Psychology

Question 1

What are the uses of psychology in medicine?

Answer 1

behaviour change (psychotherapy)
improve communication
reduce anxiety
manage chronic illness side effects
manage pain

Question 2

Define social psychology

Answer 2

the way thoughts, feelings and actions are influenced by society

Question 3

Define cognitive psychology

Answer 3

study of basic mental abilities (how people think, learn etc)

Question 4

Define developmental psychology

Answer 4

acquisition + changes in psychological processed from conception to old age

Question 5

Describe the biopsychosocial model

Answer 5

regards health as combination of effects of biological processes, psychological processes and social factors

interaction between mind, body and environment

biology = genetics, anatomy, physiology
psychology = anxiety, depression, illness beliefs
social = family, society, ethnicity

Question 6

Define health compromising behaviour

Answer 6

any activity undertaken by people with a frequency or intensity that increases risk of disease or injury
eg. sedentary lifestyle, smoking

Question 7

Define health promoting behaviour

Answer 7

any activity undertaken that decreases risk of disease or injury
eg. healthy eating, exercise, managing chronic conditions, screening

Question 8

What is health message framing?

Answer 8

different framing works for different health behaviours
gain/loss
eg. skin cancer
- self examination for skin cancer = frame in terms of loss
- sunscreen use = frame in terms of gain (prevention of cancer)

loss works well if focus is detection
gain works well if focus is prevention

Question 9

What is motivational interviewing?

Answer 9

conversation about change
collaborative + patient-centred –> empathetic
evokes person’s own thoughts + allows them to recognise own capacity for change
facilitates patient to make own decisions (reduces resistance)
develops discrepancy between where they are now and where they want to be
- open-ended questions
- affirmation
- reflective listening
- summarising + shared decision-making

Question 10

How does social support benefit health?

Answer 10

opening up + confiding in others
inhibiting/repressing traumatic event = takes up energy –> stress
talking about emotions decreases stress

Question 11

Define health

Answer 11

a state of complete physical, mental, and social wellbeing and not merely the absence of disease and infirmity

Question 12

Describe the transtheoretical stages of change model

Answer 12

1) pre-contemplation = does not think they have problem, no intention of changing
2) contemplation = aware they have a problem, knows they should change, not fully committed
3) preparation = intending to take action, may have begun to act
4) action = change has happened (over months), change occurs in behaviour, environment or experience
5) maintenance = working to prevent relapse, in this stage if remain free of problem 6 months +
6) relapse = returning to behaviour

Question 13

What should you consider in a consultation when applying the transtheoretical stages of change model?

Answer 13

stage of change patient appears to be at
factors that will help them change their behaviour
factors that act as barriers

Question 14

Describe the theory of planned behaviour model

Answer 14

describes key factors that explain behaviour + predict behaviour change
attitude, subjective norm and perceived behavioural control influence behavioural intention
behavioural intention influences behaviour

Question 15

Describe the health belief model

Answer 15

behaviour is a result of a set of core beliefs
demographic variables affect: susceptibility, severity, costs, benefits, cues to action, health motivation, perceived control
these affect likelihood of behaviour

Question 16

Describe the COM-B model

Answer 16

any given health behaviour occurs as an interaction between 3 components: capability, motivation, opportunity

capability = psychological/physical ability to carry out behaviour
motivation = reflective or autonomic mechanisms that activate or inhibit behaviour
opportunity = physical or social environment that enables behaviour

Question 17

Define stress

Answer 17

when demands of situation exceed our resources to cope with it
(increased discrepancy between demands and resources = increases experience of stress)

Question 18

State some classes of stressors

Answer 18

internal = how we make sense of a situation
external = events out of our control
acute = sudden illness, exam, work demands
chronic = long illness, relationships, work
major life events = divorce, bereavement

Question 19

What are the physiological responses to stress?

Answer 19

fight or flight response

Question 20

What are the behavioural responses to stress?

Answer 20

unhealthy diet
smoking, alcohol, drugs
risk-taking behaviours
tiredness/lack of sleep/lack of concentration
less likely to prioritise wellbeing/health behaviours

Question 21

What are some stress-related health problems?

Answer 21

high BP
headaches, migraines
muscular pain (adrenaline increases skeletal muscle tension)
digestion
diabetes
immune suppression
anxiety, depression

Question 22

What are the psychological approaches to stress management?

Answer 22

cognitive behavioural approaches = focus on appraisal + coping strategies
mindfulness-based approaches = focus on mental + physical relaxation

Question 23

What are the aims of stress management?

