Treatment of Patients with Obsessive-Compulsive Disorder

Total Page:16

File Type:pdf, Size:1020Kb

Treatment of Patients with Obsessive-Compulsive Disorder PRACTICE GUIDELINE FOR THE Treatment of Patients With Obsessive-Compulsive Disorder WORK GROUP ON OBSESSIVE-COMPULSIVE DISORDER Lorrin M. Koran, M.D., Chair Gregory L. Hanna, M.D. Eric Hollander, M.D. Gerald Nestadt, M.D. Helen Blair Simpson, M.D., Ph.D. This practice guideline was approved in October 2006 and published in July 2007. A guideline watch, summarizing significant developments in the scientific literature since publication of this guide- line, may be available in the Psychiatric Practice section of the American Psychiatric Association (APA) Web site at www.psych.org. Dr. Koran has received research grants from Forest Pharmaceuticals, Pfizer, Eli Lilly, Ortho-McNeil, Somaxon, and Jazz Pharmaceuticals. He has received honoraria from the Forest Pharmaceuticals Speakers Bureau and the Pfizer Speakers Bureau. He has received consultant fees from Cypress Bioscience. Dr. Hanna reports no competing interests. Dr. Hollander has received research grants from the National Institute of Mental Health, the National Institute of Neurological Disorders and Stroke, the National Institute on Drug Abuse, the Office of Orphan Products Development of the U.S. Food and Drug Administration, Pfizer, GlaxoSmithKline, Wyeth, Eli Lilly, Janssen, and Abbott. He has served on advisory boards for Forest Pharmaceuticals, Abbott, and Somaxon. Dr. Nestadt reports no competing inter- ests. Dr. Simpson reports no competing interests. The Executive Committee on Practice Guidelines has reviewed this guideline and found no evidence of influence from these relationships. Suggested citation: American Psychiatric Association. Practice guideline for the treatment of patients with obsessive-compulsive disorder. Arlington, VA: American Psychiatric Association, 2007. Available online at http//www.psych.org/psych_pract/treatg/pg/ prac_ guide.cfm. Copyright 2010, American Psychiatric Association. APA makes this practice guideline freely available to promote its dissemination and use; however, copyright protections are enforced in full. No part of this guideline may be reproduced except as permitted under Sections 107 and 108 of U.S. Copyright Act. For permission for reuse, visit APPI Permissions & Licensing Center at http://www.appi.org/CustomerService/Pages/Permissions.aspx. AMERICAN PSYCHIATRIC ASSOCIATION STEERING COMMITTEE ON PRACTICE GUIDELINES John S. McIntyre, M.D., Chair Sara C. Charles, M.D., Vice-Chair Daniel J. Anzia, M.D. Ian A. Cook, M.D. Molly T. Finnerty, M.D. Bradley R. Johnson, M.D. James E. Nininger, M.D. Paul Summergrad, M.D. Sherwyn M. Woods, M.D., Ph.D. Joel Yager, M.D. AREA AND COMPONENT LIAISONS Joseph Berger, M.D. (Area I) C. Deborah Cross, M.D. (Area II) Harry A. Brandt, M.D. (Area III) Philip M. Margolis, M.D. (Area IV) John P.D. Shemo, M.D. (Area V) Barton J. Blinder, M.D. (Area VI) David L. Duncan, M.D. (Area VII) Mary Ann Barnovitz, M.D. Sheila Hafter Gray, M.D. Sunil Saxena, M.D. Tina Tonnu, M.D. STAFF Robert Kunkle, M.A., Senior Program Manager Amy B. Albert, B.A., Project Manager Thomas J. Craig, M.D., M.P.H., Director, Department of Quality Improvement and Psychiatric Services Darrel A. Regier, M.D., M.P.H., Director, Division