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1
Q

Name the four elements of motivational interviewing

A

Reflective listening

Positive affirmations (rather than direct questioning, persuasion, or giving advice)

Neutral (but interested) tone

Suppress your instinct to respond to
questions or requests for advice

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2
Q

Name the two “do-nots” of motivational interviewing

A

Do not give advice until the client has verbalized their own understanding and come up with their own suggestions to workaround obstacles.

Do not give pre-digested or pre-packaged health messages.

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3
Q

How does motivational interviewing compare to the Information-Motivation-Strategy Model?

A

Presenting things in a neutral manner in MI, but not neutral in IM

One is more stage oriented, one is more value oriented

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4
Q

What are three key components of reflective listening in motivational interviewing?

A

Demonstrating Empathy

Affirm the client’s thoughts and feelings

Help client through their self-discovery process

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5
Q

How can one elicit change talk in motivational interviewing and what is its benefit?

A

Elicit self-motivational statements from the client (On a scale of 0-10, how motivated or interested are you in making a behavior change?)

People are more likely to act on something that they’ve backed up and argued for (change talk)

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6
Q

How does MI compare to Rogerian therapy?

A

MI is more directive

MI prioritizes resolving discrepancy and building motivation

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7
Q

How does MI compare to TTM?

A

MI doesn’t prescribe prewritten messages for different levels of
readiness

MI assumes greater fluidity in stages (readiness can fluctuate within
minutes in either direction)

Designed for in-person vs. automated delivery

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8
Q

How does MI compare to CBT?

A

MI rarely involves direct confrontation of maladaptive beliefs

But open to integrating CBT if the client expresses an interest in
learning a specific CBT strategy

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9
Q

Name three psychological and behavioural factors known to increase one’s risk of developing a chronic health problem

A

Stress
Lifestyle
Personality characteristics

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9
Q

Diseases of “long duration and generally slow progression”

A

Chronic disease

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9
Q

What are the three main avenues through which health psychologists can intervene in chronic disease?

A

Prevention and health-promotion work with at-risk populations prior to the onset of medical conditions

Helping patients with adherence to recommended regimens (e.g., diet, medications)

Helping patients with adjustment to a new life situation

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9
Q

List 8 potential consequences of chronic disease

A

Loss of life
Fatigue
Pain
Sleep Problems
Physical disability
Psychological distress
Inability to work
Relationship challenges

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10
Q

Name 5 specific lifestyle choices that can increase one’s risk of chronic disease

A

Tobacco smoking
Physical inactivity
Poor sleeping habits
Unhealthy eating
Excessive consumption of alcohol

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11
Q

Name four factors affecting adherence to treatment regimens

A

Is the medication regime too complicated?

Did health-care providers offer insufficient instruction?

Did the patient forget?

Does the patient have a good attitude toward treatment?

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12
Q

What are the three facets related to adjustment to a new life situation related to chronic disease identified by Stanton and colleagues?

A
  1. Chronic disease affects multiple domains of functioning and consequently adjustment must occur across these multiple domains (e.g., lifestyle, relationships, mental health).
  2. Adjustment is not a static process, but one that unfolds over time.
  3. Every individual will adjust differently.
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13
Q

Name 7 personal and situational characteristics have been found to be predictive of adjustment to chronic illness

A

Comorbid psychological disorder
Gender
Personality
Social support
Cultural background
Socio-economic status
Personal coping resources

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14
Q

Process of enabling people to increase control over, and improve, their health (WHO)

A

Health promotion

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15
Q

Name 5 ways in which health psychologists can be involved in health promotion

A

Help patients better manage their stress

Enhance patients’ motivation to make healthier choices and improve the management of their health conditions (e.g., identify barriers and solutions)

Promote health in groups at high risk for disease (e.g., provide educational sessions re: risk, prevention and mental health in those with HIV).

Be involved in policy making, media campaigns, and program development

Be engaged in research to identify risk factors for disease and strategies for the promotion of wellness

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16
Q

What are the two main streams of therapy relevant to chronic disease?

