NRNP 6635 NRNP – 6635 Psychopathology and Diagnostic Reasoning TASKS DESTINY
NRNP 6635 NRNP – 6635 Psychopathology and Diagnostic Reasoning TASKS DESTINY
Week 1: History and Theories of Psychopathology
The history of the diagnosis of mental disorders is fraught with examples of how cultural norms and prejudices interfere with and warp a diagnosis. The result is that normal behavior and orientations have been pathologized as an illness or disease. An example of this would be the story of Alan Turing, the famous British computer scientist of the 20th century, who was instrumental in inventing modern computers and deciphering German code in World War II. He was convicted in 1952 in England of gross indecency for being gay. Turing was forced by the courts to undergo 12 months of hormone therapy and could no longer work for the British government. At the time, homosexuality was pathologized as a mental disorder in the Diagnostic and Statistical Manual of Mental Disorders and was criminalized in most Western countries. It was not until 1973 that the American Psychiatric Association (APA) finally removed homosexuality from the DSM.
Historically, the process of rendering a diagnosis has been used to pathologize those who fell outside what was considered the cultural norm of human behavior. This process often marginalized diagnosed populations and prevented individuals from receiving appropriate care. It is of utmost importance to consider cultural issues that influence how you as a clinician interpret a client’s behavior and how cultural issues influence how a client may express behavior. This week, you explore the history of psychopathology and the evolution of theoretical perspectives in the field.
Learning Objective
Students will:
- Analyze historical and currently recognized biological, psychological, and sociocultural factors that inform the expression, course, and prevalence of psychopathology
Learning Resources
Required Readings (click to expand/reduce)
Sadock, B. J., Sadock, V. A., & Ruiz, P. (2015). Kaplan & Sadock’s synopsis of psychiatry (11th ed.). Wolters Kluwer.
- Chapter 1, Neural Sciences
- Chapter 2, Contributions of the Psychosocial Sciences
- Chapter 3, Contributions of the Sociocultural Sciences
- Chapter 4, Theories of Personality and Psychopathology
- Chapter 31.17c, Child Psychiatry: Other Conditions: Identity Problem
Document: NRNP 6635 Mid-term Study Guide
Assignment
Practicum Manual Acknowledgment
The Practicum Manual describes the structure and timing of the classroom-based and practicum experiences and the policies students must follow to be successful in the nurse practitioner (NP) specialties.
Click here and follow the instructions to confirm you have downloaded and read the entire MSN Nurse Practitioner Practicum Manual and will abide by the requirements described in order to successfully complete this program.
Optional Discussion Forum: PMHNP Study Support Lounge
The PMHNP Study Support Lounge is offered throughout the course as a place of academic refuge, where you can ask questions, offer insights, and interact with your peers. Your Instructor may also weigh in to provide global feedback to the group based on trends, common problems, and common strengths in student posts.
As a peer, you are encouraged to provide constructive, helpful feedback to your peers. Advanced practice nurses always benefit from the feedback of others. Your Study Support Lounge posts may be procedural (“How do I attach a Kaltura video to a Discussion post?”), conceptual (“How does this relate to the other therapy approaches we have studied?”), or analytical (“What do these diagnostic results actually mean in the context of this specific patient case?”). Although not mandatory, this is an opportunity to interact and study together as you navigate the assignments, so you are highly encouraged to take part in this activity. Full participation in activities like these is a statistically significant predictor of success.
To Participate in this Optional Discussion:
PMHNP Study Support Lounge
Discussion: Factors That Influence the Development of Psychopathology
Photo Credit: Getty Images/Blend Images
In many realms of medicine, objective diagnoses can be made: A clavicula is broken. An infection is present. TSH levels meet the diagnostic criteria for hypothyroidism. Psychiatry, on the other hand, deals with psychological phenomena and behaviors. Can these, too, be “defined objectively and by scientific criteria (Gergen, 1985), or are they social constructions?” (Sadock et al., 2015).
Thanks to myriad advances during recent decades, we know that psychopathology is caused by many interacting factors. Theoretical and clinical contributions to the field have come from the neural sciences, genetics, psychology, and social-cultural sciences. How do these factors impact the expression, classification, diagnosis, and prevalence of psychopathology, and why might it be important for a nurse practitioner to take a multidimensional, integrative approach?
To Prepare:
- Review this week’s Learning Resources, considering the many interacting factors that contribute to the development of psychopathology.
- Consider how theoretical perspective on psychopathology impacts the work of the PMHNP.
