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157 Cards in this Set
- Front
- Back
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Descriptive studies |
Prevalence, distribution, hypothesis generation Case report, cross sectional, ecological |
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Case report |
Detailed report of an unusual disease in a single patient |
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Case series |
Detailed report of an unusual condition in several patients |
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Cross sectional study |
Observational study, collect information from a defined population at one point in time Aka prevalence studies or surveys |
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Ecological study |
Data from population groups to compare disease frequencies Between populations or between same population at different points in time |
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Ecological fallacy |
Make conclusions on individual based on group data analysis |
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Analytical studies |
Explicit comparisons of groups of individuals Testing of hypotheses Case control, cohort, clinical trials |
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Case control |
Case has disease, control doesn't have disease Retrospective exposures compared Disease --> cause? |
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Cohort |
Aka follow up, longitudinal Follow up over a long period of time and compare incidence Cause --> disease? |
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Randomised controlled trial |
Experimental study where participants are randomised either to receive the new intervention or a control |
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Qualitative study |
Explores people's subjective understandings of their lives and experiences |
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Systematic reviews |
>1 study addressing a particular health question Collect studies and base conclusions on cumulated results |
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Met analysis |
Statistical process of combining results from several studies |
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Epidemiology |
The study of patterns of health and illness and associated factors at the population level Identification of risk factors and determining optimal treatment approaches |
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Effectiveness |
Does this intervention do more good than harm? |
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Diagnosis |
How likely is the patient to have the disease on he basis of test results |
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Frequency |
How common is the condition in the population? |
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Prognosis |
Prediction of future outcome |
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Evidence based medicine |
Individual clinical expertise + best external evidence + patient values and expectations |
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AAAA |
Assess access appraise act |
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Assess |
Formulate a clear clinical question PICO Identify best study design |
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Access |
Search for and retrieve research |
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Appraise |
Identify strengths and weaknesses of research and interpret results |
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Act |
Apply the evidence, taking into account its weaknesses, alongside other information |
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PICO |
Population Intervention Comparator Outcome |
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Relative risk = 1 |
No risk difference between intervention and comparator |
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Relative risk > 1 |
More outcome in intervention than in comparator |
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Relative risk < 1 |
Less outcomes in intervention than in comparator |
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Risk difference +ve |
More risk of outcome in intervention than in comparator |
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Risk difference -ve |
Less risk of outcome in intervention than in comparator |
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Number needed to treat |
Number of students you would need to treat to obtain 1 additional beneficial outcome compared to the comparator |
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Attachment |
An intense emotional relationship that is specific to two people, that endures over time, and in which prolonged separation is accompanied by stress and sorrow and reunion is accompanied by joy |
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Pre-attachment phase |
Up to 3 months Babies prefer contact with imams but can't differentiate between individuals |
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Indiscriminate attachment |
Up to 7 months Can discriminate familiar and unfamiliar people Allow strangers to look after them without distress |
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Discriminate attachment |
7-8 months Actively tries to stay close to certain people Separation anxiety Show object permanence and fear of stranger response |
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Object permanence |
The ability to know something exists even if you can't see it |
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Multiple attachment |
9 months onwards Strong additional ties formed Fear of stranger response weakens |
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Psychoanalytical theory of attachment |
Infants become attached because of the caregivers ability to satisfy instinctual needs |
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Behavioural theory of attachment |
Infants associate their caregivers with gratification and learn to approach them to satisfy their psychological needs |
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Bowlby theory of attachment |
New horns are entirely helpless and are genetically programmed to behave towards their mothers in a way to ensure survival |
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Immanent justice |
Cause of their illness is because they have been naughty and are being punished |
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Phenomonism |
Cause of illness is an external concrete phenomenon which is spatially and temporally remote |
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Contagion |
The cause of illness is located in objects or people |
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Contamination |
