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Chapter 8: Stress and Physical Health Multiple Choice 1. 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 Answer: b. 2. Stress is caused by a. confused thought processes. b. other people. c. both minor hassles and major events. d. severe traumas. Answer: c. 3. Which of the following is an accurate description of the relationship between stress and illness, according to DSM-5? a. Stress only contributes to a few physical diseases, such as ulcers. b. Psychosomatic disorders are caused by stress alone. c. Stress has no effect on physical illness but a great effect on psychological ones. d. Stress plays a role in the onset or exacerbation of all physical illnesses, from a cold to AIDS. Answer: d. 4. At work, some coworkers are discussing psychosomatic disorders. Which one 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 b. Anna, who says, “The concept of psychosomatic disorders is outdated. The mind and body both affect physical illness.” c. Sal, who says, “I don't know why anyone would want to consciously create the symptoms of a disease.” d. Ted, who says, “If you have one of these disorders you have nothing to worry about, because it’s just all in your head.” Answer: b. 5. One reason that a list of psychosomatic illnesses was not included in DSM-5 is because a. psychosomatic illnesses are only imaginary and no threat to a person’s health. b. people with psychosomatic illnesses are just seeking attention. c. this list is now only maintained in the ICD. d. medicine now takes a more holistic view of illness, including both the body and mind. Answer: d. 6. 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 every physical illness is a product of the interaction between the mind and body. 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. Answer: b. 7. Evidence indicates that learning more adaptive ways of coping can a. change the amount of stress we face. b. prevent most physical and all psychological disorders. c. limit the recurrence or improve the course of many physical illnesses. d. make it more likely that illnesses will be correctly diagnosed. Answer: c. 8. 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. holistic wellness b. psychophysiology c. behavioral medicine d. psychosomatic medicine Answer: c. 9. Which of the following is LEAST likely to take place in a behavioral medicine clinic? a. support groups for people with terminal cancer b. dialysis for patients with renal failure c. classes that introduce coping strategies to patients with chronic pain d. interventions to educate parents of chronically ill children Answer: b. 10. The case of Bob Carter, as presented in your textbook, is important because it shows a. that Bob is destined for another heart attack since he declined counseling. b. that stress and lifestyle are more important factors in heart attacks than genetic or physiological factors. c. that complex interactions between behavioral choices and outside stressors impact a person’s health. d. that Bob’s combination of genetic, behavioral, and personality factors made his heart attack inevitable. Answer: c. 11. 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 assigned the items life change units based on the judgments of a large group of normal adults. c. Scores were given to each item based on how much family members thought each event contributed to the death of a loved one. d. The items were weighted according to estimates from epidemiological research on how much each contributes to mortality. Answer: b. 12. According to the conceptualization of stress used in the Social Readjustment Rating Scale, an outstanding personal achievement would be viewed as a. a stressful event. b. a counterbalance for stress in other areas. c. stressful if it affects personal relationships. d. stressful if it were unexpected, but not stressful if it were expected. Answer: a. 13. Which of the following is an example of why some researchers object to instruments such as the Social Readjustment Rating Scale? a. Stressors rarely have physiological effects. b. Stressors can be positive or negative. c. Life changes caused by stress are always immediate. d. Stressors don’t necessarily affect social relationships. Answer: b. 14. Your teacher describes the following incident to the class: His teenage daughter called home and tearfully described getting 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: a. 15. Richard Lazarus defined stress as a. the individual’s appraisal of a challenging life event. b. the individual’s physiological response to a challenging life event. c. a difficult circumstance regardless of the individual’s reaction to it. d. an automatic physiological reaction, independent of cognitive reactions. Answer: a. 16. Imagine you have failed a class. You have evaluated this situation and decided that failing the class is stressful and important enough to make you upset. You also realize, however, that you have the option to repeat the class in summer school. This realization is an example of a. primary appraisal. b. primary prevention. c. secondary appraisal. d. secondary prevention. Answer: c. 17. Recognizing the adaptive, evolutionary aspects of stress, Walter Cannon viewed stress as the activation of the a. caretaking response. b. activation or inhibition response. c. fight-or-flight response. d. autonomic nervous system. Answer: c. 18. Cannon observed that the fight-or-flight response is 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. Answer: b. 19. An expert on human