Symptom Perception Flashcards
What are symptoms?
any variation in a physiological or emotional state that is interpreted as unusual or harmful.
What is the biomedical model?
Biomedical model: assumes a one-to-one ratio between physiological change and symptom reports.
Why is there sometimes a discrepancy between symptom reports?
Symptom reports do not correlate with objective tests or markers (Pennebaker, 1984).
Psychological factors can account for the nonlinear relationship.
What influences our symptom perception?
Attention
* The degree of attention we pay to our internal bodily states influences our symptom perception.
* We have to process multiple external and internal sensory inputs. Our attentional capacity is limited (e.g. sensory store).
Competition of cues - recognising changes in our internal states relative to competing cues in our environment.
Emotions
Consistant Relationship of negative emotions and symptom reporting, Negative Emotions include:
* Depression
* Anxiety
* Negative affect (distress)
Also
When feel threatened/anxious we are alerted to threats to our health (hypervigilant)
How is attention capacity a factor in reporting symptoms?
Unstimulating environments= less competition placed on our limited attentional capacity = more likely to detect changes in our internal states.
- Unemployed report more symptoms than employed (Pennebaker, 2012).
- People living alone report more symptoms than those cohabitating (Pennebaker, 2012).
- Music as a distraction in exercise (Silva 2016)
What are schemas and how are they influenced?
What are schemas about?
Schemas are structures in our long-term memory that allow us to store information into meaningful categories.
Schemas are influenced by past learning and new assimilated knowledge.
People will have sets of beliefs, or schemas, about:
- which illnesses they are vulnerable to
- which symptoms indicate potential illness
- which illnesses compromise a threat to their overall health
How are illness Schemas developed?
The development of illness schemas (Leventhal, 1980):
* Prior illness experience
* Interactions with peers & media
* Interactions with medical professionals
What are the five domains of illness schemas?
- Identity - Symptoms associated with a specific illness are given a label (e.g. rash = meningitis?)
- Cause - Understanding of aetiology (e.g. contact with virus?)
- Timeline - Expected duration (e.g. 1-2 weeks?)
- Consequences - Impact of symptoms (e.g. cannot go into work, pain)
-
Cure and Control - Steps needed to manage symptoms (e.g. see Doctor)
ILLNESS PERCEPTION
What is the attribution schema symmetry rule?
DECTECTION OF SYMPTOMS causes IllNESS LABELS which causes detection of symptoms
Cycle
How did emotions correlate with reliever use in asthmatics
Reliever use was unrelated to peak flow (measure of lung function)
Symptoms associated with anxiety were attributed to asthma by a third of patients
Daily levels of distress were positively related to number of uses of reliever
High distress was related to tendency to label a wide range of symptoms as signs of asthma.
What are the reasons for delays in help seeking?
1) Appraisal Delay – Am I ill?
Time taken to attribute a symptom to an illness
2) Illness Delay – Do I need medical attention?
Time taken to reach a decision about whether treatment is needed.
3) Utilisation Delay – I’m going to get treatment.
Time taken between symptom detection and presenting to a health care service
What is the appraisal delay influenced by?
Influenced by:
* Attention
E.g. do not perceive symptom/ interpret as nonthreatening
-
Misattribution
Symptoms interpreted incorrectly
What is the Illness and Utilisation delay influenced by?
Factors influencing illness delay:
Use of heuristics: age/menopause/stress
“ E.g. I’m just getting old.”
Factors influencing utilisation delay
Dispositional factors
Social pressure
No clear action plan/implementation intention
Fear-Avoidance
Why dont patient’s go in for treatment after recognition of symptoms?
- Recognition & interpretation of symptoms Vague / mild symptoms, Belief will go away, No awareness of cancer symptoms / risk
- Fear of ‘embarrassment’ Considered a time-waster or neurotic, Beliefs about help-seeking, Sensitive / sexual area
- Fear of ‘cancer’, Serious & painful symptoms, fatal, incurable, Previous negative experience, Unpleasant treatment or side effects
What is the relationship of symptoms and psychological factors to delay in seeking medical care for breast symptoms?
Demographics NOT related to patient delay.
No significant association between delay time and fear of cancer treatment.
Breast lump ~ SHORTER patient delay.
Higher levels of emotional response ~ SHORTER delay.