Psychology Flashcards

Question

Outline the two-factor theory of maintenance of classically conditioned associations e.g. fear

Answer 1

Trauma (UCS) and needle (CS)-> fear response (UCR) Avoid injections-> fear reduced-> tendency to avoid is reinforced

Answer 2

A response followed by a satisfying consequence will be more likely to occur A response followed by an aversive consequence will become less likely to occured

Answer 3

The consequences after behaviour is learned

Answer 4

Occurs when a response is strengthened by the subsequent presentation of a reinforcer Can be primary or secondary reinforcers

Answer 5

Those needed for survival e.g. food, water, sleep, sex

Answer 6

Stimuli that acquire reinforcing properties through their association with primary reinforcers e.g. money and praise

Answer 7

Occurs when a response is strengthened by the removal (or avoidance) of an aversive stimulus

Answer 8

The aversive stimulus that is removed or avoided (e.g. the use of painkillers are reinforced by removing pain)

Answer 9

NO!! | Refers to presentation or removal of a stimulus

Answer 10

Occurs when a response is weakened by the presentation of a stimulus (e.g. squirting a cat with water when it jumps on dining table)

Answer 11

Occurs when a response is weakened by the removal of a stimulus (e.g. phone confiscated)

Answer 12

Reinforcement is a much more potent influence on behaviour than punishment Largely because punishment can only make certain responses less frequent- you can't teach new behaviour

Answer 13

The weakening and eventual disappearance of a response because it is no longer reinforced

Answer 14

The degree to which non-reinforced responses persist

Answer 15

Fixed interval schedule Variable interval schedule Fixed ration schedule Variable ration schedule

Answer 16

Reinforcement occurs after fixed time interval

Answer 17

Time interval varies at random around an average

Answer 18

Reinforcement is given after a fixed number of responses

Answer 19

Reinforcement is given after a variable number of responses (all centred around an average)

Answer 20

Continuous reinforcement produces more rapid learning Association between a behaviour and its consequences is easier to understand

Answer 21

Continuously reinforced responses extinguish more rapidly The shift to no reinforcement is sudden and easier to understand

Answer 22

Chronic pain behaviour includes limping, grimacing, and medication requests Reinforced by family or staff e.g. by being overly sympathetic, encouraging rest, increasing medication Behaviour is reinforced by gratitude signals from the patient A cycle is created in which the patient receives positive consequences for "being in pain" so pain is more likely to occur in frequency

Answer 23

Bandura's belief that humans are active info processors and think about the relationship between behaviour and consequences Social imitation may hasten or short-cut the acquisition of new behaviours without the necessity of reinforcing

Answer 24

Observational (vicarious) learning= observe others and see consequences of their behaviours Vicarious reinforcement= if their behaviours are reinforced we tend to imitate the behaviours

Answer 25

Occurs by watching and imitating actions of another person or by noting consequences of a person's actions

Answer 26

Pay attention to model Remember what was done Must be able to reproduce modeled behaviour If successful or behaviour is rewarded, behaviour more likely to recur

Answer 27

72 children (approx 4y old) spent time in playroom with adult who modelled either non-aggressive or aggressive play Then spent 20 mins alone in room Aggressive behaviour was imitative

Answer 28

Seen to be rewarded High status (e.g. medical consultant) Similar to us (e.g. colleagues) Friendly (e.g. peers)

Answer 29

``` Dietary excess Alcohol consumption Lack of exercise Smoking Unsafe sexual behaviour ```

Answer 30

Any activity undertaken by an individual believing himself to be healthy for the purpose of preventing disease or detecting it at an asymptomatic stage

Answer 31

Alameda county CA List of 7 health behaviours they selected what they did.... not smoking, eating breakfast, not snacking, regular exercise, getting 7-8 hrs sleep, moderate alcohol, moderate weight After 10 years, lower mortality in individuals (1/4) who practised all 7 than those who practises <3

Answer 32

Population Individual Community

Answer 33

Change 4 life

Answer 34

Education programme (specially trained teachers over 3 months) about effects of smoking in 39 schools in England and Wales Self report questionnaire and saliva test before, immediately after and at 1 year follow up

Answer 35

Info is most effective for discrete behaviours (e.g. getting child vaccinated) Messages tailored to a particular audience (e.g. suggesting condom use to sexually active teens better than abstinence) Need more than knowledge- e.g. social and psychological support or skills to change

Answer 36

Visual (e.g. fast food signs, sweets at checkout) Auditory (e.g. ice cream bell) Olfactory (e.g. smell of baking bread) Location (e.g. the couch or car) Time (e.g. evening)/ Events (e.g. end of TV programme ) Emotional (e.g. bored, stressed, sad, happy)

Answer 37

POSITIVE REINFORCEMENT Dopamine, filling an empty void/boredom Praise for preparing a high-fat meal for the family NEGATIVE REINFORCEMENT Avoid painful emotions by comfort eating PUNISHMENT Preparing a low fat meal is criticised DELAYED (LIMITED) POSITIVE REINFORCEMENT FOR HEALTHY EATING Efforts at dietary change/weight loss go unnoticed by others Avoiding future health problems is too remote

Answer 38

STIMULUS CONTROL TECHNIQUES Keep ‘danger’ foods out of the house Avoid keeping biscuits in the same cupboard as tea & coffee Eat only at the dining table Use small plates Do not watch TV at the same time as eating COUNTER CONDITIONING Identify ‘high-risk’ situations/cues (e.g. stress) and ‘healthier’ responses EXAMPLES OF CONTINGENCY MANAGEMENT Involve significant others to praise healthy eating choices Plan specific rewards for successful weight loss Vouchers for adherence to healthy eating ad weight loss NATURALLY OCCURRING REINFORCERS Improved self-esteem (positive reinforcement) Reduction in symptoms of breathlessness (negative reinforcement)

Answer 39

Yes Incentives used in smoking cessation schemes were most effective those aimed at weight loss were the least effective NB. Very successful scheme in Dundee offered cash to expectant mothers

Answer 40

Lack of generalization (only affects behaviour regarding the specific trait that is being rewarded) Poor maintenance (rapid extinction of the desired behaviour once the reinforcer disappears) Impractical and expensive

Answer 41

Dental health teaching Low, moderate and high fear-inducing lectures given to different groups Effect on subsequent dental hygiene behaviour was measured with self-report questionnaires 1 week later High levels of fear-> denial and avoidance behaviour (Low levels better)

Answer 42

Best friends have greatest influence Then peer groups There is substantial peer group homogeneity with respect to adolescent smoking

Answer 43

High school students given 6 sessions including rehearsing skills to build confidence in ability to resist peer pressure to smoke Practical skills useful Reduced number of children starting smoking

Answer 44

The potential for a behaviour to occur in any specific situation is a function of the expectancy that the behaviour will lead to a particular outcome and the value of that outcome

Answer 45

The likelihood of behavioural change ``` As a result of: Perceived threat Cues to action Background variables Perceived susceptibility/seriousness Perceived benefits/costs ```

Answer 46

``` Susceptibility= “A lot of people I know have got flu symptoms” Seriousness= “It’s not something to really worry about” Benefits= “The vaccination will stop me getting sick” Costs/barriers= “The injection will be painful and it might make me ill for a while” Cues= Doctor strongly advises to have it ```

Answer 47

Susceptibility= Is smoking affecting your health? What would it be like if you got it? Benefits/barriers= Pros and cons of smoking for you? Anything stopping you from quitting? Cues= Giving up smoking prompt

Answer 48

Individuals expectation that the behaviour will lead to a particular outcome

Answer 49

Belief that one can execute the behaviour required to produce the outcome

Answer 50

Mastery experience Social learning Verbal persuasion or encouragement Physiological arousal

Answer 51

Beliefs about outcome (expectancy) and evaluation of outcome (value) -> attitude towards the behaviour-> intention-> behaviour Beliefs about important others' attitudes towards the behaviour-> subjective norm-> intention-> behaviour Internal control factors (e.g. self efficacy) and external control factors (e.g. perceived costs/barriers)-> perceived behavioural control-> intention-> behaviour SEE DIAGRAM

Answer 52

Explore attitudes towards smoking: - What do you think about smoking? - Is smoking a good or bad thing for you? Explore the norms of important people around her: - What do your friends/family think about you smoking? - Would you like to quit for [person]? Explore whether she intends to quit smoking: - Have you ever thought about quitting? - Do you intend to quit in the next few months? Explore how much control she thinks she has: - Do you think you can quit? - What makes you think that you can’t?

Answer 53

Circle ``` (Pre-contemplation= doesn't recognize need for change or is not actively considering change) Contemplation= recognizes problem and is considering change Preparation= getting ready to change Action= initiating change Maintenance= adjusting to change and practicing new skills/behaviours to sustain change Relapse= may occur and start cycle again (OR PERMANENT EXIT) ```

Answer 54

Listen and validate patient’s experience Identify and remedy any gaps in knowledge Identify cues and reinforcers then modify if possible and plan rewards Identify and attempt to modify unhelpful beliefs Enhance self-efficacy Identify and problem-solve barriers to change Identify positive, relevant role models Encourage social support Tailor intervention to individual’s readiness to change Motivational interviewing

Answer 55

The stimulus detection system by which our sense organs respond to and translate environmental stimuli into nerve impulses that are sent to the brain

Answer 56

The active process organising the stimulus output and giving it meaning

Answer 57

Stimulus energy (light, sound, smell etc) Sensory receptors (eyes, ears, nose, etc) Neural impulses (SENSATION->PERCEPTION) Brain (visual, auditory, olfactory areas)

Answer 58

Processing in light of existing knowledge Influenced by motives, expectations, previous experiences and cultural expectations

Answer 59

Individual elements are combined to make a unified perception Influenced by activation in auditory cortex, vibration of tympanic membrane

Answer 60

Attention Past experiences (e.g. poor people overestimate size of coins compared to affluent people) Current drive state (e.g. arousal state) (e.g. when hungry notice food-related stimuli) Emotions (e.g. anxiety increases threat perception) Individual values Environment Cultural background

Answer 61

People in W. Africa thought something above woman's head was basket not picture on wall

Answer 62

Championed top-down processing Continuity, similarity, proximity, closure

Answer 63

Figure-ground relations= our tendency to organise stimuli into central or foreground and a background Focus of attention becomes the figure, all else is background