physiology and stress responses is giving a public lecture on the history of the fight-or-flight response and 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” Answer: a. 20. The __________ system is activated during the fight-or-flight response. a. somatic b. central nervous c. sympathetic nervous d. parasympathetic nervous Answer: c. 21. Which of the following are likely to occur during the fight-or-flight response? a. respiration increases, 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 redirects for muscular activity, respiration increases, blood pressure decreases Answer: a. 22. When a person’s brain perceives a threat, the cortex 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. Answer: b. 23. Which of the following is known as the “stress hormone”? a. adrenalin b. epinephrine c. cortisol d. norepinephrine Answer: c. 24. Stress affects ________, which fight off antigens like bacteria or viruses. a. T-cells b. cortisol c. CRF d. platelets Answer: a. 25. What do we call substances like bacteria that invade the body? a. antigens b. allergens c. immuno-agents d. anti-fectious agents Answer: a. 26. What field investigates the relation between stress and immune function? a. psychoneuroimmunology b. immunosuppression studies c. neuromodulation d. somatosensory science Answer: a. 27. Cannon hypothesized that stress makes us more susceptible to illness because intense or chronic stress overwhelms the body’s ________, a term he coined to mean the tendency to return to a steady state of normal functioning. a. homeostatis b. immunosuppression c. automatic reset d. immune system Answer: a. 28. Canadian physiologist Hans Selye developed the concept of the _________, which consists of three stages: alarm, resistance, and exhaustion. a. general adaptation response b. general adaptation syndrome c. enhanced homeostatic response d. human stress response syndrome Answer: b. 29. Which best describes the current thinking about stress response and the immune system? a. Short-term stressors enhance immune responses that are quick, while chronic stressors create immunosuppression. b. Chronic stressors enhance long-term immune responses, but short-term stressors create immunosuppression. c. Neither chronic nor short-term stressors impair the immune system. d. Both chronic and short-term stressors impair the immune system. Answer: a. 30. Marcus is explaining Hans Selye’s concept of stress to the class. He correctly states that the first stage of Selye’s general adaptation syndrome is a. resistance: a period of time when the body is physiologically activated and prepared to respond to the threat. b. alarm: the mobilization of the body in reaction to threat. c. exhaustion: the body’s resources are depleted by chronic stress. d. homeostasis: : the body’s tendency to return to a steady state of normal functioning. Answer: b. 31. What are the stages of the general adaptation syndrome (GAS)? a. alertness, fight, and flight b. alarm, resistance, and exhaustion c. general arousal, adaptation, and homeostasis d. emergency response, general arousal, and specific arousal Answer: b. 32. 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. an individual’s active decision to combat stress d. a period when an individual is least susceptible to stress Answer: a. 33. According to Hans Selye, at which stage in the general adaptation syndrome does stress cause physical illness? a. exhaustion b. alarm stage c. resistance stage d. emergency response Answer: a. 34. Which of the following is the best automotive analogy for Walter Cannon’s theory of chronic stress? a. a car that 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. a car that has enough gas but has a clogged fuel line; no fuel can reach its engine d. a car that can not start because it has an electrical short in its ignition system Answer: b. 35. Which of the following is the best automotive analogy for Han Selye’s theory of chronic stress? a. a car that 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. a car that has enough gas but has a clogged fuel line; no fuel can reach its engine d. a car that can not start because it has an electrical short in its ignition system Answer: a. 36. Health psychologists asked newly married couples to engage in 30-minute discussions of marital problems. What did the psychologists find when they compared couples who were 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. Answer: a. 37. What are the two basic types of coping that were identified by Lazarus and Folkman? a. nonspecific and specific b. emergency and chronic c. adaptive and maladaptive d. problem-focused and emotion-focused Answer: d. 38. Lucas is feeling increasingly stressed because a coworker has been belittling his contributions and spreading gossip behind his back ever since he declined her offer to go out for drinks after work. Which of the following behaviors is an example of Lucas’s problem-focused coping? a. He makes an appointment with the Human Resources office to file a harassment complaint. b. He tries to see his office mate’s point of view. c. He repeats Reinhold Niebuhr’s “Serenity Prayer” until he calms down. d. He thinks about the problem so much that it interferes with his work. Answer: a. 39. Which of the following correctly describes emotion-focused coping? a. an attempt to cause others to change their emotional responses b. an attempt to change physiological responses directly in order to alter emotions indirectly c. an attempt to change a stressor d. an attempt to alter internal distress Answer: d. 40. Andy is a middle school student who is being bullied regularly after school. He hasn’t told his parents or teachers because he thinks that he should be able to control the situation by himself, which is not true. This belief will a. reduce his stress level. b. provide him with an outlet for his frustration. c. increase his stress level. d. make him tougher and more able to deal with future problems. Answer: c. 41. 