of Research MEDICAL EDITOR Laura J. Fochtmann, M.D. Copyright 2010, American Psychiatric Association. APA makes this practice guideline freely available to promote its dissemination and use; however, copyright protections are enforced in full. No part of this guideline may be reproduced except as permitted under Sections 107 and 108 of U.S. Copyright Act. For permission for reuse, visit APPI Permissions & Licensing Center at http://www.appi.org/CustomerService/Pages/Permissions.aspx. CONTENTS STATEMENT OF INTENT . .7 GUIDE TO USING THIS PRACTICE GUIDELINE . .7 DEVELOPMENT PROCESS . .8 PART A: TREATMENT RECOMMENDATIONS . 9 I. EXECUTIVE SUMMARY . .9 A. Coding System. .9 B. Executive Summary . .9 1. Psychiatric Management . 9 a. Establishing a Therapeutic Alliance . 9 b. Assessing the Patient’s Symptoms . 9 c. Using Rating Scales . 9 d. Enhancing the Safety of the Patient and Others . 10 e. Completing the Psychiatric Assessment . 10 f. Establishing Goals for Treatment . 10 g. Establishing the Appropriate Setting for Treatment . 10 h. Enhancing Treatment Adherence . 11 2. Choosing an Initial Treatment Modality . 11 3. Choosing a Specific Pharmacological Treatment . 11 4. Choosing a Specific Form of Psychotherapy . 11 5. Implementing a Treatment Plan . 12 a. Implementing Pharmacotherapy . 12 b. Implementing Cognitive-Behavioral Therapies . 12 c. Changing Treatments and Pursuing Sequential Treatment Trials . 12 6. Discontinuing Active Treatment. 13 II. FORMULATION AND IMPLEMENTATION OF A TREATMENT PLAN . .13 A. Psychiatric Management . .14 1. Establish a Therapeutic Alliance . 14 2. Assess the Patient’s Symptoms . 14 3. Consider Rating the Severity of OCD and Co-occurring Symptoms and Their Effects on the Patient’s Functioning . 16 4. Evaluate the Safety of the Patient and Others. 17 5. Complete the Psychiatric Assessment. 18 6. Establish Goals for Treatment. 21 7. Establish the Appropriate Setting for Treatment. 21 8. Enhance Treatment Adherence . 21 9. Provide Education to the Patient and, When Appropriate, to the Family . 22 10. Coordinate the Patient’s Care With Other Providers of Care and Social Agencies. 22 Copyright 2010, American Psychiatric Association. APA makes this practice guideline freely available to promote its dissemination and use; however, copyright protections are enforced in full. No part of this guideline may be reproduced except as permitted under Sections 107 and 108 of U.S. Copyright Act. For permission for reuse, visit APPI Permissions & Licensing Center at http://www.appi.org/CustomerService/Pages/Permissions.aspx. B. Acute Phase. .23 1. Choosing an Initial Treatment Modality. .23 2. Choosing a Specific Pharmacologic Treatment . .23 a. Implementing Pharmacotherapy . .24 b. Managing Medication Side Effects . .25 3. Choosing a Specific Form of Psychotherapy . .26 4. Implementing Cognitive-Behavioral Therapies. .26 5. Monitoring the Patient’s Psychiatric Status . .27 6. Determining When and Whether to Change Treatments. .27 7. Pursuing Sequential Treatment Trials . 28 C. Discontinuation of Active Treatment . .30 III. SPECIFIC CLINICAL FEATURES INFLUENCING THE TREATMENT PLAN . .31 A. Psychiatric Features. .31 1. Chronic Motor Tics . .31 2. Tourette’s Disorder . .32 3. Major Depression . 32 4. Bipolar Disorder . 32 5. Panic Disorder. ..
