Human Cognition Slides PDF

Genes, Behaviour and Environment 4MBBS103 Neuroscience, Behaviour and Social Science Human cognition. Learning objectives 1) Describe the role of sensation and perception 2) Explain the role of attention and information processing 3) Recognise the role of cognition and its effects on behaviour...

Genes, Behaviour and Environment 4MBBS103 Neuroscience, Behaviour and Social Science Human cognition. Learning objectives 1) Describe the role of sensation and perception 2) Explain the role of attention and information processing 3) Recognise the role of cognition and its effects on behaviour Why do I need to know about cognition? Knowledge about how patients cognitively process health related information can: Improve how you communicate with patients Promotes increased understanding between patient and Doctor Allows increased recall of salient information after the consultation Increases patient and doctor satisfaction Allows you to explore patients’ conscious beliefs and understanding about their health and illness in a targeted manner Describe the role of sensation and perception What do we see 2 Sensation and Perception (i) Sensation: The functioning of our sensory system (e.g. the process of stimulating our sensory receptors) Biological process Perception: Interpretation of sensory input, organising the input, and assigning meaning Cognitive process Sensation and Perception (ii) Three types: i) Mechanical (e.g. pressure, touch, vibration),; ii) Environmental stimuli Chemical (e.g. taste, smell); electromagnetic (light, heat) Transduction of stimulus i) Mechanoreceptors. Ii) Chemoreceptors, iiii) variety of via sensory receptors receptors - e.g. photoreceptors. Transmission of action Transmission occurs along the afferent pathway of the central potential in CNS nervous system. A sensory perception is generated in the brain by drawing on Interpretation the information transmitted from the afferent pathways. Sensation and Perception 3 What factors influence our perception of internal or external stimuli? Attention The ability to select salient sensory inputs to attend to Information processing systems Recognition – assign stimulus to a meaningful category. Knowledge – processing of stimulus based on pre-existing contextual knowledge “top-down processing”.  How many F and T letters are there in this sentence? INFERTILITY TREATMENT IS THE RESULT OF YEARS OF SCIENTIFIC STUDY COMBINED WITH THE EXPERTISE OF CLINICIANS Sensation and Perception 3 What factors influence our perception of internal or external stimuli? Attention The ability to select salient sensory inputs to attend to Information processing systems Recognition – assign stimulus to a meaningful category. Knowledge – processing of stimulus based on pre-existing contextual knowledge “top- down processing”. Emotions affect what we attend to and perceive  Sensation and Perception 4 After this lecture, the next time you perceive a physical symptom think about what led you to perceive this? Had you been in contact with someone who was ill and this prompts you to pay attention to your symptoms (e.g. prior knowledge “top-down processing”) Is this a new symptom? Are you able to recognise and assign meaning to what this physical sensation is? (e.g. “top-down processing”) When you first noticed the symptoms – what situation were you in? Were you in a situation where your attentional resources were not strained (e.g. sat at home with no other distractions?).  Explain the role of attention and information processing Selective Attention Test Attention i Attentional resource is limited: There are restrictions to the amount of sensory inputs that we can attend to, process, and assimilate. Sensory store/buffer Determines what sensory inputs are transmitted for further processing. Attention is part of our wider information processing system. Stimuli Sensory Short- Long- Response store Term term Memory memory Attention Attention ii Attentional control is both: Conscious and voluntary Choosing to remain focussed on learning a new skill Monitoring physiological states during illness/worsening health Unconscious and involuntary Loud noise promotes the deployment of attentional resources in direction of noise. Attentional resource is limited Particularly when processing simultaneous cues of the same sensory origin. Information is processed by parallel sensory channels. Attention in clinical practice iii Skill Acquisition: Learning new skills. 3 stages: Cognitive, Associative and Autonomous (Adams 1971) Supporting patients in developing illness self-management skills Attention in clinical practice Multitasking and medical mistakes Surgeons listening to music in operating theatres (Miskovic 2008) Attention Multitasking in and medical mistakes clinical Surgeonspractice listening to music in operating theatres (Miskovic 2008) Attention and patients v Supporting patients in developing illness self-management skills Patients self-regulation of health Patients who perceived themselves to be skilful in managing their diabetes actually adhered less to treatments (Hudson et al., 2016) Primary care context – inhaler technique  Attention When exposed to a stressful situation (e.g. and hospital) we default to survival mode exposure to stress Attentional system becomes hypervigilant, tune into threatening inputs Distract a patient’s attentional resource away from threatening context  Attention and physical symptoms i iv Pain captures attention, new, novel, intense Expecting pain, fearful or catastrophic (Keogh, Ellery, Hunt, & Hannent, 2001; Keogh, Thompson, & Hannent, 2003). Attention can become biased to attend to certain information which is deemed of particular relevance. Biased attention can become problematic e.g. anxiety, fatigue http://www.retrainpain.org/english Pain and the braini iv This is pain related brain activity The patient is given a fun/engaging of a patient with a burn video game to play Pain and the brain ii This is pain related nerve activity in the spinal cord When playing the game, pain related brain activity starts to decrease Source: Current biology, June 2012: “Attention Modulates Spinal cord responses to Pain” Information processing Stimuli Sensory Short- Long- Response store Term term Memory memory Attention How information is Basic organisation & characteristics of memory attended to and the relevance of this to medicine. and processed at the sensory level.  