Deck 7: Psychological Factors Affecting Medical Conditions

Question 1

A mechanism is

A) Something that regulates a physical system.
B) the means by which unconscious conflict produces psychological disturbances.
C) a process, activity of a living system that mediates the influence of an antecedent factor on disease.
D) the effect neurotic behaviour has on the family or social environment.
E) an axis of internal regulation that involves pulmonary and immunological functioning.

Answer 1

a process, activity of a living system that mediates the influence of an antecedent factor on disease.

Question 2

Most organs that are innervated by the sympathetic system

A) are primarily involved in digestion.
B) are typically accompanied by an awareness of their function.
C) are also innervated by the parasympathetic branch.
D) are not innervated by the parasympathetic branch of the nervous system.
E) are under the control of the parasympathetic branch of the nervous system.

Answer 2

are also innervated by the parasympathetic branch.

Question 3

It is increasingly recognized that ___________ released during stress plays an important role in the development of abdominal obesity.

A) ACTH
B) androgens
C) adrenal emissions
D) cortisol
E) catecholamines

Answer 3

cortisol

Question 4

The idea that psychological processes can affect bodily states

A) has not yet taken hold in western culture but has in other cultures.
B) is relatively new to western culture but is starting to take hold.
C) is unique to western culture but accepted elsewhere.
D) has a long history in western culture but is unique to eastern culture.
E) has a long history in western culture, and may be even more deeply embedded in other cultures.

Question 5

___________ is defined as the application of psychological methods and theories to understand origins of disease, individual responses to disease and the dimensions and determinants of good health.

A) Health Psychology
B) Behavioural medicine
C) Health Physiology
D) Biomedicine
E) Psychosomatic medicine

Question 6

The body system responsive to psychosocial variables involved in the production of hormones is the

A) immune system.
B) endocrine system.
C) autonomic nervous system.
D) central nervous system.
E) somatic nervous system.

Question 7

The brain structure that makes up part of the HPA axis is the

A) thalamus.
B) hypothalamus.
C) medulla.
D) hippocampus.
E) amygdala.

Question 8

The theorist ___________ argued that the biomedical model of disease should be expanded to a biopsychosocial model.

A) Franz Alexander
B) Helen Flanders Dunbar
C) George Engel
D) Walter Cannon
E) Hans Selye

Question 9

The early years of research concerning the role of psychological processes in physical health were known as

A) psychosomatic medicine.
B) cognitive physiology.
C) dualistic behaviourism.
D) neuropsychophysiology.
E) behavioural medicine.

Question 10

Immune cells are produced and stored in all of the following except the

A) thymus gland.
B) large intestines.
C) lymph nodes.
D) bone marrow.
E) small intestines.

Question 11

The endocrine system secretes ___________ into the _____________.

A) hormones; bloodstream
B) neuropeptides; blood stream.
C) neurotransmitters; brain.
D) hormones; pituitary gland.
E) chemicals; blood-brain barrier.

Question 12

Which of the following is true regarding psychological influences on body tissues?

A) There is no clear evidence that psychological processes can affect body tissues.
B) The endocrine system, the autonomic nervous system, and the parietal nervous system are sensitive to psychological processes.
C) Psychological influences on body tissues can be the effects of repeated behaviours.
D) There are very few examples of behaviours that promote disease by exposing tissue to pathogenic substances.
E) Psychologists have not yet examined psychological influences on body tissues.

Question 13

Perhaps the best known endocrine hormone system known to be highly responsive to psychosocial variables involves the

A) ovaries.
B) pancreas.
C) pineal gland.
D) HPA axis.
E) testes.

Question 14

The three body systems that are responsive to psychosocial variables are:

A) endocrine system; immune system; cardiovascular system
B) autonomic nervous system; endocrine system; cardiovascular system
C) autonomic nervous system; central nervous system; immune system
D) autonomic nervous system; endocrine system; immune system
E) somatic nervous system; endocrine system; cardiovascular system

Question 15

Adrenocorticotropic hormone

A) informs cells in the liver to convert glycogen to usable sugars.
B) prompts cells in the adrenal glands to secrete cortisol.
C) is released by the pineal gland.
D) is a monoamine oxidase inhibitor.
E) is a glucocorticoid.

