All of Psychology

Question 2

What is an attitude?

Answer 2

a positive or negative evaluative reaction toward a stimulus, such as a person, action, object, or concept e.g. can include behaviour such as healthy eating

Question 3

When do attiuted have stronger influence on our behaviour?

Answer 3

when situational factors that contradict our attitudes are weak

–> if atitute is inglign with the situation

Question 4

Recall the theory of planned behaviour, specifically the role of atiiture towards a topic

Answer 4

The believes and evaluation of an outcome directly influence (are) the attitute towards a behaviour

Attitute directly influenced the planning of behaviour

Question 6

What is cognitive dissonance?

Answer 6

It is a conflict between 2 opposing opinions and believes

e.g. I’m a smoker vs Smoking is bad

Question 7

What is the role of the social norms and environement in health beahaviour accoriding to the theory of planned behaviour?

Answer 7

Might directly influence the intention to do a behaviour

Question 8

What are the ways to resolve cognitive dissonance?

Answer 8

At the example of smoking

• Change behaviour:
  
  • quitting, which might be difficult and thus avoided
• •Acquire new information:
  
  • Such as seeking exceptions e.g. “My grandfather smoked all his life and lived to be 96”
• Reduce the importance of the cognitions (i.e. beliefs, attitudes).
  
  • A person could convince themself that it is better to “live for the moment”

Question 10

What makes a message more effective?

Answer 10

• Reaches recipient
• Is attention-grabbing
• Easily understood
• Relevant and important

• Easily remembered

Question 11

What makes a messenger more persuasive?

Answer 11

Credible e.g. doctors

• Trustworthy e.g. objective
• Appealing e.g. well presented

Question 12

What is framing?

Answer 12

Referes to the emphasis of benefits or loss concerning a speicial statement etc.

Question 13

When are loss-framed messages regarding health behaviour more effective?

Answer 13

to take up behaviours aimed at detecting health problems or illness (e.g. HIV testing)

Question 14

When are gain-fraimed messages regardning health behaviour changes more effective?

Answer 14

to take up behaviours aimed at promoting prevention behaviours (e.g. condom use)

Question 15

What is a stereotype?

Answer 15

Generalisations made about a group of people or members of that group, such as race, ethnicity, or gender. Or more specific such as different medical specialisations (e.g. surgeons)

Question 16

What is a prejudice?

Answer 16

To judge, often negatively, without having relevant facts, usually about a group or its individual members

Question 17

What is discrimination?

Answer 17

Behaviours that follow from negative evaluations or attitudes towards members of particular groups

Question 18

Explain how stereotypes and prejudices can influence medical care?

Answer 18

It is shown that these factors do influence medical care:

• e.g. GPs are less likely to take on new case when there is a history of mental illness
• Hip replacements are more likely to be suggested to men

Question 19

What is social loafing?

Answer 19

the tendency for people to expend less individual effort when working in a group than when working alone

Question 20

When is social loafing more likely to occur?

Answer 20

• belive thtat individual performance is not being monitored
• he task (goal) or the group has less value or meaning to the person
• The person generally displays low motivation to strive for success
• The person expects that other group members will display high effort

Question 21

Explain the role of gender and culture in social loafing

Answer 21

Occurs more strongly in all-male groups
• Occurs more often in individualistic cultures

Question 22

What are the factors that could reduce the tendency for social loafing?

Answer 22

• Individual performance is monitored
• Members highly value their group or the task goal
• Groups are smaller
• Members are of similar competence

Question 23

What is conformity?

Which factors influence conformity?

Answer 23

Conformity= the areeing within a group

Influenced by

1. group size
   
   • the larger the group the higher the confomity
   • no further change when group larger than 5
2. Presence of a disagreer
   
   • if one disagrees –> more likely for more to disagree
3. culture
   
   • greater in collectivistic cultures

Question 24

Explain the 5- step bystander decision process

Answer 24

1. Notice the event
2. Is the event an emergency?
   
   • Social comparison: look to see how others are responding
3. Assuming responsibility to intervene
   
   • Diffusion of Responsibility: believing that someone else will help
4. Self-efficacy in dealing with the situation
5. Decision to help (based on cost-benefit analysis e.g. danger)

Question 25

Which interventions could be undertaken to increase helping behaviour?

Answer 25

• Reducing restraints on helping
  
  • Reduce ambiguity and increase responsibility
  • Enhance concern for self image
• Socialise altruism
  
  • Teaching moral inclusion
  • Modelling helping behaviour
  • Attributing helpful behaviour to altruistic motives
  • Education about barriers to helping

Question 26

Which factors influence obedience?

Answer 26

• Remoteness of the victim (how far away/facing them)
• Closeness and legitimacy of the authority figure
• Diffusion of responsibility: obedience increases when someone else administers the shocks
• Not personal characteristics

Question 27

What is the concept of group think?

Answer 27

the tendency of group members to suspendcritical thinking because they they are striving to seek
agreement

Question 28

What are the advantages and disadvantages of the three leadership roles?

Answer 28

Question 29

Explain the conecpt of group polerization

Answer 29

the tendency of people to make decisions that are more extreme when they are in a group as opposed to a decision made alone or independently

Question 30

Which factors make group think more likely?

Answer 30

When a group…

• Is under high stress to reach a decision
• Is insulated from outside input
• Has a directive leader
• Has high cohesiveness

Question 32

Which social phenomen did Ash investigate when putting a suspect into a group of actors and asking for recognisisng the length of different lines?

Answer 32

Conformity

Question 33

Roughly discribe the Milgram Experiment

Answer 33

Experiment used to investgate obedience

• Shock generator used to apply punishment

• Shocks grew increasingly intense with each mistake

Question 34

Describe the Darley & Latane Experiment

Answer 34

Expreiment to analyse, explain the bystander effect

• Helping student having an epileptic seizure in an adjacent room.
  
  • 87% helped if they believed it was just them and the other student.
  • But only 31% helped when they believed they were in a group of 4 people, hardly anyone helped if group was above 4.
• If participant had not acted within first 3 minutes they never acted.

Question 35

What is an error?

Answer 35

the failure of a planned action to be completed as intended (i.e., error of execution) or the use of a wrong plan to achieve an aim (i.e., error of planning).

Question 36

Name examples of medical errors

Answer 36

• incorrect diagnosis
• failure to employ indicated tests
• error in the performance of an operation, procedure, or test,
• error in the dose or method of using a drug.

Question 37

Explain the role of medication errors in the NHS

Answer 37

It has big effects

• estimated to account for 12000 deaths per year
• and £ 0.75-1.5 billion additional costs per year

Question 38

What are the causes for diagnostic errors?

Answer 38

Are the largest errors occuring in the health care system

Question 40

Explain the characteristics of the “hot” system in clinical decision making

Answer 40

Question 41

Explain the characteristics of the cold system in clinical decision making

Answer 41

Question 42

What are the “two systems” in clinical decision making?

Answer 42

There is a “hot” and a “cold” system in clinical decision making

Question 45

What are heuristics?

What is their role in clinical decision making?

Answer 45

Heuristics are often refered to a rule of thumb due to prior experiences

• Heuristics usually involve pattern recognition and rely on a subconscious integration of patient data with prior experience

Question 46

What is confirmatory bias in medical decision making?

What is a way to prevent this?

Answer 46

The tendency to search for or seek, interpret, and recall information in a way that confirms one’s preexisting beliefs or hypotheses, often leading to errors

–> Can be prevented by making differential diagnosis

Question 47

What is the role of overconfidence in medicine?

Answer 47

Often clinicians are overconfident concerning a diagnosis

• doctors reporterd “completely certain” of why a patient died were wrong 40% of the time

Question 48

Explain the role of sunk cost fallcy in clinical decision making

Answer 48

• already invested time and money makes it less likely to step back from a diagnosis/ procedure etc.

Question 49

Explain anchoring and the role of anchoring effect in clinical decision making

Answer 49

a cognitive bias that describes the common human tendency to rely too heavily on the first piece of information offered (the “anchor”) when making decisions.

–> might lead to ignoring further informations in making a diagnosis

Question 50

What is representative heuristic?

Answer 50

It is used when we judge the probability that an object or event A belongs to class B by looking at the degree to which A resembles B. When we do this, we neglect information about the general probability of B occurring (its base rate)

• E.g: Bob loves classical music, plays chess when growing up and playes golf. What is more likely?
  
  • A= he is a classical trumpet player
  • B= he is a farmer
    
    • Many would choose A because of steriotype but B is just a lot more likely in the population

Might lead to neglect of basic information

Question 51

What are Representativeness errors?

Answer 51

Example:

• A 60-yr-old woman who has no known medical problems and who now looks and feels well reports experiencing symptoms earlier of feeling short of breath, sweaty and clammy, feeling sick, and feeling faint.
• This does not match the typical profile of an MI, which is typically characterised by chest pain.
  
  • Error–> sent her home
• BUT, it would be unwise to dismiss that possibility because MI is common among women of that age and has highly variable presentations

Question 52

Explain the role and importance of algorythms in clinical decision making

Answer 52

They can be used to limit heuristics and individual errors in clinical decision making

• often based on probability
• An algorithm is a procedure which, if followed exactly, will provide the most likely answer based on the evidence.
• where everything is well defined –> very usefull, but that is not the real life situation

Question 53

Explain the role of framing and age

Answer 53

Overall: older patients are more suspectible to framing and are more likely to agree on a treatment option when framed positively

Question 54

Explaitn the availabilty heuristic

Answer 54

People are more likely to

• overestimate the probability of a catastrophic (but unlikely) event
• overestimate the probability of a more recent event to occur again

–> easier, vivid recall of information

Question 55

Explain how cognitive errors and heuristics in clinical decision making can be imprved?

