Essentials of abnormal psychology 7th edition durand test bank

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1. Currently, some of the major contributing factors to illness and death in the United States are a. viral and bacterial. b. behavioral and psychological. c. neurological and endocrinological. d. pharmacological and hormonal.

ANSWER: b DIFFICULTY: Moderate REFERENCES: Psychological and Social Factors That Influence Health LEARNING OBJECTIVES: ABNO.DURA.16.APA1.3.a - Describe problems operationally to study them empirically OTHER: TYPE: Factual 2. At the beginning of the 20th century, the leading cause of death in the U.S. was a. automobile accidents. b. infectious diseases. c. heart attacks. d. suicides.

ANSWER: b DIFFICULTY: Easy REFERENCES: Psychological and Social Factors That Influence Health LEARNING OBJECTIVES: ABNO.DURA.16.APA1.3.a - Describe problems operationally to study them empirically OTHER: TYPE: Factual 3. Using the word psychosomatic to describe a disorder with an obvious physical component is considered misleading because a. it gives the impression that psychological disorders like anxiety or depression do not have a biological component. b. it assumes that the physical aspects of a disorder are less important than the psychological aspects. c. it emphasizes the psychological symptoms of a disorder instead of the physical symptoms. d. it gives the impression that biological disorders are not influenced by psychological factors.

ANSWER: a DIFFICULTY: Difficult REFERENCES: Psychological and Social Factors That Influence Health LEARNING OBJECTIVES: ABNO.DURA.16.APA1.3.a - Describe problems operationally to study them empirically OTHER: TYPE: Conceptual 4. Which of the following factors are universally implicated in the cause of all disorders? a. Biological only b. Psychological only c. Biological and psychological, but not social d. Biological, psychological and social ANSWER: d DIFFICULTY: Moderate REFERENCES: Psychological and Social Factors That Influence Health LEARNING OBJECTIVES: ABNO.DURA.16.APA1.3.a - Describe problems operationally to study them empirically OTHER: TYPE: Conceptual

5. What is the name of the new field of study that reflects the shift in focus from infectious disease to psychological/behavioral factors as causes of illness and death? a. Behavioral medicine b. Abnormal psychology c. Medical psychology d. Physical medicine ANSWER: a DIFFICULTY: Easy REFERENCES: Psychological and Social Factors That Influence Health LEARNING OBJECTIVES: ABNO.DURA.16.APA1.2.a(3) - Read and summarize general ideas and conclusions from psychological sources accurately OTHER: TYPE: Factual 6. Knowledge derived from the behavioral sciences applied to the prevention, diagnosis, and treatment of medical problems is called a. health psychology. b. behavioral medicine. c. psychophysiological disorders. d. psychosomatic medicine.

ANSWER: b DIFFICULTY: Moderate REFERENCES: Psychological and Social Factors That Influence Health LEARNING OBJECTIVES: ABNO.DURA.16.APA1.3.a - Describe problems operationally to study them empirically OTHER: TYPE: Factual NOTES: NEW 7. Health psychology, a subfield of behavioral medicine, focuses on all of the following EXCEPT a. psychological factors affecting health. b. health policy. c. healthcare systems. d. interdisciplinary study of psychology and health.

ANSWER: d DIFFICULTY: Difficult REFERENCES: Psychological and Social Factors That Influence Health LEARNING OBJECTIVES: ABNO.DURA.16.APA1.3.a - Describe problems operationally to study them empirically OTHER: TYPE: Conceptual 8. In which of the following ways do psychological and social factors influence health? a. They can affect basic biological processes resulting in illness and disease. b. Unhealthy lifestyles can increase the risk of developing physical disorders. c. Both of these d. Neither of these ANSWER: c DIFFICULTY: Moderate REFERENCES: Psychological and Social Factors That Influence Health LEARNING OBJECTIVES: ABNO.DURA.16.APA1.3.a - Describe problems operationally to study them empirically

OTHER:

TYPE: Conceptual

9. AIDS is directly affected by stress. Stress may negatively affect the immune system, thereby promoting the deadly progression of the disease. This is an example of a. psychological factors influencing biological processes. b. biological factors influencing psychological processes. c. both of these d. neither of these ANSWER: a DIFFICULTY: Moderate REFERENCES: Psychological and Social Factors That Influence Health LEARNING OBJECTIVES: ABNO.DURA.16.APA1.3.a - Describe problems operationally to study them empirically OTHER: TYPE: Applied 10. According to the principles of health psychology, which of the following is the best protection against acquiring AIDS? a. Getting an injection of the AIDS vaccine b. Being treated for HIV before it develops into AIDS c. Changing risky behaviors that can lead to disease acquisition d. Deciding to be sexually abstinent after years of being sexually active ANSWER: c DIFFICULTY: Easy REFERENCES: Psychological and Social Factors That Influence Health LEARNING OBJECTIVES: ABNO.DURA.16.APA1.3.a - Describe problems operationally to study them empirically OTHER: TYPE: Factual 11. As an example of a behavioral pattern that leads to illness and death, smoking has been estimated to cause approximately ____ percent of all deaths. a. 2 b. 12 c. 19 d. 32 ANSWER: c DIFFICULTY: Moderate REFERENCES: Psychological and Social Factors That Influence Health LEARNING OBJECTIVES: ABNO.DURA.16.APA1.3.a - Describe problems operationally to study them empirically OTHER: TYPE: Factual 12. Which of the following statements is true? a. Fifty percent of deaths from the 10 leading causes of death in the United States can be traced to behaviors common to certain lifestyles. b. Smoking is the leading preventable cause of death in the United States. c. Smoking has been estimated to cause around 20 percent of all deaths. d. All of the above ANSWER: d DIFFICULTY: Difficult REFERENCES: Psychosocial Effects on Physical Disorders

LEARNING OBJECTIVES: ABNO.DURA.16.APA1.3.a - Describe problems operationally to study them empirically OTHER: TYPE: Factual NOTES: NEW 13. In 1936, Canadian researcher Hans Selye discovered that giving injections to laboratory rats caused them to develop ulcers. His finding led to a new area of study called a. stress physiology. b. stress psychology. c. animal psychology. d. psychosomatic pathology.

ANSWER: a DIFFICULTY: Moderate REFERENCES: Psychological and Social Factors That Influence Health LEARNING OBJECTIVES: ABNO.DURA.16.APA1.3.a - Describe problems operationally to study them empirically OTHER: TYPE: Factual 14. When Hans Selye injected laboratory rats with saline (salty water), what happened to the rats? a. Nothing; saline is harmless and only used as a control condition b. Nothing; rats recover quickly from stress because they are not prone to anxiety as humans are c. They developed ulcers, because saline has since been discovered to have negative health consequences d. They developed ulcers, because stress directly affected their physiology.

ANSWER: d DIFFICULTY: Moderate REFERENCES: Psychological and Social Factors That Influence Health LEARNING OBJECTIVES: ABNO.DURA.16.APA1.3.a - Describe problems operationally to study them empirically OTHER: TYPE: Conceptual 15. In response to sustained stress, the body goes through several stages that together constitute the general adaptation syndrome (GAS), a concept proposed by researcher Hans Selye. This GAS consists of all the following stages EXCEPT a. alarm. b. resistance. c. exhaustion. d. deterioration.