Answer 64

When the eye is compelled to move through one object and continue to another object

Answer 65

Similar things are perceived as being grouped together

Answer 66

Objects near each other are grouped together

Answer 67

Things are grouped together if they seem to complete some entity

Answer 68

Visual agnosias (apperceptive and associative)

Answer 69

Primary visual cortex can be mostly intact (Associated with bilateral lesions to the occipital, occiptotemporal, or occipitoparietal lobes) Basic vision spared Patient not blind (Will smile at you, say hi when you come in) Knowledgeable about information from other senses (e.g. if they touch an object then naming is typically simple)

Answer 70

Failure to integrate the perceptual elements of the stimulus Individual elements perceived normally May be able to indicate discrete awareness of parts of a printed word but cannot organised into a whole Damage to lower level occipital regions

Answer 71

Failure of retrieval of semantic information Shape, colour, texture can all be perceived normally Typically sensory specific e.g. if object touched, then recognised Damage to higher order occipital regions

Answer 72

``` Visual perceptual analysis -> Viewer centred representation -> Visual object recognition system -> Semantic system -> Name retrieval ```

Answer 73

``` Visual perceptual analysis *AP AG -> Viewer centred representation *AP AG -> Visual object recognition system *AS AG -> Semantic system *AS AG -> Name retrieval ``` AP AG= apperceptive agnosia AS AG= associative agnosia

Answer 74

Process of focusing conscious awareness Providing heightened sensitivity to a limited range of experience requiring more intensive processing 2 processes= focus on a certain aspect and filter out other info

Answer 75

Focus on a certain aspect | Filter out other info

Answer 76

``` Focused attention (the spotlight) Divided attention (paying attention to more than one thing at once) ```

Answer 77

``` Intensity Novelty Movement Contrast Repetition ```

Answer 78

``` Motives Interests Threats Mood Arousal ```

Answer 79

Memory and perception ATTENTION (External stimuli-> sensory buffers)-> limited capacity short-term memory-> long-term memory-> responses

Answer 80

Register info for a few seconds which can be used to select which info info to focus on There's a limited capacity for short term memory but evidence that we can unconsciously perceive info not attended to

Answer 81

Cherry, 1953 Can focus our attention on one person's voice in spite of all the other convos When someone says your name- you hear that

Answer 82

Multi-tasking is easiest when skills are automatic and tasks are not too similar (e.g. writing an essay whilst listening to music) BUT the more automatic a task, the less conscious control available

Answer 83

Slows reaction times | Less attention on sensory inputs

Answer 84

Correct response is not most habitual or strongest Full attention not given to task High levels of stress or anxiety present

Answer 85

Psych condition amongst medical trainees that experience symptoms of the disease or diseases that they are studying High workload, stress of exams, high anxiety related to new clinical experiences and exposure to medical knowledge Leads to selective attention to physical symptoms and misinterpretation (e.g. I have X disease)-> preoccupation

Answer 86

Focus of attention contributes to the perception of our bodily symptoms ``` Treadmill study (Pennebaker & Lightner, 1980) 1st run= headphones with no sounds 2nd= amplified sounds of own breathing or street sounds ``` Symptoms worsened with breathing but massively reduced by street sounds

Answer 87

Pain is often an important sign that the body has been damaged or something is wrong Acute pain= protects from damage or infection, expectation of perceived bodily symptoms Chronic= can be from oversensitization/dysregulation

Answer 88

Anderson & Pennebaker, 1980 Students were told vibrating sandpaper would be: Painful (not painful) Pleasant (neutral, towards not painful) Not told anything (pain) Expectation changes the response to the same stimulus

Answer 89

``` External factors Pain behaviours Suffering Emotions Thoughts Pain sensation Tissue damage ```

Answer 90

Pain signals compete to get through ‘gate’ ‘Gate’ can be opened or closed by psychological and physical factors Explains pain relief by ‘rubbing it better’

Answer 91

Strong relationships between areas - Pain - Mood, thoughts and stress - Day-to-day functioning (behaviour) Pain breeds avoidance which perpetuates stress, low mood, anxiety etc.

Answer 92

No humans yet discovered without language Innate (Chomsky) or exposure (Putnam)?

Answer 93

The smallest unit of speech sound in a language that can signal a difference in meaning

Answer 94

Humans can produce just over 100 phonemes | English language consists of 44 phonemes

Answer 95

The smallest units of meaning in a language Typically one syllable Morphemes combined into words

Answer 96

Rules and principles which govern the way in which morphemes and words can be combined to communicate meaning in a particular language

Answer 97

Widely accepted theory that under normal conditions human beings will develop language with particular properties (e.g. distinguishing nouns from verbs)

Answer 98

Even though pidgin languages lack basic grammatical structures They develop languages which are fully grammatical Innate property of the brain results in this

Answer 99

1-3 months= can distinguish speech from non-speech sounds and prefers speech sounds (phonemes) Undifferentiated crying gives way to cooing when happy 4-6 months= babbling begins (vocalizations in response to verbalizations of others) 7-11 months= narrowing of babbling sounds to include only the phonemes heard in the language spoken by others in the environment = child discriminate some words without understanding their meaning and begins to imitate word sounds heard from others 12 months= first recognizable words are spoken (e.g. dada)

Answer 100

12-18 months= child increases knowledge of word meanings and begins to use single words to express whole phrases or requests (e.g. out, mostly nouns) 18-24 months= vocab expands betweens 50-100 words (rudimentary sentences e.g. more milk) without articles (the, a), conjuctions (and) or auxiliary verbs (can, will) 2-4 years= vocab expands rapidly at the rate of several hundred words every 6 months (linger sentences without grammar that exhibit basic language syntax) 4-5 years= child has learned the basic grammatical rules for combining nouns, adjectives, articles conjunctions and verbs into meaningful sentences

Answer 101

'Genie’ -was deprived of social interaction from birth until discovered aged 13 She was completely without language, and after seven years of rehabilitation still lacked linguistic competence

Answer 102

Huge individual differences in language ability, some of which depend on genetic factors E.g. KE family: across three generations about 50% suffer severe language problems (e.g. difficulties understanding speech, slow ungrammatical speech) Associated with mutations of FOXP2 gene, also found in patients with similar language problems (MacDermot et al. 2005)

Answer 103

Hemispheric specialization for language 95% of right-handed people have left-hemisphere dominance for language 18.8% of left-handed people have right-hemisphere dominance for language function Additionally, 19.8% of the left-handed have bilateral language functions

Answer 104

Non-fluent speech (expressive aphasia) Impaired repetition Poor ability to produce syntactically correct sentences Intact comprehension

Answer 105

Problems in comprehending speech (input or reception of language) Fluent meaningless speech Paraphasias- errors in producing specific words Semantic paraphasias-substituting words similar in meaning (“barn”-“house”) Phonemic paraphasias-substituting words similar in sound (“house”-“mouse”) Neologisms- non words (“galump”) Poor repetition Impairment in writing

Answer 106

``` Phonemes Morphemes Words Phrases Sentence Discourse ```

Answer 107

Broca's area is found in the inferior or front of the temporal lobe It's connected to Wernicke's area by a bundle of nerve fibers called arcuate fasciculus

Answer 108

Broca's and Wernicke's areas

Answer 109

Broca's aphasia

Answer 110

Global aphasia

Answer 111

Wernicke's aphasia

Answer 112

Modern findings show that rather than there being one key connective tract relevant to language function, there are many Tremblay and Dick conclude that language function is incredibly widely distributed through the brain

Answer 113

Stroke Traumatic brain injury Progressive neurodegenerative conditions (e.g. Alzheimer's, fronto-temporal dementias, Parkinson's)

Answer 114

TIA | Migraine

Answer 115

Dysexecutive syndrome involves the disruption of executive function and is closely related to frontal lobe damage Encompasses cognitive, emotional, and behavioural symptoms Can result from many causes including head trauma, tumours, degenerative diseases and cerebrovascular disease

Answer 116

The skills that are the mental processes that enable us to plan, focus attention, remember instructions and juggle multiple tasks successfully

Answer 117

Railway worker who got iron rod straight up into his skull Changed his personality-> swearing, inappropriate etc.

Answer 118

Intact IQ but initiating, correcting and self-regulating behaviours compromised 38 year old hand surgeon, hypoxic frontal damage during cardiac arrest Intact IQ but initiating, correcting and self-regulating behaviours compromised Was polite and responsive to questions, but volunteered nothing spontaneously and asked no questions Affect remained unchanged regardless of topic

Answer 119

``` Hypoactivity Lack of drive Apathetic Poor initiation of tasks Emotional bluntness ``` ``` Hyperactivity Impulsive Disinhibited Perseverative Emotional dysregulation ``` Socially inappropriate Rude, crass, prone to swearing Theory of mind difficulties Reduced empathy

Answer 120

Attentional and working memory difficulties Poor planning and organisation Difficulty coping with novel situations and unstructured tasks Difficulty switching from task to task Difficulty keeping track of multiple tasks Difficulty with complex/abstract thinking

Answer 121

Name the colour of the ink the word is presented in | Unless the word is underlined, then read the word

Answer 122

Pre-frontal lobes and/or subcortical structure damage is associated with impairment syndromes in executive functions

Answer 123

Scientific study of changes that occur in people over the course of their life Changes in thought, behaviour reasoning and functioning occur Influenced by biological, individual and environmental influences

Answer 124

Dependent on their age/where they are developmentally Affects how you communicate with, understand and relate to each other

Answer 125

Epigenetic The baby is an interactive project not a self powered one Nature sets out their course via gender, genetics, temperament and maturational stages Nurture shapes this predetermined course via the environment; parenting, stimulation and nutrition

Answer 126

Emotional responses Are the least hard wired in the animal kingdom and the most influenced by experience

Answer 127

Recognise their mother as a memory of her has been built up in utero Via hearing, smell and taste

Answer 128

In the womb Receptive hearing at 16 weeks Functional hearing begins at 24 weeks As a result, prefer their mothers' voices to the voices of other women

Answer 129

How baby's use what hearing they have Beings at 24th week of gestation

Answer 130

Every language has its own characteristic rhythms and newborns can detect them

Answer 131

Their own amniotic fluid Maternal breast odours (prefer their mother's) Others smells associated with their mother

