All decks that I am required to study today. Flashcards
1
Q
Health psychology involves what
A
> Promotion and maintenance of health
Prevention and treatment of illness
Identification of etiologic and diagnostic correlates of health, illness, and related dysfunction
2
Q
What is the field of Behavioural medicine?
A
> Interdisciplinary field
Concerned with health, illness, and related dysfunction
3
Q
What are three subspecialties of health psychology?
A
1) Clinical health psychology
2) Occupational health psychology
3) Community health psychology
4
Q
What is clinical psychology?
A
> Addresses management of symptoms and psychological consequences of symptoms
5
Q
What is occupational health psychology
A
> Addresses prevention and management of occupational stress
6
Q
What is community healthy psychology?
A
> Addresses community-wide health needs and health-care systems
7
Q
What is a Brief History of Health Psychology in Ancient Greece?
A
> Indoctrained by Hippocrates and Galen
They had a Holistic view of health
Believed that the mind and the body were part of the same system
they thought that a balance between physical and emotional states was necessary to sustain overall health
8
Q
What is cartesian dualism? Who invented it?
A
> René Descartes
Mind and body are separate entities; explanations for illness can be found in the body alone
The basis for much of physical medicine in Western societies
9
Q
What did Psychosomatic medicine initially focus on and what does it emphasize?
A
> Initially focused on illness behaviour that could be attributed to psychological causes
> Emphasized etiology and pathogenesis of physical disease
10
Q
Who are some Key figures in psychosomatic medicine
A
> Johann Christian August Heinroth: coined the term psychosomatic medicence
> Benjamin Rush: father of modern psychiatry
> Sigmund Freud: believed that certain symptoms represented manifestations of unconscious conflicts
> Franz Alexander: physical disease can be the result of “fundamental, nuclear, or psychological conflict”
> Helen Flanders Dunbar: founding editor of Journal of Psychosomatic Medicine
> Guze, Matarazzo, and Saslow: invented the biopsychosocial model
11
Q
What are Careers in Health Psychology?
A
> can take up Applied (clinical) work and research
12
Q
Who / what are health psychologists employed by?
A
> General/specialized hospitals and private clinics
> Legal and insurance systems (consultation)
> Various university and teaching hospital departments
13
Q
What are Major Theories and Models in Health Psychology?
A
> The biopsychosocial model
Health belief model
Social cognitive theory
Theory of planned behaviour
The common-sense model of self-regulation/illness representation
Cognitive behavioural perspective
The transtheoretical model of behaviour change
14
Q
What is The Biopsychosocial Model?
A
> Forms the conceptual basis of health psychology
> Considers the interplay and integration of biological, psychological, and social factors on health
> Contrasts with the medical model of disease, which separates the physical and psychosocial
15
Q
Readiness to take action in relation to health problems is a function of what two factors under the health belief model?
A
- Beliefs about health condition (e.g., perceived severity, perceived risk, perceived barriers to action)
- Perception of the benefits of taking action to prevent health problems
> Factors that may affect these types of beliefs (e.g., demographic variables) are considered
16
Q
What are individual perceptions under the health belief model
A
> perceived susceptibility
perceived severity
perceived benefits of preventative action
perceived barriers to prevent action
17
Q
What are modifying factors under the health belief model?
A
> demographic variables
socio-psychological variables
18
Q
What increases the likelihood of taking recommended preventive health action?
A
> percieved threat
19
Q
What are cues to action under the health belief model?
A
> information
reminders
persuasive communication
experience
20
Q
What is social cognitive theory?
A
> Based on the work of Albert Bandura
> Human behaviour is reflected in three-way model:
1) Interaction of personal factors
2) Environmental influences
3) Behaviour
21
Q
What are 4 central constructs to social cognitive theory?
A
Reinforcement, observational learning, self-control, self-efficacy
22
Q
What is the theory of planned behaviour
A
Believes that Behaviour is determined by three beliefs:
- Behavioural beliefs—Lead to favourable/ unfavourable attitudes
- Normative beliefs—Lead to perceived social pressure related to subjective norm
- Control beliefs—Lead to a perception of behavioural control
23
Q
What is The Common-Sense Model of Self-Regulation
A
> Describes the way people process and cope with health threats
> Individuals form a lay view of their health based on various sources of information; this guides their coping responses
> There is continuous feedback between the efficacy of how people cope with health threats and their perceptions of the health threat
24
Q
What is the Cognitive Behavioural Perspective?
