Ami is a 25-year-old, single Hindu female who has lived in a major metropolitan Northeastern City in the United States since studying undergraduate. Prior to arriving to the United Sates, she lived in an urban area of New Delhi, India with an extended family of a high socioeconomic status. She has a family history of depression on paternal grandmother’s side. When she was younger, Ami always wanted to be a movie star or a dancer. During her 8th class, she developed liking for a boy in her class who rejected her by calling her fat. She started to develop a dissatisfaction with her body image even when her weight was normal. She considered herself fat in the mirror and started looking for means to reduce weight. She felt her weight interfered with her achieving a career in acting or dancing. With gradually increasing concerns over growing fat, she started skipping meals and eventually would have only one meal and salads. Over another 7-month period, she lost up to 11 lbs. and looked thin, although she would consider it inadequate weight loss and view herself as herself as flabby in front of the mirror, despite the facts that others remarked that her clothes were loose. Sometime around this time, she also developed an intense liking for the high calorie foods. She would binge on them 5-6 times a month and would regret her actions afterwards. She tried to induce vomiting also once or twice. She started exercising on a Stairmaster and a tread mill for 1-1½ h in order to compensate weight gain. This pattern continued although she gave up working out in order to focus more on medical school and she gained about 14-15 lbs. She would be distressed with it. She restarted dieting sporadically, having increased craving for the high calorie foods and binging, which would be more when she would deny food in parties. Though she knew that her Body Mass Index (BMI) was well within normal range, she started taking one tablet of Orlistat daily secretly along with skipping meals and rejoining a fitness center in order to reduce her weight even more. She sold her jewelry without to undergo liposuction. She did not inform any family members of this. During last 5 years, she would compare herself with every female she met or read about on social media. She felt when she was around obese females. She could not spend an hour without fear of becoming obese. In recent times, she would avoid parties, going out with friends, standing for photos, and would spend hours in the gym. At the time of consultation with you the PMHNP in an out-patient department, her BMI was 18.5. 1. What are likely this patient’s diagnosis? 2. What comorbid personality disorders might exist? 3. What are familial, cultural, and social theories associated with the development of this disorder? 4. What are the neuropsychiatric abnormalities or neuronal problems associated with Ami’s disorder? What hormones and neurotransmitters? 5. How will you treat this patient? 6. What medications? Support your choices? 7. Is this an easy case? 8. How does culture influence clinical presentation of symptoms?
Fear based oppression has profound history since the frosty war yet this issue turned out to be most notable after psychological militant assaults in September 11 2001 and July 7 2005. As indicated by U.S division of state (2002), in excess of 3000 individuals of various nationalities were murdered in the fear based oppressor assaults in September 11, 2001. These assaults were the prominent case of fear based oppression on worldwide level. Psychological oppression influences organizations around the globe in both the long haul and here and now. Czinkota (2004) refered to that fear based oppression affected long haul karma of whole ventures, for instance tourism, retailing and assembling enterprises. There are number of meanings of fear based oppression, which are mind boggling and consider diverse measurements. Alexander et al (1979) characterize psychological oppression as "a risk or total utilization of authorization and severity to accomplish a political objective bye methods for terrorizing apprehension, and pressure". The start of 21st Century changed the world definitely and the primary explanation for this was the episode, which happened on September 11 2001. The overwhelming psychological oppressor assaults on the World Trade Center in New York. On this date, the entire world came into stun when America was under assault. The second episode, which occurred on 7 July 2005 in London added fuel to flame. As both these nations are the principle economies of the world, these occurrences had a tone affect on organizations all around the globe. In this task, we will endeavor to locate the general effect of these occurrences left on the United Kingdom organizations. We will likewise concentrate on the progressions and new improvements which happened, after these two occasions, in UK associations. This danger of psychological oppressor assaults represents a nonstop climate of hazard for all organizations in UK. This hazard itself makes expansion for treatment of hazard in administration speculations. The lion's share of administration writing speculations receive the term 'vulnerability' as a factor of unusual condition, which may impact the execution of association in certain ways. Nature affected by fear mongering additionally has a factor of flightiness in it. 2. Impacts of psychological warfare on UK economy and organizations: As indicated by the European Commission 2001 report, psychological oppressors coordinate their assaults against organizations for more than some other target. Psychological warfare can push any association or economy to the brink of collapse in light of its dread and organizations fear for more assaults may happen, so they reluctant to work as ordinary. Expanding expense of security and setting up new frameworks can cost colossal measure of cash to organizations eventually diminish in the market estimation of organizations? Psychological oppression has its huge impacts on UK economy and business exercises. It influences perniciously on organizations methodologies and most organizations working in the affected regions gets affect from the push of government arrangements to subdue fear based oppression. Organizations universally and locally are especially influenced by psychological oppression since when occurrences like 9/11 happen, it upsets the store network and bothers business exercises notwithstanding interfering with data streams. It affected on the modern request and additionally buyer request. This falling interest may have diverse results which may contains misfortunes of clients contracts, client confide in, lessened offer of the market and a critical decrease in deals, all of which could prompt business disappointment. For instance as per the report of BBC 22 July 2005, Bombs will cost just UK tourism alone; £300 million. Fear based oppression has coordinate impact on UK associations, by one