Developing a Systematic Psychosocial Stressor assessment Process utilizing the 7-Dimensional Psycho-social Stressor catalogue (7D-Psi)
Can stress alone cause us to construct corporeal and mental disorders?
What Is Pre Occupational Therapy
Diathesis-Stress Model
Researchers have proposed that many disorders are believed to construct when some kind of stressor affects a man who already has a vulnerability or diathesis for that disorder (Ingram & Luxton, 2005; Meehl, 1962; Monroe & Simons, 1991). The diathesis or vulnerabilty which could be a genetic predisposition or adverse childhood touch is not commonly sufficient to cause the disorder itself, but it is a contributory factor. For example, a child who experiences the death of a parent would be at a higher risk to construct depression as an adult. In this case the vulnerability itself was a childhood stressor.
So then experiencing psycho-social stressors may not be a sufficient cause to construct disorders, but the two added together - genetic predisposition and/ or adverse childhood touch plus (+) current stressors are sufficient causes for the amelioration of diseases, disorders, and abnormal behavior in general. Since vulnerabilities and stressors may exist on a continuum, for example fluctuating from one (1) low to ten (10) high, individuals that have high levels of vulnerabilities may only need low levels of current stressors in their life to construct disorders. Likewise, individuals with high levels of psycho-social stressors may only need low levels of diatheses (adverse childhood experiences and/ or genetic predispositions) for confident disorders to develop.
This narrative will introduce the 7 size Intervention - a unique stress-management assessment process. It will discuss the utilization of the following three instruments - to systematically document and support a client with visualizing their childhood vulnerabilities, current life stressors, and current confident activities that they are participating in to decrease stress, build resiliency, and improve their uncut wellness to hopefully motivate them to construct and monitor a health and wellness plan for their lives:
1. Adverse Childhood Experiences (Ace) Questionnaire
2. 7 Dimensional - Psycho-social Stressor catalogue (7D-Psi)
3. 7 Dimensional - Therapeutic operation peruse (7D-Tas)
What is the Ace Study?
The Adverse Childhood Experiences (Ace) Study is one of the largest investigations ever conducted on the links between childhood maltreatment and later-life health and well-being. As a collaboration between the Centers for Disease operate and stoppage and Kaiser Permanente's health assessment Clinic in San Diego, health Maintenance organization (Hmo) members undergoing a uncut corporeal exam in case,granted detailed data about their childhood touch of abuse, neglect, and family dysfunction. Over 17,000 members chose to participate. To date, over 50 scientific articles have been published and over 100 discussion and workshop presentations have been made.
The Ace Study findings recommend that these experiences are major risk factors for the leading causes of illness and death as well as poor ability of life in the United States. Advance in preventing and recovering from the nation's worst health and social problems is likely to benefit from the comprehension that many of these problems arise as a consequence of adverse childhood experiences.
What's an Ace score? Growing up experiencing any of the following conditions in the household prior to age 18 identifies your Ace score (1 point for each one):
Recurrent corporeal abuse
Recurrent emotional abuse
Contact sexual abuse
An alcohol and/or drug abuser in the household
An incarcerated household member
Someone who is chronically depressed, mentally ill, institutionalized, or suicidal
Mother is treated violently
One or no parents
Emotional neglect
Physical neglect
The Ace score can be used to quantify your childhood adverse experiences and vulnerabilities, and the score can be documented on the "Wheel of Life," to visualize a client's stress tolerance zone.
What is the point of the Ace study?
Because adverse childhood experiences (Aces) are very common, and Aces are strong predictors of health risks and disease from adolescence to adulthood - the compound of these findings makes Aces one of the leading, if not the leading determinant of the health and social well-being of our nation.
Identifying Psych-social Stressors
"The Dsm-Iv-Tr informs us that Axis Iv is for reporting psychosocial and environmental problems that may sway the diagnosis, treatment, and prognosis of mental disorders delineated on Axes I and Ii. A psychosocial or environmental problem may be a negative life event, an environmental strangeness or deficiency, a familial or other interpersonal stress, an inadequacy of social maintain or personal resources, or other problem associated to the context in which a person's difficulties have developed. When a private has many psychosocial or environmental problems, the clinician may note as many as are judged to be relevant," (Dsm-Iv-Tr, p. 31).
