Psychology Flashcards
(158 cards)
1
Q
Define Learning.
A
- a process by which experience produces a relatively enduring change in an organism’s behavior or capabilities
2
Q
Name the 4 basic learning processes.
A
- non-associative learning – response to repeated stimuli
- classical conditioning – Learning what events signal
- operant conditioning - Learning one thing leads to another
- observational learning – Learning from others
3
Q
Define Habituation.
A
- a decrease in the strength of a response to a repeated stimulus
4
Q
Define Sensitisation.
A
- an increase in the strength of response to a repeated stimulus
5
Q
Define Unconditioned Stimulus and Conditioned Stimulus.
A
- UCS: a stimulus that elicits a reflexive or innate response (the UCR) without prior learning
- CS: a stimulus that, through association with a UCS, comes to elicit a conditioned response similar to the original UCR
6
Q
Define Unconditioned Response and Conditioned Response.
A
- UCR: a reflexive or innate response that is elicited by a stimulus (the UCS) without prior learning
- CR: a response elicited by a conditioned stimulus -> occurs in some people on chemotherapy -> some people will have symptoms even before the drugs are taken
7
Q
Define Stimulus Discrimination.
A
- the ability to respond differently to various stimuli -> e.g. a fear of dogs might only include certain breeds
8
Q
How are phobias formed and maintained?
A
- traumatic injection -> pain/fear
- trauma (UCS) and needle (CS) -> fear response (UCR)
- clinic setting (CS) -> fear response (CR)
- avoid injections -> fear is reduced -> tendency to avoid is reinforced
9
Q
What is Thorndike’s Law of Effect?
A
- a response followed by a satisfying consequence will be more likely to occur
- a response followed by an aversive consequence will become less likely to occur
10
Q
What is operant conditioning?
A
- behaviour is learned and maintained by its consequences
11
Q
What is the expectancy-value principle?
A
- potential for a behaviour to occur in any specific situation is a function of the expectancy that the behaviour will lead to a particular outcome and the value of that outcome
12
Q
What is the Health Beliefs Model?
A
13
Q
Describe the Theory of Planned Behaviour.
A
- only predicts 25% of behaviour change
14
Q
What is the Transtheortical Model?
A
15
Q
How many models are combined in the Behaviour Change Wheel?
A
- 19 -> hence argueably the most accurate
16
Q
What are the aspects of social psychology?
A
- Social Thinking: how we think about our social world
- Social Influence: how other people influence our behaviour
- Social Relations: how we relate toward other people
17
Q
What is cognitive dissonance?
A
- feeling of discomfort due to holding two opposing opinions -> being a smoker and knowing it causes cancer
18
Q
How can dissonance be resolved?
A
- change in behaviour
- acquire ne information
- reduce the importance of the cognition
19
Q
What is framing?
A
o refers to whether a message emphasises the benefits or losses of that behaviour
- when we want people to take up behaviours aimed at DETECTION of health problems/illness loss-framed messages may be more effective
- when we want people to take up behaviours aimed at promoting PREVENTION BEHAVIOURS gain-framed messages may be more effective
20
Q
Define social loafing.
A
- tendency for people to expend less individual effort when working in a group than when working alone
21
Q
What is the 5-step bystander decision process?
A
- Notice the event
- Decide if the event is really an emergency -> social comparison: look to see how others are responding
- Assuming responsibility to intervene -> diffusion of Responsibility: believing that someone else will help
- Self-efficacy in dealing with the situation
- Decision to help (based on cost-benefit analysis e.g. danger)
22
Q
How can helping behaviour be increase?
A
o reducing restraints on helping -> reduce ambiguity, increase responsibility and enhance concern for self image
o socialise altruism -> teaching moral inclusion, modelling helping behaviour, attributing helpful behaviour to altruistic motives and education about barriers to helping
23
Q
What factors influence obedience?
A
- remoteness of the victim
- closeness and legitimacy of the authority figure
- diffusion of responsibility -> obedience increases when someone else does the dirty work
- not personal characteristics
24
Q
Define groupthink.
A
- the tendency of group members to suspend critical thinking because they are striving to seek agreement
- can be due to stress, outside input, derective leader or high cohesiveness
25
Define group polarisation.
- the tendency of people to make decisions that are more extreme when they are in a group as opposed to a decision made alone or independently
26
What are the 3 leadership styles?
o autocratic or authoritarian style
- decision-making powers are centralized in the leader, as with dictator leaders
- do not entertain any suggestions or initiatives from subordinates
- LEADER DOMINATED leadership
o participative or democratic style
- favours decision-making by the group, such as leader gives instruction after consulting the group
- can win the co-operation of their group and can motivate them effectively and positively
- LEADER and EMPLOYEE leadership
o laissez-faire or “free rein” style
- free-rein leader does not lead, but leaves the group entirely to itself as shown
- such a leader allows maximum freedom to subordinates
- EMPLOYEE DOMINATED leadership
27
Define medical error.
o the failure of a planned action to be completed as intended (i.e., error of execution) or the use of a wrong plan to achieve an aim (i.e. error of planning)
- for example: incorrect diagnosis, failure to employ indicated tests, error in the performance of an operation, procedure, or test, error in the dose or method of using a drug
28
What are the 2 systems of decision making?