By Day 3 of Week 1
Explain the biological (genetic and neuroscientific); psychological (behavioral and cognitive processes, emotional, developmental); and social, cultural, and interpersonal factors that influence the development of psychopathology.
Read a selection of your colleagues’ responses
By Day 6 of Week 1
Respond to at least two of your colleagues on 2 different days by explaining the implications of why, as an advanced practice nurse, it is important to adopt a multidimensional, integrative model of psychopathology.
Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link, and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit!
Submission and Grading Information
Grading Criteria
To access your rubric:
Week 1 Discussion Rubric
Post by Day 3 of Week 1 and Respond by Day 6 of Week 1
To Participate in this Discussion:
Week 1 Discussion
What’s Coming Up in Week 2?
In Week 2, you will be introduced to assessment and diagnosis of the psychiatric patient. You will explore elements of the psychiatric interview, history, and examination as well as psychiatric rating scales. You also will review the classification system of psychiatric disorders in the DSM-5 and the role the DSM-5 plays in diagnosis.
Photo Credit: [BrianAJackson]/[iStock / Getty Images Plus]/Getty Images
Practicum – Upcoming Deadline
In the Nurse Practitioner programs of study (FNP, AGACNP, AGPCNP, and PMHNP) you are required to take several practicum courses. If you plan on taking a practicum course within the next two terms, you will need to submit your application via Meditrek .
For information on the practicum application process and deadlines, please visit the Field Experience: College of Nursing: Application Process – Graduate web page.
Please take the time to review the Appropriate Preceptors and Field Sites for your courses.
Please take the time to review the practicum manuals, FAQs, Webinars and any required forms on the Field Experience: College of Nursing: Student Resources and Manuals web page.
- Field Experience: College of Nursing Quick Answers
- Field Experience: MSN Nurse Practitioner Practicum Manual
- Student Practicum Resources: NP Student Orientation
Next Week
Week 2: Assessment and Diagnosis of the Psychiatric Patient
A sensitively crafted intake assessment can be a powerful therapeutic tool. It can establish rapport between patient and therapist, further the therapeutic alliance, alleviate anxiety, provide reassurance, and facilitate the flow of information necessary for an accurate diagnosis and appropriate treatment plan.
—Pamela Bjorklund, clinical psychologist
Whether you are treating patients for physical ailments or clients for mental health issues, the assessment process is an inextricable part of health care. To properly diagnose clients and develop treatment plans, you must have a strong foundation in assessment. This includes a working knowledge of assessments that are available to aid in diagnosis, how to use these assessments, and how to select the most appropriate assessment based on a client’s presentation.
This week, as you explore assessment and diagnosis of patients in mental health settings, you examine assessment tools, including their psychometric properties and appropriate uses. You also familiarize yourself with the DSM-5 classification system.
Reference: Bjorklund, P. (2013). Assessment and diagnosis. In K. Wheeler (Ed.), Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice (2nd ed.) (pp. 95–168). Springer Publishing Company.
Learning Objectives
Students will:
- Evaluate elements of the psychiatric interview, history, and examination
- Analyze psychometric properties of psychiatric rating scales
- Justify appropriate use of psychiatric rating scales in advanced practice nursing
Learning Resources
Required Readings (click to expand/reduce)
Carlat, D. J. (2017). The psychiatric interview (4th ed.). Wolters Kluwer.
- Chapter 34, Writing Up the Results of the Interview
Sadock, B. J., Sadock, V. A., & Ruiz, P. (2015). Kaplan & Sadock’s synopsis of psychiatry (11th ed.). Wolters Kluwer.
- Chapter 5, Examination and Diagnosis of the Psychiatric Patient
- Chapter 6, Classification in Psychiatry
- Chapter 31, Child Psychiatry (Sections 31.1 and 31.2 only)
Required Media (click to expand/reduce)
Classroom Productions. (Producer). (2015). Diagnostic criteria [Video]. Walden University.
Getting Started With the DSM-5
If you were to give a box of 100 different photographs to 10 people and ask them to sort them into groups, it is very unlikely that all 10 people would sort them into the exact same groups. However, if you were to give them a series of questions or a classification system to use, the chances that all 10 people sort them exactly the same increases depending on the specificity of the system and the knowledge of those sorting the photographs.
