Anxiety and Pain psychology Flashcards

1
Q

Describe the behaviourism theory of learning

A

All behaviours are learned through interaction with the environment as a stimulus-response, focusing on observable behaviours

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2
Q

Conditioning falls into which theory of learning?

A

Behaviourism

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3
Q

what is the difference between classical and operant conditioning

A

Operant conditioning is changes in behaviour learnt by consequences (‘carrot and the stick’), classical is a learning process that occurs when two stimuli are repeatedly paired

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4
Q

How does positive and negative consequences fit into operant conditioning?

A

Not the same as reward and punishment, positive is the addition of a stimulus (such as receiving a treat) and negative is the removal of a stimulus (no homework)

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5
Q

Explain stimulus generalisation and a dental example

A

Similar stimulus to the conditioned stimulus can cause a response: White coat syndrome

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6
Q

What is high order conditioning?

A

Conditioned response evoked by new stimulus that is paired with a conditioned stimulus that already elicits the response (e.g. cringing at name of dentist)

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7
Q

Give the flaws in behaviourism learning theory

A

Knowledge is given and absolute, patient is passive, doesn’t take into account intrinsic factors (personality, genetics)

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8
Q

Define cognitivism

A

Conditioned response evoked by new stimulus that is paired with a conditioned stimulus that already elicits the response

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9
Q

What is social learning theory?

A

What we do is based on what we see: Live, verbal( what we here), images in the media e.t.c

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10
Q

Give the flaws in social learning theory

A

Does not take into account individuality, context and experience, suggests students/patients learn best as passive receivers of sensory stimuli, as opposed to being active learners , emotions and motivation are not considered important or connected to learning

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11
Q

what study showed anxiety made it harder to distinguish between sensation and pain?

A

Dworkin & Chen (1982): tooth pulp shock was delivered in laboratory and clinical situations. Significantly heightened pain was observed in the clinical dental setting

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12
Q

What are some of the problems with questionnaire-style anxiety measurements?

A

People can lie or just not want to believe their own anxiety, social desirability, central tendency bias (just going neutral on questions)

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13
Q

What is the most common measurement technique?

A

The Modified Dental Anxiety Scale (MDAS), 5 questions based on different aspects of a dental procedure

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14
Q

Name an issue with the dental anxiety inventory.

A

They could have been ok coming in but looking at a big list of the scary parts and asking your responses could cause anxiety you didn’t have initially

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15
Q

What are the three areas of the dental belief survey

A

Professionalism (e.g. the competency of the dentist), communication (I don’t know what is happening) and lack of control

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16
Q

Define Pain

A

An unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage - it is both physical and emotional

17
Q

Describe the early pain theories and how they fit into 2 categories

A

Based off of a biomedical framework, pain is caused by tissue damage. Categorises into psychogenic (all in your head) or organic (real pain with an injury)

18
Q

list some of the factors involved in a pain experience

A

Genetics, Mood, Context, Placebo, Chemical brain structure

19
Q

Is pain the same between individuals

A

Pain is whatever the experiencing person says it is, existing whenever he/she says it does so no

20
Q

Explain the two types of pain

A

Acute (recent, adaptive and meaningful)and Chronic (longer than 3 months and lasting, often without observable injury)

21
Q

Explain the gate control theory

A

There is a neural ‘gate’ at the level of the spinal cord that can open/close to allow/block pain transmission. It is inhibited by large fibres/mechanoreceptors [why rubbing reduces pain] as well as endorphins

22
Q

What is the difference between pain threshold and pain tolerance?

A

Threshold – the level at which the body 1st perceives stimuli as painful
Tolerance – how much pain a person can take

23
Q

What are all the points in SOCRATES?

A

Site, Onset, Character, Radiation, Associations, Time course, Exacerbating/Relieving factors, Severity

24
Q

Which methods of sedation are non-rehabilitative?

A

IV and GA, as the patient won’t be able to remember therefore remember a good experience so won’t help reduce overall anxiety

25
Q

Define conscious sedation.

A

“A technique in which the use of a drug or drugs produces a state of depression of the central nervous system enabling treatment to be carried out, but during which verbal contact with the patient is maintained throughout the period of sedation. The drugs and techniques used to provide conscious sedation for dental treatment should carry a margin of safety wide
enough to render loss of consciousness unlikely.” -remain conscious and cooperative, manage own airway

26
Q

What are some patient scenarios which require sedation?

A

Phobias, really unpleasant procedures (e.g. impacted lower wisdom), to overcome severe gag reflexes, reduce stress, medical:(e.g. to stop an angina attack, parkinsons)

27
Q

What are the problems with using these drugs (e.g midazolam) when there is a history of alcohol/drug abuse?

A

midazolam gets metabolised in the liver, suspect any liver damage, liver won’t be able to break it down so excess with amount so potentially lose consciousness

28
Q

List some medical contraindications to sedation.

A

severe/uncontrolled systemic disease, clashing medication, allergy to agent, pregnancy, psychosis, respiratory infection

29
Q

What is the ASA?

A

American society of Anaesthesiology (scale)

30
Q

Describe the ASA scale

A

I- normal, healthy
ii- A patient with mild systemic disease e.g. well controlled type 2 diabetes or epilepsy, mild asthma, smoker, social alcohol, pregnancy
iii - A patient with severe systemic disease limiting activity but not incapacitating (e.g. angina)
iv - incapacitating disease that is a constant threat to life
v- Moribund patient not expected to live more than 24 hours

31
Q

What is the cutoff for sedation using the ASA scale?

A

General practice up to ii, in the LDI/hospital they will go up to 3

32
Q

Give the advantages for oral sedation

A

simple to administer, cheap, patient friendly, can be self-administered

33
Q

Give the disadvantages for oral sedation

A

very unpredictable, often rapid recovery, no titration/dose of effect (don’t know how much of an effect you will get)

34
Q

Give the advantages of inhalation sedation

A

safer for children, no needles, reliable and predictable, no special patient arrangements, good safety record, rehabilitative

35
Q

Give the disadvantages of inhalation sedation

A

Specialist equipment required, requires psychological re-enforcement to produce semi-hypnotic state, nitrous oxide pollution, claustrophobia, nasal obstruction