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70 Cards in this Set

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Talbot, 2000

Placebo Effect: Coloured the warts with inert dye, and also found that having ultrasound on with the therapist and patient thought it was on, the post-wisdom tooth extraction pain was reduced.

Psychological Theory

belief in the treatment or to a subjective feeling of improvement.

Mosley

Performed the lavage, debridement or placebo surgery to help reduce patients in the osteoarthritis pain. Over 2 years, the pain ended up being the same for all treatments.


(it had a 95% confidence interval).

Williams and Anderson Model

Stress Response:


1. Cognitive Appraisal of demands


2. physiological response and attentional demand


Personality, history of stressors and coping resources influence the stress response of a person.

Adrian Owen

Patient 23: A 24 year old man, 5 year vegetative state, found asking questions to him in fMRI machine had change in blood flow to certain regions of the brain.


Patient 33: a 23 year old woman, 5 month vegetative state. In fMRI machine, Owens asked her to think of playing tennis, there was activity in the supplementary motor area (same activity as a normal healthy woman thinking of tennis).


-Owens believes 20% of veg. patients are able to communicate.

Gretchen Kerr and Judy Goss 90's

Took gymnasts, and found that using the Meichenbaum stress inoculation program, there was a correlation between lower stress and lower injury rates, especially seen as the season progressed.


Dependant: Injury Occurrence .


Outcome: Incidence of injury can be reduced in athletes when NEGATIVE athletic stress is reduced.

Meichenbaum 1985

Stress inoculation program: premise that there might be something in your environment that you find stressful. Slowly expose a person to fear or stress, with increased intensity to learn to manage fear/stress.

Cupal and Brewer 2001: Effects of Relaxation and Guided Imagery on Knee Strength, Reinjury anxiety, and pain following anterior cruciate ligament reconstruction

Procedure: Treatment with relaxation, treatment with same amount of attention, and regular physiotherapy control group.


The relaxation and guided imagery group outperforms.


Higher pain reduction correlates with higher knee strength and lessen rein jury anxiety.


Psychological: personal control, motivation


Physiological: relaxation, lessen swelling, promotes tissues regeneration.

Moderator Variable

A moderator variable is a QUANTITATIVE variable that affects the nature, the direction or the strength of a RELATION between an independent and dependant variable.


i.e. the social support and coping skills in the Conjunctive Moderator variables...Sports injuries study by Smith, Smoll, Ptacek.

Smith, Smoll, Ptacek: Conjunctive Moderator Variables in Vulnerability and Resilency Research: Life Social Support and Coping sKills and Adolescent Sport Injuries.

Independant: Injury, Dependant: Stress


Moderator: Social support and coping skills.


Prospective study, exposure controlled for, factoring that starters play more than subs.


Results: Negative stress correlates with increase injury susceptibility when athletes have both low social support and low coping skills.


r= .47, and R^2=.22, therefore 22% athletes in this condition were predicted for more injury occurrences.

Prevalence

how often the disease occurs

Incidence/occurence

rate of new disease or health events

Epidemiological Research

is observational, looking at exposure-disease relationships using naturally occurring differences in the population. Ethical. QUANTITATIVE.


Criticized: looking at correlational data, not causation.

Epidemiological Studies: Analytical Study Designs: Cohort

aka, longitudinal, prospective


-group of individuals identified and followed.


-looking for incidences, per person years.


-time is FORWARD, there is a baseline and then time moves forward.

Paffenbarger et. al

Cohort Study! Harvard alumni followed for 6-10 years. Baseline --> looking at levels of weekly exercise. Follow up looking at rates of rate, non-fatal and first time heart attacks. 2000-3000kcal/week is benefit, then it starts to level off again. >2000kcal/week, your rates are a lot higher for all heart attacks. Benefit to PA.

Epidemiological Studies: Analytical Study Designs: Case-Study

aka, retrospective study.


Group of Individuals have a disease, the question is directed at CAUSE of the disease.


Group has DEFINING CHARACTERISTIC, compared with control group who DO NOT have disease.


Time: Looks BACKWARDS


Looking for events that reduce rates.

Bernstein et. al. 1994

Investigating PA exposure with women who have breast cancer.


-Want to see the lowest value has the highest level of activity.


>3.8 hours a week reduces 58% chance of getting breast cancer.

Physical Activity and risk of breast cancer,colon cancer....meta-analysis. 2013

WHO recommends 600 MET minutes a week.


MET "metabolic equivalent", 1 MET is resting eqivalent.


*Although risks of these disease decrease with increasing level of total activity, most health gains occur at relative lower levels of activity (up to 3000-4000 MET minutes/week), with diminishing returns at higher levels of activity.