A

CBT
Mindfulness and acceptance-based approaches

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17
Q

Name four key influences on our attitudes towards sexuality

A

Where do we get our information?

How do these messages change our behaviour, thoughts, and feelings?

When is this information being received in relation to developmental milestones (e.g. puberty)?

Heteronormativity, stigmnatized identities, related impacts

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18
Q

What four dimensions does sexual activity include?

A

Behaviour
Culture
Psychology
Biology

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19
Q

Name four factors involved in sexual health (WHO)

A

Access to comprehensive, good-quality information about sex and sexuality;

Knowledge about the risks they may face and their vulnerability to adverse consequences of unprotected sexual activity

Ability to access sexual health care;

Living in an environment that affirms and promotes sexual health.

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20
Q

Name the 10 dimensions of the sexual health model

A
  1. Talking about sex
  2. Culture and sexual identity
  3. Sexual anatomy and functioning
  4. Sexual health care and safe sex
  5. Challenges
  6. Body image
  7. Masturbation and fantasy
  8. Positive sexuality
  9. Intimacy and relationships
  10. Spirituality
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21
Q

Describe the genderbread person/gender unicorn models

A

Gender and sexuality are considered across 5 dimensions…
1. Gender identity
2. Gender expression
3. Anatomical sex/sex assigned at birth
4. Physical/sexual attraction
5. Emotional/romantic attraction

