What is the key predisposing, precipitating, perpetuating and protective factor in each case? MUST have a justification for each of the four factors.
After reading the case study in the photo attached, can I please get help with question below.
What is the key predisposing, precipitating, perpetuating and protective factor in each case? MUST have a justification for each of the four factors.
Jem is a 31-year-old man who works in a marketing team for a big corporation. He recently visited his GP, as his current girlfriend (Stacey) has concerns about his "good guy, bad guy ways". Jem describes that in the past, he has had a succession of relationships with woman. None of these relationships have lasted particularly long – maybe 2 or 3 months at the most. This relationship with Stacey is different. They have been dating for almost 2 years. Jem tells his GP that he really wants to understand what is happening for him so he doesn’t lose Stacey. He also describes having relationship difficulties with friends and family. He always had social connections, but often burnt his bridges with people. The same thing has happened in previous workplaces. He describes that he often feels irritable – even when life is good for him. And feels miserable at other times for no reason but can’t seem to shake himself out of it. Jem first noticed that he had these difficulties a few years into secondary school. School, he remembers, was hard for him. He was often distracted, but he also had times when he felt on top of the world. When he felt on top of his game, he remembers being able to tackle and finish homework assignments quickly. When he was feeling low, he remembers feeling really bad about himself. He recalls feeling worthless and finding it hard to focus or motivate himself. At these times, he would have trouble with going to school, getting out of bed and would bail on plans with his friends as it was too much of an effort and he would not enjoy it anyhow. Recently, he is often irritable, and that Stacey is getting really fed up with their fighting. After their last fight, Stacy moved to a friend’s house temporarily to "get some space". Until talking with Stacey, he says that he hasn’t realised that this way of relating to others was not "normal". He describes that he has experienced mood swings his entire adult life – maybe once or twice a month when things are hectic, or perhaps every two months. There are times when he sleeps a lot, finds it hard to get out of bed and go to work. At other times he feels really productive at work, will party a few nights a week and be out for drinks every night with social acquaintances and business colleagues and is the "life of the party". He drinks a fair bit when he is out partying, but also at the times he feels down in the dumps and hates himself. Sometimes he uses marijuana to help relax his racing thoughts of an evening. Fortunately, he works from home or is out on the road for most of the time, so he has been able to manage his work responsibilities without anyone making complaints about his attendance at work. He has been in this role for a couple of years. This is the longest time he has been with the same company since he graduated from university. His performance at work fluctuates wildly, but he has been able to meet his key performance indicators at work, as he is able to cram his client contacts into the days he feels productive. On these days, he feels unbeatable, energised and really connected to others. At other times he feels seeing people is too tiring for him and often reneges on social events and can’t be bothered with friends and the hassles of communicating and being with them. Jem grew up in the country. His dad struggled with intense mood swings for which he was on medication, and also drank a lot to manage his moods. There was lots of stress in his family growing up, as his dad was often moody and would sometimes disappear for weeks at a time. Sometimes he was in hospital, at other times he was just away. His parents divorced and his mum worked hard to care and provide for the family. Life was often stressful. Jem recalls that as a child, he just wanted to get away. He would often ride his bike to the river and just sit by its banks – skimming stones and watching the water flow. At other times, he would just stay in his bedroom. He still feels close to his Mum, though he doesn’t see her much currently. He loves Stacey and doesn’t want to put her through the same thing his dad did to his mum. He lives in a rented flat and has no financial or other worries. After attending some appointments with his GP, his GP informed Jem that the results of his blood tests were normal and ruled out some physical causes of Jem’s presentation.
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