Psychology Flashcards
1
Q
Define attitude.
A
A positive or negative evaluative reaction towards a stimulus. Attitudes influence behaviour more strongly when situational factors what contradict our attitudes are weak.
2
Q
Describe the theory of planned behaviour.
A
Belief about and evaluation of behaviour leads to one’s attitude towards the behaviour.
Belief about others’ attitudes towards behaviour leads to the ‘subjective norm’.
Internal and external control factors form perceived behaviour control.
These 3 factors influence intention, which causes behaviour.
3
Q
How do people resolve cognitive dissonance? How are the characteristics of a messenger related to how persuasive they are?
A
They change their cognition to make their beliefs consistent.
Change their behaviour (e.g. quit - which is difficult)
Obtain new information
Reduce the importance of the cognitions.
More persuasive messengers are credible, trustworthy and appealing.
4
Q
Describe the concept of framing.
A
Framing refers to whether a message emphasises the benefits or losses of that behaviour.
Loss-framed messages useful when we want people to take up behaviours,
Gain-framed messages useful when we want people to adopt prevention behaviours.
5
Q
Define stereotype, prejudice and discrimination.
A
Stereotype = generalisations made about a group of people or members of that group. Prejudice = to judge, often negatively, without having relevant facts Discrimination = behaviours which follow from negative evaluations or attitudes.
6
Q
What is social loafing?
A
The tendency for people to expend less individual effort when working in a group than when working alone.
7
Q
When is social loafing more likely to occur?
A
More likely to occur in all-male groups, when people believe performance is not monitored, the task has little value or when people expect other members will display high effort.
8
Q
What factors affect conformity?
A
Group size (conformity increases up to 5 people, then plateaus).
Presence of a dissenter - one person disagreeing greatly reduces conformity.
Culture - conformity is greater in collectivistic cultures.
9
Q
Give the 5-step bystander decision process
A
Notice the event
Decide whether it is truly an emergency (social comparison - look to others).
Assuming responsibility to intervene (diffusion of responsibility - someone else will help)
Self-efficacy in dealing with the situation.
Decision to help (cost-benefit analysis).
10
Q
Milgram’s study look at the obedience of a subject in delivering electric shocks. What factors affect obedience?
A
Remoteness of the victim
Closeness and legitimacy of the authority figure.
Diffusion of responsibility (obedience increases when someone else administers the shock)
NOT personal characteristics.
11
Q
What is groupthink?
A
The tendency of group members to suspend critical thinking because they are striving to seek agreement.
12
Q
What factors increase groupthink?
A
More likely when the group is under stress to reach a decision, the group is insulated from outside input, the group has a decisive leader or the group has high cohesiveness.
13
Q
What is group polarisation?
A
The tendency of people to make decisions that are more extreme when they are in a group.
14
Q
What are the advantages and disadvantages of an autocratic leadership style?
A
Quick decisions can be made, and there is a clear hierarchy.
However, this leadership style can be demotivating and can lead to errors.
15
Q
What are the advantages and disadvantages of a democratic leadership style?
A
Wins cooperation and motivation. Improves quality.
It is, however, time-consuming and leads to disagreements.
16
Q
What are the advantages and disadvantages of a laissez-faire leadership style?
A
Allows autonomous working and expertise to be utilised
However, there is lack of direction and lack of an ultimate responsibility holder.
17
Q
Define (medical) error.
A
The failure of a planned action to be completed as intended (error of execution) or the use of a wrong plan to achieve an aim (error of planning).
18
Q
What are heuristics?
A
“Rules of thumb”, “educated guesses”, “mental shortcuts” - usually rely on pattern recognition and a subconscious integration of patient data with prior experience.
19
Q
Describe the 3 types of heuristics.
A
Anchoring: fixating too heavily on an initial piece of information leading to difficulty moving away from an idea - may lead to dismissal or excuses being made for conflicting information. Availability: a mental shortcut that relies on immediate examples that come to one's mind. Representativeness: 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).
20
Q
Describe Kahneman’s 2 systems for decision-making.
A
“Hot system (system 1) and cold system (system 2).
System 1 = emotional, “go”, simple, reflexive, fast.
System 2 = cognitive, “know”, complex, reflective, slow.
21
Q
What is confirmation bias?
A
The tendency to search for, seek, interpret and recall information in a way that confirms one’s preexisting beliefs of hypotheses, often leading to errors.
22
Q
What is the sunk cost fallacy?
A
The more time/ resources already invested the more we are prepared to invest in a problem in the future.
