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YEAR 1 > Psychology > Flashcards

Psychology Flashcards

1
Q

What is the biomedical approach?

A

Assumes all disease can be explained using physiological processes and requires a biological treatment for recovery.

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2
Q

What is a negative of the biomedical approach?

A

The theory is reductionist.

Ignores the influence of psychological and social factors on health.

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3
Q

What are the psychological factors of the biopsychosocial approach?

A 
Behaviour
Beliefs/cognitions
Coping
Stress
Pain
Emotion
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4
Q

What are the 4 social factors of the biopsychosocial approach?

A

Class
Employment
Culture
Ethnicity

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5
Q

What are the 2 types of health behaviours?

A

Reactive or Proactive/Preventative Influence

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6
Q

Name the 4 psychological models that explain health- related behaviour and behaviour change.

A

Theory of planned behaviour
Health Belief Model
COM-B Model
Theoretical or Stages of Change Model

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7
Q

What is the theory of planned behaviour?

A

Behavioural Beliefs - patient belief of behaviour
Attitude - patient evaluation of behaviour
Normative beliefs - patient belief of what others believe about the behaviour
Subjective norm - overall social pressure to towards the behaviour
Control beliefs - patient belief regarding their ability of the behaviour
Perceived behavioural control - patient belief if behaviour will be easy or difficult

which leads to Behaviour intention and then Behaviour

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8
Q

What is the health belief model?

A

Focuses on behaviour being a result of a set of core beliefs

Demographic variables - age, sex, ethnicity, personality, culture

Susceptibility - of the negative consequences of the behaviour
Severity - of the consequences from the behaviour
Costs - of the behaviour
Benefits - of the behaviour
Cues to action - that make a person want the behaviour
Health Motivation - concerned about health matters from the behaviour
Perceived control - perception on how much control needed for the behaviour

… lead to the likelihood of behaviour

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9
Q

What is the Theoretical or Stages of Change Model?

A

Focuses on the process of behaviour change

Pre-contemplation
Contemplation
Preparation
Action - short term 
Maintenance - long term

Relapse

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10
Q

What is the COM-B Model?

A

Capability - physical and psychological
Opportunity - social and physical
Motivation - reflective and automatic

Leads to behaviour.

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11
Q

What are some determinants of patient adherence?

A

Patient Factors - age, gender, health beliefs

Family support
Social support
Stigma
Financial costs - transportation, treatment, housing 
Socio-economic status
Employment status
Disease severity
Duration of treatment
Adverse effects of treatment
Barriers to healthcare
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12
Q

What is the Information-Motivation-Strategy Model?

A

Information - lack of understanding on their treatments, options, disease.
Motivation - lack of motivation can stem from patients health beliefs
Strategy - support to patients and identification of barriers and solutions

Lead to adherance

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13
Q

What are physiological effects of stress on the body from the Activation of Hypothalamus-Pituitary Adrenal Axis releasing epinephrine?

A

Release of epinephrine from adrenal glands?

    • Production of glucose from glycogen in the liver
    • Speed up breathing from the lungs
    • Increase in heart rate and blood pressure
    • Slow down of digestion and can change composition of gut bacteria
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14
Q

What are physiological effects of stress on the body from the Activation of Hypothalamus-Pituitary Adrenal Axis releasing cortisol ?

A

Release of cortisol from adrenal glands

    • Can impair lining of blood vessels
    • Increase in appetite
    • Gain of visceral fat
    • Deterioration effects on hippocampus
    • Amygdala increased activity in fear centre
    • Shrinking brain size, loss of synaptic neurones
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15
Q

What are immunological changes in the immune response of stressed individuals?

A

Lower CD4 count
Less rapid proliferation of CD4 cells
Reduced NK cell activity
Altered cytokine activity that leads to a reduction in wound healing
Increased ACTH levels cause release of anti-inflammatory preventing inflammation after healing

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16
Q

What is a definition of stress

A

Stress is what we experience when the demands of a situation exceed our resources to cope with the situation. The greater the discrepancy between demands and resources the greater the experience of stress.

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17
Q

What are behaviours in response to stress?

