Seasonal Affective Disorder

Seasonal affective disorder (SAD), also known as winter depression or winter blues, is a mood disorder in which people who have normal mental health throughout most of the year, experience depressive symptoms in the winter or, less frequently, in the summer,spring or autumn, repeatedly, year after year. In the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), SAD is not a unique mood disorder, but is "a specifier of major depression". Once regarded skeptically by the experts, seasonal affective disorder is now well established. Epidemiological studies estimate that its prevalence in the adult population of the US ranges from 1.4 percent (Florida) to 9.7 percent (New Hampshire). Social Worker Continuing Education
The US National Library of Medicine notes that "some people experience a serious mood change when the seasons change. They may sleep too much, have little energy, and may also feel depressed. Though symptoms can be severe, they usually clear up." The condition in the summer is often referred to as reverse seasonal affective disorder, and can also include heightened anxiety.

SAD was first formally described and named in 1984 by Norman E. Rosenthal and colleagues at the National Institute of Mental Health.

There are many different treatments for classic (winter-based) seasonal affective disorder, including light therapy with sunlight or bright lights, antidepressant medication, cognitive-behavioral therapy, ionized-air administration,and carefully timed supplementation of the hormone melatonin.

Symptoms

Symptoms of SAD may consist of difficulty waking up in the morning, morning sickness, tendency to oversleep as well as to overeat, and especially a craving for carbohydrates, which leads to weight gain. Other symptoms include a lack of energy, difficulty concentrating on completing tasks, and withdrawal from friends, family, and social activities. All of this leads to the depression, pessimistic feelings of hopelessness, and lack of pleasure which characterize a person suffering from this disorder.

Diagnostic criteria

According to the American Psychiatric Association DSM-IV criteria, Seasonal Affective Disorder is not regarded as a separate disorder. It is called a "course specifier" and may be applied as an added description to the pattern of major depressive episodes in patients with major depressive disorder or patients with bipolar disorder. The "Seasonal Pattern Specifier" must meet four criteria: depressive episodes at a particular time of the year; remissions or mania/hypomania at a characteristic time of year; these patterns must have lasted two years with no nonseasonal major depressive episodes during that same period; and these seasonal depressive episodes outnumber other depressive episodes throughout the patient's lifetime. The Mayo Clinic describes three types of SAD, each with its own set of symptoms. In the popular culture, sometimes the term "seasonal affective disorder" is applied inaccurately to the normal shift to lower energy levels in winter, leading people to believe they have a physical problem that should be addressed with various therapies or drugs.

Physiology

Seasonal mood variations are believed to be related to light. An argument for this view is the effectiveness of bright-light therapy. SAD is measurably present at latitudes in the Arctic region, such as Finland (64º 00´N) where the rate of SAD is 9.5%. Cloud cover may contribute to the negative effects of SAD.

The symptoms of SAD mimic those of dysthymia or even major depressive disorder. There is also potential risk of suicide in some patients experiencing SAD. One study reports 6-35% of sufferers required hospitalization during one period of illness. At times, patients may not feel depressed, but rather lack energy to perform everyday activities.

Various proximate causes have been proposed. One possibility is that SAD is related to a lack of serotonin, and serotonin polymorphisms could play a role in SAD, although this has been disputed. Mice incapable of turning serotonin into N-acetylserotonin (by Serotonin N-acetyltransferase) appear to express "depression-like" behavior, and antidepressants such as fluoxetine increase the amount of the enzyme Serotonin N-acetyltransferase, resulting in an antidepressant-like effect. Another theory is that the cause may be related to melatonin which is produced in dim light and darkness by the pineal gland, since there are direct connections, via the retinohypothalamic tract and the suprachiasmatic nucleus, between the retina and the pineal gland.

Subsyndromal Seasonal Affective Disorder is a milder form of SAD experienced by an estimated 14.3% (vs. 6.1% SAD) of the U.S. population. The blue feeling experienced by both SAD and SSAD sufferers can usually be dampened or extinguished by exercise and increased outdoor activity, particularly on sunny days, resulting in increased solar exposure. Connections between human mood, as well as energy levels, and the seasons are well documented, even in healthy individuals. Mutation of a gene expressing melanopsin has been implicated in the risk of having Seasonal Affective Disorder.

