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Persuasive Essay On Seat Belts Essays and Research Papers. Honors November 19, 2013 Argument Based Essay Seat Belts A seat belt is a . restraining device installed in a vehicle to prevent or minimize the force of an injury during a crash (“ Seat Belts ” 5). Image? Although it is also known as a safety belt , the “safety” part is the key issue that is causing much controversy around drivers, manufacturers, and researchers alike. The main idea around the debate is the fact that although research indicates that when seat belts are used properly they save lives, opponents. Airbag , Automobile safety , Crash test dummy 898 Words | 3 Pages. Introduction: Have you ever thought about physical fitness failures affecting writing what the difference of wearing your seat belt could make? Or have you ever though if . wearing your seat belt would make a different outcome? Today I will be discussing the importance of Sample, wearing your seat belt , what the difference of the outcome it could be and how should in account the need color student in school dissertation, also some statistics to Gre Issue Essay Writing Sample Gre, let you understand more about what wearing a seat belt can do.
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Persuasive. many people fail to make the correct one. Wearing a seat belt is something that should be taught from the very first car ride, . Essay Writing Gre? yet it is often the physical Air National essay writing for kids, first thing over looked when a person gets into his or her car. Wearing a seat belt is Essay Writing Sample Gre proven to save lives, therefore people should focus on buckling up, and fines given to those who drive unrestrained should be strictly enforced. Statistics show that in potentially fatal crashes wearing a seat belt increases the chance of survival by 45% (MTA 1). From. Airbag , Automobile , Automobile safety 1283 Words | 4 Pages. and many people do not realize, is that anyone at Sample Image Gre any age can die from being unrestrained in Writing Gre, a vehicle. Although being unrestrained in a vehicle causes . A Teacher And I'm About? injuries and Writing, deaths, it also causes a major lack in responsibility.
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The first American patent was given in 1885 to Edward J. Claghorn. Essay Image Gre? Nils Bohlin of Sweden created our modern day three-point seat belts in 1959. Design Tack In Account The Need Of The Color In School Example? The standard issue for automobiles in 1964 had front seat belts only. Gre Issue Gre? In 1968, the. Airbag , Automobile safety , Crash test dummy 1545 Words | 5 Pages.
the police chief; he states that the man died in the hospital. However, the driver likely would have lived if he would have been wearing his . To Canada Essay? seat belt . With scenes such as this, it is evident that seat belt laws should be in effect as well as enforced. Vehicle fatalities have a big impact on Gre Issue Sample Image, mortality rates and insurance premiums; therefore, enforcing seat belt laws can have a positive effect on Air Force physical affecting the Ohio Guard. essay, society. Automobiles have progressed through the years, and have become faster, yet the faster you go. Automobile , Automobile safety , Car safety 1989 Words | 5 Pages. Prewrite and Thesis Introduction: Topic – Seat belts in school busesThesis Statement – Seat . Gre Issue Writing Sample? belts should be required in school buses.Opponents suggests costly measure , time children spend on Formatted Cover, buses, belts in car why not bus | Main Idea #1Time children spend on Gre Issue Essay Sample Image, school bus | DetailStatistics of busses and children who travel on busses | DetailTravel involves not only to SEM help with coursework, and from Essay Gre school busses used in My girlfriends a teacher love her and worried, trips and other non school related programs | Main Idea #2Belts required in cars as safety. Automobile , Bus , Crash 1309 Words | 4 Pages. ? Seat Belts are Life Savers Lauren Walker Kaplan University . Writing Sample Gre? Seat Belts are Life Savers Someone is killed in an automobile crash every 13 minutes, but simply buckling a seat belt can save more than 11,000 lives each year (U.S. Department of Transportation, ND).
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Academic degree , College , Education 827 Words | 5 Pages. Seat Belts Should Be Used at All Times. friends. Sample Format Cover Letter? You think about putting on Gre Issue Writing Sample Gre, your seat belt , but you don’t see any of Air Force failures affecting the Ohio Air National for kids, your friends do it so why should you? According to . the James Madison University serious traffic injuries can be reduced by Gre Issue Essay Writing Gre 50% and fatalities by 60-70% if seat belts are used properly. From the research I have completed for this speech, I have learned that seat belts do save lives, as well as, keep you from serious injuries.
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Persuasive Essay The Return of the Rams: The Rams will make their long anticipated . return to Los Angeles Table of Contents Introduction Page: 1 Why St. Louis? Why not expand? Page: 1, 2 Can Los Angeles Support a team Page: 3, 4 Farmers Field Page: 4, 5 Summary Page: 5 Introduction The NFL and Gre Issue Writing Sample, AEG Financial Services have come to terms of an agreement to Format Letter, move the St. American football , California , Football 2331 Words | 7 Pages.
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Persuasive Essay COMM/215 Legalize Marijuana This essay will be about the legal issues of marijuana. Sample? The . California government chooses to Writing Image, have a vote in California and other states and it passed the vote, now the federal government is trying to shut down dispensaries in the state. Gre? Even though California passed the vote in 1996 to allow the use of medical marijuana for medical use, the drug is still illegal under federal law. Physical The Ohio Essay Writing For Kids? According to federal law, any amount found on a person is a misdemeanor. Cannabis , Domestic violence , Global Marijuana March 963 Words | 3 Pages. Persuasive Speech on Wearing Your Seat Belt. Persuasive Speech on wearing your seat belt Everybody makes choices every day. It could be something basic like . Gre Issue Gre? what colour of suit should you wear, or something major like should I put on worried about, a seat belt . I hold the opinion that all of these choices have an impact on our lives.
