MRCPsych Psychology Module: Motivation, Stress and States of Consciousness

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MRCPsych Psychology Module Motivation, Stress
and States of Consciousness

• Dr Alex Hunt
• Clinical Psychologist

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Motivation

• What makes people tick
• Motivation refers in a general sense, to
  processes involved in the initiation, direction
  and energization of human behaviour
• Each major theoretical approach has a different
  emphasis on what motivates us
• Psychodynamic
• Behaviourist
• Humanistic
• Evolutionary / biopsychology

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Theories of Motivation

• Extrinsic (pull) theories - external motivation
  for action
• Rewards, competition, coercion, threat of
  punishment
• Intrinsic (push) theories motivation driven by
  interest / enjoyment in the task itself, exists
  within the individual.
• pleasure, hobbies, achievement, interest

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Homeostatic Drive theory

• Motivation based upon the need to satisfy drives
  which maintain homeostasis in the body
• Hunger
• Thirst
• Drive - Voluntary and discontinuous. Tends to
  increase over time and operates on a feedback
  control system
• Focus on physiological needs
• Homeostasis controlled by hypothalamus

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Drive Reduction Theory

• Hull motivation based upon principles of
  positive and negative reinforcement, with respect
  to primary drives (innate, physiological drives)
• An action which reduces the tension associated
  with a biological/physiological drive is
  reinforced
• All behaviour ultimately concerned with
  satisfaction of these drives
• Secondary drives, are developed through
  conditioning
• Money food drink, etc

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Optimum Levels of Arousal

• Motivation for behaviour explained by a need to
  find an optimum level of arousal
• Yerkes-Dodson Law performance increases with
  physiological or mental arousal, but only up to a
  point. When levels of arousal become too high,
  performance decreases.
• Too little stimulation bored, seek more
  stimulation
• Too much stimulation anxious tense, seek less

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Yerkes-Dodson Law
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Intrinsic Theories

• Competence
• Curiosity and stimulation
• Mammals often engage in behaviour, not designed
  to satisfy any primary drive or physiological
  need
• Play, conducted for intrinsic purpose, learning
  incidental

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Cognitive Motives

• Need cognitive consistency
• Cognitive dissonance (Festinger) tension/
  uncomfortable feeling caused by holding
  conflicting ideas simultaneously.
• Obtain cognitive coherence rationalise /
  justify behaviour, change behaviour / attitudes /
  beliefs, blame, denial etc.
• Need for Achievement (nAch) Murray (1938)
• Desire for accomplishment, mastering of skills,
  control or high standards
• Assessed by thematic apperception test (TAT)

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Emotions as motivators

• What moves us?
• Usually say some sort of feeling
• Feelings good rewards positive reinforcement
• Avoiding threat and unwanted emotions negative
  reinforcement

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Social Motives

• Social anxiety a motivator
• Need for acceptance, positive view in eyes of
  others.
• Regarded as a basic need humans need other
  humans for survival
• Social motives develop as a need to belong in
  groups

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Maslows Hierarchy of Needs

• Humanistic theory with ranked needs with lower
  ones met before higher ones
• physiological needs (lowest)
• safety needs
• love needs
• esteem needs
• cognitive needs
• aesthetic needs
• self actualisation (highest)

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Stress

• Stress as stimulus
• What causes stress engineering model
• Stress as response or reaction
• What are the effects of stress physiological
  model
• Stress as interaction between organism and
  environment
• How do we manage and cope with stress
  transactional model

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Causes of Stress

• Disruption of circadian rhythm
• Shift work, jet lag
• Life events
• 43 life events social readjustment rating scale
  (SRRS)
• Hassles and uplifts of everyday life
• Trauma

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Causes of Stress

• Stress from an event depends on
• predictability
• controllability,
• Locus of control (Rotter) the extent to which
  individuals believe they can control events that
  effect them.
• Learned helplessness (Seligman)

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Effects of stress

• General Adaptation Syndrome
• Bodies reaction to any stressor, whether internal
  or external
• Mediated by the ANS and endocrine system
• Three stages
• Alarm fight or flight response
• Resistance/Adaptation body adapts to stressor
• Exhaustion bodys resistance to stress exhausted
  

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General Adaptation Syndrome
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Effects of Stress

• The sympathetic autonomic nervous system (sANS)
  responds to stress with general arousal - fight
  or flight
• Physical vs psychological threat
• Physical effects
• Heart rate and BP
• Increased blood cholesterol
• Psychoneuroimmunology (PNI)
• Stress reduced immunity higher likelhood of
  illness