ANSWER: d DIFFICULTY: Easy REFERENCES: Psychological and Social Factors That Influence Health LEARNING OBJECTIVES: ABNO.DURA.16.APA1.3.a - Describe problems operationally to study them empirically OTHER: TYPE: Factual 16. According to the textbook, the physiological response of an individual to a stressor is called a. adaptation. b. fight-or-flight reaction. c. stress. d. a psychological disorder.

ANSWER: c DIFFICULTY: Moderate

REFERENCES: Psychological and Social Factors That Influence Health LEARNING OBJECTIVES: ABNO.DURA.16.APA1.2.a(3) - Read and summarize general ideas and conclusions from psychological sources accurately OTHER: TYPE: Factual 17. Research has shown that increased levels of cortisol in response to stress may cause damage to parts of the a. skeletal system. b. brain. c. lungs. d. stomach.

ANSWER: b DIFFICULTY: Difficult REFERENCES: Psychological and Social Factors That Influence Health LEARNING OBJECTIVES: ABNO.DURA.16.APA1.2.a(3) - Read and summarize general ideas and conclusions from psychological sources accurately OTHER: TYPE: Factual 18. Which of the following statements accurately describes a process in the activation of the HPA axis? a. The hippocampus secretes corticotropin releasing factor (CRF). b. CRF stimulates the thyroid gland. c. The pituitary gland (via the parasympathetic nervous system) activates the adrenal glands. d. The adrenal glands secrete the stress hormone cortisol.

ANSWER: d DIFFICULTY: Difficult REFERENCES: Psychological and Social Factors That Influence Health LEARNING OBJECTIVES: ABNO.DURA.16.APA1.2.a(3) - Read and summarize general ideas and conclusions from psychological sources accurately OTHER: TYPE: Factual 19. Research has shown that excessive secretion of the stress hormone cortisol can result in cell death in the hippocampal region of the brain in cases of a. substance abuse. b. mania. c. posttraumatic stress disorder. d. AIDS. ANSWER: c DIFFICULTY: Difficult REFERENCES: Psychological and Social Factors That Influence Health LEARNING OBJECTIVES: ABNO.DURA.16.APA1.2.a(3) - Read and summarize general ideas and conclusions from psychological sources accurately OTHER: TYPE: Factual 20. The final process in the activation of the HPA axis is a. secretion of CRF by the hypothalamus. b. stimulation of the pituitary gland by CRF. c. activation of the adrenal gland by the pituitary gland. d. secretion of cortisol by the adrenal gland.

ANSWER: d DIFFICULTY: Moderate REFERENCES: Psychological and Social Factors That Influence Health LEARNING OBJECTIVES: ABNO.DURA.16.APA1.2.a(3) - Read and summarize general ideas and conclusions from psychological sources accurately OTHER: TYPE: Factual 21. Continuous secretion of the stress hormone cortisol by the adrenal glands can lead to all of the following EXCEPT a. damage to the hippocampus. b. impaired functioning of the immune system. c. muscle atrophy. d. low blood pressure in the cardiovascular system.

ANSWER: d DIFFICULTY: Moderate REFERENCES: Psychological and Social Factors That Influence Health LEARNING OBJECTIVES: ABNO.DURA.16.APA1.2.a(3) - Read and summarize general ideas and conclusions from psychological sources accurately OTHER: TYPE: Factual 22. Whether or not stress and/or anxiety develop in a stressful situation appears to be related to one’s perceived sense of a. happiness. b. excitement. c. control. d. acceptance.

ANSWER: c DIFFICULTY: Easy REFERENCES: Psychological and Social Factors That Influence Health LEARNING OBJECTIVES: ABNO.DURA.16.APA1.2.a(3) - Read and summarize general ideas and conclusions from psychological sources accurately OTHER: TYPE: Conceptual 23. Based on your knowledge of recent research studies, which of the following people would you predict is LEAST likely to “catch” a cold following exposure to the virus? a. Karen, a very sociable woman with many good friends b. Mike, a very intelligent student with good understanding of complex information and concepts c. Judy, a very assertive individual who frequently says exactly what’s on her mind d. Marilyn, a very compulsive person who often points out other people’s mistakes ANSWER: a DIFFICULTY: Difficult REFERENCES: Psychological and Social Factors That Influence Health LEARNING OBJECTIVES: ABNO.DURA.16.APA1.2.a(3) - Read and summarize general ideas and conclusions from psychological sources accurately OTHER: TYPE: Applied 24. Sapolsky and colleagues found that physical health in wild baboons was associated with a. Amount of human presence. b. Social rank.

c. Inter-colony conflict. d. Availability of food.

ANSWER: b DIFFICULTY: Moderate REFERENCES: Psychological and Social Factors That Influence Health LEARNING OBJECTIVES: ABNO.DURA.16.APA1.2.a(3) - Read and summarize general ideas and conclusions from psychological sources accurately OTHER: TYPE: Factual 25. Research findings have suggested that it might not be the stressful event itself that affects immune system functioning but rather the accompanying a. dissociation. b. isolation. c. depression. d. anger.

ANSWER: c DIFFICULTY: Moderate REFERENCES: Psychological and Social Factors That Influence Health LEARNING OBJECTIVES: ABNO.DURA.16.APA1.2.a(3) - Read and summarize general ideas and conclusions from psychological sources accurately OTHER: TYPE: Factual 26. The immune system is weakened in AIDS patients because the human immunodeficiency virus directly attacks the lymphocytes called a. killer T cells. b. T4 (helper) cells. c. suppressor T cells. d. B cells.

ANSWER: b DIFFICULTY: Difficult REFERENCES: Psychosocial Effects on Physical Disorders LEARNING OBJECTIVES: ABNO.DURA.16.APA1.2.a(3) - Read and summarize general ideas and conclusions from psychological sources accurately OTHER: TYPE: Factual 27. Contrary to the earlier belief that the brain and immune system operate independently of each other, scientists accidentally discovered a link working with rats in a(n) a. classical conditioning paradigm. b. injection trial experiment. c. rheumatoid arthritis study. d. experimental HIV trial.

ANSWER: a DIFFICULTY: Moderate REFERENCES: Psychosocial Effects on Physical Disorders LEARNING OBJECTIVES: ABNO.DURA.16.APA1.2.a(3) - Read and summarize general ideas and conclusions from psychological sources accurately OTHER: TYPE: Factual

28. In 2003, it was estimated that the total number of people afflicted with HIV, the human immunodeficiency virus, was more than a. 13 million. b. 23 million. c. 40 million. d. 43 million.

ANSWER: c DIFFICULTY: Difficult REFERENCES: Psychosocial Effects on Physical Disorders LEARNING OBJECTIVES: ABNO.DURA.16.APA4.2.b - Accurately self-assess performance quality by adhering to external standards OTHER: TYPE: Factual 29. AIDS is now treated with new combinations of drugs called “highly active antiretroviral therapy” (HAART), which a. suppress the virus in people who are HIV positive. b. cure AIDS by eliminating the virus from the body. c. suppress immune system functioning. d. are well tolerated and cause minimal side effects.

ANSWER: a DIFFICULTY: Difficult REFERENCES: Psychosocial Effects on Physical Disorders LEARNING OBJECTIVES: ABNO.DURA.16.APA1.2.a(3) - Read and summarize general ideas and conclusions from psychological sources accurately OTHER: TYPE: Conceptual 30. Estimates regarding the prevalence of AIDS in southern Africa indicate that a. the percent of the adult population that are HIV positive comprises two-thirds of the cases worldwide. b. 10 percent of the adult population has AIDS. c. 5 million children are orphaned by the disease. d. none of these ANSWER: a DIFFICULTY: Moderate REFERENCES: Psychosocial Effects on Physical Disorders OTHER: TYPE: Factual NOTES: NEW 31. Which of the following statements about AIDS is true? a. An infected person immediately develops AIDS-related complex (ARC). b. The median time for the development of full-blown AIDS is around three to five years. c. The death rate from AIDS declined 80 percent since 1990. d. The current successful cure for AIDS is highly active antiviral therapy (HAART), which eliminates the virus.

