Developing a systematic process for evaluating a psychosocial stressor using 7-dimensional psychosocial stress inventory (7D-PSI)
Can stress only cause us to develop physical and mental disorders?
Diathesis-stress model
Researchers have suggested that many disorders are thought to develop when some kind of stress affects a person who already has a vulnerability or diathesis for this disorder (Ingram & Luxton, 2005; Meehl, 1962; Monroe & Simons, 1991). Diathesis or vulnerability, which may be a genetic predisposition or an adverse experience in childhood, is usually insufficient to cause the disorder itself, but it is a contributing factor to development. For example, a child who is experiencing the death of a parent will have a higher risk of developing depression as an adult. In this case, the vulnerability itself was a stressor for children.
Thus, experiencing psychosocial stressors may not be sufficient for the development of disorders, but together, genetic predisposition and / or adverse childhood experiences plus (+) current stressors are sufficient causes of the development of diseases, disorders and abnormal behavior in general. Since vulnerabilities and stressors can exist in the continuum, for example, from one (1) to low (10) highs, people with a high level of vulnerability may need only a low level of current pressure in their lives to develop problems. Similarly, people with high levels of psychosocial stressors may need only low levels of diathesis (adverse childhood experiences and / or genetic predispositions) for the development of certain disorders.
This article will feature 7 Measurement Measurements - a unique process for assessing stress. It will discuss the use of the following three tools — systematically documenting and helping clients with the visualization of their childhood vulnerabilities, current life stressors and ongoing positive activities in which they participate to reduce stress, increase resilience and improve overall health, hopefully encourage them to develop and control your health and wellness plan for your life:
1. Adverse Childhood Questionnaire (ACE)
2. 7 dimension - psychosocial inventory of stress (7D-PSI)
3. 7 Measurement - Therapeutic Activity (7D-TAS)
What is an ACE study?
The Adverse Childhood Study (ACE) is one of the largest studies ever conducted on the links between child abuse and later health and well-being. In collaboration with the San Diego Centers for Disease Control and Prevention and San Diego Health Assessment Clinics, the health care organization’s (HMO) staff members underwent a comprehensive medical examination and provided detailed information about their childhood experiences of abuse, neglect and family dysfunction. It was attended by over 17,000 members. To date, more than 50 scientific articles have been published and over 100 presentations of conferences and seminars have been made.
The results of the ACE study show that this experience is a major risk factor for the main causes of illness and death, as well as the poor quality of life in the United States. Progress in preventing and restoring the country's worst medical and social problems is likely to benefit from the realization that many of these problems arise from adverse children's experiences.
What is an ACE score? The growing experience of any of the following conditions in a household under the age of 18 determines your ACE (1 point for each):
Repeated physical abuse
Repeated Emotional Abuse
Contact Sexual Abuse
The perpetrator of alcohol and / or drugs in the household
Family member in custody
One who is chronically depressed, mentally ill, institutionalized or suicidal
Mother is abused
One or all parents
Emotional neglect
Physical neglect
The ACE score can be used to quantify your experiences and vulnerabilities in childhood, and the score can be documented on the Wheel of Life to visualize a client's stressful area.
What is the significance of the ACE study?
Because adverse childhood experiences (ACEs) are very common, and ACEs are strong predictors of risks to health and illness from dependence on adulthood — a combination of these results makes ACEs one of the leading, if not leading, determinants of health and social well-being of our nation.
Identifying psychosocial stressors
“DSM-IV-TR informs us that Axis IV is intended to report on psychosocial and environmental issues that may affect the diagnosis, treatment and prediction of mental disorders outlined on axes I and II, environmental difficulties or deficiencies, family or other interpersonal stress, inadequate social support or personal resources, or another problem related to the context in which a person’s difficulties have arisen. When a person has several psychosocial or environmental problems, the doctor can mark as much as judge to be relevant ”(DSM-IV-TR, p. 31).
Unfortunately, clinicians rarely conduct a multifaceted, comprehensive, systematic study of their clients' psychosocial stressors to document those stressors that may be relevant to the process of planning a diagnosis and treatment. 7D - PSI was designed specifically for this purpose.
