Question 1a

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Eating disorder

Introduction

Eating disorders (EDs) are psychiatric disorders with diagnostic criteria based on psychologic, behavior, and physiologic characteristics. Eating disorders is a broad name for a number of problems faced by human beings with food in our society. While majority slip into overeating or comfort eating at some point, for some the problem goes to life-threatening extremes. For instance a common type of eating disorder is the anorexia nervosa and bulimia; there is a deep fear of being overweight that leads to an obsession about restricting the number of calories the person is taking in. This leads to an extreme state of starvation, which in turn has a number of effects on the way that the body functions and how hormones are produced. The common symptom of someone affected by an eating disorder includes:

a. Mentally keeping a balance between calories taken in and calories used up

b. Deep-seated feelings of anxiety if they consume a few calories too many

c. Self-loathing, depression or panic if they haven’t lost any weight or put a little on, despite their best efforts

Many scholars have researched the issue of diet quite deeply and know the damage they are doing to themselves but are still unable to stop. This just makes the feelings of despair and self-loathing even worse, causing their condition to continue.

Common types of eating Disorders

Research has given support to the existence of the different types of disorder put forward by Lask & Bryant-Waugh (2000). There are four main types of eating disorders namely;

Anorexia is “self-imposed starvation and occurs when someone avoids food to the point that he or she is 15 percent or more below a healthy body weight.” According to Sim, et al. the remedial action for this disorder a multidisciplinary approach involving medical management, nutritional intervention, and psychotherapy

Bulimia is “a disorder in which someone binges and then purges.” As Cassell and Gleaves note, "the most frustrating part of the disorder may be that he or she binge eats even when not hungry." Purging is “a way of counteracting overeating,” and can include “vomiting, excessive exercising, fasting, and/or taking laxatives.” Sim, et al. also note that, “The most effective treatments emerging for patients with Bulimia include a specific type of psychotherapy, cognitive behavioral therapy (CBT), that focuses on modifying the specific behaviors and ways of thinking that maintain the binge-eating and purging behaviors.”

Binge-eating disorder involves regular binge eating, but not purging. Many people with this disorder “cycle between dieting and binging,” and “they may or may not be overweight.”

Eating disorders not otherwise specified occur when "people...have variations of disordered eating, yet, they cannot meet full diagnostic criteria for Anorexia and/or Bulimia." Warning signs may include "For females, all of the criteria for Anorexia Nervosa are met except that the individual has regular menses," and "Repeatedly chewing and spitting out, but not swallowing, large amounts of food.

Common causes of eating disorders

a. While there is evidence that eating disorders can be hereditary, it isn’t yet clear how much risk for developing anorexia or bulimia is carried by genes.

a. The social and psychological factors have been better identified, but they are complicated.

b. Distorted body image

c. Low self-esteem

d. Anxiety for some control

e. An expression of deep emotions such as depression or trauma that can’t be put into words

Each person affected by an eating disorder brings their own unique experiences to the problem. For each, the meaning of anorexia or bulimia has aspects that are personal to them. The remedies or treatments for eating disorders are discussed as follows however; there is limited evidence that some psychiatric drugs can help with anorexia and bulimia, and that some psychotherapy approaches can have some effect.

Cognitive behavioral therapy (CBT) makes a good start to alleviate the issues. For longer term recovery, psychological approaches that look at how the person relates to those around them might have more effect. These could psychotherapy focusing how on interpersonal relationships work and family therapy.

Remedies for Eating Disorders
Nutrition monitoring and evaluation

✓ Monitor nutrient intake and adjust as necessary. ✓ Monitor rate of weight gain, once weight restored, adjust food intake to maintain weight

✓ Communicate individual’s progress with team and make adjustments to plan accordingly
Care coordination ✓ Provide counsel to team about protocols to maximize tolerance of feeding regimen or nutrition recommendations, guidance about supplements to ensure maximum absorption, minimize drug nutrient interactions, and referral for continuation of care as needed. ✓ Work collaboratively with treatment team, delineate specific roles and tasks, and communicate nutrition needs across the continuum of settings (for instance inpatient, day treatment, and outpatient) ✓ Act as a resource to other health care professionals and the family, provide education

