| Course | NU671 PMHNP Psychopathological Disorders and Psychotherapy |
|---|---|
| Unit | Unit 1 |
| Paper type | Discussion board post with two replies |
| Length | About 620 words, 3 pages double-spaced |
| Format | APA 7 discussion post |
| School | Purdue University Global |
| Program | MSN |
| Updated | September 2026 |
Free sample paper for NU671 Unit 1
Twenty-Two Years Without a Blood Draw: Why a Fear Outlives Its Cause, Answered Through Avoidance
NU671 · Unit 1 Discussion Board Post
Posted by [Student Name]
The patient is composite; details are bracketed.
Initial Post
Mr. [V.] is a [31]-year-old appliance repair technician. At age [nine] he fainted during a blood draw and hit his head on the chair. Since then he has refused every blood test, left a dental appointment when he saw a syringe, and avoided visiting his father after surgery. His primary care clinician has found an elevated fasting glucose on a finger stick and wants laboratory tests. He told me, "I know it's stupid. It was twenty years ago."
Why has the fear lasted two decades after one event? The answer I find most convincing is avoidance. Each time he avoids a needle, his anxiety drops, which rewards the avoidance and makes it more likely next time. More importantly, avoidance prevents him from learning anything new. He has never stayed in a room with a needle long enough to find that nothing terrible happens. The fear is not preserved by the memory of the event but by twenty-two years of never testing it.
Current models of exposure describe this in terms of learning. Exposure does not erase the original fear; it builds a new, competing memory that the feared situation is safe, and treatment works best when it maximizes the violation of the patient's expectations (Craske et al., 2014). Mr. [V.] has never given himself the chance to form that competing memory.
Blood phobia adds a twist. Unlike most phobias, it often produces a biphasic response: heart rate and blood pressure rise briefly, then drop, and the person can faint. That means his fear is not entirely irrational; he really did faint. It also means that ordinary exposure can be complicated by fainting. Öst and colleagues compared applied tension, in which patients learn to tense the large muscles of the arms, legs and trunk to raise blood pressure, with exposure alone and tension alone over five sessions. At one-year follow-up, 100 percent of the applied tension group, 90 percent of the tension-only group and 50 percent of the exposure-only group were clinically improved (Öst et al., 1991).
My plan would therefore start with applied tension, practiced until he can raise his blood pressure at will, then use it during graded exposure: pictures of needles, watching a video of a blood draw, handling a capped syringe, and finally the fasting draw itself, lying down.
Has anyone worked with a patient whose fear had a real physical danger behind it? Did it change how you explained exposure?
Reply to a Classmate Who Suggested a Benzodiazepine
You suggested lorazepam before the blood draw. It might get him through one appointment, but it could also teach him that he only coped because of the pill, which is another form of avoidance. The inhibitory learning model suggests that safety behaviors and aids can interfere with the new learning exposure is meant to create (Craske et al., 2014). I would keep medication as a last resort if the draw becomes urgent before treatment is complete.
Reply to a Classmate Who Asked About Lying Down
You asked whether lying down for the draw is itself avoidance. I do not think so. Lying down is a sensible precaution against fainting, which is a real risk in blood phobia, not a feared catastrophe. The distinction I would draw is between precautions that address an actual danger and behaviors that only reduce anxiety. Applied tension is a skill he can use anywhere, and the aim is that he will eventually need it less (Öst et al., 1991).
References
Craske, M. G., Treanor, M., Conway, C. C., Zbozinek, T., & Vervliet, B. (2014). Maximizing exposure therapy: An inhibitory learning approach. Behaviour Research and Therapy, 58, 10-23. https://doi.org/10.1016/j.brat.2014.04.006
Öst, L.-G., Fellenius, J., & Sterner, U. (1991). Applied tension, exposure in vivo, and tension-only in the treatment of blood phobia. Behaviour Research and Therapy, 29(6), 561-574. https://doi.org/10.1016/0005-7967(91)90006-O
The Purdue Global NU671 Unit 1 instructions
The opening NU671 discussion typically asks why a psychological problem persists long after whatever started it. Prompts want a composite or supplied case, a clear account of how the problem began, and an explanation of what keeps it going, drawing on learning theory or a named maintaining model. An initial post near 450 words and two replies of about 150 words each is common, and each should cite at least one source. Graders reward posts that separate onset from maintenance and that use the case to show each step of the explanation. A short pointer toward treatment is welcome if it follows from the maintaining factors, but the post should stay focused on the question of persistence rather than become a full treatment plan.