Winter Wellness Plan

Developed by CSP-NJ Institute for Wellness 2
and Recovery Initiatives – John Garafano, BS, CPRP, CFT , Jay Yudof, MS, CPRP & Peggy Swarbrick, PhD, OT,CPRP -December 2010

Winter Memories

Many of us may have good memories of winter/holiday gatherings, and/or outdoor winter recreation. Some people face challenges including isolation, limited ability to exercise, memories of losses, overeating, and overspending. This wellness planner is designed to help you plan ahead so you can maintain a sense of wellness during the winter season.

Describe a positive winter memory.
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What do you see as the benefits of the winter season?
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Holidays

The holiday season, (the holidays) is an annual festive period. Various studies have shown that the winter holiday season can have some impacts on health (social, emotional, physical etc). MFT Continuing Education
What do you like to do during the Holiday Season?
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How do you celebrate the Holiday season?
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Winter Challenges

Winter is the coldest season of the year in temperate climate, between autumn and spring. At the winter solstice, the days are shortest and the nights are longest, with days lengthening as the season progresses after the solstice.
Challenges during the holidays Many holidays occur during the winter months when people are already more susceptible to the common cold, flu, and depressed mood Holidays usually involve the obligation of spending money on gifts or food Alcohol is typically served during holiday functions which can be a trigger for some Holiday travel can be a major source of contention and stress. Dealing with traffic and the short-tempers of other travelers can also be quite challenging Social anxiety may be heightened when we are invited to parties with large gatherings of people.

General Stressors and Triggers

Physical
o Diet and nutrition, physical activity, sleep, Emotional
o Losses may impact harder during winter time Social
o Too much stimuli or may not have a support network so sense of loneliness becomes overwhelming
o Drinking can be a trigger for some people Financial
o Spending can become out of control Spiritual
o Sense of purpose and meaning can be impacted Occupational
o Work routines are altered which can impact rhythm and – over or under productive

What triggers do you face during the holidays?
(Examples include large groups of people, overspending, and alcohol at parties)
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5.

List supporters and how you can connect with them during the holidays?
Supporter Methods to Connect
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Diet and Nutrition Eat several small meals so that you are not starving when it comes time to eat a holiday feast. Drink water before your meal so that you get full faster. Watch portions. Aim to eat mostly vegetables and fruit on your plate and opt out of breads and biscuits. Opt for water instead of soda, alcoholic beverages, or caffeinated drinks. Be aware that many of us get less fresh fruit and vegetables during winter months – look for healthy ways to replace these vital nutrients.
Physical Activity and Environment: Walk around a mall with friends Join an exercise class or fitness group in the community Clean your living area Enjoy outdoor winter activities Exercise extra care to prevent slips and other winter injuries, and make sure that kids and elders do the same Health Care Practice good prevention for colds and flu such as frequent hand washing If you follow self-management for a chronic health condition, don’t let holiday events, meals. Travel, etc. let you get derailed
Family, Friends, and Supporters: Consider who in your support network is a positive supporter and who might be unhealthy for you Decide on how much socialization time you need in order to feel well Make holiday get-togethers a positive opportunity to renew acquaintances with family and friends you may not see or speak with very often Make attempts to “give back” whenever possible

Finances: Plan ahead in terms of spending and know your limits Consider ways to give gifts other than spending money

Rest/Relaxation: Know your limits and plan ahead for proper balance of sleep, relaxation, and activity. Try to get enough sleep/rest each night, and avoid oversleeping during the winter months

Spiritual: Attend spiritual gatherings and celebrate in the holiday season Find ways to express gratitude each day

Expressive Art: Art can be a great way to express yourself during the holidays Consider attending a museum or holiday light show Attend a play with a holiday theme Think about combining friends/family and expressive arts – do a project or go to a show with some of the kids (young and old) in your life. MFT Continuing Education
When considering our holiday/winter wellness, it is a good idea to think of the self-care practices that we need in order to feel well and maintain/improve our overall health status. Activities like exercise, spiritual connection, social contact, and reading can all be tools that help us to stay well during the winter season. List your top five strategies for staying well this season:

