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Despite their widespread use breast cancer journal discount tamoxifen 20mg amex, however womens health 9 diet purchase tamoxifen master card, the empirical evidence supporting the use of projective tests is mixed (Karon women's health clinic puyallup wa buy tamoxifen 20 mg on line, 2000; Wood, Nezworski, Lilienfeld, & Garb, 2003). The reliability of the measures is low because people often produce very different responses on different occasions. The projective tests often fail to distinguish between people with psychological disorders and those without or to correlate with other measures of personality or with behavior. In sum, projective tests are more useful as icebreakers to get to know a person better, to make the person feel comfortable, and to get some ideas about topics that may be of importance to that person than for accurately diagnosing personality. Trait theories of leadership are theories based on the idea that some people are simply "natural leaders" because they possess personality characteristics that make them effective (Zaccaro, 2007). What characteristics do you think he possessed that allowed him to create such a strong company, even though many similar companies failed? Former President Barack Obama photo courtesy Source Microsoft Chairman Bill Gates photo courtesy Source Illinois Senator Tammy Duckworth photo courtesy Source Research has found that being intelligent is an important characteristic of leaders, as long as the leader communicates to others in a way that is easily understood by his or her followers (Simonton, 1994, 1995). Other research has found that people with good social skills, such as the ability to accurately perceive the needs and goals of the group members and to communicate with others, also tend to make good leaders (Kenny & Zaccaro, 1983). Because so many characteristics seem to be related to leader skills, some researchers have attempted to account for leadership not in terms of individual traits, but rather in terms of a package of traits that successful leaders seem to have. Some have considered this in terms of charisma (Sternberg & Lubart, 1995; Sternberg, 2002). Charismatic leaders are leaders who are enthusiastic, committed, and self-confident; who tend to talk about the importance of group goals at a broad level; and who make personal sacrifices for the group. Charismatic leaders express views that support and validate existing group norms, but that also contain a vision of what the group could or should be. Charismatic leaders use their referent power to motivate, uplift, and inspire others. Another trait-based approach to leadership is based on the idea that leaders take either transactional or transformational leadership styles with their subordinates (Bass, 1999; Pieterse, Van Knippenberg, Schippers, & Stam, 2010). Transactional leaders are the more regular leaders, who work with their subordinates to help them understand what is required of them and to get the job done. Transformational leaders, on the other hand, are more like charismatic leaders as they have a vision of where the group is going, and attempt to stimulate and inspire their workers to move beyond their present status and to create a new and better future. In still other cases, different types of leaders may perform differently in different situations. Leaders whose personalities lead them to be more focused on fostering harmonious social relationships among the members of the group, for instance, are particularly effective in situations in which the group is already functioning well, and yet it is important to keep the group members engaged in the task and committed to the group outcomes. Leaders who are more taskoriented and directive, on the other hand, are more effective when the group is not functioning well and needs a firm hand to guide it (Ayman, Chemers, & Fiedler, 1995). Personality and Culture Culture greatly affects how individuals perceive themselves, and one important distinction is where a culture falls on the continuum between individualism and collectivism (Vazire, 2014). Individualistic cultures, such as the mainstream culture in the United States, focus on the self more than relationships. Additionally, personality differences typically assessed, such as the Big Five, appear less noticeable in collectivistic cultures. However, within any culture there will be some members who exhibit more individualism than collectivism and vice versa. Personality and Mental Health Although they may appear unrelated, personality traits and mental health disorders are often on a continuum (Twenge & Campbell, 2017). The line between what is considered normal and abnormal is due to the quantity of a trait. When in very high amounts, traits (such as narcissism) can result in a mental health diagnosis. Although clinicians prefer to interpret the patterns themselves, a variety of research has demonstrated that computers can often interpret the results as well as clinicians (Garb, 1998; Karon, 2000). Key Takeaways · · · Personality can be assessed using objective measures, including self-report and informant-rating measures. There is often only a low correlation between the specific traits that a person expresses in one situation and those that is expressed in other situations. Personality predicts behavior better when the behaviors are aggregated or averaged across different situations. Projective measures of personality show participants unstructured stimuli, such as inkblots, drawings of social situations, or incomplete sentences, and ask them to freely list what comes to mind as they think about the stimuli.