Rationally, the only factor affecting future action should be the future cost/benefits ratio.
23
Q
How can decision-making be improved?
A
Education and training, feedback (more autopsies), accountability, generating alternatives and consultation (seeking second opinions).
24
Q
What is an algorithm and when is it most useful?
A
A procedure which, if followed exactly, will provide the most likely answer based on the evidence.
Most useful in situations where the problem is well-defined, excluding many everyday situations.
25
Define learning.
A process by which experience produces a relatively enduring change in an organism's behaviours or capabilities.
26
Describe non-associative learning.
Response to repeated stimuli.
Habituation is a decrease in the strength of a response to a repeated stimulus.
Sensitisation is an increase in the strength of a response to a repeated stimulus.
27
Describe classical conditioning.
Unconditioned stimulus (UCS): A stimulus that elicits a reflexive or innate response (UCR) without prior learning.
Unconditioned response (UCR) - a reflexive or innate response that is elicited by a stimulus (UCS) without prior learning.
Conditioned stimulus: a stimulus that, through association with a UCS, comes to elicit a conditioned response similar to the original UCR.
Conditioned response - a response elicited by a conditioned stimulus.
28
When is classical conditioning strongest?
When there are repeated CS-UCS pairings, the UCS is more intense, the time interval between CS and UCS is short and the sequence involves forward pairing (CS--> UCS).
29
How does Pavlov's dogs highlight classical conditioning?
The dogs began to salivate in response to a tone which they associated with meal time (CS)- not the food itself (UCS).
30
What is meant by "extinction of the conditioned response"?
Once pairings are dropped, response quickly drops.
31
What is stimulus generalisation?
A tendency to respond to stimuli which are similar (but not identical) to a conditioned stimulus. Similar CR - but a weaked form.
32
Give an example of classical conditioning with chemotherapy patients.
```
Chemotherapy (UCS) leads to nausea (UCR)
Related cues (e.g. sight of the chemo unit) (CS) lead to anticipatory nausea (CR).
```
33
What is Thorndike's Law of Effect?
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 occur.
34
What is operant conditioning?
Operant conditioning is based on Thorndike's Law of Effect and involves behaviour being learnt and maintained by its consequences.
35
What is positive reinforcement? Define primary and secondary reinforcers.
Occurs when a response is strengthened by subsequent presentation of a reinforcer.
Primary reinforcers are those needed for survival, e.g. food, water, sleep, sex.
Secondary reinforcers are stimuli that acquire reinforcing properties though association with primary reinforcers e.g. money, praise.
36
What is negative reinforcement?
Occurs when a response is strengthened by the removal of an aversive stimulus (painkillers relieve pain).
37
Contrast positive and negative punishment.
Positive punishment = presentation (e.g. squirt a cat with water).
Negative punishment = removal (e.g. phone confiscated).
38
Which is a more potent behavioural influence, punishment or reinforcement?
Reinforcement is a more potent influence than punishment. Punishment can't teach new behaviour.
Continuous reinforcement produces more rapid learning than partial reinforcement. However, continuously reinforced responses extinguish rapidly.
39
Describe how operant conditioning can affect back pain.
Limping, grimacing and medication requests reinforced by being overly sympathetic, enocuring rest, increasing medication. This behaviour, itself, is reinforced by gratitude signals from the patient.
A cycle is created in which the patient receives positive consequences, so back pain frequency increases.
40
What is observational (vicarious) learning and reinforcement?
We observe others' behaviour and the consequences of those behaviours.
Vicarious reinforcement is where if their behaviour is reinforced, we tend to imitate it.
41
According to social learning theory, whose behaviour are we more likely to model?
Someone who is seen to be rewarded, has high status, is similar to us (e.g. colleagues) and/or is friendly.
42
Define health behaviour.
Any activity undertaken by an individual believing himself to be healthy, for the purpose of preventing disease or detecting it at an asymptomatic stage.
43
Describe the transtheoretical model of behaviour change.
Precontemplation (outside cycle) leads to contemplation, progressing to preparation and then action. Maintenance is required, which may lead to a permanent exit (leaves cycle) or relapse. After a relapse, the person contemplates the behaviour change again, and the cycle continues.
44
Explain how reinforcement and punishment may lead to unhealthy diets.
Reinforcement for producing a high-fat meal --> (+ve) dopamine release, praise from family, (-ve) avoid painful emotions by comfort eating.
Punishment e.g. criticism from family for preparing a low-fat meal.
