Abstract
Coping in the face of medical adversity is a critical advantage. This chapter illustrates the importance of adaptive coping and how physicians can help patients develop skills. This chapter, like the sample vignette in Chap. 1, uses graphics in the vignette text to help identify key facts for the project-based learning (PBL) process. While this chapter does not cover all of the psychiatric illnesses that may occur following the diagnosis of a medical illness (as these are covered in the specific chapters), it highlights both healthy and potentially unhealthy behaviors.
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Appendices
Appendix A: Tables with Possible Answers to the Vignettes
Case Vignette 6.1: Paul Davis
Learning Issue Table 6.1
Facts | Hypotheses | Information needed | Learning issues |
|---|---|---|---|
Age 75 | 1. He relies on his wife for significant support | History of Present Illness (HPI) | 1. How are adaptation and coping defined? |
Male | Medication? | ||
Married | 2. He is facing and considering end-of-life questions and issues | Sleep? Appetite? Hopelessness? Fear? | 2. What are the major neurobiological and psychosocial correlates of adaptation and coping? |
Cognitive difficulties | |||
Receiving cognitive testing | Post Medical History (PMH) | ||
Claims to be comfortable with end-of-life issues | 3. His silence and stoic disposition may be a sign of underlying difficulties in adapting to and coping with his cognitive deficits | Has he had any previous medical or psychiatric diagnoses, including substance abuse? | 3. How do social support, spirituality, and cultural variables affect adaptation and coping? |
Stoic disposition | Family History (FH) | ||
Considers wife to be a source of support | |||
Any history of psychiatric illness? | 4. What are interventions for coping deficits? | ||
Silent | 4. His silence and stoic disposition may be related to an underlying medical/neurological or psychiatric condition (e.g., major depression, dementia, etc.) | Social History SH | |
Social support besides wife? | |||
Exam | |||
Physical exam? Vital signs? | |||
5. Cognitive deficits, in particular, may be particularly difficult for him to accept because of stigma |
Appendix B: Answers to Review Questions
Answers
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1.
D
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2.
C
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3.
E
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4.
B
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Stewart, MC., Linke, L. (2016). Adaptation and Coping in a Medical Setting. In: Alicata, D., Jacobs, N., Guerrero, A., Piasecki, M. (eds) Problem-based Behavioral Science and Psychiatry. Springer, Cham. https://doi.org/10.1007/978-3-319-23669-8_6
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