Cause is viewed as a person, object or action external to the child Physical touch |
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Internalisation |
Illness located inside the body while cause is external Understand everyone dies Insensitivity - dead people can't feel |
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Physiological |
Illness described as malfunctioning of internal organs or process Death is permanent |
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Psychophysiological |
Illness is described as malfunctioning organs but are able to understand other possible causes |
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Social cognition |
The process by which people think about and make sense of other people, themselves and social situations |
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Attributions |
Causal explanations for behaviour and events |
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Kelleys covariation theory |
Dispositional/internal attributions Situational/external attributions Consensus Consistency Distinctiveness |
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Dispositional/internal attributions |
Due to person factors |
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Situational/external attributions |
Due to environmental factors |
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Consensus |
Do other people do the same in this situation? |
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Consistency |
Does the behaviour occur reliably in this situation? |
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Distinctiveness |
Does the behaviour only occur in this situation? |
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Internal locus of control |
Individual is prime determinant of health state These patients are generally easier to handle, more likely to comply, more likely to feel guilt |
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External locus of control |
Luck/fate/chance determines health state - patients less likely to comply Powerful others determine health state - often older patients |
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Fundamental attributional error |
Tendency to overestimate the importance of personality relative to environmental influences in explaining others behaviour Tend to think things that happen to people are their fault |
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Actor-observer bias |
Tendency to overestimate the importance of environmental influences relative to personality in explaining our own behaviour Because we have a greater understanding of external factors affecting ourselves than others |
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False consensus |
Tendency to believe that our own views are widely shared and consensual |
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Self serving bias |
Tendency for individuals to make dispositional attributions for their successes and situational attributions for their failures |
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Belief in a just world |
Tendency to believe people get what they deserve in life Associated with wealth and high social status |
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Hedonically based attributions |
Ripple tend to make the most pleasurable attribution Defensive avoidance due to fear This results in delays in consulting |
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Somatisation |
Patient presents with physical symptoms and attributes them to a physical cause when the cause is in fact psychological |
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Pessimistic attributional style |
Negative events are internal, stable and global |
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Components of attitude |
Cognitive (beliefs and preconceived expectations) affective (feelings/emotions aroused) and behavioural (action towards subject) |
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Acquiescence bias |
Tendency to agree |
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Screw you hypothesis |
Deliberate negative attitude |
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Hawthorne effect |
Social desirability shown in responses |
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Cognitive dissonance |
A state of tension when an individual simultaneously holds 2 cognitions that are psychologically inconsistent Need to reduce dissonance by achieving consonance (change behaviour, change belief or create new belief) |
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Primary ageing |
Natural decline |
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Secondary ageing |
Results from disease, disuse or abuse |
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Hayflick limit |
Limit to the number of times cells can divide |
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Cross linking |
Proteins in cells interact to produce molecules which make the body stiffer |
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Stereotyping |
Generalisation of specific groups and members of those groups Cognitive shortcuts, careless assumptions |
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Illusory correlation |
People tend to overestimate the coincidence of rare events |
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Illusion of our group homegeneity |
Members of our groups are seen as more similar than members of the in group |
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Relative deprivation hypothesis |
Own groups tend to feel more deprived compared to other groups |
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Prejudice |
An extreme negative attitude which is easy to learn Attitude = negative Behaviour = discrimination Cognitive = stereotype |
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Social identity theory |
Conformity to group norms Maintains our self image and self esteem |
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Conformity |
Process by which people's beliefs of behaviours are influenced by others |
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Scapegoating |
Holding a person, group of people or thing responsible for a multitude of problems |
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Stereotype threat |
Threat that behaviour of the out group will conform to the negative stereotype |
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Dictionary definition of stigma |
A mark of disgrace or infamy |
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Goffman: basic premise of stigma |
Society categorises people based on normative expectations dividing the normal from the deviant A stigmatised person is reduced from a whole and usual person to a tainted and discredited one |
