Review Flashcards
(245 cards)
1
Q
- What is the scientist practitioner model?
A
an integrative approach to science and practice wherein each must continually inform the other.
2
Q
- What do Scientist-Practitioner psychologists embody?
A
research orientation in their practice, practice relevance in their research
3
Q
- What is the social context of the SP model?
A
Origins in history of clin psych practice in US, Freud & Jung introducing psychoanalysis, medical doctors believe they should be only practitioners, major problems managing WWII vets shell shock
4
Q
- What is the political context of the SP model’s history?
A
Clin psych joined APA in 1919 but not welcome, clinicians had their own association for a while, 1944 APA accepted full responsibility for clin psych, 1949 when SP model became fully integrated into applied training through Boulder committee
5
Q
- Why do we need the SP model?
A
To ensure that the therapies clinicians use have empirical evidence (i.e. that they actually work). To make sure that clinicians know the evidence, and that researchers do evaluations of therapies being used.
6
Q
- What did Eysenck find about the efficacy of psychoanalysis?
A
Those treated by psychoanalysis improved by 44 percent, those treated eclectically improved by 64% and those just treated by general practitioners improved by 72%
The more psychotherapy, the smaller the recovery rate
7
Q
- What are the merits of the SP model?
A
In practitioners: attainment of critical thinking skills, understanding of research findings, know how to best implement interventions, can empirically justify intervention choice, avoid harm and reduce unneccesary treatment
8
Q
- What major criticisms of the SP model exist?
A
Claims that applied work is often incompatible with scientific work, not all research applies to practice
Few clin psychs publish after completing training
9
Q
- What is the practitioner-scholar model?
A
Practitioners taught to be producers of small-scale clinical science rather than traditional research science
Applied scientist who uses theory, validated principles of assessment and treatment where they exist; applies scientific methods and hypothesis testing, improves existing ones
10
Q
What is evidence-based practice?
A
Evidence-based practice is the integration of best research evidence with clinical expertise and patient values
Makes use of science, research and evidence to guide decision-making in applied and clinical settings.
11
Q
- Why use EBP?
A
Healthcare and applied knowledge grows fast, and is vast already
Skills to integrate best available info with clin expertise, patient values, health care environment
Avoid uncritical acceptance of usual practice
12
Q
- What are the five A’s of EBP
A
Ask the right question. Access relevant evidence. Appraise the evidence. Apply the evidence (e.g., intervention, assessment tool) Assess its effectiveness.
13
Q
- What are the benefits of a well focused PICO question?
A
Head start in finding relevant info
Provides checklist for main concepts included in search strategy
Makes finding info fast
14
Q
- What are the four parts of a PICO question?
A
Population/Patient/Problem
Intervention (Exposure in PECO)
Comparison
Outcome
15
Q
- What are the best places to find evidence?
A
PsychInfo, Scopus, Cochrane, Cinahl, Medline
16
Q
- What is the Cochrane Library?
A
Collection of evidence-based medicine databases, adhering to a strict process that minimises bias and ensures reliability, has a protocol for evaluations
17
Q
- What is the hierarchy of evidence?
A
Pyramid of evidence based on how good it is likely to be
Systematic reviews/meta analyses (filtered information, analysis of large numbers of studies)
Randomised Controlled Trials (participants randomly assigned to at least two interventions, one must be a control)
Control trial without randomisation
Case control studies (using existing records to identify things, medical records, etc. always retrospective, doesn’t prove causality) same level as cohort
Cohort studies (examine groups based on variables, no random assignment)
Systematic review of qualitative or descriptive
Qualitative or descriptive
Opinion/consensus
18
Q
- What are systematic reviews and meta-analyses?
A
Systematic review: Analysis of results, strengths and weaknesses of studies that relate to a particular (PICO) question.
Meta-analysis: statistical evaluation of all relevant studies, DV is effect size as common metric across studies, IV is study characteristics.
19
Q
- Are systematic reviews and meta-analyses always the best evidence?
A
The value of these analyses is based on the value of the studies they review, a large, well-run RCT may be better than a review of many less powerful RCTs
20
Q
- What is the purpose of RCTs?
A
Eliminate bias in treatment assignment Facilitates blinding (masking) of treatments to investigators, participants and assessors (including possible use of a placebo)
21
Q
- What are the disadvantages of RCTs?
A
Require rigorous control of allocation
Often long and expensive
Can’t examine rare conditions or problems with long latency
Generalisability (screens out vulnerable groups)
Is it ethical to withhold treatment?
22
Q
- What are case control studies?
A
Detemining whether exposure to something is linked to an outcome by use of existing records
Always retrospective
Useful to investigate rare diseases and disease outbreaks
Pros: quick simple and cheap
Cons: association not causal, vulnerable to bias and weaker evidence
23
Q
- What are cohort studies?
A
Examine groups that are linked and follow over time, observe what’s happed to the group exposed to some variable. Can be prospective or retrospective. Better causal and generalisability than case control, as well as rare exposure but expensive and need large sample over long term.
24
Q
- Describe the three questions (steps) of a decision tree to determine quality of studies
A
What was the aim of the study? To describe study pop (PO questions) or quantify relationship between factors (PICO)
If PICO, was the intervention randomly allocated? Yes experimental/RCT, No Observational
If observational, when were the outcomes determined? (after invention/exposure, it’s cohort-prospective. Simultaneous, it’s cross sectional. Before, it’s case control-retrospective or historic cohort).
25
1. What three question must be asked when appraising evidence?
Is it valid?
Is it clinically significant/important?
Is the evidence applicable/revelant?
26
Do you know the CASP tools/questions for systematic reviews?
Screening: Did the review address a clearly focused question, did the authors look for the right type of papers
Detailed: Were all important, relevant studies included? Did authors do enough to assess quality of included studies? Was it reasonable to combine results? What are the overall results and how precise are they? Can the results be applied to the local population? Were all important outcomes considered? Are the benefits worth the harms and costs?
