Deck 7: Psychological Factors Affecting Medical Conditions

Question 1

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

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

Answer 1

psychosomatic medicine.

Question 2

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

Answer 2

George Engel

Question 3

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

Answer 3

autonomic nervous system; endocrine system; immune system

Question 4

The difference between a sign and a symptom is

A) one refers to a lesion and the other a level of functioning.
B) one is a mainly objective and the other a mainly subjective indication of illness.
C) one refers to a psychological condition and one a medical condition.
D) one is an antecedent and one is a consequence of illness.
E) neither are directly observable.

Question 5

Illness is defined by _________ which are____________ whereas disease is defined by ____________ that are _________________.

A) signs; subjective reports of internal states; symptoms; objective indications of a specific process
B) symptoms; subjective reports of internal states; symptoms; objective indications of a process
C) signs; subjective reports of internal states; signs; objective indications of a process
D) signs; subjective reports of internal states; symptoms; objective indication of a process
E) symptoms; subjective reports of internal states; signs; objective indications of a specific process

Question 6

A mechanism is

A) something which 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.

Question 7

__________ 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 8

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 9

The DSM-5 workgroup is considering

A) eliminating Axis 3.
B) listing all "medical" and psychological disorders on one axis.
C) eliminating Axis 2.
D) listing diagnoses in a manner similar to ICD-10 does.
E) All of the above are correct.

Question 10

A medical condition may be noted on which axis of the DSM-IV-TR?

A) III
B) V
C) II
D) I
E) IV

Question 11

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 new unique to western culture but accepted elsewhere.
D) has a long history in western culture but is unique to western culture.
E) has a long history in western culture and may be even more deeply embedded in other cultures.

Question 12

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 arrythmias due to genetic illness

Question 13

A specific code meaning "a psychological factor affecting medical condition" may be found on Axis I under

A) "Health and psychological factors and illness."
B) "Psychosomatic disturbances."
C) "Psychophysiological and neurological challenges."
D) "Psychogenic medical disorders."
E) "Other conditions that may be a focus of clinical attention."

Question 14

The psychoanalyst Franz Alexander (1950) argued that the roots of psychosomatic disorders

A) lay in an imbalance of bodily humours.
B) stemmed from an overassertive super-ego.
C) were found in interpersonal stressors.
D) were unrelated to intrapsychic forces.
E) stemmed from characteristic intrapersonal conflict.

Question 15

When a sign involves the specific disruption of bodily tissue or normal function of a bodily system, these disruptions are called

A) lesions.
B) ulcers.
C) mechanisms.
D) symptoms.
E) challenges.

Question 16

Helen Flanders Dunbar (1935) suggested that

A) psychosomatic disorders are caused by true medical conditions.
B) the roots of classic psychosomatic disorders lay in interpersonal conflict.
C) intrapsychic forces could lead to abnormal brain states and consequently ulcers.
D) people with a chronic sense of rage suffered from high blood pressure.
E) specific disorders were the natural consequence of emotions and personality traits.

Question 17

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 18

If the clinician believes that a psychological factor is affecting a medical condition, s/he indicates this by

A) listing the factor on Axis 3.
B) listing the condition on Axis 3.
C) placing a specific code on Axis 1.
D) placing a specific code on Axis 3.
E) placing the factor and the condition on Axis 1.

Question 19

"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 20

Somatoform disorders involve psychological processes that give rise to apparently physical symptoms without medical basis; psychophysiological disorders, 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 21

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 22

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 23

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

Question 24

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 25

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 26

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 27

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.

Question 28

__________ control over stressful events is sufficient to reduce their harmful effects.

A) Perceived
B) Direct
C) Physical
D) Internal
E) Emotional

Question 29

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 30

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 31

Adrenocorticotrophic 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 32

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 33

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 34

The process of engulfing and digesting invading organisms is called

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

Question 35

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 36

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 37

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 38

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

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

Question 39

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 40

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

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

Question 41

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 42

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 43

Cardiovascular reactivity refers to

A) the relationship between cardiovascular function and arherosclerosis.
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 44

The psychosocial vulnerability model suggests that hostile people

A) are innately predisposed to illness.
B) experience a more demanding interpersonal life than 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 45

An example of a job rated as high in decision control and low in psychological demand is

A) forester.
B) waiter/waitress.
C) janitor.
D) truck driver.
E) secretary.

Question 46

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 47

A study on controllability by Weiss (1971) discovered that

A) rats who could control the stressor suffered the same level of ulceration as rats who could not control the stressor.
B) rats who 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 who could exercise control over the stressor suffered milder ulceration than rats who could not control the stressor.
E) rats who could control the stressor had higher levels of ulceration than those who could not control the stressor.

Question 48

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 49

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 50

In a study conducted employing cold viruses, Cohen, Tyrrell, and Smith (1993) discovered that subjects 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 51

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 52

A study on predictability conducted by Weiss (1970) discovered a relationship between

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 and unshocked 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 unshocked rats.

Question 53

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

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

Question 54

Individuals with an internal locus of control typically believe themselves

A) to be masters of their own destiny.
B) to be more stressed by events than other people.
C) to have little control over social situations.
D) to be buffeted by the random events in the world.
E) to be less healthy than those with an external locus of control.

Question 55

Frasure-Smith, Lesperance, 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 56

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

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

Question 57

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 58

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 59

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 60

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 61

A DSM-5 workgroup recommends placing all disorders on Axis 1, eliminating the distinction between psychological and medical disorders in psychiatry.

Question 62

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

A) never be as effective as drug treatment.
B) actually worse a patient's condition when standard prescription drugs were 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 63

There is considerable evidence that experience or expression of anger plays a role in heart disease.

Question 64

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

Question 65

A sign is a unmeasurable subjective experience of illness.

Question 66

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

Question 67

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 68

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

Question 69

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

Question 70

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

Question 71

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

Question 72

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

Question 73

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 74

People sometimes mistakenly use the term psychosomatic disorders to refer to illnesses more properly called somatoform disorders.

Question 75

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

Question 76

A lesion is a symptom of a physical illness.

Question 77

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 78

ACTH is secreted by the pineal gland.

Question 79

Health psychology refers to using psychological methods to mental illnesses that have physical consequences.

Question 80

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