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Discredited stigma |
Manifest stigmatising conditions can be seen openly and individuals are forced to deal with their stigma in almost all interactions |
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Discreditable stigma |
Persons who possess a stigmatising characteristic that cannot be obviously and immediately discredited and they have to make a decision to reveal it |
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Courtesy stigma |
Stigma from being related to or being in close proximity to someone who is stigmatised |
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Felt stigma |
Shane and expectation of discrimination that prevents people from talking about their experiences and stops them from seeking help |
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Refugee |
A person who has fled from and/or cannot return to their country due to a well founded fear of persecution including war or civil conflict |
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Asylum seeker |
A person who has left their country of origin, has applied for recognition as a refugee in another country and is awaiting a decision on their application |
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Exceptional leave to remain |
Granted to people who do not fulfil the criteria of the 1951 convention definition of refugee Can remain for 3 or 4 years and then have to leave Children up to 18th birthday |
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Stateless person |
A person who is not recognised as a citizen in their country of origin or in the country they have fled to |
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Gradual slant trajectory |
Long slow decline Eg COPD, heart disease |
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Downward slant trajectory |
Rapid decline Eg cancer |
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Peaks and valleys |
Alternating patterns of remission and relapse Eg cancers and remission |
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Descending plateaus |
Decline, stabilise etc Eg Parkinson's |
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Stages of grief |
Denial Anger Bargaining Depression Acceptance |
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Aggression |
Behaviour that is intended to injure. Person or destroy property and serves to enhance self |
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Ethnological perspective of aggression |
Aggression is innate disposition arising from natural selection Ensures species don't live too close together Fights select strongest and healthiest leaders |
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Psychoanalytic theory of aggression |
Aggression is a basic drive like hunger Energy that persists until satisfied Present at birth Part of the id Caused by frustration of instincts |
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Frustration aggression hypothesis |
Frustration is a result of goals being thwarted and leads to behaviour intended to injure the obstacle |
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Causes of aggression |
Frustration Direct provocation Exposure to media violence Being in a group Heightened arousal Hot and humid weather Pain |
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Psychopathy/dissocial personality disorder |
Intelligent, superficial charm, poor self control, grandiose self worth, little or no remorse Reduced prefrontal cortex activity, smaller prefrontal cortex |
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Sex/sexual identity |
Biologically determined through genetic makeup, reproductive anatomy and biological function |
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Gender/gender identity |
The social interpretation of sex, role expectations |
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Gender role |
Behaviours, attitudes, values, beliefs which society expects/considers appropriate to males and females |
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Gender stereotypes |
Widely held beliefs about psychological differences between males and females |
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Sex typing |
The process by which children acquire sex/gender identity and learn their gender appropriate behaviours |
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Intersexuality |
Low correlation of categories of sex Eg hermaphrodite |
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Hermaphrodite |
Genital ambiguity, genitals not consistent with chromosomal/gonadal sex |
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Biological gender development |
Biologically programmed for different different roles - evidence of structural and functional differences between male and female brains |
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Feminist theory gender development |
Women felt imprisoned by their gender role which was dictated and manipulated by men |
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Gender development bio social theories |
Critical period for gender identity (Money and Ehrhardt) |
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Gender development sociobiological theories |
Gender evolved so we can adapt to our environment Parental investment theory |
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Gender development social learning theories |
Behaviour learned through being treated differently Observational learning and reinforcement |
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Gender development Freud's psychoanalytic theory |
Rooted in the phallic stage of psychoanalytic development |
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Gender development cognitive development theory |
Children's discovery that they're male or female causes them to identify with and imitate same sex models Age 3 - gender labelling Age 4-5 - gender stability Age 6-7 - gender constancy |
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Gender schematic processing theory of gender development |
Gender identity alone can provide a child's with sufficient motivation to assume sex types behaviour |
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Gender development cultural relativism |
Gender is socially constructed as there is enormous cultural diversity of male and female roles |
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Transsexualism |
People are convinced they are gender opposite to chromosomal sex Psychiatric disorder Cross dressing is not for sexual arousal |
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Transvestism |
Wear the clothes of the opposite sex but not for sexual excitement, nor are they transsexuals Gain temporary member ship of the opposite sex |