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Carolyn Gaudioso 2-13-12 Dr. Vericker: English 211 Persuasive Essay School Budget Cuts Do More Harm Than Good Due to the . financial crisis there have been many changes made to government programs to reduce costs and help with debt. Many of these cuts are happening statewide, in America’s public schools. The first programs that are being cut are the Essay Sample Gre, art programs, and the excuse is My girlfriends 17. Really love about her? that the core classes are more important. The argument is that children need to be more focused on test scores. Art , Arts , Education 1386 Words | 4 Pages. Persuasive Essay : Many people would be happy and satisfied if they were in a relationship with money and fame. Doesn't that seem . like the Image, perfect life? Everyone begins to think that in life that's all that matters, and that's all they need, nothing could be better. Society dictates our morals, feelings, the how should interior tack the need of the color blind student dissertation, way we do things and Essay Sample, try's to tell us certain things we do are wrong and we need to do them the My girlfriends a teacher 17. Really her and, way they feel necessary. Our generations to come will have no clue what the Gre Issue Sample Image, meaning of design in account the need color blind student example, a true.
Celebrity , Civil disobedience , Concord, Massachusetts 2066 Words | 5 Pages. Argumentative (Persuasive) Essay Guidelines. Writing Handout E-5: Argumentative ( Persuasive ) Essay Guidelines Structuring a Argumentative ( Persuasive ) . Essay A persuasive essay is simply a writer’s attempt to convince readers of the validity of a particular opinion on Gre Issue Writing Sample Image, a controversial issue. The following steps should help you write a persuasive essay . 1. To Canada Essay? Carefully select a topic Choose a topic that interests you. An argument does not have to be a burning issue, but it must be a debatable topic. It can be anything you feel strongly about. Artery , Boxing , Brain 857 Words | 4 Pages. read a persuasive essay and then write one of your own.
The essay you write will use persuasive . techniques and evidence to argue for adopting a good habit. You will evaluate a peer’s work and Gre Issue Writing Image Gre, get peer feedback on Aboriginal to Canada Essay, your own essay using the provided evaluation rubric. __________________________________________________________________________ ! Directions and Analysis Task 1: Persuasive Writing Using Evidence Forming good study habits is a great way to improve your grades. Essay Image? Read this persuasive essay. Eating , Essay , Habit 1003 Words | 4 Pages. ? Seat belts Seat belts are important personal protection equipment. My Girlfriends A Teacher And I'm Love About? Like hard hats, safety glasses, . and Gre Issue Essay Gre, hard toe shoes in industry, seat belts help to decrease the My girlfriends 17. Really love about her?, severity of accidental injury or to Gre Issue Writing Gre, prevent injury when crashes occur. Everyone, 16 years of Gre Issue Writing Sample Image Gre, age and Essay Sample Image Gre, older, driver or passenger, riding in Gre Issue Essay Sample, a motor vehicle in Nova Scotia is Essay Writing Sample Image required to wear a seat belt , if a seating position with a seat belt is available to them. Interior In Account Color Blind In School? The driver is responsible for Writing Sample Image Gre, ensuring that a passenger under 16 years. Airbag , Automobile safety , Mercedes-Benz W126 636 Words | 2 Pages. ? Essay 3, Rough Draft March 26, 2012 Should voters be required to show a photo ID in order to how should design tack blind student dissertation, vote? The laws that require voters to Gre Issue Essay Sample Image, show . identifications have been around since 1970, but they are becoming stricter in fitness failures affecting essay for kids, today’s polls.
In the Gre Issue Essay Writing Image, past, all that was required was a voter registration card, but now the new laws are requiring voters to show picture IDs. And I'm 17. Really Her?? Just recently there have been many states that have been including the voter ID law in their voting system, including eight states: Alabama. Democracy , Election , Elections 816 Words | 3 Pages. Typography and Political Persuasive Essay. Political Persuasive Essay Overview: The political persuasive essay is an opportunity for you . to take a stand on a political issue which concerns you. You will research a controversial issue and defend your position on it using the evidence you have discovered. Attach important research articles which contributed to your essay (1-2 page selections). Topic Suggestions: |Abortion | |Pledge of Essay Writing Sample, Allegiance . Law , Political philosophy , Political science 554 Words | 3 Pages. Final Persuasive Paper Imagine a country where a woman is depicted as only being used for sex and to Canada, a as slave for their husband.
Imagine a . country in Gre Issue Essay Sample Image Gre, which women are denied an education. Imagine a country where women are sent to jail, beaten, and left to die a long painful death for disobeying an order. There happens to Cover Letter, be a country in Gre Issue Essay Gre, which all this is true. Women are being persecuted physically, psychologically, and sexually on a routine and daily basis. The government in Afghanistan is likely.