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. Answer: c. 42. 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. Answer: c. 43. In a study of stress, rats showed a smaller stress response when a flash of light signaled an impending shock than they did when the shock was not signaled. This demonstrates the importance of ________ in coping with stress. a. control b. the illusion of control c. homeostatis d. predictability Answer: d. 44. What are two critical components that allow humans to better cope with stressful events? a. alarm and exhaustion b. control and predictability c. disclosure and anticipation d. specificity and nonspecificity Answer: b. 45. 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 in regard to the rats’ stress response? a. The rats that have control will have a stronger stress response. b. The rats that have control will have a lower 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. Answer: b. 46. While walking through an abandoned area of town, you hear a deafening alarm sounding from an empty warehouse. Under which condition is this situation most likely to be 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. Answer: d. 47. The perception of control can actually increase stress when the person a. can predict when the stressor will happen. b. believes he has control of a stressor but actually does not. c. gains control over a stressor that was previously uncontrollable. d. loses control over a stressor that was previously controllable. Answer: d. 48. 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. Answer: b. 49. A study of 200 Latinos with arthritis found that their religion a. discouraged the use of medical interventions. b. had no benefit for their medical problems. c. encouraged passive coping. d. encouraged active coping. Answer: d. 50. 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 Findings: Pessimists Outlive Optimists” d. “Optimism Can Cure Heart Disease” Answer: b. 51. 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. Answer: d. 52. 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. Answer: a. 53. Why can stress indirectly cause illness? 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. Answer: c. 54. The National Research Council reported in 2013 that life expectancy in the U.S. lags behind other high-income countries for four reasons. Which of the following is one of those reasons? a. poor health behavior like excessive smoking, drinking, and eating b. people below the poverty line demanding access to excessive amounts of healthcare c. web-based medical information programs and social support networks providing misinformation d. high percentage of exercise-related injuries leading to premature death Answer: a. 55. What percentage of patients fail to fully adhere to medical advice? a. fewer than 10 percent b. 25-30 percent c. 50-60 percent d. more than 90 percent Answer: d. 56. Social support affects health because it can a. encourage positive health behavior. b. create more adaptive immune system functioning. c. encourage positive health behavior and create more adaptive immune system functioning. d. encourage positive health behavior but will tend to weaken immune system functioning. Answer: c. 57. 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-5 does not include any health-related factors in its classification system. Answer: c. 58. DSM-5 classifies stress related to physical illness as a. Conditions Resulting from Physical and Mental Factors. b. Stress-Related Physical Illnesses. c. Psychosomatic and Other Mental Illness. d. Psychological Factors Affecting Other Medical Conditions. Answer: d. 59. 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. Alice reports that she has a lot of pain, but the physician is unable to find a specific cause. Following the criteria in DSM-5, the physician diagnoses her with a. Munchhausen by proxy. b. borderline personality disorder. c. a somatic symptom disorder. d. psychosomatic illness. Answer: c. 60. DSM-5 follows a(n) ________ approach to classification, grouping diagnoses on the basis of similar, observed symptoms. a. descriptive b. hierarchical c. philosophical d. historical Answer: a. 61. In the early twentieth century, the most common forms of disease in United States were a. stress-related diseases. b. lifestyle diseases. c. infectious diseases. d. cancers. Answer: c. 62. Today, the most common forms of disease in the United States are a. lifestyle diseases. b. stress-related diseases. c. cancers. d. infectious diseases. Answer: a. 63. To a health psychologist, what interesting observation can be made when comparing the top 10 causes of death in the United States in 1900 to the top 10 causes of death in the United States in 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. Answer: a. 64. What is the leading cause of death in the United States, taking more than 100,000 additional lives compared to the second leading cause? a. cancer b. stroke c. homicide d. heart disease Answer: d. 65. Which types of laboratory rats are least able to reject implanted cancerous tumors? a. those exposed to shock from which they can escape 