Answer 132

Sweet, umami, sour, bitter (they can't taste salty until 4 months) They particularly like very sweet sugar solutions (helps before painful procedure e.g. heel pricks) and glutamate (found in breast milk) They don't like some bitter and sour substances

Answer 133

Can't see very well- newborn has blurry vision with sharpest visual acuity at the edges of the visual field ``` 12-36h= prefer mothers' face to strangers Newborns= prefer faces and face-like stimuli (particularly faces with open eyes and happy face stimuli) ```

Answer 134

Newborns prefer to look at expressive, responsive faces Bidirectional- children socialise parents just as parents socialise children Baby: cries moves, grimaces, smiles, calms, looks Parent: mirrors, repeats, interprets, responds

Answer 135

If parents responses supports or reinforces the infants efforts the infant will build on this interaction or experience and continue to develop in this area Scaffolding can occur in lots of different types of interactions not just parent child

Answer 136

Still Face paradigm, Tronick 1975

Answer 137

Scaffolding Reciprocal socialisation Provision of a stimulating and enriching environment Internal working model (Bowlby, 1969) is established through this social process (baby coordinates his systems with those of the people around him)

Answer 138

Babies of depressed mothers adjust to low stimulation and get used to lack of positive feels In the same way - agitated mothers-> over aroused baby - well managed babies-> expect a world that is responsive to feelings

Answer 139

Attachment theory= describes a biological instinct that seeks proximity to an attachment figure when threat is perceived or discomfort is experienced i.e. sense of safety a child experiences provides a secure base from which they can explore their environment Process begins before birth and is supported by reciprocal socialisation

Answer 140

Birth to 3M= prefers people to inanimate objects, indiscriminate proximity seeking e.g. clinging 3-8M= smiles discriminately to main caregivers 8-12M= selectively approaches main caregivers, uses social referencing / familiar adults as “secure base” to explore new situations; shows fear of strangers and separation anxiety From 12M (corrected age)= the attachment behaviour can be measured reliably

Answer 141

Ainsworth et al, 1978 Designed to present children with an unusual, but not overwhelmingly frightening, experience It tests how babies or young children respond to the temporary absence of their mothers-> tests ATTACHMENT Researchers are interested in two things: 1. How much the child explores the room on his own 2. How the child responds to the return of his mother Shows if child is secure or insecure

Answer 142

Strange situation test

Answer 143

Secure (65%) vs insecure (35%) ``` Secure= formed in early infancy, they are a protective factor leading to resilience throughout the life span Insecure= place individual at risk (but not causative for later problems) ``` NB. Resistant-insecure (ambivalent) and disorganized-insecure

Answer 144

Free exploration and happiness upon mother's return (The securely-attached child explores the room freely when Mum is present. He may be distressed when his mother leaves, and he explores less when she is absent. But he is happy when she returns. If he cries, he approaches his mother and holds her tightly. He is comforted by being held, and, once comforted, he is soon ready to resume his independent exploration of the world. His mother is responsive to his needs. As a result, he knows he can depend on her when he is under stress)

Answer 145

Avoidant-insecure child with little exploration and little emotional response to mother (The avoidant-insecure child doesn’t explore much, and he doesn’t show much emotion when his mother leaves. He shows no preference for his mother over a complete stranger and, when his mother returns, he tends to avoid or ignore her)

Answer 146

Little exploration, great separation anxiety and ambivalent response to mother upon her return (Like the avoidant child, the resistant-insecure child doesn’t explore much on her own. But unlike the avoidant child, the resistant child is wary of strangers and is very distressed when her mother leaves. When the mother returns, the resistant child is ambivalent. Although she wants to re-establish close proximity to her mother, she is also resentful- even angry- at her mother for leaving her in the first place. As a result, the resistant child may reject her mother’s advances)

Answer 147

Little exploration and confused response to mother (The disorganized child may exhibit a mix of avoidant and resistant behaviours. But the main theme is one of confusion and anxiety. Disorganized-insecure children are at risk for a variety of behavioural and developmental problems)

Answer 148

Disorganized-insecure

Answer 149

Independence Emotional availability Better moods Better emotional coping

Answer 150

Fewer behavioural problems Higher IQ and academic performance Contributes to a child's moral development Reduces child distress

Answer 151

``` Social competence Loyal friendships More secure parenting of offspring Greater leadership qualities Greater resistance to stress Less mental health problems such as anxiety and depression Less psychopathology e.g. schizophrenia ```

Answer 152

Enriches brain -> smarter brains and more BDNF Brain derived neurotrophic factor- needed for growth and maintenance of brain cells

Answer 153

``` Engage and interact with world Create and explore own world Experience mastery and control Practice decision-making, planning Practice adult roles Promotes language development Promotes creative problem solving Overcome fears Develop new competencies Learn how to work in group Develop own interests Extend positive emotions Maintain healthy activity level ```

Answer 154

Solitary, spectator, parallel play, associate, co-operative, competitive 0-2 years SOLITARY= he plays alone- limited interaction with other children 2 to 2.5 years SPECTATOR= observe other children playing around him but will not play with them 2.5-3 years PARALLEL PLAY= alongside others but will not play together with them 3-4 years ASSOCIATE= starts to interact with others in their play and there may be fleeting co-operation between in play - Develops friendships and the preferences for playing with some but not all other children - Play is normally in mixed sex groups 4-6 years CO-OPERATIVE= plays together with shared aims of play with others - Play may be quite difficult and he's supportive of other children in his play - As he reaches primary school age, play is normally in single sex groups 6+ years COMPETITIVE= play often involves rules and has a clear “winner”

Answer 155

Proposed Piaget's Stage Model Proposed that children's thinking changes qualitatively with age As a result of an interactive of the brain's biological maturation and personal experiences Affects schemas

Answer 156

Development occurs as we acquire new schemas and as our existing schemas become more complex Process of assimilation and accommodation which leads to adaptation

Answer 157

Incorporating new experience into existing schema

Answer 158

The difference made by the process of assimilation

Answer 159

Whereby new experiences cause existing schema to change

Answer 160

Sensorimotor stage (0-2y) Pre-operational stage (2-7y) Concrete operational stage (7-12y)

Answer 161

Birth to age 2; infants understand their world primarily through sensory experiences and physical (motor) interactions with objects Object permanence Gradually increasing use of words Learning based on trial and error

Answer 162

The understanding that an object continues to exist even when it can't be seen

Answer 163

The world is represented symbolically through words and mental images- no understanding of basic mental operation Rapid language development Understanding of the past and future No understanding of the Principle of Conservation Irreversible= can't reverse actions Animism begins Egocentrism happens

Answer 164

Attributing lifelike qualities to physical objects and natural events

Answer 165

Basic properties of objects stay the same even though their outward appearance may change

Answer 166

Difficulty in viewing the world from someone else’s perspective

Answer 167

Children can perform basic mental operations concerning problems that involve tangible (“concrete”) objects and situations Understand the concept of reversibility Display less egocentrism Easily solve conservation problems Trouble with hypothetical and abstract reasoning

Answer 168

Some researchers query whether children respond as they do to please the adult asking the question Some argue the (repeated) question is so weird (as the answer is so obvious) the child thinks the adult wants or expects you to change the original answer– when more naturalistic ways of asking the questions were developed children performed much better

Answer 169

<5y= Don't understand that death is final, universal, will take euphemisms concretely, may think they have caused deat . 5 to 10 years= gradually develop idea of death as irreversible, all functions ended, universal/unavoidable, more empathic to another’s loss; may be preoccupied with justice 10yrs to teens= understand more of long-term consequences, able to think hypothetically, draw parallels, review inconsistencies Dependent on cognitive development and experience (pets, extended family members)

Answer 170

Adolescence involves cognitive development and physical growth, as distinct from puberty, which can extend into the early twenties Transition to formal operational stage Chronological age only provides a rough marker of adolescence

Answer 171

Transitional stage of physical and psychological human development that generally occurs from puberty (biologically defined period of rapid maturation in which a person becomes capable of sexual reproduction) to legal adulthood (a social construction)

Answer 172

Follows adolescence Where abstract thought emerges Adolescent begins to think more about moral, philosophical, ethical, social and political issues that require theoretical and abstract reasoning Begin to use deductive logic or reasoning from a general principle to specific information

Answer 173

Extensive brain remodelling (myelinisation, synaptic pruning) Cognitive changes may help journey from the secure world parent(s) provided to fitting into world created by peers ``` Thrill seeking Openness to new experiences Risk taking Social rewards are very strong Prefer own age company ``` Emotionality becomes less positive through early adolescence But level off and become more stable by late adolescence Storms and stress more likely during adolescence than rest of the lifespan but not characteristic of all adolescents

Answer 174

People with 1 LTC= 2-3x more likely to develop depression (than rest of population) People with 3 LTC= 7x more likely to develop depression Increased risk of CHD and mortality from this Increased risk of death from MH problesm

Answer 175

The model proposes that illness disrupts normality and the individual is motivated to return to a “normal”, healthy state However, for patients who have a terminal illness the ability to return to health is not possible and coping becomes more about the psychological response to the inevitability of death and dying

Answer 176

Representation of health threat= identity, cause, consequence, timeline, cure/control Stage 1= interpretation Stage 2= coping Stage 3= appraisal Emotional response to health threat= fear, anxiety, depression

Answer 177

The patient’s attempts to make sense of their perceived symptoms

Answer 178

Adaptive and maladaptive ways of dealing with the problem in order to regain a sense of balance

Answer 179

The assessment of how successful, or otherwise that the coping stage has been

Answer 180

Reactions to terminal illness Outlined 5 reactions of the person facing death 1969

Answer 181

Denial (often a psych defence to cushion the impact of grief) Anger (why me?/unfair) Bargaining (with nurses/G-d/family) Depression (intense emotional pain- helplessness/sadness) Acceptance (loss accepted, work to minimise loss and cope)

Answer 182

We like to think linearly (like to predict/control) Need to make sense of the uncertain Applies to a number of different situations

