Test Bank and Instructor Manual for Health Psychology 5th Canadian Edition by Shelley E. Taylor.

Test Bank and Instructor Manual for Health Psychology 5th Edition (Canadian Edition) By Shelley E. Taylor beststudy284@gmail.com

Student name: 1) is the subarea of psychology devoted to understanding psychological influences on health, illness, and responses to those states, as well as the psychological origins and impacts of health policy and health interventions.

A) psychosomatic medicine.

B) health psychology.

C) medical psychology.

D) comparative psychology.

E) developmental psychology.

2) According to Taylor, Sirois, and Molnar (2019), health psychology encompasses all but the following:

A) health promotion and maintenance.

B) prevention and treatment of illness.

C) etiology and correlations of health, illness, and dysfunction.

D) the health care system and the formulation of health policy.

E) a primary focus on the biology of illness and disease

3)

Etiology refers to

.

A) the origins or causes of illness B) a special kind of disease state C) healthy behaviour D) the effects of stress E) the prevalence of disease in a population

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4) Health psychologists who are interested in the behavioural and social factors that contribute to health or illness and dysfunction would focus on which of the following in particular?

A) Microorganisms (i.e., bacteria) B) Cardiovascular system C) Health habits (i.e., exercise) D) The biomedical model E) Immunology

5) Health psychologists who are interested in the impact of health institutions and health professionals on people's behaviour would focus on all but the following:

A) emergency room wait times B) physician-patient communication C) geographical locations of hospitals D) the biomedical model E) physician malpractice

6) Which group proposed humoral theory for understanding the links between temperament and illness?

A) Ancient Chinese B) Germanic tribes C) Vikings D) Ancient Greeks E) Russian shaman

7) In 1986, the Epp Report proposed a health promotion approach to health that meant giving greater consideration to the that contour health.

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A) temperature and climate B) biological mechanisms C) social forces D) psychological conditions E) microorganisms

8) In 1973, the field of behavioural medicine emerged with the release of which of the following important documents?

A) John's book: Social Forces B) Birk's book: Biofeedback: Behavioral Medicine C) Smith's journal: Disease Prevention D) Horton's government report: Back to the Essence E) Rodriguez's document: Escaping the Mind

9)

In

A) ancient Greece B) the Middle Ages C) the Renaissance D) 19 th century E) the Stone Age

10)

Conversion hysteria

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, the Church was the guardian of medical knowledge.

A) is still a dominant viewpoint in health psychology.

B) occurs when specific unconscious conflicts produce physical disturbances.

C) opposed the viewpoints of Sigmund Freud.

D) was proposed by the ancient Greeks.

E) occurs when physical disturbances produce specific unconscious conflicts.

11)

The field of behavioural medicine

A) focuses on objective and clinically relevant interventions.

B) relies on subjective, verbal interventions.

C) does not recognize biofeedback as a treatment intervention.

D) preceded the works of Sigmund Freud.

E) was the basis for the field of psychoanalysis.

12) specific illnesses.

linked patterns of personality rather than a single specific conflict to

A) Dunbar and Alexander B) Galen C) Hippocrates D) Freud E) Cattell

13) Who argued that conflicts produce anxiety, which becomes unconscious and takes a physiological toll on the body?

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A) Hippocrates B) Dunbar and Alexander C) Ancient Greeks D) Ancient Romans E) Scholars in the Middle Ages

14)

An example of a disorder believed to be psychosomatic in origin is

.

A) hyperthyroidism B) a tumour C) typhoid D) yellow fever E) measles

15) Which of the following statements best reflects a current perspective of the mind-body relationship?

A) Repressed psychological conflicts can manifest as physical symptoms and illness.

B) Health and healing involve the interrelation of all of the body's systems, and illness arises as a disharmony between these systems.

C) Illness is largely a product of one's temperament.

D) Healing relies most heavily on the patient's belief in the physician.

E) Illness results only from a breakdown of organic and cellular changes within the body.

16) According to your Taylor, Sirois, and Molnar, all conditions of health and illness are influenced by

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A) psychological factors.

B) social factors.

C) biological and social factors.

D) biological, psychological, and social factors.

E) psychological and social factors.

17) The fundamental assumption of the model is that health and illness are consequences of the interplay of biological, psychological, and social factors.

A) biomedical B) sociocultural C) clinical D) psychosocial E) biopsychosocial

18) The aberrant somatic processes.

model maintains that all illness can be explained on the basis of

A) biomedical B) psychoemotional C) biopsychosocial D) psychosocial E) Psychosomatic

19) Josh is feeling achy, congested, and lethargic. Josh's doctor tells him he has been infected with a cold virus and does not consider any other contributing factors to his illness. Which model is Josh's doctor demonstrating?

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A) Biopsychosocial.

B) Sociocultural.

C) Psychosocial.

D) Biomedical.

E) Behavioural.

20) the

The notion that cancer can be cured simply by excising a tumour, most closely resembles

A) biomedical model.

B) biopsychosocial model.

C) psychosomatic model.

D) psychosocial model.

E) mind-body model.

21)

A single-factor model of illness assumes that

A) psychological and social forces combine into a single factor, which ultimately causes illnesses to develop.

B) other forces may contribute to the development of illness, but only psychological forces should be considered.

C) illness can be explained in terms of a biological malfunction.

D) only one factor of an illness can be dealt with at one time.

E) all illnesses are the result of a single and repetitive negative thought.

22)

The idea that health is the absence of disease most closely resembles the

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A) biomedical model.

B) biopsychosocial model.

C) psychosomatic model.

D) psychosocial model.

E) holistic model.

23)

The biopsychosocial model of health

A) emphasizes the social and psychological factors in health.

B) views the body as a system of organs that work holistically together.

C) proposes that complex phenomenon can be reduced down to their simpler components.

D) emphasizes the microlevel factors in health.

E) maintains that biological, psychological, and social factors are all important determinants of health and illness.

24)

According to the biopsychosocial model, state of health and illness are produced by

A) microlevel processes.

B) macrolevel processes.

C) the interaction of microlevel and macrolevel processes.

D) environment.

E) microlevel processes and the environment.

25) The maintains that health and illness are caused by multiple factors and produce multiple effects.

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A) biopsychosocial model B) psychosomatic model C) reductionistic model D) biomedical model E) psychosocial

26)

Systems theory assumes a principle of hierarchical organization. This implies that

A) changes in any one level will affect all other levels of the system.

B) only changes in the highest level will affect all levels of the system.

C) changes in one level will affect only lower levels of the system.

D) changes in intermediate levels have the most profound impacts.

E) if changes occur on only one level, all other levels will remain unchanged.

27)

According to the biopsychosocial model,

A) an interdisciplinary team approach may lead to conflicting diagnoses.

B) treatment must focus on biological, psychological, and social factors.

C) patients and practitioner relationship should be strained and formal.

D) a person's lifestyle is not related to illness.

E) individuals with unhealthy habits cannot recover from illness.

28) Until early into the 20 th century, illness and death in Canada.

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were among the major causes of

A) acute disorders B) chronic illnesses C) hereditary disorders D) accidents and homicides E) non-communicable diseases

29)

Acute disorders are

A) short-term medical illnesses that are usually responsive to cure.

B) typically non-communicable.

C) currently the major causes of death and illness in Canada.

D) long-term medical illnesses that are usually responsive to cure.

E) are very rarely caused by viruses and bacteria.

30) Currently, in industrialized countries, disability and death.

A) acute disorders B) chronic illnesses C) HIV/AIDs D) accidents and homicides E) suicide

31)

Chronic illnesses

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is/are the major contributor/s to

A) are not hereditary in nature.

B) are difficult for patients to manage, but seldom contribute to disability or death.

C) short-term medical illnesses that are usually responsive to cure.

D) are illnesses in which psychological and social factors play an important role in both cause and management.

E) are rare in industrialized countries.

32) is the study of the frequency, distribution, and causes of infectious and non-infectious disease in a population, based on an investigation of the physical and social environment.

A) Health psychology B) Etiology C) Morbidity D) Epidemiology E) Immunology

33) point in time.

refers to the number of cases of a disease that exist at some given refers to numbers of deaths due to particular causes.

A) Morbidity; Mortality B) Mortality; Etiology C) Epidemiology; Pathology D) Etiology; Epidemiology E) Prevalence; Mortality

34) Which of the following is NOT considered a determinant of health according to a population health approach?

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A) Social support networks.

B) Health services.

C) Biology and genetic endowment.

D) Employment/working conditions.

E) Race.

35) accredits a number of clinical health psychology graduate programs in Canada, thereby setting a standard of training.

A) American Psychological Association B) American Psychiatric Association C) The World Health Organization D) The Canadian Psychological Association E) Public Health Agency of Canada

36) are known for working with individuals who are emotionally and physically disabled (e.g., people who have mental illness or a disabling chronic illness)

A) Occupational therapists B) Dietitians C) Social workers D) Physiotherapists E) Chiropractors

37)

Which of the following is NOT an allied health professional?

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A) Physiotherapist B) Physician C) Dietitian D) Occupational therapist E) Social worker

38) As an allied health professional Susan has the opportunity to apply the principles of health psychology with her clients. For example, she helps patients with ongoing health issues, help them learn to use adaptive devices and become accustomed to new ways of performing old tasks. Susan most likely works as a(n):

A) Physiotherapist.

B) Physician.

C) Dietitian.

D) Occupational therapist.

E) Social worker.

39) Explain the factors that contributed to the development of behavioural medicine. In what ways has the field of behavioural medicine influenced the practice of health psychology?

40) Explain how current views of the mind-body relationship have been influenced by the growing interest in holistic health and healing.

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41) Compare and contrast the biopsychosocial and biomedical models. Explain why the biopsychosocial model has advantages over biomedical model?

42) Explain how the changing patterns of illness have contributed to the rise of health psychology. Provide an example of the changing patterns of illness in Canada.

43) Training in health psychology can lead to opportunities to work in a variety of different fields. Name any of these fields and provide examples of the roles associated with each.

44) The 1948 World Health Organization's definition of health is at the core of health psychologists' conception of health. ⊚ ⊚

true false

45) The World Health Organization defines health as a complete state of physical, mental, and social well-being and not merely the absence of disease or infirmity.

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⊚ ⊚

true false

46) Early cultures believed that disease arose when evil spirits entered the body and that these spirits could be exorcised through the treatment process. ⊚ ⊚

47)

true false

The ancient Greeks believed that an imbalance of bodily fluids caused illness. ⊚ ⊚

true false

48) In conversion hysteria, the patient converts psychological conflict into a symptom via the voluntary nervous system; they then become relatively free of the anxiety the conflict would otherwise produce. ⊚ ⊚

true false

49) The biomedical model posits that biological and sociological factors contribute to the disease process. ⊚ ⊚

true false

50) The biopsychosocial model emphasizes the importance of an effective patientpractitioner relationship. ⊚ ⊚

true false

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51) The most important factor giving rise to health psychology has been due to the consistency of illness patterns that have occurred in Canada. ⊚ ⊚

52)

true false

Morbidity may be expressed in two ways: incidence and prevalence. ⊚ ⊚

true false

53) Although health psychologists have been employed in health settings for many years, they have difficulty establishing their credibility with physicians and other health care professionals. ⊚ ⊚

true false

54) Public health researchers have the goal of improving the health of the general population through research and interventions. ⊚ ⊚

true false

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Answer Key Test name: Chapter 01 Test Bank 1) B 2) E 3) A 4) C 5) D 6) D 7) C 8) B 9) B 10) B 11) A 12) A 13) B 14) A 15) B 16) D 17) E 18) A 19) D 20) A 21) C 22) A 23) E 24) C 25) A 26) A beststudy284@gmail.com

27) B 28) A 29) A 30) B 31) D 32) D 33) A 34) E 35) D 36) A 37) B 38) A 39) Answers may vary.

40) Answers may vary.

41) Answers may vary.

42) Answers may vary.

43) Answers may vary.

44) TRUE 45) TRUE 46) TRUE 47) TRUE 48) TRUE 49) FALSE 50) TRUE 51) FALSE 52) TRUE 53) FALSE 54) TRUE

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Student name: 1)

The nervous system consists of which two primary components?

A) brain; spinal cord B) central nervous system; peripheral nervous system C) internal nervous system; external nervous system D) sensory nervous system; motor nervous system E) sympathetic nervous system; parasympathetic nervous system

2)

The peripheral nervous system consists of the .

and the

A) brain; spinal cord B) central nervous system; parasympathetic nervous system C) central nervous system; sympathetic nervous system D) somatic nervous system; autonomic nervous system E) central nervous system; somatic nervous system

3) The internal organs.

nervous system connects the central nervous system with all

A) internal B) external C) autonomic D) somatic E) voluntary

4)

The

nervous system mobilizes the body in response to stress; the nervous system controls the activities of the visceral organs under normal

conditions.

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A) parasympathetic; sympathetic B) sympathetic; parasympathetic C) central; peripheral D) internal; external E) voluntary; central

5)

Damage to the cerebellum is associated with impaired

A) muscular coordination.

B) respiration.

C) blood flow.

D) memory.

E) vision.

6) The helps regulate the centres in the medulla that control cardiac functioning, blood pressure, and respiration.

A) forebrain B) hindbrain C) hypothalamus D) medulla E) primary somatic sensory cortex

7) Mark has been preparing for his graduate school entrance exam for several weeks and is very nervous about how he will perform. Furthermore, Mark has lost his appetite and his boyfriend is concerned that he has lost interest in him because he has not displayed any sexual desire lately. Which area of Mark's brain appears to be dysregulated?

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A) hypothalamus B) adrenal medulla C) limbic system D) pituitary gland E) parietal lobe

8) John appears to be physically rigid. He walks slowly and seems to always have a shaky left hand. Which condition is John presenting?

A) epilepsy B) Parkinson's disease C) cerebral palsy D) Alzheimer's disease E) multiple sclerosis

9)

Which of the following is the most frequent cause of dementia?

A) Alzheimer's disease B) Huntington's disease C) cerebral palsy D) arthritis E) heart disease

10)

Catecholamines are

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A) specific genes.

B) neurotransmitters.

C) antigens.

D) responsible for a decrease in heart rate.

E) responsible for decreasing blood pressure.

11)

Secretion of catecholamines

A) decreases heart rate and blood pressure.

B) produces a state of relaxation.

C) increases heart rate and blood pressure.

D) stimulates digestion and urination.

E) dilates blood vessels.

12) is a chronic, nonprogressive disorder of the nervous system that is marked by lack of muscle control.

A) Epilepsy B) Parkinson's disease C) Myasthenia gravis D) Cerebral palsy E) Multiple Sclerosis

13) At birth, the blood supply to Fatima's brain was interrupted, which caused brain damage.

As a result, she lacks control of her muscles and frequently experiences seizures. Fatima has .

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A) epilepsy B) Parkinson's disease C) myasthenia gravis D) cerebral palsy E) multiple sclerosis

14) The gene for has been isolated, and a test is now available that can indicate if a person is a carrier of the gene and at what age the carrier will succumb to the disease.

A) epilepsy B) myasthenia gravis C) multiple sclerosis D) Parkinson's disease E) Huntington's disease

15) The nervous system is chiefly responsible for the body; whereas the endocrine system governs mainly

responses to changes in responses.

A) fast-acting, short-duration; slow-acting, long-duration B) slow-acting, long-duration; fast-acting, short-duration C) fast-acting, long-duration; slow-acting, short-duration D) complementary; antagonistic E) slow-acting, short-duration; fast-acting, long-duration

16)

The release of steroids via the adrenal cortex is stimulated by

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A) oxytocin.

B) cortisol.

C) thyrotropic hormone (TSH).

D) adrenocorticotropic hormone (ACTH).

E) vasopressin.

17)

Type I diabetes

A) typically occurs after age 40.

B) is a condition that occurs when the immune system falsely identifies and destroys cells in the pancreas, which compromises or eliminates their ability to produce insulin.

C) is a condition that is heavily influenced by one's lifestyle.

D) is different than type II diabetes because it lacks a genetic origin.

E) disproportionately affects white males.

18)

Conditions associated with diabetes include

A) deafness.

B) colour blindness.

C) coronary heart disease.

D) skeletal system damage.

E) loss of hair.

19)

The

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carry blood from the heart to oxygenate other organs and tissues.

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A) arteries B) veins C) capillaries D) ventricles E) atria

20) is chest pain which occurs because the muscle tissue of the heart must continue its activity without a sufficient supply of oxygen or adequate removal of carbon dioxide and other waste products.

A) Angina pectoris B) Myocardial infarction C) Phlebitis D) Arteriosclerosis E) Aneurysm

21)

Atherosclerosis is associated with which two primary clinical manifestations?

A) angina pectoris; myocardial infarction B) multiple sclerosis; amyotrophic lateral sclerosis C) upper respiratory tract infections; lower respiratory tract infections D) Crohn's disease; celiac disease E) cystic fibrosis; mesothelioma

22) During blood is taken into the heart.

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, blood is pumped out of the heart. During

,

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A) relaxation; contraction B) diastole; systole C) systole; diastole D) atherosclerosis; hypertension E) angina pectoris; myocardial infarction

23)

Hypertension is caused by

A) low blood pressure.

B) a viral infection.

C) a bacterial infection.

D) a parasitic infection.

E) too high of a cardiac output.

24)

Approximately

% of Canadians aged 12 and over have hypertension.

A) 10 B) 14 C) 18 D) 22 E) 26

25)

Approximately 55% of blood volume is composed of

A) platelets.

B) white blood cells.

C) red blood cells.

D) plasma.

E) hemoglobin.

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26) is a blood clotting disorder in which individuals are unable to produce thromboplastin and fibrin.

A) Arteriosclerosis.

B) Anemia.

C) Leukopenia.

D) Hemophilia.

E) Erythrocytosis.

27) The course of infection follows a specific sequence. Which of the following lists presents the correct order of sequence?

A) incubation period, period of nonspecific symptoms, acute phase, period of decline.

B) period of nonspecific symptoms, incubation period, acute phase, period of decline.

C) acute phase, incubation period, period of nonspecific symptoms, period of decline.

D) incubation period, acute phase, period of decline.

E) incubation period, period of nonspecific symptoms, period of decline, recovery.

28)

B lymphocytes play an important role in the functioning of the immune system by

A) secreting chemicals that kill invading organisms and infected cells.

B) providing protection against bacteria, neutralizing toxins produced by bacteria, and preventing viral infection.

C) down-regulating and eventually turning off the immune response.

D) preventing the circulation of body fluids, such as blood.

E) acting immediately after cells become infected.

29) Nabila contracted influenza from school when she accidentally shared and infected classmate's water bottle. This is an example of transmission.

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A) direct B) indirect C) biological D) mechanical E) chemical

30)

Infections may be

A) localized, focal, or systemic.

B) localized, focal, or non-systemic.

C) non-localized, non-focal, or non-systemic.

D) localized, non-focal, or systemic.

E) non-localized, focal, or systemic.

31) Nonspecific immunity is mediated in four ways. Which of the following is not one of the four ways?

A) anatomical barriers.

B) phagocytosis.

C) inflammatory responses.

D) antimicrobial substances.

E) blood clotting.

32) Shanice had an outbreak of measles. Her body has now built measles.

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immunity for

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A) natural B) artificial C) acquired D) nonspecific E) specific

33)

Humoral immunity is mediated by

A) B lymphocytes.

B) TC cells C) NK cells.

D) phagocytosis.

E) TH cells.

34)

Cell-mediated immunity is mediated by

A) B cells.

B) TC and TH cells.

C) B cells and helper and suppressor T cells.

D) interferon.

E) NK cells.

35)

The spleen

A) secretes insulin and bile into the bloodstream.

B) produces neurotransmitters and corticosteroids.

C) aids in the production of B and T cells and filters the blood.

D) produces red blood cells.

E) aids in the production of NK cells.

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36)

Infectious disorders

A) are acute problems that end when their course has run.

B) that are kept in control through hygiene may have paradoxically increased the rates of these disorders.

C) are not linked to the development of any chronic diseases.

D) are largely under control in developed countries.

E) are genetic in origin.

37)

Infectious disorders

A) are eradicated in the most developed countries.

B) may be a result of advanced sanitation and refrigeration.

C) consist of viral infections only.

D) do not cause chronic diseases.

E) can be treated effectively with large doses of antibiotics.

38)

Autoimmunity

A) involves the progressive, chronic enlargement of lymphatic tissue.

B) is a viral disorder marked by an unusually large number of monocytes.

C) is acquired through measures such as vaccination.

D) is a condition in which a specific humoral or cell-mediated immune response attacks the body's own tissue.

E) is a condition seen only in women.

39)

Autoimmunity may be implicated in

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A) diabetes.

B) arthritis.

C) hypertension.

D) jaundice.

E) typhoid.

40)

Systemic lupus erythematosus is

.

A) an autoimmune disorder B) a genetic disorder which primarily affects men.

C) a non-generalized disorder.

D) not a severe condition.

E) a birth-related disorder.

41)

Inflammation is also implicated in

A) strokes.

B) renal failure.

C) hemophilia.

D) asthma.

E) mood disorders.

42)

The adrenal cortex produces

in response to stress.

A) epinephrine and norepinephrine B) glucocorticoids C) endogenous opioids D) ACTH E) oxytocin

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43) The activation of the hypothalamic-pituitary-adrenocortical (HPA) axis most closely resembles the model of stress.

A) fight or flight B) tend and befriend C) general adaptation syndrome D) primary appraisal E) sympathetic arousal

44) Describe the difference between the nervous system and endocrine system's response to stress. Provide at least two functions of each system's stress response in your answer.

45) Describe the structure and function of both sides of the heart. In your answer, explain the two phases of the cardiac cycle.

46) Compare and contrast nonspecific and specific immune mechanisms. Provide at least two examples of each.

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47) Explain how the sympathetic-adrenomedullary (SAM) and hypothalamic-pituitaryadrenocortical (HPA) axis are implicated in the physiological response to stress.

48) Regulation of the autonomic nervous system occurs via the sympathetic nervous system and the parasympathetic nervous system. ⊚ ⊚

true false

49) The structures of the limbic system play an important role in stress and emotional responses. ⊚ ⊚

true false

50) The endocrine system is responsible for fast-acting, short-duration responses to changes in the body. ⊚ ⊚

true false

51) Angina pectoris is most likely to occur when a clot has developed in a coronary vessel and blocks the flow of blood to the heart. ⊚ ⊚

52)

true false

Arteriosclerosis results when elasticity of arteries decreases making them rigid and hard.

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⊚ ⊚

true false

53) Antigens are foreign substances whose presence stimulates the production of antibodies in the cell tissues. ⊚ ⊚

54)

true false

Compared to women, men are at greater risk of contracting autoimmune disease. ⊚ ⊚

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true false

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Answer Key Test name: Chapter 02 Test Bankt 1) B 2) D 3) C 4) B 5) A 6) C 7) A 8) B 9) A 10) B 11) C 12) D 13) D 14) E 15) A 16) D 17) B 18) C 19) A 20) A 21) A 22) C 23) E 24) C 25) D 26) D Version 1

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27) A 28) B 29) B 30) A 31) E 32) A 33) A 34) B 35) C 36) B 37) B 38) D 39) B 40) A 41) D 42) B 43) C 44) Answers may vary.

45) Answers may vary.

46) Answers may vary.

47) Answers may vary.

48) TRUE 49) TRUE 50) FALSE 51) FALSE 52) TRUE 53) TRUE 54) FALSE

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Student name: 1)

Taylor, Sirois, and Molnar define health promotion as:

A) A general philosophy that good health, or wellness is a personal and collective achievement.

B) The practice of good health behaviours.

C) The avoidance of health-compromising behaviours.

D) Medical interventions designed to enhance and maximize good health.

E) A collection of behavioural management techniques for good health behaviours.

2)

According to the text, changing health behaviours

A) may reduce the number of deaths due to diseases related to lifestyle.

B) cannot be promoted to those who lead unhealthy lifestyles.

C) do not delay the onset of chronic disease.

D) are only effective for the prevention of acute illnesses.

E) is beneficial only after illnesses have been treated.

3)

Health habits

A) are highly resistant to change, because they are continually reinforced by specific positive outcomes.

B) are unrelated to health behaviours.

C) require access to the health care delivery system.

D) are often performed automatically, without awareness.

E) are something people are consciously aware of but choose to deny.

4) According to the text, cancer deaths could be reduced by more than 50 percent simply by getting people to

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A) avoid smoking.

B) eat a carnivorous diet.

C) detox regularly.

D) demonstrate their health habits on social media.

E) consume CBD oil (cannabis) supplements daily.

5) Which of these is NOT a good health habit as pointed out by scientists Belloc and Breslow (1972)?

A) Being no more than 30 percent overweight.

B) Not smoking.

C) Eating breakfast each day.

D) Getting regular exercise.

E) Sleeping seven to eight hours a night.

6) According to the factors that influence the practice of health behaviours, which of the following individuals is most likely to practice good health behaviours?

A)

Joe, a 45-year-old high school dropout who works two jobs in order to support his

family B) Dan, a 30-year-old high school graduate who works as a file clerk in a small insurance agency who expects to be married next month C) Bill, a divorced 50-year-old corporate attorney D) Sam, a 30-year-old assistant professor who has just celebrated his fifth wedding anniversary E) Barbara, a high school senior in a small farming community

7)

The perception that one's health is under personal control is referred to as

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A) internal locus of control B) external locus of control C) health locus of control D) optimistic locus of control E) good locus of control

8)

One aspect of poor health habits that makes them difficult to modify is that

A) B)

the exact point for intervention is seldom clear. they are interdependent—a change in one habit is often reflected in changes in

others.

C) factors controlling poor health habits are generally consistent across the life span.

D) poor health habits do not develop until adulthood, when they have no apparent effect on health.

E) some poor health habits such as smoking are impossible to change.

9)

Considering the relationship of chronological age to health behaviours, health habits

A) are not affected by early socialization.

B) deteriorate in adolescence and young adulthood.

C) improve among working adults under 73.

D) improve among adults 73 and older.

E) are relatively stable throughout the lifespan.

10)

Which of the following is NOT considered a "teachable moment"?

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A) A child's first dental visit.

B) Driving in the car with children.

C) An adult with newly diagnosed coronary artery disease.

D) Crossing a busy street when in the presence of children.

E) While reprimanding an intoxicated adolescent.

11)

Generally speaking, most people's perceptions of their own health risks are

A) unrealistically optimistic.

B) unrealistically pessimistic.

C) based on scientific evidence.

D) generally accurate.

E) grounded in various psychological theories.

12) You are designing a health-promotion program for a retirement community. According to the text, which of the following behaviours would be the most important to target in your intervention?

A) Provide dietary supplements for workout routines.

B) Develop a regular exercise program.

C) Establish monthly detox programs.

D) Provide salt lamps in everybody's bedroom to eliminate "negative energy."

E) Incorporate essential oils into the daily routine.

13) Smoking rates among Indigenous youth are about general.

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A) a quarter B) half C) ten times D) twice E) triple

14)

Which of the following is the best description of prospect theory?

A) Different presentations of risk information will change people's perspectives and actions.

B) Messages that emphasize potential problems should work better for behaviours that have certain outcomes.

C) Messages that stress benefits may be more persuasive for behaviours with certain high-risk outcomes.

D) Matching the framing of the message with the health behaviour does not impact the effectiveness of the message.

E) The emotional state of the message recipient is not important.

15) Zahra is designing a public service message designed to encourage adults to engage in moderate exercise. To be most effective, her message should address

A) weight gain experienced by sedentary adults as they age.

B) decreased flexibility associated with lack of exercise.

C) positive mood and enhanced well-being associated with aerobic exercise.

D) decreased bone density as they age.

E) the reality of an early death for those who are the most inactive.

16) The health belief model states that the practice of a particular health behaviour is a function of

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A) an individual's beliefs that he or she, rather than powerful others or chance, is in control of his or her own health.

B) an individual's attitudes about a health behaviour, subjective normative beliefs, and self-efficacy.

C) an individual's perception of a personal health threat and their perception that a particular health practice can reduce that threat.

D) perceived self-efficacy and perceived invulnerability.

E) the fact that messages that emphasize potential problems should work better for behaviours that have uncertain outcomes.

17) behaviour.

is the belief that one is able to control one's practice of a particular

A) Health locus-of-control B) Self-esteem C) Self-control D) Self-efficacy E) Self-confidence

18)

According to the theory of planned behaviour, a health behavior is

A) the direct result of behavioural intention.

B) is direct result of the fight-or-flight response.

C) unlikely to be preceded by behavioural intention.

D) based on random decision making.

E) planning and self-esteem.

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19) Navin has decided that he needs to lose weight. He is concerned about the amount of "bad" fat he consumes and also suspects that his blood pressure is high. He has purchased a popular book on weight loss and has decided that he will begin exercising regularly. However, he has decided to hold off these lifestyle changes until he finishes his stressful midterm exams next week. Which stage of the transtheoretical model of behavioural change is Navin demonstrating?

A) precontemplation B) contemplation C) preparation D) action E) maintenance

20) Studies evaluating the effectiveness of Prochaska et al.'s (1992) transtheoretical model of behavioural change indicate that

A) it was 100% successful.

B) the model has become obsolete.

C) the media has even less of an effect on an individual's health behaviours than previously thought.

D) its applications have shown mixed success.

E) its applications have consistently shown to produce the complete opposite effect on health behaviours.

21) Which of the following is NOT the best example of an implementation intention to increase exercise behaviour?

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A) I want to exercise more.

B) I will go buy some new running shoes so that I can start running.

C) I will jog for 30 minutes in my neighbourhood every Tuesday and Thursday evening.

D) I will exercise 2 hours per week for the next 3 months.

E) I will complete three sets of 10 squats every day.

22) changes.

is (are) important to consider when people are trying to make behaviour

A) Self-control B) Positive self-evaluations C) Negative self-evaluations D) Self-concept E) Self-efficacy

23) focuses on the target behaviour itself, the conditions that elicit and maintain it and the factors that reinforce it.

A) Attitudinal therapy B) Operant conditioning C) Cognitive-behaviour therapy D) Modelling E) Classical conditioning.

24) trains individuals to recognize and modify negative internal monologues to promote health behaviour change.

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A) Covert self-control B) Self-efficacy C) Contingency contracting D) Assertiveness training E) Behavioural assignment

25) The use of a vomiting-inducing drug called Antabuse in the treatment of alcoholism involves having the individual consume their favourite drink while ingesting the drug. After several of these combined dosages, alcohol becomes associated with the Antabuse and elicits a(n) .

A) conditioned response B) conditioned stimulus C) unconditioned response D) unconditioned stimulus E) extinction response

26) Classical conditioning modifies the conditioning modifies the

of behaviour; operant of behaviour.

A) consequences; consequences B) consequences; antecedents C) antecedents; consequences D) antecedents; antecedents E) stimuli; responses

27) The use of positive reinforcement for weight loss (e.g., money or new clothing) in the treatment of obesity is an example of

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A) shaping.

B) modelling.

C) operant conditioning.

D) classical conditioning.

E) conditioned response.

28) Incorporating individuals with lived experiences of drug addiction as peer counselors in drug treatment programs is an example of

A) shaping.

B) modelling.

C) operant conditioning.

D) classical conditioning.

E) counterintuitive.

29)

A discriminative stimulus

A) targets the mind and not behaviours.

B) targets only minorities.

C) serves as a cue that positive reinforcement will occur.

D) focuses exclusively on the antecedents of a health habit.

E) serves as a cue that negative reinforcement will occur.

30) Kioko has been trying to lose weight and control her seemingly insatiable sweet tooth. To meet her goal, she has removed all cookies, candy, and ice cream from the kitchen cabinets and refrigerator. She now keeps a bowl of fresh fruit on the kitchen counter for snacking. Kioko is practicing

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A) vicarious self-control.

B) self-punishment.

C) stimulus control intervention.

D) self-reinforcement.

E) discriminative stimuli.

31) Fred wants to lose 20 pounds. He places 20 one-pound boxes of lard in the refrigerator.

As his weight-loss program proceeds, he removes one box of lard each time he succeeds in losing a pound. Fred's behaviour is an example of .

A) positive self-punishment B) negative self-punishment C) positive self-reward D) negative self-reward E) positive self-punishment and negative self-reward

32)

Self-punishment

A) is as effective in changing behaviour as a form of self-reward.

B) is more effective in changing behaviour when it is also coupled with self-rewarding techniques.

C) is effective in behaviour change even when individuals stop performing the target behaviour.

D) becomes increasingly effective as the punishment becomes increasingly aversive.

E) is not usually recommended due to the lasting emotional problems associated with it.

33) Dominica entered into an agreement with her friend, Ni–a, in an attempt to establish a regular exercise program. According to their agreement, Ni–a pays Dominica $1 every day that she exercises for at least 30 minutes after work. If she fails to do so, Dominica must pay Ni–a $1.

This is an example of

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A) shaping.

B) a token economy.

C) a contingency contract.

D) vicarious reinforcement.

E) negative reinforcement.

34)

Internal monologues

A) have very little impact on changing health behaviours.

B) can function as antecedents and as consequences of target behaviour.

C) are resistant to change through standard techniques of reinforcement.

D) can function as antecedents but not as consequences of target behaviour.

E) are always negative and maladaptive.

35) Wanda's weight loss counsellor has observed that she has a self-defeating pattern of beliefs and cognitions about her ability to control her overeating. Specifically, when she eats something that is not allowed on her diet, she thinks "I have no willpower; I'll always be fat" and continues to binge. Wanda's counsellor has now challenged her to reframe her negative attitude about her poor dietary decisions.

A) cognitive restructuring.

B) positive reinforcement.

C) self-monitoring.

D) self-punishment.

E) theory of reasoned behaviour.

36)

How can modelling be used to teach the client cognitive restructuring?

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A) Model maladaptive behaviours first.

B) Model stretching techniques.

C) Model adaptive self-talk.

D) Model effective breathing techniques.

E) Model rapid eye movement (REM).

37)

One goal of social skills training is to

A) reduce the anxiety associated with social situations.

B) get the client to think through and express some of his or her own reasons for and against change.

C) model the behaviours of others in social situations (i.e., drinking alcohol).

D) learn to relax all the muscles in the body to discharge tension or stress.

E) increase motivation.

38)

Motivational interviewing

A) is designed to reduce anxiety that occurs in social situations.

B) is used to train a client in cognitive restructuring.

C) helps rid the environment of discriminative stimuli that evoke the problem of health behaviour.

D) is a client-centered counselling style designed to get people to work through ambivalence they may be experiencing about changing their health behaviours.

E) sets the stage for enlisting the patient's joint participation early in the effort to modify health behaviours.

39)

Which of these behaviours may NOT necessarily lead to permanent relapse?

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A) Smoking only two cigarettes a day.

B) Having only a small drink daily.

C) Bingeing on ice cream, but only on weekends.

D) A single cigarette smoked at a cocktail party.

E) A single pack of cigarettes smoked at a cocktail party.

40)

Relapse

A) is more likely to occur when people are depressed, anxious, or under stress.

B) appears to be unrelated to situational factors; it is almost exclusively an individual problem.

C) is more likely to occur when people are happy, excited, and confident.

D) is unrelated to levels of perceived stress and social support.

E) usually occurs after a three-month period of abstinence.

41)

An abstinence violation effect is associated with

A) psychological reactance and an increased feeling of perceived control.

B) an increased feeling of perceived control and decreased likelihood of relapse.

C) a violation of self-imposed rules.

D) increased vigilance.

E) at least two lapses in vigilance.

42) An important focus of relapse prevention programs is to commitment of participants.

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A) increase; increase B) increase; decrease C) decrease; decrease D) maintain; maintain E) increase; maintain

43)

Relapse prevention techniques may involve

A) eliminating or restructuring the environments B) decrease feelings of self-efficacy.

C) increase positive expectations associated with the addictive behaviour.

D) restrict the opportunity to practice coping responses.

E) increase feelings of guilt in the person.

44) involves modifying the environment to affect one's ability to practice a particular health behaviour.

A) Social engineering B) Reconstruction C) Adaptive environmental change D) Passive retraining E) Occupational therapy

45) Which of the following is NOT an example of social engineering to change health-related behaviours?

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A) Legislating smoke-free indoor work environments.

B) Lowering the speed limit.

C) Encouraging parents to let their children play outside more often.

D) Legislation to eliminate the amount of trans fats allowed in foods.

E) Requiring immunizations for children before school entry.

46)

How do health risk assessments (HRAs) help employers?

A) They provide employers with a general view of their employees' health and areas for improvement.

B) They allow employers to judge their employees' abilities based on their health profile.

C) They give employers an opportunity to spy on their employees.

D) They allow employees to avoid hiring individuals with disabilities.

E) They serve as a measuring stick for employers to gauge their own health risks.

47) The family physician may be a particularly effective agent in promoting health-related attitudes and behaviour because

A) they have complete control of their patients.

B) there's nothing they don't know about health, illness, and disease.

C) a one-to-one approach is the least expensive and most efficient vehicle for changing health habits.

D) a physician possesses the necessary qualifications and expertise to support the patients.

E) a physician can reduce the risk status of many people at one time.

48)

Self-help groups

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A) are in person only B) are online only C) can be either in person or online D) are held at night, so people can attend after work E) are held only on weekends

49)

The effectiveness of community interventions is

.

A) very high, with a high success rate B) very low, with a low success rate C) very high, with a mixed success rate D) unknown E) controversial

50)

How does mass media serve as an effective tool for health promotion?

A) Mass media always provides accurate health information.

B) Mass media is always the best source of health information.

C) Mass media debunks "fake news" related to health claims.

D) Mass media serves as an important source of information for alerting the public to unknown health risks.

E) mass media campaigns are successful at bringing about long-term change.

51)

For more than 30 years, Participation has been specifically associated with and for many Canadians.

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A) safe sex; physical fitness B) healthy living; physical fitness C) vegetarian diets; yoga D) weight training; cardio E) disease prevention; harm reduction

52) Compare and contrast what health promotion means to individuals, medical practitioners, psychologists, and community and national policy makers.

53) Why have patterns of disease changed in Canada since the turn of the 20 th century?

Considering these trends, explain the importance of efforts to modify health behaviours and lifestyle rebalancing.

54) Describe and explain why health habits are difficult to change. Include an example of a health habit in your answer.

55) Kwame is a college student who smokes cigarettes. Use the health belief model and the theory of planned behaviour to explain why Kwame continues to smoke even though he is aware of the Surgeon General's warning about the relationship between cigarettes and cancer and heart disease.

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56) Describe the concept of relapse. Explain how relapse prevention might be incorporated into a broad-spectrum cognitive-behaviour therapy treatment plan for (choose one) alcoholism, smoking, or obesity. Be sure to include in your answer specific cognitive-behaviour techniques and their role in the therapeutic plan.

57) List three types of venues used for health behaviour change and describe how each one deals with health behaviour change. What are the advantages and disadvantages of each venue?

58) Health promotion may occur through individual efforts, through interaction with the medical system, and through a concerted health policy effort. ⊚ ⊚

true false

59) A health habit is a health related behaviour that is firmly established and often performed automatically. ⊚ ⊚

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60)

Instilling good health habits and changing poor ones is the task of primary prevention. ⊚ ⊚

true false

61) The concept of the window of vulnerability refers to the fact that certain times are better for teaching particular health practices than others. ⊚ ⊚

true false

62) Health message communicators are more persuasive if they are likable and similar to the audience. ⊚ ⊚

true false

63) Research has established that the more fear that a persuasive message elicits, the more effective it is for changing behaviour. ⊚ ⊚

true false

64) Social cognition models of health behaviour change suggest that the beliefs that people hold about particular health behaviour motivate their decision to change that behaviour. ⊚ ⊚

true false

65) Cognitive-behaviour therapy approaches to health habit modification target the behaviour itself, the conditions that elicit and maintain it and the factors that reinforce it.

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⊚ ⊚

true false

66) Social engineering approaches to health behaviour changes involves active methods that require the individual to take action. ⊚ ⊚

true false

67) Health risk assessments (HRA) identify employees' specific risks based on current age, family history, and lifestyle factors. ⊚ ⊚

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Answer Key Test name: Chapter 03 Test Bank 1) A 2) A 3) D 4) A 5) A 6) D 7) C 8) A 9) B 10) E 11) A 12) B 13) E 14) A 15) C 16) C 17) D 18) A 19) C 20) D 21) A 22) E 23) C 24) A 25) A 26) C Version 1

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27) C 28) B 29) C 30) C 31) D 32) B 33) C 34) B 35) A 36) C 37) A 38) D 39) D 40) A 41) C 42) E 43) A 44) A 45) C 46) A 47) D 48) C 49) E 50) D 51) B 52) Answers may vary.

53) Answers may vary.

54) Answers may vary.

55) Answers may vary.

56) Answers may vary.

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57) Answers may vary.

58) TRUE 59) TRUE 60) TRUE 61) FALSE 62) TRUE 63) FALSE 64) TRUE 65) TRUE 66) FALSE 67) TRUE

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Student name: 1) Which of the following options would NOT help parents prevent unintentional injuries in the home?

A) Reviewing home safety information on YouTube and Reddit.

B) Reviewing the owner's manuals for all of the children's toys in the family home.

C) Removing any dangerous chemicals from the children's play area.

D) Monitoring children while they play.

E) Discussing household safety with their family physician.

2) Which of the following provinces and territories in Canada have distracted driving legislation?

A) All of them.

B) All except New Brunswick.

C) Ontario and British Columbia.

D) Northwest Territories, British Columbia, Manitoba, and Ontario.

E) Alberta, Quebec, Nova Scotia, Newfoundland and Labrador, and Prince Edward Island.

3)

Effectively promoting the use of seat belts requires

A) mechanical engineering.

B) Social engineering, health education, and psychological education.

C) therapeutic intervention.

D) enforcing penalties for non-use only in urban areas.

E) parents to attend safety classes.

4) What is the best way to reduce the negative effects of talking on a cellphone while driving?

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A) Switch to the hands-free feature.

B) Text message instead.

C) Simply not using a cellphone while driving.

D) Simply turn down the vehicle's audio system to reduce any additional distractions.

E) Only talking on the cellphone while waiting for the light to turn green.

5) Educating women about the importance of having a regular clinical breast exam often depends on:

A) the equipment used in the screening process.

B) self-efficacy, perceived benefits of the screening procedure, and perceived barriers to screening.

C) Autonomy.

D) the time of year that the education is provided.

E) the time of day that the education is provided.