27
3. What is the RAMMbo model of evidence appraisal?
Recruitment- are p’s representative of target pop
Allocation- random allocation? Similar groups at start of trial?
Maintenance- were individuals within groups treated equally? Were the outcomes analysed for most p’s?
Measurement- were both p’s and researchers blinded? Were measurements objective and standardised?
28
4. What is the CONSORT checklist?
Consolidated Standards of Reporting Trials
evidence-based minimum set of recommendations for reporting RCTs. Standard way to prepare reports of trial findings, represented as a flow diagram
29
What is the difference between absolute risk and relative risk?
Absolute risk of a disease is the risk of developing the disease over a specific time period (ten years, life, etc.) can be represented as odds, percentage or decimal.
Relative risk is used to compare the risk in two different groups of people (smokers/non-smokers). How likely is Group Y to develop the disease relative to group X.
30
6. What are the three calculations that show how often you find a good/poor outcome?
Event Rate: How often the outcome is observed in control and treatment conditions
Absolute and Relative Risk: To allow comparison between control and treatment conditions
Number Needed to Treat: The number you need to treat to prevent a bad outcome
31
7. What is the event rate (ER)?
The event rate (ER) is the proportion of people in control/treatment conditions of an experiment who experience a particular event
CER: Control Event Rate
EER: Experimental Event Rate
32
8. What is the absolute risk reduction? (AAR, risk difference)
the difference between event rates in two groups, or size of difference between 2 treatments.
CER-EER, calculated in percentages
33
9. What is the Number Needed to Treat? NNT
Another way of expressing absolute risk reduction, is the number of patients that need to be treated in order to have an impact on one person (to avoid a bad outcome).
NNT = 1/ARR
34
10. What is Relative Risk Reduction? RRR
difference in event rates between two groups expressed as a proportion of the event rate in the untreated group
RRR=(CER-EER)/CER (is percentage in decimal form).
The disease was reduced by RRR% in the treatment group compared with the control group
35
11. What is the difference between ARR and RRR, and how do patients perceive this?
Explain same difference, in different ways. ARR is simple differences between rates, while RRR describes relative or proportional difference. A treatment phrased as reducing your relative risk of death by 25% is much more impressive than phrasing it as reducing your risk of death by 5%, even though they’re the same thing.
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12. What is an Odds Ratio OR?
The odds that an outcome will occur given a particular exposure, compared to the odds of an outcome occurring in the absence of that exposure
The cross product of the four square- (have disease and were exposed x don’t have it and weren’t exposed) divided by (don’t have disease and were exposed x have disease and weren’t exposed). Is the number of times, if you have the disease, that you are more likely to have been exposed than if you weren’t exposed.
Calculated for case control studies
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13. What is standard effect size?
Shows the practical size of treatment effects, becoming more commont.
Calculated by taking the mean difference between two treatments and dividing by pooled variance
0.2 is small effect size, 0.5 is moderate, 0.8 is large
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14. What questions should you ask when applying evidence to a case?
Do the results apply to my client?
What are my client’s values and preferences?
Can this practice be implemented in this setting?
How can I help my client make a decision?
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15. How do you apply the results to a client?
some assessment of their individual baseline risk
judgement about whether the evidence can be extrapolated to your client
understanding of factors that may increase the benefits or harm their experience
40
16. How do you assess the efficacy of a treatment?
Clinical trial with highly controlled variables to unambiguously demonstrate relationship between treatment and outcome
Involves controlling for comorbidity and other differences between patients
Using manuals to standardise delivery
Training and monitoring therapists
Controlling number of treatment sessions
Random assignment to conditions and use of blinding
41
17. How do you asses the effectiveness of a treatment?
is considered when intervention is implemented without same level of internal validity- is it useful in a clinical setting?
Similar to efficacy, but in real-world scenarios.
42
1. Where do you go to find psychologically validated measurements/tests?
Comprehensive lists (Mental measurements Yearbook (Buros), ETS test collection)
Publishes’ catologues (via Buros listing)
Books about individual tests
Academic journals
Text books on psychological testing
43
Name the test, measurement and target pop for this abbreviation? 16PF
Cattel's 16 Personality Factor Questionnaire, Personality (non-clinical), Adults
44
Name the test, measurement and target pop for this abbreviation? CBCL
Child Behaviour Checklist, problem behaviour, children
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Name the test, measurement and target pop for this abbreviation? D-KEFS
Delis-Kaplan Executive Function System, Executive function, All people
46
Name the test, measurement and target pop for this abbreviation? EPI
Eysenck's Personality Inventory, Personality (non-clinical), all (adult and junior versions)
47
Name the test, measurement and target pop for this abbreviation? Hayling and Brixton tests
Hayling and Brixton Clinical Assessment of Executive Functioning, Executive function, Adults
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Name the test, measurement and target pop for this abbreviation? MMPI
Minnesota Multiphasic Personality Inventory, personality (clinical), Adults (has adolescent version)
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Name the test, measurement and target pop for this abbreviation? Neale
Neale Analysis of Reading, Reading, All (children mainly)
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Name the test, measurement and target pop for this abbreviation? NEO
NEO-PI-3 (Covers big 5), Personality (non-clinical), Adults
51
Name the test, measurement and target pop for this abbreviation? Peabody
Peabody Picture Vocabulary Test, Vocab, All (mainly children)
52
Name the test, measurement and target pop for this abbreviation? RPM
Raven's Progressive Matrices, Intelligence, All
53
Name the test, measurement and target pop for this abbreviation? Stanford-Binet
Stanford-Binet Intelligence Scales, Intelligence, All
54
Name the test, measurement and target pop for this abbreviation? TEA
Test of Everyday Attention, Attention (-CH version for children)
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Name the test, measurement and target pop for this abbreviation? WAIS
Wechsler Adult Intelligence Scale, Intelligence, Adults
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Name the test, measurement and target pop for this abbreviation? WASI
Wechsler Abbreviated Scale of Intelligence, Intelligence, All
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Name the test, measurement and target pop for this abbreviation? WIAT
Wechsler Individual Achievement Test, Academic Achievement, All
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Name the test, measurement and target pop for this abbreviation? WISC
Wechsler Intelligence Scale for Children, Intelligence, Primary to High school
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Name the test, measurement and target pop for this abbreviation? WPPSI
Wechsler Preschool and Primary Scale of Intelligence, Intelligence, Pre-school to primary
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Name the test, measurement and target pop for this abbreviation? WRAML
Wide Range Assessment of Memory and Learning, Memory and Attention, All
61
2. What are the five factors in the Cattell-Horn-Carroll model of intelligence (used in the Stanford Binet Intelligence Scale)?