Answer 183

Stages are prescriptive and place patients in a passive role Do not account for variability in response (e.g. people deal with things differently) Focus on emotional responses and neglect cognitions and behaviour Fail to consider social, environmental or cultural factors Pathologise people who do not pass through stages ('good' and 'bad' patients) Some people may not reach state of resolution- may make experience harder knowing they should

Answer 184

Refers to the situation of a person who has recently experienced the loss of someone significant in their lives through that person’s death Strongly influenced by culture

Answer 185

Loss-> first year of bereavement-> second year of bereavement 15-50% minimal grief (early) 85% minimal grief (towards second year) 50-85% common grief (early) 15% chronic grief (towards second year) SEE FIGURE

Answer 186

Bonanno and Kaltman, 2001

Answer 187

Not working with 'consistent' phenomena

Answer 188

The distinctive and relatively enduring ways of thinking, feeling and acting that characterise a person's response to life situations

Answer 189

Relatively stable cognitive, emotional and behavioural characteristics of people Help establish their individual identities and distinguish them from others Trait= continuum along which individuals vary, like nervousness or speed of reaction Can’t observe traits but can infer from behaviour

Answer 190

Personality theory with 2 main factors: NEUROTICISM/stability= the tendency to experience negative emotions EXTRAVERSION= the degree to which a person is outgoing and seeks stimulation (2 lines cross- vertical stable to unstable, horizontal extroverted to introverted)

Answer 191

OCEAN ``` Openness to experience Conscientiousness Extraversion Agreeableness Neuroticism (emotional instability) ```

Answer 192

``` LOW Down to earth Uncreative Conventional Uncurious ``` ``` HIGH Imaginative Creative Original Curious ```

Answer 193

``` LOW Negligent Lazy Disorganised Later ``` ``` HIGH Conscientious Hard-working Well-organized Punctual ```

Answer 194

``` LOW Loner Quiet Passive Reserved ``` ``` HIGH Joiner Talkative Active Affectionate ```

Answer 195

``` LOW Suspicious Critical Ruthless Irritable ``` ``` HIGH Trusting Lenient Soft-hearted Good-natured ```

Answer 196

``` LOW Calm Even-tempered Comfortable Unemotional ``` ``` HIGH Worried Temperamental Self-conscious Emotional ```

Answer 197

Differences in customary levels of cortical arousal - Introverts are overaroused - Extroverts are underaroused Suddenness of shifts in arousal - Unstable (neurotic) people show large and sudden shifts in limbic system arousal - Stable people do not

Answer 198

Cognitions, behaviours, and the environment interact to produce personality

Answer 199

An expectancy concerning the degree of personal control we have in our lives INTERNAL= life outcomes are under personal control EXTERNAL= outcomes have less to do with one's own efforts than with the influence of external factors

Answer 200

Health may be attributed to three sources: - Internal factors (e.g. healthy lifestyle) - Powerful others (e.g. one's doctor) - Lucky (e.g. lifestyle advice will be ignored)

Answer 201

Nun study Relatively homogeneous group Autobiographies at age 22 were analysed for emotional content and survival rate examined

Answer 202

The ability to acquire knowledge and to deal adaptively with the environment

Answer 203

Mental age Binet and Simon developed first intelligence test to ID French children that might have difficulty in school Different paces children learn at

Answer 204

Mental age divided by chronological age x 100 ``` >140= very superior 1% 100= 47% about average <60= 'mentally retarded'= 3% ```

Answer 205

Average (i.e. test-taker's performance relative to average performance of other's the same age)

Answer 206

Believed intellectual activity involves a general factor (g= general/shared level of ability) and specific facto Developed factor analysis - People who excel in one area often excel in other area - Statistical procedure which examines inter-correlations b/w different tests of mental ability Categories= verbal, mechanical, spatial, numerical (and then in middle= general)

Answer 207

``` Linguistic (Shakespeare) Logical-mathematic (Einstein) Spatial (Gaudi) Musical (Lennon and cardiologists) Bodily-Kinaesthetic (Messi) Intrapersonal (Socrates) Interpersonal (Freud) Naturalistic (Ray Mears) Existential intelligence (Sartre) ```

Answer 208

g - > verbal comprehension (SI, VC, IN) - > perceptual reasoning (BD, MR, VP) - > working memory (DS, AR) - > processing speed (SS, CD)

Answer 209

``` VERBAL General info Similarities Arithmetic reasoning Vocabulary Comprehension Digit span ``` ``` PERFORMANCE Picture completion Picture arrangement Object assembly Block design Digit-symbol substitution ```

Answer 210

Take average | Don't show specific skills

Answer 211

Crystallized intelligence (gc)= ability to apply previously acquired knowledge to current problems (improves with age then stabilises) Fluid intelligence (gf)= ability to deal with novel problem-solving situations for which personal experience doesn't provide a solution (steady pattern of decline in ageing)

Answer 212

Lothian birth cohort 1921 (Scotland area) N=550 They all did same test as children Data from 1932 test (first time age 11) Given same test (first time age 80) Scores consistent and stable (intelligence must be fairly stable)

Answer 213

Physical fitness(lung FEV1, grip strength, 6m walk time)= 0.17 Cognitive ability age 11= 0.59 Sex= 0.08 Adult social class= 0.10 APOE4 status (relates to Alzheimers)= 0.08

Answer 214

Genetic factors can influence the effects produced by the environment - Accounts for 1/2 to 2/3 of the variation in IQ - No single “intelligence gene” Environment can influence how genes express themselves - Accounts for 1/3 to 1/2 of the variation in IQ - Both shared and unshared environmental factors are involved - Educational experiences are very important

Answer 215

Comparing people from different environments doesn’t make sense e.g. Black and white in America ``` WITHIN comparisons more valid than BETWEEN comparisons e.g. Black and white in same socioeconomic class in same area of USA ```

Answer 216

Almost none (Lothian= Boys 100.5, Girls 100.6) Possibly gender difference in performance on certain types of intellectual tasks not general intelligence MEN better at spatial, target-directed and maths reasoning WOMEN better at perceptual speed, verbal fluency, math calculations and precise manual tasks

Answer 217

Being able to infer the thoughts and feelings of others and having an appropriate emotional reaction

Answer 218

The drive to analyse or construct any kind of system i.e. identifying the rules that a govern a system, in order to predict how that system will behave

Answer 219

Autism 4:1 male:female ratio Asperger's 9:1 m:f Baron-Cohen explains the social and communication difficulties in autism and Asperger’s syndrome by delays or deficits in empathy whilst explaining the narrow interests with reference to skills in systemising May be under-diagnosed in females

Answer 220

I get upset if I see people suffering on news programmes. I can pick up quickly if someone says one thing but means another I can’t always see why someone should have felt offended by a remark Results (low to high): autism, males, females

Answer 221

I am fascinated by how machines work I find it very easy to use train timetables, even if this involves several connections I do not keep careful records of my household bills Results (low to high): females, males, autism

Answer 222

Impossible to exclude contribution of environment and culture Findings of sex differences reflect bias gender roles

Answer 223

Studied hysteria Believed that symptoms were related to repressed memories and feelings Personality is an energy system (instinctual drives generate psychic energy, which constantly seeks release)

Answer 224

Only structure present at birth Exists totally within unconscious mind Pleasure Principle: seeks immediate gratification and release, regardless of rational considerations and environmental realities

Answer 225

Operates primarily at the conscious level Reality Principle: tests reality to decide when and under what conditions the id can safely satisfy its needs

Answer 226

Last to develop Contains the traditional values and ideals of family and society Morality Principles

Answer 227

Id Ego Superego Struggle in Psyche- ID defeats SUPEREGO in battle to control the EGO and how the EGO struggles to explain

Answer 228

Health is a state of complete physical mental and social well-being and not merely the absence of disease or infirmity

Answer 229

Refers to a problem with a structure or organ of the body e.g. ejection fraction

Answer 230

Functional limitation with regard to a particular activity e.g. mobility, ADLs

Answer 231

Refers to a disadvantage in filling a role in life relative to a peer group e.g. access to sports centre, prejudice of employers

Answer 232

WHO suggests causal links between disease and disability But disability correlates with handicap, research shows a correlation of just r=0.19 between impairment and disability in 763 CHD patients Suggesting something in addition to impairment (structural problem) influences disability (functional limitations)

Answer 233

Have a need for social and psychological equilibrium Serious illness presents a crisis (state of disorganisation, feelings of fear, guilt, sadness etc) Crisis is self-limited because we can't remain in an extreme state of disequilibrium Affected by background, personal, physical and social environmental factors RESPONSES - Adaptive responses-> personal growth and adjustment to illness - Maladaptive responses-> poor adjustment (pysch problems, low functioning etc)

Answer 234

``` Illness related-factors: Unexpected Cause and outcome Disability Prior experience Stigma Disfigurment ``` ``` Background/personal factors: Pre-existing personality Age of onset Gender SES & occupation Pre-existing illness beliefs ``` ``` Physical and social environment: Hospitalisation Accommodation and physical aids/adaptations Social support and social role Societal attitudes ```

Answer 235

Openness= no clear link to health Conscientiousness= +2 years life expectancy Extraversion= lower rates of CHD, protective respiratory disease Agreeableness= hostility associated w/ CHD Neuroticism= higher use of alcohol and smoking, higher symptom reporting

Answer 236

4-Year prospective study of life satisfaction 307 individuals who were newly disabled (from sample of 11,680) Average change for whole sample shows some adaptability by year 4 Agreeableness shown as strongest predictor= robust - Different adaptation for high and low agreeableness

Answer 237

May be explained by more agreeable individuals… Having more social support and better quality of friendships More likely to follow self-care instructions More positive e.g. active, coping strategies

Answer 238

Increased cardiac mortality inversely correlates to network size

Answer 239

The most socially isolated cardiac patients scored higher on a hostility measure, had lower incomes, and were more likely to be smokers

Answer 240

Social isolation

Answer 241

A patients own implicit, common sense beliefs about their illness

Answer 242

The label of the illness and symptoms | E.g. “I have a cold, with a sore throat and runny nose”

Answer 243

What may have caused the problem, such as genetics, circumstances, trauma, etc. E.g. “My cold was caused by being run down”

Answer 244

Expected effects from the illness and views about the outcome E.g. “My cold will prevent me from playing football this week”