- system 1 -\> hot system, that allows us to make decisions very quickly -\> very reflexive, and allows us to respond to situations urgently
- system 2 -\> much more of a reflective system, which takes a bit longer -\> involves more weighing up of probabilities and calculations -\> good for precision, but not for fast decision-making
29
Define confirmatory bias.
- the tendency to search for or seek, interpret, and recall information in a way that confirms one's pre-existing beliefs or hypotheses, often leading to errors
30
What is sunk cost fallacy?
- sunk costs are any costs (not necessarily financial) that have been spent on a project that are irretrievable ranging including anything from money spent building a house to expensive drugs used to treat a patient with a rare disease -\> rRationally the only factor affecting future action should be the future costs/benefit ratio but humans do not always act rationally and often the more we have invested in the past the more we are prepared to invest in a problem in the future, this is known as the Sunk Cost Fallacy
31
What is the availability heuristic?
- probabilities are estimated on the basis of how easily and/or vividly they can be called to mind
- individuals typically overestimate the frequency of occurrence of catastrophic, dramatic events
- e.g. surveys show 80% believe that accidents cause more deaths than strokes
- people tend to heavily weigh their judgments toward more recent information
32
What can be done to improve decision-making?
- education
- feedback
- accountability
- generating alternatives
- consultation
33
What is represntativeness heuristism?
- subjective probability that a stimulus belongs to a particular class based on how ‘typical’ of that class it appears to be (regardless of base rate probability)
- while often useful in everyday life, it can also result in neglect of relevant base rates and other errors
34
Define personality.
- the distinctive and relatively enduring ways of thinking, feeling, and acting that characterise a person’s responses to life situations
35
What are personality traits?
- relatively stable cognitive, emotional, and behavioural characteristics of people that establish individual identities and distinguish people from others
- a trait is a continuum along which individuals vary, like nervousness or speed of reaction
- traits can’t observed but are inferred from behaviour
36
What is the Eysenck's two factor model?
o old model which suggested personality theory has two main factors:
- neuroticism or stability -\> tendency to experience negative emotions
- extraversion -\> the degree to which a person is outgoing and seeks stimulation
37
Describe the 5-factor model of personality.
- modern model derived from statistical technique called factor analysis
- OCEAN is the acronym to remember the factors
38
How much does genetics influence personality?
- 50% genetically determined -\> other half is environmental
- found by personality tests between seperated identical twins
39
Which of the 'big 5' personality traits has been most strongly associated with positive health outcomes?
- conscientiousness
- followed by neuroticism
40
Define intelligence.
- the ability to acquire knowledge, to think and reason effectively, and to deal adaptively with the environment
- important to consider that intelligence is inhibited by how it is measured
41
What is the equation for IQ?
42
What is the most commonly used intelligence score in education and clinically?
- Wechsler -\> average is 100
43
What was Garder's theory of intelligence?
- that there are multiple intelligences -\> you may thrive in one and not be able able to do another
- intelligence is dependent on the environment that you are in
44
What is the clinical problem with IQ scores?
- they are averages
- just because someone scores average on a MOCHA test, for example, doesn't mean they are okay -\> might have lost all marks on memory
- is relative to what the patients baseline is
45
What is the psychometric approach to intelligence?
o crystallized intelligence -\> the ability to apply previously acquired knowledge to current problems -\> will commonly improve with age then stabilise
o fluid intelligence -\> the ability to deal with novel problem-solving situations for which personal experience does not provide a solution -\> shows steady pattern of decline in aging
46
What factors influence intelligence?
o genetic factors can influence the effects produced by the environment
- ccounts for 1/2 to 2/3 of the variation in IQ
- no single “intelligence gene” identified
o environment can influence how genes express themselves
47
What is linked to with high levels of foetal testosterone?
- higher levels of foetal testosterone are associated with HIGHER SCORES on the autism quotient
48
Describe the Self Regulatory Model.
49
How are long-term condition and mental health linked?
- people with one LTC are 2-3 times more likely to develop depression than the rest of the population -\> with three or more conditions its seven times
- having a M/H problem increases the risk of physical ill health
- co-morbid depression doubles the risk of CHD in adults and increases the risk of mortality by 50%
- people with mental health problems such as schizophrenia or bipolar disorder die, on average, 16–25 years younger than the general population
50
What is Kubler-Ross's Stage Theory on Death and Dying?