A
> Thoughts, behaviour, and emotions are interconnected and thus our behaviours and emotions also influence our thoughts
> Different people with the same health condition may show different emotional responses to their health
> Cognitive behavioural therapy
25
What are the stages of The Transtheoretical Model of Behaviour Change?
1. Precontemplation
2. Contemplation
3. Preparation
4. Action
5. Maintenance
6. Termination
26
What are the body systems?
1. Cardiovascular system
2. Gastrointestinal system
3. Respiratory system
4. Renal system/urinary system
5. Immune system
27
What is the cardiovascular system?
> The heart maintains blood flow through a system of outgoing/incoming “pipes” (i.e., arteries, capillaries, and veins)
> Death of heart muscle cells due to myocardial infarction can produce various forms of fibrillation
> Myocardial infarctions are generally the result of atherosclerosis
28
How does the cardiovascular system work?
> Blood from venous circulation collects in right atrium → ejected into right ventricle
> Blood passed through lungs collects in left atrium → ejected into left ventricle
> Simultaneous contraction of right and left ventricles sends blood out to the lungs and the rest of the body via the aorta
29
What does the digestive system do, how is the process monitored, and what does the involvement of muscle activity suggest?
> Digestion transforms food to a form where nutrients can be easily absorbed
> The process is monitored locally and by the brain
> The involvement of muscle activity throughout the process suggests a possible means of disruption and a mechanism for functional gastrointestinal disorders that some experience during stress
30
Where does the digestive system begin?
> Breakdown begins in mouth
> Muscle contractions move mixture through esophagus to stomach
> Smooth muscle in the stomach contracts, mixing food with corrosive substances
> Materials from liver and pancreas added in small intestine
> Waste materials proceed through large intestine
31
What are the primary organs of the respiratory system, what element is required, what is a waste product of this system, and what monitors this system?
> Primary organs are the lungs
- Others include nose, mouth, trachea, diaphragm
> Oxygen is required to convert glucose into adenosine triphosphate, which powers the body’s chemical reactions
- Waste product is carbon dioxide
> Brain monitors chemical composition of the blood and can speed or slow respiration
32
How does the respiratory system work?
> Air passes into lungs
> At end of the trachea, pathway divides into two bronchi, one for each lung
> Carbon dioxide–rich blood pumped through lungs by heart’s right ventricle
> Carbon dioxide diffuses out into alveoli; oxygen from inspired air is absorbed and proceeds to left atrium for circulation to rest of body
33
How are the kidneys the main component for The Renal System/Urinary System?
> Kidneys are the main component
- Remove waste products from the blood
- Concentrate urine
- Regulate blood pressure
- Control retention/excretion of electrolytes
34
What does the immune system entail?
> Protects the body from infection
> Process of detection is not perfect
> More diverse and much less compartmentalized than other systems
> Primary components are individual cells that circulate in the bloodstream
> Fixed components also exist (i.e., lymph vessels and nodes, thymus and spleen)
35
What are some components from the Immune System, cont’d
> Circulating leukocytes (i.e., white blood cells) develop from stem cells located in bone marrow
-Contains Myeloid and lymphoid types
> Cells from myeloid line as well as some from lymphoid line provide “non-specific” immunity
- Pre-programmed to attack common invaders
> “Specific” immune cells derived from lymphoid line are more flexible
- Respond to protein patterns on new threats
36
Psychological Influences on Body Systems - how is physiology and behaviour adjusted?
> Nervous systems process information about the environment and internal condition of the body
- Adjust physiology and behaviour accordingly
> Physiological activity is also adjusted according to internal/external sensory information
37
The Peripheral Nervous System - where are neurons located for it, what does it allow the body to do, and what are the two subsystems of the body?
> Neurons are located outside the central nervous system (CNS)
> Allows the brain to make quick adjustments of body function
> Two subsystems:
Somatic nervous system
Autonomic nervous system (ANS)
38
What is The Autonomic Nervous System and what does it overall influence? How do the SNS and the PNS affect this system?
> Influences “involuntary” muscle activity
- Sympathetic nervous system (SNS)
Stimulates smooth muscle activity
- Parasympathetic nervous system (PNS)
Usually inhibits smooth muscle activity
39
How does the endocrine system work?
