BEHAVIOURAL SCIENCE .

01
 Introduction to Behavioural Science
 Learning Theories
 Psychoanalytic Theory Of The Mind
 Introduction To Ego Defenses: Transference &
Countertransference
 Behavioural Health
• Includes behaviors that impact on health and can
effect physical, emotional and cognitive illness
• Mental illness is a component of Behavioral
medicine as behavior disorders can cause or
contribute to mental illness.
• Lack of exercise, use of drugs are examples of
behavioral issues causing a mental health
problem
 Learning Objectives
• To understand what learning is and the methods
of learning
• To understand the clinical importance of learning
theories
• To understand the structure of the mind and its
clinical significance pathologically.
• To be able to differentiate between transference
and countertransference as an introduction to the
next class.
 Behavioural Science
Involves the study of:
 Underlying psychological processes
 Cognitions
 Emotions
 Actions and impulses
 Personality
Importance of this course
• Clinical practice
• Licensing exams

• For Communication • Tests the

STEP 2
STEP 1

STEP 3
• Clinical based and Interpersonal application of
Skills (CIS) clinical
vignettes for
• Standardized
demonstrating knowledge to
Patients rates the
knowledge of the making the
candidates on:
impact of “fostering the diagnosis and for
behavior, psycho- relationship, demonstrating
social factors on gathering best
an individual for information, management
the causation of an providing practices and the
illness or adversely information, helping application of
affecting the the patient make
course, treatment decisions, and behavioral
and outcome of an supporting techniques for
illness emotions.” improving
outcomes.
 Importance of Behavioural
Methods to patient care

 A survey of hospital patients indicated that 39%

listed doctor communication skills as a top concern
(vs. 7 % for pain management)

 Poor communication can lead to medical errors

LEARNING THEORIES
What is learning and How do we learn?
• Learning
– acquiring new behaviour patterns

• Learning methods
1. Habituation
2. Sensitisation
3. Classical conditioning
4. Operant conditioning
5. Modeling
 Methods of Learning.

REPEATED STIMULATION

Decreased Response
Increased Response

SENSITISATION DESENSITISATION
(HABITUATION)
CLASS ACTIVITY

?
?
 CLASSICAL CONDITIONING
• Also known as associative learning
• Learning in which a natural/reflexive/involuntary
response is elicited by a learned stimulus that was
previously presented with an unconditioned
stimulus.
• 4 elements of classical conditioning;
– An unconditioned stimulus
– An unconditioned response
– A conditioned stimulus
– A conditioned response aka Pavlovian response
https://youtu.be/hhqumfpxuzI
Certain phenomena that occur/ can occur
in associative learning.
1. Response acquisition
• The conditioned response is learned
2. Response extinction
• The conditioned response decreases if the conditioned
stimulus is never again paired with the unconditioned
stimulus
3. Stimulus Generalisation
• A new stimulus similar to the conditioned stimulus elicits
a conditioned response
 Aversive conditioning
1. An unwanted behaviour is paired with an aversive or
painful stimulus
2. An association is created between the unwanted
behaviour and painful stimulus
3. The unwanted behaviour ceases
 Learned helplessness
1. An organism receives a series of painful stimuli from
which it is unable to escape
2. By classic conditioning, the organism associates the
painful stimuli with the inability to escape
3. Subsequently, the organism does not try to escape
when faced with the painful stimulus or any other
aversive stimulus
4. The organism thus becomes hopeless and apathetic.

Clinical significance: a model for hopelessness and

helplessness in depression
 OPERANT CONDITIONING
• Learning in which a behaviour is affected (increased/
reduced) by the punishment or reward it elicits.
• This usually involves voluntary responses
• In this model of learning, the likelihood that a behaviour
will occur is increased by positive or negative
reinforcement and decreased by punishment or
extinction.
• Behaviour is determined by its consequences for the
individual.
REINFORCEMENT TARGET
BEHAVIOUR

ADDING A POSITIVE STIMULUS

= Positive Reinforcement

REMOVING AN ADVERSE STIMULUS

= Negative Reinforcement

PUNISHMENT TARGET
BEHAVIOUR

ADDING AN ADVERSE STIMULUS

= Positive Punishment

REMOVING A DESIRED REWARD

= Negative Punishment
SKINNER OPERANT CONDITIONING QUADRANT
Increase behaviour Decrease behaviour

Positive Positive
Reinforcement Punishment
stimulus
Add a

Negative Negative
Remove a
stimulus

Reinforcement Punishment
 EXTINCTION IN OPERANT CONDITIONING

 Extinction is the gradual disappearance of a learned

behaviour when reinforcement is withheld.

 How quickly a behaviour is learned and how quickly it

becomes extinct when not rewarded will depend on the
pattern and schedule of reinforcement.