- a sequence of 5 reaction that a person afces when dying
1. denial -\> an attempt to cushion the impact
2. anger
3. bargaining
4. depression
5. acceptance
51
Describe the Dual Process Model of Coping with Bereavement.
- you ossilate between the two -\> at first it is mainly loss and becomes restoration
52
When i chronic grief more likely to occur?
- death was sudden or unexpected
- deceased was a child
- was a high level of dependency in the relationship
- bereaved person has a history of psychological problems, poor support and additional stress
53
Define chronic grief.
- the symptoms of grief persisiting for after 2 years after the bereavement
54
Define health behaviour
- an activity undertaken by an individual believing himself to be healthy, for the purpose of preventing disease or detecting it at an asymptomatic stage
55
Name some behaviour change techniques.
- providing information on consequences
- prompting specific goal setting
- prompting barrier identification
- modelling the behaviour
- planning social support
56
What are the steps involved in choosing behavioural modification techniques/taxonomy?
1. behavioural target specification
2. behavioural diagnosis
3. intervention strategy selection
4. implementation strategy selection
5. selection of specific BCTs
57
Describe self-monitoring.
- an individual keeping a record of target behaviours
- additional information recorded can help to identify barriers e.g. mood, weather
- can be time-consuming over the long term
- has a large role in increasing physical activity and healthy eating studied -\> most effective technique for food and exercise
58
Describe motivational interviewing.
- a person-centred counselling style for addressing the common problem of ambivalence about change
59
Define compliance in the clinical setting.
- the extent to which patients follow doctors' prescription about medicine taking
60
Define adherence in the clinical setting.
- the extent to which patients follow through decisions about medicine taking
61
Define concordance in the clinical setting.
- the extent to which patients are successfully supported both in decision making partnerships about medicines and in their medicines taking
62
What doe sthe COM-B model say that behaviour is?
o an interaction between:
- capability
- opportunity
- motivation
63
What are the 2 big brackets of ways to improve medical adherence?
- improve understanding of illness and treatment -\> influence patient beliefs about illness
- help patients to plan and organise their treatment -\> practical barriers can get in the way
64
Define sensation, in terms of psychology.
- stimulus detection system by which our sense organs respond to and translate environmental stimuli into nerve impulses that are sent to the brain
65
Define perception.
- active process of organising the stimulus output and giving it meaning
66
What is the difference between top-down and bottom-up processing?
o top-down = processing in light of existing knowledge
- influenced by many psychological influences such as our motives, expectations, previous experiences and cultural expectations
o bottom-up = individual elements are combined to make a unified perception
- refers to the idea that the nerve impulses we receive from senses activate higher cortical areas in order for us to perceive them
67
What factors affect perception (top-down processing)?
- attention
- past experiences -\> poor children/adults overestimate the size of coins compared to affluent people
- current drive state (e.g. arousal state)
- emotions
- anxiety increases threat perception (e.g. in PTSD)
- individual values and expectations -\> telling people a stimulus might be painful makes them more likely to report pain in response to it
- environment
- cultural background – cross-cultural differences play a role in perception
68
What are the 6 categories of Gestalts Laws?
- similarity
- proximity
- good form
- closure
- common fate
- continuation
69
What is meant by continuity in Gestalt Laws?
- when the eye is compelled to move through one object and continue to another object -\> plays on the idea that when we perceive things, we look for continuity of movement
70
What is meant by similarity of Gestalt Laws?
- similar things are percieved as being grouped together
71
What is meant by proximity of Gestalt Laws?
- objects near to each other are grouped as being together
72
What is meant by closure in Gestalt Laws?
- things are grouped together if they seem to complete some entity -\> if a picture has several parts of it missing, our brains will very quickly close this gap up
- is very rapid
73
What is visual agnosia?
o an impairment in visual recognition
- basic vision is spared (primary visual cortex is intact)
74
Describe apperceptive agnosia.
o a failure to integrate the perceptual elements of the stimulus
- very basic elements of visual perception are damaged
- individual elements perceived normally and may be able to indicate discrete awareness of parts of a printed word but cannot organised into a whole
75
What causes apperceptive agnosia?
damage to the lower lever occipital regions
76
Describe associative agnosia.
o a failure of retrieval of semantic information
- damage to further up the pathway so basic components of visual perception are okay -\> shape, colour, texture can all be perceived normally but wont linked objects to their names, can’t faces to names
- typically, sensory specific -\> e.g. if object touched, then recognised
77
What causes assocative agnosia?
- damage to higher order occipital regions
78
Describe the pathway of object recognition.
79
Define attention.
- the process of focusing conscious awareness, providing heightened sensitivity to a limited range of experience requiring more intensive processing
80
What are the 2 processes of attention?
