PSYCH; Lecture 5, 6, 7 and 8 - Developmental psychology, Death, dying and bereavement, Individual differences and Coping with illness and treatment

Question 1

What is developmental psychology?

Answer 1

Scientific study of changes that occur in people over the course of their lives -> changes in thought, behaviour, reasoning and functioning occur influenced by biological, individual and environmental infuences

Question 2

What is the influence of heredity and caregiving in children’s development?

Answer 2

Nature sets course via genetics, gender, temperament and maturational stages; nurture shapes predetermined course via environment, parenting, stimulation and nutrition. How baby progresses depends on interchange between organism and child

Question 3

What is the babies’ contribution and process of reciprocal socialization?

Answer 3

Baby recognises mother as memory of her is built up in utero via hearing, smell and taste; Bidirectional, with children socialising parents and parents socialising children = baby cries/moves/smiles and parent then mirrors, repeats, interprets and responds

Question 4

When do babies’ 5 senses come about?

Answer 4

Babies can hear in womb with receptive hearing from 16/40 and functional hearing from 24/40; babies can be primed to learn very quickly about smells associated with their mothers (to own amniotic fluid, smell of maternal breast odours, smell of mother’s breast milk c.f. other breast milks; newborn can sense all tastes except salt (until 4 months), with babies loving sweet/sugar solution and glutamate (found in breast milk); babies can recognise faces a few hours after birth, prefer mothers face, faces and face-like stimuli and engaged faces

Question 5

How do parents provide a supportive environment for development?

Answer 5

Through scaffolding, reciprocal socialisation, providing a stimulating and enriching environment, give babies resources to thrive and develop

Question 6

What is attachment?

Answer 6

Theory which describes a biological instinct that seeks proximity to attachment figure when threat is perceived/discomfort is experienced -> sense of safety child experiences, provides a secure base from which they can explore environment thus promoting development -> establishment begins even before birth supported by reciprocal socialisation

Question 7

What is mind-mindedness?

Answer 7

Parents with mind-mindedness treat their children as individuals with minds, respond as if child’s acts are meaningful, motivated by feeling, thoughts or intentions, helping child to understand emotions

Question 8

When does attachment develop?

Answer 8

Birth to 3M -> prefer people to inanimate objects, indiscriminate proximity seeking; 3-8M -> smiles discriminately to main caregivers; 8-12M -> selective approach main caregivers, uses social referencing/ familiar adults as secure base to explore new situations; from 12M corrected age: attachment behaviour can be measured reliably

Question 9

What are the styles of attachment?

Answer 9

Secure = formed in early infancy and are protective factor leading to resilience throughout life span, insecure = individual at risk but not causative of later problems. Securely attached child (free exploration of room and happiness when mum returns - 65%); insecurely attached children (35%): avoidant-insecure = little exploration and little emotional response to mother; ambivalent (resistant-insecure) = little exploration, great separation anxiety and ambivalent response to mother upon return; disorganised insecure children = little exploration and confused response to mother

Question 10

What do secure attachments promote and are associated with?

Answer 10

Promotes: independence, emotional availability, better moods, better emotional coping -> associated with fewer behavioural problems, higher IQ and academic performance, contributes moral development and reduces child distress; in adolescence and adulthood = social competence, loyal friendships, more secure parenting of offspring, greater leadership qualities and resistance to stress, less mental health problems (anxiety and depression and psychopathology like schizophrenia)

Question 11

What is play for children?

Answer 11

Important positive effects on brain and on child ability to learn

Question 12

What is piaget’s theory of cognition?

Answer 12

Piaget stage model = children’s thinking changes qualitatively with age due o interaction of brains biological maturation and personal experience, development occurring as we acquire more schemas and as existing schemas become more complex -> process of assimilation and accommodation which leads to adaptation

Question 13

What are schemas?

Answer 13

Organised patterns of thought and action

Question 14

What is piaget’s sensorimotor stage?

