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Running head: NATURE VS NURTURE DEBATE PART B 1

Key Components of the Nature vs. Nurture Debate Part B Student Name: Dermot Connolly Stenberg College Surrey BC 0312 NURS 105-3 (A) Kim Bagshaw Jan 2013.

NATURE VS NURTURE DEBATE PART B

Key Components of the Nature vs. Nurture Debate Part B The nature vs. nurture debate is not as straight forward as picking one side and ignoring the other. There is increasing evidence to show that behaviors and psychiatric illnesses are influenced by both nature and nurture. (Myers, 2007). Quantifying the contribution made by each side of the debate still remains to be the question most difficult to answer, not just in the determination of psychiatric illness but also in determining criminal behavior. (Mauro, 2009). Genetic research has helped us come to understand the influence genetics has placed on our lives. Genetics does not just control the color of our eyes and hair; it also plays a significant role in determining mental illness. The purpose of this discussion is to focus on how our acquired knowledge of genetics has helped in understanding this role and how genetics has impacted psychiatric nursing. Three psychiatric illnesses will be the focus of this discussion where research has shown a clear link between genetics and their diagnoses. These illnesses are; dependent personality disorders, attention deficit hyperactivity disorder (ADHD) and depression. Individuals diagnosed with dependent personality disorder are characterized by an excessive and consistent dependence on others. They are often submissive and clinging in relationships while relying on other to help make day to day decisions. (Schultz & Videbeck, 2009). The role genetics plays in the onset and development of dependent personality disorder was demonstrated in a Norwegian twin study carried out in two time periods from 1998. (Nauert, 2012). Avoidant and dependent personality traits were compared against each twin pairing with variations categorized into genetic or environmental influences. The results of the study showed

NATURE VS NURTURE DEBATE PART B that two thirds of the avoidant and dependent personality traits could be attributed to genetics

with one third attributed to environmental factors. (Nauert, 2012). It is important to note that just because the disorder can be attributed to genetics; it does not mean that the disorder is not treatable. In fact a family history of personality disorders does not mean that it will necessarily establish itself at all. (Nauert, 2012). Genetic studies like this help psychiatric nurses understand dependent personality disorders, allowing them to better assess and diagnose their patient. For example, we now understand that the disorder is more prevalent in woman than in men and a previous history of separation anxiety increases the risk of developing dependent personality disorder. (Schultz & Videbeck, 2009). This understanding in turn leads to better treatment plans and nursing interventions such as being aware that a patients excessive dependency may transfer onto the staff where their inabilities to recognize their own abilities may prove frustrating. (Schultz & Videbeck, 2009). Much of our knowledge of attention deficit hyperactivity disorder (ADHD) stems from the over 1800 genetic studies published on the disorder to date. (Collingwood, 2010). These studies point to the link between the development of the disorder and genetics where DNA analyses on children with ADHD have found rare variations in their genetic code. (Dreaper, 2010). Other studies point to specific genes such as dopamine D4, D5 and chromosome 16. (Collingwood, 2010). There have also being studies that show a link between smaller frontal lobes, cerebellums and ADHD. (Rothenberger & Banaschewski, 2007). Through our understanding of the functions and pathways of the ADHD genes, we can develop better treatment strategies for its sufferers. This is of particular benefit to the psychiatric nurse as research suggests that individualistic responses to ADHD medication could also be genetic. (Collingwood, 2010). Traditional treatment options for ADHD include the administration of

NATURE VS NURTURE DEBATE PART B stimulant medication such as Ritalin, Adderall or Cyleft, in combination with an antidepressant. (Schultz & Videbeck, 2009). This genetic insight allows for the development of better treatment strategies which could improve patients compliance to taking medication and treatment plans. (Collingwood, 2010). Using this knowledge, nursing strategies can also be modified to include the development of the patients social skills and the provision of resources for continued support. (Schultz & Videbeck, 2009). Research has shown that genetics also plays a role in the onset of depression where low

levels of serotonin have long being associated with depression and anxiety. (Sinha, 2004). In the 1990s genetic studies on monkeys with low serotonin levels showed that they were prone to alcoholism, anxiety and aggression. (Sinha, 2004). Other research into depression has identified a serotonin transporter gene which produces a protein that transports serotonin between brain cells. (Sinha, 2004). This research has shown that individuals who are born with the short version of this gene are more prone to having anxiety disorders. (Sinha, 2004). These studies are important in the field of psychiatric nursing where drugs such as Prozac are used to increase serotonin levels in patients. (Sinha, 2004). Post mortem analysis on the brains of individuals diagnosed with major depressive disorder suggests that the MPK-1 gene was significantly impaired. This is of significant importance to the field of psychiatric nursing as rat and mouse experiments confirmed that antidepressant interventions reduced the effect of MPK-1 on the brain. (ODushlaine, 2010). Knowledge obtained from genetic studies such as these play a pivotal role in the development of treatment plans for depression which today consist of antidepressant medication and / or therapeutic goals that decrease psychotic symptoms and promotion of self esteem. (Schultz & Videbeck, 2009).

NATURE VS NURTURE DEBATE PART B The nature vs. nurture debate is complex. Central to this complexity is the attempt to quantify the impact (if any) each side of the debate plays in development of human behavior.

While there are strong arguments for both sides, this discussion focuses on the impact that nature plays on the diagnoses of mental illness. From the analysis shown, we can conclude that genetic research has, and continues to play an important role in helping to determine psychiatric illnesses such as dependent personality disorders, attention deficit hyperactivity disorder (ADHD) and depression. It has also played an important role in the development of treatment options, both pharmaceutical and therapeutic which greatly improves and alleviates patients symptoms. The analysis has shown that the fixed idea that human behavior is determined by our environment alone has being replaced with a greater understanding into the role that genetics also plays.

NATURE VS NURTURE DEBATE PART B

References: Collingwood, J. (2010). The Genetics of ADHD. Psych Central. Retrieved from: http://psychcentral.com/lib/2010/the-genetics-of-adhd/ Dreaper, J. (2010). New study claims ADHD has a genetic link. BBC News. Retrieved from: http://www.bbc.co.uk/news/health-11437079 Mauro, M. (2009). At-risk children and teens: Nature vs. nurture. Psychology today. Retrieved from: http://www.psychologytoday.com/blog/take-all-prisoners/200903/risk-childrenand-teens-nature-vs-nurture Myers, D., G. (2007). Psychology 8th ed. Worth Publishers Nauert, R. (2012). Twin study finds heavy hand of genetics in personality disorders. Retrieved from: http://psychcentral.com/news/2012/09/25/twin-study-finds-heavy-hand-ofgenetics-in-personality-disorders/45085.html ODushlaine, C. (2010). Clear new insights into the genetics of depression. Scientific American. Retrieved from: http://www.scientificamerican.com/article.cfm?id=genetics-ofdepression Rothenberger, A. & Banaschewski, T. (2007). Informing the ADHD debate. Scientific American. Retrieved from Human Development 10/11.Thirty ninth ed. McGraw Hill. 81-84.

NATURE VS NURTURE DEBATE PART B Schultz, J. M & Videbeck, S.L. (2009). Lippincotts Manual of Psychiatric Nursing Care Plans (8th ed.) Lippincott Williams & Wilkins Sinha, G. (2004). The identity dance. Psychology Today. Retrieved from Human Development 10/11.Thirty ninth ed. McGraw Hill. 3-5.