Answer 55

1. Education and Training
   
   1. teach in med school
   2. Recognise that heuristics and biases may be affecting our judgement even though we may not be conscious of them
2. Feedback
   
   • Increase number of autopsies Conduct regular and systematic audits Follow-up patients
3. Accountability
   
   • Establish clear accountability and follow-up for decisions made
4. Generating alternatives
   
   • Establish forced consideration of alternative possibilities e.g., the generation and working through of a differential diagnosis. Encourage routinely asking the question: What else might this be?
5. Consultation
   
   • Seek second opinions
6. Use of algorithms
   
   • Use of clinical decision making support systems

Question 56

Define learning

Answer 56

a process by which experience produces a relatively enduring change in an organism’s behavior or capabilities

Question 57

What are the two processes named under non-associative learning?

Answer 57

1. Habituation
2. Sensitisation

Question 58

What is Habituation?

Answer 58

A form of non-associative learning

• Habituation is a decrease in the strength of a response to a repeated stimulus (e.g. getting used to a busy road at night when moving)

Question 59

What is sensitisation?

Answer 59

A form of non-assoicative learning

Sensitisation is an increase in the strength of response to a repeated stimulus

e.g. listening more careful to nose once it has a meaning to you

Question 60

What is an unconditiones stimulus in classical conditioning?

Answer 60

A stimulus that elicits a reflexive or innate response (the UCR) without prior learning

–> e.g. food causing salivation

Question 61

What is a conditioned stimulus in classical conditioning?

Answer 61

A stimulus that, through association with a UCS, comes to elicit a conditioned response similar to the original UCR

e.g. bell in pavlovs dog

Question 62

What is an Unconditioned Response in classical conditioning? (UCR)

Answer 62

A reflexive or innate response that is elicited by a stimulus (the UCS) without prior learning

e.g. salivation caused by food

Question 63

What is the conditioned response in classical conditoning?

Answer 63

A response elicited by a conditioned stimulus.

e.g. Salivation in response to bell

Question 64

What are the factors that increase the strength of classical conditioning?

Answer 64

1. There are repeated CS-UCS pairings
2. The UCS is more intense
3. The sequence involves forward pairing (i.e. CS -> UCS)
4. The time interval between the CS and UCS is short

Question 65

Explain the time-course of extinction in classical conditioning

Answer 65

Quite easily forgotten when unpaiting of CS and CR/UCR

Question 67

What is stimulus generalization?

Answer 67

A tendency to respond to stimuli that are similar, but not identical , to a conditioned stimulus.

–> e.g. all snakes are dangerous

Question 68

What is stimulus discrimination in classical conditioning?

Answer 68

The ability to respond differently to various stimuli.

– E.g. A child will respond differently to various bells (alarms, school, timer)

– A fear of dogs might only include certain breeds

Question 69

How can classical conditioning can be exploted in a health situation?

Answer 69

E.g. chemotherapy and nausea

• Hospital can be percieved as CS to induce Nausea
• Can be undone by using overshadowing –>
  
  • ​unpleasant drink is given with chemo the first times
  • drink will become CS, not the hospital
  • drink won’t be administered later
  • patient feeling less sick

Question 70

Explain the Two-factor theory of maintenance of classically conditioned associations e.g. fear

Answer 70

1. Trauma (UCS) and Needle (CS) leading to FEar
2. Avoid injections –> fear reduced –> avoidance is increased

Question 71

What is Thorndike’s Law of Effect:?

Answer 71

A response followed by a satisfying

consequence will be more likely to

occur.

A response followed by an aversive consequence will become less likely to occur

Question 72

What is positive reinforcement in operant conditioning?

Answer 72

1) occurs when a response is strengthened by the subsequent presentation of a reinforcer (does not say anything if it is good or bad)
* if you do it you will get something

Question 73

What is negative reinforcement in operant conditioning?

Answer 73

occurs when a response is strengthened by the removal (or avoidance) of an aversive stimulus

• if you do that, you don’t have to do this

Question 74

What are primary and secondary reinforcers in operant conditioning?

Answer 74

Primary reinforcers= needed for survival e.g. food, water, sleep, sex

Secondary reinforcers: stimuli that acquire reinforcing properties through their association with primary reinforcers e.g. money, praise

Question 75

What is positive punishment in operant conditioning?

Answer 75

occurs when a response is weakened by the presentation of a stimulus (e.g. squirting a cat with water when it jumps on dining table)

Question 76

What is negative punishment in operant conditioning?

Answer 76

occurs when a response is weakened by the removal of a stimulus (e.g. phone confiscated)

Question 77

When comparing punishment and reinforcement: what is more successful?

Answer 77

Reinforcement is much more sucessful in getting desired behaviour than punishment

• punishment makes undisired less likely
• reinforcement can teach new behaviours

Question 78

How do continous and partial reinforcement differn in

• the speed of learned behaviour
• the retaining of learned behaviour

Answer 78

1. Continous reinforcement
   
   1. new behaviour is quickly learned
   2. but also faster forgotten
2. Partial reinforcement
   
   1. new behaviour takes longer to learn
   2. but also takes longer to forget

Question 79

Explain fixed and variable time and fixed and variable ratio scedule in operant conditioning

Answer 79

• Fixed interval schedule: reinforcement occurs after fixed time interval
• Variable interval schedule: the time interval varies at random around an average
• Fixed Ratio Schedule: reinforcement is given after a fixed number of responses
• Variable Ratio Schedule: reinforcement is given after a variable number of responses, all centered around an average

Question 80

How does operant conditioning play a part in health behaviour?

Answer 80

MAny influences but e.g. in chronic pain

• when patients shows pain and links it to medication request
• the sympathy from others (i.e. positive reinforcement) leads to a higher use of painkillers and e.g. more rest etc.

Question 81

What are the key hypothesis of Banduras social learning theory?

Answer 81

1. Observational (vicarious) learning - We observe the behaviours of others and the consequences of those behaviours.
2.  Vicarious reinforcement - If their behaviours are reinforced we tend to imitate the behaviours

Question 82

What are the things required for a sucessful modeling in Bandurals social learning theory?

Answer 82

• Pay attention to model
• Remember what was done
• Must be able to reproduce modeled behavior
• If successful or behavior is rewarded, behavior more likely to recur

Question 83

When do we copy behaviour of someone (according to Banduras social learning theory?

Answer 83

We don’t imitate the behaviour of everyonewe encounter

• More likely if model is:

• Seen to be rewarded
• High status (e.g. Medical consultant)
• Similar to us (e.g. colleagues)
• Friendly (e.g. peers)

Question 84

What is health behaviour?

Answer 84

Any activity undertaken by an individualbelieving himself to be healthy, for the purpose of preventing disease or detecting it at an asymptomatic stage

Question 85

What are the scales where health behaviour promotion/interventions can take place?

Answer 85

1. Individual level
2. COmmunity level
3. Population level

Question 86

Does health education work?

Answer 86

Often: not really

• though information is imporatant (and more effective when tailored to people (e..g use condoms insead of abstinence)
• More than just education needed for health behaviour changes

Question 87

Accoriding to learning theory: how does reinforcement lead to unhealthy eating?

Answer 87

• Positive reinforcement:
  
  • Dopamine (feel good), filling an empty void/boredom.
  • Praise for preparing a high-fat meal for the family.
• Negative Reinforcement:
  
  • Avoid painful emotions by comfort eating.

Question 88

How does punishment lead to unhealthy eating?

Answer 88

• Punishment:
  
  • Preparing a low fat meal is criticised.
• Limited/delayed positive reinforcement for healthy eating:
  
  • Efforts at dietary change/weight loss go unnoticed by others; Avoiding future health problems is too remote.

Question 89

What are behavioural modification technics that help with healthy eating?

Answer 89

• Stimulus control techniques:
  
  • Keep ‘danger’ foods out of the house
  • Avoid keeping biscuits in the same cupboard as tea & coffee
  • Eat only at the dining table
  • Use small plates
  • Do not watch TV at the same time as eating.
• Counter conditioning:
  
  • Identify ‘high-risk’ situations/cues (eg stress) and ‘healthier’ responses:
  • Eg Can you think of something other than eating that makes you feel better? Maybe something relaxing or exercise?

Question 90

Explain the use of positive reinforcement in health behaviour

Answer 90

Though not 100% sucessful, there stll can be succes seen (biggest in comparison to punishment etc.)

• Involve significant others to praise healthy eating choices
• Plan specific rewards for successful weight loss
• Vouchers for adherence to healthy eating & weight loss
• Improved self-esteem (positive reinforcement).
• Reduction in symptoms of breathlessness (negative reinforcement).

Question 91

What are the limitations of reinforcement programms?

Answer 91

• Lack of generalization (only affects behaviour regarding the specific trait that is being rewarded).
• Poor maintenance (rapid extinction of the desired behaviour once the reinforcer disappears)
• • Impracticalandexpensive.

Question 92

Does fear arousal work?

Answer 92

No–> when we are scared of something, we tend to look away and also avoid the information

• low to moderate formultations now are more effective

Question 93

Explain the role of social learning in health behaviour

Answer 93

Has a big role (expecially in teenagers)

• e.g. large peer group influence in smoking (+family influence)
• promoting workshop including resisting peer pressure for smoking in role-plays is sucessful

Question 94

What is the expectancy-value principle for health behaviour?

Answer 94

The potential for a behaviour to occur in any specific situation is a function of the expectancy that the behaviour will lead to a particular outcome and the value of that outcome

Question 95

Which factors influcence the likelyhood to make a health decision (Rosenstock)

(Health believe Model)

Answer 95

The backround of a person influences everything but also

• How suspectible am I to get that outcome? (percieved suspectibility)
• How serious is the outcome? (percieved seriousness)
  
  • Together: feed into percieved threat
• What are the risks and benefits if I do this? (risks and benefits)
• Cues to action (e.g. someone advises me to do something)

Question 97

What is outcome efficacy?

Answer 97

Individuals expectation that the behaviour will lead to a particular outcome

Question 98

What is self-efficacy?

