Final Flashcards
Name the four elements of motivational interviewing
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
Name the two “do-nots” of motivational interviewing
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.
How does motivational interviewing compare to the Information-Motivation-Strategy Model?
Presenting things in a neutral manner in MI, but not neutral in IM
One is more stage oriented, one is more value oriented
What are three key components of reflective listening in motivational interviewing?
Demonstrating Empathy
Affirm the client’s thoughts and feelings
Help client through their self-discovery process
How can one elicit change talk in motivational interviewing and what is its benefit?
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)
How does MI compare to Rogerian therapy?
MI is more directive
MI prioritizes resolving discrepancy and building motivation
How does MI compare to TTM?
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
How does MI compare to CBT?
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
Name three psychological and behavioural factors known to increase one’s risk of developing a chronic health problem
Stress
Lifestyle
Personality characteristics
Diseases of “long duration and generally slow progression”
Chronic disease
What are the three main avenues through which health psychologists can intervene in chronic disease?
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
List 8 potential consequences of chronic disease
Loss of life
Fatigue
Pain
Sleep Problems
Physical disability
Psychological distress
Inability to work
Relationship challenges
Name 5 specific lifestyle choices that can increase one’s risk of chronic disease
Tobacco smoking
Physical inactivity
Poor sleeping habits
Unhealthy eating
Excessive consumption of alcohol
Name four factors affecting adherence to treatment regimens
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?
What are the three facets related to adjustment to a new life situation related to chronic disease identified by Stanton and colleagues?
- Chronic disease affects multiple domains of functioning and consequently adjustment must occur across these multiple domains (e.g., lifestyle, relationships, mental health).
- Adjustment is not a static process, but one that unfolds over time.
- Every individual will adjust differently.
Name 7 personal and situational characteristics have been found to be predictive of adjustment to chronic illness
Comorbid psychological disorder
Gender
Personality
Social support
Cultural background
Socio-economic status
Personal coping resources
Process of enabling people to increase control over, and improve, their health (WHO)
Health promotion
Name 5 ways in which health psychologists can be involved in health promotion
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
What are the two main streams of therapy relevant to chronic disease?
CBT
Mindfulness and acceptance-based approaches
Name four key influences on our attitudes towards sexuality
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
What four dimensions does sexual activity include?
Behaviour
Culture
Psychology
Biology
Name four factors involved in sexual health (WHO)
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.
Name the 10 dimensions of the sexual health model
- Talking about sex
- Culture and sexual identity
- Sexual anatomy and functioning
- Sexual health care and safe sex
- Challenges
- Body image
- Masturbation and fantasy
- Positive sexuality
- Intimacy and relationships
- Spirituality
Describe the genderbread person/gender unicorn models
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
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
One’s internal sense of being male, female, neither of these, both, or another gender(s).
Gender identity
The physical manifestation of one’s gender identity through clothing, hairstyle, voice, body shape, etc.
Gender expression
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
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
Viral infection that weakens immune system and causes AIDS
HIV
Diagnosed when individual has HIV and an opportunistic infection or illness
AIDS
Who are the most vulnerable populations in Canada for contracting HIV?
Men who have sex with men
Injection drug users
Street youth
Indigenous individuals
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*
The devalueing or discrediting of an individual or group considered to have an undesirable attribute
Stigmatizing
List 6 psychiatric diagnoses seen to be more prevalent for people with HIV/AIDS
Depression
Anxiety
PTSD
Insomnia
Schizophrenia
Substance use
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)
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)
What is the most common STI?
Genital human papillomavirus (HPV)
What are four barriers to correct/consistent use?
Unanticipated sex
Discomfort obtaining condoms
Cost of obtaining condoms
Condom negotiation
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)
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)
Describe acceptance vs resignation in relation to chronic pain
Acceptance has a future-planning component
Resignation implies there is nothing to be done
Usually associated with recent ongoing tissue damage (e.g., an injury)
Acute pain
Persists beyond the normal expected healing period or is otherwise persistent over time
Chronic pain
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
An unpleasant sensory or emotional experience associated with actual or potential tissue damage or understood in terms of such damage
Pain
Processing of stimuli associated with the stimulation of nociceptors (i.e., specific receptors)
Nociception
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.)
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
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
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)
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
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
Describe the fear avoidance model of pain
Excessive avoidance of behaviours is associated with pain (when coupled with catastrophizing)
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
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
Psychological assessment of a pain patient involves obtaining which two things?
Full personal and psychological history
Assessment of co-morbidities and coping styles
The MPQ provides assessment of the which three pain dimensions?
Sensory
Affective
Evaluative
Five impacts of pain on quality of life
Mood and psychological functioning
Social and intimate relationships
Vocational functioning
Economic circumstances
Substance abuse
What are two key psychological treatments for chronic pain?
Cognitive behaviour therapy (CBT)
Acceptance and commitment therapy (ACT)
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
According to CSM, health threats are made of…
Physical signs
Physical symptoms
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
What are the six determinants of illness representation?
Physical stimuli
Personal experiences
Heuristics
Social influences
Culture
Personality/mood
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
Describe the three approaches to how family and friends respond to illness
Active engagement
Protective buffering
Overprotection
Experience of excessive anxiety about present or future health
Health anxiety
One or more distressing somatic symptoms and persistently high anxiety levels about health
Somatic symptom disorder
High level of health anxiety but no significant somatic symptoms
Illness anxiety disorder
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
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
What are the four safety behaviours asscoiated with health anxiety?
Information-seeking
Reassurance-seeking
Body monitoring
Avoidance
How does cancer arise?
Mutation in genes that regulate cell division
→ breakdown in regulation of cell division
→ uncontrolled cell proliferation
Tissue that develops
from unregulated cell growth
Tumour
Cells in malignant tumours
invade surrounding tissue and spread
through blood/lymph systems
Metastasis
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
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
Describe the primary and secondary cancer prevention strategies
Primary: Behaviour changes
Secondary: Screening
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
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
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
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
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
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
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
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
Name the three components of multicultural counseling competencies
Cultural awareness and beliefs
Cultural knowledge
Cultural skills
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.
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
Advance care planning includes…
- Getting information on the types of life-sustaining treatments that are available
- Deciding what types of treatment you would or would not want
- Sharing your personal values with your loved ones
- Putting into writing what types of treatment you would or would not want
Explain the Caregiver Stress–Health Mode
Two family member response patterns…
- Cognitive empathy: Shared or complementary emotional experience
Leaning in - 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
Why is pain often undertreated in LTC?
Under-treatment of pain due to communication challenges posed by advanced dementia
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)
Cognitive decline associated with…
Reduced cognitive processing speed
Poor decision-making
Divided attention
Link hearing loss to dementia risk
More cognitive work
Social isolation
Change in brain function
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)
