Medical Psychology - Exam 3

Frequent Criticisms of Providers

Use of jargon, lack of (digestible) feedback, depersonalized care, inattentiveness, “baby talk,” and stereotypes of patients

Use of Jargon

Refers to the use of technical language or terminology that may be difficult for patients to understand, often hindering communication and clarity in care.

Lack of Digestible Feedback

Providing information in a complex or overly technical manner that patients cannot easily understand, leading to confusion and frustration.

Depersonalized Care

Refers to a treatment approach where patients feel like they are viewed as numbers or cases rather than individuals, leading to a lack of personal connection and empathy from healthcare providers.

Inattentiveness

Refers to a lack of focus or engagement from healthcare providers, which can result in missed information, misunderstandings, and patients feeling undervalued during their care. (Common occurrence with physician documenting/typing during appts. and the elderly population)

“Baby Talk”

Refers to the use of overly simplistic or childish language when communicating with patients, which can undermine their understanding and lead to feelings of disrespect/patronization.

Stereotypes of Patients

Refers to generalized beliefs or assumptions about individuals based on their characteristics such as age, gender, race/ethnicity, socioeconomic status, and mental health history, which can impact the quality of care they receive.

How might patients unintentionally contribute to poor communication during medical visits?

Patients may come in with preconceived self-diagnoses from internet research (Dr. Google) or accidentally omit important information, due to forgetfulness, fear of judgment, or a lack of understanding about what details are relevant.

Why might patients and providers have conflicting goals during a visit?

The provider may prioritize long-term planning or non-medication options, while the patient may expect an immediate fix—often a prescription, especially after long wait times.

Why is effective patient-provider communication crucial for treatment?

Misunderstandings can lead to treatment nonadherence, not because of defiance, but due to unclear communication or expectations.

How can poor patient-provider communication affect legal risk?

Adversarial or unclear communication increases the risk of medical malpractice litigation, even when clinical care is technically appropriate. Medical malpractice litigation involves legal action taken against healthcare providers for negligence.

How can technology and AI improve patient-provider communication and care?

AI digital tools can ease provider workload by handling intake (e.g., symptom surveys via portals), analyze symptom clusters to support diagnosis, and reduce follow-ups through telehealth and secure messaging.

What role does machine learning play in clinical care?

Machine learning can infer diagnoses from patterns in patient symptoms, potentially improving diagnostic accuracy and efficiency.

How does technology help reduce the need for frequent in-person visits?

Telemedicine and secure messaging through patient portals enable follow-up care and medication management remotely—especially helpful in psychiatry.

Could increasing use of technology in care de-personalize the patient experience?

Yes, relying too much on technology may risk reducing human connection, which is vital for trust, empathy, and psychological support in care.

What is treatment non-adherence?

When patients do not follow the behaviors or treatment plans recommended by their healthcare providers

What percentage of patients with chronic illnesses are non-adherent to treatment?

As many as 50%, even when they understand that their illness may worsen without treatment

What is the estimated average non-adherence rate across all treatments?

About 26%, meaning providers may expect 1 in 4 patients to not follow through with recommendations

How high are non-adherence rates for preventive behavior change?

Nearly 80% - patients are less likely to follow recommendations for prevention than for treatment.

Which chronic illnesses tend to have the highest adherence rates?

HIV, arthritis, GI disorders, and cancer—likely because these involve imminent danger, pain, or clear outcomes if untreated.

Which chronic illnesses show the lowest adherence rates?

Pulmonary disease, diabetes, and sleep disorders—often due to complex regimens or lack of immediate noticeable benefit.

What factors influence non-adherence?

Patient perception on treatment, complexity of treatment regimen, interference with day-to-day activities, family cohesiveness, depression and other mental health disorders, time/financial resources, and low IQ

How does a patient’s perception of treatment affect adherence?

Patients are more likely to adhere if they believe the treatment is necessary, will help, and that risks or side effects don’t outweigh benefits.

How does treatment complexity affect adherence?

More complex regimens (e.g., multiple meds or steps) reduce adherence, especially when consistency is required.

How can treatment interfere with daily life and impact adherence?

If treatment disrupts daily activities (like food-related restrictions in diabetes), adherence may decrease due to social or lifestyle conflicts.

What role does family support play in treatment adherence?

