NRNP 6665 WEEK 9 ASSIGNMENT: Controversy Associated With Dissociative Disorders
Walden University NRNP 6665 WEEK 9 ASSIGNMENT: Controversy Associated With Dissociative Disorders-Step-By-Step Guide
This guide will demonstrate how to complete the Walden University NRNP 6665 WEEK 9 ASSIGNMENT: Controversy Associated With Dissociative Disorders assignment based on general principles of academic writing. Here, we will show you the A, B, Cs of completing an academic paper, irrespective of the instructions. After guiding you through what to do, the guide will leave one or two sample essays at the end to highlight the various sections discussed below.
How to Research and Prepare for NRNP 6665 WEEK 9 ASSIGNMENT: Controversy Associated With Dissociative Disorders
Whether one passes or fails an academic assignment such as the Walden University NRNP 6665 WEEK 9 ASSIGNMENT: Controversy Associated With Dissociative Disorders depends on the preparation done beforehand. The first thing to do once you receive an assignment is to quickly skim through the requirements. Once that is done, start going through the instructions one by one to clearly understand what the instructor wants. The most important thing here is to understand the required format—whether it is APA, MLA, Chicago, etc.
After understanding the requirements of the paper, the next phase is to gather relevant materials. The first place to start the research process is the weekly resources. Go through the resources provided in the instructions to determine which ones fit the assignment. After reviewing the provided resources, use the university library to search for additional resources. After gathering sufficient and necessary resources, you are now ready to start drafting your paper.
How to Write the Introduction for NRNP 6665 WEEK 9 ASSIGNMENT: Controversy Associated With Dissociative Disorders
The introduction for the Walden University NRNP 6665 WEEK 9 ASSIGNMENT: Controversy Associated With Dissociative Disorders is where you tell the instructor what your paper will encompass. In three to four statements, highlight the important points that will form the basis of your paper. Here, you can include statistics to show the importance of the topic you will be discussing. At the end of the introduction, write a clear purpose statement outlining what exactly will be contained in the paper. This statement will start with “The purpose of this paper…” and then proceed to outline the various sections of the instructions.
How to Write the Body for NRNP 6665 WEEK 9 ASSIGNMENT: Controversy Associated With Dissociative Disorders
After the introduction, move into the main part of the NRNP 6665 WEEK 9 ASSIGNMENT: Controversy Associated With Dissociative Disorders assignment, which is the body. Given that the paper you will be writing is not experimental, the way you organize the headings and subheadings of your paper is critically important. In some cases, you might have to use more subheadings to properly organize the assignment. The organization will depend on the rubric provided. Carefully examine the rubric, as it will contain all the detailed requirements of the assignment. Sometimes, the rubric will have information that the normal instructions lack.
Another important factor to consider at this point is how to do citations. In-text citations are fundamental as they support the arguments and points you make in the paper. At this point, the resources gathered at the beginning will come in handy. Integrating the ideas of the authors with your own will ensure that you produce a comprehensive paper. Also, follow the given citation format. In most cases, APA 7 is the preferred format for nursing assignments.
How to Write the Conclusion for NRNP 6665 WEEK 9 ASSIGNMENT: Controversy Associated With Dissociative Disorders
After completing the main sections, write the conclusion of your paper. The conclusion is a summary of the main points you made in your paper. However, you need to rewrite the points and not simply copy and paste them. By restating the points from each subheading, you will provide a nuanced overview of the assignment to the reader.
How to Format the References List for NRNP 6665 WEEK 9 ASSIGNMENT: Controversy Associated With Dissociative Disorders
The very last part of your paper involves listing the sources used in your paper. These sources should be listed in alphabetical order and double-spaced. Additionally, use a hanging indent for each source that appears in this list. Lastly, only the sources cited within the body of the paper should appear here.
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Sample Answer for NRNP 6665 WEEK 9 ASSIGNMENT: Controversy Associated With Dissociative Disorders
Dissociative disorders are characterized by a disturbance in the normal functions of memory, identity, motor behavior, consciousness, and environmental awareness. The disturbance can be gradual or sudden and transient or chronic (Agarwal et al., 2019). The types of Dissociative disorders include dissociative identity disorder (DID), dissociative amnesia (DA), dissociative fugue, depersonalization disorder, and dissociative disorder not otherwise specified (DDNOS). The purpose of this paper is to explore the controversy surrounding dissociative disorders and the ethical and legal considerations related to working with patients with dissociative disorders.
