Evaluating Adolescents With Depression, Anxiety, and Suicidal Thoughts - Case Study Example

Cognitive Psychology 2 Cognitive Psychology is regarded as the higher mental processes such as how individuals perceive, learn, remember, and think about information. This paper introduces a brief window into the field of cognitive psychology and its related topics. It particularly emphasizes three concepts that are important to psychologists today: (1) perception, attention, and consciousness, (2) memory models and processes, (3) knowledge representation and manipulation. Next, we will discuss why these specific topics are important and how psychologists use these facts to deal with adolescents that suffer from depression, anxiety, and suicidal thoughts as well as the effect that parents have on their children. The ideas presented in this paper will provide a foundation on which to build an understanding of the topics in cognitive psychology. Cognitive Psychology 3 Cognitive psychology is the study of higher mental processes such as attention, language use, memory, perception, problem solving, and thinking (Sternberg, 2006). According to Gerrig and Zimbardo (2002), cognition is a general term for all forms of knowing. The study of cognition is the study of your mental life. Cognition includes both contents and processes. The contents of cognition are what you know such as concepts, facts, propositions, rules, and memories: “A dog is a mammal.” “A red light means stop.” “I first left home at age 18.” Cognitive processes are how you manipulate these mental contents in ways that enable you to interpret the world around you and to find creative solutions to your life’s dilemmas. We will begin with a brief history of cognitive psychology, then we will examine the following three sub- topics (1) perception, attention, and consciousness, (2) memory models and processes, (3) knowledge representation and manipulation and discuss why they are important and how psychologists use these facets to deal with adolescents that suffer from depression, anxiety, and suicidal thoughts as well as the effect that parents have on their children. Within psychology, the study of cognition is carried out by researchers in the field of cognitive psychology. History reports, the field of cognitive psychology has been supplemented by the interdisciplinary field of cognitive science. Cognitive science focuses on the collected knowledge of several academic specialties on the same theoretical issues. It benefits the practitioners of each of these fields to share their data and insights. Many of the theories have similarly been shaped through the interactions of researchers from a number of disciplinary perspectives. According to Sternberg (2006), historians traced the beginnings of psychology back two different approaches to understanding the human mind. These two approaches are known as rationalism and empiricism. Both approaches became popular with a prominent French rationalist Rene Descartes (1596-1650) and John Locke (1623-1704). These two approaches eventually led to the first major school of thought in psychology known as structuralism. Structuralism is the study of the structure of mind and behavior; the view that all human mental experience can be understood as a combination of simple elements or events. One important alternative to structuralism, is functionalism which seeks to understand what people do and why they do it. Functionalism gave rise to pragmatists who believe that knowledge is validated by its usefulness. For example, pragmatists believe in the importance of the psychology of learning and memory. Even today, cognitive psychologists frequently point to the writings of William James (1842-1910) in discussions of core topics in the field, such as perception, attention, and consciousness. 1 ) Adolescents and depression with regard to perception Today psychologists evaluate adolescents and their associated medical conditions such as depression, anxiety, and suicide. For example, it is perceived that the prognosis, course and development of depression among adolescents is related to dysfunctional family interactions. To specify, interactions in the family of a depressed adolescent is more of rejection, conflict, abuse, communication problems and there is less support and expression when compared to non-depressed adolescents. Factors involving family is associated with parental psychopathology. Parental depression, especially maternal depression is a principal factor for depression in young people because mothers have a greater role in child rearing. Therefore, depression in a mother will have a greater impact on the adolescent child. Some of the moderators or mediator of parental influence is genetic predisposition, family interactions, learned helplessness, parent-child attachment, marital conflicts and physical abuse. Family expressed emotion or EE is defined as the amount of involvement of relatives in terms of hostility, criticism and emotional over involvement that has a crucial role in adolescent depression. Depression among adolescents is also high if there is lack of emotion support, family cohesion, social isolation or marital disharmony in their family (Beach, S.R.H. 2006 p.213). High EE in families is associated with high relapse rates and difficulties in recovery for depressed adolescents. It is found that focused strategies such as open communication in family, following rules to maintain family harmony and sharing activities can increase coping levels and decrease depressive symptoms among adolescents. The reason behind this predictive correlation of family and depression among teenagers is the change in the adolescent life with regard to becoming independent from family and the perception of emotional participation and acceptance