```
Fluid intelligence
Crystallized intelligence
Quantitative reasoning
Visual-spatial reasoning
Working memory
```
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3. How is the Stanford Binet test administered?
1 on 1 examiner, p completes 10 core tests
| Tests yield 5 factor scores, which can be combined to give an overall score for Spearman’s g
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4. What are the psychometric properties of the Stanford binet test?
Standardised on subjects, stratified by age, ethnicity, geographic region and socioeconomic level
Reliability: High internal consistency and inter-rater reliability
Valdiity: correlates with other IQ tests, factor analysis supported five factor structure
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5. What are the 4 Wechsler tests?
WPPSI-IV: Wechsler Pre-School and Primary Scale of Intelligence (4th edition). For 3-7 year olds.
WISC-V: Wechsler Intelligence Scale for Children (5th edition). For 6-16 year olds.
WAIS-IV: Wechsler Adult Intelligence Scale (4th edition). For 16 upwards.
WASI-II: Wechsler Abbreviation Scale of Intelligence (2nd edition) -30 min and 15 min versions.
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6. How is the WISC-V administered?
10 core subtest in 4 groups (verbal comprehension, working memory, perceptual reasoning, processing speed)
Can be combined into measure of general intellectual functioning (Full Scale IQ, FSIQ)
One on one session with highly trained examiner for 45-65 mins
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7. What are the psychometric properties of the WISC-V
Standardised on kids from 6-16
High test-retest reliability over 1 month, high interrater, high internal consistency
Convergent/discriminant validity, factor analysis confirms 4 groups, comparisons between clinical and non clinical samples
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8. How is Raven’s Progressive Matrices administered?
```
In a group
Nonverbally
Anyone over 5
Doesn’t require any one language
Should be independent of education
```
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9. What are the psychometric properties of RPM?
Normed worldwide
High reliability: alternate forms, internal reliability, test-retest
Validity: correlates with other aptitude tests and with academic ability
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10. What is the PPVT?
Peabody Picture Vocabulary Test
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11. How is the PPVT administered?
people aged 2+
Multiple choice, only requires pointing
No reading ability (but must be able to hear)
Rough measure of IQ for those unable to do Binet or Wechsler (not a proper substitute)
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12. What are the psychometric properties of the PPVT?
Reliability: alternate forms, internal consistency, test-retest
Validity: Content validity (all words in dictionary), test scores increase with age as predicted, correlates well with other established vocab tests, measures of oral language + reading, clinical populations performed as predicted
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13. How is the Neale Analysis of Reading Ability administered
Measures oral reading, comprehension and fluency, 6-12yrs
Can be used to diagnose reading difficulties in older readers
Children read a selection of stories out loud and complete a comprehension test on story
Administrator notes errors and time taken, scored to measure reading accuracy, reading rate, reading comprehension
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14. How was the 16PF created?
lexical approach, Cattell reviewed 18000 names for personality traits in English, determined quarter were ‘traits’ others temporary. Tested just distinguishable differences which produced 171. Students asked to rate friends on these, factor analysis, reduced to 36. Further reduced to 16 by research
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15. How is the NEO-PI-3 related to the 16PF
16PF can be scored to yield the Big Five factors instead of 16
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16. What is the consensus of the best model for personality
Five factor model/big five
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17. What are the five factors of the Big Five?
Agreeableness, Neuroticism, Extroversion, Openness to experience/culture, conscioustiousness
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18. What does the NEO-PI-3 measure?
Big Five
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19. How is the NEO-PI-3 administered?
240 items, 30-40 minutes, uses T scores, has different self-report and observer versions
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20. What are the psychometric properties of the NEO?
5 factors correlate with many other personality factors, established personality tests, social outcomes and behaviours (conscientiousness predicts GPA of uni students)
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21. According to Eysenck's personality theory, what is the underlying basis for individual differences in neuroticism?
Differences in cortical arousal
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22. The theoretical basis of Eysenck’s personality theory is at the _________ level.
Biological
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23. What did Eysenck argue to be a critical component of the mechanism underlying individual differences in extraversion-introversion?
Arousal
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24. How was the Eysenck Personality Inventory created?
Factor analytic and theoretical approach
| Biologically based theoretical model that mapped onto a 3 factor solution generated by factor analysis
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25. What are the three factors of the EPI?
Extraversion – differences in cortical arousal
Neuroticism – differences n activation thresholds in the limbic system.
Psychoticism - antisocial tendencies.
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26. Which of the following is the closest description of someone who scores high on the MMPI scale known as psychasthenia?
OCD
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27. What is a major criticism of the MMPI-2?
Lack of a nationally representative control sample
| related to demographic variables
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28. How was the MMPI created?
