Stress, Coping and Psychological Therapies

Question 1

What is psychology?

Answer 1

The science of how people think, feel and behave

Question 2

What is the biopsychosocial model?

Answer 2

When thinking about a person’s health and well being you must think about the biology, psychology and sociology.

Question 3

Identify some physiological responses to stress

Answer 3

Increased oxygen availability (breathing)
Increased fuel availability (glucose liberation)
Preparation of tissue for damage (blood clotting)
Enhanced mental functioning
Conservation of energy resources
Enhanced physical functioning (CO, BP)

Question 4

What are the 3 stages of stress?

Answer 4

Alert - first exposed
Resistance - too much, body working over homeostatic levels
Exhaustion - physiologically and psychologically depleted

Question 5

Describe the transactional model of stress

Answer 5

We look at the demands in our life and appraise them against the resources we have to deal with them. If we think we don’t have the resources then we get the stress response.

Question 6

What are the 3 types of stress appraisal?

Answer 6

Primary = Is this event a threat? How bad could it be?
Secondary = Do I have the resources/skills to cope?
Reappraisal = reconsidering the situation once you have tried to cope

Question 7

What are the 2 most important factors that influence the effects of stress?

Answer 7

Control (how much do you feel you have?)
Social support (do we have people to protect us from stress or to help us cope?)

Question 8

Describe some impacts of stress on health

Answer 8

Physical damage - CVS
Immune system up regulated
Unhealthy behaviours - alcohol, smoking
Mental health - rumination, lack of control, anxiety, depression

Question 9

Name 3 cognitive disorders associated with stress

Answer 9

Overgeneralisations
Catastrophising
Personalisation

Question 10

Define rumination

Answer 10

Reflecting or dwelling on negative thoughts

Question 11

What are the 5 strategy types for management of stress?

Answer 11

Cognitive 
Behavioural 
Emotional 
Physical
Pharmacological

Question 12

What are the 2 coping styles?

Answer 12

Emotion focussed = behavioural and cognitive approaches (do something and change how you think about it)
Problem focussed = reduce demands of stressful situation, expand resources

Question 13

Why is co-morbid depression so bad?

Answer 13

Exacerbate the pain/distress of a physical health problem

Adversely affect illness outcomes

Question 14

What are the barriers to recognising psychological problems?

Answer 14

Symptoms inadvertently missed
Patients may not disclose
HCPs may avoid asking - time/expertise/reluctance

Question 15

Name 3 learning theories

Answer 15

Classic - associative (Pavlov)
Operant - reward/punishment
Social learning theory - model your behaviour on others

Question 16

Describe CBT

Answer 16

Combination of concepts from cognitive and behavioural therapy
Relieve symptoms by changing maladaptive thoughts, beliefs and behaviours

Question 17

Give examples of behavioural therapy ideas

Answer 17

Graded exposure to feared situations
Activity scheduling
Reinforcement

Question 18

Give some examples of cognitive therapy ideas

Answer 18

Education
Monitoring
Examining/challenging negative thoughts
Rehearsal of coping with difficult situations

Question 19

Give examples of things that CBT is used to treat

Answer 19

Depression
Anxiety states
Eating disorders
Sexual dysfunction

Question 20

Who is CBT suitable for?

Answer 20

Patient who are keen to be active participants
Those who engage collaboratively
Those who can accept a model emphasising thought and feeling
Those who are able to articulate their problem and are practically seeking solutions

Question 21

What are the 2 types of psychodynamic therapy?

Answer 21

Focal

Analytic

Question 22

Describe focal psychodynamic therapy

Answer 22

Identity conflicts from early experience that are re-enacted in adult life
Use the relationship with the therapist to resolve these

Question 23

Describe analytic psychodynamic therapy

Answer 23

Allow unconscious conflicts to be reenacted with the therapist and interpreted

Question 24

What are the patient requirements for psychodynamic therapy?

Answer 24

Capacity to tolerate mental and emotional pain

Interest in self-exploration

Question 25

Describe systemic/family therapy

Answer 25

Focus on relational context
Address patterns of interaction and meaning
See people within their social context and talk to their families

Question 26

Describe humanistic/client-centred therapy

Answer 26

No universal definition
Relies on general counselling skills
Can help coping with immediate crises if there is already motivation and willingness to problem solve

Question 27

What do we consider when choosing a therapy?

Answer 27

Problem: nature, chronicity, severity, complexity
Patient: ‘psychological mindedness’, capacity to tolerate pain, preference for short/long term treatment

Question 28

What are the components of the negative cognitive triad?

Answer 28

Negative view of self
Negative view of the world around
Negative view of the future

Question 29

Name some anxiety disorders

Answer 29

Panic disorder
Social anxiety 
Specific phobias
OCD
Body dysmorphic disorder
PTSD

Question 30

How does CBT help anxiety?

Answer 30

Reduce avoidance
Cease safety-seeking behaviours
Exposure
Test beliefs

Question 31

Define psychotherapy

Answer 31

The systematic use of a relationship between a patient and a therapist as opposed to physical and social methods to produce changes in feelings, cognition and behaviour.