ANSWER: c DIFFICULTY: Difficult REFERENCES: Psychosocial Effects on Physical Disorders LEARNING OBJECTIVES: ABNO.DURA.16.APA1.2.a(3) - Read and summarize general ideas and conclusions from psychological sources accurately

OTHER: NOTES:

TYPE: Factual NEW

32. Neurohormones’ main function is to a. Lower stress b. Carry the brain’s signals to the rest of the body c. Modulate mood d. All of the above.

ANSWER: b DIFFICULTY: Difficult REFERENCES: Psychological and Social Factors That Influence Health LEARNING OBJECTIVES: ABNO.DURA.16.APA4.2.b - Accurately self-assess performance quality by adhering to external standards OTHER: TYPE: Factual 33. Psychosocial interventions such as stress reduction techniques for chronically ill individuals are thought to affect the disease process via the immune system by a. giving patients a reduced sense of control. b. helping patients effectively utilize HAART drug regimes. c. changing patients’ positive cognitions. d. helping patients reduce depression, thus reducing cortisol.

ANSWER: d DIFFICULTY: Difficult REFERENCES: Psychosocial Effects on Physical Disorders LEARNING OBJECTIVES: ABNO.DURA.16.APA4.2.b - Accurately self-assess performance quality by adhering to external standards OTHER: TYPE: Conceptual 34. Brief psychosocial treatments aimed at reducing stress while increasing coping and control lead to improved immune systems and prolonged life in a. cancer patients. b. AIDS patients. c. both d. neither ANSWER: c DIFFICULTY: Moderate REFERENCES: Psychosocial Effects on Physical Disorders LEARNING OBJECTIVES: ABNO.DURA.16.APA4.2.b - Accurately self-assess performance quality by adhering to external standards OTHER: TYPE: Factual 35. Which of the following does NOT describe an effective psychosocial intervention that has been reported in oncology research studies? a. Use of psychological treatments that reduced pain and depression and enhanced feelings of well-being b. Use of videotapes and dolls that reduced children’s stress and anxiety during medical procedures c. Use of psychotherapy that temporarily prolonged life for breast cancer patients both during and after the intervention

d. Use of psychoanalytic techniques that reduced the growth rate of tumors ANSWER: d DIFFICULTY: Easy REFERENCES: Disorders Psychosocial Effects on Physical LEARNING OBJECTIVES: ABNO.DURA.16.APA4.2.b - Accurately self-assess performance quality by adhering to external standards OTHER: TYPE: Factual 36. Unhealthy and/or risky behaviors that impact directly on the cardiovascular system may contribute to a. Panic disorder. b. Somatic symptom disorders c. strokes, high blood pressure, and coronary heart disease. d. reduced immunity to autoimmune diseases.

ANSWER: c DIFFICULTY: Easy REFERENCES: Psychosocial Effects on Physical Disorders LEARNING OBJECTIVES: ABNO.DURA.16.APA4.2.b - Accurately self-assess performance quality by adhering to external standards OTHER: TYPE: Factual 37. Various psychological factors have been used to explain individual variations in blood pressure, including all of the following EXCEPT a. coping style. b. personality. c. level of stress. d. level of intelligence.

ANSWER: d DIFFICULTY: Easy REFERENCES: Psychosocial Effects on Physical Disorders LEARNING OBJECTIVES: ABNO.DURA.16.APA4.2.b - Accurately self-assess performance quality by adhering to external standards OTHER: TYPE: Conceptual 38. Which of the following individuals have been shown to have greater tendency to suffer from hypertension? a. Those with high levels of stress whose parents had normal blood pressure b. Those with low levels of stress whose parents had high blood pressure c. Those with high levels of stress whose parents had high blood pressure d. Those with low levels of stress whose parents had normal blood pressure ANSWER: c DIFFICULTY: Easy REFERENCES: Psychosocial Effects on Physical Disorders LEARNING OBJECTIVES: ABNO.DURA.16.APA4.2.b - Accurately self-assess performance quality by adhering to external standards OTHER: TYPE: Factual 39. Since heart disease is the number one cause of death in the United States, it is very important, in terms of prevention, to determine if

a. better medications can be found to treat heart disease. b. changes in behavior, lifestyle, and attitude can prevent heart attacks. c. psychotherapy can help people adjust to having an artificial heart. d. heart transplants can be made available to more patients.

ANSWER: b DIFFICULTY: Moderate REFERENCES: Psychosocial Effects on Physical Disorders LEARNING OBJECTIVES: ABNO.DURA.16.APA4.2.b - Accurately self-assess performance quality by adhering to external standards OTHER: TYPE: Conceptual 40. Which of the following statements is true regarding hypertension in the United States? a. African-Americans are more likely to develop hypertension and have hypertensive vascular diseases than Caucasians. b. African-Americans are just as likely to develop hypertension and have hypertensive vascular diseases than Caucasians. c. African-Americans are less likely to develop hypertension and have hypertensive vascular diseases than Caucasians. d. Only African-Americans of a certain genetic variant are more likely than Caucasians to develop hypertension and have hypertensive vascular diseases than Caucasians.

ANSWER: a DIFFICULTY: Moderate REFERENCES: Psychosocial Effects on Physical Disorders LEARNING OBJECTIVES: ABNO.DURA.16.APA4.2.b - Accurately self-assess performance quality by adhering to external standards OTHER: TYPE: Factual 41. In trying to determine if the Type A/Type B classifications are reliable and valid as predictors of heart disease, it becomes apparent that a. not every individual shows distinctively Type A or Type B characteristics. b. women are usually Type A and men are usually Type B. c. interviews to assess people’s personality characteristics are more reliable than questionnaires. d. medical tests are the only valid predictors of heart disease.

ANSWER: a DIFFICULTY: Difficult REFERENCES: Psychosocial Effects on Physical Disorders LEARNING OBJECTIVES: ABNO.DURA.16.APA4.2.b - Accurately self-assess performance quality by adhering to external standards OTHER: TYPE: Factual 42. Which of the following is a correct match of medical condition and definition? a. Angina—obstruction caused by buildup of plaque in the arteries b. Atherosclerosis—deficiency of blood to a body part caused by narrowing of the arteries c. Myocardial infarction—death of heart tissue due to a completely clogged artery d. Ischemia—chest pain caused by partial obstruction of the arteries ANSWER: c DIFFICULTY: Easy

REFERENCES: Psychosocial Effects on Physical Disorders LEARNING OBJECTIVES: ABNO.DURA.16.APA1.3.b - Correctly identify antecedents and consequences of behavior and mental processes OTHER: TYPE: Factual 43. Gregor just learned that his spouse of 28 years has died in an automobile accident. Upon hearing the news, Gregor collapsed and was rushed to the hospital in apparent heart failure. Gregor probably suffered a. myocardial infarction. b. tranischemic attack. c. angina pectoris. d. myocardial stunning.