Recommended publications
  • Inositol Safety: Clinical Evidences
    European Review for Medical and Pharmacological Sciences 2011; 15: 931-936 Inositol safety: clinical evidences G. CARLOMAGNO, V. UNFER AGUNCO Obstetrics & Gynecology Center, Rome (Italy) Abstract. – Myo-inositol is a six carbon ent required by the human cells for the growth cyclitol that contains five equatorial and one axi- and survival in the culture. In humans and other al hydroxyl groups. Myo-inositol has been classi- species, Myo-inositol can be converted to either fied as an insulin sensitizing agent and it is L- or D-chiro-inositol by epimerases. Early stud- commonly used in the treatment of the Polycys- tic Ovary Syndrome (PCOS). However, despite ies showed that inositol urinary clearance was al- its wide clinical use, there is still scarce informa- tered in type 2 diabetes patients, the next step tion on the myo-inositol safety and/or side ef- was to link impaired inositol clearance with in- fects. The aim of the present review was to sum- sulin resistance (for a review see1). Because of marize and discuss available data on the myo-in- these properties, inositol have been classified as ositol safety both in non-clinical and clinical set- “insulin sensitizing agent”2. tings. The main outcome was that only the highest In the recent years, inositol has found more dose of myo-inositol (12 g/day) induced mild and more space in the reproductive clinical prac- gastrointestinal side effects such as nausea, fla- tice3-6. Indeed, since the main therapy for Poly- tus and diarrhea. The severity of side effects did cystic Ovary Syndrome (PCOS) is the use of in- not increase with the dosage.
    [Show full text]
  • First Episode Psychosis an Information Guide Revised Edition
    First episode psychosis An information guide revised edition Sarah Bromley, OT Reg (Ont) Monica Choi, MD, FRCPC Sabiha Faruqui, MSc (OT) i First episode psychosis An information guide Sarah Bromley, OT Reg (Ont) Monica Choi, MD, FRCPC Sabiha Faruqui, MSc (OT) A Pan American Health Organization / World Health Organization Collaborating Centre ii Library and Archives Canada Cataloguing in Publication Bromley, Sarah, 1969-, author First episode psychosis : an information guide : a guide for people with psychosis and their families / Sarah Bromley, OT Reg (Ont), Monica Choi, MD, Sabiha Faruqui, MSc (OT). -- Revised edition. Revised edition of: First episode psychosis / Donna Czuchta, Kathryn Ryan. 1999. Includes bibliographical references. Issued in print and electronic formats. ISBN 978-1-77052-595-5 (PRINT).--ISBN 978-1-77052-596-2 (PDF).-- ISBN 978-1-77052-597-9 (HTML).--ISBN 978-1-77052-598-6 (ePUB).-- ISBN 978-1-77114-224-3 (Kindle) 1. Psychoses--Popular works. I. Choi, Monica Arrina, 1978-, author II. Faruqui, Sabiha, 1983-, author III. Centre for Addiction and Mental Health, issuing body IV. Title. RC512.B76 2015 616.89 C2015-901241-4 C2015-901242-2 Printed in Canada Copyright © 1999, 2007, 2015 Centre for Addiction and Mental Health No part of this work may be reproduced or transmitted in any form or by any means electronic or mechanical, including photocopying and recording, or by any information storage and retrieval system without written permission from the publisher—except for a brief quotation (not to exceed 200 words) in a review or professional work. This publication may be available in other formats. For information about alterna- tive formats or other CAMH publications, or to place an order, please contact Sales and Distribution: Toll-free: 1 800 661-1111 Toronto: 416 595-6059 E-mail: [email protected] Online store: http://store.camh.ca Website: www.camh.ca Disponible en français sous le titre : Le premier épisode psychotique : Guide pour les personnes atteintes de psychose et leur famille This guide was produced by CAMH Publications.
    [Show full text]
  • Obsessive-Compulsive Disorder. [Revised.) INSTITUTION National Inst
    DOCUMENT RESUME ED 408 729 EC 305 600 AUTHOR Strock, Margaret TITLE Obsessive-Compulsive Disorder. [Revised.) INSTITUTION National Inst. of Mental Health (DHHS), Rockville, Md. REPORT NO NIH-pub-96-3755 PUB DATE Sep96 NOTE 24p. AVAILABLE FROM National Institute of Mental Health, Information Resources and Inquiries Branch, 5600 Fishers Lane, Room 7C-02, Rockville, MD 20857. PUB TYPE Guides Non-Classroom (055) EDRS PRICE MF01/PC01 Plus Postage. DESCRIPTORS *Behavior Disorders; *Behavior Modification; *Disability Identification; *Drug Therapy; Incidence; Intervention; Mental Disorders; *Neurological Impairments; Outcomes of Treatment; *Symptoms (Individual Disorders) IDENTIFIERS *Obsessive Compulsive Behavior ABSTRACT This booklet provides an overview of the causes, symptoms, and incidence of obsessive-compulsive disorder (OCD) and addresses the key features of OCD, including obsessions, compulsions, realizations of senselessness, resistance, and shame and secrecy. Research findings into the causes of OCD are reviewed which indicate that the brains of individuals with OCD have different patterns of brain activity than those of people without mental illness or with some other mental illness. Other types of illness that may be linked to OCD are noted, such as Tourette syndrome, trichotillomania, body dysmorphic disorder and hypochondriasis. The use of pharmacotherapy and behavior therapy to treat individuals with OCD is evaluated and a screening test for OCD is presented, along with information on how to get help for OCD. Lists of organizations that can be contacted and related books on the subject are also provided. Case histories of people with OCD are included in the margins of the booklet. (Contains 11 references.) (CR) ******************************************************************************** Reproductions supplied by EDRS are the best that can be made from the original document.