Controversy That Surrounds Dissociative Disorders
Dissociative disorders are controversial diagnoses with crucial medico-legal implications. There has been a long history of controversy and debates surrounding DID and dissociation in particular. Besides, many clinicians still do not believe in Dissociative disorders. There is a controversy on the interpretation of the symptoms of dissociative disorders. Questions arise on whether dissociative disorders have unique and subtle symptoms and behaviors such that providers cannot recognize them when examining the patient (Loewenstein, 2018). There is a debate on whether patients exhibit intentional malingering or induced symptoms created by other clinicians who believe something is there, but it is not. Furthermore, there is a controversy because criminals use dissociative disorders to evade punishment from the naïve justice system, which associates obnoxious behavior to another personality. Thus the perpetrator is not held accountable for their action (Loewenstein, 2018). For instance, defendants have contended committing grave crimes, such as rape and murder, while in a dissociated state.
Professional Beliefs about Dissociative Disorders
My professional belief about dissociative disorders is in line with the Trauma Model, which proposes that dissociation is a psychobiological trait or state that serves as a protective response t
o overwhelming and traumatic experiences. I conceptualize dissociation disorders as a spectrum from normal to pathological, with periods of deep absorption. Besides, dissociation disconnects from ordinary awareness of the entire meaning and effect of traumatic events on an individual. Firestone (2018) asserts that dissociation develops alongside trauma and is sustained by the trauma experiences. Dissociative reactions transpire with regard to acute trauma reactions, acute stress reactions, PTSD, and panic attacks. The Trauma Model hypothesizes that dissociation alleviates the effect of trauma by psycho-biologically impounding trauma-related information by protectively activating an altered state of consciousness (Loewenstein, 2018). Subramanyam et al. (2020) argue that dissociation is a mechanism that allows the mind to sift undesirable thoughts and memories from a person’s normal consciousness.
Strategies for Maintaining the Therapeutic Relationship
A patient’s potential to dissociate can adversely impede the creation and continuity of a therapeutic relationship,
making it difficult to achieve successful psychotherapy outcomes. The aim of creating and maintaining a therapeutic relationship with patients with dissociative disorders is to assist them in coming up with a consistent sequence of events of their early life, perceive the emotional pain related to the trauma experiences, and understand their past (Firestone, 2018). Approaches to maintaining a therapeutic relationship with patients include employing a patient-oriented approach, purposed to understand the client’s suicidality from their identity or personality issues. Another strategy is to draw the client’s narrative about their experience as crucial in creating and maintaining the therapeutic relationship and collaborating to develop a mutual understanding of the patient’s dissociation. Firestone (2018) recommends using collaborative and narrative strategies since they improve the provider’s capacity to empathize and assist the client in restoring a sense of mastery, thus strengthening the therapeutic relationship.
Ethical and Legal Considerations Related To Dissociative Disorders
Treating patients with dissociative disorders needs definite attention to various ethical and legal issues. Clinicians dealing with these clients need to obtain informed consent either from the client or the patient’s guardian by explaining the diagnosis and treatment interventions (Deshpande et al., 2020). The clinician can avoid legal implications by obtaining consent to share the client’s information with other providers. The patient’s right to autonomy should be brought into practice by involving the patient in determining treatment interventions and discussing any controversies surrounding the interventions (Deshpande et al., 2020). Discussing the controversies helps mitigate psychological distress that may arise when the client learns them from another source. Clinicians should also respect clients’ decisions on their preferred treatment options to avoid ethical implications.
Conclusion
Controversies surrounding dissociative disorders include whether they are actual disorders and if patients exhibit intentional malingering or induced symptoms. Besides, defendants have used dissociative disorders to plead not guilty for grave offenses. Using a patient-oriented approach and collaborative and narrative strategies can help establish and maintain a therapeutic relationship with a client. Legal and ethical considerations in dissociative disorders include informed consent and respect for autonomy.
References
Agarwal, V., Sitholey, P., & Srivastava, C. (2019). Clinical Practice Guidelines for the management of Dissociative disorders in children and adolescents. Indian journal of psychiatry, 61(Suppl 2), 247–253. https://doi.org/10.4103/psychiatry.IndianJPsychiatry_493_18
Deshpande, S. N., Mishra, N. N., Bhatia, T., Jakhar, K., Goyal, S., Sharma, S., Sachdeva, A., Choudhary, M., Shah, G. D., Lewis-Fernandez, R., & Jadhav, S. (2020). Informed consent in psychiatry outpatients. The Indian journal of medical research, 151(1), 35–41. https://doi.org/10.4103/ijmr.IJMR_1036_18
Firestone, L. (2018). Dissociation and Therapeutic Alliance. In Phenomenology of Suicide (pp. 167-186). Springer, Cham.