ANSWER: d DIFFICULTY: Difficult REFERENCES: Psychosocial Effects on Physical Disorders LEARNING OBJECTIVES: ABNO.DURA.16.APA1.3.b - Correctly identify antecedents and consequences of behavior and mental processes OTHER: TYPE: Applied NOTES: NEW 44. Which of the following people would be LEAST at risk for hypertension? a. Maya, who has a very Type A and controlling personality b. Dough, who tends to be melancholic and keeps to himself. c. Abhi, who has an extensive family and network of friends d. Mimi, who was recently promoted to a prestigious but highly competitive management position.

ANSWER: c DIFFICULTY: Easy REFERENCES: Psychosocial Effects on Physical Disorders LEARNING OBJECTIVES: ABNO.DURA.16.APA1.3.b - Correctly identify antecedents and consequences of behavior and mental processes OTHER: TYPE: Applied NOTES: NEW 45. In regard to the condition termed “chronic pain,” most researchers now agree that the causes of chronic pain and resulting high costs to our healthcare system are primarily a. psychological. b. social. c. imaginary d. both psychological and social.

ANSWER: d DIFFICULTY: Moderate REFERENCES: Psychosocial Effects on Physical Disorders LEARNING OBJECTIVES: ABNO.DURA.16.APA1.3.b - Correctly identify antecedents and consequences of behavior and mental processes OTHER: TYPE: Conceptual 46. All of the following are examples of “pain behaviors” EXCEPT a. complaining about pain to others.

b. grimacing. c. positional changes (while sitting or walking). d. suffering in silence.

ANSWER: d DIFFICULTY: Easy REFERENCES: Psychosocial Effects on Physical Disorders LEARNING OBJECTIVES: ABNO.DURA.16.APA1.3.b - Correctly identify antecedents and consequences of behavior and mental processes OTHER: TYPE: Factual 47. A predictor of which patients will suffer from chronic pain is a. the use of invasive surgical procedures. b. the patient’s family history with pain. c. a profile of negative emotions. d. the intensity of the initial pain.

ANSWER: c DIFFICULTY: Moderate REFERENCES: Psychosocial Effects on Physical Disorders LEARNING OBJECTIVES: ABNO.DURA.16.APA4.2.b - Accurately self-assess performance quality by adhering to external standards OTHER: TYPE: Factual 48. Which of the following is an example of the phenomenon known as “operant” control of pain behavior? a. Kate’s family has always been critical and demanding. Since her accident, though, family members have become caring and sympathetic. b. Kim is recovering from a broken leg. Although she is walking on crutches, she has been trying to be as independent as possible. c. Kinesha had to have a finger amputated after it was partially severed in a slicing accident. Since she feels discomfort in the missing finger, she has been diagnosed with “phantom limb” pain. d. Kyomi suffers from chronic back pain. However, she rarely complains about the pain to others and tries to keep her facial expressions from showing that she is in pain.

ANSWER: a DIFFICULTY: Difficult REFERENCES: Psychosocial Effects on Physical Disorders LEARNING OBJECTIVES: ABNO.DURA.16.APA4.2.b - Accurately self-assess performance quality by adhering to external standards OTHER: TYPE: Applied 49. In the phenomenon known as “operant” control of pain, the pain behaviors manifested by an individual are determined by a. the type of injury. b. social consequences. c. the side effects of medications. d. the patient’s reaction to treatment.

ANSWER: b DIFFICULTY: Moderate REFERENCES: Psychosocial Effects on Physical Disorders

LEARNING OBJECTIVES: ABNO.DURA.16.APA1.3.b - Correctly identify antecedents and consequences of behavior and mental processes OTHER: TYPE: Factual 50. Researchers who study the clinical experience of pain have determined that pain is a. entirely due to physical causes. b. entirely due to psychological causes. c. neither entirely physical nor entirely psychological. d. always due to unknown and unpredictable factors.

ANSWER: c DIFFICULTY: Moderate REFERENCES: Psychosocial Effects on Physical Disorders LEARNING OBJECTIVES: ABNO.DURA.16.APA1.2.d - Articulate criteria for identifying objective sources of psychology information OTHER: TYPE: Factual 51. Which of the following is NOT an example of the complex interaction of physical and psychological factors in the experience of pain? a. The gate control theory of pain b. Delusional pain c. Chronic pain d. Phantom limb pain.

ANSWER: b DIFFICULTY: Moderate REFERENCES: Psychosocial Effects on Physical Disorders LEARNING OBJECTIVES: ABNO.DURA.16.APA1.2.a(3) - Read and summarize general ideas and conclusions from psychological sources accurately OTHER: TYPE: Conceptual 52. The “natural” opioids called endorphins or enkephalins act like neurotransmitters to a. increase awareness of pain. b. shut down the sensation of pain. c. cause a “natural” addiction. d. Help heal damaged tissue, thereby decreasing pain.

ANSWER: b DIFFICULTY: Easy REFERENCES: Psychosocial Effects on Physical Disorders LEARNING OBJECTIVES: ABNO.DURA.16.APA1.2.a(3) - Read and summarize general ideas and conclusions from psychological sources accurately OTHER: TYPE: Factual 53. Endogenous opioids have been implicated in a variety of psychopathological conditions, including a. eating disorders. b. phobias. c. obsessive-compulsive disorder. d. personality disorders.

ANSWER: a

DIFFICULTY: Difficult REFERENCES: Psychosocial Effects on Physical Disorders LEARNING OBJECTIVES: ABNO.DURA.16.APA1.2.a(3) - Read and summarize general ideas and conclusions from psychological sources accurately OTHER: TYPE: Factual 54. Regarding gender differences in the experience of pain, women suffer more frequently than men from all of the following EXCEPT a. migraine headaches. b. arthritis. c. menstrual cramps. d. backache.

ANSWER: d DIFFICULTY: Moderate REFERENCES: Psychosocial Effects on Physical Disorders LEARNING OBJECTIVES: ABNO.DURA.16.APA1.3.b - Correctly identify antecedents and consequences of behavior and mental processes OTHER: TYPE: Factual 55. Females may have an “extra” pain-regulating pathway focused on relieving pain associated with the reproductive system. One implication of this biological gender difference is that a. men need more pain relief than women following most surgical procedures. b. women need more pain relief tan men following most surgical procedures. c. treatment of pain in men and women is still the same, because the psychological experience of pain is the same for men and women. d. males and females may benefit from different kinds of medications and different kinds of pain management.

ANSWER: d DIFFICULTY: Difficult REFERENCES: Psychosocial Effects on Physical Disorders LEARNING OBJECTIVES: ABNO.DURA.16.APA1.3.b - Correctly identify antecedents and consequences of behavior and mental processes OTHER: TYPE: Conceptual 56. According to the gate control theory of pain, the ________ of the spinal cord act as a “gate” and may open and transmit sensations of pain if the stimulation is sufficiently intense. a. dorsal horns b. somatic nerves c. coxal terminus d. epidural blocks ANSWER: a DIFFICULTY: Difficult REFERENCES: Psychosocial Effects on Physical Disorders LEARNING OBJECTIVES: ABNO.DURA.16.APA1.3.b - Correctly identify antecedents and consequences of behavior and mental processes OTHER: TYPE: Factual 57. ________ is an incapacitating exhaustion following only minimal exertion, accompanied by fever, headaches, muscle and joint pain, depression, and anxiety.

a. Somatization disorder b. Chronic fatigue syndrome c. Wasting disease d. Psychogenic pain disorder ANSWER: b DIFFICULTY: Easy REFERENCES: Psychosocial Effects on Physical Disorders LEARNING OBJECTIVES: ABNO.DURA.16.APA1.3.a - Describe problems operationally to study them empirically OTHER: TYPE: Factual 58. At various times, the symptoms of the disorder known as chronic fatigue syndrome were attributed to all of the following EXCEPT a. viral infection. b. environmental toxins. c. stress. d. brain atrophy.

