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Department of nervous diseases, psychiatry and medical psychology




НазваDepartment of nervous diseases, psychiatry and medical psychology
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Ministry of Health of Ukraine

Bukovynian State Medical University

Department of nervous diseases, psychiatry and medical psychology



Approved on the methodology meeting

of the Department of nervous diseases, psychiatry

and medical psychology

on the “21” of April 2010 (Report No 1).

Chief of the Department

_______________________

Professor V.M.Pashkovskyy


MethodOLOGical Guidance

for the lesson

Theme 3: Clinical-psychological aspects of the cognitive and emotional processes. Consciousness and self-consciousness, state of the consciousness.

For 4-th year students of medical faculty No 2


Module 1. Medical psychology

Topical module 1. General questions of medical psychology.


Сhernivtsi, 2010


^

1. Actuality Aim

Psychical activity shows by itself part of general vital functions of man. No doubt it is closely associated with work of cerebrum. However, in spite of the fact that the psychical phenomena arise up on the basis of neurophysiologic activity, psyche as it is impossible to take the ideal constituent of “Ego” even by the difficult neurophysiologic processes. The state and maintenance of psyche is determined not only the morfofunctional state of brain but also depend on the reflection of the outer world, from a capture an individual through own activity by experience and know ledges which were accumulated humanity.

2. Hours: 2


3. Teaching goal

The students must know:

  • the definition of consciousness;

  • the development of consciousness and self-consciousness;

  • cognitive processes;

  • research methods of cognitive process;

  • research methods of emotional process;

  • psychical properties.


and be able to:

  • objectively and scientifically determine the place and role of consciousness;

  • interpret conditions to create healthy psychological climate in the medical environment;

  • analyze psychological peculiarities of patients with various pathologies;

  • to determine the way of communication with patients with accentuated personality;

  • know methods of research of personality;

  • evaluate the results of experimental-psychological research of patient’s personality and attitude toward a disease.

Assimilate practical skills

  • analyze psychological peculiarities of patients with various accentuation;

  • communication with patients;

  • methods of research of attitude toward a disease;

  • experimental-psychological research of patient’s personality.


^ 4. List of disciplines necessary

for learning theme 1


Title of the discipline

Content of the discipline necessary for learning medical psychology

Anatomy

Brain construction

General psychology

Psychic functions of a normal person. Consciousness and self-consciousness. Psychology of personality.

Neuropsychology

Functions of different brain structures.

Normal physiology

Brain functions. Physiology of high nervous activity.


^ 5. Content of the theme

Psychical activity shows by itself part of general vital functions of man. No doubt it is closely associated with work of cerebrum. However, in spite of the fact that the psychical phenomena arise up on the basis of neurophysiologic activity, psyche as it is impossible to take the ideal constituent of “Ego” even by the difficult neurophysiologic processes. The state and maintenance of psyche is determined not only the morfofunctional state of brain but also depend on the reflection of the outer world, from a capture an individual through own activity by experience and know ledges which were accumulated humanity. A psyche is not given a man in the prepared kind from the moment of birth and does not develop in itself. Only in the process of socializing and co-operation of child with other people are formed higher forms of display of psyche: consciousness, language, and broadcasting.

Consciousness as a higher level of the psychical mapping is inherent only to the man. It arose up on the certain historical stage of becoming of psyche of man and is the product of its labour activity. Consciousness shows up ability to represent and understand surrounding the world, nowadays and past, to make decision and, in accordance with a situation, to manage the conduct.

It is known that at psychical diseases the functions of higher departments of brain are violated: disorder of intercommunications comes between basic psychic processes, between a bark and below placed parts of brain. These changes predetermine forming of certain symptoms of abnormal psychologies and syndromes. But not only psychical diseases are accompanied violation of psychic processes and consciousness – any diseases of organism can cause similar disorders.

Psychical processes are the psychical phenomena, which have physiology basis, provide a primary reflection and awareness of the represented reality a man. They are divided into cognitive – feeling, perception, presentation, attention, memory, thought, broadcastings, emotional and volitional. Mental conditions are temporal originality of psychical activity which is determined the general functional level of psychical activity depending on the terms of activity and existence of man and its features of personalities. Mental conditions are divided into 4 kinds: motivational (desire, aspiration, interests, trains, passions), emotional (mood, affect, stress, frustration), volitional (purposefulness, persistence, decision and other), states of consciousness (consciousness and consciousness, level of clarity of consciousness). Psychical properties – characteristic for this man relatively proof features of its psyche. For their denotation the followings concepts| are used, depending on the level of psychical development and parameters which are estimated: individual, individuality, personality.

What does conscious activities of man differ? First – activity of animals can take place only in relation toward the article of vital, biological necessity. Conscious activity of man not always and not necessarily related to biological reasons, often even despite them. It shows up, for example, in the division of functions in the process of labour activity. Second feature – a man has other forms of reflection of reality. Not only evident, perceptible, but by rational experience, abstract thought. The origin of language and broadcasting makes terms and possibilities for mastering of not only the own experience but also experience of other generations.