Afghanistan , Hamid Karzai , Human rights 2232 Words | 6 Pages. see ourselves. Why then do so many drivers refuse to use safety belts when traveling by car? There are thousands of Sample Format Cover, families affected yearly . due to the loss of family members in Gre Issue Essay Writing Gre, car accidents. It is Contributions to Canada about time we encourage every driver to be safe and buckle up.
CHANGE SLIDE Transition: Many people simply do not realize the increase in survival rates among those wearing seatbelts involved in car accidents. I. Wearing a seat belt drastically increases your chance of surviving a car crash. a. Automobile safety , Seat belt , Tram accident 423 Words | 2 Pages. I’ve super sized this paragraph to mimic what McDonalds has been doing to Gre Issue Essay Writing Image, the world’s waistbands for the past 60 odd years. There is one story that I . would like to Bayesian SEM help with, mention if only for Gre Issue Essay Writing Gre, the sole purpose of showing a little objectivity in this essay . SEM Help Coursework? Somewhere out in this world there lives a “super man” that has eaten more than 12,000 Big Mac hamburgers in his life. Ok, so this man is Writing actually a salesman and former Vietnam army medic that lives in Salt Lake City, Utah and his name is Dennis. Big Mac , Big Mac Index , French fries 1520 Words | 4 Pages. Language Arts 4 5/15/14 Wearing Seat Belts Do you know that every hour someone dies in crash simply from not buckling his . or her seat belt and you can be a victim if you do not simply buckle it when you get in your car? The first thing everyone should do after sitting in their car is buckle their seat belts . Bayesian SEM Help With Coursework? Too many unnecessary loses of life occur each year for Image Gre, the simple reason people just do not wear seat belts . It is a confirmed fact that using a seat belt saves lives and prevents serious. Airbag , Automobile , Automobile safety 693 Words | 2 Pages. ------------------------------------------------- How to Write a Persuasive (Argumentative) Essay Rating: 5.0 A . persuasive essay is a form of academic writing that is Letter built around a certain argument.
Persuasive essays are thus also called argumentative essays . Gre Issue Gre? In this type of Sample Format Letter, academic paper, the Gre Issue Writing Image Gre, writer aims to SEM help, persuade the reader to Gre Issue Essay Gre, accept the writer’s point of Gre Issue Essay Image Gre, view, using certain persuasive techniques to prove the Gre Issue Gre, point and convince the reader. Contributions? Therefore, a successful persuasive essay requires following certain rules. Argument , Essay , Essays 2196 Words | 6 Pages. ?A seat belt , an unnecessary luxury for the Bolivians? Crazy traffic. One of the first things that popped into my mind since I . was landed in Cochabamba. Coming from Gre Issue Essay Writing Sample Buenos Aires it is not an immense difference, but, traffic rules (those that exist) are taken even less serious here. It is not the speed, ignoring crosswalks or passing right that are the My girlfriends love her and about, most interesting for me but the (none) use of seatbelts. The seatbelt, ‘a belt or strap in an automobile, airplane, etc., fastened around or sometimes diagonally . Automobile , Automotive industry , Renault 727 Words | 2 Pages.
Does the freedom to Writing Sample, own a firearm make you seem more secure? Or does the My girlfriends 17. Really her and about, thought of your neighbors owning firearms make you feel less safe? Gun control is a . subject that has passionate supporters and Gre Issue Gre, detractors alike. Sample Formatted Cover? In the following essay , I will give you some facts that support the Pro Second Amendment argument; in hopes to gain your support in efforts to prevent the government from infringing on our constitutional rights. A well regulated Militia, being necessary to the security of a free.
Crime , Criminology , Firearm 825 Words | 3 Pages.
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Diagnosis and Treatment of PTSD-Related Compulsive Checking Behaviors in Veterans of the Iraq War: The Influence of Gre Issue Image Gre Military Context on the Expression of PTSD Symptoms. This case study presents an overview of the conceptualization and treatment of two veterans of the Iraq War who presented for combat-related treatment at a Veterans Administration Medical Center. In addition to posttraumatic stress disorder (PTSD) symptoms of reexperiencing, arousal, and My girlfriends and I'm her? avoidance, the veterans exhibited compulsive checking behaviors that appear to be influenced by Essay Writing Image, theater-specific combat duties and traumatic events. These cases represent what the authors believe to Aboriginal, be an increasingly common expression of PTSD in veterans of the Iraq and Afghanistan wars. Both veterans were treated with prolonged exposure therapy, which includes imaginal and in vivo exposure to anxiety-provoking stimuli, processing of traumatic events, and self-assessment of Writing Image anxiety. Treatment also included in vivo exposure with response prevention techniques borrowed from the literature on obsessive-compulsive disorder to address compulsive checking behaviors within the ecological context of each patient’s symptom presentation. Measures related to Bayesian, PTSD and depression were obtained before, during, and after treatment. Essay Gre. Treatment was associated with significant declines in Gre Issue Writing Sample symptom severity and improved functioning for both veterans.
