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Surgical procedure for subthalamic nucleus stimulation
Published in Hans O Lüders, Deep Brain Stimulation and Epilepsy, 2020
Joshua M Rosenow, Atthaporn Boongird, Nicholas M Boulis, Ali Rezai
If there is any evidence intra-operatively of hemorrhage, such as bleeding from the cannula, irrigation down the cannula is gently performed until the effluent is clear. We have had cases of active intra-operative hemorrhage where this has taken over 90 minutes, but it is crucial to continue as long as the patient is neurologically stable. Clinical hypervigilance is imperative. Any neurological deterioration, such as the onset of lethargy or a new focal deficit, is cause for immediately aborting the procedure and proceeding immediately to the CT scanner. If the patient cannot protect his or her airway, they should be intubated prior to leaving the operating room. Equipment to perform an emergency craniotomy should be readily available at all times.
Suffering and Dysfunction in Fibromyalgia Syndrome
Published in Robert M. Bennett, The Clinical Neurobiology of Fibromyalgia and Myofascial Pain, 2020
Symptom perception in chronic pain may be affected by beliefs of having been “injured.” These beliefs may be associated with the traumatic onset of an illness, and the thought that activity will lead to additional harm and symptom exacerbation. The acknowledgement that symptoms followed a specific pathological cause appears to greatly increase fear (21,22). Hypervigilance may predispose patients to attend selectively to all somatic perturbations that might otherwise be ignored and to avoid activities that they believe will contribute to further problems [i.e., fear avoidance]. Moreover, exposure to noxious agents [events, pathogens] may alter how one interprets physical sensations. Patients may identify any physical sensation as abnormal, harmful, and noxious, thereby increasing anxiety. These changes may, consequently, lower pain threshold and tolerance, increase activity avoidance, and exacerbate general deconditioning and fatigue commonly observed in FMS sufferers.
Psychological Distress in Nursing
Published in Meredith Mealer, Rowan Waldman, Coping with Caring, 2019
PTSD is classified as a trauma-and-stressor-related disorder, which explicitly includes exposure to a traumatic or stressful event. The criteria needed for a diagnosis of PTSD include (a) exposure to a traumatic event (i.e., direct exposure, witnessing the event, learning of an event that happened to a close friend or family member, and repeated exposure to aversive details of a traumatic event), (b) presence of one or more intrusion symptoms (i.e., recurrent, non-volitional memories of the event, nightmares, dissociation), (c) avoidance of reminders of the traumatic event (i.e., places, people, thoughts), (d) negative cognitions and mood associated with event, (e) hypervigilance or sleep disturbances, (f) a duration of symptoms for at least 1 month, (g) clinically significant disturbances in important areas of functioning, and (h) the symptoms and functional impairments are not the result of substance abuse or another medical condition (DSM-V, 2013).
Adolescence and Suicide: Subjective Construction of the Suicidal Process in Young Gay and Lesbian Chileans
Published in Journal of Homosexuality, 2021
Alemka Tomicic, Claudio Martínez, Catalina Rosenbaum, Francisco Aguayo, Fanny Leyton, Juliana Rodríguez, Constanza Galvez, Iside Lagazzi
In this process, the help coming from the adult world, from both the spheres of the school and mental health care, is described as rather clumsy and as something that at times deepens the problem. This is partly due to the fact that, in the experience of these young people, the problem is situated by the adult world as one that concerns their sexual orientation, thus contributing to the context of gender victimization. Particularly, in at least five of the eight cases, the psychologists’ actions are described as discriminatory, ignorant, and characterized by interventions that do not help the patient and which even amplify their problems. We also observed that many of those interventions do not take into account specific themes and motives that preoccupy sexually diverse people. In this context, the possibility of receiving help from a mental health professional is affected by the activation of hypervigilance: It’s frustrating not being able to find a clear answer because I also think that this phenomenon, becoming aware that you are homosexual, and starting to get depressed is very likely to keep others from finding out and if someone finds out it’s like the problem gets worse. Putting a psychologist in the middle of all this also makes you (I experienced that) deal with it as if it was another threat, I mean it’s like the psychologist came to treat you as if you were sick (The Secret, Gay).
Towards A Better Understanding of Hypervigilance in Combat Veterans
Published in Military Behavioral Health, 2019
Hypervigilance, defined as “an increase in attention to threatening, potentially threatening, or trauma-relevant stimuli” (Kimble, Fleming, Bandy, Kim, & Zambetti, 2010, p. 293), is frequently endorsed by combat veterans. Behaviorally, it is characterized as heightened awareness to threatening stimuli manifested by visual scanning, searching for entrances and exits in crowded places, hyper-alertness and checking behaviors, among others (Kimble et al., 2010). It is clinically considered a problematic and persistent symptom in treatment-seeking combat veterans, and often even those who do not meet criteria for PTSD continue to endorse hypervigilance to a higher degree compared to other symptoms (Kimble, Fleming, & Bennion, 2013). A recent case study presented two OEF/OIF veterans who exhibited compulsive checking behaviors related to combat-specific experiences that functioned to reduce anxiety by seeking reassurance of safety measures (Tuerk, Grubaugh, Hamner & Foa, 2009). The authors concluded that not only are hypervigilance behaviors negatively reinforced by the temporary removal of anxiety, but may also be positively reinforced by their training and professional duties. For example, a combat veteran whose job it was to identify threat in a city by scanning and attending to any potential cues will return home with a sense that this is not only his/her job, but a necessary and rewarded behavior.
What is the Current State of Occupational Therapy Practice with Children and Adolescents with Complex Trauma?
Published in Occupational Therapy in Mental Health, 2019
Kerry Fraser, Diane MacKenzie, Joan Versnel
Participants identified that a primary functional concern was the child’s inability to self-regulate in an age-appropriate way, due to a lack of emotional regulation and sensory difficulties impacting all areas of their lives. Hypervigilance, difficulty with self-soothing in adaptive ways, and disengagement were identified. Additionally, participants discussed how complex trauma affected cognitive function. The participants reported that attention, organization, planning, and transitioning from one activity to another in plan and in interactions was challenging for these children and adolescents.