Wellness Strategy How often I will do it When I will start
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The American Social Worker’s Code of Ethics

Social Worker Continuing Education is vital to ongoing responsible professional clinical practice. This includes but is not limited to LCSW Continuing Education, ASW Continuing Education, and LSW Continuing Education.
The social work profession established roots within a set of core values. These core values, embraced by social workers throughout the profession’s history, are the foundation of social work’s unique purpose and perspective:

• service
• social justice
• dignity and worth of the person
• importance of human relationships
• integrity
• competence

NASW Code of Ethics

Professional ethics are integral to the practice of social work. Social Workers have a responsibility to articulate core values and ethics. The NASW Code of Ethics was designed to help define these values and ethics. The Code of Ethics impacts all social workers and social work students in guiding their professional conduct.
The NASW Code of Ethics has several purposes including:
The Code identifies core values on which social work’s mission is based.
The Code summarizes broad ethical principles that reflect the profession’s core values and establishes a set of specific ethical standards that should be used to guide social work practice.

The Code is designed to help social workers identify relevant considerations when professional obligations conflict or ethical uncertainties arise.
The Code provides ethical standards to which the general public can hold the social work profession accountable.

The Code socializes practitioners new to the field to social work’s mission, values, ethical principles, and ethical standards. The Code articulates standards that the social work profession itself can use to assess whether social workers have engaged in unethical conduct. NASW has formal procedures to adjudicate ethics complaints filed against its members.* In subscribing to this Code, social workers are required to cooperate in its implementation, participate in NASW adjudication proceedings, and abide by any NASW disciplinary rulings or sanctions based on it.

Code of Ethics Summary
The Social Worker's Conduct as a Social Worker
• Propriety. The social worker maintains high standards of conduct in the capacity or role as a social worker.
• Competence and Professional Development. The social worker should strive to remain proficient in professional practice and professional functions.
• Service. The social worker should regard as primary the service obligation of the social work profession.
• Integrity. The social worker should act in accordance with the highest standards of professional integrity.
• Scholarship and Research. The social worker engaged in study and research should be guided by the conventions of scholarly inquiry.

The Social Worker's Ethical Responsibility to Clients
• Primacy of Clients' Interests. The social worker's primary responsibility is to clients.
• Rights and Prerogatives of Clients. The social worker should make every effort to foster maximum self-determination on the part of clients.
• Confidentiality and Privacy. The social worker should respect the privacy of clients and hold in confidence all information obtained in the course of professional service.
• Fees. When settling fees, the social worker should ensure that they are fair, reasonable, considerate and commensurate with the service performed and with due regard for the clients' ability to pay.

The Social Worker's Ethical Responsibility to Colleagues
• Respect, Fairness, and Courtesy. The social worker should treat colleagues with respect, courtesy, fairness, and good faith.
• Dealing with Colleagues' Clients. The social worker has the responsibility to relate to the clients of colleagues with full professional consideration.
The Social Worker's Ethical Responsibility to Employers and Employing Organizations
• Commitments to Employing Organizations. The social worker should adhere to commitments made to the employing organizations.
The Social Worker's Ethical Responsibility to the Social Work Profession
• Maintaining the Integrity of the Profession. The social worker should uphold and advance the values, ethics, knowledge, and mission of the profession.
• Community Service. The Social Worker should assist the profession in making social services available to the general public.
• Development of Knowledge. The social worker should take responsibility for identifying, developing, and fully utilizing knowledge for professional practice.

The Social Worker's Ethical Responsibility to Society
• Promoting the General Welfare. The social worker should promote the general welfare of society.

For more information on Social Work Ethics, visit Social Worker Continuing Education

Holiday Family Safety

The holidays are a time to celebrate, give thanks, and reflect. They are also a time to pay special attention to your health. Give the gift of health and safety to yourself and others by following these holiday tips.

