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Y2 LCRS 2 - NMH, Psych, Anatomy of Limbs, Head, Neck & Spine, Musculoskeletal > PSYCH; Lecture 13 and 14 - Psychobiology of disease and Psychological interventions > Flashcards

PSYCH; Lecture 13 and 14 - Psychobiology of disease and Psychological interventions Flashcards

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1
Q

What is the biopsychosocial model?

A

x

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2
Q

What is stress?

A
  • Can be a stimulus -> events that place strong demands on us, known as stressors.
  • Can be a response -> physiological response is fight-flight response; also presence of negative emotions inc. feeling tense, difficulty concentrating and losing your temper easily.
  • Combination of stimulus and response as a person-situation interaction
    • Stress can be defined as a pattern of cognitive appraisals, emotional reactions, physiological responses and behavioural tendencies that occur in response to a perceived imbalance between situational demands (primary appraisal) and the resources needed to cope with them (secondary appraisal).
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3
Q

What is the response to stress?

A

Sympathetic response in all these organs

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4
Q

What are the effects of stress?

A

Adrenocortical axis is activated, with cortisol being released

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5
Q

What is the General adaptation syndrome?

A

When a stressor occurs, there is the initial shift to sympathetic dominance, which eventually will lead to exhaustion of adrenal glands, after the body has been under stress for too long

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6
Q

What is cognitive appraisal in relation to stress?

A

x

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7
Q

What is Yerkes-Dodson law?

A

x

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8
Q

What are the pathways from stress to disease?

A

x

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9
Q

What is anxiety and stress associated with?

A

52% increased risk of developing CVD, independent of traditional risk factors and depression.

Heightened cortisol is associated with greater extent of coronary artery calcification

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10
Q

What are the effects of stress?

A

Wounds take 40% longer to heal during stress (exams in this study), due to decreased production of IL-1 by 68%. Immunosuppression occurs during stressful events

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11
Q

What are features of type A behaviour?

A

Time urgency, free-floating hostility, hyperagressiveness, focus on accomplishment, competitive and goal driven. Have a 31% increased risk of CHD than type B

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12
Q

What are features of type B behaviour?

A

Patience, serenity and lack of time urgency

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13
Q

What is the role of depression in CHD?

A

Both etiologic and prognostic role; with relative risk of depression leading to onset of CHD = 1.64-1.9 higher; 2-2.5x higher risk of mortality in first 2 years -> thought to be due to physiological changes (platelet activity) to behavioural changes (levels of physical activity)

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14
Q

What are 3 different coping strategies for stress?

A

Those with adequate social relationships have 50% greater likelihood of survival compared to those with poor/insufficient social relationships -> exert an independent effect beyond protective psychological role

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15
Q

What are the signs of stress burnout in the medical profession?

A

x

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16
Q

How can you manage stress?

A
  • Organisation
  • Time management
  • Recognising stress
  • Appraisal review e.g. role of perfectionism or self-criticism
  • Relaxation techniques
  • Social support
  • Formal support
17
Q

What is the placebo effect?

A

The phenomenon in which a placebo - an inactive substance like sugar, distilled water, or saline solution - can sometimes improve a patient’s condition simply because the person has the expectation that it will be helpful. Some people willingly buy placebos, in official bottles

18
Q

What is the nocebo effect?

A

A negative effect that occurs after receiving treatment (therapy, medication), even when the treatment is inert/sham Warnings about the possible side effects of a medicine makes it much more likely that the patient will report experiencing those effects One out of 20 placebo treated patients discontinued treatment due to side effects

19
Q

What are the symptoms of a panic attack?

A

x

20
Q

What is panic disorder?

A

x

21
Q

What is agoraphobia?

A

x

22
Q

What is the goal of psychotherapy?

A

Goal of all psychotherapy is to help people change maladaptive thoughts, feelings, and behavior patterns -> schools: psychodynamic, behavioural and cognitive

23
Q

What is behaviour therapy?

A

Behavioural approaches believe that: Maladaptive behaviours are not merely symptoms of underlying problems The behaviours *are* the problem. Problem behaviours are learned in the same ways normal behaviours are

24
Q

How does a phobia develop?