ANSWER: d DIFFICULTY: Moderate REFERENCES: Psychosocial Effects on Physical Disorders LEARNING OBJECTIVES: ABNO.DURA.16.APA4.2.b - Accurately self-assess performance quality by adhering to external standards OTHER: TYPE: Factual 59. Dominant baboons were found to have better physical health than subordinate ones because they had a. More food and mates. b. More resting cortisol levels. c. More predictability and controllability. d. More intelligence and leadership.

ANSWER: c DIFFICULTY: Moderate REFERENCES: Psychological and Social Factors That Influence Health LEARNING OBJECTIVES: ABNO.DURA.16.APA1.2.a(3) - Read and summarize general ideas and conclusions from psychological sources accurately OTHER: TYPE: Factual 60. The treatment for chronic fatigue syndrome developed by Michael Sharpe includes all of the following EXCEPT a. medication. b. increased activity. c. regulated rest periods. d. breathing exercises.

ANSWER: a DIFFICULTY: Easy REFERENCES: Psychosocial Effects on Physical Disorders LEARNING OBJECTIVES: ABNO.DURA.16.APA4.2.b - Accurately self-assess performance quality by adhering to external standards OTHER: TYPE: Conceptual

61. A controlled research study investigating the effects of a cognitive-behavioral treatment for chronic fatigue syndrome resulted in improvement in a. measures of fatigue. b. measures of illness belief. c. both a and b d. neither a nor b ANSWER: c DIFFICULTY: Moderate REFERENCES: Psychosocial Effects on Physical Disorders LEARNING OBJECTIVES: ABNO.DURA.16.APA4.2.b - Accurately self-assess performance quality by adhering to external standards OTHER: TYPE: Factual 62. All of the following are psychosocial treatments that have been developed for physical disorders and pain EXCEPT a. biofeedback. b. hypnosis. c. relaxation procedures. d. acupuncture.

ANSWER: d DIFFICULTY: Moderate REFERENCES: Psychosocial Treatment of Physical Disorders LEARNING OBJECTIVES: ABNO.DURA.16.APA4.2.b - Accurately self-assess performance quality by adhering to external standards OTHER: TYPE: Factual 63. The procedure known as biofeedback involves a process by which a person is first helped to become aware of his/her a. physiological functions. b. psychological state of mind. c. Past emotional processing or lack thereof. d. level of pain.

ANSWER: a DIFFICULTY: Moderate REFERENCES: Psychosocial Treatment of Physical Disorders LEARNING OBJECTIVES: ABNO.DURA.16.APA4.2.b - Accurately self-assess performance quality by adhering to external standards OTHER: TYPE: Factual 64. Physiological functions that are a focus of biofeedback procedures include all of the following EXCEPT a. EEG rhythms (“brain waves”). b. heart rate. c. digestive functioning. d. muscle tension.

ANSWER: c DIFFICULTY: Moderate REFERENCES: Psychosocial Treatment of Physical Disorders LEARNING OBJECTIVES: ABNO.DURA.16.APA4.2.b - Accurately self-assess performance quality by adhering to external standards

OTHER:

TYPE: Factual

65. Several studies have found that biofeedback techniques can reduce headache in up to ____ percent of the patients undergoing this therapy. a. 25 b. 36 c. 63 d. 92 ANSWER: c DIFFICULTY: Difficult REFERENCES: Psychosocial Treatment of Physical Disorders LEARNING OBJECTIVES: ABNO.DURA.16.APA4.2.b - Accurately self-assess performance quality by adhering to external standards OTHER: TYPE: Factual 66. In biofeedback procedures, clinicians use physiological monitoring equipment to make the responses ________ to the patient. a. visible b. audible c. visible and/or audible d. tactile ANSWER: c DIFFICULTY: Easy REFERENCES: Psychosocial Treatment of Physical Disorders LEARNING OBJECTIVES: ABNO.DURA.16.APA4.2.b - Accurately self-assess performance quality by adhering to external standards OTHER: TYPE: Factual 67. It has been suggested that biofeedback relieves the pain of tension headaches because it “teaches people to relax,” but it is more likely that a. the patients whose pain is seemingly relieved by biofeedback are probably also taking aspirin or Tylenol. b. the biofeedback training gives patients a sense of control over their headache pain. c. biofeedback has a “numbing effect” because it affects the nerve endings in the somatic nervous system. d. patients experience a placebo effect, because the headache pain returns once the biofeedback sessions are completed.

ANSWER: b DIFFICULTY: Moderate REFERENCES: Psychosocial Treatment on Physical Disorders LEARNING OBJECTIVES: ABNO.DURA.16.APA4.2.b - Accurately self-assess performance quality by adhering to external standards OTHER: TYPE: Conceptual 68. Recent clinical studies indicate that it is a good pain-relieving strategy to use biofeedback in conjunction with a. medication. b. relaxation procedures. c. a placebo. d. psychotherapy.

ANSWER: b DIFFICULTY: Easy REFERENCES: Psychosocial Treatment on Physical Disorders LEARNING OBJECTIVES: ABNO.DURA.16.APA4.2.b - Accurately self-assess performance quality by adhering to external standards OTHER: TYPE: Factual 69. In the 1970s, Herbert Benson developed a brief relaxation procedure that involved focusing on a a. word. b. photo. c. person. d. musical note.

ANSWER: a DIFFICULTY: Easy REFERENCES: Psychosocial Treatment on Physical Disorders LEARNING OBJECTIVES: ABNO.DURA.16.APA4.2.b - Accurately self-assess performance quality by adhering to external standards OTHER: TYPE: Factual 70. Cassandra is sitting cross-legged on her rug with her arms outstretched. She closes her eyes and makes a sound like “ummmm.” She continues this procedure. Cassandra is demonstrating ______________, and the sound is a(n) ______________. a. relaxation response; focus b. meditation; mantra c. biofeedback; focus d. hypnosis; focal point ANSWER: b DIFFICULTY: Moderate REFERENCES: Psychosocial Treatment on Physical Disorders LEARNING OBJECTIVES: ABNO.DURA.16.APA4.2.b - Accurately self-assess performance quality by adhering to external standards OTHER: TYPE: Applied 71. When Herbert Benson stripped transcendental meditation of what he considered its nonessentials, he developed a brief procedure he called a. mantra meditation. b. simplified transcendental meditation (STM). c. relaxation response. d. progressive relaxation.

ANSWER: c DIFFICULTY: Moderate REFERENCES: Psychosocial Treatment on Physical Disorders LEARNING OBJECTIVES: ABNO.DURA.16.APA4.2.b - Accurately self-assess performance quality by adhering to external standards OTHER: TYPE: Factual 72. A decrease in the activity of stress hormones and certain neurotransmitters appears to occur during

a. sleep. b. meditation. c. biofeedback. d. psychotherapy.

