Medical Psychology: Summary Course 1 PDF

X UMF Carol Davila - Bucharest Faculty of Medicine Department of Medical Psychology SUMMARY COURSE 1 Medical Psychology: field of interference between Medicine and psychosocial sciences Health Psychology, Psychosomatics, Behavioral Medicine, Clinical Psychology: si...

X UMF Carol Davila - Bucharest Faculty of Medicine Department of Medical Psychology SUMMARY COURSE 1 Medical Psychology: field of interference between Medicine and psychosocial sciences Health Psychology, Psychosomatics, Behavioral Medicine, Clinical Psychology: similarities and differences. The role of the clinical psychologist in the hospital environment. Behavioral traits (A,C,D) related to an increased susceptibility to the disease. Protective and risky cognitive styles. Orientation of the clinician confronting a behavioral disorder. The main research methods in Medical Psychology. 1. Health Psychology, Psychosomatics, Behavioral Medicine, Clinical Psychology: similarities and differences. 19 55/ 6 D [1. ij9  S 19. 2. The role of the clinical psychologist in the hospital environment The complementary, but necessary role of the clinical psychologist in the therapeutic team: & - - defining criteria or directing the patient affected at both levels, psychological and 5 somatic - G holgi - -g w - prevention of psychiatric comorbidity, including the iatrogenic-generated one; -- 8 ri · * [S9 id I - addressing ongoing psychological symptoms. - -g /I Psychosomatic Disorders and Psychosomatic Diseases Psychological factors (stress, trauma), plus organic vulnerability → PS disorders/PS diseases - 54/s 5. -14. PS disorders - acute, benign, reversible (without concomitant organic lesions); dis X y % - PS diseases - chronic, partially reversible or irreversible; Potentially lethal, especially in what neglected PS diseases are concerned (e.g., cardiovascular). - Is &y g - 5 Neglect of PS disorders = common in both patients and physicians. 55- jnjp 5941459 Primary prevention = important, so efforts to increase its prevalence are welcomed. So D 3. Behavioral traits (A,C,D) related to an increased susceptibility to the disease c 3.1. Type A (Friedman & Rosenman) Characteristics: T peA 191 glyss is - hostility and aggression (cognitive, verbal, behavioral); - - x - feeling of urgency andCimpatience; -4 - competitiveness; -151 is/ = Grj - strong need for accumulation ("workaholic"); => Biologically: jih - increased secretion of: - norepinephrine and adrenaline; ·/ e - testosterone; on - 25 599 ·I ag - - triglycerides and cholesterol. 8-! Easymptoms (hypertension and coronary heart disease). - somatic: cardiovascular -  - can be demanding in the relationship with the physician (wants to share the medical - decision and be selective in what concerns the medical indications); - low compliance. Jyl glist Jor. 3 - ideally, it should be approached through a semi-structured interview. - - O 3.2. Type C (Temoshok) GS Characteristics: ! - inhibits negative feelings, offering the appearance of calm, rationality; - - conflict avoidance; - a - denial and suppression of emotions (especially anger); Health effects: 21st ((e= x % - the onset of cancer through the internalization ofO. stress (↓ NK cells and I - O helper T lymphocytes); - - - - - ------- O - decreased catecholamine secretion and hyperfunction of hypothalamic pituitary adrenal (HPA) axis; - association of pathogenic behaviors (e.g., substance use); - increased risk of autoimmune diseases (e.g., rheumatoid arthritis, lupus, multiple - - sclerosis, fibromyalgia); IS /5 ·. - - - adherent to treatment, but late addressability to the doctor; -go - socially integrated, but without the ability / desire to discharge their emotions in the - presence of others. ! 3.3. Type D (Denollet) Is Characteristics: - negative affectivity; j p - social inhibition; · - 5 i - increased levels of anxiety, irritability and depressive states; gisl - does not discharge their emotions, due to fear of social rejection or disapproval; i - - low self-esteem and depressive predispositions. -s Consequences on health: - poor prognosis and health status for cardiovascular patients, including those who get 19  i operated; - loneliness, does not count on the support of others / is skeptical in this regard; - may have been family / socially stimulated in this direction. - is fully confronted with life's problems (does not benefit from social support and does not look for it). 