Also, limited/delayed positive reinforcement for healthy eating (efforts at dietary change/ weight go unnoticed by others, avoiding future health problems is too remote).
45
Give limitations of reinforcement programmes.
Lack of generalisation, poor maintenance, impracticality, expense.
46
Describe the role of fear in behaviour change.
Low fear arousal most effective to engage change in behaviour: high fear arousal causes people to "switch off".
47
Describe the health belief model.
Action influenced by susceptibility, seriousness, benefits (motivation), perceived costs/ barriers and cues.
48
Define self efficacy. What factors affect self efficacy?
A personal judgment of how well one can execute courses of action required to deal with prospective situations.
Sources include mastery experience, social learning, verbal persuasion or encouragement and physiological arousal.
49
Define compliance.
The extent to which patients follow doctors' prescriptions about taking medications (most paternalistics).
50
Define adherence.
Refers to the extent to which patients follow through decisions about medicine taking.
It is a wide spectrum of behaviour ranging from under-adherence to over-adherence.
51
Define concordance.
Refers to the extent to which patients are successfully supported both in decision-making partnerships about medicines and their medicine taking.
Most patient-centred.
52
What is unintentional non-adherence?
Where non-adherence is due to patient ability or resources (practical barriers) such as information and finances,
53
What is intentional non-adherence?
Where non-adherence is due to patient beliefs and motivations (perceptual barriers).
N.B. there is overlap with unintentional non-adherence.
54
Describe the COM-B model of behaviour.
The performance of a behaviour is caused by the interaction between capability (physical and psychological), opportunity and motivation.
N.B. B stands for behaviour.
55
Explain how treatment beliefs affect patient adherence.
Doubts about necessity + concerns about potential side effects (necessity + concerns) lead to low adherence.
56
Non-adherence is often a hidden problem, undisclosed by patients and unrecognised by providers. How can we measure non-adherence?
Directly: directly observed therapy, measurement of level of medicine/metabolite in the blood.
Indirectly: patient questionnaire, self-report, pill counts rate of prescription refills, electronic medication monitors, patient diaries.
57
How can we improve non-adherence?
Interventions: improve understanding, help to plan and organise medication taking.
Consultation: check understanding (provide clear rationale for the necessity of treatment, elicit and address concerns, identify possible barriers, agree practical plans).
58
What is a behaviour change technique (BCT)?
A systematic strategy used in an attempt to change behaviour.
E.g. giving information on consequences, prompting specific goal setting, prompting barrier identification, modelling the behaviour, planning social support.
59
Describe self-monitoring as a BCT.
Shown to be effective (but most effective BCT is based on health behaviour you wish to target).
An individual keeps a record of target behaviours. Additional information recorded can help to identify barriers (e.g. mood, weather).
Time-consuming over the long term.
Role in increasing physical activity and healthy eating well-studied.
60
Describe motivational interviewing as a BCT.
A person-centred counselling style for addressing the common problem of ambivalence about change.
Clinician embodies "motivational interviewer spirit" - non-judgemental, non-lecturing.
Recognise change in talk/emotion, stage of change (readiness), co-operation, engagement or disclosure, resistance to change, self-confidence.
61
Describe implementation intentions (action plans).
Request an individual to think about critical situations to act and appropriate responses within these situations.
"IF - THEN"
By planning in advance the situation in which an individual will act, cues become particularly available.
Strengthens connection between good situation to act and a suitable action.
62
Describe the positives and negatives of using incentives as a BCT.
Cost-effective, raises awareness, brings individuals into contact with health services allowing earlier screening and treatment of illness. Can be effective in changing behaviours - preventing disease - reducing costs associated with disease.
Limits: lack of generalisation, poor maintenance (rapid extinction), impractical and expensive.
63
Define sensation
The stimulus detection system by which our sense organs respond to and translate environmental stimuli into nerve impulses that are sent to the brain.
64
Define perception
The active process of organising the stimulus output and giving it meaning.
65
Describe bottom-up and top-down processing.
Top-down = processing in light of existing knowledge (context).
Bottom-up = individual elements are combined to make a unified perception
These processes work together for the best interpretation of the stimulus.
66
What factors affect perception?
Environment, attention, past experiences, current drive state, emotions, expectations, cultural background.
67
Describe the Gestalt Laws.
Figure ground relations - our tendency to organise stimuli into central/foreground and a background.
Similarity: similar things are perceived as being grouped together.
Proximity: objects near each other grouped together.
Closure: things grouped together if they seem to complete some entity.
68
Describe visual agnosia.
