Block 6

Question 1

What is stress?

Answer 1

An imbalance between the demands made on us and out personal resources to deal with these demands

Question 2

What are the key components of a stress response?

Answer 2

Primary: appraisal of event
Secondary: appraisal of personal coping abilities or personal resources and also the resources external to them, mainly in the immediate social network
Emotional response
Cognitive response: hard to concentrate, switch off and make decisions, self-critical
Behavioural response: comfort eating/loss of appetite, excess drinking/smoking, sleep
Physiological response: raised HR and BP, increased perspiration

Question 3

What are medically unexplained symptoms?

Answer 3

Physical symptoms not explained by organic disease which cause distress and impair functioning and for which there is positive evidence or a strong assumption that the symptoms are linked to psychological factors. Caused by unconscious mechanisms

Some MUS are normal body sensations, some are an exaggeration of minor pathology due to stress

Question 4

What are examples of direct coping mechanisms?

Answer 4

Direct
Increased gastric secretion
Negatively affects immunological responses and hosts defences

Question 5

What is problem solving?

Answer 5

Controlling the problem and reconstructing it as manageable.
Seeking info and support, develop realistic plan

Question 6

What is emotion focused coping?

Answer 6

Involved managing emotions and maintaining emotional equilibrium.
Works well but only transiently
Best reserved for brief stresses or where nothing realistically can be done to modify the stress.

Question 7

What is risk?

Answer 7

The simultaneous appreciation of the likelihood and consequence value of a situation or event occuring

Question 8

What is ‘Risk Society’?

Answer 8

Risk is now viewed as a product of human action and decision-making and has become a political issue

Question 9

What percentage of people suffer from depression at some point in their lives?

Answer 9

10-20

Question 10

What is the ratio of men to women with depression?

Answer 10

1:2

Question 11

When is the average onset of depression?

Answer 11

27 years

Question 12

What are the common presentations of MUS?

Answer 12

Palpitation
Chronic fatigue
Pelvic pain
Chest Pain
Abdominal Pain
Headache
Muscle and joint pain

Question 13

What are some common assumptions about MUS?

Answer 13

The explanation lies in the patients
Around half deny psychological factors and ‘somatise’ psychological distress
They seek cure and diagnosis
They get physical intervention because they demand it
To avoid physical intervention, doctors should help patients appreciate psychological factors

Question 14

Define Exulpation

Answer 14

Recognising the reality of suffering and ‘exculpate’ the symptoms by confirming that they are not the patients responsibility
‘Removing blame from the patient’

Question 15

What is the difference between neurotic and psychotic disorders?

Answer 15

Neurotic results in distress

Psycotic is any mental state that impairs thought, perception, and judgement

Question 16

And what is the typical presenting patient for neurotic disorders?

Answer 16

more likely female, middle-aged, separated or divorced, live alone

Question 17

And what is the typical presenting patient for psycotic disorders?

Answer 17

more likely male, separated or divorced, live alone, low educational qualifications, in social class 4 or 5

Question 18

What is the BioPhyscoSocial Model of Health and Mental Illness?

Answer 18

‘An approach in which health and/or mental illness are seen as a product with a number of interacting factors relating to the individual.’

Question 19

What are the biological factors underlying mental illness?

Answer 19

Predisposing: e.g. genetics
Precipitating: e.g. acute illness
Mediating: e.g. neurotransmitter changes

Question 20

What are the psychological factors underlying mental illness?

Answer 20

Predisposing: e.g. childhood neglect
Precipitating: e.g. psychological stress
Maintaining: e.g. dysfunctional thinking or behavioural maladaptations

Question 21

What are the social factors underlying mental illness?

Answer 21

Predisposing: e.g. physical discrimination, poverty, poor diet
Precipitating: e.g. life event such as loss of partner, job, changes in circumstances
Maintaining: e.g. poor finances, unemployment, lack of support

Question 22

What is the ‘iceberg of disease’?

Answer 22

Symptoms themselves do not cause people to visit a doctor

Most healthcare work is undertaken by lay people

Question 23

What are the major causes of learning disability?

Answer 23

Metabolic: lack of enzyme leads to build up of phenylalanine causes microcephaly/epilepsy/autism
Toxic: alcohol and lead
Injection: Rubella, syphilis
Neoplastic process: epilepsy and autism
Trauma: hypoxia during birth
Chromosomal and genetic: downs syndrome

Question 24

What is the definition of a learning disability?

Answer 24

An IQ under 70 and impaired social function and impairment occurred before the age of 18
After 18 it is ‘an acquired brain injury’
IQ less than 50 is a ‘severe mental disability’

Question 25

What is Service User Involement?

Answer 25

‘The involvement of service users in the management, design and delivery of services’ – involvement should emcompass the full range of people’s experiences – not just the things that workers or planners think are important

Question 26

What are examples of indirect coping mechanisms?

Answer 26

Indirect
Poor compliance with medication
Increased smoking and alcohol
Reduced exercise
Poor diet