Attention and Perception

Question 1

What is sensation?

Answer 1

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

Question 2

What is perception?

Answer 2

The active process of organising the stimulus output and giving it meaning e.g. what is it?

Perception is the step after sensation – it is the way in which we make sense of the information around us.

Question 3

Top down and bottom up attention

Answer 3

Top-down

• Processing in light of existing knowledge
• Influenced by many psychological influences such as our motives, expectations, previous experiences and cultural expectations

Bottom-up

• Individual elements are combined to make a unified perception
• Refers to the idea that the nerve impulses we receive from senses activate higher cortical areas in order for us to perceive them

Question 4

What factors affect perception (top-down)?

Answer 4

• Attention
• Past experiences
  Poor children/adults overestimate the size of coins compared to affluent people
• Current drive state (e.g. arousal state)
  Hunger: when hungry, we are more likely to notice food-related stimuli
• Emotions
  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
• Environment
• Cultural background – cross-cultural differences play a role in perception

Question 5

What are Gestalt’s Laws?

Answer 5

Gestalt laws of grouping involve a set of principles that account for such natural manner of perception

These include six categories: similarity, proximity, good form, closure, common fate, and continuation.

Question 6

What is figure ground relations?

Answer 6

Our tendency to organise stimuli into central or foreground and a background

Focus of attention becomes the figure, all else is background

Question 7

What is continuity (Gestalt’s laws)?

Answer 7

When the eye is compelled to move through one object and continue to another object. This plays on the idea that when we perceive things, we look for continuity of movement.

Question 8

What is similarity (Gestalt’s laws)?

Answer 8

Similar things are perceived as being grouped together.

Question 9

What is proximity (Gestalt’s laws)?

Answer 9

Objects near each other are grouped together.

Question 10

What is closure (Gestalt’s laws)?

Answer 10

Things are grouped together if they seem to complete some entity. If a picture has several parts of it missing, our brains will very quickly close this gap up. It is very rapid.

Question 11

What is visual agnosia?

Answer 11

IMPAIRMENT IN VISUAL RECOGNITION

• Basic vision spared – can make sense of distance, shape and colour
• Primary visual cortex can be mostly intact
• The patient not blind
• Knowledgeable about info. from other senses (e.g. if they touch an object, naming is typically simple)
• Associated with bilateral lesions to the occipital, occiptotemporal, or occipitoparietal lobes
• When the occipital lobes are damaged, and the pure visual pathways are damaged, the process of perception of visual stimuli received in the eye is inhibited. It is just the visual recognition that is impaired. When the patient holds an object (tactile sensation), they can often recognise it.

Question 12

What is apperceptive agnosia?

Answer 12

• A failure to integrate the perceptual elements of the stimulus
• This is when the very basic elements of visual perception are damaged
• Individual elements perceived normally
• May be able to indicate discrete awareness of parts of a printed word but cannot organised into a whole
• Damage to lower level occipital regions

Question 13

What is associative agnosia?

Answer 13

A failure of retrieval of semantic information.

• This is when damage is further up the pathway, basic components okay
• Shape, colour, texture can all be perceived normally
• Typically sensory specific e.g. if object touched, then recognised
• Damage to higher order occipital regions

Question 14

What is attention?

Answer 14

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

Attention is important in how we make sense of the information around us

2 processes of attention:

• Focus on a certain aspect
• Filter out other information

Question 15

What are the 2 components of attention?

Answer 15

Focused attention (the spotlight). This involves really focusing on something specific. Involves trying to ignore the other stimuli around us

Divided attention (paying attention to more than one thing at once

Question 16

Which stimulus factors affect attention?

Answer 16

• Intensity
• Novelty
• Movement
• Contrast
• Repetition

Question 17

What are personal factors affecting attention?

Answer 17

• Motives
• Interests
• Threats
• Mood
• Arousal

Question 18

Memory and attention

Answer 18

• Attention is heavily intertwined with other cognitive processes (e.g. memory and perception)
• We can’t learn information properly if we don’t attend to the information in front of us
• Attention is a gateway to cognition
• Sensory buffers register information for a few seconds, which can be used to select what to focus on
• But, there is evidence that we can unconsciously perceive information not attended to

Question 19

What is digit span test?

Answer 19

you read a number of digits in a row, and ask the patient to repeat it back

Question 20

What is the cocktail party effect?

