Term
| What are 3 famous placebos used in history? |
|
Definition
| theriac (vipers flesh), unicorn horn (ivory), and mandrake (harry potter) |
|
|
Term
| What are 3 things that cause a sick person to get better? |
|
Definition
1. ailment runs its course (NATURAL HISTORY EFFECT)
2. specific active components of a treatment help the person
3. nonspecific effects of a treatment help--placebo effects |
|
|
Term
| what studies do test for placebo effects (what 3 conditions are patients given)? |
|
Definition
| active drug, placebo, and nothing (antidepressants-- did way better with placebo than nothing group) |
|
|
Term
| how do you test for placebo effects? |
|
Definition
1. runs study with 3 groups of subjects
2. objectively measure your out comes (not self reported but measured or observed by someone else) |
|
|
Term
| What was the Skin Rash Study? |
|
Definition
- 13 people who were hypersinsitive to poison ivy had leaves rubbed on arms
- one arm: real poison ivy but told it was harmless (only 2 people developed rashes)
- another arm: fake poison ivy and told real |
|
|
Term
| What was Materson's Hypertension Study? |
|
Definition
| - 58% of patients recieving anti hypertensive treatment reduced their blood pressure and 31% in placebo group reduced their blood pressure-- so over 1/2 of treatment participants would have met their goal if recieved placebo |
|
|
Term
| What was Moseley's study? |
|
Definition
- Placebo Surgery-- arthroscopic surgery for arthritis in their knees
-patients randomly assigned to knee vs sham surgery
-40 % of subjects in each showed improvement-- no difference between placebo and surgery |
|
|
Term
| What were the 3 different conditions in Moseley's study? |
|
Definition
1. debridement (surgery)
2. lavage (flush knee out with water)
3. placebo |
|
|
Term
| what affects the placebo effect (4 things) |
|
Definition
1. how health care provider behaves
2. characteristics of the patient
3. situational factors/characteristics of the placebo
4. social norms |
|
|
Term
| What was Feldman's study? (Provider Behavior Matters) |
|
Definition
- all patients given tranquilizer by doctors who either expressed confidence in it or doubt in it
- confident doc: 77% effective vs. doubtful doc: 10% effective |
|
|
Term
| What was Kaptchuk's Therapeutic Ritual Study? |
|
Definition
| - Volunteers who had irritable bowel syndrome were randomly assigned to three conditions |
|
|
Term
| What were the 3 conditions of Kaptchuk's study? |
|
Definition
1) wait list
2) placebo acupuncture alone ("Limited")
3) placebo acupuncture with patient-practictioner realtionship augmented by warmth, attention, and confidence ("Augmented") |
|
|
Term
| What were the results of Kaptchuk's study? |
|
Definition
- showed LINEAR EFFECT: limited placebo better than waitlist but in some cases was no different than waitlist
- **AUGMENTED: strongest effects
- provider needs to believe in treatment and warm realtionship between patient and doctor |
|
|
Term
| What was McRae's Patient Expectation study? |
|
Definition
- double blind sham surgery that determined effectiveness of transplantation of human embryonic dopamine neurons into brains of persons with advanced Parkinsons disease
- 18 surgery, 12 placebo surgery
- no difference between real and sham surgery
patients who believed they recieved surgery improved regardless of whether they recieved surgery or not |
|
|
Term
| What is the case with situational factors/ characteristics on placebo effects? |
|
Definition
| - more "medical" it seems, the better it will work (name and color of pill) |
|
|
Term
|
Definition
- pavlovian type conditioning with body physiology
- works for people who need it more and have more pain |
|
|
Term
| What was Shiv's experiment with the Cost of Placebo? |
|
Definition
- Energy Drink Study
- either gave them energy drink at full or half price
- then gave them puzzles either told that they were high or low expectancy of solving the puzzles
- FOUND: high expectancy at full price drink but half price drink undermines the effectivness of placebo
- suggests that when buying generics, arent getting full product for your money |
|
|
Term
| What do placebos help 59% of Germans as opposed to 7% of Brazilians? |
|
Definition
| - with social norms, Germans have more faith in modern medicine than Brazilians do |
|
|
Term
| How are 4 ways placebos work? |
|
Definition
1) decrease anxiety
2) endorphin release
3) classical conditioning
4) expectations |
|
|
Term
