The Psychological Impact of Injury Flashcards
Why is being aware of the psychological impact of injury important?
How is the prevalence of psychological health issues e.g., trauma, natural disaster, serious accidents - perceived?
Often underestimated - an illusion of wellbeing
-The psychologically healthy = more likely to underestimate - more biased
-Others - have been subject to psychological health issues = more inclined to be realistic - less bias towards well-being
–> perceptions alter risk & trauma
How is injury perceived?
-We link injury w/ INvulnerability
-BUT injury is often unpredictable - can alter well-being perception illusion = feel vulnerable (= traumatic impact)
Who deals with the immediate & long-term psychological impacts of injury
-Immediate = A&E emergency team
-Long-term = GP & outpatients
What are the immediate psychological impacts of injury?
-Shock -
-Distress - of relatives & witnesses (more linked to event not injury severity)
-Anger - others (A&E team?), self, events
-Dissociation - seen in response to v. traumatic events
-Calmness & denial - seen as inappropriate
–> debates on how people should pass through these pathways - if become disjointed - is it pathological?
-BUT these = general symptoms - can’t say all people respond to immediately like this
Give an example of how a traumatic event such as an assault may effect an individual psychologically and immediately.
Loss of sense of security –> loss of personal control
What are some examples of how to manage patients who have been in a traumatic events - Mayou & Farmer 2002?
-BLS & analgesia given
-Immediately referred to ICU = PTSD risks
-Reassurance - by emergency team - relieve distress (debrief after event by medical team = possible)
-Relatives get info & support - PTSD of them too
-GP communications
—> advice on return to work & other corncerns
-Support services info
How does a person respond to an injury?
By psychological & physical responses = change over time
Responses:
-Cogs = thoughts, beliefs, expectations
-Affective = emotions, feelings, mood
-Beh = shows thoughts & emotions
What are cognitions, emotions and behaviour in terms of this responses to injury simplified model?
-Cogs = what we think
-Emots = what we feel
-Beh = how we respond
Explain how this diagram may link to a traumatic injury of being trampled by a cow.
-Cogs = think cows are scary/dangerous
-Emots = fear (of cows)
-Behs = avoid cows - as the way we think/feel impacts beh
(may be opposites if you have never had a -ve cow experience)
How are understandings of people’s cognitions of emotions gained - after a traumatic event?
Make assumptions based upon beh responses - as these are an expression of these internal processes
What are the 2 models used to predict responses to trauma?
1 = model of psychological response
2 = self-regulatory model
Give a simple explanation of the model of psychological response - as a model of response to trauma - i.e., what it focusses on.
Focus on personal & sit factors - affecting response, & recovery outcomes
INTERNAL vs EXTERNAL factors
Give a simple explanation of the self-regulatory model - as a model of response to trauma - i.e., what it focusses on.
Focus on problem solving - to find appropriate COPING strategy:
-Interpret threat
-Cope w/ threat
-Appraise threat
How is an injury perceived by an individual within the model of psychological response?
As a stressor
What are the two variables influencing how an individual interprets/appraises their injury (model of psychological response)?
-Personal factors
-Situational factors
Why do different people respond differently to the same situation?
Because their cognitive appraisal of the event - based upon personal & situational factors, is different
What does cognitive appraisal of the event then cause?
Dictates an emotional response to injury
–> which affect ind’s beh regarding injury (beh responses
What are some examples of behavioural responses to injury - as influenced by cognitive appraisal & emotional response?
Injury rehabilitation adherence
What is an important feature of cognitive appraisal, emotional and behavioural response to injury?
NOT static - i.e., will change - cognitive appraisals = often change as injury progresses - when may experience setbacks
Define cognitive appraisal.
Internal evaluations of an event
Examples of personal factors - affecting cognitive appraisal?
-Injury type
-Previous experience of that injury e.g., previous car crash injuries
-Personality - ind diffs = INTERNAL
-Demographics - age, SES, gender = EXTERNAL
-Psychological - optimism, hardiness, confidence, perception, motivation
Examples of situational factors - affecting cognitive appraisal?
PERSONAL
-Social support - family, friends, support groups
-Economic situation - financial impact of injury
-Employment - does it affect ability to work?
HEALTHCARE RELATED
-Medical provision (where did you need medical help? - in field vs near hospital = which is more traumatic?)
