A Level Psychology (Specialist options) key facts

Every chapter of A Level Psychology (Specialist options) on one page: the 411 key facts, definitions and facts to remember, in syllabus order. Use it for a last look before a test, then check yourself.

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Clinical Psychology

Schizophrenia: diagnostic criteria

ICD-11 diagnosis: at least two symptoms, at least one of them a core symptom, present most of the time for one month or more.
Core symptoms: persistent delusions, persistent hallucinations, disorganised thinking, experiences of influence, passivity or control.
Negative symptoms: blunted affect, poverty of speech (alogia), lack of motivation (avolition), social withdrawal.
ICD-11 has no subtypes such as paranoid or hebephrenic; symptom dimensions are rated instead.
Types of delusion: persecutory (others mean to harm me), grandiose (I have special power or importance), reference (neutral events carry a message for me), control (an outside force directs me).
Freeman et al. (2003): the avatars were neutral, so any hostile reading came from the participant, not from the scene.
A case study of one patient is idiographic: rich detail, but hard to generalise.

Schizophrenia: explanations

Concordance rate: the percentage of twin pairs in which both twins have the disorder.
Higher concordance in MZ (identical) than DZ (non-identical) twins points to a genetic contribution.
Adoption studies separate genes from upbringing: the risk follows the biological parent.
Dopamine hypothesis: excess activity at D2 receptors in the mesolimbic pathway gives positive symptoms; low activity in the prefrontal cortex gives negative symptoms.
Evidence for dopamine: amphetamine raises dopamine and can cause psychosis; antipsychotics block D2 receptors and reduce symptoms.
Frith: a self-monitoring fault means self-generated thoughts are blamed on an external source.
Diathesis-stress: an inherited vulnerability plus stressful experience (nature and nurture together).

Schizophrenia: treatment and management

Typical antipsychotics: dopamine D2 antagonists; long-term risk is tardive dyskinesia (involuntary movements of the face and tongue).
Atypical antipsychotics: act on dopamine and serotonin; fewer movement side effects, but weight gain is common.
Clozapine can lower white blood cell numbers (agranulocytosis), so regular blood tests are needed.
ECT: anaesthetic and muscle relaxant first, then a brief current to cause a seizure; memory loss is a risk and informed consent is an ethical issue.
Sensky et al. (2000): a randomised controlled trial; befriending controlled for the time and attention of a therapist.
Drugs work fast and need little effort from the patient; CBT needs insight and effort but teaches skills that last.
CBT is normally given together with medication, not in place of it.

Mood disorders: diagnostic criteria

Depressive disorder (unipolar): one or more depressive episodes and no history of mania or hypomania.
Bipolar type I: at least one manic episode.
Bipolar type II: at least one hypomanic episode and at least one depressive episode, and no manic episode.
Mania: elevated mood, little need for sleep, rapid speech, reckless behaviour, marked impairment; hypomania has no marked impairment and no psychosis.
BDI: 21 items, each scored 0 to 3, total 0 to 63; a higher score means more severe symptoms.
BDI strengths: quick, standardised, quantitative data; weaknesses: self-report (social desirability bias) and possible cultural bias.
Concurrent validity: a new scale agrees with an established scale taken at the same time.

Mood disorders: explanations of depressive disorder

Monoamine hypothesis: low serotonin and noradrenaline activity at synapses is linked to depression.
Oruc et al. (1997): an association study of the 5-HT2C receptor gene and the 5-HTT (serotonin transporter) gene.
An association shows a link between a gene variant and a disorder, not a cause.
Beck: negative triad, negative schemas and cognitive biases such as overgeneralisation and selective abstraction.
Depressive attributional style for bad events: internal (my fault), stable (it will last), global (it affects everything).
Seligman et al. (1988): a more pessimistic attributional style went with more severe depression, and the style became less pessimistic as patients improved with cognitive therapy.
Biological explanations are more reductionist and deterministic; cognitive explanations allow more free will.

Mood disorders: treatment and management

Tricyclics: block reuptake of serotonin and noradrenaline; more side effects and dangerous in overdose.
MAOIs: inhibit monoamine oxidase; foods with tyramine (such as mature cheese) must be avoided because blood pressure can rise dangerously.
SSRIs: selective serotonin reuptake inhibitors; usually the first choice.
Beck: treat a negative thought as a hypothesis and test it, for example with a thought diary or a behavioural experiment.
Ellis's ABCDE: Activating event, Belief, Consequence, Disputing, Effect.
REBT replaces rigid demands ('I must', 'I should') with flexible preferences.
Drugs act faster and need little effort; cognitive therapy teaches skills that may lower relapse.

Impulse control disorders: diagnostic criteria

Kleptomania: recurrent failure to resist impulses to steal objects not needed for personal use or for their money value.
Pyromania: recurrent failure to resist impulses to set fires, with fascination for fire and no motive such as money, revenge or sabotage.
Gambling disorder: impaired control, increasing priority given to gambling, continuation despite negative consequences.
Gambling disorder is normally evident over at least 12 months (shorter if symptoms are severe).
K-SAS: 11 self-rated items, each given a score where higher means more severe, on urges, thoughts and stealing behaviour in the past week.
K-SAS gives quantitative data for before and after comparison, but answers are subjective and shame may lead to under-reporting.

