Psychology Stuff

Question 1

Assumptions of the biomedical model

Answer 1

• Treats the mind and body separately: mind/body dualism (being mentally ill can have a direct impact on the physical health, which is not considered in this model)
  
  • Body can be repaired: mechanical metaphor (as much as it took in the biological aspects, sometimes other factors can be overlooked in this model)
  • Prioritises technological responses (although you can pinpoint what disease it is, can miss out on the holistic approach)
  • Focuses on the biological: reductionist at the expense of other expenses

Question 2

why do we need the biopsychosocial model

Answer 2

• Not simply the result of biochemical factors
• Influences by work, stress, environment, poverty, etc
• Therefore, we need to consider the role of a person’s mind and wider societal factors.
• We need to acknowledge that the choice to engage in the curative and preventive activity is very much dependent on people’s beliefs
We need to consider how social factors may influence access to medical care and the disease profile.

Question 3

strengths of biopsychosocial model

Answer 3

• It sets the patient in their wider social, cultural and economic context- holistic
• It affords empathetic practice, and a toolkit for improving communication
• It enables patient-centred care and practitioner reflexivity.
It enables medical practitioners to tailor their approach and advice.

Question 4

Limitations of the biopsychological model

Answer 4

• Can places responsibility for health on individuals.
• Might be regarded as being scientifically feeble
• Qualitative mythology- dominant in biopsychosocial research- sometimes regarded as inferior to quantitative mythology
The incorporation of biopsychosocial medicine topics into the curriculum vary across clinical conditions (e.g., low for renal medicine, high for cardiovascular disease).

Question 5

placebo effect

Answer 5

Placebo effect is measurable, observable, or felt improvement in health not attributable to treatment.

Question 6

nocebo effect

Answer 6

Occurs when inert substance produces symptoms congruent with anticipated harm.

Question 7

Epigenetics

Answer 7

the percent your genes are expressed which can serve as a bridge between the social sciences and the biological sciences, allowing a truly integrated approach to human health.

Question 8

Neuroplasticity

Answer 8

Similar paradigmatic shift in the brain sciences as in genetics. Brain Sciences are not deterministic- can instead talk about ‘neuroplasticity’. Brains can be re-organised or ‘rewired’- new connections can form, old ones can be rewired.

Question 9

Classical conditioning

Answer 9

Stimulus and reflex (salivation, muscle responses, perspiration, affect)- involuntary

Question 10

Unconditioned stimulus

Answer 10

Something which can initiate a reflexive response (no learning required, e..g, heat-perspiration, eating food- salivation)

Question 11

Unconditioned response

Answer 11

A reflex which is (as yet) unpaired (perspiring, crying salivating)

Question 12

Conditioned stimulus

Answer 12

a stimulus that becomes associated with an involuntary response which would not (usually) initiate that reflex

Question 13

Conditioned response

Answer 13

a response contingent on a stimulus within the environment

Question 14

Operant conditioning

Answer 14

Voluntary. Through operant conditioning, an association is made between a behavior and a consequence (whether negative or positive) for that behavior.

Question 15

Reinforcement

Answer 15

Behaviours can be associated with reinforcers which promote a behaviour (i.e., make if more likely to happen)

Question 16

Positive reinforcement:

Answer 16

Child comes to hospital for injection and is anxious (never has an injection before). They are told they will receive a sticker (already positive reinforcement).

Question 17

Negative reinforcement:

Answer 17

Adult experiences excruciating back pain when they bend over. Take paracetamol but has little effect (very unlikely to have effect as reinforcer of taking paracetamol for pain).

Question 18

Influences on imitation and observation:

Answer 18

• Status: Crossing against red light, Others most likely to follow ‘respectable’ model.
• Trustworthiness: Children more likely to imitate adults who had previously been more reliable and trustworthy
• Power: Children more likely imitate adult who they believed would be teacher.
Similarity: Over-imitation in children who perceive other’s to be in the same in-group. Influence of doctors, parents, etc., as role models
Similarity: Over-imitation in children who perceive other’s to be in the same in-group. Influence of doctors, parents, etc., as role models.

Question 19

Types of Memory:

Answer 19

• Sensory: e.g., visual memory after images
  
  • Short-term memory (STM): remembering a telephone number for the time it takes to dial it (remembering it only to use for a task)
  • Long-term memory (LTM): remembering your own telephone number

Question 20

Short-term memory

Answer 20

Short-term memory = Working memory
• Active neural nodes and process
• Limited capacity of 7(+ or - 2) items
• Attention is crucial

Question 21

Long-term memory

Answer 21

Depends on the formation of associations between nodes when they have been activated in working memory.
• Can be split into declarative memory (recollection of facts) and non-declarative memory (relates to skills that you have picked up, i.e., driving = becomes implicit and you struggle to consciously declare the processes)

Storage: • Interference
• To reduce interference, effort must be made to establish clear links to/from new material (there can be confusion between the old info and new info and important to establish those link to redefine the path)

Question 22

Three stages to memory:

Answer 22

• Encoding: getting information in
  
  • Storage: keeping the information
  • Retrieval: getting the information out when needed.