Question 16

Which of the following would most likely be considered a treatable problem in behavioural medicine?

A) gallstones
B) a stroke
C) essential hypertension
D) cancer
E) cardiac arrhythmias due to genetic illness

Question 17

"Voodoo Death" is a phenomenon in which

A) sublimated drives result in heart failure.
B) death is directly caused by voodoo.
C) ritualistic suicide occurs in Caribbean culture.
D) people die as a result of a nervous breakdown.
E) the individual dies after learning that he has been cursed.

Question 18

Glucocorticoids

A) cause inflammation.
B) have not been indicated in the development of neuronal damage in the brain.
C) prevent the development of atherosclerosis.
D) are only beneficial when released for long periods of time.
E) have been indicated in the suppression of immune system function.

Question 19

Somatic symptom and related disorders involve psychological processes that give rise to apparent physical symptoms without a medical basis; psychological factors affecting medical conditions, in contrast

A) involve psychological processes that give rise to identifiable disturbances in bodily structures and functions.
B) involve purely emotional processes that give rise to apparent physical symptoms.
C) are the result of physical processes that have psychological consequences.
D) involve physical symptoms with physiological causes.
E) involve purely cognitive processes that result in physical symptoms, without intermediary physiological processes.

Question 20

Sympathetic is to parasympathetic system as

A) accelerator is to brakes.
B) brakes are to car.
C) deceleration is to acceleration.
D) flour and sugar are to baking a cake.
E) horse is to buggy.

Question 21

A study on controllability by Weiss (1971) discovered that

A) rats that could control the stressor suffered the same level of ulceration as rats who could not control the stressor.
B) rats that could not exercise control over the stressor did not show any levels of ulceration.
C) shocked rats did not show a great deal of ulceration.
D) rats that could exercise control over the stressor suffered milder ulceration than did rats who could not control the stressor.
E) rats that could control the stressor had higher levels of ulceration than did those who could not control the stressor.

Question 22

The final phase of Hans Selye's General Adaptation Syndrome is the ___________ phase.

A) adaptation
B) resistance
C) exhaustion
D) alarm
E) resolution

Question 23

In a study conducted employing cold viruses, Cohen, Tyrrell, and Smith (1993) discovered that participants with higher perceived stress and negative affect were

A) more likely to have died after a five-year follow-up study.
B) more likely to show "hard" immune system changes.
C) less likely to recover within a 5-day period.
D) more likely to develop another more debilitating illness.
E) less likely to show clinical evidence of a cold.

Question 24

According to Alexander (1950) the role psychological factors might play in the development of ulcers is

A) unconscious conflict creates neuronal death in the hypothalamus.
B) certain personality types are prone to overeating causing medical problems.
C) lowered immune function as a result of stress allows for bacterial infection.
D) an unsatisfied desire for love results in an overactivity in the digestive system.
E) stress decreases the effectiveness of the mucosal stomach lining.

Question 25

Clients with limited capacity to delay gratification will find it difficult, particularly in the beginning, to adopt ___________ because ___________ methods provide a faster and easier escape from the unpleasant feelings associated with threats.

A) courageous; self-soothing
B) reality-based action; self-medicating
C) reality-based mood adjustment; self-medicating
D) fact-based; intellectualizing-based
E) problem-focused coping; emotion-focused coping

Question 26

Primary appraisal involves

A) deciding whether or not an event is threatening.
B) addressing our memory to determine how to deal with a threatening event.
C) choosing an appropriate course of action for dealing with the threat.
D) inducing a different feeling state as a way to deal with a problem.
E) seeking advice from a clinical psychologist about a problem.

Question 27

A study on predictability conducted by Weiss (1970) discovered that:

A) rats shocked after being provided with a warning tone showed the same ulceration as rats that did not receive a warning stimulus.
B) rats shocked after being provided with a warning tone showed ulceration much higher than shocked rats without a warning with un-shocked rats.
C) rats shocked after being provided with a warning tone showed ulceration only slightly higher than shocked rats.
D) shocked rats did not show a great deal of ulceration.
E) rats shocked and provided with a warning tone showed greater ulceration than did un-shocked rats.

