''' - Meditation - Relaxation - Exercise - Support network == conclusion == The Conclusion is arguably the most important section. It should be possible for someone to read the [[#Overview|Overview]] and the Conclusion and still get a good idea of the topic. {{tip|Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? }} ==See also== # [[wikipedia:Benzodiazepine|Benzodiazepine]] (Wikipedia) # [[Motivation and emotion/Book/2020/Methamphetamine and emotion|Methamphetamine and emotion]] (Book chapter, 2020) # [[Motivation and emotion/Book/2019/Opioid system and human emotion|Opioid system and human emotion]] (Book chapter, 2019) == '''References''' == Barlow, D. H., Allen, L. B., & Choate, M. L. (2016).Toward a unified treatment for emotional disorders–republished article. ''Behavior therapy'', ''47''(6), 838-853. https://doi.org/10.1016/j.beth.2016.11.005 Paterson, C., Karatzias, T., Dickson, A., Harper, S., Dougall, N., & Hutton, P. (2018). Psychological therapy for inpatients receiving acute mental health care: A systematic review and meta‐analysis of controlled trials. ''British Journal of Clinical Psychology'', ''57''(4), 453-472. https://doi.org/10.1111/bjc.12182 Zald, D. H. (2003). The human amygdala and the emotional evaluation of sensory stimuli. ''Brain Research Reviews'', ''41''(1), 88-123. https://doi.org/10.1111/1467-9280.00224 ==External links== * [https://www.youtube.com/watch?v=mLmfLhs0ehk Benzodiazepines (Benzos) Pharmacology: Anxiety Medication Sedative Nursing NCLEX] ( YouTube) * [https://f1000research.com/articles/11-790 Effects of concomitant benzodiazepines and antidepressants long-term use on perspective-taking] (new article on benzodiazepines and emotion) Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * [https://students.unimelb.edu.au/academic-skills/explore-our-resources/essay-writing/six-top-tips-for-writing-a-great-essay Six top tips for writing a great essay] (University of Melbourne) * [http://www.skillsyouneed.com/write/structure.html The importance of structure] (skillsyouneed.com) {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]]" gz694rzg8tg5836vpq7z4xcjvba21vt 2 285935 2419412 2413027 2022-08-26T08:46:21Z Ajeofula22 2947179 /* Facts about me: */ wikitext text/x-wiki == About me == Hi, I am Grace. Currently studying '''[[wikipedia:Psychology|psychology]]''' at ''[https://www.canberra.edu.au/ University of Canberra]'' === Facts about me: === * I started my course in Queensland at Griffith university in gold coast before moving here in 2019 * I first wanted to be a nurse and attained a diploma in nursing. I decided to study psychology because during my final placement I learned that I can not stand looking at the blood for long. * I have worked in aged care, disability, hospitality and currently working in Canberra hospital. == Book Chapter I'm working on == Studying [[Motivation and emotion]] [[Motivation and emotion/Book/2022/Benzodiazepines and emotion|Benzodiazepines and emotion]] - what are the effects of benzodiazepines on emotions? == Hobbies == # Evening walk # Catching up with friends # [[wikipedia:Cooking|Cooking]] == social contributions == o2w1z7d9avkrawwf1jauiiwbes4qk8v 2419413 2419412 2022-08-26T08:47:26Z Ajeofula22 2947179 /* About me */ wikitext text/x-wiki == About me == Hi, I am Grace. Currently studying '''[[wikipedia:Psychology|psychology]]''' at ''[https://www.canberra.edu.au/ University of Canberra]'' '''Facts about me:''' * I started my course in Queensland at Griffith university in gold coast before moving here in 2019 * I first wanted to be a nurse and attained a diploma in nursing. I decided to study psychology because during my final placement I learned that I can not stand looking at the blood for long. * I have worked in aged care, disability, hospitality and currently working in Canberra hospital. == Book Chapter I'm working on == Studying [[Motivation and emotion]] [[Motivation and emotion/Book/2022/Benzodiazepines and emotion|Benzodiazepines and emotion]] - what are the effects of benzodiazepines on emotions? == Hobbies == # Evening walk # Catching up with friends # [[wikipedia:Cooking|Cooking]] == social contributions == nzue22xahev29go1g0z1vdefw9st5pk 2419419 2419413 2022-08-26T08:57:33Z Ajeofula22 2947179 /* About me */ wikitext text/x-wiki == About me == Hi, I am Grace. Currently studying '''[[wikipedia:Psychology|psychology]]''' at ''[https://www.canberra.edu.au/ University of Canberra]'' '''Facts about me:''' * I started my course in Queensland at Griffith university in gold coast before moving here in 2019 * I first wanted to be a nurse and attained a diploma in nursing. I decided to study psychology because during my final placement I learned that I can not stand looking at the blood for long. * I have worked in aged care, disability, hospitality and currently working in Canberra hospital. == Book Chapter I'm working on == Studying [[Motivation and emotion]] [[Motivation and emotion/Book/2022/Benzodiazepines and emotion|Benzodiazepines and emotion]] - what are the effects of benzodiazepines on emotions? == Hobbies == # Evening walk # Catching up with friends # [[wikipedia:Cooking|Cooking]] == social contribution == s75w0t4dkkuuyehrgki9x3gkhihins0 2419424 2419419 2022-08-26T09:05:10Z Ajeofula22 2947179 /* social contribution */ hyperlink wikitext text/x-wiki == About me == Hi, I am Grace. Currently studying '''[[wikipedia:Psychology|psychology]]''' at ''[https://www.canberra.edu.au/ University of Canberra]'' '''Facts about me:''' * I started my course in Queensland at Griffith university in gold coast before moving here in 2019 * I first wanted to be a nurse and attained a diploma in nursing. I decided to study psychology because during my final placement I learned that I can not stand looking at the blood for long. * I have worked in aged care, disability, hospitality and currently working in Canberra hospital. == Book Chapter I'm working on == Studying [[Motivation and emotion]] [[Motivation and emotion/Book/2022/Benzodiazepines and emotion|Benzodiazepines and emotion]] - what are the effects of benzodiazepines on emotions? == Hobbies == # Evening walk # Catching up with friends # [[wikipedia:Cooking|Cooking]] == social contribution == [https://en.wikiversity.org/w/index.php?title=Motivation_and_emotion/Book/2020/Action_identification_theory&diff=prev&oldid=2419327 Added colon on the topic] cqui323qtx8bbi38lsyhwrjjv6l9tzk 2419428 2419424 2022-08-26T09:06:09Z Ajeofula22 2947179 /* social contribution */ wikitext text/x-wiki == About me == Hi, I am Grace. Currently studying '''[[wikipedia:Psychology|psychology]]''' at ''[https://www.canberra.edu.au/ University of Canberra]'' '''Facts about me:''' * I started my course in Queensland at Griffith university in gold coast before moving here in 2019 * I first wanted to be a nurse and attained a diploma in nursing. I decided to study psychology because during my final placement I learned that I can not stand looking at the blood for long. * I have worked in aged care, disability, hospitality and currently working in Canberra hospital. == Book Chapter I'm working on == Studying [[Motivation and emotion]] [[Motivation and emotion/Book/2022/Benzodiazepines and emotion|Benzodiazepines and emotion]] - what are the effects of benzodiazepines on emotions? == Hobbies == # Evening walk # Catching up with friends # [[wikipedia:Cooking|Cooking]] == social contribution == * [https://en.wikiversity.org/w/index.php?title=Motivation_and_emotion/Book/2020/Action_identification_theory&diff=prev&oldid=2419327 Added colon on the topic] rhcvm6eyndslebkzi0lbceerq4xer0n 2419429 2419428 2022-08-26T09:08:33Z Ajeofula22 2947179 /* Hobbies */ hyperlink wikitext text/x-wiki == About me == Hi, I am Grace. Currently studying '''[[wikipedia:Psychology|psychology]]''' at ''[https://www.canberra.edu.au/ University of Canberra]'' '''Facts about me:''' * I started my course in Queensland at Griffith university in gold coast before moving here in 2019 * I first wanted to be a nurse and attained a diploma in nursing. I decided to study psychology because during my final placement I learned that I can not stand looking at the blood for long. * I have worked in aged care, disability, hospitality and currently working in Canberra hospital. == Book Chapter I'm working on == Studying [[Motivation and emotion]] [[Motivation and emotion/Book/2022/Benzodiazepines and emotion|Benzodiazepines and emotion]] - what are the effects of benzodiazepines on emotions? == Hobbies == # Evening walk # Catching up with [[wikipedia:Friendship|friends]] # [[wikipedia:Cooking|Cooking]] == social contribution == * [https://en.wikiversity.org/w/index.php?title=Motivation_and_emotion/Book/2020/Action_identification_theory&diff=prev&oldid=2419327 Added colon on the topic] 6yocpqco68onqvipjurme7ejb8lksja 0 286001 2419457 2418212 2022-08-26T09:47:24Z 210.50.97.127 links wikitext text/x-wiki {{title|Humour, leadership, and work:<br>How does Humour influence workplace motivation?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== You are underway {{smile}}! This template provides tips for [[Motivation and emotion/Assessment/Topic|topic development]]. Gradually remove these suggestions as you develop the chapter. Also consult the [[Motivation and emotion/Assessment/Chapter|author guidelines]]. At the top of the chapter, the title and sub-title should match the ''exact'' wording and casing as shown in the {{Motivation and emotion/Book}}. The sub-titles all end with a question mark. This Overview section should be concise but consist of several paragraphs which engage the reader, illustrate the problem, and outline how psychological science can help. Why do we laugh and how and why does this laughter often move us to action? * Humour is an essential part of living for many living creatures, being a pro-socially evolved behaviour that reduces stress * Humor is a tool by which social actors attempt to achieve functional ends * However why we laugh and why it motivates us continues to largely be studied by philosophical fields * in comparison Humour is a relatively small field of research ( comparatively to Motivation studies) * As we will discuss further humour is used as an appeal to increase (and sometimes decrease) motivation for many types of behaviours {{RoundBoxTop|theme=3}} '''Focus questions:''' * How are Humour and motivation linked? * How does leadership humour increase motivation * Criticism of Humour use in the workplace {{RoundBoxBottom}} [[File:Workplace Humour Helps.png|thumb|''Figure 1.'' Humour Helps in a workplace ]] {{tip| Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Provide an example or case study. * Conclude with Focus questions to guide the chapter. }} = Humour, Motivation and Leadership = == Humour and Motivation: Background == === History: === * [[wikipedia:Humor_research|Humor_research]] (relatively new field of research) that encompasses linguistics, history and literature around the benefits of Humour * Humour as a motivator one of the primary research areas * wealth of literature social and clinical/health perspectives: observation of Humour as a social tool for people to achieve their goals (Foot 1986, as cited in Brooks,1992 ) and as stress relief for both patients and health practitioners (Cohen., 2001, Wanzer et al., 2005) * affiliative and self-enhancing humour are the two adaptive styles (Martin et al., 2003) === Types of Humour === * affiliative humour is used to strengthen interpersonal relationships or ease tensions within those relationships. * Self-enhancing humour involves the use of a humorous outlook on situations in life as a coping tool. Used to relieve stress without hurting others == Leadership humour == * Leadership Humour is a style of humour == Leadership Humour and workplace Morale == === Teaching environments: === * teachers who work in elementary schools and high schools state that school managers use frequently the sense of affirmative humour- * Affirmative and social humour directed from management linked towards a motivation increase in teachers (Akyol & Gündüz, 2014b) === Job Satisfaction/Motivation: === <blockquote>"Leader humour has been found to help establish high-quality relationships between leaders and followers" (Pundt and Herrmann, 2014) </blockquote> == Criticism of Humour as a form of motivation. == === Affirmative vs negative Humour: === * Humour indicates a social goal which can be linked to malicious creativity and workplace bullying (Perchtold-Stefan et al., 2020) ==== Appropriateness of Humour: ==== * Sincerity plays a key role in developing trust with employees- A humourless boss should not attempt to force humour * Humour needs to be appropriate for the context == Future Research == === Leadership humour: === === Workplace Research: === * Research needed into physical and psychological effects of Humour in the workplace * The limit to affirmative humour and physical effects at work Aim for three to six main headings between the [[#Overview|Overview]] and [[#Conclusion|Conclusion]]. {{tip|Suggestions for this section: * For the [[Motivation and emotion/Assessment/Topic|topic development]], provide at least 3 bullet-points about key content per section. Include key citations. * For the [[Motivation and emotion/Assessment/Chapter|book chapter]], expand the bullet points into paragraphs. * If a section has a lot of content, arrange it into two to five sub-headings such as in the [[#Interactive learning features|interactive learning features section]]. Avoid having sections with only one sub-heading. }} ==Learning features== What brings an online book chapter to life are its interactive learning features. Case studies, feature boxes, figures, links, tables, and quiz questions can be used throughout the chapter. ===Case studies=== Case studies describe real-world examples of concepts in action. Case studies can be real or fictional. A case could be used multiple times during a chapter to illustrate different theories or stages. It is often helpful to present case studies using [[#Feature boxes|feature boxes]]. ===Boxes=== Boxes can be used to highlight content, but don't overuse them. There are many different ways of creating boxes (e.g., see [[Help:Pretty boxes|Pretty boxes]]). Possible uses include: * Focus questions * Case studies or examples * Quiz questions * Take-home messages {{RoundBoxTop|theme=3}} ;Feature box example * Shaded background * Coloured border {{RoundBoxBottom}} ===Figures=== [[File:Monkey-typing.jpg|right|205px|thumb|''Figure 1''. Example image with descriptive caption.]] Use figures to illustrate concepts, add interest, and provide examples. Figures can be used to show photographs, drawings, diagrams, graphs, etcetera. Figures can be embedded throughout the chapter, starting with the Overview section. Figures should be captioned (using a number and a description) in order to explain their relevance to the text. Possible images can be found at [[commons:|Wikimedia Commons]]. Images can also be uploaded if they are licensed for re-use or if you created the image. Each figure should be referred to at least once in the main text (e.g., see Figure 1). ===Links=== Where key words are first used, make them into [[Help:Links|interwiki links]] such as Wikipedia links to articles about famous people (e.g., [[w:Sigmund Freud|Sigmund Freud]] and key concepts (e.g., [[w:Dreams|dreams]]) and links to book chapters about related topics (e.g., would you like to learn about how to overcome [[Motivation and emotion/Book/2020/Writer's block|writer's block]]?). ===Tables=== Tables can be an effective way to organise and summarise information. Tables should be captioned (using APA style) to explain their relevance to the text. Plus each table should be referred to at least once in the main text (e.g., see Table 1 and Table 2). Here are some [[Motivation and emotion/Wikiversity/Tables|example 3 x 3 tables]] which could be adapted. ===Quizzes=== Quizzes are a direct way to engage readers. But don't make quizzes too hard or long. It is better to have one or two review questions per major section than a long quiz at the end. Try to quiz conceptual understanding, rather than trivia. Here are some simple quiz questions which could be adapted. Choose the correct answers and click "Submit": <quiz display=simple> {Quizzes are an interactive learning feature: |type="()"} + True - False {Long quizzes are a good idea: |type="()"} - True + False </quiz> To learn about different types of quiz questions, see [[Help:Quiz|Quiz]]. ==Conclusion== The Conclusion is arguably the most important section. * Good leaders incorporate humour into there leadership style * Humour is a flexible device for potentially promoting status in a workplace or relieving tension with staff members * However Humour can be used maliciously. It needs to be used respectfully and under appropriate contexts for increased morale ==See also== * (https://en.wikipedia.org/wiki/Humor_research) {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== {{Hanging indent|1= Akyol, M. E., & Gündüz, H. B. (2014). The Motivation Level of the Teachers According to the School Managers’ Senses of Humour. Procedia - Social and Behavioral Sciences, 152, 205–213. https://doi.org/10.1016/j.sbspro.2014.09.182 Cohen, M. (2001). Happiness and humour: a medical perspective. Australian Family Physician, 30(1), 17–19. https://search.informit.org/doi/10.3316/informit.387665634831006 Davis, A., & Kleiner, B. H. (1989). The value of humour in effective leadership. Leadership & Organization Development Journal, 10(1), i–iii. Pundt, A., & Herrmann, F. (2014). Affiliative and aggressive humour in leadership and their relationship to leader-member exchange. Journal of Occupational and Organizational Psychology, 88(1), 108–125. https://doi.org/10.1111/joop.12081 WANZER, M., BOOTH-BUTTERFIELD, M., & BOOTH-BUTTERFIELD, S. (2005). “If We Didn’t Use Humor, We’d Cry”: Humorous Coping Communication in Health Care Settings. Journal of Health Communication, 10(2), 105–125. https://doi.org/10.1080/10810730590915092 Jin Yoon, H., & Mark Mayer, J. (2014). Do humour and threat work well together? International Journal of Advertising, 33(4), 725–740. https://doi.org/10.2501/ija-33-4-725-740 Daman, Stuart Jenkins, "The Influence of Humor on Approach and Avoidance Motivation" (2008). ETD Archive. 585. https://engagedscholarship.csuohio.edu/etdarchive/585 Ronglan, L. T., & Aggerholm, K. (2014). ‘Humour helps’: Elite sports coaching as a balancing act. Sports Coaching Review, 3(1), 33–45. https://doi.org/10.1080/21640629.2014.885776 }} {{tip|Suggestions for this section: * Important aspects for APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except first letter and proper names, ending in a full-stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full-stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't actually read or consulted }} ==External links== Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * [https://search.informit.org/doi/abs/10.3316/meditext.387628368888489?casa_token=TJnTNsFPQkMAAAAA%3AxK6DIdJ_LrESAGmtIBU-yDkPCXjDzYCSMJupks0HjbzIUXHBVu3PlzSzrR4wQKO4svDPe9dGFQ6Wdw How humour keeps you well] * [https://eric.ed.gov/?id=ED417113 Humor in Leadership: State of the Art in Theory and Practice.] * [https://search.informit.org/doi/10.3316/informit.387665634831006 Happiness and humour: a medical perspective] * [https://english.ahram.org.eg/News/473725.aspx Let there be humour] * [https://metro.co.uk/2022/08/02/workplace-productivity-rises-when-people-feel-they-can-show-emotions-17112840/ Employees feel more productive when they can show their emotions at work, says research] {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] __FORCETOC__ rni45dzacpm9wfm05yuucnp3ur6pelj 0 286004 2419227 2418999 2022-08-26T03:08:25Z U3227354 2947625 wikitext text/x-wiki {{title|Inspiration:<br>What is inspiration, what causes it, what are its consequences, and how can it be fostered?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== This chapter focuses on defining inspiration to have a greater understanding of why and how it occurs. In order to understand inspiration and how it occurs, both biological and psychological perspectives are required to create a combined definition. The importance of understanding inspiration and how it occurs can be advantageous for personal gain and self growth, due to the benefits of adapting to an inspiration-seeking lifestyle. '''Learning Outcomes''' * Define and discuss inspiration and how it occurs, with special mention of the impacts on everyday life * Define the difference between passive and active inspiration * Learn how to undertake an inspiration-seeking lifestyle * Discuss theories and previous research on inspiration. {{RoundBoxTop|theme=3}} '''Focus questions:''' * What is Inspiration? * What causes it? * What are its consequences? * How can it be fostered? {{RoundBoxBottom}} ==Inspiration == * Received little attention within psychological research * Inspiration is a tool created by self, used for personal gain (Thrash et al , 2014). * Inspiration is most commonly formed by mental stimulation from environmental factors such as sounds as smells which induce new ideas or feelings in one's self (Thrash et al , 2014). * Relies on other factors such as motivation and transcendence === Passive Inspiration === * Consumption of ideas and contributions of others for personal gain/growth (Hymer, 1990) * Watching others * Watching videos and other visual creations to become inspired * Not as long lasting as active inspiration [[File:Mahatma Gandhi Portrayal.jpg|thumb|Mahatma Gandhi (1869 - 1948) has been used by many, such as world leaders and scientist as a source of inspiration. ]] === Active Inspiration === * Formed by creating new things * Making mistakes and learning new ways to fix the mistakes can contribute to active inspiration (Hymer, 1990) * Results of actions, not the causes of them * Taking action causes longer lasting inspiration * Lasts longer than passive inspiration ==Inspiration Theories== Case studies describe real-world examples of concepts in action. Case studies can be real or fictional. A case could be used multiple times during a chapter to illustrate different theories or stages. It is often helpful to present case studies using [[#Feature boxes|feature boxes]]. == Biological Perspective == * Are we born with the capabilities of becoming inspired? * Are individuals genetically prone to becoming more or less inspired than others * Where in our brain does inspiration come from * {{RoundBoxTop|theme=3}} ;Feature box example * Shaded background * Coloured border {{RoundBoxBottom}} == Psychological Perspective == * == Differences Between Inspiration and Motivation == * Inspiration lasts longer as compared to motivation * Motivation is seen as coming from the outside (environment), whereas inspiration is from within ones self * Inspiration is also seen as being spontaneous whereas motivation as more deliberate * Motivation can be caused by expectations and obligations, but inspiration is naturally occurring ===Links=== Where key words are first used, make them into [[Help:Links|interwiki links]] such as Wikipedia links to articles about famous people (e.g., [[w:Sigmund Freud|Sigmund Freud]] and key concepts (e.g., [[w:Dreams|dreams]]) and links to book chapters about related topics (e.g., would you like to learn about how to overcome [[Motivation and emotion/Book/2020/Writer's block|writer's block]]?). ===Tables=== Tables can be an effective way to organise and summarise information. Tables should be captioned (using APA style) to explain their relevance to the text. Plus each table should be referred to at least once in the main text (e.g., see Table 1 and Table 2). Here are some [[Motivation and emotion/Wikiversity/Tables|example 3 x 3 tables]] which could be adapted. ===Revision Quizz=== Quizzes are a direct way to engage readers. But don't make quizzes too hard or long. It is better to have one or two review questions per major section than a long quiz at the end. Try to quiz conceptual understanding, rather than trivia. Here are some simple quiz questions which could be adapted. Choose the correct answers and click "Submit": <quiz display=simple> {Quizzes are an interactive learning feature: |type="()"} + True - False {Long quizzes are a good idea: |type="()"} - True + False </quiz> To learn about different types of quiz questions, see [[Help:Quiz|Quiz]]. ==Conclusion== The Conclusion is arguably the most important section. It should be possible for someone to read the [[#Overview|Overview]] and the Conclusion and still get a good idea of the topic. {{tip|Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? }} ==See also== * [[Motivation and emotion/Book/2011/Work motivation and work satisfaction]] (Motivation and emotion book, 2011) * https://en.wikipedia.org/wiki/Artistic_inspiration (Wikipedia) * [[Motivation and emotion/Book/2011/Exercise motivation]] (Motivation and emotion book, 2011) * {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== {{Hanging indent|1= Hymer, S. (1990). On inspiration. The Psychotherapy Patient, 6(3-4), 17-38. https://doi.org/10.1300/J358v06n03_02 Thrash, T.M., Moldovan, E.G., Oleynick, V.C. and Maruskin, L.A. (2014), The Psychology of Inspiration. Social and Personality Psychology Compass, 8: 495-510. https://doi.org/10.1111/spc3.12127 }} {{tip|Suggestions for this section: * Important aspects for APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except first letter and proper names, ending in a full-stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full-stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't actually read or consulted }} ==External links== Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * [https://www.verywellmind.com/great-psychology-quotes-2795695#:~:text=%206%20Great%20Psychology%20Quotes%20%201%20Maslow%3A,to%20start%20to%20feel%20pessimistic%20about...%20More%20 6 Great Inspirational Psychology Quotes - Inspiration From Psychology's Best-Known Thinkers] (verywellmind.com) {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] [[Category:Motivation and emotion/Book/Motivation]] [[Category:Motivation and emotion/Book/Positive psychology]] lriqxhtu75p74phs65emghr9fw4d37s 0 286009 2419216 2418231 2022-08-26T02:56:20Z Lturner2311 2947525 Added headings and added space for idea building wikitext text/x-wiki {{title|Time and motivation:<br>What is the effect of time on motivation?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== * Brief description of the topic * A This chapter focuses on the effect of time on motivation.{{RoundBoxTop|theme=3}} '''Focus questions:''' * What is the first focus question? * What is the second focus question? * What is the third focus question? {{RoundBoxBottom}} {{tip| Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Provide an example or case study. * Conclude with Focus questions to guide the chapter. }} ==What is Time?== * Idea One * Idea Two == What is Motivation? == * Idea One * Idea Two == The Effect of Time on Motivation == * Idea One * Idea Two == Procrastination and its effect on Time Management == * Idea One * Idea Two == Heading Five == * Idea One * Idea Two == Heading Six == * Idea One * Idea Two {{tip|Suggestions for this section: * For the [[Motivation and emotion/Assessment/Topic|topic development]], provide at least 3 bullet-points about key content per section. Include key citations. * For the [[Motivation and emotion/Assessment/Chapter|book chapter]], expand the bullet points into paragraphs. * If a section has a lot of content, arrange it into two to five sub-headings such as in the [[#Interactive learning features|interactive learning features section]]. Avoid having sections with only one sub-heading. }} ==Learning features== What brings an online book chapter to life are its interactive learning features. Case studies, feature boxes, figures, links, tables, and quiz questions can be used throughout the chapter. ===Case studies=== Case studies describe real-world examples of concepts in action. Case studies can be real or fictional. A case could be used multiple times during a chapter to illustrate different theories or stages. It is often helpful to present case studies using [[#Feature boxes|feature boxes]]. ===Boxes=== Boxes can be used to highlight content, but don't overuse them. There are many different ways of creating boxes (e.g., see [[Help:Pretty boxes|Pretty boxes]]). Possible uses include: * Focus questions * Case studies or examples * Quiz questions * Take-home messages {{RoundBoxTop|theme=3}} ;Feature box example * Shaded background * Coloured border {{RoundBoxBottom}} ===Figures=== [[File:Monkey-typing.jpg|right|205px|thumb|''Figure 1''. Example image with descriptive caption.]] Use figures to illustrate concepts, add interest, and provide examples. Figures can be used to show photographs, drawings, diagrams, graphs, etcetera. Figures can be embedded throughout the chapter, starting with the Overview section. Figures should be captioned (using a number and a description) in order to explain their relevance to the text. Possible images can be found at [[commons:|Wikimedia Commons]]. Images can also be uploaded if they are licensed for re-use or if you created the image. Each figure should be referred to at least once in the main text (e.g., see Figure 1). ===Links=== Where key words are first used, make them into [[Help:Links|interwiki links]] such as Wikipedia links to articles about famous people (e.g., [[w:Sigmund Freud|Sigmund Freud]] and key concepts (e.g., [[w:Dreams|dreams]]) and links to book chapters about related topics (e.g., would you like to learn about how to overcome [[Motivation and emotion/Book/2020/Writer's block|writer's block]]?). ===Tables=== Tables can be an effective way to organise and summarise information. Tables should be captioned (using APA style) to explain their relevance to the text. Plus each table should be referred to at least once in the main text (e.g., see Table 1 and Table 2). Here are some [[Motivation and emotion/Wikiversity/Tables|example 3 x 3 tables]] which could be adapted. ===Quizzes=== Quizzes are a direct way to engage readers. But don't make quizzes too hard or long. It is better to have one or two review questions per major section than a long quiz at the end. Try to quiz conceptual understanding, rather than trivia. Here are some simple quiz questions which could be adapted. Choose the correct answers and click "Submit": <quiz display=simple> {Quizzes are an interactive learning feature: |type="()"} + True - False {Long quizzes are a good idea: |type="()"} - True + False </quiz> To learn about different types of quiz questions, see [[Help:Quiz|Quiz]]. ==Conclusion== The Conclusion is arguably the most important section. It should be possible for someone to read the [[#Overview|Overview]] and the Conclusion and still get a good idea of the topic. {{tip|Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? }} ==See also== Provide up to half-a-dozen [[Help:Contents/Links#Interwiki_links|internal (wiki) links]] to relevant Wikiversity pages (esp. related [[Motivation and emotion/Book|motivation and emotion book chapters]]) and [[w:|Wikipedia articles]]. For example: * [[Motivation and emotion/Book/2016/Anorexia nervosa and extrinsic motivation|Anorexia nervosa and extrinsic motivation]] (Book chapter, 2016) * [[w:David McClelland|David McClelland]] (Wikipedia) * [[Motivation and emotion/Book/2018/Loss aversion|Loss aversion]] (Book chapter, 2018) * [[w:Maslow's hierarchy of needs|Maslow's hierarchy of needs]] (Wikipedia) {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== List the cited references in [[w:APA style|APA style]] (7th ed.) or [[w:Wikipedia:Citing sources|wiki style]]. APA style example: {{Hanging indent|1= Blair, R. J. R. (2004). The roles of orbital frontal cortex in the modulation of antisocial behavior. ''Brain and Cognition'', ''55''(1), 198–208. https://doi.org/10.1016/S0278-2626(03)00276-8 Buckholtz, J. W., & Meyer-Lindenberg, A. (2008). MAOA and the neurogenetic architecture of human aggression. ''Trends in Neurosciences'', ''31''(3), 120–129. https://doi.org/10.1016/j.tins.2007.12.006 Eckardt, M., File, S., Gessa, G., Grant, K., Guerri, C., Hoffman, P., & Tabakoff, B. (1998). Effects of moderate alcohol consumption on the central nervous system. ''Alcoholism, Clinical and Experimental Research'', ''22''(5), 998–1040. https://doi.org/10.1111/j.1530-0277.1998.tb03695.x }} {{tip|Suggestions for this section: * Important aspects for APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except first letter and proper names, ending in a full-stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full-stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't actually read or consulted }} ==External links== Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * [https://students.unimelb.edu.au/academic-skills/explore-our-resources/essay-writing/six-top-tips-for-writing-a-great-essay Six top tips for writing a great essay] (University of Melbourne) * [http://www.skillsyouneed.com/write/structure.html The importance of structure] (skillsyouneed.com) {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] [[Category:Motivation and emotion/Book/Time]] nzk4t1h030lnt71pg0fpaaptjabmkto 0 286014 2419383 2418950 2022-08-26T07:47:41Z Sebastian Armstrong 2947157 /* External links */ Added "External links" wikitext text/x-wiki {{title|Fully functioning person:<br>What is a FFP and how can full functioning be developed?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ == Overview == ;Focus questions *What it is? # '''Increasing openness to experience''' – Owning and accepting experiences as your own without a defensive barrier. # '''Increasingly existential living''' – Living in the moment without falsely distorting your perceptions or actions to fit how it 'should' be. # '''An increasing trust in their organism''' – trusting your gut and instinct without relying on social norms or external criteria of behaviour. # '''The process of functioning more fully''' – <blockquote>not being shackled by the restrictions that influence an incongruent individual; able to make a wider range of choices more fluently. Belief that one plays a role in determining one's behaviour and so feel responsible for one's own behaviour. # '''Creativity''' – feeling more free to be creative. Also more creative in the way one adapts to one's circumstances without feeling a need to conform. # '''Reliability and constructiveness''' – can be trusted to act constructively. An individual who is open to all his/her needs will be able to maintain a balance between them. Even aggressive needs will be matched and balanced by intrinsic goodness in congruent individuals. # '''A rich full life''' – the life of a fully functioning individual is rich, full and exciting; they experience joy and pain, love and heartbreak, fear and courage more intensely. Rogers' description of ''the good life'': </blockquote> *How it is developed? Rogers (1959) sugestted that people have an actualizing tendency toward development, growth and autonomy:<blockquote>This is the inherent tendency of the organism to develop all its capacities in ways which serve to maintain or enhance the organism. It involves not only the tendency to meet what Maslow (1954) terms “deficiency needs” for air, food, water, and the like, but also more generalized activities. It involves development toward the differentiation of organs and of functions, expansion in terms of growth, expansion of effectiveness through the use of tools, expansion and enhancement through reproduction. It is development toward autonomy and away from heteronomy, or control by external forces. (p. 196)</blockquote> *Whose theory is it? *How it is used? == History == === Pre-Rogers === Socrates suggests that everything has a specific function, which he defines as what that thing does best or the only thing it can do (Korsgaard, 2008). The ancient Greek's worldview suggested that, a person could only be called 'good' if their soul was in peak condition. According to Aristotle (1996), we can only know if something is good if we understand its function. He continued this theory to human nature, concluding that by performing virtuous activities of the soul, one can achieve the hight of human goodness. The concept of a soul has vanished in modern psychology, and the notion of virtue has evolved. However, the concept that goodness and functionality are linked was adopted by the first wave of humanistic psychology, most notably by Carl Rogers (Straume, 2020). === Carl Rogers === [[File:Carl Rogers.jpg|thumb|Figure 1. Carl Rogers|alt=Artist rendition of Carl Rogers]] The person-centered approach, often known as client-centered therapy, is Carl R. Rogers' method for assisting people who are dealing with a variety of personal disturbances or issues in their daily lives (Rogers, 1959; 1961; 1969; 1970; 1972; 1980; 1986). In 1939, Rogers created his theory of psychotherapy for troubled kids (Witty, 2007). Later, he broadened his theoretical framework to cover work with groups, families, and couples. His most complete theoretical statement, which covers his theories of motivation and personality development as well as those of group interaction and interpersonal interactions, was published as a chapter in Sigmund Koch's Psychology: A Study of a Science (Vol. III) in 1959. (Koch, 1959, 184–256). === Explore 7 points of FFP === === FFP - What is it/why it exists === === How do you develop FFP === == Clinical Use == === What is it used for? === <blockquote>Rogers (1959) noted several changes customarily associated with outcomes or results experienced by a person becoming more fully functioning, which are observed outside of the therapeutic relationship. The following changes were hypothesized as being relatively permanent:</blockquote> # Being more congruent, open to experience, and less defensive # Having improved psychological adjustment # Having an increased degree of positive self-regard # Perceiving the locus of evaluation and the locus of choice as residing within oneself # Experiencing more acceptance of others<blockquote>Consequences or results of the above changes:</blockquote> # More realistic, objective, extensional in perceptions, and more effective in problem solving # Less vulnerable to threat # More confident and self-directing # Values are determined by an OVP # Perceive others more realistically and accurately # Behaviors “owned” by the self are increased and those disowned as “not myself” are decreased # Behavior is perceived as being more within control, socialized, mature, creative, uniquely adaptive to new situations and problems, and fully expressive of own purpose and values Proctor C, Tweed R, Morris D. The Rogerian Fully Functioning Person: A Positive Psychology Perspective. Journal of Humanistic Psychology. 2016;56(5):503-529. doi:10.1177/0022167815605936 === How? === <blockquote>Empirical evidence also provides support of the hypothesis that more fully functioning persons move in a direction of increasing openness to experience. Rogers (1961) considered openness to experience to be the polar opposite of defensiveness. Defensiveness is “the organism’s response to experiences which are perceived or anticipated as threatening, as incongruent with the individual’s existing picture of himself, or of himself in relationship to the world” (Rogers, 1961, p. 187)</blockquote> === Case study === == Non-Clinical Use == === What areas could benifit from FFP === === Case study === == Challenges == https://www.jstor.org/stable/pdf/42573871.pdf?refreqid=excelsior%3Af77be98a01ac999d2f3e3866397ffe3d&ab_segments=&origin=&acceptTC=1 === Western perspective === There are criticisms of the fully functioning person that it is a product of primarily Western culture. Since in other cultures, Eastern cultures for example, the groups achievements are valued higher than those of any individual. === Enviromental influences === == Related Theories == === Self actualisation === === Humanistic Psychology === === Client Centered Psychology === == Conclusion == == See also == [[Motivation and emotion/Textbook/Motivation/Self-actualisation|https://en.wikiversity.org/wiki/Motivation_and_emotion/Textbook/Motivation/Self-actualisation]] [[Motivation and emotion/Tutorials/Growth psychology|https://en.wikiversity.org/wiki/Motivation_and_emotion/Tutorials/Growth_psychology]] == References == {{Hanging indent|1= Aristotle. (1996). The Nicomachean ethics (trans: Ross, W. D.). Wordsworth Editions Limited. Ware: UK. Koch, Sigmund. (Series Ed.), & Koch, S. (Vol. Ed.). (1959). Psychology: A study of a science (Vol. 3). New York: McGraw-Hill. Korsgaard, C. M. (2008). The constitution of agency: Essays on practical reason and moral psychology. Oxford: Oxford University Press. Rogers, C. R. (1959). A theory of therapy, personality, and interpersonal relationships as developed in the client-centered framework. In S. Koch (Series Ed.) & S. Koch (Vol. Ed.), Psychology: A study of a science (Vol. 3, pp. 184–256). New York: McGraw Hill. Rogers, C. R. (1961). On becoming a person. Boston: Houghton Mifflin. Rogers, C. R. (1969). Freedom to learn. Columbus, Ohio: Charles E. Merrill. Rogers, C. R. (1970). Carl Rogers on encounter groups. New York: Harper and Row. Rogers, C. R. (1972). Becoming partners: Marriage and its alternatives. New York: Dell. Rogers, C. R. (1980). Empathic: An unappreciated way of being. In A way of being (pp. 137–163). Boston: Houghton Mifflin. Rogers, C. R. (1986). Client-centered approach to therapy. In I. L. Kutash & A. Wolf (Eds.), Psychotherapist’s casebook: Theory and technique in practice (pp. 197–208). San Francisco: Jossey Bass. Straume, L.V., Vittersø, J. (2020). Fully Functioning Person. In: Zeigler-Hill, V., Shackelford, T.K. (eds) Encyclopedia of Personality and Individual Differences. Springer, Cham. https://doi.org/10.1007/978-3-319-24612-3_1469 Witty, M.C. (2007). Client-Centered Therapy. In: Kazantzis, N., LĽAbate, L. (eds) Handbook of Homework Assignments in Psychotherapy. Springer, Boston, MA . https://doi.org/10.1007/978-0-387-29681-4_3}} == External links == <nowiki>https://en.wikipedia.org/wiki/Carl_Rogers#The_fully_functioning_person</nowiki> <nowiki>https://en.wikipedia.org/wiki/Self-actualization</nowiki> [https://www.verywellmind.com/fully-functioning-person-2795197#:~:text=A%20fully%20functioning%20person%20is%20one%20who%20is%20continually%20working,open%20to%20life's%20many%20experiences. https://www.verywellmind.com/fully-functioning-person-2795197#:~:text=A%20fully%20functioning%20person%20is%20one%20who%20is%20continually%20working,open%20to%20life's%20many%20experiences.] == Overview == ''What is a FFP and How can full functioning be developed?''<blockquote> # <u>A growing openness to experience</u> # <u>An increasingly existential lifestyle</u> # <u>Increasing organismic trust</u> # <u>Freedom of choice</u> # <u>Creativity</u> # <u>Reliability and constructiveness</u> # <u>A rich full life</u> #* Rogers, Carl (1961). ''On becoming a person: A therapist's view of psychotherapy''. London: Constable. ISBN <bdi>978-1-84529-057-3</bdi>. </blockquote> == [[Caregiving and dementia/Topics/Person centred care|person-centered theory of personality]] == == History == <u>Both Plato and Aristotle proposed theories about goodness in which functioning worked as the most central concept. Arguments about goodness and functioning keep developing in contemporary work on human goodness. The work of Sen, Staudinger, and Tomasello serves as renowned examples. (https://doi.org/10.1007/978-3-319-24612-3_1469)</u><blockquote>Client-centered therapy, also called the person-centered approach, describes Carl R. Rogers’ way of working with persons experiencing all types of personal disturbances or problems in living (Rogers, 1959; 1961; 1969; 1970; 1972; 1980a; 1986a). As early as 1939, Rogers developed his theory of psychotherapy with troubled children, and went on to expand his theoretical approach to include work with couples, families, and groups. His most comprehensive theoretical statement was published as a chapter in Sigmund Koch’s Psychology: A Study of a Science (Vol. III) in 1959, and includes his theory of motivation and personality development, as well as theory of group interaction and interpersonal relationships (Koch, 1959, 184–256). Over his long career, Rogers extrapolated client-centered values to the education, marriage, group encounter, personal power, and conflict resolution (Rogers, 1969, 1970, 1972). Today, the person-centered approach is practiced in the United Kingdom, Germany, France, Greece, Portugal, Demark, Poland, Hungary, The Netherlands, Italy, Japan, Brazil, Mexico, Australia, and South Africa, as well as here in the United States and Canada. A world association, which can be contacted online, was founded in Lisbon in 1997 that reflects the growth and vitality of the approach entitled the World Association for Person-Centered and Experiential Psychotherapy and Counseling (WAPCEPC). Another international organization comprised of a diverse membership—lay persons, educators, business consultants, therapists, artists, psychologists—the Association for the Development of the Person-Centered Approach (ADPCA), is also accessible on the internet. Witty, M. C. (2007). Client-centered therapy. In ''Handbook of homework assignments in psychotherapy'' (pp. 35-50). Springer, Boston, MA.</blockquote><blockquote>According to Rogers, when fully functioning, the individual lives in close and confident relationship to the organismic valuing process, trusting that inner direction. Congruence is a constant companion. Furthermore, the fully functioning individual spontaneously communicates inner impulses both verbally and nonverbally. They are open to experience, accepts experiences as they are, and expresses those experiences in an unedited manner. The fully functioning individual is authentic. To characterize the moment-to-moment experience of the fully functioning individual, Figure 15.4 illustrates the sequential process of a motive’s emergence, acceptance, and unedited expression. The congruent, fully functioning individual lives in close proximity to the actualizing tendency and therefore experiences a marked sense of autonomy, openness to experience,and personal growth. Reeve, J. (2018). Understanding motivation and emotion. John Wiley & Sons.</blockquote><blockquote>The actualizing tendency was a theoretical construct proposed by the great holistic neurologist Kurt Goldstein (Goldstein, 1939; 1940, 1963). Witty, M.C. (2007). Client-Centered Therapy. In: Kazantzis, N., LĽAbate, L. (eds) Handbook of Homework Assignments in Psychotherapy. Springer, Boston, MA . <nowiki>https://doi.org/10.1007/978-0-387-29681-4_3</nowiki></blockquote> === [[Motivation and emotion/Tutorials/Growth psychology|Growth psychology]] === <blockquote>A second criticism is that humanistic theorists use a number of vague and ill-defined constructs. It is difficult to pinpoint precisely what an “organismic valuing process” and a “fully functioning individual” are, for example. Any theoretical construct that evades a precise operational definition must remain scientifically dubious. For this reason, humanistic views on motivation have been harshly criticized (Daniels,1988; Neher, 1991), and these criticisms were instrumental to the rise and eventual popularity of the more empirically driven (evidence-based) positive psychology. Reeve, J. (2018). Understanding motivation and emotion. John Wiley & Sons.</blockquote> === [[Talk:Carl Rogers]] === <blockquote></blockquote> === [[Motivation and emotion/Textbook/Motivation/Self-actualisation|Self-actualisation]] === === [[wikipedia:Abraham_Maslow|Abraham Maslow]] === == Clinical uses == <blockquote>This book explores, in depth, the link between modern psychiatric practice and the person-centred approach. It promotes an open dialogue between traditional rivals – counsellors and psychiatrists within the NHS – to assist greater understanding and improve practice. Easy to read and comprehend, it explains complex issues in a clear and accessible manner. The author is a full-time psychiatrist and qualified counsellor who offers a unique perspective drawing on personal experience. Humanising Psychiatry and Mental Health Care will be of significant interest and help to all mental health professionals including psychiatrists and psychiatric nurses, social care workers, occupational therapists, psychologists, person-centred counsellors and therapists. Health and social care policy makers and shapers, including patient groups, will also find it helpful and informative. Freeth, R., Thorne, B., & Shooter, M. (2007). Humanising Psychiatry and Mental Health Care: The challenge of the person-centred approach (1st ed.). CRC Press. <nowiki>https://doi.org/10.1201/9781315385051</nowiki></blockquote> == Other uses == == Conclusion == === Marking rubric === ==== Overview ==== Easy to read and understand overview of the chapter. ==== Breadth ==== Theoretical framework for understanding the topic.<blockquote>theoretical model of the person who emerges from therapy—a person functioning freely in all the fullness of his organismic potentialities; a person who is dependable in being realistic, self-enhancing, socialized and appropriate in his behavior; a creative person, whose specific formings of behavior are not easily predictable; a person who is ever-changing, ever developing, always discovering himself and the newness in himself in each succeeding moment of time. This is the person who in an imperfect way actually emerges from the experience of safety and freedom in a therapeutic experience, and this is the person whom I have tried to describe for you in "pure" form. Rogers, C. R. (1963). The concept of the fully functioning person. ''Psychotherapy: Theory, Research & Practice, 1''(1), 17–26. <nowiki>https://doi.org/10.1037/h0088567</nowiki></blockquote><blockquote>The actualizing tendency functions as an axiom in Rogers’ theory. To the extent that the therapist holds the hypothesis that the client possesses the capacity for selfdetermination he or she is more likely to perceive the client’s ideas, feelings, and actions as aspects of growth instead of pathology. It should be stated that the actualizing tendency does not mean that Rogers believed that people are “good,” simply that organisms realize their potentials limited only by internal and external environmental constraints (Rogers, 1951, 1959, 1961; Brodley, 1998). Rogers recommended that novice therapists attempt to hold the hypothesis that clients have the inner resources to meet life’s difficulties, recognizing that to discard that hypothesis would open the way for the therapist’s exerting influence over the supposedly less competent client. This hypothesis, he acknowledged, was most difficult to embrace in the face of self-destructive, self-defeating behavior on the part of the client (Rogers, 1951, pp. 20–25). Witty, M.C. (2007). Client-Centered Therapy. In: Kazantzis, N., LĽAbate, L. (eds) Handbook of Homework Assignments in Psychotherapy. Springer, Boston, MA . <nowiki>https://doi.org/10.1007/978-0-387-29681-4_3</nowiki></blockquote> ==== Depth ==== Clearly explain and integrate the theory(ies).<blockquote>Fully-functioning person. If people are able to operate their valuing processes fully, they will certainly begin to experience self movement and growth toward realization of their potentials. This shows that the person who are able be self-actualize, are called fully functioning person (Rogers, 1961). According to Roger`s terminology, they will be moving toward becoming fully functioning persons. Fully functioning person, for Rogers, are well balanced, well adjusted and interesting to know (Mcleod, 2007). Rogers, in his later writings, extended and amplified his view of the fully functioning person (1961) to emerging person (1975) Ismail, N. A. H., & Tekke, M. (2015). Rediscovering Rogers’s self theory and personality. ''Journal of Educational, Health and Community Psychology'', ''4''(3), 28-36.</blockquote> ==== Key findings ==== Explain how key, peer-reviewed research findings apply to the problem.<blockquote>Findings of this study suggested that people have intrinsic motivation to use their strengths, which results in increased authenticity, vitality, and well-being. These findings provide support for the Rogerian perspective in which autonomous individuals will show greater openness to experience and a more genuine and less defensive perception of experience (Patterson & Joseph, 2007). Overall, findings of this study suggest that the fully functioning person from the positive psychology perspective is a “person-in-process,” a person who is characterized as being in touch with their organismic valuing process (OVP) and hence experiences increased happiness and life satisfaction, who feels competent, autonomous, and relates well with others and they with them. Moreover, the fully functioning person is open, authentic, and uses their strengths, experiencing the well-being associated with doing so. When compared with other people, this person less frequently experiences feelings of anxiety or alienation from themselves. Proctor C, Tweed R, Morris D. The Rogerian Fully Functioning Person: A Positive Psychology Perspective. Journal of Humanistic Psychology. 2016;56(5):503-529. doi:10.1177/0022167815605936</blockquote> ==== Critical thinking ==== Critically analyse the research discussed. ==== Integration ==== Integrate discussion of theory and review of relevant research. ==== Conclusion ==== Emphasise the key points and take-home messages. ==== Written expression - Style ==== Readable for a layperson interested in psychological science. ==== Written expression - Learning features ==== Invite interactivity through features such as case studies, feature boxes, figures, links, tables, and quizzes. ==== Social contribution ==== Editing which enhances the quality of other book chapters. --- Add an image == Overview == You are underway {{smile}}! This template provides tips for [[Motivation and emotion/Assessment/Topic|topic development]]. Gradually remove these suggestions as you develop the chapter. Also consult the [[Motivation and emotion/Assessment/Chapter|author guidelines]]. At the top of the chapter, the title and sub-title should match the ''exact'' wording and casing as shown in the {{Motivation and emotion/Book}}. The sub-titles all end with a question mark. This Overview section should be concise but consist of several paragraphs which engage the reader, illustrate the problem, and outline how psychological science can help. {{RoundBoxTop|theme=3}} '''Focus questions:''' * What is the first focus question? * What is the second focus question? * What is the third focus question? {{RoundBoxBottom}} {{tip| Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Provide an example or case study. * Conclude with Focus questions to guide the chapter. }} ==Main headings== How you are going to structure the chapter? Aim for three to six main headings between the [[#Overview|Overview]] and [[#Conclusion|Conclusion]]. {{tip|Suggestions for this section: * For the [[Motivation and emotion/Assessment/Topic|topic development]], provide at least 3 bullet-points about key content per section. Include key citations. * For the [[Motivation and emotion/Assessment/Chapter|book chapter]], expand the bullet points into paragraphs. * If a section has a lot of content, arrange it into two to five sub-headings such as in the [[#Interactive learning features|interactive learning features section]]. Avoid having sections with only one sub-heading. }} ==Learning features== What brings an online book chapter to life are its interactive learning features. Case studies, feature boxes, figures, links, tables, and quiz questions can be used throughout the chapter. ===Case studies=== Case studies describe real-world examples of concepts in action. Case studies can be real or fictional. A case could be used multiple times during a chapter to illustrate different theories or stages. It is often helpful to present case studies using [[#Feature boxes|feature boxes]]. ===Boxes=== Boxes can be used to highlight content, but don't overuse them. There are many different ways of creating boxes (e.g., see [[Help:Pretty boxes|Pretty boxes]]). Possible uses include: * Focus questions * Case studies or examples * Quiz questions * Take-home messages {{RoundBoxTop|theme=3}} ;Feature box example * Shaded background * Coloured border {{RoundBoxBottom}} ===Figures=== [[File:Monkey-typing.jpg|right|205px|thumb|''Figure 1''. Example image with descriptive caption.]] Use figures to illustrate concepts, add interest, and provide examples. Figures can be used to show photographs, drawings, diagrams, graphs, etcetera. Figures can be embedded throughout the chapter, starting with the Overview section. Figures should be captioned (using a number and a description) in order to explain their relevance to the text. Possible images can be found at [[commons:|Wikimedia Commons]]. Images can also be uploaded if they are licensed for re-use or if you created the image. Each figure should be referred to at least once in the main text (e.g., see Figure 1). ===Links=== Where key words are first used, make them into [[Help:Links|interwiki links]] such as Wikipedia links to articles about famous people (e.g., [[w:Sigmund Freud|Sigmund Freud]] and key concepts (e.g., [[w:Dreams|dreams]]) and links to book chapters about related topics (e.g., would you like to learn about how to overcome [[Motivation and emotion/Book/2020/Writer's block|writer's block]]?). ===Tables=== Tables can be an effective way to organise and summarise information. Tables should be captioned (using APA style) to explain their relevance to the text. Plus each table should be referred to at least once in the main text (e.g., see Table 1 and Table 2). Here are some [[Motivation and emotion/Wikiversity/Tables|example 3 x 3 tables]] which could be adapted. ===Quizzes=== Quizzes are a direct way to engage readers. But don't make quizzes too hard or long. It is better to have one or two review questions per major section than a long quiz at the end. Try to quiz conceptual understanding, rather than trivia. Here are some simple quiz questions which could be adapted. Choose the correct answers and click "Submit": <quiz display=simple> {Quizzes are an interactive learning feature: |type="()"} + True - False {Long quizzes are a good idea: |type="()"} - True + False </quiz> To learn about different types of quiz questions, see [[Help:Quiz|Quiz]]. ==Conclusion== The Conclusion is arguably the most important section. It should be possible for someone to read the [[#Overview|Overview]] and the Conclusion and still get a good idea of the topic. {{tip|Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? }} ==See also== Provide up to half-a-dozen [[Help:Contents/Links#Interwiki_links|internal (wiki) links]] to relevant Wikiversity pages (esp. related [[Motivation and emotion/Book|motivation and emotion book chapters]]) and [[w:|Wikipedia articles]]. For example: * [[Motivation and emotion/Book/2016/Anorexia nervosa and extrinsic motivation|Anorexia nervosa and extrinsic motivation]] (Book chapter, 2016) * [[w:David McClelland|David McClelland]] (Wikipedia) * [[Motivation and emotion/Book/2018/Loss aversion|Loss aversion]] (Book chapter, 2018) * [[w:Maslow's hierarchy of needs|Maslow's hierarchy of needs]] (Wikipedia) {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== List the cited references in [[w:APA style|APA style]] (7th ed.) or [[w:Wikipedia:Citing sources|wiki style]]. APA style example: {{Hanging indent|1= Blair, R. J. R. (2004). The roles of orbital frontal cortex in the modulation of antisocial behavior. ''Brain and Cognition'', ''55''(1), 198–208. https://doi.org/10.1016/S0278-2626(03)00276-8 Buckholtz, J. W., & Meyer-Lindenberg, A. (2008). MAOA and the neurogenetic architecture of human aggression. ''Trends in Neurosciences'', ''31''(3), 120–129. https://doi.org/10.1016/j.tins.2007.12.006 Eckardt, M., File, S., Gessa, G., Grant, K., Guerri, C., Hoffman, P., & Tabakoff, B. (1998). Effects of moderate alcohol consumption on the central nervous system. ''Alcoholism, Clinical and Experimental Research'', ''22''(5), 998–1040. https://doi.org/10.1111/j.1530-0277.1998.tb03695.x }} {{tip|Suggestions for this section: * Important aspects for APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except first letter and proper names, ending in a full-stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full-stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't actually read or consulted }} ==External links== Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * [https://students.unimelb.edu.au/academic-skills/explore-our-resources/essay-writing/six-top-tips-for-writing-a-great-essay Six top tips for writing a great essay] (University of Melbourne) * [http://www.skillsyouneed.com/write/structure.html The importance of structure] (skillsyouneed.com) {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] [[Category:Motivation and emotion/Book/Positive psychology]] iox82fuppj9zisn6toeimgw8rzqgdct 2419385 2419383 2022-08-26T07:50:18Z Icantchooseone 2947542 /* External links */ removed the copy of the link and added in an external link wikitext text/x-wiki {{title|Fully functioning person:<br>What is a FFP and how can full functioning be developed?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ == Overview == ;Focus questions *What it is? # '''Increasing openness to experience''' – Owning and accepting experiences as your own without a defensive barrier. # '''Increasingly existential living''' – Living in the moment without falsely distorting your perceptions or actions to fit how it 'should' be. # '''An increasing trust in their organism''' – trusting your gut and instinct without relying on social norms or external criteria of behaviour. # '''The process of functioning more fully''' – <blockquote>not being shackled by the restrictions that influence an incongruent individual; able to make a wider range of choices more fluently. Belief that one plays a role in determining one's behaviour and so feel responsible for one's own behaviour. # '''Creativity''' – feeling more free to be creative. Also more creative in the way one adapts to one's circumstances without feeling a need to conform. # '''Reliability and constructiveness''' – can be trusted to act constructively. An individual who is open to all his/her needs will be able to maintain a balance between them. Even aggressive needs will be matched and balanced by intrinsic goodness in congruent individuals. # '''A rich full life''' – the life of a fully functioning individual is rich, full and exciting; they experience joy and pain, love and heartbreak, fear and courage more intensely. Rogers' description of ''the good life'': </blockquote> *How it is developed? Rogers (1959) sugestted that people have an actualizing tendency toward development, growth and autonomy:<blockquote>This is the inherent tendency of the organism to develop all its capacities in ways which serve to maintain or enhance the organism. It involves not only the tendency to meet what Maslow (1954) terms “deficiency needs” for air, food, water, and the like, but also more generalized activities. It involves development toward the differentiation of organs and of functions, expansion in terms of growth, expansion of effectiveness through the use of tools, expansion and enhancement through reproduction. It is development toward autonomy and away from heteronomy, or control by external forces. (p. 196)</blockquote> *Whose theory is it? *How it is used? == History == === Pre-Rogers === Socrates suggests that everything has a specific function, which he defines as what that thing does best or the only thing it can do (Korsgaard, 2008). The ancient Greek's worldview suggested that, a person could only be called 'good' if their soul was in peak condition. According to Aristotle (1996), we can only know if something is good if we understand its function. He continued this theory to human nature, concluding that by performing virtuous activities of the soul, one can achieve the hight of human goodness. The concept of a soul has vanished in modern psychology, and the notion of virtue has evolved. However, the concept that goodness and functionality are linked was adopted by the first wave of humanistic psychology, most notably by Carl Rogers (Straume, 2020). === Carl Rogers === [[File:Carl Rogers.jpg|thumb|Figure 1. Carl Rogers|alt=Artist rendition of Carl Rogers]] The person-centered approach, often known as client-centered therapy, is Carl R. Rogers' method for assisting people who are dealing with a variety of personal disturbances or issues in their daily lives (Rogers, 1959; 1961; 1969; 1970; 1972; 1980; 1986). In 1939, Rogers created his theory of psychotherapy for troubled kids (Witty, 2007). Later, he broadened his theoretical framework to cover work with groups, families, and couples. His most complete theoretical statement, which covers his theories of motivation and personality development as well as those of group interaction and interpersonal interactions, was published as a chapter in Sigmund Koch's Psychology: A Study of a Science (Vol. III) in 1959. (Koch, 1959, 184–256). === Explore 7 points of FFP === === FFP - What is it/why it exists === === How do you develop FFP === == Clinical Use == === What is it used for? === <blockquote>Rogers (1959) noted several changes customarily associated with outcomes or results experienced by a person becoming more fully functioning, which are observed outside of the therapeutic relationship. The following changes were hypothesized as being relatively permanent:</blockquote> # Being more congruent, open to experience, and less defensive # Having improved psychological adjustment # Having an increased degree of positive self-regard # Perceiving the locus of evaluation and the locus of choice as residing within oneself # Experiencing more acceptance of others<blockquote>Consequences or results of the above changes:</blockquote> # More realistic, objective, extensional in perceptions, and more effective in problem solving # Less vulnerable to threat # More confident and self-directing # Values are determined by an OVP # Perceive others more realistically and accurately # Behaviors “owned” by the self are increased and those disowned as “not myself” are decreased # Behavior is perceived as being more within control, socialized, mature, creative, uniquely adaptive to new situations and problems, and fully expressive of own purpose and values Proctor C, Tweed R, Morris D. The Rogerian Fully Functioning Person: A Positive Psychology Perspective. Journal of Humanistic Psychology. 2016;56(5):503-529. doi:10.1177/0022167815605936 === How? === <blockquote>Empirical evidence also provides support of the hypothesis that more fully functioning persons move in a direction of increasing openness to experience. Rogers (1961) considered openness to experience to be the polar opposite of defensiveness. Defensiveness is “the organism’s response to experiences which are perceived or anticipated as threatening, as incongruent with the individual’s existing picture of himself, or of himself in relationship to the world” (Rogers, 1961, p. 187)</blockquote> === Case study === == Non-Clinical Use == === What areas could benifit from FFP === === Case study === == Challenges == https://www.jstor.org/stable/pdf/42573871.pdf?refreqid=excelsior%3Af77be98a01ac999d2f3e3866397ffe3d&ab_segments=&origin=&acceptTC=1 === Western perspective === There are criticisms of the fully functioning person that it is a product of primarily Western culture. Since in other cultures, Eastern cultures for example, the groups achievements are valued higher than those of any individual. === Enviromental influences === == Related Theories == === Self actualisation === === Humanistic Psychology === === Client Centered Psychology === == Conclusion == == See also == [[Self-actualisation]] (Book chapter) [[Motivation and emotion/Tutorials/Growth psychology|https://en.wikiversity.org/wiki/Motivation_and_emotion/Tutorials/Growth_psychology]] Growth psychology == References == {{Hanging indent|1= Aristotle. (1996). The Nicomachean ethics (trans: Ross, W. D.). Wordsworth Editions Limited. Ware: UK. Koch, Sigmund. (Series Ed.), & Koch, S. (Vol. Ed.). (1959). Psychology: A study of a science (Vol. 3). New York: McGraw-Hill. Korsgaard, C. M. (2008). The constitution of agency: Essays on practical reason and moral psychology. Oxford: Oxford University Press. Rogers, C. R. (1959). A theory of therapy, personality, and interpersonal relationships as developed in the client-centered framework. In S. Koch (Series Ed.) & S. Koch (Vol. Ed.), Psychology: A study of a science (Vol. 3, pp. 184–256). New York: McGraw Hill. Rogers, C. R. (1961). On becoming a person. Boston: Houghton Mifflin. Rogers, C. R. (1969). Freedom to learn. Columbus, Ohio: Charles E. Merrill. Rogers, C. R. (1970). Carl Rogers on encounter groups. New York: Harper and Row. Rogers, C. R. (1972). Becoming partners: Marriage and its alternatives. New York: Dell. Rogers, C. R. (1980). Empathic: An unappreciated way of being. In A way of being (pp. 137–163). Boston: Houghton Mifflin. Rogers, C. R. (1986). Client-centered approach to therapy. In I. L. Kutash & A. Wolf (Eds.), Psychotherapist’s casebook: Theory and technique in practice (pp. 197–208). San Francisco: Jossey Bass. Straume, L.V., Vittersø, J. (2020). Fully Functioning Person. In: Zeigler-Hill, V., Shackelford, T.K. (eds) Encyclopedia of Personality and Individual Differences. Springer, Cham. https://doi.org/10.1007/978-3-319-24612-3_1469 Witty, M.C. (2007). Client-Centered Therapy. In: Kazantzis, N., LĽAbate, L. (eds) Handbook of Homework Assignments in Psychotherapy. Springer, Boston, MA . https://doi.org/10.1007/978-0-387-29681-4_3}} == External links == <nowiki>https://en.wikipedia.org/wiki/Carl_Rogers#The_fully_functioning_person</nowiki> <nowiki>https://en.wikipedia.org/wiki/Self-actualization</nowiki> [https://www.verywellmind.com/fully-functioning-person-2795197#:~:text=A%20fully%20functioning%20person%20is%20one%20who%20is%20continually%20working,open%20to%20life's%20many%20experiences. https://www.verywellmind.com/fully-functioning-person-2795197#:~:text=A%20fully%20functioning%20person%20is%20one%20who%20is%20continually%20working,open%20to%20life's%20many%20experiences.] == Overview == ''What is a FFP and How can full functioning be developed?''<blockquote> # <u>A growing openness to experience</u> # <u>An increasingly existential lifestyle</u> # <u>Increasing organismic trust</u> # <u>Freedom of choice</u> # <u>Creativity</u> # <u>Reliability and constructiveness</u> # <u>A rich full life</u> #* Rogers, Carl (1961). ''On becoming a person: A therapist's view of psychotherapy''. London: Constable. ISBN <bdi>978-1-84529-057-3</bdi>. </blockquote> == [[Caregiving and dementia/Topics/Person centred care|person-centered theory of personality]] == == History == <u>Both Plato and Aristotle proposed theories about goodness in which functioning worked as the most central concept. Arguments about goodness and functioning keep developing in contemporary work on human goodness. The work of Sen, Staudinger, and Tomasello serves as renowned examples. (https://doi.org/10.1007/978-3-319-24612-3_1469)</u><blockquote>Client-centered therapy, also called the person-centered approach, describes Carl R. Rogers’ way of working with persons experiencing all types of personal disturbances or problems in living (Rogers, 1959; 1961; 1969; 1970; 1972; 1980a; 1986a). As early as 1939, Rogers developed his theory of psychotherapy with troubled children, and went on to expand his theoretical approach to include work with couples, families, and groups. His most comprehensive theoretical statement was published as a chapter in Sigmund Koch’s Psychology: A Study of a Science (Vol. III) in 1959, and includes his theory of motivation and personality development, as well as theory of group interaction and interpersonal relationships (Koch, 1959, 184–256). Over his long career, Rogers extrapolated client-centered values to the education, marriage, group encounter, personal power, and conflict resolution (Rogers, 1969, 1970, 1972). Today, the person-centered approach is practiced in the United Kingdom, Germany, France, Greece, Portugal, Demark, Poland, Hungary, The Netherlands, Italy, Japan, Brazil, Mexico, Australia, and South Africa, as well as here in the United States and Canada. A world association, which can be contacted online, was founded in Lisbon in 1997 that reflects the growth and vitality of the approach entitled the World Association for Person-Centered and Experiential Psychotherapy and Counseling (WAPCEPC). Another international organization comprised of a diverse membership—lay persons, educators, business consultants, therapists, artists, psychologists—the Association for the Development of the Person-Centered Approach (ADPCA), is also accessible on the internet. Witty, M. C. (2007). Client-centered therapy. In ''Handbook of homework assignments in psychotherapy'' (pp. 35-50). Springer, Boston, MA.</blockquote><blockquote>According to Rogers, when fully functioning, the individual lives in close and confident relationship to the organismic valuing process, trusting that inner direction. Congruence is a constant companion. Furthermore, the fully functioning individual spontaneously communicates inner impulses both verbally and nonverbally. They are open to experience, accepts experiences as they are, and expresses those experiences in an unedited manner. The fully functioning individual is authentic. To characterize the moment-to-moment experience of the fully functioning individual, Figure 15.4 illustrates the sequential process of a motive’s emergence, acceptance, and unedited expression. The congruent, fully functioning individual lives in close proximity to the actualizing tendency and therefore experiences a marked sense of autonomy, openness to experience,and personal growth. Reeve, J. (2018). Understanding motivation and emotion. John Wiley & Sons.</blockquote><blockquote>The actualizing tendency was a theoretical construct proposed by the great holistic neurologist Kurt Goldstein (Goldstein, 1939; 1940, 1963). Witty, M.C. (2007). Client-Centered Therapy. In: Kazantzis, N., LĽAbate, L. (eds) Handbook of Homework Assignments in Psychotherapy. Springer, Boston, MA . <nowiki>https://doi.org/10.1007/978-0-387-29681-4_3</nowiki></blockquote> === [[Motivation and emotion/Tutorials/Growth psychology|Growth psychology]] === <blockquote>A second criticism is that humanistic theorists use a number of vague and ill-defined constructs. It is difficult to pinpoint precisely what an “organismic valuing process” and a “fully functioning individual” are, for example. Any theoretical construct that evades a precise operational definition must remain scientifically dubious. For this reason, humanistic views on motivation have been harshly criticized (Daniels,1988; Neher, 1991), and these criticisms were instrumental to the rise and eventual popularity of the more empirically driven (evidence-based) positive psychology. Reeve, J. (2018). Understanding motivation and emotion. John Wiley & Sons.</blockquote> === [[Talk:Carl Rogers]] === <blockquote></blockquote> === [[Motivation and emotion/Textbook/Motivation/Self-actualisation|Self-actualisation]] === === [[wikipedia:Abraham_Maslow|Abraham Maslow]] === == Clinical uses == <blockquote>This book explores, in depth, the link between modern psychiatric practice and the person-centred approach. It promotes an open dialogue between traditional rivals – counsellors and psychiatrists within the NHS – to assist greater understanding and improve practice. Easy to read and comprehend, it explains complex issues in a clear and accessible manner. The author is a full-time psychiatrist and qualified counsellor who offers a unique perspective drawing on personal experience. Humanising Psychiatry and Mental Health Care will be of significant interest and help to all mental health professionals including psychiatrists and psychiatric nurses, social care workers, occupational therapists, psychologists, person-centred counsellors and therapists. Health and social care policy makers and shapers, including patient groups, will also find it helpful and informative. Freeth, R., Thorne, B., & Shooter, M. (2007). Humanising Psychiatry and Mental Health Care: The challenge of the person-centred approach (1st ed.). CRC Press. <nowiki>https://doi.org/10.1201/9781315385051</nowiki></blockquote> == Other uses == == Conclusion == === Marking rubric === ==== Overview ==== Easy to read and understand overview of the chapter. ==== Breadth ==== Theoretical framework for understanding the topic.<blockquote>theoretical model of the person who emerges from therapy—a person functioning freely in all the fullness of his organismic potentialities; a person who is dependable in being realistic, self-enhancing, socialized and appropriate in his behavior; a creative person, whose specific formings of behavior are not easily predictable; a person who is ever-changing, ever developing, always discovering himself and the newness in himself in each succeeding moment of time. This is the person who in an imperfect way actually emerges from the experience of safety and freedom in a therapeutic experience, and this is the person whom I have tried to describe for you in "pure" form. Rogers, C. R. (1963). The concept of the fully functioning person. ''Psychotherapy: Theory, Research & Practice, 1''(1), 17–26. <nowiki>https://doi.org/10.1037/h0088567</nowiki></blockquote><blockquote>The actualizing tendency functions as an axiom in Rogers’ theory. To the extent that the therapist holds the hypothesis that the client possesses the capacity for selfdetermination he or she is more likely to perceive the client’s ideas, feelings, and actions as aspects of growth instead of pathology. It should be stated that the actualizing tendency does not mean that Rogers believed that people are “good,” simply that organisms realize their potentials limited only by internal and external environmental constraints (Rogers, 1951, 1959, 1961; Brodley, 1998). Rogers recommended that novice therapists attempt to hold the hypothesis that clients have the inner resources to meet life’s difficulties, recognizing that to discard that hypothesis would open the way for the therapist’s exerting influence over the supposedly less competent client. This hypothesis, he acknowledged, was most difficult to embrace in the face of self-destructive, self-defeating behavior on the part of the client (Rogers, 1951, pp. 20–25). Witty, M.C. (2007). Client-Centered Therapy. In: Kazantzis, N., LĽAbate, L. (eds) Handbook of Homework Assignments in Psychotherapy. Springer, Boston, MA . <nowiki>https://doi.org/10.1007/978-0-387-29681-4_3</nowiki></blockquote> ==== Depth ==== Clearly explain and integrate the theory(ies).<blockquote>Fully-functioning person. If people are able to operate their valuing processes fully, they will certainly begin to experience self movement and growth toward realization of their potentials. This shows that the person who are able be self-actualize, are called fully functioning person (Rogers, 1961). According to Roger`s terminology, they will be moving toward becoming fully functioning persons. Fully functioning person, for Rogers, are well balanced, well adjusted and interesting to know (Mcleod, 2007). Rogers, in his later writings, extended and amplified his view of the fully functioning person (1961) to emerging person (1975) Ismail, N. A. H., & Tekke, M. (2015). Rediscovering Rogers’s self theory and personality. ''Journal of Educational, Health and Community Psychology'', ''4''(3), 28-36.</blockquote> ==== Key findings ==== Explain how key, peer-reviewed research findings apply to the problem.<blockquote>Findings of this study suggested that people have intrinsic motivation to use their strengths, which results in increased authenticity, vitality, and well-being. These findings provide support for the Rogerian perspective in which autonomous individuals will show greater openness to experience and a more genuine and less defensive perception of experience (Patterson & Joseph, 2007). Overall, findings of this study suggest that the fully functioning person from the positive psychology perspective is a “person-in-process,” a person who is characterized as being in touch with their organismic valuing process (OVP) and hence experiences increased happiness and life satisfaction, who feels competent, autonomous, and relates well with others and they with them. Moreover, the fully functioning person is open, authentic, and uses their strengths, experiencing the well-being associated with doing so. When compared with other people, this person less frequently experiences feelings of anxiety or alienation from themselves. Proctor C, Tweed R, Morris D. The Rogerian Fully Functioning Person: A Positive Psychology Perspective. Journal of Humanistic Psychology. 2016;56(5):503-529. doi:10.1177/0022167815605936</blockquote> ==== Critical thinking ==== Critically analyse the research discussed. ==== Integration ==== Integrate discussion of theory and review of relevant research. ==== Conclusion ==== Emphasise the key points and take-home messages. ==== Written expression - Style ==== Readable for a layperson interested in psychological science. ==== Written expression - Learning features ==== Invite interactivity through features such as case studies, feature boxes, figures, links, tables, and quizzes. ==== Social contribution ==== Editing which enhances the quality of other book chapters. --- Add an image == Overview == You are underway {{smile}}! This template provides tips for [[Motivation and emotion/Assessment/Topic|topic development]]. Gradually remove these suggestions as you develop the chapter. Also consult the [[Motivation and emotion/Assessment/Chapter|author guidelines]]. At the top of the chapter, the title and sub-title should match the ''exact'' wording and casing as shown in the {{Motivation and emotion/Book}}. The sub-titles all end with a question mark. This Overview section should be concise but consist of several paragraphs which engage the reader, illustrate the problem, and outline how psychological science can help. {{RoundBoxTop|theme=3}} '''Focus questions:''' * What is the first focus question? * What is the second focus question? * What is the third focus question? {{RoundBoxBottom}} {{tip| Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Provide an example or case study. * Conclude with Focus questions to guide the chapter. }} ==Main headings== How you are going to structure the chapter? Aim for three to six main headings between the [[#Overview|Overview]] and [[#Conclusion|Conclusion]]. {{tip|Suggestions for this section: * For the [[Motivation and emotion/Assessment/Topic|topic development]], provide at least 3 bullet-points about key content per section. Include key citations. * For the [[Motivation and emotion/Assessment/Chapter|book chapter]], expand the bullet points into paragraphs. * If a section has a lot of content, arrange it into two to five sub-headings such as in the [[#Interactive learning features|interactive learning features section]]. Avoid having sections with only one sub-heading. }} ==Learning features== What brings an online book chapter to life are its interactive learning features. Case studies, feature boxes, figures, links, tables, and quiz questions can be used throughout the chapter. ===Case studies=== Case studies describe real-world examples of concepts in action. Case studies can be real or fictional. A case could be used multiple times during a chapter to illustrate different theories or stages. It is often helpful to present case studies using [[#Feature boxes|feature boxes]]. ===Boxes=== Boxes can be used to highlight content, but don't overuse them. There are many different ways of creating boxes (e.g., see [[Help:Pretty boxes|Pretty boxes]]). Possible uses include: * Focus questions * Case studies or examples * Quiz questions * Take-home messages {{RoundBoxTop|theme=3}} ;Feature box example * Shaded background * Coloured border {{RoundBoxBottom}} ===Figures=== [[File:Monkey-typing.jpg|right|205px|thumb|''Figure 1''. Example image with descriptive caption.]] Use figures to illustrate concepts, add interest, and provide examples. Figures can be used to show photographs, drawings, diagrams, graphs, etcetera. Figures can be embedded throughout the chapter, starting with the Overview section. Figures should be captioned (using a number and a description) in order to explain their relevance to the text. Possible images can be found at [[commons:|Wikimedia Commons]]. Images can also be uploaded if they are licensed for re-use or if you created the image. Each figure should be referred to at least once in the main text (e.g., see Figure 1). ===Links=== Where key words are first used, make them into [[Help:Links|interwiki links]] such as Wikipedia links to articles about famous people (e.g., [[w:Sigmund Freud|Sigmund Freud]] and key concepts (e.g., [[w:Dreams|dreams]]) and links to book chapters about related topics (e.g., would you like to learn about how to overcome [[Motivation and emotion/Book/2020/Writer's block|writer's block]]?). ===Tables=== Tables can be an effective way to organise and summarise information. Tables should be captioned (using APA style) to explain their relevance to the text. Plus each table should be referred to at least once in the main text (e.g., see Table 1 and Table 2). Here are some [[Motivation and emotion/Wikiversity/Tables|example 3 x 3 tables]] which could be adapted. ===Quizzes=== Quizzes are a direct way to engage readers. But don't make quizzes too hard or long. It is better to have one or two review questions per major section than a long quiz at the end. Try to quiz conceptual understanding, rather than trivia. Here are some simple quiz questions which could be adapted. Choose the correct answers and click "Submit": <quiz display=simple> {Quizzes are an interactive learning feature: |type="()"} + True - False {Long quizzes are a good idea: |type="()"} - True + False </quiz> To learn about different types of quiz questions, see [[Help:Quiz|Quiz]]. ==Conclusion== The Conclusion is arguably the most important section. It should be possible for someone to read the [[#Overview|Overview]] and the Conclusion and still get a good idea of the topic. {{tip|Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? }} ==See also== Provide up to half-a-dozen [[Help:Contents/Links#Interwiki_links|internal (wiki) links]] to relevant Wikiversity pages (esp. related [[Motivation and emotion/Book|motivation and emotion book chapters]]) and [[w:|Wikipedia articles]]. For example: * [[Motivation and emotion/Book/2016/Anorexia nervosa and extrinsic motivation|Anorexia nervosa and extrinsic motivation]] (Book chapter, 2016) * [[w:David McClelland|David McClelland]] (Wikipedia) * [[Motivation and emotion/Book/2018/Loss aversion|Loss aversion]] (Book chapter, 2018) * [[w:Maslow's hierarchy of needs|Maslow's hierarchy of needs]] (Wikipedia) {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== List the cited references in [[w:APA style|APA style]] (7th ed.) or [[w:Wikipedia:Citing sources|wiki style]]. APA style example: {{Hanging indent|1= Blair, R. J. R. (2004). The roles of orbital frontal cortex in the modulation of antisocial behavior. ''Brain and Cognition'', ''55''(1), 198–208. https://doi.org/10.1016/S0278-2626(03)00276-8 Buckholtz, J. W., & Meyer-Lindenberg, A. (2008). MAOA and the neurogenetic architecture of human aggression. ''Trends in Neurosciences'', ''31''(3), 120–129. https://doi.org/10.1016/j.tins.2007.12.006 Eckardt, M., File, S., Gessa, G., Grant, K., Guerri, C., Hoffman, P., & Tabakoff, B. (1998). Effects of moderate alcohol consumption on the central nervous system. ''Alcoholism, Clinical and Experimental Research'', ''22''(5), 998–1040. https://doi.org/10.1111/j.1530-0277.1998.tb03695.x }} {{tip|Suggestions for this section: * Important aspects for APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except first letter and proper names, ending in a full-stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full-stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't actually read or consulted }} ==External links== Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * [https://students.unimelb.edu.au/academic-skills/explore-our-resources/essay-writing/six-top-tips-for-writing-a-great-essay Six top tips for writing a great essay] (University of Melbourne) * [http://www.skillsyouneed.com/write/structure.html The importance of structure] (skillsyouneed.com) {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] [[Category:Motivation and emotion/Book/Positive psychology]] tel4f333kxas19ugc2fv59mr1l55i1i 2419386 2419385 2022-08-26T07:51:21Z Icantchooseone 2947542 /* Client Centered Psychology */ spelling mistake wikitext text/x-wiki {{title|Fully functioning person:<br>What is a FFP and how can full functioning be developed?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ == Overview == ;Focus questions *What it is? # '''Increasing openness to experience''' – Owning and accepting experiences as your own without a defensive barrier. # '''Increasingly existential living''' – Living in the moment without falsely distorting your perceptions or actions to fit how it 'should' be. # '''An increasing trust in their organism''' – trusting your gut and instinct without relying on social norms or external criteria of behaviour. # '''The process of functioning more fully''' – <blockquote>not being shackled by the restrictions that influence an incongruent individual; able to make a wider range of choices more fluently. Belief that one plays a role in determining one's behaviour and so feel responsible for one's own behaviour. # '''Creativity''' – feeling more free to be creative. Also more creative in the way one adapts to one's circumstances without feeling a need to conform. # '''Reliability and constructiveness''' – can be trusted to act constructively. An individual who is open to all his/her needs will be able to maintain a balance between them. Even aggressive needs will be matched and balanced by intrinsic goodness in congruent individuals. # '''A rich full life''' – the life of a fully functioning individual is rich, full and exciting; they experience joy and pain, love and heartbreak, fear and courage more intensely. Rogers' description of ''the good life'': </blockquote> *How it is developed? Rogers (1959) sugestted that people have an actualizing tendency toward development, growth and autonomy:<blockquote>This is the inherent tendency of the organism to develop all its capacities in ways which serve to maintain or enhance the organism. It involves not only the tendency to meet what Maslow (1954) terms “deficiency needs” for air, food, water, and the like, but also more generalized activities. It involves development toward the differentiation of organs and of functions, expansion in terms of growth, expansion of effectiveness through the use of tools, expansion and enhancement through reproduction. It is development toward autonomy and away from heteronomy, or control by external forces. (p. 196)</blockquote> *Whose theory is it? *How it is used? == History == === Pre-Rogers === Socrates suggests that everything has a specific function, which he defines as what that thing does best or the only thing it can do (Korsgaard, 2008). The ancient Greek's worldview suggested that, a person could only be called 'good' if their soul was in peak condition. According to Aristotle (1996), we can only know if something is good if we understand its function. He continued this theory to human nature, concluding that by performing virtuous activities of the soul, one can achieve the hight of human goodness. The concept of a soul has vanished in modern psychology, and the notion of virtue has evolved. However, the concept that goodness and functionality are linked was adopted by the first wave of humanistic psychology, most notably by Carl Rogers (Straume, 2020). === Carl Rogers === [[File:Carl Rogers.jpg|thumb|Figure 1. Carl Rogers|alt=Artist rendition of Carl Rogers]] The person-centered approach, often known as client-centered therapy, is Carl R. Rogers' method for assisting people who are dealing with a variety of personal disturbances or issues in their daily lives (Rogers, 1959; 1961; 1969; 1970; 1972; 1980; 1986). In 1939, Rogers created his theory of psychotherapy for troubled kids (Witty, 2007). Later, he broadened his theoretical framework to cover work with groups, families, and couples. His most complete theoretical statement, which covers his theories of motivation and personality development as well as those of group interaction and interpersonal interactions, was published as a chapter in Sigmund Koch's Psychology: A Study of a Science (Vol. III) in 1959. (Koch, 1959, 184–256). === Explore 7 points of FFP === === FFP - What is it/why it exists === === How do you develop FFP === == Clinical Use == === What is it used for? === <blockquote>Rogers (1959) noted several changes customarily associated with outcomes or results experienced by a person becoming more fully functioning, which are observed outside of the therapeutic relationship. The following changes were hypothesized as being relatively permanent:</blockquote> # Being more congruent, open to experience, and less defensive # Having improved psychological adjustment # Having an increased degree of positive self-regard # Perceiving the locus of evaluation and the locus of choice as residing within oneself # Experiencing more acceptance of others<blockquote>Consequences or results of the above changes:</blockquote> # More realistic, objective, extensional in perceptions, and more effective in problem solving # Less vulnerable to threat # More confident and self-directing # Values are determined by an OVP # Perceive others more realistically and accurately # Behaviors “owned” by the self are increased and those disowned as “not myself” are decreased # Behavior is perceived as being more within control, socialized, mature, creative, uniquely adaptive to new situations and problems, and fully expressive of own purpose and values Proctor C, Tweed R, Morris D. The Rogerian Fully Functioning Person: A Positive Psychology Perspective. Journal of Humanistic Psychology. 2016;56(5):503-529. doi:10.1177/0022167815605936 === How? === <blockquote>Empirical evidence also provides support of the hypothesis that more fully functioning persons move in a direction of increasing openness to experience. Rogers (1961) considered openness to experience to be the polar opposite of defensiveness. Defensiveness is “the organism’s response to experiences which are perceived or anticipated as threatening, as incongruent with the individual’s existing picture of himself, or of himself in relationship to the world” (Rogers, 1961, p. 187)</blockquote> === Case study === == Non-Clinical Use == === What areas could benifit from FFP === === Case study === == Challenges == https://www.jstor.org/stable/pdf/42573871.pdf?refreqid=excelsior%3Af77be98a01ac999d2f3e3866397ffe3d&ab_segments=&origin=&acceptTC=1 === Western perspective === There are criticisms of the fully functioning person that it is a product of primarily Western culture. Since in other cultures, Eastern cultures for example, the groups achievements are valued higher than those of any individual. === Environmental influences === == Related Theories == === Self actualisation === === Humanistic Psychology === === Client Centred Psychology === == Conclusion == == See also == [[Self-actualisation]] (Book chapter) [[Motivation and emotion/Tutorials/Growth psychology|https://en.wikiversity.org/wiki/Motivation_and_emotion/Tutorials/Growth_psychology]] Growth psychology == References == {{Hanging indent|1= Aristotle. (1996). The Nicomachean ethics (trans: Ross, W. D.). Wordsworth Editions Limited. Ware: UK. Koch, Sigmund. (Series Ed.), & Koch, S. (Vol. Ed.). (1959). Psychology: A study of a science (Vol. 3). New York: McGraw-Hill. Korsgaard, C. M. (2008). The constitution of agency: Essays on practical reason and moral psychology. Oxford: Oxford University Press. Rogers, C. R. (1959). A theory of therapy, personality, and interpersonal relationships as developed in the client-centered framework. In S. Koch (Series Ed.) & S. Koch (Vol. Ed.), Psychology: A study of a science (Vol. 3, pp. 184–256). New York: McGraw Hill. Rogers, C. R. (1961). On becoming a person. Boston: Houghton Mifflin. Rogers, C. R. (1969). Freedom to learn. Columbus, Ohio: Charles E. Merrill. Rogers, C. R. (1970). Carl Rogers on encounter groups. New York: Harper and Row. Rogers, C. R. (1972). Becoming partners: Marriage and its alternatives. New York: Dell. Rogers, C. R. (1980). Empathic: An unappreciated way of being. In A way of being (pp. 137–163). Boston: Houghton Mifflin. Rogers, C. R. (1986). Client-centered approach to therapy. In I. L. Kutash & A. Wolf (Eds.), Psychotherapist’s casebook: Theory and technique in practice (pp. 197–208). San Francisco: Jossey Bass. Straume, L.V., Vittersø, J. (2020). Fully Functioning Person. In: Zeigler-Hill, V., Shackelford, T.K. (eds) Encyclopedia of Personality and Individual Differences. Springer, Cham. https://doi.org/10.1007/978-3-319-24612-3_1469 Witty, M.C. (2007). Client-Centered Therapy. In: Kazantzis, N., LĽAbate, L. (eds) Handbook of Homework Assignments in Psychotherapy. Springer, Boston, MA . https://doi.org/10.1007/978-0-387-29681-4_3}} == External links == <nowiki>https://en.wikipedia.org/wiki/Carl_Rogers#The_fully_functioning_person</nowiki> <nowiki>https://en.wikipedia.org/wiki/Self-actualization</nowiki> [https://www.verywellmind.com/fully-functioning-person-2795197#:~:text=A%20fully%20functioning%20person%20is%20one%20who%20is%20continually%20working,open%20to%20life's%20many%20experiences. https://www.verywellmind.com/fully-functioning-person-2795197#:~:text=A%20fully%20functioning%20person%20is%20one%20who%20is%20continually%20working,open%20to%20life's%20many%20experiences.] == Overview == ''What is a FFP and How can full functioning be developed?''<blockquote> # <u>A growing openness to experience</u> # <u>An increasingly existential lifestyle</u> # <u>Increasing organismic trust</u> # <u>Freedom of choice</u> # <u>Creativity</u> # <u>Reliability and constructiveness</u> # <u>A rich full life</u> #* Rogers, Carl (1961). ''On becoming a person: A therapist's view of psychotherapy''. London: Constable. ISBN <bdi>978-1-84529-057-3</bdi>. </blockquote> == [[Caregiving and dementia/Topics/Person centred care|person-centered theory of personality]] == == History == <u>Both Plato and Aristotle proposed theories about goodness in which functioning worked as the most central concept. Arguments about goodness and functioning keep developing in contemporary work on human goodness. The work of Sen, Staudinger, and Tomasello serves as renowned examples. (https://doi.org/10.1007/978-3-319-24612-3_1469)</u><blockquote>Client-centered therapy, also called the person-centered approach, describes Carl R. Rogers’ way of working with persons experiencing all types of personal disturbances or problems in living (Rogers, 1959; 1961; 1969; 1970; 1972; 1980a; 1986a). As early as 1939, Rogers developed his theory of psychotherapy with troubled children, and went on to expand his theoretical approach to include work with couples, families, and groups. His most comprehensive theoretical statement was published as a chapter in Sigmund Koch’s Psychology: A Study of a Science (Vol. III) in 1959, and includes his theory of motivation and personality development, as well as theory of group interaction and interpersonal relationships (Koch, 1959, 184–256). Over his long career, Rogers extrapolated client-centered values to the education, marriage, group encounter, personal power, and conflict resolution (Rogers, 1969, 1970, 1972). Today, the person-centered approach is practiced in the United Kingdom, Germany, France, Greece, Portugal, Demark, Poland, Hungary, The Netherlands, Italy, Japan, Brazil, Mexico, Australia, and South Africa, as well as here in the United States and Canada. A world association, which can be contacted online, was founded in Lisbon in 1997 that reflects the growth and vitality of the approach entitled the World Association for Person-Centered and Experiential Psychotherapy and Counseling (WAPCEPC). Another international organization comprised of a diverse membership—lay persons, educators, business consultants, therapists, artists, psychologists—the Association for the Development of the Person-Centered Approach (ADPCA), is also accessible on the internet. Witty, M. C. (2007). Client-centered therapy. In ''Handbook of homework assignments in psychotherapy'' (pp. 35-50). Springer, Boston, MA.</blockquote><blockquote>According to Rogers, when fully functioning, the individual lives in close and confident relationship to the organismic valuing process, trusting that inner direction. Congruence is a constant companion. Furthermore, the fully functioning individual spontaneously communicates inner impulses both verbally and nonverbally. They are open to experience, accepts experiences as they are, and expresses those experiences in an unedited manner. The fully functioning individual is authentic. To characterize the moment-to-moment experience of the fully functioning individual, Figure 15.4 illustrates the sequential process of a motive’s emergence, acceptance, and unedited expression. The congruent, fully functioning individual lives in close proximity to the actualizing tendency and therefore experiences a marked sense of autonomy, openness to experience,and personal growth. Reeve, J. (2018). Understanding motivation and emotion. John Wiley & Sons.</blockquote><blockquote>The actualizing tendency was a theoretical construct proposed by the great holistic neurologist Kurt Goldstein (Goldstein, 1939; 1940, 1963). Witty, M.C. (2007). Client-Centered Therapy. In: Kazantzis, N., LĽAbate, L. (eds) Handbook of Homework Assignments in Psychotherapy. Springer, Boston, MA . <nowiki>https://doi.org/10.1007/978-0-387-29681-4_3</nowiki></blockquote> === [[Motivation and emotion/Tutorials/Growth psychology|Growth psychology]] === <blockquote>A second criticism is that humanistic theorists use a number of vague and ill-defined constructs. It is difficult to pinpoint precisely what an “organismic valuing process” and a “fully functioning individual” are, for example. Any theoretical construct that evades a precise operational definition must remain scientifically dubious. For this reason, humanistic views on motivation have been harshly criticized (Daniels,1988; Neher, 1991), and these criticisms were instrumental to the rise and eventual popularity of the more empirically driven (evidence-based) positive psychology. Reeve, J. (2018). Understanding motivation and emotion. John Wiley & Sons.</blockquote> === [[Talk:Carl Rogers]] === <blockquote></blockquote> === [[Motivation and emotion/Textbook/Motivation/Self-actualisation|Self-actualisation]] === === [[wikipedia:Abraham_Maslow|Abraham Maslow]] === == Clinical uses == <blockquote>This book explores, in depth, the link between modern psychiatric practice and the person-centred approach. It promotes an open dialogue between traditional rivals – counsellors and psychiatrists within the NHS – to assist greater understanding and improve practice. Easy to read and comprehend, it explains complex issues in a clear and accessible manner. The author is a full-time psychiatrist and qualified counsellor who offers a unique perspective drawing on personal experience. Humanising Psychiatry and Mental Health Care will be of significant interest and help to all mental health professionals including psychiatrists and psychiatric nurses, social care workers, occupational therapists, psychologists, person-centred counsellors and therapists. Health and social care policy makers and shapers, including patient groups, will also find it helpful and informative. Freeth, R., Thorne, B., & Shooter, M. (2007). Humanising Psychiatry and Mental Health Care: The challenge of the person-centred approach (1st ed.). CRC Press. <nowiki>https://doi.org/10.1201/9781315385051</nowiki></blockquote> == Other uses == == Conclusion == === Marking rubric === ==== Overview ==== Easy to read and understand overview of the chapter. ==== Breadth ==== Theoretical framework for understanding the topic.<blockquote>theoretical model of the person who emerges from therapy—a person functioning freely in all the fullness of his organismic potentialities; a person who is dependable in being realistic, self-enhancing, socialized and appropriate in his behavior; a creative person, whose specific formings of behavior are not easily predictable; a person who is ever-changing, ever developing, always discovering himself and the newness in himself in each succeeding moment of time. This is the person who in an imperfect way actually emerges from the experience of safety and freedom in a therapeutic experience, and this is the person whom I have tried to describe for you in "pure" form. Rogers, C. R. (1963). The concept of the fully functioning person. ''Psychotherapy: Theory, Research & Practice, 1''(1), 17–26. <nowiki>https://doi.org/10.1037/h0088567</nowiki></blockquote><blockquote>The actualizing tendency functions as an axiom in Rogers’ theory. To the extent that the therapist holds the hypothesis that the client possesses the capacity for selfdetermination he or she is more likely to perceive the client’s ideas, feelings, and actions as aspects of growth instead of pathology. It should be stated that the actualizing tendency does not mean that Rogers believed that people are “good,” simply that organisms realize their potentials limited only by internal and external environmental constraints (Rogers, 1951, 1959, 1961; Brodley, 1998). Rogers recommended that novice therapists attempt to hold the hypothesis that clients have the inner resources to meet life’s difficulties, recognizing that to discard that hypothesis would open the way for the therapist’s exerting influence over the supposedly less competent client. This hypothesis, he acknowledged, was most difficult to embrace in the face of self-destructive, self-defeating behavior on the part of the client (Rogers, 1951, pp. 20–25). Witty, M.C. (2007). Client-Centered Therapy. In: Kazantzis, N., LĽAbate, L. (eds) Handbook of Homework Assignments in Psychotherapy. Springer, Boston, MA . <nowiki>https://doi.org/10.1007/978-0-387-29681-4_3</nowiki></blockquote> ==== Depth ==== Clearly explain and integrate the theory(ies).<blockquote>Fully-functioning person. If people are able to operate their valuing processes fully, they will certainly begin to experience self movement and growth toward realization of their potentials. This shows that the person who are able be self-actualize, are called fully functioning person (Rogers, 1961). According to Roger`s terminology, they will be moving toward becoming fully functioning persons. Fully functioning person, for Rogers, are well balanced, well adjusted and interesting to know (Mcleod, 2007). Rogers, in his later writings, extended and amplified his view of the fully functioning person (1961) to emerging person (1975) Ismail, N. A. H., & Tekke, M. (2015). Rediscovering Rogers’s self theory and personality. ''Journal of Educational, Health and Community Psychology'', ''4''(3), 28-36.</blockquote> ==== Key findings ==== Explain how key, peer-reviewed research findings apply to the problem.<blockquote>Findings of this study suggested that people have intrinsic motivation to use their strengths, which results in increased authenticity, vitality, and well-being. These findings provide support for the Rogerian perspective in which autonomous individuals will show greater openness to experience and a more genuine and less defensive perception of experience (Patterson & Joseph, 2007). Overall, findings of this study suggest that the fully functioning person from the positive psychology perspective is a “person-in-process,” a person who is characterized as being in touch with their organismic valuing process (OVP) and hence experiences increased happiness and life satisfaction, who feels competent, autonomous, and relates well with others and they with them. Moreover, the fully functioning person is open, authentic, and uses their strengths, experiencing the well-being associated with doing so. When compared with other people, this person less frequently experiences feelings of anxiety or alienation from themselves. Proctor C, Tweed R, Morris D. The Rogerian Fully Functioning Person: A Positive Psychology Perspective. Journal of Humanistic Psychology. 2016;56(5):503-529. doi:10.1177/0022167815605936</blockquote> ==== Critical thinking ==== Critically analyse the research discussed. ==== Integration ==== Integrate discussion of theory and review of relevant research. ==== Conclusion ==== Emphasise the key points and take-home messages. ==== Written expression - Style ==== Readable for a layperson interested in psychological science. ==== Written expression - Learning features ==== Invite interactivity through features such as case studies, feature boxes, figures, links, tables, and quizzes. ==== Social contribution ==== Editing which enhances the quality of other book chapters. --- Add an image == Overview == You are underway {{smile}}! This template provides tips for [[Motivation and emotion/Assessment/Topic|topic development]]. Gradually remove these suggestions as you develop the chapter. Also consult the [[Motivation and emotion/Assessment/Chapter|author guidelines]]. At the top of the chapter, the title and sub-title should match the ''exact'' wording and casing as shown in the {{Motivation and emotion/Book}}. The sub-titles all end with a question mark. This Overview section should be concise but consist of several paragraphs which engage the reader, illustrate the problem, and outline how psychological science can help. {{RoundBoxTop|theme=3}} '''Focus questions:''' * What is the first focus question? * What is the second focus question? * What is the third focus question? {{RoundBoxBottom}} {{tip| Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Provide an example or case study. * Conclude with Focus questions to guide the chapter. }} ==Main headings== How you are going to structure the chapter? Aim for three to six main headings between the [[#Overview|Overview]] and [[#Conclusion|Conclusion]]. {{tip|Suggestions for this section: * For the [[Motivation and emotion/Assessment/Topic|topic development]], provide at least 3 bullet-points about key content per section. Include key citations. * For the [[Motivation and emotion/Assessment/Chapter|book chapter]], expand the bullet points into paragraphs. * If a section has a lot of content, arrange it into two to five sub-headings such as in the [[#Interactive learning features|interactive learning features section]]. Avoid having sections with only one sub-heading. }} ==Learning features== What brings an online book chapter to life are its interactive learning features. Case studies, feature boxes, figures, links, tables, and quiz questions can be used throughout the chapter. ===Case studies=== Case studies describe real-world examples of concepts in action. Case studies can be real or fictional. A case could be used multiple times during a chapter to illustrate different theories or stages. It is often helpful to present case studies using [[#Feature boxes|feature boxes]]. ===Boxes=== Boxes can be used to highlight content, but don't overuse them. There are many different ways of creating boxes (e.g., see [[Help:Pretty boxes|Pretty boxes]]). Possible uses include: * Focus questions * Case studies or examples * Quiz questions * Take-home messages {{RoundBoxTop|theme=3}} ;Feature box example * Shaded background * Coloured border {{RoundBoxBottom}} ===Figures=== [[File:Monkey-typing.jpg|right|205px|thumb|''Figure 1''. Example image with descriptive caption.]] Use figures to illustrate concepts, add interest, and provide examples. Figures can be used to show photographs, drawings, diagrams, graphs, etcetera. Figures can be embedded throughout the chapter, starting with the Overview section. Figures should be captioned (using a number and a description) in order to explain their relevance to the text. Possible images can be found at [[commons:|Wikimedia Commons]]. Images can also be uploaded if they are licensed for re-use or if you created the image. Each figure should be referred to at least once in the main text (e.g., see Figure 1). ===Links=== Where key words are first used, make them into [[Help:Links|interwiki links]] such as Wikipedia links to articles about famous people (e.g., [[w:Sigmund Freud|Sigmund Freud]] and key concepts (e.g., [[w:Dreams|dreams]]) and links to book chapters about related topics (e.g., would you like to learn about how to overcome [[Motivation and emotion/Book/2020/Writer's block|writer's block]]?). ===Tables=== Tables can be an effective way to organise and summarise information. Tables should be captioned (using APA style) to explain their relevance to the text. Plus each table should be referred to at least once in the main text (e.g., see Table 1 and Table 2). Here are some [[Motivation and emotion/Wikiversity/Tables|example 3 x 3 tables]] which could be adapted. ===Quizzes=== Quizzes are a direct way to engage readers. But don't make quizzes too hard or long. It is better to have one or two review questions per major section than a long quiz at the end. Try to quiz conceptual understanding, rather than trivia. Here are some simple quiz questions which could be adapted. Choose the correct answers and click "Submit": <quiz display=simple> {Quizzes are an interactive learning feature: |type="()"} + True - False {Long quizzes are a good idea: |type="()"} - True + False </quiz> To learn about different types of quiz questions, see [[Help:Quiz|Quiz]]. ==Conclusion== The Conclusion is arguably the most important section. It should be possible for someone to read the [[#Overview|Overview]] and the Conclusion and still get a good idea of the topic. {{tip|Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? }} ==See also== Provide up to half-a-dozen [[Help:Contents/Links#Interwiki_links|internal (wiki) links]] to relevant Wikiversity pages (esp. related [[Motivation and emotion/Book|motivation and emotion book chapters]]) and [[w:|Wikipedia articles]]. For example: * [[Motivation and emotion/Book/2016/Anorexia nervosa and extrinsic motivation|Anorexia nervosa and extrinsic motivation]] (Book chapter, 2016) * [[w:David McClelland|David McClelland]] (Wikipedia) * [[Motivation and emotion/Book/2018/Loss aversion|Loss aversion]] (Book chapter, 2018) * [[w:Maslow's hierarchy of needs|Maslow's hierarchy of needs]] (Wikipedia) {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== List the cited references in [[w:APA style|APA style]] (7th ed.) or [[w:Wikipedia:Citing sources|wiki style]]. APA style example: {{Hanging indent|1= Blair, R. J. R. (2004). The roles of orbital frontal cortex in the modulation of antisocial behavior. ''Brain and Cognition'', ''55''(1), 198–208. https://doi.org/10.1016/S0278-2626(03)00276-8 Buckholtz, J. W., & Meyer-Lindenberg, A. (2008). MAOA and the neurogenetic architecture of human aggression. ''Trends in Neurosciences'', ''31''(3), 120–129. https://doi.org/10.1016/j.tins.2007.12.006 Eckardt, M., File, S., Gessa, G., Grant, K., Guerri, C., Hoffman, P., & Tabakoff, B. (1998). Effects of moderate alcohol consumption on the central nervous system. ''Alcoholism, Clinical and Experimental Research'', ''22''(5), 998–1040. https://doi.org/10.1111/j.1530-0277.1998.tb03695.x }} {{tip|Suggestions for this section: * Important aspects for APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except first letter and proper names, ending in a full-stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full-stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't actually read or consulted }} ==External links== Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * [https://students.unimelb.edu.au/academic-skills/explore-our-resources/essay-writing/six-top-tips-for-writing-a-great-essay Six top tips for writing a great essay] (University of Melbourne) * [http://www.skillsyouneed.com/write/structure.html The importance of structure] (skillsyouneed.com) {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] [[Category:Motivation and emotion/Book/Positive psychology]] 8u26n6dxtrwj7ntsbow3w3emalkjrg5 2419387 2419386 2022-08-26T07:51:32Z Sebastian Armstrong 2947157 /* See also */ wikitext text/x-wiki {{title|Fully functioning person:<br>What is a FFP and how can full functioning be developed?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ == Overview == ;Focus questions *What it is? # '''Increasing openness to experience''' – Owning and accepting experiences as your own without a defensive barrier. # '''Increasingly existential living''' – Living in the moment without falsely distorting your perceptions or actions to fit how it 'should' be. # '''An increasing trust in their organism''' – trusting your gut and instinct without relying on social norms or external criteria of behaviour. # '''The process of functioning more fully''' – <blockquote>not being shackled by the restrictions that influence an incongruent individual; able to make a wider range of choices more fluently. Belief that one plays a role in determining one's behaviour and so feel responsible for one's own behaviour. # '''Creativity''' – feeling more free to be creative. Also more creative in the way one adapts to one's circumstances without feeling a need to conform. # '''Reliability and constructiveness''' – can be trusted to act constructively. An individual who is open to all his/her needs will be able to maintain a balance between them. Even aggressive needs will be matched and balanced by intrinsic goodness in congruent individuals. # '''A rich full life''' – the life of a fully functioning individual is rich, full and exciting; they experience joy and pain, love and heartbreak, fear and courage more intensely. Rogers' description of ''the good life'': </blockquote> *How it is developed? Rogers (1959) sugestted that people have an actualizing tendency toward development, growth and autonomy:<blockquote>This is the inherent tendency of the organism to develop all its capacities in ways which serve to maintain or enhance the organism. It involves not only the tendency to meet what Maslow (1954) terms “deficiency needs” for air, food, water, and the like, but also more generalized activities. It involves development toward the differentiation of organs and of functions, expansion in terms of growth, expansion of effectiveness through the use of tools, expansion and enhancement through reproduction. It is development toward autonomy and away from heteronomy, or control by external forces. (p. 196)</blockquote> *Whose theory is it? *How it is used? == History == === Pre-Rogers === Socrates suggests that everything has a specific function, which he defines as what that thing does best or the only thing it can do (Korsgaard, 2008). The ancient Greek's worldview suggested that, a person could only be called 'good' if their soul was in peak condition. According to Aristotle (1996), we can only know if something is good if we understand its function. He continued this theory to human nature, concluding that by performing virtuous activities of the soul, one can achieve the hight of human goodness. The concept of a soul has vanished in modern psychology, and the notion of virtue has evolved. However, the concept that goodness and functionality are linked was adopted by the first wave of humanistic psychology, most notably by Carl Rogers (Straume, 2020). === Carl Rogers === [[File:Carl Rogers.jpg|thumb|Figure 1. Carl Rogers|alt=Artist rendition of Carl Rogers]] The person-centered approach, often known as client-centered therapy, is Carl R. Rogers' method for assisting people who are dealing with a variety of personal disturbances or issues in their daily lives (Rogers, 1959; 1961; 1969; 1970; 1972; 1980; 1986). In 1939, Rogers created his theory of psychotherapy for troubled kids (Witty, 2007). Later, he broadened his theoretical framework to cover work with groups, families, and couples. His most complete theoretical statement, which covers his theories of motivation and personality development as well as those of group interaction and interpersonal interactions, was published as a chapter in Sigmund Koch's Psychology: A Study of a Science (Vol. III) in 1959. (Koch, 1959, 184–256). === Explore 7 points of FFP === === FFP - What is it/why it exists === === How do you develop FFP === == Clinical Use == === What is it used for? === <blockquote>Rogers (1959) noted several changes customarily associated with outcomes or results experienced by a person becoming more fully functioning, which are observed outside of the therapeutic relationship. The following changes were hypothesized as being relatively permanent:</blockquote> # Being more congruent, open to experience, and less defensive # Having improved psychological adjustment # Having an increased degree of positive self-regard # Perceiving the locus of evaluation and the locus of choice as residing within oneself # Experiencing more acceptance of others<blockquote>Consequences or results of the above changes:</blockquote> # More realistic, objective, extensional in perceptions, and more effective in problem solving # Less vulnerable to threat # More confident and self-directing # Values are determined by an OVP # Perceive others more realistically and accurately # Behaviors “owned” by the self are increased and those disowned as “not myself” are decreased # Behavior is perceived as being more within control, socialized, mature, creative, uniquely adaptive to new situations and problems, and fully expressive of own purpose and values Proctor C, Tweed R, Morris D. The Rogerian Fully Functioning Person: A Positive Psychology Perspective. Journal of Humanistic Psychology. 2016;56(5):503-529. doi:10.1177/0022167815605936 === How? === <blockquote>Empirical evidence also provides support of the hypothesis that more fully functioning persons move in a direction of increasing openness to experience. Rogers (1961) considered openness to experience to be the polar opposite of defensiveness. Defensiveness is “the organism’s response to experiences which are perceived or anticipated as threatening, as incongruent with the individual’s existing picture of himself, or of himself in relationship to the world” (Rogers, 1961, p. 187)</blockquote> === Case study === == Non-Clinical Use == === What areas could benifit from FFP === === Case study === == Challenges == https://www.jstor.org/stable/pdf/42573871.pdf?refreqid=excelsior%3Af77be98a01ac999d2f3e3866397ffe3d&ab_segments=&origin=&acceptTC=1 === Western perspective === There are criticisms of the fully functioning person that it is a product of primarily Western culture. Since in other cultures, Eastern cultures for example, the groups achievements are valued higher than those of any individual. === Environmental influences === == Related Theories == === Self actualisation === === Humanistic Psychology === === Client Centred Psychology === == Conclusion == == See also == [[Self-actualisation]] (Book chapter) [[Motivation and emotion/Tutorials/Growth psychology|Growth psychology]] == References == {{Hanging indent|1= Aristotle. (1996). The Nicomachean ethics (trans: Ross, W. D.). Wordsworth Editions Limited. Ware: UK. Koch, Sigmund. (Series Ed.), & Koch, S. (Vol. Ed.). (1959). Psychology: A study of a science (Vol. 3). New York: McGraw-Hill. Korsgaard, C. M. (2008). The constitution of agency: Essays on practical reason and moral psychology. Oxford: Oxford University Press. Rogers, C. R. (1959). A theory of therapy, personality, and interpersonal relationships as developed in the client-centered framework. In S. Koch (Series Ed.) & S. Koch (Vol. Ed.), Psychology: A study of a science (Vol. 3, pp. 184–256). New York: McGraw Hill. Rogers, C. R. (1961). On becoming a person. Boston: Houghton Mifflin. Rogers, C. R. (1969). Freedom to learn. Columbus, Ohio: Charles E. Merrill. Rogers, C. R. (1970). Carl Rogers on encounter groups. New York: Harper and Row. Rogers, C. R. (1972). Becoming partners: Marriage and its alternatives. New York: Dell. Rogers, C. R. (1980). Empathic: An unappreciated way of being. In A way of being (pp. 137–163). Boston: Houghton Mifflin. Rogers, C. R. (1986). Client-centered approach to therapy. In I. L. Kutash & A. Wolf (Eds.), Psychotherapist’s casebook: Theory and technique in practice (pp. 197–208). San Francisco: Jossey Bass. Straume, L.V., Vittersø, J. (2020). Fully Functioning Person. In: Zeigler-Hill, V., Shackelford, T.K. (eds) Encyclopedia of Personality and Individual Differences. Springer, Cham. https://doi.org/10.1007/978-3-319-24612-3_1469 Witty, M.C. (2007). Client-Centered Therapy. In: Kazantzis, N., LĽAbate, L. (eds) Handbook of Homework Assignments in Psychotherapy. Springer, Boston, MA . https://doi.org/10.1007/978-0-387-29681-4_3}} == External links == <nowiki>https://en.wikipedia.org/wiki/Carl_Rogers#The_fully_functioning_person</nowiki> <nowiki>https://en.wikipedia.org/wiki/Self-actualization</nowiki> [https://www.verywellmind.com/fully-functioning-person-2795197#:~:text=A%20fully%20functioning%20person%20is%20one%20who%20is%20continually%20working,open%20to%20life's%20many%20experiences. https://www.verywellmind.com/fully-functioning-person-2795197#:~:text=A%20fully%20functioning%20person%20is%20one%20who%20is%20continually%20working,open%20to%20life's%20many%20experiences.] == Overview == ''What is a FFP and How can full functioning be developed?''<blockquote> # <u>A growing openness to experience</u> # <u>An increasingly existential lifestyle</u> # <u>Increasing organismic trust</u> # <u>Freedom of choice</u> # <u>Creativity</u> # <u>Reliability and constructiveness</u> # <u>A rich full life</u> #* Rogers, Carl (1961). ''On becoming a person: A therapist's view of psychotherapy''. London: Constable. ISBN <bdi>978-1-84529-057-3</bdi>. </blockquote> == [[Caregiving and dementia/Topics/Person centred care|person-centered theory of personality]] == == History == <u>Both Plato and Aristotle proposed theories about goodness in which functioning worked as the most central concept. Arguments about goodness and functioning keep developing in contemporary work on human goodness. The work of Sen, Staudinger, and Tomasello serves as renowned examples. (https://doi.org/10.1007/978-3-319-24612-3_1469)</u><blockquote>Client-centered therapy, also called the person-centered approach, describes Carl R. Rogers’ way of working with persons experiencing all types of personal disturbances or problems in living (Rogers, 1959; 1961; 1969; 1970; 1972; 1980a; 1986a). As early as 1939, Rogers developed his theory of psychotherapy with troubled children, and went on to expand his theoretical approach to include work with couples, families, and groups. His most comprehensive theoretical statement was published as a chapter in Sigmund Koch’s Psychology: A Study of a Science (Vol. III) in 1959, and includes his theory of motivation and personality development, as well as theory of group interaction and interpersonal relationships (Koch, 1959, 184–256). Over his long career, Rogers extrapolated client-centered values to the education, marriage, group encounter, personal power, and conflict resolution (Rogers, 1969, 1970, 1972). Today, the person-centered approach is practiced in the United Kingdom, Germany, France, Greece, Portugal, Demark, Poland, Hungary, The Netherlands, Italy, Japan, Brazil, Mexico, Australia, and South Africa, as well as here in the United States and Canada. A world association, which can be contacted online, was founded in Lisbon in 1997 that reflects the growth and vitality of the approach entitled the World Association for Person-Centered and Experiential Psychotherapy and Counseling (WAPCEPC). Another international organization comprised of a diverse membership—lay persons, educators, business consultants, therapists, artists, psychologists—the Association for the Development of the Person-Centered Approach (ADPCA), is also accessible on the internet. Witty, M. C. (2007). Client-centered therapy. In ''Handbook of homework assignments in psychotherapy'' (pp. 35-50). Springer, Boston, MA.