    [Show full text]
  • “Cat-Gras” Delusion: a Unique Misidentification Syndrome and a Novel Explanation
    Neurocase The Neural Basis of Cognition ISSN: 1355-4794 (Print) 1465-3656 (Online) Journal homepage: http://www.tandfonline.com/loi/nncs20 “Cat-gras” delusion: a unique misidentification syndrome and a novel explanation R. Ryan Darby & David Caplan To cite this article: R. Ryan Darby & David Caplan (2016) “Cat-gras” delusion: a unique misidentification syndrome and a novel explanation, Neurocase, 22:2, 251-256, DOI: 10.1080/13554794.2015.1136335 To link to this article: https://doi.org/10.1080/13554794.2015.1136335 Published online: 14 Jan 2016. Submit your article to this journal Article views: 1195 View related articles View Crossmark data Citing articles: 4 View citing articles Full Terms & Conditions of access and use can be found at http://www.tandfonline.com/action/journalInformation?journalCode=nncs20 Download by: [Vanderbilt University Library] Date: 06 December 2017, At: 06:39 NEUROCASE, 2016 VOL. 22, NO. 2, 251–256 http://dx.doi.org/10.1080/13554794.2015.1136335 “Cat-gras” delusion: a unique misidentification syndrome and a novel explanation R. Ryan Darbya,b,c and David Caplana,c aDepartment of Neurology, Massachusetts General Hospital, Boston, MA, USA; bDepartment of Neurology, Brigham and Women’s Hospital, Boston, MA, USA; cHarvard Medical School, Boston, MA, USA ABSRACT ARTICLE HISTORY Capgras syndrome is a distressing delusion found in a variety of neurological and psychiatric diseases Received 23 June 2015 where a patient believes that a family member, friend, or loved one has been replaced by an imposter. Accepted 20 December 2015 Patients recognize the physical resemblance of a familiar acquaintance but feel that the identity of that KEYWORDS person is no longer the same.
    [Show full text]
  • Understanding Icd-10-Cm and Icd-10-Pcs 3Rd Edition Download Free
    UNDERSTANDING ICD-10-CM AND ICD-10-PCS 3RD EDITION DOWNLOAD FREE Mary Jo Bowie | 9781305446410 | | | | | International Classification of Diseases, (ICD-10-CM/PCS) Transition - Background Palmer B. Manual placenta removal. A: Understanding ICD-10-CM and ICD-10-PCS 3rd edition International Classification of Diseases ICD is a common framework and language to report, compile, use and compare health information. Psychoanalysis Adlerian therapy Analytical therapy Mentalization-based treatment Transference focused psychotherapy. Hysteroscopy Vacuum aspiration. Every code begins with an alpha character, which is indicative of the chapter to which the code is classified. Search Compliance Understanding BC, resilience standards and how to comply Follow these nine steps to first identify relevant business continuity and resilience standards and, second, launch a successful While many coders use ICD lookup software to help them, referring to an ICD code book is invaluable to build an understanding of the classification system. Pregnancy test Leopold's maneuvers Prenatal testing. Endoscopy : Colonoscopy Anoscopy Capsule endoscopy Enteroscopy Proctoscopy Sigmoidoscopy Abdominal ultrasonography Defecography Double-contrast barium enema Endoanal ultrasound Enteroclysis Lower gastrointestinal series Small-bowel follow-through Transrectal ultrasonography Virtual colonoscopy. Psychosurgery Lobotomy Bilateral cingulotomy Multiple subpial transection Hemispherectomy Corpus callosotomy Anterior temporal lobectomy. While codes in sections are structured similarly to the Medical and Surgical section, there are a few exceptions. Send Feedback Do you have Understanding ICD-10-CM and ICD-10-PCS 3rd edition on the new website? Help Learn to edit Community portal Recent changes Upload file. D Radiation oncology. Stem cell transplantation Hematopoietic stem cell transplantation. The primary distinctions are:. Palmer Joseph C.
