Ch 3

Question 1

Social determinants of health

Answer 1

Non-medical factors that influence heath outcomes
→ who gets sick, whether they get treatment, type of treatment, societal reaction

Question 2

Sociocultural factors

Answer 2

• Social regulation: the degree to which a society regulates the behaviours of its members
• social integration: the degree to which members of a society feel connected to one another and to society as a whole
• “deaths of despair”: referenced the rise in mortality/morbidity amongst certain demographics (low-education, working class)
  → mostly attributed to suicide, overdoses, and diseases due to alcoholism
  → causal factors are social, economic, political etc.

Question 3

Moral injury

Answer 3

When people are forced to act against their professional and/or personal ethics (can also happen when you witness behaviour by a person with authority)

Question 4

Dirty work

Answer 4

Work that society deems necessary but is morally troubling
→ people grant an “unconscious mandate” to dirty work (tolerance is maintained through repression)

Question 5

Environmental hazards

Answer 5

• Sacrifice zones: communities with high levels of pollutants/low levels of investment
• communities adjacent to garbage dumps are associated with high alcohol and drug consumption and increased need for psychiatric treatment
  → social exclusion and prejudice = lower wellbeing
• environmental containments (air, water, noise pollution)

Question 6

Assessment

Answer 6

• Purpose is to gather information (symptoms, patient history, physiological measurements) to conduct a differential diagnosis
  → interviews, observations, tests
• standardization: using the same materials and procedures to ensure meaningful comparisons between paItients
• reliability: consistency
  → test-retest reliability: assessments must give similar results at different times
  → inter-rater reliability: assessments must give similar results regardless of the administrator

Question 7

Assessment (validity)

Answer 7

• Internal validity: the degree to which the assessment allows causal inferences
• external validity: the degree to which an assessment can be generalizable
• construct validity: the degree to which an assessment represents a construct that is not directly visible
• content validity: the degree to which an assessment represents all aspects of a construct

Question 8

Interviews

Answer 8

• Unstructured interviews: open-ended questions and follow up on interesting/relevant responses (let client talk and help guide further questions)
• structured interviews: pre-prepared or standardized questions (ensures consistency and allows for comparison between clients)

Question 9

Observations

Answer 9

• Self-monitering: patients observe themselves and report back to the clinician
• analogue observation: clinicians observe client in a formal/artificial setting (minimize observer effects by using video cameras one-way glass)
• naturalistic observation: clinicians observe clients in everyday environments

Question 10

Diagnosis

Answer 10

• When addressing psychopathological concisions diagnosis is typically based on the DSM
  → patients may find diagnosis stigmatizing or culturally inappropriate

Question 11

Treatment

Answer 11

• treatment depends on diagnosis, severity of the condition, client history, and goals for treatment
  → gold standard: treatments that the clinician typically starts with, only using other treatments if that fails
  → non-inferiority trial: new treatments may be preferred even if there are no improvements in efficacy over gold standard (cheaper and safer)