Each dimension has associated scales

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22
The assignment and classification of people as male, female, intersex, or another sex based on a combination of anatomy, hormones, chromosomes
Anatomical sex/sex assigned at birth
23
One’s internal sense of being male, female, neither of these, both, or another gender(s).
Gender identity
24
The physical manifestation of one’s gender identity through clothing, hairstyle, voice, body shape, etc.
Gender expression
25
Give examples of results from two studies supporting the idea that a healthy sex life is associated with better overall health
Higher presence of IgA antibodies in people who had relatively frequent sex (compared to low and higher frequencies) Moderate frequency (a few times per month) of sex is positively related to later risk of cardiovascular events for men but not women, whereas good sexual quality seems to protect women but not men from cardiovascular risk in later life. Both studies see positive effects for “moderate” groups
26
Name 5 reasons as to why adolescents are more at risk for contracting STIs behaviourally and biologically
Increased risky sexual behaviours Prefrontal cortex development (related to decision making) is not complete Less likely than adults to access and use sexual health resources Differences in access to diagnosis and treatment Adolescent females are more likely to contract certain STIs due to less cervical mucus
27
Viral infection that weakens immune system and causes AIDS
HIV
28
Diagnosed when individual has HIV and an opportunistic infection or illness
AIDS
29
Who are the most vulnerable populations in Canada for contracting HIV?
Men who have sex with men Injection drug users Street youth Indigenous individuals
30
What are the three stages of HIV?
Acute HIV infection: HIV multiplies in the body\ Flu-like symptoms in first 2-4 weeks, High risk of transmission Chronic HIV infection: Asymptomatic, where HIV is still multiplying but lower levels, can still spread but the probability depends on viral load - Can stay in this stage for up to 10 years without medication AIDS: Final stage of HIV infection, immune system is severely damaged (CD4* T-cell count less than 200) - Without adequate treatment people typically survive about 3-4 years*
31
The devalueing or discrediting of an individual or group considered to have an undesirable attribute
Stigmatizing
32
List 6 psychiatric diagnoses seen to be more prevalent for people with HIV/AIDS
Depression Anxiety PTSD Insomnia Schizophrenia Substance use
33
Name 10 STIs and indicate which are curable
HIV Genital human papillomavirus (HPV) Genital herpes Hepatitis A, B, and C (Hep C is possibly curable, Hep A is curable) Chlamydia (Curable) Gonorrhea (Curable) Syphilis (Curable) Trichomoniasis (Curable) Pediculosis (pubic lice, curable) Scabies (Curable)
34
List the psychosocial risk and protective factors associated with sexual health
Protective: Good knowledge, good condom use, good communication, internet/social media use (occasionally) Risk Factors: High number of sexual partners, poor communication, substance use, personality factors (sensation-seeking and impulsivity), health disparities, internet/social media use (generally)
35
What is the most common STI?
Genital human papillomavirus (HPV)
36
What are four barriers to correct/consistent use?
Unanticipated sex Discomfort obtaining condoms Cost of obtaining condoms Condom negotiation
37
What are the three core principles of the information, motivation and behavioural skills model of sexual health?
Information (e.g., knowledge regarding STI transmission) Motivation (e.g., to change risky behaviour) Behavioural skills (e.g., performing preventative behaviours, such as negotiating condom use)
38
What are three components of the social-ecological model used in sexual health interventions?
Individual-level interventions (One-on-one counselling) Interpersonal interventions (Small-group) Community-level interventions (Outreach activities)
39
Describe acceptance vs resignation in relation to chronic pain
Acceptance has a future-planning component Resignation implies there is nothing to be done
40
Usually associated with recent ongoing tissue damage (e.g., an injury)
Acute pain
41
Persists beyond the normal expected healing period or is otherwise persistent over time
Chronic pain
42
What are some negative outcomes associated with chronic pain?
Depression, anxiety and substance abuse. At the social level, chronic pain can lead to impaired social relationships (i.e., isolation) and reduced quality of life
43
An unpleasant sensory or emotional experience associated with actual or potential tissue damage or understood in terms of such damage
Pain
44
Processing of stimuli associated with the stimulation of nociceptors (i.e., specific receptors)
Nociception
45
Describe pain as a perceptual process
Associated with selective abstraction, conscious awareness, ascribed meaning, learning, and appraisal Motivational and psychological states are very important (e.g., association with anger, sadness and disgust) This process also leads to behavioural and psychological consequences (e.g., feeling deflated, engaging in avoidance, etc.)
46
Describe specificity theory of pain and its limitation
Direct one-on-one correspondence between pain and tissue damage The greater the injury, the greater the pain Does not explain chronic pain
47
Describe the gate control theory of pain
