Blueprint Diagnostic Psych/Soc Passage 1

Session 284

Jason and I go through passage 1 from the Psych/Soc section of the Blueprint diagnostic exam and how it differs from other sections. Don’t forget to get it free at Blueprint MCAT. If you would like to follow along on YouTube, go to premed.tv.

Listen to this podcast episode with the player above, or keep reading for the highlights and takeaway points.

[02:53] How to Use Your Breaks Wisely

Jason suggests avoiding leaving the test room since you would have to sign in and sign out. You’d have to go through all the procedures of getting back into the room, and that can take time.

While in the room, take a moment to do some stretches. Stretch your neck, your back, and your legs. Close your eyes and use that time for a mental reset so you can be ready for the next section.

And so, take the entire time as well. Don’t just click Next even if you think you’re ready. Take those 10-minute breaks in between Chem/Phys and CARS, and another one in between Bio/Biochem and Psych/Soc.

[04:27] Tips for Prepping for the Psych/Soc Section

When you’re studying for MCAT Psych/Soc, don’t just study and memorize the definition. Take each of those terms and think about how it applies to something you already know or your own life.

The self-reference effect is even better because it’s going to help you remember stuff a lot more readily.

Overall, psychology is just a way of describing the behaviors that we have normally. You don’t need to necessarily take a microscope and discover something that we didn’t know was there previously. We’re assigning vocabulary words and understanding the behaviors that people exhibit already.

'When you're studying for Psych/Soc, think about how these vocabulary words relate to behaviors that you've seen in yourself and other people.'Click To Tweet

[07:27] Passage 1 (Questions 1 – 6)

Paragraph 1

In poor urban settlements in Bangladesh, the Manoshi program provides community health workers (CHWs) to support women through pregnancy, delivery, and postpartum periods. Recent evidence suggests that individuals with diversified social networks live longer and healthier lives than those who are less socially embedded and involved.

Notes:

Related to that psych/soc term, they tell us “recent evidence suggests” about diversified social networks. So it has some cause and effect. There’s a correlation between social networks and living longer and healthier.

[11:07] Paragraph 2

Researchers looking to test this hypothesis wished to determine if the introduction of CHWs into the social networks of Manoshi members mediates changes in maternal and neonatal health best practices (MNH). Two thousand women who had given birth in the last six months were interviewed. A social networks questionnaire was administered which elicited women’s perceived networks around pregnancy, delivery, and postpartum periods.

Notes:

It says we’re going to take these community health workers, integrate them into social networks and see if they have the effect that we saw from the recent evidence that the “researchers” writing this passage are citing.

Whenever we get the kind of study that’s being done, we want to take a moment just to digest that. So we’ve got a questionnaire. What they’re looking to do is correlate the responses on this questionnaire to whatever intervention they’re doing. In this case, it’s the introduction of CHWs. And we’re going to analyze those results.

[13:50] Paragraph 3

The social networks questionnaire sought information across three sections. Survey 1 asked about perceived availability of economic and emotional support by asking the respondent to identify those supports she considers “important.” Survey 2 focused on networks of support associated with pregnancy, labor and delivery, and the postpartum period. After having recorded the name of each respondent, details were elicited about their age, residence, and the frequency and nature of support provided. Finally, survey 3 requested information about the delivery itself: where it occurred, why and whether it was attended by a medically trained provider.

Notes:

The next paragraph does start to give us some more details about exactly what this questionnaire is asking.

Surveys 1 and 2 are more about perception like how this feels, rather than being about something that is a little more concrete. Survey 3 refers to all the things that we will be compared to those feelings.

[15:05] Table 1

Table 1 Type of support considered important by respondents in survey 1

Notes:

If you don’t know what instrumental support means, and looking at the table, where it’s highest in the postpartum period, what most parents need at this time would be sleep. So wouldn’t it be nice to have somebody else come and take care of the baby for an hour? It would be nice for somebody to come in, and bring you some food every once in a while. It would be nice for somebody to run a vacuum cleaner once in the six months that you’re spending all of your time trying to keep this tiny human alive. So instrumental support is about the day-to-day tasks that you don’t have time for because you are caring for the baby.