ANSWER: b DIFFICULTY: Moderate REFERENCES: Psychosocial Treatment on Physical Disorders LEARNING OBJECTIVES: ABNO.DURA.16.APA4.2.b - Accurately self-assess performance quality by adhering to external standards OTHER: TYPE: Factual 73. Although the improvement is only moderate, relaxation techniques have been shown to have a positive effect on a. headaches. b. hypertension (high blood pressure). c. pain. d. all of these ANSWER: d DIFFICULTY: Easy REFERENCES: Psychosocial Treatment on Physical Disorders LEARNING OBJECTIVES: ABNO.DURA.16.APA4.2.b - Accurately self-assess performance quality by adhering to external standards OTHER: TYPE: Factual 74. In keeping daily records of the stressful events in their lives, patients in pain management programs are taught to be very specific about all of the following EXCEPT a. the actual time of day that they experience stress. b. what seems to “trigger the stress.” c. how they attempt to control the stress. d. the level of intensity of the stress.

ANSWER: c DIFFICULTY: Moderate REFERENCES: Psychosocial Treatment on Physical Disorders LEARNING OBJECTIVES: ABNO.DURA.16.APA4.2.b - Accurately self-assess performance quality by adhering to external standards OTHER: TYPE: Factual 75. In a stressful events record, clients in a pain management program are asked to record a. somatic symptoms only. b. thoughts that occur during stress but not somatic symptoms. c. thoughts that occur during stress as well as somatic symptoms. d. intensity of the stress but not thoughts or somatic symptoms.

ANSWER: c DIFFICULTY: Easy REFERENCES: Psychosocial Treatment on Physical Disorders LEARNING OBJECTIVES: ABNO.DURA.16.APA4.2.b - Accurately self-assess performance quality by adhering to external standards OTHER: TYPE: Factual

76. Cognitive therapy is used in stress-management programs to help clients learn to do all of the following EXCEPT a. develop more realistic appraisals and attitudes. b. identify unrealistic negative thoughts. c. tell off people they don’t like, as a way of reducing stress. d. assert themselves in an appropriate way in stressful situations.

ANSWER: c DIFFICULTY: Moderate REFERENCES: Psychosocial Treatment on Physical Disorders LEARNING OBJECTIVES: ABNO.DURA.16.APA4.2.b - Accurately self-assess performance quality by adhering to external standards OTHER: TYPE: Factual 77. All of the following situations have been associated with lowered immune system functioning EXCEPT a. marital conflict or relationship difficulties. b. job loss. c. death of a loved one. d. pregnancy.

ANSWER: d DIFFICULTY: Easy REFERENCES: Psychological and Social Factors That Influence Health LEARNING OBJECTIVES: ABNO.DURA.16.APA1.2.a(3) - Read and summarize general ideas and conclusions from psychological sources accurately OTHER: TYPE: Factual 78. Individuals who are high users of pain-relieving medications are ________ to benefit from pain management programs than less frequent users. a. more likely b. less likely c. equally likely d. unable ANSWER: b DIFFICULTY: Moderate REFERENCES: Psychosocial Treatment on Physical Disorders LEARNING OBJECTIVES: ABNO.DURA.16.APA4.2.b - Accurately self-assess performance quality by adhering to external standards OTHER: TYPE: Factual 79. In a comprehensive headache treatment program, people who were low users of analgesic medications achieved at least a ____ percent reduction in headache pain. a. 25 b. 50 c. 75 d. 99 ANSWER: b DIFFICULTY: Difficult REFERENCES: Psychosocial Treatment on Physical Disorders

LEARNING OBJECTIVES: ABNO.DURA.16.APA4.2.b - Accurately self-assess performance quality by adhering to external standards OTHER: TYPE: Factual 80. Jon has just been diagnosed with cancer. His initial response is to deny the seriousness of his condition. This type of coping mechanism a. will enable him to develop better coping mechanisms later. b. is never psychologically helpful. c. doesn’t really help him endure the initial shock any more easily. d. results in higher levels of corticosteroids (stress hormones).

ANSWER: a DIFFICULTY: Difficult REFERENCES: Psychosocial Treatment on Physical Disorders LEARNING OBJECTIVES: ABNO.DURA.16.APA4.2.b - Accurately self-assess performance quality by adhering to external standards OTHER: TYPE: Applied 81. Which of the following is NOT one of the three most common behaviors that put us at risk for physical disorders? a. Unhealthy eating habits b. Lack of exercise c. Smoking d. Watching too much TV ANSWER: d DIFFICULTY: Easy REFERENCES: Psychosocial Treatment on Physical Disorders LEARNING OBJECTIVES: ABNO.DURA.16.APA1.3.a - Describe problems operationally to study them empirically OTHER: TYPE: Factual 82. Mr. V is participating in a clinical research study that is investigating psychological factors that may influence the development of heart disease. When he is instructed to imagine a situation in which he was very angry, the sensors monitoring his heart reveal that a. his heartbeat has slowed significantly. b. his heart is pumping less efficiently. c. the area around his heart has become swollen and inflamed. d. he is having a “painless” heart attack.

ANSWER: b DIFFICULTY: Difficult REFERENCES: Psychosocial Effects on Physical Disorders LEARNING OBJECTIVES: ABNO.DURA.16.APA4.2.b - Accurately self-assess performance quality by adhering to external standards OTHER: TYPE: Applied 83. Injuries kill more children than the next ________ causes of childhood death combined. a. three b. six c. eight d. five

ANSWER: b DIFFICULTY: Difficult REFERENCES: Psychosocial Treatment on Physical Disorders OTHER: TYPE: Factual 84. According to the text, injury prevention programs have proven effective in teaching children about all of the following EXCEPT a. escaping fires. b. crossing streets. c. riding bikes safely. d. avoiding strangers.

ANSWER: d DIFFICULTY: Easy REFERENCES: Psychosocial Treatment on Physical Disorders LEARNING OBJECTIVES: ABNO.DURA.16.APA4.2.b - Accurately self-assess performance quality by adhering to external standards OTHER: TYPE: Factual 85. Which is an accurate statement regarding injury prevention programs for children? a. Most communities have injury prevention programs. b. Repeated warnings have been effective in preventing or reducing the number of injuries. c. Children who participated in safety skills programs remembered what they had learned even after the programs were over. d. Injury prevention programs have been ineffective in changing children’s behavior.

ANSWER: c DIFFICULTY: Difficult REFERENCES: Psychosocial Treatment on Physical Disorders LEARNING OBJECTIVES: ABNO.DURA.16.APA4.2.b - Accurately self-assess performance quality by adhering to external standards OTHER: TYPE: Factual 86. The only effective prevention strategy currently available for reducing the spread of AIDS appears to be a. a vaccine. b. medications. c. changing high-risk behavior. d. educating people about the disease.

ANSWER: c DIFFICULTY: Easy REFERENCES: Psychosocial Treatment on Physical Disorders LEARNING OBJECTIVES: ABNO.DURA.16.APA4.2.b - Accurately self-assess performance quality by adhering to external standards OTHER: TYPE: Factual 87. Individuals in Africa are most likely to become HIV positive following a. heterosexual sex with an infected partner. b. homosexual sex with an infected partner. c. repeated injections with unsterilized needles.

d. close nonsexual contact with an infected person.

ANSWER: a DIFFICULTY: Difficult REFERENCES: 2 Psychosocial Treatment on Physical Disorders OTHER: TYPE: Factual 88. Carla and Carlos have recently learned that they are HIV positive. According to research studies involving people who are HIV positive, what is most likely to occur? a. Carla will now have sex only if her partner uses a condom. b. Carlos will abstain from sex completely. c. Both Carla and Carlos will stop sharing needles with other drug users. d. Neither Carlos nor Carla is likely to change any of their previous behaviors.

