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4. Stress-Related Disorders Multiple-Choice Questions 1. A psychologist who is studying the effects of stress on physical health is most likely a ______. A. health psychologist B. evolutionary psychologist C. positive psychologist D. psychiatrist Answer: A 2. Psychologists who study the interrelationships between psychological factors and physical well-being are called ______. A. positive psychologists B. evolutionary psychologists C. health psychologists D. psychoneuroimmunologists Answer: C 3. Which of the following refers to a pressure or demand that is placed on an organism to adapt? A. Eustress B. Immunological challenge C. Situational stimulus D. stress Answer: D 4. The term _________ refers to a state of physical or mental pain or suffering. A. mourning B. eustress C. distress D. stress Answer: C 5. The term used to describe something that is a source of stress is ______. A. an antigen B. a stressor C. an antagonist D. an initiating event Answer: B 6. Jody is suffering from severe tension headaches and anxiety due to an extremely overwhelming schedule. The most precise term for Jody’s physical and emotional reaction is ______. A. eustress B. distress C. stress D. stressors Answer: B 7. According to a recent nationwide study by the American Psychological Association, _______ percent of Americans polled reported that their level of stress had increased during the preceding five years (American Psychological Association, 2007a, 2007b, 2010). A. 18 B. 50 C. 68 D. 93 Answer: B 8. The field of ______ studies the relationship between stress and the workings of the immune system. A. psych endocrinology B. neuropsychology C. psychoneuroimmunology D. psychopathology Answer: C 9. Which bodily system that releases hormones plays a key role in the physical reaction to stress? A. endocrine B. excretory C. circulatory D. musculoskeletal Answer: A 10. The ______ system is a system of ductless glands that secrete hormones directly into the bloodstream. A. immune B. cardiovascular C. endocrine D. respiratory Answer: C 11. The endocrine glands release ______ directly into the bloodstream. A. acetylcholine B. antibodies C. antigens D. hormones Answer: D 12. During the stress response, the hypothalamus releases a hormone that stimulates the nearby pituitary gland to secrete ___________. A. human growth hormone B. testosterone C. adrenocorticotrophic hormone (ACTH) D. cortisol Answer: C 13. Cortisol and cortisone are ______. A. leukocytes B. components of haemoglobin C. androgens D. corticosteroids Answer: D 14. When you are under stress, the ______ releases a hormone that arouses the pituitary gland to release adrenocorticotrophic hormone, or ACTH. A. adrenal medulla B. hypothalamus C. kidney D. adrenal gland Answer: B 15. Hormones that boost resistance to stress, foster muscle development, induce the liver to release sugar, and help the body defend against allergic reactions and inflammation are ______. A. cortical steroids B. epinephrines C. norepinephrines D. acetylcholines Answer: A 16. Adrenaline is synonymous with ______. A. cortisol B. cortisone C. ACTH D. epinephrine Answer: D 17. Which branch of the autonomic nervous system is aroused to deal with threat? A. voluntary B. sympathetic C. parasympathetic D. involuntary Answer: B 18. Which statement is most accurate about the relationship of stress and health? A. Prolonged stress can damage multiple bodily systems. B. The immune system is the only bodily system affected by prolonged stress. C. Short-term significant stress is just as damaging as longer term stress. D. Stress can lead to emotional problems and indirectly to health problems but does not directly lead to health problems. Answer: A 19. The ______ system is the body’s system of defense against disease. A. autonomic B. nervous C. immune D. respiratory Answer: C 20. The body’s foot soldiers in the fight against disease are known as ______. A. antigens B. microbes C. leukocytes D. red blood cells Answer: C 21. Leukocytes are ______. A. white blood cells B. red blood cells C. viruses D. bacteria Answer: A 22. Which of the following is a pathogen? A. white blood cells B. leukocytes C. worn-out body cells D. corticosteroids Answer: B 23. Surface fragments on pathogens that cause leukocytes to produce antibodies to destroy them are called ______. A. antigens B. lymphocytes C. endocrines D. platelets Answer: A 24. Leukocytes recognize invading pathogens by their ____________. A. sickle shape B. protein transport C. surface fragments D. ability to attach to red blood cells Answer: C 25. A lymphocyte is a type of ______. A. pathogen B. leukocyte C. platelet D. antigen Answer: B 26. _________ are a special type of “reserve” lymphocyte that can remain in the bloodstream for years and form the basis for a quick immune response to an invader the second time around. A. Reserve lymphocytes B. Antigens C. Memory lymphocytes D. Antibodies Answer: C 27. Barbara has continuous colds during the winter. A psychoneuroimmunologist would contend that Barbara ______. A. has not been keeping herself warm enough B. has not been absorbing enough Vitamin C and sunshine C. has been too relaxed to activate her stress-combating white blood cells D. may have a weakened immune system due to prolonged stress Answer: D 28. Which of the following statements is true? A. Occasional mild stress actually strengthens the body’s immune system. B. Persistent exposure to stress improves the effectiveness of memory lymphocytes. C. Exposure to stress reduces symptoms associated with the body’s reaction to allergens. D. Even relatively brief periods of stress can weaken the body’s immune system. Answer: C 29. Scientists recently discovered that chronic stress increases levels of ______, which may contribute to the physical health problems associated with psychological stress. A. inflammation B. immune system functioning C. hair growth D. positive moods Answer: A 30. Prolonged stress has been linked to ____________, which may contribute to asthma, arthritis, and cardiovascular disease. A. inflammation B. ovulation C. increased immune system functioning D. leukocyte production Answer: A 31. The harmful effects of stress on the immune system may be moderated by ______. A. living alone B. work that keeps you very busy C. travel D. social support Answer: D 32. Lance is a dental student who studies hard in his single-person studio apartment. He has not developed any friendships in dental school. He has gotten numerous colds. Which recommendation would most likely help Lance to protect his immune system? A. develop friendships B. cut down on studying C. move to a larger apartment D. drop out of dental school Answer: A 33. Much of the research in the field of psychoneuroimmunology is ______. A. experimental B. based on case studies C. correlational D. anecdotal Answer: C 34. Recent research suggests that aside from social support, ______ may boost psychological and physical well-being. A. writing about stressful events B. taking regular vacations C. moving to a rural area D. breaking up unhealthy relationships Answer: A 35. Why is terrorism-related trauma a source of chronic stress? A. Terrorism is most likely never to occur again. B. Terrorism looms as a constant threat to our safety. C. Most people don’t worry about terrorism. D. The likelihood of an act of terrorism to occur again is very small. Answer: B 36. Evidence gathered since the 9/11 attack showed which of the following helped buffer the effects of stress? A. living near a military base B. experiencing positive emotions C. spending a great deal of time watching coverage of the events on TV D. avoiding others and cutting off social ties Answer: B 37. In more than ______ percent of households in New York City, parents reported that their children were upset by the attacks of 9/11. A. 40 B. 60 C. 75 D. 90 Answer: B 38. The general adaptation syndrome is based on the work of ______. A. Lawrence Frank B. Peter Kubiovsky C. Oliver Sacks D. Hans Selye Answer: D 39. The body’s three-stage physiological reaction to stress is called the ______. A. Stockholm syndrome B. phi phenomenon C. general adaptation syndrome D. Korsakoff syndrome Answer: C 40. Selye figured out that our body responds _________ to various kinds of unpleasant stressors. A. in a similar manner B. in different response patterns C. with varying degrees of intensity D. in consistently different Answer: A 41. The alarm reaction mobilizes the body for ______. A. defense B. illness C. threat D. invasion Answer: A 42. The alarm reaction is initiated by the brain and the ______. A. central nervous system B. parasympathetic nervous system C. voluntary nervous system D. sympathetic nervous system Answer: D 43. The “fight-or-flight” response pattern was first described by ______. A. Clifford Beers B. William James C. Wilhelm Wundt D. Walter Cannon Answer: D 44. The “fight-or-flight” reaction characterizes the ______ stage of the general adaptation syndrome. A. alarm reaction B. anxiety C. resistance D. exhaustion Answer: A 45. During the alarm reaction stage, the ______ pump(s) out stress hormones. A. thalamus B. parietal lobe C. adrenal glands D. circulatory system Answer: C 46. Which of the following changes in the body occurs during the alarm reaction stage of Selye’s General Adaptation Syndrome? A. corticosteroids are released B. muscles relax C. heart rate decreases D. respiration decreases Answer: A 47. During the alarm reaction stage of Selye’s GAS, which of the following changes in the body occurs? A. bone cells begin to rapidly multiply B. muscles begin to atrophy C. heart rate increases D. respiration decreases Answer: C 48. Julia is walking through the forest when she encounters a bear. Her body enters the alarm reaction stage of Selye’s General Adaptation Syndrome (GAS). Which of the following is most likely occurring in her body? A. blood circulation is slowing B. muscles are tensing C. heart rate is decreasing D. digestion is increasing Answer: B 49. During the alarm reaction stage of Selye’s General Adaptation Syndrome, _________. A. digestion is inhibited B. muscles tend to relax C. heart contractions stop D. respiration tends to decrease Answer: A 50. Thomas has just gotten into a fight with a bully and sustained a cut over his eye. This just happened