Assignment: Decision Tree for Early-Onset Schizophrenia Essay

Assignment: Decision Tree for Early-Onset Schizophrenia Essay

Assignment Decision Tree for Early Onset Schizophrenia Essay

Schizophrenia is a mental disease where an individual makes abnormal interpretations of reality (Sekar et al., 2016). The disease causes symptoms like delusions, hallucinations and extremely disordered thinking and behavior which are disabling and impair the daily functioning of an individual. The disease can be traced in Carrie, a 13-year-old Hispanic female who is reported to talk to people who are not real. The parents report that she was irritable when young but it is worrying that she still has “imaginary friends” at her age. The parents were initially concerned by Carrie’s failure to meet development milestones. For instance, the teacher reported that she is isolative and her social skills were lacking. According to the mother, her transit from junior high school to high school worsened her issues since she is “more lost than ever” and her assignment lacks clarity. The mother reports her fear that Carrie could be schizophrenic since her grandfather suffered from the condition. The patient reports that she has no friends since she does not need to make any and states that her teacher is miserable because she does not understand how she thinks. The mental exam reveals a constricted affect with minimal eye contact. The patient endorses hearing and seeing strange things and admit that people on TV are just for her. She has no suicidal or homicidal ideation. The purpose of this paper is to make three decisions on the diagnosis and treatment of Carrie and indicate ethical considerations that might impact her treatment.

Decision Point One

Early Onset Schizophrenia

Carrie is suffering from early-onset schizophrenia. Schizophrenia is arrived at because according to DSM-5 criteria, the patient should present with symptoms like delusions, hallucinations, disorganized speech, catatonic behavior and diminished emotional expression (Bo & Haahr, 2016). The patient should exhibit two or more of these symptoms for at least one month. Additionally, patients should report impairment in major areas of functioning and some signs should persist for at least six months. Equally, the schizoaffective disorder should be ruled out and the disease should not be linked to any medical condition or substance use. The patient’s schizophrenic episode is an early onset one because it affects adolescents between 13-18 years, which is her age bracket. Additionally, she fulfills most of the DSM-5 criteria with delusion of references, hallucinations, and impaired functionality. Nevertheless, schizoaffective disorder is avoided because patients have to present with both schizophrenia symptoms and mood disorder symptoms (Bo & Haahr, 2016). Equally, schizotypal personality disorder is rejected because it begins in adulthood and present with an eccentric personality where one dresses strangely and takes paranoid thoughts seriously. Patients have odd speech as well as a range of emotions.

Decision Point Two

Refer for Psychological Testing

Psychological testing is selected because it will help in assessing the cognitive and emotional functioning of a patient and thus aid in diagnosis and guide treatment (Aquila & Citrome, 2015). The tests are recommended for children who are experiencing difficulty in school or are not able to make personal relationships to establish the presence of dementia, anger management issues or emotional

Assignment Decision Tree for Early-Onset Schizophrenia Essay
Assignment Decision Tree for Early-Onset Schizophrenia Essay

disorders. For Carrie, there is a need to establish whether her poor academic performance is caused by intellectual disability or it can be linked to poor premorbid intellectual functioning observed among schizophrenic patients. Research indicates that patients with schizophrenia have an intelligence that is below-average before any psychosis manifests (Aquila & Citrome, 2015). Although psychodynamic psychotherapies handle residual symptoms of schizophrenia, the approach is avoided because it is not a first-line treatment (Çıtak, 2016). Clozaril 100mg is also avoided because it is approved to manage treatment-resistant schizophrenia (de Oliveira et al., 2015). Carrie has never been on any medication and thus one cannot assume that her schizophrenia is treatment-resistant. The dosage is also too high since the starting dose for adults is 25mg and that of children is 12.5 depending on their body weight. The high dosage of Clozapine would cause serious adverse effects and the parents already object the use of medication since they feel they turn patients into zombies raising compliance concerns.Assignment Decision Tree for Early Onset Schizophrenia Essay

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The psychologist should administer various tests to the patient to assess the cognitive and personality functioning of the patient, establish the underlying intellectual disabilities and support the decision that the patient has early-onset schizophrenia (Aquila & Citrome, 2015). Among the tests expected are Minnesota Multiphasic Personality Inventory that assesses psychopathology and personality traits, Kaufman Adolescent and Adult Intelligence Test (KAIT) to measure both crystallized and fluid intelligence, Millon Adolescent Clinical Inventory (MACI) to address the unique situation, pressure and concerns that Carrie may be facing and come up with intervention to handle the identified issues and Whitaker Index of Schizophrenic Thinking (WIST) test. As expected, the psychologist provided the stated tests but he also used two more tests namely Wide Range Achievement Test – 4th Edition (WRAT-4) and Rorschach test. He also suspected that the patient has early-onset schizophrenia.

