Psychology: Behaviour and Visual Impairment

Psychology: Behaviour and Visual Impairment

Topic 03

• Evaluate psychological factors impact on patient
• behavior in responding to visual impairment and eye
• care recommendationsTOPIC CONTENT
• Explain what is illness behavior and does is affect individual
• Explain the fields of psychology (Abnormal Psychology, Cognitive Psychology, Clinical psychology counselling

psychology Environmental Psychology, Educational Psychology, Health Psychology, Organizational Psychology

Developmental Psychology)

• Explain factors influencing the use of visual impairment tools for different clients (age, gender, occupation, education

health-related factors, disease and poor physical and mental health, quality of service culture religion)

• Explain physiological consequences of stress
• Explain the different types of psychological reinforcement
• Explain the Accident prone personality concept (aggressive hostile, or overactive carelessness, non-orderly)
• Explain the concept of Leaned helplessness and how it attributes to a particular outcomeIllness behavior and does is affect
• individual
• Illness behavior refers to the various ways individuals
• perceive, interpret, and act upon bodily symptoms or
• sensations. It covers the entire process of how a person
• monitors their body, defines a symptom as abnormal, takes
• action (e.g., self-care or seeking professional help), and

follows treatment recommendations.Cont…

• Minimization of Symptoms: Patients may rationalize symptoms like blurry vision or eye fatigue

as temporary, age-related, or simply "tired eyes," leading them to avoid or delay an eye exam.

• Fear and Avoidance: Anxiety surrounding potential eye disease (e.g., fear of being told they are

losing their sight) can lead to avoidance of routine care.

• Lack of Knowledge: A lack of understanding regarding the asymptomatic nature of many eye

diseases, such as glaucoma, means patients may not seek care until permanent vision loss has already occurred.

• Low Perceived Severity: Patients who do not feel their eye condition is serious, or who perceive

little threat to their quality of life, may fail to use drops, attend follow-up appointments, or fill prescriptions.Cont…

• "Drop-Out" Behavior: Patients with chronic, slow-progressing diseases may stop coming to the

optometrist once they feel their condition is stable or if they become disheartened by the lack of immediate improvement.

• Under-Reporting of Symptoms: A patient’s, particularly a child's, tendency to believe their vision

is "normal" (even if it is not) means they may not report symptoms, making diagnosis difficult.

• Emotional Responses: Fear or anxiety during the examination can lead to poor cooperation during

critical, high-stress tests like tonometry (eye pressure check).

• Perception of Pain: Patients with higher psychological stress or depression may have a lower

threshold for physical discomfort, reporting more severe dry eye or pain symptoms, which can complicate the diagnosis. .fields of psychology

• Psychology is a diverse field exploring human behavior and mental
• processes through specialized subfields. Key areas include Clinical

and Counseling Psychology for mental health treatment, Cognitive Psychology for thought processes, Developmental Psychology for lifespan growth, and Industrial-Organizational Psychology for workplace behavior. Other fields include Abnormal, Educational, Environmental, and Health PsychologyCont…

• Abnormal psychology is the scientific study of atypical thoughts, emotions,
• and behaviors to describe, predict, explain, and treat mental disorders. This
• field merges clinical, biological, and psychological perspectives to
• understand conditions like anxiety, depression, and personality disorders.
• Cognitive Psychology Focuses on how patients perceive, process,
• and remember visual information, aiding in the diagnosis of visual
• processing disorders and understanding visual attention.Cont…
• Clinical Psychology Relevant when visual impairment causes severe psychological
• distress, requiring collaboration for mental health support, or managing patient anxiety
• regarding diagnosis.
• Counselling Psychology Facilitates patient adaptation to low vision or permanent vision
• loss, helping them cope with lifestyle changes.
• Environmental Psychology: Examines how lighting, workspace design, and visual
• clutter affect vision, aiding optometrists in recommending ergonomic changes to improve
• visual comfort.
• Educational Psychology: Crucial for identifying how vision issues, such as convergence
• insufficiency, affect learning, reading, and school performance in children.Cont…
• Health Psychology Focuses on promoting behaviors that maintain eye health (e.g.,
• smoking cessation for macular degeneration) and helping patients adhere to treatment
• regimens for chronic conditions like glaucoma.
• Organizational Psychology Applies to managing the optometry practice, improving
• patient experience, and optimizing staff performance and workflow in clinics.
• Developmental Psychology Informs understanding of how visual function matures from

infancy through old age, enabling age-appropriate testing and care (e.g., pediatric vision tracking or geriatric cataracts).Factors influencing the use of visual impairment tools for different clients

• The use of visual impairment tools ranging from low-tech magnifiers
• to high-tech is influenced by a complex interplay of individual, social,
• and technical factors. Key drivers include the perceived usefulness and
• ease of use, as well as the user's emotional state, age, and level of
• social support. Despite the benefits, abandonment of these tools is high
• (30–75%), often due to poor training or stigma.Cont….