-MDT support
-Rehab env
-Accessibility & availability of rehab
What are some examples of emotional responses?
-Numbness
-Anger
-Shock
-Depression
–> Negative emotions linked to ↑ report of symptoms, pain & distress
What are some examples of behavioural responses?
-Aggression
-Agitation
-Adherence to rehabilitation
-Under-adherence (depression)
-Over-adherence (anger)
-Use of social support
-Malingering?
-Erratic
-Withdrawn
-‘Change’ from normal
Link together the emotional & behavioural responses to injury.
-Disbelief – tries to shut out reality
-Anger – aimed @ self, medics, family/friends, God – often misplaced
-Bargaining – hope some can ‘undo’ cause, God – reform lifestyle, medics for treatment
-Depression – why bother, nothing will change
-Acceptance – going to be OK, can cope
What is thought about emotional responses to injury?
People pass through sequence of emotions in response to traumatic sport injury
BUT –> no evidence - as depends on person - ind diffs & sit
What allows recovery to occur?
Supportive healthcare env & reassurance = inc adherence = +ve recovery outcomes
What are the types of recovery in terms of the model of psychological response?
Physical & psychosocial recovery!
How can recovery be measured?
-Return to everyday functioning?
–> BUT what if ind must adapt due to injury e.g., amputation, scarring
Why is recovery never the same for people?
Very individual & personal
Why can full recovery be unlikely?
-Injury has caused permanent changes for ind e.g., amputation = must adapt - may not be able to go back to same way of life
-Loss of confidence - e.g., due to physical differences as a result of injury
-Still feel unwell
-Depression
–> OVERALL - do not feel same as before
What is the stages of the self-regulatory model - simply?
How someone:
-Interprets (stage 1)
-Copes (stage 2)
-Appraises (stage 3)
an event
What does the interpretation of an event (stage 1) mean?
How perceive symptoms of injury (or just injury in general) - assign meaning to it
What does the coping of an event (stage 2) mean?
Thoughts (cognitions) & emotions of event - lead to many coping strategies: avoidant OR approach based
What does the appraisal of an event (stage 3) mean?
Evaluate effectiveness of coping strategy - if not effective decide alternative one
What factors affect a person’s perception of their injury (stage 1)?
-Social messages - affects how we perceive symptom significance = from friends, family, medics, test results
-Attention & do people notice symptoms - att = as competition of symptoms w/ env (if env is overwhelming may not pay as much att to)
-Environment - if busy = divides att = less likely notice symptoms - endorphins released = relieve pain due to social & psych demands = less att to physical symptoms –> so unemployed, bored = more att to symptoms
-Individual differences - level of att we pay to symptoms, believes & schemas about symptoms - often irrational & unconscious - int vs ext
-Emotions - anxiety = more att on symptoms - hypervigilant - look for threats in env & observe self too
What are cognitive representations (stage 1)?
-Identify injury = label symptoms
-Cause? = beliefs - int vs ext - may not be accurate
-Control - what can be done? - do they think can prevent/control/cure or is it uncontrollable? - coping strategies? (chronic illness focus on control)
-How long will it last? - can affect adjustment & adherence to treatment
-Consequences - how it affects me? - often link to symptom perception
What are some emotional responses (stage 1)?
-Denial - pretend all is fine
-Anger - @ self, friends, family, medics
-Depression - loss of self - planned future - social withdrawal
–> all based on: perceived injury threat
What does coping (stage 2) involve?
Cope w/ thoughts & emotions
What are the 2 styles of coping (stage 2)?
-Approach style – e.g. learning about injury, attending rehabilitation = more adaptive/beneficial
-Avoidant style – e.g. denial, wishful thinking, alcohol abuse
Will people cope in certain ways, & why (stage 2)?
Yes - we have predispositions to certain coping styles
Can coping strategies change (stage 2)?
-Yes - depends on length of coping strategy - short/long term
-Major life crisis may = pivotal moment in coping
What does appraisal involve (stage 3)?
Appraise:
-Coping strategies
-Impacts interpretation of threat & coping beh
-Ind = regulates own beh
-Injury itself & its consequences - learn about injury & treatment = lower threat perception = more +ve emots = adaption!
–> so appraisal can result in adaption - +ve (= mature) or -ve (= maladaptive)
Fill in & can try to add example to it.