Answer 245

How long the problem will last and whether it is seen as acute, chronic or episodic E.g. “My cold will be gone in a few days”

Answer 246

Expectations about recovery or control of the illness | E.g. “If I rest my cold will resolve quickly”

Answer 247

Identity- What symptoms are e.g. pain, tiredness Cause- “A germ or virus caused my illness” “Pollution of the environment caused my illness” “Stress was a major factor in causing my illness” Timeline- “My illness is likely to be permanent rather than temporary” “My illness will last for a long time” Consequences- “My illness has major consequences on my life” “My illness is a serious condition” Cure-Control- “There is little that can be done to improve my illness” “My treatment will be effective in curing my illness”

Answer 248

DRAWINGS OF DAMAGE PREDICT RECOVERY BETTER THAN MEDICAL VARIABLES 74 patients after MI were asked to draw pictures of their heart (before discharge from hospital) Recovery was assessed 3 months later, measuring work, exercise, distress about symptoms and perceptions of recovery Patients who drew damage to their heart perceived that their heart had recovered less at 3 months, that their heart condition would last longer and had lower perceived control over their heart condition - Extent of damage drawn correlated to slower return to work - Peak troponin-t not related to 3-month outcomes or return to work

Answer 249

Model of illness, cognition and behaviour How symptoms are perceived and interpreted by someone based on their illness representations, will influence their coping behaviour Symptoms evoke an emotional reaction Emotions and cognitions influence each other Coping and reappraisal can lead to adjustment of beliefs, emotions and coping strategies

Answer 250

“Stress caused my heart attack, smoking helps me reduce my stress levels, so I’m going to continue smoking” “Now I’ve had a heart attack, my life is as good as over, I’ll never be able to enjoy myself again” => low mood => reduce activity levels, avoid seeing friends => depression

Answer 251

TASKS RELATED TO ILLNESS OR TREATMENT (Moos 1982) Coping with symptoms or disability Adjusting to hospital environment and medical procedures Developing and maintaining good relationships with healthcare professionals TASKS RELATED TO GENERAL PSYCHOSOCIAL FUNCTIONING Controlling negative feelings and retaining a positive outlook for the future Maintaining a satisfactory self image and sense of competence Preserving good relationships with family and friends Preparing for uncertain future

Answer 252

Randomly treated 65 MI patients in hospital Intervention was aimed at modifying illness cognitions over three sessions Session 1: educated about symptoms and addressed common misconceptions of cause (e.g. stress was singularly responsible) Session 2: explored beliefs about recovery (e.g. will have to reduce activity forever) and helped patients make an explicit plan of exercise, dietary change and return to work Session 3: the action plan was reviewed, concerns about medication and symptoms were explored Patients in the treatment condition reported more positive views of their MI in terms of beliefs about consequences, time line, control/cure and symptom distress 3 months post-discharge= those treated returned to work faster etc.

Answer 253

PROBLEM-FOCUSED Seeking relevant information about an illness Learning specific illness related procedures e.g. pacing activities, helps patients gain expertise Changing behaviour e.g. diet EMOTION FOCUSED Seeking reassurance and emotional support Learning relaxation strategies Meditation Flexibility in skills/approach used most beneficial

Answer 254

Emotion focuses coping= poorer adjustment and greater levels of depression But CIRCULAR REASONING (those who are more distressed may need to engage in more emotion-focused coping) Flexibility in approach most beneficial

Answer 255

Threat= painful? survival? Resources= nothing I can do, can't cope

Answer 256

Moral/ethical responsibility to minimize suffering Greater chance of patients avoiding or not complying Distress during treatment related to longer term psychological morbidity and wide variety of treatment outcomes

Answer 257

Prepare with info (Edbert, 1964) Need detail about location, severity and duration of pain Prepared group-> less pain, less analgesics needed, post-op stay shorter

Answer 258

Info about the procedures to be untertaken

Answer 259

Info about the sensations that may be experienced

Answer 260

Ischaemic pain induced with a BP cuff Participants (male undergraduates) were given either sensory or procedural information before undergoing the pain task Results showed that the participants given sensory information reported significantly less distress during the procedure

Answer 261

Procedural and sensory information are both helpful Procedural info works by allowing patients to match ongoing events with their expectations in a non-emotional manner Sensory information works by “mapping” a nonthreatening interpretation on to these expectations

Answer 262

40 patients undergoing dental extraction surgery General or detailed info in pre-op preparation Measured distress level and desire for info/involvement High levels of presurgery anxiety are associated with poor adjustment

Answer 263

FLOOR 1 In a meeting, emphasized to residents that they could make choices and had responsibility e.g. about rearranging furniture, free times, movies and had plant to look after FLOOR 2 Similar meeting but staff would do everything for it Floor 1 showed greater engagement in activities, psychological and physical measures Fewer on floor 1 had died 18 months later than floor 2

Answer 264

Greater well-being Reduced distress

Answer 265

46 patients awaiting pre-prosthetic oral surgery Gage patient's preference for info Given a 20 minute preparation either emotion focused or problem focused or a mixed preparation Those with high pref= increased anxiety Those with low pref= increased problem

Answer 266

Children and adults use same types of coping Preference for Problem-Solving increases with age, whilst Avoidant coping declines Distraction= most effective for younger kids Matching coping strategy for specific child works for older children

Answer 267

Specific procedural and sensory info Coping skills training may also be conducted Older children >7 years benefit from info 5-7 days before Younger children benefit from info closer to procedure Modelling interventions can be hepful

Answer 268

TELL Using simple language and a matter-of-fact style, the child is told what is going to happen before each procedure (negative, emotive words are avoided). SHOW The procedure is demonstrated using an inanimate object (e.g. a doll), a member of staff or the clinician DO The procedure does not begin until the child understands what will be done

Answer 269

Mixed finding for children's distress Parents who were present were less anxious

Answer 270

120 children aged 8-12 years Mothers randomly allocated to training in one of three interaction styles: - Pain promoting (reassurance and empathy etc)-> increased pain intensity - Pain reducing (distraction, humour etc)-> reduced pain intensity - No training-> middle pain intensity All children underwent a cold pressor task

Answer 271

How we think about out social world

Answer 272

How other people influence out behaviour

Answer 273

How we relate toward other people

Answer 274

A positive or negative evaluative reaction toward a stimulus, such as a person, action, object or concept Attitudes influence behaviour more strongly when situational factors that contradict our attitudes are weak

Answer 275

Important of exploring social norms in changing health behaviour What do your friends/family think about smoking? What do your friends/family think about you smoking? Whose opinion is most important to you? What are the pros and cons of following that opinion?

Answer 276

When we hold two opposing beliefs-> unrest/dissonance within us e.g. I'm a smoker and smoking causes cancer

Answer 277

``` Change behaviour (may be difficult) Acquire new info (e.g. seek exceptions) Reduce importance of cognitions (i.e. beliefs, attitudes) ```

Answer 278

``` If the message... Reaches recipient Is attention-grabbing Easily understood Relevant and important Easily remembered ```

Answer 279

Credible e.g. doctors Trustworthy e.g. objective Attractive e.g. well presented

Answer 280

Refers to whether a message emphasises the benefits or losses of that behaviour

Answer 281

TAKING UP BEHAVIOURS AIMED AT DETECTING HEALTH PROBLEMS/ILLNESSES E.g. HIV testing Loss-framed messages may be more effective TAKING UP BEHAVIOURS AIMED AT PROMOTING PREVENTION BEHAVIOURS E.g. condom use Gain-framed messages may be more effective

Answer 282

1. If you do not undertake breast self-examination you may be more likely to die from cancer

Answer 283

2. If you do use SPF15 sunscreen, your skin will stay healthier and you may prolong your life

Answer 284

Generalisations made about a group of people or members of that group, such as race, ethnicity or gender Or more specific such as different medical specialisations (e.g. surgeons)

Answer 285

To judge, often negatively, without having relevant facts, usually about a group or its individual members

Answer 286

Behaviours that follow from negative evaluations or attitudes towards members of particular groups

Answer 287

GPs reluctant to take on patients with a mental health history despite it being well controlled

Answer 288

Mental or cognitive structures that contain general expectations and knowledge of the world Help us process information quickly and economically and facilitate memory recall Means we are more likely to remember details that are consistent with our schema than those that are inconsistent

Answer 289

Tendency for people to expend less individual effort when working in a group than when working alone

Answer 290

The person believes that individual performance is not being monitored The task (goal) or the group has less value or meaning to the person The person generally displays low motivation to strive for success The person expects that other group members will display high effort

Answer 291

Occurs more strongly in all-male groups | Occurs more often in individualistic cultures

Answer 292

Individual performance is monitored | Members highly value their group or the task goal

Answer 293

People change their responses in relation to when other people are present People will follow what others say (actors say wrong one= participant goes along with it)

Answer 294

Group size Presence of a dissenter Culture

Answer 295

Conformity increases as group size increases | No increases over five group members

Answer 296

One person disagreeing with the others greatly reduces group conformity

Answer 297

Greater in collectivistic cultures

Answer 298

One “learner”, one “teacher”- told that experiment studied the effect of punishment on learning and memory Actor always the learner, participant always teacher If the learner makes mistake-> administer small shock (shock generator to apply punishment) Shocks grew increasingly intense with each mistake Actor (learner) responded to fake shocks acting in pain 75% participants (teacher) went up to very high (near fatal) shocks

Answer 299

Remoteness of the victim (e.g. behind screen) Closeness and legitimacy of the authority figure (in white coat) Diffusion of responsibility: obedience increases when someone else does the dirty work Not personal characteristics

Answer 300

Tendency of group members to suspend critical thinking because they are striving to seek agreement

Answer 301

Tendency of people to make decisions that are more extreme when they are in a group as opposed to a decision made alone or independently