When looking at the table, take 10-15 seconds to look at the big numbers and what’s most important when.

[18:30] Paragraph 4

Analysis was performed to test the hypothesis that penetration of the Manoshi program into women’s perceived networks has an effect on MNH best practices. These practices include the use of a trained birth attendant, use of postnatal care, and the use of colostrum, a rich source of immunoglobulin A that is important for the survival of newborns. Results of this study are shown in Table 2.

Table 2 Results of the survey on maternal and neonatal health best practices

Notes:

It looks like we’re just measuring a whole bunch of stuff. And Table 2 is an absolute beast with eight different lines of information and five different columns.

At the very bottom, we get the regression results. It can be a little tough to interpret those results. The ORs are correlations. If a table or a figure is confusing, let it go. Go to the questions and if a question cares, they often will point you in the right direction. At the very least, it’s a multiple choice so the answer choices will tell you what you care about.

But if you spot the result of the regression, these are our values. Greater than 1 is a strong correlation and between 1 and -1 is a very weak correlation or no correlation at all. Less than -1 is a strong inverse relationship. So as one goes up, the other goes down.

Looking at these numbers, the trained birth attendant made a huge difference. Postnatal care received is mildly correlated. And the colostrum seems to not have any correlation whatsoever.

Ultimately, when analyzing studies, think about the study done, the variables, the information, and the major trends you can get from the results. See if there’s a conclusion that can be made from the results. Also, try to see if the researchers gave out their conclusion.

[23:04] Question 1

Which of the following are dependent variables examined in the study?

Trained birth attendant use
Maternal education

III. Use of postnatal care

A.I only

B.II and III only

C.I and III only

D.I, II, and III

Thought Process:

The independent variable is the thing that we are manipulating in this study. On the contrary, the dependent variables are the things that we are measuring.

Within each one, we’ve got the surveys where the answers to the questions and the percentages that we get are the things that we’re measuring.

We’ve got a whole bunch of stuff on like appraisal of support, how much was this support important to you? And then based on whether they use the trained professionals or not, we have the number of affirmative responses.

Then in the second table, the things we measured are trained birth support, postnatal care, and colostrum. So here, the independent variable would then be social networks.

And the only thing we didn’t measure here is II. Maternal support, which refers to the educational level of the mom.

Correct Answer: C

[30:05] Question 2

As one step in the statistical analysis of the effectiveness of CHW intervention, researchers calculated the average percentage of postnatal care use found in 10 randomly selected groups of 50 mothers. How could the researchers have increased the power of their analysis?

A.Examine 15 randomly selected groups of subjects.

B.Increase the length of questions on the survey used in the analysis.

C.Select groups comprised of CHW using mothers only.

D.Increase their rate of random error.

Thought Process:

(A) is the only answer choice that actually makes any sense in terms of what you would want to do with your study. The more people that you’re looking at, the better your study is.

Jason says that by and large, the MCAT has difficult questions with perhaps subtle differences between answer choices. There are no really tricky questions.

'There aren't really any gotcha questions on the MCAT so we're not expecting to get tricked or trapped.'Click To Tweet

If an answer choice looks really good, and the three answer choices look really bad, select the answer choice that looks really good. Don’t try to think you’re being tricked.

Correct Answer: A

[33:54] Question 3

It is found that respondents who were Manoshi members and who listed Manoshi CHWs as part of their support networks were significantly more likely to exhibit optimal MNH behavior. The CHW presence is an example of:

A.a confounding variable.

B.a mediating variable.

C.a moderating variable.

D.an independent variable.

Thought Process:

A confounding variable is an additional variable that is often not taken into account during analysis.