6) Which of the following options would be LEAST likely to increase screening through mammography?

A) Providing a universal message to all women about the importance of mammography.

B) Educating older and high-risk women about the importance of early detection.

C) Mailing a post-card that states "mammogram due soon."

D) Automated phone calls regarding upcoming appointments.

E) Providing culturally sensitive educational programs about mammography.

7)

Breast cancer is the most common cause of deaths among Canadian women aged under .

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A) 40 B) 45 C) 50 D) 55 E) 60

8)

Breast cancer and prostate cancer are similar in that

A) the average age of onset is increasing.

B) both are a common cause of death among young men and women.

C) the likelihood of survival is high.

D) the likelihood of survival improves with early detection.

E) both are specific only to women.

9)

Who is most likely to develop colorectal cancer?

A) Niimi, a 59-year-old Indigenous man.

B) Zhang, a 9-year-old Chinese boy.

C) Jiaqi, a 9-year-old Chinese girl.

D) Landon, a 59-year old European man.

E) Olena, a 74-year-old European woman.

10) cancer is the second highest cause of cancerous deaths in Western countries (including Canada).

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A) Breast B) Prostate C) Colorectal D) Skin E) Pancreatic

11)

Which of the following options would be unlikely to increase the use of sunscreen?

A) An increase in the perceived efficacy of sunscreen as protection against cancer.

B) Positive social norms about the use of sunscreen.

C) Providing free sunscreen at tanning salons.

D) Simply getting into the habit of using sunscreen.

E) Providing free sunscreen at beaches and hiking trails.

12)

Lack of sun protective practices are lowest among which age group?

A) 15 to 24 B) 25 to 34 C) 35 to 44 D) 45 to 54 E) Over 55

13)

Aerobic exercise involves

activities.

A) low-intensity, long-duration B) low-intensity, short-duration C) high-intensity, long-duration D) high-intensity, short-duration E) low endurance

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14) A typical exercise prescription is to accumulate moderate-intensity activity four days a week.

or more minutes of

A) 15 B) 20 C) 30 D) 45 E) 60

15)

Research on the cognitive benefits of exercise suggests that

A) engaging in moderate levels of aerobic exercise for as little as six months can significantly improve cognitive functioning in older adults.

B) regular cardiovascular exercise can improve academic performance for children only.

C) weight training is the only form exercise that can improve cognitive functioning for children and adults.

D) regular cardiovascular exercise can improve academic performance for adults and children of any age.

E) engaging in high intensity aerobic exercise is needed for any significant change.

16) Researchers investigating the effect of regular exercise on psychological functioning conclude that

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A) regular exercise improves mood and feelings of well-being immediately after a workout.

B) regular exercise is more effective than medication at improving mood and feelings of well-being.

C) the positive effect of exercise on mood is unrelated to increased self-efficacy.

D) whereas exercise is associated with improved mood, it has no effect on personality variables such as the self-concept and self-esteem.

E) there are no significant effects of exercise on psychological functioning.

17)

Regular exercise

A) has been consistently associated with improved cognitive functioning.

B) has been consistently associated with improved attention but not concentration.

C) can be harmful to the elderly and therefore should be avoided.

D) has not been found to have any effect on cognitive processes.

E) is not necessary, as long as you maintain a healthy diet.

18)

People who

are more likely to exercise.

A) enjoy their form of exercise B) have social media accounts dedicated to fitness C) lift heavy weights D) frequently talk about exercise E) are thin

19)

Which of the following people is LEAST likely to exercise regularly?

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A) Jevonte, a 10-year-old elementary school student.

B) Tamika, a 15-year-old high school student.

C) Jack, a 35-year-old father of two.

D) Anupreet, a 20-year-old university student.

E) Juana, a 45-year-old mother of two.

20) that

Self-efficacy has been found to be related to the positive effect derived from exercise in

A) subjects with low self-efficacy beliefs reported more positive mood.

B) positive affect has not been found to predict subsequent self-efficacy beliefs.

C) subjects with low self-efficacy beliefs are more likely to exercise.

D) positive affect may help maintain the practice of exercise.

E) subjects with high self-efficacy are less likely to exercise.

21)

The best predictor of regular exercise is

A) accessible exercise settings.

B) willpower.

C) gender.

D) regular exercise.

E) one's current BMI.

22) Which of the following characteristics would most likely result in higher rates of adherence to exercise programs?

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A) Expensive gym equipment.

B) A monthly gym membership.

C) Large exercise class sizes.

D) Sporadic exercise.

E) Convenience and accessibility.

23) The proportion of Canadians in the 10 provinces who were moderately active in their leisure time rose from 1996-97 to 2005.

A) 1% B) 3% C) 9% D) 15% E) 25%

24)

Poor diet has been linked with

A) accidents.

B) coronary artery disease.

C) sexually transmitted infections (STIs).

D) influenza.

E) psychosis.

25) Approximately of Canadians over 12 consume the recommended five servings of fruits and vegetables each day.

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A) 10% B) 25% C) 85% D) 30% E) 60%

26)

According to Brown and Miller (2002) and their research on family interventions, can be a more powerful determinant of what the family eats if the couple does not have an egalitarian relationship style.

A) the husband's food preferences B) the wife's food preferences C) the children's food preferences D) the grandparents' food preferences E) social media

27)

Successfully making dietary change depends upon

A) low motivation.

B) low self-efficacy.

C) the perception that dietary change has important health benefits.

D) the availability of processed sugar.

E) the individual's ability to use weight loss apps on their smartphone.

28) The results of the community intervention study from Nova Scotia demonstrated that the students attending schools which had an intensive, multifaceted nutrition program

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A) showed lower rates of obesity, healthier diets, and higher levels of physical activity.

B) ironically showed higher rates of obesity, unhealthier diets, and lower levels of physical activity.

C) showed that providing healthier nutrition had no effect dietary decisions.

D) showed the students became picky eaters.

E) showed no changes in physical and cognitive domains.

29)

Which one of the following people is MOST at risk for becoming overweight or obese?

A) Wakwi, an 11-year-old who lives on an Indigenous reserve B) Julie, a 15-year-old who lives in a small rural community C) Huang, a 14-year-old who lives in Toronto D) Bjorn, a 10-year-old immigrant living in Vancouver E) Annabelle, a 20-year-old who lives in the prairies

30)

People who are morbidly obese may avoid going to the doctor because

A) they simply have no desire too.

B) they don't believe in Western medicine.

C) they know that the health care system will reject them.

D) they prefer to remain morbidly obese and body positive.

E) getting in and out of the car is difficult and hospital gowns may not cover them.

31) Epidemiological evidence suggests that fat in the is an especially potent risk factor for cardiovascular disease, diabetes, hypertension, and cancer.

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A) abdomen B) hips and buttocks C) arms, hips, and buttocks D) thighs E) thighs and hips

32)

Poor eating habits in adolescence and adulthood is likely to affect all but the following.

A) Body weight.

B) Blood pressure.

C) Lipid levels.

D) Self-esteem.

E) Achieving success in the video game community.

33)

Which of the following factors is NOT implicated in the development of obesity?

A) Style of eating B) Air quality C) Family history D) Place E) Values

34)

A national longitudinal survey of Canadian children from 1994 to 2002 found that as the increased, child obesity rates declined.

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A) number of parks in the neighbourhood B) distance from a major city C) income level of the neighbourhood D) density of the neighbourhood E) fast-food prices

35)

With respect to eating behaviours, stress may

A) suppress physiological cues suggesting hunger.

B) lead to lower consumption of unhealthy food.

C) disinhibit dieters and lead to increases in protein-enriched food intake.

D) incline dieters to eat more healthy foods.

E) turn off eating altogether.

36)

is an important player in regard to weight control.

A) Oxytocin B) Inulin C) Leptin D) Insulin E) FSH

37)

When people receive ghrelin injections, they

A) lose their appetite.

B) feel very hungry.

C) crave sweets.

D) crave fatty foods.

E) feel no different than before the injections.

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38)

Very low-carbohydrate or low-fat diets

A) do a poor job in helping people lose weight initially.

B) are the hardest to maintain.

C) are dangerous and should be avoided at all costs.

D) are effective for long term weight loss.

E) are the only effective diets for weight loss.

39)

Which of the following factors is NOT conducive to staying slim?

A) Reducing caloric intake to recommended levels.

B) Increasing exercise.

C) Sticking with an eating plan.

D) Eating fruits and vegetables regularly.

E) "Crash diets".

40)

Gastric surgery to control extreme obesity

A) is no longer used as a method for weight loss.

B) is usually reserved for people who are at least 100% overweight.

C) involves removing the large intestine to reduce food intake.

D) involves removing the stomach to reduce food intake.

E) involves no risks, which is why it is an effective treatment option for weight loss.

41)

Appetite-suppressing drugs

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A) are the best option for weight loss.

B) are only available by prescription.

C) reduce appetite and restrict food consumption.

D) are only available over the counter.

E) should always be paired with daily vigorous exercise.

42) Multimodal programs to modify obesity do NOT include which of the following components?

A) Exercise.

B) Screening.

C) Social support.

D) Self-monitoring.

E) Gastric surgery.

43)

Abdominal fat that increases in response to stress is sometimes called

A) watermelon gut.

B) stress weight.

C) midriff response.

D) belly stress.

E) stress stomach.

44) According to your text, about directly or indirectly related to obesity.

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A) $1.1 billion B) $2.4 billion C) $4.3 billion D) $3.4 billion E) $8.6 billion

45)

Evaluations of cognitive-behavioural weight-loss programs conclude that

A)

such programs are unlikely to meet most people's needs because 95% of all diets

fail.

B) such programs produce only modest weight loss and maintenance of weight loss.

C) such programs can be successful for helping people lose weight and maintain weight loss up to three years later, whether they are administered on an individual or group basis.

D) such programs appear to be more useful for severely obese persons than for mildly obese persons.

E) they are ineffective because most people have a weight set point that is not easily changed.

46)

How many stages does sleep consist of?

A) 3 B) 4 C) 5 D) 6 E) 7

47) In which stage of sleep does the body temperature drop, breathing slows, and blood pressure falls?

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A) 2 and 3 B) 3 only C) 3 and 4 D) 4 only E) 5

48)

Which of the following is true about sleep disorders?

A) Sleep involves waking dozens and even hundreds of times each night without being aware of it.

B) People with sleep disorders have trouble going to sleep or staying asleep.

C) It does not contribute to high rates of accidents in the workplace.

D) Sleep disorders may be associated with fitful snoring throughout the night.

E) Insomnia is caused by an air pipe blockage.

49)

Which one of the following people is MOST likely to report insomnia?

A) Keren, who regularly takes sleeping pills.

B) Aisha, who sleeps less than 6 hours each night.

C) Steven, who suffers from sleep apnea.

D) John, who does not exercise very often.

E) Alberto, who sleeps more than 9 hours a night.

50)

How many Canadians have trouble going to sleep or staying asleep?

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A) About one in eighty.

B) About one in two.

C) About one in ninety.

D) About one in seven.

E) About one in fifty.

51)

sleep can impair metabolic and hormonal function.

A) Poor B) Less than seven hours of daily C) Moderate D) Normal E) Less than ten hours of daily

52) Christopher has been struggling from a lack of sleep lately. His doctor diagnosed him with insomnia. Which of the following issues should Christopher and his doctor address to enhance his quality of sleep?

A) Christopher's yoga routines.

B) Christopher's love for late-night talk shows.

C) Christopher's iPhone usage.

D) Christopher's fast food cravings.

E) Christopher's chronic stress.

53) Describe the pros and cons of modifying a diet for the purpose of weight loss. Based on your answer, explain why you would recommend or not recommend this approach.

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54) Describe and explain the health benefits of exercise. In your answer, include the physical, psychological, and social outcomes associated with exercise.

55) As the text notes, people who are high in self-efficacy are more likely to adhere to exercise and weight-loss regimens. Summarize the research investigating the relationship between self-efficacy, exercise, obesity, and weight loss.

56) Suppose you are designing a program to be administered through the county health department to increase the frequency of mammograms among community residents. What techniques would be most effective to include in this program and why?

57) Family history is clearly implicated in obesity. Citing the research from the text, explain why this is so.

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58) Discuss why using cell phones while driving can be just as dangerous as impaired driving.

59) Several million people are injured each year in Canada, and falls are the leading cause of serious injury. ⊚ ⊚

60)

Breast cancer is the most common cancer in women in Canada and worldwide. ⊚ ⊚

61)

true false

true false

Regular exercise can reduce the risk of heart disease and some forms of cancer. ⊚ ⊚

true false

62) Because of social factors that encourage weight-related concerns, girls and women of all ages engage in more physical activity than do boys and men. ⊚ ⊚

true false

63) Fitness levels of Canadian adults and children have significantly declined between 1981 and 2007-2009.

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⊚ ⊚

true false

64) People of lower socioeconomic status (SES) are more at risk of coronary artery disease, hypertension, diabetes, and cancer. ⊚ ⊚

65)

Greater stress is linked to consuming more fatty foods and less fruits and vegetables. ⊚ ⊚

66)

true false

true false

In Canada, Indigenous women appear to be vulnerable to obesity. ⊚ ⊚

true false

67) Most people are motivated to lose weight because being overweight is considered unattractive. ⊚ ⊚

68)

true false

Adequate sleep is equally as important as regular exercise and healthy eating. ⊚ ⊚

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Answer Key Test name: Chapter 04 Test Bank 1) A 2) A 3) B 4) C 5) B 6) A 7) C 8) D 9) A 10) C 11) C 12) A 13) C 14) C 15) D 16) A 17) A 18) A 19) E 20) D 21) D 22) E 23) C 24) B 25) D 26) A Version 1

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27) C 28) A 29) A 30) E 31) A 32) E 33) B 34) C 35) A 36) C 37) B 38) B 39) E 40) B 41) C 42) E 43) B 44) C 45) C 46) C 47) C 48) B 49) B 50) D 51) A 52) E 53) Answers may vary.

54) Answers may vary.

55) Answers may vary.

56) Answers may vary.

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57) Answers may vary.

58) Answers may vary.

59) TRUE 60) TRUE 61) TRUE 62) FALSE 63) TRUE 64) TRUE 65) TRUE 66) TRUE 67) TRUE 68) TRUE

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Student name: 1)

Alcohol abuse and smoking share a window of vulnerability in

A) adolescence.

B) young adulthood.

C) middle age.

D) old age.

E) children.

2) According to the DSM-5, occurs when an individual uses a substance repeatedly, which in turn causes the individual to experience functional or clinical impairment, such as psychopathology, physical health problems, and/or not being able to meet important obligations at home, school, or work.

A) addiction B) substance abuse C) drug use D) a substance use disorder E) substance dependence

3) Since he stopped smoking last week, Hari complains about fighting the urge for a cigarette, especially when he is around other smokers. This is an example of

A) addiction.

B) tolerance.

C) craving.

D) withdrawal.

E) aversion.

4)

Psychoactive substances

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A) impact cognitive and affective processes and alter the way a person behaves when ingested.

B) do not include illicit drugs.

C) are only harmful to those who abuse them.

D) include antibiotics.

E) include every drug except caffeine.

5) According to the first-quarter 2019 National Cannabis Survey suggest that the use of cannabis among youth age 15 to 24 is more than the national average.

A) triple B) double C) quadruple D) ten times E) twenty times

6)

Who is more likely to use prescription drugs without medical supervision?

A) Nazim, a Dean's List university student B) Jim, a basketball champion C) Elle, who drinks a lot of tea D) Zhen, who has several tattoos on her body E) Dora, who is a daily smoker

7) Anna consumed alcohol during her pregnancy, and Anna's baby was born with some facial deformities, developmental disabilities, and mental health issues. The baby has .

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A) sickle-cell anemia B) Down's syndrome C) fetal alcohol syndrome D) cerebral palsy E) autism spectrum disorder

8)

Which of the following individuals would be MOST at risk for developing alcoholism?

A) Valencia, who has open access to alcohol at home.

B) Yasuf, who works as a bartender on weekends.

C) Linda, whose adoptive mother, Gail, is an alcoholic.

D) Aito, whose father, Kazumi, is an alcoholic.

E) Sheila, whose mother, Sally, is a problem drinker.

9) Individuals who experience drinkers than those without these risk factors.

are more likely to become problem

A) positive life events B) chronic stressors C) enhanced social support D) high achievement E) high job autonomy

10) Zoey is an alcoholic. Which of the following factors should be considered when trying to understand why she began drinking alcohol?

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A) The type of alcohol Zoey consumes on a regular basis.

B) Determining how many drinks Zoey can consume in one sitting.

C) Zoey's diagnosis of depression during childhood.

D) Zoey's preference for food when she's feeling buzzed.

E) Zoey's risky sexual behaviours when she's intoxicated.

11) Broad-spectrum cognitive-behavioural therapy for the treatment of an alcohol use disorder includes

A) increasing the reinforcement associated with alcohol.

B) teaching new behaviours consistent with alcohol abuse disorder.

C) introducing reinforcement for activities that involve alcohol.

D) treating the biological and environmental factors involved simultaneously.

E) medication only.

12)

Naltrexone, a medication, is used to

A) reverse a cannabis overdose.

B) open up the opioid receptors in the brain.

C) prevent relapse among individuals experiencing alcohol use disorder.

D) give alcohol a foul taste.

E) strengthen the rewarding effects of alcohol.

13)

The philosophy of

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is a commitment to the concept of self-help.

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A) Addicts Anonymous B) Artists are Us C) Automobile Accidents Anonymous D) Alcoholics Anonymous E) Gamblers Anonymous

14) Many successful treatment programs have attempted to provide individuals with stress management techniques that they can substitute for drinking, such as:

A) aggressiveness, assertiveness, and stubbornness.

B) combining the perfect balance of aggression and relaxation.

C) consuming cannabis during stressful times.

D) social withdrawal to avoid cravings and eliminate stress.

E) relaxation, assertiveness, and social skills training.

15)

Who is most likely to succeed in an alcohol use disorder treatment program?

A) Judy, a 19-year old single mother who's currently unemployed.

B) LeShawn, a 35-year old married man who works full-time as an occupational therapist.

C) Ross, a 41-year old lawyer whose wife recently passed away.

D) Chang, an 18-year old student who works part-time at Subway, but currently doesn't have friends since he is new to the country.

E) Miigwan, a 55-year old small business owner who's been a widow for 16 years.

16) As many as drinkers.

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A) 2% B) 10% C) 16% D) 22% E) 32%

17) How do you know when to tell a friend that they are too drunk to drive and to intervene so that the drunk individual will not drive?

A) Only when the drinker's breath smells of alcohol.

B) Once the drinker's lost count of how many drinks they have consumed.

C) If the drinker cannot complete one race in Mario Kart before they drive home.

D) When you know the driver well. When you perceive that the driver really needs help. When you feel able to intervene. Having a past conversation that encouraged intervention.

E) If it's after midnight.

18)

Moderate alcohol intake has been associated with

A) an increased risk of developing coronary artery disease.

B) an increased risk of developing cardiovascular disease.

C) an increase in "good cholesterol."

D) an increase in "bad cholesterol."

E) increased risk of developing cancer.

19)

For Indigenous peoples, leaving the community for a residential addictions facility can

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A) increase the chance of healing alcoholism and problem drinking.

B) help them begin a new life outside of their problematic community.

C) decrease the chance of relapse.

D) increase the chance of alcoholism and problem drinking.

E) help them shed their outdated cultural views.

20)

is/are the single greatest cause of preventable death.

A) Obesity B) Alcoholism C) Vehicular accidents D) Smoking E) Risky sexual behaviours

21)

In Canada, approximately

deaths per year are related to smoking.

A) 10,000 B) 25,000 C) 45,000 D) 50,000 E) 65,000

22) Smoking and serum cholesterol interact to produce higher rates of morbidity and mortality by

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A) decreasing high-density lipoprotein (HDL) production.

B) increasing low-density lipoprotein (LDL) production.

C) causing the smoker to consume foods that have higher levels of sodium.

D) simultaneously increasing good and bad cholesterol.

E) increasing high-density lipoprotein (HDL) production.

23) Following the publication of the U.S. Surgeon General's report on smoking in 1964, in Canada,

A) smoking in all groups has continued to increase.

B) smoking in all groups has continued to increase, but the rate of increase has slowed.

C) male smoking subsequently declined but women's smoking remained stable during that same period.

D) smoking among older people was relatively unaffected, but the percentage of teenage smokers has declined.

E) smoking has not been affected by the Surgeon General's report.

24)

Smoking among adolescents is

A) independent of other health-compromising behaviours.

B) likely to occur in the presence of peers.

C) not harmful to the individual since their lungs have plenty of time to recover.

D) unrelated to individual differences in personality.

E) likely to occur in relation to drinking behaviour.

25)

"Experimental smokers"

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A) is a term used to describe usually light smokers.

B) is a term used to describe creative smokers.

C) are declining in number.

D) are individuals who consume more than 20 cigarettes a day.

E) typically smoke at least 6 different brands of cigarettes a day.

26) Fiissel and Lafreniere (2006) suggested that women who report that they smoke to control their appetite and weight

A) internalized the prescribed cultural standards of thinness.

B) are overweight or obese.

C) have eating disorders.

D) have a family history of eating disorders.

E) are more likely to come from single parent households.

27)

Adolescents are more likely to smoke if

A) their parents do not smoke.

B) they have a higher SES. C) the family is stress-free.

D) they feel social pressure to smoke.

E) they are of an above-average intelligence.

28)

Smoking is determined by which of the following factors?

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A) Cigarette advisements.

B) Multiple psychological and social factors.

C) Multiple physiological, psychological, and social factors.

D) Peer pressure during adolescence.

E) Genetics.

29)

Which of the following options would fit into the psychological factors for smoking?

A) To increase body temperature.

B) Anti-smoking legislation.

C) To reduce high blood pressure.

D) To improve mood.

E) To prevent physical withdrawal from nicotine.

30) Which of the following options most accurately reflects the effect of mass media antismoking messages?

A) They provide information to smokers about health habits but have little effect on attitudes about smoking.

B) They provide information about health habits to the general population but have little effect on anyone's behaviour.

C) They provide information about health habits and discourage youth from beginning to smoke.

D) They provide information about health habits and encourage adult smokers to transition to e-cigarettes.

E) They provide information about health habits and discourage youth and adults from beginning to smoke.

31)

Transdermal nicotine patches

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A) have a 100% success rate for eventual smoking cessation.

B) does not produce significant gains in smoking cessation.

C) have been shown to produce significant smoking cessation.

D) have not been used since the 1970s.

E) do not actually contain nicotine.

32) Providing a smoker with information about the adverse health consequences of smoking would position that individual in which of the following stages of change?

A) precontemplation B) contemplation C) action D) preparation E) maintenance

33)

Which of the following options would NOT give a smoker the best chance at quitting?

A) Selecting a date within three weeks to quit smoking.

B) Throwing cigarettes away.

C) Telling a trusted friend that you plan to quit smoking.

D) Hiding your cigarettes.

E) Put the money you save by not smoking in a glass jar where you can see it.

34)

Regarding smoking and relapse prevention, the best predictor of long-term abstinence is

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A) the brand of cigarettes the individual last smoked.

B) mastering the life-skills training approach.

C) having easy access to e-cigarettes.

D) remaining vigilant about not smoking.

E) strength of intention to quit.

35) advice is known to increase quit rates among adults up to 3 percent over and above unassisted quit rates, and can also improve smoking attitudes, quitting intentions, and quitting behaviour in adolescents.

A) Friendly B) Physician C) Parental D) Sibling E) Spousal

36) What would have a larger impact on preventing the number of tobacco-related deaths by the year 2050?

A) Reducing the number of current smokers.

B) Reducing the number of new smokers.

C) Making traditional cigarettes illegal to purchase.

D) Raising the price of tobacco products each year.

E) Helping current smokers' transition to e-cigarettes.

37)

More than

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Canadians successfully quit smoking each year.

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A) fifty thousand B) one hundred thousand C) two hundred thousand D) half a million E) one million

38)

Who is more likely to quit smoking?

A) Jiao, who's friend group has decided to quit smoking together.

B) Lenny, who's been smoke free to two days, despite the fact that all of his housemates do not support his lifestyle change.

C) Cree, who's currently down to one pack of cigarettes a day.

D) Johnny, a 19-year old university student who has recently switched from traditional cigarettes to e-cigarettes.

E) Zahra, a pack-a-day-smoker who struggles with depression.

39) Social influence intervention programs often use the principle of behavioural inoculation.

According to this principle, exposing individuals to a

A) strong persuasive message ensures that they will internalize the message.

B) boring, repetitive persuasive message ensures that they will become desensitized to the message.

C) one-sided message ensures that uncommitted individuals will more likely be persuaded by the message.

D) weak version of a persuasive message may help to develop counterarguments against that message so that a stronger form of that message can be successfully resisted.

E) continued message for at least 6 weeks will ensure they will internalize the message.

40)

A popular new method for reducing smoking is referred to as

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A) yap patching.

B) nicco-resting.

C) vaping.

D) e-niccorettes.

E) halo smoking.

41)

The focus of a social influence intervention program for smoking is

A) the potency of nicotine.

B) the impact of alcohol use on smoking behaviours.

C) the potential positive effects of smoking.

D) highlighting the economic burden that smoking has on society.

E) social learning.

42) Which of the following harm reduction alternatives to smoking provides a promising and safer option to quitting?

A) Cannabis edibles.

B) Nicotine gum.

C) Moderate alcohol consumption.

D) E-cigarettes.

E) Nicotine injections.

43)

Evaluation of social influence programs suggests that

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A) adolescent smoking rates are unaffected.

B) fewer adolescents begin smoking after exposure to such programs.

C) adolescent smoking rates are reduced for up to four years.

D) social environments do not impact an adolescent's decision to begin smoking.

E) these programs may delay smoking but do not necessarily reduce overall smoking rates.

44) If researchers were to design a study assessing the effectiveness of the life-skills training approach for smoking prevention, which of the following factors should they measure?

A) Attitude, mood, and academic achievement.

B) Physical skills.

C) Self-esteem, coping skills, and self-image.

D) Cognitive skills E) Physical and cognitive skills.

45)

Passive smoking (second-hand smoke) has been found to be associated with

A) normal blood carbon monoxide levels.

B) increased pulmonary functioning.

C) elevated skin plasticity.

D) childhood obesity.

E) increased rates of lung cancer.

46)

Anorexia nervosa

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A) is more common among men.

B) is characterized by the binge-and-purge syndrome.

C) is characterized by reduced interest in food and restricted physical activity.

D) is characterized by dieting and exercising that results in weight loss that is significantly below optimal levels.

E) occurs when people are nervous about being anorexic.

47)

Anorexia has been found to be correlated with

A) body image distortions.

B) successfully attracting romantic partners.

C) higher self-esteem.

D) sedentary lifestyles.

E) cheerful disposition.

48)

Initial therapy for anorexia is focused on weight gain and usually uses a approach.

A) forced feeding B) plant-based diet C) sedentary D) behavioural E) binge-eating

49) Addressing which of the following factors would NOT be helpful in understanding the origins of Jessie's anorexia nervosa?

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A) Jessie's stress.

B) Jessie's sedentary lifestyle.

C) Jessie's genetics.

D) Jessie's body image.

E) Jessie's social circle.

50)

In bulimia, the individual

A) avoids food altogether.

B) eats very little.

C) purges the last meal of the day.

D) eats a lot.

E) passes through cycles of binge eating and purging the eaten food.

51) Most therapies for anorexia utilize appears to be the most effective treatment for bulimia.

, whereas

A) behavioural therapy; medication and cognitive-behavioural therapy B) electro-convulsion therapy; hypnosis C) forced feeding; electro-convulsion therapy D) medication and inpatient treatment; cognitive-behavioural therapy E) brainwashing; hypnosis

52) Many health-compromising behaviours share several important characteristics. Describe at least two shared characteristics and explain how health professionals can intervene in each case.

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53)

Explain the biological, sociological, and psychological consequences of illicit drug use.

54) Explain the relationship between drinking alcohol, emotional regulation, and stress.

Provide an example of alternative/healthier behaviours that can be used to cope with emotional dysregulation and stress.

55) Explain the problem of relapse in the treatment of alcohol abuse. Which intervention strategies address this problem most effectively? Substantiate your answer with research from the text.

56) Answer the question posed in the text: "Why do people smoke?" Explain why some people are more likely than others to smoke on a regular basis.

57) Describe the factors associated with smoking in adolescence. Evaluate the effectiveness of prevention programs targeting adolescents.

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58) Describe the similarities and differences of anorexia and bulimia, including causes, symptoms, and treatment.

59)

Adolescence is a particularly vulnerable time for health compromising behaviours. ⊚ ⊚

true false

60) Many health compromising behaviours are more common in individuals from higher social classes. ⊚ ⊚

61)

Harm reduction focuses on completely eliminating substance use. ⊚ ⊚

62)

true false

true false

There are four main classes of illicit drugs. ⊚ ⊚

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true false

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63) Psychological and social rewards associated with drinking include reduced anxiety and depression. ⊚ ⊚

true false

64) Individuals of lower socioeconomic status (SES) are more likely than those of higher SES to succeed in treatment for an alcohol use disorder. ⊚ ⊚

true false

65) Trying cigarettes makes a person significantly more likely to use other drugs in the future. ⊚ ⊚

66)

Smokers have more accidents and injuries at work. ⊚ ⊚

67)

true false

Anorexia nervosa is classified as an obsessive disorder. ⊚ ⊚

68)

true false

true false

Bulimia is a characterized by alternating cycles of bingeing and purging.

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⊚ ⊚

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Answer Key Test name: Chapter 05 Test Bank 1) A 2) D 3) C 4) A 5) B 6) E 7) C 8) D 9) B 10) C 11) D 12) C 13) D 14) E 15) B 16) C 17) D 18) C 19) D 20) D 21) C 22) A 23) C 24) B 25) A 26) A Version 1

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27) D 28) C 29) D 30) E 31) C 32) B 33) D 34) D 35) B 36) A 37) D 38) A 39) D 40) C 41) E 42) D 43) E 44) C 45) E 46) D 47) A 48) D 49) B 50) E 51) A 52) Answers may vary.

53) Answers may vary.

54) Answers may vary.

55) Answers may vary.

56) Answers may vary.

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57) Answers may vary.

58) Answers may vary.

59) TRUE 60) FALSE 61) FALSE 62) FALSE 63) TRUE 64) FALSE 65) FALSE 66) TRUE 67) TRUE 68) TRUE

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Student name: 1)

Stress can be defined as a negative emotional experience accompanied by predictable

A) biochemical changes only.

B) cognitive changes only.

C) behavioural and physiological changes.

D) cognitive and physiological changes.

E) biochemical, physiological, cognitive, and behavioural changes.

2)

Which of the following could be considered a stressor?

A) Soothing music.

B) A bubble bath and an early bedtime.

C) Commuting to work on traffic-free roads.

D) A bad relationship.

E) Arriving on time for a test.

3) In 2017, almost bit" or "extremely stressful."

of Canadians reported feeling that most days were "quite a

A) 100% B) 75% C) 50% D) a third E) a fifth

4)

The fight-or-flight response

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A) is never adaptive.

B) involves arousal of the parasympathetic nervous system and the endocrine system.

C) involves arousal of the sympathetic nervous system and the endocrine system.

D) is exclusively a human behavior.

E) is more common in women than men.

5)

Selye's (1956, 1976) studies of the general adaptation syndrome investigated responses to stress.

A) psychological B) gastrointestinal C) adrenomedullary D) adrenocortical E) immune

6)

The correct sequence of phases of the general adaptation syndrome is

A) alarm, resistance, exhaustion.

B) exhaustion, resistance, alarm.

C) resistance, alarm, exhaustion.

D) resistance, exhaustion, alarm.

E) alarm, exhaustion, resistance.

7) According to Selye (1956, 1976), the phase of the general adaptation syndrome is responsible for the physiological damage that lays the groundwork for the development of disease.

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A) alarm B) resistance C) exhaustion D) stressor E) immune

8)

According to his critics, Selye's (1956, 1976) model

A) fails to offer a general theory of reactions to a wide variety of stressors over time.

B) has too many phases.

C) is limited because his research was only conducted on humans and not animals.

D) fails to consider the role of psychological appraisal in stress.

E) is inaccurate because he believed that stress could also be experienced without the general adaptation syndrome.

9) Rani is under constant stress and has a severe cold all the time despite taking medications to cure herself. Rani is in the stage of the General Adaptation Syndrome.

A) alarm B) resistance C) persistence D) exertion E) exhaustion

10)

The tend-and-befriend response to stress

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A) is especially characteristic of males.

B) is related to the release of the hormone, testosterone.

C) may be protective of offspring.

D) takes social behaviour out of the stress processes.

E) discourages nurturing.

11)

Amy reaches out to her friends when she is stressed. This is an example of

.

A) tending B) lending C) befriending D) tending-and-mending E) tending-and-befriending

12)

Oxytocin

A) is the primary biological factor in the tend-and-befriend response to stress.

B) increases mothering behaviour.

C) decreases warm touching between couples.

D) has effects that are unrelated to those of estrogen.

E) is highly addictive.

13)

The process of primary appraisal involves the evaluation of one's

A) current emotional state.

B) perception of a new or changing environment.

C) coping ability.

D) resources.

E) current physiological state.

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14)

The process of secondary appraisal involves the evaluation of one's

A) current emotional state.

B) general adaptation syndrome.

C) coping ability and resources.

D) perception of a new or changing environment.

E) current physiological state.

15)

According to Lazarus's model, the subjective experience of stress is a result of

A) the general adaptation syndrome.

B) primary appraisal.

C) secondary appraisal.

D) the balance between primary and secondary appraisal.

E) a low coping ability.

16) Reactivity is a term used to describe our predisposition to react physiologically to stress.

Reactivity is believed to have a partially basis.

A) genetic B) limited C) random D) sociological E) limitless

17)

Allostatic load can be assessed by

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A) a low waist-to-hip ratio.

B) problems with respiration.

C) increases in cell-mediated immunity.

D) the inability to shut off cortisol in response to stress.

E) problems with psychomotor activities.

18)

One study found that children exposed to chronic environmental noise demonstrated

A) enhanced mental processing.

B) low increases in blood pressure to a variety of different stressors.

C) longer attention spans.

D) a heightened sense of hearing.

E) enhanced fine motor skills.

19)

Physiological habituation may not occur or may not be complete when stressors are

A) family-related.

B) work-related.

C) short-term.

D) long-term.

E) low-level.

20)

Post-traumatic stress disorder (PTSD) has been associated with

A) temporary changes in the brain, involving the amygdala.

B) decreased cortisol, norepinephrine, and epinephrine.

C) biochemical and hormonal alterations that last over a long period.

D) chronically decreased T cell count.

E) improvement in memory and concentration.

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21) In Glass and Singer's (1972) study of university students, it was found that the students exposed to performed worse on tasks given to them.

A) intermittent bursts of noise B) over-crowding C) low-level light D) electric shock E) an overheated room

22) In the study of York University students, Friedlander et al. concluded that better adjustment of students was predicted by

A) increased social support from family.

B) increased social support from friends.

C) achieving good grades.

D) the university's support system.

E) individualized attention from professors.

23) The paradigm takes people into the laboratory, exposes them to shortterm stressful events, and then observes the impact of that stress on their physiological, neuroendocrine, and psychological responses.

A) acute stress B) induced disease C) SRRS D) hassles E) RLCQ

24)

Stress in laboratory tests may be reduced by

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A) making sure the researchers use a non-nonsense approach.

B) high levels of ultraviolet light.

C) the presence of a supportive other person.

D) consuming alcoholic beverages before testing.

E) having the participant count backwards from 100 as fast as they can.

25)

According to Holmes and Rahe (1967), an event is potentially stressful if it

A) occurs early in the morning.

B) involves the use of potential rewards.

C) is short-term.

D) requires substantial adjustment to the environment.

E) requires insubstantial adjustment to the environment.

26) According to Holmes and Rahe (1967), which of the following life events would be considered the most stressful?

A) Vacation.

B) Death of a spouse.

C) Christmas.

D) Getting a traffic ticket.

E) Changing one's residence.

27) A recent review of over 150 studies examining the effects of psychosocial factors including stressful life events found that experiencing stressful life events was linked to

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A) improved self-esteem.

B) cancer prognosis.

C) greater career success.

D) higher mating potential.

E) increase self-confidence.

28) Which of the following is a valid criticism of Holmes and Rahe's (1967) Stressful Life Events?

A) It is uncorrelated with illness and health behaviours.

B) It fails to consider individual differences in the experience and reporting of events.

C) It is impossible to measure stress.

D) It fails to consider the impact of multiple stressful life events.

E) The inconsistent research findings.

29) Which of the following is NOT a valid criticism of Holmes and Rahe's (1967) Stressful Life Events?

A) Some of the items on the list are too specific.

B) Individual differences in the experience of events are not taken into account.

C) It treats both positive and negative events in a similar fashion.

D) It does not assess whether events have been resolved or not.

E) Assessing specific stressful events may also tap ongoing life strain.

30)

Which of the following would NOT be considered a daily life hassle?

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A) Being stuck in a traffic jam.

B) Getting a divorce.

C) Waiting in line.

D) Losing a cell phone.

E) Deciding what to cook for dinner.

31)

Daily hassles are minor life events that

A) have a cumulative effect on health and illness.

B) are not confounded with mental and physical illness.

C) have an objective, but not subjective, component.

D) don't really affect physical health.

E) don't actually have any effect on psychological well-being.

32)

Daily hassles affect health through

A) increasing the likeliness of illness.

B) the "checks and balances" theory.

C) the "pendulum theory."

D) decreasing resilience.

E) challenging our spiritual beliefs.

33) Upon reaching the phone company's office to pay his bill on the due date, Ali was upset as he had to wait in a long queue. Moreover, as it was lunch time, there were fewer than usual cashiers helping the customers. Ali's experience is an example of

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A) hunger pangs.

B) a monthly hassle.

C) a weekly stressor.

D) a daily hassle.

E) a chronic stressor.

34) The study of women who were pregnant and living in Quebec during the ice storm of January 1998 found that

A) children exposed to a higher level of stress in utero had faster cognitive and language development because they released higher levels of stress and growth hormones.

B) even at five and half years old, children who were exposed to the ice storm while they were in utero showed permanent frostbite.

C) higher stress experienced by the mother during the ice storm was linked to her child's inability to regulate body temperature.

D) children exposed to a higher level of stress in utero had poorer cognitive and language development at age two and scored lower on IQ and language tests at age five and a half.

E) there was an increase in maternal tend-and-befriend behaviour.

35) Ben's father is physically abusive. What's worse is that Ben's mother and siblings never show him emotional or physical affection. Ben belongs to a(n) family.

A) tough love B) foreign C) risky D) old-school E) well-disciplined

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36) Tejash is involved in a long-term but ultimately unsatisfying relationship with Lee. This is an example of

A) an acute stressor.

B) a distal stressor.

C) an acute-traumatic stress syndrome.

D) chronic strain.

E) post-traumatic stress disorder.

37)

The stress from being bullied

A) has only immediate effects on well-being.

B) is only experienced by millennials.

C) is only experienced by females.

D) is only experienced by males.

E) can have both immediate and long-lasting effects on well-being.

38)

Based on the research conducted by Bauman and Newman (2013), we can determine that

A) cyberbullying is more stressful than traditional acts of bullying.

B) cyberbullying is less stressful than traditional acts of bullying.

C) cyberbullying is only stressful for millennials.

D) cyberbullying is only stressful for females.

E) cyberbullying is not uniformly more stressful than traditional acts of bullying.

39) Employees with work overload experience overload.

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A) feel more privileged B) have a higher self-esteem C) sustain less health risks D) have a lower risk of cardiovascular disease E) experience higher levels of occupational stress

40)

"Karoshi" refers to

A) sudden nocturnal death.

B) death from overwork.

C) stress-related mental illness.

D) caregiver burnout E) a higher level of stress on Mondays.

41) Ivan has been having difficulty meeting the demands of the two executives who oversee his work area and communicate conflicting expectations. One executive is concerned about production and constantly urges Ivan to meet performance quotas. The other is concerned about quality assurance and would like Ivan to slow down and focus on the quality of his work. This is an example of

A) role ambiguity.

B) role conflict.

C) work pressure.

D) role divergence.

E) work ambiguity.

42)

The inability to develop satisfying social relationships can result in

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A) less stress.

B) less psychological distress at work.

C) less workplace drama.

D) both poor physical and mental health outcomes.

E) more productivity.

43)

Karasek (1981) found that job strain can lead to

A) depression.

B) cancer.

C) coronary artery disease.

D) influenza.

E) weight gain.

44)

A stressful work environment

A) is one where demands are high, and support and control are low.

B) is linked to lower rates of workplace bullying.

C) demands are low and support is high.

D) demand and support are low.

E) supervisors are too easy going.

45)

Workers who cannot participate actively in decisions about their jobs show

.

A) lower rates of absenteeism B) no job turnover C) punctuality D) work of high quality E) high rates of sabotage

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46)

Researchers investigating the effects of multiple roles on women conclude that

A) B)

women are wired differently than men and do not suffer any negative consequences. having control and flexibility over the work environment increases the likelihood of

stress.

C) having adequate childcare does not have any effect on stress levels.

D) it protects women from depression.

E) single working mothers are five times more likely to suffer from certain cancers.

47) Joseph is stressed out because he's finding it difficult to be a good husband, father, and employee. How can he reduce his stress?

A) Take on another job.

B) Find meaning in his life.

C) Leave his family to focus on his career.

D) Increase his alcohol consumption to cope with the stress.

E) He'll just have to ride it out until the kids are 18.

48)

Explain how stress is determined according to the "Person-Environment Fit."

49) Compare and contrast the primary and secondary appraisal of the cognitive transactional model of stress.

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50)

Is it possible for people to adapt to stress?

51) A group of friends are discussing the different ways in which life can "get at you." Pat says it's the milestones in life that are most stressful, illustrating this point by describing several traumatic divorces and untimely deaths from which family members have yet to recover. On the other hand, Lee asserts that it's the little, constant annoyances in life that are most harmful to psychological and physical health, citing the annoyance experienced while commuting to work every day or coping with an intrusive landlord. Evaluate both of these arguments, citing research from the text.

52) How does workplace stress affect health? Describe how both employers and employees can reduce occupational stress?