Answer 302

``` In a group which.. Is under high stress to reach a decision Is insulated from outside input Has a directive leader Has high cohesiveness ```

Answer 303

Social psychological phenomenon that refers to cases in which individuals do not offer any means of help to a victim when other people are present The probability of help is inversely related to the number of bystander

Answer 304

Participants were invited into the lab under the pretext they were taking part in a discussion about ‘personal problems’ Participants were all in separate rooms in the lab and communicated via an intercom system Participant heard actor having seizure 87% helped if they believed it was just them and the other student. But only 31% helped when they believed they were in a group of 4 people, hardly anyone helped if group was above 4

Answer 305

Those that didn't report the emergency appeared in distress (sweating and had trembling hands) They reported shame and guilt for not helping Reasons for not helping included not wanting to expose themselves to embarrassment or to ruin the experiment which, they had been told depended on each participant remaining anonymous from the others

Answer 306

Notice the event Decide if the event is really an emergency (social comparison: look to see how others are responding) Assuming responsibility to intervene (diffusion of responsibility: believing that someone else will help) Self-efficacy in dealing with the situation Decision to help (based on cost-benefit analysis e.g. danger)

Answer 307

Reduce ambiguity and increase responsibility Enhance guilt and concern for self image

Answer 308

Reducing restraints on helping | Socialise altruism

Answer 309

Teaching moral inclusion Modelling helping behaviour Attributing helpful behaviour to altruistic motives Education about barriers to helping

Answer 310

Patient has many doctors (e.g. Yale med school case) Diagnosis never confirmed despite lots of tests by different people

Answer 311

Ability to persuade others to seek defined objectives enthusiastically A human factor which binds a group together and motivates it towards goals Management activities are dormant until leader triggers the power within people and guides towards goal

Answer 312

Autocratic/authoritarian style Participative/democratic style Laissez-faire/"free-rein" style

Answer 313

All decision-making powers are centralized in the leader as with dictator leaders They do not entertain any suggestions or initiatives from subordinates ADVANTAGES Enables quick decision making Clear hierarchy of responsibility DISADVANTAGES Can be demotivating Can lead to errors

Answer 314

Favours decision-making by the group as shown e.g. leader gives instruction after consulting the group They can win the co-operation of their group and can motivate them effectively and positively. ADVANTAGES Can win cooperation and motivate team Can improve quality of decision making DISADVANTAGES Time consuming Can lead to disagreements

Answer 315

Leader does not lead, but leaves the group entirely to itself Such a leader allows maximum freedom to subordinates, i.e., they are given a free hand in deciding their own policies and methods ADVANTAGES Allows autonomous working Allows expertise to be utilised DISADVANTAGES Can lead to lack of direction Lack of ultimate responsibility holder

Answer 316

Incorrect diagnosis Failure to employ indicated tests Error in the performance of an operation, procedure or test Error in the dose or method of using a drug

Answer 317

Failure of a planned action to be completed as intended (i.e. error of execution) or the use of a wrong plan to achieve an aim (i.e. error of planning)

Answer 318

WJ diagnosed with lymphoblastic leukaemia in 1999 aged 15 By June 2000 Wayne was in remission, but still needed three-monthly injections of two chemotherapy drugs - Vincristine (IV) and Cytosine (IT) On 4th January 2001 WJ was mistakenly given Vincristine intrathecally by SHO (who hadn't spoken up to SpR) He became slowly paralysed and almost a month later his parents agreed to turn off his life support machine The Specialist Registrar involved, Dr Feda Mulhem, was convicted of manslaughter and sentenced to 8 months imprisonment

Answer 319

Researchers placed a fictional drug in the ward drug cabinet The label clearly stated: ‘Maximum Dose 10mg’ ‘Dr Smith’ rang the ward and asked nurse to administer 20mg, and he would sign for it later 21 out of 22 nurses prepared the dose

Answer 320

Both system-related and cognitive factors (46%) Cognitive error only (28%) No-fault factors only (7%)

Answer 321

Diagnostic errors (not surgical mistakes or medication overdoses)

Answer 322

Heuristics= intuitive understanding of probabilities is combined with cognitive processes to guide clinical judgment I.e. educated guesses, or mental shortcuts Usually involve pattern recognition and rely on a subconscious integration of patient data with prior experience

Answer 323

HOT (1) COLD (2)

Answer 324

``` Emotional "Go" Simple Reflexive Fast Develops early Accentuated by stress Stimulus control ```

Answer 325

``` Cognitive "Know" Complex Reflective Slow Develops late Attenuated by stress Self control ```

Answer 326

Shown four identical pairs of tights in a row and consumers in mall asked to pick out the pair they liked the best Consumers significantly more likely to select the far right most pair (even though they were switched around randomly each time) Consumers were able to provide justifications for their choice e.g. sheerness, strength etc. None mentioned the position

Answer 327

Tendency to search for or interpret info in a way that confirms one's preconceptions (often-> errors)

Answer 328

Experienced horserace handicappers given a list of 88 variables relating to past performance of horses and riders Asked to predict outcome of a race based on 5 most important items, then 10, 20 and 40 most important variables More confident with more variables but accuracy approx the same

Answer 329

Podbregar et al studied 126 ICU patients Physicians asked to provide clinical diagnosis and level of uncertainty "Completely certain" of diagnosis ante-morte were wrong 40% of time

Answer 330

Humans don't always act rationally and often the more we have invested in the past the more we are prepared to invest in a problem in the future EXAMPLE Season ticket sold at full price, small discount or large discount Observed frequency of attendance at plays over the season Rationally, price paid for ticket should not influence how often it's used However, people who paid a higher price used the ticket more

Answer 331

Cognitive bias that describes the common human tendency to rely too heavily on the first piece of information offered (the "anchor") when making decisions During decision making, anchoring occurs when individuals use an initial piece of information to make subsequent judgments

Answer 332

Many clinical situations involve making decisions on the basis of probabilities E.g. two or more competing diagnoses, alternative treatments which may be effective etc

Answer 333

Logical fallacy involving the mistaken belief that past event will affect future events when dealing with independent events E.g. If one patient in a clinic presents with a rare condition then it would be impossible for the next patient to present with the very same condition

Answer 334

Used when making judgments about the probability of an event under uncertainty Subjective probability that a stimulus belongs to a particular class based on how ‘typical’ of that class it appears to be (regardless of base rate probability) While often very useful in everyday life, it can also result in neglect of relevant base rates and other errors

Answer 335

He doesn't match the typical profile of an MI But unwise to dismiss that possibility because MI is common among men of that age and has highly variable manifestations

Answer 336

A cognitive bias in which people react to a particular choice in different ways depending on how it is presented E.g. as a loss or as a gain. People tend to avoid risk when a positive frame is presented but seek risks when a negative frame is presented (i.e. 400 people die, 200 saved)

Answer 337

Older adults are significantly more likely to agree to a treatment when it is positively described than they are to agree to the same treatment when it is described neutrally or negatively

Answer 338

Probabilities are estimated on the basis of how easily and/or vividly they can be called to mind Individuals typically overestimate the frequency of occurrence of catastrophic, dramatic events e.g. believe that accidents cause more deaths than strokes People tend to heavily weigh their judgments toward more recent information

Answer 339

``` Education and training Feedback Accountability Generating alternatives Consultation ```

Answer 340

Integrate teaching about cognitive error and diagnostic error into medical school curricula Recognize that heuristics and biases may be affecting our judgement even though we may not be conscious of them

Answer 341

Increase feedback e.g. autopsies Conduct regular and systematic audits Follow-up patients 3

Answer 342

Establish clear accountability and follow-up for decisions made

Answer 343

Establish forced consideration of alternative possibilities e.g., the generation and working through of a differential diagnosis. Encourage routinely asking the question: What else might this be?

Answer 344

Use of algorithms Seek second opinions Use of clinical decision making support systems

Answer 345

An algorithm is a procedure which, if followed exactly, will provide the most likely answer based on the evidence e.g. rules of probability Useful in well defined situations

Answer 346

British composer Long lasting anterograde amnesia following herpes viral encephalitis-> damaged hippocampus Memory lasts 7-30 secs 'Wakes up' every 20 secs Some retrograde amnesia (knows bits e.g. name, siblings, childhood family, childhood facts, education up until uni and recognises faces of people he's known for years e.g. wife) Can still play piano/learn new music= PROCEDURAL MEMORY INTACT

Answer 347

Ability to learn how to do new things

Answer 348

Processes used to acquire, store, retain and later retrieve information There are three major processes involved in memory: encoding, storage and retrieval

Answer 349

REGISTRATION Input from our senses into memory system (not everything registered is remembered) ENCODING Processing and combining of received info (better encoding-> increased likelihood of retrieval) STORAGE Holding of that input in the memory system RETRIEVAL Recovering stored info from memory system (remembering it)

Answer 350

EFFORTFUL PROCESSING= initiated intentionally, requires conscious attention AUTOMATIC PROCESSING= occurs without intention, requires minimal attention

Answer 351

Students had to answer questions about a series of words which were flashed one at a time (e.g. bear) 3 types of questions asked 1) about word's visual appearance (e.g. case) 2) about sound of word (e.g. rhyme) 3) about meaning (e.g. animal?) After, given recognition test Shows types of encoding More meaning assigned to something the more likely it is to go into storage for later retrieval

Answer 352

False More than one type Different performance characteristics and function

Answer 353

Can mean info is lost from memory | Not always the case

Answer 354

Internal or external retrieval cues Multiple cues enhance retrieval Conscious (effortful) or unconscious (automatic)

Answer 355

Multicomponent model of working memory

Answer 356

'Backup' store which communicates with both long term memory and the components of working memory Temporarily integrates phonological, visual and spatial info into a unitary, episodic representation Provides interface with episodic LTM

Answer 357

Central executive (PFC) - > Visuospatial sketchpad (occipital lobe) - > Episodic buffer - > Phonological loop (left parietal) ALL-> Long term memory storage (Visual semantics) (Episodic LTM) (Language)

Answer 358

Can do verbal and visual tasks at same time but cant do 2 visual or 2 verbal Must be 2 different systems

Answer 359

Manipulation of information and direction of attention- driving Suppression of irrelevant information and undesired actions Supervision of information integration Coordination of multiple tasks to be executed in parallel Co-ordination of the sub-systems of working memory

Answer 360

Storage of visual and spatial info | E.g. for constructing and manipulating visual images, for the representation of mental map

Answer 361

Storage of auditory/verbal info Preventing decay by silently articulating contents, refreshing the info in a rehearsal loop E.g. phone number/ reading

Answer 362

Damage following motorbike accident to area between parietal and occipital lobe Working memory intact but impaired long term memory

Answer 363

Info in -> sensory registers Sensory registers - -> ATTENTION-> working memory - -> direct to long term memory - -> lost Working memory (REHEARSAL loop) - -> STORAGE-> long term memory - -> info lost RETRIEVAL (ltm-> wm)

Answer 364

Store of all things in memory that are not currently being used but are available for use in the future Allows use of past information to deal with present and the future Can hold unlimited amount of information

Answer 365

Retrieval from long term memory may be: Explicit/declarative (conscious)‏ Implicit/non-declarative (unconscious)‏

Answer 366

Episodic (biographical events) | Semantic (words, ideas, concepts)

Answer 367

Procedural (skills) Emotional conditioning Priming effect Conditioned reflex

Answer 368

Familiar with something, know how to interact with object or in situation but don't have to think about it (Procedural memory= for actions or behaviours) Can carry out complex activities without having to think about them e.g. walking, eating

Answer 369

Store of our knowledge | 2 separate types= episodic and semantic

Answer 370

Memory related to personal experience What we generally think of as ‘memories’ Knowing what you did last night or where you went on holiday

Answer 371

Memory for facts What we think of as general knowledge Knowing the capital of France or the colour of a bus

Answer 372

Starts from age 2-3 years Language needed to help remember Aged 6 when we remember autobiographical events 'Reminiscence bump'- we remember the most in later adolescence Is it emotionally driven? Driven by defining events?