✓ Advocate for evidenced-based treatment and access to care
Advanced training ✓ Seek specialized training in other counseling techniques, such as cognitive behavioral therapy, dialectical behavior therapy, and motivational interviewing. ✓ Use advanced knowledge and skills relating to nutrition, such as re-feeding syndrome, maintaining appropriate weight and eating behaviors, body image, and relapse prevention ✓ Seek supervision and case consultation from a licensed mental health professional to gain and maintain proficiency in eating disorders treatments

Nutrition intervention

✓ Calculate and monitor energy and macronutrient intake to establish expected rates of weight change, and to meet body composition and health goals. Guide goal setting to normalize eating patterns for nutrition rehabilitation and weight restoration or maintenance as appropriate. ✓ Ensure diet quality and regular eating pattern, increased amount and variety of foods consumed, normal perceptions of hunger and satiety, and suggestions about use of supplements ✓ Provide psychosocial support and positive reinforcement; structured re-feeding plan ✓ Counsel individuals and other caregivers on food selection considering individual preferences, health history, physical and psychological factors, and resources ✓ Additional treatment might include inpatient treatment, partial hospitalization, and drug therapy. Various types of therapy (including cognitive-behavioral therapy, interpersonal psychotherapy, and family therapy) may also be helpful. Meeting with a nutritionist may be recommended

Sexual disorder

Forms of Sexual disorders

Sexual desire disorders

Sexual desire disorders or decreased libido are characterized by a lack or absence for some period of time of sexual desire or libido for sexual activity or of sexual fantasies. The condition ranges from a general lack of sexual desire to a lack of sexual desire for the current partner. The condition may have started after a period of normal sexual functioning or the person may always have had no/low sexual desire.
The causes vary considerably, but include a possible decrease in the production of normal estrogen in women or testosterone in both men and women. Other causes may be aging, fatigue, pregnancy, medications (such as the SSRIs) or psychiatric conditions, such as depression and anxiety. Loss of libido from SSRIs usually reverses after SSRIs are discontinued, but in some cases it does not. This has been called PSSD; however, this is not a classification that would be found in any current medical text. While a number of causes for low sexual desire are often cited, only some of these have ever been the object of empirical research. Many rely entirely on the impressions of therapists.

Sexual arousal disorders

Sexual arousal disorders were previously known as frigidity in women and impotence in men, though these have now been replaced with less judgmental terms. Impotence is now known as erectile dysfunction, and frigidity has been replaced with a number of terms describing specific problems with, for example, desire or arousal.
For both men and women, these conditions can manifest themselves as an aversion to, and avoidance of, sexual contact with a partner. In men, there may be partial or complete failure to attain or maintain an erection, or a lack of sexual excitement and pleasure in sexual activity.
There may be medical causes to these disorders, such as decreased blood flow or lack of vaginal lubrication. Chronic disease can also contribute, as well as the nature of the relationship between the partners. Unlike disorders of orgasm, as the success of Viagra (sildenafil citrate) attests, most erectile disorders in men are primarily physical conditions.

Causes of sexual Disorders

There are many factors which may result in a person experiencing a sexual dysfunction. These may result from emotional or physical causes.
Sexual dysfunction may arise from emotional factors, including interpersonal or psychological problems. Interpersonal problems may arise from marital or relationship problems, performance anxiety, or from a lack of trust and open communication between partners, and psychological problems may be the result of depression, sexual fears or guilt, past sexual trauma, sexual disorders, among others.
Sexual dysfunction is especially common among people who have anxiety disorders. Ordinary anxiousness can obviously cause erectile dysfunction in men without psychiatric problems, but clinically diagnosable disorders such as panic disorder commonly cause avoidance of intercourse and premature ejaculation. Pain during intercourse is often a comorbidity of anxiety disorders among women.
Sexual activity may also be impacted by physical factors. These would include use of drugs, such as alcohol, nicotine, narcotics, stimulants, antihypertensives, antihistamines, and some psychotherapeutic drugs. For women, almost any physiological change that affects the reproductive system premenstrual syndrome, pregnancy, postpartum, menopause can have an adverse effect on libido. Injuries to the back may also impact sexual activity, as would problems with an enlarged prostate gland, problems with blood supply, nerve damage (as in spinal cord injuries). Disease, such as diabetic neuropathy, multiple sclerosis, tumors, and, rarely, tertiary syphilis may also impact on the activity, as would failure of various organ systems (such as the heart and lungs), endocrine disorders (thyroid, pituitary, or adrenal gland problems), hormonal deficiencies (low testosterone, estrogen, or androgens), and some birth defects.

