Overview
In this lecture the major topics covered throughout the
psychology component of the course will be reviewed. Ways in which the material
covered in this course links to the other courses you will do as part of your
medical degree will be discussed. For some of these courses (for example
Communication Skills) an understanding of the psychological aspects of illness
forms part of their assessment. This lecture looks at case studies where an
understanding of human behaviour is essential to the treatment of human
illness.
Objectives
· Review the main topics in psychology covered throughout
this course
· Discuss health psychology and why it is fundamental to
medical practice
· Indicate ways in which the psychological material
presented in this course links to other courses on the MB BS
Further reading
Sarafino E. (2002) Health Psychology: Biopsychosocial
Interactions NY:John Wiley and Sons
Ogden J. (2000) Health Psychology: A
textbook Buckingham, Philadelphia: OU Press
The Psychology of Pain (Brain and Behaviour - Year 2)
Overview
Pain perception provides and example of a basic psychological
process. Pain is a common complaint in medical settings, with unbearable and
chronic pain representing extreme problems for the patient. The diagnosis of
pain disorder will be considered along with the general issue of what causes
pain. Psychological theories of pain will be presented with reference to the
phantom limb phenomenon following amputation, arthritis and headache. Ways of
assessing pain will be considered and techniques of psychological pain
management will be evaluated in terms of efficacy and use in routine practice.
Objectives
· Consider explanations for unusual pain phenomena
· Describe and evaluate specificity and gate-control theories of pain
· Describe psychological methods of pain assessment
· Describe
psychological pain management techniques and evaluate evidence of their
efficacy.
Further Reading
Melzack and Wall, The Challenge of Pain, Ch.8 The
Evolution of Pain Theories.
Sarafino EP. Health Psychology: Biopsychosocial
interactions, Ch.11 The Nature and Symptoms of Pain, Ch.12 Managing and
Controlling Clinical Pain
Eccleston C. (2001) Role of psychology in pain
management, Br J. of Anaesthesia, 87, 144-152
Johnson et al (1998) The
effects of imagery and sensory detection distractors on different measures of
pain, Br J of Clinical Psychology, 37, 141-154
Weisenberg M. (1987)
Psychological intervention for the control of pain, Behaviour Research and
Therapy, 25(4), 301-312
Learning and Conditioning (Brain and Behaviour - Year 2)
Overview
Learning is a basic psychological process underpinning a variety
of human behaviour. We will be looking at the basic types of learning, as a key
to understanding human behaviour and its modification. This lecture will also
illustrate how principles of learning apply in clinical situations, such as
anticipatory responses in chemotherapy for cancer. Techniques based on learning
can be effective in managing such conditions.
Objectives
· Distinguish different types of learning and
conditioning
· Describe anticipatory reactions in medicine
· Describe the role of learning in addictive
behaviours
· Illustrate how learning principles can be applied to
clinical situations
· Provide examples of psychological treatments
based on theories of learning
Further Reading
Atkinson, R. et al
(1996). Introduction to Psychology. Fort Worth: Harcourt Brace Jovanovich.
Chapter 7 has detailed accounts of the classic learning paradigms, including the
behavioural and cognitive approaches.
Watson, M. & Marvell, C. (1992).
Anticipatory nausea and vomiting among cancer patients: A review. Psychology and
Health, 6, 97-106. This journal article explains how undesirable reactions can
be acquired during chemotherapy, and discusses ways of managing the problem.
Intelligence and Problem Solving (Human Science and Public Health - Year 2)
Overview
Processing information, solving problems and making decisions are
cognitive functions crucial for most human activity. This lecture will cover the
concept of intelligence, its measurement, determinants and issues of mental
impairment and mental giftedness. It will also provide examples of cognitive
errors which can affect medical reasoning and diagnosis.
Objectives
· Demonstrate understanding of the concept of
intelligence and describe some of its determinants
· Define mental
impairment and mental giftedness
· Appreciate procedures involved in
aptitude testing
· Identify the most frequent cognitive errors in
medicine
Further Reading
Atkinson, R. et al (2003). Introduction to Psychology.