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The male-to-female ratio for prevalence is even more highly skewed toward males than for obstructive sleep apnea hypopnea pregnancy zantac generic 20mg tamoxifen with mastercard. Cheyne-Stokes breath ing occurs in approximately 20% of individuals with acute stroke breast cancer types discount 20mg tamoxifen amex. Central sleep apnea comorbid with opioid use occurs in approximately 30% of individuals taking chronic opi oids for nonmalignant pain and similarly in individuals receiving methadone mainte nance therapy menstrual tracker app buy discount tamoxifen 20 mg. Development and Course the onset of Cheyne-Stokes breathing appears tied to the development of heart failure. The Cheyne-Stokes breathing pattern is associated with oscillations in heart rate, blood pres sure and oxygen desaturation, and elevated sympathetic nervous system activity that can promote progression of heart failure. The clinical significance of Cheyne-Stokes breathing in the setting of stroke is not known, but Cheyne-Stokes breathing may be a transient find ing that resolves with time after acute stroke. Central sleep apnea comorbid with opioid use has been documented with chronic use. The coexistence of atrial fibrillation further increases risk, as do older age and male gender. Cheyne-Stokes breathing is also seen in association with acute stroke and possibly renal failure. The underlying ventilatory instability in the setting of heart fail ure has been attributed to increased ventilatory chemosensitivity and hyperventilation due to pulmonary vascular congestion and circulatory delay. Diagnostic l/larl(ers Physical findings seen in individuals with a Cheyne-Stokes breathing pattern relate to its risk factors. Findings consistent with heart failure, such as jugular venous distension, S3 heart sound, lung crackles, and lower extremity edema, may be present. Polysonmography is used to characterize the breathing characteristics of each breathing-related sleep disorder subtype. Central sleep apneas are recorded when periods of breathing cessation for longer than 10 seconds occur. Cheyne-Stokes breathing is characterized by a pattern of periodic crescendo-decrescendo variation in tidal volume that results in central apneas and hypopneas occurring at a frequency of at least five events per hour that are accompa nied by frequent arousals. The cycle length of Cheyne-Stokes breathing (or time from end of one central apnea to the end of the next apnea) is about 60 seconds. Functional Consequences of Central Sleep Apnea Idiopathic central sleep apnea has been reported to cause symptoms of disrupted sleep, in cluding insomnia and sleepiness. Cheyne-Stokes breathing with comorbid heart failure has been associated with excessive sleepiness, fatigue, and insomnia, although many in dividuals may be asymptomatic. Coexistence of heart failure and Cheyne-Stokes breath ing may be associated with increased cardiac arrhythmias and increased mortality or cardiac transplantation. Individuals with central sleep apnea comorbid with opioid use may present with symptoms of sleepiness or insomnia. Differential Diagnosis Idiopathic central sleep apnea must be distinguished from other breathing-related sleep disorders, other sleep disorders, and medical conditions and mental disorders that cause sleep fragmentation, sleepiness, and fatigue. Central sleep apnea can be distinguished from obstructive sleep apnea hypopnea by the presence of at least five central apneas per hour of sleep. These conditions may co-occur, but central sleep apnea is considered to predominate when the ratio of central to obstructive respiratory events ex ceeds 50%. Cheyne-Stokes breathing can be distinguished from other mental disorders, including other sleep disorders, and other medical conditions that cause sleep fragmentation, sleep iness, and fatigue based on the presence of a predisposing condition. Polysomnographie respiratory findings can help distinguish Cheyne-Stokes breathing from insomnia due to other medical conditions. High-altitude periodic breathing has a pattern that resembles Cheyne-Stokes breathing but has a shorter cycle time, occurs only at high altitude, and is not associated with heart failure. Central sleep apnea comorbid with opioid use can be differentiated from other types of breathing-related sleep disorders based on the use of long-acting opioid medications in conjunction with polysomnographic evidence of central apneas and periodic or ataxic breathing. It can be distinguished from insomnia due to drug or substance use based on polysomnographic evidence of central sleep apnea. Comorbidity Central sleep apnea disorders are frequently present in users of long-acting opioids, such as methadone.