from the family which is significant during the change (Beach, S.R.H. 2006 p.214) that leads to decreased ability to think, recurrent thoughts of suicidal ideation or thoughts of death. There are different scales to assess the extent and presence of depression in adolescents. After assessing whether the adolescent is severely or moderately depressed, psychiatric consultation is provided to determine the requirement for hospitalization or medication. Antidepressant medication is proved to be effective in speeding up recovery from depression. This works synergistically with interpersonal or cognitive psychotherapy (Beach, S.R.H. 2006 p.215). Major depression in adolescents is characterized by the absence of pleasure and interest in activities which they used to previously enjoy. Painful emotions are related to mental anguish, anxiety, extreme sense of guilt and agitation (restlessness). An adolescent needs to undergo diagnosis for depression if these depressive symptoms and mood prevails for two weeks together with symptoms like hypersomnia or insomnia, weight gain or weight loss, fatigue, psychomotor retardation or feeling of worthlessness (Hepworth, D.H., Rooney, R.H., Rooney, G.D., Strom-Gottfried, K. & Larsen, J.A. 2009 p.212). While evaluating depression, it is crucial to assess the factors that precipitated the episode. In case the depressive mood has initiated from a significant loss or a number of losses, it would be complicated to differentiate the condition between extreme bereavement and depression. Since mourning and depression share certain similar characteristics like appetite disturbances, intense sleep and sadness, if grief does not include decrease in self esteem it relates to bereavement while guilt and decrease in self esteem is usually observed in depression. To explain further, adolescents who have lost a close relative or friend do not consider themselves less after such a loss or if they feel less it will be only for a short period. If a person experience guilt after bereavement, it is due to a specific aspect of loss and it is not due to a general sense of culpability (Hepworth, D.H., Rooney, R.H., Rooney, G.D., Strom-Gottfried, K. & Larsen, J.A. 2009 p.213). Depression in adolescence is marked by the intensity of feeling and the behaviors manifested with regard to developmental differences. The prevalence of depression is almost the same among girls and boys though girls are more likely to undergo depression with more feelings of inadequacy and anxiety while boys tend to have more antisocial and aggressive feelings. Parents, friends and coaches will not realize quickly when an adolescent is depressed. Therefore it is important for them to be cautious about potential symptoms of depression. Specific subgroups are likely to experience additional extreme risk factors particular to a race, gender, ethnicity or sexual orientation and the processes in which these interact with the circumstances around them. Due to the tempestuousness specific to adolescence, it can be a complex step to distinguish warning symptoms from normative behavior and actions. Parents and close acquaintances can take a cautious measure by considering such changes seriously instead of ignoring it as specific teen behavior. Even if these symptoms are not indicative of depression, behavioral changes are worth adult attention to assess the requirement of further measures like professional consultation and assessment. Suicidal risk is high when adolescents exhibit the abovementioned symptoms together with indications of hopelessness or has witnessed the death of a dear one, has extreme conflict with parents or has lost a relationship with a love interest or other close peers. These factors are adequate indicators for an attempted or completed suicide (Hepworth, D.H., Rooney, R.H., Rooney, G.D., Strom-Gottfried, K. & Larsen, J.A. 2009 p.214). Consciousness Adolescents attempt suicide because they tend to gain a consciousness that they would fail in the competition in the society to avail the stable or shrinking resources that are essential for livelihood. In social comparison processes the problem becomes more intense when adolescents feel they are short of acceptable standards (Feldman, R.S. 1996 p.92). Social contagion effects such as peer suicide attempts or peer suicide can induce ann adolescent to engage in a suicidal behavior to gain conformity. Residential mobility is another reason for adolescent suicide which is not much considered to evaluate psychological problems. The frequent movement of family from place to place results in the lack of social support from school, community and permanent peer relationships (Feldman, R.S. 1996 p.93) with further problems like divorced or single parents or conflict in family. Child maltreatment that includes physical and sexual abuse also leads to suicide attempts and self-injurious behavior (Feldman, R.S. 1996 p.94) among adolescents. A secular psychopathological trend associated with suicide is the increase in drug abuse and alcohol abuse among adolescents when self destructive behavior sets in that increase fatal risk taking behavior and impairs judgment due to alteration of consciousness and suicide is envisaged as a method to end the consciousness (Feldman, R.S. 1996 p.95). (2) Memory models and processes Memory models are used to investigate depression among individuals. Autobiographical memory paradigm is a method in which positive and negative phrases or words are presented to the depressed participants and are asked to recall the word that comes first to their memory. The choice of positive or negative word whichever comes first to the memory of the individual serves as the variable for assessment. Depressed individuals first recall memories related to negative events than positive