Answer 98

Belief that one can execute the behaviour required to produce the outcome

Question 99

Explain the Theory of Planned behaviour

Answer 99

The intetntion to persecute a planned behaviour is influenced by

1. Attitute towards the behaviour
   
   1. dependant on the beliefs and the evaluation of the outcome
2. Percieved behavioural control
   
   1. dependant on internal control factors
   2. and external control facors
3. Subjective norm
   
   1. strongly influenced by by beliefs about important others perception of behaviour

Question 100

Explain the Transtheoretical Model (Stages of Change Model)

Answer 100

1. Pre-contemplation
   
   • does not recognise the need for change
   • not actively considering change
2. Conetmplation
   
   • recognised problem and considers change
3. Preparation
   
   • is getting ready to change
4. Action
   
   • is initiating change
5. Maintainance
   
   1. Can go either into
      
      1. relapse or
      2. or permanent change
         
         1. adjusting to change and getting used to new forms to sustain

Question 101

Explain the COM-B model

Answer 101

Three factors influence behavioural change

1. Capability
   
   • influenced by
     
     • physical (skills)
     • psychological (skilly, knowledge)
2. Opportunity
   
   • social (social influences)
   • physical (enviromental resources and context)
3. Motivation
   
   • Reflective (beliefs about outcome, intentions, goals)
   • Automatic ( reinforcement, emotions

Question 102

What is the Bahaviour Change Wheel?

Answer 102

COM-B Wheel = 9 intervention functions and 7 categories of policy (on basis of the COM model)

Question 103

Which factors influcence self-efficacy?

Answer 103

• Mastery experience
• Social learning
• Verbal persuasion or encouragement
• Physiological arousal

Question 104

What is compliance?

What is treatment compliance?

Answer 104

the action or fact of applying with a wish or command

–> extent to which patients follow doctors’ prescription about medicine taking

–> old fashioned term because it is too one sieded –> patiene follows doctors order

Question 105

What is adherence?

What is the difference to compliance?

Answer 105

refers to the extent to which patients follow through decisions about medicine taking

Question 106

What are the differnt forms of adherence?

Answer 106

It is a wide spectrum from

• Overadherence via
• perfect adherence to
• uneradherenace

Question 108

How many pople usually adhere to their recommended treatment?

Answer 108

In long-term conditions: about 50% adhere to treatment

Question 109

What is the differnece between and the relation of intentional and unintentional non-adherence?

Answer 109

Unintentional

• a patient does not have the capability or resources to adhere to the treatment

Intentional :

• patiens beliefs and motivations lead to non-adherence (e.g. avoid side-effects etc)

Relation:

• they overlap e.g. if someone does not consider medication important (belief) it might be more prone to forgetting it

Question 110

Explain the COM-B model

Answer 110

It is a model to describe behaviour

• Capabilita, Opportunity and Motivation all (bidirectionally) influence behaviour
• Capability and Opportunity also directly influence Motivation

Question 111

What are the consequences of non-adherence to treatment?

Answer 111

•Poor health outcomes

•Increased healthcare costs

• Viswanathan et al. (2012) – It is estimated that in the USA, a lack of medication adherence:
• Causes nearly 125 000 deaths per year
• Causes 10% of all hospital admissions
• Costs the healthcare system $100-289 billion per year

Question 114

Explain the role of capabiliy in the COM-B model in regards to adherence

Answer 114

1. Psychological –> Capacity to engage in the thought process
   
   • unterstnadment of disesase and treatment
   • cognitive funciton (unterstanding, juding)
   • Executinve funciton (planning)
2. Physical
   
   • ability to adapt to lifestyle changes (e..g walk to supermarket etc.)

Question 115

Explain the role of Opportunity in regards to treatment adherence (COM-B model)

Answer 115

1. Physicla opportunity
   
   • financial resources
   • access (availibilty of medicaiont)
   • characteristic of medicine (taste, smell, ROA)
   • Social support
2. Social
   
   • religious beliefs
   • stigma of disease/fear of disclosure

Question 116

Explain the role of Motivation in treatement adherence in regards to the COM-B model

Answer 116

1. Reflective (Evaluation and plans)
   
   1. perception of illness
   2. beliefs about treatment
   3. outcome-expectancy
   4. self-efficacy
2. Automatic (emotions)
   
   • mood state/disorders
   • stimuli or cues for action

Question 117

Which factors highly influence treatment adherence in regards to perception of the treatment?

Answer 117

1. Doubt about Necessity of treatment with
2. Concerns about side-effects

–> low adherence

Question 118

What are interventions that can be made to increase treatment adherence?

Answer 118

• Improve understanding of illness and treatment
• Help patients to plan and organise their treatment –> e.g. via daily text message, incoorperating wife to put tablet onto table etc.

–> Can already be via simple methods

Question 119

What can be done in a consultation to facilitate informed adherence

Answer 119

Check the patient’s understanding of treatment, and if necessary:

• Provide a clear rationale for the necessity of treatment
• Elicit and address concerns
• Agree a practical plan for how, where and when to take treatment
• Identify any possible barriers

Question 120

What are behaviou change techniques?

Answer 120

•A systematic strategy used in an attempt to change behaviour

Question 121

What is the difference between behaviour change tequnique and an intervention?

Answer 121

Intervention= broader and can include more than one technique

Question 122

Name examples of behaviour change techniques

Answer 122

• Providing information on consequences
• Prompting specific goal setting
• Prompting barrier identification
• Modelling the behaviour
• Planning social support

Question 123

How can a patient-specific behaviour change technique be chosen?

Apply it to the example of healthy eating

Answer 123

1. Behavioural target specification
   
   • increasing the amount of Mediterranian diet
2. Behavioural diagnosis
   
   • Who? –> e.g. people
   • What? –> decrease non-mediterranian diet type
   • When? –> all the time
   • How Often? –> all the time
   • Where?– >Home, supermarket, cafe etc.
   • Who With? –> people influencing diet of target
3. Intervention strategy selection
   
   • using COM-B model to explore barriers
4. Implementation strategy selection
5. Selection of specific BCTs

Question 124

List effective mechanism that can influence bahavioural change

Answer 124

1. Self-monitoring
2. Motivational interviewing

Question 125

Explain the concept of self-monitoring and how it can help to change behavioural techniques

Answer 125

• An individual keeping a record of target behaviours
• Additional information recorded can help to identify barriers e.g. mood, weather
• Role in increasing physical activity and healthy eating studied –> very effective

But: can be Time-consuming over the long term

Question 127

Explain the concept or motivational interviewing

Answer 127

It is a style of consultation in which

The doctor

• MI ‘Spirit’ –> non-judging+ open minded
• MI-consistent behaviours
• MI-inconsistent behaviours
• Using specific techniques

Looking for signs of: in patients

• Change Talk/Intention
• Stage of Change e.g. readiness to change
• Co-operation, engagement or disclosure (client engagement/involvement)
• Resistance to change (client resistance)
• Self-confidence
• Sense of discrepancy

Question 128

Explain the structure of implementation intentions in the change of health behaviour

Answer 128

Action plans

• Normally: If-then
• Think about critical situation and act accordingly:
• IF it’s Friday morning at 9am THEN I will go for a run from my house around the park

Plannin in advance increases the cue to action

Question 129

Explain the role of incentives in implementing a change in behaviour

Answer 129

Reinforcement

• e.g. giving money to people to stop smoking etc.
• can be cost effective
• raie awareness
• bring individuals in contact with health service but
  
  • Normally no lon-term effects and and might be expensive long-term

Question 130

Is it effective/possible to target mutliple behavoiours at once?

Answer 130

Yes: Targeting multiple behaviours at the same time may lead to greater overall change but individual actions less effective

Focus on 2-3 points

Question 131

Does tailoring educational materials to individual result in larger changes

Answer 131

Yes – small benefit on effectiveness of behavioural interventions

Question 132

What is Implememtation of Intention?

Answer 132

action plans, think about critical situations to act and appropriate responses within those situations

Question 133

Name an example how an implementation of intention could look like?

Answer 133

1. If-then aspect “if I do this, then this will happen”
2. Planning in advance makes outcomes more possible
3. Strengthens connection between a good situation to act and a suitable action à behaviour is more likely to be enacted

Question 134

Define Sensation

Answer 134

Sensation: The stimulus detection system by which our sense organs respond to and translate environmental stimuli into nerve impulses that are sent to the brain

• ‘Is there anything out there?’

Question 135

Define Perception

Answer 135

Perception: The active process of organising the stimulus output and giving it meaning

• ‘What is it, where is it, what is it doing?’

–> Making sense of the sensory information

Question 136

What is Bottom up perception?

Answer 136

• Individual elements are combined to make a unified perception of pure sensory information we are recieving

Question 137

What is Top down perception?

How is is connected to bottom up perception?

Answer 137

Top down: Processing in light of existing knowledge, expectiations etc. –> e.g. backmasking

Bottom up and top down work together to influence the perception of a stimmulus

Question 139

Name an example on how the environment influence perception?

Answer 139

E.g. Optic illusion rooms

• expect that rooms are designed in a certain ways (90° angles)

Question 140

How does Culture influence perception?

Answer 140

Cultural backoround can influence the way we see things (e.g. how we are used to and thought patterns)

a) Woman: window vs. carry water
b: shooting elephant (african) vs. antilope (western view)

Question 144

What are the different factors that affect top-down perception?

Answer 144

• Attention
• Past experiences
  
  • Poor children and adults overestimate the size of coins compared to affluent people (Ashley et al., 1951)
• Current drive state (e.g. arousal state)
  
  • Hunger: when hungry, more likely to notice food-related stimuli (Seibt et al., 2007)
• Emotions
  
  • E.g. Anxiety increases threat perception (e.g. in PTSD)
• Individual values & expectations
  
  • Telling people a stimulus might be painful makes them more likely to report pain in response to it (Colloca et al, 2008)
• Environment
• Cultural background

Question 147

What are the different types of visual agnosia?