> The brain can influence body function by stimulating the release of hormones
> Effects of hormones complement and extend peripheral nervous system activity
> Especially hormones released from the central portion of the adrenal glands
> Most hormones are controlled by the hypothalamus and pituitary gland
40
What was Walter Cannon's take on stress?
> Walter Cannon
- “Fight-or-flight response pattern”
- SNS allows the brain to prepare the body for a potentially life-threatening situation
41
What did Hans Seyle believe about stress?
> A wide range of stimuli can elicit a pattern of physiological activity (“stress response”)
> Effects of stress on hormonal activity (specifically, adrenal hormone cortisol)
42
How are emotions and stress linked?
> link between emotion and stress
> Emotions often elicit stress reactions
> Stress response is tailored to the situation
- Anger vs. fear
> Stress response does not require actual exposure to a challenging situation
- Anticipation or memory of an event is enough
43
Psychological Factors in the Development of Illnesses- what is a common example?
> Gastrointestinal ulcers
- “Executive monkey” experiment
- More likely to occur in situations involving long-term uncontrollable stress, hopelessness, and depression
44
What are vasovagal reactions? What is it an example of?
> Dizziness, weakness, fainting
> More likely to occur in situations of short-term uncontrollable stress
> Possibly developed as a response to the anticipation of pain and/or blood loss
> Psychological Factors in the Development of Illnesses
45
What is high blood pressure formally known as and what emotions are linked to it?
> High blood pressure
> Hypertension
> Theories focus on situations and emotions related to struggle, aggression, and anger
46
What diseases are linked to cortisol?
> Coronary heart disease, obesity, impaired central nervous system function
- Cortisol
47
What is the Most important development in health psychology in the last 20 years?
> Psychoneuroimmunology
48
Who coined the term “psychoneuroimmunology”?
> Ader
> Demonstrated that aspects of immune system function can be influenced by classical conditioning
49
How did Hans Selye contribute to the Psychoneuroimmunology field?
> found Connections among stress, cortisol, immune function, and ulcers
50
Stress and susceptibility to illness has been found with what?
> common colds, AIDS, cancer
51
What has stress reduction interventions been used for?
Effects of stress reduction interventions on the progression of serious illness
52
What does stress involve?
> Stress involves some perturbation of the system in response to perceived threat or demand
53
The study of the body’s response to stress was largely launched by two theories:
Fight-or-flight response (Cannon, 1929)
General Adaptation Syndrome (Selye, 1976)
54
What is distress and what health outcomes are associated with it?
> Distress: Feeling of having insufficient resources to meet demands of a situation
- Negative health consequences
55
What is eustress and what health outcomes are associated with it? What notion is it connected to?
> Eustress: Confronting challenges one can adequately deal with
> Positive health consequences
> Connected to notion of optimal arousal
56
Does stress still remain without the presence of a stressor?
> Impact of stress will persist even after stress has passed
57
Difference between stressors could be what?
> could be how many times they recur and how long they last
58
What process turns acute stressors into chronic stressors?
> can turn acute stressors into chronic ones
59
What are some examples of Stressful Situations?
> Job/primary role
> Life events
> Caregiving
> SES - gender, race
60
Job and Primary Role Stress what does that involve?
> Job demands and amount of autonomy
> Effort–reward imbalance
> job demands vs capabilities of employee
61
What is the Social Readjustment Rating Scale (SRRS)? What does it not distinguish and what has been found from it?
> quantifies the general level of stress in a person’s life
> Does not distinguish between positive and negative events
> quantifies the general level of stress in a person’s life
Does not distinguish between positive and negative events
62
The caretaker’s role is exemplified by what factors?
> by relentless responsibility, vigilance, and hassles
63
What specific negative health outcome is associated with caregiving?
> Can reduce telomere length (marker of cellular aging)
64
Sociological Stress: SES, Gender, Race- how are women affected?
> Dual roles for women in the workforce
- creates role conflict + stress
65
Low SES leads to what health outcomes?
> poor nutrition, smoking
> Racial bias
> Poor physical health
66
Personality dimensions of stress-prone people: what are some of them?
> Type A personality
- Anger, hostility, and aggression
> Negative affectivity (NA)
- Prone to negative emotions (e.g., anger, fear, disgust, contempt, etc.)
67
Effort–distress model - how are events seen in this model?
> are seen as excessive/out of control
68
Stressfulness of SES might be the combination of what?