The central nervous system pregnancy spotting purchase tamoxifen 20mg on-line, Bowlby suggests womens health 5 minute workout order tamoxifen line, is organized in a loosely hierarchical way womens health upenn purchase tamoxifen american express, with an enormous network of two-way communications among subsystems. At the top of the hierarchy, he posits one or perhaps several principal evaluators or controllers, closely linked to long-term memory. If evaluated as relevant, it may be stored in short-term memory to select aspects thereof for further processing. Conscious processing is likely to facilitate high-level activities such as categorizing, retrieving, comparing, framing plans, and inspection of overlearned, automated action systems. In a unified personality, Bowlby claims, the principal system or systems can access all memories in whatever type of storage they are held. However, in some cases, the principal system or systems may nor be unified or capable of unimpeded intercommunication with all subsystems. In this case, particular behavioral systems may not he activated when appropriate, or signals from these behavioral systems may not become conscious, although fragments of defensively excluded information may at times seep through. Some of the dissociative or repressive phenomena involved in the deactivation of the attachment system occur during pathological mourning. For example, complete or partial disconnection of an emotional response from its cause is frequent. When the disconnection is only partial, emotional responses may be directed away from the person who caused them to third persons or to the self. I knee, a bereaved person may become morbidly preoccupied with personal reactions and sufferings, rather than attributing his or her feelings to the loss of a close relationship. The individual may he taking the role of attachment figure instead of seeking care. Attachment and Therapy this discussion of defensive processes leads into the topic that preoccupied Bowlby during the last 10 years of his life: the uses of attachment theory in psychotherapy (Bowlby, 1988), Under attachment theory, a major goal in psychotherapy is the reappraisal of inadequate, outdated working models of self in relation to attachment figures, a particularly difficult task if important others, especially parents, have forbidden their review. As psychoanalysts have repeatedly noted, a person with inadequate, rigid working models of attachment relations is likely to inappropriately impose these models on interactions with the therapist (a phenomenon known as transference). Three distinct patterns of responding were identified: Autonomous-secure parents gave a clear and coherent account of early attachments (whether these had been satisfying or not); preoccupied parents spoke of many conflicted childhood memories about attachment but did not draw them together into an organized, consistent picture; and, finally, dismissing parents were characterized by an inability to remember much about attachment relations in childhood. These findings have since been validated for prenatally administered interviews by Fonagy, Steele, and Steele (1991) and by Ward et al. Consonant findings were also obtained in a study of young adults in which Adult Attachment Interview classifications were correlated with peer reports (Kobak & Sceery, 1988). In addition, representational measures of attachment have been devised for use with children. A pictorial separation anxiety test for adolescents, developed by Hansburg (1972), was adapted for younger children by Klagsbrun and Bowlby (1976) and more recently revised and validated against observed attachment patterns by Kaplan (1984) and Slough and Greenberg (1991) Likewise, attachment-based doll story completion tasks for preschoolers were validated against behavioral measures by Bretherton, Ridgeway, and Cassidy (1990) and Cassidy (1988). In these tests, emotionally open responding tended to be associated with secure attachment classifications or related behaviors. Finally, several authors have created interviews that examine attachment from the parental as opposed to the filial perspective. Attachment Across the Life Span A related topic, attachment relationships between adults, began in the early 1970s, with studies of adult bereavement (Bowlby & Parkes, 1970; Parkes, 1972) and marital separation (Weiss, 1973, 1977). Finally, Cicirelli (1989, 1991) has applied attachment theory to the study of middle-aged siblings and their elderly parents. Much future work will be needed to delineate more fully the distinct qualities of child-adult, child-child, and adult-adult attachment relationships (see Ainsworth, 1989), as well as their interplay within the family system, a task begun by Byng-Hall (1985) and Marvin and Stewart (1990), Attachment and Developmental Psychopathology Attachment theory and research are also making a notable impact on the emerging field of developmental psychopathology (Sroufe, 1988), with longitudinal attachment-based studies of families with depression (Radke-Yarrow, Cummings, Kuczinsky, & Chapman, 1985), of families with maltreatment. Much of this work is represented in a volume on clinical implications of attachment (Belsky & Nezworski, 1988). The Ecology of Attachment Although we have made progress in examining mother-child attachment, much work needs to he done with respect to studying attachment in the microsystem of family relationships (Bronfenbrenner, 1979). Despite studies by Belsky, Gilstrap, and Rovine (1984), Lamb (1978), and Parke and Tinsley (1987) that show fathers to be competent, if sometimes less than fully participant attachment figures, we still have much to learn regarding father attachment. Another important topic, sibling attachment, has been tackled by a few researchers.