Whether or not they’re in this program is the independent variable in the study. This means that this community health worker support is something that comes in between the independent variable and the things that we’re measuring, the dependent variables. Hence, B is the correct answer.

A mediating variable is something that is between the thing that we’re manipulating and the thing that we’re studying. And there is still a correlational relationship between the first thing and the last thing, but it’s because of the stuff in the middle.

In this question, it is said that the presence of a CHW in the social network of those who are already Manoshi members was linked to improved MNH behavior. This implies that the presence of the CHW worker could be what facilitates the effects of Manoshi membership, making CHW presence a mediating variable.

Mediating Variable vs. Confounding Variable

The issue is that the part of the study that talked about whether or not mothers were exhibiting optimal MNH behavior is in Table 2. All of those things are the MNH outcomes. And in that table, the only thing that we’re looking at between the two groups is whether or not they were members of the Manoshi program.

That’s what makes this a mediating variable rather than a confounding variable because the Manoshi program is like a chain of causality. If it was CHWs causing the results that we saw, and not the Manoshi program, then that would be a confounding variable.

A mediating variable is a result of the thing that you are studying, which is a link in the chain that provides the outcome that you’re seeing in your dependent variables.

Correct Answer: B

[47:34] Question 4

After the newborn is brought home, a father agrees to change at least 2 diapers a day. What kind of support is the father providing?

A.Companionship support

B.Emotional support

C.Instrumental support

D.Informational support

Thought Process:

Instrumental support here as explained from our notes above. But even if we didn’t know that there are some signs that B and D don’t make any sense. And we’re not even sure if companionship support is a thing. So anytime you see vocabulary on psych/soc when you’ve never heard that phrase before, don’t select it.

Correct Answer: C

[48:57] Question 5

The tendency of a new mother to actively join networks almost exclusively with other young mothers is an example of:

A.implicit bias.

B.confirmation bias.

C.heterophily.

D.homophily.

Thought Process:

Implicit bias refers to the judgments and attitudes that we have towards something that is not in our conscious awareness. Homophily is when people seek people who are similar to them. Heterophily is the opposite.

As you’re reviewing questions or practice tests, if you get a question wrong. Don’t look at the explanation. Go and look up the information. Go look up the definitions. And if looking up the definitions allows you to go from a wrong answer to a right answer, then the problem is the content.

If looking up the information, you still get a wrong answer, then it’s not the content. It’s the reasoning behind what was going on that was the problem.

Correct Answer: D

[55:55] Question 6

All of the following are likely to play a role in postpartum depression EXCEPT:

A.decreased levels of serotonin.

B.decreased levels of norepinephrine.

C.decreased levels of γ-aminobutyric acid (GABA).

D.decreased levels of dopamine.

Thought Process:

This is where we get like the bio/biochem portion of the psychosocial where we’re doing the nervous system. But notice how it’s explicitly tied to behavior.

If we see neurotransmitters in bio/biochem, usually we’re talking very specifically about synapses, action potentials, and all the physiology of how that stuff works. Here, we’re looking at the behavioral side of it.

Monoamines are neurotransmitters that are most likely to be implicated in mood disorders. And so, the three monoamines here are serotonin, norepinephrine, and dopamine. All three of those are implicated in depression. GABA is not. Hence, C is the correct answer.

GABA is the chief inhibitory neurotransmitter. If we decrease levels of GABA, we are actually reducing our ability to inhibit neural signals. In terms of disorders, decreased levels of GABA are more implicated in anxiety. Because you don’t have those checks and balances on your synapses. And your synapses fire all the time. And now you’re thinking about everything all at once.

Correct Answer: C

[59:44] Final Thoughts

'Psych/Soc is about KNOWING vocabulary, and reasoning with that vocabulary, but the vocabulary is Step 1.'Click To Tweet

If you want to get good at Psych/Soc your best bet is to be examining the vocabulary. Whenever you see vocabulary in a question/answer choice that you don’t recognize, put that on your list of things that you need to conceptualize. Conceptualize, not memorize.