| What was the study on global vs local effects of placebos? |
|
Definition
- apply pain to both index fingers at once but told one finger has a placebo painkiller in it-- patients report less pain in finger with placebo painkiller
- placebos dont work by reducing stress, increasing mood, or through endorphins, cant have full explanation at a global level for specific (local) effects |
|
|
Term
| what was the conditioned pain relief involving morphine? |
|
Definition
morphine (US)--> pain reduction (UR) with needle (CS)
Needle + Morphine--> pain reduction
(CS) Needle-->(CR) pain reduction |
|
|
Term
| what are 3 problems with conditioning argument? |
|
Definition
1) placebo effects get stronger over time but conditioned effects show extinction
2) placebos can do the opposite of what they are supposed to
3) placebos can work even if no prior experience with real medicine (ex) rogaine--> led to hair growth even though placebo) |
|
|
Term
| What are 4 things that support expectation argument? |
|
Definition
1) prior experience with drug isnt necessary
2) more believable the placebo, more likely it will work
3) a placebo can do the opposite of the active drug
4) no cases of placebo effects in absense of an expectation |
|
|
Term
| what has resulted from placebo effects getting stronger? |
|
Definition
- peptide therapeutics share price dropped 33% after new allergy vaccine only affective as placebo
- Merck stopped producing anti-depressent when dummy pills worked just as well |
|
|
Term
|
Definition
| - just like placebo effects but inactive substance causes unpleasant effect such as hair loss, nausea, medical student syndrome, and asthma |
|
|
Term
| what is one problem with nocebos? |
|
Definition
| - people drop out from medical trials because of side effects even when they get the placebos |
|
|
Term
| what are the different psychological issues involved with health care policy? |
|
Definition
| evaluating evidence, prevention vs treatment, doctor-patient relations and communications, impact of incentives, end of health care |
|
|
Term
| What was the story about Sally, a 77 year old female? |
|
Definition
- had positive mammogram and biopsy revealed she has mild form of breast cancer which resulted in surgery, chemotherapy, and radiation
- since she found it early, she is now alive and doing well
- her family became advocates for early detection and "aggressive" treatment of cancer |
|
|
Term
| What are the costs and benefits of early detection? |
|
Definition
1) early trauma-- fear of death
2) physical trauma-- lost hair, energy, consdiered whether death surperior to medical trauma
3) expensive treatment-- covered by medicare
4) uncertain whtehr treatment impacted longevity
5) many countries do not perform mammograms at Sally's age |
|
|
Term
| What is the paradox of healthcare in the US? |
|
Definition
- both excess and deprivation-- some people get too much including expensive but ineffective tests and treatments-- 1/3-1/2 of all health care services have no beneficial effect on patients
- complications from medical care-- 3rd leading cause of death in US
- excessive use->cost increase->passed on to employers->discontinue of coverage->uninsured rate increased |
|
|
Term
| Who spends the most on healthcare than any other nation in the world? |
|
Definition
-US-- 1 in 6 dollars spent on doctors, hospital, and drugs in Americans earnings
- then canada (54%), UK (41%), Japan (36%) |
|
|
Term
| How is life expectancy in the UK? |
|
Definition
| - life expectancy is slightly higher and infant mortality slightly lower in US despite its per capita spending is only 41% of US |
|
|
Term
| What is the relationship between quality and medical spending by state? |
|
Definition
- states that spend more on Medicare (over 65) appear to do more poorly on indicators of quality-- those that are spending the most overall a person are doing worse in terms of health care quality-- theres bad medicare relationship
- doesnt have to do with SES |
|
|
Term
| What was Gawande's study? |
|
Definition
| - those in higher spending regions received 60% more care than elsewhere yet they did no better than other patients in terms of survival, ability to function, or satisfaction with care. If anything--worse |
|
|
Term
| What was Gawande's study in regards to McAllen, TX? |
|
Definition
- McAllen-- ne of the most expensive health care markets in country (spent 15K per enrollee here--twice national average (12K))