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 Answer: b. 66. Jane has been diagnosed with cancer; her prognosis is not good and she needs to decide about her treatment. She is considering joining a support group. What does the evidence suggest about this option? a. Patients in support groups live longer than those who are not. b. Participating in support groups can increase quality of life but not longevity. c. Such self-help groups have developed in order to prepare people to die with greater dignity. d. Time spent engaging in non-medical activities, such as support groups, takes time away from medical treatment. Answer: b. 67. An instructor asks one of his students to look up AIDS in a medical textbook. To obtain the needed information, the student should read sections on the __________ system. a. immune b. nervous c. respiratory d. circulatory Answer: a. 68. According to the Centers for Disease Control and Prevention, 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. intravenous drug users Answer: a. 69. Stress is linked with ________ HIV. a. earlier onset of b. risky behaviors associated with c. sexual preference leading to d. a more rapid progression of Answer: d. 70. For those infected with HIV, ________ is associated with a more gradual onset of symptoms. a. use of condoms b. social support c. being female d. access to prevention programs Answer: b. 71. In 1996, AIDS was the eighth leading cause of death in the United States. Today, AIDS is: a. no longer in the top 15 causes. b. second only to heart disease. c. second only to cancer. d. down to the tenth leading cause. Answer: a. 72. 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. Answer: b. 73. The goal of pain management programs is to a. use mind-over-matter techniques to reduce pain significantly. b. practice relaxation techniques to provide a moderate reduction in pain. c. help people to cope with pain in a way that minimizes its impact on their lives, even if the pain cannot be eliminated or controlled entirely. d. use a balance of relaxation techniques and medication to eliminate pain. Answer: c. 74. 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 her forget about the pain. b. Efforts will be made 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. Answer: b. 75. Which sleep-wake disorder is characterized by problems with sleep quantity or quality and may include problems in initiating or maintaining sleep? a. insomnia disorder b. hypersomnolence disorder c. a breathing-related sleep disorder d. circadian rhythm sleep disorder Answer: a. 76. 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 periods of time d. inability to breathe and sleep at the same time and difficulty getting to sleep Answer: c. 77. Four-year-old Mary’s parents rush into her bedroom when they hear her screaming in the night, but she appears to be sleeping normally when they get there. In the morning, they ask her if she had a bad dream, but she says she didn’t. Mary is experiencing a. sleep terrors. b. nightmares. c. REM sleep behavior disorder. d. hypersomnia. Answer: a. 78. 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 or pauses in breathing b. loud screams, heightened arousal, and violent outbursts c. difficulty getting to sleep and strong leg movements d. rigid body posture during sleep, punctuated by episodes of heightened physiological arousal Answer: a. 79. Cardiovascular disease is a group of disorders affecting the ________ system. a. somatosensory b. heart and circulatory c. central nervous d. peripheral nervous Answer: b. 80. 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. Answer: b. 81. Determining that someone suffers from hypertension depends on which of the following two measures? a. systolic and diastolic blood pressure b. sympathetic and parasympathetic blood pressure c. self-reports of tension and psychophysiological measures of heart rate d. self-reports of tension and objective behavior ratings by skilled observers Answer: a. 82. There is no single, identifiable cause for ________ hypertension, which accounts for approximately 85 percent of all cases of high blood pressure. a. systolic b. secondary c. essential d. diastolic Answer: c. 83. The immediate cause of coronary heart disease (CHD) is a. a family history of CHD. b. the deprivation of oxygen to the heart muscle. c. uncontrolled blood pressure. d. smoking. Answer: b. 84. Which of the following illustrates the relationship between stress and cardiovascular disease? a. Stress is associated with thinned artery walls. b. Over the long run, stress can damage the heart. c. Type B personality is associated with higher blood pressure. d. Stress causes people to focus on the warning signs of heart attack. Answer: b. 85. Ann is studying the different ways in which people respond physically to stress. While increased blood pressure and heart rate are normal reactions, researchers have long observed that some people exhibit different ________ to stress, for better or worse. a. attitudes b. cardiac resilience c. types of CHD due d. cardiovascular reactivity Answer: d. 86. Which of the following situational traits would describe a job with the highest level of stress? a. low decisional control with low psychological demands b. low decisional control with high psychological demands c. high decisional control with low psychological demands d. high decisional control with high psychological demands Answer: b. 87. In developing prevention programs with the goal of reducing heart disease in women, the health department should especially