Impulse control disorders: explanations

Dopamine explanation: the behaviour activates the reward pathway; evidence comes from Parkinson's patients on dopamine-boosting drugs who develop gambling problems.
Positive reinforcement: a behaviour followed by a pleasant consequence is more likely to be repeated.
Variable ratio schedule: reward after an unpredictable number of responses; gives behaviour that is very resistant to extinction.
Feeling-state: the linked memory of the behaviour, the intense positive emotion and the body sensations felt at the time.
Dopamine is a nature, reductionist explanation; reinforcement is a nurture, situational explanation.
Neither dopamine nor reinforcement alone explains why only some people who gamble develop a disorder.

Impulse control disorders: treatment and management

Antagonist: a drug that blocks a receptor instead of activating it.
Double-blind: neither participants nor those assessing them know who has the drug or the placebo.
Placebo: an inactive tablet that controls for the effect of expecting to improve.
Grant et al. (2008): response was judged by a fall in scores on a gambling version of the Y-BOCS; family history of alcoholism went with a better drug response.
Glover (1985): a case study of a woman with a long history of shoplifting; imagining nausea and vomiting while stealing reduced the behaviour.
Blaszczynski and Nower (2003): imaginal desensitisation uses muscle relaxation, then imagined gambling scenes that end with leaving without gambling.
Drugs reduce urges but teach no coping skills; a single case study cannot be generalised.

Anxiety and fear-related disorders: diagnostic criteria

GAD: general apprehension or excessive worry about many events, with muscle tension, restlessness, poor concentration, irritability or sleep problems.
Agoraphobia: marked fear of several situations, which are avoided, entered only with a companion or endured with intense fear.
Specific phobia: marked, excessive fear every time the object is met, with avoidance, lasting several months and causing distress or impairment.
GAD-7: seven items about the last two weeks, each scored 0 to 3; total 0 to 21.
GAD-7 cut-off points: 5 mild, 10 moderate, 15 severe.
BIPI (Mas et al., 2010): 18 situations involving blood and injections; rates cognitive, physiological and behavioural responses.
Reliability is consistency (for example test-retest); validity is measuring what the test claims to measure.

Anxiety and fear-related disorders: explanations

Unconditioned stimulus (UCS) gives an unconditioned response (UCR) without learning.
Neutral stimulus + UCS, paired repeatedly: the neutral stimulus becomes the conditioned stimulus (CS) and gives a conditioned response (CR).
Little Albert: UCS = loud noise from striking a steel bar; CS = white rat; CR = fear of the rat.
Stimulus generalisation: Albert's fear spread to similar things such as a rabbit and a fur coat.
Displacement: an emotion is moved from its real target onto a safer substitute.
Little Hans: a case study with data collected mainly by his father, a supporter of Freud, so bias is likely.
Genetic and psychodynamic explanations are both deterministic.

Anxiety and fear-related disorders: treatment and management

Systematic desensitisation, in order: relaxation training, anxiety hierarchy, gradual exposure while relaxed.
Reciprocal inhibition: two opposite states (fear and relaxation) cannot exist at the same time.
The client moves up the hierarchy only when relaxed at the present step.
Applied tension: tense the arm, leg and body muscles for several seconds, release, and repeat; this raises blood pressure and prevents fainting.
CBT for this phobia: psychoeducation, challenging fearful thoughts, graded exposure with applied tension.
Manualised therapy: each session follows a written plan, so the treatment can be replicated.
A single case with self-report ratings and no control condition is idiographic and cannot be generalised.

Obsessive-compulsive disorder: diagnostic criteria

Obsession = an unwanted, intrusive thought, image or urge; compulsion = a repeated act (seen or mental) done in response to it.
A person with OCD usually knows the thoughts are their own and are excessive, unlike a delusion.
Charles (Rapoport, 1989): a 14-year-old boy who washed for hours each day through fear of germs; the drug clomipramine reduced his symptoms.
MOCI: self-report questionnaire, 30 true/false items, sub-scales for checking, washing, slowness and doubting.
Y-BOCS: clinician-led semi-structured interview, 10 items each scored 0 to 4, total 0 to 40 (5 items on obsessions, 5 on compulsions).
MOCI is quick but shows little about severity; Y-BOCS measures severity and change but needs time and a trained clinician.
Concurrent validity = scores agree with an established measure taken at the same time.

Obsessive-compulsive disorder: explanations

Biochemical: low serotonin activity; supported by SSRIs helping, but a treatment working does not prove the cause.
Genetic: several genes each add a little risk (polygenic); less than 100% concordance in identical twins shows the environment matters too.
Cognitive: thinking errors such as inflated responsibility and thought-action fusion (believing a thought can make an event happen).
Behavioural (operant conditioning): the compulsion removes anxiety, so it is negatively reinforced and repeated.
Psychodynamic: conflict between id impulses and the superego, linked to fixation at the anal stage; defence mechanisms include undoing and reaction formation.
Biological explanations are nature, reductionist and deterministic; learning explanations are nurture.
Operant conditioning explains why compulsions continue, not where obsessions come from.