Fort Worth: Harcourt Brace Jovanovich: Chapters 9 and 12.
Sheridan, C. &
Radmacher, S. (1992). Health Psychology: Challenging the Biomedical Model. See
human information processing and medical reasoning in Chapter 6.
Personality and Illness (Human Science and Public Health - Year 2)
Overview
Beginning with Hippocrates and even earlier, theories of
personality have been developed and claims made about the link between
temperament and illness. Recent research has developed this controversy by
prospective studies suggesting that, along with biomedical factors, personality
type may influence proneness to coronary heart disease and even cancer.
Objectives
· Highlight the main theories of personality of relevance
to medicine
· Outline the evidence that personality may influence
development and response to illness
· Give a critical account of the
mechanisms by which personality may affect the development of specific diseases
· Describe some of the psychological interventions that may alleviate
or ameliorate these diseases
Further Reading
Pelosi, A. & Appleby, L. (1992). Psychological
influences on cancer and ischaemic heart disease. British Medical Journal, 304,
1295-1298.
Eysenck, H. J. (1992). Psychosocial factors, cancer and ischaemic
heart disease. British Medical Journal, 305, 457-459. Both available in the
library folder marked 'Psychology: Personality and Illness'.
Stress, Illness and Coping (Human Science and Public Health - Year 2)
Overview
There is evidence that emotional and psychosocial factors play a
role in the aetiology of many physical, as well as mental, illnesses. More
generally, stress can affect the onset, severity and prognosis of many
illnesses. This lecture will examine the concept of stress, review models that
postulate a link between stress and illness, examine the main psychosocial
factors associated with vulnerability to stress, and highlight the main coping
strategies adopted to deal with stress.
Objectives
· Discuss the nature of emotional reactions and stress
· Describe some of the mechanisms through which stress and illness
might be linked
· Examine the main psychosocial factors associated with
vulnerability to stress
· Outline coping strategies used to deal with
stress
Further Reading
Steptoe, A. (1991). The links between stress and illness.
Journal of Psychosomatic Research, 35, 633-644. A review of research examining
evidence for a relationship between stress and illness.
Sarafino E. (2002)
Health Psychology: Biopsychosocial Interactions NY:John Wiley and Sons
Preparing Patients for Unpleasant Medical Procedures (Personal and Professional Development -Year 3)
Overview
Preparing patients psychologically for surgery and other medical
procedures is a vital aspect of medicine and has direct implications for their
recovery. Research suggests a strong link between levels of anxiety and time
taken to recover from surgery. This lecture will examine these issue and ask
what psychologists can do to reduce the stress of medical procedures.
Objectives
· Identification of the need to provide psychological care
for patients undergoing stressful medical procedures
· Outline factors
that influence patient coping
· Describe the impact of anxiety on
post-surgical recovery times
· Demonstrate practical skills in preparing
patients for unpleasant investigative and therapeutic procedures.
Further reading
Johnston M and Wallace L. (eds) (1990) Stress and Medical
Procedures Oxford: Oxford Medical Publications.
Ludwick-Rosenthal, R and
Neufeld, R. (1988) Stress management during noxious medical procedures.
Psychological Bulletin 104, 326-342.
Improving Adherence to Medical Advice (Personal and Professional Development -Year 3)
Overview
Adherence and compliance are general terms used to refer to the
degree to which patients carry out the behaviours and treatments their doctors
recommend. People that don't adhere to the treatment recommended by their
doctors are, more often than not, risking prolonging or worsening their
condition or even developing health conditions that they don't already have.
This lecture charts the reasons why patients fail to adhere to advice and
describes ways of improving patient adherence.
Objectives
· Appreciation of the incidence, costs and different
patterns of non-adherence to medical advice
· Understanding the role of
health beliefs upon adherence behaviour
· Understanding the importance
of patient-doctor communication in adherence
· Knowing about strategies
for improving adherence behaviour.
