Flashcards in PCCP 3 Deck (90)
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What is the major physiological problem with stress in modern life?
Its is adapted to cope with short term not long term problems
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Why is it hard to measure how stressful certain events are?
Vary person to person
Vary over lifetime
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What is a model that maps how we deal with stress?
The transitional model of stress
- primary appraisal - is this a threat
- secondary appraisal - do i have the resources to cope
- stress greater than coping then stressful!
- reappraisal - given what happened last time can i cope now
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What makes events more stressful?
Lack of control
Lack of support
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How does stress effect physical health?
Raised cortisol means:
Suppressed immune system
Unhealthy behaviours (eating, drinking, smoking)
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How does stress effect mental health?
More vulnerable to cognitive distortion (rumination, catastrophising, personalisation). Makes person feel helpless if event occurs again even if they have more control second time.
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Symptoms of stress
Missing work
Mood swings
Anger
Ibs
Palpitations
Chest pains
Difficulty sleeping
Alcoholism
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Treatments of stress
Exercise
Counciling
Drugs
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What do patients have to cope with?
Medical problems:
Diagnosis
Physical limitations
Treatment
Hospitalisation
Loss of autonomy
Biographical disruption
Economic issues
Social issues
AND
Normal stuff (bereavement, divorce, unemployment, etc)
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What are the two main coping styles patients employ to deal with stress? Give some examples? Which is better in the long term?
Emotion focussed (humour, anger, prayer, discussion)
Problem focussed (seeking advice, taking action)
Problem focussed better long term
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How can clinicians help patients cope?
Help to direct/recognise support (social services, websites, charities, hospital visitors)
Increase personal control (pain management, adjustable medications like variable insulin, treatment choices)
Reduce uncertainty (communicate, peer contact (eg. Pairing pre op patients))
Stress management (councilling, behaviour training, relaxation stratergies, medications)
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What is the effect of chronic illness on mental health?
Depression 2-3x more likely (1 in 5 chronically ill are depressed)
Anxiety more common too
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Why might depression be hard for clinician to detect?
Onset on returning home
Pts think it is normal to be depressed
Symptoms attributed to illness (e.g. Lethargy)
Pt doesnt want to. Bother anyone
Pts dont want to be stigmatised
Clinician doesnt think it is their job (e.g. Surgeon)
Hcp steers pt back to physical problems
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What are the types of psychological therapy?
Type A - treatment in normal consultation
Type B - eclectic (broad range of influences) psychological therapy
Type C - formal psychotherapy with identified therapist
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What are the type c psychotherapies?
Cognitive behavioural therapy
Psychodynamic
Systemic
Humanistic
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What is the structure of cognitive behavioural therapy?
Example
What does it require?
Change maladaptive thoughts, beliefs and behaviours
E.g. By gradual exposure to a stressor with enforced staying still to break the operant conditioned good feeling of fleeing
Requires input and work from the patient with a defined goal (i want to be able to do 'x')
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What is the structure of psychodynamic therapy?
Example
What does it require?
Re-enactment of conflicts in early life between pt and therapist
Lots of therapist being quiet to see what pt says (transference)
Pt must be able to tolerate mental pain and be interested in self exploration
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What are systematic and humanistic therapies? When are they useful?
Systematic - focuses on relationships and interactions - can be group/family based
Humanistic - being nice - useful short term post bereavement etc.
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What is the cognitive model?
Situations don't upset us but the view we take on them (e.g. Someone not waving is worse if you feel marginalised and therefore feel ignored rather than thinking that they may just have not seen you)
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What is a stereotype?
A stereotype is a generalisation we make about a specific social groups and thus members of those groups
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Why can stereotypes be useful?
Allows us to make predictions about how people will behave and adapt our behaviour accordingly
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Why do stereotypes become engrained?
They reinforce themselves, we pick up. More on things that support our views more
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What is. Prejudice?
An evaluation of a stereotype that determines your attitude (pre judging an individual based on a stereotype)
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What is discrimination?
Acting on a prejudice treating someone differently because of their group membership
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When are we more likely to discriminate?
When under pressure
When tired
When suffering info overload
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How can we reduce discrimination?
Getting to know memebers of other groups
Reflective practice
Awareness of own stereotypes/prejudice
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What mental health problems increase with old age?
Dementias
NOT depression etc
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What are stereotypes of the old?
Grumpy
Personal stagnation
Intellectual deterioration
Introverted
Cant adapt
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Why might iq drop from 20 to 90years old?
Better education now - need to do a cohort study!
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