During diagnostics medical psychologists adhere to phenomenon approach, that use principles of understanding, instead of explaining psychologies. Experiencing of man is examined from the multidimensional point of view. It is possible to name|call| any|some| the phenomenon individually integral|whole| psychical experiencing. Every integral|whole| individual psychical experiencing of man (phenomenon) must be examined|considered| both significant, that allows to understand and explain him as in categories abnormal psychologies and psychological. On the basis of it developed some principles of alternatives.

Principle-alternative of "nozos-pathos"

A concept|notion| of illness (nozos) is a sickly|morbid| process, dynamic, fluid education|formation|. A concept|notion| of pathology (pathos) is the pathological state|figure,camp,mill|, proof|firm| changes|changing|, result of pathological processes or defect|vice|, rejection of development. At diagnostics the psychological phenomenon in accordance with these concepts|notion| must be interpreted as some one, which has nosology specificity which|what| has a sickly|morbid| mechanism of education|formation| and development, or however much pathological education|formation|, not inclined|liable,predisposed,located| to|by| some substantial transformation, has etiologic factors and pathogenesis mechanisms, with properties|virtue| of firmness stability. Nozos and pathos are|appear| regional variants different|diverse| on the essence processes and spectrums. In somatic medicine problem illness – pathology does not stand so sharply as in clinical psychology and psychiatry, where the estimation|appraisal| of the state|figure,camp,mill| of patient has a socially meaningful|meaning| role.


Ushakov (1976) were offered the followings criteria of psychical health, I will remind them you: it is a causal conditionality of the psychical phenomena, their necessity, efficiency; - maturity of senses|feeling,sentiment| answers age of man; it is the maximal approaching of subjective appearances to|by| the objects of reality, which|what| are represented, harmony between the reflection of circumstances of reality and relation of man to|by| her|it|; it is accordance of reactions (both physical and psychical) to force and frequency of external irritants; it is critical approach to|by| the circumstances of life; it is ability of self-government a conduct in accordances with norms|standard|, which|what| are set in different|diverse| collectives; it is adequacy of reactions to the public circumstances (to the social environment|Wednesday|); it is sense|feeling,sentiment| of responsibility for|after| descendants and near family members; it is sense|feeling,sentiment| of constancy|stability| and identity of experiencing in of the same types circumstances; - possibility to change the method of conduct depending on the change|changing| of vital situations; it is self-affirmation in a collective (society) without harm for other his cocks; - to plan|glide| ability|power| and carry|perform,accomplish| out the vital way and other

In medical psychology name|call| a brief (not more than|more than| 6 month) answer a psychical reaction for any|some| situation or external influencing. Determine a proof|firm| abnormal psychology syndrome the state|figure,camp,mill| without propensity to development or regress|retrogress| (more than|more than| 6 month). Development is a pathological process with internal|inlying| conformities to the law of symptoms.

Term a “psychosis” was entered in 1846р. by Feykhtershleben, is a mental condition|figure,state,camp,mill|, which|what| is characterized|described| heavy|difficult| disorders|discord| of psychical functions with violation of psychological contact with the real reality and conduct which|what| presents|represent| a danger for a patient and surrounding, in default of criticism to|by| the state|figure,camp,mill|. Nonpsychotic level - symptoms and syndromes, which|what| are accompanied criticism, adequate estimation|appraisal| of surrounding reality, a conduct is within the framework the socially accepted norms|standard|.

Absence of clear scopes|line| between psychological reactions and psychical violations, between a norm|standard| and pathology of personality|individual| represents a concept|notion| “boundary psychical disorders|discord|”, largely conditional.

To|by| the second half of ХІХ age|century| psychological knowledges got|receive| mainly by an introspection or direct|immediate| looking after other people. An analysis and clever generalization of similar|like| sort of vital factors played the positive|staid| role in history of psychology. They resulted in|to| the construction of the first scientific theories which|what| explained essence of the psychological phenomena and conduct of man. The attempts of measuring of the psychical phenomena, quantitative estimation|appraisal| of conduct of man begin from the beginning of the second half of past|passing,last| century. The first were openings|discovery| and formulations of series of laws, which linked|couple| force of feelings|sense,feeling,sentiment| with the stimuli shown in physical sizes|value|, which|what| operated on sense-organs man. The law of Veber-Fekhner-Stivens, formula by|by means of| which|what| determined the absolute and relative thresholds of feelings|sense,feeling,sentiment|, belongs|behave| to|by| them. Afterwards the tendency of the use|utillizing| of mathematical models and relations got|receive| wide distribution in the most various industries|branch,field| of psychology.

At the end of|at close of| 80th of ХІХ item in psychology began to create and apply the special technical devices and devices which|what| allowed a researcher to do a scientific experiment and control his|its| terms, for example, to measure out influencing of physical stimuli which|what| a man must react on. At first these were simple mechanical|mechanics| devices.

