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In addition cheap 20mg fluoxetine with visa, treatments such as bleeding by leeches to decrease fever or travelling to religious sites such as Lourdes in order to alleviate symptoms have also continued across the years without any obvious understanding of the processes involved cheap fluoxetine 20mg line. Faith healers are another example of inert treatments ranging from Jesus Christ buy discount fluoxetine 10mg online, Buddha and Krishna. The tradition of faith healers has persisted, although our understanding of the processes involved is very poor. Such apparently inert interventions, and the traditions involved with these practices, have lasted over many centuries. In addition, the people involved in these practices have become famous and have gained a degree of credibility. Perhaps, the maintenance of faith both in these interven- tions and in the people carrying out the treatments suggests that they were actually successful, giving the treatments themselves some validity. It is possible that there are medically active substances in some of these traditional treatments that were not understood in the past and are still not understood now (e. It is also possible that the effectiveness of some of these treatments can be understood in terms of modern-day placebo effects. Modern-day placebos Recently placebos have been studied more specifically and have been found to have a multitude of effects. For example, placebos have been found to increase performance on a cognitive task (Ross and Buckalew 1983), to be effective in reducing anxiety (Down- ing and Rickles 1983), and Haas et al. Beecher (1955), in an early study of the specific effects of placebos in pain reduction, suggested that 30 per cent of chronic pain sufferers show relief from a placebo when using both subjective (e. They reported that half the subjects with angina pain were given a sham operation, and half of the subjects were given a real heart bypass operation. The results indicated that pain reduction in both groups was equal, and the authors concluded that the belief that the individual had had an operation was sufficient to cause pain reduction and alleviation of the angina. Since the 1940s, research into the effectiveness of drugs has used randomized controlled trials and placebos to assess the real effects of a drug versus the unreal effects. However, if placebos have a multitude of effects as discussed above, perhaps, rather than being taken out they should be seen as central to health status. If placebos have a multiple number of possible effects, what factors actually mediate these changes? Several theories have been developed to try and understand the process of placebo effects. Non-interactive theories Characteristics of the individual Individual trait theories suggest that certain individuals have characteristics that make them susceptible to placebo effects. Such characteristics have been described as emotional dependency, extraversion, neurosis and being highly suggestible. Research has also suggested that individuals who respond to placebos are introverted. However, many of the characteristics described are conflicting and there is little evidence to support consistent traits as predictive of placebo responsiveness. Characteristics of the treatment Other researchers have focused on treatment characteristics and have suggested that the characteristics of the actual process involved in the placebo treatment relates to the effectiveness or degree of the placebo effect. For example, if a treatment is perceived by the individual as being serious, the placebo effect will be greater. Accordingly, surgery, which is likely to be perceived as very serious, has the greatest placebo effect, followed by an injection, followed by having two pills versus one pill. Research has also looked at the size of the pill and suggests that larger pills are more effective than small pills in eliciting a change. Characteristics of the health professional Research has also looked at the characteristics of the health professional suggesting that the kind of professional administering the placebo treatment may determine the degree of the placebo effect. For example, higher professional status and higher concern have been shown to increase the placebo effect. Problems with the non-interactive theories Theories that examine only the patient, only the treatment or only the professional ignore the interaction between patient and health professional that occurs when a placebo effect has taken place. They assume that these factors exist in isolation and can be examined independently of each other. However, if we are to understand placebo effects then perhaps theories of the interaction between health professionals and patients described within the literature (see Chapter 4) can be applied to understanding placebos. Placebo effects should be conceptualized as a multi-dimensional process that depends on an interaction between a multitude of different factors. To understand this multi-dimensional process, research has looked at possible mechanisms of the placebo effect. Experimenter bias Experimenter bias refers to the impact that the experimenter’s expectations can have on the outcome of a study. For example, if an experimenter was carrying out a study to examine the effect of seeing an aggressive film on a child’s aggressive behaviour (a classic social psychology study) the experimenter’s expectations may themselves be responsible for changing the child’s behaviour (by their own interaction with the child), not the film. Subjects were allocated to one of three conditions and were given either an analgesic (a painkiller), a placebo or naloxone (an opiate antagonist, which increases the pain experience). The patients were therefore told that this treatment would either reduce, have no effect or increase their pain.