Question 28

Therapists might find it difficult to steer clients towards methods ___________ of dealing with threats because ___________ methods are negatively reinforced (i.e., they provide a rapid escape from unpleasant thoughts / feelings associated with the problem).

A) problem-focused coping; emotion-focused coping
B) reality-based action; self-medicating action
C) reality-based mood adjustment; self-medicating mood adjustment
D) practical; intellectualizing-based
E) practical; denial

Question 29

Which of the following is true regarding the stomach and gut?

A) The brain regulates the gut through autonomic and neuroendocrine systems.
B) During stress-induced parasympathetic arousal, blood flow is directed away from the stomach lining to the skeletal muscles.
C) Studies have shown that psychological distress is associated with blunted secretion of gastric acids.
D) Patients with duodenal ulcers respond in a less dysfunctional way to stress than do patients with other cardiac ulcers.
E) Studies have shown that relaxation can be associated with hypersecretion of gastric acids.

Question 30

Cells that remain permanently altered after an immune episode are called

A) B-cells.
B) Suppressor T-cells.
C) Memory T-cells.
D) Helper T-cells.
E) Natural Killer.

Question 31

Research on conflict in married individuals has shown that high rates of hostile behaviour during stressful interactions coincide with:

A) increased release of the stress-related neurotransmitter GABA.
B) suppression of the cardiovascular system.
C) elevated epinephrine, norepinephrine and ACTH levels.
D) suppressed blood pressure response.
E) reductions in testosterone.

Question 32

In the alarm phase of Hans Selye's (1956) General Adaptation Syndrome, the body

A) waits for the brain to make a "decision" about the threat.
B) mobilizes its defences.
C) suffers tissue damage.
D) is exhausted due to depletion of energy stores.
E) actively fights or copes with the challenge to the system.

Question 33

In a study conducted by Lazarus and colleagues, the researchers found that by ___________ the scenes in films depicting rites of passage, arousal was decreased.

A) re-watching
B) identifying with
C) mentally modifying
D) intellectualizing or denying
E) ignoring

Question 34

Which of the following was NOT a characteristic of dominant male baboons in Sapolsky's (1995) studies of how social status may affect stress?

A) higher levels of circulating lymphocytes
B) reduced concentrations of cortisol
C) lower levels of high-density lipoprotein cholesterol
D) a greater ability to recover from provocation
E) lower blood pressure

Question 35

Which of the following is not a feature of alexithymia?

A) Problems identifying and describing subjective feelings.
B) Difficulty telling apart feelings and bodily sensations of emotional arousal.
C) High capacity to become easily absorbed in sensory-perceptual experiences.
D) Constricted imaginal capacities.
E) Externally-oriented cognitive style.

Question 36

Secondary appraisal is analogous to asking the question

A) "is there anything I can do about this?"
B) "how can I make myself feel better?"
C) "can anyone observe how I handle this event?"
D) "why is this happening?"
E) "is this event threatening?"

Question 37

Kanner, Coyne, Schaefer and Lazarus (1981) suggest that the most common sources of stress in people's lives are

A) inner conflicts.
B) medical problems.
C) hassles.
D) drastic life changes.
E) financial.

Question 38

Which of the following behaviours may NOT be considered emotion-focused coping?

A) watching television
B) taking drugs
C) thinking about something unrelated to the problem
D) drinking
E) identifying and rectifying the source of the threat

Question 39

The process of engulfing and digesting invading organisms is called

A) suppression.
B) cellular inhibition.
C) phagocytosis.
D) nonspecific immune response.
E) lymphocytosis.

Question 40

Which of the following is NOT evidence collected indicating that Helicobacter pylori plays a primary role in the genesis of ulcers?