- El Paso spent half of what McAllen on medicare yet there is no difference in health than McAllen
- worse health doesnt explain it |
|
|
Term
| What did Gawande conclude about the spending on healthcare? |
|
Definition
- over utilization-- medicine has become a business
- over last 15 years-- profit centers-- doctors and business people make money per service, testing, and surgery
- doctors make more money when they prescribe more treatment which involves an incentive |
|
|
Term
| What is a successful treatment according to Kaplan? |
|
Definition
| - one that makes people live longer and or improves quality of life |
|
|
Term
| What is Kaplan's disease reservoir hypothesis? |
|
Definition
- idea that we have some undiagnosed disease that is not bothering us
- as a diagnostic technology improves previously undiagnosed problems will be identified in many people who may not benefit from treatment because their length or quality of life will never be effected by this reservoir of disease |
|
|
Term
| what is the natural history of disease? |
|
Definition
1. public health campaigns: assume disease is binary-- either person has the diagnosis or not
2. chronic disease begins long before its diagnosed
3. not all people who have disease will suffer from the problem many will not even know they are sick when they die |
|
|
Term
| What was Black and Welch's study on what % of people have cancer? |
|
Definition
- they looked at autopsies of people who died from cancer vs other causes (breast and prostate)
- same percent of deaths (3%)
- looked at autopsies that if they were to get diagnosed with disease-- 39% of people who died of other things would have been diagnosed with breast cancer and 46% of prostate cancer |
|
|
Term
|
Definition
a disease that will NOT affect duration or quality of life
- even though most adults rate their health status as excellent or good, virtually all of us have some kind of problem that can be detected with modern technology
- advances in diagnostic technology may produce more harm than good because they identify pseudodisease and not real disease |
|
|
Term
| What was the study on melanoma incidence and death? |
|
Definition
- it has increased dramatically--early stage incidence
- a lot more people who could be diagnosed with skin cancer but no more people are dying from it-- detecting more pseudodisease
- study of Medicare record-- significant increase in total incidence and early stage incidence-- no increase in late stage incidence or mortality
- theres a reservoir of mild melanoma particularly in elderly Medicare patients with this skin cancer is not likely to reduce life expectancy |
|
|
Term
| What did another experiment find with early skin biopsies? |
|
Definition
- more skin biopsies--> more pseudo disease OR more cancer--> more biopsies--> better treatment?
- more testing you do, more skin cancer youll find |
|
|
Term
| What was the experiment with breast cancer diagnosis in France? |
|
Definition
| even though # of mammography machines increased 8 fold, the # of women diagnosed doubled but deaths slightly increased rather than decreased as would be expected if more cases caught early |
|
|
Term
|
Definition
-to provide comfort
-focus on symptom control (relief from pain) not curing disease
- hospices provide this along with hospitals and clinics |
|
|
Term
|
Definition
- 6 month or less prognosis
- maximizes time left to life
- symptom management
- psychosocial and spiritual support
- choice about medical care (home or facility)
-covered by medicare and insurance |
|
|
Term
| Who are hospice patients? |
|
Definition
| - more females, people over 65, cancer patients mostly |
|
|
Term
| impact of hospice care on patient survival |
|
Definition
| -live average of 29 days longer (heart failure--81 days longer, lung cancer--39 days longer) because not trying to cure disease, no chemo, radiation, or surgery, and no tests or procedures |
|
|
Term
| who makes up the hospice team? |
|
Definition
-patient and family-- focus
- biopsychosocial assessment and and plan of care
-care coordination and communication
-psychosocial support and education
-respect for culture, values, and beliefs, human connection |
|
|
Term
| What are the 5 stages of dying according to Elizabeth Kubler Ross? |
|
Definition
| 1. denial 2. anger 3. bargaining 4. depression 5. acceptance |
|
|
Term
| what is the present day assessment of Kubler-Ross' 5 Stage Theory |
|
Definition
1. some of these attitude some of the time
2. no clear stages or order
