Week 1 - Introduction to the Module

Question 1

What describes the definition of eustress?

Answer 1

Positive stress, energizes (boost of adrenaline), generally short-term, can improve performance, believed within coping mechanisms (i.e. something we can handle), pressure we thrive on

Question 2

*What describes the definition of distress?

Answer 2

Unpleasant feelings, short or long-term, decreases performance, can lead to physical illness/mental fatigue/emotional depletion, perceived outside coping mechanisms (i.e. something we cannot handle)

Question 3

Extreme stress can lead to _______

Answer 3

Distress

Question 4

Prolonged distress can cause _______

Answer 4

Immune systems to become depleted

Question 5

*What are the three factors that make up the biopsychosocial model?

Answer 5

Biological, psychological, social

Question 6

In the biopsychosocial model, biological relates to

Answer 6

Age, gender, genetics, physiologic reactions, tissue health

Question 7

In the biopsychosocial model, psychological relates to

Answer 7

Mental health, emotional health, beliefs and expectations, current mood, how resilient we feel

Question 8

In the biopsychosocial model, sociological relates to

Answer 8

Interpersonal relationships, social support dynamics, socioeconomics

Question 9

To define a “disorder”, we need to have a model of what is ______

Answer 9

Normative (violation of social, physical, or external appearance norms)

Question 10

What are all the parts of a psychological disorder?

Answer 10

Personal distress, disability, violation of social norms, dysfunction

Question 11

What are the caveats of each part of a psychological disorder?

Answer 11

Not all psychological disorders cause distress/disability/dysfunction/violation of social norms and not all distress/disability/dysfunction/violation of social norms indicates a psychological disorder

Question 12

What is disability (aka functional/activity limitation)?

Answer 12

A limitation in carrying out an important area of life

Question 13

What are social norms?

Answer 13

Widely held standards (beliefs and attitudes) that people use consciously or intuitively to make judgments about what behaviours are right or wrong, justified or unjustified, acceptable or unacceptable.

Question 14

The DSM-5 (2013) defines mental disorder as

Answer 14

Occurring within the individual, involving clinically significant difficulties in thinking, feeling, or behaving, usually involving personal distress of some sort (such as in social relationships or occupational functioning), involving dysfunction in psychological development, and/or neurobiological processes that support mental functioning, not a culturally specific reaction to an event (e.g. death of a loved one), not primarily a result of social deviance or conflict with society

Question 15

What is stigma?

Answer 15

The destructive beliefs and attitudes held by society that are ascribed to groups considered different in some manner, such as people with psychological disorders. Expectation of this can be as detrimental to the person as receiving it.

Question 16

What are the four characteristics of stigma?

Answer 16

A label is applied to a group of people that distinguishes them from others (e.g. crazy). The label is linked to deviant or undesirable attributes by society (e.g. crazy people are dangerous). People with the label are often seen as different from people without the label, contributing to us vs. them attitudes (e.g. we are not like those crazy people). People with the label are discriminated against unfairly (e.g. we can’t allow a hospital for crazy people to be built here).

Question 17

What are the four types of stigma?

Answer 17

Public stigma, self stigma, stigma by association, structural stigma

Question 18

What is public stigma?

Answer 18

Negative attitudes held by the general public

Question 19

What is self stigma?

Answer 19

Internalising the negative attitudes of others which leads to self limiting behaviour

Question 20

What is stigma by association?

Answer 20

Stigma by being associated with someone who has a psychological disorder or something that is stigmatized

Question 21

What is structural stigma?

Answer 21

When the rules, policies, or practices of social institutions restrict the rights and opportunities for people with psychological disorders (e.g. ethnicity, age, gender, mental health conditions)

Question 22

Early thinking thought the _______ in the midbrain was involved in communication between the mind and the body

Answer 22

Pineal gland

Question 23

What is the humoral theory?

Answer 23

Hippocrates 460-377 BC considered mind and body as linked with health, mental, or physical, underpinned by physical bodily changes, in blood, bile, phlegm. Galen 129-199 AD also linked these to temperament e.g. sanguine (blood), phlegmatic (phlegm), choleric, and bilious (bile)

Question 24

How did our ideas of mind and body evolve in the middle ages (5-6th centuries)?

Answer 24

Mind and body are separate. There was a new focus on religious explanations of health and illness. The body was seen as sacred, so no dissection or autopsies was allowed.

Question 25

How did our ideas of mind and body evolve in the Renaissance (15-16th century)?

Answer 25

We moved away from religious explanation. New belief that the soul (‘mind’) leaves the body at death, so study/dissection was allowed. Focused on anatomy, physical explanations led to increased understanding of the body but little thought of the mind.

Question 26

How did our ideas of mind and body evolve in the 17th century?

Answer 26

Descartes idea of dualism evolved. The ‘non-material’ mind and ‘material’ body were thought of as separate entities, with doctors/physicians focusing on body and ministers/theologians looking after the mind. This was a mechanistic view.

Question 27

What is the mechanistic view of dualism?

Answer 27

The mind is ‘non-material’ (i.e. not objective or visible, such as thoughts and feelings) and the body is ‘material’ (i.e. made up of real mechanical ‘stuff’, physical matter). The body is a machine that can only be understood in terms of its constituent parts. How could a mental thought with no physical properties cause a bodily reaction?

