Deck 6: Trauma and Stress-Related Disorders

Question 1

Kwan, a refugee from Cambodia, feels fine all day, but dies in his sleep. His autopsy shows no identifiable cause for his death. The cause of his death would likely be attributable to ____.

A) ventricular fibrillation
B) psychosomatic heart disease
C) sudden death syndrome
D) acute bradycardia

Answer 1

C

Question 2

Both Kurt and Magda survived airplane crashes. Both experience intrusive memories of the event as well as extreme anxiety and dissociative episodes. One might be diagnosed with acute stress disorder and the other with posttraumatic stress disorder if ____.

A) one experiences anxiety and the other does not
B) one relives the experience and the other does not
C) one has had symptoms for more than thirty days and the other has not
D) one experiences panic attacks and the other does not

Answer 2

C

Question 3

Continuing research on stress suggests that ____.

A) biological stressors play a more important role in affecting the immune system than do psychological or social stressors
B) biological stressors can cause physiological damage, but psychological and social stressors do not
C) there is very little relationship between stress and health
D) stress affects the immune system, heart function, hormone levels, and the hypothalamic-pituitary-adrenal systems

Answer 3

D

Question 4

Which statement concerning stressors and stress is accurate ?

A) Stressors are external events; stress is an internal reaction to such events.
B) Stress is a chronic condition; stressors are only temporary.
C) Stressors are internal reactions such as increased heartbeat; stress is an external condition.
D) Stress and stressor are two different words that have the same meaning.

Question 5

Dale seemed to be okay when he returned from military duty Afghanistan in June, 2010, despite witnessing his two best friends being killed when invading a compound. Six months after his return, he begins having nightmares and flashbacks about his experiences and lives on constant alert. He jumps at even the slightest noise. Finally, his wife insists that Dale see a therapist. The most likely diagnosis is ____.

A) noise phobia
B) panic disorder
C) posttraumatic stress disorder
D) acute stress disorder

Question 6

On one particularly stressful day, Darren learns that his girlfriend is leaving him, his mother has been robbed, and the IRS is auditing him. His body reacts with an increased heart rate and increased respiration. Viewing Darren's reaction from a biological perspective, Darren is experiencing ____.

A) activation of the sympathetic nervous system in order to prepare the body for emergency action
B) impaired immune response to stressors
C) dysfunctional cognitions regarding the stressors occurring during this day
D) pre-existing conditions that predispose him to developing stress reactions

Question 7

Leo took care of his wife for several years after she suffered a stroke. The stress on him was overwhelming. Shortly after she died, he develops a serious illness. His illness suggests ____.

A) hypertension resulting from chronic stress
B) an impaired immune response to illness resulting from chronic stress
C) hypervigilance resulting from chronic stress
D) hyperglycemia resulting from chronic stress

Question 8

The body's reaction to long-lasting stress is associated with ____.

A) enhanced immune functioning
B) deterioration of the body
C) changes in personality
D) decreased sensitivity to stressors

Question 9

Thirty years ago, a psychiatrist might have considered peptic ulcers and essential hypertension to be ____, but the term ____ is used.

A) psychosomatic illnesses; conversion disorders
B) psychophysiological disorders; neuroses
C) psychosomatic illnesses; psychophysiological disorders
D) neuroses; psychoses

Question 10

Jake is confused about what a stressor is. How would you explain the term, based on the text?

A) an internal psychological or physical response
B) an external event or situation that places a physical or psychological demand on a person
C) an item or person that irritates someone consistently
D) an event or situation that is beyond a person's ability to cope

Question 11

Stress researchers have found that ____.

A) both short-term and long-term exposure to stress are associated with deterioration of immune functioning
B) both short-term and long-term exposure to stress are associated with enhancement of immune functioning
C) brief exposure to stress enhances immune functioning; extended exposure to stress is associated with deterioration of immune functioning
D) the research is inconclusive with regard to any relationship between short- or long-term exposure to stress and immune functioning

Question 12

Imagine that you are a physician and your patient is a Hmong immigrant who has just arrived in the United States. The patient, through a translator, tells you that spirits come into his room while he sleeps and make it hard for him to breathe. He wakes up screaming. Considering reports from other Hmong immigrants, you should ____.