1. Age

• Older Adults (60+): Generally, have lower adoption rates for high-tech tools due to "low

necessity" (using vision loss as part of aging), difficulty with complex devices, and denial of the severity of their condition. However, they benefit greatly from simple, high-contrast, low-tech, and magnification devices, as well as better lighting.

• Children and Teenagers: Acceptance is generally higher if introduced early, but teenagers may

reject tools due to social stigma and the desire not to look different.

• Young/Middle-Aged Adults: Often prioritize tools that help maintain employment and high-tech,
• portable solutions.Cont….
• 2. Gender
• Prevalence and Access: Women are more likely to experience vision impairment and,

consequently, are higher users of services, but they may face more barriers, such as limited access to money and technology, particularly in lower-income settings.

• Adoption Rates: Studies have shown that while both genders use computers/screen readers,

females may feel less inclined to use smartphones or other devices due to social stigma or perceived difficulties in usage.

• Technology Preferences: Males may show a higher preference for, or better performance with,
• high-tech assistive technology.Cont…
• 3. Occupation
• Job Requirements: Professionals requiring high visual accuracy (e.g.,
• computer, reading) are more likely to use, and require, sophisticated aids
• (e.g., CCTV, screen reading software).
• Fear of Loss: Fear of losing employment can be a driver for adopting tools
• to improve efficiency, but it can also be a barrier if the user feels
• stigmatized at work.Cont…
• 4. Education
• Digital Literacy: Higher education levels are generally associated with
• better adoption and mastery of complex, high-tech assistive
• technologies.
• Awareness: Education enables users to be more aware of available
• services and tools. Conversely, low education and literacy rates are
• linked to lower utilization and poorer quality of life.CONT…

5. Health-Related Factors (Diseases, Physical/Mental Health)

• Disease Type: Conditions causing central vision loss (e.g., macular degeneration) are more

compatible with magnifiers, resulting in higher acceptance rates. Conversely, diseases affecting field vision (e.g., retinitis pigmentosa, glaucoma) often have lower adoption rates for traditional magnifiers.

• Mental Health: Depression and anxiety are common among those with visual impairment and

significantly lower the likelihood of using or persevering with new tools.

• Physical Health: Comorbidities like arthritis (limiting manual dexterity to hold magnifiers) or

cognitive decline (memory issues for learning new devices) can cause tool abandonment.CONT…..

• 6. Quality of Service
• Training and Follow-up: A crucial factor is consistent training on the device.
• Without training, tools are quickly abandoned.
• Availability/Affordability: Lack of access to low-vision clinics and high costs of
• specialized devices are primary barriers to adoption.
• Professional Competence: The expertise of the staff in fitting the correct, tailored
• tool is vital, as a wrong or poor-quality, unsuitable device leads to poor usage.CONT….
• 7. Culture and Religion
• Stigma: In many cultures, using visible aids like white canes or magnifiers carries
• a social stigma, leading to lower usage, particularly among young people.
• Social Support: Cultural and family support systems can either encourage or
• discourage the use of tools, with supportive environments improving adaptation.
• Beliefs: Specific cultural or religious beliefs regarding destiny or health might

sometimes hinder proactive, technological interventions.Explain physiological consequences of stress

• Stress has a significant impact on ocular health, acting as both a cause
• and consequence of visual dysfunction, often creating a "vicious
• cycle" of worsening symptoms. The physiological response to stress
• characterized by sympathetic nervous system activation, adrenaline

release, and elevated cortisol directly affects ocular tissues, leading to a range of symptoms from discomfort to permanent vision loss.physiological consequences of stress

• Dry Eye Syndrome: Chronic stress can disrupt the tear production balance, causing dry, irritated,
• or watery eyes. It often exacerbates symptoms in contact lens wearers, leading to reduced
• wearing time.
• Eye Strain and Fatigue (Asthenopia): Constant, prolonged near work (digital device use)

combined with stress causes excessive tension in the accommodative system (focusing muscles), leading to eye strain, fatigue, and headaches.

• Eyelid Myokymia (Twitching): Involuntary, fine muscle spasms of the eyelid (often the lower lid)

are frequently caused by fatigue and stress.

• Light Sensitivity (Photophobia): intolerance to light, causing eye discomfort, pain, squinting, and

watery eyes in response to sunlight or artificial lighting. It is a symptom of underlying conditions like migraines, dry eye, or corneal abrasions, rather than a disease itself.CONT…..

• Central Serous Chorioretinopathy (CSCR): High-stress levels are strongly associated with CSCR,

where fluid accumulates under the retina, resulting in distorted or blurry vision.

• Glaucoma: Stress can cause a rise in blood pressure and vascular dysfunction, which may increase

intraocular pressure (IOP) and accelerate vision loss in glaucoma patients.

• Age-Related Macular Degeneration (AMD): progressive eye disease and leading cause of vision loss

in people over 50, damaging the macula to blur central vision. It rarely causes total blindness but makes reading and facial recognition difficult. Main risk factors include age, smoking, genetics, and obesity.CONT…..

• Myopia Progression: Inability to cope with near-point stress can lead to functional changes in the

visual system that may contribute to the development or worsening of myopia.

