Psychology Flashcards

Question

Biopolar Aetiology

Answer 1

Genetic (evidence clear) Neuroendocrine abnormalities Triggers (severe stress post-partum, life events)

Answer 2

**Nice Guidelines → Stepped Care Model** Model provides a framework for organising the provision of services, and helps patients, carers and practitioners to identify and access the most effective interventions. The least intrusive, most effective intervention is provided first. If a person does not benefit from that intervention, or declines an intervention, they should be offered an appropriate intervention from the next step. Talking interventions first – exercise, diet

Answer 3

``` Psychoanalytical Theory – Freud Personality composed of 3 components: 1. Id – Pleasure driven – Unconscious urges & desires – well below surface of awareness 2. Superego – Morality driven – Ego ideal 3. Ego – Self – Reality principle – Conscious ideas/thoughts/feelings ```

Answer 4

Behaviourism = learning through association = stimulus – response Emphasises responses observable and measurable .’. focuses on influence of environmental factors excluding innate or inherited factors Behaviourism → observation the focus Learning inferred from observed behaviour Building connections between stimuli and response (conditioning) forms habits Reinforcement shapes learning and therefore behaviour

Answer 5

– Can have extinction (response weakened until no longer elicited by conditioned stimulus) + spontaneous recovery Pavlov With repeated pairings the neutral stimulus becomes a conditioned stimulus → elicits the conditioned response. Patient associates dentist with negativity (pain) or reward (out of pain/sticker) Baby Albert – shows stimulus generalisation

Answer 6

Learner operates on the environment and receives a reward for certain behaviour (operations). Eventually bond between operation and reward stimulus is established. Skinner – behaviour reinforced by reward/punishment Principle = behaviour shaped and maintained by consequences Pigeons rewarded randomly, repeated whatever they were doing when rewarded Patient praised for improved plaque-free score, more likely to return for more treatment Reinforcers: 1° = whatever strengthens behaviour (food, water, sex) 2° = associated with primary reinforcers (money, certificates, prizes, praise)

Answer 7

Abraham Maslow derived hierarchy of need to achieve full potential = Humanist psychology, disagreed with Freud’s psychoanalytical theory Studied successful people – Why do people who’s needs are met seek self-actualisation? = Metamotivation, desire to reach full potential Metamotivation is a term coined by Abraham Maslow to describe the motivation of people who are self-actualized and striving beyond the scope of their basic needs to reach their full potential. Maslow suggested that people are initially motivated by a series of basic needs, called the hierarchy of needs. 1. Physiologic Needs 2. Safety Needs 3. Love Needs 4. Esteem Needs 5. Self-actualisation needs If basic need not met, won’t strive for self-actualisation. E.g. a homeless patient won’t prioritise oral health.

Answer 8

Personality theory builds on work of Muslow Concerned with self-actualisation Effect of external environment on internal view of self Personal choice, feel good about teeth can smile at world

Answer 9

Beck 1976 Humans have an adaptive mechanism of anxiety = protective and modified by how individual thinks about a threat The emotional reaction (anxiety or fear) triggered when size of the threat is larger than the individual’s perception of their ability to cope.

Answer 10

Selective Attention • Orientation • Fight/Flight ``` Attention to – Threatening words (written or spoken) – People, Faces, Body language – Pictures and objects – Internal experiences – Novel neutral stimuli ``` → Threat Avoidance people will go to great lengths to avoid a potentially dangerous situation

Answer 11

• Selective remembering of –ve information E.g. Remember one negative experience over countless positive/uneventful ones • Intrusive memories • Flashbacks Very vivid memories Feel as though reliving experience, esp. with traumatic experiences May be triggered by anything related to stimulus e.g. a letter to attend dental appointment etc. • Schema = Your own personal framework of ideas Can manipulate new info to fit our schema - even if it doesn’t

Answer 12

➢ Dental phobia is the product of unconscious processes such as false connections and displacement = defence mechanism, superego acts to protect ego by viewing situations as totally unacceptable and dangerous ➢ Dentist/patient relationship governed by the treatment alliance (working with pt, overcoming obstacles i.e. eye contact, take mask off) and transference phenomena

