A: A debate about determinism and free will can be applied here.

Determinism states that our

behaviors and thoughts arise from factors out of our control while free will states that our
behaviors and thoughts arise due to factors within our control. Stress management techniques
side with the free will part of the debate. Stress can arise due to many uncontrollable situations
such as life incidents as noted by Holmes and Rahe or due to work as supported by Chandola’s
study. However, having stress does not have to stop a person from trying to achieve a quality of
life through various stress management techniques. An individual has full control over how they
can utilise the available stree management techniques to help alleviate their stress and therefor
improve their quality of life by attaining better sleep quality and reducing the risk of
cardiovaduclar diseases. For example, despite duffering from a life-altering deaseas like cancer,
the particpants in Bridge’s study achieved a reduction in thei mood scores following the
relaxationa and imagery techniques. Free will allows the person to have some level of personal
agency on how much they can let stress affect their life whereas determinism can make them
feel hopeless and succumb to the stree that they are feeling.

A debate about nomothetic vs idiographic approach can be applied here. Nomothetic approach
seeks to find general principles and patterns amongst people in a large sample and relies on
quantitative date whereas idiographic approach is based on case studies and qualitative date in
order to get an indepth understating of individual’s thoughts and behaviours. The research into
stree management techniques takes a nomothetic approach. For example, the study by Bridge
et all used th profile of mood states and the Leeds general scale to obtain a numerical measure
of the participants’s stress and anxiety levels and used the reduction in the score as a measure
of efficacy of the intervention. Using a quantitative data allows to obtain an objective data that is
not corrupted by research bias and therefore increase the validity of the findings. In Bridge’s
study, therefore, it can be comfidentky concluded that the intervention led to a general decrease
in stree in women who were in the exerimetnal group and that these findings were purely
numerical and not based on researcher’s interpretation. The downside of using a nomothetic
approach is that it does nto contexualize findings or provide a detailed understanding of the
mechanism of a person’s behaviour and thoughts. For example, it cannot be known why the
techniques worked better for women aged 55 as compared to younger women and how did the
relaxation and imagery help women in alleviating stress. A more contexulaized approach witht
he use fo wualittative data would have helped in answering such questions to gain more insight
into how stress management techniques help.

A debate about individual and situational explanations can also be applied. Individual
explanations state that our behaviours are due to our unique traits and personalities while
situational explanations state that our scenarios and circumstances dictate our behaviours. The
stress management techniques take individual approach to stress management. Some
individuals respond better to relaxation techniques than others while others may prefer imagery
to be the best way to alleviate stress. Individual factors such as level of stress, the ability to
imagine in detail, the ability to regulate one’s breathing and the commitment to follow these
techniques on a regular basis determine the efficacy of these pain management methods in
decreasing stress. The advantage of individual explanatiosn is that it allows the treatment to be
personalized based on the individual factors. For example, a person suffering from autism may
not be asked to undergo detailed imagery to attain relief in stress but they may be shown
images of places that make them feel relaxed since it is difficult for individuals to imagine
scenarios in depth. However, the disadvantage is that it is difficult to generalize the efficacy of
treatment in one case to the other. That being said the situational factors cannot be overlooked.
A person’s financial capabilities may determine the extent to which they can visit professionals
to learn stress relieving techniques or their environment such as family dynamics, personal
space at home etc can determine the extent to which they can practise stress relieving
techniques.