53)

Stress is determined by person-environment fit. ⊚ ⊚

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54) According to the general adaptation syndrome there is a heightened resistance during the alarm phase. ⊚ ⊚

true false

55) Mary is more likely than Steve to cope with stress through social and nurturant behaviours. ⊚ ⊚

true false

56) Compared to positive events, negative events show a stronger relationship to psychological distress but not physical symptoms. ⊚ ⊚

true false

57) The unique thing about human beings is that we do not have to experience a stressful event in order to experience stress. ⊚ ⊚

true false

58) Research suggests that habituation may not occur after exposure to long-term stressors and that the immune system may be particularly compromised by long-term stress. ⊚ ⊚

true false

59) Daily minor problems reduce psychological well-being in the short term, but do not produce physical symptoms.

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⊚ ⊚

true false

60) It is possible for stressful life events to contribute to the development of the common cold, but not something as serious as cancer. ⊚ ⊚

true false

61) The perception of work overload shows a stronger relationship to physical health complaints and psychological distress than do objective measurements of workload. ⊚ ⊚

true false

62) Research on multiple roles and stress among working parents indicates that men have more trouble balancing the demands of working and parenting because they spend more time providing child care. ⊚ ⊚

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Answer Key Test name: Chapter 06 Test Bank 1) E 2) D 3) E 4) C 5) D 6) A 7) C 8) D 9) E 10) C 11) E 12) B 13) B 14) C 15) D 16) A 17) D 18) B 19) D 20) C 21) A 22) B 23) A 24) C 25) D 26) B Version 1

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27) B 28) B 29) A 30) B 31) A 32) A 33) D 34) D 35) C 36) D 37) E 38) E 39) E 40) B 41) B 42) D 43) C 44) A 45) E 46) E 47) B 48) Answers may vary.

49) Answers may vary.

50) Answers may vary.

51) Answers may vary.

52) Answers may vary.

53) TRUE 54) FALSE 55) TRUE 56) FALSE Version 1

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57) TRUE 58) TRUE 59) FALSE 60) FALSE 61) TRUE 62) FALSE

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Student name: 1) Coping involves thoughts and behaviours to manage stressful situation.

and

demands of a

A) light; heavy B) serious; semi-serious C) positive; negative D) internal; external E) emotional; spiritual

2)

Which of the following is NOT an external resource for coping?

A) Effort.

B) Time.

C) Money.

D) Housing.

E) Friendships.

3)

Research on the effects of procrastination on health behaviours has found that

A) procrastination is not linked to health problems.

B) procrastination is linked to fewer health protecting and health-promoting behaviours, as well as the practice of unhealthy behaviours.

C) procrastination is linked to a delay in the practice of unhealthy behaviours.

D) procrastination is an indication of "selective prioritization."

E) procrastination is not linked to the practice of unhealthy behaviours.

4)

Current research suggests that some forms of perfectionism

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A) are associated with higher stress.

B) is associated with the practice of fewer wellness-promoting behaviours.

C) are associated with lower stress.

D) may serve to improve heart health.

E) are associated with lower stress, the practice of greater wellness-promoting behaviours, and increase the risk of longevity among older adults.

5) Coping is defined as the process of trying to taxing or exceeding one's resources.

that are appraised as

A) control outcomes B) manipulating relationships C) manage demands D) multi-task E) predict outcomes

6)

The consideration of coping as a dynamic process implies that

A) coping involves a wide range of actions and inactions to stress.

B) coping efforts can only be moderated by personal resources.

C) coping involves an ongoing set of individual responses, regardless of the environment.

D) coping involves an ongoing series of interactions by which the person and the environment are involved in a reciprocal interaction.

E) coping is exclusively dependent on the environment.

7)

Negative affectivity

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A) is a personality variable marked by a pervasive negative mood.

B) and positive affectivity are terms that are no longer used in health psychology.

C) indicates effective coping strategies.

D) is not linked to higher risk for mortality in old age.

E) is impacted by gluten sensitivity.

8)

Individuals who are high in negative affectivity

A) are less likely to use health services.

B) are more prone to have genetic markers linked to alcohol dependence.

C) suppress symptoms of psychological distress and physical illness.

D) are not prone to anxiety.

E) have a decreased risk of suicide.

9) An individual with a pessimistic explanatory style is more likely to interpret negative events in terms of qualities of the self.

A) external, unstable, specific B) external, stable, global C) internal, unstable, global D) internal, stable, global E) internal and unstable

10) Wilma has experienced increasing levels of stress due to her deteriorating test scores in psychology. She complains to her friend Betty, "I can't seem to get the hang of this stuff, and I never will." I'm going to fail at everything in life." Wilma is displaying .

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A) optimism B) pessimism C) realism D) externalism E) bedrockism

11) A study of post-menopausal women conducted by O'Donovan and colleagues (2009) found that pessimistic explanatory style is associated with

A) poorer functioning cell-mediated immunity.

B) lower rates of physical illness.

C) increased use of health facilities.

D) increased energy levels.

E) a lack of physical symptoms.

12) According to Brissette, Scheier, and Carver (2002) adaptive coping strategies compared to pessimists.

may use more

A) Sagittarius B) realists C) optimists D) determinists E) females

13) is defined as treating oneself with kindness, feeling connected with humanity, and being mindfully aware of distressing experiences.

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A) Optimism B) Personal responsibility C) Self-compassion D) Pamperdness E) Perfectionism

14) The belief that one can determine one's own internal states and behaviour, influence one's environment, and/or bring about desired outcomes is

A) optimism.

B) psychological control.

C) self-efficacy.

D) hardiness.

E) gratitude.

15)

Perceived control has been closely related to

A) low self-esteem.

B) false beliefs.

C) low self-efficacy.

D) increased self-efficacy.

E) neuroticism.

16)

High self-esteem may

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A) dampen the stress response.

B) trigger the fight-or-flight response.

C) decrease one's ability to effectively cope with stress.

D) moderate the stress-illness relationship.

E) has no association to the stress-illness relationship.

17) Research investigating the effectiveness of avoidant and approach coping strategies suggests that

A) avoidant strategies are effective in dealing with long-term stressors.

B) approach coping strategies are associated with positive health outcomes, whereas, avoidant coping is associated with negative health outcomes.

C) both avoidant and approach strategies are equally ineffective in coping with stress.

D) both avoidant and approach strategies are equally effective in coping with stress.

E) approach coping strategies are associated with negative health outcomes, whereas, avoidant coping strategies are associated with positive health outcomes.

18)

Emotion-focused coping involves efforts to

A) solve the problems that preceded the stressful event.

B) regulate emotions experienced because of a stressful event.

C) avoid any emotions associated with a stressful event.

D) experience as many emotions as possible during a stressful event.

E) solve the problems that occurred after the stressful event.

19) When Rita underwent major surgery, her husband was by her side all along. He provided strong emotional support making the coping process of dealing with stress very easy for her. This example illustrates which of the following forms of relationship-focused coping?

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A) Partnered coping.

B) Symbiotic coping.

C) Synchronized coping.

D) Dyadic coping.

E) Empathic coping.

20)

One of the most potent external resources with respect to health is

A) having good luck.

B) intrapersonal balance.

C) socio-economic status.

D) genetic factors.

E) environmental health.

21)

People who are higher in socio-economic status (SES) show

A) higher morbidity for medical and psychiatric disorders.

B) higher mortality from all causes of death.

C) high cancer rates.

D) high rates of cardiovascular diseases.

E) lower mortality from all causes of death.

22) Pedro struggles to achieve consistent academic success. However, despite his frustration, Pedro's desire to continue his education seems to increase after each failed attempt. Pedro is demonstrating which of the following health psychology concepts?

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A) Introversion.

B) Extroversion.

C) Tend-and-befriend.

D) Resilience.

E) Educational fortitude.

23) people experience positive emotions even in the context of otherwise intensely stressful events.

A) Pessimistic B) Resilient C) Perfectionistic D) Neurotic E) Emotional

24) Coping efforts centre on five main tasks. Which of the following tasks addresses the issue of interpersonal connection?

A) Maintaining a positive self-image.

B) Reducing harmful environmental conditions and enhancing the prospects of recovery.

C) Maintaining emotional equilibrium.

D) Continuing satisfying relationships with others.

E) To tolerate or adjust to negative events or realities.

25) When a supportive companion is present during a stressful situation, research has shown a subdued HPA axis response in participants. This is thought to be due to

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A) the release of oxytocin.

B) the release of cortisol.

C) an increased cardiovascular response.

D) the release of exogenous opioids.

E) a suppressed immune system.

26) is defined as information from others that one is loved and cared for, esteemed and valued, and part of a network of communication and mutual obligations from parents, spouse or lover, other relatives, friends, social and community contacts, or even a devoted pet.

A) Coping.

B) Internal resources.

C) Social support.

D) External resources.

E) Perceived control.

27)

involves the provision of services, financial assistance, or goods.

A) Visible support B) Tangible assistance C) Invisible support D) Monetary assistance E) Perceived social support

28) Kieran recently dislocated his shoulder playing soccer. Kieran's best friend had the same injury last year and has helped ease Kieran's stress by providing information about the rehab process and what to expect once he returns to playing soccer. Which type of social support is Kieran's best friend offering?

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A) Rehab support.

B) Informational support.

C) Tangible support.

D) Injury support.

E) Intrapersonal support.

29)

is defined as the assurance that one is a valuable individual who is cared for.

A) Emotional support.

B) Tangible assistance.

C) Visible support.

D) Instrumental support.

E) Invisible support.

30)

Invisible support

A) is a type of social support provided to someone without that person being aware that they are receiving support.

B) is the perception that when you need social support, it will be available.

C) often produces a sense of guilt from the person receiving the support.

D) is support that cannot be seen by anyone, including the person offering the support.

E) leads to a sense of obligation to support others.

31)

Explicit social support

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A) is defined as knowing that you have a social network that you can rely upon if there were a stressful event.

B) is a form of invisible social support.

C) is the only form of social support that that actually involves a social network.

D) always involves the exchange of tangible resources.

E) includes tangible, informational, and emotional support.

32)

Which of the following is NOT an example of the benefits of social support?

A) Reduced risk of mortality due to serious disease.

B) Discounted health care costs.

C) Faster recovery from treatment.

D) Faster recovery from illness E) Lowered likelihood of illness.

33)

According to the buffering hypothesis,

A) B)

social support is only effective at helping people cope during periods of low stress. social support is only effective at helping people cope during periods of moderate

stress.

C) social support is only beneficial for a stressed individual's psychological health.

D) social support acts as a reserve and resource that blunts the effects of stress or enables the individual to cope with stress more effectively when it is at high levels.

E) social support is only beneficial for a stressed individual's physiological health.

34) Dwayne has a supportive family and many supportive friends. Dwayne seems to benefit from his social support system during both highly stressful times and non-stressful times. Which hypothesis supports Dwayne's experience?

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A) Bidirectional effects hypothesis.

B) Redirect effects hypothesis.

C) Indirect effects hypothesis.

D) Direct effects hypothesis.

E) Buffering hypothesis.

35) Adi has been experiencing a lot of work stress lately. He's not sure how to cope effectively and usually finds himself socially isolated. Adi also doesn't expect to receive social support from anyone. Which type of attachment style does Adi demonstrate?

A) Secure.

B) Insecure.

C) Super secure.

D) Moderately secure.

E) Mildly secure.

36) The interplay of the stress experienced and expressed by one partner and the coping reactions of the other is referred to as

A) the matching hypothesis.

B) dyadic coping.

C) implicit social support.

D) the coping response.

E) invisible coping support.

37) The hypothesis that a match between one's needs and what one receives from others in one's social network is called the

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A) direct effects hypothesis.

B) buffering hypothesis.

C) matching hypothesis.

D) empathetic understanding.

E) dyadic hypothesis.

38)

According to Repetti et al., (2002), social support from one's parents in early life in later life.

A) affects coping but not health B) affects coping and health C) affects health but not coping D) predicts less independence E) does not affect coping and health

39)

Mindfulness-based stress reduction

A) is based on the practice of mindfulness of moment or moment awareness.

B) may be helpful but only among non-clinical populations.

C) is a form of "distraction therapy."

D) is geared toward producing automatic stress responses.

E) helps people escape stressful moments by encouraging them to focus on the future.

40) According to studies by Li and Ferraro (2005) and C. Schwartz, Meisenhelder, Ma, and Reed (2003), evidence suggests that on the whole, people who provide support to others

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A) suffer from poor mental health.

B) enjoy better mental and physiological health.

C) suffer from poor physical health D) do not experience health benefits.

E) are selfish.

41) Researchers investigating disclosure have found that subjects who freely express their feelings about traumatic events

A) show increased levels of physiological arousal.

B) have difficulty maintaining emotional support from others.

C) are more likely to have subsequent health problems.

D) are less likely to have subsequent health problems.

E) require lengthier hospital stays following surgery.

42) Research indicates that exercise may be a useful resource for combating the adverse effects of stress. Your text suggests this may be because exercise

A) appears to suppress the immune system.

B) appears to modulate immune activity during stress.

C) decreases exogenous opioids.

D) permanently erases bad memories of stressful experiences.

E) increases exogenous opioids.

43)

Relaxation training and stress management programs

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A) are only designed to affect the psychological experiences of stress.

B) are good in theory but have not been shown to produce measurable heath improvements.

C) have been shown to improve physical and psychological health.

D) are only designed to affect the physiological experiences of stress.

E) are not evidence-based.

44)

Which of the following is NOT an example of relaxation training?

A) Progressive muscle relaxation.

B) Guided imagery.

C) Transcendental meditation.

D) Aerobic exercise.

E) Yoga

45)

Stress management programs typically involve

phases.

A) two B) three C) four D) five E) six

46) Theshani is taking a stress management class. Her instructor provides a variety of ways Theshani can combat her stress. Theshani is instructed to try several of these techniques in order to discover the skills that work best for her. The instructor is using something known as training.

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A) stress buffer B) zen C) multi-task D) stress inoculation E) inoculation management

47)

Relaxation training techniques are

A) useless because the human stress response is genetically predetermined.

B) designed to reduce the physiological arousal associated with stress.

C) not evidence based.

D) can only be practiced by those who are enlightened.

E) physiologically ineffective.

48)

According to the text, individuals that cause you special stress are known as

A) stress carriers.

B) stress transmitters.

C) stress zombies.

D) stress alligators.

E) stress flees.

49) Explain what is meant by the term stress moderator. Identify three psychological variables and three social variables that have been found to moderate stress. Citing research from the text, explain the relationship between these variables and the experience of stress.

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50) Explain how individual differences in personality are related to coping, and how these differences impact health.

51) Explain how coping styles and coping strategies moderate the experience of stress. Citing research from the text, evaluate the effectiveness or ineffectiveness of one coping style and one coping strategy, and explain the potential health impact of each.

52) Compare and contrast three types of social support. In your answer, provide examples for each type.

53) Your roommate is suffering from stress due to final exams. Using the techniques described in the text, design a simple stress management program to assist your roommate.

Explain the function of each component and why it should be included in the program.

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54) The human stress response is universal. In other words, everyone responds the same way to stressors. ⊚ ⊚

true false

55) Individuals that are high in negative affectivity (or neuroticism) are more prone to have genetic markers linked to health compromising behaviours, mental illness, and suicidality. ⊚ ⊚

true false

56) External coping resources may include time, money, education, a decent job and the absence of other life stressors. ⊚ ⊚

true false

57) Psychological resilience means being able to bounce back from negative emotional experiences and by adapting flexibly to the changing demands of stressful experiences. ⊚ ⊚

true false

58) Refusing to tolerate or adjust to negative events or realities is an effective approach to coping. ⊚ ⊚

59)

true false

Coping efforts are considered successful when they reduce the arousal related to stress.

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⊚ ⊚

60)

true false

Social support can decrease an ill individual's recovery time. ⊚ ⊚

true false

61) Whereas social support is associated with physical and psychological well-being, research has failed to establish a relationship between social support and good health habits. ⊚ ⊚

true false

62) According to the matching hypothesis, social support is only effective if the individual providing the support matches the psychological state of the individual receiving the support. ⊚ ⊚

63)

true false

Yoga is an effective form of mindfulness-based stress reduction. ⊚ ⊚

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Answer Key Test name: Chapter 07 Test Bank 1) D 2) A 3) B 4) A 5) C 6) D 7) A 8) B 9) D 10) B 11) A 12) C 13) C 14) B 15) D 16) D 17) B 18) B 19) D 20) C 21) E 22) D 23) B 24) D 25) A 26) C Version 1

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27) B 28) B 29) A 30) A 31) E 32) E 33) D 34) D 35) B 36) B 37) C 38) B 39) A 40) B 41) D 42) B 43) C 44) D 45) B 46) D 47) B 48) A 49) Answers may vary.

50) Answers may vary.

51) Answers may vary.

52) Answers may vary.

53) Answers may vary.

54) FALSE 55) TRUE 56) TRUE Version 1

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57) TRUE 58) FALSE 59) TRUE 60) TRUE 61) FALSE 62) FALSE 63) TRUE

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Student name: 1)

Individual differences in neuroticism have been found to influence symptom

A) recognition but not reporting.

B) reporting but not recognition.

C) reporting and recognition.

D) severity.

E) hyperchondria.

2) Medical students' disease is an example of the role of recognition of symptoms.

in the

A) individual differences B) Type A behaviour C) cultural differences D) situational factors E) mood

3)

When under stress, people are more likely to

A) attribute stress-related physiological changes to stress rather than to illness.

B) exaggerate their perception and interpretation of the meaning of the symptoms.

C) believe they are less vulnerable to illness and direct their attention outward.

D) repress their physical symptoms.

E) delay seeking medical treatment.

4)

People in a negative mood

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A) suppress their symptoms.

B) believe they are more capable of alleviating their symptoms.

C) are pessimistic that any actions they might take would relieve their symptoms.

D) perceive themselves as less vulnerable to future illness.

E) tend to seek out more medical advice on the Internet.

5)

Symptom recognition is determined by individual differences in

A) attention to one's body and situational factors.

B) tolerance of physical symptoms and access to medical care.

C) physical reactivity and situational factors.

D) physical reactivity and cultural factors.

E) spiritual beliefs.

6) Compared to those with no history of a particular medical condition, people who have a history of a particular medical condition are more likely to

A) increase their vigilance and monitor their physical status to detect transitory changes in their bodily state.

B) increase their vigilance and seek out information about the condition in an attempt to regain mastery and control.

C) underestimate its prevalence in the general population and thus overestimate the threat to their health.

D) overestimate its prevalence in the general population and thus regard their situation as less serious.

E) disregard a symptom's meaning and how common it is within their culture.

7) Who of the following people is most likely to view their symptom as more serious and therefore seek treatment?

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A) Kerry, who injured her side after someone opened a door into her.

B) Eileen, who banged her knee on the coffee table edge.

C) Nada, who injured her hand from having a heavy object drop on it.

D) Kathy, who has a sore shoulder from painting the walls in her house.

E) Amina, who got a nick on her elbow.

8)

Illness schemas are acquired through

A) the media.

B) personal experiences.

C) medical dictionaries.

D) family and friends.

E) personal experience, the media, and family and friends.

9) One component of illness schemas involves perceptions of the range of symptoms and treatments associated with a particular disease. This component refers to the of the disease.

A) identity B) consequences C) cure D) causes E) symptoms

10)

Illness schemas develop in

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A) childhood.

B) adolescence.

C) early adulthood.

D) middle age.

E) they can develop at any age.

11) The or many symptoms.

model of illness is represented by alternating periods of either no

A) acute B) chronic C) cyclic D) terminal E) circular

12)

Disease models influence people's

A) preventive health behaviours.

B) adherence to treatment regimens.

C) expectations about their future health.

D) preventive health behaviours, adherence to treatment regimens, and expectations about their future health.

E) ability to cope with ambiguous symptoms.

13) Bruce has found that he becomes increasingly fatigued after even mild exertion. He discusses his problem with his neighbour, Sam, who recently suffered from a similar problem.

Sam tells him that a megadose of vitamin B complex completely eradicated his symptoms. Bruce tries Sam's remedy and does feel a little better. This is an example of

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A) folk medicine.

B) self-care.

C) disease prototypes.

D) the lay referral network.

E) cyber diagnosis.

14)

In Canada, complementary and alternative therapies

A) are viewed as simply unconventional or folk medicine.

B) can be self-administered or delivered by a practitioner.

C) exclude natural health products.

D) are often used because of the recommendation of friends and family members.

E) are less expensive than in most other countries.

15) The few studies conducted on this topic confirm that health anxiety is both a precursor and a product of .

A) hypochondria B) mitochondria C) perichondria D) cyberchondria E) cyber obsession

16)

Who is most likely to seek medical help?

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A) Anna, who has a mild cold.

B) Ram, who met with a serious injury in sports.

C) Dan, who cut himself a bit when slicing vegetables.

D) Sheila, who broke a nail.

E) Veena, who bled by stepping on a thorn.

17)

The use of health services is lowest in

A) childhood.

B) adolescence and young adulthood.

C) middle age.

D) old age.

E) infancy.

18) Women's higher use of medical care and poorer health than men may be attributed to the following factor(s):

A) higher rates of fulltime employment.

B) higher rates of part-time employment.

C) less economic hardship.

D) health care in Canada is specifically designed for women.

E) more access to benefits.

19)

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A) Lower levels of unemployment B) Lower rates of part-time employment C) Higher economic status D) More fragmented medical care E) Higher education

20)

Socio-economic factors that contribute to differences in the use of health services are:

A) income.

B) culture.

C) education.

D) that income and culture affect how health services are used, while education does not have any discernable effect.

E) that income, culture, and education are all factors that contribute to differences in how health services are used.

21) People from a lower socio-economic status (SES) make more use of health care services than people from a higher SES.

A) Studies have proved this.

B) Studies have not proved this.

C) The results from research on this topic are mixed.

D) The results from research on this topic are controversial.

E) The link between the use of health care services and SES is paradoxical.

22)

The Health Belief Model best predicts the treatment-seeking behaviour of

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A) men.

B) women.

C) ethnic minorities.

D) people who have access to health services rather than people who do not have access to health services.

E) the elderly.

23) The research conducted at Bishop's University in Quebec on the impact of linguistic barriers on the perceptions of health care services found that

A) Anglophones perceived that there were more health care services in English available to them than there actually were.

B) Anglophones were more satisfied with the services offered and therefore more likely to want to use these services in the future.

C) Anglophones rated their future health as significantly greater than that of Francophones if they remained living in Quebec.

D) Anglophones felt there were fewer health care services available to them, resulting in dissatisfaction with services received and a negative perception toward their future health care in Quebec.

E) Anglophones in Quebec deemed their health care equal to that of the Francophones living in the same province - language barriers do not affect the perception of health care.

24) The patient who complains of a medical disorder that is rightfully psychological in nature is more likely to be treated by a

A) psychiatrist.

B) general practitioner.

C) specialist.

D) lay practitioner.

E) psychologist.

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25)

Somaticizers

A) exhibit strong beliefs in self-care.

B) tend to express distress and conflict through physical symptoms.

C) repress their symptoms during times of stress.

D) will avoid stressors at any cost.

E) tend to express distress and conflict verbally.

26)

Which of the following answers best defines the term cyberchondria?

A) Excessive malingering on Internet chat rooms.

B) Worrying well after listening to health-related podcasts.

C) Excessive use of health-related Internet sites that increase anxiety.

D) Hypochondriasis as a result of Internet bullying.

E) Anxiety about a lack of secondary gains.

27)

The worried well

A) are concerned about physical and mental health.

B) tend to express distress and conflict through physical symptoms.

C) repress their symptoms during times of stress.

D) tend to use health services less.

E) are more likely to also have cyberchondria.

28) The notion that illness may actually be reinforcing because it exempts the individual from daily responsibilities is termed

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A) malingering.

B) delay behaviour.

C) secondary gains.

D) hypochondriasis.

E) somaticizing.

29)

With respect to delay behaviour,

A) people who are fearful of doctors, examinations, surgery, and medical facilities generally delay less than do people who are not fearful.

B) the elderly appear to delay more than middle-aged individuals.

C) people are less likely to visit a physician if they do not have a regular physician.

D) there is no danger associated with delay behaviour, people should seek medical help when they feel ready.

E) people who delay seeking medical help are considered nonusers.

30) doing so.

is the time between actually deciding to seek treatment and actually

A) Appraisal delay B) Illness delay C) Behavioural delay D) Medical delay E) Response delay

31)

Illness delay is the time

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A) it takes an individual to decide that a symptom is serious.

B) between the recognition that a symptom implies an illness and the decision to seek treatment.

C) between deciding to seek treatment and actually doing so.

D) between a person's recognition of a symptom and when the person seeks treatment.

E) between receiving the treatment and when a patient begins to feel better.

32)

The correct order of the stages of delay in seeking treatment is

A) appraisal, illness, behavioural, and medical delay.

B) behavioural, appraisal, illness, and medical delay.

C) appraisal, illness, medical, and behavioural delay.

D) appraisal, symptom, illness, and medical delay.

E) behavioural, illness, appraisal, and medical delay.

33) The nature of physical symptoms may play an important role in a patient's delay behaviour. Specifically, a patient will seek treatment less quickly when a symptom

A) is persistent over time.

B) is highly visible.

C) causes aches and pains.

D) is similar to a symptom that was previously deemed minor.

E) changes quickly.

34)

Medical delay

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A) accounts for at least 30% of all delay behaviours.

B) results from problems within the medical system.

C) is more likely in cases where the diagnosis is not serious.

D) is unrelated to the diagnostic process.

E) is more likely when symptoms are acute in nature.

35) You have been asked to develop a public information program designed to minimize the delay behaviour of people who evidence one or more of the seven warning signs of cancer.

Considering the research evidence presented in your text, the most effective appeal would emphasize the fact that

A) certain cancers have a very poor prognosis and a high mortality rate.

B) although the side effects can be debilitating, chemotherapy and radiation therapy can successfully treat many cancers.

C) aggressive treatment enhances one's chances of surviving cancer.

D) precancerous symptoms are seldom troublesome or alarming, yet everyone is vulnerable to the disease and should seek early treatment.

E) individuals with cancer-free parents do not need to get alarmed about any symptoms as cancer is genetic.

36) The role of the hospital has changed significantly over the last few decades. As hospitals have assumed many treatment functions, the average number of hospitalizations have

A) remained the same.

B) increased.

C) decreased.

D) leveled off.

E) increased and then decreased.

37)

In Canadian hospitals that have adopted a Johns Hopkins model, physician chiefs

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A) are at the top of the medical line of authority in the hospital.

B) are the first person to act in case of an emergency.

C) are not employees of the hospital.

D) do not treat patients.

E) act as "invited-guests" to the hospital.

38)

Nosocomial infections

A) occur even when strict handwashing and sterilization of equipment guidelines are practiced.

B) are the fourth leading cause of death in Canada.

C) are least likely to affect the elderly.

D) are infections that result from exposure to disease in the hospital setting.

E) have been reported in Ontario only.

39)

A quarter of a million Canadians per year suffer from

A) hospital infection.

B) influenza.

C) diabetes.

D) pneumonia.

E) heart disease.

40)

As reflected in the communication of hospital workers, occupational segregation

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A) is high.

B) is low.

C) is a myth.

D) exists only in some departments.

E) exists depending on the geographic location of the hospital.

41)

Which of the following is NOT one of the components of burnout?

A) emotional exhaustion B) increased concern for the client C) cynicism D) low sense of efficacy in one's job E) unsafe work conditions

42)

Psychologists in the hospital setting

A) have decreased in recent years.

B) have expanded their roles.

C) are involved in pre-surgery and post-surgery preparation of psychiatric patients only.

D) only diagnose and treat psychological problems that can complicate patient care.

E) have reduced their roles due to budgetary concerns.

43)

Burnout among nurses may result from

A) picking up heavy equipment.

B) better job prospects in other organizations.

C) experiencing emotional abuse in the workplace.

D) being overpaid.

E) working part-time.

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44)

Shields and Wilkins (2006) found that nurses in Canada

A) reported arriving late or leaving early from work.

B) reported that they were not given enough time to do what was expected of them.

C) experienced high physical demands from their job.

D) reported that they were not given enough time to do what was expected of them and experienced high physical demands from their job.

E) experience less burnout than nurses in the United States.

45) Nurses who experience job strain, low supervisor/co-worker support, low autonomy, poor nurse-physician working relations, high physical demands, and job insecurity were as likely to experience poor or fair physical and mental health compared to nurses who did not experience these demands.

A) 5 times B) 3 times C) 10 times D) 2 times E) 1.5 times

46)

People with burnout show elevated levels of

A) blood plasma.

B) red blood cells.

C) lipids.

D) chlorides.

E) cytokine.

47)

Psychological control in a hospital setting

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A) is only important for patients and not their families.

B) can be increased by providing the patient with information about their medical procedure only.

C) when increased can contribute to quick recovery of functioning.

D) cannot be achieved by providing extensive information about the admitting process.

E) does not contribute to quicken patient recovery.

48) According to a study by Kulik and Mahler in 1987, cardiac patients about to undergo surgery showed benefits when they specifically had a post-operative patient as a roommate. This could be in part due to the fact that

A) they were able to obtain information about what to expect after surgery.

B) they were relieved to see that their roommate survived the surgery.

C) they were able to obtain information about what to expect after surgery and were relieved to see that their roommate survived the surgery.

D) they had someone to talk to during non-visiting hours.

E) they got control of the television remote control, which is highly correlated to blood pressure.

49)

Research on the role of preparatory information in adjustment to surgery shows that

A) preparation is a waste of time and resources.

B) preparation is needed only when patients undergo major surgery.

C) preparation has beneficial effects on patients.

D) preparation is expensive and unnecessary.

E) patients do fine with or without preparation.

50) The results of Irving Janis's classic research (1958) evaluating presurgical controlenhancing interventions utilized with stressful medical procedures suggests that patient coping is facilitated by

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A) information about the procedure.

B) cognitive-behavioural interventions.

C) relaxation training.

D) hypnosis E) mood enhancing drugs.

51) In the study by Mahler and Kulik (1998) on the use of videos to prepare patients for upcoming procedures, compared with patients who did not receive videotaped preparation, patients who saw a videotape

A) reported higher self-efficacy during the recovery period.

B) reported much longer recovery times.

C) felt significantly better prepared for the recovery period.

D) were more adherent to recommended dietary and exercise changes during their recovery.

E) reported higher levels of anxiety prior to surgery.

52) Explain how social and individual factors are implicated in the recognition and interpretation of symptoms.

53) Answer the question posed by the text, "What predicts the use of health care services?"

Provide at least three examples in your answer.

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54)

What factors predict health care delay?

55) Explain how hospitalization may affect patients' sense of personal control. What reactions are commonly observed?

56) Summarize the research investigating the effectiveness of control-enhancing interventions.

57)

People's awareness of their internal physiological state is remarkably accurate. ⊚ ⊚

true false

58) According to the symptom perception hypothesis, people who are high in neuroticism or negative affectivity are less likely to recognize and report physical symptoms. ⊚ ⊚

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59) Illness, unintentional accident frequency, and the use of services decline in adolescence and throughout young adulthood. ⊚ ⊚

60)

true false

Women use the health care system more than men do. ⊚ ⊚

true false

61) With respect to "somaticizers," threats to self-esteem or to their accomplishments are related to their tendency to somaticize. ⊚ ⊚

62)

Physicians are more likely to perceive female patients as psychologically disturbed. ⊚ ⊚

63) die.

true false

true false

As recently as 60 or 70 years ago, hospitals were thought of as places where one goes to

⊚ ⊚

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true false

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64) Many of the infections contracted during a hospital stay could be decreased with proper handwashing. ⊚ ⊚

true false

65) Providing preparatory information to patients prior to surgery has little effect on their perception of control. ⊚ ⊚

66)

true false

Informational videos are unhelpful for patients preparing for medical procedures. ⊚ ⊚

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Answer Key Test name: Chapter 08 Test Bank 1) C 2) D 3) B 4) C 5) A 6) D 7) C 8) E 9) B 10) A 11) C 12) D 13) D 14) B 15) D 16) B 17) B 18) B 19) D 20) E 21) E 22) D 23) D 24) B 25) B 26) C Version 1

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27) A 28) C 29) C 30) C 31) B 32) A 33) D 34) B 35) D 36) C 37) A 38) D 39) A 40) A 41) B 42) B 43) C 44) B 45) D 46) E 47) C 48) C 49) C 50) A 51) D 52) Answers may vary.

53) Answers may vary.

54) Answers may vary.

55) Answers may vary.

56) Answers may vary.

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57) FALSE 58) FALSE 59) TRUE 60) TRUE 61) TRUE 62) TRUE 63) TRUE 64) TRUE 65) FALSE 66) FALSE

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Student name: 1) Xinghe is trained in traditional nursing and also has received special training in primary care. He is affiliated with a group of private practice physicians, sees his own patients, and provides routine medical care, prescribes treatment, and emphasizes health promotion and illness prevention. Xinghe is a(n)

A) advanced practice nurse.

B) nurse practitioner.

C) physician assistant.

D) clinical nurse specialist.

E) physician.

2)

What is the duration of the Physician Assistant Education Master's degree program?

A) One year.

B) Two years.

C) Three years.

D) Four years.

E) There is no such program yet.

3)

Patients

A) never judge the technical quality of the care they receive.

B) often judge technical quality of care on the basis of the manner in which the care was delivered.

C) feel that the technical quality of care is somewhat more important than the manner in which it was delivered.

D) are more qualified than their physicians to judge the technical of quality care they receive.

E) are indifferent to the technical quality of care that they receive.

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4)

The technical quality of medical care and the manner in which it is provided are

A) interrelated.

B) unknown.

C) dependent on each other.

D) unrelated.

E) bidirectional.

5)

Telehealth

A) includes a variety of services that use communication technology to connect people with health services.

B) is not used by nurses and nurse practitioners.

C) is an outdated communication tool.

D) is the only method of communication in Canada's health care system.

E) may be used for several health care issues, except for mental health.

6)

How long does an average visit to the physician last?

A) Under 5 minutes B) 5 to 9 minutes C) 10 to 12 minutes D) 12 to 15 minutes E) 15 to 18 minutes

7)

Which of the following is NOT an issue facing Canada's health care system?

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A) Indigenous Canadians are less likely to have a family physician.

B) Specialized care requires a referral.

C) Long wait times D) There is not enough family physicians, and long wait times E) Canada's health care system does not offer complementary and alternative medicine.

8) Why do people use CAM, given that traditional health care is paid for under Canada's universal health care system, and for the most part CAM is not?

A) The people who use CAM tend to have less health complaints, so they're encouraged to explore non-Western medical treatment when they do get sick.

B) CAM's are primarily focused on the biological roots of all health issues and are designed to produce positive results quickly.

C) Because people who identify as vegan and/or paleo on social media are exempt from the fees associated with CAM. D) The people who use CAM tend to be higher in socio-economic status, making cost less of an issue and consultations with CAM providers tend to be longer and often take psychosocial aspects of the patient's life into account.

E) CAM treatments take longer than traditional treatments, giving people more time off work, which is the ultimate goal.

9) The philosophy that health is a positive state to be actively achieved, not merely the absence of disease,

A) B)

is not prevalent in Western medicine. acknowledges physical and psychological influences but not spiritual influences on

health.

C) is a holistic approach to health.

D) is a traditional therapy in Western medicine.

E) is a non-holistic approach to health.

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10) According to the text, one of the changes in the philosophy of health care delivery that affects patient-provider relationships is

A) Western medicine's resistance to non-traditional therapies such as meditation and biofeedback.

B) in response to increased consumerism among patients, medical students become less egalitarian in their relationships with patients during the course of medical training.

C) that provider-patient relationships are becoming more egalitarian.

D) that a holistic view of health is not practical in Western society.

E) that a patient should not question or even discuss their care with their provider beyond what is necessary.

11) Which of the following is NOT an example of the changes in the philosophy of health care delivery?

A) The physician's role.

B) The acceptance and use of Western medicine.

C) The acceptance of alternative and complementary therapies.

D) The use of alternative and complementary therapies.

E) The sharing of responsibilities between physician, patients, and other health care providers.

12) Which of the following is a provider behaviour that interferes with provider-patient communication?

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A) Kindness.

B) Active listening.

C) Compassion.

D) Cooperation.

E) Sexism, not listening, elderspeak, and use of jargon are all behaviours that interfere with provider-patient communication

13)

The consequence of provider efforts to manage the interaction

A) may lead to acquiring too much important information.

B) may lead to loss of important information.

C) may result in a complete shift in responsibility to the patient.

D) may lead to giving the patient too much time to discuss their concerns.

E) may force the physician listen more actively.

14)

According to what the text says about the use of jargon, studies reveal that providers

A) accurately report that patients' knowledge of medical terms is quite low.

B) underestimate the level of their patients' understanding of medical terms.

C) overestimate the level of their patients' understanding of medical terms.

D) tend to blame themselves for their patients' lack of knowledge of medical terms.

E) are more effective at delivering care when they use medical jargon.

15)

When providers oversimplify terms for elderly patients, the result is

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A) more effective communication.

B) a positive overall impact to the patient's health.

C) that the elderly patient feels respected.

D) a decrease in the rate of recovery.

E) an increase in the rate of recovery.

16)

Elderspeak

A) has shown to be an effective communication technique in health care.

B) is an overly caring and infantilizing communication issue that sends the message that elderly people are incompetent.

C) is a communication style that is used between health care providers and children.

D) simplifies communication between patient and provider.

E) has a positive impact on the health care provider and the patient.

17)

Which of the following are often stereotyped as being quiet and passive?

A) Indigenous patients.

B) Spanish patients.

C) Western European patients.

D) South American patients.

E) Asian patients.

18)

Satisfaction with treatment tends to be higher when

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A) a person is seen by a provider of the same race or ethnicity.

B) the physician acts worried about the patient's health.

C) the physician takes an authoritative stance.

D) the physician is older than the patient.

E) the physician is shy and reserved.

19) The study by Ni Chróin'n and colleagues (2011) found that although 72 percent of patients being discharged felt that they had a good understanding of their diagnoses,

A) one-half did not follow-through with their doctor's recommendations.

B) older patients and those with cognitive impairments were less likely to have a clear understanding.

C) younger patients were more likely to falsely report their level of comprehension.

D) compared to women, men were less likely to follow-through with their doctor's recommendation.

E) more than half of the patients studied sought a second opinion to clarify the original diagnosis.

20)

One factor in patients' contribution to faulty communication is because patients

A) respond to different cues to illness than do practitioners.

B) always give their physicians accurate information about their health.

C) present their most distressing symptoms clearly and precisely; most faulty communication comes from the physicians.

D) have little difficulty interpreting and reporting their symptoms.

E) have no fear of asking questions during medical consultations.

21) Adi chose CAM over traditional treatment for treating his arthritis. Which of the following options best explains Adi's motivation to choose CAM treatment?

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A) The CAM provider fulfills needs not met by the conventional physician.

B) His physician is over-caring which makes him feel uncomfortable.

C) Because CAM is covered under OHIP+, so there's no additional costs associated.

D) Because Adi just wants to address his biological needs and nothing more.

E) Because CAM offers the best treatments that Western medicine has to offer.

22)

Qualities of the medical interaction that facilitate communication are

A) that providers receive little feedback from their patients.

B) that patients are more likely to provide negative rather than positive feedback.

C) that patients seldom provide feedback about the effectiveness of providers' communication.

D) that many patients are relatively cautious with providers.

E) about having agreeable personality traits.

23) Patients do not disclose their use of complementary and alternative medicine CAM to their physicians because they

A) all CAM treatments are to remain confidential and anonymous.

B) believe that their physician knows about their use of CAM from the CAM provider.

C) expect a negative response from their physician.

D) the use of CAM is shunned by the Canadian health care system.

E) will be charged extra fees by their physician.

24) The study of 20 randomly chosen hospitals in Quebec found that patients with communication problems in the delivery of their care

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A) were at greater risk for experiencing multiple preventable adverse events.

B) were less likely to complain to the ministry.

C) were more dissatisfied with the hospital staff.

D) tended to suffer from relatively minor health problems.

E) were the elderly.

25)

occurs when patients do not adopt the recommended medical treatment.

A) Malingering.

B) Reactance.

C) Doctor shopping.

D) Non-adherence.

E) Transference.

26) For short-term antibiotic regimens, an estimated _ adequately.

fail to comply

A) one-quarter B) one-third C) one-fifth D) three-quarters E) one-eighth

27)

The greatest cause of non-adherence to treatment is

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A) having too much social support.

B) when the health care regimens are too simple.

C) poor communication between the patient and physician.

D) when institutions modify their procedures to follow patients.

E) having too much trust and belief in the physician.

28)

For the most part, patients' estimates of their rates of adherence are

A) accurate.

B) unreliable and artificially high.

C) artificially low.

D) reliable and genuinely high.

E) reliable and creative.

29)

Adherence is higher in patients who are

A) anxious and vigilant.

B) satisfied with their provider.

C) younger, white, and female.

D) asked to change personal habits.

E) older.

30) Which of the following medical suggestions would be MOST likely to show high rates of non-adherence?

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A) "Take three tablets per day for five days."

B) "Please stop by the lab on your way out and have some blood drawn for a complete battery."

C) "Make sure you schedule a mammogram before your next appointment."

D) "Try to rest and take some annual leave from your job."

E) "Please bring a stool sample back to our office at your earliest convenience."

31)

Which of the following factors show the lowest level of overall adherence?

A) When the self-care regimens are simple to follow.

B) When the self-care regimens are complex.

C) When the self-care regimens include social support.

D) When the patient and physician have a satisfactory relationship.

E) When the patient has a desire to change their lifestyle.

32)

Avoidant coping strategies on the part of patients

A) are associated with good adherence to treatment regimens.

B) are associated with poor adherence to treatment regimens.

C) do not impact adherence or non-adherence.

D) have not yet been studied with respect to adherence and non-adherence.

E) are crucial for maintaining adherence.

33)

Creative non-adherence

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A) involves the arts as a core component of the treatment process.

B) is typically encouraged by physicians.

C) can also result from private theories about a disorder and its treatment.

D) is equally as effective as adherence.

E) is not associated with intelligent adherence.

34) Rana is required to take two pills of a statin in a day. He breaks the pills into quarters and has two quarters instead each day. Rana's behaviour is an example of

A) adherence.

B) non-adherence.

C) creativity.

D) creative adherence.

E) creative non-adherence.

35) When asked to explain non-adherence, physicians usually attribute it to several patient factors. Which of the following is NOT one of those factors?