</blockquote><blockquote>According to Rogers, when fully functioning, the individual lives in close and confident relationship to the organismic valuing process, trusting that inner direction. Congruence is a constant companion. Furthermore, the fully functioning individual spontaneously communicates inner impulses both verbally and nonverbally. They are open to experience, accepts experiences as they are, and expresses those experiences in an unedited manner. The fully functioning individual is authentic. To characterize the moment-to-moment experience of the fully functioning individual, Figure 15.4 illustrates the sequential process of a motive’s emergence, acceptance, and unedited expression. The congruent, fully functioning individual lives in close proximity to the actualizing tendency and therefore experiences a marked sense of autonomy, openness to experience,and personal growth. Reeve, J. (2018). Understanding motivation and emotion. John Wiley & Sons.</blockquote><blockquote>The actualizing tendency was a theoretical construct proposed by the great holistic neurologist Kurt Goldstein (Goldstein, 1939; 1940, 1963). Witty, M.C. (2007). Client-Centered Therapy. In: Kazantzis, N., LĽAbate, L. (eds) Handbook of Homework Assignments in Psychotherapy. Springer, Boston, MA . <nowiki>https://doi.org/10.1007/978-0-387-29681-4_3</nowiki></blockquote> === [[Motivation and emotion/Tutorials/Growth psychology|Growth psychology]] === <blockquote>A second criticism is that humanistic theorists use a number of vague and ill-defined constructs. It is difficult to pinpoint precisely what an “organismic valuing process” and a “fully functioning individual” are, for example. Any theoretical construct that evades a precise operational definition must remain scientifically dubious. For this reason, humanistic views on motivation have been harshly criticized (Daniels,1988; Neher, 1991), and these criticisms were instrumental to the rise and eventual popularity of the more empirically driven (evidence-based) positive psychology. Reeve, J. (2018). Understanding motivation and emotion. John Wiley & Sons.</blockquote> === [[Talk:Carl Rogers]] === <blockquote></blockquote> === [[Motivation and emotion/Textbook/Motivation/Self-actualisation|Self-actualisation]] === === [[wikipedia:Abraham_Maslow|Abraham Maslow]] === == Clinical uses == <blockquote>This book explores, in depth, the link between modern psychiatric practice and the person-centred approach. It promotes an open dialogue between traditional rivals – counsellors and psychiatrists within the NHS – to assist greater understanding and improve practice. Easy to read and comprehend, it explains complex issues in a clear and accessible manner. The author is a full-time psychiatrist and qualified counsellor who offers a unique perspective drawing on personal experience. Humanising Psychiatry and Mental Health Care will be of significant interest and help to all mental health professionals including psychiatrists and psychiatric nurses, social care workers, occupational therapists, psychologists, person-centred counsellors and therapists. Health and social care policy makers and shapers, including patient groups, will also find it helpful and informative. Freeth, R., Thorne, B., & Shooter, M. (2007). Humanising Psychiatry and Mental Health Care: The challenge of the person-centred approach (1st ed.). CRC Press. <nowiki>https://doi.org/10.1201/9781315385051</nowiki></blockquote> == Other uses == == Conclusion == === Marking rubric === ==== Overview ==== Easy to read and understand overview of the chapter. ==== Breadth ==== Theoretical framework for understanding the topic.<blockquote>theoretical model of the person who emerges from therapy—a person functioning freely in all the fullness of his organismic potentialities; a person who is dependable in being realistic, self-enhancing, socialized and appropriate in his behavior; a creative person, whose specific formings of behavior are not easily predictable; a person who is ever-changing, ever developing, always discovering himself and the newness in himself in each succeeding moment of time. This is the person who in an imperfect way actually emerges from the experience of safety and freedom in a therapeutic experience, and this is the person whom I have tried to describe for you in "pure" form. Rogers, C. R. (1963). The concept of the fully functioning person. ''Psychotherapy: Theory, Research & Practice, 1''(1), 17–26. <nowiki>https://doi.org/10.1037/h0088567</nowiki></blockquote><blockquote>The actualizing tendency functions as an axiom in Rogers’ theory. To the extent that the therapist holds the hypothesis that the client possesses the capacity for selfdetermination he or she is more likely to perceive the client’s ideas, feelings, and actions as aspects of growth instead of pathology. It should be stated that the actualizing tendency does not mean that Rogers believed that people are “good,” simply that organisms realize their potentials limited only by internal and external environmental constraints (Rogers, 1951, 1959, 1961; Brodley, 1998). Rogers recommended that novice therapists attempt to hold the hypothesis that clients have the inner resources to meet life’s difficulties, recognizing that to discard that hypothesis would open the way for the therapist’s exerting influence over the supposedly less competent client. This hypothesis, he acknowledged, was most difficult to embrace in the face of self-destructive, self-defeating behavior on the part of the client (Rogers, 1951, pp. 20–25). Witty, M.C. (2007). Client-Centered Therapy. In: Kazantzis, N., LĽAbate, L. (eds) Handbook of Homework Assignments in Psychotherapy. Springer, Boston, MA . <nowiki>https://doi.org/10.1007/978-0-387-29681-4_3</nowiki></blockquote> ==== Depth ==== Clearly explain and integrate the theory(ies).<blockquote>Fully-functioning person. If people are able to operate their valuing processes fully, they will certainly begin to experience self movement and growth toward realization of their potentials. This shows that the person who are able be self-actualize, are called fully functioning person (Rogers, 1961). According to Roger`s terminology, they will be moving toward becoming fully functioning persons. Fully functioning person, for Rogers, are well balanced, well adjusted and interesting to know (Mcleod, 2007). Rogers, in his later writings, extended and amplified his view of the fully functioning person (1961) to emerging person (1975) Ismail, N. A. H., & Tekke, M. (2015). Rediscovering Rogers’s self theory and personality. ''Journal of Educational, Health and Community Psychology'', ''4''(3), 28-36.</blockquote> ==== Key findings ==== Explain how key, peer-reviewed research findings apply to the problem.<blockquote>Findings of this study suggested that people have intrinsic motivation to use their strengths, which results in increased authenticity, vitality, and well-being. These findings provide support for the Rogerian perspective in which autonomous individuals will show greater openness to experience and a more genuine and less defensive perception of experience (Patterson & Joseph, 2007). Overall, findings of this study suggest that the fully functioning person from the positive psychology perspective is a “person-in-process,” a person who is characterized as being in touch with their organismic valuing process (OVP) and hence experiences increased happiness and life satisfaction, who feels competent, autonomous, and relates well with others and they with them. Moreover, the fully functioning person is open, authentic, and uses their strengths, experiencing the well-being associated with doing so. When compared with other people, this person less frequently experiences feelings of anxiety or alienation from themselves. Proctor C, Tweed R, Morris D. The Rogerian Fully Functioning Person: A Positive Psychology Perspective. Journal of Humanistic Psychology. 2016;56(5):503-529. doi:10.1177/0022167815605936</blockquote> ==== Critical thinking ==== Critically analyse the research discussed. ==== Integration ==== Integrate discussion of theory and review of relevant research. ==== Conclusion ==== Emphasise the key points and take-home messages. ==== Written expression - Style ==== Readable for a layperson interested in psychological science. ==== Written expression - Learning features ==== Invite interactivity through features such as case studies, feature boxes, figures, links, tables, and quizzes. ==== Social contribution ==== Editing which enhances the quality of other book chapters. --- Add an image == Overview == You are underway {{smile}}! This template provides tips for [[Motivation and emotion/Assessment/Topic|topic development]]. Gradually remove these suggestions as you develop the chapter. Also consult the [[Motivation and emotion/Assessment/Chapter|author guidelines]]. At the top of the chapter, the title and sub-title should match the ''exact'' wording and casing as shown in the {{Motivation and emotion/Book}}. The sub-titles all end with a question mark. This Overview section should be concise but consist of several paragraphs which engage the reader, illustrate the problem, and outline how psychological science can help. {{RoundBoxTop|theme=3}} '''Focus questions:''' * What is the first focus question? * What is the second focus question? * What is the third focus question? {{RoundBoxBottom}} {{tip| Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Provide an example or case study. * Conclude with Focus questions to guide the chapter. }} ==Main headings== How you are going to structure the chapter? Aim for three to six main headings between the [[#Overview|Overview]] and [[#Conclusion|Conclusion]]. {{tip|Suggestions for this section: * For the [[Motivation and emotion/Assessment/Topic|topic development]], provide at least 3 bullet-points about key content per section. Include key citations. * For the [[Motivation and emotion/Assessment/Chapter|book chapter]], expand the bullet points into paragraphs. * If a section has a lot of content, arrange it into two to five sub-headings such as in the [[#Interactive learning features|interactive learning features section]]. Avoid having sections with only one sub-heading. }} ==Learning features== What brings an online book chapter to life are its interactive learning features. Case studies, feature boxes, figures, links, tables, and quiz questions can be used throughout the chapter. ===Case studies=== Case studies describe real-world examples of concepts in action. Case studies can be real or fictional. A case could be used multiple times during a chapter to illustrate different theories or stages. It is often helpful to present case studies using [[#Feature boxes|feature boxes]]. ===Boxes=== Boxes can be used to highlight content, but don't overuse them. There are many different ways of creating boxes (e.g., see [[Help:Pretty boxes|Pretty boxes]]). Possible uses include: * Focus questions * Case studies or examples * Quiz questions * Take-home messages {{RoundBoxTop|theme=3}} ;Feature box example * Shaded background * Coloured border {{RoundBoxBottom}} ===Figures=== [[File:Monkey-typing.jpg|right|205px|thumb|''Figure 1''. Example image with descriptive caption.]] Use figures to illustrate concepts, add interest, and provide examples. Figures can be used to show photographs, drawings, diagrams, graphs, etcetera. Figures can be embedded throughout the chapter, starting with the Overview section. Figures should be captioned (using a number and a description) in order to explain their relevance to the text. Possible images can be found at [[commons:|Wikimedia Commons]]. Images can also be uploaded if they are licensed for re-use or if you created the image. Each figure should be referred to at least once in the main text (e.g., see Figure 1). ===Links=== Where key words are first used, make them into [[Help:Links|interwiki links]] such as Wikipedia links to articles about famous people (e.g., [[w:Sigmund Freud|Sigmund Freud]] and key concepts (e.g., [[w:Dreams|dreams]]) and links to book chapters about related topics (e.g., would you like to learn about how to overcome [[Motivation and emotion/Book/2020/Writer's block|writer's block]]?). ===Tables=== Tables can be an effective way to organise and summarise information. Tables should be captioned (using APA style) to explain their relevance to the text. Plus each table should be referred to at least once in the main text (e.g., see Table 1 and Table 2). Here are some [[Motivation and emotion/Wikiversity/Tables|example 3 x 3 tables]] which could be adapted. ===Quizzes=== Quizzes are a direct way to engage readers. But don't make quizzes too hard or long. It is better to have one or two review questions per major section than a long quiz at the end. Try to quiz conceptual understanding, rather than trivia. Here are some simple quiz questions which could be adapted. Choose the correct answers and click "Submit": <quiz display=simple> {Quizzes are an interactive learning feature: |type="()"} + True - False {Long quizzes are a good idea: |type="()"} - True + False </quiz> To learn about different types of quiz questions, see [[Help:Quiz|Quiz]]. ==Conclusion== The Conclusion is arguably the most important section. It should be possible for someone to read the [[#Overview|Overview]] and the Conclusion and still get a good idea of the topic. {{tip|Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? }} ==See also== Provide up to half-a-dozen [[Help:Contents/Links#Interwiki_links|internal (wiki) links]] to relevant Wikiversity pages (esp. related [[Motivation and emotion/Book|motivation and emotion book chapters]]) and [[w:|Wikipedia articles]]. For example: * [[Motivation and emotion/Book/2016/Anorexia nervosa and extrinsic motivation|Anorexia nervosa and extrinsic motivation]] (Book chapter, 2016) * [[w:David McClelland|David McClelland]] (Wikipedia) * [[Motivation and emotion/Book/2018/Loss aversion|Loss aversion]] (Book chapter, 2018) * [[w:Maslow's hierarchy of needs|Maslow's hierarchy of needs]] (Wikipedia) {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== List the cited references in [[w:APA style|APA style]] (7th ed.) or [[w:Wikipedia:Citing sources|wiki style]]. APA style example: {{Hanging indent|1= Blair, R. J. R. (2004). The roles of orbital frontal cortex in the modulation of antisocial behavior. ''Brain and Cognition'', ''55''(1), 198–208. https://doi.org/10.1016/S0278-2626(03)00276-8 Buckholtz, J. W., & Meyer-Lindenberg, A. (2008). MAOA and the neurogenetic architecture of human aggression. ''Trends in Neurosciences'', ''31''(3), 120–129. https://doi.org/10.1016/j.tins.2007.12.006 Eckardt, M., File, S., Gessa, G., Grant, K., Guerri, C., Hoffman, P., & Tabakoff, B. (1998). Effects of moderate alcohol consumption on the central nervous system. ''Alcoholism, Clinical and Experimental Research'', ''22''(5), 998–1040. https://doi.org/10.1111/j.1530-0277.1998.tb03695.x }} {{tip|Suggestions for this section: * Important aspects for APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except first letter and proper names, ending in a full-stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full-stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't actually read or consulted }} ==External links== Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * [https://students.unimelb.edu.au/academic-skills/explore-our-resources/essay-writing/six-top-tips-for-writing-a-great-essay Six top tips for writing a great essay] (University of Melbourne) * [http://www.skillsyouneed.com/write/structure.html The importance of structure] (skillsyouneed.com) {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] [[Category:Motivation and emotion/Book/Positive psychology]] 4axcej5skxe6d9yzrrkmt2m7mgxgb31 2419391 2419387 2022-08-26T07:59:49Z Sebastian Armstrong 2947157 /* Explore 7 points of FFP */ wikitext text/x-wiki {{title|Fully functioning person:<br>What is a FFP and how can full functioning be developed?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ == Overview == ;Focus questions *What it is? # '''Increasing openness to experience''' – Owning and accepting experiences as your own without a defensive barrier. # '''Increasingly existential living''' – Living in the moment without falsely distorting your perceptions or actions to fit how it 'should' be. # '''An increasing trust in their organism''' – trusting your gut and instinct without relying on social norms or external criteria of behaviour. # '''The process of functioning more fully''' – <blockquote>not being shackled by the restrictions that influence an incongruent individual; able to make a wider range of choices more fluently. Belief that one plays a role in determining one's behaviour and so feel responsible for one's own behaviour. # '''Creativity''' – feeling more free to be creative. Also more creative in the way one adapts to one's circumstances without feeling a need to conform. # '''Reliability and constructiveness''' – can be trusted to act constructively. An individual who is open to all his/her needs will be able to maintain a balance between them. Even aggressive needs will be matched and balanced by intrinsic goodness in congruent individuals. # '''A rich full life''' – the life of a fully functioning individual is rich, full and exciting; they experience joy and pain, love and heartbreak, fear and courage more intensely. Rogers' description of ''the good life'': </blockquote> *How it is developed? Rogers (1959) sugestted that people have an actualizing tendency toward development, growth and autonomy:<blockquote>This is the inherent tendency of the organism to develop all its capacities in ways which serve to maintain or enhance the organism. It involves not only the tendency to meet what Maslow (1954) terms “deficiency needs” for air, food, water, and the like, but also more generalized activities. It involves development toward the differentiation of organs and of functions, expansion in terms of growth, expansion of effectiveness through the use of tools, expansion and enhancement through reproduction. It is development toward autonomy and away from heteronomy, or control by external forces. (p. 196)</blockquote> *Whose theory is it? *How it is used? == History == === Pre-Rogers === Socrates suggests that everything has a specific function, which he defines as what that thing does best or the only thing it can do (Korsgaard, 2008). The ancient Greek's worldview suggested that, a person could only be called 'good' if their soul was in peak condition. According to Aristotle (1996), we can only know if something is good if we understand its function. He continued this theory to human nature, concluding that by performing virtuous activities of the soul, one can achieve the hight of human goodness. The concept of a soul has vanished in modern psychology, and the notion of virtue has evolved. However, the concept that goodness and functionality are linked was adopted by the first wave of humanistic psychology, most notably by Carl Rogers (Straume, 2020). === Carl Rogers === [[File:Carl Rogers.jpg|thumb|Figure 1. Carl Rogers|alt=Artist rendition of Carl Rogers]] The person-centered approach, often known as client-centered therapy, is Carl R. Rogers' method for assisting people who are dealing with a variety of personal disturbances or issues in their daily lives (Rogers, 1959; 1961; 1969; 1970; 1972; 1980; 1986). In 1939, Rogers created his theory of psychotherapy for troubled kids (Witty, 2007). Later, he broadened his theoretical framework to cover work with groups, families, and couples. His most complete theoretical statement, which covers his theories of motivation and personality development as well as those of group interaction and interpersonal interactions, was published as a chapter in Sigmund Koch's Psychology: A Study of a Science (Vol. III) in 1959. (Koch, 1959, 184–256). * Explore 7 points of FFP * FFP - What is it/why it exists * How do you develop FFP == Clinical Use == === What is it used for? === <blockquote>Rogers (1959) noted several changes customarily associated with outcomes or results experienced by a person becoming more fully functioning, which are observed outside of the therapeutic relationship. The following changes were hypothesized as being relatively permanent:</blockquote> # Being more congruent, open to experience, and less defensive # Having improved psychological adjustment # Having an increased degree of positive self-regard # Perceiving the locus of evaluation and the locus of choice as residing within oneself # Experiencing more acceptance of others<blockquote>Consequences or results of the above changes:</blockquote> # More realistic, objective, extensional in perceptions, and more effective in problem solving # Less vulnerable to threat # More confident and self-directing # Values are determined by an OVP # Perceive others more realistically and accurately # Behaviors “owned” by the self are increased and those disowned as “not myself” are decreased # Behavior is perceived as being more within control, socialized, mature, creative, uniquely adaptive to new situations and problems, and fully expressive of own purpose and values Proctor C, Tweed R, Morris D. The Rogerian Fully Functioning Person: A Positive Psychology Perspective. Journal of Humanistic Psychology. 2016;56(5):503-529. doi:10.1177/0022167815605936 === How? === <blockquote>Empirical evidence also provides support of the hypothesis that more fully functioning persons move in a direction of increasing openness to experience. Rogers (1961) considered openness to experience to be the polar opposite of defensiveness. Defensiveness is “the organism’s response to experiences which are perceived or anticipated as threatening, as incongruent with the individual’s existing picture of himself, or of himself in relationship to the world” (Rogers, 1961, p. 187)</blockquote> === Case study === == Non-Clinical Use == === What areas could benifit from FFP === === Case study === == Challenges == https://www.jstor.org/stable/pdf/42573871.pdf?refreqid=excelsior%3Af77be98a01ac999d2f3e3866397ffe3d&ab_segments=&origin=&acceptTC=1 === Western perspective === There are criticisms of the fully functioning person that it is a product of primarily Western culture. Since in other cultures, Eastern cultures for example, the groups achievements are valued higher than those of any individual. === Environmental influences === == Related Theories == === Self actualisation === === Humanistic Psychology === === Client Centred Psychology === == Conclusion == == See also == [[Self-actualisation]] (Book chapter) [[Motivation and emotion/Tutorials/Growth psychology|Growth psychology]] == References == {{Hanging indent|1= Aristotle. (1996). The Nicomachean ethics (trans: Ross, W. D.). Wordsworth Editions Limited. Ware: UK. Koch, Sigmund. (Series Ed.), & Koch, S. (Vol. Ed.). (1959). Psychology: A study of a science (Vol. 3). New York: McGraw-Hill. Korsgaard, C. M. (2008). The constitution of agency: Essays on practical reason and moral psychology. Oxford: Oxford University Press. Rogers, C. R. (1959). A theory of therapy, personality, and interpersonal relationships as developed in the client-centered framework. In S. Koch (Series Ed.) & S. Koch (Vol. Ed.), Psychology: A study of a science (Vol. 3, pp. 184–256). New York: McGraw Hill. Rogers, C. R. (1961). On becoming a person. Boston: Houghton Mifflin. Rogers, C. R. (1969). Freedom to learn. Columbus, Ohio: Charles E. Merrill. Rogers, C. R. (1970). Carl Rogers on encounter groups. New York: Harper and Row. Rogers, C. R. (1972). Becoming partners: Marriage and its alternatives. New York: Dell. Rogers, C. R. (1980). Empathic: An unappreciated way of being. In A way of being (pp. 137–163). Boston: Houghton Mifflin. Rogers, C. R. (1986). Client-centered approach to therapy. In I. L. Kutash & A. Wolf (Eds.), Psychotherapist’s casebook: Theory and technique in practice (pp. 197–208). San Francisco: Jossey Bass. Straume, L.V., Vittersø, J. (2020). Fully Functioning Person. In: Zeigler-Hill, V., Shackelford, T.K. (eds) Encyclopedia of Personality and Individual Differences. Springer, Cham. https://doi.org/10.1007/978-3-319-24612-3_1469 Witty, M.C. (2007). Client-Centered Therapy. In: Kazantzis, N., LĽAbate, L. (eds) Handbook of Homework Assignments in Psychotherapy. Springer, Boston, MA . https://doi.org/10.1007/978-0-387-29681-4_3}} == External links == <nowiki>https://en.wikipedia.org/wiki/Carl_Rogers#The_fully_functioning_person</nowiki> <nowiki>https://en.wikipedia.org/wiki/Self-actualization</nowiki> [https://www.verywellmind.com/fully-functioning-person-2795197#:~:text=A%20fully%20functioning%20person%20is%20one%20who%20is%20continually%20working,open%20to%20life's%20many%20experiences. https://www.verywellmind.com/fully-functioning-person-2795197#:~:text=A%20fully%20functioning%20person%20is%20one%20who%20is%20continually%20working,open%20to%20life's%20many%20experiences.] == Overview == ''What is a FFP and How can full functioning be developed?''<blockquote> # <u>A growing openness to experience</u> # <u>An increasingly existential lifestyle</u> # <u>Increasing organismic trust</u> # <u>Freedom of choice</u> # <u>Creativity</u> # <u>Reliability and constructiveness</u> # <u>A rich full life</u> #* Rogers, Carl (1961). ''On becoming a person: A therapist's view of psychotherapy''. London: Constable. ISBN <bdi>978-1-84529-057-3</bdi>. </blockquote> == [[Caregiving and dementia/Topics/Person centred care|person-centered theory of personality]] == == History == <u>Both Plato and Aristotle proposed theories about goodness in which functioning worked as the most central concept. Arguments about goodness and functioning keep developing in contemporary work on human goodness. The work of Sen, Staudinger, and Tomasello serves as renowned examples. (https://doi.org/10.1007/978-3-319-24612-3_1469)</u><blockquote>Client-centered therapy, also called the person-centered approach, describes Carl R. Rogers’ way of working with persons experiencing all types of personal disturbances or problems in living (Rogers, 1959; 1961; 1969; 1970; 1972; 1980a; 1986a). As early as 1939, Rogers developed his theory of psychotherapy with troubled children, and went on to expand his theoretical approach to include work with couples, families, and groups. His most comprehensive theoretical statement was published as a chapter in Sigmund Koch’s Psychology: A Study of a Science (Vol. III) in 1959, and includes his theory of motivation and personality development, as well as theory of group interaction and interpersonal relationships (Koch, 1959, 184–256). Over his long career, Rogers extrapolated client-centered values to the education, marriage, group encounter, personal power, and conflict resolution (Rogers, 1969, 1970, 1972). Today, the person-centered approach is practiced in the United Kingdom, Germany, France, Greece, Portugal, Demark, Poland, Hungary, The Netherlands, Italy, Japan, Brazil, Mexico, Australia, and South Africa, as well as here in the United States and Canada. A world association, which can be contacted online, was founded in Lisbon in 1997 that reflects the growth and vitality of the approach entitled the World Association for Person-Centered and Experiential Psychotherapy and Counseling (WAPCEPC). Another international organization comprised of a diverse membership—lay persons, educators, business consultants, therapists, artists, psychologists—the Association for the Development of the Person-Centered Approach (ADPCA), is also accessible on the internet. Witty, M. C. (2007). Client-centered therapy. In ''Handbook of homework assignments in psychotherapy'' (pp. 35-50). Springer, Boston, MA.</blockquote><blockquote>According to Rogers, when fully functioning, the individual lives in close and confident relationship to the organismic valuing process, trusting that inner direction. Congruence is a constant companion. Furthermore, the fully functioning individual spontaneously communicates inner impulses both verbally and nonverbally. They are open to experience, accepts experiences as they are, and expresses those experiences in an unedited manner. The fully functioning individual is authentic. To characterize the moment-to-moment experience of the fully functioning individual, Figure 15.4 illustrates the sequential process of a motive’s emergence, acceptance, and unedited expression. The congruent, fully functioning individual lives in close proximity to the actualizing tendency and therefore experiences a marked sense of autonomy, openness to experience,and personal growth. Reeve, J. (2018). Understanding motivation and emotion. John Wiley & Sons.</blockquote><blockquote>The actualizing tendency was a theoretical construct proposed by the great holistic neurologist Kurt Goldstein (Goldstein, 1939; 1940, 1963). Witty, M.C. (2007). Client-Centered Therapy. In: Kazantzis, N., LĽAbate, L. (eds) Handbook of Homework Assignments in Psychotherapy. Springer, Boston, MA . <nowiki>https://doi.org/10.1007/978-0-387-29681-4_3</nowiki></blockquote> === [[Motivation and emotion/Tutorials/Growth psychology|Growth psychology]] === <blockquote>A second criticism is that humanistic theorists use a number of vague and ill-defined constructs. It is difficult to pinpoint precisely what an “organismic valuing process” and a “fully functioning individual” are, for example. Any theoretical construct that evades a precise operational definition must remain scientifically dubious. For this reason, humanistic views on motivation have been harshly criticized (Daniels,1988; Neher, 1991), and these criticisms were instrumental to the rise and eventual popularity of the more empirically driven (evidence-based) positive psychology. Reeve, J. (2018). Understanding motivation and emotion. John Wiley & Sons.</blockquote> === [[Talk:Carl Rogers]] === <blockquote></blockquote> === [[Motivation and emotion/Textbook/Motivation/Self-actualisation|Self-actualisation]] === === [[wikipedia:Abraham_Maslow|Abraham Maslow]] === == Clinical uses == <blockquote>This book explores, in depth, the link between modern psychiatric practice and the person-centred approach. It promotes an open dialogue between traditional rivals – counsellors and psychiatrists within the NHS – to assist greater understanding and improve practice. Easy to read and comprehend, it explains complex issues in a clear and accessible manner. The author is a full-time psychiatrist and qualified counsellor who offers a unique perspective drawing on personal experience. Humanising Psychiatry and Mental Health Care will be of significant interest and help to all mental health professionals including psychiatrists and psychiatric nurses, social care workers, occupational therapists, psychologists, person-centred counsellors and therapists. Health and social care policy makers and shapers, including patient groups, will also find it helpful and informative. Freeth, R., Thorne, B., & Shooter, M. (2007). Humanising Psychiatry and Mental Health Care: The challenge of the person-centred approach (1st ed.). CRC Press. <nowiki>https://doi.org/10.1201/9781315385051</nowiki></blockquote> == Other uses == == Conclusion == === Marking rubric === ==== Overview ==== Easy to read and understand overview of the chapter. ==== Breadth ==== Theoretical framework for understanding the topic.<blockquote>theoretical model of the person who emerges from therapy—a person functioning freely in all the fullness of his organismic potentialities; a person who is dependable in being realistic, self-enhancing, socialized and appropriate in his behavior; a creative person, whose specific formings of behavior are not easily predictable; a person who is ever-changing, ever developing, always discovering himself and the newness in himself in each succeeding moment of time. This is the person who in an imperfect way actually emerges from the experience of safety and freedom in a therapeutic experience, and this is the person whom I have tried to describe for you in "pure" form. Rogers, C. R. (1963). The concept of the fully functioning person. ''Psychotherapy: Theory, Research & Practice, 1''(1), 17–26. <nowiki>https://doi.org/10.1037/h0088567</nowiki></blockquote><blockquote>The actualizing tendency functions as an axiom in Rogers’ theory. To the extent that the therapist holds the hypothesis that the client possesses the capacity for selfdetermination he or she is more likely to perceive the client’s ideas, feelings, and actions as aspects of growth instead of pathology. It should be stated that the actualizing tendency does not mean that Rogers believed that people are “good,” simply that organisms realize their potentials limited only by internal and external environmental constraints (Rogers, 1951, 1959, 1961; Brodley, 1998). Rogers recommended that novice therapists attempt to hold the hypothesis that clients have the inner resources to meet life’s difficulties, recognizing that to discard that hypothesis would open the way for the therapist’s exerting influence over the supposedly less competent client. This hypothesis, he acknowledged, was most difficult to embrace in the face of self-destructive, self-defeating behavior on the part of the client (Rogers, 1951, pp. 20–25). Witty, M.C. (2007). Client-Centered Therapy. In: Kazantzis, N., LĽAbate, L. (eds) Handbook of Homework Assignments in Psychotherapy. Springer, Boston, MA . <nowiki>https://doi.org/10.1007/978-0-387-29681-4_3</nowiki></blockquote> ==== Depth ==== Clearly explain and integrate the theory(ies).<blockquote>Fully-functioning person. If people are able to operate their valuing processes fully, they will certainly begin to experience self movement and growth toward realization of their potentials. This shows that the person who are able be self-actualize, are called fully functioning person (Rogers, 1961). According to Roger`s terminology, they will be moving toward becoming fully functioning persons. Fully functioning person, for Rogers, are well balanced, well adjusted and interesting to know (Mcleod, 2007). Rogers, in his later writings, extended and amplified his view of the fully functioning person (1961) to emerging person (1975) Ismail, N. A. H., & Tekke, M. (2015). Rediscovering Rogers’s self theory and personality. ''Journal of Educational, Health and Community Psychology'', ''4''(3), 28-36.</blockquote> ==== Key findings ==== Explain how key, peer-reviewed research findings apply to the problem.<blockquote>Findings of this study suggested that people have intrinsic motivation to use their strengths, which results in increased authenticity, vitality, and well-being. These findings provide support for the Rogerian perspective in which autonomous individuals will show greater openness to experience and a more genuine and less defensive perception of experience (Patterson & Joseph, 2007). Overall, findings of this study suggest that the fully functioning person from the positive psychology perspective is a “person-in-process,” a person who is characterized as being in touch with their organismic valuing process (OVP) and hence experiences increased happiness and life satisfaction, who feels competent, autonomous, and relates well with others and they with them. Moreover, the fully functioning person is open, authentic, and uses their strengths, experiencing the well-being associated with doing so. When compared with other people, this person less frequently experiences feelings of anxiety or alienation from themselves. Proctor C, Tweed R, Morris D. The Rogerian Fully Functioning Person: A Positive Psychology Perspective. Journal of Humanistic Psychology. 2016;56(5):503-529. doi:10.1177/0022167815605936</blockquote> ==== Critical thinking ==== Critically analyse the research discussed. ==== Integration ==== Integrate discussion of theory and review of relevant research. ==== Conclusion ==== Emphasise the key points and take-home messages. ==== Written expression - Style ==== Readable for a layperson interested in psychological science. ==== Written expression - Learning features ==== Invite interactivity through features such as case studies, feature boxes, figures, links, tables, and quizzes. ==== Social contribution ==== Editing which enhances the quality of other book chapters. --- Add an image == Overview == You are underway {{smile}}! This template provides tips for [[Motivation and emotion/Assessment/Topic|topic development]]. Gradually remove these suggestions as you develop the chapter. Also consult the [[Motivation and emotion/Assessment/Chapter|author guidelines]]. At the top of the chapter, the title and sub-title should match the ''exact'' wording and casing as shown in the {{Motivation and emotion/Book}}. The sub-titles all end with a question mark. This Overview section should be concise but consist of several paragraphs which engage the reader, illustrate the problem, and outline how psychological science can help. {{RoundBoxTop|theme=3}} '''Focus questions:''' * What is the first focus question? * What is the second focus question? * What is the third focus question? {{RoundBoxBottom}} {{tip| Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Provide an example or case study. * Conclude with Focus questions to guide the chapter. }} ==Main headings== How you are going to structure the chapter? Aim for three to six main headings between the [[#Overview|Overview]] and [[#Conclusion|Conclusion]]. {{tip|Suggestions for this section: * For the [[Motivation and emotion/Assessment/Topic|topic development]], provide at least 3 bullet-points about key content per section. Include key citations. * For the [[Motivation and emotion/Assessment/Chapter|book chapter]], expand the bullet points into paragraphs. * If a section has a lot of content, arrange it into two to five sub-headings such as in the [[#Interactive learning features|interactive learning features section]]. Avoid having sections with only one sub-heading. }} ==Learning features== What brings an online book chapter to life are its interactive learning features. Case studies, feature boxes, figures, links, tables, and quiz questions can be used throughout the chapter. ===Case studies=== Case studies describe real-world examples of concepts in action. Case studies can be real or fictional. A case could be used multiple times during a chapter to illustrate different theories or stages. It is often helpful to present case studies using [[#Feature boxes|feature boxes]]. ===Boxes=== Boxes can be used to highlight content, but don't overuse them. There are many different ways of creating boxes (e.g., see [[Help:Pretty boxes|Pretty boxes]]). Possible uses include: * Focus questions * Case studies or examples * Quiz questions * Take-home messages {{RoundBoxTop|theme=3}} ;Feature box example * Shaded background * Coloured border {{RoundBoxBottom}} ===Figures=== [[File:Monkey-typing.jpg|right|205px|thumb|''Figure 1''. Example image with descriptive caption.]] Use figures to illustrate concepts, add interest, and provide examples. Figures can be used to show photographs, drawings, diagrams, graphs, etcetera. Figures can be embedded throughout the chapter, starting with the Overview section. Figures should be captioned (using a number and a description) in order to explain their relevance to the text. Possible images can be found at [[commons:|Wikimedia Commons]]. Images can also be uploaded if they are licensed for re-use or if you created the image. Each figure should be referred to at least once in the main text (e.g., see Figure 1). ===Links=== Where key words are first used, make them into [[Help:Links|interwiki links]] such as Wikipedia links to articles about famous people (e.g., [[w:Sigmund Freud|Sigmund Freud]] and key concepts (e.g., [[w:Dreams|dreams]]) and links to book chapters about related topics (e.g., would you like to learn about how to overcome [[Motivation and emotion/Book/2020/Writer's block|writer's block]]?). ===Tables=== Tables can be an effective way to organise and summarise information. Tables should be captioned (using APA style) to explain their relevance to the text. Plus each table should be referred to at least once in the main text (e.g., see Table 1 and Table 2). Here are some [[Motivation and emotion/Wikiversity/Tables|example 3 x 3 tables]] which could be adapted. ===Quizzes=== Quizzes are a direct way to engage readers. But don't make quizzes too hard or long. It is better to have one or two review questions per major section than a long quiz at the end. Try to quiz conceptual understanding, rather than trivia. Here are some simple quiz questions which could be adapted. Choose the correct answers and click "Submit": <quiz display=simple> {Quizzes are an interactive learning feature: |type="()"} + True - False {Long quizzes are a good idea: |type="()"} - True + False </quiz> To learn about different types of quiz questions, see [[Help:Quiz|Quiz]]. ==Conclusion== The Conclusion is arguably the most important section. It should be possible for someone to read the [[#Overview|Overview]] and the Conclusion and still get a good idea of the topic. {{tip|Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? }} ==See also== Provide up to half-a-dozen [[Help:Contents/Links#Interwiki_links|internal (wiki) links]] to relevant Wikiversity pages (esp. related [[Motivation and emotion/Book|motivation and emotion book chapters]]) and [[w:|Wikipedia articles]]. For example: * [[Motivation and emotion/Book/2016/Anorexia nervosa and extrinsic motivation|Anorexia nervosa and extrinsic motivation]] (Book chapter, 2016) * [[w:David McClelland|David McClelland]] (Wikipedia) * [[Motivation and emotion/Book/2018/Loss aversion|Loss aversion]] (Book chapter, 2018) * [[w:Maslow's hierarchy of needs|Maslow's hierarchy of needs]] (Wikipedia) {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== List the cited references in [[w:APA style|APA style]] (7th ed.) or [[w:Wikipedia:Citing sources|wiki style]]. APA style example: {{Hanging indent|1= Blair, R. J. R. (2004). The roles of orbital frontal cortex in the modulation of antisocial behavior. ''Brain and Cognition'', ''55''(1), 198–208. https://doi.org/10.1016/S0278-2626(03)00276-8 Buckholtz, J. W., & Meyer-Lindenberg, A. (2008). MAOA and the neurogenetic architecture of human aggression. ''Trends in Neurosciences'', ''31''(3), 120–129. https://doi.org/10.1016/j.tins.2007.12.006 Eckardt, M., File, S., Gessa, G., Grant, K., Guerri, C., Hoffman, P., & Tabakoff, B. (1998). Effects of moderate alcohol consumption on the central nervous system. ''Alcoholism, Clinical and Experimental Research'', ''22''(5), 998–1040. https://doi.org/10.1111/j.1530-0277.1998.tb03695.x }} {{tip|Suggestions for this section: * Important aspects for APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except first letter and proper names, ending in a full-stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full-stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't actually read or consulted }} ==External links== Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * [https://students.unimelb.edu.au/academic-skills/explore-our-resources/essay-writing/six-top-tips-for-writing-a-great-essay Six top tips for writing a great essay] (University of Melbourne) * [http://www.skillsyouneed.com/write/structure.html The importance of structure] (skillsyouneed.com) {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] [[Category:Motivation and emotion/Book/Positive psychology]] oniioykeu13fqp8gtce1yb5najhjvkn 2419462 2419391 2022-08-26T09:58:03Z Sebastian Armstrong 2947157 /* Conclusion */ Started Conclusion wikitext text/x-wiki {{title|Fully functioning person:<br>What is a FFP and how can full functioning be developed?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ == Overview == ;Focus questions *What it is? # '''Increasing openness to experience''' – Owning and accepting experiences as your own without a defensive barrier. # '''Increasingly existential living''' – Living in the moment without falsely distorting your perceptions or actions to fit how it 'should' be. # '''An increasing trust in their organism''' – trusting your gut and instinct without relying on social norms or external criteria of behaviour. # '''The process of functioning more fully''' – <blockquote>not being shackled by the restrictions that influence an incongruent individual; able to make a wider range of choices more fluently. Belief that one plays a role in determining one's behaviour and so feel responsible for one's own behaviour. # '''Creativity''' – feeling more free to be creative. Also more creative in the way one adapts to one's circumstances without feeling a need to conform. # '''Reliability and constructiveness''' – can be trusted to act constructively. An individual who is open to all his/her needs will be able to maintain a balance between them. Even aggressive needs will be matched and balanced by intrinsic goodness in congruent individuals. # '''A rich full life''' – the life of a fully functioning individual is rich, full and exciting; they experience joy and pain, love and heartbreak, fear and courage more intensely. Rogers' description of ''the good life'': </blockquote> *How it is developed? Rogers (1959) sugestted that people have an actualizing tendency toward development, growth and autonomy:<blockquote>This is the inherent tendency of the organism to develop all its capacities in ways which serve to maintain or enhance the organism. It involves not only the tendency to meet what Maslow (1954) terms “deficiency needs” for air, food, water, and the like, but also more generalized activities. It involves development toward the differentiation of organs and of functions, expansion in terms of growth, expansion of effectiveness through the use of tools, expansion and enhancement through reproduction. It is development toward autonomy and away from heteronomy, or control by external forces. (p. 196)</blockquote> *Whose theory is it? *How it is used? == History == === Pre-Rogers === Socrates suggests that everything has a specific function, which he defines as what that thing does best or the only thing it can do (Korsgaard, 2008). The ancient Greek's worldview suggested that, a person could only be called 'good' if their soul was in peak condition. According to Aristotle (1996), we can only know if something is good if we understand its function. He continued this theory to human nature, concluding that by performing virtuous activities of the soul, one can achieve the hight of human goodness. The concept of a soul has vanished in modern psychology, and the notion of virtue has evolved. However, the concept that goodness and functionality are linked was adopted by the first wave of humanistic psychology, most notably by Carl Rogers (Straume, 2020). === Carl Rogers === [[File:Carl Rogers.jpg|thumb|Figure 1. Carl Rogers|alt=Artist rendition of Carl Rogers]] The person-centered approach, often known as client-centered therapy, is Carl R. Rogers' method for assisting people who are dealing with a variety of personal disturbances or issues in their daily lives (Rogers, 1959; 1961; 1969; 1970; 1972; 1980; 1986). In 1939, Rogers created his theory of psychotherapy for troubled kids (Witty, 2007). Later, he broadened his theoretical framework to cover work with groups, families, and couples. His most complete theoretical statement, which covers his theories of motivation and personality development as well as those of group interaction and interpersonal interactions, was published as a chapter in Sigmund Koch's Psychology: A Study of a Science (Vol. III) in 1959. (Koch, 1959, 184–256). * Explore 7 points of FFP * FFP - What is it/why it exists * How do you develop FFP == Clinical Use == === What is it used for? === <blockquote>Rogers (1959) noted several changes customarily associated with outcomes or results experienced by a person becoming more fully functioning, which are observed outside of the therapeutic relationship. The following changes were hypothesized as being relatively permanent:</blockquote> # Being more congruent, open to experience, and less defensive # Having improved psychological adjustment # Having an increased degree of positive self-regard # Perceiving the locus of evaluation and the locus of choice as residing within oneself # Experiencing more acceptance of others<blockquote>Consequences or results of the above changes:</blockquote> # More realistic, objective, extensional in perceptions, and more effective in problem solving # Less vulnerable to threat # More confident and self-directing # Values are determined by an OVP # Perceive others more realistically and accurately # Behaviors “owned” by the self are increased and those disowned as “not myself” are decreased # Behavior is perceived as being more within control, socialized, mature, creative, uniquely adaptive to new situations and problems, and fully expressive of own purpose and values Proctor C, Tweed R, Morris D. The Rogerian Fully Functioning Person: A Positive Psychology Perspective. Journal of Humanistic Psychology. 2016;56(5):503-529. doi:10.1177/0022167815605936 === How? === <blockquote>Empirical evidence also provides support of the hypothesis that more fully functioning persons move in a direction of increasing openness to experience. Rogers (1961) considered openness to experience to be the polar opposite of defensiveness. Defensiveness is “the organism’s response to experiences which are perceived or anticipated as threatening, as incongruent with the individual’s existing picture of himself, or of himself in relationship to the world” (Rogers, 1961, p. 187)</blockquote> === Case study === == Non-Clinical Use == === What areas could benifit from FFP === === Case study === == Challenges == https://www.jstor.org/stable/pdf/42573871.pdf?refreqid=excelsior%3Af77be98a01ac999d2f3e3866397ffe3d&ab_segments=&origin=&acceptTC=1 === Western perspective === There are criticisms of the fully functioning person that it is a product of primarily Western culture. Since in other cultures, Eastern cultures for example, the groups achievements are valued higher than those of any individual. === Environmental influences === == Related Theories == === Self actualisation === === Humanistic Psychology === === Client Centred Psychology === == Conclusion == * Fully functioning person is ones journey to self actualization * You can develop this by fostering your enviroment * The benifets of being fully functioning is... == See also == [[Self-actualisation]] (Book chapter) [[Motivation and emotion/Tutorials/Growth psychology|Growth psychology]] == References == {{Hanging indent|1= Aristotle. (1996). The Nicomachean ethics (trans: Ross, W. D.). Wordsworth Editions Limited. Ware: UK. Koch, Sigmund. (Series Ed.), & Koch, S. (Vol. Ed.). (1959). Psychology: A study of a science (Vol. 3). New York: McGraw-Hill. Korsgaard, C. M. (2008). The constitution of agency: Essays on practical reason and moral psychology. Oxford: Oxford University Press. Rogers, C. R. (1959). A theory of therapy, personality, and interpersonal relationships as developed in the client-centered framework. In S. Koch (Series Ed.) & S. Koch (Vol. Ed.), Psychology: A study of a science (Vol. 3, pp. 184–256). New York: McGraw Hill. Rogers, C. R. (1961). On becoming a person. Boston: Houghton Mifflin. Rogers, C. R. (1969). Freedom to learn. Columbus, Ohio: Charles E. Merrill. Rogers, C. R. (1970). Carl Rogers on encounter groups. New York: Harper and Row. Rogers, C. R. (1972). Becoming partners: Marriage and its alternatives. New York: Dell. Rogers, C. R. (1980). Empathic: An unappreciated way of being. In A way of being (pp. 137–163). Boston: Houghton Mifflin. Rogers, C. R. (1986). Client-centered approach to therapy. In I. L. Kutash & A. Wolf (Eds.), Psychotherapist’s casebook: Theory and technique in practice (pp. 197–208). San Francisco: Jossey Bass. Straume, L.V., Vittersø, J. (2020). Fully Functioning Person. In: Zeigler-Hill, V., Shackelford, T.K. (eds) Encyclopedia of Personality and Individual Differences. Springer, Cham. https://doi.org/10.1007/978-3-319-24612-3_1469 Witty, M.C. (2007). Client-Centered Therapy. In: Kazantzis, N., LĽAbate, L. (eds) Handbook of Homework Assignments in Psychotherapy. Springer, Boston, MA . https://doi.org/10.1007/978-0-387-29681-4_3}} == External links == <nowiki>https://en.wikipedia.org/wiki/Carl_Rogers#The_fully_functioning_person</nowiki> <nowiki>https://en.wikipedia.org/wiki/Self-actualization</nowiki> [https://www.verywellmind.com/fully-functioning-person-2795197#:~:text=A%20fully%20functioning%20person%20is%20one%20who%20is%20continually%20working,open%20to%20life's%20many%20experiences. https://www.verywellmind.com/fully-functioning-person-2795197#:~:text=A%20fully%20functioning%20person%20is%20one%20who%20is%20continually%20working,open%20to%20life's%20many%20experiences.] == Overview == ''What is a FFP and How can full functioning be developed?''<blockquote> # <u>A growing openness to experience</u> # <u>An increasingly existential lifestyle</u> # <u>Increasing organismic trust</u> # <u>Freedom of choice</u> # <u>Creativity</u> # <u>Reliability and constructiveness</u> # <u>A rich full life</u> #* Rogers, Carl (1961). ''On becoming a person: A therapist's view of psychotherapy''. London: Constable. ISBN <bdi>978-1-84529-057-3</bdi>. </blockquote> == [[Caregiving and dementia/Topics/Person centred care|person-centered theory of personality]] == == History == <u>Both Plato and Aristotle proposed theories about goodness in which functioning worked as the most central concept. Arguments about goodness and functioning keep developing in contemporary work on human goodness. The work of Sen, Staudinger, and Tomasello serves as renowned examples. (https://doi.org/10.1007/978-3-319-24612-3_1469)</u><blockquote>Client-centered therapy, also called the person-centered approach, describes Carl R. Rogers’ way of working with persons experiencing all types of personal disturbances or problems in living (Rogers, 1959; 1961; 1969; 1970; 1972; 1980a; 1986a). As early as 1939, Rogers developed his theory of psychotherapy with troubled children, and went on to expand his theoretical approach to include work with couples, families, and groups. His most comprehensive theoretical statement was published as a chapter in Sigmund Koch’s Psychology: A Study of a Science (Vol. III) in 1959, and includes his theory of motivation and personality development, as well as theory of group interaction and interpersonal relationships (Koch, 1959, 184–256). Over his long career, Rogers extrapolated client-centered values to the education, marriage, group encounter, personal power, and conflict resolution (Rogers, 1969, 1970, 1972). Today, the person-centered approach is practiced in the United Kingdom, Germany, France, Greece, Portugal, Demark, Poland, Hungary, The Netherlands, Italy, Japan, Brazil, Mexico, Australia, and South Africa, as well as here in the United States and Canada. A world association, which can be contacted online, was founded in Lisbon in 1997 that reflects the growth and vitality of the approach entitled the World Association for Person-Centered and Experiential Psychotherapy and Counseling (WAPCEPC). Another international organization comprised of a diverse membership—lay persons, educators, business consultants, therapists, artists, psychologists—the Association for the Development of the Person-Centered Approach (ADPCA), is also accessible on the internet. Witty, M. C. (2007). Client-centered therapy. In ''Handbook of homework assignments in psychotherapy'' (pp. 35-50). Springer, Boston, MA.</blockquote><blockquote>According to Rogers, when fully functioning, the individual lives in close and confident relationship to the organismic valuing process, trusting that inner direction. Congruence is a constant companion. Furthermore, the fully functioning individual spontaneously communicates inner impulses both verbally and nonverbally. They are open to experience, accepts experiences as they are, and expresses those experiences in an unedited manner. The fully functioning individual is authentic. To characterize the moment-to-moment experience of the fully functioning individual, Figure 15.4 illustrates the sequential process of a motive’s emergence, acceptance, and unedited expression. The congruent, fully functioning individual lives in close proximity to the actualizing tendency and therefore experiences a marked sense of autonomy, openness to experience,and personal growth. Reeve, J. (2018). Understanding motivation and emotion. John Wiley & Sons.</blockquote><blockquote>The actualizing tendency was a theoretical construct proposed by the great holistic neurologist Kurt Goldstein (Goldstein, 1939; 1940, 1963). Witty, M.C. (2007). Client-Centered Therapy. In: Kazantzis, N., LĽAbate, L. (eds) Handbook of Homework Assignments in Psychotherapy. Springer, Boston, MA . <nowiki>https://doi.org/10.1007/978-0-387-29681-4_3</nowiki></blockquote> === [[Motivation and emotion/Tutorials/Growth psychology|Growth psychology]] === <blockquote>A second criticism is that humanistic theorists use a number of vague and ill-defined constructs. It is difficult to pinpoint precisely what an “organismic valuing process” and a “fully functioning individual” are, for example. Any theoretical construct that evades a precise operational definition must remain scientifically dubious. For this reason, humanistic views on motivation have been harshly criticized (Daniels,1988; Neher, 1991), and these criticisms were instrumental to the rise and eventual popularity of the more empirically driven (evidence-based) positive psychology. Reeve, J. (2018). Understanding motivation and emotion. John Wiley & Sons.</blockquote> === [[Talk:Carl Rogers]] === <blockquote></blockquote> === [[Motivation and emotion/Textbook/Motivation/Self-actualisation|Self-actualisation]] === === [[wikipedia:Abraham_Maslow|Abraham Maslow]] === == Clinical uses == <blockquote>This book explores, in depth, the link between modern psychiatric practice and the person-centred approach. It promotes an open dialogue between traditional rivals – counsellors and psychiatrists within the NHS – to assist greater understanding and improve practice. Easy to read and comprehend, it explains complex issues in a clear and accessible manner. The author is a full-time psychiatrist and qualified counsellor who offers a unique perspective drawing on personal experience. Humanising Psychiatry and Mental Health Care will be of significant interest and help to all mental health professionals including psychiatrists and psychiatric nurses, social care workers, occupational therapists, psychologists, person-centred counsellors and therapists. Health and social care policy makers and shapers, including patient groups, will also find it helpful and informative. Freeth, R., Thorne, B., & Shooter, M. (2007). Humanising Psychiatry and Mental Health Care: The challenge of the person-centred approach (1st ed.). CRC Press. <nowiki>https://doi.org/10.1201/9781315385051</nowiki></blockquote> == Other uses == == Conclusion == === Marking rubric === ==== Overview ==== Easy to read and understand overview of the chapter. ==== Breadth ==== Theoretical framework for understanding the topic.<blockquote>theoretical model of the person who emerges from therapy—a person functioning freely in all the fullness of his organismic potentialities; a person who is dependable in being realistic, self-enhancing, socialized and appropriate in his behavior; a creative person, whose specific formings of behavior are not easily predictable; a person who is ever-changing, ever developing, always discovering himself and the newness in himself in each succeeding moment of time. This is the person who in an imperfect way actually emerges from the experience of safety and freedom in a therapeutic experience, and this is the person whom I have tried to describe for you in "pure" form. Rogers, C. R. (1963). The concept of the fully functioning person. ''Psychotherapy: Theory, Research & Practice, 1''(1), 17–26. <nowiki>https://doi.org/10.1037/h0088567</nowiki></blockquote><blockquote>The actualizing tendency functions as an axiom in Rogers’ theory. To the extent that the therapist holds the hypothesis that the client possesses the capacity for selfdetermination he or she is more likely to perceive the client’s ideas, feelings, and actions as aspects of growth instead of pathology. It should be stated that the actualizing tendency does not mean that Rogers believed that people are “good,” simply that organisms realize their potentials limited only by internal and external environmental constraints (Rogers, 1951, 1959, 1961; Brodley, 1998). Rogers recommended that novice therapists attempt to hold the hypothesis that clients have the inner resources to meet life’s difficulties, recognizing that to discard that hypothesis would open the way for the therapist’s exerting influence over the supposedly less competent client. This hypothesis, he acknowledged, was most difficult to embrace in the face of self-destructive, self-defeating behavior on the part of the client (Rogers, 1951, pp. 20–25). Witty, M.C. (2007). Client-Centered Therapy. In: Kazantzis, N., LĽAbate, L. (eds) Handbook of Homework Assignments in Psychotherapy. Springer, Boston, MA . <nowiki>https://doi.org/10.1007/978-0-387-29681-4_3</nowiki></blockquote> ==== Depth ==== Clearly explain and integrate the theory(ies).<blockquote>Fully-functioning person. If people are able to operate their valuing processes fully, they will certainly begin to experience self movement and growth toward realization of their potentials. This shows that the person who are able be self-actualize, are called fully functioning person (Rogers, 1961). According to Roger`s terminology, they will be moving toward becoming fully functioning persons. Fully functioning person, for Rogers, are well balanced, well adjusted and interesting to know (Mcleod, 2007). Rogers, in his later writings, extended and amplified his view of the fully functioning person (1961) to emerging person (1975) Ismail, N. A. H., & Tekke, M. (2015). Rediscovering Rogers’s self theory and personality. ''Journal of Educational, Health and Community Psychology'', ''4''(3), 28-36.</blockquote> ==== Key findings ==== Explain how key, peer-reviewed research findings apply to the problem.<blockquote>Findings of this study suggested that people have intrinsic motivation to use their strengths, which results in increased authenticity, vitality, and well-being. These findings provide support for the Rogerian perspective in which autonomous individuals will show greater openness to experience and a more genuine and less defensive perception of experience (Patterson & Joseph, 2007). Overall, findings of this study suggest that the fully functioning person from the positive psychology perspective is a “person-in-process,” a person who is characterized as being in touch with their organismic valuing process (OVP) and hence experiences increased happiness and life satisfaction, who feels competent, autonomous, and relates well with others and they with them. Moreover, the fully functioning person is open, authentic, and uses their strengths, experiencing the well-being associated with doing so. When compared with other people, this person less frequently experiences feelings of anxiety or alienation from themselves. Proctor C, Tweed R, Morris D. The Rogerian Fully Functioning Person: A Positive Psychology Perspective. Journal of Humanistic Psychology. 2016;56(5):503-529. doi:10.1177/0022167815605936</blockquote> ==== Critical thinking ==== Critically analyse the research discussed. ==== Integration ==== Integrate discussion of theory and review of relevant research. ==== Conclusion ==== Emphasise the key points and take-home messages. ==== Written expression - Style ==== Readable for a layperson interested in psychological science. ==== Written expression - Learning features ==== Invite interactivity through features such as case studies, feature boxes, figures, links, tables, and quizzes. ==== Social contribution ==== Editing which enhances the quality of other book chapters. --- Add an image == Overview == You are underway {{smile}}! This template provides tips for [[Motivation and emotion/Assessment/Topic|topic development]]. Gradually remove these suggestions as you develop the chapter. Also consult the [[Motivation and emotion/Assessment/Chapter|author guidelines]]. At the top of the chapter, the title and sub-title should match the ''exact'' wording and casing as shown in the {{Motivation and emotion/Book}}. The sub-titles all end with a question mark. This Overview section should be concise but consist of several paragraphs which engage the reader, illustrate the problem, and outline how psychological science can help. {{RoundBoxTop|theme=3}} '''Focus questions:''' * What is the first focus question? * What is the second focus question? * What is the third focus question? {{RoundBoxBottom}} {{tip| Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Provide an example or case study. * Conclude with Focus questions to guide the chapter. }} ==Main headings== How you are going to structure the chapter? Aim for three to six main headings between the [[#Overview|Overview]] and [[#Conclusion|Conclusion]]. {{tip|Suggestions for this section: * For the [[Motivation and emotion/Assessment/Topic|topic development]], provide at least 3 bullet-points about key content per section. Include key citations. * For the [[Motivation and emotion/Assessment/Chapter|book chapter]], expand the bullet points into paragraphs. * If a section has a lot of content, arrange it into two to five sub-headings such as in the [[#Interactive learning features|interactive learning features section]]. Avoid having sections with only one sub-heading. }} ==Learning features== What brings an online book chapter to life are its interactive learning features. Case studies, feature boxes, figures, links, tables, and quiz questions can be used throughout the chapter. ===Case studies=== Case studies describe real-world examples of concepts in action. Case studies can be real or fictional. A case could be used multiple times during a chapter to illustrate different theories or stages. It is often helpful to present case studies using [[#Feature boxes|feature boxes]]. ===Boxes=== Boxes can be used to highlight content, but don't overuse them. There are many different ways of creating boxes (e.g., see [[Help:Pretty boxes|Pretty boxes]]). Possible uses include: * Focus questions * Case studies or examples * Quiz questions * Take-home messages {{RoundBoxTop|theme=3}} ;Feature box example * Shaded background * Coloured border {{RoundBoxBottom}} ===Figures=== [[File:Monkey-typing.jpg|right|205px|thumb|''Figure 1''. Example image with descriptive caption.]] Use figures to illustrate concepts, add interest, and provide examples. Figures can be used to show photographs, drawings, diagrams, graphs, etcetera. Figures can be embedded throughout the chapter, starting with the Overview section. Figures should be captioned (using a number and a description) in order to explain their relevance to the text. Possible images can be found at [[commons:|Wikimedia Commons]]. Images can also be uploaded if they are licensed for re-use or if you created the image. Each figure should be referred to at least once in the main text (e.g., see Figure 1). ===Links=== Where key words are first used, make them into [[Help:Links|interwiki links]] such as Wikipedia links to articles about famous people (e.g., [[w:Sigmund Freud|Sigmund Freud]] and key concepts (e.g., [[w:Dreams|dreams]]) and links to book chapters about related topics (e.g., would you like to learn about how to overcome [[Motivation and emotion/Book/2020/Writer's block|writer's block]]?). ===Tables=== Tables can be an effective way to organise and summarise information. Tables should be captioned (using APA style) to explain their relevance to the text. Plus each table should be referred to at least once in the main text (e.g., see Table 1 and Table 2). Here are some [[Motivation and emotion/Wikiversity/Tables|example 3 x 3 tables]] which could be adapted. ===Quizzes=== Quizzes are a direct way to engage readers. But don't make quizzes too hard or long. It is better to have one or two review questions per major section than a long quiz at the end. Try to quiz conceptual understanding, rather than trivia. Here are some simple quiz questions which could be adapted. Choose the correct answers and click "Submit": <quiz display=simple> {Quizzes are an interactive learning feature: |type="()"} + True - False {Long quizzes are a good idea: |type="()"} - True + False </quiz> To learn about different types of quiz questions, see [[Help:Quiz|Quiz]]. ==Conclusion== The Conclusion is arguably the most important section. It should be possible for someone to read the [[#Overview|Overview]] and the Conclusion and still get a good idea of the topic. {{tip|Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? }} ==See also== Provide up to half-a-dozen [[Help:Contents/Links#Interwiki_links|internal (wiki) links]] to relevant Wikiversity pages (esp. related [[Motivation and emotion/Book|motivation and emotion book chapters]]) and [[w:|Wikipedia articles]]. For example: * [[Motivation and emotion/Book/2016/Anorexia nervosa and extrinsic motivation|Anorexia nervosa and extrinsic motivation]] (Book chapter, 2016) * [[w:David McClelland|David McClelland]] (Wikipedia) * [[Motivation and emotion/Book/2018/Loss aversion|Loss aversion]] (Book chapter, 2018) * [[w:Maslow's hierarchy of needs|Maslow's hierarchy of needs]] (Wikipedia) {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== List the cited references in [[w:APA style|APA style]] (7th ed.) or [[w:Wikipedia:Citing sources|wiki style]]. APA style example: {{Hanging indent|1= Blair, R. J. R. (2004). The roles of orbital frontal cortex in the modulation of antisocial behavior. ''Brain and Cognition'', ''55''(1), 198–208. https://doi.org/10.1016/S0278-2626(03)00276-8 Buckholtz, J. W., & Meyer-Lindenberg, A. (2008). MAOA and the neurogenetic architecture of human aggression. ''Trends in Neurosciences'', ''31''(3), 120–129. https://doi.org/10.1016/j.tins.2007.12.006 Eckardt, M., File, S., Gessa, G., Grant, K., Guerri, C., Hoffman, P., & Tabakoff, B. (1998). Effects of moderate alcohol consumption on the central nervous system. ''Alcoholism, Clinical and Experimental Research'', ''22''(5), 998–1040. https://doi.org/10.1111/j.1530-0277.1998.tb03695.x }} {{tip|Suggestions for this section: * Important aspects for APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except first letter and proper names, ending in a full-stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full-stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't actually read or consulted }} ==External links== Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * [https://students.unimelb.edu.au/academic-skills/explore-our-resources/essay-writing/six-top-tips-for-writing-a-great-essay Six top tips for writing a great essay] (University of Melbourne) * [http://www.skillsyouneed.com/write/structure.html The importance of structure] (skillsyouneed.com) {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] [[Category:Motivation and emotion/Book/Positive psychology]] dhgu06yclbord25kpuz42b2z1s2eywp 2419482 2419462 2022-08-26T11:39:07Z Sebastian Armstrong 2947157 Added "everything below this is just referencing and planning and will be deleted in the final version" wikitext text/x-wiki {{title|Fully functioning person:<br>What is a FFP and how can full functioning be developed?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ == Overview == ;Focus questions *What it is? # '''Increasing openness to experience''' – Owning and accepting experiences as your own without a defensive barrier. # '''Increasingly existential living''' – Living in the moment without falsely distorting your perceptions or actions to fit how it 'should' be. # '''An increasing trust in their organism''' – trusting your gut and instinct without relying on social norms or external criteria of behaviour. # '''The process of functioning more fully''' – <blockquote>not being shackled by the restrictions that influence an incongruent individual; able to make a wider range of choices more fluently. Belief that one plays a role in determining one's behaviour and so feel responsible for one's own behaviour. # '''Creativity''' – feeling more free to be creative. Also more creative in the way one adapts to one's circumstances without feeling a need to conform. # '''Reliability and constructiveness''' – can be trusted to act constructively. An individual who is open to all his/her needs will be able to maintain a balance between them. Even aggressive needs will be matched and balanced by intrinsic goodness in congruent individuals. # '''A rich full life''' – the life of a fully functioning individual is rich, full and exciting; they experience joy and pain, love and heartbreak, fear and courage more intensely. Rogers' description of ''the good life'': </blockquote> *How it is developed? Rogers (1959) sugestted that people have an actualizing tendency toward development, growth and autonomy:<blockquote>This is the inherent tendency of the organism to develop all its capacities in ways which serve to maintain or enhance the organism. It involves not only the tendency to meet what Maslow (1954) terms “deficiency needs” for air, food, water, and the like, but also more generalized activities. It involves development toward the differentiation of organs and of functions, expansion in terms of growth, expansion of effectiveness through the use of tools, expansion and enhancement through reproduction. It is development toward autonomy and away from heteronomy, or control by external forces. (p. 196)</blockquote> *Whose theory is it? *How it is used? == History == === Pre-Rogers === Socrates suggests that everything has a specific function, which he defines as what that thing does best or the only thing it can do (Korsgaard, 2008). The ancient Greek's worldview suggested that, a person could only be called 'good' if their soul was in peak condition. According to Aristotle (1996), we can only know if something is good if we understand its function. He continued this theory to human nature, concluding that by performing virtuous activities of the soul, one can achieve the hight of human goodness. The concept of a soul has vanished in modern psychology, and the notion of virtue has evolved. However, the concept that goodness and functionality are linked was adopted by the first wave of humanistic psychology, most notably by Carl Rogers (Straume, 2020). === Carl Rogers === [[File:Carl Rogers.jpg|thumb|Figure 1. Carl Rogers|alt=Artist rendition of Carl Rogers]] The person-centered approach, often known as client-centered therapy, is Carl R. Rogers' method for assisting people who are dealing with a variety of personal disturbances or issues in their daily lives (Rogers, 1959; 1961; 1969; 1970; 1972; 1980; 1986). In 1939, Rogers created his theory of psychotherapy for troubled kids (Witty, 2007). Later, he broadened his theoretical framework to cover work with groups, families, and couples. His most complete theoretical statement, which covers his theories of motivation and personality development as well as those of group interaction and interpersonal interactions, was published as a chapter in Sigmund Koch's Psychology: A Study of a Science (Vol. III) in 1959. (Koch, 1959, 184–256). * Explore 7 points of FFP * FFP - What is it/why it exists * How do you develop FFP == Clinical Use == === What is it used for? === <blockquote>Rogers (1959) noted several changes customarily associated with outcomes or results experienced by a person becoming more fully functioning, which are observed outside of the therapeutic relationship. The following changes were hypothesized as being relatively permanent:</blockquote> # Being more congruent, open to experience, and less defensive # Having improved psychological adjustment # Having an increased degree of positive self-regard # Perceiving the locus of evaluation and the locus of choice as residing within oneself # Experiencing more acceptance of others<blockquote>Consequences or results of the above changes:</blockquote> # More realistic, objective, extensional in perceptions, and more effective in problem solving # Less vulnerable to threat # More confident and self-directing # Values are determined by an OVP # Perceive others more realistically and accurately # Behaviors “owned” by the self are increased and those disowned as “not myself” are decreased # Behavior is perceived as being more within control, socialized, mature, creative, uniquely adaptive to new situations and problems, and fully expressive of own purpose and values Proctor C, Tweed R, Morris D. The Rogerian Fully Functioning Person: A Positive Psychology Perspective. Journal of Humanistic Psychology. 2016;56(5):503-529. doi:10.1177/0022167815605936 === How? === <blockquote>Empirical evidence also provides support of the hypothesis that more fully functioning persons move in a direction of increasing openness to experience. Rogers (1961) considered openness to experience to be the polar opposite of defensiveness. Defensiveness is “the organism’s response to experiences which are perceived or anticipated as threatening, as incongruent with the individual’s existing picture of himself, or of himself in relationship to the world” (Rogers, 1961, p. 187)</blockquote> === Case study === == Non-Clinical Use == === What areas could benifit from FFP === === Case study === == Challenges == https://www.jstor.org/stable/pdf/42573871.pdf?refreqid=excelsior%3Af77be98a01ac999d2f3e3866397ffe3d&ab_segments=&origin=&acceptTC=1 === Western perspective === There are criticisms of the fully functioning person that it is a product of primarily Western culture. Since in other cultures, Eastern cultures for example, the groups achievements are valued higher than those of any individual. === Environmental influences === == Related Theories == === Self actualisation === === Humanistic Psychology === === Client Centred Psychology === == Conclusion == * Fully functioning person is ones journey to self actualization * You can develop this by fostering your enviroment * The benifets of being fully functioning is... == See also == [[Self-actualisation]] (Book chapter) [[Motivation and emotion/Tutorials/Growth psychology|Growth psychology]] == References == {{Hanging indent|1= Aristotle. (1996). The Nicomachean ethics (trans: Ross, W. D.). Wordsworth Editions Limited. Ware: UK. Koch, Sigmund. (Series Ed.), & Koch, S. (Vol. Ed.). (1959). Psychology: A study of a science (Vol. 3). New York: McGraw-Hill. Korsgaard, C. M. (2008). The constitution of agency: Essays on practical reason and moral psychology. Oxford: Oxford University Press. Rogers, C. R. (1959). A theory of therapy, personality, and interpersonal relationships as developed in the client-centered framework. In S. Koch (Series Ed.) & S. Koch (Vol. Ed.), Psychology: A study of a science (Vol. 3, pp. 184–256). New York: McGraw Hill. Rogers, C. R. (1961). On becoming a person. Boston: Houghton Mifflin. Rogers, C. R. (1969). Freedom to learn. Columbus, Ohio: Charles E. Merrill. Rogers, C. R. (1970). Carl Rogers on encounter groups. New York: Harper and Row. Rogers, C. R. (1972). Becoming partners: Marriage and its alternatives. New York: Dell. Rogers, C. R. (1980). Empathic: An unappreciated way of being. In A way of being (pp. 137–163). Boston: Houghton Mifflin. Rogers, C. R. (1986). Client-centered approach to therapy. In I. L. Kutash & A. Wolf (Eds.), Psychotherapist’s casebook: Theory and technique in practice (pp. 197–208). San Francisco: Jossey Bass. Straume, L.V., Vittersø, J. (2020). Fully Functioning Person. In: Zeigler-Hill, V., Shackelford, T.K. (eds) Encyclopedia of Personality and Individual Differences. Springer, Cham. https://doi.org/10.1007/978-3-319-24612-3_1469 Witty, M.C. (2007). Client-Centered Therapy. In: Kazantzis, N., LĽAbate, L. (eds) Handbook of Homework Assignments in Psychotherapy. Springer, Boston, MA . https://doi.org/10.1007/978-0-387-29681-4_3}} == External links == <nowiki>https://en.wikipedia.org/wiki/Carl_Rogers#The_fully_functioning_person</nowiki> <nowiki>https://en.wikipedia.org/wiki/Self-actualization</nowiki> [https://www.verywellmind.com/fully-functioning-person-2795197#:~:text=A%20fully%20functioning%20person%20is%20one%20who%20is%20continually%20working,open%20to%20life's%20many%20experiences. https://www.verywellmind.com/fully-functioning-person-2795197#:~:text=A%20fully%20functioning%20person%20is%20one%20who%20is%20continually%20working,open%20to%20life's%20many%20experiences.] ----'''<u>Everything below this is just referencing and planning and will be deleted in the final version</u>''' == Overview == ''What is a FFP and How can full functioning be developed?''<blockquote> # <u>A growing openness to experience</u> # <u>An increasingly existential lifestyle</u> # <u>Increasing organismic trust</u> # <u>Freedom of choice</u> # <u>Creativity</u> # <u>Reliability and constructiveness</u> # <u>A rich full life</u> #* Rogers, Carl (1961). ''On becoming a person: A therapist's view of psychotherapy''. London: Constable. ISBN <bdi>978-1-84529-057-3</bdi>. </blockquote> == [[Caregiving and dementia/Topics/Person centred care|person-centered theory of personality]] == == History == <u>Both Plato and Aristotle proposed theories about goodness in which functioning worked as the most central concept. Arguments about goodness and functioning keep developing in contemporary work on human goodness. The work of Sen, Staudinger, and Tomasello serves as renowned examples. (https://doi.org/10.1007/978-3-319-24612-3_1469)</u><blockquote>Client-centered therapy, also called the person-centered approach, describes Carl R. Rogers’ way of working with persons experiencing all types of personal disturbances or problems in living (Rogers, 1959; 1961; 1969; 1970; 1972; 1980a; 1986a). As early as 1939, Rogers developed his theory of psychotherapy with troubled children, and went on to expand his theoretical approach to include work with couples, families, and groups. His most comprehensive theoretical statement was published as a chapter in Sigmund Koch’s Psychology: A Study of a Science (Vol. III) in 1959, and includes his theory of motivation and personality development, as well as theory of group interaction and interpersonal relationships (Koch, 1959, 184–256). Over his long career, Rogers extrapolated client-centered values to the education, marriage, group encounter, personal power, and conflict resolution (Rogers, 1969, 1970, 1972). Today, the person-centered approach is practiced in the United Kingdom, Germany, France, Greece, Portugal, Demark, Poland, Hungary, The Netherlands, Italy, Japan, Brazil, Mexico, Australia, and South Africa, as well as here in the United States and Canada. A world association, which can be contacted online, was founded in Lisbon in 1997 that reflects the growth and vitality of the approach entitled the World Association for Person-Centered and Experiential Psychotherapy and Counseling (WAPCEPC). Another international organization comprised of a diverse membership—lay persons, educators, business consultants, therapists, artists, psychologists—the Association for the Development of the Person-Centered Approach (ADPCA), is also accessible on the internet. Witty, M. C. (2007). Client-centered therapy. In ''Handbook of homework assignments in psychotherapy'' (pp. 35-50). Springer, Boston, MA.</blockquote><blockquote>According to Rogers, when fully functioning, the individual lives in close and confident relationship to the organismic valuing process, trusting that inner direction. Congruence is a constant companion. Furthermore, the fully functioning individual spontaneously communicates inner impulses both verbally and nonverbally. They are open to experience, accepts experiences as they are, and expresses those experiences in an unedited manner. The fully functioning individual is authentic. To characterize the moment-to-moment experience of the fully functioning individual, Figure 15.4 illustrates the sequential process of a motive’s emergence, acceptance, and unedited expression. The congruent, fully functioning individual lives in close proximity to the actualizing tendency and therefore experiences a marked sense of autonomy, openness to experience,and personal growth. Reeve, J. (2018). Understanding motivation and emotion. John Wiley & Sons.</blockquote><blockquote>The actualizing tendency was a theoretical construct proposed by the great holistic neurologist Kurt Goldstein (Goldstein, 1939; 1940, 1963). Witty, M.C. (2007). Client-Centered Therapy. In: Kazantzis, N., LĽAbate, L. (eds) Handbook of Homework Assignments in Psychotherapy. Springer, Boston, MA . <nowiki>https://doi.org/10.1007/978-0-387-29681-4_3</nowiki></blockquote> === [[Motivation and emotion/Tutorials/Growth psychology|Growth psychology]] === <blockquote>A second criticism is that humanistic theorists use a number of vague and ill-defined constructs. It is difficult to pinpoint precisely what an “organismic valuing process” and a “fully functioning individual” are, for example. Any theoretical construct that evades a precise operational definition must remain scientifically dubious. For this reason, humanistic views on motivation have been harshly criticized (Daniels,1988; Neher, 1991), and these criticisms were instrumental to the rise and eventual popularity of the more empirically driven (evidence-based) positive psychology. Reeve, J. (2018). Understanding motivation and emotion. John Wiley & Sons.</blockquote> === [[Talk:Carl Rogers]] === <blockquote></blockquote> === [[Motivation and emotion/Textbook/Motivation/Self-actualisation|Self-actualisation]] === === [[wikipedia:Abraham_Maslow|Abraham Maslow]] === == Clinical uses == <blockquote>This book explores, in depth, the link between modern psychiatric practice and the person-centred approach. It promotes an open dialogue between traditional rivals – counsellors and psychiatrists within the NHS – to assist greater understanding and improve practice. Easy to read and comprehend, it explains complex issues in a clear and accessible manner. The author is a full-time psychiatrist and qualified counsellor who offers a unique perspective drawing on personal experience. Humanising Psychiatry and Mental Health Care will be of significant interest and help to all mental health professionals including psychiatrists and psychiatric nurses, social care workers, occupational therapists, psychologists, person-centred counsellors and therapists. Health and social care policy makers and shapers, including patient groups, will also find it helpful and informative. Freeth, R., Thorne, B., & Shooter, M. (2007). Humanising Psychiatry and Mental Health Care: The challenge of the person-centred approach (1st ed.). CRC Press. <nowiki>https://doi.org/10.1201/9781315385051</nowiki></blockquote> == Other uses == == Conclusion == === Marking rubric === ==== Overview ==== Easy to read and understand overview of the chapter. ==== Breadth ==== Theoretical framework for understanding the topic.<blockquote>theoretical model of the person who emerges from therapy—a person functioning freely in all the fullness of his organismic potentialities; a person who is dependable in being realistic, self-enhancing, socialized and appropriate in his behavior; a creative person, whose specific formings of behavior are not easily predictable; a person who is ever-changing, ever developing, always discovering himself and the newness in himself in each succeeding moment of time. This is the person who in an imperfect way actually emerges from the experience of safety and freedom in a therapeutic experience, and this is the person whom I have tried to describe for you in "pure" form. Rogers, C. R. (1963). The concept of the fully functioning person. ''Psychotherapy: Theory, Research & Practice, 1''(1), 17–26. <nowiki>https://doi.org/10.1037/h0088567</nowiki></blockquote><blockquote>The actualizing tendency functions as an axiom in Rogers’ theory. To the extent that the therapist holds the hypothesis that the client possesses the capacity for selfdetermination he or she is more likely to perceive the client’s ideas, feelings, and actions as aspects of growth instead of pathology. It should be stated that the actualizing tendency does not mean that Rogers believed that people are “good,” simply that organisms realize their potentials limited only by internal and external environmental constraints (Rogers, 1951, 1959, 1961; Brodley, 1998). Rogers recommended that novice therapists attempt to hold the hypothesis that clients have the inner resources to meet life’s difficulties, recognizing that to discard that hypothesis would open the way for the therapist’s exerting influence over the supposedly less competent client. This hypothesis, he acknowledged, was most difficult to embrace in the face of self-destructive, self-defeating behavior on the part of the client (Rogers, 1951, pp. 20–25). Witty, M.C. (2007). Client-Centered Therapy. In: Kazantzis, N., LĽAbate, L. (eds) Handbook of Homework Assignments in Psychotherapy. Springer, Boston, MA . <nowiki>https://doi.org/10.1007/978-0-387-29681-4_3</nowiki></blockquote> ==== Depth ==== Clearly explain and integrate the theory(ies).<blockquote>Fully-functioning person. If people are able to operate their valuing processes fully, they will certainly begin to experience self movement and growth toward realization of their potentials. This shows that the person who are able be self-actualize, are called fully functioning person (Rogers, 1961). According to Roger`s terminology, they will be moving toward becoming fully functioning persons. Fully functioning person, for Rogers, are well balanced, well adjusted and interesting to know (Mcleod, 2007). Rogers, in his later writings, extended and amplified his view of the fully functioning person (1961) to emerging person (1975) Ismail, N. A. H., & Tekke, M. (2015). Rediscovering Rogers’s self theory and personality. ''Journal of Educational, Health and Community Psychology'', ''4''(3), 28-36.</blockquote> ==== Key findings ==== Explain how key, peer-reviewed research findings apply to the problem.<blockquote>Findings of this study suggested that people have intrinsic motivation to use their strengths, which results in increased authenticity, vitality, and well-being. These findings provide support for the Rogerian perspective in which autonomous individuals will show greater openness to experience and a more genuine and less defensive perception of experience (Patterson & Joseph, 2007). Overall, findings of this study suggest that the fully functioning person from the positive psychology perspective is a “person-in-process,” a person who is characterized as being in touch with their organismic valuing process (OVP) and hence experiences increased happiness and life satisfaction, who feels competent, autonomous, and relates well with others and they with them. Moreover, the fully functioning person is open, authentic, and uses their strengths, experiencing the well-being associated with doing so. When compared with other people, this person less frequently experiences feelings of anxiety or alienation from themselves. Proctor C, Tweed R, Morris D. The Rogerian Fully Functioning Person: A Positive Psychology Perspective. Journal of Humanistic Psychology. 2016;56(5):503-529. doi:10.1177/0022167815605936</blockquote> ==== Critical thinking ==== Critically analyse the research discussed. ==== Integration ==== Integrate discussion of theory and review of relevant research. ==== Conclusion ==== Emphasise the key points and take-home messages. ==== Written expression - Style ==== Readable for a layperson interested in psychological science. ==== Written expression - Learning features ==== Invite interactivity through features such as case studies, feature boxes, figures, links, tables, and quizzes. ==== Social contribution ==== Editing which enhances the quality of other book chapters. --- Add an image == Overview == You are underway {{smile}}! This template provides tips for [[Motivation and emotion/Assessment/Topic|topic development]]. Gradually remove these suggestions as you develop the chapter. Also consult the [[Motivation and emotion/Assessment/Chapter|author guidelines]]. At the top of the chapter, the title and sub-title should match the ''exact'' wording and casing as shown in the {{Motivation and emotion/Book}}. The sub-titles all end with a question mark. This Overview section should be concise but consist of several paragraphs which engage the reader, illustrate the problem, and outline how psychological science can help. {{RoundBoxTop|theme=3}} '''Focus questions:''' * What is the first focus question? * What is the second focus question? * What is the third focus question? {{RoundBoxBottom}} {{tip| Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Provide an example or case study. * Conclude with Focus questions to guide the chapter. }} ==Main headings== How you are going to structure the chapter? Aim for three to six main headings between the [[#Overview|Overview]] and [[#Conclusion|Conclusion]]. {{tip|Suggestions for this section: * For the [[Motivation and emotion/Assessment/Topic|topic development]], provide at least 3 bullet-points about key content per section. Include key citations. * For the [[Motivation and emotion/Assessment/Chapter|book chapter]], expand the bullet points into paragraphs. * If a section has a lot of content, arrange it into two to five sub-headings such as in the [[#Interactive learning features|interactive learning features section]]. Avoid having sections with only one sub-heading. }} ==Learning features== What brings an online book chapter to life are its interactive learning features. Case studies, feature boxes, figures, links, tables, and quiz questions can be used throughout the chapter. ===Case studies=== Case studies describe real-world examples of concepts in action. Case studies can be real or fictional. A case could be used multiple times during a chapter to illustrate different theories or stages. It is often helpful to present case studies using [[#Feature boxes|feature boxes]]. ===Boxes=== Boxes can be used to highlight content, but don't overuse them. There are many different ways of creating boxes (e.g., see [[Help:Pretty boxes|Pretty boxes]]). Possible uses include: * Focus questions * Case studies or examples * Quiz questions * Take-home messages {{RoundBoxTop|theme=3}} ;Feature box example * Shaded background * Coloured border {{RoundBoxBottom}} ===Figures=== [[File:Monkey-typing.jpg|right|205px|thumb|''Figure 1''. Example image with descriptive caption.]] Use figures to illustrate concepts, add interest, and provide examples. Figures can be used to show photographs, drawings, diagrams, graphs, etcetera. Figures can be embedded throughout the chapter, starting with the Overview section. Figures should be captioned (using a number and a description) in order to explain their relevance to the text. Possible images can be found at [[commons:|Wikimedia Commons]]. Images can also be uploaded if they are licensed for re-use or if you created the image. Each figure should be referred to at least once in the main text (e.g., see Figure 1). ===Links=== Where key words are first used, make them into [[Help:Links|interwiki links]] such as Wikipedia links to articles about famous people (e.g., [[w:Sigmund Freud|Sigmund Freud]] and key concepts (e.g., [[w:Dreams|dreams]]) and links to book chapters about related topics (e.g., would you like to learn about how to overcome [[Motivation and emotion/Book/2020/Writer's block|writer's block]]?). ===Tables=== Tables can be an effective way to organise and summarise information. Tables should be captioned (using APA style) to explain their relevance to the text. Plus each table should be referred to at least once in the main text (e.g., see Table 1 and Table 2). Here are some [[Motivation and emotion/Wikiversity/Tables|example 3 x 3 tables]] which could be adapted. ===Quizzes=== Quizzes are a direct way to engage readers. But don't make quizzes too hard or long. It is better to have one or two review questions per major section than a long quiz at the end. Try to quiz conceptual understanding, rather than trivia. Here are some simple quiz questions which could be adapted. Choose the correct answers and click "Submit": <quiz display=simple> {Quizzes are an interactive learning feature: |type="()"} + True - False {Long quizzes are a good idea: |type="()"} - True + False </quiz> To learn about different types of quiz questions, see [[Help:Quiz|Quiz]]. ==Conclusion== The Conclusion is arguably the most important section. It should be possible for someone to read the [[#Overview|Overview]] and the Conclusion and still get a good idea of the topic. {{tip|Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? }} ==See also== Provide up to half-a-dozen [[Help:Contents/Links#Interwiki_links|internal (wiki) links]] to relevant Wikiversity pages (esp. related [[Motivation and emotion/Book|motivation and emotion book chapters]]) and [[w:|Wikipedia articles]]. For example: * [[Motivation and emotion/Book/2016/Anorexia nervosa and extrinsic motivation|Anorexia nervosa and extrinsic motivation]] (Book chapter, 2016) * [[w:David McClelland|David McClelland]] (Wikipedia) * [[Motivation and emotion/Book/2018/Loss aversion|Loss aversion]] (Book chapter, 2018) * [[w:Maslow's hierarchy of needs|Maslow's hierarchy of needs]] (Wikipedia) {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== List the cited references in [[w:APA style|APA style]] (7th ed.) or [[w:Wikipedia:Citing sources|wiki style]]. APA style example: {{Hanging indent|1= Blair, R. J. R. (2004). The roles of orbital frontal cortex in the modulation of antisocial behavior. ''Brain and Cognition'', ''55''(1), 198–208. https://doi.org/10.1016/S0278-2626(03)00276-8 Buckholtz, J. W., & Meyer-Lindenberg, A. (2008). MAOA and the neurogenetic architecture of human aggression. ''Trends in Neurosciences'', ''31''(3), 120–129. https://doi.org/10.1016/j.tins.2007.12.006 Eckardt, M., File, S., Gessa, G., Grant, K., Guerri, C., Hoffman, P., & Tabakoff, B. (1998). Effects of moderate alcohol consumption on the central nervous system. ''Alcoholism, Clinical and Experimental Research'', ''22''(5), 998–1040. https://doi.org/10.1111/j.1530-0277.1998.tb03695.x }} {{tip|Suggestions for this section: * Important aspects for APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except first letter and proper names, ending in a full-stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full-stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't actually read or consulted }} ==External links== Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * [https://students.unimelb.edu.au/academic-skills/explore-our-resources/essay-writing/six-top-tips-for-writing-a-great-essay Six top tips for writing a great essay] (University of Melbourne) * [http://www.skillsyouneed.com/write/structure.html The importance of structure] (skillsyouneed.com) {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] [[Category:Motivation and emotion/Book/Positive psychology]] bnm4i44yoabhwifbo19zrwqn4cci0n1 0 286019 2419371 2418808 2022-08-26T07:38:32Z Jtneill 10242 + category + adjust sub-headings + brainstorm some content ideas wikitext text/x-wiki {{title|Triumph:<br>What is it, what causes it, and what are its impacts?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== [[File:130901 RSA Pietermaritzburg XCE Engen winning 4 by.jpg|thumb|''Figure 1''. Triumph on display]] ;Focus questions: == What is triumph? == * Definition - what type of emotion is it? * Related constructs * Is it uniquely human? Do animals display triumph? * Signs/indicators of triumph? == What causes triumph? == * Hierachies/social ranking: To establish dominace or authority (Hwang et al., 2021) * May be innate - blind athletes display the emotion (Hwang & Matsumoto, 2014 a) * Culture: Power dynamics (PD) have an effect on expressivity of triumph (Hwang & Matsumoto, 2014 b) == How can triumph be managed? == *Does it need to be? ==Conclusion== The Conclusion is arguably the most important section. It should be possible for someone to read the [[#Overview|Overview]] and the Conclusion and still get a good idea of the topic. {{tip|Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? }} ==See also== Provide up to half-a-dozen [[Help:Contents/Links#Interwiki_links|internal (wiki) links]] to relevant Wikiversity pages (esp. related [[Motivation and emotion/Book|motivation and emotion book chapters]]) and [[w:|Wikipedia articles]]. For example: * [[Motivation and emotion/Book/2016/Anorexia nervosa and extrinsic motivation|Anorexia nervosa and extrinsic motivation]] (Book chapter, 2016) * [[w:David McClelland|David McClelland]] (Wikipedia) * [[Motivation and emotion/Book/2018/Loss aversion|Loss aversion]] (Book chapter, 2018) * [[w:Maslow's hierarchy of needs|Maslow's hierarchy of needs]] (Wikipedia) {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== {{Hanging indent|Hwang, H. C., et al. (2021). Antecedents and Appraisals of Triumph across Four Countries. Cross-Cultural Research, 55(2-3), 209-229. Hwang, H. C., & Matsumoto, D. (2014). Dominance threat display for victory and achievement in competition context. Motivation and Emotion, 38(2), 206-214. Hwang, H. C., & Matsumoto, D. (2014). Cultural differences in victory signals of triumph. Cross-Cultural Research, 48(2), 177-191. Matsumoto, D., & Hwang, H. S. (2012). Evidence for a nonverbal expression of triumph. Evolution and Human Behavior, 33(5), 520-529.}}{{tip|Suggestions for this section: * Important aspects for APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except first letter and proper names, ending in a full-stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full-stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't actually read or consulted }} ==External links== * [https://youtu.be/WOPXWUEplfQ?t=65 Video of Triumph] in action with UFC fighter * [https://www.ted.com/talks/amy_cuddy_your_body_language_may_shape_who_you_are?utm_campaign=tedspread&utm_medium=referral&utm_source=tedcomshare Ted talk: Your body language may shape who you are] [[Category:{{#titleparts:{{PAGENAME}}|3}}]] [[Category:Motivation and emotion/Book/Triumph]] 6ly98xl40xcwuoq9kmikdhiwmy098uz 0 286021 2419335 2417696 2022-08-26T06:49:58Z Jtneill 10242 + categories wikitext text/x-wiki {{title|Work breaks, well-being and productivity:<br>How do work breaks affect well-being and productivity?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== [[File:Fun, men, happiness, drinking, posture, gesture, garden, hat Fortepan 2357.jpg|thumb|Figure 1. Men taking a break from work]] Work breaks, well being and productivity … In the modern world, trying to find a balance between work and play can be an incredibly difficult challenge. ... This chapter outlines ... This Overview section should be concise but consist of several paragraphs which engage the reader, illustrate the problem, and outline how psychological science can help. {{RoundBoxTop|theme=3}} '''Focus questions:''' * How do work breaks affect well-being and productivity? * How can we maximize the benefits of taking a break? * What is the third focus question? {{RoundBoxBottom}} {{tip| Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Provide an example or case study. * Conclude with Focus questions to guide the chapter. }} ==What are work breaks?== Work breaks can come in a variety of forms. Common forms found in the scientific literature include: === Micro-breaks === * Non-work activates in-between work tasks during the work day. * Common examples include, drinking coffee/tea, chatting to colleagues, snacking, briefly checking news/social media * Often viewed as counterproductive * Research suggest that micro-breaks can be beneficial in certain contexts (Kim et al., 2016) [[File:Bertrand Russell photo (cropped).jpg|thumb|Figure 2: Philosopher Bertrand Russell argued that the modern world was obsessed with productivity and instead we should spend more time on activities that were enjoyable in themselves]] === Free time === * "Discretionary time" where one engages in activities that are intrinsically enjoyable but do not necessary have to be productive * Common examples include reading, watching tv/movies, going out for dinner. * Research suggest that too much free time and be just as detrimental as too little (Sharif et al., 2021) * Sharif et al (2021) suggest that a goldilocks zone of between 2-5 hr/per day (average 3.5hr/day) of free time is optimal for well-being === Weekends === *1-2 days spend away from work *Psychological effect of weekends seem to vary drastically between individuals *Some moderating variable include: 1. Relationship with supervisor (i.e. boss or friend) *2. Work environment (i.e. Workplace toxicity) *3. Type of work (i.e. full time vs shift work) (Helliwell & Wang, 2013) *Generally, individuals report higher subjective well being on weekends that work days (Helliwell & Wang, 2013) === Holidays === How you are going to structure the chapter? Aim for three to six main headings between the [[#Overview|Overview]] and [[#Conclusion|Conclusion]]. {{tip|Suggestions for this section: * For the [[Motivation and emotion/Assessment/Topic|topic development]], provide at least 3 bullet-points about key content per section. Include key citations. * For the [[Motivation and emotion/Assessment/Chapter|book chapter]], expand the bullet points into paragraphs. * If a section has a lot of content, arrange it into two to five sub-headings such as in the [[#Interactive learning features|interactive learning features section]]. Avoid having sections with only one sub-heading. }} ==How do breaks affect well-being and productivity?== * Both casual and correlation relationships between breaks, well being and productivity have been established [citations] * A lack of spare time has been related to lower subjective happiness (Masuda et al., 2020) * Include on burnout What brings an online book chapter to life are its interactive learning features. Case studies, feature boxes, figures, links, tables, and quiz questions can be used throughout the chapter. '''Case studies''' Case studies describe real-world examples of concepts in action. Case studies can be real or fictional. A case could be used multiple times during a chapter to illustrate different theories or stages. It is often helpful to present case studies using [[#Feature boxes|feature boxes]]. '''Boxes''' Boxes can be used to highlight content, but don't overuse them. There are many different ways of creating boxes (e.g., see [[Help:Pretty boxes|Pretty boxes]]). Possible uses include: * Focus questions * Case studies or examples * Quiz questions * Take-home messages {{RoundBoxTop|theme=3}} ;Feature box example * Shaded background * Coloured border {{RoundBoxBottom}}'''Figures'''[[File:Monkey-typing.jpg|right|205px|thumb|''Figure 1''. Example image with descriptive caption.]] Use figures to illustrate concepts, add interest, and provide examples. Figures can be used to show photographs, drawings, diagrams, graphs, etcetera. Figures can be embedded throughout the chapter, starting with the Overview section. Figures should be captioned (using a number and a description) in order to explain their relevance to the text. Possible images can be found at [[commons:|Wikimedia Commons]]. Images can also be uploaded if they are licensed for re-use or if you created the image. Each figure should be referred to at least once in the main text (e.g., see Figure 1). '''Links''' Where key words are first used, make them into [[Help:Links|interwiki links]] such as Wikipedia links to articles about famous people (e.g., [[w:Sigmund Freud|Sigmund Freud]] and key concepts (e.g., [[w:Dreams|dreams]]) and links to book chapters about related topics (e.g., would you like to learn about how to overcome [[Motivation and emotion/Book/2020/Writer's block|writer's block]]?). '''Tables''' Tables can be an effective way to organise and summarise information. Tables should be captioned (using APA style) to explain their relevance to the text. Plus each table should be referred to at least once in the main text (e.g., see Table 1 and Table 2). Here are some [[Motivation and emotion/Wikiversity/Tables|example 3 x 3 tables]] which could be adapted. '''Quizzes''' Quizzes are a direct way to engage readers. But don't make quizzes too hard or long. It is better to have one or two review questions per major section than a long quiz at the end. Try to quiz conceptual understanding, rather than trivia. Here are some simple quiz questions which could be adapted. Choose the correct answers and click "Submit": <quiz display=simple> {Quizzes are an interactive learning feature: |type="()"} + True - False {Long quizzes are a good idea: |type="()"} - True + False </quiz> To learn about different types of quiz questions, see [[Help:Quiz|Quiz]]. == How can we optimize our breaks? == * What is the optimal amount of breaking for to maximize well-being and productivity? - Sharif et al (2021) has suggest 3.5hr/day of free time optimal for subjective well being. === Meditation/mindfulness === Research suggest that meditation can be an effective tool to boost wellbeing and productivity (Pagliaro et al., 2020) === Effective micro-breaking === *How can we best spend our micro-breaks? - research has suggested that stretching's exercise's on micro-breaks improved overall wellbeing and productivity (Henning et al., 1997) as well as caffeinated beverages (Kim et al., 2016). * What may be impleading our ability to micro-break effectively? - Kim et al.,( 2016) have found that engaging in cognitive intense activities (i.e. reading a book) on micro-breaks increased thee effects of work demands on negative affect ==Conclusion== * Work breaks are essential to well-being and can boost productivity when done correctly. * Much emphasis should be placed on workplaces to ensure that their employees are having sufficient break time both inside and outside the workplace. * Areas for further research ... {{tip|Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? }} ==See also== [[w:Meditation|Meditation<br />]] Provide up to half-a-dozen [[Help:Contents/Links#Interwiki_links|internal (wiki) links]] to relevant Wikiversity pages (esp. related [[Motivation and emotion/Book|motivation and emotion book chapters]]) and [[w:|Wikipedia articles]]. For example: * [[Motivation and emotion/Book/2016/Anorexia nervosa and extrinsic motivation|Anorexia nervosa and extrinsic motivation]] (Book chapter, 2016) * [[w:David McClelland|David McClelland]] (Wikipedia) * [[Motivation and emotion/Book/2018/Loss aversion|Loss aversion]] (Book chapter, 2018) * [[w:Maslow's hierarchy of needs|Maslow's hierarchy of needs]] (Wikipedia) {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== {{Hanging indent|1= Helliwell, J., & Wang, S. (2013). Weekends and Subjective Well-Being. Social Indicators Research, 116(2), 389-407. https://doi.org/10.1007/s11205-013-0306-y HENNING, R., JACQUES, P., KISSEL, G., SULLIVAN, A., & ALTERAS-WEBB, S. (1997). Frequent short rest breaks from computer work: effects on productivity and well-being at two field sites. Ergonomics, 40(1), 78-91. https://doi.org/10.1080/001401397188396 Pagliaro, G., Pelati, R., Signorini, D., Parenti, G., & Roversi, F. (2020). The effects of meditation on the performance and well-being of a company: A pilot study. EXPLORE, 16(1), 56-60. https://doi.org/10.1016/j.explore.2019.07.014 Kim, S., Park, Y., & Niu, Q. (2016). Micro-break activities at work to recover from daily work demands. Journal Of Organizational Behavior, 38(1), 28-44. https://doi.org/10.1002/job.2109 Sharif, M., Mogilner, C., & Hershfield, H. (2021). Having too little or too much time is linked to lower subjective well-being. Journal Of Personality And Social Psychology, 121(4), 933-947. https://doi.org/10.1037/pspp0000391 }} {{tip|Suggestions for this section: * Important aspects for APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except first letter and proper names, ending in a full-stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full-stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't actually read or consulted }} ==External links== [https://www.youtube.com/watch?v=V_OMWEEf1E4 Micro-breaking] Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * [https://students.unimelb.edu.au/academic-skills/explore-our-resources/essay-writing/six-top-tips-for-writing-a-great-essay Six top tips for writing a great essay] (University of Melbourne) * [http://www.skillsyouneed.com/write/structure.html The importance of structure] (skillsyouneed.com) {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] [[Category:Motivation and emotion/Book/Well-being]] [[Category:Motivation and emotion/Book/Work]] 01t5j435bzf2oc5kzbfliordsx19j6k 2419397 2419335 2022-08-26T08:13:07Z U3215603 2947641 wikitext text/x-wiki {{title|Work breaks, well-being and productivity:<br>How do work breaks affect well-being and productivity?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== [[File:Fun, men, happiness, drinking, posture, gesture, garden, hat Fortepan 2357.jpg|thumb|Figure 1. Men taking a break from work]] Work breaks, well being and productivity … In the modern world, trying to find a balance between work and play can be an incredibly difficult challenge. ... This chapter outlines ... This Overview section should be concise but consist of several paragraphs which engage the reader, illustrate the problem, and outline how psychological science can help. {{RoundBoxTop|theme=3}} '''Focus questions:''' * How do work breaks affect well-being and productivity? * How can we maximize the benefits of taking a break? * What is the third focus question? {{RoundBoxBottom}} {{tip| Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Provide an example or case study. * Conclude with Focus questions to guide the chapter. }} ==What are work breaks?== Work breaks can come in a variety of forms. Common forms found in the scientific literature include: === Micro-breaks === * Non-work activates in-between work tasks during the work day. * Common examples include, drinking coffee/tea, chatting to colleagues, snacking, briefly checking news/social media * Often viewed as counterproductive * Research suggest that micro-breaks can be beneficial in certain contexts (Kim et al., 2016) [[File:Bertrand Russell photo (cropped).jpg|thumb|Figure 2: Philosopher Bertrand Russell argued that the modern world was obsessed with productivity and instead we should spend more time on activities that were enjoyable in themselves]] === Free time === * "Discretionary time" where one engages in activities that are intrinsically enjoyable but do not necessary have to be productive * Common examples include reading, watching tv/movies, going out for dinner. * Research suggest that too much free time and be just as detrimental as too little (Sharif et al., 2021) * Sharif et al (2021) suggest that a goldilocks zone of between 2-5 hr/per day (average 3.5hr/day) of free time is optimal for well-being === Weekends === *1-2 days spend away from work *Psychological effect of weekends seem to vary drastically between individuals *Some moderating variable include: 1. Relationship with supervisor (i.e. boss or friend) *2. Work environment (i.e. Workplace toxicity) *3. Type of work (i.e. full time vs shift work) (Helliwell & Wang, 2013) *Generally, individuals report higher subjective well being on weekends that work days (Helliwell & Wang, 2013) === Holidays === How you are going to structure the chapter? Aim for three to six main headings between the [[#Overview|Overview]] and [[#Conclusion|Conclusion]]. {{tip|Suggestions for this section: * For the [[Motivation and emotion/Assessment/Topic|topic development]], provide at least 3 bullet-points about key content per section. Include key citations. * For the [[Motivation and emotion/Assessment/Chapter|book chapter]], expand the bullet points into paragraphs. * If a section has a lot of content, arrange it into two to five sub-headings such as in the [[#Interactive learning features|interactive learning features section]]. Avoid having sections with only one sub-heading. }} ==The effects of work breaks == === Work Breaks effects on Well-Being === A lack of spare time has been related to lower subjective happiness (Masuda et al., 2020) === Work Break effects on Productivity === * Both casual and correlation relationships between breaks and productivity have been established [citations] What brings an online book chapter to life are its interactive learning features. Case studies, feature boxes, figures, links, tables, and quiz questions can be used throughout the chapter. '''Case studies''' Case studies describe real-world examples of concepts in action. Case studies can be real or fictional. A case could be used multiple times during a chapter to illustrate different theories or stages. It is often helpful to present case studies using [[#Feature boxes|feature boxes]]. '''Boxes''' Boxes can be used to highlight content, but don't overuse them. There are many different ways of creating boxes (e.g., see [[Help:Pretty boxes|Pretty boxes]]). Possible uses include: * Focus questions * Case studies or examples * Quiz questions * Take-home messages {{RoundBoxTop|theme=3}} ;Feature box example * Shaded background * Coloured border {{RoundBoxBottom}}'''Figures'''[[File:Monkey-typing.jpg|right|205px|thumb|''Figure 1''. Example image with descriptive caption.]] Use figures to illustrate concepts, add interest, and provide examples. Figures can be used to show photographs, drawings, diagrams, graphs, etcetera. Figures can be embedded throughout the chapter, starting with the Overview section. Figures should be captioned (using a number and a description) in order to explain their relevance to the text. Possible images can be found at [[commons:|Wikimedia Commons]]. Images can also be uploaded if they are licensed for re-use or if you created the image. Each figure should be referred to at least once in the main text (e.g., see Figure 1). '''Links''' Where key words are first used, make them into [[Help:Links|interwiki links]] such as Wikipedia links to articles about famous people (e.g., [[w:Sigmund Freud|Sigmund Freud]] and key concepts (e.g., [[w:Dreams|dreams]]) and links to book chapters about related topics (e.g., would you like to learn about how to overcome [[Motivation and emotion/Book/2020/Writer's block|writer's block]]?). '''Tables''' Tables can be an effective way to organise and summarise information. Tables should be captioned (using APA style) to explain their relevance to the text. Plus each table should be referred to at least once in the main text (e.g., see Table 1 and Table 2). Here are some [[Motivation and emotion/Wikiversity/Tables|example 3 x 3 tables]] which could be adapted. '''Quizzes''' Quizzes are a direct way to engage readers. But don't make quizzes too hard or long. It is better to have one or two review questions per major section than a long quiz at the end. Try to quiz conceptual understanding, rather than trivia. Here are some simple quiz questions which could be adapted. Choose the correct answers and click "Submit": <quiz display=simple> {Quizzes are an interactive learning feature: |type="()"} + True - False {Long quizzes are a good idea: |type="()"} - True + False </quiz> To learn about different types of quiz questions, see [[Help:Quiz|Quiz]]. == How can we optimize our breaks? == * What is the optimal amount of breaking for to maximize well-being and productivity? - Sharif et al (2021) has suggest 3.5hr/day of free time optimal for subjective well being. === Meditation/mindfulness === Research suggest that meditation can be an effective tool to boost wellbeing and productivity (Pagliaro et al., 2020) === Effective micro-breaking === *How can we best spend our micro-breaks? - research has suggested that stretching's exercise's on micro-breaks improved overall wellbeing and productivity (Henning et al., 1997) as well as caffeinated beverages (Kim et al., 2016). * What may be impleading our ability to micro-break effectively? - Kim et al.,( 2016) have found that engaging in cognitive intense activities (i.e. reading a book) on micro-breaks increased thee effects of work demands on negative affect ==Conclusion== * Work breaks are essential to well-being and can boost productivity when done correctly. * Much emphasis should be placed on workplaces to ensure that their employees are having sufficient break time both inside and outside the workplace. * Areas for further research ... {{tip|Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? }} ==See also== [[w:Meditation|Meditation<br />]] Provide up to half-a-dozen [[Help:Contents/Links#Interwiki_links|internal (wiki) links]] to relevant Wikiversity pages (esp. related [[Motivation and emotion/Book|motivation and emotion book chapters]]) and [[w:|Wikipedia articles]]. For example: * [[Motivation and emotion/Book/2016/Anorexia nervosa and extrinsic motivation|Anorexia nervosa and extrinsic motivation]] (Book chapter, 2016) * [[w:David McClelland|David McClelland]] (Wikipedia) * [[Motivation and emotion/Book/2018/Loss aversion|Loss aversion]] (Book chapter, 2018) * [[w:Maslow's hierarchy of needs|Maslow's hierarchy of needs]] (Wikipedia) {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== {{Hanging indent|1= Helliwell, J., & Wang, S. (2013). Weekends and Subjective Well-Being. Social Indicators Research, 116(2), 389-407. https://doi.org/10.1007/s11205-013-0306-y HENNING, R., JACQUES, P., KISSEL, G., SULLIVAN, A., & ALTERAS-WEBB, S. (1997). Frequent short rest breaks from computer work: effects on productivity and well-being at two field sites. Ergonomics, 40(1), 78-91. https://doi.org/10.1080/001401397188396 Pagliaro, G., Pelati, R., Signorini, D., Parenti, G., & Roversi, F. (2020). The effects of meditation on the performance and well-being of a company: A pilot study. EXPLORE, 16(1), 56-60. https://doi.org/10.1016/j.explore.2019.07.014 Kim, S., Park, Y., & Niu, Q. (2016). Micro-break activities at work to recover from daily work demands. Journal Of Organizational Behavior, 38(1), 28-44. https://doi.org/10.1002/job.2109 Sharif, M., Mogilner, C., & Hershfield, H. (2021). Having too little or too much time is linked to lower subjective well-being. Journal Of Personality And Social Psychology, 121(4), 933-947. https://doi.org/10.1037/pspp0000391 }} {{tip|Suggestions for this section: * Important aspects for APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except first letter and proper names, ending in a full-stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full-stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't actually read or consulted }} ==External links== [https://www.youtube.com/watch?v=V_OMWEEf1E4 Micro-breaking] Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * [https://students.unimelb.edu.au/academic-skills/explore-our-resources/essay-writing/six-top-tips-for-writing-a-great-essay Six top tips for writing a great essay] (University of Melbourne) * [http://www.skillsyouneed.com/write/structure.html The importance of structure] (skillsyouneed.com) {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] [[Category:Motivation and emotion/Book/Well-being]] [[Category:Motivation and emotion/Book/Work]] ppdjq0z2ypydk9jlbhpct9nnnyez76c 2419422 2419397 2022-08-26T09:01:51Z U3215603 2947641 wikitext text/x-wiki {{title|Work breaks, well-being and productivity:<br>How do work breaks affect well-being and productivity?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== [[File:Fun, men, happiness, drinking, posture, gesture, garden, hat Fortepan 2357.jpg|thumb|Figure 1. Men taking a break from work]] ''Your alarm goes off at 7 am every morning and you rush out of bed for a quick shower. Breakfast is toast and instant coffee - all you have time for - eaten while checking your schedule for the day ahead. Realizing you're already late, you rush out the door past a stack of half-read novels you haven't touched in 6 weeks for lack of spare time. The bus to work is crowded but that doesn't stop you from checking emails and sending messages to colleagues. The work day passes in a blur. Before you know its 7 am again and you're rushing for the shower.'' Work breaks, well being and productivity … In the modern world, trying to find a balance between work and play can be an incredibly difficult challenge. ... This chapter outlines ... This Overview section should be concise but consist of several paragraphs which engage the reader, illustrate the problem, and outline how psychological science can help. {{RoundBoxTop|theme=3}} '''Focus questions:''' * How do work breaks affect well-being and productivity? * How can we maximize the benefits of taking a break? * What is the third focus question? {{RoundBoxBottom}} {{tip| Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Provide an example or case study. * Conclude with Focus questions to guide the chapter. }} ==What are work breaks?