Answer 373

Each concept represented by a node Activation of one network leads to spreading activation of related concepts and then activate neighbouring nodes (Stored ideas are connected by links of meaning, strengthened through rehearsal and elaboration) Works to a lesser extent for indirectly related nodes Multiple links make it easier to retrieve because alternative routes to locate it

Answer 374

A mental structure that represents some aspect of the world (e.g. schema for weddings even before we go to one, then reinforce it when we go) Used to organise current knowledge and provide a framework for future understanding Automatic not effortful thought e.g. stereotypes Acquired through experience

Answer 375

Provides a valuable insight into the reconstructive nature of human memory STUDY 20 English participants read a traditional native american tale Retold story to each other after a short period of time Struggled in understanding its meaning and the significance of some of its aspects RESULTS Rationalisations= people tended to add material to justify parts of the story Omissions= parts of the story that were difficult to understand were left out Changes of order= storyline was rearranged in an attempt to make sense out of it Distortions of emotion= people added their own feelings and attitudes

Answer 376

Selection= info that does not fit current schemas is ignored Abstraction= we are inclined to recall the overall gist and forget the detail Interpretation= schemas provide existing knowledge to help us understand novel situations Normalisation= memories are distorted to fit with our existing expectations Retrieval= schemas help us fill gaps in our memory by making a best guess

Answer 377

Distortion of a memory by misleading post-event information Show how language and wording can influence a person's recall of a incident E.g. eyewitness testimony (Loftus & Palmer, 1974) of car accident - Asked questions - Manipulate way question is asked to determine effects on recall (e.g. smashed/ collided/ bumped) Loftus & Zanni (1975)- more subtle wording e.g. the broken headlight instead of a broken headlight

Answer 378

Order in the list= serial position effect (primary and recency= most likely) Personal salience of words Delay time Distraction

Answer 379

Frequent repetition (verbal)‏ Forms a separate schema, not closely linked to existing knowledge Least efficient way to study Less deep processing

Answer 380

Fitting new information into existing schema(s)‏ Learning by comprehension Can only be used where there is link between old and new knowledge Deep processing Declarative

Answer 381

``` P = Preview the info to learn Q = Question= write down the questions that you want to be able to answer once finished R = Read through info that best relates to questions S = Summarise the info by writing, diagram, mnemonics, voice recording T = Test= try to answer the questions ```

Answer 382

Artificial structure for reorganising or encoding information to make it easier to remember Useful when info doesn’t fit existing into schemas Examples: hierarchies, chunking, visual imagery, acronyms Need to recall artificial structure to access information

Answer 383

Parker & Dagnall= L-R ready better (for R handed) Acting out with hand gestures helps Links learning abstract concepts to simplify physical movement Short, intense exercise bursts are better than long

Answer 384

Ineffective encoding Decay theory Interference theory Encoding Specificity Principle

Answer 385

Retrieval will occur depending on how well the retrieval cue corresponds to the memory code

Answer 386

Info not encoded in the first place

Answer 387

Forgetting occurs because memory fades with time if not used

Answer 388

Forgetting occurs due to competition for space from other material either from previously learned info or new information

Answer 389

Hippocampus one of first brain regions to suffer damage | Memory and disorientation among first symptoms to appear

Answer 390

Implicit memory HM & CW= significant anterograde amnesia for autobiographical info following bilateral medial temporal lobe ablation but implicit memory intact e.g. piano playing

Answer 391

Important in formation of new episodic or autobiographical memories May be part of larger medial temporal lobe memory system (involved in general declarative memory) Role in maintaining memories unknown (older memories remain stable so consolidation over time may happen outside of hippocampus)

Answer 392

Medial temporal lobes including the hippocampus and parahippocampal cortex

Answer 393

See a period of retrograde amnesia | Depending on the site of injury anterograde amnesia

Answer 394

Post traumatic amnesia= disrupted memory processing | Patient unable to make new memories/disorientated

Answer 395

Reduction in thiamine (vit B-1) which helps brain cells produce energy from sugar -> Inability to learn new information from recent events but also long-term memory gaps Common to see confabulation

Answer 396

Progressive loss of semantic memory | Loss of word meaning and presents as a progressive aphasia

Answer 397

Acting according to request or command

Answer 398

To stick fast to Extent to which a person's behaviour (meds/diet/lifestyle changes) corresponds with agreed recommendations from a health care provider

Answer 399

173 patients being treated for active tuberculosis Nurses and physicians rated the compliance of patients Also took patient rating, urine drug level and colour Doctors weren't often right Self report most reliable

Answer 400

DIRECT Directly observed therapy Measurement of the level of medicine or metabolite in blood Measurement of the biologic marker in blood ``` INDIRECT METHODS Patient questionnaires, patient self-reports Pill counts Rates of prescription refills Electronic medication monitors Measurement of physiologic markers Patient diaries ```

Answer 401

Very expensive Costs approximately £10 billion £37.6 million unused handed in to pharmacies each year in the UK

Answer 402

Increased hospital admissions Rejection of transplants Occurrence of complications Development of drug resistance Increased mortality

Answer 403

Unintentional non-adherence - Patient ability and resources-> PRACTICAL patient barriers to adherence Intentional non-adherence - Patient beliefs and motivations-> patient PERCEPTUAL barriers to adherence

Answer 404

Treatment does not make sense e.g. exercise for back pain Worries/ concerns about the treatment e.g. worried about SEs Beliefs about the disease e.g. not having MMR poor knowledge of measles

Answer 405

Poor HCP-Patient communication Low patient satisfaction/and or recall Cognitive difficulties Financial or other barriers Health beliefs still influence unintentional non-adherence e.g. will impact on the patient’s motivation to overcome practical barriers

Answer 406

Provides a framework for understanding factors and interactions Intentional and non-intentional adherence can be studied Useful to understand causes of non adherence to recommend effective intervention

Answer 407

Can help explain non-adherence Capability e.g. memory, dexterity, swallowing Opportunity e.g. access, HCP communication, social support Contribute to motivation (e.g. beliefs about illness, treatment, emotions, habits) and behaviour All contribute to adherence

Answer 408

``` STRONG Concerns about treatment Beliefs about illness Cost of therapy Necessity for treatment Perceived drug efficacy ``` ``` MODERATE Cognitive ability Depression Social support Coping skills Number of medicines Disease seriousness beliefs Health literacy Locus of control Self efficacy Trust in HCP HCP-Patient concordance Symptom experience ``` ``` WEAK Gender Income Age Race Personality ```

Answer 409

Identity (abstract label)= concrete symptoms that a person associates with condition Causal beliefs= stress, environment, genetics, own behaviour, ageing Timeline= perceived duration and profile e.g. chronic, acute, cyclical Consequences= personal, economic, social Cure/control= beliefs about the amenability to control or cure NB. Illness beliefs aren't strongest predictors of treatment adherence

Answer 410

Specific beliefs= views about prescribed medication Concerns= arising from beliefs about potential negative effects Necessity= reliefs about necessity of prescribed medication for maintaining health

Answer 411

``` Have an internal logic Are influenced by symptoms May differ from the ‘medical view’ May be based on mistaken beliefs/ premises May not be disclosed in consultation ``` Influence adherence Are not set in stone and can be changed

Answer 412

Use the consultation to anticipate and plan: - Check patient's understand treatment - Provide clear rationale for NECESSITY of treatment - Elicit and address CONCERNS - Agree practical plan for how, where and when to take treatment - Identify any possible barriers Interventions to: - Improve understanding of illness and treatment - Help patients plan and organise taking of the treatment

Answer 413

Interventions to improve adherence should target patients' beliefs about their medication ``` Factors predicting poor adherence 1 year after first ischaemic stroke: Younger age Concerns regarding medication Lower cognitive function Low received benefit of medication ``` Factors predicting poor adherence 6 weeks later: Younger age Concerns regarding medication Low perceived benefit of medication

Answer 414

Simple, brief intervention increased medication adherence in stroke survivors

Answer 415

Increase in symptoms Increase in healthcare utilisation Reduction in quality of life

Answer 416

Patient beliefs among factors most consistently associated with non-adherence to preventer medication Belief about illness Beliefs about medication

Answer 417

212 patients Baseline assessment Normal care vs tailored text messages for 18 weeks Then adherence assessments at 6, 12, 18 weeks and 6 months Text intervention-> more adherence

Answer 418

Capability Motivation Opportunity

Answer 419

Activity- passivity e.g. coma/trauma Guidance- cooperation e.g. acute infection Mutual participation e.g. chronic illness Use of written material

Answer 420

612 patients with poorly controlled asthma randomly allocated to either normal care or shared decision making Shared decision making was associated with better adherence to medication and clinical outcomes (including asthma control and lung function)

Answer 421

Amount of information Order Stressing importance Specificity Mode of presentation

Answer 422

INDIVIDUAL Anxiety Medical knowledge Memory impairment

Answer 423

Diagnostic statements= 87% Information about illness= 56% Instructions= 44%

Answer 424

97% would like to receive written info (Gibbs et al, 1990) Majority don't read written info (Gibbs et al, 1987) Written info leads to increased knowledge and adherence (Ley & Morris, 1984) Consider how easy info is to read (most people below reading level in leaflets)

Answer 425

Physical aspects e.g. packaging and font size Complexity of instructions Frequency of schedule- schedule Follow up- to review monitoring and to change the plan

Answer 426