target which of the following groups? a. employed women b. homemakers c. employed women with children d. homemakers with children Answer: c. 88. A ________ research design involves studying people repeatedly over time. a. sagittal b. horizontal c. cross-sectional d. longitudinal Answer: d. 89. In assessing your patients for risk of heart disease, you would be most concerned about discovering which of these Type A behavior characteristics? a. anxiety b. hostility c. impatience d. achievement orientation Answer: b. 90. The new boss is supposed to be on the job today. The word is that he is “a real Type A.” Because you are not sure what this means, you ask a fellow worker. She tells you to expect the new boss to be a. shy and anxious. b. sociable and responsible. c. humorless and unassertive. d. impatient and competitive. Answer: d. 91. Marvin has answered “Yes” to the following question: “Have you felt so sad, discouraged, hopeless, or had so many problems that you wondered if anything is worthwhile?” What can we say about Marvin’s risk for coronary heart disease (CHD) compared to the general population? a. He is depressed but not more likely to suffer CHD. b. He is twice as likely to suffer CHD. c. He is no more likely to suffer CHD but more likely to die from it. d. He is five times more likely to suffer CHD. Answer: b. 92. Which of the following is a benefit of longitudinal research? a. provides systematic control of stress b. costs less than cross-sectional research c. allows one to rule out reverse causality d. easier to conduct than cross-sectional research Answer: c. 93. In longitudinal studies, prospective designs are preferred to retrospective designs because a. it is easier to follow subjects forward in time than to follow them backward in time. b. retrospective studies are limited by distorted memories. c. only prospective designs can rule out reverse causality. d. prospective designs can be conducted more quickly. Answer: b. 94. Social ecology refers to a. teaching people about pollution in the environment. b. how behaviors such as smoking contribute to pollution. c. relationships between the individual and the social world. d. maintaining a group of close friends for social support. Answer: c. 95. A community group wants to reduce the rate of CHD. It’s important to them to only follow a method that has been proven to work. Which of the following do they choose? a. a biofeedback clinic by appointment at a local mall b. a seminar on stress management for Type A behavior c. a media campaign focusing on diet and exercise d. smoking cessation programs for cardiac patients Answer: c. 96. ________ uses laboratory equipment to monitor physical processes that are usually outside of awareness. a. TOHP b. MRFIT c. CBT d. Biofeedback Answer: d. 97. Relaxation training for patients with high blood pressure is an example of a. treatment of coronary heart disease. b. primary prevention of coronary heart disease. c. tertiary prevention of coronary heart disease. d. secondary prevention of coronary heart disease. Answer: d. 98. Carol suffers from coronary heart disease and is trying to decide between stress management and antihypertensive medication. Based on current research findings, how would you advise her? a. Stress management will provide her with greater benefit. b. Stress management might be a useful adjunct to medication. c. There is no evidence that stress management lowers blood pressure. d. Stress management is better because it has fewer side-effects. Answer: b. 99. Findings from the Trials of Hypertension Prevention (TOHP) suggest that the most important factor in lowering high blood pressure is a. anger management. b. stress management. c. weight loss. d. appropriate dietary supplements. Answer: c. 100. In designing a public health prevention program, you plan to target a group that has already experienced the problem you aim to prevent. Your program is called what type of prevention program? a. primary b. secondary c. tertiary d. serius Answer: c. 101. Successful intervention to teach Type A patients how to respond to stressful interactions with less hostility often uses ________, so the patient can try out new, less hostile ways of responding. a. acting out b. group therapy c. acting intervention d. role playing Answer: d. Short Answer 102. Lazarus defines our assessment of our abilities and resources for coping with a challenging life event as __________ appraisal. Answer: secondary 103. The ________ is the region of the brain that is considered to be the principal mediator of the stress response. Answer: amygdala 104. Taylor has suggested that the fight-or-flight response may be a predominantly male response to stressful stimuli; she suggests that females may be more likely to __________ and _________ . Answer: tend; befriend 105. Canon proposed that the body has a natural tendency to return to a steady state of normal functioning that he termed _________ . Answer: homeostasis 106. Chronic stressors and losses create ________. Answer: immunosuppression 107. Excessive sleepiness accompanied by prolonged daytime sleep is diagnosed as primary __________ . Answer: hypersomnolence disorder 108. A mismatch between an individual’s 24-hour sleep cycle and his 24-hour life demands is known as __________ rhythm sleep disorder. Answer: circadian 109. The technical term for a heart attack is __________ . Answer: myocardial infarction 110. When high blood pressure is the principal or only disorder, the diagnosis is __________ hypertension. Answer: essential 111. A study that looks at a group of people periodically over a period of time is known as a __________ study. Answer: longitudinal 112. A study that looks at a group of people at one point in time is known as a __________ study. Answer: cross-sectional Essay 113. Describe the difference between primary appraisal and secondary appraisal of stress. Answer: According to Richard Lazarus, any given life event can be a stressor if it is considered stressful by the individual. Primary appraisal is the evaluation of the challenge, threat, or harm posed by an event. Secondary appraisal is the assessment of one’s ability and resources for coping with a difficult event. 