Deck 8: Stress and Physical Health

Question 1

Your teacher describes the following incident to the class: His teen-age daughter called home and tearfully described how she received a speeding ticket on her way to an amusement park. Her father tells her not to worry, that it was not a big deal. What is he suggesting that she do?

A) change her primary appraisal of the event
B) change her secondary appraisal of the event
C) grow up and accept responsibility for what she has done
D) recognize that her id has gotten the better of her at the moment

Answer 1

change her primary appraisal of the event

Question 2

How did the developers of the Social Readjustment Rating Scale measure the amount of stress caused by each of the items on the scale?

A) Each item was evaluated by a group of experts on stress and behavioral medicine.
B) They used the judgments of a large group of normal people who assigned the items life change units.
C) Scores were given to each item based on how much family members thought each event contributed to the death loved ones.
D) The items were weighted according to estimates from epidemiological research of how much each contributes to mortality.

Answer 2

They used the judgments of a large group of normal people who assigned the items life change units.

Question 3

The case of Bob Carter presented in your text is important because it shows

A) that Bob's lifestyle was to blame for his heart attack.
B) that stress and lifestyle are more important factors in heart attacks than genetic or physiological factors.
C) the enormous advances in medical treatment for patients who have suffered heart attacks.
D) that Bob would never have had a heart attack if he didn't smoke, eat a lot of red meat, and drink too much alcohol.

Answer 3

the enormous advances in medical treatment for patients who have suffered heart attacks.

Question 4

An expert on human physiology and stress responses is giving a public lecture this evening. He intends to review the history of the fight or flight response and to describe its effectiveness in ancient and modern times. What is a good title for this presentation?

A) "When an Adaptive Response Becomes Maladaptive"
B) "Fight or Flight: Major Physiological Changes Over Time"
C) "Slowly Eroding: Elements of the Stress Response Lost to Evolution Over Time"
D) "How Speed, Toxins, and Pollution are Destroying the Fight or Flight Response"

Question 5

Which of the following problems is LEAST likely to be addressed in a behavioral medicine clinic?

A) a man with diabetes has a poor diet
B) an elderly woman mourns her husband
C) a heart patient wants to stop smoking
D) a child refuses to wear orthopaedic braces

Question 6

What is a psychosomatic illness?

A) an imaginary physical disorder
B) a fictitious psychological disorder
C) a psychological, not physical illness
D) a real physical illness involving both mind and body

Question 7

According to Richard Lazarus, what is the role of cognition in stress?

A) life events are stressors only when perceived as distressing
B) life events can be stressors even when not perceived as distressing
C) distress is an automatic cognitive reaction, independent of physiological reactions
D) distress is an automatic physiological reaction, independent of cognitive reactions

Question 8

Stress can include

A) only minor hassles.
B) only major events.
C) both minor hassles and major events.
D) only severe traumas.

Question 9

Walter Cannon believed that how we respond to stress has had obvious value for survival over the course of evolution, and with this in mind he emphasized the importance of the

A) appraisal or prevention response.
B) activation or inhibition response.
C) fight or flight response.
D) primary or secondary response.

Question 10

At work a group of coworkers is discussing psychosomatic disorders. Which of them has the best understanding of the term?

A) Hank, who says, "These disorders are not as bad as real physical illnesses."
B) Anna, who says, "The mind and the body sometimes work together to produce a disease."
C) Sal, who says, "I don't know why anyone would want to consciously create the symptoms of a disease."
D) Ann, who says, "If you have one of these disorders you have nothing to worry about, it is only in your head."

Question 11

Which of the following is an example of why some researchers object to instruments such as the Social Readjustment Rating Scale?

A) a stressor rarely has a physiological effects
B) a stressor can have different meanings for different people
C) a stressor doesn't necessarily cause immediate life changes
D) a stressor doesn't necessarily affect social relationships

Question 12

Imagine you have flunked a class. You have evaluated this situation and decided that flunking is stressful and important enough to be upset about, but you realize that you have the option to repeat the class in summer school. The realization is an example of

A) primary appraisal.
B) primary prevention.
C) secondary appraisal.
D) secondary prevention.

Question 13

How do contemporary theories of the relationship of stress and illness view the influence of stress?

A) Stress affects physical not psychological health.
B) Stress affects psychological but not physical health.
C) Stress is influential in a limited number of diseases, such as ulcers.
D) Stress plays a role in the onset or exacerbation of all physical illnesses, from a cold to AIDS.

Question 14

Activation of which bodily system is responsible for the fight or flight response?

