2. Biopsychosocial Principles of Clinic Flashcards
1
Q
What do we need to provide the best psychological care?
A
- knowledge of patient
- knowledge of common presenting psych problems
- understanding building blocks of psych theories
- ability to synthesise and reflect to fit theory to individual
2
Q
Explain ICE theory
A
- a mnemonic for consultations introduced by Pendleton
- IDEAS - what the patient thinks might be happening, whether there is a problem
- CONCERNS - what they’re worried about (may be condition, situational/making a fool)
- EXPECTATIONS - what they think is going to happen - tooth extracted vs check up
3
Q
Relevant info to look at for this as a dentist?
A
- info collected at intake
- talking to patient
- observing and reflecting on how they respond to you in appointment
- trying out theoretically-informed approaches (if appropriate, if dental fear)
- psychometric measures
4
Q
Define ‘fear’
A
- refers to here and now
- an emotion associated with danger
- strong urge to escape or fight
- often accompanied by physical response to ‘fight or flight’
5
Q
Define ‘anxiety’
A
- refers to the future
- emotion associated with anticipation of danger
- strong urge to avoid
- physical response less intense and longer-lasting
6
Q
Define ‘pain’
A
- unpleasant sensory and emotional experience associated with actual/potential tissue damage or described in terms of damage
- known to cause emotional distress and to be increased by distress
7
Q
3 behavioural science theories associated with fear, anxiety and pain
A
- behavioural learning theory
- cognitive factors
- social/environmental factors
8
Q
Define ‘classical conditioning’
A
two things that always occur together will become linked
9
Q
Examples of classical conditioning
A
- Pavlov’s dogs
- Little Albert
- dentist and unpleasant feelings/noises
10
Q
Terms of classical conditioning
A
- unconditioned stimulus and response - stimulus exerts certain response before any conditioning takes place like a sudden noise causes fear
- neutral stimulus - something which at first has no impact on response (e.g a rat)
- conditioned stimulus and response - a previously neutral stimulus is paired with the unconditioned one - conditioned stimulus comes to evoke same response as unconditioned through association
- generalization is when conditioned response also triggered by other stimuli similar to conditioned stimulus
11
Q
Implications of classical conditioning
A
- patients may react with fear to features of dental environment - smell of surgery, sight of staff in uniform etc
- elements of dental care may resemble past experiences of patients who experienced trauma/abuse
- helpful to pay close attention to env and interpersonal factors to reduce similarity with previous bad experiences
12
Q
Behaviour and … are often linked
A
- emotions
- approach behaviour and confidence, avoid behaviour and fear, aggressive behaviour and anger
13
Q
Skinner’s operant conditioning
A
- about re-inforcement (operant conditioning about behaviour being shaped by what happens immediately after behaviour)
- positive reinf is behaviour followed by rewarding outcome, negative reinf is beh followed by cessation of unwanted experience
- punishment - an unwanted experience
- extinction - behaviour is followed by no rewarding outcome - eventually stops
14
Q
For each of these reinforcement schedules, give the rate of learning and extinction
- continuous
- fixed ratio
- fixed interval
- variable ratio
- variable reinforcement
A
- slow, fast
- fast, medium
- medium, medium
- fast, slow
- fast, slow
15
Q
Explain cognitive model/impact of thinking
A
- anxious thoughts leads to feeling anxious leads back to anxious thoughts (cycle)
- feeling anxious makes it more likely that we’ll have anxious thoughts - may assume these thoughts are realistic and true
- anxious thoughts are characterised by ‘thinking the worst’ - often they’re not true
- important to recognise they aren’t facts and related to feelings - anxious thoughts can lead to anxious feelings
16
Q
How does escape, avoidance and expectations impact fear?
A
- at a triggering event, release of hormones for fight/flight/freeze
- then escape
- in expectations, arousal increases and enables imagined consequences of continued exposure
- if not there is the natural physiological trajectory remaining and the natural physiological trajectory of escaping (this flattens much quicker)
17
Q
What is vicarious learning?
A
- learning through the experience of someone else
- observing responses of another, hearing their experience or picking up on emotion of another in room
- a factor that shapes fear