ANSWER: d DIFFICULTY: Moderate REFERENCES: Psychosocial Treatment on Physical Disorders LEARNING OBJECTIVES: ABNO.DURA.16.APA1.3.b - Correctly identify antecedents and consequences of behavior and mental processes OTHER: TYPE: Applied 89. When high-risk individuals are given educational and informational pamphlets about ways to reduce their chances of becoming HIV positive, they typically a. change their high-risk behaviors. b. do not change their high-risk behaviors. c. abstain from unprotected sex. d. notify previous sex partners of their HIV condition.

ANSWER: b DIFFICULTY: Moderate REFERENCES: Psychosocial Treatment on Physical Disorders LEARNING OBJECTIVES: ABNO.DURA.16.APA4.2.a - Summarize psychological factors that can influence the pursuit of a healthy lifestyle OTHER: TYPE: Factual 90. According to consensus research, in which direction do pain signals travel to contribute to the experience of pain? a. “up,” from tissue, to spinal cord, to brain b. “down,” from brain, to spinal cord c. Both up and down. d. Neither up nor down; pain is an almost exclusively psychological phenomenon ANSWER: c DIFFICULTY: Moderate REFERENCES: Psychosocial Effects on Physical Disorders LEARNING OBJECTIVES: ABNO.DURA.16.APA1.3.b - Correctly identify antecedents and consequences of behavior and mental processes OTHER: TYPE: Factual 91. Which of the following factors accurately represents the circumstances regarding women and HIV/AIDS? a. Women frequently consider themselves at risk b. Most research on the spread of AIDS has highlighted the disease in women.

c. Women accounted for 50 percent of new AIDS cases in 2003. d. The age of highest risk of infection for women is their late teens.

ANSWER: c DIFFICULTY: Difficult REFERENCES: Psychosocial Treatment on Physical Disorders LEARNING OBJECTIVES: ABNO.DURA.16.APA4.2.b - Accurately self-assess performance quality by adhering to external standards OTHER: TYPE: Factual NOTES: NEW 92. Regarding the age ranges for the risk of HIV/AIDS, which of the following statements is accurate? a. For women, the highest risk is between the ages of 15 and 25. b. For women, the highest risk is during their late 20s and early 30s. c. The age range for risk is lower for men than for women. d. The age ranges for risk are the same for both males and females.

ANSWER: a DIFFICULTY: Moderate REFERENCES: Psychosocial Treatment on Physical Disorders LEARNING OBJECTIVES: ABNO.DURA.16.APA4.2.b - Accurately self-assess performance quality by adhering to external standards OTHER: TYPE: Factual 93. Which is a type of circumstance in which women put themselves at risk for HIV/AIDS infection differently from men? a. Having unprotected sex with partners whose sexual history is unknown b. Using contaminated needles when injecting illegal drugs c. Turning to prostitution in response to economic deprivation d. Having sex with multiple partners ANSWER: c DIFFICULTY: Moderate REFERENCES: Psychosocial Treatment on Physical Disorders LEARNING OBJECTIVES: ABNO.DURA.16.APA4.2.b - Accurately self-assess performance quality by adhering to external standards OTHER: TYPE: Applied 94. Your textbook reports on a behavioral change program to address the high rate of smoking in China. This was an important study for several reasons, including the fact that a. the number of people who smoke in China approximates the entire population of the United States. b. almost 100 percent of men in China smoke. c. Chinese media is gaining more popularity in other Asian countries and around the world, and it often models smoking behavior. d. the types of cigarettes smoked in China are more potent than those of the U.S. ANSWER: a DIFFICULTY: Difficult REFERENCES: Psychosocial Treatment on Physical Disorders LEARNING OBJECTIVES: ABNO.DURA.16.APA4.2.b - Accurately self-assess performance quality by adhering to external standards

OTHER:

TYPE: Factual

95. A massive antismoking campaign in China in 1989 involved a. bonuses to employees who quit smoking. b. withdrawn salary and work benefits to those who continued smoking. c. children reporting to their schools on their fathers’ smoking habits. d. married couples’ written agreements to stop smoking.

ANSWER: c DIFFICULTY: Moderate REFERENCES: Psychosocial Treatment on Physical Disorders LEARNING OBJECTIVES: ABNO.DURA.16.APA4.2.b - Accurately self-assess performance quality by adhering to external standards OTHER: TYPE: Factual 96. In 1989, health professionals in China began a massive antismoking effort in several cities that involved children whose fathers smoked. As part of this effort, all of the following are accurate statements EXCEPT a. schoolchildren were given antismoking literature and questionnaires to take home to their fathers. b. children wrote letters to their fathers asking them to quit smoking. c. children submitted monthly reports on their fathers’ smoking habits to their schools. d. photos of the fathers who continued smoking were published in the school newspapers.

ANSWER: d DIFFICULTY: Moderate REFERENCES: Psychosocial Treatment on Physical Disorders LEARNING OBJECTIVES: ABNO.DURA.16.APA4.2.b - Accurately self-assess performance quality by adhering to external standards OTHER: TYPE: Applied 97. In the massive antismoking campaign in China in 1989, the results indicated that ____ percent of the 10,000 fathers in the intervention group quit smoking for at least six months, in comparison to a control group of 10,000 in which only ____ percent quit smoking. a. 1; 0.1 b. 12; 0.2 c. 22; 2.2 d. 50; 25 ANSWER: b DIFFICULTY: Difficult REFERENCES: Psychosocial Treatment on Physical Disorders LEARNING OBJECTIVES: ABNO.DURA.16.APA4.2.b - Accurately self-assess performance quality by adhering to external standards OTHER: TYPE: Factual 98. One of the most successful efforts to reduce risk factors for a medical condition involved three entire communities in California in which residents received different types of interventions or no intervention at all (for the community that served as the control group). The targeted condition in this effort was a. diabetes. b. cancer. c. heart disease.

d. obesity.

ANSWER: c DIFFICULTY: Easy REFERENCES: Psychosocial Treatment on Physical Disorders LEARNING OBJECTIVES: ABNO.DURA.16.APA4.2.b - Accurately self-assess performance quality by adhering to external standards OTHER: TYPE: Factual 99. A new medical subspecialty called psychoncology reflects the influence of psychological factors in the development and progression of a. cancer. b. coronary heart disease. c. eating disorders. d. high blood pressure.

ANSWER: a DIFFICULTY: Easy REFERENCES: Psychosocial Treatment on Physical Disorders LEARNING OBJECTIVES: ABNO.DURA.16.APA4.2.b - Accurately self-assess performance quality by adhering to external standards OTHER: TYPE: Factual 100. A new medical specialty called psychoneuroimmunology reflects the relationship among a. psychological factors including stress. b. the immune system. c. the nervous system. d. all of these ANSWER: d DIFFICULTY: Easy REFERENCES: Psychosocial Treatment on Physical Disorders LEARNING OBJECTIVES: ABNO.DURA.16.APA4.2.b - Accurately self-assess performance quality by adhering to external standards OTHER: TYPE: Factual 101. The field of stress physiology began with the research of Hans Selye and his laboratory rats. Explain how his findings developed into an understanding of the physical impact of stress.