A) somatic system
B) central nervous system
C) sympathetic nervous system
D) parasympathetic nervous system

Question 15

In what way do contemporary researchers' views on psychosomatic illness differ from views held earlier?

A) They now believe in the specificity hypothesis.
B) They now believe that all physical illnesses can have psychological components.
C) They now believe that only certain physical illnesses have psychological components.
D) They now believe that depression is the primary cause of most of these types of illness.

Question 16

What multidisciplinary field includes both medical and mental health professionals who investigate psychological factors in the symptoms, etiology, and treatment of physical illness and chronic disease?

A) wellness
B) psychophysiology
C) behavioral medicine
D) psychosomatic medicine

Question 17

Which of the following characterizes one of the observations that Canon had about the fight or flight response?

A) seen in animals but not in humans
B) maladaptive to modern day stress
C) most adaptive in the face of social danger
D) most adaptive in the face of psychological stressors

Question 18

Evidence indicates that learning more adaptive ways of coping can limit the recurrence or improve the course of many physical illnesses by

A) changing the amount of stress we face.
B) strengthening the body's immune system.
C) diminishing the burden of stress.
D) making it more likely that the illnesses will be correctly diagnosed.

Question 19

According to the conceptualization of stress used in the Social Readjustment Rating Scale, how would an outstanding personal achievement be viewed?

A) a stressful event
B) a counterbalance for stress in other areas
C) counted as stressful if it affects personal relationships
D) counted as stressful if it is unexpected, but not if expected

Question 20

What broad definition of stress has been offered by scientists?

A) a subtype of mental disorder that emphasizes physiological symptoms
B) a challenging event that requires behavioral, cognitive, and physiological adaptation
C) a set of specific symptoms that are associated with increased risk for mental disorders
D) an evolutionary development that has enabled humans to adapt to rapid technological changes

Question 21

After reading Hans Selye's work on the concept of stress, you are required to summarize his general views. What did he call his concept of the physiological effects of stress over time?

A) stress syndrome
B) general adaptation syndrome
C) psychoneuroimmunology
D) general distress response

Question 22

What is emotion-focused coping?

A) an attempt to change a stressor
B) an attempt to alter internal distress
C) an attempt to cause others to change their emotional responses
D) an attempt to change physiological responses directly in order to alter emotions indirectly

Question 23

How could we describe the resistance stage of the general adaptation syndrome?

A) a period of physiological activation
B) a period of physiological replenishment
C) the individual's active decision to combat stress
D) a period when the individual is least susceptible to stress

Question 24

What are the stages of the general adaptation syndrome (GAS)?

A) alertness, fight, flight
B) alarm, resistance, exhaustion
C) general arousal, adaptation, homeostasis
D) emergency response, general arousal, specific arousal

Question 25

Health psychologists had newly married couples engage in a 30-minute discussion of marital problems. What did they find when they compared couples who were more hostile and negative with those who had more positive conversations?

A) Hostile interactions were associated with immunosuppression.
B) Hostile interactions led to a higher rate of colds over the next month.
C) Although hostile interactions raised blood pressure, it quickly returned to normal.
D) The type of interaction had no demonstrated effect on any aspect of immune system functioning.

Question 26

Which of the following describes the process by which stress is thought to impair immune functioning?

A) adrenal hormones inhibit T-cells
B) T-cells inhibit adrenal hormones
C) T-cells increase adrenal hormones
D) adrenal hormones increase T-cells

Question 27

What are lymphocytes?

A) a type of white blood cell that fights antigens
B) a category of stress hormones that are released during the fight or flight response
C) a type of neuromodulator released in response in high levels of chronic stress
D) a category of bacteria that invades the body when we are under a great deal of stress

Question 28

Which of the following are likely to occur during the fight or flight response?

A) increased respiration, blood pressure rises, pupils dilate
B) pupils constrict, blood pressure increases, heart rate increases
C) blood sugar levels decrease, blood pressure rises, pupils dilate
D) blood flow redirected for muscular activity, increased respiration, blood pressure decreases

Question 29

According to Hans Selye, what is the mechanism through which stress causes physical illness?

A) exhaustion
B) alarm stage
C) resistance stage
D) emergency response

Question 30

When a perceived threat is registered in the brain's cortex, it sends a signal to the part of the brain responsible for activating the stress response known as the

A) cingulate.
B) amygdala.
C) hippocampus.
D) CRF.

Question 31

What do we call substances such as bacteria that invade the body?

