COGNITIVE FOUNDATIONS OF BHD Flashcards
Classical conditioning
occurs unconsciously through associations between stimuli within our environment.
Operant conditioning
learning controlled by the
consequences of our behaviour.
Unconditioned Stimulus
Naturally elicits a reflexive response.
Example: Food.
Unconditioned Response
Reflexive response to the US.
Example: Salivation.
Neutral Stimulus
Initially does not elicit the response.
Example: Bell.
Process of Operant conditioning
Pairing: Repeatedly pairing the NS with the US.
Conditioned Response (CR): After repeated pairings, the NS becomes a Conditioned Stimulus (CS) and elicits the response on its own.
Example: The bell (CS) causes salivation (CR) after being associated with food.
Conditioned Stimulus
A previously neutral stimulus that is able to elicit a particular response after being paired with the unconditioned stimulus.
Conditioned Response
The response elicited by the conditioned stimulus.
Acquisition
learning phase during which a conditioned response is established.
* Impacted by frequency and timing of stimuli.
Extinction
gradual reduction and elimination of the CR after the CS is presented repeatedly without the UCS.
Spontaneous recovery
a seemingly extinct CR reappears if the CS is presented again.
Stimulus generalisation
individual responds to stimuli that are similar to the CS.
Stimulus discrimination
individual can discriminate between stimuli that are similar to the CS less pronounced CR, or NO RESPONSE
Chemotherapy
Nausea is a common side effect of chemotherapy.
* Conditioned taste aversions
* Neutral stimuli CS when
paired with the UCS
OPERANT CONDITIONING
Learning controlled by the consequences of our
behaviour probability that a behaviour will occur is
influenced by the previous consequences of that behaviour.
Thorndike’s Law of Effect
Behaviours which lead to a “satisfying state of affairs”
are more likely to be repeated in the future.
Skinner Box (Operant Conditioning Chamber)
Invented by: B.F. Skinner to study operant conditioning.
Key Features: Lever/button for animal to press, delivers rewards (food/water) or punishments (mild shock).
Purpose: Animal learns to perform actions (e.g., pressing lever) for rewards or to avoid punishment.
Significance: Demonstrates how reinforcement and punishment shape behavior in controlled experiments.
Reinforcement
stimulus which occurs after the behaviour and increases the likelihood that the behaviour will occur again
Punishment
stimulus which occurs after the behaviour and decreases the likelihood that the behaviour will occur again
Positive reinforcement
The presentation of a pleasant stimulus after a behaviour
Positive punishment
The presentation of an unpleasant stimulus after a behaviour
Negative reinforcement
The removal of an unpleasant stimulus after a behaviour
Negative punishment
The removal of a pleasant stimulus after a behaviour
Extinction (operant)
the fading out of a behaviour when reinforcement of the behaviour stops
Extinction burst
initial increase in behaviour following withdrawal of reinforcement
Stimulus generalisation
eliciting a response to stimuli which are similar, but not identical, to the original stimulus
Stimulus discrimination
displaying a less pronounced
response (or no response) to
stimuli that differ from the
original stimulus.
Continuous reinforcement schedules
Reinforcement occurs after every response (after each time the behaviour is performed)
Intermittent/partial reinforcement schedules
Reinforcement occurs intermittently rather than
after every response
* Fixed or variable
* Ratio schedules or interval schedules
Fixed Ratio
Reinforcement occurs after a fixed number of behavioural responses
Variable Ratio
Reinforcement occurs after variable number of behavioural responses, the average of which is predetermined.
* VR schedules usually yield the highest rates of responding, and are most resistant to extinction
Fixed Interval
reinforcement occurs for the first behavioural response performed following a specified time interval.
Variable Interval
reinforcement occurs for the first behavioural response performed after a variable time interval, the average of which is predetermined.
Key factors of observational learning
Motivation
Attention
Retention
Reproduction
Vicarious Conditioning
Definition: Learning through observation of others being rewarded or punished for their behavior.