Unfortunately, clinicians rarely show the way a multi-dimensionally uncut systematic investigation of their client's psychosocial stressors to document those stressors that may be primary to the prognosis and rehabilitation planning process. The 7D - Psi was industrialized specifically for this purpose.
7 Dimensional - Psycho-social Stressor catalogue (7D-Psi)
The 7 - Dimensional Psychosocial catalogue (7d-Psi) is an productive and productive 170-item psychosocial stressors tool that facilitates the uncut and systematic assessment of an individual's stressful life experiences. The purpose of identifying as complete a list as possible, of an individual's psychosocial stressors, is so that a rehabilitation plan can be industrialized that will address the most leading of those factors. This method enhances the use of resources. It also can support with and improve the Dsm-Iv-Tr, Axis Iv (Psychosocial Stressor) diagnosis. The 7D-Psi targets the adult population, but it can be modified to be used with adolescents. The 170 items can surely be assessed within 15 minutes. It is surely scored, and the results can be fast integrated into a 7 - Dimensional Wheel of Life to be viewed by the client as a motivational enhancement. In increasing to the 7 D - Psi's effectiveness in targeting the most leading psycho-social stressors needing attention, it has the potential to identify differential primary diagnoses for additional evaluation. The 7 D - Psi's brevity, ease of management and scoring make it highly useful for research applications. Based on independent interviews by a mental health professional, this catalogue administered by primary care practitioners' demonstrated good accuracy (sensitivity and specificity) for identifying psycho-social stressors primary to prognosis and rehabilitation planing. rehabilitation outcome studies are presently in process (Slobodzien, 2005).
Protective Factors
Protective factors in childhood or influences that may modify a child's reaction or response to a stressor must also be determined in the equation. These protective factors such as having a family environment in childhood in which at least one one parent was supportive and a good attachment relationship between parent and child was industrialized can protect against the harmful effects of an abusive parent (Masten & Coatsworth, 1998). Other childhood protective factors that can protect against a range of stressors consist of having an easygoing temperament, high self-esteem, high intelligence, and school achievement (Masten, 2001; Masten & Coatsworth, 1998; Rutter, 1987).
Building Resiliency
So, what is a man to do if they should fall in the class of having high levels of childhood vulnerabilities (diatheses); having had low levels of childhood protective factors; and currently having high levels of psycho-social stressors in their life. How do population cope with serious illnesses, the loss of a job, the death of a loved one, or other life curious events and/ or traumatic experiences? Should you just give up and give into the symptoms that you are already developing. Is it confident or just fate that you will construct these disorders, or is their something that you can start doing for yourself now to decrease your risk?
Since stress is defined by some experts as the response or touch of an private to demands that he or she perceives as taxing or exceeding his or her personal resources (Folkman & Moskovitz, 2004; Lazarus, 1993; Taylor & Stanton, 2007), it is logical to reconsider that we could growth our personal resources to build resiliency in all the dimensions of our lives - to decrease the risk of developing these disorders and their harmful consequences. Resilience is the ability to recover from or adjust surely to turn or misfortune. To be resilient means to be flexible, elastic, and springy. In other words, when bad things happen to you, you are determined to be resilient when you are able to bounce back and adapt successfully to very difficult circumstances.
There is increasing evidence that if a child's fundamental systems of adaptation (such as brain and cognitive development, ability to self-regulate, motivation to accomplish mastery, productive parenting, and well-functioning neurobiological systems for handling stress) are operating normally, then most threatening circumstances will have minimal impact on him or her (Masten, 2001). Problems may arise when a serious stressor damages one or more of these systems or when the level of challenge far exceeds human capacity to adapt (e.g., exposure to persisting trauma in war or persisting maltreatment in abusive families (Cicchetti, 2004; Cicchetti & Toth, 2005; Masten & Coatsworth, 1998). Resilience is not a personality trait that population are born with. It is an ability that can be learned and industrialized in anyone. Resilience can be systematically built multi-dimensionally into many areas of your life by developing a holistic health and wellness plan. The following Therapeutic operation peruse can be utilized to collate an individuals current behaviors/ activities associated to decreasing stress, construction resiliency, and improving over-all wellness.