Nerve impulses are transmitted from afferent fibres to spinal cord transmission cells modulated by a gating mechanism in the dorsal horn of the spinal cord Large-diameter fibres tend to “close the gate” by inhibiting transmission while small fibres “open the gate” by facilitating transmission Stimulating large diameter nerves may “close the gate” thereby inhibiting pain (e.g. putting pressure on a painful area) Descending control from the brain can also influence the opening/closing of the gate
48
Describe the neuromatrix model of pain
Emphasizes the role of the brain in pain perception of nerve impulses Creates patterns of responses (loops) that, when activated, create pain Even if the original receptors are no longer there, if the loop gets activated, pain can be experienced (explains phantom limb pain)
49
List the inputs and output identified in the neuromatrix model of pain
Inputs: Cognitive-evaluative, sensory-discriminative, motivational-affective Outputs: Pain perception Action programs Stress-regulation programs
50
Describe and explain a criticism of the operant model of pain
Importance of reinforcement in the development and maintenance of pain behaviour Criticized for failing to take into account interpretations and appraisals of pain
51
Describe the fear avoidance model of pain
Excessive avoidance of behaviours is associated with pain (when coupled with catastrophizing)
52
Describe the communication model of pain
The chain of pain communication is a three-step process… A. Internal experience of pain - behaviour + affect cognition + motivation B. Verbal and non-verbal expressive behaviour - Cognitive executive mediation C. Decoding of pain behaviour by observer - Observer behaviour, cognitive responses, affective responses, motivation
53
Describe Cognitive Behavioural Conceptualization of Pain
Focuses on the role of cognitive factors and beliefs in the pain experience Interconnections among thoughts, feelings, and behaviours Supports the use of Cognitive behaviour therapy (CBT) to treat pain
54
Psychological assessment of a pain patient involves obtaining which two things?
Full personal and psychological history Assessment of co-morbidities and coping styles
55
The MPQ provides assessment of the which three pain dimensions?
Sensory Affective Evaluative
56
Five impacts of pain on quality of life
Mood and psychological functioning Social and intimate relationships Vocational functioning Economic circumstances Substance abuse
57
What are two key psychological treatments for chronic pain?
Cognitive behaviour therapy (CBT) Acceptance and commitment therapy (ACT)
58
Describe the Common-Sense Model of Illness Representation
Information-processing model for understanding how we respond to physical signs and symptoms with a cognitive appraisal We form a “common-sense” representation of physical sensations in order to determine their meaning
59
According to CSM, health threats are made of...
Physical signs Physical symptoms
60
Which 5 dimensions are health/illness conceptualized by?
Identity: How we label signs/symptoms Cause: Our beliefs about what brought on signs/symptoms Consequences: Impact of signs/symptoms on our everyday lives Timeline: Our beliefs about how long signs/symptoms will last Controllability: Our beliefs about whether we have control over signs/symptoms
61
What are the six determinants of illness representation?
Physical stimuli Personal experiences Heuristics Social influences Culture Personality/mood
62
What are the three heuristics associated with illness representation?
Symmetry rule: we tend to believe we are ill if we experience symptoms, and believe we are healthy if we do not experience symptoms Stress–illness rule: symptoms that develop in the context of stressful events are assumed to be part of stress rather than illness Age–illness rule: we tend to believe that mild symptoms that develop gradually are a normal part of aging
63
Describe the three approaches to how family and friends respond to illness
Active engagement Protective buffering Overprotection
64
Experience of excessive anxiety about present or future health
Health anxiety
65
One or more distressing somatic symptoms and persistently high anxiety levels about health
Somatic symptom disorder
66
High level of health anxiety but no significant somatic symptoms
Illness anxiety disorder
67
Describe the cognitive behavioural model of health anxiety
Dysfunctional thoughts based on past experience trigger health anxiety Result from misinterpretation and preoccupation Anxiety develops by holding beliefs that… 1. The feared disease is serious/catastrophic 2. One is vulnerable to disease 3. One is not capable of coping with the feared illness 4. Inadequate medical resources are available to treat the illness
68
What are the three cognitive biases associated with health anxiety?
Confirmatory bias: Focus on information that confirms fears and overlooking information that disconfirms fears Thought–action–fusion bias: Tendency to believe that thinking a negative thought will make it come true Ex-consequentia reasoning: Tendency to believe that feeling anxious must mean there is danger present
69
What are the four safety behaviours asscoiated with health anxiety?
Information-seeking Reassurance-seeking Body monitoring Avoidance
70
How does cancer arise?
Mutation in genes that regulate cell division → breakdown in regulation of cell division → uncontrolled cell proliferation
71
Tissue that develops from unregulated cell growth
Tumour
72
Cells in malignant tumours invade surrounding tissue and spread through blood/lymph systems
Metastasis
73
Name the 5 main type of cancers