== Work breaks can come in a variety of forms. Common forms found in the scientific literature include: === Micro-breaks === * Non-work activates in-between work tasks during the work day. * Common examples include, drinking coffee/tea, chatting to colleagues, snacking, briefly checking news/social media * Often viewed as counterproductive * Research suggest that micro-breaks can be beneficial in certain contexts (Kim et al., 2016) [[File:Bertrand Russell photo (cropped).jpg|thumb|Figure 2: Philosopher Bertrand Russell argued that the modern world was obsessed with productivity and instead we should spend more time on activities that were enjoyable in themselves]] === Free time === * "Discretionary time" where one engages in activities that are intrinsically enjoyable but do not necessary have to be productive * Common examples include reading, watching tv/movies, going out for dinner. * Research suggest that too much free time and be just as detrimental as too little (Sharif et al., 2021) * Sharif et al (2021) suggest that a goldilocks zone of between 2-5 hr/per day (average 3.5hr/day) of free time is optimal for well-being === Weekends === *1-2 days spend away from work *Psychological effect of weekends seem to vary drastically between individuals *Some moderating variable include: 1. Relationship with supervisor (i.e. boss or friend) *2. Work environment (i.e. Workplace toxicity) *3. Type of work (i.e. full time vs shift work) (Helliwell & Wang, 2013) *Generally, individuals report higher subjective well being on weekends that work days (Helliwell & Wang, 2013) === Holidays === How you are going to structure the chapter? Aim for three to six main headings between the [[#Overview|Overview]] and [[#Conclusion|Conclusion]]. {{tip|Suggestions for this section: * For the [[Motivation and emotion/Assessment/Topic|topic development]], provide at least 3 bullet-points about key content per section. Include key citations. * For the [[Motivation and emotion/Assessment/Chapter|book chapter]], expand the bullet points into paragraphs. * If a section has a lot of content, arrange it into two to five sub-headings such as in the [[#Interactive learning features|interactive learning features section]]. Avoid having sections with only one sub-heading. }} ==The effects of work breaks == === Work Breaks effects on Well-Being === A lack of spare time has been related to lower subjective happiness (Masuda et al., 2020) === Work Break effects on Productivity === * Both casual and correlation relationships between breaks and productivity have been established [citations] What brings an online book chapter to life are its interactive learning features. Case studies, feature boxes, figures, links, tables, and quiz questions can be used throughout the chapter. '''Case studies''' Case studies describe real-world examples of concepts in action. Case studies can be real or fictional. A case could be used multiple times during a chapter to illustrate different theories or stages. It is often helpful to present case studies using [[#Feature boxes|feature boxes]]. '''Boxes''' Boxes can be used to highlight content, but don't overuse them. There are many different ways of creating boxes (e.g., see [[Help:Pretty boxes|Pretty boxes]]). Possible uses include: * Focus questions * Case studies or examples * Quiz questions * Take-home messages {{RoundBoxTop|theme=3}} ;Feature box example * Shaded background * Coloured border {{RoundBoxBottom}}'''Figures'''[[File:Monkey-typing.jpg|right|205px|thumb|''Figure 1''. Example image with descriptive caption.]] Use figures to illustrate concepts, add interest, and provide examples. Figures can be used to show photographs, drawings, diagrams, graphs, etcetera. Figures can be embedded throughout the chapter, starting with the Overview section. Figures should be captioned (using a number and a description) in order to explain their relevance to the text. Possible images can be found at [[commons:|Wikimedia Commons]]. Images can also be uploaded if they are licensed for re-use or if you created the image. Each figure should be referred to at least once in the main text (e.g., see Figure 1). '''Links''' Where key words are first used, make them into [[Help:Links|interwiki links]] such as Wikipedia links to articles about famous people (e.g., [[w:Sigmund Freud|Sigmund Freud]] and key concepts (e.g., [[w:Dreams|dreams]]) and links to book chapters about related topics (e.g., would you like to learn about how to overcome [[Motivation and emotion/Book/2020/Writer's block|writer's block]]?). '''Tables''' Tables can be an effective way to organise and summarise information. Tables should be captioned (using APA style) to explain their relevance to the text. Plus each table should be referred to at least once in the main text (e.g., see Table 1 and Table 2). Here are some [[Motivation and emotion/Wikiversity/Tables|example 3 x 3 tables]] which could be adapted. '''Quizzes''' Quizzes are a direct way to engage readers. But don't make quizzes too hard or long. It is better to have one or two review questions per major section than a long quiz at the end. Try to quiz conceptual understanding, rather than trivia. Here are some simple quiz questions which could be adapted. Choose the correct answers and click "Submit": <quiz display=simple> {Quizzes are an interactive learning feature: |type="()"} + True - False {Long quizzes are a good idea: |type="()"} - True + False </quiz> To learn about different types of quiz questions, see [[Help:Quiz|Quiz]]. == How can we optimize our breaks? == * What is the optimal amount of breaking for to maximize well-being and productivity? - Sharif et al (2021) has suggest 3.5hr/day of free time optimal for subjective well being. === Meditation/mindfulness === Research suggest that meditation can be an effective tool to boost wellbeing and productivity (Pagliaro et al., 2020) === Effective micro-breaking === *How can we best spend our micro-breaks? - research has suggested that stretching's exercise's on micro-breaks improved overall wellbeing and productivity (Henning et al., 1997) as well as caffeinated beverages (Kim et al., 2016). * What may be impleading our ability to micro-break effectively? - Kim et al.,( 2016) have found that engaging in cognitive intense activities (i.e. reading a book) on micro-breaks increased thee effects of work demands on negative affect ==Conclusion== * Work breaks are essential to well-being and can boost productivity when done correctly. * Much emphasis should be placed on workplaces to ensure that their employees are having sufficient break time both inside and outside the workplace. * Areas for further research ... {{tip|Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? }} ==See also== [[w:Meditation|Meditation<br />]] Provide up to half-a-dozen [[Help:Contents/Links#Interwiki_links|internal (wiki) links]] to relevant Wikiversity pages (esp. related [[Motivation and emotion/Book|motivation and emotion book chapters]]) and [[w:|Wikipedia articles]]. For example: * [[Motivation and emotion/Book/2016/Anorexia nervosa and extrinsic motivation|Anorexia nervosa and extrinsic motivation]] (Book chapter, 2016) * [[w:David McClelland|David McClelland]] (Wikipedia) * [[Motivation and emotion/Book/2018/Loss aversion|Loss aversion]] (Book chapter, 2018) * [[w:Maslow's hierarchy of needs|Maslow's hierarchy of needs]] (Wikipedia) {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== {{Hanging indent|1= Helliwell, J., & Wang, S. (2013). Weekends and Subjective Well-Being. Social Indicators Research, 116(2), 389-407. https://doi.org/10.1007/s11205-013-0306-y HENNING, R., JACQUES, P., KISSEL, G., SULLIVAN, A., & ALTERAS-WEBB, S. (1997). Frequent short rest breaks from computer work: effects on productivity and well-being at two field sites. Ergonomics, 40(1), 78-91. https://doi.org/10.1080/001401397188396 Pagliaro, G., Pelati, R., Signorini, D., Parenti, G., & Roversi, F. (2020). The effects of meditation on the performance and well-being of a company: A pilot study. EXPLORE, 16(1), 56-60. https://doi.org/10.1016/j.explore.2019.07.014 Kim, S., Park, Y., & Niu, Q. (2016). Micro-break activities at work to recover from daily work demands. Journal Of Organizational Behavior, 38(1), 28-44. https://doi.org/10.1002/job.2109 Sharif, M., Mogilner, C., & Hershfield, H. (2021). Having too little or too much time is linked to lower subjective well-being. Journal Of Personality And Social Psychology, 121(4), 933-947. https://doi.org/10.1037/pspp0000391 }} {{tip|Suggestions for this section: * Important aspects for APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except first letter and proper names, ending in a full-stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full-stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't actually read or consulted }} ==External links== [https://www.youtube.com/watch?v=V_OMWEEf1E4 Micro-breaking] Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * [https://students.unimelb.edu.au/academic-skills/explore-our-resources/essay-writing/six-top-tips-for-writing-a-great-essay Six top tips for writing a great essay] (University of Melbourne) * [http://www.skillsyouneed.com/write/structure.html The importance of structure] (skillsyouneed.com) {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] [[Category:Motivation and emotion/Book/Well-being]] [[Category:Motivation and emotion/Book/Work]] isaorb6th69ejcyh2xxn8fnziavzuw8 2419427 2419422 2022-08-26T09:05:49Z U3215603 2947641 wikitext text/x-wiki {{title|Work breaks, well-being and productivity:<br>How do work breaks affect well-being and productivity?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== [[File:Fun, men, happiness, drinking, posture, gesture, garden, hat Fortepan 2357.jpg|thumb|Figure 1. Men taking a break from work]] ''Your alarm goes off at 6 am every morning and you rush out of bed for a quick shower. Breakfast is toast and instant coffee - all you have time for - eaten while checking your schedule for the day ahead. Realizing you're already late, you rush out the door past a stack of half-read novels you haven't touched in 5 weeks for lack of spare time. The bus to work is crowded but that doesn't stop you from checking emails and sending messages to colleagues. The work day passes in a blur. Before you know its 6 am again and you're rushing for the shower.'' Work breaks, well being and productivity … In the modern world, trying to find a balance between work and play can be an incredibly difficult challenge. ... This chapter outlines ... This Overview section should be concise but consist of several paragraphs which engage the reader, illustrate the problem, and outline how psychological science can help. {{RoundBoxTop|theme=3}} '''Focus questions:''' * How do work breaks affect well-being and productivity? * How can we maximize the benefits of taking a break? * What is the third focus question? {{RoundBoxBottom}} {{tip| Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Provide an example or case study. * Conclude with Focus questions to guide the chapter. }} ==What are work breaks?== Work breaks can come in a variety of forms. Common forms found in the scientific literature include: === Micro-breaks === * Non-work activates in-between work tasks during the work day. * Common examples include, drinking coffee/tea, chatting to colleagues, snacking, briefly checking news/social media * Often viewed as counterproductive * Research suggest that micro-breaks can be beneficial in certain contexts (Kim et al., 2016) [[File:Bertrand Russell photo (cropped).jpg|thumb|Figure 2: Philosopher Bertrand Russell argued that the modern world was obsessed with productivity and instead we should spend more time on activities that were enjoyable in themselves]] === Free time === * "Discretionary time" where one engages in activities that are intrinsically enjoyable but do not necessary have to be productive * Common examples include reading, watching tv/movies, going out for dinner. * Research suggest that too much free time and be just as detrimental as too little (Sharif et al., 2021) * Sharif et al (2021) suggest that a goldilocks zone of between 2-5 hr/per day (average 3.5hr/day) of free time is optimal for well-being === Weekends === *1-2 days spend away from work *Psychological effect of weekends seem to vary drastically between individuals *Some moderating variable include: 1. Relationship with supervisor (i.e. boss or friend) *2. Work environment (i.e. Workplace toxicity) *3. Type of work (i.e. full time vs shift work) (Helliwell & Wang, 2013) *Generally, individuals report higher subjective well being on weekends that work days (Helliwell & Wang, 2013) === Holidays === How you are going to structure the chapter? Aim for three to six main headings between the [[#Overview|Overview]] and [[#Conclusion|Conclusion]]. {{tip|Suggestions for this section: * For the [[Motivation and emotion/Assessment/Topic|topic development]], provide at least 3 bullet-points about key content per section. Include key citations. * For the [[Motivation and emotion/Assessment/Chapter|book chapter]], expand the bullet points into paragraphs. * If a section has a lot of content, arrange it into two to five sub-headings such as in the [[#Interactive learning features|interactive learning features section]]. Avoid having sections with only one sub-heading. }} ==The effects of work breaks == === Work Breaks effects on Well-Being === A lack of spare time has been related to lower subjective happiness (Masuda et al., 2020) === Work Break effects on Productivity === * Both casual and correlation relationships between breaks and productivity have been established [citations] What brings an online book chapter to life are its interactive learning features. Case studies, feature boxes, figures, links, tables, and quiz questions can be used throughout the chapter. '''Case studies''' Case studies describe real-world examples of concepts in action. Case studies can be real or fictional. A case could be used multiple times during a chapter to illustrate different theories or stages. It is often helpful to present case studies using [[#Feature boxes|feature boxes]]. '''Boxes''' Boxes can be used to highlight content, but don't overuse them. There are many different ways of creating boxes (e.g., see [[Help:Pretty boxes|Pretty boxes]]). Possible uses include: * Focus questions * Case studies or examples * Quiz questions * Take-home messages {{RoundBoxTop|theme=3}} ;Feature box example * Shaded background * Coloured border {{RoundBoxBottom}}'''Figures'''[[File:Monkey-typing.jpg|right|205px|thumb|''Figure 1''. Example image with descriptive caption.]] Use figures to illustrate concepts, add interest, and provide examples. Figures can be used to show photographs, drawings, diagrams, graphs, etcetera. Figures can be embedded throughout the chapter, starting with the Overview section. Figures should be captioned (using a number and a description) in order to explain their relevance to the text. Possible images can be found at [[commons:|Wikimedia Commons]]. Images can also be uploaded if they are licensed for re-use or if you created the image. Each figure should be referred to at least once in the main text (e.g., see Figure 1). '''Links''' Where key words are first used, make them into [[Help:Links|interwiki links]] such as Wikipedia links to articles about famous people (e.g., [[w:Sigmund Freud|Sigmund Freud]] and key concepts (e.g., [[w:Dreams|dreams]]) and links to book chapters about related topics (e.g., would you like to learn about how to overcome [[Motivation and emotion/Book/2020/Writer's block|writer's block]]?). '''Tables''' Tables can be an effective way to organise and summarise information. Tables should be captioned (using APA style) to explain their relevance to the text. Plus each table should be referred to at least once in the main text (e.g., see Table 1 and Table 2). Here are some [[Motivation and emotion/Wikiversity/Tables|example 3 x 3 tables]] which could be adapted. '''Quizzes''' Quizzes are a direct way to engage readers. But don't make quizzes too hard or long. It is better to have one or two review questions per major section than a long quiz at the end. Try to quiz conceptual understanding, rather than trivia. Here are some simple quiz questions which could be adapted. Choose the correct answers and click "Submit": <quiz display=simple> {Quizzes are an interactive learning feature: |type="()"} + True - False {Long quizzes are a good idea: |type="()"} - True + False </quiz> To learn about different types of quiz questions, see [[Help:Quiz|Quiz]]. == How can we optimize our breaks? == * What is the optimal amount of breaking for to maximize well-being and productivity? - Sharif et al (2021) has suggest 3.5hr/day of free time optimal for subjective well being. === Meditation/mindfulness === Research suggest that meditation can be an effective tool to boost wellbeing and productivity (Pagliaro et al., 2020) === Effective micro-breaking === *How can we best spend our micro-breaks? - research has suggested that stretching's exercise's on micro-breaks improved overall wellbeing and productivity (Henning et al., 1997) as well as caffeinated beverages (Kim et al., 2016). * What may be impleading our ability to micro-break effectively? - Kim et al.,( 2016) have found that engaging in cognitive intense activities (i.e. reading a book) on micro-breaks increased thee effects of work demands on negative affect ==Conclusion== * Work breaks are essential to well-being and can boost productivity when done correctly. * Much emphasis should be placed on workplaces to ensure that their employees are having sufficient break time both inside and outside the workplace. * Areas for further research ... {{tip|Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? }} ==See also== [[w:Meditation|Meditation<br />]] Provide up to half-a-dozen [[Help:Contents/Links#Interwiki_links|internal (wiki) links]] to relevant Wikiversity pages (esp. related [[Motivation and emotion/Book|motivation and emotion book chapters]]) and [[w:|Wikipedia articles]]. For example: * [[Motivation and emotion/Book/2016/Anorexia nervosa and extrinsic motivation|Anorexia nervosa and extrinsic motivation]] (Book chapter, 2016) * [[w:David McClelland|David McClelland]] (Wikipedia) * [[Motivation and emotion/Book/2018/Loss aversion|Loss aversion]] (Book chapter, 2018) * [[w:Maslow's hierarchy of needs|Maslow's hierarchy of needs]] (Wikipedia) {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== {{Hanging indent|1= Helliwell, J., & Wang, S. (2013). Weekends and Subjective Well-Being. Social Indicators Research, 116(2), 389-407. https://doi.org/10.1007/s11205-013-0306-y HENNING, R., JACQUES, P., KISSEL, G., SULLIVAN, A., & ALTERAS-WEBB, S. (1997). Frequent short rest breaks from computer work: effects on productivity and well-being at two field sites. Ergonomics, 40(1), 78-91. https://doi.org/10.1080/001401397188396 Pagliaro, G., Pelati, R., Signorini, D., Parenti, G., & Roversi, F. (2020). The effects of meditation on the performance and well-being of a company: A pilot study. EXPLORE, 16(1), 56-60. https://doi.org/10.1016/j.explore.2019.07.014 Kim, S., Park, Y., & Niu, Q. (2016). Micro-break activities at work to recover from daily work demands. Journal Of Organizational Behavior, 38(1), 28-44. https://doi.org/10.1002/job.2109 Sharif, M., Mogilner, C., & Hershfield, H. (2021). Having too little or too much time is linked to lower subjective well-being. Journal Of Personality And Social Psychology, 121(4), 933-947. https://doi.org/10.1037/pspp0000391 }} {{tip|Suggestions for this section: * Important aspects for APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except first letter and proper names, ending in a full-stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full-stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't actually read or consulted }} ==External links== [https://www.youtube.com/watch?v=V_OMWEEf1E4 Micro-breaking] Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * [https://students.unimelb.edu.au/academic-skills/explore-our-resources/essay-writing/six-top-tips-for-writing-a-great-essay Six top tips for writing a great essay] (University of Melbourne) * [http://www.skillsyouneed.com/write/structure.html The importance of structure] (skillsyouneed.com) {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] [[Category:Motivation and emotion/Book/Well-being]] [[Category:Motivation and emotion/Book/Work]] 7nq6kge9n8hbkek9k5ncdppix83a3ma 2419432 2419427 2022-08-26T09:15:52Z U3215603 2947641 wikitext text/x-wiki {{title|Work breaks, well-being and productivity:<br>How do work breaks affect well-being and productivity?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== [[File:Fun, men, happiness, drinking, posture, gesture, garden, hat Fortepan 2357.jpg|thumb|Figure 1. Men taking a break from work]] ''Your alarm goes off at 6 am every morning and you rush out of bed for a quick shower. Breakfast is toast and instant coffee - all you have time for - eaten while checking your schedule for the day ahead. Realizing you're already late, you rush out the door past a stack of half-read novels you haven't touched in 5 weeks for lack of spare time. The bus to work is crowded but that doesn't stop you from checking emails and sending messages to colleagues. The work day passes in a blur. Before you know its 6 am again and you're rushing for the shower.'' Regardless of how hard we work, each of us will - inevitability - need a break. But in the the modern world, trying to find a balance between work and play can be an incredibly difficult challenge. With only 24 hours in a day, trying to juggle work, study, family and social life and even just a reasonable amount of 'me time' is, for many people, impossible. Your are not alone if you are feeling this way. Cross-cultural research by [someone] has found that adults in all around the world are expressing concern about their lack of spare time. ndeed, a recent report has dound This chapter outlines ... This Overview section should be concise but consist of several paragraphs which engage the reader, illustrate the problem, and outline how psychological science can help. {{RoundBoxTop|theme=3}} '''Focus questions:''' * How do work breaks affect well-being and productivity? * How can we maximize the benefits of taking a break? * What is the third focus question? {{RoundBoxBottom}} {{tip| Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Provide an example or case study. * Conclude with Focus questions to guide the chapter. }} ==What are work breaks?== Work breaks can come in a variety of forms. Common forms found in the scientific literature include: === Micro-breaks === * Non-work activates in-between work tasks during the work day. * Common examples include, drinking coffee/tea, chatting to colleagues, snacking, briefly checking news/social media * Often viewed as counterproductive * Research suggest that micro-breaks can be beneficial in certain contexts (Kim et al., 2016) [[File:Bertrand Russell photo (cropped).jpg|thumb|Figure 2: Philosopher Bertrand Russell argued that the modern world was obsessed with productivity and instead we should spend more time on activities that were enjoyable in themselves]] === Free time === * "Discretionary time" where one engages in activities that are intrinsically enjoyable but do not necessary have to be productive * Common examples include reading, watching tv/movies, going out for dinner. * Research suggest that too much free time and be just as detrimental as too little (Sharif et al., 2021) * Sharif et al (2021) suggest that a goldilocks zone of between 2-5 hr/per day (average 3.5hr/day) of free time is optimal for well-being === Weekends === *1-2 days spend away from work *Psychological effect of weekends seem to vary drastically between individuals *Some moderating variable include: 1. Relationship with supervisor (i.e. boss or friend) *2. Work environment (i.e. Workplace toxicity) *3. Type of work (i.e. full time vs shift work) (Helliwell & Wang, 2013) *Generally, individuals report higher subjective well being on weekends that work days (Helliwell & Wang, 2013) === Holidays === How you are going to structure the chapter? Aim for three to six main headings between the [[#Overview|Overview]] and [[#Conclusion|Conclusion]]. {{tip|Suggestions for this section: * For the [[Motivation and emotion/Assessment/Topic|topic development]], provide at least 3 bullet-points about key content per section. Include key citations. * For the [[Motivation and emotion/Assessment/Chapter|book chapter]], expand the bullet points into paragraphs. * If a section has a lot of content, arrange it into two to five sub-headings such as in the [[#Interactive learning features|interactive learning features section]]. Avoid having sections with only one sub-heading. }} ==The effects of work breaks == === Work Breaks effects on Well-Being === A lack of spare time has been related to lower subjective happiness (Masuda et al., 2020) === Work Break effects on Productivity === * Both casual and correlation relationships between breaks and productivity have been established [citations] What brings an online book chapter to life are its interactive learning features. Case studies, feature boxes, figures, links, tables, and quiz questions can be used throughout the chapter. '''Case studies''' Case studies describe real-world examples of concepts in action. Case studies can be real or fictional. A case could be used multiple times during a chapter to illustrate different theories or stages. It is often helpful to present case studies using [[#Feature boxes|feature boxes]]. '''Boxes''' Boxes can be used to highlight content, but don't overuse them. There are many different ways of creating boxes (e.g., see [[Help:Pretty boxes|Pretty boxes]]). Possible uses include: * Focus questions * Case studies or examples * Quiz questions * Take-home messages {{RoundBoxTop|theme=3}} ;Feature box example * Shaded background * Coloured border {{RoundBoxBottom}}'''Figures'''[[File:Monkey-typing.jpg|right|205px|thumb|''Figure 1''. Example image with descriptive caption.]] Use figures to illustrate concepts, add interest, and provide examples. Figures can be used to show photographs, drawings, diagrams, graphs, etcetera. Figures can be embedded throughout the chapter, starting with the Overview section. Figures should be captioned (using a number and a description) in order to explain their relevance to the text. Possible images can be found at [[commons:|Wikimedia Commons]]. Images can also be uploaded if they are licensed for re-use or if you created the image. Each figure should be referred to at least once in the main text (e.g., see Figure 1). '''Links''' Where key words are first used, make them into [[Help:Links|interwiki links]] such as Wikipedia links to articles about famous people (e.g., [[w:Sigmund Freud|Sigmund Freud]] and key concepts (e.g., [[w:Dreams|dreams]]) and links to book chapters about related topics (e.g., would you like to learn about how to overcome [[Motivation and emotion/Book/2020/Writer's block|writer's block]]?). '''Tables''' Tables can be an effective way to organise and summarise information. Tables should be captioned (using APA style) to explain their relevance to the text. Plus each table should be referred to at least once in the main text (e.g., see Table 1 and Table 2). Here are some [[Motivation and emotion/Wikiversity/Tables|example 3 x 3 tables]] which could be adapted. '''Quizzes''' Quizzes are a direct way to engage readers. But don't make quizzes too hard or long. It is better to have one or two review questions per major section than a long quiz at the end. Try to quiz conceptual understanding, rather than trivia. Here are some simple quiz questions which could be adapted. Choose the correct answers and click "Submit": <quiz display=simple> {Quizzes are an interactive learning feature: |type="()"} + True - False {Long quizzes are a good idea: |type="()"} - True + False </quiz> To learn about different types of quiz questions, see [[Help:Quiz|Quiz]]. == How can we optimize our breaks? == * What is the optimal amount of breaking for to maximize well-being and productivity? - Sharif et al (2021) has suggest 3.5hr/day of free time optimal for subjective well being. === Meditation/mindfulness === Research suggest that meditation can be an effective tool to boost wellbeing and productivity (Pagliaro et al., 2020) === Effective micro-breaking === *How can we best spend our micro-breaks? - research has suggested that stretching's exercise's on micro-breaks improved overall wellbeing and productivity (Henning et al., 1997) as well as caffeinated beverages (Kim et al., 2016). * What may be impleading our ability to micro-break effectively? - Kim et al.,( 2016) have found that engaging in cognitive intense activities (i.e. reading a book) on micro-breaks increased thee effects of work demands on negative affect ==Conclusion== * Work breaks are essential to well-being and can boost productivity when done correctly. * Much emphasis should be placed on workplaces to ensure that their employees are having sufficient break time both inside and outside the workplace. * Areas for further research ... {{tip|Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? }} ==See also== [[w:Meditation|Meditation<br />]] Provide up to half-a-dozen [[Help:Contents/Links#Interwiki_links|internal (wiki) links]] to relevant Wikiversity pages (esp. related [[Motivation and emotion/Book|motivation and emotion book chapters]]) and [[w:|Wikipedia articles]]. For example: * [[Motivation and emotion/Book/2016/Anorexia nervosa and extrinsic motivation|Anorexia nervosa and extrinsic motivation]] (Book chapter, 2016) * [[w:David McClelland|David McClelland]] (Wikipedia) * [[Motivation and emotion/Book/2018/Loss aversion|Loss aversion]] (Book chapter, 2018) * [[w:Maslow's hierarchy of needs|Maslow's hierarchy of needs]] (Wikipedia) {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== {{Hanging indent|1= Helliwell, J., & Wang, S. (2013). Weekends and Subjective Well-Being. Social Indicators Research, 116(2), 389-407. https://doi.org/10.1007/s11205-013-0306-y HENNING, R., JACQUES, P., KISSEL, G., SULLIVAN, A., & ALTERAS-WEBB, S. (1997). Frequent short rest breaks from computer work: effects on productivity and well-being at two field sites. Ergonomics, 40(1), 78-91. https://doi.org/10.1080/001401397188396 Pagliaro, G., Pelati, R., Signorini, D., Parenti, G., & Roversi, F. (2020). The effects of meditation on the performance and well-being of a company: A pilot study. EXPLORE, 16(1), 56-60. https://doi.org/10.1016/j.explore.2019.07.014 Kim, S., Park, Y., & Niu, Q. (2016). Micro-break activities at work to recover from daily work demands. Journal Of Organizational Behavior, 38(1), 28-44. https://doi.org/10.1002/job.2109 Sharif, M., Mogilner, C., & Hershfield, H. (2021). Having too little or too much time is linked to lower subjective well-being. Journal Of Personality And Social Psychology, 121(4), 933-947. https://doi.org/10.1037/pspp0000391 }} {{tip|Suggestions for this section: * Important aspects for APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except first letter and proper names, ending in a full-stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full-stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't actually read or consulted }} ==External links== [https://www.youtube.com/watch?v=V_OMWEEf1E4 Micro-breaking] Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * [https://students.unimelb.edu.au/academic-skills/explore-our-resources/essay-writing/six-top-tips-for-writing-a-great-essay Six top tips for writing a great essay] (University of Melbourne) * [http://www.skillsyouneed.com/write/structure.html The importance of structure] (skillsyouneed.com) {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] [[Category:Motivation and emotion/Book/Well-being]] [[Category:Motivation and emotion/Book/Work]] pb888iq0135752kjd844thw411zkb70 2419434 2419432 2022-08-26T09:20:14Z U3215603 2947641 wikitext text/x-wiki {{title|Work breaks, well-being and productivity:<br>How do work breaks affect well-being and productivity?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== [[File:Fun, men, happiness, drinking, posture, gesture, garden, hat Fortepan 2357.jpg|thumb|Figure 1. Men taking a break from work]] ''Your alarm goes off at 6 am every morning and you rush out of bed for a quick shower. Breakfast is toast and instant coffee - all you have time for - eaten while checking your schedule for the day ahead. Realizing you're already late, you rush out the door past a stack of half-read novels you haven't touched in 5 weeks for lack of spare time. The bus to work is crowded but that doesn't stop you from checking emails and sending messages to colleagues. The work day passes in a blur. Before you know its 6 am again and you're rushing for the shower.'' Regardless of how hard we work, each of us will - inevitability - need a break. But in the the modern world, trying to find a balance between work and play can be an incredibly difficult challenge. With only 24 hours in a day, trying to juggle work, study, family and social life and even just a reasonable amount of 'me time' is, for many people, impossible. You are not alone if you are feeling this way. Cross-cultural research by Hamermesh & Lee (2007) has found that adults all around the world are expressing concern about their lack of spare time - particularly in the middle and upper classes. ndeed, a recent report has dound This chapter outlines ... This Overview section should be concise but consist of several paragraphs which engage the reader, illustrate the problem, and outline how psychological science can help. {{RoundBoxTop|theme=3}} '''Focus questions:''' * How do work breaks affect well-being and productivity? * How can we maximize the benefits of taking a break? * What is the third focus question? {{RoundBoxBottom}} {{tip| Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Provide an example or case study. * Conclude with Focus questions to guide the chapter. }} ==What are work breaks?== Work breaks can come in a variety of forms. Common forms found in the scientific literature include: === Micro-breaks === * Non-work activates in-between work tasks during the work day. * Common examples include, drinking coffee/tea, chatting to colleagues, snacking, briefly checking news/social media * Often viewed as counterproductive * Research suggest that micro-breaks can be beneficial in certain contexts (Kim et al., 2016) [[File:Bertrand Russell photo (cropped).jpg|thumb|Figure 2: Philosopher Bertrand Russell argued that the modern world was obsessed with productivity and instead we should spend more time on activities that were enjoyable in themselves]] === Free time === * "Discretionary time" where one engages in activities that are intrinsically enjoyable but do not necessary have to be productive * Common examples include reading, watching tv/movies, going out for dinner. * Research suggest that too much free time and be just as detrimental as too little (Sharif et al., 2021) * Sharif et al (2021) suggest that a goldilocks zone of between 2-5 hr/per day (average 3.5hr/day) of free time is optimal for well-being === Weekends === *1-2 days spend away from work *Psychological effect of weekends seem to vary drastically between individuals *Some moderating variable include: 1. Relationship with supervisor (i.e. boss or friend) *2. Work environment (i.e. Workplace toxicity) *3. Type of work (i.e. full time vs shift work) (Helliwell & Wang, 2013) *Generally, individuals report higher subjective well being on weekends that work days (Helliwell & Wang, 2013) === Holidays === How you are going to structure the chapter? Aim for three to six main headings between the [[#Overview|Overview]] and [[#Conclusion|Conclusion]]. {{tip|Suggestions for this section: * For the [[Motivation and emotion/Assessment/Topic|topic development]], provide at least 3 bullet-points about key content per section. Include key citations. * For the [[Motivation and emotion/Assessment/Chapter|book chapter]], expand the bullet points into paragraphs. * If a section has a lot of content, arrange it into two to five sub-headings such as in the [[#Interactive learning features|interactive learning features section]]. Avoid having sections with only one sub-heading. }} ==The effects of work breaks == === Work Breaks effects on Well-Being === A lack of spare time has been related to lower subjective happiness (Masuda et al., 2020) === Work Break effects on Productivity === * Both casual and correlation relationships between breaks and productivity have been established [citations] What brings an online book chapter to life are its interactive learning features. Case studies, feature boxes, figures, links, tables, and quiz questions can be used throughout the chapter. '''Case studies''' Case studies describe real-world examples of concepts in action. Case studies can be real or fictional. A case could be used multiple times during a chapter to illustrate different theories or stages. It is often helpful to present case studies using [[#Feature boxes|feature boxes]]. '''Boxes''' Boxes can be used to highlight content, but don't overuse them. There are many different ways of creating boxes (e.g., see [[Help:Pretty boxes|Pretty boxes]]). Possible uses include: * Focus questions * Case studies or examples * Quiz questions * Take-home messages {{RoundBoxTop|theme=3}} ;Feature box example * Shaded background * Coloured border {{RoundBoxBottom}}'''Figures'''[[File:Monkey-typing.jpg|right|205px|thumb|''Figure 1''. Example image with descriptive caption.]] Use figures to illustrate concepts, add interest, and provide examples. Figures can be used to show photographs, drawings, diagrams, graphs, etcetera. Figures can be embedded throughout the chapter, starting with the Overview section. Figures should be captioned (using a number and a description) in order to explain their relevance to the text. Possible images can be found at [[commons:|Wikimedia Commons]]. Images can also be uploaded if they are licensed for re-use or if you created the image. Each figure should be referred to at least once in the main text (e.g., see Figure 1). '''Links''' Where key words are first used, make them into [[Help:Links|interwiki links]] such as Wikipedia links to articles about famous people (e.g., [[w:Sigmund Freud|Sigmund Freud]] and key concepts (e.g., [[w:Dreams|dreams]]) and links to book chapters about related topics (e.g., would you like to learn about how to overcome [[Motivation and emotion/Book/2020/Writer's block|writer's block]]?). '''Tables''' Tables can be an effective way to organise and summarise information. Tables should be captioned (using APA style) to explain their relevance to the text. Plus each table should be referred to at least once in the main text (e.g., see Table 1 and Table 2). Here are some [[Motivation and emotion/Wikiversity/Tables|example 3 x 3 tables]] which could be adapted. '''Quizzes''' Quizzes are a direct way to engage readers. But don't make quizzes too hard or long. It is better to have one or two review questions per major section than a long quiz at the end. Try to quiz conceptual understanding, rather than trivia. Here are some simple quiz questions which could be adapted. Choose the correct answers and click "Submit": <quiz display=simple> {Quizzes are an interactive learning feature: |type="()"} + True - False {Long quizzes are a good idea: |type="()"} - True + False </quiz> To learn about different types of quiz questions, see [[Help:Quiz|Quiz]]. == How can we optimize our breaks? == * What is the optimal amount of breaking for to maximize well-being and productivity? - Sharif et al (2021) has suggest 3.5hr/day of free time optimal for subjective well being. === Meditation/mindfulness === Research suggest that meditation can be an effective tool to boost wellbeing and productivity (Pagliaro et al., 2020) === Effective micro-breaking === *How can we best spend our micro-breaks? - research has suggested that stretching's exercise's on micro-breaks improved overall wellbeing and productivity (Henning et al., 1997) as well as caffeinated beverages (Kim et al., 2016). * What may be impleading our ability to micro-break effectively? - Kim et al.,( 2016) have found that engaging in cognitive intense activities (i.e. reading a book) on micro-breaks increased thee effects of work demands on negative affect ==Conclusion== * Work breaks are essential to well-being and can boost productivity when done correctly. * Much emphasis should be placed on workplaces to ensure that their employees are having sufficient break time both inside and outside the workplace. * Areas for further research ... {{tip|Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? }} ==See also== [[w:Meditation|Meditation<br />]] Provide up to half-a-dozen [[Help:Contents/Links#Interwiki_links|internal (wiki) links]] to relevant Wikiversity pages (esp. related [[Motivation and emotion/Book|motivation and emotion book chapters]]) and [[w:|Wikipedia articles]]. For example: * [[Motivation and emotion/Book/2016/Anorexia nervosa and extrinsic motivation|Anorexia nervosa and extrinsic motivation]] (Book chapter, 2016) * [[w:David McClelland|David McClelland]] (Wikipedia) * [[Motivation and emotion/Book/2018/Loss aversion|Loss aversion]] (Book chapter, 2018) * [[w:Maslow's hierarchy of needs|Maslow's hierarchy of needs]] (Wikipedia) {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== {{Hanging indent|1= Hamermesh, D., & Lee, J. (2007). Stressed Out on Four Continents: Time Crunch or Yuppie Kvetch?. Review Of Economics And Statistics, 89(2), 374-383. https://doi.org/10.1162/rest.89.2.374 Helliwell, J., & Wang, S. (2013). Weekends and Subjective Well-Being. Social Indicators Research, 116(2), 389-407. https://doi.org/10.1007/s11205-013-0306-y HENNING, R., JACQUES, P., KISSEL, G., SULLIVAN, A., & ALTERAS-WEBB, S. (1997). Frequent short rest breaks from computer work: effects on productivity and well-being at two field sites. Ergonomics, 40(1), 78-91. https://doi.org/10.1080/001401397188396 Pagliaro, G., Pelati, R., Signorini, D., Parenti, G., & Roversi, F. (2020). The effects of meditation on the performance and well-being of a company: A pilot study. EXPLORE, 16(1), 56-60. https://doi.org/10.1016/j.explore.2019.07.014 Kim, S., Park, Y., & Niu, Q. (2016). Micro-break activities at work to recover from daily work demands. Journal Of Organizational Behavior, 38(1), 28-44. https://doi.org/10.1002/job.2109 Sharif, M., Mogilner, C., & Hershfield, H. (2021). Having too little or too much time is linked to lower subjective well-being. Journal Of Personality And Social Psychology, 121(4), 933-947. https://doi.org/10.1037/pspp0000391 }} {{tip|Suggestions for this section: * Important aspects for APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except first letter and proper names, ending in a full-stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full-stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't actually read or consulted }} ==External links== [https://www.youtube.com/watch?v=V_OMWEEf1E4 Micro-breaking] Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * [https://students.unimelb.edu.au/academic-skills/explore-our-resources/essay-writing/six-top-tips-for-writing-a-great-essay Six top tips for writing a great essay] (University of Melbourne) * [http://www.skillsyouneed.com/write/structure.html The importance of structure] (skillsyouneed.com) {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] [[Category:Motivation and emotion/Book/Well-being]] [[Category:Motivation and emotion/Book/Work]] 8699e9y7vmdc7k5lu5bm91zjnq9s0ai 2419442 2419434 2022-08-26T09:33:12Z U3215603 2947641 wikitext text/x-wiki {{title|Work breaks, well-being and productivity:<br>How do work breaks affect well-being and productivity?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== [[File:Fun, men, happiness, drinking, posture, gesture, garden, hat Fortepan 2357.jpg|thumb|Figure 1. Men taking a break from work]] ''Your alarm goes off at 6 am every morning and you rush out of bed for a quick shower. Breakfast is toast and instant coffee - all you have time for - eaten while checking your schedule for the day ahead. Realizing you're already late, you rush out the door past a stack of half-read novels you haven't touched in 5 weeks for lack of spare time. The bus to work is crowded but that doesn't stop you from checking emails and sending messages to colleagues. The work day passes in a blur. Before you know its 6 am again and you're rushing for the shower.'' Regardless of how hard we work, each of us will - inevitability - need a break. But in the the modern world, trying to find a balance between work and play can be an incredibly difficult challenge. With only 24 hours in a day, trying to juggle work, study, family and social life and even just a reasonable amount of 'me time' is, for many people, impossible. You are not alone if you are feeling this way. Cross-cultural research by Hamermesh & Lee (2007) has found that adults all around the world are expressing concern about their lack of spare time - particularly in the middle and upper classes. The effects of a lack of spare time and its inevitable end - burnout - are well noted (Lee & Eissenstat, 2018). But despite its negative outcomes in extreme cases, we must not forgot that work is also essential to society's functioning, Therefore. the question we seek to address in this chapter is how we could find an appropriate balance between working and breaking that could maintain our well-being (mental and physical) yet is still reasonable productive. The question, indeed, is a complex one. This Overview section should be concise but consist of several paragraphs which engage the reader, illustrate the problem, and outline how psychological science can help. {{RoundBoxTop|theme=3}} '''Focus questions:''' * How do work breaks affect well-being and productivity? * How can we maximize the benefits of taking a break? * What is the third focus question? {{RoundBoxBottom}} {{tip| Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Provide an example or case study. * Conclude with Focus questions to guide the chapter. }} ==What are work breaks?== Work breaks can come in a variety of forms. Common forms found in the scientific literature include: === Micro-breaks === * Non-work activates in-between work tasks during the work day. * Common examples include, drinking coffee/tea, chatting to colleagues, snacking, briefly checking news/social media * Often viewed as counterproductive * Research suggest that micro-breaks can be beneficial in certain contexts (Kim et al., 2016) [[File:Bertrand Russell photo (cropped).jpg|thumb|Figure 2: Philosopher Bertrand Russell argued that the modern world was obsessed with productivity and instead we should spend more time on activities that were enjoyable in themselves]] === Free time === * "Discretionary time" where one engages in activities that are intrinsically enjoyable but do not necessary have to be productive * Common examples include reading, watching tv/movies, going out for dinner. * Research suggest that too much free time and be just as detrimental as too little (Sharif et al., 2021) * Sharif et al (2021) suggest that a goldilocks zone of between 2-5 hr/per day (average 3.5hr/day) of free time is optimal for well-being === Weekends === *1-2 days spend away from work *Psychological effect of weekends seem to vary drastically between individuals *Some moderating variable include: 1. Relationship with supervisor (i.e. boss or friend) *2. Work environment (i.e. Workplace toxicity) *3. Type of work (i.e. full time vs shift work) (Helliwell & Wang, 2013) *Generally, individuals report higher subjective well being on weekends that work days (Helliwell & Wang, 2013) === Holidays === How you are going to structure the chapter? Aim for three to six main headings between the [[#Overview|Overview]] and [[#Conclusion|Conclusion]]. {{tip|Suggestions for this section: * For the [[Motivation and emotion/Assessment/Topic|topic development]], provide at least 3 bullet-points about key content per section. Include key citations. * For the [[Motivation and emotion/Assessment/Chapter|book chapter]], expand the bullet points into paragraphs. * If a section has a lot of content, arrange it into two to five sub-headings such as in the [[#Interactive learning features|interactive learning features section]]. Avoid having sections with only one sub-heading. }} ==The effects of work breaks == === Work Breaks effects on Well-Being === A lack of spare time has been related to lower subjective happiness (Masuda et al., 2020) === Work Break effects on Productivity === * Both casual and correlation relationships between breaks and productivity have been established [citations] What brings an online book chapter to life are its interactive learning features. Case studies, feature boxes, figures, links, tables, and quiz questions can be used throughout the chapter. '''Case studies''' Case studies describe real-world examples of concepts in action. Case studies can be real or fictional. A case could be used multiple times during a chapter to illustrate different theories or stages. It is often helpful to present case studies using [[#Feature boxes|feature boxes]]. '''Boxes''' Boxes can be used to highlight content, but don't overuse them. There are many different ways of creating boxes (e.g., see [[Help:Pretty boxes|Pretty boxes]]). Possible uses include: * Focus questions * Case studies or examples * Quiz questions * Take-home messages {{RoundBoxTop|theme=3}} ;Feature box example * Shaded background * Coloured border {{RoundBoxBottom}}'''Figures'''[[File:Monkey-typing.jpg|right|205px|thumb|''Figure 1''. Example image with descriptive caption.]] Use figures to illustrate concepts, add interest, and provide examples. Figures can be used to show photographs, drawings, diagrams, graphs, etcetera. Figures can be embedded throughout the chapter, starting with the Overview section. Figures should be captioned (using a number and a description) in order to explain their relevance to the text. Possible images can be found at [[commons:|Wikimedia Commons]]. Images can also be uploaded if they are licensed for re-use or if you created the image. Each figure should be referred to at least once in the main text (e.g., see Figure 1). '''Links''' Where key words are first used, make them into [[Help:Links|interwiki links]] such as Wikipedia links to articles about famous people (e.g., [[w:Sigmund Freud|Sigmund Freud]] and key concepts (e.g., [[w:Dreams|dreams]]) and links to book chapters about related topics (e.g., would you like to learn about how to overcome [[Motivation and emotion/Book/2020/Writer's block|writer's block]]?). '''Tables''' Tables can be an effective way to organise and summarise information. Tables should be captioned (using APA style) to explain their relevance to the text. Plus each table should be referred to at least once in the main text (e.g., see Table 1 and Table 2). Here are some [[Motivation and emotion/Wikiversity/Tables|example 3 x 3 tables]] which could be adapted. '''Quizzes''' Quizzes are a direct way to engage readers. But don't make quizzes too hard or long. It is better to have one or two review questions per major section than a long quiz at the end. Try to quiz conceptual understanding, rather than trivia. Here are some simple quiz questions which could be adapted. Choose the correct answers and click "Submit": <quiz display=simple> {Quizzes are an interactive learning feature: |type="()"} + True - False {Long quizzes are a good idea: |type="()"} - True + False </quiz> To learn about different types of quiz questions, see [[Help:Quiz|Quiz]]. == How can we optimize our breaks? == * What is the optimal amount of breaking for to maximize well-being and productivity? - Sharif et al (2021) has suggest 3.5hr/day of free time optimal for subjective well being. === Meditation/mindfulness === Research suggest that meditation can be an effective tool to boost wellbeing and productivity (Pagliaro et al., 2020) === Effective micro-breaking === *How can we best spend our micro-breaks? - research has suggested that stretching's exercise's on micro-breaks improved overall wellbeing and productivity (Henning et al., 1997) as well as caffeinated beverages (Kim et al., 2016). * What may be impleading our ability to micro-break effectively? - Kim et al.,( 2016) have found that engaging in cognitive intense activities (i.e. reading a book) on micro-breaks increased thee effects of work demands on negative affect ==Conclusion== * Work breaks are essential to well-being and can boost productivity when done correctly. * Much emphasis should be placed on workplaces to ensure that their employees are having sufficient break time both inside and outside the workplace. * Areas for further research ... {{tip|Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? }} ==See also== [[w:Meditation|Meditation<br />]] Provide up to half-a-dozen [[Help:Contents/Links#Interwiki_links|internal (wiki) links]] to relevant Wikiversity pages (esp. related [[Motivation and emotion/Book|motivation and emotion book chapters]]) and [[w:|Wikipedia articles]]. For example: * [[Motivation and emotion/Book/2016/Anorexia nervosa and extrinsic motivation|Anorexia nervosa and extrinsic motivation]] (Book chapter, 2016) * [[w:David McClelland|David McClelland]] (Wikipedia) * [[Motivation and emotion/Book/2018/Loss aversion|Loss aversion]] (Book chapter, 2018) * [[w:Maslow's hierarchy of needs|Maslow's hierarchy of needs]] (Wikipedia) {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== {{Hanging indent|1= Hamermesh, D., & Lee, J. (2007). Stressed Out on Four Continents: Time Crunch or Yuppie Kvetch?. Review Of Economics And Statistics, 89(2), 374-383. https://doi.org/10.1162/rest.89.2.374 Helliwell, J., & Wang, S. (2013). Weekends and Subjective Well-Being. Social Indicators Research, 116(2), 389-407. https://doi.org/10.1007/s11205-013-0306-y HENNING, R., JACQUES, P., KISSEL, G., SULLIVAN, A., & ALTERAS-WEBB, S. (1997). Frequent short rest breaks from computer work: effects on productivity and well-being at two field sites. Ergonomics, 40(1), 78-91. https://doi.org/10.1080/001401397188396 Kim, S., Park, Y., & Niu, Q. (2016). Micro-break activities at work to recover from daily work demands. Journal Of Organizational Behavior, 38(1), 28-44. https://doi.org/10.1002/job.2109 Lee, Y., & Eissenstat, S. (2018). A longitudinal examination of the causes and effects of burnout based on the job demands-resources model. International Journal For Educational And Vocational Guidance, 18(3), 337-354. https://doi.org/10.1007/s10775-018-9364-7 Masuda, Y., Williams, J., & Tallis, H. (2020). Does Life Satisfaction Vary with Time and Income? Investigating the Relationship Among Free Time, Income, and Life Satisfaction. Journal Of Happiness Studies, 22(5), 2051-2073. https://doi.org/10.1007/s10902-020-00307-8 Pagliaro, G., Pelati, R., Signorini, D., Parenti, G., & Roversi, F. (2020). The effects of meditation on the performance and well-being of a company: A pilot study. EXPLORE, 16(1), 56-60. https://doi.org/10.1016/j.explore.2019.07.014 Sharif, M., Mogilner, C., & Hershfield, H. (2021). Having too little or too much time is linked to lower subjective well-being. Journal Of Personality And Social Psychology, 121(4), 933-947. https://doi.org/10.1037/pspp0000391 }} {{tip|Suggestions for this section: * Important aspects for APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except first letter and proper names, ending in a full-stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full-stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't actually read or consulted }} ==External links== [https://www.youtube.com/watch?v=V_OMWEEf1E4 Micro-breaking] Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * [https://students.unimelb.edu.au/academic-skills/explore-our-resources/essay-writing/six-top-tips-for-writing-a-great-essay Six top tips for writing a great essay] (University of Melbourne) * [http://www.skillsyouneed.com/write/structure.html The importance of structure] (skillsyouneed.com) {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] [[Category:Motivation and emotion/Book/Well-being]] [[Category:Motivation and emotion/Book/Work]] tkfdahr8gsmpp59qn6cevthef72d9rh 2419447 2419442 2022-08-26T09:36:14Z U3215603 2947641 wikitext text/x-wiki {{title|Work breaks, well-being and productivity:<br>How do work breaks affect well-being and productivity?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== [[File:Fun, men, happiness, drinking, posture, gesture, garden, hat Fortepan 2357.jpg|thumb|Figure 1. Men taking a break from work]] ''Your alarm goes off at 6 am every morning and you rush out of bed for a quick shower. Breakfast is toast and instant coffee - all you have time for - eaten while checking your schedule for the day ahead. Realizing you're already late, you rush out the door past a stack of half-read novels you haven't touched in 5 weeks for lack of spare time. The bus to work is crowded but that doesn't stop you from checking emails and sending messages to colleagues. The work day passes in a blur. Before you know its 6 am again and you're rushing for the shower.'' Regardless of how hard we work, each of us will - inevitability - need a break. But in the the modern world, trying to find a balance between work and play can be an incredibly difficult challenge. With only 24 hours in a day, trying to juggle work, study, family and social life and even just a reasonable amount of 'me time' is, for many people, impossible. You are not alone if you are feeling this way. Cross-cultural research by Hamermesh & Lee (2007) has found that adults all around the world are expressing concern about their lack of spare time - particularly in the middle and upper classes. The effects of a lack of spare time and its inevitable end - burnout - are well noted (Lee & Eissenstat, 2018). But despite its negative outcomes in extreme cases, we must not forgot that work is also essential to society's functioning, Therefore. the question we seek to address in this chapter is how we could find an appropriate balance between working and breaking that could maintain our well-being (mental and physical) yet is still reasonable productive. The question, indeed, is a complex one. This Overview section should be concise but consist of several paragraphs which engage the reader, illustrate the problem, and outline how psychological science can help. {{RoundBoxTop|theme=3}} '''Focus questions:''' * How do work breaks affect well-being and productivity? * How can we maximize the benefits of taking a break? * What is the third focus question? {{RoundBoxBottom}} {{tip| Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Provide an example or case study. * Conclude with Focus questions to guide the chapter. }} ==What are work breaks?== Work breaks can come in a variety of forms. Common forms found in the scientific literature include: === Micro-breaks === * Non-work activates in-between work tasks during the work day. * Common examples include, drinking coffee/tea, chatting to colleagues, snacking, briefly checking news/social media * Often viewed as counterproductive * Research suggest that micro-breaks can be beneficial in certain contexts (Kim et al., 2016) [[File:Bertrand Russell photo (cropped).jpg|thumb|Figure 2: Philosopher Bertrand Russell argued that the modern world was obsessed with productivity and instead we should spend more time on activities that were enjoyable in themselves]] === Free time === * "Discretionary time" where one engages in activities that are intrinsically enjoyable but do not necessary have to be productive * Common examples include reading, watching tv/movies, going out for dinner. * Research suggest that too much free time and be just as detrimental as too little (Sharif et al., 2021) * Sharif et al (2021) suggest that a goldilocks zone of between 2-5 hr/per day (average 3.5hr/day) of free time is optimal for well-being === Weekends === *1-2 days spend away from work *Psychological effect of weekends seem to vary drastically between individuals *Some moderating variable include: 1. Relationship with supervisor (i.e. boss or friend) *2. Work environment (i.e. Workplace toxicity) *3. Type of work (i.e. full time vs shift work) (Helliwell & Wang, 2013) *Generally, individuals report higher subjective well being on weekends that work days (Helliwell & Wang, 2013) === Holidays === How you are going to structure the chapter? Aim for three to six main headings between the [[#Overview|Overview]] and [[#Conclusion|Conclusion]]. {{tip|Suggestions for this section: * For the [[Motivation and emotion/Assessment/Topic|topic development]], provide at least 3 bullet-points about key content per section. Include key citations. * For the [[Motivation and emotion/Assessment/Chapter|book chapter]], expand the bullet points into paragraphs. * If a section has a lot of content, arrange it into two to five sub-headings such as in the [[#Interactive learning features|interactive learning features section]]. Avoid having sections with only one sub-heading. }} ==The effects of work breaks == === Work Breaks effects on Well-Being === * A lack of spare time has been related to lower subjective happiness (Masuda et al., 2020) * Include section on burnout (Lee & Eissenstat, 2018) === Work Break effects on Productivity === * Both casual and correlation relationships between breaks and productivity have been established [citations] What brings an online book chapter to life are its interactive learning features. Case studies, feature boxes, figures, links, tables, and quiz questions can be used throughout the chapter. '''Case studies''' Case studies describe real-world examples of concepts in action. Case studies can be real or fictional. A case could be used multiple times during a chapter to illustrate different theories or stages. It is often helpful to present case studies using [[#Feature boxes|feature boxes]]. '''Boxes''' Boxes can be used to highlight content, but don't overuse them. There are many different ways of creating boxes (e.g., see [[Help:Pretty boxes|Pretty boxes]]). Possible uses include: * Focus questions * Case studies or examples * Quiz questions * Take-home messages {{RoundBoxTop|theme=3}} ;Feature box example * Shaded background * Coloured border {{RoundBoxBottom}}'''Figures'''[[File:Monkey-typing.jpg|right|205px|thumb|''Figure 1''. Example image with descriptive caption.]] Use figures to illustrate concepts, add interest, and provide examples. Figures can be used to show photographs, drawings, diagrams, graphs, etcetera. Figures can be embedded throughout the chapter, starting with the Overview section. Figures should be captioned (using a number and a description) in order to explain their relevance to the text. Possible images can be found at [[commons:|Wikimedia Commons]]. Images can also be uploaded if they are licensed for re-use or if you created the image. Each figure should be referred to at least once in the main text (e.g., see Figure 1). '''Links''' Where key words are first used, make them into [[Help:Links|interwiki links]] such as Wikipedia links to articles about famous people (e.g., [[w:Sigmund Freud|Sigmund Freud]] and key concepts (e.g., [[w:Dreams|dreams]]) and links to book chapters about related topics (e.g., would you like to learn about how to overcome [[Motivation and emotion/Book/2020/Writer's block|writer's block]]?). '''Tables''' Tables can be an effective way to organise and summarise information. Tables should be captioned (using APA style) to explain their relevance to the text. Plus each table should be referred to at least once in the main text (e.g., see Table 1 and Table 2). Here are some [[Motivation and emotion/Wikiversity/Tables|example 3 x 3 tables]] which could be adapted. '''Quizzes''' Quizzes are a direct way to engage readers. But don't make quizzes too hard or long. It is better to have one or two review questions per major section than a long quiz at the end. Try to quiz conceptual understanding, rather than trivia. Here are some simple quiz questions which could be adapted. Choose the correct answers and click "Submit": <quiz display=simple> {Quizzes are an interactive learning feature: |type="()"} + True - False {Long quizzes are a good idea: |type="()"} - True + False </quiz> To learn about different types of quiz questions, see [[Help:Quiz|Quiz]]. == How can we optimize our breaks? == * What is the optimal amount of breaking for to maximize well-being and productivity? - Sharif et al (2021) has suggest 3.5hr/day of free time optimal for subjective well being. === Meditation/mindfulness === Research suggest that meditation can be an effective tool to boost wellbeing and productivity (Pagliaro et al., 2020) === Effective micro-breaking === *How can we best spend our micro-breaks? - research has suggested that stretching's exercise's on micro-breaks improved overall wellbeing and productivity (Henning et al., 1997) as well as caffeinated beverages (Kim et al., 2016). * What may be impleading our ability to micro-break effectively? - Kim et al.,( 2016) have found that engaging in cognitive intense activities (i.e. reading a book) on micro-breaks increased thee effects of work demands on negative affect ==Conclusion== * Work breaks are essential to well-being and can boost productivity when done correctly. * Much emphasis should be placed on workplaces to ensure that their employees are having sufficient break time both inside and outside the workplace. * Areas for further research ... {{tip|Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? }} ==See also== [[w:Meditation|Meditation<br />]] Provide up to half-a-dozen [[Help:Contents/Links#Interwiki_links|internal (wiki) links]] to relevant Wikiversity pages (esp. related [[Motivation and emotion/Book|motivation and emotion book chapters]]) and [[w:|Wikipedia articles]]. For example: * [[Motivation and emotion/Book/2016/Anorexia nervosa and extrinsic motivation|Anorexia nervosa and extrinsic motivation]] (Book chapter, 2016) * [[w:David McClelland|David McClelland]] (Wikipedia) * [[Motivation and emotion/Book/2018/Loss aversion|Loss aversion]] (Book chapter, 2018) * [[w:Maslow's hierarchy of needs|Maslow's hierarchy of needs]] (Wikipedia) {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== {{Hanging indent|1= Hamermesh, D., & Lee, J. (2007). Stressed Out on Four Continents: Time Crunch or Yuppie Kvetch?. Review Of Economics And Statistics, 89(2), 374-383. https://doi.org/10.1162/rest.89.2.374 Helliwell, J., & Wang, S. (2013). Weekends and Subjective Well-Being. Social Indicators Research, 116(2), 389-407. https://doi.org/10.1007/s11205-013-0306-y HENNING, R., JACQUES, P., KISSEL, G., SULLIVAN, A., & ALTERAS-WEBB, S. (1997). Frequent short rest breaks from computer work: effects on productivity and well-being at two field sites. Ergonomics, 40(1), 78-91. https://doi.org/10.1080/001401397188396 Kim, S., Park, Y., & Niu, Q. (2016). Micro-break activities at work to recover from daily work demands. Journal Of Organizational Behavior, 38(1), 28-44. https://doi.org/10.1002/job.2109 Lee, Y., & Eissenstat, S. (2018). A longitudinal examination of the causes and effects of burnout based on the job demands-resources model. International Journal For Educational And Vocational Guidance, 18(3), 337-354. https://doi.org/10.1007/s10775-018-9364-7 Masuda, Y., Williams, J., & Tallis, H. (2020). Does Life Satisfaction Vary with Time and Income? Investigating the Relationship Among Free Time, Income, and Life Satisfaction. Journal Of Happiness Studies, 22(5), 2051-2073. https://doi.org/10.1007/s10902-020-00307-8 Pagliaro, G., Pelati, R., Signorini, D., Parenti, G., & Roversi, F. (2020). The effects of meditation on the performance and well-being of a company: A pilot study. EXPLORE, 16(1), 56-60. https://doi.org/10.1016/j.explore.2019.07.014 Sharif, M., Mogilner, C., & Hershfield, H. (2021). Having too little or too much time is linked to lower subjective well-being. Journal Of Personality And Social Psychology, 121(4), 933-947. https://doi.org/10.1037/pspp0000391 }} {{tip|Suggestions for this section: * Important aspects for APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except first letter and proper names, ending in a full-stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full-stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't actually read or consulted }} ==External links== [https://www.youtube.com/watch?v=V_OMWEEf1E4 Micro-breaking] Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * [https://students.unimelb.edu.au/academic-skills/explore-our-resources/essay-writing/six-top-tips-for-writing-a-great-essay Six top tips for writing a great essay] (University of Melbourne) * [http://www.skillsyouneed.com/write/structure.html The importance of structure] (skillsyouneed.com) {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] [[Category:Motivation and emotion/Book/Well-being]] [[Category:Motivation and emotion/Book/Work]] 7jd4ihai5nu4qwv8ly7036qjfg4v0do 2419450 2419447 2022-08-26T09:38:16Z U3215603 2947641 wikitext text/x-wiki {{title|Work breaks, well-being and productivity:<br>How do work breaks affect well-being and productivity?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== [[File:Fun, men, happiness, drinking, posture, gesture, garden, hat Fortepan 2357.jpg|thumb|Figure 1. Men taking a break from work]] ''Your alarm goes off at 6 am every morning and you rush out of bed for a quick shower. Breakfast is toast and instant coffee - all you have time for - eaten while checking your schedule for the day ahead. Realizing you're already late, you rush out the door past a stack of half-read novels you haven't touched in 5 weeks for lack of spare time. The bus to work is crowded but that doesn't stop you from checking emails and sending messages to colleagues. The work day passes in a blur. Before you know its 6 am again and you're rushing for the shower.'' Regardless of how hard we work, each of us will - inevitability - need a break. But in the the modern world, trying to find a balance between work and play can be an incredibly difficult challenge. With only 24 hours in a day, trying to juggle work, study, family and social life and even just a reasonable amount of 'me time' is, for many people, impossible. You are not alone if you are feeling this way. Cross-cultural research by Hamermesh & Lee (2007) has found that adults all around the world are expressing concern about their lack of spare time - particularly in the middle and upper classes. The effects of a lack of spare time and its inevitable end - burnout - are well noted (Lee & Eissenstat, 2018). But despite its negative outcomes in extreme cases, we must not forgot that work is also essential to society's functioning, Therefore. the question we seek to address in this chapter is how we could find an appropriate balance between working and breaking that could maintain our well-being (mental and physical) yet is still reasonable productive. The question, indeed, is a complex one. This Overview section should be concise but consist of several paragraphs which engage the reader, illustrate the problem, and outline how psychological science can help. {{RoundBoxTop|theme=3}} '''Focus questions:''' * How do work breaks affect well-being and productivity? * How can we maximize the benefits of taking a break? * What is the third focus question? {{RoundBoxBottom}} {{tip| Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Provide an example or case study. * Conclude with Focus questions to guide the chapter. }} ==What are work breaks?== Work breaks can come in a variety of forms. Common forms found in the scientific literature include: === Micro-breaks === * Non-work activates in-between work tasks during the work day. * Common examples include, drinking coffee/tea, chatting to colleagues, snacking, briefly checking news/social media * Often viewed as counterproductive * Research suggest that micro-breaks can be beneficial in certain contexts (Kim et al., 2016) [[File:Bertrand Russell photo (cropped).jpg|thumb|Figure 2: Philosopher Bertrand Russell argued that the modern world was obsessed with productivity and instead we should spend more time on activities that were enjoyable in themselves]] === Free time === * "Discretionary time" where one engages in activities that are intrinsically enjoyable but do not necessary have to be productive * Common examples include reading, watching tv/movies, going out for dinner. * Research suggest that too much free time and be just as detrimental as too little (Sharif et al., 2021) * Sharif et al (2021) suggest that a goldilocks zone of between 2-5 hr/per day (average 3.5hr/day) of free time is optimal for well-being === Weekends === *1-2 days spend away from work *Psychological effect of weekends seem to vary drastically between individuals *Some moderating variable include: 1. Relationship with supervisor (i.e. boss or friend) *2. Work environment (i.e. Workplace toxicity) *3. Type of work (i.e. full time vs shift work) (Helliwell & Wang, 2013) *Generally, individuals report higher subjective well being on weekends that work days (Helliwell & Wang, 2013) === Holidays === How you are going to structure the chapter? Aim for three to six main headings between the [[#Overview|Overview]] and [[#Conclusion|Conclusion]]. {{tip|Suggestions for this section: * For the [[Motivation and emotion/Assessment/Topic|topic development]], provide at least 3 bullet-points about key content per section. Include key citations. * For the [[Motivation and emotion/Assessment/Chapter|book chapter]], expand the bullet points into paragraphs. * If a section has a lot of content, arrange it into two to five sub-headings such as in the [[#Interactive learning features|interactive learning features section]]. Avoid having sections with only one sub-heading. }} ==The effects of work breaks == === Work Breaks effects on Well-Being === * A lack of spare time has been related to lower subjective happiness (Masuda et al., 2020) * Include section on burnout (Lee & Eissenstat, 2018) === Work Break effects on Productivity === * Both casual and correlation relationships between breaks and productivity have been established [citations] What brings an online book chapter to life are its interactive learning features. Case studies, feature boxes, figures, links, tables, and quiz questions can be used throughout the chapter. '''Case studies''' Case studies describe real-world examples of concepts in action. Case studies can be real or fictional. A case could be used multiple times during a chapter to illustrate different theories or stages. It is often helpful to present case studies using [[#Feature boxes|feature boxes]]. '''Boxes''' Boxes can be used to highlight content, but don't overuse them. There are many different ways of creating boxes (e.g., see [[Help:Pretty boxes|Pretty boxes]]). Possible uses include: * Focus questions * Case studies or examples * Quiz questions * Take-home messages {{RoundBoxTop|theme=3}} ;Feature box example * Shaded background * Coloured border {{RoundBoxBottom}}'''Figures'''[[File:Monkey-typing.jpg|right|205px|thumb|''Figure 1''. Example image with descriptive caption.]] Use figures to illustrate concepts, add interest, and provide examples. Figures can be used to show photographs, drawings, diagrams, graphs, etcetera. Figures can be embedded throughout the chapter, starting with the Overview section. Figures should be captioned (using a number and a description) in order to explain their relevance to the text. Possible images can be found at [[commons:|Wikimedia Commons]]. Images can also be uploaded if they are licensed for re-use or if you created the image. Each figure should be referred to at least once in the main text (e.g., see Figure 1). '''Links''' Where key words are first used, make them into [[Help:Links|interwiki links]] such as Wikipedia links to articles about famous people (e.g., [[w:Sigmund Freud|Sigmund Freud]] and key concepts (e.g., [[w:Dreams|dreams]]) and links to book chapters about related topics (e.g., would you like to learn about how to overcome [[Motivation and emotion/Book/2020/Writer's block|writer's block]]?). '''Tables''' Tables can be an effective way to organise and summarise information. Tables should be captioned (using APA style) to explain their relevance to the text. Plus each table should be referred to at least once in the main text (e.g., see Table 1 and Table 2). Here are some [[Motivation and emotion/Wikiversity/Tables|example 3 x 3 tables]] which could be adapted. '''Quizzes''' Quizzes are a direct way to engage readers. But don't make quizzes too hard or long. It is better to have one or two review questions per major section than a long quiz at the end. Try to quiz conceptual understanding, rather than trivia. Here are some simple quiz questions which could be adapted. Choose the correct answers and click "Submit": <quiz display=simple> {Quizzes are an interactive learning feature: |type="()"} + True - False {Long quizzes are a good idea: |type="()"} - True + False </quiz> To learn about different types of quiz questions, see [[Help:Quiz|Quiz]]. == How can we optimize our breaks? == * What is the optimal amount of breaking for to maximize well-being and productivity? - Sharif et al (2021) has suggest 3.5hr/day of free time optimal for subjective well being. * What should we be doing in our spare time? === Meditation/mindfulness === Research suggest that meditation can be an effective tool to boost wellbeing and productivity (Pagliaro et al., 2020) === Effective micro-breaking === *How can we best spend our micro-breaks? - research has suggested that stretching's exercise's on micro-breaks improved overall wellbeing and productivity (Henning et al., 1997) as well as caffeinated beverages (Kim et al., 2016). * What may be impleading our ability to micro-break effectively? - Kim et al.,( 2016) have found that engaging in cognitive intense activities (i.e. reading a book) on micro-breaks increased the "effects of work demands on negative affect" (i.e. less productivity) ==Conclusion== * Work breaks are essential to well-being and can boost productivity when done correctly. * Much emphasis should be placed on workplaces to ensure that their employees are having sufficient break time both inside and outside the workplace. * Areas for further research ... {{tip|Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? }} ==See also== [[w:Meditation|Meditation<br />]] Provide up to half-a-dozen [[Help:Contents/Links#Interwiki_links|internal (wiki) links]] to relevant Wikiversity pages (esp. related [[Motivation and emotion/Book|motivation and emotion book chapters]]) and [[w:|Wikipedia articles]]. For example: * [[Motivation and emotion/Book/2016/Anorexia nervosa and extrinsic motivation|Anorexia nervosa and extrinsic motivation]] (Book chapter, 2016) * [[w:David McClelland|David McClelland]] (Wikipedia) * [[Motivation and emotion/Book/2018/Loss aversion|Loss aversion]] (Book chapter, 2018) * [[w:Maslow's hierarchy of needs|Maslow's hierarchy of needs]] (Wikipedia) {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== {{Hanging indent|1= Hamermesh, D., & Lee, J. (2007). Stressed Out on Four Continents: Time Crunch or Yuppie Kvetch?. Review Of Economics And Statistics, 89(2), 374-383. https://doi.org/10.1162/rest.89.2.374 Helliwell, J., & Wang, S. (2013). Weekends and Subjective Well-Being. Social Indicators Research, 116(2), 389-407. https://doi.org/10.1007/s11205-013-0306-y HENNING, R., JACQUES, P., KISSEL, G., SULLIVAN, A., & ALTERAS-WEBB, S. (1997). Frequent short rest breaks from computer work: effects on productivity and well-being at two field sites. Ergonomics, 40(1), 78-91. https://doi.org/10.1080/001401397188396 Kim, S., Park, Y., & Niu, Q. (2016). Micro-break activities at work to recover from daily work demands. Journal Of Organizational Behavior, 38(1), 28-44. https://doi.org/10.1002/job.2109 Lee, Y., & Eissenstat, S. (2018). A longitudinal examination of the causes and effects of burnout based on the job demands-resources model. International Journal For Educational And Vocational Guidance, 18(3), 337-354. https://doi.org/10.1007/s10775-018-9364-7 Masuda, Y., Williams, J., & Tallis, H. (2020). Does Life Satisfaction Vary with Time and Income? Investigating the Relationship Among Free Time, Income, and Life Satisfaction. Journal Of Happiness Studies, 22(5), 2051-2073. https://doi.org/10.1007/s10902-020-00307-8 Pagliaro, G., Pelati, R., Signorini, D., Parenti, G., & Roversi, F. (2020). The effects of meditation on the performance and well-being of a company: A pilot study. EXPLORE, 16(1), 56-60. https://doi.org/10.1016/j.explore.2019.07.014 Sharif, M., Mogilner, C., & Hershfield, H. (2021). Having too little or too much time is linked to lower subjective well-being. Journal Of Personality And Social Psychology, 121(4), 933-947. https://doi.org/10.1037/pspp0000391 }} {{tip|Suggestions for this section: * Important aspects for APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except first letter and proper names, ending in a full-stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full-stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't actually read or consulted }} ==External links== [https://www.youtube.com/watch?v=V_OMWEEf1E4 Micro-breaking] Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * [https://students.unimelb.edu.au/academic-skills/explore-our-resources/essay-writing/six-top-tips-for-writing-a-great-essay Six top tips for writing a great essay] (University of Melbourne) * [http://www.skillsyouneed.com/write/structure.html The importance of structure] (skillsyouneed.com) {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] [[Category:Motivation and emotion/Book/Well-being]] [[Category:Motivation and emotion/Book/Work]] d5ielqhgzta7xq17aqa509fm5g8vq3h 2419451 2419450 2022-08-26T09:41:29Z U3215603 2947641 wikitext text/x-wiki {{title|Work breaks, well-being and productivity:<br>How do work breaks affect well-being and productivity?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== ''Your alarm goes off at 6 am every morning and you rush out of bed for a quick shower. Breakfast is toast and instant coffee - all you have time for - eaten while checking your schedule for the day ahead. Realizing you're already late, you rush out the door past a stack of half-read novels you haven't touched in 5 weeks for lack of spare time. The bus to work is crowded but that doesn't stop you from checking emails and sending messages to colleagues. The work day passes in a blur. Before you know its 6 am again and you're rushing for the shower.'' Regardless of how hard we work, each of us will - inevitability - need a break. But in the the modern world, trying to find a balance between work and play can be an incredibly difficult challenge. With only 24 hours in a day, trying to juggle work, study, family and social life and even just a reasonable amount of 'me time' is, for many people, impossible. You are not alone if you are feeling this way. Cross-cultural research by Hamermesh & Lee (2007) has found that adults all around the world are expressing concern about their lack of spare time - particularly in the middle and upper classes. The effects of a lack of spare time and its inevitable end - burnout - are well noted (Lee & Eissenstat, 2018). But despite its negative outcomes in extreme cases, we must not forgot that work is also essential to society's functioning, Therefore. the question we seek to address in this chapter is how we could find an appropriate balance between working and breaking that could maintain our well-being (mental and physical) yet is still reasonable productive. The question, indeed, is a complex one. [[File:Fun, men, happiness, drinking, posture, gesture, garden, hat Fortepan 2357.jpg|thumb|Figure 1. Men taking a break from work]] This Overview section should be concise but consist of several paragraphs which engage the reader, illustrate the problem, and outline how psychological science can help. {{RoundBoxTop|theme=3}} '''Focus questions:''' * How do work breaks affect well-being and productivity? * How can we maximize the benefits of taking a break? * What is the third focus question? {{RoundBoxBottom}} {{tip| Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Provide an example or case study. * Conclude with Focus questions to guide the chapter. }} ==What are work breaks?== Work breaks can come in a variety of forms. Common forms found in the scientific literature include: === Micro-breaks === * Non-work activates in-between work tasks during the work day. * Common examples include, drinking coffee/tea, chatting to colleagues, snacking, briefly checking news/social media * Often viewed as counterproductive * Research suggest that micro-breaks can be beneficial in certain contexts (Kim et al., 2016) [[File:Bertrand Russell photo (cropped).jpg|thumb|Figure 2: Philosopher Bertrand Russell argued that the modern world was obsessed with productivity and instead we should spend more time on activities that were enjoyable in themselves]] === Free time === * "Discretionary time" where one engages in activities that are intrinsically enjoyable but do not necessary have to be productive * Common examples include reading, watching tv/movies, going out for dinner. * Research suggest that too much free time and be just as detrimental as too little (Sharif et al., 2021) * Sharif et al (2021) suggest that a goldilocks zone of between 2-5 hr/per day (average 3.5hr/day) of free time is optimal for well-being === Weekends === *1-2 days spend away from work *Psychological effect of weekends seem to vary drastically between individuals *Some moderating variable include: 1. Relationship with supervisor (i.e. boss or friend) *2. Work environment (i.e. Workplace toxicity) *3. Type of work (i.e. full time vs shift work) (Helliwell & Wang, 2013) *Generally, individuals report higher subjective well being on weekends that work days (Helliwell & Wang, 2013) === Holidays === How you are going to structure the chapter? Aim for three to six main headings between the [[#Overview|Overview]] and [[#Conclusion|Conclusion]]. {{tip|Suggestions for this section: * For the [[Motivation and emotion/Assessment/Topic|topic development]], provide at least 3 bullet-points about key content per section. Include key citations. * For the [[Motivation and emotion/Assessment/Chapter|book chapter]], expand the bullet points into paragraphs. * If a section has a lot of content, arrange it into two to five sub-headings such as in the [[#Interactive learning features|interactive learning features section]]. Avoid having sections with only one sub-heading. }} ==The effects of work breaks == === Work Breaks effects on Well-Being === * A lack of spare time has been related to lower subjective happiness (Masuda et al., 2020) * Include section on burnout (Lee & Eissenstat, 2018) === Work Break effects on Productivity === * Both casual and correlation relationships between breaks and productivity have been established [citations] What brings an online book chapter to life are its interactive learning features. Case studies, feature boxes, figures, links, tables, and quiz questions can be used throughout the chapter. '''Case studies''' Case studies describe real-world examples of concepts in action. Case studies can be real or fictional. A case could be used multiple times during a chapter to illustrate different theories or stages. It is often helpful to present case studies using [[#Feature boxes|feature boxes]]. '''Boxes''' Boxes can be used to highlight content, but don't overuse them. There are many different ways of creating boxes (e.g., see [[Help:Pretty boxes|Pretty boxes]]). Possible uses include: * Focus questions * Case studies or examples * Quiz questions * Take-home messages {{RoundBoxTop|theme=3}} ;Feature box example * Shaded background * Coloured border {{RoundBoxBottom}}'''Figures'''[[File:Monkey-typing.jpg|right|205px|thumb|''Figure 1''. Example image with descriptive caption.]] Use figures to illustrate concepts, add interest, and provide examples. Figures can be used to show photographs, drawings, diagrams, graphs, etcetera. Figures can be embedded throughout the chapter, starting with the Overview section. Figures should be captioned (using a number and a description) in order to explain their relevance to the text. Possible images can be found at [[commons:|Wikimedia Commons]]. Images can also be uploaded if they are licensed for re-use or if you created the image. Each figure should be referred to at least once in the main text (e.g., see Figure 1). '''Links''' Where key words are first used, make them into [[Help:Links|interwiki links]] such as Wikipedia links to articles about famous people (e.g., [[w:Sigmund Freud|Sigmund Freud]] and key concepts (e.g., [[w:Dreams|dreams]]) and links to book chapters about related topics (e.g., would you like to learn about how to overcome [[Motivation and emotion/Book/2020/Writer's block|writer's block]]?). '''Tables''' Tables can be an effective way to organise and summarise information. Tables should be captioned (using APA style) to explain their relevance to the text. Plus each table should be referred to at least once in the main text (e.g., see Table 1 and Table 2). Here are some [[Motivation and emotion/Wikiversity/Tables|example 3 x 3 tables]] which could be adapted. '''Quizzes''' Quizzes are a direct way to engage readers. But don't make quizzes too hard or long. It is better to have one or two review questions per major section than a long quiz at the end. Try to quiz conceptual understanding, rather than trivia. Here are some simple quiz questions which could be adapted. Choose the correct answers and click "Submit": <quiz display=simple> {Quizzes are an interactive learning feature: |type="()"} + True - False {Long quizzes are a good idea: |type="()"} - True + False </quiz> To learn about different types of quiz questions, see [[Help:Quiz|Quiz]]. == How can we optimize our breaks? == * What is the optimal amount of breaking for to maximize well-being and productivity? - Sharif et al (2021) has suggest 3.5hr/day of free time optimal for subjective well being. * What should we be doing in our spare time? === Meditation/mindfulness === Research suggest that meditation can be an effective tool to boost wellbeing and productivity (Pagliaro et al., 2020) === Effective micro-breaking === *How can we best spend our micro-breaks? - research has suggested that stretching's exercise's on micro-breaks improved overall wellbeing and productivity (Henning et al., 1997) as well as caffeinated beverages (Kim et al., 2016). * What may be impleading our ability to micro-break effectively? - Kim et al.,( 2016) have found that engaging in cognitive intense activities (i.e. reading a book) on micro-breaks increased the "effects of work demands on negative affect" (i.e. less productivity) ==Conclusion== * Work breaks are essential to well-being and can boost productivity when done correctly. * Much emphasis should be placed on workplaces to ensure that their employees are having sufficient break time both inside and outside the workplace. * Areas for further research ... {{tip|Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? }} ==See also== [[w:Meditation|Meditation<br />]] Provide up to half-a-dozen [[Help:Contents/Links#Interwiki_links|internal (wiki) links]] to relevant Wikiversity pages (esp. related [[Motivation and emotion/Book|motivation and emotion book chapters]]) and [[w:|Wikipedia articles]]. For example: * [[Motivation and emotion/Book/2016/Anorexia nervosa and extrinsic motivation|Anorexia nervosa and extrinsic motivation]] (Book chapter, 2016) * [[w:David McClelland|David McClelland]] (Wikipedia) * [[Motivation and emotion/Book/2018/Loss aversion|Loss aversion]] (Book chapter, 2018) * [[w:Maslow's hierarchy of needs|Maslow's hierarchy of needs]] (Wikipedia) {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== {{Hanging indent|1= Hamermesh, D., & Lee, J. (2007). Stressed Out on Four Continents: Time Crunch or Yuppie Kvetch?. Review Of Economics And Statistics, 89(2), 374-383. https://doi.org/10.1162/rest.89.2.374 Helliwell, J., & Wang, S. (2013). Weekends and Subjective Well-Being. Social Indicators Research, 116(2), 389-407. https://doi.org/10.1007/s11205-013-0306-y HENNING, R., JACQUES, P., KISSEL, G., SULLIVAN, A., & ALTERAS-WEBB, S. (1997). Frequent short rest breaks from computer work: effects on productivity and well-being at two field sites. Ergonomics, 40(1), 78-91. https://doi.org/10.1080/001401397188396 Kim, S., Park, Y., & Niu, Q. (2016). Micro-break activities at work to recover from daily work demands. Journal Of Organizational Behavior, 38(1), 28-44. https://doi.org/10.1002/job.2109 Lee, Y., & Eissenstat, S. (2018). A longitudinal examination of the causes and effects of burnout based on the job demands-resources model. International Journal For Educational And Vocational Guidance, 18(3), 337-354. https://doi.org/10.1007/s10775-018-9364-7 Masuda, Y., Williams, J., & Tallis, H. (2020). Does Life Satisfaction Vary with Time and Income? Investigating the Relationship Among Free Time, Income, and Life Satisfaction. Journal Of Happiness Studies, 22(5), 2051-2073. https://doi.org/10.1007/s10902-020-00307-8 Pagliaro, G., Pelati, R., Signorini, D., Parenti, G., & Roversi, F. (2020). The effects of meditation on the performance and well-being of a company: A pilot study. EXPLORE, 16(1), 56-60. https://doi.org/10.1016/j.explore.2019.07.014 Sharif, M., Mogilner, C., & Hershfield, H. (2021). Having too little or too much time is linked to lower subjective well-being. Journal Of Personality And Social Psychology, 121(4), 933-947. https://doi.org/10.1037/pspp0000391 }} {{tip|Suggestions for this section: * Important aspects for APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except first letter and proper names, ending in a full-stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full-stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't actually read or consulted }} ==External links== [https://www.youtube.com/watch?v=V_OMWEEf1E4 Micro-breaking] Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * [https://students.unimelb.edu.au/academic-skills/explore-our-resources/essay-writing/six-top-tips-for-writing-a-great-essay Six top tips for writing a great essay] (University of Melbourne) * [http://www.skillsyouneed.com/write/structure.html The importance of structure] (skillsyouneed.com) {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] [[Category:Motivation and emotion/Book/Well-being]] [[Category:Motivation and emotion/Book/Work]] iokzyerre5vswj0pb9qao9fggplo37y 2419454 2419451 2022-08-26T09:43:34Z U3215603 2947641 wikitext text/x-wiki {{title|Work breaks, well-being and productivity:<br>How do work breaks affect well-being and productivity?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== ''Your alarm goes off at 6 am every morning and you rush out of bed for a quick shower. Breakfast is toast and instant coffee - all you have time for - eaten while checking your schedule for the day ahead. Realizing you're already late, you rush out the door past a stack of half-read novels you haven't touched in 5 weeks for lack of spare time. The bus to work is crowded but that doesn't stop you from checking emails and sending messages to colleagues. The work day passes in a blur. Before you know its 6 am again and you're rushing for the shower.'' Regardless of how hard we work, each of us will - inevitability - need a break. But in the the modern world, trying to find a balance between work and play can be an incredibly difficult challenge. With only 24 hours in a day, trying to juggle work, study, family and social life and even just a reasonable amount of 'me time' is, for many people, impossible. You are not alone if you are feeling this way. Cross-cultural research by Hamermesh & Lee (2007) has found that adults all around the world are expressing concern about their lack of spare time - particularly in the middle and upper classes. The effects of a lack of spare time and its inevitable end - burnout - are well noted (Lee & Eissenstat, 2018). But despite its negative outcomes in extreme cases, we must not forgot that work is also essential to society's functioning, Therefore. the question we seek to address in this chapter is how we could find an appropriate balance between working and breaking that could maintain our well-being (mental and physical) yet is still reasonable productive. The question, indeed, is a complex one. [[File:Fun, men, happiness, drinking, posture, gesture, garden, hat Fortepan 2357.jpg|thumb|Figure 1. Men taking a break from work]] This Overview section should be concise but consist of several paragraphs which engage the reader, illustrate the problem, and outline how psychological science can help. {{RoundBoxTop|theme=3}} '''Focus questions:''' * How do work breaks affect well-being and productivity? * How can we maximize the benefits of taking a break? * What is an optimal balance between working and breaking? {{RoundBoxBottom}} {{tip| Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Provide an example or case study. * Conclude with Focus questions to guide the chapter. }} ==What are work breaks?== Work breaks can come in a variety of forms. Common forms found in the scientific literature include: === Micro-breaks === * Non-work activates in-between work tasks during the work day. * Common examples include, drinking coffee/tea, chatting to colleagues, snacking, briefly checking news/social media * Often viewed as counterproductive * Research suggest that micro-breaks can be beneficial in certain contexts (Kim et al., 2016) [[File:Bertrand Russell photo (cropped).jpg|thumb|Figure 2: Philosopher Bertrand Russell argued that the modern world was obsessed with productivity and instead we should spend more time on activities that were enjoyable in themselves]] === Free time === * "Discretionary time" where one engages in activities that are intrinsically enjoyable but do not necessary have to be productive * Common examples include reading, watching tv/movies, going out for dinner. * Research suggest that too much free time and be just as detrimental as too little (Sharif et al., 2021) * Sharif et al (2021) suggest that a goldilocks zone of between 2-5 hr/per day (average 3.5hr/day) of free time is optimal for well-being === Weekends === *1-2 days spend away from work *Psychological effect of weekends seem to vary drastically between individuals *Some moderating variable include: 1. Relationship with supervisor (i.e. boss or friend) *2. Work environment (i.e. Workplace toxicity) *3. Type of work (i.e. full time vs shift work) (Helliwell & Wang, 2013) *Generally, individuals report higher subjective well being on weekends that work days (Helliwell & Wang, 2013) === Holidays === How you are going to structure the chapter? Aim for three to six main headings between the [[#Overview|Overview]] and [[#Conclusion|Conclusion]]. {{tip|Suggestions for this section: * For the [[Motivation and emotion/Assessment/Topic|topic development]], provide at least 3 bullet-points about key content per section. Include key citations. * For the [[Motivation and emotion/Assessment/Chapter|book chapter]], expand the bullet points into paragraphs. * If a section has a lot of content, arrange it into two to five sub-headings such as in the [[#Interactive learning features|interactive learning features section]]. Avoid having sections with only one sub-heading. }} ==The effects of work breaks == === Work Breaks effects on Well-Being === * A lack of spare time has been related to lower subjective happiness (Masuda et al., 2020) * Include section on burnout (Lee & Eissenstat, 2018) === Work Break effects on Productivity === * Both casual and correlation relationships between breaks and productivity have been established [citations] What brings an online book chapter to life are its interactive learning features. Case studies, feature boxes, figures, links, tables, and quiz questions can be used throughout the chapter. '''Case studies''' Case studies describe real-world examples of concepts in action. Case studies can be real or fictional. A case could be used multiple times during a chapter to illustrate different theories or stages. It is often helpful to present case studies using [[#Feature boxes|feature boxes]]. '''Boxes''' Boxes can be used to highlight content, but don't overuse them. There are many different ways of creating boxes (e.g., see [[Help:Pretty boxes|Pretty boxes]]). Possible uses include: * Focus questions * Case studies or examples * Quiz questions * Take-home messages {{RoundBoxTop|theme=3}} ;Feature box example * Shaded background * Coloured border {{RoundBoxBottom}}'''Figures'''[[File:Monkey-typing.jpg|right|205px|thumb|''Figure 1''. Example image with descriptive caption.]] Use figures to illustrate concepts, add interest, and provide examples. Figures can be used to show photographs, drawings, diagrams, graphs, etcetera. Figures can be embedded throughout the chapter, starting with the Overview section. Figures should be captioned (using a number and a description) in order to explain their relevance to the text. Possible images can be found at [[commons:|Wikimedia Commons]]. Images can also be uploaded if they are licensed for re-use or if you created the image. Each figure should be referred to at least once in the main text (e.g., see Figure 1). '''Links''' Where key words are first used, make them into [[Help:Links|interwiki links]] such as Wikipedia links to articles about famous people (e.g., [[w:Sigmund Freud|Sigmund Freud]] and key concepts (e.g., [[w:Dreams|dreams]]) and links to book chapters about related topics (e.g., would you like to learn about how to overcome [[Motivation and emotion/Book/2020/Writer's block|writer's block]]?). '''Tables''' Tables can be an effective way to organise and summarise information. Tables should be captioned (using APA style) to explain their relevance to the text. Plus each table should be referred to at least once in the main text (e.g., see Table 1 and Table 2). Here are some [[Motivation and emotion/Wikiversity/Tables|example 3 x 3 tables]] which could be adapted. '''Quizzes''' Quizzes are a direct way to engage readers. But don't make quizzes too hard or long. It is better to have one or two review questions per major section than a long quiz at the end. Try to quiz conceptual understanding, rather than trivia. Here are some simple quiz questions which could be adapted. Choose the correct answers and click "Submit": <quiz display=simple> {Quizzes are an interactive learning feature: |type="()"} + True - False {Long quizzes are a good idea: |type="()"} - True + False </quiz> To learn about different types of quiz questions, see [[Help:Quiz|Quiz]]. == How can we optimize our breaks? == * What is the optimal amount of breaking for to maximize well-being and productivity? - Sharif et al (2021) has suggest 3.5hr/day of free time optimal for subjective well being. * What should we be doing in our spare time? === Meditation/mindfulness === Research suggest that meditation can be an effective tool to boost wellbeing and productivity (Pagliaro et al., 2020) === Effective micro-breaking === *How can we best spend our micro-breaks? - research has suggested that stretching's exercise's on micro-breaks improved overall wellbeing and productivity (Henning et al., 1997) as well as caffeinated beverages (Kim et al., 2016). * What may be impleading our ability to micro-break effectively? - Kim et al.,( 2016) have found that engaging in cognitive intense activities (i.e. reading a book) on micro-breaks increased the "effects of work demands on negative affect" (i.e. less productivity) ==Conclusion== * Work breaks are essential to well-being and can boost productivity when done correctly. * Much emphasis should be placed on workplaces to ensure that their employees are having sufficient break time both inside and outside the workplace. * Areas for further research ... {{tip|Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? }} ==See also== [[w:Meditation|Meditation<br />]] Provide up to half-a-dozen [[Help:Contents/Links#Interwiki_links|internal (wiki) links]] to relevant Wikiversity pages (esp. related [[Motivation and emotion/Book|motivation and emotion book chapters]]) and [[w:|Wikipedia articles]]. For example: * [[Motivation and emotion/Book/2016/Anorexia nervosa and extrinsic motivation|Anorexia nervosa and extrinsic motivation]] (Book chapter, 2016) * [[w:David McClelland|David McClelland]] (Wikipedia) * [[Motivation and emotion/Book/2018/Loss aversion|Loss aversion]] (Book chapter, 2018) * [[w:Maslow's hierarchy of needs|Maslow's hierarchy of needs]] (Wikipedia) {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== {{Hanging indent|1= Hamermesh, D., & Lee, J. (2007). Stressed Out on Four Continents: Time Crunch or Yuppie Kvetch?. Review Of Economics And Statistics, 89(2), 374-383. https://doi.org/10.1162/rest.89.2.374 Helliwell, J., & Wang, S. (2013). Weekends and Subjective Well-Being. Social Indicators Research, 116(2), 389-407. https://doi.org/10.1007/s11205-013-0306-y HENNING, R., JACQUES, P., KISSEL, G., SULLIVAN, A., & ALTERAS-WEBB, S. (1997). Frequent short rest breaks from computer work: effects on productivity and well-being at two field sites. Ergonomics, 40(1), 78-91. https://doi.org/10.1080/001401397188396 Kim, S., Park, Y., & Niu, Q. (2016). Micro-break activities at work to recover from daily work demands. Journal Of Organizational Behavior, 38(1), 28-44. https://doi.org/10.1002/job.2109 Lee, Y., & Eissenstat, S. (2018). A longitudinal examination of the causes and effects of burnout based on the job demands-resources model. International Journal For Educational And Vocational Guidance, 18(3), 337-354. https://doi.org/10.1007/s10775-018-9364-7 Masuda, Y., Williams, J., & Tallis, H. (2020). Does Life Satisfaction Vary with Time and Income? Investigating the Relationship Among Free Time, Income, and Life Satisfaction. Journal Of Happiness Studies, 22(5), 2051-2073. https://doi.org/10.1007/s10902-020-00307-8 Pagliaro, G., Pelati, R., Signorini, D., Parenti, G., & Roversi, F. (2020). The effects of meditation on the performance and well-being of a company: A pilot study. EXPLORE, 16(1), 56-60. https://doi.org/10.1016/j.explore.2019.07.014 Sharif, M., Mogilner, C., & Hershfield, H. (2021). Having too little or too much time is linked to lower subjective well-being. Journal Of Personality And Social Psychology, 121(4), 933-947. https://doi.org/10.1037/pspp0000391 }} {{tip|Suggestions for this section: * Important aspects for APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except first letter and proper names, ending in a full-stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full-stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't actually read or consulted }} ==External links== [https://www.youtube.com/watch?v=V_OMWEEf1E4 Micro-breaking] Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * [https://students.unimelb.edu.au/academic-skills/explore-our-resources/essay-writing/six-top-tips-for-writing-a-great-essay Six top tips for writing a great essay] (University of Melbourne) * [http://www.skillsyouneed.com/write/structure.html The importance of structure] (skillsyouneed.com) {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] [[Category:Motivation and emotion/Book/Well-being]] [[Category:Motivation and emotion/Book/Work]] 1tgg4d70495icwh8z7dx1hbahrk8i90 2419456 2419454 2022-08-26T09:46:35Z U3215603 2947641 wikitext text/x-wiki {{title|Work breaks, well-being and productivity:<br>How do work breaks affect well-being and productivity?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== ''Your alarm goes off at 6 am every morning and you rush out of bed for a quick shower. Breakfast is toast and instant coffee - all you have time for - eaten while checking your schedule for the day ahead. Realizing you're already late, you rush out the door past a stack of half-read novels you haven't touched in 5 weeks for lack of spare time. The bus to work is crowded but that doesn't stop you from checking emails and sending messages to colleagues. The work day passes in a blur. Before you know its 6 am again and you're rushing for the shower.'' Regardless of how hard we work, each of us will - inevitability - need a break. But in the the modern world, trying to find a balance between work and play can be an incredibly difficult challenge. With only 24 hours in a day, trying to juggle work, study, family and social life and even just a reasonable amount of 'me time' is, for many people, impossible. You are not alone if you are feeling this way. Cross-cultural research by Hamermesh & Lee (2007) has found that adults all around the world are expressing concern about their lack of spare time - particularly in the middle and upper classes. The effects of a lack of spare time and its inevitable end - burnout - are well noted (Lee & Eissenstat, 2018). But despite its negative outcomes in extreme cases, we must not forgot that work is also essential to society's functioning, Therefore. the question we seek to address in this chapter is how we could find an appropriate balance between working and breaking that could maintain our well-being (mental and physical) yet is still reasonable productive. The question, indeed, is a complex one. [[File:Fun, men, happiness, drinking, posture, gesture, garden, hat Fortepan 2357.jpg|thumb|Figure 1. Men taking a break from work]] This Overview section should be concise but consist of several paragraphs which engage the reader, illustrate the problem, and outline how psychological science can help. {{RoundBoxTop|theme=3}} '''Focus questions:''' * How do work breaks affect well-being and productivity? * How can we maximize the benefits of taking a break? * What is an optimal balance between working and breaking? {{RoundBoxBottom}} {{tip| Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Provide an example or case study. * Conclude with Focus questions to guide the chapter. }} ==What are work breaks?== Work breaks can come in a variety of forms. Common forms found in the scientific literature include: === Micro-breaks === * Non-work activates in-between work tasks during the work day. * Common examples include, drinking coffee/tea, chatting to colleagues, snacking, briefly checking news/social media * Often viewed as counterproductive * Research suggest that micro-breaks can be beneficial in certain contexts (Kim et al., 2016) [[File:Bertrand Russell photo (cropped).jpg|thumb|Figure 2: Philosopher Bertrand Russell argued that the modern world was obsessed with productivity and instead we should spend more time on activities that were enjoyable in themselves]] === Free time === * "Discretionary time" where one engages in activities that are intrinsically enjoyable but do not necessary have to be productive * Common examples include reading, watching tv/movies, going out for dinner. * Research suggest that too much free time and be just as detrimental as too little (Sharif et al., 2021) * Sharif et al (2021) suggest that a goldilocks zone of between 2-5 hr/per day (average 3.5hr/day) of free time is optimal for well-being === Weekends === *1-2 days spend away from work *Psychological effect of weekends seem to vary drastically between individuals *Some moderating variable include: 1. Relationship with supervisor (i.e. boss or friend) *2. Work environment (i.e. Workplace toxicity) *3. Type of work (i.e. full time vs shift work) (Helliwell & Wang, 2013) *Generally, individuals report higher subjective well being on weekends that work days (Helliwell & Wang, 2013) === Holidays === How you are going to structure the chapter? Aim for three to six main headings between the [[#Overview|Overview]] and [[#Conclusion|Conclusion]]. {{tip|Suggestions for this section: * For the [[Motivation and emotion/Assessment/Topic|topic development]], provide at least 3 bullet-points about key content per section. Include key citations. * For the [[Motivation and emotion/Assessment/Chapter|book chapter]], expand the bullet points into paragraphs. * If a section has a lot of content, arrange it into two to five sub-headings such as in the [[#Interactive learning features|interactive learning features section]]. Avoid having sections with only one sub-heading. }} ==The effects of work breaks == === Work Breaks effects on Well-Being === * A lack of spare time has been related to lower subjective happiness (Masuda et al., 2020) * Include section on burnout (Lee & Eissenstat, 2018) === Work Break effects on Productivity === * Both casual and correlation relationships between breaks and productivity have been established [citations] '''Is well being and productivity connected? Sharif et al., (2021) suggest that a lack of productive leads to lower subjective well being [explore further]''' What brings an online book chapter to life are its interactive learning features. Case studies, feature boxes, figures, links, tables, and quiz questions can be used throughout the chapter. '''Case studies''' Case studies describe real-world examples of concepts in action. Case studies can be real or fictional. A case could be used multiple times during a chapter to illustrate different theories or stages. It is often helpful to present case studies using [[#Feature boxes|feature boxes]]. '''Boxes''' Boxes can be used to highlight content, but don't overuse them. There are many different ways of creating boxes (e.g., see [[Help:Pretty boxes|Pretty boxes]]). Possible uses include: * Focus questions * Case studies or examples * Quiz questions * Take-home messages {{RoundBoxTop|theme=3}} ;Feature box example * Shaded background * Coloured border {{RoundBoxBottom}}'''Figures'''[[File:Monkey-typing.jpg|right|205px|thumb|''Figure 1''. Example image with descriptive caption.]] Use figures to illustrate concepts, add interest, and provide examples. Figures can be used to show photographs, drawings, diagrams, graphs, etcetera. Figures can be embedded throughout the chapter, starting with the Overview section. Figures should be captioned (using a number and a description) in order to explain their relevance to the text. Possible images can be found at [[commons:|Wikimedia Commons]]. Images can also be uploaded if they are licensed for re-use or if you created the image. Each figure should be referred to at least once in the main text (e.g., see Figure 1). '''Links''' Where key words are first used, make them into [[Help:Links|interwiki links]] such as Wikipedia links to articles about famous people (e.g., [[w:Sigmund Freud|Sigmund Freud]] and key concepts (e.g., [[w:Dreams|dreams]]) and links to book chapters about related topics (e.g., would you like to learn about how to overcome [[Motivation and emotion/Book/2020/Writer's block|writer's block]]?). '''Tables''' Tables can be an effective way to organise and summarise information. Tables should be captioned (using APA style) to explain their relevance to the text. Plus each table should be referred to at least once in the main text (e.g., see Table 1 and Table 2). Here are some [[Motivation and emotion/Wikiversity/Tables|example 3 x 3 tables]] which could be adapted. '''Quizzes''' Quizzes are a direct way to engage readers. But don't make quizzes too hard or long. It is better to have one or two review questions per major section than a long quiz at the end. Try to quiz conceptual understanding, rather than trivia. Here are some simple quiz questions which could be adapted. Choose the correct answers and click "Submit": <quiz display=simple> {Quizzes are an interactive learning feature: |type="()"} + True - False {Long quizzes are a good idea: |type="()"} - True + False </quiz> To learn about different types of quiz questions, see [[Help:Quiz|Quiz]]. == How can we optimize our breaks? == * What is the optimal amount of breaking for to maximize well-being and productivity? - Sharif et al (2021) has suggest 3.5hr/day of free time optimal for subjective well being. * What should we be doing in our spare time? === Meditation/mindfulness === Research suggest that meditation can be an effective tool to boost wellbeing and productivity (Pagliaro et al., 2020) === Effective micro-breaking === *How can we best spend our micro-breaks? - research has suggested that stretching's exercise's on micro-breaks improved overall wellbeing and productivity (Henning et al., 1997) as well as caffeinated beverages (Kim et al., 2016). * What may be impleading our ability to micro-break effectively? - Kim et al.,( 2016) have found that engaging in cognitive intense activities (i.e. reading a book) on micro-breaks increased the "effects of work demands on negative affect" (i.e. less productivity) ==Conclusion== * Work breaks are essential to well-being and can boost productivity when done correctly. * Much emphasis should be placed on workplaces to ensure that their employees are having sufficient break time both inside and outside the workplace. * Areas for further research ... {{tip|Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? }} ==See also== [[w:Meditation|Meditation<br />]] Provide up to half-a-dozen [[Help:Contents/Links#Interwiki_links|internal (wiki) links]] to relevant Wikiversity pages (esp. related [[Motivation and emotion/Book|motivation and emotion book chapters]]) and [[w:|Wikipedia articles]]. For example: * [[Motivation and emotion/Book/2016/Anorexia nervosa and extrinsic motivation|Anorexia nervosa and extrinsic motivation]] (Book chapter, 2016) * [[w:David McClelland|David McClelland]] (Wikipedia) * [[Motivation and emotion/Book/2018/Loss aversion|Loss aversion]] (Book chapter, 2018) * [[w:Maslow's hierarchy of needs|Maslow's hierarchy of needs]] (Wikipedia) {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== {{Hanging indent|1= Hamermesh, D., & Lee, J. (2007). Stressed Out on Four Continents: Time Crunch or Yuppie Kvetch?. Review Of Economics And Statistics, 89(2), 374-383. https://doi.org/10.1162/rest.89.2.374 Helliwell, J., & Wang, S. (2013). Weekends and Subjective Well-Being. Social Indicators Research, 116(2), 389-407. https://doi.org/10.1007/s11205-013-0306-y HENNING, R., JACQUES, P., KISSEL, G., SULLIVAN, A., & ALTERAS-WEBB, S. (1997). Frequent short rest breaks from computer work: effects on productivity and well-being at two field sites. Ergonomics, 40(1), 78-91. https://doi.org/10.1080/001401397188396 Kim, S., Park, Y., & Niu, Q. (2016). Micro-break activities at work to recover from daily work demands. Journal Of Organizational Behavior, 38(1), 28-44. https://doi.org/10.1002/job.2109 Lee, Y., & Eissenstat, S. (2018). A longitudinal examination of the causes and effects of burnout based on the job demands-resources model. International Journal For Educational And Vocational Guidance, 18(3), 337-354. https://doi.org/10.1007/s10775-018-9364-7 Masuda, Y., Williams, J., & Tallis, H. (2020). Does Life Satisfaction Vary with Time and Income? Investigating the Relationship Among Free Time, Income, and Life Satisfaction. Journal Of Happiness Studies, 22(5), 2051-2073. https://doi.org/10.1007/s10902-020-00307-8 Pagliaro, G., Pelati, R., Signorini, D., Parenti, G., & Roversi, F. (2020). The effects of meditation on the performance and well-being of a company: A pilot study. EXPLORE, 16(1), 56-60. https://doi.org/10.1016/j.explore.2019.07.014 Sharif, M., Mogilner, C., & Hershfield, H. (2021). Having too little or too much time is linked to lower subjective well-being. Journal Of Personality And Social Psychology, 121(4), 933-947. https://doi.org/10.1037/pspp0000391 }} {{tip|Suggestions for this section: * Important aspects for APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except first letter and proper names, ending in a full-stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full-stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't actually read or consulted }} ==External links== [https://www.youtube.com/watch?v=V_OMWEEf1E4 Micro-breaking] Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * [https://students.unimelb.edu.au/academic-skills/explore-our-resources/essay-writing/six-top-tips-for-writing-a-great-essay Six top tips for writing a great essay] (University of Melbourne) * [http://www.skillsyouneed.com/write/structure.html The importance of structure] (skillsyouneed.com) {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] [[Category:Motivation and emotion/Book/Well-being]] [[Category:Motivation and emotion/Book/Work]] i4ppat6fb3z5u0wlcsbjcahx23wf35l 118 286028 2419238 2418884 2022-08-26T03:18:59Z Guy vandegrift 813252 /* Characteristic frequencies associated with an interval */ wikitext text/x-wiki __TOC__ {{center|''The reader should know that this section is poorly understood. Look elsewhere if you want simple answers or a full discussion. <br>The intent here is to create an excuse for [https://www.pinterest.com/pin/164662930098107644/ "messing around"] with mathematical and computational methods.'' (See also [https://pure.mpg.de/rest/items/item_66382/component/file_468040/content Plomp and Levelt 1965]])<ref>Plomp, Reinier, and Willem Johannes Maria Levelt. [https://pure.mpg.de/rest/items/item_66382/component/file_468040/content "Tonal consonance and critical bandwidth."] The journal of the Acoustical Society of America 38.4 (1965): 548-560. </ref>''}} ==Terminology and scope of discussion== An interval is any pair of musical notes, but here we shall focus on pairs that range between a simple<ref>Here, a "simple unison" refers to the same pitch played by two different instruments</ref> unison and an octave.<ref>In music, and octave refers to two pitches whose fundamental frequency differs by a factor of two.</ref> It is well understood that an interval is consonant<ref>In casual language a '''consonant''' interval is often called '''harmonious'''. But since '''harmony''' is such a broad topic, it is better to be more precise with '''consonance'''.</ref> if the ratio of pitches<ref><nowiki>''</nowiki>Pitch<nowiki>''</nowiki> is often referred to as <nowiki>''</nowiki>frequency<nowiki>''</nowiki>, measured in <nowiki>''</nowiki>cycles-per-second<nowiki>''</nowiki> (cps) or <nowiki>''</nowiki>hertz<nowiki>''</nowiki> (Hz).</ref> involve small integers. For our purposes, the most fundamental interval is the perfect fifth, which has {{Math|3:2}} pitch ratio. At some point the integers become too large for the interval to be considered consonant. The {{Math|8:5}} ratio corresponds to the minor sixth, which generally sounds quite consonant. Apparently {{Math|8}} is somehow viewed as a variation of the much smaller integer {{Math|2}}, since the {{Math|7:5}} interval (tritone) is usually viewed as dissonant. The reader can see and hear these three intervals in passage shown below. It conludes with a [[w:Dominant seventh chord|dominant seventh]] ({{math|C7}}) chord called a that will be discussed shortly. <score sound="1">\language "english" \relative c' { % display G for C, etc. and one octave higher \time 4/4 c4 g' <c, g'>2 % fifth c4 gs' <c,gs'>2 % minor sixth c4 fs <c fs>2 r2 <c e g bf> \bar "|."} \addlyrics { \skip 1 fifth \skip 1 \skip 1 minor-sixth \skip 1 \skip 1 tritone \skip 1 "C7" } </score> ==Consonance and musical intervals== [[Image:Beating Frequency.svg|thumb|275px|'''Simple Beat Frequency Figure:''' Beat frequency for two notes of nearly the same pitch.]] [[w:special:permalink/1102305761|Wikipedia has defined]] a '''beat''' as an [[w:Interference (wave propagation)|interference]] pattern between two [[w:sound|sounds]] of slightly different [[w:frequency|frequencies]], ''perceived'' as a periodic variation in [[w:amplitude (music)|volume]] whose rate is the [[w:Difference (mathematics)|difference]] of the two frequencies. [[w:Special:Permalink/1102305761#Mathematics_and_physics_of_beat_tones|The mathematics of beating]] can be summarized by the figure to the left, which leads to the following: ::<math> f_\text{beat} = f_2 - f_1 = \frac{1}{T_b} = \frac{\left|\omega_2-\omega_1\right|}{2\pi}</math> ::where, ::<math>fT =1</math>, and <math>\omega T = 2\pi,</math> ::are easy ways to remember the relation between frequency <math>f</math>, period <math>T</math>, and angular frequency, <math>\omega</math>. ==Phase-shift beating== {{clear}} ====Characteristic frequencies associated with an interval==== [[File:Characteristic frequencies tritone versus fifth.svg|thumb|275px|'''Characteristic Frequencies Figure'''These frequencies are associated with just musical intervals. Shown are the characteristic frequencies associated with a perfect fifth and a tritone. The shortest period (highest frequency) is T_0: the lowest matching harmonic for a a pair of periodic signals for which all harmonics are present. The longest period is T_x: the periodicity of the signal if the interval's pitches are exactly just.]] {| class="wikitable floatleft |-style="background-color:white; style=text-align:center" | <| <math>T_p=pT_0</math> || <math>T_q=qT_0</math> ||<math>qT_p=pT_q</math> |-style="background-color:white; style=text-align:center" | <math>pf_p=f_0</math> || <math>qf_q=f_0</math> ||<math>pf_q=qf_p</math> |-style="background-color:white; " |colspan=3 style=text-align:center|<math>T_\text{x}= pqT_0 \quad\quad\quad pqf_x=f_\text{0}</math> |-style="background-color:white; " |colspan=3 style=text-align:center|<math>f_p= qf_x \quad\quad\quad f_p= qf_x</math> |} {| class="wikitable floatleft style=text-align:center |-style="background-color:white; text-align:center" | <math>1<p/q<2</math> |-style="background-color:white; text-align:center" | <math>f_\text{x}<f_p<f_q<f_0</math> |-style="background-color:white; style=text-align:center" |<math>T_0<T_q<T_p<T_\text{x}</math> |} Let <math>p</math> and <math>q</math> be relative prime numbers that establish a musical interval between frequencies <math>f_q</math> and <math>f_p</math> that are less than one octave apart. It helps to also define a high frequency <math>f_0</math> and a low frequency <math>f_\text{x}</math>. All these frequencies (and associated periods) are shown in the table to the left. The table to the right might help reader sort out these frequencies and periods. ==Beats in musical intervals == ====Just interval phase shifts==== [[File:Just interval phase shifts.svg|thumb|450px|left|'''Phase Shift Figure:''' Shifting one signal in a just interval will shift the segment marked <math>T_x</math> by a time that is related to the periods of the two signals that create the just interval. The periodicity of the sum of the two signals is <math>T_x.</math> ]] This figure illustrates variations in a just interval that occur when a time delay is introduced between the two sinusoidals. We begin with the perfect fifth shown in top portion of the figure. The periodicity, <math>T_x</math> holds only to the extent that the interval is a perfect just ratio of two integers. Before considering small tempered variations from perfect justness, we first address the fact that a just interval is defined not only by the frequency ratio, but also by any phase difference that might exist between the two sinusoidals that. A perfect fifth is first shown with zero phase shift, assuming that we adopt adopt the convention that both signals are sine waves (the phase shift is <math>\pi/4</math> if they are cosines.) The reader can visually verify that advancing the low frequency signal by time, <math>t=T_0</math> returns this phase shift back to zero, for both the fifth, as well as the tritone. To facilitate visualization of this effect, alternate cycles of the sine wave are shaded (blue or yellow)<ref>According to [[c:Special:Permalink/576541721]], most color-blind readers should perceive the difference in shaded backgrounds of this figure.</ref> The region of unshifted sine waves can be recognized by the fact that only the corners of the two shaded regions are in contact with each other (at the start of a new period of length <math>T_x</math>.) ===="Phase" cycles==== A different sort of beat occurs between sinusoidal waves at frequencies <math>pf_0</math> and <math>qf_0</math>. We shall define this beat frequency to be <math>f_b</math> in order to distinguish it from <math>f_\text{beat}</math>, due to traditional beating between lowest matching harmonics of two signals. We shall find that <math>f_b=f_\text{beat}</math>, though two comments are worth keeping in mind: # The "phase cycles" is the simple variations in amplitude associated with beats between two signals of nearly the same frequency. They not likely to involve fluctuations power delivered to a person's ears.