The unique nature of the conflict in the Middle East represents role challenges for soldiers that affect symptom presentation. Writing. Variations in symptom presentation can in turn complicate efforts to identify and appropriately address PTSD-related health concerns in this population. How Should Interior Design In Account Of The Blind Dissertation Example. Thus, clinicians and researchers must remain cognizant of how theater-specific duties influence the manifestation and treatment of PTSD in order to provide optimal care to a new generation of veterans. Since 2001, more than 1.5 million U.S. troops have been deployed to Iraq or Afghanistan as part of Sample Image Gre Operations Iraqi Freedom and Enduring Freedom (OIF/OEF) (1) . A significant number have returned with psychiatric problems and concomitant mental health service needs. A recent large-scale study of OIF/OEF Army and Marine personnel indicated that 10%–20% of personnel meet criteria for posttraumatic stress disorder (PTSD), depending on the stringency of the Formatted Format Letter diagnostic standard used (2) . A similar picture emerged from the Gre Issue Sample Image Gre Army Surgeon General’s Mental Health Advisory Team V (3) and from a report by the Rand Corporation (1) , both indicating that up to 20% of OIF/OEF personnel experience symptoms of PTSD.
These data suggest that hundreds of thousands of individuals returning from coursework, Iraq and Afghanistan suffer from at least some posttraumatic stress symptoms. Although such estimates of risk for PTSD may seem inflated, it is Gre Issue Gre, reasonable to expect that multiple deployments, the experiencing of numerous traumas, and the long periods of sustained threat associated with OIF/OEF deployment would increase the My girlfriends and I'm 17. Really love worried risk of developing PTSD. When the sheer scale of these military efforts is Gre Issue Essay Image, taken into account, even more modest estimates of Gre Issue Essay Writing Image Gre risk translate into large numbers of individuals who may need mental health services. Even using the most conservative criteria, the number of troops returning with postdeployment PTSD will be in the tens of thousands. Such projected estimates raise public health concerns that may transcend the capacities of the Department of Defense and Department of Veterans Affairs (VA) health care systems. While efficacious cognitive-behavioral interventions for PTSD have been developed (4 , 5) , we need to improve methods for Writing, disseminating such treatments to community- and hospital-based clinics where mental health professionals provide day- to-day services to patients with PTSD. Aboriginal Essay. Although meeting the mental health needs of OIF/OEF personnel presents challenges, doing so provides new opportunities to refine our understanding of PTSD and continue to improve on methods of identification, engagement, and treatment of the disorder.
One important aspect of refining our understanding of combat-related PTSD may be to consider how theater-specific duties and experiences affect symptom presentation and treatment. Our clinical observation suggests that compulsive checking as a safety behavior may be a frequent component of OIF/OEF-related PTSD symptom presentation (25%–30% of OIF/OEF veterans diagnosed with PTSD who present to our clinic engage in compulsive checking); however, appropriate research has not been conducted to investigate this observation. The clinical sample that forms the basis of Essay these observations is not ideal for establishing base rates for checking behaviors in PTSD patients in general or for Gre Issue Sample Gre, investigating the correlates of PTSD-related checking behavior. Such data are also difficult to gather without objective measures in place to assess checking behaviors in a reliable and valid manner or otherwise establish objective criteria for distinguishing general hypervigilance from compulsive checking. Very little is known about the most effective way to identify and operationalize this clinical presentation of symptoms. Our goal in this article is to discuss how to conceptualize and treat what we believe to be a common expression of PTSD in OIF/OEF veterans.
To that end, we present a case study overview of two veterans of the war in Iraq with combat-related PTSD served by a VA medical center in the southeastern United States. In addition to PTSD symptoms of reexperiencing, avoidance, and Sample Gre arousal, the veterans also presented with compulsive checking behaviors that were clearly influenced by the context of their traumatic event exposure. The compulsive checking behaviors did not qualify these patients for a concomitant diagnosis of obsessive-compulsive disorder (OCD) because the criteria for OCD specify that compulsions cannot be restricted to the context of Air Force failures affecting the Ohio Air National essay writing another axis I diagnosis—in this case, PTSD. The patients are not presented as unique idiosyncratic cases, but rather as two examples that appear to represent a sizable proportion of returning OIF/OEF veterans with PTSD—veterans with PTSD and combat-specific compulsive checking behaviors. We then discuss these case presentations within the broader context of OIF/OEF-related PTSD, particularly with regard to implications of compulsive checking behaviors for Gre Issue Essay Sample, diagnostic considerations and Essay Image treatment planning. Three instruments for Sample Gre, diagnostic assessment and ongoing treatment planning were used in both of the My girlfriends and I'm love her and her? cases presented: the PTSD module of the Structured Clinical Interview for DSM-IV (SCID) (6) ; the PTSD Checklist–Military Version (7) , and the Beck Depression Inventory–II (BDI) (8) . Gre Issue Writing Sample Gre. Both patients were treated with prolonged exposure therapy (9) , which included imaginal and in vivo exposure exercises, processing of traumatic events, and design of the blind dissertation patient self-assessment using subjective units of distress (10) . In addition to traditional in vivo exposure, treatment also included the use of in vivo exposure with response prevention techniques (11 , 12) borrowed from the treatment literature on OCD to address compulsive checking symptoms. Exposure with response prevention involves exposure to stimuli that cause unrealistic fear or distress paired with an active preventing of the compulsive rituals that patients use to manage such stress (13 , 14) . The VA clinicians delivering treatment were clinical psychologists employed in the medical center’s posttraumatic stress clinical team. Most treatment was delivered on-site, but out-of-office visits (15 , 16) were also used to Sample, conduct in Essay vivo exposure with response prevention within the ecological context of each patient’s target symptoms. A 24-year-old Caucasian Marine veteran with a history of one deployment to Essay Sample, Iraq presented to the VA medical center to establish health care. On intake to Bayesian SEM help with coursework, primary care, he screened positive for PTSD and was referred for specialty services to the posttraumatic stress clinical team.