Answer 147

1. won’t form a whole object on them –> can’t recognise a shape e.g. a triangle, can’t draw it
   
   1. severer
2. Might be able to see+ draw things but cannot name: no access to information difficult to access more information on the object

Question 148

Explain the Figure ground Relation of the Gestalt laws

Answer 148

Figure ground relation

our tendency to organise stimuli into central or foreground and a background.  Focus of attention becomes the figure, all else is background

Question 149

Explain the law of continuity in the Gestalt law

Answer 149

When the eye is compelled to move through one object and continue to another object

– >Make sense of flowing

Question 150

Explain the law of Similarity of the Gestalt laws

Answer 150

Similarity: Similar things are perceived as being grouped together

Question 151

What is the Cocktail party effect?

Answer 151

Cocktailparty effect: Filtering a lot

in conversation: focus on one conversation but when spmeone calls oput name: response and divert the attention n

Question 152

Explain the law of proximity of the Gestalt laws

Answer 152

Proximity: Object near each other are grouped together

Question 153

Explain the law of closture in the Gestalt laws

Answer 153

Closure: Things are grouped together if they seem to complete some entity.

Question 154

What is visual agnosia?

Answer 154

Processign fo vison is damaged –> see and can navigate but naming + accessing information is damaged

• Basic vision spared
• Primary visual cortex can be mostly intact
• Patient not blind
• Knowledgeable about information from other senses (e.g. if they touch an object then naming is typically simple)

Question 156

What are the different stimulus factors that influence attention?

Answer 156

Attention increases with

• intensity
• novelty
• movement
• contrast
• Repetition

of the stimulus

Question 157

Explain the role of attention in the process of perception

Answer 157

Attention is the process of focusing conscious awareness, providing heightened sensitivity to a limited range of experience requiring more intensive processing.

2 processes:

• Focus on a certain aspect
• Filter out other information

-> e.g. not seeing bear when just looking at something else

Question 158

What are personal factors that influence attention?

Answer 158

• Interests
• motives
• threat
• mood and
• arousal

Question 159

What are different types (compenents) of attention?

Answer 159

1. Focused attention
   
   • spotlight
2. Devided Attention
   
   • payint attention to more than one thing at once

Question 160

Explain how attention differs in the different states of how we learn (clinical) skills (and explain each of them)

Answer 160

There are three stages and with each the attention decreases

1. Cognitive stage
   
   • thinking about it and learning the procedure via direct instructions
2. Associative stage
   
   • we know how to do it (cognitively) but still need to learn how exactly to do it and think about is while doing it
3. Autonomous state
   
   • The skill is largely automatic –> implicit knowledge and motor co-ordination, rather than instruction (don’t think about the skill anymore)

Question 161

What are the factors that can influence our attention?

Answer 161

Characteristics of the stimulus

• intensity
• novelty
• movement
• contrast

+ Personal factors:

• motives
• interests
• threats
• mood
• arousal

Question 162

Explain the Medical Student syndrome (MSS)

Answer 162

• Medical students focus more on bodily symptoms due to more attention
• Percieve more symptoms due to more attention
• –> Think they have something that has been mentioned in the lecture

Question 164

Explain the Fear Avoidance Model of Chronic Pain

Answer 164

It is a vicious circle

Model: Pain influences the mood and anxiety as well as engagement with everyday activities (and all influence each other aswell

• Pain breeds avoidance which perpetuates stress, low mood, anxiety etc.

Question 165

What are the three basic stages of learning?

Answer 165

1. Cognitive stage
   
   1. new information
   2. what are the steps involved? Observing
2. Associative Stage
   
   1. development of patterns
3. Autonomous stage
   
   1. doing things without even really thinking about it

Question 166

Explain the relationship between attention and medical mistakes

Answer 166

If e..g learning reches autonomous skills

–> medical skills if they are autonomous–> loss of concious attentions of tasks

–> medical errors can happen when processes are automatic

Question 167

What are different factors that influence (chronic) pain perception

Answer 167

• 28 million people experience chronic pain in the UK
• different from acute pain
• more the 3 month, tdamage is healed but person stilll pervieves pain
• thought to be due to loss of cancellation of painful stimulus due to
  
  • complex informaiton processing in brain

Pain is influenced by

• attention
• how we feel, think
• mindfullness –> cange focuss of attention and change of sensory processing
• Might lead to vicious cycle in pain –> if not doing fun things due to pain more focus on pain etc. and more anxiety, stress therefore more pain

Question 168

What are the Gestalt Laws?

Answer 168

Trying to explain how we organise the parts of our perceptual field in a whole

• Figure-ground relation
• Continuity
• Similarity
• Proximity
• Closure

Question 170

What are the two ways that we can pay attention to something?

Answer 170

We can give

1. Focused (“spotlight”) attention or
2. Divided attention -> paying attention to more than one thing

Question 172

What is the Cocktail party effect?

Answer 172

We can focus our attention on one person’s voice in spite of all the other conversations in a party shows that

• we can filter information, depending how we direct our attention
• (but if someone says name: we are likely to hear it –> we subconciously also hear more)

Question 174

Explain how attention can affect medical errors

Answer 174

If we are in a autonomous state of learning:

• don’t think about the taks anymore: mistakes happen
• in a study: “Over half of patient deaths were due to unconscious errors that could be the direct consequence of automatic behaviour”

Question 176

How can attention influence pain perception?

Answer 176

If one

• draws more attention to a symptom/pain it is percieved as more severe and
• If one is expecting pain (–> more attention to the feeling) it will be more severe

Question 177

What are the main challanges in chronic illness?

Answer 177

E.g.

• Adjusting to symptoms and disability
• Maintaining a reasonable emotional balance
• Preserving a satisfactory self-image and sense of competence
• Learning about symptoms, treatment procedures and self-management
• Sustaining relationships with family and friends
• Forming and maintaining relationships with healthcare providers
• Preparing for an uncertain future

Question 178

Explain the Self Regulatory Model

((Leventhal)

Answer 178

1. Interpretation of situation (e.g. all the symptoms)
2. Coping (what am I doing with it? How am I going to cope with it?)
3. Appraisal

All bidirectuaonally are influenced by

• Emotional response to health threat
  
  • fear
  • anxiety
  • depression
• Representation of health threat
  
  • identity
  • cause
  • consequnece
  • timeline
  • cure and control

Question 180

What are the psychological impact of long term conditions?

What is the relationship between mental and physical illness?

Answer 180

• With mental illness: More likely to develop depression
  
  • 1 chrnoic illness: 3x more likely
  • >3 conditions: 7x more likely
• mental health conditions increases the risk of physical illness
• people with severe mental health problems die younger

Question 181

What are the possible positive adaptations and psychological growth in chronic illness?

What are the effects of that?

Answer 181

• Chronic illness can induce post-traumatic growth
• 60-90% of people with HIV and cancer experience positive growth

​Growt might lead to

• less distress short term and better mental and physical health overall

Question 182

What is meant by the phrase “Narratives in Medicine”?

What is its role?

Answer 182

All the canges (positive and negative) around a chronic condition become part of peoples Story and are somethimes made publlic

These stories might

• transform the perception and concept of illness
• might help people to reconstruct identitiy etc.
• help to understand their illness
• make it a collective experience

Question 183

What is meant by the term narrative based medicine?

Answer 183

emphasis is on listening to people’s narratives and using these to improve clinical care

Question 184

What are the main psychological factors of palliative care?

Answer 184

• Founded on providing terminally ill people with compassionate care
• Addressing medical, psychological, social and spiritual aspects of dying
• Relieving/ managing symptoms (e.g.,pain, breathlessness) rather than curing disease
• Collaborative approach with honest communication
• Empowerment – control and choice is paramount

–> Improve quality of life during the time left and prepare for death

Question 185

Explain 5 phases of dealing with death according to Elisabeth Kübler-Ross

Answer 185

1. Denial
   
   • this does not happen to me –> defence mechanism, often includes lies to oneself etc.
2. Anger
   
   • why does this happen to me?
   • generalised rage at the world –> feel isolated and furious, feel its unfair and betrayed
3. Bargaining
   
   • I’ll be a good person, if I get another chance, If I do this, I can make it better
4. Depression
   
   • absorbed in the intense emotional pain
   • feeling helpless and sadness
5. Acceptance
   
   • The loss is accepted and we work on alternatives to coping with the loss and to minimise the loss

Question 186

What are the advantages/ reasons for development of stage theories (5 phases by Kübler Ross) in death?

Answer 186

• Linear progression – gives a sense of conceptual order to a complex process – proving a degree of predictability & control
  
  • An overwhelming cultural desire to “make sense” of the uncertain
• Developed at a time when limited literature on death & dying existed
• Applied to a number of different situations (including bereavement)

Question 187

What are the weaknesses of stage theories in the concept of coping with death?

(Wortman & Silver)

Answer 187

• They place patients in passive roles
• don’t account for variability in patinets
• Focus on emotional responses and neglect cognitions and behaviour
• Fail to consider social, environmental or cultural factors
• Pathologise people who do not pass through stages

Question 188

Explain stress theories of bereavement

Answer 188

Emphasise stress and coping with bereavement as a dynamic process

• Involves 2 changes with bouncing between them
  
  • orientation toward loss
  • orientation towards restoration
• Orientation toward loss:
  
  • Preoccupation
  • Think and yearn for the person lost
  • Seeking out places as reminders or searching for the person
• Orientation toward restoration:
  
  • Adjustments to lifestyle
  • Coping with day-to-day life
  • Building a new identity
• – Distracting away from painful thoughts

Question 189

What is the problem with pathologising patients that don’t fit into the stage theories of coping with death?

Answer 189

1. Distress or depression is not inevitable:
   
   • Many people report significant and valuable changes from the experience of the illness (Weinman et al., 1999)
   • Some even report benefits (e.g., “Posttraumatic Growth” Tedeshi & Calhoun)
2. Acceptance” might not be achieved
   
   1. Reaching a state of resolution may not be possible for some
   2. Complex cognitive and emotional responses may continue to be present

Forms categories of “Good” patients vs “Bad” patients (not true)!

Question 191

How lond does bereavement last for most people?

Which factors can influence this?