> available resources and the ways individuals use them
> i.e., being poor AND living beyond one’s means
69
Stress also depends on the particulars of the person and the situation- what occupation was found to be affected by the particulars of the person?
> Traffic enforcement agents: hostile interactions + hostile personality = high levels of stress
70
What is a primary and secondary appraisal?
> Primary appraisal: Determination of the magnitude and nature of the threat
> Secondary appraisal: Determination of the resources available to deal with the threat
71
What is problem focused coping?
> Directly addressing the demands of a situation
72
What is emotion focused coping?
> Addressing the emotions that come with stressful situations
73
What is avoidant focused coping?
> Ignoring the problem and resulting emotions
74
In the Ways of Coping Scale (Folkman et al.), what are the different types of coping?
1) Confrontative coping
- “I tried to get the person to change his/her mind”
2) Distancing
- “I went on as if nothing had happened”
3) Self-controlling
- “I tried not to act too hastily”
4) Seeking social support
- “I talked to someone about how I was feeling”
5) Accepting responsibility
- “I realized I brought the problem on myself ”
6) Escape-avoidance
- “I slept more than usual”
7) Planful problem-solving
- “I made a plan of action and followed it”
8) Positive reappraisal
“I changed something about myself”
75
What is social support?
a social network in which others care about one’s well-being and provide help and assistance.
76
Help is generally divided into four categories for social support:
1) Emotional
2) Instrumental
3) Informational
4) Appraisal support
77
What is the main effects model?
> Social support is generally beneficial to health and well-being (whether we are carefree or stress-ridden)
78
What is the buffering model?
> Social support reduces stress and its negative effects on one’s health
79
Women are more likely do what with social support compared to men?
> are more likely to seek social support than men
80
What is the gender difference between the Tend-and-befriend vs. fight-or-flight?
> From an evolutionary perspective, women are physically smaller and weaker, and are often pregnant or caring for small children—a fight-or-flight response is not feasible
81
Women may have a modified stress response due to what hormone?
> the hormone oxytocin
- Encourages affiliation and caregiving
82
What is emotional disclosure?
> there may be benefits in “discussing” a problem with oneself (e.g., journaling)
83
How does exercise impact stress?
> Research shows that people who exercise frequently tend to report lower levels of stress, bore studies are needed to explain why
84
Stress is a major risk factor for what two psychological disorders?
> for depression and anxiety disorders
85
what is PTSD?
> Intrusive thoughts, often even when sleeping, of the traumatic event, and this rumination extends the duration of the stressor and multiplies its impact
86
What is rumination and what is it predictive of?
> fixating and dwelling on events that might be considered minor
- Predictive of future anxiety and depression
- Can make depression worse
87
Stress and Sleep- what factors impact sleep?
> stress and sleep have a Bidirectional relationship
> Job-related stress - interferes with sleep
> Digital media use = more stress
> Shift-work - interferes with sleep
88
What are some examples of Stress Management
> Cognitive behavioural therapy (CBT)
> Biofeedback
> Relaxation
> Mindfulness
> Pharmacological treatments
89
Social Networking, Stress, and Online Social Support - how does social networking impact stress + perceived support?
> Online social networks do not confer perceived social support benefits the way in-person social support can
> Both positive and negative effects on stress
90
Society is becoming increasingly what?
> becoming increasingly multicultural and globally conscious
91
How are we experiencing "Shifting demographics"?
> there is an Increasing presence of visible minorities.
92
What is the Importance of becoming culturally competent/what does it mean to become culturally competent?
> Understanding how different groups respond to physical/psychological symptoms and view medical services
93
What is race?
> Biological variation between groups
94
What is ethnicity?
> the acceptance of group mores and practices of one’s culture of origin and the concomitant sense of belonging
> the definition is Subjective and self-reflective of this concept.
95
What is culture and how is it developed?
> Shared set of values, ideals, and beliefs
> Learned or transmitted through interaction
96
Hofstede’s Value Dimensions of Culture - what are the 5 dimensions?
1) Individualism–collectivism
2) Power distance
3) Uncertainty avoidance
4) Masculinity–femininity
5) Confucian dynamism
97
What is Individualism–collectivism?
> Degree to which people within society act individually rather than as part of a group
98
What is power distance?
> Societal acceptance of equal/unequal distribution of power within institutions
99
what is Uncertainty avoidance?
> Ability of societies to tolerate ambiguity as indicated by presence/absence of clear rules
100
What is masculinity/femininity?