A 
Poor diet
Poor physical activity
Alcohol, smoking and drug use
Risk taking behaviours
Unlikely to follow health advice
Unlikely to focus on well-being
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18
Q

What are health problems linked to stress?

A

Headaches, migraines
High BP
IBS, Ulcers, dyspepsia - reduced digestion, acids remain in GI tract
Diabetes - increased production of glucose
Infections - suppression of immune system
Anxiety, depression, stress
Burnout
Muscular pain/weakness - adrenaline increases skeletal muscle tension
Type 2 diabetes
Extreme fatigue

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19
Q

What are signs of stress?

A 
Anxiety
Depression
Sleep problems
Crying
Irritability/anger
Difficulty concentrating
Tiredness
Chest pains
Appetite changes
Constipation or diarrhoea
Restlessness
Muscular pains
Lower libido
Sexual difficulties
Decreased confidence
Lack of motivation
Lack of interest
Hopelessness
Isolation
Discomfort
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20
Q

What is the Diathesis/Vulnerability-Stress Model?

A

Shows how pre-existing vulnerability can increase the likeliness of an individual developing a disorder.

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21
Q

What are psychological approaches to stress?

A

CBT

Mindful-based approaches

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22
Q

What are psychological factors that can influence a patients chronic pain?

A

Emotions - Distress, Depression, Anger, Fear, Anxiety
Cognitions - Attitudes, Beliefs
Pain behaviour and coping strategies
Lack of control
Compensation/legal issues
Social factors - Cultural expectations, Family pressure, Employment, Finances

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23
Q

What are 5 components of the biopsychosocial model for chronic pain?

A 
Sensory - nociception
Cognition - pain
Affective - suffering 
Illness - pain behaviour 
Social/Cultural Environment
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24
Q

What is a definition of pain?

A

An unpleasant sensory and emotional experience associated with, or resembling that associated with actual or potential tissue damage.

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25
Q

What is the overactivity-rest cycle?

A

Doing too much on good days that ultimately results in bad days where little can be done, with pain, low mood and frustration.

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26
Q

What is Phase 1 in chronic pain?

A

Active coping
Belief that pain is controllable
Increase physiological arousal
Anxiety is common

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27
Q

What is Phase 2 in chronic pain?

A

Testing different coping styles
Varying between activity
Depression may occur

28
Q

What is Phase 3 of chronic pain?

A

Hope of cure diminishes
Reduced activity
Problems with pain medication may occur
Belief that pain is uncontrollable, tendency towards passive coping strategies
Depression is common
Focus on bodily complaints, chronic muscle spasm, reduced muscle strength and endurance

29
Q

What are pain management programmes?

A

Enable people to cope or manage pain better with the aim of reducing distress and disability, and improving quality of life

  • Education about pain
  • Techniques to address anxiety and depression and promote coping
  • Effective medication use
30
Q

What are non-pharmacological treatments in pain management?

A 
CBT
Helpful Cognitions
Mindfulness based stress reduction
Acceptance and commitment therapy 
Stress management and relaxation techniques in general
31
Q

What are some placebo treatments in pain management?

A 
Hypnosis
Physical therapy 
Biofeedback
Acupuncture 
Osteopathy/Chiropractic
32
Q

What are psychological reasons patients may be reluctant to seek medial help?

A 
Fear of diagnosis
Lack of confidence in GP
Lack of confidence in health service
Lack of health literacy
Fear of losing job
Denial of illness
33
Q

What are psychological reasons patients may be reluctant to seek medial help?

A 
Fear of diagnosis
Lack of confidence in GP
Lack of confidence in health service
Lack of health literacy
Fear of losing job
Denial of illness
34
Q

What are sociological reasons patients may be reluctant to seek medial help?

A 
Not registered with a GP
Cost of prescription
Immigration status
Language barrier
Lack of child care
Transport difficulties
35
Q

What are signs of an infant in forming attachments?

A

Crying - clear signal of a need
Looking
Smiling - starts as a reflex at 2 months but becomes social
Cuddling - allows human contact
Preference - for caregivers face, voice, smell, touch

36
Q

What is secure attachment?