A) Attention to detail.

B) Lack of motivation.

C) Forgetfulness.

D) Uncooperative personalities E) Ignorance.

36)

The best predictor of physician sensitivity is

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A) extraversion.

B) technical competence.

C) an interest in people.

D) idealism.

E) gender.

37)

Teaching physicians

can increase treatment adherence.

A) avoidant coping strategies B) to communicate effectively C) to ignore certain patient concerns D) to increase their use of medical jargon E) to dominate the patient-physician conversations

38)

Which of the following is NOT associated with patient-centered communication?

A) it is an important way to improve the patient outcomes.

B) it enlists the patient directly in decisions about medical care.

C) it is especially effective with "difficult" patients, such as those who are high in anxiety.

D) it is well-suited for working with patients with more advanced communication deficits such as stroke survivors.

E) it is more dependent on the physician's gender.

39)

Communication skills training for physicians should include

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A) a focus on patient-centred dialogue.

B) the effective use of nonverbal behaviours.

C) the use of simple rules of courtesy.

D) simple tactics that should become second nature.

E) cognitive, behavioural, and psychological aspects.

40) According to a study of patient-provider communication skills conducted by Thompson, Nanni, and Schwankovsky (1990), patient satisfaction, perceptions of personal control, and patient question asking was highest in

A) women who listed questions after the visit.

B) women whose physicians discouraged them from asking of questions.

C) women who listed questions before the visit and women whose physicians encouraged them to ask questions.

D) women who had done research on the Internet before the visit.

E) women who had stronger personalities.

41) Efforts to identify the personalities of physicians who communicate effectively have revealed that

A) there is no one reliable characteristic that predicts good communication skills.

B) interest in people is the only reliable indicator of physician sensitivity.

C) physicians scoring high on extraversion are effective communicators.

D) there are multiple reliable indicators of physician sensitivity.

E) physicians scoring high on extraversion are effective communicators and there are multiple reliable indicators of physician sensitivity.

42)

Adherence to treatment is improved when providers

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A) prescribe complex health regimens.

B) demand that patients follow their prescribed health regimens.

C) encourage creative non-adherence.

D) involve the patient's spouse or partner.

E) does not involve the patient's spouse or partner.

43)

Of the following, which is NOT an important factor in increasing adherence to treatment?

A) Modifying institutional procedures for following patients.

B) Presenting the treatment regimen clearly.

C) Increasing the skill of the practitioner in communicating with the patient.

D) Following up with the patient by phone or postcard.

E) Pestering the patient until they adhere.

44)

The effectiveness of a placebo

A) is 35%.

B) is 50%.

C) varies.

D) is 75%.

E) is 100%.

45)

Placebos

A) may also work by suppressing endogenous opioids.

B) may also work by releasing exogenous opioids.

C) may also work by releasing endogenous opioids.

D) are only found in non-human research subjects.

E) may also work by suppressing exogenous opioids.

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46)

Placebo effects vary according to

A) the smell of the placebo.

B) the chemical composition of the placebo.

C) the density of the placebo.

D) how a provider interacts with the patient, the provider's belief in the power of the placebo, and the provider's warmth, confidence, and empathy.

E) the texture and taste of the placebo.

47) Researchers examining the links between the Big Five Factors and placebo responding has found that

A) B) C) D)

people scoring low in agreeableness were more likely to experience placebo effects. people scoring low in openness were more likely to experience placebo effects. extraversion was the only one to uniquely predict placebo responding. people scoring high in conscientiousness were more likely to experience placebo

E)

people scoring high in neuroticism were more likely to experience the placebo

effects. effects.

48)

Which of the following characteristics influence the placebo response?

A) The marketing of the placebo, as well as the country in which the placebo was manufactured.

B) The spiritual beliefs of the individual taking the placebo, as well as the mysticism surrounding the placebo's potential to improve health.

C) There are no specific characteristics known to influence the placebo response.

D) The characteristics of the placebo itself, and the setting in which its administered.

E) Any random characteristic can influence the placebo response.

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49) Which of the following experimental procedures is known as the standard for measuring the placebo effect?

A) Double-blind studies.

B) Prospective studies.

C) Retrospective studies.

D) Drug studies.

E) Single-blind studies.

50) Describe at least three types of health care providers in the Canadian health care system.

Present at least one responsibility/duty of each provider.

51) Discuss the factors that have contributed to patient consumerism and how patient consumerism has affected the patient-provider relationship.

52) How can patient-provider communication be improved? Provide specific examples in your answer.

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53) Compare and contrast the causes of treatment adherence and non-adherence. Discuss how non-adherence can be reduced.

54) Explain the ways in which interventions that target health care providers' communication skills may be related to increased patient satisfaction and increased treatment adherence.

55) A friend is laughing about another friend's self-prescribed herbal remedies. He scoffs that the placebo effect is purely psychological, thus "all in your head." Explain the nature and effect of placebos, and why this statement is inaccurate.

56) The placebo effect may result in false treatment claims. Explain why some individuals may be convinced of a drug's efficacy after experiencing the placebo effect.

57)

The typical physician assistant program lasts two years. ⊚ ⊚

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58) Good communication between patient and provider leads to a vague sense of satisfaction and does not improve adherence to treatments. ⊚ ⊚

59)

true false

Canada does NOT use "gatekeepers" within its health care system. ⊚ ⊚

true false

60) The changing philosophy of health care delivery means that many physicians accept the use of complementary and alternative therapies. ⊚ ⊚

true false

61) Disclosure of complementary and alternative medicine use to physicians ranges from only 22 to 42 percent. ⊚ ⊚

true false

62) The research suggests that patients are very likely to report to their physician that they have used complimentary or alternative medicine. ⊚ ⊚

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63) A health care provider's sensitivity is more a matter of motivation than skill; hence, anyone, given the desire, has the potential to be an effective communicator. ⊚ ⊚

true false

64) Patient-centered communication is an important way to improve the patient-provider dialogue and also improve patient outcomes. ⊚ ⊚

true false

65) Non-adherence occurs when patients do not adopt the behaviours and treatments their providers recommend. ⊚ ⊚

66)

true false

The placebo effect is defined as the medically beneficial impact of an inert treatment. ⊚ ⊚

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Answer Key Test name: Chapter 09 Test Bank 1) B 2) B 3) B 4) D 5) A 6) D 7) E 8) D 9) C 10) C 11) B 12) E 13) B 14) B 15) D 16) B 17) A 18) A 19) B 20) A 21) A 22) E 23) C 24) A 25) D 26) B Version 1

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27) C 28) B 29) B 30) D 31) B 32) B 33) C 34) E 35) A 36) C 37) B 38) E 39) E 40) C 41) B 42) D 43) E 44) C 45) C 46) D 47) C 48) D 49) A 50) Answers may vary.

51) Answers may vary.

52) Answers may vary.

53) Answers may vary.

54) Answers may vary.

55) Answers may vary.

56) Answers may vary.

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57) TRUE 58) FALSE 59) FALSE 60) TRUE 61) TRUE 62) FALSE 63) TRUE 64) TRUE 65) TRUE 66) TRUE

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Student name: 1)

Pain is significant because it

A) is directly related to the severity of physical symptoms.

B) has an important survival function.

C) causes physical symptoms critical for daily living.

D) is an important component of most medical school curricula.

E) allows clinicians to treat more important psychological issues.

2)

Pain has important medical consequences because

A) patients' delay behaviour is related to the experience of debilitating pain.

B) practitioners are trained to devote a significant amount of time to diagnosing the source of pain, which often impairs the quality of medical interactions.

C) it is the symptom most likely to lead an individual to seek treatment.

D) after death, pain is the most feared aspect of illness or medical treatment.

E) chronic pain patients monopolize the health care system.

3)

In Canada,

of dollars are spent every year on over the counter remedies.

A) millions B) thousands C) hundreds of thousands D) billions E) decreasing amounts.

4) Beecher's (1959) study of wartime injuries investigated the effect of on pain.

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A) placebos B) fear C) arousal D) interpretation E) isolation

5) Athletes who continue to play, despite being injured, may be experiencing a short-term reduction of pain sensitivity due to

A) sympathetic arousal.

B) parasympathetic arousal.

C) effective training and coaching.

D) activities that focus their attention on the pain.

E) endogenous opioids.

6)

Cross-cultural differences have been found in the

A) discrimination of painful stimuli.

B) reporting time and intensity of reactions to pain.

C) sensory aspect of pain.

D) categorization of pain E) amount one seeks treatment for certain pain.

7)

The perception or interpretation of pain may be influenced by

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A) context.

B) culture.

C) attention.

D) coping styles.

E) context, culture, gender, and coping styles.

8)

Self-report measures such as the McGill Pain Questionnaire typically measure

A) pain threshold.

B) the nature and intensity of pain.

C) pain tolerance.

D) pain and encouraged tolerance level.

E) personality and the experience of pain.

9)

Pain behaviours

A) are observable, measurable behaviours that are manifestations of chronic pain.

B) have not proven useful in identifying the dynamics of different pain syndromes.

C) are not reliable in assessing the impact of pain on quality of life.

D) cannot be used to assess how pain has disrupted the life of particular patients or groups of patients.

E) have no physiological components.

10)

Which of these following behaviours is a manifestation of chronic pain?

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A) Bodily expressions of stress B) Distortions in posture or gait C) Positive effect D) Hyperactivity E) Incoherent speech

11)

Nociception is the

of pain.

A) physiological process B) chemical process C) sensation D) perception E) description

12)

The sensory aspect of pain seems to be determined primarily by

A) A-delta fibres.

B) C-fibres.

C) the limbic system.

D) the cerebral cortex.

E) the adrenal medulla.

13)

The affective and motivational aspect of pain seems to be determined primarily by

A) A-delta fibres.

B) C-fibres.

C) endorphins.

D) the cerebral cortex.

E) psychosocial factors.

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14)

According to the gate control theory of pain, relaxation is a(n) the pain gate.

factor that

A) cognitive; opens B) emotional; closes C) physical; closes D) physical; opens E) emotional; opens

15)

nociception is pain that triggers chemical reactions from tissue damage.

A) Polymorphic B) Polymodal C) Intermodal D) Chronic E) Acute

16)

The neuromatrix theory of pain suggests

A) pain is caused by chemical factors alone.

B) pain is caused by sensory factors alone.

C) pain is caused by cognitive and sensory factors.

D) pain is caused by cognitive and chemical factors.

E) pain is a multidimensional experience caused by multiple determinants.

17)

Endogenous opioids appear to play a role in the

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A) inhibition of pain.

B) stress response.

C) functioning of the immune system.

D) beneficial effects of exercise on health.

E) inhibition of pain, stress response, the functioning of the immune system, the beneficial effects of exercise on health.

18)

As an alternative intervention for phantom limb pain, immersive virtual reality

A) creates a virtual limb to occupy the phenomenal space where the phantom limb is perceived to be.

B) uses virtual reality surgery to train potential surgeons in severing the amputee's nerve that was previously connected to the missing limb.

C) is accomplished by transposing amputees' intact limbs with mirrors.

D) is a meditation technique.

E) can be successful in just one visit.

19)

Acute pain

A) is not associated with anxiety and depression.

B) is long term and persists for more than six months.

C) responds to the administration of painkillers or other medication.

D) increases with the passage of time.

E) is more serious than chronic pain.

20)

Chronic pain

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A) decreases with the passage of time.

B) begins with an acute pain episode.

C) readily responds to treatment.

D) unlike acute pain, has no subcategories.

E) is rare in people under 65.

21)

Chronic low back pain and myofascial pain syndrome are examples of

A) acute pain.

B) chronic benign pain.

C) recurrent acute pain.

D) chronic progressive pain.

E) chronic terminal pain.

22)

A migraine headache is an example of

A) acute pain.

B) chronic benign pain.

C) recurrent acute pain.

D) chronic progressive pain.

E) gradual chronic pain.

23)

Pain that persists longer than six months and increases in severity is considered to be

A) acute pain.

B) chronic benign pain.

C) recurrent acute pain.

D) chronic progressive pain.

E) psychosomatic pain.

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24)

In comparison with acute pain patients, chronic pain patients

A) share a similar psychological profile.

B) experience higher levels of pain.

C) are more responsive to pain management techniques.

D) suffer from a syndrome involving physiological, psychological, social and behavioural components.

E) experience greater satisfaction of their provider.

25)

Compared to persons with chronic pain, acute pain patients

A) have a larger impact on families and society.

B) report more restrictions in their day to day activities.

C) experience less success with the pain control techniques commonly used to treat acute pain.

D) are more likely to view their lives as stressful.

E) have reduced anxiety after painkillers are administered.

26) Compensation for pain resulting from an injury may severity of the pain.

the perceived

A) increase B) decrease C) pacify D) mask E) exacerbate

27)

Chronic pain patients who are married often

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A) experience good marital and sexual functioning.

B) do not communicate well with their families.

C) restrict their social contact to members of their immediate family.

D) take smaller amounts of pain killers than patients who are not married.

E) cope with pain more productively than patients who are not married.

28)

The transition from acute to chronic pain is

A) always determined by the pain intensity.

B) unrelated to functional disability.

C) likely facilitated by a complex interplay of predisposing and contextual factors.

D) more common in women than in men.

E) inevitable.

29) Chronic pain patients typically show elevated scores on the following three MMPI subscales:

A) hysteria, hypochondriasis, and depression.

B) hypochondriasis, hysteria, and mania.

C) negative affectivity, hypochondriasis, and anxiety.

D) hypochondriasis, anxiety, and depression.

E) chronic pain patients do not show elevated scores in any category of the MMPI.

30) Nina has chronic pain, and her physician is certain that it is associated with another condition she has, that of .

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A) persistent coughing B) influenza C) depression D) eczema E) an upset stomach

31)

Pain control can mean

A) that the patient has a tingling sensation in the area that once hurt.

B) that the patient is concerned about the pain.

C) that the patient feels pain and is constantly concerned about it.

D) that the patient is still hurting but now able to stand it.

E) that the pain comes and goes.

32)

Antidepressants combat pain by

A) reducing anxiety.

B) improving mood.

C) affecting the downward pathways from the brain that control pain.

D) reducing anxiety, improving mood, and affecting the downward pathways from the brain that control pain.

E) reducing anxiety and improving mood only.

33)

Pharmacological control of pain

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A) is dangerous in that it usually leads to addiction to prescription drugs.

B) is of no concern to researchers and practitioners.

C) is often sufficient and successful in the management of acute pain.

D) is the treatment of last resort.

E) can contribute to psychological disorders in some patients.

34)

The use of OxyContin for pain

A) B)

has increased by two-thirds in Canada. is very effective in eliminating side effects such as headaches associated with other

drugs.

C) can lead to counterirritation.

D) has been discontinued in Canada because it is highly addictive.

E) is less effective when used in conjunction with caffeine.

35)

The use of surgical techniques to control pain

A) involves the use of spinal blocks that block the upward transmission of impulses in the spinal column.

B) is becoming increasingly common as a treatment of last resort.

C) may result in only temporary improvement and have no lasting negative side effects.

D) may damage the nervous system and actually exacerbate chronic pain.

E) works if the individual has not already adapted to the pain.

36)

Counterirritation involves

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A) influencing the central control mechanism.

B) inhibiting pain in one part of the body by stimulating another area.

C) creating lesions in pain fibres and receptors.

D) influencing the transmission of pain impulses from the peripheral receptors.

E) irritation in the nervous system.

37)

Exercise releases endogenous opioids, which are

A) enzymes that help clotting of blood.

B) natural pain killers.

C) mood enhancers.

D) pain enhancers.

E) responsible for making the body tired.

38)

Biofeedback training

A) shows a great deal of evidence that it is effective in reducing pain.

B) is not effective for reducing the frequency of migraine headache attacks.

C) is probably is no more effective for controlling pain than are relaxation techniques.

D) has not been used to treat chronic conditions.

E) requires a strong personal will and is not for everyone.

39)

Relaxation training strategies are

A) effective ways of coping with stress B) generally less effective in reducing chronic pain than are meditation techniques.

C) effective in alleviating chronic but not acute pain.

D) most effective if combined with pharmaceutical interventions.

E) difficult for people to adhere to due to the level of education needed.

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40)

Controlled breathing is a component of

A) hypnosis.

B) relaxation.

C) distraction.

D) acupuncture.

E) aerobics.

41)

One of the oldest methods of pain control is

A) biofeedback.

B) relaxation training.

C) hypnosis.

D) self-efficacy training.

E) meditation.

42)

Hypnosis relies on

A) physiological relaxation.

B) distraction.

C) reinterpretation of sensations.

D) physiological relaxation, distraction, and reinterpretation of sensations.

E) physiological relaxation and distraction only, the senses do not play a role in hypnosis.

43)

Acupuncture

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A) may function as a sensory method of controlling pain.

B) may be effective because patients believe it will work.

C) may trigger the release of endorphins.

D) may increase endogenous opioids bringing about relevant physiological changes with its use.

E) may function as a sensory method of controlling pain, be effective because patients believe it will work, trigger the release of endorphins and be placebo-like in nature.

44)

Tatiana received acupuncture as an analgesic before her surgery. During her surgery, she

A) is conscious.

B) is unconscious.

C) is partly alert.

D) has phases of being alert, and then sleeps a bit.

E) is conscious but unable to talk with the surgeons.

45) used

In general, distraction is most effective in reducing pain when distraction techniques are

A) intermittently.

B) regularly.

C) only to treat chronic pain.

D) only to treat acute pain.

E) in conjunction with other pain control strategies.

46)

Listening to music to reduce pain

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A) is associated with higher quality of life scores among chronic pain sufferers.

B) has not been tested in hospital settings.

C) has no effect on pain tolerance.

D) is a form of audio-analgesia.

E) is a form of audio-analgesia and is associated with higher quality of life scores among chronic pain sufferers.

47)

Aggressive imagery

A) may improve coping with the uncomfortable effects of a treatment or illness.

B) has no effect on perceptions of control over the pain.

C) is not effective as it excites the body which increases pain.

D) is still in its early experimental stages.

E) is another term for guided imagery.

48)

Cognitive-behavioural pain interventions

A) encourage patients to entrust the management of their pain to the treatment team.

B) attempt to modify maladaptive cognitions but not overt and covert behaviours.

C) encourage clients to attribute their success to the treatment intervention.

D) help patients reconceptualize the problem from overwhelming to manageable.

E) are less effective than meditation for controlling pain.

49) Of the cognitive-behavioural treatment strategies for pain management, those designed to target may be especially helpful.

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A) depression B) hostility C) hypochondriasis D) self-efficacy E) negative affect

50)

Pain management programs

A) encourage patients to rest so pain is not aggravated.

B) provide patients with pain killers such as morphine.

C) involve providing patients with complete information about the nature of their condition.

D) have less wait times than other programs.

E) are privately funded.

51) The incidence of relapse following initial successful treatment of persistent pain appears to range from about to .

A) 10 percent; 90 percent B) 30 percent; 60 percent C) 50 percent; 75 percent D) 60 percent; 90 percent E) 10 percent; 20 percent

52)

Relapse following initial successful treatment of pain is directly related to

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A) lack of social support.

B) coping styles.

C) non-adherence to treatment regimen.

D) personality traits.

E) gender.

53)

Explain why pain is important.

54)

Explain how social and psychological variables influence the perception of pain.

55) gate.

Describe the gate control theory of pain. Outline the factors that open or close the pain

56)

Differentiate between acute and chronic pain.

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57) Pain control by use of physical, cognitive, sensory or pharmacological techniques has long been used by health care providers. For which type of pain are they most useful and why?

58) How effective are biofeedback, acupuncture, and hypnosis in pain management? Do they work better with some types of pain? Are they superior to simple distraction and relaxation?

59)

Describe the design and implementation of pain management programs.

60) There is a strong positive correlation between perceived pain and severity of an underlying problem. ⊚ ⊚

61)

true false

There are ethnic or racial differences in the ability to discriminate painful stimuli. ⊚ ⊚

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62)

The McGill Pain Questionnaire assesses pain behaviours. ⊚ ⊚

63)

true false

A-delta fibres are un-myelinated nerve fibres that transmit dull or aching pain. ⊚ ⊚

true false

64) Beta-endorphins produce peptides that have widespread neuronal, endocrine, and central nervous system distributions. ⊚ ⊚

true false

65) Although depression is common among chronic pain patients, chronic pain is not a sufficient condition for the development of depression. ⊚ ⊚

true false

66) Hypnosis is one of the oldest strategies for the management and treatment of acute and chronic pain. ⊚ ⊚

67)

true false

Acupuncture is effective in reducing the experience of pain.

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⊚ ⊚

68) pain.

true false

Listening to one's favourite music is an easy-to-use and effective means of managing

⊚ ⊚

true false

69) Pain management programs include interventions aimed at the distorted negative perceptions patients hold about their pain. ⊚ ⊚

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Answer Key Test name: Chapter 10 Test Bank 1) B 2) C 3) D 4) D 5) A 6) B 7) E 8) B 9) A 10) B 11) D 12) A 13) B 14) B 15) B 16) E 17) E 18) A 19) C 20) B 21) B 22) C 23) D 24) D 25) E 26) A Version 1

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27) B 28) C 29) A 30) C 31) D 32) D 33) C 34) D 35) D 36) B 37) B 38) C 39) A 40) B 41) C 42) D 43) D 44) A 45) E 46) E 47) A 48) D 49) D 50) C 51) B 52) C 53) Answers may vary.

54) Answers may vary.

55) Answers may vary.

56) Answers may vary.

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57) Answers may vary.

58) Answers may vary.

59) Answers may vary.

60) FALSE 61) FALSE 62) FALSE 63) FALSE 64) FALSE 65) TRUE 66) TRUE 67) TRUE 68) TRUE 69) TRUE

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Student name: 1)

Subjective self-reports of health status

A) are an important aspect of quality of life.

B) have found to predict morbidity beyond medical and psychological factors.

C) have found to predict mortality beyond medical and psychological factors.

D) are an important aspect of quality of life, have found to predict morbidity and mortality beyond medical and psychological factors.

E) are unreliable.

2)

is NOT a component of quality of life.

A) Physical functioning B) Psychological status C) Social functioning D) Disease- or treatment-related symptomatology E) Education

3)

Medical measures of quality of life are

A) seldom based on objective criteria.

B) poorly correlated with patients' and relatives' assessments.

C) poorly correlated with patients' assessments but are moderately correlated with relatives' assessments.

D) moderately correlated with health psychologists' assessments.

E) None of these answers are correct.

4)

Which of these is NOT a factor determining quality of life?

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A) How much the disease and its treatment interferes with the activities of daily living.

B) The functional aspects of daily living.

C) The extent to which a patient's normal life activities have been compromised by disease and treatment.

D) Differences depending on whether the chronic illness is in an acute phase or when symptoms are less active.

E) Medications a person regularly takes to keep functional.

5)

Studying quality of life

A) makes it possible to determine what kinds of interventions may be needed.

B) is an unnecessary intrusion into patients' lives.

C) cannot be used to compare therapies.

D) tells us little that the diagnosis does not provide.

E) has always been a top priority in medicine.

6)

Immediately after a chronic illness is diagnosed,

A) patients are unusually calm.

B) patients find their habitual ways of coping with problems work very well.

C) anxiety, fear, and depression often diminish D) Patients can be in a state of crisis where they find their habitual ways of coping do not work and anxiety, fear, and depression take over.

E) patients begin to develop a sense of how the chronic illness will alter their lives right away.

7)

Denial

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A)

is a coping mechanism by which people confront the immediate implications of an

illness.

B) may help the patient control her or his emotional reaction.

C) can mask the fear associated with a chronic disease.

D) is a defence mechanism by which people avoid the immediate implications of an illness, and can mask the fear associated with a chronic disease, however it may help the patient control their emotional reaction.

E) inhibits the success of medical treatments for chronic illness.

8)

Denial may serve a protective function

A) before the patient seeks medical treatment.

B) in the acute phase of the illness.

C) when patients must play an active role in the treatment regimen.

D) during the rehabilitative phase of the illness.

E) if the illness is chronic.

9)

Denial is useful in helping patients

A) control their emotional reaction to illness.

B) monitor their physical condition.

C) seek treatment.

D) become active in their treatment regimen.

E) denial is never helpful.

10)

Anxiety

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A) is no more common in people with heart disease than it is with the general population.

B) helps with glucose control in diabetic patients.

C) aids with assessments of severity of the disease and its treatment.

D) can increase the risk of subsequent heart attacks among patients with heart disease.

E) is a normal reaction to illness of any kind.

11)

According to Clarke and Currie (2009), anxiety is more common in

A) women.

B) men.

C) children with life threatening illnesses.

D) people with stroke, heart disease, and cancer.

E) people who are not in a significant relationship.

12)

Depression in chronically ill patients is

A) independent of illness severity.

B) most commonly found in the acute phase of illness.

C) easily and reliably assessed.

D) related to the symptoms experienced and the overall prospects for rehabilitation and recovery.

E) least in patients with fibromyalgia.

13)

Unlike anxiety and denial, depression

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A) may be a delayed reaction to chronic illness.

B) is at a steady state during the course of chronic illness.

C) is the first response to chronic illness.

D) may be intermittent and unrelenting.

E) is usually a short-term reaction to chronic illness.

14)

Which of the following is NOT a predictor of depression among chronically ill patients?

A) the severity of the illness B) chronic pain C) marital status D) becoming disabled E) the duration of the illness

15)

Benefit finding is

A)

acknowledgement of the negative changes brought about in one's life due to an

illness.

B) acknowledgement of the positive effects of an illness in one's life.

C) a worker's acknowledgement of benefits provided by the workplace.

D) acknowledgement of an illness.

E) acknowledgement of effects of an illness in completing daily tasks.

16) With regards to chronic illness, an enduring tendency to notice and appreciate the positive in life may

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A) make adjustment to chronic illness worse.

B) make taking medications easier.

C) make the days go by easily.

D) improve adjustment to chronic illness.

E) change social life drastically.

17) one's

The perception and evaluation of one's physical functioning and appearance comprises

A) physical self.

B) self-concept.

C) body image.

D) self-evaluation.

E) self-esteem.

18)

Body image can be improved by

A) ignoring the area of disfigurement.

B) reconstructive surgery.

C) medication.

D) stressing other aspects of appearance and health.

E) biofeedback.

19)

Achievement through vocational activities and personal goals is an important aspect of

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A) self-esteem.

B) self-image.

C) self-confidence.

D) self-help.

E) selflessness.

20)

Anita is recovering from a chronic illness. Her social identity

A) will be rebuilt very easily.

B) will be rebuilt with a lot of difficulty.

C) will never be the same as before her illness.

D) will be rebuilt with challenges.

E) will be lost now.

21) are visions of the self for the future, which can help to motivate, organize, and direct an individual's current goals and aspirations.

A) Social selves B) Achieving selves C) Possible selves D) Physical selves E) Potential selves

22) According to a study of cancer patients conducted by Dunkel-Schetter and her colleagues (1992), the most frequently cited stressor was

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A) fear and uncertainty about the future.

B) limitations in physical abilities.

C) pain management.

D) altered physical appearance and lifestyle.

E) financial worries.

23) Analyses of the effectiveness of coping strategies in managing the stress associated with chronic illness conclude that

A) the coping strategies used by chronically ill patients are significantly different from the strategies observed in healthy samples.

B) avoidant coping is associated with reduced psychological distress and better psychological adjustment.

C) confrontative coping is associated with better adjustment than the use of multiple coping strategies.

D) active coping has been associated with good adjustment to multiple sclerosis and spinal cord injury.

E) vigilant coping is associated with reduced psychological distress over the long-term.

24)

Successful adjustment to chronic illness is associated with

A) having an inappropriate or accurate model for one's illness.

B) developing an acute model of one's disorder.

C) blaming others for one's illness and thus minimizing self-blame.

D) having a personal sense of control, or self-efficacy.

E) avoidant coping.

25)

Blaming another person for one's disorder

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A) is maladaptive.

B) may be tied to unresolved hostility.

C) can interfere with adjustment to the disease.

D) is most effective when the person being blamed is not a close friend or family member.

E) is maladaptive, may be tied to unresolved hostility, and can interfere with adjustment to the disease.

26)

In general, high levels of perceived control facilitate adjustment, EXCEPT in cases where

A) patients are seriously debilitated, both physically and psychosocially.

B) patients must cope with long-term chronic illness.

C) patients must cope with acute disorders and treatment.

D) actual control is low.

E) patients are seriously debilitated and must cope with long-term chronic illness.

27) According to researchers at the University of British Columbia, children with asthma benefit most from

A) perceived control.

B) self-esteem.

C) parental support.

D) emotion focused coping.

E) self-efficacy.

28)

Which of the following is NOT one of the goals of rehabilitation discussed in your text?

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A) Redefining oneself as being chronically ill.

B) Adherence to one's treatment regimen.

C) The control of energy expenditure.

D) Learning new physical management skills.

E) They are all goals of rehabilitation discussed in your text.

29)

Fibromyalgia

A) affects almost 400,000 Canadians.

B) is associated with sleep apnea.

C) is associated with increased parasympathetic system stress responses.

D) is more common among men than women.

E) is not a real disease.

30)

Which of the following is NOT a functional somatic syndrome?

A) Chronic fatigue syndrome.

B) Fibromyalgia.

C) Sick building syndrome.

D) Vietnam War syndrome.

E) Chemical sensitivity.

31)

Myalgic encephalomyelitis

A) is a disorder of well-known etiology.

B) affects approximately 14 percent of Canadians.

C) is more common in men.

D) is a disorder marked by debilitating fatigue present for at least six months.

E) is a disorder most prevalent among children and adolescents.

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32)

Adherence to treatment regimens in chronically ill patients is

A) significantly higher than in patients being treated for acute disorders.

B) significantly lower than in patients being treated for acute disorders.

C) unaffected by the side effects of treatment.

D) especially problematic and complex for long-term medical regimens.

E) significantly lower in women than in men.

33)

Creative non-adherence to treatment regimens among people with chronic illness

A) is rare.

B) may occur because they know their disease extremely well.

C) occurs because they are not tuned into their internal feedback.

D) is recommended by doctors when there are no traditional methods left to try.

E) is not an issue that health psychologists are concerned with.

34) The study by Lacaille and colleagues (2007) on the work-related problems of people with arthritis found that

A) fatigue was the most limiting symptom of arthritis that created problems at work.

B) co-workers' relationships were supportive.

C) job satisfaction, aspirations for advancement, and salary were unaffected by their arthritis.

D) they avoided working too hard so they could save their energy for their home lives.

E) ergonomic solutions in the office were not helpful.

35)

With respect to the vocational issues in chronic illness

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A) job counselling, retraining programs, and advice on how to avoid or combat discrimination should be assessed later in the recovery process so as to not interrupt the healing process.

B) some people may have to find ways to cope with working conditions that are not ideal but necessary to stay employed.

C) cancer patients are rarely fired or laid off.

D) employers will often allow for a patient to take more sick days than an average employee.

E) many people who suffer from chronic illness are able to keep their jobs with no complications.

36)

Negative reactions to chronically ill patients include

A) discrimination.

B) distress.

C) feeling worn down.

D) stereotypes.

E) shunning.

37)

Divorce rates for families with a chronic illness are

A) higher when the patriarch is sick because they are the primary breadwinner.

B) lower than families without a chronic illness.

C) higher than families without a chronic illness.

D) no different than families without a chronic illness.

E) lower in families with children because they take on new roles to help out.

38)

Regarding caregiving for people with chronic illness,

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A) care for people with chronic illness is notoriously irregular.

B) the care-giving role more commonly falls to the oldest child.

C) caregiving is usually more rewarding for men than women.

D) the caregiver should only help with the psychological care of a patient.

E) the caregiving role requires a vast amount of medical knowledge or research in order to be effective.

39)

Most caregiving for the chronically ill is provided by

A) formal services such as home health nurses or nursing homes.

B) men.

C) family members.

D) friends.

E) hospices.

40)

Researchers investigating gender and the impact of chronic illness have found that

A) women with chronic illness also experience less distress than men.

B) women have a higher burden of disease than men.

C) married women spend fewer days in nursing homes than married men.

D) men with chronic illness are less likely to be married than disabled women.

E) hospitalization of one's spouse does not increase risk of death for husbands or wives.

41) Collins et al. (1990) reported that more than of the cancer patients in their study reported at least some beneficial changes in their life as a result of the cancer.

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A) 20 percent B) 45 percent C) 75 percent D) 90 percent E) 50 percent

42)

Which of the following is NOT a result of caring for those with chronic illness

A) strains the relationship between patient and caregiver.

B) increases risk for depression.

C) compromises the health of the caregiver.

D) is linked to alterations in immune functioning.

E) increases resiliency in most people.

43)

Research on the positive changes in response to chronic illness has found

A) that achieving a high quality of life is linked to having positive self-perceptions and expectations about the future.

B) that approximately 40 percent of cancer patients reported at least some beneficial changes in their lives as a result of the cancer.

C) that finding benefits in illness is not always associated with good adjustment.

D) that there is better psychological adjustment, but poorer social adjustment.

E) that there is better social adjustment, but poorer psychological adjustment.

44) Which one of the following would hamper a child's ability to cope effectively with a chronic illness?

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A) The parents do not appear distressed.

B) The child continues to attend school throughout their illness.

C) The parents have a history of depression or other mental illness.

D) The child takes part in physical activities.

E) The parents giving them some control over their treatment.

45)

Patient education programs that include coping skills training

A) increase knowledge about the disease only.

B) increase patients' feelings of purpose and meaning in life only.

C) increase adherence to treatment.

D) can increase knowledge about the disease and increase feelings of purpose and meaning in life but does not address adherence to treatment.

E) can increase knowledge about the disease and increase feelings of purpose and meaning in life, all the while addressing adherence to treatment.

46)

Family support of patients with a chronic illness is especially important because

A) they encourage the patient to be cheerful.

B) they are the only ones available when friends cannot be counted on.

C) they promote adherence to treatment.

D) they help the patient cope with the stigma associated with certain disorders.

E) they allow the patient to make their own choices.

47)

A social support group is most likely to help

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A) Fred, an insurance company executive who is recovering from a fractured leg.

B) Mar'a, a recent immigrant from the Philippines who suffers from allergies.

C) Sybil, a high-school dropout with three children who is recovering from a mastectomy.

D) Anna, who has had a relapse of influenza.

E) Rita, who is suffering from pneumonia.

48)

Discuss the components of quality of life.

49) What are the common emotional responses to chronic illness? How do these responses impact care and adjustment?

50)

Answer the question posed in the text: "How is the self changed by chronic disease?"

51) What are the coping strategies commonly used to cope with chronic illness? Which ones are more adaptive and which ones are less adaptive? What factors influence which strategies are used?

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52) Explain how a patient's beliefs might positively or negatively impact their adjustment to living with a chronic illness.

53) Explain the role of social support in coping with chronic illness. In your answer, consider both the benefits and the costs of social support, and the different forms that it can take.

54) Medical measures are only weakly related to patients' or relatives' assessments of quality of life. ⊚ ⊚

true false

55) There is evidence that depression may occur somewhat earlier in the adjustment process than denial or severe anxiety. ⊚ ⊚

true false

56) Whereas disease severity and the presence of debilitating symptoms affect quality of life, they are unrelated to body image.

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⊚ ⊚

57)

Illness duration influences which types of coping strategies are used. ⊚ ⊚

58)

true false

Self-blame for chronic illness is widespread. ⊚ ⊚

59)

true false

true false

Chronic whiplash is a functional somatic disorder. ⊚ ⊚

true false

60) Due to the chronic strain involved, the divorce rate among families with a chronic illness is higher than that for the general population. ⊚ ⊚

61)

true false

Many chronic illnesses lead to a decrease in sexual activity. ⊚ ⊚

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62) The Internet is a good source of information about skills for coping with common illnessrelated problems. ⊚ ⊚

true false

63) Simply telling patients that anxiety is a normal response to the stress of chronic illness does not alleviate their concerns about how they are reacting. ⊚ ⊚

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Answer Key Test name: Chapter 11 Test Bank 1) D 2) E 3) B 4) E 5) A 6) D 7) D 8) B 9) A 10) D 11) D 12) D 13) A 14) C 15) B 16) D 17) C 18) D 19) A 20) D 21) C 22) A 23) D 24) D 25) E 26) D Version 1

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27) A 28) A 29) A 30) D 31) D 32) D 33) B 34) A 35) B 36) A 37) D 38) A 39) C 40) B 41) D 42) E 43) A 44) C 45) E 46) C 47) C 48) Answers may vary.

49) Answers may vary.

50) Answers may vary.

51) Answers may vary.

52) Answers may vary.

53) Answers may vary.

54) TRUE 55) FALSE 56) FALSE Version 1

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57) TRUE 58) TRUE 59) TRUE 60) FALSE 61) TRUE 62) TRUE 63) FALSE

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Student name: 1)

The infant mortality rate in Canada

A) is higher relative to some Western European countries.

B) is higher for Indigenous infants than for white infants.

C) is unrelated to socio-economic status.

D) is higher relative to some Western European countries, is higher for Indigenous infants, and is related to socio-economic status.

E) is higher relative to some Western European nations, is higher for Indigenous infants, but is unrelated to socioeconomic status.

2)

Poor adjustment for parents of children who have died from SIDS is associated with

A) maternal smoking.

B) self-blame.

C) socio-economic status.

D) alcoholism.

E) fear of having more children.

3)

In the first year of life, the main causes of death are

A) congenital abnormalities and SIDS. B) acute illness.

C) accidents and congenital abnormalities.

D) cancer, especially leukemia, and SIDS. E) external factors.

4)

After infancy, the main cause of death among children younger than age 15 is

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A) acute illness.

B) SIDS. C) external causes.

D) cancer, especially leukemia.

E) congenital abnormalities.

5) For children or the devil.

, death is personified into a shadowy figure, such as a ghost

A) five to six years old B) five to nine years old C) nine to ten years old D) 11 to 12 years old E) 13 to 14 years old

6)

Suicide between the ages of 15 to 24 is the is/are the fourth leading cause of death.

cause of death while

A) first leading; cancer B) second leading; homicide C) second leading; cancer D) first leading; external causes E) third leading; homicide

7)

According to the text, one important contributing factor to midlife crisis is the

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A) gradual realization of impending death.

B) growing awareness that one's risk factors for chronic illness are increasing.

C) cultural emphasis placed on youth.

D) declining importance middle-aged adults place on their work.

E) lower income of many middle-aged adults.

8)

The main cause of premature death in adulthood is sudden death due to

A) accidents.

B) stroke or heart attack.

C) AIDS. D) homicide.

E) drowning.

9)

Sudden death

A) is preferred by most people compared to slow and painful death.

B) has the advantage of not allowing people to prepare their exit.

C) does not facilitate a more graceful departure.

D) is less kind to family members than a slow and painful death.

E) is brought about by physical deterioration and loss of mental faculties.

10)

Death in the elderly is

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A) B) C) D)

more likely to be sudden. less likely to be caused by degenerative diseases. usually accompanied by a shorter terminal phase. usually protracted because there is often more than one biological competitor for

E)

more likely to be prolonged.

death.

11) Which of the following is one of the factors that have been found to predict mortality in the elderly age group?

A) distant family relationships B) psychological distress C) satisfactory work-life balance D) hardiness E) the neighbourhood they live in

12)

In Canada,

have a longer lifespan than

.

A) men; women B) older adults; younger adults C) older male adults; middle-aged male adults D) older female adults; middle-aged female adults E) women; men

13) Which of the following is NOT one of the factors that have been identified as contributing to a "good death"?

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A) Pain and symptom management B) Seeking forgiveness C) Preferences for the dying process D) Dignity E) Sense of life completion

14) Which of the following is NOT cited by your text as one of the factors that contribute to women's lower mortality rates?

A) Biological fitness B) Health beliefs C) Fewer risky behaviours D) Social support E) They are all cited by your text as factors that can contribute to women's lower mortality rates.

15)

Currently, physician aid-in-dying (PAD) is legal in

A) the Netherlands and Switzerland.

B) only the Netherlands.

C) Oregon (US), Washington (US), and Montana (US).

D) California (US).

E) Canada, the Netherlands, Switzerland, and the U.S. states of Oregon, Vermont, Washington, Montana, New Jersey, Hawaii, Colorado, District of Columbia, and California.

16)

A living will outlines

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A) a patient's wishes to undergo euthanasia.

B) a patient's request that extraordinary life-sustaining procedures not be used.

C) the conditions under which a patient requests to remain alive.

D) the disposition of one's belongings after death.

E) how children will be taken care of after one's death.

17) Which of the following is NOT one of the problematic issues surrounding euthanasia and physician aid in dying cited in your text?

A) It conflicts with the physician's oath to "do no harm."

B) The reduction of patients' autonomy.

C) It will cause a change in how society views illness and disease.

D) It could lead to patients being killed or coerced into taking aid-in-dying against their will.

E)

18)

It makes the patient comfortable during the last few days.

Advancing illness can threaten the

of patients.

A) self-image B) self-morale C) self-esteem D) self-concept E) self-pride

19)

Emotional and social withdrawal in terminally ill patients

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A) is successfully treated with antidepressants.

B) is always due to anticipatory grieving.

C) may be caused by fear of depressing others and becoming an emotional burden.

D) is a social problem, unrelated to health concerns.

E) is not an issue because terminally ill patients are hospitalized with others in a similar condition.

20) As a patient's prognosis worsens, interpersonal communications often deteriorate. The reasons for this breakdown are generally due to

A) the belief that others do not want to talk about death.

B) long-term communication problems in the family.

C) indifference among medical staff members.

D) health care providers often have feelings of guilt or failure and are therefore reluctant to talk about the future.

E) a worry that focusing on death will cause the patient to die sooner.

21)

In evaluating Kübler-Ross's theory

A) the knowledge of the five-stage model may actually create more anxiety and fear about the process of dying.

B) research has found that people do go through the five stages in a pre-determined order.

C) we see that patients, but not nurses or physicians expect people to go through each and every stage in a particular order.

D) the five stages theory has helped to normalize death, and thus reduce the fear of dying significantly.

E) it is shown that the five stages only occur in elderly patients.

22)

The correct order of Kübler-Ross's stages of adjustment to dying is

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A) depression, anger, bargaining, denial, acceptance.

B) denial, anger, bargaining, acceptance, depression.

C) denial, bargaining, anger, depression, acceptance.

D) denial, anger, bargaining, depression, acceptance.