- focus on a certain aspect
- filter out other information
81
What are the components of attention?
o focused attention -\> involves really focusing on something specific and trying to ignore the other stimuli around us
o divided attention -\> paying attention to more than one thing at once
82
What factors affect attention?
o stimulus -\> intensity, novelty, movement, contrast, repetition
o personal -\> motives, interests, threats, mood, arousal
83
What is attention heavily intertwined with?
- other cognitive processes -\> memory and perception
84
What is the cocktail party effect?
- we can focus our attention on one person’s voice in spite of all the other conversations
- but, when someone says your name in another conversation nearby, you will pay attention to it
- in a crowded room, we reject some conversations, and generally focus on one -\> any conversation we do not focus on, we struggle to recall any information
85
What are the stages of learning a new skill?
1. cognitive stage -\> development of mental resources
- learning requires explicit instruction through teaching from an ‘expert’, demonstration, and self-observation
2. associative stage
- an effective motor programme has been developed to carry out the broad skill but lacks ability to perform finer subtasks with fluency
3. autonomous stage -\> skill is largely automatic
- rely on implicit knowledge and motor co-ordination, rather than instruction -\> the more automatic a task, the less conscious control available
86
Describe medical student syndrome.
o through being taught a lot about the human body, and what can go wrong, some medical students begin to think they have problems
- may receive a lecture about a topic (e.g. cancer), and afterwards they start to develop anxious thoughts -\> start to mention symptoms in their body.
- we all experience normal bodily sensations (pain, pins and needles, headaches etc.) when this is coupled with medical lectures, the perception of these symptoms can become quite catastrophic -\> ANXIETY
87
Describe the stages theory of memory.
- REGISTRATION -\> input from our senses into the memory system
- ENCODING -\> processing and combining of received information (e.g. through repetition)
- STORAGE -\> holding of that input in the memory system (a process of consolidation)
- RETRIEVAL -\> recovering stored information from the memory system (remembering)
88
Describe the duration theory of memory.
- SENSORY -\> can last just seconds
- WORKING/SHORT TERM MEMORY -\> lasts for a few minutes
- LONG TERM MEMORY -\> lasts for an indefinite period of time and has an infinite capacity
89
What are the 2 types of long term memory?
- declarative
- non-declarative
90
Describe declarative long term memory.
o memory is available to conscious retrieval, and can be declared (propositional)
- what did I eat for breakfast? (episodic)
- what is the capital of Spain? (semantic)
- what did I just say? (working)
91
Describe non-declarative long term memory.
o causes experience-induced change in behaviour, and can’t be declared (procedural)
- subliminal advertising? (priming)
- how to ride a bike? (skills)
- phobias (conditioning)
92
What area of the brain is associated with declarative long term memory?
- medial temporal lobe diencephalon
93
What areas of the brain are associated with non-declarative long term memory?
- procedural/skills and habits = striatum
- priming = neocortex
- emotional responses = amygdala
- skeletal musculature/muscle memory = cerebellum
94
WHat area is involved in learning/developing new memories?
- hippocampus
95
What types of memory are stored in the left and right hemispheres?
- left = verbal
- right = non-verbal
96
What influences the propability of recalling a word?
- order in the list – words at the beginning and end
- personal salience of words
- number of words
- chunking or other encoding strategy
- delay time
- distraction
97
Describe the structure of language.
- phoneme = smallest unit of speech sound in a language that can signal a difference in meaning -\> humans can produce just over 100 phonemes -\> English language consists of 44 phonemes
- morphemes = smallest units of meaning in a language -\> typically consist of one syllable and are made up of phoneme -\> morphemes are combined into words
98
Describe language development in infants.
o 1-3 months -\> infant can distinguish speech from non-speech sounds and prefers speech sounds (phonemes) -\> undifferentiated crying gives way to cooing when happy
o 4-6 months -\> babbling sounds begin to occur -\> contain sounds from virtually every language -\> vocalizes in response to verbalizations of others
o 7-11 months -\> babbling sounds narrow to include only the phonemes heard in the language spoken by others in the environment -\> moves tongue with vocalizations -\> can discriminate some words without understanding their meaning and begins to imitate word sounds heard from others
o 12 months -\> first recognizable words typically spoken as one-word utterances to name familiar people or objects (e.g. da-da)
o 12-18 months -\> child increases knowledge of word meanings and begins to use single words to express whole phrases or requests (e.g. “out” to express desire to get out of the cot; primarily uses nouns.)
o 18-24 months -\> vocabulary expands to between 50-100 words -\> rudimentary sentences appear, usually consisting of two words (e.g. “more milk!”) with little or no use of articles (the, a), conjunctions (and) or auxiliary verbs (can, will)
o 2-4 years -\> vocabulary expands rapidly at the rate of several hundred words every 6 months -\> longer sentences that, though often grammatically incorrect, exhibit basic language syntax-\> begins to express concepts with words and to use language to describe imaginary objects and ideas -\> over time sentences become more correct syntactically
o 4-5 years -\> child has learned the basic grammatical rules for combining nouns, adjectives, articles conjunctions and verbs into meaningful sentences
99
What is the critical period for language development?