and he is in the alarm reaction stage of Selye’s General Adaptation Syndrome. Which of the following changes in the body that occurs during this stage is most likely to help him with specific regard to the cut over his eye? A. muscles relax B. blood-clotting ability is increased C. blood pressure drops D. respiration decreases Answer: B 51. Which of the following is the adaptation stage of the general adaptation syndrome? A. alarm reaction B. anxiety C. resistance D. exhaustion Answer: C 52. The proper sequence of stages in the general adaptation syndrome are ______. A. alarm reaction, exhaustion, resistance B. resistance, alarm reaction, exhaustion C. alarm reaction, resistance, exhaustion D. resistance, exhaustion, alarm reaction Answer: C 53. Which of the following does the American Psychological Association suggest for coping with traumatic experiences? A. Try to adjust as soon as possible. B. Communicate your experience. C. Make major life decisions during this time. D. Avoid exercise and your regular routines. Answer: B 54. In the GAS, the body tries to renew spent energy and repair damage during the ______ stage. A. alarm reaction B. arousal C. resistance D. exhaustion Answer: C 55. The ______ nervous system dominates the exhaustion stage. A. parasympathetic B. sympathetic C. peripheral D. voluntary Answer: A 56. If a source of stress is unrelenting and enduring, Selye believed that we would develop ______. A. a nervous breakdown B. chronic resistance C. burnout and meltdown D. diseases of adaptation Answer: D 57. The immune system is weakened by continuous secretion of ______. A. saliva B. serotonin C. gastric juices D. cortical steroids Answer: D 58. Life changes are sources of stress ______. A. only when they are negative changes B. only when they are unexpected or involve some sort of loss C. because they force us to adjust D. because they are emotionally upsetting Answer: C 59. Research shows that people who experience greater numbers of life changes are ______ likely to suffer from psychological problems and ______ likely to suffer from physical health problems. A. less, less B. less, more C. more, less D. more, more Answer: D 60. ______ life changes can be stressful. A. Neither positive nor negative B. Only positive C. Only negative D. Both positive and negative Answer: D 61. The process of adaptation by which immigrants, native groups, and ethnic minorities adjust to the new culture through making behavioral and attitudinal changes is called ______. A. assimilation B. immersement C. acculturation D. appeasement Answer: C 62. Pressure that results from the demands placed on immigrant, native, and ethnic minority groups to adjust to life in the mainstream culture is called ___________. A. acculturative adaptation B. bicultural adaptation C. acculturative stress D. bicultural stress Answer: C 63. Which of the following is a one of the general theories about the relationship between acculturation and psychological adjustment presented in your text? A. melting-pot theory B. adaptation theory C. immigrant adjustment theory D. assimilation theory Answer: A 64. According to research by Cartano (1987), highly acculturated Hispanic American women are more likely than relatively unacculturated Hispanic American women to ___________. A. remain single B. avoid drinking and smoking C. become heavy drinkers D. be victims of domestic violence Answer: C 65. The melting-pot theory holds that ______. A. immigrants can never truly acculturate B. immigrants themselves can never truly acculturate but their children can C. acculturation should be resisted until the third generation after immigration D. acculturation helps people adjust to the host culture Answer: D 66. According to the melting pot theory, Hispanic Americans’ adjustment would improve by ______. A. learning English B. saving money for their children’s education C. moving where there are many other Hispanic Americans D. maintaining close contact with relatives and friends in their native countries Answer: A 67. The theory that psychosocial adjustment for immigrants is aided by identification with both the traditional and host cultures is called the ______ theory. A. melting pot B. multicultural C. bicultural D. immersion Answer: C 68. According to the bicultural theory, immigrants will adjust better if they ______. A. replace their ethnic identity and traditional values with those of the new culture B. learn the new culture’s language but otherwise resist assimilation C. maintain their original culture while adapting to the new culture D. maintain their original language but otherwise adapt to the new culture Answer: C 69. Highly acculturated adolescent Hispanic women have been found to be more likely to ______. A. resist speaking Spanish B. develop eating disorders C. cook only American foods D. show an increased involvement in sexual intercourse Answer: D 70. In Latin American cultures, compared to women, men tend to drink ______ alcohol compared to female Latin Americans. A. much less B. slightly less C. slightly more D. much more Answer: D 71. Which of the following is true of Charles Negy’s research of Latinos in the United States? A. Latinos greatly varied in their degree of acculturation to the U.S. culture. B. The longer Latinos lived in the U.S, the less acculturated they tended to be. C. Scores of more acculturated Mexican-Americans were very different to non-Hispanic whites on standardized personality tests. D. Mexican couples reported less verbal and/or physical aggression in their relationships than did Mexican-American couples. Answer: A 72. In Latino adolescents, higher levels of acculturation are also linked to increased risk of __________. A. gambling B. social anxiety C. smoking D. depression Answer: C 73. According to research presented in the text, for Latina teens, acculturation makes them more vulnerable to accepting and striving towards the demands of contemporary American ________. A. cultural trend of casual sexual relationships B. view that women should be assertive C. ideal of the slender woman D. model of women as career-oriented Answer: B 74. Compared to less acculturated Hispanic American high school girls, more acculturated girls were more likely to ______. A. show indications of having an eating disorder B. attend college C. give up their religion D. use drugs Answer: A 75. Increased bicultural adaptation among Mexican American elders ______. A. created conflicts between spouses B. accelerated decisions to retire C. decreased likelihood of depression D. resulted in rejection by relatives still in Mexico Answer: C 76. In a study of Mexican American elders, it was found that those who had the highest levels of depression were ______. A. moderately acculturated B. minimally acculturated C. highly acculturated D. bicultural Answer: B 77. Low levels of acculturation among Mexican American immigrants are ______ socioeconomic status. A. not related to B. related to high C. related to fluctuating D. related to low Answer: D 78. Maria is a highly acculturated third-generation Mexican American teenager. Which behavior is most likely to be adopted by Maria? A. avoiding sexual intercourse B. improved subjective body image C. being concerned about fitness D. disturbed eating behaviors Answer: D 79. It has been reported in a study that Mexican Americans who were more proficient in English generally had ______________ than did their less English-proficient counterparts. A. more marital discord B. fewer signs of depression and anxiety C. stronger relationships with their country of origin D. more signs of psychological distress Answer: B 80. In a Northern California sample, research found better mental health among Mexican immigrants than among ______. A. Korean immigrants B. Mexican Americans born in the United States C. homosexuals D. African Americans Answer: B 81. It appears that “Americanization” of Mexican American immigrants may have a ______ effect on mental health and retention of cultural traditions may have a ______ effect. A. damaging; damaging B. damaging; buffering C. buffering; damaging D. buffering; buffering Answer: B 82. Ethnic minority children with a high ethic identity are more likely to experience ______. A. higher self-esteem B. more conflicts with Anglo Americans C. academic problem D. loneliness Answer: A 83. Kim is an Asian immigrant living in San Francisco. She is most likely to experience emotional problems if ______. A. her parents are rich B. her parents push her to hard academically C. she is alienated from both of her cultures D. she is an only child Answer: C 84. Wives in ______ acculturated Mexican American couples report greater marital distress than those in ______ acculturated couples. A. wealthier; poorer B. first generation; third generation C. less; more D. more; less Answer: D 85. In a 1990 study by Salgado de Snyder, Cervantes, & Padilla, female immigrants exhibited higher levels of ______ than male immigrants. A. socialization B. tranquilizer addiction C. depression D. English usage Answer: C 86. More acculturated Mexican-American college students tend to come from ______ socioeconomic backgrounds. A. lower B. moderate C. mixed D. higher Answer: D 87. The Mexican-American college students who are most likely to experience suicidal thinking have ______ levels of depression and ______ levels of acculturation. A. low; low B. high; low C. low; high D. high; high Answer: D 88. When compared to Mexican couples, Mexican-American couples had ______ egalitarian relationships and ______ levels of marital satisfaction. A. less; lower B. less; higher C. more; lower D. more; higher Answer: D 89. Ann recognizes her stressors, evaluates them and modifies her reactions to render them less harmful. She is applying ______ coping. A. sensate-focused B. emotion-focused C. problem-focused D. intuitive Answer: C 90. In emotion-focused coping, people take ______ measures to reduce the impact of the stressor. A. provocative B. immediate C. self-enhancing D. enduring Answer: B 91. A coping style that attempts to minimize emotional responsiveness rather than deal directly with a stressor is known as ______ coping. A. rational B. problem-focused C. sensate-focused D. emotion-focused Answer: D 92. A coping style that attempts to confront the stressor directly is ______ coping. A. rational