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Community mental health services are psychological treatments and interventions that are distributed at the community level best fluoxetine 10 mg. Community mental health services are provided by nurses purchase fluoxetine 20mg online, psychologists order 20 mg fluoxetine visa, social workers, and other professionals in sites such as schools, hospitals, police stations, drug treatment clinics, and residential homes. The goal is to establish programs that will help people get the mental health services that they need (Gonzales, Kelly, Mowbray, Hays, & [5] Snowden, 1991). Unlike traditional therapy, the primary goal of community mental health services is prevention. Just as widespread vaccination of children has eliminated diseases such as polio and smallpox, mental health services are designed to prevent psychological disorder (Institute of Medicine, [6] 1994). Community prevention can be focused on one more of three levels: primary prevention, secondary prevention, and tertiary prevention. Primary prevention is prevention in which all members of the community receive the treatment. Examples of primary prevention are programs designed to encourage all pregnant women to avoid cigarettes and alcohol because of the risk of health problems for the fetus, and programs designed to remove dangerous lead paint from homes. Secondary prevention is more limited and focuses on people who are most likely to need it— those who display risk factors for a given disorder. Risk factors are the social, environmental, and economic vulnerabilities that make it more likely than average that a given individual will [7] develop a disorder (Werner & Smith, 1992). The following presents a list of potential risk factors for psychological disorders. Some Risk Factors for Psychological Disorders Community mental health workers practicing secondary prevention will focus on youths with these markers of future problems. Community prevention programs are designed to provide support during childhood or early adolescence with the hope that the interventions will prevent disorders from appearing or will keep existing disorders from expanding. Interventions include such things as help with housing, counseling, group therapy, emotional regulation, job and skills training, literacy training, social responsibility training, exercise, stress management, rehabilitation, family therapy, or removing a child from a stressful or dangerous home situation. The goal of community interventions is to make it easier for individuals to continue to live a normal life in the face of their problems. Community mental health services are designed to make it less likely that vulnerable populations will end up in institutions or on the streets. In summary, their goal is to allow at-risk individuals to continue to participate in community life by assisting them within their own communities. Suicide is a leading cause of death worldwide, and prevention efforts can help people consider other alternatives, particularly if it can be determined who is most at risk. Determining whether a person is at risk of suicide is difficult, however, because people are motivated to deny or conceal such thoughts to avoid intervention or hospitalization. One recent study found that 78% of patients who die by suicide explicitly deny suicidal thoughts in their last verbal communications [8] before killing themselves (Busch, Fawcett, & Jacobs, 2003). They measured implicit associations about death and suicide in 157 people seeking treatment at a psychiatric emergency department. Using a notebook computer, participants classified stimuli representing the constructs of ―death‖ (i. Response latencies for all trials were recorded and analyzed, and the strength of each participant‘s association between ―death‖ and ―me‖ was calculated. The researchers then followed participants over the next 6 months to test whether the measured implicit association of death with self could be used to predict future suicide attempts. These results suggest that measures of implicit cognition may be useful for determining risk factors for clinical behaviors such as suicide. Imagine the impact of a natural disaster like Hurricane Katrina on the population of the city of New Orleans. How would you expect such an event to affect the prevalence of psychological disorders in the community? What recommendations would you make in terms of setting up community support centers to help the people in the city? The efficacy of group psychotherapy for depression: A meta-analysis and review of the empirical research. Researching self-help/mutual aid groups and organizations: Many roads, one journey. Reducing risks for mental disorders: Frontiers for preventive intervention research. Measuring individual differences in implicit cognition: The Implicit Association Test. Summarize the ways that scientists evaluate the effectiveness of psychological, behavioral, and community service approaches to preventing and reducing disorders. We have seen that psychologists and other practitioners employ a variety of treatments in their attempts to reduce the negative outcomes of psychological disorders. But we have not yet considered the important question of whether these treatments are effective, and if they are, which approaches are most effective for which people and for which disorders. Accurate empirical answers to these questions are important as they help practitioners focus their efforts on the techniques that have been proven to be most promising, and will guide societies as they make decisions about how to spend public money to improve the quality of life of their citizens [1] (Hunsley & Di Giulio, 2002). Psychologists use outcome research, that is, studies that assess the effectiveness of medical treatments, to determine the effectiveness of different therapies.