Fact (F) (other side's will have fact too) 20% of Canadians will experience a mental illness in their life time

8% of Canadians will experience MDD in life time

F:49% of Canadians who feel they experienced some kind of mental illness did not talk to a doctor

121 million people are effected by depression worldwide



F:

25% of people have access to effective treatment worldwide

7% of Americans have MDD in a year



F:13% of Americans have experience MDD in lifetime

Women experience depression more than men

F:

Depression is the leading cause of disability as measured by years lived with disability

Depression is the fourth leading contributor to Global burden of disease (sum of years lost to premature mortality and years lost due to disability), will be 2nd in 2030 behind HIV/AIDS.


Mood

is a specific, short term feeling states or emotional tones that are positive or negative

Anxiety

an unpleasant feeling state and physiological reaction provoked by fear (by threat)


-Arousal is key


-Trait vs. state anxiety

Trait Anxiety

is a personality disposition, wired that way

State Anxiety

determines anxiety in the here and now, situational.

Depression

the state that eventuates from the perception of an important one or the threat of such a loss.


Characterized by withdrawal, avoidance, diminished activity


2 Core, 9 other symptoms


1 core and 5 other for diagnosis within last two weeks of month

Two Core Symptoms of Depression

1. Depressed mood almost all of, or all of day, nearly every day.


2. Markedly diminished pleasure in all or almost all activities

9 Core Symptoms of Depression

Guilt, sucidal thoughts, sleeping troubles, appetite changes, concentrating, little energy, agitation or slowing of body.

Beck Depression Inventory

Assess presence and intensity of depression in PSYCHIATRIC populations


-self report

Center for Epidemiological Studies Depression Scale

Assess presence and intensity of depression in general population

Farb 2011

Found that using fMRI, watching formerly-depressed patients brains while they watched sad movie. Some relapsed. When faced with sadness, compared to healthy, the patients processed it in the medial prefrontal gyrus (for thinking and processing) Patients also had higher rumination scores (tendency to think of upsetting aspects of situations) and negative events.

Brain Atrophy: Campbell 2004

Depression is associated with atrophy, especially hippocampus (responsible for memory consolidation from short to long). More severe atrophy, the worse the depression.

Atrophy is cortisol-mediated neurotoxicity: Jacobs

Hypothalamic-Pituitary Adrenal axis: Stress causes the hypothalamus to release CORTICOTROPIN STIMULATING HORMONE causing the stimulation of the pituitary gland to release cortisol.


Depressed patents have stress all day = constant release of cortisol, --> causes atrophy of hip.

Role of Translocation Protein Density, a Marker of Neuroinflammation, in the brain during Major Depressive Episodes (no name)

PET uses radiopharmaceutical to bind to translocator protein (TSPO) in microglia cells. Level of protein density is increase in activated microglia cells. Case-control study


TSPO against HDRS, the higher the HDRS score the higher the protein density.


Microglia activation is implication in major depressive episode.

F: If your family member has depression you are 20-30% more at risk to developing than normal (10%)

F: Identical twins, you are 49% more likely to develop depression. Fraternal twins are only 20% more likely.

Genetics: Caspi et. al 2004

Study on serotonin regulator gene: 5-HTT gene. Short and long.


If you had at least one short form copy you were 33% more likely to develop depression, compared to both long genes of 17%.

Attributional style

the reasons give for events, can be pessimistic or optimistic

Burns et al. 2002: Personal-Negative thought processing

Pessimistic: internal, global, stable (likely to happen again)


Optimistic: external, specific, unstable

F: Canada is the third highest user of antidepressants in 23 developed countries. 86 doses/1000 people.

Antidepressant levels: 11.2 (1998) to 23.3 million (2010).

Kirsch et al. 2008: Meta-analysis of data submitted to FDA

for so many people taking drug, how much of it is working vs. placebo?


-meta-analysis shows that meds only have modest benefits over placebo.


-to establish the relation of baseline severity and antidepressant efficacy using un/published trials.


Results: placebo had 7.8 improvement (HDRS) and drug 9.6. Fails to meet 3 point drug-placebo criterion. NICE wants 3.


SMD for placebo .92 and drug 1.24, difference was .32, NICe wants .5


The ONLY SIG. DIFFERENCE WAS ON EXTREME DEPRESSION END.


look at conc. in notes

F: 2012: global sales fell from $15 billion to $6 billion by 2016, for cheaper generics.

:Did you know? CMHA and CAHM centre do not promote exercise as a direct medication for depression?

Yoshiuchi et al. 2006

step count and daily duration of moderate Pa were significantly and inversely correlated with depression.

Paffenbarger et. al 1994

Based on levels of kcal/week, longitudinal study. found that highest EE were 28% less likely, and moderate were 17% like to develop depression compared to low EE.