Obsessive-compulsive disorder: treatment and management

SSRIs raise serotonin in the synapse; they treat symptoms, not the cause.
ERP = graded exposure to the trigger + no ritual, until anxiety falls (habituation).
Lehmkuhl et al. (2008): case study of a 12-year-old boy with autism and OCD; ERP-based CBT adapted to his needs brought a large fall in symptoms, which lasted at follow-up.
Lovell et al. (2006): randomised controlled non-inferiority trial with 72 adult OCD patients in the UK, randomly allocated to telephone or face-to-face CBT (exposure therapy), 10 weekly sessions.
Lovell measures: Y-BOCS, a depression inventory and client satisfaction, with follow-up to 6 months.
Lovell result: both groups improved; telephone CBT was not inferior, and satisfaction was high in both groups.
Non-inferiority trial = tests whether a new treatment is no worse than the standard one.

Consumer Psychology

The physical environment: retail store design

Storefront = sign, entrance and front of the building; window display = goods shown behind glass; landscaping = plants and outdoor features.
Mower et al. (2012): online questionnaire study about a small clothing shop; window displays and landscaping increased liking of the exterior and intention to shop there.
Grid: efficient use of space, quick to find items, suits supermarkets.
Freeform: relaxed browsing, suits fashion shops, uses space less efficiently.
Racetrack (loop): leads shoppers past every department, suits department stores.
Vrechopoulos et al. (2004): laboratory experiment with three virtual grocery layouts; grid was judged easiest to use, freeform the most useful and entertaining.
Questionnaire ratings of a store are subjective, quantitative data.

The physical environment: sound and consumer behaviour

North et al. (2003): IV = classical, pop or no music; DV = spend per head on food and drink; 393 diners; independent measures design.
North result: spending was highest with classical music; pop and no music were similar.
North explanation: classical music suggests sophistication and wealth, so spending more feels fitting.
North evaluation: high ecological validity, but different diners each evening and no informed consent.
Woods et al. (2011) study 1: blindfolded participants ate foods while hearing no sound, quiet or loud white noise through headphones; loud noise lowered sweetness and saltiness ratings and raised crunchiness ratings.
Woods study 2: the more people liked the background sound, the more they liked the food.
Slow tempo: longer stay and more spent on drinks; fast tempo: quicker eating.

The physical environment: retail atmospherics

PAD sequence: environmental stimulus → emotions (pleasure, arousal, dominance) → approach or avoidance.
Approach = stay longer, explore, spend, return; avoidance = leave early, buy less.
Chebat and Michon (2003): field experiment in a Canadian shopping mall with a citrus scent on some weeks and none on others, measured by questionnaire.
Chebat and Michon result: the scent improved shoppers' perception of the mall and of product quality, and through this their spending; its direct effect on mood was weak.
Machleit et al. (2000): questionnaire studies; higher perceived crowding went with lower shopping satisfaction, through its effect on emotions.
Machleit: two kinds of crowding, human (too many people) and spatial (too little room); the effect depends on expectations and tolerance of crowds.
A head count is objective data; a crowding rating is subjective data.

The psychological environment: environmental influences on consumers

Dogu and Erkip (2000): questionnaire to shoppers in a mall in Ankara, Turkey; most found their way fairly easily, but signs were judged not sufficient and many had not noticed the 'you are here' maps.
Short trip: in, a few items, out. Round trip: up one side of the store and back by another.
Central trip: along the main aisle with side visits into aisles. Wave trip: zigzag along the aisles to the far end.
Specialist: long time on a few products. Native: a regular who goes to the aisles they know.
Tourist: stays near the entrance. Explorer: longest trip, covers nearly all the store. Raider: fast, goes straight to chosen items.
Grouping shoppers into types is nomothetic and can be reductionist.
Inter-rater reliability = two observers classify the same paths in the same way.

The psychological environment: menu design psychology

Primacy = better memory or preference for the first items; recency = for the last items.
Dayan and Bar-Hillel (2011): a menu-choice experiment with students and a field experiment in a real café in Israel, with the order of items changed.
Dayan and Bar-Hillel result: items placed at the beginning or end of their category were chosen more than the same items in the middle.
Lockyer (2006): focus groups and a survey in New Zealand comparing different wordings of the same menu.
Lockyer result: descriptive wording was preferred; words that suggested freshness and quality appealed.
Sales figures are objective data; ratings of how appetising a dish sounds are subjective data.
Field experiment in a restaurant: high ecological validity, weak control of customers, days and weather.

The psychological environment: consumer behaviour and personal space

Hall's zones: intimate 0 to 45 cm; personal 45 cm to 1.2 m; social 1.2 to 3.6 m; public over 3.6 m.
Robson et al. (2011): online questionnaire with over 1,000 American adults, who saw pictures of tables for two set 6, 12 or 24 inches apart and imagined a dining situation.
Robson result: closely spaced tables made people feel more stressed, less private and less in control, most strongly for a romantic meal.
Robson conclusion: tight spacing fits more tables in but may reduce comfort and return visits.
Milgram et al. (1986): field experiment in real queues in New York; one or two confederates pushed in and observers recorded reactions.
Milgram result: two intruders brought more objections than one; most objections came from people directly behind the intruder; 'buffer' confederates who did not object reduced objections.
Responses to intrusion: verbal (objecting), non-verbal (glaring, gesturing), occasionally physical; many people did nothing.