Associated with bilateral lesions to the occipital lobes.
Basic vision spared. Primary visual cortex mostly intact. Knowledgeable about information from other senses (touch an object).
69
Describe aperceptive agnosia
Failure to integrate the perceptual elements of the stimulus. Individual elements perceived normally. Can't organise into a whole. Damage to lower level occipital regions.
70
Describe associative agnosia.
A failure of retrieval of semantic information. Shape, colour, texture can all be perceived normally. Can't name object. Typically sensory specific - if object touched, then recognised. Damage to higher order occipital regions.
71
Define attention
Focusing conscious awareness, providing heightened sensitivity to a limited range of experiences requiring more intensive processing. 2 processes: focusing on a certain aspect and filtering out other information.
72
Give factors which affect attention.
Intensity, novelty, movement, contrast, repetition, motives, mood, arousal, interests, threats.
73
Describe the cocktail party effect.
The idea that we can unconsciously perceive information not attended to, highlighted by our ability to focus our attention on one person's voice at a cocktail party, but retain the ability to respond if someone else mentions our name.
74
Describe the amount of attention required at different stages of learning a skill.
Cognitive state: development of mental resources. Instruction from expert.
Associative state: motor programme developed. Lack ability to perform finer subtasks fluently.
Autonomous stage: skill is largely automatic. Relies on implicit knowledge and motor co-ordination.
75
What is medical student syndrome?
Health anxiety caused by attending medical lectures. Subsequent normal body sensations are attended to and thought about more. Leads to hypervigilance of body, which may lead to catastrophic interpretation. This causes anxiety and checking behaviours.
76
Outline Kubler-Ross' stage theory of adjustment.
Denial, anger, bargaining, depression, acceptance.
77
Give limitations of Kubler-Ross' stage theory.
The stages are linear in progression, not accounting for variability in responses.
Pathologises people who don't pass through the stages.
Distress/ depression is not inevitable: acceptance might not be achieved.
Fails to consider social, environmental and cultural factors.
78
Give some loss-oriented and some restoration-oriented activities to help cope with grief, as highlighted in Stroebe and Schut's dual process of coping with bereavament.
Loss-oriented: grief work, intrusion of grief, relinquishing-continuing-relocating ties, denial/avoidance of restoration changes.
Restoration-oriented: attending to life-changes, doing new things, distraction, denial/avoidance of grief, new roles/ identities/ relationships.
79
What factors affect the duration of grief?
How attached they were to the deceased person, the circumstances of death and the situation of loss, how much time they had to work through anticipatory mourning.
85% of people will usually adjust by 2nd year of bereavement.
80
What factors can worsen chronic grief?
More likely if the death was sudden or unexpected, if the deceased was a child or there was a high level of dependency on the deceased.
81
Describe the interplay of nature and nurture in the development of babies.
Nature sets out their course via gender, genetics, temperament and maturational stages.
Nurture shapes this predetermined course via the environment, parenting, stimulation and nutrition.
Progression depends on the interplay.
82
Define temperament.
Consistent individual differences in behavior that are biologically based and are relatively independent of learning, system of values and attitudes.
83
Describe reciprocal socialisation.
The idea that infants socialise parents just as parents socialise infants: a bidirectional socialization.
E.g. baby cries, moves, grimaces, smiles, calms, looks and the parent mirrors, repeats, interprets, responds. And so on and so forth.
84
Describe a newborn's interaction with its mother.
By term, babies are able to recognise their mother as a memory of her has been built up in utero via hearing, smell and taste. Babies can hear in the womb. Babies seem primed to learn very quickly about the smells associated with their mothers (maternal breast odours etc).
Newborns particularly like the taste of glutamate, found in breast milk.
Within a few hours, newborns can recognise faces. They show preference for faces with eyes open and happy expressions.
85
Describe attachement.
The biological instinct that seeks proximity to an attachment figure when threat is perceived or discomfort is experienced. The sense of safety the child experiences provides a secure base from which they can explore their environment. Process of establishing attachment begins even before birth.
86
What is mind-mindedness?
Parents with mind-mindedness treat their children as individuals with minds - they respond as if their children's acts are meaningful, which ultimately helps them to understand others' emotions and actions.
87
What types of attachment were found in the strange situation test.
Securely-attached children (65%) - free exploration and happiness upon mother's return.
35% insecurely-attached:
Avoidant-insecure - little exploration and little emotional response to mother.
Resistant-insecure - greater distress at separation, ambivalent upon mother's return.
