topics about psycopathology Flashcards
what is the general adaption syndrome and who came up with it?
process of stress follows: alarm–>resistence–>exhaustion - therefore severe and sustained stress can cause disease
above a model for occupational burnout
what happens when you are stressed and who realised this?
cohen et al.
stress causes: cognitive impairment, bad concentration span and disorganised thoughts –> anger –>depression, apathy and helplessness and anxiety through acute stress disorder
what are the symptoms of post traumatic stress disorders?
ptsd is a natural emotional reaction to a deeply shocking and disturbing experience
symptoms:
- repeated reliving of traumatic event
- persistent efforts at avoidance of memories and emotional blunting
- persistent symptoms of hyper arousal
- survivors guilt
what event was used to study ptsd and who studied it?
the fire on the oil rig piper alpha in 1988
hull et al
“hull of a boat, oil rigs are at sea”
who devised a social readjustment scale and what was ranked as being the top 3 most stressful things, in order?
holmes and rahe
1 - death of a spouse
2 - divorce
3 - marital seperation
who divided a hassle and uplifts scale to show how stressed people were in day to day life?
lazarus and folkeman
“shows how general FOLKE are stressed in day to day life”
what are the characteristics of type A behaviour and what does it predispose a person to?
- thinking of/doing two things at once
- scheduling more and more activities into less and less time
- hurrying the speech of others
- becoming unduly irritated when waiting in traffic/queue
- having difficulty sitting and doing nothing
- playing nearly every game to win
doubles likelihood of a heart attack
what is the lifestyle intervention used to reduce stress, what does it involve and which two researchers studied its effectiveness?
ornish programme:
- diet
- exercise
- stress management
- group support
billings (2000)
silberman (2010)
Who came up with the appraisal process (re stress)? and what are the 3 parts to it?
lazarus and folkman
- primary: perception of demands (potential for threat, harm or challenge)
- secondary: available coping options
- reappraisal: continual re-evaluation or re-labelling above
what are the 2 main types of coping mechanisms?
problem-focused:
-changing the situation, avoiding in future
emotion focused (2 subtypes):
- behavioural strategies (physical exercise, drinking, venting anger)
- cognitive strategies (denial, rumination, discussion)
describe pain as a concept
physiological - nocioception (sensory pain receptors) sensory - quality, intensity affective - unpleasantness cognitive - expectations, mental models behavioural - vocalising, posture
what is the gate control theory and who came up with it?
melzack & wall (“have GATEs in WALLs”)
gate open - pain
gate closed - pain reduces (can be closed by rubbing injury or via top-down processing)
pain is a perception of an active individual, has multiple causes and experience varies per individual
(no physical evidence of gate through neurotransmitters though)
if you are told what is going to happen do you feel more or less pain?
less pain
what are 2 mild sedatives that are used to treat chronic pain?
N20 and valium
what is the biomedical definition of disability? 2
The result of disease, trauma or some other health condition - restriction of ability within a range considered normal resulting from impairment
restriction of ability within a range considered normal RESULTING from impairment
biomedical definition of impairment
Deviations from the ‘normal’ healthy state - organic/physical loss, abnormality, disease or condition
biomedical definition of handicap
social disadvantage (social, economic and psychological handicap) - a CONSEQUENCE of disability
biomedical approach to disability interventions
aimed at the individual and their impairment , trying to facilitate normal functioning(rehabilitation)
e.g. giving someone with hearing problems hearing aids
social model of disability
rejects impairment as inevitable cause of disability
disadvantages result less from impairment than from society’s inability to accommodate difference
barriers in society disable those with impairment
suggested interventions of social model of disability
SOCIAL CHANGE, not just medical intervention or ‘prevention’ (through prenatal selection)
what is the cause of disability according to the (1) biomedical and the (2) social model of disability?
1) cause within individual
2) cause within society
definition of prejudice
affective evaluations (positive and negative attitudes) associated with stereotypes
discrimination definition
enacted behaviour influenced by attitudes
discrimination definition
to treat one group of people less favourably than others
what is indirect discrimination?
rules, regulations or procedures that have the effect of discriminating against groups of people
victimisation definition
to punish or treat a person less favourably because that person has asserted his/her rights
what is quality of life and what 6 things is it affected by?
an individual’s judgement of their overall life experience, affected by their:
1) physical health (e.g. pain, energy, sleep)
2) psycological factors (eg emotions, self esteem, memory, feelings, body image)
3) level of independence (e.g. daily activities, work, self-care, treatment, capacity to work)
4) social relationships (e.g. personal relationships, support)
5) relation to the environment (e.g. safety, home, money)
6) personal beliefs (e.g. religion)
3 key factors about quality of life
it is multidimensional (lots of different aspects contribute to it)
it is dynamic (changes over time)
it is subjective (his/her judgement within his/her culture)
what are instrumental values, what are terminal values and who came up with this approach of looking at QoL?
instrumental value = goals to allow a person to reach a TERMINAL value
Rokeach “roadkill has a pretty low QoL”
what is clinical effectiveness and what is patient reported effectiveness?
clinical: mortality, morbidity, complication rates
patient-reported: value or utility of care to patient
what is health-related QoL?
the functional effect of a medical condition and/or its therapy, as assessed by the patient
what are PROMS
patient reported outcome measures:
patient ratings of the effects of a disease, condition and/or treatment
an example of a disease specific PROM?