> Extent to which society values assertiveness/ monetary acquisition as opposed to co-operation
101
What is Confucian dynamism?
> Refers to future-oriented values as compared with present/past orientation
102
What are some Criticisms of Hofstede’s Value Dimensions of Culture?
> Minimizes possibility of many cultures operating simultaneously within a country
> Assumes national boundaries demarcate different cultural orientations
> Engenders Westernized, patriarchal structures
- Challenge raised using postcolonial theory
103
Culture and ethnicity are recognized within the biopsychosocial formulation of health - why?
> Important for causation, prevention, and management of illness
104
What are Influences that culture exerts on health?
> Coping styles, economic resources, appraisals of and exposure to stress, and illness exposure
105
Culture may affect what kind of beliefs? how so?
> may affect people’s health beliefs (health beliefs model of social cognition)
> How beliefs interact to produce behavioural effects
> Value expectancy theory
106
Culture may affect attributions about health- what are attributions of health?
> Causal explanations people assign to illness and wellness
107
Health beliefs and attributions provide information about what with respect to our health?
> provide information about the meaning and seriousness of symptoms and influence health behaviours
108
What are the components of Traditional Chinese medicine (TCM)?
> Holistic approach
> Opposing forces in the body
> Pairings of organs and qi are sought to be balanced and harmonized
109
Native American medicine is more akin to what?
> More akin to healing than to curing
110
What are the components of native American Medicence?
> Focuses on restoring well-being and harmony to the body
> Considers elements of natural world alongside the human world
> Emphasis on finding connections among life experience and illness
> Ritual, ceremony, and spirit world are often given consideration
111
In Western medicine- what are Complementary and alternative approaches?
> Alternative medicine: non-mainstream approaches to health that are used in place of conventional medicine
> Complementary approaches: the use of non-mainstream approaches in conjunction with conventional medicine
112
What are Health disparities?
> : the gap between incidence and prevalence rates of illness and death among different groups of people
113
How are differences evaluated for Health disparities?
Differences are evaluated quantitatively and qualitatively
114
The relationship between health disparities and ethnic status is considered what?
> not straight forward.
115
Canada’s Aboriginal peoples fare much worse than the majority of Canadians in what health outcomes?
> Life expectancy
> Infant mortality
> Chronic disease outcomes
> Health behaviours
116
African-Americans fare much worse than non-Hispanic White Americans in:
> Life expectancy
> Infant mortality
> Cardiovascular disease and stroke
117
Health disparities among the US Hispanic population include:
> Diabetes
> Cancer
> Liver disease
> HIV mortality
118
Health-care disparities occur due to what?
> occur due to a complex chain of secondary mediating variables (health-care disparities)
119
What are Determinants of health?
> Range of factors that account for health status of groups of people
> can be: Personal, socio-economic, environmental
120
Socio-economic status (SES) includes:
Education, income, work status
121
APA’s Task Force on Socioeconomic Status describes three conceptualizations of SES: what are they?
Materialist
Gradient
Social class
122
Berry’s (1997) two-factor model of acculturation identifies four outcomes:
1) seperation
2) marginalization
3) assimilation
4) integration
123
Acculturation occurs in:
> stages across several domains such as language and socio-economic status
124
Positive or negative effects on health behaviours culturally depend on what?
> depending on the frequency of the behaviour in the original and new cultures
125
The relationship between mental disorders and physical conditions is well established- but what hasn't been researched?
> But possible cross-cultural differences have not yet been researched
126
Do Immigrants across countries have psychological disorders? Provide a Canadian example that can relate to this idea:
> Immigrants across countries have increased rates of psychological disorders compared to native populations
> Canadian First Nations people have higher rates of suicide, alcoholism, and incidences of violence
127
Rates of disorders, psychopathology patterns, and symptom presentation are influenced by what?
> cultural factors
128
What are Culture-bound syndromes?
> Recurrent patterns of abnormal behaviour and troubling experience that occur specifically to a local culture/ community
129
Empirically Supported Therapies: What are the limitations? Is the gap narrowing?
> Minority groups are under-represented in most psychotherapy studies
> The gap between evidence-based practice and multicultural interventions has closed
130
What are the three types of cultural competence?
> Cultural competence vs. cultural sensitivity vs. patient-centred cultural sensitivity
131
Three components of multicultural counselling competencies:
1) Cultural awareness and beliefs
2) Cultural knowledge
3) Cultural skills
132
What Is Pediatric Psychology?