Substance related disorder e.g alcoholism, drug abuse

Introduction
A maladaptive pattern of substance use manifested by recurrent and significant adverse consequences related to the repeated use of substances. These problems must occur recurrently during the same 12-month period the criteria for Substance Abuse do not include tolerance, withdrawal, or a pattern of compulsive use and instead include only the harmful consequences of repeated use. A diagnosis of Substance Abuse is preempted by the diagnosis of Substance Dependence if the individual's pattern of substance use has ever met the criteria for Dependence for that class of substances.

Substance abuse, also known as drug abuse, is a maladaptive patterned use of a substance (drug) in which the user consumes the substance in amounts or with methods not condoned by medical professionals. Substance abuse/drug abuse is not limited to mood-altering or psycho-active drugs. Activity is also considered substance abuse when inappropriately used (as in steroids for performance enhancement in sports). Therefore, mood-altering and psychoactive substances are not the only drugs of abuse. Substance abuse often includes problems with impulse control and impulsivity.

Causes and symptoms

Causes

The causes of substance dependence are not well established, but three factors are believed to contribute to substance-related disorders: genetic factors, psychopathology, and social learning. In genetic epidemiological studies of alcoholism, the probability of identical twins both exhibiting alcohol dependence was significantly greater than with fraternal twins, thus suggesting a genetic component in alcoholism. It is unclear, however, whether the genetic factor is related to alcoholism directly, or whether it is linked to other psychiatric disorders that are known to be associated with substance abuse. For example, there is evidence that alcoholic males from families with depressive disorders tend to have more severe courses of substance dependence than alcoholic men from families without such family histories.

These and other findings suggest substance use may be way to relieve the symptoms of a psychological disorder. In this model, unless the underlying pathology is treated, attempts to permanently stop substance dependence are ineffective. Psychopathologies that are associated with substance dependence include antisocial personality disorder, bipolar disorder, depression, anxiety disorder, and schizophrenia.

A third factor related to substance dependence is social environment. In this model, drug-taking is essentially a socially learned behavior. Local social norms determine the likelihood that a person is exposed to the substance and whether continued use is reinforced. For example, individuals may, by observing family or peer role models, learn that substance use is a normal way to relieve daily stresses. External penalties, such as legal or social sanctions, may reduce the likelihood of substance use.

At the level of neurobiology, it is believed that substances of abuse operate through similar pathways in the brain. The chemical changes induced by the stimulation of these pathways by initial use of the substance lead to the desire to continue substance use, and eventual substance dependence.

Symptoms

The DSM-IV-TR identifies seven criteria (symptoms), at least three of which must be met during a given 12-month period, for the diagnosis of substance dependence:

a. Tolerance, as defined either by the need for increasing amounts of the substance to obtain the desired effect or by experiencing less effect with extended use of the same amount of the substance.

b. Withdrawal, as exhibited either by experiencing unpleasant mental, physiological, and emotional changes when drug-taking ceases or by using the substance as a way to relieve or prevent withdrawal symptoms.

c. Longer duration of taking substance or use in greater quantities than was originally intended.

d. Persistent desire or repeated unsuccessful efforts to stop or lessen substance use.

e. A relatively large amount of time spent in securing and using the substance, or in recovering from the effects of the substance.

f. Important work and social activities reduced because of substance use.

g. Continued substance use despite negative physical and psychological effects of use.

Although not explicitly listed in the DSM-IV-TR criteria, "craving," or the overwhelming desire to use the substance regardless of countervailing forces, is a universally-reported symptom of substance dependence.

Treatment

According to the American Psychiatric Association, there are three goals for the treatment of people with substance use disorders: the patient abstains from or reduces the use and effects of the substance; the patient reduces the frequency and severity of relapses; and the patient develops the psychological and emotional skills necessary to restore and maintain personal, occupational, and social functioning.

In general, before treatment can begin, many treatment centers require that the patient undergo detoxification. Detoxification is the process of weaning the patient from his or her regular substance use. Detoxification can be accomplished "cold turkey," by complete and immediate cessation of all substance use, or by slowly decreasing (tapering) the dose which a person is taking, to minimize the side effects of withdrawal. Some substances must be tapered because "cold turkey" methods of detoxification are potentially life threatening. In some cases, medications may be used to combat the unpleasant and threatening physical and psychological symptoms of withdrawal. For example, methadone is used to help patients adjust to the tapering of heroin use.