A) reassure the patient that there is nothing to worry about and that symptoms will disappear on their own
B) assume the patient suffers from a psychotic mental condition
C) treat the person for anxiety disorder
D) be concerned that the patient's psychological stress can lead to sudden death

Question 13

Ramon sees a therapist because he is reliving a traumatic experience and has been trying to avoid reminders of it. The onset of his problem occurred three weeks ago, after he was brutally assaulted and robbed. The therapist would most likely diagnose Ramon with which disorder?

A) acute stress disorder
B) posttraumatic stress disorder
C) generalized anxiety disorder
D) panic disorder

Question 14

Professor McLeod says, "Psychological factors can influence physical processes by producing physiological changes in the immune system. For hundreds of years, health care professionals have understood this connection between psychological and physical factors. However, psychological conditions cannot influence neural and biological systems. Additionally, a person's beliefs about the causes, symptoms, duration, and curability of a disease do not affect that person's willingness to seek treatment and follow through with it." Which part of Professor McLeod's statement is accurate ?

A) Psychological factors can influence physical processes by producing physiological changes in the immune system.
B) For hundreds of years, health care professionals have understood this connection between psychological and physical factors.
C) Psychological conditions cannot influence neural and biological systems.
D) A person's beliefs about the causes, symptoms, duration, and curability of a disease do not affect that person's willingness to seek treatment and follow through with it."

Question 15

DSM-5 places psychophysiological disorders into ____.

A) "Psychological Factors Affecting Other Medical Conditions"
B) Axis II
C) a separate class of disorder on Axis I
D) "General Psychological Factors Affecting Overall Health"

Question 16

Which individual has a psychophysiological disorder?

A) Carla, who complains of a loss of feeling but shows no signs of a medical condition to account for it
B) Wendy, who was diagnosed with an anxiety disorder
C) Brenda, whose migraine headaches began several days after a stressful life event
D) Hallie, whose medical condition is genetic

Question 17

Sandi is diagnosed as having two conditions: migraine headaches and hypertension. A mental health professional should consider her as suffering from ____.

A) a psychophysiological disorder (migraine) and a physical condition (hypertension)
B) two physical conditions that normally have little to do with psychological factors
C) a psychophysiological disorder (hypertension) and a conversion disorder (migraine)
D) two psychophysiological disorders

Question 18

Which of the following is not a recognized characteristic of psychophysiological disorders?

A) actual tissue damage
B) disease process
C) physical dysfunction
D) feelings of depression or anxiety

Question 19

A dominant theme in understanding the manifestation of stress is that _____.

A) negative stressors have greater impact on health than positive stressors
B) illness results from a complex interaction of biological, psychological, social, and sociocultural factors
C) the most important factor in the interaction between stress and health is interpretation of the situation
D) the more stress a person encounters, the more likely that person is to become ill

Question 20

Lifetime prevalence of posttraumatic stress disorder (PTSD) is highest among ____.

A) African Americans
B) Hispanic Americans
C) White Americans
D) Asian Americans

Question 21

What is now known as posttraumatic stress disorder (PTSD) was called ____ in World War I.

A) shell shock
B) soldier's heart
C) battle fatigue
D) postwar syndrome

Question 22

Which of the following is a risk factor for trauma survivors developing PTSD?

A) lack of social support
B) excessive control over one's actions and thoughts
C) above-average cognitive skills
D) low scores on neuroticism

Question 23

Which system in the human body maintains health by recognizing and destroying pathogens that produce disease?

A) the endocrine system
B) the hormonal system
C) the immune system
D) the central nervous system

Question 24

Drazen was in Bosnia during the civil war there. He has daytime flashbacks of the bombing and is emotionally numb, withdrawing from friends and family. Although he is much calmer than he was before the war, symptoms have lasted for several months. What about Drazen's case is unusual for a person with posttraumatic stress disorder (PTSD)?