7 Dimensional - Therapeutic operation peruse (7D-Tas)
The 7D-Tas is a 21 request peruse that can identify exact therapeutic activities in the following seven life-functioning dimensions:
1. Medical/ corporeal Stress - Dimension
2. Self-regulation/ Impulse operate Stress - size
3. Educational/ Occupational Stress - size
4. Social/ Cultural Stress - size
5. Financial/ Legal Stress - size
6. Mental/ Emotional Stress - size
7. Spiritual/ Religious Stress - Dimension
The following three questions are asked:
1. Are you currently participating in activities that will decrease stress, build resiliency, and improve your uncut wellness in in each of the 7 dimensions?
2. If Yes - What exact activities are you participating in for at least 30 minutes per day?
3. How many days per month are you participating in these activities?
Six of the seven dimensions are coarse to most health and wellness models, but the second dimension: Self-regulation/ Impulse operate may wish some explanation, so I will list the following second size questions for consideration:
Self-regulation/ Impulse operate Dimension:
1. Are you currently maintaining a balanced lifestyle by avoiding alcohol/ drug abuse and/ or other addictive/ high-risk behaviors (e.g., gambling, sexual compulsive behaviors, food - binging/ purging, obsessive religious practices, risky/ perilous behaviors - speeding/ reckless driving, and/ or assaults/ violence/ self-harm, excessive - internet use shopping, exercise, work activities, etc.). Yes/ No
2. If Yes - Circle the following activities that you are participating in: self-monitoring, daily journaling, talk to family members/ friends, sponsor/ peer coach, read self-help books, attend maintain groups (religious meetings, Alcoholics Anonymous), individual/ group counseling/ therapy, etc. Other: _____________
3. If Yes - Circle the amount of Days per Month: 0 --- 5 --- 10 --- 15 --- 20 --- 25 --- 30
Total ration (%) scores are then tallied and can then be documented on a "Wheel of Life" to be visualized to emphasize the cognitive dissonance between what you (or your client) are surely doing to improve your life at this time and what you think you may be doing.
Self-regulation is one of the major executive functions of the human brain and is a centrally leading process and life-functioning dimension. Not only does it hold leading keys to self theory, but it also has uncut pragmatic applications. Indeed, the majority of personal and social problems faced by modern Western citizens - addiction, violence and crime, debt, sexually transmitted diseases, underachievement, unwanted pregnancy, obesity, failure to exercise, gambling, failure to save money, and others - are rooted in failures of self-regulation (Higgins, E. T., 1996).
Putting It All Together
Guidelines for implementing a 7 size Intervention:
1. Start the interview with the "Open question" technique to elicit as much detailed data as potential from the client, prior to administering any questionnaires or checklists (Utilize reflective listening skills, etc.).
2. Administer the Ace questions and infer the Ace score.
3. Administer the 7D - Psi and infer scores.
4. Administer the 7D - Tas and infer scores and plot all scores on the Wheel of Life to visualize the diathesis levels, current psycho-social stressor levels, and the current efforts to decrease stress and build resiliency.
5. Administer the "Stages of Change" question: On a scale of 1 to 10 - with 10 representing the top motivation for turn that you have at this time, how motivated are you?
Pre-contemplation Stage = 1 - 3
Contemplation Stage = 4 - 5
Preparation Stage = 6 - 7
Action Stage = 8 - 9
Maintenance Stage = 10
6. Supply a "Motivational Interviewing" session with your client discussing the "Stages of Change." The brevity of this narrative does not allow for an summary of this session (Tomlin, K. & Richardson, H., 2004)
7. construct a holistic multidimensional health and wellness plan and a uncut individualized rehabilitation plan if primary along with a case management and rehabilitation monitoring system.
7 - Dimensional Model
In the "Addictions recovery estimation principles (Arms)," (Slobodzien, J. 2005), the following seven life-functioning therapeutic operation dimensions for Advance outcome measurements consist of the 7D-Psi. Each of the seven dimensions has individualized assessment criteria:
1. Medical/ corporeal Stress - Dimension
2. Self-regulation/ Impulse operate Stress - size
3. Educational/ Occupational Stress - size
4. Social/ Cultural Stress - size
5. Financial/ Legal Stress - size
6. Mental/ Emotional Stress - size
7. Spiritual/ Religious Stress - Dimension
The 7 - size model was initially designed to quantum patient Advance by assessing therapeutic life-functioning activities, any way research may prove it to be productive as a generalized model for recovery, from all pathological diseases, disorders, and disabilities. It's multidimensional assessment/ rehabilitation process includes the internal interconnection of many dimensions from biomedical to spiritual - taking into catalogue the effects of feedback and the existence of each size mutually influencing each other simultaneously. Because of the complexity of human nature, rehabilitation Advance needs to be initially tailored and guided by an individualized rehabilitation plan based on a uncut bio-psychosocial assessment that identifies exact problems, goals, objectives, methods, and timetables for achieving the goals and objectives of treatment.