B. problem-focused C. sensate-focused D. emotion-focused Answer: B 93. Which of the following is not an example of denying that an illness is present? A. Recognizing the seriousness of the illness B. Minimizing the emotional distress the illness causes C. Misattributing symptoms to other causes D. Ignoring threatening information about the illness Answer: A 94. An example of emotion-focused coping is ______. A. obsessing B. intellectualizing C. rationalizing D. denial Answer: D 95. Avoidance and denial are forms of ______. A. effective stress coping B. emotion-focused coping C. problem-focused coping D. common coping strategies that recent immigrants from Mexico employ Answer: B 96. In one study, people with cancer showed greater disease progression if they maintained ______ style of coping. A. a problem-focused B. an intuitive C. an aggressive D. an avoidant Answer: D 97. Wish-fulfilment fantasy is ______. A. an effective means of coping with an illness B. a strategy that needs to result in real wish-fulfilment C. an example of emotion-focused coping D. provides alternative plans for dealing with a stressor Answer: C 98. Informed cardiac patients with a repressive style showed ______ incidence of medical complications than uninformed patients. A. a lower B. a similar C. an unpredictable D. a higher Answer: D 99. Cardiac patients with a(n) ______ style who were informed about their conditions showed a higher incidence of medical complications than their uninformed counterparts with the same style. A. repressive B. obsessive C. vigilant D. sensitized Answer: A 100. Cardiac patients with a repressive style who were informed about their conditions showed a higher incidence of ______ than uniformed patients with a repressive style. A. spontaneous recovery B. medical complications C. anger D. crying Answer: B 101. Seeking information about an illness through research is an example of ______. A. a repressive style B. wish-fulfilment fantasy C. self-defeating obsessiveness D. problem-focused coping Answer: D 102. Beliefs in one’s ability to accomplish certain tasks are known as ______. A. psychological hardiness B. self-efficacy expectancies C. psychological perseveration D. self-enhancement heuristics Answer: B 103. In his study with spider-phobic women, Bandura found that stress declines with our ______. A. knowledge about the stressful situation B. ability to escape the situation quickly C. confidence that we will be able to cope effectively D. recognition that we are not alone in dealing with the situation Answer: C 104. Max is afraid of dogs. According to Bandura, therapy should help Max to ______. A. develop confidence that he can cope with the presence of dogs B. learn to devise strategies to avoid dogs C. focus on developing a close relationship with another kind of animal D. dream about positive interaction with dogs Answer: A 105. The effects of self-efficacy expectancies on buffering stress were first investigated by ______. A. Albert Ellis B. Suzanne Kobasa C. Hans Selye D. Albert Bandura Answer: D 106. Epinephrine and norepinephrine make us feel ______. A. generally nervous B. relaxed C. angry D. generally confident Answer: A 107. Lower secretion of stress hormones is associated with ______. A. emotion-focused coping B. high self-efficacy expectancies C. an avoidant or repressive style of coping D. ability to effectively utilize the general adaptation syndrome Answer: B 108. Psychological hardiness in business executives was investigated by ______. A. Mary Ainsworth B. Janet Rafferty C. Eloise Ferrer D. Suzanne Kobasa Answer: D 109. The trait that Kobasa has conceptualized as helping people cope with stress is ______. A. self-esteem B. spirituality C. hardiness D. confidence Answer: C 110. The effects of stress can be moderated or buffered by which of the following? A. skepticism B. work C. self-efficacy expectation D. relocation to a new community Answer: C 111. A cluster of stress-buffering traits characterized by commitment, challenge, and control are known as ______. A. psychological hardiness B. psychological perseveration C. self-efficacy expectancies D. self-enhancement heuristics Answer: A 112. Which of the following is a trait associated with psychologically hardy executives? A. adaptability B. concreteness C. commitment D. detachment Answer: C 113. Scott recently learned that he has a form of treatable cancer. Traits that will help Scott to cope more effectively with his illness and its treatment are ______. A. hardiness and optimism B. motivation and intelligence C. avoidance and denial D. assertiveness and ambitiousness Answer: A 114. Which trait is characteristic of psychological hardy people? A. Reliance on wish-fulfilment fantasies. B. A preference for active problem-solving approaches. C. The perception that they have no control over the stressors they face in life. D. A tendency to deny the existence of problems. Answer: B 115. Psychologically hardy people report ______ physical symptoms and ______ depression in the face of stress than nonhardy people. A. fewer; more B. greater; less C. fewer; less D. greater; more Answer: C 116. Locus of control is a construct that was suggested by ______. A. Gardner Murphy B. Julian Rotter C. Gordon Allport D. Hans Eysenck Answer: B 117. A limitation of research linking optimism and better health outcome is that it ______. A. has not been conducted on children and adolescents B. has only involved hospitalized patients C. has been correlational D. has focused almost exclusively on females Answer: C 118. The study of optimism falls within a broader contemporary movement in psychology known as ______ psychology. A. positive B. wish fulfilment C. health D. evolutionary Answer: A 119. Researchers found that a broad network of social contacts strengthens resistance to ______. A. propaganda B. distraction C. colds D. flirting Answer: C 120. A recent study of women suggests a relationship between greater optimism and ___________. A. lower rates of heart disease and greater longevity B. a lower divorce rate C. fewer eating disorders such as obesity and bulimia D. athleticism Answer: A 121. The Optimism Scale measures ______. A. stress levels B. sexual preference C. career interests and goals D. whether someone tends to look on the bright side Answer: D 122. The particular stressors that African Americans often face, such as racism, poverty, violence, and overcrowded living conditions, may contribute to ____________. A. higher rates of anorexia nervosa B. higher rates of emotion-focused coping C. heightened risks of serious health-related problems D. higher rates of bipolar illness Answer: C 123. Compared to Whites, African Americans have a ______ risk of developing chronic and serious health-related problems but also have a ______ degree of resiliency in coping with stress. A. lower, low B. higher, low C. higher, low D. higher, high Answer: D 124. Strong social and family networks, coping skills, ethnic identity and self-efficacy are particular factors that help buffer stress among ______. A. Euro-Americans B. Asian Americans C. Hispanic Americans D. African Americans Answer: D 125. Stresses imposed by racism or perceived discrimination may be moderated by ______. A. intermarriage B. moving to a more tolerant community C. ethnic pride D. ethnic alienation Answer: C 126. Evidence links ____________ among ethnic minorities to poorer mental and physical health and to higher rates of substance abuse. A. perceived discrimination B. pride in one’s ethnicity C. preference in music D. presence of a specific gene Answer: A 127. Calvin, an African American, has a strong sense of ethnic identity. According to past research, Calvin will most likely have ________. A. fewer social networks B. an external locus of control C. a negative self-image D. perceptions of a better quality of life Answer: D 128. African Americans and other ethnic minorities who __________ may be more vulnerable to the effects of stress, which in turn may increase risks of physical and mental health problems. A. become alienated from their ethnic identity B. are more resilient C. are more effective in coping D. have stronger ties to their culture Answer: A 129. Adjustment disorders are classified in the DSM-5 within a category of ____________. A. Schizophrenic Disorders B. Trauma and Stressor-Related Disorders C. Anxiety Disorders D. Childhood Disorders Answer: B 130. In the DSM-5, acute stress disorder and posttraumatic stress disorder are classified in which of the following categories? A. Schizophrenic Disorders B. Substance Abuse Disorders C. Trauma-and Stressor-Related Disorders D. Childhood Disorders Answer: C 131. According to the APA, what percentage of people seeking outpatient mental health services present with a diagnosis of adjustment disorder? A. 80% to 90% B. 50% to 70% C. 30% to 50% D. 5% to 20% Answer: D 132. If an adjustment disorder lasts for more than six months after the stressor (or its consequences) has been removed, the diagnosis may _______. A. suggest that the client did not present an accurate history B. be changed C. be associated with an underlying physical malady D. motivate the clinician to change his treatment methods to a more suitable course Answer: B 133. According to DSM-5, a maladaptive reaction to an identified stressor, characterized by impaired functioning or emotional distress that exceeds what would normally be expected is a (n)_______. A. distress disorder B. adjustment disorder C. stress disorder D. anxiety disorder Answer: B 134. Jean is so sad she is unable to go to work because her husband Bert left her for another woman a week ago. Prior to Bert’s leaving Jean only missed work if she was physically ill. A likely diagnosis for Jean is a(n) ______. A. adjustment disorder B. marital dissolution disorder C. major depressive disorder D. bereavement disorder Answer: A 135. Adjustment disorders are among the ______ types of disorders. A. rarest B. most distressing C. most severe D. mildest Answer: D 136. In order for an adjustment disorder to be diagnosed, a person’s emotional reaction must ______. A. include significant levels of anxiety B. not involve any loss of relationships C. exceed what would be expected with normal coping D. equal the expected response for coping normally Answer: C 137. Which of the following is a specific type