A) Antibodies to the bacterium have been found in the serum of healthy controls.
B) This bacterium is present in the stomachs of a large proportion of individuals with ulcer disease.
C) Twenty percent of people who test positive for the bacterium show evidence of ulcer.
D) Animals injected with H. pylori suffered from ulcer disease.
E) The condition of patients treated with drugs to kill H. Pylori improves.

Question 41

Frasure-Smith, Lespérance, and Talajic (1993) found that depression soon after the heart attack

A) had no effect on the risk of dying.
B) was associated with a greater than five-fold increase in the risk of dying within six months.
C) was associated with a greater than five-fold increase in the risk of another heart attack within 6 months.
D) was associated with a greater than five-fold increase in the risk of dying within six months only in men, but not in women.
E) was associated with a greater than ten-fold increase in the risk of another heart attack within 6 months.

Question 42

Large trials targeting psychosocial variables to reduce morbidity and mortality following cardiovascular disease have:

A) been universally supportive.
B) not been conducted.
C) not been universally supportive.
D) been impossible to undertake due to the large number of factors that would need to be accounted for.
E) been in the progress with results unknown at this time.

Question 43

Health psychology refers to the application of psychological methods to mental illnesses that have physical consequences.

Question 44

Cognitive-behavioural techniques aimed at stress management do so by

A) teaching control of specific muscle groups.
B) helping the individual to re-assess stress causing thought patterns.
C) using biofeedback to lower physiological arousal responses.
D) encouraging people to invoke images of warmth and heaviness.
E) autogenic training.

Question 45

Type A people in general show more of the following except

A) neurotic behaviour.
B) hyperalertness.
C) competitiveness.
D) sense of time urgency.
E) hostility.

Question 46

Cardiovascular reactivity refers to

A) the relationship between cardiovascular function and atherosclerosis.
B) that relationship between psychosocial stressors and cardiovascular disease.
C) the relationship between hypertension and psychosocial stressors.
D) how much a person's cardiovascular function changes in response to a psychologically significant stimulus.
E) how much hypertension is caused by a psychosocial stressor.

Question 47

The INTERHEART study found that of the nine risk factors, the following three had the greatest impact on the risk of heart attack.

A) abdominal obesity, psychosocial factors, and low physical activity
B) raised lipids, smoking, and psychosocial factors
C) psychosocial factors, high blood pressure, and raised lipids
D) low consumption of fruits and vegetables, high blood pressure, and diabetes
E) smoking, low physical activity, and lack of consumption of moderate amounts of alcohol

Question 48

Pain is in large part a psychological phenomenon.

Question 49

A number of studies using the ___________ have found an association between hostility and increased risk of heart disease.

A) The Anger Interview
B) Cook-Medley Hostility Scale
C) Turner Interruption Test
D) Stroop Colour-Word Conflict Test
E) Structured Interview

Question 50

In a series of interventions for stress performed by Dean Ornish and colleagues (1996), found that ____ predicted the extent of coronary lesions.

A) hours spent meditating in a week
B) aerobic exercise
C) the amount of practice patients devoted to stress management
D) the switch to a vegetarian diet
E) the number of people involved in group support meetings

Question 51

In terms of cardiovascular functioning, which of the following is a modifiable risk factor?

A) jogging
B) high blood cholesterol
C) exercise
D) marriage
E) high demand occupations

Question 52

Consistent with the water pump analogy of the cardiovascular system, the peak of the wave of blood flow corresponds with

A) the point in the cardiac cycle called the systole.
B) the peripheral resistance found in the right ventricle.
C) cardiac output.
D) the point in the cardiac cycle called the diastole.
E) the contraction of the right ventricle.

Question 53

Under precisely defined conditions in a doctor's office, hypertension is defined by

A) blood pressure reading of more than 140/80.
B) blood pressure reading of more than 120/70.
C) decreased tension in blood vessel walls.
D) blood pressure reading of more than 160/100.
E) cardiac distress under high demand exercise.

Question 54

The psychosocial vulnerability model suggests that hostile people

A) are innately predisposed to illness.
B) experience a more demanding interpersonal life than do others.
C) are more likely to engage in unhealthy behaviours and less likely to have healthy practices, such as exercise.
D) are more at risk for diseases because they experience exaggerated autonomic and neuroendocrine responses during stress.
E) create a social world that is antagonistic and unsupportive.