Low family support can make patients feel isolated. Shared understanding and behavior within the family unit improves adherence—especially in illnesses like diabetes.

How does depression affect adherence?

Even mild depressive symptoms increase the risk of non-adherence. There’s a dose-response relationship: more symptoms → more interference (e.g., ART for HIV).

How do time and financial resources affect treatment adherence?

Limited time, money, or access can make it hard for patients to obtain or stick to treatments—especially for chronic conditions.

What is the impact of low IQ or health literacy on adherence?

Patients with lower IQ or low health literacy may struggle to understand or follow treatment plans, leading to reduced adherence.

How can providers reduce non-adherence?

Teach-back instruction and written instruction, use of checklists, usage of electronic patient portals, automated appointment reminders & follow-up, listening, usage of pill organizers/reminders, and family member/caregiver involvement.

How can the "teach-back" method help reduce non-adherence?

By having patients repeat instructions in their own words, providers can confirm understanding. Giving written instructions at a clear reading level also improves retention.

How can checklists improve adherence?

Checklists help patients and providers stay organized—clarifying visit goals, treatment steps, and ensuring nothing important is missed.

What is the benefit of using electronic patient portals?

Portals give access to medication lists, test results, notes, and enable messaging between visits, especially helpful in fragmented care systems.

How do appointment reminders and follow-ups support adherence?

Automated reminders and follow-ups after missed visits help ensure patients show up—a key step especially when physical exams or in-person care are needed.

Why is listening important in reducing non-adherence?

Listening builds trust, helps providers understand barriers to adherence, and shows patients their concerns and goals are being taken seriously.

How can medication tools support adherence?

Using pill organizers, alarms, or reminders helps patients—especially those with multiple medications or chronic illness burden—stay on track.

How can family involvement improve adherence?

With the patient's consent, involving family or caregivers helps with support, monitoring, and coordination of at-home treatment tasks.

What proportion of U.S. adults has at least one chronic condition?

60% of U.S. adults have at least one chronic condition.

What percentage of U.S. healthcare spending is due to chronic disease management?

90% of healthcare spending goes toward managing chronic conditions, including mental health disorders.

Why does chronic illness contribute so heavily to healthcare spending?

Because it involves long-term management, especially for those with complications or disability from delayed or inconsistent care.

What is multimorbidity?

Having two or more chronic conditions that require care or limit daily activities—affects nearly 50% of adults aged 45–65.

How do complex treatment regimens affect chronic disease care?

Each chronic condition (e.g., diabetes, hypertension, CVD) often requires distinct treatments, increasing complexity and lowering adherence.

How does chronic disease burden affect healthcare costs?

Patients with multiple conditions have more complex needs, often resulting in higher healthcare costs and resource use.

What are the personal impacts of managing multiple chronic conditions?

People may experience lower quality of life due to symptoms, treatment demands, and increased stress—and often have reduced life expectancy.

What is Quality of Life (QoL) in the context of health?

Refers to the extent to which a person’s normal life activities are impacted by illness and treatment.

What are the four domains of Quality of Life (according to the WHO)?

Physical Functioning, Psychological Status, Social Functioning, and Occupational/Vocational/Economic Functioning

What does the physical domain of QoL include?

Mobility, ability to complete activities of daily living (ADLs) like bathing, cooking, and managing finances independently.

What is assessed under psychological status in QoL?

Life satisfaction, happiness, and mental health issues (e.g., depression due to chronic illness like diabetes or heart disease).

What is evaluated in the social functioning domain of QoL?

Ability to engage in hobbies, participate in social activities, and draw on social support when needed.

What is included in the occupational/economic domain of QoL?

Whether someone can work, volunteer, or contribute to family responsibilities—and whether these roles offer economic or personal stability.

How can denial affect patients after a diagnosis?

Denial may protect patients from initial shock, but long-term it can interfere with medical understanding, self-advocacy, and illness management.

How does anxiety present after a medical diagnosis?

Anxiety may not appear immediately but can involve catastrophizing, especially in those already prone to it. Anticipation of treatment side effects or test results may heighten anxiety.

Can anxiety be helpful in managing chronic illness?

Yes—moderate anxiety can motivate patients to attend appointments and follow treatment. However, anxiety may also lead to avoidance behaviors.

How common is depression in medical patients?

Up to 1/3 of medical inpatients report depressive symptoms; up to 1/4 of newly diagnosed chronic illness patients report severe depression.