A) It is unusual for people with PTSD to have flashbacks.
B) It is unusual for people with PTSD to withdraw from others.
C) It is unusual for people with PTSD to become calm.
D) It is unusual for people with PTSD to have symptoms longer than thirty days.

Question 25

In the study by Cohen and his colleagues (1998) on susceptibility to the cold virus, ____.

A) stress was not related to whether participants developed cold symptoms.
B) all of the subjects who became infected with the virus developed cold symptoms because they all suffered some level of stress.
C) only participants who suffered from acute stressful life events for less than a month developed cold symptoms.
D) the stressors most closely related to colds were long-term conflicts with family or friends and either unemployment or underemployment.

Question 26

Gina was driving on a bridge when it collapses over a river. Although she was not physically injured, she has to wait in her car for three hours before she is helped off the bridge. Which hormone is most likely to have been released to help her body deal with this dangerous and frightening situation?

A) thyroxin
B) testosterone
C) cortisol
D) estradiol

Question 27

During the experience of an overwhelming and traumatic stimulus, ____.

A) initial stress reactions of most individuals is normal
B) most individuals experience severe PTSD
C) most individuals develop ASD
D) most individuals engage in maladaptive appraisals of the trauma

Question 28

Which substance suppresses the immune system?

A) T-cells
B) cortisol
C) lymphocytes
D) phagocytes

Question 29

Mrs. Fujimori has been caring for her husband who has lung cancer. She reports feeling depressed and states she herself has become unusually susceptible to infections. One explanation is that the stress has weakened her immune system. Another is that she has ____.

A) a hardy personality
B) a Type A personality
C) many other emotionally supportive relationships
D) become more pessimistic

Question 30

Cortina and Kubiak (2006) found that ____.

A) women are more likely than men to experience stress because women are more likely to be exposed to violent interpersonal situations
B) men are more likely than women to experience stress because men are more likely to be exposed to violent interpersonal situations
C) women are more likely than men to experience stress because of women's physiological make up
D) men are more likely than women to experience stress because men are more violent than women

Question 31

What is the relationship between cognitive functioning and stress?

A) Stressors are not influenced by cognitive function, but do influence it.
B) Cognitive factors like perceived control can moderate the impact of stressors.
C) Higher cognitive functioning may serve as a vulnerability for developing PTSD.
D) Optimism tends to have a negative effect on cognitive function during stress.

Question 32

Which trauma survivor is at highest risk for developing PTSD?

A) Juana, who lost her daughter in an earthquake
B) Cynthia, who normally has a positive outlook
C) Sam, who does not have a support system in place
D) Samantha, who was raped by a man she did not know

Question 33

Suppose you were the director of a rape crisis center. What could you expect in terms of the frequency of posttraumatic stress disorder (PTSD) among the clients who come to your center immediately and at three months after a traumatic experience?

A) Because PTSD is delayed, no one would meet the criteria for PTSD at this time.
B) About 10 percent would meet the criteria for PTSD immediately; about 50 percent would suffer from PTSD at three months.
C) PTSD symptoms could be present immediately, but symptoms could go away for periods of time.
D) Because rape is quite common, there will be almost no cases of PTSD either immediately or three months after the assault.

Question 34

Which statement accurately describes the relationship between stress and health?

A) Stress reactions increase vulnerability to disease because the immune system is strengthened.
B) Stress reactions directly cause infections in the body.
C) Stress reactions occur after the immune system's strength has been decreased by other factors.
D) Stress reactions decrease the immune system's efficiency and thereby increase vulnerability to disease.

Question 35

It is suspected that the prevalence of ASD is underestimated because ____.

A) individuals with the symptoms may not seek treatment within the thirty-day period that defines the disorder
B) people who have it are too embarrassed to ask for help
C) it is not a well-recognized diagnosis
D) clinicians are more likely to diagnose PTSD than ASD for insurance purposes

Question 36

Mitchell, a Vietnam veteran, spends his therapy sessions describing the horrors of combat. His therapist has him recall all the details, focusing on the horrific events for extended periods of time. Mitchell's therapist is most likely using ____ to treat him for ____.