Disorganised-insecure - little exploration and confused response to mother. May be a risk factor for a variety of behavioural and developmental problems.
88
Summarise how attachment can influence the child in later life.
Secure attachments formed in early infancy are a protective factor leading to resilience throughout lifespan.
Insecure attachment may place the child at risk, but is not causative of, later problems.
89
Why is play important?
It has important positive effects on brain and ability to learn. Helps children to overcome fears, develop new competencies, learn to work in a group, promotes creativity and problem solving.
90
Summarise the types of play at different ages.
```
0-2 years: unoccupied and then solitary play.
2-2.5 years: onlooker/spectator.
2.5-3 years: parallel play.
3-4 years: associative play.
4-6 years: cooperative play.
6 years +: competitive play.
```
91
Describe the outline/basis of piaget's theory of cognition.
Piaget's stage model proposed that children's thinking changes qualitatively with age. as a result of the interaction between the brain's biological maturation and personal experiences. Schemas = organised pattern of thoughts and action. Development occurs as we acquire new schemas and as our existing schemas become more complex. Process of assimilation (incorporating new experiences) and accomodation (difference made by the process of assimilation) which leads to adaptation (whereby new experiences cause existing schema to change).
92
Describe the sensorimotor stage of Piaget's theory of cognition.
Birth - 2 years. Infants understand their world primarily though sensory experiences and physical (motor) interactions with objects.
Object permanence: the understanding that an object continues to exist even when it cannot be seen.
Gradually increasing use to words to represent objects, needs and actions. Learning based on trial and error (but errors are not assimilated).
93
Describe the preoperational stage of Piaget's theory of cognition.
Ages 2-7. World represented symbolically through words and mental images. No understanding of basic mental processes or rules.
Rapid language development. Understanding of the past and future. Irreversibility (can't mentally reverse actions). Animism (attributing lifelike qualities to physical objects and natural events). Egocentrism: difficulty viewing the world from someone else's perspective.
No understanding of principle of conservation (basic properties of objects stay the same though their outward appearance may change.
94
Describe the concrete operational stage of Piaget's theory of cognition.
Ages 7-12. Children can perform basic mental operations concerning problems that involve tangible (concrete) objects and simulations.
Understand the concept of reversibility, display less egocentrism, easily solve conservation problems, trouble with hypothetical and abstract reasoning.
95
Describe the adolescent stage of Piaget's theory of cognition.
Transition to formal operational stage where abstract though emerges. Begins to think about moral, philosophical, ethical, social and political issues.
Adolescence involves cognitive development and physical growth, as distinct from puberty, which can extend into the early twenties. Chronological age only provides a rough marker of adolescence. Begin to use deductive logic.
Thrill seeking, openness to new experiences, risk taking, social rewards are very strong. Prefer own age company.
Storms and stress more likely. Emotionally become less positive through early adolescence.
96
Why do adolescents require more sleep?
Since from ages 12-25 the brain extensively remodels (myelination, synaptic pruning).
97
Give limits/ criticisms of piaget's theory of cognition.
Some argue whether children respond as they do to please the adult asking the question.
Some argue the repeating question is so weird (as the answer is so obvious) the child thinks the adult wants or expects you to change the original answer.
98
Describe the concepts of death held by children of different ages.
Under 5s: do not understand that death is final, universal, will take euphemisms concretely, may think that they have caused death.
5-10 years: gradually develop idea that death is irreversible, all functions ended, universal/ unavoidable.
More empathetic to another's loss, may be preoccupied with justice.
10 years - adolescence: long-term consequences awareness, ability to think hypothetically and to draw parallels.
99
Describe the stages of memory.
Registration (input from senses), encoding (processing and combining of info), storage (holding that input in memory systems), retrieval (recovering stored info).
100
Give the types of long-term memory.
Declarative: episodic and semantic (knowledge).
| Non-declarative: procedural (bike), priming, conditioning, non-associative learning.
101
Give brain structures which relate to each type of long-term memory.
Episodic and semantic (declarative memory) = medial temporal lobe and diencephalon.
Procedural = striatum.
Priming = neocortex.
Conditioning: emotional = amygdala, skeletal = cerebellum
102
Which hemisphere is mainly concerned with verbal information processing?
Left hemisphere.
103
Describe the serial position effect.
In a list of words, there is a primacy and recency effect (the first and last words are more likely to be recalled).
104
What is the probability of recalling a word related to?
Order in the list, personal salience of words, number of words, chunking or other encoding strategy, delay time and distraction.
105
How can we improve patient's likelihood to remember important information from a consultation?
