HP4 Quiz 1 2010

1

There is a high prevalence of psychological problems in medical patients. One proposed reason for this is:


  some medical disorders also cause psychological problems.

  patients may preferentially report physical symptoms rather than emotional symptoms.

  negative cognitions and affect are central to poor illness behaviours.

  both A and C.


Lecture 1 page 6:
Three proposed reasons are described:

  1. Causality: The medical disorder causes the psychological disorder (e.g. hypothyroidism).
  2. Comorbidity: The medical disorder increases the risk of psychological problems (e.g. neurological disorders/CV disease/diabetes).
  3. Coincidence: Common conditions coexist because both are prevalent.

2

Systematic desensitisation is useful in the treatment of phobias because it:


  decouples the unconditioned stimulus from the conditioned response.

  targets the cognitive domain of patient functioning.

  assists with decreasing avoidant behaviours.

  addresses the link between irrational beliefs and negative emotions.


Lecture 2 page 5:
Avoidant behaviours increase anxiety over time as well as the patient's degree of disability; controlled exposure to the anxiety provoking stimulus in relaxed conditions reduces anxiety symptoms. Highly effective for treatment of phobias.

3

The placebo effect


  demonstrates the importance of evidence based pharmacological treatments.

  misattributes drug effects to treatment expectations.

  demonstrates the importance of treatment expectations.

  misattributes drug effects to coping strategies.


Lecture 3 page 4:
The placebo effect is defined as symptoms of physiological change reported by patients who believe they are experiencing an effective treatment, but in reality are experiencing an inert treatment - this highlights the powerful effect of treatment expectations. Five mechanisms underly the effect.

4

A 28 year old female describes a history of persistent symptoms of anxiety. As her treating medical practitioner, you suspect a generalised anxiety disorder rather than a phobia. This is because the


  anxiety is associated with a specific pattern of response.

  symptoms occur in most situations.

  symptoms include panic attacks.

  anxiety has resulted in repeated emergency medical presentations.


Lecture 2 page 4:
A is incorrect: This would be more characteristic of phobic anxiety. C is incorrect: Discrete episodes of intense fear indicate a panic disorder. D is incorrect: This is more characteristic of panic disorder. B is correct: Generalised anxiety disorder is characterised by pervasive anxiety (> 6 months) in a range of settings.

5

According to Zajonc (1984)


  cognitive processing is integral to emotional experience.

  cognitive appraisal influences the type of emotional response.

  emotional experiences can occur in the absence of cognitive processing.

  cognitive attributes are central to illness perceptions and emotional responses.


Lecture 3 page 2:
The main question here is "Is cognition essential to experiencing an affective response?". Zajonc (1984) essentially presents the "no" argument: "affect and cognition are separate and partially independent systems and... although they ordinarily function conjointly, affect could be generated without a prior cognitive process."

6

The comorbidity of psychiatric disorders in general medical patients is closest to


  50%

  10%

  25%

  75%


Lecture 1 page 5:
At least 25-30% of medical patients have co-existing depression, anxiety, somatoform or alcohol misuse disorders.