Treatment itself consists of three parts: (1) assessment; (2) formulation of a treatment plan; (3) psychiatric management. The first step in treatment is a comprehensive medical and psychiatric evaluation of the patient. This evaluation includes:

✓ A history of the patient's past and current substance use, and its cognitive, psychological, physiological, and behavioral effects

✓ A medical and psychiatric history and examination

✓ A history of psychiatric treatments and outcomes

✓ A family and social history

✓ Screening of blood, breath, or urine for substances

✓ Other laboratory tests to determine the presence of other conditions commonly found with substance use disorders

Gender identity disorder

Introduction

Gender identity disorder (GID) is the formal diagnosis used by psychologists and physicians to describe persons who experience significant gender dysphoria (discontent with the sex they were assigned at birth and/or the gender roles associated with that sex). It describes the symptoms related to transsexualism, as well as less severe manifestations of gender dysphoria.
Gender identity disorder (GID) or transsexualism is defined by strong, persistent feelings of identification with the opposite gender and discomfort with one's own assigned sex. People with GID desire to live as members of the opposite sex and often dress and use mannerisms associated with the other gender. For instance, a person identified as a boy may feel and act like a girl. This is distinct from homosexuality in that homosexuals nearly always identify with their apparent sex or gender.
Identity issues may manifest in a variety of different ways. For example, some people with normal genitals and secondary sex characteristics of one gender privately identify more with the other gender. Some may cross-dress, and some may actually seek sex-change surgery. Others are born with ambiguous genitalia, which can raise identity issues.
Associated Features and Disorders of Gender Identity Disorder
Many individuals with gender identity disorder become socially isolated, whether by choice or through ostracization, which can contribute to low self-esteem and may lead to school aversion or even dropping out. Peer ostracism and teasing are especially common consequences for boys with the disorder. Boys with gender identity disorder often show marked feminine mannerisms and speech patterns.
The disturbance can be so pervasive that the mental lives of some individuals revolve only around activities that lessen gender distress. They are often preoccupied with appearance, especially early in the transition to living in the opposite sex role. Relationships with parents also may be seriously impaired. Some males with gender identity disorder resort to self-treatment with hormones and may (very rarely) perform their own castration or penectomy. Especially in urban centers, some males with the disorder may engage in prostitution, placing them at a high risk for human immunodeficiency virus (HIV) infection. Suicide attempts and substance-related disorders are common.
Children with gender identity disorder may manifest coexisting separation anxiety disorder, generalized anxiety disorder and symptoms of depression.
Adolescents are particularly at risk for depression and suicidal ideation and suicide attempts.
Adults may display anxiety and depressive symptoms. Some adult males have a history of transvestic fetishism as well as other paraphilias. Associated personality disorders are more common among males than among females being evaluated at adult gender clinics.
Symptoms of Gender Identity Disorder
Gender identity disorder occurs when a person feels as if their biological gender doesn’t accord with who they feel themselves to be. The following are the major symptoms of GID in various categories of individuals;
Children
a. Express the desire to be the opposite sex b. Have disgust with their own genitals c. Believe that they will grow up to become the opposite sex d. Are rejected by their peer group and feel isolated e. Have depression f. Have anxiety
Adults:
a. Desire to live as a person of the opposite sex b. Wish to be rid of their own genitals c. Dress in a way that is typical of the opposite sex d. Feel isolated e. Have anxiety

Causes of Gender Identity Disorder

People with gender identity disorder act and present themselves as members of the opposite sex. The disorder may affect self-concept, choice of sexual partners and the display of femininity or masculinity through mannerisms, behavior and dress.
The feeling of being in the body of the "wrong" gender must persist for at least two years for this diagnosis to be made. The cause is unknown, but hormonal influences in the womb, genetics and environmental factors (such as parenting) are suspected to be involved. The disorder may occur in children or adults, and is rare.
There are no recent studies to provide data on prevalence of gender identity disorder. Data from some countries in Europe suggest that roughly 1 per 30,000 adult males and 1 per 100,000 adult females seek sex-reassignment surgery.
Onset of cross-gender interests and activities is usually between ages 2 and 4 years, and some parents report that their child has always had cross-gender interests. Only a very small number of children with gender identity disorder will continue to have symptoms that meet criteria for the disorder in later adolescence or adulthood. Typically, children are referred around the time of school entry because of parental concern that what they regarded as a phase does not appear to be passing.
Treatments of Gender Identity Disorder

Individual and family counseling is recommended for children and individual or couples therapy is recommended for adults. Sex reassignment through surgery and hormonal therapy is an option, but severe problems may persist after this form of treatment. A better outcome is associated with the early diagnosis and treatment of this disorder.