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Have a happy marriage—people with marital problems tend to find retirement more stressful because they do not have a positive home life to return to and can no longer seek refuge in long working hours buy generic fluoxetine 10mg. Take care of physical and financial health—a sound financial plan and good physical health can ensure a healthy order fluoxetine 10mg online, peaceful retirement cheap 20mg fluoxetine amex. Retire early from a stressful job—people who stay in stressful jobs for fear that they will lose their pensions or won‘t be able to find work somewhere else feel trapped. Retire “on time‖—retiring too early or too late can cause people to feel“out of sync‖ or to feel they have not achieved their goals. Death, Dying, and Bereavement Living includes dealing with our own and our loved ones‘ mortality. In her book, On Death and [19] Dying (1997), Elizabeth Kübler-Ross describes five phases of grief through which people pass in grappling with the knowledge that they or someone close to them is dying: Denial:“I feel fine. As an example, Japanese Americans [21] restrain their grief (Corr, Nabe, & Corr, 2009) so as not to burden other people with their pain. In some cultures the elderly are more likely to be living and coping alone, or perhaps only with their spouse, whereas in other cultures, such as the Hispanic culture, the elderly are more likely to be living Attributed to Charles Stangor Saylor. These researchers also found that people going through the grieving process suffered more physical and psychological symptoms and illnesses and used more medical services. The health of survivors during the end of life is influenced by factors such as circumstances surrounding the loved one‘s death, individual personalities, and ways of coping. People serving as caretakers to partners or other family members who are ill frequently experience a great deal of stress themselves, making the dying process even more stressful. Despite the trauma of the loss of a loved one, people do recover and are able to continue with effective lives. Grief intervention programs can go a long way in helping people cope during the bereavement period [24] (Neimeyer, Holland, Currier, & Mehta, 2008). Are there other ways that people in your society might learn to think about aging that would be more beneficial? Based on the information you have read in this chapter, what would you tell your parents about how they can best maintain healthy physical and cognitive function into late adulthood? The role of motivation in the age-related positivity effect in autobiographical memory. The development of the person: The Minnesota study of risk and adaptation from birth to adulthood. Aging free from negative stereotypes: Successful memory in China among the American deaf. Inhibitory changes after age 60 and the relationship to measures of attention and memory. The Journals of Gerontology: Series B: Psychological Sciences and Social Sciences, 57B(3), P223–P232. Age differences in everyday problem-solving effectiveness: Older adults select more effective strategies for interpersonal problems. The Journals of Gerontology: Series B: Psychological Sciences and Social Sciences, 62B(1), P61–P64. Responding to the challenges of late life: Strategies for maintaining and enhancing competence. The association between physical activity in leisure time and leukocyte telomere length. Effects of social integration on preserving memory function in a nationally representative U. Profiling retirees in the retirement transition and adjustment process: Examining the longitudinal change patterns of retirees’ psychological well-being. The other side of sadness: What the new science of bereavement tells us about life after a loss. Meaning reconstruction in later life: Toward a cognitive- constructivist approach to grief therapy. Babies are born prepared with reflexes and cognitive skills that contribute to their survival and growth. Piaget‘s stage model of cognitive development proposes that children learn through assimilation and accommodation and that cognitive development follows specific sequential stages: sensorimotor, preoperational, concrete operational, and formal operational. An important part of development is the attainment of social skills, including the formation of the self-concept and attachment. Adolescence involves rapid physical changes, including puberty, as well as continued cognitive changes. In Western cultures, adolescence blends into emerging adulthood, the period from age 18 until the mid-20s. Fertility, particularly for women, also decreases, and women eventually experience menopause. Most older adults maintain an active lifestyle—remaining as happy or happier than they were when they were younger—and increasingly value their social connections with family and friends. Although older adults have slower cognitive processing overall (fluid intelligence), their experience in the form of crystallized intelligence, or existing knowledge about the world and the ability to use it, is maintained and even strengthened during aging.

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