KDQoL - Kidney disease quality of life questionnaire
what is a recalibration of QoL? and what for what 3 reasons can it occur?
means that people with a chronic illness disability can rate their QoL as better than a ‘healthy’ person
response shift:
- when people change their internal standards, values re-evaluated, expectation-experience gap
rating scale:
- ‘health now compared to 10 years ago’ vs ‘your health compared to others your age’
items assessed:
- different stages in life, different aspects of life more important, so different scores
definition of a certain decision
know what getting (e.g. get x if chosen)
definition of an uncertain decision
chance will get/not get the outcome, probability UNKNOWN
definition of a risky decision
chance will get/not get the outcome, probability KNOWN
What is classical decision theory and who came up with it?
von Neumann and Morgenstern
“very rational, and STERN, approach to making decisions, hence the german names”
A normative theory of how people should make their decsisions
probability based
structure linking the choice made with peoples value towards the outcomes of options and the probability of these outcome occurring
4 assumptions required for rational decision making
people are motivated to follow rules or axioms
people have complete knowledge of all options
people’s representations of opinions, risk and benefits are accurate
people know what their values are and people’s values are stable
who came up with bounded rationality and what is it?
people don’t have the processing capacity to calculate EUT and so use simpler, less effortful strategies
what is the ‘satisfying’ method of decision making and who came up with it?
simon - “simple simon is easily satisfied”
choose a satisfactory criterion and the first option that matches
-eg must have 5 rooms, choose first house with 5 rooms
what is the ‘elimination by aspects’ method of decision making and who came up with it?
tversky “sounds like a russian communist leader who “eliminated” a lot of people”
choose an attribute and make trade offs between options
eg compare all houses with 5 rooms
what is the ‘heuristic’ method of decision making and who came up with it?
chaiken “your mother (her) uses a rule of thumb and writes it on a board in chalk”
use a rule of thumb, not option information
e.g. friend said X, i’ve done it before
information processing strategies: system 1
quick way- attend to part of the information or decision context
choice based on rule of thumb (heuristic)
rule of thumb enforced by experience
subconscious, quick, little effort/emotion
more likely to regret choice or make wrong choice
information processing strategies: system 2
“twice as hard, but twice as good rewards”
attend to details- evaluate pros and cons- make choice based on trade offs
conscious, time consuming and emotionally demanding,
results in more stable values
happier with choice made, less likely to regret decision
treatment decisions, risk and bias
people find risk difficult to understand and assimilate
perceptions of risk influence choice, not actual figures
people are hardwired to use context to give meaning to risk:
- representativeness
- gamblers fallacy
- availability heuristic (i.e. what we hear on the news, e.g. makes us think that tornados are more likely to kill us than asthma)
- anchoring and adjustment
- hindsight bias
- averaging
what are the three types of error in medical diagnosis and who recognised these?
graber et al “he grabs for the swiss cheese model”
1) no fault (eg silent disease, mimics, not known, poor quality data from patient etc)
2) system (e.g. culture left too long, missed appointment, unsupervised junior, delays in x-rays etc)
3) cognitive (misdiagnosis from poor data collection, interpretation, flawed reasoning, incomplete knowledge - BEING A HUMAN)
who came up with the dual process model of diagnostic reasoning?
croskerry “as he was CROSS that diagnostic mistakes kept happening”
what does it mean to be ill and who came up with this definition? 5
lau “because he loses being well”
- more than not being well:
symptoms: having bodily signs or physical sensations (pain, tired, nausea/blood pressure, rash etc)
attention: sensations are novel/non-attributable (e.g. if you have a headache because you drank a lot last night then this sensation is attributable)
perception: not feeling normal
behaviour: not being able to do what you normally do
timeline: having symptoms for some time
what percentage of symptoms result in person going to a doctor with them and who realised this?
what things affect a person’s perception of symptoms? 6
PERSISTENCE:
severity, worsening and/or more symptoms
ATTENTION:
focus/distraction/context (e.g. medical-student-itis)
SOCIETAL MORES:
- stereotypes (e.g. it is perceived that men get MIs more than women but actually same likelihood)
- cuture/socialisation (eg socially acceptable to be ill/not be ill)
INDIVIDUAL DIFFERENCES:
life stage, sex (e.g. man flu, women tend to be more stoical), personality style
MOOD:
happy, sad, anxious, relaxed (e.g. negative mood = more symptoms)
EXPERIENCE:
knowledge, lifespan, learning and illness experience