> Specialized field within health psychology
> Integrates scientific research and clinical practice to address psychological aspects of children’s medical conditions
> Promotes health behaviours in children and families
133
Is there a division of the APA for Pediatric psychology? What journal is published under this division?
> Society of Pediatric Psychology (SPP)
> Division 54 of the American Psychological Association (APA)
> Publishes the Journal of Pediatric Psychology
134
What are some Cross-cutting themes for Pediatric Psychology?
> Coping with chronic medical conditions
> Treatment adherence
> Coping with medical procedures
> Chronic pain
> Palliative care
135
What is the Trajectory of chronic medical conditions?
1) Sudden onset of medical symptoms
2) Family seeks initial medical consultation
3) Diagnosis of specific medical condition
4) Identification/implementation of medical management plan
5) Longer-term phase of adjustment to impact of medical condition
136
What should be noted about the Trajectory of chronic medical conditions?
. For some, medical diagnosis and management plan may not always be immediate/evident
137
Wha are the Three most common areas of stressors identified by children with cancer?
1) Interruptions in daily role functioning
2) Physical effects associated with treatment
3) Uncertainty about the cancer
138
What did parents of children with cancer report as the most stressful?
> Parents reported cancer caregiving as most stressful
139
Behavioural coping strategies are more common in early childhood - what do they later evolve into?
> Later evolve into cognitive strategies
140
What are the types of coping identified under Control-based model of coping (Compas et al., 2012)?
1) Primary control/active coping (i.e., efforts to act on the source of stress or one’s emotions)
2) Secondary control/accommodative coping (i.e., efforts to adapt to the source of stress)
3) Disengagement/passive coping (i.e., efforts to avoid or deny the stressor)
141
Assessment of children’s pain is often done with what questionnaire?
> using the Pain Coping Questionnaire and Kidcope
142
Psycho-educational interventions that incorporate CBT techniques in improving range of outcomes such as:
> Self-efficacy
> Self-management of disease
> Family functioning
> General psychosocial well-being
> Reduced isolation
> Social competence
> Knowledge
> Hope
143
Overall non-adherence rate of what for pediatric patients?
> Overall non-adherence rate of 50% for pediatric patients
144
Variables associated with adherence to treatment in children:
> Child age
> Child emotional development
> Family factors
> Disease- and treatment-specific considerations
> Reinforcement-based interventions
145
What are some common Interventions for Pediatric psychology?
> Reinforcement-based interventions
> Monitoring
> Goal-setting
> Contingency contracting
> Problem-solving
> Linking medication with established routines
146
Successful interventions for Pediatric psychology do what?
> Target adherence to a narrow age range
> Include the family
> Improve access to care
147
What are the most feared experiences of children
> Needle procedures are most feared experiences of children
148
The majority of children undergoing painful medical procedures don't receive what?
> no pain-relieving interventions
149
Poorly managed painful procedures early in childhood are related to:
> Increased pain sensitivity
> impaired brain development
150
Parent reassurance is associated with what?
> child pain and distress;
151
distraction/humour is associated with what?
> with child coping
152
Children are able to provide self-reports of pain using what scale?
> the Faces Pain Scale–Revised
153
Aside from scales, what other ways can pain in children be measured?
> can also be assessed using behavioural measures
154
Pain management strategies for children include:
> Pharmacological
> Psychological
> Physical
> Combined
155
Pediatric Chronic Pain is experienced by what percentage of children? What are three common examples of chronic pain?
> Experienced by 20% of adolescents
> Headaches, stomach aches, backaches
156
Core outcome domains for assessment of pain are:
> Pain intensity
> Physical functioning
> Emotional functioning
> Role functioning
> Sleep
157
Multidisciplinary interventions include:
> Medication
> Nursing support
> Physical therapy
> Psychological interventions (e.g., CBT)
> School-based modifications
158
Only 10% of dying children receive what?
> hospice or palliative services
159
What are the Goals of care (pediatric)
> Symptom management
> Advanced-care planning
> Ethical/legal considerations
160
How does pediatric care differ from adult care
> Types of medical conditions experienced by children
> their understanding of death/dying differ from those of adults
161
Sleep problems are:
> Associated with emotional and behavioural issues
> Include bedtime resistance and night wakings
> Support for efficacy of behavioural interventions
162
Feeding issues what are the two most common feeding issues and what is it related to?