Question 1b

Choose a psychological disorder and look at it in details include issues;

Diagnosis, causes, theoretical perception and areas of research

Introduction

A psychological disorder, also known as a mental disorder, is a pattern of behavioral or psychological symptoms that impact multiple life areas and/or create distress for the person. Psychological disorders are abnormalities of the mind that result in persistent behavior patterns that can seriously affect your day-to-day function and life. Many different psychological disorders have been identified and classified, including eating disorders, such as anorexia nervosa; mood disorders, such as depression; personality disorders, such as antisocial personality disorder; psychotic disorders, such as schizophrenia; sexual disorders, such as sexual dysfunction; and others. Multiple psychological disorders may exist in one person.

Depression
The biopsychosocial model proposes that biological, psychological, and social factors all play a role in causing depression. The diathesis–stress model specifies that depression results when a preexisting vulnerability, or diathesis, is activated by stressful life events. The preexisting vulnerability can be either genetic, implying an interaction between nature and nurture, or schematic, resulting from views of the world learned in childhood.
These interactive models have gained empirical support. For example, researchers in New Zealand took a prospective approach to studying depression, by documenting over time how depression emerged among an initially normal cohort of people. The researchers concluded that variation among the serotonin transporter (5-HTT) gene affects the chances that people who have dealt with very stressful life events will go on to experience depression
A depression diagnosis is often difficult to make because clinical depression can manifest in so many different ways. For example, some clinically depressed individuals seem to withdraw into a state of apathy. Others may become irritable or even agitated. Eating and sleeping patterns can be exaggerated. A depressed person may either sleep or eat to excess or almost eliminate those activities.
Observable or behavioral symptoms of clinical depression may be minimal despite a person experiencing profound inner turmoil. Depression can be an all-encompassing disorder, and it affects a person's body, feelings, thoughts, and behaviors in varying ways.

What does the doctor look for to make a depression diagnosis?

A doctor can rule out other conditions that may cause depression with a physical examination, personal interview, and lab tests. The doctor will also conduct a complete diagnostic evaluation, discussing any family history of depression or other mental illness. The doctor will evaluate the patients symptoms, including how long he or she had them, when they started, and how they were treated. The doctor will ask questions about the way the patient feel, including whether he or she has any symptoms of depression such as the following: a. Sadness or depressed mood most of the day or almost every day b. Loss of enjoyment in things that were once pleasurable c. Major change in weight (gain or loss of more than 5% of weight within a month) or appetite d. Insomnia or excessive sleep almost every day e. Physically restless or rundown that is noticeable by others f. Fatigue or loss of energy almost every day
g. Feelings of hopelessness or worthlessness or excessive guilt almost every day
h. Problems with concentration or making decisions almost every day
i. Recurring thoughts of death or suicide, suicide plan, or suicide attempt

Causes of depression

Biology. Studies indicates that certain parts of the brain don't seem to be working normally. Depression might also be affected by changes in the levels of certain chemicals in the brain, called neurotransmitters.

Genetics. Researchers know that if depression runs in your family, you have a higher chance of becoming depressed.

Gender. Studies show that women are about twice as likely as men to become depressed. No one's sure why. The hormonal changes that women go through at different times of their lives may be a factor.

Age. People who are elderly are at higher risk of depression. That can be compounded by other factors living alone and having a lack of social support.

Health conditions. Conditions such as cancer, heart disease, thyroid problems, chronic pain, and many others increase your risk of becoming depressed.

Trauma and grief. Trauma, such as violence or physical or emotional abuse whether it's early in life or more recent can trigger depression. Grief after the death of a friend or loved one is in itself a normal emotion, but like all forms of loss can sometimes lead to depression.