E) depression, denial, bargaining, anger, acceptance.

23) Lazarus (1983) argues that illness is both normal and useful.

early on in adjustment to life-threatening

A) anxiety B) bargaining C) denial D) anger E) acceptance

24)

Long-term denial of one's life-threatening illness

A) is a typical reaction.

B) is functional in coping with anxiety.

C) may require therapeutic intervention.

D) is a barrier to patient provider communication.

E) is healthy because it allows the patient to focus on enjoying life.

25)

According to Kübler-Ross, the dying patient who asks, "why me?" is experiencing

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A) anxiety.

B) bargaining.

C) denial.

D) anger.

E) acceptance.

26) According to Kübler-Ross, the dying patient who is experiencing "anticipatory grief" is in the stage.

A) denial.

B) depression.

C) bargaining.

D) acceptance.

E) anger

27)

The depressed terminally ill patient may be

A) coming to terms with a lot of control.

B) experiencing anticipatory relief.

C) experiencing an expected transitory psychological state which requires intervention.

D) depressed as a result of experiencing tangible evidence that the illness is not going to be cured, such as a worsening of symptoms.

E) coming out of a state of morose.

28)

According to critics, Kübler-Ross's theory has limitations because

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A) it recognizes death as a complex and individual process.

B) it places too much importance on anxiety.

C) there is little if any empirical evidence to support the proposition that patients go through five stages in a predetermined order.

D) there is no evidence to support the proposition that patients go through stages.

E) it recognizes death as a process subject to rules and regulations.

29)

The hospitalized terminally ill patient runs the risk of being

A) ignored by the medical staff.

B) isolated by the medical staff.

C) overmedicated by the medical staff.

D) undermedicated by the medical staff.

E) over-nurtured by the medical staff.

30)

Palliative care involves

A) final attempts to cure the terminally ill patient.

B) life-prolonging interventions such as placing the patient on a respirator.

C) ending the life of a patient who is suffering from a painful terminal illness.

D) care designed to make the patient feel comfortable.

E) withholding medical information that might upset the patient.

31)

Cultural differences have been found in beliefs about whether physicians think patients

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A) should be informed of all prognoses, terminal or not.

B) should make the decision about the use of life support.

C) work through stages of dying.

D) should seek out CAM when all traditional methods have failed.

E) should keep a terminal prognosis a secret from close friends or family.

32) Which of the following is NOT one of the goals of medical staff who work with the dying?

A) Informing patients of their condition and treatment B) Helping patients live as long as possible C) Enabling patients and their families to experience anticipatory grief D) Helping the patients use their remaining time as well as possible E) Allowing the patients to achieve death with dignity

33)

Therapy with the dying differs from traditional psychotherapy in that

A)

the frequency and depth of sessions need to depend on the energy level of the

patient.

B) it is a long-term commitment.

C) it is necessary to discuss issues the patient clearly does not wish to discuss before it is too late.

D) it should focus heavily on preparations that need to be made for survivors, especially dependent children.

E) therapy with a dying patient is not different from traditional psychotherapy.

34)

Those who study death and dying are

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A) grief assistants B) thanatologists C) geriatricians D) epidemiologists E) paleologists

35)

Cognitive-behavioural therapy can be employed with dying patients, especially

A) positive self-talk.

B) self-monitoring.

C) progressive muscle relaxation.

D) positive self-talk and self-monitoring.

E) progressive muscle relaxation and positive self-talk.

36)

Symbolic immortality is

A) therapy with the dying.

B) the feeling that children are one's legacy.

C) beliefs about the meaning of death and dying.

D) short-term, palliative care for the dying.

E) therapy with the dying that finds a sense that one is leaving behind a legacy through their children or work or that one is joining the afterlife and becoming one with a higher being.

37)

Counselling with terminally ill children

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A) cannot proceed if the parents are unhappy, frightened, and confused.

B) can proceed very much like counselling with a terminally ill adult.

C) involves taking cues of what to say directly from the parents.

D) involves directing the child to talk about topics the therapist thinks are important to discuss.

E) is very different from counseling with terminally ill adults.

38) Canada's Indigenous people view death as one of the human spirit through the circle of life.

stages of the journey of the

A) three B) four C) five D) six E) seven

39)

In Canada, where do the majority of deaths take place?

A) At home B) In hospices C) In hospitals D) In walk-in clinics E) In mental hospitals

40)

The psychological response to bereavement is

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A) empathy B) sympathy C) grief D) sorrow E) depression

41)

Dignity therapy

A) was developed from interviews with stroke patients.

B) involves a thanatologist recording an interview with the patient.

C) has a "generativity" document as its end product.

D) is widely used for restoring dignity among the terminally ill.

E) is not a commonly used technique because of low success rates.

42)

The goals of hospice care do NOT include

A) palliative care.

B) psychological comfort.

C) improved social support.

D) relief of suffering rather than the curing of an illness.

E) administration of invasive therapies to reduce the symptoms of pain experienced by the patient.

43)

Hospices

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A) have had only limited success as a treatment model.

B) are seldom affiliated with hospitals due to fears of malpractice litigation.

C) are increasingly being incorporated into traditional hospitals.

D) are providing more individualized care than in the past.

E) are decreasing due to lack of support by communities.

44) Evaluations of hospice care indicate that, compared to patients who receive traditional treatment, hospice patients

A) live longer.

B) receive fewer invasive procedures.

C) report lower levels of anxiety.

D) are more satisfied with their interpersonal care.

E) report a lack of care.

45)

According to your text, by 2046

of Canadians will need home care.

A) 750,000 B) 75,000 C) 7,500,000 D) just over a million E) just over two million

46)

The psychological advantages of home care do NOT include

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A) having a familiar and comfortable environment.

B) being surrounded by personal items.

C) the opportunity to maintain personal control.

D) the availability of social support.

E) loneliness during the day when all family members leave for work.

47) Which of the following factors does NOT impact how well caregivers cope with the stress of dealing with a family member who is dying at home?

A) having a good relationship with the patient.

B) caregiver security.

C) the patient acknowledging the caregiver's efforts.

D) reducing the time that caregivers have to mentally or emotionally prepare for a family member's death.

E) the caregiver's outlook on life.

48)

People from another culture witnessing the death practices in Canada would think that

A) the majority of deaths take place in hospices.

B) there are strong social pressures on the friends and relatives of the deceased to show little sign of emotion.

C) the direction of the viewing and burial rituals is handled by immediate family members.

D) death is a painful event.

E) death is similar in all cultures.

49)

The grief response appears to be aggravated in

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A) women and those who experience sudden and unexpected loss.

B) men and those who experience sudden and unexpected loss.

C) survivors whose family members have experienced a protracted and painful death.

D) young children who experience the death of a sibling.

E) people with pets.

50) Explain how children's understanding of death differs from when they are under age 5 to when they are over age 5.

51) Explain the medical, social, and psychological issues associated with continuing treatment of a terminal illness. What options are now available to terminally ill patients and their families?

52)

Describe Kübler-Ross's Five-stage theory of dying. Evaluate the usefulness of her theory.

53) What are the concerns in the psychological management of the terminally ill patient for medical staff? How can these concerns be managed?

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54) Hospice and home care have become increasingly popular treatment alternatives for the terminally ill. What are the advantages and disadvantages of each for patients and care providers (both family and medical staff)?

55)

Describe the psychological and physiological correlates of grief.

56) The infant mortality rates for Indigenous infants are lower than those for non-Indigenous infants. ⊚ ⊚

57)

true false

The major cause of death in youths aged 15 to 24 is unintentional injury. ⊚ ⊚

true false

58) Attaining the ideal of the good death is always possible, regardless of the health condition.

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⊚ ⊚

59)

Canadian right-to-die advocate Sue Rodriguez suffered from terminal multiple sclerosis. ⊚ ⊚

60)

true false

true false

Long-term denial of a terminal illness should be a target of therapeutic intervention. ⊚ ⊚

true false

61) Kübler-Ross's theory has made an important contribution in identifying the universal stages of dying and breaking the taboo surrounding death. ⊚ ⊚

true false

62) The development of a sense that one is leaving behind a legacy through one's children or one's work is termed "symbolic immortality." ⊚ ⊚

63)

true false

Dignity therapy is administered by family members. ⊚ ⊚

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64) Evaluations of hospice care suggest that it can provide more emotionally satisfying care for both patients and their families when compared to standard hospital care. ⊚ ⊚

true false

65) Both caregiver and patient characteristics can impact how well caregivers cope with the stress of dealing with a family member who is dying at home. ⊚ ⊚

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Answer Key Test name: Chapter 12 Test Bank 1) E 2) B 3) A 4) C 5) B 6) B 7) A 8) B 9) A 10) C 11) B 12) E 13) B 14) B 15) E 16) B 17) E 18) D 19) C 20) A 21) A 22) D 23) C 24) C 25) D 26) B Version 1

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27) D 28) C 29) D 30) D 31) A 32) B 33) A 34) B 35) E 36) E 37) B 38) B 39) C 40) C 41) C 42) E 43) C 44) A 45) A 46) E 47) D 48) B 49) B 50) Answers may vary.

51) Answers may vary.

52) Answers may vary.

53) Answers may vary.

54) Answers may vary.

55) Answers may vary.

56) FALSE Version 1

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57) TRUE 58) FALSE 59) FALSE 60) TRUE 61) FALSE 62) TRUE 63) FALSE 64) TRUE 65) TRUE

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Student name: 1) In Canada, 22 percent of deaths in women.

accounts for about 20 percent of deaths in men and over

A) diabetes B) coronary heart disease C) hypertension D) cancer E) parainfluenza

2)

One of the most significant aspects of coronary heart disease is that

A) a number of the deaths that occur each year are premature deaths.

B) it is a disease of lifestyle.

C) it involves modifiable risk factors.

D) it is a non-communicable disease.

E) it is not as serious as most people think.

3) The combination of obesity centered around the waist, high levels of triglycerides, low levels of HDL cholesterol, and difficulty metabolizing blood sugar are symptomatic of

A) inflammation due to C-reactive protein.

B) metabolic syndrome.

C) angina pectoris.

D) cardiac arrest.

E) diabetes.

4) Which of the following job factors has been found to be related to increased risk of CHD?

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A) High work demands and low control.

B) A discrepancy between one's education level and one's occupation.

C) Low job security.

D) Occupational stress in general.

E) Socializing with coworkers.

5)

Coronary heart disease (CHD) is the

leading cause of death in Canada.

A) first B) second C) third D) fourth E) fifth

6)

Women

A) show greater increases in cardiovascular, neuroendocrine, and some metabolic responses in response to stress than do men.

B) experience a higher risk of cardiovascular disease after menopause.

C) develop CHD on average about 15 years earlier than do men.

D) seem to be protected at young ages against CHD due to their lower levels of HDL cholesterol.

E) have not been shown to have different risks for CHD than men.

7) The personality quality "agency" is associated with unmitigated "communion" has been tied to

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A) good physical and mental health outcomes; reduced psychological stress B) good physical and mental health outcomes; adverse health outcomes C) few relations to physical and mental health outcomes; good physical and mental health outcomes D) reduced psychological stress; good physical and mental health outcomes E) they are both related to good physical and mental health outcomes

8)

Besides chronic stress, what other emerging factor may lead to coronary heart disease?

A) socio-economic status B) PTSD C) ethnicity D) career choice E) mobile phone use

9)

Hostility

A) is not a potential risk factor for the development of heart disease.

B) is not a predictor of survival of heart disease.

C) is only implicated in diabetes.

D) is learnt from the environment and has no genetic factors implicated in it.

E) is implicated as a risk factor for CHD.

10)

One characteristic of cynical hostility is

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A) suspiciousness.

B) little resentment.

C) infrequent angry episodes.

D) trust in others.

E) paranoid schizophrenia.

11)

Higher levels of hostility have been found among

A) men.

B) non-whites.

C) people low in socio-economic status (SES).

D) men, non-whites, and people with low socio-economic status (SES).

E) men and non-whites only, socio-economic status (SES) does not affect higher hostility levels.

12)

Hostility has been tied to

A) a weak antagonistic response to sympathetic activity in response to stress.

B) Lower levels of proinflammatory cytokines.

C) higher levels of proinflammatory cytokines and to the metabolic syndrome.

D) different patterns of immune activation in response to sympathetic activation.

E) an inability to react to stress.

13)

Which type of hostility is most related to CHD?

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A) oppositional defiant hostility B) familial hostility C) conflictual hostility D) cynical hostility E) major depressive hostility

14)

Individuals who are high in hostility

A) have chronically higher blood pressure.

B) show more pronounced heart rate reactivity to laboratory stressors.

C) show more pronounced physiological reactions in response to interpersonal stressors.

D) exhibit a strong antagonistic response to sympathetic activity in response to stress.

E) exhibit higher levels of serotonin.

15)

Depression may be a risk factor for CHD due to its relationship with

A) C-reactive protein.

B) the metabolic syndrome.

C) both C-reactive protein and the metabolic syndrome.

D) decreased energy levels.

E) Depression is not a risk factor for CHD.

16)

Social dominance refers to

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A) AIDS. B) just-cause mortality.

C) a pattern of attempting to dominate social interactions.

D) a slower than normal speaking rate.

E) patiently listening to others.

17) As a recommended intervention for the modification of coronary-prone behaviour, exercise

A) can reduce CHD risk factors only for a short duration.

B) can enhance psychological well-being only during exercise sessions.

C) can reduce CHD morbidity temporarily.

D) can help reduce the anxiety associated with CHD following cardiac events.

E) has no effect on anxiety associated with CHD.

18) Which of the following has NOT been found to be associated with delay before seeking treatment for myocardial infarction?

A) Interpretation of symptoms as mild disorders B) Being young C) A history of angina or diabetes D) Experiencing an attack during the daytime E) A distracting environment

19)

Beta-blocking agents are used in cardiac rehabilitation

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A) to activate the parasympathetic nervous system.

B) to resist the effects of sympathetic nervous system stimulation.

C) to control the pain of angina pectoris.

D) when behavioural stress management interventions fail.

E) to lower levels of LDL cholesterol.

20)

The goals of cardiac rehabilitation are to

A) relieve the patient from symptoms.

B) provide emotional support to the patient.

C) provide economic and vocational support to the patient.

D) produce relief from symptoms, reduce severity of the disease, and promote psychological and social adjustment.

E) provide medical support to the patient.

21) is/are the most common drug treatment for reducing the incidence of death, heart attack, and stroke.

A) Statins B) Diuretics C) Beta-blockers D) Vitamins E) Aspirin

22) CHD.

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is an Internet-delivered program for increasing physical activity in patients with

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A) Let's Move B) CardioFit C) GetFit D) Let's Cardio E) FitCardio

23)

Cardiac rehabilitation programs involve

A) exercise therapy.

B) smoking cessation.

C) nutritional counselling D) Exercise therapy, psychological counselling, support groups, nutritional counselling, and education.

E) exercise therapy and nutritional counselling only.

24)

Cardiac invalidism occurs when

A) patients and their partners underestimate the patient's physical abilities.

B) spouses underestimate the extent of disability.

C) patients malinger in order to reap secondary gains associated with the sick role.

D) patients feel that they are unable to control the stressors in their daily lives.

E) spouses overestimate the patient's physical abilities.

25) In a study of cardiac invalidism (Taylor et al., 1985), wives' perceptions of their husbands' cardiac and physical efficiency were highest when they had

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A) been provided information about their husband's medical and psychological condition.

B) observed their husband's performance on a treadmill task.

C) personally experienced the treadmill task themselves.

D) been involved in the decision-making process regarding treatment.

E) observed them at home doing everyday tasks.

26)

Sudden death from heart attack is most likely to occur

A) at home.

B) at work.

C) on vacation.

D) while the patient is asleep.

E) at a restaurant.

27)

Diastolic pressure is related to

A) resistance of the blood vessels to blood flow.

B) the amount of force developed during contraction of the heart.

C) the volume of blood leaving the heart.

D) the arteries' elasticity.

E) diagnosing hypertension.

28)

Males are at greater risk for hypertension

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A) across the life span.

B) before age 40.

C) before age 50.

D) after age 50.

E) after age 60.

29) There is mounting evidence that hypertension.

may be a risk factor for

A) positive affectivity B) occasional anger C) excessive competitiveness D) emotional dampening E) defensiveness

30)

The role of stress in the development and exacerbation of hypertension

A) is the same for people at risk for hypertension and those who are not at risk.

B) does not change as hypertension progresses.

C) may be different for people at risk for hypertension.

D) has not been studied enough to determine what the role is.

E) is still unclear.

31) In a study of Canadian-Chinese and American-Chinese women by Satia-Abouta, Patterson, Kristal, Teh, and Tu (2002), the prevalence of hypertension associated with acculturation may be traced to

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A) the stress of acculturation.

B) the pressure to change traditional lifestyle practices, including an adopted diet lower in fruit and vegetables.

C) exposure to chronic environmental stressors.

D) anxiety related to learning a new language.

E) There are no health risks associated with acculturation.

32)

The longer immigrants have been living in Canada

A) the more levels of hypertension resemble the general population.

B) the greater the likelihood of having hypertension.

C) the less researchers can separate hypertension from socio-economic variables.

D) the incidence of hypertension drops dramatically.

E) has no effect, hypertension can set in at any time during acculturation.

33)

One drug treatment for hypertension, beta-adrenergic blockers, work by

A) decreasing cardiac output and decreasing plasma renin activity.

B) decreasing sympathetic outflow from the central nervous system.

C) depleting catecholamines from the brain and the adrenal medulla.

D) reducing blood volume by promoting the excretion of sodium.

E) decreasing cardiac output and increasing plasma renin activity.

34) Caffeine restriction is often included as part of the dietary treatment of hypertension because

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A) caffeine alone elevates blood pressure responses among those at risk for or already diagnosed with hypertension.

B) caffeine generally contributes to rising levels of hypertension.

C) it is an easy and inexpensive treatment.

D) caffeine, in conjunction with stress, elevates blood pressure, and contributes to rising levels of hypertension.

E) caffeine restriction is never a recommended part of a dietary treatment for hypertension.

35)

Asha regularly engages in transcendental meditation (TM), which is likely to

A) increase her muscle mass.

B) reduce her appetite altogether.

C) reduce her cravings for sweets only.

D) reduce her blood pressure.

E) increase endurance for lifting weights.

36)

Cognitive behavioural techniques

A) may substitute for drug treatments in cases of severe hypertension.

B) aggravate sympathetic nervous system activity.

C) are effective but expensive compared to drug treatments for hypertension.

D) designed to control the expression of anger have been unsuccessful in the treatment of hypertension.

E) can be used without supervision and have no side effects.

37)

The correlation between beliefs about level of blood pressure and actual blood pressure is

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A) high.

B) moderate.

C) low.

D) zero.

E) > than 8.

38)

The risk factors for stroke

A) are independent of those for heart disease.

B) decrease with age.

C) are not subject to modification by lifestyle changes.

D) include cigarette smoking.

E) include a high white blood cell count.

39)

Patients with right-brain damage due to stroke typically have

A) communication disorders such as aphasia.

B) impaired performance on cognitive tasks that require the use of short-term memory.

C) difficulty in processing visual feedback.

D) extreme anxiety and depression.

E) impaired performance on tasks that require language generation.

40) Small strokes that produce temporary weakness, clumsiness, or loss of feeling in one side or limb are called

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A) cerebral hemorrhages.

B) hypertension.

C) CHD. D) transient ischemic attacks.

E) temporary cerebral attacks.

41)

Predictors of depression in stroke patients does NOT include

A) overprotection by a caregiver.

B) the site and severity of stroke.

C) poor relation with a caregiver.

D) a caregiver with a negative viewpoint on the caregiving situation.

E) over-medication.

42) Which of the following is NOT one of the rehabilitative interventions used for stroke patients?

A) psychotherapy.

B) cognitive remedial training.

C) family counselling.

D) the use of structured, stimulating environments to challenge the stroke patient's capabilities.

E) training in specific skills development.

43)

Ram suffered from a stroke. Recovery via rehabilitation will work best

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A) only within the first three months of the stroke.

B) only within the first six months of the stroke.

C) only within the first year of the stroke.

D) only within the first two years of the stroke.

E) over subsequent years.

44)

Type I (insulin-dependent) diabetes

A) develops relatively late in life (after age 40).

B) accounts for 90 percent of all diabetics.

C) is characterized by an abrupt onset of symptoms.

D) usually is inherited.

E) is related to obesity.

45)

Type II (noninsulin-dependent) diabetes

A) develops relatively late in life (after age 40) but is becoming more common in children and adolescents.

B) accounts for 70 percent of all diabetics.

C) occurs when insulin action and secretion is regulated.

D) most commonly occur in women.

E) is a disorder primarily found among adolescents.

46)

Diabetes has NOT been linked to

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A) blindness among adults.

B) nervous system damage.

C) sexual dysfunction in men and women.

D) impaired memory.

E) longer than average life expectancy.

47)

Poor adherence to diabetes treatment seems, in part, to be due to

A) The nature of the treatment regimen; requiring self-control for lifestyle factors such as diet and exercise.

B) regional factors.

C) personality factors.

D) family background.

E) socio-economic status.

48)

Which of the following would NOT improve adherence to a diabetic treatment regimen?

A) Strong social support; either personal or professional.

B) Accurate information and sufficient understanding of the rationale for a treatment regimen.

C) Any intervention that focuses on improving a sense of self-efficacy and the ability to independently regulate one's behaviour.

D) Feeling threatened by one's disease.

E) Interventions that promote a future time perspective.

49) Studies of diabetic control and adherence indicate that better outcomes can be found among adolescents who have

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A) individual therapy.

B) family therapy.

C) parents who are actively involved in diabetes management tasks such as monitoring glucose levels.

D) a dense social support network.

E) parents who allow them to monitor their own glucose levels, giving them a sense of independence and accomplishment.

50) Explain the relationship of lifestyle factors to coronary heart disease and cardiac rehabilitation.

51) Discuss what we currently know regarding how women experience coronary heart disease. Include the factors contributing to its development and the consequences for women in comparison to men.

52) In what ways is acculturation related to the incidence of hypertension? How might acculturation directly, or indirectly, impact health?

53) What are the consequences of stroke? What are the rehabilitative interventions used to manage the consequences of stroke?

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54) Explain why adherence to diabetic treatment programs is so difficult for most people to achieve.

55) One of the most significant aspects of CHD is that a number of the deaths that occur each year are premature deaths. ⊚ ⊚

true false

56) Across the life span, women seem to be protected against coronary heart disease relative to men. ⊚ ⊚

57)

true false

A type of proinflammatory cytokine is implicated in the development of atherosclerosis. ⊚ ⊚

true false

58) Cognitive behavioural interventions may reduce the drug requirements for the treatment of hypertension.

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⊚ ⊚

59)

true false

Mild hypertension is defined by a diastolic pressure consistently between 105 and 119. ⊚ ⊚

true false

60) National campaigns to educate Canadians about hypertension have not been very successful in getting people diagnosed and treated. ⊚ ⊚

61)

true false

Stroke occurs more often in women than in men. ⊚ ⊚

true false

62) In terms of emotional response, patients with left-brain damage from a stroke seem indifferent to their situation. ⊚ ⊚

true false

63) Whereas stress adversely affects adherence to treatment and diet, stress has not been found to directly affect Type I and Type II diabetes. ⊚ ⊚

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64)

Depression often is a complication of diabetes. ⊚ ⊚

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Answer Key Test name: Chapter 13 Test Bank 1) B 2) A 3) B 4) D 5) B 6) B 7) B 8) B 9) E 10) A 11) A 12) C 13) D 14) C 15) C 16) C 17) D 18) B 19) B 20) D 21) A 22) B 23) D 24) A 25) C 26) A Version 1

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27) A 28) C 29) D 30) C 31) B 32) B 33) A 34) D 35) D 36) E 37) C 38) D 39) C 40) D 41) E 42) C 43) E 44) C 45) A 46) E 47) A 48) D 49) C 50) Answers may vary.

51) Answers may vary.

52) Answers may vary.

53) Answers may vary.

54) Answers may vary.

55) TRUE 56) FALSE Version 1

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57) TRUE 58) TRUE 59) FALSE 60) FALSE 61) FALSE 62) FALSE 63) FALSE 64) TRUE

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Student name: 1)

Psychoneuroimmunology refers to

A) the relationship between stress and psychology.

B) inflammatory and allergic reactions.

C) the activation of T cells through the secretion of cytokine.

D) the interactions among behavioural, neuroendocrine, and immunological processes of adaptation.

E) the relationship between the immune system and psychology.

2)

Intense, short-term stressors

A) B) pathogens.

C) D) E)

3)

recruit cells that may help defend against wounds and infection. upregulate immune functioning in ways likely to ward off threats posed by affect most measures of immune functioning adversely. contribute to heart disease and declines in cognitive performance. are more dangerous than chronic stressors.

Stress has been related to

A) rates of infectious disease in children and adults.

B) the development of herpes virus infections.

C) faster wound healing.

D) delayed immune functioning.

E) immunocompetence.

4)

Which of these is NOT a chronic psychosocial stressor?

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A) unemployment B) a low socio-economic status C) job stress D) childhood adversities E) secure attachment

5)

Academic stress has been associated with

A) decreases in total T, and lymphocytes.

B) increases in natural killer cells.

C) higher rates of infectious disease in adults but not children.

D) increased distress but few changes in immune functioning.

E) compromised immune functioning.

6)

Evidence supports the notion that immune functioning is impaired by

A) hardiness.

B) worry.

C) depression.

D) problem solving.

E) resilience.

7)

can trigger apoptosis (cell death) of white blood cells.

A) Cytokines B) Cortisol C) Testosterone D) Aldosterone E) Dopamine

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8) Evidence suggests that some of the adverse effects of depression on immunity may be mediated by

A) hostility.

B) disturbed hypothalamic functioning.

C) poor maturation of the immune system.

D) sleep disturbance.

E) overactive thyroid.

9) The quality of one's interpersonal relationships has been implicated in immunocompromise. Which of the following has NOT been found to be associated with physical and emotional illness?

A) Being single.

B) Bereavement.

C) Loneliness.

D) Divorce and separation.

E) Being an empty nester.

10)

The links between social support and immune functioning

A) are especially strong for adolescents.

B) are supported by studies showing perceived social support predicted greater NK cell activity.

C) suggest that loneliness is not a risk factor for poor antibody response to influenza vaccination.

D) indicate that being newly separated or divorced positively impacts immunity.

E) are weak.

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11) Feelings of self-efficacy and the ability to exercise control over stressful events are associated with

A) less immunocompromise under stress.

B) less immunocompetence under stress.

C) more immunocompromise under stress.

D) more immunocompetence under stress.

E) more immunocompetence and immunocompromise under stress.

12) Studies of coping and resilience have found that the stress-immune functioning relationship is moderated by

A) pessimism.

B) self-efficacy.

C) external locus of control.

D) passive coping methods.

E) the fact that personality and coping styles do not moderate the stress-immune functioning relationship.

13) Research on relaxation for enhancing immunocompetence has found that increased the number of circulating leukocytes and decreased cortisol.

A) Swedish massage B) mindfulness meditation C) tai chi chih D) a 20-minute leg massage E) group intervention programs

14)

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may mute the effects of stress on the immune system.

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A) Relaxation B) Social contact C) Repressing one's thoughts about the stressful event D) Stress management skills E) Meditation

15)

HIV primarily attacks

A) helper T cells and macrophages.

B) leukocytes.

C) natural killer cells.

D) B cells.

E) platelets.

16) for women.

and

are the two main means of exposure to HIV

A) Heterosexual contact; injection drug use B) Homosexual contact; injection drug use C) Blood transfusions; injection drug use D) Injection drug use; bisexual contact E) Bisexual contact; blood transfusions

17)

What percentage of HIV-infected Canadians are women?

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A) 10 B) 17 C) 25 D) 47 E) 59

18)

The most promising development in the treatment of AIDS is

A) an HIV vaccine.

B) AZT. C) protease inhibitors.

D) DDI. E) HIV prevention programs.

19) Worldwide, it is estimated that approximately a third of all new reported HIV infections occur within this group:

A) ethnic minorities.

B) gay men.

C) minority women.

D) IV drug users.

E) adolescents and young adults

20) Ruma has been diagnosed with AIDS, and has little social support. What is likely to accompany AIDS?

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A) Anxiety B) Phobia C) Depression D) Asthma E) Arthritis

21)

According to the text, whose germs are seen as less threatening?

A) Sally, whom you dislike intensely.

B) Susan/Tom, your lover.

C) Tony, whom you have just met.

D) Francoise, whom you met on the streets of Paris.

E) Lindsay, your co-worker.

22)

Improving the effectiveness of AIDS education as a primary prevention strategy

A) includes starting in elementary school before sexual activity begins.

B) should include making AIDS education culturally sensitive.

C) includes giving the education after a man has been dating his partner for six weeks.

D) should target inner-city women.

E) is a lost cause, since education is an ineffective prevention strategy.

23)

Evidence suggests that HIV counselling and education was an effective means of

A) primary prevention for HIV + individuals.

B) reducing behaviours that might infect others.

C) primary prevention for uninfected participants.

D) raising awareness of the implications of HIV and pregnancy.

E) raising awareness of the implications of HIV and alcohol use.

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24) Perceptions of self-efficacy, with respect to AIDS risk-related behaviour, have been related to

A) decreased condom use among gay men.

B) increased number of sexual partners.

C) increased number of anonymous sexual partners.

D) increased condom use among university students.

E) frequency of visits to a primary physician.

25)

Condom use among adolescents

A) appears to be decreasing.

B) is independent of other behavioural problems such as drug and alcohol use.

C) has been found to be related to peer norms and perceptions of personal efficacy.

D) appears to be increasing.

E) is independent of peer norms.

26)

Intervention programs developed to work with IV drug users

A) should be targeted towards reducing contact with infected needles.

B) should focus on individual psychotherapy interventions.

C) should not include methadone programs as they don't work.

D) have found that needle exchange programs are ineffective.

E) should target individual drug users.

27) Research suggests that those who used the Internet in conjunction with managing their seropositive status than those not using the Internet.

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A) had fewer active coping skills B) had less social support C) had less accurate HIV disease knowledge D) had more social support and active coping skills E) had more HIV-disease knowledge, had more active coping skills, engaged in more information-seeking coping, and had more social support

28) A sense of AIDS.

is important in successful medication adherence and adjustment to

A) self-efficacy B) self-achievement C) self-control D) self-esteem E) self-monitoring

29) Studies have found that _ beliefs about the self and the future are associated with the onset of AIDS in individuals with HIV.

A) positive B) negative C) neutral D) unrealistic E) individual

30) According to the research cited in your text, which of the following patients would be expected to be better adjusted and most successful in coping with AIDS?

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A) Paul, who is confident that the medical personnel who staff his experimental treatment program are outstanding in the field and his best chance for survival.

B) Mary, who contracted AIDS through a transfusion and feels that she has no personal control over the disease.

C) Tom, who has turned to alternatives to traditional medicine and feels that his holistic practitioner can best arrest the progression of the disorder.

D) John, who feels that he can control the disease and its symptoms and has taken personal responsibility for its treatment.

E) Rita, who feels hopeless about her future with AIDS.

31)

All cancers result from

A) immunocompromise.

B) a dysfunction in RNA. C) a dysfunction in DNA. D) a reduction in DNA. E) lifestyle factors.

32) According to the World Health Organization (2019), between _ percent of cancer could be prevented by modifying or reducing risk factors such as tobacco use, obesity, low intake of fruits and vegetables, physical inactivity, alcohol use, and sexual transmission of the HPV.

A) 20 to 30 B) 30 to 50 C) 40 to 60 D) 50 to 70 E) 60 to 65

33)

On the whole, the fact that many cancers run in families is most closely tied to:

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A) a genetically inherited predisposition to cancer.

B) lifestyle factors that may influence the development of cancer.

C) ethnic differences in the development of certain cancers.

D) a shared vulnerability to infectious agents implicated in the development of some cancers.

E) sociocultural development of cancer.

34)

Research on the association between depression and cancer has found that

A) there is a modest but questionable association between depression and cancer mortality.

B) decreasing depression scores are associated with significantly longer cancer survival.

C) there is little research supporting the notion that depression is linked to cancer progression.

D) elevated neural endocrine responses associated with depression are unrelated to cancer development.

E) increased levels of depression significantly increase the spread of cancer.

35)

Stress may be linked to cancer via which of the following mechanisms?

A) Immunocompromise B) NK cell inactivity C) Active coping D) Research findings are contradictory E) Research is inconclusive

36)

According to the Canadian Cancer Society, each year cancer causes approximately deaths in Canada.

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A) 20,000 B) 35,000 C) 42,600 D) 78,000 E) 100,000

37) The consequence of receiving chemotherapy in the same place by the same person under the same circumstances is

A) conditioned nausea.

B) conditioned immune suppression.

C) impaired long-term compliance.

D) debilitating nausea.

E) unconditioned nausea.

38)

For cancer patients, effective social support

A) improves immunologic responses.

B) improves social adjustment.

C) can be problematic as it makes them dependent on others.

D) brings to mind intrusive thoughts about the cancer.

E) lowers their self-esteem.

39)

Research shows that cancer survivors may show elevated levels of cortisol due to

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A) fear of recurrence.

B) effects of medications.

C) excitement about improvement in health.

D) worry about the future.

E) social maladjustment.

40) A study of cancer patients conducted by Dunkel-Schetter and her colleagues (1992) found that patients who coped with their cancer-related problems via showed more emotional distress.

A) social support B) cognitive escape-avoidant strategies C) distancing D) emotion-focused coping E) online support groups

41) Several interventions have been employed to facilitate cancer patients' coping with chemotherapy. Which of the following interventions may be one way to help counteract the negative immunological effects of standard cancer treatments?

A) relaxation training B) expressive disclosure C) dragon boat racing D) mindfulness-based stress reduction E) body massages

42)

Peer counselling groups, such as Reach to Recovery, involve

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A) groups of patients with the same disorder who discuss common issues and problems.

B) a well-adjusted patient acting as an adviser to a newly diagnosed patient.

C) a well-adjusted patient counselling the newly diagnosed patient's family in social support skills.

D) one-on-one intensive psychotherapy.

E) a healthy person acting as an adviser to a newly diagnosed patient.

43)

Rheumatoid arthritis

A) is the least crippling form of arthritis.

B) can affect any age group, including children.

C) has been associated with a perfectionist and depressed personality type.

D) is relatively unaffected by stress and psychological variables.

E) is unrelated to immune function.

44)

A lack of understanding may be particularly problematic when the person with arthritis

A) is having flare.

B) has to depend on others for support.

C) does not have any outwards signs of the disease.

D) does not communicate their physical limitations.

E) is an athlete.

45)

Osteoarthritis

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A) affects the small joints of the wrists, hands, and feet.

B) involves the destruction of the bone and muscle tissue of the joint.

C) involves the deterioration of cartilage in weight-bearing joints.

D) is caused by weight gain.

E) only occurs in individuals over age 65.

46)

Lupus

A) is most common among women of child-bearing age (15-45).

B) results from the buildup of uric acid in the body.

C) can be managed by maintaining proper weight and taking aspirin.

D) is more prevalent in rainy climates.

E) is most common among people who avoid outdoor activity.

47) Explain how stress is related to immunocompromise. Exactly how does the immune system respond to stress?

48) What is the relationship among depression, loneliness, interpersonal conflict, and immunocompromise? Do individual differences in coping styles affect this relationship? If so, how?

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49) What is the psychosocial impact of AIDS? What factors can amplify or lessen this impact?

50)

How do psychosocial factors influence the initiation and course of cancer?

51) What is the psychosocial impact of rheumatoid arthritis (RA)? How are psychosocial factors implicated in the course and treatment of RA?

52) Psychoneuroimmunology refers to the interactions among behavioural, neuroendocrine, and immunological processes of adaptation. ⊚ ⊚

true false

53) Studies with human subjects indicate that exposure to stressors is related to immunologic change. ⊚ ⊚

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54) Studies have found impaired immune functioning among bereaved individuals, even if these individuals do not show evidence of depression. ⊚ ⊚

true false

55) Impaired immune functioning has been found in samples of adults who have experienced short-term marital conflict, marital separation, and divorce. ⊚ ⊚

56)

true false

Loneliness has an adverse effect on immune functioning. ⊚ ⊚

true false

57) The majority of people diagnosed with AIDS appear to make positive changes in their health behaviours almost immediately after diagnosis. ⊚ ⊚

58)

true false

Past sexual practice is an important predictor of AIDS risk-related behaviour. ⊚ ⊚

true false

59) In Canada mortality rates for lung and prostate cancer in men, and breast and cervical cancer in women have increased between 1988 and 2017.

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⊚ ⊚

60)

One of the most common complications of rheumatoid arthritis is depression. ⊚ ⊚

61)

true false

true false

Rheumatoid arthritis is the most common form of arthritis in Canada. ⊚ ⊚

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Answer Key Test name: Chapter 14 Test Bank 1) D 2) A 3) D 4) E 5) E 6) C 7) B 8) D 9) A 10) B 11) A 12) B 13) A 14) A 15) A 16) A 17) C 18) C 19) E 20) C 21) B 22) B 23) B 24) D 25) C 26) A Version 1

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27) E 28) A 29) B 30) D 31) C 32) B 33) B 34) B 35) A 36) D 37) A 38) A 39) A 40) B 41) A 42) B 43) B 44) C 45) C 46) A 47) Answers may vary.

48) Answers may vary.

49) Answers may vary.

50) Answers may vary.

51) Answers may vary.

52) TRUE 53) TRUE 54) FALSE 55) TRUE 56) TRUE Version 1

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57) TRUE 58) TRUE 59) FALSE 60) TRUE 61) FALSE

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Student name: 1)

Which of the following is NOT an ethical concern with regard to death and dying?

A) Aid in dying.

B) The spread of communicable disease.

C) Advanced care directives.

D) The patient's right to die.

E) Euthanasia.

2) As the elderly population increases, a corresponding increase is expected in the incidence of all BUT the following?

A) Deafness B) Vision problems C) Arthritis D) Osteoporosis E) Drunk driving fatalities

3)

Health promotion programs that target the elderly

A) are a waste of money because health habits are established early in life.

B) are important right now, but they will become less important as the size of the elderly cohort declines over the next 10 years.

C) will become increasingly important as the size of the elderly cohort continues to increase over the next 10 years.

D) will become less important because the elderly cohort is exceptionally healthy and active.

E) should focus only on the dietary habits and not than social/emotional effects of aging.

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4) Significant gains in the quality of life would best be achieved by reorienting the focus of health promotion toward

A) B) C) D) E) elsewhere.

5)

increasing the period of morbidity. reducing morbidity and delaying mortality. tapering off social support to foster greater independence. detoxing with essential oils and treating all health conditions with cannabis oils. euthanizing the sickest individuals, so health care resources can be allocated

Future programs targeting the management of chronic illness must incorporate

A) cost-effective interventions to improve quality of life.

B) methods of downgrading chronic illness to acute illness.

C) a primary focus on cancer and HIV, since they cost the most to treat.

D) psychic mediums to help predict which people will develop chronic illness.

E) the elimination of immunizations that cause autism.

6)

Advancements in the treatment of chronic disease include

A) increased use of improved pharmacological pain control techniques.

B) a shift in the responsibility for pain control from the practitioner to the patient.

C) increased acceptance of co-management of pain by the practitioner and the patient.

D) state-of-the-art treatments for chronic pain becoming increasingly available at local clinics and hospitals.

E) increasing the frequency of non-invasive surgeries for minor symptoms.

7)

One of the chief remaining tasks of managing chronic disorders is identifying

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A) how to improve pain management with cognitive-behavioural methods.

B) how to increase acceptance of alternative medicine.

C) the best way to gain adherence to multiple treatment goals simultaneously.

D) how to shift responsibility for pain control from the patient to the practitioner.

E) the best way to increase gender equality in adherence.

8)

Refocusing health promotion strategies toward morbidity

A) should reduce health care costs.

B) will raise health care costs significantly.

C) is unnecessary because there will always be 10 top causes of death.

D) will not enhance quality of life.

E) is only important for those at risk of chronic illness.

9)

Allostatic load is

A) the weight that load bearing muscles experience when lifting heavy items.

B) the mental load on cognitive faculties from too much studying.

C) another term for lack of sleep.

D) the "wear and tear" on the body in response to prolonged stress.

E) another term for having too many medications.

10)

Average Canadian Indigenous peoples live

than average Canadians.

A) the same B) less C) more D) ten years longer E) ten years less

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11)

Future health promotion efforts could promote resilience by

A) finding ways to increasing social support and a sense of connectedness to one's community.

B) ignoring factors that may reduce morbidity or delay mortality.

C) teaching people avoidant coping strategies.

D) exploring how to decrease personal control with age.

E) discourage exercise among senior citizens.

12) is

The Health Council of Canada has suggested that the biggest health care issue in Canada

A) growing health care costs.

B) inequality.

C) health care access.

D) patient consumerism.

E) the high prevalence of health compromising behaviours.

13)

To better address the health needs of women in the future, it may be necessary to

A) recognize the diversity among Canadian women with respect to risk factors for health and access to health care.

B) conduct more research on men to give the women a control group to compare to.

C) mirror the health recommendations that have been established for men.

D) focus on women with strong social support systems.

E) focus on women who are highly educated and of higher socio-economic status.

14)

Heart disease research has substantially overrepresented in

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A) men.

B) women.

C) the elderly.

D) minorities.

E) alcoholics.

15) Occupational stress researchers have identified job characteristics that are tied to stress.

Which is NOT one of these characteristics?

A) Having little opportunity for social support.

B) Transient employment.

C) Jobs with high control and low demands.

D) Unstable employment.

E) Uncertain employment.

16) With respect to the advances in stress management, which group of people should researchers focus on?

A) The populations at the lowest risk for stress-related disorders.

B) The populations at particular risk for stress-related disorders.

C) The populations that have strong social support systems.

D) Married couples.

E) The population with the highest socio-economic status.

17)

Some of the limitations of virtual social support may be overcome by

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A) surfing the Internet.

B) the growing use of social networking sites.

C) reading.

D) watching television.

E) viewing favourite films and shows on Netflix.

18) Which of the following is NOT one of the basic problems facing the users of the health care system in Canada?

A) The marginal gaps in health status among Canadians, which makes it difficult to determine which areas need improvement.

B) The inequity of health care.

C) The access to health care.

D) The delivery of health care.