Answer 23

decrease depression + anxiety
increase self-esteem
increase quality of life + wellbeing
increase performance at work

Question 24

Describe the diathesis-stress model

Answer 24

stress exposure + responses –> precursors of disease –> disease

pre-existing vulnerability also plays a part

Question 25

Define attachment

Answer 25

an enduring emotional relationship between 2 people

Question 26

Describe what attachment involves

Answer 26

starts from around 7 months - involves physical proximity seeking - provokes separation anxiety - provides comfort, care, security and safe base for exploration

Question 27

Describe the cycle of secure attachment

Answer 27

``` separation, fear, discomfort anxiety --> attachment behaviour (eg. crying) carers response re-establishes proximity anxiety decreases attachment behaviour drops safety ```

Question 28

Describe the features of securely-attached children

Answer 28

- have sensitive, warm, responsive parents - know that carer will consistently meet needs - positive view of themselves + others - trust + confidence in carers - sense of security/safety to explore, play, learn

Question 29

What are the implications of secure attachment?

Answer 29

- increased emotional + social competence - increased resilience - increased self-esteem + independence - positive peer relations - increased psychological health - secure attachment with own children

Question 30

Describe the cycle of avoidant/ambivalent attachment

Answer 30

separation, fear, discomfort anxiety --> attachment behaviour inconsistent, rejecting, indifferent, insensitive, unavailable carers fail to comfort, protect, provide safety experience of prolonged distress + unregulated emotions no return to safety

Question 31

Describe the cycle of disorganised attachment

Answer 31

``` separation, fear, discomfort anxiety --> attachment behaviour neglectful, abusive carers carers are the source of distress unresolved fear, trauma, permanent feelings of lack of control, confusion, helplessness no return to safety ```

Question 32

Describe the features of insecurely attached children

Answer 32

- have rejecting, unavailable, inconsistent, unresponsive or abusive parents - learn that caregiver is unavailable + not able to meet their needs (or hostile) - develop a distorted view of: themselves as unworthy of love, of others as emotionally unavailable (or causing them confusion, harm + pain)

Question 33

What are the implications of insecure attachment?

Answer 33

linked to: - poor emotional + social competence - poor emotional regulation - difficulties at school, more likely to be bullied - difficulty in showing empathy - unregulated biological stress system: abnormal patterns of cortisol release - decreased self-esteem, lack of trust in others - emotional + behavioural problems (depression, aggression, over-controlling or over-compliant behaviour)

Question 34

Define loss

Answer 34

experience when a person we are attached to becomes permanently unavailable

Question 35

Define grief

Answer 35

human reaction to loss (acute-integrated-complicated)

Question 36

Define bereavement

Answer 36

psychological processes through which people react to loss

Question 37

What are the 4 categories used to group reactions to grief?

Answer 37

physical cognitive behavioural emotional

Question 38

List some physical reactions to normal grief

Answer 38

``` Fatigue Sleep/appetite disturbances Aches + pains SOB Palpitations Digestive problems ```

Question 39

List some emotional reactions to normal grief

Answer 39

``` Depression Anxiety Anger Guilt Loneliness Numbness Sense of detachment ```

Question 40

List some cognitive reactions to normal grief

Answer 40

``` Poor concentration Short attention span Memory loss Confusion Hallucinations Search for meaning ```

Question 41

List some behavioural reactions to normal grief

Answer 41

``` Crying Restlessness Searching Social withdrawal Difficulty fulfilling normal roles ```

Question 42

Name 3 models of grief

Answer 42

Phase model Grief work model Dual process model

Question 43

Describe the phase model of grief

Answer 43

1) Initial shock, disbelief + denial 2) Acute grief → intermediate acute mourning period of physical + emotional discomfort, yearning and mourning, social withdrawal 3) Integrated grief → gradual shift to restitution phase when attention reverts to re-engaging with world → adaptation + recovery

Question 44

Describe the grief work model of grief

Answer 44

``` Tasks of grief (TEAR) T = to accept reality of loss E = experience pain of loss A = adjust to new environment without lost person R = reinvest in new reality ```

Question 45

Describe the dual process model of grief

Answer 45

fluctuation between loss-oriented and restoration-oriented - loss-oriented = grief work, intrusion of grief, breaking bonds/ties/relocation, denial/avoidance of restoration changes - restoration-oriented = attending ti life changes, doing new things, distraction from grief, denial/avoidance of grief, new roles/identities/relationships

Question 46

What is normal grief?

Answer 46

adaptation + integration over time (6 months → 1 year)

Question 47

List some cognitive reactions to complicated grief

Answer 47

``` Ruminating on death Emptiness Hallucinations of deceased Suicidal ideation Thinking about person Self-blame Desire to be with deceased ```

Question 48

List some physical reactions to complicated grief

Answer 48

Digestive issues Fatigue Depression

Question 49

List some behavioural reactions to complicated grief

Answer 49

``` Withdrawn Not functioning Unable to work Avoid reminders of loss Lack of social engagement ```

Question 50

List some emotional reactions to complicated grief

Answer 50

Intense sadness Intense distress Loneliness Anger

Question 51

How is complicated grief diagnosed?

Answer 51

Unshakeable grief → does not improve over time Persistent + intense emotions/moods + severe symptoms that impair functioning DSM-V has specific criteria

Question 52

What are the types of complex grief?

Answer 52

Chronic grief → lasts for prolonged/extended period of time Delayed grief → postponed Disenfranchised grief → socially difficult to relate to/negated by others (eg loss deemed too small/relationship seemed too distant to justify grief response) Anticipatory grief → prior to known future loss

Question 53

What are some risk factors for complicated grief?

Answer 53

Pre-loss = pre-existing MH conditions, lack of info about death, conflict/difficult relationship between person + deceased When loss occurs = if loss is result of violence or trauma or accident, others unable to offer comfort + support, person died from inherited disease/long illness, death associated with stigma (eg AIDS) Post-death = inadequate support, traumatic reminders/anniversaries, further losses/bereavements