Changes and stressful events. It's not surprising that people might become depressed during stressful times such as during a divorce or while caring for a sick relative. Yet even positive changes like getting married or starting a new job can sometimes trigger depression.

Medications and substances. Many prescription drugs can cause symptoms of depression. Alcohol or substance abuse is common in depressed people. It often makes their condition worse.

Beck's Cognitive Theory of Depression Features Underlying Dysfunctional Beliefs

Beck's main argument was that depression was instituted by one's view of oneself, instead of one having a negative view of oneself due to depression. This has large social implications of how we as a group perceive each other and relate our dissatisfactions with one another. Abela and D'Alessandro's (2002) study on college admissions is a good example of this phenomenon. In their study they found that the student's negative views about their future strongly controlled the interaction between dysfunctional attitudes and the increase in depressed mood. The research clearly backed up Beck's claim that those at risk for depression due to dysfunctional attitudes who did not get into their college of choice then doubted their futures, and these thoughts lead to symptoms of depression.

Therefore, the students' self-perceptions became negative after failing to get into college, and many showed signs of depression due to this thinking. Other aspects of this study did not match up well with Beck. They elaborate: "As for participants' more enduring mood reactions, our findings are incongruent with Beck's...theory.... Therefore, one possible explanation of discrepancies between these studies is that immediately following the occurrence of a negative event, cognitively vulnerable individuals show marked increases in depressed mood. At the same time, the do not yet exhibit increases in other symptoms of depression.... However, in vulnerable individuals…such depressed mood may be to be accompanied by a host of other depressive symptoms.... Their level of depressed mood, however, was simply not more severe than individuals who did not possess dysfunctional attitudes" (Abela & D'Allesandro, 2002, p.122). What occurred is that the requirements, according to Beck, for depressive symptoms were there but they did not occur regardless. Findings like this show that Beck's theory may not be as complete as we would like, and there is likely to be factors which are unaccounted for in play in situations like this.

Another study, which was performed on Beck's Theory, was Sato and McCann's (2000) study on the Beck sociotropy-autonomy scale. The scale had originally meant to identify self-feelings that would lead to depression, mainly solitude/interpersonal insensitivity, independence, and individualistic achievement. However, the results of the study showed that the independence did not correlate with depression, and the sociotropy, not autonomy was a precursor of depression. As they described, "sociotropy can be characterized by an individual's emphasis on interpersonal interactions involving intimacy, sharing, empathy, understanding, approval, affection, protection, guidance, and help…tend to place importance on seeking approval from others and on trying to avoid disapproval from others as much as possible." (Sato, & McCann, 2000, p.66) So it is seen that a strong correlation with sociotropy and depression was found, which is a trait that is strong when relating to underlying thoughts and emotions. This support for cognitively caused depression is an interesting use of Beck's Theory.

Moilanen's (1995) study of adolescent depression also attempts to validate Beck's theory in a new way, as Beck worked mostly with adults. Indeed, she found that the student's depression was often associated with dysfunctional beliefs and negative future attitudes. She suggests that the cognitive theory has reasonable validity for describing the symptoms of depression for nonreferred adolescents, and that the subject's depression is closely correlated with his or her ability to deal with dysfunctional attitudes and beliefs, as well as doubt towards the future. Her findings may not sound truly convincing, because she did find some discrepancies: "However, the results of this study were not entirely consistent with Beck's theory, particularly the proposition that a predominantly negative self-schema underlies the information processing of depressed individuals." (Moilanen, 1995, p.440) We see how perhaps, at least in adolescents, the idea of the negative self-schema is not a clear as Beck wishes it to be.

An earlier study by Molianen (1993) showed even stronger results when evaluating college students. This study showed much more clearer results: "In support of Beck's cognitive theory of depression, the student's current depressive states were consistently found to be related to their negative processing of personal information" (Moilanen, 1993, p.345). The students' cognitive thoughts were shown to be affecting them, and as a result they developed symptoms of depression. Molianen, impressed by the findings, seems to suggest that Beck's theory should be used in further research in the college student population and how depressed students are treated, as counselors and therapists would do well to closely look at a student's cognitive thoughts as a way of assisting the student in recovery. These results are positive, because there is enough evidence for Molianen to suggest a cognitive treatment for depression via Beck's Theory. Molianen's work with Beck's Theory is no doubt a welcome look at cognitive thinking.

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