<ref>Some fluctuation in power is possible if the two frequencies are sufficiently far apart. Keep in mind that most treatments of wave energy and power focus only on time-averaged passage of energy through a reference plane.</ref> Instead "phase cycles" are a periodic variation in the shape of the waveform associated with the phase difference between two sine (or cosine) waves. # To the best of my knowledge, the the "phase cycles" described below have not been established to be responsible for the beats one hears when a musical interval deviates slightly from just intonation. ====Phase cycle beat frequency==== [[File:Where strain is distributed in a stretched wire.svg|thumb|'''Linear Elasticity Figure:''' illustrates how we can think of a small change in the wavelength of a sinusoidal resembles the theory of linear elasticity: When we uniformly "stretch" a sine wave, each small region experiences the same strain because strain is an intensive parameter. The advantage in dealing with only intensive parameters is that equations seem more obvious: As you include factors in an expression, you know you are wrong if both sides are not intensive. A thread or thin string cannot be used to measure something that is a few meters long because even though a short segment might seem stiff, a long segment is so springy it doesn't seem to have a well-defined "length". See also [http://courses.washington.edu/bioen326/lectures/Lecture%2003%202013%20Bioen%20326%20stress%20strain.pdf '''these''' Washington University notes.]]] To construct this plausibility argument, we replace the integer <math>p</math> of the higher frequency by a slightly smaller number, <math>\widetilde{p}=p-\Delta p,\,</math> that is not an integer. This will stretch the figure by a factor of approximately <math>\widetilde p/p</math>. '''Phase Shift Figure''' (above) informs us that time-shifting the signal by <math>T_0</math>, which is the smallest of our timescales. The new location of <math>T_x</math> is not a serious problem because if one is very close to just intonation, the beat time is much large than <math>T_x</math>. Listeners will not likely notice by a beat that is early or late by such a small time interval. Defining, <math>T_B=f_B^{-1}</math>, as the beat period, we shall always work in the approximation that: <math>T_B>>T_x</math> Consider a single beat with periodicity <math>T_B</math> that consists of many short segments of length <math>N\Delta T_p</math>. Our goal is to gently "stretch" the <math>p</math>-wave so its length is increased from <math>T_B</math> to <math>T_B+T_0</math>: <math>N\left(T_p+\Delta T_p\right)=T_B+T_0</math> The LHS of this equation represents the fact that we have increased the p-wavetrains length (in time) by decreasing the frequency (and hence increasing its period, <math>T_p</math> by a the small time interval <math>\Delta T_p</math>. The RHS represents the fact that we must enhance the length of the <math>p</math>-wave by <math>T_0</math> to create the new beat illustrated in '''Phase Shift Figure.''' Since the length of the <math>p</math>-wavetrain was <math>T_B</math> before we "stretched' the period <math>T_p</math>, we have: <math>NT_p=T_B\to N=\frac{T_B}{T_p}</math> Since <math>\Delta T_p</math> was chosen to "stretch" the <math>p</math>-wavetrain by an amount equal to <math>T_0,\,</math>we have: <math>N\Delta T_p=T_0\to N=\frac{T_0}{\Delta T_p} </math> Combining the previous two equations yields: <math>T_B=T_0\frac{T_p}{\Delta T_p}\to f_B=\frac{1}{T_B}=f_0\frac{\Delta f_p}{f_p} </math> From the table above we combine, <math>f_0=pf_p </math>, and after some thought<ref>The "thought" is more of a long story than rigorous logic: I know that raising two notes in a just interval by the same number of cents will preserve the just nature of the interval and maintain <math>f_B=0</math>. Also, it is clear that this is the correct formula of the q-frequency is instead varied (keeping the p-frequency constant.) Hence, we know this formula is correct for three special cases.</ref> we conclude: <math>f_B=|p\Delta f_p -q\Delta f_q| </math> ===Helmholtz argument=== [[w:special:permalink/1101504020#Consonant_and_dissonant|Helmholtz]] proposed that beats produced by the consonant musical intervals are caused by beating between pairs of harmonics of the two pitches which have nearly the same frequency. The the {{math|q}}-th harmonic of <math>f_p</math> and the {{math|p}}-harmonic of <math>f_q</math> both equal <math>f_0=pf_p=qf_q</math>. Using the formula for beats between signals of the same frequency: :<math>f_\text{HB}=\left| p\Delta f_p - q\Delta f_q\right|</math> Again, the reader is challenged to verify my guess that this equation correctly describes simultaneous changes to <math>f_p</math> and <math>f_q</math> if these changes are small. ===Images=== {{wide image|Beat pattern for fifth.svg|1600px|Beat pattern for a 3:2 ratio (perfect fifth) that is off by 57 cents.}} {{wide image|File:Beat pattern for tritone.svg|2400px|Beat pattern for tritone that is off by ?? cents.}} [[File:Beat pattern for tritone.svg|thumb|220px|Range of phase shifts for a just perfect fifth musical interval]] > ===Discussion=== Consider a just interval between the two periods, <math>T_p=pT_0</math>, and <math>T_q=qT_0</math>, where <math>p=3</math> and <math>q=2</math> as shown in the figure. Because <math>T_p</math> and <math>T_q</math> make an exactly just interval, we have: :<math>q T_p =p T_q</math> ( <math>3 T_p = 2T_q</math> for a P5<ref>P5 denotes a perfect fifth, a 3:2 frequency ratio.</ref>) ALSO DEFINE A LONG PERIOD :<math>T_x=pqT_0=qT_p=pT_q</math> ===Code=== ‎<syntaxhighlight lang="python"> triton=True if tritone: p , q = 7, 4 f_0=50 Df_p=2 else: p , q = 3, 2 f_0=100 Df_p=2 Df_q=0 f_p= p*f_0 f_q= q*f_0 Df_q=0 f_b=abs(p*Df_q - q*Df_p)#--------------------Helmholtz (checked) f_c=p*f_b/q#new T_c=1/f_c#new cents=1200*(np.log2(1+Df_p/f_p)-np.log2(1+Df_q/f_q))#error (cents) tbeat=1/f_b#-----------------------------------calculate beat period topi=2*np.pi om_p,om_q=(f_p+Df_p)*topi,(f_q+Df_q)*topi#-----define two omegas yp=Amplitude*np.cos(om_p*t)/2 yq=Amplitude*np.cos(om_q*t)/2 y=yp+yq </syntaxhighlight> ==Fourier analysis== {{cot|Not yet needed}} ''See also'' [[w:Kramers–Kronig relations]], [[w:Cauchy principal value]], [https://wiki.seg.org/wiki/Dictionary:Hilbert_transform]and [[w:Sokhotski–Plemelj theorem]] <math> \int_\infty^\infty e^{i\omega t}d\omega=2\pi\delta(t)</math> <math>\frac{1}{X+i\epsilon} = \frac {X}{X^2+ \epsilon^2} - i \pi \delta(X)</math> <math>\frac{1}{X+i\epsilon} = \frac {X}{X^2+ \epsilon^2} - \frac {i\epsilon}{X^2+ \epsilon^2}</math> <math>\frac 1 X = \text{pp} \frac 1 X -i\pi \delta(X)</math> {{cob}} ==Links== ===Basic=== * <u>[[Wikipedia:Beat (acoustics)]]</u>: The fact that Wikipedia only covers the basic ideas supports my contention that material beyond these well known topics will always be murky.<ref>{{cite journal |last= Weinberger |first= Norman |date= September 2006 |title= Music And The Brain |url= https://www.scientificamerican.com/article/music-and-the-brain-2006-09/ |journal= Scientific American |volume= 16 |issue= 3 |pages= 36-43 |doi= 10.1038/scientificamerican0906-36sp |accessdate=2022-08-04 }}</ref><ref>Note the inserted footnote templates regarding "verification" and "original research?" at [[w:special:permalink/1102305761]]. </ref> * <u>[http://hyperphysics.phy-astr.gsu.edu/hbase/Sound/beat.html Hyperphysics: Sound/beat:]</u> parallels the Wikipedia article. * [https://www.omnicalculator.com/physics/beat-frequency <u>Omnicalculator's beat frequency demonstration</u>] effectively how the 3:2 rhythm pattern is just an ultra slow version of the consonant perfect fifth in music. * [http://www.sengpielaudio.com/calculator-centsratio.htm online cents to ratio calculator] ===Advanced or different=== * <u>[https://www.violinist.com/discussion/archive/18551/ Violinist.com]</u> discussion on using beats to tune a violin *Footnote.<ref>Let <math>f(t)=T^{-1}</math>, and take the derivative to get, <math>df/dt=-T^{-2}</math>, which leads to: <math>df/f=-dT/T</math></ref> ===Algebra and/or failed efforts=== *[[Special:Permalink/2418671#Phase-shift_beating]] I spent a lot of time getting here. All the identities are correct in this version, but getting the T and f identities right gave me dyslexia. But I was wrong from the beginning with not understanding that I just need to "stretch" a period of time \tau_{beat} by the tiny time interval T_0. *[[Special:Permalink/2418517#Calculation_of_phase_cycle_beat_frequency]] contains a possibly flawed explanation of why my algebra made intuitive leaps of faith. Also, I redid the calculation (see above.) *[[c:File:Where strain is distributed in a stretched wire.svg]] ==Footnotes== o03n5fpj7z62cyru1j4d3dn3rijcd45 0 286138 2419096 2413719 2022-08-25T22:37:30Z Jtneill 10242 + category wikitext text/x-wiki {{title|Chapter title:<br>Subtitle?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== You are underway {{smile}}! This template provides tips for [[Motivation and emotion/Assessment/Topic|topic development]]. Gradually remove these suggestions as you develop the chapter. Also consult the [[Motivation and emotion/Assessment/Chapter|author guidelines]]. At the top of the chapter, the title and sub-title should match the ''exact'' wording and casing as shown in the {{Motivation and emotion/Book}}. The sub-titles all end with a question mark. This Overview section should be concise but consist of several paragraphs which engage the reader, illustrate the problem, and outline how psychological science can help. {{RoundBoxTop|theme=3}} '''Focus questions:''' * What is the first focus question? * What is the second focus question? * What is the third focus question? {{RoundBoxBottom}} {{tip| Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Provide an example or case study. * Conclude with Focus questions to guide the chapter. }} ==Main headings== How you are going to structure the chapter? Aim for three to six main headings between the [[#Overview|Overview]] and [[#Conclusion|Conclusion]]. {{tip|Suggestions for this section: * For the [[Motivation and emotion/Assessment/Topic|topic development]], provide at least 3 bullet-points about key content per section. Include key citations. * For the [[Motivation and emotion/Assessment/Chapter|book chapter]], expand the bullet points into paragraphs. * If a section has a lot of content, arrange it into two to five sub-headings such as in the [[#Interactive learning features|interactive learning features section]]. Avoid having sections with only one sub-heading. }} ==Learning features== What brings an online book chapter to life are its interactive learning features. Case studies, feature boxes, figures, links, tables, and quiz questions can be used throughout the chapter. ===Case studies=== Case studies describe real-world examples of concepts in action. Case studies can be real or fictional. A case could be used multiple times during a chapter to illustrate different theories or stages. It is often helpful to present case studies using [[#Feature boxes|feature boxes]]. ===Boxes=== Boxes can be used to highlight content, but don't overuse them. There are many different ways of creating boxes (e.g., see [[Help:Pretty boxes|Pretty boxes]]). Possible uses include: * Focus questions * Case studies or examples * Quiz questions * Take-home messages {{RoundBoxTop|theme=3}} ;Feature box example * Shaded background * Coloured border {{RoundBoxBottom}} ===Figures=== [[File:Monkey-typing.jpg|right|205px|thumb|''Figure 1''. Example image with descriptive caption.]] Use figures to illustrate concepts, add interest, and provide examples. Figures can be used to show photographs, drawings, diagrams, graphs, etcetera. Figures can be embedded throughout the chapter, starting with the Overview section. Figures should be captioned (using a number and a description) in order to explain their relevance to the text. Possible images can be found at [[commons:|Wikimedia Commons]]. Images can also be uploaded if they are licensed for re-use or if you created the image. Each figure should be referred to at least once in the main text (e.g., see Figure 1). ===Links=== Where key words are first used, make them into [[Help:Links|interwiki links]] such as Wikipedia links to articles about famous people (e.g., [[w:Sigmund Freud|Sigmund Freud]] and key concepts (e.g., [[w:Dreams|dreams]]) and links to book chapters about related topics (e.g., would you like to learn about how to overcome [[Motivation and emotion/Book/2020/Writer's block|writer's block]]?). ===Tables=== Tables can be an effective way to organise and summarise information. Tables should be captioned (using APA style) to explain their relevance to the text. Plus each table should be referred to at least once in the main text (e.g., see Table 1 and Table 2). Here are some [[Motivation and emotion/Wikiversity/Tables|example 3 x 3 tables]] which could be adapted. ===Quizzes=== Quizzes are a direct way to engage readers. But don't make quizzes too hard or long. It is better to have one or two review questions per major section than a long quiz at the end. Try to quiz conceptual understanding, rather than trivia. Here are some simple quiz questions which could be adapted. Choose the correct answers and click "Submit": <quiz display=simple> {Quizzes are an interactive learning feature: |type="()"} + True - False {Long quizzes are a good idea: |type="()"} - True + False </quiz> To learn about different types of quiz questions, see [[Help:Quiz|Quiz]]. ==Conclusion== The Conclusion is arguably the most important section. It should be possible for someone to read the [[#Overview|Overview]] and the Conclusion and still get a good idea of the topic. {{tip|Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? }} ==See also== Provide up to half-a-dozen [[Help:Contents/Links#Interwiki_links|internal (wiki) links]] to relevant Wikiversity pages (esp. related [[Motivation and emotion/Book|motivation and emotion book chapters]]) and [[w:|Wikipedia articles]]. For example: * [[Motivation and emotion/Book/2016/Anorexia nervosa and extrinsic motivation|Anorexia nervosa and extrinsic motivation]] (Book chapter, 2016) * [[w:David McClelland|David McClelland]] (Wikipedia) * [[Motivation and emotion/Book/2018/Loss aversion|Loss aversion]] (Book chapter, 2018) * [[w:Maslow's hierarchy of needs|Maslow's hierarchy of needs]] (Wikipedia) {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== List the cited references in [[w:APA style|APA style]] (7th ed.) or [[w:Wikipedia:Citing sources|wiki style]]. APA style example: {{Hanging indent|1= Blair, R. J. R. (2004). The roles of orbital frontal cortex in the modulation of antisocial behavior. ''Brain and Cognition'', ''55''(1), 198–208. https://doi.org/10.1016/S0278-2626(03)00276-8 Buckholtz, J. W., & Meyer-Lindenberg, A. (2008). MAOA and the neurogenetic architecture of human aggression. ''Trends in Neurosciences'', ''31''(3), 120–129. https://doi.org/10.1016/j.tins.2007.12.006 Eckardt, M., File, S., Gessa, G., Grant, K., Guerri, C., Hoffman, P., & Tabakoff, B. (1998). Effects of moderate alcohol consumption on the central nervous system. ''Alcoholism, Clinical and Experimental Research'', ''22''(5), 998–1040. https://doi.org/10.1111/j.1530-0277.1998.tb03695.x }} {{tip|Suggestions for this section: * Important aspects for APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except first letter and proper names, ending in a full-stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full-stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't actually read or consulted }} ==External links== Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * [https://students.unimelb.edu.au/academic-skills/explore-our-resources/essay-writing/six-top-tips-for-writing-a-great-essay Six top tips for writing a great essay] (University of Melbourne) * [http://www.skillsyouneed.com/write/structure.html The importance of structure] (skillsyouneed.com) {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] [[Category:Motivation and emotion/Book/Money]] ru13vww7x24o80jaf84svawyrbwi1o6 2419356 2419096 2022-08-26T07:22:32Z Molzaroid 2947706 /* Overview */ started editing book chapter wikitext text/x-wiki {{title|Money priming, motivation, and emotion:<br>What is the effect of money priming on motivation and emotion?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== {{tip|If you were to think of food, how would you see this word? S_ _ P Did you think of soup? Yet, if you were to think of showering, how would you see this word? S _ _ P Did you think of soap? This is the effect of priming }} [[File:Child's Angry Face.jpg|thumb|''Figure 1.'' Priming can alter our subconscious in ways that truly effect our motivations, emotions and behaviours and how we percieve the world around us. For example, a young boy can be primed to be aggressive, this may alter the many psychological facets of his life.]] Priming is the effect in which recent experience of [[wikipedia:Stimulus_(psychology)|stimulus]] facilitates of inhibits later processing of the same or similar stimulus (APA, 2022). Priming effects are greatly influential, priming the single concept of aggression in a young boy can have multiple effects across a wide array of psychological systems within him, such as behaviour, perception, motivation, evaluation and emotion (Bargh, 2006). {{RoundBoxTop|theme=3}} '''Focus questions:''' * What is the first focus question? * What is the second focus question? * What is the third focus question? {{RoundBoxBottom}} == What is Priming? == discuss and define priming, the guy who thought of it, how it works... === A Famous Study === == What is Money Priming? == What is the importance of money and its representation in media and what not, (basically its everywhere, cant get away from it) == Money and Motivation == === Predicting Priming Effects === ===Quizzes=== Quizzes are a direct way to engage readers. But don't make quizzes too hard or long. It is better to have one or two review questions per major section than a long quiz at the end. Try to quiz conceptual understanding, rather than trivia. Here are some simple quiz questions which could be adapted. Choose the correct answers and click "Submit": <quiz display=simple> {Quizzes are an interactive learning feature: |type="()"} + True - False {Long quizzes are a good idea: |type="()"} - True + False </quiz> To learn about different types of quiz questions, see [[Help:Quiz|Quiz]]. ==Conclusion== The Conclusion is arguably the most important section. It should be possible for someone to read the [[#Overview|Overview]] and the Conclusion and still get a good idea of the topic. {{tip|Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? }} ==See also== Provide up to half-a-dozen [[Help:Contents/Links#Interwiki_links|internal (wiki) links]] to relevant Wikiversity pages (esp. related [[Motivation and emotion/Book|motivation and emotion book chapters]]) and [[w:|Wikipedia articles]]. For example: * [[Motivation and emotion/Book/2016/Anorexia nervosa and extrinsic motivation|Anorexia nervosa and extrinsic motivation]] (Book chapter, 2016) * [[w:David McClelland|David McClelland]] (Wikipedia) * [[Motivation and emotion/Book/2018/Loss aversion|Loss aversion]] (Book chapter, 2018) * [[w:Maslow's hierarchy of needs|Maslow's hierarchy of needs]] (Wikipedia) {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== List the cited references in [[w:APA style|APA style]] (7th ed.) or [[w:Wikipedia:Citing sources|wiki style]]. APA style example: {{Hanging indent|1= Blair, R. J. R. (2004). The roles of orbital frontal cortex in the modulation of antisocial behavior. ''Brain and Cognition'', ''55''(1), 198–208. https://doi.org/10.1016/S0278-2626(03)00276-8 Buckholtz, J. W., & Meyer-Lindenberg, A. (2008). MAOA and the neurogenetic architecture of human aggression. ''Trends in Neurosciences'', ''31''(3), 120–129. https://doi.org/10.1016/j.tins.2007.12.006 Eckardt, M., File, S., Gessa, G., Grant, K., Guerri, C., Hoffman, P., & Tabakoff, B. (1998). Effects of moderate alcohol consumption on the central nervous system. ''Alcoholism, Clinical and Experimental Research'', ''22''(5), 998–1040. https://doi.org/10.1111/j.1530-0277.1998.tb03695.x }} {{tip|Suggestions for this section: * Important aspects for APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except first letter and proper names, ending in a full-stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full-stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't actually read or consulted }} ==External links== Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * [https://students.unimelb.edu.au/academic-skills/explore-our-resources/essay-writing/six-top-tips-for-writing-a-great-essay Six top tips for writing a great essay] (University of Melbourne) * [http://www.skillsyouneed.com/write/structure.html The importance of structure] (skillsyouneed.com) {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] [[Category:Motivation and emotion/Book/Money]] briip7z28b37afxdn7y3wq9jckds3dp 2419375 2419356 2022-08-26T07:41:51Z Molzaroid 2947706 added famous study information wikitext text/x-wiki {{title|Money priming, motivation, and emotion:<br>What is the effect of money priming on motivation and emotion?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== {{tip|If you were to think of food, how would you see this word? S_ _ P Did you think of soup? Yet, if you were to think of showering, how would you see this word? S _ _ P Did you think of soap? This is the effect of priming }} [[File:Child's Angry Face.jpg|thumb|''Figure 1.'' Priming can alter our subconscious in ways that truly effect our motivations, emotions and behaviours and how we percieve the world around us. For example, a young boy can be primed to be aggressive, this may alter the many psychological facets of his life.]] Priming is the effect in which recent experience of [[wikipedia:Stimulus_(psychology)|stimulus]] facilitates of inhibits later processing of the same or similar stimulus (APA, 2022). Priming is a largely subconscious activiation of knowledge that have been studied ferociously over the past 25 years (Bargh, 2006). Priming effects are greatly influential, priming the single concept of aggression in a young boy can have multiple effects across a wide array of psychological systems within him, such as behaviour, perception, motivation, evaluation and emotion (Bargh, 2006). {{RoundBoxTop|theme=3}} '''Focus questions:''' * What is the first focus question? * What is the second focus question? * What is the third focus question? {{RoundBoxBottom}} == What is Priming? == discuss and define priming, the guy who thought of it, how it works... === A Famous Study === Bargh, Chen and Burrows' 1996 famous study on priming shone a perspective specifically on the unconscious determinants of behavioural priming. Within experiment two in the study, participants were unwittingly exposed to the stereotypical trait construct of "being old", then proceeded to walk out of the laboratory slower than how they entered. The exposure to elderly traits was enough to elicit behavioural effects that were unaware to participants and famously influential to social psychologists. (Further information regarding Bargh, Chen and Burrows' 1996 study can be found [https://pubmed.ncbi.nlm.nih.gov/8765481/ here]) == What is Money Priming? == What is the importance of money and its representation in media and what not, (basically its everywhere, cant get away from it) == Money and Motivation == === Predicting Priming Effects === ===Quizzes=== Quizzes are a direct way to engage readers. But don't make quizzes too hard or long. It is better to have one or two review questions per major section than a long quiz at the end. Try to quiz conceptual understanding, rather than trivia. Here are some simple quiz questions which could be adapted. Choose the correct answers and click "Submit": <quiz display=simple> {Quizzes are an interactive learning feature: |type="()"} + True - False {Long quizzes are a good idea: |type="()"} - True + False </quiz> To learn about different types of quiz questions, see [[Help:Quiz|Quiz]]. ==Conclusion== The Conclusion is arguably the most important section. It should be possible for someone to read the [[#Overview|Overview]] and the Conclusion and still get a good idea of the topic. {{tip|Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? }} ==See also== Provide up to half-a-dozen [[Help:Contents/Links#Interwiki_links|internal (wiki) links]] to relevant Wikiversity pages (esp. related [[Motivation and emotion/Book|motivation and emotion book chapters]]) and [[w:|Wikipedia articles]]. For example: * [[Motivation and emotion/Book/2016/Anorexia nervosa and extrinsic motivation|Anorexia nervosa and extrinsic motivation]] (Book chapter, 2016) * [[w:David McClelland|David McClelland]] (Wikipedia) * [[Motivation and emotion/Book/2018/Loss aversion|Loss aversion]] (Book chapter, 2018) * [[w:Maslow's hierarchy of needs|Maslow's hierarchy of needs]] (Wikipedia) {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== List the cited references in [[w:APA style|APA style]] (7th ed.) or [[w:Wikipedia:Citing sources|wiki style]]. APA style example: {{Hanging indent|1= Blair, R. J. R. (2004). The roles of orbital frontal cortex in the modulation of antisocial behavior. ''Brain and Cognition'', ''55''(1), 198–208. https://doi.org/10.1016/S0278-2626(03)00276-8 Buckholtz, J. W., & Meyer-Lindenberg, A. (2008). MAOA and the neurogenetic architecture of human aggression. ''Trends in Neurosciences'', ''31''(3), 120–129. https://doi.org/10.1016/j.tins.2007.12.006 Eckardt, M., File, S., Gessa, G., Grant, K., Guerri, C., Hoffman, P., & Tabakoff, B. (1998). Effects of moderate alcohol consumption on the central nervous system. ''Alcoholism, Clinical and Experimental Research'', ''22''(5), 998–1040. https://doi.org/10.1111/j.1530-0277.1998.tb03695.x }} {{tip|Suggestions for this section: * Important aspects for APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except first letter and proper names, ending in a full-stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full-stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't actually read or consulted }} ==External links== Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * [https://students.unimelb.edu.au/academic-skills/explore-our-resources/essay-writing/six-top-tips-for-writing-a-great-essay Six top tips for writing a great essay] (University of Melbourne) * [http://www.skillsyouneed.com/write/structure.html The importance of structure] (skillsyouneed.com) {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] [[Category:Motivation and emotion/Book/Money]] te3v2j5yqw553h5m9eue2yj0hmq1tx8 2419389 2419375 2022-08-26T07:54:39Z Molzaroid 2947706 /* A Famous Study */ wikitext text/x-wiki {{title|Money priming, motivation, and emotion:<br>What is the effect of money priming on motivation and emotion?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== {{tip|If you were to think of food, how would you see this word? S_ _ P Did you think of soup? Yet, if you were to think of showering, how would you see this word? S _ _ P Did you think of soap? This is the effect of priming }} [[File:Child's Angry Face.jpg|thumb|''Figure 1.'' Priming can alter our subconscious in ways that truly effect our motivations, emotions and behaviours and how we percieve the world around us. For example, a young boy can be primed to be aggressive, this may alter the many psychological facets of his life.]] Priming is the effect in which recent experience of [[wikipedia:Stimulus_(psychology)|stimulus]] facilitates of inhibits later processing of the same or similar stimulus (APA, 2022). Priming is a largely subconscious activiation of knowledge that have been studied ferociously over the past 25 years (Bargh, 2006). Priming effects are greatly influential, priming the single concept of aggression in a young boy can have multiple effects across a wide array of psychological systems within him, such as behaviour, perception, motivation, evaluation and emotion (Bargh, 2006). {{RoundBoxTop|theme=3}} '''Focus questions:''' * What is the first focus question? * What is the second focus question? * What is the third focus question? {{RoundBoxBottom}} == What is Priming? == discuss and define priming, the guy who thought of it, how it works... === A Famous Study === [[File:An elderly man in northern France Art.IWMART1517950.jpg|thumb|''Figure 2.'' Being exposed to "elderly traits" can elicit behavioural priming effects. Pictured is an artwork of an old man using a cane as he walks. ]] Bargh, Chen and Burrows' 1996 famous study on priming shone a perspective specifically on the unconscious determinants of behavioural priming. Within experiment two in the study, participants were unwittingly exposed to the stereotypical trait construct of "being old", then proceeded to walk out of the laboratory slower than how they entered (Doyen, et al., 2012). The exposure to elderly traits was enough to elicit behavioural effects that were unaware to participants and famously influential to social psychologists. (Further information regarding Bargh, Chen and Burrows' 1996 study can be found [https://pubmed.ncbi.nlm.nih.gov/8765481/ here]) == What is Money Priming? == What is the importance of money and its representation in media and what not, (basically its everywhere, cant get away from it) == Money and Motivation == === Predicting Priming Effects === ===Quizzes=== Quizzes are a direct way to engage readers. But don't make quizzes too hard or long. It is better to have one or two review questions per major section than a long quiz at the end. Try to quiz conceptual understanding, rather than trivia. Here are some simple quiz questions which could be adapted. Choose the correct answers and click "Submit": <quiz display=simple> {Quizzes are an interactive learning feature: |type="()"} + True - False {Long quizzes are a good idea: |type="()"} - True + False </quiz> To learn about different types of quiz questions, see [[Help:Quiz|Quiz]]. ==Conclusion== The Conclusion is arguably the most important section. It should be possible for someone to read the [[#Overview|Overview]] and the Conclusion and still get a good idea of the topic. {{tip|Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? }} ==See also== Provide up to half-a-dozen [[Help:Contents/Links#Interwiki_links|internal (wiki) links]] to relevant Wikiversity pages (esp. related [[Motivation and emotion/Book|motivation and emotion book chapters]]) and [[w:|Wikipedia articles]]. For example: * [[Motivation and emotion/Book/2016/Anorexia nervosa and extrinsic motivation|Anorexia nervosa and extrinsic motivation]] (Book chapter, 2016) * [[w:David McClelland|David McClelland]] (Wikipedia) * [[Motivation and emotion/Book/2018/Loss aversion|Loss aversion]] (Book chapter, 2018) * [[w:Maslow's hierarchy of needs|Maslow's hierarchy of needs]] (Wikipedia) {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== List the cited references in [[w:APA style|APA style]] (7th ed.) or [[w:Wikipedia:Citing sources|wiki style]]. APA style example: {{Hanging indent|1= Blair, R. J. R. (2004). The roles of orbital frontal cortex in the modulation of antisocial behavior. ''Brain and Cognition'', ''55''(1), 198–208. https://doi.org/10.1016/S0278-2626(03)00276-8 Buckholtz, J. W., & Meyer-Lindenberg, A. (2008). MAOA and the neurogenetic architecture of human aggression. ''Trends in Neurosciences'', ''31''(3), 120–129. https://doi.org/10.1016/j.tins.2007.12.006 Eckardt, M., File, S., Gessa, G., Grant, K., Guerri, C., Hoffman, P., & Tabakoff, B. (1998). Effects of moderate alcohol consumption on the central nervous system. ''Alcoholism, Clinical and Experimental Research'', ''22''(5), 998–1040. https://doi.org/10.1111/j.1530-0277.1998.tb03695.x }} {{tip|Suggestions for this section: * Important aspects for APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except first letter and proper names, ending in a full-stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full-stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't actually read or consulted }} ==External links== Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * [https://students.unimelb.edu.au/academic-skills/explore-our-resources/essay-writing/six-top-tips-for-writing-a-great-essay Six top tips for writing a great essay] (University of Melbourne) * [http://www.skillsyouneed.com/write/structure.html The importance of structure] (skillsyouneed.com) {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] [[Category:Motivation and emotion/Book/Money]] na0rvwfbm3ywb7cj3m0mp0xr8f194wz 2419398 2419389 2022-08-26T08:22:25Z Molzaroid 2947706 /* Overview */ wikitext text/x-wiki {{title|Money priming, motivation, and emotion:<br>What is the effect of money priming on motivation and emotion?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== {{tip|If you were to think of food, how would you see this word? S_ _ P Did you think of soup? Yet, if you were to think of showering, how would you see this word? S _ _ P Did you think of soap? This is the effect of priming }} [[File:Child's Angry Face.jpg|thumb|''Figure 1.'' Priming can alter our subconscious in ways that truly effect our motivations, emotions and behaviours and how we percieve the world around us. Pictured is an image of an angry boy.]] Priming is the effect in which recent experience of [[wikipedia:Stimulus_(psychology)|stimulus]] facilitates of inhibits later processing of the same or similar stimulus (APA, 2022). Priming is a largely subconscious activiation of knowledge that have been studied ferociously over the past 25 years (Bargh, 2006). Priming effects are greatly influential, priming the single concept of aggression in a young boy can have multiple effects across a wide array of psychological systems within him, such as behaviour, perception, motivation, evaluation and emotion (Bargh, 2006). {{RoundBoxTop|theme=3}} '''Focus questions:''' * What is priming and how does it work? * What is money priming? * What are the motivations and emotions associated with money priming? * Is money priming an helpful or unhelpful phenomenon?{{RoundBoxBottom}} == What is Priming? == discuss and define priming, the guy who thought of it, how it works... === Priming in Media, Advertising and Politics === === A Famous Study === [[File:An elderly man in northern France Art.IWMART1517950.jpg|thumb|''Figure 2.'' Being exposed to "elderly traits" can elicit behavioural priming effects. Pictured is an artwork of an old man using a cane as he walks. ]] Bargh, Chen and Burrows' 1996 famous study on priming shone a perspective specifically on the unconscious determinants of behavioural priming. Within experiment two in the study, participants were unwittingly exposed to the stereotypical trait construct of "being old", then proceeded to walk out of the laboratory slower than how they entered (Doyen, et al., 2012). The exposure to elderly traits was enough to elicit behavioural effects that were unaware to participants and famously influential to social psychologists. (Further information regarding Bargh, Chen and Burrows' 1996 study can be found [https://pubmed.ncbi.nlm.nih.gov/8765481/ here]) == What is Money Priming? == What is the importance of money and its representation in media and what not, (basically its everywhere, cant get away from it) === Schemas === == Money and Motivation == ===Quizzes=== Quizzes are a direct way to engage readers. But don't make quizzes too hard or long. It is better to have one or two review questions per major section than a long quiz at the end. Try to quiz conceptual understanding, rather than trivia. Here are some simple quiz questions which could be adapted. Choose the correct answers and click "Submit": <quiz display=simple> {Quizzes are an interactive learning feature: |type="()"} + True - False {Long quizzes are a good idea: |type="()"} - True + False </quiz> To learn about different types of quiz questions, see [[Help:Quiz|Quiz]]. ==Conclusion== The Conclusion is arguably the most important section. It should be possible for someone to read the [[#Overview|Overview]] and the Conclusion and still get a good idea of the topic. {{tip|Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? }} ==See also== Provide up to half-a-dozen [[Help:Contents/Links#Interwiki_links|internal (wiki) links]] to relevant Wikiversity pages (esp. related [[Motivation and emotion/Book|motivation and emotion book chapters]]) and [[w:|Wikipedia articles]]. For example: * [[Motivation and emotion/Book/2016/Anorexia nervosa and extrinsic motivation|Anorexia nervosa and extrinsic motivation]] (Book chapter, 2016) * [[w:David McClelland|David McClelland]] (Wikipedia) * [[Motivation and emotion/Book/2018/Loss aversion|Loss aversion]] (Book chapter, 2018) * [[w:Maslow's hierarchy of needs|Maslow's hierarchy of needs]] (Wikipedia) {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== List the cited references in [[w:APA style|APA style]] (7th ed.) or [[w:Wikipedia:Citing sources|wiki style]]. APA style example: {{Hanging indent|1= Blair, R. J. R. (2004). The roles of orbital frontal cortex in the modulation of antisocial behavior. ''Brain and Cognition'', ''55''(1), 198–208. https://doi.org/10.1016/S0278-2626(03)00276-8 Buckholtz, J. W., & Meyer-Lindenberg, A. (2008). MAOA and the neurogenetic architecture of human aggression. ''Trends in Neurosciences'', ''31''(3), 120–129. https://doi.org/10.1016/j.tins.2007.12.006 Eckardt, M., File, S., Gessa, G., Grant, K., Guerri, C., Hoffman, P., & Tabakoff, B. (1998). Effects of moderate alcohol consumption on the central nervous system. ''Alcoholism, Clinical and Experimental Research'', ''22''(5), 998–1040. https://doi.org/10.1111/j.1530-0277.1998.tb03695.x }} {{tip|Suggestions for this section: * Important aspects for APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except first letter and proper names, ending in a full-stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full-stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't actually read or consulted }} ==External links== Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * [https://students.unimelb.edu.au/academic-skills/explore-our-resources/essay-writing/six-top-tips-for-writing-a-great-essay Six top tips for writing a great essay] (University of Melbourne) * [http://www.skillsyouneed.com/write/structure.html The importance of structure] (skillsyouneed.com) {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] [[Category:Motivation and emotion/Book/Money]] 8x4b3fxoh1wzxl2biu3hbmhyh728mrg 2419410 2419398 2022-08-26T08:45:47Z Molzaroid 2947706 /* What is Money Priming? */ wikitext text/x-wiki {{title|Money priming, motivation, and emotion:<br>What is the effect of money priming on motivation and emotion?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== {{tip|If you were to think of food, how would you see this word? S_ _ P Did you think of soup? Yet, if you were to think of showering, how would you see this word? S _ _ P Did you think of soap? This is the effect of priming }} [[File:Child's Angry Face.jpg|thumb|''Figure 1.'' Priming can alter our subconscious in ways that truly effect our motivations, emotions and behaviours and how we percieve the world around us. Pictured is an image of an angry boy.]] Priming is the effect in which recent experience of [[wikipedia:Stimulus_(psychology)|stimulus]] facilitates of inhibits later processing of the same or similar stimulus (APA, 2022). Priming is a largely subconscious activiation of knowledge that have been studied ferociously over the past 25 years (Bargh, 2006). Priming effects are greatly influential, priming the single concept of aggression in a young boy can have multiple effects across a wide array of psychological systems within him, such as behaviour, perception, motivation, evaluation and emotion (Bargh, 2006). {{RoundBoxTop|theme=3}} '''Focus questions:''' * What is priming and how does it work? * What is money priming? * What are the motivations and emotions associated with money priming? * Is money priming an helpful or unhelpful phenomenon?{{RoundBoxBottom}} == What is Priming? == discuss and define priming, the guy who thought of it, how it works... [[File:An elderly man in northern France Art.IWMART1517950.jpg|thumb|''Figure 2.'' Being exposed to "elderly traits" can elicit behavioural priming effects. Pictured is an artwork of an old man using a cane as he walks. ]] === Priming in Media, Advertising and Politics === === A Famous Study === Bargh, Chen and Burrows' 1996 famous study on priming shone a perspective specifically on the unconscious determinants of behavioural priming. Within experiment two in the study, participants were unwittingly exposed to the stereotypical trait construct of "being old", then proceeded to walk out of the laboratory slower than how they entered (Doyen, et al., 2012). The exposure to elderly traits was enough to elicit behavioural effects that were unaware to participants and famously influential to social psychologists. (Further information regarding Bargh, Chen and Burrows' 1996 study can be found [https://pubmed.ncbi.nlm.nih.gov/8765481/ here]) == What is Money Priming? == What is it? === The Representation and Influence of Money === * Money is a symbol of the establishment that upholds existing socioeconomic systems (Vohs, 2015). * Money is featured everywhere, songs, paintings and movies. And is a heavily consumed idea that affects all. === The Importance of Money === * Discuss Maslow's Hierarchy of Needs and its importance in maintaining our physiological and basic needs === Schemas === * Discuss the schema of money and its importance to how we function day to day == Money and Motivation == === Undesirables of Money Priming === === Desirables of Money Priming === == Money and Emotion == == Quizzes == Here are some simple quiz questions which could be adapted. Choose the correct answers and click "Submit": <quiz display=simple> {Quizzes are an interactive learning feature: |type="()"} + True - False {Long quizzes are a good idea: |type="()"} - True + False </quiz> To learn about different types of quiz questions, see [[Help:Quiz|Quiz]]. ==Conclusion== The Conclusion is arguably the most important section. It should be possible for someone to read the [[#Overview|Overview]] and the Conclusion and still get a good idea of the topic. {{tip|Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? }} ==See also== Provide up to half-a-dozen [[Help:Contents/Links#Interwiki_links|internal (wiki) links]] to relevant Wikiversity pages (esp. related [[Motivation and emotion/Book|motivation and emotion book chapters]]) and [[w:|Wikipedia articles]]. For example: * [[Motivation and emotion/Book/2016/Anorexia nervosa and extrinsic motivation|Anorexia nervosa and extrinsic motivation]] (Book chapter, 2016) * [[w:David McClelland|David McClelland]] (Wikipedia) * [[Motivation and emotion/Book/2018/Loss aversion|Loss aversion]] (Book chapter, 2018) * [[w:Maslow's hierarchy of needs|Maslow's hierarchy of needs]] (Wikipedia) {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== List the cited references in [[w:APA style|APA style]] (7th ed.) or [[w:Wikipedia:Citing sources|wiki style]]. APA style example: {{Hanging indent|1= Blair, R. J. R. (2004). The roles of orbital frontal cortex in the modulation of antisocial behavior. ''Brain and Cognition'', ''55''(1), 198–208. https://doi.org/10.1016/S0278-2626(03)00276-8 Buckholtz, J. W., & Meyer-Lindenberg, A. (2008). MAOA and the neurogenetic architecture of human aggression. ''Trends in Neurosciences'', ''31''(3), 120–129. https://doi.org/10.1016/j.tins.2007.12.006 Eckardt, M., File, S., Gessa, G., Grant, K., Guerri, C., Hoffman, P., & Tabakoff, B. (1998). Effects of moderate alcohol consumption on the central nervous system. ''Alcoholism, Clinical and Experimental Research'', ''22''(5), 998–1040. https://doi.org/10.1111/j.1530-0277.1998.tb03695.x }} {{tip|Suggestions for this section: * Important aspects for APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except first letter and proper names, ending in a full-stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full-stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't actually read or consulted }} ==External links== Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * [https://students.unimelb.edu.au/academic-skills/explore-our-resources/essay-writing/six-top-tips-for-writing-a-great-essay Six top tips for writing a great essay] (University of Melbourne) * [http://www.skillsyouneed.com/write/structure.html The importance of structure] (skillsyouneed.com) {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] [[Category:Motivation and emotion/Book/Money]] r92rvovu3g1ekwcj8u0dmxolj195f3u 0 286181 2419089 2418013 2022-08-25T22:23:37Z Jtneill 10242 + categories wikitext text/x-wiki {{title|Wanting and liking: What are the similarities and differences between wanting and liking, and what are the implications?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== You are underway {{smile}}! This template provides tips for [[Motivation and emotion/Assessment/Topic|topic development]]. Gradually remove these suggestions as you develop the chapter. Also consult the [[Motivation and emotion/Assessment/Chapter|author guidelines]]. At the top of the chapter, the title and sub-title should match the ''exact'' wording and casing as shown in the {{Motivation and emotion/Book}}. The sub-titles all end with a question mark. This Overview section should be concise but consist of several paragraphs which engage the reader, illustrate the problem, and outline how psychological science can help. {{RoundBoxTop|theme=3}} '''Focus questions:''' * What is the first focus question? * What is the second focus question? * What is the third focus question? {{RoundBoxBottom}} {{tip| Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Provide an example or case study. * Conclude with Focus questions to guide the chapter. }} == The ‘Liking vs Wanting’ distinction == How you are going to structure the chapter? Aim for three to six main headings between the [[#Overview|Overview]] and [[#Conclusion|Conclusion]]. {{tip|Suggestions for this section: * For the [[Motivation and emotion/Assessment/Topic|topic development]], provide at least 3 bullet-points about key content per section. Include key citations. * For the [[Motivation and emotion/Assessment/Chapter|book chapter]], expand the bullet points into paragraphs. * If a section has a lot of content, arrange it into two to five sub-headings such as in the [[#Interactive learning features|interactive learning features section]]. Avoid having sections with only one sub-heading. }} ==Liking== What brings an online book chapter to life are its interactive learning features. Case studies, feature boxes, figures, links, tables, and quiz questions can be used throughout the chapter. ===Case studies=== Case studies describe real-world examples of concepts in action. Case studies can be real or fictional. A case could be used multiple times during a chapter to illustrate different theories or stages. It is often helpful to present case studies using [[#Feature boxes|feature boxes]]. ===Boxes=== Boxes can be used to highlight content, but don't overuse them. There are many different ways of creating boxes (e.g., see [[Help:Pretty boxes|Pretty boxes]]). Possible uses include: * Focus questions * Case studies or examples * Quiz questions * Take-home messages {{RoundBoxTop|theme=3}} ;Feature box example * Shaded background * Coloured border {{RoundBoxBottom}} ===Figures=== [[File:Monkey-typing.jpg|right|205px|thumb|''Figure 1''. Example image with descriptive caption.]] Use figures to illustrate concepts, add interest, and provide examples. Figures can be used to show photographs, drawings, diagrams, graphs, etcetera. Figures can be embedded throughout the chapter, starting with the Overview section. Figures should be captioned (using a number and a description) in order to explain their relevance to the text. Possible images can be found at [[commons:|Wikimedia Commons]]. Images can also be uploaded if they are licensed for re-use or if you created the image. Each figure should be referred to at least once in the main text (e.g., see Figure 1). ===Links=== Where key words are first used, make them into [[Help:Links|interwiki links]] such as Wikipedia links to articles about famous people (e.g., [[w:Sigmund Freud|Sigmund Freud]] and key concepts (e.g., [[w:Dreams|dreams]]) and links to book chapters about related topics (e.g., would you like to learn about how to overcome [[Motivation and emotion/Book/2020/Writer's block|writer's block]]?). ===Tables=== Tables can be an effective way to organise and summarise information. Tables should be captioned (using APA style) to explain their relevance to the text. Plus each table should be referred to at least once in the main text (e.g., see Table 1 and Table 2). Here are some [[Motivation and emotion/Wikiversity/Tables|example 3 x 3 tables]] which could be adapted. ===Quizzes=== Quizzes are a direct way to engage readers. But don't make quizzes too hard or long. It is better to have one or two review questions per major section than a long quiz at the end. Try to quiz conceptual understanding, rather than trivia. Here are some simple quiz questions which could be adapted. Choose the correct answers and click "Submit": <quiz display=simple> {Quizzes are an interactive learning feature: |type="()"} + True - False {Long quizzes are a good idea: |type="()"} - True + False </quiz> To learn about different types of quiz questions, see [[Help:Quiz|Quiz]]. == Wanting == === blah === === blah === === blah === ==Conclusion== The Conclusion is arguably the most important section. It should be possible for someone to read the [[#Overview|Overview]] and the Conclusion and still get a good idea of the topic. {{tip|Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? }} ==See also== Provide up to half-a-dozen [[Help:Contents/Links#Interwiki_links|internal (wiki) links]] to relevant Wikiversity pages (esp. related [[Motivation and emotion/Book|motivation and emotion book chapters]]) and [[w:|Wikipedia articles]]. For example: * [[Motivation and emotion/Book/2016/Anorexia nervosa and extrinsic motivation|Anorexia nervosa and extrinsic motivation]] (Book chapter, 2016) * [[w:David McClelland|David McClelland]] (Wikipedia) * [[Motivation and emotion/Book/2018/Loss aversion|Loss aversion]] (Book chapter, 2018) * [[w:Maslow's hierarchy of needs|Maslow's hierarchy of needs]] (Wikipedia) {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== List the cited references in [[w:APA style|APA style]] (7th ed.) or [[w:Wikipedia:Citing sources|wiki style]]. APA style example: {{Hanging indent|1= Blair, R. J. R. (2004). The roles of orbital frontal cortex in the modulation of antisocial behavior. ''Brain and Cognition'', ''55''(1), 198–208. https://doi.org/10.1016/S0278-2626(03)00276-8 Buckholtz, J. W., & Meyer-Lindenberg, A. (2008). MAOA and the neurogenetic architecture of human aggression. ''Trends in Neurosciences'', ''31''(3), 120–129. https://doi.org/10.1016/j.tins.2007.12.006 Eckardt, M., File, S., Gessa, G., Grant, K., Guerri, C., Hoffman, P., & Tabakoff, B. (1998). Effects of moderate alcohol consumption on the central nervous system. ''Alcoholism, Clinical and Experimental Research'', ''22''(5), 998–1040. https://doi.org/10.1111/j.1530-0277.1998.tb03695.x }} {{tip|Suggestions for this section: * Important aspects for APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except first letter and proper names, ending in a full-stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full-stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't actually read or consulted }} ==External links== Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * [https://students.unimelb.edu.au/academic-skills/explore-our-resources/essay-writing/six-top-tips-for-writing-a-great-essay Six top tips for writing a great essay] (University of Melbourne) * [http://www.skillsyouneed.com/write/structure.html The importance of structure] (skillsyouneed.com) {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] [[Category:Motivation and emotion/Book/Liking]] [[Category:Motivation and emotion/Book/Wanting]] evvkqp0uo8gz3bc8518kf0mj7cbv0g6 2419090 2419089 2022-08-25T22:23:56Z Jtneill 10242 wikitext text/x-wiki {{title|Wanting and liking:<br>What are the similarities and differences between wanting and liking, and what are the implications?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== You are underway {{smile}}! This template provides tips for [[Motivation and emotion/Assessment/Topic|topic development]]. Gradually remove these suggestions as you develop the chapter. Also consult the [[Motivation and emotion/Assessment/Chapter|author guidelines]]. At the top of the chapter, the title and sub-title should match the ''exact'' wording and casing as shown in the {{Motivation and emotion/Book}}. The sub-titles all end with a question mark. This Overview section should be concise but consist of several paragraphs which engage the reader, illustrate the problem, and outline how psychological science can help. {{RoundBoxTop|theme=3}} '''Focus questions:''' * What is the first focus question? * What is the second focus question? * What is the third focus question? {{RoundBoxBottom}} {{tip| Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Provide an example or case study. * Conclude with Focus questions to guide the chapter. }} == The ‘Liking vs Wanting’ distinction == How you are going to structure the chapter? Aim for three to six main headings between the [[#Overview|Overview]] and [[#Conclusion|Conclusion]]. {{tip|Suggestions for this section: * For the [[Motivation and emotion/Assessment/Topic|topic development]], provide at least 3 bullet-points about key content per section. Include key citations. * For the [[Motivation and emotion/Assessment/Chapter|book chapter]], expand the bullet points into paragraphs. * If a section has a lot of content, arrange it into two to five sub-headings such as in the [[#Interactive learning features|interactive learning features section]]. Avoid having sections with only one sub-heading. }} ==Liking== What brings an online book chapter to life are its interactive learning features. Case studies, feature boxes, figures, links, tables, and quiz questions can be used throughout the chapter. ===Case studies=== Case studies describe real-world examples of concepts in action. Case studies can be real or fictional. A case could be used multiple times during a chapter to illustrate different theories or stages. It is often helpful to present case studies using [[#Feature boxes|feature boxes]]. ===Boxes=== Boxes can be used to highlight content, but don't overuse them. There are many different ways of creating boxes (e.g., see [[Help:Pretty boxes|Pretty boxes]]). Possible uses include: * Focus questions * Case studies or examples * Quiz questions * Take-home messages {{RoundBoxTop|theme=3}} ;Feature box example * Shaded background * Coloured border {{RoundBoxBottom}} ===Figures=== [[File:Monkey-typing.jpg|right|205px|thumb|''Figure 1''. Example image with descriptive caption.]] Use figures to illustrate concepts, add interest, and provide examples. Figures can be used to show photographs, drawings, diagrams, graphs, etcetera. Figures can be embedded throughout the chapter, starting with the Overview section. Figures should be captioned (using a number and a description) in order to explain their relevance to the text. Possible images can be found at [[commons:|Wikimedia Commons]]. Images can also be uploaded if they are licensed for re-use or if you created the image. Each figure should be referred to at least once in the main text (e.g., see Figure 1). ===Links=== Where key words are first used, make them into [[Help:Links|interwiki links]] such as Wikipedia links to articles about famous people (e.g., [[w:Sigmund Freud|Sigmund Freud]] and key concepts (e.g., [[w:Dreams|dreams]]) and links to book chapters about related topics (e.g., would you like to learn about how to overcome [[Motivation and emotion/Book/2020/Writer's block|writer's block]]?). ===Tables=== Tables can be an effective way to organise and summarise information. Tables should be captioned (using APA style) to explain their relevance to the text. Plus each table should be referred to at least once in the main text (e.g., see Table 1 and Table 2). Here are some [[Motivation and emotion/Wikiversity/Tables|example 3 x 3 tables]] which could be adapted. ===Quizzes=== Quizzes are a direct way to engage readers. But don't make quizzes too hard or long. It is better to have one or two review questions per major section than a long quiz at the end. Try to quiz conceptual understanding, rather than trivia. Here are some simple quiz questions which could be adapted. Choose the correct answers and click "Submit": <quiz display=simple> {Quizzes are an interactive learning feature: |type="()"} + True - False {Long quizzes are a good idea: |type="()"} - True + False </quiz> To learn about different types of quiz questions, see [[Help:Quiz|Quiz]]. == Wanting == === blah === === blah === === blah === ==Conclusion== The Conclusion is arguably the most important section. It should be possible for someone to read the [[#Overview|Overview]] and the Conclusion and still get a good idea of the topic. {{tip|Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? }} ==See also== Provide up to half-a-dozen [[Help:Contents/Links#Interwiki_links|internal (wiki) links]] to relevant Wikiversity pages (esp. related [[Motivation and emotion/Book|motivation and emotion book chapters]]) and [[w:|Wikipedia articles]]. For example: * [[Motivation and emotion/Book/2016/Anorexia nervosa and extrinsic motivation|Anorexia nervosa and extrinsic motivation]] (Book chapter, 2016) * [[w:David McClelland|David McClelland]] (Wikipedia) * [[Motivation and emotion/Book/2018/Loss aversion|Loss aversion]] (Book chapter, 2018) * [[w:Maslow's hierarchy of needs|Maslow's hierarchy of needs]] (Wikipedia) {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== List the cited references in [[w:APA style|APA style]] (7th ed.) or [[w:Wikipedia:Citing sources|wiki style]]. APA style example: {{Hanging indent|1= Blair, R. J. R. (2004). The roles of orbital frontal cortex in the modulation of antisocial behavior. ''Brain and Cognition'', ''55''(1), 198–208. https://doi.org/10.1016/S0278-2626(03)00276-8 Buckholtz, J. W., & Meyer-Lindenberg, A. (2008). MAOA and the neurogenetic architecture of human aggression. ''Trends in Neurosciences'', ''31''(3), 120–129. https://doi.org/10.1016/j.tins.2007.12.006 Eckardt, M., File, S., Gessa, G., Grant, K., Guerri, C., Hoffman, P., & Tabakoff, B. (1998). Effects of moderate alcohol consumption on the central nervous system. ''Alcoholism, Clinical and Experimental Research'', ''22''(5), 998–1040. https://doi.org/10.1111/j.1530-0277.1998.tb03695.x }} {{tip|Suggestions for this section: * Important aspects for APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except first letter and proper names, ending in a full-stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full-stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't actually read or consulted }} ==External links== Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * [https://students.unimelb.edu.au/academic-skills/explore-our-resources/essay-writing/six-top-tips-for-writing-a-great-essay Six top tips for writing a great essay] (University of Melbourne) * [http://www.skillsyouneed.com/write/structure.html The importance of structure] (skillsyouneed.com) {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] [[Category:Motivation and emotion/Book/Liking]] [[Category:Motivation and emotion/Book/Wanting]] o1o7m0mcgoc78mm1stkqujno9gtitk4 2 286188 2419349 2417254 2022-08-26T07:14:15Z U3215976 2947554 /* Social Contributions */ wikitext text/x-wiki Hello, I am a student of '''[[w:Psychology|Psychology]]''' at the ''[https://www.canberra.edu.au/future-students/?ef_id=CjwKCAjwi8iXBhBeEiwAKbUofV30BVaJPsDkgQ0xdtyJNdLiFDAd6pFhk9AOU1wCVoYTOdQP-gRGDxoCp4AQAvD_BwE:G:s&s_kwcid=AL!10441!3!589066594450!e!!g!!university%20of%20canberra!12340014388!118571458020&gclid=CjwKCAjwi8iXBhBeEiwAKbUofV30BVaJPsDkgQ0xdtyJNdLiFDAd6pFhk9AOU1wCVoYTOdQP-gRGDxoCp4AQAvD_BwE University of Canberra]''. I am currently studying a bachelor of science in psychology and I am in my second year of study. I am studying [[motivation and emotion]]. == About me: == I love skiing, snowboarding and riding mountain bikes. I have a keen interest in psychology. and I am keen to pursue post-graduate study after finishing my undergrad studies. == Book Chapter in progress == [[Motivation and emotion/Book/2022/Social cure|The Social Cure]] - What is the social cure and how can it be applied? U3215976 == Social Contributions == Book Chapter Edit - Climate Change Helplessness - [https://en.wikiversity.org/w/index.php?title=Motivation_and_emotion/Book/2022/Climate_change_helplessness&diff=2419340&oldid=2419332 Spelling fix in the main title] 26/08/2022 Book Chapter Edit - Climate Change Helplessness - [https://en.wikiversity.org/w/index.php?title=Motivation_and_emotion/Book/2022/Climate_change_helplessness&diff=2419344&oldid=2419340 Potential third main title] 26/08/2022 Book Chapter Edit - Climate Change Helplessness - [https://en.wikiversity.org/w/index.php?title=Motivation_and_emotion/Book/2022/Climate_change_helplessness&diff=2419347&oldid=2419344 Potential focus questions] 26/08/2022 == Hobbies == [[File:Klammer Franz 049.jpg|alt=Skiing|thumb|Figure 1. Downhill ski racing]] * [[wikipedia:Skiing|Skiing]] * Snowboarding * Downhill * Soccer sp2luwcoiv592kkxjg6tfsfof2fyhgq 2419351 2419349 2022-08-26T07:15:16Z U3215976 2947554 wikitext text/x-wiki Hello, I am a student of '''[[w:Psychology|Psychology]]''' at the ''[https://www.canberra.edu.au/future-students/?ef_id=CjwKCAjwi8iXBhBeEiwAKbUofV30BVaJPsDkgQ0xdtyJNdLiFDAd6pFhk9AOU1wCVoYTOdQP-gRGDxoCp4AQAvD_BwE:G:s&s_kwcid=AL!10441!3!589066594450!e!!g!!university%20of%20canberra!12340014388!118571458020&gclid=CjwKCAjwi8iXBhBeEiwAKbUofV30BVaJPsDkgQ0xdtyJNdLiFDAd6pFhk9AOU1wCVoYTOdQP-gRGDxoCp4AQAvD_BwE University of Canberra]''. I am currently studying a bachelor of science in psychology and I am in my second year of study. I am studying [[motivation and emotion]]. == About me: == I love skiing, snowboarding and riding mountain bikes. I have a keen interest in psychology. and I am keen to pursue post-graduate study after finishing my undergrad studies. == Book Chapter in progress == [[Motivation and emotion/Book/2022/Social cure|The Social Cure]] - [[Motivation and emotion/Book/2022/Social cure|What is the social cure and how can it be applied?]] U3215976 == Social Contributions == Book Chapter Edit - Climate Change Helplessness - [https://en.wikiversity.org/w/index.php?title=Motivation_and_emotion/Book/2022/Climate_change_helplessness&diff=2419340&oldid=2419332 Spelling fix in the main title] 26/08/2022 Book Chapter Edit - Climate Change Helplessness - [https://en.wikiversity.org/w/index.php?title=Motivation_and_emotion/Book/2022/Climate_change_helplessness&diff=2419344&oldid=2419340 Potential third main title] 26/08/2022 Book Chapter Edit - Climate Change Helplessness - [https://en.wikiversity.org/w/index.php?title=Motivation_and_emotion/Book/2022/Climate_change_helplessness&diff=2419347&oldid=2419344 Potential focus questions] 26/08/2022 == Hobbies == [[File:Klammer Franz 049.jpg|alt=Skiing|thumb|Figure 1. Downhill ski racing]] * [[wikipedia:Skiing|Skiing]] * Snowboarding * Downhill * Soccer ersuued534m6eo58px4vxnujnhhbnpv 2 286192 2419343 2418996 2022-08-26T07:07:24Z Icantchooseone 2947542 /* Book Chapter - I'm working on */ wikitext text/x-wiki == '''About me''' == I am currently a [[w:Psychology|psychology]] student at the [https://www.canberra.edu.au University of Canberra]. In the future, I hope to become a clinical psychologist specialising in Autism Spectrum Disorder (ASD) and Post Traumatic Stress Disorder (PTSD). I'm undertaking [[Motivation and emotion|Motivation and Emotion]] and developing a book chapter. == '''Book Chapter''' - I'm working on == * [[Motivation and emotion/Book/2022/Fear|Fear - What is fear, what causes it, and how can it be managed?]] (See Figure 1) [[File:Scared man.png|thumb|alt=man is scared|Figure 1: Fear is one of the core emotions.]] == '''Social contributions''' == # [https://en.wikiversity.org/w/index.php?title=Motivation_and_emotion/Book/2022/Academic_self-regulation&diff=prev&oldid=2413323 Added template and titles to Academic self-regulation chapter] == '''Hobbies''' == * snowboarding * badminton * painting * puzzle 8chxkuijlko0dg8g8nrlbr2qmpavjql 2419390 2419343 2022-08-26T07:55:33Z Icantchooseone 2947542 /* Social contributions */ wikitext text/x-wiki == '''About me''' == I am currently a [[w:Psychology|psychology]] student at the [https://www.canberra.edu.au University of Canberra]. In the future, I hope to become a clinical psychologist specialising in Autism Spectrum Disorder (ASD) and Post Traumatic Stress Disorder (PTSD). I'm undertaking [[Motivation and emotion|Motivation and Emotion]] and developing a book chapter. == '''Book Chapter''' - I'm working on == * [[Motivation and emotion/Book/2022/Fear|Fear - What is fear, what causes it, and how can it be managed?]] (See Figure 1) [[File:Scared man.png|thumb|alt=man is scared|Figure 1: Fear is one of the core emotions.]] == '''Social contributions''' == # [https://en.wikiversity.org/w/index.php?title=Motivation_and_emotion/Book/2022/Academic_self-regulation&diff=prev&oldid=2413323 Added template and titles to Academic self-regulation chapter] # [https://en.wikiversity.org/w/index.php?title=Motivation_and_emotion/Book/2022/Fully_functioning_person&diff=prev&oldid=2419386 fixed spelling mistake on Fully functioning person] # [https://en.wikiversity.org/w/index.php?title=Motivation_and_emotion/Book/2022/Fully_functioning_person&diff=prev&oldid=2419385 added an external link to Fully functioning person] == '''Hobbies''' == * snowboarding * badminton * painting * puzzle pe76dmt9x02c3uh4h8svpzkm141g9je 0 286194 2419098 2416940 2022-08-25T22:42:39Z Jtneill 10242 + category wikitext text/x-wiki {{title|The wave metaphor for emotion:<br> In what respects is an ocean wave a helpful metaphor for understanding human emotions?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC____TOC__ ==Overview== * The wave metaphor for [[wikipedia:Emotion|emotion]]<nowiki/>s is a way to conceptualise emotions in a physical way. * In summary the metaphor discusses the representation of the inner movement that emotions create. * emotions vary light and calm or heavy and angry * Uncontrollable movements and unpreventable * also referred to as "Riding the wave" * there are many different interpretations of the metaphor This template provides tips for [[Motivation and emotion/Assessment/Topic|topic development]]. Gradually remove these suggestions as you develop the chapter. Also consult the [[Motivation and emotion/Assessment/Chapter|author guidelines]]. At the top of the chapter, the title and sub-title should match the ''exact'' wording and casing as shown in the {{Motivation and emotion/Book}}. The sub-titles all end with a question mark. This Overview section should be concise but consist of several paragraphs which engage the reader, illustrate the problem, and outline how psychological science can help. {{RoundBoxTop|theme=3}} '''Focus questions:''' * What is the wave metaphor? * What are emotions? * How can this metaphor be used with psychological theories? {{RoundBoxBottom}} {{tip| Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Provide an example or case study. * Conclude with Focus questions to guide the chapter. }} ==History== How you are going to structure the chapter? Aim for three to six main headings between the [[#Overview|Overview]] and [[#Conclusion|Conclusion]]. {{tip|Suggestions for this section: * For the [[Motivation and emotion/Assessment/Topic|topic development]], provide at least 3 bullet-points about key content per section. Include key citations. * For the [[Motivation and emotion/Assessment/Chapter|book chapter]], expand the bullet points into paragraphs. * If a section has a lot of content, arrange it into two to five sub-headings such as in the [[#Interactive learning features|interactive learning features section]]. Avoid having sections with only one sub-heading. }} ==Learning features== What brings an online book chapter to life are its interactive learning features. Case studies, feature boxes, figures, links, tables, and quiz questions can be used throughout the chapter. ===Case studies=== Case studies describe real-world examples of concepts in action. Case studies can be real or fictional. A case could be used multiple times during a chapter to illustrate different theories or stages. It is often helpful to present case studies using [[#Feature boxes|feature boxes]]. ===Boxes=== Boxes can be used to highlight content, but don't overuse them. There are many different ways of creating boxes (e.g., see [[Help:Pretty boxes|Pretty boxes]]). Possible uses include: * Focus questions * Case studies or examples * Quiz questions * Take-home messages {{RoundBoxTop|theme=3}} ;Feature box example * Shaded background * Coloured border {{RoundBoxBottom}} ===Figures=== [[File:Monkey-typing.jpg|right|205px|thumb|''Figure 1''. Example image with descriptive caption.]] Use figures to illustrate concepts, add interest, and provide examples. Figures can be used to show photographs, drawings, diagrams, graphs, etcetera. Figures can be embedded throughout the chapter, starting with the Overview section. Figures should be captioned (using a number and a description) in order to explain their relevance to the text. Possible images can be found at [[commons:|Wikimedia Commons]]. Images can also be uploaded if they are licensed for re-use or if you created the image. Each figure should be referred to at least once in the main text (e.g., see Figure 1). ===Links=== Where key words are first used, make them into [[Help:Links|interwiki links]] such as Wikipedia links to articles about famous people (e.g., [[w:Sigmund Freud|Sigmund Freud]] and key concepts (e.g., [[w:Dreams|dreams]]) and links to book chapters about related topics (e.g., would you like to learn about how to overcome [[Motivation and emotion/Book/2020/Writer's block|writer's block]]?). ===Tables=== Tables can be an effective way to organise and summarise information. Tables should be captioned (using APA style) to explain their relevance to the text. Plus each table should be referred to at least once in the main text (e.g., see Table 1 and Table 2). Here are some [[Motivation and emotion/Wikiversity/Tables|example 3 x 3 tables]] which could be adapted. ===Quizzes=== Quizzes are a direct way to engage readers. But don't make quizzes too hard or long. It is better to have one or two review questions per major section than a long quiz at the end. Try to quiz conceptual understanding, rather than trivia. Here are some simple quiz questions which could be adapted. Choose the correct answers and click "Submit": <quiz display=simple> {Quizzes are an interactive learning feature: |type="()"} + True - False {Long quizzes are a good idea: |type="()"} - True + False </quiz> To learn about different types of quiz questions, see [[Help:Quiz|Quiz]]. ==Conclusion== The Conclusion is arguably the most important section. It should be possible for someone to read the [[#Overview|Overview]] and the Conclusion and still get a good idea of the topic. {{tip|Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? }} ==See also== Provide up to half-a-dozen [[Help:Contents/Links#Interwiki_links|internal (wiki) links]] to relevant Wikiversity pages (esp. related [[Motivation and emotion/Book|motivation and emotion book chapters]]) and [[w:|Wikipedia articles]]. For example: * [[Motivation and emotion/Book/2016/Anorexia nervosa and extrinsic motivation|Anorexia nervosa and extrinsic motivation]] (Book chapter, 2016) * [[w:David McClelland|David McClelland]] (Wikipedia) * [[Motivation and emotion/Book/2018/Loss aversion|Loss aversion]] (Book chapter, 2018) * [[w:Maslow's hierarchy of needs|Maslow's hierarchy of needs]] (Wikipedia) {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== List the cited references in [[w:APA style|APA style]] (7th ed.) or [[w:Wikipedia:Citing sources|wiki style]]. APA style example: {{Hanging indent|1= Blair, R. J. R. (2004). The roles of orbital frontal cortex in the modulation of antisocial behavior. ''Brain and Cognition'', ''55''(1), 198–208. https://doi.org/10.1016/S0278-2626(03)00276-8 Buckholtz, J. W., & Meyer-Lindenberg, A. (2008). MAOA and the neurogenetic architecture of human aggression. ''Trends in Neurosciences'', ''31''(3), 120–129. https://doi.org/10.1016/j.tins.2007.12.006 Eckardt, M., File, S., Gessa, G., Grant, K., Guerri, C., Hoffman, P., & Tabakoff, B. (1998). Effects of moderate alcohol consumption on the central nervous system. ''Alcoholism, Clinical and Experimental Research'', ''22''(5), 998–1040. https://doi.org/10.1111/j.1530-0277.1998.tb03695.x }} {{tip|Suggestions for this section: * Important aspects for APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except first letter and proper names, ending in a full-stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full-stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't actually read or consulted }} ==External links== Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * [https://students.unimelb.edu.au/academic-skills/explore-our-resources/essay-writing/six-top-tips-for-writing-a-great-essay Six top tips for writing a great essay] (University of Melbourne) * [http://www.skillsyouneed.com/write/structure.html The importance of structure] (skillsyouneed.com) {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] This template provides tips for [[Motivation and emotion/Assessment/Topic|topic development]]. Gradually remove these suggestions as you develop the chapter. Also consult the [[Motivation and emotion/Assessment/Chapter|author guidelines]]. At the top of the chapter, the title and sub-title should match the ''exact'' wording and casing as shown in the {{Motivation and emotion/Book}}. The sub-titles all end with a question mark. This Overview section should be concise but consist of several paragraphs which engage the reader, illustrate the problem, and outline how psychological science can help. {{RoundBoxTop|theme=3}} '''Focus questions:''' * What is the first focus question? * What is the second focus question? * What is the third focus question? {{RoundBoxBottom}} {{tip| Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Provide an example or case study. * Conclude with Focus questions to guide the chapter. }} ==Main headings== How you are going to structure the chapter? Aim for three to six main headings between the [[#Overview|Overview]] and [[#Conclusion|Conclusion]]. {{tip|Suggestions for this section: * For the [[Motivation and emotion/Assessment/Topic|topic development]], provide at least 3 bullet-points about key content per section. Include key citations. * For the [[Motivation and emotion/Assessment/Chapter|book chapter]], expand the bullet points into paragraphs. * If a section has a lot of content, arrange it into two to five sub-headings such as in the [[#Interactive learning features|interactive learning features section]]. Avoid having sections with only one sub-heading. }} ==Learning features== What brings an online book chapter to life are its interactive learning features. Case studies, feature boxes, figures, links, tables, and quiz questions can be used throughout the chapter. ===Case studies=== Case studies describe real-world examples of concepts in action. Case studies can be real or fictional. A case could be used multiple times during a chapter to illustrate different theories or stages. It is often helpful to present case studies using [[#Feature boxes|feature boxes]]. ===Boxes=== Boxes can be used to highlight content, but don't overuse them. There are many different ways of creating boxes (e.g., see [[Help:Pretty boxes|Pretty boxes]]). Possible uses include: * Focus questions * Case studies or examples * Quiz questions * Take-home messages {{RoundBoxTop|theme=3}} ;Feature box example * Shaded background * Coloured border {{RoundBoxBottom}} ===Figures=== [[File:Monkey-typing.jpg|right|205px|thumb|''Figure 1''. Example image with descriptive caption.]] Use figures to illustrate concepts, add interest, and provide examples. Figures can be used to show photographs, drawings, diagrams, graphs, etcetera. Figures can be embedded throughout the chapter, starting with the Overview section. Figures should be captioned (using a number and a description) in order to explain their relevance to the text. Possible images can be found at [[commons:|Wikimedia Commons]]. Images can also be uploaded if they are licensed for re-use or if you created the image. Each figure should be referred to at least once in the main text (e.g., see Figure 1). ===Links=== Where key words are first used, make them into [[Help:Links|interwiki links]] such as Wikipedia links to articles about famous people (e.g., [[w:Sigmund Freud|Sigmund Freud]] and key concepts (e.g., [[w:Dreams|dreams]]) and links to book chapters about related topics (e.g., would you like to learn about how to overcome [[Motivation and emotion/Book/2020/Writer's block|writer's block]]?). ===Tables=== Tables can be an effective way to organise and summarise information. Tables should be captioned (using APA style) to explain their relevance to the text. Plus each table should be referred to at least once in the main text (e.g., see Table 1 and Table 2). Here are some [[Motivation and emotion/Wikiversity/Tables|example 3 x 3 tables]] which could be adapted. ===Quizzes=== Quizzes are a direct way to engage readers. But don't make quizzes too hard or long. It is better to have one or two review questions per major section than a long quiz at the end. Try to quiz conceptual understanding, rather than trivia. Here are some simple quiz questions which could be adapted. Choose the correct answers and click "Submit": <quiz display=simple> {Quizzes are an interactive learning feature: |type="()"} + True - False {Long quizzes are a good idea: |type="()"} - True + False </quiz> To learn about different types of quiz questions, see [[Help:Quiz|Quiz]]. ==Conclusion== The Conclusion is arguably the most important section. It should be possible for someone to read the [[#Overview|Overview]] and the Conclusion and still get a good idea of the topic. {{tip|Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? }} ==See also== Provide up to half-a-dozen [[Help:Contents/Links#Interwiki_links|internal (wiki) links]] to relevant Wikiversity pages (esp. related [[Motivation and emotion/Book|motivation and emotion book chapters]]) and [[w:|Wikipedia articles]]. For example: * [[Motivation and emotion/Book/2016/Anorexia nervosa and extrinsic motivation|Anorexia nervosa and extrinsic motivation]] (Book chapter, 2016) * [[w:David McClelland|David McClelland]] (Wikipedia) * [[Motivation and emotion/Book/2018/Loss aversion|Loss aversion]] (Book chapter, 2018) * [[w:Maslow's hierarchy of needs|Maslow's hierarchy of needs]] (Wikipedia) {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== List the cited references in [[w:APA style|APA style]] (7th ed.) or [[w:Wikipedia:Citing sources|wiki style]]. APA style example: {{Hanging indent|1= Blair, R. J. R. (2004). The roles of orbital frontal cortex in the modulation of antisocial behavior. ''Brain and Cognition'', ''55''(1), 198–208. https://doi.org/10.1016/S0278-2626(03)00276-8 Buckholtz, J. W., & Meyer-Lindenberg, A. (2008). MAOA and the neurogenetic architecture of human aggression. ''Trends in Neurosciences'', ''31''(3), 120–129. https://doi.org/10.1016/j.tins.2007.12.006 Eckardt, M., File, S., Gessa, G., Grant, K., Guerri, C., Hoffman, P., & Tabakoff, B. (1998). Effects of moderate alcohol consumption on the central nervous system. ''Alcoholism, Clinical and Experimental Research'', ''22''(5), 998–1040. https://doi.org/10.1111/j.1530-0277.1998.tb03695.x }} {{tip|Suggestions for this section: * Important aspects for APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except first letter and proper names, ending in a full-stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full-stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't actually read or consulted }} ==External links== Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * [https://students.unimelb.edu.au/academic-skills/explore-our-resources/essay-writing/six-top-tips-for-writing-a-great-essay Six top tips for writing a great essay] (University of Melbourne) * [http://www.skillsyouneed.com/write/structure.html The importance of structure] (skillsyouneed.com) {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] [[Category:Motivation and emotion/Book/Emotion]] oonhlunz2cyqyf8lbjucofj6m8x8im4 0 286198 2419093 2418197 2022-08-25T22:32:15Z Jtneill 10242 + category wikitext text/x-wiki {{title|Hedonic adaptation prevention model:<br>What is the HAP model and how can it be applied?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== You are underway {{smile}}! This template provides tips for [[Motivation and emotion/Assessment/Topic|topic development]]. Gradually remove these suggestions as you develop the chapter. Also consult the [[Motivation and emotion/Assessment/Chapter|author guidelines]]. This Overview section should be concise but consist of several paragraphs which engage the reader, illustrate the problem, and outline how psychological science can help. {{RoundBoxTop|theme=3}} '''Focus questions:''' * What is the Hedonic Adaptation Prevention (HAP) model? * How can the HAP model be applied? {{RoundBoxBottom}} {{tip| Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Provide an example or case study. * Conclude with Focus questions to guide the chapter. }} ==Main headings== How you are going to structure the chapter? Aim for three to six main headings between the [[#Overview|Overview]] and [[#Conclusion|Conclusion]]. {{tip|Suggestions for this section: * For the [[Motivation and emotion/Assessment/Topic|topic development]], provide at least 3 bullet-points about key content per section. Include key citations. * For the [[Motivation and emotion/Assessment/Chapter|book chapter]], expand the bullet points into paragraphs. * If a section has a lot of content, arrange it into two to five sub-headings such as in the [[#Interactive learning features|interactive learning features section]]. Avoid having sections with only one sub-heading. }} ==Learning features== What brings an online book chapter to life are its interactive learning features. Case studies, feature boxes, figures, links, tables, and quiz questions can be used throughout the chapter. ===Case studies=== Case studies describe real-world examples of concepts in action. Case studies can be real or fictional. A case could be used multiple times during a chapter to illustrate different theories or stages. It is often helpful to present case studies using [[#Feature boxes|feature boxes]]. ===Boxes=== Boxes can be used to highlight content, but don't overuse them. There are many different ways of creating boxes (e.g., see [[Help:Pretty boxes|Pretty boxes]]). Possible uses include: * Focus questions * Case studies or examples * Quiz questions * Take-home messages {{RoundBoxTop|theme=3}} ;Feature box example * Shaded background * Coloured border {{RoundBoxBottom}} ===Figures=== [[File:Monkey-typing.jpg|right|205px|thumb|''Figure 1''. Example image with descriptive caption.]] Use figures to illustrate concepts, add interest, and provide examples. Figures can be used to show photographs, drawings, diagrams, graphs, etcetera. Figures can be embedded throughout the chapter, starting with the Overview section. Figures should be captioned (using a number and a description) in order to explain their relevance to the text. Possible images can be found at [[commons:|Wikimedia Commons]]. Images can also be uploaded if they are licensed for re-use or if you created the image. Each figure should be referred to at least once in the main text (e.g., see Figure 1). ===Links=== Where key words are first used, make them into [[Help:Links|interwiki links]] such as Wikipedia links to articles about famous people (e.g., [[w:Sigmund Freud|Sigmund Freud]] and key concepts (e.g., [[w:Dreams|dreams]]) and links to book chapters about related topics (e.g., would you like to learn about how to overcome [[Motivation and emotion/Book/2020/Writer's block|writer's block]]?). ===Tables=== Tables can be an effective way to organise and summarise information. Tables should be captioned (using APA style) to explain their relevance to the text. Plus each table should be referred to at least once in the main text (e.g., see Table 1 and Table 2). Here are some [[Motivation and emotion/Wikiversity/Tables|example 3 x 3 tables]] which could be adapted. ===Quizzes=== Quizzes are a direct way to engage readers. But don't make quizzes too hard or long. It is better to have one or two review questions per major section than a long quiz at the end. Try to quiz conceptual understanding, rather than trivia. Here are some simple quiz questions which could be adapted. Choose the correct answers and click "Submit": <quiz display=simple> {Quizzes are an interactive learning feature: |type="()"} + True - False {Long quizzes are a good idea: |type="()"} - True + False </quiz> To learn about different types of quiz questions, see [[Help:Quiz|Quiz]]. ==Conclusion== The Conclusion is arguably the most important section. It should be possible for someone to read the [[#Overview|Overview]] and the Conclusion and still get a good idea of the topic. {{tip|Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? }} ==See also== Provide up to half-a-dozen [[Help:Contents/Links#Interwiki_links|internal (wiki) links]] to relevant Wikiversity pages (esp. related [[Motivation and emotion/Book|motivation and emotion book chapters]]) and [[w:|Wikipedia articles]]. For example: * [[Motivation and emotion/Book/2016/Anorexia nervosa and extrinsic motivation|Anorexia nervosa and extrinsic motivation]] (Book chapter, 2016) * [[w:David McClelland|David McClelland]] (Wikipedia) * [[Motivation and emotion/Book/2018/Loss aversion|Loss aversion]] (Book chapter, 2018) * [[w:Maslow's hierarchy of needs|Maslow's hierarchy of needs]] (Wikipedia) {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== Bao, K. J., & Lyubomirsky, S. (2014). Making happiness last: Using the hedonic adaptation prevention model to extend the success of positive interventions. ''The Wiley Blackwell handbook of positive psychological interventions'', 373-384. ==External links== Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * [https://students.unimelb.edu.au/academic-skills/explore-our-resources/essay-writing/six-top-tips-for-writing-a-great-essay Six top tips for writing a great essay] (University of Melbourne) * [http://www.skillsyouneed.com/write/structure.html The importance of structure] (skillsyouneed.com) {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] [[Category:Motivation and emotion/Book/Pleasure]] dob17fcsnr5r6w53olheg3c5phpn2co 2 286215 2419477 2418261 2022-08-26T11:00:10Z GeorgiaFairweather 2947505 /* Social Contributions */ wikitext text/x-wiki == About me == My name is Georgia Fairweather and I am a 3rd year university student at [https://www.youtube.com UC]. I am studying a double degree of [[Psychology]] and [[Business|Business.]] This semester I am enrolled in [[Motivation and emotion|Motivation and Emotion.]] == Hobbies == If I am not studying or working you will find me walking my labrador and sausage dog or going for a few cocktails with [[User:U3200859|Zoe,]] another student in this unit. == Book chapter == The book chapter that I am working on is [[Motivation and emotion/Book/2022/Choice overload|Choice Overload.]] == Social Contributions == [[Talk:Motivation and emotion/Book/2022/Humour, leadership, and work#Wording of title of topic]] 0aq0aasoz7mdqfg0yupk5dpn7t66ss0 0 286234 2419474 2418461 2022-08-26T10:50:56Z GeorgiaFairweather 2947505 /* Overview */ wikitext text/x-wiki {{title|Choice Overload<br>What is choice overload? What is the optimal amount of choice? }} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== Why did you choose to select this book chapter to read out of the 184 options readily available to you? Did you feel overwhelmed with the amount of options to read? How many readings would you have preferred to choose from? A [[choice]] is the range of different things from which a being can choose such as the different chapter topics in Motivation and Motivation book for 2022. Making a choice may seem simple however in order to make a choice, people need to have the relevant knowledge and information to evaluate all possible selections (Johns et al., 2013). There has been competing theories and arguments in regards to whether they can be such thing as too much choice. The investigation to answer this complex and arguably transcendent question, a phenomenon known as choice overload was established. Choice overload can also be termed as choice paradox and overchoice. This phenomenon refers to the complex decision-making problems that are caused by the excessive availability of alternatives (Park & Kang, 2022). Therefore, choice overload is directly related to the relationship between the number of alternative choices and an individual’s choice behavior (Park & Jang, 2013). Why is multiple alternative choices a bad thing? Once people perceive the amount choices are too high for ones ability to process them, they are at a higher risk of being overwhelmed (Park & Kang, 2022). * ''Define overwhelmed'' ''What is the problem, why is it important'' ''How can psychological science help, specific emotion or motivation theories'' ''Provide example of case study'' {{RoundBoxTop|theme=3}} '''Focus questions:''' * Is more the more choice the better? * What is the Goldilocks Effect? * How does ones knowledge influence choice perception? {{RoundBoxBottom}} ==Economic Rational Choice Theory == [[File:A tower of used books - 8443.jpg|thumb|266x266px|Multiple books: According to the Economic Rational Choice Theory the increase choice of options should increase satisfaction. ]] The Economic Rational Choice Theory hypotheses that increased choice should increase satisfaction with the chosen option as it increases the likelihood that people can satisfy their personal preferences (Hafner et al., 2018). === Mass Customisation === Mass customization is the new frontier in business in which technology is used to increase a  variety and customisation with products or services without increasing total costs. This is an appealing and strategic advantage for marketing to our society which is consumer driven and provides a positive economic value. * ''Define consumerism'' Park and Kang (2022) states that mass customisation includes a key form of customer involvement, which is the simple concept of making a choice which we will later find, is far more complex. The "more is better" perception for choice supported by the Economic Rational Choice Theory has been transferred into the analysis of consumer behaviour. Economists Benartzi and Thaler (2001) insist that more choices increase people’s willingness to make a choice that eventually maximises utility. Further studies have found that  the greater number of choices determines a greater likelihood of achieving a customers purchase goals, enhances customers’ enjoyment and the hedonic value of purchasing through learning about and comparing product trends (Chernev et al., 2015; Babin et al., 1994). * ''Discuss counter arguments'' === Customer Satisfaction === A positive relationship between customisation and customer satisfaction has been established by multiple studies investigating the phenomenon of choice (Kanama, 2017). This relationship is due the fact that customisation has a positive influence on service quality, trust, and customer loyalty to the service providers thus creating a satisfied customer (Coelho and Henseler, 2012). ==The Goldilocks Effect == The Goldilocks Effect is a theory titled after the popular children's story, [[wikipedia:Goldilocks_and_the_Three_Bears|Goldilocks and the Three Bears]] as Goldilocks preferred her porridge not too hot, nor too cold, but “just right”. Similarly, it is suggested peoples preferences is somewhere in the middle and more satisfied with choices drawn from a midrange choice set in comparison to too little or too much choice (Hafner et al., 2018). {{RoundBoxTop|theme=3}} ;Set Size Example * Small range (2-4 choices) * Midsize range (10-12 choices) * Large range (30-40 choices) {{RoundBoxBottom}} What brings an online book chapter to life are its interactive learning features. Case studies, feature boxes, figures, links, tables, and quiz questions can be used throughout the chapter{{RoundBoxTop|theme=3}} ;Case Study * Research example to be inserted {{RoundBoxBottom}} == Choice and Knowledge == It has been established that the provision of choices influences the decision makers’ motivation, satisfaction, and willingness to act, however, influences on how one interprets and perceives a choice set has not been investigated thus far (Hadar and Sood, 2014). One major influence on how a person interprets and perceives a choice set, is the persons subjective knowledge. Subjective knowledge is the decision makers’ beliefs about their state of knowledge (Hadar and Sood, 2014). ===Quiz=== <quiz display="simple"> {Question One} + True - False {Question Two} - True + False </quiz> == Choice Presentation == Does the presentation of a choice set prevent choice overload? Variety of a choice can make the process more difficult and complex thus the presentation of the choice can also increase or decrease the complexity of the choice (Townsend & Kahn, 2014). Broniarczyk, Hoyer, and McAlister (1998) hypothesised and confirmed that the likelihood that consumers will purchase from a retail site is positively related to the perceived variety that they think the assortment offers, rather than the actual variety. Additionally, Huffman and Kahn (1998) showed that when actual variety in choice sets was large and overwhelming, perceived variety and hence consumer satisfaction could be controlled through both the way information about the options was presented and consumer input in the product examination process. ==Conclusion== - Answer to subtitle - Answer to focus questions - Practical/Take home messages ==See also== * [[Motivation and emotion/Book/2014/University student motivation|University Student Motivation]] (Book chapter, 2014) * [[Facing Facts]] (Beaumont, 2017) == References == {{Hanging indent|1= Hadar, & Sood, S. (2014). When Knowledge Is Demotivating: Subjective Knowledge and Choice Overload. Psychological Science, 25(9), 1739–1747. https://doi.org/10.1177/0956797614539165 Hafner, White, M. P., & Handley, S. J. (2018). The Goldilocks Placebo Effect: Placebo Effects Are Stronger When People Select a Treatment from an Optimal Number of Choices. The American Journal of Psychology, 131(2), 175–184. https://doi.org/10.5406/amerjpsyc.131.2.0175 Park, & Kang, J. (2022). More is not always better: determinants of choice overload and satisfaction with customization in fast casual restaurants. Journal of Hospitality Marketing & Management, 31(2), 205–225. https://doi.org/10.1080/19368623.2021.1946879 Scheibehenne, Greifeneder, R., & Todd, P. M. (2010). Can There Ever Be Too Many Options? A Meta‐Analytic Review of Choice Overload. The Journal of Consumer Research, 37(3), 409–425. https://doi.org/10.1086/651235 Townsend, & Kahn, B. E. (2014). The “Visual Preference Heuristic”: The Influence of Visual versus Verbal Depiction on Assortment Processing, Perceived Variety, and Choice Overload. The Journal of Consumer Research, 40(5), 993–1015. https://doi.org/10.1086/673521}} == External links == [https://www.youtube.com/watch?v=VO6XEQIsCoM The Paradox of Choice] (Schwartz, 2007) [https://www.apa.org/monitor/jun04/toomany Consumerism -- Too many choices?] (American Psychological Association, 2004) [[Category:{{#titleparts:{{PAGENAME}}|3}}]] bmpevob8r8a0b54jxddpynvyffjk56f 0 286247 2419366 2418703 2022-08-26T07:27:12Z Jtneill 10242 + categories wikitext text/x-wiki {{title|Insular cortex and emotion:<br>What role does the insular cortex play in emotion?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== You are underway {{smile}}! [[File:Insula animation small.gif|thumb|Figure 1 - Anatomical position of the insular cortex]] This template provides tips for [[Motivation and emotion/Assessment/Topic|topic development]]. Gradually remove these suggestions as you develop the chapter. Also consult the [[Motivation and emotion/Assessment/Chapter|author guidelines]]. At the top of the chapter, the title and sub-title should match the ''exact'' wording and casing as shown in the {{Motivation and emotion/Book}}. The sub-titles all end with a question mark. This Overview section should be concise but consist of several paragraphs which engage the reader, illustrate the problem, and outline how psychological science can help. {{RoundBoxTop|theme=3}} '''Focus questions:''' * What is the first focus question? * What is the second focus question? * What is the third focus question? {{RoundBoxBottom}} {{tip| Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Provide an example or case study. * Conclude with Focus questions to guide the chapter. }} ==Main headings== How you are going to structure the chapter? Aim for three to six main headings between the [[#Overview|Overview]] and [[#Conclusion|Conclusion]]. {{tip|Suggestions for this section: * For the [[Motivation and emotion/Assessment/Topic|topic development]], provide at least 3 bullet-points about key content per section. Include key citations. * For the [[Motivation and emotion/Assessment/Chapter|book chapter]], expand the bullet points into paragraphs. * If a section has a lot of content, arrange it into two to five sub-headings such as in the [[#Interactive learning features|interactive learning features section]]. Avoid having sections with only one sub-heading. }} ==Learning features== What brings an online book chapter to life are its interactive learning features. Case studies, feature boxes, figures, links, tables, and quiz questions can be used throughout the chapter. ===Case studies=== Case studies describe real-world examples of concepts in action. Case studies can be real or fictional. A case could be used multiple times during a chapter to illustrate different theories or stages. It is often helpful to present case studies using [[#Feature boxes|feature boxes]]. ===Boxes=== Boxes can be used to highlight content, but don't overuse them. There are many different ways of creating boxes (e.g., see [[Help:Pretty boxes|Pretty boxes]]). Possible uses include: * Focus questions * Case studies or examples * Quiz questions * Take-home messages {{RoundBoxTop|theme=3}} ;Feature box example * Shaded background * Coloured border {{RoundBoxBottom}} ===Figures=== [[File:Monkey-typing.jpg|right|205px|thumb|''Figure 1''. Example image with descriptive caption.]] Use figures to illustrate concepts, add interest, and provide examples. Figures can be used to show photographs, drawings, diagrams, graphs, etcetera. Figures can be embedded throughout the chapter, starting with the Overview section. Figures should be captioned (using a number and a description) in order to explain their relevance to the text. Possible images can be found at [[commons:|Wikimedia Commons]]. Images can also be uploaded if they are licensed for re-use or if you created the image. Each figure should be referred to at least once in the main text (e.g., see Figure 1). ===Links=== Where key words are first used, make them into [[Help:Links|interwiki links]] such as Wikipedia links to articles about famous people (e.g., [[w:Sigmund Freud|Sigmund Freud]] and key concepts (e.g., [[w:Dreams|dreams]]) and links to book chapters about related topics (e.g., would you like to learn about how to overcome [[Motivation and emotion/Book/2020/Writer's block|writer's block]]?). ===Tables=== Tables can be an effective way to organise and summarise information. Tables should be captioned (using APA style) to explain their relevance to the text. Plus each table should be referred to at least once in the main text (e.g., see Table 1 and Table 2). Here are some [[Motivation and emotion/Wikiversity/Tables|example 3 x 3 tables]] which could be adapted. ===Quizzes=== Quizzes are a direct way to engage readers. But don't make quizzes too hard or long. It is better to have one or two review questions per major section than a long quiz at the end. Try to quiz conceptual understanding, rather than trivia. Here are some simple quiz questions which could be adapted. Choose the correct answers and click "Submit": <quiz display=simple> {Quizzes are an interactive learning feature: |type="()"} + True - False {Long quizzes are a good idea: |type="()"} - True + False </quiz> To learn about different types of quiz questions, see [[Help:Quiz|Quiz]]. ==Conclusion== The Conclusion is arguably the most important section. It should be possible for someone to read the [[#Overview|Overview]] and the Conclusion and still get a good idea of the topic. {{tip|Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? }} ==See also== 1 internal link (other chapter) 1 external link (ted talk, organisation website) Provide up to half-a-dozen [[Help:Contents/Links#Interwiki_links|internal (wiki) links]] to relevant Wikiversity pages (esp. related [[Motivation and emotion/Book|motivation and emotion book chapters]]) and [[w:|Wikipedia articles]]. For example: * [[Motivation and emotion/Book/2016/Anorexia nervosa and extrinsic motivation|Anorexia nervosa and extrinsic motivation]] (Book chapter, 2016) * [[w:David McClelland|David McClelland]] (Wikipedia) * [[Motivation and emotion/Book/2018/Loss aversion|Loss aversion]] (Book chapter, 2018) * [[w:Maslow's hierarchy of needs|Maslow's hierarchy of needs]] (Wikipedia) {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== List the cited references in [[w:APA style|APA style]] (7th ed.) or [[w:Wikipedia:Citing sources|wiki style]]. APA style example: {{Hanging indent|1= Blair, R. J. R. (2004). The roles of orbital frontal cortex in the modulation of antisocial behavior. ''Brain and Cognition'', ''55''(1), 198–208. https://doi.org/10.1016/S0278-2626(03)00276-8 Buckholtz, J. W., & Meyer-Lindenberg, A. (2008). MAOA and the neurogenetic architecture of human aggression. ''Trends in Neurosciences'', ''31''(3), 120–129. https://doi.org/10.1016/j.tins.2007.12.006 Eckardt, M., File, S., Gessa, G., Grant, K., Guerri, C., Hoffman, P., & Tabakoff, B. (1998). Effects of moderate alcohol consumption on the central nervous system. ''Alcoholism, Clinical and Experimental Research'', ''22''(5), 998–1040. https://doi.org/10.1111/j.1530-0277.1998.tb03695.x }} {{tip|Suggestions for this section: * Important aspects for APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except first letter and proper names, ending in a full-stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full-stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't actually read or consulted }} ==External links== Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * [https://students.unimelb.edu.au/academic-skills/explore-our-resources/essay-writing/six-top-tips-for-writing-a-great-essay Six top tips for writing a great essay] (University of Melbourne) * [http://www.skillsyouneed.com/write/structure.html The importance of structure] (skillsyouneed.com) {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] [[Category:Motivation and emotion/Book/Cortex]] [[Category:Motivation and emotion/Book/Emotion]] 8w1u5n8noeou7ps6ln9t6ka8ddjia6m 2 286250 2419373 2417634 2022-08-26T07:39:59Z Jtneill 10242 /* Social Contributions */ wikitext text/x-wiki Hello, I am Bill == About Me == - I study psychology at the [https://www.canberra.edu.au/ University of Canberra], upon completion of my degree, I plan to move into postgraduate study to eventually become a psychologist === Hobbies === * Brazilian Jiu Jitsu * Exercising * Stocks * Reading * Psychology [[File:Hochzinödl, Gesäuse National Park, Ennstaler Alpen, Austria 01.jpg|thumb|Figure 1. Austrian national park]] === Social Contributions === # I have made a [https://en.wikiversity.org/w/index.php?title=Motivation_and_emotion/Book/2022/Academic_help-seeking&diff=prev&oldid=2417626 social contribution] to a fellow students Book chapter on [[Motivation and emotion/Book/2022/Academic help-seeking|Academic help seeking]]. I suggested what main headings the student could use for the book chapter == Book Chapter == === Topic: [[Motivation and emotion/Book/2022/Triumph|Triumph]] === pvugwxxpgaxnq9caugmriwveo8z1s27 2 286293 2419408 2413883 2022-08-26T08:42:30Z U3215603 2947641 added social contribution wikitext text/x-wiki == About Me == [[File:A Smiling boy from Bangladesh.jpg|thumb|Figure 1]] '''''Hi my name is Jacob I'm a [[wikipedia:Student|student]] at the University of Canberra studying [[w:Psychology|Psychology]]''''' === Hobbies === == Book Chapter I am Working On == [[Motivation and emotion/Book/2022/Work breaks, well-being, and productivity|Work breaks, well-being and productivity]] == Social Contributions == [https://en.wikiversity.org/w/index.php?title=Talk%3AMotivation_and_emotion%2FBook%2F2022%2FChildhood_trauma_and_subsequent_drug_use#tDCS_for_Drug_Abuse_Treatment Left feedback and suggested an idea for chapter on Childhood Abuse and Subsequent Drug Use] gbqczf0v7xnz5roqsvr1qrok4g6oss4 0 286295 2419334 2413897 2022-08-26T06:48:17Z Jtneill 10242 + categories wikitext text/x-wiki [[Category:{{#titleparts:{{PAGENAME}}|3}}]] [[Category:Motivation and emotion/Book/Goal pursuit]] q5hy8h448bcgxpzxxles1oea33k7ggv 0 286301 2419321 2418980 2022-08-26T05:47:02Z AEMOR 2947559 wikitext text/x-wiki {{title|Chapter title:<br>Subtitle?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== You are underway {{smile}}! This template provides tips for [[Motivation and emotion/Assessment/Topic|topic development]]. Gradually remove these suggestions as you develop the chapter. Also consult the [[Motivation and emotion/Assessment/Chapter|author guidelines]]. At the top of the chapter, the title and sub-title should match the ''exact'' wording and casing as shown in the {{Motivation and emotion/Book}}. The sub-titles all end with a question mark. This Overview section should be concise but consist of several paragraphs which engage the reader, illustrate the problem, and outline how psychological science can help. {{RoundBoxTop|theme=3}} '''Focus questions:''' * What is the first focus question? * What is the second focus question? * What is the third focus question? {{RoundBoxBottom}} {{tip| Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Provide an example or case study. * Conclude with Focus questions to guide the chapter. }} ==Main headings== How you are going to structure the chapter? Aim for three to six main headings between the [[#Overview|Overview]] and [[#Conclusion|Conclusion]]. {{tip|Suggestions for this section: * For the [[Motivation and emotion/Assessment/Topic|topic development]], provide at least 3 bullet-points about key content per section. Include key citations. * For the [[Motivation and emotion/Assessment/Chapter|book chapter]], expand the bullet points into paragraphs. * If a section has a lot of content, arrange it into two to five sub-headings such as in the [[#Interactive learning features|interactive learning features section]]. Avoid having sections with only one sub-heading. }} == What is perfectionism? == * General overview of society's interpretation of perfectionism * General overview of literature/research's interpretations of perfectionism * Outline why an understanding of the intricacies of perfectionism is important in our modern world == What motivates perfectionism? == * Describe how research demonstrates through factor analysis that perfectionism has been broken down into two dimensions === Two-factor model === ==== 1. Perfectionistic strivings ==== * setting excessively high standards of oneself * link to intrinsic motivation ====== Self and other-oriented and socially prescribed perfectionism ====== * Self-oriented perfectionism is the tendency to hold high expectations of standards or performance for oneself, with the intrinsic need to be perfect. This is characterised by compulsive strivings for self improvement and critical self-evaluations if the individual fails to meet these expectations. * Socially prescribed perfectionists believe that others expect them to be perfect. These perfectionists obsess over whether they are or their performance is 'good enough' to meet society's expectations. * Other-oriented perfectionism relates to holding others to high and unrealistic standards, being judgemental and critical of other's performance. It is not connected to the components of motivation for the self (intrapersonal), rather interpersonally focused. (Curran & Hill, 2021; Hewitt & Flett, 1991) ===== 2. Perfectionistic concerns ===== * excessive concern for making mistakes, preoccupation with failure and highly attentive to fears, doubts and worry * link to extrinsic motivation == Is perfectionism good or bad? == === Adaptive === * * * === Maladaptive === * * * ==Managing perfectionism== * * * ==Learning features== What brings an online book chapter to life are its interactive learning features. Case studies, feature boxes, figures, links, tables, and quiz questions can be used throughout the chapter. ===Case studies=== Case studies describe real-world examples of concepts in action. Case studies can be real or fictional. A case could be used multiple times during a chapter to illustrate different theories or stages. It is often helpful to present case studies using [[#Feature boxes|feature boxes]]. ===Boxes=== Boxes can be used to highlight content, but don't overuse them. There are many different ways of creating boxes (e.g., see [[Help:Pretty boxes|Pretty boxes]]). Possible uses include: * Focus questions * Case studies or examples * Quiz questions * Take-home messages {{RoundBoxTop|theme=3}} ;Feature box example * Shaded background * Coloured border {{RoundBoxBottom}} ===Figures=== [[File:Monkey-typing.jpg|right|205px|thumb|''Figure 1''. Example image with descriptive caption.]] Use figures to illustrate concepts, add interest, and provide examples. Figures can be used to show photographs, drawings, diagrams, graphs, etcetera. Figures can be embedded throughout the chapter, starting with the Overview section. Figures should be captioned (using a number and a description) in order to explain their relevance to the text. Possible images can be found at [[commons:|Wikimedia Commons]]. Images can also be uploaded if they are licensed for re-use or if you created the image. Each figure should be referred to at least once in the main text (e.g., see Figure 1). ===Links=== Where key words are first used, make them into [[Help:Links|interwiki links]] such as Wikipedia links to articles about famous people (e.g., [[w:Sigmund Freud|Sigmund Freud]] and key concepts (e.g., [[w:Dreams|dreams]]) and links to book chapters about related topics (e.g., would you like to learn about how to overcome [[Motivation and emotion/Book/2020/Writer's block|writer's block]]?). ===Tables=== Tables can be an effective way to organise and summarise information. Tables should be captioned (using APA style) to explain their relevance to the text. Plus each table should be referred to at least once in the main text (e.g., see Table 1 and Table 2). Here are some [[Motivation and emotion/Wikiversity/Tables|example 3 x 3 tables]] which could be adapted. ===Quizzes=== Quizzes are a direct way to engage readers. But don't make quizzes too hard or long. It is better to have one or two review questions per major section than a long quiz at the end. Try to quiz conceptual understanding, rather than trivia. Here are some simple quiz questions which could be adapted. Choose the correct answers and click "Submit": <quiz display=simple> {Quizzes are an interactive learning feature: |type="()"} + True - False {Long quizzes are a good idea: |type="()"} - True + False </quiz> To learn about different types of quiz questions, see [[Help:Quiz|Quiz]]. ==Conclusion== The Conclusion is arguably the most important section. It should be possible for someone to read the [[#Overview|Overview]] and the Conclusion and still get a good idea of the topic. {{tip|Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? }} ==See also== Provide up to half-a-dozen [[Help:Contents/Links#Interwiki_links|internal (wiki) links]] to relevant Wikiversity pages (esp. related [[Motivation and emotion/Book|motivation and emotion book chapters]]) and [[w:|Wikipedia articles]]. For example: * [[Motivation and emotion/Book/2016/Anorexia nervosa and extrinsic motivation|Anorexia nervosa and extrinsic motivation]] (Book chapter, 2016) * [[w:David McClelland|David McClelland]] (Wikipedia) * [[Motivation and emotion/Book/2018/Loss aversion|Loss aversion]] (Book chapter, 2018) * [[w:Maslow's hierarchy of needs|Maslow's hierarchy of needs]] (Wikipedia) {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== Hewitt, P.L., & Flett, G.L. (1991). Perfectionism in the self and social contexts: Conceptualization, assessment, and association with psychopathology. Journal of Personality and Social Psychology, 60, 456–470. <nowiki>https://doi.org/10.1037/0022-3514.60.3.456</nowiki> Curran, T., & Hill, A. P. (2019). Perfectionism is increasing over time: A meta-analysis of birth cohort differences from 1989 to 2016. Psychological Bulletin, 145(4), 410–429. <nowiki>https://doi.org/10.1037/bul0000138</nowiki> List the cited references in [[w:APA style|APA style]] (7th ed.) or [[w:Wikipedia:Citing sources|wiki style]]. APA style example: {{Hanging indent|1= Blair, R. J. R. (2004). The roles of orbital frontal cortex in the modulation of antisocial behavior. ''Brain and Cognition'', ''55''(1), 198–208. https://doi.org/10.1016/S0278-2626(03)00276-8 Buckholtz, J. W., & Meyer-Lindenberg, A. (2008). MAOA and the neurogenetic architecture of human aggression. ''Trends in Neurosciences'', ''31''(3), 120–129. https://doi.org/10.1016/j.tins.2007.12.006 Eckardt, M., File, S., Gessa, G., Grant, K., Guerri, C., Hoffman, P., & Tabakoff, B. (1998). Effects of moderate alcohol consumption on the central nervous system. ''Alcoholism, Clinical and Experimental Research'', ''22''(5), 998–1040. https://doi.org/10.1111/j.1530-0277.1998.tb03695.x }} {{tip|Suggestions for this section: * Important aspects for APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except first letter and proper names, ending in a full-stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full-stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't actually read or consulted }} ==External links== Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * [https://students.unimelb.edu.au/academic-skills/explore-our-resources/essay-writing/six-top-tips-for-writing-a-great-essay Six top tips for writing a great essay] (University of Melbourne) * [http://www.skillsyouneed.com/write/structure.html The importance of structure] (skillsyouneed.com) {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] [[Category:Motivation and emotion/Book/Perfectionism]] g0250fj67xhcdf3bftunsdavn40486m 2419328 2419321 2022-08-26T06:34:51Z AEMOR 2947559 wikitext text/x-wiki {{title|Chapter title:<br>Subtitle?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== You are underway {{smile}}! This template provides tips for [[Motivation and emotion/Assessment/Topic|topic development]]. Gradually remove these suggestions as you develop the chapter. Also consult the [[Motivation and emotion/Assessment/Chapter|author guidelines]]. At the top of the chapter, the title and sub-title should match the ''exact'' wording and casing as shown in the {{Motivation and emotion/Book}}. The sub-titles all end with a question mark. This Overview section should be concise but consist of several paragraphs which engage the reader, illustrate the problem, and outline how psychological science can help. {{RoundBoxTop|theme=3}} '''Focus questions:''' * What is the first focus question? * What is the second focus question? * What is the third focus question? {{RoundBoxBottom}} {{tip| Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Provide an example or case study. * Conclude with Focus questions to guide the chapter. }} ==Main headings== How you are going to structure the chapter? Aim for three to six main headings between the [[#Overview|Overview]] and [[#Conclusion|Conclusion]]. {{tip|Suggestions for this section: * For the [[Motivation and emotion/Assessment/Topic|topic development]], provide at least 3 bullet-points about key content per section. Include key citations. * For the [[Motivation and emotion/Assessment/Chapter|book chapter]], expand the bullet points into paragraphs. * If a section has a lot of content, arrange it into two to five sub-headings such as in the [[#Interactive learning features|interactive learning features section]]. Avoid having sections with only one sub-heading. }} == What is perfectionism? == * General overview of society's interpretation of perfectionism * General overview of literature/research's interpretations of perfectionism * Outline why an understanding of the intricacies of perfectionism is important in our modern world == Models of perfectionism == === Hewitt and Flett's three factor model === *Self-oriented perfectionism is the tendency to hold high expectations of standards or performance for oneself, with the intrinsic need to be perfect. This is characterised by compulsive strivings for self improvement and critical self-evaluations if the individual fails to meet these expectations. * Socially prescribed perfectionists believe that others expect them to be perfect. These perfectionists obsess over whether they are or their performance is 'good enough' to meet society's expectations. * Other-oriented perfectionism relates to holding others to high and unrealistic standards, being judgemental and critical of other's performance. It is not connected to the components of motivation for the self (intrapersonal), rather interpersonally focused. === Frost, Marten, Lahart, and Rosenblate five dimension model === * Excessive concern over making mistakes * High personal standards * Perception of high parental expectations and criticism * Doubt regarding the quality of one's actions * Preference for order and organisation === Hill, Huelsman, Furr, Kibler, Vicente and Kennedy eight factor model === * Planfulness, Organisation, Striving for Excellence, Concern over Mistakes, Need for Approval, High Standards for Others, Perceived Parental Pressure, and Rumination === Two factor model of perfectionism === 1. Perfectionistic strivings * setting excessively high standards of oneself 2. Perfectionistic concerns * excessive concern for making mistakes, preoccupation with failure and highly attentive to fears, doubts and worry == What motivates perfectionism? == * Describe how research demonstrates through factor analysis that perfectionism has been broken down into two dimensions === Is perfectionism good or bad? === === Adaptive === * * * === Maladaptive === * * * ==Managing perfectionism== * * * ==Learning features== What brings an online book chapter to life are its interactive learning features. Case studies, feature boxes, figures, links, tables, and quiz questions can be used throughout the chapter. ===Case studies=== Case studies describe real-world examples of concepts in action. Case studies can be real or fictional. A case could be used multiple times during a chapter to illustrate different theories or stages. It is often helpful to present case studies using [[#Feature boxes|feature boxes]]. ===Boxes=== Boxes can be used to highlight content, but don't overuse them. There are many different ways of creating boxes (e.g., see [[Help:Pretty boxes|Pretty boxes]]). Possible uses include: * Focus questions * Case studies or examples * Quiz questions * Take-home messages {{RoundBoxTop|theme=3}} ;Feature box example * Shaded background * Coloured border {{RoundBoxBottom}} ===Figures=== [[File:Monkey-typing.jpg|right|205px|thumb|''Figure 1''. Example image with descriptive caption.]] Use figures to illustrate concepts, add interest, and provide examples. Figures can be used to show photographs, drawings, diagrams, graphs, etcetera. Figures can be embedded throughout the chapter, starting with the Overview section. Figures should be captioned (using a number and a description) in order to explain their relevance to the text. Possible images can be found at [[commons:|Wikimedia Commons]]. Images can also be uploaded if they are licensed for re-use or if you created the image. Each figure should be referred to at least once in the main text (e.g., see Figure 1). ===Links=== Where key words are first used, make them into [[Help:Links|interwiki links]] such as Wikipedia links to articles about famous people (e.g., [[w:Sigmund Freud|Sigmund Freud]] and key concepts (e.g., [[w:Dreams|dreams]]) and links to book chapters about related topics (e.g., would you like to learn about how to overcome [[Motivation and emotion/Book/2020/Writer's block|writer's block]]?). ===Tables=== Tables can be an effective way to organise and summarise information. Tables should be captioned (using APA style) to explain their relevance to the text. Plus each table should be referred to at least once in the main text (e.g., see Table 1 and Table 2). Here are some [[Motivation and emotion/Wikiversity/Tables|example 3 x 3 tables]] which could be adapted. ===Quizzes=== Quizzes are a direct way to engage readers. But don't make quizzes too hard or long. It is better to have one or two review questions per major section than a long quiz at the end. Try to quiz conceptual understanding, rather than trivia. Here are some simple quiz questions which could be adapted. Choose the correct answers and click "Submit": <quiz display=simple> {Quizzes are an interactive learning feature: |type="()"} + True - False {Long quizzes are a good idea: |type="()"} - True + False </quiz> To learn about different types of quiz questions, see [[Help:Quiz|Quiz]]. ==Conclusion== The Conclusion is arguably the most important section. It should be possible for someone to read the [[#Overview|Overview]] and the Conclusion and still get a good idea of the topic. {{tip|Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? }} ==See also== Provide up to half-a-dozen [[Help:Contents/Links#Interwiki_links|internal (wiki) links]] to relevant Wikiversity pages (esp. related [[Motivation and emotion/Book|motivation and emotion book chapters]]) and [[w:|Wikipedia articles]]. For example: * [[Motivation and emotion/Book/2016/Anorexia nervosa and extrinsic motivation|Anorexia nervosa and extrinsic motivation]] (Book chapter, 2016) * [[w:David McClelland|David McClelland]] (Wikipedia) * [[Motivation and emotion/Book/2018/Loss aversion|Loss aversion]] (Book chapter, 2018) * [[w:Maslow's hierarchy of needs|Maslow's hierarchy of needs]] (Wikipedia) {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== Hewitt, P.L., & Flett, G.L. (1991). Perfectionism in the self and social contexts: Conceptualization, assessment, and association with psychopathology. Journal of Personality and Social Psychology, 60, 456–470. <nowiki>https://doi.org/10.1037/0022-3514.60.3.456</nowiki> Curran, T., & Hill, A. P. (2019). Perfectionism is increasing over time: A meta-analysis of birth cohort differences from 1989 to 2016. Psychological Bulletin, 145(4), 410–429. <nowiki>https://doi.org/10.1037/bul0000138</nowiki> List the cited references in [[w:APA style|APA style]] (7th ed.) or [[w:Wikipedia:Citing sources|wiki style]]. APA style example: {{Hanging indent|1= Blair, R. J. R. (2004). The roles of orbital frontal cortex in the modulation of antisocial behavior. ''Brain and Cognition'', ''55''(1), 198–208. https://doi.org/10.1016/S0278-2626(03)00276-8 Buckholtz, J. W., & Meyer-Lindenberg, A. (2008). MAOA and the neurogenetic architecture of human aggression. ''Trends in Neurosciences'', ''31''(3), 120–129. https://doi.org/10.1016/j.tins.2007.12.006 Eckardt, M., File, S., Gessa, G., Grant, K., Guerri, C., Hoffman, P., & Tabakoff, B. (1998). Effects of moderate alcohol consumption on the central nervous system. ''Alcoholism, Clinical and Experimental Research'', ''22''(5), 998–1040. https://doi.org/10.1111/j.1530-0277.1998.tb03695.x }} {{tip|Suggestions for this section: * Important aspects for APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except first letter and proper names, ending in a full-stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full-stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't actually read or consulted }} ==External links== Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * [https://students.unimelb.edu.au/academic-skills/explore-our-resources/essay-writing/six-top-tips-for-writing-a-great-essay Six top tips for writing a great essay] (University of Melbourne) * [http://www.skillsyouneed.com/write/structure.html The importance of structure] (skillsyouneed.com) {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] [[Category:Motivation and emotion/Book/Perfectionism]] l71hypqsbo47x6sl3qe3becg1dcpke4 2419329 2419328 2022-08-26T06:36:22Z AEMOR 2947559 wikitext text/x-wiki {{title|Chapter title:<br>Subtitle?