E) The wide gaps in health status among Canadians.

19) Which of the following is NOT one of the suggested solutions to deal with Canada's health care access issues?

A) Easing the restrictions placed upon foreign physicians.

B) Training and integrating physician assistants into the health care system.

C) Increasing the availability of telehealth technologies to underserved areas such as Canada's northern and rural communities.

D) Integrating virtual health care.

E) Privatizing health care altogether.

20) Complementary and alternative medicine (CAM) providers may be one potential venue for encouraging and supporting health behaviour change because

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A) it takes all of the responsibility away from the patient.

B) many Canadians prefer a non-holistic approach to treatment C) they provide "proven" alternative medicines that have yet to be approved by Health Canada.

D) the patient is more engaged and therefore feels more responsible for their health.

E) only those who are capable of behavioural change will use their services.

21)

Integrative care

A) is exclusively focused on complementary therapies.

B) is exclusively focused on conventional treatments.

C) has never been funded by the Canadian government.

D) combines complementary therapies with conventional treatments.

E) does not represent a holistic treatment approach.

22)

Comprehensive intervention models

A) concentrate and coordinate medical and psychological expertise in well-defined areas of medical practice.

B) have yet to be developed for chronic diseases.

C) are focused exclusively on providing traditional medical care.

D) aim to isolate and focus on individual symptoms.

E) are on the decline in Canada.

23) The current trend toward cost containment pushes health psychology in the direction of research questions designed to

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A) develop interventions that are time-limited, symptom-focused, and offered as outpatient services.

B) keep people out of the health care system altogether.

C) lower the costs of providing health care services in rural areas.

D) narrow the field of health psychology towards mental health exclusively.

E) cure, rather than treat complex health conditions altogether.

24) Fewer hospital days, higher accessibility, and safer treatments are the result of providing appropriate psychological services. The number one reason Canada continues to see many psychologists in the health care system is because

A) opening a private practice is no longer legal in Canada.

B) psychologists are paid higher than any other health care provider.

C) there is pressure to contain costs in the health care system.

D) there is a lower incidence of mental illness than there was 20 years ago.

E) there are currently more mentally ill Canadians than there are mentally well Canadians.

25) Why is refocusing health promotion efforts important and how can this be achieved?

Explain which institutions and factors need to be considered in order to improve health promotion in the future.

26) Broadly speaking, what are some of the issues in chronic illness management for the future? How can these issues be addressed from a macro perspective? Provide examples of possible solutions.

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27) In regard to stress management, explain how and why virtual social support may be more effective than in-person social support for some individuals.

28) Explain the current pressures toward cost containment of health care services. In what ways do these economic factors affect research and practice in health psychology?

29)

A long life does not necessarily mean that one has lived a healthy life. ⊚ ⊚

30)

true false

Researchers have finally reached consensus on a definition of healthy aging. ⊚ ⊚

true false

31) Although some of the racial differences in Indigenous health stems from differences in socio-economic status, some differences are due to the lack of access to traditional medicines, healers, or wellness practices.

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⊚ ⊚

32)

Gender is a key social determinant of health. ⊚ ⊚

33)

true false

true false

In Canada, women are more likely than men to take care of their aging parents. ⊚ ⊚

true false

34) Interprofessional teams can be used to address the current problems with health care access in remote communities. ⊚ ⊚

true false

35) In Canada, the face of AIDS is shifting toward poor urban populations, as well as the country's Indigenous peoples. ⊚ ⊚

true false

36) Integrative care provides holistic treatment and aims to increase a patient's sense of control over their health. ⊚ ⊚

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37)

A pain management program is an example of a comprehensive intervention model. ⊚ ⊚

38)

true false

For every $1 spent on psychological care there is a $5 saving in medical costs. ⊚ ⊚

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Answer Key Test name: Chapter 15 Test Bank 1) B 2) E 3) C 4) B 5) A 6) C 7) C 8) A 9) D 10) B 11) A 12) B 13) A 14) A 15) C 16) B 17) B 18) A 19) E 20) D 21) D 22) A 23) B 24) C 25) Answers may vary.

26) Answers may vary.

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27) Answers may vary.

28) Answers may vary.

29) TRUE 30) FALSE 31) TRUE 32) TRUE 33) TRUE 34) TRUE 35) TRUE 36) TRUE 37) TRUE 38) TRUE

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CHAPTER 1 WHAT IS HEALTH PSYCHOLOGY?

Learning Objectives 1 2 3 4 5

Describe and Define Health Psychology Understand How Our View of the Mind-Body Relationship Changed Over Time Explain the Biopsychosocial Model of Health Identify Why the Field of Health Psychology is Needed Relate the Purpose of Health Psychology Training

Lecture Suggestions Socioeconomic Status and Health This review assesses the links between socioeconomic status and health across the lifespan and makes recommendations for future research.

Matthews, K. A., & Gallo, L. C. (2011). Psychological Perspectives on Pathways Linking Socioeconomic Status and Physical Health. Annual Review of Psychology, 62(1), 501-530.

Exercises, Projects, and Activities Health Psychology in the Popular Press Have students bring articles from the news media, blogs, and the popular press about health issues to discuss in class. Many newspapers have a weekly health section, and magazines devoted to health, fitness, and wellness are readily available. These news items and articles may provide the basis for a discussion on the dissemination of research findings to the general population, the problems in interpreting research in health psychology, and the frustrations experienced by media consumers who may have to sift through a series of competing health-related claims.

Beliefs About Illness and Healing To explore different perspectives on health and healing that incorporate the biopsychosocial approach, you can introduce the whole systems research model (Verhoef, Vanderheyden, Dryden, Mallory, & Ware, 2006) to students for discussion. Verhoef, who formerly held a Canada Research in Complementary Medicine at the University of Calgary, outlines a synergistic model of complementary medicine outcomes that highlights how psychological, social, physical, and spiritual factors may interplay with contextual factors to enhance clinical outcomes. Students can discuss their views on how the outcomes included may or may not be important for health and healing. Have students rate on a scale from not important to very important how meaningful each of the outcomes is for them in the short term, and then again in the long term, and then discuss why their ratings may have changed.

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Verhoef, M. J., Vanderheyden, L. C., Dryden, T., Mallory, D., & Ware, M. A. (2006). Evaluating complementary and alternative medicine interventions: in search of appropriate patient-centered outcome measures. BMC Complementary and Alternative Medicine, 6(1), 38.

Social Determinants of Illness To promote discussion of the role of social factors in health and illness have students read and discuss some of the facts from the World Health Organization’s (WHO) Fact sheet on the top ten causes of death worldwide. Ask students to review and discuss the reasons why the causes of death differ from high, middle, and low income countries in the world, and similarly why death trends differ by age among countries with different socioeconomic resources.

Students can view the online version of the WHO fact sheet at: https://www.who.int/en/news-room/fact-sheets/detail/the-top-10-causes-of-death

Recommended Reading Mikkonen, J., & Raphael, D. (2010). Social Determinants of Health: The Canadian Facts.

Toronto: York University School of Health Policy and Management.

This document in pdf format is available for download: http://www.thecanadianfacts.org/The_Canadian_Facts.pdf

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Web Videos In this short video clip a Naturopathic doctor explains holistic health and how it differs from biomedicine, and outlines what occurs in a typical holistic health consultation with a client. http://www.dailymotion.com/video/xitcdi_toronto-alternative-medicine_people Bio-Psychosocial Model of Health and Illness Dr, Kenneth Craig discusses the biopsychosocial model of health and illness http://www.youtube.com/watch?v=pQbnmi5fTZY The Honorable Marc Lalonde In this video, the historical and political forces surrounding the introduction of the Lalonde Report are presented. It also features reflections by Marc Lalonde and others on the impact of this report for public health promotion. http://www.youtube.com/watch?v=QUivL3y8Jzk Diagnosing illness in the 15th Century This short video clip of a reenactment of how physicians in the 15th century would have diagnosed illness based on the Ancient Greek model of the four humors provides an interesting perspective on how models of health and illness guide treatment. http://www.youtube.com/watch?v=aJEqw0o1cEc

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CHAPTER 2 THE SYSTEMS OF THE BODY Learning Objectives 1 2 3 4 5

Describe the Function of the Nervous System Explain How the Endocrine System Operates Identify How the Cardiovascular System Works Describe the Function of the Immune System Understand the Physiological Systems Involved in the Stress Response

Exercises, Projects, and Activities Mapping the Brain Identifying the areas of the brain and learning their functions often is difficult for students. An exercise that provides practice for this knowledge is locating and labeling specific areas on a drawing of the brain.

Students can use diagrams provided in the text for aid in locating the areas.

The Role of Neurotransmitters—A Play Hamilton and Knox (1996) developed a rather innovative class demonstration to portray the neuron activity and physiology. A “play” is staged with class members acting the parts of the various parts of the neuron (e.g., dendrites, axons, sodium molecules). At one point, the neurotransmitters are bumped across the synapse into the arms of the receptors. An interesting variation on this sequence is for the neurotransmitters to be bumped into the receptors, but the receptors’ arms are closed. Complete directions, including props, can be found in Hamilton and Knox (1996).

Hamilton, S. B., & Knox, T. A. (1996). The colossal neuron: Acting our physiological psychology. In M. E. Ware & D. E. Johnson (Eds.), Handbook of demonstrations and activities in the teaching of psychology (pp. 14–18). Mahwah, NJ: Lawrence Erlbaum.

If You Had to Get Infected…..A Hypothetical Discussion Exercise One exercise that I (F. Sirois) have used to promote interesting and engaging in-class discussion about infection and immunity involves asking students to imagine that they are in a situation whereby they have to become infected by one of the four routes of transmission outlined in the text. Given this implausible, yet interesting situation, ask students about which of the four ways they would most prefer contracting an infection and why, as well as which route of disease transmission would they least prefer. Instruct them to be specific in their answers by naming the possible diseases that may be transmitted by their preferred and least preferred transmission choices. Have students discuss and defend their answers in small groups first and then open it up for them to share with the whole class. You can also extend this exercise by asking them about the steps they would take to reduce their risk of contracting disease through their chosen modes of transmission. Not only does this promote an understanding of the ways in which infection can occur (air borne, person to person contact, via insects or animals, etc.), but also it highlights the types of diseases/illnesses that are transmitted through each route. In addition, students may become aware of how perceptions of health threat influence the practice of health behaviours (covered in Chapter 3), and make them more aware of how to protect themselves from becoming infected.

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Recommended Reading The following chapters in Johnson, Perry, & Rozensky (2002) describe diseases and disorders of the physiological systems discussed in this chapter. Each chapter reviews the contributions of health psychology to the treatment of the disease.

Johnson, S. B., Perry, N. W., Jr., & Rozensky, R. H. (eds.), Handbook of clinical health psychology: Vol. I. Medical disorders and behavioral applications. Washington, DC: APA Brown, R. T., Mulhern, R. K., & Simonian, S. Diseases of the blood and blood-forming organs (pp. 101141).

Ironson, G., Balbin, E., & Schneiderman, N. Health psychology and Infectious Diseases (pp. 5-35).

Suchday, S., Tucker, D. L., & Krantz, D. S. Diseases of the circulatory system (pp. 203-237).

Wysocki, T., & Buckloh, L. M. Endocrine, metabolic, nutritional, and immune disorders (pp. 65-99).

An in-depth discussion of the nervous system and diseases of the nervous system can be found in the following book:

Sontheimer, H. (2015). Diseases of the nervous system. Academic Press.

Web Videos What is Alzheimer's disease? This short animated web video provides a quick but clear overview of the processes involved in the development of Alzheimer’s disease and its effects.

https://www.youtube.com/watch?v=wfLP8fFrOp0 Documentary sharers Glen Campbell’s Alzheimer’s Journey-MAYO Clinic. This MAYO Clinic video (taken from Glen Campbell: I’ll Be Me, PCH Films) provides a more human glimpse of the devastating effects of Alzheimer’s disease by featuring the story of legendary singer/songwriter Glen Campbell who developed Alzheimer’s and the effects it is having on his family.

https://www.youtube.com/watch?v=asPGGUCygXE These brief animations provide an illustrative view of key physiological systems.

The Anatomy of the Heart

https://www.youtube.com/watch?v=UMTDmP81mG4

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The Stress Response http://www.youtube.com/watch?v=BIfK0L8xDP0 Lymphocytes http://www.youtube.com/watch?v=cD_uAGPBfQQ Phagocytes http://www.youtube.com/watch?v=CEOV-SFTlpY

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CHAPTER 3 HEALTH BEHAVIOURS Learning Objectives 1

Describe and Define Health Promotion

2

Explain Why Health Behaviours are Important

3

Know the Theories and Models used for Understanding Health Behaviour Change

4

Describe How Cognitive-Behavioural Approaches are used to Change Health Behaviours

6

Understand the Other Methods for Changing Health Behaviours

Lecture Suggestions Models of Health/Risk Behaviour and Behaviour Change Theoretical models provide a framework for understanding the questions posed and the answers proposed within an area. Part I of Suls and Wallston’s (2003) edited book focuses on the most prominent theories of health behaviour and of behaviour change. Chapters by Friedman, Weinstein, and Salovey and Wegener present models focused on prevention, whereas chapters by Fisher and colleagues, Gibbons and colleagues, McCaul and Mullens, and Renner and Schwarzer focus on models of health behaviour and change.

Fisher, W. A., Fisher, J. D., & Harman, J. (2003). The information-motivation-behavioural skills model: A general social psychological approach to understanding and promoting health behaviour. In J. Suls, & K. A. Wallston (Eds.), Social psychological foundations of health and illness (pp. 82-106).

Malden, MA: Blackwell.

Friedman, H. S. (2003). Healthy Life-style across the life-span: The heck with the Surgeon General! In J. Suls & K. A. Wallston (Eds.), Social psychological foundations of health and illness (pp. 3-21).

Malden, MA: Blackwell.

Gibbons, F. S., Gerrard, M., & Lane, D. J. (2003). A social reaction model of adolescent health risk. In J. Suls & K. A. Wallston (Eds.), Social psychological foundations of health and illness (pp. 107-136).

Malden, MA: Blackwell.

McCaul, K. D., & Mullens, A. B. (2003). Affect, thought, and self-protective health behaviour: The case of worry and cancer screening. In J. Suls & K. A. Wallston (Eds.), Social psychological foundations of health and illness (pp. 314-331). Malden, MA: Blackwell.

Renner, B., & Schwarzer, R. (2003). Social-cognitive factors in health behaviour change. In J. Suls & K. A. Wallston (Eds.), Social psychological foundations of health and illness (pp. 169-196). Malden, MA: Blackwell.

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Salovey, P., and Wegener, D. T. (2003). Communicating about Health: Message framing, persuasion, and health behaviour. In J. Suls & K. A. Wallston (Eds.), Social psychological foundations of health and illness (pp. 54-81). Malden, MA: Blackwell.

Weinstein, N. D. (2003). Exploring the links between risk perceptions and preventive health behaviour.

In J. Suls & K. A. Wallston (Eds.), Social psychological foundations of health and illness (pp. 22-53).

Malden, MA: Blackwell.

Health Promotion Interventions and the Elderly This environmental scan provides a snapshot of provincial based programs and initiatives for promoting healthy aging in Canada.

Canadian Agency for Drugs and Technologies in Health (CADTH) (2011). Initiatives for Healthy Aging in Canada, Environmental Scan, Issue 17. http://www.cadth.ca/media/pdf/Initiatives_on_Healthy_Aging_in_Canada_es-17_e.pdf Place and Health This pan-Canadian report provides a snapshot of the health of rural Canadians and examines the social determinants of health for those living in rural areas as compared to urban-dwelling Canadians.

Canadian Institute for Health Information. (2006). How healthy are rural Canadians? An assessment of their health status and health determinants. http://www.phac-aspc.gc.ca/publicat/rural06/pdf/rural_canadians_2006_report_e.pdf Theory of Planned Behaviour An editorial in Health Psychology Review on why the Theory of Planned Behaviour should be retired sparked some controversy and several rebuttals, including one from Azjen himself, about its merits and shortcomings. This lively debate could form the basis of a more in-depth and critical lecture discussion on this popular health behaviour change model.

Ajzen, I. (2015). The theory of planned behaviour is alive and well, and not ready to retire: a commentary on Sniehotta, Presseau, and Araújo-Soares. Health Psychology Review, 9(2), 131-137. doi:10.1080/17437199.2014.883474 Conner, M. (2015). Extending not retiring the theory of planned behaviour: a commentary on Sniehotta, Presseau and Araújo-Soares. Health Psychology Review, 9(2), 141-145. doi:10.1080/17437199.2014.899060 Hagger, M. S. (2015). Retired or not, the theory of planned behaviour will always be with us. Health Psychology Review, 9(2), 125-130. doi:10.1080/17437199.2015.1034470 Ogden, J. (2015). Time to retire the theory of planned behaviour?: one of us will have to go! A commentary on Sniehotta, Presseau and Araújo-Soares. Health Psychology Review, 9(2), 165167. doi:10.1080/17437199.2014.898679 Schwarzer, R. (2015). Some retirees remain active: a commentary on Sniehotta, Presseau and AraújoSoares. Health Psychology Review, 9(2), 138-140. doi:10.1080/17437199.2014.898407 Sniehotta, F. F., Presseau, J., & Araújo-Soares, V. (2014). Time to retire the theory of planned behaviour.

Health Psychology Review, 8(1), 1-7. doi:10.1080/17437199.2013.869710

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Worksite Interventions Although evaluations of worksite interventions are fraught with design and execution problems, evidence of their effectiveness is mounting. The first review examines worksite interventions specifically designed to target employee diet. The second review of 27 studies discusses the difficulties inherent in these evaluations and the extent to which worksite interventions demonstrate both clinical- and cost-effective outcomes.

Ni Mhurchu, C., Aston, L., & Jebb, S. (2010). Effects of worksite health promotion interventions on employee diets: a systematic review. BMC Public Health, 10(1), 62. Open access

Social Norms and Health Behaviour Change Social norms are a key componet of many health behaviour change theories. This review by Blanton and colleagues provides and overview and discussion of how misperceptions of social norms may defuse their effectiveness for health behaviour and suggests how interventions designed to debias such misperceptions may be successful for reducing risky health behaviours.

Blanton, H., Köblitz, A., & McCaul, K. D. (2008). Misperceptions about norm misperceptions: Descriptive, injunctive, and affective ‘social norming’ efforts to change health behaviors. Social and Personality Psychology Compass, 2(3), 1379-1399.

Motivating the unmotivated Most models of health behaviour change assume that indivudal are motivated to make health behaviour changes. Hardcastle and colleagues discuss and often neglected issue in heath behaviour change, namely how do you motivate those who are not motivatd to change thero health behaviours, even when making such chnages woud be in ther best interest. They suggest a number of approaches that can be used to effectively deal with people in the so called “pre-contemplation stage”.

Hardcastle, S. J., Hancox, J., Hattar, A., Maxwell-Smith, C., Thøgersen-Ntoumani, C., & Hagger, M. S. (2015). Motivating the unmotivated: how can health behavior be changed in those unwilling to change? Frontiers in Psychology, 6, 835. doi:10.3389/fpsyg.2015.00835 Health Communication and Affect In this review paper Cameron and Chan discuss the role of affect in health promotion communications and some of the reasons why fear appeals may backfire. They suggest other promising ways for increasing the effectiveness of health communications including harnessing positive affect and mental simulations.

Cameron, L. D., & Chan, C. K. Y. (2008). Designing health communications: Harnessing the power of affect, imagery, and self-regulation. Social and Personality Psychology Compass, 2(1), 262-282.

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Analysis of Media Appeals Have students bring to class two to three media appeals designed to modify health behaviours (e.g., a magazine or web advertisement from the Canadian Cancer Society, or the Heart & Stroke Foundation, e.g., “Make Health Last”), and discuss the effectiveness of each appeal. The effectiveness of each appeal could be analyzed in terms of the text’s discussion of factors influencing the effectiveness of health messages. The text notes that several factors often limit the effectiveness of such messages, and a discussion of specific media appeals may reinforce the importance of these factors. Another approach is to examine these media appeals from the perspective of prospect theory. Have students discuss whether the message is loss or gain framed and then whether the behaviour has certain or uncertain outcomes.

Based on this theory students can then speculate how effective the media appeal may be, and/or how it might be more effective.

Make Health Last. What will your last 10 years look like? http://www.youtube.com/watch?v=Qo6QNU8kHxI The Make Health Last website also features interactive tools for evaluating how healthy your later years will be and what health behavior changes can help make a difference. https://www.makehealthlast.ca/ Health Belief Model An independent project would provide an opportunity for students to critically evaluate the relationship between beliefs and attitudes toward health promotion and wellness. Have students interview a friend about his or her health-related beliefs, attitudes, and behaviours, and analyze them within the context of the issues discussed in Chapter 3 and lecture. Assignments might be structured in a manner similar to the sample assignment that follows: 1.

Develop a brief interview format that you will use to discuss the relevant beliefs, attitudes, and behaviours. Make it specific in order to address the goals of this assignment. Include your interview format as an appendix to your assignment.

2.

Discuss the specific responses in relationship to health promotion and wellness (e.g., eating habits, contraception, and avoidance of health-compromising behaviours). For example, do any of these beliefs relate to components of the health belief model? Does your friend indicate that normative pressures influence his or her beliefs or attitudes?

3.

Explicitly discuss the relationship between actual behaviours and attitudes and beliefs. Do you find a strong positive relationship between beliefs and attitudes or are some beliefs at odds with others?

How are beliefs and attitudes translated into behaviours?

4.

What do you conclude about your friend’s health-related beliefs, attitudes, and behaviours? What factors seem to be involved in a good attitude-behaviour match (if observed)? Can you identify factors that seem to explain why you fail to find good attitude-behaviour concordance?

Cognitive-Behavioural Modification Have students work in groups of three to four in order to develop a comprehensive multimodal cognitive behavioural therapy. Case histories that describe hypothetical patients, their psychosocial characteristics, and a target behaviour to be changed can be prepared before class or developed by each group. Having each group report the nature of the intervention that has been designed gives an opportunity to assess students’ comprehension of the principles of cognitive-behavioural modification. The text asserts that the Taylor, Sirois & Molnar, Health Psychology, 5th Canadian Edition | Instructor’s Manual -4-

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complementary nature of methods chosen for such programs is a critical variable associated with successful health behaviour modification. Discussing the reasons each group presents for, including each component in the therapeutic program, should reinforce this point.

Social Engineering The concept of social engineering is often new to students, and they may have difficulty recognizing it in their own environment. Have several students take digital pictures of examples of social engineering on campus and prepare a PowerPoint presentation. These examples do not necessarily need to be healthrelated. They can include “No Smoking” signs, hand sanitization stations, extra lighting in hazardous areas, landscaping to control foot traffic, and so on.

Web Activities ParticipACTION The new and revised ParticipACTION web site includes a variety of different materials regarding guidelines and tips on how to get more active. Included are pdf guides and short YouTube clips on how to find new and fun ways to stay active all year round, as well as links to media coverage on staying active and community-based programs for promoting physical activity. Possible activities could include watching the short ParticipACTION video campaign clips and analyzing them from the perspective of various health behaviour change theories to highlight how such theories are used in practice. http://www.participaction.com/en-us/Home.aspx

Recommended Reading Conner, M. and Norman, P. (2005) (Eds.), Predicting Health Behaviour: Research and Practice with Social Cognition Models (2nd edition). Buckingham: Open University Press.

This edited volume covers a wide range of social cognition models as applied to health behaviour change including the Theory of Planned Behaviour, Protection Motivation theory, the Health Belief model, and stage theories.

Web Videos The PartcipACTION Archive Project http://www.usask.ca/archives/participaction/english/motivate/theearlyyears.html Archives of the history of the ParticipACTION campaign in its many forms since its inception in the 1970’s is housed at this site hosted by the University of Saskatchewan. Included are video segments of media campaigns, including the classic “60 year-old Swede” ad and later Body Break ads featuring Hal Johnson and Joanne McLeod.

Make Health Last. Report urges boomers to make healthy change http://www.youtube.com/watch?v=ZcHsMtNCOZ0 This video is based on the Heart and Stroke Foundation's 2013 Report on the Health of Canadians.

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CHAPTER 4 PREVENTIVE AND HEALTH-PROMOTING BEHAVIOURS Learning Objectives 1

Identify Preventable Injuries

2

Describe Cancer-Related Health Behaviours

3

Understand How Exercise Enhances Health

4

Explain Why Maintaining a Healthy Weight is Important

5

Describe How Sleep is Related to Health

Lecture Suggestions Cancer Screening In this paper Bennett discusses the impact of cancer screening and especially as it relates to genetic risk for breast cancer. Distress is a common risk of cancer screening, and accordingly this paper discusses the need for interventions that help minimize this risk by focusing on emotion-focused coping strategies and mindfulness.

Bennett, P. (2009). How can we reduce the distress associated with health screening? From psychological theory to clinical practice. Social and Personality Psychology Compass, 3(6), 939-948.

Physical Activity and Happiness The paper by Lathia and colleagues (2017) presents some interesting evidence on the psychological benefits of exercise, as well as highlighting how smart phone technology can help researchers answer important questions about the effects of exercise as they occur in day to day life.

Lathia, N., Sandstrom, G. M., Mascolo, C., & Rentfrow, P. J. (2017). Happier People Live More Active Lives: Using Smartphones to Link Happiness and Physical Activity. PloS one, 12(1), e0160589. doi:10.1371/journal.pone.0160589 Insomnia According to Espie (2002), sleep disturbance is a common complaint that often persists over many years.

Insomnia constitutes an important public health problem. Although usually treated as a symptom that does not merit treatment in its own right, he argues that it can be either a symptom or a disorder in that it may cause considerable distress and functional impairment. The various proposed causes are reviewed, e.g., faulty conditioning, poor chronobiological timing, physiological and cognitive hyper-arousal.

Problems with the literature in each area are examined. A psychobiological model of normal sleep is proposed as well as a psychobiological inhibition model of insomnia.

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Espie, C. A. (2002). Insomnia: Conceptual issues in the development, persistence, and treatment of sleep disorder in adults. Annual Review of Psychology, 53, 215-243.

Exercises, Projects, and Activities Personal Health Behaviour Change Assign an independent project, and have students identify a health behaviour of their own that they would like to modify. Complete projects might include a self-observation log that chronicles the behavioural antecedents, the target behaviour, and its consequence; a planned cognitive-behavioural modification program designed to modify the behaviour; and an evaluation of the effectiveness of the intervention.

Alternatively you can have students chart their baseline behaviour, and then invite them to try and make changes to this behaviour. They can then journal about their experiences with trying to modify this health behaviour. A final component can involve an application of one of the health behaviour change theories from chapter 3 to their own experience, along with a critical, personal discussion of the benefits and shortfalls of the theory.

Sun Safety Practices Getting people to engage in cancer-related health behaviours has obvious implications, yet many people neglect these important preventive health behaviours. Have students break off into small groups to discuss why it is so difficult to get people to wear sunscreen – what they see as the barriers to using sunscreen.

Ask them to address the following question: If you had to design a campaign to increase sunscreen use what would you do – list all techniques you would use and why you think they would be effective.

Compare the different strategies generated with a larger class discussion.

Web Resources for Activities: Exercise and Older Adults The Government of Canada’s website on physical activity tips for older adults provides information for adults 65 and over on staying active. Along with information that covers the benefits of regular exercise, it also presents clear definitions of what is meant by moderate and vigorous exercise, as well as strengthening exercises. https://www.canada.ca/en/public-health/services/publications/healthy-living/physical-activity-tips-olderadults-65-years-older.html ParticipAction also has a guide for exercise for older adults that can be downloaded in pdf form at: https://www.csep.ca/CMFiles/Guidelines/CSEP_PAGuidelines_older-adults_en.pdf Health Promotion and Wellness One way to begin a discussion of health-enhancing behaviours would be to have students reflect on their personal practice of wellness. In particular, you can have students review the new Canadian Food guide and discuss how their own eating habits compare to the recommended daily standards. To add a diversity component to this exercise, students can also compare the Food Guide with the version for First Nations, Inuit and Métis. This is the first national food guide that has been created to reflect the values, choices and traditions of Canada’s aboriginal peoples. Invite students to discuss the need for such a guide and the possible implications for Canada’s First Nations, Inuit and Métis.

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Canada’s Food Guide: https://food-guide.canada.ca/en/ Canada’s Food Guide - First Nations, Inuit and Métis. http://www.hc-sc.gc.ca/fn-an/alt_formats/fnihb-dgspni/pdf/pubs/fnim-pnim/2007_fnim-pnim_food-guidealiment-eng.pdf

Distracted Driving The Canadian Automobile Association (CAA) has an excellent interactive site on distracted driving that can be used to launch a discussion on the dangers of distracted driving. In particular their distracted driving simulator allows for choosing of the variables that affect reaction time while driving under distraction such as texting.

CAA Distracted driving simulator http://distracteddriving.caa.ca/index.php This activity can be supplemented by reading the 5-part National Post series Fatal Distraction which features stories on distracted driving in the: https://nationalpost.com/features/fatal-distraction Viewing public awareness advertising aimed at reducing distracted driving can also help students understand how behaviour change principles can be used for a real life issue. After viewing the ads, ask students which behaviour change principles have been used to target viewer beliefs and attitudes, and why or why not these ads may be effective for changing distracted driving behaviour.

Don't Text and Drive. Quebec Insurance: This ad takes a unique historical approach to changing people’s perspectives about texting while driving. http://www.youtube.com/watch?v=QaNWM4P5E5Q Don't Text And Drive - Public Service Campaign: This series of anti-texting ads uses fear appeals with a touch of humour. http://www.youtube.com/watch?v=Q_Z1qPBNaVs

The Rise of Obesity in Canada and the World

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The alarming increases in the rates of obesity in Canada and worldwide are taking frontstage in many new stories. After students read/watch these news stories, have them discuss whether the increase in obesity is inevitable given modern conveniences and lifestyles and an aging population, or if it can be halted, and if so how.

Obesity rate predicted to reach 20% by 2025 http://www.cbc.ca/news/health/obesity-global-1.3516729 Canada's obesity rates triple in less than 30 years http://www.cbc.ca/news/health/canada-s-obesity-rates-triple-in-less-than-30-years-1.2558365 Obesity as a Disease?

The recent decision by the American Medical Association to recognize obesity as a disease can serve as starting point for a debate on the pros on cons of this way of viewing obesity. After watching the CBC news story on this landmark decisions, have students take sides arguing why labeling obesity as a disease may or may not be a good decision and it implications for the individual and society. https://www.cbc.ca/news/health/obesity-now-recognized-as-a-disease-1.1320011 This debate can lead into further discussion regarding the high rates of obesity among Canadian children and the impact of thinking about obesity as a disease for children.

31% of Canadian kids are overweight or obese http://www.cbc.ca/news/health/31-of-canadian-kids-are-overweight-or-obese-1.1154456 Insomnia Insomnia is a common occurrence for students. CTV news features a series of stories regarding the prevalence of insomnia in Canada with a three-part series, Sleep Solutions, that highlights some ways to help promote better sleep habits.

40% of Canadians suffer from sleep disorders, study says http://kitchener.ctvnews.ca/40-of-canadians-suffer-from-sleep-disorders-study-says1.1113990#ixzz2idsDEsCs After watching the news stories, a possible activity is to have students think about the times when they have had trouble staying and falling asleep and identify the factors that may have helped or hindered their sleeping patterns.

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Importance of 1 Hour of Physical Activity a Day Many people have jobs that require that they sit for hours a day. This story from the National highlights research suggesting the benefits of being physically active for only one hour a day to offset the harmful effects of sitting on health. http://www.cbc.ca/player/play/733575235542 Tanning and Sunscreen Use Daily sunscreen use protects against aging, study finds. This news story provides a brief overview of the Australian study discussed in the text which found that sunscreen use prevents aging. http://www.ctvnews.ca/health/daily-sunscreen-use-protects-against-aging-study-finds-1.1309895 The Truth About Tanning: https://www.cancercare.on.ca/cms/one.aspx?objectId=8099&contextId=1377 This web video clip from the National Cancer Institute of Canada provides a brief overview of the cancer risks associated with the use of tanning beds.

Health Apps This story from the National highlights how to get the most out of health apps for managing health. https://www.cbc.ca/news/thenational/getting-the-most-from-health-apps-1.3655475 Overeating Mindless Eating: Food Psychologist Explains The Mindless Way People Overeat https://www.youtube.com/watch?v=XhmJ1aDGNS0 This news video clip from CNN examines the effects of factors such as plate size and convenience on unconscious eating and overeating.

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CHAPTER 5 HEALTH-COMPROMISING BEHAVIOURS Learning Objectives 1

Identify the Characteristics of Health-Compromising Behaviours

2

Describe and Define Substance Dependence

3

Understand how Alcoholism and Problem Drinking Compromise Health

4

Explain how Smoking is Harmful for Health and what Factors Influence Smoking

5

Describe Eating Disorders

Lecture Suggestions Alcohol Use and Misuse This chapter provides a comprehensive background on a variety of alcohol-related issues. It examines the epidemiology of alcohol usage, effects of alcohol on physical systems, the social consequences of alcohol, and its etiology.

Wood, M., Vinson, D., & Sher, K. (2001). Alcohol use and misuse. In A. Baum, T. Revenson, & J. Singer (Eds.), Handbook of health psychology (pp. 281–318). Mahwah, NJ: Lawrence Erlbaum.

Drinking among Postsecondary Students Given that research indicates that alcohol use is especially prevalent among postsecondary students a lecture examining alcohol use among this specific population is warranted and may be of special interest to your students. Below are several articles and reports that discuss the prevalence of alcohol-use among postsecondary students with a special emphasis on binge drinking, as this is a common public health concern across postsecondary campuses. The resources below also discuss etiological and maintenance factors associated with alcohol use among postsecondary students.

Meister, S.R., Barker, B., & Flores Pajot, M.-C. (2018). Heavy Episodic Drinking Among Post-secondary Students: Influencing Factors and Implications. Ottawa, Ont.: Canadian Centre on Substance Use and Addiction.

Ray, A. E., Stapleton, J. L., Turrisi, R., & Mun, E. Y. (2014). Drinking game play among firstyear college student drinkers: An event-specific analysis of the risk for alcohol use and problems. The American journal of drug and alcohol abuse, 40(5), 353-358.

Vander Ven T. (2011). Getting wasted: Why college students drink too much and party so hard. New York University Press.

Lee, M. J. (2018). Frequency of Binge Drinking and the Perception of Peer Alcohol Use among Post-Secondary Students: A Survey of University Students in a Western Canadian Province.

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Merrill, J. E., & Carey, K. B. (2016). Drinking over the lifespan: Focus on college ages. Alcohol Research: Current Reviews, 38(1), 103-114.

Alcohol Prevention for Secondary and College Students The edited volume by Biglan, Wang, and Walberg from the series edited by Gullotta, Walberg, and Weissberg (2003) approaches the prevention of five types of adolescent behaviour using problem behaviour theory. For each problem behaviour, specific background information is provided followed by prevention suggestions. The chapter by Zucker focuses on alcohol. The social norms approach guides the prevention program in the book edited by Perkins (2003). This approach argues that the perception of the extent and level of drinking by peers is higher than the reality. Thus, high levels of drinking are tolerated by secondary and college students. Prevention programs attempt to bring perceptions into line with reality which is expected to lower the level of drinking the average student sees as acceptable for others in the peer group.

Cole, H. A., Prassel, H. B., & Carlson, C. R. (2018). A meta-analysis of computer-delivered drinking interventions for college students: a comprehensive review of studies from 2010 to 2016. Journal of studies on alcohol and drugs, 79(5), 686-696.

Perkins, H. W. (Ed.) (2003). The social norms approach to preventing school and college age substance abuse: A handbook for educators, counselors, and clinicians. San Francisco, CA: John Wiley.

Mallett, K. A., Varvil‐Weld, L., Borsari, B., Read, J. P., Neighbors, C., & White, H. R. (2013).

An update of research examining college student alcohol‐related consequences: New perspectives and implications for interventions. Alcoholism: Clinical and Experimental Research, 37(5), 709-716.

Carey, K. B., Scott-Sheldon, L. A., Garey, L., Elliott, J. C., & Carey, M. P. (2016). Alcohol interventions for mandated college students: A meta-analytic review. Journal of consulting and clinical psychology, 84(7), 619.

Leavens, E. L., Leffingwell, T. R., Miller, M. B., Brett, E. I., & Lombardi, N. (2017). Subjective evaluations of alcohol-related consequences among college students: Experience with consequences matters. Journal of American college health, 65(4), 243-249.

Alcohol and Older Adults There is mounting recognition that alcohol abuse or dependence is a problem for many older adults. This text, written by a gerontologist and recovering alcoholic, covers a broad range of topics. It is a resource for a lecture examining the antecedents of Late-Onset Alcoholism and potential prevention and treatment programs.

Armstrong-Moore, R., Haighton, C., Davinson, N., & Ling, J. (2018). Interventions to reduce the negative effects of alcohol consumption in older adults: a systematic review. BMC public health, 18(1), 302.

Han, B. H., Moore, A. A., Sherman, S. E., & Palamar, J. J. (2018). Prevalence and correlates of binge drinking among older adults with multimorbidity. Drug and alcohol dependence, 187, 4854.

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Blow, F. C., & Barry, K. L. (2012). Alcohol and substance misuse in older adults. Current psychiatry reports, 14(4), 310-319.

Treatment for Alcohol Dependence Monti and his colleagues (2002) provide a detailed manual for skills training for alcohol-dependent persons. Based on learning theory, this treatment program guide is designed for mental health professionals. Miller and Muňoz’s (2005) book is a self-help book. It, too, uses a social skills training approach to assist the individual in moderating or stopping alcohol consumption.

Miller, W., & Muňoz, R. (2005). Controlling your drinking: Tools to make moderation work for you.

NY: Guilford.

Monti, P., Kadden, R., Rohsenow, D., Cooney, N., & Abrams, D. (2002). Treating alcohol dependence: A coping skills training guide. NY: Guilford.

Tanner-Smith, E. E., & Lipsey, M. W. (2015). Brief alcohol interventions for adolescents and young adults: A systematic review and meta-analysis. Journal of substance abuse treatment, 51, 1-18.

Smoking Prevention Programs for Adolescents Programs for preventing adolescents from beginning smoking have spanned the last 40 years. Although there are initial reductions in rates of onset, these effects “water down.” Evans (2001) addresses this issue and the role of fear appeals in these programs. Botvin and Kanton (2000) provide a research update on Life Skills Training. Biglan and Severson (2003) report on a community-based intervention. These can be used to expand the text’s treatment of this issue.

Biglan, A., & Severson, H. (2003). The prevention of tobacco use. In T. Gullotta, H. Walberg, & R. Weisberg (Series Eds.), and A. Bigland, M. Wang, & H. Walberg (Vol. Eds.), Preventing youth problems (pp. 63-85). New York: Plenum.

Peirson, L., Ali, M. U., Kenny, M., Raina, P., & Sherifali, D. (2016). Interventions for prevention and treatment of tobacco smoking in school-aged children and adolescents: a systematic review and meta-analysis. Preventive medicine, 85, 20-31.

Das, J. K., Salam, R. A., Arshad, A., Finkelstein, Y., & Bhutta, Z. A. (2016). Interventions for adolescent substance abuse: An overview of systematic reviews. Journal of Adolescent Health, 59(4), S61-S75.

Evans, R. (2001). Social influences in etiology and prevention of smoking and other health threatening behaviours in children and adolescents. In A. Baum, T. Revenson, & J. Singer (Eds.), Handbook of health psychology (pp. 459–468). Mahwah, NJ: Lawrence Erlbaum.

Why People Smoke and Why It Is So Difficult to Quit Swan, Hudmon, and Khroygon (2003) provide material to expand the text’s treatment of the physiological, psychological, and social factors involved in smoking and smoking cessation. Baker, Brandon, and Chassin’s (2004) review examines the nature and natural history of cigarette smoking.

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Their focus, however, is on the development and maintenance of smoking. Wills and his colleagues (2004) and Wetter and his colleagues (2004) examine the correlates of smoking onset and maintenance at three different ages in high school and over the four years of college, respectively. Sloan, Smith, and Taylor (2003) present an economic model that assumes that consumers know or can form beliefs about risk that affect their well-being. They present evidence from a variety of methodologies to support this model.

Baker, T., Brandon, T., & Chassin, L. (2004). Motivational influences on cigarette smoking. Annual Review of Psychology, 55, 463-491.

National Center for Chronic Disease Prevention and Health Promotion (US) Office on Smoking and Health. Preventing Tobacco Use Among Youth and Young Adults: A Report of the Surgeon General. Atlanta (GA): Centers for Disease Control and Prevention (US); 2012. 4, Social, Environmental, Cognitive, and Genetic Influences on the Use of Tobacco Among Youth.

Available from: https://www.ncbi.nlm.nih.gov/books/NBK99236/ Sloan, F. A., Smith, V. K., & Taylor, D. J., Jr. (2003). The smoking puzzle: Information, risk perception, and choice. Cambridge, MA: Harvard University Press.

Swan, G., Hudmon, K., & Khroygon, T. (2003). Tobacco dependence. In I. V. Weiner (Series Ed.) & A. M. Nezu, C. M. Nezu, & P. A. Geller (Vol. Eds.), Handbook of psychology: Vol. 9, Health psychology (pp. 147-168). Hoboken, NJ: John Wiley.

Rosa, J. D. R., Aloise-Young, P. A., & Henry, K. L. (2014). Using motives for smoking to distinguish between different college student smoker typologies. Psychology of Addictive Behaviors, 28(4), 1297-1304.

Hertel, A. W., & Mermelstein, R. J. (2016). Smoker identity development among adolescents who smoke. Psychology of Addictive Behaviors, 30(4), 475.

Smoking Cessation The treatment programs that follow are based on different theoretical models. Myers and Frost (2002) report that smokers’ have a more optimistic outlook about the potential impact of smoking on their health than do nonsmokers. They report on a social cognition treatment plan designed to change this bias. On the other hand, the authors in Abrams and colleagues’ (2003) edited book use behaviourally-based treatment approaches. A variety of short- and long-term treatments are described.

Abrams, D.., Niaura, R., Brown, R., Emmons, K., Goldstein, M., & Monti, P. (Vol. Ed.) (2003). The tobacco dependence treatment handbook. In D. Barlow, (Series Ed.), Treatment manuals for practitioners. NY: Guilford.

