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S. While these behaviors may be viewed by some as pointless self-mutilation, they have a long and multi-varied history in this and many other cultures. The focus of this article is on generally-accepted mutilation, which causes harm to the body and does not meet cultural norms. In its worst form, self-mutilation can include cutting off a limb or self-castration; it is thus a serious problem with a subset of those in the SIB cohort. As with many forms of OCD, self-mutilation generally begins in late childhood and the early teen years.
The authors argue that moderate- to severe SIB requires a combination of therapies. Since much of the etiology is based in family problems with children and young teens, it is necessary to, when possible, initiate family therapy in order to discover the problems which may have led to SIB. The authors recommend combining this with individual therapy, as the child may have specific self-reinforcing behaviors which need to be adapted. It would have been helpful if the authors had indicated what forms of individual therapy were employed in their practice and in the literature. There was also no mention of the use of drugs as an adjunct to treatment, either by the authors themselves or in their study of the relevant literature.
In family therapy, the theme of repression and poor communication seems to be common. According to the authors, families must express their feelings, including "scare, angry, manipulated, useless, nervous, irritated...," as lack of such expression may lead to SIB behaviors. It would have been helpful if the authors had indicated how boys react in such families; one is left to surmise that they are more likely to act out aggressively to the outside world, rather than take action against their bodies.
Measurement of Nonclinical Personality Characteristics of Women with Anorexia Nervosa or Bulimia Nervosa (Pryor, 1996)
The authors analyze a significant population of women with anorexia nervosa (n=35) and bulimia nervosa (n=45), looking for personality traits which may be inherited. As two of the...
The authors administered the MPQ (Multidimensional Personality Questionnaire) to the subjects, and found very low scores on well-being, social closeness and positive affectivity.
As one might expect, these same teens had high scores on stress reaction, alienation and negative affectivity. The authors posit that these 'non-clinical' observations may be helpful in treating these patients.
Conclusion
OCD encompasses a broad number of disorders which first appear in children and early teens. The advent of SSRI's has assisted the profession in dealing with acute symptoms, but talk therapy of various forms is needed in order to bring an understanding of the fundamental causes of the OCD, and to assist the patients in ameliorating the diseases over a longer period of time.
Bibliography
Franklin, M.F. (2003). The Pediatric Obsessive-Compulsive Disorder Treatment Study: Rationale, Design, and Methods. Journal of Child and Adolescent Pharmacology, 39-51.
Geller, D.B. (2003). Which SSRI? A Meta-Analysis of Pharmacotherapy Trials in Pediatric Obsessive-Compulsive Disorder. Am J. Psychiatry, n.p.
March, J. (2004). Cognitive-Behavior Therapy, Sertraline, and Their Combination for Children and Adolescents With Obsessive-Compulsive Disorder. JAMA, n.p.
Nelson, T.R. (2007). A Narrative Approach to Body Dysmorphic Disorder. Journal of Mental Health Counseling, 67-80.
Pryor, T. a. (1996). Measurement of Nonclinical Personality Characteristics of Women with Anorexia Nervosa or Bulimia Nervosa. Journal of Personality Assessment, 414-422.
Stone, J. a. (2003). Self-Injurious Behavior: A Bi-Modal Treatment Approach to Working with Adolescent Females. Journal of Mental Health Counseling, 112-130.
Wonderlich, S.B. (1997). Relationship of Childhood Sexual Abuse and Eating Disorders. Child & Adolescent Psychiatry, n.p.
Nursing: OCD
Bibliography
Franklin, M.F. (2003). The Pediatric Obsessive-Compulsive Disorder Treatment Study: Rationale, Design, and Methods. Journal of Child and Adolescent Pharmacology, 39-51.
Geller, D.B. (2003). Which SSRI? A Meta-Analysis of Pharmacotherapy Trials in Pediatric Obsessive-Compulsive Disorder. Am J. Psychiatry, n.p.
March, J. (2004). Cognitive-Behavior Therapy, Sertraline, and Their Combination for Children and Adolescents With Obsessive-Compulsive Disorder. JAMA, n.p.
Nelson, T.R. (2007). A Narrative Approach to Body Dysmorphic Disorder. Journal of Mental Health Counseling, 67-80.
Charity, selflessness, altruism and entrepreneurship are, therefore, not contradictory. It is well-known that the well-paid traditional nurse is likely to be a better worker better able to devote more attention to her patient (Hardin & . Kaplow, 2001). Deductively, therefore, the independent nurse who is motivated to work well in order to be successfully self-employed would likely (although not necessarily) be a better nurse in terms of the intrinsic
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