Discussion: Discussion Spark Below is a case study of Tiffany. What would you diagnose Tiffany with?What disorders would you rule out based on a lack of evidence?How did you come to your diagnosis? ********************** You are a working in a student counseling center at a small liberal arts college in your community. Your schedule for the day shows that you will be doing an initial assessment on Tiffany, a 20-year-old Asian American student, currently enrolled as a drama major. Her presenting complaint, from her paperwork, is “relationships and stress.” When you meet Tiffany, you are struck by her thin frame. She is thin, bordering on tiny, weighing at most 95 pounds. Her clothes are baggy and hang down on her body, hiding any indication of being female. She stands about 5′ 5″ tall. She greets you with mild enthusiasm. She is groomed adequately though wears no makeup or jewelry. She looks younger than her stated age of 20 and has almost a boyish appearance. Her eye contact is good and she is relatively cooperative with the interview. Her mood she describes as “up and down” though her affect appears mildly dysphoric. There is no evidence on mental status examination of any mania, psychosis, or dissociation. She denies any auditory or visual hallucinations. Her speech and language are normal. Her judgment appears intact though she demonstrates poor insight into the causes of her problems. She appears to be of average to above average intelligence. By way of history, Tiffany informs you that she has been feeling “poorly” though not necessarily depressed. She complains of being fatigued frequently, feeling lethargic, having no motivation to complete her studies, and unsure of why she has failed in her relationships with men at college. She frequently feels overwhelmed by her studies and demonstrates no particular strategies for coping. Your normal intake reveals that she has not had a menstrual period for more than 6 months, a fact that does not concern Tiffany. You inquire as to her eating habits and Tiffany is somewhat vague about that, stating she eats “whenever I’m hungry” and tends to weigh herself several times per day. But, she explains, this is “not unusual for fine arts majors.” You find Tiffany’s self image to be poor. She frequently puts herself down during the interview, calling herself “ugly” at one point, and later using the term “fat” to explain why she can’t maintain a romantic relationship. This concerns you given your observation about her size but she refuses to engage you in that line of questioning. Tiffany shares with you that she has quite a bit of pressure from her family to be successful. She describes her father, a local surgeon, as being “driven” and her mother as an artist with considerable reputation in the community. She denies outright abuse in her family of origin but concedes that “I’m trying to forget my childhood.” *********************** With these thoughts in mind: Post a 1- to 2-paragraph response to the Discussion Spark. Main Discussion: Eating Disorders: Sociological Factors For many years, researchers and clinicians who work with individuals with eating disorders including anorexia and bulimia have been dedicated to working predominantly with Caucasian females. For example, as noted in Fundamentals of Abnormal Psychology, “Ninety to 95 percent of all cases of anorexia nervosa occur in females” (Comer, 2016, p. 280). However, this may be changing in some significant ways, as evidenced in the video program entitled The Perfect Image. This documentary on eating disorders in elite gymnasts depicts one man’s experiences with anorexia nervosa, demonstrating that eating disorders can also affect men. In a similar way, the section titled “Multicultural Factors: Racial and Ethnic Differences,” beginning on page 295 in the textbook, highlights increasing similarities between women from other ethnic minority groups and Caucasian American women with respect to their concerns about weight and appearance, their dieting practices, and their vulnerability to the development of eating disorders. In this week’s Discussion, you will comment on and share your reactions to this changing landscape for eating disorders. To prepare for this Discussion: Review the Learning Resources on eating disorders, including the article by Jackson & Chen (2015).Jackson, T., & Chen, H. (2015). Features of objectified body consciousness and sociocultural perspectives as risk factors for disordered eating among late-adolescent women and men. Journal of Counseling Psychology, 62(4), 741–752. https://web-a-ebscohost-com.ezp.waldenulibrary.org/ehost/detail/detail?vid=1&sid=197161a7-eb74-499a-b27d-9e2f76025932%40sessionmgr4010&bdata=JnNpdGU9ZWhvc3QtbGl2ZSZzY29wZT1zaXRl#AN=2015-32536-001&db=pdh Consider the role of sociocultural factors in some of these recent developments in the area of eating disorders. With these thoughts in mind: Post an analysis of the sociocultural risk factors contributing to a rise in eating disorders in both men and women in a variety of racial and ethnic groups. Include in your analysis an explanation of the factors that present the most risk for these groups, as well as your thoughts about why there has been an increase in and “spread” of these disorders. Be sure to justify your response with citations from the Learning Resources as well as at least one outside resource. Finally, given your new understanding regarding the development of eating disorders, comment on whether you think it is possible to develop a comprehensive sociocultural risk factor model and why (refer to Chapter 2, “Models of Abnormality”). Assignment: Controlled Drug Use: Is Addiction a Disease? One of the more controversial issues related to the substance-related disorders is whether or not someone with a substance-related disorder can ever learn to keep his or her drug or alcohol use under control. A related issue is whether or not an individual with a substance-related disorder has a disease, which is the position of Alcoholics Anonymous (AA). In this week’s Assignment, you will address each of these controversial issues. To prepare for this Assignment: Review the Learning Resources on substance-related disorders, including the articles by Bujarski, O’Malley, Lunny, & Ray (2013) and Koerkel (2006). Bujarski, S., O’Malley, S. S., Lunny, K., & Ray, L. A. (2013). The effects of drinking goal on treatment outcome for alcoholism. Journal of Consulting and Clinical Psychology, 81(1), 13–22. https://web-b-ebscohost-com.ezp.waldenulibrary.org/ehost/detail/detail?vid=1&sid=d5da4744-727c-4bb0-9311-aed619b06331%40sessionmgr102&bdata=JnNpdGU9ZWhvc3QtbGl2ZSZzY29wZT1zaXRl#AN=2012-32635-001&db=pdh Koerkel, J. (2006). Behavioral self-management with problem drinkers: One-year follow-up of a controlled drinking group treatment approach. Addiction Research & Theory, 14(1), 35–49. https://web-b-ebscohost-com.ezp.waldenulibrary.org/ehost/detail/detail?vid=1&sid=de1759b5-4029-4c27-9680-d7b4ad372218%40sessionmgr103&bdata=JnNpdGU9ZWhvc3QtbGl2ZSZzY29wZT1zaXRl#AN=20180118&db=a9h Consider your thoughts on two controversial issues introduced in the Learning Resources: (1) whether or not someone with a substance-related disorder can engage in controlled drug use, and (2) whether or not someone with a substance-related disorder has a disease. The Assignment (2–3 pages): Analyze these controversial issues, based on your own experiences as well as your review of this week’s required Learning Resources. In your Assignment, do the following: Present an argument for your stance with respect to the first controversial issue regarding substance-related disorders: Is it possible for individuals with substance-related disorders, such as those who abuse alcohol, to moderate their use instead of taking the abstinence approach to treatment? Support your argument with evidence from this week’s required Learning Resources. Present an argument for your stance with respect to the second controversial issue—namely, is a substance-related disorder a disease? Again, support your argument with evidence from this week’s required Learning Resources.