Answer 20

• We can focus our attention on one person’s voice in spite of all the other conversations
• But, when someone says your name in another conversation nearby, you will pay attention to it
• In a crowded room, we reject some conversations, and generally focus on one
• Any conversation we do not focus on, we struggle to recall any information

Question 21

Attention and clinical skills - 3 stages, explain them

Answer 21

Cognitive stage:

• Development of mental resources
• Learning requires explicit instruction through teaching from an ‘expert’, demonstration, and self-observation

Associative stage:
- An effective motor programme has been developed to carry out the broad skill but lacks ability to perform finer subtasks with fluency

Autonomous stage

• The skill is largely automatic
• Rely on implicit knowledge and motor co-ordination, rather than instruction
• The more automatic a task, the less conscious control available

Question 22

Attention and clinical skills - 3 stages, what are they

Answer 22

cognitive, associative and autonomous

Question 23

Medical mistakes

Answer 23

• The more automatic a task, the less conscious control available (e.g. driving)
• High levels of stress and anxiety can impact performance
• Over half of patient deaths were due to unconscious errors that could be the direct consequence of automatic behaviour
• Checks needed to reduce errors
• Junior doctors learning new surgical skills performed 3x better when not listening to music compared to if they did

Question 24

Medical student syndrome

Answer 24

• Through being taught a lot about the human body, and what can go wrong, some medical students begin to think they have problems.
• We all experience normal bodily sensations (pain, pins and needles, headaches etc.). when this is coupled with medical lectures, the perception of these symptoms can become quite catastrophic -> anxiety

Question 25

Perception of bodily symptoms

Answer 25

• Focus of attention contributes to the perception of our bodily symptoms
• Perception of symptoms whilst jogging on a treadmill (Pennebaker & Lightner, 1980)
• 56 participants walked on treadmill for 11 minutes on 2 occasions
• They were asked to perceive how many physical sensations they experienced
• 1st time: wore headphones but heard nothing
• 2nd time: one group heard amplified sounds of their own breathing, other group heard street sounds (e.g. cars, conversations)
• RESULTS: the first time round (control), reporting of sensations was similar in both groups
• The group hearing street sounds (2nd time round) perceived physical symptoms much less

Question 26

Acute pain perception affected by expectations

Answer 26

• Stimulus: vibrating piece of sandpaper – students were asked to touch it
• Students were told it would be either painful or pleasant, OR were not told anything
• Those who were told it would be pleasant reported it as being not very painful
• Those who were told it would be painful found it much more painful

Question 27

What are the 2 kinds of pain?

Answer 27

Acute pain: pain that we have only experienced for a short amount of time that is directly related to tissue damage within the body. It generally starts to heal.

Chronic pain: pain has been experienced for a longer period of time. There are lots of psychological factors influencing the way in which pain is experienced and perceived.

Question 28

Chronic pain

Answer 28

• Pain is usually a sign of body damage
• Chronic pain is when pain has been present for greater than 3 months
• At this point, it is likely that original damage has healed
• 28 million people in UK have chronic pain
• Chronic pain tends to carry on for an extended period of time
• The patients need to be considered as a whole

Question 29

Gate theory of pain

Answer 29

• Pain signals compete to get through ‘gate’
• ‘Gate’ can be opened or closed by psychological and physical factors
• The gate theory of pain is the idea that within the dorsal horn of the body (just below the brain), there are ‘gates’. There is a theory to suggest that there are certain things that will open and close this gate for the perception of pain. This may include our emotions, stress levels, previous experience and beliefs
• In chronic pain, we often see a higher level of stress and depression
• The neurones can become sensitised and there may be a loss of control of this gate. - The perception of pain itself is complex
• The pain itself is brain related
• There are many areas of the brain that perceive pain
• This includes areas involved in emotion (amygdala, anterior cingulate cortex) – heavy involvement
• Pain is very emotional
• We also see involvement from areas of the pre-frontal cortex – involved in personality and thinking
• When people experience chronic pain, these areas of the brain light up in fMRI
• There are ways of treating this problem (e.g. mindfulness thinking and therapy)

Question 30

Fear avoidance model of chronic pain

Answer 30

When people experience chronic pain over many years, it is scary. This may make people avoid things (e.g. going out, socialising and working) for fear of pain. Increased pain sensation correlated with low activity, means that patients are more likely to feel low, stressed and anxious.
- Pain breeds avoidance, which perpetuates stress, low mood, anxiety etc.