BSS Flashcards
What is social drift?
Once incapacitated by a mental health disorder one is likely to slip lower down the socio-economic ladder
What percentage of those with long term mental health problems are employed?
24%
What is the link between socio-economic status and mental health?
Low socio-economic status is a risk factor for mental health
What is the link between mental health and employment?
Those affected by a mental health condition find it harder to study and work
Often stigma attached results in problems or lack of support in work leads to them leaving work
What is the link between mental health incidence and growing up in a less well off family?
Incidence increased in poorer families
What is the link between substance abuse and mental illness?
SA not a diagnosis but often a duel diagnosis with mental health conditions
Those with SA problems often find it hard to get a job/ can be associated with criminal behaviour
What is the link between mental and physical health?
Decreased MH results in decreased PH (possibly due to lifestyle changes)
Poorer access to treatment for PH in patients with MH, could be due to diagnostic overshadowing (focussing on mental not physical)
What is esteem support?
Where other people increase P’s self esteem
What is informational support?
Other people offer advice
What is companionship?
Support through activities and spending time together
What is instrumental support?
Physical help (buy shopping etc)
What is the main effect hypothesis in relation to support?
Social support is beneficial and a lack of is stressful
What does the stress buffering hypothesis suggest about support?
That social support can help individuals cope with stress
What is the base assumption made in relation to mental capacity?
A person has capacity unless proven otherwise, they are not incapable of making decisions unless steps to help them do so have been taken without success. An unwise decision does not show lack of capacity
In order to have capacity you must be able to:
Understand information
Retain that information
Be able to weigh the information
Be able to communicate your decision
What is the link between emotional state and pain?
Resilience/ optimism/ accepting/ self coping = Reduced pain
Vulnerability/ anxiety/ depression/ fear/ catastrophising = Increased pain
What is catastrophising?
Exaggeration of negative orientation
What is the biopyschosocial model of pain?
Pain is a genuine physical sensation with both physiological and psychological components
What is the fear avoidance model of disability?
Injury = pain = defence/ avoidance = disuse = disability
What are pain management programs and what is their purpose?
Psych based rehab with MDT.
Aims to move patient from medical pain model to biopyschosocial model
CBT for pain- reconceptulisation and relaxation training
What is a disability?
A physical or mental impairment which has substantial long term, -ve effect on normal ADL
What is the medical model of disability?
Disability result from persons physical or mental limitations (Any restriction of ability from that considered normal)
What is the social model of disability?
A consequence of environmental, social and attitude barriers which prevent people with impairments from maximum participation in society (Disability from societies failure to meet needs)
Define substance abuse
Use that doesn’t conform to social norm
Define substance dependence
Need drug for normal function
Define substance addiciton
Acquiring and using the drug drives behaviour
What is operant conditioning?
Voluntary behaviour which has favourable effects is repeated
Positive reinforcement: Press lever for food
Neg reinforcement: Press lever to stop pain
What is the opponent process theory?
You start substance abuse because it makes you happy but you don’t stop because you don’t want to feel bad
How many people who ‘quit’ relapse in one year? Which substances cause most relapse?
75% of those who ‘quit’ relapse in 1yr
Easiest) Alcohol < opiates < marjuana < cocaine (Hardest
What is motivational interviewing?
Targets ambivilance (mixed feelings). Can be used to combat things like addiction or to make other behaviour changes
What is community reinforcement?
Where rewards are given for good behaviour
E.g. money for clean urine sample when coming off addictive substances
What is a pain management program?
Groups of 6-8 people who teach you how to live with your pain
What is a pain clinic?
For chronic pain (<3months). Range of professionals with medication, CBT, acupuncture, physio etc
What is problem focussed coping?
Lazerus and Folkman
Targeting stress in practical ways, helps reduce stress
Characteristics: Take control, seek information
What is emotion focussed coping?
Lazerus and Folkman
Trying to decrease neg emotional response:
Characteristics: Ignore/ rant/ pray/ keep busy/ pessimism
What are AD’s and in what section of the MHA are advance directives covered?
Outline future treatment decisions, made whilst P has capacity in anticipation of a time when incapacitated
In MHA section 24 (1a+b)
When can AD’s be withdrawn? In what section of the MHA is this covered?
At any time (or it’s invalid if P has capacity or has done anything to suggest inconsistency with AD)
MHA section 25
What is lasting power of attorney? What are the names for the patient and the person with LPA?
They can make decisions on your behalf
Patient is the DONOR
Person with LPA is the ATTORNEY
What is an advance care plan?
A discussion with trained member of staff about what P wants to happen (and doesn’t) and who they want to be responsible for them
Name three factors which can influence perception of symptom severity?
Intensity
Familiarity
Duration/ frequency
Which three groups of people are most likely to visit their GP?