Wash your hands often.
Keeping hands clean is one of the most important steps you can take to avoid getting sick and spreading germs to others. Wash your hands with soap and clean running water for at least 20 seconds. If soap and clean water are not available, use an alcohol-based product.

Clean Hands Save Lives


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Stay warm.
Cold temperatures can cause serious health problems, especially in infants and older adults. Stay dry, and dress warmly in several layers of loose-fitting, tightly woven clothing.


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Manage stress.
The holidays don’t need to take a toll on your health. Keep a check on over-commitment and over-spending. Balance work, home, and play. Get support from family and friends. Keep a relaxed and positive outlook.


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Travel safely.
Whether you're traveling across town or around the world, help ensure your trip is safe. Don’t drink and drive, and don’t let someone else drink and drive. Wear a seat belt every time you drive or ride in a motor vehicle. Always buckle your child in the car using a child safety seat, booster seat, or seat belt according to his/her height, weight, and age.

Available through the CDC:
Extreme Cold: A Prevention Guide to Promote Your Personal Health and Safety

Impaired Driving

Keep Kids Safe on the Road

Stay Safe and Healthy in Winter Weather

Traumatic Brain Injury

Travelers’ Health


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Be smoke-free.
Avoid smoking and breathing other people's smoke. If you smoke, quit today! Call 1-800-QUIT-NOW or talk to your health care provider for help.


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Get check-ups and vaccinations.
Exams and screenings can help find problems before they start. They can also help find problems early, when the chances for treatment and cure are better. Vaccinations help prevent diseases and save lives. Schedule a visit with your health care provider for a yearly exam. Ask what vaccinations and tests you should get based on your age, lifestyle, travel plans, medical history, and family health history.

Available through the CDC:
Things to Do Before Your Next Check-Up

Family Health History Resources and Tools

Get Smart: Know When Antibiotics Work

Vaccines and Immunizations

Safety of 2010-2011 Flu Vaccines

Women: Stay Healthy at Any Age (AHRQ)

Men: Stay Healthy at Any Age (AHRQ)


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Watch the kids.
Children are at high risk for injuries that can lead to death or disability. Keep a watchful eye on your kids when they’re eating and playing. Keep potentially dangerous toys, food, drinks, household items, choking hazards (like coins and hard candy), and other objects out of kids' reach. Learn how to provide early treatment for children who are choking. Make sure toys are used properly.

Injuries among Children and Adolescents
Toy Safety Tips (CPSC)

Counselor Continuing Education

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Prevent injuries.
Injuries can occur anywhere and some often occur around the holidays. Use step stools instead of furniture when hanging decorations. Leave the fireworks to the professionals. Wear a bicycle helmet to help prevent head injuries.

Most residential fires occur during the winter months. Keep candles away from children, pets, walkways, trees, and curtains. Never leave fireplaces, stoves, or candles unattended. Don't use generators, grills, or other gasoline- or charcoal-burning devices inside your home or garage. Install a smoke detector and carbon monoxide detector in your home. Test them once a month, and replace batteries twice a year.

Bicycle Related Injuries

Carbon Monoxide (CO) Poisoning Prevention

Fall-Related Injuries during the Holiday Season- United States, 2000-2003

General Injury Related Information

Fire Deaths and Injuries: Prevention Tips

Fireworks-Related Injuries


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Handle and prepare food safely.
As you prepare holiday meals, keep you and your family safe from food-related illness. Wash hands and surfaces often. Avoid cross-contamination by keeping raw meat, poultry, seafood, and eggs (including their juices) away from ready-to-eat foods and eating surfaces. Cook foods to the proper temperature. Refrigerate promptly. Do not leave perishable foods out for more than two hours.

It's Turkey Time: Safely Prepare Your Holiday Meal

Seasonal Food Safety: Fact Sheets (USDA)


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Eat healthy, and be active.
With balance and moderation, you can enjoy the holidays the healthy way. Choose fresh fruit as a festive and sweet substitute for candy. Select just one or two of your favorites from the host of tempting foods. Find fun ways to stay active, such as dancing to your favorite holiday music. Be active for at least 2½ hours a week. Help kids and teens be active for at least 1 hour a day.