Answer 191

Can be influenced by:

• How attached they were to the deceased person
• The circumstances of death and the situation of loss
• How much time they had to work through anticipatory mourning

85% will normally have adjusted by the 2nd year of bereavement

Question 192

What is the hereditary influence in human development?

Answer 192

It has some genetic influence (genetic blueprint with inate abilities) that then can be fed with environmental influences

gender,genetics, temperament and maturational stages

Question 193

What is the influence of the environmet on the development of children?

Answer 193

Nurture shapes this predetermined genetic course via the environment;

1. parenting,
2. stimulation and
3. nutrition

–> for development: influence of changing environment and organism

Question 194

What is the sensual developmental state of a child at birth?

Explain its role in the concept of reciprocal socialization

Answer 194

1. Hearing - hear mothers vioce
2. Smell - recognise smell of mother (ambiotic fluid, breast milk)
3. Taste - can’t taste salt until 4 month old but otherwise can taste (like sugar + glutamate (present in breast milk)
4. Seight: Blurred vision but does reconise faces

–> At birth: babies are able to recognise mothers! (important for reciprocal socialization)

Question 195

Why do babies look cute?

Answer 195

They are social creatures and

utterly dependent upon their caregivers

• So it is a matter of survival that they get noticed

Question 196

Explain the process of reciprocal socialisation

Answer 196

Reciprocal socialisation is bidirectional; children socialise parents just as parents socialise children

Question 198

What is the internal working model?

Answer 198

“internal working model” Bowlby (1969)

–> (Very similar to reciprocal socialisation) is established through this social process; The baby coordinates his systems with those of the people around him

Question 199

What is the role of the parents in the development of their babies?

Answer 199

Parents give babies the resources to develop through

• scaffolding = assisting a child to accomplish task
• reciprocal socialisation,
• provision of a stimulating and enriching environment (both physiologically and psychologically)

Question 200

What is Attachment?

Answer 200

It is the instict that seeks proximity to a carer when threat or discomfort is experienced/ percieved

• carer gives sense of savety from secure base
  
  • allows child to expolre world wihle being protected

Mediated by Mind-mindedness

• carer percieve child as individual with own meaningful thoughts and ideas

Question 201

Explain the stages of developing attachment

Answer 201

It is a stage model and babies goes through phases of attachment (develops expecially in first year)

• Birth to 3M; baby prefers people to inanimate objects, indiscriminate proximity seeking eg clinging to carer
• 3-8M; smiles discriminately to main caregivers
• 8 – 12M; selectively approaches main caregivers, uses socialreferencing / familiar adults as “secure base” to explore new situations; shows fear of strangers and separation anxiety
• From 12M; the attachment behaviour can be measured reliably.

Question 202

Explain the strange situation test

Answer 202

See how babies respond to (slightly stressful) temporary absence of their mother

Researchers are interested in two things:

1. How much the child explores the room on his own, and
2. How the child responds to the return of his mother

Question 203

What are the characteristics of a securely attached child in the strange situation test?

Answer 203

When secure base

• allows development and exploitation –> security and comfort
• preference for a mother
• explores the room freely when Mum is presen
• He may be distressed when his mother leaves, and he explores less when she is absent.
• is happy when she returns
• If he cries, he approaches his mother and holds her tightly. He is comforted by being held, and,
• once comforted, he is soon ready to resume his independent exploration of the world.
• His mother is responsive to his needs. As a result, he knows he can depend on her when he is under stress (Ainsworth et al 1978).

Question 204

What does a secure attachment in childhood lead to?

Answer 204

Promotes: resilience and social skills

Promotes

• Independence
• Emotional availability
• Better moods
• Better emotional coping

Associated with

• fewer behavioural problems
• higher IQ and academic performance
• Contributes to a child’s moral development
• Reduces child distress

In adolescence and adulthood associated with

• Social competence
• Loyal friendships
• More secure parenting of offspring
• Greater leadership qualities
• Greater resistance to stress
• Less mental health problems such as anxiety and depression
• Less psychopathology e.g schizophrenia

Question 205

What are the characteristics of an insecure attachment

Answer 205

Different types of insecure attachments

1. Avoidant insecure
   
   • limited exploration with mother present
   • no response when mother leaves
   • no preference for mother over other people
2. Resistant insecure
   
   • not much exploration
   • preferes mother over others
   • distressed when mother leaves
   • when mother returns is not just happy and wants to bind but also angry that mother has left
3. Disorganized-insecure
   • mix of avoidance and reisistant insecure
   • incrreased risk of behavioural and developmental problems

Question 206

What does the an insecure attachment style lead to?

Answer 206

Insecure attachments place the individual at risk but are not causative for later problems.

–> risk factor for non-social, more problematic behaviour

Question 207

Explain the role and benefits of play

Answer 207

Overall: beneficial, important and promotes development and cognitive development

• Practice decision-making,
• Overcome fears
• Develop new competencies Learn how to work in group Develop own interests
• planning
• Practice adult roles
• Promotes language development
• Promotes creative problem solving
• Extend positive emotions
• Maintain healthy activity level

Question 208

What are the different stages in play development

Answer 208

1. 0-2 Years Unoccupied / Solitary:
   
   • ​​alone, limited interaction with other chilren
2. 2 to 2 1⁄2 Years Spectator / onlooker :
   
   • Observe others playing around him but will not play with them.
3. 2 1⁄2 to 3 Years Parallel Play:
   
   • alongside others but will not play together with them.
4. •3-4 Years Associate: Starts to interact with others in their play and there may be fleeting co-operation between in play. Develops friendships and the preferences for playing with some but not all other children. Play is normally in mixed sex groups.
5. 4 – 6Years Co-operative:
   
   • ​​together with others + shared aims
   • non-competitive and supportive of other child
6. •6+ Years Competitive: Play often involves rules and has a clear“winner”.

Question 209

Summarist Piagets model of development

Answer 209

it is a gradual development of cognition via developing schemas

• via assimilation –> incoorperating new experience in existing schmas
• accomodation – differnce made by assimilation
  
  • leading to adaptation –> new experiences leading to change of existing schema

Question 210

What are the stages of Piagets model of cognitive behaviour?

Answer 210

1. Sensorimotor stage (0-2)
2. Preoperational Stage (2-7)
3. Concrete Operational Stage (7.12)
4. Formal operational stage >12

Question 211

What happens during the senromotor stage of Piagets Model of Cognitive development?

Answer 211

• infants understand word through sensory experience and motor interaction of world
  
  • Child develop concept of object permanence (still excist when not be seen)
  • increase use of word
  • Learning is based on trial and error (although errors do not become assimilated!)

Question 212

Explain Piagets Preopertional Stage

Answer 212

Preoperational Stage: age 2-7;

Representation of world in symbols and mental images

no understanding of basic mental operations or rules

• Rapid language development
• Understanding of the past and future
• No
  
  • ​ understanding of Conservation
  • Irreversibility: cannot mentally reverse actions
• Animism: attributing life-like qualities to physical objects and natural events
• Egocentrism: difficulty in viewing the world from someone else’s perspective

Question 213

Explain piagets concept of concrete operational stage

Answer 213

Concrete Operational Stage: ages 7-12;

• perform basic mental operations with concrete problems/objectsand situations
  
  • Understand the concept of reversibility
  • Display less egocentrism
  • Easily solve conservation problems
  • Trouble with hypothetical and abstract reasoning

Question 214

Explain piagets formal operational stage

Answer 214

Formal Operational stage >12

• abstract thoght (e.g. moral, politial etc)

Begin to use deductive logic, or reasoning from a general principle to specific information.

Question 215

What is adolecent and what are the main changes that occur?

Answer 215

• 12 – 25 yrs extensive brain remodelling (myelinisation, synaptic pruning – reason for so much sleeping!)
• Go from parents to peers and social group
  
  • Thrill seeking
  • Openness to new experiences
  • Risk taking
  • Social rewards are very strong
  • Prefer own age company
• Emotionality becomes less positive through early adolescence
  
  • But level off and become more stable by late adolescence
• Storms and stress more likely during adolescence than rest of the lifespan but not characteristic of all adolescents.

Question 216

What are the limitations of criticism of piagets model of cognitive development?

Answer 216

Though: Outcomes have been replicated in populations around the world

• Manybe children respond the way the researchers want to
• Critics of weird/too obvious question style
  
  • might lead to child thinking the adult wants to change the anser (e.g. with conservation)

Question 217

Explain the development of the concept of death in children

Answer 217

• Under 5s:
  
  • don’t understand death is final and universal,
  • may think they have caused death.
• 5 to 10 years:
  
  • develop idea of death as
    
    • irreversible, all functions ended, universal/unavoidable,
  • more empathic to another’s loss; may be preoccupied with justice
• 10yrs through adolescence:
  
  • understand long-term consequences,
  • able to think hypothetically, draw parallels, review inconsistencies

Dependent on cognitive development and experience (pets, extended family members)

Question 218

When does adulthood start?

Answer 218

It is a social concept that does not really mean anything, unclear when it actually is

Question 219

What are the characteristics of a secure attachment?

Answer 219

Parents are responsive to childrens needs

Ginving them a safe base to allow indipendant exploration of the world

Can be calmed down by mother in the strange situation test

Question 220

What is Adolescence?

Answer 220

Transitional stage of physical and psychological development

• from puberty (biological)
• to adulthood (social construct)

Also involved cognitive development (distinct from puberty)

Question 221

What is Temperament?

Answer 221

temperament broadly refers to consistent individual differences in behavior that are biologically based and are relatively independent of learning, system of values and attitudes

Question 222

What are the different stages of memory?