Reviewed large pool of items
gave preliminary questionnaire to several groups of psychiatric in-patients and a control group
Used item analusis to choose items with best discriminatory ability
Standardised using control group
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29. What are the features/description of the MMPI-2
Comprehensive personality test designed to diagnose abnormal groups
Most frequently used test by neuropsychologists
Used to differentiate between “organic” and psychiatric disorders, detecting personality changes post head injury, assessing the validity of a patient’s self-report
Uses empirical criterion keying
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30. What is empirical criterion keying using the item discrimination index and how does it work?
True false statements are given to people with and without a certain condition. The IDI for each item is calculated by finding the difference between the proportion of people who had the condition and answered ‘true’ (out of the total pop with condition) and the proportion of people who didn’t have the condition and answered ‘true’ (out of total pop without condition). This can be done with groups that rank highly and lowly on other scales, etc.
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31. What do hypochondriasis, psychastenia and hypomania mean?
hypochondriasis – exaggerate health issues
psychasthenia – roughly means OCD
hypomania – manic-depressive disorder
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32. What are the psychometric properties of the MMPI?
Reliability: test-retest and internal consistency
Validity: construct validity (>10000 studies mapped profiles onto specific behaviours) criterion validity (MMPI scores map onto ratings by spouses and professionals
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33. What are the weaknesses of the MMPI?
Item overlap
Response bias affects scored (not enough reversed items
Correlates with demographic variables
Not nationally representative samples
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34. What are the scales used by the MMPI to detect lies?
Missing responses/double marked
Lie scale – negative statements that apply to most people
Infrequency scale – eccentric statements with low endorsement rates
Correction scale – willing to admit deviacy
TRIN (true response inconsistency) – times two answers that should have opposite answers, but don’t
VRIN (Variable Response Inconsistency)
Back F – are later responses similar to earlier ones
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35. How were the lie scales for the MMPI validated?
Neurotypical people were asked to fake a disease, and were detected.
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1. What is a psychologist according to the APS?
A psychologist studies the way people feel, think, act and interact. Aim to reduce distress and enhance emotional wellbeing. Are experts in human behavior. Assist people having difficulty controlling their emotions, thinking behavior.
Must be registered with Psychology Board of Australia (AHPRA)
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2. What is the function of the APS?
Support from peers in psychology
Cheaper insurance rates
Professional development
Advocate on the behalf of psychologists
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3. What is the difference between a clinical and counselling psychologist?
Who knows?
Counselling psych say they do more holistically with the issue, person centred, integrative approach (multiple theories)
Clin psychs say they’re expert in assessment (major focus on diagnosis, medical model)
This is a problem, because Clin psychs get Tier 1 rebates (124 an hour) while everyone else gets Tier 2 (88)
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4. What is the best recommendation on seeing a psychologist for somebody with a mental health problem?
See either clin psych or counselling psych, no difference
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5. When someone is going to see a psychologist, and they’re asked about the difficult thing they’re dealing with, what is likely to be their first response?
Lie
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6. What is shame?
Living negatively in the minds of others
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7. How does personality interact with secrets?
The higher you are in compassion, the more secrets are disclosed to you
People would predict that they would disclose more to polite than assertive or compassionate, but in reality they disclosed least to polite and most to compassionate and assertive
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8. What should therapists provide, according to Mikulincer & Shaver (2007)?
Safety, comfort, unconditional positive regard, help client manage distress associated with painful memories, thoughts and feelings. Affirm client’s ability to handle distress, admire and applaud client’s efforts. Like a good parent, therapist can be relied upon for safety and support while the client becomes increasingly capable of dealing with distress autonomously.
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9. What is Bordin’s model of therapy?
Therapy involves three core elements, Bonds, Tasks, and Goals
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10. What is a bond (Bordin)?
The affective quality of the relationship, A critical mediatory factor. Is a degree of the client’s perceived safeness.
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11. What is a goal and what is a task (Bordin’s model)
Goal: agreement on general objectives
Task: agreement on specific activities
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12. How should a therapist work in relation to a client?
Think with, not for, the client
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13. How did Gordon Paul describe how evidence should be considered in terms of therapy?
which treatment, prescribed by whom, and in which circumstances, is the most effective for this particular individual with this specific problem?”
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14. How should evidence from multiple sources be used in therapy?
Use assessment measures that have been validated
Use therapies that have been evaluated
Track clients throughout session (active scientist-practitioners): multiple time points (medicare 1st, 6th and 10th session), measure outcome questionnaire (45 items) and rating scales (outcome rating scale, session rating scale) each session.
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15. What is being a scientist-practitioner therapist about?
Making sure you use treatments that have evidence behind them but also track individually (at the N=1 level) with the client how they are going session to session
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16. What are the two most widely used self-report measures in therapy?
BDI-2 (depression inventory), DASS. BDI is diagnostic, DASS is not.
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17. What are the benefits of using self report scales?
Find points of contradiction between what they say and how they answer questions
Help monitor changes over time reliably. (Per session trackers)
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18. What is the purpose of the Outcome Rating Scale?
Immediately before session
| Give an idea of what happened over the last week, and give focus for the session (what needs to be focused on)
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19. What is the purpose of the Session Rating Scale?
Immediately after session
| Feedback on how the session went
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20. What is the purpose of a thought diary?
Capture information, qualitative feedback on how things are going through the week as opposed to just relying on memory
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21. What is efficacy in therapy?
How effective a therapy works under ideal conditions, difference between test group and control group, neither with comorbidities. Emphasise internal validity, standardisation
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22. What is effectiveness in therapy?
Real world scenario testing of a therapy, no screening out of comorbidities, less standardisation. Smaller effect sizes than efficacy, but more generalisability. Emphasises external validity.
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23. What is the gold standard for evidence supported treatments?
RCT, other RCTs not by the people that developed them, and effectiveness trials
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24. What is the process of getting therapy through Medicare Better Access?