A: An evaluation of psychometric tests can be applied here. Psychometrics tests are the
mathematical measure of the mind. They are self reports that make use of quantitative data to
obtain numerical scores for subjective feelings and behaviours such as pain, anxiety, depression
etc. The McGill Pain questionnaire and the visual analogue scales are both examples of
psychometric tests. The advantage of psychometric tests is that they provide quantitative data
on the individual’s pain. The data is objective and not susceptible to researcher/ doctor’s bias. It
allows for the pain ratings to be compared amongst other patients or participants in a study.
They are also useful for measuring treatment efficacy as the pain ratings before the treatment
and after the treatment can be compared using statistical tests. For example, the psychometric
tests were used to compare the childrens’s ratings of pain against the ratings given by the
doctor and the parents in Brudvik’s study. The downside of using psychometric tests, however,
is that they do not provide context behind the person’s pain or how it is affecting their life.
Detailed information about the individual’s pain cannot be obtained. Moreover, since
psychometric tests are self reports, a person may underreport their pain to not worry their family
or they may overreport it to get access to certain medications. The inaccurate ratings provided
by the patients can reduce the validity of the psychometric used.

An evaluation about cultural difference is also applicable to ways of measuring pain. The tests
such as McGill Questionnaire is designed in English which is not the native language of many
around the globe, making it inaccessible to a larger percentage of the population without
accruate translation which can be hard to do. It implies that McGill questionnaire may only
provide accurate measure of pain in Western English speaking countries only, which makes it
culturally limited. Moreover, the questionnaire included unique words such as lancinating and
flickering which may be hard to understand by an average English speakers as well. This leads
to inaccurate descriptions of pain if people do not undersatnd the meaning of the words
accurately. The questionnaire does not include a glossary for the unique words either further
reducing its validity.

There are many practical advantages and disadvantages of using psychometric tests to meaure
pain. For example, both the UAB and the visual pain analogue scale are quick and easy to use.
This saves the time both for the patient and the doctor and allows them to get to the treatment
options as soon as possible. This quick and time saving nature of these measures prevents the
worsening of pain over time, allowing for minimally invasive treatment options to be effective.
The downside to using pain measures such as UAB is that it is difficult to observe someone
else’s pain and then report it accurately. It is possible that the patient may be faking the pain or
under reporitng it and these nuances may be missed by the observer reporting the pain. The
UAB is also heavily reliant on the observer’s theory of mind and attention to detail when
reporting pain which may not be the finest in all the observers. It is also possible that the
observer may not be around when the patient demonstrates pain, making the UAB not the ideal
way to measure pain. The scores on the UAB and the McGill Questionnaire also did not
correlate, showing that there are difference in pain ratings when they are self reported vs when
someone else measures it, reducing the concurrent validity of UAB.

A: An evaluation of reductionism vs holism can be applied to the theories of pain. Reductionism

is when large complex ideas are broken down into simpler biological factors while holism
considers biological as well as psychological factors that influence thoughts and behaviors. The
specificity theory is reductionist. It considers pain to be a purely biological sensation. For
example, it states that pain is felt when receptors detect a change in stimulus and send the
nerve impulses to the pain center where the signal is processed. The advantage of reductionism
in the theory of pain is the development of appropriate treatment to control the biological
mechanisms that lead to pain. For example, opiates are used so that endorphins bind the
receptors and therefore the action potentials cannot be generated in the postsynaptic knob and
the impulse for pain can be blocked from traveling to the brain, resulting in a decrease in pain.
The disadvantage of reductionism is that it doesn't take into account a wide range of
non-biological factors that can cause the sensation of pain or determine the intensity with which
one experiences pain. A more holistic approach to explaining pain is the gate control theory. It
takes into consideration both the psychological as well as the biological factors that may cause
pain. For example, the gates can open if the activity in the small fibers is high (biological) but
they can also open due to the messages that brains send to the spinal cord for emotions such
as anxiety and boredom, which in turn increases the sensation of pain (psychological). The
benefit of the holistic approach is that not only medical treatments can reduce the intensity of
pain but also psychological interventions such as attention diversion can allow the sensation of
pain to be reduced. The disadvantage, however, is that too many factors can affect how much
pain a person feels and it becomes difficult to isolate a primary factor, making it difficult to
choose the most ideal course of intervention to manage pain.
A debate about individual and situational explanations can also be applied here. The individual
explanation states that our behaviors is governed by our unique traits and personality while the
situational explanations state that our behavior and thoughts are governed by our scenarios and
situations. The theories of pain side with the individual explanations of pain. It recognizes how
each experiences a different level of pain depending on the activation of the T cells or the
amount of stimulus detected by the receptors or the extent to which the gates open due to
activity in the small fibers. These are the individual biological factors that determine how much
pain one can feel, leading to different thresholds for pain for each person. The advantage of
individual explanations is that more personalized treatments can be achieved for people, based
on their pain threshold and intensity, leading to more treatment efficacy rather than providing a
same generic dosage and type of pain medication all the individuals. That being said, the
situational explanations cannot be avoided when explaining pain. The type of environment,
exposure to different types of weather, substances as well as exposure to emotionally damaging
situations can increase the intensity of the pain while exposure to positive feelings and
distractions may provide pain relief. The advantage of situational explanations is that apart from
medications and proper interventions, the removal of the situation can also be linked to a
decrease in pain, allowing the individual to be less reliant on external sources of pain relief and
seek ways to change their surroundings to manage their pain in a better way.