Answer 14

Birth to 2y = infants understand world through sensory experiences and physical interactions with objects; objects permanence (understanding object continues to exist even when it can’t be seen; gradual increase use of words to represent objects, needs and actions, with learning based on trial and error

Question 15

What is Piaget’s preoperational stage?

Answer 15

Animism = ‘naughty chair’

Question 16

What is Piaget’s concrete operational stage?

Answer 16

x

Question 17

How do children develop concept of death?

Answer 17

Under 5s: do not understand that death is final, universal, will take euphemisms concretely, may think they have caused death. 5 to 10 years: gradually develop idea of death as irreversible, all functions ended, universal/unavoidable, more empathic to another’s loss; may be preoccupied with justice 10yrs through 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)

Question 18

What is adolescence and what are the changes in cognition, emotion and relationships?

Answer 18

x

Question 19

What occurs in adolescent brains?

Answer 19

x

Question 20

What is the effect of illness and chronic diseases on patients?

Answer 20

2-3x more likely to develop depression than the rest of the popn with one long term condition, 7x more likely with >3 conditions -> having MH problem increases risk of physical ill health, comorbid depression doubles risk of CHD

Question 21

What is the self-regulatory model?

Answer 21

Interpretation: make sense of disease that they are seeing, checking for cure/what it entails; coping: patient attempts to deal with problem to maintain sense of balance

Question 22

What is the Kubler-Ross’s stage theory?

Answer 22

Reaction to terminal illness -> Denial, Anger, Bargaining, Depression and Acceptance. Patients often don’t understand the psychological impact

Question 23

What is Denial in Kubler-ross theory?

Answer 23

Person think it’s not really happening, temporary situation, telling themselves it is temporary and everything will be back to normal soon -> often used as a psych defence in attempt to cushion impact of source of grief

Question 24

What is Anger in Kubler-ross theory?

Answer 24

Person thinks ‘why me?’, feels generalised rage at the world for allowing something like this to happen; feel isolated and furious, think its unfair and may feel betrayed; outbursts of anger in unrelated situations can occur

Question 25

What is Bargaining in Kubler-Ross theory?

Answer 25

Person thinks ‘if I do this, I can make it better and fix things’. May feel guilt and feel it is their responsibility to fix the problems, often try to strike bargains with God, spouses

Question 26

What is Depression in Kubler-Ross theory?

Answer 26

The person thinks “my heart feels broken” or “this loss is really going to happen and it’s really sad”; person is absorbed in the intense emotional pain that they feel from having their world come apart, can be overwhelmed with feelings of helplessness and sadness

Question 27

What is Acceptance in Kubler-Ross theory?

Answer 27

Person thinks “this did occur, but I have great memories” or “it is sad but I have so much to live for and so many to love” The loss is accepted and we work on alternatives to coping with the loss and to minimise the loss

Question 28

What is the problem of pathologising patients that don’t go through the stages of Kubler-ross theory?

Answer 28

Post-traumatic growth -> learn things after a traumatic incident; good vs bad = those that work through the stages are seen as good patients, with those still showing the problems in the stages are the bad patients

Question 29

*What is bereavement?

Answer 29

• Situation of a person who has recently experienced the loss of someone significant in their lives through that person’s death;
• Death doesn’t occur in isolation.
• How we grieve is strongly influenced by cultural customs and norms.
• Range of established theoretical approaches which consider responses to the process of bereavement.
• Perspectives include general stress and trauma theories, general theories of grief and models of coping which are specific to bereavement

Question 30

What are the responses to bereavement?

Answer 30

• The duration of severity of a person’s grief may depend on:
  
  • How attached they were to the deceased person
  • The circumstances of death and the situation of loss
  • How much time they had to work through anticipatory mourning
• Chronic grief can be associated with worsening mental health and is more likely if:
  
  • The death was sudden or unexpected
  • The deceased was a child
  • There was a high level of dependency in the relationship
  • The bereaved person has a history of psychological problems, poor support and additional stress

Question 31

What is personality?

Answer 31

Distinctive and relatively enduring ways of thinking, feeling, and acting that characterise a person’s responses to life situations

Question 32

What is a personality trait?

