Final Exam Review Flashcards
Pain
an unpleasant sensory & emotional experience associated with actual or potential tissues damage, or described in terms of such damage
Severe & prolonged pain can impair:
General functioning
Ability to work
Social relationships
Emotional adjustment
Social & Economic effects
Headache, back and joint pain are common causes of work absence and disability in North America, costs $$$$ in loot productivity, treatment and disability payments
Organic Pain
Clearly linked to tissue pressure or damage
Psychogenic Pain
Pain with no tissue damage, could result from psychological processes
Neuropathic Pain
results from current or past disease or damage in peripheral nerves
Pain as a continuum
Both physiological and psychosocial factors play a role in pain - involves organic and psychogenic causes
Acute Pain
temporary painful conditions that last less than 3 months - higher than normal levels of anxiety while the pain exists but distress subsides as pain decreases
Chronic-recurrent pain
From benign causes & involves repeated and intense episode of pain separated by periods w/o pain
Chronic-intractable-benign pain
Typically present all the time, varying levels of intensity, not related to underlying condition
Chronic-progressive pain
Continuous discomfort associated with malignant condition, becomes more intense as condition worsens
Nociception
Process by which info about actual tissue damage or potential for damage is relayed to brain
Neural encoding - pain is subjective experience (not the same)
Referred Pain
Pain perceived at a location other than the site of the painful stimulus/origin - result of a network interconnection sensory nerves
Phantom limb pain
Although the limb is gone, the nerve endings at the site of the amputation continue to send pain signals to the brain that make the brain think the limb is still there
The role of pain
alert the body to potential damage; through nocicpetion, the neural processing of harmful stimuli
Gate-control theory of pain
Conditions that open the gate:
- Physical cognitions (extent of injury)
- Emotional conditions (anxiety, depression)
- Mental conditions (focusing on pain, boredom)
Conditions that close the gate:
- Physical (medication)
- Emotional (positive, rest)
- Mental (distraction, concentration)
Rene Descartes - Pain
The intensity of the message is directly proportionate to the severity of the injury - inaccurate
Perceiving Pain
Body sense pain in response to noxious stimuli - physical pressure, lacerations, heat or cold
Includes emotional component
Interplay of physiological and psychological processes
Meaning of Pain
Some believe individuals come to like pain through classical conditioning - by participating or viewing activities that associate pain with pleasure
Most people are conditioned to fear pain
Neurochemical transmission & inhibition of pain
Stimulation-produced analgesia
Endogenous opioids
Personal & Social Experiences - Pain
Learning & pain
Pain Behaviours
Pain Behaviours
- Facial or audible distress
- Distorted ambulation or posture
- negative affect
- Avoidance
Social Experiences & Pain
- Social communication model of pain
- Communal coping model of pain catastrophizing
- Gender & socio-cultural factors
Emotions, coping and pain
- Emotions and pain
- Stress and pain
- Coping with pain
Canada Health Act
Canadian act, provinces determine own policies, extended health care
Perceiving & Interpreting Symptoms
Perception of symptoms vary across people & differentiations within the same person across the time
- Individual differences
- Competing environmental stimuli
- Psychosocial influences (pshycogenic illness)
- Gender & sociocultural differences
Individual Differences
-Having more symptoms
-Differing in experience of same symptom: almost all people have a uniform threshold for pain but differentiations in their tolerance fo pain (some notices changes more quickly)
Internally focused people tend to overestimate changed and perceive recovery as slower
Completing Environmental Stimuli
Environments that contain a lot of sensory info or which are exciting are negatively related to symptom reporting
Boredom increases symptoms reporting
Psychosocial Influences
Expectations influence symptom perception
Interaction of cognitive, social and emotional factors
Mass psychogenic illness: may involves a range of neurological symptoms, from movement disorder to blindness but no physical explanations
Gender Differences in Pain
Women report lower discomfort at lower stimulus intensities and request termination of painful stimuli sooner than men
Cultural Differences in Pain
Different cultures reinforce symptom experiences and symptom reporting behaviour
Asians report more physical symptoms w psychological bases
America pain patients report more impairment
African American heart arrack patent symptoms are less typical and delay getting treatment longer