Impact: Behavior is more likely to be imitated if the model is observed being rewarded, and less likely if punished.
Imitation Factors:
Model’s Characteristics:
Prestige: Higher status increases likelihood of imitation.
Likeability and Attractiveness: More likely to imitate someone who is likable and attractive
Cognition
the mental action or process of acquiring knowledge and understanding through thought, experience, and the senses.
SOCIAL-COGNITIVE LEARNING is influenced by
- Interpersonal differences in perception
- Subjective interpretation of our environment and
personal relationships.
Learned helplessness
the tendency to feel helpless in the face of events that we cannot control.
The path to learned helplessness
Uncontrollable Adverse Events: Trigger feelings of helplessness.
Perceived Lack of Control: Leads to the belief that one cannot escape aversive events.
Feelings of Helplessness: Result in helpless behavior.
Explanatory Style: Expectation that one cannot escape aversive events.
Three Types of Deficits
Motivational: Slow to initiate known actions.
Emotional: Appear rigid, lethargic, frightened, or distressed.
Cognitive: Demonstrate poor learning in new situations.
LOCUS OF CONTROL
- We form expectations about the consequences of our behaviours
- We might believe that reinforcements and/or
punishments lie inside or outside of our
control
Internal locus of control
Belief that our own actions
determine our fate
External locus of control
Belief that our lives are
governed by forces outside
of our control, or by
people more powerful
than ourselves
Locus of Control in Healthcare
Impact on Health:
Internal Locus of Control: Individuals who believe they control their own health are more likely to engage in healthy behaviors and practice good healthcare habits.
External Locus of Control: Those who believe their health is controlled by external factors may take fewer actions to improve their health, potentially leading to poorer health outcomes.
Self efficacy key factors
Mastery
Experience
Vicarious
Experience
Persuasion
Emotional
Arousal
High self-efficacy in health context
people feel in control of their own health, and the effects of their health condition become less of a stressor.
Low self-efficacy in health context
negative impact on their health outcomes.
* Complex / strict diet
* Self-injecting insulin
Dispositional attributions
behaviour is caused by an internal or personal factor
Situational attributions
behaviour is caused by an external, or environmental factor
Optimistic style
credits success to internal factors, failures to external-> confidently work for
success
Pessimistic style
Credits success to luck and failure to lack of ability-> low expectation of success
Fundamental Attribution Error
Definition: The tendency to attribute another person’s behavior to their personality (disposition) while ignoring situational causes.
Key Points:
Underestimation of Situational Factors: Even when strong situational cues are present, we often downplay their influence.
Reasons for Making the Error:
Lack of Information: We often don’t have enough information about the situational factors affecting the other person.
Self-Reflection: We may not reflect on how we would behave in the same situation.
Cultural Influences: Cultural norms and values can shape our tendency to make dispositional attributions.
FUNDAMENTAL ATTRIBUTION ERROR
HEALTH CONTEXT
*Can influence communication in a health care team and hinder collaboration
* Can influence how interpret a patient’s adherence to a medication/treatment/
lifestyle change
* Can exacerbate health inequity, e.g. judgment about missed appointments
Self-Serving Bias
Definition: The tendency to attribute personal successes to internal factors (e.g., talent, effort) and personal failures to external factors (e.g., luck, circumstances).
Short-Term Effect: Can be protective, boosting self-esteem.
Long-Term Impact: May prevent learning from mistakes and hinder personal growth.
WHAT IS PAIN?
“An unpleasant sensory and emotional experience
associated with actual or potential tissue damage.”
Sensation
activation of sense organ → neural impulses transmitted to the brain
Perception
the brain’s organisation + interpretation of sensory input
What is the starting point of the pain pathway?
The site of injury, where nociceptors detect harmful stimuli.
What type of fibers transmit sharp, acute pain signals?
A-fibers (fast, myelinated fibers).
What type of fibers transmit slow, dull, aching pain signals?
C-fibers (slow, unmyelinated fibers).