A) exposure; generalized anxiety disorder (GAD)
B) extinction; generalized anxiety disorder (GAD)
C) psychoeducation; posttraumatic stress disorder (PTSD)
D) exposure; posttraumatic stress disorder (PTSD)

Question 37

Stacey suffers from a psychophysiological disorder. Which statement about her condition is accurate ?

A) Psychological factors play an important role in her physical condition.
B) Her condition is psychological, not physical.
C) She most likely suffers from conversion disorder.
D) Medical treatment will provide the best outcome for her disorder.

Question 38

Rhonda has been diagnosed with PTSD after being beaten and raped by her ex-husband. She is discussing various treatment options with her therapist. Why might her therapist suggest cognitive-behavioral therapy rather than medication?

A) Medications only numb the emotions, they do not help with the problems.
B) The ability to express emotions and develop adaptive strategies will be more helpful.
C) Cognitive-behavior treatments are easier to deal with after this type of event.
D) Medications have not been found to be successful for treating PTSD.

Question 39

Which group of disorders involve actual physical conditions?

A) hypochondriasis
B) somatic disorders
C) psychophysiological disorders
D) anxiety disorders

Question 40

Stress produces physiological changes in the body. Part of the stress response involves ____ that can impair immune functioning.

A) high levels of T-cells
B) the release of hormones
C) high levels of B-cells
D) high levels of phagocytes

Question 41

Norman Cousins is credited with suggesting that immune functioning is increased by ____.

A) exercise
B) humor
C) self-efficacy
D) perception of control

Question 42

Which person would be diagnosed with hypertension?

A) Adele, whose blood pressure reading is 92/40
B) Bernard, whose blood pressure reading is 100/70
C) Carlysle, whose blood pressure reading is 120/70
D) Denny, whose blood pressure reading is 141/92

Question 43

Based on current knowledge about cancer, its prevalence, and factors related to its progression, which statement is accurate ?

A) Cancer is a specific disease with relatively clear diagnostic criteria.
B) The negative emotions of people who have received a diagnosis of cancer may be the result of the knowledge of their disease rather than their personality traits.
C) Because cancer generally develops quickly over a short period of time, it is possible to determine a temporal relationship between its occurrence and specific moods.
D) Retrospective studies allow researchers to determine whether emotions related to cancer came before or after the diagnosis.

Question 44

A friend of yours is taking care of an elderly aunt. The friend wants advice on how best to provide the care so that the aunt is both happy and healthy. Based on research, you should suggest that ____.

A) the aunt's activity level be increased beyond the range of which she thinks she is capable
B) your friend enable the aunt to have control in her daily life and make as many decisions as she can
C) your friend reduces to a minimum all decisions the aunt must make
D) the aunt be protected from all visitors and changes in her daily schedule

Question 45

Jill has a sense of control over her own life; she says she enjoys the challenge of change and is open to it. We would expect that Jill ____.

A) gets stressed out a lot
B) is happy and active
C) will burn out in the near future
D) does not have a good sense of reality

Question 46

Women with high job stress or who have a pessimistic outlook on life may have increased risk of ____.

A) breast cancer
B) fatal asthma attacks
C) classic migraine headaches
D) coronary heart disease

Question 47

A researcher interested in resolving the issue of whether emotional states play a causal role in cancer must answer which of the following questions?

A) Is Type A personality a consistent trait?
B) Are people at risk for cancer also at risk for coronary heart disease?
C) Does knowledge that one has cancer cause changes in emotional states, or vice versa?
D) Do we have enough retrospective data to make an unambiguous conclusion?

Question 48

The text presents the story of Vang Xiong, a Hmong refugee who almost succumbed to sudden death syndrome. What treatment appears to have helped his symptoms disappear?

A) A Hmong healer interpreted his problems as being caused by unhappy spirits and she performed ceremonies to release the spirits.
B) A psychiatrist prescribed SSRIs for his symptoms.
C) A psychoanalyst interpreted his symptoms as survivor's guilt, which helped him work through his problems.
D) A cognitive-behavioral therapist helped him deal with his problems through confrontational role playing and learning relaxation techniques.