7 Dimension - psychosocial inventory of stress (7D-PSI)
A 7-dimensional psychosocial inventory (7d-PSI) is an effective and effective tool for psychosocial stressors of 170 subjects, which facilitates a comprehensive and systematic assessment of a person’s stressful life situations. The goal of identifying as complete a list of individual psychosocial stressors as possible is that a treatment plan can be developed that will address the most important of these factors. This method extends the use of resources. It can also help and improve the diagnosis of DSM-IV-TR, Axis IV (psychosocial stress). 7D-PSI is intended for adults, but can be modified for use with adolescents. 170 items can be easily assessed within 15 minutes. It is easily clogged, and the results can be quickly integrated into the 7-dimensional wheel of life, which will be considered by the client as a motivational improvement. In addition to the effectiveness of 7 D-PSI aimed at the most important psycho-social stressors requiring attention, it can identify differential primary diagnoses for further evaluation. The reduction of 7 D-PSI, ease of administration and scoring make it very useful for research applications. Based on independent surveys of a mental health professional, this inventory, administered by primary care practitioners, demonstrated good accuracy (sensitivity and specificity) for identifying psychosocial stressors important for diagnosis and treatment planning. Studies are currently being conducted to exit treatment (Slobodzien, 2005).
Protective factors
Protective factors in childhood or flu that can modify a child’s response or stress response should also be considered in the equation. These protective factors, such as the presence of a family environment in childhood, in which at least one parent was supported, and a good parent-child relationship, were developed to protect against the harmful effects of an abusive parent (Masten & Coatsworth, 1998). Other protective factors of childhood that can protect against a multitude of stressors include light temperament, high self-esteem, high intelligence and school performance (Masten, 2001; Masten & Coatsworth, 1998; Rutter, 1987).
Building stability
So, what should a person do if they fall into the category of high level of vulnerability of children (diathesis); low levels of child protection factors; and currently with high levels of psychosocial stressors in their lives. How do people cope with serious illness, job loss, death of a loved one or other life related events and / or traumatic experiences? If you just give up and give the symptoms that you are already developing. Is it inevitable or just destiny that you will develop these disorders, or is it something you can start doing for yourself now to reduce your risk?
Since stress is defined by some experts as a response or individual experience to statements that he or she perceives as taxing or overspending his personal resources (Folkman & Moskovitz, 2004; Lazarus, 1993; Taylor & Stanton, 2007), it is logical to take into account that we could to increase our personal resources to increase sustainability in all dimensions of our lives — to reduce the risk of developing these disorders and their harmful effects. Resilience is the ability to recover or easily tune in to change or failure. To be elastic, you need to be flexible, resilient and resilient. In other words, when bad things happen to you, you are considered sustainable when you can jump back and adapt successfully to very difficult circumstances.
There is growing evidence that if a child’s fundamental systems of adaptation (such as intelligence and cognitive development, self-regulation ability, skill motivation, effective education, and well-functioning neurobiological systems for treating stress), usually, the most threatening circumstances will have minimal impact on him or her (Masten, 2001). Problems can arise when a serious stressor damages one or more of these systems or when the level of a problem far exceeds a person’s ability to adapt (for example, susceptibility to chronic trauma during war or chronic abuse in families with an offensive attitude (Cicchetti, 2004; Cicchetti & Toth, 2005, Masten & Coatsworth, 1998). Sustainability is not a personality trait with which people are born. A whole plan of health and well-being. The following analysis of therapeutic activity can be used to assess current behavior of people / activities related to stress reduction, resistance and improving overall health.
7 Measurement - Therapeutic Activity (7D-TAS)
7D-TAS is a 21 survey that can identify specific therapeutic actions in the following seven dimensions of life:
1. Medical / physical stress measurement
2. Self-Regulation / Pulse Voltage Control - Measurement
3. Educational professional tension - measurement
4. Social / Cultural Tension - Measurement
5. Financial / legal stress - measurement
6. Mental / Emotional Stress - Measurement
7. Spiritual / Religious Tension - Measurement
The following three questions are asked:
1. Do you participate in activities that reduce stress, increase resistance, and improve overall health in each of the 7 dimensions?