means or another in a roundabout way influences on purchasers, which unquestionably decreases in purchaser request makes flighty movements, interference in store network, interruption in the stream of approaches, control and furthermore widy affects the macroeconomic variables of the nation. Czinkota et al (2004) refered to that finished all every factor in economy gets the effect of psychological warfare and certainly reacts to the activity of fear based oppression. Present day psychological warfare is especially burdensome, as a result of normal for now is the right time. The effect of psychological oppression on macroeconomic is essential, clients feel themselves in stress and some sort of ceaseless dread, which certainly impacts the spending designs. At the point when psychological oppressor assaults occurred in New York and London, they influenced organizations in an immediate and aberrant way and disturbed the monetary procedure. Both of these assaults were on the primary monetary urban areas of the world exchange. To make the impacts of the fear monger exercises more grounded, psychological oppressor bunches focused on open and private associations. Organizations are more alluring focus for fear based oppressor as their essence is all around and their aftermaths are more profound on society and on the financial matters. 2.1 Direct impact of fear based oppression on organizations: Coordinate impacts of fear based oppression contain moment and prompt outcomes of psychological warfare. As per London Chamber of Commerce and Industry 2005 report, after the World Trade Center assaults, the IFM scaled back its figure of UK monetary development by 0.6% from 2.4% to 1.8% and as indicated by Office of national Statistics information UK genuine development was 1.6%, which was weakest financial development for over 10 years. As per the Institute of Directors report in 2002, after New York assaults 20% of private associations had expanded business security, 52% of associations conveyed customary hazard appraisal to evaluate their helplessness to assault. The impacts of seventh July 2005 London bombings on UK associations was even serious than the September 2001 assaults. The business trust in London has drooped to the most reduced levels not seen since the eve of Iraq War 2003. Number of UK associations was expecting that the economy will enhance in coming year however an emotional droop given the - 16% adjust found in the primary quarter of the year. In August 2005, The Bank of England diminished Interest rates by one-quarter percent to enhance monetary conditions. The assaults brought terrible time for the London not simply in occasional but rather monetary term too. As per Time Online (2005) UK's financial development apparently was the weakest since 1993. Numerous associations respondents revealed that their workers were terrified to movement on open transport and wanted to movement via autos or navigates which prompt expanded travel costs. For the general population and associations, which affected independently the misfortune was very heartbreaking. In addition, coordinate impacts incorporate sudden increment in cost of item, diminish underway and yield of firm, and loss of profitable human capital. 2.2 Indirect Effect: 2.2A Change in buyer request heterogeneously: While the roundabout impacts of fear mongering in UK incorporate unmistakable lessening in purchaser request, impromptu moves and negative interference in inventory network. Its likewise urge specialists towards the new strategies and their quick usage. Roundabout impacts likewise incorporate outside relations of the UK associations and nation's legislatures, which influences exchange. As indicated by Loewenstein et al (2001) particularly aberrant impacts contains request of customer that may interfere with the arrangement of procurement or supply. It is clear that industry works as indicated by the request of purchaser. This is contaminating an across the board of basic dread of people, which in comes about decrease sought after of mechanical merchandise. Daniel Steel (2008) portrays that monetary research likewise has establishes in connection and among conduct and feeling. The negative feelings like condition of dread unquestionably impacts purchaser conduct, even after the occurrence of those occasions Czinkota et al (2004) portrayed that there might be need of making of arrangements, laws, and controls for open and private association in response to these psychological militant assaults. While these activities are proposed to enhance security conditions, they likewise cause delays in productive business tasks. 2.2B Indirect impacts on authoritative tasks: The other backhanded impacts of psychological warfare on UK associations was irregularity in supply of basic products, administrations and assets and at some point impromptu moves. These issues cause genuine effect on the task of associations. In July 7 London fear monger assaults on neighborhood transportation and sensible framework (store network) impacts gravely on organizations around London. Because of suspension of inventory network all organizations battled and furthermore diminish in effectiveness of associations. Usually issue, while in fear monger assaults, the fleeting lack of administrations, great, input crude materials and parts happens; it set aside certain opportunity to recuperate from this sort of deficiency. 2.2C Macro monetary wonder: The full scale financial wonder of London and New York psychological warfare was obvious decrease in per-capita salary, diminish or sudden change in securities exchange esteem and increment in joblessness. Such pattern influences the UK economy and customer desire. The long run affect was diminish in fare and decreases in GDP and expense incomes and the expectation for everyday comforts of individuals. 3. Managing Terrorism Shaped BCCM Planning: In this part we will fundamentally dissect the diverse administration methodologies and procedures, which could be useful for associations to manage the worldwide emergencies like September 11 2001 and London Bombing 2005. In this piece of the task will assess execution and adjustment of appropriate methodology by associations on various sort of business exercises and examine the diverse business key perspectives, which an association can embrace for limiting the impacts of psychological warfare. We will likewise examine diverse ways that associations can profit in term of increment in benefit and limit the effect of psychological oppression. With the danger of fear based oppression, associations need to center around the specific assets which are accessible to manage these dangers. But fear mongering, there are some different dangers (money related and non-monetary) which are additionally impact the hierarchical exhibitions in the meantime, authoritative administration have bind assets and mental steam to manage impacts of psychological oppression.>GET ANSWER