A

Via classical conditioning

25
Q

Give an example of a behaviour therapy?

A
  • Exposure
  • Approach is influenced by both classical and operant conditioning approaches: Treat phobias through exposure to the feared CS (i.e. car) in the absence of the UCS (i.e. accident)
  • Response prevention is used to keep the operant avoidant response from occurring
  • Highly effective for reducing anxiety responses
  • Controversial because intense temporary anxiety is created by treatment.
  • SYSTEMATIC DESENSITISATION
26
Q

What is Clark’s cognitive theory of panic?

A

Individuals with panic interpret certain bodily sensations in catastrophic fashion -> sensations are considered to be a sign of impending physical or psychological disaster

27
Q

What is cognitive restructuring?

A

ID nature of thoughts which don’t need to be true to affect emotions; learn about common biases in thoughts. Treat thoughts as guesses or hypotheses about the world

28
Q

What is cognitive behavioural therapy for cardiac anxiety?

A

Treatment comprised of:

  • Psychoeducation
  • Relaxation techniques
  • Cognitive restructuring
  • Behavioural experiments
  • Graded exposure
  • Relapse prevention
29
Q

What are the core features of CBT?

A
  • Focuses on problematic beliefs and behaviours that maintain disorders (‘here and now’ rather than original causes).
  • Goal oriented i.e. Specific and measurable
  • Collaborative relationship between therapist and patient
  • Brief (8-16 sessions)
  • ‘Scientific’ approach e.g. Collecting data, testing hypotheses.
  • Works well (>70%) in all anxiety disorder, panic disorder, PTSD, social phobia and specific phobias.
  • Has significantly lower relapse rates than anti-depressant meds
30
Q

What are the NICE guidelines for CBT?

A

CBT recommended as first line treatment for:

  • Depression
  • Social anxiety
  • PTSD
  • Generalised anxiety disorder
  • OCD
  • Bulimia
  • Panic disorder and specific phobia
  • Schizophrenia
31
Q

What are the signs and symptoms of depression?

A
  • Be alert to possible depression ->
    • Particularly in people with a past history of depression or a chronic physical health problem with associated functional impairment.
  • Consider asking people who may have depression two questions, specifically:
    • During the last month, have you often been bothered by feeling down, depressed or hopeless?
    • During the last month, have you often been bothered by having little interest or pleasure in doing things?
32
Q

What drug treatment does NICE recommend for depression?

A
  • Do not use antidepressants routinely to treat persistent subthreshold depressive symptoms or mild depression because the risk–benefit ratio is poor
  • Consider antidepressants for people with:
    • a past history of moderate or severe depression or
    • subthreshold depressive symptoms present for a long time or
    • subthreshold depressive symptoms or
    • mild depression that persist(s) after other interventions.
33
Q

What are the NICE guidelines for psychological interventions for relapse prevention in depression?

A

x

34
Q

What is mindfulness-based cognitive therapy?

A

Paying attention in a particular way: on purpose, in the present moment and non-judgementally.

Recognising thoughts as thoughts – not ‘you’ and not ‘reality’.

35
Q

What are psychological interventions for health behaviour change?

A
  1. Motivational Interviewing: helps the patient identify the thoughts and feelings that cause him or her to continue “unhealthy” behaviours and help her to develop new thought patterns to aid in behaviour change.
    • Used for smoking, alcohol use, drug addiction, weight loss, medication adherence.
  2. Pain Management: involves teaching relaxation techniques, changing old beliefs about pain, building new coping skills and addressing any anxiety or depression related to pain. Often uses CBT techniques
    • Used for any kind of chronic pain, including back pain, arthritis, pelvic pain etc
36
Q

What is the efficacy of psychological interventions for health behaviour change?

A

Effective in 75% of randomized controlled trials 94% of the trials used individual interviews MI outperformed traditional advice giving in 75% of these studies

Effectiveness was shown even in brief encounters of only 15 minutes

Effect was not related to education background (physician vs. psychologist)

37
Q

What are the vicious circles of pain?

A

Y2 LCRS 2 - NMH, Psych, Anatomy of Limbs, Head, Neck & Spine, Musculoskeletal (17 decks)

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