of adjustment disorder found in the DSM-5? A. Adjustment disorder with agitation B. Adjustment disorder with psychomotor disturbance C. Adjustment disorder with anhedonia D. Adjustment disorder with disturbance of conduct Answer: D 138. Danny, a first semester college freshman referred to the college counseling centre. He has recently begun spray painting obscenities on the student centre bathroom walls. Several weeks ago, Danny’s longtime girlfriend, who attends college in a neighbouring state, broke up with him. Danny does not present in the interview with emotional distress. He has no history of psychological problems and, until his recent vandalism activities, was considered a peaceful and law-abiding member of the college community. Based on the aforementioned history, which of the following diagnoses would a therapist would most likely diagnose Danny with? A. Adjustment disorder with disturbance of conduct B. Adjustment disorder with anxiety C. Adjustment disorder with mixed anxiety and depressed mood D. Adjustment disorder with mixed disturbance of emotion and conduct Answer: A 139. Abigail’s 18-year-old son has left home for the first time and now serving in the Army. Since her son’s departure, Abigail has been experiencing uncontrolled crying episodes and loneliness. Based on this information, a clinician might diagnose Abigail with a (n) A. Acute Stress Disorder B. Adjustment disorder with mixed anxiety and depressed mood C. Adjustment disorder with depressed mood D. Adjustment disorder with disturbance of conduct Answer: C 140. Randy’s father recently died in an automobile accident. Since his father’s death, Randy has appeared emotionally unchanged but is now frequently truant from school, engages in reckless driving, and fights with other teens. A suitable diagnosis for Randy might be a (n) ___________. A. adjustment disorder with mixed disturbance of emotion and conduct B. adjustment disorder with mixed anxiety and depressed mood C. adjustment disorder with disturbance of conduct D. adjustment disorder unspecified Answer: C 141. A maladaptive pattern of behavior for a period of three days to one month following exposure to a traumatic event is called a (n) _____________ disorder. A. acute stress B. posttraumatic stress C. adjustment D. personality Answer: A 142. Individuals suffering from Acute Stress Disorder may feel ______________. A. as though they are experiencing a heart attack B. angry and betrayed by the world C. “in a daze” or feel that the world seems like a dreamlike or unreal place. D. unaware of their internal emotions Answer: C 143. Paul witnessed a murder while walking through the subway three weeks ago. Three days after witnessing the murder, Paul began experiencing intense anxiety and reliving what he saw at night in his dreams. Paul would most like be diagnosed with ____________. A. an anxiety disorder B. an acute stress disorder C. an adjustment disorder with anxiety D. dissociative identity disorder Answer: B 144. In what way is Acute Stress Disorder is different from Post-Traumatic Stress Disorder (PTSD)? A. Acute Stress Disorder is a reaction to a less intense trauma than those experienced by someone with PTSD. B. The symptoms of Acute Stress Disorder are limited to one month. C. Individuals with Acute Stress Disorder report more frequent flashbacks than an individual with PTSD would. D. Individuals with PTSD never recover from their trauma; those with Acute Stress Disorder do recover. Answer: B 145. First responders who are responsible for collecting human remains or police officers who regularly interview children about the details of child abuse ________________ as a result of exposure to trauma in their work. A. often develop dissociative identity disorder B. rarely develop acute stress disorder C. may develop acute stress disorder D. may develop a personality disorder Answer: C 146. Heather’s boyfriend Matt served combat duty in Iraq. After returning to the US last month and reuniting with Heather, Matt shared the details of the battles he was involved with and the trauma he experienced while serving. Heather has begun to experience intense periods of anxiety and feels as if she is “in a daze”. It is possible Heather has developed _____________ as a result of listening to Matt’s experiences. A. Post-Traumatic Stress Disorder B. an Acute Stress Disorder C. an Adjustment disorder with anxiety D. an Adjustment disorder unspecified Answer: B 147. For an individual with Acute Stress Disorder, stronger or more persistent symptoms of dissociation around the time of the trauma is associated with a greater likelihood of later development of ________. A. major depression B. panic disorder C. PTSD D. Dissociative Identity Disorder Answer: C 148. Last week, Hannah witnessed an accident where a pedestrian was struck and killed by an automobile. Since the accident, Hannah has experienced anxiety and actively avoids the street where she witnessed the accident. A clinician might diagnose Hannah as having __________. A. an adjustment disorder with anxiety B. PTSD C. reactive stress disorder D. acute stress disorder Answer: D 149. Acute stress disorder has features similar to those of PTSD, but are limited to a period of ______ following direct exposure to the trauma, witnessing other people exposed to the trauma, or learning about a trauma experienced by a close family member or friend. A. 1 week B. one year C. one month D. one decade Answer: C 150. The lifetime prevalence rate of Acute Stress Disorder (ASD) in the population is ______. A. 10% B. 90% C. 50% D. unknown Answer: A 151. A prolonged maladaptive reaction to an extreme stressor, such as combat or a natural disaster, is ______ disorder. A. acute stress B. posttraumatic stress C. an adjustment D. a chronic stress Answer: B 152. Of the following situations, which is the most likely to result in PTSD? A. divorce B. death of a family member due to natural causes C. being in an airplane crash D. being involved in a “fender bender” accident Answer: C 153. About ______ of people suffer a traumatic experience at some point in their lives. A. one-fourth B. one-third C. one-half D. two-thirds Answer: D 154. The prevalence of PTSD among U.S. soldiers who served in the Vietnam War is about one in ______. A. two B. three C. four D. five Answer: D 155. As it pertains to the common features of traumatic stress disorders, the example of a rape survivor avoiding traveling to the part of town where she was attacked is an example of __________. A. Avoidance behavior B. Re-experiencing the trauma C. Emotional distress and impaired functioning D. Heightened arousal Answer: A 156. If someone is having intrusive memories, recurrent disturbing dreams, or momentary flashbacks of a traumatic event such as being pursued by an attacker, the individual is most likely experiencing which of the following common features of traumatic stress disorders? A. Re-experiencing the trauma B. Emotional distress and impaired functioning C. Heightened arousal D. Emotional numbing Answer: A 157. After witnessing a terrible car accident, John is experiencing so much emotional distress that he is having difficulty taking care of his responsibilities at work. He is most likely experiencing which of the following common features of traumatic stress disorders? A. Avoidance behavior B. Emotional distress and impaired functioning C. Heightened arousal D. Emotional numbing Answer: B 158. Hector is hypervigilant, is having difficulty sleeping and concentrating, easily becomes irritable and has outbursts of anger. He is most likely experiencing which of the following common features of traumatic stress disorders? A. Avoidance behavior B. Re-experiencing the trauma C. Emotional distress and impaired functioning D. Heightened arousal Answer: C 159. Sheila just witnessed someone being brutally attacked. Now she seems to jump at any sudden noise. She is most likely experiencing which of the following common features of traumatic stress disorders? A. Avoidance behavior B. Re-experiencing the trauma C. Emotional distress and impaired functioning D. Heightened arousal Answer: D 160. In PTSD, the loss of the ability to have loving feelings is which of the following common features of traumatic stress disorders? A. Avoidance behavior B. Emotional distress and impaired functioning C. Heightened arousal D. Emotional numbing Answer: D 161. The feeling of detachment from oneself or one's environment is known as ______. A. dissociation B. a hallucination C. a delusion D. a personality disorder Answer: A 162. The major difference between the features of an acute stress disorder and posttraumatic stress disorder is the emphasis on ______. A. abreaction B. hallucinations C. length of persistence of the symptoms D. compulsions Answer: C 163. Joe is a combat veteran who returned from active duty in Iraq one week ago. He is extremely anxious and feels like he is in a "daze." Joe is also disorganized and unable to arrange for the medical help he needs. It appears that Joe is suffering from a(n) _________ disorder. A. acute stress B. posttraumatic stress C. adjustment D. personality Answer: A 164. Ron is an Iraq War veteran. He wakes up in the middle of the night in a cold sweat due to nightmares in which he relives his most frightening war experiences. He refuses to talk about the war with anyone and is constantly fidgety and "on edge." He is unable to enjoy himself or develop intimate relationships. His symptoms have continued for over 3 years. He is best diagnosed as suffering from a(n) ______ disorder. A. personality B. adjustment C. acute stress D. posttraumatic stress Answer: D 165. Rhonda had undergone chemotherapy for a serious case of breast cancer. Even six months after this successful treatment, she finds that she is on edge, has nightmares about death, and no longer enjoys sex with her husband. She is probably experiencing ______ disorder. A. sleep terror B. dysthymia C. posttraumatic stress D. adjustment disorder Answer: C 166. Women are ______ as likely as men to develop posttraumatic stress disorder. A. half B. equally C. twice D. four times Answer: C 167. Compared to women, men are ______ likely to have a traumatic experience and are ______ likely to develop PTSD. A. less, less B. less, more C. more, less D. more, more Answer: C 168. Recently, investigators