Question 49

Harry works in a noisy manufacturing plant. According to research, his epinephrine levels and sense of anxiety will be higher if he ____.

A) hears the noise loud and clear
B) cannot hear the noise clearly
C) believes he cannot control the noise
D) believes he has a way of controlling the noise

Question 50

Dr. Frank is doing research on cancer. Rats are injected with cancer cells and then either given no electric shocks or shocks in two conditions: having control over stopping the shocks or having no control. What results should Dr. Frank expect?

A) The sickest groups should be those getting shocks.
B) The sickest group should be the "control shock" condition.
C) The sickest group should be the "no shock" controls.
D) The sickest group should be the "no control shock" condition.

Question 51

All of the following women are 50 years old and have similar health histories. Which of them is at highest risk of dying from coronary heart disease?

A) Naomi, who is always on the go
B) Nancy, who suffers from minor depression
C) Nina, who suffers from major depression
D) Nora, who suffers from dysthymia

Question 52

All of the following individuals have the same type of cancer and are currently at the same state of health, receiving the same type of treatment, at the same facility. Who is most likely to live longest?

A) Abby, who has high self-efficacy and is unrealistically optimistic
B) Bernie, who has high self-efficacy and a realistic acceptance of his condition
C) Carl, who has low self-efficacy, but is nonetheless optimistic
D) Doug, who has low self-efficacy and is pessimistic about his outcome

Question 53

Which condition leads to one out of every six deaths in the United States each year, and is also related to stress?

A) Cancer
B) Migraine headaches
C) Asthma
D) Coronary heart disease

Question 54

Bill, a high-powered executive, is rarely ill. Which characteristic would be most important for Bill's good health?

A) interpersonal abilities
B) genetic factors
C) sense of commitment and involvement of ongoing changes
D) the ability to delegate responsibility to others

Question 55

What is the most widely held opinion concerning the effect of mood and attitude on cancer treatment?

A) Mood and attitude have no impact on the course of cancer.
B) Mood and attitude influence the course of cancer only in females, not in males.
C) Research so far is unable to show conclusively that mood and attitude affect cancer treatment.
D) Positive moods have been shown to cause cancer remission.

Question 56

Tindle et al. (2009) research study of women demonstrated that women who scored high on optimism ____ in comparison to women who had hostile thoughts about others.

A) engage in physical exercise
B) has a lower risk of developing heart disease
C) have an increased sense of competence
D) have decreased stress levels

Question 57

Which statement about headaches is true?

A) People who suffer from headaches usually only suffer from one specific type.
B) Men experience headaches more often than women.
C) Negative emotions have been associated with the onset of headaches.
D) All three types of headaches have the same causes, although they manifest differently in different people.

Question 58

Which individual would be at highest risk for essential hypertension?

A) Ariela, an 80-year-old African American female
B) Botan, a 50-year-old Asian American female
C) Carlos, a 50-year-old Hispanic American male
D) Tzvi, a 35-year-old Middle Eastern male

Question 59

What role do genetic factors play with regard to blood pressure?

A) They play no known role.
B) They play only a minimal role.
C) They play a moderate role for females but not males.
D) They play an important role based on twin research.

Question 60

Based on research concerning control, personality, and stress-related illness, which person would be least likely to experience a weakened immune system?

A) Joe, who feels that his manager controls his work life
B) Jennifer, who feels little involvement in or commitment to her job
C) Jason, who is always optimistic and perceives that he has a lot of control over things in his life
D) Rochelle, who wants her job to remain the same forever

Question 61

Who is at highest risk for high blood pressure?

A) Marianne, an African American woman who has a strong social support system
B) Peter, a white male who has been involved in the civil rights movement since he was a child
C) Damon, an African American male who has experienced and accepted discrimination since he was a child
D) Diana, a white female who has been aware of the lower status of women in our culture since she was a child

Question 62

Which type of headaches are thought to be caused by prolonged contraction of the muscles in the scalp and neck?

A) migraine
B) tension
C) classic
D) cluster

Question 63

Who is most likely to suffer from migraine headaches?

