Health & Clinical

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  • Created by: Ella
  • Created on: 16-01-14 16:58
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  • Health & Clinical
    • Dysfunctional Behaviours
      • Diagnosis
        • Classification Manuals
          • ICD - International Classification of Disorders
            • OUtside of USA
            • Published by WHO
            • Both physical & mental disorders
            • Draft in 1987 was used in 40 countries to see if this improved psychiatric diagnosis across cultures
          • DSM - Diagnostic Statistics Manual
            • USA
            • Multi Axial Tool
              • More Holistic
              • Takes into accountbany social or environmental problems
          • Diagnostic Tools which enable practitioners to identify & treat a particular disorder
        • Biases
          • Females  with ASPD misdiagnosed with HPD 46% of the time
          • Males only misdiagnosed with HPD 15% of the times
      • Explanations
        • Behavioural
          • Classical Conditioning
          • Evaluation
            • Can't explain all dys. behaviours
        • Biological
          • Genes / instinct
          • Schizophrenia
            • A psychotic disoder involving a break with reality
          • Evaluation
            • Valid
              • Methods used to investigate are Falsifiable
                • BUT reliant on correlation
            • REductionist
        • Cognitive
          • Faulty /  Negative cognitions or thought processes
            • Depression
          • Cognitive Triad
            • Perception of self
              • Future
              • Experiences
                • Future
          • Evaluation
            • Effective Treatments
              • Developed CBT from this explanation - shown to be effective
            • Holistic
              • To some extent as  cognitions are influenced by upbringing experiences and biology (has neurological basis)
            • Can't establish Cause & Effect
              • Can't be 100% sure that faulty cognitions are the root cause or the symptoms
      • Treatments
        • Behavioural
          • Systematic Desensitisation
            • Stages
              • Gradual exposure to feared stimulus
                • Create hierarchy of fear
                  • Taught relaxation techniques / breathing / imagery to use when gradually exposed
                    • Start with least feared stimulus (e.g. picture of it) and gradually increase to more feared stimulus when fear is replaced by relaxation
          • Treatments based on on reversing / reconditioning
          • Evaluation
            • Reductionist
              • Doesn't consider biological or cognitive factors
            • Practical Problems
              • Gradual change and also requires motivation so can be time consuming
            • Long Lasting
              • Suggests that it deals with the root cause of behaviour (CC response is reversed)
                • Valid as observable/ measurable change during treatment
        • Biological
          • Drug treatments which affect the activity of neurotransmitters
          • Evaluation
            • Not Long Term
              • But does start working immdeiately
            • Useful for most Dys. Behaviours
        • Cognitive
          • CBT
            • Identify faulty cognitions
              • Practice positive cognitions and apply them
          • Evaluation
            • Reliant on Self Report
            • Long Term Effect
    • Healthy Living
      • Health Theories
        • Health Belief Model
          • Perceived Seriousness & Susceptibility
          • Cost - Benefit Analysis
          • Internal Cues
            • Period of ill health
            • Insecirities
          • External Cues
            • TV Adverts/Media
            • Doctors, Parents etc...
          • Demographic Variables
            • Age
            • Education
            • Occupation
          • Evaluation
            • Holistic
              • Takes into account multiple factors to assess the possibility of an individual adopting a health behaviour
                • E.g. Includes social aspects such as culture
                • Only slightly REDUCTIONIST as it doesn't look at all factors
                  • E.g. Personality type, mood and other health disorders.
            • Useful/ Effective
              • Becker's study found HBM to be a useful model to predict & explain different levels of compliance with medical regimens
                • Good Face Validity
            • Deterministic
              • Predicts that if individual feels a high seriousness & susceptibility then we will behave in a certain way
                • However involves free will when weighing up costs and benefits
        • Locus of Control
          • Suggests that a person thinks that the control of their health will influence whether they adopt a health behaviour
          • Internal
            • Suggests that a person feels that they control their own health
          • External
            • Seeing that their health is in someone else's control
              • E.g. Doctors, Parents, Religion, Fate.
          • Evaluation
            • LOC is not fixed... can change depending on experiences
            • Reductionist
              • Says that people with a internal LOC will engage in health behaviours
            • Deterministic
              • If someone has high internal LOC, then they will engage in health related behaviours
        • Self Efficacy
          • How effective a person thinks they will be at successfully adopting a health behaviour
          • Cognitive Based Model
            • Links to idea of high internal LOC
      • Health Promotion
        • Media Campaigns
          • Yale Model of Communication
            • Hovland started a series of studies to find out how to get people to respond better to health promotion campaigns
            • Focuses on 3 aspects
              • The Communicator
                • Has to be credibile
              • The Message
                • One sided
                  • If complicated, should state what to do
                • Two sided
                  • If simple, should allow audience to make up their own mind
              • Active participation
                • The audience are more likely to maintain attitude & behaviour change if they have actively participated in the message rather than passively received it.
