Overview of dental anxiety Flashcards
Name the 3 theories of learning
- Behaviourism
- Cognitivism
- Social Learning theory
Give a brief definition of what behaviourism is?
Is is learning through association
What does behaviourism focus on?
It focuses on observable behaviour
What is the key form of leaning according to the behaviourism theory?
Conditioning
Name the 2 types of conditioning
- Classical
2. Operant
What did pavlov discover?
Pavlov found that dogs would also salivate to a related stimuli – a pitch fork of a higher or lower tone would elicit some degree of salivation
What does classical conditioning say?
A response similar or identical to one originally elicited by unconditioned stimulus is made into a response to a conditioned stimulus based on pairing the two stimuli
Give an example of classical conditioning in a dental situation?
A pairing of pain during a dental procedure with environmental stimuli leads to development of the fear response to the environmental cues alone
What is stimulus generalisation?
Conditioned response evoked by stimuli that are similar to the original conditioned stimulus
Give an example of stimulus generalisation in a dental situation?
Patient shows fear when visiting a new dental practice
What is stimulus discrimination?
Conditioned response not evoked by stimuli similar to but not identical to conditioned stimulus
Give an example of stimulus discrimination in a dental situation?
Patient shows fear response to sight of the drill but not to equipment used to clean the teeth
What is extinction?
Weakening of conditioned response when conditioned stimulus is repeatedly presented without the unconditioned stimulus
Give an example of extinction in a dental situation?
Use of anaesthetics and painless procedures leads to gradual reduction and elimination of fear of the dentist
What is spontaneous recovery?
Spontaneous return of the conditioned response some time after extinction occurs
Give an example of spontaneous recovery in a dental situation?
Fear of dentist returns spontaneously a few months or years after extinction
What is High order conditioning?
Conditioned response evoked by new stimulus that is paired with a conditioned stimulus that already elicits the response
Give an example of High order conditioning in a dental situation?
Patient cringes when hearing the dentist’s name
When is the conditioned response more reliable?
The more often the conditioned stimulus is paired with the unconditioned stimulus the more reliable the
What can happen to a patient who has had a very traumatic experience?
A patient who has a very traumatic experience may be left with an enduring fear of the DCP.
Define acquisition
when conditioning is occurring; depends on the nature of the stimulus, its strength and its timing.
Define higher order conditioning?
another stimulus is coupled to the CS
Define Habituation
we may stop responding to a frequently presented stimulus
Give an example of Habituation in a dental situation?
you are accustomed to the drill’s sound, patients are not
What are responses learned because of in Operant and instrumental conditioning ?
Responses are learned because of their consequences
What is behaviour shaped and maintained by in Operant and instrumental conditioning ?
Behaviour is shaped and maintained by consequences
What is the focus of the behaviourism theory?
Observation
How do habits form?
By Building connections between stimuli and response (conditioning) forms habits
What does reinforcement shape?
Reinforcement shapes learning and therefore behaviour
Give some Critique of behaviourism ?
- Advocates a passive patient learning in a DCP-led environment
- Knowledge is given and is absolute
- It does not account for processing that cannot be observed
What is the difference between the between behaviourist theory and cognitivist theory?
Behaviourism - change of behaviour as a result of experience that can be measured
Cognitivism – change in mental representations and associations brought about by experiences
What does the cognitivism theory say about the mind?
That it works like a computer
Information comes in, is being processed, and leads to certain outcomes
How does the cognitivism theory justify why humans are rational beings??
People are rational beings that require active participation in order to learn, and whose actions are a consequence of thinking.
What are changes in behaviour seen as in the cognitivism theory ?
Changes in behaviour are observed, but only as an indication of what is occurring in the learner’s head
What are the 3 stages of memory?
- Registration
- Storage
- Retrieval
What is retrieval ?
It is the conscious accessing of stored information
What are the 2 types of retrieval?
Context-dependent memory
State-dependent memory
What is State-dependent memory?
Recalling something that angered you making you angry again
What is Context-dependent memory?
Returning to the scene of the crime to prompt memories
How long does the sensory memory stage last?
Last up to 4 seconds
What does the sensory memory stage use?
Uses both visual and echoic cues
echoic last 2-3 seconds longer than visual
What is the capacity of our short term memory?
7 ‘bits’ of unrelated information.
How can the capacity our short term memory be improved?
By chunking
How long does our short term memory last?
15-30 seconds
How can the duration our short term memory be improved?
Can be increased by rehearsal
How is our short term memory coded?
Mainly acoustic, some semantic, visual is also possible
What is the capacity of our long term memory?
Unlimited
How long does our long term memory last?
From a few seconds to several years (potentially
permanently)
How is our long term memory coded?
Semantic, visual, acoustic, olfactory and gustatory
What is consolidation?
Convert unstable short term memory to lasting stable memories
What are the 2 types of long term memory?
- Declarative (revealed through knowledge)
2. Non-declarative (revealed through behaviour)
What are the 2 groups of Declarative long term memory?
- Semantic (knowledge)
2. Episodic (experiences)
What are the 2 groups of non- Declarative long term memory?
- Procedural (skills)
2. Conditioning (reactions)
What is episodic memory?
Autobiographical memory of:
- Events
- People
- Objects personally encountered
- Time and space
What is Semantic memory>?
General factual knowledge
Concepts
Rules
Languages
What are some critiques of the cognitivism theory
- knowledge itself is given and absolute
- Input-process-output model is mechanistic and deterministic
- It does not account enough for individuality
- It has little emphasis on affective characteristics
Where did the social leaning theory grow out of?
Grew out of cognitivism
What is observed in the social learning theory?
Observation of behaviour and sensorial experiences and Consequences of that behaviour
What are some factors models can be influenced by in the social learning theory?
How much power the model seems to have
How capable the model seems to be
How nurturing/caring the model seems to be
How similar the learner perceives self and model
How many models the learner observes
What are some critiques of the social leaning theory ?
- Does not take into account individuality, context and experience as mediating factors
- Suggests students/patients learn best as passive receivers of sensory stimuli, as opposed to being active learners
- Emotions and motivation are not considered important or connected to learning
When is the emotional reaction of anxiety or fear triggered?
triggered when the size of the threat is larger than the individual’s perception of their ability to cope
What are some common emotional components of anxiety?
Fright
Nervousness
Irritability
What are some common Cognitive components of anxiety?
Hypervigilance
Poor concentration
Rumination
What are some common Behavioural
components of anxiety?
Freezing up
Defensive aggressive
Avoidant behaviour
What are some common Physical components of anxiety?
Dry mouth
Muscle tension
Pounding heart
What might a person with anxiety suffer from?
Selective attention
Memory alteration
What is selective attention
When someone tends to focus on Threatening words (written, spoken), Faces, Pictures and objects, Internal experiences, Novel neutral stimuli
Talk through the pain and anxiety cycle
Pain causes anxiety
Fear of pain causes anxiety
Anxiety about potential pain causes pain
What may increased anxiety make it more difficult to do?
Increased anxiety may make it difficult to discriminate between sensation and pain
What are some factors that can cause dental anxiety?
- Painful and traumatic dental visits
- Personality variables
- Psychological co-morbidity
- Familial dental attitudes
- Attachment style
- Evolutionary factors
- Fear of the unknown
What does dental phobia share characteristics with?
Shares characteristics of anxiety, fear and panic
What can dental phobia lead to?
Highly developed avoidance
Unable to explain logically
Embarrassment/shame
Sense they are viewed as ridiculous