100
What are the symptoms of Broca's aphasia?
- non-fluent speech
- impaired repetition
- poor ability to produce syntactically correct sentences
- intact comprehension -\> can understand the speech but struggle to generate a response
- patients are at high risk of developing low mood and depression
101
What are the symptoms of Wernicke's aphasia?
o problems in comprehending speech (input or reception of language)
o fluent meaningless speech (contentless) -\> no problem with speaking
o paraphasias -\> errors in producing specific words
- semantic paraphasias = substituting words similar in meaning (barn and house)
- phonemic paraphasias = substituting words similar in sound (house and mouse)
- neologisms -\> non words (“galump”)
- poor repetition
- impairment in writing
102
What connects Broca's and Wernicke's areas?
- arcuate fasciculus
103
What conditions are associated with aphasia?
o lesions to the dominant hemisphere can be caused by -\> stroke, traumatic brain injury or neurodegenerative conditions (e.g. Alzheimer’s, fronto-temporal dementia, Parkinson’s)
o transient aphasia can be associated with -\> transient ischaemic attack (TIA) or a migraine
104
What are executive functioning skills?
- mental processes that enable us to plan, focus attention, remember instructions, and juggle multiple tasks successfully
105
What is dysexecutive syndrome?
- dysexecutive syndrome involves the disruption of executive function -\> closely related to frontal lobe damage
- encircles/stops cognitive, emotional, and behavioural symptoms
- can result from many causes, including head trauma, tumours, degenerative diseases, and cerebrovascular disease, as well as in several psychiatric conditions
106
What are the symptoms of dusexecutive syndrome?
o can present with: hypoactivity, lack of drive, apathetic (lack of interest), poor initiation of tasks, emotional bluntness, theory of mind difficulties and reduced empathy
o can present with: hyperactivity, impulsive, disinhibited, perseverative, emotional dysregulation, socially inappropriate, rude, crass, prone to swearing
o cogntive aspects = attentional and working memory difficulties (ability to retain information before working with it), poor planning & organisation, difficulty coping with novel situations and unstructured tasks and complex/abstract thinking
107
Describe the crisis theory of coping with illness.
- similar to homoeostasis -\> we have a need for social and psychological equilibrium
- serious illness presents ‘a crisis’ (our usual, habitual ways of coping are in adequate) -\> leads to a state of disorganisation, feelings of fear, guilt, sadness etc.
- crisis, by definition, is self-limited because we cannot remain in an extreme state of disequilibrium
o adaptive responses -\> lead to personal growth and adjustment to the illness
o maladaptive responses -\> lead to poor adjustment -\> psychological problems, low functioning etc.
108
What 3 factors affect the coping process in the crisis theory of coping with illness?
- illness related factors
- background and personal factors
- physical and social environment
109
What illness related factors affect coping?
- unexpected -\> if something comes as a complete shock, it is harder to come to terms with
- cause and outcome/prognosis -\> if someone feels they played a part in the illness (genetics/poor health choices), they feel guilt
- level of disability and disfigurement
- stigma of the particular illness
- prior experience
110
What background and personal factors affect coping?
- age of onset -\> diagnosis of a life-threatening diseases in young adults tends to be harder to cope
- gender -\> women tend to struggle more
- people from lower socio-economic backgrounds find it harder to cope with illnesses
- occupation
- pre-existing illness beliefs about their illness affects coping
- pre-existing personality affects the coping process (OCEAN personality traits)
111
What physical and social environment factors affect coping?
- hospitalisation -\> hospitals can be a dull and restricting place
- accommodation and physical aids/adaptations at home
- societal attitudes
- social support & social role -\> those with better social support do better
112
Define illness beliefs.
- a patients own implicit, common sense beliefs about their illness
113
What are the 5 different types of belief people have about illnesses?
- identity -\> the label of the illness and symptoms -\> e.g. "i have a cold with a sore thoart and runny nose"
- cause -\> what may have caused the problem, such as genetics, circumstances, trauma, etc. -\> e.g. “my cold was caused by being stressed and run down”
- consequences -\> expected effects from the illness and views about the outcome -\> e.g. “my cold will prevent me from playing netball this week”
- timeline -\> how long the problem will last-\> e.g. “my cold will be gone in a few days”
- curability/controllability -\> expectations about recovery or control of the illness -\> e.g. “if I rest my cold will resolve quickly”
114
What are the 2 adaptive task that must be done according to the crisis theory of coping with illness?