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== You are underway {{smile}}! This template provides tips for [[Motivation and emotion/Assessment/Topic|topic development]]. Gradually remove these suggestions as you develop the chapter. Also consult the [[Motivation and emotion/Assessment/Chapter|author guidelines]]. At the top of the chapter, the title and sub-title should match the ''exact'' wording and casing as shown in the {{Motivation and emotion/Book}}. The sub-titles all end with a question mark. This Overview section should be concise but consist of several paragraphs which engage the reader, illustrate the problem, and outline how psychological science can help. {{RoundBoxTop|theme=3}} '''Focus questions:''' * What is the first focus question? * What is the second focus question? * What is the third focus question? {{RoundBoxBottom}} {{tip| Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Provide an example or case study. * Conclude with Focus questions to guide the chapter. }} ==Main headings== How you are going to structure the chapter? Aim for three to six main headings between the [[#Overview|Overview]] and [[#Conclusion|Conclusion]]. {{tip|Suggestions for this section: * For the [[Motivation and emotion/Assessment/Topic|topic development]], provide at least 3 bullet-points about key content per section. Include key citations. * For the [[Motivation and emotion/Assessment/Chapter|book chapter]], expand the bullet points into paragraphs. * If a section has a lot of content, arrange it into two to five sub-headings such as in the [[#Interactive learning features|interactive learning features section]]. Avoid having sections with only one sub-heading. }} == What is perfectionism? == * General overview of society's interpretation of perfectionism * General overview of literature/research's interpretations of perfectionism * Outline why an understanding of the intricacies of perfectionism is important in our modern world == Models of perfectionism == === Hewitt and Flett's three factor model === *Self-oriented perfectionism is the tendency to hold high expectations of standards or performance for oneself, with the intrinsic need to be perfect. This is characterised by compulsive strivings for self improvement and critical self-evaluations if the individual fails to meet these expectations. * Socially prescribed perfectionists believe that others expect them to be perfect. These perfectionists obsess over whether they are or their performance is 'good enough' to meet society's expectations. * Other-oriented perfectionism relates to holding others to high and unrealistic standards, being judgemental and critical of other's performance. It is not connected to the components of motivation for the self (intrapersonal), rather interpersonally focused. === Frost, Marten, Lahart, and Rosenblate five dimension model === * Excessive concern over making mistakes * High personal standards * Perception of high parental expectations and criticism * Doubt regarding the quality of one's actions * Preference for order and organisation === Hill, Huelsman, Furr, Kibler, Vicente and Kennedy eight factor model === * Planfulness, Organisation, Striving for Excellence, Concern over Mistakes, Need for Approval, High Standards for Others, Perceived Parental Pressure, and Rumination === Two factor model of perfectionism === 1. Perfectionistic strivings * setting excessively high standards of oneself 2. Perfectionistic concerns * excessive concern for making mistakes, preoccupation with failure and highly attentive to fears, doubts and worry == What motivates perfectionism? == === Extrinsic Motivation === === Intrinsic Motivation === == Is perfectionism good or bad? == * ==Managing perfectionism== * * * ==Learning features== What brings an online book chapter to life are its interactive learning features. Case studies, feature boxes, figures, links, tables, and quiz questions can be used throughout the chapter. ===Case studies=== Case studies describe real-world examples of concepts in action. Case studies can be real or fictional. A case could be used multiple times during a chapter to illustrate different theories or stages. It is often helpful to present case studies using [[#Feature boxes|feature boxes]]. ===Boxes=== Boxes can be used to highlight content, but don't overuse them. There are many different ways of creating boxes (e.g., see [[Help:Pretty boxes|Pretty boxes]]). Possible uses include: * Focus questions * Case studies or examples * Quiz questions * Take-home messages {{RoundBoxTop|theme=3}} ;Feature box example * Shaded background * Coloured border {{RoundBoxBottom}} ===Figures=== [[File:Monkey-typing.jpg|right|205px|thumb|''Figure 1''. Example image with descriptive caption.]] Use figures to illustrate concepts, add interest, and provide examples. Figures can be used to show photographs, drawings, diagrams, graphs, etcetera. Figures can be embedded throughout the chapter, starting with the Overview section. Figures should be captioned (using a number and a description) in order to explain their relevance to the text. Possible images can be found at [[commons:|Wikimedia Commons]]. Images can also be uploaded if they are licensed for re-use or if you created the image. Each figure should be referred to at least once in the main text (e.g., see Figure 1). ===Links=== Where key words are first used, make them into [[Help:Links|interwiki links]] such as Wikipedia links to articles about famous people (e.g., [[w:Sigmund Freud|Sigmund Freud]] and key concepts (e.g., [[w:Dreams|dreams]]) and links to book chapters about related topics (e.g., would you like to learn about how to overcome [[Motivation and emotion/Book/2020/Writer's block|writer's block]]?). ===Tables=== Tables can be an effective way to organise and summarise information. Tables should be captioned (using APA style) to explain their relevance to the text. Plus each table should be referred to at least once in the main text (e.g., see Table 1 and Table 2). Here are some [[Motivation and emotion/Wikiversity/Tables|example 3 x 3 tables]] which could be adapted. ===Quizzes=== Quizzes are a direct way to engage readers. But don't make quizzes too hard or long. It is better to have one or two review questions per major section than a long quiz at the end. Try to quiz conceptual understanding, rather than trivia. Here are some simple quiz questions which could be adapted. Choose the correct answers and click "Submit": <quiz display=simple> {Quizzes are an interactive learning feature: |type="()"} + True - False {Long quizzes are a good idea: |type="()"} - True + False </quiz> To learn about different types of quiz questions, see [[Help:Quiz|Quiz]]. ==Conclusion== The Conclusion is arguably the most important section. It should be possible for someone to read the [[#Overview|Overview]] and the Conclusion and still get a good idea of the topic. {{tip|Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? }} ==See also== Provide up to half-a-dozen [[Help:Contents/Links#Interwiki_links|internal (wiki) links]] to relevant Wikiversity pages (esp. related [[Motivation and emotion/Book|motivation and emotion book chapters]]) and [[w:|Wikipedia articles]]. For example: * [[Motivation and emotion/Book/2016/Anorexia nervosa and extrinsic motivation|Anorexia nervosa and extrinsic motivation]] (Book chapter, 2016) * [[w:David McClelland|David McClelland]] (Wikipedia) * [[Motivation and emotion/Book/2018/Loss aversion|Loss aversion]] (Book chapter, 2018) * [[w:Maslow's hierarchy of needs|Maslow's hierarchy of needs]] (Wikipedia) {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== Hewitt, P.L., & Flett, G.L. (1991). Perfectionism in the self and social contexts: Conceptualization, assessment, and association with psychopathology. Journal of Personality and Social Psychology, 60, 456–470. <nowiki>https://doi.org/10.1037/0022-3514.60.3.456</nowiki> Curran, T., & Hill, A. P. (2019). Perfectionism is increasing over time: A meta-analysis of birth cohort differences from 1989 to 2016. Psychological Bulletin, 145(4), 410–429. <nowiki>https://doi.org/10.1037/bul0000138</nowiki> List the cited references in [[w:APA style|APA style]] (7th ed.) or [[w:Wikipedia:Citing sources|wiki style]]. APA style example: {{Hanging indent|1= Blair, R. J. R. (2004). The roles of orbital frontal cortex in the modulation of antisocial behavior. ''Brain and Cognition'', ''55''(1), 198–208. https://doi.org/10.1016/S0278-2626(03)00276-8 Buckholtz, J. W., & Meyer-Lindenberg, A. (2008). MAOA and the neurogenetic architecture of human aggression. ''Trends in Neurosciences'', ''31''(3), 120–129. https://doi.org/10.1016/j.tins.2007.12.006 Eckardt, M., File, S., Gessa, G., Grant, K., Guerri, C., Hoffman, P., & Tabakoff, B. (1998). Effects of moderate alcohol consumption on the central nervous system. ''Alcoholism, Clinical and Experimental Research'', ''22''(5), 998–1040. https://doi.org/10.1111/j.1530-0277.1998.tb03695.x }} {{tip|Suggestions for this section: * Important aspects for APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except first letter and proper names, ending in a full-stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full-stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't actually read or consulted }} ==External links== Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * [https://students.unimelb.edu.au/academic-skills/explore-our-resources/essay-writing/six-top-tips-for-writing-a-great-essay Six top tips for writing a great essay] (University of Melbourne) * [http://www.skillsyouneed.com/write/structure.html The importance of structure] (skillsyouneed.com) {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] [[Category:Motivation and emotion/Book/Perfectionism]] 9osthqmcewedzh3vz86uv2h6tu4v3ws 2419417 2419329 2022-08-26T08:54:17Z AEMOR 2947559 /* Models of perfectionism */ wikitext text/x-wiki {{title|Chapter title:<br>Subtitle?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== You are underway {{smile}}! This template provides tips for [[Motivation and emotion/Assessment/Topic|topic development]]. Gradually remove these suggestions as you develop the chapter. Also consult the [[Motivation and emotion/Assessment/Chapter|author guidelines]]. At the top of the chapter, the title and sub-title should match the ''exact'' wording and casing as shown in the {{Motivation and emotion/Book}}. The sub-titles all end with a question mark. This Overview section should be concise but consist of several paragraphs which engage the reader, illustrate the problem, and outline how psychological science can help. {{RoundBoxTop|theme=3}} '''Focus questions:''' * What is the first focus question? * What is the second focus question? * What is the third focus question? {{RoundBoxBottom}} {{tip| Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Provide an example or case study. * Conclude with Focus questions to guide the chapter. }} ==Main headings== How you are going to structure the chapter? Aim for three to six main headings between the [[#Overview|Overview]] and [[#Conclusion|Conclusion]]. {{tip|Suggestions for this section: * For the [[Motivation and emotion/Assessment/Topic|topic development]], provide at least 3 bullet-points about key content per section. Include key citations. * For the [[Motivation and emotion/Assessment/Chapter|book chapter]], expand the bullet points into paragraphs. * If a section has a lot of content, arrange it into two to five sub-headings such as in the [[#Interactive learning features|interactive learning features section]]. Avoid having sections with only one sub-heading. }} == What is perfectionism? == * General overview of society's interpretation of perfectionism * General overview of literature/research's interpretations of perfectionism * Outline why an understanding of the intricacies of perfectionism is important in our modern world == Models of perfectionism == === Hewitt and Flett's three factor model === #Self-oriented perfectionism is the tendency to hold high expectations of standards or performance for oneself, with the intrinsic need to be perfect. This is characterised by compulsive strivings for self improvement and critical self-evaluations if the individual fails to meet these expectations. # Socially prescribed perfectionists believe that others expect them to be perfect. These perfectionists obsess over whether they are or their performance is 'good enough' to meet society's expectations. # Other-oriented perfectionism relates to holding others to high and unrealistic standards, being judgemental and critical of other's performance. It is not connected to the components of motivation for the self (intrapersonal), rather interpersonally focused. === Frost, Marten, Lahart, and Rosenblate six dimension model === # Excessive concern over making mistakes # High personal standards # Perception of high parental expectations # Perception of high parental criticism # Doubt regarding the quality of one's actions # Preference for order and organisation === Hill, Huelsman, Furr, Kibler, Vicente and Kennedy eight factor model === # Planfulness # Organisation # Striving for Excellence # Concern over Mistakes # Need for Approval # High Standards for Others # Perceived Parental Pressure # Rumination === Two factor model of perfectionism === 1. Perfectionistic strivings * setting excessively high standards of oneself 2. Perfectionistic concerns * excessive concern for making mistakes, preoccupation with failure and highly attentive to fears, doubts and worry == What motivates perfectionism? == === Extrinsic motivation === === Intrinsic motivation === === Three needs theory === === Self-worth theory of motivation === == Is perfectionism good or bad? == * ==Managing perfectionism== * * * ==Learning features== What brings an online book chapter to life are its interactive learning features. Case studies, feature boxes, figures, links, tables, and quiz questions can be used throughout the chapter. ===Case studies=== Case studies describe real-world examples of concepts in action. Case studies can be real or fictional. A case could be used multiple times during a chapter to illustrate different theories or stages. It is often helpful to present case studies using [[#Feature boxes|feature boxes]]. ===Boxes=== Boxes can be used to highlight content, but don't overuse them. There are many different ways of creating boxes (e.g., see [[Help:Pretty boxes|Pretty boxes]]). Possible uses include: * Focus questions * Case studies or examples * Quiz questions * Take-home messages {{RoundBoxTop|theme=3}} ;Feature box example * Shaded background * Coloured border {{RoundBoxBottom}} ===Figures=== [[File:Monkey-typing.jpg|right|205px|thumb|''Figure 1''. Example image with descriptive caption.]] Use figures to illustrate concepts, add interest, and provide examples. Figures can be used to show photographs, drawings, diagrams, graphs, etcetera. Figures can be embedded throughout the chapter, starting with the Overview section. Figures should be captioned (using a number and a description) in order to explain their relevance to the text. Possible images can be found at [[commons:|Wikimedia Commons]]. Images can also be uploaded if they are licensed for re-use or if you created the image. Each figure should be referred to at least once in the main text (e.g., see Figure 1). ===Links=== Where key words are first used, make them into [[Help:Links|interwiki links]] such as Wikipedia links to articles about famous people (e.g., [[w:Sigmund Freud|Sigmund Freud]] and key concepts (e.g., [[w:Dreams|dreams]]) and links to book chapters about related topics (e.g., would you like to learn about how to overcome [[Motivation and emotion/Book/2020/Writer's block|writer's block]]?). ===Tables=== Tables can be an effective way to organise and summarise information. Tables should be captioned (using APA style) to explain their relevance to the text. Plus each table should be referred to at least once in the main text (e.g., see Table 1 and Table 2). Here are some [[Motivation and emotion/Wikiversity/Tables|example 3 x 3 tables]] which could be adapted. ===Quizzes=== Quizzes are a direct way to engage readers. But don't make quizzes too hard or long. It is better to have one or two review questions per major section than a long quiz at the end. Try to quiz conceptual understanding, rather than trivia. Here are some simple quiz questions which could be adapted. Choose the correct answers and click "Submit": <quiz display=simple> {Quizzes are an interactive learning feature: |type="()"} + True - False {Long quizzes are a good idea: |type="()"} - True + False </quiz> To learn about different types of quiz questions, see [[Help:Quiz|Quiz]]. ==Conclusion== The Conclusion is arguably the most important section. It should be possible for someone to read the [[#Overview|Overview]] and the Conclusion and still get a good idea of the topic. {{tip|Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? }} ==See also== Provide up to half-a-dozen [[Help:Contents/Links#Interwiki_links|internal (wiki) links]] to relevant Wikiversity pages (esp. related [[Motivation and emotion/Book|motivation and emotion book chapters]]) and [[w:|Wikipedia articles]]. For example: * [[Motivation and emotion/Book/2016/Anorexia nervosa and extrinsic motivation|Anorexia nervosa and extrinsic motivation]] (Book chapter, 2016) * [[w:David McClelland|David McClelland]] (Wikipedia) * [[Motivation and emotion/Book/2018/Loss aversion|Loss aversion]] (Book chapter, 2018) * [[w:Maslow's hierarchy of needs|Maslow's hierarchy of needs]] (Wikipedia) {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== Hewitt, P.L., & Flett, G.L. (1991). Perfectionism in the self and social contexts: Conceptualization, assessment, and association with psychopathology. Journal of Personality and Social Psychology, 60, 456–470. <nowiki>https://doi.org/10.1037/0022-3514.60.3.456</nowiki> Curran, T., & Hill, A. P. (2019). Perfectionism is increasing over time: A meta-analysis of birth cohort differences from 1989 to 2016. Psychological Bulletin, 145(4), 410–429. <nowiki>https://doi.org/10.1037/bul0000138</nowiki> List the cited references in [[w:APA style|APA style]] (7th ed.) or [[w:Wikipedia:Citing sources|wiki style]]. APA style example: {{Hanging indent|1= Blair, R. J. R. (2004). The roles of orbital frontal cortex in the modulation of antisocial behavior. ''Brain and Cognition'', ''55''(1), 198–208. https://doi.org/10.1016/S0278-2626(03)00276-8 Buckholtz, J. W., & Meyer-Lindenberg, A. (2008). MAOA and the neurogenetic architecture of human aggression. ''Trends in Neurosciences'', ''31''(3), 120–129. https://doi.org/10.1016/j.tins.2007.12.006 Eckardt, M., File, S., Gessa, G., Grant, K., Guerri, C., Hoffman, P., & Tabakoff, B. (1998). Effects of moderate alcohol consumption on the central nervous system. ''Alcoholism, Clinical and Experimental Research'', ''22''(5), 998–1040. https://doi.org/10.1111/j.1530-0277.1998.tb03695.x }} {{tip|Suggestions for this section: * Important aspects for APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except first letter and proper names, ending in a full-stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full-stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't actually read or consulted }} ==External links== Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * [https://students.unimelb.edu.au/academic-skills/explore-our-resources/essay-writing/six-top-tips-for-writing-a-great-essay Six top tips for writing a great essay] (University of Melbourne) * [http://www.skillsyouneed.com/write/structure.html The importance of structure] (skillsyouneed.com) {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] [[Category:Motivation and emotion/Book/Perfectionism]] bhahusjw6cdt5x2l643287m8lrnxwai 2419423 2419417 2022-08-26T09:02:57Z AEMOR 2947559 wikitext text/x-wiki {{title|Chapter title:<br>Subtitle?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== You are underway {{smile}}! This template provides tips for [[Motivation and emotion/Assessment/Topic|topic development]]. Gradually remove these suggestions as you develop the chapter. Also consult the [[Motivation and emotion/Assessment/Chapter|author guidelines]]. At the top of the chapter, the title and sub-title should match the ''exact'' wording and casing as shown in the {{Motivation and emotion/Book}}. The sub-titles all end with a question mark. This Overview section should be concise but consist of several paragraphs which engage the reader, illustrate the problem, and outline how psychological science can help. {{RoundBoxTop|theme=3}} '''Focus questions:''' * What is the first focus question? * What is the second focus question? * What is the third focus question? {{RoundBoxBottom}} {{tip| Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Provide an example or case study. * Conclude with Focus questions to guide the chapter. }} ==Main headings== How you are going to structure the chapter? Aim for three to six main headings between the [[#Overview|Overview]] and [[#Conclusion|Conclusion]]. {{tip|Suggestions for this section: * For the [[Motivation and emotion/Assessment/Topic|topic development]], provide at least 3 bullet-points about key content per section. Include key citations. * For the [[Motivation and emotion/Assessment/Chapter|book chapter]], expand the bullet points into paragraphs. * If a section has a lot of content, arrange it into two to five sub-headings such as in the [[#Interactive learning features|interactive learning features section]]. Avoid having sections with only one sub-heading. }} == What is perfectionism? == * General overview of society's interpretation of perfectionism * General overview of literature/research's interpretations of perfectionism * Outline why an understanding of the intricacies of perfectionism is important in our modern world == Models of perfectionism == === Hewitt and Flett's three factor model === #Self-oriented perfectionism is the tendency to hold high expectations of standards or performance for oneself, with the intrinsic need to be perfect. This is characterised by compulsive strivings for self improvement and critical self-evaluations if the individual fails to meet these expectations. # Socially prescribed perfectionists believe that others expect them to be perfect. These perfectionists obsess over whether they are or their performance is 'good enough' to meet society's expectations. # Other-oriented perfectionism relates to holding others to high and unrealistic standards, being judgemental and critical of other's performance. It is not connected to the components of motivation for the self (intrapersonal), rather interpersonally focused. === Frost, Marten, Lahart, and Rosenblate six dimension model === # Excessive concern over making mistakes # High personal standards # Perception of high parental expectations # Perception of high parental criticism # Doubt regarding the quality of one's actions # Preference for order and organisation === Hill, Huelsman, Furr, Kibler, Vicente and Kennedy eight factor model === # Planfulness # Organisation # Striving for Excellence # Concern over Mistakes # Need for Approval # High Standards for Others # Perceived Parental Pressure # Rumination === Two factor model of perfectionism === 1. Perfectionistic strivings * setting excessively high standards of oneself 2. Perfectionistic concerns * excessive concern for making mistakes, preoccupation with failure and highly attentive to fears, doubts and worry == What motivates perfectionism? == === Extrinsic motivation === === Intrinsic motivation === === Three needs theory === === Self-worth theory of motivation === == Is perfectionism good or bad? == * ==Managing perfectionism== * * * == Test yourself! == Use [https://www.idrlabs.com/multidimensional-perfectionism/test.php The Multidimensional Perfectionism Test] to see your level of perfectionism. ==Learning features== What brings an online book chapter to life are its interactive learning features. Case studies, feature boxes, figures, links, tables, and quiz questions can be used throughout the chapter. ===Case studies=== Case studies describe real-world examples of concepts in action. Case studies can be real or fictional. A case could be used multiple times during a chapter to illustrate different theories or stages. It is often helpful to present case studies using [[#Feature boxes|feature boxes]]. ===Boxes=== Boxes can be used to highlight content, but don't overuse them. There are many different ways of creating boxes (e.g., see [[Help:Pretty boxes|Pretty boxes]]). Possible uses include: * Focus questions * Case studies or examples * Quiz questions * Take-home messages {{RoundBoxTop|theme=3}} ;Feature box example * Shaded background * Coloured border {{RoundBoxBottom}} ===Figures=== [[File:Monkey-typing.jpg|right|205px|thumb|''Figure 1''. Example image with descriptive caption.]] Use figures to illustrate concepts, add interest, and provide examples. Figures can be used to show photographs, drawings, diagrams, graphs, etcetera. Figures can be embedded throughout the chapter, starting with the Overview section. Figures should be captioned (using a number and a description) in order to explain their relevance to the text. Possible images can be found at [[commons:|Wikimedia Commons]]. Images can also be uploaded if they are licensed for re-use or if you created the image. Each figure should be referred to at least once in the main text (e.g., see Figure 1). ===Links=== Where key words are first used, make them into [[Help:Links|interwiki links]] such as Wikipedia links to articles about famous people (e.g., [[w:Sigmund Freud|Sigmund Freud]] and key concepts (e.g., [[w:Dreams|dreams]]) and links to book chapters about related topics (e.g., would you like to learn about how to overcome [[Motivation and emotion/Book/2020/Writer's block|writer's block]]?). ===Tables=== Tables can be an effective way to organise and summarise information. Tables should be captioned (using APA style) to explain their relevance to the text. Plus each table should be referred to at least once in the main text (e.g., see Table 1 and Table 2). Here are some [[Motivation and emotion/Wikiversity/Tables|example 3 x 3 tables]] which could be adapted. ===Quizzes=== Quizzes are a direct way to engage readers. But don't make quizzes too hard or long. It is better to have one or two review questions per major section than a long quiz at the end. Try to quiz conceptual understanding, rather than trivia. Here are some simple quiz questions which could be adapted. Choose the correct answers and click "Submit": <quiz display=simple> {Quizzes are an interactive learning feature: |type="()"} + True - False {Long quizzes are a good idea: |type="()"} - True + False </quiz> To learn about different types of quiz questions, see [[Help:Quiz|Quiz]]. ==Conclusion== The Conclusion is arguably the most important section. It should be possible for someone to read the [[#Overview|Overview]] and the Conclusion and still get a good idea of the topic. {{tip|Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? }} ==See also== Provide up to half-a-dozen [[Help:Contents/Links#Interwiki_links|internal (wiki) links]] to relevant Wikiversity pages (esp. related [[Motivation and emotion/Book|motivation and emotion book chapters]]) and [[w:|Wikipedia articles]]. For example: * [[Motivation and emotion/Book/2016/Anorexia nervosa and extrinsic motivation|Anorexia nervosa and extrinsic motivation]] (Book chapter, 2016) * [[w:David McClelland|David McClelland]] (Wikipedia) * [[Motivation and emotion/Book/2018/Loss aversion|Loss aversion]] (Book chapter, 2018) * [[w:Maslow's hierarchy of needs|Maslow's hierarchy of needs]] (Wikipedia) {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== Hewitt, P.L., & Flett, G.L. (1991). Perfectionism in the self and social contexts: Conceptualization, assessment, and association with psychopathology. Journal of Personality and Social Psychology, 60, 456–470. <nowiki>https://doi.org/10.1037/0022-3514.60.3.456</nowiki> Curran, T., & Hill, A. P. (2019). Perfectionism is increasing over time: A meta-analysis of birth cohort differences from 1989 to 2016. Psychological Bulletin, 145(4), 410–429. <nowiki>https://doi.org/10.1037/bul0000138</nowiki> List the cited references in [[w:APA style|APA style]] (7th ed.) or [[w:Wikipedia:Citing sources|wiki style]]. APA style example: {{Hanging indent|1= Blair, R. J. R. (2004). The roles of orbital frontal cortex in the modulation of antisocial behavior. ''Brain and Cognition'', ''55''(1), 198–208. https://doi.org/10.1016/S0278-2626(03)00276-8 Buckholtz, J. W., & Meyer-Lindenberg, A. (2008). MAOA and the neurogenetic architecture of human aggression. ''Trends in Neurosciences'', ''31''(3), 120–129. https://doi.org/10.1016/j.tins.2007.12.006 Eckardt, M., File, S., Gessa, G., Grant, K., Guerri, C., Hoffman, P., & Tabakoff, B. (1998). Effects of moderate alcohol consumption on the central nervous system. ''Alcoholism, Clinical and Experimental Research'', ''22''(5), 998–1040. https://doi.org/10.1111/j.1530-0277.1998.tb03695.x }} {{tip|Suggestions for this section: * Important aspects for APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except first letter and proper names, ending in a full-stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full-stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't actually read or consulted }} ==External links== Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * [https://students.unimelb.edu.au/academic-skills/explore-our-resources/essay-writing/six-top-tips-for-writing-a-great-essay Six top tips for writing a great essay] (University of Melbourne) * [http://www.skillsyouneed.com/write/structure.html The importance of structure] (skillsyouneed.com) {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] [[Category:Motivation and emotion/Book/Perfectionism]] g0lpfsbcusy0bwtwvhatsdh79x7zcus 0 286347 2419337 2416580 2022-08-26T06:52:55Z Jtneill 10242 + category wikitext text/x-wiki {{title|Mudita:<br>What is mudita and how can it be developed?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== You are underway {{smile}}! This template provides tips for [[Motivation and emotion/Assessment/Topic|topic development]]. Gradually remove these suggestions as you develop the chapter. Also consult the [[Motivation and emotion/Assessment/Chapter|author guidelines]]. At the top of the chapter, the title and sub-title should match the ''exact'' wording and casing as shown in the {{Motivation and emotion/Book}}. The sub-titles all end with a question mark. This Overview section should be concise but consist of several paragraphs which engage the reader, illustrate the problem, and outline how psychological science can help. {{RoundBoxTop|theme=3}} '''Focus questions:''' * What is the first focus question? * What is the second focus question? * What is the third focus question? {{RoundBoxBottom}} {{tip| Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Provide an example or case study. * Conclude with Focus questions to guide the chapter. }} ==Main headings== How you are going to structure the chapter? Aim for three to six main headings between the [[#Overview|Overview]] and [[#Conclusion|Conclusion]]. {{tip|Suggestions for this section: * For the [[Motivation and emotion/Assessment/Topic|topic development]], provide at least 3 bullet-points about key content per section. Include key citations. * For the [[Motivation and emotion/Assessment/Chapter|book chapter]], expand the bullet points into paragraphs. * If a section has a lot of content, arrange it into two to five sub-headings such as in the [[#Interactive learning features|interactive learning features section]]. Avoid having sections with only one sub-heading. }} ==Learning features== What brings an online book chapter to life are its interactive learning features. Case studies, feature boxes, figures, links, tables, and quiz questions can be used throughout the chapter. ===Case studies=== Case studies describe real-world examples of concepts in action. Case studies can be real or fictional. A case could be used multiple times during a chapter to illustrate different theories or stages. It is often helpful to present case studies using [[#Feature boxes|feature boxes]]. ===Boxes=== Boxes can be used to highlight content, but don't overuse them. There are many different ways of creating boxes (e.g., see [[Help:Pretty boxes|Pretty boxes]]). Possible uses include: * Focus questions * Case studies or examples * Quiz questions * Take-home messages {{RoundBoxTop|theme=3}} ;Feature box example * Shaded background * Coloured border {{RoundBoxBottom}} ===Figures=== [[File:Monkey-typing.jpg|right|205px|thumb|''Figure 1''. Example image with descriptive caption.]] Use figures to illustrate concepts, add interest, and provide examples. Figures can be used to show photographs, drawings, diagrams, graphs, etcetera. Figures can be embedded throughout the chapter, starting with the Overview section. Figures should be captioned (using a number and a description) in order to explain their relevance to the text. Possible images can be found at [[commons:|Wikimedia Commons]]. Images can also be uploaded if they are licensed for re-use or if you created the image. Each figure should be referred to at least once in the main text (e.g., see Figure 1). ===Links=== Where key words are first used, make them into [[Help:Links|interwiki links]] such as Wikipedia links to articles about famous people (e.g., [[w:Sigmund Freud|Sigmund Freud]] and key concepts (e.g., [[w:Dreams|dreams]]) and links to book chapters about related topics (e.g., would you like to learn about how to overcome [[Motivation and emotion/Book/2020/Writer's block|writer's block]]?). ===Tables=== Tables can be an effective way to organise and summarise information. Tables should be captioned (using APA style) to explain their relevance to the text. Plus each table should be referred to at least once in the main text (e.g., see Table 1 and Table 2). Here are some [[Motivation and emotion/Wikiversity/Tables|example 3 x 3 tables]] which could be adapted. ===Quizzes=== Quizzes are a direct way to engage readers. But don't make quizzes too hard or long. It is better to have one or two review questions per major section than a long quiz at the end. Try to quiz conceptual understanding, rather than trivia. Here are some simple quiz questions which could be adapted. Choose the correct answers and click "Submit": <quiz display=simple> {Quizzes are an interactive learning feature: |type="()"} + True - False {Long quizzes are a good idea: |type="()"} - True + False </quiz> To learn about different types of quiz questions, see [[Help:Quiz|Quiz]]. ==Conclusion== The Conclusion is arguably the most important section. It should be possible for someone to read the [[#Overview|Overview]] and the Conclusion and still get a good idea of the topic. {{tip|Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? }} ==See also== Provide up to half-a-dozen [[Help:Contents/Links#Interwiki_links|internal (wiki) links]] to relevant Wikiversity pages (esp. related [[Motivation and emotion/Book|motivation and emotion book chapters]]) and [[w:|Wikipedia articles]]. For example: * [[Motivation and emotion/Book/2016/Anorexia nervosa and extrinsic motivation|Anorexia nervosa and extrinsic motivation]] (Book chapter, 2016) * [[w:David McClelland|David McClelland]] (Wikipedia) * [[Motivation and emotion/Book/2018/Loss aversion|Loss aversion]] (Book chapter, 2018) * [[w:Maslow's hierarchy of needs|Maslow's hierarchy of needs]] (Wikipedia) {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== List the cited references in [[w:APA style|APA style]] (7th ed.) or [[w:Wikipedia:Citing sources|wiki style]]. APA style example: {{Hanging indent|1= Blair, R. J. R. (2004). The roles of orbital frontal cortex in the modulation of antisocial behavior. ''Brain and Cognition'', ''55''(1), 198–208. https://doi.org/10.1016/S0278-2626(03)00276-8 Buckholtz, J. W., & Meyer-Lindenberg, A. (2008). MAOA and the neurogenetic architecture of human aggression. ''Trends in Neurosciences'', ''31''(3), 120–129. https://doi.org/10.1016/j.tins.2007.12.006 Eckardt, M., File, S., Gessa, G., Grant, K., Guerri, C., Hoffman, P., & Tabakoff, B. (1998). Effects of moderate alcohol consumption on the central nervous system. ''Alcoholism, Clinical and Experimental Research'', ''22''(5), 998–1040. https://doi.org/10.1111/j.1530-0277.1998.tb03695.x }} {{tip|Suggestions for this section: * Important aspects for APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except first letter and proper names, ending in a full-stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full-stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't actually read or consulted }} ==External links== Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * [https://students.unimelb.edu.au/academic-skills/explore-our-resources/essay-writing/six-top-tips-for-writing-a-great-essay Six top tips for writing a great essay] (University of Melbourne) * [http://www.skillsyouneed.com/write/structure.html The importance of structure] (skillsyouneed.com) {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] [[Category:Motivation and emotion/Book/Joy]] rj6w4oka1fuxs3l4k4b63xg5igdykyi 0 286367 2419395 2418882 2022-08-26T08:10:10Z Ana028 2947571 /* See also */ wikitext text/x-wiki {{title|Nature Therapy:<br>What is nature therapy and how can it be applied?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== This Overview section should be concise but consist of several paragraphs which engage the reader, illustrate the problem, and outline how psychological science can help. * ... * ... * ... * Add case study in green box - move around? {{RoundBoxTop|theme=3}} '''Focus questions:''' * What is nature therapy? * What are the benefits of nature therapy? * How can nature therapy be applied? {{RoundBoxBottom}} {{RoundBoxTop|theme=9}} Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Conclude with Focus questions to guide the chapter. {{RoundBoxBottom}} ==What is nature therapy?== * nature therapy is... (reference) * ... * ... {{RoundBoxTop|theme=9}} '''Case Study:''' (Avoid having sections with only one sub-heading) {{RoundBoxBottom|theme=9}} ==What can be gained from nature and its inclusion in therapy?== === General benefits === * ... {{RoundBoxTop|theme=9}} '''Case study:''' How to make a box - source edit {{RoundBoxBottom}} === Protective factors of nature === * Studies showing forest-bathing and nature therapy as a preventive measurement agaisnt depression () {{RoundBoxTop|theme=9}} '''Case study:''' {{RoundBoxBottom}} === Illness and mental health disorders === * Positive results looking at the effect of nature-based therapy on stress-related illness sufferers () * Evidence of significant results of nature therapy helping those with mental health disorders () {{RoundBoxTop|theme=9}} '''Case study:''' {{RoundBoxBottom}} == The application of nature therapy == === Individuals === * Benefits to the relationship between psychoologist and client to add an ecotherapy-based dimension into treatment planning () {{RoundBoxTop|theme=9}} '''Case study:''' {{RoundBoxBottom}} === Families and/or couples === * Studies have demonstrated that a natural environment for group family therapy sessions plays a role in aiding the development of inter-family relationships () {{RoundBoxTop|theme=9}} '''Case study:''' {{RoundBoxBottom}} === Children === * Children with learning disabilities engaged well with nature therapy, demonstrating both group and personal growth (Berger, 2008) {{RoundBoxTop|theme=9}} '''Case study:''' {{RoundBoxBottom}} == How has nature therapy grown and taken different forms? == === Indigenous Australia === * Aboriginal and Torres Strait Islander peoples consider contact with nature an important aspects of their health and wellbeing, and have closely intertwined relationships with nature and Country () === Forest bathing === * Includes forest-based exercise in combination with non-physical activities, such as meditation () === Virtual === * Early in studies relating to virtual nature therapy, though literature reviews indicates positive influences on stress levels () ==Conclusion== The Conclusion is arguably the most important section. It should be possible for someone to read the [[#Overview|Overview]] and the Conclusion and still get a good idea of the topic. * ... * ... * ... {{RoundBoxTop|theme=3}} Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? (put these in this box?) {{RoundBoxBottom|theme=9}} ==See also== * [[wikipedia:Nature_therapy|Nature therapy]] (Wikipedia) ==References== {{Hanging indent|1= Abdullah, S.S.S., Alyan, E., Diyana, N., Merienne, F., Rambli, D.R.A., & Sulaiman, S. (2021). The impact of virtual nature therapy on stress responses: A systematic qualitative review. ''Forests'', ''12''(12), Article 1776. https://doi.org/10.3390/f12121776 Berger, R. (2008). Going on a journey: a case study of nature therapy with children with a learning difficulty. ''Emotional and Behavioural Difficulties'', ''13''(4), 315-326. https://doi.org/10.1080/13632750802440361 Bondas, T., Poulsen, D.V., Sidenius, U., & Stigsdotter, U.K. (2017). "I look at my own forest and fields a different way": The lived experience of nature-based therapy in a therapy garden when suffering from stress-related illness. ''International Journal of Qualitative Studies on Health and Well-Being'', ''12''(1), Article 1324700. https://doi.org/10.1080/17482631.2017.1324700 }} {{tip|Suggestions for this section: ** Provide the full doi as a URL and working hyperlink }} ==External links== * [https://www.wwf.org.uk/5-ways-connect-nature-help-our-wellbeing 5 ways to connect to nature] (WWF) * [https://www.youtube.com/watch?v=kYNpQu0jIyE Nature wisdom] (TED) [[Category:{{#titleparts:{{PAGENAME}}|3}}]] 0ff74xg81o9kqpsm3ym251jm1uz7l5l 2419400 2419395 2022-08-26T08:26:31Z Ana028 2947571 /* General benefits */ wikitext text/x-wiki {{title|Nature Therapy:<br>What is nature therapy and how can it be applied?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== This Overview section should be concise but consist of several paragraphs which engage the reader, illustrate the problem, and outline how psychological science can help. * ... * ... * ... * Add case study in green box - move around? {{RoundBoxTop|theme=3}} '''Focus questions:''' * What is nature therapy? * What are the benefits of nature therapy? * How can nature therapy be applied? {{RoundBoxBottom}} {{RoundBoxTop|theme=9}} Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Conclude with Focus questions to guide the chapter. {{RoundBoxBottom}} ==What is nature therapy?== * nature therapy is... (reference) * ... * ... {{RoundBoxTop|theme=9}} '''Case Study:''' (Avoid having sections with only one sub-heading) {{RoundBoxBottom|theme=9}} ==What can be gained from nature and its inclusion in therapy?== === General benefits === * Rejuvenation of depleted mental faculties, as well as hIgh levels of positive affect, personal growth and wellbeing (Mayseless & Naor, 2021) {{RoundBoxTop|theme=9}} '''Case study:''' How to make a box - source edit {{RoundBoxBottom}} === Protective factors of nature === * Studies showing forest-bathing and nature therapy as a preventive measurement agaisnt depression () {{RoundBoxTop|theme=9}} '''Case study:''' {{RoundBoxBottom}} === Illness and mental health disorders === * Positive results looking at the effect of nature-based therapy on stress-related illness sufferers () * Evidence of significant results of nature therapy helping those with mental health disorders () {{RoundBoxTop|theme=9}} '''Case study:''' {{RoundBoxBottom}} == The application of nature therapy == === Individuals === * Benefits to the relationship between psychoologist and client to add an ecotherapy-based dimension into treatment planning () {{RoundBoxTop|theme=9}} '''Case study:''' {{RoundBoxBottom}} === Families and/or couples === * Studies have demonstrated that a natural environment for group family therapy sessions plays a role in aiding the development of inter-family relationships () {{RoundBoxTop|theme=9}} '''Case study:''' {{RoundBoxBottom}} === Children === * Children with learning disabilities engaged well with nature therapy, demonstrating both group and personal growth (Berger, 2008) {{RoundBoxTop|theme=9}} '''Case study:''' {{RoundBoxBottom}} == How has nature therapy grown and taken different forms? == === Indigenous Australia === * Aboriginal and Torres Strait Islander peoples consider contact with nature an important aspects of their health and wellbeing, and have closely intertwined relationships with nature and Country () === Forest bathing === * Includes forest-based exercise in combination with non-physical activities, such as meditation () === Virtual === * Early in studies relating to virtual nature therapy, though literature reviews indicates positive influences on stress levels () ==Conclusion== The Conclusion is arguably the most important section. It should be possible for someone to read the [[#Overview|Overview]] and the Conclusion and still get a good idea of the topic. * ... * ... * ... {{RoundBoxTop|theme=3}} Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? (put these in this box?) {{RoundBoxBottom|theme=9}} ==See also== * [[wikipedia:Nature_therapy|Nature therapy]] (Wikipedia) ==References== {{Hanging indent|1= Abdullah, S.S.S., Alyan, E., Diyana, N., Merienne, F., Rambli, D.R.A., & Sulaiman, S. (2021). The impact of virtual nature therapy on stress responses: A systematic qualitative review. ''Forests'', ''12''(12), Article 1776. https://doi.org/10.3390/f12121776 Berger, R. (2008). Going on a journey: a case study of nature therapy with children with a learning difficulty. ''Emotional and Behavioural Difficulties'', ''13''(4), 315-326. https://doi.org/10.1080/13632750802440361 Bondas, T., Poulsen, D.V., Sidenius, U., & Stigsdotter, U.K. (2017). "I look at my own forest and fields a different way": The lived experience of nature-based therapy in a therapy garden when suffering from stress-related illness. ''International Journal of Qualitative Studies on Health and Well-Being'', ''12''(1), Article 1324700. https://doi.org/10.1080/17482631.2017.1324700 }} {{tip|Suggestions for this section: ** Provide the full doi as a URL and working hyperlink }} ==External links== * [https://www.wwf.org.uk/5-ways-connect-nature-help-our-wellbeing 5 ways to connect to nature] (WWF) * [https://www.youtube.com/watch?v=kYNpQu0jIyE Nature wisdom] (TED) [[Category:{{#titleparts:{{PAGENAME}}|3}}]] t8bz54dfxo1ho1dxaq6shct27wcfo97 2419401 2419400 2022-08-26T08:29:54Z Ana028 2947571 /* What is nature therapy? */ wikitext text/x-wiki {{title|Nature Therapy:<br>What is nature therapy and how can it be applied?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== This Overview section should be concise but consist of several paragraphs which engage the reader, illustrate the problem, and outline how psychological science can help. * ... * ... * ... * Add case study in green box - move around? {{RoundBoxTop|theme=3}} '''Focus questions:''' * What is nature therapy? * What are the benefits of nature therapy? * How can nature therapy be applied? {{RoundBoxBottom}} {{RoundBoxTop|theme=9}} Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Conclude with Focus questions to guide the chapter. {{RoundBoxBottom}} ==What is nature therapy?== * The incorporation of nature as a active setting and participant in therapeutic processes * ... * ... {{RoundBoxTop|theme=9}} '''Case Study:''' (Avoid having sections with only one sub-heading) {{RoundBoxBottom|theme=9}} ==What can be gained from nature and its inclusion in therapy?== === General benefits === * Rejuvenation of depleted mental faculties, as well as hIgh levels of positive affect, personal growth and wellbeing (Mayseless & Naor, 2021) {{RoundBoxTop|theme=9}} '''Case study:''' How to make a box - source edit {{RoundBoxBottom}} === Protective factors of nature === * Studies showing forest-bathing and nature therapy as a preventive measurement agaisnt depression () {{RoundBoxTop|theme=9}} '''Case study:''' {{RoundBoxBottom}} === Illness and mental health disorders === * Positive results looking at the effect of nature-based therapy on stress-related illness sufferers () * Evidence of significant results of nature therapy helping those with mental health disorders () {{RoundBoxTop|theme=9}} '''Case study:''' {{RoundBoxBottom}} == The application of nature therapy == === Individuals === * Benefits to the relationship between psychoologist and client to add an ecotherapy-based dimension into treatment planning () {{RoundBoxTop|theme=9}} '''Case study:''' {{RoundBoxBottom}} === Families and/or couples === * Studies have demonstrated that a natural environment for group family therapy sessions plays a role in aiding the development of inter-family relationships () {{RoundBoxTop|theme=9}} '''Case study:''' {{RoundBoxBottom}} === Children === * Children with learning disabilities engaged well with nature therapy, demonstrating both group and personal growth (Berger, 2008) {{RoundBoxTop|theme=9}} '''Case study:''' {{RoundBoxBottom}} == How has nature therapy grown and taken different forms? == === Indigenous Australia === * Aboriginal and Torres Strait Islander peoples consider contact with nature an important aspects of their health and wellbeing, and have closely intertwined relationships with nature and Country () === Forest bathing === * Includes forest-based exercise in combination with non-physical activities, such as meditation () === Virtual === * Early in studies relating to virtual nature therapy, though literature reviews indicates positive influences on stress levels () ==Conclusion== The Conclusion is arguably the most important section. It should be possible for someone to read the [[#Overview|Overview]] and the Conclusion and still get a good idea of the topic. * ... * ... * ... {{RoundBoxTop|theme=3}} Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? (put these in this box?) {{RoundBoxBottom|theme=9}} ==See also== * [[wikipedia:Nature_therapy|Nature therapy]] (Wikipedia) ==References== {{Hanging indent|1= Abdullah, S.S.S., Alyan, E., Diyana, N., Merienne, F., Rambli, D.R.A., & Sulaiman, S. (2021). The impact of virtual nature therapy on stress responses: A systematic qualitative review. ''Forests'', ''12''(12), Article 1776. https://doi.org/10.3390/f12121776 Berger, R. (2008). Going on a journey: a case study of nature therapy with children with a learning difficulty. ''Emotional and Behavioural Difficulties'', ''13''(4), 315-326. https://doi.org/10.1080/13632750802440361 Bondas, T., Poulsen, D.V., Sidenius, U., & Stigsdotter, U.K. (2017). "I look at my own forest and fields a different way": The lived experience of nature-based therapy in a therapy garden when suffering from stress-related illness. ''International Journal of Qualitative Studies on Health and Well-Being'', ''12''(1), Article 1324700. https://doi.org/10.1080/17482631.2017.1324700 }} {{tip|Suggestions for this section: ** Provide the full doi as a URL and working hyperlink }} ==External links== * [https://www.wwf.org.uk/5-ways-connect-nature-help-our-wellbeing 5 ways to connect to nature] (WWF) * [https://www.youtube.com/watch?v=kYNpQu0jIyE Nature wisdom] (TED) [[Category:{{#titleparts:{{PAGENAME}}|3}}]] hnc5xbhxg0jtq37kgf6ey92v0llub9j 2419403 2419401 2022-08-26T08:37:11Z Ana028 2947571 /* What is nature therapy? */ wikitext text/x-wiki {{title|Nature Therapy:<br>What is nature therapy and how can it be applied?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== This Overview section should be concise but consist of several paragraphs which engage the reader, illustrate the problem, and outline how psychological science can help. * ... * ... * ... * Add case study in green box - move around? {{RoundBoxTop|theme=3}} '''Focus questions:''' * What is nature therapy? * What are the benefits of nature therapy? * How can nature therapy be applied? {{RoundBoxBottom}} {{RoundBoxTop|theme=9}} Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Conclude with Focus questions to guide the chapter. {{RoundBoxBottom}} ==What is nature therapy?== * Incorporation of nature as a active setting and participant in therapeutic processes (Mayseless & Naor, 2021) * * Holistic framework involving a large range of therapeutic techniques (Berger, 2009) {{RoundBoxTop|theme=9}} '''Case Study:''' (Avoid having sections with only one sub-heading) {{RoundBoxBottom|theme=9}} ==What can be gained from nature and its inclusion in therapy?== === General benefits === * Rejuvenation of depleted mental faculties, as well as hIgh levels of positive affect, personal growth and wellbeing (Mayseless & Naor, 2021) {{RoundBoxTop|theme=9}} '''Case study:''' How to make a box - source edit {{RoundBoxBottom}} === Protective factors of nature === * Studies showing forest-bathing and nature therapy as a preventive measurement agaisnt depression () {{RoundBoxTop|theme=9}} '''Case study:''' {{RoundBoxBottom}} === Illness and mental health disorders === * Positive results looking at the effect of nature-based therapy on stress-related illness sufferers () * Evidence of significant results of nature therapy helping those with mental health disorders () {{RoundBoxTop|theme=9}} '''Case study:''' {{RoundBoxBottom}} == The application of nature therapy == === Individuals === * Benefits to the relationship between psychoologist and client to add an ecotherapy-based dimension into treatment planning () {{RoundBoxTop|theme=9}} '''Case study:''' {{RoundBoxBottom}} === Families and/or couples === * Studies have demonstrated that a natural environment for group family therapy sessions plays a role in aiding the development of inter-family relationships () {{RoundBoxTop|theme=9}} '''Case study:''' {{RoundBoxBottom}} === Children === * Children with learning disabilities engaged well with nature therapy, demonstrating both group and personal growth (Berger, 2008) {{RoundBoxTop|theme=9}} '''Case study:''' {{RoundBoxBottom}} == How has nature therapy grown and taken different forms? == === Indigenous Australia === * Aboriginal and Torres Strait Islander peoples consider contact with nature an important aspects of their health and wellbeing, and have closely intertwined relationships with nature and Country () === Forest bathing === * Includes forest-based exercise in combination with non-physical activities, such as meditation () === Virtual === * Early in studies relating to virtual nature therapy, though literature reviews indicates positive influences on stress levels () ==Conclusion== The Conclusion is arguably the most important section. It should be possible for someone to read the [[#Overview|Overview]] and the Conclusion and still get a good idea of the topic. * ... * ... * ... {{RoundBoxTop|theme=3}} Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? (put these in this box?) {{RoundBoxBottom|theme=9}} ==See also== * [[wikipedia:Nature_therapy|Nature therapy]] (Wikipedia) ==References== {{Hanging indent|1= Abdullah, S.S.S., Alyan, E., Diyana, N., Merienne, F., Rambli, D.R.A., & Sulaiman, S. (2021). The impact of virtual nature therapy on stress responses: A systematic qualitative review. ''Forests'', ''12''(12), Article 1776. https://doi.org/10.3390/f12121776 Berger, R. (2008). Going on a journey: a case study of nature therapy with children with a learning difficulty. ''Emotional and Behavioural Difficulties'', ''13''(4), 315-326. https://doi.org/10.1080/13632750802440361 Bondas, T., Poulsen, D.V., Sidenius, U., & Stigsdotter, U.K. (2017). "I look at my own forest and fields a different way": The lived experience of nature-based therapy in a therapy garden when suffering from stress-related illness. ''International Journal of Qualitative Studies on Health and Well-Being'', ''12''(1), Article 1324700. https://doi.org/10.1080/17482631.2017.1324700 }} {{tip|Suggestions for this section: ** Provide the full doi as a URL and working hyperlink }} ==External links== * [https://www.wwf.org.uk/5-ways-connect-nature-help-our-wellbeing 5 ways to connect to nature] (WWF) * [https://www.youtube.com/watch?v=kYNpQu0jIyE Nature wisdom] (TED) [[Category:{{#titleparts:{{PAGENAME}}|3}}]] dl5bagrk7k8cz0wv5u2o5xx1v142mgc 2419409 2419403 2022-08-26T08:42:52Z Ana028 2947571 /* What is nature therapy? */ wikitext text/x-wiki {{title|Nature Therapy:<br>What is nature therapy and how can it be applied?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== This Overview section should be concise but consist of several paragraphs which engage the reader, illustrate the problem, and outline how psychological science can help. * ... * ... * ... * Add case study in green box - move around? {{RoundBoxTop|theme=3}} '''Focus questions:''' * What is nature therapy? * What are the benefits of nature therapy? * How can nature therapy be applied? {{RoundBoxBottom}} {{RoundBoxTop|theme=9}} Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Conclude with Focus questions to guide the chapter. {{RoundBoxBottom}} ==What is nature therapy?== * Incorporation of nature as a active setting and participant in therapeutic processes (Mayseless & Naor, 2021) *Reconnecting with natural environments in order to achieve physical and mental health benefits (Annerstedt & Währborg, 2011) * Holistic framework involving a large range of therapeutic techniques (Berger, 2009) {{RoundBoxTop|theme=9}} '''Case Study:''' (Avoid having sections with only one sub-heading) {{RoundBoxBottom|theme=9}} ==What can be gained from nature and its inclusion in therapy?== === General benefits === * Rejuvenation of depleted mental faculties, as well as hIgh levels of positive affect, personal growth and wellbeing (Mayseless & Naor, 2021) {{RoundBoxTop|theme=9}} '''Case study:''' How to make a box - source edit {{RoundBoxBottom}} === Protective factors of nature === * Studies showing forest-bathing and nature therapy as a preventive measurement agaisnt depression () {{RoundBoxTop|theme=9}} '''Case study:''' {{RoundBoxBottom}} === Illness and mental health disorders === * Positive results looking at the effect of nature-based therapy on stress-related illness sufferers () * Evidence of significant results of nature therapy helping those with mental health disorders () {{RoundBoxTop|theme=9}} '''Case study:''' {{RoundBoxBottom}} == The application of nature therapy == === Individuals === * Benefits to the relationship between psychoologist and client to add an ecotherapy-based dimension into treatment planning () {{RoundBoxTop|theme=9}} '''Case study:''' {{RoundBoxBottom}} === Families and/or couples === * Studies have demonstrated that a natural environment for group family therapy sessions plays a role in aiding the development of inter-family relationships () {{RoundBoxTop|theme=9}} '''Case study:''' {{RoundBoxBottom}} === Children === * Children with learning disabilities engaged well with nature therapy, demonstrating both group and personal growth (Berger, 2008) {{RoundBoxTop|theme=9}} '''Case study:''' {{RoundBoxBottom}} == How has nature therapy grown and taken different forms? == === Indigenous Australia === * Aboriginal and Torres Strait Islander peoples consider contact with nature an important aspects of their health and wellbeing, and have closely intertwined relationships with nature and Country () === Forest bathing === * Includes forest-based exercise in combination with non-physical activities, such as meditation () === Virtual === * Early in studies relating to virtual nature therapy, though literature reviews indicates positive influences on stress levels () ==Conclusion== The Conclusion is arguably the most important section. It should be possible for someone to read the [[#Overview|Overview]] and the Conclusion and still get a good idea of the topic. * ... * ... * ... {{RoundBoxTop|theme=3}} Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? (put these in this box?) {{RoundBoxBottom|theme=9}} ==See also== * [[wikipedia:Nature_therapy|Nature therapy]] (Wikipedia) ==References== {{Hanging indent|1= Abdullah, S.S.S., Alyan, E., Diyana, N., Merienne, F., Rambli, D.R.A., & Sulaiman, S. (2021). The impact of virtual nature therapy on stress responses: A systematic qualitative review. ''Forests'', ''12''(12), Article 1776. https://doi.org/10.3390/f12121776 Berger, R. (2008). Going on a journey: a case study of nature therapy with children with a learning difficulty. ''Emotional and Behavioural Difficulties'', ''13''(4), 315-326. https://doi.org/10.1080/13632750802440361 Bondas, T., Poulsen, D.V., Sidenius, U., & Stigsdotter, U.K. (2017). "I look at my own forest and fields a different way": The lived experience of nature-based therapy in a therapy garden when suffering from stress-related illness. ''International Journal of Qualitative Studies on Health and Well-Being'', ''12''(1), Article 1324700. https://doi.org/10.1080/17482631.2017.1324700 }} {{tip|Suggestions for this section: ** Provide the full doi as a URL and working hyperlink }} ==External links== * [https://www.wwf.org.uk/5-ways-connect-nature-help-our-wellbeing 5 ways to connect to nature] (WWF) * [https://www.youtube.com/watch?v=kYNpQu0jIyE Nature wisdom] (TED) [[Category:{{#titleparts:{{PAGENAME}}|3}}]] roe98r1jqpyt415zefvndg74wlasmjt 2419414 2419409 2022-08-26T08:49:38Z Ana028 2947571 /* What is nature therapy? */ wikitext text/x-wiki {{title|Nature Therapy:<br>What is nature therapy and how can it be applied?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== This Overview section should be concise but consist of several paragraphs which engage the reader, illustrate the problem, and outline how psychological science can help. * ... * ... * ... * Add case study in green box - move around? {{RoundBoxTop|theme=3}} '''Focus questions:''' * What is nature therapy? * What are the benefits of nature therapy? * How can nature therapy be applied? {{RoundBoxBottom}} {{RoundBoxTop|theme=9}} Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Conclude with Focus questions to guide the chapter. {{RoundBoxBottom}} ==What is nature therapy?== * Incorporation of nature as a active setting and participant in therapeutic processes (Mayseless & Naor, 2021) *Reconnecting with natural environments in order to achieve physical and mental health benefits (Annerstedt & Währborg, 2011) * Holistic framework involving a large range of therapeutic techniques (Berger, 2009) {{RoundBoxTop|theme=9}} '''Case Study:''' {{RoundBoxBottom|theme=9}} ==What can be gained from nature and its inclusion in therapy?== === General benefits === * Rejuvenation of depleted mental faculties, as well as hIgh levels of positive affect, personal growth and wellbeing (Mayseless & Naor, 2021) {{RoundBoxTop|theme=9}} '''Case study:''' {{RoundBoxBottom}} === Protective factors of nature === * Studies showing forest-bathing and nature therapy as a preventive measurement agaisnt depression () {{RoundBoxTop|theme=9}} '''Case study:''' {{RoundBoxBottom}} === Illness and mental health disorders === * Positive results looking at the effect of nature-based therapy on stress-related illness sufferers () * Evidence of significant results of nature therapy helping those with mental health disorders () {{RoundBoxTop|theme=9}} '''Case study:''' {{RoundBoxBottom}} == The application of nature therapy == === Individuals === * Benefits to the relationship between psychoologist and client to add an ecotherapy-based dimension into treatment planning () {{RoundBoxTop|theme=9}} '''Case study:''' {{RoundBoxBottom}} === Families and/or couples === * Studies have demonstrated that a natural environment for group family therapy sessions plays a role in aiding the development of inter-family relationships () {{RoundBoxTop|theme=9}} '''Case study:''' {{RoundBoxBottom}} === Children === * Children with learning disabilities engaged well with nature therapy, demonstrating both group and personal growth (Berger, 2008) {{RoundBoxTop|theme=9}} '''Case study:''' {{RoundBoxBottom}} == How has nature therapy grown and taken different forms? == === Indigenous Australia === * Aboriginal and Torres Strait Islander peoples consider contact with nature an important aspect of their health and wellbeing, and have closely intertwined relationships with nature and Country (Bolam et al., 2013) === Forest bathing === * Includes forest-based exercise in combination with non-physical activities, such as meditation (Collado et al., 2021) === Virtual === * Early in studies relating to virtual nature therapy, though literature reviews indicates positive influences on stress levels (Abdullah et al., 2021) ==Conclusion== The Conclusion is arguably the most important section. It should be possible for someone to read the [[#Overview|Overview]] and the Conclusion and still get a good idea of the topic. * ... * ... * ... {{RoundBoxTop|theme=3}} Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? (put these in this box?) {{RoundBoxBottom|theme=9}} ==See also== * [[wikipedia:Nature_therapy|Nature therapy]] (Wikipedia) ==References== {{Hanging indent|1= Abdullah, S.S.S., Alyan, E., Diyana, N., Merienne, F., Rambli, D.R.A., & Sulaiman, S. (2021). The impact of virtual nature therapy on stress responses: A systematic qualitative review. ''Forests'', ''12''(12), Article 1776. https://doi.org/10.3390/f12121776 Berger, R. (2008). Going on a journey: a case study of nature therapy with children with a learning difficulty. ''Emotional and Behavioural Difficulties'', ''13''(4), 315-326. https://doi.org/10.1080/13632750802440361 Bondas, T., Poulsen, D.V., Sidenius, U., & Stigsdotter, U.K. (2017). "I look at my own forest and fields a different way": The lived experience of nature-based therapy in a therapy garden when suffering from stress-related illness. ''International Journal of Qualitative Studies on Health and Well-Being'', ''12''(1), Article 1324700. https://doi.org/10.1080/17482631.2017.1324700 }} {{tip|Suggestions for this section: ** Provide the full doi as a URL and working hyperlink }} ==External links== * [https://www.wwf.org.uk/5-ways-connect-nature-help-our-wellbeing 5 ways to connect to nature] (WWF) * [https://www.youtube.com/watch?v=kYNpQu0jIyE Nature wisdom] (TED) [[Category:{{#titleparts:{{PAGENAME}}|3}}]] r4lxqv2iagq7xcsxa9zex18ctqh741s 2419415 2419414 2022-08-26T08:50:28Z Ana028 2947571 /* The application of nature therapy */ wikitext text/x-wiki {{title|Nature Therapy:<br>What is nature therapy and how can it be applied?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== This Overview section should be concise but consist of several paragraphs which engage the reader, illustrate the problem, and outline how psychological science can help. * ... * ... * ... * Add case study in green box - move around? {{RoundBoxTop|theme=3}} '''Focus questions:''' * What is nature therapy? * What are the benefits of nature therapy? * How can nature therapy be applied? {{RoundBoxBottom}} {{RoundBoxTop|theme=9}} Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Conclude with Focus questions to guide the chapter. {{RoundBoxBottom}} ==What is nature therapy?== * Incorporation of nature as a active setting and participant in therapeutic processes (Mayseless & Naor, 2021) *Reconnecting with natural environments in order to achieve physical and mental health benefits (Annerstedt & Währborg, 2011) * Holistic framework involving a large range of therapeutic techniques (Berger, 2009) {{RoundBoxTop|theme=9}} '''Case Study:''' {{RoundBoxBottom|theme=9}} ==What can be gained from nature and its inclusion in therapy?== === General benefits === * Rejuvenation of depleted mental faculties, as well as hIgh levels of positive affect, personal growth and wellbeing (Mayseless & Naor, 2021) {{RoundBoxTop|theme=9}} '''Case study:''' {{RoundBoxBottom}} === Protective factors of nature === * Studies showing forest-bathing and nature therapy as a preventive measurement agaisnt depression () {{RoundBoxTop|theme=9}} '''Case study:''' {{RoundBoxBottom}} === Illness and mental health disorders === * Positive results looking at the effect of nature-based therapy on stress-related illness sufferers () * Evidence of significant results of nature therapy helping those with mental health disorders () {{RoundBoxTop|theme=9}} '''Case study:''' {{RoundBoxBottom}} == The application of nature therapy == === Individuals === * Benefits to the relationship between psychologist and client to add an ecotherapy-based dimension into treatment planning () {{RoundBoxTop|theme=9}} '''Case study:''' {{RoundBoxBottom}} === Families and/or couples === * Studies have demonstrated that a natural environment for group family therapy sessions plays a role in aiding the development of inter-family relationships () {{RoundBoxTop|theme=9}} '''Case study:''' {{RoundBoxBottom}} === Children === * Children with learning disabilities engaged well with nature therapy, demonstrating both group and personal growth (Berger, 2008) {{RoundBoxTop|theme=9}} '''Case study:''' {{RoundBoxBottom}} == How has nature therapy grown and taken different forms? == === Indigenous Australia === * Aboriginal and Torres Strait Islander peoples consider contact with nature an important aspect of their health and wellbeing, and have closely intertwined relationships with nature and Country (Bolam et al., 2013) === Forest bathing === * Includes forest-based exercise in combination with non-physical activities, such as meditation (Collado et al., 2021) === Virtual === * Early in studies relating to virtual nature therapy, though literature reviews indicates positive influences on stress levels (Abdullah et al., 2021) ==Conclusion== The Conclusion is arguably the most important section. It should be possible for someone to read the [[#Overview|Overview]] and the Conclusion and still get a good idea of the topic. * ... * ... * ... {{RoundBoxTop|theme=3}} Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? (put these in this box?) {{RoundBoxBottom|theme=9}} ==See also== * [[wikipedia:Nature_therapy|Nature therapy]] (Wikipedia) ==References== {{Hanging indent|1= Abdullah, S.S.S., Alyan, E., Diyana, N., Merienne, F., Rambli, D.R.A., & Sulaiman, S. (2021). The impact of virtual nature therapy on stress responses: A systematic qualitative review. ''Forests'', ''12''(12), Article 1776. https://doi.org/10.3390/f12121776 Berger, R. (2008). Going on a journey: a case study of nature therapy with children with a learning difficulty. ''Emotional and Behavioural Difficulties'', ''13''(4), 315-326. https://doi.org/10.1080/13632750802440361 Bondas, T., Poulsen, D.V., Sidenius, U., & Stigsdotter, U.K. (2017). "I look at my own forest and fields a different way": The lived experience of nature-based therapy in a therapy garden when suffering from stress-related illness. ''International Journal of Qualitative Studies on Health and Well-Being'', ''12''(1), Article 1324700. https://doi.org/10.1080/17482631.2017.1324700 }} {{tip|Suggestions for this section: ** Provide the full doi as a URL and working hyperlink }} ==External links== * [https://www.wwf.org.uk/5-ways-connect-nature-help-our-wellbeing 5 ways to connect to nature] (WWF) * [https://www.youtube.com/watch?v=kYNpQu0jIyE Nature wisdom] (TED) [[Category:{{#titleparts:{{PAGENAME}}|3}}]] lpgsjotvlmuehvtnmazs0iacdqbcnxf 2419418 2419415 2022-08-26T08:57:31Z Ana028 2947571 /* The application of nature therapy */ wikitext text/x-wiki {{title|Nature Therapy:<br>What is nature therapy and how can it be applied?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== This Overview section should be concise but consist of several paragraphs which engage the reader, illustrate the problem, and outline how psychological science can help. * ... * ... * ... * Add case study in green box - move around? {{RoundBoxTop|theme=3}} '''Focus questions:''' * What is nature therapy? * What are the benefits of nature therapy? * How can nature therapy be applied? {{RoundBoxBottom}} {{RoundBoxTop|theme=9}} Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Conclude with Focus questions to guide the chapter. {{RoundBoxBottom}} ==What is nature therapy?== * Incorporation of nature as a active setting and participant in therapeutic processes (Mayseless & Naor, 2021) *Reconnecting with natural environments in order to achieve physical and mental health benefits (Annerstedt & Währborg, 2011) * Holistic framework involving a large range of therapeutic techniques (Berger, 2009) {{RoundBoxTop|theme=9}} '''Case Study:''' {{RoundBoxBottom|theme=9}} ==What can be gained from nature and its inclusion in therapy?== === General benefits === * Rejuvenation of depleted mental faculties, as well as hIgh levels of positive affect, personal growth and wellbeing (Mayseless & Naor, 2021) {{RoundBoxTop|theme=9}} '''Case study:''' {{RoundBoxBottom}} === Protective factors of nature === * Studies showing forest-bathing and nature therapy as a preventive measurement agaisnt depression () {{RoundBoxTop|theme=9}} '''Case study:''' {{RoundBoxBottom}} === Illness and mental health disorders === * Positive results looking at the effect of nature-based therapy on stress-related illness sufferers () * Evidence of significant results of nature therapy helping those with mental health disorders () {{RoundBoxTop|theme=9}} '''Case study:''' {{RoundBoxBottom}} == The application of nature therapy == === Individuals === * Benefits to the relationship between psychologist and client to add an ecotherapy-based dimension into treatment planning (Lollar et al., 2022) {{RoundBoxTop|theme=9}} '''Case study:''' {{RoundBoxBottom}} === Families and/or couples === * Studies have demonstrated that a natural environment for group family therapy sessions plays a role in aiding the development of inter-family relationships (Lo & Ma, 2022) {{RoundBoxTop|theme=9}} '''Case study:''' {{RoundBoxBottom}} === Children === * Children with learning disabilities engaged well with nature therapy, demonstrating both group and personal growth (Berger, 2008) {{RoundBoxTop|theme=9}} '''Case study:''' {{RoundBoxBottom}} == How has nature therapy grown and taken different forms? == === Indigenous Australia === * Aboriginal and Torres Strait Islander peoples consider contact with nature an important aspect of their health and wellbeing, and have closely intertwined relationships with nature and Country (Bolam et al., 2013) === Forest bathing === * Includes forest-based exercise in combination with non-physical activities, such as meditation (Collado et al., 2021) === Virtual === * Early in studies relating to virtual nature therapy, though literature reviews indicates positive influences on stress levels (Abdullah et al., 2021) ==Conclusion== The Conclusion is arguably the most important section. It should be possible for someone to read the [[#Overview|Overview]] and the Conclusion and still get a good idea of the topic. * ... * ... * ... {{RoundBoxTop|theme=3}} Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? (put these in this box?) {{RoundBoxBottom|theme=9}} ==See also== * [[wikipedia:Nature_therapy|Nature therapy]] (Wikipedia) ==References== {{Hanging indent|1= Abdullah, S.S.S., Alyan, E., Diyana, N., Merienne, F., Rambli, D.R.A., & Sulaiman, S. (2021). The impact of virtual nature therapy on stress responses: A systematic qualitative review. ''Forests'', ''12''(12), Article 1776. https://doi.org/10.3390/f12121776 Berger, R. (2008). Going on a journey: a case study of nature therapy with children with a learning difficulty. ''Emotional and Behavioural Difficulties'', ''13''(4), 315-326. https://doi.org/10.1080/13632750802440361 Bondas, T., Poulsen, D.V., Sidenius, U., & Stigsdotter, U.K. (2017). "I look at my own forest and fields a different way": The lived experience of nature-based therapy in a therapy garden when suffering from stress-related illness. ''International Journal of Qualitative Studies on Health and Well-Being'', ''12''(1), Article 1324700. https://doi.org/10.1080/17482631.2017.1324700 }} {{tip|Suggestions for this section: ** Provide the full doi as a URL and working hyperlink }} ==External links== * [https://www.wwf.org.uk/5-ways-connect-nature-help-our-wellbeing 5 ways to connect to nature] (WWF) * [https://www.youtube.com/watch?v=kYNpQu0jIyE Nature wisdom] (TED) [[Category:{{#titleparts:{{PAGENAME}}|3}}]] huy95016no9fkyq7a4zwodcghsnml98 2419426 2419418 2022-08-26T09:05:42Z Ana028 2947571 /* Protective factors of nature */ wikitext text/x-wiki {{title|Nature Therapy:<br>What is nature therapy and how can it be applied?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== This Overview section should be concise but consist of several paragraphs which engage the reader, illustrate the problem, and outline how psychological science can help. * ... * ... * ... * Add case study in green box - move around? {{RoundBoxTop|theme=3}} '''Focus questions:''' * What is nature therapy? * What are the benefits of nature therapy? * How can nature therapy be applied? {{RoundBoxBottom}} {{RoundBoxTop|theme=9}} Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Conclude with Focus questions to guide the chapter. {{RoundBoxBottom}} ==What is nature therapy?== * Incorporation of nature as a active setting and participant in therapeutic processes (Mayseless & Naor, 2021) *Reconnecting with natural environments in order to achieve physical and mental health benefits (Annerstedt & Währborg, 2011) * Holistic framework involving a large range of therapeutic techniques (Berger, 2009) {{RoundBoxTop|theme=9}} '''Case Study:''' {{RoundBoxBottom|theme=9}} ==What can be gained from nature and its inclusion in therapy?== === General benefits === * Rejuvenation of depleted mental faculties, as well as hIgh levels of positive affect, personal growth and wellbeing (Mayseless & Naor, 2021) {{RoundBoxTop|theme=9}} '''Case study:''' {{RoundBoxBottom}} === Protective factors of nature === * Studies show forest-bathing and nature therapy is a preventive measure against depression (Collado et al., 2021) {{RoundBoxTop|theme=9}} '''Case study:''' {{RoundBoxBottom}} === Illness and mental health disorders === * Positive results looking at the effect of nature-based therapy on stress-related illness sufferers () * Evidence of significant results of nature therapy helping those with mental health disorders () {{RoundBoxTop|theme=9}} '''Case study:''' {{RoundBoxBottom}} == The application of nature therapy == === Individuals === * Benefits to the relationship between psychologist and client to add an ecotherapy-based dimension into treatment planning (Lollar et al., 2022) {{RoundBoxTop|theme=9}} '''Case study:''' {{RoundBoxBottom}} === Families and/or couples === * Studies have demonstrated that a natural environment for group family therapy sessions plays a role in aiding the development of inter-family relationships (Lo & Ma, 2022) {{RoundBoxTop|theme=9}} '''Case study:''' {{RoundBoxBottom}} === Children === * Children with learning disabilities engaged well with nature therapy, demonstrating both group and personal growth (Berger, 2008) {{RoundBoxTop|theme=9}} '''Case study:''' {{RoundBoxBottom}} == How has nature therapy grown and taken different forms? == === Indigenous Australia === * Aboriginal and Torres Strait Islander peoples consider contact with nature an important aspect of their health and wellbeing, and have closely intertwined relationships with nature and Country (Bolam et al., 2013) === Forest bathing === * Includes forest-based exercise in combination with non-physical activities, such as meditation (Collado et al., 2021) === Virtual === * Early in studies relating to virtual nature therapy, though literature reviews indicates positive influences on stress levels (Abdullah et al., 2021) ==Conclusion== The Conclusion is arguably the most important section. It should be possible for someone to read the [[#Overview|Overview]] and the Conclusion and still get a good idea of the topic. * ... * ... * ... {{RoundBoxTop|theme=3}} Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? (put these in this box?) {{RoundBoxBottom|theme=9}} ==See also== * [[wikipedia:Nature_therapy|Nature therapy]] (Wikipedia) ==References== {{Hanging indent|1= Abdullah, S.S.S., Alyan, E., Diyana, N., Merienne, F., Rambli, D.R.A., & Sulaiman, S. (2021). The impact of virtual nature therapy on stress responses: A systematic qualitative review. ''Forests'', ''12''(12), Article 1776. https://doi.org/10.3390/f12121776 Berger, R. (2008). Going on a journey: a case study of nature therapy with children with a learning difficulty. ''Emotional and Behavioural Difficulties'', ''13''(4), 315-326. https://doi.org/10.1080/13632750802440361 Bondas, T., Poulsen, D.V., Sidenius, U., & Stigsdotter, U.K. (2017). "I look at my own forest and fields a different way": The lived experience of nature-based therapy in a therapy garden when suffering from stress-related illness. ''International Journal of Qualitative Studies on Health and Well-Being'', ''12''(1), Article 1324700. https://doi.org/10.1080/17482631.2017.1324700 }} {{tip|Suggestions for this section: ** Provide the full doi as a URL and working hyperlink }} ==External links== * [https://www.wwf.org.uk/5-ways-connect-nature-help-our-wellbeing 5 ways to connect to nature] (WWF) * [https://www.youtube.com/watch?v=kYNpQu0jIyE Nature wisdom] (TED) [[Category:{{#titleparts:{{PAGENAME}}|3}}]] 2dhnsrgle602iyqrb7tanic4lymcxx3 2419431 2419426 2022-08-26T09:15:45Z Ana028 2947571 /* Illness and mental health disorders */ wikitext text/x-wiki {{title|Nature Therapy:<br>What is nature therapy and how can it be applied?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== This Overview section should be concise but consist of several paragraphs which engage the reader, illustrate the problem, and outline how psychological science can help. * ... * ... * ... * Add case study in green box - move around? {{RoundBoxTop|theme=3}} '''Focus questions:''' * What is nature therapy? * What are the benefits of nature therapy? * How can nature therapy be applied? {{RoundBoxBottom}} {{RoundBoxTop|theme=9}} Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Conclude with Focus questions to guide the chapter. {{RoundBoxBottom}} ==What is nature therapy?== * Incorporation of nature as a active setting and participant in therapeutic processes (Mayseless & Naor, 2021) *Reconnecting with natural environments in order to achieve physical and mental health benefits (Annerstedt & Währborg, 2011) * Holistic framework involving a large range of therapeutic techniques (Berger, 2009) {{RoundBoxTop|theme=9}} '''Case Study:''' {{RoundBoxBottom|theme=9}} ==What can be gained from nature and its inclusion in therapy?== === General benefits === * Rejuvenation of depleted mental faculties, as well as hIgh levels of positive affect, personal growth and wellbeing (Mayseless & Naor, 2021) {{RoundBoxTop|theme=9}} '''Case study:''' {{RoundBoxBottom}} === Protective factors of nature === * Studies show forest-bathing and nature therapy is a preventive measure against depression (Collado et al., 2021) {{RoundBoxTop|theme=9}} '''Case study:''' {{RoundBoxBottom}} === Illness and mental health disorders === * Positive results looking at the effect of nature-based therapy on stress-related illness sufferers (Bondas et al., 2017) * Evidence of significant results of nature therapy helping those with mental health disorders (Banerjee & Chaudhury, 2020) {{RoundBoxTop|theme=9}} '''Case study:''' {{RoundBoxBottom}} == The application of nature therapy == === Individuals === * Benefits to the relationship between psychologist and client to add an ecotherapy-based dimension into treatment planning (Lollar et al., 2022) {{RoundBoxTop|theme=9}} '''Case study:''' {{RoundBoxBottom}} === Families and/or couples === * Studies have demonstrated that a natural environment for group family therapy sessions plays a role in aiding the development of inter-family relationships (Lo & Ma, 2022) {{RoundBoxTop|theme=9}} '''Case study:''' {{RoundBoxBottom}} === Children === * Children with learning disabilities engaged well with nature therapy, demonstrating both group and personal growth (Berger, 2008) {{RoundBoxTop|theme=9}} '''Case study:''' {{RoundBoxBottom}} == How has nature therapy grown and taken different forms? == === Indigenous Australia === * Aboriginal and Torres Strait Islander peoples consider contact with nature an important aspect of their health and wellbeing, and have closely intertwined relationships with nature and Country (Bolam et al., 2013) === Forest bathing === * Includes forest-based exercise in combination with non-physical activities, such as meditation (Collado et al., 2021) === Virtual === * Early in studies relating to virtual nature therapy, though literature reviews indicates positive influences on stress levels (Abdullah et al., 2021) ==Conclusion== The Conclusion is arguably the most important section. It should be possible for someone to read the [[#Overview|Overview]] and the Conclusion and still get a good idea of the topic. * ... * ... * ... {{RoundBoxTop|theme=3}} Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? (put these in this box?) {{RoundBoxBottom|theme=9}} ==See also== * [[wikipedia:Nature_therapy|Nature therapy]] (Wikipedia) ==References== {{Hanging indent|1= Abdullah, S.S.S., Alyan, E., Diyana, N., Merienne, F., Rambli, D.R.A., & Sulaiman, S. (2021). The impact of virtual nature therapy on stress responses: A systematic qualitative review. ''Forests'', ''12''(12), Article 1776. https://doi.org/10.3390/f12121776 Berger, R. (2008). Going on a journey: a case study of nature therapy with children with a learning difficulty. ''Emotional and Behavioural Difficulties'', ''13''(4), 315-326. https://doi.org/10.1080/13632750802440361 Bondas, T., Poulsen, D.V., Sidenius, U., & Stigsdotter, U.K. (2017). "I look at my own forest and fields a different way": The lived experience of nature-based therapy in a therapy garden when suffering from stress-related illness. ''International Journal of Qualitative Studies on Health and Well-Being'', ''12''(1), Article 1324700. https://doi.org/10.1080/17482631.2017.1324700 }} {{tip|Suggestions for this section: ** Provide the full doi as a URL and working hyperlink }} ==External links== * [https://www.wwf.org.uk/5-ways-connect-nature-help-our-wellbeing 5 ways to connect to nature] (WWF) * [https://www.youtube.com/watch?v=kYNpQu0jIyE Nature wisdom] (TED) [[Category:{{#titleparts:{{PAGENAME}}|3}}]] ntgzo1o3gomi59ra7lnnyqv02mfbc9q 2419437 2419431 2022-08-26T09:22:56Z Ana028 2947571 /* Overview */ wikitext text/x-wiki {{title|Nature Therapy:<br>What is nature therapy and how can it be applied?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== (Overview section should be concise but consist of several paragraphs which engage the reader, illustrate the problem, and outline how psychological science can help) * Numerous studies have demonstrated that nature therapy has a positive affect on physical, mental and interrelational health and wellbeing * Effects of nature therapy and exposure to nature range from personal, preventive and physical health benefits * Nature therapy can be applied in a number of contexts, including but not limited to individually, group settings and young people {{RoundBoxTop|theme=3}} '''Focus questions:''' * What is nature therapy? * What are the benefits of nature therapy? * How can nature therapy be applied? {{RoundBoxBottom}} {{RoundBoxTop|theme=9}} Case study: (How can specific motivation and/or emotion theories and research help?) {{RoundBoxBottom}} ==What is nature therapy?== * Incorporation of nature as a active setting and participant in therapeutic processes (Mayseless & Naor, 2021) *Reconnecting with natural environments in order to achieve physical and mental health benefits (Annerstedt & Währborg, 2011) * Holistic framework involving a large range of therapeutic techniques (Berger, 2009) {{RoundBoxTop|theme=9}} '''Case Study:''' {{RoundBoxBottom|theme=9}} ==What can be gained from nature and its inclusion in therapy?== === General benefits === * Rejuvenation of depleted mental faculties, as well as hIgh levels of positive affect, personal growth and wellbeing (Mayseless & Naor, 2021) {{RoundBoxTop|theme=9}} '''Case study:''' {{RoundBoxBottom}} === Protective factors of nature === * Studies show forest-bathing and nature therapy is a preventive measure against depression (Collado et al., 2021) {{RoundBoxTop|theme=9}} '''Case study:''' {{RoundBoxBottom}} === Illness and mental health disorders === * Positive results looking at the effect of nature-based therapy on stress-related illness sufferers (Bondas et al., 2017) * Evidence of significant results of nature therapy helping those with mental health disorders (Banerjee & Chaudhury, 2020) {{RoundBoxTop|theme=9}} '''Case study:''' {{RoundBoxBottom}} == The application of nature therapy == === Individuals === * Benefits to the relationship between psychologist and client to add an ecotherapy-based dimension into treatment planning (Lollar et al., 2022) {{RoundBoxTop|theme=9}} '''Case study:''' {{RoundBoxBottom}} === Families and/or couples === * Studies have demonstrated that a natural environment for group family therapy sessions plays a role in aiding the development of inter-family relationships (Lo & Ma, 2022) {{RoundBoxTop|theme=9}} '''Case study:''' {{RoundBoxBottom}} === Children === * Children with learning disabilities engaged well with nature therapy, demonstrating both group and personal growth (Berger, 2008) {{RoundBoxTop|theme=9}} '''Case study:''' {{RoundBoxBottom}} == How has nature therapy grown and taken different forms? == === Indigenous Australia === * Aboriginal and Torres Strait Islander peoples consider contact with nature an important aspect of their health and wellbeing, and have closely intertwined relationships with nature and Country (Bolam et al., 2013) === Forest bathing === * Includes forest-based exercise in combination with non-physical activities, such as meditation (Collado et al., 2021) === Virtual === * Early in studies relating to virtual nature therapy, though literature reviews indicates positive influences on stress levels (Abdullah et al., 2021) ==Conclusion== The Conclusion is arguably the most important section. It should be possible for someone to read the [[#Overview|Overview]] and the Conclusion and still get a good idea of the topic. * ... * ... * ... {{RoundBoxTop|theme=3}} Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? (put these in this box?) {{RoundBoxBottom|theme=9}} ==See also== * [[wikipedia:Nature_therapy|Nature therapy]] (Wikipedia) ==References== {{Hanging indent|1= Abdullah, S.S.S., Alyan, E., Diyana, N., Merienne, F., Rambli, D.R.A., & Sulaiman, S. (2021). The impact of virtual nature therapy on stress responses: A systematic qualitative review. ''Forests'', ''12''(12), Article 1776. https://doi.org/10.3390/f12121776 Berger, R. (2008). Going on a journey: a case study of nature therapy with children with a learning difficulty. ''Emotional and Behavioural Difficulties'', ''13''(4), 315-326. https://doi.org/10.1080/13632750802440361 Bondas, T., Poulsen, D.V., Sidenius, U., & Stigsdotter, U.K. (2017). "I look at my own forest and fields a different way": The lived experience of nature-based therapy in a therapy garden when suffering from stress-related illness. ''International Journal of Qualitative Studies on Health and Well-Being'', ''12''(1), Article 1324700. https://doi.org/10.1080/17482631.2017.1324700 }} {{tip|Suggestions for this section: ** Provide the full doi as a URL and working hyperlink }} ==External links== * [https://www.wwf.org.uk/5-ways-connect-nature-help-our-wellbeing 5 ways to connect to nature] (WWF) * [https://www.youtube.com/watch?v=kYNpQu0jIyE Nature wisdom] (TED) [[Category:{{#titleparts:{{PAGENAME}}|3}}]] 8jvwmpbagq3dwdcnz8ew1tkcvcy7rni 2419439 2419437 2022-08-26T09:25:08Z Ana028 2947571 wikitext text/x-wiki {{title|Nature Therapy:<br>What is nature therapy and how can it be applied?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== * Numerous studies have demonstrated that nature therapy has a positive affect on physical, mental and interrelational health and wellbeing * Effects of nature therapy and exposure to nature range from personal, preventive and physical health benefits * Nature therapy can be applied in a number of contexts, including but not limited to individually, group settings and young people {{RoundBoxTop|theme=3}} '''Focus questions:''' * What is nature therapy? * What are the benefits of nature therapy? * How can nature therapy be applied? {{RoundBoxBottom}} {{RoundBoxTop|theme=9}} '''Case study:''' (How can specific motivation and/or emotion theories and research help?) {{RoundBoxBottom}} ==What is nature therapy?== * Incorporation of nature as a active setting and participant in therapeutic processes (Mayseless & Naor, 2021) *Reconnecting with natural environments in order to achieve physical and mental health benefits (Annerstedt & Währborg, 2011) * Holistic framework involving a large range of therapeutic techniques (Berger, 2009) {{RoundBoxTop|theme=9}} '''Case Study:''' {{RoundBoxBottom|theme=9}} ==What can be gained from nature and its inclusion in therapy?== === General benefits === * Rejuvenation of depleted mental faculties, as well as hIgh levels of positive affect, personal growth and wellbeing (Mayseless & Naor, 2021) {{RoundBoxTop|theme=9}} '''Case study:''' {{RoundBoxBottom}} === Protective factors of nature === * Studies show forest-bathing and nature therapy is a preventive measure against depression (Collado et al., 2021) {{RoundBoxTop|theme=9}} '''Case study:''' {{RoundBoxBottom}} === Illness and mental health disorders === * Positive results looking at the effect of nature-based therapy on stress-related illness sufferers (Bondas et al., 2017) * Evidence of significant results of nature therapy helping those with mental health disorders (Banerjee & Chaudhury, 2020) {{RoundBoxTop|theme=9}} '''Case study:''' {{RoundBoxBottom}} == The application of nature therapy == === Individuals === * Benefits to the relationship between psychologist and client to add an ecotherapy-based dimension into treatment planning (Lollar et al., 2022) {{RoundBoxTop|theme=9}} '''Case study:''' {{RoundBoxBottom}} === Families and/or couples === * Studies have demonstrated that a natural environment for group family therapy sessions plays a role in aiding the development of inter-family relationships (Lo & Ma, 2022) {{RoundBoxTop|theme=9}} '''Case study:''' {{RoundBoxBottom}} === Children === * Children with learning disabilities engaged well with nature therapy, demonstrating both group and personal growth (Berger, 2008) {{RoundBoxTop|theme=9}} '''Case study:''' {{RoundBoxBottom}} == How has nature therapy grown and taken different forms? == === Indigenous Australia === * Aboriginal and Torres Strait Islander peoples consider contact with nature an important aspect of their health and wellbeing, and have closely intertwined relationships with nature and Country (Bolam et al., 2013) === Forest bathing === * Includes forest-based exercise in combination with non-physical activities, such as meditation (Collado et al., 2021) === Virtual === * Early in studies relating to virtual nature therapy, though literature reviews indicates positive influences on stress levels (Abdullah et al., 2021) ==Conclusion== The Conclusion is arguably the most important section. It should be possible for someone to read the [[#Overview|Overview]] and the Conclusion and still get a good idea of the topic. * ... * ... * ... {{RoundBoxTop|theme=3}} Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? (put these in this box?) {{RoundBoxBottom|theme=9}} ==See also== * [[wikipedia:Nature_therapy|Nature therapy]] (Wikipedia) ==References== {{Hanging indent|1= Abdullah, S.S.S., Alyan, E., Diyana, N., Merienne, F., Rambli, D.R.A., & Sulaiman, S. (2021). The impact of virtual nature therapy on stress responses: A systematic qualitative review. ''Forests'', ''12''(12), Article 1776. https://doi.org/10.3390/f12121776 Berger, R. (2008). Going on a journey: a case study of nature therapy with children with a learning difficulty. ''Emotional and Behavioural Difficulties'', ''13''(4), 315-326. https://doi.org/10.1080/13632750802440361 Bondas, T., Poulsen, D.V., Sidenius, U., & Stigsdotter, U.K. (2017). "I look at my own forest and fields a different way": The lived experience of nature-based therapy in a therapy garden when suffering from stress-related illness. ''International Journal of Qualitative Studies on Health and Well-Being'', ''12''(1), Article 1324700. https://doi.org/10.1080/17482631.2017.1324700 }} {{tip|Suggestions for this section: ** Provide the full doi as a URL and working hyperlink }} ==External links== * [https://www.wwf.org.uk/5-ways-connect-nature-help-our-wellbeing 5 ways to connect to nature] (WWF) * [https://www.youtube.com/watch?v=kYNpQu0jIyE Nature wisdom] (TED) [[Category:{{#titleparts:{{PAGENAME}}|3}}]] enyq52phw49khupusdf8pg96a3fc06g 2419441 2419439 2022-08-26T09:32:41Z Ana028 2947571 /* Overview */ wikitext text/x-wiki {{title|Nature Therapy:<br>What is nature therapy and how can it be applied?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== * Numerous studies have demonstrated that nature therapy has a positive affect on physical, mental and interrelational health and wellbeing * Effects of nature therapy and exposure to nature range from personal, preventive and physical health benefits * Nature therapy can be applied in a number of contexts, including but not limited to individually, group settings and young people {{RoundBoxTop|theme=3}} '''Focus questions:''' * What is nature therapy? * What are the benefits of nature therapy? * How can nature therapy be applied? {{RoundBoxBottom}} {{RoundBoxTop|theme=9}} '''Case study:''' {{RoundBoxBottom}} ==What is nature therapy?== * Incorporation of nature as a active setting and participant in therapeutic processes (Mayseless & Naor, 2021) *Reconnecting with natural environments in order to achieve physical and mental health benefits (Annerstedt & Währborg, 2011) * Holistic framework involving a large range of therapeutic techniques (Berger, 2009) {{RoundBoxTop|theme=9}} '''Case Study:''' {{RoundBoxBottom|theme=9}} ==What can be gained from nature and its inclusion in therapy?== === General benefits === * Rejuvenation of depleted mental faculties, as well as hIgh levels of positive affect, personal growth and wellbeing (Mayseless & Naor, 2021) {{RoundBoxTop|theme=9}} '''Case study:''' {{RoundBoxBottom}} === Protective factors of nature === * Studies show forest-bathing and nature therapy is a preventive measure against depression (Collado et al., 2021) {{RoundBoxTop|theme=9}} '''Case study:''' {{RoundBoxBottom}} === Illness and mental health disorders === * Positive results looking at the effect of nature-based therapy on stress-related illness sufferers (Bondas et al., 2017) * Evidence of significant results of nature therapy helping those with mental health disorders (Banerjee & Chaudhury, 2020) {{RoundBoxTop|theme=9}} '''Case study:''' {{RoundBoxBottom}} == The application of nature therapy == === Individuals === * Benefits to the relationship between psychologist and client to add an ecotherapy-based dimension into treatment planning (Lollar et al., 2022) {{RoundBoxTop|theme=9}} '''Case study:''' {{RoundBoxBottom}} === Families and/or couples === * Studies have demonstrated that a natural environment for group family therapy sessions plays a role in aiding the development of inter-family relationships (Lo & Ma, 2022) {{RoundBoxTop|theme=9}} '''Case study:''' {{RoundBoxBottom}} === Children === * Children with learning disabilities engaged well with nature therapy, demonstrating both group and personal growth (Berger, 2008) {{RoundBoxTop|theme=9}} '''Case study:''' {{RoundBoxBottom}} == How has nature therapy grown and taken different forms? == === Indigenous Australia === * Aboriginal and Torres Strait Islander peoples consider contact with nature an important aspect of their health and wellbeing, and have closely intertwined relationships with nature and Country (Bolam et al., 2013) === Forest bathing === * Includes forest-based exercise in combination with non-physical activities, such as meditation (Collado et al., 2021) === Virtual === * Early in studies relating to virtual nature therapy, though literature reviews indicates positive influences on stress levels (Abdullah et al., 2021) ==Conclusion== * Nature therapy is an important and emerging therapeutic technique that could have widespread positive benefits across multiple demographics * Numerous benefits from exposure to nature have been studied and verified * The flexible essence of nature therapy means that it can be applied in various contexts to provide a range of positive outcomes {{RoundBoxTop|theme=3}} Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? (put these in this box?) {{RoundBoxBottom|theme=9}} ==See also== * [[wikipedia:Nature_therapy|Nature therapy]] (Wikipedia) ==References== {{Hanging indent|1= Abdullah, S.S.S., Alyan, E., Diyana, N., Merienne, F., Rambli, D.R.A., & Sulaiman, S. (2021). The impact of virtual nature therapy on stress responses: A systematic qualitative review. ''Forests'', ''12''(12), Article 1776. https://doi.org/10.3390/f12121776 Berger, R. (2008). Going on a journey: a case study of nature therapy with children with a learning difficulty. ''Emotional and Behavioural Difficulties'', ''13''(4), 315-326. https://doi.org/10.1080/13632750802440361 Bondas, T., Poulsen, D.V., Sidenius, U., & Stigsdotter, U.K. (2017). "I look at my own forest and fields a different way": The lived experience of nature-based therapy in a therapy garden when suffering from stress-related illness. ''International Journal of Qualitative Studies on Health and Well-Being'', ''12''(1), Article 1324700. https://doi.org/10.1080/17482631.2017.1324700 }} {{tip|Suggestions for this section: ** Provide the full doi as a URL and working hyperlink }} ==External links== * [https://www.wwf.org.uk/5-ways-connect-nature-help-our-wellbeing 5 ways to connect to nature] (WWF) * [https://www.youtube.com/watch?v=kYNpQu0jIyE Nature wisdom] (TED) [[Category:{{#titleparts:{{PAGENAME}}|3}}]] 9brrd2t9oof16uty41rd79kx2rgc6ts 2419444 2419441 2022-08-26T09:33:58Z Ana028 2947571 wikitext text/x-wiki {{title|Nature Therapy:<br>What is nature therapy and how can it be applied?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== * Numerous studies have demonstrated that nature therapy has a positive affect on physical, mental and interrelational health and wellbeing * Effects of nature therapy and exposure to nature range from personal, preventive and physical health benefits * Nature therapy can be applied in a number of contexts, including but not limited to individually, group settings and young people {{RoundBoxTop|theme=3}} '''Focus questions:''' * What is nature therapy? * What are the benefits of nature therapy? * How can nature therapy be applied? {{RoundBoxBottom}} {{RoundBoxTop|theme=9}} '''Case study:''' {{RoundBoxBottom}} ==What is nature therapy?== * Incorporation of nature as a active setting and participant in therapeutic processes (Mayseless & Naor, 2021) *Reconnecting with natural environments in order to achieve physical and mental health benefits (Annerstedt & Währborg, 2011) * Holistic framework involving a large range of therapeutic techniques (Berger, 2009) {{RoundBoxTop|theme=9}} '''Case Study:''' {{RoundBoxBottom|theme=9}} ==What can be gained from nature and its inclusion in therapy?== === General benefits === * Rejuvenation of depleted mental faculties, as well as hIgh levels of positive affect, personal growth and wellbeing (Mayseless & Naor, 2021) {{RoundBoxTop|theme=9}} '''Case study:''' {{RoundBoxBottom}} === Protective factors of nature === * Studies show forest-bathing and nature therapy is a preventive measure against depression (Collado et al., 2021) {{RoundBoxTop|theme=9}} '''Case study:''' {{RoundBoxBottom}} === Illness and mental health disorders === * Positive results looking at the effect of nature-based therapy on stress-related illness sufferers (Bondas et al., 2017) * Evidence of significant results of nature therapy helping those with mental health disorders (Banerjee & Chaudhury, 2020) {{RoundBoxTop|theme=9}} '''Case study:''' {{RoundBoxBottom}} == The application of nature therapy == === Individuals === * Benefits to the relationship between psychologist and client to add an ecotherapy-based dimension into treatment planning (Lollar et al., 2022) {{RoundBoxTop|theme=9}} '''Case study:''' {{RoundBoxBottom}} === Families and/or couples === * Studies have demonstrated that a natural environment for group family therapy sessions plays a role in aiding the development of inter-family relationships (Lo & Ma, 2022) {{RoundBoxTop|theme=9}} '''Case study:''' {{RoundBoxBottom}} === Children === * Children with learning disabilities engaged well with nature therapy, demonstrating both group and personal growth (Berger, 2008) {{RoundBoxTop|theme=9}} '''Case study:''' {{RoundBoxBottom}} == How has nature therapy grown and taken different forms? == === Indigenous Australia === * Aboriginal and Torres Strait Islander peoples consider contact with nature an important aspect of their health and wellbeing, and have closely intertwined relationships with nature and Country (Bolam et al., 2013) === Forest bathing === * Includes forest-based exercise in combination with non-physical activities, such as meditation (Collado et al., 2021) === Virtual === * Early in studies relating to virtual nature therapy, though literature reviews indicates positive influences on stress levels (Abdullah et al., 2021) ==Conclusion== * Nature therapy is an important and emerging therapeutic technique that could have widespread positive benefits across multiple demographics * Numerous benefits from exposure to nature have been studied and verified * The flexible essence of nature therapy means that it can be applied in various contexts to provide a range of positive outcomes {{RoundBoxTop|theme=3}} Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? (put these in this box?) {{RoundBoxBottom|theme=9}} ==See also== * [[wikipedia:Nature_therapy|Nature therapy]] (Wikipedia) ==References== {{Hanging indent|1= Abdullah, S.S.S., Alyan, E., Diyana, N., Merienne, F., Rambli, D.R.A., & Sulaiman, S. (2021). The impact of virtual nature therapy on stress responses: A systematic qualitative review. ''Forests'', ''12''(12), Article 1776. https://doi.org/10.3390/f12121776 Berger, R. (2008). Going on a journey: a case study of nature therapy with children with a learning difficulty. ''Emotional and Behavioural Difficulties'', ''13''(4), 315-326. https://doi.org/10.1080/13632750802440361 Bondas, T., Poulsen, D.V., Sidenius, U., & Stigsdotter, U.K. (2017). "I look at my own forest and fields a different way": The lived experience of nature-based therapy in a therapy garden when suffering from stress-related illness. ''International Journal of Qualitative Studies on Health and Well-Being'', ''12''(1), Article 1324700. https://doi.org/10.1080/17482631.2017.1324700 ==External links== * [https://www.wwf.org.uk/5-ways-connect-nature-help-our-wellbeing 5 ways to connect to nature] (WWF) * [https://www.youtube.com/watch?v=kYNpQu0jIyE Nature wisdom] (TED) [[Category:{{#titleparts:{{PAGENAME}}|3}}]] bxmfyjmtav66v5e5xz61pxy7es0usl7 0 286393 2419342 2419036 2022-08-26T07:05:33Z BradMcgrath 2947530 wikitext text/x-wiki {{title|What are the barriers and enablers of help-seeking in boys?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Background== {{RoundBoxTop|theme=3}} '''Focus questions:''' * Has fatherlessness demonstrated to boys that a lack of motivation is normal? * What barriers do boys need help overcoming in order to enable help-seeking behaviour? * Is the tendency for boys to ascribe help-seeking as a loss of control suggestive of a broader problem associated with fatherlessness and masculinity? {{RoundBoxBottom}}The low prevalence of help-seeking among adolescent boys is a phenomenon that has been widely recognised and supported for more than two decades (Addis & Mahalik, 2003; Berger et al., 2005; Clement et al., 2015; Lynch et al., 2018; Tudiver & Talbot, 1999; Yousaf et al., 2015). Traditionally, seeking help for mental health among nuclear families was often approached with a negative attitude, in part due to stigma that can develop in youth (Berger et al., 2005; Weiss, 1994; Zartaloudi & Madianos, 2010). For many boys, help-seeking was a dichotomy to their role in society as a sole-breadwinner, as many were raised within the structure of male role norms that included an independent style of achievement and self-containment. This sense of competency and autonomy helped to prepare boys for raising children and establishing oneself into his community (Thompson & Pleck, 1986). In other words, these social and cultural scripts helped them to fulfill their lives. The central theory of the life course, first proposed by Erikson (1950), who proposed that adolescence occurred before young adulthood, which started in the late teens and finished at about age 40. During this time, many people in industrialised societies married and could reap the benefits of stable full-time work by around age 20 (Arnett, 2007). However, by the end of the century, this tradition began to change. The median age of marriage had increased and a new period of life was characterised by job change and aspirations for post-secondary education (Arnett, 2007). During this time, relationships among men and women had changed dramatically and premarital sex and cohabitation in the 20s had become widely acceptable, with many young people sharing a preference for spending their late teens to mid-20s outside the confines of marriage (Arnett, 2007). ''The Boy Crisis'', a term coined by American political scientist and author, Warren Pharrell, is believed to be a manifestation of a purpose void in consequence to these behavioural, psychological and physiological changes associated with modern family structures and, in particular, the absence of fathers. In Australia, 1.1 million (15.0%) of Australian households are one parent families, with 80% of these being single mothers (ABS, 2021). Bryan Rodgers of the Australian National University says “Australian studies with adequate samples have shown parental divorce to be a risk factor for a wide range of social and psychological problems in adolescence and adulthood, including poor academic achievement, low self-esteem, psychological distress, delinquency and recidivism, substance use and abuse, sexual precocity, adult criminal offending, depression, and suicidal behaviour.” He concludes: “There is no scientific justification for disregarding the public health significance of marital dissolution in Australia, especially with respect to mental health.” (Rodgers, 1995, p. 180). == Definitions == === Help-seeking === === Mental Health === === Stigma === === Masculinity === == Barriers to help-seeking among boys == === Cognitive Evaluation Theory === ==== Controlling behaviour vs informing competence ==== ==== Amotivation ==== === Psychological barriers === ==== The Purpose Void ==== ==== Need for control ==== ===== Vulnerability ===== ==== Lack of tools for emotional expression ==== === Social barriers === ==== Stigma ==== ==== Stereotypes ==== ==== Masculinity ==== ===== Toxic Masculinity ===== ==== Fatherlessness ==== ==== Over-reliance on male peers ==== ==== Absence of social support and community connections ==== == Motivation for help-seeking among boys == == Help-seeking Motivation Theories == === Health Belief Model === === Social Cognitive Theory === === Theory of Reasoned Action and Planned Behaviour === === Mentoring === === Physiological needs === ==== Testosterone ==== === Psychological needs === ==== Autonomy ==== ==== Competence ==== ==== Relatedness ==== === Intervention practices === ==== Activity-based interventions ==== ==== Exercise-based interventions ==== ==== Sports-based interventions ==== Lynch, L., Long, M., & Moorhead, A. (2018). Young men, help-seeking, and mental health services: Exploring barriers and solutions. ''American Journal of Men's Health, 12''(1), pp. 138–149. https://doi.org/10.1177/1557988315619469. Australian Bureau of Statistics. (2021, October 12). ''Labor force status of families''. ABS. https://www.abs.gov.au/statistics/labour/employment-and-unemployment/labour-force-status-families/latest-release#:~:text=1.1%20million%20(15.0%25)%20were,age%20siblings)%20(Table%201) Addis, M. E., & Mahalik, J. R. (2003). Men, masculinity, and the contexts of help seeking. ''American Psychologist, 58''(1), pp. 5–14. https://doi.org/10.1037/0003-066X.58.1.5. Arnett, J. J. (2007). Emerging adulthood: What is it, and what is it good for? ''Child Development Perspectives, 1''(2), pp. 68–73. https://doi.org/10.1111/j.1750-8606.2007.00016.x. Berger, J. M., Levant, R., McMillan, K. K., Kelleher, W., & Sellers, A. (2005). Impact of Gender Role Conflict, Traditional Masculinity Ideology, Alexithymia, and Age on Men's Attitudes Toward Psychological Help Seeking. ''Psychology of Men & Masculinity, 6''(1), pp. 73–78. https://doi.org/10.1037/1524-9220.6.1.73. Clement, S., Schauman, O., Graham, T., Maggioni, F., Evans-Lacko, S., Bezborodovs, N., Morgan, C., Rüsch, N., Brown, J. S. L., & Thornicroft, G. (2015). What is the impact of mental health-related stigma on help-seeking? A systematic review of quantitative and qualitative studies. ''Psychological Medicine, 45''(1), 11–27. https://doi.org/10.1017/S0033291714000129. Erikson, E. H. (1950). Growth and crises of the "healthy personality." In M. J. E. Senn (Ed.), ''Symposium on the healthy personality'' (pp. 91–146). Josiah Macy, Jr. Foundation. Bryan Rodgers, “Social and Psychological Wellbeing of Children from Divorced Families: Australian Research Findings,” ''Australian Psychologist'', 31(3), pp. 174-182. Thompson Jr, E. H., & Pleck, J. H. (1986). The structure of male role norms. ''American Behavioral Scientist'', ''29''(5), pp. 531-543. https://doi.org/10.1177/000276486029005003. Tudiver, F., & Talbot, Y. (1999). Why don't men seek help? Family physicians' perspectives on help-seeking behavior in men. ''The Journal of Family Practice, 48''(1), pp. 47–52. Weiss, M. F. (1994). Children's attitudes toward the mentally ill: An eight-year longitudinal follow-up. ''Psychological Reports, 74''(1), 51–56. https://doi.org/10.2466/pr0.1994.74.1.51. Yousaf, O., Grunfeld, E. A., & Hunter, M. S. (2015). A systematic review of the factors associated with delays in medical and psychological help-seeking among men. ''Health Psychology Review, 9''(2), pp. 264–276. https://doi.org/10.1080/17437199.2013.840954. Zartaloudi, A., & Madianos, M. (2010). Stigma related to help-seeking from a mental health professional. ''Health science journal'', ''4''(2), p. 77. \You are underway {{smile}}! This template provides tips for [[Motivation and emotion/Assessment/Topic|topic development]]. Gradually remove these suggestions as you develop the chapter. Also consult the [[Motivation and emotion/Assessment/Chapter|author guidelines]]. At the top of the chapter, the title and sub-title should match the ''exact'' wording and casing as shown in the {{Motivation and emotion/Book}}. The sub-titles all end with a question mark. This Overview section should be concise but consist of several paragraphs which engage the reader, illustrate the problem, and outline how psychological science can help.{{tip| Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Provide an example or case study. * Conclude with Focus questions to guide the chapter. }} ==Main headings== How you are going to structure the chapter? Aim for three to six main headings between the [[#Overview|Overview]] and [[#Conclusion|Conclusion]]. {{tip|Suggestions for this section: * For the [[Motivation and emotion/Assessment/Topic|topic development]], provide at least 3 bullet-points about key content per section. Include key citations. * For the [[Motivation and emotion/Assessment/Chapter|book chapter]], expand the bullet points into paragraphs. * If a section has a lot of content, arrange it into two to five sub-headings such as in the [[#Interactive learning features|interactive learning features section]]. Avoid having sections with only one sub-heading. }} ==Learning features== What brings an online book chapter to life are its interactive learning features. Case studies, feature boxes, figures, links, tables, and quiz questions can be used throughout the chapter. ===Case studies=== Case studies describe real-world examples of concepts in action. Case studies can be real or fictional. A case could be used multiple times during a chapter to illustrate different theories or stages. It is often helpful to present case studies using [[#Feature boxes|feature boxes]]. ===Boxes=== Boxes can be used to highlight content, but don't overuse them. There are many different ways of creating boxes (e.g., see [[Help:Pretty boxes|Pretty boxes]]). Possible uses include: * Focus questions * Case studies or examples * Quiz questions * Take-home messages {{RoundBoxTop|theme=3}} ;Feature box example * Shaded background * Coloured border {{RoundBoxBottom}} ===Figures=== [[File:Monkey-typing.jpg|right|205px|thumb|''Figure 1''. Example image with descriptive caption.]] Use figures to illustrate concepts, add interest, and provide examples. Figures can be used to show photographs, drawings, diagrams, graphs, etcetera. Figures can be embedded throughout the chapter, starting with the Overview section. Figures should be captioned (using a number and a description) in order to explain their relevance to the text. Possible images can be found at [[commons:|Wikimedia Commons]]. Images can also be uploaded if they are licensed for re-use or if you created the image. Each figure should be referred to at least once in the main text (e.g., see Figure 1). ===Links=== Where key words are first used, make them into [[Help:Links|interwiki links]] such as Wikipedia links to articles about famous people (e.g., [[w:Sigmund Freud|Sigmund Freud]] and key concepts (e.g., [[w:Dreams|dreams]]) and links to book chapters about related topics (e.g., would you like to learn about how to overcome [[Motivation and emotion/Book/2020/Writer's block|writer's block]]?). ===Tables=== Tables can be an effective way to organise and summarise information. Tables should be captioned (using APA style) to explain their relevance to the text. Plus each table should be referred to at least once in the main text (e.g., see Table 1 and Table 2). Here are some [[Motivation and emotion/Wikiversity/Tables|example 3 x 3 tables]] which could be adapted. ===Quizzes=== Quizzes are a direct way to engage readers. But don't make quizzes too hard or long. It is better to have one or two review questions per major section than a long quiz at the end. Try to quiz conceptual understanding, rather than trivia. Here are some simple quiz questions which could be adapted. Choose the correct answers and click "Submit": <quiz display=simple> {Quizzes are an interactive learning feature: |type="()"} + True - False {Long quizzes are a good idea: |type="()"} - True + False </quiz> To learn about different types of quiz questions, see [[Help:Quiz|Quiz]]. ==Conclusion== The Conclusion is arguably the most important section. It should be possible for someone to read the [[#Overview|Overview]] and the Conclusion and still get a good idea of the topic. {{tip|Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? }} ==See also== Provide up to half-a-dozen [[Help:Contents/Links#Interwiki_links|internal (wiki) links]] to relevant Wikiversity pages (esp. related [[Motivation and emotion/Book|motivation and emotion book chapters]]) and [[w:|Wikipedia articles]]. For example: * [[Motivation and emotion/Book/2016/Anorexia nervosa and extrinsic motivation|Anorexia nervosa and extrinsic motivation]] (Book chapter, 2016) * [[w:David McClelland|David McClelland]] (Wikipedia) * [[Motivation and emotion/Book/2018/Loss aversion|Loss aversion]] (Book chapter, 2018) * [[w:Maslow's hierarchy of needs|Maslow's hierarchy of needs]] (Wikipedia) {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== List the cited references in [[w:APA style|APA style]] (7th ed.) or [[w:Wikipedia:Citing sources|wiki style]]. APA style example: {{Hanging indent|1= Blair, R. J. R. (2004). The roles of orbital frontal cortex in the modulation of antisocial behavior. ''Brain and Cognition'', ''55''(1), 198–208. https://doi.org/10.1016/S0278-2626(03)00276-8 Buckholtz, J. W., & Meyer-Lindenberg, A. (2008). MAOA and the neurogenetic architecture of human aggression. ''Trends in Neurosciences'', ''31''(3), 120–129. https://doi.org/10.1016/j.tins.2007.12.006 Eckardt, M., File, S., Gessa, G., Grant, K., Guerri, C., Hoffman, P., & Tabakoff, B. (1998). Effects of moderate alcohol consumption on the central nervous system. ''Alcoholism, Clinical and Experimental Research'', ''22''(5), 998–1040. https://doi.org/10.1111/j.1530-0277.1998.tb03695.x }} {{tip|Suggestions for this section: * Important aspects for APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except first letter and proper names, ending in a full-stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full-stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't actually read or consulted }} ==External links== Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * [https://students.unimelb.edu.au/academic-skills/explore-our-resources/essay-writing/six-top-tips-for-writing-a-great-essay Six top tips for writing a great essay] (University of Melbourne) * [http://www.skillsyouneed.com/write/structure.html The importance of structure] (skillsyouneed.com) {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] [[Category:Motivation and emotion/Book/Children]] [[Category:Motivation and emotion/Book/Male]] [[Category:Motivation and emotion/Book/Help-seeking]] kc6002ech1qc06phvdyi0k8pnj57682 2419382 2419342 2022-08-26T07:47:28Z BradMcgrath 2947530 wikitext text/x-wiki {{title|What are the barriers and enablers of help-seeking in boys?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Background== {{RoundBoxTop|theme=3}} '''Focus questions:''' * Has fatherlessness demonstrated to boys that a lack of motivation is normal? * What barriers do boys need help overcoming in order to enable help-seeking behaviour? * Is the tendency for boys to ascribe help-seeking as a loss of control suggestive of a broader problem associated with fatherlessness and masculinity? {{RoundBoxBottom}}The low prevalence of help-seeking among adolescent boys is a phenomenon that has been widely recognised and supported for more than two decades (Addis & Mahalik, 2003; Berger et al., 2005; Clement et al., 2015; Lynch et al., 2018; Tudiver & Talbot, 1999; Yousaf et al., 2015). Traditionally, seeking help for mental health among nuclear families was often approached with a negative attitude, in part due to stigma that can develop in youth (Berger et al., 2005; Weiss, 1994; Zartaloudi & Madianos, 2010). For many boys, help-seeking was a dichotomy to their role in society as a sole-breadwinner, as many were raised within the structure of male role norms that included an independent style of achievement and self-containment. This sense of competency and autonomy helped to prepare boys for raising children and establishing oneself into his community (Thompson & Pleck, 1986). In other words, these social and cultural scripts helped them to fulfill their lives. The central theory of the life course, first proposed by Erikson (1950), who proposed that adolescence occurred before young adulthood, which started in the late teens and finished at about age 40. During this time, many people in industrialised societies married and could reap the benefits of stable full-time work by around age 20 (Arnett, 2007). However, by the end of the century, this tradition began to change. The median age of marriage had increased and a new period of life was characterised by job change and aspirations for post-secondary education (Arnett, 2007). During this time, relationships among men and women had changed dramatically and premarital sex and cohabitation in the 20s had become widely acceptable, with many young people sharing a preference for spending their late teens to mid-20s outside the confines of marriage (Arnett, 2007). ''The Boy Crisis'', a term coined by American political scientist and author, Warren Pharrell, is believed to be a manifestation of a purpose void in consequence to these behavioural, psychological and physiological changes associated with modern family structures and, in particular, the absence of fathers. In Australia, 1.1 million (15.0%) of Australian households are one parent families, with 80% of these being single mothers (ABS, 2021). Bryan Rodgers of the Australian National University says “Australian studies with adequate samples have shown parental divorce to be a risk factor for a wide range of social and psychological problems in adolescence and adulthood, including poor academic achievement, low self-esteem, psychological distress, delinquency and recidivism, substance use and abuse, sexual precocity, adult criminal offending, depression, and suicidal behaviour.” He concludes: “There is no scientific justification for disregarding the public health significance of marital dissolution in Australia, especially with respect to mental health.” (Rodgers, 1995, p. 180). == Definitions == === Help-seeking === Rickwood and Thomas’ (2012) definition of help-seeking for mental health problems is described as “an adaptive coping process that is the attempt to obtain external assistance to deal with mental health concerns” (Rickwood and Thomas, 2012, p. 12). === Mental Health === === Stigma === === Fatherlessness === === Masculinity === == Barriers to help-seeking == === Cognitive Evaluation Theory === === Psychological barriers === ==== Need for control ==== ===== Vulnerability ===== ==== Lack of tools for emotional expression ==== === Social barriers === ==== Stigma ==== ==== Stereotypes ==== ==== Masculinity ==== ===== Toxic Masculinity ===== ==== Fatherlessness ==== ==== Over-reliance on male peers ==== ==== Absence of social support and community connections ==== == Help-seeking Motivation Theories == === Health Belief Model === === Social Cognitive Theory === === Theory of Reasoned Action and Planned Behaviour === === Mentoring === === Physiological needs === ==== Testosterone ==== === Psychological needs === ==== Autonomy ==== ==== Competence ==== ==== Relatedness ==== === Intervention practices === ==== Activity-based interventions ==== ==== Exercise-based interventions ==== ==== Sports-based interventions ==== == References == Lynch, L., Long, M., & Moorhead, A. (2018). Young men, help-seeking, and mental health services: Exploring barriers and solutions. ''American Journal of Men's Health, 12''(1), pp. 138–149. https://doi.org/10.1177/1557988315619469. Australian Bureau of Statistics. (2021, October 12). ''Labor force status of families''. ABS. https://www.abs.gov.au/statistics/labour/employment-and-unemployment/labour-force-status-families/latest-release#:~:text=1.1%20million%20(15.0%25)%20were,age%20siblings)%20(Table%201) Addis, M. E., & Mahalik, J. R. (2003). Men, masculinity, and the contexts of help seeking. ''American Psychologist, 58''(1), pp. 5–14. https://doi.org/10.1037/0003-066X.58.1.5. Arnett, J. J. (2007). Emerging adulthood: What is it, and what is it good for? ''Child Development Perspectives, 1''(2), pp. 68–73. https://doi.org/10.1111/j.1750-8606.2007.00016.x. Berger, J. M., Levant, R., McMillan, K. K., Kelleher, W., & Sellers, A. (2005). Impact of Gender Role Conflict, Traditional Masculinity Ideology, Alexithymia, and Age on Men's Attitudes Toward Psychological Help Seeking. ''Psychology of Men & Masculinity, 6''(1), pp. 73–78. https://doi.org/10.1037/1524-9220.6.1.73. Clement, S., Schauman, O., Graham, T., Maggioni, F., Evans-Lacko, S., Bezborodovs, N., Morgan, C., Rüsch, N., Brown, J. S. L., & Thornicroft, G. (2015). What is the impact of mental health-related stigma on help-seeking? A systematic review of quantitative and qualitative studies. ''Psychological Medicine, 45''(1), 11–27. https://doi.org/10.1017/S0033291714000129. Erikson, E. H. (1950). Growth and crises of the "healthy personality." In M. J. E. Senn (Ed.), ''Symposium on the healthy personality'' (pp. 91–146). Josiah Macy, Jr. Foundation. Bryan Rodgers, “Social and Psychological Wellbeing of Children from Divorced Families: Australian Research Findings,” ''Australian Psychologist'', 31(3), pp. 174-182. Rickwood, D., & Thomas, K. (2012). Conceptual measurement framework for help-seeking for mental health problems. ''Psychology research and behavior management'', ''5'', pp. 173-183. Thompson Jr, E. H., & Pleck, J. H. (1986). The structure of male role norms. ''American Behavioral Scientist'', ''29''(5), pp. 531-543. https://doi.org/10.1177/000276486029005003. Tudiver, F., & Talbot, Y. (1999). Why don't men seek help? Family physicians' perspectives on help-seeking behavior in men. ''The Journal of Family Practice, 48''(1), pp. 47–52. Weiss, M. F. (1994). Children's attitudes toward the mentally ill: An eight-year longitudinal follow-up. ''Psychological Reports, 74''(1), 51–56. https://doi.org/10.2466/pr0.1994.74.1.51. Yousaf, O., Grunfeld, E. A., & Hunter, M. S. (2015). A systematic review of the factors associated with delays in medical and psychological help-seeking among men. ''Health Psychology Review, 9''(2), pp. 264–276. https://doi.org/10.1080/17437199.2013.840954. Zartaloudi, A., & Madianos, M. (2010). Stigma related to help-seeking from a mental health professional. ''Health science journal'', ''4''(2), p. 77. \You are underway {{smile}}! This template provides tips for [[Motivation and emotion/Assessment/Topic|topic development]]. Gradually remove these suggestions as you develop the chapter. Also consult the [[Motivation and emotion/Assessment/Chapter|author guidelines]]. At the top of the chapter, the title and sub-title should match the ''exact'' wording and casing as shown in the {{Motivation and emotion/Book}}. The sub-titles all end with a question mark. This Overview section should be concise but consist of several paragraphs which engage the reader, illustrate the problem, and outline how psychological science can help.