Go to GP
Get referred to psychologist
Have the psychologist complete evidence-based treatment
After 6 sessions refer back to GP
Can get an additional 4 sessions
Maximum 10 sessions in a calendar year
Rebate: $124 for clinical psychologists about $84 for a psychologist
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25. What are the major problems with the current Medicare system?
Prioritises clinical psychologists without evidence
10 sessions is too few to treat something like depression even in best case scenario (shortest Kirby saw was 18 sessions with ACT)
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26. What is the difference between common and specific factors in therapies?
Common: similarities between most therapies that account for a substantial amount of improvement in people undertaking psychotherapy.
Specific: factors unique to individual therapies that may not be nearly as effective as they seem
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27. What did Lambert & Barley 2001 find accounted for most of change?
Extra-theraputic (stuff in client’s life) 40%
Expectancy effect 15%
Theraputic Alliance 30%
Specific techniques 15%
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28. Why does psychotherapy work?
Most often cited is therapeutic relationship/therapeutic alliance
Some researchers hold that it accounts for much more than any specific factors.
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29. What is the dodo theory?
that all therapies are equally effective and therefore all good at the same level (it’s the commonalities that matter, nothing else)
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30. What are Rogers’ five key concepts?
```
Positive regard
Genuineness
Empathy
Openness
Curiosity
```
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31. What is the role of therapy?
Help the person narrate their story with curiosity and Socratic dialogues.
Hear a story and mindfully reflect – noticing themes and patterns
Move towards a collaborative, shared emergent, ongoing formulation with guided discovery
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32. What are Socratic questions/dialogues?
Questions: advanced open ended questions, enable/encourage patient to form connections in meaning-making
Designed to help clients explore in more detail meanings and implications
What did that mean to you, what did you make of that, what is your worst fear in that situation?
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33. What is guided discovery?
Exploration with intention of making new connections/reframing
Process involved when exploring/understanding material world from psych world, incl. social interest, empathy, mentalising
Let’s imagine that…
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34. List five microskills involved in a Basic Listening Sequence
```
Open/Closed Questions
Encouragers
Paraphrasing
Summarization
Clarification
Reflection of Feeling
Reflection of Meaning
```
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35. What is the purpose of the Basic Listening Sequence?
Alliance building and maintenance
Help create safe and gentle pace
Use voice and body language to create safeness
Important to use pre gearing up
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36. What are the benefits of reflecting emotion?
Allow therapist to convey understanding and awareness of client’s internal experience, build empathic bridge.
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37. What is the definition of compassion, according to Paul Gilbert?
“Compassion is an awareness and sensitivity to the suffering of self and others, with a commitment to try and alleviate and prevent it”
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38. What is the focus of Compassion Focused Therapy (CFT)?
Theraputic relationship- can be applied to any therapy modality?
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39. What is the theoretical underpinning of CFT?
Evolutionary models, neuro- affective and developmental psychology
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40. What are the unique elements of CFT?
```
Psychoeducation
Model of affect regulation
Evolutionary Functional Analysis
Building of compassion-focused motives
Works with fears, blocks and resistances to compassion and positive emotion
```
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41. What does Compassion begin with?
A reality check- gene built with evolved brains, struggle to survive and avoid pain
All born, decay, die, susceptible to injuries, limited time
Socially shaped from gene expressions to sense of self.
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42. What is the basic philosophy of CFT?
We’re all just here, no one to blame, life is filled with tragedies, our brains are not under our control, we’re all in the same boat.
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43. What are the two main elements of developing a compassionate mind?
Sensitivity to suffering of self and others (connect with difficult experiences, courage)
with a commitment to try and relieve it (commitment to relieve distress, dedication
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44. What are the three aspects of the Interactive Flow of Compassion?
Self-compassion, compassion from others, compassion to others
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45. What are the three circles in the three circles model, and how does compassion affect them?
Drive and Achievement
Soothing and connection
Threat and self-protect
Compassion helps to balance them.
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1. Describe the basic outline of the first steps of visual processing
Optic nerve at back of eyes, split at optic chiasm (crossover), then to lateral geniculate nucleus (LGN), then through optic radiation to primary visual cortex
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2. What does the first step in the primary visual cortex react to, compared to the retina or LGN?
Bars of light in certain orientations, compared to dots of light.
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3. What does the second step in the PVC respond to that step one doesn’t?
Illusory orientations/bars, places where it seems like things should be.
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4. What does V4 in the PVC respond to?
Shapes, colours, and even later faces for particular people
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5. What happens when you have a brain lesion at a) optic nerve, b) optic chiasm, c) after optic chiasm?
a) lose sight in one eye.
b) lose outer half of sight in both eyes (contralateral)
c) lose some vision (depending) from both eyes
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6. How is vision represented in the PVC?
Retinotropically, Inverted both horizontally and vertically
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7. What do the superior colliculi do?
Take about 10% of nerve fibres from LGN, work in orienting head/eye movements.
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8. If a patient loses vision in the lower right area, what is it called and where was their brain damaged?
Right inferior quandrantopia, occipital region on left side above calcarine sulchus
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9. If a patient loses vision in the right area, what is it called and where was their brain damaged?
Right hemianopia, lesion covers whole left visual cortex
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10. What is cortical blindness?
When blindness is in the visual cortex but the retina is intact
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11. How do you test for cortical blindness?
Blink response to threat is absent
May be no opto-kinetic reflex
No alpha rhythm on posterior region (no response to opening/closing of eyes
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12. What reflex often persists with cortical blindness?
Photic reflex
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13. What is the order of recovery from cortical blindness?
Presence/absence of light
Primitive movement
Contours
Colours
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14. How can people with cortical blindness look towards a stimulus in visual field even without seeing it?
Superior colliculus, if undamaged, can still orient eye movement towards stimuli.
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15. What was Helen the monkey able to do without her visual cortex?