Women
Pre-school children
Adults over 65
Name 5 social triggers to consultation:
Crisis (death in family)
Relationship (partner can’t sleep)
Sanctioning (you look pale/ ill)
Temporalising (I’ll go on Monday if still bad)
Activities (If it’s interfering with what you want to do)
What is the difference between morbidity and mortality rates?
Mortality rate = No deaths/ no population (corrected for age and sex as more M die younger)
Morbidity rate= No affected/ no population
What is the difference between objective and subjective measures of functioning?
Subjective: Individuals rate their own health
Objective: Functional questions (eg ADL)
What are unidimensional, multidimensional and composite scales of health measurement?
Uni: Focusses on on health aspect (e.g. mood)
Multi: Assess broad health (e.g. is your health good. bad)
Composite: Combines both
What is response shift?
Each time P judges their health they create a FRAME OF REFERENCE (what do health/ work etc. mean to them), they then create STANDARDS OF COMPARISON and then create a SAMPLING STRATEGY (deciding which parts of life to assess)
What is pavlovian conditioning?
(Classical conditioning)
Initially neutral stimulus (noise- ka conditioned stimulus) is paired with a noxious stimulus (pain- unconditioned stimulus)
What is the James-Lange Theory of emotion?
Emotions experienced because of the bodies physical response to fear (unlikely)
What is the cannon-bard theory of emotion?
Emotionally significant events cause independent emotional and physical responses
What is the cognitive labelling (shacter) theory of emotion?
Physiological arousal needed for emotional arousal but only if we label the arousal as relevant
What is the difference between top down and bottom up attention?
Top Down: We choose to focus our attention
Bottom Up: Our attention is forced by a stimuli
What is the ways of coping (Lazarus and Folkman) questionnaire used to asses?
Coping processes
In Lazarus’ transactional model of stress, what is the primary appraisal?
Evaluate significance of stressor
In Lazarus’ transactional model of stress, what is the secondary appraisal?
Evaluation of controllability of stressor and ability to cope
In Lazarus’ transactional model of stress, what are coping efforts?
Actual strategies used
What are the stages in lazarus transactional stress model?
Primary appraisal- Of situation
Secondary appraisal- Of ability to cope
Coping efforts
Outcomes
What kind of questioning is used in CBT?
Socratic
“What evidence do you have for that”
“How else could you look at that”
NICE guidelines suggest how many sessions of CBT for generalised anxiety disorders?
12-15
What is the difference between recognition and recall?
Recognition needs initial cue, recall does not
What is the name of the curve that predicts how much information you will retain?
Ebbinghaus forgetting curve
Recall at 30 days is similar to recall at 5 days (30%)
What is the multi story model of memory?
Lots of discrete stores (Sensory, STM, LTM, information is moved between them)
What is the working memory model of memory?
Central executive which directs info to phonological loop, visuospatial sketchpad. Episodic buffer links domains to integrate them
What is the levels of processing model of memory?
Memory is a schema which we construct. If we only superficially process this it will not be remembered but if we process it deeply we will remember Has implicit (unconscious) and explicit (conscious)
What is the constructive model of memory?
Memory tasks are not just repeated but people actively reconstruct what they remember, memories are stored in several interconnected areas and memory increases as more links are made
A set of cognitive distortions - including a negative view of oneself, current experiences, and the future - is known as?
A cognitive triad
This legislation supports a 77 year old cancer patient’s right to refuse treatment against medical advice?
Mental Capacity Act 2005
You can only be treated against your will under the MHA Section 3 until what point?
3 months
Then must be reviewed by a second opinion appointed doctor (who can agree to treatment continuing for another 3 months)
In the health belief model what is perceived susceptibility and perceived severity?
Susceptibility: Ones opinion of the chances of getting a condition
Severity: Ones opinion of how bad a condition would be to have
In the health belief model what are perceived benefits and barriers?
Benefits: Ones belief in the efficacy of the advised action to reduce risk or impact
Barriers: Ones opinion of the tangible and psychological costs of the advised action
In the health belief model what are cues to action?
Symptoms, media information, family illness, education
In the health belief model what is a lack of health motivation?
“Better things to do”- Seen as unimportant
According to the health belief model when will someone take a health related action?
The patient:
1) Believes a health condition can be avoided
2) Believes taking the action will avoid the health condition
3) Believes they can take the action
The ‘social model’ of disability differs from the ‘medical model’ of disability because the former stresses that the experience of ‘disability’ is the direct result of an individual’s…
Social environment
A GP would like Sarah to remember the name of her new medication. According to the Levels of Processing Approach to memory, this information is more likely to be remembered if Sarah is asked to:
Relate the word to herself in some way
Eldery people are less likely to present in a GP setting because….
They believe their health condition is part of the natural ageing process