reported that the ___________ was smaller in a group of combat veterans with PTSD than in combat veterans without PTSD (Moreyet al., 2012). A. cerebellum B. DNA C. amygdala D. corpus callosum Answer: C 169. Morey et al., (2012) recently reported that the amygdala was _________ in a group of combat veterans with PTSD compared to combat veterans without PTSD. A. smaller B. not functioning C. fluid-filled D. larger Answer: A 170. Recent research has shown that people who experience __________ during or immediately after the trauma stand a greater risk of developing PTSD than do other trauma survivors. A. dissociative experiences B. positive emotions C. extreme physical pain D. significant temperature drop Answer: A 171. Experts have asserted that ______ represent the type of trauma most often leading to PTSD. A. natural disasters B. acts of terrorism C. plane crashes D. vehicular accidents Answer: D 172. Which of the following medications has recently been shown to reduce acquired fear reactions? A. Seroquel B. Propranolol C. Ritalin D. Prozac Answer: B 173. Propranolol blocks adrenaline receptors in the _________, which may weaken memories of fearful stimuli. A. thalamus B. hypothalamus C. pons D. amygdala Answer: D 174. In the classical conditioning model of posttraumatic stress disorder, the traumatic event serves as the ______. A. unconditioned stimulus B. unconditioned response C. conditioned stimulus D. conditioned response Answer: A 175. In the classical conditioning model of posttraumatic stress disorder, sights, smells, and sounds associated with the original traumatic event serve as ______. A. unconditioned stimuli B. unconditioned responses C. conditioned stimuli D. conditioned responses Answer: C 176. From the learning perspective, the fear component of posttraumatic stress disorder is learned through ______. A. classical conditioning B. vicarious learning C. operant conditioning D. prepared conditioning Answer: A 177. In the classical conditioning model of posttraumatic stress disorder, anxiety that is elicited by exposure to trauma-related stimuli serves as ________. A. an unconditioned stimuli B. an adaptive response C. a conditioned stimuli D. a conditioned response Answer: D 178. An exposure-based homework assignment for a patient with combat-based PTSD could be ______. A. volunteering as a little league coach B. watching a war movie C. supervising a Boy Scout troop D. driving alone for two hours Answer: B 179. EMDR is a technique to treat ______. A. PTSD B. phobia C. generalized anxiety disorder D. obsessive-compulsive disorder Answer: A 180. The controversy related to EMDR is ______. A. whether or not it works B. whether the eye movements are necessary C. the use of a blindfold that may cause anxiety in some PTSD victims D. the ethical propriety of touching the patient as part of treatment Answer: B 181. According to Taylor (et al, 2003), the real reason EMDR works is because of ______. A. rapid eye movements B. aversive conditioning C. repeated exposure D. response cost Answer: C 182. If we invoke the principle of parsimony, then the most likely explanation for the success of EMDR is ______. A. rapid eye movements B. aversive conditioning C. repeated exposure D. response cost Answer: C 183. The idea that the simplest explanation is usually the best explanation is known as ______. A. the Peter Principle B. Weber’s Law C. the Law of Effect D. the Principle of Parsimony Answer: D True-False Questions 183. Psychologists who study interrelationships between psychological factors, including stress, and physical health are called health psychologists. Answer: True 184. The term distress refers to a state of physical or mental pain or suffering. Answer: True 185. The field of psychoneuroimmunology studies relationships between psychological factors, especially stress, and the workings of the immune system Answer: True 186. The endocrine system consists of ducts distributed throughout the body. Answer: False 187. Endocrine glands pour their secretions—called hormones—directly into the bloodstream. Answer: True 188. Norepinephrine is also produced in the amygdala, where it functions as a neurotransmitter. Answer: False 189. Leukocytes stimulate the adrenal medulla to release hormones. Answer: False 190. Leukocytes recognize invading pathogens by their surface fragments, called antigens. Answer: True 191. Some leukocytes produce antigens which are specialized proteins. Answer: False 192. Social support networks can act as a buffer against cold symptoms. Answer: True 193. Through a conditioning process, stress improves the body’s resistance to the common cold. Answer: False 194. Writing about traumatic experiences may be good for physical and emotional health. Answer: True 195. Correlational research helps scientists demonstrate causal connections. Answer: False 196. Although most people exposed to traumatic events do not develop PTSD, many do experience symptoms associated with the disorder, such as difficulties concentrating and high levels of arousal. Answer: True 197. People have basically similar reactions to traumatic stress. Answer: False 198. In more than 80% of households in New York City, parents reported that their children were upset by the attacks of 9/11. Answer: False 199. Evidence gathered since 9/11 shows that experiencing positive emotions, such as feelings of gratitude and love, helped buffer the effects of stress. Answer: True 200. The GAS model suggests that our bodies, under stress, are like clocks with alarm systems that do not shut off until their energy is perilously depleted. Answer: True 201. During the alarm reaction, the adrenal glands, controlled by the pituitary gland in the brain, pump out cortical steroids. Answer: True 202. When a stressor is persistent, we progress to the second stage, also known as the exhaustion stage, of the GAS. Answer: False 203. Life changes are sources of stress because they force us to adjust. Answer: False 204. Bicultural theory holds that acculturation helps people adjust to living in the host culture. Answer: False 205. Evidence shows that highly acculturated Hispanic-American women are less likely than relatively unacculturated Hispanic-American women to become heavy drinkers. Answer: False 206. A study of elderly Mexican Americans found that subjects who were minimally acculturated showed higher levels of depression than either their highly acculturated or their bicultural counterparts. Answer: True 207. People who are minimally acculturated often face less economic hardship and tend to occupy the higher strata of socioeconomic status. Answer: False 208. Denial is an example of emotion-focused coping. Answer: True 209. In problem-focused coping, people examine the stressors they face and do what they can to change them or modify their own reactions to render stressors less harmful. Answer: True 210. Avoidance is another form of emotion-based coping. Answer: True 211. As a form of coping, the use of wish-fulfilment fantasies, has been linked to poor adjustment in coping with serious illness. Answer: True 212. A mismatch between the individual’s style of coping and the amount of information provided about his condition may impede recovery. Answer: True 213. Self-efficacy expectancies refer to our expectations that we will not succeed in coping with the challenges we face. Answer: False 214. Albert Bandura and colleagues found that spiderphobic women showed high levels of GABA and serotonin. Answer: False 215. Three key traits identified by Kobasa that distinguished the psychologically hardy executives from other executives were concern, contentment, and commitment. Answer: False 216. Psychologically hardy people appear to cope more effectively with stress by using more emotion-focused problem-solving approaches. Answer: False 217. Research by Tindle (2009) links greater optimism in women to lower rates of heart disease and greater longevity. Answer: True 218. The developers of positive psychology believe that psychology should focus more of its efforts on the positive aspects of the human experience. Answer: True 219. Evidence links perceived discrimination among ethnic minorities to poorer mental and physical health and to higher rates of substance abuse Answer: True 220. African Americans often demonstrate a low level of resiliency in coping with stress. Answer: False 221. Acquiring and maintaining pride in their racial identity and cultural heritage may help African Americans and other ethnic minorities withstand stresses imposed by racism. Answer: True 222. African Americans and other ethnic minorities who become alienated from their culture or ethnic identity may be more vulnerable to the effects of stress. Answer: True 223. Ethnic identity is associated with perceptions of a better quality of life among African Americans Answer: False 224. An adjustment disorder is a maladaptive reaction to a distressing life event or stressor that develops within 3 years of the onset of the stressor. Answer: False 225. For the diagnosis of an adjustment disorder to apply, the stress-related reaction must be sufficient enough to also meet the diagnostic criteria for an anxiety disorder and a mood disorder. Answer: False 226. It is estimated that between 5% and 20% of people receiving outpatient mental health services present with a diagnosis of adjustment disorder (APA, 2013). Answer: True 227. If the adjustment disorder lasts for more than one month after the stressor (or its consequences) has been removed, the diagnosis may be changed. Answer: False 228. Traumatic stress disorders are characterized by maladaptive patterns of behavior in response to trauma that involve marked personal distress or significant impairment of functioning. Answer: True 229. In acute stress disorder, the person shows a maladaptive pattern of behavior many months following exposure to a traumatic event. Answer: False 230. People with acute stress disorder may feel they are “in a daze” or that the world seems like a dreamlike or unreal place. Answer: True 231. In acute stress disorder, the person shows a maladaptive pattern of behavior many months following exposure to a traumatic event. Answer: False 232. In acute stress disorder, the traumatic event may involve exposure to either actual or threatened death, a serious accident, or a sexual