A) antigens
B) allergens
C) immuno-agents
D) anti-fectious agents

Question 32

Andy is dealing with a situation over which he really has no control and which has no real solution; nonetheless, he still insists on trying to solve it. In this instance, his problem-focused coping will probably

A) reduce his distress anyway.
B) increase, not reduce, his distress.
C) provide him with an outlet for his frustration.
D) make him tougher and more able to deal with future problems.

Question 33

Which of these is the best analogy of Walter Cannon's theory of chronic stress?

A) a car has run out of gas and is damaged because stress keeps turning the key
B) a car in which the engine continues to race instead of idling down after running fast
C) the car has enough gas but the fuel line is clogged and no fuel is getting to the engine
D) there is an electrical short in the ignition system that is making it impossible to start the car

Question 34

What is the body's major defense against "foreign invaders" such as bacteria or viruses?

A) immune system
B) pituitary gland
C) circulatory system
D) central nervous system

Question 35

What is the most important distinction in types of coping that Lazarus and Folkman identified?

A) nonspecific vs. specific
B) emergency vs. resistance
C) adaptive vs. maladaptive
D) problem-focused vs. emotion-focused

Question 36

Which of the following represents a project that a researcher in psychoneuroimmunology might undertake?

A) using brain scans to estimate brain dopamine levels
B) measuring the number of T-cells in individuals exposed to loud noise
C) counting the number of stressors that college students encounter during registration
D) evaluating ways to reduce stress by training individuals to use the relaxation response

Question 37

Which best describes the current thinking about the stress response and the immune system?

A) Short term stressors enhance the immune responses that are quick, while chronic stressors create immunosuppression.
B) Chronic stressors enhance the immune responses that are long term, but short term stressors crate immunosuppression.
C) Neither chronic nor short term stressors impair the immune system.
D) Both chronic and short term stressors impair the immune system.

Question 38

Which of the following is known as the "stress hormone"?

A) adrenalin
B) epinephrine
C) cortisol
D) norepinephrine

Question 39

Which of the following is the best analogy of Han Selye's theory of chronic stress?

A) a car has run out of gas and is damaged because stress keeps turning the key
B) a car in which the engine continues to race instead of idling down after running fast
C) the car has enough gas but the fuel line is clogged and no fuel is getting to the engine
D) there is an electrical short in the ignition system that is making it impossible to start the car

Question 40

Earl works in an office where his office mate smokes. This irritates and frustrates Earl. Which of the following behaviors is an example of problem-focused coping?

A) putting in a filter and opening a window
B) trying to see the office mate's point of view
C) using relaxation techniques to feel less frustrated
D) thinking about the problem so much it interferes with work

Question 41

Optimism can have an influence on health because optimists

A) experience less cardiovascular reactivity.
B) are better able to deny their distress.
C) experience fewer stressors.
D) have a more effective coping style.

Question 42

What are the two critical issues in cognitive responses to stress?

A) alarm and exhaustion
B) control and predictability
C) disclosure and anticipation
D) specificity and nonspecificity

Question 43

Control can actually increase stress when it is

A) illusory.
B) not predictable.
C) perceived but attempts fail.
D) perceived and can be exercised.

Question 44

A study of Latinos with arthritis found that their religion

A) discouraged their use of medical treatments.
B) had no benefit for their medical problems.
C) encouraged passive coping.
D) encouraged active coping.

Question 45

Stress can indirectly affect our health and contribute to illness by leading people to

A) engage in more unhealthy activities.
B) exercise in excessive and risky ways.
C) seek out unnecessary medical treatment.
D) engage in more primitive fight-flight responses.

Question 46

Shana is under a lot of stress but she is not acknowledging any anxiety and seems to be repressing unpleasant emotions. Evidence suggests that as a result Shana will probably

A) develop a dissociative disorder.
B) develop an anxiety disorder.
C) experience heightened psychophysiological reactions to stress.
D) strengthen her positive outlook and maintain good health.

Question 47

Which of the following is an example of how stress may cause illness indirectly?

A) Stress tends to lead to premature nerve cell death.
B) The hormones released during stress are the actual cause of illness, not the stress itself.
C) People under a great deal of stress are less likely to engage in actions that promote good health.
D) The mind of a stressed person is racing so fast that it burns energy that could be used for other purposes.

Question 48

Research studies have shown that when people are encouraged to recount very stressful experiences, they show

A) increased physiological distress.
B) increased psychological distress.
C) reductions in psychophysiological stress indicators.
D) increases in psychophysiological stress indicators.

Question 49

Which of the following would be a good title for an article in a health journal that reviews the relationship between optimism and health?