Decision Three

Begin Lurasidone 40 mg Daily

Lurasidone is selected because it is FDA approved and can be used by children. As an atypical antipsychotic, it has an affinity for dopamine and serotonin resulting in antidepressant and pro-cognitive effects useful in management of schizophrenia (Goldman et al., 2017). Additionally, lurasidone is linked to minimal effect on body weight and its impact on glucose, lipids or electrocardiography parameters is minimal. As outlined above, Clozapine is avoided because it is recommended for drug-resistant schizophrenia. Lastly, although family intervention would prevent relapse and admission to the hospital, the priority is to tackle the patient presenting problem and then provide the family intervention as a measure to avoid relapse.

Expected Results

The medication should decrease patient delusion and hallucination. She should report clear thoughts, less nervousness, and ease in handling daily activities (Goldman et al., 2017). The patient should also indicate better mood, appetite, sleep, and energy levels. As expected, the patient reported better symptoms. The imaginary friends had disappeared and she no longer felt like some TV programs were meant for her. Her academic performance improved since her current papers are coherent and well thought. She has also made friends and she seems happy about it.

Ethical Implications

Informed consent is a key issue when handling young patients. The therapist has to explain available treatment options and side effect profiles, treatment outcomes and illness prognosis (Bo & Haahr, 2016). The consent becomes valid when the patient understands the information offered and becomes part of the decision made. For instance the medication selected is Lurasidone, the parents should be taught about its pros and cons, therapeutic endpoint and goals of treatment. Secondly when offering antipsychotic medication, it is essential to establish fasting plasma glucose levels, take weight, assess BMI and evaluate fasting triglycerides and blood pressure. Antipsychotics impact these factors adversely and any medication selected should have minimal impact.

Assignment: Decision Tree for Early-Onset Schizophrenia Essay Conclusion

Schizophrenia is a disease that causes hallucinations, delusions and disordered behavior. In the case study, the patient symptoms coincide with early-onset schizophrenia which prompts the need to get psychological tests to determine the cause of her intellectual disabilities. The patient is then initiated on Lurasidone after getting consent from the parents.

 

Assignment 2: Practicum: Decision Tree

Childhood psychosis is extremely rare; however, children that present with psychosis must be carefully assessed and evaluated with appropriate interviewing of parent, child, and use of assessment tools.

For this Assignment, as you examine the client case study in this week’s Learning Resources, consider how you might assess and treat clients presenting with early onset schizophrenia.

Learning Objectives

Students will:

Evaluate clients for treatment of mental health disorders
Analyze decisions made throughout diagnosis and treatment of clients with mental health disorders
The Assignment:

Examine Case 3:

You will be asked to make three decisions concerning the diagnosis and treatment for this client. Be sure to consider co-morbid physical as well as mental factors that might impact the client’s diagnosis and treatment.

At each Decision Point, stop to complete the following:

Decision #1: Differential Diagnosis

Which Decision did you select?
Why did you select this Decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this Decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #1 and the results of the Decision. Why were they different?

Decision #2: Treatment Plan for Psychotherapy

Why did you select this Decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this Decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #2 and the results of the Decision. Why were they different?

Decision #3: Treatment Plan for Psychopharmacology

Why did you select this Decision? Support your response with evidence and references to the Learning Resources.
What were you hoping to achieve by making this Decision? Support your response with evidence and references to the Learning Resources.
Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?
Also include how ethical considerations might impact your treatment plan and communication with clients and their families.

Case #3

A young girl with strange behaviors
A young girl with strange behaviors

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Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes.

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Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for tips on improving your paper and SI score.

Late Policy

The university’s policy on late assignments is 10% penalty PER DAY LATE. This also applies to late DQ replies.

Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances.

If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect.

I do not accept assignments that are two or more weeks late unless we have worked out an extension.

As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.