    [Show full text]
  • Debbie Sookman Is an Outstanding Contribution to the Science and Clinical Practice Related to the Full Range of Obsessive Com- Pulsive Disorder
    Downloaded by [New York University] at 04:59 12 August 2016 “I strongly recommend this expert clinical guide to the psychological treat- ment of obsessive compulsive disorders. The depth of Dr. Sookman’s clinical experience and her command of the literature are evident in the thorough coverage of assessment procedures, how to optimize the effects of therapy and deal with problems. The numerous case illustrations are well-chosen and clearly described.” —S. Rachman, Emeritus Professor, Institute of Psychiatry, London University, and University of British Columbia. “Specialized Cognitive Behavior Therapy for Obsessive Compulsive Disorder: An Expert Clinician Guidebook by Dr. Debbie Sookman is an outstanding contribution to the science and clinical practice related to the full range of Obsessive Com- pulsive Disorder. This is an excellent book in every way imaginable. Clearly written and organized, Sookman provides a critical and scholarly review of the state of the art on OCD. Every researcher and clinician can benefit from this superb book. The reader benefits from the considerable clinical expe- rience and scholarship that Dr Sookman possesses, while learning specific and powerful tools in helping those who suffer from OCD. Case examples illustrate the importance of conceptualization and the value of empirically supported treatments. I am particularly impressed that Sookman was able to balance such sophistication in her critical and scientific understanding of OCD, while still writing a clear and concise book on the topic. This is a book I will recommend to both beginning clinicians in training and to seasoned researchers and practitioners.” —Robert L. Leahy, Ph.D., Director, American Institute for Cognitive Therapy “Dr.
    [Show full text]
  • Analyzing Cohesive Devices in the Students Narrative
    ANALYZING COHESIVE DEVICES IN THE STUDENTS NARRATIVE TEXT WRITTEN BASED ON FRONT OF THE CLASS MOVIE SCRIPT (A Descriptive Research at the Third Semester in Muhammadiyah University of Makassar ) A THESIS Submitted at the Fulfillment to Accomplish Sarjana Degree at Faculty of Teacher Training and Education Makassar Muhammadiyah University MARSELLA 10535661515 ENGLISH EDUCATION DEPARTMENT FACULTY OF TEACHER TRAINING AND EDUCATION MUHAMMADIYAH UNIVERSITY OF MAKASSAR 2020 Jalan Sultan Alauddin No. 259Makassar UNIVERSITAS MUHAMMADIYAH MAKASSAR Telp : 0411-860837/860132 (Fax) FAKULTAS KEGURUAN DAN ILMU PENDIDIKANEmail : [email protected] Web : www.fkp.unismuh.ac.id PRODI PENDIDIKAN BAHASA INGGRIS SURAT PERNYATAAN Saya yang bertandatangan di bawah ini: Nama : Marsella NIM : 10535 6615 15 Jurusan : Pendidikan Bahasa Inggris Judul Skripsi : Analyzing Cohesive Devices In The Students Narrative Text Written Based On Front Of The Class Movie Script Dengan ini menyatakan bahwa skripsi yang saya buat di depan Tim penguji adalah hasil karya saya sendiri bukan hasil ciptaan orang lain atau pun dibuatkan oleh siapa pun. Demikianlah pernyataan ini saya buat dengan sebenar-benarnya dan saya bersedia menerima sanksi apabila pernyataan ini tidak benar. Makassar, 2020 Yang Membuat Pernyataan Marsella Jalan Sultan Alauddin No. 259Makassar UNIVERSITAS MUHAMMADIYAH MAKASSAR Telp : 0411-860837/860132 (Fax) FAKULTAS KEGURUAN DAN ILMU PENDIDIKANEmail : [email protected] Web : www.fkp.unismuh.ac.id PRODI PENDIDIKAN BAHASA INGGRIS SURAT PERJANJIAN Saya yang bertandatangan di bawah ini: Nama : Marsella NIM : 10535 6615 15 Jurusan : Pendidikan Bahasa Inggris Fakultas : Keguruan dan Ilmu Pendidikan Dengan ini menyatakan perjanjian sebagai berikut: 1. Mulai dari penyusunan proposal sampai dengan selesainya skripsi saya, saya akan menyusun sendiri skripsi saya, tidak dibuatkan oleh siapa pun.