Interpreting Symptoms
Prior experience with an illness may increase or decrease accuracy or interpretation
Common Sense Models
Cognitive representations of illness developed through direct experience or from available info about illness
Lay referral network
before many people seek medical attention they seek advice from friends, relatives or coworkers
Why people use/don’t use health services
Social & emotional factors
- emotional states: embarrassment, anxiety
- seeking help seen as sign of weakness
Doctor-Centered Interaction
- Questions requiring brief answers
- Focus on initial problem while ignoring other issues
- Focused on link between problem & organic cause
Patient-Centered Interaction
- Open ended questions
- Opportunities for client to introduce new facts
- Avoid medical jargon
- Patient participation
Compliance
giving in to a request or demand
Adherence
suggest a collaborative nature of treatment
Communicating with patients
Adherence depends on good communication on the behalf of the practitioner
Patients of patient-centered physicians are more likely to adhere to advice
Depersonalization
- Stress
- Hectic schedules
- To deal w emotions
Psychosocial & physical exhaustion that results from chronic exposure to high levels of stress w little personal control
Psychosocial Components of Burnout
Emotional exhaustion (commonly reported)
Depersonalization
Perceived inadequacy of professional accomplishment
More time spent in direct care of patients –> greater risk of EE
Reducing Burnout
Provide opportunities to mix direct care w other tasks
Establish support groups
Training in stress management & coping methods
Adjustment to Injury/Illness
Physical
Psychosocial
Activities of Daily Living
Overall Quality of life
Adjustment to Hospitalization
Emotional adjustment
Taking on the patient role
Cognitive coping
- blaming others lead to poorer adjustment
3 themes to cognitive adjustment
- finding meaning in illness
- gaining a sense of control over illness
- restring self-esteem, sometimes by comparing themselves with less fortunate people
social support can impact adjustment
Early concern following diagnosis
Mortality is the main issue
patients show optimism but tentative future plans
Coping often switches from avoidance to problem focused approached
Developing Regular Activities
Activities provide respite from thinking about conditions
patients may over-estimate abilities & become discouraged
Family/supporter dynamics
a cycle of dependence can emerge due to patient helplessness & family nurturance
Adapting in Recurrence or relapse
Perceived as bad sign
patients tend to use similar coping strategies but may be less hopeful
Grief & Bereavement
Bereavement is the start elf having lost someone through death
Grief is the characteristic feeling
Morning is the expression of those
5 Stages of Grief *
Denial (Not to me, this isn’t real)
Anger (why me, its not fair)
Bargaining (just let me live to see …)
Depression (what’s the point)
Acceptance (its going to be ok)
Adapting to bereavement
Everyone adjusts at their own rate
Spousal grief is similar before & after death, greater for middle age, men adjust poorer than women, younger men worse than older
Sudden deaths - difficult to adjust
Patterns of Grief
Resilient Recovered Chronic Delayed -Little neg. emotion is not an indication of maladjustment (as long as it is not avoidance)
Adjusting when a child die
death of child may result in years of grieving
surviving siblings need special attention, not uncommon for them to show little grief
Individual therapy & support
group discussion & role playing
Systematic desensitization
Long-term adjustment
build new lives w social support
serving spouses receive attention, eventually this changes & they return to life
Some never adjust but enriching lives can be built
Cancer
Disease of the cells characterized by uncontrolled cell proliferation that usually forms a malignant neoplasm
Carcinomas
Develop in epithelial tissues around internal organs (breast, lung)
Sarcomas
soft tissue or bone tutors (muscles, nerves, bones, connective tissue)
Lymphomas
Lymph gland (HD & NHL)
Leukemias
White blood cells- named after specific type of cell affected (myeloid or lymphoid ) and acuity (acute or chronic)
Canadian Stats
43% of Canadians will be diagnosed w cancer in their lifetime
4 most frequently diagnosed cancers (lung, breast, colorectal and prostate cancers) are expected to account for 46% of all cancers diagnosed in 2021
Incidence: Types of Cancer
Prostate, breast, lung and colorectal – together are expected to account for more than half (52%) of all cancers diagnosed in Canada
Risk Factors
Smoking Eating habits Weight/obesity Physical inactivity Ultraviolet radiation Carcinogens Infections
Cancer Care Continuum
Pre diagnosis screening Diagnosis Treatment Post-Treatment Recurrence Palliation Grief
Oncology
Study of the human side of cancer experience