3. not very useful
4. doesnt apply to grief |
|
|
Term
| What are 5 things that hospice patients want that they rate "very important" at EOL? |
|
Definition
1. pain and symptom control
2. not prolonging life
3. not being a burden to others
4. sense of control
5. strengthening relationships |
|
|
Term
| What do the family caregivers want? |
|
Definition
1. to feel competent and prepared
2. have enough information
3. emotional support
4. access to coordinated care
5. follow patients wishes |
|
|
Term
| What was Pearson's research with hospice care? |
|
Definition
- caregivers survey after patient died-- looked at confidence in caregivers at EOL, how prepared and competent they felt when patient was dying
- found caregivers were LESS confident when they lacked information and felt patient was referred too late to hospice |
|
|
Term
| What are effects of unresolved pain at the end of life? |
|
Definition
1. physical activity reduced
2. sleep impacted
3. social withdrawl
4. depression
5. anger
6. fear and anxiety
pain can shorten the life |
|
|
Term
| what if patient doesnt want to take medications? |
|
Definition
| - respect patient automony and self determination-- maybe provide alternative methods of pain control |
|
|
Term
| What is Grief and Bereavement? |
|
Definition
-grief is reactions to loss
- bereavement is condition in which we feel grief
- excess morbidity and mortality= "loss effect"
- NOT mental disorder |
|
|
Term
| what are common grief reactions? |
|
Definition
| - deep distress, emotional, psychological dysregulation, shock, sleep and appetite changes, yearning for deceased, confusion and cognitive disturbances, fatigue and physical symptoms, surges of emotion |
|
|
Term
|
Definition
| -initial deep distress and grief symptoms, recovers in few weeks of months |
|
|
Term
| what is considered prolonged grief disorder? |
|
Definition
| - people who do not recover from loss and have specific symptoms more than 6 months after loss that cause significant daily impairment |
|
|
Term
| What was Pennebaker's study? |
|
Definition
- grief workshop that uses writing to deal with loss-- members write up to 10-15 minutes on theme and positive support feedback only
- high evaluations from past members |
|
|
Term
| What were the results of the classic eating study with how much ice cream someone will eat if given 0 or 2 milkshakes to try in configuration to if they are on a diet or not? |
|
Definition
non dieters: thoughse who had 0 milkshakes ate a lot more ice cream and the opposite if had 2 milkshakes
dieters: those who had 0 milkshakes had lot less ice cream and vice versa
- we have a particular threshold and when we think it has been blown, it is portrayed in an all or nothing way |
|
|
Term
| What did this study conclude? |
|
Definition
1. eating of dieters controlled more by external than internal factors-- obese people find it easier to restrict eating (yom kippor example)
2. dieters are important group of people to study
3. new methodology of studying eating |
|
|
Term
| What were the results of the second study on dependence of milk shakes labeled high in fat or low fat? |
|
Definition
- in high fat milkshakes that were actually nonfat, participants acted just as though they were eating regular milkshakes- werent controlled by internal cues
- when switched- wont eat as much icecream
- dieters were more controlled by external factors than internal cues
- stress and if there is another person in the room are other factors that can matter |
|
|
Term
| what did they conclude about eating of non-dieters? |
|
Definition
- influenced more by hunger than cognitive, social, or emotional factors
-eat less after a big milkshake
- doesnt matter if they think its high in fat
- doesnt matter if theres other people in the room of if they are stressed
- OPPOSITE FOR DIETERS |
|
|
Term
| What did Mann and Ward come up with for attentional myopia? |
|
Definition
- when cognitive resources are low people will focus on most salient feature of environment-- cognitive load can either more or less eating among dieters
- ex) memorizing 1 or 8 digit task
ex) milkshake vs milkshake with scale in room
- scale: salient on dieting |
|
|
Term
| What was Rozin's Memory and Eating study? |
|
Definition
- 2 patients with brain injuries and 2 patients with amnesia were brought lunch, ate lunch and trays were cleared, distracted for 20 min, then brought another lunch
- measured if patients ate 2nd lunch |
|
|
Term