Answer 222

4 Stages

1. Registration- sensory input and attention
2. Encoding: lay down of new information (problem in Alzheimers)
3. Storage of new information
4. Retrieval (remembering) -recall layed down memory –> Disfunction can be present at any stage

Question 224

Explain how different types of memory

Answer 224

• Sensory memory
  
  • can either go into working memory store (limited capacity) or
  • directly into long term memory (but always a lot of information is lost)
• Some of working can be transformed into long term memory
• Long term memory can be retrieved into working memory

Question 225

Explain the different types of long term memory

Answer 225

• Declerative memory
  
  • Episodic
    
    • ike went to my trip to my hilday semantic
  • factual
    
    • E.g. what is the capital
• Non-declerative
  
  • Procedural
    
    • knowing how to do things (walking/talking)
  • Priming
  • Conditioning
  • Non-assiciative learning
    
    • a relatively permanent change in the strength of response to a single stimulus due to repeated exposure to that stimulus

Question 226

Explain how Memory can be distinguished accordint to its duration

Answer 226

• Conceptual divisions in memory systems
  
  • Sensory- very short time (not everything processed)
  • Working or short term memory (the information that is laid down) –> technically few seconds
  • Long-term memory

Be aware of different languages used (e.g. patients referring to short time memory often referes to things happening weeks/days ago)

Question 227

Which part of the brain is involved in semantic memory?

Answer 227

Inferolateral temporal lobe

Semantic memory= knowing of facts etc.

Question 228

Which part of the brain is associated with working memory (short term)

Answer 228

Prefontal Cortex

Question 230

Explain the role of the serioal position effect in memory formation

Answer 230

• Primary effect (absent in Alzheimers) –> remembrering first part of memroy
• Recency effect –> Remember the most recent experiences/words

Question 232

Explain the gross structure of language

Answer 232

Phonemes (sounds) give rise to morphemes (small unit with meaning) which are combined to words (which then give sentences)

Question 233

What are the types of memory that are often assessed in clinic

Answer 233

Often: Declerative learning (Hippocampus) + Diencephalon

Question 236

Explain the different modalities of memory

Answer 236

Very broadly speaking: • Left hemisphere: Mainly concerned with verbal information processing • Right hemisphere: Mainly concerned with non-verbal information (e.g. face)

Question 237

Where is a lesion present with someone with receptive aphasia?

Answer 237

Wernicke Lesion

Posterior part of Temporal lobe (+part of parietal lobe)

Question 239

Explain the different factors that influence the probability of recalling a word from a words list

Answer 239

1. Order in the list
2. Personal salience of words
3. Number of words
4. Chunking or other encoding strategy (e.g. occupation, animal etc.)
5. Delay time
6. Distraction

Question 241

Summrise language development in childhood

Answer 241

There is a critical period of language (the younger the more, up to about 5-6)

But general

• 0-3 Month: recognition of language vs no language
• 4-6: babbling with phenomes from any language
• 7-11: babbling with phenomes heard in language spoken, imitates words
• 1year: starts words
• 12-18: using single words to communicate
• 18-24: expansion of vocabulary, simple sentences
• 2-4 years: further expansion of vocabulary and whole sentences

Question 242

In which hemisphere is language located?

Answer 242

95% left hemisphere dominance (for right handed people)

In left handed people: a bit less but still right sided dominance

Question 243

Where is a lesion present with someone with expressive aphasia?

Answer 243

In the Broca’s area located in left hemisphere (frontal(between frontal and temporal lobe)

Question 244

What are the characteristics of expressive aphasia?

Answer 244

Intact comprehension but problem to produce speech:

• Non-fluent speech
• Impaired repetition
• Poor ability to produce syntactically correct sentences

Question 245

Which part of the brain is associated with procedual memory?

Answer 245

Basal Ganglia

Supplementary Motor Area

Cerebellum

Question 246

Which parts of the brain are associated with episodic memory?

Answer 246

Involves the medial temporal lobes including

• the hippocampus,
• entorhinal cortex,
• mammilary bodies, and
• parahippocampal cortex

Question 248

What are the characteristics of Wernikckes aphasia?

Answer 248

Problems in understaning spech but are able to talk

• Fluent meaningless speech
• Paraphasias – errors in producing specific words
  
  • semantic substituting words similar in meaning (“barn” –“house”)
  • Phonemic substituting words similar in sound (“house” –“mouse”)
• Poor repetition
• Impairment in writing

Question 249

Explain the Language Circuit

Answer 249

Many areas are involved

1. Information from primary auditory cortex to Wernickes area
2. Wernicke analyses words said Trasnmitted to Brocas area via the arcuate fasciculus
3. Brocas area forms motor plan
4. Motor cortex implements plan

Not just the individual areas are important but also their connecting pathways

Question 250

What are different conditions that can cause aphasia?

Answer 250

• Stroke
• Traumatic brain injury
• Cerebral tumour
• Progressive neurodegenerative conditions

Question 251

What is dysexecutive Syndrome?

Answer 251

Behavior change as result of direct damage of frontal lobe –> Disruption of executive function (e.g. planning, focus attention, remember instructions etc)

• Involving: cognitive, emotional and bahavioural symptoms

Cause: head trauma, tumours, degenerative diseases, and cerebrovascular disease, as well as in several psychiatric conditions

Question 252

What are behavioral aspects of dysecutive syndrome

Answer 252

Can be different in everyone ususally on of the sides:

hypoactivity vs hyperactivity

lack of drive vs impulsive

apathetic vs disinhibited

poor initiation of tasks vs perseverative

Emotional bluntness vs dysregulation

All togehter:

• theory of mind difficulty, social inappropriate and rude due to lakc of empathy

Question 253

What are the cognitive aspect sinovled in dysexecutive syndrome?

Answer 253

• Attentional and working memory difficulties
• Poor planning & organisation
• Difficulty
  
  • coping with novel situations and unstructured tasks
  • switching from task to task
  • keeping track of multiple tasks
  • with complex/abstract thinking

Question 254

What are the different parts of the frontal lobe that are associated with dysexecutive syndrome

Answer 254

• Orbito-frontal
  
  • Impulsivity, disinhibition
• Medial
  
  • Loss of spontaneity, initiation (akinetic mutism)
• Posteriolateral
  
  • Inability to formulate and carry out plans

+ signaling/ communicating pathways involved (subcortical areas)

Question 257

What is total amnesia?

Answer 257

It is a rare form of amnesia –>expecially rare if isolated with otherwised preserved cognition

Question 258

Which parts of memory are often defect and intact in people with memory disorders?

Answer 258

Intact: Implicit memory or learning often intact in memory disorders

Othwerwise:

• depending on the disease different parts of memory can be affected

Question 259

Briefly state four ways in which you can reduce the amount of information forgotten by a patient during a consultation

Answer 259

• Reduce amount of info
• Stress importance
• Be specific
• Give written info
• Follow up
• Order of information (rist and last information)
• Mode of presentation

Question 260

What is a personality trait?

Answer 260

Stable cognitive, emotional and behavioral characteristics of people that help establish their individual identities and distinguish them from others

• Every character trait is a continuum
• can’t be directly measured but behavior can be observed to see trait

Question 261

What is a personality state?

Answer 261

Difference in behavior in different situations (e.g. the different ways we are in bar vs. work etc.)

Question 262

Explain the two factors that that Eysenecks two factor model of personality describes

Answer 262

1. Neuroticism (stability, shift of emotions) –> tendency to experience negative emotions
2. Extraversion- the degree to which a person is outgoing and seeks stimulation (not always social, but any outside stimulation)

Question 263

Explain the big five factors of personality

Answer 263

Thought to be personality “supertraids” give main dimensions of a character (everyone is a spectrum)

OCEAN

1. Openess
2. Conscientiousness
3. Extraversion
4. Agreeableness
5. Neuroticism

Question 265

Describe the Characteristics of the character trait openess (according to the big five)

Answer 265

If high score:

• engage with philosophy
• creative but in a cognitive way
• a bit more concrete and more conservative

Question 266

Describe the Characteristics of the character trait Conscientiousness (according to the big five)

Answer 266

= Gewissenhaft/Pflichtbewussseitn

• well organized
• on time
• hard working

Question 267

Describe the Characteristics of the character trait Conscientiousness (according to the big five)

Answer 267

Often stimulation seeking from environment, people, thrill seeking activity (does not have to be social stimmulation)

• joiner
• talkative
• active
• affectionate

Question 268

Describe the Characteristics of the character trait Agreeableness (according to the big five)

Answer 268

More about Empathy, ability to listen

• soft-hearted
• generous
• trusting

Question 269

Describe the Characteristics of the character trait Necroticism (according to the big five)

Answer 269

Tendency to experience emotional shifts

• worried
• tempramental
• self-conscious
• Emotional

Question 270

What does Eyseneck proposed are the bases of the different personality traits (big five)?

Answer 270

He explained it with biological differences

1. differnet levels of cortical arousal (RAAS)
   
   1. Introverts are overaroused
   2. extraverts are underaroused
2. Suddenness of shifts in arousal
   
   1. Unstable (neurotic) people show large and sudden shifts in limbic system arousal;
   2. stable people do not

Question 271

What is the genetical influence on character taraits?

Answer 271

Difficult to determine but research suggest that approx 25-50% is genetically determined

Question 272

Explain the influence of conscientiousness on health

Answer 272

Overall with higher health outcomes (+ longevity), probably due to

• higher adherence
• increased health beneficial health behavior
• In people with less ability, who are less organised:
  
  • Can be increased with e.g. text reminders, goal setting

Question 273

What is the influence Neuroticism on health?

Answer 273

Overall: poorer health outcome

• higher mental health condictions
• higher report of somatic symptoms (e.g. pain)
• Higher mortality rated in chronicle illnesses (e.g. CVS)
• higher rates of health care usage but less likely to adhere to treatment

Question 274

Describe Spearman’s two factor theory of intelligence

Answer 274

Believed intellectual activity involved general factor (g) and specific factor (s)

Question 275

Explain the concept of general factor intelligence

Answer 275

Basically what is measured in IQ test and mapped onto Wechsler intelligence scale

Question 276

What is intelligence?