2. If Yes - What specific actions do you take for at least 30 minutes a day?
3. How many days per month do you attend these events?
Six of the seven dimensions are common to most health and wellness models, but the second dimension: self-regulation / impulse control may require some explanation, so I listed the following questions of the second dimension:
Self-Regulation / Pulse Control Dimensions:
1. You are currently maintaining a balanced lifestyle, avoiding alcohol / drug abuse and / or other addictive / risky behaviors (for example, gambling, sexual compulsive behavior, food - beating / cleansing, obsessive religious practices, risky / dangerous behavior - accelerating / reckless driving and / or assault / violence / self-harm, excessive use of online stores, exercise, work, etc.). Well no
2. If “Yes” - combine the following actions in which you participate: self-control, daily journaling, conversation with family members / friends, coach / trainer, read self-help books, attend support groups (religious meetings, alcoholics anonymous), individual / group counseling / therapy, etc. Other: _____________
3. If “Yes” - round the number of days per month: 0 --- 5 --- 10 --- 15 --- 20 --- 25 --- 30
Total percentages (%) are then counted and then can be documented on the “Wheel of Life” to visualize, to emphasize the cognitive dissonance between what you (or your client) actually do, to improve your life at this time and what you think what you can do.
Self-regulation is one of the main executive functions of the human brain and is a centrally important process and vital dimension. It not only contains important keys to the theory of self, but also has extensive pragmatic applications. Indeed, most of the personal and social problems that modern Western citizens face — addiction, violence and crime, debt, sexually transmitted diseases, under-receipt, unwanted pregnancy, obesity, inability to play sports, gambling, inability to save money, and others — are rooted in self-regulation failures (Higgins, ET, 1996).
Together
Recommendations for the implementation of 7-dimensional intervention:
1. Start an interview with the “Open Question” method to get as much information as possible from the client before entering any questionnaires or checklists (use reflexive listening skills, etc.).
2. Administer the ACE questions and calculate the ACE score.
3. Administer 7D - PSI and score.
4. Manage 7D - TAS and calculate estimates and make all assessments on the Wheel of Life to visualize diathesis levels, current psychosocial stressor levels, and current efforts to reduce stress and increase sustainability.
5. Administer the question “Stages of Change”: on a scale from 1 to 10 - with 10 the highest motivation for the changes you currently have, how motivated?
Stage of preliminary contemplation = 1 - 3
Stage of Contemplation = 4 - 5
Stage of preparation = 6 - 7
Stage of action = 8 - 9
Maintenance phase = 10
6. Conduct a “Motivational Interview” session in which your client will discuss the “Stages of Change”. The brevity of this article does not allow a review of this session (Tomlin, K. & Richardson, H., 2004)
7. If necessary, develop a holistic, multidimensional health and wellness plan and a comprehensive individual treatment plan, as well as a system for monitoring cases and treatment.
7. Overall model
In the "System of Measurement of Addiction (ARMS)" (Slobodzien, J., 2005), the following seven vital activity indicators for measures to move forward include 7D-PSI. Each of the seven dimensions has individual evaluation criteria:
1. Medical / physical stress measurement
2. Self-Regulation / Pulse Voltage Control - Measurement
3. Educational professional tension - measurement
4. Social / Cultural Tension - Measurement
5. Financial / legal stress - measurement
6. Mental / Emotional Stress - Measurement
7. Spiritual / Religious Tension - Measurement
Initially, the 7-Dimension model was developed to measure patient progress by assessing therapeutic activity, but research can prove that it is effective as a generalized model of recovery from all pathological diseases, disorders and disorders. The multidimensional assessment / treatment process includes the internal interrelation of several dimensions from biomedicine to spiritual - taking into account the effects of feedback and the existence of each dimension mutually influencing each other simultaneously. Due to the complexity of human nature, treatment progress must initially be adapted and focused on an individual treatment plan based on a comprehensive bio-psychosocial assessment that identifies specific problems, goals, objectives, methods and schedules to achieve the goals and objectives of the treatment.
Psychosocial stressors can affect many areas of individual functioning and require holistic health and wellness planning along with multimodal treatment. The goals of treatment include reducing multidimensional stress and simultaneously improving multidimensional functioning. Real progress takes time, commitment and discipline in thinking about it, planning its work, executing the plan and monitoring success to increase sustainability. Он также требует соответствующих вмешательств и стимулирования стратегий для каждой области прогресса жизни каждого человека.