Question 23

Encoding

Answer 23

• Rehearsal and level of processing.
  
  • Level of processing thought to be key (e..g, thinking of meaning behind facts/information, more important than repeating facts)

Question 24

Storage

Answer 24

• Primary- Recency effect ( we remember things at the top and bottom of a list, but not in the middle. See graph)
□
• Early- no competition (for e.g., if I say bike, you remember bike, when you add more words to it, it provides as competition, like a conveyer belt. So new word pushes off the old world, unless there is a rehearsal)
• Most recent- not yet replaced

Question 25

Retrieval:

Answer 25

A key influence of memories is their organisation when they are stored.
Retrieval cues- similarity of contextual cues during coding and retrieval, includes mood, etc.,
Cue overload- the number of different memories associated with a retrieval cue, e.g., what were you doing at a specific time- hard to think about a specific date and the range of things we do on the specific date.

Question 26

Emotions- memory and learning.

Answer 26

Memory is an active process best learning occurs when there is an optimal arousal few distractions- related to attention.
At low arousal
• We take in less detail, but have a more broad focus
At high arousal
• We take in more detail, but within a narrow range.
• “Flashlight” analogy
Negative emotions narrow range of attention.
Implication for patient- practitioner communications.

Question 27

Flashbulb memories:

Answer 27

• FBMs triggered by surprise and consequentially
• Special memories
• Highly surprising, impact, sometimes traumatic events
• Rehearsal important for maintenance and elaboration
• Flashbulb memories can be vivid and there is high perceived confidence in accuracy (rather than actual accuracy)
Why are FBMs relevant in medical contexts?
• Patients might receive surprising diagnoses
• Practitioners might be put in surprising/emotional situations

Question 28

Implications for concordance:

Answer 28

Giving information does not necessarily change in behaviour
• Patients immediately forget about 50% of what they are told by their doctor (Kessler, 2003)
Information provided to patients may not be remembered if
• It is not attended to
• It is not understood
• Too much information is given
It is not ‘encoded’ through repetition, rehearsal or sufficient processing.

Question 29

Attention:

Answer 29

Attention is important for encoding- avoid distractions
Ask patients to say in their own words what they have been told, and to correct any inaccuracies (increases level of processing) Be aware of emotions/arousal- can attention and perception.

Question 30

Improving encoding and retrieval:

Answer 30

Use patient-friendly records of important information (Watson & Mc Kinstry, 2009)
• Print
• Audio
• Video
Multiple, complementary, formats can be of benefit.
Images relevant to written or verbal information can improve attention to, and recall of, health information (Houts et al., 2006)

Question 31

Sociological perspective on normal

Answer 31

• Sociology teaches us what stands as normal is not simply an expression of a statistical norm.
  
  • What is healthy and what is normal are shaped by historical, social and cultural influences.
  • Sociological research establishes that health cannot be regarded simply as an objective measure, rather it carried subjective meaning, albeit underscored by social factors such as age and stage of the life course, class, gender, disability and ethnicity.

Question 32

A social norm vs statistical normal

Answer 32

• a social norm: an expected form of behaviour

- a statistical norm- a frequency, that relied on the idea of of normal distribution

Question 33

three stages of pregnancy

Answer 33

1. Separation – the person leaves the old ways of being, takes on a new role, is seen differently by society. In pregnancy will visualise herself as a mother, through pregnancy and through birth
   • 2. Limen – betwixt the two of who she is, to who she is becoming
   • 3. Aggregation – recognised by society in her new role. Mother & child emerge together

Question 34

Cultural contexts affecting birth patterns

Answer 34

Global health inequality, poverty, and gender oppression continue to overwhelm those most vulnerable throughout the world, in particular; women and girls who live in developing and low resource countries including sub-Sahara, Africa, Asia and
India (sSAAI).
• In some parts of Africa 1:100 die in childbirth (The
Maternal & New-born Health Thematic Fund 2018).
• In 2015 maternal deaths in these countries according to WHO (2015) accounted for over one third of global maternal deaths

Question 35

Hormonal events of puberty:

Answer 35

• Gondarche: biological process beginning with activation of the hypothalamic-pituitary-gonadal axis and ending with the attainment of reproductive competence.
• Adrenarche: activation of the hypothalamic-pituitary-adrenal axis, often begins earlier than gonadarche.
Activation of the growth axis: resulting in a linear growth spurt at around age 12 in girls, and age 14 in boys, as well as changes in body size and composition.