violation. Answer: True 233. For a diagnosis of acute stress disorder, the traumatic events can only include a sexual violation. Answer: False 234. In acute stress disorder, the person with acute stress disorder may have been directly exposed to the trauma, witnessed other people experiencing the trauma, or learned about a trauma experienced by a close friend or family member. Answer: True 235. In order to be diagnosed with acute stress disorder, the person with acute stress disorder must have been directly exposed to the trauma. Answer: False 236. Stronger or more persistent symptoms of dissociation around the time of the trauma is associated with a greater likelihood of later development of PTSD. Answer: True 237. A person with acute stress disorder may have problems sleeping; may develop irritable or aggressive behavior or exhibit an exaggerated startle response to sudden noises. Answer: True 238. Individuals with traumatic stress disorders do not exhibit difficulty effectively meeting daily responsibilities. Answer: False 239. One of the common features of PTSD is that the person may feel “numb” inside and lose the ability to have loving feelings. Answer: True 240. Posttraumatic stress disorder is a prolonged maladaptive reaction that lasts longer than one month after the traumatic experience. Answer: True 241. First responders to traumatic events do not develop PTSD. Answer: False 242. High rates of PTSD are found among earthquake and hurricane survivors in many countries. Answer: True 243. About 50% of combat veterans returning from the wars in Iraq and Afghanistan have developed PTSD. Answer: False 244. Investigators found that survivors of terrorist acts had double the rate of PTSD as compared with survivors of motor vehicle accidents. Answer: True 245. PTSD is found in very few cultures. Answer: False 246. As many as 300,000 American soldiers returning from the war zones in Iraq and Afghanistan show symptoms of posttraumatic stress disorder or depression. Answer: True 247. Less than one-third of people suffer a traumatic experience at some point in their lives. Answer: False 248. An individual who experiences detachment or “dissociation” shortly following the trauma, or feeling numb is more vulnerable to developing PTSD. Answer: True 249. The more direct the exposure to the trauma, the greater the person’s likelihood of developing PTSD. Answer: True 250. Although women more often have traumatic experiences, men are more likely to develop PTSD. Answer: False 251. Investigators reported that the brain structure, amygdala, was larger in a group of combat veterans with PTSD than in combat veterans without PTSD Answer: False 252. Individuals with a history of childhood sexual abuse are more at risk for developing PTSD. Answer: True 253. Evidence from carefully controlled studies demonstrates little in the way of therapeutic benefits for EMDR in treating PTSD. Answer: False 254. The Principle of Parsimony holds that the more complex the explanation, the better. Answer: False Essay Questions 255. How do Americans feel about stress? Discuss this within the context of the findings of the American Psychological Association’s nationwide study. Answer: Americans' perceptions of stress: According to the American Psychological Association (APA)’s nationwide studies and surveys: • Prevalence of stress: Many Americans report high levels of stress, with factors such as work, finances, and health being significant stressors. • Impact of stress: Stress is commonly linked to negative effects on physical and mental health, including sleep disturbances, anxiety, and depression. • Coping mechanisms: Strategies like exercise, spending time with family, and seeking support from friends are commonly cited as ways to manage stress. • Awareness: There is a growing awareness of the importance of stress management and resilience-building techniques among the American population. • Gender and age differences: Women often report higher stress levels than men, and stress levels can vary across different age groups and socioeconomic backgrounds. Overall, the APA studies highlight that stress is a pervasive issue in American society, influencing various aspects of life and health. 256. Explain the role of the endocrine system in the experience of stress. Answer: Role of the endocrine system in the experience of stress: The endocrine system plays a crucial role in the body's response to stress through the release of hormones, particularly cortisol and adrenaline: • Hypothalamus: Perceives stress and triggers the release of corticotropin-releasing hormone (CRH). • Pituitary gland: Responds to CRH by releasing adrenocorticotropic hormone (ACTH) into the bloodstream. • Adrenal glands: Stimulated by ACTH, the adrenal glands release cortisol and adrenaline. • Effects: Cortisol increases blood sugar, suppresses the immune system, and aids in metabolism, while adrenaline enhances alertness and prepares the body for action. Chronic stress can dysregulate the endocrine system, leading to long-term health issues such as cardiovascular disease, obesity, and immune dysfunction. 257. Describe the different parts of the immune system and the interplay with the experience of stress. Answer: Parts of the immune system and interplay with stress: The immune system consists of: • Innate immune system: Provides immediate, nonspecific defense against pathogens through mechanisms like skin barriers, phagocytes, and inflammation. • Adaptive immune system: Develops specific responses to pathogens through T cells and B cells, which produce antibodies and target specific antigens. Interplay with stress: • Stress response: Acute stress can temporarily enhance immune function, preparing the body for potential injury or infection. • Chronic stress: Prolonged stress suppresses immune function, increasing susceptibility to infections and delaying wound healing. • Inflammation: Stress hormones like cortisol can exacerbate inflammatory responses, contributing to chronic inflammatory conditions. Understanding the interaction between stress and the immune system is crucial for managing stress-related health outcomes and promoting overall well-being. 258. Describe how of the experience of stress can lead to a compromised immune system. Answer: Stress can compromise the immune system through various mechanisms: 1. Hormonal imbalance: Chronic stress leads to prolonged activation of the hypothalamic-pituitary-adrenal (HPA) axis, resulting in elevated levels of cortisol. High cortisol levels suppress the immune response by reducing the production of cytokines, which are essential for immune function. 2. Inflammatory response: Stress triggers the release of pro-inflammatory cytokines and other molecules that promote inflammation. Chronic inflammation, induced by prolonged stress, can impair immune cell function and contribute to the development of autoimmune disorders and chronic diseases. 3. Decreased immune cell activity: Stress hormones like cortisol and adrenaline can suppress the activity of immune cells such as lymphocytes (T cells and B cells), natural killer cells, and macrophages. These cells play crucial roles in identifying and eliminating pathogens and cancerous cells. 4. Impaired barrier function: Stress can compromise the integrity of physical barriers like the skin and mucous membranes, making it easier for pathogens to enter the body and cause infections. 5. Altered microbiome: Stress influences the composition and function of the gut microbiota, which plays a significant role in immune regulation. Dysbiosis (imbalance in gut microbiota) due to stress can negatively impact immune function. Overall, chronic stress disrupts the intricate balance of the immune system, making individuals more susceptible to infections, inflammatory conditions, and other health issues. 259. Describe how psychological factors translate into physical health problems. Answer: Psychological factors can impact physical health through several pathways: 1. Stress response: Prolonged stress activates the sympathetic nervous system and the HPA axis, leading to the release of stress hormones (e.g., cortisol, adrenaline). Chronic activation of these systems contributes to cardiovascular disease, hypertension, and metabolic disorders. 2. Behavioral factors: Psychological factors such as depression, anxiety, or chronic stress can lead to unhealthy behaviors like poor diet, lack of exercise, substance abuse, and inadequate sleep. These behaviors increase the risk of obesity, diabetes, cardiovascular disease, and other chronic illnesses. 3. Immune system dysregulation: Stress and negative emotions can dysregulate the immune system, leading to chronic inflammation, impaired immune function, and increased susceptibility to infections and autoimmune disorders. 4. Neuroendocrine interactions: Psychological stressors can disrupt neuroendocrine pathways, affecting hormone levels (e.g., cortisol, insulin) and contributing to metabolic imbalances and endocrine disorders. 5. Psychosocial factors: Social isolation, lack of social support, and chronic interpersonal conflicts can impact mental health and contribute to physical health problems such as cardiovascular disease, immune dysfunction, and slower recovery from illness or injury. 260. Summarize the steps one can take to restore emotional wellbeing and a sense of control following a disaster or other traumatic experience, Answer: Steps to restore emotional wellbeing and a sense of control following a disaster or traumatic experience: 1. Seek social support: Connect with friends, family, or support groups to share feelings and experiences. 2. Practice self-care: Prioritize sleep, nutrition, and physical activity to support overall health and resilience. 3. Engage in relaxation techniques: Practice mindfulness, deep breathing, yoga, or meditation to reduce stress and promote relaxation. 4. Seek professional help: Consult with a therapist or counsellor trained in trauma-focused therapies such as cognitive-behavioral therapy (CBT) or eye movement desensitization and reprocessing (EMDR). 5. Establish routines: Create structure and predictability in daily activities to regain a sense of control and stability. 6. Limit exposure to triggers: Minimize exposure to reminders or triggers of the traumatic event when possible. 