Why is depression clinically significant in chronic illness?

Depression can lead to worse adherence, worsened symptoms, and predicts higher all-cause mortality (adherence complications, intensity of symptoms increasing with perceived severity of disorder).

What role does self-blame play in chronic illness?

Patients may feel internalized shame for contributing to their illness (e.g., risky behaviors, not getting screenings), which can worsen emotional distress.

What are the major social factors that impact the experience of living with a chronic illness?

Stigma and negative stereotypes, financial strain, dependency on family members, deficit in social support - gender disparities, potential for post-traumatic growth (benefit finding)

How can discrimination and stigma affect people with chronic illness?

Negative stereotypes and stigma—especially around HIV, weight, or lifestyle-related causes—can lead to shame, isolation, and emotional distress.

How does chronic illness create financial strain?

Costs include medical care, time off work, and unpaid leave (e.g., under FMLA), especially if the patient lacks short-term disability coverage.

What is the role of family in managing chronic illness?

Patients may become dependent on family for care, which can lead to caregiver stress and affect family dynamics.

What is the impact of low social support on chronic illness?

Deficits in social support can worsen health outcomes and emotional well-being, making it harder to manage treatment and recovery.

Who is often more socially impacted by chronic illness?

Women tend to experience greater social and caregiving burdens in the context of chronic illness.

What is post-traumatic growth in chronic illness?

Some patients experience benefit-finding—gaining new perspectives, resilience, or purpose—after facing the challenges of chronic illness.

What is the medical term for Long COVID?

Post-acute sequelae of SARS-CoV-2 infection (PASC)

How is Long COVID defined?

The presence of new, otherwise unexplained symptoms that persist for at least 4 weeks after a COVID-19 infection—often beginning around 12 weeks post-infection.

How does Long COVID typically present in patients?

Patients may feel recovered after acute COVID but later experience recurring flu-like symptoms along with additional symptoms that suggest a new chronic condition, not a reinfection.

What are the three major subcategories of Long COVID (PASC)?

Organ/tissue damage after severe COVID, new chronic illnesses (e.g., autoimmune conditions), mysterious new symptoms without clear cause

What kind of patients typically experience organ or tissue damage in Long COVID?

Patients who had severe COVID and were hospitalized—a key risk factor for lasting organ/tissue damage.

What are examples of chronic illnesses that may develop after COVID

Cases of autoimmune diabetes have emerged post-COVID, likely due to viral damage to insulin-producing cells in the pancreas.

What kinds of mysterious symptoms are seen in Long COVID?

Includes post-viral symptoms like cough, headaches, joint pain, shortness of breath, and neurologic/inflammatory symptoms from autonomic nervous system dysfunction.

What is POTS, and how is it related to Long COVID?

POTS (Postural Orthostatic Tachycardia Syndrome) causes fast heart rate, dizziness, and fatigue upon standing—an example of dysautonomia, often triggered or worsened by COVID.

What are nearly universal symptoms reported in Long COVID?

Fatigue, brain fog, and post-exertional malaise—where physical activity causes abnormal exhaustion and prolonged recovery.

What are the key statistics and impacts of Long COVID in the U.S.?

Long COVID can involve up to 203 symptoms and has affected 15% of Americans (~40 million), including children and teens. Around 6% (~15 million) still experience symptoms, and 5 million are out of the workforce due to disability. Despite its impact, many face barriers to receiving disability benefits. The ongoing medical burden has contributed to over half a trillion dollars in extra healthcare costs, driven by severe initial infections and extensive follow-up care.

Who is most at risk for developing Long COVID?

People who were at higher risk for severe COVID, especially those with underlying conditions like obesity, diabetes, or other metabolic disorders.

How do autoimmune and connective tissue disorders relate to Long COVID risk?

People with autoimmune diseases (e.g., Lupus, Rheumatoid Arthritis) or connective tissue disorders (e.g., Ehlers-Danlos Syndrome) are more prone to Long COVID and dysautonomic conditions like POTS.

What is the connection between Ehlers-Danlos Syndrome and Long COVID?

EDS involves loose ligaments and chronic pain, and is often comorbid with POTS and other autonomic nervous system dysfunctions, increasing vulnerability to Long COVID.

How do latent virus reactivations factor into Long COVID?