{{tip| Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Provide an example or case study. * Conclude with Focus questions to guide the chapter. }} ==Main headings== How you are going to structure the chapter? Aim for three to six main headings between the [[#Overview|Overview]] and [[#Conclusion|Conclusion]]. {{tip|Suggestions for this section: * For the [[Motivation and emotion/Assessment/Topic|topic development]], provide at least 3 bullet-points about key content per section. Include key citations. * For the [[Motivation and emotion/Assessment/Chapter|book chapter]], expand the bullet points into paragraphs. * If a section has a lot of content, arrange it into two to five sub-headings such as in the [[#Interactive learning features|interactive learning features section]]. Avoid having sections with only one sub-heading. }} ==Learning features== What brings an online book chapter to life are its interactive learning features. Case studies, feature boxes, figures, links, tables, and quiz questions can be used throughout the chapter. ===Case studies=== Case studies describe real-world examples of concepts in action. Case studies can be real or fictional. A case could be used multiple times during a chapter to illustrate different theories or stages. It is often helpful to present case studies using [[#Feature boxes|feature boxes]]. ===Boxes=== Boxes can be used to highlight content, but don't overuse them. There are many different ways of creating boxes (e.g., see [[Help:Pretty boxes|Pretty boxes]]). Possible uses include: * Focus questions * Case studies or examples * Quiz questions * Take-home messages {{RoundBoxTop|theme=3}} ;Feature box example * Shaded background * Coloured border {{RoundBoxBottom}} ===Figures=== [[File:Monkey-typing.jpg|right|205px|thumb|''Figure 1''. Example image with descriptive caption.]] Use figures to illustrate concepts, add interest, and provide examples. Figures can be used to show photographs, drawings, diagrams, graphs, etcetera. Figures can be embedded throughout the chapter, starting with the Overview section. Figures should be captioned (using a number and a description) in order to explain their relevance to the text. Possible images can be found at [[commons:|Wikimedia Commons]]. Images can also be uploaded if they are licensed for re-use or if you created the image. Each figure should be referred to at least once in the main text (e.g., see Figure 1). ===Links=== Where key words are first used, make them into [[Help:Links|interwiki links]] such as Wikipedia links to articles about famous people (e.g., [[w:Sigmund Freud|Sigmund Freud]] and key concepts (e.g., [[w:Dreams|dreams]]) and links to book chapters about related topics (e.g., would you like to learn about how to overcome [[Motivation and emotion/Book/2020/Writer's block|writer's block]]?). ===Tables=== Tables can be an effective way to organise and summarise information. Tables should be captioned (using APA style) to explain their relevance to the text. Plus each table should be referred to at least once in the main text (e.g., see Table 1 and Table 2). Here are some [[Motivation and emotion/Wikiversity/Tables|example 3 x 3 tables]] which could be adapted. ===Quizzes=== Quizzes are a direct way to engage readers. But don't make quizzes too hard or long. It is better to have one or two review questions per major section than a long quiz at the end. Try to quiz conceptual understanding, rather than trivia. Here are some simple quiz questions which could be adapted. Choose the correct answers and click "Submit": <quiz display=simple> {Quizzes are an interactive learning feature: |type="()"} + True - False {Long quizzes are a good idea: |type="()"} - True + False </quiz> To learn about different types of quiz questions, see [[Help:Quiz|Quiz]]. ==Conclusion== The Conclusion is arguably the most important section. It should be possible for someone to read the [[#Overview|Overview]] and the Conclusion and still get a good idea of the topic. {{tip|Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? }} ==See also== Provide up to half-a-dozen [[Help:Contents/Links#Interwiki_links|internal (wiki) links]] to relevant Wikiversity pages (esp. related [[Motivation and emotion/Book|motivation and emotion book chapters]]) and [[w:|Wikipedia articles]]. For example: * [[Motivation and emotion/Book/2016/Anorexia nervosa and extrinsic motivation|Anorexia nervosa and extrinsic motivation]] (Book chapter, 2016) * [[w:David McClelland|David McClelland]] (Wikipedia) * [[Motivation and emotion/Book/2018/Loss aversion|Loss aversion]] (Book chapter, 2018) * [[w:Maslow's hierarchy of needs|Maslow's hierarchy of needs]] (Wikipedia) {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== List the cited references in [[w:APA style|APA style]] (7th ed.) or [[w:Wikipedia:Citing sources|wiki style]]. APA style example: {{Hanging indent|1= Blair, R. J. R. (2004). The roles of orbital frontal cortex in the modulation of antisocial behavior. ''Brain and Cognition'', ''55''(1), 198–208. https://doi.org/10.1016/S0278-2626(03)00276-8 Buckholtz, J. W., & Meyer-Lindenberg, A. (2008). MAOA and the neurogenetic architecture of human aggression. ''Trends in Neurosciences'', ''31''(3), 120–129. https://doi.org/10.1016/j.tins.2007.12.006 Eckardt, M., File, S., Gessa, G., Grant, K., Guerri, C., Hoffman, P., & Tabakoff, B. (1998). Effects of moderate alcohol consumption on the central nervous system. ''Alcoholism, Clinical and Experimental Research'', ''22''(5), 998–1040. https://doi.org/10.1111/j.1530-0277.1998.tb03695.x }} {{tip|Suggestions for this section: * Important aspects for APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except first letter and proper names, ending in a full-stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full-stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't actually read or consulted }} ==External links== Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * [https://students.unimelb.edu.au/academic-skills/explore-our-resources/essay-writing/six-top-tips-for-writing-a-great-essay Six top tips for writing a great essay] (University of Melbourne) * [http://www.skillsyouneed.com/write/structure.html The importance of structure] (skillsyouneed.com) {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] [[Category:Motivation and emotion/Book/Children]] [[Category:Motivation and emotion/Book/Male]] [[Category:Motivation and emotion/Book/Help-seeking]] 9brifqwo9s6v9q9dhy471r1dyattv58 2419393 2419382 2022-08-26T08:05:46Z BradMcgrath 2947530 wikitext text/x-wiki {{title|What are the barriers and enablers of help-seeking in boys?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Background== {{RoundBoxTop|theme=3}} '''Focus questions:''' * Has fatherlessness demonstrated to boys that a lack of motivation is normal? * What barriers do boys need help overcoming in order to enable help-seeking behaviour? * Is the tendency for boys to ascribe help-seeking as a loss of control suggestive of a broader problem associated with fatherlessness and masculinity? {{RoundBoxBottom}}The low prevalence of help-seeking among adolescent boys is a phenomenon that has been widely recognised and supported for more than two decades (Addis & Mahalik, 2003; Berger et al., 2005; Clement et al., 2015; Lynch et al., 2018; Tudiver & Talbot, 1999; Yousaf et al., 2015). Traditionally, seeking help for mental health among nuclear families was often approached with a negative attitude, in part due to stigma that can develop in youth (Berger et al., 2005; Weiss, 1994; Zartaloudi & Madianos, 2010). For many boys, help-seeking was a dichotomy to their role in society as a sole-breadwinner, as many were raised within the structure of male role norms that included an independent style of achievement and self-containment. This sense of competency and autonomy helped to prepare boys for raising children and establishing oneself into his community (Thompson & Pleck, 1986). In other words, these social and cultural scripts helped them to fulfill their lives. The central theory of the life course, first proposed by Erikson (1950), theorised that adolescence occurred before young adulthood, which started in the late teens and finished at about age 40. During this time, many people in industrialised societies married and could reap the benefits of stable full-time work by around age 20 (Arnett, 2007). However, by the end of the century, this tradition began to change. The median age of marriage had increased and a new period of life was characterised by job change and aspirations for post-secondary education (Arnett, 2007). During this time, relationships among men and women had changed dramatically and premarital sex and cohabitation in the 20s had become widely acceptable, with many young people sharing a preference for spending their late teens to mid-20s outside the confines of marriage (Arnett, 2007). ''The Boy Crisis'', a term coined by American political scientist and author, Warren Pharrell, is believed to be a manifestation of a purpose void in consequence to these behavioural, psychological and physiological changes associated with modern family structures and, in particular, the absence of fathers. In Australia, 1.1 million (15.0%) of Australian households are one parent families, with 80% of these being single mothers (ABS, 2021). Bryan Rodgers of the Australian National University says “Australian studies with adequate samples have shown parental divorce to be a risk factor for a wide range of social and psychological problems in adolescence and adulthood, including poor academic achievement, low self-esteem, psychological distress, delinquency and recidivism, substance use and abuse, sexual precocity, adult criminal offending, depression, and suicidal behaviour.” He concludes: “There is no scientific justification for disregarding the public health significance of marital dissolution in Australia, especially with respect to mental health.” (Rodgers, 1995, p. 180). Boys who grow up fatherless are more likely to drop out of school (), drink (), become delinquent (), and end up in prison (). Furthermore, father involvement is at least five times as important in preventing drug use than closeness to parent, parental trust, strictness, ethnicity or social class (Pruett in Cath et al., 1989). == Definitions == === Help-seeking === Rickwood and Thomas’ (2012) definition of help-seeking for mental health problems is described as “an adaptive coping process that is the attempt to obtain external assistance to deal with mental health concerns” (Rickwood and Thomas, 2012, p. 12). === Mental Health === === Stigma === === Fatherlessness === === Masculinity === == Barriers to help-seeking == === Cognitive Evaluation Theory === === Psychological barriers === ==== Need for control ==== ===== Vulnerability ===== ==== Lack of tools for emotional expression ==== === Social barriers === ==== Stigma ==== ==== Stereotypes ==== ==== Masculinity ==== ===== Toxic Masculinity ===== ==== Fatherlessness ==== ==== Over-reliance on male peers ==== ==== Absence of social support and community connections ==== == Help-seeking Motivation Theories == === Health Belief Model === === Social Cognitive Theory === === Theory of Reasoned Action and Planned Behaviour === === Mentoring === === Physiological needs === ==== Testosterone ==== === Psychological needs === ==== Autonomy ==== ==== Competence ==== ==== Relatedness ==== === Intervention practices === ==== Activity-based interventions ==== ==== Exercise-based interventions ==== ==== Sports-based interventions ==== == References == Lynch, L., Long, M., & Moorhead, A. (2018). Young men, help-seeking, and mental health services: Exploring barriers and solutions. ''American Journal of Men's Health, 12''(1), pp. 138–149. https://doi.org/10.1177/1557988315619469. Australian Bureau of Statistics. (2021, October 12). ''Labor force status of families''. ABS. https://www.abs.gov.au/statistics/labour/employment-and-unemployment/labour-force-status-families/latest-release#:~:text=1.1%20million%20(15.0%25)%20were,age%20siblings)%20(Table%201) Addis, M. E., & Mahalik, J. R. (2003). Men, masculinity, and the contexts of help seeking. ''American Psychologist, 58''(1), pp. 5–14. https://doi.org/10.1037/0003-066X.58.1.5. Arnett, J. J. (2007). Emerging adulthood: What is it, and what is it good for? ''Child Development Perspectives, 1''(2), pp. 68–73. https://doi.org/10.1111/j.1750-8606.2007.00016.x. Berger, J. M., Levant, R., McMillan, K. K., Kelleher, W., & Sellers, A. (2005). Impact of Gender Role Conflict, Traditional Masculinity Ideology, Alexithymia, and Age on Men's Attitudes Toward Psychological Help Seeking. ''Psychology of Men & Masculinity, 6''(1), pp. 73–78. https://doi.org/10.1037/1524-9220.6.1.73. Clement, S., Schauman, O., Graham, T., Maggioni, F., Evans-Lacko, S., Bezborodovs, N., Morgan, C., Rüsch, N., Brown, J. S. L., & Thornicroft, G. (2015). What is the impact of mental health-related stigma on help-seeking? A systematic review of quantitative and qualitative studies. ''Psychological Medicine, 45''(1), 11–27. https://doi.org/10.1017/S0033291714000129. Erikson, E. H. (1950). Growth and crises of the "healthy personality." In M. J. E. Senn (Ed.), ''Symposium on the healthy personality'' (pp. 91–146). Josiah Macy, Jr. Foundation. Bryan Rodgers, “Social and Psychological Wellbeing of Children from Divorced Families: Australian Research Findings,” ''Australian Psychologist'', 31(3), pp. 174-182. Pruett, K. D. (1989). The nurturing male: A longitudinal study of primary nurturing fathers. In S. H. Cath, A. Gurwitt, & L. Gunsberg (Eds.), ''Fathers and their families'' (pp. 389–405). Analytic Press, Inc. Rickwood, D., & Thomas, K. (2012). Conceptual measurement framework for help-seeking for mental health problems. ''Psychology research and behavior management'', ''5'', pp. 173-183. Thompson Jr, E. H., & Pleck, J. H. (1986). The structure of male role norms. ''American Behavioral Scientist'', ''29''(5), pp. 531-543. https://doi.org/10.1177/000276486029005003. Tudiver, F., & Talbot, Y. (1999). Why don't men seek help? Family physicians' perspectives on help-seeking behavior in men. ''The Journal of Family Practice, 48''(1), pp. 47–52. Weiss, M. F. (1994). Children's attitudes toward the mentally ill: An eight-year longitudinal follow-up. ''Psychological Reports, 74''(1), 51–56. https://doi.org/10.2466/pr0.1994.74.1.51. Yousaf, O., Grunfeld, E. A., & Hunter, M. S. (2015). A systematic review of the factors associated with delays in medical and psychological help-seeking among men. ''Health Psychology Review, 9''(2), pp. 264–276. https://doi.org/10.1080/17437199.2013.840954. Zartaloudi, A., & Madianos, M. (2010). Stigma related to help-seeking from a mental health professional. ''Health science journal'', ''4''(2), p. 77. \You are underway {{smile}}! This template provides tips for [[Motivation and emotion/Assessment/Topic|topic development]]. Gradually remove these suggestions as you develop the chapter. Also consult the [[Motivation and emotion/Assessment/Chapter|author guidelines]]. At the top of the chapter, the title and sub-title should match the ''exact'' wording and casing as shown in the {{Motivation and emotion/Book}}. The sub-titles all end with a question mark. This Overview section should be concise but consist of several paragraphs which engage the reader, illustrate the problem, and outline how psychological science can help.{{tip| Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Provide an example or case study. * Conclude with Focus questions to guide the chapter. }} ==Main headings== How you are going to structure the chapter? Aim for three to six main headings between the [[#Overview|Overview]] and [[#Conclusion|Conclusion]]. {{tip|Suggestions for this section: * For the [[Motivation and emotion/Assessment/Topic|topic development]], provide at least 3 bullet-points about key content per section. Include key citations. * For the [[Motivation and emotion/Assessment/Chapter|book chapter]], expand the bullet points into paragraphs. * If a section has a lot of content, arrange it into two to five sub-headings such as in the [[#Interactive learning features|interactive learning features section]]. Avoid having sections with only one sub-heading. }} ==Learning features== What brings an online book chapter to life are its interactive learning features. Case studies, feature boxes, figures, links, tables, and quiz questions can be used throughout the chapter. ===Case studies=== Case studies describe real-world examples of concepts in action. Case studies can be real or fictional. A case could be used multiple times during a chapter to illustrate different theories or stages. It is often helpful to present case studies using [[#Feature boxes|feature boxes]]. ===Boxes=== Boxes can be used to highlight content, but don't overuse them. There are many different ways of creating boxes (e.g., see [[Help:Pretty boxes|Pretty boxes]]). Possible uses include: * Focus questions * Case studies or examples * Quiz questions * Take-home messages {{RoundBoxTop|theme=3}} ;Feature box example * Shaded background * Coloured border {{RoundBoxBottom}} ===Figures=== [[File:Monkey-typing.jpg|right|205px|thumb|''Figure 1''. Example image with descriptive caption.]] Use figures to illustrate concepts, add interest, and provide examples. Figures can be used to show photographs, drawings, diagrams, graphs, etcetera. Figures can be embedded throughout the chapter, starting with the Overview section. Figures should be captioned (using a number and a description) in order to explain their relevance to the text. Possible images can be found at [[commons:|Wikimedia Commons]]. Images can also be uploaded if they are licensed for re-use or if you created the image. Each figure should be referred to at least once in the main text (e.g., see Figure 1). ===Links=== Where key words are first used, make them into [[Help:Links|interwiki links]] such as Wikipedia links to articles about famous people (e.g., [[w:Sigmund Freud|Sigmund Freud]] and key concepts (e.g., [[w:Dreams|dreams]]) and links to book chapters about related topics (e.g., would you like to learn about how to overcome [[Motivation and emotion/Book/2020/Writer's block|writer's block]]?). ===Tables=== Tables can be an effective way to organise and summarise information. Tables should be captioned (using APA style) to explain their relevance to the text. Plus each table should be referred to at least once in the main text (e.g., see Table 1 and Table 2). Here are some [[Motivation and emotion/Wikiversity/Tables|example 3 x 3 tables]] which could be adapted. ===Quizzes=== Quizzes are a direct way to engage readers. But don't make quizzes too hard or long. It is better to have one or two review questions per major section than a long quiz at the end. Try to quiz conceptual understanding, rather than trivia. Here are some simple quiz questions which could be adapted. Choose the correct answers and click "Submit": <quiz display=simple> {Quizzes are an interactive learning feature: |type="()"} + True - False {Long quizzes are a good idea: |type="()"} - True + False </quiz> To learn about different types of quiz questions, see [[Help:Quiz|Quiz]]. ==Conclusion== The Conclusion is arguably the most important section. It should be possible for someone to read the [[#Overview|Overview]] and the Conclusion and still get a good idea of the topic. {{tip|Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? }} ==See also== Provide up to half-a-dozen [[Help:Contents/Links#Interwiki_links|internal (wiki) links]] to relevant Wikiversity pages (esp. related [[Motivation and emotion/Book|motivation and emotion book chapters]]) and [[w:|Wikipedia articles]]. For example: * [[Motivation and emotion/Book/2016/Anorexia nervosa and extrinsic motivation|Anorexia nervosa and extrinsic motivation]] (Book chapter, 2016) * [[w:David McClelland|David McClelland]] (Wikipedia) * [[Motivation and emotion/Book/2018/Loss aversion|Loss aversion]] (Book chapter, 2018) * [[w:Maslow's hierarchy of needs|Maslow's hierarchy of needs]] (Wikipedia) {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== List the cited references in [[w:APA style|APA style]] (7th ed.) or [[w:Wikipedia:Citing sources|wiki style]]. APA style example: {{Hanging indent|1= Blair, R. J. R. (2004). The roles of orbital frontal cortex in the modulation of antisocial behavior. ''Brain and Cognition'', ''55''(1), 198–208. https://doi.org/10.1016/S0278-2626(03)00276-8 Buckholtz, J. W., & Meyer-Lindenberg, A. (2008). MAOA and the neurogenetic architecture of human aggression. ''Trends in Neurosciences'', ''31''(3), 120–129. https://doi.org/10.1016/j.tins.2007.12.006 Eckardt, M., File, S., Gessa, G., Grant, K., Guerri, C., Hoffman, P., & Tabakoff, B. (1998). Effects of moderate alcohol consumption on the central nervous system. ''Alcoholism, Clinical and Experimental Research'', ''22''(5), 998–1040. https://doi.org/10.1111/j.1530-0277.1998.tb03695.x }} {{tip|Suggestions for this section: * Important aspects for APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except first letter and proper names, ending in a full-stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full-stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't actually read or consulted }} ==External links== Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * [https://students.unimelb.edu.au/academic-skills/explore-our-resources/essay-writing/six-top-tips-for-writing-a-great-essay Six top tips for writing a great essay] (University of Melbourne) * [http://www.skillsyouneed.com/write/structure.html The importance of structure] (skillsyouneed.com) {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] [[Category:Motivation and emotion/Book/Children]] [[Category:Motivation and emotion/Book/Male]] [[Category:Motivation and emotion/Book/Help-seeking]] 1qgepvqlwwd0wv7i4ppg5giabnkgio8 2419396 2419393 2022-08-26T08:12:09Z BradMcgrath 2947530 wikitext text/x-wiki {{title|What are the barriers and enablers of help-seeking in boys?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Background== {{RoundBoxTop|theme=3}} '''Focus questions:''' * Has fatherlessness demonstrated to boys that a lack of motivation is normal? * What barriers do boys need help overcoming in order to enable help-seeking behaviour? * Is the tendency for boys to ascribe help-seeking as a loss of control suggestive of a broader problem associated with fatherlessness and masculinity? {{RoundBoxBottom}}The low prevalence of help-seeking among adolescent boys is a phenomenon that has been widely recognised and supported for more than two decades (Addis & Mahalik, 2003; Berger et al., 2005; Clement et al., 2015; Lynch et al., 2018; Tudiver & Talbot, 1999; Yousaf et al., 2015). Traditionally, seeking help for mental health among nuclear families was often approached with a negative attitude, in part due to stigma that can develop in youth (Berger et al., 2005; Weiss, 1994; Zartaloudi & Madianos, 2010). For many boys, help-seeking was a dichotomy to their role in society as a sole-breadwinner, as many were raised within the structure of male role norms that included an independent style of achievement and self-containment. This sense of competency and autonomy helped to prepare boys for raising children and establishing oneself into his community (Thompson & Pleck, 1986). In other words, these social and cultural scripts helped them to fulfill their lives. The central theory of the life course, first proposed by Erikson (1950), theorised that adolescence occurred before young adulthood, which started in the late teens and finished at about age 40. During this time, many people in industrialised societies married and could reap the benefits of stable full-time work by around age 20 (Arnett, 2007). However, by the end of the century, this tradition began to change. The median age of marriage had increased and a new period of life was characterised by job change and aspirations for post-secondary education (Arnett, 2007). During this time, relationships among men and women had changed dramatically and premarital sex and cohabitation in the 20s had become widely acceptable, with many young people sharing a preference for spending their late teens to mid-20s outside the confines of marriage (Arnett, 2007). ''The Boy Crisis'', a term coined by American political scientist and author, Warren Pharrell, is believed to be a manifestation of a purpose void in consequence to these behavioural, psychological and physiological changes associated with modern family structures and, in particular, the absence of fathers. In Australia, 1.1 million (15.0%) of Australian households are one parent families, with 80% of these being single mothers (ABS, 2021). Bryan Rodgers of the Australian National University says “Australian studies with adequate samples have shown parental divorce to be a risk factor for a wide range of social and psychological problems in adolescence and adulthood, including poor academic achievement, low self-esteem, psychological distress, delinquency and recidivism, substance use and abuse, sexual precocity, adult criminal offending, depression, and suicidal behaviour.” He concludes: “There is no scientific justification for disregarding the public health significance of marital dissolution in Australia, especially with respect to mental health.” (Rodgers, 1995, p. 180). Boys who grow up fatherless are more likely to drop out of school (), drink (), become delinquent (), and end up in prison (). Furthermore, father involvement is at least five times as important in preventing drug use than closeness to parent, parental trust, strictness, ethnicity or social class (Pruett in Cath et al., 1989). == Definitions == === Help-seeking === Rickwood and Thomas’ (2012) definition of help-seeking for mental health problems is described as “an adaptive coping process that is the attempt to obtain external assistance to deal with mental health concerns” (Rickwood and Thomas, 2012, p. 12). === Mental Health === According to the World Health Organization, Mental health "is a state of mental well-being that enables people to cope with the stresses of life, realize their abilities, learn well and work well, and contribute to their community. It is an integral component of health and well-being that underpins our individual and collective abilities to make decisions, build relationships and shape the world we live in" (WHO, 2022, para. 1). === Stigma === === Fatherlessness === === Masculinity === == Barriers to help-seeking == === Cognitive Evaluation Theory === === Psychological barriers === ==== Need for control ==== ===== Vulnerability ===== ==== Lack of tools for emotional expression ==== === Social barriers === ==== Stigma ==== ==== Stereotypes ==== ==== Masculinity ==== ===== Toxic Masculinity ===== ==== Fatherlessness ==== ==== Over-reliance on male peers ==== ==== Absence of social support and community connections ==== == Help-seeking Motivation Theories == === Health Belief Model === === Social Cognitive Theory === === Theory of Reasoned Action and Planned Behaviour === === Mentoring === === Physiological needs === ==== Testosterone ==== === Psychological needs === ==== Autonomy ==== ==== Competence ==== ==== Relatedness ==== === Intervention practices === ==== Activity-based interventions ==== ==== Exercise-based interventions ==== ==== Sports-based interventions ==== == References == Lynch, L., Long, M., & Moorhead, A. (2018). Young men, help-seeking, and mental health services: Exploring barriers and solutions. ''American Journal of Men's Health, 12''(1), pp. 138–149. https://doi.org/10.1177/1557988315619469. Australian Bureau of Statistics. (2021, October 12). ''Labor force status of families''. ABS. https://www.abs.gov.au/statistics/labour/employment-and-unemployment/labour-force-status-families/latest-release#:~:text=1.1%20million%20(15.0%25)%20were,age%20siblings)%20(Table%201) Addis, M. E., & Mahalik, J. R. (2003). Men, masculinity, and the contexts of help seeking. ''American Psychologist, 58''(1), pp. 5–14. https://doi.org/10.1037/0003-066X.58.1.5. Arnett, J. J. (2007). Emerging adulthood: What is it, and what is it good for? ''Child Development Perspectives, 1''(2), pp. 68–73. https://doi.org/10.1111/j.1750-8606.2007.00016.x. Berger, J. M., Levant, R., McMillan, K. K., Kelleher, W., & Sellers, A. (2005). Impact of Gender Role Conflict, Traditional Masculinity Ideology, Alexithymia, and Age on Men's Attitudes Toward Psychological Help Seeking. ''Psychology of Men & Masculinity, 6''(1), pp. 73–78. https://doi.org/10.1037/1524-9220.6.1.73. Clement, S., Schauman, O., Graham, T., Maggioni, F., Evans-Lacko, S., Bezborodovs, N., Morgan, C., Rüsch, N., Brown, J. S. L., & Thornicroft, G. (2015). What is the impact of mental health-related stigma on help-seeking? A systematic review of quantitative and qualitative studies. ''Psychological Medicine, 45''(1), 11–27. https://doi.org/10.1017/S0033291714000129. Erikson, E. H. (1950). Growth and crises of the "healthy personality." In M. J. E. Senn (Ed.), ''Symposium on the healthy personality'' (pp. 91–146). Josiah Macy, Jr. Foundation. Bryan Rodgers, “Social and Psychological Wellbeing of Children from Divorced Families: Australian Research Findings,” ''Australian Psychologist'', 31(3), pp. 174-182. Pruett, K. D. (1989). The nurturing male: A longitudinal study of primary nurturing fathers. In S. H. Cath, A. Gurwitt, & L. Gunsberg (Eds.), ''Fathers and their families'' (pp. 389–405). Analytic Press, Inc. Rickwood, D., & Thomas, K. (2012). Conceptual measurement framework for help-seeking for mental health problems. ''Psychology research and behavior management'', ''5'', pp. 173-183. Thompson Jr, E. H., & Pleck, J. H. (1986). The structure of male role norms. ''American Behavioral Scientist'', ''29''(5), pp. 531-543. https://doi.org/10.1177/000276486029005003. Tudiver, F., & Talbot, Y. (1999). Why don't men seek help? Family physicians' perspectives on help-seeking behavior in men. ''The Journal of Family Practice, 48''(1), pp. 47–52. Weiss, M. F. (1994). Children's attitudes toward the mentally ill: An eight-year longitudinal follow-up. ''Psychological Reports, 74''(1), 51–56. https://doi.org/10.2466/pr0.1994.74.1.51. World Health Organization. (2022, June 17). ''Mental health: strengthening our response''. WHO. https://www.who.int/news-room/fact-sheets/detail/mental-health-strengthening-our-response. Yousaf, O., Grunfeld, E. A., & Hunter, M. S. (2015). A systematic review of the factors associated with delays in medical and psychological help-seeking among men. ''Health Psychology Review, 9''(2), pp. 264–276. https://doi.org/10.1080/17437199.2013.840954. Zartaloudi, A., & Madianos, M. (2010). Stigma related to help-seeking from a mental health professional. ''Health science journal'', ''4''(2), p. 77. \You are underway {{smile}}! This template provides tips for [[Motivation and emotion/Assessment/Topic|topic development]]. Gradually remove these suggestions as you develop the chapter. Also consult the [[Motivation and emotion/Assessment/Chapter|author guidelines]]. At the top of the chapter, the title and sub-title should match the ''exact'' wording and casing as shown in the {{Motivation and emotion/Book}}. The sub-titles all end with a question mark. This Overview section should be concise but consist of several paragraphs which engage the reader, illustrate the problem, and outline how psychological science can help.{{tip| Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Provide an example or case study. * Conclude with Focus questions to guide the chapter. }} ==Main headings== How you are going to structure the chapter? Aim for three to six main headings between the [[#Overview|Overview]] and [[#Conclusion|Conclusion]]. {{tip|Suggestions for this section: * For the [[Motivation and emotion/Assessment/Topic|topic development]], provide at least 3 bullet-points about key content per section. Include key citations. * For the [[Motivation and emotion/Assessment/Chapter|book chapter]], expand the bullet points into paragraphs. * If a section has a lot of content, arrange it into two to five sub-headings such as in the [[#Interactive learning features|interactive learning features section]]. Avoid having sections with only one sub-heading. }} ==Learning features== What brings an online book chapter to life are its interactive learning features. Case studies, feature boxes, figures, links, tables, and quiz questions can be used throughout the chapter. ===Case studies=== Case studies describe real-world examples of concepts in action. Case studies can be real or fictional. A case could be used multiple times during a chapter to illustrate different theories or stages. It is often helpful to present case studies using [[#Feature boxes|feature boxes]]. ===Boxes=== Boxes can be used to highlight content, but don't overuse them. There are many different ways of creating boxes (e.g., see [[Help:Pretty boxes|Pretty boxes]]). Possible uses include: * Focus questions * Case studies or examples * Quiz questions * Take-home messages {{RoundBoxTop|theme=3}} ;Feature box example * Shaded background * Coloured border {{RoundBoxBottom}} ===Figures=== [[File:Monkey-typing.jpg|right|205px|thumb|''Figure 1''. Example image with descriptive caption.]] Use figures to illustrate concepts, add interest, and provide examples. Figures can be used to show photographs, drawings, diagrams, graphs, etcetera. Figures can be embedded throughout the chapter, starting with the Overview section. Figures should be captioned (using a number and a description) in order to explain their relevance to the text. Possible images can be found at [[commons:|Wikimedia Commons]]. Images can also be uploaded if they are licensed for re-use or if you created the image. Each figure should be referred to at least once in the main text (e.g., see Figure 1). ===Links=== Where key words are first used, make them into [[Help:Links|interwiki links]] such as Wikipedia links to articles about famous people (e.g., [[w:Sigmund Freud|Sigmund Freud]] and key concepts (e.g., [[w:Dreams|dreams]]) and links to book chapters about related topics (e.g., would you like to learn about how to overcome [[Motivation and emotion/Book/2020/Writer's block|writer's block]]?). ===Tables=== Tables can be an effective way to organise and summarise information. Tables should be captioned (using APA style) to explain their relevance to the text. Plus each table should be referred to at least once in the main text (e.g., see Table 1 and Table 2). Here are some [[Motivation and emotion/Wikiversity/Tables|example 3 x 3 tables]] which could be adapted. ===Quizzes=== Quizzes are a direct way to engage readers. But don't make quizzes too hard or long. It is better to have one or two review questions per major section than a long quiz at the end. Try to quiz conceptual understanding, rather than trivia. Here are some simple quiz questions which could be adapted. Choose the correct answers and click "Submit": <quiz display=simple> {Quizzes are an interactive learning feature: |type="()"} + True - False {Long quizzes are a good idea: |type="()"} - True + False </quiz> To learn about different types of quiz questions, see [[Help:Quiz|Quiz]]. ==Conclusion== The Conclusion is arguably the most important section. It should be possible for someone to read the [[#Overview|Overview]] and the Conclusion and still get a good idea of the topic. {{tip|Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? }} ==See also== Provide up to half-a-dozen [[Help:Contents/Links#Interwiki_links|internal (wiki) links]] to relevant Wikiversity pages (esp. related [[Motivation and emotion/Book|motivation and emotion book chapters]]) and [[w:|Wikipedia articles]]. For example: * [[Motivation and emotion/Book/2016/Anorexia nervosa and extrinsic motivation|Anorexia nervosa and extrinsic motivation]] (Book chapter, 2016) * [[w:David McClelland|David McClelland]] (Wikipedia) * [[Motivation and emotion/Book/2018/Loss aversion|Loss aversion]] (Book chapter, 2018) * [[w:Maslow's hierarchy of needs|Maslow's hierarchy of needs]] (Wikipedia) {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== List the cited references in [[w:APA style|APA style]] (7th ed.) or [[w:Wikipedia:Citing sources|wiki style]]. APA style example: {{Hanging indent|1= Blair, R. J. R. (2004). The roles of orbital frontal cortex in the modulation of antisocial behavior. ''Brain and Cognition'', ''55''(1), 198–208. https://doi.org/10.1016/S0278-2626(03)00276-8 Buckholtz, J. W., & Meyer-Lindenberg, A. (2008). MAOA and the neurogenetic architecture of human aggression. ''Trends in Neurosciences'', ''31''(3), 120–129. https://doi.org/10.1016/j.tins.2007.12.006 Eckardt, M., File, S., Gessa, G., Grant, K., Guerri, C., Hoffman, P., & Tabakoff, B. (1998). Effects of moderate alcohol consumption on the central nervous system. ''Alcoholism, Clinical and Experimental Research'', ''22''(5), 998–1040. https://doi.org/10.1111/j.1530-0277.1998.tb03695.x }} {{tip|Suggestions for this section: * Important aspects for APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except first letter and proper names, ending in a full-stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full-stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't actually read or consulted }} ==External links== Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * [https://students.unimelb.edu.au/academic-skills/explore-our-resources/essay-writing/six-top-tips-for-writing-a-great-essay Six top tips for writing a great essay] (University of Melbourne) * [http://www.skillsyouneed.com/write/structure.html The importance of structure] (skillsyouneed.com) {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] [[Category:Motivation and emotion/Book/Children]] [[Category:Motivation and emotion/Book/Male]] [[Category:Motivation and emotion/Book/Help-seeking]] hzy7ykuu6e1bgavgcdynxqn31kp379g 0 286397 2419136 2419034 2022-08-26T00:03:25Z U3210431 2947391 /* What is childhood trauma? */ polishing wikitext text/x-wiki {{title|Childhood trauma and subsequent drug use:<br>How does childhood trauma influence drug use?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== [[File:Toxicoman - Substance abuse.jpg|thumb|384x384px|''Figure 1.'' Drug use can heavily impact an individuals physical and mental health ]] The use of drugs has jumped from the romanticisation of the “love drug” known by the name of methylenedioxymetamfetamine (MDMA) and hallucinogenic drugs in the 1980s, to the rumination of them and their lethal and detrimental nature across time. When it comes to [[Drug misuse|drug]] consumption, we see those individuals who search for a deeper meaning, those who try to find an escape and those who conform to [[social norms]]. Yet, humans are aware of the detrimental consequences of drug consumption. From a young age we are taught about drugs and their lethal consequences. Why do individuals partake in drug consumption when they are aware of what might happen? Imagine an individual who has consistently used drugs for years, developed an addiction and is therefore unemployed. This behaviour has caused family members and friends to detach themselves, leaving this individual lonely. Family members constantly asking why they have done this to themselves and the blame being pointed at the individual for ruining their life. Although it is not out of the picture, we tend to believe that people are responsible for their actions and therefore blame them for using drugs. Why do we tend to believe this? Is it truly the individuals fault or can drug use be influenced by previous traumatic experiences? This chapter focuses on how childhood trauma can influence subsequent drug use. {{RoundBoxTop|theme=3}} '''Focus questions:''' * What is childhood trauma? * What are theoretical underpinnings of childhood trauma induced drug use? * How does childhood trauma influence drug use? * What are the strategies for treating trauma-induced drug use? {{RoundBoxBottom}} {{tip| Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Provide an example or case study. * Conclude with Focus questions to guide the chapter. }} ==What is childhood trauma== [[File:Crying child with blonde hair.jpg|thumb|342x342px|''Figure 2.'' Childhood trauma negatively impacts a child's emotional well-being]]The [https://www.apa.org/pi/families/resources/update.pdf American Psychological Association] (APA) defines a traumatic life event as:<blockquote>"One that threatens, injury, death, or the physical integrity of self or others and also causes horror, terror, or helplessness at the time it occurs. Traumatic events include sexual abuse, physical abuse, domestic violence, community and school violence, medical trauma, motor vehicle accidents, acts of terrorism, war experiences, natural and human-made disasters, suicides, and other traumatic losses (American Psychological Association, 2008)." </blockquote> * When these events are experienced in a developing child, this constitutes as childhood trauma. * Due to children's vulnerability and lack of understanding, depending on their age, trauma can be especially harmful and result in many consequences throughout adolescence and adulthood. === Types of childhood trauma === Childhood trauma refers to negative events that threaten or cause harm to a child's emotional and/or physical wellbeing. Childhood trauma is most commonly the result of a child perceiving themselves to be in a life-threatening situation. Terr (1991) introduced two types of childhood trauma: * '''Type I''' - results from a single event such as an accident, witnessing a crime or rape. ** Individuals affected by Type I trauma especially if the incident occurred after the age of 3, are thought to remember the incident and experience perceptual symptoms such as visual hallucinations as a consequence of the trauma. * '''Type II -''' results from repeated exposure of extreme traumatising events such as re-occurring abuse ** Individuals affected by Type II trauma, are proposed to repress the event using denial and dissociation methods to avoid the trauma exposure. === Consequences of childhood trauma === * Emerging literature puts a strong focus on the effects of childhood trauma on brain development. Adverse events experienced in childhood, exposes children to become insecurely attached and develop poor self-regulation skills (Ford, 2009). Emotional dysregulation as a consequence of childhood trauma, has been highly linked to substance use with heavy consumption in adulthood (Dass-Breilsford & Myrick, 2010). * Longer term reactions include unpredictable emotions, sleep disturbances, separation anxiety, the development of new fears, anger irritability, and even physical symptoms like headaches to nausea." '''(APA)''' * Since children are still developing, childhood trauma can have long-lasting effects on a child's physical, mental and emotional well-being which carries onto adulthood. Moreover, common consequences of childhood trauma includes co-occuring psychiatric problems and substance abuse (Dye, 2018). == What constitutes drug use? == * Drugs have been been used medically and recreationally throughout history with early civilisations using them for religious rituals. * [[Substance abuse|Drug misuse]] is defined as the recreational use of alcohol, illicit drugs and pain medications which can lead to emotional, physical and social harm (Ghuran & Nolan, 2000). * Repeated drug use often leads to substance use disorder (SUD) which commonly constitutes addiction and the inability to discontinue drug use. * According to the 5^th edition of the Diagnostic Manual of Mental Disorders (DSM-5) substance induced disorders occur when the substance use leads to intoxication, addiction, withdrawal and induced psychological disorders such as psychosis and and depressive disorders (American Psychiatric Association, 2013). === Alcohol === * The World Health Organisation (WHO) has identified [https://www.who.int/health-topics/alcohol#tab=tab_1 alcohol] as a psychoactive type of drug which is highly addictive and the cause of around 3 million deaths per year (World Health Organisation, 2022). * Repeated alcohol use can result in alcohol use disorder which can impact an individual's psychological, physical and social well-being === Pain medication === * Pain medication such as opioids are crucial in the medical world and have a purpose of delivering an analgesic effect for those individuals experiencing agonising pain. Acute pain patients benefit from these drugs immensely. * The use of pain medication is common among those who suffer from chronic pain conditions and is commonly not addictive or harmful when used in moderation. Nonetheless, the addictive properties in opioids paired with repeated use can quickly lead to drug addiction (Schnoll & Weaver, 2003) === Illicit drugs === * What makes a drug illicit? An illicit drug is one which has not been medically approved and is prohibited and illegal to be consumed, possess and sold. Illicit drugs are illegal due to the risk of [[addiction]] and the psychological and physiological risks attached to them. The international illegality of these drugs extends from plant-based drugs (e.g. cannabis, cocaine heroin) to pharmaceutical drugs (e.g. benzodiazepines) and synthetic drugs (e.g. MDMA, amphetamines) (Degenhardt & Hall, 2012). * The use of illicit drugs is commonly looked down upon and seen as the self-endangerment of an individual's well-being and sanity. So why do individuals partake in illicit drug use? {{Robelbox|theme=7|title=Quiz Time!|iconwidth=48px|icon=Nuvola_apps_korganizer.svg}}<div style="{{Robelbox/pad}}"> <quiz display=simple> {What makes a drug illicit?} - When it has been medically approved for consumption + When it has not been medically approved and is prohibited and illegal - When it is a plant-based drug </quiz> </div> {{Robelbox-close}} ==What are the theoretical underpinnings of trauma induced drug use?== * Using drugs is a dangerous behaviour that is commonly performed recreationally with large negative consequences. Although drug use is often initiated by peer pressure within social situations, psychological trauma can be a precursor for drug use throughout the lifespan. Trauma-exposed individuals are likely engaging in drug use as a maladaptive coping strategy to experience an emotional relief which may be compounding distress (Sheerin et al., 2016). * This part of the chapter will discuss the theoretical concepts surrounding the motivation behind trauma induced drug use. === Protection Motivation theory === * Protection motivation theory proposed by Rogers (1997) considers how individuals cope in distressing situations in order to protect oneself from perceived threat. This theory operates on three aspects: *# The magnitude of the threat within a specific event *# the probability that this event will re-occur *# The efficacy of a protective response === Extrinsic Motivation === * Extrinsic motivation describes a situation whereby, an individual follows the pursuit of an instrumental goal. Operant condtioning falls under extrinsic motivation since we see motivation of certain behaviours occur due to rewards and punishment. One theoretical underpinning that may explain why individuals who has experienced childhood trauma reach out to drugs can be explained by negative reinforcement. * When considering the negative reinforcement model and its influence in drug use, we can suggest that childhood trauma and the subsequent emotional damage, can motivate drug use. This can be considered whereby trauma may place an individual in an uncomfortable and distressing emotional state which can be relieved through an immediate short-term reward illicit by the consumption of drugs (May et al., 2020) == How does psychological trauma motivate drug use? == * It comes as no surprise that individuals turn to drug misuse to self-medicate against the unbearable pain and distress caused by unresolved and unprocessed traumatic experiences (Marcenko et al., 2000). The sad reality is that a lot of children who experience trauma in the early years are unaware of the extent to which this event may have impacted them later in life. A common coping mechanism of childhood trauma is repressing the event especially in younger children who do not understand the concept of right and wrong yet. * What trauma types are most relevant to drug use? Is there a specific type of event that is more likely to lead to drug use later in life? What does it mean to self-medicate? === Childhood trauma types most relevant to drug use === * It comes as no surprise that adverse childhood experiences play a role in maladaptive coping mechanisms. Nonetheless, it is important to address the types of trauma that affect this behaviour in order to successfully treat it. * A study conducted by Dube et al. (2003) demonstrated that ''childhood neglect'' was a predictor for illicit drug use. How does this occur? * Household dysfunction consisting of domestic violence, violence towards parent, divorce, mentally family member etc. presents another predictor for potential drug use. *Another type of childhood trauma that heavily influences drug use is childhood sexual abuse with the most common mean age at 11 - 13 years of age. Childhood sexual abuse is more commonly related to later substance use in comparison to an adulthood sexual abuse life event (Liebschutz, 2002). * === Self-medication following childhood trauma === * Early childhood sexual trauma has been theorised to result in drug use due to the desire to numb the painful affect caused by the trauma (Marcenko et al., 2000) . * Moreover, the psychological impact that childhood trauma has on a developing child plays a large role in how the child learns to adapt and cope. For example, a child with severe attachment issues due to a physically abusive parents, may turn to drugs to counteract the insecure relationships they experience throughout adulthood - avoidance of loneliness. == What are the strategies for treating trauma induced drug use? == * From a physiological perspective, the neurobiological pathways that are impacted by trauma (causing PTSD) and substance use have some similarities whereby, certain drugs have a depressing or arousal effect causing hyper-vigilance. * When considering treatment strategies for childhood trauma induced drug use, it is important to consider that both potential disorders need to be addressed simultaneously. The childhood trauma may have developed into PTSD and the symptoms may have induced a dependence on drugs causing substance use disorder (SUD). * Types of treatment for treating trauma induced drug use may include cognitive behavioural therapy (CBT), eye-movement desensitisation reprocessing (EMDR), medication and behavioural counselling (Note: I may turn these into sub-headings but unsure at this point). ===Case studies=== Case studies describe real-world examples of concepts in action. Case studies can be real or fictional. A case could be used multiple times during a chapter to illustrate different theories or stages. It is often helpful to present case studies using [[#Feature boxes|feature boxes]]. ===Boxes=== Boxes can be used to highlight content, but don't overuse them. There are many different ways of creating boxes (e.g., see [[Help:Pretty boxes|Pretty boxes]]). Possible uses include: * Focus questions * Case studies or examples * Quiz questions * Take-home messages {{RoundBoxTop|theme=3}} ;Feature box example * Shaded background * Coloured border {{RoundBoxBottom}} ===Figures=== [[File:Monkey-typing.jpg|right|205px|thumb|''Figure 1''. Example image with descriptive caption.]] Use figures to illustrate concepts, add interest, and provide examples. Figures can be used to show photographs, drawings, diagrams, graphs, etcetera. Figures can be embedded throughout the chapter, starting with the Overview section. Figures should be captioned (using a number and a description) in order to explain their relevance to the text. Possible images can be found at [[commons:|Wikimedia Commons]]. Images can also be uploaded if they are licensed for re-use or if you created the image. Each figure should be referred to at least once in the main text (e.g., see Figure 1). ===Links=== Where key words are first used, make them into [[Help:Links|interwiki links]] such as Wikipedia links to articles about famous people (e.g., [[w:Sigmund Freud|Sigmund Freud]] and key concepts (e.g., [[w:Dreams|dreams]]) and links to book chapters about related topics (e.g., would you like to learn about how to overcome [[Motivation and emotion/Book/2020/Writer's block|writer's block]]?). ===Tables=== Tables can be an effective way to organise and summarise information. Tables should be captioned (using APA style) to explain their relevance to the text. Plus each table should be referred to at least once in the main text (e.g., see Table 1 and Table 2). Here are some [[Motivation and emotion/Wikiversity/Tables|example 3 x 3 tables]] which could be adapted. ===Quizzes=== Quizzes are a direct way to engage readers. But don't make quizzes too hard or long. It is better to have one or two review questions per major section than a long quiz at the end. Try to quiz conceptual understanding, rather than trivia. Here are some simple quiz questions which could be adapted. Choose the correct answers and click "Submit": <quiz display=simple> {Quizzes are an interactive learning feature: |type="()"} + True - False {Long quizzes are a good idea: |type="()"} - True + False </quiz> To learn about different types of quiz questions, see [[Help:Quiz|Quiz]]. ==Conclusion== The Conclusion is arguably the most important section. It should be possible for someone to read the [[#Overview|Overview]] and the Conclusion and still get a good idea of the topic. {{tip|Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? }} ==See also== Provide up to half-a-dozen [[Help:Contents/Links#Interwiki_links|internal (wiki) links]] to relevant Wikiversity pages (esp. related [[Motivation and emotion/Book|motivation and emotion book chapters]]) and [[w:|Wikipedia articles]]. For example: * [[Motivation and emotion/Book/2018/Childhood trauma and emotion|childhood trauma and emotion]] (Book chapter, 2018) * [[wikipedia:Protection_motivation_theory|Protection motivation theory]] (Wikipedia) * [[wikipedia:Recreational_drug_use|Recreational drug use]] (Wikipedia) * [[Motivation and emotion/Book/2021/Safety as a psychological need|Safety as a psychological need]] (Book chapter, 2018) {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== List the cited references in [[w:APA style|APA style]] (7th ed.) or [[w:Wikipedia:Citing sources|wiki style]]. APA style example: {{Hanging indent|1= Blair, R. J. R. (2004). The roles of orbital frontal cortex in the modulation of antisocial behavior. ''Brain and Cognition'', ''55''(1), 198–208. https://doi.org/10.1016/S0278-2626(03)00276-8 Buckholtz, J. W., & Meyer-Lindenberg, A. (2008). MAOA and the neurogenetic architecture of human aggression. ''Trends in Neurosciences'', ''31''(3), 120–129. https://doi.org/10.1016/j.tins.2007.12.006 Eckardt, M., File, S., Gessa, G., Grant, K., Guerri, C., Hoffman, P., & Tabakoff, B. (1998). Effects of moderate alcohol consumption on the central nervous system. ''Alcoholism, Clinical and Experimental Research'', ''22''(5), 998–1040. https://doi.org/10.1111/j.1530-0277.1998.tb03695.x }} {{tip|Suggestions for this section: * Important aspects for APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except first letter and proper names, ending in a full-stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full-stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't actually read or consulted }} ==External links== Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * [https://students.unimelb.edu.au/academic-skills/explore-our-resources/essay-writing/six-top-tips-for-writing-a-great-essay Six top tips for writing a great essay] (University of Melbourne) * [http://www.skillsyouneed.com/write/structure.html The importance of structure] (skillsyouneed.com) {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] [[Category:Motivation and emotion/Book/Children]] [[Category:Motivation and emotion/Book/Trauma]] hxu76m021d44natgubb83viwzoy3mdg 2419138 2419136 2022-08-26T00:12:13Z U3210431 2947391 /* What is childhood trauma */ wikitext text/x-wiki {{title|Childhood trauma and subsequent drug use:<br>How does childhood trauma influence drug use?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== [[File:Toxicoman - Substance abuse.jpg|thumb|384x384px|''Figure 1.'' Drug use can heavily impact an individuals physical and mental health ]] The use of drugs has jumped from the romanticisation of the “love drug” known by the name of methylenedioxymetamfetamine (MDMA) and hallucinogenic drugs in the 1980s, to the rumination of them and their lethal and detrimental nature across time. When it comes to [[Drug misuse|drug]] consumption, we see those individuals who search for a deeper meaning, those who try to find an escape and those who conform to [[social norms]]. Yet, humans are aware of the detrimental consequences of drug consumption. From a young age we are taught about drugs and their lethal consequences. Why do individuals partake in drug consumption when they are aware of what might happen? Imagine an individual who has consistently used drugs for years, developed an addiction and is therefore unemployed. This behaviour has caused family members and friends to detach themselves, leaving this individual lonely. Family members constantly asking why they have done this to themselves and the blame being pointed at the individual for ruining their life. Although it is not out of the picture, we tend to believe that people are responsible for their actions and therefore blame them for using drugs. Why do we tend to believe this? Is it truly the individuals fault or can drug use be influenced by previous traumatic experiences? This chapter focuses on how childhood trauma can influence subsequent drug use. {{RoundBoxTop|theme=3}} '''Focus questions:''' * What is childhood trauma? * What are theoretical underpinnings of childhood trauma induced drug use? * How does childhood trauma influence drug use? * What are the strategies for treating trauma-induced drug use? {{RoundBoxBottom}} {{tip| Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Provide an example or case study. * Conclude with Focus questions to guide the chapter. }} ==What is childhood trauma== [[File:Crying child with blonde hair.jpg|thumb|342x342px|''Figure 2.'' Childhood trauma negatively impacts a child's emotional well-being]]The [https://www.apa.org/pi/families/resources/update.pdf American Psychological Association] (APA) defines a traumatic life event as:<blockquote>"One that threatens, injury, death, or the physical integrity of self or others and also causes horror, terror, or helplessness at the time it occurs. Traumatic events include sexual abuse, physical abuse, domestic violence, community and school violence, medical trauma, motor vehicle accidents, acts of terrorism, war experiences, natural and human-made disasters, suicides, and other traumatic losses (American Psychological Association, 2008)." </blockquote> * When these events are experienced in a developing child, this constitutes as childhood trauma. * Due to children's vulnerability and lack of understanding, depending on their age, trauma can be especially harmful and result in many consequences throughout adolescence and adulthood. === Types of childhood trauma === Childhood trauma refers to negative events that threaten or cause harm to a child's emotional and/or physical wellbeing. Childhood trauma is most commonly the result of a child perceiving themselves to be in a life-threatening situation. Terr (1991) introduced two types of childhood trauma: * '''Type I''' - results from a single event such as an accident, witnessing a crime or rape. ** Individuals affected by Type I trauma especially if the incident occurred after the age of 3, are thought to remember the incident and experience perceptual symptoms such as visual hallucinations as a consequence of the trauma. * '''Type II -''' results from repeated exposure of extreme traumatising events such as re-occurring abuse ** Individuals affected by Type II trauma, are proposed to repress the event using denial and dissociation methods to avoid the trauma exposure. === Consequences of childhood trauma === * Emerging literature puts a strong focus on the effects of childhood trauma on brain development. Adverse events experienced in childhood, exposes children to become insecurely attached and develop poor self-regulation skills (Ford, 2009). Emotional dysregulation as a consequence of childhood trauma, has been highly linked to substance use with heavy consumption in adulthood (Dass-Breilsford & Myrick, 2010). * Longer term reactions include unpredictable emotions, sleep disturbances, separation anxiety, the development of new fears, anger irritability, and even physical symptoms like headaches to nausea (American Psychological Association, 2008). * Since children are still developing, childhood trauma can have long-lasting effects on a child's physical, mental and emotional well-being which carries onto adulthood. Moreover, common consequences of childhood trauma includes co-occuring psychiatric problems and substance abuse (Dye, 2018). == What constitutes drug use? == * Drugs have been been used medically and recreationally throughout history with early civilisations using them for religious rituals. * [[Substance abuse|Drug misuse]] is defined as the recreational use of alcohol, illicit drugs and pain medications which can lead to emotional, physical and social harm (Ghuran & Nolan, 2000). * Repeated drug use often leads to substance use disorder (SUD) which commonly constitutes addiction and the inability to discontinue drug use. * According to the 5^th edition of the Diagnostic Manual of Mental Disorders (DSM-5) substance induced disorders occur when the substance use leads to intoxication, addiction, withdrawal and induced psychological disorders such as psychosis and and depressive disorders (American Psychiatric Association, 2013). === Alcohol === * The World Health Organisation (WHO) has identified [https://www.who.int/health-topics/alcohol#tab=tab_1 alcohol] as a psychoactive type of drug which is highly addictive and the cause of around 3 million deaths per year (World Health Organization, 2022). * Repeated alcohol use can result in alcohol use disorder which can impact an individual's psychological, physical and social well-being === Pain medication === * Pain medication such as opioids are crucial in the medical world and have a purpose of delivering an analgesic effect for those individuals experiencing agonising pain. Acute pain patients benefit from these drugs immensely. * The use of pain medication is common among those who suffer from chronic pain conditions and is commonly not addictive or harmful when used in moderation. Nonetheless, the addictive properties in opioids paired with repeated use can quickly lead to drug addiction (Schnoll & Weaver, 2003) === Illicit drugs === * What makes a drug illicit? An illicit drug is one which has not been medically approved and is prohibited and illegal to be consumed, possess and sold. Illicit drugs are illegal due to the risk of [[addiction]] and the psychological and physiological risks attached to them. The international illegality of these drugs extends from plant-based drugs (e.g. cannabis, cocaine heroin) to pharmaceutical drugs (e.g. benzodiazepines) and synthetic drugs (e.g. MDMA, amphetamines) (Degenhardt & Hall, 2012). * The use of illicit drugs is commonly looked down upon and seen as the self-endangerment of an individual's well-being and sanity. So why do individuals partake in illicit drug use? {{Robelbox|theme=7|title=Quiz Time!|iconwidth=48px|icon=Nuvola_apps_korganizer.svg}}<div style="{{Robelbox/pad}}"> <quiz display=simple> {What makes a drug illicit?} - When it has been medically approved for consumption + When it has not been medically approved and is prohibited and illegal - When it is a plant-based drug </quiz> </div> {{Robelbox-close}} ==What are the theoretical underpinnings of trauma induced drug use?== * Using drugs is a dangerous behaviour that is commonly performed recreationally with large negative consequences. Although drug use is often initiated by peer pressure within social situations, psychological trauma can be a precursor for drug use throughout the lifespan. Trauma-exposed individuals are likely engaging in drug use as a maladaptive coping strategy to experience an emotional relief which may be compounding distress (Sheerin et al., 2016). * This part of the chapter will discuss the theoretical concepts surrounding the motivation behind trauma induced drug use. === Protection Motivation theory === * Protection motivation theory proposed by Rogers (1997) considers how individuals cope in distressing situations in order to protect oneself from perceived threat. This theory operates on three aspects: *# The magnitude of the threat within a specific event *# the probability that this event will re-occur *# The efficacy of a protective response === Extrinsic Motivation === * Extrinsic motivation describes a situation whereby, an individual follows the pursuit of an instrumental goal. Operant condtioning falls under extrinsic motivation since we see motivation of certain behaviours occur due to rewards and punishment. One theoretical underpinning that may explain why individuals who has experienced childhood trauma reach out to drugs can be explained by negative reinforcement. * When considering the negative reinforcement model and its influence in drug use, we can suggest that childhood trauma and the subsequent emotional damage, can motivate drug use. This can be considered whereby trauma may place an individual in an uncomfortable and distressing emotional state which can be relieved through an immediate short-term reward illicit by the consumption of drugs (May et al., 2020) == How does psychological trauma motivate drug use? == * It comes as no surprise that individuals turn to drug misuse to self-medicate against the unbearable pain and distress caused by unresolved and unprocessed traumatic experiences (Marcenko et al., 2000). The sad reality is that a lot of children who experience trauma in the early years are unaware of the extent to which this event may have impacted them later in life. A common coping mechanism of childhood trauma is repressing the event especially in younger children who do not understand the concept of right and wrong yet. * What trauma types are most relevant to drug use? Is there a specific type of event that is more likely to lead to drug use later in life? What does it mean to self-medicate? === Childhood trauma types most relevant to drug use === * It comes as no surprise that adverse childhood experiences play a role in maladaptive coping mechanisms. Nonetheless, it is important to address the types of trauma that affect this behaviour in order to successfully treat it. * A study conducted by Dube et al. (2003) demonstrated that ''childhood neglect'' was a predictor for illicit drug use. How does this occur? * Household dysfunction consisting of domestic violence, violence towards parent, divorce, mentally family member etc. presents another predictor for potential drug use. *Another type of childhood trauma that heavily influences drug use is childhood sexual abuse with the most common mean age at 11 - 13 years of age. Childhood sexual abuse is more commonly related to later substance use in comparison to an adulthood sexual abuse life event (Liebschutz, 2002). * === Self-medication following childhood trauma === * Early childhood sexual trauma has been theorised to result in drug use due to the desire to numb the painful affect caused by the trauma (Marcenko et al., 2000) . * Moreover, the psychological impact that childhood trauma has on a developing child plays a large role in how the child learns to adapt and cope. For example, a child with severe attachment issues due to a physically abusive parents, may turn to drugs to counteract the insecure relationships they experience throughout adulthood - avoidance of loneliness. == What are the strategies for treating trauma induced drug use? == * From a physiological perspective, the neurobiological pathways that are impacted by trauma (causing PTSD) and substance use have some similarities whereby, certain drugs have a depressing or arousal effect causing hyper-vigilance. * When considering treatment strategies for childhood trauma induced drug use, it is important to consider that both potential disorders need to be addressed simultaneously. The childhood trauma may have developed into PTSD and the symptoms may have induced a dependence on drugs causing substance use disorder (SUD). * Types of treatment for treating trauma induced drug use may include cognitive behavioural therapy (CBT), eye-movement desensitisation reprocessing (EMDR), medication and behavioural counselling (Note: I may turn these into sub-headings but unsure at this point). ===Case studies=== Case studies describe real-world examples of concepts in action. Case studies can be real or fictional. A case could be used multiple times during a chapter to illustrate different theories or stages. It is often helpful to present case studies using [[#Feature boxes|feature boxes]]. ===Boxes=== Boxes can be used to highlight content, but don't overuse them. There are many different ways of creating boxes (e.g., see [[Help:Pretty boxes|Pretty boxes]]). Possible uses include: * Focus questions * Case studies or examples * Quiz questions * Take-home messages {{RoundBoxTop|theme=3}} ;Feature box example * Shaded background * Coloured border {{RoundBoxBottom}} ===Figures=== [[File:Monkey-typing.jpg|right|205px|thumb|''Figure 1''. Example image with descriptive caption.]] Use figures to illustrate concepts, add interest, and provide examples. Figures can be used to show photographs, drawings, diagrams, graphs, etcetera. Figures can be embedded throughout the chapter, starting with the Overview section. Figures should be captioned (using a number and a description) in order to explain their relevance to the text. Possible images can be found at [[commons:|Wikimedia Commons]]. Images can also be uploaded if they are licensed for re-use or if you created the image. Each figure should be referred to at least once in the main text (e.g., see Figure 1). ===Links=== Where key words are first used, make them into [[Help:Links|interwiki links]] such as Wikipedia links to articles about famous people (e.g., [[w:Sigmund Freud|Sigmund Freud]] and key concepts (e.g., [[w:Dreams|dreams]]) and links to book chapters about related topics (e.g., would you like to learn about how to overcome [[Motivation and emotion/Book/2020/Writer's block|writer's block]]?). ===Tables=== Tables can be an effective way to organise and summarise information. Tables should be captioned (using APA style) to explain their relevance to the text. Plus each table should be referred to at least once in the main text (e.g., see Table 1 and Table 2). Here are some [[Motivation and emotion/Wikiversity/Tables|example 3 x 3 tables]] which could be adapted. ===Quizzes=== Quizzes are a direct way to engage readers. But don't make quizzes too hard or long. It is better to have one or two review questions per major section than a long quiz at the end. Try to quiz conceptual understanding, rather than trivia. Here are some simple quiz questions which could be adapted. Choose the correct answers and click "Submit": <quiz display=simple> {Quizzes are an interactive learning feature: |type="()"} + True - False {Long quizzes are a good idea: |type="()"} - True + False </quiz> To learn about different types of quiz questions, see [[Help:Quiz|Quiz]]. ==Conclusion== The Conclusion is arguably the most important section. It should be possible for someone to read the [[#Overview|Overview]] and the Conclusion and still get a good idea of the topic. {{tip|Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? }} ==See also== Provide up to half-a-dozen [[Help:Contents/Links#Interwiki_links|internal (wiki) links]] to relevant Wikiversity pages (esp. related [[Motivation and emotion/Book|motivation and emotion book chapters]]) and [[w:|Wikipedia articles]]. For example: * [[Motivation and emotion/Book/2018/Childhood trauma and emotion|childhood trauma and emotion]] (Book chapter, 2018) * [[wikipedia:Protection_motivation_theory|Protection motivation theory]] (Wikipedia) * [[wikipedia:Recreational_drug_use|Recreational drug use]] (Wikipedia) * [[Motivation and emotion/Book/2021/Safety as a psychological need|Safety as a psychological need]] (Book chapter, 2018) {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== List the cited references in [[w:APA style|APA style]] (7th ed.) or [[w:Wikipedia:Citing sources|wiki style]]. APA style example: {{Hanging indent|1= Blair, R. J. R. (2004). The roles of orbital frontal cortex in the modulation of antisocial behavior. ''Brain and Cognition'', ''55''(1), 198–208. https://doi.org/10.1016/S0278-2626(03)00276-8 Buckholtz, J. W., & Meyer-Lindenberg, A. (2008). MAOA and the neurogenetic architecture of human aggression. ''Trends in Neurosciences'', ''31''(3), 120–129. https://doi.org/10.1016/j.tins.2007.12.006 Eckardt, M., File, S., Gessa, G., Grant, K., Guerri, C., Hoffman, P., & Tabakoff, B. (1998). Effects of moderate alcohol consumption on the central nervous system. ''Alcoholism, Clinical and Experimental Research'', ''22''(5), 998–1040. https://doi.org/10.1111/j.1530-0277.1998.tb03695.x }} {{tip|Suggestions for this section: * Important aspects for APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except first letter and proper names, ending in a full-stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full-stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't actually read or consulted }} ==External links== Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * [https://students.unimelb.edu.au/academic-skills/explore-our-resources/essay-writing/six-top-tips-for-writing-a-great-essay Six top tips for writing a great essay] (University of Melbourne) * [http://www.skillsyouneed.com/write/structure.html The importance of structure] (skillsyouneed.com) {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] [[Category:Motivation and emotion/Book/Children]] [[Category:Motivation and emotion/Book/Trauma]] pfwthmtbvvugf5ar0x7mctkbpzrlew8 2419140 2419138 2022-08-26T00:31:01Z U3210431 2947391 /* References */ wikitext text/x-wiki {{title|Childhood trauma and subsequent drug use:<br>How does childhood trauma influence drug use?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== [[File:Toxicoman - Substance abuse.jpg|thumb|384x384px|''Figure 1.'' Drug use can heavily impact an individuals physical and mental health ]] The use of drugs has jumped from the romanticisation of the “love drug” known by the name of methylenedioxymetamfetamine (MDMA) and hallucinogenic drugs in the 1980s, to the rumination of them and their lethal and detrimental nature across time. When it comes to [[Drug misuse|drug]] consumption, we see those individuals who search for a deeper meaning, those who try to find an escape and those who conform to [[social norms]]. Yet, humans are aware of the detrimental consequences of drug consumption. From a young age we are taught about drugs and their lethal consequences. Why do individuals partake in drug consumption when they are aware of what might happen? Imagine an individual who has consistently used drugs for years, developed an addiction and is therefore unemployed. This behaviour has caused family members and friends to detach themselves, leaving this individual lonely. Family members constantly asking why they have done this to themselves and the blame being pointed at the individual for ruining their life. Although it is not out of the picture, we tend to believe that people are responsible for their actions and therefore blame them for using drugs. Why do we tend to believe this? Is it truly the individuals fault or can drug use be influenced by previous traumatic experiences? This chapter focuses on how childhood trauma can influence subsequent drug use. {{RoundBoxTop|theme=3}} '''Focus questions:''' * What is childhood trauma? * What are theoretical underpinnings of childhood trauma induced drug use? * How does childhood trauma influence drug use? * What are the strategies for treating trauma-induced drug use? {{RoundBoxBottom}} {{tip| Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Provide an example or case study. * Conclude with Focus questions to guide the chapter. }} ==What is childhood trauma== [[File:Crying child with blonde hair.jpg|thumb|342x342px|''Figure 2.'' Childhood trauma negatively impacts a child's emotional well-being]]The [https://www.apa.org/pi/families/resources/update.pdf American Psychological Association] (APA) defines a traumatic life event as:<blockquote>"One that threatens, injury, death, or the physical integrity of self or others and also causes horror, terror, or helplessness at the time it occurs. Traumatic events include sexual abuse, physical abuse, domestic violence, community and school violence, medical trauma, motor vehicle accidents, acts of terrorism, war experiences, natural and human-made disasters, suicides, and other traumatic losses (American Psychological Association, 2008)." </blockquote> * When these events are experienced in a developing child, this constitutes as childhood trauma. * Due to children's vulnerability and lack of understanding, depending on their age, trauma can be especially harmful and result in many consequences throughout adolescence and adulthood. === Types of childhood trauma === Childhood trauma refers to negative events that threaten or cause harm to a child's emotional and/or physical wellbeing. Childhood trauma is most commonly the result of a child perceiving themselves to be in a life-threatening situation. Terr (1991) introduced two types of childhood trauma: * '''Type I''' - results from a single event such as an accident, witnessing a crime or rape. ** Individuals affected by Type I trauma especially if the incident occurred after the age of 3, are thought to remember the incident and experience perceptual symptoms such as visual hallucinations as a consequence of the trauma. * '''Type II -''' results from repeated exposure of extreme traumatising events such as re-occurring abuse ** Individuals affected by Type II trauma, are proposed to repress the event using denial and dissociation methods to avoid the trauma exposure. === Consequences of childhood trauma === * Emerging literature puts a strong focus on the effects of childhood trauma on brain development. Adverse events experienced in childhood, exposes children to become insecurely attached and develop poor self-regulation skills (Ford, 2009). Emotional dysregulation as a consequence of childhood trauma, has been highly linked to substance use with heavy consumption in adulthood (Dass-Breilsford & Myrick, 2010). * Longer term reactions include unpredictable emotions, sleep disturbances, separation anxiety, the development of new fears, anger irritability, and even physical symptoms like headaches to nausea (American Psychological Association, 2008). * Since children are still developing, childhood trauma can have long-lasting effects on a child's physical, mental and emotional well-being which carries onto adulthood. Moreover, common consequences of childhood trauma includes co-occuring psychiatric problems and substance abuse (Dye, 2018). == What constitutes drug use? == * Drugs have been been used medically and recreationally throughout history with early civilisations using them for religious rituals. * [[Substance abuse|Drug misuse]] is defined as the recreational use of alcohol, illicit drugs and pain medications which can lead to emotional, physical and social harm (Ghuran & Nolan, 2000). * Repeated drug use often leads to substance use disorder (SUD) which commonly constitutes addiction and the inability to discontinue drug use. * According to the 5^th edition of the Diagnostic Manual of Mental Disorders (DSM-5) substance induced disorders occur when the substance use leads to intoxication, addiction, withdrawal and induced psychological disorders such as psychosis and and depressive disorders (American Psychiatric Association, 2013). === Alcohol === * The World Health Organisation (WHO) has identified [https://www.who.int/health-topics/alcohol#tab=tab_1 alcohol] as a psychoactive type of drug which is highly addictive and the cause of around 3 million deaths per year (World Health Organization, 2022). * Repeated alcohol use can result in alcohol use disorder which can impact an individual's psychological, physical and social well-being === Pain medication === * Pain medication such as opioids are crucial in the medical world and have a purpose of delivering an analgesic effect for those individuals experiencing agonising pain. Acute pain patients benefit from these drugs immensely. * The use of pain medication is common among those who suffer from chronic pain conditions and is commonly not addictive or harmful when used in moderation. Nonetheless, the addictive properties in opioids paired with repeated use can quickly lead to drug addiction (Schnoll & Weaver, 2003) === Illicit drugs === * What makes a drug illicit? An illicit drug is one which has not been medically approved and is prohibited and illegal to be consumed, possess and sold. Illicit drugs are illegal due to the risk of [[addiction]] and the psychological and physiological risks attached to them. The international illegality of these drugs extends from plant-based drugs (e.g. cannabis, cocaine heroin) to pharmaceutical drugs (e.g. benzodiazepines) and synthetic drugs (e.g. MDMA, amphetamines) (Degenhardt & Hall, 2012). * The use of illicit drugs is commonly looked down upon and seen as the self-endangerment of an individual's well-being and sanity. So why do individuals partake in illicit drug use? {{Robelbox|theme=7|title=Quiz Time!|iconwidth=48px|icon=Nuvola_apps_korganizer.svg}}<div style="{{Robelbox/pad}}"> <quiz display=simple> {What makes a drug illicit?} - When it has been medically approved for consumption + When it has not been medically approved and is prohibited and illegal - When it is a plant-based drug </quiz> </div> {{Robelbox-close}} ==What are the theoretical underpinnings of trauma induced drug use?== * Using drugs is a dangerous behaviour that is commonly performed recreationally with large negative consequences. Although drug use is often initiated by peer pressure within social situations, psychological trauma can be a precursor for drug use throughout the lifespan. Trauma-exposed individuals are likely engaging in drug use as a maladaptive coping strategy to experience an emotional relief which may be compounding distress (Sheerin et al., 2016). * This part of the chapter will discuss the theoretical concepts surrounding the motivation behind trauma induced drug use. === Protection Motivation theory === * Protection motivation theory proposed by Rogers (1997) considers how individuals cope in distressing situations in order to protect oneself from perceived threat. This theory operates on three aspects: *# The magnitude of the threat within a specific event *# the probability that this event will re-occur *# The efficacy of a protective response === Extrinsic Motivation === * Extrinsic motivation describes a situation whereby, an individual follows the pursuit of an instrumental goal. Operant condtioning falls under extrinsic motivation since we see motivation of certain behaviours occur due to rewards and punishment. One theoretical underpinning that may explain why individuals who has experienced childhood trauma reach out to drugs can be explained by negative reinforcement. * When considering the negative reinforcement model and its influence in drug use, we can suggest that childhood trauma and the subsequent emotional damage, can motivate drug use. This can be considered whereby trauma may place an individual in an uncomfortable and distressing emotional state which can be relieved through an immediate short-term reward illicit by the consumption of drugs (May et al., 2020) == How does psychological trauma motivate drug use? == * It comes as no surprise that individuals turn to drug misuse to self-medicate against the unbearable pain and distress caused by unresolved and unprocessed traumatic experiences (Marcenko et al., 2000). The sad reality is that a lot of children who experience trauma in the early years are unaware of the extent to which this event may have impacted them later in life. A common coping mechanism of childhood trauma is repressing the event especially in younger children who do not understand the concept of right and wrong yet. * What trauma types are most relevant to drug use? Is there a specific type of event that is more likely to lead to drug use later in life? What does it mean to self-medicate? === Childhood trauma types most relevant to drug use === * It comes as no surprise that adverse childhood experiences play a role in maladaptive coping mechanisms. Nonetheless, it is important to address the types of trauma that affect this behaviour in order to successfully treat it. * A study conducted by Dube et al. (2003) demonstrated that ''childhood neglect'' was a predictor for illicit drug use. How does this occur? * Household dysfunction consisting of domestic violence, violence towards parent, divorce, mentally family member etc. presents another predictor for potential drug use. *Another type of childhood trauma that heavily influences drug use is childhood sexual abuse with the most common mean age at 11 - 13 years of age. Childhood sexual abuse is more commonly related to later substance use in comparison to an adulthood sexual abuse life event (Liebschutz, 2002). * === Self-medication following childhood trauma === * Early childhood sexual trauma has been theorised to result in drug use due to the desire to numb the painful affect caused by the trauma (Marcenko et al., 2000) . * Moreover, the psychological impact that childhood trauma has on a developing child plays a large role in how the child learns to adapt and cope. For example, a child with severe attachment issues due to a physically abusive parents, may turn to drugs to counteract the insecure relationships they experience throughout adulthood - avoidance of loneliness. == What are the strategies for treating trauma induced drug use? == * From a physiological perspective, the neurobiological pathways that are impacted by trauma (causing PTSD) and substance use have some similarities whereby, certain drugs have a depressing or arousal effect causing hyper-vigilance. * When considering treatment strategies for childhood trauma induced drug use, it is important to consider that both potential disorders need to be addressed simultaneously. The childhood trauma may have developed into PTSD and the symptoms may have induced a dependence on drugs causing substance use disorder (SUD). * Types of treatment for treating trauma induced drug use may include cognitive behavioural therapy (CBT), eye-movement desensitisation reprocessing (EMDR), medication and behavioural counselling (Note: I may turn these into sub-headings but unsure at this point). ===Case studies=== Case studies describe real-world examples of concepts in action. Case studies can be real or fictional. A case could be used multiple times during a chapter to illustrate different theories or stages. It is often helpful to present case studies using [[#Feature boxes|feature boxes]]. ===Boxes=== Boxes can be used to highlight content, but don't overuse them. There are many different ways of creating boxes (e.g., see [[Help:Pretty boxes|Pretty boxes]]). Possible uses include: * Focus questions * Case studies or examples * Quiz questions * Take-home messages {{RoundBoxTop|theme=3}} ;Feature box example * Shaded background * Coloured border {{RoundBoxBottom}} ===Figures=== [[File:Monkey-typing.jpg|right|205px|thumb|''Figure 1''. Example image with descriptive caption.]] Use figures to illustrate concepts, add interest, and provide examples. Figures can be used to show photographs, drawings, diagrams, graphs, etcetera. Figures can be embedded throughout the chapter, starting with the Overview section. Figures should be captioned (using a number and a description) in order to explain their relevance to the text. Possible images can be found at [[commons:|Wikimedia Commons]]. Images can also be uploaded if they are licensed for re-use or if you created the image. Each figure should be referred to at least once in the main text (e.g., see Figure 1). ===Links=== Where key words are first used, make them into [[Help:Links|interwiki links]] such as Wikipedia links to articles about famous people (e.g., [[w:Sigmund Freud|Sigmund Freud]] and key concepts (e.g., [[w:Dreams|dreams]]) and links to book chapters about related topics (e.g., would you like to learn about how to overcome [[Motivation and emotion/Book/2020/Writer's block|writer's block]]?). ===Tables=== Tables can be an effective way to organise and summarise information. Tables should be captioned (using APA style) to explain their relevance to the text. Plus each table should be referred to at least once in the main text (e.g., see Table 1 and Table 2). Here are some [[Motivation and emotion/Wikiversity/Tables|example 3 x 3 tables]] which could be adapted. ===Quizzes=== Quizzes are a direct way to engage readers. But don't make quizzes too hard or long. It is better to have one or two review questions per major section than a long quiz at the end. Try to quiz conceptual understanding, rather than trivia. Here are some simple quiz questions which could be adapted. Choose the correct answers and click "Submit": <quiz display=simple> {Quizzes are an interactive learning feature: |type="()"} + True - False {Long quizzes are a good idea: |type="()"} - True + False </quiz> To learn about different types of quiz questions, see [[Help:Quiz|Quiz]]. ==Conclusion== The Conclusion is arguably the most important section. It should be possible for someone to read the [[#Overview|Overview]] and the Conclusion and still get a good idea of the topic. {{tip|Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? }} ==See also== Provide up to half-a-dozen [[Help:Contents/Links#Interwiki_links|internal (wiki) links]] to relevant Wikiversity pages (esp. related [[Motivation and emotion/Book|motivation and emotion book chapters]]) and [[w:|Wikipedia articles]]. For example: * [[Motivation and emotion/Book/2018/Childhood trauma and emotion|childhood trauma and emotion]] (Book chapter, 2018) * [[wikipedia:Protection_motivation_theory|Protection motivation theory]] (Wikipedia) * [[wikipedia:Recreational_drug_use|Recreational drug use]] (Wikipedia) * [[Motivation and emotion/Book/2021/Safety as a psychological need|Safety as a psychological need]] (Book chapter, 2018) {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== {{Hanging indent|1= American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing. American Psychological Association. (2008). Children and trauma: Update for mental health professionals. https://www.apa.org/pi/families/resources/update.pdf Dass-Brailsford, P., & Myrick, A. C. (2010). Psychological trauma and substance abuse: The need for an integrated approach. Trauma, Violence, & Abuse, 11(4), 202-213. https://doi.org/10.1177/1524838010381252 Degenhardt, L., & Hall, W. (2012). Extent of illicit drug use and dependence, and their contribution to the global burden of disease. The Lancet, 379(9810), 55-70. https://doi.org/10.1016/S0140-6736(11)61138-0 Dube, S. R., Felitti, V. J., Dong, M., Chapman, D. P., Giles, W. H., & Anda, R. F. (2003). Childhood abuse, neglect, and household dysfunction and the risk of illicit drug use: the adverse childhood experiences study. Pediatrics, 111(3), 564-572. https://doi.org/10.1542/peds.111.3.564 Dye, H. (2018). The impact and long-term effects of childhood trauma. Journal of Human Behavior in the Social Environment, 28(3), 381-392. https://doi.org/10.1080/10911359.2018.1435328 Ford, J. D. (2009). Neurobiological and developmental research. Treating complex traumatic stress disorders: An evidence-based guide, 31-58. (Guilford Press) Ghuran, A., & Nolan, J. (2000). Recreational drug misuse: issues for the cardiologist. Heart, 83(6), 627-633. https://doi.org/10.1136/heart.83.6.627 Liebschutz, J., Savetsky, J. B., Saitz, R., Horton, N. J., Lloyd-Travaglini, C., & Samet, J. H. (2002). The relationship between sexual and physical abuse and substance abuse consequences. Journal of substance abuse treatment, 22(3), 121-128. https://doi.org/10.1016/S0740-5472(02)00220-9 Marcenko, M. O., Kemp, S. P., & Larson, N. C. (2000). Childhood experiences of abuse, later substance use, and parenting outcomes among low‐income mothers. American Journal of Orthopsychiatry, 70(3), 316-326. https://doi.org/10.1037/h0087853 Rogers, R. W., & Prentice-Dunn, S. (1997). Protection motivation theory. https://doi.org/10.1080/00223980.1975.9915803 Schnoll, S. H., & Weaver, M. F. (2003). Addiction and pain. The American journal on addictions, 12, S27-S35. https://doi.org/10.1111/j.1521-0391.2003.tb00554.x Sheerin, C., Berenz, E. C., Knudsen, G. P., Reichborn-Kjennerud, T., Kendler, K. S., Aggen, S. H., & Amstadter, A. B. (2016). A population-based study of help seeking and self-medication among trauma-exposed individuals. Psychology of Addictive Behaviors, 30(7), 771. https://doi.org/10.1037/adb0000185 Terr, L. C. (1991). Acute responses to external events and posttraumatic stress disorders. pp.755-763. Williams & Wilkins Co. World Health Organization. (2022). Alcohol. https://www.who.int/health-topics/alcohol#tab=tab_1 }} {{tip|Suggestions for this section: * Important aspects for APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except first letter and proper names, ending in a full-stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full-stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't actually read or consulted }} ==External links== Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * [https://students.unimelb.edu.au/academic-skills/explore-our-resources/essay-writing/six-top-tips-for-writing-a-great-essay Six top tips for writing a great essay] (University of Melbourne) * [http://www.skillsyouneed.com/write/structure.html The importance of structure] (skillsyouneed.com) {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] [[Category:Motivation and emotion/Book/Children]] [[Category:Motivation and emotion/Book/Trauma]] k5c50rso1np5wveg9rhj7rbvw2d0kvo 2419142 2419140 2022-08-26T00:34:37Z U3210431 2947391 /* References */ wikitext text/x-wiki {{title|Childhood trauma and subsequent drug use:<br>How does childhood trauma influence drug use?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== [[File:Toxicoman - Substance abuse.jpg|thumb|384x384px|''Figure 1.'' Drug use can heavily impact an individuals physical and mental health ]] The use of drugs has jumped from the romanticisation of the “love drug” known by the name of methylenedioxymetamfetamine (MDMA) and hallucinogenic drugs in the 1980s, to the rumination of them and their lethal and detrimental nature across time. When it comes to [[Drug misuse|drug]] consumption, we see those individuals who search for a deeper meaning, those who try to find an escape and those who conform to [[social norms]]. Yet, humans are aware of the detrimental consequences of drug consumption. From a young age we are taught about drugs and their lethal consequences. Why do individuals partake in drug consumption when they are aware of what might happen? Imagine an individual who has consistently used drugs for years, developed an addiction and is therefore unemployed. This behaviour has caused family members and friends to detach themselves, leaving this individual lonely. Family members constantly asking why they have done this to themselves and the blame being pointed at the individual for ruining their life. Although it is not out of the picture, we tend to believe that people are responsible for their actions and therefore blame them for using drugs. Why do we tend to believe this? Is it truly the individuals fault or can drug use be influenced by previous traumatic experiences? This chapter focuses on how childhood trauma can influence subsequent drug use. {{RoundBoxTop|theme=3}} '''Focus questions:''' * What is childhood trauma? * What are theoretical underpinnings of childhood trauma induced drug use? * How does childhood trauma influence drug use? * What are the strategies for treating trauma-induced drug use? {{RoundBoxBottom}} {{tip| Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Provide an example or case study. * Conclude with Focus questions to guide the chapter. }} ==What is childhood trauma== [[File:Crying child with blonde hair.jpg|thumb|342x342px|''Figure 2.'' Childhood trauma negatively impacts a child's emotional well-being]]The [https://www.apa.org/pi/families/resources/update.pdf American Psychological Association] (APA) defines a traumatic life event as:<blockquote>"One that threatens, injury, death, or the physical integrity of self or others and also causes horror, terror, or helplessness at the time it occurs. Traumatic events include sexual abuse, physical abuse, domestic violence, community and school violence, medical trauma, motor vehicle accidents, acts of terrorism, war experiences, natural and human-made disasters, suicides, and other traumatic losses (American Psychological Association, 2008)." </blockquote> * When these events are experienced in a developing child, this constitutes as childhood trauma. * Due to children's vulnerability and lack of understanding, depending on their age, trauma can be especially harmful and result in many consequences throughout adolescence and adulthood. === Types of childhood trauma === Childhood trauma refers to negative events that threaten or cause harm to a child's emotional and/or physical wellbeing. Childhood trauma is most commonly the result of a child perceiving themselves to be in a life-threatening situation. Terr (1991) introduced two types of childhood trauma: * '''Type I''' - results from a single event such as an accident, witnessing a crime or rape. ** Individuals affected by Type I trauma especially if the incident occurred after the age of 3, are thought to remember the incident and experience perceptual symptoms such as visual hallucinations as a consequence of the trauma. * '''Type II -''' results from repeated exposure of extreme traumatising events such as re-occurring abuse ** Individuals affected by Type II trauma, are proposed to repress the event using denial and dissociation methods to avoid the trauma exposure. === Consequences of childhood trauma === * Emerging literature puts a strong focus on the effects of childhood trauma on brain development. Adverse events experienced in childhood, exposes children to become insecurely attached and develop poor self-regulation skills (Ford, 2009). Emotional dysregulation as a consequence of childhood trauma, has been highly linked to substance use with heavy consumption in adulthood (Dass-Breilsford & Myrick, 2010). * Longer term reactions include unpredictable emotions, sleep disturbances, separation anxiety, the development of new fears, anger irritability, and even physical symptoms like headaches to nausea (American Psychological Association, 2008). * Since children are still developing, childhood trauma can have long-lasting effects on a child's physical, mental and emotional well-being which carries onto adulthood. Moreover, common consequences of childhood trauma includes co-occuring psychiatric problems and substance abuse (Dye, 2018). == What constitutes drug use? == * Drugs have been been used medically and recreationally throughout history with early civilisations using them for religious rituals. * [[Substance abuse|Drug misuse]] is defined as the recreational use of alcohol, illicit drugs and pain medications which can lead to emotional, physical and social harm (Ghuran & Nolan, 2000). * Repeated drug use often leads to substance use disorder (SUD) which commonly constitutes addiction and the inability to discontinue drug use. * According to the 5^th edition of the Diagnostic Manual of Mental Disorders (DSM-5) substance induced disorders occur when the substance use leads to intoxication, addiction, withdrawal and induced psychological disorders such as psychosis and and depressive disorders (American Psychiatric Association, 2013). === Alcohol === * The World Health Organisation (WHO) has identified [https://www.who.int/health-topics/alcohol#tab=tab_1 alcohol] as a psychoactive type of drug which is highly addictive and the cause of around 3 million deaths per year (World Health Organization, 2022). * Repeated alcohol use can result in alcohol use disorder which can impact an individual's psychological, physical and social well-being === Pain medication === * Pain medication such as opioids are crucial in the medical world and have a purpose of delivering an analgesic effect for those individuals experiencing agonising pain. Acute pain patients benefit from these drugs immensely. * The use of pain medication is common among those who suffer from chronic pain conditions and is commonly not addictive or harmful when used in moderation. Nonetheless, the addictive properties in opioids paired with repeated use can quickly lead to drug addiction (Schnoll & Weaver, 2003) === Illicit drugs === * What makes a drug illicit? An illicit drug is one which has not been medically approved and is prohibited and illegal to be consumed, possess and sold. Illicit drugs are illegal due to the risk of [[addiction]] and the psychological and physiological risks attached to them. The international illegality of these drugs extends from plant-based drugs (e.g. cannabis, cocaine heroin) to pharmaceutical drugs (e.g. benzodiazepines) and synthetic drugs (e.g. MDMA, amphetamines) (Degenhardt & Hall, 2012). * The use of illicit drugs is commonly looked down upon and seen as the self-endangerment of an individual's well-being and sanity. So why do individuals partake in illicit drug use? {{Robelbox|theme=7|title=Quiz Time!|iconwidth=48px|icon=Nuvola_apps_korganizer.svg}}<div style="{{Robelbox/pad}}"> <quiz display=simple> {What makes a drug illicit?} - When it has been medically approved for consumption + When it has not been medically approved and is prohibited and illegal - When it is a plant-based drug </quiz> </div> {{Robelbox-close}} ==What are the theoretical underpinnings of trauma induced drug use?== * Using drugs is a dangerous behaviour that is commonly performed recreationally with large negative consequences. Although drug use is often initiated by peer pressure within social situations, psychological trauma can be a precursor for drug use throughout the lifespan. Trauma-exposed individuals are likely engaging in drug use as a maladaptive coping strategy to experience an emotional relief which may be compounding distress (Sheerin et al., 2016). * This part of the chapter will discuss the theoretical concepts surrounding the motivation behind trauma induced drug use. === Protection Motivation theory === * Protection motivation theory proposed by Rogers (1997) considers how individuals cope in distressing situations in order to protect oneself from perceived threat. This theory operates on three aspects: *# The magnitude of the threat within a specific event *# the probability that this event will re-occur *# The efficacy of a protective response === Extrinsic Motivation === * Extrinsic motivation describes a situation whereby, an individual follows the pursuit of an instrumental goal. Operant condtioning falls under extrinsic motivation since we see motivation of certain behaviours occur due to rewards and punishment. One theoretical underpinning that may explain why individuals who has experienced childhood trauma reach out to drugs can be explained by negative reinforcement. * When considering the negative reinforcement model and its influence in drug use, we can suggest that childhood trauma and the subsequent emotional damage, can motivate drug use. This can be considered whereby trauma may place an individual in an uncomfortable and distressing emotional state which can be relieved through an immediate short-term reward illicit by the consumption of drugs (May et al., 2020) == How does psychological trauma motivate drug use? == * It comes as no surprise that individuals turn to drug misuse to self-medicate against the unbearable pain and distress caused by unresolved and unprocessed traumatic experiences (Marcenko et al., 2000). The sad reality is that a lot of children who experience trauma in the early years are unaware of the extent to which this event may have impacted them later in life. A common coping mechanism of childhood trauma is repressing the event especially in younger children who do not understand the concept of right and wrong yet. * What trauma types are most relevant to drug use? Is there a specific type of event that is more likely to lead to drug use later in life? What does it mean to self-medicate? === Childhood trauma types most relevant to drug use === * It comes as no surprise that adverse childhood experiences play a role in maladaptive coping mechanisms. Nonetheless, it is important to address the types of trauma that affect this behaviour in order to successfully treat it. * A study conducted by Dube et al. (2003) demonstrated that ''childhood neglect'' was a predictor for illicit drug use. How does this occur? * Household dysfunction consisting of domestic violence, violence towards parent, divorce, mentally family member etc. presents another predictor for potential drug use. *Another type of childhood trauma that heavily influences drug use is childhood sexual abuse with the most common mean age at 11 - 13 years of age. Childhood sexual abuse is more commonly related to later substance use in comparison to an adulthood sexual abuse life event (Liebschutz, 2002). * === Self-medication following childhood trauma === * Early childhood sexual trauma has been theorised to result in drug use due to the desire to numb the painful affect caused by the trauma (Marcenko et al., 2000) . * Moreover, the psychological impact that childhood trauma has on a developing child plays a large role in how the child learns to adapt and cope. For example, a child with severe attachment issues due to a physically abusive parents, may turn to drugs to counteract the insecure relationships they experience throughout adulthood - avoidance of loneliness. == What are the strategies for treating trauma induced drug use? == * From a physiological perspective, the neurobiological pathways that are impacted by trauma (causing PTSD) and substance use have some similarities whereby, certain drugs have a depressing or arousal effect causing hyper-vigilance. * When considering treatment strategies for childhood trauma induced drug use, it is important to consider that both potential disorders need to be addressed simultaneously. The childhood trauma may have developed into PTSD and the symptoms may have induced a dependence on drugs causing substance use disorder (SUD). * Types of treatment for treating trauma induced drug use may include cognitive behavioural therapy (CBT), eye-movement desensitisation reprocessing (EMDR), medication and behavioural counselling (Note: I may turn these into sub-headings but unsure at this point). ===Case studies=== Case studies describe real-world examples of concepts in action. Case studies can be real or fictional. A case could be used multiple times during a chapter to illustrate different theories or stages. It is often helpful to present case studies using [[#Feature boxes|feature boxes]]. ===Boxes=== Boxes can be used to highlight content, but don't overuse them. There are many different ways of creating boxes (e.g., see [[Help:Pretty boxes|Pretty boxes]]). Possible uses include: * Focus questions * Case studies or examples * Quiz questions * Take-home messages {{RoundBoxTop|theme=3}} ;Feature box example * Shaded background * Coloured border {{RoundBoxBottom}} ===Figures=== [[File:Monkey-typing.jpg|right|205px|thumb|''Figure 1''. Example image with descriptive caption.]] Use figures to illustrate concepts, add interest, and provide examples. Figures can be used to show photographs, drawings, diagrams, graphs, etcetera. Figures can be embedded throughout the chapter, starting with the Overview section. Figures should be captioned (using a number and a description) in order to explain their relevance to the text. Possible images can be found at [[commons:|Wikimedia Commons]]. Images can also be uploaded if they are licensed for re-use or if you created the image. Each figure should be referred to at least once in the main text (e.g., see Figure 1). ===Links=== Where key words are first used, make them into [[Help:Links|interwiki links]] such as Wikipedia links to articles about famous people (e.g., [[w:Sigmund Freud|Sigmund Freud]] and key concepts (e.g., [[w:Dreams|dreams]]) and links to book chapters about related topics (e.g., would you like to learn about how to overcome [[Motivation and emotion/Book/2020/Writer's block|writer's block]]?). ===Tables=== Tables can be an effective way to organise and summarise information. Tables should be captioned (using APA style) to explain their relevance to the text. Plus each table should be referred to at least once in the main text (e.g., see Table 1 and Table 2). Here are some [[Motivation and emotion/Wikiversity/Tables|example 3 x 3 tables]] which could be adapted. ===Quizzes=== Quizzes are a direct way to engage readers. But don't make quizzes too hard or long. It is better to have one or two review questions per major section than a long quiz at the end. Try to quiz conceptual understanding, rather than trivia. Here are some simple quiz questions which could be adapted. Choose the correct answers and click "Submit": <quiz display=simple> {Quizzes are an interactive learning feature: |type="()"} + True - False {Long quizzes are a good idea: |type="()"} - True + False </quiz> To learn about different types of quiz questions, see [[Help:Quiz|Quiz]]. ==Conclusion== The Conclusion is arguably the most important section. It should be possible for someone to read the [[#Overview|Overview]] and the Conclusion and still get a good idea of the topic. {{tip|Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? }} ==See also== Provide up to half-a-dozen [[Help:Contents/Links#Interwiki_links|internal (wiki) links]] to relevant Wikiversity pages (esp. related [[Motivation and emotion/Book|motivation and emotion book chapters]]) and [[w:|Wikipedia articles]]. For example: * [[Motivation and emotion/Book/2018/Childhood trauma and emotion|childhood trauma and emotion]] (Book chapter, 2018) * [[wikipedia:Protection_motivation_theory|Protection motivation theory]] (Wikipedia) * [[wikipedia:Recreational_drug_use|Recreational drug use]] (Wikipedia) * [[Motivation and emotion/Book/2021/Safety as a psychological need|Safety as a psychological need]] (Book chapter, 2018) {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== {{Hanging indent|1= American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing. American Psychological Association. (2008). Children and trauma: Update for mental health professionals. https://www.apa.org/pi/families/resources/update.pdf Dass-Brailsford, P., & Myrick, A. C. (2010). Psychological trauma and substance abuse: The need for an integrated approach. Trauma, Violence, & Abuse, 11(4), 202-213. https://doi.org/10.1177/1524838010381252 Degenhardt, L., & Hall, W. (2012). Extent of illicit drug use and dependence, and their contribution to the global burden of disease. The Lancet, 379(9810), 55-70. https://doi.org/10.1016/S0140-6736(11)61138-0 Dube, S. R., Felitti, V. J., Dong, M., Chapman, D. P., Giles, W. H., & Anda, R. F. (2003). Childhood abuse, neglect, and household dysfunction and the risk of illicit drug use: the adverse childhood experiences study. Pediatrics, 111(3), 564-572. https://doi.org/10.1542/peds.111.3.564 Dye, H. (2018). The impact and long-term effects of childhood trauma. Journal of Human Behavior in the Social Environment, 28(3), 381-392. https://doi.org/10.1080/10911359.2018.1435328 Ford, J. D. (2009). Neurobiological and developmental research. Treating complex traumatic stress disorders: An evidence-based guide, 31-58. (Guilford Press) Ghuran, A., & Nolan, J. (2000). Recreational drug misuse: issues for the cardiologist. Heart, 83(6), 627-633. https://doi.org/10.1136/heart.83.6.627 Ghuran, A., & Nolan, J. (2000). Recreational drug misuse: issues for the cardiologist. Heart, 83(6), 627-633. https://doi.org/10.1136/heart.83.6.627 Liebschutz, J., Savetsky, J. B., Saitz, R., Horton, N. J., Lloyd-Travaglini, C., & Samet, J. H. (2002). The relationship between sexual and physical abuse and substance abuse consequences. Journal of substance abuse treatment, 22(3), 121-128. https://doi.org/10.1016/S0740-5472(02)00220-9 Marcenko, M. O., Kemp, S. P., & Larson, N. C. (2000). Childhood experiences of abuse, later substance use, and parenting outcomes among low‐income mothers. American Journal of Orthopsychiatry, 70(3), 316-326. https://doi.org/10.1037/h0087853 Rogers, R. W., & Prentice-Dunn, S. (1997). Protection motivation theory. https://doi.org/10.1080/00223980.1975.9915803 Schnoll, S. H., & Weaver, M. F. (2003). Addiction and pain. The American journal on addictions, 12, S27-S35. https://doi.org/10.1111/j.1521-0391.2003.tb00554.x Schnoll, S. H., & Weaver, M. F. (2003). Addiction and pain. The American journal on addictions, 12, S27-S35. https://doi.org/10.1111/j.1521-0391.2003.tb00554.x Sheerin, C., Berenz, E. C., Knudsen, G. P., Reichborn-Kjennerud, T., Kendler, K. S., Aggen, S. H., & Amstadter, A. B. (2016). A population-based study of help seeking and self-medication among trauma-exposed individuals. Psychology of Addictive Behaviors, 30(7), 771. https://doi.org/10.1037/adb0000185 Terr, L. C. (1991). Acute responses to external events and posttraumatic stress disorders. pp.755-763. Williams & Wilkins Co. World Health Organization. (2022). Alcohol. https://www.who.int/health-topics/alcohol#tab=tab_1 }} {{tip|Suggestions for this section: * Important aspects for APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except first letter and proper names, ending in a full-stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full-stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't actually read or consulted }} ==External links== Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * [https://students.unimelb.edu.au/academic-skills/explore-our-resources/essay-writing/six-top-tips-for-writing-a-great-essay Six top tips for writing a great essay] (University of Melbourne) * [http://www.skillsyouneed.com/write/structure.html The importance of structure] (skillsyouneed.com) {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] [[Category:Motivation and emotion/Book/Children]] [[Category:Motivation and emotion/Book/Trauma]] 0jtt9d7qsd0lekz5vkwdudigmp0ek3j 2419150 2419142 2022-08-26T00:54:58Z U3210431 2947391 /* See also */ wikitext text/x-wiki {{title|Childhood trauma and subsequent drug use:<br>How does childhood trauma influence drug use?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== [[File:Toxicoman - Substance abuse.jpg|thumb|384x384px|''Figure 1.'' Drug use can heavily impact an individuals physical and mental health ]] The use of drugs has jumped from the romanticisation of the “love drug” known by the name of methylenedioxymetamfetamine (MDMA) and hallucinogenic drugs in the 1980s, to the rumination of them and their lethal and detrimental nature across time. When it comes to [[Drug misuse|drug]] consumption, we see those individuals who search for a deeper meaning, those who try to find an escape and those who conform to [[social norms]]. Yet, humans are aware of the detrimental consequences of drug consumption. From a young age we are taught about drugs and their lethal consequences. Why do individuals partake in drug consumption when they are aware of what might happen? Imagine an individual who has consistently used drugs for years, developed an addiction and is therefore unemployed. This behaviour has caused family members and friends to detach themselves, leaving this individual lonely. Family members constantly asking why they have done this to themselves and the blame being pointed at the individual for ruining their life. Although it is not out of the picture, we tend to believe that people are responsible for their actions and therefore blame them for using drugs. Why do we tend to believe this? Is it truly the individuals fault or can drug use be influenced by previous traumatic experiences? This chapter focuses on how childhood trauma can influence subsequent drug use. {{RoundBoxTop|theme=3}} '''Focus questions:''' * What is childhood trauma? * What are theoretical underpinnings of childhood trauma induced drug use? * How does childhood trauma influence drug use? * What are the strategies for treating trauma-induced drug use? {{RoundBoxBottom}} {{tip| Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Provide an example or case study. * Conclude with Focus questions to guide the chapter. }} ==What is childhood trauma== [[File:Crying child with blonde hair.jpg|thumb|342x342px|''Figure 2.'' Childhood trauma negatively impacts a child's emotional well-being]]The [https://www.apa.org/pi/families/resources/update.pdf American Psychological Association] (APA) defines a traumatic life event as:<blockquote>"One that threatens, injury, death, or the physical integrity of self or others and also causes horror, terror, or helplessness at the time it occurs. Traumatic events include sexual abuse, physical abuse, domestic violence, community and school violence, medical trauma, motor vehicle accidents, acts of terrorism, war experiences, natural and human-made disasters, suicides, and other traumatic losses (American Psychological Association, 2008)." </blockquote> * When these events are experienced in a developing child, this constitutes as childhood trauma. * Due to children's vulnerability and lack of understanding, depending on their age, trauma can be especially harmful and result in many consequences throughout adolescence and adulthood. === Types of childhood trauma === Childhood trauma refers to negative events that threaten or cause harm to a child's emotional and/or physical wellbeing. Childhood trauma is most commonly the result of a child perceiving themselves to be in a life-threatening situation. Terr (1991) introduced two types of childhood trauma: * '''Type I''' - results from a single event such as an accident, witnessing a crime or rape. ** Individuals affected by Type I trauma especially if the incident occurred after the age of 3, are thought to remember the incident and experience perceptual symptoms such as visual hallucinations as a consequence of the trauma. * '''Type II -''' results from repeated exposure of extreme traumatising events such as re-occurring abuse ** Individuals affected by Type II trauma, are proposed to repress the event using denial and dissociation methods to avoid the trauma exposure. === Consequences of childhood trauma === * Emerging literature puts a strong focus on the effects of childhood trauma on brain development. Adverse events experienced in childhood, exposes children to become insecurely attached and develop poor self-regulation skills (Ford, 2009). Emotional dysregulation as a consequence of childhood trauma, has been highly linked to substance use with heavy consumption in adulthood (Dass-Breilsford & Myrick, 2010). * Longer term reactions include unpredictable emotions, sleep disturbances, separation anxiety, the development of new fears, anger irritability, and even physical symptoms like headaches to nausea (American Psychological Association, 2008). * Since children are still developing, childhood trauma can have long-lasting effects on a child's physical, mental and emotional well-being which carries onto adulthood. Moreover, common consequences of childhood trauma includes co-occuring psychiatric problems and substance abuse (Dye, 2018). == What constitutes drug use? == * Drugs have been been used medically and recreationally throughout history with early civilisations using them for religious rituals. * [[Substance abuse|Drug misuse]] is defined as the recreational use of alcohol, illicit drugs and pain medications which can lead to emotional, physical and social harm (Ghuran & Nolan, 2000). * Repeated drug use often leads to substance use disorder (SUD) which commonly constitutes addiction and the inability to discontinue drug use. * According to the 5^th edition of the Diagnostic Manual of Mental Disorders (DSM-5) substance induced disorders occur when the substance use leads to intoxication, addiction, withdrawal and induced psychological disorders such as psychosis and and depressive disorders (American Psychiatric Association, 2013). === Alcohol === * The World Health Organisation (WHO) has identified [https://www.who.int/health-topics/alcohol#tab=tab_1 alcohol] as a psychoactive type of drug which is highly addictive and the cause of around 3 million deaths per year (World Health Organization, 2022). * Repeated alcohol use can result in alcohol use disorder which can impact an individual's psychological, physical and social well-being === Pain medication === * Pain medication such as opioids are crucial in the medical world and have a purpose of delivering an analgesic effect for those individuals experiencing agonising pain. Acute pain patients benefit from these drugs immensely. * The use of pain medication is common among those who suffer from chronic pain conditions and is commonly not addictive or harmful when used in moderation. Nonetheless, the addictive properties in opioids paired with repeated use can quickly lead to drug addiction (Schnoll & Weaver, 2003) === Illicit drugs === * What makes a drug illicit? An illicit drug is one which has not been medically approved and is prohibited and illegal to be consumed, possess and sold. Illicit drugs are illegal due to the risk of [[addiction]] and the psychological and physiological risks attached to them. The international illegality of these drugs extends from plant-based drugs (e.g. cannabis, cocaine heroin) to pharmaceutical drugs (e.g. benzodiazepines) and synthetic drugs (e.g. MDMA, amphetamines) (Degenhardt & Hall, 2012). * The use of illicit drugs is commonly looked down upon and seen as the self-endangerment of an individual's well-being and sanity. So why do individuals partake in illicit drug use? {{Robelbox|theme=7|title=Quiz Time!|iconwidth=48px|icon=Nuvola_apps_korganizer.svg}}<div style="{{Robelbox/pad}}"> <quiz display=simple> {What makes a drug illicit?} - When it has been medically approved for consumption + When it has not been medically approved and is prohibited and illegal - When it is a plant-based drug </quiz> </div> {{Robelbox-close}} ==What are the theoretical underpinnings of trauma induced drug use?