Where do pain signals first synapse in the spinal cord?
In the dorsal horn of the spinal cord.
What is the role of the somatosensory cortex in the pain pathway?
It interprets the physical sensation of pain.
How does the limbic system contribute to the pain response?
The limbic system processes the emotional and cognitive response to pain.
What is the role of the thalamus in the pain pathway?
The thalamus acts as a relay station for pain signals to various parts of the brain.
What is the name of the pathway that transmits pain signals to the brain?
The spinothalamic tract.
What part of the brain is responsible for processing both the sensation and emotional response to pain?
The cerebrum, involving the somatosensory cortex, limbic system, and thalamus.
WHY DO WE EXPERIENCE PAIN?
Pain is an evolved defence mechanism which informs
the individual of injury or dangerous stimuli → critical
for our survival…
* Prevents tissue damage and/or protects from
further damage
* Promotes immobilisation for healing
Traditional biomedical perspective assumes
Symptoms are the result of tissue damage
* Pain severity is proportional to the amount of tissue damage
* There is an organic explanation for all pain symptoms. Therefore… everyone with the same injury should experience the same amount of pain!
PAIN BEHAVIOURS
Responses can include:
* Outward expressions of the pain
* Attempts to reduce the pain (i.e. medication, withdrawing
from activities)
* Attempts to cope with or ignore the pain (i.e. distraction). Pain behaviours can impact the way we perceive and experience pain
CHRONIC PRIMARY PAIN
Pain in one or more body systems that:
(a) persists or recurs for longer than 3 months,
(b) is associated with significant emotional distress and/or
significant functional disability, and
(c) includes symptoms that are not better accounted for by another diagnosis.
GATE CONTROL THEORY
A “gate” exists at the spinal cord that can block some
pain signals while allowing others through to the brain
The “gate” receives two-way input:
* Ascending messages are biological in nature (activation of pain receptors); can be modulated by non-painful stimuli → i.e. touch/pressure
* Descending messages are psychological in nature →
i.e. attention, emotional state (stress, anxiety)
What does Gate Control theory explain?
explains how psychological
states can influence pain
perception…
* Negative emotional states
(stress, anxiety) + focused
attention = GATE OPEN
* Positive emotional states
(acceptance, calm) +
distraction = GATE CLOSED
PAIN MANAGEMENT (Gate)
Focuses on techniques to ‘close’ the gate
- Rubbing the site of injury
- Distraction techniques
- Relaxation exercises
- ‘Non-traditional’ therapies, i.e. acupuncture or massage therapy
OPERANT THEORY
Operant model offers a behavioural approach to pain, particularly the development and maintenance of
chronic pain + associated behaviours.
Pain Management (Operant)
Pain behaviours → create a cycle of chronic pain,
where the patient receives positive consequences for
being in pain (i.e. rest, attention from others)
Focuses on changing behaviours (behaviour modification)
Uses principles of learning through conditioning to:
* Decrease unhelpful behaviours, i.e. avoidance
* Increase helpful behaviours, i.e. exercises, relaxation
Interventions seek to:
* Identify/modify antecedents of experiences/behaviours
* Identify controlling consequences of behaviours
* Reinforce helpful behaviours
* ‘Punish’ unhelpful behaviours
COGNITIVE BEHAVIOURAL THEORY
- Initially developed as a treatment framework for
mental health problems → since been applied to
management of chronic pain. - Role of patient’s appraisals (experience, perception)
and coping strategies (behavioural responses) is key.
Active coping
Focus on trying to control pain or function despite it
* Regular exercise
* Maintaining ADLs
* Distracting yourself from
pain sensation
* Relaxation exercises
Passive coping
Focus on avoiding the pain
* Using medications, and
increasing clinician visits
* Avoidance of activity +
socially withdrawn
* Increased reaction to
painful stimuli
COGNITIVE BEHAVIOURAL THEORY - Pain management
Helps individuals develop skills to change negative
thoughts and behaviors.
* Improves coping strategies: passive → active coping.
