Intro to psych

Question 1

What does psychology consider people as?

Answer 1

• Biological organisms, whose behaviours are controlled by nervous systems, endocrine systems etc and the product of evolution
• players in a social setting, influenced by and influencing people around them, and determined by. the culture they find themselves in
• processors of information and experiencers of emotion

Question 2

What did Loftus and Palmer do and when?

Answer 2

1974
- Showed subjects a video of a two car accident and after that they asked them to evaluate the speed at which the cars were travelling when they collided
- however, for half the subjects they used the word ‘smashed’ instead of ‘collided’
-Subjects who were asked the question with the word ‘smashed’ provided higher speed estimates and were also more likely to produce a false memory of glass on the road
- 32% of those who hear ‘smashed’ in the previous question said ‘yes’ to there being broken glass
- ‘14% of those who heard ‘hit’ said there had been broken glass
- there wasnt in fact any broken glass
This shows that recall is reconstructive, and that it is influenced by our expectations of what the memory should be like

Question 3

What did Ley et al do and when?

Answer 3

1997

• Showed that recall of medical advice by patients is rather poor
• Interviewed patients in GP surgeries right after their consultations and found that they only recalled about 50% of the advice they had just received; sometimes the proportion was down to as low as 10%
• Moreover, 40-80% of information in a consultation is forgotten almost immediately
• The more that is said, the lower the proportion remembered
• Almost 50% of information recalled is actually incorrect!

Question 4

Ideas on how to give information in the consultation to improve patient recall

Answer 4

• important info first and last - it will be better recalled due to the primacy and recency effect
• organise info into meaning groups (e.g. what is wrong w you, benefits of treatment, side effects, when to do what, etc)
• restrict info to what the patient can process
• repeat and otherwise emphasise key info
• simple and short sentences
• be specific
• be calm

Question 5

What is the serial position recall effect?

Answer 5

The tendency of a person to recall the first and last items in a series best, and the middle items worse

Question 6

What did Kiley et al show and when?

Answer 6

1993
Non-adherence to medical recommendations was shown to be behind 80% of renal graft failure in the second year after transplant

Question 7

What are the possible causes of non-adherence with medical advice?

Answer 7

• Not remembering the advice

- Patients beliefs that clash with the treatment

Question 8

Give an example of how patient beliefs may clash with treatment leading to non-adherence
Who did a study on this?

Answer 8

• Blood pressure can be viewed as an acute or a chronic disorder by patients
• Patients new to treatment were shown to be more likely to drop out if they constructed the disease and treatment to be acute (Meyer et al 1985)

Question 9

What did Katoh show and when?

Answer 9

1998

Over 40% of GP visit relate to physical symptoms for which no organic cause can be identified

Question 10

Give the first example of example of how perceived symptoms may arise?

Answer 10

Concern about an illness → focus attention on relevant part of the body → perceived symptoms

Question 11

Ehlers and Breuer

Answer 11

1992

• Asked patients with anxiety about their heart and control mentally healthy patients and patients with other anxiety disorders to silently count their heart beats without taking their pulse
• The cardiac concerned patients performed significantly better (lowest % errors heart beat perception), despite no group differences being found in the ability to estimate time intervals
• Showed enhanced focussing on the organ that was bothering the patient

Question 12

Give the second example of how concern about an illness leads to conscious persistent checking for problems which the facilitates the perception of symptoms

Answer 12

Concern about an illness → checking all is working → percieved symptoms

Question 13

How may patients with MUS following ‘checking all is working’ be treated?

Answer 13

• Appropriate physical tests followed by reassurance that there are no medical problems works for many, but not all
• If reassurance needs to be repeated, then it is not working
• In this case, it is advisable to try to identify positive evidence for a psychological explanation (e.g. by showing patients they can trigger the symptoms simply by thinking about them)
• In severe cases, referral to a psychiatrist should be made

Question 14

What are common associations in medically unexplained symptoms?

Answer 14

Breathless - suffocate
Chest tight - heart attack
Palpitations - dying

Question 15

What is psychological debriefing after traumatic events?

Answer 15

The idea that detailed discussion of the event and expression of emotions can prevent long-term problems

Question 16

Discuss Mayou, Ehlers & Hobbs experiment

Answer 16

2000

• Until recently, psychological debriefing after trauma was commonly used because symptoms tended to decline afterthe intervention and patient satisfaction was high
• However, a RCT of road traffic accident victims then showed that patients who received debriefing had higher impact event scale scores than those who had received no intervention at both 4 month and 3 year follow ups

Question 17

What is the impact event scale?

Answer 17

• self-report measure that assesses subjective distress caused by traumatic events

Question 18

What do NICE currently recommend regarding psychological debriefing?

Answer 18

Recommend against it
Suggest an initial period of watchful waiting, after which only those patients who fail to improve are offered interventions

Question 19

Discuss Ehlers et al 2003

Answer 19

The best treatment for those with symptoms at 3 months after watchful waiting has been shown to be CBTwhen compared to further waiting or self-help