> Getting children to eat food at assigned mealtimes and encouraging children to try new foods
> Children’s nutritional behaviours related to parent attitudes
163
Toileting issues - what is Enuresis?
> Involuntary passage of urine
- More common in boys than in girls
- Urine alarms are promising
164
Toileting issues - what is Encopresis?
> Passing of feces in inappropriate places
> In most cases, occurs as direct result of overflow incontinence
> Treatment includes education about constipation, laxatives, behavioural treatment, and compliance with medication
165
What is the impact of a child's medical condition on the their parents?
> Caregiving affects work, social life, care of other children, and household chores
> Problem-solving therapy improves parents’ distress
> CBT is associated with improvements in the child’s medical symptoms
166
What is the impact of a child's medical condition on the their Siblings?
> Group-based interventions
> Developmentally-appropriate information, coping skills training, opportunity to meet others
167
What is included under e-Health (electronic health) ?
> Telemedicine
> Internet-based self-management
> Distraction devices (e.g., MEDi)
> m-Health (mobile health)
168
Social media have been used to do what in respect to pediatric psychology?
> facilitate direct communication and engagement between clinicians, researchers, youth, and their families
> deliver health-promotion programs for children with medical conditions and their parents
> run virtual focus groups
> recruit hard-to-reach clinical populations
> deliver research evidence to parents in a way that is functional, accessible, and that can be implemented in everyday life
169
Older adults are considered what segment of the US and Canadian populations?
> Older adults are fastest-growing segment of US and Canadian populations
170
Prevalence of most types of disability increases with age, such as:
> problems in mobility, agility, hearing, vision, pain
171
Prevalence of seven chronic illnesses increases across lifespan: what are they?
> Angina/coronary heart disease, arthritis, cancer, diabetes, heart attack, hypertension, stroke
172
Health disparities reduce the ability to achieve best health outcomes among what specific groups?
> People of colour
> Women
> Those with low education and income
> Rural-dwelling individuals
173
Risk factors - what are the main two components for Geropsychology?
> Genetic influences account for 35%
> Environmental/lifestyle influences account for the largest percentage
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Poor health outcomes associated with multiple chronic illnesses:
> Increased hospitalizations
> Complicated medication schedules
> Duplicated medical tests
> Conflicting medical advice
> Increased disability
> Death
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Chronic conditions are often accompanied by what?
> psychological disorders
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What is Collaborative care?
> Integrated health programs that combine mental health screening and services into medical care settings
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What does collaborative care support?
> Supports systematic diagnosis and health or mental health outcomes tracking, and facilitates adjustment of treatments based on these outcomes
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What is advanced care planning?
> making decisions about the care you would want to receive if you become unable to speak for yourself
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Advance care planning includes four elements:
1) Getting information on the types of life-sustaining treatments that are available
2) Deciding what types of treatment you would or would not want
3) Sharing your personal values with your loved ones
4) Putting into writing what types of treatment you would or would not want
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Family behaviours/communication patterns are important in overall patient outcomes - the Caregiver Stress–Health Model suggests two family member response patterns - what are they?
1. Cognitive empathy: Shared or complementary emotional experience
2. Conditioned emotional responses: May occur when family member has paired certain emotions with past experiences of older person’s suffering
181
Chronic pain affects what percentage of older adults in the community and what percentage in LTC?
> Chronic pain affects at least 50% of older adults who live in the community and as many as 80% of seniors who live in long-term care facilities
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There are unique challenges to working with older persons - what is a commonly held belief about this?
> Commonly held false beliefs (e.g., idea that pain is inevitable part of aging)
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Is the focus the same in CBT for Geropsychology?
Methods are similar to those employed with younger persons, but with a different focus
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Acceptance and Commitment Therapy (ACT) approaches incorperate what?
> incorporating mindfulness
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What is Bibliotherapy?
> self-help using books or manuals
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Under-treatment of pain is due to what?
> due to communication challenges posed by advanced dementia
> Associated with impairments in judgement and language abilities
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What are some methods for pain assessment in older adults?
> Behavioural observation assessment methods emphasize non-verbal pain behaviours
> Pain Assessment Checklist for Seniors with Limited Ability to Communicate and the PACSLAC-II
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Untreated pain in older adults can lead to what?