Carcinoma (skin and tissues that line or cover organs) Sarcoma (connect tissue, muscle or boné) Leukemia (bone marrow) Lymphoma (lymphatic system) Central nervous system cancer
74
What are the four main risk factors for cancer?
Biological factors: gene mutations, family-history Environmental: Carcinogens, radiation, infections Behavioural: Tobacco, alcohol, diet/exercise Sociodemographic: Age, sex, SES, nationality, race/ethnicity
75
Describe the primary and secondary cancer prevention strategies
Primary: Behaviour changes Secondary: Screening
76
Describe the disease process of CVD
Endothelium (cells lining the interior surface of blood vessels) damaged by hypertension, diabetes, and hyperlipidemia (too much cholesterol) Atherosclerosis: Cells become inflamed, starts build up Heart works harder to pump blood; diameter of heart vessel gets smaller Ischemia: Temporary restriction of blood flow Myocardial infarction (MI): Complete blockage in the coronary artery - Heart attack Heart failure: Cannot pump sufficient blood to meet the demands of the body
77
For CVD management, what are two revascularization interventions to restore sufficient blood flow?
Angioplasty: Catheter used to insert a tube into coronary vessel - mesh tube is expanded to allow for blood flow Coronary artery bypass grafting (CABG) - Uses arteries/veins from another part of the body to create a new path for blood to flow
78
What are the psychosocial risk factors for the development and prognosis of CVD?
Perceived job and home stress (chronic) Higher risk after the death of a spouse, natural disasters (acute) Social isolation Depression Anxiety
79
Describe the theorized relationship between depression and CVD
Psychosocial and demogrpahic factors influence potential biological mechanisms which bidirectionaly impact both depression and CVD These lead to potential behavioural mechanisms, which are impacted by depression and then in turn impact CVD Connected to perceived loss, which is influenced by the CVD and contributes to depression
80
Link positive psychology to CVD
Positive ways of coping that lead to health-protective behaviours More positive states and well-being associated with reduced mortality and hospitalization
81
Explain Hofstede's value dimensions of culture
Individualism–collectivism: Degree to which people within society act individually rather than as part of a group Power distance: Societal acceptance of equal/unequal distribution of power within institutions Uncertainty avoidance: Ability of societies to tolerate ambiguity as indicated by presence/absence of clear rules Masculinity–femininity: Extent to which society values assertiveness/monetary acquisition as opposed to co-operation Short/long-term orientation (Confucian dynamism): Refers to future-oriented values as compared with present/past orientation
82
What are the 12 determinants of healh according to Health Canada?
Income and social status Employment and working conditions Education and literacy Childhood experiences Physical environments Social supports and coping skills Healthy behaviours Access to health services Biology and genetic endowment Gender Culture Race/Racism
83
Describe Berry’s (1997) two-factor model of acculturation
Describes affiliation with the native and host culture on a high-low scale Low native, low host = marginalization Low native, high host = assimilation High native, high host = integration High native, low host = separation
84
Name the three components of multicultural counseling competencies
Cultural awareness and beliefs Cultural knowledge Cultural skills
85
What considerations are important to geropsychology?
Older adults are fastest-growing segment of US and Canadian populations Prevalence of most types of disability increases with age Prevalence of seven chronic illnesses increases across lifespan in the US Dementia is a significant public health need in older populations.
86
Health disparities reduce the ability to achieve best health outcomes among which older adults?
People of colour Women Those with low education and income Rural-dwelling individuals
87
Advance care planning includes...
1. Getting information on the types of life-sustaining treatments that are available 2. Deciding what types of treatment you would or would not want 3. Sharing your personal values with your loved ones 4. Putting into writing what types of treatment you would or would not want
88
Explain the Caregiver Stress–Health Mode
Two family member response patterns... 1. Cognitive empathy: Shared or complementary emotional experience Leaning in 2. Conditioned emotional responses: May occur when family member has paired certain emotions with past experiences of older person’s suffering - Complex relationships between the caregiver and the older person may complicate care and impact emotional responses
89
Why is pain often undertreated in LTC?
Under-treatment of pain due to communication challenges posed by advanced dementia
90
What are the risk factors associated with falls?
Medical: Visual problems, significant orthopedic diagnosis, use of medications that affect balance Psychological: Depression, excessive fear of falling (causes imbalance)
91
Cognitive decline associated with…
Reduced cognitive processing speed Poor decision-making Divided attention
92
Link hearing loss to dementia risk
More cognitive work Social isolation Change in brain function
93
Which are the four time periods when psychologists can contribute to end-of-life care?
Before illness After diagnosis During advanced illness and dying process After death (caregivers)

Psychosocial Aspects of Health (3 decks)

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