| What was the experiment with eating and developmental factors and kids? |
|
Definition
- measured how many calories children eat if they are allowed to eat as much as they want for 6 days
- althought valroies eaten at particular meals day to day are highly variable, day to day it was highly stable
- proves that children can regulate their intake by day |
|
|
Term
| What was Key's Semi- Starvation Study? |
|
Definition
- WW2-- alternative to military service did study for a year at U of Minnesota
- lived in dorms for one year
1) control period: 3 months (3200 cal/day)
2) semi-starvation period: 6 months (1800 cal/day)-- diet ~ post war europe food
3) controlled eating rehabilitations: 3 months-- diff strategies
4) free eating rehabilitation: 3 months +-- eating carefully monitored
- ended up being very skinny after because overcompunsated: ate much more and then eventually turn to baseline
3) |
|
|
Term
| What are the psychological effects of hunger? |
|
Definition
| obsession with food, eating rituals, weak, tired, irritable, no self control, anxious, nervous, self centered, apathetic, clinician depression, psychotic reactions (1/6th of subjects), weak and irritable, still feel hungry every single day |
|
|
Term
| What determines what people eat? |
|
Definition
1. culture and eating
2. genetic factors
3. aging and novelty |
|
|
Term
| What did they find with music in relation to aging and novelty? |
|
Definition
| - most ppl are 20 or younger when they hear the populat music they choose to listen to for the rest of their lives, if you are more than 35 years old when a style of music is introduced, 95% chance you wont listen to it |
|
|
Term
| What did Kurt Lewins come up with about theories? |
|
Definition
theoretical idea that there is nothing so practical as a good theory
o If you pursue basic science, it will lead to practical applied developments
o If you are only in applied concerns, you might not get the full picture—because you can demonstrate that one message is more effective than another
o Idea that we should go from theory to application |
|
|
Term
| What was Zajonc's theory? |
|
Definition
• Had paper and proposed idea that methods don’t reach motor and other semantic systems of the organism
o Theres a real motor components to doing things that your body is involved with and thinks that he should get peoples bodies involved so could find some way to provoke muscularter. |
|
|
Term
| What is the embodied cognition approach? |
|
Definition
• We need to pay attention to body where minds exist
• Attitudes and knowledge can be acquired, processed, ad represented through bodily kinesthetic interactions with stimuli
• Idea that we acquire information not just by directly hearing it but also by bodily interactions with the world
o When information is recalled, sensory, motor, and affective systems are partially reactivated |
|
|
Term
| What example was linked to the embodied cognition approach? |
|
Definition
| - the ferocious bear study: when see a bear and get scared and then tell roommate after, just the thought of the frightening experience brings back physical sensations of mental, cognitive reactivation of sensation of the bear because the physical experience is embodied and acquired |
|
|
Term
| What did the flossing (imagination vs motor and imagination condition) experiment try to prove? |
|
Definition
utilizing the motor system during persuasion attempts, via mere motor manipulations, lead to increased persuasion as reflected in health behavior change
- when given 10 floss sticks, found those in second condition flossed more teeth and correctly a week later
-found men flossed less than women |
|
|
Term
| What are the different trainings in healthy psychology career? |
|
Definition
o Clinical psychology:
• Patient counseling and contact, designing and evaluation interventions for patients
o Social psychology:
• Research in health behavior change, stress, eating, coping with chronic disease
o Physiological psychology:
• Bio and neurological aspects of health
o Public health (can also get masters in PH)
• Improving health of communities, social policy |
|
|
Term
| what do health psychologists do? |
|
Definition
| conduct research in academic, medical, and clinical settings |
|
|
Term
|
Definition
| recognize symptoms reported quickly, exaggerate symptoms |
|
|
Term
|
Definition
| - argues that ppl had implicit commonsense beliegs about their symptoms and illness that result in organized illness representations or schemas |
|