> Untreated pain can lead to behavioural disturbances which can be misattributed to psychiatric conditions
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What is the Leading cause of painful injury and hospitalization? Accordingly, what are the stats for it?
> falls
> One in three older persons experiences a fall
Half fall more than once per year
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What are medical risk factors for falls?
> Visual problems, significant orthopedic diagnosis, use of medications that affect balance
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What are Psychological risk factors for falls?
> Depression
> Excessive fear of falling (causes imbalance)
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What are the Educational interventions recommend for falls?
> Appropriate footwear
> Environmental modifications
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How does CBT treat fall fears?
> Increases self-efficacy beliefs regarding falls
> Increases sense of control over falling
> Corrects misconceptions about the view of falls and fall risk
> Sets realistic goals for safely increasing physical activity,
> changing home environment
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Transitions to LTC are precipitated by what? As a result, what does this lead to?
> are precipitated by increasing physical/cognitive impairments
> May result in depression and loneliness
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In the US, requirements for adequate care include:
> Psychosocial and quality-of-life assessments
> Activities personnel
196
What does Brief Behavioural Activation Treatment for Depression (BATD) focus on?
> Goal-setting and activity-planning
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What kind of activity programs should be used for depressed residents?
> Individually tailored activity programs for depressed residents
198
How does the APA define the end of life
> the period when health-care providers would not be surprised if death occurred within six months (APA)
199
Four time periods when psychologists can contribute to end-of-life care:
1) Before illness strikes
2) After illness is diagnosed
3) During advanced illness and the dying process
4) After the death of the patient with bereaved caregivers
200
What is palliative care?
> an approach that improves the quality of life of patients and their families through the prevention and relief of suffering
201
What does hospice entail and what does it require?
> requires a prognosis of six months or less with focus on physical and emotional comfort, not curing illness
202
Is all hospice care technically palliative care?
> All hospice care is palliative care, but not all palliative care is hospice care
203
What are Kübler-Ross’s five stages of grief?
> Denial, anger, bargaining, depression, acceptance
204
How has grief been conceptualized?
> , grief has been conceptualized as a life process that varies in intensity rather than a single experience or series of stages
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What is an important factor in grief work?
> Importance of normalizing and validating the grief process
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Grief experiences are considered:
> are unique and personal and the length of time required to heal varies
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Life review and reminiscence interventions in older adults
do what?
> Reduce symptoms of depression
> Improve social interactions, quality of life, aspects of well-being
> Assist in integration, maintenance, or development of the self
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Reminiscence Therapy in the Community is associated with:
> with decreased anxiety, denial, despair, and isolation
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Reminiscence Therapy in Long-Term Care - what are the benefits?
> Benefits in self-esteem, self-integration, quality of life, modification of problematic behaviour
210
Self-Identity in Dementia Questionnaire - what did it find?
> Identification of salient identity roles
1) Family heritage,
2) success of a relative,
3) academic achievement,
4) occupations,
4) traits, and
5) survival
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What is CIRCA?
> is a touch-screen interface to support reminiscence
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What is a unique activity of Chochinov’s Dignity Therapy?
> “Generativity or legacy”: provides comfort through the telling of the life story and sense that one’s life will transcend death
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What is the The Legacy Project?
> Improves caregiving stress, religious meaning, social interaction, family communication
214
Acceptance and commitment therapy (ACT) is designed to do what?
> Designed to help people change how they approach problems using techniques related to mindfulness, acceptance, and values-based living
215
Medically assisted death is now legal in Canada, if strict eligibility criteria are met - what is the criteria?
> Over the age of 18 years
> Eligible for medical services funded by the Government of Canada
> Incurable illness/disease/disability
> Natural death is “reasonably foreseeable”
> Suffering is intolerable to the person and cannot be relieved under acceptable conditions
216
Cognitive decline associated with:
> Reduced cognitive processing speed
> Poor decision-making
> Divided attention
217
What is Cognitive rehabilitation therapy?
> the process of relearning cognitive skills that have been lost or altered as a result of damage to brain cells/ chemistry
218
How can we improve cognitive rehabilitation?
> Instruction at a slower pace, fewer distractions, instruction in multiple modalities
219
Cognitive Rehabilitation for Dementia - what two types don't recieve benefits:
> Limited evidence for benefits of cognitive training for early stage Alzheimer’s disease or vascular dementia
220
Why hasn't cognitive rehabilitation for dementia not received benefits?
> Lack of randomized control trials