Loewenstein, R. J. (2018). Dissociation debates: everything you know is wrong. Dialogues in clinical neuroscience, 20(3), 229–242. https://doi.org/10.31887/DCNS.2018.20.3/rloewenstein
Subramanyam, A. A., Somaiya, M., Shankar, S., Nasirabadi, M., Shah, H. R., Paul, I., & Ghildiyal, R. (2020). Psychological Interventions for Dissociative disorders. Indian journal of psychiatry, 62(Suppl 2), S280–S289. https://doi.org/10.4103/psychiatry.IndianJPsychiatry_777_19
Sample Answer 2 for NRNP 6665 WEEK 9 ASSIGNMENT: Controversy Associated With Dissociative Disorders
Recent advances in the field of mental health and illness have led to the improvement of diagnostics and treatment strategies to enhance patient outcomes. Formulated guidelines and treatment strategies for most mental illnesses are agreeable and, therefore, applied in the treatment and management of various mental illnesses. For example, the DSM-5-TR has been used as a diagnostic tool for years. However, it has evolved to include legal cases, access to services, and billing (First et al.,2023). However, it is worth noting that not all practitioners usually agree with its structure and content. One disorder that some don’t agree with is the dissociative disorder. These disorders are usually complicated to diagnose and distinguish. Controversy exists over the legitimacy of particular disorders, such as dissociative identity disorder. As such, the purpose of this assignment is to explore the controversy surrounding dissociative disorder and discuss the legal, ethical, and clinical considerations pertinent to working with patients with such disorders.
Controversy Surrounding Dissociative Disorders
Dissociative disorders are characterized by an individual disconnecting from their sense of identity, memories, feelings, or thoughts. However, over the years, controversy has surrounded dissociative disorders, especially since the start of modern psychology and psychiatry. It is worth noting that in some cases, the professionals’ beliefs about dissociative disorders are not based on any scientific research, findings, or literature (Dodier et al.,2022). A substantial amount of recent data and evidence has supported a relationship between dissociative disorders and psychological trauma, particularly early life and or cumulative trauma. However, there are also individuals who have countered such evidence by clinging to statements such as dissociative disorders are artefactual conditions that are brought about by socio-cultural factors.
Those who oppose the existence of dissociative disorders use three interconnected models to advance their positions. For example, they use the Iatrogenic model, which views the condition as produced in highly suggestible and hypnotizable patients, in most cases with Borderline Personality Disorder by clinicians who believe in multiple personalities and repressed memory (Lyn et al.,2022). Therefore, they use treatment approaches such as hypnosis to exhume the once-forgotten traumas and implant false memories. According to the sociocognitive model, psychotherapy is not required for severe dissociative disorder development.
The third model, which is the Fantasy Model, considers dissociation as a cognitive characteristic that causes fantasies. The proponents of these theories argue that there is insufficient data that supports the relationship between dissociation and trauma. They also argue that there are no psychological processes that can explain amnesia for trauma since the individuals remember the experiences well (Lyn et al.,2022). Therefore, treatment entails turning a blind eye to dissociative disorder and the symptoms of trauma, focusing on everyday problems, and treating the real existing mental disorders such as depression.
Professional Beliefs About Dissociative Disorders
Debates regarding dissociative disorders will always exist since there are still a large number of individuals who believe in their existence and others who don’t believe in their existence. As such, it is important to discuss the professional’s beliefs regarding such dissociative disorder. Among my professional beliefs about dissociative disorders is that it should be an obligation of a mental health practitioner to carry out a comprehensive patient assessment during the diagnosis of suspected dissociative disorders. Such an approach or strategy will help in differentiating this condition from other conditions that may present with similar symptoms, such as borderline personality disorder (Lyn et al.,2022). Accurate diagnosis can be important to initiate the right treatment strategies for better patient outcomes.