    [Show full text]
  • Tic Disorders
    No. 35 May 2012 Tic Disorders A tic is a problem in which a part of the body moves repeatedly, quickly, suddenly and uncontrollably. Tics can occur in any body part, such as the face, shoulders, hands or legs. They can be stopped voluntarily for brief periods. Sounds that are made involuntarily (such as throat clearing, sniffing) are called vocal tics. Most tics are mild and hardly noticeable. However, in some cases they are frequent and severe, and can affect many areas of a child's life. The most common tic disorder is called "transient tic disorder" and may affect up to 10 percent of children during the early school years. Teachers or others may notice the tics and wonder if the child is under stress or "nervous." Transient tics go away by themselves. Some may get worse with anxiety, tiredness, and some medications. Some tics do not go away. Tics which last one year or more are called "chronic tics." Chronic tics affect less than one percent of children and may be related to a special, more unusual tic disorder called Tourette's Disorder. Children with Tourette's Disorder have both body and vocal tics (throat clearing). Some tics disappear by early adulthood, and some continue. Children with Tourette's Disorder may also have problems with attention, and learning disabilities. They may act impulsively, and/or develop obsessions and compulsions. Sometimes people with Tourette's Disorder may blurt out obscene words, insult others, or make obscene gestures or movements. They cannot control these sounds and movements and should not be blamed for them.
    [Show full text]
  • 200750261.Pdf
    View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by Apollo Compulsivity in obsessive-compulsive disorder and addictions Martijn Figeea, Tommy Pattijb, Ingo Willuhna,c, Judy Luigjesa, Wim van den Brinka,d, Anneke Goudriaana,d, Marc N. Potenzae, Trevor W. Robbinsf, Damiaan Denysa,c a Academic Medical Center, Department of Psychiatry, Amsterdam, the Netherlands b Neuroscience Campus Amsterdam, Department of Anatomy and Neurosciences, VU University Medical Center, Amsterdam, The Netherlands. c The Institute for Neuroscience, an institute of the Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands d Amsterdam Institute for Addiction Research, Amsterdam, the Netherlands e Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States; Department of Neurobiology, Yale University School of Medicine, New Haven, CT, United States; Child Study Center, Yale University School of Medicine, New Haven, CT, United States. f Department of Psychology and Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, United Kingdom Please address all correspondence to: Damiaan Denys, M.D., Academic Medical Center, University of Amsterdam, Department of Psychiatry, Postbox 75867, 1070 AW Amsterdam, The Netherlands. E-mail: [email protected] ABSTRACT Compulsive behaviors are driven by repetitive urges and typically involve the experience of limited voluntary control over these urges, a diminished ability to delay or inhibit these behaviors, and a tendency to perform repetitive acts in a habitual or stereotyped manner. Compulsivity is not only a central characteristic of obsessive-compulsive disorder (OCD) but is also crucial to addiction. Based on this analogy, OCD has been proposed to be part of the concept of behavioral addiction along with other non-drug-related disorders that share compulsivity, such as pathological gambling, skin-picking, trichotillomania and compulsive eating.