Consumer decision-making: models and strategies

Utility theory: rational choice of the option with the greatest utility; assumes full information.
Satisficing: accept the first option that meets a minimum standard.
Prospect theory: loss aversion, a reference point, and framing (the same offer feels different as a gain or as a loss).
Compensatory: all attributes are weighed and traded off, e.g. scoring each product and adding up.
Non-compensatory: a cut-off rejects options whatever their other strengths, e.g. 'nothing over my budget'.
Partially compensatory: options are compared on some attributes or in pairs, with only limited trade-offs, e.g. cut-offs first and scoring after.
Jedetski et al. (2002): a website with a tool for comparing products by feature led to more compensatory choosing and higher satisfaction than a site without one; with very many alternatives people used non-compensatory strategies more.

Consumer decision-making: choice heuristics

Availability: judging by how easily examples come to mind.
Representativeness: judging by how well something matches a typical example or stereotype.
Recognition: choosing the option you have heard of over one you have not.
Take-the-best: comparing options on the most important cue first and stopping at the first cue that separates them.
Anchoring: a first number sets a reference point, and later estimates stay close to it.
Wansink et al. (1998): multiple unit prices ('3 for ...'), purchase limits ('limit of 12 per person') and suggestive selling ('buy 18 for your freezer') all raised the quantity bought; explained by anchoring and adjustment.
Del Campo et al. (2016): compared people's decision-making styles with the heuristics they used when choosing a product, in two countries; style was related to heuristic use, but the links were not strong or the same everywhere.

Consumer decision-making: mistakes in decision-making

System 1: quick and intuitive, e.g. picking a familiar brand; System 2: effortful, e.g. comparing unit prices. Shleifer (2012) reviewed these ideas for economics.
Hall et al. (2010): field experiment with 180 shoppers at a tasting stall in a Swedish supermarket.
Hall procedure: shoppers chose between two jams (or two teas); a hidden double-ended jar swapped the chosen one for the rejected one; they tasted 'their choice' again and gave reasons.
Hall result: fewer than a third of all switches were detected, even for very different pairs.
Hall conclusion: people have limited insight into their own preferences, so stated reasons can be unreliable.
Proactive: old disrupts new. Retroactive: new disrupts old.
Burke and Srull (1988): laboratory experiments with magazine adverts; adverts for competing brands, or for other products of the same brand, reduced recall, both proactively and retroactively.

The product: packaging and positioning

Gift-wrapping: creates surprise, hides the gift, shows care and marks the item as a gift.
Types of wrapping: traditional paper and ribbon, gift bags and boxes, or shop wrapping.
Sensation transference: features of the package (shape, colour, material) are transferred to the product.
Becker et al. (2011): field experiment in a supermarket; IVs were pot shape (angular or rounded) and colour saturation; the yoghurt was the same in every pot.
Becker et al. result: angular packaging gave a more intense taste impression, mostly for shoppers sensitive to design.
Planogram: a diagram showing where every product goes on the shelves.
Atalay et al. (2012): eye-tracking showed that items in the horizontal centre get more looks and are chosen more often.

The product: selling the product

Customer-focused: meets the buyer’s needs; best for the long-term buyer–seller relationship.
Competitor-focused: shows how the product beats rival products.
Product-focused: lists features and qualities of the product itself.
Disrupt-then-reframe: a confusing statement first, then a clear persuasive message straight after.
Need for cognitive closure rises with time pressure, noise and tiredness; it falls when a person must be accurate or has plenty of time.
Cialdini’s six: reciprocity, commitment and consistency, social proof, authority, liking, scarcity.

The product: buying the product

EKB order: need recognition → information search → evaluation of alternatives → purchase → post-purchase evaluation.
Information search can be internal (memory) or external (reviews, friends, sellers).
Sinha et al. (2002): convenience (nearness) and merchandise were leading reasons for store choice; men and women weighted them differently.
Dissonance is stronger when the purchase is expensive, important, hard to reverse and the rejected options were attractive.
Reducing dissonance: seek information that supports the choice, value the chosen item more, devalue the rejected one, or return the item.
Retailers reduce it with guarantees, easy returns and reassuring follow-up messages.

Advertising: types of advertising and advertising techniques

Yale model, five features: source, message, medium, audience, situation.
Source: credibility, expertise, attractiveness. Message: one-sided or two-sided, emotional or factual.
Eye-tracking: objective data on fixations (where, how long, in what order).
EEG: objective data on brain activity while viewing; it shows response, not what the person will buy.
4 Cs: consumer (not product), cost (not price), convenience (not place), communication (not promotion).
Cost means the total cost to the buyer, including time and travel, not only the price tag.

Advertising: advertising-consumer interaction

High self-monitor: prefers image-based (soft-sell) adverts. Low self-monitor: prefers quality-based (hard-sell) adverts.
Self-monitoring was measured with Snyder’s Self-Monitoring Scale, a true/false self-report.
Snyder and DeBono study 3: IVs were self-monitoring (high or low) and the message (image or quality); DV was willingness to use the shampoo.
Mere exposure: repeated contact with a brand increases liking, even without awareness.
Auty and Lewis (2004): children who saw a film clip with a branded cola were more likely to choose that brand afterwards.
In Auty and Lewis the effect was linked to having seen the film before (a reminder), not to recalling the brand.