A) "Optimism: Much Ado about Nothing"
B) "Optimism: A Road to Good Health"
C) "Unexpected Finding: Pessimists Outlive Optimists"
D) "Optimism Can Cure Heart Disease"

Question 50

In the past year, Alice's mother and two friends died. Because she has been laid off several times, Alice has moved and currently lives in an unsafe neighborhood. The medical clinic has diagnosed her as hypertensive. They have put her on medication and also referred her to a therapist at the mental health clinic. After an assessment at the clinic, the psychologist's diagnosis should contain entries on which DSM axes?

A) I and II
B) I, IV and V
C) III and IV
D) II and III

Question 51

Positive psychologists define the ability to cope well with life's challenges, even stressful ones, as

A) immunosupport.
B) resilience.
C) self actualization.
D) very rare.

Question 52

As an influence on health, social support

A) can encourage positive health behavior.
B) can create more adaptive immune system functioning.
C) can encourage positive health behavior and can create more adaptive immune system functioning.
D) can encourage positive health behavior but will tend to weaken immune system functioning.

Question 53

To understand the relationship between stress and health, it is important to realize that

A) only certain types of stress can affect health.
B) only chronic stress can affect health.
C) stress can affect health and health problems can create stress.
D) DSM-IV-TR does not include any health-related factors in its classification system.

Question 54

What are the major reasons that account for improved health and increased life expectancy over the last two centuries?

A) improved personal hygiene and an adequate diet
B) stress management programs and exercise programs
C) Web-based medical information programs and social support networks
D) discovery of antibiotics and development of new surgical techniques

Question 55

In a study of stress, what is the effect of a signal given before a rat is shocked?

A) The anticipation leaves the rat in a chronically stressed state.
B) The anticipation is more stressful than if there were no warning.
C) The signal gives the rat a sense of a lack of control over the stressor.
D) The anticipatory response is stressful, but weaker than if there were no warning.

Question 56

What percentage of patients fail to fully adhere to medical advice?

A) less than 10 percent
B) 25 percent
C) 50 percent
D) over 90 percent

Question 57

Why were ratings of the amount of stress in earlier versions of DSM abandoned in DSM-IV?

A) The ratings were not reliable.
B) The list of possible stressors was too long.
C) The guidelines for ratings were too detailed.
D) The number of stressors is more important than the severity.

Question 58

While walking through an abandoned area of town, you hear a deafening alarm sounding from an empty warehouse. Under which condition is this situation hypothesized to be most stressful?

A) you know there is nothing you can do to stop the alarm
B) you use emotion-focused coping before problem-focused coping
C) you use problem-focused coping before emotion-focused coping
D) you think you could stop the alarm if you could reach it, but you can't reach it

Question 59

The DSM-IV-TR does not distinguish "____________ disorders" from other physical illnesses.

A) personality
B) stress
C) psychosomatic
D) hypochondriacally

Question 60

Consider a study in which two different groups of rats are being exposed to exactly the same amount of painful shock. One group is able to stop the shock by pressing a bar, while the other group can do nothing to stop the shock. What would you expect to happen to their stress response?

A) The rats that have control will have a larger stress response.
B) The rats that have control will have a smaller stress response.
C) There will be no difference in stress response because the shock is equally painful for both groups.
D) The painful electric shock will prevent the rats from being able to learn to press the bar.

Question 61

Psychologists have used a variety of techniques to treat pain; these techniques include hypnosis, biofeedback, relaxation training, and cognitive therapy. What has research demonstrated concerning the effectiveness of these treatments for pain?

A) None of the techniques has any notable effect.
B) Cognitive therapy is the most effective treatment.
C) All the techniques reduce pain, but only modestly.
D) The combination of cognitive therapy and relaxation training has led to high rates of success.

Question 62

Your instructor asks one of the students to look up AIDS in a medical textbook. What chapter should the student read to obtain the needed information?

A) immune system
B) nervous system
C) respiratory system
D) circulatory system

Question 63

To a health psychologist, what interesting observation can be made when you compare the top 10 causes of death in the United States in 1900 and 2000?

A) The leading causes of death today are lifestyle diseases.
B) Infectious diseases continue to be the major causes.
C) There has been little change over almost 100 years.
D) Homicide and suicide cause almost as many deaths as cancer.

Question 64

What are the two major categories of sleep disorders in DSM?

A) dyssomnias and parasomnias
B) hypersomnia and hyposomnia
C) circadian rhythm disorders and REM disorders
D) sleep onset disorders and sleep maintenance disorders

Question 65

Which types of laboratory rats are least likely to reject the start of cancerous tumors?