== * Using drugs is a dangerous behaviour that is commonly performed recreationally with large negative consequences. Although drug use is often initiated by peer pressure within social situations, psychological trauma can be a precursor for drug use throughout the lifespan. Trauma-exposed individuals are likely engaging in drug use as a maladaptive coping strategy to experience an emotional relief which may be compounding distress (Sheerin et al., 2016). * This part of the chapter will discuss the theoretical concepts surrounding the motivation behind trauma induced drug use. === Protection Motivation theory === * Protection motivation theory proposed by Rogers (1997) considers how individuals cope in distressing situations in order to protect oneself from perceived threat. This theory operates on three aspects: *# The magnitude of the threat within a specific event *# the probability that this event will re-occur *# The efficacy of a protective response === Extrinsic Motivation === * Extrinsic motivation describes a situation whereby, an individual follows the pursuit of an instrumental goal. Operant condtioning falls under extrinsic motivation since we see motivation of certain behaviours occur due to rewards and punishment. One theoretical underpinning that may explain why individuals who has experienced childhood trauma reach out to drugs can be explained by negative reinforcement. * When considering the negative reinforcement model and its influence in drug use, we can suggest that childhood trauma and the subsequent emotional damage, can motivate drug use. This can be considered whereby trauma may place an individual in an uncomfortable and distressing emotional state which can be relieved through an immediate short-term reward illicit by the consumption of drugs (May et al., 2020) == How does psychological trauma motivate drug use? == * It comes as no surprise that individuals turn to drug misuse to self-medicate against the unbearable pain and distress caused by unresolved and unprocessed traumatic experiences (Marcenko et al., 2000). The sad reality is that a lot of children who experience trauma in the early years are unaware of the extent to which this event may have impacted them later in life. A common coping mechanism of childhood trauma is repressing the event especially in younger children who do not understand the concept of right and wrong yet. * What trauma types are most relevant to drug use? Is there a specific type of event that is more likely to lead to drug use later in life? What does it mean to self-medicate? === Childhood trauma types most relevant to drug use === * It comes as no surprise that adverse childhood experiences play a role in maladaptive coping mechanisms. Nonetheless, it is important to address the types of trauma that affect this behaviour in order to successfully treat it. * A study conducted by Dube et al. (2003) demonstrated that ''childhood neglect'' was a predictor for illicit drug use. How does this occur? * Household dysfunction consisting of domestic violence, violence towards parent, divorce, mentally family member etc. presents another predictor for potential drug use. *Another type of childhood trauma that heavily influences drug use is childhood sexual abuse with the most common mean age at 11 - 13 years of age. Childhood sexual abuse is more commonly related to later substance use in comparison to an adulthood sexual abuse life event (Liebschutz, 2002). * === Self-medication following childhood trauma === * Early childhood sexual trauma has been theorised to result in drug use due to the desire to numb the painful affect caused by the trauma (Marcenko et al., 2000) . * Moreover, the psychological impact that childhood trauma has on a developing child plays a large role in how the child learns to adapt and cope. For example, a child with severe attachment issues due to a physically abusive parents, may turn to drugs to counteract the insecure relationships they experience throughout adulthood - avoidance of loneliness. == What are the strategies for treating trauma induced drug use? == * From a physiological perspective, the neurobiological pathways that are impacted by trauma (causing PTSD) and substance use have some similarities whereby, certain drugs have a depressing or arousal effect causing hyper-vigilance. * When considering treatment strategies for childhood trauma induced drug use, it is important to consider that both potential disorders need to be addressed simultaneously. The childhood trauma may have developed into PTSD and the symptoms may have induced a dependence on drugs causing substance use disorder (SUD). * Types of treatment for treating trauma induced drug use may include cognitive behavioural therapy (CBT), eye-movement desensitisation reprocessing (EMDR), medication and behavioural counselling (Note: I may turn these into sub-headings but unsure at this point). ===Case studies=== Case studies describe real-world examples of concepts in action. Case studies can be real or fictional. A case could be used multiple times during a chapter to illustrate different theories or stages. It is often helpful to present case studies using [[#Feature boxes|feature boxes]]. ===Boxes=== Boxes can be used to highlight content, but don't overuse them. There are many different ways of creating boxes (e.g., see [[Help:Pretty boxes|Pretty boxes]]). Possible uses include: * Focus questions * Case studies or examples * Quiz questions * Take-home messages {{RoundBoxTop|theme=3}} ;Feature box example * Shaded background * Coloured border {{RoundBoxBottom}} ===Tables=== Tables can be an effective way to organise and summarise information. Tables should be captioned (using APA style) to explain their relevance to the text. Plus each table should be referred to at least once in the main text (e.g., see Table 1 and Table 2). Here are some [[Motivation and emotion/Wikiversity/Tables|example 3 x 3 tables]] which could be adapted. To learn about different types of quiz questions, see [[Help:Quiz|Quiz]]. ==Conclusion== The Conclusion is arguably the most important section. It should be possible for someone to read the [[#Overview|Overview]] and the Conclusion and still get a good idea of the topic. {{tip|Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? }} ==See also== * [[Motivation and emotion/Book/2018/Childhood trauma and emotion|childhood trauma and emotion]] (Book chapter, 2018) * [[wikipedia:Protection_motivation_theory|Protection motivation theory]] (Wikipedia) * [[wikipedia:Recreational_drug_use|Recreational drug use]] (Wikipedia) * [[Motivation and emotion/Book/2021/Safety as a psychological need|Safety as a psychological need]] (Book chapter, 2018) {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== {{Hanging indent|1= American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing. American Psychological Association. (2008). Children and trauma: Update for mental health professionals. https://www.apa.org/pi/families/resources/update.pdf Dass-Brailsford, P., & Myrick, A. C. (2010). Psychological trauma and substance abuse: The need for an integrated approach. Trauma, Violence, & Abuse, 11(4), 202-213. https://doi.org/10.1177/1524838010381252 Degenhardt, L., & Hall, W. (2012). Extent of illicit drug use and dependence, and their contribution to the global burden of disease. The Lancet, 379(9810), 55-70. https://doi.org/10.1016/S0140-6736(11)61138-0 Dube, S. R., Felitti, V. J., Dong, M., Chapman, D. P., Giles, W. H., & Anda, R. F. (2003). Childhood abuse, neglect, and household dysfunction and the risk of illicit drug use: the adverse childhood experiences study. Pediatrics, 111(3), 564-572. https://doi.org/10.1542/peds.111.3.564 Dye, H. (2018). The impact and long-term effects of childhood trauma. Journal of Human Behavior in the Social Environment, 28(3), 381-392. https://doi.org/10.1080/10911359.2018.1435328 Ford, J. D. (2009). Neurobiological and developmental research. Treating complex traumatic stress disorders: An evidence-based guide, 31-58. (Guilford Press) Ghuran, A., & Nolan, J. (2000). Recreational drug misuse: issues for the cardiologist. Heart, 83(6), 627-633. https://doi.org/10.1136/heart.83.6.627 Ghuran, A., & Nolan, J. (2000). Recreational drug misuse: issues for the cardiologist. Heart, 83(6), 627-633. https://doi.org/10.1136/heart.83.6.627 Liebschutz, J., Savetsky, J. B., Saitz, R., Horton, N. J., Lloyd-Travaglini, C., & Samet, J. H. (2002). The relationship between sexual and physical abuse and substance abuse consequences. Journal of substance abuse treatment, 22(3), 121-128. https://doi.org/10.1016/S0740-5472(02)00220-9 Marcenko, M. O., Kemp, S. P., & Larson, N. C. (2000). Childhood experiences of abuse, later substance use, and parenting outcomes among low‐income mothers. American Journal of Orthopsychiatry, 70(3), 316-326. https://doi.org/10.1037/h0087853 Rogers, R. W., & Prentice-Dunn, S. (1997). Protection motivation theory. https://doi.org/10.1080/00223980.1975.9915803 Schnoll, S. H., & Weaver, M. F. (2003). Addiction and pain. The American journal on addictions, 12, S27-S35. https://doi.org/10.1111/j.1521-0391.2003.tb00554.x Schnoll, S. H., & Weaver, M. F. (2003). Addiction and pain. The American journal on addictions, 12, S27-S35. https://doi.org/10.1111/j.1521-0391.2003.tb00554.x Sheerin, C., Berenz, E. C., Knudsen, G. P., Reichborn-Kjennerud, T., Kendler, K. S., Aggen, S. H., & Amstadter, A. B. (2016). A population-based study of help seeking and self-medication among trauma-exposed individuals. Psychology of Addictive Behaviors, 30(7), 771. https://doi.org/10.1037/adb0000185 Terr, L. C. (1991). Acute responses to external events and posttraumatic stress disorders. pp.755-763. Williams & Wilkins Co. World Health Organization. (2022). Alcohol. https://www.who.int/health-topics/alcohol#tab=tab_1 }} {{tip|Suggestions for this section: * Important aspects for APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except first letter and proper names, ending in a full-stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full-stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't actually read or consulted }} ==External links== Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * [https://students.unimelb.edu.au/academic-skills/explore-our-resources/essay-writing/six-top-tips-for-writing-a-great-essay Six top tips for writing a great essay] (University of Melbourne) * [http://www.skillsyouneed.com/write/structure.html The importance of structure] (skillsyouneed.com) {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] [[Category:Motivation and emotion/Book/Children]] [[Category:Motivation and emotion/Book/Trauma]] qmw52i2swd1afc9pbxyn69zjnjebsc1 2419155 2419150 2022-08-26T01:08:32Z U3210431 2947391 /* References */ wikitext text/x-wiki {{title|Childhood trauma and subsequent drug use:<br>How does childhood trauma influence drug use?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== [[File:Toxicoman - Substance abuse.jpg|thumb|384x384px|''Figure 1.'' Drug use can heavily impact an individuals physical and mental health ]] The use of drugs has jumped from the romanticisation of the “love drug” known by the name of methylenedioxymetamfetamine (MDMA) and hallucinogenic drugs in the 1980s, to the rumination of them and their lethal and detrimental nature across time. When it comes to [[Drug misuse|drug]] consumption, we see those individuals who search for a deeper meaning, those who try to find an escape and those who conform to [[social norms]]. Yet, humans are aware of the detrimental consequences of drug consumption. From a young age we are taught about drugs and their lethal consequences. Why do individuals partake in drug consumption when they are aware of what might happen? Imagine an individual who has consistently used drugs for years, developed an addiction and is therefore unemployed. This behaviour has caused family members and friends to detach themselves, leaving this individual lonely. Family members constantly asking why they have done this to themselves and the blame being pointed at the individual for ruining their life. Although it is not out of the picture, we tend to believe that people are responsible for their actions and therefore blame them for using drugs. Why do we tend to believe this? Is it truly the individuals fault or can drug use be influenced by previous traumatic experiences? This chapter focuses on how childhood trauma can influence subsequent drug use. {{RoundBoxTop|theme=3}} '''Focus questions:''' * What is childhood trauma? * What are theoretical underpinnings of childhood trauma induced drug use? * How does childhood trauma influence drug use? * What are the strategies for treating trauma-induced drug use? {{RoundBoxBottom}} {{tip| Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Provide an example or case study. * Conclude with Focus questions to guide the chapter. }} ==What is childhood trauma== [[File:Crying child with blonde hair.jpg|thumb|342x342px|''Figure 2.'' Childhood trauma negatively impacts a child's emotional well-being]]The [https://www.apa.org/pi/families/resources/update.pdf American Psychological Association] (APA) defines a traumatic life event as:<blockquote>"One that threatens, injury, death, or the physical integrity of self or others and also causes horror, terror, or helplessness at the time it occurs. Traumatic events include sexual abuse, physical abuse, domestic violence, community and school violence, medical trauma, motor vehicle accidents, acts of terrorism, war experiences, natural and human-made disasters, suicides, and other traumatic losses (American Psychological Association, 2008)." </blockquote> * When these events are experienced in a developing child, this constitutes as childhood trauma. * Due to children's vulnerability and lack of understanding, depending on their age, trauma can be especially harmful and result in many consequences throughout adolescence and adulthood. === Types of childhood trauma === Childhood trauma refers to negative events that threaten or cause harm to a child's emotional and/or physical wellbeing. Childhood trauma is most commonly the result of a child perceiving themselves to be in a life-threatening situation. Terr (1991) introduced two types of childhood trauma: * '''Type I''' - results from a single event such as an accident, witnessing a crime or rape. ** Individuals affected by Type I trauma especially if the incident occurred after the age of 3, are thought to remember the incident and experience perceptual symptoms such as visual hallucinations as a consequence of the trauma. * '''Type II -''' results from repeated exposure of extreme traumatising events such as re-occurring abuse ** Individuals affected by Type II trauma, are proposed to repress the event using denial and dissociation methods to avoid the trauma exposure. === Consequences of childhood trauma === * Emerging literature puts a strong focus on the effects of childhood trauma on brain development. Adverse events experienced in childhood, exposes children to become insecurely attached and develop poor self-regulation skills (Ford, 2009). Emotional dysregulation as a consequence of childhood trauma, has been highly linked to substance use with heavy consumption in adulthood (Dass-Breilsford & Myrick, 2010). * Longer term reactions include unpredictable emotions, sleep disturbances, separation anxiety, the development of new fears, anger irritability, and even physical symptoms like headaches to nausea (American Psychological Association, 2008). * Since children are still developing, childhood trauma can have long-lasting effects on a child's physical, mental and emotional well-being which carries onto adulthood. Moreover, common consequences of childhood trauma includes co-occuring psychiatric problems and substance abuse (Dye, 2018). == What constitutes drug use? == * Drugs have been been used medically and recreationally throughout history with early civilisations using them for religious rituals. * [[Substance abuse|Drug misuse]] is defined as the recreational use of alcohol, illicit drugs and pain medications which can lead to emotional, physical and social harm (Ghuran & Nolan, 2000). * Repeated drug use often leads to substance use disorder (SUD) which commonly constitutes addiction and the inability to discontinue drug use. * According to the 5^th edition of the Diagnostic Manual of Mental Disorders (DSM-5) substance induced disorders occur when the substance use leads to intoxication, addiction, withdrawal and induced psychological disorders such as psychosis and and depressive disorders (American Psychiatric Association, 2013). === Alcohol === * The World Health Organisation (WHO) has identified [https://www.who.int/health-topics/alcohol#tab=tab_1 alcohol] as a psychoactive type of drug which is highly addictive and the cause of around 3 million deaths per year (World Health Organization, 2022). * Repeated alcohol use can result in alcohol use disorder which can impact an individual's psychological, physical and social well-being === Pain medication === * Pain medication such as opioids are crucial in the medical world and have a purpose of delivering an analgesic effect for those individuals experiencing agonising pain. Acute pain patients benefit from these drugs immensely. * The use of pain medication is common among those who suffer from chronic pain conditions and is commonly not addictive or harmful when used in moderation. Nonetheless, the addictive properties in opioids paired with repeated use can quickly lead to drug addiction (Schnoll & Weaver, 2003) === Illicit drugs === * What makes a drug illicit? An illicit drug is one which has not been medically approved and is prohibited and illegal to be consumed, possess and sold. Illicit drugs are illegal due to the risk of [[addiction]] and the psychological and physiological risks attached to them. The international illegality of these drugs extends from plant-based drugs (e.g. cannabis, cocaine heroin) to pharmaceutical drugs (e.g. benzodiazepines) and synthetic drugs (e.g. MDMA, amphetamines) (Degenhardt & Hall, 2012). * The use of illicit drugs is commonly looked down upon and seen as the self-endangerment of an individual's well-being and sanity. So why do individuals partake in illicit drug use? {{Robelbox|theme=7|title=Quiz Time!|iconwidth=48px|icon=Nuvola_apps_korganizer.svg}}<div style="{{Robelbox/pad}}"> <quiz display=simple> {What makes a drug illicit?} - When it has been medically approved for consumption + When it has not been medically approved and is prohibited and illegal - When it is a plant-based drug </quiz> </div> {{Robelbox-close}} ==What are the theoretical underpinnings of trauma induced drug use?== * Using drugs is a dangerous behaviour that is commonly performed recreationally with large negative consequences. Although drug use is often initiated by peer pressure within social situations, psychological trauma can be a precursor for drug use throughout the lifespan. Trauma-exposed individuals are likely engaging in drug use as a maladaptive coping strategy to experience an emotional relief which may be compounding distress (Sheerin et al., 2016). * This part of the chapter will discuss the theoretical concepts surrounding the motivation behind trauma induced drug use. === Protection Motivation theory === * Protection motivation theory proposed by Rogers (1997) considers how individuals cope in distressing situations in order to protect oneself from perceived threat. This theory operates on three aspects: *# The magnitude of the threat within a specific event *# the probability that this event will re-occur *# The efficacy of a protective response === Extrinsic Motivation === * Extrinsic motivation describes a situation whereby, an individual follows the pursuit of an instrumental goal. Operant condtioning falls under extrinsic motivation since we see motivation of certain behaviours occur due to rewards and punishment. One theoretical underpinning that may explain why individuals who has experienced childhood trauma reach out to drugs can be explained by negative reinforcement. * When considering the negative reinforcement model and its influence in drug use, we can suggest that childhood trauma and the subsequent emotional damage, can motivate drug use. This can be considered whereby trauma may place an individual in an uncomfortable and distressing emotional state which can be relieved through an immediate short-term reward illicit by the consumption of drugs (May et al., 2020) == How does psychological trauma motivate drug use? == * It comes as no surprise that individuals turn to drug misuse to self-medicate against the unbearable pain and distress caused by unresolved and unprocessed traumatic experiences (Marcenko et al., 2000). The sad reality is that a lot of children who experience trauma in the early years are unaware of the extent to which this event may have impacted them later in life. A common coping mechanism of childhood trauma is repressing the event especially in younger children who do not understand the concept of right and wrong yet. * What trauma types are most relevant to drug use? Is there a specific type of event that is more likely to lead to drug use later in life? What does it mean to self-medicate? === Childhood trauma types most relevant to drug use === * It comes as no surprise that adverse childhood experiences play a role in maladaptive coping mechanisms. Nonetheless, it is important to address the types of trauma that affect this behaviour in order to successfully treat it. * A study conducted by Dube et al. (2003) demonstrated that ''childhood neglect'' was a predictor for illicit drug use. How does this occur? * Household dysfunction consisting of domestic violence, violence towards parent, divorce, mentally family member etc. presents another predictor for potential drug use. *Another type of childhood trauma that heavily influences drug use is childhood sexual abuse with the most common mean age at 11 - 13 years of age. Childhood sexual abuse is more commonly related to later substance use in comparison to an adulthood sexual abuse life event (Liebschutz, 2002). * === Self-medication following childhood trauma === * Early childhood sexual trauma has been theorised to result in drug use due to the desire to numb the painful affect caused by the trauma (Marcenko et al., 2000) . * Moreover, the psychological impact that childhood trauma has on a developing child plays a large role in how the child learns to adapt and cope. For example, a child with severe attachment issues due to a physically abusive parents, may turn to drugs to counteract the insecure relationships they experience throughout adulthood - avoidance of loneliness. == What are the strategies for treating trauma induced drug use? == * From a physiological perspective, the neurobiological pathways that are impacted by trauma (causing PTSD) and substance use have some similarities whereby, certain drugs have a depressing or arousal effect causing hyper-vigilance. * When considering treatment strategies for childhood trauma induced drug use, it is important to consider that both potential disorders need to be addressed simultaneously. The childhood trauma may have developed into PTSD and the symptoms may have induced a dependence on drugs causing substance use disorder (SUD). * Types of treatment for treating trauma induced drug use may include cognitive behavioural therapy (CBT), eye-movement desensitisation reprocessing (EMDR), medication and behavioural counselling (Note: I may turn these into sub-headings but unsure at this point). ===Case studies=== Case studies describe real-world examples of concepts in action. Case studies can be real or fictional. A case could be used multiple times during a chapter to illustrate different theories or stages. It is often helpful to present case studies using [[#Feature boxes|feature boxes]]. ===Boxes=== Boxes can be used to highlight content, but don't overuse them. There are many different ways of creating boxes (e.g., see [[Help:Pretty boxes|Pretty boxes]]). Possible uses include: * Focus questions * Case studies or examples * Quiz questions * Take-home messages {{RoundBoxTop|theme=3}} ;Feature box example * Shaded background * Coloured border {{RoundBoxBottom}} ===Tables=== Tables can be an effective way to organise and summarise information. Tables should be captioned (using APA style) to explain their relevance to the text. Plus each table should be referred to at least once in the main text (e.g., see Table 1 and Table 2). Here are some [[Motivation and emotion/Wikiversity/Tables|example 3 x 3 tables]] which could be adapted. To learn about different types of quiz questions, see [[Help:Quiz|Quiz]]. ==Conclusion== The Conclusion is arguably the most important section. It should be possible for someone to read the [[#Overview|Overview]] and the Conclusion and still get a good idea of the topic. {{tip|Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? }} ==See also== * [[Motivation and emotion/Book/2018/Childhood trauma and emotion|childhood trauma and emotion]] (Book chapter, 2018) * [[wikipedia:Protection_motivation_theory|Protection motivation theory]] (Wikipedia) * [[wikipedia:Recreational_drug_use|Recreational drug use]] (Wikipedia) * [[Motivation and emotion/Book/2021/Safety as a psychological need|Safety as a psychological need]] (Book chapter, 2018) {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== {{Hanging indent|1= American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing. American Psychological Association. (2008). ''Children and trauma: Update for mental health professionals.'' https://www.apa.org/pi/families/resources/update.pdf Dass-Brailsford, P., & Myrick, A. C. (2010). Psychological trauma and substance abuse: The need for an integrated approach. ''Trauma, Violence, & Abuse'', ''11''(4), 202-213. https://doi.org/10.1177/1524838010381252 Degenhardt, L., & Hall, W. (2012). Extent of illicit drug use and dependence, and their contribution to the global burden of disease. ''The Lancet'', ''379''(9810), 55-70. https://doi.org/10.1016/S0140-6736(11)61138-0 Dube, S. R., Felitti, V. J., Dong, M., Chapman, D. P., Giles, W. H., & Anda, R. F. (2003). Childhood abuse, neglect, and household dysfunction and the risk of illicit drug use: the adverse childhood experiences study. ''Pediatrics'', ''111''(3), 564-572. https://doi.org/10.1542/peds.111.3.564 Dye, H. (2018). The impact and long-term effects of childhood trauma. ''Journal Of Human Behavior In The Social Environment'', ''28''(3), 381-392. https://doi.org/10.1080/10911359.2018.1435328 Ford, J. D. (2009). Neurobiological and developmental research. ''Treating complex traumatic stress disorders: An evidence-based guide'',(pp.31-58). Guilford Press Ghuran, A., & Nolan, J. (2000). Recreational drug misuse: Issues for the cardiologist. ''Heart'', ''83''(6), 627-633. https://doi.org/10.1136/heart.83.6.627 Ghuran, A., & Nolan, J. (2000). Recreational drug misuse: Issues for the cardiologist. ''Heart'', ''83''(6), 627-633. https://doi.org/10.1136/heart.83.6.627 Liebschutz, J., Savetsky, J. B., Saitz, R., Horton, N. J., Lloyd-Travaglini, C., & Samet, J. H. (2002). The relationship between sexual and physical abuse and substance abuse consequences. ''Journal of substance abuse treatment'', ''22''(3), 121-128. https://doi.org/10.1016/S0740-5472(02)00220-9 Marcenko, M. O., Kemp, S. P., & Larson, N. C. (2000). Childhood experiences of abuse, later substance use, and parenting outcomes among low‐income mothers. ''American Journal Of Orthopsychiatry'', ''70''(3), 316-326. https://doi.org/10.1037/h0087853 Rogers, R. W., & Prentice-Dunn, S. (1997). Protection motivation theory. ''The Journal Of Psychology'', ''91''(1), 93-114. https://doi.org/10.1080/00223980.1975.9915803 Schnoll, S. H., & Weaver, M. F. (2003). Addiction and pain. ''The American journal on addictions'', ''12'', S27-S35. https://doi.org/10.1111/j.1521-0391.2003.tb00554.x Schnoll, S. H., & Weaver, M. F. (2003). Addiction and pain. T''he American journal on addictions'', ''12'', S27-S35. https://doi.org/10.1111/j.1521-0391.2003.tb00554.x Sheerin, C., Berenz, E. C., Knudsen, G. P., Reichborn-Kjennerud, T., Kendler, K. S., Aggen, S. H., & Amstadter, A. B. (2016). A population-based study of help seeking and self-medication among trauma-exposed individuals. ''Psychology Of Addictive Behaviors'', ''30''(7), 771. https://doi.org/10.1037/adb0000185 Terr, L. C. (1991). ''Acute responses to external events and posttraumatic stress disorders'' (pp.755-763). Williams & Wilkins Co. World Health Organization. (2022). ''Alcohol''. https://www.who.int/health-topics/alcohol#tab=tab_1 }} {{tip|Suggestions for this section: * Important aspects for APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except first letter and proper names, ending in a full-stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full-stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't actually read or consulted }} ==External links== Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * [https://students.unimelb.edu.au/academic-skills/explore-our-resources/essay-writing/six-top-tips-for-writing-a-great-essay Six top tips for writing a great essay] (University of Melbourne) * [http://www.skillsyouneed.com/write/structure.html The importance of structure] (skillsyouneed.com) {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] [[Category:Motivation and emotion/Book/Children]] [[Category:Motivation and emotion/Book/Trauma]] kqs5rv6h424wwdjfc47tqouy8tisjcj 2419156 2419155 2022-08-26T01:09:31Z U3210431 2947391 /* References */ wikitext text/x-wiki {{title|Childhood trauma and subsequent drug use:<br>How does childhood trauma influence drug use?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== [[File:Toxicoman - Substance abuse.jpg|thumb|384x384px|''Figure 1.'' Drug use can heavily impact an individuals physical and mental health ]] The use of drugs has jumped from the romanticisation of the “love drug” known by the name of methylenedioxymetamfetamine (MDMA) and hallucinogenic drugs in the 1980s, to the rumination of them and their lethal and detrimental nature across time. When it comes to [[Drug misuse|drug]] consumption, we see those individuals who search for a deeper meaning, those who try to find an escape and those who conform to [[social norms]]. Yet, humans are aware of the detrimental consequences of drug consumption. From a young age we are taught about drugs and their lethal consequences. Why do individuals partake in drug consumption when they are aware of what might happen? Imagine an individual who has consistently used drugs for years, developed an addiction and is therefore unemployed. This behaviour has caused family members and friends to detach themselves, leaving this individual lonely. Family members constantly asking why they have done this to themselves and the blame being pointed at the individual for ruining their life. Although it is not out of the picture, we tend to believe that people are responsible for their actions and therefore blame them for using drugs. Why do we tend to believe this? Is it truly the individuals fault or can drug use be influenced by previous traumatic experiences? This chapter focuses on how childhood trauma can influence subsequent drug use. {{RoundBoxTop|theme=3}} '''Focus questions:''' * What is childhood trauma? * What are theoretical underpinnings of childhood trauma induced drug use? * How does childhood trauma influence drug use? * What are the strategies for treating trauma-induced drug use? {{RoundBoxBottom}} {{tip| Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Provide an example or case study. * Conclude with Focus questions to guide the chapter. }} ==What is childhood trauma== [[File:Crying child with blonde hair.jpg|thumb|342x342px|''Figure 2.'' Childhood trauma negatively impacts a child's emotional well-being]]The [https://www.apa.org/pi/families/resources/update.pdf American Psychological Association] (APA) defines a traumatic life event as:<blockquote>"One that threatens, injury, death, or the physical integrity of self or others and also causes horror, terror, or helplessness at the time it occurs. Traumatic events include sexual abuse, physical abuse, domestic violence, community and school violence, medical trauma, motor vehicle accidents, acts of terrorism, war experiences, natural and human-made disasters, suicides, and other traumatic losses (American Psychological Association, 2008)." </blockquote> * When these events are experienced in a developing child, this constitutes as childhood trauma. * Due to children's vulnerability and lack of understanding, depending on their age, trauma can be especially harmful and result in many consequences throughout adolescence and adulthood. === Types of childhood trauma === Childhood trauma refers to negative events that threaten or cause harm to a child's emotional and/or physical wellbeing. Childhood trauma is most commonly the result of a child perceiving themselves to be in a life-threatening situation. Terr (1991) introduced two types of childhood trauma: * '''Type I''' - results from a single event such as an accident, witnessing a crime or rape. ** Individuals affected by Type I trauma especially if the incident occurred after the age of 3, are thought to remember the incident and experience perceptual symptoms such as visual hallucinations as a consequence of the trauma. * '''Type II -''' results from repeated exposure of extreme traumatising events such as re-occurring abuse ** Individuals affected by Type II trauma, are proposed to repress the event using denial and dissociation methods to avoid the trauma exposure. === Consequences of childhood trauma === * Emerging literature puts a strong focus on the effects of childhood trauma on brain development. Adverse events experienced in childhood, exposes children to become insecurely attached and develop poor self-regulation skills (Ford, 2009). Emotional dysregulation as a consequence of childhood trauma, has been highly linked to substance use with heavy consumption in adulthood (Dass-Breilsford & Myrick, 2010). * Longer term reactions include unpredictable emotions, sleep disturbances, separation anxiety, the development of new fears, anger irritability, and even physical symptoms like headaches to nausea (American Psychological Association, 2008). * Since children are still developing, childhood trauma can have long-lasting effects on a child's physical, mental and emotional well-being which carries onto adulthood. Moreover, common consequences of childhood trauma includes co-occuring psychiatric problems and substance abuse (Dye, 2018). == What constitutes drug use? == * Drugs have been been used medically and recreationally throughout history with early civilisations using them for religious rituals. * [[Substance abuse|Drug misuse]] is defined as the recreational use of alcohol, illicit drugs and pain medications which can lead to emotional, physical and social harm (Ghuran & Nolan, 2000). * Repeated drug use often leads to substance use disorder (SUD) which commonly constitutes addiction and the inability to discontinue drug use. * According to the 5^th edition of the Diagnostic Manual of Mental Disorders (DSM-5) substance induced disorders occur when the substance use leads to intoxication, addiction, withdrawal and induced psychological disorders such as psychosis and and depressive disorders (American Psychiatric Association, 2013). === Alcohol === * The World Health Organisation (WHO) has identified [https://www.who.int/health-topics/alcohol#tab=tab_1 alcohol] as a psychoactive type of drug which is highly addictive and the cause of around 3 million deaths per year (World Health Organization, 2022). * Repeated alcohol use can result in alcohol use disorder which can impact an individual's psychological, physical and social well-being === Pain medication === * Pain medication such as opioids are crucial in the medical world and have a purpose of delivering an analgesic effect for those individuals experiencing agonising pain. Acute pain patients benefit from these drugs immensely. * The use of pain medication is common among those who suffer from chronic pain conditions and is commonly not addictive or harmful when used in moderation. Nonetheless, the addictive properties in opioids paired with repeated use can quickly lead to drug addiction (Schnoll & Weaver, 2003) === Illicit drugs === * What makes a drug illicit? An illicit drug is one which has not been medically approved and is prohibited and illegal to be consumed, possess and sold. Illicit drugs are illegal due to the risk of [[addiction]] and the psychological and physiological risks attached to them. The international illegality of these drugs extends from plant-based drugs (e.g. cannabis, cocaine heroin) to pharmaceutical drugs (e.g. benzodiazepines) and synthetic drugs (e.g. MDMA, amphetamines) (Degenhardt & Hall, 2012). * The use of illicit drugs is commonly looked down upon and seen as the self-endangerment of an individual's well-being and sanity. So why do individuals partake in illicit drug use? {{Robelbox|theme=7|title=Quiz Time!|iconwidth=48px|icon=Nuvola_apps_korganizer.svg}}<div style="{{Robelbox/pad}}"> <quiz display=simple> {What makes a drug illicit?} - When it has been medically approved for consumption + When it has not been medically approved and is prohibited and illegal - When it is a plant-based drug </quiz> </div> {{Robelbox-close}} ==What are the theoretical underpinnings of trauma induced drug use?== * Using drugs is a dangerous behaviour that is commonly performed recreationally with large negative consequences. Although drug use is often initiated by peer pressure within social situations, psychological trauma can be a precursor for drug use throughout the lifespan. Trauma-exposed individuals are likely engaging in drug use as a maladaptive coping strategy to experience an emotional relief which may be compounding distress (Sheerin et al., 2016). * This part of the chapter will discuss the theoretical concepts surrounding the motivation behind trauma induced drug use. === Protection Motivation theory === * Protection motivation theory proposed by Rogers (1997) considers how individuals cope in distressing situations in order to protect oneself from perceived threat. This theory operates on three aspects: *# The magnitude of the threat within a specific event *# the probability that this event will re-occur *# The efficacy of a protective response === Extrinsic Motivation === * Extrinsic motivation describes a situation whereby, an individual follows the pursuit of an instrumental goal. Operant condtioning falls under extrinsic motivation since we see motivation of certain behaviours occur due to rewards and punishment. One theoretical underpinning that may explain why individuals who has experienced childhood trauma reach out to drugs can be explained by negative reinforcement. * When considering the negative reinforcement model and its influence in drug use, we can suggest that childhood trauma and the subsequent emotional damage, can motivate drug use. This can be considered whereby trauma may place an individual in an uncomfortable and distressing emotional state which can be relieved through an immediate short-term reward illicit by the consumption of drugs (May et al., 2020) == How does psychological trauma motivate drug use? == * It comes as no surprise that individuals turn to drug misuse to self-medicate against the unbearable pain and distress caused by unresolved and unprocessed traumatic experiences (Marcenko et al., 2000). The sad reality is that a lot of children who experience trauma in the early years are unaware of the extent to which this event may have impacted them later in life. A common coping mechanism of childhood trauma is repressing the event especially in younger children who do not understand the concept of right and wrong yet. * What trauma types are most relevant to drug use? Is there a specific type of event that is more likely to lead to drug use later in life? What does it mean to self-medicate? === Childhood trauma types most relevant to drug use === * It comes as no surprise that adverse childhood experiences play a role in maladaptive coping mechanisms. Nonetheless, it is important to address the types of trauma that affect this behaviour in order to successfully treat it. * A study conducted by Dube et al. (2003) demonstrated that ''childhood neglect'' was a predictor for illicit drug use. How does this occur? * Household dysfunction consisting of domestic violence, violence towards parent, divorce, mentally family member etc. presents another predictor for potential drug use. *Another type of childhood trauma that heavily influences drug use is childhood sexual abuse with the most common mean age at 11 - 13 years of age. Childhood sexual abuse is more commonly related to later substance use in comparison to an adulthood sexual abuse life event (Liebschutz, 2002). * === Self-medication following childhood trauma === * Early childhood sexual trauma has been theorised to result in drug use due to the desire to numb the painful affect caused by the trauma (Marcenko et al., 2000) . * Moreover, the psychological impact that childhood trauma has on a developing child plays a large role in how the child learns to adapt and cope. For example, a child with severe attachment issues due to a physically abusive parents, may turn to drugs to counteract the insecure relationships they experience throughout adulthood - avoidance of loneliness. == What are the strategies for treating trauma induced drug use? == * From a physiological perspective, the neurobiological pathways that are impacted by trauma (causing PTSD) and substance use have some similarities whereby, certain drugs have a depressing or arousal effect causing hyper-vigilance. * When considering treatment strategies for childhood trauma induced drug use, it is important to consider that both potential disorders need to be addressed simultaneously. The childhood trauma may have developed into PTSD and the symptoms may have induced a dependence on drugs causing substance use disorder (SUD). * Types of treatment for treating trauma induced drug use may include cognitive behavioural therapy (CBT), eye-movement desensitisation reprocessing (EMDR), medication and behavioural counselling (Note: I may turn these into sub-headings but unsure at this point). ===Case studies=== Case studies describe real-world examples of concepts in action. Case studies can be real or fictional. A case could be used multiple times during a chapter to illustrate different theories or stages. It is often helpful to present case studies using [[#Feature boxes|feature boxes]]. ===Boxes=== Boxes can be used to highlight content, but don't overuse them. There are many different ways of creating boxes (e.g., see [[Help:Pretty boxes|Pretty boxes]]). Possible uses include: * Focus questions * Case studies or examples * Quiz questions * Take-home messages {{RoundBoxTop|theme=3}} ;Feature box example * Shaded background * Coloured border {{RoundBoxBottom}} ===Tables=== Tables can be an effective way to organise and summarise information. Tables should be captioned (using APA style) to explain their relevance to the text. Plus each table should be referred to at least once in the main text (e.g., see Table 1 and Table 2). Here are some [[Motivation and emotion/Wikiversity/Tables|example 3 x 3 tables]] which could be adapted. To learn about different types of quiz questions, see [[Help:Quiz|Quiz]]. ==Conclusion== The Conclusion is arguably the most important section. It should be possible for someone to read the [[#Overview|Overview]] and the Conclusion and still get a good idea of the topic. {{tip|Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? }} ==See also== * [[Motivation and emotion/Book/2018/Childhood trauma and emotion|childhood trauma and emotion]] (Book chapter, 2018) * [[wikipedia:Protection_motivation_theory|Protection motivation theory]] (Wikipedia) * [[wikipedia:Recreational_drug_use|Recreational drug use]] (Wikipedia) * [[Motivation and emotion/Book/2021/Safety as a psychological need|Safety as a psychological need]] (Book chapter, 2018) {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== {{Hanging indent|1= American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing. American Psychological Association. (2008). ''Children and trauma: Update for mental health professionals.'' https://www.apa.org/pi/families/resources/update.pdf Dass-Brailsford, P., & Myrick, A. C. (2010). Psychological trauma and substance abuse: The need for an integrated approach. ''Trauma, Violence, & Abuse'', ''11''(4), 202-213. https://doi.org/10.1177/1524838010381252 Degenhardt, L., & Hall, W. (2012). Extent of illicit drug use and dependence, and their contribution to the global burden of disease. ''The Lancet'', ''379''(9810), 55-70. https://doi.org/10.1016/S0140-6736(11)61138-0 Dube, S. R., Felitti, V. J., Dong, M., Chapman, D. P., Giles, W. H., & Anda, R. F. (2003). Childhood abuse, neglect, and household dysfunction and the risk of illicit drug use: the adverse childhood experiences study. ''Pediatrics'', ''111''(3), 564-572. https://doi.org/10.1542/peds.111.3.564 Dye, H. (2018). The impact and long-term effects of childhood trauma. ''Journal Of Human Behavior In The Social Environment'', ''28''(3), 381-392. https://doi.org/10.1080/10911359.2018.1435328 Ford, J. D. (2009). Neurobiological and developmental research. ''Treating complex traumatic stress disorders: An evidence-based guide'',(pp.31-58). Guilford Press Ghuran, A., & Nolan, J. (2000). Recreational drug misuse: Issues for the cardiologist. ''Heart'', ''83''(6), 627-633. https://doi.org/10.1136/heart.83.6.627 Liebschutz, J., Savetsky, J. B., Saitz, R., Horton, N. J., Lloyd-Travaglini, C., & Samet, J. H. (2002). The relationship between sexual and physical abuse and substance abuse consequences. ''Journal of substance abuse treatment'', ''22''(3), 121-128. https://doi.org/10.1016/S0740-5472(02)00220-9 Marcenko, M. O., Kemp, S. P., & Larson, N. C. (2000). Childhood experiences of abuse, later substance use, and parenting outcomes among low‐income mothers. ''American Journal Of Orthopsychiatry'', ''70''(3), 316-326. https://doi.org/10.1037/h0087853 Rogers, R. W., & Prentice-Dunn, S. (1997). Protection motivation theory. ''The Journal Of Psychology'', ''91''(1), 93-114. https://doi.org/10.1080/00223980.1975.9915803 Schnoll, S. H., & Weaver, M. F. (2003). Addiction and pain. ''The American journal on addictions'', ''12'', S27-S35. https://doi.org/10.1111/j.1521-0391.2003.tb00554.x Sheerin, C., Berenz, E. C., Knudsen, G. P., Reichborn-Kjennerud, T., Kendler, K. S., Aggen, S. H., & Amstadter, A. B. (2016). A population-based study of help seeking and self-medication among trauma-exposed individuals. ''Psychology Of Addictive Behaviors'', ''30''(7), 771. https://doi.org/10.1037/adb0000185 Terr, L. C. (1991). ''Acute responses to external events and posttraumatic stress disorders'' (pp.755-763). Williams & Wilkins Co. World Health Organization. (2022). ''Alcohol''. https://www.who.int/health-topics/alcohol#tab=tab_1 }} {{tip|Suggestions for this section: * Important aspects for APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except first letter and proper names, ending in a full-stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full-stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't actually read or consulted }} ==External links== Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * [https://students.unimelb.edu.au/academic-skills/explore-our-resources/essay-writing/six-top-tips-for-writing-a-great-essay Six top tips for writing a great essay] (University of Melbourne) * [http://www.skillsyouneed.com/write/structure.html The importance of structure] (skillsyouneed.com) {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] [[Category:Motivation and emotion/Book/Children]] [[Category:Motivation and emotion/Book/Trauma]] 0gvz2kt9iu7050g7k4xkghimayhr8mi 2419249 2419156 2022-08-26T03:54:53Z U3210431 2947391 /* External links */ Edited external links wikitext text/x-wiki {{title|Childhood trauma and subsequent drug use:<br>How does childhood trauma influence drug use?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== [[File:Toxicoman - Substance abuse.jpg|thumb|384x384px|''Figure 1.'' Drug use can heavily impact an individuals physical and mental health ]] The use of drugs has jumped from the romanticisation of the “love drug” known by the name of methylenedioxymetamfetamine (MDMA) and hallucinogenic drugs in the 1980s, to the rumination of them and their lethal and detrimental nature across time. When it comes to [[Drug misuse|drug]] consumption, we see those individuals who search for a deeper meaning, those who try to find an escape and those who conform to [[social norms]]. Yet, humans are aware of the detrimental consequences of drug consumption. From a young age we are taught about drugs and their lethal consequences. Why do individuals partake in drug consumption when they are aware of what might happen? Imagine an individual who has consistently used drugs for years, developed an addiction and is therefore unemployed. This behaviour has caused family members and friends to detach themselves, leaving this individual lonely. Family members constantly asking why they have done this to themselves and the blame being pointed at the individual for ruining their life. Although it is not out of the picture, we tend to believe that people are responsible for their actions and therefore blame them for using drugs. Why do we tend to believe this? Is it truly the individuals fault or can drug use be influenced by previous traumatic experiences? This chapter focuses on how childhood trauma can influence subsequent drug use. {{RoundBoxTop|theme=3}} '''Focus questions:''' * What is childhood trauma? * What are theoretical underpinnings of childhood trauma induced drug use? * How does childhood trauma influence drug use? * What are the strategies for treating trauma-induced drug use? {{RoundBoxBottom}} {{tip| Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Provide an example or case study. * Conclude with Focus questions to guide the chapter. }} ==What is childhood trauma== [[File:Crying child with blonde hair.jpg|thumb|342x342px|''Figure 2.'' Childhood trauma negatively impacts a child's emotional well-being]]The [https://www.apa.org/pi/families/resources/update.pdf American Psychological Association] (APA) defines a traumatic life event as:<blockquote>"One that threatens, injury, death, or the physical integrity of self or others and also causes horror, terror, or helplessness at the time it occurs. Traumatic events include sexual abuse, physical abuse, domestic violence, community and school violence, medical trauma, motor vehicle accidents, acts of terrorism, war experiences, natural and human-made disasters, suicides, and other traumatic losses (American Psychological Association, 2008)." </blockquote> * When these events are experienced in a developing child, this constitutes as childhood trauma. * Due to children's vulnerability and lack of understanding, depending on their age, trauma can be especially harmful and result in many consequences throughout adolescence and adulthood. === Types of childhood trauma === Childhood trauma refers to negative events that threaten or cause harm to a child's emotional and/or physical wellbeing. Childhood trauma is most commonly the result of a child perceiving themselves to be in a life-threatening situation. Terr (1991) introduced two types of childhood trauma: * '''Type I''' - results from a single event such as an accident, witnessing a crime or rape. ** Individuals affected by Type I trauma especially if the incident occurred after the age of 3, are thought to remember the incident and experience perceptual symptoms such as visual hallucinations as a consequence of the trauma. * '''Type II -''' results from repeated exposure of extreme traumatising events such as re-occurring abuse ** Individuals affected by Type II trauma, are proposed to repress the event using denial and dissociation methods to avoid the trauma exposure. === Consequences of childhood trauma === * Emerging literature puts a strong focus on the effects of childhood trauma on brain development. Adverse events experienced in childhood, exposes children to become insecurely attached and develop poor self-regulation skills (Ford, 2009). Emotional dysregulation as a consequence of childhood trauma, has been highly linked to substance use with heavy consumption in adulthood (Dass-Breilsford & Myrick, 2010). * Longer term reactions include unpredictable emotions, sleep disturbances, separation anxiety, the development of new fears, anger irritability, and even physical symptoms like headaches to nausea (American Psychological Association, 2008). * Since children are still developing, childhood trauma can have long-lasting effects on a child's physical, mental and emotional well-being which carries onto adulthood. Moreover, common consequences of childhood trauma includes co-occuring psychiatric problems and substance abuse (Dye, 2018). == What constitutes drug use? == * Drugs have been been used medically and recreationally throughout history with early civilisations using them for religious rituals. * [[Substance abuse|Drug misuse]] is defined as the recreational use of alcohol, illicit drugs and pain medications which can lead to emotional, physical and social harm (Ghuran & Nolan, 2000). * Repeated drug use often leads to substance use disorder (SUD) which commonly constitutes addiction and the inability to discontinue drug use. * According to the 5^th edition of the Diagnostic Manual of Mental Disorders (DSM-5) substance induced disorders occur when the substance use leads to intoxication, addiction, withdrawal and induced psychological disorders such as psychosis and and depressive disorders (American Psychiatric Association, 2013). === Alcohol === * The World Health Organisation (WHO) has identified [https://www.who.int/health-topics/alcohol#tab=tab_1 alcohol] as a psychoactive type of drug which is highly addictive and the cause of around 3 million deaths per year (World Health Organization, 2022). * Repeated alcohol use can result in alcohol use disorder which can impact an individual's psychological, physical and social well-being === Pain medication === * Pain medication such as opioids are crucial in the medical world and have a purpose of delivering an analgesic effect for those individuals experiencing agonising pain. Acute pain patients benefit from these drugs immensely. * The use of pain medication is common among those who suffer from chronic pain conditions and is commonly not addictive or harmful when used in moderation. Nonetheless, the addictive properties in opioids paired with repeated use can quickly lead to drug addiction (Schnoll & Weaver, 2003) === Illicit drugs === * What makes a drug illicit? An illicit drug is one which has not been medically approved and is prohibited and illegal to be consumed, possess and sold. Illicit drugs are illegal due to the risk of [[addiction]] and the psychological and physiological risks attached to them. The international illegality of these drugs extends from plant-based drugs (e.g. cannabis, cocaine heroin) to pharmaceutical drugs (e.g. benzodiazepines) and synthetic drugs (e.g. MDMA, amphetamines) (Degenhardt & Hall, 2012). * The use of illicit drugs is commonly looked down upon and seen as the self-endangerment of an individual's well-being and sanity. So why do individuals partake in illicit drug use? {{Robelbox|theme=7|title=Quiz Time!|iconwidth=48px|icon=Nuvola_apps_korganizer.svg}}<div style="{{Robelbox/pad}}"> <quiz display=simple> {What makes a drug illicit?} - When it has been medically approved for consumption + When it has not been medically approved and is prohibited and illegal - When it is a plant-based drug </quiz> </div> {{Robelbox-close}} ==What are the theoretical underpinnings of trauma induced drug use?== * Using drugs is a dangerous behaviour that is commonly performed recreationally with large negative consequences. Although drug use is often initiated by peer pressure within social situations, psychological trauma can be a precursor for drug use throughout the lifespan. Trauma-exposed individuals are likely engaging in drug use as a maladaptive coping strategy to experience an emotional relief which may be compounding distress (Sheerin et al., 2016). * This part of the chapter will discuss the theoretical concepts surrounding the motivation behind trauma induced drug use. === Protection Motivation theory === * Protection motivation theory proposed by Rogers (1997) considers how individuals cope in distressing situations in order to protect oneself from perceived threat. This theory operates on three aspects: *# The magnitude of the threat within a specific event *# the probability that this event will re-occur *# The efficacy of a protective response === Extrinsic Motivation === * Extrinsic motivation describes a situation whereby, an individual follows the pursuit of an instrumental goal. Operant condtioning falls under extrinsic motivation since we see motivation of certain behaviours occur due to rewards and punishment. One theoretical underpinning that may explain why individuals who has experienced childhood trauma reach out to drugs can be explained by negative reinforcement. * When considering the negative reinforcement model and its influence in drug use, we can suggest that childhood trauma and the subsequent emotional damage, can motivate drug use. This can be considered whereby trauma may place an individual in an uncomfortable and distressing emotional state which can be relieved through an immediate short-term reward illicit by the consumption of drugs (May et al., 2020) == How does psychological trauma motivate drug use? == * It comes as no surprise that individuals turn to drug misuse to self-medicate against the unbearable pain and distress caused by unresolved and unprocessed traumatic experiences (Marcenko et al., 2000). The sad reality is that a lot of children who experience trauma in the early years are unaware of the extent to which this event may have impacted them later in life. A common coping mechanism of childhood trauma is repressing the event especially in younger children who do not understand the concept of right and wrong yet. * What trauma types are most relevant to drug use? Is there a specific type of event that is more likely to lead to drug use later in life? What does it mean to self-medicate? === Childhood trauma types most relevant to drug use === * It comes as no surprise that adverse childhood experiences play a role in maladaptive coping mechanisms. Nonetheless, it is important to address the types of trauma that affect this behaviour in order to successfully treat it. * A study conducted by Dube et al. (2003) demonstrated that ''childhood neglect'' was a predictor for illicit drug use. How does this occur? * Household dysfunction consisting of domestic violence, violence towards parent, divorce, mentally family member etc. presents another predictor for potential drug use. *Another type of childhood trauma that heavily influences drug use is childhood sexual abuse with the most common mean age at 11 - 13 years of age. Childhood sexual abuse is more commonly related to later substance use in comparison to an adulthood sexual abuse life event (Liebschutz, 2002). * === Self-medication following childhood trauma === * Early childhood sexual trauma has been theorised to result in drug use due to the desire to numb the painful affect caused by the trauma (Marcenko et al., 2000) . * Moreover, the psychological impact that childhood trauma has on a developing child plays a large role in how the child learns to adapt and cope. For example, a child with severe attachment issues due to a physically abusive parents, may turn to drugs to counteract the insecure relationships they experience throughout adulthood - avoidance of loneliness. == What are the strategies for treating trauma induced drug use? == * From a physiological perspective, the neurobiological pathways that are impacted by trauma (causing PTSD) and substance use have some similarities whereby, certain drugs have a depressing or arousal effect causing hyper-vigilance. * When considering treatment strategies for childhood trauma induced drug use, it is important to consider that both potential disorders need to be addressed simultaneously. The childhood trauma may have developed into PTSD and the symptoms may have induced a dependence on drugs causing substance use disorder (SUD). * Types of treatment for treating trauma induced drug use may include cognitive behavioural therapy (CBT), eye-movement desensitisation reprocessing (EMDR), medication and behavioural counselling (Note: I may turn these into sub-headings but unsure at this point). ===Case studies=== Case studies describe real-world examples of concepts in action. Case studies can be real or fictional. A case could be used multiple times during a chapter to illustrate different theories or stages. It is often helpful to present case studies using [[#Feature boxes|feature boxes]]. ===Boxes=== Boxes can be used to highlight content, but don't overuse them. There are many different ways of creating boxes (e.g., see [[Help:Pretty boxes|Pretty boxes]]). Possible uses include: * Focus questions * Case studies or examples * Quiz questions * Take-home messages {{RoundBoxTop|theme=3}} ;Feature box example * Shaded background * Coloured border {{RoundBoxBottom}} ===Tables=== Tables can be an effective way to organise and summarise information. Tables should be captioned (using APA style) to explain their relevance to the text. Plus each table should be referred to at least once in the main text (e.g., see Table 1 and Table 2). Here are some [[Motivation and emotion/Wikiversity/Tables|example 3 x 3 tables]] which could be adapted. To learn about different types of quiz questions, see [[Help:Quiz|Quiz]]. ==Conclusion== The Conclusion is arguably the most important section. It should be possible for someone to read the [[#Overview|Overview]] and the Conclusion and still get a good idea of the topic. {{tip|Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? }} ==See also== * [[Motivation and emotion/Book/2018/Childhood trauma and emotion|childhood trauma and emotion]] (Book chapter, 2018) * [[wikipedia:Protection_motivation_theory|Protection motivation theory]] (Wikipedia) * [[wikipedia:Recreational_drug_use|Recreational drug use]] (Wikipedia) * [[Motivation and emotion/Book/2021/Safety as a psychological need|Safety as a psychological need]] (Book chapter, 2018) {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== {{Hanging indent|1= American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing. American Psychological Association. (2008). ''Children and trauma: Update for mental health professionals.'' https://www.apa.org/pi/families/resources/update.pdf Dass-Brailsford, P., & Myrick, A. C. (2010). Psychological trauma and substance abuse: The need for an integrated approach. ''Trauma, Violence, & Abuse'', ''11''(4), 202-213. https://doi.org/10.1177/1524838010381252 Degenhardt, L., & Hall, W. (2012). Extent of illicit drug use and dependence, and their contribution to the global burden of disease. ''The Lancet'', ''379''(9810), 55-70. https://doi.org/10.1016/S0140-6736(11)61138-0 Dube, S. R., Felitti, V. J., Dong, M., Chapman, D. P., Giles, W. H., & Anda, R. F. (2003). Childhood abuse, neglect, and household dysfunction and the risk of illicit drug use: the adverse childhood experiences study. ''Pediatrics'', ''111''(3), 564-572. https://doi.org/10.1542/peds.111.3.564 Dye, H. (2018). The impact and long-term effects of childhood trauma. ''Journal Of Human Behavior In The Social Environment'', ''28''(3), 381-392. https://doi.org/10.1080/10911359.2018.1435328 Ford, J. D. (2009). Neurobiological and developmental research. ''Treating complex traumatic stress disorders: An evidence-based guide'',(pp.31-58). Guilford Press Ghuran, A., & Nolan, J. (2000). Recreational drug misuse: Issues for the cardiologist. ''Heart'', ''83''(6), 627-633. https://doi.org/10.1136/heart.83.6.627 Liebschutz, J., Savetsky, J. B., Saitz, R., Horton, N. J., Lloyd-Travaglini, C., & Samet, J. H. (2002). The relationship between sexual and physical abuse and substance abuse consequences. ''Journal of substance abuse treatment'', ''22''(3), 121-128. https://doi.org/10.1016/S0740-5472(02)00220-9 Marcenko, M. O., Kemp, S. P., & Larson, N. C. (2000). Childhood experiences of abuse, later substance use, and parenting outcomes among low‐income mothers. ''American Journal Of Orthopsychiatry'', ''70''(3), 316-326. https://doi.org/10.1037/h0087853 Rogers, R. W., & Prentice-Dunn, S. (1997). Protection motivation theory. ''The Journal Of Psychology'', ''91''(1), 93-114. https://doi.org/10.1080/00223980.1975.9915803 Schnoll, S. H., & Weaver, M. F. (2003). Addiction and pain. ''The American journal on addictions'', ''12'', S27-S35. https://doi.org/10.1111/j.1521-0391.2003.tb00554.x Sheerin, C., Berenz, E. C., Knudsen, G. P., Reichborn-Kjennerud, T., Kendler, K. S., Aggen, S. H., & Amstadter, A. B. (2016). A population-based study of help seeking and self-medication among trauma-exposed individuals. ''Psychology Of Addictive Behaviors'', ''30''(7), 771. https://doi.org/10.1037/adb0000185 Terr, L. C. (1991). ''Acute responses to external events and posttraumatic stress disorders'' (pp.755-763). Williams & Wilkins Co. World Health Organization. (2022). ''Alcohol''. https://www.who.int/health-topics/alcohol#tab=tab_1 }} {{tip|Suggestions for this section: * Important aspects for APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except first letter and proper names, ending in a full-stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full-stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't actually read or consulted }} ==External links== * [https://www.healthdirect.gov.au/drug-abuse Drug abuse] (healthdirect.com.au) * [https://blueknot.org.au/resources/understanding-trauma-and-abuse/what-is-childhood-trauma/ What is Childhood trauma?] (blueknot.org.au) {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] [[Category:Motivation and emotion/Book/Children]] [[Category:Motivation and emotion/Book/Trauma]] qks6py2do8hpeuqndvor6h0vj5tz6wf 0 286403 2419292 2419001 2022-08-26T05:14:23Z Teermeej Hossain 2948258 editing callout boxes wikitext text/x-wiki {{title|Chapter title:<br>Subtitle?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== Are you feeling stuck in your current situation, and not improving further? Has your weakness ever been that you needed more experience? The ideas behind Actively Open-minded Thinking (AOT) can allow anyone to experience from different lenses, and learn better from a different perspective. There's been a long debate of whether people think more rationally than others. A study was found afterwards that those with a strong disposition to think reflectively, and use all their cognitive skills to think things through, tend to display good reasoning, as apposed to those who have a lower strive for thinking, therefore displaying poorer reasoning (Satnovich, 2009). {{RoundBoxTop|theme=1}}Focus questions *How can AOT be used *What are the benifits *What are the disadvanatges *Can AOT be of use in most cases{{RoundBoxBottom}} ==Actively Open-minded Thinking== === What is it === Actively open-minded thinking (AOT) is one of several thinking styles, or thinking dispositions, suggested to play an important role for how humans reason. {{tip|Suggestions for this section: * For the [[Motivation and emotion/Assessment/Topic|topic development]], provide at least 3 bullet-points about key content per section. Include key citations. * For the [[Motivation and emotion/Assessment/Chapter|book chapter]], expand the bullet points into paragraphs. * If a section has a lot of content, arrange it into two to five sub-headings such as in the [[#Interactive learning features|interactive learning features section]]. Avoid having sections with only one sub-heading. }} ==Learning features== What brings an online book chapter to life are its interactive learning features. Case studies, feature boxes, figures, links, tables, and quiz questions can be used throughout the chapter. ===Case studies=== Case studies describe real-world examples of concepts in action. Case studies can be real or fictional. A case could be used multiple times during a chapter to illustrate different theories or stages. It is often helpful to present case studies using [[#Feature boxes|feature boxes]]. ===Boxes=== Boxes can be used to highlight content, but don't overuse them. There are many different ways of creating boxes (e.g., see [[Help:Pretty boxes|Pretty boxes]]). Possible uses include: * Focus questions * Case studies or examples * Quiz questions * Take-home messages {{RoundBoxTop|theme=3}} ;Feature box example * Shaded background * Coloured border {{RoundBoxBottom}} ===Figures=== [[File:Monkey-typing.jpg|right|205px|thumb|''Figure 1''. Example image with descriptive caption.]] Use figures to illustrate concepts, add interest, and provide examples. Figures can be used to show photographs, drawings, diagrams, graphs, etcetera. Figures can be embedded throughout the chapter, starting with the Overview section. Figures should be captioned (using a number and a description) in order to explain their relevance to the text. Possible images can be found at [[commons:|Wikimedia Commons]]. Images can also be uploaded if they are licensed for re-use or if you created the image. Each figure should be referred to at least once in the main text (e.g., see Figure 1). ===Links=== Where key words are first used, make them into [[Help:Links|interwiki links]] such as Wikipedia links to articles about famous people (e.g., [[w:Sigmund Freud|Sigmund Freud]] and key concepts (e.g., [[w:Dreams|dreams]]) and links to book chapters about related topics (e.g., would you like to learn about how to overcome [[Motivation and emotion/Book/2020/Writer's block|writer's block]]?). ===Tables=== Tables can be an effective way to organise and summarise information. Tables should be captioned (using APA style) to explain their relevance to the text. Plus each table should be referred to at least once in the main text (e.g., see Table 1 and Table 2). Here are some [[Motivation and emotion/Wikiversity/Tables|example 3 x 3 tables]] which could be adapted. ===Quizzes=== Quizzes are a direct way to engage readers. But don't make quizzes too hard or long. It is better to have one or two review questions per major section than a long quiz at the end. Try to quiz conceptual understanding, rather than trivia. Here are some simple quiz questions which could be adapted. Choose the correct answers and click "Submit": <quiz display=simple> {Quizzes are an interactive learning feature: |type="()"} + True - False {Long quizzes are a good idea: |type="()"} - True + False </quiz> To learn about different types of quiz questions, see [[Help:Quiz|Quiz]]. ==Conclusion== The Conclusion is arguably the most important section. It should be possible for someone to read the [[#Overview|Overview]] and the Conclusion and still get a good idea of the topic. {{tip|Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? }} ==See also== Provide up to half-a-dozen [[Help:Contents/Links#Interwiki_links|internal (wiki) links]] to relevant Wikiversity pages (esp. related [[Motivation and emotion/Book|motivation and emotion book chapters]]) and [[w:|Wikipedia articles]]. For example: * [[Motivation and emotion/Book/2016/Anorexia nervosa and extrinsic motivation|Anorexia nervosa and extrinsic motivation]] (Book chapter, 2016) * [[w:David McClelland|David McClelland]] (Wikipedia) * [[Motivation and emotion/Book/2018/Loss aversion|Loss aversion]] (Book chapter, 2018) * [[w:Maslow's hierarchy of needs|Maslow's hierarchy of needs]] (Wikipedia) {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== List the cited references in [[w:APA style|APA style]] (7th ed.) or [[w:Wikipedia:Citing sources|wiki style]]. APA style example: {{Hanging indent|1= Blair, R. J. R. (2004). The roles of orbital frontal cortex in the modulation of antisocial behavior. ''Brain and Cognition'', ''55''(1), 198–208. https://doi.org/10.1016/S0278-2626(03)00276-8 Buckholtz, J. W., & Meyer-Lindenberg, A. (2008). MAOA and the neurogenetic architecture of human aggression. ''Trends in Neurosciences'', ''31''(3), 120–129. https://doi.org/10.1016/j.tins.2007.12.006 Eckardt, M., File, S., Gessa, G., Grant, K., Guerri, C., Hoffman, P., & Tabakoff, B. (1998). Effects of moderate alcohol consumption on the central nervous system. ''Alcoholism, Clinical and Experimental Research'', ''22''(5), 998–1040. https://doi.org/10.1111/j.1530-0277.1998.tb03695.x }} {{tip|Suggestions for this section: * Important aspects for APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except first letter and proper names, ending in a full-stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full-stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't actually read or consulted }} ==External links== Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * [https://students.unimelb.edu.au/academic-skills/explore-our-resources/essay-writing/six-top-tips-for-writing-a-great-essay Six top tips for writing a great essay] (University of Melbourne) * [http://www.skillsyouneed.com/write/structure.html The importance of structure] (skillsyouneed.com) {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] 4hcid1qgwcgkyr1890onqjjm4drnoea 2419301 2419292 2022-08-26T05:26:10Z Teermeej Hossain 2948258 wikitext text/x-wiki {{title|Actively open-minded theory:<br>How can AOT be used to improve human performance?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== Are you feeling stuck in your current situation, and not improving further? Has your weakness ever been that you needed more experience? The ideas behind Actively Open-minded Thinking (AOT) can allow anyone to experience from different lenses, and learn better from a different perspective. There's been a long debate of whether people think more rationally than others. A study was found afterwards that those with a strong disposition to think reflectively, and use all their cognitive skills to think things through, tend to display good reasoning, as apposed to those who have a lower strive for thinking, therefore displaying poorer reasoning (Satnovich, 2009). {{RoundBoxTop|theme=1}}Focus questions *How can AOT be used *What are the benifits *What are the disadvanatges *Can AOT be of use in most cases{{RoundBoxBottom}} ==Actively Open-minded Thinking== === What is it === Actively open-minded thinking (AOT) is one of several thinking styles, or thinking dispositions, suggested to play an important role for how humans reason. {{tip|Suggestions for this section: * For the [[Motivation and emotion/Assessment/Topic|topic development]], provide at least 3 bullet-points about key content per section. Include key citations. * For the [[Motivation and emotion/Assessment/Chapter|book chapter]], expand the bullet points into paragraphs. * If a section has a lot of content, arrange it into two to five sub-headings such as in the [[#Interactive learning features|interactive learning features section]]. Avoid having sections with only one sub-heading. }} ==Learning features== What brings an online book chapter to life are its interactive learning features. Case studies, feature boxes, figures, links, tables, and quiz questions can be used throughout the chapter. ===Case studies=== Case studies describe real-world examples of concepts in action. Case studies can be real or fictional. A case could be used multiple times during a chapter to illustrate different theories or stages. It is often helpful to present case studies using [[#Feature boxes|feature boxes]]. ===Boxes=== Boxes can be used to highlight content, but don't overuse them. There are many different ways of creating boxes (e.g., see [[Help:Pretty boxes|Pretty boxes]]). Possible uses include: * Focus questions * Case studies or examples * Quiz questions * Take-home messages {{RoundBoxTop|theme=3}} ;Feature box example * Shaded background * Coloured border {{RoundBoxBottom}} ===Figures=== [[File:Monkey-typing.jpg|right|205px|thumb|''Figure 1''. Example image with descriptive caption.]] Use figures to illustrate concepts, add interest, and provide examples. Figures can be used to show photographs, drawings, diagrams, graphs, etcetera. Figures can be embedded throughout the chapter, starting with the Overview section. Figures should be captioned (using a number and a description) in order to explain their relevance to the text. Possible images can be found at [[commons:|Wikimedia Commons]]. Images can also be uploaded if they are licensed for re-use or if you created the image. Each figure should be referred to at least once in the main text (e.g., see Figure 1). ===Links=== Where key words are first used, make them into [[Help:Links|interwiki links]] such as Wikipedia links to articles about famous people (e.g., [[w:Sigmund Freud|Sigmund Freud]] and key concepts (e.g., [[w:Dreams|dreams]]) and links to book chapters about related topics (e.g., would you like to learn about how to overcome [[Motivation and emotion/Book/2020/Writer's block|writer's block]]?). ===Tables=== Tables can be an effective way to organise and summarise information. Tables should be captioned (using APA style) to explain their relevance to the text. Plus each table should be referred to at least once in the main text (e.g., see Table 1 and Table 2). Here are some [[Motivation and emotion/Wikiversity/Tables|example 3 x 3 tables]] which could be adapted. ===Quizzes=== Quizzes are a direct way to engage readers. But don't make quizzes too hard or long. It is better to have one or two review questions per major section than a long quiz at the end. Try to quiz conceptual understanding, rather than trivia. Here are some simple quiz questions which could be adapted. Choose the correct answers and click "Submit": <quiz display=simple> {Quizzes are an interactive learning feature: |type="()"} + True - False {Long quizzes are a good idea: |type="()"} - True + False </quiz> To learn about different types of quiz questions, see [[Help:Quiz|Quiz]]. ==Conclusion== The Conclusion is arguably the most important section. It should be possible for someone to read the [[#Overview|Overview]] and the Conclusion and still get a good idea of the topic. {{tip|Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? }} ==See also== Provide up to half-a-dozen [[Help:Contents/Links#Interwiki_links|internal (wiki) links]] to relevant Wikiversity pages (esp. related [[Motivation and emotion/Book|motivation and emotion book chapters]]) and [[w:|Wikipedia articles]]. For example: * [[Motivation and emotion/Book/2016/Anorexia nervosa and extrinsic motivation|Anorexia nervosa and extrinsic motivation]] (Book chapter, 2016) * [[w:David McClelland|David McClelland]] (Wikipedia) * [[Motivation and emotion/Book/2018/Loss aversion|Loss aversion]] (Book chapter, 2018) * [[w:Maslow's hierarchy of needs|Maslow's hierarchy of needs]] (Wikipedia) {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== List the cited references in [[w:APA style|APA style]] (7th ed.) or [[w:Wikipedia:Citing sources|wiki style]]. APA style example: {{Hanging indent|1= Blair, R. J. R. (2004). The roles of orbital frontal cortex in the modulation of antisocial behavior. ''Brain and Cognition'', ''55''(1), 198–208. https://doi.org/10.1016/S0278-2626(03)00276-8 Buckholtz, J. W., & Meyer-Lindenberg, A. (2008). MAOA and the neurogenetic architecture of human aggression. ''Trends in Neurosciences'', ''31''(3), 120–129. https://doi.org/10.1016/j.tins.2007.12.006 Eckardt, M., File, S., Gessa, G., Grant, K., Guerri, C., Hoffman, P., & Tabakoff, B. (1998). Effects of moderate alcohol consumption on the central nervous system. ''Alcoholism, Clinical and Experimental Research'', ''22''(5), 998–1040. https://doi.org/10.1111/j.1530-0277.1998.tb03695.x }} {{tip|Suggestions for this section: * Important aspects for APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except first letter and proper names, ending in a full-stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full-stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't actually read or consulted }} ==External links== Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * [https://students.unimelb.edu.au/academic-skills/explore-our-resources/essay-writing/six-top-tips-for-writing-a-great-essay Six top tips for writing a great essay] (University of Melbourne) * [http://www.skillsyouneed.com/write/structure.html The importance of structure] (skillsyouneed.com) {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] b7xtgz03rknzdl86bkh3vdybnmz7d4n 2 286460 2419054 2418254 2022-08-25T12:24:48Z ArtOfHappiness 2947543 /* Social contribution */ wikitext text/x-wiki == About me == Hey , I am Manav (pronounced "Maanav"/Mɑnʌv, meaning "human" , मानव) . [[File:Manav Profile Pic.jpg|thumb|220x220px|A better version of me.]] For as long as I can remember, I knew that I wanted to make a difference in the world. I knew that the first step was to attend an accredited university, and that university happened to be '''[https://www.canberra.edu.au/about-uc University of Canberra]'''. I am an aspiring Psychologist & COVID19 Response Public Health Support Officer with a positive attitude contributing to the national response to the pandemic. I have extensive experience working with people in various fields of hospitality, construction, public transport, and information awareness.  Looking for a rewarding career that truly makes a difference in people's lives with a high level of passion and energy that motivates others. I volunteer with '''[https://mieact.org.au/ MIEACT]''', '''[https://reachoutcanberra.com.au/ Reach Out Canberra]''' and '''[https://www.lifeline.org.au/ Lifeline]'''. === Interests === * Cooking * Painting * Woodworking * Photography === Qualification === * Bachelor of Engineering - Chemical (1996) * Master of International Business (2000) * Bachelor of Science in Psychology (2022) * Certificate IV in Mental Health (2022) === My book chapter === As part of [[Motivation and emotion|Motivation and Emotion]] unit , I am currently working on the [[Motivation and emotion/Book/2022/Workplace mental health training|Workplace mental health training]] chapter. We spend one-third of our adult lives working, workplace mental health and well-being are inextricably linked to our overall wellness. As the world faces a mental health crisis, workplaces around the world are changing workplace culture by raising awareness. Check out my book chapter on [[Motivation and emotion/Book/2022/Workplace mental health training|Workplace mental health training]] if you want to learn more about what techniques are currently used for workplace mental health training and their impact on achieving mental wellbeing. I'd love to hear any suggestions or feedback you have for improving the chapter. Please feel free to edit, comment, and provide feedback on the chapter throughout the semester. == Books i recommend to inspire your reading == * [https://www.goodreads.com/book/show/11468377-thinking-fast-and-slow?from_search=true&from_srp=true&qid=R2RZ0XaBga&rank=1 Thinking, Fast and Slow] - Daniel Kahneman * [https://www.amazon.com/Power-Positive-Thinking-Norman-Vincent/dp/0743234804 The Power of Positive Thinking] - Dr. Norman Vincent Peale * [https://www.booktopia.com.au/if-you-re-so-smart-why-aren-t-you-happy-raj-raghunathan/book/9781785040412.html?source=pla&gclid=Cj0KCQjw9ZGYBhCEARIsAEUXITVOMM23eEpJjbGP6Qp7jWUFiFQEZ5CehtPrBy1UsAX9jQ1bOyqnH_waAt7jEALw_wcB If You're So Smart, Why Aren't You Happy?] - Raj Raghunathan * [https://www.google.com.au/books/edition/Don_t_Believe_Everything_You_Think/_puVf0woEosC?hl=en&gbpv=1&printsec=frontcover Don't Believe Everything You Think] - Thomas Edward Kida == Social contribution == === Wikiversity === * [https://en.wikiversity.org/w/index.php?title=Motivation_and_emotion%2FBook%2F2020%2FWorkplace_mental_health&type=revision&diff=2417707&oldid=2379266 05:49, 23 August 2022 - Provided definition of workplace mental health and fixed grammatical errors on 2020 Book Chapter -Workplace mental health.] * [https://en.wikiversity.org/w/index.php?title=Happiness%2FHave_a_Happy_Job&type=revision&diff=2417942&oldid=1582285 15:20, 23 August 2022 - Fixed grammer on Wikiversity page on Happiness/Have a Happy Job .] == External links == * [https://portfolio.canberra.edu.au/view/view.php?t=jT6aDSZ7UsGnLdeqRyYg e-Portfolio] * [https://www.linkedin.com/in/manav-porwal-79b8a26/?originalSubdomain=au LinkedIn Profile] k5r6w0oybatmk7go6l7yxp2cr08ukim 2 286519 2419288 2416139 2022-08-26T05:10:43Z WUser1307 2948261 /* Social Contribtion */ wikitext text/x-wiki == About me == I am studying a psychology degree at the University of Canberra. == Hobbies == My dog Theo Drinking Wine Making candles == Book Chapter == ERG Theory == Book Chapter == providing online feedback about the development of at least one other chapter cet72a6owpe0q6gu5aq8k6qc7v85che 2419289 2419288 2022-08-26T05:11:30Z WUser1307 2948261 /* Book Chapter */ wikitext text/x-wiki == About me == I am studying a psychology degree at the University of Canberra. == Hobbies == My dog Theo Listening to music Making candles == Book Chapter == ERG Theory == Social Component == providing online feedback about the development of at least one other chapter c3j5d3ebb83iacr1zckznw0em6acw6b 2419290 2419289 2022-08-26T05:12:29Z WUser1307 2948261 /* Book Chapter */ wikitext text/x-wiki == About me == I am studying a psychology degree at the University of Canberra. == Hobbies == My dog Theo Listening to music Making candles == Book Chapter == [[Motivation and emotion/Book/2022/ERG theory]] == Social Component == providing online feedback about the development of at least one other chapter p4xy4wcap1hwuyw32qtalkk4p2ou6lu 2419308 2419290 2022-08-26T05:31:47Z WUser1307 2948261 /* Social Component */ wikitext text/x-wiki == About me == I am studying a psychology degree at the University of Canberra. == Hobbies == [[File:LED Candles.jpg|thumb|Figure 1. Candles]] My dog Theo Listening to music Making candles == Book Chapter == [[Motivation and emotion/Book/2022/ERG theory]] == Social Component == Feedback for (Nature Therapy: What is nature therapy and how can it be applied?) https://unicanberra.instructure.com/courses/11508/pages/assessment The depth of content that they want to achieve is a great start. My constructive feedback would involve making the headings clearer in what they want the audience to focus on. Currently there are too many headings which are bold, which may be hard to read, i would select a couple, then make the rest sub categories in order to filter the text in a better way. In addition, it seems there is a case study for every single heading, i would take out a couple of case study's in order to make room for more in-depth case studies rather than a lot of smaller ones. This will allow the audience to get a more in-depth and better sense of the theory and research behind the topic Overall, well done! 046ftjf21o33l3qneruar6ecnaht62i 2 286521 2419435 2416066 2022-08-26T09:20:33Z Alec.cortez 2947555 /* Social contribution */ wikitext text/x-wiki == About me == ''I am'' Alec. I was born in ¹⁹⁷⁸. I am learning how to use wiki. '''BOLD.''' * 3rd year science of [[w:Psychology|psychology]] student at the [https://www.canberra.edu.au/ University of Canberra] * lived in Canberra my whole life * My unit in semester two, 2022 is [[motivation and emotion]] === Hobbies/past times === Travel, Netflix, walking, mobile games == Book chapter I am working on == [[Motivation and emotion/Book/2022/Hypomania and emotion|hypomania and emotion]] == Social contribution == [[Motivation and emotion/Book/2020/Hypomania and motivation|Overview section: added a question mark and capitalised letter]] (Hypomania, book chapter 2020) couczc268d1n06p2qhx4hc2sz1hs2lv 2 286544 2419134 2418264 2022-08-25T23:45:44Z U3200859 2947964 /* Hobbies */ wikitext text/x-wiki == About me == Hello and welcome to my page! My name is Zoe and I am a student at the [https://www.canberra.edu.au/ University of Canberra]. I am studying a double degree of [[wikipedia:Psychology|Psychology]] and [[wikipedia:Business|Business]] while on a working holiday in Byron Bay. This semester I am enrolled in [[Motivation and emotion|Motivation and Emotion]] and am looking forward to learning about this subject over the next few months. === Hobbies === In my spare time when I am not working between my two jobs or studying, you will find me either walking along the beach or catching up with my best friend [[User:GeorgiaFairweather|Georgia]] who is also enrolled in this unit. My interests include: * Walking my dog, Molly * Listening to the Happy Hour Podcast * Going to the beach == Book Chapter == The book chapter that I am working on is [[Motivation and emotion/Book/2022/Honesty motivation|honesty motivation]] == Social Contributions == i7mf3oxhviuejtqbupwyg22kedlv9cb 0 286548 2419323 2418078 2022-08-26T05:59:55Z U3215976 2947554 wikitext text/x-wiki {{title|Social Cure:<br>What is the social cure and how can it be applied?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ =='''Overview'''== You are underway {{smile}}! This template provides tips for [[Motivation and emotion/Assessment/Topic|topic development]]. Gradually remove these suggestions as you develop the chapter. Also consult the [[Motivation and emotion/Assessment/Chapter|author guidelines]]. At the top of the chapter, the title and sub-title should match the ''exact'' wording and casing as shown in the {{Motivation and emotion/Book}}. The sub-titles all end with a question mark. This Overview section should be concise but consist of several paragraphs which engage the reader, illustrate the problem, and outline how psychological science can help. {{RoundBoxTop|theme=3}} '''Focus questions:''' * What is the first focus question? * What is the second focus question? * What is the third focus question? {{RoundBoxBottom}}In today's modern society, many factors are present that can affect our physical and mental health. Factors include bullying, [[File:-Friends Forever -Life Long -Friends 4 life -Together -Friends -Reunion -Memories.jpg|thumb|''Figure'' 1. Group of Friends]]low-socioeconomic status leading to poor health choices such as smoking and drinking, psychological determinants such as anxiety and depression and many more. ''Social Cure'' seeks to alleviate many of these potential problems by illustrating the usefulness and effectiveness of social support for individuals. This book chapter seeks to identify the ways in which social cure can be an effective way of bolstering physical and mental health and wellbeing.{{tip| Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Provide an example or case study. * Conclude with Focus questions to guide the chapter. }} == '''Social Cure''' == How you are going to structure the chapter? Aim for three to six main headings between the [[#Overview|Overview]] and [[#Conclusion|Conclusion]]. === Dynamics of Social Cure === Theory: Research: Application/examples: * Increased social activity/interaction positively effecting mental health and wellbeing - (Jetten et al, 2017). * === '''Importance of Groups''' === Theory: Research: Application/examples: === '''Social Networking''' === Theory: Research: Application/examples:{{tip|Suggestions for this section: * For the [[Motivation and emotion/Assessment/Topic|topic development]], provide at least 3 bullet-points about key content per section. Include key citations. * For the [[Motivation and emotion/Assessment/Chapter|book chapter]], expand the bullet points into paragraphs. * If a section has a lot of content, arrange it into two to five sub-headings such as in the [[#Interactive learning features|interactive learning features section]]. Avoid having sections with only one sub-heading. }} ==Learning features== What brings an online book chapter to life are its interactive learning features. Case studies, feature boxes, figures, links, tables, and quiz questions can be used throughout the chapter. ===Case studies=== Case studies describe real-world examples of concepts in action. Case studies can be real or fictional. A case could be used multiple times during a chapter to illustrate different theories or stages. It is often helpful to present case studies using [[#Feature boxes|feature boxes]]. ===Boxes=== Boxes can be used to highlight content, but don't overuse them. There are many different ways of creating boxes (e.g., see [[Help:Pretty boxes|Pretty boxes]]). Possible uses include: * Focus questions * Case studies or examples * Quiz questions * Take-home messages {{RoundBoxTop|theme=3}} ;Feature box example * Shaded background * Coloured border {{RoundBoxBottom}} ===Figures=== [[File:Monkey-typing.jpg|right|205px|thumb|''Figure 1''. Example image with descriptive caption.]] Use figures to illustrate concepts, add interest, and provide examples. Figures can be used to show photographs, drawings, diagrams, graphs, etcetera. Figures can be embedded throughout the chapter, starting with the Overview section. Figures should be captioned (using a number and a description) in order to explain their relevance to the text. Possible images can be found at [[commons:|Wikimedia Commons]]. Images can also be uploaded if they are licensed for re-use or if you created the image. Each figure should be referred to at least once in the main text (e.g., see Figure 1). ===Links=== Where key words are first used, make them into [[Help:Links|interwiki links]] such as Wikipedia links to articles about famous people (e.g., [[w:Sigmund Freud|Sigmund Freud]] and key concepts (e.g., [[w:Dreams|dreams]]) and links to book chapters about related topics (e.g., would you like to learn about how to overcome [[Motivation and emotion/Book/2020/Writer's block|writer's block]]?). ===Tables=== Tables can be an effective way to organise and summarise information. Tables should be captioned (using APA style) to explain their relevance to the text. Plus each table should be referred to at least once in the main text (e.g., see Table 1 and Table 2). Here are some [[Motivation and emotion/Wikiversity/Tables|example 3 x 3 tables]] which could be adapted. ===Quizzes=== Quizzes are a direct way to engage readers. But don't make quizzes too hard or long. It is better to have one or two review questions per major section than a long quiz at the end. Try to quiz conceptual understanding, rather than trivia. Here are some simple quiz questions which could be adapted. Choose the correct answers and click "Submit": <quiz display=simple> {Quizzes are an interactive learning feature: |type="()"} + True - False {Long quizzes are a good idea: |type="()"} - True + False </quiz> To learn about different types of quiz questions, see [[Help:Quiz|Quiz]]. ==Conclusion== The Conclusion is arguably the most important section. It should be possible for someone to read the [[#Overview|Overview]] and the Conclusion and still get a good idea of the topic. {{tip|Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? }} ==See also== Provide up to half-a-dozen [[Help:Contents/Links#Interwiki_links|internal (wiki) links]] to relevant Wikiversity pages (esp. related [[Motivation and emotion/Book|motivation and emotion book chapters]]) and [[w:|Wikipedia articles]]. For example: * [[Motivation and emotion/Book/2016/Anorexia nervosa and extrinsic motivation|Anorexia nervosa and extrinsic motivation]] (Book chapter, 2016) * [[w:David McClelland|David McClelland]] (Wikipedia) * [[Motivation and emotion/Book/2018/Loss aversion|Loss aversion]] (Book chapter, 2018) * [[w:Maslow's hierarchy of needs|Maslow's hierarchy of needs]] (Wikipedia) * [[Mental health|Mental Health]] (Wikipedia) {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== {{Hanging indent|1= Currie, C., Zanotti, C., Morgan, A., Currie, D., De Looze, M., Roberts, C., Samdal, O., Smith, O. R., & Barnekow, V. (2009). Social determinants of health and well-being among young people. Health Behaviour in School-aged Children (HBSC) study: international report from the, 2010, 271. [https://d1wqtxts1xzle7.cloudfront.net/39900069/Social_determinants_of_health_and_well-b20151111-27604-w42wjb-with-cover-page-v2.pdf?Expires=1661148517&Signature=hG-B6MV1OU2j9Et0tU2yTeQ4ye1~FfSbJF783dpZC5v3CjDVVrlzLGXWKFOw58R6Lwt~4mfP3l3D5ixHOKRz5zVIv1DG5GLFpRBy0-fvyab90PhRaZ97Mi-0z0kQxZ9yl5AVpFHxpcrw2-u-R~DnPpkXg2nt4LBUatVcQcvNOClO6lSmUroQ2PASg9FNmHDBR03JNNlIGhqr62KoBjPyyZSUS~DXZE~D69dnFLqLRWvGCoMP1c0pJRM0DW3QmmNI1tZzrdY1HrllFK-Yky2YLn8TkS5KRcWLRYfqYrKg5od5vQqUKO6xg4IRAJk7Sw~A3iOohm6blOGoMnSNWKopyQ__&Key-Pair-Id=APKAJLOHF5GGSLRBV4ZA] Jetten, J., Haslam, S. A., Cruwys, T., Greenaway, K. H., Haslam, C., & Steffens, N. K. (2017). Advancing the social identity approach to health and well‐being: Progressing the social cure research agenda. European journal of social psychology, 47(7), 789-802. https://doi.org/10.1002/ejsp.2333 Hajak, V. L., Sardana, S., Verdeli, H., & Grimm, S. (2021). A systematic review of factors affecting mental health and well-being of asylum seekers and refugees in Germany. Frontiers in psychiatry, 12, 643704. https://www.frontiersin.org/articles/10.3389/fpsyt.2021.643704/full }} ==External links== Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * [https://students.unimelb.edu.au/academic-skills/explore-our-resources/essay-writing/six-top-tips-for-writing-a-great-essay Six top tips for writing a great essay] (University of Melbourne) * [http://www.skillsyouneed.com/write/structure.html The importance of structure] (skillsyouneed.com) * [https://www.researchgate.net/profile/Jolanda-Jetten/publication/247446655_The_Social_Cure/links/58d0b571a6fdcc344b0c1364/The-Social-Cure.pdf The Social Cure] (Book by Jolanda Jetten) {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] j518syopewg7esi0i7fykhuyq2vz60c 2419325 2419323 2022-08-26T06:21:16Z U3215976 2947554 wikitext text/x-wiki {{title|Social Cure:<br>What is the social cure and how can it be applied?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ =='''Overview'''== You are underway {{smile}}! This template provides tips for [[Motivation and emotion/Assessment/Topic|topic development]]. Gradually remove these suggestions as you develop the chapter. Also consult the [[Motivation and emotion/Assessment/Chapter|author guidelines]]. At the top of the chapter, the title and sub-title should match the ''exact'' wording and casing as shown in the {{Motivation and emotion/Book}}. The sub-titles all end with a question mark. This Overview section should be concise but consist of several paragraphs which engage the reader, illustrate the problem, and outline how psychological science can help. {{RoundBoxTop|theme=3}} '''Focus questions:''' * What is the first focus question? * What is the second focus question? * What is the third focus question? {{RoundBoxBottom}}In today's modern society, many factors are present that can affect our physical and mental health. Factors include bullying, [[File:-Friends Forever -Life Long -Friends 4 life -Together -Friends -Reunion -Memories.jpg|thumb|''Figure'' 1. Group of Friends]]low-socioeconomic status leading to poor health choices such as smoking and drinking, psychological determinants such as anxiety and depression and many more. ''Social Cure'' seeks to alleviate many of these potential problems by illustrating the usefulness and effectiveness of social support for individuals. This book chapter seeks to identify the ways in which social cure can be an effective way of bolstering physical and mental health and wellbeing.{{tip| Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Provide an example or case study. * Conclude with Focus questions to guide the chapter. }} == '''Social Cure''' == How you are going to structure the chapter? Aim for three to six main headings between the [[#Overview|Overview]] and [[#Conclusion|Conclusion]]. === Dynamics of Social Cure === Theory: * Social Identity Theory Research: * Increased social activity/interaction positively effecting mental health and wellbeing - (Jetten et al, 2017). * Meta-analytic research indicates that social support and social integration are highly protective against mortality - (Haslam et al, 2017) Application/examples: * === '''Importance of Groups''' === Theory: Research: Application/examples: === '''Social Networking''' === Theory: Research: Application/examples:{{tip|Suggestions for this section: * For the [[Motivation and emotion/Assessment/Topic|topic development]], provide at least 3 bullet-points about key content per section. Include key citations. * For the [[Motivation and emotion/Assessment/Chapter|book chapter]], expand the bullet points into paragraphs. * If a section has a lot of content, arrange it into two to five sub-headings such as in the [[#Interactive learning features|interactive learning features section]]. Avoid having sections with only one sub-heading. }} == '''How can Social Cure be Applied?''' == === '''Applications for adolescents''' === Theory: Research: Application/examples: === '''Applications for Adults''' === Theory: Research: Application/examples: ==Learning features== What brings an online book chapter to life are its interactive learning features. Case studies, feature boxes, figures, links, tables, and quiz questions can be used throughout the chapter. ===Case studies=== Case studies describe real-world examples of concepts in action. Case studies can be real or fictional. A case could be used multiple times during a chapter to illustrate different theories or stages. It is often helpful to present case studies using [[#Feature boxes|feature boxes]]. ===Boxes=== Boxes can be used to highlight content, but don't overuse them. There are many different ways of creating boxes (e.g., see [[Help:Pretty boxes|Pretty boxes]]). Possible uses include: * Focus questions * Case studies or examples * Quiz questions * Take-home messages {{RoundBoxTop|theme=3}} ;Feature box example * Shaded background * Coloured border {{RoundBoxBottom}} ===Figures=== [[File:Monkey-typing.jpg|right|205px|thumb|''Figure 1''. Example image with descriptive caption.]] Use figures to illustrate concepts, add interest, and provide examples. Figures can be used to show photographs, drawings, diagrams, graphs, etcetera. Figures can be embedded throughout the chapter, starting with the Overview section. Figures should be captioned (using a number and a description) in order to explain their relevance to the text. Possible images can be found at [[commons:|Wikimedia Commons]]. Images can also be uploaded if they are licensed for re-use or if you created the image. Each figure should be referred to at least once in the main text (e.g., see Figure 1). ===Links=== Where key words are first used, make them into [[Help:Links|interwiki links]] such as Wikipedia links to articles about famous people (e.g., [[w:Sigmund Freud|Sigmund Freud]] and key concepts (e.g., [[w:Dreams|dreams]]) and links to book chapters about related topics (e.g., would you like to learn about how to overcome [[Motivation and emotion/Book/2020/Writer's block|writer's block]]?). ===Tables=== Tables can be an effective way to organise and summarise information. Tables should be captioned (using APA style) to explain their relevance to the text. Plus each table should be referred to at least once in the main text (e.g., see Table 1 and Table 2). Here are some [[Motivation and emotion/Wikiversity/Tables|example 3 x 3 tables]] which could be adapted. ===Quizzes=== Quizzes are a direct way to engage readers. But don't make quizzes too hard or long. It is better to have one or two review questions per major section than a long quiz at the end. Try to quiz conceptual understanding, rather than trivia. Here are some simple quiz questions which could be adapted. Choose the correct answers and click "Submit": <quiz display=simple> {Quizzes are an interactive learning feature: |type="()"} + True - False {Long quizzes are a good idea: |type="()"} - True + False </quiz> To learn about different types of quiz questions, see [[Help:Quiz|Quiz]]. ==Conclusion== The Conclusion is arguably the most important section. It should be possible for someone to read the [[#Overview|Overview]] and the Conclusion and still get a good idea of the topic. {{tip|Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? }} ==See also== Provide up to half-a-dozen [[Help:Contents/Links#Interwiki_links|internal (wiki) links]] to relevant Wikiversity pages (esp. related [[Motivation and emotion/Book|motivation and emotion book chapters]]) and [[w:|Wikipedia articles]]. For example: * [[Motivation and emotion/Book/2016/Anorexia nervosa and extrinsic motivation|Anorexia nervosa and extrinsic motivation]] (Book chapter, 2016) * [[w:David McClelland|David McClelland]] (Wikipedia) * [[Motivation and emotion/Book/2018/Loss aversion|Loss aversion]] (Book chapter, 2018) * [[w:Maslow's hierarchy of needs|Maslow's hierarchy of needs]] (Wikipedia) * [[Mental health|Mental Health]] (Wikipedia) {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== {{Hanging indent|1= Currie, C., Zanotti, C., Morgan, A., Currie, D., De Looze, M., Roberts, C., Samdal, O., Smith, O. R., & Barnekow, V. (2009). Social determinants of health and well-being among young people. Health Behaviour in School-aged Children (HBSC) study: international report from the, 2010, 271. [https://d1wqtxts1xzle7.cloudfront.net/39900069/Social_determinants_of_health_and_well-b20151111-27604-w42wjb-with-cover-page-v2.pdf?Expires=1661148517&Signature=hG-B6MV1OU2j9Et0tU2yTeQ4ye1~FfSbJF783dpZC5v3CjDVVrlzLGXWKFOw58R6Lwt~4mfP3l3D5ixHOKRz5zVIv1DG5GLFpRBy0-fvyab90PhRaZ97Mi-0z0kQxZ9yl5AVpFHxpcrw2-u-R~DnPpkXg2nt4LBUatVcQcvNOClO6lSmUroQ2PASg9FNmHDBR03JNNlIGhqr62KoBjPyyZSUS~DXZE~D69dnFLqLRWvGCoMP1c0pJRM0DW3QmmNI1tZzrdY1HrllFK-Yky2YLn8TkS5KRcWLRYfqYrKg5od5vQqUKO6xg4IRAJk7Sw~A3iOohm6blOGoMnSNWKopyQ__&Key-Pair-Id=APKAJLOHF5GGSLRBV4ZA] Hajak, V. L., Sardana, S., Verdeli, H., & Grimm, S. (2021). A systematic review of factors affecting mental health and well-being of asylum seekers and refugees in Germany. Frontiers in psychiatry, 12, 643704. https://www.frontiersin.org/articles/10.3389/fpsyt.2021.643704/full Haslam, S., McMahon, C., Cruwys, T., Haslam, C., Jetten, J., & Steffens, N. K. (2017). Social cure, what social cure? The propensity to underestimate the importance of social factors for health. Social Science & Medicine, 198. https://doi.org/10.1016/j.socscimed.2017.12.020 Jetten, J., Haslam, S. A., Cruwys, T., Greenaway, K. H., Haslam, C., & Steffens, N. K. (2017). Advancing the social identity approach to health and well‐being: Progressing the social cure research agenda. European journal of social psychology, 47(7), 789-802. https://doi.org/10.1002/ejsp.2333 }} ==External links== Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * [https://students.unimelb.edu.au/academic-skills/explore-our-resources/essay-writing/six-top-tips-for-writing-a-great-essay Six top tips for writing a great essay] (University of Melbourne) * [http://www.skillsyouneed.com/write/structure.html The importance of structure] (skillsyouneed.com) * [https://www.researchgate.net/profile/Jolanda-Jetten/publication/247446655_The_Social_Cure/links/58d0b571a6fdcc344b0c1364/The-Social-Cure.pdf The Social Cure] (Book by Jolanda Jetten) {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] kib3heyhyyvh1sfr2655womr8rye1v3 2419353 2419325 2022-08-26T07:18:19Z U3215976 2947554 /* Overview */ wikitext text/x-wiki {{title|Social Cure:<br>What is the social cure and how can it be applied?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ =='''Overview'''== You are underway {{smile}}! This template provides tips for [[Motivation and emotion/Assessment/Topic|topic development]]. Gradually remove these suggestions as you develop the chapter. Also consult the [[Motivation and emotion/Assessment/Chapter|author guidelines]]. At the top of the chapter, the title and sub-title should match the ''exact'' wording and casing as shown in the {{Motivation and emotion/Book}}. The sub-titles all end with a question mark. This Overview section should be concise but consist of several paragraphs which engage the reader, illustrate the problem, and outline how psychological science can help. {{RoundBoxTop|theme=3}} '''Focus questions:''' * What is the social cure? * How can the social cure be applied? * What are the benefits of social interactions?{{RoundBoxBottom}}In today's modern society, many factors are present that can affect our physical and mental health. Factors include bullying, low-socioeconomic status leading to poor health choices such as smoking and drinking, psychological determinants such as anxiety and depression and many more. ''Social Cure'' seeks to alleviate many of these potential problems by illustrating the usefulness and effectiveness of social support for individuals. This book chapter seeks to identify the ways in which social cure can be an effective way of bolstering physical and mental health and wellbeing.[[File:-Friends Forever -Life Long -Friends 4 life -Together -Friends -Reunion -Memories.jpg|thumb|''Figure'' 1. Group of Friends|center|218x218px]]{{tip| Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Provide an example or case study. * Conclude with Focus questions to guide the chapter. }} == '''Social Cure''' == How you are going to structure the chapter? Aim for three to six main headings between the [[#Overview|Overview]] and [[#Conclusion|Conclusion]]. === Dynamics of Social Cure === Theory: * Social Identity Theory Research: * Increased social activity/interaction positively effecting mental health and wellbeing - (Jetten et al, 2017). * Meta-analytic research indicates that social support and social integration are highly protective against mortality - (Haslam et al, 2017) Application/examples: * === '''Importance of Groups''' === Theory: Research: Application/examples: === '''Social Networking''' === Theory: Research: Application/examples:{{tip|Suggestions for this section: * For the [[Motivation and emotion/Assessment/Topic|topic development]], provide at least 3 bullet-points about key content per section. Include key citations. * For the [[Motivation and emotion/Assessment/Chapter|book chapter]], expand the bullet points into paragraphs. * If a section has a lot of content, arrange it into two to five sub-headings such as in the [[#Interactive learning features|interactive learning features section]]. Avoid having sections with only one sub-heading. }} == '''How can Social Cure be Applied?''' == === '''Applications for adolescents''' === Theory: Research: Application/examples: === '''Applications for Adults''' === Theory: Research: Application/examples: ==Learning features== What brings an online book chapter to life are its interactive learning features. Case studies, feature boxes, figures, links, tables, and quiz questions can be used throughout the chapter. ===Case studies=== Case studies describe real-world examples of concepts in action. Case studies can be real or fictional. A case could be used multiple times during a chapter to illustrate different theories or stages. It is often helpful to present case studies using [[#Feature boxes|feature boxes]]. ===Boxes=== Boxes can be used to highlight content, but don't overuse them. There are many different ways of creating boxes (e.g., see [[Help:Pretty boxes|Pretty boxes]]). Possible uses include: * Focus questions * Case studies or examples * Quiz questions * Take-home messages {{RoundBoxTop|theme=3}} ;Feature box example * Shaded background * Coloured border {{RoundBoxBottom}} ===Figures=== [[File:Monkey-typing.jpg|right|205px|thumb|''Figure 1''. Example image with descriptive caption.]] Use figures to illustrate concepts, add interest, and provide examples. Figures can be used to show photographs, drawings, diagrams, graphs, etcetera. Figures can be embedded throughout the chapter, starting with the Overview section. Figures should be captioned (using a number and a description) in order to explain their relevance to the text. Possible images can be found at [[commons:|Wikimedia Commons]]. Images can also be uploaded if they are licensed for re-use or if you created the image. Each figure should be referred to at least once in the main text (e.g., see Figure 1). ===Links=== Where key words are first used, make them into [[Help:Links|interwiki links]] such as Wikipedia links to articles about famous people (e.g., [[w:Sigmund Freud|Sigmund Freud]] and key concepts (e.g., [[w:Dreams|dreams]]) and links to book chapters about related topics (e.g., would you like to learn about how to overcome [[Motivation and emotion/Book/2020/Writer's block|writer's block]]?). ===Tables=== Tables can be an effective way to organise and summarise information. Tables should be captioned (using APA style) to explain their relevance to the text. Plus each table should be referred to at least once in the main text (e.g., see Table 1 and Table 2). Here are some [[Motivation and emotion/Wikiversity/Tables|example 3 x 3 tables]] which could be adapted. ===Quizzes=== Quizzes are a direct way to engage readers. But don't make quizzes too hard or long. It is better to have one or two review questions per major section than a long quiz at the end. Try to quiz conceptual understanding, rather than trivia. Here are some simple quiz questions which could be adapted. Choose the correct answers and click "Submit": <quiz display=simple> {Quizzes are an interactive learning feature: |type="()"} + True - False {Long quizzes are a good idea: |type="()"} - True + False </quiz> To learn about different types of quiz questions, see [[Help:Quiz|Quiz]]. ==Conclusion== The Conclusion is arguably the most important section. It should be possible for someone to read the [[#Overview|Overview]] and the Conclusion and still get a good idea of the topic. {{tip|Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? }} ==See also== Provide up to half-a-dozen [[Help:Contents/Links#Interwiki_links|internal (wiki) links]] to relevant Wikiversity pages (esp. related [[Motivation and emotion/Book|motivation and emotion book chapters]]) and [[w:|Wikipedia articles]]. For example: * [[Motivation and emotion/Book/2016/Anorexia nervosa and extrinsic motivation|Anorexia nervosa and extrinsic motivation]] (Book chapter, 2016) * [[w:David McClelland|David McClelland]] (Wikipedia) * [[Motivation and emotion/Book/2018/Loss aversion|Loss aversion]] (Book chapter, 2018) * [[w:Maslow's hierarchy of needs|Maslow's hierarchy of needs]] (Wikipedia) * [[Mental health|Mental Health]] (Wikipedia) {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== {{Hanging indent|1= Currie, C., Zanotti, C., Morgan, A., Currie, D., De Looze, M., Roberts, C., Samdal, O., Smith, O. R., & Barnekow, V. (2009). Social determinants of health and well-being among young people. Health Behaviour in School-aged Children (HBSC) study: international report from the, 2010, 271. [https://d1wqtxts1xzle7.cloudfront.net/39900069/Social_determinants_of_health_and_well-b20151111-27604-w42wjb-with-cover-page-v2.pdf?Expires=1661148517&Signature=hG-B6MV1OU2j9Et0tU2yTeQ4ye1~FfSbJF783dpZC5v3CjDVVrlzLGXWKFOw58R6Lwt~4mfP3l3D5ixHOKRz5zVIv1DG5GLFpRBy0-fvyab90PhRaZ97Mi-0z0kQxZ9yl5AVpFHxpcrw2-u-R~DnPpkXg2nt4LBUatVcQcvNOClO6lSmUroQ2PASg9FNmHDBR03JNNlIGhqr62KoBjPyyZSUS~DXZE~D69dnFLqLRWvGCoMP1c0pJRM0DW3QmmNI1tZzrdY1HrllFK-Yky2YLn8TkS5KRcWLRYfqYrKg5od5vQqUKO6xg4IRAJk7Sw~A3iOohm6blOGoMnSNWKopyQ__&Key-Pair-Id=APKAJLOHF5GGSLRBV4ZA] Hajak, V. L., Sardana, S., Verdeli, H., & Grimm, S. (2021). A systematic review of factors affecting mental health and well-being of asylum seekers and refugees in Germany. Frontiers in psychiatry, 12, 643704. https://www.frontiersin.org/articles/10.3389/fpsyt.2021.643704/full Haslam, S., McMahon, C., Cruwys, T., Haslam, C., Jetten, J., & Steffens, N. K. (2017). Social cure, what social cure? The propensity to underestimate the importance of social factors for health. Social Science & Medicine, 198. https://doi.org/10.1016/j.socscimed.2017.12.020 Jetten, J., Haslam, S. A., Cruwys, T., Greenaway, K. H., Haslam, C., & Steffens, N. K. (2017). Advancing the social identity approach to health and well‐being: Progressing the social cure research agenda. European journal of social psychology, 47(7), 789-802. https://doi.org/10.1002/ejsp.2333 }} ==External links== Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * [https://students.unimelb.edu.au/academic-skills/explore-our-resources/essay-writing/six-top-tips-for-writing-a-great-essay Six top tips for writing a great essay] (University of Melbourne) * [http://www.skillsyouneed.com/write/structure.html The importance of structure] (skillsyouneed.com) * [https://www.researchgate.net/profile/Jolanda-Jetten/publication/247446655_The_Social_Cure/links/58d0b571a6fdcc344b0c1364/The-Social-Cure.pdf The Social Cure] (Book by Jolanda Jetten) {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] mjip0npd7gey0hl6vksvh1x5cfnzsc6 2419369 2419353 2022-08-26T07:35:54Z U3215976 2947554 /* Importance of Groups */ wikitext text/x-wiki {{title|Social Cure:<br>What is the social cure and how can it be applied?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ =='''Overview'''== You are underway {{smile}}! This template provides tips for [[Motivation and emotion/Assessment/Topic|topic development]]. Gradually remove these suggestions as you develop the chapter. Also consult the [[Motivation and emotion/Assessment/Chapter|author guidelines]]. At the top of the chapter, the title and sub-title should match the ''exact'' wording and casing as shown in the {{Motivation and emotion/Book}}. The sub-titles all end with a question mark. This Overview section should be concise but consist of several paragraphs which engage the reader, illustrate the problem, and outline how psychological science can help. {{RoundBoxTop|theme=3}} '''Focus questions:''' * What is the social cure? * How can the social cure be applied? * What are the benefits of social interactions?{{RoundBoxBottom}}In today's modern society, many factors are present that can affect our physical and mental health. Factors include bullying, low-socioeconomic status leading to poor health choices such as smoking and drinking, psychological determinants such as anxiety and depression and many more. ''Social Cure'' seeks to alleviate many of these potential problems by illustrating the usefulness and effectiveness of social support for individuals. This book chapter seeks to identify the ways in which social cure can be an effective way of bolstering physical and mental health and wellbeing.[[File:-Friends Forever -Life Long -Friends 4 life -Together -Friends -Reunion -Memories.jpg|thumb|''Figure'' 1. Group of Friends|center|218x218px]]{{tip| Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Provide an example or case study. * Conclude with Focus questions to guide the chapter. }} == '''Social Cure''' == How you are going to structure the chapter? Aim for three to six main headings between the [[#Overview|Overview]] and [[#Conclusion|Conclusion]]. === Dynamics of Social Cure === Theory: * Social Identity Theory Research: * Increased social activity/interaction positively effecting mental health and wellbeing - (Jetten et al, 2017). * Meta-analytic research indicates that social support and social integration are highly protective against mortality - (Haslam et al, 2017) Application/examples: * === '''Importance of Groups''' === Theory: Social Exchange Theory Research: Intergroup contact has been offered as an important vehicle for prejudice and discrimination reduction - (Sedikides et al, 1997). Research has shown a significant relationship between group positive affect and a wide variety of group outcomes (e.g., behaviors, wellbeing, and performance) - (Peñalver et al, 2020) Application/examples: === '''Social Networking''' === Theory: Social exchange theory in the context of online social interactions Research: Application/examples:{{tip|Suggestions for this section: * For the [[Motivation and emotion/Assessment/Topic|topic development]], provide at least 3 bullet-points about key content per section. Include key citations. * For the [[Motivation and emotion/Assessment/Chapter|book chapter]], expand the bullet points into paragraphs. * If a section has a lot of content, arrange it into two to five sub-headings such as in the [[#Interactive learning features|interactive learning features section]]. Avoid having sections with only one sub-heading. }} == '''How can Social Cure be Applied?''' == === Applications for adolescents === Theory: Research: Application/examples: === Applications for Adults === Theory: Research: Application/examples: ==Learning features== What brings an online book chapter to life are its interactive learning features. Case studies, feature boxes, figures, links, tables, and quiz questions can be used throughout the chapter. ===Case studies=== Case studies describe real-world examples of concepts in action. Case studies can be real or fictional. A case could be used multiple times during a chapter to illustrate different theories or stages. It is often helpful to present case studies using [[#Feature boxes|feature boxes]]. ===Boxes=== Boxes can be used to highlight content, but don't overuse them. There are many different ways of creating boxes (e.g., see [[Help:Pretty boxes|Pretty boxes]]). Possible uses include: * Focus questions * Case studies or examples * Quiz questions * Take-home messages {{RoundBoxTop|theme=3}} ;Feature box example * Shaded background * Coloured border {{RoundBoxBottom}} ===Figures=== [[File:Monkey-typing.jpg|right|205px|thumb|''Figure 1''. Example image with descriptive caption.]] Use figures to illustrate concepts, add interest, and provide examples. Figures can be used to show photographs, drawings, diagrams, graphs, etcetera. Figures can be embedded throughout the chapter, starting with the Overview section. Figures should be captioned (using a number and a description) in order to explain their relevance to the text. Possible images can be found at [[commons:|Wikimedia Commons]]. Images can also be uploaded if they are licensed for re-use or if you created the image. Each figure should be referred to at least once in the main text (e.g., see Figure 1). ===Links=== Where key words are first used, make them into [[Help:Links|interwiki links]] such as Wikipedia links to articles about famous people (e.g., [[w:Sigmund Freud|Sigmund Freud]] and key concepts (e.g., [[w:Dreams|dreams]]) and links to book chapters about related topics (e.g., would you like to learn about how to overcome [[Motivation and emotion/Book/2020/Writer's block|writer's block]]?). ===Tables=== Tables can be an effective way to organise and summarise information. Tables should be captioned (using APA style) to explain their relevance to the text. Plus each table should be referred to at least once in the main text (e.g., see Table 1 and Table 2). Here are some [[Motivation and emotion/Wikiversity/Tables|example 3 x 3 tables]] which could be adapted. ===Quizzes=== Quizzes are a direct way to engage readers. But don't make quizzes too hard or long. It is better to have one or two review questions per major section than a long quiz at the end. Try to quiz conceptual understanding, rather than trivia. Here are some simple quiz questions which could be adapted. Choose the correct answers and click "Submit": <quiz display=simple> {Quizzes are an interactive learning feature: |type="()"} + True - False {Long quizzes are a good idea: |type="()"} - True + False </quiz> To learn about different types of quiz questions, see [[Help:Quiz|Quiz]]. ==Conclusion== The Conclusion is arguably the most important section. It should be possible for someone to read the [[#Overview|Overview]] and the Conclusion and still get a good idea of the topic. {{tip|Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? }} ==See also== Provide up to half-a-dozen [[Help:Contents/Links#Interwiki_links|internal (wiki) links]] to relevant Wikiversity pages (esp. related [[Motivation and emotion/Book|motivation and emotion book chapters]]) and [[w:|Wikipedia articles]]. For example: * [[Motivation and emotion/Book/2016/Anorexia nervosa and extrinsic motivation|Anorexia nervosa and extrinsic motivation]] (Book chapter, 2016) * [[w:David McClelland|David McClelland]] (Wikipedia) * [[Motivation and emotion/Book/2018/Loss aversion|Loss aversion]] (Book chapter, 2018) * [[w:Maslow's hierarchy of needs|Maslow's hierarchy of needs]] (Wikipedia) * [[Mental health|Mental Health]] (Wikipedia) {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== {{Hanging indent|1= Currie, C., Zanotti, C., Morgan, A., Currie, D., De Looze, M., Roberts, C., Samdal, O., Smith, O. R., & Barnekow, V. (2009). Social determinants of health and well-being among young people. Health Behaviour in School-aged Children (HBSC) study: international report from the, 2010, 271. [https://d1wqtxts1xzle7.cloudfront.net/39900069/Social_determinants_of_health_and_well-b20151111-27604-w42wjb-with-cover-page-v2.pdf?Expires=1661148517&Signature=hG-B6MV1OU2j9Et0tU2yTeQ4ye1~FfSbJF783dpZC5v3CjDVVrlzLGXWKFOw58R6Lwt~4mfP3l3D5ixHOKRz5zVIv1DG5GLFpRBy0-fvyab90PhRaZ97Mi-0z0kQxZ9yl5AVpFHxpcrw2-u-R~DnPpkXg2nt4LBUatVcQcvNOClO6lSmUroQ2PASg9FNmHDBR03JNNlIGhqr62KoBjPyyZSUS~DXZE~D69dnFLqLRWvGCoMP1c0pJRM0DW3QmmNI1tZzrdY1HrllFK-Yky2YLn8TkS5KRcWLRYfqYrKg5od5vQqUKO6xg4IRAJk7Sw~A3iOohm6blOGoMnSNWKopyQ__&Key-Pair-Id=APKAJLOHF5GGSLRBV4ZA] Hajak, V. L., Sardana, S., Verdeli, H., & Grimm, S. (2021). A systematic review of factors affecting mental health and well-being of asylum seekers and refugees in Germany. Frontiers in psychiatry, 12, 643704. https://www.frontiersin.org/articles/10.3389/fpsyt.2021.643704/full Haslam, S., McMahon, C., Cruwys, T., Haslam, C., Jetten, J., & Steffens, N. K. (2017). Social cure, what social cure? The propensity to underestimate the importance of social factors for health. Social Science & Medicine, 198. https://doi.org/10.1016/j.socscimed.2017.12.020 Jetten, J., Haslam, S. A., Cruwys, T., Greenaway, K. H., Haslam, C., & Steffens, N. K. (2017). Advancing the social identity approach to health and well‐being: Progressing the social cure research agenda. European journal of social psychology, 47(7), 789-802. https://doi.org/10.1002/ejsp.2333 Peñalver, J., Salanova, M., & Martínez, I. M. (2020). Group Positive Affect and Beyond: An Integrative Review and Future Research Agenda. Int J Environ Res Public Health, 17(20). https://doi.org/10.3390/ijerph17207499 Sedikides, C., Schopler, J., Insko, C.A., & Insko, C. (Eds.). (1997). Intergroup Cognition and Intergroup Behavior (1st ed.). Psychology Press. https://doi.org/10.4324/9780203763575 }} ==External links== Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * [https://students.unimelb.edu.au/academic-skills/explore-our-resources/essay-writing/six-top-tips-for-writing-a-great-essay Six top tips for writing a great essay] (University of Melbourne) * [http://www.skillsyouneed.com/write/structure.html The importance of structure] (skillsyouneed.com) * [https://www.researchgate.net/profile/Jolanda-Jetten/publication/247446655_The_Social_Cure/links/58d0b571a6fdcc344b0c1364/The-Social-Cure.pdf The Social Cure] (Book by Jolanda Jetten) {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] il3abez1h6evcnj4mth1xkhgdud1hnw 1 286575 2419192 2417499 2022-08-26T02:32:56Z U3216563 2947577 /* Comment on figure */ new section wikitext text/x-wiki == Resources for your 'Rogers' section == Hi, These sources might be useful for your section on Rogers and FFP. Stephen, S., & Elliott, R. (2022). The Strathclyde Inventory: Development of a Brief Instrument for Assessing Outcome in Counseling According to Rogers’ Concept of the Fully Functioning Person. ''Measurement and Evaluation in Counseling and Development, 55''(3), 187–206. https://doi.org/10.1080/07481756.2021.1955213 Proctor, C., Tweed, R., & Morris, D. (2016). The Rogerian Fully Functioning Person: A Positive Psychology Perspective. ''The Journal of Humanistic Psychology, 56''(5), 503–529. https://doi.org/10.1177/0022167815605936 Renger, S., & Macaskill, A. (2021). Simplifying the definition of the fully functioning person for client use. ''Counselling and Psychotherapy Research, 21''(4), 970–982. https://doi.org/10.1002/capr.12386 Rogers. C. R. (1963). The concept of the fully functioning person. ''Psychotherapy (Chicago, Ill.), 1''(1), 17–26. https://doi.org/10.1037/h0088567 [[User:U3216256|U3216256]] ([[User talk:U3216256|discuss]] • [[Special:Contributions/U3216256|contribs]]) 00:25, 20 August 2022 (UTC) == Heading casing == {| style="float: center; background:transparent;" |- | [[File:Crystal Clear app ktip.svg|48px|left]] | {{#if:Sebastian Armstrong|Hi [[User:Sebastian Armstrong|Sebastian Armstrong]].