ones. Research indicates that the difference is due to the probability that depressed individuals would have undergone more negative events in their life and associates themselves with negative thoughts. The above mentioned method has given way to a standardized emotional stimuli method in a laboratory setting to evaluate depressed and non-depressed individuals. Memory bias in depression is studied basically with two types of encoding system: an imagination task and a self rating task. Individuals are given words that vary in emotional valence. They are then required to encode the words with reference to their self. In self rating task, individuals are required to assess the word and explain, emotionally how well the words explains them (Johnson, S.L. 2000 p.124). In imagination task the individuals are given words one by one and are asked to imagine scenes that involve themselves and the given word. Investigators assess depression in two categories for the response received after encoding: implicit and explicit memory. Explicit memory bias is assessed by asking the person to write down the stimuli from encoding task which is called a free recall procedure while implicit memory bias is assessed by requiring a individual to make perceptual judgment quickly which is called a lexical decision task. Implicit memory is also assessed through a word completion task. Implicit and explicit memory measures differ based on whether the stimuli encoded is recalled intentionally (Johnson, S.L. 2000 p.125). Information processing methods used to evaluate bias in memory and attention in depression is a significant step over previous self report methodologies ( Johnson, S.L. 2000 p.129) because depressed individuals invariably demonstrate good memory for negative stimuli than for positive factors and the pattern is not demonstrated by non depressed individuals. However depression associated differences in attention function is less consistent and is found to differ due to various reasons. Factors that contribute to inconsistencies in attentional bias are increased level of comorbid anxiety, the use of unpleasant and pleasant stimuli to assess depression, (Johnson, S.L. 2000 p.130) the use of more stimulus for the individual to process and the allocation of different processing options, and the fourth factor for inconsistency is the notion that processing the task implicitly offers guessing strategy (Johnson, S.L. 2000 p.131). Though there has been various promising results through these methods, there are several significant issues related to cognitive biases among depressed adolescent that needs to be researched (Johnson, S.L. 2000 p.138). (3) Knowledge representation and manipulation  Cognitive Technical systems formulate devices that anticipate problems and functions pro-actively based on its previous experience. These technical systems are used to fulfill fundamental requirements such as the acquisition, perception of the environment and structure of knowledge to arrive at conclusion after observations, and impose control on the system behavior. Knowledge representation has technical challenges with regard to self learning systems, learning paradigms, social and psychological questions while devising it through computer programs in medicine and health care. The use of machine to guide a person with dementia is an example of knowledge representation. Machines that offer diagnostics as well as therapy are called theranostics. Nano-, micro- and bio-technologies are to be converged into a system to evaluate multiple parameters and assess predefined patterns to provide specific therapy to a patient. In the case of depression, applications and technologies can be used to improve human capabilities. Manipulation of human psyche with the use of electrical stimulation is possible to treat extreme cases of depression as well as to use it as a party drug in worst case scenarios. These are used to enhance the human sense through infrared vision in sensor pathway and through the use of ultrasound. Hippocampus has a significant role in brain memory. Technical electronic devices that replicate the connectivity of hippocampus are under extensive research. But the use of embedded technical units through implantation is under research for possible risks and side effects and therapies. In the event of an infection post the implantation process, it will pose a hazard to the patient and discredit the invention. Neuro-technical equipments to treat functional losses and diseases must address the questions which neuro-pharmacology research also does. Relevant questions such as risk-benefit analysis, regulation for known consent, side effects, reimbursement and other related issues must be considered before implementing such systems (Sakas, D.E., Simpso, B.A., & Krames, E. 2007 p.440). It may be concluded that investigators can use various cognitive psychology theories that range from common day to day association with families to assessment with memory models and process and through knowledge representation and manipulation methods using technology to diagnose as well as treat adolescents with depression, anxiety and suicidal thoughts. Reference Beach, S.R.H. 2006 Relational processes and DSM-V: neuroscience, assessment, prevention, and intervention Arlington:American Psychiatric Publication Feldman, R.S. 1996 The psychology of adversity Massachusetts: University of Massachusetts Press Hepworth, D.H., Rooney, R.H., Rooney, G.D., Strom-Gottfried, K. & Larsen, J.A. 2009 Direct Social Work Practice: Theory and Skills California: Cengage Learning Johnson, S.L. 2000 Stress, coping, and depression New Jersey: Routledge Sakas, D.E., Simpso, B.A., & Krames, E. 2007 Operative neuromodulation: Functional neuroprosthetic surgery, Volume 1 Springer Wien : New York Read More