        • Legislation
          • A Law which has been produced by a governing body in order to restrict, regulate, authorise or declare
          • E.g. Smoking Ban (England: 1st July 2007)
          • Why Effective?
            • Forces people to follow particular behaviour change
            • Increases perception of seriousness & susceptibility
              • HBM!
          • What decreases its effectiveness?
            • Level of punishment
            • Differential Association?
            • Demographic Variables
        • Fear Arousal
          • A persuasive message which emphasises the harmful physical/social consequences of failing to comply with the recommendations of the message
          • Links to HBM
            • Increases perception of seriousness & susceptibility
      • Adherence
        • Non Adherence
          • Rational Choice theory
            • Person believes to be making a logical or rational decision
              • They may have reason to believe treatment isn't working
              • Practical barriers to the treatment
                • Cost
                • Availability
                • Social Difficulties
          • Psychoanalytic Theory
            • Avoidance Behaviour
            • In Denial about problem
          • HBM
            • Costs outweigh benefits
              • Side effects
          • Sackett (1976)
            • Where compliance goes against well established habits & strong motives, compliance is even worse
            • 50% of patients in USA did not take prescribed meds according to instructions
        • Measuring Adherence
          • Self Report
            • Can produce unexpected info / first hand details to why patient didn't adhere
          • Physiological
            • Not possible in all cases
          • Therapeutic Outcomes
            • Observe medicines effect on a persons health
              • BUT sometimes despite strict adherence, the outcome isn't always positive
          • Chung & Naya (2000)
            • Looked at effectiveness of a mechanical device for measuring adherence
            • Found high compliance rates
              • However were told that their compliance would be assessed
          • Evaluation
            • Ethics
              • Observing people in their home
              • Using child patients
            • Usefulness
              • 70% of hospital admissions could have been prevented if patients had been  adherent to health requests
            • Situational
              • Adherence will differ for the same person depending on the situation they're in
        • Improving Adherence
          • Positive Reinforcement - Watt
          • Increase Education
            • Early school programmes
            • Media promotion
              • Can increase perceived seriousness & susceptibility
                • SO increases internal LOC & self efficacy!
                • Early school programmes
                • Doctors & Nurses
            • Doctors & Nurses
          • Make medication more acessible
          • Legislation
        • When someone supports or sticks to a particular set of ideas or rules such as a medical regimen.
    • Stress
      • Causes of Stress
        • Work
          • Approx. 12,800,000 working days  in UK were lost due to stress
        • Daily Hassles
          • A minor event that arises in the course of a normal day
        • Lack of Control
          • Can make people feel helpless about a situation
        • Types
          • Internal
            • A response within a person
              • Memory, imagination, thoughts etc...
          • External
            • An event outside of the organism / external force that places stress on us
              • Noise, Jobs,  Injury etc...
      • Measuring Stress
        • Self Report
          • Rating Scales, Questionnaires, Interviews
        • Physiological
          • Blood & urines tests, GSR, heart rate, blood pressure
        • Combined methods
          • Concurrent validity
      • Management of Stress
        • Stress Inoculation Therapy
          • Cognitive & Behavioural
          • 3 stages
            • Conceptualisation
            • Skills Acquisition & rehersal
            • Application
        • Biofeedback
          • Feedback on ones biological functioning
            • Stages...
              • Connected to EMG which produces tone at muscle tension
                • Focus thoughts on tensions
                  • Signals / tones start to reduce so patient can see change
          • Physiological & Behavioural
          • Helps people to be aware of their stress responses
            • Operant conditioning
        • Social Support
          • Shown effective by Waxel
          • Difficult to measure
      • Stress is the  physical / psychological response to a demanding or adverse situation
      • Selye (1936)
        • Experimented & exposed a variety of animals to a range of severe but non-lethal stressors
          • A long term response to stress was observed that was independent of stressor type
            • 3 parts to model
              • Alarm
                • Imediate response to stressor (fight or flight)
              • Resistance
                • Body tries to adapt to stressor
                  • e.g. hormone changes
              • Exhaustion
                • Total depletion of coping resources

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