* Explores patient’s expectations + understanding of
pain → reframing beliefs regarding chronic pain
* Promotes relaxation + distraction skills
Multidisciplinary approach, i.e. medications, physical
therapy, lifestyle changes
What does EEG measure?
EEG measures the electrical activity of the brain in the form of nerve impulses.
What are the four basic brain waves?
The four basic brain waves are Alpha, Beta, Delta, and Theta.
How are brain waves measured?
Brain waves are measured by their frequency (Hz) and amplitude (microvolts).
Which brain wave is associated with relaxation?
Alpha waves
Which brain wave is linked to active thinking?
Beta waves
Which brain wave is dominant during deep sleep?
Delta waves
Which brain wave is associated with light sleep and drowsiness?
Theta waves
How long does NREM Stage 1 last?
NREM Stage 1 lasts 5-10 minutes.
What happens during NREM Stage 1?
It is the transition from drowsiness into sleep, where eye movements slow, blood pressure drops, muscles relax, and the body enters a calm state.
Which brain waves start to appear in NREM Stage 1?
Slower Theta waves start to appear in NREM Stage 1.
NREM: Sleep Stage 2
- Sleep deepens
- Main body of light sleep
- Memory consolidation + synaptic pruning
- Alpha waves disappear
- EEG shows slightly larger Theta waves along with bursts of:
- Sleep spindles (fast, low amplitude)
- K complexes (slow, high amplitude)
NREM: SLEEP STAGE 3 & 4
- Also known as Delta sleep or deep sleep
- Characterised by relaxed muscles, lowering of body
temperature; muscles rest and rejuvenate - Stage 3 characterised by large, slow Delta waves
- When delta waves make up 50% of recorded brain activity
you have entered Stage 4 sleep - Stage 4 – Delta waves >50% of brain activity
REM SLEEP (STAGE 5)
Rapid Eye Movement (REM) Sleep:
* Named for the darting eye movements in this stage
* Stage in which most dreams occur
* EEG shows an active pattern resembling awake state
(Beta waves) but body movement is inhibited
* HR and BP increase
* Respiration becomes fast and irregular
What are the three main factors affecting sleep?
Biological, Psychological, and Social/Environmental factors.
Biological Factors
Age
Genetics
Hormonal changes (e.g., during puberty, menopause)
Circadian rhythm
Physical health conditions (e.g., sleep apnea, chronic pain)
Neurotransmitter levels
Medications and substances (e.g., caffeine, alcohol, drugs)
Psychological Factors
Stress and anxiety
Depression and other mental health disorders
Emotional trauma
Cognitive patterns (e.g., racing thoughts, worry)
Mental health conditions (e.g., bipolar disorder, schizophrenia)
Social/Environmental Factors
Sleep environment (e.g., noise, light, temperature)
Work schedule (e.g., shift work, long hours)
Lifestyle habits (e.g., diet, exercise, screen time)
Social interactions and relationships
Cultural norms and expectations
Life events (e.g., moving, job changes, personal loss)
LACK OF SLEEP & HEALTH
Insufficient / poor sleep can lead to a range of health problems:
* Obesity
* Cardiovascular health
* Diabetes
* Impaired self regulation
* Mood
* Memory problems
What is encoding in the memory process?
Encoding is converting information into a form usable in memory.
What is storage in the memory process?
Storage is the process of retaining information in memory.
What is retrieval in the memory process?
Retrieval is bringing to mind information stored in memory.
Encoding initial stimuli & short term memories
The set of processes involved in transforming
external events & internal thoughts into both temporary & long lasting memories
Encoding long-term memories
- Anatomical change via neurotransmitter release
- Engram created: physical memory trace in brain
- Long Term Potential: gradual strengthening of the connections among
neurons from repetitive stimulation
What does good memory depend on?
Good memory depends on the depth and elaboration of the initial encoding.
What is Semantic encoding?
Semantic encoding involves processing information based on its meaning, which leads to deeper memory.