Photo Credit: [Peter Polak]/[iStock / Getty Images Plus]/Getty Images
This is not unlike what has occurred in the process of classifying mental disorders. A system that provides enough specificity to appropriately classify a large variety of mental disorders while also attempting to include all of the possible symptoms, many of which can change over time, is a daunting task when used by a variety of specialists, doctors, and other professionals with varied experience, cultures, expertise, and beliefs. The DSM has undergone many transformations since it was first published in 1952. Many of these changes occurred because the uses for the DSM changed. However, the greatest changes began with the use of extensive empirical research to guide the creation of the classification system and its continued revisions.
In order to assess and diagnose patients, you must learn to use the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, usually abbreviated as the DSM-5, to render a diagnosis. In this second week of the course, you will examine how DSM-5 is organized and how clinicians use it to render diagnoses.
Review the Learning Resources this week, with special emphasis on viewing the Diagnostic Criteria video. This video explains the purpose and organization of the DSM-5 classification system, the purpose of the ICD-10 coding system, their relationship to one another, and the importance to the PMHNP role.
Discussion: The Psychiatric Evaluation and Evidence-Based Rating Scales
Assessment tools have two primary purposes: 1) to measure illness and diagnose clients, and 2) to measure a client’s response to treatment. Often, you will find that multiple assessment tools are designed to measure the same condition or response. Not all tools, however, are appropriate for use in all clinical situations. You must consider the strengths and weaknesses of each tool to select the appropriate assessment tool for your client. For this Discussion, as you examine the assessment tool assigned to you by the Course Instructor, consider its use in psychotherapy.
Photo Credit: [shironosov]/[iStock / Getty Images Plus]/Getty Images
To Prepare:
- Review this week’s Learning Resources and reflect on the insights they provide regarding psychiatric assessment and diagnosis.
- Consider the elements of the psychiatric interview, history, and examination.
- Consider the assessment tool assigned to you by the Course Instructor.
By Day 3 of Week 2
Post a brief explanation of three important components of the psychiatric interview and why you consider these elements important. Explain the psychometric properties of the rating scale you were assigned. Explain when it is appropriate to use this rating scale with clients during the psychiatric interview and how the scale is helpful to a nurse practitioner’s psychiatric assessment. Support your approach with evidence-based literature.
Read a selection of your colleagues’ responses.
By Day 6 of Week 2
Respond to at least two of your colleagues on 2 different days by comparing your assessment tool to theirs.
Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link, and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit!
Submission and Grading Information
Grading Criteria
To access your rubric:
Week 2 Discussion Rubric
Post by Day 3 of Week 2 and Respond by Day 6 of Week 2
To Participate in this Discussion:
Week 2 Discussion
What’s Coming Up in Module 2?
Photo Credit: [BrianAJackson]/[iStock / Getty Images Plus]/Getty Images
In Module 2, you will begin a systematic review of mental health disorders. You will apply concepts, theories, and principles related to patient interviewing, diagnostic reasoning, and recording patient information. You will also formulate differential diagnoses for patients across the lifespan using DSM-5 criteria.
Next Module
Week 3: Mood Disorders
While most people experience the sadness or grief at some point in their lives, it is typically of short duration and may occur in response to some type of loss. Clinically significant depression, on the other hand, is more disruptive and serious. It lasts longer and has more symptoms that interfere with daily functioning.
This week, you will explore the differences among mood disorders such as depressive, bipolar, and related disorders, and you will examine challenges in properly differentiating among them for the purpose of accurately rendering a diagnosis. You also will look at steps that can be taken to increase the likelihood that patients who are diagnosed with these disorders benefit from treatment and refrain from physically harming themselves or others.
Learning Objectives
Students will:
- Apply concepts, theories, and principles related to patient interviewing, diagnostic reasoning, and recording patient information
- Formulate differential diagnoses using DSM-5 criteria for patients with mood disorders across the lifespan
Learning Resources
Required Readings (click to expand/reduce)
Sadock, B. J., Sadock, V. A., & Ruiz, P. (2015). Kaplan & Sadock’s synopsis of psychiatry (11th ed.). Wolters Kluwer.