Butler, K. M., Fallin, A., & Ridner, S. L. (2012). Evidence-based smoking cessation for college students. Nurs Clin North Am, 47(1), 21-30.

Electronic Cigarette Use & Vaping

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The advent of electronic cigarette use and vaping has changed the landscape of substance use.

Originally promoted as a safer alternative to smoking and as a tool for smoking cessation, vaping is soaring among adolescents and adults. However, recent evidence is beginning to question the safety of vaping and its use as a strategy for smoking cessation. Reading are provided below to aid lecture material on this important topic.

Camenga, D. R., Cavallo, D. A., Kong, G., Morean, M. E., Connell, C. M., Simon, P., ... & Krishnan-Sarin, S. (2015). Adolescents’ and young adults’ perceptions of electronic cigarettes for smoking cessation: A focus group study. Nicotine & Tobacco Research, 17(10), 1235-1241.

Cooper, M., Loukas, A., Case, K. R., Marti, C. N., & Perry, C. L. (2018). A longitudinal study of risk perceptions and e-cigarette initiation among college students: Interactions with smoking status. Drug and alcohol dependence, 186, 257-263.

Durham, N. C., Sear, A., & Rogerson, K. (2018). To smoke or to vape? E-cigarette regulation in the US, the UK, and Canada.

Goldenson, N. I., Leventhal, A. M., Stone, M. D., McConnell, R. S., & Barrington-Trimis, J. L. (2017). Associations of electronic cigarette nicotine concentration with subsequent cigarette smoking and vaping levels in adolescents. JAMA pediatrics, 171(12), 1192-1199.

Hammond, D., Reid, J. L., Rynard, V. L., Fong, G. T., Cummings, K. M., McNeill, A., ... & O’Connor, R. (2019). Prevalence of vaping and smoking among adolescents in Canada, England, and the United States: repeat national cross sectional surveys. bmj, 365, l2219.

Miech, R., Patrick, M. E., O'malley, P. M., & Johnston, L. D. (2017). What are kids vaping?

Results from a national survey of US adolescents. Tobacco control, 26(4), 386-391.

Zuckermann, A. M., Williams, G., Battista, K., de Groh, M., Jiang, Y., & Leatherdale, S. T. (2019). Trends of poly-substance use among Canadian youth. Addictive behaviors reports, 10, 100189.

Eating Disorders and Adolescent Boys The focus on white adolescent and young adult women in the eating disorder literature has turned attention from the growing number of women and girls of colour and of men with these disorders.

Ricciardelli and McCabe (2004) reviewed studies of adolescent boys to determine correlates and risk factors for young men. Although similarities between men and women were noted, men tended to focus more on striving for muscularity. The video, Eating Disorders, listed in the Video section below, is an excellent adjunct to this lecture.

Kelley, Courtney C. Galliger, Jennie M. Neufeld, and Dara R. Musher-Eizenman. "Drive for thinness and drive for muscularity: Opposite ends of the continuum or separate constructs?."

Body Image 7.1 (2010): 74-77.

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Murnen, S. K., & Karazsia, B. T. (2017). A review of research on men's body image and drive for muscularity The psychology of men and masculinities. (pp. 229-257). Washington, DC, US: American Psychological Association.

Exercises, Projects, and Activities Harm Reduction programs Harm reduction programs such as Vancouver’s Insite program are controversial and are therefore an interesting topic to debate. Have students form two teams to debate for and against another harm reduction program which features handing put clean crack pipes featured in the link below. To make it more interesting, have students make a case for the position that they do not agree with to help develop critical thinking. http://ottawa.ctv.ca/servlet/an/local/CTVNews/20110731/vancouver-hand-out-unused-crack-pipes-pilotproject-110731/20110731/?hub=OttawaHome Substance Abuse Programs Assign groups of three to four students each the task of contacting community programs that target drug, alcohol, or other substance abuse. An increasing number of education and intervention programs that target school-aged children have been established, and many will be happy to provide educational materials that can form the basis of a discussion of the efficacy of such programs. Because many programs have a speaker board, an in-class presentation might also be effective in promoting discussion of different health-compromising behaviours.

Health Canada and Consumer Warnings Ask students to bring to class advertisements for alcohol and vaping products that carry a health warning from Health Canada. The message on these ads is varied often in an attempt to heighten the message’s impact. An in-class discussion might focus on the use of the mass media in eliminating healthcompromising behaviours, the health beliefs each message targets, how or why people may discount or fail to recall such messages, and so on. The ethics and success of social engineering might also be introduced, especially if state or local laws have recently been proposed or enacted (e.g., no vaping in schools).

Legalization of Cannabis in Canada Cannabis was legalized in Canada on October 17th, 2018. Assign students to groups so that they may have a structured debate concerning the potential advantages and disadvantages of legalizing cannabis highlighting lifespan issues (what are the effects for different age groups) and different aspects of life these new laws may affect (health, economy, education etc.).

Web Resources for Activities: Substance Abuse

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The Vancouver Coastal Health web site features information and resources about InSite, North America’s first legal supervised injection site. In addition to fact sheets and research findings, there are firsthand stories about those who have used InSite. http://www.vch.ca/your-health/health-topics/supervised-injection/ The Centre for Addiction and Mental Health web site features several pages about marijuana, including rules governing cannabis use in Canada.

https://www.camh.ca/en/camh-news-and-stories/changes-to-rules-governing-cannabis-in-canada Alcohol Health Canada provides a web page on responsible holiday drinking which outlines the short and long term effects of drinking, and provides alcohol related links and resources. http://healthycanadians.gc.ca/healthy-living-vie-saine/substance-abuse-toxicomanie/alcohol-alcool/indexeng.php#a4 The Center for Addiction and Mental Health (CAMH) has a Web page where students can evaluate their drinking and compare it to that of other Canadians.

https://www.camh.ca/-/media/files/guides-and-publications/thinking-about-drinking.pdf Also included on the CAMH site are several other pages that deal with topics such as how to quit or cut down drinking: http://www.camh.net/About_Addiction_Mental_Health/Drug_and_Addiction_Information/dealing_with_ drinking.html The Canadian Centre on Substance Abuse also has this colourful pdf brochure outlining Canada’s LowRisk Alcohol Drinking Guidelines http://www.ccsa.ca/Resource%20Library/2012-Canada-Low-Risk-Alcohol-Drinking-GuidelinesBrochure-en.pdf The Manitoba Liquor Control Commission (MLCC) hosts the Be Undrunk site, with several pages designed to raising awareness about the consequences of binge drinking. Aimed at adolescents and young adults, the site features print and video ads from the Be Undrunk social marketing campaign. As well as an interactive page that highlights the physical and psychological effects as a function of the number of alcoholic drinks consumed. http://www.mbll.ca/content/be-undrunk Tobacco The Physicians for a Smoke-Free Canada site has a web page with resources such as tobacco fact sheets, research papers, newsletters, the latest news on tobacco, tobacco marketing and secondhand smoke. http://www.smoke-free.ca/warnings/default.htm

Smoking in the Movies is a site by the Centers for Disease Control and Prevention that documents facts about the depiction of smoking in the movies, and how this tends to normalize smoking. The site suggests that depiction of smoking in film is more frequent than what actually occurs in every day life. After

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reviewing the site in class, invite students to discuss the possible impact of smoking in film and among celebrities on the smoking behaviour and norms of young adults. https://www.cdc.gov/tobacco/data_statistics/fact_sheets/youth_data/movies/index.htm Another featured web page on the Physicians for a Smoke-free Canada web site is the What am I inhaling? page. Designed for non-smokers, this page provides an interactive form for calculating Personal Inhalation Rates, which is the amount of chemicals they may be exposed to through second hand smoke. http://www.smoke-free.ca/eng_issues/etschemssmokers.htm

Online Self-tests and Quizzes Online self-test: Drinker's Check-up http://www.drinkerscheckup.com/?id=moderationmanagement Online self test: Alcohol Problem Self-Assessment http://www.intheknowzone.com/do-you-have-an-alcohol-problem.html Online Quiz: Marijuana http://www.intheknowzone.com/test-your-knowledge-27.html Online self-test: Check Your Drinking University http://www.checkyourself.ca/CYD/CYDScreenerP1_0.aspx

Recommended Reading Babor, T. R., & Del Boca, F. K. (2003). Treatment matching in alcoholism. Cambridge, UK: Cambridge University Press.

The authors present the results of Project MATCH, an extensive set of clinical trials attempting to match alcohol addiction treatment type to client characteristics. Three treatment modalities were examined, cognitive-behavioural, motivational enhancement, and Twelve Step Facilitation. Implications for further research are included.

Kozlowski, L., Henningfield, J., & Brigham, J. (2001). Cigarettes, nicotine, & health: A biobehavioural approach. Thousand Oaks, CA: Sage.

This brief text from the Behavioural Medicine and Health Psychology series uses an explicit biobehavioural approach for understanding the use of cigarettes as a nicotine delivery system. Chapters include a history of the use of nicotine, demographic information, and physiological and psychological processes involved in nicotine consumption and addiction.

Web Videos Second-hand Smoke

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YouTube has the 2007 video “Heather Crowe’s Legacy: An Ordinary Canadian’s Extraordinary Gift” which documents the life and death of smoke free activist Heather Crowe. (film, 25 mins; 42 seconds). https://www.youtube.com/watch?v=-zRXWjBxCb8 Smoking This Canadian Cancer Society ad “Breath" provides brief (31 sec.) visualization of the effects of smoking. http://www.youtube.com/watch?v=Lx-43LO7PY8

This CBC story highlights some of the issues with the latest smoking trend, “vaping” and how Health Canada is looking into limiting vaping among youth. https://www.youtube.com/watch?v=qr5lLu6e9Xk

This fifth estate investigative report examines the use of e-cigarettes and their association with the “Big Tobacco” industry.

https://www.youtube.com/watch?v=B2myg-4zkE8 This video by the National in Canada “Meet the Students Trying to Battle the Vaping Epidemic” includes a discussion of vaping among adolescents and how schools are trying to educate youth about vaping.

https://www.youtube.com/watch?v=FkPSDSxC9LE Drinking and Driving The Mothers Against Drunk Driving website has a section with various web video clips. In addition to their familiar warnings about the perils of impaired driving, there are outreach videos, including one for First Nations and Metis victims of impaired driving. “Too Close to Home” highlights the effects of driving while high and documents a multi-vehicle crash relating to cannabis impairment that occurred in the Ottawa area. Videos range in length from 9 to 23 minutes. http://madd.ca/english/research/media.html Touring a Supervised Injection Site This CBC video provides a guided tour by a registered nurse of a safe injection site.

https://www.cbc.ca/player/play/1394072131747 Prescription Drug Abuse In this news story, Pill Popping Nation? America’s Growing Addiction, the growing problem of prescription drug abuse is discussed including the growing popularity of “pharm” parties. Although this provides American coverage of the issue, that statistics on teen abuse of prescription drugs in the U.S. and Canada are virtually identical.

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http://www.cbn.com/media/player/index.aspx?s=/mp4/LJO180v4_WS

Eating Disorders What are male anorexia symptoms?

https://www.youtube.com/watch?v=XgmclqkzPFc Eating disorders and asking for help in athletes: Kally’s Story.

https://vimeo.com/106777370 Eating disorder signs and symptoms.

https://www.youtube.com/watch?v=0n7gYfUF2bQ

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CHAPTER 6 STRESS Learning Objectives 1.

Describe and Define Stress

2.

Know the Theories and Models used to Study Stress

3.

Understand What Makes Events Stressful

4.

Explain How Stress has Been Assessed

5.

Describe the Sources of Chronic Stress

Lecture Suggestions Tend-and-Befriend In the text, Taylor proposes a complementary model of stress response. Rather than the singular fight-orflight model of primary physiological response to stress, she proposes that women are more likely to tendand-befriend. She and her colleagues (Taylor, 2002; Taylor et al., 2006) review the physiological processes that may lie at the core of this response. Dickerson and Kemeny’s (2004) meta-analysis reviews 208 articles examining the stressor-cortisol relationship. Carter (2013) reviews the evidence suggesting that oxytocin pathways act to allow the high levels of social sensitivity and attunement necessary for human sociality. Finally, Levy et al. (2019) uses attachment theory as a theoretical framework to explain potential sex-related differences in tend-and-befriend responses.

Carter, C. S. (2013). Oxytocin pathways and the evolution of human behavior. Annual Review of Psychology.

Dickerson, S. S., & Kemeny, M. E. (2004). Acute stressors and cortisol responses: A theoretical integration and synthesis of laboratory research. Psychological Bulletin, 130, 355-391.

Taylor, S.E. (2002). The tending instinct: Women, men, and the biology of nurturing. New York: Holt Rinehart Winston.

Taylor, S. E. (2006). Tend and befriend: Biobehavioral bases of affiliation under stress. Current directions in psychological science, 15(6), 273-277.Taylor, S. E., Klein, L. C., Lewis, B. P., Gruenewald, T. L., Gurung R. A. R., & Fernandes-Taylor, S. (2003). Affiliation, social support, and biobehavioural responses to stress. In Suls, J., & Wallston, K. A. (Eds.), Social psychological foundations of health and illness (pp. 314-331). Malden, MA: Blackwell.

Levy, K. N., Hlay, J. K., Johnson, B. N., & Witmer, C. P. (2019). An Attachment Theoretical Perspective on Tend-and-Befriend Stress Reactions. Evolutionary Psychological Science. doi:10.1007/s40806019-00197-x

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Measurement Issues in Stress Measurement issues in stress research have not been resolved. Selye’s model with its emphasis on Pavlovian-type responses is not generally accepted as conceptually complex. Lazarus and Folkman’s transactional model, although conceptually more appropriate, is difficult to measure as a process.

Schwazer and Schulz (2001) provide support for the validity of the stressful life events or stimulus-based approach whereas Epel et al (2018) argue in favour of a transdisciplinary approach to stress. Finally, Kopp et al. (2010) and Mauss et al. (2015) critically review common measures of stress of the literature.

Schwazer, R., & Schulz, U. (2001). Stressful life events. In I. V. Weiner (Series Ed.) & A. M. Nezu, C. M. Nezu, & P. A. Geller (Vol. Eds.), Handbook of psychology: Vol. 9, Health psychology (pp. 2749). Hoboken, NJ: John Wiley.

Epel, E. S., Crosswell, A. D., Mayer, S. E., Prather, A. A., Slavich, G. M., Puterman, E., & Mendes, W. B. (2018). More than a feeling: A unified view of stress measurement for population science.

Frontiers in Neuroendocrinology, 49, 146-169.

Kopp MS, Thege BK, Balog P, Stauder A, Salavecz G, Rózsa S, Purebl G, Adám S. (2010) Measures of stress in epidemiological research. J Psychosom Res 69, 211–25.

Mauss, D., Li, J., Schmidt, B., Angerer, P., & Jarczok, M. N. (2015). Measuring allostatic load in the workforce: a systematic review. Industrial health, 53(1), 5–20.

PTSD and Physical Health Research on PTSD has focused primarily on mental health. However, traumatic events have long-term health outcomes. For example, Friedman and McEwen (2004) explore biological correlates of PTSD. They examine the potential causal effects of these correlates using the concept of allostatic load.

McFarlane (2010) and Pacella et al (2013) review how traumatic stress is associated with a number of both mental and physical health problems. O’Toole and Catts (2008) examine how trauma and PTSD are associated with physical health in a select sample of Australian Vietnam veterans. Finally, Schnurr (2015) explores why PTSD may be related to physical health.

Friedman, M., & McEwen, B. (2004). Posttraumatic stress disorder, allostatic load, and medical illness.

In P. Schnurr & B. Green (Eds.), Trauma and Health: Physical health consequences of exposure to extreme stress (pp. 157-188). Washington, DC: APA. O'Toole, B. I., & Catts, S. V. (2008). Trauma, PTSD, and physical health: An epidemiological study of Australian Vietnam veterans. Journal of Psychosomatic Research, 64(1), 33-40.

McFarlane A. C. (2010). The long-term costs of traumatic stress: intertwined physical and psychological consequences. World psychiatry: official journal of the World Psychiatric Association (WPA), 9(1), 3– 10.

Pacella, M. L., Hruska, B., & Delahanty, D. L. (2013). The physical health consequences of PTSD and PTSD symptoms: A meta-analytic review. Journal of Anxiety Disorders, 27(1), 33-46.

Schnurr, P. P. (2015). Understanding Pathways from Traumatic Exposure to Physical Health. In U. Schnyder & M. Cloitre (Eds.), Evidence Based Treatments for Trauma-Related Psychological Disorders: A Practical Guide for Clinicians (pp. 87-103). Cham: Springer International Publishing.

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Exercises, Projects, and Activities The Experience of Stress The topic of stress may be introduced through class discussion. Ask students about their personal experiences under stress. The following list of questions has been developed to encourage discussion of the roles that physiological arousal, appraisal, and life events play in the experience of stress.

1.

2.

3.

4.

How do you know when you’re under stress?

What does stress feel like?

How does stress differ from anticipation? Excitement? Other emotions?

Can positive events be stressful? How?

To further elucidate the differences between the physiological and subjective experience of stress, ask students to identify the physical changes they experience when they are under stress and then link them to the underlying physiological changes (i.e., sympathetic nervous system activation, increased adrenaline, increased blood flow, decreased digestion, etc.).

Stress Log The following assignment has been designed to provide a review of models of stress, the role of appraisal, and perceived control in the experience of stress. A complementary assignment that requires students to evaluate their log in terms of coping styles is described in Chapter 7.

For this assignment, review the text’s description of various models of stress. Keep a log of events that most people would think might produce stress (everything from minor hassles to major annoyances) for at least three days. Be sure to hand in your log with this assignment. In addition to your log of stressful events, consider any other factors that might influence the effects of these events (e.g., positive events).

Discuss the contents of your log in relation to the following points: 1.

Apply Lazarus’s model (all aspects) to explain whether these events were actually related to the subjective experience of stress in your case.

2.

Did any factors buffer the effects of these stressors? What were they? Why do you feel they reduced your perceptions of stress?

3.

Discuss the role that perceived control may have played in your perception of stress.

Web Resources for Activities: Holmes and Rahe Life Events Scale This online version of the Life Events scale can be used to demonstrate the scoring of each life event as it relates to risk for illness. Scoring of events is immediate and given with an interpretation of the total score. https://www.mindtools.com/pages/article/newTCS_82.htm Measuring stress

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The Canadian Mental Health Association has an online stress test that provides a stress index score for self-evaluation. A review of the index can be a good starting point for discussing why each question may be an indication of higher stress levels. http://www.cmha.ca/mental_health/whats-your-stress-index/#.Ucz29qzRazI Work-life Balance Canadian Mental Health Association provides a brief Work-Life Balance Quiz, which can be used to start discussion work-life balance. This short quiz provides an instant score and an interpretation guide. http://www.cmha.ca/mental_health/work-life-balance-quiz/#.Ucz57KzRazJ

Recommended Reading Carroll, D., Lovallo, W. R., & Phillips, A. C. (2009). Are large physiological reactions to acute psychological stress always bad for health? Social and Personality Psychology Compass, 3(5), 725-743.

This review paper presents an interesting perspective on reactivity and health by presenting evidence that low reactivity to stress may be associated with just as many adverse health outcomes as high reactivity.

Lazarus, R. S. (1966) Psychological stress and the coping process. NY: McGraw-Hill.

This classic book provides the background for Lazarus’ theory emphasizing the importance of cognitive processes in the stress process.

Selye, H. (1976). The stress of life. New York: McGraw-Hill.

This classic volume presents Selye’s model of the general adaptation syndrome to a popular audience.

Mangelsdorf, J., Eid, M., & Luhmann, M. (2019). Does growth require suffering? A systematic review and meta-analysis on genuine posttraumatic and postecstatic growth. Psychol Bull, 145(3), 302338.

This review paper discusses the sometimes controversial topic of posttraumatic growth and specifically addresses whether event type (i.e., positive or negative) is important in predicting whether posttraumatic stress leads to later growth and whether suffering is a necessary condition for posttraumatic growth.

Web Videos Stress belief & health

https://www.cbc.ca/player/play/2395293061 Cyberbullying 2.0 This video from the RCMP outlines the facts about cyberbullying and what can be done to deal with it.

https://www.youtube.com/watch?v=DasHGVlDtfQ&feature=youtu.be Unemployment May Increase Heart Attack Risk This CBC news story features the results from a study showing evidence that unemployment can take a toll on health. http://connecticut.cbslocal.com/2012/11/27/unemployment-may-increase-heart-attack-risk/

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CHAPTER 7 MODERATORS OF THE STRESS EXPERIENCE Learning Objectives 1.

Describe and Define Coping

2.

Know the Role of External Coping Resources

3.

List Coping Outcomes

4.

Explain How Social Support Affects Stress

5.

Describe Coping Interventions

Lecture Suggestions Personality, Stress, and Health The role of personality in illness is an area of great interest to students. Perfectionism and procrastination are two personality traits that have been linked to stress and coping, and that are particularly relevant for students and. Dunkley, Solomon-Krause and Moroz (2016) provide an overview of the different ways in which perfectionism dimensions are associated with stressors, appraisals, and coping strategies, and highlight emerging research on the impact of perfectionism on physiological measures of stress. Molnar, Sirois, & Methot-Jones (2016) discuss the implications of perfectionism for living with the chronic stress of chronic health conditions, and how perfectionism may create vulnerability for further stress and poor coping. Sirois (2016a) outlines how the stress from procrastination can compromise health and wellbeing, and then further elaborates a model of how chronic procrastination may create enduring patterns of poor coping that can create vulnerability for chronic health conditions (Sirois, 2016b). Lastly, Smyth Zawadki, and Gerin (2013) present a model describing how individual differences can lead to an acute stressor becoming a chronic stressor through a combination of rumination and reactivation of the stressor and poor coping strategies.

Dunkley, D. M., Solomon-Krakus, S., & Moroz, M. (2016). Personal standards and self-critical perfectionism and distress: Stress, coping, and perceived social support as mediators and moderators.

In F. M. Sirois and D. S. Molnar (Eds.), Perfectionism, Health, and Well-being. Springer.

Molnar, D. M., Sirois, F. M., & Methot-Jones, T. (2016).Trying to be perfect in an imperfect world: Examining perfectionism in the context of chronic illness. In F. M. Sirois and D. S. Molnar (Eds.), Perfectionism, Health, and Well-being. Springer.

Sirois, F. M. (2016). Conceptualizing the relations of procrastination to health and well-being. In F. M. Sirois and T. A. Pychyl (Eds.), Procrastination, Health, and Well-Being. Elsevier.

Sirois, F. M. (2016b). Procrastination, stress, and chronic health conditions: A temporal perspective. In F. M. Sirois and T. A. Pychyl (Eds.), Procrastination, Health, and Well-Being. Elsevier.

Smyth, J., Zawadzki, M., & Gerin, W. (2013). Stress and Disease: A Structural and Functional Analysis.

Social and Personality Psychology Compass, 7(4), 217-227.

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Coping Following a review of the history of coping, Folkman and Moskowitz (2004) discuss problems identified in the last few years. These include measurement issues, issues of nomenclature, and the effectiveness of coping. They address new developments in coping theory. Of particular interest is the work on coping and positive emotions. Manne (2003) focuses on the impact of coping on physical health outcomes.

Whereas Folkman and Moskowitz limit their discussion to cognitive approaches, Manne covers defensefocused approaches as well.

Folkman, S., & Moskowitz, J. (2004). Coping: Pitfalls and promise. Annual Review of Psychology 55, pp. 745-774.

Manne, S. (2003). Coping and social support. In I. V. Weiner (Series Ed.) & A. M. Nezu, C. M. Nezu, & P. A. Geller (Vol. Eds.), Handbook of psychology: Vol. 9, Health psychology (pp. 51-74). Hoboken, NJ: John Wiley.

Personality and Coping In this paper Carver and Conner-Smith discuss current research on the links between personality traits and coping as well as the role of moderating factors such as age and stressor severity.

Carver, C. S., & Connor-Smith, J. (2010). Personality and coping. Annual Review of Psychology, 61(1), 679-704.

Resilience in the Context of Chronic Stress Although the term resilience has been most commonly used within the developmental literature, in terms of health it is increasingly being used to describe how adults cope with and withstand major or chronic stressors. This paper surveys current research on resilience and how it is conceptualized. In particular Dunkel-Schetter and Dolbier focus on resilence to chronic stresssors and propose a taxonomy of resilience resources that might guide future research.

Dunkel-Schetter, C., & Dolbier, C. (2011). Resilience in the context of chronic stress and health in adults.

Social and Personality Psychology Compass, 5(9), 634-652.

Written Disclosure as a Coping Mechanism Cross-cultural studies suggest that people everywhere want to share their emotions and their secrets.

Smyth and Pennebaker (2001) present evidence indicating that such sharing, whether verbal or nonverbal, serves as a coping mechanism. In this chapter, they examine the efficacy of written disclosure and discuss the possible mechanisms through which this may occur.

Smyth, J. M., & Pennebaker, J. W. (2001). What are the health effects of disclosure? In A. Baum, T. Revenson, & J. Singer (Eds.), Handbook of health psychology (pp. 339–348). Mahwah, NJ: Lawrence Erlbaum.

Conceptualizing Social Support

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As the text notes, social support is a complex psychosocial variable. Manne (2003) present reviews of this construct that are useful in developing a lecture to present to students the conceptual and methodological issues surrounding this construct. Wills and Fegan (2001) address the mechanisms of social support. In addition, it may be useful to address the negative aspects of social support. Students often fail to consider the obligations that membership in a complex social network places on the individual.

Manne, S. (2003). Coping and social support. In I. V. Weiner (Series Ed.) & A. M. Nezu, C. M. Nezu, & P. A. Geller (Vol. Eds.), Handbook of psychology: Vol. 9, Health psychology (pp. 51-74). Hoboken, NJ: John Wiley.

Wills, T. A., & Fegan, M. F. (2001). Social networks and social support. In A. Baum, T. Revenson, & J. Singer (Eds.), Handbook of health psychology (pp. 209–234). Mahwah, NJ: Lawrence Erlbaum.

Exercises, Projects, and Activities Coping Styles and Strategies The topic of coping may be introduced by asking students to list on the board the ways in which they typically handle stress. The similarities and differences of the individual coping strategies may then be discussed. Finally, categorize each strategy according to the Ways of Coping Scale criteria.

Assessing Coping Strategies Student analyses of their daily coping strategies may form the basis of an independent assignment. This assignment may be integrated with the stress log discussed in Chapter 6. A sample assignment with suggested guidelines follows.

For this assignment, review the log of stressors that you handed in with Assignment . Be sure to hand in your log again with this assignment. If you wish, you might monitor your stress and coping for another day or two to provide you with more information for your analysis. In addition to your log of stressful events, consider any other factors that you discussed in your earlier assignment (e.g., positive events).

Write an essay that addresses the following points: 1.

How did you cope with these events? Could you summarize your coping strategies according to a particular coping style(s)?

2.

How successful were your coping efforts? Did some coping strategies work better than others? Were certain efforts more successful with certain stressors?

3.

What role, if any, did social support play in your coping with stress? Were certain support efforts more effective than others? Why or why not?

4.

Do you feel that stress management techniques might improve your coping? Which one(s)? Why?

Web Resources for Activities: Self-Compassion Kristen Neff‘s site on self-compassion incudes several videos describing self-compassion and its benefits, including her TEDx talk. Also included is a self-compassion self-test that can launch a discussion on measurement and application. http://www.self-compassion.org/ Test how self-compassionate you are Taylor, Sirois & Molnar Health Psychology, 5th Canadian Edition | Instructor’s Manual -3-

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http://www.self-compassion.org/test-your-self-compassion-level.html Relaxation This two-minute relaxation technique video provides complete details on the steps for achieving a quick self taught relaxation which can be easily used in class. http://video.about.com/altmedicine/2-Minute-Relaxation-Technique.htm This HelpGuide site offers a list of 8 different techniques for reducing stress and promoting relaxation that can be discussed in class.

Relaxation Techniques for Stress Relief https://www.helpguide.org/articles/stress/relaxation-techniques-for-stress-relief.htm

Recommended Reading Lazarus, R. S., & Folkman, S. (1984). Stress, appraisal, and coping. New York: Springer.

An excellent review of social and psychological processes related to stress. The authors discuss the role of cognitive appraisal and coping in stress and adaptation, stress management, and the relationship between cognition and emotions.

Stahl, Bob and Elisha Goldstein. (2010). A Mindfulness-Based Stress Reduction Workbook. Oakland, CA: New Harbinger Publications, Inc. This workbook provides an easy to understand introduction to the use of mindfulness-based stress reduction.

Web Videos See What Happens Inside Your Body When You Procrastinate This research-informed animation from Men’s Health magazine illustrates the potential harmful effects of the stress from procrastination. The detailed outline of the physiological effects of stress may be helpful for reinforcing Chapter 2 knowledge. http://www.menshealth.com/health/procrastination-is-killing-you Pets and Stress Reduction.

There a number of research studies now showing the benefits of interacting with pets for reducing stress.

The links below are to videos that summarize some of this research.

Pet Your Worries Away: Study Finds Just 10 Minutes With Cats, Dogs Tangibly Lowers Stress https://www.studyfinds.org/pet-your-worries-away-study-finds-just-10-minutes-with-cats-dogs-tangiblylowers-stress/ New Study Confirms Therapy Dogs Reduce Stress for College Students (UBC study) https://people.com/pets/new-study-university-british-columbia-therapy-dogs-reduce-stress-students/

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CHAPTER 8 USING HEALTH SERVICES

Learning Objectives 1

Explain How People Recognize and Interpret Symptoms

2

Know What Predicts the Use of Health Services

3

Describe How Health Services are Misused

4

Understand How Hospitalization Impacts the Patient

5

Describe How Control can be Increased in Hospital Settings

Lecture Suggestions The Sick Role The article by Miczo (2004) may be used to expand on the text’s discussion of the use of health services for nonmedical reasons. In this article the researchers argue that sick-role behaviour may be better conceptualized as a set of illness attitudes and care-seeking behaviours. He found that attitudinal factors (release, consideration, burden, and deviance) were moderate predictors of care-seeking intentions as were stressors and social support for the sick role.

Miczo, N. (2004). Stressors and social support perceptions predict illness attitudes and care-seeking intentions: Re-examining the sick role. Health Communication, 16, 347-361.

Burnout This editorial on burnout and health by Shirom presents a brief review of key health areas impacted by burnout as an introduction to a special issue on this topic.

Shirom, A. (2009). Burnout and health: expanding our knowledge. Stress and Health, 25(4), 281-285.

Exercises, Projects, and Activities The Lay Referral Network Students often are not aware of how much their lay referral network may influence their choices regarding how to deal with a troubling symptom or condition, especially when such influence is indirect. To make them more aware of how they use their own social network in this decision process, have students recall (and possibly write about) the last time they experienced a troubling symptom. Then in small groups, ask them to discuss what they did – visit a doctor or alternative health care provider, ask a friend for advice, recall a similar situation that a friend or relative may have had. This discussion can be expanded to address whether they would contact the same people or recall the same advice if it was a different symptom, and if not why.

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Web Resources for Activities: Nosocomial Infections CBC’s Marketplace has a series of videocasts and updates to a show “Dirty doctors” which addressed the issue of nosocomial infections. The website also includes web extras and related links to sites with relevant content including information on how to reduce hospital infections, and Health Canada’s handwashing recommendations for health care workers. http://www.cbc.ca/player/play/1555611046 After viewing the recommendations form Health Canada, have students break off into groups to design an intervention, campaign, or hospital policy designed to increase handwashing in health care facilities. You can also suggest that they identify the theory behind their method. A discussion about the pros and cons of each method can follow as students share what they have designed.

Symptom Checking and Cyberchondria Symptom checking is becoming a widespread phenomena amongst Canadian according to a statistics Canda report which is highlighted in the video Canadians Seeking Online Medical Advice. As a class activity, track a hypothetical symptom through one of the on-line symptom checkers listed below to see what advice is given. Then discuss how the different symptom checkers are similar, how and why they may impact symptom interpretation, how when used repeatedly they may develop into cyberchondria.

The slide show 10 Signs You Have Cyberchondria can be shown as a follow-up.

Canadians Seeking Online Medical Advice https://www.youtube.com/watch?v=x7qlZ9bhIAk WebMD Symptom checker http://symptoms.webmd.com/#introView Mayo Clinic http://www.mayoclinic.com/health/symptom-checker/DS00671

BC Health Guide http://www.healthlinkbc.ca/kb/sx.html Wrong Diagnosis.com http://symptoms.wrongdiagnosis.com/

Cyberchondria - Mayo Clinic https://www.youtube.com/watch?v=CY2i5eGF7Q0

Recommended Reading Broadbent, E. (2010). Illness perceptions and health: Innovations and clinical applications. Social and Personality Psychology Compass, 4(4), 256-266.

Illness perceptions are the focus of this review paper. After outlining the links between illness perceptions and health behaviours this paper reviews measurement issues in illness perception research and presents Taylor, Sirois, & Molnar, Health Psychology, 5th Canadian Edition | Instructor’s Manual -2-

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recent research exploring the potential role of interventions to alter illness perceptions and improve health outcomes.

Web Videos The Warning Signs of Stroke. This short video clip features the Heart and Stroke Foundation public service announcement ad that is discussed in Box 8.1 This clip may also be used for Chapter 14 which covers stroke. https://www.youtube.com/watch?v=OpJ16he8F-A Controlling hospital infections a continuing concern. This CBC news video highlights concerns over nosocomial infection rates in Newfoundland and Labrador which are higher than the national average. http://www.cbc.ca/news/canada/newfoundland-labrador/controlling-hospital-infections-a-continuingconcern-1.1352584 Stress and burnout for nurses. In this CBC news video, the issue of burnout in Canadian nurses is addressed. http://www.cbc.ca/player/play/2374116522

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CHAPTER 9 PATIENT-PROVIDER RELATIONS Learning Objectives 1

Define Health Care Provider

2

Explain Why Patient-Provider Communication is Important

3

Describe How to Improve Patient-Provider Communication

4

Define Non-adherence and How it can be Reduced

5

Understand the Placebo Effect

Lecture Suggestions Elderspeak Within the Medical Interaction The nonverbal behaviour exchanged between patients and their providers may be a revealing source of information about interpersonal expectations and attitudes. Elderly patients often complain about being treated in a patronizing or infantilizing fashion by medical providers when they use overly endearing and personal terms to address them, known as elderspeak. O’Connor and St. Pierre (2006) address the issue of context when communicating with older adults and how what is seen as warm in the context of communications with familiar family and friends is perceived competed differently when it comes from health care workers. Balsis and Carpenter (2006) examine perceptions of those who deliver and receive elderspeak in an experimental study and find that elderspeak is associated with negative perceptions of both the person using it and also of those who receive it. The reasons why this may occur is a good starting place for an in-class discussion. Finally, Williams et al. (2016) provide some recommendations on how to avoid elderspeak with older adults.

Balsis, S., & Carpenter, B. D. (2006). Evaluations of elderspeak in a caregiving context. Clinical Gerontologist, 29(1), 79-96.

O'Connor, B. P., & St. Pierre, E. (2004). Older persons' perceptions of the frequency and meaning of elderspeak from family, friends, and service workers. International Journal of Aging and Human Development, 58, 197-221.

Williams, K., Kemper, S., & Hummert, M. L. (2016). Enhancing communication with older adults: overcoming elderspeak. Journal of psychosocial nursing and mental health services, 43(5), 1216.

Explaining Illness Whaley (2000) provides an excellent resource for developing a lecture on the issues involved in explaining illness. The chapter by Thompson has excellent sections on medical jargon and on effective communication. Gillotti and Applegate’s chapter examines the issues involved in delivering bad news and provides suggestions for effective practice. Gill & Maynard take a sociolinguisitic approach and integrate patient perspectives with physician responses. Other chapters focus on specific populations.

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Gillotti, C., & Applegate, J. (2000). Explaining illness as bad news: Individual differences in explaining illness-related information. In B. Whaley (Ed.), Explaining illness: Research, theory, and strategies (pp. 101–120). Mahwah, NJ: Erlbaum.

Thompson, T. L. (2000). The nature and language of illness explanations. In B. Whaley (Ed.), Explaining illness: Research, theory, and strategies (pp. 3–39). Mahwah, NJ: Erlbaum Whaley, B. (Ed.). (2000). Explaining illness: Research, theory, and strategies. Mahwah, NJ: Erlbaum.

Gill, V. T., & Maynard, D. W. (2006). Explaining illness: patients' proposals and physicians' responses. Studies in Interactional Sociolinguistics, 20, 115.

Adherence to Treatment Regimen The chapter by Dunbar-Jacob and Schlenk (2000) can be used to extend the text’s discussion of adherence. The authors examine the problems inherent in assessing adherence, predictors of poor adherence and its relation to clinical outcomes, and suggest some interventions to promote adherence.

The social support literature provides evidence for the relationship of social support and health.

DiMatteo’s (2004) meta-analysis indicates that this relationship is mediated by adherence. The remainder of the readings provide reviews of the state of nonadherence in specific types of illnesses including mental illness, hypertension, and chronic pain.

Abegaz, T. M., Shehab, A., Gebreyohannes, E. A., Bhagavathula, A. S., & Elnour, A. A. (2017).

Nonadherence to antihypertensive drugs: A systematic review and meta-analysis. Medicine, 96(4), e5641. doi:10.1097/MD.0000000000005641 DiMateo, RM. R. (2004). Social support and patient adherence to medical treatment: A meta-analysis.

Health Psychology, 23, 207-218.

Dunbar-Jacob, J., & Schlenk, E. (2000). Patient adherence to treatment regimen. In A. Baum, T. Revenson, & J. Singer (Eds.), Handbook of health psychology (pp. 571–580). Mahwah, NJ: Lawrence Erlbaum Timmerman, L., Stronks, D. L., Groeneweg, J. G., & Huygen, F. J. (2016). Prevalence and determinants of medication non-adherence in chronic pain patients: a systematic review. Acta Anaesthesiologica Scandinavica, 60(4), 416-431.

Velligan, D. I., Sajatovic, M., Hatch, A., Kramata, P., & Docherty, J. P. (2017). Why do psychiatric patients stop antipsychotic medication? A systematic review of reasons for nonadherence to medication in patients with serious mental illness. Patient preference and adherence, 11, 449–468. doi:10.2147/PPA.S124658 The Placebo Puzzle Placebos are intriguing to students. They often question how and why they work. Stewart-Williams (2004) and Stewart-Williams and Podd (2004a) explore these questions. They discuss the possibility that this is not a true effect and examine the criticisms directed toward the effect. They then describe two theories, expectancy theory and classical conditioning, followed by an analysis of how and why these theories explain the action of the placebo. They close with an integration of the two theories. Two additional articles comment on this issue.

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Kirsch, I. (2004). Conditioning, expectancy and the placebo effect: Comment on Stewart-Williams and Podd. Psychological Bulletin, 130, 341-343.

Stewart-Williams, S. (2004). The placebo puzzle: Putting together the pieces. Health Psychology, 23, 198-206.

Stewart-Williams, S., & Podd J. (2004a). The placebo effect: Dissolving the expectancy versus conditioning debate. Psychological Bulletin, 130, 324-340.

Stewart-Williams, S., & Podd J. (2004b). Placebo psychotherapies and nonconscious learning in the placebo effect: Reply to Kirsch (2004). Psychological Bulletin, 130, 344-345.

Kaptchuk (2002) takes a different perspective on the placebo effect by examining its role in alternative medicine. In this essay he examines the impact of the healing context in placebo effects, especially as they pertain to alternative medicine, and examines how these non-specific effects may contribute to positive health outcomes. This paper is available for free download and may be a good additional reading for this chapter.

Kaptchuk, T. J. (2002). The placebo effect in alternative medicine: Can the performance of a healing ritual have clinical significance? Annals of Internal Medicine, 136(11), 817-825.

Exercises, Projects, and Activities Evaluation of Student Health Center If you have the support of the campus student health center director, an evaluation of the facility’s psychosocial climate makes a useful class assignment. I have found that campus health care personnel will make their facilities open for individual student tours during a specified time block. This assignment takes some advance planning, but student responses have been positive. It is important for students to understand that patients’ privacy must be respected and that they must follow any guidelines that the health care personnel may provide. Assignments might follow an outline such as follows.

The Director of Student Health has agreed to make the on-campus facilities available to the class to evaluate the psychosocial environment in the center. In order to protect patient confidentiality, it is important that you do not conduct your evaluation during the times that they have physicians examining patients.

Your assignment should follow these guidelines: 1.

Develop a system of evaluating the clinic’s psychosocial climate (include your criteria and questions with your assignment).

2.

Conduct an evaluation of the clinic according to your criteria.

3.

What do you conclude about the psychosocial environment? Do you have any recommendations for improvement? If so, what are they?

Web Resources for Activities: Complementary and Alternative Health

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The University of Rochester has an online quiz that can be used to test students’ knowledge about CAM. Alternative and Complementary Medicine Quiz http://www.urmc.rochester.edu/encyclopedia/document.aspx?ContentTypeID=40&ContentID=C ompMed Interactive activity: Wait times for priority procedures in Canada http://waittimes.cihi.ca/ Web Videos This series of videos on the placebo effect by leading expert Ted Kaptchuk covers everything from the basics of what constitutes a placebo effect to how powerful placebo effects can be.

The Potential of Placebo https://www.youtube.com/watch?v=hJB8qeWKV6w Making Sense of the Placebo Effect. Q and A with Ted Kaptchuk https://www.youtube.com/watch?v=1qFFcImQzSw Ted Kaptchuk On The Power of Placebos https://www.youtube.com/watch?v=1_UrGI2IsJs The Nature of Things feature story Brain Magic: The Power of Placebos, investigates claims that placebos can have powerful – and real – effects on our mind and body: http://www.cbc.ca/natureofthings/episodes/brain-magic-the-power-of-the-placebo In this web video, Interview Holistic Health Practitioner | Alternative Healthcare Careers, from Careers Out There.com, a holistic health practitioner explains the differences between the various holistic health careers including acupuncture, massage therapy, Chinese medicine and more. The web video is available in both short (6 mins.) and long (52 mins.) formats. The web page also includes a full interview transcript. http://careersoutthere.com/holistic-health-practitioner-alternative-healthcare-careers/ “Plymouth Nurses Give Advice on “Elderspeak”” This CCX Media news clip features the topic of elderspeak and highlights some of the reasons why it occurs and its consequences. The clip also provides advice on how to avoid elderspeak.

https://www.youtube.com/watch?v=Trl_afHOP14 In this Medscape Journal video, The Doctor-Patient Relationship II: Not Listening, Dr. Ursula Snyder provides a different perspective on why patients may feel that doctors don’t listen. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2644023/

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CHAPTER 10 PAIN AND ITS MANAGEMENT Learning Objectives 1

Understand the Significance of Pain

2

Explain Why Pain is Difficult to Study

3

Identify the Clinical Issues in Pain Management

4

Describe the Techniques Used to Control Pain

5

Explain How Chronic Pain is Managed

Lecture Suggestions Pain Turk and Okifuji’s (2002, 2003) chapters on chronic pain are an excellent organizing focus for a lecture.