Alcohol: Frequently Asked Questions

Get Smart Entertaining

Healthy Weight

Be Physically Active in the New Year

Managing Diabetes During the Holidays

Physical Activity for Everyone


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Protect pets from rabies.
Pets are also considered family members by many. Keep them healthy. There are several things you can do to protect your pet from rabies. First, visit your veterinarian with your pet on a regular basis and keep rabies vaccinations up-to-date for all cats, ferrets, and dogs.

A Guide to Managing Stress in Crisis Response Professions

A Guide to Managing Stress in Crisis Response Profession

Click here for more information
on Crisis Response and Crisis
Counseling CEUs

CHAPTER I. Understanding the Stress Cycle
Common Stress Reactions
Extreme Stress Reactions
Stress is an elevation in a person's state of arousal or readiness, caused by some stimulus or demand. As stress arousal increases, health and performance actually improve. Within manageable levels, stress can help sharpen our attention and mobilize our bodies to cope with threatening situations.

At some point, stress arousal reaches maximum effect. Once it does, all that was gained by stress arousal is then lost and deterioration of health and performance begins (Luxart Communications, 2004).

Whether a stressor is a slight change in posture or a lifethreatening assault, the brain determines when the body's inner equilibrium is disturbed; the brain initiates the actions that restore the balance. The brain decides what is threatening and what is not. When we face challenging situations, the brain does a quick search. Have we been here before? If so, how did we feel? What was the outcome? Can we cope with the situation now? If there's doubt as to any of these questions, the stress response goes into high gear (McEwen & Lasley, 2002).

The following provides workers and managers with a list of common stress reactions. Most people are resilient and experience mild or transient psychological disturbances from which they readily bounce back. The stress response becomes problematic when it does not or cannot turn off; that is, when symptoms last too long or interfere with daily life.

Back to Top

Common Stress Reactions
Behavioral

Increase or decrease in activity level
Substance use or abuse (alcohol or drugs)
Difficulty communicating or listening
Irritability, outbursts of anger, frequent arguments
Inability to rest or relax
Decline in job performance; absenteeism
Frequent crying
Hyper-vigilance or excessive worry
Avoidance of activities or places that trigger memories
Becoming accident prone

Physical

Gastrointestinal problems
Headaches, other aches and pains
Visual disturbances
Weight loss or gain
Sweating or chills
Tremors or muscle twitching
Being easily startled
Chronic fatigue or sleep disturbances
Immune system disorders

Psychological/Emotional

Feeling heroic, euphoric, or invulnerable
Denial
Anxiety or fear
Depression
Guilt
Apathy
Grief

Thinking

Memory problems
Disorientation and confusion
Slow thought processes; lack of concentration
Difficulty setting priorities or making decisions
Loss of objectivity

Social

Isolation
Blaming
Difficulty in giving or accepting support or help
Inability to experience pleasure or have fun

(Adapted from CMHS, 2004)

First the brain sounds an alert to the adrenal glands. The adrenals answer by pouring out the first of the major stress hormones—adrenaline—for the classic fight-orflight response.

The fight-or-flight response evolved with the prime directive of ensuring our safety and survival. The pulse begins to race as the adrenaline steps up the heart rate, sending extra blood to the muscles and organs. Oxygen rushes in as the bronchial tubes in the lungs dilate; extra oxygen also reaches the brain, which helps keep us alert. During this stage of the fight-or-flight response, the brain releases natural painkillers called endorphins. This phase, in which adrenaline plays a leading role, is the immediate response to stress (McEwen & Lasley, 2002).

When the stress response is active for a long period of time, it can damage the cardiovascular, immune, and nervous systems. People develop patterns of response to stress that are as varied as the individuals (Selye, 1984). These responses simply suggest a need for corrective action to limit their impact (Mitchell & Bray, 1990; Selye, 1984).







Acknowledgments
This publication was produced by the Substance Abuse and Mental Health Services Administration (SAMHSA), Center for Mental Health Services (CMHS), U.S. Department of Health and Human Services (DHHS) and was reviewed by a group of experts. Ms. Maria Baldi served as the Government project officer. The SAMHSA Disaster Technical Assistance Center (operated by ESI under contract with CMHS), researched, compiled, and edited the information, and designed the cover and layout for this publication. SAMHSA gratefully acknowledges the contributions of Nancy C. Carter, M.S.W.