I also believe that dissociative disorders exist and that they are not just here-says or creations of other individuals. These conditions are mental health disorders that have existed for a long time, as indicated by Loewenstein et al.(2022). There are records of individuals who have presented with the condition’s symptoms in the past and have been treated using formal treatment approaches (Maldonado & Spiegel, 2024). As such, I also believe that patients presenting with these symptoms should seek professional help in the treatment and management of the symptoms. There is also evidence that dissociative disorders can be differentiated from other conditions using the current diagnostic strategies; as such, individuals are also treated and managed using different approaches. Indeed, a recent research by Kate et al. (2020) showed that prevalence of the dissociative disorder is about 12%.
Strategies For Maintaining Therapeutic Relationship With A Client That May Present With Dissociative Disorder
It is evident that there are controversies surrounding dissociative disorders. Besides, there still exist challenges in diagnosing these conditions and differentiating them from others. As such, patients diagnosed with this condition should taken care of. One aspect of ensuring better outcomes is striking and maintaining a therapeutic relationship with a client who may present with dissociative disorder. One of the strategies is using and encouraging open communication with such patients (Fung et al.,2022). Open and effective communication can play an important role in helping the patients share their feelings and experiences, which can be vital to the formulation of appropriate treatment and management plans agreeable to both parties. It is also important to keep the patient’s information private and confidential.
Ethical and Legal Considerations In Dissociative Disorder
It is important to explore ethical and legal considerations in dissociative disorder. One of them is determination if the patient is competent to make decisions concerning their treatment as they may have multiple identities, which can lead to conflicting preferences (Lynn et al.,2022). Therefore, patient autonomy is put at risk, which requires collaborative and multidisciplinary approaches to avoid any legal issues. There is also a need to offer patient treatment without coercion.
Conclusion
Controversies still exist regarding dissociative disorders. Therefore, it is important to have an idea of what such controversies are. This assignment has explored such controversies and professional beliefs regarding these disorders. In addition, strategies for maintaining therapeutic relationships with patients with such patients have been explored.
References
Dodier, O., Otgaar, H., & Lynn, S. J. (2022, November). A critical analysis of myths about dissociative identity disorder. In Annales Médico-psychologiques, revue psychiatrique (Vol. 180, No. 9, pp. 855-861). Elsevier Masson. https://doi.org/10.1016/j.amp.2021.10.007
First, M. B., Clarke, D. E., Yousif, L., Eng, A. M., Gogtay, N., & Appelbaum, P. S. (2023). DSM-5-TR: rationale, process, and overview of changes. Psychiatric Services, 74(8), 869-875. Doi: 10.1176/appi.ps.20220334
Fung, H. W., Ross, C. A., Lam, S. K. K., & Hung, S. L. (2022). Recent research on the interventions for people with dissociation. European Journal of Trauma & Dissociation, 6(4), 100299. https://doi.org/10.1016/j.ejtd.2022.100299
Kate, M. A., Hopwood, T., & Jamieson, G. (2020). The prevalence of dissociative disorders and dissociative experiences in college populations: A meta-analysis of 98 studies. Journal of Trauma & Dissociation, 21(1), 16-61. https://doi.org/10.1080/15299732.2019.1647915
Loewenstein, R. J. (2022). Dissociation debates: Everything you know is wrong. Dialogues In Clinical Neuroscience. https://doi.org/10.31887/DCNS.2018.20.3/rloewenstein
Lynn, S. J., Polizzi, C., Merckelbach, H., Chiu, C. D., Maxwell, R., van Heugten, D., & Lilienfeld, S. O. (2022). Dissociation and dissociative disorders reconsidered: Beyond sociocognitive and trauma models toward a transtheoretical framework. Annual Review of Clinical Psychology, 18, 259-289. https://doi.org/10.1146/annurev-clinpsy-081219-102424
Maldonado, J. R., & Spiegel, D. (2024). Dissociative disorders. In Tasman’s Psychiatry (pp. 1-46). Cham: Springer International Publishing. https://doi.org/10.1007/978-3-030-42825-9_80-1
Sample Answer 3 for NRNP 6665 WEEK 9 ASSIGNMENT: Controversy Associated With Dissociative Disorders
Dissociative disorders affect the patient’s thought process and hinder a continuous and consistent way of thinking, memory, actions and personal identity. It is one of the rare psychiatric disorders that affects about 1.5 percent of the world population (Mitra & Jain, 2021). Initially, the condition was referred to as Multiple Personality Disorder. The patient exhibits behaviors that are self-injurious and more often substance abuse. The purpose of this paper is to discuss the controversies associated with the condition by addressing various aspects.