A 
Baby distressed at separation 
Leads to anxiety and attachment behaviour
Carer re-establishes proximity
Anxiety decreases 
Attachment behaviour drops
Baby feels safe
37
Q

What are implications of securely attached children

A 
Emotional and social competence
Greater resilience
Higher self esteem and independence
Positive peer relations
Better psychological health
Secure attachment with their own children
38
Q

What do securely attached children develop in themselves?

A

Positive view of themselves
Trust and confidence
Sense of security/safety to explore, play and learn

39
Q

What is avoidant/ambivalent attachment?

A

Baby distressed at separation
Leads to anxiety and attachment behaviour
Carer rejection, indifferent, unavailable, insensitive
Failure to comfort
Experience of prolonged distress and unregulated emotion
No return to safety

40
Q

What is disorganised attachment?

A

Baby distressed at separation
Leads to anxiety and attachment behaviour
Neglectful, abusive carers
Carers are the source of distress
Unresolved fear, trauma
Permanent feelings of lack of control, helplessness, confusion
No return to safety

41
Q

What are the implications of insecurely attached children?

A

Poor emotional and social competence
Poor regulation of emotions
Difficulties at school, more likely to be bullied
Difficulty in showing empathy
Unregulated biological stress system - abnormal patterns of cortisol release
Lower self esteem, lack of trust in others
Emotional and behavioural problems - depression, aggression, over controlling or over compliant behaviour

42
Q

What view do insecurely attached children have of themselves?

A

Unworthy of love

Others as emotional unavailable

43
Q

When should we look into attachment issues in children

A

When children do not reach normal developmental milestones
When children struggle at school because of behavioural or emotional difficulties
Children with mood disorders, clinical anxiety, depression, attachment disorders

Mothers with pre or postnatal depression may find it harder to connect to their babies

44
Q

What are physical symptoms of bereavement?

A 
Fatigue
Sleep disturbance
Appetite changes
Aches and pains
SOB
Palpitations
Restlelessness
Illness vulnerability
Digestive problems
45
Q

What are emotional symptoms of bereavement?

A 
Depression
Anxiety
Anger
Guilt
Yearning/pinning
Loneliness
Sense of detachment
Helplessness
Numbness
46
Q

What are behavioural symptoms of bereavement?

A 
Crying
Irritability
Restlessness
Searching
Social withdrawal
Difficulty in fulfilling normal roles
47
Q

What are cognitive symptoms of bereavement?

A 
Poor concentration
Short attention span
Memory loss
Confusion
Preoccupation
Search for meaning
Hallucinations
Disturbances of identity
48
Q

What is the phase model of grief?

A

Three overlapping phases

  1. Initial period of shock, disbelief and denial
  2. Acute grief - intermediate acute mourning period of physical and emotional discomfort - the impact of loss is registered physically and emotionally, yearning and mourning, social withdrawal
  3. Integrated grief - gradual shift to the restitution phase when attention shifts back to reengaging with the world. Adaption and recovery
49
Q

What is the grief work model?

A

Cognitive process of confronting the reality of a loss and adjusting to life with this loss

  • Tasks of grief - the work grieving people do when they face a loss
TEAR
To accept the reality of the loss
Experience the pain of the loss
Adjust to the new environment without the loss person
Reinvest in the new reality
50
Q

What is the dual-process model of grief?

A

Explains how people cope with grief
Predicts good and poor adjustments to bereavement

  • Loss orientated - preoccupied with experience of grief, avoiding efforts to recover and adapt - focus on confrontation of the loss
  • Restoration orientated - avoid and distracting themselves from grief, building new identities, re-planning life, focus on avoidance of the loss

Oscillation - between the to parts of the model - balancing confrontation and avoidance is critical for adaptive coping

51
Q

What do children experience with grief and what is important to do?

A

Feelings of sadness
Fear of being alone
Anger, boisterous play, nightmares, irritability, bed wetting
Regression to earlier development stages - need more attention, unreasonable demands, acting younger than their age
If extreme and long lasting - indicate poor coping and may require psychological support

KEY - open and timely communication about death with a bereaved child, naming emotions and normalising emotional responses and reassuring children

52
Q

What are the 5 types of complex grief?

A

Chronic grief - Lasts for a prolonged or extended period of time
Delayed grief - Has been postponed
Disenfranchised grief - Seen as socially difficult to relate to or are negative by others
Compound grief - occurs following multiple losses
Anticipatory grief - occurs prior to a known future loss

53
Q

What are physical responses of complicated grief?