Public Domain Notice
All material appearing in this document is in the public domain and may be reproduced or copied without permission from SAMHSA or CMHS. Citation of the source is appreciated. However, this publication may not be reproduced or distributed for a fee without the specific, written authorization of the Office of Communications, SAMHSA, DHHS.

Electronic Access and Copies of Publication
This publication may be accessed electronically through the following Internet connection: www.samhsa.gov. For additional free copies of this document, please contact SAMHSA's National Mental Health Information Center at 1-800-789-2647 or 1-866-889-2647 (TDD).

Citation
U.S. Department of Health and Human Services. A Guide to Managing Stress in Crisis Response Professions. DHHS Pub. No. SMA 4113. Rockville, MD: Center for Mental Health Services, Substance Abuse and Mental Health Services Administration, 2005.

Originating Office
Substance Abuse and Mental Health Services Administration
1 Choke Cherry Road, Rockville, Maryland 20857
DHHS Publication No. SMA 4113
Printed 2005

Human Sexuality

© 2009 by Aspira Continuing Education. All rights reserved. No part of this material may be transmitted or reproduced in any form, or by any means, mechanical or electronic without written permission of Aspira Continuing Education. Course Objectives: This course is designed to help you: 1. Define the different study/research areas of human sexuality. 2. Increase familiarity with concepts related to the psychology of sex 3. Identify and evaluate clinical perspectives related to sexual activity and lifestyles. 4. Explore the impact religious belief systems on sex. 5. Learn specific laws related to sex and sexual crimes. 6. Identify the causes and symptoms of STDs 7. Increase familiarity with sexual disorders Table of Contents: 1. Definition 2. Psychology and Sex 3. Sexual Activity and Lifestyles 4. Religion and Sex 5. The Law and Sex 6. Sexually Transmitted Diseases 7. Masters and Johnson
8. Sexual Disorders 9. References 1. Definition Human sexuality can be defined as the manner in which people experience and express themselves as sexual beings. There are many facets in the study of human sexuality including: • Biological • Emotional • Physical • Sociological • Philosophical (Ellen Ross, Rayna Rapp Sex and Society: A Research Note from Social History and Anthropology Comparative Studies in Society and History). From a biological perspective, sexuality is defined as “the reproductive mechanism as well as the basic biological drive that exists in all species and can encompass sexual intercourse and sexual contact in all its forms”. There are also emotional or physical perspectives of sexuality, which refers to the “bond that exists between individuals, which may be expressed through
profound feelings or emotions, and which may be manifested in physical or medical concerns about the physiological or even psychological aspects of sexual behavior”. Sociologically, it includes the cultural, political, and legal aspects of sexual behavior. Philosophically, it emphasizes the moral, ethical, theological, spiritual or religious aspects of sexual behavior (Ellen Ross, Rayna Rapp Sex and Society: A Research Note from Social History and Anthropology Comparative Studies in Society and History). Human sexuality research has revealed that sexual variables are significant in developing one’s identity and to social evolution of individuals: “Human sexuality is not simply imposed by instinct or stereotypical conducts, as it happens in animals, but it is influenced both by superior mental activity and by social, cultural, educational and normative characteristics of those places where the subjects grow up and their personality develops. Consequently, the analysis of sexual sphere must be based on the convergence of several lines of development such as affectivity, emotions and relations” (Ellen Ross, Rayna Rapp Sex and Society: A Research Note from Social History and Anthropology Comparative Studies in Society and History). The biological aspects of human sexuality include human reproduction and other aspects such as organic and neurological responses, heredity, hormonal issues, gender issues and sexual dysfunction (Ellen Ross, Rayna Rapp Sex and Society: A Research Note from Social History and Anthropology Comparative Studies in Society and History). Additionally, human sexuality can be conceptualized as inclusive of the social life of humans, governed by implied rules of behavior. Of course, this involves cultural and societal influences including media such as politics and the mass media. Historically, media has caused significant changes in sexual social norms such as the sexual revolution (Ellen Ross, Rayna Rapp Sex and Society: A Research Note from Social History and Anthropology Comparative Studies in Society and History). 2. Psychology and Sex Human sexual experience can include significant emotional and psychological responses. Research studies on sexuality focus on psychological influences that impact sexual behavior and experience. Early psychological analyses were conducted by Sigmund Freud. He also introduced the concepts of erogenous zones, psychosexual development, and
