Lectures 9-12 Flashcards
In Justin’s lecture about children’s accidental injuries (lecture 9) what are the three child symptom trajectories (or groups of injured kids) and what percentage of the population falls into these 3 trajectory groups?
- Resilient (57%) = best off
- Recovering (33%)
- Chronic (10%)
In Justin’s lecture about children’s accidental injuries (lecture 9) what are the three parent tools subjective distress symptom trajectories (or groups of parents) and what percentage of the population falls into these 3 trajectory groups?
- Stable low (78%) = the healthiest
- High declining (8%)(most dangerous, sits below clinical stress levels but plateaus there)
- Moderate stable (14%)
Kids with resilient trajectories more likely to have parents with resilient trajectories
Parents with resilient trajectories have kids with… Or … Trajectories
Parents with moderate stable have kids with high levels of ongoing … Distress
Resilient or declining
Chronic
If parents or caregivers are also affected by medical traumatic stress, this may adversely affect their parenting in 3 ways:
unresponsive parenting
Overprotective
Re-enacting/endangering/frightening
What is the DSM-V criteria for PTSD for kids (0-6 years old?)
Exposure to traumatic event
Intrusions
Avoidance of memories/reminders of traumatic event OR negative mood and cognition
Persistent hyperarousal (including irritable and angry behaviour)
Social impairment
Over 4 weeks
Hold outcomes of PTSD in 0-6 year olds
Excessive clinginess
Avoidance of reminders of traumatic event
Temper tantrums
In Justin’s lecture (9) what is involved in the first phase or peri-trauma intervention?
Goal: reduce the potential for experiencing trauma and increase everyone’s sense of safety and control
- increase information and help make sense of experiences
- increase comfort and decrease distress
- address anxiety and coping skills issues early
- increase support and connection to helpful others
Traumatic stress in injured children’s consider DEF (what does this stand for)
Distress
Emotional support
Family
In Justin’s lecture (9) what is involved in the second phase or post-trauma intervention?
Goal: reduce traumatic distress or prevent PTSD
- accurately assess PTSD risk to identify children families who will benefit
- identify and correct inaccurate information predictive of PTSD
- decrease impact (consolidation) of traumatic memories
What does Justin’s intervention (post traumatic injury with children, lecture 9) wish to provide?
Identify children at risk of distress/PTSD via screening
Provide low impact care for low risk
Take account of natural spontaneous remission through re-screening
Provide intervention that includes family
Follow up
What is involved in phase 3 (tertiary)?
Specialist mental health care
Trauma focused CBT especially with parents included
What percentage does a reaction to the traumatic event remain similar in parents to their children?
86% parents and Children in sync or near in sync with Their trajectories
What did Eysenck argue to be the part of the brain that processed reward sensitivity and approach behaviour?
The Mesolimbic dopamine system
What did Eysenck argue to be the part of the brain that processed punishment sensitivity (fear) and avoidance behaviour?
Amygdala, noradrenaline, serotonin
What did Eysenck argue to be the part of the brain that processed anxiety and inhibitory control?
Septo-hippocampal system, OFC, serotonin
Krueger in 1999 found a 2 factor and a 3 factor model for explaining mental disorders. Explain
The 2 factor model (mainly for children and adolescents) internalising and externalising
3 factor model (adults) Anxiety Fear (avoidance) Externalising problems (acting out)
What is one pathway through which hazardous substance use is met?
Reward drive –> rash impulsiveness –> negative affect –> hazardous substance use
What are brain regions involved in addiction?
Nucleus accumbens (RD) (a key structure in the Mesolimbic system = hyperactivity) and orbitofrontal cortex (RI) (inhibitory control area = hypo activity) are key neural substrates
What is the genetic heritability of impulsiveness ?
0.6
What are the two key domains of cognition that predict substance use?
Positive alcohol expectancy (positive correlation)
Drinking refusal self efficacy (treatment outcome, relapse)
In the Personality lecture (Gullo lecture 10) rash impulsiveness is cognitively reflected in … Self esteem due to … Experiences
Decreased self efficacy due to past experiences
What did Gullo et al.’s study find?
Sensitivity to reward positively correlated with positive alcohol expectancy (which negatively correlated with drinking refusal self efficacy) which positively correlated with hazardous alcohol use.
Rash impulsiveness negatively correlated with drinking refusal self efficacy.
Working out in the field can give a … Check to our theories as scientists/academics
Reality check
Research suggests that pain explains only …% of the variance in pain related disability
10%
Some of the pain reducing interventions actually … Disability
Increase
Narcotic drugs increase chances of NOT going back to work by %
1400%
Psychosocial risk factors have been shown to account for as much as …% of the variance in the magnitude of disability
And these psychosocial risk factors amplify…(3 answers)
30%
Psychosocial factors amplify suffering, distress, disability
What does the PGAP do?
- Gets them to write what they do every day
- Gets them waking up same time as they used to, morning routine, take a 15 min walk (same routine as when they were at work)
3.
What is a simple definition of knowledge translation?
Making research findings understandable to lay people
Implementation science - the PARiHS
What are the three factors that determine research use:
Evidence
Context
Facilitation
What does John Pickering’s systems-contextual analysis involve?
- Scientific analysis
- Project and policy analysis
- Prototypes analysis
- Stakeholder analysis
- Behaviour analysis
What are the three major theories underpinning project cane changer?
Social cognitive theory
Social identity theory
Diffusions of innovation theory
What are the 5 categories of innovation adoptee (Rogers, 1962)
Innovators Early adopters Early majority Late majority Laggards
What are some barriers to change for the cane growers?
Lack of control and learned helplessness
Lack of positive reinforcement for change
Escalation spiral
Traditions and customs
Lack of confidence and skill gaps
What are johns 4 ways of measuring change?
Behavioural innovation
Self control and personal agency
Social connectivity
Personal wellbeing