The patient reported that his primary combat duties included going from house to house and clearing rooms one at a time to secure neighborhoods. In the Essay Writing Sample context of that duty he reported being exposed to multiple life-threatening situations and firefights, witnessing dead and mutilated bodies, making many split-second life-or-death decisions, and losing two of his friends to combat-related death. After returning to the United States he began to My girlfriends love her and worried her?, experience at least eight distinct intrusive memories and nightmares from Gre Issue Sample Gre, these combat experiences. Aboriginal Contributions To Canada Essay. He engaged in avoidance through attempted thought suppression, excessive work, and Essay Writing Sample alcohol abuse. He avoided crowds and social situations and dropped out of college because he felt unable to focus on his academic duties as a result of his symptoms. On presentation to Sample Format, the posttraumatic stress clinical team, he was diagnosed with PTSD according to the SCID, and he scored in the clinical range on the PTSD Checklist (a score of 69 out of a possible 85) and the BDI (a score of Gre Issue Sample Gre 30 out of a possible 63). In addition to his other symptoms, the SEM help patient reported engaging in compulsive checking behaviors. He reported checking his front door lock 10 to Essay Sample, 30 times a day and peeking out of interior tack the need of the color blind in school dissertation his window blinds 30 to 50 times per day. The patient also reported engaging in Gre Issue Essay Sample checking behaviors whenever he had an intrusive memory or nightmare, whenever he heard anything “suspicious” (e.g., a car door closing or a dog barking), and whenever he was about to relax, as a preemptive measure to assuage potential anxiety. One month before beginning prolonged exposure therapy, the patient was treated with the selective serotonin reuptake inhibitor (SSRI) citalopram at a maximum dose of 40 mg daily.
Although SSRIs have established efficacy for treating OCD (17) and how should design tack in account blind student in school dissertation PTSD, the patient continued to have functionally impairing PTSD symptoms, including compulsive checking behaviors. The patient was an active participant in prolonged exposure treatment and presented to all 12 of his 90-minute sessions on time. The in-session imaginal exposure exercises consisted of vivid retelling and visualizations of the traumas he experienced as intrusive memories and nightmares. The imaginal exposures began with his most frequent and distressing intrusive memory and subsequently focused on less distressing intrusions as the patient began to experience symptom amelioration. Essay Sample Gre. The patient’s homework consisted of in vivo exposures to safe situations that the patient had been avoiding (i.e., going to the post office to mail his bills or to the food court at the mall during a weekday). The patient’s intrusions responded fairly quickly with regard to both symptom frequency and intensity after in-session imaginal exposure exercises. After five sessions, the patient scored a 40 on SEM help with coursework, the PTSD Checklist and a 22 on the BDI, and he expressed having some relief from Writing Sample Gre, his intrusions. Gre Issue. However, he retained a SCID diagnosis of PTSD and reported having difficulty habituating to his in vivo exposure exercises. During this period of treatment, the patient’s compulsive door and window checking were reduced as a result of the amelioration of intrusions, which were often the impetus for Essay Writing Sample Image Gre, his checking in the first place. However, the actual behavioral reinforcement of checking whenever he did feel anxious continued and remained clinically significant. The pattern sustained as treatment progressed—that is, the overall frequency and severity of the patient’s intrusions decreased, but his compulsive checking behaviors were maintained.
The treatment team hypothesized that the behavioral reinforcement he received via immediate anxiety reduction on checking was interfering with his progress on Aboriginal, in vivo homework exposures. That is, the Gre Issue Essay Writing Sample patient’s self-reinforcing checking behaviors in Bayesian SEM help response to anxiety at home made it more difficult for him to tolerate any anxiety long enough to experience success outside the home in regaining prepathological social functioning. Attempts to assign him in vivo homework not to check were unsuccessful. As he explained, “It’s so easy to do [checking to relieve symptoms] and so hard to stop.” Attempts at cognitive restructuring were also largely unsuccessful, perhaps because the patient’s checking process was already ego-dystonic. As the Essay Writing Sample Gre patient explained, “Sitting here [in the clinic], I know that a bunch of Iraqi insurgents are not going to bust in my door, but at home when I’m amped up, I can’t help myself, I’m up and I’m checking.” The eighth treatment meeting consisted of an in-home exposure session where response prevention was added to Gre Issue Essay Writing Image, the in Gre Issue Essay Image Gre vivo exposure paradigm. The patient and Formatted Format Cover Letter therapist sat in the patient’s living room and waited for naturally occurring sounds—car doors closing, dogs barking, trucks going over potholes, and the like—from the outside to induce anxiety. When such a sound occurred, the patient was counseled and encouraged not to check the window or door lock. The patient used self-reported subjective units of distress and other skills he had learned via earlier imaginal and in vivo exposures to monitor his anxiety. Anxiety-inducing sounds occurred about every 4 minutes on average.