the Oedipus complex (Ellen Ross, Rayna Rapp Sex and Society: A Research Note from Social History and Anthropology Comparative Studies in Society and History). Behaviorists including John B. Watson and B. F. Skinner evaluate the connection between behavior theory and sex. For example, they might study a child who is punished for sexual exploration and see if they grow up to associate negative feelings with sex in general. Social-learning theorists use similar concepts, but focus on cognitive activity and modeling (Ellen Ross, Rayna Rapp Sex and Society: A Research Note from Social History and Anthropology Comparative Studies in Society and History). Gender identity is “a person's own sense of identification as female, male, both, neither, or somewhere in between”. The social construction of gender has been discussed by a wide variety of scholars, Judith Butler notable among them. Recent contributions consider the influence of feminist theory and courtship research (Ellen Ross, Rayna Rapp Sex and Society: A Research Note from Social History and Anthropology Comparative Studies in Society and History). Human sexual behavior encompasses the search for a partner or partners, interactions between individuals, physical, emotional intimacy, and sexual contact. Unprotected sex may result unwanted pregnancy or sexually transmitted diseases. Prior to reliable contraception methods, controlling sexual behavior was practically important to parents in some societies. The methodologies employed by parents to try to prevent their children from prematurely becoming parents themselves could have a profound effect on the minds of those children (Ellen Ross, Rayna Rapp Sex and Society: A Research Note from Social History and Anthropology Comparative Studies in Society and History). Sexual behavior Sexual function is impacted significantly by cognitive process. Male sexual dysfunction includes inability to achieve an erection, penile insensitivity, premature ejaculation. Female sexual dysfunction includes inability to achieve orgasm and vaginismus. The dysfunctions described may contribute to the development of secondary problems. For example, sufferers may self medicate with substances. Sexual dysfunction clinical focus may include addressing low self esteem, guilt, and self-destructive impulses. Freud
claimed that neither predominantly different, nor same-sex sexuality was the norm. instead he argued that bisexuality is the normal human condition thwarted by society. A 1901 medical dictionary lists heterosexuality as "perverted" different-sex attraction, while by the 1960s its use in all forums referred to "normal" different-sex sexuality. In 1948 Alfred Kinsey publishes Sexual Behavior in the Human Male, popularly known as the Kinsey Reports (Ellen Ross, Rayna Rapp Sex and Society: A Research Note from Social History and Anthropology Comparative Studies in Society and History). For many years, homosexuality was classified as a psychiatric disorder. In 1973 homosexuality was declassified as a mental illness in the United Kingdom. In 1986 homosexuality as a psychiatric disorder was removed from the Diagnostic and Statistical Manual of Mental Disorders (DSM) of the American Psychiatric Association (Ellen Ross, Rayna Rapp Sex and Society: A Research Note from Social History and Anthropology Comparative Studies in Society and History). 3. Sexual Activity and Lifestyles Different-sex sexual practices are limited by laws in many places. In some countries, mostly those where religion has a strong influence on social policy, marriage laws serve the purpose of encouraging people to only have sex within marriage. Laws also ban adults from committing sexual abuse, committing sexual acts with anyone under an age of consent, performing sexual activities in public, and engaging in sexual activities for money. Heterosexual activities may be monogamous, serially monogamous, or polyamorous, and, depending on the definition of sexual practice, abstinent or autoerotic (Ellen Ross, Rayna Rapp Sex and Society: A Research Note from Social History and Anthropology Comparative Studies in Society and History).