A) Candice, a 24-year-old white female
B) Claudia, a 24-year-old African American female
C) Carl, a 24-year-old white male
D) Clayton, a 24-year-old African American male

Question 64

For most cases of hypertension, the cause is ____.

A) easily determined
B) not known
C) determined by a blood test
D) not associated with stress

Question 65

Blood pressure tends to be temporarily higher when people ____.

A) are Type B personalities
B) respond to stressors physiologically
C) are depressed and guilt-ridden
D) talk about their anger after cooling down

Question 66

Research on high blood pressure indicates that ____.

A) there is a much higher percentage of men with hypertension
B) there are higher prevalence rates for older women than older men
C) about one quarter of U.S. adults require treatment for hypertension
D) about 10% of U.S. adults are unaware of their hypertension

Question 67

Otto complains of excruciatingly painful headaches that are centered near one eye. His eye tears, and his nose is blocked when the headache occurs. From what kind of headache is Otto probably suffering?

A) cluster
B) common migraine
C) classic migraine
D) tension

Question 68

Racial differences in rates of ____ for women seem to be influenced by the availability of ____.

A) asthma; healthy diet
B) coronary heart disease; fibrinogen
C) hypertension; social support
D) migraine and other headaches; social support

Question 69

Who is most likely to suffer from migraines?

A) Sarah, a 25-year-old waitress with a high school education
B) Patricia, a 35-year-old psychology professor with a Ph.D.
C) Ziba, a 24-year-old secretary with a B.A.
D) Kent, a 50-year-old social worker with an MSW

Question 70

Which condition are associated with headaches?

A) positive emotions
B) strong odors
C) hypertension
D) asthma

Question 71

An individual who has hypertension is a person who ____.

A) is anxious or hostile most of the time
B) has heart disease because of blocked arteries
C) has blood pressure of 140 over 90 or higher
D) is subject to muscle spasms that have no physical basis

Question 72

Tanya experiences pulsating, intense pain in her head. Prior to these attacks, her vision is distorted or she feels numbness in her fingers. The headaches are caused by excessive dilation of blood vessels. Tanya can be diagnosed with ____.

A) migraine headache
B) cluster headache
C) common tension headache
D) stabbing headache

Question 73

Which individual is most likely to have high blood pressure?

A) Rebecca, a 45-year-old white woman
B) Randy, a 50-year-old Asian American male
C) Raul, an 80-year-old Mexican American male
D) Rosa, an 80-year-old African American woman

Question 74

Reduction of stress through relaxation appears to ____.

A) make no difference in the blood pressure of those with essential hypertension
B) increase arteriosclerosis in those with essential hypertension
C) significantly reduce headaches
D) increase blood pressure in those with essential hypertension

Question 75

Of the following, which group has the lowest prevalence of asthma?

A) Hispanic
B) Native American
C) African American
D) Asian

Question 76

What is the most common type of headache?

A) migraine
B) tension
C) cluster
D) stress

Question 77

Which type of headache results from constricting of the cranial arteries, followed by dilation of the cerebral blood vessels?

A) migraine
B) tension
C) cluster
D) intermittent

Question 78

Murray is a child with allergies who has respiratory attacks that make breathing very difficult. These attacks often occur at night and when his parents have had a fight. Murray is probably suffering from ____.

A) angina pectoris
B) asthma
C) essential hypertension
D) posttraumatic stress disorder

Question 79

Recent research suggests that severe migraine headaches may involve a ____.

A) structural change in brain
B) autonomic stress response
C) stimulus specificity
D) somatic weakness

Question 80

Dr. Kazinsky says, "Headaches are among the most common psychophysiological complaints. It is clear that there are three different forms of headache, each with its own cause. All headache pain is due to the contraction of the scalp and neck muscles, and in some cases stress plays a role." What portion of this statement is accurate ?

A) It is accurate to say that headache is among the most common complaints.
B) It is accurate to say that all headache pain is due to the contraction of the scalp and neck muscles.
C) It is accurate to say that pain can range from dull to excruciating.
D) It is accurate to say that stress plays a role in some headaches.