How this NU671 Unit 1 example is built
Mr. V.'s history comes first: the faint at nine, twenty-two years of refusals, and the prediabetes that now makes the fear costly. The avoidance paragraph explains negative reinforcement and the missed chance to learn, and a highlighted sentence says what really preserves the fear. The inhibitory learning account from Craske and colleagues adds a current framework. A separate paragraph explains the biphasic blood pressure response and reports the one-year results for applied tension, tension alone and exposure alone. A graded plan follows in one sentence, and the post ends by asking classmates about fears with a real physical danger behind them. Each reply takes one classmate's suggestion and answers it with a source.
NU671 Unit 1 rubric: what earns full points
Rubrics here tend to weigh the explanation of persistence most, then the accurate use of theory, the fit between case and explanation, peer engagement and APA mechanics. The persistence row rewards a post that names the maintaining process and shows it operating in the patient's own behavior. Theory points go to correct use of learning concepts, such as the difference between negative reinforcement and punishment. The fit row checks that every claim about the patient is anchored in the case details. Engagement credit depends on replies that add evidence or a distinction the classmate missed. Mechanics cover citations in the post and replies and staying within the length limits set by the instructor.
Common NU671 Unit 1 mistakes, and how to avoid them
A common error is explaining how the fear began and stopping there, which answers a different question from the one asked. Another is treating blood phobia like any other phobia and missing the fainting response that makes it distinctive. Students sometimes describe avoidance vaguely without tracing the relief that rewards it each time. Some posts jump straight to a full therapy plan, which uses up the word count needed for the explanation. Replies that praise a classmate without engaging their reasoning earn little. And confusing a sensible precaution against fainting with a safety behavior can lead to advice that is unsafe for this particular fear.
Get an NU671 Unit 1 example written to your instructions
Which condition does your Unit 1 board ask about: a phobia, a compulsion, a low mood that outlasted its cause? Put that question beside the NU671 rubric and whatever case the section provided. A first post returns free in 24-48h, written to those instructions, separating onset from maintenance and closing on a response to a single classmate. The paper above is an original model document written by our desk, not a submitted student paper and not an official Purdue University Global document.
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NU671 Unit 1 questions, answered
Is two-factor theory still accepted?
As a description of how avoidance maintains fear, largely yes; as a complete account of how fears begin, no. Rachman showed that observation and information also produce fears, and later work on inhibitory learning refined how extinction operates. Presenting the theory with its date and its limits reads to a grader as currency rather than as disagreement with the reading.
Can the example be a personal fear?
Check the prompt first, since some sections ask for a composite or a supplied case. If personal material is allowed, the same structure works: pattern, acquisition, maintenance, limit. Keep the detail proportionate, because a board is a shared space and the analysis earns the credit, not the disclosure. Any sample prepared for you uses a composite by default.
Where can I find a free NU671 Unit 1 sample paper?
The whole NU671 Unit 1 post and its two replies are shown on this page, from the case and the avoidance explanation to the applied tension evidence, with two references. A post about a different persistent fear can be drafted to your prompt.
What is applied tension in the NU671 Unit 1 post?
A technique in which the patient tenses the large muscles of the arms, legs and trunk to raise blood pressure and prevent fainting. In the Öst trial, 100 percent of the applied tension group were clinically improved at one year, against 50 percent with exposure alone.
Why does blood phobia differ from other phobias in NU671 Unit 1?
It often produces a biphasic response: heart rate and blood pressure rise briefly and then drop, and the person may faint. That makes the fear partly realistic and means plain exposure can be complicated by fainting, which is why applied tension is taught first.