Short term memory/working Short- Term Memory memory Example in medicine: Temporary storage system with visual & auditory processing - First learning a patients history Limited processing capabilities: 7 ± 2 pieces of information (Miller, 1956) - Making a diagnosis Functional MRI’s suggest 4 (Luck & Vogel, 1997) - Calculating drug doses 50% of information given during consultation forgotten within 5 mins (Kessels, 2003) Clinical implications: - Giving information to patients Important information at beginning and end Chunk Write-down Check-back  Teach-Back Method Jill, you have told me that you don't want to get pregnant, so I want to make sure that I explained things clearly. Let's check how clear I was by having you tell me how you are going to take the pills.” “I want to make sure I explained this clearly. I know your daughter helps you manage your health. What will you tell her about the changes we made to your blood pressure medication?”  Short term memory/working Short- Term Memory memory Example in medicine: Temporary storage system with visual & auditory processing - First learning a patients history Limited processing capabilities: 7 ± 2 pieces of information (Miller, 1956) - Making a diagnosis Functional MRI’s suggest 4 (Luck & Vogel, 1997) - Calculating drug doses 50% of information given during consultation forgotten within 5 mins (Kessels, 2003) Clinical implications: - Giving information to patients Chunk information according to pre-existing long-term Important memory/organisational structures 0800-123-456 information at beginning and end Primacy and recency effect Chunk Write-down Check-back Long-term memory Stores information for future retrieval Memory structures are created through process of encoding Semantically meaningful categories (schemas) are generated Different types: Declarative knowledge Procedural knowledge Declarative knowledge “Knowing that” Episodic memory Personal experiences & Semantic memory Facts, ideas, concepts Explicit memory (conscious retrieval) Procedural knowledge “Knowing how” Cognitive/Problem solving skills Perceptual skills Motor skills Repetition Classical conditioning Implicit memory (unconscious retrieval) Recap on cognition Perception: Interpret, organise input, and assign meaning to external stimuli Attention: Ability to select what sensory inputs are attended to (voluntary and involuntary) Additional Information processing: Short-term memory Long-term memory (schemas) Cognition applied to health We need to understand how the below influence health behaviours/outcomes: Perception Attention Memory/Schemas Terminology below often used interchangeably: Cognition Beliefs Schemas Representation  Recognise the role of cognition and its effects on behaviour  Health behaviours Risky Increase chance of morbidity and mortality Promoting/Protective Enhance health and prevent disease Illness related Aimed at managing and acute/chronic illness  Psychological Models of Health Behaviour Need for comprehensive yet adaptive theories of behaviour: Capability: Psychological capacity (knowledge, skills, & confidence) Physical capacity Motivation: Voluntary (conscious rational decision making) Involuntary (habits, emotions, impulse) Need to adapt the COM-B model when specific health behaviours are targeted  The phenomenon of perception….. A: results in a perfectly accurate representation of the world Quick B: Is an interpretation of sensory input, organising the input, and assigning quiz meaning C: Is the functioning of our sensory system (e.g. the process of stimulating our sensory receptors) D: has evolved only recently  The phenomenon of perception….. A: results in a perfectly accurate representation of the world Quick B: Is an interpretation of sensory input, organising the input, and assigning quiz meaning C: Is the functioning of our sensory system (e.g. the process of stimulating our sensory receptors) D: has evolved only recently  Let's say you are at a loud party leaning in to listen to your friend talk to you. What kind of attention are you using? Quick A: Executive attention quiz B: Selective attention C: Sustained attention D: Divided attention  Let's say you are at a loud party leaning in to listen to your friend talk to you. What kind of attention are you using? Quick A: Executive attention quiz B: Selective attention C: Sustained attention D: Divided attention  During a medical consultation the patient relies on their short-term/ working memory to retain information given by the health care professional. Quick However, research shows that 50% of information given during a medical consultation is forgotten within 5 mins. Why is this the case? quiz A Limited processing capacity B Recency effect in short-term memory C Lack of schema in short-term memory D Lack of visual cues to aid processing  During a medical consultation the patient relies on their short-term/ working memory to retain information given by the health care professional. Quick However, research shows that 50% of information given during a medical consultation is forgotten within 5 mins. Why is this the case? quiz A Limited processing capacity B Recency effect in short-term memory C Lack of schema in short-term memory D Lack of visual cues to aid processing Reading Ayers, S., et al(2007). Cambridge handbook of psychology, health and medicine. Cambridge, Cambridge University Press. Ayers, S., & De Visser, R. (2017). Psychology for medicine and healthcare. Sage. Ogden, J.(2012).Health psychology. London, McGraw Hill Education, UK References. Ferner, R. E., & McDowell, S. E. (2006). Doctors charged with manslaughter in the course of medical practice, 1795–2005: a literature review. Journal of the Royal Society of Medicine, 99(6), 309-314. Hudson, J. L., Bundy, C., Coventry, P., Dickens, C., Wood, A., & Reeves, D. (2016). What are the combined effects of negative emotions and illness cognitions on self-care in people with type 2 diabetes? A longitudinal structural equation model. Psychology & health, 31(7), 873-890. 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