Psychology Flashcards
What are the two types of health behaviours? Provide with examples
- Health compromising e.g. smoking, alchohol, low medicaton compliance
- Health promoting e.g. healthy eating, excercise, screening
What are the 5 leading behavioural and dietary risks that 1/3 of cancers deaths are due to?
- High BMI
- Low fruit and veg intake
- Lack of phycial activing
- Tobacco use
- Alcohol use
Describe motivational interviewing
- Collaborative and person centred - makes patient feel heard and understood (empathy)
- Evokes person’s own thought - helpes them to identify their own motivations and commitments to guide them to recognsie their own capacity for change (self-efficacy)
- Facilitates eliciting person’s own solutions (reduces resistance)
- Develops discrepancy - between where they are now and where they want to be
a) What is the WHO’s (1992) defenition of health?
b) What are the limitations?
a) Health is a state of complete, physical, mental,a nd social wellbeing and not merely the absence of disease and infirmity
b) Inclusive but too broad and unrealistic as a defenition e.g., how about those with chronic disease?
We think of health in 6 different ways (Baxter, 1990). List the 6 different ways
- Not having symptoms
- Having physical or social reserves
- Having healthy lifestyles
- Being physically fit
- Psychological wellbeing
- Being able to function
Health exists on a continuum, from optimal wellness to death (Antonovosky, 1987). Describe the components of this continuum
- Very healthy signs and lifestyle
- Healthy signs and lifestyle
- Average signs
- Worse than average signs
- Symptoms and minor disability
- Major disability from illness
a) What is health psychology?
b) What are the 3 main goals of health psychology?
a) Health psychology is a branch of psychology that studies psychological processes in health, illness, and healthcare
b)
- Understand psychlogical factors that affect health/illness
- Promote and maintain health by encouragig positive behaviours e.g., excercise, diet
- Prevent and treat illlness by using psychological principles
What are health behaviours?
Behaviours that affect our health positively or negatively
a) Provide 3 examples of health promoting behaviours
b) Provide 3 examples of health compromising behaviours
a) Excercising, adequate sleep, balanced diet
b) Smoking, excessive alcohol, inadequate sleep
What is the importance of health promoting behaviours for managing illness?
Health promoting behaviours such as excercise and healthy eating not only will help with prevention/recurrence of illness but also aid managment
Describe the role of psychological determinants on health (and illness) behaviours
Psychological determinants can work together to influence if we carry out or refrain from:
- Health behaviours - usually preventative/proactive and aim to maintain health e.g., deciding to regulary excercise to prevent high cholesterol
- Illness behaviours - usually reactive and are in response to an illness e.g., stressed so begins to drink alcohol
a) Describe the biomedical approach to medicine
b) What are the limitations?
a)
- Biomedical approach assumes all disease can be explained using physiological processes and treatment is for the disease, not the person
- Seperate body and mind and makes doctors fully responsible for health
b)
- Reductionist to reduce disease down to biomedical science
- If psychological factors have no infleunce, how can we exlain the placebo effect?
- Ignores influence of social factors
Describe the biopsychosocial approach to medicine
- More holisitic and makes the link between psychological, social factors and health more explicit
- Illness is viewed as the result of many factors, rather than pathogens alone
- Responsibility for health and illness lies on individuals and society rather than on the medical profession alone
- Treatment considers all these contributing factors as well. Individual behaviour is therefore a key aspect of health
Why is it important to discuss and encourage positive health behaviours?
- Behaviours plays an important role in people’s healrh: smoking, alcohol consumption, poor diet, lack of excercise or sexual risk-taking can cause a large number of diseases
- If we understand why people carry out health risk behaviours, we can help them change these behaviours (illness prevention) and perhaps take up health protective behaviours (health promotion)
Name the key psychological models which explain health-related behaviour
- Theory of planned behaviour
- Health belief model
- Transtheoretical /stages model
- COM-B model
Describe the health belief model
Behaviour is a set of core belief
- Demographic variables: Variables such as age, sex, ethnicity, personality and culture.
- Susceptibility: The patient’s belief of how susceptible they are to the negative consequences of carrying out the behaviour
- Severity: The patient’s belief of how severe those consequences might be of carrying out the behaviour
- Costs: The costs of carrying out the behaviour or stopping
- Benefits: The benefits of carrying out the behaviour or stopping
- Cues to action: Cues that make a person want to do something about their behaviour. These can be internal or external.