|
Term
| what were 6 parts of commonsense model? |
|
Definition
1) idetntiy
2) causes
3) consequences
4) timeline
5) control/cure
6) coherence |
|
|
Term
| what was the lay referral network? |
|
Definition
| - informal network of family and friends who offer their own interpretations of symptoms well before any medical treatment is sought (ethnic communities) |
|
|
Term
|
Definition
| individuals who express distress and conflict through bodily symptoms convince themselves they are ill |
|
|
Term
|
Definition
| illness bring benefits (ability to rest, take off work. etc) |
|
|
Term
|
Definition
| person may live with one or more of potentially serious symptoms for months without seeking care |
|
|
Term
| what are different delay behaviors? |
|
Definition
1) appraisal delay-- decide symptoms are serious
2) illness delay- symptoms=illness
3) behavioral delay-- deciding to seek treatment and actually doing so
4) medical delay (scheduling and treatment) |
|
|
Term
|
Definition
| - during 1st year of life main cause of death-- infant stops breathing, most likely in low income families |
|
|
Term
| what is the number one cause of death in children under 15? second leading cause? |
|
Definition
| - accidents and then cancer |
|
|
Term
| What are the different ideas of death at ages 5, 5-9, and after 9? |
|
Definition
under 5: death as a great sleep
5-9: death is final may develop
9: death is universal and inevitable |
|
|
Term
| what are top two causes of death in adolensence? |
|
Definition
| - accidents (automobile) and homocide/suicide |
|
|
Term
|
Definition
| ending the life of a person suffering from painful terminal illness. oregan is only state that allows it. Living will: middle ages people come to terms with death |
|
|
Term
|
Definition
| - designed to make patient feel comfortable |
|
|
Term
|
Definition
| those who study death and dying-- suggest that behavioral and cog-behavioral therapies can be constructively employed with dying patient |
|
|
Term
| what is symbolic immortality? |
|
Definition
| sense that one is leaving behind a legacy through ones children or ones work while joining after life |
|
|
Term
| what are the give things in Weisman's appropriate death? |
|
Definition
1) informed consent
2) safe conduct
3) significant survival
4) anticipatory grief
5) timely and appropriate death |
|
|
Term
| what two hormones control eating? |
|
Definition
|
|
Term
|
Definition
- secreted by fat cells tells hypothalamus whether the body has sufficient energy stores of fat or whether there is extra energy
-inhibits neurons that stimulate appetite and activates those thats suppress apetite |
|
|
Term
|
Definition
| secreted by specialized cells in stomach spiking just before meals and downwards afterward (when given injections= hungry) |
|
|
Term
| what happens with weight gain when your older? |
|
Definition
| -grey matter in brain is reduced and significant cognitive decline |
|
|
Term
| what determines size and amount of fat cells in body? |
|
Definition
- # of them is determined in first few years of life
- eating in adolescence affects size not #
- high basal insulin levels |
|
|
Term
|
Definition
| successive cycles of dieting and weight gain enhance the efficiency of food use and lower metabolic rate |
|
|
Term
| what is the set point theory of weight? |
|
Definition
| - the idea that each individual has an ideal biological weight which cant be greatly modified |
|
|
Term
| what women are prone to bulimia? |
|
Definition
altered HPA axis and elevated cortisol levels
- has to do with decreased leptin functioning, hypothalamus dysfunctions, disorder of opiod system, neurological disorder
- treatment: cognitive-behavioral therapy and meds |
|
|
Term
| what are 3 problems with health services? |
|
Definition
1) cost too high 2) grossly inequitable favoring wealthy
3) health care consumers use services inappropriately |
|
|
Term
| what is comprehensive intervention models: |
|
Definition
| all available treatment has been brought together that individual regimens can be developed for each patient |
|
|
Term
| what is cost containment? |
|
Definition
prompted the development of interventions that are time limited, symptom focused, and offered to an outpatient basis
ex) relaxation |
|
|
Term
| what is evidence based medicine? |
|
Definition
| now the criterion for adopting medical standards-- conscientious, explicit use for best scientific evidence for making decisions about care of individual patients |
|
|