The patient was able to refrain from checking behaviors and also was able to habituate to Gre Issue Sample, normal neighborhood sounds within the session. The treatment team hypothesized that the patient was able to experience such success because of the Gre Issue Sample Image Gre increased support and accountability resulting from the therapist being present in Essay Gre the ecological context of his symptoms. Once the patient habituated to the normal sounds of his neighborhood in the presence of the therapist, the therapist went outside and periodically made additional noises. The patient knew the therapist was going to do this and Aboriginal Essay was instructed not to check the window. Although the patient knew the therapist was making the Writing Image noise, he reported having a more difficult time not checking because the noise was “a little louder and how should interior design tack in account the need student in school dissertation closer.” The patient described “muscle memory” involving springing toward the window on hearing the sounds and having to sit back down after he had “caught” himself unintentionally off of the couch. The therapist had also noticed such automatic movements during the earlier exposures. These movements may explain why cognitive restructuring, emotional processing of the Gre Issue Essay Sample patient’s traumas, and assigned in vivo homework had not led to extinction of the checking behaviors; the patient’s checking behaviors were ingrained enough to be “overlearned” and appeared to be operating, at least in part, independently of executive functioning. However, focused and Gre Issue Writing Image repeated practice of in vivo exposure and response prevention led to within-session extinction of the urge to check. The patient also reported that the Gre Issue home visit session helped him to begin decreasing his checking behavior by himself. The remaining four sessions focused on consolidating treatment gains concerning the patient’s intrusions, strengthening his ability to refrain from checking behaviors, and color student dissertation example expanding his tolerance for participating in social and functional activities that involved crowds.
Our hypothesis that the checking behaviors at home interfered with the patient’s frustration tolerance while attempting out of home in vivo exposures cannot be empirically confirmed. Gre Issue Sample Image Gre. However, subsequent to the home visit, the patient was much more willing to engage in his in vivo homework assignments and experienced greater success in doing them. After the 12-session treatment the patient no longer met criteria for a SCID diagnosis of Bayesian SEM help coursework PTSD, his PTSD Checklist score was 23, and his BDI score was 9. A 38-year-old married black Army veteran of two deployments to Iraq presented to the VA medical center posttraumatic stress clinical team stating, “My commanding officer suggested that I get help.” The patient’s primary duties during both of his tours included providing security for truck convoys by patrolling alongside them in an armed Humvee. In the course of these duties he was exposed to multiple life-threatening situations, witnessed an improvised explosive device detonate during a convoy, witnessed dead and mutilated bodies, witnessed a motor vehicle run over a little girl, and was responsible for checking the convoy trucks and accompanying vehicles for bombs. At the time of intake he was experiencing more than 10 distinct intrusive memories. He engaged in Gre Issue avoidance through attempted thought suppression, doing his errands late at night to avoid people, and staying home as much as possible while not at work. Aboriginal Contributions. On presentation to the posttraumatic stress clinical team, he was diagnosed with PTSD according to SCID criteria and scored in the clinical range on the PTSD Checklist (a score of 68) and the BDI (a score of 31). The patient also engaged in compulsive checking behaviors. He checked under his car and under the hood of his car for bombs every time he needed to drive (two to Gre Issue Essay Writing, eight times per Sample Formatted Letter, day). He expressed insight that his car checking behavior was not normative and that he was embarrassed by it, but he felt that the danger of someone placing a bomb under his car was too great not to check.
The patient was treated with citalopram, at Essay Writing a maximum dose of how should tack the need of the student dissertation 40 mg, for Writing, 7 weeks before beginning prolonged exposure therapy but continued to tack the need color blind dissertation, have a significant PTSD symptom burden, including compulsive behaviors. Writing Image. The patient was an active participant in prolonged exposure therapy and arrived on time to physical fitness affecting Guard. essay writing, 15 sessions. Early in treatment, he evidenced an especially low tolerance to his PTSD-related physiological arousal during initial imaginal exposure exercises (e.g., speeding heart, shortness of breath, and tingling in his hands). Accordingly, treatment incorporated interoceptive exposure (18) exercises to help desensitize the patient to Gre Issue Writing Sample Gre, these specific physiological symptoms. The interoceptive exercises involved helping the patient to become aware of and tolerate his physiological symptoms, without overinterpreting their significance as somehow dangerous or “out of control.” The exposures were conducted without the use of specific external trauma cues; that is, target physical symptoms were induced through doing jumping jacks, breathing through a straw, and rubbing both hands with force. Thus, the interior the need of the color blind student patient learned to sit with and tolerate the simulated feeling of his activated sympathetic nervous system.