Answer 276

The ability to acquire knowledge, to think and reason effectively, deal adaptively with the environment

But: hard to measure so now definition is more: (“intelligence is intelligence tests measure)

Question 279

Explain the Idea of Gardners Multiple Intelligences

Answer 279

There is not just one general inteligence but many forms of different intelligences (not need to know them)

• Linguistic Intelligence: e.g. Shakespeare
• Logical-Mathematic Intelligence: e.g. Einstein
• Spatial Intelligence: e.g. Zaha Hadid
• Musical Intelligence: e.g. Prince
  
  • Furthermore, Gardner believes cardiologists may have this kind of intelligence in abundance as they make diagnoses on the careful listening to patterns of sounds.
• Bodily-Kinaesthetic Intelligence: e.g. Serena Williams
• Intrapersonal Intelligence: e.g. Dalai Lama
• Interpersonal functioning: e.g. Susie Orbach
• Naturalistic Intelligence, the ability to understand and work effectively in the natural world e.g. Bear Grylls
• Existential Intelligence the ability to ponder questions about existence e.g. Sartre.

Question 280

What are different factors that influence cognitive ability at age?

Answer 280

Many influences summarised in picture:

but overall: a lot of general intelligence at young age + environmental factors (but overall declining at age)

Question 281

Explain why IQ not always a useful concept to describe an individual’s abilities

Answer 281

1. Because there might not just be a single type of intelligence that can be measured in a IQ test
2. Averaging does not necessarily make sense (needs individual scores) for individual inteligences

Question 282

Describe the findings of twin studies on the roles of heredity and environment in intelligence research

Answer 282

• Some genetic influence on intelligence
• but hard to determine
  
  • even adopted twins often have similar upbringing

Question 283

What is Crystallized Intelligence?

How does it change with age?

Answer 283

GC

1. the ability to apply previously acquired knowledge to current problems.
2. Improves with age then stabelises

Question 284

What is autism?

Answer 284

3 Aspects are involve. People have difficulties in

1. Social and Emotional areas (empathy, friendship)
2. Language and Communication (jokes, sarcasm, body language)
3. Flexibility of thought and imagination

Question 285

What is Fluid Intelligence?

How does it change with age?

Answer 285

GF

• the ability to deal with novel problem-solving situations for which personal experience does not provide a solution.
• Shows steady pattern of decline in aging.

Question 287

What is the influence of genes and environment in intelligence?

Answer 287

1. Genetic factors can influence the effects produced by the environment
   
   • Accounts for 1/2 of the variation in IQ?
     
     • No single “intelligence gene” identified
2. Environment can influence how genes express themselves
   
   • Accounts for 1/2 of the variation in IQ?
   • Both shared and unshared environmental factors are involved
   • Educational experiences are very important

Question 289

Explain the influence of sex on intelligence

Answer 289

Though there are areas where men and women score better, unsure what the reason ist a lot of gender+ social influence

Question 291

Explain Baron Cohen theory of atism

Answer 291

Extreme Male brain hypothesis –> Male is more extreme in high systemising ans low empathising

Two factors influence autism

1. Empathising
   
   • being able to infer the thoughts and feelings of others (‘Theory of Mind’) and having an appropriate emotional reaction
2. Systemising
   
   • ​​is the drive to analyse or construct any kind of system i.e. identifying the rules that a govern a system, in order to predict how that system will behave

Question 292

Define Simon Baron-Cohen’s Systemising and Empathising Quotients and how they relate to autism

Answer 292

Atism= low empathizing quotient and high systmising quotient

–> Systemising and empathising quotient measured (with giving scores to qustions)

Question 293

What is more effective: problem focussed or emotion focused coping with disease?

Answer 293

Optimal coping depends on the individual and the situation- flexibility is the most beneficial.

• but most studies: emotional less effective (but might be due to close proximity to avoidance coping)

Question 294

What Is impairment?

Answer 294

impairment refers to a problem with a structure or organ of the body

(poor correlation to disability)

Question 295

What is a disability?

Answer 295

disability is a functional limitation with regard to a particular activity (strongly correlated with handicap)

Question 296

What is a handicap?

Answer 296

handicap refers to a disadvantage in filling a role in life relative to a peer group, as a result of impairment and disability

Question 297

Explain the overall concept of the crisis theory of coping with illness

Answer 297

• Normally: we seek a state of social and psychological equilibrium
• Serious illness presents ‘a crisis’ and our usual, habitual ways of coping are inadequate.
• Leading to: A state of disorganisation, feelings of fear, guilt, sadness etc
• But: crisis needs to end and be adjusted leading to
  
  • Adaptive responses personal growth and adjustment to the illness.
  • If it goes wrong: Maladaptive responses poor adjustment (psychological problems, low functioning etc).

Question 298

What are the difference factors that influence adaptation according to the crisis theory of coping with illness

Answer 298

1. Illness related factors
   
   • unexpected
   • cause (e.g. self blame)
   • outcome+ prognosis,
   • disability,
   • stigma
   • disfigurement
   • prior experiences
2. Backrund and Personal factors
   
   • age of onset
   • gender(? women seek more support?)
   • Socioeconomic status (lower= less cping)
   • occupation (e.g. professional athlete) ,
   • pre-existing illness beliefs and personality
3. Physical and Social Environment
   
   • Hospitalisation (being in unknown environment)
   • Accommodation and physical aids/adaptations (made to home)
   • Societal attitudes
   • Social support
   • social role (e.g feeling of demascuralisation due tot illness)

Question 300

What is the influence of an “Open” personality according to the “Big Five” personality traits on health?

Answer 300

no difference

Question 301

What is the influence of an “Extravert” personality according to the “Big Five” personality traits on health?

Answer 301

Overall: beneficial:

• lower rates of CHD protective respiratory disease
  
  • more likely to have support network
  • and seek help

Question 302

What is the influence of an “Agreeableness” personality according to the “Big Five” personality traits on health?

Answer 302

If negative:

• Hostility associated w/ CHD + poor adjustment to disability

High agreeableness= better adjustment

Question 303

Explain the role of social support in coping with illness

Answer 303

Very important: the more and higher social network: the better the prognosis

Because: social isolation is bad predictor of disease and mortality (even when adjusted for other risk factors)

Question 304

Summarist the coping process of the crisis theory of coping with serious illness

Answer 304

Three states:

1. coping appraisal
   
   • is influenced by health beliefs and illness representation Adaptation /Adaptive tasks
2. Adaptive tasks
   
   • Illness related
   • Psychosocial function related
3. coping Skills
   
   • Problem Focussed
   • Emotional Focussed

Question 305

What is illness representation?

Answer 305

“A patients own implicit, common sense beliefs about their illness”

Influenced by 5 factors

Question 306

What are the factors determining illness Representation?

Answer 306

1. Identity:
   
   • ​​the label of the illness and symptoms • E.g. “I have a cold, with a sore throat and runny nose”
2. Cause: what may have caused the problem
   
   • E.g. “My cold was caused by being stressed and run down”
3. Consequences:
   
   • ​​expected effects from the illness and views about the outcome
4. Time-line:
   
   • ​​ how long the problem will last and whether it is seen as acute, chronic or episodic
5. Cure/control:
   
   • ​​expectations about recovery or control of the illness

Question 307

Explain the influence of the individual beliefs about a conditions /illness beliefs on recovery from illness

Answer 307

If positive: can be very good and promote recovery but can also have a negative effect if high percieved illness and diability for recovery

Question 308

What are adaptive tasks in the process of adaptation according to the Crisis theory of coping with serious illness

Answer 308

1. Tasks related to illness or treatment
   
   1. Coping with symptoms or disability
   2. Adjusting to hospital environment/medical procedures
   3. Developing and maintaining good relationships with healthcare professionals
2. Tasks related to general psychosocial functioning
   
   1. Controlling negative feelings and retaining a positive outlook
   2. Maintaining a satisfactory self image and sense of competence
   3. Preserving good relationships with family and friends
   4. Preparing for an uncertain future

if managed positively: more likely to adapt to illness and recover faster!

Question 309

Explain the role of coping skills

Answer 309

Coping= Cognitive and behavioural efforts to master, reduce or tolerate external and internal demands and conflicts’

1. Problem Focussed coping:
   
   • Efforts directed at changing the environment in some way or changing one’s own actions or attitudes.(e.g. increasing revision, changing behavior)
2. Emotion focussed coping:
   
   • Efforts designed to manage the stress-related emotional responses in order to maintain one’s own morale and allow one to function (seeking support, relaxation, meditation)

Question 310

What is stress?

Answer 310

Stress is a condition that results when the person / environment transactions lead the individual to perceive a discrepancy between the demands of the situation and the coping resources available.

Question 311

What can be done to do medical procedures less stressful for patients?

Answer 311

1. Preparation, two types of information that can given
   
   1. procedual information
      
      • What will be done during the procedure?
   2. Senry information
      
      • What is likely to be felt during procedure
2. Involvement of patient and giving them controll
   
   • e.g. give buzzer/ device to stop the procedure or signal pain

Question 312

How much information is needed for reducing distress during procedures

Answer 312

Need to be adjusted to personal expectations and preferences of the patients (if want to have little information but get a lot= distressed and the other way around)

Question 313

What are specific adaptations that needs to be done for reducing distress in children?

Answer 313

1. Information should also contain procedual and sensory information
2. Adjusted to time (older children about a week in advance, younger closer to the procedure
3. Modelling can be helpful (e.g. movie, book abour operation)

involve parents (if they are calming and distractive, humor) (More effects on girls over boys)

USE Show-Tell-Do apporach

Question 314

How do children cope with illness?

Answer 314

Overall same strategies as adults but

• problem-solving increasing with age
• distracting decreasing with age:

Younger children: distraction

Older children: matching the chosen coping mechanism to preferrred coping mechanism

Question 315

Explain the Dual process Hypothesis

Answer 315

Explains that a combination of procedual and sensory information is most effective in reducing distress because thes have different effects:

1. Procedural information works by allowing patients to match ongoing events with their expectations in a non- emotional manner.
2. Sensory information works by “mapping” a non- threatening interpretation on to these expectations.

Question 316

What are the different types of stress?