Psychosocial oncology addresses the psychological, social and behavioural dimensions
- psychological responses of patients & families
- Social & behavioural issues
Psychosocial impact of cancer
remission, site of cancer, close relationships
Psychosocial interventions for cancer
Coping interventions, mindfulness-based stress reduction
Program based on concept of “Mindfulness”:
Developing awareness of all that is happening in the present moment, without judgment or evaluation
Mindfulness-Based Stress Reduction
MBSR decreases stress symptoms
MBSR decreases evening cortisol levels
Associated with mean daily cortisol decreases over one year
May affect cytokine regulation
Decreases systolic blood pressure in those with higher initial levels
Exercise: Survival Benefits
Breast, colon and prostate cancer studied to date
Significantly reduced risk of cancer recurrence
Significantly reduced risk of cancer-mortality
Significantly reduced risk of all- cause mortality
Psychological Benefits: Exercise Intervention
Improved: Body image, self-esteem, coping skills and quality of life, social support… extends to family
Reduced: Perceived stress, anxiety and depression
Thrive Center
Free exercise facility for cancer survivors and support
Volunteer operated
60-80 volunteers
>350 participants
Fitness testing and prescription certified exercise
BEAUTY Program
12 Week exercise intervention + 12 week maintenance.
Breast cancer survivors on treatment.
Funded externally, free for participants
ENHANCE
Randomized controlled trial
Head/neck cancer survivors
12-week exercise intervention
PEER Program
Community based program
Children’s activities
Kids Cancer Care Network
ACTIVE Recovery
Psychosocial interventions
Psychosocial interventions effective for improving distress, anxiety, depression, coping, symptom control, quality of life
Mixed evidence for the effect of psychosocial interventions on survival (very controversial!)
Goals for Health Psychology
Enhancing illness prevention and treatment
- Advances in research and technology
Improving efforts for helping patients cope Identifying evidence-based interventions and cost-benefit ratios
Expanding psychologists’ roles in medical settings
Empowerment of health
Issues and Controversies
Environment, health, and psychology
- The growing role of climate change in human health
Quality of life
Ethical issues in healthcare
- Technology and medical decisions
- Physician-assisted suicide and euthanasia
Expanding definitions of health
Future Focuses in Health Psychology
Lifespan health and illness
- From conception to adolescence
- Adulthood and old age
- Caregiving
Sociocultural factors in health
Gender differences and women’s health issues
Mental Health
Novel drug therapies for treatment-resistant depression
⅓ of those suffering from depression do not respond to two or more antidepressants and are considered treatment resistant
Telehealth and community-based mental healthcare during COVID-19
Digital care options through teletherapy and all manner of new apps
Online services reach the most remote regions and circumvent fears of stigma for making the decision to seek treatment.
Data from social media to spot trends and prevent self- harm
Four billion people use social media, generating huge stores of data from their devices- studies show that language patterns and images in posts can reveal and predict mental health conditions for individuals and evaluate mental health trends across entire populations
Psychedelics to assist the treatment of psychiatric disorders
the use of psychedelics, especially psilocybin and MDMA, is undergoing a renaissance
studies have reignited the hope that psychedelics could be powerful medicines for mental disorders- disorders like MDD and PTSD
Digital devices to revolutionize how research is done
Smart phones and wearables to create more representative data pools of our global population than studies done with WEIRD (western, educated, industrialized, rich and democratic) research participants
Digital tools to train providers and fill gaps in mental healthcare
⅘ people with mental disorders in low and middle income countries do not receive any form of mental health care
Predictive analytics to guide mental health policy
Over the past 12 months, a series of models of the social and economic impacts of COVID-19 on mental health have been developed that simulated trajectories of psychological distress, mental health service waiting times, mental health-related hospital presentations, and suicide over the next 5 years
Digital marketplaces to ensure quality mental health solutions
Several organizations, such as OneMind, Health Navigator and the World Economic Forum, have begun developing assessment criteria for digital mental-health tools.
Factors Affecting Health Psychology’s Future
Financial support for psychological services
Education and training in health psychology
Developments in medicine