114. Both Walter Cannon and Hans Selye theorized about a link between stress and physical disease. Describe the primary differences in their theories. Answer: Selye saw exhaustion as the key to the link: after prolonged stress, the body can no longer respond appropriately and is subsequently damaged. Cannon saw chronic arousal as most important to the link: experiencing fight-or-flight arousal, without being able to fight or flee, causes prolonged arousal of the sympathetic nervous system, which in turn causes physical damage to the body. 115. Describe the difference between emotion-focused coping and problem-focused coping. Answer: Lazarus and Folkman suggested two general methods or strategies for coping with stress. Problem-focused coping involves attempts to change a stressor. While problem-focused methods involve trying to find ways to alter your external circumstances, emotion-focused coping involves attempts to alter your own internal distress. Emotion-focused methods help you alter your own internal responses to stressors. 116. Define health behavior and explain how such behaviors are related to illness. Answer: Health behavior involves activities that promote good health, and it includes both positive actions like eating, sleeping, and exercising adequately and the avoidance of unhealthy activities, such as cigarette smoking, excessive alcohol consumption, and drug use. Stress can lead people to engage in less positive and more negative health behavior, and these poor health habits, and not stress, per se, may be responsible for much of the relationship between stress and illness. 117. Discuss the relationship between stress, health behavior, and cancer. Answer: While cancer is a biological disorder with genetic and physiological causes, there are still links between this disease and behavior and stress. The major preventable cause of cancer in the United States is a voluntary behavior, smoking. For those with cancer, there is the danger of anxiety and depression, both of which can lead to behavior that is unhealthy, such as drinking alcohol or failing to maintain a healthy diet and exercise regime. Social support can contribute to healthy behavior, medication and treatment compliance, and reduced stress. 118. Discuss the psychological favors affecting cardiovascular disease (CVD). Answer: In addition to biological and possibly genetic causes, CVD is affected by certain psychological factors. These include health behavior, such as smoking, lack of exercise, and unhealthy diet; immediate and chronic stress, which can damage the heart; personality, with an emphasis on Type A behavior, especially hostility; and the presence of depression and anxiety, since depression is three times more common among CHD patients than the general population. While it remains unknown whether depression acts as a symptom or a cause of CHD, it is certain that anxiety is a critical aspect of sudden cardiac death. 119. Describe the concept of Type A behavior and how it is measured. What does research show concerning the relationship between Type A and cardiovascular disease? Answer: Type A behavior is characterized as a time-urgent, hostile, competitive, impatient, and achievement-oriented style of responding to challenges. The classification of Type A behavior has predicted CHD in several prospective studies; however, other studies have failed to support these findings. Researchers now suggest that only one element of Type A behavior increases risk for CHD, and that element is hostility. One study found that three items reliably predicted death among men who had a history of CHD or hypertension: ease with which anger was aroused, argumentativeness, and irritability. 120. Give examples of the primary, secondary, and tertiary prevention of cardiovascular disease. Answer: Primary prevention focuses on encouraging people to develop positive health behaviors that will help keep them from developing CVD. For instance, public service programs that encourage people to quit smoking, eat well, exercise, monitor their blood pressure, and otherwise improve their health can all be considered primary prevention. Secondary prevention involves treating essential hypertension so that it does not develop into CHD. These attempts fall into two categories: improving health behavior and stress management programs. Tertiary prevention focuses on patients who have already had a cardiac event, such as a myocardial infarction. The goal of tertiary prevention is to prevent or reduce the incidence of recurrence. Examples of tertiary prevention include exercise programs and interventions that teach patients how to respond to stressful interactions with reduced hostility. Test Bank for Abnormal Psychology Thomas F. Oltmanns, Robert E. Emery 9780205997947, 9780205970742, 9780134899053, 9780134531830, 9780205965090

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