Blumental et al. 1999

MDD in older adults, medication , med and exercise, and exercise.


Improvements in BDI, and aerobic capacity, life satisfaction, self-esteem, anxiety.


Medication works just as well as exercise, medication has more immediate effects, but same results after 16 weeks.

Cooney et al. 2014

Said that the recent findings of -0.62 of SMD for exercise is too small, even though NICE is .5 standard.

Honey I shrunk the pooled SMD - ekkekakis

Why? Apply rule: only examine studies where exercise is compared to a passive (non-excerise) control. It shows you what an antidepressant would do.



F: prevalence of dementia is expected to nearly double from 35.6 to 65.7 million from 2010 to 2030.

2014: Lumos sued for not backing up evidence for study

C. Groot et al. The effect of PA on cognitive function in patents with dementia: Meta-analysis

Is there a difference in those who exercise with dementia to those who don't? Breaking up groups with AD and non, exercise is beneficially either way. MUST BE AEROBIC BASED.


-

Anorexi Nervosa Charateristics

1. Refusal to maintain body weight at or above a minimally normal weight for age and height, less than 85% of expected.

2. INTENSE fear of gaining weight or become fat, even though underweight


3.Undue influence of body weight or shape on self-evaluation or denial of seriousness of current low body weight.




F: 2002, 1.5% of Canadian women 15-24 had ED

F: Prevalence of an. or bulimia is 0.3% to 1% in young women

F. 10% of individuals with ED are men. Men are more likely to have binge eating

F:AN has highest mortality rate of any psychotic illness 10% will die in 10 years from onset.

F: 2002, 28% of gr. 9 girls and 29% of gr. 10 girls engages in weight loss behaviors

F. 37% of girls in gr. 9 and 40% in 10 perceived themselves as too fat, 19% believed they were too fat, 12% reported trying to lose weight.

F: gr.7-12, 30%/29% girls and 25%/16% boys reported teasing by friends/family

F: body based teasing at home causes girls to be 1.5 times more likely o engage in binge-eating and extreme weight control behaviours five years later.

F: 30 million suffer from an ED

every 62 min, someone dies of ED



F: 13% of women of 50 engage in ED behaviours

F: 16% of transgender college students had ED



Military personelle. 5.5% of women and 4% of men had ED during, and it increased to 3.3% more and 2.6% after service

0.9% of american women suffer from anorexia in their lifetime

1 in 5 anorexia deaths is suicide

2.8% of american adults suffer from binge ED in lifetime.



nearly half of BED patients have comorbid mood or anxiety disorder.

Theoretical Distinction of Perfectionism: Terry Short-et. al.

Postive perfectionism is good, trying to achieve good outcomes, but negative perfectionism is bad because your whole perfectionism is to avoid negative consequences.

Psychological Mechanisms of ED - Slade 1982

Low self esteem and negative perfectionism. If the patient feels they are loosing control of that, they will use control of food for feeling of control.

Physiological Mechanisms of ED - Kaye and Stromber

ED patients have abnormally high levels of serotonin, restricting food lowers the levels and decreases anxiety.

Perfectionism and Eating Attitudes in Rowers:the Moderating Effects of Body Mass, Weight Classification and Gender: Haase 1999

Athletes may be at greater risk of developing an ED in sports where leanness is emphasized.


Many athletes also have negative perfectionism.


Taking EAT tests. Results: lightweight rowers with higher BMIs will have higher EAT scores. r=.76, R^2 = .58


Low BMI, there is not a lot going on, Low BMI will have low EAT scores.


Negative perfectionism is positively releated to eating attitudes.


Body mass, weight classification and gender MODERATE relation between negative perfection and disturbed eating attitudes.

Prevalence of ED in athletes

Many athletes share similar psychological factors as those with ED in clinical settings. Highly competitive, high emphasis on control, and perfectionist tendencies.

Sandgot-Borgen: Prevalence of Eating Disorders in Elite Athletes is Higher than in the general Population

Found that different sports will effect if it influences an ED or not. It supports the idea that emphasized leanness in a sport will lead to ED.


It found that female athletes were more at risk than any others. Male athletes and regular women are at same risk, and male non-athletes have the lowest risk.

F:Tobacco kills 37,000 Canadians and 480,000 Americans

If you have a low socio-economic status or are a routine/manual worker, you are more likely to smoke.

F: 80% of cancers are due to factors that could have been controlled. What are the factors?

Tobacco use, physical inactivity, unhealthy diet, excess body weight, alcohol, environment

F: only 3% of americans meet all four health behaviour goes of being a nonsmoker, heaving healthy weight, being physically active and eating 5 or more fruits and vegetables a day.

Failure rates among self-quitters have been 95-98% after 1 year.

F: 70% of smokers wish to quit or have tried at least once to quit.

:D