Answer 32

Relatively stable cognitive, emotional and behavioural characteristics of people that help establish their individual identities and distinguish them from others -> continuum along which individuals vary, like nervousness or speed of reaction

Question 33

What is neuroticism or stability?

Answer 33

Tendency to experience negative emotions

Question 34

What is extraversion?

Answer 34

Degree to which a person is outgoing and seeks stimulation

Question 35

What are the five factors of personality?

Answer 35

Describe main dimensions of personalit = OCEAN neuroticism, extraversion, openness to experience, agreeableness and conscientiousness

Question 36

What is Eysenck’s biological/genetic basis for personality traits?

Answer 36

Differences in customary levels of cortical arousal (introverts are overaroused, extroverts are underaroused); suddenness of shifts in arousal -> unstable people sow large and sudden shifts in limbic system arousal and stable people don’t

Question 37

What are Bandura’s key terms?

Answer 37

Reciprocal determinism -> cognitions, behaviours and the environment interact to produce personality

Question 38

What is a locus of control?

Answer 38

An expectancy concerning the degree of personal control we have in our lives -> internal = life outcomes are under personal control; external = outcomes have less to do with ones efforts than with influence of external factors

Question 39

What is intelligence?

Answer 39

The ability to acquire knowledge, to think and reason effectively and to deal adaptively with the environment -> measured by IQ = mental age/chronological age * 100; score of 100 is average, score of <50 is mentally retarded and score of >140 is very superior

Question 40

What is Charles Spearman’s theory of intelligence?

Answer 40

Intellectual activity involves a general factor and specific factor

Question 41

What are Gardner’s mutliple intelligences?

Answer 41

Linguistic, logical-mathematic, spatial, musical (also cardiologists as listen to sounds and diagnose heart problems), bodily-kinaesthetic, intrapersonal (socrates), interpersonal (freud), naturalistic and existential intelligences

Question 42

What is the factor structure of WAIS-IV?

Answer 42

However this has little clinical application

Question 43

What is crystallised intelligence?

Answer 43

Ability to apply previously acquired knowledge to current problems, which improves with age and then stabilises

Question 44

What is fluid intelligence?

Answer 44

The ability to deal with novel problem-solving situations for which personal experience doesn’t provide a solution, shows decline in aging

Question 45

How is intelligence acquired - genetic vs environment?

Answer 45

Genetic can influence effects produced by environment = 1/2-2/3 of variation in IQ but no single intelligence gene; environment can influence how genes express themselves = accounts for 1/3 to 1/2 of variation in IQ, both shared and unshared environmental factors involved and educational experiences are very important

Question 46

What are the differences in intelligence by gender?

Answer 46

Differences in performance on certain types of intellectual tasks, not general intelligence; men outperform women on spatial tasks, tests of target-directed skills and mathematical reasoning; women outperform men in tests of perceptual speed, verbal fluency, mathematical calculation and precise manual tasks

Question 47

What is autism?

Answer 47

Autism 4m:1f, Asperger’s syndrome 9m:1f -> described the social and communication difficulties of those with Autism/Asperger’s by delays/deficits in empathising whilst explaining the narrow interests with reference to skills in systemising

Question 48

What is empathising?

Answer 48

Consists of both being able to infer the thoughts and feelings of others and having an appropriate emotional reaction -> females find this easiest, then males and then autistic people

Question 49

What is systemising?

Answer 49

Drive to analyse or construct any kind of system in order to predict how system will behave -> autistic people are best at this, then males and then females

Question 50

What is health?

Answer 50

Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity

Question 51

What is an impairment?

Answer 51

Problem with a structure or organ of the body

Question 52

What is a disability?

Answer 52

Functional limitation with regard to a particular activity

Question 53

What is a handicap?

Answer 53

Disadvantage in filling a role in life relative to a peer group

Question 54

What are the 2 ways of coping with illness (Crisis theory of coping with illness)?

Answer 54

Adaptive response -> personal growth and adjustment to illness; maladaptive responses -> poor adjustment (psychological problems, low functioning)

Question 55

What is the crisis theory of coping with serious illness?

