Learnign And Memory - Psychosocial Flashcards
Learning
Relatively permanent change in behaviour or knowledge occurring as a result of experience
Classical conditioning
Learning through association
NS + UCS = UCR
NS -> CS
UCR -> CR
CS associated with UCS
Pavlov (1902) - salivating dogs
Watson and Raynor (1928) - little Albert
Operant conditioning
Learning through consequences
Positive and negative reinforcement and punishment
Skinners box
Operant conditioning: positive reinforcement
Add a pleasant thing to increase the behaviour
Operant conditioning: negative reinforcement
Take away unpleasant thing to increase the behaviour
Operant conditioning: positive punishment
Add an unpleasant thing to reduce the behaviour
Operant conditioning: negative punishment
Take away pleasant thing to reduce the behaviour
Observational learning
Bandura (1961) - Bobo doll experiment
Learning through others
Modelling behaviour
Dependent on the consequences of the model and on the prestige of the model
Avoidance learning
Type of operant conditioning
Learning active behaviour or response to prevent or avoid an adverse/unpleasant stimuli
Experience pain, fear or anxiety
Chronic pain behaviours
Reflexive and result of intentional decision making
Coping behaviours learnt by association to avoid or reduce pain - avoiding activities, unhelpful behaviours, increased use of medication
Passive behaviours associated with psychological distress
Observational learning - observe more negative reactions of others experiencing pain
Memory: process
Ability to retain information or representation of past experiences
Memory: object
Specific information or experience that is recalled
Memory: storage
Hypothesised part of the brain where traces of information and past experience are stored
Simplified model of memory
Atkinson and Shiffrin (1968)
Sensory - lots of things from environment, lose information quickly if you’re not paying attention
Short term - 7 +/- 2 (Miller, 1956), 15-30 seconds, rehearsal it stays longer
Long term - unlimited
Influence on memory: recognition and recall
Recognise things we see or hear them again, difficult to recall details spontaneously
Hear what we expect to hear
Recall familiar things mor easily than new things
Recognition
Prompted by something
More accurate
Lasts longer
Recall
From long term memory to short term memory
Less accurate
Influence on memory
Age
Health literacy
Expectations
Desire for information
Arousal - high = anxiety, low = poor attention
Disease/treatment consequences
Amount of information provided
Use of medical jargon
Influence on memory: context-dependent memory
Certain memories may return due to context
E.g. crime reconstruction
Influence on memory: state-dependent memory
Certain memories may return due to the state of the person
E.g. memories of events triggered when drunk
Influence on memory: primary and recency effects
Recall more of the first and last bit of information
Middle bits of information will be lost
Perception
What does the patient already know
What events have led up to now
Spend time trying to get them to say what they think the diagnosis is
Use open ended questions
Is there anything you have been worried about
Invitation/information
How much and what kind of information would be helpful
Would you like me to tell you what’s happening
Would you prefer to have someone with you
Delivery
Give a warning
Share information slowly, avoiding medical jargon and check understanding
Chunk information
Pause and wait, let information sink in
Silence
Do not overwhelm with information, let the patient take the lead
Summarise
Summarise the news and next steps with appropriate language
Check understanding
Questions? Now or later
Is there something you would like me to do
Enhance memory: do
Find out what the person already knows
Identify immediate concerns
Raise or refuse arousal
Key message first and repeat it last
Don’t try and give too much at once
Use language they can understand
Supplement with hard copy to take away
Enhance memory: don’t
Don’t expect perfect recall from unwell patients - limits to memory, anxiety or stress
Don’t assume that people who don’t ask don’t want to know
Don’t assume that all people want to know the same things
Aiding memory
Provide written/vision information to support understanding
Encourage to bring someone with them to share later recall
Encourage to record interview
Aiding memory
Provide written/vision information to support understanding
Encourage to bring someone with them to share later recall
Encourage to record interview