7. Engage in meaningful activities: Pursue hobbies, interests, or activities that bring joy and fulfilment. 8. Educate oneself: Learn about trauma reactions and coping strategies to better understand and manage one's emotional responses. By taking proactive steps to address emotional and psychological needs after a traumatic experience, individuals can promote recovery, resilience, and overall wellbeing. 261. Describe the stages of General Adaptation Syndrome. What is the possible outcome of prolonged exposure to stress? Answer: Stages of General Adaptation Syndrome (GAS) and outcomes of prolonged stress: Stages of General Adaptation Syndrome: 1. Alarm reaction stage: •Response: Initial response to stressor; body mobilizes resources to combat stress. •Physiological changes: Increased heart rate, heightened senses, activation of fight-or-flight response. •Hormonal response: Release of adrenaline and cortisol. 2. Stage of resistance: •Response: Body attempts to cope with ongoing stress. •Physiological changes: Adaptation to continued stress; physiological responses stabilize. •Hormonal response: Continued release of stress hormones to maintain heightened alertness. 3. Stage of exhaustion: •Response: Resources are depleted; body's ability to resist stress declines. •Physiological changes: Increased vulnerability to illness, fatigue, and emotional exhaustion. •Hormonal response: Persistent high levels of stress hormones; immune system suppression. Outcome of prolonged exposure to stress: Prolonged exposure to stress, especially in the stage of exhaustion, can lead to: • Physical health problems: Chronic conditions such as cardiovascular disease, hypertension, diabetes, and gastrointestinal disorders. • Mental health issues: Increased risk of anxiety disorders, depression, burnout, and emotional instability. • Immune system suppression: Reduced immune function, leading to frequent infections, slower wound healing, and susceptibility to autoimmune disorders. • Cognitive impairment: Impaired memory, concentration difficulties, and decreased cognitive flexibility. • Behavioral changes: Disrupted sleep patterns, appetite changes, substance abuse, and social withdrawal. Managing stress and adopting effective coping strategies are crucial to prevent the detrimental effects of prolonged stress on physical, mental, and emotional wellbeing. 262. Summarize research findings regarding life changes and their relationship to stress. Answer: Research findings on life changes and stress: Research has shown that life changes can significantly impact stress levels and health outcomes: • Holmes and Rahe Stress Scale: Developed a scale assigning stress values to major life events (e.g., marriage, divorce, job change) based on their potential to disrupt an individual's life. • Relationship to health: Higher cumulative stress scores correlate with increased vulnerability to illness, both physical and psychological. • Individual differences: Perceptions and coping strategies influence how individuals respond to life changes and subsequent stress. • Chronic stress: Prolonged exposure to multiple stressors can lead to chronic stress, exacerbating health risks and reducing overall resilience. Understanding the relationship between life changes and stress helps in identifying potential stressors and developing interventions to mitigate their impact on health and wellbeing. 263. Discuss Charles Negy’s research that investigated the quality of relationships in acculturated and non-acculturated Mexican-American couples. Answer: Charles Negy's research on relationship quality in Mexican-American couples: Charles Negy's research investigated differences in relationship quality between acculturated and non-acculturated Mexican-American couples: • Acculturation levels: Acculturation refers to the degree of adaptation to the dominant culture (in this case, American culture) while retaining aspects of one's original culture. • Research findings: Negy found that acculturated Mexican-American couples tended to report lower relationship satisfaction compared to non-acculturated couples. • Factors influencing relationship quality: Differences in values, communication styles, gender roles, and expectations within the relationship were noted between acculturated and non-acculturated couples. • Implications: The study highlighted the complexity of cultural adaptation and its impact on interpersonal relationships within Mexican-American communities. Understanding these dynamics is essential for culturally sensitive counseling and interventions aimed at supporting healthy relationships and family dynamics across diverse cultural contexts. 264. Discuss the forms of denial of illness and the impact this coping strategy may have on health and recovery. Answer: Forms of denial of illness and impact on health and recovery: Forms of denial: 1. Denial of symptoms: Ignoring or minimizing physical symptoms that indicate illness. 2. Denial of diagnosis: Refusing to accept or acknowledge a diagnosis given by healthcare professionals. 3. Denial of impact: Believing that the illness will not have serious consequences or effects on one's life. 4. Denial of emotional response: Suppressing or avoiding feelings of fear, sadness, or anxiety associated with the illness. Impact on health and recovery: • Delayed treatment: Denial can delay seeking medical help or following treatment recommendations, which can worsen the condition. • Reduced adherence: Denial may lead to non-compliance with medication, therapy, or lifestyle changes necessary for recovery. • Psychological distress: Avoiding emotions and realities of illness can increase stress, anxiety, and depression. • Isolation: Denial may hinder social support-seeking behaviors, leading to feelings of loneliness and decreased coping resources. • Worsened prognosis: Ignoring symptoms or failing to manage the illness effectively can lead to complications and poorer health outcomes. Addressing denial requires supportive and empathetic communication from healthcare providers, education about the illness and its consequences, and encouragement for individuals to acknowledge and accept their condition to facilitate effective coping and treatment. 265. Compare and contrast the effectiveness of the problem-focused and emotion-focused styles of coping with stress in dealing with serious illness. Answer: Effectiveness of problem-focused and emotion-focused coping styles in dealing with serious illness: Problem-focused coping: • Strategy: Directly addressing and solving the stressor or problem causing distress. • Effectiveness: Effective in situations where the stressor is controllable or changeable (e.g., adhering to treatment regimen, seeking medical advice). • Outcome: Associated with increased sense of control, reduced distress, and improved health-related behaviors. Emotion-focused coping: • Strategy: Managing emotional responses to stressors through acceptance, emotional expression, or seeking social support. • Effectiveness: Helpful when the stressor is uncontrollable or unchangeable (e.g., managing feelings of uncertainty or loss). • Outcome: Associated with reduced emotional distress, enhanced emotional wellbeing, and improved quality of life. Comparison: • Context-dependent: Effectiveness of coping styles can vary based on the nature of stressors and individual preferences. • Complementary: Often used together to manage different aspects of stress and illness-related challenges. • Personal preference: Individuals may naturally gravitate towards one style over another based on personality, coping history, and perceived control over the situation. In dealing with serious illness, a balanced approach integrating problem-focused and emotion-focused coping strategies tailored to individual needs and circumstances is often most effective for promoting resilience and adaptation. 266. Discuss research findings relating the concepts of self-efficacy expectancies, hardiness, and optimism to health. Answer: Research findings on self-efficacy expectancies, hardiness, and optimism related to health: Self-efficacy expectancies: • Definition: Beliefs in one's ability to successfully perform specific tasks or behaviors related to health (e.g., managing symptoms, adhering to treatment). • Impact: Higher self-efficacy is associated with better health outcomes, increased motivation for health-promoting behaviors, and improved adherence to medical recommendations. Hardiness: • Definition: Psychological resilience characterized by commitment (sense of purpose), control (belief in personal agency), and challenge (ability to perceive stressors as opportunities for growth). • Impact: Individuals with high hardiness are more likely to perceive stressful situations as manageable, leading to reduced psychological distress and improved coping with illness. Optimism: • Definition: Positive outlook and expectation that good things will happen in the future. • Impact: Optimism is associated with better physical health, faster recovery from illness, and enhanced psychological wellbeing. Optimistic individuals tend to engage in proactive health behaviors and exhibit greater resilience in the face of adversity. Conclusion: Research consistently demonstrates the significant impact of self-efficacy expectancies, hardiness, and optimism on health outcomes. Cultivating these traits through interventions and supportive environments can promote resilience, enhance coping with illness, and improve overall health and wellbeing. 267. Discuss the relationship between optimism and the subjective experience of pain. Answer: Relationship between optimism and the subjective experience of pain: Optimism, characterized by a positive outlook and expectation for favorable outcomes, can influence the subjective experience of pain in several ways: • Pain perception: Optimistic individuals tend to perceive pain as less intense or distressing compared to pessimistic individuals. This is partly due to their cognitive appraisal of pain as manageable or temporary. • Coping strategies: Optimists are more likely to employ adaptive coping strategies, such as problem-solving and seeking social support, which can mitigate the impact of pain and enhance their ability to manage discomfort. • Physiological responses: Optimism has been linked to lower levels of stress hormones (e.g., cortisol) and reduced activation of pain-sensitive brain regions, leading to less physiological arousal in response to pain stimuli. • Recovery and resilience: Optimistic individuals may recover more quickly from painful experiences and injuries, as their positive outlook fosters motivation for rehabilitation and adherence to treatment plans. Clinical implications: Incorporating interventions that promote optimism, such as cognitive-behavioral therapy (CBT) and mindfulness-based approaches, can complement pain management strategies and improve overall patient outcomes. 