7. Размеры - это нелинейная, динамическая, неиерархическая модель, которая фокусируется на взаимодействии между несколькими факторами риска и ситуационными детерминантами, подобными теориям катастроф и хаоса, в прогнозировании и объяснении привыкания к поведению и рецидиве. Множество влияний запускаются и действуют в ситуациях высокого риска и влияют на глобальную многомерную функцию человека. Процесс наращивания устойчивости включает взаимодействие между многими факторами фона (например, семейная история, социальная поддержка и сопутствующая психопатология), физиологические состояния, когнитивные процессы (например, самоэффективность, мотивация, прогнозные ожидания) и навыки преодоления. Проще говоря, небольшие изменения в индивидуальном поведении могут привести к большим качественным изменениям на глобальном уровне, а модели на глобальном уровне системы возникают исключительно из многочисленных небольших взаимодействий. Клиническая полезность модели восстановления 7 - Dimensions заключается в ее способности помочь поставщикам медицинских услуг быстро собирать подробную информацию об индивидуальной личности, истории, истории употребления психоактивных веществ, аффективном состоянии, самоэффективности и навыках преодоления прогноз, диагностика, планирование лечения и меры по выходу.
7 - Размеры & теория способствует синергетическому положительному эффекту, который может воспламенять и освобождать человеческий дух, когда индивидуальные показатели жизнедеятельности повышаются в гомеостатической системе. Взаимодействие между духовностью и многомерным прогрессом жизни, установление глубочайших внутренних самооценок и поведенческих изменений.
Основополагающая теория 7 - измерений утверждает, что комбинация индивидуумов повышенные и сбалансированные множественные функционально-функциональные измерения могут вызывать синергически стойкий, упругий и духовно положительный индивидуальный гомеостаз. Так же, как сочетание алкоголя и наркотиков (например, валиума) при совместном воздействии создает синергетический эффект (эффекты потенции не складываются вместе, а умножаются) и могут развиваться в зависимость или несбалансированный образ жизни, положительную эффективность лечения и успешные результаты являются результатом синергетического отношения с «Высшей Силой».
Conclusion
Быстро растущая совокупность доказательств подтверждает взаимосвязь между неблагоприятным опытом детства и физическими / психическими расстройствами. Клинические исследования, исследующие эти отношения, заключают, что психосоциальные стрессоры в детстве в сочетании с текущими стрессорами могут быть причиной и следствием психических расстройств. Кроме того, недавние данные показали, что планирование здоровья и хорошего самочувствия для снижения стресса и повышения устойчивости может уменьшить симптомы, которые приводят к психическим расстройствам.
К сожалению, влияние психосоциальных стрессоров на психические расстройства остается недооцененным по сравнению с традиционными генетико-биологическими причинами. Поставщики психиатрических услуг должны проводить систематический скрининг психосоциальных стрессоров для выявления потенциальных симптомов для дальнейшей диагностики и планирования лечения. Следует уделить особое внимание разработке уникальных вмешательств для оказания помощи пациентам в осознании связей между их деятельностью в области образа жизни и будущими психическими расстройствами. Сочетание устройств скрининга, обсуждаемых в этой статье, чтобы помочь пациентам визуализировать свои детские уязвимости, текущие стрессоры и текущую терапевтическую деятельность, успешно побудило пациентов к осуществлению позитивных терапевтических действий для определения конкретных стрессоров, влияющих на конкретные размеры их жизней, чтобы уменьшить стресс, повысить сопротивляемость, и улучшить их общее состояние здоровья. 7-мерное вмешательство было особенно полезно для пациентов с нарушениями злоупотребления психоактивными веществами, возникающими при других хронических заболеваниях.
Пришло время для поставщиков психиатрических услуг признать влияние семимерного подхода к психическому здоровью. Модель 7-мерных измерений не претендует на роль панацеи от болезней всего человечества, но это шаг в правильном направлении для того, чтобы клиницисты могли изменить способ их практического применения, изменив системы лечебных учреждений на включенные научно обоснованные результаты исследований об эффективных вмешательствах. Задача для тех, кто заинтересован в проведении оценочных оценок для повышения качества обслуживания, заключается в том, чтобы внедрить систему, которая будет стандартизировать их процедуры оценки, программы лечения и методы клинического лечения. Тщательно следуя стандартизированной системе, чтобы получить исходные данные о результатах своей программы лечения, эффективность которых будет постоянно оцениваться, они смогут оценить эффективность последующих лечебных вмешательств.
Для получения дополнительной информации см .: Поли-поведенческая зависимость и система оценки восстановления зависимостей (ARMS) по адресу: http://ezinearticles.com/?expert_bio=James_Slobodzien
Джеймс Слободзиен, Psy.D.
Recommendations
Американская психиатрическая ассоциация: диагностическое и статистическое руководство по психическим расстройствам, четвертое издание, текстовое редактирование. Вашингтон, округ Колумбия, Американская психиатрическая ассоциация, 2000, с. 787 & p. 731.
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