Psychologically women's health center gretna cheap 20 mg tamoxifen amex, sexuality arises from the desire to obama's view on women's health issues buy 20mg tamoxifen with visa be sexual with a particular person women's health clinic hampton park order tamoxifen 20 mg free shipping, in a certain situation, at a specific moment. Fantasies and thoughts, body image, the subjective sense of being male or female-all of these factors and others influence sexuality. Woody Allen once commented that his favorite part of masturbation was the cuddling afterward. This joke only serves to emphasize that sexuality is ultimately social: It involves relationships. Sexuality is influenced by general emotional satisfaction with a partner, how satisfied the partner has been, the context of a particular sexual encounter, moral and religious teachings about sexuality, and cultural views of appropriate sexual behavior (Malatesta & Adams, 2001). All of these conditions and circumstances are ultimately rooted in social factors. Abnormalities in sexuality and sexual behavior are also influenced by neuropsychosocial factors. Similarly, some individuals may have sexual fantasies that disturb them, or they may have difficulties with sexual functioning that lead Paraphilias What Are Paraphilias? Levine/Newscom What is viewed as normal and abnormal sexuality is partly based on the cultural views of appropriate sexual behavior. In addition, families, communities, or cultures determine which sexual fantasies, urges, and behaviors are considered "deviant" or "abnormal. Moreover, like most other psychological problems and disorders, normal and abnormal sexuality and sexual behavior fall on a continuum. Simply having unusual or "deviant" sexual fantasies or engaging in unusual sexual behaviors is not generally sufficient for a diagnosis. That said, some disorders have predominantly neurological and other biological criteria (the sexual dysfunctions) whereas others have primarily psychological and social criteria (the paraphilias and gender identity disorder). Gender identity disorder A psychological disorder characterized by a cross-gender identification that leads the individual to be chronically uncomfortable with his or her biological sex. Gender role the outward behaviors, attitudes, and traits that a culture deems masculine or feminine. Gender Identity Disorder Last year, Mike became confused when his good friend, Sam, began to dress like and live as a woman. In fact, Sam was changing his name to Sandy and would, within the next couple of years, have surgery to acquire female genitals. Seeing Sam as a woman made Mike uncomfortable, and now they only saw each other occasionally. Mike found himself wondering what life-and sex-had been like for Sam, and what it was like now for Sandy. Alaska Stock Images Gender and Sexual Disorders 4 7 5 What Is Gender Identity Disorder? Like Sam, a small percentage of people who are born one sex (either a biological female or a biological male) do not feel comfortable with their corresponding gender identity. For instance, there are people like Sam, who have normal male sexual anatomy but feel as if they are female. Conversely, there are people with normal female anatomy who feel as if they are male. For people with these feelings, their sense of their gender identity does not correspond to their biological sex, a condition known as cross-gender identification. Such individuals are said to have a gender identity disorder, a cross-gender identification that leads them to be chronically uncomfortable with their biological sex. A strong and persistent cross-gender identification (not merely ways that are typical of children of the other gender. That is, they wish to a desire for any perceived cultural advantages of being the other behave in accordance with the gender role of the other sex; gender role sex). In adolescents and adults, the disturbance is manifested by refers to the outward behaviors, attitudes, and traits that a culture deems symptoms such as a stated desire to be the other sex, frequent masculine or feminine. For instance, gender roles for females often allow passing as the other sex, desire to live or be treated as the other a wider variety of emotions (anger, tears, and fear) to be displayed in sex, or the conviction that he or she has the typical feelings and reactions of the other sex.
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