Answer 13

➢ Conditioning of dental anxiety: Pairing of a bad experience (US) with a dental visit (CS) → CR – Anxiety. So the on the CS – dental visit needed to initiate the CR – anxiety. ➢ Generalisation: Fear of dental visit -> fear of dentist -> picture of dentist/person in white coat → CR – Anxiety ➢ Reinforcement: Attend dentist -> Anxiety Avoidance -> No anxiety (reward) Reward - > Behaviour reinforced Attend dentist -> Anxiety Behaviour (crying) -> Dentist stops treatment, mother comforts child → Behaviour reinforced ➢ Extinction: Extinction -> remission of anxiety Latent Inhibition Many pain/trauma free visits -> no anxiety Bad experience -> no anxiety .’. prior good experiences have a protective effect against the conditioning process.

Answer 14

➢ Catastrophising – thinking the worst, raises anxiety levels ➢ Imagery – seeing yourself in a catastrophic situation ➢ Memory – harking back to a (perceived?) bad experience ➢ Self-efficacy and locus of control – feeling of helplessness, not able to control or predict outcome

Answer 15

• Biological preparedness • Social learning theory (Albert Bandura) = Bobo doll experiment; Observational learning + Imitation/modeling -> learning is a cognitive process that takes place in a social context – fear can be learnt from the fear of others. o Live model – actual person demonstrating desired behaviour o Verbal – individual describes the desired behaviour in detail o Symbolic – modelling occurs via media e.g. movies, TV, Internet, literature, radio… stimuli can be either real or fictional characters. • Personality differences

Answer 16

• Increased anxiety may make it difficult to discriminate between sensation and pain (Dworkin & Chen, 1982) Dworkin & Chen (1982) – Subjects served as their own control when tooth pulp shock was delivered in laboratory and clinical situations. Significantly heightened pain was observed in the clinical dental setting. The dental setting proved more anxiety-provoking and associated with reduced tolerance for pain, suggesting that cognitive contexts of a dental setting may elicit heightened subjective pain responses. • Many studies have found that painful and traumatic dental visits are cited as the cause of their anxiety by anxious and phobic patients. • Some believe that a second episode is necessary for the development of fear and anxiety. • Now understood that cognitive factors important in process. • No single aetiology identifiable • Conditioning in combination with other factors most common cause • Some anxious patients haven’t had a bad experience • Some patients with a bad experience aren’t anxious …which means…. • A good understanding of the multi-factorial causes of anxiety should help clinicians to recognise anxiety and tailor treatment accordingly

Answer 17

Body language, idiosyncratic behaviour - Closed body language - Shaking/fidgeting - Holding a part of their body – clutching hands / holding stomach Sweating – brow / hands / arm pits / all over Levels of speech No eye contact / talking very fast / agreeing to anything / agreeing to nothing / saying nothing Aggression Hyperventilation – fast, shallow breathing May tell you feeling stressed/anxious/nervous Crying Needing the toilet excessively Won’t sit down / trying to leave Making excuses

Answer 18

Communication vital –> informed consent, pt satisfaction ``` Open body language Listen Open questions Don’t use dental jargon Speech Tone Pitch Speed Quantity & relevance of info Pain control STOP signal Length of procedure Can take breaks Describe sensation ``` Anxious pts often have external locus of control – feel lack control over situation, good communication involving them in decision making process, empower them.

Answer 19

Gentle reassurance Counselling/complex cognitive behavioural methods Chemical Management • IV sedation • GA ** But neither eradicate anxiety – no memory of dental procedure so does nothing to help overcome fear of dentist short vs long term – BM takes time but longer lasting effect .’. can save time in future

Answer 20

Not all badly behaved children are anxious (Arnrup & Bodin 2003) - However: Treat all behavioural problems as if the child is anxious Some children need sedation in addition to behavior management Integrated use of sedation increases acceptance of dental treatment particularly in fearful children ``` Children → Eye level Appropriate age vocabulary Tone of voice Understanding level (child development) ``` Threats and bribes are not helpful Reward when appropriate – compliance, not an incentive

Answer 21

Gillick competence ➢ Used in medical law to decide whether individuals 16 years and younger are able to consent to medical treatment without parental consent/knowledge.

Answer 22