Answer 316

Can be a stimulus E.g. events that place strong demands on us

Can be a response - physiological response to stress –> fight and flight (also negative emotions etc)

Question 317

What happens during a stress response?

Answer 317

Normally SNS increase + activation of Hipoythalamic pituitary adrenocortical axis –> more sustained stress response

Question 318

Explain the General Adaptation Syndrome to stress

Answer 318

1. alarm reaction
   
   • shift to SNS reaction
   • caues increased arousal
2. resistance
   
   • endocriene system activation
   • and activation of immune system
     
     • Maintains increased arousal
3. ehaustion
   
   • depletion of resurces of endocrine (adrenals) and immune system –> more vulnerable to consequences of stress (chronic stress)

Question 319

What is stress?

Answer 319

Stress is a combination of a stimulus and a resposnse –> Can be positive and negative

• Togehter:
  
  • pattern of cognitive appraisals
  • emotional reactions
  • physiological responses
  • and behavioural tendencies
• that occur in response to a perceived imbalance between
  
  • ​ situational demands (primary appraisal) and
  • resources needed to cope with them (secondary appraisal).

Question 320

What is a cognitive appraisal of stress?

Answer 320

Primary appraisal of stress

1. How hard will it be?
2. How much will it count?

Secondary appraisal

• How does my current situation influence it? e.g.
  
  • what do i already know to pass the exam

Also taken into account:

• consequences of failing
• likelyhood and seriousness can be evaluated differently depending on personal beliefs

Question 322

What is the overall relationship between stress and disease

Answer 322

Stress might lead to

1. unhealthy lifestyle choices (behavioral change)
2. physiological changes due to stress

–> Increasing the likelyhood of Disease

Question 325

Explain the relationship between stress and performance

Answer 325

for good performance: a little bit of stress is good

Question 327

Explain the relationship between CHD and stress

Answer 327

High response to stress: –> higher likelihood of coronary artery calcification

• more stress might lead to increase in CHD

Question 328

What are different coping mechanisms with stress

Answer 328

1. problem focussed
2. emotion focussed
3. Seeking social support

Question 329

Explain the relationship between would healing and stress

Answer 329

Slower would healing in more stressful period - might be due to decreased production of IL1(decreased immune function)

Question 330

What are the features of a Type A (personality)?

Answer 330

• Ultra-competitice
• Time urgency
• Free-floating
• hostility
• Hyper-aggressiveness
• Focus on accomplishment
• Competitive and goal-driven

Question 331

Explain the relationship between a Type A personality and CHD

Answer 331

Type A personalities have higher risk of CHD

• (doubled) due to
  
  • also due to unhealthy lifestyle changes
  • but also just behavior pattern alone 30% increase in risk
• Main driver; hostility and quickness to aggression for behavior factor
• (but poor replication, not 100% proved)

Question 332

Explain the relationship between depression and CHD

Answer 332

Depression: increased risk in CHD and outcome of someone with CHD poorer (increased mortality)

Possibly due to

• phyiolgical changes (e.g. platelet activation)
• and behavior changes (smoking)

Question 334

Explain the difference between approach and avoidance in coping with illness/ stress

Answer 334

1. Approach = activity that is oriented toward a threat (e.g. problem-solving, planning a response)
2. Avoidance = activity that is oriented away from a threat (e.g., denial, distraction) –> coping strategy might depend in the situation

Question 335

What is the role of social support in health?

Answer 335

Important: people who rate social support higher

• live longer possibly
• increased quality of life
• possibly: low social support leading to side effect like
  
  • poor health behavior,
  • depression etc

True mechanism is not clear

Question 336

What is the placebo effect?

Answer 336

Placebo effect: expectation of response influences the outcome

Question 337

What is the nocebo effect?

Answer 337

Nocebo effect: expectation of negative effect that occurs after receiving treatment causes negative symptoms

Question 338

What are the psychological mechanisms that underly the placebo effect?

Answer 338

1. framing –> e.g. explanation in post-operative pain
2. social learning –> seeing positive results in someone you know from medication
3. experiential – >you have experienced pain relief from tablets
4. learning –> see : tablet helps: tablet that looks similar helps too classical conditioning

Question 339

What are the clinical implications of the placebo effect

Answer 339

• E.g. dose extending in opioid use
• but still early stage

Question 340

What is the problem with the clinical use of placebo

Answer 340

Ethical issues: Might damage patient-doctor relationship (lying) - but also open placebo works

Question 341

What are the different factors that influence the strenght towards a Placebo response?

What are the advantages?

Answer 341

influenced by

• form (e.g. branded table) and
• manner (positive framing)
• Expecially helpful in conditions with psychological compnents (e.g. pain: has always a psychological/subjective compnent)
• normally; no negative side effect (except of nocebo)

Question 342

Do Placebos still work even when saying they are placebos?

Answer 342

YES

Question 343

What is a Panic Attack?

Answer 343

• intense apprehension, fearfulness or terror
• often with feeling of impending doom and loss of control
  
  • Manifestation in Symptoms: SOB, Chest pain,choking,

Question 344

What is Agrophobia

Answer 344

It is a complication of a Panick Attack

describes:

• Fear of having a panic attack in a situation where it is difficult to escape from –> where there are few placed to hide (e.g. theatre/cinema), supermarket

Question 345

What is the biomedical model?

Answer 345

Aim is to classify mental disorder on the basis of objective makers

• –> the acutal implication and utility is still quesionable

Question 346

What are thre three psychological models used as a basis for psychotherapy?

Answer 346

Goal of all psychotherapy is to help people change maladaptive thoughts, feelings, and behavior patterns

Main theories

• Psychodynamic
• Behavioural
• Cognitive

Question 347

Explain the theory behind behavior therapy

Answer 347

Maladaptive behaviors are not merely symptoms of underlying problems

• but behaviour itself it the problem
• problematic behaviors are learned in the same way as normal behaviors are (e.g. classical conditioning)

Question 348

What is the approach to behavior (exposure) therapy?

Answer 348

Linked to Classical conditioning

1. Expose the person the the stimulus in the absence of the Unconditioned response
   
   • prevent the response towards CS (not getting into the car (uncoupeling of CS and UCS)
   • prevent reinforcement of anxiety (avoid supermarkets–> fear is acoided–> tendency of avoidance in strenthened
2. with systematic desensitization –> getting progressively slowly towards the fear stimulus

Question 350

Explain the model and the cognitive theory of panic (according to Clark)

Answer 350

trigger causes a percieved threat leading to

1. anxiety,
2. anxiety leading to symptoms and that to
3. misinterpretation, leading to anxiety again (Vicious cycle)

Question 351

Explain the theory behind cognitive therey

Answer 351

Other than Behavioural therapy (Stiummulus –> Response)

• There is addiotional cognitive appraisal between stimulus and response
  
  • e.g. in panic attacks: not the stimuls itself but the appraisal of the situation is the problem

Question 353

What are the treatment approach for Cognitive behavirou theraps for anxiety /panic attacks

Answer 353

Treatment comprised of:

• Psychoeducation
• Relaxation techniques
• Cognitive restructuring
• Behavioural experiments
• Graded exposure
• Relapse prevention

Question 354

What are the main features of cognitive behavioral therapy?

Answer 354

• Focuses on problematic beliefs and behaviours that maintain disorders (‘here and now’ rather than original causes).
• Goal oriented i.e. Specific and measurable
• Collaborative relationship between therapist and patient
• Brief (8-16 sessions)
• ‘Scientific’ approach e.g. Collecting data, testing hypotheses

Question 355

Explain the symptoms of a depressive episode

Answer 355

A depressive episode is characterized by:

1. a period of almost daily depressed mood or diminished interest in activities lasting at least two weeks
2. Other symptoms include:
   
   • difficulty concentrating,
   • feelings of worthlessness
   • excessive or inappropriate guilt,
   • hopelessness,
   • recurrent thoughts of death or suicide,
   • changes in appetite or sleep,
   • psychomotor agitation or retardation,
   • reduced energy or fatigue

Question 356

What is the general treatment of depression?

Answer 356

psychotherapy (expecially CBT) – > first line in mild to moderat depression

Question 357

What is the role of psychotherapy in depression? What is the treatment in depression?

Answer 357

psychotherapy (expecially CBT) is quite effective but comparison with other therapy, advantages are limited

• Additional: antidepressant
• but ofen 53% with “untreated” depression show improvement after 12 mont ( but treatment might come from other parts of life)

Question 358

What is the approach to assessing mental health in someone with a chornic physical health problem?

Answer 358

1. Chronical physical health problems are often associated with depression so ask -
   
   • did you feel down, depressed, hopeless in the past month?
   • have you been bothered by having little interest or pleasure in doing things
   • • BUT: be careful with anti-depressants (not just perscribe them)!

Question 359

What is the concept behind mindfulness- Based Cognitive Therapy?

Answer 359

1. paying attention on the present
2. without judging
3. Recognise thought as thought (and nothing else)
   
   1. evidence for decreasing cortisol levels during mindfulness

–> Can be seen in Acceptance and Commitment Therapy

Question 360

Explain the relationship between anti-depressants and clinical depression

Answer 360

In more severe depression:

• more effective than placbeo but
• little more effect (but present) in less severe depression than placebo

Question 361

How could you apply the Acceptance and Commitment therapy in chronic pain

Answer 361

Induce psychological flexibility

Question 362

summarise the treatment for relapsing depression

Answer 362

Refere to CBT or Mindful-ness based cognitive therap

Question 364

Explain the vicious circles of pain

Answer 364

Pain can lead to physical: conditioning can decrease activity progressively and lead to avoidance of activity y And Psychological vicious cycle and increase anger, anxiety and depression

Question 366

What are the clinical Applications for Cognitive Behavioral therapy?

Answer 366

CBT recommended as first line treatment for:

• Mild to moderate depression
• Social anxiety
• PTSD
• Generalised anxiety disorder
• OCD
• Bulimia
• Panic disorder and specific phobia
• Schizophrenia