An hallucination is a sensory perception experienced in the absence of an external stimulus, as distinct from an illusion, which is a misperception of an external stimulus. Hallucinations may occur in any sensory modality - visual, auditory, olfactory, gustatory, tactile, or proprioception (sense of balance and position in space). Charles Bonnet Syndrome is the name given to visual hallucinations experienced by blind patients. The hallucinations can usually be dispersed by opening or closing the eyelids until the visual images disappear. The hallucinations usually occur during the morning or evening, but are not dependent on low light conditions. These prolonged hallucinations usually do not disturb the patients very much as they are aware that they are hallucinating. There are numerous medical and psychiatric causes of hallucinations. Common causes include:

  • Fever, which can occur with almost any infection, frequently produces hallucinations in children and the elderly

  • Intoxication or withdrawal from such drugs as marijuana, LSD, cocaine or crack, heroin, and alcohol

  • Delirium or dementia

  • Sensory deprivation such as blindness or deafness

  • Severe medical illness including liver failure, kidney failure, and brain cancer

  • Some psychiatric disorders, particularly schizophrenia, psychotic depression, and post-traumatic stress disorder.

Memory is an organism's ability to store, retain, and subsequently recall information. The human brain stores information in at least two different ways:

1 Declarative memory. This is the storage of material that is available to the conscious mind and which can therefore be encoded in symbols and expressed by language. Declarative memory includes episodic memory (recall of a specific episode) and semantic memory (recall of a cluster of undated information about some subject such as the meanings of words).

2 Procedural memory. This refers to the storage of material that involves skills and behaviours that are not available to the conscious mind in any detail. They are acquired and retrieved at an unconscious level. The classic examples are remembering how to ride a bicycle or play a musical instrument. The storage of these memories involve different memory systems from the ones that we will be looking at in this website.

Amnesia is a condition in which memory is disturbed. The causes of amnesia are organic or functional. Organic causes include damage to the brain, through trauma or disease, or use of certain (generally sedative) drugs. Functional causes are psychological factors, such as defense mechanisms. Hysterical post-traumatic amnesia is an example of this. Amnesia may also be spontaneous, in the case of transient global amnesia. This global type of amnesia is more common in middle-aged to elderly people, particularly males, and usually lasts less than 24 hours.

Thinking involves both cerebral hemispheres. The cerebral hemispheres work together to learn new information, form thoughts, make judgments, and store memories.

^ Left Cerebral Hemisphere - For most people, the left cerebral hemisphere is important in language (including speech, reading, and writing) and math (see Figure). People with brain injuries in the left hemisphere sometimes have a disturbance in verbal communication. This disorder is called aphasia.

^ Right Cerebral Hemisphere - The right cerebral hemisphere is important for paying attention and understanding as well as expressing emotions . Also, it is important for visual spatial skills, such as having a sense of direction. A person with good visual spatial skills can find the family car in a large parking lot. Each lobe is important and has special functions.

Attention is the cognitive process of selectively concentrating on one aspect of the environment while ignoring other things.


^ 5.2. Theoretical questions:

  1. The definition of consciousness.

  2. The development of consciousness and self-consciousness.

  3. What cognitive processes do you know?

  4. Research methods of cognitive process?

  5. Research methods of emotional process?

  6. Perception disorders.

  7. Memory disorders.

  8. Thoughts disorders.

  9. States of consciousness.


^ 5.3. Practical training during the tutorial

1. Clinical observation of the behavior of the patient.

2. Clinical interview and plan of psychological research.


5.4. Materials for self-control

A. Questions for self-control:

  1. The definition of consciousness.

  2. The development of consciousness and self-consciousness.

  3. What cognitive processes do you know?

  4. Research methods of cognitive process?

  5. Research methods of emotional process?

  6. Perception disorders.

  7. Memory disorders.

  8. Thoughts disorders.

  9. States of consciousness.

B. Tasks for self-control

1. Typical, ordinary – II level.

2. Untypical, no ordinary – III level.

C. Tests for self-control.


Literature

  1. R.J.Gatchel An introduction to health psychology. – New York: Random house. – 386 p.

  2. Lectures.

  3. Internet resource.

  4. Вітенко І.С., Вітенко Т.І. Основи психології: Підручник для студентів вищих медичних навчальних закладів ІІІ – ІV рівнів акредитації. – Вінниця, 2001.

  5. Вітенко І.С., Чабан О.С., Бусло О.О. Сімейна медицина: психологічні аспекти діагностики, профілактики і лікування хворих. – Тернопіль, ”Укрмедкнига”, 2002.

  6. Гавенко В.Л., Вітенко І.С., Самардакова Г.О. Практикум з медичної психології. – Харків: Регіон-інформ, 2002.

  7. Квасенко А.В., Зубарев Ю.Т. Психология больного. М., 1980.

  8. Лакосина Н.Д., Ушаков Г.К. Медицинская психология. М., 1984.

  9. Менделевич В.Д. Клиническая и медицинская психология. – М.: Мед.прес., 1998.

  10. Мягков И.Ф., Боков С.Н. Медицинская психология: основы патопсихологии и психопатологии: Учебник для вузов.- М.: Издательская корпорация „Логос”, 1999.



Prepared by assistant N.V.Grinko


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