Advertising: brand awareness and recognition

Logo recognition comes first; understanding that adverts aim to persuade comes later in childhood.
Brand recognition: picking out a brand when it is shown (aided). Brand recall: naming it from memory (unaided).
Brand image: the associations and personality a consumer attaches to the brand.
Functions of slogans: build brand awareness and shape brand image.
Kohli et al. (2007): link the slogan to the brand, use it to position the brand, think long term, repeat it, be creative, add a jingle if possible.
Research with children needs parental consent and protection from distress.

Health Psychology

The patient-practitioner relationship: interpersonal skills

Non-verbal communication: messages sent without words, such as clothing, gesture, eye contact and tone of voice.
McKinstry and Wang (1991): photographs of doctors and a questionnaire; formal dress was preferred, especially by older patients.
McKinlay (1975): some medical terms were not understood; doctors underestimated the women’s understanding but used the terms anyway.
Clear communication: plain words, short statements, key advice first, repeat it and check understanding.
Photographs of the same doctor in different clothes control other variables, but they are less true to life.
Questionnaires give quick quantitative data from many patients; this is a nomothetic approach.

The patient-practitioner relationship: diagnosis and style

False positive: told you have the condition when you do not (needless worry and treatment).
False negative: told you are clear when you have the condition (illness goes untreated).
Directed style: doctor is the expert, gives a firm diagnosis and instructions.
Sharing style: patient’s views are asked for and treatment is negotiated.
Savage and Armstrong: field experiment; IV was consulting style; DV was satisfaction, by questionnaire straight after and one week later.
Result: the directing style gave higher satisfaction, for example on feeling understood and on the quality of the explanation, mainly for physical problems.
Limits: one GP and one practice, so generalising is hard; expectations of doctors differ between cultures.

The patient-practitioner relationship: misusing health services

Total delay = appraisal delay + illness delay + utilisation delay.
Safer et al.: strong pain or bleeding shortened delay; worry about cost lengthened utilisation delay.
Health belief model: perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cues to action.
Munchausen syndrome: internal motive (attention and care as a patient). Malingering: external motive (money, time off, avoiding duty).
Essential features of Munchausen syndrome: pathological lying, moving from hospital to hospital, repeated feigned or self-caused illness.
Supporting features include many hospital stays, many scars, medical knowledge and a dramatic presentation.
Aleem and Ajarim (1995): case study of a young woman in Saudi Arabia whose repeated abscesses were found to be self-inflicted.

Adherence to medical advice: types and reasons for non-adherence

Types: failure to follow treatment; failure to attend appointments.
Rational non-adherence: a deliberate choice after weighing costs (side effects, money, effort) against benefits.
Laba et al. (2012): online discrete choice experiment; choices depended on the medicine’s benefits, its harms and its cost.
Health belief model: perceived susceptibility + perceived severity = perceived threat.
Adherence is likely when the threat is seen as high and benefits are seen as greater than barriers.
Cue to action: a trigger such as a symptom, a reminder or a friend’s illness.
Individual explanation: beliefs and decisions. Situational explanation: distance, cost, complex treatment.

Adherence to medical advice: measuring non-adherence

Pill count adherence (%) = tablets taken ÷ tablets prescribed × 100.
Tablets taken = tablets given − tablets left.
Self-report: quick, gives reasons (qualitative data), but social desirability lowers validity.
Pill count: objective and cheap, but missing tablets may have been thrown away, not swallowed.
Electronic dispenser: records date and time of each opening; opening the cap does not prove the dose was swallowed.
Blood or urine test: direct evidence the drug is in the body; shows recent intake only.

Adherence to medical advice: improving adherence

Funhaler: uses positive reinforcement (operant conditioning) to make inhaler use fun.
Contract: agreed targets, signed by patient and practitioner, with rewards.
Prompt: a cue at the right time (text, phone call, alarm, calendar pack).
Customising: simpler doses and timing matched to the patient’s daily life.
Yokley and Glenwick: IV was the type of intervention; DV was the number of children immunised, taken from clinic records.
Their groups: general prompt, specific prompt, specific prompt + increased access, specific prompt + money incentive, and two control groups.
Result: the general prompt had little effect; the specific prompt with a money incentive had the most.

Pain: types and theories of pain

Functions of pain: warning of damage, protective withdrawal, rest and healing.
Acute pain: short-term, linked to injury. Chronic pain: continues beyond the normal healing time.
Specificity theory: specific receptors → direct pathway → brain. It is biological and reductionist.
Gate control theory: small nerve fibres open the gate, large fibres close it, and messages from the brain can also close it.
Phantom limb pain: pain felt in a limb that is no longer there, so it cannot come from receptors in that limb.
Mirror treatment: the patient watches the reflection of the intact limb moving, so the brain 'sees' the missing limb move.
MacLachlan et al. (2004): case study of one man with a leg amputation; mirror treatment reduced his phantom pain and gave him more control over the phantom limb.