ANSWER: Sample Answer: Selye theorized that the body goes through several stages in response to sustained stress. The first phase is a type of alarm response to immediate danger or threat. With continuing stress, we seem to pass into a stage of resistance, in which we mobilize various coping mechanisms to respond to the stress. Finally, if the stress is too intense or lasts too long, we may enter a stage of exhaustion, in which our bodies suffer permanent damage or death. Selye called this sequence the general adaptation syndrome (GAS).

The physiological effects of the early stages of stress, in particular its activating effect on the sympathetic nervous system, mobilizes our resources during times of threat or danger by activating internal organs to prepare the body for immediate action, either fight or flight. These changes increase our strength and mental activity.

102. Explore the relationship between stress and the immune system. What is the HPA axis? What are stress hormones? Is there a “lab” test to measure stress levels in human beings?

ANSWER: Sample Answer: The activity of the endocrine system increases when we are stressed, primarily through activation of the hypothalamic–pituitary–adrenocortical (HPA) axis. Although a variety of neurotransmitters

begin flowing in the nervous system, much attention has focused on the endocrine system’s neuromodulators or neuropeptides, hormones affecting the nervous system that are secreted by the glands directly into the bloodstream. These neuromodulating hormones act much like neurotransmitters in carrying the brain’s messages to various parts of the body. One of the neurohormones, corticotropin-releasing factor (CRF), is secreted by the hypothalamus and stimulates the pituitary gland. Farther down the chain of the HPA axis, the pituitary gland (along with the autonomic nervous system) activates the adrenal gland, which secretes, among other things, the hormone cortisol. Because of their close relationship to the stress response, cortisol and other related hormones are known as the stress hormones.

The hypothalamus, at the top of the brain stem, is right next to the limbic system, which contains the hippocampus and seems to control our emotional memories. The hippocampus is responsive to cortisol. When stimulated by this hormone during HPA axis activity, the hippocampus helps to turn off the stress response, completing a feedback loop between the limbic system and the various parts of the HPA axis.

This answer does not address the last part of the question regarding a “lab test” for stress levels.

103. Discuss how psychological factors including negative cognitions affect immune system functioning. Give examples of physical conditions that are considered stress-related.

ANSWER: Sample Answer: The level of stress you are experiencing at the time seems to play a major role in whether the exposure results in a cold. Researchers found that the chance a participant would get sick was directly related to how much stress the person had experienced during the past year. They also linked the intensity of stress and negative affect at the time of exposure to the later severity of the cold, as measured by mucus production.

In an interesting twist, it was demonstrated that how sociable you are—that is, the quantity and quality of your social relationships—affects whether you come down with a cold when exposed to the virus, perhaps because socializing with friends relieves stress.

Almost certainly, the effect of stress on susceptibility to infections is mediated through the immune system, which protects the body from any foreign materials that may enter it. Humans under stress show clearly increased rates of infectious diseases, including colds, herpes, and mononucleosis. Direct evidence links a number of stressful situations to lowered immune system functioning, including marital discord or relationship difficulties, job loss, and the death of a loved one.

104. Discuss why stress is often implicated as a factor in cardiovascular disease. Define Type A personality and discuss research regarding its validity.

ANSWER: Sample Answer: The cardiovascular system includes the heart, blood vessels, and control mechanisms for its regulation. Cardiovascular disease often occurs because of blockages in blood vessels to the heart, which cause heart attacks, and in blood vessels to the brain, which cause stress. High blood pressure (hypertension) and high cholesterol levels contribute to both of these problems. Hypertension can occur as a result of strong physiological responses to stress, kidney problems, emotional distress, feelings of uncontrollability, and low social support. Type A behavior was originally described as a combination of impatience, energy, time pressure, and competitiveness. Early researchers (Freidman and Rosenman) thought this behavior pattern caused heart disease, although later research suggests that the relationship is complex, with negative emotions such as anger, hostility, anxiety, and depression being stronger predictors of cardiovascular disease than the Type A pattern itself.

105. Discuss chronic pain. What factors, including psychological, are thought to maintain chronic pain?

ANSWER: Sample AnswerChronic pain usually begins with an acute episode or injury, but the pain does not decrease over time, even when the injury has healed or effective treatments have been administered. Typically, chronic pain occurs in muscles, joints, or tendons, but it can also be related to headaches and degenerative diseases.

Chronic pain can affect all aspects of a person’s life, but responses vary as a function of psychological responses. Anxiety and depression exacerbate the affects of chronic pain, while a sense of control and optimism can result in less distress and disability.

106. Describe the use of biofeedback, meditation, and relaxation techniques in the management of stress-related disorders.

How effective are these treatments for stress management and pain relief?

ANSWER: Sample Answer: Biofeedback refers to the process of making patients aware of specific physiological functions that they would not ordinarily notice such as heart rate and muscle tension. Using feedback

regarding their responses, they are taught to alter or change these responses to promote relaxation.

Biofeedback has been shown to be effective at controlling a number of types of pain, including headaches.

Relaxation and meditation techniques focus on helping people to focus attention on either a single thought or image, or part of the body, in order to promote the relaxation response. By minimizing distractions, people learn to focus on internal sensations. This process can promote a sense of calm, control, and mastery, and relax the body. Such techniques have been shown to have positive effects on headaches, hypertension, and some types of acute and chronic pain.

107. Discuss prevention and intervention programs. What medical conditions and/or behaviors are targeted? Compare injury prevention programs with the more typical information and warnings.

ANSWER: Sample Answer: In stress-management programs, individuals practice a variety of procedures presented to them in a workbook. First, they learn to monitor their stress closely and to identify the stressful events in their daily lives. Clients are taught to be specific about recording the times they experience stress, the intensity of the stress, and what seems to trigger it. They also note the somatic symptoms and thoughts that occur when they are stressed. All this monitoring becomes important in carrying through with the program, but it can be helpful in itself because it reveals precise patterns and causes of stress and helps clients learn what changes to make to cope better.

After learning to monitor stress, clients are taught deep muscle relaxation, which first involves tensing various muscles to identify the location of different muscle groups. Clients are then systematically taught to relax the muscle groups beyond the point of inactivity, that is, to actively let go of the muscle so that no tension remains in it.

Appraisals and attitudes are an important part of stress, and clients learn how they exaggerate the negative impact of events in their day-to-day lives. In the program, therapist and client use cognitive therapy to develop more realistic appraisals and attitudes. In this program, individuals work hard to identify unrealistic negative thoughts and to develop new appraisals and attitudes almost instantaneously when negative thoughts occur.

Such assessment is often the most difficult part of the program. Finally, clients in stress-reduction programs develop new coping strategies, such as time management and assertiveness training. During time-management training, patients are taught to prioritize their activities and pay less attention to nonessential demands. During assertiveness training, they learn to stand up for themselves in an appropriate way. Clients also learn other procedures for managing everyday problems.

Some evidence suggests that chronic reliance on over-the-counter analgesic (pain reliever) medications lessens the efficacy of comprehensive programs in the treatment of headache and may make headaches worse because patients experience increased headache pain every time the medication wears off or is stopped.

A variety of programs focusing on behavior change have proved effective for preventing injuries in children.

For example, children have been systematically and successfully taught to escape fires, identify and report emergencies, safely cross streets, ride bicycles safely, and deal with injuries such as serious cuts. In many of these programs, the participating children maintained the safety skills they had learned for months after the intervention—as long as assessments were continued, in most cases. Because little evidence indicates that repeated warnings are effective in preventing injuries, programmatic efforts to change behavior are important.

Such programs, however, are nonexistent in most communities.