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Stress Personality

• Type A behaviour pattern (TABP)
• Was considered a trait, now a set of behavioural
  responses
• Greater risk of HBP CHD
• Greater likelihood rather than fixed
• Type C greater risk of Cancer
• Protective factors - hardiness 3Cs
• Commitment
• Control
• challenge

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Stress Response

• Problem focused coping active strategies to
  change stressful situations
• Emotion focused coping attempt to reduce
  negative emotions associated with experience of
  stress
• Transactional Model of Stress and Coping (Lazarus
  and Folkman)
• Stress occurs when there is a discrepancy between
  perceived demands and perceived resources
• Cognitive defence and behavioural response

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Responses to Stress

• Primary appraisal is it a threat?
• Secondary appraisal what can be done?
• Lazarus - coping responses
• Direct action
• Information seeking
• Inhibition of action
• Intrapsychic or palliative coping
• Turn to others

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Transaction Model of Stress and Coping Lazarus
Folkman, 1984
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Measuring Stress

• Social Readjustment Rating Scale (Holmes Rahe
  Stress Scale)
• 43 life events that can contribute to illness
• No. of Life Changing Units that apply to events
  in the past year of an individuals life are
  added to give a score roughly estimating how
  stress affects health.
• Negative Event (Hassle) scales- every day events.
  Better predictors of ill health.

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States of Consciousness

• Not dichotomous - on/off - levels of
  consciousness
• Lack of consciousness - hyperconsciousness
• Conscious vs unconscious processing
• Purpose of consciousness
• Monitor information
• Control behaviour

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Arousal Alertness

• Tonic alertness
• Consciousness follow body rhythms
• RAS, thalamus and hypothalamus
• Phasic alertness
• Momentary fluctuations dependent on stimuli
• Heart rate, pupil dilation
• Habituation occurs rapidly

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Consciousness and Attention

• Consciousness what we are attending to
• Focal attention - what is in our awareness
• Peripheral attention - what is just outside, but
  could become focal
• Skill acquisition
• Initially requires full attention
• Quickly becomes automatic

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Sleep

• Stages / Levels of sleep
• Stage 1 early sleep - slow theta waves
• Stage 2 deeper sleep - sleep spindles
• Stage 3 sleep becomes deeper - spindles dissapear
  - delta waves
• Stage 4 - delta sleep - unresponsive, difficult
  to wake
• REM - rapid eye movement, dreams are common

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Sleep

• Evolutionarily disadvantageous - must be
  important
• Sleep - remain motionless
• Restoration
• Body repair
• Brain replenishment - proteins
• Hypnagogic (in to sleep) / hypnopompic (out of
  sleep) states

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Dreaming

• Freudian theory
• Dreams represent manifestations of repressed
  desires and wishes
• Reorganisation of mental structures - schema
  reconstructions
• Activation Synthesis Model brain activity
• Brain is active from internal signals, cognitive
  system interprets them as if they have come from
  external sources

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Parasomnias

• Sleep terrors - psychological stress and
  biological factors
• NREM sleep stage 1-2, where brain active is
  relative high, but there is no paralysis
• REM Sleep Behaviour Disorder (RBD)
• REM sleep parasomnia - muscle atonia is absent.
• Narcolepsy
• excessive daytime sleepiness
• Related to poor nocturnal sleep / insomnia

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Biorhythms

• Circadian
• 25 hour day - cave experiment
• Lark vs Owl 5-10 at extremes
• Diurnal rhythm
• Variation in alertness during wakefulness
• Ultradian rhythm (lt24 hours)
• Sleep cycles

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Circadian Rhythm
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Sleep Deprivation

• Disruption of cognitive and motor performance
  after 12 -14 hours of sleep deprivation
• Rats -weight plummets, while food consumption
  soars temperature decreases becomes more
  unstable - death
• Abrupt reduction, irritability, intellectual
  inefficiency, intense fatigue
• Gradual reduction - no marked effects
• Core amount of sleep 4/5 hours can be tolerated

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Hypnosis and Suggestibility

• Suggestibility extent to which an individual is
  responsive to suggestion of others
• Hypnosis
• An apparent sleep like state
• Highly selective attention
• Increased suggestibility
• Potential for post-hypnotic suggestibility
• Increased passivity
• Can you be led to do something out of your normal
  values/morals?

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Meditation and Trances

• Trance state General state of reduced awareness
  to the world reduction in consciousness
• Hypnagogic (in to sleep) / hypnopompic (out of
  sleep) state
• Mediation intense internal focus to the
  exclusion of external (and internal) stimuli
• EEG alpha wave activity
• lowered blood pressure and pulse
• Lowered oxygen consumption
• Mediation and therapy mindfulness
• Decreased arousal
• Increased mental control