(I was about to write nature v/s nurture as the third explanation but the points are almost
the same as the my first paragraph which i always find to be the case whenever I am
writing about the reductionism debate and nature debate in the same question. How do i
clearly differentiate?

A: One strength of the health belief model is that it is holistic in nature. Holism is when a range
of different factors are taken into account to explain behaviours and throughts. The health belief
models is holistic in a way that it refers to many factors, from the perceived seriousness of the
illness to barriers that prevent people from accessing medication to cues to actions that may
encourage the individuals from adhering to medication. This holistic approach allows for a
thorough analysis to be made when it comes to determining factors that affect non adherence. It
covers a range of factors that may be applicable to an individual and there reasons for non
adherence.
One weakness of the health belief model is that it could be culturally biased. It assumes the
traditional practitioner and patient relationship where the doctor may try to address each factor
in the health belief model that affects the individual’s adherence. Different cultures have a
different practitioner-patient relationship and a theoretical framework like health belief model
may not be adequate to provide explanations for nonadherence
A: There are different ways of improving adherence from using prompts, contracts, and
customizing treatments to using child-appropriate medical interventions to improve adherence
amongst children.

Contracts can be verbal between the practitioner and the patient whereby the practitioner asks
the patient to follow the treatment and follow-ups diligently. The contracts are often not
law-abiding but if the patient continues to not adhere to the medication, the doctor has the right
to refuse treatment and appointment the next time the patient falls ill. Prompts are reminders
that allow individuals to remember to take their medication and immunizations on time. For
example, many applications can track the medication intake of a person and notify them when
it's time for the person to take their dosage for the day. Other examples of prompts include
emails and SMS reminders that remind individuals of their follow-up appointments or about any
blood work they may have to get done for a diagnosis to be made. Many pill dispensers also
come with alarms to remind the individual to take their medication at a specific time of the day.
The study by Yokley and Glenwich made use of different types of prompts such as general
prompts and specific prompts through emails to encourage parents to get their children
immunized. It was found that specific prompts that contained the child’s name, the nearest clinic
hours, and the number and type of immunizations needed, with the monetary incentive of a
cash prize through a raffle resulted in the highest amount of immunizations, indicating that
prompts are an effective way of improving adherence

Using child-appropriate interventions can also increase adherence among children. Chaney’s
study about the Funhaler is one example. The study aimed to investigate how the adherence
amongst children with asthma changes if the normal inhaler is replaced with the Funhaler, a
novel device that includes a spinning toy when it is used. The Funahler was administered by the
parents at home and in the same manner, a normal inhaler would be administered. It was found
that adherence to inhaler amongst children increased from 4% to 88% when using the Funhaler.
Children can be fussy when it comes to following treatment and usign child appropriate
measures that can be engaging for children can increase adherence amongst them.

(for part b i am a little confused, do i evaluate the study by Yokely and Glenwick or
Chaney or both?).