Pain: measuring pain

Clinical interview: open questions about where the pain is, what it feels like and how it affects life; qualitative and idiographic.
McGill pain questionnaire (Melzack): words in sensory, affective and evaluative groups (plus miscellaneous), giving a pain rating index.
Sensory = what it feels like (burning); affective = emotional effect (exhausting); evaluative = overall strength (unbearable).
Visual analogue scale: a line, usually 10 cm, from 'no pain' to 'worst pain'; the score is the distance from the 'no pain' end.
UAB pain behaviour scale: an observer scores 10 behaviours (such as grimacing, limping, verbal complaints) as 0, 0.5 or 1, giving a total out of 10.
Brudvik et al. (2016): physicians underestimated children's pain most; parents' ratings were closer to the child's; pain relief was not given often enough.
Psychometric tests give quantitative data that can be compared across patients (nomothetic).

Pain: managing and controlling pain

Non-opioid analgesics (aspirin, ibuprofen): reduce prostaglandins and inflammation at the site of injury.
Opioids (morphine, codeine): bind to opioid receptors like endorphins; risks are tolerance and dependence.
Attention diversion: focus on something else, such as counting or music.
Non-pain imagery: build a vivid, pleasant mental scene that has nothing to do with the pain.
Cognitive redefinition: replace threatening thoughts about the pain with realistic or positive ones.
TENS (transcutaneous electrical nerve stimulation): pulses stimulate large fibres, which close the gate.
Drugs alone are a reductionist approach; combining drugs with psychological methods is holistic.

Stress: sources of stress

Alarm: fight or flight, adrenaline released, heart rate rises.
Resistance: the body adapts and seems to cope, but cortisol stays high and resources are being used up.
Exhaustion: resources are used up, immunity is low, illness is likely.
Holmes and Rahe's Social Readjustment Rating Scale: 43 life events, each with life change units (death of a spouse = 100, marriage = 50); a higher yearly total means a higher risk of illness.
Chandola et al. (2008): a long study of British civil servants found that chronic work stress was linked with coronary heart disease, most clearly in younger workers.
Type A: competitive, impatient (time urgency), hostile. Type B: relaxed and patient.
Life events and work are situational explanations; Type A personality is an individual explanation.

Stress: measures of stress

Objective measures: heart rate, fMRI, salivary cortisol. Subjective measures: questionnaires and interviews.
fMRI: detects changes in blood flow and oxygen, an indirect sign of brain activity; costly and artificial.
Salivary cortisol: painless to collect, so sampling does not add stress; must be taken at the same time of day because cortisol is highest in the morning.
Evans and Wener (2007): the number of people sitting close to the commuter mattered more than how full the whole carriage was.
Life events questionnaire: tick the events of the past year and add the life change units.
Reliability = consistency of a measure. Validity = whether it measures what it claims to measure.
Self-reports can be affected by memory, honesty and social desirability.

Stress: managing stress

Biofeedback: monitor a response → give immediate feedback → learn to control it → use the skill without the machine.
Budzynski et al. (1969): muscle tension (EMG) feedback; the tone fell as the forehead muscle relaxed, and headaches became less frequent.
Bridge et al. (1988): three groups: control (talking only), relaxation, and relaxation plus imagery, during six weeks of radiotherapy.
Bridge et al. result: mood was best with relaxation plus imagery, then relaxation, and worst in the controls; women aged 55 and over gained most.
Phase 1, conceptualisation: learn about stress and identify your own stressors and reactions.
Phase 2, skills acquisition and rehearsal: learn and practise coping skills such as relaxation and positive self-statements.
Phase 3, application and follow-through: use the skills in real situations of increasing difficulty, with follow-up.

Health promotion: strategies for promoting health

Fear arousal: a threatening message intended to motivate change.
Janis and Feshbach (1953): three fear levels plus a control group; the minimal fear group followed the dental advice most, the strong fear group least.
Fear works best at a low to moderate level and when people are told exactly what to do and believe they can do it.
Providing information: clear, specific, practical advice works better than long technical detail.
Lewin et al. (1992): home-based manual for heart attack patients; less anxiety and depression, fewer visits to the family doctor and fewer returns to hospital.
Knowing the risk does not always change behaviour, so information is often combined with other strategies.
Ethics: frightening people conflicts with protection from psychological harm.

Health promotion: schools and worksites

Food Dudes uses three things: peer modelling (videos), rewards, and repeated tasting.
Modelling comes from social learning theory: children copy admired role models who are a little older than they are.
Rewards are positive reinforcement: behaviour followed by a reward is repeated.
Fox et al. (1987): stamps for no lost-time injuries, and extra stamps when the whole work group stayed injury-free, so an injury cost the group its award.
Token economy: tokens (secondary reinforcers) are earned for target behaviour and exchanged for goods.
Both studies are longitudinal field studies: high ecological validity but less control of variables.
Research with children needs consent from parents or guardians as well as the child's agreement.

Health promotion: individual factors in changing health beliefs

Unrealistic optimism is stronger for events people think they can control and for events they have no personal experience of.
The pleasant life: having positive emotions and pleasures and learning to enjoy them.
The good life: being engaged and absorbed, using your own strengths (flow).
The meaningful life: using your strengths to serve something larger than yourself.
Applications: writing down three good things each day, gratitude letters, finding and using signature strengths.
Shoshani and Steinmetz (2014): adolescents in one school received the programme from their teachers; a similar school was the control; questionnaires were repeated over two years.
Result: in the programme school distress, anxiety and depression fell, and self-esteem, self-efficacy and optimism rose; symptoms in the control school got worse.