Question 28

What is the biomedical model of health and illness?

Answer 28

Health is defined as the absence of disease. Any symptom of illness is thought to have an underlying pathology that will hopefully be cured through medical intervention. This model is mechanistic, reductionist, relies more on objectivity, and focuses on the individual (but not context).

Question 29

What are the assumptions of the biomedical model of health and illness?

Answer 29

It only deals with objective facts - symptoms/illness and underlying pathology. The removal of the pathology (damaged part) will lead to restored health. There is a direct relationship between bodily changes/pathology and outcomes.

Question 30

What does it mean for the biomedical model of health and illness to be reductionist?

Answer 30

The mind, matter (body), and human behaviour can all be reduced to, and explained at, the level of cells, neural activity, or biochemical activity.

Question 31

What are critiques of the biomedical model of health and illness?

Answer 31

This relatively mechanistic view of how our bodies and its organs work, fail, and can be treated allows little room for subjectivity of experience. Tends to ignore evidence that different people respond (physically, emotionally, and behaviorally) in different ways to the same underlying disease. This could be because of differences in personality, cognition, social support resources, cultural beliefs, etc.

Question 32

What two phenomena does the biomedical model fail to explain?

Answer 32

Phantom limb pain and the placebo effect

Question 33

What are the statistics for phantom limb pain?

Answer 33

70% report is soon after amputation and up to 1/3 report it a year on.

Question 34

What are the statistics for the placebo effect?

Answer 34

It works for anywhere between 30-50% of people.

Question 35

What is the biopsychosocial model of health and illness?

Answer 35

Illness can be perceived in two different ways: objectively (what is actually going on at the level of tissues) and subjectively (what you feel/think about it). Illness elicits uniquely individual responses due to the action of the mind, i.e. subjective responses. Social, cultural, and political context of health/illness is crucial (e.g. diagnosis of AIDS in the 1980s vs now).

Question 36

What are the benefits to the biopsychosocial model of health and illness?

Answer 36

We needed to move beyond the dualism and mind-body split to study their interaction. The subjectivity of how beliefs, expectations, and emotions interact with bodily reactions allows us to do this. This perspective on health, illness, and activity limitation can offer potential for a range of interventions, not solely targeting pathology or physical symptomatology.

Question 37

How was health defined in the 1940s? Why was this definition challenged?

Answer 37

WHO (1947) defines it as a ‘state of complete physical, mental, and social well-being and… not merely the absence of disease or infirmity.’ The use of the term ‘complete’ in relation to physical or mental well-being is unrealistic since health is a fluctuating state, especially as we age.

Question 38

What did Bauman’s (1961) study determine?

Answer 38

Health means a ‘general sense of well-being’. Health is identified with the ‘absence of symptoms of disease’. Health can be seen in ‘the things that a person who is physically fit is able to do.” Thus, health is related to feeling, symptom orientation, and performance. Important to note that nearly half of the sample used 2 of the above categories and 12% used all 3 types of definition. This highlights the fact that the way we think about health is often multi-faceted.

Question 39

What were the critiques of Bauman’s (1961) study?

Answer 39

It was hard to generalize these findings. The patient sample consisted of patients with diagnoses of quite serious disease. It is likely that health people will think about health in a different way.

Question 40

What categories of health did the Health and Lifestyles Survey (Blaxter 1990) identify?

Answer 40

Health as not ill (i.e. no symptoms, no visits to doctor). Health as reserve (i.e. come from strong family; recovered quickly from operation). Health as behaviour (i.e. usually applied to others rather than self; e.g. they are healthy because they look after themselves). Health as physical fitness and vitality (used more often by younger respondents and often in reference to a male). Health as psychosocial well-being (mental state; e.g. being in harmony, feeling proud, or enjoying others). Health as function (the ability to perform one’s duties; i.e. being able to do what you want when you want, without being handicapped in any way by ill health or physical limitation). Later addition: Health as a state of being, having (positive resource/strength), doing (Bennett 2000)

Question 41

What was the Health and Lifestyles Survey (Blaxter 1990)?

Answer 41

More representative study than Bauman (1961) in which 9000 members of the general public were questioned. About 15% could not think of anyone who was ‘very healthy’ and about 10% could not describe what it was like for them to ‘feel healthy’. The latter was particularly evident in young males (they believed health to be a norm) and older women (either pessimism about their condition or they could not remember what it was like to feel well).

Question 42

What were the findings of Self-Rated Health (SRH) in the Health Survey for England (Norman & Fraser, 2013)?

Answer 42

79% reported good SRH. Influenced by: health behaviours (smokers report poorer SRH, health eaters and active people report better SRH), body mass index (has U-shaped relationship… poor SRH in both underweight and overweight adults), age (no differences between 16-24’s and 25-34’s but increased odds of reporting poor health thereafter), and ethnicity (compared to white group, South Asian and Chinese living in England are significantly more likely to report poor health). When socioeconomic status (SES) is controlled for, ethnicity effect of South Asians strengthens and gender effects appear (females are less likely than males to report poor health).

Question 43

True or False: Stress and distress can be ‘normal’ responses to challenging circumstances, or they can be associated with psychological disorders.

Answer 43

True