• Visual Field Loss: reduction or loss of vision in specific areas (peripheral or central) often

resulting from damage to the eye, optic nerve, or brain due to conditions like glaucoma, stroke, retinal detachment, or tumors.

• Blurred and Distorted Vision: Chronic stress triggers adrenaline, which can raise
• pressure within the eyes, causing blurriness and potentially aggravating conditions like
• glaucoma.Explain the different types of psychological
• reinforcement
• Positive Reinforcement: is the addition of a positive outcome to
• strengthen behavior. Adds a positive or rewarding stimulus immediately
• following a behavior to increase the likelihood of that behavior being
• repeated (e.g., praising a child for cleaning their room).
• Primary Reinforcement: Involves natural or innate reinforcers that do not
• require learning, such as food, water, or shelter.Cont…
• Negative Reinforcement: is the removal of a negative outcome to
• strengthen a behavior. Removes or avoids an unpleasant or aversive
• stimulus to increase a behavior Unlike punishment, which decreases
• behavior, this technique strengthens desired actions by eliminating
• annoyance, such as turning off a buzzing alarm to stop the
• noise. (e.g., buzzing alarm clock when you get out of bed waking up,

or skipping a final exam for good attendance).CONT…

• Secondary (Conditioned) Reinforcement: Involves stimuli that have become rewarding through
• association with primary reinforcers, such as money, tokens, or praise.
• Continuous Reinforcement: Reinforcing the desired behavior every single time it occurs.
• Partial (Intermittent) Reinforcement: Reinforcing a behavior only part of the time, which can

include fixed-ratio, variable-ratio, fixed-interval, or variable-interval schedules, leading to more durable behavior changes.Explain the Accident prone personality concept (aggressive hostile, or overactive carelessness, non-orderly) Accident-prone personality refers to the theory that certain individuals have a higher, consistent susceptibility to accidents due to stable psychological traits rather than random chance.

• Traits often linked to this phenomenon include high impulsivity,
• risk-taking, sensation-seeking, and low conscientiousness. It
• implies a predisposition to accidents, such as in traffic or
• workplaces.Explain the Accident prone personality concept (aggressive
• hostile, or overactive carelessness, non-orderly)
• Aggressive/Hostile Behavior: intentional, harmful actions or attitudes
• designed to cause physical, verbal, or social distress to others. It is
• characterized by anger, lack of empathy, and a desire to dominate or
• control, often manifesting as violence, bullying, intimidation, or intense
• emotional outbursts. Individuals with this trait often display high levels of
• frustration, irritability, and resentment toward authority or rules. Eg of
• aggressive behavior shouting, swearing, harsh language, acts of physical
• violence etc.Cont….
• Overactive Carelessness: This involves a tendency to
• act immediately on impulses without considering
• consequences, planning, or safety precautions. It is
• characterized by rushing through tasks, taking
• unnecessary risks, and having a "thrill-seeking"
• attitude.Cont…
• Non-Orderly: individuals often show a lack of organization,
• structure, or proper arrangement, often implying chaos,
• messiness, or a haphazard approach. They may disregard

safety protocols, have poor attention to detail, or be easily distracted, leading to a failure to notice hazards.Explain the concept of Leaned helplessness and how it attributes to a particular outcome

• Learned helplessness is a psychological state in which an individual,
• after repeated exposure to uncontrollable negative events, believes
• they are powerless to change their situation, even when
• opportunities to do so arise.
• Learned helplessness theory is the view that clinical depression and
• related mental illnesses may result from a real or perceived absence
• of control over the outcome of a situation.CONT….
• Motivational Deficit (Giving Up): The primary outcome is a lack of
• motivation to initiate response. Because the individual believes their efforts
• are useless, they do not attempt to solve problems, even when solutions
• are available.
• Cognitive Deficit (Impaired Learning): The individual fails to learn from
• new situations. Even if a new opportunity to change things arises, the
• person may not recognize it or act on it because their mental model
• remains that "nothing I do matters".CONT….
• Emotional Deficit (Depression/Anxiety): The feeling of hopelessness
• often leads to apathy, anxiety, and in severe cases, clinical depression.
• Attributional Style (Negative Interpretation): How an individual explains
• these failures determines the severity of the outcome. People are more
• likely to fall into deep helplessness if they attribute negative events to
• causes that are Internal ("I am stupid"), Stable ("This will never change"),
• and Global ("Everything is ruined").Cont….
• Academic failure (schooling)
• A student who struggles with math may conclude they are bad at it
• even when they have the ability to improve through tutoring they may
• stop trying, leading to continued low grades.
• Health neglect & chronic illness
• Individual with chronic illnesses may feel there is no point in managing
• their condition, causing them to neglect medication or lifestyle
• changes.Cont….
• Generational poverty
• A sense that escape is impossible can lead individuals to live in the
• moment rather than planning for the future a pattern that can be
• passed down to children.
• Abusive or unhealthy relationship
• Victims of abuse may believe they cannot escape or that leaving will
• not improve their lives, leading to a trapped state where they continue

to endure harm.END OF TOPIC ONE