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Teaching
Introduction To Medical Psychology Lectures
On this page:
Introduction to Medical Psychology (Human Science and Public Health - Year 1)

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

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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

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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.

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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.

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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'.

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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

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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.

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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.)

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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

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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

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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:

  1. To appreciate the link between behavioural and medical problems
  2. To understand problems in defining psychological abnormality.
  3. To discuss general approaches to understanding psychological illness.
  4. 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

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Addictive Behaviours

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:

  1. To see the concept of addiction in its social context
  2. To understand the principles of learning and conditioning as applied to addiction
  3. To examine individual differences in vulnerability to addiction
  4. 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

 
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