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Paraphilias |
Sexual urges directed to non human objects, suffering/humiliation of oneself or partner, towards others incapable of giving consent Eg fetishism, exhibitionism, voyeurism, sadomasochism, paedophilia |
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Sexual response |
Desire Arousal Plateau Orgasm Resolution |
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Histrionic patients |
Dramatic, overwhelming and emotional style of presenting May be seductive and flirtatious towards the doctor |
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Dependant patients |
Need an inordinate amount of attention but don't appear reassured, repeated urgent calls between Ppointments, demand special treatment |
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Demanding patients |
Demand discomfort and problems be eliminated immediately Act entitled and superior to mask feelings of helplessness and weakness while endangering depression fear and rage |
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Narcissistic patients |
Act as if superior to others including the doctor May initially idealise doctor but soon turns to feelings of contempt for the doctor's inadequacies |
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Suspicious patients |
Chronic deeply ingrained suspicion that other people are unreliable, untrustworthy and only want to cause them harm Misinterpret neutral events as conspiracy against them |
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Help rejecting complainer |
Communicate through list of complaints and disappointments Blame others and make others feel guilty for not caring enough |
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Manipulative patients |
Appear to use lying and manipulation as a means of communicating Malinger to gain external objectives History of violence and threats of self harm for gain |
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Somatisation disorder |
History of physical complaints beginning before the age of 30 4 pain, 2 GI, 1 sexual, 1 pseudo neurological Appropriate investigation shows symptoms are inexplicable by medical condition or symptoms are in excess of physical illness |
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Hypochondriacal disorder |
Preoccupation with fears of having a serious disease based on misinterpretations of bodily symptoms Persist despite negative medical evaluation |
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Conversion disorder |
Presents as an alteration or loss of physical function suggestive of a physical disorder Psychological conflicts or stressors precede initiation or exacerbation |
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Psychodynamic theory (conversion disorder) |
Unconscious psychological conflict repressed and anxiety is converted to physical symptoms |
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La belle indifference (conversion disorder) |
Patient seems surprisingly unconcerned about their physical symptoms |
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Body dysmorphic disorder |
Preoccupation with an imagined defect in appearance or a markedly excessive concern for a slight physical anomaly |
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Factitious disorder |
Intentional production of symptoms with the motivation to assume the sick role External incentives are absent |
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Factitious disorder by proxy |
Physical or psychological symptoms or signs intentionally produced or invented by a parent or carer who aims to assume the sick role by proxy |
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Malingering |
Consciously motivated intentional production of signs and symptoms with clear external incentives |
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Legitimate power |
Formal authority within the organisation |
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Referent power |
Power from the ability to persuade or influence |
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Expert power |
Power from possessing needed skills and experience |
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Reward power |
Power from the ability to give valued benefits |
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Coercive power |
Power from the ability to punish or withhold rewards |
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Medic power |
The ability to impose ones will on others even if they resist in some way The real or perceived ability or potential to bring about significant change in people's lives through ones actions The power to define illness and accordingly manage |
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Medical dominance |
The authority that the medical profession can exercise over others through being cultural authorities in matters relating to health |
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Medical autonomy |
The legitimated (publicly accepted) control thy the medical profession exercises over the organisation and terms of its work |
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Socialisation |
Mechanisms by which people learn the rules, regulations and acceptable ways of behaving in the society or group they belong to |
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Primary socialisation |
Socialisation that occurs in the family |
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Secondary socialisation |
Socialisation that continues throughout life Eg from peers, school, occupation |
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Anticipatory socialisation |
Socialisation when someone rehearses for future position |
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Patient socialisation |
Learning correct behaviour as a patient and how to interact with health systems |
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Medicalisation |
The process by which non medical problems become defined and treated as medical problems |
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Total institutions |
All aspects of life are conducted in the same place under a single authority Daily life is carried out in a group with others with scheduled activities Sharp distinction between managers and the managed with little communication between Institutional perspective and therefore the assumption of an overall rotational plan |
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Negligence: the law |
The defendant must owe the claimant a duty of care The defendant must be in breach of this duty This breach must cause the claimant's harm |
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Enacted stigma (Scrambler) |
The actual experience of being treated differently because of stigma |