A

Digestive issues
Fatigue
Depression

54
Q

What are cognitive responses of complicated grief?

A 
Constantly ruminating on death
Emptiness
Hallucinations of the deceased
Suicidal ideation
Thinking about the person
Self-blame
Desire to be with deceased
55
Q

What are emotional responses of complicated grief?

A

Intense sadness
Intense distress
Loneliness
Anger

56
Q

What are behavioural responses of complicated grief?

A 
Withdrawn
Not functioning
Unable to work
Avoid reminders of loss
Lack of social engagement
57
Q

What is pathological grief?

A

When grief does not resolve within a reasonable time (6 months - 1 year), or individuals have extreme experiences, the process is probably no longer adaptive

Unshakeable grief that does not improve over time
Persistent and intense emotions or moods and unusual, severe symptoms that impair major areas of functioning or that cause extreme distress
Prolonged grief symptoms are a unitary construct distinct from the more transient symptoms of depression and anxiety that characterise normal bereavement

58
Q

What are treatments of complicated grief?

A

Talking therapies - ACT, cognitive restructuring, psycho-education, CG-CBT
Medication
Group therapy

Those that self-refer have better outcomes

59
Q

What are diverse issues in grief?

A

Barriers to seeking support - more difficult for LGBT population - can lead to complicated grief

Migrants may experience loneliness and social isolation following death of loved one

60
Q

What are associated conditions with complicated grief?

A

Elevated rates of suicidal ideation and suicide attempts

Increased incidence of cancer, hypertension and cardiac events after several years

Immune disorders and dysfunction more frequent

Increased adverse health behaviours

Higher health service use and higher sick leave rates

61
Q

What are differential diagnoses for complicated grief?

A

Normal grief - doesn’t last as long or interfere as much with life

Depressive disorder - depressed mood not focused on the loss

PTSD - suffer intrusive thoughts about a traumatic event rather than thoughts on the deceased or circumstances of their death

Separation anxiety disorder - seperation from a living individual

62
Q

What is the Proposed DSM-V Category: Persistent Complex Bereavement Disorder (PCBD)?

A

Grief disorder for those who significantly and functionally impaired by prolonged grief symptoms for at least one month after six months of bereavement…

PLUS ONE

- Intense and persistent yearning for the deceased
- intense feelings of emptiness or loneliness
- Frequent preoccupation with the deceased
- Recurrent thoughts that life is meaningless or unfair without the deceased
- Frequent urge to join the deceased in death

AT LEAST 2… for minimum 1 months…

- Feeling shocking, stunned or numb since loved ones death
- Rumination about the circumstances or consequences of the death
- Anger or bitterness about the death
- Experiencing pain that the deceased suffered, or hearing/seeing the deceased
- Trouble trusting or caring about others
- Intense reactions to memories or reminders of the deceased
- Avoidance of reminders of the deceased or the opposite - seeking out reminders to feel close to the deceased
63
Q

What are pre loss risk factors for complicated grief?

A

Pre-existing mental health problems
Lack of knowledge and info about death
Previous experience of trauma or multiple stressors
Conflict and difficult relationships between the person and the deceased
Children and adolescent, young spouses, older people in long-term relationships

64
Q

What are post loss risk factors for complicated grief?

A

Inadequate family or community stressors or physical and emotional care
Traumatic reminders, anniversaries and other significant events
Secondary stresses that seriously disrupt family functioning
Further losses of bereavements

65
Q

What are risk factors for complicated grief when the loss occurs?

A

Loss is result of violence, trauma or accident
Others are unable to offer support and comfort
Person died form an inherited disease or suffered a long illness
Death is associated with stigma, or shame, for example AIDS

66
Q

What are patient psychosocial needs in terminal illness?

A

Good interaction with HCP and the quality of the HCP

Good quality of care systems and procedures

Active involvement in treatment and health care decisions

Quality information requirements and opportunities

Involvement with social support networks, their range and quality

Support with emotion, feeling states, worries, anxieties, spiritual concerns

Managing challenges to self-identify - body and self-image

YEAR 1 (17 decks)

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