 The resistance to extinction is the force that prevents the

behaviour from disappearing after a reward is withheld .
Schedules of Reinforcement
SCHEDULE REINFORCEMENT
Continuous Presented after every response

Fixed Ratio Presented after a designated number of

responses
Presented after a designated amount of time
Fixed interval
Variable Ratio Presented after a random and unpredictable
number of responses
Variable interval Presented after a random and unpredictable
amount of time.
 Shaping
rewarding closer and closer approximations of the wanted
behavior until the correct behavior is achieved

 Modeling
Modeling is a type of observational learning
PSYCHOANALYTIC THEORY OF THE
MIND
 The Psychoanalytic Theory
• This is based on Freud’s concept that behavior is determined
by forces derived from unconscious mental processes.
• This theory forms the basis of psychoanalysis and its related
therapies.
• Sigmund Freud developed the topographic theory of the mind
as well as the structural theory of the mind.
 Freud’s theory of the mind
A. The Topographic theory of the mind:
In the topographic theory, the mind has 3 levels
– The unconscious mind
• Holds repressed feelings and thoughts
• Uses primary process thinking.
– The preconscious mind
• Holds memories that are not immediately availble but can be
accessed easily
– The conscious mind
• Holds thoughts that are immediately available
• The person is aware of these thoughts
• Uses secondary process thinking
 Freud’s theory of the mind
A. The Structural theory of the mind: In the structural
theory, the mind has 3 parts
– The Id
– The Ego
– The Superego
 Id, ego and superego
Structural Topographic level of Age of Characteristics
component operation development

Id Unconscious Birth • Contains instinctive drives

(Eros and Thanatos)
• Controlled by primary
process thinking – impulsive
• Not influenced by external
reality
• Pleasure principle
Ego Unconscious, Development • Decision making component
Preconscious, begins of personality
Conscious immediately • Reality principle
after birth - Controls the expression of
the id to adapt to reality,
primarily through defense
mechanisms
 Id, ego and superego
Structural Topographic level of Age of Characteristics
component operation development

Ego Unconscious, Development • Enables one to maintain a

Preconscious, begins sense of reality about the
Conscious immediately body and external world
after birth • Enables one to sustain
satisfying interpersonal
relationships through reality
testing.

Superego Unconscious, Around 6 years • Moral values and

Preconscious, of age conscience
Conscious • Controls the expression of
the id.
The ego is 'like a man on horseback, who has to
hold in check the superior strength of the horse.'
(Freud, 1923, p. 15)
 TRANSFERENCE vs
COUNTERTRANSFERENCE

These are unconscious mental attitudes based on important

past personal relationships that can alter judgement and
behaviour in the doctor-patient relationship.
• Transference –
When a patient projects feelings about formative or other
important persons unto the physician

• Countertransference –
When the physician projects feelings about formative or other
important persons unto the patient
 Sample Question
• You are seeing a 53 year old male patient who has been
diagnosed with bipolar disorder and diabetes. At his clinic
visits, the daughter relays that during his manic episodes, he
doesn’t sleep, talks a mile a minute, eats any food he likes
and goes on shopping sprees online. This kind of thinking is
seen in?
A. Adults
B. Young children
C. Psychotic adults
D. Throughout life
E. B & C
F. All except C
 Sample Question
• A 44 year old man has undergone three sessions of
chemotherapy in a hospital. Each session has resulted in
nausea. Before the fourth session, the patient becomes
nauseated when he enters the hospital lobby. The patient’s
reaction is a result of the type of learning best described as;
A. Punishment
B. Negative reinforcement
C. Positive reinforcement
D. Classical conditioning
E. Shaping
F. Sensitisation
 Sample Question
• A 16-year-old steals from family members and
friends at school. When no one is watching, he
also tortures the family cat. Which aspect of the
mind is deficient in this teenager?
A. The unconscious mind
B. The preconscious mind
C. The conscious mind
D. The superego
E. The ego
 Sample Question
• Which of the following structures of the mind
is (are) at least partly developed in a typical 4-
year-old child?
A. The id only
B. The id and the ego only
C. The id, ego, and superego
D. The ego and superego only
E. Not the id, ego, or superego
 Sample Question
A mother scolds her daughter when she hits the
dog. The child stops hitting the dog. This change
in the daughter’s behaviour is most likely due to:
A. Punishment
B. Negative reinforcement
C. Positive reinforcement
D. Extinction
E. Shaping
F. Habituation.
 Sample Question
In the past, a child has received money for cleaning his
room. Despite the fact that he has not received money
for cleaning his room for the past 3 weeks, he continues
to keep his room clean. This child’s room-cleaning
behaviour was probably learned using which of the
following methods?
A. Continuous reinforcement
B. Fixed ratio reinforcement
C. Fixed interval reinforcement
D. Variable ratio reinforcement
E. Punishment
 REFERENCES.
• Freud, S. (1920). Beyond the pleasure principle. SE, 18: 1-64.
• Freud, S. (1923). The ego and the id. SE, 19: 1-66
• Tao, L. , Vikas, B. (2021). FIRST AID FOR THE USMLE STEP 1, 2021: 575-576.
• Kaplan (2018). Behavioural Science & Social Sciences, 4:61-66, 5:67-72
• Fadem, B (2017). BRS, Behavioural science, 6: 57-61, 7: 65-68
• McLeod, S. A. (2018, October 08). Pavlov's dogs. Simply Psychology.
https://www.simplypsychology.org/pavlov.html
• McLeod, S. A. (2019, September 25). Id, ego and superego. Simply Psychology.
https://www.simplypsychology.org/psyche.html
• All images from Google Images