Give important info at beginning and end of consultation.
Emphasise and repeat important info.
Make salient to the person.
Chunk information into meaningful categories.
Avoid overloading with information.
106
Give an example of a retrieval technique.
Mnenomics.
107
Define phoneme, morpheme and syntax.
```
Phoneme = smallest unit of speech sound in a language that can signal a difference in meaning.
Morpheme = smallest units of meaning in a language - typically one syllable.
Syntax = rules and principles which govern the way morphemes and words can be combined to communicate meaning in a particular language.
```
108
What is the critical period in language acquisition?
Ease of learning dramatically decreases after 5 years old.
109
Describe Broca's (expressive) aphasia.
Non-fluent speech, impaired repetition, poor ability to produce syntactically correct sentences, intact comprehension.
110
Describe Wernicke's (receptive) aphasia.
Problems in comprehending speech. Fluent, meaningless speech. Paraphasias - errors in producing specific words.
Semantic paraphasias: substituting words with similar meaning.
Phonemic paraphasias: substituting words with similar sounds.
Neologisms: non-words.
111
Describe the language circuit.
Info about sound analysed by primary auditory cortex, transmitted to Wernicke's area.
Wernicke's area analyses sound info - determines what was said.
Transmitted through arcuate fasciculus to Broca's area.
Broca's area forms a motor plan to repeat the word and sends it to motor cortex.
Motor cortex implements the plan.
112
Describe a lesion of the arcuate fasciculus.
Disrupts transfer from Wernicke's area to Broca's area. Patient has difficulty repeating spoken words - but retains comprehension of spoken language and can still speak spontaneously.
113
Describe dysexecutive syndrome.
Disruption of executive function, closely related to frontal lobe damage.
Executive function skills allow us to plan, focus, remember instructions and juggle multiple tasks.
Encompasses cognitive, emotional and behavioural symptoms.
114
What behaviour and emotion symptoms are associated with dysexecutive syndrome?
Can be hypoactive, lack of drive, apathy, poor initiation, emotional bluntness.
Could be hyperactive, impulsive, disinhibited, perseverative, emotionally dysregulated.
115
What cognitive symptoms are associated with dysexecutive syndrome?
Difficulty coping with novel situations and uninstructed tasks, difficulty switching from task to task, difficulty with complex/ abstract thinking.
116
What does a deficit in the orbitofrontal lobe lead to?
Impulsivity, disinhibition
117
What does a deficit in the medial frontal lobe cause?
Loss of spontaneity, loss of initiation (akinetic mutism).
118
What does a deficit in the lateral frontal lobe cause?
Inability to formulate/carry out plans.
119
Define impairment, disability and handicap.
Impairment refers to a problem with a structure or organ of the body.
Disability is a functional limitation with regard to a particular activity.
Handicap refers to a disadvantage in fulfilling a role in life relative to a peer group - as a result of impairment or disability.
120
Explain the role and basis of illness perceptions questionnaires.
Correct any unhelpful misconceptions regarding illness representations that patients may have.
Illness representations are a patient's own implicit, common-sense beliefs about their illness, including identity, cause, consequences, timeline and cure/control.
121
Define coping.
Cognitive and behavioural efforts to master, reduce or tolerate external and internal demands and conflicts.
122
Describe problem-focussed coping.
Efforts directed at changing the environment in some way/ changing one's actions or attitudes.
123
Describe emotion-focussed coping.
Efforts designed to manage stress-related emotional responses in order to maintain one's own morale and allow one to function.
124
Give the transactional definition of stress.
Stress is a condition that results when the person/environment transactions lead the individual to perceive a discrepancy between the demands of the situation and coping resources available.
125
Describe the dual process hypothesis.
Procedural (info about procedures to be undertaken) and sensory (information about sensations which may be experienced) information are helpful because they work in different ways.
Procedural info works by allowing patients to match ongoing events with their expectations in a non-emotional process.
Sensory info works by "mapping" a non-threatening interpretation onto these expectations.
126
Describe the results of Auerbach's 1983 experiment into how much information is enough.
Patients who indicated they would like detailed information and were subsequently given general information were more distressed than those who previously said they desire general information. And vice versa.
It is, therefore, important to gauge how much information and involvement they would like.
127
Describe the results of Langer and Rodin's 1976 nursing home study.
Residents on floor 1, given more responsibilities (get to rearrange their room, choose and water a plant, choose the film for movie night) showed greater engagement in activities and self-reports and nurse accounts showed better psychological and physical well being than floor 2 residents. Also, after 18 months, 15% of floor 1 had died compared to 30% of floor 2.