Question 55

Linden and Chambers (1994) in their study on hypertension, discovered that stress management could

A) never be as effective as drug treatment.
B) worsen a patient's condition when standard prescription drugs are not given.
C) be effective if coupled with drug treatment.
D) be as effective as drug treatment if targeted and individualized to each patient.
E) be as effective as drug treatment if implemented in a standardized fashion.

Question 56

Consistent with the plumbing analogy of the cardiovascular system, which of the following best describes atherosclerosis?

A) The tubing expands reducing pressure.
B) The tubing develops calcium deposits from the water.
C) The pump begins to operate sporadically.
D) The tubing branch points dry out and become brittle.
E) The pump begins to leak water.

Question 57

Friedman et al. (1986) found that after three years of cardiac counselling implemented through the Recurrent Coronary Prevention Project, patients showed

A) an increase in the amount of type A behaviour.
B) no change in the amount of type A behaviour.
C) half as many occurrences of cardiac events as controls.
D) no difference from controls in the occurrences of cardiac events.
E) half as many occurrences of cardiac events as controls, but also no reduction in measured Type A behaviour.

Question 58

Which of the following are most closely tied into the regulation of the cardiovascular system?

A) serotonergic agonists
B) glucocorticoids
C) monoamine oxidase inhibitors
D) dopaminergic antagonists
E) catecholamines

Question 59

The stress reactivity paradigm is used

A) to determine the risk of cardiovascular disease as a function of cardiovascular reactivity.
B) to show how cardiovascular disease causes stress.
C) to measure the effects of risk factors such as smoking on cardiovascular disease.
D) to determine the cause of "essential" hypertension.
E) to show how the cardiovascular system can be altered by stressful psychosocial stimuli or events.

Question 60

Since the 1950s deaths due to heart attack and stroke have declined by almost

A) 25%.
B) 10%.
C) 70%.
D) 50%.
E) 90%.

Question 61

The endocrine system is characterized by manufacturing hormones that produce an effect in "targeted" areas of the body.

Question 62

In humoral immunity, invading antigens are presented by macrophages to B- lymphocytes, some of which remain as memory B-cells.

Question 63

Cardiac output, one of the aspects of blood pressure, specifically refers to the diameter of the blood vessels.

Question 64

Cellular immunity is based on the action of granulocytes and monocytes.

Question 65

In comparison to sympathetic system innervation, which relies on hormonal transmission, the parasympathetic system operates much more quickly.

Question 66

In 90% of cases of hypertension a specific cause can be identified and isolated.

Question 67

A mechanism is a process, an activity of a living system that mediates the influence of an antecedent factor on disease.

Question 68

Cardiovascular reactivity refers to how much an individual's cardiovascular function changes in response to a psychologically significant stimulus.

Question 69

The three body systems affected by psychosocial variables are the autonomic nervous system, the somatic nervous system and the immune system.

Question 70

Primary appraisal may be thought of as if a person were asking the question "is this a threat to me?"

Question 71

One of the effects produced by cortisol is the reduction of inflammation.

Question 72

ACTH is secreted by the pineal gland.

Question 73

Evidence has been found to indicate glucocorticoids suppress immune function and promote the development of atherosclerosis.

Question 74

In terms of psychosocial factors that may affect disease, a dominance hierarchy in monkeys may be seen as analogous to socio-economic-status.

Question 75

Epinephrine and norepinephrine interact directly with blood cells and the cells lining blood vessel walls.

Question 76

Ischemic heart disease is a condition in which the blood supply to the heart becomes compromised.

Question 77

One of the effects produced by prolonged release of cortisol is neuronal damage that may contribute to dementia.

Question 78

In the resistance phase of the GAS, the body mobilizes its defenses, in order to deal with a stressor.

Question 79

Most, but not all organs that are innervated by the sympathetic system are also innervated by the parasympathetic branch.

Question 80

Some key Type A characteristics are hyperarousal, competitiveness, and hostility.