Locate peanuts as they fell with incredible accuracy, while avoiding obstacles fairly easily.
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16. What was D.B. the half blind human man able to do?
Orient gaze towards stimulus in his blind field
Point to stimulus
Above chance when guessing if stimulus is horizontal or vertical
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17. What was found about DB’s blindsight with letters and movement?
Could distinguish quite accurately between Xs and Os in blind field, close to perfectly when they were larger. Claims not to be able to see, but guesses well above chance
With movement, can guess highly accurately for movement (only below chance with movement of .01 degrees that is more than 30 degrees from centre gaze
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18. How accurate is DB’s guessing at shapes in periphery?
Similar to controls, not fantastic but not much worse than anyone else
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19. What other things could DB determine in his blind field?
Colours, direction of movement, spatial frequency, flicker
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20. What are the two explanations for how blindsight works?
Processing of visual information by the superior colliculus. If superior colliculus is destroyed, blindsight disappears (monkeys)
Some think it’s sent from the colliculus on to other regions for further processing
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21. How did TN’s reaction to emotional faces differ to that of a sighted person?
It didn’t, he had the same amygdala activation
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22. How did TN and DB’s blindsight differ?
TN had affective blindsight - could see emotions
| DB could see shapes and colours, etc. Light in general
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23. What is Ledoux’s high road/low road theory for threat stimuli?
Suggests a secondary, rapid, subcortical pathway for threat stimuli that doesn’t have conscious awareness (and would be present in cortically blind patients as it doesn’t pass through visual cortex
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24. How did they prove the existence of a retino-tectal pathway?
Conditioned one angry face with white noise, and didn’t condition the other. Briefly presented these faces (among controls) very briefly (subliminal) and longer, the conditioned activated the right amygdala even when subliminal, but not unconditional. Also showed activity in superior colliculus and pulvinars, this activity is correlated with activity in amygdala.
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25. How did they determine the speed of the retino-tectal pathway (as speed is a necessary part of the theory)?
EEG- compared reactions to fearful and neutral faces
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26. What is ‘crude visual information’ and how was TN processing it?
Low spatial frequency information (blurred, low detail)
| Processed fearful faces well with all info and with low spatial frequency, but neutral faces with high spatial frequency
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27. What are the five main features of TN’s blindsight
Guess above chance emotion on a face that he can’t see
Amygdala responds to emotional stimuli even though he lacks a primary visual cortex
Must be through alternate pathway
Is rapid response
Relies on crude (low spatial frequency) information
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28. What is gaze blindsight?
Slightly above chance ability to tell if someone is looking at you
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1. What is the definition of a role model?
Individuals who have mastered a given role and who facilitate a role aspirant’s acquisition of this or a similar role
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2. What three ways do role models facilitate a role aspirant’s acquisition of the role?
Emulation (modelling)
Inspiration (motivation)
Self-efficacy (seeing that achieving the role is possible)
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3. How are role models portrayed in popular culture?
Role models matter, they’re an important aspect in people achieving those goals
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4. What is the evidence that role model interventions work?
There’s very little, despite the belief in policy-making that an increase in role models would lead to an increase of certain people in certain roles. Evaluations of these programs are very rare
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5. What assumptions about role models are there in the literature?
That structural positions make role models- i.e. a person is a role model by being visibly and extraordinarily successful
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6. How are expectations influenced by extraordinariness?
If we think something is possible (others have done it) we’re more likely to work towards it- Roger Bannister broke the 4 minute mile 60 years ago despite it being thought impossible, after that people continued to break it further and further
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7. What did Lockwood and Kunda 2007 find about exposing people to high achievers?
When reacting to the story of a stellar 4th year accounting student, it had a positive effect on 1st year accounting students and a negative effect on 4th year accounting students.
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8. What is stereotype threat?
that negative stereotypes, when salient, can undermine performance
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9. What did Marx and Roman 2002 find about stereotype threat when testing men and women at maths (in the company of a female PhD student)?
The men performed much better in the company of a poorly maths-literate student than a highly maths literate one, while women performed poorly with the incompetent female student, and equal to men with the competent one.
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10. What did Taylor et al 2011 find about stereotype threat, role models and maths performance in women?
Women who believed that the role model (Hillary Clinton) deserved her success performed as well as the control on the maths test, but those who believed she did not performed worse
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11. What is the identification approach to role models?
Role models are not just the visibly successful, but are made through an act of identification by the role aspirant
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12. How do aspirants identify role models?
Idiosyncratically, based on a range of attributes beyond just competence or success including integrity, warmth and generosity
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13. What are the four kinds of role models, according to Steffens, Rees and Peters (2015)?
Positive – you want to be like
Negative – you don’t want to be like
Ambivalent – person you want to be like and unlike
Neutral – person who is not relevant
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14. What are the top four most common sources of role models, in order?
Family (by far, 50%), task related, friend, celebrity
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15. What are the most important characterisations of role models?
Assertiveness, warmth, morality, competence
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How do the types of role models interact with ingroup/outgroup membership?
Positive: don’t know personally, but admire and makes want to try hard
Negative: Don’t want to live in shadow, or resemble them, or they are draining
Ambivalent: close relationship, want to be like in some ways
Neutral: regular sibling relationship, role model but don’t aspire to be like
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17. What are the effects of positive and ambivalent role models?
Boost self-efficacy, are emulated and inspiring
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18. What is the motivational effect of negative role models?
Avoidance behaviours
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What did Peters & Steffens find when they asked adults to reflect on managers who were competent/incompentent and moral/immoral?
Morality was more important than competence when selecting role models.
Both competence and morality were important for boosting self-efficacy, for considering emulation and to find the model inspiring
A role model is typically both moral and competent
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20. What was found in regards to morality and role models?
People described role models in terms of positive aspects- competent if immoral and competent, moral if incompetent and moral.