128
Describe the relationship between levels of perceived control and distress.
The higher the perceived control (E.g. if given a device to signal discomfort/pain in a dental exam or given a buzzer to halt an MRI) show less distress.
129
Give ways we can help children to cope.
Give combined prep info 1 week before in older children (7+) or one the day for younger children.
Modelling information (e.g. a film)
Distraction is the most effective coping strategy for younger children (with age, problem-solving increases and avoidant coping declines).
Show-Do-Tell (tell in simple language, with comparisons as needed; show on an inanimate object, then do once the child understands what will be done).
Remove parents: children's distress correlated with distress shown by parents.
130
Define personality traits.
Relatively stable cognitive, emotional and behavioural characteristics of people that help to establish individual identities and distinguish them from others.
A trait is a continuum along which individuals vary.
131
Describe the 5 factor model of personality.
5 big factors of personality, "supertraits" thought to describe them main dimensions of personality - "OCEAN":
Neuroticism (emotional instability), extraversion, openness to experience, agreeableness and conscientiousness.
132
Describe how conscientiousness and neuroticism related to health.
Conscientiousness associated with longevity: less likely to engage in harmful behaviours and more likely to engage in healthy behaviours. Higher medical engagement and adherence.
Neuroticism associated with increased reporting of somatic symptoms, e.g. pain. Higher rates of MHDs. Higher mortality rates (e.g CHD). Higher rates of healthcare usage, less adherence to healthy behaviours, higher rate of health harming behaviours.
133
Define intelligence.
The ability to acquire knowledge, to think and reason effectively and to deal adaptively with the environment.
134
Define IQ.
(Mental age/ chronological age) *100
| Performance in the test is relative to performance of others of the same age. A score of 100 is considered average.
135
Give some criticisms of IQ.
Averages components of cognitive abilities to give an overall score (relevant e.g. for stroke patients where specific cognitive functions might be affected).
Culturally biased? Since differences between groups due to environment.
136
Describe crystallised intelligence and fluid intelligence.
Cattell and horn broke down Spearman's generic factor 'g' of intelligence into these 2 components.
Crystallised intelligence, gc, is the ability to apply previously acquire knowledge to current problems. Commonly improves with age then stabilises.
Fluid intelligence, gf, is the ability to deal with novel problem-solving situations for which personal experience doesn't provide a solution. Shows a steady pattern of decline in aging.
137
Describe sex differences in intelligence.
Differences prevail in certain intellectual tasks, not general intelligence.
Men generally outperform women on spatial tasks, tests of target-directed skills and mathematical reasoning.
Women outperform men on tests of perceptual speed, verbal fluency, mathematical calculation and precise manual tasks.
138
Describe Baron Cohen's empathising/systemising theory.
Explains social and communication difficulties in high functioning autism by delays or deficits in empathising whilst explaining the narrow interests with reference to skills in systemising.
139
What is systemising?
The drive to analyse or construct any kind of system i.e. identifying the rules that govern a system in order to predict how it will behave.
140
Define empathising.
The ability to infer the thoughts and feelings of others and to have an appropriate emotional response.
141
Describe the concept of neurosexism.
Environment and culture produce gender differences: by providing a framework for treating adults and children differently on the basis of gender, causing them to behave differently, so-called gender differences are created.
142
What are the 5 brain types suggested by Baron-Cohen?
E-type: empathy stronger than systemising - "female brain"
S-type: systemising stronger than empathy - "male brain"
B-type: both systemising and empathising are equal
Extreme E-type
Extreme S-type - systemising very strong, empathising very weak - "autistic brain"
143
Describe Seyle's general adaptation syndrome.
A physiological response pattern to strong and prolonged stressors.
Initially, the alarm reaction - shift to sympathetic domination.
Then resistance stage - stress hormones maintain arousal, peak resistance to stress occurs in this stage.
Exhaustion stage - adrenal glands lose ability to function normally.
144
Give the transactional definition of stress
Stress is a condition that results when the person/environment lead the individual to perceive a discrepancy between the demands of the situation and coping resources available.
Primary appraisal - is there a threat?
Secondary appraisal - do you have the resources to cope with the perceived threat? If yes, POSITIVE stress, if not NEGATIVE threat.
145
Give the 5 myths of coping with loss
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Distress or depression is inevitable
Distress is necessary (failure to be distressed is pathological)
Importance of "working through" loss
Expectations of recovery
Reaching a state of resolution
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146
How does stress lead to disease?