``` Tell-show-do Modelling Distraction Desensitisation Cognitive Behaviour Therapy (CBT) Relaxation Techniques Hypnosis Biofeedback Acupuncture ``` (Tell Me Doctor Do Cows Really Have Bad Ankles)

Answer 23

Social Learning Theory; Bandura (1961) – imitating bobo doll Can be live or video/computer Videos - Most effective if model similar in age, gender, ethnicity to pt – reliability - Model ‘good’ behaviour -> positive reinforcement - Positive outcome demonstrated

Answer 24

``` Headset – music, stories TV – cartoons, news Visual distractions - Fish tank Stories Video games ``` Corah, Gale and Illig,1979 –adults – relaxation and distraction can be effective in alleviating anxiety and reducing stress. Women seem to prefer relaxation, whereas men prefer distraction

Answer 25

Talk pt through progressive muscle relaxation

Answer 26

= Reciprocal inhibition Can’t be relaxed and anxious at same time 1. Teach relaxation and imagery 2. When relaxed imagine anxiety provoking items 3. Progress through hierarchy least – most 4. Treatment Can combine psychological and physiological = more effective in children High success rate with adults (Gale and Ayer, 1969), some initiating follow on appointments themselves to complete treatment (thus change in locus of control, reduction/desensitisation) Long-term effectiveness (Moore, Bordsgaard and Abrahamsen, 2002)

Answer 27

– Cognitive restructuring – Modification of ‘dysfunctional/unhelpful’ thinking – Directive; action based therapy E.g. Reframing She’s prying into my personal life → She needs to know my medical history to devise the best treatment plan Setting goals: Next time I’ll sit in the chair when first asked and not wait until asked a second time

Answer 28

e.g. Lie detector, measures physiological changes

Answer 29

(Patient) When reminded in the present of someone from past who aroused strong emotions (may have been forgotten) - feel same emotions in the present related to the person with whom we are interacting. Feelings are strong and the reasons for them are UNCONSCIOUS

Answer 30

(Clinician) When transference directed from clinician towards patient. Can be unhelpful in managing pt’s problem as involves making unhelpful assumptions e.g. high level of understanding, uncooperative, non compliance likely etc. which may not be true for the patient with which you are dealing.

Answer 31

Founded by Eric Berne 3 ego states: • Parent – authoritative • Adult – goal of TA to draw people more towards this objective state • Child – emotional responses

Answer 32

one party responds inappropriately; wrong role

Answer 33

Adult – Adult -> mutuality in consultation, pt centred approach

Answer 34

- Paternalistic - Mutualistic - Consumerist - Default

Answer 35

Parent – child interaction Disease centred High control by professional Passive patient; expected to rely on dentist

Answer 36

Adult-Adult interaction Patient autonomy Patient centred consultation Equality of control between professional and patient Recognises patient as expert on their own problem Consultation led by pt’s concerns

Answer 37

Pt consumer of health service; makes demands expect to be met –> high levels of investigation, treatment, blaming & litigation Promoted by government – patient choice and patient charters

Answer 38

Neither clinician nor pt has much control. No one takes responsibility for health outcomes – series of referrals and investigations with no responsibility taken for the patient No pt education takes place so no learning occurs

Psychology Flashcards

(62 cards)