A) those exposed to shock that they have to figure out how to escape from
B) those exposed to the stress of inescapable shock
C) those who observe siblings exposed to shock
D) those who have no experience of shock

Question 66

Transmission of HIV always involves contact with

A) bodily fluids.
B) dirty needles.
C) sexual secretions.
D) sexual partners.

Question 67

Which of the following has been linked directly to an increase in the rate of progression of HIV?

A) SES
B) age of onset
C) sexual preference of patient
D) stress

Question 68

Why is hypertension often called the silent killer?

A) It has a strong genetic link.
B) It produces no obvious symptoms.
C) It is not currently a focus of research efforts.
D) It results from the use of convenience foods and reliance on modern conveniences that reduce opportunities for exercise.

Question 69

Mary just experienced a nightmare and Alice experienced a sleep terror. What is one way to distinguish what these two people experienced?

A) Alice had no memory of the events.
B) Mary was sleepwalking during the episode.
C) Mary had a higher rate of arousal during the nightmare.
D) Alice experienced insomnia at the beginning of the night.

Question 70

Jane has been diagnosed as suffering from cancer; her prognosis is not good and she needs to decide about her treatment. One of the options that she is considering joining a support group. What does the evidence suggest about these groups?

A) Cancer does not respond to such treatments.
B) Although the mechanisms are not clear, such groups are associated with lower death rates.
C) Such self-help groups have developed in order to prepare people to die with greater dignity.
D) The social support that such groups provide has a positive effect on psychological well-being, but no documented effect on physical aspects of cancer.

Question 71

Research indicates that psychological interventions, such as support groups for people with HIV/AIDS

A) have significantly lowered the death rate.
B) do not necessarily have any physical benefit but can lower distress.
C) have been effective only for some groups within the population.
D) lead people to put less emphasis on taking appropriate preventive measures.

Question 72

In the United States in the early 20th century the most common forms of disease were

A) stress related diseases.
B) life style related diseases.
C) infectious diseases.
D) cancers.

Question 73

What is the leading cause of death in the United States?

A) cancer
B) violence
C) accidents
D) heart disease

Question 74

Which group has the highest rate of new cases of HIV infection in the United States?

A) individuals who participate in high-risk heterosexual sexual intercourse
B) homosexual women who engage in high risk homosexual intercourse
C) heterosexual males in general
D) IV drug users

Question 75

A patient being prepared to sleep in the sleep laboratory is believed to suffer from sleep apnea. You have been given permission to observe this evening. What do you expect to observe?

A) loud snoring, gasping, and body movements
B) loud screams, heightened arousal, and violent outbursts
C) difficulty getting to sleep, strong leg movements, and screaming
D) rigid body posture during sleep, punctuated by episodes of heightened physiological arousal

Question 76

Researchers have discovered an association between depression/anxiety and pain. How do they explain this association?

A) People who are prone to anxiety and depression have lower levels of endogenous opioids.
B) Anxious and depressed people are more sensitive to pain and less able to cope with it.
C) Anxious and depressed people are more likely to become involved in accidents as a result of high levels of distractibility.
D) People who are anxious and/or depressed have learned that reporting pain symptoms is a prime means of gaining attention from friends and relatives.

Question 77

At the start of the 21st century the most common forms of disease in the United States were

A) lifestyle diseases.
B) infectious diseases.
C) cancers.
D) drug addiction diseases.

Question 78

Your text devotes considerable coverage to cardiovascular disease (CVD) because

A) it is the disease most subject to psychological influences.
B) it is the number one killer in the United States today.
C) it is more easily studied than other diseases.
D) people are more willing to seek help for CVD than for other diseases.

Question 79

Rebecca is suffering from recurrent chronic pain; she is referred to a psychologist who talks in terms of pain management. What can Rebecca expect when the psychologist begins treatment?

A) hypnosis will be used to help the client forget about the pain
B) efforts to help her cope in ways that minimize the pain's impact on her life
C) a psychoanalytic approach will delve into the unconscious roots of the pain
D) a variety of drugs will be mixed to reduce the pain to the lowest level possible, without causing severe side effects

Question 80

Your uncle returns home after visiting a sleep clinic. He says the sleep specialists diagnosed him as suffering from narcolepsy. Which of the following sets of symptoms probably led to his decision to seek an evaluation at the sleep clinic?

A) loud snoring and violent leg movements during sleep
B) early morning waking and an inability to get back to sleep
C) irresistible sleep attacks and sudden loss of muscle tone for brief period of time
D) inability to breathe and sleep at the same time and difficulty getting to sleep