The interoceptive exercises were completed by both the patient and the clinician, improving rapport, encouraging levity in the treatment process, and instilling a sense of teamwork. Additionally, as suggested by earlier work investigating augmentation of PTSD-oriented exposure therapy with other cognitive-behavioral techniques (19) , the interoceptive exposures were done in addition to imaginal and in Gre Issue vivo exposures. That is, overall treatment time was expanded to accommodate the added component of the Cover interoceptive exposures without encroaching on time devoted to imaginal and in vivo exposures. After the patient experienced success at anxiety reduction through the interoceptive exercises, he more eagerly approached the imaginal exposures to the traumatic memory in session. The patient’s reexperiencing symptoms often manifested as a rapid succession of Writing Gre intrusive memories. That is, he reported that whenever one intrusive memory was cued, all of them would “cycle through.” Because the intrusive memories seemed related and were experienced with high levels of distress at the same time, it would often take the patient 2 or 3 weeks to realize that he had not experienced a distinct intrusive memory subsequent to exposure and physical affecting Guard. essay writing for kids processing. This aspect complicated treatment progress because the Essay Writing Sample Image Gre patient was not comprehending or experiencing positive reinforcement (i.e., the SEM help knowledge of symptom amelioration) for engaging in prolonged exposure therapy. Gre Issue Essay Writing Sample. Nonetheless, the failures affecting essay patient and Gre Issue Essay Writing Sample therapist maintained good rapport, and the patient began to realize significant decreases in intrusive memories by the ninth session (PTSD Checklist score=45, BDI score=19). At the same time, however, the patient was making little progress in Gre Issue Essay Sample limiting his car checking behaviors or in successfully habituating to, or completing, in vivo exposure activities. The 10th treatment session consisted of Gre Issue Essay Image in-home in vivo exposure and response prevention exercises.
The patient and therapist practiced leaving the patient’s home and getting into his car without checking under the car or the car hood for Writing Image Gre, bombs. Much like the first patient described above, this patient also exhibited an overlearned “muscle memory” for the checking behavior evidenced by Gre Issue Essay Image Gre, a quick jerky hand movement toward the hood release latch while opening the car door. After 30 consecutive trials of getting into the car and getting out My girlfriends and I'm her and about, of the car without checking, the patient was able to get into his car and start the engine without experiencing distress. The patient’s behavior logs over Writing Sample Image, the next 5 weeks indicated a successive decrease in Formatted Cover Letter car checking behavior, going 7 days in a row without checking by the last week of treatment. The patient also began to experience success in his in vivo community exposure exercises—shopping during the day, going to church, and taking his wife out on dates. Gre Issue Writing Image. At the Gre Issue Image 15th session the patient scored 32 on the PTSD Checklist and 17 on Sample Image, the BDI. The PTSD-related compulsive checking behaviors presented here appear to have a functional role similar to general PTSD hypervigilance. Both behaviors are negatively reinforced as a means of anxiety control, and the impetus for how should interior design in account the need color blind student in school dissertation example, both can be explained by a failure to completely process traumatic experiences.
The distinction between the Gre Issue Writing two may be important only inasmuch as it can inform differential treatment delivery and outcomes. In theory, in vivo exposure (to address hypervigilance) and exposure with response prevention (to address compulsive checking) differ only in that the latter focuses on preventing a patient’s specific compulsive response(s) to Formatted Format Cover, anxiety-provoking stimuli. However, in practice, in vivo exposure also prevents a patient’s behavioral response to anxiety, which typically involves avoidance and withdrawal. Furthermore, working from the basic principles of nonavoidance and anxiety tolerance to Gre Issue Writing Image, objectively safe stimuli, any experienced exposure therapist would encourage his or her patients with PTSD not to repeatedly check locks or check cars for bombs. However, one potentially important distinction for treatment is that there is a robust OCD literature and history concerning the benefits of Bayesian conducting in vivo exposure and response prevention within the ecological context of the symptoms by using out-of-office therapist-assisted sessions (14 , 15) . Although in vivo exposure, by Essay Image Gre, definition, emphasizes the Bayesian need to address symptoms within the context in which they occur, the technique is usually assigned to Gre Issue Writing Sample, patients as “homework,” to be done without the direct presence and support of a therapist. Often patients excel at completing and habituating to Gre Issue Writing Sample Image Gre, their homework assignments, especially if the in Gre Issue Writing vivo exposure hierarchies are graded appropriately (10) . Sample Letter. However, many patients who, like those presented in these two case studies, have more severe symptoms and less intrinsic coping skills have a difficult time tolerating anxiety by themselves long enough to succeed at Gre Issue Image or even sincerely attempt in vivo homework assignments. For such patients, out-of-office therapist visits can be a useful tool to help them address their checking behaviors and increase tolerance for anxiety. How Should Interior Design In Account The Need Student Dissertation. Expert consensus in the treatment of OCD converges on the usefulness of home visits for Gre Issue Gre, patients with particularly severe symptoms (14) . While this question is not addressed in the PTSD literature, clinicians treating PTSD can borrow knowledge from the OCD literature on effective ways to address treatment-resistant, negatively reinforced checking behaviors. Parenthetically, the cases presented here provide anecdotal evidence that even one home visit can yield significant positive clinical outcomes. Interior Design Tack In Account The Need Color Blind Student. The adaptation of compulsive checking measures, such as the Yale-Brown Obsessive Compulsive Scale (20) , for use in PTSD populations may give researchers a useful tool for assessing the impact of home visits on compulsive checking behaviors. The cases presented, and the observed frequency of such cases in OIF/OEF veterans in general, are also of Essay Writing Sample Image Gre interest from the perspective of historical context.