Organisational Psychology

Motivation to work: need theories

Maslow, lowest to highest: physiological, safety, love and belonging, esteem, self-actualisation.
At work: pay for food and housing (physiological), job security (safety), friendly colleagues (belonging), praise and status (esteem), reaching full potential (self-actualisation).
Need for achievement (nAch): prefers moderately difficult goals, personal responsibility and quick feedback.
Need for affiliation (nAff): wants warm relationships, cooperation and to be liked.
Need for power (nPow): wants to influence, lead and control others.
McClelland measured needs with the Thematic Apperception Test: people write stories about ambiguous pictures, and the themes are scored.
Criticism of Maslow: the order is not the same for every person or culture.

Motivation to work: cognitive theories

Five goal-setting principles: clarity, challenge, commitment, feedback, task complexity.
SMART goals: specific, measurable, achievable, relevant, time-bound.
Expectancy (E): the belief that effort will lead to good performance.
Instrumentality (I): the belief that good performance will lead to the outcome or reward.
Valence (V): how much the person values that outcome.
motivation = expectancy × instrumentality × valence
Both theories treat workers as rational decision makers, which supports free-will but ignores emotion and habit.

Motivation to work: motivators at work

Pay: fixed wage or salary. Bonus: an extra payment for reaching a target.
Profit-sharing: staff receive a share of the company's profit. Performance-related pay: pay depends on the individual's measured performance.
Empowerment: giving workers authority and trust to make decisions about their own work.
Competence: feeling effective and able. Autonomy: feeling that you choose your own actions. Relatedness: feeling connected to others.
A reward that feels controlling reduces autonomy and can lower intrinsic motivation.
Landry et al. (2019): what matters is how a reward is presented and what it means to the person, not only that it is given.
Landry et al. study 1 was a laboratory experiment with students: good control, but low ecological validity and limited generalisation to employees.

Leadership and management: traditional and modern theories

Great person theory: leadership comes from inborn traits (the nature side of the debate).
Transformational leader: idealised influence, inspirational motivation, intellectual stimulation, individualised consideration.
Ohio State: consideration (concern for staff and trust) and initiating structure (roles, procedures, deadlines).
Michigan: employee-oriented leaders (people and their needs) versus production-oriented leaders (tasks and output).
Heifetz's six principles: get on the balcony; identify the adaptive challenge; regulate distress; maintain disciplined attention; give the work back to the people; protect voices of leadership from below.
Adaptive leader's responsibilities: direction, protection, orientation, managing conflict, shaping norms.
Technical problem: an expert can fix it with known methods. Adaptive challenge: people's values, beliefs or habits must change.

Leadership and management: leadership style

Directive autocrat: decides alone, supervises closely.
Permissive autocrat: decides alone, leaves staff free in how they do the work.
Directive democrat: staff share the decision, leader supervises closely.
Permissive democrat: staff share the decision and have freedom in how they do the work.
Scouller: public = two or more people together; private = one to one; personal = the leader's own technical skill, attitude to others and self-mastery.
Cuadrado et al.: Spanish participants read about a male or female leader using a stereotypically masculine (autocratic, task-oriented) or feminine (democratic, relationship-oriented) style, then rated the leader.
Cuadrado et al. result: women using the masculine style were not rated worse than men; the feminine styles were rated more favourably whatever the leader's sex.

Leadership and management: leaders and followers

Five practices: Model the Way, Inspire a Shared Vision, Challenge the Process, Enable Others to Act, Encourage the Heart.
LPI: 30 statements, six for each practice, rated for how often the leader does it; LPI-Self and LPI-Observer versions.
Alienated follower: independent thinker but passive; capable and cynical.
Conformist follower ('yes person'): active but dependent; does what is asked without question.
Passive follower ('sheep'): dependent and passive; needs constant direction.
Exemplary (effective) follower: independent and active; takes initiative and challenges constructively.
Pragmatist (survivor): in the middle on both dimensions; waits to see which way things go.

Group behaviour: group development and decision-making

Forming (polite, unsure) → storming (conflict over roles and leadership) → norming (rules agreed, cohesion) → performing (work gets done) → adjourning (group ends).
Belbin's nine roles: plant, resource investigator, co-ordinator, shaper, monitor evaluator, teamworker, implementer, completer finisher, specialist (the role added later).
Groupthink features: illusion of invulnerability, collective rationalisation, belief in the group's own morality, stereotyped views of outsiders, pressure on dissenters, self-censorship, illusion of unanimity, self-appointed mindguards.
Sins of commission: belief perseverance, sunk cost bias, extra-evidentiary bias, hindsight bias.
Sins of omission: base rate bias, fundamental attribution error.
Sins of imprecision: availability heuristic, conjunctive bias, representativeness heuristic.
To avoid faulty decisions: a devil's advocate, outside experts, a leader who does not state a preference first, a second-chance meeting.