- tasks related to illness or treatment -\> coping with symptoms or disability, adjusting to hospital environment and medical procedures and developing and maintaining good relationships with healthcare professionals
- tasks related to general psychosocial functioning -\> controlling negative feelings and retaining a positive outlook for the future, maintaining a satisfactory self-image and sense of competence, preserving good relationships with family and friends and preparing for an uncertain future
115
Define coping.
- cognitive and behavioural efforts to master, reduce or tolerate external and internal demands and conflicts
116
What are the 2 main types of coping?
- problem focused coping -\> efforts directed at changing the environment in some way or changing one’s own actions or attitudes -\> more revision, changing behavoiur (quit smoking)
- emotion focused coping -\> efforts designed to manage the stress-related emotional responses in order to maintain one’s own morale and allow one to function -\> go for a run or a night out, learning new relaxation strategies or seeking emotional support
117
Which coping strategery tends to have a poor adjustment to illness?
o emotion focused coping strategies are associated with poorer adjustment and greater levels of depression -\> maybe because this can be associated it with avoidance
- however, we need to beware of circular reasoning -\> those who are more distressed may need to engage in more emotion-focused coping
- optimal coping strategy depends on both the individual’s preferred coping style and also the situation
o flexibility is the most beneficial -\> being able to adapt one’s coping strategy is a good thing
118
Why is patient distress a bad thing?
- moral/ethical responsibility to minimize suffering if possible
- distress during treatment is related to longer-term psychological morbidity and poorer health outcomes
- if treatment is distressing there’s a greater chance of patients not complying -\> poorer outcomes
119
How can patients treatment distress be best handled?
o preparing patients
- studies show that prepared groups report less pain, used less analgesic medication and their post-operative stay in hospital was an average of 2.7 days shorter
120
What kind of information can be given by health care professionals to patients before they undergo treatment?
- procedural information -\> information about the procedures to be undertaken
- sensory information -\> information about the sensations that may be experienced
121
What is developmental psychology and why is it relevant to doctors?
- scientific study of changes that occur in people over the course of their life -\> changes in thought, behaviour, reasoning and functioning (physical and psychological) occur due to biological, individual and environmental factors
- children are patients -\> depending on where they are developmentally it will change how they communicate with you, understand you and relate to you and how you communicate with them, understand them and relate to them
122
Define reciprocal socialisation.
- a socialization process that is bidirectional; children socialize parents just as parents socialize children
- the parent/care givers response (particularly facial expression) to a certain action will determine whether a baby will do the action again -\> called scaffolding
123
How do babies contribute to reciprocal socialisation?
o by the time a baby is delivered it is able to recognise its mother as a memory of her has been built up in-utero via hearing, smell and taste
o hearing -\> babies can hear in the womb -\> receptive hearing begins at 16 weeks GA and functional hearing begins at 24 -\> newborn babies are already familiar with their mother’s voices
o smell -\> babies are primed to learn very quickly about smells associated with their mothers -\> possibly due to trying to find food, or bonding with parent -\> newborns prefer the smell of breast milk rather than formula milk
o taste -\> a newborn senses all of the primary tastes except for salt (not until 4 months old) -\> like sweet things and things that taste of glutamate which is found in breast milk
o sight -\> newborns can’t see very well (sharpest sight around the edges rather than centre of field) however, babies learn to recognize faces in the first hour ex-utero and by 12-36 hrs show preference to their mother’s face vs stranger
124
What are the 5 primary tastes?
- sweet
- salt
- bitter
- sour
- umami (savoury)
125
What is attachment theory?
- describes a biological instinct that seeks proximity to an attachment figure (parent/carer) when threat is perceived, or discomfort is experienced
- the sense of safety the child experiences provides a secure base from which they can explore their environment thus promoting development through learning whilst being protected in the environment
Process of establishing the attachment bond begins even before birth -\> supported by reciprocal socialisation
126
Describe development of attachment over the first year of a babies life.
- birth to 3 months -\> baby prefers people to inanimate objects, indiscriminate proximity seeking e.g. clinging to carer but aren't too fussed who holds them
- 3 to 8 months -\> smiles discriminately to main caregivers
- 8 to 12 -\> selectively approaches main caregivers, uses social referencing (uses familiar adults as “secure base” to explore new situations and shows fear of strangers) and separation anxiety begins
- from 12 months -\> attachment behaviour can be measured reliably
127
What are the 4 attachment styles?
1. securely-attached children - the aim
2. avoidant-insecure children
3. resistent-insecure children
4. disorganised-insecure children
- last 3 are all insecurely attached children - not ideal
128
Why is secure attachment aimed for?
o promotes independence, emotional availability, better moods and better emotional coping
o associated with fewer behavioural problems, higher IQ and academic performance, contributes to a child’s moral development and reduces child distress
o In adolescence and adulthood associated with social competence, loyal friendships, secure parenting of offspring, greater leadership qualities, greater resistance to stress, less mental health problems such as anxiety and depression and less psychopathology e.g schizophrenia
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How does play change as babies get older?