COVID can reactivate latent viruses like Herpes Zoster (shingles) and Epstein-Barr Virus, contributing to prolonged or worsening symptoms.

Is pre-infection psychological distress a risk factor for Long COVID?

Yes—conditions like depression and anxiety elevate inflammation, increasing risk for severe COVID and possibly post-COVID conditions.

Why does chronic inflammation increase Long COVID risk?

Chronic stress and psychological disorders can sustain high inflammation, which—combined with COVID’s inflammatory effects—may lead to cytokine storms and lasting tissue damage.

What are some possible causal mechanisms for Long COVID?

Dysfunction of immune system due to overactivation, chronic inflammation due to viral fragments remaining, inducing of autoimmunity, issues with blood flow and microclotting, neurological inflammation, and the body’s inability to use oxygen

How does immune system overactivation contribute to Long COVID?

COVID can lead to immune system dysfunction through chronic overactivation, especially if viral fragments remain, causing prolonged inflammation.

How might COVID trigger autoimmunity?

Persistent immune activity may lead the body to attack itself, inducing autoimmune disorders like type 1 diabetes in previously healthy individuals.

How is serotonin linked to cognitive symptoms in Long COVID?

COVID may cause serotonin depletion, which affects memory and contributes to brain fog and other cognitive issues.

What is the role of blood flow and microclotting in Long COVID symptoms?

COVID can cause microclotting and poor blood flow, reducing oxygen delivery to the frontal lobe, which affects executive functioning and contributes to fatigue and brain fog.

How does COVID affect oxygen use in the body?

Some patients show poor oxygen extraction—blood returns to the heart still rich in oxygen, leading to compensatory increases in heart and respiratory rates, worsening fatigue and creating a vicious cycle.

What is the foundational principle of treating patients with Long COVID?

Always believe the patient. Validating their symptoms is crucial for trust, treatment engagement, and emotional well-being.

Why is an interdisciplinary team important in treating Long COVID?

Long COVID affects multiple systems, so collaborative care across specialties (as in Long COVID clinics) improves access and coordination.

Why is it important to rule out other medical problems in Long COVID?

Symptoms should not be automatically attributed to COVID—other conditions must be considered and ruled out through a thorough workup.

How should providers address mental health in Long COVID patients?

Screen for depression and anxiety. Offer support like psychotherapy, especially if patients don’t want additional medications.

What is the general recovery outlook for Long COVID?

Many patients improve or recover within 12–18 months, but even temporary disability can cause major financial strain, especially among women and people of color.

What is Chronic Fatigue Syndrome (CFS/ME)?

A post-viral illness involving persistent or relapsing fatigue for at least 6 months, often following infection. It overlaps with many other conditions.

What symptoms are required for a CFS/ME diagnosis?

Fatigue for ≥6 months is required, plus 4 or more of: Post-exertional malaise, Impaired memory/concentration, Unrefreshing sleep, Muscle or multi-joint pain, Tender lymph nodes, Sore throat, Headache

Are there objective biological findings in CFS/ME?

Yes—research supports abnormalities in the central and autonomic nervous systems, though symptoms remain invisible externally.

How is CFS/ME diagnosed?

It is a diagnosis of exclusion—other conditions (e.g., autoimmune diseases, arthritis) must be ruled out first.

How has COVID impacted awareness of post-viral illnesses?

While tragic, COVID has helped bring greater recognition and validation to people with CFS/ME-like symptoms who were previously dismissed or misunderstood.

What proportion of cancer deaths globally are linked to behavioral and dietary risks?

1/3 of all cancer deaths worldwide are due to 5 major behavioral and dietary risk factors.

What are the five key behavioral and dietary risk factors for cancer?

High Body Mass Index (BMI), Low fruit and vegetable intake, lack of physical activity, tobacco use, alcohol use

How can psychosocial services support patients during the pre-diagnosis phase of cancer care?

Psychologists may assist patients seeking genetic counseling or facing preventive surgeries (e.g., prophylactic mastectomy), and assess mental health prior to high-risk procedures.

Why is the time of cancer diagnosis a key point for psychological support?

The diagnosis phase is often marked by high emotional distress, and psychologists are frequently involved to provide early coping support.

What is the psychologist’s role during cancer treatment?

Psychologists help patients cope with physical side effects, emotional strain, and quality of life issues throughout the treatment process.