268. Discuss the factors involved with African American ethnic identity and resiliency to stress. Answer: Factors involved with African American ethnic identity and resiliency to stress: African American ethnic identity contributes to resilience to stress through various factors: • Cultural values: Strong cultural identity and pride in African American heritage provide a sense of belonging, community support, and solidarity during challenging times. • Religious and spiritual practices: Many African Americans draw strength and resilience from religious beliefs, community involvement in churches, and spiritual practices that offer comfort, hope, and guidance. • Family and social support: Tight-knit family networks and social support systems within African American communities provide emotional support, practical assistance, and encouragement during stressful life events. • Racial identity development: Positive racial identity development promotes self-esteem, self-efficacy, and a sense of empowerment, buffering the effects of discrimination and prejudice. • Coping strategies: Cultural coping strategies such as humor, storytelling, music, and art serve as outlets for emotional expression and stress relief within African American communities. Understanding these factors is crucial for developing culturally sensitive interventions that build upon strengths and promote resilience among African Americans facing stressors and adversity. 269. Discuss the similarities and differences between Acute Stress disorder and PTSD. Answer: Similarities and differences between Acute Stress Disorder (ASD) and Posttraumatic Stress Disorder (PTSD): Similarities: • Trigger: Both ASD and PTSD are triggered by exposure to a traumatic event that threatens life, safety, or physical integrity. • Symptoms: Both disorders involve symptoms of re-experiencing the trauma (e.g., intrusive memories, nightmares), avoidance of reminders of the trauma, negative changes in mood and cognition, and heightened arousal. Differences: • Duration: ASD symptoms occur within one month of the trauma and last for at least three days but no more than one month. PTSD symptoms persist for more than one month after the trauma. • Diagnosis timing: ASD is diagnosed within the first month after the trauma, while PTSD can be diagnosed anytime after one month if symptoms persist. • Impairment: ASD symptoms may cause significant distress and impairment, but the diagnosis is temporary if symptoms resolve within a month. PTSD involves persistent symptoms that cause clinically significant distress or impairment in social, occupational, or other areas of functioning. 270. Summarize the factors that could contribute to an individual having an increased vulnerability to PTSD. Answer: Factors contributing to increased vulnerability to PTSD: Several factors can increase an individual's vulnerability to developing PTSD after exposure to a traumatic event: • Severity and nature of the trauma: Exposure to severe, life-threatening, or prolonged trauma increases the risk of developing PTSD. • Personal history: Previous experiences of trauma or adversity, especially in childhood, can increase vulnerability. • Biological factors: Genetic predisposition or differences in brain structure and function related to stress response and emotion regulation. • Psychological factors: Pre-existing mental health conditions (e.g., anxiety, depression), poor coping skills, and negative cognitive appraisals of the trauma. • Social support: Lack of adequate social support, isolation, or experiencing stigma can exacerbate vulnerability. • Additional stressors: Concurrent life stressors, such as financial difficulties, relationship problems, or ongoing health concerns, can increase vulnerability to PTSD. Understanding these factors helps in identifying at-risk individuals early, providing timely interventions, and developing effective strategies for prevention and treatment of PTSD. 271. Within a classical conditioning framework, describe the elements (conditioned response, unconditioned stimuli, etc.) as they apply to the associations formed from a traumatic experience. Answer: Classical conditioning framework and traumatic experiences: In classical conditioning, traumatic experiences can lead to the formation of associations between stimuli and responses, influencing behavior and emotional responses. Here’s how the elements of classical conditioning apply: • Unconditioned Stimulus (US): The traumatic event itself serves as the unconditioned stimulus. It is an inherently aversive and distressing experience that elicits an unconditioned response. • Unconditioned Response (UR): The emotional and physiological reactions naturally triggered by the traumatic event, such as fear, anxiety, or arousal, constitute the unconditioned response. • Conditioned Stimulus (CS): Any stimuli associated with the traumatic event, such as specific sights, sounds, smells, or situations, can become conditioned stimuli. These cues become triggers that evoke conditioned responses. • Conditioned Response (CR): Emotional and behavioral responses elicited by the conditioned stimuli, which are similar to the original unconditioned response. This can include heightened arousal, fear responses, avoidance behaviors, or intrusive memories. Example: Imagine someone who has experienced a traumatic event involving a loud noise (US). After the trauma, even hearing a similar loud noise (CS) can evoke fear and anxiety (CR), similar to the initial emotional reaction (UR) during the traumatic event. Understanding these conditioning processes is crucial in trauma therapy, where interventions aim to modify these associations to alleviate symptoms of PTSD and related disorders. 272. Summarize the research using the drug propranolol, in the treatment of traumatic memory. How might morphine be used in treating traumatized soldiers? Answer: Research on propranolol and morphine in treating traumatic memory: Propranolol: • Mechanism: Propranolol, a beta-blocker, disrupts the consolidation of emotional memories by blocking noradrenaline activity in the brain. Administered shortly after a traumatic event, it aims to reduce the emotional intensity associated with the memory. • Research findings: Studies suggest that propranolol administration shortly after trauma can reduce symptoms of PTSD by weakening the emotional impact of traumatic memories. Morphine: • Mechanism: Morphine, an opioid, affects pain perception and emotional processing. It may be used in acute trauma care to alleviate physical pain and potentially modulate emotional responses to traumatic events. • Research implications: Research on morphine's role in treating traumatized soldiers focuses on its immediate effects on pain and emotional distress, potentially reducing the risk of developing PTSD. Both propranolol and morphine are under investigation for their therapeutic potential in mitigating traumatic memories and associated psychological distress among trauma survivors and soldiers. 273. Describe how cognitive behavioral therapy has been used in the treatment of PTSD. Answer: Cognitive Behavioral Therapy (CBT) in the treatment of PTSD: Approach: • Exposure therapy: Involves gradual, controlled exposure to trauma-related memories, situations, or stimuli to reduce fear and avoidance responses. • Cognitive restructuring: Targets maladaptive beliefs and cognitive distortions related to the trauma, aiming to promote more adaptive thinking patterns. • Skill-building: Teaches coping skills such as relaxation techniques, stress management, and problem-solving to manage symptoms. Effectiveness: CBT for PTSD has shown significant effectiveness in reducing symptoms, improving coping skills, and enhancing quality of life for trauma survivors. It is often delivered in structured sessions over a set period, tailored to individual needs and trauma history. 274. Describe EMDR and discuss the controversy regarding its use. Why is it worthwhile to consider the famous dictum known as Occam’s razor in evaluating EMDR? Answer: Eye Movement Desensitization and Reprocessing (EMDR): Description: • Technique: EMDR involves recalling distressing memories while simultaneously engaging in bilateral stimulation (eye movements, tapping, or auditory tones). • Theory: Aims to facilitate processing of traumatic memories, reducing their emotional intensity and promoting adaptive resolution. • Controversy: Some critics question the underlying mechanisms of EMDR and its efficacy compared to established therapies like CBT. • Occam’s Razor: Occam’s razor suggests that the simplest explanation is often the best. In evaluating EMDR, it's essential to consider whether its additional components (e.g., bilateral stimulation) provide benefits beyond standard exposure therapies or cognitive restructuring alone. Controversy and evaluation: • Evidence: While some studies support EMDR's effectiveness, others suggest that its success may be attributed to components shared with CBT (e.g., exposure therapy). • Integration: Considering Occam’s razor encourages researchers to critically evaluate whether the additional components of EMDR provide significant therapeutic benefits or if simpler explanations, such as exposure therapy alone, might achieve similar outcomes. In conclusion, while EMDR has gained popularity and shown promise in treating PTSD, ongoing research and critical evaluation are essential to understand its mechanisms and effectiveness compared to other evidence-based treatments like CBT. Test Bank for Abnormal Psychology in a Changing World Jeffrey S. Nevid, Spencer A. Rathus, Beverly Greene 9780205965014, 9780135821688, 9780134458311, 9780205961719, 9780130052162

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