Further reading
Sarafino E. (2002) Health Psychology: Biopsychosocial
Interactions NY:John Wiley and Sons
Ogden J. (2000) Health Psychology: A
textbook Buckingham, Philadelphia: OU Press
Medicines Partnership (2003) Why
bother with concordance? From Compliance to Concordance: An Overview of
Supporting Evidence.
Meichenbaum D. and Turk DC. (1987) Facilitating Tratment
Advice: A Practitioner's Guidebook. London: Plenum Press. (Especially Chapters 7
and 8.)
Lifestyle and Disease: Advising Patients on Obesity - Personal and Professional Development (Year 3)
Overview
This half-day session takes a look at the problem of obesity and
considers some of the lifestyle factors that contribute to the rise in
prevalence of obesity in Britain. It examines some of the difficulties we
face when trying to help people change their behaviours and - with input
from experts in dietetics, metabolism and endocrinology - describes at some of
the surgical and medical treatments of obesity currently available. We also look
at psychological models that might help in the understanding of the problem of
obesity and lifestyle change.
Objectives
· Describe the importance of lifestyle factors such as
smoking, eating and exercise in medicine
· Outline some of the
difficulties in trying to help people change their lifestyles.
· Outline
the rationale and efficacy of treatments for obesity
· Explain the model
of treatment of obesity developed by 'Weight Watchers'
· Demonstrate
skill in providing elementary guidance to obese patients.
Further reading
Brownell K, and Wadden T. (1992) Aetiology and treatment
of obesity: Understanding a serious prevalent and refractory disorder. Journal
of Consulting and Clinical Psychology 60, 505-517.
Sarafino E. (2002) Health
Psychology: Biopsychosocial Interactions NY:John Wiley and Sons
Lifestyle and Disease: Helping patients stop smoking - Personal and Professional Development (Year 3)
Overview
This half-day session focuses on practical skills in helping smokers quit. It examines reasons why some smokers find quitting difficult, reviews the key behavioural and pharmacological treatments for smokers, covers practical skills in their implementation, and provides information about the work of specialist smokers clinics and the appropriate referral routes. The session includes small group practicals facilitated by experienced practitioners.
Objectives
1. Describe the pharmacological and psychological aspects of smoking.
2. Show awareness of existing treatments for smokers, and of their efficacy.
3. Show basic skills in advising smokers in routine medical consultations.
Further reading
Royal College of Physicians (2000): Nicotine Addiction in Britain. RCP, London
McEwen A., Hajek P., McRobbie H, West R (2006) Manual of smoking cessation, Blackwell, Oxford
West, R., Shiffman, S. (2007) Fast facts: Smoking cessation. Health Press, Oxford
Explanations of Madness: Paradigms in Abnormal Psychology
Overview
A large proportion of medical consultations involve psychological problems. The session provides an introduction into categorising and understanding psychological ‘abnormality’. The teaching session includes a video of an unusual psychological disorder to illustrate the main points of the lecture
Objectives:
- To appreciate the link between behavioural and medical problems
- To understand problems in defining psychological abnormality.
- To discuss general approaches to understanding psychological illness.
- To explain the main concepts of biological, psychodynamic, behavioural, cognitive and evolutionary paradigms of mental illness.
Further reading:
Davison G., Neal J., Kring A. (2007): Abnormal psychology, Wiley, New York
Bentall R. (2003) Madness explained. Penguin, London
Overview
The session provides an outline of psychological factors involved in addictive behaviours, in particular the role of conditioning and social influence. Attempts to use such insights in treatment are discussed and illustrated by video vignettes.
Objectives:
- To see the concept of addiction in its social context
- To understand the principles of learning and conditioning as applied to addiction
- To examine individual differences in vulnerability to addiction
- To discuss the main treatment approaches and their limitations
Further reading:
Selected sections from:
Davison G., Neal J., Kring A. (2007): Abnormal psychology, Wiley, New York
Galanter M., Kleber H. (2008) Substance abuse treatment, APP, Arlington
West R. (2006) Theory of addiction. Bl;ackwell, Oxford