- Health motivation: The patient’s readiness to be concerned about health matters occurring due to their behaviour (consideration of behaviour change)
- Perceived control: The patient’s perception on how much control they have to stop the behaviour
Describe the theory of planned behaviour model
Describes the key factors that explain behaviour and predict change
- Behavioural beliefs - The patient’s beliefs about the behaviour
- Attitude - The patient’s overall evaluation of the behaviour (is it good or bad?)
- Normative beliefs - The patient’s beliefs about what they think significant others think about their behaviour. This can involve their motivation to comply with those people or not.
- Subjective norm - The overall social pressure to engage (or not) in the behaviour.
- Control beliefs - The patient’s beliefs regarding their ability to quit/maintain the behaviour. Do they have the internal (e.g., willpower) or external resources (e.g. money) that they may need to do this?
- Perceived Behavioural Control - Belief as to whether it will be easy or difficult to quit the behaviour.
State whether these questions are regarding attitude, norms, perceived control, or intention
Describe the transtheoretical or stages of change model
Focuses on the process of behaviour change (rather than factors predicting it)
Stages of change:
Stages of change:
- Pre-contemplation - Does not perceive they have a problem, has no intention of changing.
- Contemplation - Aware they have a problem, know they should make a change, not fully committed to idea (sitting on the fence).
- Preparation - Intending to act, may have begun to act
- Action - Change has happened (over months) change occurs in behaviour, environment, or experience.
- Maintenance -Working to prevent relapse, in maintenance stage if they remain free of problem for 6moths +
The following 3 components should be considered in addition to the stages:
- Decisional balance (pros and cons)
- Self-efficacy (confidence) and temptations
- Processes of change (e.g., Counterconditioning, raising awareness, reinforcement management, re-evaluation of self and environment, helping relationships)
Describe the COM-B model
Any given health behaviour occurs as an interaction between 3 components: capability, opportunity, motivation
Can be used to understand why a person is carrying out a health risk behaviour but also to consider how we might intervene/design intervnetions if we’re encouraging a health protective behaviour
COM-B model:
- Capability: Psychological or physical ability to carry out the behaviour
- Opportunity: Physical or social environment that enables behaviour
- Motivation: Reflective or automatic mechanisms that activate or inhibit behaviour
Physical capability: Having the physical skill to carry out a given behaviour
Psychological capability: Having the capacity to engage in necessary thought processes such as comprehension about a behaviour
Reflective motivation: Evaluation and having plans involving a behaviour
Automatic motivation: Emotions and impulses associated with a given behaviour that will influence consideration of behaviour change
Physical opportunity: Having the physical environment/tools needed to allow a behaviour to occur
Social opportunity: Having the cultural context to allow behaviour to occur
Fill out which components of the COM-B model applies to each statement
Explain how psychological models (Theory of lanned behaviour, health belief model, stages of change and COM-B) can be used as tools in clinical practice
- Psychological models can be used as tools in clinical practice to explain and predict health related behaviours, and influence behaviour change
- We can ask questions in a consultation in order to try to identify elements from specific models
- For examples, by asking the right questions we can identify barriers, benefits, attitudes, stages of change etc
- Behaviour change advice or education could then be provided for example, in order to promote change
Our cognitions (how think we think) about pain is very important. Describe 4 cognitions of pain
- Unhelpful (anxiety provoking) thoughts
- Catastrophizing - extreme assumptions/amplifying the negative aspects
- Rumination - “I keep thinking about how much it hurts”
- Expectations - about cause, mangement and recovery etc can be unrealisitics, these drive behaviours and impactful if expectations are not fulfilled
Describe the emotions pain generates and the health outcomes this is linked to
- Pain generates negative feelings (fear, anxiety, guilt, fustration, anger, depression).