Group behaviour: individual and group performance

Dominant response: the most likely response. It is correct for a well-learned task and often wrong for a new one.
Social impact depends on the strength, immediacy and number of the people present; in a team the pressure from one manager is divided among the members.
Loafing falls when each person's output can be identified and is recorded.
Earley (1993): managers from China, Israel and the USA worked alone, with an in-group or with an out-group.
Earley's result: collectivist managers (China, Israel) did best with an in-group; individualist US managers did best alone.
Claypoole and Szalma, experiment 1: a laboratory vigilance task, with or without electronic monitoring.
Their result: monitored participants detected more of the critical signals, as social facilitation predicts.

Group behaviour: conflict at work

Intra-individual: one person torn between demands. Inter-individual: two people. Intra-group: within one team. Inter-group: between teams or departments.
Competing: high assertiveness, low cooperativeness. Accommodating: low assertiveness, high cooperativeness.
Collaborating: high on both, a solution that fully satisfies both sides. Avoiding: low on both.
Compromising: moderate on both; each side gives something up.
Einarsen's types: predatory bullying (the victim has done nothing to provoke it) and dispute-related bullying (grows out of a conflict).
Einarsen's phases: aggressive behaviour → bullying → stigmatisation → severe trauma.
Causes: personality of victim or bully, envy, and organisational factors such as poor leadership, role conflict and a culture that tolerates aggression.

Organisational work conditions: physical work conditions

Hawthorne effect: a change in behaviour caused by being observed, not by the variable being tested.
Kompier: the Hawthorne studies had weak methods (small samples, uncontrolled variables), so their conclusions are unsafe.
Open-plan office: a large shared space with few or no internal walls.
Claimed benefits of open plan: easier communication, lower cost. Claimed costs: noise, distraction, loss of privacy.
Oldham and Brass: a natural (quasi) experiment using questionnaires before the move and again after it.
Their result: satisfaction and internal motivation fell after the move; staff reported less privacy, less chance to concentrate and less feedback and friendship.
No random allocation, so cause and effect cannot be certain.

Organisational work conditions: temporal conditions

Rapid rotation: shifts change every few days, e.g. the metropolitan rota (2 early, 2 late, 2 night, then rest days) and the continental rota (2-2-3 pattern).
Slow rotation: the same shift for weeks or months before changing.
On-call: no fixed hours, but the worker must be available if needed.
Flexitime: workers choose start and finish times around fixed core hours.
Gold et al.: nurses reported their shifts, sleep, nodding off at work or while driving, and accidents or errors.
Gold et al. result: rotating-shift nurses reported poorer sleep and about twice the odds of a sleepiness-related accident or error, compared with day and evening nurses.
Self-report data: depends on memory and honesty, and a link does not prove cause.

Organisational work conditions: health and safety

Omission: a step is not done. Commission: a wrong action is done.
Sequencing: steps done in the wrong order. Timing: the right action done too soon or too late.
Controls should match what people expect (e.g. clockwise = more) and be easy to tell apart by shape, colour or position.
Displays should be clear and visible; important warnings should be placed where the operator looks.
Fox et al.: workers at two open-pit mines earned trading stamps for periods without lost-time injuries; injuries, days lost and costs fell and stayed low for years.
Swat: accident causes were grouped as insufficient supervision, poor workplace organisation, technical factors and human error; poor housekeeping was a common hazard.
Risk events (near-misses) are more frequent than accidents, so monitoring them shows hazards before anyone is hurt.

Satisfaction at work: theories of job satisfaction

Hygiene factors: pay, company policy, supervision, working conditions, job security, relations with others.
Motivators: achievement, recognition, the work itself, responsibility, advancement, growth.
Skill variety, task identity and task significance → experienced meaningfulness of the work.
Autonomy → experienced responsibility for outcomes. Feedback → knowledge of results.
Job enrichment: more responsibility and control (e.g. planning, checking quality).
Job enlargement: more tasks at the same level. Job rotation: moving between different jobs.
Belias and Sklikas (2013): a review of these job design techniques and their link with satisfaction.

Satisfaction at work: measuring job satisfaction

JDI facets: the work itself, pay, promotion opportunities, supervision, co-workers.
JDI format: 72 short words or phrases; the worker answers yes, no or cannot decide (?) for each.
Walton 1 to 4: adequate and fair compensation; safe and healthy working conditions; immediate opportunity to use and develop human capacities; opportunity for continued growth and security.
Walton 5 to 8: social integration in the work organisation; constitutionalism (rights such as privacy, free speech, fair treatment); work and total life space (work-life balance); social relevance of work life.
Test-retest reliability: similar scores from the same people on two occasions.
Concurrent validity: scores agree with an established measure of the same thing.
Scales give quantitative data that are easy to compare but do not explain why; interviews give the reasons in depth.

Satisfaction at work: attitudes to work

Giacalone and Rosenfeld's method groups: work slowdowns, destruction (of machinery, premises or products), dishonesty, causing chaos.
Their result: workers who accepted more reasons for sabotage rated slowdowns, destruction and causing chaos as more justified; dishonesty showed no such difference.
Self-reports on sabotage risk under-reporting, so anonymity is essential.
Voluntary absence: the worker chooses not to attend. Involuntary absence: beyond the worker's control, e.g. illness.
High involvement, high commitment: institutionalised stars; mainly medical absence.
High involvement, low commitment: lone wolves; career-enhancing absence. Low involvement, high commitment: corporate citizens; normative absence.
Low involvement, low commitment: apathetic employees; calculative absence, the highest absence and turnover.