- birth to 3 months -\> unoccupied -\> makes lots of movement of their arms, legs, hands, feet etc.
- 0 to 2 years -\> Solitary -\> play alone/limited interaction with other children
- 2 to 2 ½ years -\> spectator -\> observe other children playing around them but will not play with them.
- 2 ½ to 3 years -\> parallel play -\> alongside others but will not play with them
- 3 to 4 years -\> associate -\> starts to interact with others in their play and there may be fleeting co-operation between in play -\> friendships develop and preferences for playing with some but not all other children begins
- 4 to 6 years -\> co-operative -\> play together with shared aims of play with others -\> play transitions from mixed sex to single sex groups
- 6+ years -\> competitive -\> play often involves rules and has a clear “winner”
130
What is Piaget's stage model?
o theory of cognition -\> proposed that children's thinking changes qualitatively with age as a result of interaction of the brain with biological and personal experiences
o schemas: organised patterns of thoughts and action -\> development occurs as we acquire new schemas and as our existing schemas become more complex
- process of assimilation (incorporating new experience into existing schema) and accommodation (the difference made by the process of assimilation) leads to adaptation (whereby new experiences cause existing schema to change)
131
What are Piaget's 4 stages to cognitive development?
- sensorimotor stage -\> birth to 2 years
- preoperational stage -\> 2 to 7 years
- concrete operational stage -\> 7 to 11 years
- formal operational stage -\> 12 and up
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Describe the sensorimotor stage.
o birth to age 2
o infants understand their world primarily through sensory experiences and physical (motor) interactions with objects
- object permanence -\> understanding that an object continues to exist even when it cannot be seen -\> gradually increasing use of words to represent objects, needs, and actions
- learning is based on trial and error -\> approach to problem-solving and knowledge acquisition based on manipulating objects and trial and error learning
133
Describe the preoperational stage.
o age 2-7
o world is represented symbolically through words and mental images with no understanding of basic mental operations or rules
- rapid language development
understanding of the past and future
no understanding of principle of conservation -\> basic properties of objects stay the same even though their outward appearance may change
- irreversibilityof mental actions
- animism -\> attributing lifelike qualities to physical objects and natural events -\> assumes that everything exists with consciousness -\> e.g. car is sick
- egocentrism -\> difficulty in viewing the world from someone else’s perspective -\> e.g. describing what the other person would be able to see
134
Describe the concrete operational stage.
o ages 7-12
o children can perform basic mental operations concerning problems that involve tangible (“concrete”) objects and situations
- understand the concept of reversibility
- display less egocentrism
- easily solve conservation problems
- trouble with hypothetical and abstract reasoning -\> can’t take in hypothetical rules -\> e.g. telling them a rule that goes against something they know -\> feather can’t break glass because its soft, even though they were told it would break it
135
Describe the formal operational stage.
o 12+ in age
o abstract thoughts emerge and adolescents begin to think more about moral, philosophical, ethical, social and political issues that require theoretical and abstract reasoning
o begin to use deductive logic, or reasoning from a general principle to specific information
136
Why do adolescents, in general, sleep a lot?
- 12-25 years of age aligns with extensive brain remodelling -\> myelinisation, synaptic pruning -\> takes time and a lot of energy -\> sleep is require for this
- also the reason for thrill seeking, openness to new experiences, risk taking, the emphasis on social rewards etc
137
How does a childs concept of death develop?
o under 5s -\> do not understand that death is final, universal, will ask lots of questions that an adult may deem inappropriate, will take euphemisms concretely, may think they have caused death
o 5 to 10 years -\> gradually develop idea of death as irreversible, all functions ended, universal/unavoidable, more empathic to another’s loss, can be preoccupied with justice
o 10 years through to adolescence -\> understand more of long-term consequences, able to think hypothetically, draw parallels, review inconsistencies
- dependent on cognitive development and experience (pets, extended family members)
o NEVER describe death as going to sleep -\> sleep is a daily activity that is essential -\> associating sleep with death could cause unnecessary stress/anxiety about going to sleep
138
What physiological changes occur when someone is stressed?
- sympathetic nervous system is activated by stimuli that produce an adrenaline release
- HPA axis is also stimulated by adrenaline -\> allows us to maintain any sort of stress response -\> hormones that are released at this point (e.g. cortisol) can allow for increased usage of energy (helps release cortisol) during this period of stress
139
Describe general adaption syndrome.
- is an immediate activation of sympathetic nervous system and GPA axis in response to stress
- can only do this for so long- \> adrenal glands begin to lose the ability to function normally -\> cannot maintain the stress response -\> chronic stressors can lead to the stage of exhaustion -\> at this point the immune system function may be compromised
140
Define stress.