Psycho-social stressors may sway many domains of an individual's functioning and wish holistic health and wellness planning along with multi-modal treatment. Goals of rehabilitation consist of allowance in multi-dimensional stress, and simultaneous improvement in multi-dimensional functioning. Real Advance requires time, commitment, and discipline in mental about it, planning for it, working the plan, and monitoring the successes made to growth resilience. It also requires standard interventions and motivating strategies for each Advance area of an individual's life.
7 - Dimensions is a nonlinear, dynamical, non-hierarchical model that focuses on interactions between many risk factors and situational determinants similar to catastrophe and chaos theories in predicting and explaining addictive behaviors and relapse. many influences trigger and operate within high-risk situations and sway the global multidimensional functioning of an individual. The process of construction resilience incorporates the interaction between many background factors (e.g., family history, social support, and co morbid psychopathology), physiological states, cognitive processes (e.g., self-efficacy, motivation, outcome expectancies), and coping skills. To put it simply, small changes in an individual's behavior can effect in large qualitative changes at the global level and patterns at the global level of a principles emerge solely from numerous limited interactions. The clinical utility of the 7 - Dimensions recovery model is in its ability to support health care providers to fast get detailed data about an individual's personality, background, substance use history, affective state, self-efficacy, and coping skills for prognosis, diagnosis, rehabilitation planning, and outcome measures.
The 7 - Dimensions' principles promotes a synergistically confident effect that can ignite and set free the human spirit when an individual's life functioning dimensions are elevated in a homeostatic system. The reciprocity between spirituality and multidimensional life functioning progress, construct the deepest intrinsic self-image and behavioral changes.
The fundamental 7 - Dimensions principles purports that the compound of an individuals' elevated and balanced many life-functioning dimensions can produce a synergistically tenacious, resilient, and spiritually confident private homeostasis. Just as the compound of alcohol and drugs (for example valium) when taken together produce a synergistic effect (potency effects are not added together, but multiplied), and can construct into an addiction or unbalanced life-style, confident rehabilitation effectiveness and successful outcomes are the effect of a synergistic relationship with "The Higher Power."
Conclusion
A rapidly growing body of evidence supports the relationship between adverse childhood experiences and physical/ mental disorders. Clinical research investigating this relationship concludes that psychosocial stressors in childhood combined with current stressors can be both a cause and a consequence of mental disorders. Furthermore, modern data have shown that health and wellness planning to decrease stress and build resiliency might reduce the symptoms that lead up to mental disorders.
Unfortunately, the sway of psychosocial stressors upon mental disorders remains underrecognized compared to primary genetic-biologic causes. mental health providers should accomplish systematic screening for psychosocial stressors to identify potential symptoms for additional prognosis and rehabilitation planning. Considerations should be given to developing unique interventions to support patients with becoming aware of the connections between their lifestyle activities and future mental health disorders. The compound of screening devices discussed in this narrative to help patients visualize their childhood vulnerabilities, current stressors, and current therapeutic activities have successfully motivated patients to implement confident therapeutic activities to target exact stressors affecting particular dimensions of their lives to decrease stress, build resiliency, and improve their uncut wellness. The 7 size Intervention has been particularly useful in patients with substance abuse disorders occurring with other persisting diseases.
The time has come for mental health providers to identify the impact of a seven dimensional advent to mental health. The 7 - Dimensions Model is not claiming to be the panacea for the ills of all mankind, but it is a step in the right direction for getting clinicians to turn the way they practice, by changing rehabilitation premise systems to combine evidence-based research findings on productive interventions. The challenge for those curious in conducting outcome evaluations to improve their ability of care is to combine a principles that will standardize their assessment procedures, rehabilitation programs, and clinical rehabilitation practices. By diligently following a standardized principles to get base-line outcome statistics of their rehabilitation program effectiveness despite the outcome, they will be able to collate the effectiveness of subsequent rehabilitation interventions.
For more info see: Poly-Behavioral Addiction and the Addictions recovery estimation principles (Arms) at: http://ezinearticles.com/?expert_bio=James_Slobodzien
by James Slobodzien, Psy.D.
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