Young Man, Steven. We Analyze

¶ … young man, Steven. We analyze his behavior and habits and draw possible conclusions on what are the key factors that led him to suffer from depression as well as decision making problems. His peers are also evaluated in order to come up with a definitive conclusion on the actual issues that might be affecting his behavior. We present our findings by means of a thorough literature review of the possible causes of depression as well as indecisiveness. The paper then proceeds to present my personal thoughts of the causes of depression and indecisiveness in our contemporary society. The legal and ethical implication dilemmas of the case scenario are also considered. This case scenario also presents a case of a correlation between depression and substance abuse. The paper also includes what actions should be taken in order to treat, manage and avoid problems associated with depression, indecisiveness and self-cutting.

Introduction

Depression is one of the greatest problems affecting the youth of today. The problem is however compounded by other complementary problems such as indecisiveness as well as drug abuse. The contemporary society is marred with several issues and challenges that affect the youth of today. They have to battle with adolescence, peer pressure, poverty and drug abuse as well as abusive romantic relationships.

The case scenario presented is a clear example of a youth who is faced with a variety of challenges amidst being mildly mentally retarded. Steven is indeed a challenged individual who deserves a lot of help. The sad part is that he doesn't not seem to be aware of what dangers he is exposed to.

Steven's drug abuse case analysis.

Spooner (1999) studies the different types of drug induced mental disorder. He reviews are however important in the process of distinguishing between the aetiology of drug use as well as its aetiology.The causes of drug abuse are more social than anything else as pointed out by Spooner. The problematic use of drugs is however attributed to psychological causes as she stated. In this light we can attribute the causes of Steven's drug problem to both as a result of the multiple exhibits that are evident in his case.

According to Spooner, it is important to consider the type and level of parental modeling when evaluating a drug addict. This is because the addict could be engaging in drugs as a result of influence that exudes from the parent-child interaction/relationship as therefore lesser extent contribute to the addict's situation.

The fact that Steven engages in "cutting" so that he can feel free as a result of his relationship with his girlfriend is a clear sign of strong per pressure. This in a way suggests that since he is engaged in cutting with his peers then probably he started taking ecstasy as a result of peer influence. This is because it has been shown by various scholars that one's association with their peers is a major predictor of their behavior and habits. The influence is however noted to be complex. Spooner's interpretation that one's engagement in drugs is normally as a result of being rejected by their peers who in this case are considered prosocial. An interesting phenomenon that has continuously been studied is that the more one's peer influence escalates; the inverse becomes true for their family ties which undergoes a downward slump.

Mental disorder has never been used as a reliable indicator of drug abuse. This is also true for one's socio-economic status. It is important to ensure that a thorough evaluation is carried on Steven so as to come up with the exact variables that are causal factors to his state.It is therefore crucial to figure out the best method of ensuring that Steven provides the most accurate information regarding his feelings, his habits and also his environment. This is supported by the importance to carry out a detailed and complex analysis of the scenario as prescribed by Kaplan and Johnson (1992). The two scholars found out that the strongest predictors of increased drug use was due to the kind of social labeling that the addicts were exposed to. This means that individuals who always land in trouble as a result of taking drugs would increase their indulgence in the drugs instead of decreasing it. It is therefore important that as Steven undergoes his therapy, he should never be exposed to negative social sanctions. It is therefore important to advice Steven's family and friends to give him support as he recovers from his drug addiction. He should be motivated to conform rather than criticized for his acts. In order to avoid alienation he should be encouraged to attend the therapy sessions with his girlfriend so that they both receive help. This too would help them to cope with the real world and in the process socialize with even non-drug users.

Steven's scenario can also be viewed by means of Rhodes and Jason's (1988) social stress model which can prove instrumental in coming up with an intervention for his treatment. The model has a proposition that involves the calculation of a risk as well as the protective index.

The formula used is as follows:

Risk factors (stress+ drug normalization + drug experience) / Protective factors (attachments +skills + resources)

This formula seems appropriate in the coining of a solution for Steven's scenario since apparently all the constituent of the formula are present in his case scenario.

There is however some amount of criticism that has been generated about the use of intervention in the treatment of drug abuse cases. As pointed out by White and Pitts (1998) in their systematic review on the various effects of intervention on use of most illicit drugs. Their study actually shown that the effects of intervention were little and decreased with time. It is therefore to consider such factors while treating Steven.

There is also a general lack of evidence to support the effects of intervention measures. This is as a result of lack of evidence on effective outcome. Such evidence could include prevention, reduction in level of drug use and delay. This makes it really difficult know what best intervention works to be used on young and vulnerable victims such as Steven.

Another piece of literature to consider when treating Steven is the one by (Macleod et al., 2004). This involved a longitudinal study on general population which reported a strong association between the use of illicit drugs in young people and various forms of psychological harm. This is really important in evaluating if ecstasy is a strong player in Steven's mental retardation.

Analysis of Steven's self-cutting scenario

The issue of self cutting is one that many people engage in as a way of inflicting pain on their bodies . This issue has been widely studied and may include self-harm (Gratz & Roemer, 2008), self-injury (Giebenhain, Anderson, & Keller) and even self mutilation as mentioned by Favazza, (1998).

The act of self cutting has been widely linked to cases of suicide making. The act is also not socially acceptable and normally is not linked to mental retardation. It is however worth noting that research has generally indicated that between 55% and 85% of persons who self-injure will at attempt suicide at one time. This in other word means there are high chances that Steven might become suicidal at one point.(Dulit, Fryer, Leon, Brodsky, & Frances, 1994; Gardner, A.R., & Garnder,; Rosenthal, Rinzler, Walsh, & Klausner, 1972; Stanley, B., Winchel, Molcho, Simeon, & Stanley, M., 1992).This therefore calls for a more vigorous regimen for his treatment.

It is worth noting that there is currently no description whatsoever of self cutting as an independent psychological disorder. This is because it lacks a definition in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) (American Psychiatric Association [APA], 2000). There is however a mentioning of self-injury in a section of the DSM-IV-TR that is used as a diagnostic criteria for Borderline Personality Disorder (BPD). This occurs at the 5th criterion where it states; "(5) recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior." This lack of clear definition has lead to so much frustration among various psychiatric and medical professionals treating patients with the self-injury behavior (McAllister, et. al., 2002).

The act of self cutting by Steven should never be viewed as an isolated case since there are various mentions of self cutting among various categories of persons such as those with depressive and anxiety disorder (Oltmanns, & Turkheimer, 2003) and persons with substance abuse disorders (Matsumoto & Imamura, 2008).