Religion and Theology

Imitated Aggression Methodologies
Introduction
When evaluating a patient for any symptoms, primary things to consider are the patients age, weight, lifestyle, patient history, and family history.  It is also important to know the onset of the symptoms experienced as well as any recent physical changes, or current events, such as problems that the patient may be dealing with.  Another consideration is if the patient is currently taking any medications and if so, what medications the patient is taking, including dosage and frequency.

Presents with Complaint of Tiredness and Exhaustion
Patient presents with complaint of lacking energy, inability to maintain hygiene, clean house or get out of bed.  Advised increased appetite.  Inability to sleep.  Complaints of joint pain, and dizziness.  Headaches, indigestion, and weight gain.  Denies taking any medications.  Smokes one pack of cigarettes a day.

Physical Examination
Upon examination, lungs and eyes are clear.  Heart is NSR, no palpitations.  Blood pressure 19090. Temperature is 100.2.  Patient appears to be in good health, although blood pressure is slightly high.

Mental Evaluation
Difficulty concentrating, forgetfulness, and having problems with making decisions.  Experiencing anxiety, and anger, with mood swings.  Sporadic crying episodes.  Controlling affect, constant criticizing of others.

Consultation
Patient is a 42 year old female complaining of chronic fatigue.  There is no history of depression.  Not currently taking any OTC, or prescribed medications.  Patient advises inability to function, with extreme difficulty sleeping.  Experiencing increased appetite, with weight gain of twenty pounds.   Recent break up with boyfriend, and loss of job.  Inability to keep still, constant shaking of leg noted with bodily tremors.

DSM-IV-TR
Evaluate patient for psychosocial stressors in relation to symptoms of acute stress disorder (ASD).
307.42  Insomnia related to Axis IV
309.28  With anxiety and depressed mood
309.4 With mixed disturbance of emotions and conduct
V71.01 Adult antisocial behavior
V61.1 Partner relational problem
V62.89 Phase of life problem

Diagnosis Criteria
The first step in establishing treatment for acute stress disorder is to receive a professional diagnosis. From within the guidelines of the DSM- IV-TR, a psychiatrist will look at the following criteria in determination of the disorder. Relevant data such as background, series of events, and proposed emotional status play a role in the process. Medications and addressing of other mental and physical issues are factors considered (Axelrod, 2007).

Symptomology
Mulhauser (2010) advises to reach a diagnosis of acute distress disorder the factors evaluated consist of
There is a dual primary indicative relation consisting of having witnessed a traumatic event in which death or severe injury occurred and of having an overwhelming response of horrification leading to a state of helplessness.
There is a subsequent reactionary initiative in a cumulative of three or more relative instances resulting in
Detachment of emotion, in becoming numb and unresponsive
Loss of time and space in being in a dazed, and disoriented state
Loss of reality
Loss of sense of self
Disassociation from the events resulting in amnesia
The events continue in a pattern of thoughts, with an inability to control.

Focus is on increased avoidance of triggers in having to deal with the reoccurrence of the event.
There is mounting anxiety with a heightened awareness, affecting active daily living, and sleeping.
There is an inability to cope or function with a fixation on the event in repetitive expression of event.
Acute onset of symptoms relative to the trauma, and occurring anywhere from two to four days, or within 4 weeks of event.

To rule out any other physiological or mental associate conditions as a causative factor.

An evaluation to identify and determine specific symptoms is relevant in initiating a clear and concise diagnosis for treatment. Symptoms that professionals look for include stress related responses. Stoppler (2010) expresses the physical impact of stress on the nervous system and its contribution to other bodily dysfunctions
Physical
Raised blood pressure
Suppression of immune system
Increased risk of heart attack and stroke
Contribution to infertility
Age progression
Emotional

ICBS (2007) provides the emotional signs and symptoms of stress. These symptoms allude to an emotional disorder that could, depending on severity and time constitute a diagnosis of acute stress disorder apparent within a month of the event and short lived, or that of a posttraumatic disorder which is chronic.
Irritation
Anger and hostility
Depression and withdrawal
Jealousy
Restlessness and anxiousness
Decreased initiative
Inability to be reality based or overtly alert
Decreased personal involvement
Non interest
Crying bouts
Critical depiction of others
Self deprecating
Having nightmares
Weak reflexes of emotional responses
Behavioral

The most common behaviors associated with acute stress disorder that are easy to recognize according to Aetna (2007) who advises these behaviors exhibit frequently and increase in frequency if intervention does not occur
Nail biting
Increased smoking, or use of alcohol and drugs
Neglect of responsibility
Poor job performance
Bad hygiene
Identify Dominant Treatment Modalities

Modalities in place in attribution of treatment of ASD are psychotherapy and pharmacology, prescribed separately, or a combination of both may apply. It all depends on the individual diagnosis and response. There have not been many studies on the effects of pharmacological treatment on patients, but from those conducted it is known that the administration of serotonin reuptake inhibitors prove invaluable in providing quality of life to those who need treatment (Seedat, 2006).

Preferred Therapeutic Interventions of Treatment for Acute Stress Disorder
The possibilities of intervention practices in alleviation of stress have proved to be effective on a broad scale. Historically continued exposure to stress can lead to psychological disturbances. Cases reportedly advise of physical reactions to stress such as manifestations of blindness. The American Civil War was the first to notice the effects of combat on soldiers. The traumatic neuroses, war neurosis, shell shock, battle fatigue, or physioneurosis (Hughes  Thompson, 2004).

These historical events personified human experience (Hughes  Thompson, 2004). This was a breakthrough of scientific significance, regarding the preponderance of evidence that events of traumatic nature could affect persons in such a way as to emotionally cause harm. Even further, this discovery revealed that based on the exposure time, and the individual, the impact could be acute or chronic based.

Other intervention practices developed over time in the treatment for acute stress disorder have clarified the connection of ASD to PTSD in recognition of acute to chronic realism on a functional scale that escalates from minor to major in debilitation. With the early studies indicative of the existence of stress overall in relation traumatic events, it is still not decidedly accepted as a precise science. There is still much more to know in its acquisition, and about the triggers that result in manifestation of physical and emotional turmoil, and effective treatment from a short and long-term stance (Johnson  Greenberg, 2010).

Research will take a harder look at applicable demographics constituting a percentile of factors involving the likelihood of experiencing a traumatic event, with results indicative of one person out of 60.7 percent of men, and 51.2 percent of women. In ensuring that the criteria for diagnosis in relation to overall patient satisfaction is provided for effective coping skills, in addition the advancements with pharmacological and psychotherapeutic treatment have not gone unnoticed (Frey, 2010).