NRNP 6635 NRNP – 6635 Psychopathology and Diagnostic Reasoning TASKS DESTINY Grading Rubric
| Performance Category | 100% or highest level of performance
100% 16 points |
Very good or high level of performance
88% 14 points |
Acceptable level of performance
81% 13 points |
Inadequate demonstration of expectations
68% 11 points |
Deficient level of performance
56% 9 points
|
Failing level
of performance 55% or less 0 points |
| Total Points Possible= 50 | 16 Points | 14 Points | 13 Points | 11 Points | 9 Points | 0 Points |
| Scholarliness
Demonstrates achievement of scholarly inquiry for professional and academic topics. |
Presentation of information was exceptional and included all of the following elements:
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Presentation of information was good, but was superficial in places and included all of the following elements:
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Presentation of information was minimally demonstrated in all of the following elements:
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Presentation of information is unsatisfactory in one of the following elements:
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Presentation of information is unsatisfactory in two of the following elements:
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Presentation of information is unsatisfactory in three or more of the following elements
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| 16 Points | 14 Points | 13 Points | 11 Points | 9 Points | 0 Points | |
| Application of Course Knowledge
Demonstrate the ability to analyze and apply principles, knowledge and information learned in the outside readings and relate them to real-life professional situations |
Presentation of information was exceptional and included all of the following elements:
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Presentation of information was good, but was superficial in places and included all of the following elements:
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Presentation of information was minimally demonstrated in the all of the following elements:
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Presentation of information is unsatisfactory in one of the following elements:
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Presentation of information is unsatisfactory in two of the following elements:
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Presentation of information is unsatisfactory in three of the following elements
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| 10 Points | 9 Points | 6 Points | 0 Points | |||
| Interactive Dialogue
Initial post should be a minimum of 300 words (references do not count toward word count) The peer and instructor responses must be a minimum of 150 words each (references do not count toward word count) Responses are substantive and relate to the topic. |
Demonstrated all of the following:
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Demonstrated 3 of the following:
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Demonstrated 2 of the following:
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Demonstrated 1 or less of the following:
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| 8 Points | 7 Points | 6 Points | 5 Points | 4 Points | 0 Points | |
| Grammar, Syntax, APA
Points deducted for improper grammar, syntax and APA style of writing. The source of information is the APA Manual 6th Edition Error is defined to be a unique APA error. Same type of error is only counted as one error. |
The following was present:
AND
AND
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The following was present:
AND/OR
AND/OR
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The following was present:
AND/OR
AND/OR
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The following was present:
AND/OR
AND/OR
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The following was present:
AND/OR
AND/OR
AND/OR
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The following was present:
AND/OR
AND/OR
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| 0 Points Deducted | 5 Points Lost | |||||
| Participation
Requirements |
Demonstrated the following:
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Failed to demonstrate the following:
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| 0 Points Lost | 5 Points Lost | |||||
| Due Date Requirements | Demonstrated all of the following:
A minimum of one peer and one instructor responses are to be posted within the course no later than Sunday, 11:59 pm MT. |
Demonstrates one or less of the following.
A minimum of one peer and one instructor responses are to be posted within the course no later than Sunday, 11:59 pm MT. |
As we begin this session, I would like to take this opportunity to clarify my expectations for this course:
Please note that GCU Online weeks run from Thursday (Day 1) through Wednesday (Day 7).
Course Room Etiquette:
- It is my expectation that all learners will respect the thoughts and ideas presented in the discussions.
- All postings should be presented in a respectful, professional manner. Remember – different points of view add richness and depth to the course!
Office Hours:
- My office hours vary so feel free to shoot me an email at [email protected] or my office phone is 602.639.6517 and I will get back to you within one business day or as soon as possible.
- Phone appointments can be scheduled as well. Send me an email and the best time to call you, along with your phone number to make an appointment.
- I welcome all inquiries and questions as we spend this term together. My preference is that everyone utilizes the Questions to Instructor forum. In the event your question is of a personal nature, please feel free to post in the Individual Questions for Instructor forumI will respond to all posts or emails within 24 or sooner.
Late Policy and Grading Policy
Discussion questions:
- I do not mark off for late DQ’s.
- I would rather you take the time to read the materials and respond to the DQ’s in a scholarly way, demonstrating your understanding of the materials.
- I will not accept any DQ submissions after day 7, 11:59 PM (AZ Time) of the week.
- Individual written assignments – due by 11:59 PM AZ Time Zone on the due dates indicated for each class deliverable.
Assignments:
- Assignments turned in after their specified due dates are subject to a late penalty of -10%, each day late, of the available credit. Please refer to the student academic handbook and GCU policy.
- Any activity or assignment submitted after the due date will be subject to GCU’s late policy
- Extenuating circumstances may justify exceptions, which are at my sole discretion. If an extenuating circumstance should arise, please contact me privately as soon as possible.
- No assignments can be accepted for grading after midnight on the final day of class.