|}} FYI, the recommended [[Wikiversity]] heading style uses [[w:Letter case#Sentence_case|sentence casing]]. For example:<br> <big><big>Self-determination theory</big></big> rather than <big><big>Self-Determination Theory</big></big> Here's an example chapter with correct heading casing: [[Motivation and emotion/Book/2019/Growth mindset development|Growth mindset development]] -- [[User:Jtneill|Jtneill]] - <small>[[User talk:Jtneill|Talk]] - [[Special:Contributions/Jtneill|c]]</small> 23:58, 22 August 2022 (UTC) |} == Comment on figure == Hi, i think you are on a very good track here, however, i think with your firgure it may be good to add a little description for what the figure is for :) [[User:U3216563|U3216563]] ([[User talk:U3216563|discuss]] • [[Special:Contributions/U3216563|contribs]]) 02:32, 26 August 2022 (UTC) qbkqmdwz38x63mbbxmvjnt53h6ol3ge 2 286594 2419339 2417955 2022-08-26T06:59:31Z Jtneill 10242 wikitext text/x-wiki == About me == <mapframe latitude="-28.420391" longitude="136.757813" zoom="2" width="200" height="109" align="right">{ "type": "FeatureCollection", "features": [ { "type": "Feature", "properties": {}, "geometry": { "type": "Point", "coordinates": [ 149.12419, -35.308275 ] } } ] }</mapframe> Hello, my name is Susan, I live in Canberra and I am currently studying Science in Psychology. I consist the intention of furthering my studies once I graduate from my current degree. I enjoy reading books which is something that developed during covid-19. I assume the pandemic was a blessing and a curse in my perspective. [[File:Parliament House at dusk, Canberra ACT.jpg|thumb|Parliament of Australia]] I am also passionate about physical activities particularly long-distance running, hiking, and playing tennis with my siblings. The challenge of strengthening my cardio and looking physically fit is what inspires me to proceed with engaging in these activities. I occasionally find my attention captured by Australian politics, it’s interesting to know what’s happening in our government. Finally, I am a part time employee. rwn0pdcb19vwxgpl1qs8j5s9788uem4 2 286637 2419260 2419038 2022-08-26T04:28:18Z Kate Carloff 2948680 wikitext text/x-wiki {{title|Simple Vegan Kitchen. September's Family Plan. }} __TOC__ ==Overview== {{RoundBoxTop|theme=3}} '''September Plan:''' * Kate - primarily from 'Simple Vegan Kitchen'. * Kids - cut right down on processed foods and sugar {{RoundBoxBottom}} === September's Scaffolding === # Don't buy sugary or processed snacks # Run down the cereal and sugar we already have here # Kids can try baking and dessert making instead # No greasy take-aways for the month. Look for an eat-out alternative # No cooked processed breakfasts # Start building up a healthy breakfast arsenal instead # Keep it simple. think lighter meals. not an every-night cooking production. # Kate - primarily eating from 'Simple Vegan Kitchen'. Go for no processed September. # Kate. Alcohol. Just don't. If the kids can cut the crap I can cut the alcohol. Think 74 kgs on Oct 22. Harder with a hip out of action. # Kids. Can bloody well help prepare & clean in the kitchen. == Kate - Recipes from Simple Vegan Kitchen == === Breakfasts === Simple blueberry bircher. pg. 34 Banana & cinnamon porridge. pg. 43 Best ever brekkie burrito. pg. 55 Tofu scramble. pg. 56 === Main Meals === Smoky cauliflower steaks with salsa verde. pg. 148 Crispy teriyaki tofu bowl pg. 150 Lentil shepherds pie. pg. 153 Sweet and Sour Cauliflower salad. pg. 154 Mac & Greens. pg. 157 creamy ramen with sweetcorn & tofu. pg. 170 === Lighter Meals === Mushroom, chive & three cheese toastie. pg. 62 Avocado, kale & pesto toastie. pg. 64. Spicy tomato chickpeas on toast with feta. pg. 74 sweetcorn & mushroom soup. pg. 85 Shaved broccoli & cranberry salad. pg. 90 Mediterranean chickpea salad. pg. 100 Pesto pasta salad with peas & broccolini. pg. 118 === Other === Crispy curried chickpeas. pg. 137 == Family - Recipes that we can adapt for all == === Breakfasts === Everyday banana pikelets. pg.26 Apple crumble breakfast bake. pg. 40 Blueberry & coconut brekkie crumble. pg. 46 Eggs on toast (poached, scrambled, fried). Ham & cheese toasties. === Main Meals === Mushroom & leek risotto. pg. 160 Honey & tamari noodles. pg. 162 Fried rice. pg. 164 cheesy rice & black bean bake. pg. 174 curried vegan sausages. pg. 188 === Lighter Meals === Wraps. kids - meat. me - vege. Bacon and egg rolls Burgers Lentil bolognese sausage rolls. pg.111 Black bean quesadillas with chipotle cream. pg. 121 === Sides === The best crispy potatoes. pg. 124 Veggie chips, three ways pg. 134. == Kids - snack and grazing ideas == === Healthier Snacks === Home-made Banana Bread. === Obvious D'uh Ideas === * salad roll Saturdays (like me as a kid) Aim for three to six main headings between the [[#Overview|Overview]] and [[#Conclusion|Conclusion]]. ==Other Thoughts and Ideas== * [[Category:{{#titleparts:{{PAGENAME}}|3}}]] sy9yy58whxpgq7jinqwmwsgiozpuik1 0 286683 2419116 2418990 2022-08-25T23:18:29Z Cedevlin9 2947652 /* Overview */ wikitext text/x-wiki {{title|Chapter title:<br>Subtitle?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== === What is Self -help? === Self- help [https://www.psychologytoday.com/au/basics/self-help#:~:text=In%20contemporary%20parlance%2C%20the%20term,with%20a%20big%20picture%20view.] is === What motivates people to engage in Self -help? === People are [https://en.wikiversity.org/w/index.php?title=Motivation_and_emotion/Book/2022/Self-help&action=edit&redlink=1 motivated] to engage in Self-help activities for a variety of reasons This Overview section should be concise but consist of several paragraphs which engage the reader, illustrate the problem, and outline how psychological science can help. {{RoundBoxTop|theme=3}} '''Focus questions:''' * What are the theoretical approaches to self help? * What are the different types of self help interventions? * Is self help effective? {{RoundBoxBottom}} {{tip| Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Provide an example or case study. * Conclude with Focus questions to guide the chapter. }} == What is Self Help == == What sort of interventions are considered Self -help == Books Courses Web based programs Other technologies (apps) == What types of conditions are addressed by Self-help interventions == Depression Eating disorders Positive Psychology and mindfulness practices == What motivates people to engage in Self -help == == What are the theoretical approaches to Self-help == == How effective are Self-help interventions in treating psychological conditions == == Conclusion == Aim for three to six main headings between the [[#Overview|Overview]] and [[#Conclusion|Conclusion]]. {{tip|Suggestions for this section: * For the [[Motivation and emotion/Assessment/Topic|topic development]], provide at least 3 bullet-points about key content per section. Include key citations. * For the [[Motivation and emotion/Assessment/Chapter|book chapter]], expand the bullet points into paragraphs. * If a section has a lot of content, arrange it into two to five sub-headings such as in the [[#Interactive learning features|interactive learning features section]]. Avoid having sections with only one sub-heading. }} ==Learning features== What brings an online book chapter to life are its interactive learning features. Case studies, feature boxes, figures, links, tables, and quiz questions can be used throughout the chapter. ===Case studies=== Case studies describe real-world examples of concepts in action. Case studies can be real or fictional. A case could be used multiple times during a chapter to illustrate different theories or stages. It is often helpful to present case studies using [[#Feature boxes|feature boxes]]. ===Boxes=== Boxes can be used to highlight content, but don't overuse them. There are many different ways of creating boxes (e.g., see [[Help:Pretty boxes|Pretty boxes]]). Possible uses include: * Focus questions * Case studies or examples * Quiz questions * Take-home messages {{RoundBoxTop|theme=3}} ;Feature box example * Shaded background * Coloured border {{RoundBoxBottom}} ===Figures=== [[File:Monkey-typing.jpg|right|205px|thumb|''Figure 1''. Example image with descriptive caption.]] Use figures to illustrate concepts, add interest, and provide examples. Figures can be used to show photographs, drawings, diagrams, graphs, etcetera. Figures can be embedded throughout the chapter, starting with the Overview section. Figures should be captioned (using a number and a description) in order to explain their relevance to the text. Possible images can be found at [[commons:|Wikimedia Commons]]. Images can also be uploaded if they are licensed for re-use or if you created the image. Each figure should be referred to at least once in the main text (e.g., see Figure 1). ===Links=== Where key words are first used, make them into [[Help:Links|interwiki links]] such as Wikipedia links to articles about famous people (e.g., [[w:Sigmund Freud|Sigmund Freud]] and key concepts (e.g., [[w:Dreams|dreams]]) and links to book chapters about related topics (e.g., would you like to learn about how to overcome [[Motivation and emotion/Book/2020/Writer's block|writer's block]]?). ===Tables=== Tables can be an effective way to organise and summarise information. Tables should be captioned (using APA style) to explain their relevance to the text. Plus each table should be referred to at least once in the main text (e.g., see Table 1 and Table 2). Here are some [[Motivation and emotion/Wikiversity/Tables|example 3 x 3 tables]] which could be adapted. ===Quizzes=== Quizzes are a direct way to engage readers. But don't make quizzes too hard or long. It is better to have one or two review questions per major section than a long quiz at the end. Try to quiz conceptual understanding, rather than trivia. Here are some simple quiz questions which could be adapted. Choose the correct answers and click "Submit": <quiz display=simple> {Quizzes are an interactive learning feature: |type="()"} + True - False {Long quizzes are a good idea: |type="()"} - True + False </quiz> To learn about different types of quiz questions, see [[Help:Quiz|Quiz]]. ==Conclusion== The Conclusion is arguably the most important section. It should be possible for someone to read the [[#Overview|Overview]] and the Conclusion and still get a good idea of the topic. {{tip|Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? }} ==See also== Provide up to half-a-dozen [[Help:Contents/Links#Interwiki_links|internal (wiki) links]] to relevant Wikiversity pages (esp. related [[Motivation and emotion/Book|motivation and emotion book chapters]]) and [[w:|Wikipedia articles]]. For example: * [[Motivation and emotion/Book/2016/Anorexia nervosa and extrinsic motivation|Anorexia nervosa and extrinsic motivation]] (Book chapter, 2016) * [[w:David McClelland|David McClelland]] (Wikipedia) * [[Motivation and emotion/Book/2018/Loss aversion|Loss aversion]] (Book chapter, 2018) * [[w:Maslow's hierarchy of needs|Maslow's hierarchy of needs]] (Wikipedia) {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== {{Hanging indent|1= Buntrock, C., Ebert, D. D., Lehr, D., Smit, F., Riper, H., Berking, M., & Cuijpers, P. (2016). Effect of a Web-Based Guided Self-help Intervention for Prevention of Major Depression in Adults With Subthreshold Depression. JAMA, 315(17), 1854. https://doi.org/10.1001/jama.2016.4326 Cavanagh, K., Strauss, C., Forder, L., & Jones, F. (2014). Can mindfulness and acceptance be learnt by self-help?: A systematic review and meta-analysis of mindfulness and acceptance-based self-help interventions. Clinical Psychology Review, 34(2), 118–129. https://doi.org/10.1016/j.cpr.2014.01.001 Ebert, D. D., Donkin, L., Andersson, G., Andrews, G., Berger, T., Carlbring, P., Rozenthal, A., Choi, I., Laferton, J. A. C., Johansson, R., Kleiboer, A., Lange, A., Lehr, D., Reins, J. A., Funk, B., Newby, J., Perini, S., Riper, H., Ruwaard, J., & Sheeber, L. (2016). Does Internet-based guided-self-help for depression cause harm? An individual participant data meta-analysis on deterioration rates and its moderators in randomized controlled trials. Psychological Medicine, 46(13), 2679–2693. https://doi.org/10.1017/s0033291716001562 Schueller, S. M., & Parks, A. C. (2014). The Science of Self-Help. European Psychologist, 19(2), 145–155. https://doi.org/10.1027/1016-9040/a000181 }} {{tip|Suggestions for this section: * Important aspects for APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except first letter and proper names, ending in a full-stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full-stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't actually read or consulted }} ==External links== Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * [https://students.unimelb.edu.au/academic-skills/explore-our-resources/essay-writing/six-top-tips-for-writing-a-great-essay Six top tips for writing a great essay] (University of Melbourne) * [http://www.skillsyouneed.com/write/structure.html The importance of structure] (skillsyouneed.com) {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] mhjyxwhkpw6bgjrz28byx6b22z6i09g 2419120 2419116 2022-08-25T23:20:54Z Cedevlin9 2947652 /* External links */ wikitext text/x-wiki {{title|Chapter title:<br>Subtitle?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== === What is Self -help? === Self- help [https://www.psychologytoday.com/au/basics/self-help#:~:text=In%20contemporary%20parlance%2C%20the%20term,with%20a%20big%20picture%20view.] is === What motivates people to engage in Self -help? === People are [https://en.wikiversity.org/w/index.php?title=Motivation_and_emotion/Book/2022/Self-help&action=edit&redlink=1 motivated] to engage in Self-help activities for a variety of reasons This Overview section should be concise but consist of several paragraphs which engage the reader, illustrate the problem, and outline how psychological science can help. {{RoundBoxTop|theme=3}} '''Focus questions:''' * What are the theoretical approaches to self help? * What are the different types of self help interventions? * Is self help effective? {{RoundBoxBottom}} {{tip| Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Provide an example or case study. * Conclude with Focus questions to guide the chapter. }} == What is Self Help == == What sort of interventions are considered Self -help == Books Courses Web based programs Other technologies (apps) == What types of conditions are addressed by Self-help interventions == Depression Eating disorders Positive Psychology and mindfulness practices == What motivates people to engage in Self -help == == What are the theoretical approaches to Self-help == == How effective are Self-help interventions in treating psychological conditions == == Conclusion == Aim for three to six main headings between the [[#Overview|Overview]] and [[#Conclusion|Conclusion]]. {{tip|Suggestions for this section: * For the [[Motivation and emotion/Assessment/Topic|topic development]], provide at least 3 bullet-points about key content per section. Include key citations. * For the [[Motivation and emotion/Assessment/Chapter|book chapter]], expand the bullet points into paragraphs. * If a section has a lot of content, arrange it into two to five sub-headings such as in the [[#Interactive learning features|interactive learning features section]]. Avoid having sections with only one sub-heading. }} ==Learning features== What brings an online book chapter to life are its interactive learning features. Case studies, feature boxes, figures, links, tables, and quiz questions can be used throughout the chapter. ===Case studies=== Case studies describe real-world examples of concepts in action. Case studies can be real or fictional. A case could be used multiple times during a chapter to illustrate different theories or stages. It is often helpful to present case studies using [[#Feature boxes|feature boxes]]. ===Boxes=== Boxes can be used to highlight content, but don't overuse them. There are many different ways of creating boxes (e.g., see [[Help:Pretty boxes|Pretty boxes]]). Possible uses include: * Focus questions * Case studies or examples * Quiz questions * Take-home messages {{RoundBoxTop|theme=3}} ;Feature box example * Shaded background * Coloured border {{RoundBoxBottom}} ===Figures=== [[File:Monkey-typing.jpg|right|205px|thumb|''Figure 1''. Example image with descriptive caption.]] Use figures to illustrate concepts, add interest, and provide examples. Figures can be used to show photographs, drawings, diagrams, graphs, etcetera. Figures can be embedded throughout the chapter, starting with the Overview section. Figures should be captioned (using a number and a description) in order to explain their relevance to the text. Possible images can be found at [[commons:|Wikimedia Commons]]. Images can also be uploaded if they are licensed for re-use or if you created the image. Each figure should be referred to at least once in the main text (e.g., see Figure 1). ===Links=== Where key words are first used, make them into [[Help:Links|interwiki links]] such as Wikipedia links to articles about famous people (e.g., [[w:Sigmund Freud|Sigmund Freud]] and key concepts (e.g., [[w:Dreams|dreams]]) and links to book chapters about related topics (e.g., would you like to learn about how to overcome [[Motivation and emotion/Book/2020/Writer's block|writer's block]]?). ===Tables=== Tables can be an effective way to organise and summarise information. Tables should be captioned (using APA style) to explain their relevance to the text. Plus each table should be referred to at least once in the main text (e.g., see Table 1 and Table 2). Here are some [[Motivation and emotion/Wikiversity/Tables|example 3 x 3 tables]] which could be adapted. ===Quizzes=== Quizzes are a direct way to engage readers. But don't make quizzes too hard or long. It is better to have one or two review questions per major section than a long quiz at the end. Try to quiz conceptual understanding, rather than trivia. Here are some simple quiz questions which could be adapted. Choose the correct answers and click "Submit": <quiz display=simple> {Quizzes are an interactive learning feature: |type="()"} + True - False {Long quizzes are a good idea: |type="()"} - True + False </quiz> To learn about different types of quiz questions, see [[Help:Quiz|Quiz]]. ==Conclusion== The Conclusion is arguably the most important section. It should be possible for someone to read the [[#Overview|Overview]] and the Conclusion and still get a good idea of the topic. {{tip|Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? }} ==See also== Provide up to half-a-dozen [[Help:Contents/Links#Interwiki_links|internal (wiki) links]] to relevant Wikiversity pages (esp. related [[Motivation and emotion/Book|motivation and emotion book chapters]]) and [[w:|Wikipedia articles]]. For example: * [[Motivation and emotion/Book/2016/Anorexia nervosa and extrinsic motivation|Anorexia nervosa and extrinsic motivation]] (Book chapter, 2016) * [[w:David McClelland|David McClelland]] (Wikipedia) * [[Motivation and emotion/Book/2018/Loss aversion|Loss aversion]] (Book chapter, 2018) * [[w:Maslow's hierarchy of needs|Maslow's hierarchy of needs]] (Wikipedia) {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== {{Hanging indent|1= Buntrock, C., Ebert, D. D., Lehr, D., Smit, F., Riper, H., Berking, M., & Cuijpers, P. (2016). Effect of a Web-Based Guided Self-help Intervention for Prevention of Major Depression in Adults With Subthreshold Depression. JAMA, 315(17), 1854. https://doi.org/10.1001/jama.2016.4326 Cavanagh, K., Strauss, C., Forder, L., & Jones, F. (2014). Can mindfulness and acceptance be learnt by self-help?: A systematic review and meta-analysis of mindfulness and acceptance-based self-help interventions. Clinical Psychology Review, 34(2), 118–129. https://doi.org/10.1016/j.cpr.2014.01.001 Ebert, D. D., Donkin, L., Andersson, G., Andrews, G., Berger, T., Carlbring, P., Rozenthal, A., Choi, I., Laferton, J. A. C., Johansson, R., Kleiboer, A., Lange, A., Lehr, D., Reins, J. A., Funk, B., Newby, J., Perini, S., Riper, H., Ruwaard, J., & Sheeber, L. (2016). Does Internet-based guided-self-help for depression cause harm? An individual participant data meta-analysis on deterioration rates and its moderators in randomized controlled trials. Psychological Medicine, 46(13), 2679–2693. https://doi.org/10.1017/s0033291716001562 Schueller, S. M., & Parks, A. C. (2014). The Science of Self-Help. European Psychologist, 19(2), 145–155. https://doi.org/10.1027/1016-9040/a000181 }} {{tip|Suggestions for this section: * Important aspects for APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except first letter and proper names, ending in a full-stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full-stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't actually read or consulted }} ==External links== Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * Why Self-help will not change your life [https://www.ted.com/talks/marianne_power_why_self_help_will_not_change_your_life TED] Talk {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] jr5ent7slqsocazpjwaa3vmq5rqvlg4 2419121 2419120 2022-08-25T23:23:38Z Cedevlin9 2947652 /* External links */ wikitext text/x-wiki {{title|Chapter title:<br>Subtitle?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== === What is Self -help? === Self- help [https://www.psychologytoday.com/au/basics/self-help#:~:text=In%20contemporary%20parlance%2C%20the%20term,with%20a%20big%20picture%20view.] is === What motivates people to engage in Self -help? === People are [https://en.wikiversity.org/w/index.php?title=Motivation_and_emotion/Book/2022/Self-help&action=edit&redlink=1 motivated] to engage in Self-help activities for a variety of reasons This Overview section should be concise but consist of several paragraphs which engage the reader, illustrate the problem, and outline how psychological science can help. {{RoundBoxTop|theme=3}} '''Focus questions:''' * What are the theoretical approaches to self help? * What are the different types of self help interventions? * Is self help effective? {{RoundBoxBottom}} {{tip| Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Provide an example or case study. * Conclude with Focus questions to guide the chapter. }} == What is Self Help == == What sort of interventions are considered Self -help == Books Courses Web based programs Other technologies (apps) == What types of conditions are addressed by Self-help interventions == Depression Eating disorders Positive Psychology and mindfulness practices == What motivates people to engage in Self -help == == What are the theoretical approaches to Self-help == == How effective are Self-help interventions in treating psychological conditions == == Conclusion == Aim for three to six main headings between the [[#Overview|Overview]] and [[#Conclusion|Conclusion]]. {{tip|Suggestions for this section: * For the [[Motivation and emotion/Assessment/Topic|topic development]], provide at least 3 bullet-points about key content per section. Include key citations. * For the [[Motivation and emotion/Assessment/Chapter|book chapter]], expand the bullet points into paragraphs. * If a section has a lot of content, arrange it into two to five sub-headings such as in the [[#Interactive learning features|interactive learning features section]]. Avoid having sections with only one sub-heading. }} ==Learning features== What brings an online book chapter to life are its interactive learning features. Case studies, feature boxes, figures, links, tables, and quiz questions can be used throughout the chapter. ===Case studies=== Case studies describe real-world examples of concepts in action. Case studies can be real or fictional. A case could be used multiple times during a chapter to illustrate different theories or stages. It is often helpful to present case studies using [[#Feature boxes|feature boxes]]. ===Boxes=== Boxes can be used to highlight content, but don't overuse them. There are many different ways of creating boxes (e.g., see [[Help:Pretty boxes|Pretty boxes]]). Possible uses include: * Focus questions * Case studies or examples * Quiz questions * Take-home messages {{RoundBoxTop|theme=3}} ;Feature box example * Shaded background * Coloured border {{RoundBoxBottom}} ===Figures=== [[File:Monkey-typing.jpg|right|205px|thumb|''Figure 1''. Example image with descriptive caption.]] Use figures to illustrate concepts, add interest, and provide examples. Figures can be used to show photographs, drawings, diagrams, graphs, etcetera. Figures can be embedded throughout the chapter, starting with the Overview section. Figures should be captioned (using a number and a description) in order to explain their relevance to the text. Possible images can be found at [[commons:|Wikimedia Commons]]. Images can also be uploaded if they are licensed for re-use or if you created the image. Each figure should be referred to at least once in the main text (e.g., see Figure 1). ===Links=== Where key words are first used, make them into [[Help:Links|interwiki links]] such as Wikipedia links to articles about famous people (e.g., [[w:Sigmund Freud|Sigmund Freud]] and key concepts (e.g., [[w:Dreams|dreams]]) and links to book chapters about related topics (e.g., would you like to learn about how to overcome [[Motivation and emotion/Book/2020/Writer's block|writer's block]]?). ===Tables=== Tables can be an effective way to organise and summarise information. Tables should be captioned (using APA style) to explain their relevance to the text. Plus each table should be referred to at least once in the main text (e.g., see Table 1 and Table 2). Here are some [[Motivation and emotion/Wikiversity/Tables|example 3 x 3 tables]] which could be adapted. ===Quizzes=== Quizzes are a direct way to engage readers. But don't make quizzes too hard or long. It is better to have one or two review questions per major section than a long quiz at the end. Try to quiz conceptual understanding, rather than trivia. Here are some simple quiz questions which could be adapted. Choose the correct answers and click "Submit": <quiz display=simple> {Quizzes are an interactive learning feature: |type="()"} + True - False {Long quizzes are a good idea: |type="()"} - True + False </quiz> To learn about different types of quiz questions, see [[Help:Quiz|Quiz]]. ==Conclusion== The Conclusion is arguably the most important section. It should be possible for someone to read the [[#Overview|Overview]] and the Conclusion and still get a good idea of the topic. {{tip|Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? }} ==See also== Provide up to half-a-dozen [[Help:Contents/Links#Interwiki_links|internal (wiki) links]] to relevant Wikiversity pages (esp. related [[Motivation and emotion/Book|motivation and emotion book chapters]]) and [[w:|Wikipedia articles]]. For example: * [[Motivation and emotion/Book/2016/Anorexia nervosa and extrinsic motivation|Anorexia nervosa and extrinsic motivation]] (Book chapter, 2016) * [[w:David McClelland|David McClelland]] (Wikipedia) * [[Motivation and emotion/Book/2018/Loss aversion|Loss aversion]] (Book chapter, 2018) * [[w:Maslow's hierarchy of needs|Maslow's hierarchy of needs]] (Wikipedia) {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== {{Hanging indent|1= Buntrock, C., Ebert, D. D., Lehr, D., Smit, F., Riper, H., Berking, M., & Cuijpers, P. (2016). Effect of a Web-Based Guided Self-help Intervention for Prevention of Major Depression in Adults With Subthreshold Depression. JAMA, 315(17), 1854. https://doi.org/10.1001/jama.2016.4326 Cavanagh, K., Strauss, C., Forder, L., & Jones, F. (2014). Can mindfulness and acceptance be learnt by self-help?: A systematic review and meta-analysis of mindfulness and acceptance-based self-help interventions. Clinical Psychology Review, 34(2), 118–129. https://doi.org/10.1016/j.cpr.2014.01.001 Ebert, D. D., Donkin, L., Andersson, G., Andrews, G., Berger, T., Carlbring, P., Rozenthal, A., Choi, I., Laferton, J. A. C., Johansson, R., Kleiboer, A., Lange, A., Lehr, D., Reins, J. A., Funk, B., Newby, J., Perini, S., Riper, H., Ruwaard, J., & Sheeber, L. (2016). Does Internet-based guided-self-help for depression cause harm? An individual participant data meta-analysis on deterioration rates and its moderators in randomized controlled trials. Psychological Medicine, 46(13), 2679–2693. https://doi.org/10.1017/s0033291716001562 Schueller, S. M., & Parks, A. C. (2014). The Science of Self-Help. European Psychologist, 19(2), 145–155. https://doi.org/10.1027/1016-9040/a000181 }} {{tip|Suggestions for this section: * Important aspects for APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except first letter and proper names, ending in a full-stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full-stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't actually read or consulted }} ==External links== Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * [https://www.ted.com/talks/marianne_power_why_self_help_will_not_change_your_life Why Self-help will not change your life] TEDTalk * [https://positivepsychology.com/self-motivation/ Self Motivation explained] (Positive Psychology) article {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] p97rf5x05fwnp5j9qn0innew8gdssbe 2419123 2419121 2022-08-25T23:25:32Z Cedevlin9 2947652 /* See also */ wikitext text/x-wiki {{title|Chapter title:<br>Subtitle?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== === What is Self -help? === Self- help [https://www.psychologytoday.com/au/basics/self-help#:~:text=In%20contemporary%20parlance%2C%20the%20term,with%20a%20big%20picture%20view.] is === What motivates people to engage in Self -help? === People are [https://en.wikiversity.org/w/index.php?title=Motivation_and_emotion/Book/2022/Self-help&action=edit&redlink=1 motivated] to engage in Self-help activities for a variety of reasons This Overview section should be concise but consist of several paragraphs which engage the reader, illustrate the problem, and outline how psychological science can help. {{RoundBoxTop|theme=3}} '''Focus questions:''' * What are the theoretical approaches to self help? * What are the different types of self help interventions? * Is self help effective? {{RoundBoxBottom}} {{tip| Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Provide an example or case study. * Conclude with Focus questions to guide the chapter. }} == What is Self Help == == What sort of interventions are considered Self -help == Books Courses Web based programs Other technologies (apps) == What types of conditions are addressed by Self-help interventions == Depression Eating disorders Positive Psychology and mindfulness practices == What motivates people to engage in Self -help == == What are the theoretical approaches to Self-help == == How effective are Self-help interventions in treating psychological conditions == == Conclusion == Aim for three to six main headings between the [[#Overview|Overview]] and [[#Conclusion|Conclusion]]. {{tip|Suggestions for this section: * For the [[Motivation and emotion/Assessment/Topic|topic development]], provide at least 3 bullet-points about key content per section. Include key citations. * For the [[Motivation and emotion/Assessment/Chapter|book chapter]], expand the bullet points into paragraphs. * If a section has a lot of content, arrange it into two to five sub-headings such as in the [[#Interactive learning features|interactive learning features section]]. Avoid having sections with only one sub-heading. }} ==Learning features== What brings an online book chapter to life are its interactive learning features. Case studies, feature boxes, figures, links, tables, and quiz questions can be used throughout the chapter. ===Case studies=== Case studies describe real-world examples of concepts in action. Case studies can be real or fictional. A case could be used multiple times during a chapter to illustrate different theories or stages. It is often helpful to present case studies using [[#Feature boxes|feature boxes]]. ===Boxes=== Boxes can be used to highlight content, but don't overuse them. There are many different ways of creating boxes (e.g., see [[Help:Pretty boxes|Pretty boxes]]). Possible uses include: * Focus questions * Case studies or examples * Quiz questions * Take-home messages {{RoundBoxTop|theme=3}} ;Feature box example * Shaded background * Coloured border {{RoundBoxBottom}} ===Figures=== [[File:Monkey-typing.jpg|right|205px|thumb|''Figure 1''. Example image with descriptive caption.]] Use figures to illustrate concepts, add interest, and provide examples. Figures can be used to show photographs, drawings, diagrams, graphs, etcetera. Figures can be embedded throughout the chapter, starting with the Overview section. Figures should be captioned (using a number and a description) in order to explain their relevance to the text. Possible images can be found at [[commons:|Wikimedia Commons]]. Images can also be uploaded if they are licensed for re-use or if you created the image. Each figure should be referred to at least once in the main text (e.g., see Figure 1). ===Links=== Where key words are first used, make them into [[Help:Links|interwiki links]] such as Wikipedia links to articles about famous people (e.g., [[w:Sigmund Freud|Sigmund Freud]] and key concepts (e.g., [[w:Dreams|dreams]]) and links to book chapters about related topics (e.g., would you like to learn about how to overcome [[Motivation and emotion/Book/2020/Writer's block|writer's block]]?). ===Tables=== Tables can be an effective way to organise and summarise information. Tables should be captioned (using APA style) to explain their relevance to the text. Plus each table should be referred to at least once in the main text (e.g., see Table 1 and Table 2). Here are some [[Motivation and emotion/Wikiversity/Tables|example 3 x 3 tables]] which could be adapted. ===Quizzes=== Quizzes are a direct way to engage readers. But don't make quizzes too hard or long. It is better to have one or two review questions per major section than a long quiz at the end. Try to quiz conceptual understanding, rather than trivia. Here are some simple quiz questions which could be adapted. Choose the correct answers and click "Submit": <quiz display=simple> {Quizzes are an interactive learning feature: |type="()"} + True - False {Long quizzes are a good idea: |type="()"} - True + False </quiz> To learn about different types of quiz questions, see [[Help:Quiz|Quiz]]. ==Conclusion== The Conclusion is arguably the most important section. It should be possible for someone to read the [[#Overview|Overview]] and the Conclusion and still get a good idea of the topic. {{tip|Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? }} ==See also== Provide up to half-a-dozen [[Help:Contents/Links#Interwiki_links|internal (wiki) links]] to relevant Wikiversity pages (esp. related [[Motivation and emotion/Book|motivation and emotion book chapters]]) and [[w:|Wikipedia articles]]. For example: * [[Motivation]] * {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== {{Hanging indent|1= Buntrock, C., Ebert, D. D., Lehr, D., Smit, F., Riper, H., Berking, M., & Cuijpers, P. (2016). Effect of a Web-Based Guided Self-help Intervention for Prevention of Major Depression in Adults With Subthreshold Depression. JAMA, 315(17), 1854. https://doi.org/10.1001/jama.2016.4326 Cavanagh, K., Strauss, C., Forder, L., & Jones, F. (2014). Can mindfulness and acceptance be learnt by self-help?: A systematic review and meta-analysis of mindfulness and acceptance-based self-help interventions. Clinical Psychology Review, 34(2), 118–129. https://doi.org/10.1016/j.cpr.2014.01.001 Ebert, D. D., Donkin, L., Andersson, G., Andrews, G., Berger, T., Carlbring, P., Rozenthal, A., Choi, I., Laferton, J. A. C., Johansson, R., Kleiboer, A., Lange, A., Lehr, D., Reins, J. A., Funk, B., Newby, J., Perini, S., Riper, H., Ruwaard, J., & Sheeber, L. (2016). Does Internet-based guided-self-help for depression cause harm? An individual participant data meta-analysis on deterioration rates and its moderators in randomized controlled trials. Psychological Medicine, 46(13), 2679–2693. https://doi.org/10.1017/s0033291716001562 Schueller, S. M., & Parks, A. C. (2014). The Science of Self-Help. European Psychologist, 19(2), 145–155. https://doi.org/10.1027/1016-9040/a000181 }} {{tip|Suggestions for this section: * Important aspects for APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except first letter and proper names, ending in a full-stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full-stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't actually read or consulted }} ==External links== Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * [https://www.ted.com/talks/marianne_power_why_self_help_will_not_change_your_life Why Self-help will not change your life] TEDTalk * [https://positivepsychology.com/self-motivation/ Self Motivation explained] (Positive Psychology) article {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] 76cakv6c0e4pqqrwicvp9un015x4pqk 1 286696 2419476 2418227 2022-08-26T10:59:07Z GeorgiaFairweather 2947505 /* Wording of title of topic */ wikitext text/x-wiki == Wording of title of topic == Heya, love how you have all the points already listed out even though it is just the early stages if your page. I do suggest though that you just use " Humour, leadership and work: How does humour influence workplace motivation?" rather than "HUMOUR, leadership, and work: HOW does Humour influence workplace motivation?" Since it looks a bit neater and more presentable. Totally understandable if you want to do your title like that to attract more attention. [[User:CNK.20|CNK.20]] ([[User talk:CNK.20|discuss]] • [[Special:Contributions/CNK.20|contribs]]) 10:29, 24 August 2022 (UTC) Hi there, your page is very clear and set out very well, congratulations! I would love to see maybe how humour develops? This would be beneficial in the history section as humour is developed before one joins a workplace environment. --[[User:GeorgiaFairweather|GeorgiaFairweather]] ([[User talk:GeorgiaFairweather|discuss]] • [[Special:Contributions/GeorgiaFairweather|contribs]]) 10:59, 26 August 2022 (UTC) 1nyfn2lsgqc81xqecpolymhdfrgwtx0 0 286725 2419086 2418686 2022-08-25T21:00:51Z U3230861 2947549 /* References */ wikitext text/x-wiki {{title|Emotional development in adolescence:<br>How does emotionality develop during adolescence?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview == You are underway {{smile}}! This template provides tips for [[Motivation and emotion/Assessment/Topic|topic development]]. Gradually remove these suggestions as you develop the chapter. Also consult the [[Motivation and emotion/Assessment/Chapter|author guidelines]]. At the top of the chapter, the title and sub-title should match the ''exact'' wording and casing as shown in the {{Motivation and emotion/Book}}. The sub-titles all end with a question mark. This Overview section should be concise but consist of several paragraphs which engage the reader, illustrate the problem, and outline how psychological science can help. {{RoundBoxTop|theme=3}} '''Focus questions:''' * What is the first focus question? * What is the second focus question? * What is the third focus question? {{RoundBoxBottom}} {{tip| Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Provide an example or case study. * Conclude with Focus questions to guide the chapter. }} ==heading== How you are going to structure the chapter? Aim for three to six main headings between the [[#Overview|Overview]] and [[#Conclusion|Conclusion]]. {{tip|Suggestions for this section: * For the [[Motivation and emotion/Assessment/Topic|topic development]], provide at least 3 bullet-points about key content per section. Include key citations. * For the [[Motivation and emotion/Assessment/Chapter|book chapter]], expand the bullet points into paragraphs. * If a section has a lot of content, arrange it into two to five sub-headings such as in the [[#Interactive learning features|interactive learning features section]]. Avoid having sections with only one sub-heading. }} == Understanding emotions on the daily basis == What brings an online book chapter to life are its interactive learning features. Case studies, feature boxes, figures, links, tables, and quiz questions can be used throughout the chapter. ===Hormones === Case studies describe real-world examples of concepts in action. Case studies can be real or fictional. A case could be used multiple times during a chapter to illustrate different theories or stages. It is often helpful to present case studies using [[#Feature boxes|feature boxes]]. ===Emotional response=== Boxes can be used to highlight content, but don't overuse them. There are many different ways of creating boxes (e.g., see [[Help:Pretty boxes|Pretty boxes]]). Possible uses include: * Focus questions * Case studies or examples * Quiz questions * Take-home messages {{RoundBoxTop|theme=3}} ;Feature box example * Shaded background * Coloured border {{RoundBoxBottom}} ===School=== [[File:Monkey-typing.jpg|right|205px|thumb|''Figure 1''. Example image with descriptive caption.]] Use figures to illustrate concepts, add interest, and provide examples. Figures can be used to show photographs, drawings, diagrams, graphs, etcetera. Figures can be embedded throughout the chapter, starting with the Overview section. Figures should be captioned (using a number and a description) in order to explain their relevance to the text. Possible images can be found at [[commons:|Wikimedia Commons]]. Images can also be uploaded if they are licensed for re-use or if you created the image. Each figure should be referred to at least once in the main text (e.g., see Figure 1). ===Links=== Where key words are first used, make them into [[Help:Links|interwiki links]] such as Wikipedia links to articles about famous people (e.g., [[w:Sigmund Freud|Sigmund Freud]] and key concepts (e.g., [[w:Dreams|dreams]]) and links to book chapters about related topics (e.g., would you like to learn about how to overcome [[Motivation and emotion/Book/2020/Writer's block|writer's block]]?). ===Tables=== Tables can be an effective way to organise and summarise information. Tables should be captioned (using APA style) to explain their relevance to the text. Plus each table should be referred to at least once in the main text (e.g., see Table 1 and Table 2). Here are some [[Motivation and emotion/Wikiversity/Tables|example 3 x 3 tables]] which could be adapted. ===Quizzes=== Quizzes are a direct way to engage readers. But don't make quizzes too hard or long. It is better to have one or two review questions per major section than a long quiz at the end. Try to quiz conceptual understanding, rather than trivia. Here are some simple quiz questions which could be adapted. Choose the correct answers and click "Submit": <quiz display=simple> {Quizzes are an interactive learning feature: |type="()"} + True - False {Long quizzes are a good idea: |type="()"} - True + False </quiz> To learn about different types of quiz questions, see [[Help:Quiz|Quiz]]. ==Emotion regulation== The Conclusion is arguably the most important section. It should be possible for someone to read the [[#Overview|Overview]] and the Conclusion and still get a good idea of the topic. {{tip|Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? }} ==See also== Provide up to half-a-dozen [[Help:Contents/Links#Interwiki_links|internal (wiki) links]] to relevant Wikiversity pages (esp. related [[Motivation and emotion/Book|motivation and emotion book chapters]]) and [[w:|Wikipedia articles]]. For example: * [[Motivation and emotion/Book/2016/Anorexia nervosa and extrinsic motivation|Anorexia nervosa and extrinsic motivation]] (Book chapter, 2016) * [[w:David McClelland|David McClelland]] (Wikipedia) * [[Motivation and emotion/Book/2018/Loss aversion|Loss aversion]] (Book chapter, 2018) * [[w:Maslow's hierarchy of needs|Maslow's hierarchy of needs]] (Wikipedia) {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== List the cited references in [[w:APA style|APA style]] (7th ed.) or [[w:Wikipedia:Citing sources|wiki style]]. APA style example: Larson, R. W., Moneta, G., Richards, M. H., & Wilson, S. (2002). Continuity, Stability, and Change in Daily Emotional Experience across Adolescence. ''Child Development'', ''73''(4), 1151-1165. <nowiki>https://doi.org/https://doi.org/10.1111/1467-8624.00464</nowiki> McLaughlin, K. A., Garrad, M. C., & Somerville, L. H. (2015). What develops during emotional development? A component process approach to identifying sources of psychopathology risk in adolescence. ''Dialogues in Clinical Neuroscience'', ''17''(4), 403-410. <nowiki>https://doi.org/10.31887/DCNS.2015.17.4/kmclaughlin</nowiki> {{tip|Suggestions for this section: * Important aspects for APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except first letter and proper names, ending in a full-stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full-stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't actually read or consulted }} ==External links== Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * [https://students.unimelb.edu.au/academic-skills/explore-our-resources/essay-writing/six-top-tips-for-writing-a-great-essay Six top tips for writing a great essay] (University of Melbourne) * [http://www.skillsyouneed.com/write/structure.html The importance of structure] (skillsyouneed.com) {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] 5i35vbhahb92hws43vpqsxuqcdlr6vl 2419258 2419086 2022-08-26T04:25:58Z U3230861 2947549 /* Emotion regulation */ wikitext text/x-wiki {{title|Emotional development in adolescence:<br>How does emotionality develop during adolescence?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview == You are underway {{smile}}! This template provides tips for [[Motivation and emotion/Assessment/Topic|topic development]]. Gradually remove these suggestions as you develop the chapter. Also consult the [[Motivation and emotion/Assessment/Chapter|author guidelines]]. At the top of the chapter, the title and sub-title should match the ''exact'' wording and casing as shown in the {{Motivation and emotion/Book}}. The sub-titles all end with a question mark. This Overview section should be concise but consist of several paragraphs which engage the reader, illustrate the problem, and outline how psychological science can help. {{RoundBoxTop|theme=3}} '''Focus questions:''' * What is the first focus question? * What is the second focus question? * What is the third focus question? {{RoundBoxBottom}} {{tip| Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Provide an example or case study. * Conclude with Focus questions to guide the chapter. }} == Understanding emotions on the daily basis == What brings an online book chapter to life are its interactive learning features. Case studies, feature boxes, figures, links, tables, and quiz questions can be used throughout the chapter. ===Hormones === Case studies describe real-world examples of concepts in action. Case studies can be real or fictional. A case could be used multiple times during a chapter to illustrate different theories or stages. It is often helpful to present case studies using [[#Feature boxes|feature boxes]]. ===Emotional response=== Boxes can be used to highlight content, but don't overuse them. There are many different ways of creating boxes (e.g., see [[Help:Pretty boxes|Pretty boxes]]). Possible uses include: * Focus questions * Case studies or examples * Quiz questions * Take-home messages ===School=== [[File:Monkey-typing.jpg|right|205px|thumb|''Figure 1''. Example image with descriptive caption.]] Use figures to illustrate concepts, add interest, and provide examples. Figures can be used to show photographs, drawings, diagrams, graphs, etcetera. Figures can be embedded throughout the chapter, starting with the Overview section. Figures should be captioned (using a number and a description) in order to explain their relevance to the text. Possible images can be found at [[commons:|Wikimedia Commons]]. Images can also be uploaded if they are licensed for re-use or if you created the image. Each figure should be referred to at least once in the main text (e.g., see Figure 1). ==Emotion regulation== * Adolescents find it more difficult to regulate emotions, particularly those inclusive of anxiety and depressed states * Studies have found the possible cause of "emotional reactivity during adolescence might increase the need for top-down control and put individuals with less control" (Hare et al., 2008). * Brain areas that include this reactivity is the amygdala ==See also== * {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== List the cited references in [[w:APA style|APA style]] (7th ed.) or [[w:Wikipedia:Citing sources|wiki style]]. APA style example: Hare, T. A., Tottenham, N., Galvan, A., Voss, H. U., Glover, G. H., & Casey, B. J. (2008). Biological Substrates of Emotional Reactivity and Regulation in Adolescence During an Emotional Go-Nogo Task. ''Biological Psychiatry'', ''63''(10), 927-934. <nowiki>https://doi.org/10.1016/j.biopsych.2008.03.015</nowiki> Larson, R. W., Moneta, G., Richards, M. H., & Wilson, S. (2002). Continuity, Stability, and Change in Daily Emotional Experience across Adolescence. ''Child Development'', ''73''(4), 1151-1165. <nowiki>https://doi.org/https://doi.org/10.1111/1467-8624.00464</nowiki> McLaughlin, K. A., Garrad, M. C., & Somerville, L. H. (2015). What develops during emotional development? A component process approach to identifying sources of psychopathology risk in adolescence. ''Dialogues in Clinical Neuroscience'', ''17''(4), 403-410. <nowiki>https://doi.org/10.31887/DCNS.2015.17.4/kmclaughlin</nowiki> {{tip|Suggestions for this section: * Important aspects for APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except first letter and proper names, ending in a full-stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full-stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't actually read or consulted }} ==External links== Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * [https://students.unimelb.edu.au/academic-skills/explore-our-resources/essay-writing/six-top-tips-for-writing-a-great-essay Six top tips for writing a great essay] (University of Melbourne) * [http://www.skillsyouneed.com/write/structure.html The importance of structure] (skillsyouneed.com) {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] tet7qiovkovzr1ntceoaj9uk68buxr6 2419261 2419258 2022-08-26T04:29:24Z U3230861 2947549 /* Emotion regulation */ wikitext text/x-wiki {{title|Emotional development in adolescence:<br>How does emotionality develop during adolescence?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview == You are underway {{smile}}! This template provides tips for [[Motivation and emotion/Assessment/Topic|topic development]]. Gradually remove these suggestions as you develop the chapter. Also consult the [[Motivation and emotion/Assessment/Chapter|author guidelines]]. At the top of the chapter, the title and sub-title should match the ''exact'' wording and casing as shown in the {{Motivation and emotion/Book}}. The sub-titles all end with a question mark. This Overview section should be concise but consist of several paragraphs which engage the reader, illustrate the problem, and outline how psychological science can help. {{RoundBoxTop|theme=3}} '''Focus questions:''' * What is the first focus question? * What is the second focus question? * What is the third focus question? {{RoundBoxBottom}} {{tip| Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Provide an example or case study. * Conclude with Focus questions to guide the chapter. }} == Understanding emotions on the daily basis == What brings an online book chapter to life are its interactive learning features. Case studies, feature boxes, figures, links, tables, and quiz questions can be used throughout the chapter. ===Hormones === Case studies describe real-world examples of concepts in action. Case studies can be real or fictional. A case could be used multiple times during a chapter to illustrate different theories or stages. It is often helpful to present case studies using [[#Feature boxes|feature boxes]]. ===Emotional response=== Boxes can be used to highlight content, but don't overuse them. There are many different ways of creating boxes (e.g., see [[Help:Pretty boxes|Pretty boxes]]). Possible uses include: * Focus questions * Case studies or examples * Quiz questions * Take-home messages ===School=== [[File:Monkey-typing.jpg|right|205px|thumb|''Figure 1''. Example image with descriptive caption.]] Use figures to illustrate concepts, add interest, and provide examples. Figures can be used to show photographs, drawings, diagrams, graphs, etcetera. Figures can be embedded throughout the chapter, starting with the Overview section. Figures should be captioned (using a number and a description) in order to explain their relevance to the text. Possible images can be found at [[commons:|Wikimedia Commons]]. Images can also be uploaded if they are licensed for re-use or if you created the image. Each figure should be referred to at least once in the main text (e.g., see Figure 1). ==Emotion regulation== * Adolescents find it more difficult to regulate emotions, particularly those inclusive of anxiety and depressed states * Studies have found the possible cause of "emotional reactivity during adolescence might increase the need for top-down control and put individuals with less control" (Hare et al., 2008). * Brain areas that include this reactivity is the amygdala === The amygdala === ==See also== * {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== List the cited references in [[w:APA style|APA style]] (7th ed.) or [[w:Wikipedia:Citing sources|wiki style]]. APA style example: Hare, T. A., Tottenham, N., Galvan, A., Voss, H. U., Glover, G. H., & Casey, B. J. (2008). Biological Substrates of Emotional Reactivity and Regulation in Adolescence During an Emotional Go-Nogo Task. ''Biological Psychiatry'', ''63''(10), 927-934. <nowiki>https://doi.org/10.1016/j.biopsych.2008.03.015</nowiki> Larson, R. W., Moneta, G., Richards, M. H., & Wilson, S. (2002). Continuity, Stability, and Change in Daily Emotional Experience across Adolescence. ''Child Development'', ''73''(4), 1151-1165. <nowiki>https://doi.org/https://doi.org/10.1111/1467-8624.00464</nowiki> McLaughlin, K. A., Garrad, M. C., & Somerville, L. H. (2015). What develops during emotional development? A component process approach to identifying sources of psychopathology risk in adolescence. ''Dialogues in Clinical Neuroscience'', ''17''(4), 403-410. <nowiki>https://doi.org/10.31887/DCNS.2015.17.4/kmclaughlin</nowiki> {{tip|Suggestions for this section: * Important aspects for APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except first letter and proper names, ending in a full-stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full-stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't actually read or consulted }} ==External links== Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * [https://students.unimelb.edu.au/academic-skills/explore-our-resources/essay-writing/six-top-tips-for-writing-a-great-essay Six top tips for writing a great essay] (University of Melbourne) * [http://www.skillsyouneed.com/write/structure.html The importance of structure] (skillsyouneed.com) {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] 2lgybuhdiarjee7bndonrkjn0t4ynt4 2419268 2419261 2022-08-26T04:37:07Z U3230861 2947549 /* School paragraph dot points*/ wikitext text/x-wiki {{title|Emotional development in adolescence:<br>How does emotionality develop during adolescence?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview == You are underway {{smile}}! This template provides tips for [[Motivation and emotion/Assessment/Topic|topic development]]. Gradually remove these suggestions as you develop the chapter. Also consult the [[Motivation and emotion/Assessment/Chapter|author guidelines]]. At the top of the chapter, the title and sub-title should match the ''exact'' wording and casing as shown in the {{Motivation and emotion/Book}}. The sub-titles all end with a question mark. This Overview section should be concise but consist of several paragraphs which engage the reader, illustrate the problem, and outline how psychological science can help. {{RoundBoxTop|theme=3}} '''Focus questions:''' * What is the first focus question? * What is the second focus question? * What is the third focus question? {{RoundBoxBottom}} {{tip| Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Provide an example or case study. * Conclude with Focus questions to guide the chapter. }} == Understanding emotions on the daily basis == Adolescents === School === * Those in their adolescent years particularly from 12-15 are creating new social groups * There is significant change in social dynamics of adolescence, that present difficult challenges for adolescents to navigate (McLaughlin et al., 2015). * Academic stress can be a factor causing emotional reactions ===Emotional response=== * [[File:Monkey-typing.jpg|right|205px|thumb|''Figure 1''. Example image with descriptive caption.]] == Emotion regulation == * Adolescents find it more difficult to regulate emotions, particularly those inclusive of anxiety and depressed states * Studies have found the possible cause of "emotional reactivity during adolescence might increase the need for top-down control and put individuals with less control" (Hare et al., 2008). * Brain areas that include this reactivity is the amygdala === The amygdala === ==See also== * {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== List the cited references in [[w:APA style|APA style]] (7th ed.) or [[w:Wikipedia:Citing sources|wiki style]]. APA style example: Hare, T. A., Tottenham, N., Galvan, A., Voss, H. U., Glover, G. H., & Casey, B. J. (2008). Biological Substrates of Emotional Reactivity and Regulation in Adolescence During an Emotional Go-Nogo Task. ''Biological Psychiatry'', ''63''(10), 927-934. <nowiki>https://doi.org/10.1016/j.biopsych.2008.03.015</nowiki> Larson, R. W., Moneta, G., Richards, M. H., & Wilson, S. (2002). Continuity, Stability, and Change in Daily Emotional Experience across Adolescence. ''Child Development'', ''73''(4), 1151-1165. <nowiki>https://doi.org/https://doi.org/10.1111/1467-8624.00464</nowiki> McLaughlin, K. A., Garrad, M. C., & Somerville, L. H. (2015). What develops during emotional development? A component process approach to identifying sources of psychopathology risk in adolescence. ''Dialogues in Clinical Neuroscience'', ''17''(4), 403-410. <nowiki>https://doi.org/10.31887/DCNS.2015.17.4/kmclaughlin</nowiki> {{tip|Suggestions for this section: * Important aspects for APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except first letter and proper names, ending in a full-stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full-stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't actually read or consulted }} ==External links== Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * [https://students.unimelb.edu.au/academic-skills/explore-our-resources/essay-writing/six-top-tips-for-writing-a-great-essay Six top tips for writing a great essay] (University of Melbourne) * [http://www.skillsyouneed.com/write/structure.html The importance of structure] (skillsyouneed.com) {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] 3z5aqz61r0ubg29g4qylluoy4264kf4 2419269 2419268 2022-08-26T04:38:16Z U3230861 2947549 /* Emotional response paragraph*/ wikitext text/x-wiki {{title|Emotional development in adolescence:<br>How does emotionality develop during adolescence?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview == You are underway {{smile}}! This template provides tips for [[Motivation and emotion/Assessment/Topic|topic development]]. Gradually remove these suggestions as you develop the chapter. Also consult the [[Motivation and emotion/Assessment/Chapter|author guidelines]]. At the top of the chapter, the title and sub-title should match the ''exact'' wording and casing as shown in the {{Motivation and emotion/Book}}. The sub-titles all end with a question mark. This Overview section should be concise but consist of several paragraphs which engage the reader, illustrate the problem, and outline how psychological science can help. {{RoundBoxTop|theme=3}} '''Focus questions:''' * What is the first focus question? * What is the second focus question? * What is the third focus question? {{RoundBoxBottom}} {{tip| Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Provide an example or case study. * Conclude with Focus questions to guide the chapter. }} == Understanding emotions on the daily basis == Adolescents === School === * Those in their adolescent years particularly from 12-15 are creating new social groups * There is significant change in social dynamics of adolescence, that present difficult challenges for adolescents to navigate (McLaughlin et al., 2015). * Academic stress can be a factor causing emotional reactions ===Emotional response=== *Social media * [[File:Monkey-typing.jpg|right|205px|thumb|''Figure 1''. Example image with descriptive caption.]] == Emotion regulation == * Adolescents find it more difficult to regulate emotions, particularly those inclusive of anxiety and depressed states * Studies have found the possible cause of "emotional reactivity during adolescence might increase the need for top-down control and put individuals with less control" (Hare et al., 2008). * Brain areas that include this reactivity is the amygdala === The amygdala === ==See also== * {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== List the cited references in [[w:APA style|APA style]] (7th ed.) or [[w:Wikipedia:Citing sources|wiki style]]. APA style example: Hare, T. A., Tottenham, N., Galvan, A., Voss, H. U., Glover, G. H., & Casey, B. J. (2008). Biological Substrates of Emotional Reactivity and Regulation in Adolescence During an Emotional Go-Nogo Task. ''Biological Psychiatry'', ''63''(10), 927-934. <nowiki>https://doi.org/10.1016/j.biopsych.2008.03.015</nowiki> Larson, R. W., Moneta, G., Richards, M. H., & Wilson, S. (2002). Continuity, Stability, and Change in Daily Emotional Experience across Adolescence. ''Child Development'', ''73''(4), 1151-1165. <nowiki>https://doi.org/https://doi.org/10.1111/1467-8624.00464</nowiki> McLaughlin, K. A., Garrad, M. C., & Somerville, L. H. (2015). What develops during emotional development? A component process approach to identifying sources of psychopathology risk in adolescence. ''Dialogues in Clinical Neuroscience'', ''17''(4), 403-410. <nowiki>https://doi.org/10.31887/DCNS.2015.17.4/kmclaughlin</nowiki> {{tip|Suggestions for this section: * Important aspects for APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except first letter and proper names, ending in a full-stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full-stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't actually read or consulted }} ==External links== Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * [https://students.unimelb.edu.au/academic-skills/explore-our-resources/essay-writing/six-top-tips-for-writing-a-great-essay Six top tips for writing a great essay] (University of Melbourne) * [http://www.skillsyouneed.com/write/structure.html The importance of structure] (skillsyouneed.com) {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] c6anxksuqjtmwzv9ef9kibefatbbboa 2419273 2419269 2022-08-26T04:46:26Z U3230861 2947549 /* Understanding emotions on the daily basis Figure added*/ wikitext text/x-wiki {{title|Emotional development in adolescence:<br>How does emotionality develop during adolescence?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview == You are underway {{smile}}! This template provides tips for [[Motivation and emotion/Assessment/Topic|topic development]]. Gradually remove these suggestions as you develop the chapter. Also consult the [[Motivation and emotion/Assessment/Chapter|author guidelines]]. At the top of the chapter, the title and sub-title should match the ''exact'' wording and casing as shown in the {{Motivation and emotion/Book}}. The sub-titles all end with a question mark. This Overview section should be concise but consist of several paragraphs which engage the reader, illustrate the problem, and outline how psychological science can help. {{RoundBoxTop|theme=3}} '''Focus questions:''' * What is the first focus question? * What is the second focus question? * What is the third focus question? {{RoundBoxBottom}} {{tip| Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Provide an example or case study. * Conclude with Focus questions to guide the chapter. }} == Understanding emotions on the daily basis == Adolescents === School === * Those in their adolescent years particularly from 12-15 are creating new social groups * There is significant change in social dynamics of adolescence, that present difficult challenges for adolescents to navigate (McLaughlin et al., 2015). * Academic stress can be a factor causing emotional reactions ===Emotional response=== *Social media * == Emotion regulation == * Adolescents find it more difficult to regulate emotions, particularly those inclusive of anxiety and depressed states * Studies have found the possible cause of "emotional reactivity during adolescence might increase the need for top-down control and put individuals with less control" (Hare et al., 2008). * Brain areas that include this reactivity is the amygdala [[File:Amygdala small.gif|thumb|Figure 1. The Amygdala]] === The amygdala === ==See also== * {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== List the cited references in [[w:APA style|APA style]] (7th ed.) or [[w:Wikipedia:Citing sources|wiki style]]. APA style example: Hare, T. A., Tottenham, N., Galvan, A., Voss, H. U., Glover, G. H., & Casey, B. J. (2008). Biological Substrates of Emotional Reactivity and Regulation in Adolescence During an Emotional Go-Nogo Task. ''Biological Psychiatry'', ''63''(10), 927-934. <nowiki>https://doi.org/10.1016/j.biopsych.2008.03.015</nowiki> Larson, R. W., Moneta, G., Richards, M. H., & Wilson, S. (2002). Continuity, Stability, and Change in Daily Emotional Experience across Adolescence. ''Child Development'', ''73''(4), 1151-1165. <nowiki>https://doi.org/https://doi.org/10.1111/1467-8624.00464</nowiki> McLaughlin, K. A., Garrad, M. C., & Somerville, L. H. (2015). What develops during emotional development? A component process approach to identifying sources of psychopathology risk in adolescence. ''Dialogues in Clinical Neuroscience'', ''17''(4), 403-410. <nowiki>https://doi.org/10.31887/DCNS.2015.17.4/kmclaughlin</nowiki> {{tip|Suggestions for this section: * Important aspects for APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except first letter and proper names, ending in a full-stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full-stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't actually read or consulted }} ==External links== Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * [https://students.unimelb.edu.au/academic-skills/explore-our-resources/essay-writing/six-top-tips-for-writing-a-great-essay Six top tips for writing a great essay] (University of Melbourne) * [http://www.skillsyouneed.com/write/structure.html The importance of structure] (skillsyouneed.com) {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] 2uo8hal2ua4sw37e6sfkym5sd3n2rpo 2419274 2419273 2022-08-26T04:47:34Z U3230861 2947549 /* Overview added title */ wikitext text/x-wiki {{title|Emotional development in adolescence:<br>How does emotionality develop during adolescence?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==From Tweens to Teens == You are underway {{smile}}! This template provides tips for [[Motivation and emotion/Assessment/Topic|topic development]]. Gradually remove these suggestions as you develop the chapter. Also consult the [[Motivation and emotion/Assessment/Chapter|author guidelines]]. At the top of the chapter, the title and sub-title should match the ''exact'' wording and casing as shown in the {{Motivation and emotion/Book}}. The sub-titles all end with a question mark. This Overview section should be concise but consist of several paragraphs which engage the reader, illustrate the problem, and outline how psychological science can help. {{RoundBoxTop|theme=3}} '''Focus questions:''' * What is the first focus question? * What is the second focus question? * What is the third focus question? {{RoundBoxBottom}} {{tip| Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Provide an example or case study. * Conclude with Focus questions to guide the chapter. }} == Understanding emotions on the daily basis == Adolescents === School === * Those in their adolescent years particularly from 12-15 are creating new social groups * There is significant change in social dynamics of adolescence, that present difficult challenges for adolescents to navigate (McLaughlin et al., 2015). * Academic stress can be a factor causing emotional reactions ===Emotional response=== *Social media * == Emotion regulation == * Adolescents find it more difficult to regulate emotions, particularly those inclusive of anxiety and depressed states * Studies have found the possible cause of "emotional reactivity during adolescence might increase the need for top-down control and put individuals with less control" (Hare et al., 2008). * Brain areas that include this reactivity is the amygdala [[File:Amygdala small.gif|thumb|Figure 1. The Amygdala]] === The amygdala === ==See also== * {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== List the cited references in [[w:APA style|APA style]] (7th ed.) or [[w:Wikipedia:Citing sources|wiki style]]. APA style example: Hare, T. A., Tottenham, N., Galvan, A., Voss, H. U., Glover, G. H., & Casey, B. J. (2008). Biological Substrates of Emotional Reactivity and Regulation in Adolescence During an Emotional Go-Nogo Task. ''Biological Psychiatry'', ''63''(10), 927-934. <nowiki>https://doi.org/10.1016/j.biopsych.2008.03.015</nowiki> Larson, R. W., Moneta, G., Richards, M. H., & Wilson, S. (2002). Continuity, Stability, and Change in Daily Emotional Experience across Adolescence. ''Child Development'', ''73''(4), 1151-1165. <nowiki>https://doi.org/https://doi.org/10.1111/1467-8624.00464</nowiki> McLaughlin, K. A., Garrad, M. C., & Somerville, L. H. (2015). What develops during emotional development? A component process approach to identifying sources of psychopathology risk in adolescence. ''Dialogues in Clinical Neuroscience'', ''17''(4), 403-410. <nowiki>https://doi.org/10.31887/DCNS.2015.17.4/kmclaughlin</nowiki> {{tip|Suggestions for this section: * Important aspects for APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except first letter and proper names, ending in a full-stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full-stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't actually read or consulted }} ==External links== Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * [https://students.unimelb.edu.au/academic-skills/explore-our-resources/essay-writing/six-top-tips-for-writing-a-great-essay Six top tips for writing a great essay] (University of Melbourne) * [http://www.skillsyouneed.com/write/structure.html The importance of structure] (skillsyouneed.com) {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] bn5v48d603jkcjzwgdb1e17zvb6the9 2419275 2419274 2022-08-26T04:48:59Z U3230861 2947549 /* References */ wikitext text/x-wiki {{title|Emotional development in adolescence:<br>How does emotionality develop during adolescence?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==From Tweens to Teens == You are underway {{smile}}! This template provides tips for [[Motivation and emotion/Assessment/Topic|topic development]]. Gradually remove these suggestions as you develop the chapter. Also consult the [[Motivation and emotion/Assessment/Chapter|author guidelines]]. At the top of the chapter, the title and sub-title should match the ''exact'' wording and casing as shown in the {{Motivation and emotion/Book}}. The sub-titles all end with a question mark. This Overview section should be concise but consist of several paragraphs which engage the reader, illustrate the problem, and outline how psychological science can help. {{RoundBoxTop|theme=3}} '''Focus questions:''' * What is the first focus question? * What is the second focus question? * What is the third focus question? {{RoundBoxBottom}} {{tip| Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Provide an example or case study. * Conclude with Focus questions to guide the chapter. }} == Understanding emotions on the daily basis == Adolescents === School === * Those in their adolescent years particularly from 12-15 are creating new social groups * There is significant change in social dynamics of adolescence, that present difficult challenges for adolescents to navigate (McLaughlin et al., 2015). * Academic stress can be a factor causing emotional reactions ===Emotional response=== *Social media * == Emotion regulation == * Adolescents find it more difficult to regulate emotions, particularly those inclusive of anxiety and depressed states * Studies have found the possible cause of "emotional reactivity during adolescence might increase the need for top-down control and put individuals with less control" (Hare et al., 2008). * Brain areas that include this reactivity is the amygdala [[File:Amygdala small.gif|thumb|Figure 1. The Amygdala]] === The amygdala === ==See also== * {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== Hare, T. A., Tottenham, N., Galvan, A., Voss, H. U., Glover, G. H., & Casey, B. J. (2008). Biological Substrates of Emotional Reactivity and Regulation in Adolescence During an Emotional Go-Nogo Task. ''Biological Psychiatry'', ''63''(10), 927-934. <nowiki>https://doi.org/10.1016/j.biopsych.2008.03.015</nowiki> Larson, R. W., Moneta, G., Richards, M. H., & Wilson, S. (2002). Continuity, Stability, and Change in Daily Emotional Experience across Adolescence. ''Child Development'', ''73''(4), 1151-1165. <nowiki>https://doi.org/https://doi.org/10.1111/1467-8624.00464</nowiki> McLaughlin, K. A., Garrad, M. C., & Somerville, L. H. (2015). What develops during emotional development? A component process approach to identifying sources of psychopathology risk in adolescence. ''Dialogues in Clinical Neuroscience'', ''17''(4), 403-410. <nowiki>https://doi.org/10.31887/DCNS.2015.17.4/kmclaughlin</nowiki> ==External links== Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * [https://students.unimelb.edu.au/academic-skills/explore-our-resources/essay-writing/six-top-tips-for-writing-a-great-essay Six top tips for writing a great essay] (University of Melbourne) * [http://www.skillsyouneed.com/write/structure.html The importance of structure] (skillsyouneed.com) {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] mo5zt139808kw9po2cyyabpf3b585w6 2419279 2419275 2022-08-26T04:57:44Z U3230861 2947549 /* Emotion regulation */ wikitext text/x-wiki {{title|Emotional development in adolescence:<br>How does emotionality develop during adolescence?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==From Tweens to Teens == You are underway {{smile}}! This template provides tips for [[Motivation and emotion/Assessment/Topic|topic development]]. Gradually remove these suggestions as you develop the chapter. Also consult the [[Motivation and emotion/Assessment/Chapter|author guidelines]]. At the top of the chapter, the title and sub-title should match the ''exact'' wording and casing as shown in the {{Motivation and emotion/Book}}. The sub-titles all end with a question mark. This Overview section should be concise but consist of several paragraphs which engage the reader, illustrate the problem, and outline how psychological science can help. {{RoundBoxTop|theme=3}} '''Focus questions:''' * What is the first focus question? * What is the second focus question? * What is the third focus question? {{RoundBoxBottom}} {{tip| Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Provide an example or case study. * Conclude with Focus questions to guide the chapter. }} == Understanding emotions on the daily basis == Adolescents === School === * Those in their adolescent years particularly from 12-15 are creating new social groups * There is significant change in social dynamics of adolescence, that present difficult challenges for adolescents to navigate (McLaughlin et al., 2015). * Academic stress can be a factor causing emotional reactions ===Emotional response=== *Social media * == Emotion regulation == * Adolescents find it more difficult to regulate emotions, particularly those inclusive of anxiety and depressed states * Studies have found the possible cause of "emotional reactivity during adolescence might increase the need for top-down control and put individuals with less control" (Hare et al., 2008). * Brain areas that include this reactivity is the amygdala [[File:Amygdala small.gif|thumb|Figure 1. The Amygdala]] === The amygdala === === The Prefrontal Cortex === * Conversely, the prefrontal cortex — which plays a central role in the effortful emotion regulation — shows continued development through adolescence, and could constrain the efficiency of emotion regulation (McLaughlin et al., 2015). * ==See also== * {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== Hare, T. A., Tottenham, N., Galvan, A., Voss, H. U., Glover, G. H., & Casey, B. J. (2008). Biological Substrates of Emotional Reactivity and Regulation in Adolescence During an Emotional Go-Nogo Task. ''Biological Psychiatry'', ''63''(10), 927-934. <nowiki>https://doi.org/10.1016/j.biopsych.2008.03.015</nowiki> Larson, R. W., Moneta, G., Richards, M. H., & Wilson, S. (2002). Continuity, Stability, and Change in Daily Emotional Experience across Adolescence. ''Child Development'', ''73''(4), 1151-1165. <nowiki>https://doi.org/https://doi.org/10.1111/1467-8624.00464</nowiki> McLaughlin, K. A., Garrad, M. C., & Somerville, L. H. (2015). What develops during emotional development? A component process approach to identifying sources of psychopathology risk in adolescence. ''Dialogues in Clinical Neuroscience'', ''17''(4), 403-410. <nowiki>https://doi.org/10.31887/DCNS.2015.17.4/kmclaughlin</nowiki> ==External links== * https://www.youtube.com/watch?v=PzyXGUCngoU crash course on adolescence [[Category:{{#titleparts:{{PAGENAME}}|3}}]] 1o30ugqcsv30qut2bcvi95c0tzqrfsi 2419280 2419279 2022-08-26T04:58:49Z U3230861 2947549 /* added self identity */ wikitext text/x-wiki {{title|Emotional development in adolescence:<br>How does emotionality develop during adolescence?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==From Tweens to Teens == You are underway {{smile}}! This template provides tips for [[Motivation and emotion/Assessment/Topic|topic development]]. Gradually remove these suggestions as you develop the chapter. Also consult the [[Motivation and emotion/Assessment/Chapter|author guidelines]]. At the top of the chapter, the title and sub-title should match the ''exact'' wording and casing as shown in the {{Motivation and emotion/Book}}. The sub-titles all end with a question mark. This Overview section should be concise but consist of several paragraphs which engage the reader, illustrate the problem, and outline how psychological science can help. {{RoundBoxTop|theme=3}} '''Focus questions:''' * What is the first focus question? * What is the second focus question? * What is the third focus question? {{RoundBoxBottom}} {{tip| Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Provide an example or case study. * Conclude with Focus questions to guide the chapter. }} == Understanding emotions on the daily basis == Adolescents === School === * Those in their adolescent years particularly from 12-15 are creating new social groups * There is significant change in social dynamics of adolescence, that present difficult challenges for adolescents to navigate (McLaughlin et al., 2015). * Academic stress can be a factor causing emotional reactions === Self identity === == Emotion regulation == * Adolescents find it more difficult to regulate emotions, particularly those inclusive of anxiety and depressed states * Studies have found the possible cause of "emotional reactivity during adolescence might increase the need for top-down control and put individuals with less control" (Hare et al., 2008). * Brain areas that include this reactivity is the amygdala [[File:Amygdala small.gif|thumb|Figure 1. The Amygdala]] === The amygdala === === The Prefrontal Cortex === * Conversely, the prefrontal cortex — which plays a central role in the effortful emotion regulation — shows continued development through adolescence, and could constrain the efficiency of emotion regulation (McLaughlin et al., 2015). * ==See also== * {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== Hare, T. A., Tottenham, N., Galvan, A., Voss, H. U., Glover, G. H., & Casey, B. J. (2008). Biological Substrates of Emotional Reactivity and Regulation in Adolescence During an Emotional Go-Nogo Task. ''Biological Psychiatry'', ''63''(10), 927-934. <nowiki>https://doi.org/10.1016/j.biopsych.2008.03.015</nowiki> Larson, R. W., Moneta, G., Richards, M. H., & Wilson, S. (2002). Continuity, Stability, and Change in Daily Emotional Experience across Adolescence. ''Child Development'', ''73''(4), 1151-1165. <nowiki>https://doi.org/https://doi.org/10.1111/1467-8624.00464</nowiki> McLaughlin, K. A., Garrad, M. C., & Somerville, L. H. (2015). What develops during emotional development? A component process approach to identifying sources of psychopathology risk in adolescence. ''Dialogues in Clinical Neuroscience'', ''17''(4), 403-410. <nowiki>https://doi.org/10.31887/DCNS.2015.17.4/kmclaughlin</nowiki> ==External links== * https://www.youtube.com/watch?v=PzyXGUCngoU crash course on adolescence [[Category:{{#titleparts:{{PAGENAME}}|3}}]] omhq7cgcezogv63opuwpoih7lywzldp 2419282 2419280 2022-08-26T05:01:32Z U3230861 2947549 /* Self identity */ wikitext text/x-wiki {{title|Emotional development in adolescence:<br>How does emotionality develop during adolescence?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==From Tweens to Teens == You are underway {{smile}}! This template provides tips for [[Motivation and emotion/Assessment/Topic|topic development]]. Gradually remove these suggestions as you develop the chapter. Also consult the [[Motivation and emotion/Assessment/Chapter|author guidelines]]. At the top of the chapter, the title and sub-title should match the ''exact'' wording and casing as shown in the {{Motivation and emotion/Book}}. The sub-titles all end with a question mark. This Overview section should be concise but consist of several paragraphs which engage the reader, illustrate the problem, and outline how psychological science can help. {{RoundBoxTop|theme=3}} '''Focus questions:''' * What is the first focus question? * What is the second focus question? * What is the third focus question? {{RoundBoxBottom}} {{tip| Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Provide an example or case study. * Conclude with Focus questions to guide the chapter. }} == Understanding emotions on the daily basis == Adolescents === School === * Those in their adolescent years particularly from 12-15 are creating new social groups * There is significant change in social dynamics of adolescence, that present difficult challenges for adolescents to navigate (McLaughlin et al., 2015). * Academic stress can be a factor causing emotional reactions === Self identity === * Erikson's 8 Stages of Progressive Psychosocial Development * Identity vs role of confusion == Emotion regulation == * Adolescents find it more difficult to regulate emotions, particularly those inclusive of anxiety and depressed states * Studies have found the possible cause of "emotional reactivity during adolescence might increase the need for top-down control and put individuals with less control" (Hare et al., 2008). * Brain areas that include this reactivity is the amygdala [[File:Amygdala small.gif|thumb|Figure 1. The Amygdala]] === The amygdala === === The Prefrontal Cortex === * Conversely, the prefrontal cortex — which plays a central role in the effortful emotion regulation — shows continued development through adolescence, and could constrain the efficiency of emotion regulation (McLaughlin et al., 2015). * ==See also== * {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== Hare, T. A., Tottenham, N., Galvan, A., Voss, H. U., Glover, G. H., & Casey, B. J. (2008). Biological Substrates of Emotional Reactivity and Regulation in Adolescence During an Emotional Go-Nogo Task. ''Biological Psychiatry'', ''63''(10), 927-934. <nowiki>https://doi.org/10.1016/j.biopsych.2008.03.015</nowiki> Larson, R. W., Moneta, G., Richards, M. H., & Wilson, S. (2002). Continuity, Stability, and Change in Daily Emotional Experience across Adolescence. ''Child Development'', ''73''(4), 1151-1165. <nowiki>https://doi.org/https://doi.org/10.1111/1467-8624.00464</nowiki> McLaughlin, K. A., Garrad, M. C., & Somerville, L. H. (2015). What develops during emotional development? A component process approach to identifying sources of psychopathology risk in adolescence. ''Dialogues in Clinical Neuroscience'', ''17''(4), 403-410. <nowiki>https://doi.org/10.31887/DCNS.2015.17.4/kmclaughlin</nowiki> ==External links== * https://www.youtube.com/watch?v=PzyXGUCngoU crash course on adolescence [[Category:{{#titleparts:{{PAGENAME}}|3}}]] 4bcgui4014b1qlgcqtxv8l3saf3o8tz 2419359 2419282 2022-08-26T07:23:45Z U3230861 2947549 /* overview */ wikitext text/x-wiki {{title|Emotional development in adolescence:<br>How does emotionality develop during adolescence?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==From Tweens to Teens == * Through out adolescence, teens are developing emotionally but what exactly are these developments? * Adolescences are depicted to be typically moody, we will digress the hows and whys of these emotional changes. * Stresses such school, life and social media cause a big impact on emotions for adolescents. == Understanding emotions on the daily basis == * Adolescents * * === School === * Those in their adolescent years particularly from 12-15 are creating new social groups * There is significant change in social dynamics of adolescence, that present difficult challenges for adolescents to navigate (McLaughlin et al., 2015). * Academic stress can be a factor causing emotional reactions === Self identity === * Erikson's 8 Stages of Progressive Psychosocial Development * Identity vs role of confusion * == Emotion regulation == * Adolescents find it more difficult to regulate emotions, particularly those inclusive of anxiety and depressed states * Studies have found the possible cause of "emotional reactivity during adolescence might increase the need for top-down control and put individuals with less control" (Hare et al., 2008). * [[File:Amygdala small.gif|thumb|Figure 1. The Amygdala]] === The amygdala === * Brain areas that include this reactivity is the amygdala * * === The Prefrontal Cortex === * Conversely, the prefrontal cortex — which plays a central role in the effortful emotion regulation — shows continued development through adolescence, and could constrain the efficiency of emotion regulation (McLaughlin et al., 2015). * * == Conclusion == ==See also== * {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== Hare, T. A., Tottenham, N., Galvan, A., Voss, H. U., Glover, G. H., & Casey, B. J. (2008). Biological Substrates of Emotional Reactivity and Regulation in Adolescence During an Emotional Go-Nogo Task. ''Biological Psychiatry'', ''63''(10), 927-934. <nowiki>https://doi.org/10.1016/j.biopsych.2008.03.015</nowiki> Larson, R. W., Moneta, G., Richards, M. H., & Wilson, S. (2002). Continuity, Stability, and Change in Daily Emotional Experience across Adolescence. ''Child Development'', ''73''(4), 1151-1165. <nowiki>https://doi.org/https://doi.org/10.1111/1467-8624.00464</nowiki> McLaughlin, K. A., Garrad, M. C., & Somerville, L. H. (2015). What develops during emotional development? A component process approach to identifying sources of psychopathology risk in adolescence. ''Dialogues in Clinical Neuroscience'', ''17''(4), 403-410. <nowiki>https://doi.org/10.31887/DCNS.2015.17.4/kmclaughlin</nowiki> ==External links== * https://www.youtube.com/watch?v=PzyXGUCngoU Crash course on adolescence [[Category:{{#titleparts:{{PAGENAME}}|3}}]] aohb14aqf7y0dlx8wucj3uu2ilh09vx 2419361 2419359 2022-08-26T07:24:38Z U3230861 2947549 /* The amygdala heading*/ wikitext text/x-wiki {{title|Emotional development in adolescence:<br>How does emotionality develop during adolescence?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==From Tweens to Teens == * Through out adolescence, teens are developing emotionally but what exactly are these developments? * Adolescences are depicted to be typically moody, we will digress the hows and whys of these emotional changes. * Stresses such school, life and social media cause a big impact on emotions for adolescents. == Understanding emotions on the daily basis == * Adolescents * * === School === * Those in their adolescent years particularly from 12-15 are creating new social groups * There is significant change in social dynamics of adolescence, that present difficult challenges for adolescents to navigate (McLaughlin et al., 2015). * Academic stress can be a factor causing emotional reactions === Self identity === * Erikson's 8 Stages of Progressive Psychosocial Development * Identity vs role of confusion * == Emotion regulation == * Adolescents find it more difficult to regulate emotions, particularly those inclusive of anxiety and depressed states * Studies have found the possible cause of "emotional reactivity during adolescence might increase the need for top-down control and put individuals with less control" (Hare et al., 2008). * [[File:Amygdala small.gif|thumb|Figure 1. The Amygdala]] === The Amygdala === * Brain areas that include this reactivity is the amygdala * * === The Prefrontal Cortex === * Conversely, the prefrontal cortex — which plays a central role in the effortful emotion regulation — shows continued development through adolescence, and could constrain the efficiency of emotion regulation (McLaughlin et al., 2015). * * == Conclusion == ==See also== * {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== Hare, T. A., Tottenham, N., Galvan, A., Voss, H. U., Glover, G. H., & Casey, B. J. (2008). Biological Substrates of Emotional Reactivity and Regulation in Adolescence During an Emotional Go-Nogo Task. ''Biological Psychiatry'', ''63''(10), 927-934. <nowiki>https://doi.org/10.1016/j.biopsych.2008.03.015</nowiki> Larson, R. W., Moneta, G., Richards, M. H., & Wilson, S. (2002). Continuity, Stability, and Change in Daily Emotional Experience across Adolescence. ''Child Development'', ''73''(4), 1151-1165. <nowiki>https://doi.org/https://doi.org/10.1111/1467-8624.00464</nowiki> McLaughlin, K. A., Garrad, M. C., & Somerville, L. H. (2015). What develops during emotional development? A component process approach to identifying sources of psychopathology risk in adolescence. ''Dialogues in Clinical Neuroscience'', ''17''(4), 403-410. <nowiki>https://doi.org/10.31887/DCNS.2015.17.4/kmclaughlin</nowiki> ==External links== * https://www.youtube.com/watch?v=PzyXGUCngoU Crash course on adolescence [[Category:{{#titleparts:{{PAGENAME}}|3}}]] f2f1dtpggxqvgzcjsageugjo0yhcemm 2419367 2419361 2022-08-26T07:31:17Z U3230861 2947549 /* Understanding emotions on the daily basis */ wikitext text/x-wiki {{title|Emotional development in adolescence:<br>How does emotionality develop during adolescence?}} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==From Tweens to Teens == * Through out adolescence, teens are developing emotionally but what exactly are these developments? * Adolescences are depicted to be typically moody, we will digress the hows and whys of these emotional changes. * Stresses such school, life and social media cause a big impact on emotions for adolescents. == Understanding emotions on the daily basis == * Adolescents *Adolescents experience more intense positive and negative emotions. In experience-sampling studies, adolescents transitioned through emotional states more rapidly (McLaughlin et al., 2015). * === School === * Those in their adolescent years particularly from 12-15 are creating new social groups * There is significant change in social dynamics of adolescence, that present difficult challenges for adolescents to navigate (McLaughlin et al., 2015). * Academic stress can be a factor causing emotional reactions === Self identity === * Erikson's 8 Stages of Progressive Psychosocial Development * Identity vs role of confusion * == Emotion regulation == * Adolescents find it more difficult to regulate emotions, particularly those inclusive of anxiety and depressed states * Studies have found the possible cause of "emotional reactivity during adolescence might increase the need for top-down control and put individuals with less control" (Hare et al., 2008). * [[File:Amygdala small.gif|thumb|Figure 1. The Amygdala]] === The Amygdala === * Brain areas that include this reactivity is the amygdala * * === The Prefrontal Cortex === * Conversely, the prefrontal cortex — which plays a central role in the effortful emotion regulation — shows continued development through adolescence, and could constrain the efficiency of emotion regulation (McLaughlin et al., 2015). * * == Conclusion == ==See also== * {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== Hare, T. A., Tottenham, N., Galvan, A., Voss, H. U., Glover, G. H., & Casey, B. J. (2008). Biological Substrates of Emotional Reactivity and Regulation in Adolescence During an Emotional Go-Nogo Task. ''Biological Psychiatry'', ''63''(10), 927-934. <nowiki>https://doi.org/10.1016/j.biopsych.2008.03.015</nowiki> Larson, R. W., Moneta, G., Richards, M. H., & Wilson, S. (2002). Continuity, Stability, and Change in Daily Emotional Experience across Adolescence. ''Child Development'', ''73''(4), 1151-1165. <nowiki>https://doi.org/https://doi.org/10.1111/1467-8624.00464</nowiki> McLaughlin, K. A., Garrad, M. C., & Somerville, L. H. (2015). What develops during emotional development? A component process approach to identifying sources of psychopathology risk in adolescence. ''Dialogues in Clinical Neuroscience'', ''17''(4), 403-410. <nowiki>https://doi.org/10.31887/DCNS.2015.17.4/kmclaughlin</nowiki> ==External links== * https://www.youtube.com/watch?v=PzyXGUCngoU Crash course on adolescence [[Category:{{#titleparts:{{PAGENAME}}|3}}]] 3onhv9zg7or13ms58wg8wba6hfckq5h 0 286731 2419443 2418782 2022-08-26T09:33:31Z U3203936 2948030 /* Commitment Bias */ wikitext text/x-wiki == Commitment Bias == {{title|Commitment Bias: What motivates escalation of commitment even it does not lead to desirably outcomes? }} {{MECR3|1=https://yourlinkgoeshere.com}} __TOC__ ==Overview== You are underway {{smile}}! This template provides tips for [[Motivation and emotion/Assessment/Topic|topic development]]. Gradually remove these suggestions as you develop the chapter. Also consult the [[Motivation and emotion/Assessment/Chapter|author guidelines]]. At the top of the chapter, the title and sub-title should match the ''exact'' wording and casing as shown in the {{Motivation and emotion/Book}}. The sub-titles all end with a question mark. This Overview section should be concise but consist of several paragraphs which engage the reader, illustrate the problem, and outline how psychological science can help. {{RoundBoxTop|theme=3}} '''Focus questions:''' * What is the first focus question? * What is the second focus question? * What is the third focus question? {{RoundBoxBottom}} {{tip| Suggestions for this section: * What is the problem? Why is it important? * How can specific motivation and/or emotion theories and research help? * Provide an example or case study. * Conclude with Focus questions to guide the chapter. }} ==Main headings== How you are going to structure the chapter? Aim for three to six main headings between the [[#Overview|Overview]] and [[#Conclusion|Conclusion]]. {{tip|Suggestions for this section: * For the [[Motivation and emotion/Assessment/Topic|topic development]], provide at least 3 bullet-points about key content per section. Include key citations. * For the [[Motivation and emotion/Assessment/Chapter|book chapter]], expand the bullet points into paragraphs. * If a section has a lot of content, arrange it into two to five sub-headings such as in the [[#Interactive learning features|interactive learning features section]]. Avoid having sections with only one sub-heading. }} ==Learning features== What brings an online book chapter to life are its interactive learning features. Case studies, feature boxes, figures, links, tables, and quiz questions can be used throughout the chapter. ===Case studies=== Case studies describe real-world examples of concepts in action. Case studies can be real or fictional. A case could be used multiple times during a chapter to illustrate different theories or stages. It is often helpful to present case studies using [[#Feature boxes|feature boxes]]. ===Boxes=== Boxes can be used to highlight content, but don't overuse them. There are many different ways of creating boxes (e.g., see [[Help:Pretty boxes|Pretty boxes]]). Possible uses include: * Focus questions * Case studies or examples * Quiz questions * Take-home messages {{RoundBoxTop|theme=3}} ;Feature box example * Shaded background * Coloured border {{RoundBoxBottom}} ===Figures=== [[File:Monkey-typing.jpg|right|205px|thumb|''Figure 1''. Example image with descriptive caption.]] Use figures to illustrate concepts, add interest, and provide examples. Figures can be used to show photographs, drawings, diagrams, graphs, etcetera. Figures can be embedded throughout the chapter, starting with the Overview section. Figures should be captioned (using a number and a description) in order to explain their relevance to the text. Possible images can be found at [[commons:|Wikimedia Commons]]. Images can also be uploaded if they are licensed for re-use or if you created the image. Each figure should be referred to at least once in the main text (e.g., see Figure 1). ===Links=== Where key words are first used, make them into [[Help:Links|interwiki links]] such as Wikipedia links to articles about famous people (e.g., [[w:Sigmund Freud|Sigmund Freud]] and key concepts (e.g., [[w:Dreams|dreams]]) and links to book chapters about related topics (e.g., would you like to learn about how to overcome [[Motivation and emotion/Book/2020/Writer's block|writer's block]]?). ===Tables=== Tables can be an effective way to organise and summarise information. Tables should be captioned (using APA style) to explain their relevance to the text. Plus each table should be referred to at least once in the main text (e.g., see Table 1 and Table 2). Here are some [[Motivation and emotion/Wikiversity/Tables|example 3 x 3 tables]] which could be adapted. ===Quizzes=== Quizzes are a direct way to engage readers. But don't make quizzes too hard or long. It is better to have one or two review questions per major section than a long quiz at the end. Try to quiz conceptual understanding, rather than trivia. Here are some simple quiz questions which could be adapted. Choose the correct answers and click "Submit": <quiz display=simple> {Quizzes are an interactive learning feature: |type="()"} + True - False {Long quizzes are a good idea: |type="()"} - True + False </quiz> To learn about different types of quiz questions, see [[Help:Quiz|Quiz]]. ==Conclusion== The Conclusion is arguably the most important section. It should be possible for someone to read the [[#Overview|Overview]] and the Conclusion and still get a good idea of the topic. {{tip|Suggestions for this section: * What is the answer to the question in the sub-title (based on psychological theory and research)? * What are the answers to the focus questions? * What are the practical, take-home messages? }} ==See also== Provide up to half-a-dozen [[Help:Contents/Links#Interwiki_links|internal (wiki) links]] to relevant Wikiversity pages (esp. related [[Motivation and emotion/Book|motivation and emotion book chapters]]) and [[w:|Wikipedia articles]]. For example: * [[Motivation and emotion/Book/2016/Anorexia nervosa and extrinsic motivation|Anorexia nervosa and extrinsic motivation]] (Book chapter, 2016) * [[w:David McClelland|David McClelland]] (Wikipedia) * [[Motivation and emotion/Book/2018/Loss aversion|Loss aversion]] (Book chapter, 2018) * [[w:Maslow's hierarchy of needs|Maslow's hierarchy of needs]] (Wikipedia) {{tip|Suggestions for this section: * Present in alphabetical order. * Include the source in parentheses. }} ==References== List the cited references in [[w:APA style|APA style]] (7th ed.) or [[w:Wikipedia:Citing sources|wiki style]]. APA style example: {{Hanging indent|1= Blair, R. J. R. (2004). The roles of orbital frontal cortex in the modulation of antisocial behavior. ''Brain and Cognition'', ''55''(1), 198–208. https://doi.org/10.1016/S0278-2626(03)00276-8 Buckholtz, J. W., & Meyer-Lindenberg, A. (2008). MAOA and the neurogenetic architecture of human aggression. ''Trends in Neurosciences'', ''31''(3), 120–129. https://doi.org/10.1016/j.tins.2007.12.006 Eckardt, M., File, S., Gessa, G., Grant, K., Guerri, C., Hoffman, P., & Tabakoff, B. (1998). Effects of moderate alcohol consumption on the central nervous system. ''Alcoholism, Clinical and Experimental Research'', ''22''(5), 998–1040. https://doi.org/10.1111/j.1530-0277.1998.tb03695.x }} {{tip|Suggestions for this section: * Important aspects for APA style include: ** Wrap the set of references in the hanging indent template. Using "Edit source": <nowiki>{{Hanging indent|1= the full list of references}}</nowiki> ** Author surname, followed by a comma, then author initials separated by full stops and spaces ** Year of publication in parentheses ** Title of work in lower case except first letter and proper names, ending in a full-stop. ** Journal title in italics, volume number in italics, issue number in parentheses, first and last page numbers separated by an en-dash(–), followed by a full-stop. ** Provide the full doi as a URL and working hyperlink * Common mistakes include: ** incorrect capitalisation ** incorrect italicisation ** providing a "retrieved from" date (not part of APA 7th ed. style). ** citing sources that weren't actually read or consulted }} ==External links== Provide up to half-a-dozen [[Help:Contents/Links#External_links|external links]] to relevant resources such as presentations, news articles, and professional sites. For example: * [https://students.unimelb.edu.au/academic-skills/explore-our-resources/essay-writing/six-top-tips-for-writing-a-great-essay Six top tips for writing a great essay] (University of Melbourne) * [http://www.skillsyouneed.com/write/structure.html The importance of structure] (skillsyouneed.com) {{tip|Suggestions for this section: * Only select links to major external resources about the topic * Present in alphabetical order * Include the source in parentheses after the link }} [[Category:{{#titleparts:{{PAGENAME}}|3}}]] 8z389vpwie8n7teebry4prj9qn0z3fi 2 286742 2419053 2022-08-25T12:08:10Z Wearthatmask 2948868 My first edit to my userpage wikitext text/x-wiki Looking forward to contribute on subjects that are interesting to me 7k34gm1dzjgeaaj3ldwff90f0u49tru 6 286743 2419064 2022-08-25T14:17:20Z Young1lim 21186 {{Information |Description=Laurent.5: Applications 6A (20220825 - 20220824) |Source={{own|Young1lim}} |Date=2022-08-25 |Author=Young W. Lim |Permission={{cc-by-sa-3.0,2.5,2.0,1.0}} }} wikitext text/x-wiki == Summary == {{Information |Description=Laurent.5: Applications 6A (20220825 - 20220824) |Source={{own|Young1lim}} |Date=2022-08-25 |Author=Young W. Lim |Permission={{cc-by-sa-3.0,2.5,2.0,1.0}} }} == Licensing == {{self|GFDL|cc-by-sa-4.0,3.0,2.5,2.0,1.0}} rpqxciksocnqnmega7oqnth83ltyopw 6 286744 2419065 2022-08-25T14:18:08Z Young1lim 21186 {{Information |Description=C04.Series.1: Arrays 1A (20220825 - 20220824) |Source={{own|Young1lim}} |Date=2022-08-25 |Author=Young W. Lim |Permission={{GFDL}} }} wikitext text/x-wiki == Summary == {{Information |Description=C04.Series.1: Arrays 1A (20220825 - 20220824) |Source={{own|Young1lim}} |Date=2022-08-25 |Author=Young W. Lim |Permission={{GFDL}} }} == Licensing == {{self|GFDL|cc-by-sa-4.0,3.0,2.5,2.0,1.0}} naog78y0fsaekfvdrbc20zi3sfi4zpz 6 286745 2419066 2022-08-25T14:19:12Z Young1lim 21186 {{Information |Description=C04.Series.3: Array Pointers 1A (20220825 - 20220824) |Source={{own|Young1lim}} |Date=2022-08-25 |Author=Young W. Lim |Permission={{GFDL}} }} wikitext text/x-wiki == Summary == {{Information |Description=C04.Series.3: Array Pointers 1A (20220825 - 20220824) |Source={{own|Young1lim}} |Date=2022-08-25 |Author=Young W. Lim |Permission={{GFDL}} }} == Licensing == {{self|GFDL|cc-by-sa-4.0,3.0,2.5,2.0,1.0}} rs6cpgr2q2e660ks8407t9a6kwwfv9i 6 286746 2419067 2022-08-25T14:20:10Z Young1lim 21186 {{Information |Description=C04.Series.1App: Applications of Arrays 1A (20220825 - 20220824) |Source={{own|Young1lim}} |Date=2022-08-25 |Author=Young W. Lim |Permission={{GFDL}} }} wikitext text/x-wiki == Summary == {{Information |Description=C04.Series.1App: Applications of Arrays 1A (20220825 - 20220824) |Source={{own|Young1lim}} |Date=2022-08-25 |Author=Young W. Lim |Permission={{GFDL}} }} == Licensing == {{self|GFDL|cc-by-sa-4.0,3.0,2.5,2.0,1.0}} 8ursie096lj63ulajyxx00218hfnpy2 6 286747 2419068 2022-08-25T14:21:32Z Young1lim 21186 {{Information |Description=VLSI.Arith.1.A: Variable Block Adders (20220825 - 20220824) |Source={{own|Young1lim}} |Date=2022-08-25 |Author=Young W. Lim |Permission={{GFDL}} }} wikitext text/x-wiki == Summary == {{Information |Description=VLSI.Arith.1.A: Variable Block Adders (20220825 - 20220824) |Source={{own|Young1lim}} |Date=2022-08-25 |Author=Young W. Lim |Permission={{GFDL}} }} == Licensing == {{self|GFDL|cc-by-sa-4.0,3.0,2.5,2.0,1.0}} k6nbl66vlipowbfww4n518u9kxwffht 6 286748 2419082 2022-08-25T19:43:26Z Young1lim 21186 {{Information |Description=5MRV.3B: Stationary Random Process Examples (20220825 - 20220824) |Source={{own|Young1lim}} |Date=2022-08-25 |Author=Young W. Lim |Permission={{cc-by-sa-3.0,2.5,2.0,1.0}} }} wikitext text/x-wiki == Summary == {{Information |Description=5MRV.3B: Stationary Random Process Examples (20220825 - 20220824) |Source={{own|Young1lim}} |Date=2022-08-25 |Author=Young W. Lim |Permission={{cc-by-sa-3.0,2.5,2.0,1.0}} }} == Licensing == {{self|GFDL|cc-by-sa-4.0,3.0,2.5,2.0,1.0}} qi50r0l5tus595ombnicf08uo76eudh 14 286749 2419092 2022-08-25T22:28:51Z Jtneill 10242 New resource with "[[Category:Motivation and emotion/Book]]" wikitext text/x-wiki [[Category:Motivation and emotion/Book]] el9qvhucy3r3wr6hsy1s5wiw7gf7i80 1 286750 2419125 2022-08-25T23:29:12Z U3216256 2942574 /* References */ new section wikitext text/x-wiki == References == Hi, It looks like you have a lot of references. Here are a few more that you might find useful. Schunck, R. (2014). Estimating causal effects with longitudinal data : does unemployment affect mental health? SAGE Publications. Backhans, M. C., & Hemmingsson, T. (2012). Unemployment and mental health--who is (not) affected? European Journal of Public Health, 22(3), 429–433. https://doi.org/10.1093/eurpub/ckr059 Artazcoz, L., Benach, J., Borrell, C., & Cortes, I. (2004). Unemployment and Mental Health: Understanding the Interactions Among Gender, Family Roles, and Social Class. American Journal of Public Health (1971), 94(1), 82–88. https://doi.org/10.2105/AJPH.94.1.82 Huegaerts, K., Spruyt, B., & Vanroelen, C. (2018). Youth Unemployment and Mental Health: The Mediating Role of Embodiment. Societies (Basel, Switzerland), 8(2), 43–. https://doi.org/10.3390/soc8020043 Lam, J., & Ambrey, C. L. (2019). The Scarring Effects of Father’s Unemployment? Job-Security Satisfaction and Mental Health at Midlife. The Journals of Gerontology. Series B, Psychological Sciences and Social Sciences, 74(1), 105–112. https://doi.org/10.1093/geronb/gbx117 Buffel, V., Beckfield, J., & Bracke, P. (2017). The Institutional Foundations of Medicalization: A Cross-national Analysis of Mental Health and Unemployment. Journal of Health and Social Behavior, 58(3), 272–290. https://doi.org/10.1177/0022146517716232 [[User:U3216256|U3216256]] ([[User talk:U3216256|discuss]] • [[Special:Contributions/U3216256|contribs]]) 23:29, 25 August 2022 (UTC) 7v3917vebtzsuxwrnjb6ovyoena0rjd 0 286752 2419245 2022-08-26T03:47:51Z 37.46.113.247 New resource with "<br>Существует так много способов создания и генерации обратных ссылок на вашу веб-страницу. Почему бы вам не заплатить немного денег, чтобы повысить свой рейтинг и привлечь пассивных посетителей на свою веб-страницу? Однако для тех, кто столкнулся с ограничен..." wikitext text/x-wiki <br>Существует так много способов создания и генерации обратных ссылок на вашу веб-страницу. Почему бы вам не заплатить немного денег, чтобы повысить свой рейтинг и привлечь пассивных посетителей на свою веб-страницу? Однако для тех, кто столкнулся с ограничением символов в текстовой области привязки, пожалуйста, свяжитесь через панель управления, и мы постараемся расширить его для вас. Да, если вы столкнулись с ограничением символов в дисциплине анкорного текстового контента, свяжитесь с нами через панель управления, и мы постараемся увеличить его для вас. Таким образом, после выбора гиперссылки вы можете напрямую проверить URL-адрес, чтобы убедиться, что ваш якорный текст отображается точно. Мы представляем вам именно то, как можно получить более высокий рейтинг в основных поисковых системах, оставив вас сосредоточиться на том, что вам нравится делать - сдаче в аренду надувных лодок и доставлении счастья вашим клиентам! Написание отзывов или мнений для других может показаться нелогичным, но это может быть полезно для вашего SEO и техники обратных ссылок. Делегирование этих обязанностей лучшим специалистам освобождает ваше время для того, чтобы заниматься тем, что у вас хорошо получается и нравится делать. 1: Войдите в свою учетную запись и выберите «Начать сейчас». После входа в систему вы отвечаете на ряд вопросов, чтобы Google мог лучше понять, что вы продвигаете, и какие ключевые слова лучше использовать.<br><br> Таким образом, вам нужно будет зарегистрироваться для каждого типа учетной записи отдельно. Чем больше ссылок у вас есть, тем более важным кажется ваш сайт и тем выше он будет отображаться в результатах поиска. Основная концепция заключается в том, что чем больше ссылок у вас может быть на вашем сайте, тем выше качество контента в этом месте, и, следовательно, он должен иметь более высокий рейтинг в поисковых системах, таких как Google. Однако теперь, когда вы просто понимаете сходства и различия между SEM и Seo, вы сможете лучше определить, как каждый из них может помочь вашей компании в достижении ее целей. Когда вы выбираете синтетические стратегии для создания гиперссылок, это может быть не обнаружено сейчас, но может быть обнаружено рано или поздно. Для каждой учетной записи потребуется уникальное имя человека и адрес электронной почты (для восстановления пароля). Однако остальные данные учетной записи могут быть одинаковыми. Когда вы выбираете ссылки, вы увидите значки «большой палец вверх» и «палец вниз» с точностью до онлайн-страницы. Привлекательная часть владения рекламным агентством заключается в том, что вы просто видите слишком много данных, можете заметить множество событий и определить, что работает для всех отраслей.<br><br> Кредит(ы) гиперссылки могут быть автоматически возвращены вам, поэтому вы можете сделать альтернативный выбор в качестве замены. Если по какой-либо причине он не отображается должным образом, вы можете отменить выбор гиперссылки. Чтобы ввести свой идентификатор PayPal, войдите в свою учетную запись BackLinks и щелкните ссылку программы Associates на панели навигации. Если вы рекламодатель, вы полностью поддерживаете использование нашего API, свяжитесь с нами, используя гиперссылку в своей учетной записи. Мы не предлагаем API для учетных записей издателей. Наш выбор API доступен только для учетных записей рекламодателей, которые ежемесячно тратят на нас значительную сумму. Подстраницы и поддомены составляют 25% домашней веб-страницы. Это отображается рядом со страницами в вашей панели управления, когда издатель веб-страницы решил НЕ принимать гиперссылки только из категории вашего объявления с гиперссылками. Да, к сожалению, в настоящее время у нас нет опции для смешанной учетной записи рекламодателя и издателя. Пожалуйста, создайте учетную запись, а затем посмотрите видео и отправьте сведения о своем заказе, и мы предоставим вам возможность быть обнаруженными в Интернете. И поскольку они практически уверены в повышении авторитета вашего домена, они также, несомненно, будут способствовать вашему рейтингу.<br><br>PR-усилия не только помогают вам завоевать доверие, они могут даже наводить мосты между вашим брендом и сообществами, в которых вы пытаетесь добиться успеха. Поэтому, когда вы выбираете ключевые фразы, сосредоточьтесь на тех, которые связаны с выбранной темой. Если это говорит вам о чем-то, так это о том, что обратные ссылки крайне необходимы и с ними нужно обращаться соответственно. Является ли индекс обратных ссылок бесплатным с высоким авторитетом DA или нет? Пока вы ожидаете, что поисковые системы найдут и проиндексируют ваши ссылки, мы также советуем вам потратить немного времени на внутреннюю оптимизацию и социальные сети. Маркетинг в поисковых системах на веб-странице происходит внутри сайта, в то время как внестраничная поисковая оптимизация происходит вне позиционирования. Хотя поисковые системы, такие как Google, рассматривают различные вопросы, пытаясь выяснить, насколько важен сайт, одним из жизненно важных факторов ранжирования является количество и высокое качество веб-сайтов, которые ссылаются на вас. К счастью, вам не нужно запоминать все факторы ранжирования. Если у вас нет учетной записи, вы сможете создать ее, не потратив ни копейки. Один из отличных способов начать строить отношения и зарекомендовать себя как эксперта в своем бизнесе — это быть активным в социальных сетях. Вы можете не использовать все эти инструменты, но для положительного эффекта достаточно одного из них.<br> aqn0hpmzggts41jaq7v4rebcmzxf92k 2 286753 2419250 2022-08-26T03:59:58Z SunandaUC 2947974 Did about me wikitext text/x-wiki == About me == I am currently studying a Bachelor of Science in Psychology. Alongside, my studies I work as a support worker. == Book Chapter == I am currently working on the [[Motivation and emotion/Book/2022/Bewilderment|Bewilderment]] chapter gxx4eembbl8orm1wkik6n9906wfxtvu 2419251 2419250 2022-08-26T04:02:40Z SunandaUC 2947974 Finished my me page wikitext text/x-wiki == About me == I am currently studying for a Bachelor of Science in Psychology. Alongside, my studies I work as a support worker. == Book Chapter == I am currently working on the [[Motivation and emotion/Book/2022/Bewilderment|Bewilderment]] chapter. == Social Contribution == == Hobbies == * Reading books * Listening to podcasts * Dancing 5bsgvaxjhis25lai4su94yp8qnwmrha 2419374 2419251 2022-08-26T07:40:11Z SunandaUC 2947974 changed my topic wikitext text/x-wiki == About me == I am currently studying for a Bachelor of Science in Psychology. Alongside, my studies I work as a support worker. == Book Chapter == I am currently working on the [[Motivation and emotion/Book/2022/Discounts and consumer purchase behaviour|Discounts and consumer purchase behaviour]] chapter. == Social Contribution == == Hobbies == * Reading books * Listening to podcasts * Dancing 75q9ytr2tp7j734jtrmirpl0nod5ush 2419378 2419374 2022-08-26T07:45:20Z SunandaUC 2947974 wikitext text/x-wiki ==Overview== == Current research on consumer behaviour in purchasing == == The role of discounts in consumer behaviour == == History of shopping and discounts == == Figures and tables == == Conclusion == == Quiz == == References == == External Links == 6pca1si6ze80kah7j9gk3z7sawncxte 2419381 2419378 2022-08-26T07:46:16Z SunandaUC 2947974 Undo all revisions. Resource is empty, but not [[Wikiversity:Deletions|deleted]]. wikitext text/x-wiki phoiac9h4m842xq45sp7s6u21eteeq1 2419388 2419381 2022-08-26T07:51:56Z SunandaUC 2947974 about me wikitext text/x-wiki == About me == I am currently studying a Bachelor of Science in Psychology. Alongside my studies, I am working as a support worker. == Book Chapter == I am currently doing the [[Motivation and emotion/Book/2022/Discounts and consumer purchase behaviour|Discounts and consumer purchase behaviour]] topic. == Social Contribution == == Hobbies == * Listening to podcasts * Reading * Dancing n68xdablh7z92ku7f5g250jrr7eim8k 1 286754 2419270 2022-08-26T04:38:44Z Lturner2311 2947525 /* Reference Assistance */ new section wikitext text/x-wiki == Reference Assistance == Hi, this is a really good topic as I believe that a lot of people suffer from burnout due to current world situations that are ever changing. With the increase in the cost of living and the people’s yearly wages remaining unchanged but there being an increase in workload, I believe we might see a rise in job burnout in the near future. I have provided you with a couple of references that I think might be helpful to your topic. Maslach, C., & Leiter, M. P. (2006). Burnout. ''Stress and quality of working life: current perspectives in occupational health'', ''37'', 42-49. Leiter, M. P., Maslach, C., & Frame, K. (2014). Burnout. ''The encyclopedia of clinical psychology'', 1-7. Maslach, C., Schaufeli, W. B., & Leiter, M. P. (2001). Job burnout. ''Annual review of psychology'', ''52''(1), 397-422. [[User:Lturner2311|Lturner2311]] ([[User talk:Lturner2311|discuss]] • [[Special:Contributions/Lturner2311|contribs]]) 04:38, 26 August 2022 (UTC) h606w8krc59pq9ltfstzuodcuk04bak 3 286755 2419324 2022-08-26T06:12:35Z Aj Ajay Mehta 007 2940095 Creating discuss page wikitext text/x-wiki Welcome nmrb2m0p86z9yjfwkvs20dmiksw9ptk 1 286756 2419333 2022-08-26T06:47:47Z Jtneill 10242 Heading casing wikitext text/x-wiki == Heading casing == {| style="float: center; background:transparent;" |- | [[File:Crystal Clear app ktip.svg|48px|left]] | {{#if:U3193000|Hi [[User:U3193000|U3193000]].|}} FYI, the recommended [[Wikiversity]] heading style uses [[w:Letter case#Sentence_case|sentence casing]]. For example:<br> <big><big>Self-determination theory</big></big> rather than <big><big>Self-Determination Theory</big></big> Here's an example chapter with correct heading casing: [[Motivation and emotion/Book/2019/Growth mindset development|Growth mindset development]] -- [[User:Jtneill|Jtneill]] - <small>[[User talk:Jtneill|Talk]] - [[Special:Contributions/Jtneill|c]]</small> 06:47, 26 August 2022 (UTC) |} 47d2v7trk589enlsxyp3qjacj6s02k4 1 286757 2419350 2022-08-26T07:14:46Z Jtneill 10242 Heading casing wikitext text/x-wiki == Heading casing == {| style="float: center; background:transparent;" |- | [[File:Crystal Clear app ktip.svg|48px|left]] | {{#if:KingMob221|Hi [[User:KingMob221|KingMob221]].|}} FYI, the recommended [[Wikiversity]] heading style uses [[w:Letter case#Sentence_case|sentence casing]]. For example:<br> <big><big>Self-determination theory</big></big> rather than <big><big>Self-Determination Theory</big></big> Here's an example chapter with correct heading casing: [[Motivation and emotion/Book/2019/Growth mindset development|Growth mindset development]] -- [[User:Jtneill|Jtneill]] - <small>[[User talk:Jtneill|Talk]] - [[Special:Contributions/Jtneill|c]]</small> 07:14, 26 August 2022 (UTC) |} jzq4a7u1e1e5rih4tsfsdd8s998dii9 14 286758 2419354 2022-08-26T07:19:56Z Jtneill 10242 New resource with "[[Category:Motivation and emotion/Book]]" wikitext text/x-wiki [[Category:Motivation and emotion/Book]] el9qvhucy3r3wr6hsy1s5wiw7gf7i80 14 286759 2419362 2022-08-26T07:24:40Z Jtneill 10242 New resource with "[[Category:Motivation and emotion/Book/Brain]]" wikitext text/x-wiki [[Category:Motivation and emotion/Book/Brain]] 9twrer62g9zy098i8n14wz2j176jlrh 0 286760 2419379 2022-08-26T07:46:01Z SunandaUC 2947974 New resource with "==Overview== == Current research on consumer behaviour in purchasing == == The role of discounts in consumer behaviour == == History of shopping and discounts == == Figures and tables == == Conclusion == == Quiz == == References == == External Links ==" wikitext text/x-wiki ==Overview== == Current research on consumer behaviour in purchasing == == The role of discounts in consumer behaviour == == History of shopping and discounts == == Figures and tables == == Conclusion == == Quiz == == References == == External Links == 6pca1si6ze80kah7j9gk3z7sawncxte 2419394 2419379 2022-08-26T08:07:13Z SunandaUC 2947974 wikitext text/x-wiki ==Overview== == Theories == == Current research on consumer behaviour in purchasing == == The role of discounts in consumer behaviour == == History of shopping and discounts == == Figures and tables == == Conclusion == == Quiz == == References == == External Links == oid0o8mjtdb0wg6p2zdgxrrbgnf8wnd 1 286761 2419405 2022-08-26T08:39:55Z U3215603 2947641 /* tDCS for Drug Abuse Treatment */ new section wikitext text/x-wiki == tDCS for Drug Abuse Treatment == Hello there, you have a really interesting and relevant topic and I have really enjoyed reading your chapter so far. For the section you have included on treatment of drug abuse problems I was wondering if you have possibly considered looking at how trans-cranial direct current stimulation (tDCS) could be applied to treat drug abuse disorders. I know that it has been used to effectively treat other serious mental health conditions like schizophrenia but I would be curious to see if it could have any effect on drug use. Thank you very much [[User:U3215603|U3215603]] ([[User talk:U3215603|discuss]] • [[Special:Contributions/U3215603|contribs]]) 08:39, 26 August 2022 (UTC) 6ydca8tcc2wsdgsouqyarvo1ekd7ikc 1 286762 2419445 2022-08-26T09:34:18Z Jtneill 10242 Heading casing wikitext text/x-wiki == Heading casing == {| style="float: center; background:transparent;" |- | [[File:Crystal Clear app ktip.svg|48px|left]] | {{#if:U962051|Hi [[User:U962051|U962051]].|}} FYI, the recommended [[Wikiversity]] heading style uses [[w:Letter case#Sentence_case|sentence casing]]. For example:<br> <big><big>Self-determination theory</big></big> rather than <big><big>Self-Determination Theory</big></big> Here's an example chapter with correct heading casing: [[Motivation and emotion/Book/2019/Growth mindset development|Growth mindset development]] -- [[User:Jtneill|Jtneill]] - <small>[[User talk:Jtneill|Talk]] - [[Special:Contributions/Jtneill|c]]</small> 09:34, 26 August 2022 (UTC) |} mx135jf73dj48n05iloj8vf7h2p8qfj 14 286763 2419449 2022-08-26T09:38:14Z Jtneill 10242 New resource with "[[Category:Motivation and emotion/Book]]" wikitext text/x-wiki [[Category:Motivation and emotion/Book]] el9qvhucy3r3wr6hsy1s5wiw7gf7i80 3 286764 2419465 2022-08-26T10:15:17Z Realplatinum1 2948917 /* Is bluechew legit for people to be used? */ new section wikitext text/x-wiki == Is bluechew legit for people to be used? == There are so many people available all across the globe who ask the similar kind of the question every time that Is bluechew legit to be used by the people? The answer to the same question that Is bluechew legit to be used is Yes! The blue chew is a legit company in the US, and all the subscriptions given by the same company are affiliated by the state healthcare providers. All the laws are also being maintained properly by the company. [[User:Realplatinum1|Realplatinum1]] ([[User talk:Realplatinum1|discuss]] • [[Special:Contributions/Realplatinum1|contribs]]) 10:15, 26 August 2022 (UTC) 8vtay45y8noley1hrasncrmhryc40tk 2419466 2419465 2022-08-26T10:16:21Z Realplatinum1 2948917 /* Is bluechew legit for people to be used? */ wikitext text/x-wiki == Is bluechew legit for people to be used? == There are so many people available all across the globe who ask the similar kind of the question every time that Is bluechew legit to be used by the people? The answer to the same question that [https://realplatinumlife.com/bluechew-subscription-review/ '''Is bluechew legit'''] to be used is Yes! The blue chew is a legit company in the US, and all the subscriptions given by the same company are affiliated by the state healthcare providers. All the laws are also being maintained properly by the company. [[User:Realplatinum1|Realplatinum1]] ([[User talk:Realplatinum1|discuss]] • [[Special:Contributions/Realplatinum1|contribs]]) 10:15, 26 August 2022 (UTC) im85ohn5tggcy1f4ys1ibabc5g6axuk 2419481 2419466 2022-08-26T11:21:35Z Technomizinfo 2948924 /* What is currency & which is the Strongest Currency in the World? */ new section wikitext text/x-wiki == Is bluechew legit for people to be used? == There are so many people available all across the globe who ask the similar kind of the question every time that Is bluechew legit to be used by the people? The answer to the same question that [https://realplatinumlife.com/bluechew-subscription-review/ '''Is bluechew legit'''] to be used is Yes! The blue chew is a legit company in the US, and all the subscriptions given by the same company are affiliated by the state healthcare providers. All the laws are also being maintained properly by the company. [[User:Realplatinum1|Realplatinum1]] ([[User talk:Realplatinum1|discuss]] • [[Special:Contributions/Realplatinum1|contribs]]) 10:15, 26 August 2022 (UTC) == What is currency & which is the Strongest Currency in the World? == '''What is a currency?''' A currency is a country's specific form of money. It can be utilized for trade, investment, and lending. In order for a currency to work, it needs to have three basic attributes that are stated below: First, is a unit of measure that is divisible and uniform in value (e.g. the dollar has dollars). Second, it must have a supply that can vary in quantity but not in quality (e.g., silver or diamonds). And thirdly, a way to compare the relative value of one unit with another (e.g., the price of silver should be equal to the price of diamonds). What happens when you exchange your currency with another currency? The answer to this question can be found in two perspectives: macro-economic perspective and microeconomic perspective. From a macro-economic point of view, when you exchange with other currencies, then you get a lot of benefits like cheaper prices than if you pay with your own country's currency. The second perspective is from a micro-economics standpoint; it shows that people who have access to other currencies in addition to their domestic money suffer from inflation because they have to convert their money constantly. '''What do you mean by the strongest currency in the world?''' The [https://www.technomiz.com/world-powerful-currency-not-dollar-it-is-the-strongest-currency-in-the-world-know-which-are-the-top-5-mudras/ Strongest currency in the world] refers to the currency that is a traded currency that has an increasing relative strength leveling with other currencies. It is the most stable and reliable currency in the world because its value is constantly increasing. The strongest currency is gaining economic power, as indicated by a decrease in the direct exchange rate for the currency. ''What makes a country's currency the "strongest"?''' The status of a country's currency as the strongest in the world is attributed to a variety of factors. The most common factor is the country's ability to produce goods and services that are in high demand and have a level of consistency that ranks higher than other countries. Economists feel this is indicative of the stability and trustworthiness of these goods and services, which makes them more desirable in international markets. Liquidy (which can be easily converted to another type of currency) is another factor that makes a country’s currency the strongest in the world. '''Which is the strongest currency in the world?''' The strongest currency in the world is Kuwait’s Kuwaiti Dinar. It is made of pure brass and has a power of 3.3 US dollars. If you want your bank to grow, invest in Kuwaiti Dinar. It is one of the most valued currencies in the world. Kuwait's wealth can be attributed to its heavy exports of oil to a global market and high standard of living. Kuwaitis can invest their money in any currency they want and be confident that they will not lose their savings. The supply of oil in the world is majorly from Kuwait. It's no wonder why it's one of the richest countries with wealth from its oil exports. '''Kuwait''' Kuwait is a country in the Middle East. It shares borders with Iraq and Saudi Arabia. It has Kuwait Bay, which is its main natural resource. Oil was discovered in 1938 and it was an important part of the economy from then on. Kuwait is one of the richest countries in terms of GDP per capita, second only to Qatar among GCC countries. It also has one of the highest inflation rates in the world because they peg its currency to US dollars so it can have access to cheap oil. '''Conclusion''' The conclusion is that currency has been a symbol of wealth and power in human cultures for millennia. It has also made the world more open and connected. However, it is necessary to adopt new currencies for an ever-changing global economy. [[User:Technomizinfo|Technomizinfo]] ([[User talk:Technomizinfo|discuss]] • [[Special:Contributions/Technomizinfo|contribs]]) 11:21, 26 August 2022 (UTC) h844mmm6jisosuu9xsg36ctbor8rcdb