4. Protective and risky cognitive styles is 4.1. Self-efficacy (Bandura, 1977) = the person belief in their abilities to mobilize own cognitive and motivational resources in order to successfully fulfill their tasks. · 1981 jig 4.2. Internal control locus (ILC) (Rotter, 1966) = the belief that the responsibility for failure lies in the defects, mistakes of the person, - T and the merit for success - in the skills and qualities of the person and have little to do - & with chance; os) - ILC = associated with increased responsibility (e.g. in chronic diseases) and greater adherence. - external locus of control (ELC) = associated with resignation, fatalism, projection of guilt on the other (including on the physician). -gu - excessive ILC = associated to taking on unnecessary responsibilities (may become maladaptive, through the decrease of symptoms acceptance). 19 4.3. Hardiness (Kobasa, 1979) = the ability to withstand stress, mental pressure or change, despite difficulties. - components: - control; - commitment; - challenge. - can be cultivated / modeled through counseling / psychotherapy.  5 4.4. Coherence (Antonovsky, 1984) = the way a person perceives, judges and interprets the world and themselves. - components: - comprehensibility (the person believes that life events have a meaning, are predictable and explainable); - manageability (the person considers having the necessary resources to deal with daily requests; - purposefulness (the person believes that environmental challenges have meaning and purpose, so they are worth facing). is Is important in chronic diseases (the patient can understand the importance of preventive measures) (the patient can address the cause of a certain effect). I p/ 4.5. Self-esteem = represents the ratio between the individual's self-perceived value, and their abilities to achieve the desired goals. Js I 4.6. Optimism = the generally favorable cognitions that a person has about the future. - unrealistic optimism = potentially harmful (non-compliance). ↳i 5. Orientation of the clinician confronting a behavioral disorder. (The classical view on mental disorders) - 5.1. Neurosis: - reactive disorders ← stress, trauma; - awareness = present; - inserted in society; - should be primarily oriented towards the psychologist; - good / very good results of psychotherapy. j id 5.2. Psychosis: - "mixed etiology" (genetic + environmental factors); - high degree of maladaptation;  - social integration is abnormal, problematic; - awareness = low; - pharmacological treatment = preferred (primary referral to the psychiatrist). 191 - 5.3. Personality disorders: S - distorted behavior (but social functioning can be acceptable in restricted areas); - awareness = low; - perceived as “interesting” or “special” people; - origin in childhood / adolescence; - special communication techniques (they are difficult patients, they often display low compliance). 6. The main research methods in Health Psychology & 6.1. Observation = contemplating one’s / own behavior; - can be: direct or indirect (mediated); Advantages: - low costs; - encourages the spontaneity of the subject; Disadvantages: - does not ensure control to the observer; - subjective; - retrospective. 6.2. Clinical interview Structured · - "closed" (standard) questions; - corresponds to the "technical" anamnesis; - allows obtaining accurate information in a short time; - does not offer the possibility of emotional catharsis to the patient.  i Semi-structured - the patient is given a higher liberty to choose words to answer (“open” questions); - corresponds to the "psychoanalytic" (non-directive) anamnesis; - offers the possibility of emotional catharsis; - is time-consuming; - provides unstructured information, difficult to process statistically or operationalize. 6.3. Experiment & joine - the method by which, in psychology, a behavior can be provoked, controlled or manipulated; - allows clear associations to be established between the studied variables. 6.4. Psychological tests = standardized psychological tests that measure or describe a certain type of behavior. Parameters: Reliability - to provide comparable results over time; Validity - shows if a test really measures what it is meant to test; Sensitivity - the finesse of the possible differences obtained by using the test. - Types of tests: - Questionnaires - Projective tests I = - 6.5. Case studies %1 = a qualitative description of a behavior or of a psychological phenomenon that cannot be analyzed by quantitative methods, due to its complexity and variety; 6.6. Meta-analysis - 184 & = the statistical analysis of a large number of previously studies; ·9./I 291 Jes i S 6.7. Ethnographic studies sigX j = the study of beliefs, mentalities and specific ways to understand and explain reality; 29.5! Fig Jos 6.8. Study of diaries and other biographic documents = used successfully in longitudinal studies.