Lectures, Seminars and Workshops available to the business and professional community.
- Psychological Aspects of Work-Related Injury
- Mood Disorders Affecting Physical Pain
- Personality Types in Medical Management
- Overcoming Fear of Re-Injury
- Catastrophic InjuriesSomatoform Disorders - Somatoform Pain and Conversion
- Factitious disorders
- Depression and Anxiety Complicating Recovery from Work Injury
- Factors in Lumbar, Cervical & Carpal Tunnel Injuries
- Posttraumatic and Acute Stress Disorders
- Pre- and Post Surgical Cases: Psychological Complications and Solutions
- The Aging Injured Worker
- Personal Injury: Exacerbated, Exaggerated or Fabricated
Seminars are typically scheduled on Friday mornings, although alternate accommodations can be made for regional, annual, lunch and learn, or other special presentation needs.
To arrange a seminar, call Atlanta Medical Psychology at 404-252-6454 to determine date availability and coordinate media needs. Past audiences include:
- The Georgia Board of Workers' Compensation
- Institute of Continuing Legal Education
- Georgia Association of Occupational Medicine
- Georgia Nursing Association
- Risk management associations
- Nurse case management companies
- Employers and insurers
Case Management Update
This Week's Topic: “Early Life Adversity”
Question: “…by contrast your consultative reports refer to the patient’s early life trauma and stressors…is that really important?”
Dr. Adams replies: There is no doubt that too often psychological evaluations are incomplete, inaccurate and disappointing. The focus is almost always upon the individual following an injury with little reference to early life.
There is also the erroneous belief that if there has been past early life trauma that all current problems are “simply pre-existing.”
The term allostatic load (AL) was coined by McEwen and Stellar in 1993. Allostatic load is "the wear and tear on the body" which grows over time when the individual is exposed to repeated or chronic stress. It represents the physiological consequences of chronic exposure to fluctuating stress demands or the patient’s heightened response to repeated or chronic stress.
We know that the allostatic load impacts high blood pressure, diabetes, inflammatory disease and most notably heart disease. Recent studies suggest that AL also impacts the patient’s experience of, and response to, pain.
We often cite functional capacity exams (FCE) in which the examiner notes that the patient’s responses are excessive and “non-biological” when, in fact, they may be the result of early life stressors, expectancies and fear.
Early life adversity (ELA) can make a person stronger and more capable of dealing with pain and stress. However, quite often ELA has made the patient fearful of, and overly responsive to, discomfort and suffering. Do not forget that children attempt to stop abuse by crying out in pain.
The most common form of ELA is low socioeconomic status (SES) and associated poverty. Poor health behaviors, poor response to symptoms and dysfunctional relationships are more common in lower SES groups. In fact, those raised in a low SES tend to become adults of low SES and this, in turn, is linked to poor health behaviors (smoking, drinking, obesity and risk-taking behaviors).
Recent studies indicate that those who are reared in low SES families can mitigate some of their risk by educational achievement. However, the impact of early life physical and abuse persists, and the physical impact can be great; greater than a better education will overcome.
In fact, “early life circumstances have a lasting imprint on” physical functioning later in life.
Thus, to have a better understanding as to why a patient is noncompliant, angry, readily disappointed, and overly responsive to physical pain, the clinician must have a knowledge of the patient’s early life adversities. In this way we can determine what early life trauma contributes to their emotional responses, subjective complaints and maladaptive behaviors.
Friedman, E. M., Karlamangla, A. S. et al. (2015) Early life adversity and adult biological risk profiles. Psychosomatic Medicine, V77, 175-185.
Online Referral: https://psychological.com/consultation-form/
Linkedin: Dr. David B. Adams
Google Places: https://plus.google.com/+PsychologicalDoctorAdams/posts
Dr. David B. Adams is Board Certified in Clinical Psychology (ABPP) and specializes in the treatment of mood, anxiety and pain disorders in adults.
In addition to his private practice, Dr. Adams consults to physicians, attorneys, employers and insurers in the diagnosis and treatment of chronic pain, posttraumatic stress disorder, disability determination and psychological complications in work-related injuries. He performs stimulator-implant-candidacy evaluations.
Dr. Adams is a Distinguished Practitioner in the National Academy of Practice in Psychology, a member of the American Psychosomatic Society, and a platinum member of the National Register of Health Service Providers in Psychology.
He is Fellow of the Academy of Clinical Psychology and a Fellow of the American Psychological Association and it's Division of Psychologists in Independent Practice, the Division of Psychotherapy; the Society of Clinical Psychology, and the Academy of Consultation Liaison Psychiatry.
Dr. Adams is a graduate of the University of Cincinnati, Xavier University, and the University of Alabama with a postdoctoral fellowship from the Institute of Clinical Training of the Devereux Foundation (Philadelphia).
Dr. Adams is the author of greater than sixty articles on the impact of psychological functioning upon claims of disability. He is a well-known presenter of seminars and regional workshops, addressing the psychological aspects of physical disease and injury.
His practice is located in The Medical Quarters, adjacent to Northside, Scottish Rite and Emory Saint Joseph's Hospitals in north Atlanta.
Atlanta Medical Psychology
5555 Peachtree-Dunwoody Road, N.E.
The Medical Quarters - Suite 251
Atlanta, GA 30342-1703.
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