- a pattern of cognitive appraisals, emotional reactions, physiological responses and behavioural tendencies that occur in response to a perceived imbalance between situational demands (primary appraisal) and the resources needed to cope with them (secondary appraisal)
141
What is the Yerkes-Dodson law?
- a level of stress is helpful, and improves our performance however if this level of arousal is too high, performance decreases
142
How can stress lead to disease?
- events may evoke stress, which in turn lead to behavioural changes -\> includes eating badly, drinking alcohol or a lack of exercise -\> all have a negative impact on health -\> has other influencing factors such as levels of percieved support
- physiological chages in the body due to the stress
143
What is the possible mechanims whihc would explain why wound healing is slower in a time of stress?
- decreased production of interleukin-1
144
How depression incresse CHD disease?
- behavioural -\> eating, drinking, smoking, exercise etc
- physiological -\> platelet activity
145
How do people cope with stress in different ways?
146
What are the possible mechanisms behind the placebo effect?
- expectancy
- classical conditioning
- anxiety/attention
- release of endogenous opiates
147
What is a panic attack?
- a discrete period in which there is the sudden onset of intense apprehension, fearfulness, or terror, often associated with feeling of impending doom
- symptoms include shortness of breath, palpitations, chest pain or discomfort, choking or smothering sensations, and fear of losing control/"going crazy"
148
How might agoraphobia develop?
- develops as a complication of panic attacks -\> may arise by the fear of having a panic attack in a setting from which escape is difficult
- consequently sufferers of agoraphobia avoid public and/or unfamiliar places, especially large, open, spaces where there are few 'places to hide‘ or prevent easy escape
149
What is psychodynamic therapy?
- the idea is to bring out our preconscious ideas into conscious awareness -\> we can see the symptoms, but the real problem is more than what meets the eye - iceberg effect
- e.g. exploring childhood traumatic experiences can lead to symptom relief
150
What is behavioural therapy?
- behavioural therapy is less focused on the cause of distress
- behavioural approaches believe that maladaptive behaviours are not symptoms of underlying problems -\> the behaviours are the problem
- problem behaviours are learned in the same ways normal behaviours are -\> behaviour therapy uses learning theory to understand the difficulties
151
How are behavioural therapies used to treat anxiety?
o exposure approach - aka as systematic desensitisation
- used to treat phobias through exposure to the feared CS (i.e. car) in the absence of the UCS (i.e. accident) -\> slowly build up from sitting in a stationary car
- response prevention is used to keep the operant avoidant response from occurring
- highly effective for reducing anxiety responses
- controversial because intense temporary anxiety is created by treatment
152
Describe Clark's cognitive theory of panic.
- individuals with panic interpret certain bodily sensations in a catastrophic fashion
- sensations (especially those involved in normal anxiety responses e.g., palpitations, breathlessness, dizziness) are considered to be a sign of impending physical or psychological disaster -\> e.g. palpitations à “I’m having heart attack”
153
What are the core features of cognitive behavioural therapy?
- focuses on problematic beliefs and behaviours that maintain disorders -\> ‘here and now’ rather than original causes -\> is goal oriented i.e. there should be specific and measurable outcomes
- is a collaborative relationship between the therapist and patient
- must be brief (8-16 sessions)
- has a 'scientific' approach e.g. collecting data, testing hypotheses
154
When is CBT most useful?
- evidence for CBT suggests that it is most useful for anxiety disorders -\> is some evidence base for success in depression too
155
How does NICE describe the identification and recognition of depression?
- be alert to possible depression -\> articularly in people with a past history of depression or a chronic physical health problem with associated functional impairment
- consider asking people who may have depression two questions, specifically:
o during the last month, have you often been bothered by feeling down, depressed or hopeless?
o during the last month, have you often been bothered by having little interest or pleasure in doing things?
156
When should antidepressants be considered as a treatment for depression?
o past history of moderate or severe depression or…
o sub-threshold depressive symptoms present for a long time or…
o sub-threshold depressive symptoms or mild depression that persist(s) after other interventions
- CBT and other conselling should be tried first
157
Describe mindfulness based cognitive therapy.
- paying attention in a particular way: on purpose, in the present moment and non-judgementally
- recognising thoughts as thoughts -\> not ‘you’ and not ‘reality’
- is accumulating evidence indicating that cortisol levels decrease following participation in a mindfulness program even in healthy individuals with no history of illness
158
What is acceptance and commitment therapy?
- a form of cognitive therapy -\> revolves around acceptance and commitment
- ties in with the goal setting aspect of other therapies
- can be helpful in medical settings -\> many people are living with difficult health conditions -\> is important to prioritise what is important to the patient, despite functional impairment or poor symptom control