Events --> stress --> behavioural changes + physiological changes --> disease
147
Why might anxiety management be a target for future CVD reduction?
Anxiety is associated with a 52% increased risk of developing CVD, independent of traditional factors and depression.
148
Describe Type A behaviour.
Time urgency, free-floating hostility, hyper-aggressiveness, focus on accomplishment, competitive and goal driven.
Type A behaviour pattern significantly increases the risk of CHD, independent of other risk factors.
Central role of hostility as key type A behaviour problem.
149
What is thought to explain the association between type D behaviour, characterised by social inhibition and negative affect, and CHD?
Under-reporting of symptoms
150
Contrast coping by avoidance with approach
Approach = activity that is oriented towards a threat (e.g. problem solving, planning a response). May want to discuss illness and treatment in detail.
Avoidance = activity that is oriented away from a threat (e.g. denial, distraction). May find it difficult to engage in discussions around illness and treatment.
151
How does social support relate to health?
Individuals with adequate social relationships have a 50% greater likelihood of survival compared to those with poor or insufficient social relationships.
Social relationships exert an independent effect beyond protective and psychological role.
Effect comparable with quitting smoking and it exceed many well-known risk factors for mortality.
152
Define the placebo effect.
Phenomenon in which a placebo (inactive substance) can improve a patient's condition through the expectation that it will help.
N.B. a placebo without deception still confers significant improvements.
153
Define the nocebo effect.
A negative effect that occurs after receiving treatment, even when the treatment is inert. Warnings about the possible side effects make it more likely a patient will experience these effects.
154
What are the clinical implications of the placebo effect?
The effect of many interventions can be increased by the way they are presented, both in form and manner.
Particularly helpful for conditions with psychological components. Placebos are free of negative side effects.
Dose-extending placebos: keeping the size of the tablet the same but halving the dose - reduces dependence and/or side effects.
155
Define panic attack and agoraphobia.
Panic attack: a discrete period in which there is a sudden onset of intense apprehension, fearfulness or terror, often associated with feelings of impending doom.
Symptoms such as S.O.B., palpitations, chest pain/ discomfort, choking or smothering sensations and fear of going crazy or losing control.
Agoraphobia is a complication of panic attacks where the fear of having an attack in an inescapable setting/ embarrassing setting leads sufferers to avoid public/ unfamiliar places.
156
Describe the 3 major schools of the psychological model - especially behavioural approaches.
Psychodynamic: address inner conflict between ego, superego and identity.
Behavioural: maladaptive behaviours are not merely symptoms of underlying problems, but are the problems themselves. Phobia development is learnt (through classic conditioning and negative reinforcement). EXPOSURE to the fear (CS) in the absence of the UCS leads to desensitization. highly effective for reducing anxiety responses.
Cognitive therapy: the appraisal is the problem (not stimulus--> response but stimulus --> cognition (where the appraisal occurs) --> response.
157
Give some examples of CBTs.
Psychoeducation, relaxation techniques, cognitive restructuring, behavioural experiments (building-up tolerance), graded exposure, relapse prevention.
Focus on problematic beliefs and behaviours which maintain disorders (focus on the 'here and now' rather than the original causes).
158
Define depression
Almost daily pervasive depressed mood or diminished interest in activities lasting at least 2 weeks.
Other symptoms: difficulty concentrating, feelings of worthlessness, excessive or inappropriate guilt, hopelessness, death and suicidal thoughts, changes in appetite or sleep, fatigue, restlessness.
159
What is the best treatment for depression and what 2 questions should you ask to people who may have depression? When should antidepressants be used?
CBT
Only consider antidepressants when moderate or severe OR subthreshold depressive symptoms present for a long time or subthreshold/ mild depression persists after other interventions.
During the last month, have you often been bothered by feeling down, depressed or hopeless?
During the last month, have you often been bothered by having little interest or pleasure in doing things?
160
Describe mindfulness-based cognitive therapy.
Delivered to people who are currently well - to prevent relapse.
Recognising thoughts as just thoughts, that happen and are just there (CBT tries to challenge these thoughts).
161
Describe the schedules of reinforcement.
Fixed ratio - reinforcement depends on a definite number of responses - activity slows after reinforcement, then picks up
Variable ratio - number of responses needed for reinforcement varies (e.g. slot machines) - leads to greatest activity of all schedules.
Fixed interval - activity increases as deadline nears (As you draw nearer to reinforcement event)
Variable interval - steady activity results.