They provide theoretical models and discuss ways we learn pain using learning theory. In addition, they examine the affective and cognitive components of pain. After discussing the Gate Control Theory of Pain and the Biopsychosocial Theory, they provide a cognitive-behaviour treatment. Keefe and colleagues’ (2005) article, which focuses on disease-related pain, also provides an excellent basis for a lecture. They discuss the biomedical model of disease-related pain and its limitations. Using psychological approaches, they present pain management techniques for patients with rheumatoid arthritis and with cancer.

Keefe, F. J., Abernathy, A. P., & Campbell, L.C. (2005). Psychological approaches to understanding and treating disease-related pain. Annual Review of Psychology, 56, 601-630.

Turk, D. C., & Okifuji, A. (2002). Chronic pain. In Christensen, A. J., & Antoni, M. H. (Eds.), Chronic physical disorders: Behavioural medicine’s perspective (pp. 165-190). Malden, MA: Blackwell.

Turk, D. C., & Okifuji, A. (2003). Pain Management. In I. V. Weiner (Series Ed.) & A. M. Nezu, C. M. Nezu, & P. A. Geller (Vol. Eds.), Handbook of psychology: Vol. 9, Health psychology (pp. 293315). Hoboken, NJ: John Wiley.

Gate-Control Theory Gate-control theory is one of the most popular explanations for the factors that influence pain. However, because it is not the only theory, an exploration and critique of gate-control theory, along with some alternate but also incomplete models, may be appropriate. Turk (2001) provides an exceptional overview of the physiological and psychological processes of pain. He examines the gate-control theory and reviews the diathesis-stress model and the cognitive-behaviour model.

Turk, D. C. (2001). Physiological and psychological bases of pain. In A. Baum, T. Revenson, & J. Singer (Eds.), Handbook of health psychology (pp. 117–137). Mahwah, NJ: Lawrence Erlbaum.

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Exercises, Projects, and Activities Pain Management Programs If your university is affiliated with a medical center or if a local rehabilitation clinic is accessible, request a guest speaker for a classroom presentation of pain management intervention techniques.

Preferred Music and Pain Management Take a poll of whether students have ever turned to music to manage pain from say a sports injury, migraine, or other source. Then survey the types of music that they listened to see if there is any common ground or if they instinctually chose their favourite music. This can then lead into a discussion of why preferred music might be effective for managing pain as well as whether they believe there are limits to the types of pain that can be managed this way.

The Subjective Experience of Pain Have students write essays about an incident during which their experience of pain was modulated by some set of psychological or situational factors. With some thought, most students can recall a sportsrelated injury or a stressful experience that influenced their perception of pain. A sample assignment might follow these guidelines: The readings and the material discussed during this week of class focus on the experience of pain and techniques by which individuals and/or providers manage their physical pain. Pick any topic discussed in class or in this week’s readings and write a brief essay on this topic. Your essay should include: 

A brief description of a personal experience or an observation that illustrates one or more of the phenomena covered in class or the text



A brief explanation of the theory or research that you will apply to this experience or observation



An evaluation of how well this research or theory seems to explain this experience or observation

Medical/Dental Procedures and Pain Management An alternative assignment might involve specifically targeting the control of pain and anxiety during a medical or dental procedure. The use of an interview format would ensure that students assess the perception of pain in a comprehensive and thorough manner. A sample assignment is provided as follows.

Interview two friends (use pseudonyms please), and ask them to recall a medical or dental procedure during which they had to regulate the amount of pain and/or anxiety they were experiencing. Then, analyze your friends’ responses within the context of the issues discussed in Chapter 10 of the text and lectures. This task will consist of the following: 1.

Develop a brief interview format that you will use to discuss these issues. Make it specific in order to address the goals of this assignment. Include your interview format as an appendix to your assignment.

2.

Discuss the specific interview responses in relationship to pain and its control and management.

3.

What do you conclude about your friends’ experiences with pain and its management? What factors seem to be involved in successful pain control and management (if observed)? Can you identify factors that seem to explain why your friends might have had difficulty managing their pain?

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4.

What role (if any) did perceived control play?

5.

Make sure you incorporate the theories and concepts discussed in class in your analysis

Managing Pain with Opioids As discussed in chapter 10 of the text, Canada is in the midst of an opioid epidemic. While there are many disadvantages to using opioids to manage pain, evidence suggests that opioids are still one of the best pharmaceutical aids for pain management. Have students put themselves into groups so that they can have an educated discussion with respect to the use of opioids to treat pain. Each group can be assigned one of the following topics: a) opioid poisonings and other opioid-related harms that result in emergency room visits; b) opioid addiction; c) pain-relieving properties of opioids; d) use of opioids among different samples (young people, acute pain, chronic pain, terminal illness). Each of these topics is discussed in chapter 10.

Web Activities Pain The Discovery channel’s How Stuff Works site includes a How Pain Works set of web pages that feature an overview of the gate control theory, and information about of pain. Featured is a short web video on how Shaolin monks use meditation to tolerate pain from extraordinary acts. http://health.howstuffworks.com/pain4.htm

Pain Quiz: Test Your IQ of Pain http://www.medicinenet.com/pain_quiz/quiz.htm Recommended Reading Doleys, D. M. (2000). Chronic pain. In R. G. Frank & T. R. Elliott (Eds), Handbook of rehabilitation psychology (pp. 185–203). Washington, DC: American Psychological Association.

This chapter, written for professionals, provides background information on recurrent acute and chronic pain. Issues of prevention, management, and treatment are discussed.

Hadjistavropoulos, T., & Craig, K. T. (2004). Pain: Psychological perspectives. Mahwah, N.J.: Lawrence Erlbaum.

This edited volume includes contributions from clinical, social, and biopsychological perspectives, as well as the latest theories and clinical issues in pain and its management.

Melzack, R., & Wall, P. D. (1982). The challenge of pain. New York: Basic Books.

This classic study of pain reviews theories of pain, the underlying physiological elements of pain, and techniques of pain management and control.

Busse, J. W., Wang, L., Kamaleldin, M., Craigie, S., Riva, J. J., Montoya, L., . . . Guyatt, G. H. (2018).

Opioids for Chronic Noncancer Pain: A Systematic Review and Meta-analysis. JAMA, 320(23), 24482460.

This meta-analysis provides a systematic review of randomized clinical trials that assess the effectiveness of opioids for managing non-cancer pain and discusses alternatives to opioid use for non-cancer pain.

Sanger, N., Bhatt, M., Singhal, N., Ramsden, K., Baptist-Mohseni, N., Panesar, B., . . . Samaan, Z. (2019). Adverse Outcomes Associated with Prescription Opioids for Acute Low Back Pain: A Systematic Review and Meta-Analysis. Pain Physician, 22(2), 119-138.

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This meta-analysis examines use of opioids for acute pain and deleterious consequences associated with opioid use.

Web Videos In this YouTube web video “Bio-Psychosocial Model of Health and Illness” Kenneth D. Craig, PhD explains the science behind the Bio-Psychosocial Model of Health and Illness and its influence on the treatment of chronic pain. http://www.youtube.com/watch?v=pQbnmi5fTZY “Healing Power of Music”. This brief web video provides an overview of some of the research on the use of music for managing pain and other physical ailments. https://www.youtube.com/watch?v=Ketz-mJ-x-Q “Why pain — and pain treatment — is still a grey area of medicine” by the National Post. This brief video provides an overview of pain and differences between acute and chronic pain. It also discusses the complexities of treating pain from a medical perspective. https://nationalpost.com/health/why-pain-and-how-best-to-treat-it-is-still-a-grey-area-of-medicine

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CHAPTER 11 LIVING WITH CHRONIC ILLNESS Learning Objectives 1

Define Quality of Life

2

Understand the Different Responses to Chronic Illness

3

Describe How the Self is Changed by Chronic Illness

4

Explain How People Cope with and Manage Chronic Illness

5

Describe the Psychological Interventions Used to Manage Chronic Illness

Lecture Suggestions Quality of Life Quality of life is a widely used and important term that can be interpreted differently across different disciplines and settings. This systematic review by Haraldstad and colleagues examines how current research uses the term, with a focus on how medicine and other health-related fields view the term and differentiate it from health-related quality of life, and can be used to develop a lecture that unpacks the term and its different components and meanings.

Haraldstad, K., Wahl, A., Andenæs, R., Andersen, J. R., Andersen, M. H., Beisland, E., . . . the, L. n.

(2019). A systematic review of quality of life research in medicine and health sciences. Quality of Life Research, 28(10), 2641-2650.

Adjusting to Chronic Illness Stanton, Revenson, and Tennen (2007) are an excellent resource for a lecture on the complexities of adjusting to chronic illness. They examine proximal and distal factors involved in adjustment, as well as the role of risk and protective factors over time. Devellis, Lewis, and Sterba (2003) apply the social psychological literature on emotion control to adjustment to chronic illness. Several chapters in Christensen and Antoni’s (2002) edited book address these issues.

Carver, C. S., & Scheier, M. F. (2002). Coping processes and adjustment to chronic illness. In Christensen, A. J., & Antoni, M. H. (Eds.), Chronic physical disorders: Behavioural medicine’s perspective (pp. 47-68). Malden, MA: Blackwell.

Dunbar-Jacob, J., Schlenk, E. A., & Caruthers, D. (2002). Adherence in the management of chronic disorders. In Christensen, A. J., & Antoni, M. H. (Eds.), Chronic physical disorders: Behavioural medicine’s perspective (pp. 69-82). Malden, MA: Blackwell.

DeVellis, R. F., Lewis, M. A., & Sterba, K. R. (2003). Interpersonal emotional processes in adjustment to chronic illness. In Suls, J., & Wallston, K. A. (Eds.), Social psychological foundations of health and illness (pp. 256-287). Malden, MA: Blackwell.

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Helgeson. V. S., & Reynolds, K. A. (2002). Social psychological aspects of chronic illness. In Christensen, A. J., & Antoni, M. H. (Eds.), Chronic physical disorders: Behavioural medicine’s perspective (pp. 25-46). Malden, MA: Blackwell.

Kaplan, R. M. (2002). Quality of life and chronic illness. In Christensen, A. J., & Antoni, M. H. (Eds.), Chronic physical disorders: Behavioural medicine’s perspective (pp. 1-24). Malden, MA: Blackwell.

Stanton, A. L., Revenson, T. A., & Tennen, H. (2007). Health psychology: Psychological adjustment to chronic disease. Annual Review of Psychology, 58(1), 565-592.

Benefit Finding Finding benefit in the experience of chronic illness is an often reported phenomena that defies clear explanation. Bower and colleagues (2008) review evidence suggesting that benefit finding involves changes across a number of different life domains that can be beneficial for physical health and propose an explanatory model.

Bower, J. E., Low, C. A., Moskowitz, J. T., Sepah, S., & Epel, E. (2008). Benefit finding and physical health: Positive psychological changes and enhanced allostasis. Social and Personality Psychology Compass, 2(1), 223-244.

Hope, Purpose, and Adjustment The popular literature is replete with articles touting the life-giving resources of hope and purpose. A lecture examining these issues from a scientific basis can be developed from Scheier and Carver’s (2001) chapter using an expectancy-value model to examine hope and purpose in adjusting to cancer.

Scheier, M.F., & Carver, C. S. (2001). Adapting to cancer: The importance of hope and purpose. In A. Baum & B. L. Anderson (Eds.), Social interventions for cancer (pp. 15–36). Washington, DC: American Psychological Association.

Individual Differences Adjustment to chronic illness is complicated and research points to the importance of considering individual differences with respect to some key personality factors that may modulate how individuals adjust to illness.

Gustavsson-Lilius M., Julkunen J., Keskivaara P., Lipsanen J., Hietanen P. (2012). Predictors of distress in cancer patients and their partners: the role of optimism in the sense of coherence construct. Psychology and Health, 27, 178–195.

Jokela, M., Hakulinen, C., Singh-Manoux, A., & Kivimaki, M. (2014). Personality change associated with chronic diseases: Pooled analysis of four prospective cohort studies. Psychological Medicine, 44, 2629–2640.

Molnar, D. S., Sirois, F. M., & Methot-Jones, T. (2016). Trying to be perfect in an imperfect world: Examining the role of perfectionism in the context of chronic illness. In F. M Sirois, & D. S. Molnar (Eds.), Perfectionism, Health, and Well-Being (pp. 69-99). New York, NY: Springer.

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Sirois, F. M., Molnar, D. S., & Hirsch, J. K. (2015). Self-Compassion, Stress, and Coping in the Context of Chronic Illness. Self and Identity, 14(3), 334-347.

Exercises, Projects, and Activities The Impact of Chronic Illness It is often useful to have students consider how their lives might be affected if they developed a chronic illness. This exercise also provides an opportunity to discuss the very high probability that students will develop one or more chronic illnesses over their lifetimes. In addition, it allows a discussion of the wide range of chronic disorders (e.g., emphysema, asthma, hearing loss) that millions of people successfully manage on a daily basis. I have often found that many students write about chronic conditions that they now are struggling to manage. Some guidelines are presented as follows: For this assignment, you need to select one of the chronic illnesses discussed in class or in your text, and consider the ways in which your life might change if you had to cope with this condition on a daily basis.

Then I would like you to consider your physical environment, your daily activities, your relationships with other people, and so on, and write an essay that addresses the following points: 1.

Which chronic illness or disorder did you select? What symptoms are characteristic of this condition?

What is the prognosis? What particular aspects of this illness may be particularly problematic in managing the day-to-day aspects of your illness?

2.

Would any aspects of your physical environment have to be modified? Which ones? Why?

3.

Would you need to change or modify any of your daily activities due to the demands of this condition? Which ones? Why?

4.

Would you expect any of your relationships (from casual acquaintances to intimates) to change?

Why? Do you feel that you might need a particular type of social support? Why?

5.

Do you feel that your social network could provide you with effective social support? Why or why not? Do you feel that your support network would be strained because of your condition? Why or why not?

Support Groups Invite a representative from a social support group (such as a Reach to Recovery volunteer) to speak to the class about the group’s functions, members, and so on. A listing of organizations is usually available from local hospitals and county and provincial agencies.

Alternatively have students search for online support groups related to different specific or classes of chronic health conditions. The popular ButYouDontLookSick.com is a good place to start. Students can review the contents and organization of the web sites to get a better idea of the provision of social support online for people living with chronic illness.

Web Activities

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Noncommunicable Diseases The World Health Organization (WHO) features a fact file on noncommunicable diseases around the world that can be used to help stimulate discussion about the role of health inequities in the rise of chronic disease.

Interactive Fact File: 10 facts on Noncommunicable Diseases http://www.who.int/features/factfiles/noncommunicable_diseases/facts/en/index.html Quality of Life and Place One way to help illustrate the role of place in health is to use this quality of life map from the Atlas of Canada which color codes areas of high and low quality of life across the country. Invite students to discuss what factors may be linked to high quality of life areas, and why other areas of the country tend to have lower overall quality of life. The interactive zoom tool helps to focus in on specific areas. http://geogratis.gc.ca/api/en/nrcan-rncan/ess-sst/edfb3bf0-8893-11e0-8e44-6cf049291510.html Fibromyalgia and Chronic Fatigue Syndrome The Fibromyalgia (FM) and Chronic Fatigue Syndrome (CFS) Canada web site features patient testimonials about living with medically unexplained physical symptoms. There are a wide range of stories, indexed by theme, that provide first hand perspectives on what it is like to live with these puzzling yet challenging chronic conditions. http://www.fm-cfs.ca/videos/index.html#FullLength Medicine Net.com also feature quizzes on chronic fatigue syndrome (CFS), and fibromyalgia that can be used to test students’ knowledge about the facts regarding CFS. Chronic Fatigue Quiz http://www.medicinenet.com/chronic_fatigue_quiz/quiz.htm Fibromyalgia: Myth or Fact? http://www.healthcentral.com/chronic-pain/fibromyalgia-197044.html

Web Videos Elliot Krane: The mystery of chronic pain (7 min. 57 sec). This Ted Talk examines the experience of chronic pain. https://www.ted.com/talks/elliot_krane_the_mystery_of_chronic_pain?language=en

This webvideo, Psychology and Chronic Illness, from the APA Help Center features psychologist Rosalind Dorlen, PsyD discussing how a psychologist can help people living with chronic illness deal with the initial diagnosis, comply to treatment, and stay positive to better manage their illness. http://www.youtube.com/watch?v=MpcwVU93FAg In this web video, Top Tips for coping with Chronic Illness, Carolyn Matheson shares tips for coping with chronic illness based on her own experiences. http://www.youtube.com/watch?v=7yTb-4toE2U Taylor, Sirois & Molnar, Health Psychology, 5th Canadian Edition | Instructor’s Manual -4-

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CHAPTER 12 PSYCHOLOGICAL ISSUES IN ADVANCING AND TERMINAL ILLNESS Learning Objectives 1

Describe How Death Differs Across the Life Span

2

Know the Psychological Issues in Advancing Illness

3

Identify the Stages in Adjustment to Dying

4

Understand the Concerns in the Psychological Management of the Terminally Ill

5

Describe the Alternatives to Hospital Care for the Terminally Ill

Lecture Suggestions Expressing One’s Grief and Bereavement As mentioned in the text, Bonnano et al., 2002 and Calhoun, Tedeschi, Cann, and Hanks (2010) find that grieving may actually result in positive changes some people. This research might be discussed in light of the cross-cultural perspectives on grief and bereavement from this chapter.

Denckla, C. A., Mancini, A. D., Bornstein, R. F., & Bonanno, G. A. (2011). Adaptive and maladaptive dependency in bereavement: Distinguishing prolonged and resolved grief trajectories. Personality and Individual Differences, 51(8), 1012-1017. doi:10.1016/j.paid.2011.08.014 Lotterman, J. H., Bonanno, G. A., & Galatzer-Levy, I. (2014). The heterogeneity of long-term grief reactions. Journal of Affective Disorders, 167, 12-19. doi:10.1016/j.jad.2014.05.048 Mancini, A. D., Sinan, B., & Bonanno, G. A. (2015). Predictors of prolonged grief, resilience, and recovery among bereaved spouses. Journal of Clinical Psychology, 71(12), 1245-1258. doi:10.1002/jclp.22224

Exercises, Projects, and Activities Attitudes Toward Death Personal and cultural attitudes toward death may be explored by having students choose a culture and prepare a short report on how that culture views death and dying. This project can be conducted in groups and then a spokesperson from each group can give a brief presentation based on the group’s research.

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The Right to Die Debate The Right-To-Die Debate: Doctors weigh in on Supreme Court ruling. This clip by Global News provides an insightful debate on the issue of whether Canadians should have the right to die from the perspective of physicians who have years of experience in palliative care. http://globalnews.ca/video/1817315/right-to-die-debate-doctors-weigh-in-on-supreme-court-ruling A recent ruling from the Quebec government challenges the federal physician-assisted suicide laws, suggesting that they are too restrictive in limiting access to such laws to only those who are at the end of life. This article can make for an interesting debate as to who should and should not be eligible for assisted suicide and whether the current laws need further amendment.

Canadian court rules parts of assisted-suicide law violate patient rights https://www.reuters.com/article/us-canada-quebec-euthanasia/canadian-court-rules-parts-of-assistedsuicide-law-violate-patient-rights-idUSKCN1VW2LH Life Expectancy and Causes of Death To help students better understand the behavioural and genetic factors that contribute to premature death have them use the life expectancy calculator. This can be followed up with a discussion of the role of modifiable risk factors and the role of health psychology in increasing the life expectancy of Canadians.

The public Health Agency of Canada also has a colorful graphic to help visualize the causes of death in Canada that can be used to supplement this discussion.

Life expectancy calculator http://www5.statcan.gc.ca/cansim/pick-choisir?lang=eng&searchTypeByValue=1&id=1020561 http://www.projectbiglife.ca/life/ http://www.huffingtonpost.ca/2014/05/29/life-expectancy-calculator_n_5408205.html

Recommended Reading Konigsberg, R. D. (2011). The Truth About Grief: The Myth of Its Five Stages and the New Science of Loss. Simon & Schuster.

In this book Konisberg challenges the notion of a stage theory of death and dying suggesting instead a more hopeful view based on current empirical research. Based on these findings she proposes that people are much more resilient that what Kubler-Ross’s five stage theory suggests.

Kübler-Ross, E. (1969). On death and dying. New York: Macmillan.

This book originally presented Kübler-Ross’s theory to the general audience. It provides a rich description of the personal and social processes associated with dying in this culture. It also contains revealing interviews with patients, practitioners, and family members.

Northcott, H. C., Wilson, D. M. (2008). Dying and death in Canada. 2nd edition. Broadview Press.

Written for a wide audience by researchers form the University of Alberta, this book provides a Canadian perspective on death and dying and features causes of death, societal and cultural responses to death, and death from the perspective of the dying and bereaved.

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Web Videos Ethical Dilemmas in Death.. This CBC episode of the fifth estate examines the variability in standards surrounding when an individual can be declared legally dead and the implications that this issue has for assisted dying. http://www.cbc.ca/fifth/episodes/2013-2014/dead-enough

Medical Aid in Dying in Canada The aid in dying debate was recently stirred up when Canada changed it laws. This video chronicles the life and death of Gloria Taylor, the first Canadian ever to win the right to ask a physician for help in dying, when and how and where she wished. "The Life and Death of Gloria Taylor" follows Gloria Taylor as she engages in a public battle to alter the law over the course of what would be the final year of her life.

https://www.youtube.com/watch?v=7blnXINYTOM

Stages of Grief Two web videos provide an overview of the classic work by Kubler-Ross and more recent challenges to the validity of this work for understanding emotional reactions at the end of life.

Dr. Elisabeth Kubler-Ross, Early Speech - Experiences with dying patients, 1975 http://www.youtube.com/watch?v=T-A7WfsEmsA Author Ruth Davis Konigsberg challenges Elizabeth Kubler Ross's Five Stages of Grief http://www.youtube.com/watch?v=7SdM-RQHyww Palliative and Hospice Care Services. This short video clip from Care-West services provides an overview of hospice care and what types of services are involved.

http://www.carewest.ca/index.php?page=videos Canadian Virtual Hospice Palliative Care Video. This is a short video on hospice care from Canadian Virtual Hospice, a resource site that uses technology to help patients and families with end of life concerns. http://www.virtualhospice.ca/ http://www.youtube.com/watch?v=ZWLoQkJD0WA

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CHAPTER 13 HEART DISEASE, HYPERTENSION, STROKE, AND DIABETES Learning Objectives 1

Describe Coronary Heart Disease (CHD)

2

Explain Hypertension

3

Understand Stroke

4

Describe Diabetes

Lecture Suggestions Coronary Heart Disease Smith and Ruiz (2002), and O’Callahan, Andres, and Kranz (2003) provide straight forward reviews of CHD. These chapters contain information on the etiology and course of the disease, and on behavioural and psychosocial risk factors. Adjustment to both the crisis phrase and the long-term phase is covered, as well as treatment components. Ford (2004) examines the relationship of depression and heart disease.

Hilmert and Kvasnicka (2010) review the research on cardiovascular reactivity and its links to emotional responses to stress. Phillips and Klein examine the role of social cognitive factors in explaining the link between socioeconomic status and cardiovascular disease.

Ford, D. (2004). Depression, trauma, and cardiovascular health. In P. Schnurr & B. Green (Eds.), Trauma and health: Physical health consequences of exposure to extreme stress (pp. 73-97).

Washington, DC: APA. Hilmert, C., & Kvasnicka, L. (2010). Blood pressure and emotional responses to stress: Perspectives on cardiovascular reactivity. Social and Personality Psychology Compass, 4(7), 470-483.

O’Callahan, M., Andrews, A., & Krantz, D. (2003). Coronary heart disease and hypertension. In A. M. Nezu, C. M. Nezu, & P. A. Geller (Eds.), Handbook of psychology: Volume 9, health psychology (pp. 339-364). Hoboken, NJ: John Wiley.

Phillips, J. E., & Klein, W. M. P. (2010). Socioeconomic status and coronary heart disease risk: The role of social cognitive factors. Social and Personality Psychology Compass, 4(9), 704-727.

Stansfeld, S., & Marmot, M. (Eds.) (2002). Stress and the heart: Psychosocial pathways to coronary heart disease. London: BMJ. Self-Treatment of Diabetes Although 90% of diagnosed cases require medication, diet and exercise are an important component of treatment. Medication levels are highly dependent on the extent to which the patient maintains regular dietary control and exercise. Thus, self-treatment is the major component of a treatment plan. GonderFrederick, Cox, and Clarke (2002) discuss a psychobiohavioral approach to self-treatment. LandelTaylor, Sirois & Molnar, Health Psychology, 4th Canadian Edition | Instructor’s Manual -1-

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Graham, Yount, and Rudnicki (2003) address adherence issues, particularly psychosocial factors. Special attention is paid to sexual dysfunction in women as well as in men, hypoglycemia, and weight management.

Gonder-Frederick, L., Cox, D. J., & Clarke, W. L. (2002). Diabetes. In Christensen, A. J., & Antoni, M. H. (Eds.), Chronic physical disorders: Behavioural medicine’s perspective (pp. 137-164). Malden, MA: Blackwell.

Landel-Graham, J., Yount, S., and Rucnicki, S. (2003). Diabetes mellitus. In I. V. Weiner (Series Ed.) & A. M. Nezu, C. M. Nezu, & P. A. Geller (Vol. Eds.), Handbook of psychology: Vol. 9, Health psychology (pp. 191-217). Hoboken, NJ: John Wiley.

Exercises, Projects, and Activities Risk Profiles for Coronary Heart Disease Have students work in small groups in order to identify their personal risk factors for coronary heart disease. This will provide an opportunity to review the risk factors described in the text within the context of their personal health habits.

They can then check their knowledge of risk factors against this interactive Heart Truth Quiz, which gives detailed advice about each risk factor for poor heart health: http://www.thehearttruth.ca/the-heart-truth-quiz/

Web Activities Diabetes The World Health Organization (WHO) fact sheet on diabetes provides a good overview of the prevalence and dangers associated with diabetes that serve as a starting point for a discussion about the pandemic of diabetes.

Interactive Fact Sheet: 10 Facts about diabetes http://www.who.int/features/factfiles/diabetes/01_en.html The Canadian Diabetes Association provides a web page with various resources on diabetes called Get Checked Now. Included are several links and resources with information and acts about Type 2 diabetes and its complications to encourage Canadians to get checked for diabetes. Also included is a risk questionnaire which could be used as an in class or pre-lecture activity to facilitate discussion. http://www.diabetestest.ca/ Heart Disease and Stroke The Heart and Stroke Foundation’s Heart Truth web site features video clips and information to raise awareness about the risk for heart disease among Canadian women. There are numerous resources and activities, including multicultural resources and an on-line quiz for women to evaluate their risk for heart disease. http://www.thehearttruth.ca/ Included on the site are three The Heart Truth Documentaries, videos featuring women who have heart disease or have experienced a heart attack who share their stories.

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http://thehearttruth.ca/the-campaign/documentaries/

Web Videos Heart Disease and Stroke The World Health Organization (WHO) video ad, WHO: Control Your Blood Pressure - World Health Day 2013, provides an overview of the issues related to having high blood pressure as well as ways to cut the risk of developing high blood pressure. http://www.youtube.com/watch?v=LDWPJijPuBY This CBC news video, Prescribing exercise, discusses the role of exercise in the treatment of heart disease. http://www.cbc.ca/player/play/2383498746 This news story from Global News Health Matters highlights how symptoms of heart attack in women often go unrecognized.

Heart disease in women is under-diagnosed, under-treated and under-researched: Heart and Stroke report: https://globalnews.ca/news/3998811/heart-disease-in-women-is-under-diagnosed-under-treated-andunder-researched-heart-and-stroke-report/ Loneliness Negatively Impacts Heart Health. This news story presents recent research indicating the negative effects of loneliness for heart health. http://5newsonline.com/2016/04/29/loneliness-negatively-impacts-heart-health/ Diabetes Explaining Diabetes: Animation about diabetes and the body. This animated video provides a physiological overview of the dysfunctional processes underlying diabetes in easy to understand terms.

'Diabetes epidemic in Indigenous populations' highlights disparity. This CBC news story highlights the alarming rise in rates of diabetes among Canada’s First Nation’s peoples. http://www.cbc.ca/news/health/diabetes-type-2-first-nations-1.3768773 Video: Diabetes in Chinese-Canadians takes jump http://www.cbc.ca/player/play/2388505964

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CHAPTER 14 PSYCHONEUROIMMUNOLOGY, AIDS, CANCER, AND ARTHRITIS Learning Objectives 1

Explain Psychoneuroimmunology

2

Understand AIDS and its Consequences

3

Describe Cancer and the Psychosocial Factors Involved

4

Define Arthritis

Lecture Suggestions Psychoneuroimmunology Evidence linking psychological stress to susceptibility to upper respiratory infections is well established; however, the mediation of this relationship is not clear. This is an excellent point in the semester to review the biopsychosocial model and immune functioning. The chapter by Lutgendorf and Costanzo (2003) provides material for such a lecture. Byrne-Davis and Vedhara (2008) provide an excellent introduction to the topic of psychoneuroimmunology and further discuss the important questions of whether and how social and psychological factors contribute to the development of illness. The role of social support in buffering the stress–illness relationship is reviewed. Kielcolt-Glaser and her colleagues (2002) explore the impact of negative emotions on morbidity and mortality. The pathways of these impacts are examined. Resistance factors also are discussed. Morey et al. (2015) review the impact of stress on immune functioning in vulnerable populations such as the children and the elderly, and discuss new directions in the field.

Byrne-Davis, L. M. T., & Vedhara, K. (2008). Psychoneuroimmunology. Social and Personality Psychology Compass, 2(2), 751-764.

Kielcolt-Glaser, J., McGuire, L., Robles, T., & Glaser, R. (2002). Emotions, morbidity, and mortality: New perspectives from psychoneuroimmunology. Annual Review of Psychology, 53, 83-107.

Lutgendorf, S., & Costanzo, E. (2003). Psychoneuroimmunology and health psychology: An integrative model. Brain, Behaviour, and Immunity, 17, 225-232.

Morey, J. N., Boggero, I. A., Scott, A. B., & Segerstrom, S. C. (2015). Current directions in stress and human immune function. Current Opinion in Psychology, 5, 13-17.

AIDS/HIV Carey and Vanable (2003) give background information on AIDS/HIV including epidemiology, transmission, impact, and primary and secondary prevention. Antoni (2002) provides a clear presentation

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of the biobehavioural aspects of HIV and AIDS. He examines these factors as they relate to disease course and reviews individual and group therapies for managing the psychosocial factors.

Antoni, M. H. (2002) HIV and AIDS. In Christensen, A. J., & Antoni, M. H. (Eds.), Chronic physical disorders: Behavioural medicine’s perspective (pp. 191-219). Malden, MA: Blackwell.

Carey, M., & Vanable, P. (2003). AIDS/HIV. In I. V. Weiner (Series Ed.) & A. M. Nezu, C. M. Nezu, & P. A. Geller (Vol. Eds.), Handbook of psychology: Vol. 9, Health psychology (pp. 219-244).

Hoboken, NJ: John Wiley.

Cancer Nezu and his colleagues (2003) present an overview of psychosocial factors in cancer including risks, emotional effects, and interventions. Andersen and Wells (2002) provide a review of the biobehavioural aspects of cancer as well as research relevant to each period in the progression. Many of the chapters in the edited book by Given and his colleagues (2003) are useful for lectures on interventions. Lepore and Revenson (2007) review the literature on disclosure and cancer and discuss the potentially harmful effects of social constraints of disclosure related to cancer related thoughts and feelings.

Andersen, B. L., & Wells, S. (2003). Cancer. In Christensen, A. J., & Antoni, M. H. (Eds.), Chronic physical disorders: Behavioural medicine’s perspective (pp. 112-136). Malden, MA: Blackwell.

Given, C., Given, B., Champion, V., Kozachik, S., & DeVoss, D. (Eds.) (2003). Evidence-based cancer care and prevention: Behavioural interventions. NY: Springer.

Lepore, S. J., & Revenson, T. A. (2007). Social constraints on disclosure and adjustment to cancer. Social and Personality Psychology Compass, 1(1), 313-333.

Nezu, A., Nezu, C., Felgoise, S., & Zwick, M. (2003). In I. V. Weiner (Series Ed.) & A. M. Nezu, C. M. Nezu, & P. A. Geller (Vol. Eds.), Handbook of psychology: Vol. 9, Health psychology (pp. 267292). Hoboken, NJ: John Wiley.

Stress-diathesis Approach to understanding Arthritis Although rheumatoid arthritis and osteoarthritis have a biological component, they, like fibromyalgia, are best understood within the framework of the interacting biological, psychological, and social sources of stress and vulnerability. Burke and her colleagues (2002, 200) examine each of these disorders focusing on each of the factors.

Burke, H. M., Zautra, A. J., Davis, M. D, Schultz, A. S., &. Reich, J. W. (2002). Arthritis and musculoskeletal conditions. In I. V. Weiner (Series Ed.) & A. M. Nezu, C. M. Nezu, & P. A. Geller (Vol. Eds.), Handbook of psychology: Vol. 9, Health psychology (pp. 169-190). Hoboken, NJ: John Wiley.

Burke, H. M., Zautra, A. J., Schultz, A. S., Reich, J. W., & Davis, M. D. Arthritis (2002). In Christensen, A. J., & Antoni, M. H. (Eds.), Chronic physical disorders: Behavioural medicine’s perspective (pp. 268-287). Malden, MA: Blackwell.

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Exercises, Projects, and Activities AIDS Education Perhaps one of the most relevant classroom activities would be to invite a guest speaker for a frank discussion of HIV transmission and high-risk sexual behaviours. Knowledgeable speakers may usually be recruited from public health organizations. Student counselling centers also may have speakers available who are trained in conducting workshops in communication-skills training that specifically target sexual behaviour and STDs. An excellent introduction to the topic is a test of the students’ knowledge of AIDS myths. One such activity is found at Medicine.Net which has an interactive live scored quiz that tests your medical IQ regarding the topic of HIV/AIDS. http://www.medicinenet.com/hiv-aids_quiz/quiz.htm Also from this site the HIV AIDS Pictures Slideshow: Myths and Facts on Symptoms and Treatments provides a pictorial presentation of common myths and facts regarding the recognition and treatment of HIV/AIDS. http://www.medicinenet.com/hiv_aids_myths_and_facts_pictures_slideshow/article.htm Finally, a historical perspective on HIV/AIDS is presented in the AIDS Retrospective Pictures Slideshow: A Pictorial Timeline of the HIV/AIDS Pandemic slideshow at MedicineNet. http://www.medicinenet.com/aids_retrospective_pictures_slideshow/article.htm AIDS and Sexual Behaviour Have students write essays that describe the manner in which they would approach the topic of AIDS and STDs within the context of their role as parents providing sex education and counselling to their children.

A sample assignment follows.

You are a university-educated parent. You realize that you and your two children, Joe (age 11) and Clara (age 13), should discuss matters related to birth control and sexuality; however, you also would like to discuss HIV transmission and infection. Write an essay that describes this discussion. Make sure you include examples of high-risk behaviours, as well as behaviours associated with safer sex.

Life-Threatening Illness and Identity Management The text argues that one of the most distressing aspects of chronic, advancing, and terminal disease is the threat to one’s self and identity. The cancer research discussed in this chapter most clearly raises these issues. Have students write an essay discussing the relationship between identity management, illness, and coping. Ask them to consider what the challenges are of healthy acceptance of one’s illness versus identification with one’s illness. This assignment might also be used as an integrative final exam question.

Web Activities Cancer The World Health Organization (WHO) interactive fact sheet, 10 Facts on Cancer, provides a succinct overview of the key facts and issues in cancer. http://www.who.int/features/factfiles/cancer/facts/en/index.html Taylor, Sirois & Molnar, Health Psychology, 5th Canadian Edition | Instructor’s Manual -3-

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Arthritis Slideshow: A Visual Guide to Understanding Osteoarthritis http://www.webmd.com/osteoarthritis/ss/slideshow-osteoarthritis-overview

Web Videos and Audio Cancer This brief CBC player clip by Dr Goldman discusses research finding that cancer rates are growing among younger Canadians: https://www.cbc.ca/player/play/1644379715893 This accompanying clip delves into the reason for this troubling trend. https://www.cbc.ca/player/play/1644367427750 Arthritis Living With Arthritis provides an overview of the main types of arthritis, risk factors, and one woman’s story of how she didn’t let arthritis take over her life. https://www.youtube.com/watch?v=D6HtMELddcg

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CHAPTER 15 HEALTH PSYCHOLOGY: CHALLENGES FOR THE FUTURE Learning Objectives 1. Describe the Importance of Health Promotion for Healthy Aging 2. Identify the Issues in Chronic Illness Management for the Future 3. Know Where Stress Research is Headed 4. Understand the Future of Health Services Women’s Health Initiative As has been mentioned throughout the text, medical research on women’s health is sorely lacking in some areas. A report by Johnson et al. (2014) sheds light on how medical clinical trials tend to exclude women.

Rimer, McBride, and Crump (2000) review research on women and health, including suggested interventions in specific areas. Koss, Ingram, and Pepper (2000) focus on a more specific women’s issue, male partner violence, and its relation to health. Whitfield and his colleagues (2003) examine the biological, behavioural, psychosocial, and biobehavioural factors in gender differences in health and discuss implications for treatment.

Johnson, P. A., Fitzgerald, T., Salganicoff, A., Wood, S. F., & Goldstein, J. M. (2014). Sex-specific medical research: Why women’s health can’t wait. A report of the Mary Horrigan Connors Center for Women’s health & gender biology at Brigham and Women’s Hospital. Retrieved on November 18, 2019 from https://www.brighamandwomens.org/assets/BWH/womenshealth/pdfs/ConnorsReportFINAL.pdf.

Koss, M. P., Ingram, M., & Pepper, S. L. (2000). Male partner violence: Relevance to health care providers. In A. Baum, T. Revenson, & J. Singer (Eds.), Handbook of health psychology (pp. 541– 557). Mahwah, NJ: Lawrence Erlbaum.

Rimer, B. K., McBride, C. M., Crump, C. (2000). Women’s health promotion. In A. Baum, T. Revenson, & J. Singer (Eds.), Handbook of health psychology (pp. 519–539). Mahwah, NJ: Lawrence Erlbaum.

Whitfield, K., Weidner, G., Clark, R., & Anderson, N. (2003). Cultural aspects of health psychology. In I. V. Weiner (Series Ed.) & A. M. Nezu, C. M. Nezu, & P. A. Geller (Vol. Eds.), Handbook of psychology: Vol. 9, Health psychology (pp. 545-567). Hoboken, NJ: John Wiley.

Age-Related Issues An important area of future efforts for health psychologists are variations in health and illness related to one’s place in the life span. Of particular interest are those areas of high morbidity and mortality—older adulthood. Evans (2000) focuses on health-threatening behaviours of children and adolescents. Jaul and Barron (2017) discuss differences in normal aging and diseases of old age. They provide recommendations to support better quality of life as individuals age.

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Evans, R. I. (2000). Social influences in etiology and prevention of smoking and other health-threatening behaviours in children and adolescents. In A. Baum, T. Revenson, & J. Singer (Eds.), Handbook of health psychology (pp. 459–468). Mahwah, NJ: Lawrence Erlbaum.

Jaul, E., & Barron, J. (2017). Age-Related Diseases and Clinical and Public Health Implications for the 85 Years Old and Over Population. Frontiers in public health, 5, 335. doi:10.3389/fpubh.2017.00335

Web Activities The Statistics Canada web site has an interactive census map (Geosearch) of Canada which includes a breakdown of the population by gender and age for each region. There is also a lot of additional information including number of children, relationship status, and income, as well as a comparison of the region of interest to the rest of Canada. Census Mapper also has interactive maps and you can also create your own map depending on what characteristics you are interested in from the census data. These graphs may be useful for starting a discussion on how the greying of the nation may affect the health of Canadians in the future, and what can be done to reduce current trends towards rising chronic illness.

https://www12.statcan.gc.ca/census-recensement/2016/geo/geosearch-georecherche/indexeng.cfm https://censusmapper.ca/#12/49.2432/-123.1475 Recommended Reading Taylor, S. (2011). The Future of Social-Health Psychology: Prospects and Predictions. Social and Personality Psychology Compass, 5(5), 275-284.

This review in Social and Personality Compass highlights possible new directions and developments in the field of Health Psychology in the years to come, and discusses the importance of integrating technological, biological and genetic advances into health psychology to advance the field.

Web Videos This TedxOcala talk Retirement Redefined by John Shields discusses the concept of retirement and how people adjust to and find meaning in retirement. Questions such as, what age should I retire, and will I have enough money to retire on are discussed as well.

https://www.youtube.com/watch?v=xABqKHyg2RY In this web interview Dr. Andrew Weil talks about the factors and behaviours that can facilitate Healthy Aging https://www.youtube.com/watch?v=HZ0UJoZx2Gw Canadians eager for more virtual, mobile health care solutions This Global News video highlights the rise in interest in mobile phone health care apps in Canada. http://globalnews.ca/news/617206/canadians-eager-for-more-virtual-mobile-health-care-solutions/ The World health Organization’s (WHO) video, Healthy ageing -- adding life to years, was created for World Health Day 2012 to highlight the importance of considering health in the later adult years. http://www.youtube.com/watch?v=LL-TJjCJPaI

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The CBC news story Long-distance medical consultations, features the use of video conferencing by some BC doctors to deal with their patients. http://www.cbc.ca/player/play/2389509870

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