Controversies and Examples of Dissociative Disorders
Dissociative identity disorder is one of the dissociative disorders that has attracted a wide spread controversies from its diagnosis to the treatment procedures. Some of the areas of concern include; epidemiology and etiology of DID, the allegations of abuse by the patients, assessment of the disease and the treatment dilemma of whether to deal with alters and the trauma history or not. In terms of epidemiology of the disease, research findings reveal that the disease goes undiagnosed for and that the disease is not uncommon as it is thought to be. Additionally, it occurs in many different countries and at uniform rates even in psychiatric inpatient population (Loewenstein, 2018).
In terms of etiology of the disease, controversy arises about the nature of the symptoms exhibited by the DID patients. There is a point of contention whether the symptoms are natural or iatrogenic. In this context the patients could adopt to behave in certain manner as imposed by the therapists or the environment which could be the social, cultural or religious underpinning of the patient. Additionally, the issue of hypnotics and its relation to DID patients have been an area of debate for a long time while some psychiatrists argue that those who perpetuate this idea are just “enthusiast” of taking advantage of the condition (Loewenstein, 2018). There are three major types of dissociative disorders, they include; dissociative identity disorder (DID), dissociative amnesia and derealization or depersonalization disorder.
Professional Beliefs about Dissociative Disorders
In the efforts to promote mental health awareness, it is imperative for the healthcare organizations, institutions of medicine, clinical and nurse training to put special attention to the studies on diagnosis and treatment of dissociative disorders. It is just like other mental disorders and the patients require adequate medical attention. Psychiatrists and other mental associations have a responsibility of demystifying the myths behind the condition and be proactive in addressing the issue candidly. There could be a large population in the USA already battling with the cases of DD and if we do not act on the matter decisively and with certainty it could emerge to be a silent healthcare catastrophe that is unfolding right in front of our sight (Loewenstein, 2018).
Strategies to Maintain Therapeutic Relationship with a Client That May Present Dissociative Disorder
Since each patient is different in terms of the symptoms exhibited and the severity of the disease, it is imperative to have an individualized approach to psychotherapy. One of the strategies applied entails switching in and out of several treatment models to achieve therapeutic flexibility to the varying clinical realities. In order to come up with long-term intervention strategies, it is imperative to analyze the following steps; establishing the psychotherapy, preliminary interventions, gathering of the patient’s history and mapping, metabolism of the trauma, moving towards integration, integration-resolution, learning new coping skills, solidification of the gains and working through them and finally follow up (Gentile et al., 2019). Those steps will alleviate the impact of the issue.
Legal and Ethical Considerations
The concept of ethical issues in the diagnosis, management and treatment of dissociative disorders is crucial to promoting the safety of the patient and better quality of life (Rasoal et al., 2017). Therefore, PMHNP and other associated personnel have a responsibility to maintain high standards of ethical issues when dealing with the patients. The nurses are called upon to practice high level of confidentiality with patient’s information, autonomy of the patient, nonmaleficence and beneficence (Liu & Kohlen, 2017). The patient or the caregivers have to be informed of any medical procedures being used on the patient and the consent of the patient is key and patient has the freedom of choice. Additionally, beneficence demands that the best practices that promote the best of outcome is offered to the patient.
Conclusion
Dissociative disorders impact a large percentage of the population. There are controversies associated with the conditions with each one manifesting varied issues. However, nurse practitioners may use effective strategies to attempt to manage the effects of the condition.
References
Gentile, J. P., Dillon, K. S., & Gillig, P. M. (2019). Psychotherapy and pharmacotherapy for patients with dissociative identity disorder. Innovations in Clinical Neuroscience, 10(2), 22–29. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3615506/
Liu, P.-Y., & Kohlen, H. (2017). Tensions in Diabetes Care Practice: Ethical Challenges with a Focus on Nurses in a Home-Based Care Team. Care in Healthcare, 211–235. https://doi.org/10.1007/978-3-319-61291-1_11
Loewenstein, R. J. (2018). Dissociation debates: everything you know is wrong. Dialogues in Clinical Neuroscience, 20(3), 229–242. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6296396/
Mitra, P., & Jain, A. (2021). Dissociative Identity Disorder. StatPearls. https://www.statpearls.com/ArticleLibrary/viewarticle/130663
Rasoal, D., Skovdahl, K., Gifford, M., & Kihlgren, A. (2017). Clinical Ethics Support for Healthcare Personnel: An Integrative Literature Review. HEC Forum, 29(4), 313–346. https://doi.org/10.1007/s10730-017-9325-4