Immoral incompetent and moral competent models were most motivating (negative and positive)
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21. What did Peters, Tee & Paladino 2015 find when researching opinions of local entrepreneur?
‘Transportability’ was the most important aspect for identification (over hard work and success) and through that had the most effect on role model, inspiration and behavioural modelling
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1. What are the Red Flags of ASD?
Delayed milestones, not interested in play, unusual behaviours, no gestures, loss of language
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2. What is the word autism derived from?
Greek word for auto and self
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3. How was autism initially described?
A lack of interest in other people, aloneness, changes to environment resulted in distress, childhood psychosis
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4. How did the concept of autism change in 1970?
Not a psychiatric illness, came hand in hand with intellectual impairment
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5. When did autism enter the DSM?
DSMIII, 1980
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6. How is the view of autism different in the DSMV compared to previous versions?
No longer a variety of disorders (Aspergers, etc.) just ASD. Social communication and social interactions as one domain, behaviours interests and rituals as another. Two primary areas of deficit
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7. What is the prevalence rate for Autism?
10:10000 – 16:10000 in 8 year olds, more than 164k Australians (child and adult), rates increasing (might be due to better diagnosis, more awareness about ASD, or unknown)
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8. What were Jacob’s symptoms of Autism?
Screams at people, little interest in people, limited play, parents can’t get him to listen, speech regressed, did not crawl and walked late, doesn’t sleep through the night, sensitive to noise and light, family history
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9. What is the parental interview? (ASD)
Involves following up with parent about symptoms, is a semi-structured interview using DSMV criteria to guide questioning, history-taking
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10. What is DSMV criteria A for ASD? What are the three symptoms that make this up?
Persistent deficits in social communication and social interaction across multiple contexts, as manifested by all of the following:
Deficits in social-emotional reciprocity
Deficits in nonverbal communicative behaviours used for social interaction
Deficits in developing, maintaining and understanding relationships
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11. What is DSMV criteria B for ASD? What are the four symptoms related to this?
Restricted, repetitive patterns of behavior, interests, or activities, as manifested by at least two of the following:
Stereotyped or repetitive motor movements, use of objects, or speech
Insistence on sameness, inflexible adherence to routines, or ritualized patterns or verbal nonverbal behavior
Highly restricted, fixated interests that are abnormal in intensity or focus
Hyper- or hypo reactivity to sensory input or unusual interests in sensory aspects of the environment
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12. What are the DSMV criteria C, D and E for ASD?
Symptoms must be present in the early developmental period
Symptoms cause clinically significant impairment in social, occupational, or other important areas of current functioning
These disturbances are not better explained by intellectual disability (intellectual developmental disorder) or global developmental delay
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13. What is the Eyberg Child Behaviour Inventory and why is it used in ASD diagnosis?
36 item test asking how often certain behaviours occur (never to always, is it a problem)
Shows the effect of possible ASD on parents, also standardised test to see if ASD behaviours are present
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14. What is the Parenting Scale and why is it used in ASD diagnosis?
Looks at styles of parenting and how they might be interacting with child, first subscale sees how active or passive a parent is, second looks at verbosity- how often do they talk/reason with child when managing behaviour. Third scale looks at over-reactivity, how do parents react when stressed
How is the situation affecting the parents, how are they dealing with it?
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15. What is the Relationship Quality Index and why is it used in ASD diagnosis?
General quality of relationship, cues psychologist into whether the problems may stem from poor parent relationship
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16. Why is the DAS (Depression/anxiety/stress scale) used in ASD diagnosis?
Further insight into parents, may affect child
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17. What kind of observations are important in ASD diagnosis?
Informal ones- first session, seeing how relates, how they do in new circumstances, naturalistic observations in comfortable settings. Depends where problem behaviours are occurring
Formal observations: ADOS (Autism Observation Diagnostic Schedule)
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18. What is the ADOS?
Autism Observation Diagnostic Schedule
Standardised test, set up generally social situations and ask child to engage in them. Observe and score how the child reacts. Hours long, resource intensive. Only used in grey cases
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19. List the six kinds of assessment typically used in diagnosing ASD
```
Semi-structured interview
Child Observation
Parent Questionnaires
ADOS
Medical Exam
OT, Speech, Physio assessments
```
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20. What is the key requirement for a Gold Standard diagnostic assessment of Autism?
Multi Disciplinary Case Conference, all professionals involved in assessment come together and discuss the evidence for and against diagnosis.
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21. In regards to ASD, what is a formulation?
Developing hypothesis about causes and maintaining factors, as well as planning treatment.
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22. What is the five P’s model of ASD formulation?
What is the Problem?
Predisposing- what made this child vulnerable? Genetic? Family issues? Trauma/abuse?
Precipitants/triggers? Why now?
Perpetuating?
Positives- what are the child’s strengths?
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23. What are the four elements of child-focused early intervention for ASD?
Medication
Applied Behavioural Analysis
Social Skills Training
Therapy (Psych, Speech, Physio, Occupational)
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24. What is Stepping Stones Triple P?
Helps parents deal with developmental disabilities in EBP way. Assessment, teach child and parent skills, etc.
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25. What are the six elements (sessions) of Triple P Stepping Stones?
1st session: Positive Parents (teaching principles, causes of child behaviour issues)
Promoting children’s development (developing positive relationships/encouraging desirable behaviours
Teaching new behaviours/skills (communication, problem solving, self-regulation)
Managing misbehaviour and routines (strategies to manage behaviour)
Planning ahead (high risk situations, routines, tips for parents)
Implementing parenting routines (phone calls to support)
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26. What is a planned activities routine (Triple P)?
Strategy to deal with misbehaviour, rewards/punishments, activities, practice session (implement strategy in less difficult situation)
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27. What is the circle of security?