Conflict Resolution CEUs

Copyright 2009 by Aspira Continuing Education. All rights reserved. No part of this material may be transmitted or reproduced in any form, or by any means, mechanical or electronic without written permission of Aspira Continuing Education.

1. Define the process of conflict resolution 2. Learn specific conflict resolution techniques 3. Identify various theoretical approaches to conflict resolution 4. Identify the barriers to conflict resolution 5. Clinically address the barriers to conflict resolution Table of Contents: 1. Definition 2. Causes 3. Assessment and Intervention 4. Resources 5. References

1. Definition

Conflict resolution includes several techniques and processes designed to decrease or manage conflict in relationships. The term "conflict resolution" is sometimes used interchangeably with the term dispute resolution or alternative dispute resolution. Conflict resolution may sometimes include negotiation, mediation and diplomacy. Conflict resolution has been the source of research in animals such as dogs and primates (Frans de Waal, 2000). Studies have demonstrated that aggression is more common among relatives and within a group, than between groups. Instead of creating a distance between the individuals, however, the primates were more intimate in the period after the aggressive incident. These intimacies consisted of grooming and various forms of body contact. Stress responses, like an increased heart rate, usually decrease after these reconciliatory signals. Different types of primates, as well as many other species living in groups, show different types of conciliatory behavior. Resolving conflicts that threaten the interaction between individuals in a group is necessary for survival, hence has a strong evolutionary value. These findings contradicted previous existing theories about the general function of aggression, i.e. creating space between individuals (Konrad Lorenz), which seems to be more the case in group conflicts (Frans de Waal, 2000). Conflict is an unavoidable consequence of natural disagreements resulting from individuals or groups that differ in beliefs, attitudes, values or needs. Conflict may also originate from past rivalries and personality differences. Other causes of conflict include attempting to negotiate prematurely or before necessary information is available. The following includes common sources of conflict: • communication failure • personality conflict • value differences • goal differences • methodological differences • substandard performance • lack of cooperation • differences regarding authority • differences regarding responsibility • competition over resources • non-compliance with rules 2. Causes Structural Factors (How the conflict is set up) • Authority Relationships • Common Resources • Goal Differences • Interdependence • Jurisdictional Ambiguities • Specialization • Status inconsistencies • Personal Factors • Communication barriers • Conflict management style • Cultural differences • Emotions • Perception • Personalities • Skills and abilities • Values and Ethics There are many variables intertwined with conflict including behavioral, physiological, cognitive variables. • Behavioral- The manner in which the emotional experience is expressed which can be verbal or non-verbal and internalized or externalized. • Physiological- The bodily experience of emotion. The way emotions make us feel in relationship to our identity. • Cognitive- The concept that we "assess or appraise" an event to reveal its relevancy to ourselves.

The following three variables demonstrate that the meanings of emotional experience and expression are determined by cultural values, beliefs, and practices: • Cultural values- cultural values and norms influence, "which emotions ought to be expressed in particular situations" and "what emotions are to be felt." • Physical- This escalation results from "anger or frustration." • Verbal- This escalation results from "negative perceptions of the offender’s character." There are several principles of conflict and emotion including: 1. Conflict is emotionally defined. Conflict involves emotion because something "triggers" it. The conflict is with the parties involved and how they decide to resolve it. Events that trigger conflict are events that elicit emotion. 2. Conflict is emotionally varied. Emotion levels during conflict can be intense or less intense. The "intensity" levels "may be indicative of the importance and meaning of the conflict issues for each party”. 3. Conflict invokes a moral stance. When an event occurs it can be interpreted as moral or immoral. The judging of this morality "influences one's orientation to the conflict, relationship to the parties involved, and the conflict issues". 4. Conflict is identity based. Emotions and identity are a part of conflict. When a person knows their values, beliefs, and morals they are able to determine whether the conflict is personal, relevant, and moral. "Identity related conflicts are potentially more destructive." 5. Conflict is relational. "Conflict is relational in the sense that emotional communication conveys relational definitions that impact conflict." "Key relational elements are power and social status." (Joyce Hocker-Wilmot, William W. Wilmot, 2006. Interpersonal conflict, Iowa: Won C. Brown Com).