    [Show full text]
  • Síndrome De Tourette: Uma Análise Biográfica a Partir Do Filme “O Primeiro Da Classe”
    SÍNDROME DE TOURETTE: UMA ANÁLISE BIOGRÁFICA A PARTIR DO FILME “O PRIMEIRO DA CLASSE” Anne Caroline Silva Aires – Graduanda em Pedagogia José Batista de Farias Neto- Graduando em História Martha Valéria Silva Araújo– Graduanda em Pedagogia Adenize Queiroz de Farias- Orientadora Universidade Estadual da Paraíba (UEPB) [email protected] [email protected] [email protected] [email protected] Resumo A Síndrome de Tourette (ST) é uma síndrome neuropsiquiátrica que integra o espectro dos transtornos de tiques. Tiques são vocalizações ou movimentos involuntários, rápidos, não-rítmicos, repetitivos e estereotipados. Partindo deste pressuposto escolhemos o filme “O Primeiro da Classe”, para melhor entender e compreender como ocorre essa síndrome em Brad e como ele reagiu aos preconceitos encontrados na sociedade. Este artigo tem por objetivo analisar os fatores interligando os conteúdos pesquisados sobre a Tourette com os autores Loureiro (2012), Jankovic (2001) e Metz (2007) e com relação ao filme destacando os planos e sequência mais marcantes do mesmo. Nesta situação o filme supracitado traz uma história biográfica de Brad Cohen que desde os seus sete anos de idade sofre rejeições, tanto das instituições de ensino que estudou, quanto pelo seu pai. Na maior parte das vezes, o preconceito é resultado de falta de informação, desconhecimento, ignorância. De fato, algumas pessoas buscam algum tipo de segurança quando escolhem encapsular a diferença de alguém em algum tipo de rótulo. Essas rejeições se davam porque Brad fazer "barulhos", e as pessoas não entendiam, achava que era uma brincadeira de mau gosto e o desprezavam e o castigavam por isso. Brad nunca foi vítima da sua deficiência.
    [Show full text]
  • Final Program
    FINAL PROGRAM 2nd Pan American Parkinson’s Disease and Movement Disorders Congress JUNE 22-24, 2018 MIAMI, FLORIDA, USA www.pascongress2018.org Table of Contents About MDS ...............................................................................................................................................................................................................................................2 About MDS-PAS Section ...........................................................................................................................................................................................................................3 Continuing Medical Education (CME) Information ....................................................................................................................................................................................4 Hilton Miami Downtown Floor Plan .........................................................................................................................................................................................................4 Schedule-At-A-Glance .............................................................................................................................................................................................................................5 Session Definitions ...................................................................................................................................................................................................................................6
    [Show full text]
  • Glossary of Psychological Terms
    Glossary of Psychological Terms From Gerrig, Richard J. & Philip G. Zimbardo. Psychology And Life, 16/e Published by Allyn and Bacon, Boston, MA. Copyright (c) 2002 by Pearson Education. Reprinted by permission of the publisher. http://www.apa.org/research/action/glossary.aspx#b ABCDEFGHIJKLMNOPRSTUVWYZ A A-B-A design Experimental design in which participants first experience the baseline condition (A), then experience the experimental treatment (B), and then return to the baseline (A). Abnormal psychology The area of psychological investigation concerned with understanding the nature of individual pathologies of mind, mood, and behavior. Absolute threshold The minimum amount of physical energy needed to produce a reliable sensory experience; operationally defined as the stimulus level at which a sensory signal is detected half the time. Accommodation The process by which the ciliary muscles change the thickness of the lens of the eye to permit variable focusing on near and distant objects. Accommodation According to Piaget, the process of restructuring or modifying cognitive structures so that new information can fit into them more easily; this process works in tandem with assimilation. Acquisition The stage in a classical conditioning experiment during which the conditioned response is first elicited by the conditioned stimulus. Action potential The nerve impulse activated in a neuron that travels down the axon and causes neurotransmitters to be released into a synapse. Acute stress A transient state of arousal with typically clear onset and offset patterns. Addiction A condition in which the body requires a drug in order to function without physical and psychological reactions to its absence; often the outcome of tolerance and dependence.
    [Show full text]