Secure base- somewhere kids can leave from, are allowed to explore out of, can be protected from
Safe haven- welcomed back, safe to return to, make everything make sense
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28. What is perceived injustice and what is it associated with?
Psych risk factor for recovery following injury (people don’t believe they deserved it, blame on others, feels unfair)
Associated with higher levels of pain, depression, anger and catastrophic thinking, disability
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29. What contributes to perceived injustice?
Communication, processes/procedures, symptoms and disability
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1. What was Matt Sanders’ idea of a good place to raise children?
Parents have knowledge/skills/confidence to raise children in safe/loving/low conflict world
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2. Why are children’s relationships important?
Positive nurturing relationships lead to better bonding, self regulation, and academic success, which in turn lead to good life course outcomes. Lack of these increase risks of substance abuse, antisocial behaviour
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3. What are SEB problems?
Social Emotional Behavioural Problems
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4. What are the main types of Adverse Childhood Experiences (ACEs)?
Abuse, neglect, household dysfunction
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5. List five of the ten major ACEs.
Physical/Emotional/Sexual Abuse
Physical/Emotional Neglect
Household dysfunction (mental illness, incarcerated relative, parent treated violently, substance abuse, divorce
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6. What do ACEs lead to greater likelihood of?
```
Suicide 12.2x
Injection drug use 10.3
alcoholism 10.3
stroke 2.4x
ischemic heart disease 2.2x
cancer 1.9x
diabetes 1.6x
```
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7. What are the aims of the Triple P System?
Reduce prevalence rates of serious social, emotional, behaviour issues in children
Reduce child maltreatment
Increase number of parents with evidence-based culturally appropriate effective parenting knowledge
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8. What are the five principles of positive parenting?
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Safe and engaging environment
Positive learning environment
Consistent assertive discipline
Reasonable expectations
Taking care of oneself
```
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9. What are the four kinds of positive parenting strategies?
Developing a positive relationship
Encouraging desirable behaviour
Teaching new skills and behaviour
Promoting self control
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10. What is necessary to solve a major problem in society?
```
Synergistically bring together knowledge from across disciplines
Work on a population level
Needs to be culturally appropriate
Effective
Different outcomes
Inclusive
```
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11. What is the major issue with trying to solve society issues from a psychology perspective?
You can’t fix it from just psych interventions alone, there are too few of us and too few people seeking that help. You have to involve the people that will be interacting with the targets already.
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12. Briefly, how does the multi-level system of Triple P work?
The fewest number of people with the most severe issues undergo intensive interventions for specific problems, and as the interventions become less involved and more broad they are received by more people for less time and require less training.
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13. What are the five levels of Triple P?
5 Individual/group, high intensity family intervention
4 Indiv/group, self-help, online, broad focused parenting support
3 Indiv/group, online, narrow focus parenting support
2 Indiv/Group Brief parenting advice
1 Universal, communication strategy
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14. How does the broader ecological context matter in improving parenting?
Psych sucks at influencing policy change, we’re mostly good in small groups or one-on-one
It’s a lot easier to influence parenting change in countries that already support it
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15. What is the main benefit of a multidisciplinary workforce?
People who work and think in different ways can reach out to different people in ways better suited to them
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16. How was the Triple P program adapted for Maori people?
Incorporating Maori cultural values into the systems (Triple P values linked to tikanga
Culturally appropriate methods of welcoming people to the group
Culturally appropriate examples (Whanau (a building) used to explain the principles in a way that was culturally relevant to Maori participants)
Ran for all families, as screening people would have lead to no participants
Significant benefits
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17. What positive outcomes for children does the Triple P Program have?
Reduced Child Maltreatment
Better mental/physical health
Improved school outcomes
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What are the 4 steps in youth AOD treatment?
Regulatory: Encourage current users to reduce risky patterns of use
Prevention: Delay age of onset of substance use
(3) Early intervention: Reduce the number of who progress to regular and problematic use
(4) Treatment of AOD dependence
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What strategies have been used to regulate alcohol consumption in Aus?
Taxation and price regulation (minimum unit price).
Regulating marketing (population exposure, content)
Regulating availability (outlet density, opening hours, minimum age)
Provision of information (mass media, social marketing, abstinence challenges, labelling)
Managing the drinking environment (law enforcement, serving practices, bans, cab supervisors, glassware)
Preventing drink/drug driving
AOD school education
Brief Interventions and treatment
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How effective was the CLIMATE program in reducing alcohol/cannabis use?
High reduction of both post at 6mnths and 12, control of HPE program increased during this time. It invovled both a substance use and mental health module.
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What are the risk factors for AOD?
early onset use (< age 14)
Disengaged youth
AOD related injury/illness
family history of AOD dependence
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What is motivational interviewing and what is it for?
“Motivational interviewing is a collaborative conversation style for strengthening a person’s own motivation and commitment to change”
Enhancing motivation to change (to fix AOD)
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What are the principles of motivational interviewing?
1. Express Empathy
2. Develop Discrepancy
3. Respond to Sustain talk and Discord (formerly Roll with Resistance)
4. Support Self-Efficacy
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What are the four traits of personality risk for AOD?
Anxiety-sensitivity
(ii) Depression-proneness
(iii) Sensation seeking
(iv) Impulsivity
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What is knowledge translation?
Knowledge Translation is making research findings understandable and useable to a broad audience
Knowledge Translation is the science of moving research into policy and practice
Or simply
Putting research into practice!
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Why is Knowledge Translation important?
lack of knowledge translation (KT) may lead to underuse of efficacious treatment, incorrect use of treatment and excessive use of inefficacious or unevaluated treatment and thus deprive patients of optimal healthcare
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What is the PARiHS model?
Promoting Action on Research Implementation in Health Sciences
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What three factors determine research use? (What are the core elements of the PARiHS model?)
Evidence (E)
Context (C)
Facilitation (F)