- These are powerful drivers of behaviours
- These negative feelings are linked to poorer outcomes, slower recovery, higher reporting of pain intensity, length of sick leave taken
a) Anxiety is understandably common in patients experiencing pain. List some other associated symptoms of anxiety
b) Describe interventions for anxiety
a) Associated with restlessness, fatigue, difficulty concentrating, sleep disturbance, marked muscle tension. The anxiety itself may cause significant distress or impairment
b)
- Education - to help patient understand that chronic pain does not indicate underlying pathology
- Relaxation - relaxation techniques, including diaphragmatic breathing, guided imager, progressive muscle relaxation (PMR) etc
- CBT/ACT - working to challenge unhelpful or negative thoughts
Depression in pain is generally best tackled as an understandable psychological response. List interventions to tackle depression
- CBT
- Education
- Realisitc goal setting
- Graded and paced activity excercise - to gradually participate in other activites (work, hobbies etc)
List non-pharmacological treatments in pain management
- Cognitive behavioral therapy (CBT)
- Mindfulness based stress reduction (MBSR)
- Acceptance and commitment therapy (ACT)
- Stress managment and relaxation techniques
- Hypnosis
- Biofeedback
- Physicaltherapy e.g., transcutaneous electrical nerve stimulation (TENS) machine, heat pads, cold packs, massage
- Excercise
- Acupuncture
- Osteopathy/chiropractic
Describe cognitive behavioural therapy (CBT)
- CBT model proposes that people react to, and mangage their illness in ways which are consistent, with their beliefs about their illness, themselves, and their world
- Assesses ther beliefs on: impact, cause, cure and prospects
- Addresses unhelpful patterns of thinking
- Helps to develop better coping strategies and target underlying beliefs
Describe mindfulness based stress reduction (MBSR)
- MBSR proposes pain and suffering are part of life; we can learn how to deal with them and go on living
- Focuses on increasing awareness of moment-to-moment experiences
Describe acceptane and commitment therapy (ACT)
- Proposes that suffering is normal
- Uses acceptance and mindfulnes skills to deal with painful thoughts and feeling effectively and to help people live a more meaningful life
- The goal is to refocus their energies on what they can achieve despite pain - psychological flexibility
Describe factors helping acceptance (of pain)
- The person understands
- The reason that their pain persists
- Limitations of existing treatments
- Further treatments will not cure pain
- That they can make changes which will improve things
- A sense of identitfy, which is not entirely tied up with the pain
- Support from health professionals, family, friends and employers
What is involved in stress management and relaxation techniques
- Breathing techniques (e.g., diaphragmatic breathing)
- Excercise such a t’ai chi or yoga
- Attention techniques to reduce tension in parts of the body (progressive muscle relaxation)
- Guided imagery relaxation excercises (relxation CDs)
- Listening to sounds from nature
Can be used along with CBT/ACT
a) Describe the pain management programmes (PMP)
b) Describe their 3 aims
a) Uses combination of CBT, ACT, and education along with excercise to enable people to cope or manage pain better
b)
- Education about pain
- Techniques to address anxiety and depression to promote coping
- Effective medication use
Discuss whether everyone is affected by stress using the diathesis-stress model
- The diathesis-stress model views illness as the result of an interaction between pre-existing vulnerability (diathesis),andthe external stress caused by life experiences
- Pre-existing vulnerabilities can be biologically based e.g., foetal exposure to stress during pregnancy or can be created by environmental stressor in one’s life e.g., poverty, neglect, abuse, or by the interaction of the two
- This interaction can explain why some people are very resilient and are able to adapt while others develop illness or delayed recovery times
- People with pre-existing vulnerabilities might be more susceptible to illness when they are exposed to external stress
How does secure attachment work?
Describe how avoidant/ambivalent attachment works
Decsribe how disorganised attachment works
Normal grief reactions can be physical, emotional, behavioural and cognitive. Decribe the reactions of grief in each category
Describe the grief work model (Worden, 1991;1999)
- This model describes the cognitive process of confronting the reality of a loss and adjusting to life with loss
- This process involves tasks of grief rather than stages. People who enage with these tasks, adapt better than those who don’t
T = To accept the reality of the loss
E = Experience the pain of loss
A = Adjust to the new environment without the lost person
R = Reinvest in the new reality
Describe the dual-process model (Storebe and Schut, 1999;2010)
- This theory of grief describes two different ways of behaving: loss-oriented and restoration-oriented.
- Loss-orientated - thoughts, feelings, actions and events that make you focus on your grief and pain.
- Restoration-orientated - Things that let you get on with daily life and distract you from your grief for a while.
- As you grieve, you will switch, or ‘oscillate’, between these two different modes of being.
- Oscilliation is the key element - pathological grief may result from complex lack of oscillation
Compare the phase model, grief work (task) model and dual-process model
Describe the physical, cognitive, emotional and behavioural responses to complicated grief?