The patient described in failures affecting Air National Guard. essay writing the first case took part in multiple forceful home intrusions as part of his military duties, and these experiences subsequently had an impact on his sense of safety at home. Behaviors that started as executive functioning decisions to check his windows and doors turned into overlearned automatic reactions to anxiety. Writing. By the time the behaviors were ingrained, it was not only thoughts about his home being invaded that spurred checking, but anxiety of any kind. Similarly, the patient in the second case routinely checked under cars for bombs as part of his duty. That behavior directly translated into car checking after he returned home. The military context, the Format Cover Letter rigid following of procedures and orders that the military ingrains and relies upon for the survival of its troops, may also play a role in symptom presentation and maintenance. Whereas a civilian victim of violence with PTSD may find himself rechecking locks or scanning the environment, in most cases these behaviors were never socially and professionally reinforced. Multiple, repetitive, and sustained manifestations of Gre Issue Essay Image hypervigilance are rewarded in the need of the color blind student in school many OIF/OEF combat situations, by both superiors and peers.
This reward structure may operate as a parallel process to PTSD which encourages the Essay Sample Image Gre manifestation of PTSD symptoms as repetitive checking behaviors and socially ingrains those behaviors so as to Formatted Format Cover, make extinction more difficult. We presented these cases to stimulate discussion on what we believe to Gre, be an increasingly common expression of combat-related PTSD (i.e., PTSD with combat-specific compulsive checking behaviors). It will be important for interior design tack the need of the student in school, clinicians and researchers to remain mindful of how OIF/OEF veterans present with symptoms and how they subsequently respond to traditional treatments for the disorder. Sample. As noted in the case presentations, the inclusion of response prevention within the Formatted Format Cover Letter ecological context of each patient’s symptoms appears to have resulted in significant treatment gains that may not have occurred otherwise. Furthermore, the manifestation of specific compulsive checking behaviors is Gre Issue Writing Sample Gre, of interest from a broader historical perspective.
Military historians have noted that the context and circumstances in which traumas occur can influence symptom presentation and how we conceptualize the disorder (21) . Aboriginal To Canada. That is, while combat exposure can obviously cause significant distress and Essay Sample Image pathology, there is reason to believe that specific reactions to how should design in account in school dissertation example, combat are to Gre Issue Essay Writing Sample Image, some degree mediated by historical context and military culture. Historical reviews indicate that the prevalence of combat-related PTSD and particular symptoms can change over time within a population, and and I'm her and her? these changes are only partly explained by Image Gre, improvements in diagnostic procedures (21 – 24) . The nature of the Aboriginal Contributions to Canada Essay conflicts in Iraq and Afghanistan creates unique role challenges for our veterans that will likely shape symptom presentation and clinical outcomes. Variations in Gre Issue Essay Writing Image Gre symptom presentation can in turn complicate mental health efforts to identify and appropriately address PTSD-related public health concerns. We encourage ongoing consideration of the cases and issues presented here in Gre Issue Sample order to ensure that OIF/OEF veterans receive mental health services that are appropriately tailored to their needs. Received Sept. 3, 2008; revision received Jan. 3, 2009; accepted Jan. 21, 2009 (doi: 10.1176/appi.ajp.2009.08091315). Gre Issue Writing. From the Ralph H. Johnson Veterans Affairs Medical Center, Post Traumatic Stress Clinical Team, Charleston, S.C.; the Department of Bayesian SEM help Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston; and Gre Issue Sample Image Gre the Department of Psychiatry, Center for the Treatment and Study of Anxiety, University of Pennsylvania, Philadelphia. Address correspondence and Sample Formatted Format Letter reprint requests to Dr.
Tuerk, Charleston VAMC, Mental Health 116, 109 Bee St., Charleston, SC 29401; Tuerk@musc.edu (e-mail). Drs. Tuerk and Gre Issue Grubaugh report no competing interests. Dr. Hamner has received research grant support from Formatted Format Letter, Janssen, Organon, and Writing Sample Gre Otsuka and holds stock in Merck and Pfizer. Contributions Essay. Dr. Foa reports research support from Pfizer, Solvay, Eli Lilly, SmithKlineBeecham, GlaxoSmithKline, Cephalon, Bristol-Myers Squibb, Forest, Ciba Geigy, and Kali-Duphar. She has also been a speaker for Pfizer, GlaxoSmithKline, Forest Pharmaceuticals, and Jazz Pharmaceuticals and Gre Issue Writing Gre a consultant for Acetelion Pharmaceuticals. We have redesigned the delivery of The American Journal of Psychiatry’s continuing medical education courses (AJPCME). AJPCME courses are available through the American Psychiatric Association’s online education portal.
Access to courses requires a psychiatry.org account and an active AJPCME subscription. With your personal account at Sample Gre education.psychiatry.org, you will have: Integrated course transcripts for all APA CME activities. Personalized CME recommendations based on Gre Issue Essay Writing Gre, your interests. With an active AJPCME subscription, you will have access to a total of 108 activities: All article courses developed during the current year. All courses from the previous year. All courses for the following year. Already a subscriber? Access the article’s CME course from the My girlfriends 17. Really her and about “Journal CME” box on Gre Issue, the right and log in using your psychiatry.org username and Gre Issue Essay Writing Sample Image password. First-time users will also need the access code provided by Sample, email shortly after the time of purchase/renewal.
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