- All assignments will be graded in accordance with the Assignment Grading Rubrics
Participation
- Participation in each week’s Discussion Board forum accounts for a large percentage of your final grade in this course.
- Please review the Course Syllabus for a comprehensive overview of course deliverables and the value associated with each.
- It is my expectation that each of you will substantially contribute to the course discussion forums and respond to the posts of at least three other learners.
- A substantive post should be at least 200 words. Responses such as “great posts” or “I agree” do notmeet the active engagement expectation.
- Please feel free to draw on personal examples as you develop your responses to the Discussion Questions but you do need to demonstrate your understanding of the materials.
- I do expect outside sources as well as class materials to formulate your post.
- APA format is not necessary for DQ responses, but I do expect a proper citation for references.
- Please use peer-related journals found through the GCU library and/or class materials to formulate your answers. Do not try to “Google” DQ’s as I am looking for class materials and examples from the weekly materials.
- I will not accept responses that are from Wikipedia, Business com, or other popular business websites. You will not receive credit for generic web searches – this does not demonstrate graduate-level research.
- Stay away from the use of personal pronouns when writing.As a graduate student, you are expected to write based on research and gathering of facts. Demonstrating your understanding of the materials is what you will be graded on. You will be marked down for lack of evidence to support your ideas.
Plagiarism
- Plagiarism is the act of claiming credit for another’s work, accomplishments, or ideas without appropriate acknowledgment of the source of the information by including in-text citations and references.
- This course requires the utilization of APA format for all course deliverables as noted in the course syllabus.
- Whether this happens deliberately or inadvertently, whenever plagiarism has occurred, you have committed a Code of Conduct violation.
- Please review your LopesWrite report prior to final submission.
- Every act of plagiarism, no matter the severity, must be reported to the GCU administration (this includes your DQ’s, posts to your peers, and your papers).
Plagiarism includes:
- Representing the ideas, expressions, or materials of another without due credit.
- Paraphrasing or condensing ideas from another person’s work without proper citation and referencing.
- Failing to document direct quotations without proper citation and referencing.
- Depending upon the amount, severity, and frequency of the plagiarism that is committed, students may receive in-class penalties that range from coaching (for a minor omission), -20% grade penalties for resubmission, or zero credit for a specific assignment. University-level penalties may also occur, including suspension or even expulsion from the University.
- If you are at all uncertain about what constitutes plagiarism, you should review the resources available in the Student Success Center. Also, please review the University’s policies about plagiarism which are covered in more detail in the GCU Catalog and the Student Handbook.
- We will be utilizing the GCU APA Style Guide 7th edition located in the Student Success Center > The Writing Center for all course deliverables.
LopesWrite
- All course assignments must be uploaded to the specific Module Assignment Drop Box, and also submitted to LopesWrite every week.
- Please ensure that your assignment is uploaded to both locations under the Assignments DropBox. Detailed instructions for using LopesWrite are located in the Student Success Center.
Assignment Submissions
- Please note that Microsoft Office is the software requirement at GCU.
- I can open Word files or any file that is saved with a .rtf (Rich Text Format) extension. I am unable to open .wps files.
- If you are using a “.wps” word processor, please save your files using the .rtf extension that is available from the drop-down box before uploading your files to the Assignment Drop Box.
Grade of Incomplete
- The final grade of Incomplete is granted at the discretion of the instructor; however, students must meet certain specific criteria before this grade accommodation is even possible to consider.
- The grade of Incomplete is reserved for times when students experience a serious extenuating circumstance or a crisis during the last week of class which prevents the completion of course requirements before the close of the grading period. Students also must pass the course at the time the request is made.
- Please contact me personally if you are having difficulties in meeting course requirements or class deadlines during our time together. In addition, if you are experiencing personal challenges or difficulties, it is best to contact the Academic Counselor so that you can discuss the options that might be available to you, as well as each option’s academic and financial repercussions.
Grade Disputes
- If you have any questions about a grade you have earned on an individual assignment or activity, please get in touch with mepersonally for further clarification.
- While I have made every attempt to grade you fairly, on occasion a misunderstanding may occur, so please allow me the opportunity to learn your perspective if you believe this has occurred. Together, we should be able to resolve grading issues on individual assignments.
- However, after we have discussed individual assignments’ point scores, if you still believe that the final grade you have earned at the end of the course is not commensurate with the quality of work you produced for this class, there is a formal Grade Grievance procedurewhich is outlined in the GCU Catalog and Student Handbook.