Communication

Communication is so very important. There are multiple ways to communicate with me:

Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class.

Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.

Important information for writing discussion questions and participation

Welcome to class

Hello class and welcome to the class and I will be your instructor for this course. This is a -week course and requires a lot of time commitment, organization, and a high level of dedication. Please use the class syllabus to guide you through all the assignments required for the course. I have also attached the classroom policies to this announcement to know your expectations for this course. Please review this document carefully and ask me any questions if you do. You could email me at any time or send me a message via the “message” icon in halo if you need to contact me. I check my email regularly, so you should get a response within 24 hours. If you have not heard from me within 24 hours and need to contact me urgently, please send a follow up text to

I strongly encourage that you do not wait until the very last minute to complete your assignments. Your assignments in weeks 4 and 5 require early planning as you would need to present a teaching plan and interview a community health provider. I advise you look at the requirements for these assignments at the beginning of the course and plan accordingly. I have posted the YouTube link that explains all the class assignments in detail. It is required that you watch this 32-minute video as the assignments from week 3 through 5 require that you follow the instructions to the letter to succeed. Failure to complete these assignments according to instructions might lead to a zero. After watching the video, please schedule a one-on-one with me to discuss your topic for your project by the second week of class. Use this link to schedule a 15-minute session. Please, call me at the time of your appointment on my number. Please note that I will NOT call you.

Please, be advised I do NOT accept any assignments by email. If you are having technical issues with uploading an assignment, contact the technical department and inform me of the issue. If you have any issues that would prevent you from getting your assignments to me by the deadline, please inform me to request a possible extension. Note that working fulltime or overtime is no excuse for late assignments. There is a 5%-point deduction for every day your assignment is late. This only applies to approved extensions. Late assignments will not be accepted.

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Plagiarism is highly prohibited. Please ensure you are citing your sources correctly using APA 7th edition. All assignments including discussion posts should be formatted in APA with the appropriate spacing, font, margin, and indents. Any papers not well formatted would be returned back to you, hence, I advise you review APA formatting style. I have attached a sample paper in APA format and will also post sample discussion responses in subsequent announcements.

Your initial discussion post should be a minimum of 200 words and response posts should be a minimum of 150 words. Be advised that I grade based on quality and not necessarily the number of words you post. A minimum of TWO references should be used for your initial post. For your response post, you do not need references as personal experiences would count as response posts. If you however cite anything from the literature for your response post, it is required that you cite your reference. You should include a minimum of THREE references for papers in this course. Please note that references should be no more than 5 years old except recommended as a resource for the class. Furthermore, for each discussion board question, you need ONE initial substantive response and TWO substantive responses to either your classmates or your instructor for a total of THREE responses. There are TWO discussion questions each week, hence, you need a total minimum of SIX discussion posts for each week. I usually post a discussion question each week. You could also respond to these as it would count towards your required SIX discussion posts for the week.

I understand this is a lot of information to cover in 5 weeks, however, the Bible says in Philippians 4:13 that we can do all things through Christ that strengthens us. Even in times like this, we are encouraged by God’s word that we have that ability in us to succeed with His strength. I pray that each and every one of you receives strength for this course and life generally as we navigate through this pandemic that is shaking our world today. Relax and enjoy the course!

Hi Class,

Please read through the following information on writing a Discussion question response and participation posts.

Contact me if you have any questions.

Important information on Writing a Discussion Question

  • Your response needs to be a minimum of 150 words (not including your list of references)
  • There needs to be at least TWO references with ONE being a peer reviewed professional journal article.
  • Include in-text citations in your response
  • Do not include quotes—instead summarize and paraphrase the information
  • Follow APA-7th edition
  • Points will be deducted if the above is not followed

Participation –replies to your classmates or instructor

  • A minimum of 6 responses per week, on at least 3 days of the week.
  • Each response needs at least ONE reference with citations—best if it is a peer reviewed journal article
  • Each response needs to be at least 75 words in length (does not include your list of references)
  • Responses need to be substantive by bringing information to the discussion or further enhance the discussion. Responses of “I agree” or “great post” does not count for the word count.
  • Follow APA 7th edition
  • Points will be deducted if the above is not followed
  • Remember to use and follow APA-7th edition for all weekly assignments, discussion questions, and participation points.
  • Here are some helpful links
  • Student paper example
  • Citing Sources
  • The Writing Center is a great resource