``` Cognitive restructuring Imagery / role play Goal setting/ problem solving Stepped behaviour change Rewards Relapse prevention Stress management De-sensitization to stressful stimuli (e.g. needle phobia) Assertiveness training/ increase self-efficacy ```

Answer 427

``` Support groups Buddy systems Social media/ web forums Making changes with other family members Support from HP ```

Answer 428

Psychological Sociological Biological (Venn diagram)

Answer 429

Stress can be a stimulus or response (combination as person-situation interaction) ``` Stimulus= stressors Response= fight or flight (physiological response) ``` 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) Negative emotions e.g. feeling tense, difficulty concentrating and losing your temper easily

Answer 430

Life events preceding illness Rated on level of stress Stressful events worst for health

Answer 431

Events that place strong demands on us

Answer 432

Sympathetic nervous system Hypothalamic pituitary adrenocortical axis (releases cortisol)

Answer 433

Selye, 1956 STAGE 1= Alarm reaction The shift to sympathetic dominance causes increased arousal STAGE 2= Resistance The endocrine system releases stress hormones to maintain increased arousal (above normal stress level) STAGE 3= Exhaustion The adrenal glands lose their ability to function normally

Answer 434

Situational demands= primary appraisal Resources needed to cope with them= secondary appraisal

Answer 435

Take into account potential consequences with primary and secondary appraisal Apply psychological meaning of the consequences may be related to beliefs about yourself or the world

Answer 436

How hard it will be and how much it counts (primary appraisal) How your current knowledge equips you to pass (secondary appraisal)‏ Add potential consequences and psychological meaning of the consequences

Answer 437

Arousal (low-high) vs performance (weak-strong) Shape of normal curve Highest optimal arousal and optimal performance in middle

Answer 438

Events -> stress -> physiological OR behavioural changes -> disease

Answer 439

Health behaviour and stress Smoking and alcohol increased more by exams in people who had less support system

Answer 440

Increased number of heart attacks in 3 days after Beckham was sent off in 1998

Answer 441

Anxiety associated with increased risk of developing CVD Independent of traditional risk factors e.g. smoking, obesity, high BP and depression 'Psychosocial stress and coronary heart disease' related (artery calcification more in high stress response)

Answer 442

Psychoneuroimmunology Slower healing (e.g. reduced interleukin 1 production) Immunosuppression

Answer 443

Mucosal wound healing and exam stress Dental students were each administered two punch biopsy wounds on the hard palate One during the summer vacation and one before a major exam Pictured everyday Wounds took 40% longer to heal during exams Interleukin 1 production declined by 68% during the exam

Answer 444

Nasal wash with cold virus Stress index assigned to them More stressed-> more likely to get colds

Answer 445

``` Time urgency Free-floating hostility Hyper-aggressiveness Focus on accomplishment Competitive and goal-driven ```

Answer 446

Type A= 31% increase in risk for CHD compared to type B May be because of anger and hostility as key to relationship with CHD Type D= social inhibition and negative affect-> increased CHD (maybe under-reporting of symptoms)

Answer 447

Depression very important in CHD Higher risk of mortality Physiological changes (e.g. platelet activity) and behavioural changes (e.g. levels of physical activity)

Answer 448

``` PROBLEM-FOCUSED COPING Planning Active coping and problem solving Suppressing competing activities Exercising restraint Assertive confrontation ``` ``` EMOTION-FOCUSED COPING Positive reinterpretation Acceptance Denial Repression Escape-avoidance Wishful thinking Controlling feelings ``` ``` SEEKING SOCIAL SUPPORT Help and guidance Emotional support Affirmation of worth Tangible aid (e.g. money) ```

Answer 449

Social relationships increase likelihood of survival Protective psychological role As important as not smoking E.g. for breast cancer support group helps survival chances

Answer 450

Emotional and physical exhaustion Depersonalisation Reduced personal accomplishment

Answer 451

Patients seen less as individuals and situations become simply part of a routine

Answer 452

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

Answer 453

Branded drugs= people more likely to feel better An inactive substance like sugar, distilled water, or saline solution can sometimes improve a patient's condition simply because the person has the expectation

Answer 454

I will harm Negative effect that occurs after receiving treatment even when the treatment is inert Warnings about the possible SEs of a medicine make it more likely patient will report them

Answer 455

Deception NB. IBS study showed knowing drug was placebo still improved symptoms and QoL

Answer 456

Expectancy Classical conditioning Anxiety and attention Release of endogenous opiates Not mutually exclusive!!!

Answer 457

Mixed anxiety and depression

Answer 458

Four or more of the following symptoms: Palpitations, pounding heart, or accelerated heart rate Sweating Trembling or shaking Sensations of shortness of Breath or smothering Chest pain or discomfort Feeling dizzy, unsteady, lightheaded, or faint Feelings of unreality (derealization) or being detached from oneself (depersonalization) Fear of losing control or going crazy Fear of dying Paresthesias (numbness or tingling sensations) Chills or hot flushes

Answer 459

1. Recurrent unexpected panic attacks AND 2. At least one of the attacks has been followed by 1 month (or more) of one (or more) of the following: Persistent concern about having additional attacks Worry about the implications of the attack or its consequences (e.g., losing control, having a heart attack, "going crazy") Significant change in behaviour related to the attacks

Answer 460

Develops as a complication of panic attacks Agoraphobia may arise by the fear of having a panic attack in a setting from which escape is difficult Sufferers of agoraphobia avoid public or unfamiliar places, especially large, open, spaces where there are few 'places to hide‘ or prevent easy escape

Answer 461

To help people change maladaptive thoughts, feelings and behaviour patterns Consider psychodynamic, behavioural and cognitive

Answer 462

Psychodynamic therapy Conscious (iceberg above surface, superego and ego) Preconscious (superego and ego) Unconscious (all of id, some S and some E)

Answer 463

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

Answer 464

Two-factor theory E.g. for fear Classical conditioning of fear (CS= car, UCS= traumatic car accident -> conditioned gear response to cars CR) Operant conditioning of avoidance (avoid cards-> fear is reduced-> tendency to avoid cars in strengthened)

Answer 465

Influenced by both classical and operant conditioning approaches Treat phobias tHROUGH exposure to the feared CS in the absence of the UCS (e.g. car without accident) Intense temporary anxiety created by treatment but long term highly effective

Answer 466

Behavioural technique commonly used to treat fear, anxiety disorders and phobias Using this method, the person is engaged in some type of relaxation exercise and gradually exposed to an anxiety producing stimulus, like an object or place E.g. start in non-moving car, gradually build up to driving

Answer 467

Stimulus-> cognition-> response

Answer 468

Internal or external trigger-> perceived threat-> anxiety-> physical and cognitive symptoms-> misinterpretation-> anxiety etc. Individuals with panic interpret certain bodily sensations in a catastrophic fashion Sensations (esp. those involved in normal anxiety responses e.g., palpitations, breathlessness, dizziness) are considered to be a sign of impending physical or psychological disaster

Answer 469

Identify the nature of thoughts (don't have to be true to affect emotions) Learn about common biases in thoughts Treat thoughts as guesses or hypotheses about the world E.g. get someone to recognise they are having a panic attack not a heart attack

Answer 470

``` Psychoeducation Relaxation techniques Cognitive restructuring Behavioural experiments Graded exposure Relapse prevention ``` CBT= thought, behaviour, emotion

Answer 471

Focuses on problematic beliefs and behaviours that maintain disorders Goal oriented Collaborative relationship between therapist and patient Brief (8-16 sessions)

Answer 472

71% recovery rate with CBT CBT has been lower to have relapse rates lower than anti-depressants medications in some conditions

Answer 473

``` Depression Social anxiety PTSD Generalised anxiety disorder OCD Bulimia Panic disorder and specific phobia Schizophrenia ```

Answer 474

Five (or more) of the following symptoms have been present during the same 2-week period and represent a change from previous functioning; at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure Loss of appetite Insomnia or Hypersomnia nearly every day Psychomotor agitation or retardation nearly every day Fatigue or loss of energy nearly every day Feelings of worthlessness or excessive or inappropriate guilt Diminished ability to think or concentrate Recurrent thoughts of death, recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide NB. These symptoms don't meet criteria for a mixed expisode Clinically significant distress caused

Answer 475

Antidepressants not routinely used to treat persistent subthreshold depressive symptoms or mild depression Appropriate for people with: A past history of moderate or severe depression Subthreshold depressive symptoms present for a long time Subthreshold depressive symptoms or mild depression that persist(s) after other interventions

Answer 476

Kirsch et al, 2008 say no

Answer 477

CBT | Mindfulness-based cognitive therapy

Answer 478

Paying attention in a particular way In the present moment, on purpose and non-judgementally Recognise thoughts as thoughts

Answer 479

Motivational interviewing | Pain management

Answer 480

Helps the patient identify the thoughts and feelings that cause them to continue "unhealthy" behaviours and help to develop new thought patterns to aid in behaviour change Used for smoking, alcohol use, drug addiction, weight loss, medication adherence

Answer 481

Elicit- e.g. what patient knows or would like to know Provide- give info in a neutral nonjudgemental fashion (avoid I and YOU) Elicit- get patients interpretation

Answer 482

Yes Even in brief encounters Effect not related to education background

Answer 483

PSYCHOLOGICAL Pain-> anger, anxiety, fear, distress etc. -> impoverished mood-> depression-> increased perception of pain-> pain PHYSICAL Pain-> activity avoidance-> progressive deconditioning-> pain with decreasing activity-> further activity avoidance-> further deconditioning-> pain

Answer 484

Psychological intervention for health behaviour change 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.

Answer 485

CBT for chronic pain can have positive effects on factors such as disability, negative mood and pain self-efficacy - Maintained at six months post intervention

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Psychology Flashcards

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