Answer 55

x

Question 56

Which illness related factors affect adjustment to illness?

Answer 56

Unexpected, cause and outcome/prognosis, disability, prior experience, stigma, disfigurement

Question 57

Which background/personal factors affect adjustment to illness?

Answer 57

Pre-existing personality, age of onset, gender, SES and occupation, pre-existing illness beliefs

Question 58

What are the illnesses associated with each of the big 5 personality traits?

Answer 58

Openness - no clear link to health. Conscintiousness - +2y life expectancy. Extraversion - lower CHD rates and protective respiratory disease. Agreeableness - hostility associated with CHD (more adaptation with disablity as may have more social support and better quality of friendships and more liekly to follow self care instructions and have positive coping strategies). Neuroticism - higher use of alcohol and smoking, higher symptom reporting

Question 59

Which physical and social environmental factors affect adjustment to illness?

Answer 59

Hospitalisation, accommodation and physical aids/adapptations, social support and social role, societal attitudes

Question 60

What are the illness representations from a patient?

Answer 60

A patients own implicit, common sense beliefs about their illness -> Identity (label of illness and symptoms), Cause (what may have caused problem), consequences (expected effects from illness and views about outcome), time line (how long it lasts and seen as acute, chronic or episodic) and curability/controllability (expectation about recovery/control of illness)

Question 61

What is the self-regulation model of illness cognition and behaviour?

Answer 61

x

Question 62

Which adaptive tasks can be carried out to help cope with illness?

Answer 62

Related to illness or treatment: coping with symptoms or disability, adjusting to hospital environment and medical procedures, developing and maintaining good relationships with healthcare professionals. General psychosocial functioning: controlling -ve feelings and retaining a positive outlook for future, maintaining a satisfactory self image and sense of competence, preserving good relationships with family and friends and preparing for uncertain future

Question 63

What are the 3 types of coping skills?

Answer 63

Coping (Cognitive and behavioural efforts to master, reduce or tolerate external and internal demands and conflicts), problem focused coping (Efforts directed at changing the environment in some way or changing one’s own actions or attitudes) and 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.)

Question 64

What are the types of coping?

Answer 64

Problem focused -> seek relevant info on illness, learning related procedures and changing behaviour; emotion focused -> seeking reassurance and emotional support, learning relaxation strategies, meditation

Question 65

What is the transactional definition of stress?

Answer 65

Stress is a condition that results when the person/environment transactions lead the individual to perceive a discrepancy between the demands of the situation and the coping resources available. With medical procedures = resources vs threat

Question 66

Why is patient distress a bad thing?

Answer 66

1. Moral/ethical responsibility to minimize suffering if possible. 2. If treatment is distressing there is a greater chance of patients avoiding or not complying. 3. Distress during treatment related to longer term psychological morbidity. 4. Distress during treatment related to wide variety of treatment outcomes.

Question 67

What is the difference between procedural vs sensory information which can be told to the patient in preparation for surgical procedure?

Answer 67

Procedural = info about procedures to be undertaken -> works by allowing patient to match ongoing events with their expectations in a non-emotional manner. Sensory = info about sensations that may be experienced -> works by mapping a non-threatening interpretation on to these expectations. Sensory report less distress than the procedural ones

Question 68

How do children cope with illness?

Answer 68

Distraction is most effective coping strategy for younger children; for older children matching coping strategy to child’s preferred coping strategy is more effective

Question 69

How can you prepare children for treatment?

Answer 69

Prep info should be specific and include procedural and sensory information; older children (>7y) benefit most from info presented 5-7d before procedure whilst younger children benefit from info closer to procedure. Modelling interventions can be helpful

Question 70

What is the combined approach to children coping strategies?

Answer 70

Tell -> simple language and matter of fact style, where child told what is going to happen before each procedure, comparisons child understands; Show -> procedure demonstrated using inanimate object, member of staff or clinician; and Do -> procedure doesn’t begin until child understands what will be done